Sample records for small head circumference

  1. Longitudinal growth of head circumference in term symmetric and asymmetric small for gestational age infants.

    PubMed

    Kaur, Harvinder; Bhalla, A K; Kumar, Praveen

    2012-07-01

    To study longitudinal growth pattern of head circumference of full-term symmetric and asymmetric small for gestational age (SGA) infants of the two sexes during first year of life. Mixed-longitudinal growth research design. Head circumference amongst full-term 100 symmetric, 100 asymmetric as well as 100 appropriate for gestational age (AGA) infants was measured at birth, 1, 3, 6, 9 and 12 months of age using standardized technique and instrument. The mean head circumference of male symmetric SGA infants measured significantly (p≤0.001) smaller than asymmetric SGA infants while, in female symmetric SGA infants it measured shorter beyond 6 months. As compared to AGA infants, head circumference in symmetric and asymmetric SGA infants measured significantly smaller in size. Growth velocity for head circumference amongst symmetric and asymmetric SGA male infants did not show statistically significant differences. Rate of head circumference growth remained significantly higher amongst female asymmetric SGA infants than the symmetric ones between 3 and 6 months while, a reversal of trend was observed between 9 and 12 months. The better growth attainments for head circumference of male and female asymmetric SGA infants than their symmetric SGA counterparts during first postnatal year of life may be attributed to the continuation of influence of "head sparing" experienced by asymmetric SGA babies during prenatal life. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Antenatal antecedents of a small head circumference at age 24-months post-term equivalent in a sample of infants born before the 28th post-menstrual week.

    PubMed

    Leviton, Alan; Kuban, Karl; Allred, Elizabeth N; Hecht, Jonathan L; Onderdonk, Andrew; O'Shea, T Michael; McElrath, Thomas; Paneth, Nigel

    2010-08-01

    Little is known about the antecedents of microcephaly in early childhood among children born at extremely low gestational age. To identify some of the antecedents of microcephaly at age two years among children born before the 28th week of gestation. Observational cohort study. 1004 infants born before the 28th week of gestation. Head circumference Z-scores of <-2 and >or=-2, <-1. Risk of microcephaly and a less severely restricted head circumference decreased monotonically with increasing gestational age. After adjusting for gestational age and other potential confounders, the risk of microcephaly at age 2 years was increased if microcephaly was present at birth [odds ratio: 8.8 ((95% confidence interval: 3.7, 21)], alpha hemolytic Streptococci were recovered from the placenta parenchyma [2.9 (1.2, 6.9)], the child was a boy [2.8 (1.6, 4.9)], and the child's mother was not married [2.5 (1.5, 4.3)]. Antecedents associated not with microcephaly, but with a less extreme reduction in head circumference were recovery of Propionibacterium sp from the placenta parenchyma [2.9 (1.5, 5.5)], tobacco exposure [2.0 (1.4, 3.0)], and increased syncytial knots in the placenta [2.0 (1.2, 3.2)]. Although microcephaly at birth predicts a small head circumference at 2 years among children born much before term, pregnancy and maternal characteristics provide supplemental information about the risk of a small head circumference years later. Two findings appear to be novel. Tobacco exposure during pregnancy, and organisms recovered from the placenta predict reduced head circumference at age two years. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Antenatal antecedents of a small head circumference at age 24-months post-term equivalent in a sample of infants born before the 28th post-menstrual week

    PubMed Central

    Leviton, Alan; Kuban, Karl; Allred, Elizabeth N.; Hecht, Jonathan L.; Onderdonk, Andrew; O'Shea, T. Michael; McElrath, Thomas; Paneth, Nigel

    2010-01-01

    Background Little is known about the antecedents of microcephaly in early childhood among children born at extremely low gestational age. Aim To identify some of the antecedents of microcephaly at age two years among children born before the 28th week of gestation. Study design Observational cohort study. Subjects 1004 infants born before the 28th week of gestation. Outcome measures Head circumference Z-scores of <−2 and ≥−2, <−1. Results Risk of microcephaly and a less severely restricted head circumference decreased monotonically with increasing gestational age. After adjusting for gestational age and other potential confounders, the risk of microcephaly at age 2 years was increased if microcephaly was present at birth [odds ratio: 8.8 ((95% confidence interval: 3.7, 21)], alpha hemolytic Streptococci were recovered from the placenta parenchyma [2.9 (1.2, 6.9)], the child was a boy [2.8 (1.6, 4.9)], and the child's mother was not married [2.5 (1.5, 4.3)]. Antecedents associated not with microcephaly, but with a less extreme reduction in head circumference were recovery of Propionibacterium sp from the placenta parenchyma [2.9 (1.5, 5.5)], tobacco exposure [2.0 (1.4, 3.0)], and increased syncytial knots in the placenta [2.0 (1.2, 3.2)]. Conclusions Although microcephaly at birth predicts a small head circumference at 2 years among children born much before term, pregnancy and maternal characteristics provide supplemental information about the risk of a small head circumference years later. Two findings appear to be novel. Tobacco exposure during pregnancy, and organisms recovered from the placenta predict reduced head circumference at age two years. PMID:20674197

  4. Brief report: a preliminary study of fetal head circumference growth in autism spectrum disorder.

    PubMed

    Whitehouse, Andrew J O; Hickey, Martha; Stanley, Fiona J; Newnham, John P; Pennell, Craig E

    2011-01-01

    Fetal head circumference (HC) growth was examined prospectively in children with autism spectrum disorder (ASD). ASD participants (N = 14) were each matched with four control participants (N = 56) on a range of parameters known to influence fetal growth. HC was measured using ultrasonography at approximately 18 weeks gestation and again at birth using a paper tape-measure. Overall body size was indexed by fetal femur-length and birth length. There was no between-groups difference in head circumference at either time-point. While a small number of children with ASD had disproportionately large head circumference relative to body size at both time-points, the between-groups difference did not reach statistical significance in this small sample. These preliminary findings suggest that further investigation of fetal growth in ASD is warranted.

  5. Occupational physical activities, working hours and outcome of pregnancy: findings from the Southampton Women's Survey.

    PubMed

    Bonzini, M; Coggon, D; Godfrey, K; Inskip, H; Crozier, S; Palmer, K T

    2009-10-01

    To investigate risks of physical activity at work by pregnancy trimester, including the effects on head and abdominal circumference. At 34 weeks of gestation we interviewed 1327 mothers from the prospective Southampton Women's Survey (SWS); we asked about their activities (working hours, standing/walking, kneeling/squatting, trunk bending, lifting and night shifts) in jobs held at each of 11, 19 and 34 weeks of gestation, and subsequently ascertained four birth outcomes (preterm delivery, small for gestational age (SGA) and reduced head or abdominal circumference) blinded to employment history. Risk of preterm delivery was elevated nearly threefold in women whose work at 34 weeks entailed trunk bending for >1 h/day. Small head circumference was more common in babies born to women who worked for >40 h/week. However, no statistically significant associations were found with SGA or small abdominal circumference, and preterm delivery showed little association with long working hours, lifting, standing or shift work. There is a need for more research on trunk bending late in pregnancy, and on the relationship of work to reduced head circumference. Our findings on several other occupational exposures common among pregnant workers are reassuring.

  6. Factors associated with small head circumference at birth among infants born before the 28th week

    PubMed Central

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

    2010-01-01

    OBJECTIVE We sought to identify risk factors for congenital microcephaly in extremely low gestational age newborns. STUDY DESIGN Demographic, clinical, and placental characteristics of 1445 infants born before the 28th week were gathered and evaluated for their relationship with congenital microcephaly. RESULTS Almost 10% of newborns (n = 138), rather than the expected 2.2%, had microcephaly defined as a head circumference >2 SD below the median. In multivariable models, microcephaly was associated with nonwhite race, severe intrauterine growth restriction, delivery for preeclampsia, placental infarction, and being female. The risk factors for a head circumference between <1 and >2 SD below the median were similar to those of microcephaly. CONCLUSION Characteristics associated with fetal growth restriction and preeclampsia are among the strongest correlates of microcephaly among children born at extremely low gestational ages. The elevated risk of a small head among nonwhites and females might reflect the lack of appropriate head circumference standards. PMID:20541727

  7. Head circumference, education and risk of dementia: findings from the Nun Study.

    PubMed

    Mortimer, James A; Snowdon, David A; Markesbery, William R

    2003-08-01

    To examine the prevalence of dementia associated with having a smaller brain, lower education or both of these characteristics, 294 Catholic sisters were assessed annually for dementia. Sixty participants died and their brains were evaluated to determine fulfillment of neuropathological criteria for Alzheimer's disease (AD). Lower educational attainment and the interaction of smaller head circumference with lower education were associated with the presence of dementia, controlling for age and the presence of one or more apolipoprotein E-epsilon 4 alleles. By contrast, neither low educational attainment nor head circumference was significantly associated with fulfillment of neuropathological criteria for AD. Individuals having both low education and small head circumference were four times as likely to be demented as the rest of the sample. The findings suggest that higher education and larger head size, alone or in combination, may reduce the risk of expressing dementia in late life.

  8. Small head circumference at birth and early age at adiposity rebound.

    PubMed

    Eriksson, J G; Kajantie, E; Lampl, M; Osmond, C; Barker, D J P

    2014-01-01

    The adiposity rebound is the age in childhood when body mass index is at a minimum before increasing again. The age at rebound is highly variable. An early age is associated with increased obesity in later childhood and adult life. We have reported that an early rebound is predicted by low weight gain between birth and 1 year of age and resulting low body mass index at 1 year. Here, we examine whether age at adiposity rebound is determined by influences during infancy or is a consequence of foetal growth. Our hypothesis was that measurements of body size at birth are related to age at adiposity rebound. Longitudinal study of 2877 children born in Helsinki, Finland, during 1934-1944. Early age at adiposity rebound was associated with small head circumference and biparietal diameter at birth, but not with other measurements of body size at birth. The mean age at adiposity rebound rose from 5.8 years in babies with a head circumference of ≤33 cm to 6.2 in babies with a head circumference of >36 cm (P for trend = 0.007). The association between thinness in infancy and early rebound became apparent at 6 months of age. It was not associated with adverse living conditions. In a simultaneous regression, small head circumference at birth, high mother's body mass index and tall maternal stature each had statistically significant trends with early adiposity rebound (P = 0.002, <0.001, 0.004). We hypothesize that the small head size at birth that preceded an early adiposity rebound was the result of inability to sustain a rapid intra-uterine growth trajectory initiated in association with large maternal body size. This was followed by catch-up growth in infancy, and we hypothesize that this depleted the infant's fat stores. © 2013 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  9. Fever in pregnancy and offspring head circumference.

    PubMed

    Dreier, Julie Werenberg; Strandberg-Larsen, Katrine; Uldall, Peter Vilhelm; Nybo Andersen, Anne-Marie

    2018-02-01

    To examine whether maternal fever during pregnancy is associated with reduced head circumference and risk of microcephaly at birth. A prospective study of 86,980 live-born singletons within the Danish National Birth Cohort was carried out. Self-reported maternal fever exposure was ascertained in two interviews during pregnancy and information on head circumference at birth was extracted from the Danish Medical Birth Registry. Fever in pregnancy was reported by 27% of the mothers, and we identified 3370 cases of microcephaly (head circumference less than or equal to third percentile for sex and gestational age) and 1140 cases of severe microcephaly (head circumference less than or equal to first percentile for sex and gestational age). In this study, maternal fever exposure was not associated with reduced head circumference (adjusted β = 0.03, 95% confidence intervals [CI]: 0.01-0.05), increased risk of microcephaly (odds ratio: 0.95, 95% CI: 0.88-1.03) nor severe microcephaly (odds ratio: 1.01, 95% CI: 0.88-1.15) in the offspring. These findings were consistent for increasing numbers of fever episodes, for increasing fever severity, and for exposure in both early pregnancy and midpregnancy. In this most comprehensive study to date, we found no indication that maternal fever in pregnancy is associated with small head size in the offspring. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Brain mass estimation by head circumference and body mass methods in neonatal glycaemic modelling and control.

    PubMed

    Gunn, Cameron Allan; Dickson, Jennifer L; Pretty, Christopher G; Alsweiler, Jane M; Lynn, Adrienne; Shaw, Geoffrey M; Chase, J Geoffrey

    2014-07-01

    Hyperglycaemia is a common complication of stress and prematurity in extremely low-birth-weight infants. Model-based insulin therapy protocols have the ability to safely improve glycaemic control for this group. Estimating non-insulin-mediated brain glucose uptake by the central nervous system in these models is typically done using population-based body weight models, which may not be ideal. A head circumference-based model that separately treats small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) infants is compared to a body weight model in a retrospective analysis of 48 patients with a median birth weight of 750g and median gestational age of 25 weeks. Estimated brain mass, model-based insulin sensitivity (SI) profiles, and projected glycaemic control outcomes are investigated. SGA infants (5) are also analyzed as a separate cohort. Across the entire cohort, estimated brain mass deviated by a median 10% between models, with a per-patient median difference in SI of 3.5%. For the SGA group, brain mass deviation was 42%, and per-patient SI deviation 13.7%. In virtual trials, 87-93% of recommended insulin rates were equal or slightly reduced (Δ<0.16mU/h) under the head circumference method, while glycaemic control outcomes showed little change. The results suggest that body weight methods are not as accurate as head circumference methods. Head circumference-based estimates may offer improved modelling accuracy and a small reduction in insulin administration, particularly for SGA infants. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Effect of parental head circumference on that of the newborn child.

    PubMed Central

    Osborne, J; Havalad, S; Hudson, B; Hughes, A

    1980-01-01

    The head circumferences of 74 term, normal babies were measured, together with the head circumferences of their parents. Maternal head circumference had a significant effect on that of the newborn infant but paternal head circumference had not. An equation is given for estimating the expected head circumference of a newborn infant, provided the birthweight and maternal head circumference are known. PMID:7436491

  12. HEAD CIRCUMFERENCE REFERENCES FOR SCHOOL AGE CHILDREN IN WESTERN ROMANIA.

    PubMed

    Chirita-Emandi, Adela; Doros, Gabriela; Simina, Iulia Jurca; Gafencu, Mihai; Puiu, Maria

    2015-01-01

    To provide head circumference references for school-aged children in western Romania, and compare them with references from other European countries. A total of 2742 children, aged 6-19 years, from Timis county, were examined by medical students, between February 2010-June 2011. Head circumference references were constructed by Cole's LMS method with LMSChartMaker software. The Romanian 3rd, 50th and 97th percentiles for head circumference were compared with recent references from Belgium and Germany. Generally, boys show significantly larger head circumference compared to girls at any age. The head circumference increments between 6 and 19 years are < 1 cm/year. Head circumference increments decrease in increasing age of the children. In girls, adult head circumference is reached at the age of 16 years, whereas head circumference growth continues, in boys, slowly until 18 years. The comparison of Romanian head percentiles with those from Belgium and Germany revealed a smaller head circumference in Romanian children (both girls and boys). Comparing head circumference references from Romania to those from Germany and Belgium, we found lower median head circumference in Romanian boys and girls, that could be explained by a taller stature of boys and girls in Germany and Belgium compared to Romania.

  13. Head Circumference Charts for Turkish Children Aged Five to Eighteen Years.

    PubMed

    Kara, Bülent; Etiler, Nilay; Aydoğan Uncuoğlu, Ayşen; Maraş Genç, Hülya; Ulak Gümüşlü, Esen; Gökçay, Gülbin; Furman, Andrezej

    2016-03-01

    Most head circumference growth references are useful during the first years of life, but they are also useful for older children when screening for developmental, neurological, and genetic disorders. We aimed to develop head circumference growth reference charts for age, height, and waist circumference for Turkish children aged 5-18 years. Head circumference, height, and waist circumference measurements were obtained from 5079 students aged 5-18 years from İzmit, Kocaeli Province, Turkey. The LMS method was used to construct reference centile curves. Head circumference measurements were strongly correlated with height (r=0.74), weight (r=0.76), and waist circumference (r=0.68). The mean head circumference values for boys were larger than those for girls at all ages. Compared with data from the United States, the World Health Organization, and other studies from Turkey, our data showed a decrease in head circumference at all ages for both sexes. Local growth charts can be used to evaluate head circumference growth in older Turkish children and adolescents.

  14. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure

    PubMed Central

    Treit, Sarah; Zhou, Dongming; Chudley, Albert E.; Andrew, Gail; Rasmussen, Carmen; Nikkel, Sarah M.; Samdup, Dawa; Hanlon-Dearman, Ana; Loock, Christine; Beaulieu, Christian

    2016-01-01

    Head circumference is used together with other measures as a proxy for central nervous system damage in the diagnosis of fetal alcohol spectrum disorders, yet the relationship between head circumference and brain volume has not been investigated in this population. The objective of this study is to characterize the relationship between head circumference, brain volume and cognitive performance in a large sample of children with prenatal alcohol exposure (n = 144) and healthy controls (n = 145), aged 5–19 years. All participants underwent magnetic resonance imaging to yield brain volumes and head circumference, normalized to control for age and sex. Mean head circumference, brain volume, and cognitive scores were significantly reduced in the prenatal alcohol exposure group relative to controls, albeit with considerable overlap between groups. Males with prenatal alcohol exposure had reductions in all three measures, whereas females with prenatal alcohol exposure had reduced brain volumes and cognitive scores, but no difference in head circumference relative to controls. Microcephaly (defined here as head circumference ≤ 3rd percentile) occurred more often in prenatal alcohol exposed participants than controls, but 90% of the exposed sample had head circumferences above this clinical cutoff indicating that head circumference is not a sensitive marker of prenatal alcohol exposure. Normalized head circumference and brain volume were positively correlated in both groups, and subjects with very low head circumference typically had below-average brain volumes. Conversely, over half of the subjects with very low brain volumes had normal head circumferences, which may stem from differential effects of alcohol on the skeletal and nervous systems. There were no significant correlations between head circumference and any cognitive score. These findings confirm group-level reductions in head circumference and increased rates of microcephaly in children with prenatal alcohol exposure, but raise concerns about the predictive value of this metric at an individual-subject level. PMID:26928125

  15. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure.

    PubMed

    Treit, Sarah; Zhou, Dongming; Chudley, Albert E; Andrew, Gail; Rasmussen, Carmen; Nikkel, Sarah M; Samdup, Dawa; Hanlon-Dearman, Ana; Loock, Christine; Beaulieu, Christian

    2016-01-01

    Head circumference is used together with other measures as a proxy for central nervous system damage in the diagnosis of fetal alcohol spectrum disorders, yet the relationship between head circumference and brain volume has not been investigated in this population. The objective of this study is to characterize the relationship between head circumference, brain volume and cognitive performance in a large sample of children with prenatal alcohol exposure (n = 144) and healthy controls (n = 145), aged 5-19 years. All participants underwent magnetic resonance imaging to yield brain volumes and head circumference, normalized to control for age and sex. Mean head circumference, brain volume, and cognitive scores were significantly reduced in the prenatal alcohol exposure group relative to controls, albeit with considerable overlap between groups. Males with prenatal alcohol exposure had reductions in all three measures, whereas females with prenatal alcohol exposure had reduced brain volumes and cognitive scores, but no difference in head circumference relative to controls. Microcephaly (defined here as head circumference ≤ 3rd percentile) occurred more often in prenatal alcohol exposed participants than controls, but 90% of the exposed sample had head circumferences above this clinical cutoff indicating that head circumference is not a sensitive marker of prenatal alcohol exposure. Normalized head circumference and brain volume were positively correlated in both groups, and subjects with very low head circumference typically had below-average brain volumes. Conversely, over half of the subjects with very low brain volumes had normal head circumferences, which may stem from differential effects of alcohol on the skeletal and nervous systems. There were no significant correlations between head circumference and any cognitive score. These findings confirm group-level reductions in head circumference and increased rates of microcephaly in children with prenatal alcohol exposure, but raise concerns about the predictive value of this metric at an individual-subject level.

  16. Could head circumference be used to screen for autism in young males with developmental delay?

    PubMed

    Gray, Kylie M; Taffe, John; Sweeney, Deborah J; Forster, Sheridan; Tonge, Bruce J

    2012-04-01

    Research has suggested an abnormal acceleration in head circumference growth in children with autism within the first 12 months of life. This study aimed to examine head circumference at birth and head circumference growth rates in young children with autism and developmental delay, and young children with developmental delay without autism. This study assessed head circumference at birth and rate of change in head circumference in young children with autism (n=86) and children with developmental delay without autism (n=40). For both groups of children, head circumference at birth and head circumference growth were compared with Centers for Disease Control normative data. No differences were found between the group of children with autism and developmental delay compared with the group with developmental delay only. However, when the sample was compared with a range of selected Centers for Disease Control normative medians, the children with autism were found to have significantly smaller head circumferences at birth and significantly larger head circumference at 18.5 months of age. These results are discussed in relation to the potential of accelerated head circumference growth as an early marker for autism. This study failed to find a difference in the head circumferences of children with autism and developmental delay and children with developmental delay only, thus suggesting that head circumference measurement has limited value as an early marker for autism. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  17. Head Circumference Charts for Turkish Children Aged Five to Eighteen Years

    PubMed Central

    KARA, Bülent; ETİLER, Nilay; AYDOĞAN UNCUOĞLU, Ayşen; MARAŞ GENÇ, Hülya; ULAK GÜMÜŞLÜ, Esen; GÖKÇAY, Gülbin; FURMAN, Andrezej

    2016-01-01

    Introduction Most head circumference growth references are useful during the first years of life, but they are also useful for older children when screening for developmental, neurological, and genetic disorders. We aimed to develop head circumference growth reference charts for age, height, and waist circumference for Turkish children aged 5–18 years. Methods Head circumference, height, and waist circumference measurements were obtained from 5079 students aged 5–18 years from İzmit, Kocaeli Province, Turkey. The LMS method was used to construct reference centile curves. Results Head circumference measurements were strongly correlated with height (r=0.74), weight (r=0.76), and waist circumference (r=0.68). The mean head circumference values for boys were larger than those for girls at all ages. Compared with data from the United States, the World Health Organization, and other studies from Turkey, our data showed a decrease in head circumference at all ages for both sexes. Conclusion Local growth charts can be used to evaluate head circumference growth in older Turkish children and adolescents. PMID:28360767

  18. Maternal seafood consumption and infant birth weight, length and head circumference in the Norwegian Mother and Child Cohort Study.

    PubMed

    Brantsæter, Anne Lise; Birgisdottir, Bryndis Eva; Meltzer, Helle Margrete; Kvalem, Helen Engelstad; Alexander, Jan; Magnus, Per; Haugen, Margareta

    2012-02-01

    Results from previous studies on associations between maternal fish and seafood intakes and fetal growth are inconclusive. The aim of the present study was to investigate how maternal intakes of seafood, subtypes of seafood and supplementary n-3 fatty acids were associated with infant birth weight, length and head circumference in a prospective study in Norway. The study population included 62 099 participants in the Norwegian Mother and Child Cohort Study. The mothers answered an FFQ in mid pregnancy. The FFQ comprised detailed questions about intake of various seafood items and n-3 supplements. Data on infant birth weight, length and head circumference were obtained from the Medical Birth Registry. We used multivariable regression to examine how total seafood, various seafood subtypes and supplementary n-3 intakes were associated with birth size measures. Total seafood intake was positively associated with birth weight and head circumference. Lean fish was positively associated with all birth size measures; shellfish was positively associated with birth weight, while fatty fish was not associated with any birth size measures. Intake of supplementary n-3 was negatively associated with head circumference. The relative risk of giving birth to a small baby ( < 2500 g) in full-term pregnancies was significantly lower in women who consumed >60 g/d of seafood than in women who consumed ≤ 5 g/d (OR = 0·56 (95 % CI 0·35, 0·88). In conclusion, maternal seafood consumption was positively associated with birth size, driven by lean fish intake, while supplementary n-3 intake was negatively associated with infant head circumference.

  19. Diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life.

    PubMed

    van Dommelen, Paula; Deurloo, Jacqueline A; Gooskens, Rob H; Verkerk, Paul H

    2015-04-01

    Increased head circumference is often the first and main sign leading to the diagnosis of hydrocephalus. Our aim is to investigate the diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life. A reference group with longitudinal head circumference data (n = 1938) was obtained from the Social Medical Survey of Children Attending Child Health Clinics study. The case group comprised infants with hydrocephalus treated in a tertiary pediatric hospital who had not already been detected during pregnancy (n = 125). Head circumference data were available for 43 patients. Head circumference data were standardized according to gestational age-specific references. Sensitivity and specificity of a very large head circumference (>2.5 standard deviations on the growth chart) were, respectively, 72.1% (95% confidence interval [CI]: 56.3-84.7) and 97.1% (95% CI:96.2-97.8). These figures were, respectively, 74.4% (95% CI: 58.8-86.5) and 93.0% (95% CI:91.8-94.1) for a large head circumference (>2.0 standard deviation), and 76.7% (95% CI:61.4-88.2) and 96.5% (95% CI:95.6-97.3) for a very large head circumference and/or a very large (>2.5 standard deviation) progressive growth of head circumference. A very large head circumference and/or a very large progressive growth of head circumference shows the best diagnostic accuracy to detect hydrocephalus at an early stage. Gestational age-specific growth charts are recommended. Further improvements may be possible by taking into account parental head circumference. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Head circumference, atrophy, and cognition: implications for brain reserve in Alzheimer disease.

    PubMed

    Perneczky, R; Wagenpfeil, S; Lunetta, K L; Cupples, L A; Green, R C; Decarli, C; Farrer, L A; Kurz, A

    2010-07-13

    Clinical and epidemiologic studies suggest that patients with Alzheimer disease (AD) with larger head circumference have better cognitive performance at the same level of brain pathology than subjects with smaller head circumference. A total of 270 patients with AD participating in the Multi-Institutional Research in Alzheimer's Genetic Epidemiology (MIRAGE) study underwent cognitive testing, APOE genotyping, and MRI of the brain in a cross-sectional study. Linear regression analysis was used to examine the association between cerebral atrophy, as a proxy for AD pathology, and level of cognitive function, adjusting for age, duration of AD symptoms, gender, head circumference, APOE genotype, diabetes mellitus, hypertension, major depression, and ethnicity. An interaction term between atrophy and head circumference was introduced to explore if head circumference modified the association between cerebral atrophy and cognition. There was a significant inverse association between atrophy and cognitive function, and a significant interaction between atrophy and head circumference. With greater levels of atrophy, cognition was higher for individuals with greater head circumference. This study suggests that larger head circumference is associated with less cognitive impairment in the face of cerebral atrophy. This finding supports the notion that head circumference (and presumably brain size) offers protection against AD symptoms through enhanced brain reserve.

  1. Growth in Head Size during Infancy: Implications for Sound Localization.

    ERIC Educational Resources Information Center

    Clifton, Rachel K.; And Others

    1988-01-01

    Compared head circumference and interaural distance in infants between birth and 22 weeks of age and in a small sample of preschool children and adults. Calculated changes in interaural time differences according to age. Found a large shift in distance. (SKC)

  2. Head Circumference and Height in Autism

    PubMed Central

    Lainhart, Janet E.; Bigler, Erin D.; Bocian, Maureen; Coon, Hilary; Dinh, Elena; Dawson, Geraldine; Deutsch, Curtis K.; Dunn, Michelle; Estes, Annette; Tager-Flusberg, Helen; Folstein, Susan; Hepburn, Susan; Hyman, Susan; McMahon, William; Minshew, Nancy; Munson, Jeff; Osann, Kathy; Ozonoff, Sally; Rodier, Patricia; Rogers, Sally; Sigman, Marian; Spence, M. Anne; Stodgell, Christopher J.; Volkmar, Fred

    2016-01-01

    Data from 10 sites of the NICHD/NIDCD Collaborative Programs of Excellence in Autism were combined to study the distribution of head circumference and relationship to demographic and clinical variables. Three hundred thirty-eight probands with autism-spectrum disorder (ASD) including 208 probands with autism were studied along with 147 parents, 149 siblings, and typically developing controls. ASDs were diagnosed, and head circumference and clinical variables measured in a standardized manner across all sites. All subjects with autism met ADI-R, ADOS-G, DSM-IV, and ICD-10 criteria. The results show the distribution of standardized head circumference in autism is normal in shape, and the mean, variance, and rate of macrocephaly but not microcephaly are increased. Head circumference tends to be large relative to height in autism. No site, gender, age, SES, verbal, or non-verbal IQ effects were present in the autism sample. In addition to autism itself, standardized height and average parental head circumference were the most important factors predicting head circumference in individuals with autism. Mean standardized head circumference and rates of macrocephaly were similar in probands with autism and their parents. Increased head circumference was associated with a higher (more severe) ADI-R social algorithm score. Macrocephaly is associated with delayed onset of language. Although mean head circumference and rates of macrocephaly are increased in autism, a high degree of variability is present, underscoring the complex clinical heterogeneity of the disorder. The wide distribution of head circumference in autism has major implications for genetic, neuroimaging, and other neurobiological research. PMID:17022081

  3. [Weight/head circumference ratio at birth for assessing fetal growth].

    PubMed

    Gonçalves, Fabiana Cristina Lima da Silva Pastich; Lira, Pedro Israel Cabral de; Eickmann, Sophie Helena; Lima, Marilia de Carvalho

    2015-09-01

    The objective of this study was to use weight/head circumference ratio at birth to assess fetal growth. A retrospective cohort study was conducted in Zona da Mata, Pernambuco State, Brazil, with 915 term infants. Infants' anthropometric measurements and data on prenatal care, smoking during pregnancy, family income, and maternal schooling and nutritional status were collected in the first 24 hours after birth. Infants were classified as proportionate (weight/head circumference ratio ≥ 0.90) versus disproportionate (< 0.90). Lower mean weight/head circumference ratio was associated with maternal smoking, younger age, inadequate prenatal care, and low BMI, height, and triceps skinfold thickness. Mean weight, length, head and chest circumference, arm circumference, and triceps skinfold thickness were lower among infants with disproportionate weight/head circumference ratio, independently of sex. In conclusion, weight/head circumference ratio and birth weight are important indicators of fetal growth.

  4. Head circumference and height in autism: a study by the Collaborative Program of Excellence in Autism.

    PubMed

    Lainhart, Janet E; Bigler, Erin D; Bocian, Maureen; Coon, Hilary; Dinh, Elena; Dawson, Geraldine; Deutsch, Curtis K; Dunn, Michelle; Estes, Annette; Tager-Flusberg, Helen; Folstein, Susan; Hepburn, Susan; Hyman, Susan; McMahon, William; Minshew, Nancy; Munson, Jeff; Osann, Kathy; Ozonoff, Sally; Rodier, Patricia; Rogers, Sally; Sigman, Marian; Spence, M Anne; Stodgell, Christopher J; Volkmar, Fred

    2006-11-01

    Data from 10 sites of the NICHD/NIDCD Collaborative Programs of Excellence in Autism were combined to study the distribution of head circumference and relationship to demographic and clinical variables. Three hundred thirty-eight probands with autism-spectrum disorder (ASD) including 208 probands with autism were studied along with 147 parents, 149 siblings, and typically developing controls. ASDs were diagnosed, and head circumference and clinical variables measured in a standardized manner across all sites. All subjects with autism met ADI-R, ADOS-G, DSM-IV, and ICD-10 criteria. The results show the distribution of standardized head circumference in autism is normal in shape, and the mean, variance, and rate of macrocephaly but not microcephaly are increased. Head circumference tends to be large relative to height in autism. No site, gender, age, SES, verbal, or non-verbal IQ effects were present in the autism sample. In addition to autism itself, standardized height and average parental head circumference were the most important factors predicting head circumference in individuals with autism. Mean standardized head circumference and rates of macrocephaly were similar in probands with autism and their parents. Increased head circumference was associated with a higher (more severe) ADI-R social algorithm score. Macrocephaly is associated with delayed onset of language. Although mean head circumference and rates of macrocephaly are increased in autism, a high degree of variability is present, underscoring the complex clinical heterogeneity of the disorder. The wide distribution of head circumference in autism has major implications for genetic, neuroimaging, and other neurobiological research.

  5. Accuracy of birth certificate head circumference measurements: Massachusetts, 2012-2013.

    PubMed

    Somerville, Nicholas J; Chen, Xiaoli; Heinke, Dominique; Stone, Sarah L; Higgins, Cathleen; Manning, Susan E; Pagnano, Sharon; Yazdy, Mahsa M; Anderka, Marlene

    2018-03-15

    Zika virus has recently emerged as a novel cause of microcephaly. CDC has asked states to rapidly ascertain and report cases of Zika-linked birth defects, including microcephaly. Massachusetts added head circumference to its birth certificate (BC) in 2011. The accuracy of head circumference measurements from state vital records data has not been reported. We sought to assess the accuracy of Massachusetts BC head circumference measurements by comparing them to measurements for 2,217 infants born during 2012-2013 captured in the Massachusetts Birth Defects Monitoring Program (BDMP) data system. BDMP contains information abstracted directly from infant medical records and served as the true head circumference value (i.e., gold standard) for analysis. We calculated the proportion of head circumference measurements in agreement between the BC and BDMP data. We assigned growth chart head circumference percentile categories to each BC and BDMP measurement, and calculated the sensitivity and specificity of BC-based categories to predict BDMP-based categories. No difference was found in head circumference measurements between the two sources in 77.9% (n = 1,727) of study infants. The sensitivity of BC-based head circumference percentile categories ranged from 85.6% (<3rd percentile) to 92.7% (≥90th percentile) and the specificity ranged from 97.6% (≥90th percentile) to 99.3% (<3rd percentile). BC head circumference measurements agreed with those abstracted from the medical chart the majority of the time. Head circumference measurements on the BC were more specific than sensitive across all standardized growth chart percentile categories. © 2017 Wiley Periodicals, Inc.

  6. Head circumference (image)

    MedlinePlus

    Head circumference is a measurement of the circumference of the child's head at its largest area, above the eyebrows and ears and around the back of the head. During routine check-ups, the distance is ...

  7. Head circumference

    MedlinePlus

    ... a child's head circumference. Normal ranges for a child's sex and age (weeks, months), based on values that experts have obtained for normal growth rates of infants' and children's heads. Measurement of the head circumference is an ...

  8. Influence of anthropometry on the kinematics of the cervical spine and the risk of injury in sled tests in female volunteers.

    PubMed

    Dehner, Christoph; Schick, Sylvia; Arand, Markus; Elbel, Martin; Hell, Wolfram; Kramer, Michael

    2008-07-01

    The objective of this study was to investigate the influence of anthropometric data on the kinematics of the cervical spine and the risk factors for sustaining a neck injury during rear-end collisions occurring in a sled test. A rear-end collision with a velocity change (DeltaV) of 6.3 km/h was simulated in a sled test with eight healthy female subjects. The study analysed the association of anthropometric data with the initial distance between the head and the head restraint, defined kinematic characteristics, the neck injury criterion (NIC) and the neck injury criterion minor (NICmin). The head circumference is negatively associated (r=-0.598) with the initial distance between the head and the head restraint, the maximal head extension (r=-0.687) and the maximal dorsal angular head acceleration (r=-0.633). The body weight (r=0.800), body height (r=0.949) and thorax circumference (r=0.632) are positively associated with the maximal ventral head translation. The neck length correlates positively with the NIC (r=0.826) and negatively with the NICmin (r=-0.797). Anthropometric factors influence the kinematics of the cervical spine and the risk of injury. A high risk of injury may be assumed for individuals with a small head circumference, long neck, tall body height and high body weight.

  9. Beneficial effects of zinc supplementation on head circumference of Nepalese infants and toddlers: a randomized controlled trial.

    PubMed

    Surkan, P J; Shankar, M; Katz, J; Siegel, E H; Leclerq, S C; Khatry, S K; Stoltzfus, R J; Tielsch, J M

    2012-07-01

    To assess the effects of micronutrient supplementation on head circumference of rural Nepali infants and children. We used a randomized controlled trial to assess the effects of micronutrient supplementation on head circumference in 569 rural Nepali infants and children aged 4-17 months. Children were randomized to: (1) zinc, (2) iron-folic acid, (3) zinc plus iron-folic acid or (4) a placebo group. Data on head circumference were collected during five visits at ∼3 month intervals over the course of a year. We calculated change in head circumference in treatment groups receiving zinc and iron comparing the first and fifth visits as well as used generalized estimating equations (GEE) to take advantage of data from all points in time. Models were adjusted for covariates unbalanced in the randomization and for baseline head circumference. Estimating differences in head circumference between baseline and visit 5, children in the zinc treatment group showed smaller decreases in head circumference z-score compared with placebo (adjusted β=0.13, 95% confidence interval (CI): 0.03 to 0.23). Using GEE, zinc treatment was associated with 0.11 (95% CI: 0.05 to 0.17) decrease in the rate of decline in head circumference z-score across visits as compared with placebo. Iron-folic acid supplementation was not associated with head circumference z-scores when comparing visits 1 with 5 or including data across all visits in adjusted models. Our results suggest that zinc supplementation confers a beneficial effect on the rate of head growth in Nepali infants.

  10. Volumetric MRI study of brain in children with intrauterine exposure to cocaine, alcohol, tobacco, and marijuana.

    PubMed

    Rivkin, Michael J; Davis, Peter E; Lemaster, Jennifer L; Cabral, Howard J; Warfield, Simon K; Mulkern, Robert V; Robson, Caroline D; Rose-Jacobs, Ruth; Frank, Deborah A

    2008-04-01

    The objective of this study was to use volumetric MRI to study brain volumes in 10- to 14-year-old children with and without intrauterine exposure to cocaine, alcohol, cigarettes, or marijuana. Volumetric MRI was performed on 35 children (mean age: 12.3 years; 14 with intrauterine exposure to cocaine, 21 with no intrauterine exposure to cocaine) to determine the effect of prenatal drug exposure on volumes of cortical gray matter; white matter; subcortical gray matter; cerebrospinal fluid; and total parenchymal volume. Head circumference was also obtained. Analyses of each individual substance were adjusted for demographic characteristics and the remaining 3 prenatal substance exposures. Regression analyses adjusted for demographic characteristics showed that children with intrauterine exposure to cocaine had lower mean cortical gray matter and total parenchymal volumes and smaller mean head circumference than comparison children. After adjustment for other prenatal exposures, these volumes remained smaller but lost statistical significance. Similar analyses conducted for prenatal ethanol exposure adjusted for demographics showed significant reduction in mean cortical gray matter; total parenchymal volumes; and head circumference, which remained smaller but lost statistical significance after adjustment for the remaining 3 exposures. Notably, prenatal cigarette exposure was associated with significant reductions in cortical gray matter and total parenchymal volumes and head circumference after adjustment for demographics that retained marginal significance after adjustment for the other 3 exposures. Finally, as the number of exposures to prenatal substances grew, cortical gray matter and total parenchymal volumes and head circumference declined significantly with smallest measures found among children exposed to all 4. CONCLUSIONS; These data suggest that intrauterine exposures to cocaine, alcohol, and cigarettes are individually related to reduced head circumference; cortical gray matter; and total parenchymal volumes as measured by MRI at school age. Adjustment for other substance exposures precludes determination of statistically significant individual substance effect on brain volume in this small sample; however, these substances may act cumulatively during gestation to exert lasting effects on brain size and volume.

  11. [Nutritional status of women with gestational diabetes and characteristics of newborn].

    PubMed

    González Stäger, Maria Angelica; Rodríguez Fernández, Alejandra; Ortega Quintana, Victoria; Oliveras Vega, Leslie

    2012-12-01

    The objective was to determine the relationship between the mother's nutritional status and the newborn's gestational characteristics. A sample of 149 women with gestational diabetes was controlled in the High Risk Obstetric Unit of the Medical Specialties Public Health Center before delivery in the maternity ward of the Hospital Clinico Herminda Martín de Chillán, Chile in 2010. Data were obtained from the perinatal clinical history and the newborn's chart. The variables recorded for the mother were nutritional status, type of delivery, number of pregnancies, and metabolic control. Data for the newborn were weight, length, head circumference, and gestational diagnosis. These data were analyzed by ANOVA, Chi-square test, and Multiple Correspondence. Women with a normal nutritional status were multiparous with natural childbirth; the newborn had an adequate gestational age and normal head circumference. On the other hand, maternal obesity was related to a Cesarean; the newborn was large for gestational age and had a larger head circumference. Overweight women were primiparous and the newborn was small for gestational age with a smaller head circumference (p < 0.01). It was concluded that obesity in women with gestational diabetes explains variables such as type of delivery, number of gestations, and the newborn's diagnosis.

  12. Pre-conception and prenatal alcohol exposure from mothers and fathers drinking and head circumference: results from the Norwegian Mother-Child Study (MoBa).

    PubMed

    Zuccolo, Luisa; DeRoo, Lisa A; Wills, Andrew K; Davey Smith, George; Suren, Pål; Roth, Christine; Stoltenberg, Camilla; Magnus, Per

    2016-12-23

    Although microcephaly is a feature of Fetal Alcohol Syndrome, it is currently unknown whether low-to-moderate prenatal alcohol exposure affects head circumference. Small magnitude associations reported in observational studies are likely to be misleading due to confounding and misclassification biases. Alternative analytical approaches such as the use of family negative controls (e.g. comparing the effects of maternal and paternal exposure) could help disentangle causal effects. We investigated the association of maternal and paternal alcohol drinking before and early in pregnancy with infant head circumference, using data from 68,244 mother-father-offspring trios from the Norwegian Mother and Child Cohort Study (MoBa) (1999-2009). In analyses adjusted for potential confounders, we found no consistent pattern of association between maternal or paternal alcohol intake before or during pregnancy and offspring head circumference modelled as a continuous outcome. However, we found higher odds of microcephaly at birth for higher paternal, but not maternal, alcohol consumption before pregnancy, and similar but weaker effect estimates for first trimester drinking. Associations with paternal drinking before pregnancy were unexpected and should be regarded as hypothesis generating, until independently replicated, although potentially important given the absence of guidelines on safe drinking levels for men in couples trying for a pregnancy.

  13. Head circumference as a useful surrogate for intracranial volume in older adults.

    PubMed

    Hshieh, Tammy T; Fox, Meaghan L; Kosar, Cyrus M; Cavallari, Michele; Guttmann, Charles R G; Alsop, David; Marcantonio, Edward R; Schmitt, Eva M; Jones, Richard N; Inouye, Sharon K

    2016-01-01

    Intracranial volume (ICV) has been proposed as a measure of maximum lifetime brain size. Accurate ICV measures require neuroimaging which is not always feasible for epidemiologic investigations. We examined head circumference as a useful surrogate for ICV in older adults. 99 older adults underwent Magnetic Resonance Imaging (MRI). ICV was measured by Statistical Parametric Mapping 8 (SPM8) software or Functional MRI of the Brain Software Library (FSL) extraction with manual editing, typically considered the gold standard. Head circumferences were determined using standardized tape measurement. We examined estimated correlation coefficients between head circumference and the two MRI-based ICV measurements. Head circumference and ICV by SPM8 were moderately correlated (overall r = 0.73, men r = 0.67, women r = 0.63). Head circumference and ICV by FSL were also moderately correlated (overall r = 0.69, men r = 0.63, women r = 0.49). Head circumference measurement was strongly correlated with MRI-derived ICV. Our study presents a simple method to approximate ICV among older patients, which may prove useful as a surrogate for cognitive reserve in large scale epidemiologic studies of cognitive outcomes. This study also suggests the stability of head circumference correlation with ICV throughout the lifespan.

  14. Parental determinants of offspring head circumference using a sample of patients attending a government hospital in Lagos, Nigeria.

    PubMed

    Taiwo, I A; Adeleye, A

    2013-01-01

    Head circumference at birth is an important neonatal parameter in view of its association with perinatal and postnatal morbidity and mortality. It is an indicator of brain volume and a tool for assessing the development of the central nervous system. Being a complex hereditary trait, predicting baby's head circumference from parental anthropometrics could complement the already existing ultrasonographic method of prediction. To identify the parental anthropometric determinants of baby's head circumference in Lagos, Nigeria, using a sample of patients attending a government hospital. Parental anthropometric parameters were obtained from 250 couples. The baby's head circumference was measured immediately after birth. The data were subjected to multivariate analysis. The parental variables that were most predictive of babies' head circumference were mid-parental weight, maternal height, maternal weight gain during pregnancy and maternal age. Assessment of these parental attributes can complement ultrasonographic data in predicting baby's head circumference for better perinatal outcome.

  15. Increased head circumference

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/003305.htm Increased head circumference To use the sharing features on this page, please enable JavaScript. Increased head circumference is when the measured distance around the widest ...

  16. Short-term growth in head circumference and its relationship with supine length in healthy infants.

    PubMed

    Caino, Silvia; Kelmansky, Diana; Adamo, Paula; Lejarraga, Horacio

    2010-01-01

    Daily changes in height have been found to be a non-linear process. Its exact pattern is still controversial. In previous studies on 34 healthy children aged 0.32-12.99 years, we found that growth is a tri-phasic process: stasis, steep changes (or saltation) and continuous growth. There is very little information in the literature about daily changes in head circumference. The present study analysed growth in head circumference and supine length in eight healthy infants. Supine length and head circumference was measured five times a week during 151 days. Mean intra-observer technical error of measurement (TEM) for head circumference and supine length were 0.10 and 0.15 cm, respectively; smoothing techniques used were based on the TEM with a hard rejection criterion. The three types of events previously found in supine length are also present in head circumference. The number of steep changes was greater in supine length than in head circumference. Growth is a discontinuous and irregular process, present not only in long bones but also in skull bones. Although long-term growth curves of head circumference and supine length are different, when measured on a daily basis findings suggest that skull and long bones have a common pattern; the physiological basis needs future research.

  17. Head Circumference as a Useful Surrogate for Intracranial Volume in Older Adults

    PubMed Central

    Hshieh, Tammy T.; Fox, Meaghan L.; Kosar, Cyrus M.; Cavallari, Michele; Guttmann, Charles R.G.; Alsop, David; Marcantonio, Edward R.; Schmitt, Eva M.; Jones, Richard N.; Inouye, Sharon K.

    2015-01-01

    Background Intracranial volume (ICV) has been proposed as a measure of maximum lifetime brain size. Accurate ICV measures require neuroimaging which is not always feasible for epidemiologic investigations. We examined head circumference as a useful surrogate for intracranial volume in older adults. Methods 99 older adults underwent Magnetic Resonance Imaging (MRI). ICV was measured by Statistical Parametric Mapping 8 (SPM8) software or Functional MRI of the Brain Software Library (FSL) extraction with manual editing, typically considered the gold standard. Head circumferences were determined using standardized tape measurement. We examined estimated correlation coefficients between head circumference and the two MRI-based ICV measurements. Results Head circumference and ICV by SPM8 were moderately correlated (overall r=0.73, men r=0.67, women r=0.63). Head circumference and ICV by FSL were also moderately correlated (overall r=0.69, men r=0.63, women r=0.49). Conclusions Head circumference measurement was strongly correlated with MRI-derived ICV. Our study presents a simple method to approximate ICV among older patients, which may prove useful as a surrogate for cognitive reserve in large scale epidemiologic studies of cognitive outcomes. This study also suggests the stability of head circumference correlation with ICV throughout the lifespan. PMID:26631180

  18. At what age is hydrocephalus detected, and what is the role of head circumference measurements?

    PubMed

    Breuning-Broers, Jacqueline M; Deurloo, Jacqueline A; Gooskens, Rob H; Verkerk, Paul H

    2014-02-01

    To investigate at what age hydrocephalus is detected and to assess the role of head circumference measurements in detecting hydrocephalus, we performed a retrospective chart review in children with hydrocephalus treated in a tertiary paediatric hospital in the Netherlands. The study group contained 146 patients; 38 patients (31%) were referred because of abnormalities in head circumference. Eighty-nine per cent of the patients were detected in the first year of life. After this period, no patients were referred because of an abnormal head circumference. Therefore, head circumference measurements seem to have little value for detecting hydrocephalus after the first year of life.

  19. Head circumference in young children with autism: the impact of different head circumference charts.

    PubMed

    Morhardt, Duncan R; Barrow, William; Jaworski, Margie; Accardo, Pasquale J

    2014-03-01

    The hypothesis that the presence of macrocephaly might vary with the specific growth chart used was tested by using the Nellahus, CDC, and recent Rollins et al revision head circumference charts to plot the head circumferences of 253 children with neurodevelopmental disorders and with ages between 12 to 36 months; of these children, 59 had a diagnosis of autism spectrum disorder. The CDC and Rollins et al head circumference charts identified more cases of macrocephaly and fewer cases of microcephaly than did the older Nellhaus chart but did not significantly differ in their identification of macrocephaly in children with autism.

  20. Sonographic large fetal head circumference and risk of cesarean delivery.

    PubMed

    Lipschuetz, Michal; Cohen, Sarah M; Israel, Ariel; Baron, Joel; Porat, Shay; Valsky, Dan V; Yagel, Oren; Amsalem, Hagai; Kabiri, Doron; Gilboa, Yinon; Sivan, Eyal; Unger, Ron; Schiff, Eyal; Hershkovitz, Reli; Yagel, Simcha

    2018-03-01

    Persistently high rates of cesarean deliveries are cause for concern for physicians, patients, and health systems. Prelabor assessment might be refined by identifying factors that help predict an individual patient's risk of cesarean delivery. Such factors may contribute to patient safety and satisfaction as well as health system planning and resource allocation. In an earlier study, neonatal head circumference was shown to be more strongly associated with delivery mode and other outcome measures than neonatal birthweight. In the present study we aimed to evaluate the association of sonographically measured fetal head circumference measured within 1 week of delivery with delivery mode. This was a multicenter electronic medical record-based study of birth outcomes of primiparous women with term (37-42 weeks) singleton fetuses presenting for ultrasound with fetal biometry within 1 week of delivery. Fetal head circumference and estimated fetal weight were correlated with maternal background, obstetric, and neonatal outcome parameters. Elective cesarean deliveries were excluded. Multinomial regression analysis provided adjusted odds ratios for instrumental delivery and unplanned cesarean delivery when the fetal head circumference was ≥35 cm or estimated fetal weight ≥3900 g, while controlling for possible confounders. In all, 11,500 cases were collected; 906 elective cesarean deliveries were excluded. A fetal head circumference ≥35 cm increased the risk for unplanned cesarean delivery: 174 fetuses with fetal head circumference ≥35 cm (32%) were delivered by cesarean, vs 1712 (17%) when fetal head circumference <35 cm (odds ratio, 2.49; 95% confidence interval, 2.04-3.03). A fetal head circumference ≥35 cm increased the risk of instrumental delivery (odds ratio, 1.48; 95% confidence interval, 1.16-1.88), while estimated fetal weight ≥3900 g tended to reduce it (nonsignificant). Multinomial regression analysis showed that fetal head circumference ≥35 cm increased the risk of unplanned cesarean delivery by an adjusted odds ratio of 1.75 (95% confidence interval, 1.4-2.18) controlling for gestational age, fetal gender, and epidural anesthesia. The rate of prolonged second stage of labor was significantly increased when either the fetal head circumference was ≥35 cm or the estimated fetal weight ≥3900 g, from 22.7% in the total cohort to 31.0%. A fetal head circumference ≥35 cm was associated with a higher rate of 5-minute Apgar score ≤7: 9 (1.7%) vs 63 (0.6%) of infants with fetal head circumference <35 cm (P = .01). The rate among fetuses with an estimated fetal weight ≥3900 g was not significantly increased. The rate of admission to the neonatal intensive care unit did not differ among the groups. Sonographic fetal head circumference ≥35 cm, measured within 1 week of delivery, is an independent risk factor for unplanned cesarean delivery but not instrumental delivery. Both fetal head circumference ≥35 cm and estimated fetal weight ≥3900 g significantly increased the risk of a prolonged second stage of labor. Fetal head circumference measurement in the last days before delivery may be an important adjunct to estimated fetal weight in labor management. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. 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 ...

  2. Head circumferences of children born to HIV-infected and HIV-uninfected mothers in Zimbabwe during the preantiretroviral therapy era

    PubMed Central

    Evans, Ceri; Chasekwa, Bernard; Ntozini, Robert; Humphrey, Jean H.; Prendergast, Andrew J.

    2016-01-01

    Objectives: To describe the head growth of children according to maternal and child HIV infection status. Design: Longitudinal analysis of head circumference data from 13 647 children followed from birth in the ZVITAMBO trial, undertaken in Harare, Zimbabwe, between 1997 and 2001, prior to availability of antiretroviral therapy (ART) or cotrimoxazole prophylaxis. Methods: Head circumference was measured at birth, then at regular intervals through 24 months of age. Mean head circumference-for-age Z-scores (HCZ) and prevalence of microcephaly (HCZ < −2) were compared between HIV-unexposed children, HIV-exposed uninfected (HEU) children and children infected with HIV in utero (IU), intrapartum (IP) and postnatally (PN). Results: Children infected with HIV in utero had head growth restriction at birth. Head circumference Z-scores remained low throughout follow-up in IP children, whereas they progressively declined in IU children. During the second year of life, HCZ in the PN group declined, reaching a similar mean as IP-infected children by 21 months of age. Microcephaly was more common among IU and IP children than HIV-uninfected children through 24 months. HEU children had significantly lower head circumferences than HIV-unexposed children through 12 months. Conclusion: HIV-infected children had lower head circumferences and more microcephaly than HIV-uninfected children. Timing of HIV acquisition; influenced HCZ, with those infected before birth having particularly poor head growth. HEU children had poorer head growth until 12 months of age. Correlations between head growth and neurodevelopment in the context of maternal/infant HIV infection, and further studies from the current ART era, will help determine the predictive value of routine head circumference measurement. PMID:27428746

  3. Head circumference during infancy in a birth cohort of Sri Lankan children: are we using the correct chart?

    PubMed

    Perera, P J; Fernando, M P; Samaranayake, R

    2014-12-01

    Measuring head circumference and plotting it in centile charts is a routine practice in paediatrics. However if wrong charts are used, serious misinterpretations can ensue. This study was carried out to ascertain the appropriateness of charts used in Sri Lanka. Out of a birth cohort of 2215 children, 250 from each sex were invited for a follow up study. Head circumference was measured at 2, 4, 6, 9 and 12 months. Statistical characteristics of head circumference for each sex, at each age were calculated. At the first follow up 244 boys and 241 girls were assessed. Out of this, 85% of boys and 86% of girls completed the follow up. Head circumference of both sexes deviated significantly at all ages from the charts available in the Child Health Developmental Record (CHDR). Head circumference charts available in the CHDR are inappropriate for use in Sri Lankan children.

  4. Pre-natal exposures to cocaine and alcohol and physical growth patterns to age 8 years

    PubMed Central

    Lumeng, Julie C.; Cabral, Howard J.; Gannon, Katherine; Heeren, Timothy; Frank, Deborah A.

    2007-01-01

    Two hundred and two primarily African American/Caribbean children (classified by maternal report and infant meconium as 38 heavier, 74 lighter and 89 not cocaine-exposed) were measured repeatedly from birth to age 8 years to assess whether there is an independent effect of prenatal cocaine exposure on physical growth patterns. Children with fetal alcohol syndrome identifiable at birth were excluded. At birth, cocaine and alcohol exposures were significantly and independently associated with lower weight, length and head circumference in cross-sectional multiple regression analyses. The relationship over time of pre-natal exposures to weight, height, and head circumference was then examined by multiple linear regression using mixed linear models including covariates: child’s gestational age, gender, ethnicity, age at assessment, current caregiver, birth mother’s use of alcohol, marijuana and tobacco during the pregnancy and pre-pregnancy weight (for child’s weight) and height (for child’s height and head circumference). The cocaine effects did not persist beyond infancy in piecewise linear mixed models, but a significant and independent negative effect of pre-natal alcohol exposure persisted for weight, height, and head circumference. Catch-up growth in cocaine-exposed infants occurred primarily by 6 months of age for all growth parameters, with some small fluctuations in growth rates in the preschool age range but no detectable differences between heavier versus unexposed nor lighter versus unexposed thereafter. PMID:17412558

  5. Pre-conception and prenatal alcohol exposure from mothers and fathers drinking and head circumference: results from the Norwegian Mother-Child Study (MoBa)

    PubMed Central

    Zuccolo, Luisa; DeRoo, Lisa A.; Wills, Andrew K.; Davey Smith, George; Suren, Pål; Roth, Christine; Stoltenberg, Camilla; Magnus, Per

    2016-01-01

    Although microcephaly is a feature of Fetal Alcohol Syndrome, it is currently unknown whether low-to-moderate prenatal alcohol exposure affects head circumference. Small magnitude associations reported in observational studies are likely to be misleading due to confounding and misclassification biases. Alternative analytical approaches such as the use of family negative controls (e.g. comparing the effects of maternal and paternal exposure) could help disentangle causal effects. We investigated the association of maternal and paternal alcohol drinking before and early in pregnancy with infant head circumference, using data from 68,244 mother-father-offspring trios from the Norwegian Mother and Child Cohort Study (MoBa) (1999–2009). In analyses adjusted for potential confounders, we found no consistent pattern of association between maternal or paternal alcohol intake before or during pregnancy and offspring head circumference modelled as a continuous outcome. However, we found higher odds of microcephaly at birth for higher paternal, but not maternal, alcohol consumption before pregnancy, and similar but weaker effect estimates for first trimester drinking. Associations with paternal drinking before pregnancy were unexpected and should be regarded as hypothesis generating, until independently replicated, although potentially important given the absence of guidelines on safe drinking levels for men in couples trying for a pregnancy. PMID:28008975

  6. Clinical, morphological, and biochemical correlates of head circumference in autism.

    PubMed

    Sacco, Roberto; Militerni, Roberto; Frolli, Alessandro; Bravaccio, Carmela; Gritti, Antonella; Elia, Maurizio; Curatolo, Paolo; Manzi, Barbara; Trillo, Simona; Lenti, Carlo; Saccani, Monica; Schneider, Cindy; Melmed, Raun; Reichelt, Karl-Ludvig; Pascucci, Tiziana; Puglisi-Allegra, Stefano; Persico, Antonio M

    2007-11-01

    Head growth rates are often accelerated in autism. This study is aimed at defining the clinical, morphological, and biochemical correlates of head circumference in autistic patients. Fronto-occipital head circumference was measured in 241 nonsyndromic autistic patients, 3 to 16 years old, diagnosed according to DSM-IV criteria. We assessed 1) clinical parameters using the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, Vineland Adaptive Behavioral Scales, intelligence quotient measures, and an ad hoc clinical history questionnaire; 2) height and weight; 3) serotonin (5-HT) blood levels and peptiduria. The distribution of cranial circumference is significantly skewed toward larger head sizes (p < .00001). Macrocephaly (i.e., head circumference >97th percentile) is generally part of a broader macrosomic endophenotype, characterized by highly significant correlations between head circumference, weight, and height (p < .001). A head circumference >75th percentile is associated with more impaired adaptive behaviors and with less impairment in IQ measures and motor and verbal language development. Surprisingly, larger head sizes are significantly associated with a positive history of allergic/immune disorders both in the patient and in his/her first-degree relatives. Our study demonstrates the existence of a macrosomic endophenotype in autism and points toward pathogenetic links with immune dysfunctions that we speculate either lead to or are associated with increased cell cycle progression and/or decreased apoptosis.

  7. Use of head circumference as a predictor of height of individual.

    PubMed

    Mansur, D I; Haque, M K; Sharma, K; Mehta, D K; Shakya, R

    2014-01-01

    Establishing personal identity is one of the main concerns in forensic investigations. In forensic anthropology, estimation of height from head circumference has a significant role in establishing personal identity. The objective of the present study was an attempt to understand the relationship between height and head circumference of an individual and to derive regression formulae to estimate the height from the head circumference. The present study consisted of 440 (258 male and 182 female) students of age group 17 to 25 years studying in Kathmandu University School of Medical Sciences, Dhulikhel, Nepal during the period from November 2012 to October 2013. Height and head circumference of an individual were measured in centimeter. Data were analyzed by using statistical software SPSS-16. The findings of the present study were significant correlation between height and head circumference (r = 0.443, p < 0.01 for male, r = 0.302, p<0.01 for female, and r = 0. 398, p < 0.01 for combined (male and female). The regression equation for height and head circumference was found to be Y = 1.734X + 70.36 (R2 = 0.196) for male, Y = 0.916X + 106.8 (R2 = 0.091) for female, and Y = 1.648 X + 71.69 (R2 = 0.158) for combined (male and female), where Y is the height of Individual and X is the Head Circumference. Head circumference showed highly significant positive correlation with individual's height. Therefore, the present study will help in medico-legal cases in establishing the identity of an individual and this would also be useful for Anatomists and Anthropologists.

  8. The value of head circumference measurements after 36 months of age: a clinical report and review of practice patterns.

    PubMed

    James, Hector E; Perszyk, Anthony A; MacGregor, Teresa L; Aldana, Philipp R

    2015-08-01

    OBJECT The cranium is documented to grow from birth through adolescence. The standard of practice in primary care is measuring head circumference and plotting growth using curves that stop at 36 months. The authors report the importance of their experience with measuring head circumference in the child and same-sex parent beyond 36 months. METHODS In the University of Florida genetics and pediatric neurosurgery clinics, head circumference is measured and plotted on growth charts through 18 years of age. Circumference and rate of growth over time are compared with those of the same-sex parent. A diagnostic workup is initiated if there is a discrepancy with the patient's head circumference or if there is significant change in the growth rate of the cranium. RESULTS Between January 2004 and December 2007, the lead author examined 190 patients referred by pediatricians and/or pediatric subspecialists because of the concerns regarding head size of the child. Neuroimaging was performed in 70% of the patients prior to referral. None of the patients had their head size compared with that of their same-sex parent prior to referral. On assessing referring physician responses as to why the same-sex parents, head measurements were not pursued prior to imaging or referral to the specialists, the results were: 1) only have head circumference sheets to 36 months of age (n = 28); 2) the American Academy of Pediatrics does not recommend it (n = 3); and 3) the head stops growing at 36 months of age (n = 2). CONCLUSIONS Pediatricians and pediatric subspecialists need instruction on head circumference measurement in children from infancy through adolescence, and when indicated, in comparison with the head size of the same-sex parent. This measurement may be an effective and inexpensive assessment tool.

  9. Sex-specific differences of craniofacial traits in Croatia: the impact of environment in a small geographic area.

    PubMed

    Buretic-Tomljanovic, Alena; Giacometti, Jasminka; Ostojic, Sasa; Kapovic, Miljenko

    2007-01-01

    Craniometric variation in humans reflects different genetic and environmental influences. Long-term climatic adaptation is less likely to show an impact on size and shape variation in a small local area than at the global level. The aim of this work was to assess the contribution of the particular environmental factors to body height and craniofacial variability in a small geographic area of Croatia. A total of 632 subjects, aged 18-21, participated in the survey. Body height, head length, head breadth, head height, head circumference, cephalic index, morphological face height, face breadth, and facial index were analysed regarding geographic, climatic and dietary conditions in different regions of the country, and correlated with the specific climatic variables (cumulative multiyear sunshine duration, cumulative multiyear average precipitation, multiyear average air temperatures) and calcium concentrations in drinking water. Significant differences between groups classified according to geographic, climatic or dietary affiliation, and the impact of the environmental predictors on the variation in the investigated traits were assessed using multiple forward stepwise regression analyses. Higher body height measures in both sexes were significantly correlated with Mediterranean diet type. Mediterranean diet type also contributed to higher head length and head circumference measures in females. Cephalic index values correlated to geographic regions in both sexes, showing an increase from southern to eastern Croatia. In the same direction, head length significantly decreased in males and head breadth increased in females. Mediterranean climate was associated with higher and narrower faces in females. The analysis of the particular climatic variables did not reveal a significant influence on body height in either sex. Concurrently, climatic features influenced all craniofacial traits in females and only head length and facial index in males. Mediterranean climate, characterized by higher average sunshine duration, higher average precipitation and higher average air temperatures, was associated with longer, higher and narrower skulls, higher head circumference, lower cephalic index, and higher and narrower faces (lower facial index). Calcium concentrations in drinking water did not correlate significantly with any dependent variable. A significant effect of environmental factors on body height and craniofacial variability was found in Croatian young adult population. This effect was more pronounced in females, revealing sex-specific craniofacial differentiation. However, the impact of environment was low and may explain only 1.0-7.32% variation of the investigated traits.

  10. Head circumference growth reference charts of children younger than 7 years in Chinese rural areas.

    PubMed

    Xie, Shengnan; Shi, Junxin; Wang, Jianmin; Li, Neng; Yang, Senbei; Zhang, Jing

    2014-12-01

    The head circumference growth reference charts for children in China are presently based on urban children. However, the references may not apply to rural children because of the differences between urban and rural areas, such as economy, culture, and dietary habits. Our objective was to provide a reliable continuous set of head circumference growth reference charts for male and female children less than 7 years of age in Chinese rural areas. Children in our study were identified by multistage stratified cluster sampling from rural areas of 10 provinces in China. Questionnaire survey and anthropometric measurements were conducted in data collection. Head circumference was measured with a nonelastic tape on a line passing over the glabella and posterior occipital protrusion in children. We compared the fiftieth percentile of our cross-sectional data with the data of Chinese cities, World Health Organization, and the United States. A total of 95,904 children (48,722 boys and 47,182 girls) were included in the study. We present age- and sex-appropriate head circumference growth charts younger than 7 years for Chinese rural areas. The head circumference percentiles of the children in rural China are much smaller than the children in Chinese urban areas, World Health Organization, and the US percentiles after 2 years old. Head circumference percentiles can be applied in growth monitoring, but current head circumference growth references promulgated in urban China may not be suitable for rural areas in China. Providing head circumference growth reference charts for rural Chinese children who are younger than 7 years old is very important. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Head circumference growth reference charts for Turkish children aged 0-84 months.

    PubMed

    Elmali, Ferhan; Altunay, Canan; Mazicioglu, Mümtaz M; Kondolot, Meda; Ozturk, Ahmet; Kurtoglu, Selim

    2012-05-01

    This study sought to produce updated head circumference references in a representative population of Turkish children aged 0 to <84 months. Head circumference measurements are very important in monitoring child growth, to evaluate macrocephaly and microcephaly. Primary sampling units involved family health centers in the city center and suburbs of Kayseri. In total, 2989 children (1479 boys and 1510 girls) were included. Head circumference was measured with a nonelastic tape on a line passing over the glabella and posterior occipital protrusion in children aged 0-2 years lying on a bed, and children aged more than 2 years standing up. We compared the 50th percentile of our cross-sectional data with longitudinal Belgian and American data. The comparison indicated that Turkish head circumference percentiles were similar to, or not much lower than, Belgian and American percentiles. Head circumference percentiles can be used to evaluate children with microcephaly and macrocephaly (±2 standard deviations), and to monitor growth. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Normative data for penile length in Turkish newborns.

    PubMed

    Kutlu, Alev Oğuz

    2010-01-01

    Local normative data for penile size will aid physicians in clinical practice. There are no studies on stretched penile length (SPL) in newborn Turkish boys. To establish normative data for SPL of newborn Turkish boys and compare these with data from different countries. 514 newborn Turkish boys, who were not small for gestational age (SGA) or premature, were included in this cross-sectional study. SPLs of the newborns were measured by the same investigator. The correlations between SPL and gestational age, weight, length, and head circumference were evaluated. The 3(rd) percentile value for SPL was found as 3.00 cm in these Turkish newborns. Positive correlations were shown between SPL and height (r=0.240, p<0.001), weight (r=0.251, p<0.001), and head circumference (r=0.235, p<0.001). Multiple linear regression analysis showed that SPL positively correlated with height and head circumference (p=0.021 and p= 0.042, respectively). This is the largest study on SPL in newborns from our country. This normative data can be used in clinical practice for defining micropenis.

  13. Correlates of head circumference growth in infants later diagnosed with autism spectrum disorders.

    PubMed

    Mraz, Krista D; Green, James; Dumont-Mathieu, Thyde; Makin, Sarah; Fein, Deborah

    2007-06-01

    Previous research has demonstrated that children diagnosed with autism spectrum disorder show an abnormal acceleration of head growth during the first year of life. This study attempts to replicate these findings and to determine whether overgrowth is associated with clinical outcome. Measurements of head circumference, body length, and body weight taken during the first 2 years of life were obtained from a sample of 35 children diagnosed with autism spectrum disorder and compared to both national normative data (Centers for Disease Control and Prevention) and a control group of 37 healthy infants. Results demonstrated that compared to national averages, infants who were later diagnosed with autism spectrum disorder had a significantly smaller head circumference at birth to 2 weeks and a significantly larger head circumference by 10 to 14 months. Children with autism spectrum disorder were also significantly longer and heavier beginning at 1 to 2 months. However, when overall length and weight were controlled, head circumference was not bigger in the autistic spectrum disorder group compared to local controls. Correlations between head circumference and clinical outcome were significant for 5 of the 30 clinical variables that were run, suggesting that there appears to be no simple or straightforward relationship between head circumference and clinical outcome. Smaller head circumference at birth to 2 weeks was associated with a greater number of symptoms related to social impairment and a greater total number of autism spectrum disorder symptoms based on the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition criteria. Larger head circumference at 15 to 25 months was also associated with a greater number of symptoms of social impairment. In addition, greater head circumference change during the first 2 years was associated with poorer performance on the visual reception subtest of the Mullen Scales of Early Learning and a smaller number of stereotyped and repetitive behaviors and interests based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. These findings support previous findings of accelerated brain growth during the first year of life in autism spectrum disorder and question whether growth factors might contribute to both accelerated brain growth and overall body growth.

  14. Autism spectrum disorders: head circumference and body length at birth are both relative.

    PubMed

    Grandgeorge, Marine; Lemonnier, Eric; Jallot, Nelle

    2013-09-01

    Although the body length and weight of an infant are related to head circumference, little research on ASDs has examined these factors. Our study compared the head circumferences of neonates who were later diagnosed with ASD with a control group. Additional comparisons on morphological disproportions at birth included the head circumference-to-height and head circumference-to-weight ratios. We recruited 422 children with ASD and 153 typically developing children. Head circumference, body length and weight at birth were collected and standardized as percentile scores according to gestational age and gender. Our results revealed that genuine macrocephaly was significantly higher in children with other pervasive developmental disorders compared with the control group. This difference was not observed with regard to genuine microcephaly. Relative macrocephaly and relative microcephaly were significantly more frequent in children with autism disorder compared with the control group with regard to body length. The differences in relative macrocephaly and microcephaly, as well as in other parameters, between diagnostic subgroups suggest that the presence of several neurological mechanisms plays a role in the later expression of different phenotypes. An increased head circumference-to-body length ratio in newborns may be a factor to follow that could be related to ASD. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Associations between maternal exposure to air pollution and traffic noise and newborn's size at birth: A cohort study.

    PubMed

    Hjortebjerg, Dorrit; Andersen, Anne Marie Nybo; Ketzel, Matthias; Pedersen, Marie; Raaschou-Nielsen, Ole; Sørensen, Mette

    2016-10-01

    Maternal exposure to air pollution and traffic noise has been suggested to impair fetal growth, but studies have reported inconsistent findings. Objective To investigate associations between residential air pollution and traffic noise during pregnancy and newborn's size at birth. From a national birth cohort we identified 75,166 live-born singletons born at term with information on the children's size at birth. Residential address history from conception until birth was collected and air pollution (NO2 and NOx) and road traffic noise was modeled at all addresses. Associations between exposures and indicators of newborn's size at birth: birth weight, placental weight and head and abdominal circumference were analyzed by linear and logistic regression, and adjusted for potential confounders. In mutually adjusted models we found a 10μg/m(3) higher time-weighted mean exposure to NO2 during pregnancy to be associated with a 0.35mm smaller head circumference (95% confidence interval (CI): 95% CI: -0.57; -0.12); a 0.50mm smaller abdominal circumference (95% CI: -0.80; -0.20) and a 5.02g higher placental weight (95% CI: 2.93; 7.11). No associations were found between air pollution and birth weight. Exposure to residential road traffic noise was weakly associated with reduced head circumference, whereas none of the other newborn's size indicators were associated with noise, neither before nor after adjustment for air pollution. This study indicates that air pollution may result in a small reduction in offspring's birth head and abdominal circumference, but not birth weight, whereas traffic noise seems not to affect newborn's size at birth. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Effect of head circumference on parameters of pattern reversal visual evoked potential in healthy adults of central India.

    PubMed

    Kothari, R; Singh, R; Singh, S; Bokariya, P

    2012-06-01

    Visual evoked response testing has been one of the most exciting clinical tools to be developed from neurophysiologic research in recent years and has provided us with an objective method of identifying abnormalities of the afferent visual pathways. Investigation were carried out to see whether the head circumference influence the pattern reversal visual evoked potential (PRVEP) parameters. The study comprised of pattern reversal visual evoked potential (PRVEP) recordings in 400 eyes of 200 normal subjects. Two hundred fourty eight eyes were males and 152 eyes were from 76 female subjects recruited from the Central Indian population in the age range of 40-79 years. Visual evoked potential (VEP) recordings were performed in accordance to the standardized methodology of International Federation of Clinical Neurophysiology (IFCN) Committee Recommendations and International Society for Clinical Electrophysiology of Vision (ISCEV) Guidelines and montages were kept as per 10-20 International System of EEG Electrode placements. The stimulus configuration in this study consisted of the transient pattern reversal method in which a black and white checker board was generated (full field) and displayed on a VEP Monitor by an electronic pattern regenerator inbuilt in an Evoked Potential Recorder (RMS EMG EP MARK II). VEP latencies, duration and amplitude were measured in all subjects and the data were analyzed. The correlation of all the electrophysiological parameters with head circumference was evaluated by Pearson's correlation co-efficient (r) and its statistical significance was evaluated. The prediction equations for all the VEP parameters with respect to head circumference were derived. We found a positive correlation of P 100 latency and N 155 latency with mean head circumference, while a highly significant negative correlation were noted of P 100 amplitude with head circumference. N 70 latency was significantly correlated with head circumference. P 100 duration showed in negative correlation with head circumference. These findings suggest that VEP latencies, duration and amplitude are influenced by the head circumference of the individual in a sample of healthy subjects and head circumference can be a useful predictor of VEP peak latencies, amplitude and duration.

  17. Body size and violent offending among males in the Northern Finland 1966 birth cohort.

    PubMed

    Ikäheimo, Pauliina; Räsänen, Pirkko; Hakko, Helinä; Hartikainen, Anna-Liisa; Laitinen, Jaana; Hodgins, Sheilagh; Tiihonen, Jari

    2007-10-01

    Childhood onset aggressive behavior is one of the most stable human characteristics. Previous literature indicates that this behavioral trait may be associated with body size. The present study investigated the association between body sizes at different ages and committing violent crimes in adulthood. The Northern Finland 1966 Birth Cohort includes 5636 males followed up to age 31 years prospectively. Information on criminality was extracted from official records. Body sizes were measured at birth, 12 months and 14 years of age, and compared the violent and the non-violent offenders with the non-offenders. Optimal cut-off points for each of the body size measures for the differentiation of the three groups were identified. Odds ratios were adjusted taking account of maternal age, socioeconomic status of the family of origin, mother's marital status, parity, smoking during pregnancy, gestational age and unwanted pregnancy. Both high body mass index (BMI) and small head circumference at 12 months were associated with increased risk of violent offending (adjusted ORs 1.6-1.8). High BMI at 12 months combined with small head circumference was associated with substantially increased risk of violent offending (OR 4.2, 95% CI 2.6-6.8). In males, small head circumference and large body size at 12 months of age were strongly associated with an increased risk of violent, but not non-violent offending in adulthood. The measures at 12 months were the strongest predictors, suggesting that this association may be explained by genetic or early environmental factors, rather than social learning later in childhood and adolescence.

  18. Head circumference, leg length and its association with dementia among older adult population in Singapore.

    PubMed

    Chang, Sherilyn; Ong, Hui Lin; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Jeyagurunathan, Anitha; Shafie, Saleha; Mahendran, Rathi; Subramaniam, Mythily; Chong, Siow Ann

    2017-12-01

    Head circumference and leg length serve as reliable proxy indicators of early-life environment. Research studies have shown that these anthropometric measurements are associated with cognitive impairment and dementia among older adults. The aim of the present study was to assess the associations between dementia with head circumference and leg length among the older adult population in Singapore. This study also aimed to examine the sociodemographic correlates of these anthropometric measurements. Data were collected from 2565 older adults aged 60 years and above, in a population study on the Well-being of the Singapore Elderly. Head circumference and leg length measurements were obtained, and sociodemographic information was recorded. Dementia diagnosis was made using the 10/66 dementia algorithm. Anthropometric measurements were first stratified into quarters, and then logistic regression analysis was used to examine factors associated with head circumference and leg length, as well as to examine the association between dementia with these measurements. Sociodemographic correlates of head circumference and leg length include age, gender, ethnicity and education level. Smaller head circumference was independently associated with higher odds of 10/66 dementia (OR = 2.173-2.709). When the regression analysis was stratified by gender, the association was found only in the male sample. Leg length was not significantly associated with dementia after controlling for sociodemographic variables. Smaller head circumference is independently associated with dementia among older adults in Singapore. Findings from this study suggest that risk factors for dementia begin their influence in early life. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Does superior caval vein pressure impact head growth in Fontan circulation?

    PubMed

    Trachsel, Tina; Balmer, Christian; Wåhlander, Håkan; Weber, Roland; Dave, Hitendu; Poretti, Andrea; Kretschmar, Oliver; Cavigelli-Brunner, Anna

    2016-10-01

    Patients with bidirectional cavopulmonary anastomosis have unphysiologically high superior caval vein pressure as it equals pulmonary artery pressure. Elevated superior caval vein pressure may cause communicating hydrocephalus and macrocephaly. This study analysed whether there exists an association between head circumference and superior caval vein pressure in patients with single ventricle physiology. We carried out a retrospective analysis of infants undergoing Fontan completion at our institution from 2007 to 2013. Superior caval vein pressures were measured during routine catheterisation before bidirectional cavopulmonary anastomosis and Fontan completion as well as head circumference, adjusted to longitudinal age-dependent percentiles. We included 74 infants in our study. Median ages at bidirectional cavopulmonary anastomosis and Fontan were 4.8 (1.6-12) and 27.9 (7-40.6) months, respectively. Head circumference showed significant growth from bidirectional cavopulmonary anastomosis until Fontan completion (7th (0-100th) versus 20th (0-100th) percentile). There was no correlation between superior caval vein pressure and head circumference before Fontan (R2=0.001). Children with lower differences in superior caval vein pressures between pre-bidirectional cavopulmonary anastomosis and pre-Fontan catheterisations showed increased growth of head circumference (R2=0.19). Patients with moderately elevated superior caval vein pressure associated with single ventricle physiology did not have a tendency to develop macrocephaly. There is no correlation between superior caval vein pressure before Fontan and head circumference, but between bidirectional cavopulmonary anastomosis and Fontan head circumference increases significantly. This may be explained by catch-up growth of head circumference in patients with more favourable haemodynamics and concomitant venous pressures in the lower range. Further studies with focus on high superior caval vein pressures are needed to exclude or prove a correlation.

  20. Brief Report: Cognitive Correlates of Enlarged Head Circumference in Children with Autism.

    ERIC Educational Resources Information Center

    Deutsch, Curtis K.; Joseph, Robert M.

    2003-01-01

    A study examined the frequency and cognitive correlates of enlarged head circumference in 63 children with autism (ages 4-14). Macrocephaly occurred at a significantly higher frequency. Children with discrepantly high nonverbal abilities had a mean standardized head circumference that was more than 1 standard deviation greater than the reference…

  1. Early biometric lag in the prediction of small for gestational age neonates and preeclampsia.

    PubMed

    Schwartz, Nadav; Pessel, Cara; Coletta, Jaclyn; Krieger, Abba M; Timor-Tritsch, Ilan E

    2011-01-01

    An early fetal growth lag may be a marker of future complications. We sought to determine the utility of early biometric variables in predicting adverse pregnancy outcomes. In this retrospective cohort study, the crown-rump length at 11 to 14 weeks and the head circumference, biparietal diameter, abdominal circumference, femur length, humerus length, transverse cerebellar diameter, and estimated fetal weight at 18 to 24 weeks were converted to an estimated gestational age using published regression formulas. Sonographic fetal growth (difference between each biometric gestational age and the crown-rump length gestational age) minus expected fetal growth (number of days elapsed between the two scans) yielded the biometric growth lag. These lags were tested as predictors of small for gestational age (SGA) neonates (≤10th percentile) and preeclampsia. A total of 245 patients were included. Thirty-two (13.1%) delivered an SGA neonate, and 43 (17.6%) had the composite outcome. The head circumference, biparietal diameter, abdominal circumference, and estimated fetal weight lags were identified as significant predictors of SGA neonates after adjusted analyses (P < .05). The addition of either the estimated fetal weight or abdominal circumference lag to maternal characteristics alone significantly improved the performance of the predictive model, achieving areas under the curve of 0.72 and 0.74, respectively. No significant association was found between the biometric lag variables and the development of preeclampsia. Routinely available biometric data can be used to improve the prediction of adverse outcomes such as SGA. These biometric lags should be considered in efforts to develop screening algorithms for adverse outcomes.

  2. A study on causes and types of abnormal increase in infants' head circumference in kashan/iran.

    PubMed

    Talebian, Ahmad; Soltani, Babak; Moravveji, Alireza; Salamati, Ladan; Davami, Majid

    2013-01-01

    Head circumference is a valuable index of brain growth and its disturbances can indicate different disorders of nervous system. Abnormal increased head circumference (macrocephaly) is common and observed in about 2% of infants. In this study, the causes and clinical types of abnormal increase in infants' head circumference were investigated in Kashan, Iran. This cross-sectional study was performed on 90 infants less than 2 years of age with abnormal increase in head circumference in Kashan, during 2009- 2011. The data were collected by history taking, physical examination, growth chart, and imaging. 65 (72%) cases out of 90 infants were male and 25 ( 28%) cases were female. Fifty-three (58.8%) cases had familial megalencephaly, 30 (33.4%) had hydrocephalus, and other causes were observed in 7 (7.8%) cases. Eighty-three percent of Infants with familial megalencephaly and 50% with hydrocephalus had normal fontanels. In 90.6% of cases with familial megalencephaly, family history for large head was positive. Motor development was normal in 100% of cases with familial megalencephaly and 76.7% of hydrocephalic infants. Familial megalencephaly was the most common cause of macrocephaly in the studied infants, and most of them had normal physical examination and development, so, parental head circumferences should be considered in the interpretation of infant's head circumference and in cases of abnormal physical examination or development, other diagnostic modalities, including brain imaging should be done.

  3. The association between weight, height, and head circumference reconsidered.

    PubMed

    Scheffler, Christiane; Greil, Holle; Hermanussen, Michael

    2017-05-01

    Under normal nutritional and health conditions, body height, weight and head circumference are significantly related. We hypothesize that the apparent general association between weight, height, and head circumference of the growing child might be misleading. We reanalyzed data of 7,444 boys and 7,375 girls measured in East-Germany between 1986 and 1990, aged from 0 to 7 y with measurements of body length/height, leg length, sitting height, biacromial shoulder breadth, thoracic breadth, thoracic depth, thoracic circumference, body weight, head volume, percentage of body fat, and hip skinfold vertical, using principal component analysis. Strong associations exist between skeletal growth, fat accumulation, and head volume increments. Yet in spite of this general proportionality, skeletal growth, fat acquisition, and head growth exhibit different patterns. Three components explain between almost 60% and more than 75% of cumulative variance between birth and age 7 y. Parameters of skeletal growth predominantly load on the first component and clearly separate from indicators of fat deposition. After age of 2 y, head volume loads on a separate third component in both sexes indicating independence of head growth. Under appropriate nutritional and health circumstances, nutritional status, body size, and head circumference are not related.

  4. Sensory Impairment and Head Circumference in Fragile X Syndrome, Down Syndrome and Idiopathic Intellectual Disability.

    ERIC Educational Resources Information Center

    Turk, Jeremy; Patton, Michael

    2000-01-01

    Eighteen boys with fragile X syndrome were compared with 42 with idiopathic intellectual disability, and 45 with Down syndrome. Boys with Down syndrome had more sensory problems and smaller head circumferences than normal. Head circumferences of boys with fragile X syndrome and with idiopathic intellectual disability were larger than normal.…

  5. Alternative metrics for real-ear-to-coupler difference average values in children.

    PubMed

    Blumsack, Judith T; Clark-Lewis, Sandra; Watts, Kelli M; Wilson, Martha W; Ross, Margaret E; Soles, Lindsey; Ennis, Cydney

    2014-10-01

    Ideally, individual real-ear-to-coupler difference (RECD) measurements are obtained for pediatric hearing instrument-fitting purposes. When RECD measurements cannot be obtained, age-related average RECDs based on typically developing North American children are used. Evidence suggests that these values may not be appropriate for populations of children with retarded growth patterns. The purpose of this study was to determine if another metric, such as head circumference, height, or weight, can be used for prediction of RECDs in children. Design was a correlational study. For all participants, RECD values in both ears, head circumference, height, and weight were measured. The sample consisted of 68 North American children (ages 3-11 yr). Height, weight, head circumference, and RECDs were measured and were analyzed for both ears at 500, 750, 1000, 1500, 2000, 3000, 4000, and 6000 Hz. A backward elimination multiple-regression analysis was used to determine if age, height, weight, and/or head circumference are significant predictors of RECDs. For the left ear, head circumference was retained as the only statistically significant variable in the final model. For the right ear, head circumference was retained as the only statistically significant independent variable at all frequencies except at 2000 and 4000 Hz. At these latter frequencies, weight was retained as the only statistically significant independent variable after all other variables were eliminated. Head circumference can be considered as a metric for RECD prediction in children when individual measurements cannot be obtained. In developing countries where equipment is often unavailable and stunted growth can reduce the value of using age as a metric, head circumference can be considered as an alternative metric in the prediction of RECDs. American Academy of Audiology.

  6. In utero Head Circumference is Associated with Childhood Allergy.

    PubMed

    Eviston, David P; Minasyan, Anna; Mann, Kristy P; Campbell, Dianne E; Nanan, Ralph K

    2015-01-01

    Altered fetal growth is known to be associated with allergic disease. Specifically, increased head circumference at birth has been linked to asthma and elevated IgE. However, few studies have examined a link between early fetal anthropometry and allergic disease. The aim of this study was to examine head circumference at mid-gestation in children diagnosed with allergy. This was a retrospective cohort study, comprising pregnancies delivered between 10/2006 and 9/2010 at Nepean Hospital, Australia. Exclusion criteria were illegal drug use, alcohol consumption, gestation <35 weeks, and gestational hypertension. Pregnancy data were sourced from the Nepean Obstetric Database. Atopic diseases (asthma, atopic dermatitis, and IgE-mediated food allergy) were assessed by questionnaire at age 1-5 years. Infants from pregnancies with completed questionnaires, who also had a mid-gestation ultrasound scan, were included (N = 121). Multiple logistic regression techniques were used to model head circumference against the development of allergies. Smaller head circumference at mid-gestation was associated with increased odds of allergic disease in children aged 1-5 years. A 1 mm smaller head circumference was associated with a 7% increased chance of allergies being later diagnosed, adjusted for gestation (95% CI: 1-14%, p = 0.036). Head circumference at mid-gestation was also inversely correlated with the presence of multiple atopic disease. Smaller mid-gestational head circumference is associated with early childhood allergic disease, which suggests that fetal programing of allergic disease occurs before mid-gestation. This suggests that mediators such as brain-derived neurotrophic factor may be dysregulated early in utero in a milieu, which also predisposes to atopic disease.

  7. The influence of fetal head circumference on labor outcome: a population-based register study.

    PubMed

    Elvander, Charlotte; Högberg, Ulf; Ekéus, Cecilia

    2012-04-01

    To investigate the association between postnatal head circumference and the occurrence of the three main indications for instrumental delivery, namely prolonged labor, signs of fetal distress and maternal distress. We also studied the association between postnatal fetal head circumference and the use of vacuum extraction and emergency cesarean section. Population-based register study. Nationwide study in Sweden. A total of 265 456 singleton neonates born to nulliparous women at term between 1999 and 2008 in Sweden. Register study with data from the Swedish Medical Birth Register. Prolonged labor, signs of fetal distress, maternal distress, use of vacuum extraction and emergency cesarean section. The prevalence of each outcome increased gradually as the head circumference increased. Compared with women giving birth to a neonate with average size head circumference (35 cm), women giving birth to an infant with a very large head circumference (39-41 cm) had significantly higher odds of being diagnosed with prolonged labor [odds ratio (OR) 1.49, 95% confidence interval (CI) 1.33-1.67], signs of fetal distress (OR 1.73, 95% CI 1.49-2.03) and maternal distress (OR 2.40, 95% CI 1.96-2.95). The odds ratios for vacuum extraction and cesarean section were thereby elevated to 3.47 (95% CI 3.10-3.88) and 1.22 (95% CI 1.04-1.42), respectively. The attributable risk proportion percentages associated with vacuum extraction and cesarean section were 46 and 39%, respectively among the cases exposed to a head circumference of 37-41 cm. Large fetal head circumference is associated with complicated labor and is etiological to a considerable proportion of assisted vaginal births and emergency cesarean sections. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  8. Head circumference, apolipoprotein E genotype and cognition in the Bavarian School Sisters Study.

    PubMed

    Perneczky, R; Alexopoulos, P; Wagenpfeil, S; Bickel, H; Kurz, A

    2012-04-01

    The apolipoprotein E (APOE) ɛ4 allele is correlated with an earlier onset of Alzheimer's disease symptoms; larger head circumference has been associated with an individual resilience against cognitive impairment. We explored if larger head circumference attenuates the effect of the APOE ɛ4 allele on cognition in 380 Catholic sisters covering the spectrum from normal cognitive performance to severe dementia. Linear regression analysis, adjusting for risk factors for cognitive decline, revealed that APOE ɛ4 was correlated with worse cognition and that larger head circumference attenuated the negative effect of the ɛ4 allele on cognitive performance. Larger head circumference (i.e. larger brain size) seems to be associated with greater resilience against genetic determinants of cognitive impairment, possibly due to enhanced brain or cognitive reserve. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  9. Geographical variation in neonatal phenotype

    PubMed Central

    Leary, Sam; Fall, Caroline; Osmond, Clive; Lovel, Hermione; Campbell, Doris; Eriksson, Johan; Forrester, Terrence; Godfrey, Keith; Hill, Jacqui; Jie, Mi; Law, Catherine; Newby, Rachel; Robinson, Sian; Yajnik, Chittaranjan

    2009-01-01

    Background Recent studies have shown associations between size and body proportions at birth and health outcomes throughout the life cycle, but there are few data on how neonatal phenotype varies in different populations around the world. Methods Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria and Jamaica (N=22 067) were used to characterise geographical differences in phenotype in singleton, liveborn newborns. Measurements included birthweight, placental weight, length, head, chest, abdominal and arm circumferences and skinfolds. Results Neonates in Europe were the largest, followed by Jamaica, East Asia (China), then Africa and South Asia. Birthweight varied widely (mean values 2730g to 3570g), but in contrast, head circumference was similar in all except China (markedly smaller). The main difference in body proportions between populations was the head to length ratio, with small heads relative to length in China and large heads relative to length in South Asia and Africa. Conclusions These marked geographical differences in neonatal phenotype need to be considered when investigating determinants of fetal growth, and optimal phenotype for short-term and long-term outcomes. PMID:16929412

  10. Growth chart

    MedlinePlus

    ... while standing up in children over age 3) Head circumference , a measurement of the head size taken by ... carefully. Alternative Names Height and weight chart Images Head circumference Height/weight chart References Cooke DW, Dival SA, ...

  11. Supine Length, Weight and Head Circumference at Birth in Central Iran

    ERIC Educational Resources Information Center

    Ayatollahi, S. M. T.; Rafiei, Mohammad

    2007-01-01

    Supine length, weight and head circumferences of 10,241 neonates (5241 boys, 5000 girls, sex ratio 105) born in Arak (central Iran) in 2004 are reported. The mean plus or minus standard deviation of boys' and girls' (p value for sex difference) supine length (mm), weight (g) and head circumference (mm) were estimated as 501 plus or minus 30 and…

  12. Decreased head circumference in shunt-treated compared with healthy children.

    PubMed

    Nilsson, Daniel; Svensson, Johanna; Korkmaz, Betül A; Nelvig, Helena; Tisell, Magnus

    2013-11-01

    In this study, the authors' goal was to compare head circumference in hydrocephalic children during the first 4 years of ventriculoperitoneal (VP) shunt treatment with data on healthy children and to investigate predictors of skull growth in children with a VP shunt. Children from western Sweden treated for hydrocephalus with an initial VP shunt insertion performed between 2001 and 2006 who were younger than 12 months of age at the time of surgery were included. Children with major brain malformations, craniofacial syndromes, large cysts, and tumors were excluded. Head circumference, weight, and height at 9 defined ages up to 4 years were obtained and compared with data from a reference population of 3650 healthy children using the standard deviation score (SDS). Predictors (length, weight, etiology of hydrocephalus, valve type, number of revisions, valve setting, number of adjustments, and time of first surgery) for head circumference SDS and changes in head circumference SDS from shunt insertion at 1 year to last measurement were analyzed using bivariate and multiple linear regression analysis. Fifty children were included. The mean SDSs for head circumference in shunt-treated compared with healthy children were 1.95 ± 2.50 at shunt insertion (p < 0.001, n = 44), 0.38 ± 1.97 at 1 year (p = 0.27, n = 33), -0.96 ± 2.05 at 2 years (p = 0.046, n = 21), -1.39 ± 2.25 at 3 years (p = 0.026, n = 16), and 0.63 ± 3.34 at 4 years (p = 0.73, n = 4). Significant predictors for low head circumference SDS at 1 year of age were low weight (p = 0.002) and short height (p = 0.022) and at last measurement low weight (p < 0.0001), short height (p = 0.002), and 1-4 shunt revisions (p = 0.034). A significant predictor for change in head circumference SDS from shunt insertion to 1 year of age was the number of shunt valve revisions (p = 0.04) and at last measurement an etiology of intraventricular hemorrhage (p = 0.0058). Shunt-treated children have smaller head circumferences at 2 and 3 years of age than healthy children. Low weight, short height, etiology of intraventricular hemorrhage, and frequent shunt valve revisions are predictors for decreased head circumference. Prospective, randomized studies comparing skull growth using fixed and adjustable pressure-regulated shunt valves and flow-regulated valves are needed.

  13. Altered Growth Trajectory of Head Circumference During Infancy and Schizophrenia in a National Birth Cohort

    PubMed Central

    Brown, Alan S.; Gyllenberg, David; Hinkka-Yli-Salomäki, Susanna; Sourander, Andre; McKeague, Ian W.

    2016-01-01

    Identification of abnormalities in the developmental trajectory during infancy of future schizophrenia cases offers the potential to reveal pathogenic mechanisms of this disorder. Previous studies of head circumference in pre-schizophrenia were limited to measures at birth. The use of growth acceleration of head circumference (defined as the rate of change in head circumference) provides a more informative representation of the maturational landscape of this measure compared to studies based on static head circumference measures. To date, however, no study has examined whether HC growth acceleration differs between pre-schizophrenia cases and controls. In the present study, we employed a nested case control design of a national birth cohort in Finland. Cases with schizophrenia or schizoaffective disorder (N=375) and controls (N=375) drawn from the birth cohort were matched 1:1 on date of birth (within 1 month), sex, and residence in Finland at case diagnosis. Longitudinal data were obtained on head circumference from birth through age 1. Data were analyzed using a new nonparametric Bayesian inversion method which allows for a detailed understanding of growth dynamics. Adjusting for growth velocity of height and weight, and gestational age, there was significantly accelerated growth of head circumference in females with schizophrenia from birth to 2 months; the findings remained significant following Bonferroni correction (p < 0.0125). This is the first study to report abnormal HC growth acceleration, a more sensitive measure of somatic developmental deviation of this measure, in schizophrenia. PMID:27818077

  14. Infant head circumference growth is saltatory and coupled to length growth.

    PubMed

    Lampl, Michelle; Johnson, Michael L

    2011-05-01

    Rapid growth rates of head circumference and body size during infancy have been reported to predict developmental pathologies that emerge during childhood. This study investigated whether growth in head circumference was concordant with growth in body length. Forty infants (16 males) were followed between the ages of 2 days and 21 months for durations ranging from 4 to 21 months (2616 measurements). Longitudinal anthropometric measurements were assessed weekly (n=12), semi-weekly (n=24) and daily (n=4) during home visits. Individual head circumference growth was investigated for the presence of saltatory patterns. Coincident analysis tested the null hypothesis that head growth was randomly coupled to length growth. Head circumference growth during infancy is saltatory (p<0.05), characterized by median increments of 0.20 cm (95% confidence interval, 0.10-0.30 cm) in 24-h, separated by intervals of no growth ranging from 1 to 21 days. Daily assessments identified that head growth saltations were coupled to length growth saltations within a median time frame of 2 days (interquartile 0-4, range 1-8 days). Assessed at semi-weekly and weekly intervals, an average 82% (SD 0.13) of head growth saltations was non-randomly concordant with length growth (p≤0.006). Normal infant head circumference grows by intermittent, episodic saltations that are temporally coupled to growth in total body length by a process of integrated physiology that remains to be described. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Vacuum extraction failure is associated with a large head circumference.

    PubMed

    Kabiri, Doron; Lipschuetz, Michal; Cohen, Sarah M; Yagel, Oren; Levitt, Lorinne; Herzberg, Shmuel; Ezra, Yossef; Yagel, Simcha; Amsalem, Hagai

    2018-04-24

    To determine whether large head circumference increases the risk of vacuum extraction failure. This EMR-based study included all attempted vacuum extractions performed in a tertiary center between January 2010 and June 2015. All term singleton live births were eligible. Cases were divided into four groups: head circumference ≥90th percentile both with birth weight ≥90th percentile and <90th percentile and fetal head circumference <90th percentile with birth weight ≥90th and <90th percentile. Risk of failed vacuum extraction was compared among these groups. Other neonatal and maternal parameters were also evaluated as potential risk factors. Multinomial multivariable regression provided adjusted odds ratio for vacuum extraction failure while controlling for potential confounders. During the study period, 48,007 deliveries met inclusion criteria, of which 3835 had an attempt at vacuum extraction. We identified 215 (5.6%) cases of vacuum extraction failure. The adjusted odds ratios (aOR) for vacuum extraction failure in cases of large fetal head circumference was 2.31 (95%CI, 1.7-3.15, p < .001). Primiparity, prolonged second stage and occipito-posterior presentation were also found to be significant risk factors for failed vacuum extraction. In this study, we found that large head circumference was associated with vacuum extraction failure rather than high birth weight.

  16. 15 CFR 241.5 - Standard dimensions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 133/8 115/8 Distance between heads 231/2 201/2 18 Circumference of bulge, outside measurement 581/2.../8 11 Distance between heads 23 20 171/2 Circumference of bulge, outside measurement 533/8 47 413/8... head 171/8 161/4 Effective diameter of head (see § 241.4) 163/4 157/8 Distance between heads 26 251/4...

  17. 15 CFR 241.5 - Standard dimensions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 133/8 115/8 Distance between heads 231/2 201/2 18 Circumference of bulge, outside measurement 581/2.../8 11 Distance between heads 23 20 171/2 Circumference of bulge, outside measurement 533/8 47 413/8... head 171/8 161/4 Effective diameter of head (see § 241.4) 163/4 157/8 Distance between heads 26 251/4...

  18. 15 CFR 241.5 - Standard dimensions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 133/8 115/8 Distance between heads 231/2 201/2 18 Circumference of bulge, outside measurement 581/2.../8 11 Distance between heads 23 20 171/2 Circumference of bulge, outside measurement 533/8 47 413/8... head 171/8 161/4 Effective diameter of head (see § 241.4) 163/4 157/8 Distance between heads 26 251/4...

  19. 15 CFR 241.5 - Standard dimensions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 133/8 115/8 Distance between heads 231/2 201/2 18 Circumference of bulge, outside measurement 581/2.../8 11 Distance between heads 23 20 171/2 Circumference of bulge, outside measurement 533/8 47 413/8... head 171/8 161/4 Effective diameter of head (see § 241.4) 163/4 157/8 Distance between heads 26 251/4...

  20. 15 CFR 241.5 - Standard dimensions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 133/8 115/8 Distance between heads 231/2 201/2 18 Circumference of bulge, outside measurement 581/2.../8 11 Distance between heads 23 20 171/2 Circumference of bulge, outside measurement 533/8 47 413/8... head 171/8 161/4 Effective diameter of head (see § 241.4) 163/4 157/8 Distance between heads 26 251/4...

  1. Altered growth trajectory of head circumference during infancy and schizophrenia in a National Birth Cohort.

    PubMed

    Brown, Alan S; Gyllenberg, David; Hinkka-Yli-Salomäki, Susanna; Sourander, Andre; McKeague, Ian W

    2017-04-01

    Identification of abnormalities in the developmental trajectory during infancy of future schizophrenia cases offers the potential to reveal pathogenic mechanisms of this disorder. Previous studies of head circumference in pre-schizophrenia were limited to measures at birth. The use of growth acceleration of head circumference (defined as the rate of change in head circumference) provides a more informative representation of the maturational landscape of this measure compared to studies based on static head circumference measures. To date, however, no study has examined whether HC growth acceleration differs between pre-schizophrenia cases and controls. In the present study, we employed a nested case control design of a national birth cohort in Finland. Cases with schizophrenia or schizoaffective disorder (N=375) and controls (N=375) drawn from the birth cohort were matched 1:1 on date of birth (within 1month), sex, and residence in Finland at case diagnosis. Longitudinal data were obtained on head circumference from birth through age 1. Data were analyzed using a new nonparametric Bayesian inversion method which allows for a detailed understanding of growth dynamics. Adjusting for growth velocity of height and weight, and gestational age, there was significantly accelerated growth of head circumference in females with schizophrenia from birth to 2months; the findings remained significant following Bonferroni correction (p<0.0125). This is the first study to report abnormal HC growth acceleration, a more sensitive measure of somatic developmental deviation of this measure, in schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Effects of head circumference and metabolic syndrome on cognitive decline.

    PubMed

    Lee, Kang Soo; Eom, Jin-Sup; Cheong, Hae-Kwan; Oh, Byoung Hoon; Hong, Chang Hyung

    2010-01-01

    Brain volume progressively decreases with an increase in atrophy, and the brain becomes more susceptible to degenerative brain diseases such as Alzheimer's disease. Metabolic syndrome has also been associated with an increased risk of cognitive decline in the elderly. In this study, we aimed to examine the effects of head circumference and metabolic syndrome on cognitive decline. This study was part of a longitudinal study conducted on Koreans aged 60 years or older. We analyzed a final sample of 596 Korean participants with complete baseline and 2-year follow-up data. The cognitive function of the subjects was assessed using the Korean version of the Mini Mental State Examination (MMSE). Head circumference was measured from the glabella to the occipital protuberance using a measuring tape. Metabolic syndrome was defined according to the NCEP-ATP III standards. Central obesity was assessed on the basis of waist-circumference values, in accordance with the World Health Organization Western Pacific Region report on Asians. We used a longitudinal factorial design in which the MMSE score was the dependent variable, and head circumference and metabolic syndrome were considered as factors. After adjusting the results for age, gender, education, height, weight, baseline MMSE, and number of follow-up years, we observed that smaller head circumference and the presence of metabolic syndrome were independently associated with rapid cognitive decline. All these findings suggest that smaller head circumference and the presence of metabolic syndrome have additive effects on cognitive decline. Copyright 2009 S. Karger AG, Basel.

  3. Normative data for IQ, height and head circumference for children in Saudi Arabia.

    PubMed

    Batterjee, Adel A; Khaleefa, Omar; Ashaer, Khalil; Lynn, Richard

    2013-07-01

    Normative data are reported for intelligence, height and head circumference for a sample of 1553 6- to 15-year-olds in Saudi Arabia, and for the correlations between these variables. Intelligence was tested with the Standard Progressive Matrices, on which the Saudi sample obtained a British IQ of 76.2. There were no significant differences in means between boys and girls and differences in variability were inconsistent. The heights of the Saudi sample were generally lower than those of the American norms. The differences in head circumferences between the Saudi children and the American norms were inconsistent. Correlations between IQ and height were weaker than those found in other studies but correlations between IQ and head circumference were positive.

  4. Down Syndrome: Gestational Age-Related Neonatal Anthropometrics for Germany.

    PubMed

    Hoffmann, Paul F; Jung, Anna-Maria; Stierkorb, Eva; Monz, Dominik; Gortner, Ludwig; Rohrer, Tilman R

    2016-01-01

    Neonates with Down syndrome (DS) weigh less, are smaller and have increased first-year mortality, especially if born small for gestational age (GA). DS-specific GA-related neonatal anthropometrics for Germany are lacking. To construct reference tables and centile curves for birth weight (g), crown-heel length (cm) and head circumference (cm) by sex and GA for German DS neonates. Retrospective anthropometric data from live-born singleton DS neonates born in Germany from January 1966 to June 2010 were collected using standardized questionnaires and patient records. Reference tables were created based on means and standard deviations. The 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile curves were constructed and smoothed using running medians and Cole's LMS method. Anthropometric measurements were obtained for 1,304 DS neonates [males/females: 713/591 (54.7%/45.3%)]. Reference tables and centile charts were constructed from 3,542 (males/females: 1,932/1,610) observations for GA 32-41 weeks. Compared with general-population newborns, prematurity was increased (21.1 vs. 6.3%) at GA 32-36 weeks. Term-born (GA 40 weeks) male and female DS neonates were 352.5 and 223.5 g lighter and 1.5 and 1.4 cm smaller than general-population neonates, and head circumference was also 1.4 and 1.5 cm smaller, respectively. This is the first study to report GA-related, sex-specific reference tables and centile charts of birth weight, length and head circumference for DS neonates born in Germany. Compared with the general German population, DS newborns are more frequently born prematurely, weigh less, are smaller and have a smaller head circumference at birth. © 2016 S. Karger AG, Basel.

  5. Retarded head growth and neurocognitive development in infants of mothers with a history of eating disorders: longitudinal cohort study.

    PubMed

    Koubaa, S; Hällström, T; Hagenäs, L; Hirschberg, A L

    2013-10-01

    To characterise early growth and neurocognitive development in children of mothers with a history of eating disorders (ED). A longitudinal cohort study. Child-care centres in Stockholm, Sweden. Children born to mothers with previous ED (n = 47) (24 anorexia nervosa, 20 bulimia nervosa, 3 unspecified ED), and controls (n = 65). Mean values and standard deviation scores of weight and height from birth to 5 years of age and head circumference up to 18 months of age were compared between groups. Neurocognitive development was studied at the age of 5 years by the validated parent questionnaire Five to Fifteen. Head growth and neurocognitive development. We previously reported that mothers with a history of ED conceived infants with lower birthweight and head circumference than controls. At 3 months of age, body mass index (BMI) was no longer reduced but mean head circumferences of the children born to mothers with ED were smaller throughout the observation period. Similarly, the longitudinal results of the standard deviation scores of head circumference showed a significant overall group effect with lower levels in both subgroups of ED (anorexia nervosa and bulimia nervosa). The children of the ED mothers also had significantly higher Five to Fifteen scores than controls, reflecting difficulties in language skills. Head circumference at birth correlated with language skills in the children of mothers with ED. Children of mothers with previous ED demonstrated an early catch-up in BMI, but the average head circumference continued to be delayed until at least 18 months of age. The reduced head growth was related to delayed neurocognitive development. © 2013 RCOG.

  6. Is neonatal head circumference related to caesarean section for failure to progress?

    PubMed

    de Vries, Bradley; Bryce, Bianca; Zandanova, Tatiana; Ting, Jason; Kelly, Patrick; Phipps, Hala; Hyett, Jon A

    2016-12-01

    There is global concern about rising caesarean section rates. Identification of risk factors could lead to preventative measures. To describe the association between neonatal head circumference and (i) caesarean section for failure to progress, (ii) intrapartum caesarean section overall. This was a retrospective cohort study of 11 687 singleton live births with cephalic presentation, attempted vaginal birth and at least 37 completed weeks gestation from January 2005 to June 2009. Neonatal head circumference was grouped into quartiles and multiple logistic regressions performed. The rates of caesarean section for failure to progress were 4.1, 6.4, 8.8 and 14.3% in successive head circumference quartiles. Rates of intrapartum caesarean section overall were 8.7, 12.1, 15.8 and 21.5%. The odds ratios for caesarean section for failure to progress were: 1.00, 1.33 (95% CI 1.02- 1.73), 1.54 (1.18-2.02) and 1.93 (1.44-2.57) for successive head circumference quartiles after adjusting for multiple demographic and clinical factors. The adjusted odds ratios for intrapartum caesarean section for any indication were: 1.00, 1.52 (95% CI 1.24-1.87), 1.99 (1.62-2.46) and 2.38 (1.89-3.00), respectively. There is a strong positive relationship between head circumference quartile and both caesarean section for failure to progress and caesarean for any indication. If this finding is confirmed using ultrasound measurements, there is potential for head circumference to be incorporated into predictive models for intrapartum caesarean section with a view to offering interventions to reduce the risk of caesarean section. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  7. Head circumference and body growth in autism spectrum disorders.

    PubMed

    Fukumoto, Aya; Hashimoto, Toshiaki; Mori, Kenji; Tsuda, Yoshimi; Arisawa, Kokichi; Kagami, Shoji

    2011-08-01

    Research has shown that there is a relationship between increased head circumference and autism spectrum disorders (ASD). This study examined this relationship during the first year of life in subjects with ASD. We compared 280 children with ASD and 609 controls. In the ASD-male group, increases were observed in head circumference from 3 to 12months, in height from 3 to 9months, and in body weight from 3 to 6 and 12months. On the other hand, in the ASD-female group increases in head circumference, in body height, and in body weight were only observed at 3months. After adjusting for height, weight, and age, only the head circumference in the male ASD group was significantly increased from 6 to 9months after birth, reaching a peak at 6months after birth. No difference was found in the female ASD group. Although body overgrowth in the ASD group also started early after birth, the increase in head circumference was more marked than that in body growth. The values of physical measurements in the first year may be useful, minimally invasive parameters for the early detection of autism in combination with observing the timing of certain behaviors such as smiling, eye contact, crawling, pointing, and joint attention. Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  8. Association of birthweight and head circumference at birth to cognitive performance in 9- to 10-year-old children in South India: prospective birth cohort study.

    PubMed

    Veena, Sargoor R; Krishnaveni, Ghattu V; Wills, Andrew K; Kurpad, Anura V; Muthayya, Sumithra; Hill, Jacqueline C; Karat, Samuel C; Nagarajaiah, Kiran K; Fall, Caroline H D; Srinivasan, Krishnamachari

    2010-04-01

    To examine whether birthweight and head circumference at birth are associated with childhood cognitive ability in South India, cognitive function was assessed using three core tests from the Kaufman Assessment Battery for children and additional tests measuring long-term retrieval/storage, attention and concentration, and visuospatial and verbal abilities among 505 full-term born children (mean age 9.7 y). In multiple linear regression adjusted for age, sex, gestation, socioeconomic status, parent's education, maternal age, parity, body mass index, height, rural/urban residence, and time of testing, Atlantis score (learning ability/long-term storage and retrieval) rose by 0.1 SD per SD increase in newborn weight and head circumference, respectively (p < 0.05 for all), and Kohs' block design score (visuospatial ability) increased by 0.1 SD per SD increase in birthweight (p < 0.05). The associations were reduced after further adjustment for current head circumference. There were no associations of birthweight and/or head circumference with measures of short-term memory, fluid reasoning, verbal abilities, and attention and concentration. In conclusion, higher birthweight and larger head circumference at birth are associated with better childhood cognitive ability. The effect may be specific to learning, long-term storage and retrieval, and visuospatial abilities, but this requires confirmation by further research.

  9. Decreased head circumference velocity as related to developmental deficit in infancy.

    PubMed

    Tal, Galit; Cohen, Ayala; Habib, Sonia; Tirosh, Emanuel

    2012-11-01

    We evaluated the significance of head circumference growth velocity as related to developmental deficits during infancy. Head circumferences, lengths, and developmental diagnoses were retrieved in a standard manner at ≥ 2 time points from 437 infants with developmental deficits, and 3909 normally developing infants. Infants' ages ranged from 1-24 months, with final diagnoses ascertained at age 24 months. Increased velocity during the first 2 months in typical infants was evident in the study group during the period 2-4 months. A differential head circumference growth velocity was observed, and infants diagnosed with motor delay presented decreased velocity between ages 2-4 months, compared with infants receiving other nonmotor developmental diagnoses. These differences remained after controlling for birth weight and length. No significant sex effect was evident. Infants with developmental deficits demonstrate delayed acceleration of head circumference velocity, compared with typical infants in the first 2 months. Infants with motor delay manifest decreased velocity, compared with infants presenting other developmental deficits. These differences may be related to delayed white matter maturation. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Growth charts for Australian children with achondroplasia.

    PubMed

    Tofts, Louise; Das, Sandeep; Collins, Felicity; Burton, Karen L O

    2017-08-01

    Achondroplasia is an autosomal dominant disorder, the most common genetic cause of short stature in humans. Reference curves for head circumference, weight, height, and BMI are needed in clinical practice but none exist for the Australian population. This study aimed to produce head circumference, height, weight, and BMI reference percentile curves for Australian children and adolescents with achondroplasia. Measurements of head circumference, height and weight taken at clinical visits were retrospectively extracted from the electronic medical record. Age was corrected for prematurity. Patients were excluded from head circumference analysis if they had significant neurosurgical complications and from the weight and BMI analysis when they had a clinical diagnosis of overweight. Measurements were available on 138 individuals (69 males and 69 females) taken between 1970 and 2015, with over 50% collected since 2005. A total of 3,352 data points were available. The LMS method was used to produce growth charts with estimated centiles (10, 25, 50, 75, and 90th) separately for males and females. For females birth weight was 3 kg (2.5-3.5 kg), birth length 48 cm (44-50 cm) and head circumference 37.5 cm (36-39 cm), adult height was 125 cm (116-132 cm), weight 42 kg (34-54 kg), and head circumference 58 cm (55.5-60.5 cm) all 50th centile (10-90th). For males birth weight was 3.5 kg (3-4 kg), length 49 cm (46-52 cm) and head circumference 38.5 cm (36-41 cm), adult height was 134 cm (125-141 cm), weight 41 kg (24.5-57 kg) and head circumference 61 cm (58-64 cm). The curves are similar to previously published reference data from the USA and have expected population wide variation from curves from an Argentinian population. Despite limitations of our curves for adolescents (12 years and older) due to data paucity, these Australian growth charts for children and adolescents with achondroplasia will be a useful reference in clinical practice. © 2017 Wiley Periodicals, Inc.

  11. Generational changes in the growth of children from Maribor and Slovenia.

    PubMed

    Bigec, Martin

    2013-05-01

    Among the numerous factors which influence a child's growth and development are also factors of changeable socio-economic environment and life style. Our aim was to evaluate these changes and contribute to preventive measures and evaluation of a child's growth in pediatric practice. Therefore, we decided to estimate the state of body growth in two generations of children from Maribor at five and six years of age of both gender, establish secular changes and define standards. On a representative sample (gender and age) of 1461 children from Maribor measured in 1996 and a sample of 608 children from Maribor, measured in 1966, 28 body features were studied and compared in each population unit. Variables were statistically and epidemiologically assessed and results were controlled by a test. The following anthropometric differences were significant: in 5-year old boys the measures in the 1996 generation are statistically higher than in 1966 - foot length, head length, upper arm skinfold, subscapular skinfold, arm length, arm diameter, upper thigh skinfold, stature (length), suprailiac skinfold, and body weight. Decreased measures are: abdomen circumference, knee circumference, sitting height, elbow circumference, biacromial diameter, and face heigth. In 6-year old boys additional features have increased in comparison with the year 1966: sternal height, tight circumference, hip width, chest circumference; following measures have decreased: face height, head circumference. In 5-year old girls: increased measures in comparison with the generation from 1966 are: lower leg length, head length, ankle circumference, upper arm skinfold, body weight, billiac diameter, body height, subscapular skinfold, chest circumference, hip circumference, sternal height, suprailiac skinfold, decreased measures are: head circumference, elbow circumference, face circumference, shoulder with, sitting height. In 6-year old girls additional measures are increased: wrist circumference, arm length and chest circumference. Changing trends show an increased tendency towards decrease or increase of most body measurements. In everyday practice the most commonly used measurements are: body mass, head circumference, body length in babies and body height in pre-school children. Our measurements proved, with a p-value of 0.001, that measurements of children in 1966, also shown in diagrams, are significantly different from measurements in 1996. In the second part of this paper we present a part of the anthropometric measurement study carried out for the standardization of the DENVER II developmental screening test. There were 1596 healthy Slovene children between zero and six and half years of age included into the observation. Children come from Maribor, Koper, Velenje and Ljubljana. We used the Cameron's measurement and statistical method. Diagrams were made for following body measures: body mass, body height, head circumference, upper arm circumference, thigh circumference and body mass index. A comparative analysis with the Euro-Growth study showed that our results correspond with the European standards. Therefore, our results are suggested to be applied in everyday pediatric practice.

  12. Free testosterone levels in umbilical-cord blood predict infant head circumference in females.

    PubMed

    Whitehouse, Andrew J O; Maybery, Murray T; Hart, Roger; Sloboda, Deborah M; Stanley, Fiona J; Newnham, John P; Hickey, Martha

    2010-03-01

    Fetal androgens influence fetal growth as well as postnatal neurocognitive ability. However, to our knowledge, no published study has prospectively examined the impact of early-life androgens on infant brain growth. We report the association between circulating fetal androgen levels, measured from umbilical-cord blood at birth, and a proxy measure of brain growth: head circumference. Participants were 82 unselected female infants from a large representative birth cohort (mean gestational age 39.4 wks, SD 1.7). Umbilical-cord blood was obtained at birth and analysed for androgen concentrations (total testosterone, androstenedione, dehyrdroepiandrosterone, and its sulphated metabolite). Head circumference and two other measures of growth - weight (mean 3311.4 g, SD 461.3) and length - were measured within 3 days of birth and again at approximately 1 year of age (mean age 13.1 mo, SD 1.1). Multivariate linear regressions found an inverse association between levels of free testosterone and growth in head circumference (correlation=-.24), even when adjusting for sociodemographic/obstetric covariates and head size at birth. Growth in weight and length could not be predicted by free testosterone concentration. This is the first report of an association between prenatal androgen levels and postnatal growth in head circumference. These findings suggest that early-life androgens may impact brain development during infancy.

  13. Common variants at 12q15 and 12q24 are associated with infant head circumference.

    PubMed

    Taal, H Rob; Pourcain, Beate St; Thiering, Elisabeth; Das, Shikta; Mook-Kanamori, Dennis O; Warrington, Nicole M; Kaakinen, Marika; Kreiner-Møller, Eskil; Bradfield, Jonathan P; Freathy, Rachel M; Geller, Frank; Guxens, Mònica; Cousminer, Diana L; Kerkhof, Marjan; Timpson, Nicholas J; Ikram, M Arfan; Beilin, Lawrence J; Bønnelykke, Klaus; Buxton, Jessica L; Charoen, Pimphen; Chawes, Bo Lund Krogsgaard; Eriksson, Johan; Evans, David M; Hofman, Albert; Kemp, John P; Kim, Cecilia E; Klopp, Norman; Lahti, Jari; Lye, Stephen J; McMahon, George; Mentch, Frank D; Müller, Martina; O'Reilly, Paul F; Prokopenko, Inga; Rivadeneira, Fernando; Steegers, Eric A P; Sunyer, Jordi; Tiesler, Carla; Yaghootkar, Hanieh; Breteler, Monique M B; Debette, Stephanie; Fornage, Myriam; Gudnason, Vilmundur; Launer, Lenore J; van der Lugt, Aad; Mosley, Thomas H; Seshadri, Sudha; Smith, Albert V; Vernooij, Meike W; Blakemore, Alexandra If; Chiavacci, Rosetta M; Feenstra, Bjarke; Fernandez-Benet, Julio; Grant, Struan F A; Hartikainen, Anna-Liisa; van der Heijden, Albert J; Iñiguez, Carmen; Lathrop, Mark; McArdle, Wendy L; Mølgaard, Anne; Newnham, John P; Palmer, Lyle J; Palotie, Aarno; Pouta, Annneli; Ring, Susan M; Sovio, Ulla; Standl, Marie; Uitterlinden, Andre G; Wichmann, H-Erich; Vissing, Nadja Hawwa; DeCarli, Charles; van Duijn, Cornelia M; McCarthy, Mark I; Koppelman, Gerard H; Estivill, Xavier; Hattersley, Andrew T; Melbye, Mads; Bisgaard, Hans; Pennell, Craig E; Widen, Elisabeth; Hakonarson, Hakon; Smith, George Davey; Heinrich, Joachim; Jarvelin, Marjo-Riitta; Jaddoe, Vincent W V

    2012-04-15

    To identify genetic variants associated with head circumference in infancy, we performed a meta-analysis of seven genome-wide association studies (GWAS) (N = 10,768 individuals of European ancestry enrolled in pregnancy and/or birth cohorts) and followed up three lead signals in six replication studies (combined N = 19,089). rs7980687 on chromosome 12q24 (P = 8.1 × 10(-9)) and rs1042725 on chromosome 12q15 (P = 2.8 × 10(-10)) were robustly associated with head circumference in infancy. Although these loci have previously been associated with adult height, their effects on infant head circumference were largely independent of height (P = 3.8 × 10(-7) for rs7980687 and P = 1.3 × 10(-7) for rs1042725 after adjustment for infant height). A third signal, rs11655470 on chromosome 17q21, showed suggestive evidence of association with head circumference (P = 3.9 × 10(-6)). SNPs correlated to the 17q21 signal have shown genome-wide association with adult intracranial volume, Parkinson's disease and other neurodegenerative diseases, indicating that a common genetic variant in this region might link early brain growth with neurological disease in later life.

  14. The diagnostic yield of ultrasound of the head in healthy infants presenting with the clinical diagnosis of benign macrocrania.

    PubMed

    Naffaa, L; Rubin, M; Stamler, A C; Haddad, M; Saade, C

    2017-01-01

    To investigate the frequency of sonographic findings that required neurosurgical consultation for all referred outpatients suspected to have benign macrocrania (BMC). A retrospective review was performed from September 2011 until June 2015 for all outpatients referred to the ultrasound (US) department for BMC. Electronic medical records, US images, and reports were reviewed in conjunction with follow-up imaging. Each review consisted of gender, specialty of referring physician, first head circumference, head circumference at or closest to the time of the head US, the last head circumference, and any neurological issue prior to the US, at the time of US, or following the US, and clinical outcomes. Statistical analysis employed the Kruskal-Wallis rank sum test and Fischer's exact test (chi square test of independence) that compared normal/BMC patients from the patients requiring a neurosurgical consultation. One hundred and thirty (40.9%) had a normal head US, 181 patients (56.9%) had sonographic findings of BMC, and seven (2.2%) patients had an abnormal head US that required a neurosurgical consultation. Of the 181 patients with BMC, 23 underwent follow-up imaging with 22 patients having unchanged BMC or a normal head US and one patient developing mild ventriculomegaly that was stable on follow-up imaging. Three of the seven patients (1%) aged 1.8, 2.3, and 13.1 months with abnormal head US requiring neurosurgical consultation, had mild ventriculomegaly that was stable on follow-up imaging. Four of the seven patients (1.2%) that required neurosurgical consultation needed a neurosurgical procedure. Between the two US subgroups (normal and BMC), no statistical significance was noted regarding age of patient at US, head circumference at clinical and radiological presentation (p>0.05) except for the first head circumference clinically documented which demonstrated statistical significance (p<0.03). Short interval surveillance including head circumference and assessment for the development of bulging anterior fontanelle and neurological abnormalities may be more cost effective than US in the initial evaluation of patients clinically suspected to have BMC. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. [Intrauterine growth curves for body weight, body length, head circumference, chest circumference, and crown-rump length in 16 887 neonates with a gestational age of 27-42 weeks in Shenzhen, China].

    PubMed

    Huang, Xiao-Yun; Liu, Hui-Long; Lei, Min; Mai, Hui-Fen; Lian, Chao-Hui; Li, You-Cong

    2017-08-01

    To establish the intrauterine growth curves of neonates in Shenzhen, China and to investigate the intrauterine growth of neonates in Shenzhen. Cross-sectional cluster sampling was performed for an on-the-spot investigation of 16 887 neonates (9 418 males and 7 469 females) with a gestational age of 27-42 weeks who were born in two hospitals in Shenzhen from April 2013 to September 2015. The Lambda Mu Sigma (LMS) method was used for the curve fitting of body weight, body length, head circumference, chest circumference, and crown-rump length. The 3rd-97th percentile intrauterine growth curves for body weight, body length, head circumference, chest circumference, and crown-rump length were plotted for the neonates with a gestational age of 27-42 weeks who were divided into three groups (male, female, and mixed). The male neonates had significantly higher curves for the five indices than the female counterparts. The pattern and changing trend of body weight curves of these neonates were basically consistent with those in China Neonatal Network. The percentile intrauterine growth curves for body weight, body length, head circumference, chest circumference, and crown-rump length in neonates with a gestational age of 27-42 weeks in Shenzhen which has been established can provide a reference for clinical practice in the department of neonatology.

  16. Head circumference of children with sickle cell disease in Lagos, Nigeria.

    PubMed

    Senbanjo, Idowu Odunayo; Oshikoya, Kazeem Adeola; Salisu, Mohammed; Diaku-Akinwumi, Ijeoma Nnenna

    2016-01-01

    Growth retardation and under-nutrition are common in children with sickle cell disease (SCD). The aim of this study was to compare the head circumference (HC) of SCD children and non-SCD children and to determine the effect of malnutrition on head circumference of children with SCD. This was a prospective case-control study conducted at the Lagos State University Teaching Hospital, Nigeria, involving SCD children (subject, n = 118) and non-SCD children (control, n = 118) matched for age, sex, and socioeconomic status. Weight, height and HC were measured using standard techniques. The mean ages of children with and without SCD were 7.46 ± 3.69 years and 7.01 ± 3.58 years, respectively. The HC increased significantly with age in both males and females (r = 0.75, p = < 0.001; r = 0.70, p < 0.001 respectively). There was no significant difference in HC between males and females (p > 0.05). At all ages, the mean head circumference of SCD children was not significantly (p > 0.05) different from non-SCD children. The In the age group 11-15 years, the prevalence of stunting was significantly higher among SCD children than non-SCD children. The mean HC of SCD children with stunting was significantly lower than those not stunted (51.7 vs. 53.5; P= 0.006) in age group 11.15 years. The head circumference of children with SCD is not significantly different from that of non-SCD children. Therefore, the HC chart for the general population is also applicable for monitoring head growth in children with SCD. The effect of malnutrition on head circumference of SCD children is most marked in age group 11-15 years.

  17. Head circumference of children with sickle cell disease in Lagos, Nigeria

    PubMed Central

    Senbanjo, Idowu Odunayo; Oshikoya, Kazeem Adeola; Salisu, Mohammed; Diaku-Akinwumi, Ijeoma Nnenna

    2016-01-01

    Introduction Growth retardation and under-nutrition are common in children with sickle cell disease (SCD). The aim of this study was to compare the head circumference (HC) of SCD children and non-SCD children and to determine the effect of malnutrition on head circumference of children with SCD. Methods This was a prospective case-control study conducted at the Lagos State University Teaching Hospital, Nigeria, involving SCD children (subject, n = 118) and non-SCD children (control, n = 118) matched for age, sex, and socioeconomic status. Weight, height and HC were measured using standard techniques. Results The mean ages of children with and without SCD were 7.46 ± 3.69 years and 7.01 ± 3.58 years, respectively. The HC increased significantly with age in both males and females (r = 0.75, p = < 0.001; r = 0.70, p < 0.001 respectively). There was no significant difference in HC between males and females (p > 0.05). At all ages, the mean head circumference of SCD children was not significantly (p > 0.05) different from non-SCD children. The In the age group 11-15 years, the prevalence of stunting was significantly higher among SCD children than non-SCD children. The mean HC of SCD children with stunting was significantly lower than those not stunted (51.7 vs. 53.5; P= 0.006) in age group 11.15 years. Conclusion The head circumference of children with SCD is not significantly different from that of non-SCD children. Therefore, the HC chart for the general population is also applicable for monitoring head growth in children with SCD. The effect of malnutrition on head circumference of SCD children is most marked in age group 11-15 years. PMID:28154697

  18. On the relationship between head circumference, brain size, prenatal long-chain PUFA/5-methyltetrahydrofolate supplementation and cognitive abilities during childhood.

    PubMed

    Catena, Andrés; Martínez-Zaldívar, Cristina; Diaz-Piedra, Carolina; Torres-Espínola, Francisco J; Brandi, Pilar; Pérez-García, Miguel; Decsi, Tamás; Koletzko, Berthold; Campoy, Cristina

    2017-03-29

    Head circumference in infants has been reported to predict brain size, total grey matter volume (GMV) and neurocognitive development. However, it is unknown whether it has predictive value on regional and subcortical brain volumes. We aimed to explore the relationship between several head circumference measurements since birth and distributions of GMV and subcortical volumes at later childhood. We examined seventy-four, Caucasian, singleton, term-born infants born to mothers randomised to receive fish oil and/or 5-methyltetrahydrofolate or placebo prenatal supplementation. We assessed head circumference at birth and at 4 and 10 years of age and cognitive abilities at 7 years of age. We obtained brain MRI at 10 years of age, on which we performed voxel-based morphometry, cortical surface extraction and subcortical segmentation. Analyses were controlled for sex, age, height, weight, family status, laterality and total intracranial volume. Prenatal supplementation did not affect head circumference at any age, cognitive abilities or total brain volumes. Head circumference at 4 years presented the highest correlation with total GMV, white matter volume and brain surface area, and was also strongly associated with GMV of frontal, temporal and occipital areas, as well as with caudate nucleus, globus pallidus, putamen and thalamus volumes. As relationships between brain volumes in childhood and several outcomes extend into adulthood, we have found that ages between 0 and 4 years as the optimal time for brain growth; postnatal factors might have the most relevant impact on structural maturation of certain cortical areas and subcortical nuclei, independent of prenatal supplementation.

  19. Common variants at 12q15 and 12q24 are associated with infant head circumference

    PubMed Central

    Warrington, Nicole M; Kaakinen, Marika; Kreiner-Møller, Eskil; Bradfield, Jonathan P; Freathy, Rachel M; Geller, Frank; Guxens, Mònica; Cousminer, Diana L; Kerkhof, Marjan; Timpson, Nicholas J; Ikram, M Arfan; Beilin, Lawrence J; Bønnelykke, Klaus; Buxton, Jessica L; Charoen, Pimphen; Chawes, Bo Lund Krogsgaard; Eriksson, Johan; Evans, David M; Hofman, Albert; Kemp, John P; Kim, Cecilia E; Klopp, Norman; Lahti, Jari; Lye, Stephen J; McMahon, George; Mentch, Frank D; Müller, Martina; O’Reilly, Paul F; Prokopenko, Inga; Rivadeneira, Fernando; Steegers, Eric A P; Sunyer, Jordi; Tiesler, Carla; Yaghootkar, Hanieh; Breteler, Monique M B; Debette, Stephanie; Fornage, Myriam; Gudnason, Vilmundur; Launer, Lenore J; van der Lugt, Aad; Mosley, Thomas H; Seshadri, Sudha; Smith, Albert V; Vernooij, Meike W; Blakemore, Alexandra IF; Chiavacci, Rosetta M; Feenstra, Bjarke; Fernandez-Benet, Julio; Grant, Struan F A; Hartikainen, Anna-Liisa; van der Heijden, Albert J; Iñiguez, Carmen; Lathrop, Mark; McArdle, Wendy L; Mølgaard, Anne; Newnham, John P; Palmer, Lyle J; Palotie, Aarno; Pouta, Annneli; Ring, Susan M; Sovio, Ulla; Standl, Marie; Uitterlinden, Andre G; Wichmann, H-Erich; Vissing, Nadja Hawwa; DeCarli, Charles; van Duijn, Cornelia M; McCarthy, Mark I; Koppelman, Gerard H.; Estivill, Xavier; Hattersley, Andrew T; Melbye, Mads; Bisgaard, Hans; Pennell, Craig E; Widen, Elisabeth; Hakonarson, Hakon; Smith, George Davey; Heinrich, Joachim; Jarvelin, Marjo-Riitta; Jaddoe, Vincent W V

    2013-01-01

    To identify genetic variants associated with head circumference in infancy, we performed a meta-analysis of seven genome-wide association (GWA) studies (N=10,768 from European ancestry enrolled in pregnancy/birth cohorts) and followed up three lead signals in six replication studies (combined N=19,089). Rs7980687 on chromosome 12q24 (P=8.1×10−9), and rs1042725 on chromosome 12q15 (P=2.8×10−10) were robustly associated with head circumference in infancy. Although these loci have previously been associated with adult height1, their effects on infant head circumference were largely independent of height (P=3.8×10−7 for rs7980687, P=1.3×10−7 for rs1042725 after adjustment for infant height). A third signal, rs11655470 on chromosome 17q21, showed suggestive evidence of association with head circumference (P=3.9×10−6). SNPs correlated to the 17q21 signal show genome-wide association with adult intra cranial volume2, Parkinson’s disease and other neurodegenerative diseases3-5, indicating that a common genetic variant in this region might link early brain growth with neurological disease in later life. PMID:22504419

  20. Head circumference at birth and childhood developmental disorders in a nationwide cohort in Denmark.

    PubMed

    Aagaard, Kristina; Bach, Cathrine Carlsen; Henriksen, Tine Brink; Larsen, René Tidemand; Matthiesen, Niels Bjerregård

    2018-06-08

    Early markers of Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) may improve the understanding and early recognition of these disorders. We aimed to estimate the association between head circumference at birth, a measure of cerebral size at birth, and the risk of ADHD and ASD. We present a register-based cohort study of all Danish singletons born alive between 1997 and 2013. Cox proportional hazards regression was used for the statistical analyses. Sibling-matched analyses were performed to account for unmeasured confounding shared by siblings. The analyses included 986 909 new-borns. Compared to normocephalic children, microcephaly was associated with an increased risk of ADHD (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12, 1.32). Macrocephaly was associated with a decreased risk of ADHD (HR 0.90, 95% CI 0.82, 0.99). Neither microcephaly nor macrocephaly were associated with ASD (HR 1.06, 95% CI 0.94, 1.19 and 1.03, 95% CI 0.90, 1.19). The largest difference was found within the normocephalic children. A head circumference at the lower limit of normocephaly compared to a head circumference at the upper limit was associated with an increased risk of ADHD (HR 1.52, 95% CI 1.43, 1.63). The sibling analyses confirmed the increased risk of ADHD with decreasing head circumference in the normocephalic children. No other clear associations were present in the sibling analyses. Within normocephalic children, smaller head circumference at birth was associated with a higher risk of ADHD. Restricted foetal brain growth may be a risk factor for the development of ADHD but not ASD. © 2018 John Wiley & Sons Ltd.

  1. Nucleotide supplementation and the growth of term small for gestational age infants.

    PubMed Central

    Cosgrove, M.; Davies, D. P.; Jenkins, H. R.

    1996-01-01

    A double blind randomised controlled trial in small for gestational age (SGA) infants, whose intestinal mucosa was shown to be functionally impaired as a result of intrauterine undernutrition, was carried out to investigate the hypothesis that nucleotide supplementation of a milk formula could improve catchup growth. Anthropometric data were collected on 74 infants, 39 randomly allocated to the nucleotide supplemented group (group N) and 35 to a standard formula group (group S). From study entry to 2 months of age, infants in group N had significantly higher mean rates of weight gain (106.3 compared with 94.7 g/kg baseline weight/week) and length gain (21.8 v 19.7 mm/m baseline length/week). Over the whole six months for which the trial formula was provided group N had significantly higher mean rates of gain of weight (80.1 compared with 71.8 g/kg baseline weight/week), length (16.2 compared with 15.0 mm/m baseline length/week), and head circumference (11.8 compared with 10.8 mm/m baseline head circumference/week). Catchup growth in SGA infants is therefore improved by nucleotide supplementation of infant formula. PMID:8777659

  2. Customized Fetal Growth Charts for Parents' Characteristics, Race, and Parity by Quantile Regression Analysis: A Cross-sectional Multicenter Italian Study.

    PubMed

    Ghi, Tullio; Cariello, Luisa; Rizzo, Ludovica; Ferrazzi, Enrico; Periti, Enrico; Prefumo, Federico; Stampalija, Tamara; Viora, Elsa; Verrotti, Carla; Rizzo, Giuseppe

    2016-01-01

    The purpose of this study was to construct fetal biometric charts between 16 and 40 weeks' gestation that were customized for parental characteristics, race, and parity, using quantile regression analysis. In a multicenter cross-sectional study, 8070 sonographic examinations from low-risk pregnancies between 16 and 40 weeks' gestation were analyzed. The fetal measurements obtained were biparietal diameter, head circumference, abdominal circumference, and femur diaphysis length. Quantile regression was used to examine the impact of parental height and weight, parity, and race across biometric percentiles for the fetal measurements considered. Paternal and maternal height were significant covariates for all of the measurements considered (P < .05). Maternal weight significantly influenced head circumference, abdominal circumference, and femur diaphysis length. Parity was significantly associated with biparietal diameter and head circumference. Central African race was associated with head circumference and femur diaphysis length, whereas North African race was only associated with femur diaphysis length. In this study we constructed customized biometric growth charts using quantile regression in a large cohort of low-risk pregnancies. These charts offer the advantage of defining individualized normal ranges of fetal biometric parameters at each specific percentile corrected for parental height and weight, parity, and race. This study supports the importance of including these variables in routine sonographic screening for fetal growth abnormalities.

  3. Foot length, chest and head circumference measurements in detection of Low birth weight neonates in Mekelle, Ethiopia: a hospital based cross sectional study.

    PubMed

    Hadush, Marta Yemane; Berhe, Amanuel Hadgu; Medhanyie, Araya Abrha

    2017-04-21

    Low birth weight (Birth weight < 2500 g) is a leading cause of prenatal and neonatal deaths. The early identification of Low birth weight (LBW) neonates is essential for any comprehensive initiative to improve their chance of survival. However, a large proportion of births in developing countries take place at home and birth weight statistics are not available. Therefore, there is a need to develop simple, inexpensive and practical methods to identify low birth weight (LBW) neonates soon after birth. This is a hospital based cross sectional study. Four hundred twenty two (422) live born neonates were included and anthropometric measurements were carried out within 24 h of birth by three trained nurses. Birth weight was measured by digital scale. Head and chest circumference were measured by using non extendable measuring tape and foot length with hard transparent plastic ruler. Data was entered into SPSS version 20 for analysis. Characteristics of study participants were analyzed using descriptive statistics such as frequency and percentage for categorical data and mean and standard deviation for continuous data. Correlation with birth weight using Pearson's correlation coefficient and linear regression were used to identify the association between dependent and independent variables. Receiver operating characteristic (ROC) curve was used to evaluate accuracy of the anthropometric measurements to predict LBW. The prevalence of low birth weight was found to be 27%. All anthropometric measurements had a positive correlation with birth weight, chest circumference attaining the highest correlation with birth weight (r = 0.85) and foot length had the weakest correlation (r = 0.74). Head circumference had the highest predictive value for birth weight (AUC = 0.93) followed by Chest circumference (AUC = 0.91). A cut off point of chest circumference 30.15 cm had 84.2% sensitivity, 85.4% specificity and diagnostic accuracy (P < 0.001). A cut off point of head circumference 33.25 had the highest positive predictive value (77%). Chest circumference and head circumference were found to be better surrogate measurements to identify low birth weight neonates.

  4. For Debate: Growth Hormone Treatment of Infants Born Small for Gestational Age should be Started at or before the First Year of Age.

    PubMed

    Laron, Zvi; Laron-Kenet, Tamar; Klinger, Gil

    2016-12-01

    Children born small for gestational age without early catch-up of somatic growth and head circumference subsequently remain short and suffer from various degrees of neurocognitive and psychological impairment. Based upon the role of growth hormone (GH) and insulin-like growth factor-I on early brain growth and maturation, we propose that GH treatment of these infants be instituted prior to their 2nd birthday. Copyright© of YS Medical Media ltd.

  5. Birth weight and optic nerve head parameters.

    PubMed

    Samarawickrama, Chameen; Huynh, Son C; Liew, Gerald; Burlutsky, George; Mitchell, Paul

    2009-06-01

    To assess the relationship of birth weight, birth length, and head circumference as proxy markers of intrauterine growth, cup/disc ratio, and other optic disc parameters measured using optical coherence tomography (OCT). Population-based cross sectional analysis. The Sydney Childhood Eye Study examined 2353 primarily 12-year-old children from 21 randomly selected secondary schools during 2003 to 2005. Of 2353 children examined, 2134 (90.7%) had OCT scans (Zeiss Stratus OCT, Carl Zeiss Meditec, Dublin, CA) and are included in this study. The "fast" optic disc scan protocol was used. Birth weight, birth length, and head circumference were ascertained from health records. Height and weight were measured using standardized protocols, body mass index (BMI) was defined as weight (kilograms)/ height squared (meters), and sociodemographic information was collected in a questionnaire completed by parents. Low birth weight was defined as birth weight

  6. Outcomes of fetuses with small head circumference on second-trimester ultrasonography.

    PubMed

    Deloison, Benjamin; Chalouhi, Gihad E; Bernard, Jean-Pierre; Ville, Yves; Salomon, Laurent J

    2012-09-01

    We examined the outcomes of pregnancies in which the fetal head circumference (HC) was below the 5(th) centile at the routine second-trimester scan. We retrospectively analysed outcomes of 18,377 women according to HC Z scores at second-trimester ultrasound examination between 2001 and 2008. We collected all major malformations, intrauterine deaths and other abnormal outcomes. Six hundred seventy-four fetuses (3.7%) had an HC below the 5(th) centile. Twenty-one major malformations were noted, consisting mainly of neurological abnormalities (3.1%). There were seven intra uterine fetal death (1.3%). Of all the fetuses, 26% were lost to follow-up. Outcome and neurological development was normal in 467 cases, based on neonatal examination and/or parent or general practitioner reports. Major abnormalities were noted in respectively 26.2%, 3.0% and 1.1% of fetuses with Z scores < -2.5, -2.5 to -2.0, and -2 to -1.645, compared with 0.3% of fetuses with normal HC (p < 10(-4)). A head circumference below the 5(th) centile at second-trimester scan is associated with various abnormalities, especially neurological disorders. The outcome was worse when the HC was smaller. An HC Z score below -2.5 was strongly associated with neurological and chromosomal abnormalities. Conversely, an HC Z score below -1.645 but above -2, excluding cases with prenatally diagnosed malformations, seems to be reassuring for favorable neonatal outcome. © 2012 John Wiley & Sons, Ltd.

  7. Children in the Extremes of Physical and Psychological Measurements

    ERIC Educational Resources Information Center

    Stine, Oscar C.; and others

    1969-01-01

    Study of children in Early School Admission Project in Baltimore confirms that among those in extremes of ten measurements there are previously identified correlations between height, weight and head circumference. No association found between low head circumference and intelligence on behavior. However, improved physical growth may affect mental…

  8. Small biparietal diameter and head circumference are part of the phenotype instead of independent prognostic markers in fetuses with spinal dysraphism.

    PubMed

    Cuppen, Inge; de Bruijn, Dagmar; Geerdink, Niels; Rotteveel, Jan J; Willemsen, Michèl A A P; van Vugt, John M G; Pasman, Jaco W; Roeleveld, Nel

    2015-01-01

    The aim of this retrospective study was to assess the fetal biparietal diameter (BPD) and head circumference (HC) in the second trimester of pregnancy in fetuses with open spinal dysraphism. BPD and HC were measured at 16-26 weeks in 74 fetuses with open spinal dysraphism and compared with reference values. BPD was smaller in fetuses with open spinal dysraphism. Of all cases with open spinal dysraphism, 62.2% had a BPD <3rd percentile and 79.7% had a BPD <10th percentile. Of all patients, 54.1% had an HC <3rd percentile and 74.3% had an HC <10th percentile. Almost all fetuses with open neural tube defects have a smaller BPD and HC at 16-26 weeks compared with reference values, which implicates that this is part of the phenotype of children with open spinal dysraphism instead of an independent prognostic marker for a poor cognitive outcome. © 2014 S. Karger AG, Basel.

  9. Head circumference - a useful single parameter for skull volume development in cranial growth analysis?

    PubMed

    Martini, Markus; Klausing, Anne; Lüchters, Guido; Heim, Nils; Messing-Jünger, Martina

    2018-01-10

    The measurement of maximal head circumference is a standard procedure in the examination of childrens' cranial growth and brain development. The objective of the study was to evaluate the validity of maximal head circumference to cranial volume in the first year of life using a new method which includes ear-to-ear over the head distance and maximal cranial length measurement. 3D surface scans for cranial volume assessment were conducted in this method comparison study of 44 healthy Caucasian children (29 male, 15 female) at the ages of 4 and 12 months. Cranial volume increased from measurements made at 4 months to 12 months of age by an average of 1174 ± 106 to 1579 ± 79 ml. Maximal cranial circumference increased from 43.4 ± 9 cm to 46.9 ± 7 cm and the ear-to ear measurement increased from 26.3 ± 21 cm to 31.6 ± 18 cm at the same time points. There was a monotone association between maximal head circumference (HC) and increase in volume, yet a backwards inference from maximal circumference to the volume had a predictive value of only 78% (adjusted R 2 ). Including the additional measurement of distance from ear to ear strengthened the ability of the model to predict the true value attained to 90%. The addition of the parameter skull length appeared to be negligible. The results demonstrate that for a distinct improvement in the evaluation of a physiological cranial volume development, the additional measurement of the ear-to ear distance using a measuring tape is expedient, and, especially for cases with pathological skull changes, such as craniosynostosis, ought to be conducted.

  10. Finding the most accurate method to measure head circumference for fetal weight estimation.

    PubMed

    Schmidt, Ulrike; Temerinac, Dunja; Bildstein, Katharina; Tuschy, Benjamin; Mayer, Jade; Sütterlin, Marc; Siemer, Jörn; Kehl, Sven

    2014-07-01

    Accurate measurement of fetal head biometry is important for fetal weight estimation (FWE) and is therefore an important prognostic parameter for neonatal morbidity and mortality and a valuable tool for determining the further obstetric management. Measurement of the head circumference (HC) in particular is employed in many commonly used weight equations. The aim of the present study was to find the most accurate method to measure head circumference for fetal weight estimation. This prospective study included 481 term pregnancies. Inclusion criteria were a singleton pregnancy and ultrasound examination with complete fetal biometric parameters within 3 days of delivery, and an absence of structural or chromosomal malformations. Different methods were used for ultrasound measurement of the HC (ellipse-traced, ellipse-calculated, and circle-calculated). As a reference method, HC was also determined using a measuring tape immediately after birth. FWE was carried out with Hadlock formulas, including either HC or biparietal diameter (BPD), and differences were compared using percentage error (PE), absolute percentage error (APE), limits of agreement (LOA), and cumulative distribution. The ellipse-traced method showed the best results for FWE among all of the ultrasound methods assessed. It had the lowest median APE and the narrowest LOA. With regard to the cumulative distribution, it included the largest number of cases at a discrepancy level of ±10%. The accuracy of BPD was similar to that of the ellipse-traced method when it was used instead of HC for weight estimation. Differences between the three techniques for calculating HC were small but significant. For clinical use, the ellipse-traced method should be recommended. However, when BPD is used instead of HC for FWE, the accuracy is similar to that of the ellipse-traced method. The BPD might therefore be a good alternative to head measurements in estimating fetal weight. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Brief Report: A Preliminary Study of Fetal Head Circumference Growth in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Whitehouse, Andrew J. O.; Hickey, Martha; Stanley, Fiona J.; Newnham, John P.; Pennell, Craig E.

    2011-01-01

    Fetal head circumference (HC) growth was examined prospectively in children with autism spectrum disorder (ASD). ASD participants (N = 14) were each matched with four control participants (N = 56) on a range of parameters known to influence fetal growth. HC was measured using ultrasonography at approximately 18 weeks gestation and again at birth…

  12. Head Circumferences in Twins with and without Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Froehlich, Wendy; Cleveland, Sue; Torres, Andrea; Phillips, Jennifer; Cohen, Brianne; Torigoe, Tiffany; Miller, Janet; Fedele, Angie; Collins, Jack; Smith, Karen; Lotspeich, Linda; Croen, Lisa A.; Ozonoff, Sally; Lajonchere, Clara; Grether, Judith K.; Hallmayer, Joachim

    2013-01-01

    To determine the genetic relationship between head circumference (HC) and Autism Spectrum Disorders (ASDs). Twin pairs with at least one twin with an ASD were assessed. HCs in affected and unaffected individuals were compared, as were HC correlations in monozygotic and dizygotic pairs. 404 subjects, ages 4-18, were included. 20% of males and 27%…

  13. The effect of height, weight and head circumference on gross motor development in achondroplasia.

    PubMed

    Ireland, Penelope Jane; Ware, Robert S; Donaghey, Samantha; McGill, James; Zankl, Andreas; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M

    2013-02-01

    This study aimed to investigate whether height, weight, head circumference and/or relationships between these factors are associated with gross motor milestone acquisition in children with achondroplasia. Population-based data regarding timing of major gross motor milestones up to 5 years were correlated with height, weight and head circumference at birth and 12 months in 48 children with achondroplasia born in Australia and New Zealand between 2000 and 2009. Although as a group children with achondroplasia showed delayed gross motor skill acquisition, within group differences in height, weight or head circumference did not appear to influence timing of gross motor skills before 5 years. The exception was lie to sit transitioning, which appears likely to occur earlier if the child is taller and heavier at 12 months, and later if the child has significant head-to-body disproportion. This is the first study to investigate the relationship between common musculoskeletal impairments associated with achondroplasia and timing of gross motor achievement. Identification of the musculoskeletal factors that exacerbate delays in transitioning from lying to sitting will assist clinicians to provide more proactive assessment, advice and intervention regarding motor skill acquisition for this population. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  14. Impact on fetal growth of prenatal exposure to pesticides due to agricultural activities: a prospective cohort study in Brittany, France

    PubMed Central

    2010-01-01

    Background Pesticide use is widespread in agriculture. Several studies have shown that pesticides used in agricultural fields can contaminate the domestic environment and thus be an important source of pesticide exposure of populations residing nearby. Epidemiological studies that have examined the health effects of in utero pesticide exposure from residence near agricultural activities suggest adverse effects, but the results are inconsistent. Our purpose was to investigate the effect on intrauterine growth of such exposure due to agricultural activities in the residential municipality. Methods A prospective birth cohort recruited 3421 pregnant women in a French agricultural region (Brittany, 2002-2006) through gynecologists, ultrasonographers, and maternity hospitals during routine prenatal care visits before 19 weeks of gestation. The national agricultural census in 2000 provided the percentages of the municipality area devoted to cultivation of corn, wheat, colza, peas, potatoes, and fresh vegetables. Results Birth weight and the risk of fetal growth restriction were not associated with agricultural activities in the municipality of residence in early pregnancy. Children whose mother lived in a municipality where peas were grown had a smaller head circumference at birth than those in municipalities not growing peas (-0.2 cm, p = 0.0002). Head circumference also tended to be lower when wheat was grown, but not to a statistically significant degree (p-trend = 0.10). Risk of an infant with a small head circumference was higher for mothers living in a municipality where peas (OR = 2.2; 95% CI = 1.2-3.6) or potatoes (OR = 1.5; 95% CI = 0.9-2.4) were grown. Conclusions Agricultural activities in the municipality of residence may have negative effects on cranial growth. Cultivation of pea crops and, to a lesser degree, potato and wheat crops, may negatively affect head circumference. Insecticides, including organophosphate insecticides, were applied to most of the area devoted to pea and potato crops; this was less true for corn and wheat crops. These results must be interpreted in light of the study's limitations, in particular, the scale at which we could assess pesticide exposure. PMID:21078166

  15. BMI curves for preterm infants.

    PubMed

    Olsen, Irene E; Lawson, M Louise; Ferguson, A Nicole; Cantrell, Rebecca; Grabich, Shannon C; Zemel, Babette S; Clark, Reese H

    2015-03-01

    Preterm infants experience disproportionate growth failure postnatally and may be large weight for length despite being small weight for age by hospital discharge. The objective of this study was to create and validate intrauterine weight-for-length growth curves using the contemporary, large, racially diverse US birth parameters sample used to create the Olsen weight-, length-, and head-circumference-for-age curves. Data from 391 681 US infants (Pediatrix Medical Group) born at 22 to 42 weeks' gestational age (born in 1998-2006) included birth weight, length, and head circumference, estimated gestational age, and gender. Separate subsamples were used to create and validate curves. Established methods were used to determine the weight-for-length ratio that was most highly correlated with weight and uncorrelated with length. Final smoothed percentile curves (3rd to 97th) were created by the Lambda Mu Sigma (LMS) method. The validation sample was used to confirm results. The final sample included 254 454 singleton infants (57.2% male) who survived to discharge. BMI was the best overall weight-for-length ratio for both genders and a majority of gestational ages. Gender-specific BMI-for-age curves were created (n = 127 446) and successfully validated (n = 126 988). Mean z scores for the validation sample were ∼0 (∼1 SD). BMI was different across gender and gestational age. We provide a set of validated reference curves (gender-specific) to track changes in BMI for prematurely born infants cared for in the NICU for use with weight-, length-, and head-circumference-for-age intrauterine growth curves. Copyright © 2015 by the American Academy of Pediatrics.

  16. Tracing Back to the Onset of Abnormal Head Circumference Growth in Italian Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Muratori, Filippo; Calderoni, Sara; Apicella, Fabio; Filippi, Tiziana; Santocchi, Elisa; Calugi, Simona; Cosenza, Angela; Tancredi, Raffaella; Narzisi, Antonio

    2012-01-01

    This retrospective study aims to describe head circumference (HC) developmental course during the first year of life in 50 Italian children with autism spectrum disorder (ASD) and in a control group of 100 typically developing children (TD). To this end, we use anthropometric measurements (HC, body height, body weight) obtained at birth (T0), 1-2…

  17. Growth of Head Circumference in Autistic Infants during the First Year of Life

    ERIC Educational Resources Information Center

    Fukumoto, Aya; Hashimoto, Toshiaki; Ito, Hiromichi; Nishimura, Mio; Tsuda, Yoshimi; Miyazaki, Masahito; Mori, Kenji; Arisawa, Kokichi; Kagami, Shoji

    2008-01-01

    This study analyzed the increase in head circumference (HC) of 85 autistic infants (64 boys and 21 girls) during their first year of life. The data were collected from their "mother-and-baby" notebooks. This notebook is a medical record of the baby's growth and development delivered to the parents of all babies born in Japan. This is a…

  18. Head Circumference as an Early Predictor of Autism Symptoms in Younger Siblings of Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Elder, Lauren M.; Dawson, Geraldine; Toth, Karen; Fein, Deborah; Munson, Jeff

    2008-01-01

    Siblings of children with autism have an increased risk for autism spectrum disorders (ASD). As children with autism often exhibit an atypical trajectory of head circumference (HC) growth, HC may be an indicator of vulnerability to autism. This study investigated whether infant siblings of children with ASD (n = 77) with an atypical trajectory of…

  19. Genetic and Environmental Relationships between Head Circumference Growth in the First Year of Life and Sociocognitive Development in the Second Year: A Longitudinal Twin Study

    ERIC Educational Resources Information Center

    Fujisawa, Keiko K.; Ozaki, Koken; Suzuki, Kunitake; Yamagata, Shinji; Kawahashi, Ikko; Ando, Juko

    2012-01-01

    Although growth in head circumference (HC) during infancy is known to predict later childhood outcomes, the mechanisms underlying this association with later sociocognitive abilities remain undetermined. Thus, using a sample of 241 pairs of normally developing Japanese twins, this study investigated the underpinnings of the association between HC…

  20. Incense Burning during Pregnancy and Birth Weight and Head Circumference among Term Births: The Taiwan Birth Cohort Study.

    PubMed

    Chen, Le-Yu; Ho, Christine

    2016-09-01

    Incense burning for rituals or religious purposes is an important tradition in many countries. However, incense smoke contains particulate matter and gas products such as carbon monoxide, sulfur, and nitrogen dioxide, which are potentially harmful to health. We analyzed the relationship between prenatal incense burning and birth weight and head circumference at birth using the Taiwan Birth Cohort Study. We also analyzed whether the associations varied by sex and along the distribution of birth outcomes. We performed ordinary least squares (OLS) and quantile regressions analysis on a sample of 15,773 term births (> 37 gestational weeks; 8,216 boys and 7,557 girls) in Taiwan in 2005. The associations were estimated separately for boys and girls as well as for the population as a whole. We controlled extensively for factors that may be correlated with incense burning and birth weight and head circumference, such as parental religion, demographics, and health characteristics, as well as pregnancy-related variables. Findings from fully adjusted OLS regressions indicated that exposure to incense was associated with lower birth weight in boys (-18 g; 95% CI: -36, -0.94) but not girls (1 g; 95% CI: -17, 19; interaction p-value = 0.31). Associations with head circumference were negative for boys (-0.95 mm; 95% CI: -1.8, -0.16) and girls (-0.71 mm; 95% CI: -1.5, 0.11; interaction p-values = 0.73). Quantile regression results suggested that the negative associations were larger among the lower quantiles of birth outcomes. OLS regressions showed that prenatal incense burning was associated with lower birth weight for boys and smaller head circumference for boys and girls. The associations were more pronounced among the lower quantiles of birth outcomes. Further research is necessary to confirm whether incense burning has differential effects by sex. Chen LY, Ho C. 2016. Incense burning during pregnancy and birth weight and head circumference among term births: The Taiwan Birth Cohort Study. Environ Health Perspect 124:1487-1492; http://dx.doi.org/10.1289/ehp.1509922.

  1. Incense Burning during Pregnancy and Birth Weight and Head Circumference among Term Births: The Taiwan Birth Cohort Study

    PubMed Central

    Chen, Le-Yu; Ho, Christine

    2016-01-01

    Background: Incense burning for rituals or religious purposes is an important tradition in many countries. However, incense smoke contains particulate matter and gas products such as carbon monoxide, sulfur, and nitrogen dioxide, which are potentially harmful to health. Objectives: We analyzed the relationship between prenatal incense burning and birth weight and head circumference at birth using the Taiwan Birth Cohort Study. We also analyzed whether the associations varied by sex and along the distribution of birth outcomes. Methods: We performed ordinary least squares (OLS) and quantile regressions analysis on a sample of 15,773 term births (> 37 gestational weeks; 8,216 boys and 7,557 girls) in Taiwan in 2005. The associations were estimated separately for boys and girls as well as for the population as a whole. We controlled extensively for factors that may be correlated with incense burning and birth weight and head circumference, such as parental religion, demographics, and health characteristics, as well as pregnancy-related variables. Results: Findings from fully adjusted OLS regressions indicated that exposure to incense was associated with lower birth weight in boys (–18 g; 95% CI: –36, –0.94) but not girls (1 g; 95% CI: –17, 19; interaction p-value = 0.31). Associations with head circumference were negative for boys (–0.95 mm; 95% CI: –1.8, –0.16) and girls (–0.71 mm; 95% CI: –1.5, 0.11; interaction p-values = 0.73). Quantile regression results suggested that the negative associations were larger among the lower quantiles of birth outcomes. Conclusions: OLS regressions showed that prenatal incense burning was associated with lower birth weight for boys and smaller head circumference for boys and girls. The associations were more pronounced among the lower quantiles of birth outcomes. Further research is necessary to confirm whether incense burning has differential effects by sex. Citation: Chen LY, Ho C. 2016. Incense burning during pregnancy and birth weight and head circumference among term births: The Taiwan Birth Cohort Study. Environ Health Perspect 124:1487–1492; http://dx.doi.org/10.1289/ehp.1509922 PMID:26967367

  2. Fetal head detection and measurement in ultrasound images by an iterative randomized Hough transform

    NASA Astrophysics Data System (ADS)

    Lu, Wei; Tan, Jinglu; Floyd, Randall C.

    2004-05-01

    This paper describes an automatic method for measuring the biparietal diameter (BPD) and head circumference (HC) in ultrasound fetal images. A total of 217 ultrasound images were segmented by using a K-Mean classifier, and the head skull was detected in 214 of the 217 cases by an iterative randomized Hough transform developed for detection of incomplete curves in images with strong noise without user intervention. The automatic measurements were compared with conventional manual measurements by sonographers and a trained panel. The inter-run variations and differences between the automatic and conventional measurements were small compared with published inter-observer variations. The results showed that the automated measurements were as reliable as the expert measurements and more consistent. This method has great potential in clinical applications.

  3. Maternal Personal Exposure to Airborne Benzene and Intrauterine Growth

    PubMed Central

    Slama, Rémy; Thiebaugeorges, Olivier; Goua, Valérie; Aussel, Lucette; Sacco, Paolo; Bohet, Aline; Forhan, Anne; Ducot, Béatrice; Annesi-Maesano, Isabella; Heinrich, Joachim; Magnin, Guillaume; Schweitzer, Michel; Kaminski, Monique; Charles, Marie-Aline

    2009-01-01

    Background Studies relying on outdoor pollutants measures have reported associations between air pollutants and birth weight. Objective Our aim was to assess the relation between maternal personal exposure to airborne benzene during pregnancy and fetal growth. Methods We recruited pregnant women in two French maternity hospitals in 2005–2006 as part of the EDEN mother–child cohort. A subsample of 271 nonsmoking women carried a diffusive air sampler for a week during the 27th gestational week, allowing assessment of benzene exposure. We estimated head circumference of the offspring by ultrasound measurements during the second and third trimesters of pregnancy and at birth. Results Median benzene exposure was 1.8 μg/m3 (5th, 95th percentiles, 0.5, 7.5 μg/m3). Log-transformed benzene exposure was associated with a gestational age–adjusted decrease of 68 g in mean birth weight [95% confidence interval (CI), −135 to −1 g] and of 1.9 mm in mean head circumference at birth (95% CI, −3.8 to 0.0 mm). It was associated with an adjusted decrease of 1.9 mm in head circumference assessed during the third trimester (95% CI, −4.0 to 0.3 mm) and of 1.5 mm in head circumference assessed at the end of the second trimester of pregnancy (95% CI, −3.1 to 0 mm). Conclusions Our prospective study among pregnant women is one of the first to rely on personal monitoring of exposure; a limitation is that exposure was assessed during 1 week only. Maternal benzene exposure was associated with decreases in birth weight and head circumference during pregnancy and at birth. This association could be attributable to benzene and a mixture of associated traffic-related air pollutants. PMID:19672414

  4. Maternal personal exposure to airborne benzene and intrauterine growth.

    PubMed

    Slama, Rémy; Thiebaugeorges, Olivier; Goua, Valérie; Aussel, Lucette; Sacco, Paolo; Bohet, Aline; Forhan, Anne; Ducot, Béatrice; Annesi-Maesano, Isabella; Heinrich, Joachim; Magnin, Guillaume; Schweitzer, Michel; Kaminski, Monique; Charles, Marie-Aline

    2009-08-01

    Studies relying on outdoor pollutants measures have reported associations between air pollutants and birth weight. Our aim was to assess the relation between maternal personal exposure to airborne benzene during pregnancy and fetal growth. We recruited pregnant women in two French maternity hospitals in 2005-2006 as part of the EDEN mother-child cohort. A subsample of 271 nonsmoking women carried a diffusive air sampler for a week during the 27th gestational week, allowing assessment of benzene exposure. We estimated head circumference of the offspring by ultrasound measurements during the second and third trimesters of pregnancy and at birth. Median benzene exposure was 1.8 microg/m(3) (5th, 95th percentiles, 0.5, 7.5 microg/m(3)). Log-transformed benzene exposure was associated with a gestational age-adjusted decrease of 68 g in mean birth weight [95% confidence interval (CI), -135 to -1 g] and of 1.9 mm in mean head circumference at birth (95% CI, -3.8 to 0.0 mm). It was associated with an adjusted decrease of 1.9 mm in head circumference assessed during the third trimester (95% CI, -4.0 to 0.3 mm) and of 1.5 mm in head circumference assessed at the end of the second trimester of pregnancy (95% CI, -3.1 to 0 mm). Our prospective study among pregnant women is one of the first to rely on personal monitoring of exposure; a limitation is that exposure was assessed during 1 week only. Maternal benzene exposure was associated with decreases in birth weight and head circumference during pregnancy and at birth. This association could be attributable to benzene and a mixture of associated traffic-related air pollutants.

  5. Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children.

    PubMed

    Neyzi, Olcay; Bundak, Rüveyde; Gökçay, Gülbin; Günöz, Hülya; Furman, Andrzej; Darendeliler, Feyza; Baş, Firdevs

    2015-12-01

    This study aimed to integrate the existing updated reference standards for the growth of Turkish infants and children and to compare these values with World Health Organization (WHO) reference data, data from some European countries, and also with previous local data. Weight, height, and head circumference measurements were obtained on 2,391 boys and 2,102 girls who were regular attenders of a well child clinic and on 1,100 boys and 1,020 girls attending schools in relatively well-off districts in İstanbul. Mean number of measurements per child was 8.2±3.6 in the age group 0-5 years and 5.5±3.3 in the age group 6-18 years. All children were from well-to-do families and all were healthy. All measurements with the exception of measurements at birth, which were based on reported values, were done by trained personnel. The LMS method was used in the analyses and in the construction of the percentile charts. There is an increase in weight for age and body mass index values for age starting in prepubertal ages, indicating an increasing trend for obesity. Compared to WHO reference data, weight and height values in Turkish children were slightly higher in infants and in children younger than 5 years, while they showed similarity to those reported for children from Norway and Belgium. Head circumference values, which were slightly higher than the WHO references in the first 5 years, were comparable to the data on Belgian and Norwegian children in the first 9 years of life. At older ages, Turkish children showed higher values for head circumference. The relatively larger head circumference values were interpreted to reflect a genetic characteristic.

  6. [Management of positional head deformity in 31 infants].

    PubMed

    Pan, Wei-Wei; Tong, Xiao-Mei

    2017-02-01

    To investigate the clinical effect of postural correction training and helmet therapy in the treatment of moderate-severe positional head deformity defined as asymmetric head shape in infants. A total of 31 infants who were diagnosed with moderate-severe plagiocephaly and/or brachiocephaly were enrolled. According to the different treatment methods, the infants were divided into helmet therapy group with 11 infants and postural correction training group with 20 infants. The cranial vault asymmetry index (CVAI), cephalic ratio (CR), and head circumference growth were compared between the two groups before and after treatment. Compared with the postural correction training group, the helmet therapy group had significantly lower CVAI and CR after treatment. The helmet therapy group had significantly better improvements in CVAI and CR after treatment compared with the postural correction training group (CVAI difference: 6.0±1.9 vs 0.7±0.8, P=0.001; CR difference: 0.047±0.009 vs 0.008±0.005, P<0.001). There was no significant difference in head circumference growth between the two groups (P=0.55). Helmet therapy has a significantly better effect in the treatment of moderate-severe positional head deformity than postural correction training in infants. Helmet therapy does not limit head circumference growth.

  7. A biometric analysis of brain size in micrencephalics.

    PubMed

    Hofman, M A

    1984-01-01

    Brain weight and head circumference in micrencephalic patients were analysed as a function of age, height and sex in relation to normal human standards. A quantitative definition of micrencephaly is proposed, which is based on these analyses. Evidence is presented, furthermore, that micrencephalics have a significantly lower brain weight in adolescence than in early childhood, and that this cerebral dystrophy continues throughout adulthood, leading to death in more than 85% of the males and 78% of the females before they reach the age of 30 years. Since this decline in brain weight after approximately 3-5 years of age is not accompanied by a similar reduction in head circumference, the brains of elderly micrencephalic patients no longer occupy the entire cranial cavity. It is evident, therefore, that head circumference in the case of micrencephaly is an unsuitable parameter for estimating brain size.

  8. Racial differences in birth weight of term infants in a northern California population.

    PubMed

    Madan, Ashima; Holland, Sharon; Humbert, John E; Benitz, William E

    2002-01-01

    Census data show that an increasing proportion of the population of the United States is of Asian or Hispanic origin. Reference curves used to characterize fetal growth relative to gestational age are predominantly based on data for White infants. The goal of this study was to compare the birth weight distributions for term Asian or Hispanic infants with that for White infants, and to determine whether the prevalence of small (SGA) or large size(LGA) for gestational age differs between Asian or Hispanic and White infants. A community hospital in Northern California. Data was collected prospectively from May 1 to September 13, 2000 on all singleton term infants born at this hospital. Gestational age was assessed by the best obstetrical estimate and ethnicity was determined by parental report. Infants were categorized as White, Hispanic, Chinese, Asian Indian, Other Asian, and Other. Birth weights, length, and head circumferences were compared using ANOVA and the Student-Newman-Keuls test. Differences in rates of diagnosis of SGA or LGA were assessed by chi square. 1539 infants were included in the study sample; 30% were White, 21% Asian Indian, 15% Chinese, 9% Hispanic, 7% other Asian, and 18% Other. Asian (Chinese, Asian Indian, or Other Asian), Hispanic, and Other babies had lower mean birth weights, shorter mean lengths, and smaller mean head circumferences than White babies. Asian, Hispanic, and Other male babies were lighter, shorter, and had smaller heads than white male babies. Asian females, but not Hispanic or Other ones, were lighter and had smaller head circumferences than White females; Asian Indian, Other Asian, and Other females had shorter lengths than White female infants. Indian and Other Asian, but not Chinese, babies were more likely than White babies to be SGA; babies in all three Asian groups were less likely than White babies to be LGA. Failure to account for ethnic differences in intrauterine growth may lead to inaccurate diagnosis of fetal growth abnormalities in infants of Asian ancestry.

  9. Body Weight, Length and Head Circumference at Birth in a Cohort of Turkish Newborns

    PubMed Central

    Kurtoğlu, Selim; Hatipoğlu, Nihal; Mazıcıoğlu, Mustafa Mümtaz; Akın, Mustafa Ali; Çoban, Dilek; Gökoğlu, Sonay; Baştuğ, Osman

    2012-01-01

    Objective: Intrauterine growth references are primarily useful indicators in the assessment of the general health status of newborn infants. Although Lubchenco’s references are still used in many neonatal care units, we believe that there is a need for up-to-date intrauterine growth references specific for different populations. To develop gestational age-and gender-specific national references for birth weight, birth length and head circumference. Methods: Data were collected from neonatal records of perinatology services of eleven hospitals from January to December 2009. The anthropometry of a total of 4750 singleton live births born between 28 and 41 weeks of gestation were recorded. Means and standard deviations were calculated, and percentiles for each gender and gestational week were produced using the LMS program. The results were compared with US infants and also with local data. Results: Gestational age- and gender-specific 3rd, 5th, 10th, 15th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentile values were produced. Comparison of the 10th, 50th and 90th percentile values showed that the boys were heavier and longer than the girls. Head circumference values were also higher in the boys. Proportions of small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) infants in the sample were 10.1%, 79.1% and 10.8%, respectively. Conclusion: These gender- and gestational age-specific references will be of use in clinical practice and also for research purposes until more comprehensive, reliable and accessible national data pertaining to the intrauterine growth of Turkish infants are produced. Conflict of interest:None declared. PMID:22664362

  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. Head circumference and brain size in autism spectrum disorder: A systematic review and meta-analysis.

    PubMed

    Sacco, Roberto; Gabriele, Stefano; Persico, Antonio M

    2015-11-30

    Macrocephaly and brain overgrowth have been associated with autism spectrum disorder. We performed a systematic review and meta-analysis to provide an overall estimate of effect size and statistical significance for both head circumference and total brain volume in autism. Our literature search strategy identified 261 and 391 records, respectively; 27 studies defining percentages of macrocephalic patients and 44 structural brain imaging studies providing total brain volumes for patients and controls were included in our meta-analyses. Head circumference was significantly larger in autistic compared to control individuals, with 822/5225 (15.7%) autistic individuals displaying macrocephaly. Structural brain imaging studies measuring brain volume estimated effect size. The effect size is higher in low functioning autistics compared to high functioning and ASD individuals. Brain overgrowth was recorded in 142/1558 (9.1%) autistic patients. Finally, we found a significant interaction between age and total brain volume, resulting in larger head circumference and brain size during early childhood. Our results provide conclusive effect sizes and prevalence rates for macrocephaly and brain overgrowth in autism, confirm the variation of abnormal brain growth with age, and support the inclusion of this endophenotype in multi-biomarker diagnostic panels for clinical use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. [Adverse birth outcomes of maternal smoking during pregnancy and genetic polymorphisms: exploiting gene-environment interaction].

    PubMed

    Sasaki, Seiko; Kishi, Reiko

    2009-09-01

    It has been recognized that metabolic enzymes mediating genetic susceptibility to environmental chemicals such as polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls might be related to adverse human health. Recent studies, including the Hokkaido Study of Environmental and Children's Health, have shown that metabolic enzymes mediating genetic susceptibility to environmental chemicals including tobacco smoke might be related to adverse birth outcomes. Certain maternal genetic polymorphisms in the polycyclic aromatic hydrocarbons (PAHs)-metabolizing enzymes have been shown to enhance the association between maternal smoking and infant birth weight in both Caucasians and Japanese. For maternal genetic polymorphisms encoding the N-nitrosamine-metabolizing enzymes, we found that infant birth weight, birth length and birth head circumference were significantly smaller among infants of smokers than among those of nonsmokers and quitters. The adverse effects of maternal smoking on infant birth size may be modified by maternal genetic polymorphisms. Further study is required to clarify the potential association between genetic polymorphisms and cognitive function in childhood, becauae it has been reported that a small birth length or a small head circumference at birth might affect neurobehavioral development during early childhood. It is necessary to elucidate additive impacts of genetic factors on adverse effects of various chemicals commonly encountered in our daily lives, follow up the development of children, and carry out longitudinal observation.

  13. Impact of maternal and paternal smoking on birth outcomes.

    PubMed

    Inoue, Sachiko; Naruse, Hiroo; Yorifuji, Takashi; Kato, Tsuguhiko; Murakoshi, Takeshi; Doi, Hiroyuki; Subramanian, S V

    2017-09-01

    The adverse effects of maternal and paternal smoking on child health have been studied. However, few studies demonstrate the interaction effects of maternal/paternal smoking, and birth outcomes other than birth weight have not been evaluated. The present study examined individual effects of maternal/paternal smoking and their interactions on birth outcomes. A follow-up hospital-based study from pregnancy to delivery was conducted from 1997 to 2010 with parents and newborn infants who delivered at a large hospital in Hamamatsu, Japan. The relationships between smoking and growth were evaluated with logistic regression. The individual effects of maternal smoking are related to low birth weight (LBW), short birth length and small head circumference. The individual effects of paternal smoking are related to short birth length and small head circumference. In the adjusted model, both parents' smoking showed clear associations with LBW (odds ratio [OR] = 1.64, 95% confidence interval [CI] 1.18-2.27) and short birth length (-1 standard deviation [SD] OR = 1.38, 95% CI 1.07-1.79; -2 SD OR = 2.75, 95% CI 1.84-4.10). Maternal smoking was significantly associated with birth weight and length, but paternal smoking was not. However, if both parents smoked, the risk of shorter birth length increased. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Sex-specific differences in fetal growth in newborns exposed prenatally to traffic-related air pollution in the PELAGIE mother-child cohort (Brittany, France).

    PubMed

    Bertin, Mélanie; Chevrier, Cécile; Serrano, Tania; Monfort, Christine; Cordier, Sylvaine; Viel, Jean-François

    2015-10-01

    Numerous studies have linked prenatal traffic-related air pollution exposure to fetal growth. Recently, several studies have suggested exploring this association independently among boys and girls because of potential sex-specific biological vulnerability to air pollution. Residence-based factors can also influence fetal growth by enhancing susceptibility to the toxic effects of air pollution and must also be considered in these relations. We examined sex-specific associations between prenatal air pollution exposure and fetal growth and explored whether they differed by the urban-rural status of maternal residence. This study relied on the PELAGIE mother-child cohort (2521 women, Brittany, France, 2002-2006). Fetal growth was assessed through birth weight, head circumference and small weight (SGA) and small head circumference (SHC) for gestational age. Nitrogen dioxide (NO2) concentrations at mothers' homes were estimated by using a land use regression model taking into account temporal variation during pregnancy. Associations between estimated NO2 concentrations and fetal growth were assessed with linear regression or logistic regression models, depending on the outcome investigated. An interquartile range (8.8 µg m(-3)) increase in NO2 exposure estimates was associated with a 27.4 g (95% CI 0.8 to 55.6) increase in birth weight and a 0.09 cm (95% CI 0.00-0.17) significant increase in head circumference, among newborn boys only. Their risks of SGA and SHC were reduced (OR 0.70, 95% CI 0.53-0.92, OR 0.76, 95% CI 0.56-1.03, respectively, for an increase of 8.8 µg m(-3)). No statistically significant trends were observed among girls. Urban-rural status modified the effect of air pollution only for SHC and again only for newborn boys. Findings from this study confirm the need to consider sex-specific associations between air pollution and fetal growth and to investigate possible mechanisms by which traffic-related air pollution may increase anthropometric parameters at birth. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Association of head circumference and shoulder dystocia in macrosomic neonates.

    PubMed

    Larson, Austin; Mandelbaum, David E

    2013-04-01

    To determine whether asymmetric macrosomia (disproportionately large body size in comparison to head circumference) could be demonstrated in a population of infants suffering shoulder dystocia during delivery relative to those that did not suffer from shoulder dystocia. A case-control study was conducted as a retrospective chart review over 3 years at a large maternity hospital in an urban setting. Among infants over 4,000 g, those that suffered from shoulder dystocia during delivery had a smaller mean head circumference than infants of a similar size that did not suffer from shoulder dystocia. A statistically significant difference was also present when cases of documented gestational diabetes were excluded. Asymmetric macrosomia is more likely to be present in a population of infants who suffered shoulder dystocia during delivery. This knowledge could be used in designing tools to predict which pregnancies are at highest risk for shoulder dystocia during delivery.

  16. Air Pollution Exposure During Pregnancy, Ultrasound Measures of Fetal Growth, and Adverse Birth Outcomes: A Prospective Cohort Study

    PubMed Central

    Pierik, Frank H.; de Kluizenaar, Yvonne; Willemsen, Sten P.; Hofman, Albert; van Ratingen, Sjoerd W.; Zandveld, Peter Y.J.; Mackenbach, Johan P.; Steegers, Eric A.P.; Miedema, Henk M.E.; Jaddoe, Vincent W.V.

    2011-01-01

    Background: Air pollution exposure during pregnancy might have trimester-specific effects on fetal growth. Objective: We prospectively evaluated the associations of maternal air pollution exposure with fetal growth characteristics and adverse birth outcomes in 7,772 subjects in the Netherlands. Methods: Particulate matter with an aerodynamic diameter < 10 μm (PM10) and nitrogen dioxide (NO2) levels were estimated using dispersion modeling at the home address. Fetal head circumference, length, and weight were estimated in each trimester by ultrasound. Information on birth outcomes was obtained from medical records. Results: In cross-sectional analyses, NO2 levels were inversely associated with fetal femur length in the second and third trimester, and PM10 and NO2 levels both were associated with smaller fetal head circumference in the third trimester [–0.18 mm, 95% confidence interval (CI): –0.24, –0.12 mm; and –0.12 mm, 95% CI: –0.17, –0.06 mm per 1-μg/m3 increase in PM10 and NO2, respectively]. Average PM10 and NO2 levels during pregnancy were not associated with head circumference and length at birth or neonatally, but were inversely associated with birth weight (–3.6 g, 95% CI: –6.7, –0.4 g; and –3.4 g, 95% CI: –6.2, –0.6 g, respectively). Longitudinal analyses showed similar patterns for head circumference and weight, but no associations with length. The third and fourth quartiles of PM10 exposure were associated with preterm birth [odds ratio (OR) = 1.40, 95% CI: 1.03, 1.89; and OR = 1.32; 95% CI: 0.96, 1.79, relative to the first quartile]. The third quartile of PM10 exposure, but not the fourth, was associated with small size for gestational age at birth (SGA) (OR = 1.38; 95% CI: 1.00, 1.90). No consistent associations were observed for NO2 levels and adverse birth outcomes. Conclusions: Results suggest that maternal air pollution exposure is inversely associated with fetal growth during the second and third trimester and with weight at birth. PM10 exposure was positively associated with preterm birth and SGA. PMID:22222601

  17. Multiple regression analysis of anthropometric measurements influencing the cephalic index of male Japanese university students.

    PubMed

    Hossain, Md Golam; Saw, Aik; Alam, Rashidul; Ohtsuki, Fumio; Kamarul, Tunku

    2013-09-01

    Cephalic index (CI), the ratio of head breadth to head length, is widely used to categorise human populations. The aim of this study was to access the impact of anthropometric measurements on the CI of male Japanese university students. This study included 1,215 male university students from Tokyo and Kyoto, selected using convenient sampling. Multiple regression analysis was used to determine the effect of anthropometric measurements on CI. The variance inflation factor (VIF) showed no evidence of a multicollinearity problem among independent variables. The coefficients of the regression line demonstrated a significant positive relationship between CI and minimum frontal breadth (p < 0.01), bizygomatic breadth (p < 0.01) and head height (p < 0.05), and a negative relationship between CI and morphological facial height (p < 0.01) and head circumference (p < 0.01). Moreover, the coefficient and odds ratio of logistic regression analysis showed a greater likelihood for minimum frontal breadth (p < 0.01) and bizygomatic breadth (p < 0.01) to predict round-headedness, and morphological facial height (p < 0.05) and head circumference (p < 0.01) to predict long-headedness. Stepwise regression analysis revealed bizygomatic breadth, head circumference, minimum frontal breadth, head height and morphological facial height to be the best predictor craniofacial measurements with respect to CI. The results suggest that most of the variables considered in this study appear to influence the CI of adult male Japanese students.

  18. Inter-observer variability in fetal biometric measurements.

    PubMed

    Kilani, Rami; Aleyadeh, Wesam; Atieleh, Luay Abu; Al Suleimat, Abdul Mane; Khadra, Maysa; Hawamdeh, Hassan M

    2018-02-01

    To evaluate inter-observer variability and reproducibility of ultrasound measurements for fetal biometric parameters. A prospective cohort study was implemented in two tertiary care hospitals in Amman, Jordan; Prince Hamza Hospital and Albashir Hospital. 192 women with a singleton pregnancy at a gestational age of 18-36 weeks were the participants in the study. Transabdominal scans for fetal biometric parameter measurement were performed on study participants from the period of November 2014 to March 2015. Women who agreed to participate in the study were administered two ultrasound scans for head circumference, abdominal circumference and femur length. The correlation coefficient was calculated. Bland-Altman plots were used to analyze the degree of measurement agreement between observers. Limits of agreement ± 2 SD for the differences in fetal biometry measurements in proportions of the mean of the measurements were derived. Main outcome measures examine the reproducibility of fetal biometric measurements by different observers. High inter-observer inter-class correlation coefficient (ICC) was found for femur length (0.990) and abdominal circumference (0.996) where Bland-Altman plots showed high degrees of agreement. The highest degrees of agreement were noted in the measurement of abdominal circumference followed by head circumference. The lowest degree of agreement was found for femur length measurement. We used a paired-sample t-test and found that the mean difference between duplicate measurements was not significant (P > 0.05). Biometric fetal parameter measurements may be reproducible by different operators in the clinical setting with similar results. Fetal head circumference, abdominal circumference and femur length were highly reproducible. Large organized studies are needed to ensure accurate fetal measurements due to the important clinical implications of inaccurate measurements. Copyright © 2018. Published by Elsevier B.V.

  19. Amniotic Fluid Arginine from Gestational Weeks 13 to 15 Is a Predictor of Birth Weight, Length, and Head Circumference.

    PubMed

    Bjørke-Jenssen, Astrid; Ueland, Per Magne; Bjørke-Monsen, Anne-Lise

    2017-12-14

    Arginine is a constituent of proteins and a precursor for polyamines and nitric oxide, and is essential for placentation, angiogenesis, and growth. Maternal plasma arginine concentrations are found to be lower in pregnancies complicated by fetal growth restriction, and arginine supplementation in later pregnancy is reported to increase birth weight. We measured arginine and the metabolites asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in the amniotic fluid obtained in pregnancy weeks 13 to 15 from 363 pregnancies with a documented normal outcome and related the concentrations to birth weight, length, and head circumference. Arginine was higher in the amniotic fluid from female (mean 40.8 (SD 10.6) µmol/L) compared to male fetuses (37.4 (SD 11.2) µmol/L, p = 0.003). Despite the gender difference, arginine in the amniotic fluid from gestational weeks 13-15 was the strongest predictor for birth weight, length, and head circumference. ADMA was a strong predictor for birth weight and length, SDMA for birth weight, while Arg/ADMA and Arg/SDMA only predicted head circumference in multiple linear regression models. Due to increased arginine demands, pregnancy is considered a state of relative arginine deficiency. Our findings reflect the importance of a good maternal arginine status in early pregnancy, an observation that should be evaluated in an intervention study.

  20. Creation and validation of the Singapore birth nomograms for birth weight, length and head circumference based on a 12-year birth cohort.

    PubMed

    Poon, Woei Bing; Fook-Chong, Stephanie M C; Ler, Grace Y L; Loh, Zhi Wen; Yeo, Cheo Lian

    2014-06-01

    Both gestation and birth weight have significant impact on mortality and morbidity in newborn infants. Nomograms at birth allow classification of infants into small for gestational age (SGA) and large for gestational age (LGA) categories, for risk stratification and more intensive monitoring. To date, the growth charts for preterm newborn infants in Singapore are based on the Fenton growth charts, which are constructed based on combining data from various Western growth cohorts. Hence, we aim to create Singapore nomograms for birth weight, length and head circumference at birth, which would reflect the norms and challenges faced by local infants. Growth parameters of all babies born or admitted to our unit from 2001 to 2012 were retrieved. Following exclusion of outliers, nomograms for 3 percentiles of 10th, 50th, and 90th were generated for the gestational age (GA) ranges of 25 to 42 weeks using quantile regression (QR) combined with the use of restricted cubic splines. Various polynomial models (second to third degrees) were investigated for suitability of fit. The optimum QR model was found to be a third degree polynomial with a single knotted cubic spline in the mid-point of the GA range, at 33.5 weeks. Check for goodness of fit was done by visual inspection first. Next, check was performed to ensure the correct proportion: 10% of all cases fall above the upper 90th percentile and 10% fall below the lower 10th percentile. Furthermore, an alternative formula-based method of nomogram construction, using mean, standard deviation (SD) and assumption of normality at each gestational age, was used for counterchecking. A total of 13,403 newborns were included in the analysis. The new infant-foetal growth charts with respect to birth weight, heel-crown length and occipitofrontal circumference from 25 to 42 weeks gestations with the 10th, 50th and 90th were presented. Nomograms for birth weight, length and head circumference at birth had significant impact on neonatal practice and validation of the Singapore birth nomograms against Fenton growth charts showed better sensitivity and comparable specificity, positive and negative predictive values.

  1. The influence of head growth in fetal life, infancy, and childhood on intelligence at the ages of 4 and 8 years.

    PubMed

    Gale, Catharine R; O'Callaghan, Finbar J; Bredow, Maria; Martyn, Christopher N

    2006-10-01

    We investigated the effects of head growth prenatally, during infancy, and during later periods of development on cognitive function at the ages of 4 and 8 years. We studied 633 term-born children from the Avon Longitudinal Study of Parents and Children cohort whose head circumference was measured at birth and at regular intervals thereafter. Their cognitive function was assessed with the Wechsler Preschool and Primary Scale of Intelligence at the age of 4 years and with the Wechsler Intelligence Scale for Children at the age of 8 years. Linear regression analysis was used to calculate postnatal head growth between successive time points, conditional on previous size, and to examine the relationship between head growth during different periods of development and later IQ. When the influence of head growth was distinguished for different periods, only prenatal growth and growth during infancy were associated with subsequent IQ. At 4 years, after adjustment for parental characteristics, full-scale IQ increased an average of 2.41 points for each 1-SD increase in head circumference at birth and 1.97 points for each 1-SD increase in head growth during infancy, conditional on head size at birth. At 8 years, head circumference at birth was no longer associated with IQ, but head growth during infancy remained a significant predictor, with full-scale IQ increasing an average of 1.56 points for each 1-SD increase in growth. The brain volume a child achieves by the age of 1 year helps determine later intelligence. Growth in brain volume after infancy may not compensate for poorer earlier growth.

  2. Head growth and neurocognitive outcomes.

    PubMed

    Wright, Charlotte M; Emond, Alan

    2015-06-01

    There is a lack of evidence on the value of head circumference (HC) as a screening measure. We aimed to describe the incidence of head centile shifting and the relationship between extremes of head size and later neurodevelopmental problems in the Avon Longitudinal Study of Parents and Children. HC was measured routinely at 2, 9, and 18 or 24 months and by researchers at ages 4, 8, 12, and 18 months. IQ according to the Wechsler Intelligence Scale for Children was measured in research clinics at age 8 for all. Neurocognitive disorders (NCDs) were identified from chart review. There were 10 851 children with ≥2 head measurements. At each age, 2% to 3% of children had scores that were < -2 or >2 SDs below or above the mean, but for most children this was only found at 1 age. More than 15% of children showed centile shifts, but less than one-third of these were sustained at subsequent measurements. Only 0.5% showed a sustained shift beyond the normal range. Children with consistently small heads were up to 7 times more likely to have an NCD, but 85% of children with small heads had no NCDs, and 93% of children with NCDs had head SD scores within the normal range. Centile shifts within the normal range occur commonly and seem mainly to reflect measurement error. This finding makes robust assessment of the head trajectory difficult and may result in many children being investigated unnecessarily. Extreme head size is neither specific nor sensitive for detecting NCDs, suggesting that routine measurement of HC is unhelpful. Copyright © 2015 by the American Academy of Pediatrics.

  3. Reference charts of fetal biometric parameters in 31,476 Brazilian singleton pregnancies.

    PubMed

    Araujo Júnior, Edward; Martins Santana, Eduardo Félix; Martins, Wellington P; Júnior, Julio Elito; Ruano, Rodrigo; Pires, Claudio Rodrigues; Filho, Sebastião Marques Zanforlin

    2014-07-01

    The purpose of this study was to establish reference charts of fetal biometric parameters measured by 2-dimensional sonography in a large Brazilian population. A cross-sectional retrospective study was conducted including 31,476 low-risk singleton pregnancies between 18 and 38 weeks' gestation. The following fetal parameters were measured: biparietal diameter, head circumference, abdominal circumference, femur length, and estimated fetal weight. To assess the correlation between the fetal biometric parameters and gestational age, polynomial regression models were created, with adjustments made by the determination coefficient (R(2)). The means ± SDs of the biparietal diameter, head circumference, abdominal circumference, femur length, and estimated fetal weight measurements at 18 and 38 weeks were 4.2 ± 2.34 and 9.1 ± 4.0 cm, 15.3 ± 7.56 and 32.3 ± 11.75 cm, 13.3 ± 10.42 and 33.4 ± 20.06 cm, 2.8 ± 2.17 and 7.2 ± 3.58 cm, and 256.34 ± 34.03 and 3169.55 ± 416.93 g, respectively. Strong correlations were observed between all fetal biometric parameters and gestational age, best represented by second-degree equations, with R(2) values of 0.95, 0.96, 0.95, 0.95, and 0.95 for biparietal diameter, head circumference, abdominal circumference, femur length, and estimated fetal weight. Fetal biometric parameters were determined for a large Brazilian population, and they may serve as reference values in cases with a high risk of intrauterine growth disorders. © 2014 by the American Institute of Ultrasound in Medicine.

  4. Estimation of body density based on hydrostatic weighing without head submersion in young Japanese adults.

    PubMed

    Demura, S; Sato, S; Kitabayashi, T

    2006-06-01

    This study examined a method of predicting body density based on hydrostatic weighing without head submersion (HWwithoutHS). Donnelly and Sintek (1984) developed a method to predict body density based on hydrostatic weight without head submersion. This method predicts the difference (D) between HWwithoutHS and hydrostatic weight with head submersion (HWwithHS) from anthropometric variables (head length and head width), and then calculates body density using D as a correction factor. We developed several prediction equations to estimate D based on head anthropometry and differences between the sexes, and compared their prediction accuracy with Donnelly and Sintek's equation. Thirty-two males and 32 females aged 17-26 years participated in the study. Multiple linear regression analysis was performed to obtain the prediction equations, and the systematic errors of their predictions were assessed by Bland-Altman plots. The best prediction equations obtained were: Males: D(g) = -164.12X1 - 125.81X2 - 111.03X3 + 100.66X4 + 6488.63, where X1 = head length (cm), X2 = head circumference (cm), X3 = head breadth (cm), X4 = head thickness (cm) (R = 0.858, R2 = 0.737, adjusted R2 = 0.687, standard error of the estimate = 224.1); Females: D(g) = -156.03X1 - 14.03X2 - 38.45X3 - 8.87X4 + 7852.45, where X1 = head circumference (cm), X2 = body mass (g), X3 = head length (cm), X4 = height (cm) (R = 0.913, R2 = 0.833, adjusted R2 = 0.808, standard error of the estimate = 137.7). The effective predictors in these prediction equations differed from those of Donnelly and Sintek's equation, and head circumference and head length were included in both equations. The prediction accuracy was improved by statistically selecting effective predictors. Since we did not assess cross-validity, the equations cannot be used to generalize to other populations, and further investigation is required.

  5. Leg length, skull circumference, and the prevalence of dementia in low and middle income countries; a 10/66 population-based cross sectional survey

    PubMed Central

    Prince, Martin; Acosta, Daisy; Dangour, Alan D; Uauy, Ricardo; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Llibre Rodriguez, Juan J.; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D.; Acosta, Isaac; Albanese, Emiliano; Dewey, Michael E.; Ferri, Cleusa P.; Stewart, Robert; Gaona, Ciro; Jotheeswaran, AT.; Senthil Kumar, P; Li, Shuran; Llibre Guerra, Juan C.; Rodriguez, Diana; Rodriguez, Guillermina

    2017-01-01

    Background Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life. Methods One phase cross-sectional surveys of all over 65 year old residents (n=14,960) in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru. The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 Dementia, controlling for age, gender, education and family history of dementia. Results The pooled meta-analysed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender. Conclusions Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration. PMID:20701817

  6. Head fat is a novel method of measuring metabolic disorder in Chinese obese patients

    PubMed Central

    2014-01-01

    Background Body adiposity, especially ectopic fat accumulation, has a range of metabolic and cardiovascular effects. The aim of this study was to investigate the association between head fat and metabolic values in Chinese obese patients. Methods Data of this cross-sectional study from 66 obese patients were collected. Fat distribution was measured by dual-energy X-ray absorptiometry, and data of body weight, body mass index (BMI), neck circumference (NC), waist circumference (WC), hip circumference (HC), visceral index, basal metabolism (BM), glucose metabolism, lipid levels, uric acid (UA) had been collected. Results 1) Head fat was significantly associated with BMI, WC, HC, visceral index, BM, total fat and total fat excluding head fat in both males and females (p < 0.05). Head fat was positively correlated with upper limb fat, trunk fat, weight, fasting plasma C peptide, fasting plasma insulin and UA in women(p < 0.05), and the association was not statistically significant in male (p > 0.05). Head fat was positively corrected with NC in males (p < 0.05) but not females (p > 0.05). There was no significant correlation between head fat and fasting plasma glucose, total choleslerolemia, triglyceridemia, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and free fat acid in either gender (p > 0.05). 2) Receiver operating characteristic analysis showed that a head fat of 1925.6 g and a head fat of 1567.85 g were the best cut-off values to determine subjects with low high-density lipoprotein cholesterol and hyperuricemia respectively. Conclusions Head fat accumulation was closely associated with increased body fat, hyperinsulinemia, hyperuricemia, and impared lipid profile, suggesting it might be used as an indicator for dyslipidemia and hyperuricemia. PMID:25015267

  7. 15 CFR 241.7 - Tolerances to be allowed.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... follows: Tolerance inches Diameter of head 1/4 Effective diameter of head 1/4 Distance between heads 1/4 Circumference of bulge, outside measurement 11/2 Length of stave 1/2 (1) If no dimension of a barrel of Class 1... the effective diameter of head and the distance between heads algebraically and multiply the result by...

  8. 15 CFR 241.7 - Tolerances to be allowed.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... follows: Tolerance inches Diameter of head 1/4 Effective diameter of head 1/4 Distance between heads 1/4 Circumference of bulge, outside measurement 11/2 Length of stave 1/2 (1) If no dimension of a barrel of Class 1... the effective diameter of head and the distance between heads algebraically and multiply the result by...

  9. 15 CFR 241.7 - Tolerances to be allowed.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... follows: Tolerance inches Diameter of head 1/4 Effective diameter of head 1/4 Distance between heads 1/4 Circumference of bulge, outside measurement 11/2 Length of stave 1/2 (1) If no dimension of a barrel of Class 1... the effective diameter of head and the distance between heads algebraically and multiply the result by...

  10. 15 CFR 241.7 - Tolerances to be allowed.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... follows: Tolerance inches Diameter of head 1/4 Effective diameter of head 1/4 Distance between heads 1/4 Circumference of bulge, outside measurement 11/2 Length of stave 1/2 (1) If no dimension of a barrel of Class 1... the effective diameter of head and the distance between heads algebraically and multiply the result by...

  11. Sex differences in the association between foetal growth and child attention at age four: specific vulnerability of girls.

    PubMed

    Murray, Elizabeth; Matijasevich, Alicia; Santos, Iná S; Barros, Aluísio J D; Anselmi, Luciana; Barros, Fernando C; Stein, Alan

    2015-12-01

    Recent evidence suggests that impaired foetal growth may provide an early indication of increased risk of child attention problems. However, despite both foetal growth and child attention problems differing by sex, few studies have examined sex differences in this association. Furthermore, no studies have been conducted in low- and middle-income countries, where there are higher rates of perinatal problems. This study aimed to test for sex differences in the association between foetal growth indices and attention problems at age four, in a large, prospective birth cohort from a middle-income country. A total of 3,749 neonates from the 2004 Pelotas birth cohort (Brazil) with foetal growth indices collected at birth [low birthweight (LBW), small-for-gestational age (SGA), head circumference (HC), head circumference-to-abdominal circumference ratio (HC/AC) and ponderal index (PI)], were assessed for attention problems using the Child Behaviour Checklist at age four. Ordinal logistic regression with successive adjustment for maternal, demographic, gestational, perinatal and child nutrition/mother-child morbidity, was conducted separately for girls and boys. In girls, attention difficulties were associated with being born SGA (OR = 1.40, CI = 1.08-1.82, p = .012), with a small HC (OR = 1.52, CI = 1.11-2.08, p = .009), or with a low PI (OR = 1.29, CI = 1.08-1.54, p = .005). There were no associations identified between attention difficulties and any foetal growth indices in boys. Our results show that girls with impaired foetal growth may be particularly at risk of attention difficulties in childhood. This is consistent with emerging research that female foetuses may be more vulnerable to certain suboptimal intrauterine environments, inducing epigenetic changes that lead to disturbed growth and long-term developmental impairment. © 2015 Association for Child and Adolescent Mental Health.

  12. Growth and Specialized Growth Charts of Children with Congenital Hypothyroidism Detected by Neonatal Screening in Isfahan, Iran

    PubMed Central

    Feizi, Awat; Hashemipour, Mahin; Hovsepian, Silva; Amirkhani, Zeynab; Kelishadi, Roya; Yazdi, Maryam; Heydari, Kamal; Sajadi, Ali; Amini, Masoud

    2013-01-01

    Objectives. The aim of the current study was to investigate the growth status of CH, generate specialized growth charts of CH infants, and compare them with their counterparts of regional normal infants. Methods. In this prospective cohort study, 760 (345 girls and 415 boys) neonates born in 2002–2009 diagnosed by neonatal CH screening program in Isfahan were followed up from the time of diagnosis. 552 healthy children were recruited as a control group. The empirical 3rd, 15th, 50th, 85th, and 97th percentiles for height, weight, and head circumference of both sexes were determined and compared with their counterpart values of the control group. The relative frequency of patients with impaired growth for each studied variable was determined. Also, specialized growth charts of CH patients were generated. Results. The percentiles of weight, height, and head circumference of studied patients are significantly different from regional healthy children (P < 0.001). The relative frequency of impaired head circumference was decreased to less than 3% at the 3rd year of age and for height it reached gradually 3% and 9% at the 5th year of age for boys and girls, respectively (P < 0.05); however for weight still it was statistically more than 3% in both sexes. Conclusion. CH patients had impaired growth development which was improved during follow up, but the catch-up time was earlier for head circumference and later for weight. PMID:23476799

  13. Estimating the relative contributions of maternal genetic, paternal genetic and intrauterine factors to offspring birth weight and head circumference.

    PubMed

    Rice, Frances; Thapar, Anita

    2010-07-01

    Genetic factors and the prenatal environment contribute to birth weight. However, very few types of study design can disentangle their relative contribution. To examine maternal genetic and intrauterine contributions to offspring birth weight and head circumference. To compare the contribution of maternal and paternal genetic effects. Mothers and fathers were either genetically related or unrelated to their offspring who had been conceived by in vitro fertilization. 423 singleton full term offspring, of whom 262 were conceived via homologous IVF (both parents related), 66 via sperm donation (mother only related) and 95 via egg donation (father only related). Maternal weight at antenatal booking, current weight and maternal height. Paternal current weight and height were all predictors. Infant birth weight and head circumference were outcomes. Genetic relatedness was the main contributing factor between measures of parental weight and offspring birth weight as correlations were only significant when the parent was related to the child. However, there was a contribution of the intrauterine environment to the association between maternal height and both infant birth weight and infant head circumference as these were significant even when mothers were unrelated to their child. Both maternal and paternal genes made contributions to infant birth weight. Maternal height appeared to index a contribution of the intrauterine environment to infant growth and gestational age. Results suggested a possible biological interaction between the intrauterine environment and maternal inherited characteristics which suppresses the influence of paternal genes. 2010 Elsevier Ltd. All rights reserved.

  14. Growth to Age 18 Months Following Prenatal Supplementation with Docosahexaenoic Acid Differs by Maternal Gravidity in Mexico1234

    PubMed Central

    Stein, Aryeh D; Wang, Meng; Martorell, Reynaldo; Neufeld, Lynnette M.; Flores-Ayala, Rafael; Rivera, Juan A.; Ramakrishnan, Usha

    2011-01-01

    Little is known about the long-term effects of DHA intake during pregnancy. Offspring of primagravid Mexican women who received 400 mg/d DHA from wk 20 of gestation through delivery were heavier and had larger head circumferences at birth than children whose mothers received placebo; no effect was observed in offspring of multigravidae. We have followed these children (n = 739; 76% of the birth cohort), measuring length, weight, and head circumference at 1, 3, 6, 9, 12, and 18 mo. At 18 mo, intent-to-treat differences between placebo and DHA, adjusted for maternal height and child sex and age at measurement, were: length, −0.21 cm (95% CI = −0.58, 0.15); weight, −0.03 kg (95% CI =−0.19, 0.13); and head circumference, 0.02 cm (95% CI = −0.18, 0.21) (all P > 0.05). There was heterogeneity of associations by maternal gravidity for weight (P < 0.08), length (P < 0.02), and head circumference (P < 0.05). Among offspring of primagravid women, length at 18 mo was increased by 0.72 cm (95% CI = 0.11, 1.33) following DHA supplementation, representing 0.26 length-for-age Z-score units; among offspring of multigravidae, the estimate was −0.13 cm (95% CI = −0.59, 0.32) (P > 0.5). Maternal DHA supplementation during the second half of gestation may enhance growth through 18 mo of children born to primagravid women. PMID:21178082

  15. The influence of birth size on intelligence in healthy children.

    PubMed

    Broekman, Birit F P; Chan, Yiong-Huak; Chong, Yap-Seng; Quek, Swee-Chye; Fung, Daniel; Low, Yen-Ling; Ooi, Yoon-Phaik; Gluckman, Peter D; Meaney, Michael J; Wong, Tien-Yin; Saw, Seang-Mei

    2009-06-01

    Birth parameters have been hypothesized to have an influence on IQ. However, studies within the range of normal birth size have been sparse. With this study we examined the associations between birth length, birth weight, head circumference, and gestational age within the normal birth size range in relation to childhood IQ in Asian children. A cohort of 1979 of 2913 Asian children aged 7 to 9 years, recruited from 3 schools in Singapore, were followed yearly from 1999 onward. Birth parameters were recorded by health personnel. Childhood IQ was measured with the Raven's Standard Progressive Matrices at ages 8 to 12. The mean IQ score across the sample (n = 1645) was 114.2. After controlling for multiple confounders for every 1-cm increment in birth length, 1 kg in birth weight, or 1 cm in head circumference, there was a corresponding increase in IQ of 0.49 points (P for trend < .001), 2.19 points (P for trend = .007) and .62 points (P for trend = .003), respectively. These associations persisted even after exclusion of premature children and children with extreme weights and head circumferences. Longer birth length, higher birth weight, or larger head circumferences within the normal birth size range are associated with higher IQ scores in Asian children. Our results suggest that antenatal factors reflected in altered rates of growth but within the normative range of pregnancy experiences play a role in generating cognitive potential. This has implications for targeting early intervention and preventative programs.

  16. Autism with intellectual disability related to dynamics of head circumference growth during early infancy.

    PubMed

    McKeague, Ian W; Brown, Alan S; Bao, Yuanyuan; Hinkka-Yli-Salomäki, Susanna; Huttunen, Jukka; Sourander, Andre

    2015-05-01

    It is not yet definitively known whether dynamic features of head circumference growth are associated with autism. To address this issue, we carried out a nested matched case-control study using data from national well baby clinics in Finland; autism cases were identified from the Finnish Hospital and Outpatient Discharge Registry. A nonparametric Bayesian method was used to construct growth velocity trajectories between birth and 2 years of age in autism cases and matched control subjects (n = 468 in main analyses, 1:1 matched control subjects). Estimates of odds ratios for autism risk in relation to the growth velocities were obtained using conditional logistic regression. Growth velocity of head circumference at 3 months of age, adjusting for gestational age at birth and maternal age, is significantly associated with autism (p = .014); the finding was observed in subjects with comorbid intellectual disability (ID) (p = .025) but not in those without ID (p = .15). Height growth velocity among subjects with autism and without ID is significantly associated with autism at 6 months (p = .007), and weight growth velocity at 18 months without ID (p = .02) and 24 months without ID (p = .042) and with ID (p = .037). Acceleration in head circumference growth is associated with autism with comorbid ID at 3 months but not subsequently. This association is unrelated to acceleration in height and weight, which are not strongly associated with autism until after 6 months. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Growth to age 18 months following prenatal supplementation with docosahexaenoic acid differs by maternal gravidity in Mexico.

    PubMed

    Stein, Aryeh D; Wang, Meng; Martorell, Reynaldo; Neufeld, Lynnette M; Flores-Ayala, Rafael; Rivera, Juan A; Ramakrishnan, Usha

    2011-02-01

    Little is known about the long-term effects of DHA intake during pregnancy. Offspring of primagravid Mexican women who received 400 mg/d DHA from wk 20 of gestation through delivery were heavier and had larger head circumferences at birth than children whose mothers received placebo; no effect was observed in offspring of multigravidae. We have followed these children (n = 739; 76% of the birth cohort), measuring length, weight, and head circumference at 1, 3, 6, 9, 12, and 18 mo. At 18 mo, intent-to-treat differences between placebo and DHA, adjusted for maternal height and child sex and age at measurement, were: length, -0.21 cm (95% CI = -0.58, 0.15); weight, -0.03 kg (95% CI =-0.19, 0.13); and head circumference, 0.02 cm (95% CI = -0.18, 0.21) (all P > 0.05). There was heterogeneity of associations by maternal gravidity for weight (P < 0.08), length (P < 0.02), and head circumference (P < 0.05). Among offspring of primagravid women, length at 18 mo was increased by 0.72 cm (95% CI = 0.11, 1.33) following DHA supplementation, representing 0.26 length-for-age Z-score units; among offspring of multigravidae, the estimate was -0.13 cm (95% CI = -0.59, 0.32) (P > 0.5). Maternal DHA supplementation during the second half of gestation may enhance growth through 18 mo of children born to primagravid women.

  18. Maternal Leisure Time Physical Activity and Infant Birth Size.

    PubMed

    Badon, Sylvia E; Wander, Pandora L; Qiu, Chunfang; Miller, Raymond S; Williams, Michelle A; Enquobahrie, Daniel A

    2016-01-01

    Associations of maternal leisure time physical activity with birth size are inconsistent. Roles of infant sex and maternal prepregnancy body mass index (BMI) in these associations have not been studied. Participants (N = 3,310) in the Omega study, a cohort in Washington State (1996-2008), reported leisure time physical activity duration and energy expenditure in the year prepregnancy and in early pregnancy (mean 15 weeks gestation). Regression models estimated mean differences in infant head circumference, birthweight, and ponderal index (birthweight/length) across quartiles of pre- or early-pregnancy leisure time physical activity. We assessed effect modification by infant sex or prepregnancy overweight/obese status (BMI ≥ 25 kg/m). We observed positive associations between prepregnancy leisure time physical activity and head circumference overall and among male infants. Among males, each quartile increase in prepregnancy physical activity duration was associated with 0.14 cm (95% confidence interval = 0.046, 0.24; trend P = 0.004) greater head circumference. We did not observe associations between leisure time physical activity and birthweight or ponderal index overall. Each quartile increase in pre- or early-pregnancy physical activity duration was associated with 17-23 g lower birthweight among female infants and among women with normal prepregnancy BMI. We observed positive associations between prepregnancy leisure time physical activity and head circumference among male infants, and inverse associations of pre- and early-pregnancy physical activity with birthweight among female infants and women with normal prepregnancy BMI. Future studies should confirm results and elucidate mechanisms of observed associations.

  19. Head-circumference distribution in a large primary care network differs from CDC and WHO curves.

    PubMed

    Daymont, Carrie; Hwang, Wei-Ting; Feudtner, Chris; Rubin, David

    2010-10-01

    To compare currently available head-circumference growth curves to curves constructed from clinical measurements from patients in a large US primary care network (PCN). We performed a retrospective cohort study of 75 412 patients in an urban-suburban PCN. Patients with a birth weight of <1500 g or gestational age of <33 weeks at birth were excluded. We compared percentile values and the proportion of head-circumference observations above the 95th percentile and below the 5th percentile for the existing and PCN curves. The PCN curves were most similar to the National Center for Health Statistics (NCHS) curves and were substantially different from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) curves. The overall proportion of observations above the 95th percentile was 4.9% (PCN), 6.2% (NCHS), 8.6% (CDC), and 14.0% (WHO). The proportion below the 5th percentile was 4.4% (PCN), 5.1% (NCHS), 2.9% (CDC), and 2.3% (WHO). When using the CDC curves, the proportion above the 95th percentile increased from 0.2% for children younger than 2 weeks to 11.8% for children 12 months old. When using the WHO curves, the proportion above the 95th percentile was >5% at all ages, with a maximum of 18.0% for children older than 24 months. The CDC and WHO head-circumference curves describe different distributions than the clinical measurements in our PCN population, especially for children with larger heads. The resulting percentile misclassification may delay diagnosis in children with intracranial pathology in very young infants and spur unnecessary evaluation of healthy children older than 6 months.

  20. Mother's educational level and fetal growth: the genesis of health inequalities.

    PubMed

    Silva, Lindsay M; Jansen, Pauline W; Steegers, Eric A P; Jaddoe, Vincent W V; Arends, Lidia R; Tiemeier, Henning; Verhulst, Frank C; Moll, Henriëtte A; Hofman, Albert; Mackenbach, Johan P; Raat, Hein

    2010-10-01

    Women of low socio-economic status (SES) give birth to lighter babies. It is unknown from which moment during pregnancy socio-economic differences in fetal weight can be observed, whether low SES equally affects different fetal-growth components, or what the effect of low SES is after taking into account mediating factors. In 3545 pregnant women participating in the Generation R Study, we studied the association of maternal educational level (high, mid-high, mid-low and low) as a measure of SES with fetal weight, head circumference, abdominal circumference and femur length. We did this before and after adjusting for potential mediators, including maternal height, pre-pregnancy body mass index and smoking. In fetuses of low-educated women relative to those of high-educated women, fetal growth was slower, leading to a lower fetal weight that was observable from late pregnancy onwards. In these fetuses, growth of the head [-0.16 mm/week; 95% confidence interval (CI): -0.25 to -0.07; P = 0.0004], abdomen (-0.10 mm/week; 95% CI: -0.21 to 0.01; P = 0.08) and femur (-0.03 mm/week; 95% CI: -0.05 to -0.006; P = 0.01) were all slower; from mid-pregnancy onwards, head circumference was smaller, and from late pregnancy onwards, femur length was also smaller. The negative effect of low education was greatest for head circumference (difference in standard deviation score in late pregnancy: -0.26; 95% CI: -0.36 to -0.15; P < 0.0001). This effect persevered even after adjustment for the potential mediators (adjusted difference: -0.14; 95% CI: -0.25 to -0.03; P = 0.01). Low maternal education is associated with a slower fetal growth and this effect appears stronger for growth of the head than for other body parts.

  1. Dietary change mediates relationships between stress during pregnancy and infant head circumference measures: the QF2011 study.

    PubMed

    Dancause, Kelsey N; Mutran, Dima; Elgbeili, Guillaume; Laplante, David P; Kildea, Sue; Stapleton, Helen; McIntyre, David; King, Suzanne

    2017-07-01

    Prenatal maternal stress can adversely affect birth outcomes, likely reflecting effects of maternal stress hormones on fetal development. Maternal stress might also induce behavioural changes, such as dietary change, that might influence fetal development. Few studies have documented relationships between stress and dietary change in pregnancy. We analysed stress and dietary change among 222 pregnant women exposed to the 2011 Queensland Floods. We assessed women's objective hardship, subjective distress and cognitive appraisal of the disaster; changes in their diets and their associations with infants' gestational age, weight, length and head circumference at birth, head circumference to birth length ratio (HC/BL) and ponderal index. Greater objective hardship was correlated with more negative dietary change, skipped meals and skipped multivitamins. There were no direct effects of stress or dietary change on birth outcomes. However, we observed an interactive effect of dietary change and exposure timing on head circumference for gestational age (HC for GA) (p = 0.010) and a similar trend for HC/BL (p = 0.064). HC for GA and HC/BL were larger among children whose mothers experienced negative changes to their diet in early pregnancy compared with later pregnancy, consistent with a 'head-sparing' response with early gestation exposure. Further analyses indicated that dietary change mediates the relationship between objective hardship because of the floods and these outcomes. This is the first report of relationships among an independent stressor, dietary change and birth outcomes. It highlights another possible mechanism in the relationship between prenatal maternal stress and child development that could guide future research and interventions. © 2016 John Wiley & Sons Ltd.

  2. [Effect of docosahexenoic acid supplementation on infant's growth and body mass index during maternal pregnancy].

    PubMed

    Li, P; Shang, Y; Liu, Y J; Chang, X L; Yao, H Y; Liang, A M; Qi, K M

    2018-04-10

    Objective: To investigate the effects of docosahexenoic acid (DHA) supplementation on infant's growth and BMI during pregnancy. Methods: A total of 1 516 healthy pregnant women delivered their babies in two maternal and child health care hospitals in Beijing and were chosen as the subjects in this cohort study from May to October 2015. Self-developed questionnaires were used to gather general information of the subjects, including age, height, weight, weight gain during pregnancy, delivery mode, DHA supplementation etc ., before giving birth. Information on body length, weight, head circumference and BMI at birth and 6 months postnatal, of the infants were recorded. Breast milk was collected to test the fatty acid profiles by using the gas chromatography (GC) method at one to three months postnatally. Results: The overall rate of DHA supplementation was 47.76% among the pregnant women, in which introduction of DHA from the early and second stage of the pregnancy accounted for 49.31% and 39.64% respectively. When DHA supplementation began from the early pregnant stage, the DHA concentration showed an increase in the milk ( P <0.05), whereas the supplementation began from the second and third stages did not affect the milk DHA concentration ( P >0.05). Higher height and lower BMI were seen in the infants at birth and 6 months in the supplementation group when comparing to the non-supplementary group ( P <0.05), with the greatest effects noticed in the earliest supplementation group. Specifically, the head circumference appeared larger from the early pregnant stage in the DHA supplementary group, than that in the non-supplement group ( P =0.001). The increment of head circumference was larger than that in the other groups when the infants were 6-month old ( P <0.01). Results from the partial regression analysis showed that during pregnancy, there were positive correlations between DHA supplementation and height ( r =0.324, r =0.216), head circumference ( r =0.221, r =0.302) as well as the increment of head circumference ( r =0.276) at birth and 6 months ( P <0.05). Whereas, a negative correlation was shown between DHA and the infants' BMI ( r =-0.310, r =-0.371) ( P <0.05) when supplementation was given during maternal pregnancy. Conclusions: When DHA supplementation program was carried out during maternal pregnancy, it could increase the height and head circumference and inhibit the rapid increase of BMI in the infants BMI. Our findings seemed helpful in promoting brain development and preventing the childhood obesity.

  3. Heavy metal exposure has adverse effects on the growth and development of preschool children.

    PubMed

    Zeng, Xiang; Xu, Xijin; Qin, Qilin; Ye, Kai; Wu, Weidong; Huo, Xia

    2018-04-25

    The purpose of this study was to investigate the associations between levels of lead (Pb), cadmium (Cd), chromium (Cr), and manganese (Mn) in the PM 2.5 and blood and physical growth, and development parameters including birth length and weight, height, weight, body mass index (BMI), head circumference, and chest circumference in preschool children from Guiyu (e-waste exposure area) and Haojiang (the reference area). A total of 470 preschool children from Guiyu and Haojiang located in southeast coast of China were recruited and required to undergo physical examination and blood tests during the study period. Birth length and weight were obtained by birth records and questionnaire. Pb and Cd in both PM 2.5 and blood were significantly higher in Guiyu than Haojiang. Remarkably, the children of Guiyu had significantly lower birth weight and length, BMI, and chest circumference when compare to their peers from the reference area (all p value < 0.05). Spearman correlation analyses showed that blood Pb was negatively correlated with height (r = -0.130, p < 0.001), weight (r = -0.169, p < 0.001), BMI (r = -0.100, p < 0.05), head circumference (r = -0.095, p < 0.05), and chest circumference (r = -0.112, p < 0.05). After adjustment for the potential confounders in further linear regression analyses, blood Pb was negatively associated with height (β = -0.066, p < 0.05), weight (β = -0.119, p < 0.001), head circumference (β = -0.123, p < 0.01), and chest circumference (β = -0.104, p < 0.05), respectively. No significant association between blood Cd, Cr, or Mn was found with any of our developmental outcomes. Taken together, lead exposure limits or delays the growth and development of preschool children.

  4. Cognitive ability in adolescents born small for gestational age: Associations with fetal growth velocity, head circumference and postnatal growth.

    PubMed

    Jensen, Rikke Beck; Juul, Anders; Larsen, Torben; Mortensen, Erik Lykke; Greisen, Gorm

    2015-12-01

    Small size at birth may be associated with impaired cognitive ability later in life. The aim of this study was to examine the effect of being born small for gestational age (SGA), with or without intrauterine growth restriction (IUGR) on cognitive ability in late adolescence. A follow-up study of a former cohort included 123 participants (52 males); 47 born SGA and 76 born appropriate for gestational age (AGA). Fetal growth velocity (FGV) was determined by serial ultrasound measurements during the third trimester. A control group matched for age and birthplace was included. The original Wechsler Adult Intelligence Scale (WAIS) was administered, and verbal, performance and full-scale Intelligence Quotient (IQ) scores were calculated. There was no difference in IQ between adolescents born SGA and AGA. FGV or IUGR during the third trimester did not influence cognitive ability in late adolescence. Full-scale IQ was positively related to head circumference (HC) in adolescence (B: 1.30, 95% CI: 0.32-2.28, p=0.01). HC at birth and three months was positively associated with full-scale IQ. Catch-up growth in the group of SGA children was associated with a significantly increased height, larger HC, increased levels of insulin-like growth factor-I (IGF-I) and increased full-scale IQ compared to those born SGA without catch-up growth. SGA and IUGR may not be harmful for adult cognitive ability, at least not in individuals born at near-term. However, known risk factors of impaired fetal growth may explain the link between early growth and cognitive ability in adulthood. Copyright © 2015. Published by Elsevier Ireland Ltd.

  5. Daughter and her mildly affected father with Keipert syndrome.

    PubMed

    Dumic, Miroslav; Kokic, Durda Dovzak; Matic, Toni; Potocki, Kristina

    2006-11-15

    A 10-year-old girl with characteristic features of Keipert syndrome (broad terminal phalanges, especially of the thumb and hallux, sensorineural deafness, unusual facial features, large head circumference, maxillary hypoplasia, hoarse voice) and her mildly affected father (broad terminal phalanges, especially of the thumb and hallux, large head circumference, maxillary hypoplasia, and hoarse voice) are presented. The girl is the first reported female with this rare syndrome to date, and the fact that she probably inherited the disease from her father suggests an autosomal dominant pattern of inheritance. (c) 2006 Wiley-Liss, Inc.

  6. Maternal use of cannabis and pregnancy outcome.

    PubMed

    Fergusson, David M; Horwood, L John; Northstone, Kate

    2002-01-01

    To document the prevalence of cannabis use in a large sample of British women studied during pregnancy, to determine the association between cannabis use and social and lifestyle factors and assess any independent effects on pregnancy outcome. Self-completed questionnaire on use of cannabis before and during pregnancy. Over 12,000 women expecting singletons at 18 to 20 weeks of gestation who were enrolled in the Avon Longitudinal Study of Pregnancy and Childhood. Any association with the use of cannabis before and during pregnancy with pregnancy outcome was examined, taking into account potentially confounding factors including maternal social background and other substance use during pregnancy. Late fetal and perinatal death, special care admission of the newborn infant, birthweight, birth length and head circumference. Five percent of mothers reported smoking cannabis before and/or during pregnancy; they were younger, of lower parity, better educated and more likely to use alcohol, cigarettes, coffee, tea and hard drugs. Cannabis use during pregnancy was unrelated to risk of perinatal death or need for special care, but, the babies of women who used cannabis at least once per week before and throughout pregnancy were 216 g lighter than those of non-users, had significantly shorter birth lengths and smaller head circumferences. After adjustment for confounding factors, the association between cannabis use and birthweight failed to be statistically significant (P = 0.056) and was clearly non-linear: the adjusted mean birthweights for babies of women using cannabis at least once per week before and throughout pregnancy were 90 g lighter than the offspring of other women. No significant adjusted effects were seen for birth length and head circumference. The results of this study suggest that the use of cannabis during pregnancy was not associated with increased risk of perinatal mortality or morbidity in this sample. However, frequent and regular use of cannabis throughout pregnancy may be associated with small but statistically detectable decrements in birthweight.

  7. Microcephaly and Macrocephaly in Autism.

    ERIC Educational Resources Information Center

    Fombonne, Eric; Roge, Bernadette; Claverie, Jacques; Courty, Stephanie; Fremolle, Jeanne

    1999-01-01

    Analysis of data from 126 children with autism found macrocephaly (head circumstance microcephaly (head circumference <3rd centile) was found in 15.1%. Microcephaly was significantly associated with the presence of medical disorders. (Author/DB)

  8. Femur-sparing pattern of abnormal fetal growth in pregnant women from New York City after maternal Zika virus infection.

    PubMed

    Walker, Christie L; Merriam, Audrey A; Ohuma, Eric O; Dighe, Manjiri K; Gale, Michael; Rajagopal, Lakshmi; Papageorghiou, Aris T; Gyamfi-Bannerman, Cynthia; Adams Waldorf, Kristina M

    2018-05-05

    Zika virus is a mosquito-transmitted flavivirus, which can induce fetal brain injury and growth restriction following maternal infection during pregnancy. Prenatal diagnosis of Zika virus-associated fetal injury in the absence of microcephaly is challenging due to an incomplete understanding of how maternal Zika virus infection affects fetal growth and the use of different sonographic reference standards around the world. We hypothesized that skeletal growth is unaffected by Zika virus infection and that the femur length can represent an internal standard to detect growth deceleration of the fetal head and/or abdomen by ultrasound. We sought to determine if maternal Zika virus infection is associated with a femur-sparing pattern of intrauterine growth restriction through analysis of fetal biometric measures and/or body ratios using the 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project and World Health Organization Fetal Growth Chart sonographic references. Pregnant women diagnosed with a possible recent Zika virus infection at Columbia University Medical Center after traveling to an endemic area were retrospectively identified and included if a fetal ultrasound was performed. Data were collected regarding Zika virus testing, fetal biometry, pregnancy, and neonatal outcomes. The 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project and World Health Organization Fetal Growth Chart sonographic standards were applied to obtain Z-scores and/or percentiles for fetal head circumference, abdominal circumference, and femur length specific for each gestational week. A novel 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project standard was also developed to generate Z-scores for fetal body ratios with respect to femur length (head circumference:femur length, abdominal circumference:femur length). Data were then grouped within clinically relevant gestational age strata (<24, 24-27 6/7, 28-33 6/7, >34 weeks) to analyze time-dependent effects of Zika virus infection on fetal size. Statistical analysis was performed using Wilcoxon signed-rank test on paired data, comparing either abdominal circumference or head circumference to femur length. A total of 56 pregnant women were included in the study with laboratory evidence of a confirmed or possible recent Zika virus infection. Based on the Centers for Disease Control and Prevention definition for microcephaly after congenital Zika virus exposure, microcephaly was diagnosed in 5% (3/56) by both the 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project and World Health Organization Fetal Growth Chart standards (head circumference Z-score ≤-2 or ≤2.3%). Using 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project, intrauterine fetal growth restriction was diagnosed in 18% of pregnancies (10/56; abdominal circumference Z-score ≤-1.3, <10%). Analysis of fetal size using the last ultrasound scan for all subjects revealed a significantly abnormal skewing of fetal biometrics with a smaller abdominal circumference vs femur length by either 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project or World Health Organization Fetal Growth Chart (P < .001 for both). A difference in distribution of fetal abdominal circumference compared to femur length was first apparent in the 24-27 6/7 week strata (2014 International Fetal and Newborn Growth Consortium for the 21st Century Project, P = .002; World Health Organization Fetal Growth Chart, P = .001). A significantly smaller head circumference compared to femur length was also observed by 2014 International Fetal and Newborn Growth Consortium for the 21st Century Project as early as the 28-33 6/7 week strata (2014 International Fetal and Newborn Growth Consortium for the 21st Century Project, P = .007). Overall, a femur-sparing pattern of growth restriction was detected in 52% of pregnancies with either head circumference:femur length or abdominal circumference:femur length fetal body ratio <10th percentile (2014 International Fetal and Newborn Growth Consortium for the 21st Century Project Z-score ≤-1.3). An unusual femur-sparing pattern of fetal growth restriction was detected in the majority of fetuses with congenital Zika virus exposure. Fetal body ratios may represent a more sensitive ultrasound biomarker to detect viral injury in nonmicrocephalic fetuses that could impart long-term risk for complications of congenital Zika virus infection. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Does early second-trimester sonography predict adverse perinatal outcomes in monochorionic diamniotic twin pregnancies?

    PubMed

    Allaf, M Baraa; Campbell, Winston A; Vintzileos, Anthony M; Haeri, Sina; Javadian, Pouya; Shamshirsaz, Amir A; Ogburn, Paul; Figueroa, Reinaldo; Wax, Joseph; Markenson, Glenn; Chavez, Martin R; Ravangard, Samadh F; Ruano, Rodrigo; Sangi-Haghpeykar, Haleh; Salmanian, Bahram; Meyer, Marjorie; Johnson, Jeffery; Ozhand, Ali; Davis, Sarah; Borgida, Adam; Belfort, Michael A; Shamshirsaz, Alireza A

    2014-09-01

    To determine whether intertwin discordant abdominal circumference, femur length, head circumference, and estimated fetal weight sonographic measurements in early second-trimester monochorionic diamniotic twins predict adverse obstetric and neonatal outcomes. We conducted a multicenter retrospective cohort study involving 9 regional perinatal centers in the United States. We examined the records of all monochorionic diamniotic twin pregnancies with two live fetuses at the 16- to 18-week sonographic examination who had serial follow-up sonography until delivery. The intertwin discordance in abdominal circumference, femur length, head circumference, and estimated fetal weight was calculated as the difference between the two fetuses, expressed as a percentage of the larger using the 16- to 18-week sonographic measurements. An adverse composite obstetric outcome was defined as the occurrence of 1 or more of the following in either fetus: intrauterine growth restriction, twin-twin transfusion syndrome, intrauterine fetal death, abnormal growth discordance (≥20% difference), and very preterm birth at or before 28 weeks. An adverse composite neonatal outcome was defined as the occurrence of 1 or more of the following: respiratory distress syndrome, any stage of intraventricular hemorrhage, 5-minute Apgar score less than 7, necrotizing enterocolitis, culture-proven early-onset sepsis, and neonatal death. Receiver operating characteristic and logistic regression-with-generalized estimating equation analyses were constructed. Among the 177 monochorionic diamniotic twin pregnancies analyzed, intertwin abdominal circumference and estimated fetal weight discordances were only predictive of adverse composite obstetric outcomes (areas under the curve, 79% and 80%, respectively). Receiver operating characteristic curves showed that intertwin discordances in abdominal circumference, femur length, head circumference, and estimated fetal weight were not acceptable predictors of twin-twin transfusion syndrome or adverse neonatal outcomes. In our cohort, only second-trimester abdominal circumference and estimated fetal weight discordances in monochorionic diamniotic twin pregnancies were predictive of adverse composite obstetric outcomes. Twin-twin transfusion syndrome and adverse neonatal outcomes were not predicted by any of the intertwin discordances measured. © 2014 by the American Institute of Ultrasound in Medicine.

  10. Bobble-head doll syndrome associated with Dandy-Walker syndrome. Case report.

    PubMed

    de Brito Henriques, José Gilberto; Henriques, Karina Santos Wandeck; Filho, Geraldo Pianetti; Fonseca, Luiz Fernando; Cardoso, Francisco; Da Silva, Márcia Cristina

    2007-09-01

    Bobble-head doll syndrome (BHDS) presents in childhood and is usually associated with lesions of the third ventricle. This disorder is characterized by stereotypical head movements of the type "yes-yes" (up and down) at a frequency of 2 to 3 Hz. Rarely, movements of the type "no-no" (side-to-side) are described. There are a few hypotheses to explain the mechanism responsible for BHDS, but its real pathophysiological characteristics are still unknown. The authors describe the case of a child born with hydrocephalus and Dandy-Walker syndrome. A ventriculoperitoneal shunt was implanted in the child because of progressive head enlargement. One year after shunt placement, she began making frequent horizontal head movements of the type "no-no". There were no other signs or symptoms. Imaging studies demonstrated small ventricles and a posterior fossa cyst with no signs of hypertension. The child's growth, development, and head circumference (within the 5th percentile) remained satisfactory. Three aspects of this case were of interest: the association of BHDS with Dandy-Walker syndrome, the rare occurrence of BHDS of the "no-no" type, and the absence of third ventricle dilation. The authors' findings support the hypothesis that cerebellar malformations themselves can

  11. Maternal Night-Fasting Interval during Pregnancy Is Directly Associated with Neonatal Head Circumference and Adiposity in Girls but Not Boys.

    PubMed

    Loy, See Ling; Wee, Poh Hui; Colega, Marjorelee T; Cheung, Yin Bun; Aris, Izzuddin M; Chan, Jerry Kok Yen; Godfrey, Keith M; Gluckman, Peter D; Tan, Kok Hian; Shek, Lynette Pei-Chi; Chong, Yap-Seng; Natarajan, Padmapriya; Müller-Riemenschneider, Falk; Lek, Ngee; Rajadurai, Victor Samuel; Tint, Mya-Thway; Lee, Yung Seng; Chong, Mary Foong-Fong; Yap, Fabian

    2017-07-01

    Background: Synchrony between daily feeding-fasting signals and circadian rhythms has been shown to improve metabolic health in animals and adult humans, but the potential programming effect on fetal growth is unknown. Objective: We examined the associations of the maternal night-fasting interval during pregnancy with offspring birth size and adiposity. Methods: This was a cross-sectional study of mother-offspring dyads within the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. For 384 mothers aged 30.8 ± 4.8 y (mean ± SD), the night-fasting interval at 26-28 wk of gestation was determined from a 3-d food diary based on the average of the fasting duration at night (1900-0659). Offspring birth weight, length, and head circumference were measured and converted to weight-for-gestational age (GA), length-for-GA, and head circumference-for-GA z scores, respectively, by using local customized percentile charts. The percentage of neonatal total body fat (TBF) was derived by using a validated prediction equation. Multivariable general linear models, stratified by child sex, were performed. Results: The mean ± SD maternal night-fasting interval was 9.9 ± 1.3 h. In infant girls, each 1-h increase in the maternal night-fasting interval was associated with a 0.22-SD (95% CI: 0.05-, 0.40-SD; P = 0.013) increase in birth head circumference-for-GA and a 0.84% (95% CI: 0.19%, 1.49%; P = 0.012) increase in TBF at birth, after adjustment for confounders. In infant boys, no associations were observed between the maternal night-fasting interval and birth size or TBF. Conclusions: An increased maternal night-fasting interval in the late second trimester of pregnancy is associated with increased birth head circumference and TBF in girls but not boys. Our findings are in accordance with previous observations that suggest that there are sex-specific responses in fetal brain growth and adiposity, and raise the possibility of the maternal night-fasting interval as an underlying influence. This trial was registered at clinicaltrials.gov as NCT01174875. © 2017 American Society for Nutrition.

  12. Maternal urinary iodine concentration up to 1.0 mg/L is positively associated with birth weight, length, and head circumference of male offspring.

    PubMed

    Rydbeck, Filip; Rahman, Anisur; Grandér, Margaretha; Ekström, Eva-Charlotte; Vahter, Marie; Kippler, Maria

    2014-09-01

    Adequate iodine status in early life is crucial for neurodevelopment. However, little is known about the effects of maternal iodine status during pregnancy on fetal growth. The present study investigated the potential impact of maternal iodine status during pregnancy on offspring birth size. This large prospective cohort study was nested in a Bangladeshi population-based randomized supplementation trial in pregnant women [MINIMat (Maternal and Infant Nutrition Interventions in Matlab)]. Urine samples obtained at 8 wk of gestation from 1617 women were analyzed for iodine and other elements, such as arsenic and cadmium, using inductively coupled plasma mass spectrometry. Anthropometric measurements at birth included weight, length, and head and chest circumference. Maternal urinary iodine concentrations (UICs) ranged from 0.020 to 10 mg/L, with a median of 0.30 mg/L. Below ∼1.0 mg/L, UIC was significantly positively associated with birth weight and length. Birth weight and length increased by 9.3 g (95% CI: 2.9, 16) and 0.042 cm (95% CI: 0.0066, 0.076), respectively, for each 0.1-mg/L increase in maternal UIC. No associations were observed between UIC and head or chest circumference. When we stratified the analyses by newborn sex, the positive associations between maternal UIC (<1 mg/L) and measurements of size at birth were restricted to boys, with no evidence in girls. Among boys, the mean weight, length, and head circumference increased by 70 g (P = 0.019), 0.41 cm (P = 0.013), and 0.28 cm (P = 0.031) for every 0.5-mg/L increase in maternal UIC. Maternal iodine status was positively associated with weight, length, and head circumference in boys up to ∼1 mg/L, which is well above the recommended maximum concentration of 0.5 mg/L. The associations leveled off at UIC ≥ 1 mg/L. Our findings support previous conclusions that the advantages of correcting potential iodine deficiency outweigh the risks of excess exposure. © 2014 American Society for Nutrition.

  13. Estimating the relative contributions of maternal genetic, paternal genetic and intrauterine factors to offspring birth weight and head circumference

    PubMed Central

    Rice, Frances; Thapar, Anita

    2010-01-01

    Background Genetic factors and the prenatal environment contribute to birth weight. However, very few types of study design can disentangle their relative contribution. Aims To examine maternal genetic and intrauterine contributions to offspring birth weight and head circumference. To compare the contribution of maternal and paternal genetic effects. Study design Mothers and fathers were either genetically related or unrelated to their offspring who had been conceived by in vitro fertilization. Subjects 423 singleton full term offspring, of whom 262 were conceived via homologous IVF (both parents related), 66 via sperm donation (mother only related) and 95 via egg donation (father only related). Measures Maternal weight at antenatal booking, current weight and maternal height. Paternal current weight and height were all predictors. Infant birth weight and head circumference were outcomes. Results Genetic relatedness was the main contributing factor between measures of parental weight and offspring birth weight as correlations were only significant when the parent was related to the child. However, there was a contribution of the intrauterine environment to the association between maternal height and both infant birth weight and infant head circumference as these were significant even when mothers were unrelated to their child. Conclusions Both maternal and paternal genes made contributions to infant birth weight. Maternal height appeared to index a contribution of the intrauterine environment to infant growth and gestational age. Results suggested a possible biological interaction between the intrauterine environment and maternal inherited characteristics which suppresses the influence of paternal genes. PMID:20646882

  14. Maternal smokeless tobacco use in Alaska Native women and singleton infant birth size.

    PubMed

    England, Lucinda J; Kim, Shin Y; Shapiro-Mendoza, Carrie K; Wilson, Hoyt G; Kendrick, Juliette S; Satten, Glen A; Lewis, Claire A; Whittern, Persenia; Tucker, Myra J; Callaghan, William M

    2012-01-01

    To examine the effects of maternal prenatal smokeless tobacco use on infant birth size. A retrospective medical record review of 502 randomly selected deliveries. Singleton deliveries to Alaska Native women residing in a defined geographical region in western Alaska, 1997-2005. A regional medical center's electronic records were used to identify singleton deliveries. Data on maternal tobacco exposure and pregnancy outcomes were abstracted from medical records. Logistic models were used to estimate adjusted mean birthweight, length and head circumference for deliveries to women who used no tobacco (n=121), used smokeless tobacco (n=237) or smoked cigarettes (n=59). Differences in mean birthweight, length and head circumference, 95% confidence intervals and p-values were calculated using non-users as the reference group. Infant birthweight, crown-heel length and head circumference. After adjustment for gestational age and other potential confounders, the mean birthweight of infants of smokeless tobacco users was reduced by 78 g compared with that of infants of non-users (p=0.18) and by 331 g in infants of smokers (p<0.01). No association was found between maternal smokeless tobacco use and infant length or infant head circumference. We found a modest but non-significant reduction in the birthweight of infants of smokeless tobacco users compared with infants of tobacco non-users. Because smokeless tobacco contains many toxic compounds that could affect other pregnancy outcomes, results of this study should not be construed to mean that smokeless tobacco use is safe during pregnancy. © 2011 Nordic Federation of Societies of Obstetrics and Gynecology No claim to original US government works.

  15. Birth weight, head circumference, and prenatal exposure to acrylamide from maternal diet: the European prospective mother-child study (NewGeneris).

    PubMed

    Pedersen, Marie; von Stedingk, Hans; Botsivali, Maria; Agramunt, Silvia; Alexander, Jan; Brunborg, Gunnar; Chatzi, Leda; Fleming, Sarah; Fthenou, Eleni; Granum, Berit; Gutzkow, Kristine B; Hardie, Laura J; Knudsen, Lisbeth E; Kyrtopoulos, Soterios A; Mendez, Michelle A; Merlo, Domenico F; Nielsen, Jeanette K; Rydberg, Per; Segerbäck, Dan; Sunyer, Jordi; Wright, John; Törnqvist, Margareta; Kleinjans, Jos C; Kogevinas, Manolis

    2012-12-01

    Acrylamide is a common dietary exposure that crosses the human placenta. It is classified as a probable human carcinogen, and developmental toxicity has been observed in rodents. We examined the associations between prenatal exposure to acrylamide and birth outcomes in a prospective European mother-child study. Hemoglobin (Hb) adducts of acrylamide and its metabolite glycidamide were measured in cord blood (reflecting cumulated exposure in the last months of pregnancy) from 1,101 singleton pregnant women recruited in Denmark, England, Greece, Norway, and Spain during 2006-2010. Maternal diet was estimated through food-frequency questionnaires. Both acrylamide and glycidamide Hb adducts were associated with a statistically significant reduction in birth weight and head circumference. The estimated difference in birth weight for infants in the highest versus lowest quartile of acrylamide Hb adduct levels after adjusting for gestational age and country was -132 g (95% CI: -207, -56); the corresponding difference for head circumference was -0.33 cm (95% CI: -0.61, -0.06). Findings were similar in infants of nonsmokers, were consistent across countries, and remained after adjustment for factors associated with reduced birth weight. Maternal consumption of foods rich in acrylamide, such as fried potatoes, was associated with cord blood acrylamide adduct levels and with reduced birth weight. Dietary exposure to acrylamide was associated with reduced birth weight and head circumference. Consumption of specific foods during pregnancy was associated with higher acrylamide exposure in utero. If confirmed, these findings suggest that dietary intake of acrylamide should be reduced among pregnant women.

  16. Fetal growth velocity and body proportion in the assessment of growth.

    PubMed

    Hiersch, Liran; Melamed, Nir

    2018-02-01

    Fetal growth restriction implies failure of a fetus to meet its growth potential and is associated with increased perinatal mortality and morbidity. Therefore, antenatal detection of fetal growth restriction is of major importance in an attempt to deliver improved clinical outcomes. The most commonly used approach towards screening for fetal growth restriction is by means of sonographic fetal weight estimation, to detect fetuses small for gestational age, defined by an estimated fetal weight <10th percentile for gestational age. However, the predictive accuracy of this approach is limited both by suboptimal detection rate (as it may overlook non-small-for-gestational-age growth-restricted fetuses) and by a high false-positive rate (as most small-for-gestational-age fetuses are not growth restricted). Here, we review 2 strategies that may improve the diagnostic accuracy of sonographic fetal biometry for fetal growth restriction. The first strategy involves serial ultrasound evaluations of fetal biometry. The information obtained through these serial assessments can be interpreted using several different approaches including fetal growth velocity, conditional percentiles, projection-based methods, and individualized growth assessment that can be viewed as mathematical techniques to quantify any decrease in estimated fetal weight percentile, a phenomenon that many care providers assess and monitor routinely in a qualitative manner. This strategy appears promising in high-risk pregnancies where it seems to improve the detection of growth-restricted fetuses at increased risk of adverse perinatal outcomes and, at the same time, decrease the risk of falsely diagnosing healthy constitutionally small-for-gestational-age fetuses as growth restricted. Further studies are needed to determine the utility of this strategy in low-risk pregnancies as well as to optimize its performance by determining the optimal timing and interval between exams. The second strategy refers to the use of fetal body proportions to classify fetuses as either symmetric or asymmetric using 1 of several ratios; these include the head circumference to abdominal circumference ratio, transverse cerebellar diameter to abdominal circumference ratio, and femur length to abdominal circumference ratio. Although these ratios are associated with small for gestational age at birth and with adverse perinatal outcomes, their predictive accuracy is too low for clinical practice. Furthermore, these associations become questionable when other, potentially more specific measures such as umbilical artery Doppler are being used. Furthermore, these ratios are of limited use in determining the etiology underlying fetal smallness. It is possible that the use of the 2 gestational-age-independent ratios (transverse cerebellar diameter to abdominal circumference and femur length to abdominal circumference) may have a role in the detection of mild-moderate fetal growth restriction in pregnancies without adequate dating. In addition, despite their limited predictive accuracy, these ratios may become abnormal early in the course of fetal growth restriction and may therefore identify pregnancies that may benefit from closer monitoring of fetal growth. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Measures of growth in children at risk for Huntington disease

    PubMed Central

    Mathews, Kathy; Schlaggar, Bradley; Perlmutter, Joel; Paulsen, Jane S.; Epping, Eric; Burmeister, Leon; Nopoulos, Peg

    2012-01-01

    Objective: The effect of mHTT on human development was examined by evaluating measures of growth in children at risk for Huntington disease (HD). Methods: Children at risk for HD with no manifest symptoms (no juvenile HD included) were enrolled and tested for gene expansion for research purposes only. Measurements of growth (height, weight, body mass index [BMI], and head circumference) in children tested as gene-expanded (n = 20, 7–18 years of age, CAG repeats ≥39) were compared to those of a large database of healthy children (n = 152, 7–18 years of age). Results: Gene-expanded children had significantly lower measures of head circumference, weight, and BMI. Head circumference was abnormally low even after correcting for height, suggesting a specific deficit in brain growth, rather than a global growth abnormality. Conclusions: These results indicate that, compared to a control population, children who were estimated to be decades from HD diagnosis have significant differences in growth. Further, they suggest that mHTT may play a role in atypical somatic, and in particular, brain development. PMID:22815549

  18. The Significance of Macrocephaly or Enlarging Head Circumference in Infants With the Triad

    PubMed Central

    Miller, David; Barnes, Patrick; Miller, Marvin

    2015-01-01

    Abstract Infants with the triad (neurologic dysfunction, subdural hematoma [SDH], and retinal hemorrhage) are often diagnosed as victims of shaken baby syndrome. Medical conditions/predisposing factors to developing the triad are often dismissed: short falls, birth-related SDH that enlarges, macrocephaly, sinus/cortical vein thrombosis, and others. Six infants with the triad are described in which child abuse was diagnosed, but parents denied wrongdoing. All 6 had either macrocephaly or enlarging head circumference, which suggested medical explanations. Three infants incurred short falls, 1 had a difficult delivery in which there was likely a rebleed of a birth-related SDH, 1 had a spontaneous SDH associated with increased extra-axial fluid spaces, and 1 had a sinus thrombosis. Following legal proceedings, all 6 infants were returned to their parents, and there has been no child maltreatment in follow-up, suggesting child abuse never happened. The results indicate that alternative medical explanations for causing the triad should be considered and that macrocephaly or an enlarging head circumference raises the possibility of a medical explanation. PMID:25893912

  19. Imprinted gene expression in fetal growth and development.

    PubMed

    Lambertini, L; Marsit, C J; Sharma, P; Maccani, M; Ma, Y; Hu, J; Chen, J

    2012-06-01

    Experimental studies showed that genomic imprinting is fundamental in fetoplacental development by timely regulating the expression of the imprinted genes to overlook a set of events determining placenta implantation, growth and embryogenesis. We examined the expression profile of 22 imprinted genes which have been linked to pregnancy abnormalities that may ultimately influence childhood development. The study was conducted in a subset of 106 placenta samples, overrepresented with small and large for gestational age cases, from the Rhode Island Child Health Study. We investigated associations between imprinted gene expression and three fetal development parameters: newborn head circumference, birth weight, and size for gestational age. Results from our investigation show that the maternally imprinted/paternally expressed gene ZNF331 inversely associates with each parameter to drive smaller fetal size, while paternally imprinted/maternally expressed gene SLC22A18 directly associates with the newborn head circumference promoting growth. Multidimensional Scaling analysis revealed two clusters within the 22 imprinted genes which are independently associated with fetoplacental development. Our data suggest that cluster 1 genes work by assuring cell growth and tissue development, while cluster 2 genes act by coordinating these processes. Results from this epidemiologic study offer solid support for the key role of imprinting in fetoplacental development. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. A Statistical Skull Geometry Model for Children 0-3 Years Old

    PubMed Central

    Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P.; Rupp, Jonathan D.; Hoff, Carrie N.; Hu, Jingwen

    2015-01-01

    Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0–3 YO population. In this study, head CT scans from fifty-six 0–3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models. PMID:25992998

  1. A statistical skull geometry model for children 0-3 years old.

    PubMed

    Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

    2015-01-01

    Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0-3 YO population. In this study, head CT scans from fifty-six 0-3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.

  2. Is sub-nutrition necessary for a poor outcome following early institutional deprivation?

    PubMed

    Sonuga-Barke, Edmund J S; Beckett, Celia; Kreppner, Jana; Castle, Jenny; Colvert, Emma; Stevens, Suzanne; Hawkins, Amanda; Rutter, Michael

    2008-09-01

    Institutional deprivation is multifaceted and includes adverse psychosocial and nutrition-related components. In this study we partitioned these risks in relation to cognitive impairment and mental ill health, and explored the mediating role of reduced head/brain size. There were 138 participants (61 males, 77 females) in the study. Participants were Romanian adoptees who had experienced at least 2 weeks of early institutional deprivation. The sample was stratified on the basis of duration of deprivation (high risk >6 mo in institutions) and sub-nutrition (i.e. 1.5 SD below UK age-related norms for weight at UK entry). UK children adopted before 6 months of age and a group of non-institutionally deprived Romanian children constituted the comparison groups. Duration of deprivation was associated with smaller head circumference, lowered IQ, and increased mental heath problems, independently of effects found for sub-nutrition on head circumference and IQ. The mediating role of head circumference was limited to either sub-nourished (IQ) or non-sub-nourished (inattention/overactivity and disinhibited attachment) subgroups. Many negative effects of early deprivation, including stunted brain growth, occur without sub-nutrition: psychosocial deprivation plays a major role in neurodevelopmental effects of deprivation. Further studies of functional and structural neuroanatomy following institutional deprivation are required to delineate the role of brain development in its effects.

  3. The growth of very-low-birth-weight infants at 5 years old in Taiwan.

    PubMed

    Wang, Pei-Wei; Fang, Li-Jung; Tsou, Kuo-Inn

    2014-04-01

    The goal of this study was to compare the growth and effect of growth on cognitive performance at 5 years of age of a group of very-low-birth-weight (VLBW) infants and a group of healthy full-term infants. Beginning in 1995, under the sponsorship of the Premature Baby Foundation, the Society of Neonatology, Taiwan, conducted a multicenter follow-up study of VLBW infants in Taiwan. The study enrolled 322 VLBW infants and 103 controls for assessment of growth data and cognitive performance at several time points from birth through to 5 years of age. Growth data were assessed with measurements of weight, height, and head circumference taken at the ages of 6 months, 12 months, 24 months, and 60 months. Cognitive performance was assessed at the age of 5 years. The VLBW infants were regarded as "failed" if a measurement was 2 standard deviations below the mean measurement of the control group. Neonatal and perinatal data had been collected prospectively as part of a longitudinal study. Cognitive performance was assessed using the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R). From 6 months to 5 years, VLBW infants had lower weight, height, and head circumference than the controls. Two hundred twenty-four VLBW infants (69.6%) returned for assessment at 5 years old. Of the 224 VLBW infants, complete sets of measurements of weight, height, and head circumference were obtained for 126 cases (56.3%), 127 cases (56.7%), and 106 cases (47.3%), respectively. Of these, 13 patients (10.3%) failed in weight, 11 patients (8.7%) failed in height, and 17 patients (16.0%) failed in head circumference at the age of 5 years. The mean WPPSI-R scores at the age of 5 years for VLBW children were: 94.1 ± 16.4 (performance IQ), 87.2 ± 12.8 (verbal IQ), and 89.5 ± 14.6 (full IQ). All of these values were also lower than those of the control group, with the differences being statistically significant (p < 0.05). The WPPSI-R scores of VLBW children who failed in head circumference were notably lower than those of VLBW children whose head circumference had caught up with that of their peers. The growth of VLBW infants was lower than that of healthy full-term infants through 5 years of age. The cognitive performance for VLBW children was also decreased compared to that of the control group, and there was an association between slower growth and decreased cognitive ability. Copyright © 2013. Published by Elsevier B.V.

  4. Fetal head detection and measurement in ultrasound images by a direct inverse randomized Hough transform

    NASA Astrophysics Data System (ADS)

    Lu, Wei; Tan, Jinglu; Floyd, Randall C.

    2005-04-01

    Object detection in ultrasound fetal images is a challenging task for the relatively low resolution and low signal-to-noise ratio. A direct inverse randomized Hough transform (DIRHT) is developed for filtering and detecting incomplete curves in images with strong noise. The DIRHT combines the advantages of both the inverse and the randomized Hough transforms. In the reverse image, curves are highlighted while a large number of unrelated pixels are removed, demonstrating a "curve-pass filtering" effect. Curves are detected by iteratively applying the DIRHT to the filtered image. The DIRHT was applied to head detection and measurement of the biparietal diameter (BPD) and head circumference (HC). No user input or geometric properties of the head were required for the detection. The detection and measurement took 2 seconds for each image on a PC. The inter-run variations and the differences between the automatic measurements and sonographers" manual measurements were small compared with published inter-observer variations. The results demonstrated that the automatic measurements were consistent and accurate. This method provides a valuable tool for fetal examinations.

  5. Megalencephalic Leukoencephalopathy with Subcortical Cysts (MLC)

    MedlinePlus

    ... patients, the first symptom is an increase in head circumference in the first year of life. Patients can have a delayed development and may subsequently show neurological deterioration ... an abnormally large head Seizures (present in ~75% of patients and most ...

  6. CORRELATIONS BETWEEN INTELLIGENCE, HEAD CIRCUMFERENCE AND HEIGHT: EVIDENCE FROM TWO SAMPLES IN SAUDI ARABIA.

    PubMed

    Bakhiet, Salaheldin Farah Attallah; Essa, Yossry Ahmed Sayed; Dwieb, Amira Mahmood Mohsen; Elsayed, Abdelkader Mohamed Abdelkader; Sulman, Afra Sulman Mohammed; Cheng, Helen; Lynn, Richard

    2017-03-01

    This study was based on two independent studies which in total consisted of 1812 school pupils aged 6-12 years in Saudi Arabia. Study I consisted of 1591 school pupils (609 boys and 982 girls) attending state schools, and Study II consisted of 211 boys with learning disabilities. Intelligence (measured using the Standard Progressive Matrices Plus for Study I and the Standard Progressive Matrices for Study II), head size and height were measured for the two samples. The results showed that intelligence was statistically significantly correlated with head circumference (r=0.350, p<0.001 for Study I and r=0.168, p<0.05 for Study II) and height (r=0.271, p<0.001 for Study I and r=0.178, p<0.05 for Study II).

  7. Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam

    PubMed Central

    Young, Melissa F.; Hong Nguyen, Phuong; Addo, O. Yaw; Pham, Hoa; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

    2017-01-01

    Objective To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21–29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. Methods Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. Results Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21–29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46–0.70). Conclusion There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. Trial Registration ClinicalTrials.gov, NCT01665378 PMID:28114316

  8. Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.

    PubMed

    Young, Melissa F; Hong Nguyen, Phuong; Addo, O Yaw; Pham, Hoa; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

    2017-01-01

    To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. ClinicalTrials.gov, NCT01665378.

  9. 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), 75.5% (+2 weeks), and 91.5% (+3 weeks). This mathematical model may be used in identifying preterm neonates. PMID:24592594

  10. Birth Weight, Head Circumference, and Prenatal Exposure to Acrylamide from Maternal Diet: The European Prospective Mother–Child Study (NewGeneris)

    PubMed Central

    Pedersen, Marie; von Stedingk, Hans; Botsivali, Maria; Agramunt, Silvia; Alexander, Jan; Brunborg, Gunnar; Chatzi, Leda; Fleming, Sarah; Fthenou, Eleni; Granum, Berit; Gutzkow, Kristine B.; Hardie, Laura J.; Knudsen, Lisbeth E.; Kyrtopoulos, Soterios A.; Mendez, Michelle A.; Merlo, Domenico F.; Nielsen, Jeanette K.; Rydberg, Per; Segerbäck, Dan; Sunyer, Jordi; Wright, John; Törnqvist, Margareta; Kleinjans, Jos C.

    2012-01-01

    Background: Acrylamide is a common dietary exposure that crosses the human placenta. It is classified as a probable human carcinogen, and developmental toxicity has been observed in rodents. Objectives: We examined the associations between prenatal exposure to acrylamide and birth outcomes in a prospective European mother–child study. Methods: Hemoglobin (Hb) adducts of acrylamide and its metabolite glycidamide were measured in cord blood (reflecting cumulated exposure in the last months of pregnancy) from 1,101 singleton pregnant women recruited in Denmark, England, Greece, Norway, and Spain during 2006–2010. Maternal diet was estimated through food-frequency questionnaires. Results: Both acrylamide and glycidamide Hb adducts were associated with a statistically significant reduction in birth weight and head circumference. The estimated difference in birth weight for infants in the highest versus lowest quartile of acrylamide Hb adduct levels after adjusting for gestational age and country was –132 g (95% CI: –207, –56); the corresponding difference for head circumference was –0.33 cm (95% CI: –0.61, –0.06). Findings were similar in infants of nonsmokers, were consistent across countries, and remained after adjustment for factors associated with reduced birth weight. Maternal consumption of foods rich in acrylamide, such as fried potatoes, was associated with cord blood acrylamide adduct levels and with reduced birth weight. Conclusions: Dietary exposure to acrylamide was associated with reduced birth weight and head circumference. Consumption of specific foods during pregnancy was associated with higher acrylamide exposure in utero. If confirmed, these findings suggest that dietary intake of acrylamide should be reduced among pregnant women. PMID:23092936

  11. Fetal growth and subsequent risk of breast cancer: results from long term follow up of Swedish cohort.

    PubMed

    McCormack, V A; dos Santos Silva, I; De Stavola, B L; Mohsen, R; Leon, D A; Lithell, H O

    2003-02-01

    To investigate whether size at birth and rate of fetal growth influence the risk of breast cancer in adulthood. Cohort identified from detailed birth records, with 97% follow up. Uppsala Academic Hospital, Sweden. 5358 singleton females born during 1915-29, alive and traced to the 1960 census. Incidence of breast cancer before (at age <50 years) and after (> or = 50 years) the menopause. Size at birth was positively associated with rates of breast cancer in premenopausal women. In women who weighed > or =4000 g at birth rates of breast cancer were 3.5 times (95% confidence interval 1.3 to 9.3) those in women of similar gestational age who weighed <3000 g at birth. Rates in women in the top fifths of the distributions of birth length and head circumference were 3.4 (1.5 to 7.9) and 4.0 (1.6 to 10.0) times those in the lowest fifths (adjusted for gestational age). The effect of birth weight disappeared after adjustment for birth length or head circumference, whereas the effects of birth length and head circumference remained significant after adjustment for birth weight. For a given size at birth, gestational age was inversely associated with risk (P=0.03 for linear trend). Adjustment for markers of adult risk factors did not affect these findings. Birth size was not associated with rates of breast cancer in postmenopausal women. Size at birth, particularly length and head circumference, is associated with risk of breast cancer in women aged <50 years. Fetal growth rate, as measured by birth size adjusted for gestational age, rather than size at birth may be the aetiologically relevant factor in premenopausal breast cancer.

  12. Microcephaly in north-east Brazil: a retrospective study on neonates born between 2012 and 2015

    PubMed Central

    Soares de Araújo, Juliana Sousa; Regis, Cláudio Teixeira; Gomes, Renata Grigório Silva; Tavares, Thiago Ribeiro; Rocha dos Santos, Cícera; Assunção, Patrícia Melo; Nóbrega, Renata Valéria; Pinto, Diana de Fátima Alves; Bezerra, Bruno Vinícius Dantas

    2016-01-01

    Abstract Objective To assess the number of children born with microcephaly in the State of Paraíba, north-east Brazil. Methods We contacted 21 maternity centres belonging to a paediatric cardiology network, with access to information regarding more than 100 000 neonates born between 1 January 2012 and 31 December 2015. For 10% of these neonates, nurses were requested to retrieve head circumference measurements data from delivery-room books. We used three separate criteria to classify whether a neonate had microcephaly: (i) the Brazilian Ministry of Health proposed criterion: term neonates (gestational age ≥ 37 weeks) with a head circumference of less than 32 cm; (ii) Fenton curves: neonates with a head circumference of less than −3 standard deviation for age and gender; or (iii) the proportionality criterion: neonates with a head circumference of less than ((height/2))+10) ± 2. Findings Between 1 and 31 December 2015, nurses obtained data for 16 208 neonates. Depending on which criterion we used, the number of neonates with microcephaly varied from 678 to 1272 (4.2–8.2%). Two per cent (316) of the neonates fulfilled all three criteria. We observed temporal fluctuations of microcephaly prevalence from late 2012. Conclusion The numbers of microcephaly reported here are much higher than the 6.4 per 10 000 live births reported by the Brazilian live birth information system. The results raise questions about the notification system, the appropriateness of the diagnostic criteria and future implications for the affected children and their families. More studies are needed to understand the epidemiology and the implications for the Brazilian health system. PMID:27821886

  13. Microcephaly in north-east Brazil: a retrospective study on neonates born between 2012 and 2015.

    PubMed

    Soares de Araújo, Juliana Sousa; Regis, Cláudio Teixeira; Gomes, Renata Grigório Silva; Tavares, Thiago Ribeiro; Rocha Dos Santos, Cícera; Assunção, Patrícia Melo; Nóbrega, Renata Valéria; Pinto, Diana de Fátima Alves; Bezerra, Bruno Vinícius Dantas; Mattos, Sandra da Silva

    2016-11-01

    To assess the number of children born with microcephaly in the State of Paraíba, north-east Brazil. We contacted 21 maternity centres belonging to a paediatric cardiology network, with access to information regarding more than 100 000 neonates born between 1 January 2012 and 31 December 2015. For 10% of these neonates, nurses were requested to retrieve head circumference measurements data from delivery-room books. We used three separate criteria to classify whether a neonate had microcephaly: (i) the Brazilian Ministry of Health proposed criterion: term neonates (gestational age ≥ 37 weeks) with a head circumference of less than 32 cm; (ii) Fenton curves: neonates with a head circumference of less than -3 standard deviation for age and gender; or (iii) the proportionality criterion: neonates with a head circumference of less than ((height/2))+10) ± 2. Between 1 and 31 December 2015, nurses obtained data for 16 208 neonates. Depending on which criterion we used, the number of neonates with microcephaly varied from 678 to 1272 (4.2-8.2%). Two per cent (316) of the neonates fulfilled all three criteria. We observed temporal fluctuations of microcephaly prevalence from late 2012. The numbers of microcephaly reported here are much higher than the 6.4 per 10 000 live births reported by the Brazilian live birth information system. The results raise questions about the notification system, the appropriateness of the diagnostic criteria and future implications for the affected children and their families. More studies are needed to understand the epidemiology and the implications for the Brazilian health system.

  14. Evaluation of physical growth in cerebral palsied children and its possible relationship with gross motor development.

    PubMed

    Ibrahim, Alaa I; Hawamdeh, Ziad M

    2007-03-01

    The object of this study was to detect any possible relation between the current gross motor function score for cerebral palsy children and their physical growth parameters. We measured 71 children with spastic cerebral palsy (35 diplegic, 25 quadriplegic and 11 hemiplegic) and a control group of 80 normal children. Measures taken for cerebral palsy and normal children included stature, weight, head circumference and mid upper-arm circumference, and, additionally for the cerebral palsied children, duration of the disease, birth weight, presence or absence of orofacial dysfunction, distribution of paralysis and degree of spasticity. Motor abilities were measured using the Gross Motor Function Measure. Results showed a significant decrease in the stature, current weight, head circumference and mid upper-arm circumference of both sexes of the quadriplegic children, and significant decreases in the current weight of the diplegic girls and the head circumference of the hemiplegic girls. There were also significant decreases in all scores of the quadriplegic children compared to the diplegic and hemiplegic children. Diplegic children had significantly decreased standing, walking and running, and total scores, compared to the hemiplegic children. Total score at age of testing was independently predicted by the duration of the disease, distribution of paralysis, presence or absence of orofacial dysfunction, spasticity index and the current body weight. Our findings indicate that in spastic cerebral palsy the physical growth parameters were markedly decreased in the quadriplegic form compared to other forms. Only current body weight, from the growth parameters, in addition to other relevant clinical data, can be considered predictors of the current gross motor abilities of those children.

  15. Prevalence of subdural collections in children with macrocrania.

    PubMed

    Greiner, M V; Richards, T J; Care, M M; Leach, J L

    2013-12-01

    The relationship between enlarged subarachnoid spaces and subdural collections is poorly understood and creates challenges for clinicians investigating the etiology of subdural collections. The purpose of this study was to determine the prevalence of subdural collections on cross sectional imaging in children with macrocephaly correlating with subarachnoid space enlargement. The radiology information system of a large pediatric medical center was reviewed for "macrocrania" and "macrocephaly" on reports of cranial MRI/CT examinations in children <24 months of age, over a 24-month period. Head circumference was obtained from the clinical record. Studies were reviewed blindly for subdural collection presence and subarachnoid space size. Children with prior cranial surgery, parenchymal abnormalities, hydrocephalus, or conditions predisposing to parenchymal volume loss were excluded. Chart review was performed on those with subdural collections. Imaging from 177 children with enlarged head circumference was reviewed. Nine were excluded, for a final cohort of 168 subjects (108 with enlarged subarachnoid space). Subdural collections were identified in 6 (3.6%), all with enlarged subarachnoid space (6/108, 5.6%). In 4, subdural collections were small, homogeneous, and nonhemorrhagic. In 2, the collections were complex (septations or hemorrhage). Two children were reported as victims of child abuse (both with complex collections). No definitive etiology was established in the other cases. The prevalence of subdural collections in imaged children with macrocrania was 3.6%, all occurring in children with enlarged subarachnoid space. Our results suggest that enlarged subarachnoid space can be associated with some subdural collections in this cohort. Despite this, we believe that unexpected subdural collections in children should receive close clinical evaluation for underlying causes, including abusive head trauma.

  16. Colombian reference growth curves for height, weight, body mass index and head circumference.

    PubMed

    Durán, Paola; Merker, Andrea; Briceño, Germán; Colón, Eugenia; Line, Dionne; Abad, Verónica; Del Toro, Kenny; Chahín, Silvia; Matallana, Audrey Mary; Lema, Adriana; Llano, Mauricio; Céspedes, Jaime; Hagenäs, Lars

    2016-03-01

    Published Growth studies from Latin America are limited to growth references from Argentina and Venezuela. The aim of this study was to construct reference growth curves for height, weight, body mass index (BMI) and head circumference of Colombian children in a format that is useful for following the growth of the individual child and as a tool for public health. Prospective measurements from 27 209 Colombian children from middle and upper socio-economic level families were processed using the generalised additive models for location, scale and shape (GAMLSS). Descriptive statistics for length and height, weight, BMI and head circumference for age are given as raw and smoothed values. Final height was 172.3 cm for boys and 159.4 cm for girls. Weight at 18 years of age was 64.0 kg for boys and 54 kg for girls. Growth curves are presented in a ± 3 SD format using logarithmic axes. The constructed reference growth curves are a start for following secular trends in Colombia and are also in the presented layout an optimal clinical tool for health care. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Associations Between Dietary Energy Density in Mothers and Growth of Breastfeeding Infants During the First 4 Months of Life.

    PubMed

    Moradi, Maedeh; Maracy, Mohammad R; Esmaillzadeh, Ahmad; Surkan, Pamela J; Azadbakht, Leila

    2018-05-31

    Despite the overwhelming impact of dietary energy density on the quality of the entire diet, no research has investigated dietary energy density among lactating mothers. Hence, the present study was undertaken to assess the influence of maternal dietary energy density during lactation on infant growth. Three hundred healthy lactating mother-infant pairs were enrolled in the study. Detailed demographic information and dietary intake data were collected from the lactating mothers. Anthropometric features such as infant weight, height, and head circumference at birth and 2 and 4 months and mother's pregnancy and postpartum weight and height were derived from health center records. Data on physical activity were reported using the International Physical Activity Questionnaire. After adjusting for confounding variables, infant weight, length, weight-for-height, and head circumference at birth, 2 months, and 4 months did not show significant differences among four dietary energy density categories (all p values > 0.01). Our study showed no association among quartiles of dietary energy density among lactating mothers and infant weight, length, weight-for-height, and head circumference growth by 2 and 4 months of age.

  18. Post term dietary-induced changes in DHA and AA status relate to gains in weight, length, and head circumference in preterm infants.

    PubMed

    van de Lagemaat, Monique; Rotteveel, Joost; Muskiet, Frits A J; Schaafsma, Anne; Lafeber, Harrie N

    2011-12-01

    Preterms need supplementation with docosahexaenoic (DHA) and arachidonic (AA) acids to prevent steep postnatal declines. Associations between growth and erythrocyte (RBC) DHA and AA were studied in 139 preterms (51% male, gestational age 30.3±1.5 weeks, birth weight 1341±288g) fed human milk with breast milk fortifier or preterm formula until term, followed by postdischarge formula (PDF; n=52, 0.4% DHA, 0.4% AA), term formula (TF; n=41, 0.2% DHA, 0.2% AA), or human milk (HM; n=46). At six months, PDF resulted in higher RBC-DHA than TF and HM, while RBC-AA was higher than TF, but similar to HM. There were no between-group differences in growth between term and six months. RHC-DHA related positively with gain in weight and length and negatively with gain in head circumference. RBC-AA related positively with gain in head circumference and negatively with gain in weight and length. In conclusion, PDF with higher DHA and AA than TF may promote postnatal growth of preterms. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. White Matter Damage in 4,725 Term-Born Infants Is Determined by Head Circumference at Birth: The Missing Link

    PubMed Central

    Holmer, Bert

    2018-01-01

    Background White matter damage (WMD) is a prime risk factor for cerebral palsy, in part occurring unexplained. Though primarily a problem of preterm infants, there is growing evidence that in large newborns cephalopelvic disproportion and prolonged labor are involved. Objective To explore both incidence of and morphometric risk factors for WMD in term-born infants. Study Design We related growth variables and risk factors of term-born infants to WMD (61/4,725) using odds ratios of z-score bands. Results The key result is the novel observation that head circumference is a prime and unique index for WMD in term-born neonates over the whole range of centiles (U-shaped; WMD (%) = 3.1168–0.12797∗HC (centile) + 0.0014741∗HC2; p < 0.0001). This suggests different mechanisms for WMD in the lowest and highest z-score band. In the latter, cephalic pressure gradients and prolonged labor with preserved neonatal vitality prevail, whereas in the previous one, acute and chronic oxygen deprivation with reduced vitality predominate. Conclusions The fact that seemingly healthy term-born neonates are not screened by head imaging, in spite of both large head circumference and prolonged labor, is considered to be the missing link between the insult that escapes diagnosis and the development of unexplained developmental delay and cerebral palsy in childhood. PMID:29681945

  20. White Matter Damage in 4,725 Term-Born Infants Is Determined by Head Circumference at Birth: The Missing Link.

    PubMed

    Jensen, Arne; Holmer, Bert

    2018-01-01

    White matter damage (WMD) is a prime risk factor for cerebral palsy, in part occurring unexplained. Though primarily a problem of preterm infants, there is growing evidence that in large newborns cephalopelvic disproportion and prolonged labor are involved. To explore both incidence of and morphometric risk factors for WMD in term-born infants. We related growth variables and risk factors of term-born infants to WMD (61/4,725) using odds ratios of z -score bands. The key result is the novel observation that head circumference is a prime and unique index for WMD in term-born neonates over the whole range of centiles (U-shaped; WMD (%) = 3.1168-0.12797 ∗ HC (centile) + 0.0014741 ∗ HC 2 ; p < 0.0001). This suggests different mechanisms for WMD in the lowest and highest z -score band. In the latter, cephalic pressure gradients and prolonged labor with preserved neonatal vitality prevail, whereas in the previous one, acute and chronic oxygen deprivation with reduced vitality predominate. The fact that seemingly healthy term-born neonates are not screened by head imaging, in spite of both large head circumference and prolonged labor, is considered to be the missing link between the insult that escapes diagnosis and the development of unexplained developmental delay and cerebral palsy in childhood.

  1. Poor postdischarge head growth is related to a 10% lower intelligence quotient in very preterm infants at the chronological age of five years.

    PubMed

    Neubauer, Vera; Fuchs, Teresa; Griesmaier, Elke; Kager, Katrin; Pupp-Peglow, Ulrike; Kiechl-Kohlendorfer, Ursula

    2016-05-01

    This study examined the relationship between head growth and cognitive outcome at the age of five years in preterm infants born at less than 32 weeks of gestation from 2003 to 2009, as previous research has mostly focused on outcomes in toddlers. The head circumference of 273 very preterm infants born in Tyrol, Austria, was measured at birth, discharge, the corrected ages of three, 12 and 24 months and the chronological age of five years. Suboptimal head size was defined as a head circumference of more than one standard deviation below the mean. Full-scale intelligence quotient (IQ) at five years was determined using Wechsler Preschool and Primary Scales of Intelligence, third edition. Infants with a suboptimal head size at the age of three months had a significantly lower median IQ than those with a normal head size (90 [20-122] versus 98 [20-138], p = 0.001) and from three months onwards they were more likely to exhibit cognitive delay. A suboptimal head size from the age of three months was consistently related to a 10% lower IQ, and this study adds further evidence that head growth failure, especially during the early postdischarge period, is related to impaired cognitive abilities. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  2. Critical periods of brain growth and cognitive function in children.

    PubMed

    Gale, Catharine R; O'Callaghan, Finbar J; Godfrey, Keith M; Law, Catherine M; Martyn, Christopher N

    2004-02-01

    There is evidence that IQ tends to be higher in those who were heavier at birth or who grew taller in childhood and adolescence. Although these findings imply that growth in both foetal and postnatal life influences cognitive performance, little is known about the relative importance of brain growth during different periods of development. We investigated the relationship between brain growth in different periods of pre- and postnatal life and cognitive function in 221 9-year-old children whose mothers had taken part in a study of nutrition in pregnancy and whose head circumference had been measured at 18 weeks gestation, birth and 9 months of age. Cognitive function of the children and their mothers was assessed with the Wechsler Abbreviated Scale of Intelligence. Full-scale IQ at age 9 years rose by 1.98 points [95% confidence interval (CI) 0.34 to 3.62] for each SD increase in head circumference at 9 months and by 2.87 points (95% CI 1.05 to 4.69) for each SD increase in head circumference at 9 years of age, after adjustment for sex, number of older siblings, maternal IQ, age, education, social class, duration of breastfeeding and history of low mood in the post-partum period. Postnatal head growth was significantly greater in children whose mothers were educated to degree level or of higher socio-economic status. There was no relation between IQ and measurements of head size at 18 weeks gestation or at birth. These results suggest that brain growth during infancy and early childhood is more important than growth during foetal life in determining cognitive function.

  3. Fetal omphalocele ratios predict outcomes in prenatally diagnosed omphalocele.

    PubMed

    Montero, Freddy J; Simpson, Lynn L; Brady, Paula C; Miller, Russell S

    2011-09-01

    The objective of the study was to evaluate whether ratios considering omphalocele diameter relative to fetal biometric measurements perform better than giant omphalocele designation at predicting inability to achieve neonatal primary surgical closure. Cases of fetal omphalocele that underwent evaluation between May 2003 and July 2010 were identified. Inclusion was restricted to live births with plan for postnatal repair. Omphalocele diameter upon antenatal ultrasound was compared with abdominal circumference, femur length, and head circumference, yielding the respective omphalocele (O)/abdominal circumference (AC), O/femur length (FL), and O/head circumference (HC) ratios. The absolute measurements were used to classify giant lesions. Omphalocele ratios and giant omphalocele designations were evaluated as predictors of inability to achieve primary repair. Among 25 included cases, staged or delayed closure occurred in 52%. With an optimal cutoff of 0.21 or greater, O/HC best predicted the primary outcome (sensitivity, 84.6%; specificity, 58.3%; odds ratio, 7.7). The O/HC of 0.21 or greater outperformed giant designations. The O/HC of 0.21 or greater best predicted staged or delayed omphalocele closure. Giant omphalocele designation, regardless of definition, poorly predicted outcome. Copyright © 2011 Mosby, Inc. All rights reserved.

  4. Fetal head circumference growth in children with specific language impairment.

    PubMed

    Whitehouse, Andrew J O; Zubrick, Stephen R; Blair, Eve; Newnham, John P; Hickey, Martha

    2012-01-01

    To characterise fetal brain growth in children with specific language impairment (SLI). A nested case-control study. Perth, Western Australia. Thirty children meeting criteria for SLI at age 10 years were individually matched with a typically developing comparison child on sex, non-verbal ability, fetal gestational age, maternal age at conception, smoking and alcohol intake during pregnancy. Occipitofrontal head circumference (HC) was measured using ultrasonography at approximately 18 weeks gestation. Femur length provided a measure of fetal length. Occipitofrontal HC was measured at birth and at the 1-year postnatal follow-up using a precise paper tape measure, while crown-heel length acted as an index of body length at both time points. Raw data were transformed to z-scores using reference norms. The SLI group had a significantly smaller mean HC than the typically developing comparison children at birth, but there was no group difference at 18 weeks gestation or at the 1-year postnatal follow-up. Individual analyses found that 12 SLI children had an HC z-score less than -1 at birth, with three of these cases meeting criteria for microcephaly. There was no group difference in the indices of overall body size at any time point. Children with SLI are more likely to have a small HC at birth but not at 18 weeks gestation or infancy, suggesting growth asynchrony in brain development during the second half of pregnancy.

  5. Low-birthweight rates higher among Bangladeshi neonates measured during active birth surveillance compared to national survey data.

    PubMed

    Klemm, Rolf D W; Merrill, Rebecca D; Wu, Lee; Shamim, Abu Ahmed; Ali, Hasmot; Labrique, Alain; Christian, Parul; West, Keith P

    2015-10-01

    Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small-for-gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth size distributions were explored based on raw values as well as after z-score standardisation in reference to World Health Organization (WHO) 2006 growth standards. Mean (SD) birthweight (g), length (cm) and head circumference (cm) measurements, completed within [median (25th, 75th percentile)] 15 (8, 23) h of life, were 2433 (425), 46.4 (2.4) and 32.4 (1.6), respectively. Twenty-two per cent were born preterm. Over one-half (55.3%) of infants were born low birthweight; 46.6%, 37.0% and 33.6% had a weight, length and head circumference below -2 z-scores of the WHO growth standard at birth; and 70.9%, 72.2% and 59.8% were SGA for weight based on Alexander et al., Oken et al. and Olsen et al. references, respectively. Infants in this typical rural Bangladesh setting were commonly born small, reflecting a high burden of fetal growth restriction and preterm birth. Our findings, produced by active birth surveillance, suggest that low birthweight is far more common than suggested by cross-sectional survey estimates. Interventions that improve fetal growth during pregnancy may have the largest impact on reducing SGA rates. © 2013 John Wiley & Sons Ltd.

  6. Fetal and Postnatal Head Circumference Growth: Synergetic Factors for Neurodevelopmental Outcome at 2 Years of Age for Preterm Infants.

    PubMed

    Sicard, Mélanie; Nusinovici, Simon; Hanf, Matthieu; Muller, Jean-Baptiste; Guellec, Isabelle; Ancel, Pierre-Yves; Gascoin, Géraldine; Rozé, Jean-Christophe; Flamant, Cyril

    2017-01-01

    Preterm infants present higher risk of non-optimal neurodevelopmental outcome. Fetal and postnatal growth, in particular head circumference (HC), is associated with neurodevelopmental outcome. We aimed to calculate the relationship between HC at birth, HC delta Z-score (between birth and hospital discharge), and non-optimal neurodevelopmental outcome at 2 years of corrected age in preterm infants. Surviving infants born ≤34 weeks of gestation were included in the analysis. The relationship between the risk of being non-optimal at 2 years and both HC at birth and HC growth was assessed. The 2 Z-scores were considered first independently and then simultaneously to investigate their effect on the risk of non-optimality using a generalized additive model. A total of 4,046 infants with both HC measures at birth and hospital discharge were included. Infants with small HC at birth (Z-score <-2 SD), or presenting suboptimal HC growth (dZ-score <-2 SD), are at higher risk of non-optimal neurodevelopmental outcome at 2 years (respectively OR 1.7 [95% CI 1.4-2] and OR 1.4 [95% CI 1.2-1.8]). Interestingly, patients cumulating small HC Z-score at birth (-2 SD) and presenting catch-down growth (HC dZ-score [-2 SD]) have a significantly increased risk for neurocognitive impairment (OR >2) while adjusting for gestational age, twin status, sex, and socioeconomic information. HC at birth and HC dZ-score between birth and hospital discharge are synergistically associated to neurodevelopmental outcome at 2 years of corrected age, in a population-based prospective cohort of preterm infants born ≤34 weeks of gestation. © 2017 S. Karger AG, Basel.

  7. Effect of DHA-containing formula on growth of preterm infants to 59 weeks postmenstrual age.

    PubMed

    Ryan, Alan S.; Montalto, Michael B.; Groh-Wargo, Sharon; Mimouni, Francis; Sentipal-Walerius, Joan; Doyle, Jeanine; Siegman, Joel S.; Thomas, Alicia J.

    1999-01-01

    Between May 1993, and September 1994, a randomized, blinded clinical trial was conducted to evaluate measures of growth and body composition in 63 (32 males; 31 females) healthy, low-birth-weight infants (940-2250 g) who were randomly assigned to an infant formula with docosahexaenoic acid (22:6n3, DHA, 0.2 wt%) from fish oil or to a control formula. A preterm formula with or without DHA was fed beginning at 7-10 days prior to hospital discharge through 43 weeks postmenstrual age (PMA). Then, from 43-59 weeks PMA, infants were fed a term infant formula with or without a corresponding amount of DHA. Growth (weight, length, head circumference), regional body fatness (triceps, subscapular, suprailiac skinfold thicknesses), circumferences (arm, abdominal, chest), and estimates of body composition determined by total body electrical conductivity (TOBEC) (fat-free mass [FFM]) were evaluated. Growth was slower in males fed the DHA formula. They had significantly (P < 0.05) smaller gains in weight, length, and head circumference between study enrollment to 59 weeks PMA than those fed the control formula. At 51 weeks PMA, males in the DHA group had significantly smaller head circumferences (P < 0.05) and lower FFM (P < 0.05). At 59 weeks PMA, males in the DHA group weighed less (P < 0.05), had shorter recumbent lengths (P < 0.01), smaller head circumferences (P < 0.05), and lower FFM (P < 0.01) than those fed the control formula. Energy intakes from formula (kcal/d), however, were lower at 51 weeks (P < 0.05) and 59 weeks (P < 0.05) PMA in males fed the DHA formula. Adjusted for body weight (kcal/kg/d), mean energy intakes from formula at 51 and 59 weeks PMA were not significantly different between feeding groups. The differences in recumbent length, head circumference, and FFM remained statistically significant after controlling for energy and protein intakes (P < 0.01). For all males, neither FFM nor total body fat (TBF), when expressed as a percentage of total body weight, differed significantly between feeding groups. Among females, there were no significant differences between the feeding groups in measures of growth, body composition, or energy intake. The results indicated that infant formula with fish oil containing DHA and EPA in a 5:1 ratio had a significant, negative effect on growth and body composition in males during the first 6 months of life. It is not clear why the growth deficits were limited to males and not females. The eicosanoids, bioactive metabolites of omega-3 and omega-6 fatty acids, may mediate several important growth hormones. The present results do not support the addition of DHA alone in infant formulas. Am. J. Hum. Biol. 11:457-467, 1999. Copyright 1999 Wiley-Liss, Inc.

  8. Disproportionate Fetal Growth and the Risk for Congenital Cerebral Palsy in Singleton Births

    PubMed Central

    Streja, Elani; Miller, Jessica E.; Wu, Chunsen; Bech, Bodil H.; Pedersen, Lars Henning; Schendel, Diana E.; Uldall, Peter; Olsen, Jørn

    2015-01-01

    Objective To investigate the association between proportionality of fetal and placental growth measured at birth and the risk for congenital cerebral palsy (CP). Study Design We identified all live-born singletons born in Denmark between 1995 and 2003 and followed them from 1 year of age until December 31st, 2008. Information on four indices of fetal growth: ponderal index, head circumference/ abdominal circumference ratio, cephalization index and birth weight/ placenta weight ratio was collected. Cox proportional hazards regression models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI). All measurements were evaluated as gestational age and sex specific z-scores and in z-score percentile groups, adjusted for potential confounders, and stratified on gestational age groups (<32, 32-36, 37-38, 39, 40, ≥41 weeks). Results We identified 503,784 singleton births, of which 983 were confirmed cases of CP. Head/ abdominal circumference ratio (aHR:1.12; 95%CI:1.07-1.16) and cephalization index (aHR:1.14; 95%CI:1.11-1.16) were associated with the risk of CP irrespective of gestational age. Birth weight-placental weight ratio was also associated with CP in the entire cohort (aHR:0.90; 95%CI:0.83-0.97). Ponderal index had a u-shaped association with CP, where both children with low and high ponderal index were at higher risk of CP. Conclusions CP is associated with disproportions between birth weight, birth length, placental weight and head circumference suggesting pre and perinatal conditions contribute to fetal growth restriction in children with CP. PMID:25974407

  9. Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders

    PubMed Central

    Nordahl, Christine Wu; Lange, Nicholas; Li, Deana D.; Barnett, Lou Ann; Lee, Aaron; Buonocore, Michael H.; Simon, Tony J.; Rogers, Sally; Ozonoff, Sally; Amaral, David G.

    2011-01-01

    Autism is a heterogeneous disorder with multiple behavioral and biological phenotypes. Accelerated brain growth during early childhood is a well-established biological feature of autism. Onset pattern, i.e., early onset or regressive, is an intensely studied behavioral phenotype of autism. There is currently little known, however, about whether, or how, onset status maps onto the abnormal brain growth. We examined the relationship between total brain volume and onset status in a large sample of 2- to 4-y-old boys and girls with autism spectrum disorder (ASD) [n = 53, no regression (nREG); n = 61, regression (REG)] and a comparison group of age-matched typically developing controls (n = 66). We also examined retrospective head circumference measurements from birth through 18 mo of age. We found that abnormal brain enlargement was most commonly found in boys with regressive autism. Brain size in boys without regression did not differ from controls. Retrospective head circumference measurements indicate that head circumference in boys with regressive autism is normal at birth but diverges from the other groups around 4–6 mo of age. There were no differences in brain size in girls with autism (n = 22, ASD; n = 24, controls). These results suggest that there may be distinct neural phenotypes associated with different onsets of autism. For boys with regressive autism, divergence in brain size occurs well before loss of skills is commonly reported. Thus, rapid head growth may be a risk factor for regressive autism. PMID:22123952

  10. Biomarkers of nutrition and stress in pregnant women with a history of eating disorders in relation to head circumference and neurocognitive function of the offspring.

    PubMed

    Koubaa, Saloua; Hällström, Tore; Brismar, Kerstin; Hellström, Per M; Hirschberg, Angelica Lindén

    2015-11-27

    Eating disorders during pregnancy can affect fetal growth and the child's early development, but the underlying mechanisms have not been elucidated. The aim of the present study was to investigate serum biomarkers of nutrition and stress in pregnant women with previous eating disorders compared to controls and in relation to head circumference and early neurocognitive development of the offspring. In a longitudinal cohort study, pregnant nulliparous non-smoking women with a history of anorexia nervosa (n = 20), bulimia nervosa (n = 17) and controls (n = 59) were followed during pregnancy and their children's growth and neurocognitive development were followed up to five years of age. We investigated maternal serum biomarkers of nutrition and stress (ferritin, cortisol, thyroid-stimulating hormone, free thyroxine, insulin, insulin-like growth factor I (IGF-I) and IGF binding protein 1) in blood samples collected during early pregnancy and compared between groups (ANOVA, LSD post-hoc test). The results were related to previous data on head circumference at birth and neurocognitive development at five years of age of the offspring (Spearman rank correlation or Pearson correlation test). Serum levels of ferritin in the women with previous anorexia nervosa, but not in those with a history of bulimia nervosa, were significantly lower than in the controls (p < 0.01), and correlated strongly to impaired memory function in their children (rs = -0.70, p < 0.001). Maternal serum levels of free thyroxine were similar between groups but correlated positively to reduced head circumference at birth of the children in the bulimia nervosa group (r = 0.48, p < 0.05), and with the same tendency in the anorexia nervosa group (r = 0.42, p = 0.07), but not in the controls (r = 0.006). There were no significant differences in cortisol or the other biomarkers between groups. Low maternal serum ferritin in women with previous anorexia nervosa may be of importance for impaired memory capacity in the offspring at five years of age. Our results also indicate that thyroxin levels in pregnant women with previous eating disorders are positively associated with fetal head growth.

  11. Implementation of a Nutrition Program Reduced Post-Discharge Growth Restriction in Thai Very Low Birth Weight Preterm Infants.

    PubMed

    Japakasetr, Suchada; Sirikulchayanonta, Chutima; Suthutvoravut, Umaporn; Chindavijak, Busba; Kagawa, Masaharu; Nokdee, Somjai

    2016-12-17

    Very low birth weight (VLBW) preterm infants are vulnerable to growth restriction after discharge due to cumulative protein and energy deficits during their hospital stay and early post-discharge period. The current study evaluated the effectiveness of the preterm infant, post-discharge nutrition (PIN) program to reduce post-discharge growth restriction in Thai VLBW preterm infants. A prospective, non-randomized interventional cohort study was undertaken to assess the growth of 22 VLBW preterm infants who received the PIN program and compared them with 22 VLBW preterm infants who received conventional nutrition services. Infant's growth was recorded monthly until the infants reached six months' corrected age (6-moCA). Intervention infants had significantly greater body weights ( p = 0.013) and head circumferences ( p = 0.009). Also, a greater proportion of the intervention group recovered their weight to the standard weight at 4-moCA ( p = 0.027) and at 6-moCA ( p = 0.007) and their head circumference to the standard head circumference at 6-moCA ( p = 0.004) compared to their historical comparison counterparts. Enlistment in the PIN program thus resulted in significantly reduced post-discharge growth restriction in VLBW preterm infants. Further research on longer term effects of the program on infant's growth and development is warranted.

  12. Ultrasound assessment of fetal head circumference at the onset of labor as a predictor of operative delivery.

    PubMed

    Ooi, Poh Vei; Ramphul, Meenakshi; Said, Soha; Burke, Gerard; Kennelly, Mairead M; Murphy, Deirdre J

    2015-01-01

    This study sought to determine whether ultrasound assessment of fetal head circumference (FHC) at the onset of labor can predict the likelihood of operative delivery. We performed a prospective cohort study of 200 nulliparous women with singleton, cephalic, term pregnancies in an Irish Maternity Hospital. Transabdominal ultrasound assessment of FHC was performed when spontaneous labor was diagnosed or immediately prior to induction. Odds ratios for operative delivery (instrumental delivery or cesarean section) and maternal and neonatal morbidity were calculated using logistic regression with FHC categorized at a ≥350-mm cut-off (90th percentile). Ultrasound assessment of FHC at the onset of labor was highly correlated with post-delivery neonatal head circumference (NHC) (Pearson's correlation coefficient 0.74), suggesting that it can be measured reliably. FHC ≥350 mm was associated with more than twice the risk of any operative delivery (OR 2.5, 95% CI 1.0-6.2) and a two-fold increased risk of cesarean section for dystocia (OR 2.0, 95% CI 1.0-4.3). Differences in maternal and neonatal morbidity were not statistically significant. These preliminary data suggest that ultrasound assessment of FHC at the onset of labor may be useful in identifying women at greater risk of intrapartum intervention and warrant further research.

  13. [Characteristics of growth and development in children from families at social risk].

    PubMed

    Stojadinović, A

    2001-01-01

    Body height and weight are important indicators of children's health status. There are many evidences that children from disadvantaged families have lower height and weight than children of the same age from families without social risk. The aim of this study was to investigate characteristics of growth and development of children from economically disadvantaged families. The study was partly retrospective and partly prospective. The retrospective study included 509 children from disadvantaged families hospitalized at the Institute of Child and Adolescent Health Care in Novi Sad, during a five-year period. The prospective study included 90 children from disadvantaged families (experimental group) and 132 children from families without social risk (control group) hospitalized at the Institute during a six month period. Height/length, weight, head circumference, and psychomotor/intellectual development have been examined. In the retrospective study results were compared with theoretically expected values, whereas the prospective study results of experimental and control group were compared. In the retrospective study that included only children from disadvantaged families, 136 (26.7%) children had height/length, 173 (34%) had weight, and 86 (16.9%) children had head circumference below 10th percentile. Delay in psychomotor/intellectual development was established in 177 (34.8%) children. Children from families with social risk have significantly more often height/length, weight, head circumference and developmental delay than theoretically expected. In the prospective study 40 (44.4%) children from experimental group had height/length, 29 (32.2%) had weight, 20 (22.2%) children had head circumference below 10th percentile, and 17 (26.2%) had delay in psychomotor/intellectual development. Children from disadvantaged families (experimental group) significantly more often had delay in growth and development comparing with children from families without social risk (control group). Children from disadvantaged families significantly more often exhibit delay in growth and development, comparing with children of the same age from families without social risk. Therefore, pediatricians should consider social risk factors whenever treating children with growth or developmental delay.

  14. Reference curves of birth weight, length, and head circumference for gestational ages in Yogyakarta, Indonesia.

    PubMed

    Haksari, Ekawaty L; Lafeber, Harrie N; Hakimi, Mohammad; Pawirohartono, Endy P; Nyström, Lennarth

    2016-11-21

    The birth weight reference curve to estimate the newborns at risk in need of assessment and monitoring has been established. The previous reference curves from Indonesia, approximately 8 years ago, were based on the data collected from teaching hospitals only with limited gestational ages. The aims of the study were to update the reference curves for birth weight, supine length and head circumference for Indonesia, and to compare birth weight curves of boys and girls, first child and later children, and the ones in the previous studies. Data were extracted from the Maternal-Perinatal database between 1998-2007. Only live singletons with recorded gestational ages of 26 to 42 weeks and the exact time of admission to the neonatal facilities delivered or referred within 24 h of age to Sardjito Hospital, five district hospitals and five health centers in Yogyakarta Special Territory were included. Newborns with severely ill conditions, congenital anomaly and chromosomal abnormality were excluded. Smoothening of the curves was accomplished using a third-order polynomial equation. Our study included 54,599 singleton live births. Growth curves were constructed for boys (53.3%) and girls (46.7%) for birth weight, supine length, and head circumference. At term, mean birth weight for each gestational age of boys was significantly higher than that of girls. While mean birth weight for each gestational age of first-born-children, on the other hand was significantly lower than that of later-born-children. The mean birth weight was lower than that of Lubchenco's study. Compared with the previous Indonesian study by Alisyahbana, no differences were observed for the aterm infants, but lower mean birth weight was observed in preterm infants. Updated neonatal reference curves for birth weight, supine length and head circumference are important to classify high risk newborns in specific area and to identify newborns requiring attention.

  15. Mode of genetic inheritance modifies the association of head circumference and autism-related symptoms: a cross-sectional study.

    PubMed

    Davis, Jonathan M; Keeney, Jonathon G; Sikela, James M; Hepburn, Susan

    2013-01-01

    Frequently individuals with autism spectrum disorder (ASD) have been noted with a larger head circumference (HC) than their typical developing peers. Biologic hypotheses suggest that an overly rapid brain growth leads to the core symptoms of ASD by impairing connectivity. Literature is divided however where deleterious, protective and null associations of HC with ASD symptoms in individuals with ASD have been found. Individuals (n = 1,416) from the Autism Genetic Resource Exchange with ASD were examined for associations of HC with ASD like symptoms. Mixed models controlling for sex, age, race/ethnicity, simplex/multiplex status and accounting for correlations between siblings were used. Interactions by simplex/multiplex were explored. Adjustments for height in a sub-population with available data were explored as well. A Significant interaction term (p = 0.03) suggested that the effect of HC was dependent on whether the individual was simplex or multiplex. In simplex individuals at mean age (8.9 years) 1 cm increase in head circumference was associated with a 24% increase in the odds of a high social diagnostic score from the Autism Diagnostic Interview-Revised (odds ratio  = 1.24, p = 0.01). There was no association in multiplex individuals. Additionally, individuals classified with a non-verbal IQ <70 were 90% simplex and had a significantly increased head circumference (0.7 cm p = 0.03) relative to a mid-range non-verbal IQ group. Interestingly, children classified with a >110 non-verbal IQ also had an increased HC (0.4 cm p = 0.04), relative to a mid-range non-verbal IQ group, and were 90% multiplex. HC effects do not appear to be confounded by height, however, larger samples with height information are needed. The potential link between brain growth and autism like symptoms is complex and could depend on specific etiologies. Further investigations accounting for a likely mode of inheritance will help identify an ASD subtype related to HC.

  16. Epidemiology of Benign External Hydrocephalus in Norway-A Population-Based Study.

    PubMed

    Wiig, Ulrikke S; Zahl, Sverre M; Egge, Arild; Helseth, Eirik; Wester, Knut

    2017-08-01

    Benign external hydrocephalus is defined as a rapidly increasing head circumference (occipitofrontal circumference) with characteristic radiological findings of increased subarachnoid cerebrospinal fluid spaces on neuroimaging. The incidence of benign external hydrocephalus has not been previously reported, and there is no available information on the ratio of benign external hydrocephalus in the population of hydrocephalic children. This study is retrospective and population-based study, geographically covering two health regions in the southern half of Norway with a total mean population of 3.34 million in the ten-year study period, constituting approximately 75% of the Norwegian population. Children with a head circumference crossing two percentiles, or greater than the 97.5th percentile, and with typical imaging findings of enlarged frontal subarachnoid spaces with or without enlarged ventricles were included. Children were excluded if they had a history of head trauma, intracranial hemorrhage, central nervous system infection, other known causes of hydrocephalus, or were born preterm defined as birth before 37 weeks of gestation. A total of 176 children fitting the criteria were identified, giving an incidence of 0.4 per 1000 live births. One hundred fifty-two (86.4%) of the patients were male, and mean age at referral was 7.3 months. Increasing head circumference was the main reason for referral in 158 (89.8%) patients and the only finding in 60 (34.1%) patients. Thirty-seven (21%) children had normal ventricles on imaging; the remainder had increased ventricular size. The incidence of pediatric hydrocephalus in Norway is reported to be 0.75 per 1000 live births, thus benign external hydrocephalus accounts for approximately 50% of hydrocephalic conditions in this population. The incidence of benign external hydrocephalus was found to be 0.4 per 1000 live births in this population. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Dietary nucleotides and early growth in formula-fed infants: a randomized controlled trial.

    PubMed

    Singhal, Atul; Kennedy, Kathy; Lanigan, J; Clough, Helen; Jenkins, Wendy; Elias-Jones, Alun; Stephenson, Terrence; Dudek, Peter; Lucas, Alan

    2010-10-01

    Dietary nucleotides are nonprotein nitrogenous compounds that are found in high concentrations in breast milk and are thought to be conditionally essential nutrients in infancy. A high nucleotide intake has been suggested to explain some of the benefits of breastfeeding compared with formula feeding and to promote infant growth. However, relatively few large-scale randomized trials have tested this hypothesis in healthy infants. We tested the hypothesis that nucleotide supplementation of formula benefits early infant growth. Occipitofrontal head circumference, weight, and length were assessed in infants who were randomly assigned to groups fed nucleotide-supplemented (31 mg/L; n=100) or control formula without nucleotide supplementation (n=100) from birth to the age of 20 weeks, and in infants who were breastfed (reference group; n=101). Infants fed with nucleotide-supplemented formula had greater occipitofrontal head circumference at ages 8, 16, and 20 weeks than infants fed control formula (mean difference in z scores at 8 weeks: 0.4 [95% confidence interval: 0.1-0.7]; P=.006) even after adjustment for potential confounding factors (P=.002). Weight at 8 weeks and the increase in both occipitofrontal head circumference and weight from birth to 8 weeks were also greater in infants fed nucleotide-supplemented formula than in those fed control formula. Our data support the hypothesis that nucleotide supplementation leads to increased weight gain and head growth in formula-fed infants. Therefore, nucleotides could be conditionally essential for optimal infant growth in some formula-fed populations. Additional research is needed to test the hypothesis that the benefits of nucleotide supplementation for early head growth, a critical period for brain growth, have advantages for long-term cognitive development.

  18. Relationships of maternal and paternal anthropometry with neonatal body size, proportions and adiposity in an Australian cohort.

    PubMed

    Pomeroy, Emma; Wells, Jonathan C K; Cole, Tim J; O'Callaghan, Michael; Stock, Jay T

    2015-04-01

    The patterns of association between maternal or paternal and neonatal phenotype may offer insight into how neonatal characteristics are shaped by evolutionary processes, such as conflicting parental interests in fetal investment and obstetric constraints. Paternal interests are theoretically served by maximizing fetal growth, and maternal interests by managing investment in current and future offspring, but whether paternal and maternal influences act on different components of overall size is unknown. We tested whether parents' prepregnancy height and body mass index (BMI) were related to neonatal anthropometry (birthweight, head circumference, absolute and proportional limb segment and trunk lengths, subcutaneous fat) among 1,041 Australian neonates using stepwise linear regression. Maternal and paternal height and maternal BMI were associated with birthweight. Paternal height related to offspring forearm and lower leg lengths, maternal height and BMI to neonatal head circumference, and maternal BMI to offspring adiposity. Principal components analysis identified three components of variability reflecting neonatal "head and trunk skeletal size," "adiposity," and "limb lengths." Regression analyses of the component scores supported the associations of head and trunk size or adiposity with maternal anthropometry, and limb lengths with paternal anthropometry. Our results suggest that while neonatal fatness reflects environmental conditions (maternal physiology), head circumference and limb and trunk lengths show differing associations with parental anthropometry. These patterns may reflect genetics, parental imprinting and environmental influences in a manner consistent with parental conflicts of interest. Paternal height may relate to neonatal limb length as a means of increasing fetal growth without exacerbating the risk of obstetric complications. © 2014 The Authors American Journal of Physical Anthropology Published by Wiley Periodicals, Inc.

  19. Relationships of maternal and paternal anthropometry with neonatal body size, proportions and adiposity in an Australian cohort

    PubMed Central

    Pomeroy, Emma; Wells, Jonathan CK; Cole, Tim J; O'Callaghan, Michael; Stock, Jay T

    2015-01-01

    The patterns of association between maternal or paternal and neonatal phenotype may offer insight into how neonatal characteristics are shaped by evolutionary processes, such as conflicting parental interests in fetal investment and obstetric constraints. Paternal interests are theoretically served by maximizing fetal growth, and maternal interests by managing investment in current and future offspring, but whether paternal and maternal influences act on different components of overall size is unknown. We tested whether parents' prepregnancy height and body mass index (BMI) were related to neonatal anthropometry (birthweight, head circumference, absolute and proportional limb segment and trunk lengths, subcutaneous fat) among 1,041 Australian neonates using stepwise linear regression. Maternal and paternal height and maternal BMI were associated with birthweight. Paternal height related to offspring forearm and lower leg lengths, maternal height and BMI to neonatal head circumference, and maternal BMI to offspring adiposity. Principal components analysis identified three components of variability reflecting neonatal “head and trunk skeletal size,” “adiposity,” and “limb lengths.” Regression analyses of the component scores supported the associations of head and trunk size or adiposity with maternal anthropometry, and limb lengths with paternal anthropometry. Our results suggest that while neonatal fatness reflects environmental conditions (maternal physiology), head circumference and limb and trunk lengths show differing associations with parental anthropometry. These patterns may reflect genetics, parental imprinting and environmental influences in a manner consistent with parental conflicts of interest. Paternal height may relate to neonatal limb length as a means of increasing fetal growth without exacerbating the risk of obstetric complications. Am J Phys Anthropol 156:625–636, 2015. PMID:25502164

  20. Preliminary analysis of in utero low-level arsenic exposure and fetal growth using biometric measurements extracted from fetal ultrasound reports.

    PubMed

    Davis, Matthew A; Higgins, John; Li, Zhigang; Gilbert-Diamond, Diane; Baker, Emily R; Das, Amar; Karagas, Margaret R

    2015-03-30

    Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero. Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation. In a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs = -0.08, p-value = 0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs = - 0.21, p-value < 0.05). Although, associations were attenuated in adjusted analyses - among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: -0.151, 0.007) decrease in biparietal head diameter Z-score. Our study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation.

  1. Socioeconomic status, anthropometric status, and psychomotor development of Kenyan children from resource-limited settings: A path-analytic study

    PubMed Central

    Abubakar, Amina; de Vijver, Fons Van; Baar, Anneloes Van; Mbonani, Leonard; Kalu, Raphael; Newton, Charles; Holding, Penny

    2014-01-01

    Background Sub-optimal physical growth has been suggested as a key pathway between the effect of environmental risk and developmental outcome. Aim To determine if anthropometric status mediates the relation between socioeconomic status and psychomotor development of young children in resource-limited settings. Study design A cross-sectional study design was used. Subjects A total of 204 (105 girls) children from two resource-limited communities in the Coast Province, Kenya. The mean age of these children was 29 months (SD=3.43; range: 24–35 months). Outcome measure Psychomotor functioning was assessed using a locally developed and validated measure, the Kilifi Developmental Inventory. Results A significant association was found between anthropometric status (as measured by weight-for-age, height-for-age, mid-upper arm circumference, and head circumference) and psychomotor functioning and also between socioeconomic status and anthropometric status; no direct effects were found between socioeconomic status and developmental outcome. The models showed that weight, height and to a lesser extent mid-upper arm circumference mediate the relation between socioeconomic status and developmental outcome, while head circumference did not show the same effect. Conclusion Among children under 3 years living in poverty, anthropometric status shows a clear association with psychomotor development while socioeconomic status may only have an indirect association. PMID:18499363

  2. Web-based questionnaires to assess perinatal outcome proved to be valid.

    PubMed

    van Gelder, Marleen M H J; Vorstenbosch, Saskia; Derks, Lineke; Te Winkel, Bernke; van Puijenbroek, Eugène P; Roeleveld, Nel

    2017-10-01

    The objective of this study was to validate a Web-based questionnaire completed by the mother to assess perinatal outcome used in a prospective cohort study. For 882 women with an estimated date of delivery between February 2012 and February 2015 who participated in the PRegnancy and Infant DEvelopment (PRIDE) Study, we compared data on pregnancy outcome, including mode of delivery, plurality, gestational age, birth weight and length, head circumference, birth defects, and infant sex, from Web-based questionnaires administered to the mothers 2 months after delivery with data from obstetric records. For continuous variables, we calculated intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs), whereas sensitivity and specificity were determined for categorical variables. We observed only very small differences between the two methods of data collection for gestational age (ICC, 0.91; 95% CI, 0.90-0.92), birth weight (ICC, 0.96; 95% CI, 0.95-0.96), birth length (ICC, 0.90; 95% CI, 0.87-0.92), and head circumference (ICC, 0.88; 95% CI, 0.80-0.93). Agreement between the Web-based questionnaire and obstetric records was high as well, with sensitivity ranging between 0.86 (termination of pregnancy) and 1.00 (four outcomes) and specificity between 0.96 (term birth) and 1.00 (nine outcomes). Our study provides evidence that Web-based questionnaires could be considered as a valid complementary or alternative method of data collection. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Music and 25% glucose pain relief for the premature infant: a randomized clinical trial.

    PubMed

    Cardoso, Maria Vera Lúcia Moreira Leitão; Farias, Leiliane Martins; de Melo, Gleicia Martins

    2014-10-01

    To analyze the total Premature Infant Pain Profile scores of premature infants undergoing arterial puncture during music and 25% glucose interventions, and to assess their association with neonatal and therapeutic variables. A randomized clinical trial with 80 premature infants; 24 in the Experimental Group 1 (music), 33 in the Experimental Group 2 (music and 25% glucose), 23 in the Positive Control Group (25% glucose). All premature infants were videotaped and a lullaby was played for ten minutes before puncture in Experimental Groups 1 and 2; 25% glucose administered in Experimental Group 2 and the Positive Control Group two minutes before puncture. 60.0% of premature infants had moderate or maximum pain; pain scores and intervention groups were not statistically significant. Statistically significant variables: Experimental Group 1: head and chest circumference, Apgar scores, corrected gestational age; Experimental Group 2: chest circumference, Apgar scores, oxygen therapy; Positive Control group: birth weight, head circumference. Neonatal variables are associated with pain in premature infants. Brazilian Registry of Clinical Trials: UTN: U1111-1123-4821.

  4. Diagnosis of intrauterine growth restriction: comparison of ultrasound parameters.

    PubMed

    Ott, William J

    2002-04-01

    The objective of this study is an attempt to evaluate the best ultrasonic method of diagnosing intrauterine growth restriction (IUGR); a retrospective study of patients with singleton pregnancies who had been scanned at the author's institution within 2 weeks of their delivery was undertaken. Estimated fetal weight, abdominal circumference, head circumference/abdominal circumference ratio, abdominal circumference/femur length ratio, and umbilical artery S/D ratio were compared for accuracy in prediction IUGR in the neonate using both univariant and multivariant statistical analysis. Five hundred one (501) patients were analyzed. One hundred fourteen (114) neonates were classified as IUGR (22.8%). Doppler evaluation of the umbilical artery showed the best sensitivity while both abdominal circumference alone and estimated fetal weight showed similar specificity, positive and negative predictive value, and lowest false-positive and -negative results. Logistic regression analysis confirmed the univariant results and showed that, when used in combination, abdominal circumference and Doppler, or estimated fetal weight and Doppler resulted in the best predictive values. Either estimated fetal weight or abdominal circumference (alone) are accurate predictors of IUGR. Combined with Doppler studies of the umbilical artery either method will provide accurate evaluation of suspected IUGR.

  5. Growth in Inuit children exposed to polychlorinated biphenyls and lead during fetal development and childhood.

    PubMed

    Dallaire, Renée; Dewailly, Éric; Ayotte, Pierre; Forget-Dubois, Nadine; Jacobson, Sandra W; Jacobson, Joseph L; Muckle, Gina

    2014-10-01

    Because of their geographical location and traditional lifestyle, Canadian Inuit children are highly exposed to polychlorinated biphenyls (PCBs) and lead (Pb), environmental contaminants that are thought to affect fetal and child growth. We examined the associations of these exposures with the fetal and postnatal growth of Inuit children. We conducted a prospective cohort study among Inuit from Nunavik (Arctic Québec). Mothers were recruited at their first prenatal visit; children (n=290) were evaluated at birth and at 8-14 years of age. Concentrations of PCB 153 and Pb were determined in umbilical cord and child blood. Weight, height and head circumference were measured at birth and during childhood. Cord blood PCB 153 concentrations were not associated with anthropometric measurements at birth or school age, but child blood PCB 153 concentrations were associated with reduced weight, height and head circumference during childhood. There was no association between cord Pb levels and anthropometric outcomes at birth, but cord blood Pb was related to smaller height and shows a tendency of a smaller head circumference during childhood. Our results suggest that chronic exposure to PCBs during childhood is negatively associated with skeletal growth and weight, while prenatal Pb exposure is related to reduced growth during childhood. This study is the first to link prenatal Pb exposure to poorer growth in school-age children. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Cognition and behavioural development in early childhood: the role of birth weight and postnatal growth.

    PubMed

    Huang, Cheng; Martorell, Reynaldo; Ren, Aiguo; Li, Zhiwen

    2013-02-01

    We evaluate the relative importance of birth weight and postnatal growth for cognition and behavioural development in 8389 Chinese children, 4-7 years of age. Method Weight was the only size measure available at birth. Weight, height, head circumference and intelligence quotient (IQ) were measured between 4 and 7 years of age. Z-scores of birth weight and postnatal conditional weight gain to 4-7 years, as well as height and head circumference at 4-7 years of age, were the exposure variables. Z-scores of weight at 4-7 years were regressed on birth weight Z-scores, and the residual was used as the measure of postnatal conditional weight gain. The outcomes were child's IQ, measured by the Chinese Wechsler Young Children Scale of Intelligence, as well as internalizing behavioural problems, externalizing behavioural problems and other behavioural problems, evaluated by the Child Behavior Checklist 4-18. Multivariate regressions were conducted to investigate the relationship of birth weight and postnatal growth variables with the outcomes, separately for preterm children and term children. Both birth weight and postnatal weight gain were associated with IQ among term children; 1 unit increment in Z-score of birth weight (∼450 g) was associated with an increase of 1.60 [Confidence interval (CI): 1.18-2.02; P < 0.001] points in IQ, and 1 unit increment in conditional postnatal weight was associated with an increase of 0.46 (CI: 0.06-0.86; P = 0.02) points in IQ, after adjustment for confounders; similar patterns were observed when Z-scores of postnatal height and head circumference at age 4-7 years were used as alternative measurements of postnatal growth. Effect sizes of relationships with IQ were smaller than 0.1 of a standard deviation in all cases. Neither birth weight nor postnatal growth indicators were associated with behavioural outcomes among term children. In preterm children, neither birth weight nor postnatal growth measures were associated with IQ or behavioural outcomes. Both birth weight and postnatal growth were associated with IQ but not behavioural outcomes for Chinese term children aged 4-7 years, but the effect sizes were small. No relation between either birth weight or postnatal growth and cognition or behavioural outcomes was observed among preterm children aged 4-7 years.

  7. Growth perturbations in a phenotype with rapid fetal growth preceding preterm labor and term birth.

    PubMed

    Lampl, Michelle; Kusanovic, Juan Pedro; Erez, Offer; Gotsch, Francesca; Espinoza, Jimmy; Goncalves, Luis; Lee, Wesley; Gomez, Ricardo; Nien, Jyh Kae; Frongillo, Edward A; Romero, Roberto

    2009-01-01

    The variability in fetal growth rates and gestation duration in humans is not well understood. Of interest are women presenting with an episode of preterm labor and subsequently delivering a term neonate, who is small relative to peers of similar gestational age. To further understand these relationships, fetal growth patterns predating an episode of preterm labor were investigated. Retrospective analysis of fetal biometry assessed by serial ultrasound in a prospectively studied sample of pregnancies in Santiago, Chile, tested the hypothesis that fetal growth patterns among uncomplicated pregnancies (n = 3,706) and those with an episode of preterm labor followed by term delivery (n = 184) were identical across the time intervals 16-22 weeks, 22-28 weeks, and 28-34 weeks in a multilevel mixed-effects regression. The hypothesis was not supported. Fetal weight growth rate was faster from 16 weeks among pregnancies with an episode of preterm labor (P < 0.05), declined across midgestation (22-28 weeks, P < 0.05), and rebounded between 28 and 34 weeks (P = 0.06). This was associated with perturbations in abdominal circumference growth and proportionately larger biparietal diameter from 22 gestational weeks (P = 0.03), greater femur (P = 0.01), biparietal diameter (P = 0.001) and head circumference (P = 0.02) dimensions relative to abdominal circumference across midgestation (22-28 weeks), followed by proportionately smaller femur diaphyseal length (P = 0.02) and biparietal diameter (P = 0.03) subsequently. A distinctive rapid growth phenotype characterized fetal growth preceding an episode of preterm labor among this sample of term-delivered neonates. Perturbations in abdominal circumference growth and patterns of proportionality suggest an altered growth strategy pre-dating the preterm labor episode.

  8. Learning-based scan plane identification from fetal head ultrasound images

    NASA Astrophysics Data System (ADS)

    Liu, Xiaoming; Annangi, Pavan; Gupta, Mithun; Yu, Bing; Padfield, Dirk; Banerjee, Jyotirmoy; Krishnan, Kajoli

    2012-03-01

    Acquisition of a clinically acceptable scan plane is a pre-requisite for ultrasonic measurement of anatomical features from B-mode images. In obstetric ultrasound, measurement of gestational age predictors, such as biparietal diameter and head circumference, is performed at the level of the thalami and cavum septum pelucidi. In an accurate scan plane, the head can be modeled as an ellipse, the thalami looks like a butterfly, the cavum appears like an empty box and the falx is a straight line along the major axis of a symmetric ellipse inclined either parallel to or at small angles to the probe surface. Arriving at the correct probe placement on the mother's belly to obtain an accurate scan plane is a task of considerable challenge especially for a new user of ultrasound. In this work, we present a novel automated learning-based algorithm to identify an acceptable fetal head scan plane. We divide the problem into cranium detection and a template matching to capture the composite "butterfly" structure present inside the head, which mimics the visual cues used by an expert. The algorithm uses the stateof- the-art Active Appearance Models techniques from the image processing and computer vision literature and tie them to presence or absence of the inclusions within the head to automatically compute a score to represent the goodness of a scan plane. This automated technique can be potentially used to train and aid new users of ultrasound.

  9. Gestational age

    MedlinePlus

    ... looking at the baby's weight, length, head circumference , vital signs, reflexes, muscle tone, posture, and the condition of the skin and hair. If the baby's gestational age findings after birth match the calendar age, the baby ...

  10. Mode of Genetic Inheritance Modifies the Association of Head Circumference and Autism-Related Symptoms: A Cross-Sectional Study

    PubMed Central

    Davis, Jonathan M.; Keeney, Jonathon G.; Sikela, James M.; Hepburn, Susan

    2013-01-01

    Background Frequently individuals with autism spectrum disorder (ASD) have been noted with a larger head circumference (HC) than their typical developing peers. Biologic hypotheses suggest that an overly rapid brain growth leads to the core symptoms of ASD by impairing connectivity. Literature is divided however where deleterious, protective and null associations of HC with ASD symptoms in individuals with ASD have been found. Method Individuals (n = 1,416) from the Autism Genetic Resource Exchange with ASD were examined for associations of HC with ASD like symptoms. Mixed models controlling for sex, age, race/ethnicity, simplex/multiplex status and accounting for correlations between siblings were used. Interactions by simplex/multiplex were explored. Adjustments for height in a sub-population with available data were explored as well. Results A Significant interaction term (p = 0.03) suggested that the effect of HC was dependent on whether the individual was simplex or multiplex. In simplex individuals at mean age (8.9 years) 1 cm increase in head circumference was associated with a 24% increase in the odds of a high social diagnostic score from the Autism Diagnostic Interview – Revised (odds ratio  = 1.24, p = 0.01). There was no association in multiplex individuals. Additionally, individuals classified with a non-verbal IQ <70 were 90% simplex and had a significantly increased head circumference (0.7 cm p = 0.03) relative to a mid-range non-verbal IQ group. Interestingly, children classified with a >110 non-verbal IQ also had an increased HC (0.4 cm p = 0.04), relative to a mid-range non-verbal IQ group, and were 90% multiplex. HC effects do not appear to be confounded by height, however, larger samples with height information are needed. Conclusion The potential link between brain growth and autism like symptoms is complex and could depend on specific etiologies. Further investigations accounting for a likely mode of inheritance will help identify an ASD subtype related to HC. PMID:24058641

  11. Maternal Fish Consumption and Infant Birth Size and Gestation: New York State Angler Cohort Study

    PubMed Central

    Buck, Germaine M; Tee, Grace P; Fitzgerald, Edward F; Vena, John E; Weiner, John M; Swanson, Mya; Msall, Michael E

    2003-01-01

    Background The scientific literature poses a perplexing dilemma for pregnant women with respect to the consumption of fish from natural bodies of water. On one hand, fish is a good source of protein, low in fat and a rich source of other nutrients all of which have presumably beneficial effects on developing embryos and fetuses. On the other hand, consumption of fish contaminated with environmental toxicants such as polychlorinated biphenyls (PCBs) has been associated with decrements in gestation and birth size. Methods 2,716 infants born between 1986–1991 to participants of the New York State Angler Cohort Study were studied with respect to duration of maternal consumption of contaminated fish from Lake Ontario and its tributaries and gestation and birth size. Hospital delivery records (maternal and newborn) were obtained for 92% of infants for the ascertainment of gestation (weeks), birth size (weight, length, chest, and head circumference) and other known determinants of fetal growth (i.e., maternal parity, history of placental infarction, uterine bleeding, pregnancy loss or cigarette smoking and infant's race, sex and presence of birth defect). Duration of maternal fish consumption prior to the index infant's birth was categorized as: none; 1–2, 3–7, 8+ years, while birth weight (in grams), birth length (in centimeters), and head and chest circumference (in centimeters) were left as continuous variables in multiple linear regression models. Birth size percentiles, ponderal indices and head to chest circumference ratios were computed to further assess proportionality and birth size in relation to gestational age. Results Analysis of variance failed to identify significant mean differences in gestation or any measure of birth size in relation to duration of maternal lifetime fish consumption. Multiple linear regressions identified gestational age, male sex, number of daily cigarettes, parity and placental infarction, as significant determinants of birth size. Conclusions The results support the absence of an adverse relation between Lake Ontario fish consumption and reduced birth size as measured by weight, length and head circumference. Biological determinants and maternal cigarette smoking during pregnancy remain important determinants of birth size. PMID:12826023

  12. [Growth standardized values and curves based on weight, length/height and head circumference for Chinese children under 7 years of age].

    PubMed

    Li, Hui

    2009-03-01

    To construct the growth standardized data and curves based on weight, length/height, head circumference for Chinese children under 7 years of age. Random cluster sampling was used. The fourth national growth survey of children under 7 years in the nine cities (Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Fuzhou, Guangzhou and Kunming) of China was performed in 2005 and from this survey, data of 69 760 urban healthy boys and girls were used to set up the database for weight-for-age, height-for-age (length was measured for children under 3 years) and head circumference-for-age. Anthropometric data were ascribed to rigorous methods of data collection and standardized procedures across study sites. LMS method based on BOX-COX normal transformation and cubic splines smoothing technique was chosen for fitting the raw data according to study design and data features, and standardized values of any percentile and standard deviation were obtained by the special formulation of L, M and S parameters. Length-for-age and height-for-age standards were constructed by fitting the same model but the final curves reflected the 0.7 cm average difference between these two measurements. A set of systematic diagnostic tools was used to detect possible biases in estimated percentiles or standard deviation curves, including chi2 test, which was used for reference to evaluate to the goodness of fit. The 3rd, 10th, 25th, 50th, 75th, 90th, 97th smoothed percentiles and -3, -2, -1, 0, +1, +2, +3 SD values and curves of weight-for-age, length/height-for-age and head circumference-for-age for boys and girls aged 0-7 years were made out respectively. The Chinese child growth charts was slightly higher than the WHO child growth standards. The newly established growth charts represented the growth level of healthy and well-nourished Chinese children. The sample size was very large and national, the data were high-quality and the smoothing method was internationally accepted. The new Chinese growth charts are recommended as the Chinese child growth standards in 21st century used in China.

  13. Association between patterns of maternal substance use and infant birth weight, length, and head circumference.

    PubMed

    Shankaran, Seetha; Das, Abhik; Bauer, Charles R; Bada, Henrietta S; Lester, Barry; Wright, Linda L; Smeriglio, Vincent

    2004-08-01

    To determine the effects of patterns of drug use during term pregnancy on infant growth parameters at birth. Histories of cocaine, opiate, alcohol, tobacco, and marijuana use during the 3-month period before pregnancy and the 3 trimesters of pregnancy were recorded at the infants' 1-month visit. Patterns of use were categorized as consistently high, moderate, or low/none or increasing/decreasing, and effects on growth parameters were analyzed in multivariate linear regression analyses, with adjustment for clinical site, maternal age, prepregnancy weight, multidrug use, and socioeconomic status. A total of 241 cocaine-exposed women and 410 non-cocaine-exposed women participated in the study. In the cocaine-exposed group, 75% used alcohol, 90% used tobacco, and 53% used marijuana; in the non-cocaine-exposed group, 57% used alcohol, 34% used tobacco, and 19% used marijuana. Birth weight, birth length, and head circumference were significantly greater among infants born to women who used no drugs, compared with women with any cocaine, opiate, alcohol, tobacco, or marijuana use, and were greater among infants born to cocaine nonusers, compared with cocaine users. With adjustment for confounders, birth weight was significantly affected by cocaine (deficit of 250 g with consistently low pattern) and tobacco (deficits of 232 g with consistently high pattern, 173 g with consistently moderate pattern, 153 g with decreasing pattern, and 103 g with consistently low pattern). Head size was affected by cocaine (deficit of 0.98 cm with consistently moderate pattern) and tobacco (deficits of 0.72 cm with consistently high pattern and 0.89 cm with consistently moderate pattern). Birth length was affected by tobacco use only (deficits of 0.82 cm with consistently high pattern and 0.98 cm with decreasing use). Patterns of tobacco use during pregnancy affect birth weight, length, and head circumference, whereas cocaine affects birth weight and head size, when adjustments are made for confounders, including multidrug use.

  14. Head circumference and height abnormalities in autism revisited: the role of pre- and perinatal risk factors.

    PubMed

    Schrieken, Margo; Visser, Janne; Oosterling, Iris; van Steijn, Daphne; Bons, Daniëlle; Draaisma, Jos; van der Gaag, Rutger-Jan; Buitelaar, Jan; Donders, Rogier; Rommelse, Nanda

    2013-01-01

    Pre/perinatal risk factors and body growth abnormalities have been studied frequently as early risk markers in autism spectrum disorder (ASD), yet their interrelatedness in ASD has received very little research attention. This is surprising, given that pre/perinatal risk factors can have a substantial impact on growth trajectories in the first years of life. We aimed to determine which pre/perinatal factors were more prevalent in ASD children and if these factors differentially influenced body growth in ASD and control children. A total of 96 ASD and 163 control children matched for gender participated. Data of growth of head size and body length during the first 13 months of life were collected. Data on pre/perinatal risk factors were retrospectively collected through standardized questionnaires. Results indicated that after matching for SES, prematurity/low birth weight and being first born were more prevalent in the ASD versus the control group. In addition, with increasing age children with ASD tended to have a proportionally smaller head circumference compared to their height. However, the effect of prematurity/low birth weight on head growth corrected for height was significantly different in ASD and control children: premature/low birth weight control children showed a disproportionate larger head circumference in relation to height during their first year of life, whereas this effect was absent in premature/low birth weight ASD children. This may suggest that the etiology of abnormal growth is potentially different in ASD and control children: where abnormal growth in control children is related to suboptimal conditions in the uterus, abnormal growth in ASD may be more strongly related to the causal factors that also increase the risk for ASD. However, prospective studies measuring growth and ASD characteristics in both premature/low birth weight and a terme children are necessary to support this conclusion.

  15. Efficacy of Transcerebellar Diameter/Abdominal Circumference Versus Head Circumference/Abdominal Circumference in Predicting Asymmetric Intrauterine Growth Retardation

    PubMed Central

    Bhimarao; Bhat, Venkataramana; Gowda, Puttanna VN

    2015-01-01

    Background The high incidence of IUGR and its low recognition lead to increasing perinatal morbidity and mortality for which prediction of IUGR with timely management decisions is of paramount importance. Many studies have compared the efficacy of several gestational age independent parameters and found that TCD/AC is a better predictor of asymmetric IUGR. Aim To compare the accuracy of transcerebellar diameter/abdominal circumference with head circumference/abdominal circumference in predicting asymmetric intrauterine growth retardation after 20 weeks of gestation. Materials and Methods The prospective study was conducted over a period of one year on 50 clinically suspected IUGR pregnancies who were evaluated with 3.5 MHz frequency ultrasound scanner by a single sonologist. BPD, HC, AC and FL along with TCD were measured for assessing the sonological gestational age. Two morphometric ratios- TCD/AC and HC/AC were calculated. Estimated fetal weight was calculated for all these pregnancies and its percentile was determined. Statistical Methods The TCD/AC and HC/AC ratios were correlated with advancing gestational age to know if these were related to GA. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) for TCD/AC and HC/AC ratios in evaluating IUGR fetuses were calculated. Results In the present study, linear relation of TCD and HC in IUGR fetuses with gestation was noted. The sensitivity, specificity, PPV, NPV & DA were 88%, 93.5%, 77.1%, 96.3% & 92.4% respectively for TCD/AC ratio versus 84%, 92%, 72.4%, 95.8% & 90.4% respectively for HC/AC ratio in predicting IUGR. Conclusion Both ratios were gestational age independent and can be used in detecting IUGR with good diagnostic accuracy. However, TCD/AC ratio had a better diagnostic validity and accuracy compared to HC/AC ratio in predicting asymmetric IUGR. PMID:26557588

  16. Relationships between neonatal weight, limb lengths, skinfold thicknesses, body breadths and circumferences in an Australian cohort.

    PubMed

    Pomeroy, Emma; Stock, Jay T; Cole, Tim J; O'Callaghan, Michael; Wells, Jonathan C K

    2014-01-01

    Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life.

  17. Relationships between Neonatal Weight, Limb Lengths, Skinfold Thicknesses, Body Breadths and Circumferences in an Australian Cohort

    PubMed Central

    Pomeroy, Emma; Stock, Jay T.; Cole, Tim J.; O'Callaghan, Michael; Wells, Jonathan C. K.

    2014-01-01

    Background Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. Methods We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Results Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Conclusions Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life. PMID:25162658

  18. Differences in physical growth of Aymara and Quechua children living at high altitude in Peru.

    PubMed

    de Meer, K; Bergman, R; Kusner, J S; Voorhoeve, H W

    1993-01-01

    Physical growth of Amerindian children living in two Aymara and three Quechua peasant communities in the Andean highlands of southern Peru (altitude 3,810-3,840 m) was studied, taking into account differences in the microclimate, agronomic situation, and sociodemographic variables. Anthropometric measurements were taken in 395 children aged under 14 years of age in a sample of 151 families in these communities, who were surveyed for sociodemographic variables as well. Data on the land system were available for 77 families. In comparison with reference populations from the United States (NCHS) and The Netherlands, stature, weight, head circumference, and midupper arm circumference (but not weight for stature) in the sample children were reduced. Growth retardation increased after the age of 1 year. Stature and weight in the present sample were very similar compared with previously published data on growth of rural Aymara children living near Lake Titicaca in Bolivia. Head circumference, midupper arm circumference, and weight for stature were significantly larger in Aymara children compared with Quechua children. Land was significantly more fragmented in Aymara compared with Quechua families, but amount of land owned was not different. Perinatal and infant mortality was elevated in Aymara vs. Quechua communities. Most families in Aymara communities used protected drinking water. One Quechua community had a severe microclimate, grim economic outlook, and weak social cohesion. Children in this community showed significant reductions in weight and midupper arm circumference compared with their peers in the other communities. We conclude that (presumably nutritionally mediated) intervillage and Aymara-Quechua differences in childhood physical growth existed in this rural high-altitude population in Peru and were associated with microclimate and the village economy, sociodemographic factors, and differences in the land system.

  19. Medical Care and Your Newborn

    MedlinePlus

    ... Weight, length, and head circumference will be measured. Temperature will be taken, and your baby's breathing and ... an eye infection. Fever in a newborn (rectal temperature above 100.4°F or 38°C) should ...

  20. Socioeconomic determinants of infant growth: The Perspective Cohort Study of Thai Children.

    PubMed

    Phuphaibul, Rutja; Kongsaktrakul, Chuenreudee; Phusamon, Srisamon; Peasue, Noppawan; Mosuwan, Ladda; Choprapawon, Chanpen

    2014-01-01

      The present study is based on the Prospective Cohort Study of Thai Children (PCTC), and focuses on socioeconomic factors including maternal age, maternal education, living with parents, family size, family income, locality, and sex that affect the growth outcomes of infants at 1 year of age.   Data was collected among 3679 pairs of mothers and infants in the PCTC cohort in rural and urban locations during 2001-2002. Data collection was performed by interviewing mothers in their 7th to 8th month of pregnancy using family profile questionnaires. The anthropometric measures including weight, length, and head circumference of the infants were later collected at 1 year of age at home.   The results show the effects of family socioeconomic status maternal education, living with parents, family size, family income, locality, and sex on their weight (R(2) = 14.2%, P < 0.001) and length (R(2) = 8.7%, P < 0.001) at 1 year of age. The findings suggest that maternal age, maternal education, living with parents, family size, family income, locality, and sex predict infant head circumference (R(2) = 16.8%, P < 0.001) at 1 year of age.   Infants' growth, including weight, height, and head circumference, are affected by family socioeconomic status factors. It is recommended that the effect of maternal age on growth and development of children among those in the PCTC cohort is examined in the future. © 2012 The Authors. Japan Journal of Nursing Science © 2012 Japan Academy of Nursing Science.

  1. Infant Head Growth and Cognitive Status at 36 Months in Children with In-Utero Drug Exposure

    ERIC Educational Resources Information Center

    Butz, Arlene M.; Pulsifer, Margaret; Belcher, Harolyn M. E.; Leppert, Mary; Donithan, Michele; Zeger, Scott

    2005-01-01

    Previous studies of children with in-utero drug exposure (IUDE) raise concerns that decreased head circumference (HC) at birth increases the child's risk for later compromised cognitive functioning. The purpose of this study was to determine if HC at birth and HC growth change are associated with cognitive functioning (IQ) at 36 months of age in…

  2. Identification of Infants at Risk for Autism Spectrum Disorder and Developmental Language Delay Prior to 12 Months

    ERIC Educational Resources Information Center

    Samango-Sprouse, Carole A.; Stapleton, Emily J.; Aliabadi, Farhad; Graw, Robert; Vickers, Rebecca; Haskell, Kathryn; Sadeghin, Teresa; Jameson, Robert; Parmele, Charles L.; Gropman, Andrea L.

    2015-01-01

    Studies have shown an increased head circumference and the absence of the head tilt reflex as possible risk factors for autism spectrum disorder, allowing for early detection at 12 months in typically developing population of infants. Our aim was to develop a screening tool to identify infants prior to 12 months at risk for autism spectrum…

  3. Neurocognitive abilities in young adults with very low birth weight.

    PubMed

    Pyhälä, R; Lahti, J; Heinonen, K; Pesonen, A-K; Strang-Karlsson, S; Hovi, P; Järvenpää, A-L; Eriksson, J G; Andersson, S; Kajantie, E; Räikkönen, K

    2011-12-06

    Although severely preterm birth has been associated with impaired neurocognitive abilities in children, follow-up studies in adulthood are scarce. We set out to study whether adults born with very low birth weight (VLBW) (<1,500 g), either small for gestational age (SGA) (birth weight ≤-2 SD) or appropriate for gestational age (AGA), differ in a range of neurocognitive abilities and academic performance from adults born at term and not SGA. As part of the Helsinki Study of Very Low Birth Weight Adults, 103 VLBW (37 SGA) and 105 term-born control adults (mean age 25.0, range 21.4-29.7 years) without major neurosensory impairments participated in the follow-up study in 2007-2008. The test battery included measures of general cognitive ability as well as executive functioning and related abilities. Academic performance was self-reported. With adjustment for sex and age, the VLBW group scored lower or performed slower than the control group in some indices of all tests (these mean differences ranged from 0.3 to 0.5 SD units, p ≤ 0.03) and they had received remedial education at school more frequently; however, no differences existed in self-reported academic performance. The differences were evident in both VLBW-SGA and VLBW-AGA groups. Further covariate adjustments for parental education, current head circumference, and head circumference at birth and, in tests of executive functioning and related abilities, adjustment for IQ estimate had minor effects on the results. In comparison with control adults, VLBW adults scored lower on several neurocognitive tests. Poorer neurocognitive performance is associated with VLBW irrespective of the intrauterine growth pattern.

  4. The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample.

    PubMed

    May, Philip A; Marais, Anna-Susan; de Vries, Marlene M; Kalberg, Wendy O; Buckley, David; Hasken, Julie M; Adnams, Colleen M; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Tabachnick, Barbara; Robinson, Luther K; Manning, Melanie A; Jones, Kenneth Lyons; Bezuidenhout, Heidre; Seedat, Soraya; Parry, Charles D H; Hoyme, H Eugene

    2016-11-01

    The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences. Physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59-79 per 1,000 children, and total FASD in 170-233 per 1,000 children, or 17% to 23%. Very high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. THE CONTINUUM OF FETAL ALCOHOL SPECTRUM DISORDERS IN A COMMUNITY IN SOUTH AFRICA: PREVALENCE AND CHARACTERISTICS IN A FIFTH SAMPLE

    PubMed Central

    May, Philip A.; Marais, Anna-Susan; de Vries, Marlene M.; Kalberg, Wendy O.; Buckley, David; Hasken, Julie M.; Adnams, Colleen M.; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Tabachnick, Barbara; Robinson, Luther K.; Manning, Melanie A.; Jones, Kenneth Lyons; Bezuidenhout, Heidre; Seedat, Soraya; Parry, Charles D.H.; Hoyme, H. Eugene

    2016-01-01

    Background The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. Methods An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/ dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences. Results Physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59 – 79 per 1,000 children, and total FASD in 170 – 233 per 1,000 children, or 17% to 23%. Conclusions Very high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population. PMID:27736681

  6. [Risk factors and clinical prediction of shoulder dystocia in non-macrosomia].

    PubMed

    Li, Na; Li, Qiuling; Chang, Liang; Liu, Caixia

    2015-01-01

    To investigate the risk factors, clinical prediction and intrapartum management of shoulder dystocia in non-macrosomia. Totally 7 811 cases of vaginal delivery were retrospectively reviewed from Juanary 2009 to December 2013 in Shengjing Hospital. Shoulder dystocia was found in 11 cases (0.14% , 11/7 811), including 1 case of macrosomia and 10 cases of non-macrosomia (shoulder dystocia group). Each non-macrosomia shoulder dystocia case was matched with 10 cases of normal delivery in the same week, which were selected randomly as the control group. The tendency and risk factors of shoulder dystocia in macrosomia and non-macrosomia were analyzed, and the following data between the two groups were compared, including the height of uterus fundus, abdominal circumference of the pregnant woman, the increasing of body mass index (BMI), fetal biparietal diameter (BPD), fetal femur length (FL), duration of every stage of labor, birth weight of the newborn, head circumference and chest circumference of the newborn, Apgar score. (1) There were 213 macrosomias among the 7 811 vaginal deliveries, with the incidence of 2.73% (213/7 811). Only 1 shoulder dystocia was macrosomia (0.46%, 1/213); while the other 10 cases were non-macrosomia ( 0.13%, 10/7 598). (2) From 2009 to 2013, the macrosomia happened by 24 cases (2.32%, 24/1 034), 42 cases (3.61%, 42/1 164), 46 cases (2.60%, 46/1 772), 62 cases (3.01%, 62/2 060), 39 cases (2.19%, 39/1781), respectively. The incidence of macrosomia had no significant difference among these 5 years (P > 0.05). The shoulder dystosia occurrence without macrosia in these 5 years were 1 case ( 0.10% , 1/1 034), 3 cases (0.26%, 3/1 164), 2 cases ( 0.11%, 2/1 172), 2 cases (0.10%, 2/2 060), 2 cases ( 0.11%, 1/1 781), respectively. The incidence of shoulder dystocia without macrosomia had no significant difference among these 5 years (P > 0.05). (3) In the should dystocia group, 5 cases were complicated with premature rupture of membrane (5/10), 4 cases were mother≥ 35 years old (4/10), 3 cases were multipara(3/10), 3 cases had gestational diabetes mellitus(3/10), 3 cases were occiput posterior during the first stage of labor (3/10), 3 cases had prolonged second stage of labor (3/10) and 6 cases had routine lateral incision (6/10). In the control group, 3 cases were complicated with premature rupture of membrane(3/10); 1 case was mother≥35 years old (1/10); 2 cases were multipara(2/10), 3 cases had gestational diabetes mellitus (3/10), 1 case had prolonged second stage (1/10) and 7 cases had routine lateral incision (7/10). (4) There were no significant difference in the height of uterus fundus, BMI, BPD, FL, and duration of the first stage of labor between the shoulder dystocia group and the control group (P > 0.05). Compared with the control group, the increasing of BMI [(6.8±3.1) vs (4.8±1.4) kg/m(2)], the time of the second stage of labor[(86±65) vs (38±28) minutes ] and abdominal circumference[(108±8) vs (101±7) cm] were significantly higher in the shoulder dystosia group (P < 0.05). (5) There were significant difference in the chest circumference of the newborn [(34.0±1.6) vs (32.2±1.9) cm ] and the ratio of chest circumference to head circumference of the newborn [(0.99±0.03) vs (0.97±0.03) ] between the two groups (P < 0.05). The 1-minute Apgar score of the newborn (7.4±2.8) was significantly lower than the control group (10.0±0.0) (P < 0.01). Clavicular fracture occurred in 3 newborns and brachial plexus injury occurred in 4 newborns in the shoulder dystosia group. It is difficult to predict shoulder dystocia in non-macrosomia. Shoulder dystocia of non-macrosomia could be predicted by measurement of the head circumference, chest circumference, the ratio of chest circumference to head circumference by using prenatal ultrasound. The risk factors may complicated with premature rupture of membrane, abnormal occiput position during the first stage of labor and prolonged second stage of labor.

  7. Neck circumference correlates with tumor size and lateral lymph node metastasis in men with small papillary thyroid carcinoma.

    PubMed

    Kim, Mi Ra; Kim, Sang Soo; Huh, Jung Eun; Lee, Byung Joo; Lee, Jin Choon; Jeon, Yun Kyung; Kim, Bo Hyun; Kim, Seong Jang; Wang, Soo Geun; Kim, Yong Ki; Kim, In Joo

    2013-01-01

    Obesity is correlated with numerous diseases, including thyroid cancer, but the clinical significance of obesity with regard to the clinical characteristics of thyroid cancer remains unclear. Neck circumference is an index of upper-body adipose tissue distribution. In total, 401 patients with papillary thyroid carcinoma (PTC) measuring ≤ 2 cm were included. Neck circumference was measured horizontally at the level just below the thyroid cartilage on preoperative neck computed tomographic images. Neck circumference correlated significantly with tumor size in men (p = 0.001) but not in women (p = 0.930). Body mass index (BMI) did not significantly correlate with tumor size in either sex. Neck circumference was significantly larger in men with lateral lymph node (LN) metastasis than in those without (p = 0.004). Neck circumference and BMI did not differ significantly in women according to other factors such as tumor size, multifocality, extrathyroid extension, and LN metastasis. Tumor size and the prevalence of lateral LN metastasis in men tended to increase in the middle/large neck circumference subgroup compared with those in the low neck circumference subgroup. Multivariate logistic regression analysis revealed that neck circumference (p = 0.009) was a predictor for the presence of lateral LN metastasis in men. BMI was not a predictive factor for lateral LN involvement in either sex. Neck circumference, an indicator of central or visceral obesity but not BMI, may be associated with some prognostic factors in men with small PTC.

  8. Genetics Home Reference: PPP2R5D-related intellectual disability

    MedlinePlus

    ... and delayed speech development. Recurrent seizures (epilepsy) and autism spectrum disorder , which is characterized by impaired communications ... Increased Head Circumference Encyclopedia: Intellectual Disability Health Topic: Autism Spectrum ... Topic: Developmental Disabilities Additional NIH ...

  9. [Short, medium and long-term benefits of human milk intake in very-low-birth-weight infants].

    PubMed

    Chinea Jiménez, Bibiana; Awad Parada, Yumana; Villarino Marín, Antonio; Sáenz de Pipaón Marcos, Miguel

    2017-10-24

    The aim of the present study is to evaluate the effect of human milk feeding during the first weeks of life in very low birth weight infants on weight gain at discharge, length of hospitalization, postmenstrual age at discharge and nutritional assessment, growth and neurodevelopment at two and five years. Longitudinal study of very-low-birth-weight infants (< 1,500 grams) admitted to the Neonatal Intensive Care Unit of La Paz University Hospital, from January 1st 2009 to December 31st 2009, followed in the follow-up clinic. Their parents agreed to perform a more exhaustive anthropometric study at five years, classified according to the type of feeding at the time of discharge (exclusive human milk, formula milk or mixed). Initial hospital duration and anthropometry at discharge were evaluated. At two years of age, anthropometric data (weight, height and head circumference) were collected and neurodevelopment was assessed according to the Bayley scale of child development. Data at five years were collected prospectively. Measurements of weight, height and head circumference, waist circumference, hip, relaxed and contracted arm, thigh and middle leg, bicipital, triceps, subscapular, suprailiac and leg skin folds were performed. For patients older than five years, the Kaufman test battery for children was used. The effect of human milk on the variables of interest was investigated using a multivariate analysis correcting for gestational age and weight at birth. One hundred and fifty-two infants born in 2009 were discharged from our unit: exclusive breast milk (59), formula (55) or mixed milk (38). More detailed follow-up was carried out for 61 of them. Human milk during the first admission decreases the initial hospital stay, and is associated with a higher head circumference at two and five years, and a better score in the global and verbal cognitive area at five years. Our results suggest that maternal milk feeding during initial admission should be encouraged because it can improve neurodevelopment at five years of age.

  10. Military Interoperable Digital Hospital Testbed

    DTIC Science & Technology

    2012-07-01

    Subject outcome measures include blood pressure, waist circumference, weight, body mass index (BMI), body fat, HDL cholesterol, triglycerides , glucose ...master patient index (MPI), 625 duplicate chest x-rays and CT scans of the head between sending and receiving institution (taken within 0-7 days) were... Index (MPI) software. The report included chest x-rays (CPT 71010 and 71020) and CT scans of the head (CPT 70450) for the stated time periods. The

  11. Growth patterns in children with intrauterine growth retardation and their correlation to neurocognitive development.

    PubMed

    Fattal-Valevski, Aviva; Toledano-Alhadef, Hagit; Leitner, Yael; Geva, Ronny; Eshel, Rina; Harel, Shaul

    2009-07-01

    The relationship between somatic growth and neurocognitive outcome was studied in a cohort of 136 children with intrauterine growth retardation. The children were followed up from birth to 9 to 10 years of age by annual measurements of growth parameters, neurodevelopmental evaluations, and IQ. The rate of catch-up for height between 1 and 2 years of age was significantly higher than the catch-up for weight (P < .001). The cognitive outcome at 9 to 10 years correlated with head circumference at all ages. The neurodevelopmental outcome at 9 to 10 years correlated with weight at all ages. Correlation with head circumference was more significant with IQ, while with weight it was stronger with the neurodevelopmental score. Height at 1 year was a significant predictor for IQ and neurodevelopmental outcome at 9 to 10 years. These findings are of distinct importance for prediction of subsequent neurodevelopmental outcome in children with intrauterine growth retardation.

  12. Smart material joint band

    NASA Astrophysics Data System (ADS)

    Tucchio, Michael A.; Stoodt, Robert A.; Livsey, Robert A.

    1994-11-01

    The present invention relates to an improved connector for joining two tubular members together. The connector is formed by a plurality of longitudinally extending fingers extending from an end of one of tubular members and at least one locking groove in the other of the tubular members for receiving the fingers. The connector further includes a circumferentially extending wire member which is received in a notch in a head portion of each of the plurality of fingers. The wire member is preferably formed from a shape memory alloy and has an original circumference less than the circumference of a circle formed by the notches in a head portions of the fingers. The connector includes apertures through which electric wires may be connected to the shape memory alloy ring member so as to cause the shape memory alloy ring member to return to its original shape and allow release of the joint connection.

  13. Smart material joint band

    NASA Astrophysics Data System (ADS)

    Tucchio, Michael A.; Stoodt, Robert A.; Livsey, Robert A.

    1993-12-01

    The present invention relates to an improved connector for joining two tubular members together. The connector is formed by a plurality of longitudinally extending fingers extending from an end of one of the tubular members and at least one locking groove in the other of the tubular members for receiving the fingers. The connector further includes a circumferentially extending wire member which is received in a notch in a head portion of each of the plurality of fingers. The wire member is preferably formed from a shape memory alloy and has an original circumference less than the circumference of a circle formed by the notches in the head portions of the fingers. The connector includes apertures through which electric wires may be connected to the shape memory alloy ring member so as to cause the shape memory alloy ring member to return to its original shape and allow release of the joint connection.

  14. Measured Adiposity in Relation to Head and Neck Cancer Risk in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Ward, Heather A; Wark, Petra A; Muller, David C; Steffen, Annika; Johansson, Mattias; Norat, Teresa; Gunter, Marc J; Overvad, Kim; Dahm, Christina C; Halkjær, Jytte; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Mesrine, Sylvie; Brennan, Paul; Freisling, Heinz; Li, Kuanrong; Kaaks, Rudolf; Trichopoulou, Antonia; Lagiou, Pagona; Panico, Salavatore; Grioni, Sara; Tumino, Rosario; Vineis, Paolo; Palli, Domenico; Peeters, Petra H M; Bueno-de-Mesquita, H Bas; Weiderpass, Elisabete; Agudo, Antonio; Quirós, Jose Ramón; Larrañaga, Nerea; Ardanaz, Eva; Huerta, José María; Sánchez, María-José; Laurell, Göran; Johansson, Ingegerd; Westin, Ulla; Wallström, Peter; Bradbury, Kathryn E; Wareham, Nicholas J; Khaw, Kay-Tee; Pearson, Clare; Boeing, Heiner; Riboli, Elio

    2017-06-01

    Background: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer. However, most studies have used self-reported anthropometry which is prone to error. Methods: Among 363,094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of head and neck cancer. Head and neck cancer risk was examined in relation to body mass index (BMI) [lean: <22.5 kg/m 2 , normal weight (reference): 22.5-24.9 kg/m 2 , overweight 25-29.9 kg/m 2 , obese: ≥30 kg/m 2 ], waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) using Cox proportional hazards models. Results: Among men, a BMI < 22.5 kg/m 2 was associated with higher head and neck cancer risk [HR 1.62; 95% confidence interval (CI), 1.23-2.12)]; BMI was not associated with head and neck cancer among women. WC and WHR were associated with greater risk of head and neck cancer among women (WC per 5 cm: HR, 1.08; 95% CI, 1.02-1.15; WHR per 0.1 unit: HR, 1.64; 95% CI, 1.38-1.93). After stratification by smoking status, the association for WHR was present only among smokers ( P interaction = 0.004). Among men, WC and WHR were associated with head and neck cancer only upon additional adjustment for BMI (WC per 5 cm: HR 1.16; 95% CI, 1.07-1.26; WHR per 0.1 unit: HR, 1.42; 95% CI, 1.21-1.65). Conclusions: Central adiposity, particularly among women, may have a stronger association with head and neck cancer risk than previously estimated. Impact: Strategies to reduce obesity may beneficially impact head and neck cancer incidence. Cancer Epidemiol Biomarkers Prev; 26(6); 895-904. ©2017 AACR . ©2017 American Association for Cancer Research.

  15. Growth charts for non-growth hormone treated Prader-Willi syndrome.

    PubMed

    Butler, Merlin G; Lee, Jaehoon; Manzardo, Ann M; Gold, June-Anne; Miller, Jennifer L; Kimonis, Virginia; Driscoll, Daniel J

    2015-01-01

    The goal of this study was to generate and report standardized growth curves for weight, height, head circumference, and BMI for non-growth hormone-treated white male and female US subjects with Prader-Willi syndrome (PWS) between 3 and 18 years of age and develop standardized growth charts. Anthropometric measures (N = 133) were obtained according to standard methods from 120 non-growth hormone-treated white subjects (63 males and 57 females) with PWS between 3 and 18 years of age. Standardized growth curves were developed for the third, 10th, 25th, 50th, 75th, 90th, and 97th percentiles by using the LMS method for weight, height, head circumference, and BMI for PWS subjects along with the normative third, 50th, and 97th percentiles from national and international growth data. The LMS smoothing procedure summarized the distribution of the anthropometric variables at each age using three parameters: power of the Box-Cox transformation λ (L), median μ (M) and coefficient of variation δ (S). Weight, height, head circumference, and BMI standardized growth charts representing 7 percentile ranges were developed from 120 non-growth hormone-treated white male and female US subjects with PWS (age range: 3-18 years) and normative third, 50th, and 97th percentiles from national and international data. We encourage the use of syndrome-specific growth standards to examine and evaluate subjects with PWS when monitoring growth patterns and determining nutritional and obesity status. These variables can be influenced by culture, individual medical care, diet intervention, and physical activity plans. Copyright © 2015 by the American Academy of Pediatrics.

  16. Influence of prenatal and postnatal growth on intellectual functioning in school-aged children.

    PubMed

    Pongcharoen, Tippawan; Ramakrishnan, Usha; DiGirolamo, Ann M; Winichagoon, Pattanee; Flores, Rafael; Singkhornard, Jintana; Martorell, Reynaldo

    2012-05-01

    To assess the relative influence of size at birth, infant growth, and late postnatal growth on intellectual functioning at 9 years of age. A follow-up, cross-sectional study. Three districts in Khon Kaen province, northeast Thailand. A total of 560 children, or 92% of former participants of a trial of iron and/or zinc supplementation during infancy. Prenatal (size at birth), early infancy (birth to 4 months), late infancy (4 months to 1 year), and late postnatal (1 to 9 years) growth. Multiple-stage least squares analyses were used to generate uncorrelated residuals of postnatal growth. Intellectual functioning was measured at 9 years using the Wechsler Intelligence Scale for Children and the Raven's Colored Progressive Matrices (Pearson). Analyses included adjustment for maternal, household, and school characteristics. Significant relationships were found between growth and IQ (Wechsler Intelligence Scale for children, third edition, Thai version), but only up to 1 year of age; overall, growth was not related to the Raven's Colored Progressive Matrices. The strongest and most consistent relationships were with length (birth, early infancy, and late infancy); for weight, only early infancy gain was consistently related to IQ. Head circumference at birth was not collected routinely; head circumference at 4 months (but not head circumference growth thereafter) was related to IQ. Late postnatal growth was not associated with any outcome. Physical growth in early infancy (and, to a lesser extent, physical growth in late infancy and at birth) is associated with IQ at 9 years of age. Early infancy may be a critical window for human development.

  17. Efficacy of Antenatal Corticosteroid Treatment on Neurodevelopmental Outcome according to Head Circumference at Birth.

    PubMed

    Basset, Helene; Nusinovici, Simon; Huetz, Noémie; Sentilhes, Loic; Berlie, Isabelle; Flamant, Cyril; Roze, Jean-Christophe; Gascoin, Geraldine

    2018-01-01

    There are concerns about the efficacy of antenatal corticosteroid treatment (ACT) in the growth-restricted fetus. To evaluate the effect of ACT on neurodevelopmental outcome at 2 years of corrected age according to the z score of birth head circumference (ZS HC) in a large prospective cohort of preterm infants. This study was conducted as a population-based, prospective, multicenter study, including 4,965 infants born between 24 and 33 weeks' gestation and whose status regarding ACT and the measurement of head circumference at birth were available. They were evaluated at 2 years of corrected age to assess neurological outcome. Three approaches were considered to estimate the effect of ACT on neurodevelopment: (i) logistic regression with adjustment on propensity score, (ii) weighted logistic regression using the inverse probability of treatment weighting method, and (iii) 1:1 matching of gestational age, ZS HC, and propensity score between treated and nontreated infants. ACT was documented in 60% of infants. Three groups of infants were considered according to their ZS HC: between -3 and -1 standard deviation (SD), -1 and +1 SD, and +1 and +3 SD, respectively. ACT was associated with a significant improvement of neurodevelopmental outcome only for infants with an ZS HC of between +1 and +3 SD (adjusted OR 1.72; 95% CI 1.06-2.79). Moreover, ORs estimated in the -3 to -1 and +1 to +3 categories were significantly different. We found beneficial effects of ACT on neurodevelopmental outcomes at 2 years of corrected age only in preterm infants with a ZS HC >1 SD. © 2017 S. Karger AG, Basel.

  18. Early Head Growth in Infants at Risk of Autism: A Baby Siblings Research Consortium Study

    PubMed Central

    Zwaigenbaum, Lonnie; Young, Gregory S.; Stone, Wendy L.; Dobkins, Karen; Ozonoff, Sally; Brian, Jessica; Bryson, Susan E.; Carver, Leslie J.; Hutman, Ted; Iverson, Jana M.; Landa, Rebecca J.; Messinger, Daniel

    2014-01-01

    Objective: While early brain overgrowth is frequently reported in autism spectrum disorder (ASD), the relationship between ASD and head circumference (HC) is less clear, with inconsistent findings from longitudinal studies that include community controls. Our aim was to examine whether head growth in the first 3 years differed between children with ASD from a high-risk (HR) sample of infant siblings of children with ASD (by definition, multiplex), HR siblings not diagnosed with ASD, and low-risk (LR) controls. Method: Participants included 442 HR and 253 LR infants from 12 sites of the international Baby Siblings Research Consortium. Longitudinal HC data were obtained prospectively, supplemented by growth records. Random effects non-linear growth models were used to compare HC in HR infants and LR infants. Additional comparisons were conducted with the HR group stratified by diagnostic status at age 3: ASD (n=77), developmental delay (DD; n=32), and typical development (TD; n=333). Nonlinear growth models were also developed for height to assess general overgrowth associated with ASD. Results: There was no overall difference in head circumference growth over the first 3 years between HR and LR infants, although secondary analyses suggested possible increased total growth in HR infants, reflected by the model asymptote. Analyses stratifying the HR group by 3-year outcomes did not detect differences in head growth or height between HR infants who developed ASD and those who did not, nor between infants with ASD and LR controls. Conclusion: Head growth was uninformative as an ASD risk marker within this HR cohort. PMID:25245349

  19. The Association of Waist Circumference with Walking Difficulty Among Adults with or at Risk of Knee Osteoarthritis: The Osteoarthritis Initiative

    PubMed Central

    Gill, Simone V.; Hicks, Gregory E.; Zhang, Yuqing; Niu, Jingbo; Apovian, Caroline M.; White, Daniel K.

    2016-01-01

    Objective Excess weight is a known risk factor for functional limitation and common in adults with knee osteoarthritis (OA). We asked to what extent high waist circumference was linked with developing difficulty with walking speed and distance over 4 years in adults with or at risk of knee OA. Method Using data from the Osteoarthritis Initiative, we employed WHO categories for Body Mass Index (BMI) and waist circumference (small/medium and large). Difficulty with speed was defined by slow gait: < 1.2 m/s during a 20-meter walk, and difficulty with distance was defined by an inability to walk 400 meters. We calculated risk ratios (RR) to examine the likelihood of developing difficulty with distance and speed using obesity and waist circumference as predictors with RRs adjusted for potential confounders (i.e., age, sex, race, education, physical activity, and OA status). Results Participants with obesity and large waists were 2.2 times more likely to have difficulty with speed at 4 years compared to healthy weight and small/medium waisted participants (Adjusted RR 2.2 [95% Confidence interval (CI) 1.6, 3.1], P < .0001). Participants with obesity and a large waist circumference had 2.4 times the risk of developing the inability to walk 400 meters compared with those with a healthy BMI and small/medium waist circumference (Adjusted RR 0.9 [95% CI 1.6, 3.7], P < .0001). Conclusions Waist circumference may be a main risk factor for developing difficulty with speed in adults with or at risk of knee OA. PMID:27492464

  20. Cognition and behavioural development in early childhood: the role of birth weight and postnatal growth

    PubMed Central

    Huang, Cheng; Martorell, Reynaldo; Ren, Aiguo; Li, Zhiwen

    2013-01-01

    Background We evaluate the relative importance of birth weight and postnatal growth for cognition and behavioural development in 8389 Chinese children, 4–7 years of age. Method Weight was the only size measure available at birth. Weight, height, head circumference and intelligence quotient (IQ) were measured between 4 and 7 years of age. Z-scores of birth weight and postnatal conditional weight gain to 4–7 years, as well as height and head circumference at 4–7 years of age, were the exposure variables. Z-scores of weight at 4–7 years were regressed on birth weight Z-scores, and the residual was used as the measure of postnatal conditional weight gain. The outcomes were child’s IQ, measured by the Chinese Wechsler Young Children Scale of Intelligence, as well as internalizing behavioural problems, externalizing behavioural problems and other behavioural problems, evaluated by the Child Behavior Checklist 4–18. Multivariate regressions were conducted to investigate the relationship of birth weight and postnatal growth variables with the outcomes, separately for preterm children and term children. Results Both birth weight and postnatal weight gain were associated with IQ among term children; 1 unit increment in Z-score of birth weight (∼450 g) was associated with an increase of 1.60 [Confidence interval (CI): 1.18–2.02; P < 0.001] points in IQ, and 1 unit increment in conditional postnatal weight was associated with an increase of 0.46 (CI: 0.06–0.86; P = 0.02) points in IQ, after adjustment for confounders; similar patterns were observed when Z-scores of postnatal height and head circumference at age 4–7 years were used as alternative measurements of postnatal growth. Effect sizes of relationships with IQ were smaller than 0.1 of a standard deviation in all cases. Neither birth weight nor postnatal growth indicators were associated with behavioural outcomes among term children. In preterm children, neither birth weight nor postnatal growth measures were associated with IQ or behavioural outcomes. Conclusions Both birth weight and postnatal growth were associated with IQ but not behavioural outcomes for Chinese term children aged 4–7 years, but the effect sizes were small. No relation between either birth weight or postnatal growth and cognition or behavioural outcomes was observed among preterm children aged 4–7 years. PMID:23243117

  1. Lipid-based nutrient supplement increases the birth size of infants of primiparous women in Ghana.

    PubMed

    Adu-Afarwuah, Seth; Lartey, Anna; Okronipa, Harriet; Ashorn, Per; Zeilani, Mamane; Peerson, Janet M; Arimond, Mary; Vosti, Stephen; Dewey, Kathryn G

    2015-04-01

    The International Lipid-Based Nutrient Supplements Project developed a small-quantity (20 g/d) lipid-based nutrient supplement (LNS) for pregnant and lactating women. We evaluated the effects of prenatal LNS supplementation on fetal growth. In a community-based, partially double-blind, individually randomized controlled trial, 1320 women ≤20 wk pregnant received 60 mg Fe/400 μg folic acid (IFA), or 1-2 Recommended Dietary Allowances of 18 micronutrients, including 20 mg Fe (MMN), or LNS with the same micronutrients as the MMN group, plus 4 minerals and macronutrients contributing 118 kcal (LNS) daily until delivery. Fetal growth was compared across groups by using intention-to-treat analysis. The primary outcome was birth length. This analysis included 1057 women (IFA = 349, MMN = 354, LNS = 354). Groups did not differ significantly in mean birth length, length-for-age z score (LAZ), head circumference, or percentage low birth length but differed in mean birth weight (P = 0.044), weight-for-age z score (WAZ; P = 0.046), and BMI-for-age z score (BMIZ; P = 0.040), with a trend toward differences in low birth weight (P = 0.069). In pairwise comparisons, the LNS group had greater mean birth weight (+85 g; P = 0.040), WAZ (+0.19; P = 0.045), and BMIZ (+0.21; P = 0.035) and a lower risk of low birth weight (RR: 0.61, 95% CI: 0.39, 0.96; P = 0.032) than did the IFA group. The other group differences were not significant. The effect of intervention was modified by mother's parity, age, height, baseline hemoglobin, household food insecurity, and child sex, with parity being the most consistent modifier. Among primiparous women (IFA = 131; MMN = 110; LNS = 128), the LNS group had greater mean birth length (+0.91 cm; P = 0.001), LAZ (+0.47; P = 0.001), weight (+237 g; P < 0.001), WAZ (+0.56; P < 0.001), BMIZ (+0.52; P < 0.001), head circumference (0.50 cm; P = 0.017), and head circumference-for-age z score (+0.40; P = 0.022) than did the IFA group; similar differences were found when comparing the LNS and MMN groups among primiparous women, and no group differences were found among multiparous women. Prenatal LNS supplementation can improve fetal growth among vulnerable women in Ghana, particularly primiparous women. This trial was registered at clinicaltrials.gov as NCT00970866. © 2015 American Society for Nutrition.

  2. Birth month associations with height, head circumference, and limb lengths among Peruvian children.

    PubMed

    Pomeroy, Emma; Wells, Jonathan C K; Stanojevic, Sanja; Miranda, J Jaime; Cole, Tim J; Stock, Jay T

    2014-05-01

    Associations between season of birth and body size, morbidity, and mortality have been widely documented, but it is unclear whether different parts of the body are differentially sensitive, and if such effects persist through childhood. This may be relevant to understanding the relationship between early life environment and body size and proportions. We investigated associations between birth month and anthropometry among rural highland (n = 162) and urban lowland (n = 184) Peruvian children aged 6 months to 8 years. Stature; head-trunk height; total limb, ulna, tibia, hand, and foot lengths; head circumference; and limb measurements relative to head-trunk height were converted to internal age-sex-specific z scores. Lowland and highland datasets were then analyzed separately for birth month trends using cosinor analysis, as urban conditions likely provide a more consistent environment compared with anticipated seasonal variation in the rural highlands. Among highland children birth month associations were significant most strongly for tibia length, followed by total lower limb length and stature, with a peak among November births. Results were not significant for other measurements or among lowland children. The results suggest a prenatal or early postnatal environmental effect on growth that is more marked in limb lengths than trunk length or head size, and persists across the age range studied. We suggest that the results may reflect seasonal variation in maternal nutrition in the rural highlands, but other hypotheses such as variation in maternal vitamin D levels cannot be excluded. Copyright © 2014 Wiley Periodicals, Inc.

  3. Head and neck lymphedema management: Evaluation of a therapy program.

    PubMed

    Pigott, Amanda; Nixon, Jodie; Fleming, Jennifer; Porceddu, Sandro

    2018-06-01

    The purpose of this pilot study was to examine a therapeutic intervention for head and neck lymphedema. The 22-week intervention involved therapist-led care and participant self-management. Effectiveness was evaluated using a previously described lymphedema assessment tool, the Assessment of Lymphedema of the Head and Neck (ALOHA) to detect change over the course of the 22 weeks of treatment, and before and after a single treatment session. A prospective observational pilot study was conducted with a cohort of 10 participants assessed. Measurements of size (tape measurements) and water content (tissue dielectric constant [TDC]) were used, per the ALOHA protocol. Participants received 13 lymphedema therapy treatments at reducing frequencies over 22 weeks and daily self-management. There was an overall significant reduction in lower neck circumference (F [2.15,19.35] = 7.11; P = .004), upper neck circumference (F [5,45] = 7.27; P < .001) and TDC (F (5,45) = 8.92; P < .001) over time. There were no significant differences over the course of treatment for mean ear-to-ear measurements or before and after a single session of treatment. This pilot study found a reduction in head and neck lymphedema over the 22-week lymphedema treatment course. This intervention may be successful in reducing head and neck lymphedema; however, further studies are needed to investigate these findings in a larger sample with the use of a control group to negate improvements from healing over time. © 2018 Wiley Periodicals, Inc.

  4. Neonatal outcomes following exposure in utero to fallout from Chernobyl.

    PubMed

    Hatch, Maureen; Little, Mark P; Brenner, Alina V; Cahoon, Elizabeth K; Tereshchenko, Valery; Chaikovska, Ludmyla; Pasteur, Igor; Likhtarov, Ilya; Bouville, Andre; Shpak, Victor; Bolshova, Olena; Zamotayeva, Galyna; Grantz, Katherine; Sun, Liping; Mabuchi, Kiyohiko; Albert, Paul; Tronko, Mykola

    2017-12-01

    Iodine 131 (I-131), the principal component of nuclear fallout from the Chernobyl accident, concentrates in the thyroid gland and may pose risks to fetal development. To evaluate this, neonatal outcomes following the accident in April of 1986 were investigated in a cohort of 2582 in utero-exposed individuals from northern Ukraine for whom estimates of fetal thyroid I-131 dose were available. We carried out a retrospective review of cohort members' prenatal, delivery and newborn records. The relationships of dose with neonatal anthropometrics and gestational length were modeled via linear regression with adjustment for potentially confounding variables. We found similar, statistically significant dose-dependent reductions in both head circumference (-1.0 cm/Gy, P = 0.005) and chest circumference (-0.9 cm/Gy, P = 0.023), as well as a similar but non-significant reduction in neonatal length (-0.6 cm/Gy, P = 0.169). Gestational length was significantly increased with increasing fetal dose (0.5 wks/Gy, P = 0.007). There was no significant (P > 0.1) effect of fetal dose on birth weight. The observed associations of radioiodine exposure with decreased head and chest circumference are consistent with those observed in the Japanese in utero-exposed atomic bomb survivors.

  5. Leukocytes as risk markers for cardiovascular disease in adolescents: association with birth characteristics, nutritional status and biochemical tests

    PubMed Central

    do Prado, Pedro Paulo; de Faria, Franciane Rocha; de Faria, Eliane Rodrigues; Franceschini, Sylvia do Carmo Castro; Priore, Silvia Eloiza

    2016-01-01

    Abstract Objective: To evaluate the correlation between the number of leukocytes and cardiovascular risks associated with birth characteristics, nutritional status and biochemical tests. Methods: Cross-sectional study developed with 475 adolescents, born between 1992 and 2001, in the municipality of Viçosa (MG). Maternal medical records were analyzed in the hospital units, and the following was recorded: birth weight and length, head circumference, chest circumference, Apgar score, gestational age. In adolescents, body mass index, skinfold thickness, body composition, blood count, biochemical tests and clinical variables were also assessed. The statistical analyses was carried out using Statistical Package for Social Sciences (SPSS) version 20.0 and Data Analysis and Statistical Software (STATA) with Kruskal–Wallis, Mann–Whitney, chi-square or Fisher's exact tests and Linear Regression. Significance level was set at α<0.05. The study was approved by the Research Ethics Committee of UFV for studies with human subjects. Results: Weight and birth length, head and chest circumference were higher among boys. In adolescents, the number of leukocytes was higher in individuals with excess weight and body fat and high adiposity index, waist-to-height ratio and waist circumference. Only altered triglycerides showed differences between leukocyte medians. Regardless of the anthropometric variable of the final regression model, the stage of adolescence, number of platelets, eosinophils, monocytes and lymphocytes were associated with the increase in leukocytes. Conclusions: The birth variables were not associated with changes in leukocyte numbers, whereas the anthropometric variables were good indicators for a higher leukocyte count, regardless of the stage of adolescence and gender. PMID:26572104

  6. A prospective study of fetal head growth, autistic traits and autism spectrum disorder

    PubMed Central

    Blanken, Laura M. E.; Dass, Alena; Alvares, Gail; van der Ende, Jan; Schoemaker, Nikita K.; El Marroun, Hanan; Hickey, Martha; Pennell, Craig; White, Scott; Maybery, Murray T.; Dissanayake, Cheryl; Jaddoe, Vincent W. V.; Verhulst, Frank C.; Tiemeier, Henning; McIntosh, Will; Whitehouse, Andrew

    2018-01-01

    Altered trajectories of brain growth are often reported in Autism Spectrum Disorder (ASD), particularly during the first year of life. However, less is known about prenatal head growth trajectories, and no study has examined the relation with postnatal autistic symptom severity. The current study prospectively examined the association between fetal head growth and the spectrum of autistic symptom severity in two large population‐based cohorts, including a sample of individuals with clinically diagnosed ASD. This study included 3,820 children from two longitudinal prenatal cohorts in The Netherlands and Australia, comprising 60 individuals with a confirmed diagnosis of ASD. Latent growth curve models were used to examine the relationship between fetal head circumference measured at three different time points and autistic traits measured in postnatal life using either the Social Responsiveness Scale or the Autism‐Spectrum Quotient. While lower initial prenatal HC was weakly associated with increasing autistic traits in the Dutch cohort, this relationship was not observed in the Australian cohort, nor when the two cohorts were analysed together. No differences in prenatal head growth were found between individuals with ASD and controls. This large population‐based study identified no consistent association across two cohorts between prenatal head growth and postnatal autistic traits. Our mixed findings suggest that further research in this area is needed. Autism Res 2018, 11: 602–612. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary It is not known whether different patterns of postnatal brain growth in Autism Spectrum Disorder (ASD) also occurs prenatally. We examined fetal head growth and autistic symptoms in two large groups from The Netherlands and Australia. Lower initial prenatal head circumference was associated with autistic traits in the Dutch, but not the Australian, group. No differences in head growth were found in individuals with ASD and controls when the data was combined. Our mixed findings suggest that more research in this area is needed. PMID:29356450

  7. The effect of the skull of low-birthweight neonates on applied potential tomography imaging of centralised resistivity changes.

    PubMed

    McArdle, F J; Brown, B H; Pearse, R G; Barber, D C

    1988-01-01

    An investigation is presented into the likely effects of the neonatal skull on impedance images produced by applied potential tomography (APT) by imaging impedance changes inside the skull of a human infant of occipito-frontal circumference 30 cm. Measurements have been made with the skull immersed in a tank of saline and electrodes fixed to the perimeter of the tank. Sensitivity measurements have been assessed for imaging a small target close to the centre of the skull as compared with images produced without the skull. The results obtained compare favourably with measurements on a more realistic model of the neonatal head constructed by filling the skull with agar jelly to leave only a thin exterior coating of jelly to simulate the scalp. These experiments suggest that in the central region of the head of a neonate, measured changes by the APT technique are about 44% of that expected from a homogeneous phantom, but that this might vary from 32% to 55% at different points in the image in a very complex manner.

  8. Cigarette smoking in pregnancy: relationship to perinatal outcomes in six Italian centres.

    PubMed

    De Scrilli, A; Boracchi, P; Pardi, G; Bevilacqua, G; Pezzani, F M; Marconi, A; Davanzo, R; Paludetto, R; Selvaggi, L; Zuppa, A A

    1986-01-01

    In this study the relationship of maternal smoking in pregnancy to low birth weight, fetal growth retardation, preterm delivery, and perinatal deaths has been investigated in a sample of 36,544 women with their single newborns, from 6 Italian centers (Triese, Milan, Parma, Rome, Naples, Bari), where a multicenter survey of perinatal preventive medicine (MPPI) was carried out, between 1973 and 1979, with the financial support of the Consiglio Nazionale dell Ricerche. The proportions of babies weighing 2500 g or less, and of babies with birth weight, head circumference or crown-heel length below the 10th centile were similar among nonsmokers and "stopped" smoker mothers, while they increased with increasing smoking levels. As regards head circumference and crown-heel length below the 10th centile, odds ratios are essentially the same before and after adjustment for age, parity, and socioeconomic class (about 1.5 for "1-10CGT" and up to 2.5 for "11+CGT"). Only slight increases have been observed in the odds ratios concerning low birthweight below the 10th centile (about 1.5 for "1-10CGT" and up to 3.5 for "11+CGT") after adjusting for the socioeconomic demographic variables (i.e. mainly removing the favourable effect of high socioeconomic class or low parity, which more frequently characterize smoker mothers). Owing to the lower smokers' frequencies, cigarette smoking estimated attributable risks concerning low birth weight and "small for dates" babies in the MPPI centres (between 4% and 19%) are considerably lower than those estimated in studies carried out in the US or Canada. Data analyzed in the present study do not indicate any relationship between maternal smoking and preterm delivery or perinatal deaths.

  9. Outcomes of Extremely Preterm Infants Born to Insulin-Dependent Diabetic Mothers

    PubMed Central

    Boghossian, Nansi S.; Hansen, Nellie I.; Brumbaugh, Jane E.; Stoll, Barbara J.; Laptook, Abbot R.; Shankaran, Seetha; Wyckoff, Myra H.; Colaizy, Tarah T.; Das, Abhik; Higgins, Rosemary D.

    2016-01-01

    BACKGROUND AND OBJECTIVE: Little is known about in-hospital morbidities and neurodevelopmental outcomes among extremely preterm infants born to women with insulin-dependent diabetes mellitus (IDDM). We examined risks of mortality, in-hospital morbidities, and neurodevelopmental outcomes at 18 to 22 months’ corrected age between extremely preterm infants of women with insulin use before pregnancy (IBP), with insulin use started during pregnancy (IDP), and without IDDM. METHODS: Infants 22 to 28 weeks’ gestation born or cared for at a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network center (2006–2011) were studied. Regression models compared the association between maternal IDDM and timing of insulin use and the outcomes of the 3 groups. RESULTS: Of 10 781 infants, 536 (5%) were born to women with IDDM; 58% had IBP, and 36% had IDP. Infants of mothers with IBP had higher risks of necrotizing enterocolitis (adjusted relative risk [RR] = 1.55 [95% confidence interval (CI) 1.17–2.05]) and late-onset sepsis (adjusted RR = 1.26 [95% CI 1.07–1.48]) than infants of mothers without IDDM. There was some indication of higher in-hospital mortality risk among infants of mothers with IBP compared with those with IDP (adjusted RR = 1.33 [95% CI 1.00–1.79]). Among survivors evaluated at 18 to 22 months’ corrected age, average head circumference z score was lower for infants of mothers with IBP compared with those without IDDM, but there were no differences in risk of neurodevelopmental impairment. CONCLUSIONS: In this cohort of extremely preterm infants, infants of mothers with IBP had higher risks of necrotizing enterocolitis, sepsis, and small head circumference. PMID:27244849

  10. Growth of infants fed formula supplemented with Bifidobacterium lactis Bb12 or Lactobacillus GG: a systematic review of randomized controlled trials.

    PubMed

    Szajewska, Hania; Chmielewska, Anna

    2013-11-12

    Growth is an essential outcome measure for evaluating the safety of any new ingredients, including probiotics, added to infant formulae. The aim of this systematic review was to determine the effects of supplementation of infant formulae with Bifidobacterium lactis Bb12 (B lactis) and/or Lactobacillus rhamnosus GG (LGG) compared with unsupplemented formula on the growth of healthy infants. The MEDLINE, EMBASE, and Cochrane Library databases were searched in June 2013 for relevant randomized controlled trials (RCTs) conducted in healthy term infants. Unpublished data were obtained from the manufacturer of B lactis-supplemented formula. The primary outcome measures were weight, length, and head circumference. Nine eligible trials were identified. Compared with unsupplemented controls, supplementation of infant formula with B lactis had no effect on weight gain [4 RCTs, n = 266, mean difference (MD) 0.96 g/day, 95% confidence interval (CI) -0.70 to 2.63)], length gain (4 RCTs, n = 261, MD -0.39 mm/month, 95% CI -1.32 to 0.53), or head circumference gain (3 RCTs, n = 207, MD 0.56 mm/month, 95% CI -0.17 to 1.30). Data limited to one small (n = 105) trial suggest that infants who received standard infant formula supplemented with LGG grew significantly better. No such effect was observed in infants fed hydrolyzed formula supplemented with LGG. Supplementation of infant formula with B lactis results in growth similar to what is found in infants fed unsupplemented formula. Limited data do not allow one to reach a conclusion regarding the effect of LGG supplementation on infant growth.

  11. Fetal Growth and Childhood Cancer: A Population-Based Study

    PubMed Central

    Sørensen, Henrik Toft; Grotmol, Tom; Engeland, Anders; Stephansson, Olof; Gissler, Mika; Tretli, Steinar; Troisi, Rebecca

    2013-01-01

    OBJECTIVE: The etiology of childhood cancers is largely unknown. Studies have suggested that birth characteristics may be associated with risk. Our goal was to evaluate the risk of childhood cancers in relation to fetal growth. METHODS: We conducted a case-control study nested within Nordic birth registries. The study included cancer cases diagnosed in Denmark, Finland, Norway, and Sweden among children born from 1967 to 2010 and up to 10 matched controls per case, totaling 17 698 cases and 172 422 controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were derived from conditional logistic regression. RESULTS: Risks of all childhood cancers increased with increasing birth weight (Ptrend ≤ .001). Risks of acute lymphoid leukemia and Wilms tumor were elevated when birth weight was >4000 g and of central nervous system tumors when birth weight was >4500 g. Newborns large for gestational age were at increased risk of Wilms tumor (OR: 2.1 [95% CI: 1.2–3.6]) and connective/soft tissue tumors (OR: 2.1 [95% CI: 1.1–4.4]). In contrast, the risk of acute myeloid leukemia was increased among children born small for gestational age (OR: 1.8 [95% CI: 1.1–3.1]). Children diagnosed with central nervous system tumors at <1 year of age had elevated risk with increasing head circumference (Ptrend < .001). Those with head circumference >39 cm had the highest risk (OR: 4.7 [95% CI: 2.5–8.7]). CONCLUSIONS: In this large, Nordic population-based study, increased risks for several childhood tumors were associated with measures of fetal growth, supporting the hypothesis that tumorigenesis manifesting in childhood is initiated in utero. PMID:24167169

  12. [Measurement and analysis of human head-face dimensions].

    PubMed

    DU, Li-Li; Wang, Li-Min; Zhuang, Ziqing

    2008-05-01

    To probe into the physical changes on the head and face of Chinese adults, find the representative indexes and provide references for head-face products design especially in the field of labor protection. The ISO7250-1996 and GB/T5703-99 Basic Human Body Measurements for Technological Design was used. Twenty items of head-face referential parameters and 4 items of body indexes (height, weight, waist circumference and buttock circumference) were measured by using sliding caliper, spreading caliper and pupillometer. The populations were sampled by age, gender and region and their influences on the head and face dimensions were statistically analyzed. By studying the relationship between these parameters with correlation and cluster analysis, the representative indexes of head and face dimensions were concluded. 3000 objectives (2026 men and 974 women) were involved in this survey. The results enunciated that the values of the items in male were larger than those in female. For example, the mean values of face length, face width, jaw width, lip length and nose protrusion were 117.0, 147.6, 118.5, 51.7, 18.7 mm for male and 109.7, 140.1, 114.5, 49.3, 17.7 mm for female. The regional disparity and obesity were significant factors. The sizes of head and face of north-eastern population were significantly bigger than those of south-western population except of maximum length of head, the length of lip and face configuration length. The sizes of head and face of obesity population were significantly bigger than those of non-obesity population (P < 0.01). By the cluster analysis, five representative indexes (face length, face width, jaw width, lip length and nose protrusion) were obtained. Further correction analysis suggested that these indexes could well represent the head-face dimensions. The influence of gender, region and obesity on the head-face dimensions is significant. The age is not a significant influential factor. Five representative indexes (face length, face width, jaw width, lip length and nose protrusion) are obtained to provide foundation in the standard design of head-face products.

  13. Estimating a structural bottle neck for eye-brain transfer of visual information from 3D-volumes of the optic nerve head from a commercial OCT device

    NASA Astrophysics Data System (ADS)

    Malmberg, Filip; Sandberg-Melin, Camilla; Söderberg, Per G.

    2016-03-01

    The aim of this project was to investigate the possibility of using OCT optic nerve head 3D information captured with a Topcon OCT 2000 device for detection of the shortest distance between the inner limit of the retina and the central limit of the pigment epithelium around the circumference of the optic nerve head. The shortest distance between these boundaries reflects the nerve fiber layer thickness and measurement of this distance is interesting for follow-up of glaucoma.

  14. Severe perineal lacerations in nulliparous women and episiotomy type.

    PubMed

    Aytan, Hakan; Tapisiz, Omer L; Tuncay, Gorkem; Avsar, Filiz A

    2005-07-01

    To determine the patient-related factors associated with severe perineal lacerations in nulliparous women and to evaluate the effect of episiotomy type on the risk of severe perineal tears. In all, 400 nulliparous women admitted in labor between June and December 2001 were prospectively enrolled. Maternal height, perineal length, fetal birth weight, fetal head circumference, and severe perineal lacerations (third and fourth degrees) were recorded. The rate of severe perineal lacerations was 2% (8/400); 3% with midline, 1% with mediolateral groups. In patients with severe lacerations, perineal length was significantly (p < 0.001) shorter and the head circumference of their babies in the midline significantly (p < 0.05) greater than normal, and birth weights were also significantly (p < 0.05) greater in the mediolateral group. A cut-off value for perineal length of 3.05 cm was found for severe lacerations in the midline group. If episiotomy is to be performed, it must be borne in mind that patients with a perineal length of < or = 3 cm have an elevated risk of severe perineal lacerations, and if clinical or ultrasound examination suggests that the fetal head is large, mediolateral episiotomy may be preferred. Otherwise, midline episiotomy must be considered.

  15. Influence of maternal factors on the successful outcome of kangaroo mother care in low birth-weight infants: A randomized controlled trial.

    PubMed

    Lumbanraja, S N

    2016-01-01

    Kangaroo mother care (KMC) is associated with positive neonatal outcomes. Studies demonstrated significant influence of maternal factors on the success of applying KMC. To determine maternal factors that influence on anthropometric parameters in low birth weight babies that received kangaroo mother care. This is a randomized controlled study that involved low birth weight newborns. We randomly assigned newborns into two groups; a group who received KMC and a group who received conventional care. Maternal factors were recorded. We followed weight, length, and head circumferences of newborns for thirty days. A total of 40 newborns were included. Weight parameters were significantly higher in the KMC group than the conventional group. From maternal characteristics, only gestational age was found to influence increased head circumference in KMC group (p = 0.035); however, it did not affect the increase in weight or length. Maternal age, parity, education, mode of delivery, fetal sex, and initial Apgar score did not influence growth parameters in either groups. KMC was associated with increased weight gain in LBW infants. Gestational age influences head growth in infants who received KMC.

  16. The association of waist circumference with walking difficulty among adults with or at risk of knee osteoarthritis: the Osteoarthritis Initiative.

    PubMed

    Gill, S V; Hicks, G E; Zhang, Y; Niu, J; Apovian, C M; White, D K

    2017-01-01

    Excess weight is a known risk factor for functional limitation and common in adults with knee osteoarthritis (OA). We asked to what extent high waist circumference was linked with developing difficulty with walking speed and distance over 4 years in adults with or at risk of knee OA. Using data from the Osteoarthritis Initiative (OAI), we employed World Health Organization (WHO) categories for Body Mass Index (BMI) and waist circumference (small/medium and large). Difficulty with speed was defined by slow gait: <1.2 m/s during a 20-m walk, and difficulty with distance was defined by an inability to walk 400 m. We calculated risk ratios (RR) to examine the likelihood of developing difficulty with distance and speed using obesity and waist circumference as predictors with RRs adjusted for potential confounders (i.e., age, sex, race, education, physical activity, and OA status). Participants with obesity and large waists were 2.2 times more likely to have difficulty with speed at 4 years compared to healthy weight and small/medium waisted participants (Adjusted RR 2.2 [95% Confidence interval (CI) 1.6, 3.1], P < .0001). Participants with obesity and a large waist circumference had 2.4 times the risk of developing the inability to walk 400 m compared with those with a healthy BMI and small/medium waist circumference (Adjusted RR 0.9 [95% CI 1.6, 3.7], P < .0001). Waist circumference may be a main risk factor for developing difficulty with speed in adults with or at risk of knee OA. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  17. 29 CFR 1910.27 - Fixed ladders.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... unbroken length of 30 feet. EC27OC91.005 Figure D-5—Deflector Plates for Head Hazards EC27OC91.006 Figure D.... Vertical bars shall be located at a maximum spacing of 40 degrees around the circumference of the cage...

  18. 29 CFR 1910.27 - Fixed ladders.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... unbroken length of 30 feet. EC27OC91.005 Figure D-5—Deflector Plates for Head Hazards EC27OC91.006 Figure D.... Vertical bars shall be located at a maximum spacing of 40 degrees around the circumference of the cage...

  19. 29 CFR 1910.27 - Fixed ladders.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... unbroken length of 30 feet. EC27OC91.005 Figure D-5—Deflector Plates for Head Hazards EC27OC91.006 Figure D.... Vertical bars shall be located at a maximum spacing of 40 degrees around the circumference of the cage...

  20. Leg length, sitting height, and body proportions references for achondroplasia: New tools for monitoring growth.

    PubMed

    Del Pino, Mariana; Ramos Mejía, Rosario; Fano, Virginia

    2018-04-01

    Achondroplasia is the most common form of inherited disproportionate short stature. We report leg length, sitting height, and body proportion curves for achondroplasia. Seven centile format of sitting height, leg length, sitting height/leg length ratio, sitting height/height ratio, and head circumference/height ratio were estimated by the LMS method. The Q-test was applied to assess the goodness of fit. For comparison, centiles of sitting height and leg length were graphed using Argentine national growth references for achondroplasia and non-achondroplasia populations. The sample consisted of 342 children with achondroplasia (171 males, 171 females) aged 0-18 years. The median (interquartile range) number of measurements per child was 6 (3, 12) for sitting height and 8 (3, 13) for head circumference. Median leg length increased from 14 cm at age 1 week to 44 and 40 cm (males and females, respectively) in achondroplasia adolescents which is 3.5 cm shorter than non-achondroplasia children at age 1 week and, 38 cm shorter at adolescence. Median sitting height increased from 34 cm at birth to 86 and 81 in adolescents' boys and girls respectively, only 5 cm shorter than non-achondroplasia children. Sitting height/leg length decreased from 2.61 at birth to approximately 1.90 at adolescent. Median head circumference/height ratio decreased from 0.79 at birth to 0.46 at 18 years in both sexes. Growth of lower limbs is affected early in life and becomes more noticeable throughout childhood. The disharmonic growth between the less affected trunk and the severely affected limbs determine body disproportion in achondroplasia. © 2018 Wiley Periodicals, Inc.

  1. Antenatal betamethasone and fetal growth in prematurely born children: implications for temperament traits at the age of 2 years.

    PubMed

    Pesonen, Anu-Katriina; Räikkönen, Katri; Lano, Aulikki; Peltoniemi, Outi; Hallman, Mikko; Kari, M Anneli

    2009-01-01

    We explored whether repeated dose of antenatal betamethasone and variation in intrauterine growth of prematurely born children predict temperament characteristics at the age of 2 years. The patients (n = 142) were prematurely born children (mean gestational age: 31.0 weeks; range: 24.6-35.0 weeks) who participated in a randomized and blinded trial testing the effects of a repeated dose of antenatal betamethasone in imminent preterm birth. Fetal growth was estimated as weight, length, and head circumference in SDs according to Finnish growth charts. Parents assessed their toddlers' temperament with 201 items of the Early Childhood Temperament Questionnaire (mean child corrected age: 2.1 years). No significant main effects of repeated betamethasone on toddler temperament existed. However, a significant interaction between study group and duration of exposure to betamethasone emerged; those exposed to a repeated dose for >24 hours before delivery were more impulsive. One-SD increases in weight, length, and head circumference at birth were associated with 0.14- to 0.19-SD lower levels of negative affectivity (fearfulness, anger proneness, and sadness); 1-SD increases in length, weight, and head circumference at birth were associated with 0.14- to 0.18-SD higher levels of effortful control (self-regulation). Repeated antenatal betamethasone did not induce alterations in toddler temperament. The results, however, suggest that a longer duration of exposure is associated with higher impulsivity scores. Regardless of betamethasone exposure, slower fetal growth exerted influences on temperament. Our findings indicate prenatal programming of psychological development and imply that more attention is needed to support the development of infants born at the lower end of the fetal growth distribution.

  2. Early childhood growth and cognitive outcomes: Findings from the MAL-ED study.

    PubMed

    Scharf, Rebecca J; Rogawski, Elizabeth T; Murray-Kolb, Laura E; Maphula, Angelina; Svensen, Erling; Tofail, Fahmida; Rasheed, Muneera; Abreu, Claudia; Vasquez, Angel Orbe; Shrestha, Rita; Pendergast, Laura; Mduma, Estomih; Koshy, Beena; Conaway, Mark R; Platts-Mills, James A; Guerrant, Richard L; DeBoer, Mark D

    2018-02-02

    Although many studies around the world hope to measure or improve developmental progress in children to promote community flourishing and productivity, growth is sometimes used as a surrogate because cognitive skills are more difficult to measure. Our objective was to assess how childhood measures of anthropometry correlate with measures of child development in low-income settings with high prevalence of poor nutrition and enteric disease, to inform studies considering growth outcomes in the absence of direct child developmental skill assessment. Children from the MAL-ED study were followed from birth to 24 months of age in field sites in 8 low- and middle-income countries across 3 continents. Monthly weight, length, and head circumference measurements were performed. At 24 months, the Bayley Scales of Infant and Toddler Development was administered. We correlated cognitive measures at 24 months with anthropometric measurements from birth to 2 years comparing 3 constructs: absolute attained monthly measures, summative difference in measures from the mean growth curve, and rate of change in measures. Growth faltering at multiple time periods is related to Bayley cognitive outcomes at 24 months. Birthweight, overall growth by 18-24 months, and rate of growth in the 6- to 18-month period were most associated with 24-month developmental scores. In this study, head circumference measurements, compared with length, was more closely linked to cognitive scores at 24 months. Notably, all studies between growth and cognitive outcomes exhibited low r 2 values (0.001-0.049). Anthropometric measures, particularly head circumference, were related to cognitive development, although explaining a low percent of variance. When feasible, direct measures of child development may be more useful. © 2018 John Wiley & Sons Ltd.

  3. Impact of neonatal growth on IQ and behavior at early school age.

    PubMed

    Smithers, Lisa G; Lynch, John W; Yang, Seungmi; Dahhou, Mourad; Kramer, Michael S

    2013-07-01

    The objective was to examine associations of neonatal weight gain (NWG) and head circumference gain (HCG) with IQ scores and behavior at early school age. We used data from the Promotion of Breastfeeding Intervention Trial, involving Belarusian infants born full term and weighing ≥2500 g. NWG and HCG were measured as the percentage gain in weight and head circumference over the first 4 weeks relative to birth size. IQ and behavior were measured at 6.5 years of age by using the Wechsler Abbreviated Scales of Intelligence and the Strengths and Difficulties Questionnaire (SDQ), respectively, with SDQ collected from parents and teachers. The associations between the exposures (NWG, HCG) and children's IQ and SDQ were examined by using mixed models to account for clustering of measurements, and adjustment for potentially confounding perinatal and socioeconomic factors. Mean NWG was 26% (SD 10%) of birth weight. In fully adjusted models, infants in the highest versus lowest quartile of NWG had 1.5-point (95% confidence interval [CI] 0.8 to 2.2) higher IQ scores (n = 13 840). A weak negative (protective) association between NWG and SDQ total difficulties scores was observed for the teacher-reported (β = -0.39, 95% CI -0.71 to -0.08, n = 12 016), but not the parent-reported (β = -0.12, 95% CI -0.39 to 0.15, n = 13 815), SDQ. Similar associations were observed with HCG and IQ and behavior. Faster gains in weight or head circumference in the 4 weeks after birth may contribute to children's IQ, but reverse causality (brain function affects neonatal growth) cannot be excluded.

  4. Impact of Neonatal Growth on IQ and Behavior at Early School Age

    PubMed Central

    Lynch, John W.; Yang, Seungmi; Dahhou, Mourad; Kramer, Michael S.

    2013-01-01

    OBJECTIVES: The objective was to examine associations of neonatal weight gain (NWG) and head circumference gain (HCG) with IQ scores and behavior at early school age. METHODS: We used data from the Promotion of Breastfeeding Intervention Trial, involving Belarusian infants born full term and weighing ≥2500 g. NWG and HCG were measured as the percentage gain in weight and head circumference over the first 4 weeks relative to birth size. IQ and behavior were measured at 6.5 years of age by using the Wechsler Abbreviated Scales of Intelligence and the Strengths and Difficulties Questionnaire (SDQ), respectively, with SDQ collected from parents and teachers. The associations between the exposures (NWG, HCG) and children’s IQ and SDQ were examined by using mixed models to account for clustering of measurements, and adjustment for potentially confounding perinatal and socioeconomic factors. RESULTS: Mean NWG was 26% (SD 10%) of birth weight. In fully adjusted models, infants in the highest versus lowest quartile of NWG had 1.5-point (95% confidence interval [CI] 0.8 to 2.2) higher IQ scores (n = 13 840). A weak negative (protective) association between NWG and SDQ total difficulties scores was observed for the teacher-reported (β = −0.39, 95% CI −0.71 to −0.08, n = 12 016), but not the parent-reported (β = −0.12, 95% CI −0.39 to 0.15, n = 13 815), SDQ. Similar associations were observed with HCG and IQ and behavior. CONCLUSIONS: Faster gains in weight or head circumference in the 4 weeks after birth may contribute to children’s IQ, but reverse causality (brain function affects neonatal growth) cannot be excluded. PMID:23776123

  5. Size at birth and blood pressure: cross sectional study in 8-11 year old children.

    PubMed Central

    Taylor, S. J.; Whincup, P. H.; Cook, D. G.; Papacosta, O.; Walker, M.

    1997-01-01

    OBJECTIVE: To identify which patterns of fetal growth, represented by different measurements of size at birth, are associated with increased blood pressure in children aged 8-11 years. DESIGN AND SETTING: School based, cross sectional survey conducted in 10 towns in England and Wales in 1994. SUBJECTS: 3010 singleton children (response rate 75%) with physical measurements and information on birth weight from parental questionnaires. Hospital birth records were examined for 1573. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure at age 8-11 years. RESULTS: In the whole group birth weight was inversely related to systolic pressure (regression coefficient -1.48 mm Hg/kg; 95% confidence interval -2.20 to -0.76) after adjustment for current body size. There was no significant association between birth weight and diastolic pressure. The association with systolic pressure was much stronger in girls (-2.54 mm Hg/kg; -3.60 to -1.48) than in boys (-0.64 mm Hg/kg; -1.58 to 0.30), with a significant difference between the sexes (P = 0.006). Among the other neonatal measures, head circumference and placental weight were inversely associated with subsequent blood pressure in girls, and placental ratio (placental weight:birth weight) was positively associated with blood pressure in boys. Neither ponderal index at birth nor length:head circumference ratio was related to blood pressure in either sex. CONCLUSIONS: In these contemporary children the association between birth weight and blood pressure was apparent only in girls. There was no evidence that measures of size at birth, which may be related to nutrition at critical periods of pregnancy (thinness at birth or shortness in relation to head circumference), are related to blood pressure in the offspring. PMID:9056797

  6. Growth changes in infants born of adolescent mothers: Results of a national cohort study in Taiwan

    PubMed Central

    Chen, Yu-Ju; Li, Chi-Rong; Lee, Shu-Hsin; Hsu, Bu-Qing; Wu, Wei-Ya; Kuo, Ching-Pyng; Hwang, Shiow-Li; Lee, Ming-Chih

    2014-01-01

    Background: Adolescent pregnancy and childbirth are associated with increased risk and challenges for both mothers and birth outcomes. Objective: To investigate the associations of growth change over time with parenting factors and to compare the differences between children born to adolescent and adult mothers in Taiwan. Materials and Methods: The dataset retrieved from Taiwan birth cohort study (TBCS) was collected by interviews using structured questionnaires, birth certificate and Passport of Well-baby Care of each child. Changes in body weight, body height and head circumference from birth to 18 months, as well as other variables were assessed by statistical analysis. Results: There were 4.13% births born to adolescent mothers in 2005. Higher ratios of breastfeeding and working were found among adult mothers (p<0.001). Significantly higher percentage of adolescent mothers caregave their infants up to 18 months (p<0.001). Children born to adolescent mothers were associated with statistically significant lower body weight (p<0.001), body height (p<0.001) and head circumference (p<0.001) in spite of velocity and slop of growth patterns were similar over time. Breastfeeding did not significantly affected growth rate during the first 6 months. Generalized estimated equation models showed that gender and preterm birth were predictive factors for birth outcomes (both p<0.001) and correlated to changes over time. Conclusion: Adolescent childbearing was associated with preterm birth and lower body weight, body height and head circumference from birth to 18 months. The changes in growth and development among children born to adolescent mothers remain to be followed and evaluated with the TBCS. PMID:25709629

  7. Diet quality in early pregnancy and its effects on fetal growth outcomes: the Infancia y Medio Ambiente (Childhood and Environment) Mother and Child Cohort Study in Spain.

    PubMed

    Rodríguez-Bernal, Clara L; Rebagliato, Marisa; Iñiguez, Carmen; Vioque, Jesús; Navarrete-Muñoz, Eva M; Murcia, Mario; Bolumar, Francisco; Marco, Alfredo; Ballester, Ferran

    2010-06-01

    Maternal diet has been associated with fetal growth outcomes; however, evidence is scarce on the role of dietary quality. The objective was to assess the effect of diet quality during the first trimester of pregnancy, as measured by the Alternate Healthy Eating Index (AHEI) adapted for pregnancy, on fetal growth. We studied 787 women and their newborns from a Spanish cohort study. Diet quality was assessed by using a modification of the AHEI. Adjusted birth weight, birth length, and head circumference were used as continuous outcomes. We used a customized model to define fetal growth restriction in weight, length, and head circumference. After adjustment of multivariate models, a positive association was observed between diet quality and adjusted birth weight and adjusted birth length. The greatest differences were found between the fourth and first quintiles of the AHEI. Newborns of women in the fourth quintile were on average 126.3 g (95% CI: 38.5, 213.9 g) heavier and 0.47 cm (95% CI: 0.08, 0.86 cm) longer than those in the lowest quintile (P for trend = 0.009 and 0.013, respectively). Women with the highest AHEI scores had a significantly lower risk of delivering a fetal growth-restricted infant for weight (odds ratio: 0.24; 95% CI: 0.10, 0.55; P for trend = 0.001) than did women in the lowest quintile, but this was not the case for fetal growth restriction in length (P for trend = 0.538) or head circumference (P for trend = 0.070). A high-quality diet in the first trimester of pregnancy is associated with birth size and the risk of fetal growth restriction.

  8. Growth profiles of 34 patients with Wolf-Hirschhorn syndrome

    PubMed Central

    Shimojima, Keiko; Yamamoto, Toshiyuki

    2012-01-01

    Wolf-Hirschhorn syndrome (WHS) encompasses multiple congenital anomalies and mental retardation and is caused by partial deletions in the short arm of chromosome 4. Prenatal-onset growth deficiency is one of the WHS characteristics. Assessing and recording growth profiles of patients with WHS were the aims of this study. Anonymous questionnaire surveys were conducted with cooperation of a WHS peer-support group in Japan, and data from 34 WHS patients (12 males and 22 females; age, 1–23 years) were retrospectively collected. Height, weight, and head circumference (occipitofrontal head circumference) were measured and plotted on the standard growth charts of healthy Japanese children. Results indicated that most WHS patients showed growth retardation under the 3rd percentile since the first year of life and extremely poor body-weight gain after pubertal age. These findings are characteristic of WHS patients. The assessed growth patterns in this study could help monitoring and documentation of growth of WHS patients. PMID:27625799

  9. Revisiting head circumference of Brazilian newborns in public and private maternity hospitals.

    PubMed

    Amorim, Maria do Socorro Teixeira; Melo, Aurea Nogueira de

    2017-06-01

    To revisit the head circumference (HC) of newborns in public and private maternity hospitals; to correlate our findings with the gestational age, gender, and type of delivery; and build and validate graphs and curves. This was a prospective study performed on healthy newborns. Differences in HC were analyzed as a function of gestational age, gender, the healthcare system and the type of delivery. Smoothed percentile curves were created using the least mean squares method. Of the included newborns, 697 were born in private maternity hospitals and 2,150 were born in public maternity hospitals. In all, 839 were born by vaginal delivery, and 1,311 were born by cesarean delivery. At 37 to 42 weeks of gestation, male newborns had a larger HC than females. Infants born in private maternity and those born by cesarean delivery had a larger HC. An important result of the present study is that our analyses allowed us to generate curves and statistically-validated graphs that can be used in clinical neonatal practice.

  10. The relationships among acculturation, biobehavioral risk, stress, corticotropin-releasing hormone, and poor birth outcomes in Hispanic women.

    PubMed

    Ruiz, R Jeanne; Dolbier, Christyn L; Fleschler, Robin

    2006-01-01

    To determine the predictive ability of acculturation as an antecedent of stress, biobehavioral risk, corticotropin-releasing hormone levels, and poor birth outcomes in pregnant Hispanic women. A prospective, observational design with data collected at 22-25 weeks of gestation and at birth through medical record review. Public prenatal health clinics in south Texas serving low-income women. Self-identified Hispanic women who had singleton pregnancies, no major medical risk complications, and consented to answer questionnaires as well as a venipuncture and review of their prenatal and birth medical records. Gestational age, Apgar scores, length, weight, percentile size, and head circumference of the infant at birth. Significant differences were seen in infant birth weight, head circumference, and percentile size by acculturation. English acculturation predicted stress, corticotropin-releasing hormone, biobehavioral risk, and decreased gestational age at birth. Investigation must continue to understand the circumstances that give rise to the decline in birth outcomes observed in Hispanics with acculturation to the dominant English culture in the United States.

  11. Growth from birth to early adolescence in offspring prenatally exposed to cigarettes and marijuana.

    PubMed

    Fried, P A; Watkinson, B; Gray, R

    1999-01-01

    Weight, height, and head circumference were examined in children from birth to early adolescence for whom prenatal exposure to marijuana and cigarettes had been ascertained. The subjects were from a low-risk, predominantly middle-class sample participating in an ongoing longitudinal study. The negative association between growth measures at birth and prenatal cigarette exposure was overcome, sooner in males than females, within the first few years, and by the age of six, the children of heavy smokers were heavier than control subjects. Pre and postnatal environmental tobacco smoke did not have a negative effect upon the growth parameters; however, the choice of bottle-feeding or shorter duration of breast-feeding by women who smoked during pregnancy appeared to play an important positive role in the catch-up observed among the infants of smokers. Prenatal exposure to marijuana was not significantly related to any growth measures at birth, although a smaller head circumference observed at all ages reached statistical significance among the early adolescents born to the heavy marijuana users.

  12. A comparison of the effects of prenatal exposure to tobacco, alcohol, cannabis and caffeine on birth size and subsequent growth.

    PubMed

    Fried, P A; O'Connell, C M

    1987-01-01

    Maternal use of cigarettes, alcohol, cannabis, and caffeine was established for four time periods; prepregnancy, first trimester, third trimester and average use over pregnancy. The relationship between such usage and growth parameters of offspring followed up from birth to 12 and 24 months of age were examined. Of the soft drugs used, nicotine had the most pronounced effect. After adjustment for other relevant variables, nicotine use prior to and during pregnancy was negatively related to weight and head circumference at birth. Furthermore, third trimester nicotine use was a stronger predictor of decreased weight and head circumference at birth than was first trimester use. The results obtained are consistent with ponderal index (PI) literature suggesting a recovery of growth retardation in infants with a lowered PI. Average consumption of greater than one ounce of absolute alcohol per day was negatively related to birth weight and length. Neither cannabis nor caffeine use had a significant negative effect on any growth parameter.

  13. Language development in preschool children born after asymmetrical intrauterine growth retardation.

    PubMed

    Simić Klarić, Andrea; Kolundžić, Zdravko; Galić, Slavka; Mejaški Bošnjak, Vlatka

    2012-03-01

    After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions. The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. There were statistically significant differences (p < 0.05) in language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head [(Actual head circumference - head circumference at birth)/(Body weight - birth weight)] and language outcome. Children with neonatal complications had lower results (p < 0.05) in language comprehension and total expressive language. Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  14. Patterns of fetal growth in a rural Indian cohort and a comparison with a western European population, data from the Pune Maternal Nutrition Study

    PubMed Central

    KINARE, Arun S; CHINCHWADKAR, Manoj C; NATEKAR, Asit S; COYAJI, Kurus J; WILLS, Andrew K; JOGLEKAR, Charudatta V; YAJNIK, Chittaranjan S; FALL, Caroline HD

    2012-01-01

    Objective To describe fetal size in a rural Indian population and compare it with European and urban Indian populations using ultrasound. Methods Participants were from the Pune Maternal Nutrition Study, India. Fetal growth curves were constructed from serial ultrasound scans at ~18, 30 and 36 weeks gestation in 653 singleton pregnancies. Measurements included femur length (FL) and abdominal circumference (AC), and biparietal diameter (BPD) and occipito-frontal diameter (OFD) from which head circumference (HC) was estimated. Measurements were compared with data from a large population-based study in France and a study of urban mothers in Vellore, South India. Results Fetal AC and BPD were smaller than the French reference at 18 weeks gestation (−1.38 SD and −1.30 SD respectively), while FL and HC were more comparable (−0.77 SD and −0.59 SD). The deficit remained similar at 36 weeks for AC (−0.97 SD), FL (−0.43 SD) and HC (−0.52 SD) and increased for BPD (−2.3 SD). Ultrasound at 18 weeks under-estimated gestational age, compared with LMP date, by a median of −1.4 (IQR −4.6, 1.8) days. The Pune fetuses were smaller, even at the 1st scan, than the urban Vellore sample. Conclusions Fetal size is smaller in a rural Indian population than in European or urban Indian populations, even in mid pregnancy. The deficit varied for different fetal measurements; it was greatest for abdominal circumference and biparietal diameter and least for femur length and head circumference. PMID:20103791

  15. [Leukocytes as risk markers for cardiovascular disease in adolescents: association with birth characteristics, nutritional status and biochemical tests].

    PubMed

    do Prado Junior, Pedro Paulo; Faria, Franciane Rocha de; Faria, Eliane Rodrigues de; Franceschini, Sylvia do Carmo Castro; Priore, Silvia Eloiza

    2016-01-01

    To evaluate the correlation between the number of leukocytes and cardiovascular risks associated with birth characteristics, nutritional status and biochemical tests. Cross-sectional study developed with 475 adolescents, born between 1992 and 2001, in the municipality of Viçosa (MG). Maternal medical records were analyzed in the hospital units, and the following was recorded: birth weight and length, head circumference, chest circumference, Apgar score, gestational age. In adolescents, body mass index, skinfold thickness, body composition, blood count, biochemical tests and clinical variables were also assessed. The statistical analyses was carried out using Statistical Package for Social Sciences (SPSS) version 20.0 and Data Analysis and Statistical Software (STATA) with Kruskal-Wallis, Mann-Whitney, chi-square or Fisher's exact tests and Linear Regression. Significance level was set at α<0.05. The study was approved by the Research Ethics Committee of UFV for studies with human subjects. Weight and birth length, head and chest circumference were higher among boys. In adolescents, the number of leukocytes was higher in individuals with excess weight and body fat and high adiposity index, waist-to-height ratio and waist circumference. Only altered triglycerides showed differences between leukocyte medians. Regardless of the anthropometric variable of the final regression model, the stage of adolescence, number of platelets, eosinophils, monocytes and lymphocytes were associated with the increase in leukocytes. The birth variables were not associated with changes in leukocyte numbers, whereas the anthropometric variables were good indicators for a higher leukocyte count, regardless of the stage of adolescence and gender. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  16. Development of a New Growth Standard for Breastfed Chinese Infants: What Is the Difference from the WHO Growth Standards?

    PubMed

    Huang, Xiaona; Chang, Jenjen; Feng, Weiwei; Xu, Yiqun; Xu, Tao; Tang, He; Wang, Huishan; Pan, Xiaoping

    2016-01-01

    The objectives of this longitudinal study were to examine the trajectory of breastfed infants' growth in China to update growth standards for early childhood, and to compare these updated Chinese growth standards with the growth standards recommended by the World Health Organization (WHO) in 2006.This longitudinal cohort study enrolled 1,840 healthy breastfed infants living in an "optimal" environment favorable to growth and followed up until one year of age from 2007 to 2010. The study subjects were recruited from 60 communities in twelve cities in China. A participating infant's birth weight was measured within the first hour of the infant's life, and birth length and head circumference within 24 hours after birth. Repeated weekly and monthly anthropometric measurements were also taken. Multilevel (ML) modelling via MLwiN2.25 was fitted to estimate the growth curves of weight-for-age (WFA), length-for-age (LFA), and head circumference-for-age (HFA) for the study sample as a whole and by child sex, controlling for mode of delivery, the gravidity and parity of the mother, infant's physical measurements at birth, infant's daily food intaking frequency per day, infant's medical conditions, the season when the infant's physical measurement was taken, parents' ages, heights, and attained education, and family structure and income per month. During the first four weeks after birth, breastfed infants showed an increase in weight, length, and head circumference of 1110g, 4.9 cm, and 3.2 cm, respectively, among boys, and 980 g, 4.4 cm, and 2.8 cm, respectively, among girls. Throughout infancy, the total growth for these three was 6930 g, 26.4 cm, and 12.5 cm, respectively, among boys, and 6480 g, 25.5 cm, and 11.7 cm, respectively, among girls. As expected, there was a significant sex difference in growth during the first year. In comparison with the WHO growth standards, breastfed children in our study were heavier in weight, longer in length, and bigger in head circumference, with the exception of a few age points during the first two to four months on the upper two percentile curves.Our data suggested the growth curves for breastfed infants in China were significantly different in comparison with those based on the WHO standards. The adoption of the WHO infant growth standards among Chinese infants, as well as the methods used in the development of such growth standards in China, need careful and coordinated consideration.

  17. Development of a New Growth Standard for Breastfed Chinese Infants: What Is the Difference from the WHO Growth Standards?

    PubMed Central

    Chang, Jenjen; Feng, Weiwei; Xu, Yiqun; Xu, Tao; Tang, He; Wang, Huishan; Pan, Xiaoping

    2016-01-01

    The objectives of this longitudinal study were to examine the trajectory of breastfed infants’ growth in China to update growth standards for early childhood, and to compare these updated Chinese growth standards with the growth standards recommended by the World Health Organization (WHO) in 2006.This longitudinal cohort study enrolled 1,840 healthy breastfed infants living in an "optimal" environment favorable to growth and followed up until one year of age from 2007 to 2010. The study subjects were recruited from 60 communities in twelve cities in China. A participating infant’s birth weight was measured within the first hour of the infant’s life, and birth length and head circumference within 24 hours after birth. Repeated weekly and monthly anthropometric measurements were also taken. Multilevel (ML) modelling via MLwiN2.25 was fitted to estimate the growth curves of weight-for-age (WFA), length-for-age (LFA), and head circumference-for-age (HFA) for the study sample as a whole and by child sex, controlling for mode of delivery, the gravidity and parity of the mother, infant’s physical measurements at birth, infant’s daily food intaking frequency per day, infant’s medical conditions, the season when the infant’s physical measurement was taken, parents’ ages, heights, and attained education, and family structure and income per month. During the first four weeks after birth, breastfed infants showed an increase in weight, length, and head circumference of 1110g, 4.9 cm, and 3.2 cm, respectively, among boys, and 980 g, 4.4 cm, and 2.8 cm, respectively, among girls. Throughout infancy, the total growth for these three was 6930 g, 26.4 cm, and 12.5 cm, respectively, among boys, and 6480 g, 25.5 cm, and 11.7 cm, respectively, among girls. As expected, there was a significant sex difference in growth during the first year. In comparison with the WHO growth standards, breastfed children in our study were heavier in weight, longer in length, and bigger in head circumference, with the exception of a few age points during the first two to four months on the upper two percentile curves.Our data suggested the growth curves for breastfed infants in China were significantly different in comparison with those based on the WHO standards. The adoption of the WHO infant growth standards among Chinese infants, as well as the methods used in the development of such growth standards in China, need careful and coordinated consideration. PMID:27977706

  18. Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study.

    PubMed

    Elizabeth, Nabiwemba L; Christopher, Orach Garimoi; Patrick, Kolsteren

    2013-04-12

    Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth.Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson's correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Birth weights ranged from 1370-5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns.

  19. Longitudinal changes in fetal biometry and cerebroplacental hemodynamics in fetuses with congenital heart disease.

    PubMed

    Ruiz, A; Cruz-Lemini, M; Masoller, N; Sanz-Cortés, M; Ferrer, Q; Ribera, I; Martínez, J M; Crispi, F; Arévalo, S; Gómez, O; Pérez-Hoyos, S; Carreras, E; Gratacós, E; Llurba, E

    2017-03-01

    To determine the longitudinal behavior of fetal biometric measures and cerebroplacental hemodynamics throughout gestation in fetuses with congenital heart disease (CHD). Fetal biometry and Doppler hemodynamics (uterine artery (UtA), umbilical artery (UA) and fetal middle cerebral artery (MCA)) were measured serially in a cohort of consecutive fetuses diagnosed with CHD. Evaluations were made at various time points, from diagnosis (20-25 weeks) to delivery, with at least two measurements per fetus that were at least 2 weeks apart. Fetuses were classified into three groups according to the pattern of blood supply to the brain (placental vs systemic) that would be expected on the basis of the type of CHD. All parameters were transformed into Z-scores. A linear mixed model to analyze repeated measurements was constructed for each parameter to assess its behavior throughout gestation. Four hundred and forty-four ultrasound examinations were performed in 119 CHD fetuses, with a median of two measurements per fetus. The fetuses presented a small head at diagnosis (biparietal diameter (BPD) Z-score, -1.32 ± 0.99; head circumference (HC) Z-score, -0.79 ± 1.02), which remained small throughout gestation. UtA and UA pulsatility indices (PI) showed a significant increase towards the end of pregnancy, whereas no significant changes were observed in MCA-PI or cerebroplacental ratio (CPR) with gestational age. Both MCA and CPR presented significant differences in longitudinal behavior between CHD groups, while BPD and HC did not. CHD fetuses have a relatively small head from the second trimester of pregnancy, regardless of the type of CHD anomaly, and increasing resistance in the UtA and UA as pregnancy progresses, suggestive of increasing degree of placental impairment. Our findings indicate the early onset of mechanisms that could lead to poorer neurodevelopment later in life. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  20. A prospective study of fetal head growth, autistic traits and autism spectrum disorder.

    PubMed

    Blanken, Laura M E; Dass, Alena; Alvares, Gail; van der Ende, Jan; Schoemaker, Nikita K; El Marroun, Hanan; Hickey, Martha; Pennell, Craig; White, Scott; Maybery, Murray T; Dissanayake, Cheryl; Jaddoe, Vincent W V; Verhulst, Frank C; Tiemeier, Henning; McIntosh, Will; White, Tonya; Whitehouse, Andrew

    2018-04-01

    Altered trajectories of brain growth are often reported in Autism Spectrum Disorder (ASD), particularly during the first year of life. However, less is known about prenatal head growth trajectories, and no study has examined the relation with postnatal autistic symptom severity. The current study prospectively examined the association between fetal head growth and the spectrum of autistic symptom severity in two large population-based cohorts, including a sample of individuals with clinically diagnosed ASD. This study included 3,820 children from two longitudinal prenatal cohorts in The Netherlands and Australia, comprising 60 individuals with a confirmed diagnosis of ASD. Latent growth curve models were used to examine the relationship between fetal head circumference measured at three different time points and autistic traits measured in postnatal life using either the Social Responsiveness Scale or the Autism-Spectrum Quotient. While lower initial prenatal HC was weakly associated with increasing autistic traits in the Dutch cohort, this relationship was not observed in the Australian cohort, nor when the two cohorts were analysed together. No differences in prenatal head growth were found between individuals with ASD and controls. This large population-based study identified no consistent association across two cohorts between prenatal head growth and postnatal autistic traits. Our mixed findings suggest that further research in this area is needed. Autism Res 2018, 11: 602-612. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. It is not known whether different patterns of postnatal brain growth in Autism Spectrum Disorder (ASD) also occurs prenatally. We examined fetal head growth and autistic symptoms in two large groups from The Netherlands and Australia. Lower initial prenatal head circumference was associated with autistic traits in the Dutch, but not the Australian, group. No differences in head growth were found in individuals with ASD and controls when the data was combined. Our mixed findings suggest that more research in this area is needed. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.

  1. Opiate and Cocaine Exposed Newborns: Growth Outcomes.

    ERIC Educational Resources Information Center

    Butz, Arlene M.; Kaufmann, Walter E.; Royall, Richard; Kolodner, Ken; Pulsifer, Margaret B.; Lears, Mary Kathleen; Henderson, Robin; Belcher, Harolyn; Sellers, Sherri; Wilson, Modena

    1999-01-01

    Examines growth parameters at birth in 204 infants born to mothers who used cocaine and/or opiates during pregnancy. Outcome measures included birth weight, length, and head circumference. Study provides support that in utero cocaine exposure may confer more risk for somatic growth retardation at birth than opiate exposure. (Author/GCP)

  2. Growth and Nutritional Status of Migrant Farmworker Preschool Children: Are the Programs Working?

    ERIC Educational Resources Information Center

    McCracken, Robert D.

    1978-01-01

    Data on height, weight, and head circumference collected from 904 preschool-aged children of Mexican American farmworkers, enrolled in a Headstart/Daycare program in Colorado, revealed significant clusterings of children in the lower percentiles on all measures of growth at all ages above six months. (NQ)

  3. Sonographic Measurement of Fetal Ear Length in Turkish Women with a Normal Pregnancy

    PubMed Central

    Özdemir, Mucize Eriç; Uzun, Işıl; Karahasanoğlu, Ayşe; Aygün, Mehmet; Akın, Hale; Yazıcıoğlu, Fehmi

    2014-01-01

    Background: Abnormal fetal ear length is a feature of chromosomal disorders. Fetal ear length measurement is a simple measurement that can be obtained during ultrasonographic examinations. Aims: To develop a nomogram for fetal ear length measurements in our population and investigate the correlation between fetal ear length, gestational age, and other standard fetal biometric measurements. Study Design: Cohort study. Methods: Ear lengths of the fetuses were measured in normal singleton pregnancies. The relationship between gestational age and fetal ear length in millimetres was analysed by simple linear regression. In addition, the correlation of fetal ear length measurements with biparietal diameter, head circumference, abdominal circumference, and femur length were evaluated.Ear length measurements were obtained from fetuses in 389 normal singleton pregnancies ranging between 16 and 28 weeks of gestation. Results: A nomogram was developed by linear regression analysis of the parameters ear length and gestational age. Fetal ear length (mm) = y = (1.348 X gestational age)−12.265), where gestational ages is in weeks. A high correlation was found between fetal ear length and gestational age, and a significant correlation was also found between fetal ear length and the biparietal diameter (r=0.962; p<0.001). Similar correlations were found between fetal ear length and head circumference, and fetal ear length and femur length. Conclusion: The results of this study provide a nomogram for fetal ear length. The study also demonstrates the relationship between ear length and other biometric measurements. PMID:25667783

  4. Mild intellectual disability in children in Lahore, Pakistan: aetiology and risk factors.

    PubMed

    Yaqoob, M; Bashir, A; Zaman, S; Ferngren, H; Von Dobeln, U; Gustavson, K-H

    2004-10-01

    One of the main objectives of studying intellectual disability (ID) in children is to explore its causes. A specific aetiological diagnosis is important in determining the prognosis, nature and extent of services needed to support affected children. Aetiology and risk factors in mild ID were studied in a cohort of longitudinally followed children (6-10 years of age, n = 40) in four population groups in and around Lahore, Pakistan. The overall prevalence of mild ID was 6.2%. In 22% of the cases the onset of mild ID was prenatal with small for gestational age and multifactorial inheritance as the main underlying factors. During the postnatal period (28% of the cases), social deprivation and malnutrition were the major causes of ID. In a substantial proportion of the cases (50%), the cause of ID could not be traced. The present study indicates a clear relationship of mild ID with prenatal and postnatal malnutrition and social deprivation. Two independent variables, maternal illiteracy and small head circumference at birth, showed a clear association with the development of mild mental disability among children in the study population.

  5. Children of Methadone-Maintained Mothers: Three-Year Follow-Up.

    ERIC Educational Resources Information Center

    Johnson, Helen L.; And Others

    The physical and neurobehavioral findings at 3 years of age for 39 children born to mothers on methadone- maintenance and 23 children born to drug-free comparison mothers are reported. The methadone children had a higher incidence of head circumferences less than the third percentile, nystagmus/strabismus, and otitis media. No differences were…

  6. Effect of mild pressure applied by the ultrasound transducer on fetal cephalic measurements at 20-24 weeks' gestation.

    PubMed

    Kliper, Yael; Ben-Ami, Moshe; Perlitz, Yuri

    2014-01-01

    The aim of this study was to assess the effect of mild pressure applied on the abdominal wall by the ultrasound transducer on fetal cephalic indices. We examined by ultrasound 60 fetuses of healthy women, at 20-24 weeks of pregnancy, during routine prenatal evaluation. For every fetus biparietal diameter and head circumference were measured, with and without applying mild pressure by the ultrasound transducer. The weight and gestational age (GA) were calculated. The pressure applied by the transducer had a significant effect on the cephalic indices and on the weight and GA evaluations (p < 0.001). Fetal positioning significantly affected the impact that applied pressure had on head circumference and on the weight evaluation derived from it (p < 0.05). Applied pressure by an abdominal ultrasound probe affects cephalic indices and the derived weight and GA estimations. This may lead to incorrect diagnoses or hide pathological findings. The effect of applied pressure depends on fetal positioning. The examiner must be aware of this effect when evaluating the results of the measurements.

  7. New formulas for calculating the lung-to-head ratio in healthy fetuses between 20 and 40 weeks' gestation.

    PubMed

    Kehl, Sven; Eckert, Sven; Berlit, Sebastian; Tuschy, Benjamin; Sütterlin, Marc; Siemer, Jörn

    2013-11-01

    The purpose of this study was to develop new formulas for the expected fetal lung area-to-head circumference ratio in normal singleton pregnancies between 20 and 40 weeks' gestation. The lung-to-head ratio and complete fetal biometric parameters of 126 fetuses between 20 and 40 weeks' gestation were prospectively measured. The lung-to-head ratio was measured by 3 different methods (longest diameter, anteroposterior diameter, and tracing). Formulas for predicting right and left lung-to-head ratios with regard to gestational age and biometric parameters were derived by stepwise regression analysis. New formulas for calculating right and left lung-to-head ratios by each measurement method were derived. The formulas included gestational age only and no biometric parameters. The new formulas for estimating the expected lung-to-head ratio by the 3 different methods in normal singleton pregnancies up to 40 weeks' gestation may help improve the prognostic power of observed-to-expected lung-to-head ratio assessment in fetuses with congenital diaphragmatic hernias.

  8. Adverse effects of maternal lead levels on birth outcomes in the ALSPAC study: a prospective birth cohort study.

    PubMed

    Taylor, C M; Golding, J; Emond, A M

    2015-02-01

    To study the associations of prenatal blood lead levels (B-Pb) with pregnancy outcomes in a large cohort of mother-child pairs in the UK. Prospective birth cohort study. Avon area of Bristol, UK. Pregnant women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples were collected and analysed by inductively coupled plasma dynamic reaction cell mass spectrometry (n = 4285). Data collected on the infants included anthropometric variables and gestational age at delivery. Linear regression models for continuous outcomes and logistic regression models for categorical outcomes were adjusted for covariates including maternal height, smoking, parity, sex of the baby and gestational age. Birthweight, head circumference and crown-heel length, preterm delivery and low birthweight. The mean blood lead level (B-Pb) was 3.67 ± 1.47 μg/dl. B-Pb ≥ 5 μg/dl significantly increased the risk of preterm delivery (adjusted odds ratio [OR] 2.00 95% confidence interval [95% CI] 1.35-3.00) but not of having a low birthweight baby (adjusted OR 1.37, 95% CI 0.86-2.18) in multivariable binary logistic models. Increasing B-Pb was significantly associated with reductions in birth weight (β -13.23, 95% CI -23.75 to -2.70), head circumference (β -0.04, 95% CI -0.07 to -0.06) and crown-heel length (β -0.05, 95% CI -0.10 to -0.00) in multivariable linear regression models. There was evidence for adverse effects of maternal B-Pb on the incidence of preterm delivery, birthweight, head circumference and crown-heel length, but not on the incidence of low birthweight, in this group of women. © 2014 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  9. Efficacy and safety of long-term continuous growth hormone treatment in children with Prader-Willi syndrome.

    PubMed

    de Lind van Wijngaarden, Roderick F A; Siemensma, Elbrich P C; Festen, Dederieke A M; Otten, Barto J; van Mil, Edgar G A H; Rotteveel, Joost; Odink, Roelof J H; Bindels-de Heus, G C B Karen; van Leeuwen, Mariëtte; Haring, Danny A J P; Bocca, Gianni; Houdijk, E C A Mieke; Hoorweg-Nijman, J J Gera; Vreuls, René C F M; Jira, Petr E; van Trotsenburg, A S Paul; Bakker, Boudewijn; Schroor, Eelco J; Pilon, Jan Willem; Wit, Jan M; Drop, Stenvert L S; Hokken-Koelega, Anita C S

    2009-11-01

    Children with Prader-Willi syndrome (PWS) have abnormal body composition and impaired growth. Short-term GH treatment has beneficial effects. The aim of the study was to investigate effects of long-term continuous GH treatment on body composition, growth, bone maturation, and safety parameters. We conducted a multicenter prospective trial. Fifty-five children with a mean +/- sd age of 5.9 +/- 3.2 yr were followed during 4 yr of continuous GH treatment (1 mg/m(2) . d). Data were annually obtained in one center: fat percentage (fat%) and lean body mass (LBM) by dual-energy x-ray absorptiometry, height, weight, head circumference, bone age, blood pressure, and fasting IGF-I, IGF binding protein-3, glucose, insulin, glycosylated hemoglobin, total cholesterol, high-density lipoprotein, and low-density lipoprotein. sd scores (SDS) were calculated according to Dutch and PWS reference values (SDS and SDS(PWS)). Fat%SDS was significantly lower after 4 yr of GH treatment (P < 0.0001). LBMSDS significantly increased during the first year (P = 0.02) but returned to baseline values the second year and remained unchanged thereafter. Mean +/- sd height normalized from -2.27 +/- 1.2 SDS to -0.24 +/- 1.2 SDS (P < 0.0001). Head circumference SDS increased from -0.79 +/- 1.0 at start to 0.07 +/- 1.1 SDS after 4 yr. BMISDS(PWS) significantly decreased. Mean +/- sd IGF-I and the IGF-I/IGF binding protein-3 ratio significantly increased to 2.08 +/- 1.1 and 2.32 +/- 0.9 SDS, respectively. GH treatment had no adverse effects on bone maturation, blood pressure, glucose homeostasis, and serum lipids. Our study in children with PWS shows that 4 yr of continuous GH treatment (1 mg/m(2) . d) improves body composition by decreasing fat%SDS and stabilizing LBMSDS and head circumference SDS and normalizes heightSDS without adverse effects. Thus, long-term continuous GH treatment is an effective and safe therapy for children with PWS.

  10. Practice Parameter: Evaluation of the child with microcephaly (an evidence-based review)

    PubMed Central

    Ashwal, Stephen; Michelson, David; Plawner, Lauren; Dobyns, William B.

    2009-01-01

    Objective: To make evidence-based recommendations concerning the evaluation of the child with microcephaly. Methods: Relevant literature was reviewed, abstracted, and classified. Recommendations were based on a 4-tiered scheme of evidence classification. Results: Microcephaly is an important neurologic sign but there is nonuniformity in its definition and evaluation. Microcephaly may result from any insult that disturbs early brain growth and can be seen in association with hundreds of genetic syndromes. Annually, approximately 25,000 infants in the United States will be diagnosed with microcephaly (head circumference <−2 SD). Few data are available to inform evidence-based recommendations regarding diagnostic testing. The yield of neuroimaging ranges from 43% to 80%. Genetic etiologies have been reported in 15.5% to 53.3%. The prevalence of metabolic disorders is unknown but is estimated to be 1%. Children with severe microcephaly (head circumference <−3 SD) are more likely (∼80%) to have imaging abnormalities and more severe developmental impairments than those with milder microcephaly (−2 to −3 SD; ∼40%). Coexistent conditions include epilepsy (∼40%), cerebral palsy (∼20%), mental retardation (∼50%), and ophthalmologic disorders (∼20% to ∼50%). Recommendations: Neuroimaging may be considered useful in identifying structural causes in the evaluation of the child with microcephaly (Level C). Targeted and specific genetic testing may be considered in the evaluation of the child with microcephaly who has clinical or imaging abnormalities that suggest a specific diagnosis or who shows no evidence of an acquired or environmental etiology (Level C). Screening for coexistent conditions such as cerebral palsy, epilepsy, and sensory deficits may also be considered (Level C). Further study is needed regarding the yield of diagnostic testing in children with microcephaly. GLOSSARY CP = cerebral palsy; GDD = global developmental delay; HC = head circumference; MRE = medically refractory epilepsy; OMIM = Online Mendelian Inheritance in Man. PMID:19752457

  11. Maternal serum markers of lipid metabolism in relation to neonatal anthropometry

    PubMed Central

    Boghossian, Nansi S.; Mendola, Pauline; Liu, Aiyi; Robledo, Candace; Yeung, Edwina H.

    2017-01-01

    Objective To examine associations between lipids (HDL, LDL, total cholesterol, triglycerides, lipoprotein (a)) measured on average three time-points during pregnancy and neonatal anthropometrics. Study Design Stored samples from a preeclampsia trial measured as part of a case-control study from five US centers (1992-1995) were used. The sample included women without pregnancy complications (n=136), and cases of gestational diabetes (n=93), abnormal glucose tolerance (n=76), gestational hypertension (n=170), and preeclampsia (n=177). Linear regression and linear mixed-effects models estimated adjusted associations between lipids and birth weight z-score, ponderal index, length, and head circumference. Results Among women without complications, cross-sectional associations between total cholesterol measured at different gestational ages increased ponderal index 2.23 to 2.55 kg/m3 per-unit increase in cholesterol. HDL was inversely associated with birth length (β's=-2.21 and -2.56 cm). For gestational hypertension, triglycerides were associated with birth weight z-score (β's=0.24 to 0.31). For preeclampsia, HDL was associated with lower birth weight z-scores (β's=-0.49 and -0.82). Women with gestational diabetes or abnormal glucose tolerance had inconsistent associations. Examining the level changes across pregnancy, each 0.0037 mmol/L increase in HDL was associated with decreased birth weight z-score (β=-0.22), length (β=-0.24 cm), and head circumference (β=-0.24 cm) whereas each 0.028 mmol/L increase in triglycerides was associated with increased birth weight z-score (β=0.13) and head circumference (β=0.19 cm). Conclusion Although associations varied by complications, in general, growth promoting fuels as total cholesterol and triglycerides were associated with increased neonatal size whereas high HDL was associated with smaller size. Maternal HDL that failed to decrease over pregnancy was associated with smaller neonate size. PMID:28333159

  12. Pregnancy outcome and cord blood cotinine level: A cross-sectional comparative study between secondhand smokers and non-secondhand smokers.

    PubMed

    Abdullah, B; Muadz, B; Norizal, M N; Ismail, N; Kornain, N K; Kutty, M

    2017-07-01

    To compare the pregnancy outcome and cord blood cotinine levels between secondhand smokers and non-secondhand smokers. This was a cross-sectional comparative study in a Malaysian tertiary obstetric hospital involving 200 non-smoking pregnant women at term, of whom 100 were secondhand smokers and 100 were non-secondhand smokers. Those with multiple pregnancies, with a body mass index (BMI) of more than 30kg/m 2 or who delivered by Caesarean section were excluded. The participants' basic demographic details, delivery details, neonatal outcome and placental weight were recorded. Umbilical cord blood samples were obtained, and cord blood cotinine levels were measured with a Cotinine ELISA kit. The primary outcomes were baby's birth weight, length, and head circumference, Apgar score at 5min and placental weight. The secondary outcome was difference in cord blood cotinine levels between the two groups and the correlation of these differences with the neonatal outcome. The secondhand smoker group had significantly lower baby weight (2.94±0.31kg vs 3.05±0.40kg), head circumference (30.87±2.35cm vs 37.13±2.36cm), length (46.58±1.95cm vs 51.53±2.05cm) and placental weight (520±73.5g vs 596±61.3g) and significantly higher cord blood cotinine levels (16.35±12.84ng/mL vs 0.56±0.22ng/mL). Cord blood cotinine levels had significant negative correlations with placental weight (r=-0.461), baby's weight (r=-0.297), baby's head circumference (r=-0.501) and baby's length (r=-0.374). Secondhand smoke increases the incidence of adverse pregnancy outcomes (newborns'anthropometric measurements and placental weight) and causes higher cord blood cotinine levels. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Association of Organophosphate Pesticide Exposure and Paraoxonase with Birth Outcome in Mexican-American Women

    PubMed Central

    Harley, Kim G.; Huen, Karen; Aguilar Schall, Raul; Holland, Nina T.; Bradman, Asa; Barr, Dana Boyd; Eskenazi, Brenda

    2011-01-01

    Background Epidemiologic studies suggest that maternal organophosphorus (OP) pesticide exposure is associated with poorer fetal growth, but findings are inconsistent. We explored whether paraoxonase (PON1), a key enzyme involved in detoxification of OPs, could be an effect modifier in this association. Methods The study population included 470 pregnant women enrolled in the CHAMACOS Study, a longitudinal cohort study of mothers and children living in an agricultural region of California. We analyzed urine samples collected from mothers twice during pregnancy for dialkyl phosphate (DAP) metabolites of OP pesticides. We analyzed maternal and fetal (cord) blood samples for PON1 genotype (PON1192 and PON1−108) and enzyme activity (paraoxonase and arylesterase). Infant birth weight, head circumference, and gestational age were obtained from medical records. Results Infants' PON1 genotype and activity were associated with birth outcome, but mothers' were not. Infants with the susceptible PON1−108TT genotype had shorter gestational age (β = −0.5 weeks, 95% Confidence Interval (CI): −0.9, 0.0) and smaller head circumference (β = −0.4 cm, 95% CI: −0.7, 0.0) than those with the PON1−108CC genotype. Infants' arylesterase and paraoxonase activity were positively associated with gestational age. There was some evidence of effect modification with DAPs: maternal DAP concentrations were associated with shorter gestational age only among infants of the susceptible PON1−108TT genotype (p-valueinteraction = 0.09). However, maternal DAP concentrations were associated with larger birth weight (p-valueinteraction = 0.06) and head circumference (p-valueinteraction<0.01) in infants with non-susceptible genotypes. Conclusions Infants whose PON1 genotype and enzyme activity levels suggested that they might be more susceptible to the effects of OP pesticide exposure had decreased fetal growth and length of gestation. PON1 may be another factor contributing to preterm or low birth weight birth. PMID:21904599

  14. Effect of antenatal corticosteroids on fetal growth and gestational age at birth.

    PubMed

    Murphy, Kellie E; Willan, Andrew R; Hannah, Mary E; Ohlsson, Arne; Kelly, Edmond N; Matthews, Stephen G; Saigal, Saroj; Asztalos, Elizabeth; Ross, Susan; Delisle, Marie-France; Amankwah, Kofi; Guselle, Patricia; Gafni, Amiram; Lee, Shoo K; Armson, B Anthony

    2012-05-01

    To estimate the effect of multiple courses of antenatal corticosteroids on neonatal size, controlling for gestational age at birth and other confounders, and to determine whether there was a dose-response relationship between number of courses of antenatal corticosteroids and neonatal size. This is a secondary analysis of the Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study, a double-blind randomized controlled trial of single compared with multiple courses of antenatal corticosteroids in women at risk for preterm birth and in which fetuses administered multiple courses of antenatal corticosteroids weighed less, were shorter, and had smaller head circumferences at birth. All women (n=1,858) and children (n=2,304) enrolled in the Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study were included in the current analysis. Multiple linear regression analyses were undertaken. Compared with placebo, neonates in the antenatal corticosteroids group were born earlier (estimated difference and confidence interval [CI]: -0.428 weeks, CI -0.10264 to -0.75336; P=.01). Controlling for gestational age at birth and confounding factors, multiple courses of antenatal corticosteroids were associated with a decrease in birth weight (-33.50 g, CI -66.27120 to -0.72880; P=.045), length (-0.339 cm, CI -0.6212 to -0.05676]; P=.019), and head circumference (-0.296 cm, -0.45672 to -0.13528; P<.001). For each additional course of antenatal corticosteroids, there was a trend toward an incremental decrease in birth weight, length, and head circumference. Fetuses exposed to multiple courses of antenatal corticosteroids were smaller at birth. The reduction in size was partially attributed to being born at an earlier gestational age but also was attributed to decreased fetal growth. Finally, a dose-response relationship exists between the number of corticosteroid courses and a decrease in fetal growth. The long-term effect of these findings is unknown. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00187382. II.

  15. Decreased birth weight, length, and head circumference in children born by women years after treatment for hyperthyroidism.

    PubMed

    Ohrling, Hans; Törring, Ove; Yin, Li; Iliadou, Anastasia N; Tullgren, Ove; Abraham-Nordling, Mirna; Wallin, Göran; Hall, Per; Lönn, Stefan

    2014-09-01

    Whether hyperthyroidism influences the birth characteristics of children born several years after treatment is unknown. The objective of the study was to compare birth characteristics in singleton newborns delivered by women previously treated for Graves' disease (GD), toxic nodular goiter (TNG), or nontoxic goiter (NTG). This was a nested case-control design within a national cohort registry study from 1950 through 2006. The study was conducted at a university and a hospital center in collaboration. The birth characteristics of newborns (n = 3421) delivered in a cohort of 43 633 women treated for GD or toxic nodular goiter by radioiodine or surgery (exposed group) at least 1 year prior to pregnancy were compared with newborns (n = 2914) of 45 655 mothers, previously operated for NTG (unexposed group). The primary outcome was birth weight, length, and head circumference. The secondary outcome was malformations, gestational age, and type of hyperthyroidism. The birth weight of exposed children was 3431 ± 607 g (mean ± SD) compared with the unexposed, 3520 ± 641 g (P < .001). The cumulative odds ratio (OR) for lower birth weight was 1.29 [95% confidence interval (CI) 1.16-1.43]. The average birth length for the exposed children was 50.0 ± 2.7 cm compared with the unexposed of 50.4 cm ± 2.6 cm (P < .01) [cumulative OR 1.25 (95% CI 1.13-1.37)]. The head circumference was 34.5 ± 1.9 cm among exposed and 34.7 ± 1.8 cm, respectively (P < .001), with an OR of 1.24 (95% CI 1.13-1.35). No differences in birth characteristics were observed between children born after maternal GD or toxic nodular goiter. Previous GD or TNG may influence the birth characteristics several years after radioiodine or surgical treatment.

  16. Preconception and prenatal urinary concentrations of phenols and birth size of singleton infants born to mothers and fathers from the Environment and Reproductive Health (EARTH) study.

    PubMed

    Messerlian, Carmen; Mustieles, Vicente; Minguez-Alarcon, Lidia; Ford, Jennifer B; Calafat, Antonia M; Souter, Irene; Williams, Paige L; Hauser, Russ

    2018-05-01

    Although pregnancy concentrations of some phenols have been associated with infant size at birth, there is limited data on the effect of preconception exposure. We aimed to examine paternal and maternal preconception and maternal prenatal urinary phenol concentrations in relation to birth weight and head circumference. We evaluated 346 singletons born to 346 mothers and 184 fathers (184 couples) from a prospective preconception cohort of subfertile couples from the Environment and Reproductive Health (EARTH) Study in Boston, USA. We used multiple urine samples collected before the index pregnancy in both men and women to estimate mean preconception urinary benzophenone-3, triclosan, butylparaben, propylparaben, methylparaben, or ethylparaben concentrations. We also estimated mean maternal prenatal urinary phenol concentrations by averaging trimester-specific urine samples. Birth weight and head circumference were abstracted from delivery records. We estimated the association of natural log-phenol concentrations with birth outcomes using multivariable linear regression models, adjusting for known confounders. In adjusted models, each log-unit increase in paternal preconception benzophenone-3 concentration was associated with a 137 g increase in birth weight (95% CI: 60, 214). Additional adjustment for prenatal benzophenone-3 concentration strengthened this association. None of the maternal preconception phenol concentrations were associated with birth weight. However, maternal prenatal triclosan concentrations were associated with a 38 g decrease in birth weight (95% CI: -76, 0). Few associations were observed between phenols and head circumference except for a decrease of 0.27 cm (95% CI: -54, 0) in relation to maternal preconception methylparaben concentration. Although our findings should be interpreted in light of inherent study limitations, these results suggest potential evidence of associations between some paternal or maternal phenol concentrations and birth size. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2015-10-01

    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. 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). 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. No evidence of early head circumference enlargements in children later diagnosed with autism in Israel.

    PubMed

    Dinstein, Ilan; Haar, Shlomi; Atsmon, Shir; Schtaerman, Hen

    2017-01-01

    Large controversy exists regarding the potential existence and clinical significance of larger brain volumes in toddlers who later develop autism. Assessing this relationship is important for determining the clinical utility of early head circumference (HC) measures and for assessing the validity of the early overgrowth hypothesis of autism, which suggests that early accelerated brain development may be a hallmark of the disorder. We performed a retrospective comparison of HC, height, and weight measurements between 66 toddlers who were later diagnosed with autism and 66 matched controls. These toddlers represent an unbiased regional sample from a single health service provider in the southern district of Israel. On average, participating toddlers had >8 measurements between birth and the age of two, which enabled us to characterize individual HC, height, and weight development with high precision and fit a negative exponential growth model to the data of each toddler with exceptional accuracy. The analyses revealed that HC sizes and growth rates were not significantly larger in toddlers with autism even when stratifying the autism group based on verbal capabilities at the time of diagnosis. In addition, there were no significant correlations between ADOS scores at the time of diagnosis and HC at any time-point during the first 2 years of life. These negative results add to accumulating evidence, which suggest that brain volume is not necessarily larger in toddlers who develop autism. We believe that conflicting results reported in other studies are due to small sample sizes, use of misleading population norms, changes in the clinical definition of autism over time, and/or inclusion of individuals with syndromic autism. While abnormally large brains may be evident in some individuals with autism and more clearly visible in MRI scans, converging evidence from this and other studies suggests that enlarged HC is not a common etiology of the entire autism population. Early HC measures, therefore, offer very limited clinical utility for assessment of autism risk in the general population.

  19. High doses of folic acid in the periconceptional period and risk of low weight for gestational age at birth in a population based cohort study.

    PubMed

    Navarrete-Muñoz, Eva María; Valera-Gran, Desirée; Garcia-de-la-Hera, Manuela; Gonzalez-Palacios, Sandra; Riaño, Isolina; Murcia, Mario; Lertxundi, Aitana; Guxens, Mònica; Tardón, Adonina; Amiano, Pilar; Vrijheid, Martine; Rebagliato, Marisa; Vioque, Jesus

    2017-11-27

    We investigated the association between maternal use of folic acid (FA) during pregnancy and child anthropometric measures at birth. We included 2302 mother-child pairs from a population-based birth cohort in Spain (INMA Project). FA dosages at first and third trimester of pregnancy were assessed using a specific battery questionnaire and were categorized in non-user, < 1000, 1000-4999, and ≥ 5000 µg/day. Anthropometric measures at birth (weight in grams, length and head circumference in centimetres) were obtained from medical records. Small for gestational age according to weight (SGA-w), length (SGA-l) and head circumference (SGA-hc) were defined using the 10th percentile based on Spanish standardized growth reference charts. Multiple linear and logistic regression analyses were used to explore the association between FA dosages in different stages of pregnancy and child anthropometric measures at birth. In the multiple linear regression analysis, we found a tendency for a negative association between the use of high dosages of FA (≥ 5000 µg/day) in the periconceptional period of pregnancy and weight at birth compared to mothers who were non-users of FA (β = - 73.83; 95% CI - 151.71, 4.06). In the multiple logistic regression, a greater risk of SGA-w was also evident among children whose mothers took FA dosages of 1000-4999 (OR = 2.21; 95% CI 1.17, 4.19) and of ≥ 5000 µg/day (OR = 2.32; 95% CI 1.06, 5.08) compared to mothers non-users of FA in the periconceptional period of pregnancy. Our findings suggest that a high dosage of FA (≥ 1000 µg/day) may be associated with an increased risk of SGA-w at birth.

  20. [Concordance between a head circumference growth function and intellectual disability in relation with the cause of microcephaly].

    PubMed

    Coronado, R; Macaya Ruíz, A; Giraldo Arjonilla, J; Roig-Quilis, M

    2015-08-01

    Our aim was to investigate the correlations between patterns of head growth and intellectual disability among distinct aetiological presentations of microcephaly. 3,269 head circumference (HC) charts of patients from a tertiary neuropediatric unit were reviewed and 136 microcephalic participants selected. Using the Z-scores of registered HC measurements we defined the variables: HC Minimum, HC Drop and HC Catch-up. We classified patients according to the presence or absence of intellectual disability (IQ below 71) and according to the cause of microcephaly (idiopathic, familial, syndromic, symptomatic and mixed). Using Discriminant Analysis a C-function was defined as C=HC Minimum + HC Drop with a cut-off level of C=-4.32 Z-score. In our sample 95% of patients scoring below this level, severe microcephaly, were classified in the disabled group while the overall concordance was 66%. In the symptomatic-mixed group the concordance between HC function and outcome reached 82% in contrast to only 54% in the idiopathic-syndromic group (P-value=0.0002). We defined a HC growth function which discriminates intellectual disability of microcephalic patients better than isolated HC measurements, especially for those with secondary and mixed aetiologies. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  1. Associations between sperm abnormalities, breed, age, and scrotal circumference in beef bulls

    PubMed Central

    Menon, Ajitkumar G.; Barkema, Herman W.; Wilde, Randy; Kastelic, John P.; Thundathil, Jacob C.

    2011-01-01

    The objectives of this study were to determine the associations of breed, age, and scrotal circumference (SC), and their interaction, on the prevalence of sperm abnormalities in beef bulls in Alberta, Canada, and the percentage of satisfactory potential breeders identified during breeding soundness examination solely due to normal sperm morphology. Eosin-nigrosin stained semen smears and evaluation reports of 1642 bull breeding soundness evaluations were procured from 6 veterinary clinics in Alberta. Sperm morphology was determined for at least 100 sperm per bull. The most common defects were detached head [4.86% ± 5.71%; mean ± standard deviation (s)], distal midpiece reflex (6.19% ± 9.13%), and bent tail (1.01% ± 1.54%). Although breed, age, and SC did not significantly affect the prevalence of head or midpiece defects, morphologically normal or abnormal sperm, tail defects were more prevalent in Angus and Hereford bulls compared with other breeds. Overall, solely on the basis of sperm morphology, 1363 (83.0%) bulls were classified as satisfactory potential breeders and the remainder 279 (17.0%) as unsatisfactory (> 30% abnormal sperm, > 20% defective heads, or both). Although not significantly different, the breed with the highest percentage of satisfactory potential breeders was Limousin (90.6%) and the lowest was Hereford (78.8%). That 17% of bulls subjected to breeding soundness evaluation were designated as unsatisfactory solely on the basis of sperm morphology highlights its importance. PMID:22468020

  2. Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study

    PubMed Central

    2013-01-01

    Background Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. Methods This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth. Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson’s correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Results Birth weights ranged from 1370–5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. Conclusions This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns. PMID:23587297

  3. Thinness at birth in a northern industrial town.

    PubMed

    Law, C M; Barker, D J; Richardson, W W; Shiell, A W; Grime, L P; Armand-Smith, N G; Cruddas, A M

    1993-08-01

    To determine whether babies in an area of Britain with unusually high perinatal mortality have different patterns of fetal growth to those born elsewhere in the country. Measurement of body size in newborn babies. Burnley (perinatal mortality in 1988 15.9/1000 total births) and Salisbury (perinatal mortality 10.8/1000 total births), England. Subjects comprised 1544 babies born in Burnley, Pendle, and Rossendale Health District, and 1025 babies born in Salisbury Health District. Birthweight, length, head, arm and abdominal circumferences, and placental weight were determined. Compared with babies born in Salisbury, Burnley babies had lower mean birthweight (difference 116 g, 95% confidence interval (CI) 77,154), smaller head circumferences (difference 0.3 cm, 95% CI 0.2, 0.4), and were thinner as measured by arm circumference (difference 0.3 cm, 95% CI 0.3, 0.4), abdominal circumference (difference 0.5 cm, 95% CI 0.4, 0.6) and ponderal index (difference 0.8 kg/m3, 95% CI 0.6, 1.0). The ratio of placental weight to birthweight was higher in Burnley (difference 0.6%, 95% CI 0.4, 0.9). These differences were found in boys and girls and did not depend on differences in duration of gestation or on the different ethnic mix of the two districts. Mothers in Burnley were younger, shorter in stature, had had more children, were of lower social class, and more of them smoked during pregnancy than mothers in Salisbury. These differences did not explain the greater thinness of their babies. Babies born in Burnley, an area with high perinatal mortality, are thin. The reason is unknown. Poor maternal nutrition is suspected because Burnley babies have a higher ratio of placental weight to birthweight. The greater thinness at birth of Burnley babies could have long term consequences, including higher rates of cardiovascular disease.

  4. Age dynamics and secular changes of indices characterizing the neurocranium and facial cranium in ethnic Bulgarian 7-17-year-old children from the region of the Eastern Rhodopes.

    PubMed

    Tineshev, Slavi At

    2010-01-01

    It is impossible to give an objective anthropologic assessment of the overall physical development of a child's body during the time of intensive growth (7-17 years) without taking into account the age and gender changes in the absolute and relative head and face measurements. Head growth has specific characteristics that makes it different from the growth of other parts of the body. The head of a child differs from the head of an adult not only by metric characteristics but also by the proportions between the different head measurements. Growth and proportionality of the head comply with the general growth pattern, but there are also certain regional, populational and temporal differences. That was the reason why we conducted a study targeted at children and adolescents from the region of the Eastern Rhodopes. The aim Of the present study was to determine the growth dynamics in between-gender and between-age aspects of the variables characterizing the neurocranium and facial cranium, and establish the tendency and direction of the secular changes, The study included 1481 children and adolescents (699 boys and 782 girls) aged 7 to 17 years that were examined using the classical methodology of Martin-Saller (1957). Head length, width, height and circumference, as well as face width, mandible width, morphological and physiognomic height of the face were measured. Head index, morphological face index and jugulormandibular index were calculated using standard formulas. The secular changes were analyzed comparing data from 1907 and 1960 with the data of the present study. The head index classified the children from both genders and all age groups as mesocephals. The girls from the study region had a relatively greater mandible width and boys - relatively greater face width. In the beginning of the growth period wider face forms prevailed especially in the girls, while narrower face forms were more characteristic for the adolescence and postadolescence and better manifested in the boys. Throughout the entire study period the boys presented with greater measurements of the neurocranium and facial cranium than the girls. For both genders the increase in the neurocranium measurements anticipates that in the facial cranium measurements. In the examined children and adolescents the width cephalometric variables complete their growth earlier than the height variables. The head circumference and head width decrease, while the differences in the head length and facial height increase in both genders and all age groups in the end of the 20th and beginning of the 21st century.

  5. Growth trajectories of the human embryonic head and periconceptional maternal conditions.

    PubMed

    Koning, I V; Baken, L; Groenenberg, I A L; Husen, S C; Dudink, J; Willemsen, S P; Gijtenbeek, M; Koning, A H J; Reiss, I K M; Steegers, E A P; Steegers-Theunissen, R P M

    2016-05-01

    Can growth trajectories of the human embryonic head be created using 3D ultrasound (3D-US) and virtual reality (VR) technology, and be associated with second trimester fetal head size and periconceptional maternal conditions? Serial first trimester head circumference (HC) and head volume (HV) measurements were used to create reliable growth trajectories of the embryonic head, which were significantly associated with fetal head size and periconceptional maternal smoking, age and ITALIC! in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) treatment. Fetal growth is influenced by periconceptional maternal conditions. We selected 149 singleton pregnancies with a live born non-malformed fetus from the Rotterdam periconception cohort. Bi-parietal diameter and occipital frontal diameter to calculate HC, HV and crown-rump length (CRL) were measured weekly between 9 + 0 and 12 + 6 weeks gestational age (GA) using 3D-US and VR. Fetal HC was obtained from second trimester structural anomaly scans. Growth trajectories of the embryonic head were created with general additive models and linear mixed models were used to estimate associations with maternal periconceptional conditions as a function of GA and CRL, respectively. A total of 303 3D-US images of 149 pregnancies were eligible for embryonic head measurements (intra-class correlation coefficients >0.99). Associations were found between embryonic HC and fetal HC ( ITALIC! ρ = 0.617, ITALIC! P < 0.001) and between embryonic HV and fetal HC ( ITALIC! ρ = 0.660, ITALIC! P < 0.001) in ITALIC! Z-scores. Maternal periconceptional smoking was associated with decreased, and maternal age and IVF/ICSI treatment with increased growth trajectories of the embryonic head measured by HC and HV (All ITALIC! P < 0.05). The consequences of the small effect sizes for neurodevelopmental outcome need further investigation. As the study population consists largely of tertiary hospital patients, external validity should be studied in the general population. Assessment of growth trajectories of the embryonic head may be of benefit in future early antenatal care. This study was funded by the Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre and Sophia Foundation for Medical Research, Rotterdam, The Netherlands (SSWO grant number 644). No competing interests are declared. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Early Identification of Autism: Early Characteristics, Onset of Symptoms, and Diagnostic Stability

    ERIC Educational Resources Information Center

    Webb, Sara Jane; Jones, Emily J. H.

    2009-01-01

    In the first year of life, infants who later go on to develop autistic spectrum disorders (ASD) may exhibit subtle disruptions in social interest and attention, communication, temperament, and head circumference growth that occur prior to the onset of clinical symptoms. These disruptions may reflect the early course of ASD development and may also…

  7. Head circumference and body proportions before and during growth hormone treatment in short children who were born small for gestational age.

    PubMed

    Arends, Nicolette J T; Boonstra, Venje H; Hokken-Koelega, Anita C S

    2004-09-01

    Although short children who were born small for gestational age (SGA) seem to have normal body proportions, objective data both before and during growth hormone (GH) treatment are very limited. Therefore, we investigated in a large group of short children who were born SGA the effects of GH treatment versus no treatment on head circumference (HC) and body proportions. Furthermore, we studied differences in linear growth and HC between SGA children who were born with a low birth length and birth weight (SGA(L+W)) and SGA children who were born with a low birth length only (SGA(L)). An open-labeled, GH-controlled, multicenter study was conducted for 3 years. Non-GH-deficient short SGA children (n = 87), with a mean age (standard deviation) of 5.9 (1.5) years, were randomized to either a GH group (n = 61), receiving GH in a dose of 33 microg/kg/day, or an untreated control group (n = 26). Height; weight; HC; sitting height; armspan; and hand, tibial, and foot size were measured and expressed as standard deviation score (SDS) adjusting for gender and age. At baseline, all anthropometric measurements, except HC SDS, were significantly lower compared with -2 SDS. During GH treatment, all anthropometric measurements normalized in accordance to the normalization of height SDS. At the start of the study, mean HC SDS was significantly lower in SGA(L+W) children compared with SGA(L) children. It is interesting that most (14 of 16) children with an HC SDS less than -2.00 had been born SGA(L+W). During GH treatment, the 3-year increase in height, HC, and other anthropometric measurements was comparable between SGA(L+W) and SGA(L) children. In both SGA(L+W) and SGA(L) control subjects, no changes in SDSs of height, HC, and other anthropometric measurements were found during the 3-year follow-up period. Untreated short SGA children have normal body proportions with the exception of HC, which is relatively large in many of these children. SGA(L+W) children still had a smaller HC at the age of 5.9 years compared with SGA(L) children. Three years of GH treatment induced a proportionate growth resulting in a normalization of height and other anthropometric measurements, including HC, in contrast to untreated SGA control subjects.

  8. Prenatal supplementation with Corn Soya Blend Plus reduces the risk of maternal anemia in late gestation and lowers the rate of preterm birth but does not significantly improve maternal weight gain and birth anthropometric measurements in rural Cambodian women: a randomized trial.

    PubMed

    Janmohamed, Amynah; Karakochuk, Crystal D; Boungnasiri, Somchit; Chapman, Gwen E; Janssen, Patricia A; Brant, Rollin; Green, Timothy J; McLean, Judy

    2016-02-01

    Corn Soya Blend (CSB) Plus is a fortified dietary supplement used to help Cambodian women meet their nutritional requirements in pregnancy, although little is known about its ability to improve pregnancy outcomes. This study assessed the effect of prenatal CSB Plus supplementation on birth weight and secondary outcomes of low birth weight (<2500 g), small for gestational age, birth length and head circumference, preterm birth (<37 wk), maternal weight gain, and anemia at 24-28 wk, 30-32 wk, and 36-38 wk of gestation among rural Cambodian women. A cluster-randomized trial was conducted in 75 villages in Kampong Chhnang Province, in which 547 women received CSB Plus (treatment) during the first trimester until delivery or continued their normal diet (control) based on their village residence. All women received routine daily iron folic acid tablets and were treated with additional iron folic acid if they were anemic (hemoglobin <11 g/dL). Cluster-adjusted linear mixed-effect and logistic regression models were used to examine group differences. There was no significant difference in birth weight between the CSB Plus and control group (46 g; 95% CI: -31, 123 g; P = 0.24). Significant reductions were observed in preterm birth (OR = 0.33; 95% CI: 0.12, 0.89) and anemia at 36-38 wk (OR = 0.51; 95% CI: 0.34, 0.77). There were no significant differences in low birth weight, small for gestational age, birth length, head circumference, or maternal weight gain. A higher rate of fetal loss was observed in the treatment group (10.2% compared with 3.7%; P < 0.01). In Cambodian women, CSB Plus consumed during pregnancy did not significantly increase maternal weight gain or improve birth size but did reduce maternal anemia in late gestation and preterm birth in comparison with women consuming a normal diet. The unexpectedly higher rate of fetal loss in the treatment group is concerning and warrants further investigation. This trial was registered at clinicaltrials.gov as NCT01413776. © 2016 American Society for Nutrition.

  9. Changes in size and compliance of the calf after 30 days of simulated microgravity

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.; Doerr, Donald F.; Stein, Stewart L.

    1989-01-01

    The hypothesis that reducing muscle compartment by a long-term exposure to microgravity would cause increased leg venous compliance was tested in eight men who were assessed for vascular compliance and for serial circumferences of the calf before and after 30 days of continuous 6-deg head-down bed rest. It was found that head-down bed rest caused decreases in the calculated calf volume and the calf-muscle compartment, as well as increases in calf compliance. The percent increases in calf compliance correlated significantly with decreases in calf muscle compartment.

  10. Ramadan fasting and pregnancy: implications for fetal development in summer season.

    PubMed

    Sakar, Mehmet Nafi; Gultekin, Huseyin; Demir, Bulent; Bakir, Vuslat Lale; Balsak, Deniz; Vuruskan, Erkut; Acar, Hicran; Yucel, Oguz; Yayla, Murat

    2015-05-01

    In the Islamic religion, Ramadan is a month in the year that is passed by fasting. Healthy adult individuals are prohibited to eat, drink, and smoke from sunrise to sunset. In the present study, our aim was to assess the relation of Ramadan fasting with fetal development and maternal-fetal Doppler indices in pregnant women. This is a prospective case-control study carried out in the month of Ramadan in 2013 (9 July-7 August). One hundred and six pregnant women at the second and third trimesters of pregnancy were enrolled into the study. The sample size of the fasting group was 83 and the non-fasting group sample size was also 83. Fetal biometric measurements, such as biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, amniotic fluid index, and Doppler indices of both uterine and umbilical arteries were evaluated by gray scala and color Doppler ultrasound at the beginning and end of Ramadan. At the end of the Ramadan, increase in biparietal diameter, head circumference, and femur length showed a statistically significant difference from initial measurements (P<0.05). When fasting and non-fasting groups were compared separately, an increase in amniotic fluid index was statistically significant in the non-fasting group (P<0.05). We demonstrated some adverse effects of Ramadan fasting on fetal development. In the Islamic religion, pregnant individuals have the privilege of not fasting; therefore, they should consider postponing fasting to the postpartum period, especially in the summer season. If they are willing to do so, an appropriate nutritional program should be recommended.

  11. Prediction of microcephaly at birth using three reference ranges for fetal head circumference: can we improve prenatal diagnosis?

    PubMed

    Leibovitz, Z; Daniel-Spiegel, E; Malinger, G; Haratz, K; Tamarkin, M; Gindes, L; Schreiber, L; Ben-Sira, L; Lev, D; Shapiro, I; Bakry, H; Weizman, B; Zreik, A; Egenburg, S; Arad, A; Tepper, R; Kidron, D; Lerman-Sagie, T

    2016-05-01

    To evaluate the prediction of microcephaly at birth (micB) using established and two new reference ranges for fetal head circumference (HC) and to assess whether integrating additional parameters can improve prediction. Microcephaly in utero was defined as a fetal HC 3SD below the mean for gestational age according to Jeanty et al.'s reference range. The records of cases with fetal microcephaly (Fmic) were evaluated for medical history, imaging findings, biometry and postnatal examination/autopsy findings. Microcephaly was confirmed at birth (micB) by an occipitofrontal circumference (OFC) or a brain weight at autopsy 2SD below the mean for gestational age. The new INTERGROWTH-21(st) Project and a recent Israeli reference for fetal growth were applied for evaluation of the Fmic positive predictive value (PPV) for diagnosis of micB cases. Optimal HC cut-offs were determined for each of the new references with the aim of detecting all micB cases whilst minimizing the number of false positives found to have a normal HC at birth. We also assessed the difference between the Z-scores of the prenatal HC and the corresponding OFC at birth, the frequency of small-for-gestational age (SGA), decreased HC/abdominal circumference (AC) and HC/femur length (FL) ratios, the prevalence of associated malformations and family history. Forty-two fetuses were diagnosed as having Fmic according to the Jeanty reference, but micB was confirmed in only 24 (PPV, 57.1%). The optimal INTERGROWTH and Israeli reference HC cut-offs for micB diagnosis were mean - 3SD and mean - 2.3SD, resulting in a statistically non-significant improvement in PPV to 61.5% and 66.7%, respectively. The presence of a family history of microcephaly, SGA, associated malformations and application of stricter HC cut-offs resulted in a higher PPV of micB, although not statistically significant and with a concurrent increase in the number of false-negative results. The deviation of the HC from the mean, by all references, was significantly larger compared with the actual deviation of the OFC at birth, with mean differences between the corresponding Z-scores of -1.15, -1.95 and -0.74 for the Jeanty, INTERGROWTH and Israeli references, respectively. The evaluated reference ranges all result in considerable over-diagnosis of fetal microcephaly. The use of the two new HC reference ranges did not significantly improve micB prediction compared with that of Jeanty et al., whilst use of additional characteristics and stricter HC cut-offs could improve the PPV with an increase in false negatives. The postnatal OFC deviates significantly less from the mean compared with the prenatal HC, and we propose that adjustment for this would enable better prediction of the actual OFC deviation at birth. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  12. Neuropsychological development in preschool children born with asymmetrical intrauterine growth restriction and impact of postnatal head growth.

    PubMed

    Klaric, Andrea Simić; Galić, Slavka; Kolundzić, Zdravko; Bosnjak, Vlatka Mejaski

    2013-07-01

    Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences (P< .03) in motor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth-restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

  13. Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries.

    PubMed

    Wu, Jennifer M; Williams, Kathryn S; Hundley, Andrew F; Connolly, AnnaMarie; Visco, Anthony G

    2005-08-01

    The purpose of this study was to determine whether an occiput posterior (OP) fetal head position increases the risk for anal sphincter injury when compared with an occiput anterior (OA) position in vacuum-assisted deliveries. We conducted a retrospective cohort study of 393 vacuum-assisted singleton vaginal deliveries. Maternal demographics and obstetric and neonatal data were collected from an obstetric database and chart review. Within the OP group, 41.7% developed a third- or fourth-degree laceration compared with 22.0% in the OA group (OR 2.5, 95% CI 1.4-4.7). In a logistic regression model that controlled for BMI, race, nulliparity, length of second stage, episiotomy, birth weight, head circumference, and fetal head position, OP position was 4.0 times (95% CI 1.7-9.6) more likely to be associated with an anal sphincter injury than OA position. Among vacuum deliveries, an OP head position confers an incrementally increased risk for anal sphincter injury over an OA position.

  14. Phenotypic characteristics of local cattle in Madura Island

    NASA Astrophysics Data System (ADS)

    Maylinda, Sucik; Nugroho, H.; Busono, W.

    2017-05-01

    The aim of the research is to (1) analyze phenotypic variance both qualitative and quantitative characters in Madura cattle, (2) to analyze the relationship between that characters and body weight. Cattle studied were located in Waru and Pademawu subdistrict, Pamekasan district, Indonesia. The sampling technique was accidental sampling. Subject animals were 8-20 month-old cows, grouped into 2 age groups of <1 and >1 years old. Both qualitative and quantitative phenotypic characteristics were recorded. Qualitative characteristics were the color of the body, white color in bottom and leg, black color at the back, and the presence of horns. Quantitative characteristics were the head index, body weight, chest girth (CG), body height (BH), body length (BL), and body condition score (BCS). Data were analyzed with correlation and regression analyses. Results showed that qualitative characteristics of the Madura local cattle were all those of the reference Madura cattle standard, such as the white color of leg and bottom, with small head indexes. We found that (1) most of Madura Local cattle had the standard Madura cattle characteristics in both sexes, and (2) the best cattle, in terms of body weight, can be selected based on chest girth rather than other measurements, which is advantageous because measuring the chest circumference is quicker and easier than directly measuring cattle weight in rural villages.

  15. IMPACT OF PARTIAL KANGAROO MOTHER CARE ON GROWTH RATES AND DURATION OF HOSPITAL STAY OF LOW BIRTH WEIGHT INFANTS AT THE KENYATTA NATIONAL HOSPITAL, NAIROBI.

    PubMed

    Mwendwa, A C; Musoke, R N; Wamalwa, D C

    2012-02-01

    To determine the effect of partial Kangaroo Mother Care (KMC) on growth rates and duration of hospital stay of Low Birth Weight (LBW) infants. Unblinded, randomised clinical controlled trial. Kenyatta National Hospital, Nairobi, Kenya. Over a nine month period, consecutive recruitment of eligible LBW infants weighing 1000 g to 1750 g was done until a sample of 166 infants was reached. Kangaroo mother care was practised over an eight hour period per day for the intervention group while the controls remained in incubators or cots. Weight, head circumference, and mid upper arm circumference were monitored for all infants till discharge at 1800 g. Of the 166 infants recruited 157 were followed up to discharge. Baseline characteristics were similar for the two groups except for mother's age, with the KMC group mothers having a mean age of 26.5 years while the control group mothers had a mean age of 24 years, (p = 0.04). The KMC group had significantly higher growth rates as shown by the higher mean weight gain of 22.5 g/kg/day compared with 16.7g/kg/day for the control group, (p < 0.001); higher mean head circumference gain of 0.91 cm/week compared with 0.54 cm/week for the control group, (p < 0.001) and higher mean mid upper arm circumference gain of 0.76 cm/week compared with 0.48 cm/week for the control group, (p = 0.002). Although overall duration of stay was similar between study arms, when infants were stratified into those above or below 1500 g KMC infants' duration of stay was significantly shorter than those in regular care. Using logistic regression, KMCwas the strongest predictor formeanweight, meanhead circumference and mean MUAC gain while mother's age (older) was the strongest predictor for mean duration of stay with KMC being an independent predictor of duration of stay. Low birth weight infants in this cohort achieved rates of growth within the recommended intrauterine growth but babies managed using partial KMC grew faster and were thus discharged earlier than those on standard of care. Since partial KMC was beneficial, it should be fully implemented for all eligible infants.

  16. Association of brain metabolism with sulcation and corpus callosum development assessed by MRI in late-onset small fetuses.

    PubMed

    Sanz-Cortes, Magdalena; Egaña-Ugrinovic, Gabriela; Simoes, Rui V; Vazquez, Lucia; Bargallo, Nuria; Gratacos, Eduard

    2015-06-01

    We sought to determine the relationship between fetal brain metabolism and microstructure expressed by brain sulcation, and corpus callosum (CC) development assessed by fetal brain magnetic resonance (MR) imaging and proton MR spectroscopy ((1)H-MRS). A total of 119 fetuses, 64 that were small for gestational age (estimated fetal weight <10th centile and normal umbilical artery Doppler) and 55 controls underwent a 3T MR imaging/(1)H-MRS exam at 37 weeks. Anatomical T2-weighted images were obtained in the 3 orthogonal planes and long echo time (TE) (1)H-MRS acquired from the frontal lobe. Head biometrics, cortical fissure depths (insula, Sylvian, parietooccipital, cingulate, and calcarine), and CC area and biometries were blindly performed by manual and semiautomated delineation using Analyze software and corrected creating ratios for biparietal diameter and frontooccipital diameter, respectively, for group comparison. Spectroscopic data were processed using LCModel software and analyzed as metabolic ratios of N-acetylaspartate (NAA) to choline (Cho), Cho to creatine (Cr), and myo-inositol (Ino) to Cho. Differences between cases and controls were assessed. To test for the association between metabolic ratios and microstructural parameters, bivariate correlation analyses were performed. Spectroscopic findings showed decreased NAA/Cho and increased Cho/Cr ratios in small fetuses. They also presented smaller head biometrics, shorter and smaller CC, and greater insular and cingulate depths. Frontal lobe NAA/Cho significantly correlated with biparietal diameter (r = 0.268; P = .021), head circumference (r = 0.259; P = .026), CC length (r = 0.265; P = .026), CC area (r = 0.317; P = .007), and the area of 6 from the 7 CC subdivisions. It did not correlate with any of the cortical sulcation parameters evaluated. None of the other metabolic ratios presented significant correlations with cortical development or CC parameters. Frontal lobe NAA/Cho levels-which are considered a surrogate marker of neuronal activity-show a strong association with CC development. These results suggest that both metabolic and callosal alterations may be part of the same process of impaired brain development associated with intrauterine growth restriction. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Glucose Transporter Type 1 Deficiency Syndrome with Carbohydrate-Responsive Symptoms but without Epilepsy

    ERIC Educational Resources Information Center

    Koy, Anne; Assmann, Birgit; Klepper, Joerg; Mayatepek, Ertan

    2011-01-01

    Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is caused by a defect in glucose transport across the blood-brain barrier. The main symptoms are epilepsy, developmental delay, movement disorders, and deceleration of head circumference. A ketogenic diet has been shown to be effective in controlling epilepsy in GLUT1-DS. We report a female…

  18. Brain Development in Autism: Early Overgrowth Followed by Premature Arrest of Growth

    ERIC Educational Resources Information Center

    Courchesne, Eric

    2004-01-01

    Due to the relatively late age of clinical diagnosis of autism, the early brain pathology of children with autism has remained largely unstudied. The increased use of retrospective measures such as head circumference, along with a surge of MRI studies of toddlers with autism, have opened a whole new area of research and discovery. Recent studies…

  19. Brain Development Parameters and Intelligence in Chilean High School Graduates

    ERIC Educational Resources Information Center

    Ivanovic, Daniza M.; Leiva, Boris P.; Castro, Carmen G.; Olivares, Manuel G.; Jansana, Joan Manuel M.; Castro, Veronica G.; Almagia, Atilio Aldo F.; Toro, Triana D.; Urrutia, Maria Soledad C.; Miller, Patricio T.; Bosch, Enrique O.; Larrain, Cristian G.; Perez, Hernan T.

    2004-01-01

    The hypothesis that independently of sex, brain volume (BV) and head circumference (HC) are positively and significantly associated with intellectual quotient (IQ) was examined in a sample of 96 high school graduates of high [Wechsler Intelligence Scale for Adults--Revised (WAIS-R) is greater than 120] and low IQ (WAIS-R is less than 100) (1:1),…

  20. Bendectin and fetal development. A study of Boston City Hospital.

    PubMed

    Morelock, S; Hingson, R; Kayne, H; Dooling, E; Zuckerman, B; Day, N; Alpert, J J; Flowerdew, G

    1982-01-15

    As part of a prospective study investigating maternal characteristics and habits during pregnancy and their impact on fetal development, 1,690 mother/infant pairs were studied. Of the mothers, 375 reported using Bendectin during pregnancy. Multivariate analyses examining birth weight, length, head circumference, gestational age, and congenital malformations as dependent variables demonstrated no associations between Bendectin exposure and adverse fetal outcome.

  1. A Pilot Study of Abnormal Growth in Autism Spectrum Disorders and Other Childhood Psychiatric Disorders

    ERIC Educational Resources Information Center

    Rommelse, Nanda N. J.; Peters, Cindy T. R.; Oosterling, Iris J.; Visser, Janne C.; Bons, Danielle; van Steijn, Daphne J.; Draaisma, Jos; van der Gaag, Rutger-Jan; Buitelaar, Jan. K.

    2011-01-01

    The aims of the current study were to examine whether early growth abnormalities are (a) comparable in autism spectrum disorders (ASD) and other childhood psychiatric disorders, and (b) specific to the brain or generalized to the whole body. Head circumference, height, and weight were measured during the first 19 months of life in 129 children…

  2. [Nutritional status of pregnant women and birth outcome].

    PubMed

    Kaim, Irena; Sochacka-Tatara, Elzbieta; Pac, Agnieszka; Basta, Antoni; Jedrychowski, Wiesław

    2009-01-01

    The aim of the study was to determine whether nutritional status of pregnant women influences the birth outcome. A prospective study, conducted in Krakow, in 382 non-smoking, no obese pregnant women between the ages of 18 - 35. The course of pregnancy was uncomplicated, finished with natural labor, in biological time limits. The impact of mother's nutritional status before pregnancy and weight gain on newborns weight, length and head circumference was estimated by multivariate linear regression. The infant birth weight depended on mothers nutritional status before pregnancy and was lower in the group of underweight subjects (3381.6 g vs. 3479.9 g, p = 0.022). Women with low increase in body mass during pregnancy delivered newborns with lower anthropometrics parameters. The increase in body weight of one category resulted in statistically significant increase of birth weight by 140.9 g, increase of length by 0.51 cm and in head circumference by 0.27 cm. Increase in body mass during pregnancy is particularly important in the group of women underweight before pregnancy. Change of nutritional habits before and in the course of pregnancy may have beneficial effects for intrauterine fetal development.

  3. Editorial brain malformation surveillance in the Zika era

    PubMed Central

    Trevathan, Edwin

    2016-01-01

    The current surveillance systems for congenital microcephaly are necessary to monitor the impact of Zika virus (ZIKV) on the developing human brain, as well as the ZIKV prevention efforts. However, these congenital microcephaly surveillance systems are insufficient. Abnormalities of neuronal differentiation, development and migration may occur among infants with normal head circumference who have intrauterine exposure to ZIKV. Therefore, surveillance for congenital microcephaly does not ascertain many of the infants seriously impacted by congenital ZIKV infection. Furthermore, many infants with normal head circumference and with malformations of the brain cortex do not have clinical manifestations of their congenital malformations until several months to many years after birth, when they present with clinical manifestations such as seizures/epilepsy, developmental delays with or without developmental regression, and/or motor impairment. In response to the ZIKV threat, public health surveillance systems must be enhanced to ascertain a wide variety of congenital brain malformations, as well as their clinical manifestations that lead to diagnostic brain imaging. Birth Defects Research (Part A) 106:869–874, 2016. © 2016 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc. PMID:27891785

  4. Anthropometric standardisation and quality control protocols for the construction of new, international, fetal and newborn growth standards: the INTERGROWTH-21st Project.

    PubMed

    Cheikh Ismail, L; Knight, H E; Ohuma, E O; Hoch, L; Chumlea, W C

    2013-09-01

    The primary aim of the INTERGROWTH-21(st) Project is to construct new, prescriptive standards describing optimal fetal and preterm postnatal growth. The anthropometric measurements include the head circumference, recumbent length and weight of the infants, and the stature and weight of the parents. In such a large, international, multicentre project, it is critical that all study sites follow standardised protocols to ensure maximal validity of the growth and nutrition indicators used. This paper describes in detail the anthropometric training, standardisation and quality control procedures used to collect data for these new standards. The initial standardisation session was in Nairobi, Kenya, using newborns, which was followed by similar sessions in the eight participating study sites in Brazil, China, India, Italy, Kenya, Oman, UK and USA. The intraobserver and inter-observer technical error of measurement values for head circumference range from 0.3 to 0.4 cm, and for recumbent length from 0.3 to 0.5 cm. These standardisation protocols implemented at each study site worldwide ensure that the anthropometric data collected are of the highest quality to construct international growth standards. © 2013 Royal College of Obstetricians and Gynaecologists.

  5. Changes in weight, length, head circumference, and ponderal index at birth of healthy term newborns in nine cities in China during the period of rapid social development 1985-2005.

    PubMed

    Zhang, Ya-qin; Li, Hui

    2015-12-01

    The changes in the anthropometric parameters at birth of healthy singleton term newborns in nine cities in China were analyzed by means of the data collected in three large-scale cross-sectional physical growth surveys in 1985, 1995, and 2005 (n=6660, 7109 and 6144). Between 1985 and 2005, average increases in body weight (BW), body length (BL), ponderal index (PI), and head circumference (HC) of newborns were statistically significant: 107g, 0.2cm, 0.6kg/m(3) and 0.4cm, respectively. The relative increase in BW was more than that in BL (3.4% vs 0.4%) in the last two decades, leading to an increase in PI. The distribution of birth size shifted slightly to the right, and the proportion of macrosomia increased from 3.2% in 1985 to 3.4% in 1995 and to 4.3% in 2005. The increases in BW and PI and the increase in rate of macrosomia are concerns from public health perspectives. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Fetal Biometry of Head Circumference for Malaysian Pregnant Women

    NASA Astrophysics Data System (ADS)

    Ramli, Remsen Maizan; Jaafar, M. S.; Ismail, N. E.; Saltani, Hend A. A.; Ahmad, A. L.; Bermakai, M. Yahaya

    2010-07-01

    The purpose of this research is to study the fetal head circumference (HC) biometry for local population. Retrospective study was selected, done at Hospital Pulau Pinang and 5551 files of pregnant women were collected. The HC mean values of this study (HCmean) was compared with other published studies to see whether there was any difference between the various populations in the world. Comparison of means, regression analysis and paired sample t-test in SPSS software version 11.5 were used in the analysis. A total of 9874 HC data (mm) were recorded for gestational age (GA) of 12 to 41 weeks. The HC growth rate in second trimester (11.32 mm/week) has decreased to nearly half than in third trimester (5.53 mm/week). The HCmean was found to be highly significant difference (SD) than other 9 studies and only lower than HC values of USA, UK and Zimbabwe populations. The HC values of German show close similarity with HCmean. From 45 comparisons done, more than three-quarter of the comparisons resulted as SD (37) compared to insignificant differences (8). Consequently, each country should have their own standard HC of fetus biometry of the various gestations for their own population.

  7. The test characteristics of head circumference measurements for pathology associated with head enlargement: a retrospective cohort study

    PubMed Central

    2012-01-01

    Background The test characteristics of head circumference (HC) measurement percentile criteria for the identification of previously undetected pathology associated with head enlargement in primary care are unknown. Methods Electronic patient records were reviewed to identify children age 3 days to 3 years with new diagnoses of intracranial expansive conditions (IEC) and metabolic and genetic conditions associated with macrocephaly (MGCM). We tested the following HC percentile threshold criteria: ever above the 95th, 97th, or 99.6th percentile and ever crossing 2, 4, or 6 increasing major percentile lines. The Centers for Disease Control and World Health Organization growth curves were used, as well as the primary care network (PCN) curves previously derived from this cohort. Results Among 74,428 subjects, 85 (0.11%) had a new diagnosis of IEC (n = 56) or MGCM (n = 29), and between these 2 groups, 24 received intervention. The 99.6th percentile of the PCN curve was the only threshold with a PPV over 1% (PPV 1.8%); the sensitivity of this threshold was only 15%. Test characteristics for the 95th percentiles were: sensitivity (CDC: 46%; WHO: 55%; PCN: 40%), positive predictive value (PPV: CDC: 0.3%; WHO: 0.3%; PCN: 0.4%), and likelihood ratios positive (LR+: CDC: 2.8; WHO: 2.2; PCN: 3.9). Test characteristics for the 97th percentiles were: sensitivity (CDC: 40%; WHO: 48%; PCN: 34%), PPV (CDC: 0.4%; WHO: 0.3%; PCN: 0.6%), and LR+ (CDC: 3.6; WHO: 2.7; PCN: 5.6). Test characteristics for crossing 2 increasing major percentile lines were: sensitivity (CDC: 60%; WHO: 40%; PCN: 31%), PPV (CDC: 0.2%; WHO: 0.1%; PCN: 0.2%), and LR+ (CDC: 1.3; WHO: 1.1; PCN: 1.5). Conclusions Commonly used HC percentile thresholds had low sensitivity and low positive predictive value for diagnosing new pathology associated with head enlargement in children in a primary care network. PMID:22269214

  8. Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma

    PubMed Central

    Fischer, Barbara; Mitteroecker, Philipp

    2015-01-01

    Compared with other primates, childbirth is remarkably difficult in humans because the head of a human neonate is large relative to the birth-relevant dimensions of the maternal pelvis. It seems puzzling that females have not evolved wider pelvises despite the high maternal mortality and morbidity risk connected to childbirth. Despite this seeming lack of change in average pelvic morphology, we show that humans have evolved a complex link between pelvis shape, stature, and head circumference that was not recognized before. The identified covariance patterns contribute to ameliorate the “obstetric dilemma.” Females with a large head, who are likely to give birth to neonates with a large head, possess birth canals that are shaped to better accommodate large-headed neonates. Short females with an increased risk of cephalopelvic mismatch possess a rounder inlet, which is beneficial for obstetrics. We suggest that these covariances have evolved by the strong correlational selection resulting from childbirth. Although males are not subject to obstetric selection, they also show part of these association patterns, indicating a genetic–developmental origin of integration. PMID:25902498

  9. Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma.

    PubMed

    Fischer, Barbara; Mitteroecker, Philipp

    2015-05-05

    Compared with other primates, childbirth is remarkably difficult in humans because the head of a human neonate is large relative to the birth-relevant dimensions of the maternal pelvis. It seems puzzling that females have not evolved wider pelvises despite the high maternal mortality and morbidity risk connected to childbirth. Despite this seeming lack of change in average pelvic morphology, we show that humans have evolved a complex link between pelvis shape, stature, and head circumference that was not recognized before. The identified covariance patterns contribute to ameliorate the "obstetric dilemma." Females with a large head, who are likely to give birth to neonates with a large head, possess birth canals that are shaped to better accommodate large-headed neonates. Short females with an increased risk of cephalopelvic mismatch possess a rounder inlet, which is beneficial for obstetrics. We suggest that these covariances have evolved by the strong correlational selection resulting from childbirth. Although males are not subject to obstetric selection, they also show part of these association patterns, indicating a genetic-developmental origin of integration.

  10. Serial Head and Brain Imaging of 17 Fetuses With Confirmed Zika Virus Infection in Colombia, South America.

    PubMed

    Parra-Saavedra, Miguel; Reefhuis, Jennita; Piraquive, Juan Pablo; Gilboa, Suzanne M; Badell, Martina L; Moore, Cynthia A; Mercado, Marcela; Valencia, Diana; Jamieson, Denise J; Beltran, Mauricio; Sanz-Cortes, Magda; Rivera-Casas, Ana Maria; Yepez, Mayel; Parra, Guido; Ospina Martinez, Martha; Honein, Margaret A

    2017-07-01

    To evaluate fetal ultrasound and magnetic resonance imaging findings among a series of pregnant women with confirmed Zika virus infection to evaluate the signs of congenital Zika syndrome with respect to timing of infection. We conducted a retrospective case series of pregnant women referred to two perinatal clinics in Barranquilla and Ibagué, Colombia, who had findings consistent with congenital Zika syndrome and Zika virus infection confirmed in maternal, fetal, or neonatal samples. Serial ultrasound measurements, fetal magnetic resonance imaging results, laboratory results, and perinatal outcomes were evaluated. We describe 17 cases of confirmed prenatal maternal Zika virus infection with adverse fetal outcomes. Among the 14 symptomatic women, the median gestational age for maternal Zika virus symptoms was 10 weeks (range 7-14 weeks of gestation). The median time between Zika virus symptom onset and microcephaly (head circumference less than 3 standard deviations below the mean) was 18 weeks (range 15-24 weeks). The earliest fetal head circumference measurement consistent with microcephaly diagnosis was at 24 weeks of gestation. The earliest sign of congenital Zika syndrome was talipes equinovarus, which in two patients was noted first at 19 weeks of gestation. Common findings on fetal magnetic resonance imaging were microcephaly, ventriculomegaly, polymicrogyria, and calcifications. Our analysis suggests a period of at least 15 weeks between maternal Zika virus infection in pregnancy and development of microcephaly and highlights the importance of serial and detailed neuroimaging.

  11. The head-mounted microscope.

    PubMed

    Chen, Ting; Dailey, Seth H; Naze, Sawyer A; Jiang, Jack J

    2012-04-01

    Microsurgical equipment has greatly advanced since the inception of the microscope into the operating room. These advancements have allowed for superior surgical precision and better post-operative results. This study focuses on the use of the Leica HM500 head-mounted microscope for the operating phonosurgeon. The head-mounted microscope has an optical zoom from 2× to 9× and provides a working distance from 300 mm to 700 mm. The headpiece, with its articulated eyepieces, adjusts easily to head shape and circumference, and offers a focus function, which is either automatic or manually controlled. We performed five microlaryngoscopic operations utilizing the head-mounted microscope with successful results. By creating a more ergonomically favorable operating posture, a surgeon may be able to obtain greater precision and success in phonomicrosurgery. Phonomicrosurgery requires the precise manipulation of long-handled cantilevered instruments through the narrow bore of a laryngoscope. The head-mounted microscope shortens the working distance compared with a stand microscope, thereby increasing arm stability, which may improve surgical precision. Also, the head-mounted design permits flexibility in head position, enabling operator comfort, and delaying musculoskeletal fatigue. A head-mounted microscope decreases the working distance and provides better ergonomics in laryngoscopic microsurgery. These advances provide the potential to promote precision in phonomicrosurgery. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  12. Anthropometric and craniofacial patterns in mentally retarded males with emphasis on the fragile X syndrome.

    PubMed

    Butler, M G; Pratesi, R; Watson, M S; Breg, W R; Singh, D N

    1993-09-01

    Anthropometric and craniofacial profile patterns indicating the percent difference from the overall mean were developed on 34 physical parameters with 31 white, mentally retarded males (23 adults and 8 children) with the fra(X) syndrome matched for age with 31 white, mentally retarded males without a known cause of their retardation. The fra(X) syndrome males consistently showed larger dimensions for all anthropometric variables, with significant differences for height, sitting height, arm span, hand length, middle finger length, hand breadth, foot length, foot breadth, and testicular volume. A craniofacial pattern did emerge between the two groups of mentally retarded males, but with overlap of several variables. Significant differences were noted for head circumference, head breadth, lower face height, bizygomatic diameter, inner canthal distance, ear length and ear width, with the fra(X) syndrome males having larger head dimensions (head circumference, head breadth, head length, face height and lower face height), but smaller measurements for minimal frontal diameter, bizygomatic diameter, bigonial diameter, and inner canthal distance. Several significant correlations were found with the variables for both mentally retarded males with and without the fra(X) syndrome. In a combined anthropometric and craniofacial profile of 19 variables comparing 26 white fra(X) syndrome males (13 with high expression (> 30%) and 13 with low expression (< 30%), but matched for age), a relatively flat profile was observed with no significant differences for any of the variables. Generally, fra(X) syndrome males with increased fragile X chromosome expression have larger amplifications of the CGG trinucleotide repeat of the FMR-1 gene. No physical differences were detectable in our study between fra(X) males with high expression and apparently larger amplifications of the CGG trinucleotide repeats compared with those patients with low expression. Our research illustrates the use of anthropometry in identifying differences between mentally retarded males with or without the fra(X) syndrome and offers a comprehensive approach for screening males for the fra(X) syndrome and selecting those individuals for cytogenetic and/or molecular genetic testing.

  13. Anthropometric and craniofacial patterns in mentally retarded males with emphasis on the fragile X syndrome

    PubMed Central

    Butler, Merlin G.; Pratesi, Riccardo; Watson, Michael S.; Breg, W. Roy; Singh, Dharmdeo N.

    2017-01-01

    Anthropometric and craniofacial profile patterns indicating the percent difference from the overall mean were developed on 34 physical parameters with 31 white, mentally retarded males (23 adults and 8 children) with the fra(X) syndrome matched for age with 31 white, mentally retarded males without a known cause of their retardation. The fra(X) syndrome males consistently showed larger dimensions for all anthropometric variables, with significant differences for height, sitting height, arm span, hand length, middle finger length, hand breadth, foot length, foot breadth, and testicular volume. A craniofacial pattern did emerge between the two groups of mentally retarded males, but with overlap of several variables. Significant differences were noted for head circumference, head breadth, lower face height, bizygomatic diameter, inner canthal distance, ear length and ear width, with the fra(X) syndrome males having larger head dimensions (head circumference, head breadth, head length, face height and lower face height), but smaller measurements for minimal frontal diameter, bizygomatic diameter, bigonial diameter, and inner canthal distance. Several significant correlations were found with the variables for both mentally retarded males with and without the fra(X) syndrome. In a combined anthropometric and craniofacial profile of 19 variables comparing 26 white fra(X) syndrome males (13 with high expression (>30%) and 13 with low expression (< 30%), but matched for age), a relatively flat profile was observed with no significant differences for any of the variables. Generally, fra(X) syndrome males with increased fragile X chromosome expression have larger amplifications of the CGG trinucleotide repeat of the FMR-1 gene. No physical differences were detectable in our study between fra(X) males with high expression and apparently larger amplifications of the CGG trinucleotide repeats compared with those patients with low expression. Our research illustrates the use of anthropometry in identifying differences between mentally retarded males with or without the fra(X) syndrome and offers a comprehensive approach for screening males for the fra(X) syndrome and selecting those individuals for cytogenetic and/or molecular genetic testing. PMID:8275570

  14. Personalized Assessment of kV Cone Beam Computed Tomography Doses in Image-guided Radiotherapy of Pediatric Cancer Patients

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhang Yibao; Yan Yulong; Nath, Ravinder

    2012-08-01

    Purpose: To develop a quantitative method for the estimation of kV cone beam computed tomography (kVCBCT) doses in pediatric patients undergoing image-guided radiotherapy. Methods and Materials: Forty-two children were retrospectively analyzed in subgroups of different scanned regions: one group in the head-and-neck and the other group in the pelvis. Critical structures in planning CT images were delineated on an Eclipse treatment planning system before being converted into CT phantoms for Monte Carlo simulations. A benchmarked EGS4 Monte Carlo code was used to calculate three-dimensional dose distributions of kVCBCT scans with full-fan high-quality head or half-fan pelvis protocols predefined by themore » manufacturer. Based on planning CT images and structures exported in DICOM RT format, occipital-frontal circumferences (OFC) were calculated for head-and-neck patients using DICOMan software. Similarly, hip circumferences (HIP) were acquired for the pelvic group. Correlations between mean organ doses and age, weight, OFC, and HIP values were analyzed with SigmaPlot software suite, where regression performances were analyzed with relative dose differences (RDD) and coefficients of determination (R{sup 2}). Results: kVCBCT-contributed mean doses to all critical structures decreased monotonically with studied parameters, with a steeper decrease in the pelvis than in the head. Empirical functions have been developed for a dose estimation of the major organs at risk in the head and pelvis, respectively. If evaluated with physical parameters other than age, a mean RDD of up to 7.9% was observed for all the structures in our population of 42 patients. Conclusions: kVCBCT doses are highly correlated with patient size. According to this study, weight can be used as a primary index for dose assessment in both head and pelvis scans, while OFC and HIP may serve as secondary indices for dose estimation in corresponding regions. With the proposed empirical functions, it is possible to perform an individualized quantitative dose assessment of kVCBCT scans.« less

  15. Bicycle helmet size, adjustment, and stability.

    PubMed

    Thai, Kim T; McIntosh, Andrew S; Pang, Toh Yen

    2015-01-01

    One of the main requirements of a protective bicycle helmet is to provide and maintain adequate coverage to the head. A poorly fitting or fastened helmet may be displaced during normal use or even ejected during a crash. The aims of the current study were to identify factors that influence the size of helmet worn, identify factors that influence helmet position and adjustment, and examine the effects of helmet size worn and adjustment on helmet stability. Recreational and commuter cyclists in Sydney were surveyed to determine how helmet size and/or adjustment affected helmet stability in the real world. Anthropometric characteristics of the head were measured and, to assess helmet stability, a test analogous to the requirements of the Australian bicycle helmet standard was undertaken. Two hundred sixty-seven cyclists were recruited across all age groups and 91% wore an AS/NZS 2063-compliant helmet. The main ethnic group was Europeans (71%) followed by Asians (18%). The circumferences of the cyclists' heads matched well the circumference of the relevant ISO headform for the chosen helmet size, but the head shapes differed with respect to ISO headforms. Age and gender were associated with wearing an incorrectly sized helmet and helmet adjustment. Older males (>55 years) were most likely to wear an incorrectly sized helmet. Adult males in the 35-54 year age group were most likely to wear a correctly adjusted helmet. Using quasistatic helmet stability tests, it was found that the correctness of adjustment, rather than size, head dimensions, or shape, significantly affected helmet stability in all test directions. Bicycle helmets worn by recreational and commuter cyclists are often the wrong size and are often worn and adjusted incorrectly, especially in children and young people. Cyclists need to be encouraged to adjust their helmets correctly. Current headforms used in standards testing may not be representative of cyclists' head shapes. This may create challenges to helmet suppliers if on one hand they optimize the helmet to meet tests on ISO-related headforms while on the other seeking to offer greater range of sizes.

  16. GROWTH AND DEVELOPMENT OF NEGRO INFANTS. IX, STUDIES ON WEIGHT, HEIGHT, PELVIC BREADTH, HEAD AND CHEST CIRCUMFERENCES DURING THE FIRST YEAR OF LIFE.

    ERIC Educational Resources Information Center

    SCOTT, ROLAND B.; AND OTHERS

    THIS ARTICLE PRESENTS SIZE AND GROWTH VELOCITY DATA COLLECTED DURING A LONGITUDINAL STUDY OF 111 NORMAL, HEALTHY NEGRO INFANTS FROM LOWER-MIDDLE-CLASS FAMILIES. DATA WERE OBTAINED FROM BIRTH RECORDS AND MEASUREMENTS TAKEN DURING ROUTINE PHYSICAL EXAMINATIONS. WHEN THIS NEGRO SAMPLE WAS COMPARED WITH WHITE INFANTS IN SIMILAR STUDIES IT WAS FOUND…

  17. IMPACT OF BARBECUED MEAT CONSUMED IN PREGNANCY ON BIRTH OUTCOMES ACCOUNTING FOR PERSONAL PRENATAL EXPOSURE TO AIRBORNE POLYCYCLIC AROMATIC HYDROCARBONS. BIRTH COHORT STUDY IN POLAND

    PubMed Central

    Jedrychowski, Wieslaw; Perera, Frederica P.; Tang, Deliang; Stigter, Laura; Mroz, Elzbieta; Flak, Elzbieta; Spengler, John; Budzyn-Mrozek, Dorota; Kaim, Irena; Jacek, Ryszard

    2011-01-01

    We previously reported an association between prenatal exposure to airborne PAH and lower birth weight, birth length and head circumference. The main goal of the present analysis was to assess the possible impact of co-exposure to PAH-containing of barbecued meat consumed during pregnancy on birth outcomes. The birth cohort consisted of 432 pregnant women who gave birth at term (>36 weeks of gestation). Only non-smoking women with singleton pregnancies, 18-35 years of age, and who were free from chronic diseases such as diabetes and hypertension were included in the study. Detailed information on diet over pregnancy was collected through interviews and the measurement of exposure to airborne PAHs was carried out by personal air monitoring during the second trimester of pregnancy. The effect of barbecued meat consumption on birth outcomes (birthweight, length and head circumference at birth) was adjusted in multiple linear regression models for potential confounding factors such as prenatal exposure to airborne PAHs, child’s sex, gestational age, parity, size of mother (maternal prepregnancy weight, weight gain in pregnancy) and prenatal environmental tobacco smoke (ETS). The multivariable regression model showed a significant deficit in birthweight associated with barbecued meat consumption in pregnancy (coeff = −106.0 g; 95%CI: −293.3, −35.8); The effect of exposure to airborne PAHs was about the same magnitude order (coeff. = −164.6 g; 95%CI: −172.3, − 34.7). Combined effect of both sources of exposure amounted to birth weight deficit of 214.3 g (95%CI: −419.0, − 9.6). Regression models performed for birth length and head circumference showed similar trends but the estimated effects were of borderline significance level. As the intake of barbecued meat did not affect the duration of pregnancy, the reduced birthweight could not have been mediated by shortened gestation period. In conclusion, the study results provided epidemiologic evidence that prenatal PAH exposure from diet including grilled meat might be hazardous for fetal development. PMID:22079395

  18. Prenatal Exposure to Organophosphorous Pesticides and Fetal Growth: Pooled Results from Four Longitudinal Birth Cohort Studies.

    PubMed

    Harley, Kim G; Engel, Stephanie M; Vedar, Michelle G; Eskenazi, Brenda; Whyatt, Robin M; Lanphear, Bruce P; Bradman, Asa; Rauh, Virginia A; Yolton, Kimberly; Hornung, Richard W; Wetmur, James G; Chen, Jia; Holland, Nina T; Barr, Dana Boyd; Perera, Frederica P; Wolff, Mary S

    2016-07-01

    Organophosphorous (OP) pesticides are associated with reduced fetal growth in animals, but human studies are inconsistent. We pooled data from four cohorts to examine associations of prenatal OP exposure with birth weight (n = 1,169), length (n = 1,152), and head circumference (n = 1,143). Data were from the CHAMACOS, HOME, Columbia, and Mount Sinai birth cohorts. Concentrations of three diethyl phosphate (ΣDEP) and three dimethyl phosphate (ΣDMP) metabolites of OP pesticides [summed to six dialkyl phosphates (ΣDAPs)] were measured in maternal urine. Linear regression and mixed-effects models were used to examine associations with birth outcomes. We found no significant associations of ΣDEP, ΣDMP, or ΣDAPs with birth weight, length, or head circumference overall. However, among non-Hispanic black women, increasing urinary ΣDAP and ΣDMP concentrations were associated with decreased birth length (β = -0.4 cm; 95% CI: -0.9, 0.0 and β = -0.4 cm; 95% CI: -0.8, 0.0, respectively, for each 10-fold increase in metabolite concentration). Among infants with the PON1192RR genotype, ΣDAP and ΣDMP were negatively associated with length (β = -0.4 cm; 95% CI: -0.9, 0.0 and β = -0.5 cm; 95% CI: -0.9, -0.1). This study confirms previously reported associations of prenatal OP exposure among black women with decreased infant size at birth, but finds no evidence of smaller birth weight, length, or head circumference among whites or Hispanics. Contrary to our hypothesis, we found stronger inverse associations of DAPs and birth outcome in infants with the less susceptible PON1192RR genotype. The large pooled data set facilitated exploration of interactions by race/ethnicity and PON1 genotype, but was limited by differences in study populations. Harley KG, Engel SM, Vedar MG, Eskenazi B, Whyatt RM, Lanphear BP, Bradman A, Rauh VA, Yolton K, Hornung RW, Wetmur JG, Chen J, Holland NT, Barr DB, Perera FP, Wolff MS. 2016. Prenatal exposure to organophosphorous pesticides and fetal growth: pooled results from four longitudinal birth cohort studies. Environ Health Perspect 124:1084-1092; http://dx.doi.org/10.1289/ehp.1409362.

  19. Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge.

    PubMed

    Carver, J D; Wu, P Y; Hall, R T; Ziegler, E E; Sosa, R; Jacobs, J; Baggs, G; Auestad, N; Lloyd, B

    2001-04-01

    At hospital discharge, preterm infants may have low body stores of nutrients, deficient bone mineralization, and an accumulated energy deficit. This double-blind, randomized study evaluated the growth of premature infants with birth weights <1800 g who were fed a 22 kcal/fl oz nutrient-enriched postdischarge formula (PDF) or a 20 kcal/fl oz term-infant formula (TF) from hospital discharge to 12 months' corrected age (CA). Infants were randomized to PDF or TF a few days before hospital discharge with stratification by gender and birth weight (<1250 g or >/=1250 g). The formulas were fed to 12 months' CA. Growth was evaluated using analysis of variance controlling for site, feeding, gender, and birth weight group. Interaction effects were also assessed. Secondary analyses included a repeated measures analysis and growth modeling. One hundred twenty-five infants were randomized; 74 completed to 6 months' CA and 53 to 12 months' CA. PDF-fed infants weighed more than TF-fed infants at 1 and 2 months' CA, gained more weight from study day 1 to 1 and 2 months' CA, and were longer at 3 months' CA. There were significant interactions between feeding and birth weight group-among infants with birth weights <1250 g, those fed PDF weighed more at 6 months' CA, were longer at 6 months' CA, had larger head circumferences at term 1, 3, 6, and 12 months' CA, and gained more in head circumference from study day 1 to term and to 1 month CA. The repeated measures and growth modeling analyses confirmed the analysis of variance results. The PDF formula seemed to be of particular benefit for the growth of male infants. Infants fed the PDF consumed less formula and had higher protein intakes at several time points. Energy intakes, however, were not different. Growth was improved in preterm infants fed a nutrient-enriched postdischarge formula after hospital discharge to 12 months' CA. Beneficial effects were most evident among infants with birth weights <1250 g, particularly for head circumference measurements.

  20. Astronomical Instruments with Two Scales Drawn on Their Common Circumference of Rings in the Joseon Dynasty

    NASA Astrophysics Data System (ADS)

    Mihn, Byeong-Hee; Choi, Goeun; Lee, Yong Sam

    2017-03-01

    This study examines the scale unique instruments used for astronomical observation during the Joseon dynasty. The Small Simplified Armillary Sphere (小簡儀, So-ganui) and the Sun-and-Stars Time-Determining Instrument (日星定時儀, Ilseong-jeongsi-ui) are minimized astronomical instruments, which can be characterized, respectively, as an observational instrument and a clock, and were influenced by the Simplified Armilla (簡儀, Jianyi) of the Yuan dynasty. These two instruments were equipped with several rings, and the rings of one were similar both in size and in scale to those of the other. Using the classic method of drawing the scale on the circumference of a ring, we analyze the scales of the Small Simplified Armillary Sphere and the Sun-and-Stars Time-Determining Instrument. Like the scale feature of the Simplified Armilla, we find that these two instruments selected the specific circumference which can be drawn by two kinds of scales. If Joseon`s astronomical instruments is applied by the dual scale drawing on one circumference, we suggest that 3.14 was used as the ratio of the circumference of circle, not 3 like China, when the ring`s size was calculated in that time. From the size of Hundred-interval disk of the extant Simplified Sundial in Korea, we make a conclusion that the three rings` diameter of the Sun-and-Stars Time-Determining Instrument described in the Sejiong Sillok (世宗實錄, Veritable Records of the King Sejong) refers to that of the middle circle of every ring, not the outer circle. As analyzing the degree of 28 lunar lodges (lunar mansions) in the equator written by Chiljeongsan-naepyeon (七政算內篇, the Inner Volume of Calculation of the Motions of the Seven Celestial Determinants), we also obtain the result that the scale of the Celestial-circumference-degree in the Small Simplified Armillary Sphere was made with a scale error about 0.1 du in root mean square (RMS).

  1. MATERNAL HEIGHT AND PRE-PREGNANCY WEIGHT STATUS ARE ASSOCIATED WITH FETAL GROWTH PATTERNS AND NEWBORN SIZE.

    PubMed

    Pölzlberger, Eva; Hartmann, Beda; Hafner, Erich; Stümpflein, Ingrid; Kirchengast, Sylvia

    2017-05-01

    The impact of maternal height, pre-pregnancy weight status and gestational weight gain on fetal growth patterns and newborn size was analysed using a dataset of 4261 singleton term births taking place at the Viennese Danube Hospital between 2005 and 2013. Fetal growth patterns were reconstructed from three ultrasound examinations carried out at the 11th/12th, 20th/21th and 32th/33th weeks of gestation. Crown-rump length, biparietal diameter, fronto-occipital diameter, head circumference, abdominal transverse diameter, abdominal anterior-posterior diameter, abdominal circumference and femur length were determined. Birth weight, birth length and head circumference were measured immediately after birth. The vast majority of newborns were of normal weight, i.e. between 2500 and 4000 g. Maternal height showed a just-significant but weak positive association (r=0.03: p=0.039) with crown-rump length at the first trimester and with the majority of fetal parameters at the second trimester (r>0.06; p0.09; p0.08; p0.17; p0.13; p0.13; p<0.001), were significantly positively associated with newborn size. Some of these associations were quite weak and the statistical significance was mainly due to the large sample size. The association patterns between maternal height and pre-pregnancy weight status with fetal growth patterns (p<0.001), as well as newborn size (p<0.001), were independent of maternal age, nicotine consumption and fetal sex. In general, taller and heavier women gave birth to larger infants. This association between maternal size and fetal growth patterns was detectable from the first trimester onwards.

  2. Residential environmental risks for reproductive age women in developing countries.

    PubMed

    Dyjack, David; Soret, Samuel; Chen, Lie; Hwang, Rhonda; Nazari, Nahid; Gaede, Donn

    2005-01-01

    Published research suggests there is an association between maternal inhalation of common ambient air pollutants and adverse birth outcomes, including an increased risk for preterm delivery, intrauterine growth retardation, small head circumference, low birth weight, and increased rate of malformations. The air pollutants produced by indoor combustion of biomass fuels, used by 50% of households worldwide, have been linked to acute lower respiratory infections, the single most important cause of mortality in children under the age of 5. This report describes a hypothesis-generating study in West Wollega, Ethiopia, conducted to assess airborne particulate matter concentrations in homes that combust biomass fuels (biomass homes). Respirable suspended particulate matter was measured in biomass homes and nonbiomass homes using NIOSH method 0600. Measured airborne particulate concentrations in biomass homes were up to 130 times higher than air quality standards. These findings, in part, confirm that exposure to indoor air pollutants are a major source of concern for mother/child health. Midwives are encouraged to raise awareness, contribute to research efforts, and assist in interventions.

  3. Performance of third-trimester ultrasound for prediction of small-for-gestational-age neonates and evaluation of contingency screening policies.

    PubMed

    Souka, A P; Papastefanou, I; Pilalis, A; Michalitsi, V; Kassanos, D

    2012-05-01

    To assess the performance of third-trimester fetal biometry and fetal Doppler studies for the prediction of small-for-gestational-age (SGA) neonates, and to explore contingency strategies using a first-trimester prediction model based on maternal and fetal parameters and third-trimester ultrasound. This was an observational cross-sectional study of uncomplicated singleton pregnancies. Risk assessment for chromosomal abnormality was carried out in 4702 pregnancies using a combination of ultrasound markers (fetal nuchal translucency thickness (NT) and nasal bone assessment) and biochemistry (free beta-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A)) at 11 to 13 + 6 weeks. Maternal demographic characteristics and method of conception were recorded. Third-trimester (30-34 weeks) fetal biometry (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL)) and umbilical artery (UA) and middle cerebral artery Doppler studies were performed routinely in a subgroup (n = 2310). Reference ranges for birth weight were constructed using the cohort of 4702 women, and neonates were classified as small (SGA, ≤ 5th centile) or appropriate (AGA) for gestational age. First-trimester, third-trimester and integrated first- and third-trimester prediction models for SGA were constructed using regression analysis and three different contingency strategies of rescanning in the third trimester were investigated. According to the areas under the receiver-operating characteristics curves (AUCs), AC (AUC = 0.85) and ultrasound-estimated fetal weight (EFW, AUC = 0.87) were equally good predictors of SGA. The model was marginally improved by the addition of UA Doppler, smoking status and first-trimester indices (free β-hCG and PAPP-A multiples of the median) (combined model, AUC = 0.88), but the difference was not statistically significant. A contingency strategy of rescanning 50% of the population in the third trimester according to the risk estimated by a first-trimester prediction model yielded a detection rate of 79% for a 25% screen-positive rate. Third-trimester ultrasound is effective in screening for SGA in uncomplicated pregnancies. The use of a contingency screening policy can reduce the need for unnecessary examinations. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  4. Impact of replacing Chinese ethnicity-specific fetal biometry charts with the INTERGROWTH-21(st) standard.

    PubMed

    Cheng, Yky; Leung, T Y; Lao, Tth; Chan, Y M; Sahota, D S

    2016-09-01

    To assess the impact of adopting the INTERGROWTH-21(st) biometry standards in a Chinese population. Retrospective cohort study. A teaching hospital in Hong Kong. A total of 10 527 Chinese women with a singleton pregnancy having a second- or third-trimester fetal anomaly or growth scan between January 2009 and June 2014. Z-scores were derived for fetal abdominal circumference (AC), head circumference (HC), and femur length (FL) using the INTERGROWTH-21(st) and Chinese biometry standards. Pregnancies with aneuploidy, structural or skeletal abnormalities, or that developed pre-eclampsia were excluded. Z-scores were stratified as <2.5th, <5th, <10th, >90th, >95th, or >97.5th percentile. Birthweight centile, adjusted for gestation and gender, was categorised as ≤3rd, 3rd to ≤5th, 5th to ≤10th, and >10th. Pairwise comparison and the McNemar test were performed to assess biometry Z-score differences and concordance between the INTERGROWTH-21(st) and Chinese standards. The sensitivity of both the local and INTERGROWTH-21(st) AC standards to identify pregnancies that were small-for-gestational-age (SGA) was assessed. INTERGROWTH-21(st) AC, HC, and FL Z-scores were significantly lower than those obtained using our local reference for AC, HC, and FL (P < 0.0001 for all). The proportion of fetuses with biometry in the <2.5th, <5th, <10th, >90th, >95th, or >97.5th percentiles was statistically significant (P < 0.01 for all). A total of 1224 (15.5%) of the scans at 18-22 weeks of gestation had AC, HC, or FL below the 3rd percentile of the INTERGROWTH-21(st) standard. Adopting the INTERGROWTH-21(st) standard would lead to a significant number of fetuses being at risk of misdiagnosis for small fetal size, particularly when using HC and FL measures. INTERGROWTH-21(st) biometry assessment in Chinese leads to fetuses being at risk of misdiagnosis of small fetal size. © 2016 Royal College of Obstetricians and Gynaecologists.

  5. Gender Disparities in Speech-evoked Auditory Brainstem Response in Healthy Adults.

    PubMed

    Jalaei, Bahram; Zakaria, Mohd Normani; Mohd Azmi, Mohd Hafiz Afifi; Nik Othman, Nik Adilah; Sidek, Dinsuhaimi

    2017-04-01

    Gender disparities in speech-evoked auditory brainstem response (speech-ABR) outcomes have been reported, but the literature is limited. The present study was performed to further verify this issue and determine the influence of head size on speech-ABR results between genders. Twenty-nine healthy Malaysian subjects (14 males and 15 females) aged 19 to 30 years participated in this study. After measuring the head circumference, speech-ABR was recorded by using synthesized syllable /da/ from the right ear of each participant. Speech-ABR peaks amplitudes, peaks latencies, and composite onset measures were computed and analyzed. Significant gender disparities were noted in the transient component but not in the sustained component of speech-ABR. Statistically higher V/A amplitudes and less steeper V/A slopes were found in females. These gender differences were partially affected after controlling for the head size. Head size is not the main contributing factor for gender disparities in speech-ABR outcomes. Gender-specific normative data can be useful when recording speech-ABR for clinical purposes.

  6. Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

    PubMed

    Miller, Thomas A; Zak, Victor; Shrader, Peter; Ravishankar, Chitra; Pemberton, Victoria L; Newburger, Jane W; Shillingford, Amanda J; Dagincourt, Nicholas; Cnota, James F; Lambert, Linda M; Sananes, Renee; Richmond, Marc E; Hsu, Daphne T; Miller, Stephen G; Zyblewski, Sinai C; Williams, Richard V

    2016-01-01

    To assess the variability in asymmetric growth and its association with neurodevelopment in infants with single ventricle (SV). We analyzed weight-for-age z-score minus head circumference-for-age z-score (HCAZ), relative head growth (cm/kg), along with individual growth variables in subjects prospectively enrolled in the Infant Single Ventricle Trial. Associations between growth indices and scores on the Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) of the Bayley Scales of Infant Development-II (BSID-II) at 14 months were assessed. Of the 230 subjects enrolled in the Infant Single Ventricle trial, complete growth data and BSID-II scores were available in 168 (73%). Across the cohort, indices of asymmetric growth varied widely at enrollment and before superior cavopulmonary connection (SCPC) surgery. BSID-II scores were not associated with these asymmetry indices. In bivariate analyses, greater pre-SCPC HCAZ correlated with higher MDI (r = 0.21; P = .006) and PDI (r = 0.38; P < .001) and a greater HCAZ increase from enrollment to pre-SCPC with higher PDI (r = 0.15; P = .049). In multivariable modeling, pre-SCPC HCAZ was an independent predictor of PDI (P = .03), but not MDI. In infants with SV, growth asymmetry was not associated with neurodevelopment at 14 months, but pre-SCPC HCAZ was associated with PDI. Asymmetric growth, important in other high-risk infants, is not a brain-sparing adaptation in infants with SV. Clinicaltrials.gov: NCT00113087. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Normal variation in early parental sensitivity predicts child structural brain development.

    PubMed

    Kok, Rianne; Thijssen, Sandra; Bakermans-Kranenburg, Marian J; Jaddoe, Vincent W V; Verhulst, Frank C; White, Tonya; van IJzendoorn, Marinus H; Tiemeier, Henning

    2015-10-01

    Early caregiving can have an impact on brain structure and function in children. The influence of extreme caregiving experiences has been demonstrated, but studies on the influence of normal variation in parenting quality are scarce. Moreover, no studies to date have included the role of both maternal and paternal sensitivity in child brain maturation. This study examined the prospective relation between mothers' and fathers' sensitive caregiving in early childhood and brain structure later in childhood. Participants were enrolled in a population-based prenatal cohort. For 191 families, maternal and paternal sensitivity was repeatedly observed when the child was between 1 year and 4 years of age. Head circumference was assessed at 6 weeks, and brain structure was assessed using magnetic resonance imaging (MRI) measurements at 8 years of age. Higher levels of parental sensitivity in early childhood were associated with larger total brain volume (adjusted β = 0.15, p = .01) and gray matter volume (adjusted β = 0.16, p = .01) at 8 years, controlling for infant head size. Higher levels of maternal sensitivity in early childhood were associated with a larger gray matter volume (adjusted β = 0.13, p = .04) at 8 years, independent of infant head circumference. Associations with maternal versus paternal sensitivity were not significantly different. Normal variation in caregiving quality is related to markers of more optimal brain development in children. The results illustrate the important role of both mothers and fathers in child brain development. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Fetal growth in different racial groups.

    PubMed Central

    Alvear, J; Brooke, O G

    1978-01-01

    Three racial groups of mothers and their newborn babies-- North European 75, Negro 75, and "Indian" Asian 37--were matched for parity, gestational age, sex, maternal age, maternal smoking habits, and social class. Multiple anthropometric measurements, including skinfold thickness, limb circumferences, and various linear measurements were made on the mothers and their infants to determine the effects of race and smoking on fetal size. Indian-Asian mothers, though shorter and lighter than Europeans and Negroes, had similar skinfold thickness and weight: height2 ratios and gained as much weight during pregnancy. Their infants, however, were lighter than the others, and had smaller head and limb circumferences, although their linear measurements were the same. Negro and European infants were almost identical in size. We found no effect on any of the fetal measurements which could be attributed to smoking. PMID:626515

  9. Catheter-Directed Thrombolysis via Small Saphenous Veins for Treating Acute Deep Venous Thrombosis.

    PubMed

    Yang, Bin; Xu, Xiao-Dong; Gao, Peng; Yu, Ji-Xiang; Li, Yu; Zhu, Ai-Dong; Meng, Ran-Ran

    2016-08-23

    BACKGROUND There is little data comparing catheter-directed thrombolysis (CDT) via small saphenous veins vs. systematic thrombolysis on complications and efficacy in acute deep venous thrombosis patients. The aim of our study was to compare the efficacy and safety of CDT via the small saphenous veins with systematic thrombolysis for patients with acute deep venous thrombosis (DVT). MATERIAL AND METHODS Sixty-six patients with acute DVT admitted from June 2012 to December 2013 were divided into 2 groups: 27 patients received systemic thrombolysis (ST group) and 39 patients received CDT via the small saphenous veins (CDT group). The thrombolysis efficiency, limb circumference differences, and complications such as post-thrombotic syndrome (PTS) in the 2 groups were recorded. RESULTS The angiograms demonstrated that all or part of the fresh thrombus was dissolved. There was a significant difference regarding thrombolysis efficiency between the CDT group and ST group (71.26% vs. 48.26%, P=0.001). In both groups the postoperative limb circumference changes were higher compared to the preoperative values. The differences between postoperative limb circumferences on postoperative days 7 and 14 were significantly higher in the CDT group than in the ST group (all P<0.05). The incidence of postoperative PTS in the CDT group (17.9%) was significantly lower in comparison to the ST group (51.85%) during the follow-up (P=0.007). CONCLUSIONS Catheter-directed thrombolysis via the small saphenous veins is an effective, safe, and feasible approach for treating acute deep venous thrombosis.

  10. Effects of Techa River Radiation Contamination on the Reproductive Function of Residents

    DTIC Science & Technology

    2006-06-01

    The newborn 16 development histories contained information on hereditary factors both on the maternal and paternal side, labor traumas...of exposed parents , and 0.72 for controls. Thus, according to informa- tion provided by maternity homes which analyzed labor histories and neonatal...physical parameters (length, weight, head circumference) were not changed if the parents were irradiated, but deviations in both directions from the mean

  11. Chromosomal contacts connect loci associated with autism, BMI and head circumference phenotypes

    PubMed Central

    Loviglio, M N; Leleu, M; Männik, K; Passeggeri, M; Giannuzzi, G; van der Werf, I; Waszak, S M; Zazhytska, M; Roberts-Caldeira, I; Gheldof, N; Migliavacca, E; Alfaiz, A A; Hippolyte, L; Maillard, A M; Loviglio, Maria Nicla; Männik, Katrin; van der Werf, Ilse; Giannuzzi, Giuliana; Zazhytska, Marianna; Gheldof, Nele; Migliavacca, Eugenia; Alfaiz, Ali A; Roberts-Caldeira, Inês; Hippolyte, Loyse; Maillard, Anne M; Ferrarini, Alessandra; Butschi, Florence Niel; Conrad, Bernard; Addor, Marie-Claude; Belfiore, Marco; Roetzer, Katharina; Dijck, Anke Van; Blaumeiser, Bettina; Kooy, Frank; Roelens, Filip; Dheedene, Annelies; Chiaie, Barbara Delle; Menten, Björn; Oostra, Ann; Caberg, Jean-Hubert; Carter, Melissa; Kellam, Barbara; Stavropoulos, Dimitri J; Marshall, Christian; Scherer, Stephen W; Weksberg, Rosanna; Cytrynbaum, Cheryl; Bassett, Anne; Lowther, Chelsea; Gillis, Jane; MacKay, Sara; Bache, Iben; Ousager, Lilian B; Smerdel, Maja Patricia; Graakjaer, Jesper; Kjaergaard, Susanne; Metspalu, Andres; Mathieu, Michele; Bonneau, Dominique; Guichet, Agnes; Parent, Philippe; Férec, Claude; Gerard, Marion; Plessis, Ghislaine; Lespinasse, James; Masurel, Alice; Marle, Nathalie; Faivre, Laurence; Callier, Patrick; Layet, Valerie; Meur, Nathalie Le; Le Goff, Céline; Duban-Bedu, Bénédicte; Sukno, Sylvie; Boute, Odile; Andrieux, Joris; Blanchet, Patricia; Geneviève, David; Puechberty, Jacques; Schneider, Anouck; Leheup, Bruno; Jonveaux, Philippe; Mercier, Sandra; David, Albert; Le Caignec, Cédric; de Pontual, Loic; Pipiras, Eva; Jacquette, Aurelia; Keren, Boris; Gilbert-Dussardier, Brigitte; Bilan, Frederic; Goldenberg, Alice; Chambon, Pascal; Toutain, Annick; Till, Marianne; Sanlaville, Damien; Leube, Barbara; Royer-Pokora, Brigitte; Grabe, Hans Jörgen; Schmidt, Carsten Oliver; Schurmann, Claudia; Homuth, Georg; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Bernardini, Laura; Novelli, Antonio; Micale, Lucia; Merla, Giuseppe; Zollino, Marcella; Mari, Francesca; Rizzo, Caterina Lo; Renieri, Alessandra; Silengo, Margherita; Vulto-van Silfhout, Anneke T; Schouten, Meyke; Pfundt, Rolph; de Leeuw, Nicole; Vansenne, Fleur; Maas, Saskia M; Barge-Schaapveld, Daniela QCM; Knegt, Alida C; Stadheim, Barbro; Rodningen, Olaug; Houge, Gunnar; Price, Sue; Hawkes, Lara; Campbell, Carolyn; Kini, Usha; Vogt, Julie; Walters, Robin; Blakemore, Alexandra; Gusella, James F; Shen, Yiping; Scott, Daryl; Bacino, Carlos A; Tsuchiya, Karen; Ladda, Roger; Sell, Susan; Asamoah, Alexander; Hamati, Aline I; Rosenfeld, Jill A; Shaffer, Lisa G; Mitchell, Elyse; Hodge, Jennelle C; Beckmann, Jacques S; Jacquemont, Sébastien; Reymond, Alexandre; Reymond, Alexandre; Ewans, Lisa J; Mowat, David; Walker, Jan; Amor, David J; Esch, Hilde Van; Leroy, Patricia; Caberg, Jean-Hubert; Bamforth, John-Steven; Babu, Deepti; Till, Marianne; Sanlaville, Damien; Geneviève, David; Puechberty, Jacques; Isidor, Bertrand; DiDonato, Nataliya; Hackmann, Karl; Passeggeri, Marzia; Haeringen, Arie van; Rosenfeld, Jill A; Shaffer, Lisa G; Smith, Rosemarie; Ellingwood, Sara; Farber, Darren M; Puri, Vinay; Zadeh, Neda; Weaver, David D; Miller, Mandy; Wilks, Timothy; Jorgez, Carolina J; Lafayette, DeeDee; Jacquemont, Sébastien; Van Dijck, A; Kooy, R F; Sanlaville, D; Rosenfeld, J A; Shaffer, L G; Andrieux, J; Marshall, C; Scherer, S W; Shen, Y; Gusella, J F; Thorsteinsdottir, U; Thorleifsson, G; Dermitzakis, E T; Deplancke, B; Beckmann, J S; Rougemont, J; Jacquemont, S; Reymond, A

    2017-01-01

    Copy number variants (CNVs) are major contributors to genomic imbalance disorders. Phenotyping of 137 unrelated deletion and reciprocal duplication carriers of the distal 16p11.2 220 kb BP2-BP3 interval showed that these rearrangements are associated with autism spectrum disorders and mirror phenotypes of obesity/underweight and macrocephaly/microcephaly. Such phenotypes were previously associated with rearrangements of the non-overlapping proximal 16p11.2 600 kb BP4-BP5 interval. These two CNV-prone regions at 16p11.2 are reciprocally engaged in complex chromatin looping, as successfully confirmed by 4C-seq, fluorescence in situ hybridization and Hi-C, as well as coordinated expression and regulation of encompassed genes. We observed that genes differentially expressed in 16p11.2 BP4-BP5 CNV carriers are concomitantly modified in their chromatin interactions, suggesting that disruption of chromatin interplays could participate in the observed phenotypes. We also identified cis- and trans-acting chromatin contacts to other genomic regions previously associated with analogous phenotypes. For example, we uncovered that individuals with reciprocal rearrangements of the trans-contacted 2p15 locus similarly display mirror phenotypes on head circumference and weight. Our results indicate that chromosomal contacts’ maps could uncover functionally and clinically related genes. PMID:27240531

  12. Effect of Breastfeeding on Head Circumference of Children from Impoverished Communities

    PubMed Central

    Xavier Júnior, Antonio Fernando Silva; de Assunção, Monica Lopes; dos Santos, Ewerton Amorim; Horta, Bernardo Lessa

    2013-01-01

    Abstract Objective This study investigated the effect of exclusive breastfeeding on head circumference (HC) among children living in impoverished communities. Subjects and Methods A cross-sectional study was conducted among children 12–60 months old from the 39 quilombos located in the State of Alagoas, Brazil. HC deficit was defined by a z-score of less than −2 from the median (based on the 2006 World Health Organization growth standards). Prevalence ratio and 95% confidence interval (95% CI) were estimated using Poisson regression with robust adjustment of the variance, and estimates were adjusted for possible confounders (anthropometric, socioeconomic, demographic, and health-related variables). Results We evaluated 725 children (365 boys and 360 girls). The prevalence of HC deficit was 13.3% among those children who were exclusively breastfed for less than 30 days, 10.6% among those exclusively breastfed for 30–119 days, and 5.8% among those who were exclusively breastfed for 120 days or more. Even after controlling for possible confounding variables, exclusive breastfeeding for ≥4 months decreased the risk of HC deficit (prevalence ratio, 0.48; 95% CI 0.24, 0.99). Conclusions Exclusive breastfeeding for ≥4 months was associated with a larger HC in children exposed to great social vulnerability in impoverished communities. PMID:23414229

  13. Head circumference and development in young children after renal transplantation.

    PubMed

    Motoyama, Osamu; Kawamura, Takeshi; Aikawa, Atushi; Hasegawa, Akira; Iitaka, Kikuo

    2009-02-01

    Growth impairment, microcephaly and developmental delay in young children with chronic renal failure improve after successful renal transplantation. There have been few reports on head circumference (HC) and development after transplantation. Standard deviation scores (SDS) of height and HC and developmental quotient (DQ) after successful renal transplantation were evaluated in 12 recipients under 5 years of age. At the time of transplantation their mean age was 2.5 years and mean bodyweight was 9.0 kg. Mean height SDS was -3.0 at transplantation and increased to -2.3 at 1 year after transplant (P = 0.002). Mean HC-SDS increased from -1.4 to -0.9 at 1 year after transplant (P = 0.02). As for each category of DQ examined 1 year after transplant, mean scores of gross motor function, basic practice, personal relations, speech and recognition increased from 69 to 90 (P = 0.007), from 77 to 102 (P = 0.02), from 87 to 103 (P = 0.04), from 71 to 90 (P = 0.0006), and from 88 to 101 (P = 0.03), respectively. In young children, physical growth, HC growth and DQ scores increased 1 year after transplantation. Dialysis and transplantation program should be planned in young children with end-stage renal failure in anticipation of growth and development of each patient.

  14. Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa.

    PubMed

    May, Philip A; De Vries, Marlene M; Marais, Anna-Susan; Kalberg, Wendy O; Buckley, David; Adnams, Colleen M; Hasken, Julie M; Tabachnick, Barbara; Robinson, Luther K; Manning, Melanie A; Bezuidenhout, Heidre; Adam, Margaret P; Jones, Kenneth L; Seedat, Soraya; Parry, Charles D H; Hoyme, H Eugene

    2017-05-12

    Background : Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods : Active case ascertainment focused on children with height, weight and/or head circumference ≤25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results : Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 9-129 per 1000 children. Total FASD affect 196-276 per 1000 or 20-28% of the children in these communities. Conclusions : Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions.

  15. Ultrasonographic biometry of the normal eye of the Persian cat.

    PubMed

    Mirshahi, A; Shafigh, S H; Azizzadeh, M

    2014-07-01

    To describe the normal ultrasonographic biometry of the Persian cat's eyes using B-mode ultrasonography. In a cross-sectional study, 20 healthy Persian cats with no history of previous ophthalmic disease were examined. Ocular biometry of the left and right eyes was measured using B-mode ultrasonography. Comparison of the average measurements between left and right eyes and between vertical and horizontal planes was performed using paired-sample t test. Correlation of ocular parameters with sex, age, head circumference and eye colour was evaluated. Mean ± standard deviation (SD) measurements of the ocular structures of anterior chamber, lens thickness, vitreous chamber and anterior to posterior dimension of the globe in 40 eyes were 4.1 ± 0.7, 7.7 ± 0.5, 8.2 ± 0.4 and 20.7 ± 1.0 mm, respectively. No significant difference was found between the ocular biometry of the left and right eyes or the horizontal and vertical planes. Of the ocular parameters, the following had a significant positive correlation with head circumference: axial globe length, anterior chamber and lens thickness. The vitreous body had a positive correlation with age. Regarding the breed predisposition of Persian cats to ocular problems, the present study provides baseline information for further clinical investigations of ocular abnormalities using B-mode ultrasonography. © 2014 Australian Veterinary Association.

  16. Patent ductus arteriosus and indomethacin treatment as independent risk factors for plus disease in retinopathy of prematurity.

    PubMed

    Tsui, Irena; Ebani, Edward; Rosenberg, Jamie B; Lin, Juan; Angert, Robert M; Mian, Umar

    2013-01-01

    To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment. Retrospective, cross-sectional study. Charts were reviewed for gestational age, birth weight, birth head circumference, birth length, maternal characteristics, gender, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, blood transfusions, and sepsis. Main outcome measures were increased rates of plus disease or ROP requiring treatment. A total of 450 premature infants screened for ROP in a mid-sized, urban neonatal intensive care unit were included. On univariate analysis, gestational age, birth weight, birth head circumference, birth length, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, and sepsis were significantly correlated to plus disease and ROP requiring treatment. PDA was significantly associated with bronchopulmonary dysplasia, neurologic comorbidities, sepsis, and blood transfusions (P < .0001). With type 3 multivariate analysis, only gestational age and bronchopulmonary dysplasia were independent risk factors for ROP. PDA and indomethacin were associated with plus disease and ROP requiring treatment on univariate analysis but this was not significant after adjusting for other risk factors. PDA was also strongly related to bronchopulmonary dysplasia and blood transfusions, which may explain its effect on ROP. Copyright 2013, SLACK Incorporated.

  17. Infant size at 8 months of age: relationship to maternal use of alcohol, nicotine, and caffeine during pregnancy.

    PubMed

    Barr, H M; Streissguth, A P; Martin, D C; Herman, C S

    1984-09-01

    To examine the relationship of maternal alcohol consumption, caffeine use, and smoking to infant size at 8 months of age, a follow-up cohort of 453 infants was examined at birth and again at their 8-month birthday. Even after adjustment for other relevant variables, maternal alcohol use during early pregnancy (average ounces of absolute alcohol by self-report) was significantly related to infant weight and length at 8 months of age but not as strongly related to head circumference. Maternal smoking and caffeine use during pregnancy were not significantly related to infant size at 8 months, although nicotine use had been highly related to the birth size in this sample. Maternal use of marijuana was significantly and negatively related to infant length at 8 months of age, but not to weight or head circumference. The magnitude of the growth retardation is smaller at 8 months than at birth in this sample of infants whose mothers are primarily white, married, and well-educated, and who report a variety of alcohol use patterns. Significance was tested using multiple regression analyses that adjusted for the effects of nicotine use, caffeine use, birth order, maternal height, and gestational age as well as sex and age of infant at examination.

  18. Neurocognitive Outcome of Children Exposed to Perinatal Mother-to-Child Chikungunya Virus Infection: The CHIMERE Cohort Study on Reunion Island

    PubMed Central

    Ramful, Duksha; Boumahni, Brahim; Bintner, Marc; Alessandri, Jean-Luc; Carbonnier, Magali; Tiran-Rajaoefera, Isabelle; Beullier, Gilles; Boya, Irénée; Noormahomed, Tahir; Okoï, Jocelyn; Rollot, Olivier; Cotte, Liliane; Jaffar-Bandjee, Marie-Christine; Michault, Alain; Favier, François; Kaminski, Monique; Fourmaintraux, Alain; Fritel, Xavier

    2014-01-01

    Background Little is known about the neurocognitive outcome in children exposed to perinatal mother-to-child Chikungunya virus (p-CHIKV) infection. Methods The CHIMERE ambispective cohort study compared the neurocognitive function of 33 p-CHIKV-infected children (all but one enrolled retrospectively) at around two years of age with 135 uninfected peers (all enrolled prospectively). Psychomotor development was assessed using the revised Brunet-Lezine scale, examiners blinded to infectious status. Development quotients (DQ) with subscores covering movement/posture, coordination, language, sociability skills were calculated. Predictors of global neurodevelopmental delay (GND, DQ≤85), were investigated using multivariate Poisson regression modeling. Neuroradiologic follow-up using magnetic resonance imaging (MRI) scans was proposed for most of the children with severe forms. Results The mean DQ score was 86.3 (95%CI: 81.0–91.5) in infected children compared to 100.2 (95%CI: 98.0–102.5) in uninfected peers (P<0.001). Fifty-one percent (n = 17) of infected children had a GND compared to 15% (n = 21) of uninfected children (P<0.001). Specific neurocognitive delays in p-CHIKV-infected children were as follows: coordination and language (57%), sociability (36%), movement/posture (27%). After adjustment for maternal social situation, small for gestational age, and head circumference, p-CHIKV infection was found associated with GND (incidence rate ratio: 2.79, 95%CI: 1.45–5.34). Further adjustments on gestational age or breastfeeding did not change the independent effect of CHIKV infection on neurocognitive outcome. The mean DQ of p-CHIKV-infected children was lower in severe encephalopathic children than in non-severe children (77.6 versus 91.2, P<0.001). Of the 12 cases of CHIKV neonatal encephalopathy, five developed a microcephaly (head circumference <−2 standard deviations) and four matched the definition of cerebral palsy. MRI scans showed severe restrictions of white matter areas, predominant in the frontal lobes in these children. Conclusions The neurocognitive outcome of children exposed to perinatal mother-to-child CHIKV infection is poor. Severe CHIKV neonatal encephalopathy is associated with an even poorer outcome. PMID:25033077

  19. International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project.

    PubMed

    Papageorghiou, Aris T; Ohuma, Eric O; Altman, Douglas G; Todros, Tullia; Cheikh Ismail, Leila; Lambert, Ann; Jaffer, Yasmin A; Bertino, Enrico; Gravett, Michael G; Purwar, Manorama; Noble, J Alison; Pang, Ruyan; Victora, Cesar G; Barros, Fernando C; Carvalho, Maria; Salomon, Laurent J; Bhutta, Zulfiqar A; Kennedy, Stephen H; Villar, José

    2014-09-06

    In 2006, WHO produced international growth standards for infants and children up to age 5 years on the basis of recommendations from a WHO expert committee. Using the same methods and conceptual approach, the Fetal Growth Longitudinal Study (FGLS), part of the INTERGROWTH-21(st) Project, aimed to develop international growth and size standards for fetuses. The multicentre, population-based FGLS assessed fetal growth in geographically defined urban populations in eight countries, in which most of the health and nutritional needs of mothers were met and adequate antenatal care was provided. We used ultrasound to take fetal anthropometric measurements prospectively from 14 weeks and 0 days of gestation until birth in a cohort of women with adequate health and nutritional status who were at low risk of intrauterine growth restriction. All women had a reliable estimate of gestational age confirmed by ultrasound measurement of fetal crown-rump length in the first trimester. The five primary ultrasound measures of fetal growth--head circumference, biparietal diameter, occipitofrontal diameter, abdominal circumference, and femur length--were obtained every 5 weeks (within 1 week either side) from 14 weeks to 42 weeks of gestation. The best fitting curves for the five measures were selected using second-degree fractional polynomials and further modelled in a multilevel framework to account for the longitudinal design of the study. We screened 13,108 women commencing antenatal care at less than 14 weeks and 0 days of gestation, of whom 4607 (35%) were eligible. 4321 (94%) eligible women had pregnancies without major complications and delivered live singletons without congenital malformations (the analysis population). We documented very low maternal and perinatal mortality and morbidity, confirming that the participants were at low risk of adverse outcomes. For each of the five fetal growth measures, the mean differences between the observed and smoothed centiles for the 3rd, 50th, and 97th centiles, respectively, were small: 2·25 mm (SD 3·0), 0·02 mm (3·0), and -2·69 mm (3·2) for head circumference; 0·83 mm (0·9), -0·05 mm (0·8), and -0·84 mm (1·0) for biparietal diameter; 0·63 mm (1·2), 0·04 mm (1·1), and -1·05 mm (1·3) for occipitofrontal diameter; 2·99 mm (3·1), 0·25 mm (3·2), and -4·22 mm (3·7) for abdominal circumference; and 0·62 mm (0·8), 0·03 mm (0·8), and -0·65 mm (0·8) for femur length. We calculated the 3rd, 5th 10th, 50th, 90th, 95th and 97th centile curves according to gestational age for these ultrasound measures, representing the international standards for fetal growth. We recommend these international fetal growth standards for the clinical interpretation of routinely taken ultrasound measurements and for comparisons across populations. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Angular distribution of Pigment epithelium central limit-Inner limit of the retina Minimal Distance (PIMD), in the young not pathological optic nerve head imaged by OCT

    NASA Astrophysics Data System (ADS)

    Söderberg, Per G.; Sandberg-Melin, Camilla

    2018-02-01

    The present study aimed to elucidate the angular distribution of the Pigment epithelium central limit-Inner limit of the retina Minimal Distance measured over 2π radians in the frontal plane (PIMD-2π) in young healthy eyes. Both healthy eyes of 16 subjects aged [20;30[ years were included. In each eye, a volume of the optical nerve head (ONH) was captured three times with a TOPCON DRI OCT Triton (Japan). Each volume renders a representation of the ONH 2.8 mm along the sagittal axis resolved in 993 steps, 6 mm long the frontal axis resolved in 512 steps and 6 x mm along the longitudinal axis resolved in 256 steps. The captured volumes were transferred to a custom made software for semiautomatic segmentation of PIMD around the circumference of the ONH. The phases of iterated volumes were calibrated with cross correlation. It was found that PIMD-2π expresses a double hump with a small maximum superiorly, a larger maximum inferiorly, and minima in between. The measurements indicated that there is no difference of PIMD-2π between genders nor between dominant and not dominant eye within subject. The variation between eyes within subject is of the same order as the variation among subjects. The variation among volumes within eye is substantially lower.

  1. Sonographic correlation of foetal neck circumference and area with gestational age among pregnant women in Port Harcourt, Nigeria.

    PubMed

    Abonyi, Obinna Everistus; Eze, Charles Ugwoke; Onwuzu, Sobechukwu W I

    2017-11-01

    The purpose of this study was to create a reference range nomogram of foetal neck circumference (FNC) and foetal neck area (FNA) in a Nigerian population using polynomial regression models. This cross-sectional study involved 723 pregnant women between 14 and 40 weeks of gestation. Axial measurements of the FNC and FNA were obtained in three measurements and the mean taken as the final value and the 5th, 50th and 95th percentiles for each foetal gestational age (FGA) were calculated. FNC and FNA correlated strongly with FGA, biparietal diameter, abdominal circumference, head circumference, and femoral length. Cubic models fitted the FNC vs FGA, and FNA vs. FGA values, and the mathematical relationships are given as: [Formula: see text] [Formula: see text] [Formula: see text]. Nomograms of FNC and FNA are thus generated. Impact statement The foetal neck circumference (FNC) and foetal neck area (FNA) can serve as predictors of foetal gestational age (FGA) since they correlate strongly and positively with FGA and known biometric parameters. The measurements obtained vary with the population studied. This study provides a nomogram of the FNA and FNC for an African population. The values correlate with that of the Caucasian population up to 32 weeks FGA. Interestingly, FNA and FNC measurements demonstrate high correlation but poor agreement in measurements between sonographers. Even though FNA and FNC could be used as predictors of foetal gestational age, the measurements vary significantly between sonographers. This is attributable to the difficulty in obtaining a satisfactory axial view of foetal neck, which is dependent on foetal presentation.

  2. Are obesity and anthropometry risk factors for diabetic retinopathy? The diabetes management project.

    PubMed

    Dirani, Mohamed; Xie, Jing; Fenwick, Eva; Benarous, Rehab; Rees, Gwyneth; Wong, Tien Yin; Lamoureux, Ecosse L

    2011-06-22

    To investigate the relationship between anthropometric parameters and diabetic retinopathy (DR) in adults with diabetes. Five hundred participants with diabetes were recruited prospectively from ophthalmology clinics in Melbourne, Australia. Each underwent an eye examination, anthropometric measurements, and standardized interview-administered questionnaires, and fasting blood glucose and serum lipids were analyzed. Two-field fundus photographs were taken and graded for DR. Height; weight; body mass index (BMI); waist, hip, neck, and head circumferences; and skinfold measurements were recorded. A total of 492 patients (325 men, 66.1%) aged between 26 and 90 years (median, 65) were included in the analysis: 171 (34.8%), 187 (38.0%), and 134 (27.2%) with no DR, nonproliferative DR (NPDR), and proliferative DR (PDR), respectively. After multiple adjustments, higher BMI (odds ratio [OR], 1.06; 95% confidence interval [CI],1.01-1.11; P = 0.02) was significantly associated with any DR. Obese people were 6.5 times more likely to have PDR than were those with normal weight (OR, 6.52; 95% CI, 1.49-28.6; P = 0.013). Neck circumference (OR, 1.05; 95% CI, 1.00-1.10; P = 0.03) and waist circumference (OR, 1.12; 95% CI, 1.03-1.22; P = 0.01) were significantly associated with any DR. BMI (OR, 1.04; 95% CI, 1.00-1.08; P = 0.04) and neck circumference (OR, 1.04 95% CI, 1.01-1.08; P = 0.04) were also positively associated with increasing severity levels of DR. Persons with diabetes with higher BMI and larger neck circumference are more likely to have DR and more severe stages of DR. These data suggest that obesity is an independent risk factor for DR.

  3. Microcephaly: general considerations and aids to nosology.

    PubMed

    Opitz, J M; Holt, M C

    1990-01-01

    Microcephaly is defined as an occipito-frontal head circumference (OFC) 2 or more standard deviations below the mean for age and sex using the new Roche et al. [Pediatrics 1987;79:706-712] charts, and corrected for parental OFC by the method of Weaver and Christian [J Pediatr 1980;96:990-994]. "Relative" microcephaly, i.e., a small head on a small child, may be associated with a much better intellectual prognosis than absolute microcephaly, although the average IQ of children with absolute microcephaly ascertained in a normal school system is normal when compared with that of appropriate control children. "Primary" microcephaly means an abnormal OFC at birth (corrected for gestational age and length), and "secondary" microcephaly a normal birth OFC with later, acquired microcephaly due to deceleration of brain growth reflecting infection, trauma, intoxication, metabolic disease, the Rett syndrome, or a true CNS degenerative disease. Some cases of syndromal microcephaly may be associated with normal intelligence including some "primordial dwarfs," children with Dubowitz syndrome, FAS, mild SC-Roberts syndrome, and an occasional Brachmann-de Lange individual. The nosology of (syndromal) microcephaly is extraordinarily complex and requires the assistance of special library resources and information retrieval expertise. At a minimum, it requires McKusick's Catalog of Mendelian Inheritance in Man (MIM); however, we find that our work is greatly enhanced by recently developed electronic databases such as MIM-online (OMIM), POSSUM, SYNDROME, and MEDLINE, as well. Three groups of syndromal and non-syndromal microcephaly are discussed selectively in order to illustrate the marvels of pleiotropy in human development and its abnormalities and the difficulties encountered in splitting and lumping entities with overlapping manifestations.

  4. Gender- and parity-specific reference charts for fetal size in low risk singleton pregnancies at the onset of the third trimester.

    PubMed

    De Reu, Paul; Smits, Luc J; Oosterbaan, Herman P; Snijders, Rosalinde J; De Reu-Cuppens, Marga J; Nijhuis, Jan G

    2007-01-01

    To determine fetal growth in low risk pregnancies at the beginning of the third trimester and to assess the relative importance of fetal gender and maternal parity. Dutch primary care midwifery practice. Retrospective cohort study on 3641 singleton pregnancies seen at a primary care midwifery center in the Netherlands. Parameters used for analysis were fetal abdominal circumference (AC), fetal head circumference (HC), gestational age, fetal gender and maternal parity. Regression analysis was applied to describe variation in AC and HC with gestational age. Means and standard deviations in the present population were compared with commonly used reference charts. Multiple regression analysis was applied to examine whether gender and parity should be taken into account. The fetal AC and HC increased significantly between the 27th and the 33rd week of pregnancy (AC r2=0.3652, P<0.0001; HC r2=0.3301, P<0.0001). Compared to some curves, our means and standard deviations were significantly smaller (at 30+0 weeks AC mean=258+/-13 mm; HC mean=281+/-14 mm), but corresponded well with other curves. Fetal gender was a significant determinant for both AC (P<0.0001) and HC (P<0.0001). Parity contributed significantly to AC only but the difference was small (beta=0.00464). At the beginning of the third trimester, fetal size is associated with fetal gender and, to a lesser extent, with parity. Some fetal growth charts (e.g., Chitty et al.) are more suitable for the low-risk population in the Netherlands than others.

  5. [Chart for estimation of fetal weight 2014 by the French College of Fetal Sonography (CFEF)].

    PubMed

    Massoud, M; Duyme, M; Fontanges, M; Combourieu, D

    2016-01-01

    To establish a reference chart for estimated fetal weight (EFW) using the Hadlock formula based on recent biometric data (2012-2013). A prospective multicentric longitudinal study was carried out. Biometric parameters as the head circumference (HC), abdominal circumference (AC) and the femur length were measured in multiple areas of France from January 2012 until December 2013. EFW was calculated using the predictive formula of Hadlock using three parameters. The accurate gestational age was the main inclusion criteria calculated in weeks of gestation (WG). A polynomial regression approach was used to calculate the mean and standard deviation for every WG adjusted to raw data. Centiles of EFW were calculated from the z score that corresponds to the -1.88, -1.28, 0, +1.28, +1.88 respectively for the 3rd, 10th, 50th, 90th, et 97th percentile in order to establish a new chart of EFW. Measurements were obtained for 33,143 fetus between 17 et 38 WG. Reference charts with the 3rd, 10th, 50th, 90th et 97th percentiles were presented. The reference Chart 2014 is an in utero chart for EFW based on ultrasound measurements data reliable and homogenous from a sample of 33,143 fetus of a general population. It offers a tool to use in routine ultrasound examination for the survey of the fetal growth and to diagnose fetus that are small for gestational age or presenting a restriction in growth. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Effect of nutritional support in children with spastic quadriplegia.

    PubMed

    Soylu, Ozlem Bekem; Unalp, Aycan; Uran, Nedret; Dizdarer, Gülsen; Ozgonul, Figen Oksel; Conku, Aliye; Ataman, Hamide; Ozturk, Aysel Aydogan

    2008-11-01

    Malnutrition is a common problem in patients with cerebral palsy. We evaluated the effect of nutritional support on clinical findings in children with spastic quadriplegia. Feeding history, numbers of lower respiratory tract infections, and gastrointestinal and neurologic findings were evaluated via questionnaire. Weight, height, head circumference, midarm circumference, and triceps skinfold thickness were measured. Height for age, weight for age, weight for height, body mass index, and weight and height z-scores were calculated. Clinical findings and anthropometric parameters were re-evaluated after nutritional support for 6 months. Forty-five patients were enrolled. No difference was evident between the first and the last height z-scores of 31 patients who completed the follow-up. Weight, height, weight z-scores, weight for age, weight for height, body mass index, midarm circumference, and triceps skinfold thickness exhibited improvement. Moreover, a significant decrease in number of infections was evident. Frequency of seizures and Gross Motor Function Classification System status did not change. Constipation decreased significantly. Nutritional therapy revealed improvements in some anthropometric findings and a decrease in number of infections. Although there was no difference regarding motor development or seizure frequency, further studies with a longer follow-up are required.

  7. Risk factors for obstetric anal sphincter injuries and postpartum anal and urinary incontinence: a case-control trial.

    PubMed

    Burrell, Madeline; Dilgir, Sapna; Patton, Vicki; Parkin, Katrina; Karantanis, Emmanuel

    2015-03-01

    Obstetric anal sphincter injuries (OASIS) cause serious maternal morbidity for mothers. A clearer understanding of aetiological factors is needed. We aimed to determine the risk factors for OASIS . Birth details of 222 primiparous women sustaining OASIS were compared with 174 women who did not sustain OASIS (controls) to determine the relevant risk factors. The data underwent univariate analysis and logistic regression analysis. Asian or Indian ethnicity, operative vaginal birth (p = 0.00), persistent occipito-posterior position (p = 0.038) and rapid uncontrolled delivery of the head were identified as risk factors for OASIS. Pushing time, use of epidural, episiotomy and head circumference were not predictors of OASIS. Women with Asian or Indian ethnicity, operative vaginal birth, persistent occipito-posterior position and rapid uncontrolled delivery of the fetal head were likely to sustain OASIS. Awareness of these factors may help to minimise the incidence of OASIS.

  8. Cardiovascular dynamics during the initial period of head-down tilt

    NASA Technical Reports Server (NTRS)

    Tomaselli, Clare Marie; Kenney, Richard A.; Frey, Mary Anne Bassett; Hoffler, G. Wyckliffe

    1987-01-01

    The cardiovascular response to 1 h of 60-deg head-down tilt was studied in 12 male subjects, ages 30-39 years, to simulate the early effects of weightlessness. Fluid shifts, hemodynamic variables, and indices of myocardial contractility were evaluated by utilizing electrocardiography, systolic time intervals, impedance cardiography, sphygmomanometry, and measurement of calf circumference. Most cardiovascular variables remained stable throughout the initial 30 min of the protocol, even though translocation of fluid from the legs to the thorax commenced immediately with the onset of head-down tilt. In contrast, minutes 30-60 were characterized by reduced stroke volume, cardiac output, mean stroke ejection rate, and Heather index concomitant with an elevation in mean arterial pressure. Intrathoracic fluid volume continued to increase, while leg volume continued to decrease. This latter physiological response suggests intrathoracic sequestration of fluid volume; blood was apparently redistributed to the pulmonary circulation rather than being retained in the great veins.

  9. Effect of a central redistribution of fluid volume on response to lower-body negative pressure

    NASA Technical Reports Server (NTRS)

    Tomaselli, Clare M.; Frey, Mary A. B.; Kenney, Richard A.; Hoffler, G. Wyckliffe

    1990-01-01

    Cardiovascular responses to lower-body negative pressure (LBNP) were studied following 1 hour of 6-deg head-down tilt to determine whether a redistribution of blood volume toward the central circulation modifies the subsequent response to orthostatic stress. Responses of 12 men, ages 30-39 years, were evaluated by electrocardiography, impedance cardiography, sphygmomanometry, and measurement of calf circumference. During the LBNP that followed head-down tilt, as compared with control LBNP (no preceding head-down tilt) subjects, had smaller stroke volume and cardiac output, greater total peripheral resistance, and less calf enlargement. These differences reflect differences in the variables immediately preceding LBNP. Magnitudes of the responses from pre-LBNP to each pressure stage of the LBNP procedure did not differ between protocols. Mean and diastolic arterial pressures were slightly elevated after LBNP-control, but they fell slightly during LBNP post-tilt.

  10. Clinical phenotype of ASD-associated DYRK1A haploinsufficiency.

    PubMed

    Earl, Rachel K; Turner, Tychele N; Mefford, Heather C; Hudac, Caitlin M; Gerdts, Jennifer; Eichler, Evan E; Bernier, Raphael A

    2017-01-01

    DYRK1A is a gene recurrently disrupted in 0.1-0.5% of the ASD population. A growing number of case reports with DYRK1A haploinsufficiency exhibit common phenotypic features including microcephaly, intellectual disability, speech delay, and facial dysmorphisms. Phenotypic information from previously published DYRK1A cases ( n  = 51) and participants in an ongoing study at the University of Washington (UW, n  = 10) were compiled. Frequencies of recurrent phenotypic features in this population were compared to features observed in a large sample with idiopathic ASD from the Simons Simplex Collection ( n  = 1981). UW DYRK1A cases were further characterized quantitatively and compared to a randomly subsampled set of idiopathic ASD cases matched on age and gender ( n  = 10) and to cases with an ASD-associated disruptive mutation to CHD8 ( n  = 12). Contribution of familial genetic background to clinical heterogeneity was assessed by comparing head circumference, IQ, and ASD-related symptoms of UW DYRK1A cases to their unaffected parents. DYRK1A haploinsufficiency results in a common phenotypic profile including intellectual disability, speech and motor difficulties, microcephaly, feeding difficulties, and vision abnormalities. Eighty-nine percent of DYRK1A cases ascertained for ASD presented with a constellation of five or more of these symptoms. When compared quantitatively, DYRK1A cases presented with significantly lower IQ and adaptive functioning compared to idiopathic cases and significantly smaller head size compared to both idiopathic and CHD8 cases. Phenotypic variability in parental head circumference, IQ, and ASD-related symptoms corresponded to observed variability in affected child phenotype. Results confirm a core clinical phenotype for DYRK1A disruptions, with a combination of features that is distinct from idiopathic ASD. Cases with DYRK1A mutations are also distinguishable from disruptive mutations to CHD8 by head size. Measurable, quantitative characterization of DYRK1A haploinsufficiency illuminates clinical variability, which may be, in part, due to familial genetic background.

  11. Comparing discriminant analysis and neural network for the determination of sex using femur head measurements.

    PubMed

    Alunni, Véronique; Jardin, Philippe du; Nogueira, Luisa; Buchet, Luc; Quatrehomme, Gérald

    2015-08-01

    The measurement of the femoral head is usually considered an interesting variable for the sex determination of skeletal remains. To date, there are few published reference measurements of the femoral head in a modern European population for the purpose of sex determination. In this study, 116 femurs from 58 individuals of the South of France (Nice Bone Collection, Nice, France) were studied. Three measurements of the femoral head were taken: the vertical head diameter (VHD), the transversal head diameter (THD) and the head circumference (HC). The results show that: (i) there is no statistical difference between the right and left femurs for each of the three measurements (VHD, THD and HC). Therefore we arbitrarily chose to use the measures from the right femurs (N=58) to pursue our experiments; (ii) the measurements of the femoral head are similar to those of contemporary American populations; (iii) the dimensions of the femoral head place the measurements of the French population somewhere between Germany or Croatia, and Spain; (iv) there is no significant secular trend (in contrast with the femoral neck diameter); (v) the femoral head measurement as a single variable is useful for sex determination: a 96.5% rate of accuracy was obtained using THD and HC measurements with the artificial neural network; and a 94.8% rate of accuracy using VHD, both with the discriminant analysis and the neural network. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Small and Large Number Processing in Infants and Toddlers with Williams Syndrome

    ERIC Educational Resources Information Center

    Van Herwegen, Jo; Ansari, Daniel; Xu, Fei; Karmiloff-Smith, Annette

    2008-01-01

    Previous studies have suggested that typically developing 6-month-old infants are able to discriminate between small and large numerosities. However, discrimination between small numerosities in young infants is only possible when variables continuous with number (e.g. area or circumference) are confounded. In contrast, large number discrimination…

  13. Device Rotates Bearing Balls For Inspection

    NASA Technical Reports Server (NTRS)

    Burley, R. K.

    1988-01-01

    Entire surface of ball inspected automatically and quickly. Device holds and rotates bearing ball for inspection by optical or mechanical surface-quality probe, eddy-current probe for detection of surface or subsurface defects, or circumference-measuring tool. Ensures entire surface of ball moves past inspection head quickly. New device saves time and increases reliability of inspections of spherical surfaces. Simple to operate and provides quick and easy access for loading and unloading of balls during inspection.

  14. Intrauterine Growth Restriction, Head Size at Birth, and Outcome in Very Preterm Infants.

    PubMed

    Guellec, Isabelle; Marret, Stephane; Baud, Olivier; Cambonie, Gilles; Lapillonne, Alexandre; Roze, Jean-Christophe; Fresson, Jeanne; Flamant, Cyril; Charkaluk, Marie-Laure; Arnaud, Catherine; Ancel, Pierre-Yves

    2015-11-01

    To determine whether small head circumference (HC) or birth weight (BW) or both are associated with neonatal and long-term neurologic outcome in very preterm infants. All 2442 live births from the 1997 Epipage study between 26 and 32 weeks of gestational age in 9 regions of France were analyzed. A total of 1395 were tested at age 5 years for cognitive performance and 1315 with school performance reports at age 8 years. Symmetric growth restriction (SGR) was defined by HC and BW <20th percentile and in the same percentile range, and asymmetric growth restriction by at least 1 of HC and BW <20th percentile and the other in a higher decile range. There were 2 forms of asymmetric growth restriction: head growth restriction (HGR) and weight growth restriction (WGR). Appropriate for gestational age was defined by both BW and HC >20th percentile. Compared with appropriate for gestational age, SGR was significantly associated with neonatal mortality (aOR 2.99, 95% CI 1.78-5.03), moderate and severe cognitive deficiency (aOR 1.65, 95% CI 1.01-2.71 and aOR 2.61, 95% CI 1.46-4.68, respectively), and poor school performance (aOR 1.79; 95% CI 1.13-2.83). HGR was significantly associated with severe cognitive deficiency (aOR 2.07, 95% CI 1.15-3.74). WGR was not significantly associated with cognitive or school performance despite higher rates of neonatal morbidity. SGR in preterm infants was associated with neonatal mortality and impaired cognitive and school performance. The outcome of asymmetric growth restriction differed according to HC. HGR was associated with impaired cognitive function; WGR was not. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Anthropometric surrogates for screening of low birth weight newborns: a community-based study.

    PubMed

    Rustagi, Neeti; Prasuna, J G; Taneja, D K

    2012-03-01

    In developing countries, where about 75% of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. This study compares various anthropometric surrogates for identification of low birth weight neonates. A longitudinal community based study was done in an urban resettlement colony and 283 singleton neonates within 7 days of birth were examined for the anthropometric measurements such as head, chest, mid upper arm circumference and foot length as a screening tool for low birth weight. Chest circumference measured within 7 days of birth appeared to be the most appropriate surrogate of low birth weight with highest sensitivity (75.4%), specificity (78.4%), and positive predictive value (48.9%) as compared with other anthropometric parameters. Low birth weight neonates in absence of weighing scales can be early identified by using simple anthropometric measurements for enhanced home-based care and timely referral.

  16. Hot SPOT Eclipses in Dwarf Novae

    NASA Astrophysics Data System (ADS)

    Smak, J.

    1996-10-01

    Eclipses of the hot spot in four dwarf novae: U Gem, IP Peg, Z Cha, and OY Car are re-analyzed, assuming two models for the shape of the spot. In Model 1 an elliptical spot is assumed, with the semi-axes s_a in the orbital plane and s_b perpendicular to the orbital plane, its center located on the stream trajectory. The results show that such an ellipse is, within errors, tangent to the disk's circumference. In all four cases the resulting dimensions of the spot s_a are larger than the theoretical cross-section of the stream. Accordingly, in Model2 the spot is assumed to consist of a head, centered on the stream trajectory, and a tail, extending downstream, ie., along disk's circumference. In some cases the resulting parameters, eg., mass ratios or disk radii, differ significantly from those obtained with Model 1.

  17. Body fat and blood pressure: comparison of blood pressure measurements in Chinese children with different body fat levels.

    PubMed

    Ma, Jun; Wang, Zhiqiang; Dong, Bin; Song, Yi; Hu, Peijin; Zhang, Bing

    2012-11-14

    Children in China are experiencing a rapid increase in the prevalence of obesity, which is associated with hypertension. To compare the effect of body fat on blood pressure (BP) with that of the normal physical growth, we compared BP levels in Chinese children with different body fat levels. In the present population-based study, 13 972 children in the highest-skinfold-thickness-quartile group were individually matched to 13 972 children in the lowest-skinfold-thickness-quartile group by height and weight. Similarly, 5103 children in the highest-waist-circumference-quartile group were matched to the same number of children in the lowest-waist-circumference-quartile group. The high- and low-fat groups had similar height and weight but the high-fat group had significantly higher skinfold and waist circumference measurements. The differences in systolic BP (SBP) between the high- and low-skinfold-thickness groups were small: 0·01 (95 % CI -0·41, 0·44) mmHg in boys and 0·20 (95 % CI -0·15, 0·54) mmHg in girls. The differences in diastolic BP (DBP) were also small (0·39 and 0·38 mmHg for boys and girls, respectively) but were statistically significant. The differences in both SBP and DBP between the high- and low-waist-circumference groups were small but not statistically significant. For a given body size as measured by height and weight, relative body fat had little impact on BP levels in these children. Fat mass and lean mass may have a similar quantitative impact on BP in healthy-weight children.

  18. Are there critical periods for brain growth in children born preterm?

    PubMed

    Cooke, R W I

    2006-01-01

    Children born very preterm who attend mainstream schools have a high prevalence of minor motor, behavioural, and learning disorders. These appear to be associated with reduced postnatal growth, particularly of the head. It is unclear when this poor growth occurs and whether growth restriction during different periods has different effects on later function. To identify periods during early development, in children born preterm, when impaired head growth may influence minor motor and cognitive function. A geographically defined cohort of 194 infants born in Merseyside during 1980-81 and weighing less than 1500 g. Measurements of head circumference (occipitofrontal circumference (OFC)) were available at birth, hospital discharge, 4 years, and 15 years of age. Assessments of intelligence (intelligence quotient (IQ)) and minor motor impairment (test of motor impairment (TOMI)) were made at 8 years of age. Clinical, social, and demographic variables were obtained from the clinical record and maternal interviews. IQ correlated significantly with OFC at 4 and 15 years of age after correction for growth restriction at birth (intrauterine growth restriction (IUGR)) and social class. TOMI scores correlated significantly with OFC at all four times, but especially with OFC at discharge and with change in OFC between birth and discharge. They were not affected by correction for social class or IUGR. Although both IQ and minor motor impairments correlate strongly with each other at school age in very low birthweight children, the factors determining them and their timing of operation are different. Interventions designed to improve IQ in this population would need to reduce IUGR and improve later childhood growth. Those aimed to improve motor ability need to be targeted more at brain protection during the neonatal period.

  19. Head circumference: the forgotten tool for hydrocephalus management. A reference interval study in the Spanish population.

    PubMed

    Poca, Maria A; Martínez-Ricarte, Francisco R; Portabella, Mireia; Torné, Ramon; Fuertes, Maria L; González-Tartiere, Pilar; Sahuquillo, Juan

    2013-11-01

    In children, deviations from the normal range of head circumference (HC) have traditionally been related with CSF dynamics abnormalities. In adults, this neglected parameter is helpful in the diagnosis and understanding of the pathophysiology of some CSF abnormalities. It has been demonstrated that HC is related to height. Because humans have increased in stature dramatically during the last 50 years, pediatric charts for head growth physiology and normal HC values in adults should be reevaluated. The main aim of the present study was to assess HC in a series of 270 normal healthy Spanish adults and to determine any differences between sexes and age groups. A secondary aim was to discuss the relevance of this parameter in the management of hydrocephalus in adult people. HC measurements were taken using a measuring tape placed over the greatest frontal and occipital protuberances. The reference interval and the upper and lower thresholds for HC were calculated by 3 different methods: normal distribution, the non-parametrical percentile method, and the "robust method". The results were consistent and showed that Spanish adult men with a HC greater than 60 cm, and Spanish adult women with a HC greater than 58 cm should be considered macrocephalic. Microcephaly should be considered when HC is 53.6 cm in men and 51.3 cm in women. Adult age groups of either sex do not present any statistically significant differences in HC. HC obtained in Spanish adult people are greater than those reported in the classical Nellhaus graphs in both men and women aged 18. These findings should be considered in the management of hydrocephalus in adults today. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project.

    PubMed

    Villar, José; Cheikh Ismail, Leila; Victora, Cesar G; Ohuma, Eric O; Bertino, Enrico; Altman, Doug G; Lambert, Ann; Papageorghiou, Aris T; Carvalho, Maria; Jaffer, Yasmin A; Gravett, Michael G; Purwar, Manorama; Frederick, Ihunnaya O; Noble, Alison J; Pang, Ruyan; Barros, Fernando C; Chumlea, Cameron; Bhutta, Zulfiqar A; Kennedy, Stephen H

    2014-09-06

    In 2006, WHO published international growth standards for children younger than 5 years, which are now accepted worldwide. In the INTERGROWTH-21(st) Project, our aim was to complement them by developing international standards for fetuses, newborn infants, and the postnatal growth period of preterm infants. INTERGROWTH-21(st) is a population-based project that assessed fetal growth and newborn size in eight geographically defined urban populations. These groups were selected because most of the health and nutrition needs of mothers were met, adequate antenatal care was provided, and there were no major environmental constraints on growth. As part of the Newborn Cross-Sectional Study (NCSS), a component of INTERGROWTH-21(st) Project, we measured weight, length, and head circumference in all newborn infants, in addition to collecting data prospectively for pregnancy and the perinatal period. To construct the newborn standards, we selected all pregnancies in women meeting (in addition to the underlying population characteristics) strict individual eligibility criteria for a population at low risk of impaired fetal growth (labelled the NCSS prescriptive subpopulation). Women had a reliable ultrasound estimate of gestational age using crown-rump length before 14 weeks of gestation or biparietal diameter if antenatal care started between 14 weeks and 24 weeks or less of gestation. Newborn anthropometric measures were obtained within 12 h of birth by identically trained anthropometric teams using the same equipment at all sites. Fractional polynomials assuming a skewed t distribution were used to estimate the fitted centiles. We identified 20,486 (35%) eligible women from the 59,137 pregnant women enrolled in NCSS between May 14, 2009, and Aug 2, 2013. We calculated sex-specific observed and smoothed centiles for weight, length, and head circumference for gestational age at birth. The observed and smoothed centiles were almost identical. We present the 3rd, 10th, 50th, 90th, and 97th centile curves according to gestational age and sex. We have developed, for routine clinical practice, international anthropometric standards to assess newborn size that are intended to complement the WHO Child Growth Standards and allow comparisons across multiethnic populations. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. To compare growth outcomes and cost-effectiveness of "Kangaroo ward care" with "intermediate intensive care" in stable extremely low birth weight infants: randomized control trial.

    PubMed

    Sharma, Deepak; Murki, Srinivas; Pratap, Oleti Tejo

    2017-07-01

    To compare growth outcome and cost-effectiveness of "Kangaroo ward care" (KWC) with "Intermediate intensive care" (IIC) in stable extremely low birth weight (ELBW) infants. This is secondary analysis of the study and we analyzed 62 ELBW infants, 33 were randomized to KWC and 29 to IIC once the infant reached a weight of 1150 g. Infants in the KWC group were shifted to the Kangaroo ward immediately after randomization and in the IIC group received IIC care till they attain a weight of 1250 g before shifting to Kangaroo ward. The gain in weight (g/day), length (cm/week), and head circumference (cm/week) were comparable between the two groups. The mean weight, length, and head circumference were comparable at term gestational age. The infants in KWC group were shifted five days earlier to Kangaroo ward when compared to IIC group. The cost-effective analysis using "top-down" and "bottom-up" accounting method showed that there was significant reduction of hospital and parents expenditure in KWC group (p < 0.001) with approximate saving of 452 USD for each patient in the KWC group. Early shifting of ELBW infants for KWC is very efficacious and cost-effective intervention when compared to IIC. (CTRI/2014/05/004625).

  2. Introducing depression and developmental screenings into the national programme on immunization (NPI) in southeast Nigeria: an experimental cross-sectional assessment.

    PubMed

    Bakare, Muideen O; Okoye, Jane O; Obindo, James T

    2014-01-01

    This study investigates the possibility of introducing depression and developmental screening tools into the National Programme on Immunization (NPI) in southeast Nigeria. The specific objectives were to determine the prevalence of postpartum depression (PPD) among mothers attending immunization clinics and to assess the association of maternal PPD and infant growth in relation to World Health Organization (WHO) recommendations. Four hundred and eight (408) mothers completed the sociodemographic questionnaire and the self-report Edinburgh Postnatal Depression Scale (EPDS). The weights, lengths and head circumferences of their infants were recorded, while the WHO recommended equivalents at 50th percentiles were also recorded for each child. The mothers were then interviewed with the major depressive episode module of Mini International Neuropsychiatric Interview (M.I.N.I.) to make diagnosis of depression. About 24.8% and 15.2% of the mothers were found to be depressed using EPDS and major depressive episode module of M.I.N.I., respectively. It was found that maternal PPD is significantly associated with the growth parameters of weights and lengths of the infants studied but not their head circumference. NPI may provide appropriate forum for early screening of mothers for PPD and interventions in Nigeria. The NPI would also serve a useful avenue of screening for developmental concerns in Nigerian children. © 2014.

  3. Relationship between Maternal General and Specific-Pregnancy Stress, Anxiety, and Depression Symptoms and Pregnancy Outcome.

    PubMed

    Hasanjanzadeh, Parvin; Faramarzi, Mahbobeh

    2017-04-01

    Despite scientific advances in the field of physical problems during pregnancy, the effect of mental problems on the health of pregnant women is still an important issue that needs further research. To determine the association of symptoms of stress, anxiety and depression during pregnancy and there effect on the pregnancy outcome. This was a descriptive correlational study. The population included 200 pregnant women of the urban and rural health centers affiliated with Babol University of Medical Sciences. There were 100 each in second and third trimester. Convenience multi stage cluster sampling was performed. Data collection was received through the Hospital Anxiety Depression Scale (HADS), Pregnancy Distress Questionnaire (PDQ), and Perceived Stress Scale (PSS-14) questionnaires. The correlation results showed a significant difference between variables of depression, stress, and anxiety with birth weight, birth height and head circumference and infants' APGAR score (p<0.05). Multiple regression analysis showed that interpersonal relationships on prediction of infant weight (B=-0.324), anxiety on prediction of infant height (B=-0.197), stress on prediction of head circumference (B=-0.350) and depression on prediction of APGAR score (B=-0.323) are effective (p<0.001). The findings emphasize the need to identify women with depression, anxiety and stress in pregnancy, and scheduling to avoid adverse consequences of the pregnancy outcome.

  4. Smoking and caffeine and alcohol intake during pregnancy in a northern population: effect on fetal growth.

    PubMed Central

    Godel, J C; Pabst, H F; Hodges, P E; Johnson, K E; Froese, G J; Joffres, M R

    1992-01-01

    OBJECTIVES: To assess the prevalence of smoking and of caffeine and alcohol intake during pregnancy in a northern population and to determine the relation of these factors to birth weight, length and head circumference. DESIGN: Questionnaire survey and collection of maternal and newborn measurements. SETTING: Ten communities in the Inuvik Zone, NWT. PATIENTS: A total of 162 women (56 Inuit, 38 Indian, 37 white and 31 mixed race) who presented for prenatal care in their community and gave birth in Inuvik between September 1987 and January 1990 and their newborns. RESULTS: In all, 64% (101/159) of the women smoked, 57% (88/154) ingested more than 300 mg of caffeine daily, and 34% (50/145) drank alcohol during their pregnancy. Smoking, caffeine intake and binge drinking were most frequent among the Inuit and Indian mothers. Smoking was significantly associated with decreased birth weight (p less than 0.001) and length (p less than 0.05). Alcohol intake, especially binge drinking, was significantly associated with decreased head circumference (p less than 0.05). Caffeine was found not to be related to any of the outcome variables after smoking was controlled for through stepwise multiple regression. CONCLUSIONS: The marked prevalence of smoking and alcohol intake during pregnancy and their effects on the newborn are public health concerns in the Northwest Territories and warrant intensive countermeasures. PMID:1623464

  5. Chronic opiate use in pregnancy and newborn head circumference.

    PubMed

    Visconti, Kevin C; Hennessy, Kerry C; Towers, Craig V; Howard, Bobby C

    2015-01-01

    The aim of the study is to evaluate whether chronic opiate use in pregnancy affects newborn head circumference (HC). All newborns from January 1, 2010, to June 30, 2012, admitted to the neonatal intensive care unit for treatment of neonatal abstinence syndrome were prospectively collected. The demographic, obstetrical, neonatal, and perinatal ultrasound data were retrospectively obtained. A gestational age-matched control was used for comparison purposes. Of 332 neonates admitted for the treatment of neonatal abstinence syndrome, 98 (29.5%) had a HC ≤ 10th percentile for gestational age that was significantly increased when compared with controls (p < 0.001). Of these 98, 25 had a HC ≤ 3rd percentile. Of the case population, 141 had an ultrasound in the perinatal unit within 10 days of birth. A HC < 5th percentile was found in 38.3% of cases of which 74% were ≤ 10th percentile postdelivery. The ultrasound femur and humerus length measurements were also < 5th percentile in 36.2 and 28.9%, respectively. Chronic opiate use in pregnancy appears to increase the risk for a HC ≤ 10th percentile and ≤ 3rd percentile when compared with controls. From ultrasound findings, femur and humerus lengths also appear to be shortened suggesting a possible effect on bone growth. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Improving Growth for Infants ≤1250 Grams Receiving an Exclusive Human Milk Diet.

    PubMed

    Huston, Robert K; Markell, Andrea M; McCulley, Elizabeth A; Gardiner, Stuart K; Sweeney, Sean L

    2018-02-16

    An exclusive human milk diet (EHM) fortified with human milk-based fortifier decreases necrotizing enterocolitis (NEC) compared to maternal milk supplemented with preterm formula and bovine fortifier (PTF). Growth has been less with EHM and also maternal milk supplemented with donor human milk and bovine fortifier (HMBF). The objective was to evaluate the effect of a standardized feeding protocol on the growth of infants ≤1250 g birth weight supported with EHM and HMBF. The effect on the incidence of NEC was also evaluated. A retrospective study of growth before and after implementation of a feeding protocol for infants who received either EHM or HMBF. Primary outcomes were weight, length, and head circumference gain velocities from birth to discharge. The incidence of NEC was also recorded. Analysis of covariance for 379 total infants showed that earlier day of life for fortification to 24 Kcal/oz was associated with increased weight gain (p = 0.0166) and length gain (p = 0.0064). Implementation of the feeding protocol was associated with increased head circumference gain (p = 0.006). EHM was associated with decreased incidence of NEC (p = 0.0302). Implementation of a standardized feeding protocol including earlier fortification of maternal milk was associated with improved growth for infants receiving human milk feedings. EHM significantly decreased NEC. Earlier fortification had no effect on NEC. © 2018 American Society for Parenteral and Enteral Nutrition.

  7. Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa

    PubMed Central

    May, Philip A.; De Vries, Marlene M.; Marais, Anna-Susan; Kalberg, Wendy O.; Buckley, David; Adnams, Colleen M.; Hasken, Julie M.; Tabachnick, Barbara; Robinson, Luther K.; Manning, Melanie A.; Bezuidenhout, Heidre; Adam, Margaret P.; Jones, Kenneth L.; Seedat, Soraya; Parry, Charles D.H.; Hoyme, H. Eugene

    2017-01-01

    Background: Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods: Active case ascertainment focused on children with height, weight and/or head circumference ≤25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results: Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 89–129 per 1000 children. Total FASD affect 196–276 per 1000 or 20–28% of the children in these communities. Conclusions: Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions. PMID:28498341

  8. Maternal active or passive smoking causes oxidative stress in placental tissue.

    PubMed

    Aycicek, Ali; Varma, Mustafa; Ahmet, Koc; Abdurrahim, Kocyigit; Erel, Ozcan

    2011-05-01

    The aim of this study was to assess the influence of active and passive maternal smoking on placenta total oxidant/antioxidant status in term infants. The levels of cord blood total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were measured in samples of fetal placental tissue, cord blood, and the maternal peripheral blood serum and from 19 mothers who were active smokers, 19 who were passive smokers, and 22 who were nonsmokers (not exposed to active or passive smoking). The pregnancies were between 37 and 40 weeks' gestation, were uncomplicated, and the infants were delivered vaginally. Birth weight and head circumference in the active smokers were significantly (P < 0.001) lower than those in the controls. Placenta, cord blood, and the maternal peripheral TAC levels were significantly lower in the active smokers compared with the controls (P < 0.001), while TOS and OSI levels were significantly higher in the active and passive smokers than in the controls (P < 0.001). A positive significant correlation was found between active maternal smoking and placenta TOS and OSI levels (P < 0.016), and a significant negative correlation was found between number of cigarettes exposed to and birthweight and head circumference (P < 0.05). In conclusion, active or passive maternal smoking is associated with important alterations in oxidant and antioxidant balance in fetal placental tissue and causes potent oxidative stress.

  9. Anthropometry and head and neck cancer:a pooled analysis of cohort data

    PubMed Central

    Gaudet, Mia M; Kitahara, Cari M; Newton, Christina C; Bernstein, Leslie; Reynolds, Peggy; Weiderpass, Elisabete; Kreimer, Aimée R; Yang, Gong; Adami, Hans-Olov; Alavanja, Michael C; Beane Freeman, Laura E; Boeing, Heiner; Buring, Julie; Chaturvedi, Anil; Chen, Yu; D’Aloisio, Aimee A; Freedman, Michal; Gao, Yu-Tang; Gaziano, J Michael; Giles, Graham G; Håkansson, Niclas; Huang, Wen-Yi; Lee, I-Min; Linet, Martha S; MacInnis, Robert J; Park, Yikyung; Prizment, Anna; Purdue, Mark P; Riboli, Elio; Robien, Kim; Sandler, Dale P; Schairer, Catherine; Sesso, Howard D; Ou Shu, Xiao; White, Emily; Wolk, Alicja; Xiang, Yong-Bing; Zelenuich-Jacquotte, Anne; Zheng, Wei; Patel, Alpa V; Hartge, Patricia; Berrington de González, Amy; Gapstur, Susan M

    2015-01-01

    Background: Associations between anthropometry and head and neck cancer (HNC) risk are inconsistent. We aimed to evaluate these associations while minimizing biases found in previous studies. Methods: We pooled data from 1 941 300 participants, including 3760 cases, in 20 cohort studies and used multivariable-adjusted Cox proportional hazard regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of anthropometric measures with HNC risk overall and stratified by smoking status. Results: Greater waist circumference (per 5 cm: HR = 1.04, 95% CI 1.03–1.05, P-value for trend = <0.0001) and waist-to-hip ratio (per 0.1 unit: HR = 1.07, 95% CI 1.05–1.09, P-value for trend = <0.0001), adjusted for body mass index (BMI), were associated with higher risk and did not vary by smoking status (P-value for heterogeneity = 0.85 and 0.44, respectively). Associations with BMI (P-value for interaction = <0.0001) varied by smoking status. Larger BMI was associated with higher HNC risk in never smokers (per 5 kg/m2: HR = 1.15, 95% CI 1.06–1.24, P-value for trend = 0.0006), but not in former smokers (per 5 kg/m2: HR = 0.99, 95% CI 0.93–1.06, P-value for trend = 0.79) or current smokers (per 5 kg/m2: HR = 0.76, 95% CI 0.71–0.82, P-value for trend = <0.0001). Larger hip circumference was not associated with a higher HNC risk. Greater height (per 5 cm) was associated with higher risk of HNC in never and former smokers, but not in current smokers. Conclusions: Waist circumference and waist-to-hip ratio were associated positively with HNC risk regardless of smoking status, whereas a positive association with BMI was only found in never smokers. PMID:26050257

  10. Anthropometry and head and neck cancer:a pooled analysis of cohort data.

    PubMed

    Gaudet, Mia M; Kitahara, Cari M; Newton, Christina C; Bernstein, Leslie; Reynolds, Peggy; Weiderpass, Elisabete; Kreimer, Aimée R; Yang, Gong; Adami, Hans-Olov; Alavanja, Michael C; Beane Freeman, Laura E; Boeing, Heiner; Buring, Julie; Chaturvedi, Anil; Chen, Yu; D'Aloisio, Aimee A; Freedman, Michal; Gao, Yu-Tang; Gaziano, J Michael; Giles, Graham G; Håkansson, Niclas; Huang, Wen-Yi; Lee, I-Min; Linet, Martha S; MacInnis, Robert J; Park, Yikyung; Prizment, Anna; Purdue, Mark P; Riboli, Elio; Robien, Kim; Sandler, Dale P; Schairer, Catherine; Sesso, Howard D; Ou Shu, Xiao; White, Emily; Wolk, Alicja; Xiang, Yong-Bing; Zelenuich-Jacquotte, Anne; Zheng, Wei; Patel, Alpa V; Hartge, Patricia; Berrington de González, Amy; Gapstur, Susan M

    2015-04-01

    Associations between anthropometry and head and neck cancer (HNC) risk are inconsistent. We aimed to evaluate these associations while minimizing biases found in previous studies. We pooled data from 1,941,300 participants, including 3760 cases, in 20 cohort studies and used multivariable-adjusted Cox proportional hazard regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of anthropometric measures with HNC risk overall and stratified by smoking status. Greater waist circumference (per 5 cm: HR = 1.04, 95% CI 1.03-1.05, P-value for trend = <0.0001) and waist-to-hip ratio (per 0.1 unit: HR = 1.07, 95% CI 1.05-1.09, P-value for trend = <0.0001), adjusted for body mass index (BMI), were associated with higher risk and did not vary by smoking status (P-value for heterogeneity = 0.85 and 0.44, respectively). Associations with BMI (P-value for interaction = <0.0001) varied by smoking status. Larger BMI was associated with higher HNC risk in never smokers (per 5 kg/m(2): HR = 1.15, 95% CI 1.06-1.24, P-value for trend = 0.0006), but not in former smokers (per 5 kg/m(2): HR = 0.99, 95% CI 0.93-1.06, P-value for trend = 0.79) or current smokers (per 5 kg/m(2): HR = 0.76, 95% CI 0.71-0.82, P-value for trend = <0.0001). Larger hip circumference was not associated with a higher HNC risk. Greater height (per 5 cm) was associated with higher risk of HNC in never and former smokers, but not in current smokers. Waist circumference and waist-to-hip ratio were associated positively with HNC risk regardless of smoking status, whereas a positive association with BMI was only found in never smokers. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  11. Small Size at Birth or Abnormal Intrauterine Growth Trajectory: Which Matters More for Child Growth?

    PubMed Central

    Hutcheon, Jennifer A.; Jacobsen, Geir W.; Kramer, Michael S.; Martinussen, Marit; Platt, Robert W.

    2016-01-01

    Small size at birth is linked with lifelong adverse health implications. However, small size is only a proxy for the pathological process of interest, intrauterine growth restriction. We examined the extent to which information on intrauterine growth patterns improved prediction of childhood anthropometry, above and beyond birth weight alone. We obtained fetal weights estimated via serial ultrasound for 478 children in the Scandinavian Successive Small-for-Gestational-Age Births Study (1986–1988). Size at birth was classified using birth weight-for-gestational-age z scores and conditional fetal growth z scores (reflecting growth between 25 weeks’ gestation and birth) using internal references. Conditional z scores were also expressed as residuals of birth weight z scores. Growth measures were linked with age-5-years anthropometric characteristics using linear regression. In univariable analyses, conditional fetal growth z scores were positively associated with z scores for child height, body mass index, total skinfold thickness, and head circumference (β = 0.24 (95% confidence interval (CI): 0.18, 0.31), β = 0.16 (95% CI: 0.09, 0.23), β = 0.08 (95% CI: 0.01, 0.16), and β = 0.37 (95% CI: 0.22, 0.52), respectively). However, conditional z scores were highly correlated with birth weight z scores (r = 0.9), and residuals explained minimal additional variation in anthropometric factors (null coefficients; adjusted R2 increases < 0.01). Information on the intrauterine trajectory through which birth weight was attained provided little additional insight into child growth beyond that obtained from absolute size at birth. PMID:27257112

  12. Cervical isometric strength and range of motion of elite rugby union players: a cohort study

    PubMed Central

    2014-01-01

    Background Head and neck injury is relatively common in Rugby Union. Despite this, strength and range-of-motion characteristics of the cervical spine are poorly characterised. The aim of this study was to provide data on the strength and range-of-motion of the cervical spine of professional rugby players to guide clinical rehabilitation. Methods A cohort study was performed evaluating 27 players from a single UK professional rugby club. Cervical isometric strength and range-of-motion were assessed in 3 planes of reference. Anthropometric data was collected and multivariate regression modelling performed with a view to predicting cervical isometric strength. Results Largest forces were generated in extension, with broadly equal isometric side flexion forces at around 90% of extension values. The forwards generated significantly more force than the backline in all parameters bar flexion. The forwards had substantially reduced cervical range-of-motion and larger body mass, with differences observed in height, weight, neck circumference and chest circumference (p < 0.002). Neck circumference was the sole predictor of isometric extension (adjusted R2 = 30.34). Conclusion Rehabilitative training programs aim to restore individuals to pre-injury status. This work provides reference ranges for the strength and range of motion of the cervical spine of current elite level rugby players. PMID:25120916

  13. Cervical isometric strength and range of motion of elite rugby union players: a cohort study.

    PubMed

    Hamilton, David F; Gatherer, Don

    2014-01-01

    Head and neck injury is relatively common in Rugby Union. Despite this, strength and range-of-motion characteristics of the cervical spine are poorly characterised. The aim of this study was to provide data on the strength and range-of-motion of the cervical spine of professional rugby players to guide clinical rehabilitation. A cohort study was performed evaluating 27 players from a single UK professional rugby club. Cervical isometric strength and range-of-motion were assessed in 3 planes of reference. Anthropometric data was collected and multivariate regression modelling performed with a view to predicting cervical isometric strength. Largest forces were generated in extension, with broadly equal isometric side flexion forces at around 90% of extension values. The forwards generated significantly more force than the backline in all parameters bar flexion. The forwards had substantially reduced cervical range-of-motion and larger body mass, with differences observed in height, weight, neck circumference and chest circumference (p < 0.002). Neck circumference was the sole predictor of isometric extension (adjusted R(2) = 30.34). Rehabilitative training programs aim to restore individuals to pre-injury status. This work provides reference ranges for the strength and range of motion of the cervical spine of current elite level rugby players.

  14. On the accuracy of the Head Impact Telemetry (HIT) System used in football helmets.

    PubMed

    Jadischke, Ron; Viano, David C; Dau, Nathan; King, Albert I; McCarthy, Joe

    2013-09-03

    On-field measurement of head impacts has relied on the Head Impact Telemetry (HIT) System, which uses helmet mounted accelerometers to determine linear and angular head accelerations. HIT is used in youth and collegiate football to assess the frequency and severity of helmet impacts. This paper evaluates the accuracy of HIT for individual head impacts. Most HIT validations used a medium helmet on a Hybrid III head. However, the appropriate helmet is large based on the Hybrid III head circumference (58 cm) and manufacturer's fitting instructions. An instrumented skull cap was used to measure the pressure between the head of football players (n=63) and their helmet. The average pressure with a large helmet on the Hybrid III was comparable to the average pressure from helmets used by players. A medium helmet on the Hybrid III produced average pressures greater than the 99th percentile volunteer pressure level. Linear impactor tests were conducted using a large and medium helmet on the Hybrid III. Testing was conducted by two independent laboratories. HIT data were compared to data from the Hybrid III equipped with a 3-2-2-2 accelerometer array. The absolute and root mean square error (RMSE) for HIT were computed for each impact (n=90). Fifty-five percent (n=49) had an absolute error greater than 15% while the RMSE was 59.1% for peak linear acceleration. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. The effect of paternal age on offspring intelligence and personality when controlling for paternal trait level.

    PubMed

    Arslan, Ruben C; Penke, Lars; Johnson, Wendy; Iacono, William G; McGue, Matt

    2014-01-01

    Paternal age at conception has been found to predict the number of new genetic mutations. We examined the effect of father's age at birth on offspring intelligence, head circumference and personality traits. Using the Minnesota Twin Family Study sample we tested paternal age effects while controlling for parents' trait levels measured with the same precision as offspring's. From evolutionary genetic considerations we predicted a negative effect of paternal age on offspring intelligence, but not on other traits. Controlling for parental intelligence (IQ) had the effect of turning an initially positive association non-significantly negative. We found paternal age effects on offspring IQ and Multidimensional Personality Questionnaire Absorption, but they were not robustly significant, nor replicable with additional covariates. No other noteworthy effects were found. Parents' intelligence and personality correlated with their ages at twin birth, which may have obscured a small negative effect of advanced paternal age (<1% of variance explained) on intelligence. We discuss future avenues for studies of paternal age effects and suggest that stronger research designs are needed to rule out confounding factors involving birth order and the Flynn effect.

  16. Neonatal stretched penile length: relationship with gestational maturity and anthropometric parameters at birth.

    PubMed

    Bhakhri, Bhanu Kiran; Meena, Shyam Sundar; Rawat, Mayank; Datta, Vikram

    2015-02-01

    It is inappropriate to use universal cut-off points to interpret stretched penile length (SPL) measurements in newborns with variable body dimensions. To assess neonatal SPL on the basis of gestational maturity and anthropometric parameters at birth. A cross-sectional observational study of SPL was conducted on stable newborns at a referral teaching hospital in north India between January and June 2012. Gestational maturity, SPL and anthropometric parameters (weight, length, head circumference and foot length) were recorded within 24 hours of birth. Variation of SPL in relation to gestational age and anthropometric parameters were evaluated using multiple linear regression models. The equation using lower confidence limits of 95% confidence intervals for the correlation coefficients provides cut-off points to define a small penis. Data from 1249 newborns demonstrated that penile growth follows the pattern of increase in body dimensions in newborns. SPL can be predicted best in relation to body and foot length taken together. SPL should be interpreted in relation to anthropometric parameters in newborns, particularly body and foot length.

  17. New aids for the non-invasive prenatal diagnosis of achondroplasia: dysmorphic features, charts of fetal size and molecular confirmation using cell-free fetal DNA in maternal plasma.

    PubMed

    Chitty, L S; Griffin, D R; Meaney, C; Barrett, A; Khalil, A; Pajkrt, E; Cole, T J

    2011-03-01

    To improve the prenatal diagnosis of achondroplasia by constructing charts of fetal size, defining frequency of sonographic features and exploring the role of non-invasive molecular diagnosis based on cell-free fetal deoxyribonucleic acid (DNA) in maternal plasma. Data on fetuses with a confirmed diagnosis of achondroplasia were obtained from our databases, records reviewed, sonographic features and measurements determined and charts of fetal size constructed using the LMS (lambda-mu-sigma) method and compared with charts used in normal pregnancies. Cases referred to our regional genetics laboratory for molecular diagnosis using cell-free fetal DNA were identified and results reviewed. Twenty-six cases were scanned in our unit. Fetal size charts showed that femur length was usually on or below the 3(rd) centile by 25 weeks' gestation, and always below the 3(rd) by 30 weeks. Head circumference was above the 50(th) centile, increasing to above the 95(th) when compared with normal for the majority of fetuses. The abdominal circumference was also increased but to a lesser extent. Commonly reported sonographic features were bowing of the femora, frontal bossing, short fingers, a small chest and polyhydramnios. Analysis of cell-free fetal DNA in six pregnancies confirmed the presence of the c.1138G > A mutation in the FGRF3 gene in four cases with achondroplasia, but not the two subsequently found to be growth restricted. These data should improve the accuracy of diagnosis of achondroplasia based on sonographic findings, and have implications for targeted molecular confirmation that can reliably and safely be carried out using cell-free fetal DNA. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

  18. Anthropometric study with emphasis on hand and foot measurements in the Prader-Willi syndrome: sex, age and chromosome effects.

    PubMed

    Butler, M G; Haynes, J L; Meaney, F J

    1991-01-01

    Age, sex and chromosome effects on weight, height, sitting height, three head dimensions, and five hand and three foot measurements were analyzed from 57 patients (35 males and 22 females) with the Prader-Willi syndrome (PWS). No significant differences were observed in anthropometric data between PWS patients with the 15q chromosome deletion and those with normal chromosomes. Preschool children were found to have dolichocephaly, while hand and foot measurements, stature and sitting height were within normal range, although foot size was smaller than hand size in females when compared with PWS males. However, anthropometric measurements, excluding weight, head length and ankle breadth, were less than -2 SD in adult patients. Abnormal growth patterns apparently exist with significant negative correlations with age, particularly in PWS males, for height, sitting height, head circumference, and hand and foot measurements, but a significant positive correlation for weight was found in patients below 10 years of age.

  19. Cardiovascular fitness moderates the relations between estimates of obesity and physical self-perceptions in rural elementary school students.

    PubMed

    Mitchell, Nathanael G; Moore, Justin B; Bibeau, Wendy S; Rudasill, Kathleen M

    2012-02-01

    Levels of physical activity decline throughout childhood. Children's physical self-perceptions have been found to relate to their physical activity. Understanding the relationships among physical self-perceptions, obesity, and physical activity could have important implications for interventions in children. The current study investigated the moderating effect of cardiovascular fitness (CVF, heart rate recovery from a 3-minute step test) on the relationship between obesity (BMI, waist circumference) and physical self-perceptions (athletic competence, physical appearance) in 104 fourth- and fifth-grade children from a small rural community. Hierarchical regression analyses indicated that CVF moderated the relations between BMI and waist circumference on athletic competence. For children with lower fitness, higher waist circumference was associated with lower athletic competence, while for children with higher fitness levels, higher BMI was associated with higher athletic competence. Results also indicated that both BMI and waist circumference were negatively related to physical appearance. CVF moderated these relations such that only children with lower fitness, greater BMI and waist circumference was associated with poorer physical appearance scores. Implications include the need for support of fitness programs to promote psychological well-being and to investigate the relationship between obesity and physical self-perceptions within the context of fitness.

  20. A study of mid-arm and chest circumferences as predictors of low birthweight.

    PubMed

    Rogo, K; Nyagudi, O; Ferguson, A

    1991-02-01

    Nine hundred ninety-nine newborns were examined in order to determine the relationship between birthweight and mid-arm and chest circumstances. An early neonatal mortality rate of 51/1000 was recorded, being much higher for preterm (301/1000) than term babies (2.5/1000). Both mid-arm and chest circumference showed highly significant correlations with birthweight (r = 0.872, P less than 0.0001 and r = 0.918, P less than 0.0001, respectively). The correlation between weight and chest circumstances was upheld even for very small babies.

  1. Analysis of the variation in OCT measurements of a structural bottle neck for eye-brain transfer of visual information from 3D-volumes of the optic nerve head, PIMD-Average [02π

    NASA Astrophysics Data System (ADS)

    Söderberg, Per G.; Malmberg, Filip; Sandberg-Melin, Camilla

    2016-03-01

    The present study aimed to analyze the clinical usefulness of the thinnest cross section of the nerve fibers in the optic nerve head averaged over the circumference of the optic nerve head. 3D volumes of the optic nerve head of the same eye was captured at two different visits spaced in time by 1-4 weeks, in 13 subjects diagnosed with early to moderate glaucoma. At each visit 3 volumes containing the optic nerve head were captured independently with a Topcon OCT- 2000 system. In each volume, the average shortest distance between the inner surface of the retina and the central limit of the pigment epithelium around the optic nerve head circumference, PIMD-Average [02π], was determined semiautomatically. The measurements were analyzed with an analysis of variance for estimation of the variance components for subjects, visits, volumes and semi-automatic measurements of PIMD-Average [0;2π]. It was found that the variance for subjects was on the order of five times the variance for visits, and the variance for visits was on the order of 5 times higher than the variance for volumes. The variance for semi-automatic measurements of PIMD-Average [02π] was 3 orders of magnitude lower than the variance for volumes. A 95 % confidence interval for mean PIMD-Average [02π] was estimated to 1.00 +/-0.13 mm (D.f. = 12). The variance estimates indicate that PIMD-Average [02π] is not suitable for comparison between a onetime estimate in a subject and a population reference interval. Cross-sectional independent group comparisons of PIMD-Average [02π] averaged over subjects will require inconveniently large sample sizes. However, cross-sectional independent group comparison of averages of within subject difference between baseline and follow-up can be made with reasonable sample sizes. Assuming a loss rate of 0.1 PIMD-Average [02π] per year and 4 visits per year it was found that approximately 18 months follow up is required before a significant change of PIMDAverage [02π] can be observed with a power of 0.8. This is shorter than what has been observed both for HRT measurements and automated perimetry measurements with a similar observation rate. It is concluded that PIMDAverage [02π] has the potential to detect deterioration of glaucoma quicker than currently available primary diagnostic instruments. To increase the efficiency of PIMD-Average [02π] further, the variation among visits within subject has to be reduced.

  2. Implementing the INTERGROWTH-21st fetal growth standards in France: a 'flash study' of the College Français d'Echographie Foetale (CFEF).

    PubMed

    Stirnemann, J J; Fries, N; Bessis, R; Fontanges, M; Mangione, R; Salomon, L J

    2017-04-01

    To assess potential differences in fetal size between the French population and the international population from the INTERGROWTH-21 st (IG-21 st ) Project and to measure the impact of switching to the IG-21 st reference standards for fetal size. This was a nationwide cross-sectional study of fetal ultrasound biometry. Low-risk singleton pregnancies were recruited prospectively within the network of the national French College of Fetal Ultrasound, CFEF, over a 6-week period. Further selection was performed based on the criteria of the IG-21 st Project in order to obtain a comparable population. Head circumference (HC) was used as the main fat-free skeletal measure of growth for comparison of French fetal size with that of the IG-21 st population. The impact of switching to the IG-21 st fetal growth standards was quantified by comparing Z-scores calculated using the IG-21 st standards with those calculated using locally derived reference ranges for HC, abdominal circumference (AC) and femur length (FL). Following selection, 4858 cases were analyzed. The distribution of HC demonstrated clear similarity between our French population and the IG-21 st population: our observed centile curves closely matched those of IG-21 st and the Z-scores were close to 0 across gestational age. The IG-21 st standards performed as well as did locally derived charts in terms of screening for small-for-gestational age by AC, while they identified significantly fewer small FL values than were expected and than did the locally derived charts. Under strict selection criteria, fetal size in France is similar to that of the international population used in the IG-21 st Project. The discrepancies in FL are unlikely to impact on prenatal management. Therefore, switching from locally derived reference ranges to the IG-21 st standards appears to be a safe option. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  3. Longitudinal analysis of head and somatic growth in fetuses with congenital heart defects.

    PubMed

    Turan, Sifa; Rosenbloom, Joshua I; Hussein, Mostafa; Berg, Christoph; Gembruch, Ulrich; Baschat, Ahmet A; Turan, Ozhan M

    2017-02-01

    Fetal head and somatic growth dynamics differs in fetuses with congenital heart defects (CHD). We longitudinally characterized fetal head and somatic growth in relation to the type of CHD. Four hundred eleven exams from isolated CHD were compared with 1,219 controls. Head and somatic growth was assessed using head circumference (HC), brain volume (BrV = 1/6 × π × (HC/π)3)/2), fetal cephalization index (FCI = BrV/[estimated fetal weight]), and growth percentile. Umbilical and middle cerebral artery Doppler indices were obtained. CHD were grouped as: (1) d-transposition of great arteries (n = 11); (2) left ventricular outflow tract obstruction with retrograde isthmic flow (n = 18); (3) left ventricular outflow tract obstruction with antegrade isthmic flow (n = 16); (4) pulmonary outflow tract obstructions (n = 22). The smallest head size was seen in group 1. Growth asymmetry was diagnosed in group 2. Brain sparing was seen in groups 2 and 4 (p < 0.0001). HC and BrV percentiles decreased with advancing gestational age (p < 0.001) in group 2, and a significant drop was observed around 28 weeks. d-Transposition of great arteries and left-sided CHD leading to isthmic blood flow reversal are associated with delayed head growth. Prenatal evaluation of central hemodynamics in CHD may be contributive for predicting neurodevelopmental risks in CHD and help directing prenatal interventions. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:96-104, 2017. © 2016 Wiley Periodicals, Inc.

  4. Recombinant EphB4-HSA Fusion Protein and Pembrolizumab, MK-3475

    ClinicalTrials.gov

    2018-03-30

    ALK Gene Mutation; BRAF Gene Mutation; EGFR Gene Mutation; Head and Neck Squamous Cell Carcinoma; Metastatic Head and Neck Carcinoma; Recurrent Head and Neck Carcinoma; Recurrent Non-Small Cell Lung Carcinoma; ROS1 Gene Mutation; Stage III Non-Small Cell Lung Cancer; Stage IIIA Non-Small Cell Lung Cancer; Stage IIIB Non-Small Cell Lung Cancer; Stage IV Non-Small Cell Lung Cancer

  5. Ultrasound predictors of neonatal outcome in intrauterine growth restriction.

    PubMed

    Craigo, S D; Beach, M L; Harvey-Wilkes, K B; D'Alton, M E

    1996-11-01

    Our purpose was to assess the value of commonly performed ultrasound parameters in predicting neonatal outcome of fetuses with intrauterine growth restriction (IUGR). One hundred twenty-seven patients were identified on ultrasound examination to have IUGR. Estimated weight percentile, amniotic fluid volume, umbilical artery Doppler velocimetry, and head circumference/abdominal circumference ratio were compared with neonatal outcome. Thirty infants had severely adverse courses. The degree of growth restriction was strongly associated with adverse outcome and neonatal death. Umbilical artery Doppler waveforms with absent or reverse end-diastolic flow were predicted of neonatal death, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and adverse outcome in general. Oligohydramnios was predictive of adverse outcome and neonatal death. Logistic regression also showed that absent or reverse end-diastolic flow and oligohydramnios were independent predictors of adverse outcome. Ultrasound findings of low estimated weight percentile, absent or reverse end-diastolic umbilical blood flow, and oligohydramnios are independent predictors of adverse neonatal outcome of growth restricted fetuses.

  6. Growth and metabolic response of premature infants fed whey- or casein-dominant formulas after hospital discharge.

    PubMed

    Bernbaum, J C; Sasanow, S R; Churella, H R; Daft, A

    1989-10-01

    We conducted a double-blind, randomized study to test the hypothesis that a whey-dominant formula permits a growth and metabolic advantage over a casein-dominant formula in preterm infants after hospital discharge. Nineteen low birth weight infants were studied for 6 months from the time of discharge. Ten received a casein-dominant formula, and nine received a whey-dominant formula. Growth (weight, length, head circumference, mid-arm circumference, and skin-fold thickness), biochemical measurements (alkaline phosphatase activity, acid-base status, and hemoglobin, serum total protein, albumin, and urea nitrogen levels), and quantity of formula intake did not differ significantly between the groups over a 6-month study period. Serum transthyretin and urea nitrogen concentrations differed significantly between the two feeding groups at the day of entry into the study only. The results indicate that, after hospital discharge, premature infants fed a whey-dominant formula do not differ in growth or biochemical measurements from those fed a casein-dominant formula.

  7. Endochondral gigantism: a newly recognized skeletal dysplasia with pre- and postnatal overgrowth and endocrine abnormalities.

    PubMed

    Schmidt, Heinrich; Kammer, Birgit; Grasser, Monika; Enders, Angelika; Rost, Imma; Kiess, Wieland

    2007-08-15

    We report on a 3-year-old male, born at 34 weeks of gestation, with marked pre- and postnatal overgrowth, birth weight of 6,600 g, length of 61 cm, and head circumference of 38.5 cm. A striking phenotype was recorded at birth, which became more evident during the follow-up period. He had macrobrachycephaly, facial abnormalities, small thoracic cage, long trunk, deformed spine, rhizomelia, large hands and feets, absent subcutaneous fat, small umbilical hernia, inguinal hernias, and large joints with mild contractures. Hypoglycemic episodes and obstructive apnea complicated the neonatal period. During follow-up, overgrowth continued with a height of 146 cm (+11.65 SDS) and a weight of 39 kg (BMI 18.3 kg/m(2)) at 3.5 years. Endocrinological work-up disclosed extremely low levels of growth hormone, insulin-like growth factors, and insulin. What makes our patient unique is the association of marked prenatal overgrowth; unusual phenotype; skeletal dysplasia caused by accelerated endochondral ossification resulting in cartilage hyperplasia of the skull base and spine, and postnatal gigantism; and complete absence of subcutaneous fat. Other well-known overgrowth syndromes were excluded. We hypothesize that autocrine/paracrine growth factors could be the cause of excessive endochondral ossification. Alternately, activating mutations in transcription factors involved in both growth and endocrine/metabolic homeostasis could be responsible for this unusual phenotype. (c) 2007 Wiley-Liss, Inc.

  8. Fetal sex modifies effects of prenatal stress exposure and adverse birth outcomes.

    PubMed

    Wainstock, Tamar; Shoham-Vardi, Ilana; Glasser, Saralee; Anteby, Eyal; Lerner-Geva, Liat

    2015-01-01

    Prenatal maternal stress is associated with pregnancy complications, poor fetal development and poor birth outcomes. Fetal sex has also been shown to affect the course of pregnancy and its outcomes. The aim of this study was to evaluate whether fetal sex modifies the association between continuous exposure to life-threatening rocket attack alarms and adverse pregnancy outcomes. A retrospective cohort study was conducted in which the exposed group was comprised of 1846 women exposed to rocket-attack alarms before and during pregnancy. The unexposed group, with similar sociodemographic characteristics, delivered during the same period of time at the same medical center, but resided out of rocket-attack range. Multivariable models for each gender separately, controlling for possible confounders, evaluated the risk associated with exposure for preterm births (PTB), low birthweight (LBW), small for gestational age and small head circumference (HC). In both univariable and multivariable analyses exposure status was a significant risk factor in female fetuses only: PTB (adj. OR = 1.43; 1.04-1.96), LBW (adj. OR = 1.41; 1.02-1.95) and HC < 31 cm (adj. OR = 1.78; 1.11-2.88). In addition, regarding all adverse outcomes, the male-to-female ratio was higher in the exposed group than in the unexposed group. The findings support the hypothesis that male and female fetuses respond differentially to chronic maternal stress.

  9. Maternal breast and body symmetry in pregnancy and offspring condition.

    PubMed

    Żelaźniewicz, Agnieszka; Pawłowski, Bogusław

    2018-05-01

    Fluctuating asymmetry (FA) is hypothesized to reflect the level of an individual's developmental instability, and therefore genetic quality. As a potential signal of biological condition, female body (including breast) symmetry was shown to be perceived as more attractive in mate choice context. If symmetry reflects a woman's genetic quality, it is possible that FA, similarly to other maternal anthropometric cues of biological condition (e.g., body height or waist-to-hip ratio), may be also related to her offspring condition. To test this, breast and body asymmetry was measured in 93 pregnant women in the 1st, 2nd, and 3rd pregnancy trimester. Child's birth weight, length, chest and head circumference, information on the Apgar score, congenital malformations, and birth complications was taken from hospital records. The relationships between offspring birth characteristics and maternal breast FA and body FA were analyzed separately, controlled for a child's sex and maternal weight in pregnancy. Breast asymmetry was not a predictor of a child's neonatal condition assessed from morphological parameters at birth. Asymmetry of maternal non-ornamental body characteristcs, commonly used to assess body FA, correlated negatively with a child's weight, head and chest circumference at birth. A composite asymmetry index of eight body traits, non-sexually selected characteristics, seems to be a better predictor of a woman's ability to invest in fetus during pregnancy than breast asymmetry, sexual ornamentation that is perceived as a signal of a woman's attractiveness and biological condition. © 2018 Wiley Periodicals, Inc.

  10. Associations of Maternal Light/Moderate Leisure-Time Walking and Yoga With Offspring Birth Size.

    PubMed

    Badon, Sylvia E; Littman, Alyson J; Chan, K C Gary; Williams, Michelle A; Enquobahrie, Daniel A

    2018-06-01

    Although perinatal walking and yoga have been associated with decreased risks of pregnancy complications, associations with offspring birth size have been inconsistent. We investigated associations of prepregnancy and early pregnancy leisure-time light/moderate walking and yoga practice with birth size. Study participants (N = 3687) reported leisure-time physical activity duration (hours per week) in the year before pregnancy and early pregnancy. Birth size was abstracted from medical records. Regression was used to determine mean differences in birth weight, head circumference, and ponderal index. Interaction terms were used to assess effect modification by offspring sex. About one-third of women reported light/moderate leisure-time walking and about 10% reported yoga practice. Women in the highest tertile for prepregnancy (mean: 2.9 h/wk; range: 1.4-20 h/wk) or early pregnancy (mean: 5.9 h/wk; range: 3.1-24 h/wk) light/moderate walking had offspring with 0.9 and 1.5 kg/m 3 greater ponderal index (95% confidence interval, 0.3 to 1.4 and 0.7 to 2.4, respectively) compared with women who reported no light/moderate walking in the same time period. Light/moderate walking was not associated with birth weight or head circumference. Yoga practice was not associated with birth size. Associations were similar by offspring sex. Light/moderate leisure-time walking may be associated with greater offspring ponderal index.

  11. Head circumference at birth and exposure to tobacco, alcohol and illegal drugs during early pregnancy.

    PubMed

    Ortega-García, Juan A; Gutierrez-Churango, Jorge E; Sánchez-Sauco, Miguel F; Martínez-Aroca, Miguel; Delgado-Marín, Juan L; Sánchez-Solis, M; Parrilla-Paricio, J J; Claudio, Luz; Martínez-Lage, Juan F

    2012-03-01

    We aimed to assess the effects of exposure to tobacco smoke, alcohol and illegal drugs during early pregnancy on the head circumference (HC) at birth of otherwise healthy neonates. A follow-up study from the first trimester of pregnancy to birth was carried out in 419 neonates. An environmental reproductive health form was used to record data of substance exposure obtained during the first obstetric visit at the end of the first trimester. A multiple linear regression model was created for this purpose. Alcohol intake during pregnancy and medical ionizing radiation exposure were the most significant predictors of HC. The mothers' alcohol consumption increased with the mothers' and fathers' education level, net family income and fathers' alcohol consumption. In contrast, maternal smoking decreased with increasing mothers' and fathers' education level and net family income. About 13% of the surveyed embryos were exposed to illegal drugs. Mild to moderate alcohol consumption diminishes the at-birth HC of theoretically healthy newborns in a linear form. There was no threshold dose. We perceived a need for increasing the awareness, and for training, of health care professionals and parents, in regard to risks of alcohol consumption and for recommending abstinence of these substances in both parents during pregnancy. It should also be remembered that medical ionizing radiation should be performed only during the first half of the cycle in fertile women. We think that our study has an important social impact as it affords data for implementing policies for promoting "healthy pregnancies".

  12. Association of Fetal Abdominal–Head Circumference Size Difference With Shoulder Dystocia: A Multicenter Study

    PubMed Central

    Endres, Loraine; DeFranco, Emily; Conyac, Theresa; Adams, Marci; Zhou, Ying; Magner, Kristin; O'Rourke, Luke; Bernhard, Kiley A.; Siddiqui, Danish; McCormick, Anna; Abramowicz, Jacques; Merkel, Ronald; Jawish, Rana; Habli, Mounira; Floman, Alissa; Magann, Everett F.; Chauhan, Suneet P.

    2015-01-01

    Objective This study aims to determine if shoulder dystocia is associated with a difference in the fetal abdominal (AC) to head circumference (HC) of 50 mm or more noted on antenatal ultrasound. Study Design A multicenter matched case–control study was performed comparing women who had shoulder dystocia to controls who did not. Women with vaginal births of live born nonanomalous singletons ≥ 36 weeks of gestation with an antenatal ultrasound within 4 weeks of delivery were included. Controls were matched for gestational age, route of delivery, and diabetes status. Results We identified 181 matched pairs. Only 5% of the fetuses had an AC to HC of ≥ 50 mm. The proportion of AC to HC difference of ≥ 50 mm was significantly higher in shoulder dystocia cases (8%) than controls (1%, p = 0.002). With multivariate regression, the three significant factors associated with shoulder dystocia were AC to HC ≥ 50 mm (odds ratio [OR], 7.3; confidence interval [CI], 1.6–33.3; p = 0.010), femur length (OR, 1.1; CI, 1.0–1.2; p = 0.002), and induced labor (OR, 1.8; CI, 1.1–3.1; p = 0.027). Conclusion A prenatal ultrasound finding of a difference in AC to HC of ≥ 50 mm while uncommon is associated with shoulder dystocia. PMID:26495163

  13. The Impact of Gender on Anthropometric Measures of Twins.

    PubMed

    Jahanfar, Shayesteh; Lim, Kenneth

    2016-12-01

    Literature suggests that male hormones influence fetal growth in singleton pregnancies. We hypothesized that the same phenomenon is seen in twin gestations. (1) to identify the impact of gender associated with fetal birth weight, head circumference, and birth length for twins; (2) to examine the effect of gender on standardized fetal growth at birth, according to gestational age and birth order; (3) to examine the effect of gender on placenta weight and dimensions. This was a population-based retrospective cohort study of twins (4,368 twins, 2,184 pairs) born in British Columbia, Canada from 2000-2010. We excluded twins with stillbirth, congenital anomalies, and those delivered with cesarean section. We also controlled for confounding factors, including birth order, gestational age, maternal anthropometric measures, maternal smoking habits, and obstetric history. A subsample of this population was analyzed from Children and Women Hospital to obtain chorionicity information. Male-male twins were heavier than male-females and female-female twin pairs (p=.01). Within sex-discordant twin pairs, males were also heavier than females (p=.01). Regression analysis suggested that gender affects birth weight independent of birth order and gestational age. Other newborn anthropometric measures were not found to be dependent on gender. In analyzing a subsample with chorionicity data, birth weight was the only anthropometric measure that was both statistically and clinically affected by sex, even after adjustment for gestational age, chorionicity, birth order, and maternal age. Birth weight was affected by gender while head circumference and birth length were not.

  14. Association between sonographic measurement of fetal head circumference and labor outcome.

    PubMed

    Aviram, Amir; Yogev, Yariv; Bardin, Ron; Hiersch, Liran; Wiznitzer, Arnon; Hadar, Eran

    2016-01-01

    To evaluate the association between sonographically measured head circumference (HC) and labor outcome. In a retrospective study at a tertiary medical center in Israel, data were reviewed for all term singleton deliveries between July 2007 and December 2012 with HC measurements up to 7days before delivery. HC was compared between women with operative vaginal delivery (OVD) or cesarean delivery for prolonged second stage and those with normal vaginal delivery. The impact of HC above the 75th percentile on pregnancy outcome was analyzed. The study included 2351 women, of whom 2045 (87.0%) had a normal vaginal delivery, 259 (11.0%) underwent OVD, and 47 (2.0%) cesarean. Each 10mm increase in HC was associated with increased risk for obstetric intervention because of a prolonged second stage (adjusted odds ratio [aOR] 1.26; 95% confidence interval [CI] 1.08-1.46). HC above the 75th percentile was independently associated with increased odds of OVD (aOR 1.77; 95% CI 1.30-2.41), 1-minute Apgar score less than 7 (aOR 2.91; 95% CI 1.50-5.66), and neonatal asphyxia (aOR 2.19; 95% CI 1.02-4.71). Term HC above the 75th percentile was associated with increased rates of obstetric interventions because of a prolonged second stage and might be associated with neonatal asphyxia. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Implementing Routine Head Circumference Measurements in Addis Ababa, Ethiopia: Means and Challenges.

    PubMed

    Eriksen, Arvid A; Johnsen, Joakim S; Tennøe, Anders H; Tirsit, Abenezer; Laeke, Tsegazeab; Amare, Ephrem B; Wester, Knut

    2016-07-01

    A substantial number of infants in Ethiopia suffer from hydrocephalus. Neurosurgical expertise has until recently been virtually nonexistent in the country; however, since 2006, a neurosurgery training program has been established in Addis Ababa, where hydrocephalus surgery now is performed in 3 hospitals. Our experience is that hydrocephalus is diagnosed and treatment is too late to avoid severe brain damage. Introducing routine head circumference (HC) measurements can ease the detection of hydrocephalus and thus lead to earlier diagnosis, thereby reducing the brain damage caused by the condition. The present pilot project had two major aims: to get the process of implementation started and to gain experience with how this implementation best can be achieved. We educated and encouraged the nurse staff members of 12 randomly selected health (mother and child) clinics in Addis Ababa in performing HC measurements, using a recently developed Ethiopian HC chart. Much of the work was related to follow-up. A local Ethiopian healthcare worker was employed to lead the follow-up and to continue the implementation in the remaining 14 clinics. During our attempted implementation of routine HC measuring, we encountered a line of administrational, cultural, infrastructural, and didactic problems and challenges, which are discussed. The experience we have gained during this pilot project will be used in further development and implementation of routine HC measuring throughout Ethiopia. These experiences may be of interest and use to others wanting to introduce similar routines in low-income countries. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Sex differences in the effects of prenatal lead exposure on birth outcomes.

    PubMed

    Wang, Ju; Gao, Zhen-Yan; Yan, Jin; Ying, Xiao-Lan; Tong, Shi-Lu; Yan, Chong-Huai

    2017-06-01

    Studies on the associations between prenatal lead exposure and birth outcomes have been inconsistent, and few data are available on the sex differences in these associations. We measured the cord blood lead levels of newborns in Shanghai and determined their associations with birth outcomes, which included birth weight, birth length, head circumference, and the ponderal index, in the total sample and within sex subgroups. A total of 1009 mother-infant pairs were enrolled from 10 hospitals in Shanghai between September 2008 and October 2009. The geometric mean of the cord blood lead concentrations was 4.07 μg/dl (95% CI: 3.98-4.17 μg/dl). A significant inverse association was found between cord blood lead levels and head circumference only in the male subgroup, and increasing cord blood lead levels were related to significant decreases in the ponderal index only in females. The birth weights of the male infants were positively associated with cord blood lead levels; after adjusting for the maternal intake frequency of preserved eggs, the estimated mean differences in birth weights decreased by 11.7% for each 1-unit increase in the log10-transformed cord blood lead concentration. Our findings suggest that prenatal lead exposure may have sex-specific effects on birth outcomes and that maternal dietary intake may be a potential confounder in these relationships. Further studies on this topic are highly warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Ten-year changes in anthropometric characteristics of elderly Europeans.

    PubMed

    de Groot, C P G M; Enzi, G; Matthys, C; Moreiras, O; Roszkowski, W; Schroll, M

    2002-01-01

    Assess longitudinal (10-y) changes in height, body weight and circumferences in elderly Europeans. Longitudinal assessments including baseline measurements taken in 1988/1989 which were repeated in 1993 (follow-up) and in 1999 (Finale). Longitudinal data were collected in nine European research towns: Hamme/Belgium (H/B), Roskilde/Denmark (R/DK), Haguenau/France (H/F), Romans/France (R/F), Padua/Italy (P/I), Culemborg/the Netherlands (C/NL), Vila Franca de Xira/Portugal (V/P), Betanzos/Spain (B/E), Yverdon/Switzerland (Y/CH). Using standardised methodologies data were collected from a random stratified sample of elderly men and women born between 1913 and 1918 including a total of 662 subjects in 1999. On average stature had decreased by 1,5-2 cm. Mean weight changed by -2.6 kg to - 4.2 kg in only three towns. An increase of at least 5 kg of body weight had taken place in 13 % of both men and women whereas 23 % of men and 27 % women had lost at least 5 kg of their baseline weight. Such weight loss over the first 4 years of follow-up was associated with higher mortality rates in men (crude RR 2.2, p<0.0001). Serial changes in arm circumference were small but waist circumference had increased by 3-4 cm. Whilst small-to-modest average changes in height, body weight and circumferences emerged over SENECA's 10-year follow-up period, considerable gains and losses of body weight had occurred in a significant proportion of the SENECA populations, whereby early weight loss might be predictive of subsequent survival.

  18. Clinical and Pathologic Studies of Patients Undergoing Treatment With EGFR Inhibitors

    ClinicalTrials.gov

    2016-07-20

    Anal, Colon, and Rectal Cancers; Head and Neck Cancer; Lung Cancer; Colon Cancer; Colonic Neoplasms; Colorectal Neoplasms; Colon/Rectal Cancer; Colon/Rectal Cancer Colon Cancer; Colon/Rectal Cancer Rectal Cancer; Colon/Rectal Cancer Anal Cancer; Head and Neck Cancers; Head and Neck Cancers Lip; Head and Neck Cancers Oral Cavity; Head and Neck Cancers Nasopharynx; Head and Neck Cancers Oropharynx; Head and Neck Cancers Hypopharynx; Head and Neck Cancers Larynx; Head and Neck Cancers Trachea; Lung Cancer Non-Small Cell Cancer (NSCLC); Lung Cancer Small Cell Lung Cancer (SCLC)

  19. Head-and-face anthropometric survey of Chinese workers.

    PubMed

    Du, Lili; Zhuang, Ziqing; Guan, Hongyu; Xing, Jingcai; Tang, Xianzhi; Wang, Limin; Wang, Zhenglun; Wang, Haijiao; Liu, Yuewei; Su, Wenjin; Benson, Stacey; Gallagher, Sean; Viscusi, Dennis; Chen, Weihong

    2008-11-01

    Millions of workers in China rely on respirators and other personal protective equipment to reduce the risk of injury and occupational diseases. However, it has been >25 years since the first survey of facial dimensions for Chinese adults was published, and it has never been completely updated. Thus, an anthropometric survey of Chinese civilian workers was conducted in 2006. A total of 3000 subjects (2026 males and 974 females) between the ages of 18 and 66 years old was measured using traditional techniques. Nineteen facial dimensions, height, weight, neck circumference, waist circumference and hip circumference were measured. A stratified sampling plan of three age strata and two gender strata was implemented. Linear regression analysis was used to evaluate the possible effects of gender, age, occupation and body size on facial dimensions. The regression coefficients for gender indicated that for all anthropometric dimensions, males had significantly larger measurements than females. As body mass index increased, dimensions measured increased significantly. Construction workers and miners had significantly smaller measurements than individuals employed in healthcare or manufacturing for a majority of dimensions. Five representative indexes of facial dimension (face length, face width, nose protrusion, bigonial breadth and nasal root breadth) were selected based on correlation and cluster analysis of all dimensions. Through comparison with the facial dimensions of American subjects, this study indicated that Chinese civilian workers have shorter face length, smaller nose protrusion, larger face width and longer lip length.

  20. Impact of nutrition education and medical supervision on pregnancy outcome.

    PubMed

    Sachdeva, R; Mann, S K

    1993-11-01

    Sixty Punjabi women from low and lower middle income groups were selected from eight villages of Ludhiana district. The supplements of iron, folic acid and calcium in the form of Folifer and Calcium Sandoz tablets were regularly supplied to experimental (E) group from second trimester onwards. A pamphlet about the diet during pregnancy was distributed to the E group along with four individual and three group contacts during the second half of pregnancy. The control (C) group was provided iron and folate supplements as per Government practice. Body height, weight, mid-upper arm circumference (MUA) and skinfold thickness of the subjects were recorded. Weight gained during pregnancy and post partum weight were also recorded and body mass index was calculated. In addition, crown heel length (CHL), birth weight (BW), skinfold thickness, MUA, head circumference (HC), Chest circumference (CC) and ponderal index (PI) of the neonates were recorded within eight hours of their birth. The gain in weight during pregnancy was 6.30 and 5.7 kg in E and C groups respectively. The study revealed that BW, CHL, skinfold thickness and PI of the newborns were significantly (p < 0.01) higher in E group. The mean BW of newborns in E and C groups was 2700 g and 2300 g, respectively. Weight gained during pregnancy had significant (p < 0.05) correlation to MUA, BW and skinfold thickness of the newborn.

  1. Air pollution exposure during pregnancy and ultrasound and birth measures of fetal growth: A prospective cohort study in Korea.

    PubMed

    Lamichhane, Dirga Kumar; Ryu, Jia; Leem, Jong-Han; Ha, Mina; Hong, Yun-Chul; Park, Hyesook; Kim, Yangho; Jung, Dal-Young; Lee, Ji-Young; Kim, Hwan-Cheol; Ha, Eun-Hee

    2018-04-01

    Few studies have examined the effects of air pollution on fetal growth based on ultrasound measures during pregnancy. More data is needed to evaluate the windows of special vulnerability. Our aim was to investigate the association of ambient air pollution during pregnancy with fetal and neonatal characteristics in a cohort of Korean women. Maternal exposure to particulate matter with an aerodynamic diameter<10μm (PM 10 ) and nitrogen dioxide (NO 2 ) was estimated using land-use regression models based on residential address. The biparietal diameter (BPD), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW) were evaluated via ultrasonography, and birth weight (BW), birth length (BL), and head circumference at birth (BHC) were obtained from medical records. The multiple linear regression model was used to adjust for confounders, and the mixed-effect model was used to evaluate longitudinal effect. The negative effects for NO 2 and PM 10 were estimated; in the adjusted analyses the decreases of BPD were -0.26mm (95% confidence interval [CI]=-0.41 to -0.11, with a 10μg/m 3 increase) in the second trimester for NO 2 , and -0.30mm (95% CI=-0.59 to -0.03, with a 10μg/m 3 increase) in the third trimester for PM 10 . Both NO 2 and PM 10 levels (10μg/m 3 ) during third trimester were inversely associated with BHC, and NO 2 level was inversely associated with BL in all exposure windows. No significant associations for AC, FL, and EFW were observed. The longitudinal analyses showed inverse association of NO 2 exposure with head and length growth (P<0.001). Our findings suggest that ambient air pollution is associated with impaired fetal head size from mid-gestation onwards. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Diagnostic accuracy of maternal anthropometric measurements as predictors for dystocia in nulliparous women

    PubMed Central

    Alijahan, Rahele; Kordi, Masoumeh; Poorjavad, Munira; Ebrahimzadeh, Saeed

    2014-01-01

    Background: Dystocia is one of the important causes of maternal morbidity and mortality in low-income countries. This study was aimed to determine the diagnostic accuracy of maternal anthropometric measurements as predictors for dystocia in nulliparous women. Materials and Methods: This prospective cohort study was conducted on 447 nulliparous women who referred to Omolbanin hospital. Several maternal anthropometric measurements such as height, transverse and vertical diameters of Michaelis sacral rhomboid area, foot length, head circumference, vertebral and lower limb length, symphysio-fundal height, and abdominal girth were taken in cervical dilatation ≤ 5 cm. Labor progression was controlled by a researcher blind to these measurements. After delivery, the accuracy of individual and combined measurements in prediction of dystocia was analyzed. Dystocia was defined as cesarean section and vacuum or forceps delivery for abnormal progress of labor (cervical dilatation less than 1 cm/h in the active phase for 2 h, and during the second stage, beyond 2 h or fetal head descend less than 1 cm/h). Results: Among the different anthropometric measurements, transverse diameter of the Michaelis sacral rhomboid area ≤9.6 cm, maternal height ≤ 155 cm, height to symphysio-fundal height ratio ≤4.7, lower limb length ≤78 cm, and head circumference to height ratio ≥ 35.05 with accuracy of 81.2%, 68.2%, 65.5%, 63.3%, and 61.5%, respectively, were better predictors. The best predictor was obtained by combination of maternal height ≤155 cm or the transverse diameter of the Michaelis sacral rhomboid area ≤9.6 cm and Johnson's formula estimated fetal weight ≥3255 g, with an accuracy of 90.5%, sensitivity of 70%, and specificity of 93.7%. Conclusions: Combination of other anthropometric measurements and estimated fetal weight with maternal height in comparison to maternal height alone leads to a better predictor for dystocia. PMID:24554954

  3. Diagnostic accuracy of maternal anthropometric measurements as predictors for dystocia in nulliparous women.

    PubMed

    Alijahan, Rahele; Kordi, Masoumeh; Poorjavad, Munira; Ebrahimzadeh, Saeed

    2014-01-01

    Dystocia is one of the important causes of maternal morbidity and mortality in low-income countries. This study was aimed to determine the diagnostic accuracy of maternal anthropometric measurements as predictors for dystocia in nulliparous women. This prospective cohort study was conducted on 447 nulliparous women who referred to Omolbanin hospital. Several maternal anthropometric measurements such as height, transverse and vertical diameters of Michaelis sacral rhomboid area, foot length, head circumference, vertebral and lower limb length, symphysio-fundal height, and abdominal girth were taken in cervical dilatation ≤ 5 cm. Labor progression was controlled by a researcher blind to these measurements. After delivery, the accuracy of individual and combined measurements in prediction of dystocia was analyzed. Dystocia was defined as cesarean section and vacuum or forceps delivery for abnormal progress of labor (cervical dilatation less than 1 cm/h in the active phase for 2 h, and during the second stage, beyond 2 h or fetal head descend less than 1 cm/h). Among the different anthropometric measurements, transverse diameter of the Michaelis sacral rhomboid area ≤9.6 cm, maternal height ≤ 155 cm, height to symphysio-fundal height ratio ≤4.7, lower limb length ≤78 cm, and head circumference to height ratio ≥ 35.05 with accuracy of 81.2%, 68.2%, 65.5%, 63.3%, and 61.5%, respectively, were better predictors. The best predictor was obtained by combination of maternal height ≤155 cm or the transverse diameter of the Michaelis sacral rhomboid area ≤9.6 cm and Johnson's formula estimated fetal weight ≥3255 g, with an accuracy of 90.5%, sensitivity of 70%, and specificity of 93.7%. Combination of other anthropometric measurements and estimated fetal weight with maternal height in comparison to maternal height alone leads to a better predictor for dystocia.

  4. Growth patterns and cerebro-placental hemodynamics in fetuses with congenital heart disease.

    PubMed

    Mebius, M J; Clur, S A B; Vink, A S; Pajkrt, E; Kalteren, W S; Kooi, E M W; Bos, A F; du Marchie Sarvaas, G J; Bilardo, C M

    2018-05-28

    Congenital heart disease (CHD) has been associated with a reduced fetal head circumference (HC). The underlying pathophysiological background remains undetermined. We aimed to define trends in fetal growth and cerebro-placental Doppler flow, and to investigate the association between head growth and cerebro-placental flow in fetuses with CHD. Fetuses with CHD and serial measurements of HC, abdominal circumference (AC), middle cerebral artery pulsatility index (MCA-PI), umbilical artery pulsatility index (UA-PI), and cerebro-placental ratio (CPR) were included. CHD was categorized into 3 groups based on expected cerebral arterial oxygen saturation: normal, mild to moderately reduced, and severely reduced. Trends over time in Z-scores were analyzed using a linear mixed-effects model. 181 fetuses fulfilled the inclusion criteria. Expected cerebral arterial oxygen saturation in CHD was classified as normal in 44, mild to moderately reduced in 84 and severely reduced in 53 cases. HC z-scores showed a tendency to decrease until 23 weeks, then to increase until 33 weeks, followed by a decrease again in the late third trimester. AC increased progressively with advancing gestation. MCA-PI and UA-PI showed significant trends throughout pregnancy, but CPR did not. There were no associations between expected cerebral arterial oxygen saturation and fetal growth. Average trends in MCA-PI were significantly different in the three subgroups (P=0.010), whereas average trends in UA-PI and CPR were similar (P=0.530 and P=0.285). Furthermore, there was no significant association between MCA-PI and HC (P=0.284). Fetal biometry and Doppler flow patterns are within normal ranges in fetuses with CHD, but show trends over time. Fetal head growth is not associated with the cerebral blood flow pattern or placental function and HC is not influenced by the cerebral arterial oxygen saturation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. The effect of decibel level of music stimuli and gender on head circumference and physiological responses of premature infants in the NICU.

    PubMed

    Cassidy, Jane W

    2009-01-01

    The purpose of this study was to examine different protocols with regard to the presentation of music stimuli and compare gender differential reactions to those stimuli. Subjects for this study (N = 63) were premature infants in the Neonatal Intensive Care Unit (NICU) between the gestational ages of 28 and 33 weeks. Half of the experimental infants listened to 20 mins of lullaby music (female voice with orchestral background) on 2 days followed by 20 mins of classical music (Mozart string music) on 2 days. The other half listened to the same music in the reverse order. One quarter of the males and one quarter of the females listened to music presented at an average of 65 dB, one quarter at an average of 70 dB, one quarter at an average of 75 dB, and one quarter did not listen to any music and served as control subjects. Head circumference data were collected four times by the researcher: (a) upon receipt of parental consent, (b) on the first day of music presentation (1 week after consent), (c) on the last day of music presentation, and (d) 1 week after music presentation. Physiological data (heart rate, respiratory rate, oxygen saturation) were recorded by the researcher at 2-minute intervals starting 4 minutes prior to and ending 4 minutes after music presentation. There was a significant difference (p < .0001) in average daily head growth across time, but this seems unrelated to the music condition as the same curvilinear trend (larger gain during days of treatment, smaller gain during baseline before and after treatment) was noted for control infants who did not listen to music. Results indicate a significant (p = .002), but biologically unimportant, decrease in heart rate over the course of data collection. No differences due to gender were noted.

  6. Central obesity, leptin and cognitive decline: the Sacramento Area Latino Study on Aging.

    PubMed

    Zeki Al Hazzouri, Adina; Haan, Mary N; Whitmer, Rachel A; Yaffe, Kristine; Neuhaus, John

    2012-01-01

    Central obesity is a risk factor for cognitive decline. Leptin is secreted by adipose tissue and has been associated with better cognitive function. Aging Mexican Americans have higher levels of obesity than non-Hispanic Whites, but no investigations examined the relationship between leptin and cognitive decline among them or the role of central obesity in this association. We analyzed 1,480 dementia-free older Mexican Americans who were followed over 10 years. Cognitive function was assessed every 12-15 months with the Modified Mini Mental State Exam (3MSE) and the Spanish and English Verbal Learning Test (SEVLT). For females with a small waist circumference (≤35 inches), an interquartile range difference in leptin was associated with 35% less 3MSE errors and 22% less decline in the SEVLT score over 10 years. For males with a small waist circumference (≤40 inches), an interquartile range difference in leptin was associated with 44% less 3MSE errors and 30% less decline in the SEVLT score over 10 years. There was no association between leptin and cognitive decline among females or males with a large waist circumference. Leptin interacts with central obesity in shaping cognitive decline. Our findings provide valuable information about the effects of metabolic risk factors on cognitive function. Copyright © 2012 S. Karger AG, Basel.

  7. Reference values of anthropometric measurements in Dutch children. The Oosterwolde Study.

    PubMed

    Gerver, W J; Drayer, N M; Schaafsma, W

    1989-03-01

    In the period 1979-1980 the following anthropometric measurements were recorded in 2351 healthy Dutch children from 0-17 years of age: height, weight, sitting height, arm span, lengths of upper-arm, lower-arm and hand, tibial length, foot length, biacromial diameter, biiliacal diameter, and head circumference. Corresponding percentile values were constructed on the basis of normality assumptions, the mean and standard deviation at age t being determined by a cubic spline approximation. The results are compared with other studies and given in the form of growth charts.

  8. Computational investigations of organic materials for hybrid nanodevice and optoelectronic applications

    NASA Astrophysics Data System (ADS)

    Crenshaw, Jasmine Davenport

    2011-12-01

    This dissertation examines two organic material systems, biotinylated microtubule filaments and thiophene. Biotinylated microtubule filaments partially coated with streptavidin and gliding on surface-adhered kinesin motor proteins converge to form linear "nanowire" and circular "nanospool" structures. We present a cellular automaton simulation tool that models the dynamics of microtubule gliding and interactions. In this method, each microtubule is composed of a head, body, and tail segments. The microtubule surface density, lengths, persistence length, and modes of interaction are dictated by the user. The microtubules are randomly arranged and move across a hexagonal lattice surface with the direction of motion of the head segment being determined probabilistically: the body and tail segments follow the path of the head. The analysis of the motion and interactions allow statistically meaningful data to be obtained regarding the number of generated spools, radial distribution in the distance between spools, and the average spool circumference lengths which can be compared to experimental results. This technique will aid in predictions of the formation process of nanowires and nanospools. Information regarding the kinetics and microstructure of any system can be extracted through this tool by the manipulation in the time and space dimensions. Chemical reactions of thiophene with organic molecules are of interest to chemically modify thermally deposited coatings or thin films of conductive polymers. Energy barriers are identified for reactive systems involving thiophene and small hydrocarbon radicals. The transition states for these reactive systems occurred through hydrogen abstraction. The results provide quantum mechanical level insights into the chemical processes that occur in the chemical modification processes described above, such as Surface Polymerization by Ion-Assisted Deposition (SPIAD), electropolymerization, and ion beam deposition. Enthalpies of formation are calculated for organic molecules using B3LYP, BMK, and B98 hybrid functionals. G3 and CBS-QB3 are used as standards in conjunction, due to their accurate thermochemistry parameters, with experimental values. The BMK functional proves to perform best with the selected organic molecules.

  9. Influence of some socio-economic factors on growth and development of the boys in the Tuzla region (Bosnia and Herzegovina).

    PubMed

    Redzić, Amira; Hadzihalilović, Jasminka

    2007-06-01

    The impact of certain exogenous factor (socio-economic, ecological) has been investigated with special attention paid to the parents' living standard, and number of family members on some anthropometric parameters like: body height, body mass, chest circumference, upper leg circumference, upper arm circumference, sitting height, arm length, leg length, pelvis width, shoulders width, lenght of head and with of head on the sample of 698 boys aged 11 to 16 (17) years in the Tuzla region (the northeastern Bosnia, Western Balkan peninsula). Anthropometric measurements have been carried out using methodology proposed by the International Biological program (IBP). The results of these investigations have shown that there is a certain impact of the socio-economic conditions on the growth and development of boys. Children from families that have better living standard are, as a rule, taller, which is indicated by the statistical significant differences (P > 0.01). This trend indicates also value of Body Mass Index (BMI), which is in younger children from the families with lower living standard 16, while in the same category in the children from the families with better living standard it has value 18.5. The real impact of living conditions on the dynamics of development could be the best seen in the period of puberty. The number of children in the family has negative relationship with anthropometric features. Statistically significant differences (P > 0.001) have been detected in numerous analysed features in families with one or two children in comparison with families with three, four, or five children. Therefore, BMI has been significantly lower (16) in children from families with several children, while in the families with one child in the same growth class (11 years) it was significantly higher (17.4). Similar value of BMI (17.9) have children from the families with five children and which are 17 years old. Besides socio-economic conditions, high level of environmental pollution which is typical for Tuzla region for a long time, has also significant impact on the growth and development of children.

  10. Anthropometric Analysis of Cephalofacial Dimensions in Kerman, Iran.

    PubMed

    Pouya, Fatemeh; Eftekhar-Vaghefi, Seyed Hassan; Salehinejad, Parvin

    2017-04-01

    The human body dimensions are affected by ecological, biological, geographical, racial, sex, and age factors. Craniofacial measurements can be considered to be one of the important tools for determination of the morphological characteristics of the head and face. In this study, which was conducted on Persian adolescents living in Kerman/Iran, different forms of head and face were determined for using in various aspects of medicine. The study was conducted on 732 participants including 366 males and 366 females in the age of 18-20-year-old. In addition to the height and weight of the participants, cephalofacial sizes of them were measured and then cephalic, facial, and brain indices were calculated. Among the cephalofacial sizes, cranial length and breadth, cranial circumference, prosopic length and prosopic breadth were significantly greater in males compared to females (P<0.005). Also, volume and weight of brain were significantly greater in male comparing to female participants (P<0.005). The predominant type of head was meso-cephal, and the predominant type of face was meso-prosopic in both sexes.

  11. Penile enhancement using a porcine small intestinal submucosa graft in a rat model.

    PubMed

    Leungwattanakij, S; Pummangura, N; Ratana-Olarn, K

    2006-01-01

    Several biodegradable materials have been experimented for penile enhancement, but none show the potential for clinical use. This study was designed to use porcine small intestinal submucosa (SIS) augmenting the normal tunica albuginea to increase the functional girth of the rat penis. In all, 20 adult male Sprague-Dawley rats constituted the study population. The animals were divided into two groups: group 1 consisted of the control (n=10) and group 2 (n=10) consisted of rats that underwent penile enhancement by a longitudinal I-shaped incision of the tunica albuginea on both sides, and the dissection of the plane between tunica albuginea and cavernosal tissue was carried out (n=10). The incision was then patched with a 3 x 10 mm2 piece of SIS, using a 6/0 nylon suture material. The penile length and mid-circumference were then measured using a Vernier Caliper before and 2 months after surgery. All rat penises underwent histological examination using Masson's trichome and Verhoff's van Giesen's stain for collagen and elastic fibers. The penile length, mid-circumference and degree of fibrosis score were expressed as mean+/-s.e. (standard error) and analyzed using a Wilcoxon rank-sum test. A statistical significance was accepted at P-value < or =0.05. Our results showed similar preoperative penile length and circumference in both groups. However, 2 months after the surgery, the mean penile circumference of the SIS group has grown significantly larger than the control group, while the mean penile length remained unchanged. The histological study of the rat penises revealed minimal amounts of fibrosis under the graft, and the elastic fibers of the graft showed orientation in a circular manner. In conclusion, SIS appears promising for material use in a penile enhancement.

  12. Prenatal head growth and child neuropsychological development at age 14 months.

    PubMed

    Álamo-Junquera, Dolores; Sunyer, Jordi; Iñiguez, Carmen; Ballester, Ferran; Garcia-Esteban, Raquel; Forns, Joan; Turner, Michelle C; Lertxundi, Aitana; Lertxundi, Nerea; Fernandez-Somoano, Ana; Rodriguez-Dehli, Cristina; Julvez, Jordi

    2015-05-01

    We sought to assess the association between prenatal head growth and child neuropsychological development in the general population. We evaluated 2104 children at the age of 14 months from a population-based birth cohort in Spain. Head circumference (HC) was measured by ultrasound examinations at weeks 12, 20, and 34 of gestation and by a nurse at birth. Head growth was assessed using conditional SD scores between weeks 12-20 and 20-34. Trained psychologists assessed neuropsychological functioning using the Bayley Scales of Infant Development. Head size measurements at birth were transformed into a 3-category variable: microcephalic (<10th percentile), normocephalic (≥10th and <90th percentile), and macrocephalic (≥90th percentile) based on the cohort distribution. P values<.05 were considered statistically significant. No overall associations were observed between HC or head growth and mental and psychomotor scores. In particular, no associations were found between HC at birth and mental scores (coefficient, 0.04; 95% confidence interval, -0.02 to 0.09) and between interval head growth (20-34 weeks) and mental scores (0.31; 95% confidence interval, -0.36 to 0.99). Upon stratification by microcephalic, normocephalic, or macrocephalic head size, results were imprecise, although there were some significant associations in the microcephalic and macrocephalic groups. Adjustment by various child and maternal cofactors did not affect results. The minimum sample size required for present study was 883 patients (β=2, α=0.05, power=0.80). Overall prenatal and perinatal HC was not associated with 14-month-old neuropsychological development. Findings suggest HC growth during uterine life among healthy infants may not be an important marker of early-life neurodevelopment but may be marginally useful with specific populations. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Research on the magnetorheological finishing (MRF) technology with dual polishing heads

    NASA Astrophysics Data System (ADS)

    Huang, Wen; Zhang, Yunfei; He, Jianguo; Zheng, Yongcheng; Luo, Qing; Hou, Jing; Yuan, Zhigang

    2014-08-01

    Magnetorheological finishing (MRF) is a key polishing technique capable of rapidly converging to the required surface figure. Due to the deficiency of general one-polishing-head MRF technology, a dual polishing heads MRF technology was studied and a dual polishing heads MRF machine with 8 axes was developed. The machine has the ability to manufacture large aperture optics with high figure accuracy. The large polishing head is suitable for polishing large aperture optics, controlling large spatial length's wave structures, correcting low-medium frequency errors with high removal rates. While the small polishing head has more advantages in manufacturing small aperture optics, controlling small spatial wavelength's wave structures, correcting mid-high frequency and removing nanoscale materials. Material removal characteristic and figure correction ability for each of large and small polishing head was studied. Each of two polishing heads respectively acquired stable and valid polishing removal function and ultra-precision flat sample. After a single polishing iteration using small polishing head, the figure error in 45mm diameter of a 50 mm diameter plano optics was significantly improved from 0.21λ to 0.08λ by PV (RMS 0.053λ to 0.015λ). After three polishing iterations using large polishing head , the figure error in 410mm×410mm of a 430mm×430mm large plano optics was significantly improved from 0.40λ to 0.10λ by PV (RMS 0.068λ to 0.013λ) .This results show that the dual polishing heads MRF machine not only have good material removal stability, but also excellent figure correction capability.

  14. Changes in head dimensions in children from Northern Kashubia (Pomerania, Poland) during 60 years.

    PubMed

    Cymek, Lidia; Roznowski, Jarosław; Roznowski, Franciszek

    2015-01-01

    Over 100 years ago Franz Boas introduced the term 'cranial plasticity' defined as a response to various environmental factors. The subject is under continuous debate. Some researchers have concluded that cephalic growth is responsible to environmental change meanwhile other have found that cephalic proportion are highly heritable and do not respond readily to environmental insults. While secular trend in growth is commonly observed, head dimensions vary significantly not only between different regions of the world but also in those regions themselves. Adam Wrzosek and Michał Ćwirko-Godycki initiated studies of Kashubian children as early as in 1925 and continued them into 1936. Throughout those 11 years they accumulated measurement data regarding body height and craniometric features. The research included boys and girls from 18 localities. Sixty years later, anthropometric measurements were conducted on primary school children from nine of the original localities. The aim of our study was to determine the direction of changes in head dimensions and corresponding indices in rural children from the Kashubia region examined 60 years after Ćwirko-Godycki and Wrzosek's study emphasizing great socio-economic status improvement. All children that were examined by us in 1997 are significantly taller (by between 5.18 cm and 14.74 cm) than their peers 60 years ago, their heads are longer (by between 2.69 mm and 10.41 mm), they have broader foreheads (by 3.79 - 7.24 mm), wider faces (by 4.68 - 8.09 mm) and mandibles (by 5.04 - 7.40 mm), larger head circumferences (by 0.64 - 2.22 cm) and larger total face heights (by 2.15 - 8.13 mm). The effect persists in all age groups (from 7 to 14 years old). All the noted differences are statistically significant by p < 0.05. The smallest differences were observed in head breadth (between 0.62 and 3.5 mm), with statistical significance only reached in 9-year-old girls, and 11- and 14-year-old boys. Since migration in Kashubian villages was minimal in the period in question and the mating radius for couples living there was small, it can be assumed that the chance of introducing 'new' genes into the population was low. We thus gravitate towards environmental factors being the major contributors to the observed changes, doubtlessly to do with an improvement in socio-economic status.

  15. Obstetric and Gynecologic Problems Associated with Eating Disorders

    PubMed Central

    Kimmel, M.C.; Ferguson, E.H.; Zerwas, S.; Bulik, C.M.; Meltzer-Brody, S.

    2017-01-01

    Objective This article summarizes the literature on obstetric and gynecologic complications associated with eating disorders. Method We performed a comprehensive search of the current literature on obstetric and gynecologic complications associated with eating disorders using PubMed. More recent randomized-controlled trials and larger data sets received priority. We also chose those that we felt would be the most relevant to providers. Results Common obstetric and gynecologic complications for women with eating disorders include infertility, unplanned pregnancy, miscarriage, poor nutrition during pregnancy, having a baby with small head circumference, postpartum depression and anxiety, sexual dysfunction and complications in the treatment for gynecologic cancers. There are also unique associations by eating disorder diagnosis, such as earlier cessation of breastfeeding in anorexia nervosa; increased polycystic ovarian syndrome in bulimia nervosa; and complications of obesity as a result of binge eating disorder. Discussion We focus on possible biological and psychosocial factors underpinning risk for poor obstetric and gynecological outcomes in eating disorders. Understanding these factors may improve both our understanding of the reproductive needs of women with eating disorders and their medical outcomes. We also highlight the importance of building multidisciplinary teams to provide comprehensive care to women with eating disorders during the reproductive years. PMID:26711005

  16. The Effect of Paternal Age on Offspring Intelligence and Personality when Controlling for Parental Trait Levels

    PubMed Central

    Arslan, Ruben C.; Penke, Lars; Johnson, Wendy; Iacono, William G.; McGue, Matt

    2014-01-01

    Paternal age at conception has been found to predict the number of new genetic mutations. We examined the effect of father’s age at birth on offspring intelligence, head circumference and personality traits. Using the Minnesota Twin Family Study sample we tested paternal age effects while controlling for parents’ trait levels measured with the same precision as offspring’s. From evolutionary genetic considerations we predicted a negative effect of paternal age on offspring intelligence, but not on other traits. Controlling for parental intelligence (IQ) had the effect of turning an initially positive association non-significantly negative. We found paternal age effects on offspring IQ and Multidimensional Personality Questionnaire Absorption, but they were not robustly significant, nor replicable with additional covariates. No other noteworthy effects were found. Parents’ intelligence and personality correlated with their ages at twin birth, which may have obscured a small negative effect of advanced paternal age (<1% of variance explained) on intelligence. We discuss future avenues for studies of paternal age effects and suggest that stronger research designs are needed to rule out confounding factors involving birth order and the Flynn effect. PMID:24587224

  17. Holoprosencephaly with Dandy-Walker cyst. Rare coexistence of two major malformations.

    PubMed

    Kurokawa, Y; Tsuchita, H; Sohma, T; Kitami, K; Takeda, T; Hattori, S

    1990-01-01

    A case of holoprosencephaly associated with Dandy-Walker cyst is reported. The patient was a male baby whose mother had normal serum titers for toxoplasma, syphilis, rubella and hepatitis B. She had no history of diabetes mellitus, administration of drugs or irradiation during the pregnancy. At the 8th month of gestation, fetal hydrocephalus was diagnosed by ultrasonic imaging. He was delivered by caesarean section at 34 weeks and 4 days, weighing 2,644 g. His head circumference was 42 cm; the anterior fontanel was not distended and its tension was normal. The chromosomal karyotype was a normal 46 XY. X-ray CT showed a large dorsal sac cyst in the supratentorial space and a hypoplastic cerebellum with a large cyst in the posterior fossa. He received a cyst-peritoneal shunt 24 days after birth. After this procedure, his head enlargement was arrested. We discuss the etiology of this rare coexistence of two major malformations.

  18. Comparison of Foveal, Macular, and Peripapillary Intraretinal Thicknesses Between Autism Spectrum Disorder and Neurotypical Subjects.

    PubMed

    García-Medina, José Javier; García-Piñero, María; Del-Río-Vellosillo, Mónica; Fares-Valdivia, Jesarán; Ragel-Hernández, Ana Belén; Martínez-Saura, Salvador; Cárcel-López, María Dolores; Zanon-Moreno, Vicente; Pinazo-Duran, María Dolores; Villegas-Pérez, María Paz

    2017-11-01

    To compare thicknesses of intraretinal layers segmented by spectral-domain optical coherence tomography (SD-OCT) between autism spectrum disorder (ASD) and neurotypical (NT) individuals. We performed 2 scans on 108 eyes from 54 participants (27 high-functioning ASD and 27 age- and sex-matched NT subjects): macular fast volume and peripapillary retinal nerve fiber layer (pRNFL). Macula was automatically segmented. The mean foveal and macular thickness of nine different layers and the thickness of nine pRNFL sectors were considered. Data from the right and left eyes were averaged for each participant. The results were compared between the ASD and NT groups. Associations between the Kaufman brief intelligence test (K-BIT), head circumference and SD-OCT results were also investigated in ASD individuals. ASD subjects showed greater foveal thickness at total retina, total inner retina, inner plexiform and inner nuclear layers, and greater macular thickness at total retina and total inner retina. Inferior, nasal inferior and temporal inferior sectors of pRNFL were also thicker in the ASD participants than in the controls (P < 0.05, unpaired t-test). Significant correlations were found between some K-BIT results and temporal inferior and inferior pRNFL thicknesses in the ASD group (P < 0.05, Spearman's rank correlation). No associations were seen between head circumference and OCT parameters. There are intraretinal thickenings at different locations in ASD subjects when compared to NT controls. This fact should be taken into account when interpreting SD-OCT examinations in ASD individuals. Plus, some pRNFL thicknesses present positive correlations with scores of cognitive status in ASD.

  19. Prenatal and Neonatal Brain Structure and White Matter Maturation in Children at High Risk for Schizophrenia

    PubMed Central

    Gilmore, John H.; Kang, Chaeryon; Evans, Dianne D.; Wolfe, Honor M.; Smith, J. Keith; Lieberman, Jeffrey A.; Lin, Weili; Hamer, Robert M.; Styner, Martin; Gerig, Guido

    2011-01-01

    Objective Schizophrenia is a neurodevelopmental disorder associated with abnormalities of brain structure and white matter, although little is known about when these abnormalities arise. This study was conducted to identify structural brain abnormalities in the prenatal and neonatal periods associated with genetic risk for schizophrenia. Method Prenatal ultrasound scans and neonatal structural magnetic resonance imaging (MRI) and diffusion tensor imaging were prospectively obtained in the offspring of mothers with schizophrenia or schizoaffective disorder (N=26) and matched comparison mothers without psychiatric illness (N=26). Comparisons were made for prenatal lateral ventricle width and head circumference, for neonatal intracranial, CSF, gray matter, white matter, and lateral ventricle volumes, and for neonatal diffusion properties of the genu and splenium of the corpus callosum and corticospinal tracts. Results Relative to the matched comparison subjects, the offspring of mothers with schizophrenia did not differ in prenatal lateral ventricle width or head circumference. Overall, the high-risk neonates had nonsignificantly larger intracranial, CSF, and lateral ventricle volumes. Subgroup analysis revealed that male high-risk infants had significantly larger intracranial, CSF, total gray matter, and lateral ventricle volumes; the female high-risk neonates were similar to the female comparison subjects. There were no group differences in white matter diffusion tensor properties. Conclusions Male neonates at genetic risk for schizophrenia had several larger than normal brain volumes, while females did not. To the authors' knowledge, this study provides the first evidence, in the context of its limitations, that early neonatal brain development may be abnormal in males at genetic risk for schizophrenia. PMID:20516153

  20. Genetic Mutations, Birth Lengths, Weights and Head Circumferences of Children with IGF-I Receptor Defects. Comparison with other Congenital Defects in the GH/IGF-I axis.

    PubMed

    Essakow, Jenna Lee; Lauterpacht, Aharon; Lilos, Pearl; Kauli, Rivka; Laron, Zvi

    2016-09-01

    In recent years more and more genetic defects along the GHRH-GH-IGF-I axis have been reported. Mutations of the IGF-I receptor (R) are a rare abnormality of whom only the heterozygote progenies survive. To summarize, from the literature, data on birth length, weight and head circumference of neonates with IGF-I-R mutations, and to correlate the data with that of other types of mutations in the GH/IGF-I axis. Sixty seven neonates from 24 published articles were included and forty seven different mutations of the IGF-I (R) located on chromosome 15 have been identified. Mean (±SD) birth length (BL), available for 26, (10 M, 16F) neonates with a gestational age of 34-41weeks, was 44.2±4cm; one was premature (30cm at 31 weeks). There was a significant correlation between birth length and gestational age (GA) r=0.71 (p>.001). Mean birth weight (BW) of 41 neonates (18M, 23F) was 2388±743gr. Two premature neonates weighed 650gr and 950gr respectively. The BW correlated significantly with gestational age, (males: r=0.68; p=0.007, females: r=0.49; p=0.024). The BMI of 25 neonates ranged from 6 to 13. In 22 records marked microcephaly was ascertained or stated. Nine of 16 mothers were short (133 -148cm), m±SD = 150.5±7.3cm. Copyright© of YS Medical Media ltd.

  1. Adjusting head circumference for covariates in autism: clinical correlates of a highly heritable continuous trait.

    PubMed

    Chaste, Pauline; Klei, Lambertus; Sanders, Stephan J; Murtha, Michael T; Hus, Vanessa; Lowe, Jennifer K; Willsey, A Jeremy; Moreno-De-Luca, Daniel; Yu, Timothy W; Fombonne, Eric; Geschwind, Daniel; Grice, Dorothy E; Ledbetter, David H; Lord, Catherine; Mane, Shrikant M; Lese Martin, Christa; Martin, Donna M; Morrow, Eric M; Walsh, Christopher A; Sutcliffe, James S; State, Matthew W; Devlin, Bernie; Cook, Edwin H; Kim, Soo-Jeong

    2013-10-15

    Brain development follows a different trajectory in children with autism spectrum disorders (ASD) than in typically developing children. A proxy for neurodevelopment could be head circumference (HC), but studies assessing HC and its clinical correlates in ASD have been inconsistent. This study investigates HC and clinical correlates in the Simons Simplex Collection cohort. We used a mixed linear model to estimate effects of covariates and the deviation from the expected HC given parental HC (genetic deviation). After excluding individuals with incomplete data, 7225 individuals in 1891 families remained for analysis. We examined the relationship between HC/genetic deviation of HC and clinical parameters. Gender, age, height, weight, genetic ancestry, and ASD status were significant predictors of HC (estimate of the ASD effect = .2 cm). HC was approximately normally distributed in probands and unaffected relatives, with only a few outliers. Genetic deviation of HC was also normally distributed, consistent with a random sampling of parental genes. Whereas larger HC than expected was associated with ASD symptom severity and regression, IQ decreased with the absolute value of the genetic deviation of HC. Measured against expected values derived from covariates of ASD subjects, statistical outliers for HC were uncommon. HC is a strongly heritable trait, and population norms for HC would be far more accurate if covariates including genetic ancestry, height, and age were taken into account. The association of diminishing IQ with absolute deviation from predicted HC values suggests HC could reflect subtle underlying brain development and warrants further investigation. © 2013 Society of Biological Psychiatry.

  2. Comparison of growth and nutritional status in infants receiving goat milk-based formula and cow milk-based formula: a randomized, double-blind study.

    PubMed

    Xu, Meihong; Wang, Yibin; Dai, Zhiyong; Zhang, Yanchun; Li, Yong; Wang, Junbo

    2015-01-01

    To compare the growth and nutritional status of infants fed goat milk-based formula (GMF) and cow milk-based formula (CMF). The study was conducted in Beijing, China. It was a double-blind randomized controlled trial. A total of 79 infants aged 0-3 months old were recruited and randomized in GMF or CMF group. The infants were fed the allocated formula to 6 months. The weight, length, and head circumference were measured at the enrolment, 3 and 6 months. The start time and types of solid food were recorded. Blood elements, urinal, and fecal parameters were also tested. The average weight of infants in the GMF group (mean±SD) was 4.67±0.99 kg and in the CMF group 4.73±1.10 kg at enrolment, and 8.75±0.98 kg (GMF) and 8.92±0.88 kg (CMF) at 6 months. There were no differences in the adjusted intention-to-treat analyses of weight, length, head circumference, and BMI z-scores between the two formula-fed groups over the 6-month study. Similarly, there were no remarkable differences in the timing and types of solid food, blood elements, urinal, and feces parameters, between the GMF and CMF group. No group differences have been shown in bowel motion consistency, duration of crying, ease of settling, or frequency of adverse events. GMF-provided growth and nutritional outcomes did not differ from those provided by CMF.

  3. Preterm infants fed nutrient-enriched formula until 6 months show improved growth and development.

    PubMed

    Jeon, Ga Won; Jung, Yu Jin; Koh, Sun Young; Lee, Yeon Kyung; Kim, Kyung Ah; Shin, Son Moon; Kim, Sung Shin; Shim, Jae Won; Chang, Yun Sil; Park, Won Soon

    2011-10-01

    The purpose of the present study was to determine the effect of feeding nutrient-enriched preterm formula to preterm infants until 6 months' corrected age (CA) on growth and development in the first 18 months of life. Very low-birthweight preterm infants were fed preterm formula until term (40 weeks CA). Infants were then assigned to one of three groups and were fed term formula until 6 months' CA (group 1, n= 29); preterm formula to 3 months' CA and then term formula to 6 months' CA (group 2, n= 30); or preterm formula until 6 months' CA (group 3, n= 31). Anthropometry was performed at term, 3, 6, 9, 12, 15, and at s18 months' CA. Mental and psychomotor development were assessed using the Bayley Scales of Infant Development II at 18 months' CA. Although body weight, length, head circumference and z score for CA at term in group 3 were significantly lower than those of groups 1 and 2, growth rates of these parameters were significantly higher in group 3 up to 18 months CA', as compared to groups 1 and 2. The mental developmental index and psychomotor developmental index of the Bayley test were not significantly different between the three groups. Very low-birthweight preterm infants fed nutrient-enriched preterm formula until 6 months' CA demonstrated significantly improved growth rates for bodyweight, length and head circumference, and comparable mental and psychomotor development throughout the first 18 months of life. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  4. [Effect of positive nutritional support strategy on extrauterine growth restriction in preterm infants].

    PubMed

    Wang, Xue-Min; Zhu, Yan-Ping; Wang, Li

    2013-12-01

    To investigate the effects of positive nutritional support in the early stage after birth on the nutritional status during hospitalization and extrauterine growth restriction (EUGR) in preterm infants. There were two groups of preterm infants. Group A (n=99) was given the previous nutritional program, while group B (n=101) was given positive nutritional support. The nutritional intake, growth rate and EUGR incidence were compared between the two groups. Compared with group A, group B had significantly higher enteral calorie intake and total calorie intake within one week after birth. Additionally, the age of first feeding, time of regaining birth weight, duration of intravenous nutrition, time to full enteral feeding, and length of hospital stay in group B were all shorter than in group A. Group B also had less physiological weight loss than group A. Among the preterm infants with a gestational age less than 32 weeks, group B had faster increases in body weight, head circumference, and body length and a lower incidence of EUGR compared with group A. Among the preterm infants with a gestational age not less than 32 weeks, group B had faster increases in body weight and a lower incidence of EUGR (evaluated based on body weight and head circumference) compared with group A. During hospitalization, group B had significantly lower incidence of feeding intolerance, necrotizing enterocolitis, and sepsis than group A. Positive nutritional support strategy, applied in preterm infants early after birth, can effectively improve their nutritional status during hospitalization and reduce the incidence of EUGR without increasing the incidence of related complications during hospitalization.

  5. Late effects of early growth hormone treatment in Down syndrome.

    PubMed

    Myrelid, Å; Bergman, S; Elfvik Strömberg, M; Jonsson, B; Nyberg, F; Gustafsson, J; Annerén, G

    2010-05-01

    Down syndrome (DS) is associated with short stature and psychomotor delay. We have previously shown that growth hormone (GH) treatment during infancy and childhood normalizes growth velocity and improves fine motor skill performance in DS. The aim of this study was to investigate late effects of early GH treatment on growth and psychomotor development in the DS subjects from the previous trial. Twelve of 15 adolescents with DS (3 F) from the GH group and 10 of 15 controls (5 F) participated in this follow-up study. Fifteen other subjects with DS (6 F) were included as controls in anthropometric analyses. Cognitive function was assessed with the Leiter International Performance Scale-Revised (Leiter-R) and selected subtests of the Wechsler Intelligence Scale for Children, Third edition (WISC-III). The Bruininks-Oseretsky Test of Motor Proficiency, Second edition (BOT-2), was used to assess general motor ability. Although early GH treatment had no effect on final height, the treated subjects had a greater head circumference standard deviation score (SDS) than the controls (-1.6 SDS vs. -2.2 SDS). The adolescents previously treated with GH had scores above those of the controls in all subtests of Leiter-R and WISC-III, but no difference in Brief IQ-score was seen between the groups. The age-adjusted motor performance of all subjects was below -2 SD, but the GH-treated subjects performed better than the controls in all but one subtest. The combined finding of a greater head circumference SDS and better psychomotor performance indicates that DS subjects may benefit from early GH treatment.

  6. Maternal exposure to UV filters: associations with maternal thyroid hormones, IGF-I/IGFBP3 and birth outcomes.

    PubMed

    Krause, M; Frederiksen, H; Sundberg, K; Jørgensen, F S; Jensen, L N; Nørgaard, P; Jørgensen, C; Ertberg, P; Petersen, J H; Feldt-Rasmussen, U; Juul, A; Drzewiecki, K T; Skakkebaek, N E; Andersson, A M

    2018-02-01

    Several chemical UV filters/absorbers ('UV filters' hereafter) have endocrine-disrupting properties in vitro and in vivo . Exposure to these chemicals, especially during prenatal development, is of concern. To examine maternal exposure to UV filters, associations with maternal thyroid hormone, with growth factor concentrations as well as to birth outcomes. Prospective study of 183 pregnant women with 2nd trimester serum and urine samples available. Maternal concentrations of the chemical UV filters benzophenone-1 (BP-1) and benzophenone-3 (BP-3) in urine and 4-hydroxy-benzophenone (4-HBP) in serum were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The relationships between 2nd trimester maternal concentrations of the three chemical UV filters and maternal serum concentrations of thyroid hormones and growth factors, as well as birth outcomes (weight, height, and head and abdominal circumferences) were examined. Positive associations between maternal serum concentrations of 4-HBP and triiodothyronine (T 3 ), thyroxine (T 4 ), insulin-like growth factor I (IGF-I) and its binding protein IGFBP3 were observed in mothers carrying male fetuses. Male infants of mothers in the middle 4-HBP exposure group had statistically significantly lower weight and shorter head and abdominal circumferences at birth compared to the low exposure group. Widespread exposure of pregnant women to chemical UV filters and the possible impact on maternal thyroid hormones and growth factors, and on fetal growth, calls for further studies on possible long-term consequences of the exposure to UV filters on fetal development and children's health. © 2018 The authors.

  7. Multiple courses of antenatal corticosteroids for preterm birth study: 2-year outcomes.

    PubMed

    Asztalos, Elizabeth V; Murphy, Kellie E; Hannah, Mary E; Willan, Andrew R; Matthews, Stephen G; Ohlsson, Arne; Kelly, Edmond N; Saigal, Saroj; Ross, Susan; Delisle, Marie-France; Amankwah, Kofi; Guselle, Patricia; Gafni, Amiram; Lee, Shoo K; Armson, B Anthony; Sananes, Renee; Tomat, Laura

    2010-11-01

    The aim of this study was to determine the effects of repeated courses of prenatal corticosteroid therapy versus placebo on death or neurologic impairment among the children enrolled in the Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study, at 18 to 24 months of age. A total of 2305 infants were eligible for follow-up evaluation; 2104 infants (1069 in the prenatal corticosteroid therapy group and 1035 in the placebo group) were monitored. The primary outcome was death or neurologic impairment, defined as either cerebral palsy or cognitive delay, at 18 to 24 months of age. The secondary outcomes were measurements of growth (height, weight, and head circumference). Children exposed to multiple courses of prenatal corticosteroid therapy had similar rates of death or neurologic impairment, compared with children exposed to placebo (148 children [13.8%] vs 142 children [13.7%]; odds ratio: 1.001[95% confidence interval: 0.75-1.30]; P = .95). They had a mean weight of 11.94 kg, compared with 12.14 kg in the placebo group (P = .04), a mean height of 85.51 cm, compared with 85.46 cm (P = .87), and a mean head circumference of 48.18 cm, compared with 48.25 cm (P = .45). Multiple courses of prenatal corticosteroid therapy, given every 14 days, did not increase or decrease the risk of death or neurologic impairment at 18 to 24 months of age, compared with a single course of prenatal corticosteroid therapy. Continued follow-up monitoring of these children is necessary to assess neurobehavioral function, school performance, and possible susceptibility to disease.

  8. Congenital Heart Defects and Measures of Fetal Growth in Newborns with Down Syndrome or 22q11.2 Deletion Syndrome.

    PubMed

    Matthiesen, Niels B; Agergaard, Peter; Henriksen, Tine B; Bach, Cathrine C; Gaynor, J William; Hjortdal, Vibeke; Østergaard, John R

    2016-08-01

    To estimate the association between congenital heart defects (CHD) and indices of fetal growth in Down and 22q11.2 deletion syndromes. We established 2 Danish nationwide cohorts of newborn singletons with either Down syndrome (n = 670) or 22q11.2 deletion syndrome (n = 155), born 1997-2011. In both cohorts, we analyzed the association between CHD, CHD severity, and indices of fetal growth by multivariable linear regression adjusted for potential confounders. We report mean differences in gestational age specific z-scores compared with newborns without CHD. Down syndrome and 22q11.2 deletion syndrome were both associated with lower mean birth weight and head circumference z-scores. We found no association between CHD or CHD severity and indices of fetal growth. In Down syndrome, the association between any CHD and the mean difference in head circumference z-score was 0.03 (95% CI -0.12, 0.18), and the estimate regarding birth weight z-score was 0.09 (95% CI -0.08, 0.25). The corresponding estimates in 22q11.2 deletion syndrome were 0.00 (95% CI -0.33, 0.32) and -0.09 (95% CI -0.45, 0.26). We found no association between CHD and fetal growth measures in newborns with Down syndrome or 22q11.2 deletion syndrome. Thus, in certain subtypes of CHD, the contribution of genetic factors to prenatal growth impairment may be more important than circulatory disturbances. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Enhancing reproducibility of ultrasonic measurements by new users

    NASA Astrophysics Data System (ADS)

    Pramanik, Manojit; Gupta, Madhumita; Krishnan, Kajoli Banerjee

    2013-03-01

    Perception of operator influences ultrasound image acquisition and processing. Lower costs are attracting new users to medical ultrasound. Anticipating an increase in this trend, we conducted a study to quantify the variability in ultrasonic measurements made by novice users and identify methods to reduce it. We designed a protocol with four presets and trained four new users to scan and manually measure the head circumference of a fetal phantom with an ultrasound scanner. In the first phase, the users followed this protocol in seven distinct sessions. They then received feedback on the quality of the scans from an expert. In the second phase, two of the users repeated the entire protocol aided by visual cues provided to them during scanning. We performed off-line measurements on all the images using a fully automated algorithm capable of measuring the head circumference from fetal phantom images. The ground truth (198.1±1.6 mm) was based on sixteen scans and measurements made by an expert. Our analysis shows that: (1) the inter-observer variability of manual measurements was 5.5 mm, whereas the inter-observer variability of automated measurements was only 0.6 mm in the first phase (2) consistency of image appearance improved and mean manual measurements was 4-5 mm closer to the ground truth in the second phase (3) automated measurements were more precise, accurate and less sensitive to different presets compared to manual measurements in both phases. Our results show that visual aids and automation can bring more reproducibility to ultrasonic measurements made by new users.

  10. Birth weight, length and head circumference: Progression and impact over the outcome of patients with congenital heart disease.

    PubMed

    Silveira, Daniélle Bernardi; da Rosa, Ernani Bohrer; Correia, Jamile Dutra; Trevisan, Patrícia; Fiegenbaum, Marilu; Oliveira, Ceres Andréia; Grapiglia, Carolina Geitens; Nunes, Mauricio Rouvel; Rosa, Rosana Cardoso Manique; Zen, Tatiana Diehl; Zen, Paulo Ricardo Gazzola; Rosa, Rafael Fabiano Machado

    2017-09-15

    There are few studies assessing the birth measures of patients with congenital heart disease (CHD). Our aim to evaluate their progression and impact over the outcome. The cases consisted of patients with CHD during their first hospitalization in a reference cardiac and pediatric intensive care unit (ICU) from Southern Brazil. Controls were composed of patients with no clinical evidence of CHD hospitalized soon after cases. The cases underwent high-resolution karyotype and fluorescence in situ hybridization (FISH) for 22q11 microdeletion. We analyzed birth weight, length and head circumference of patients of both groups. For CHD patients, we evaluated their progression and impact until hospitalization at ICU. Our sample was composed of 198 cases and controls. We observe a difference in birth weight of CHD patients only in relation to general population. There was a significant increase in children with CHD and weight below the lower limit from birth until the hospitalization at ICU, and this occurred more in those without complex CHD. Syndromic patients and with an extracardiac malformation also presented a greater difficulty to maintain not only the weight but also the length/height until the hospitalization. Individuals with weight below the lower limit at hospitalization who died had a tendency to present longer stay at ICU. Some CHD patients, especially without complex defects, and with syndromic aspect and a major extracardiac malformation, present a higher difficult to maintain their weight and growth, and, therefore, may be at risk and should be more closely monitored. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Correlation between lung to thorax transverse area ratio and observed/expected lung area to head circumference ratio in fetuses with left-sided diaphragmatic hernia.

    PubMed

    Hidaka, Nobuhiro; Murata, Masaharu; Sasahara, Jun; Ishii, Keisuke; Mitsuda, Nobuaki

    2015-05-01

    Observed/expected lung area to head circumference ratio (o/e LHR) and lung to thorax transverse area ratio (LTR) are the sonographic indicators of postnatal outcome in fetuses with congenital diaphragmatic hernia (CDH), and they are not influenced by gestational age. We aimed to evaluate the relationship between these two parameters in the same subjects with fetal left-sided CDH. Fetuses with left-sided CDH managed between 2005 and 2012 were included. Data of LTR and o/e LHR values measured on the same day prior to 33 weeks' gestation in target fetuses were retrospectively collected. The correlation between the two parameters was estimated using the Spearman's rank-correlation coefficient, and linear regression analysis was used to assess the relationship between them. Data on 61 measurements from 36 CDH fetuses were analyzed to obtain a Spearman's rank-correlation coefficient of 0.74 with the following linear equation: LTR = 0.002 × (o/e LHR) + 0.005. The determination coefficient of this linear equation was sufficiently high at 0.712, and the prediction accuracy obtained with this regression formula was considered satisfactory. A good linear correlation between the LTR and the o/e LHR was obtained, suggesting that we can translate the predictive parameters for each other. This information is expected to be useful to improve our understanding of different investigations focusing on LTR or o/e LHR as a predictor of postnatal outcome in CDH. © 2014 Japanese Teratology Society.

  12. Intrapartum fetal head circumference and estimated fetal weight as predictors of operative delivery.

    PubMed

    Rabei, Noha H; El-Helaly, Amr M; Farag, Amr H; El-Naggar, Ahmed K; Etman, Mohamed K; El-Moteily, Moataz M

    2017-04-01

    To assess intrapartum sonographic measurements of fetal head circumference (HC) and estimated fetal weight (EFW) to predict operative delivery. In a prospective study, 200 spontaneously parturient primiparous women aged 20-30 years were enrolled at a teaching hospital in Cairo, Egypt, between October 2, 2015, and January 28, 2016. HC and EFW were measured by transabdominal ultrasonography. After delivery, the association between type of delivery and ultrasonography findings was assessed. Intrapartum HC and EFW were significantly higher among women with operative delivery (n=76) than among those with normal vaginal delivery (n=124; P<0.001 for both). Intrapartum HC of 36.8 cm or more was associated with an increased risk of operative delivery (relative risk [RR] 2.87, 95% CI 1.87-4.41), as was EFW of 3920 g or more (RR 3.69, 95% CI 2.13-6.40). The area under the receiver operating characteristic curve was 0.807 and 0.748 for HC and EFW, respectively (P<0.001 for both). At 36.8-cm cutoff, HC had 44.7% sensitivity, 91.9% specificity, 77.3% positive predictive value (PPV), and 73.1% negative predictive value (NPV). At 3920-g cutoff, EFW had 68.4% sensitivity, 82.3% specificity, 70.3% PPV, and 81.0% NPV. Intrapartum HC and EFW were directly correlated with second-stage duration (P=0.005 and 0.002, respectively). Intrapartum HC and EFW seem to be good predictors of operative delivery. © 2017 International Federation of Gynecology and Obstetrics.

  13. Nutritional status of low birth weight infants in Makkah region: Evaluation of anthropometric and biochemical parameters.

    PubMed

    Kensara, Osama Adnan; Azzeh, Firas Sultan

    2016-04-01

    To assess the nutritional status of low birth weight infants from Makkah area immediately after birth. The prospective study was conducted between October and December 2012 at Al-Noor Speciality Hospital, Makkah, Saudi Arabia, and comprised low birth weight infants who were divided into three equal groups according to their birth weight: group A (low birthweight1501-2500gm), group B (very low birthweight1001-1500gm), and group C (extremely low birth weight < 1000gm). Mothers who had delivered low birth weight infants were enrolled. Weight, length, head circumference, complete blood count, and blood tests were performed for all the infants under investigation. There were 300 infants in the study; 100(33.3%) in each of the 3 groups. Group C showed the lowest gestational age, length, and head circumferences (p< 0.05 each). No significant discrepancies were found in complete blood count results among the three groups (p>0.05). Normal serum phosphorus, potassium and magnesium levels and mild hypocalcaemia were observed in all infants. However, hypernatraemia was significantly evident (p< 0.05) for group C. All infants had hyperglycaemia and hyperbilirubinaemia. Albumin content decreased significantly (p< 0.05) as birth weight decreased. Groups B and C infants showed higher serum urea than group A infants (p< 0.05). Low newborn birth weight was related to the deteriorated nutritional status in terms of low anthropometric and abnormal biochemical measures. It was not possible to correlate the birth weight of the neonates to the parameters of the complete blood tests.

  14. Adjusting head circumference for covariates in autism: clinical correlates of a highly heritable continuous trait

    PubMed Central

    Chaste, Pauline; Klei, Lambertus; Sanders, Stephan J.; Murtha, Michael T.; Hus, Vanessa; Lowe, Jennifer K.; Willsey, A. Jeremy; Moreno-De-Luca, Daniel; Yu, Timothy W.; Fombonne, Eric; Geschwind, Daniel; Grice, Dorothy E.; Ledbetter, David H.; Lord, Catherine; Mane, Shrikant M.; Martin, Christa Lese; Martin, Donna M.; Morrow, Eric M.; Walsh, Christopher A.; Sutcliffe, James S.; State, Matthew W.; Devlin, Bernie; Cook, Edwin H.; Kim, Soo-Jeong

    2013-01-01

    BACKGROUND Brain development follows a different trajectory in children with Autism Spectrum Disorders (ASD) than in typically developing children. A proxy for neurodevelopment could be head circumference (HC), but studies assessing HC and its clinical correlates in ASD have been inconsistent. This study investigates HC and clinical correlates in the Simons Simplex Collection cohort. METHODS We used a mixed linear model to estimate effects of covariates and the deviation from the expected HC given parental HC (genetic deviation). After excluding individuals with incomplete data, 7225 individuals in 1891 families remained for analysis. We examined the relationship between HC/genetic deviation of HC and clinical parameters. RESULTS Gender, age, height, weight, genetic ancestry and ASD status were significant predictors of HC (estimate of the ASD effect=0.2cm). HC was approximately normally distributed in probands and unaffected relatives, with only a few outliers. Genetic deviation of HC was also normally distributed, consistent with a random sampling of parental genes. Whereas larger HC than expected was associated with ASD symptom severity and regression, IQ decreased with the absolute value of the genetic deviation of HC. CONCLUSIONS Measured against expected values derived from covariates of ASD subjects, statistical outliers for HC were uncommon. HC is a strongly heritable trait and population norms for HC would be far more accurate if covariates including genetic ancestry, height and age were taken into account. The association of diminishing IQ with absolute deviation from predicted HC values suggests HC could reflect subtle underlying brain development and warrants further investigation. PMID:23746936

  15. Growth reference for Saudi preschool children: LMS parameters and percentiles.

    PubMed

    Shaik, Shaffi Ahamed; El Mouzan, Mohammad Issa; AlSalloum, Abdullah Abdulmohsin; AlHerbish, Abdullah Sulaiman

    2016-01-01

    Previous growth charts for Saudi children have not included detailed tables and parameters needed for research and incorporation in electronic records. The objective of this report is to publish the L, M, and S parameters and percentiles as well as the corresponding growth charts for Saudi preschool children. Community-based survey and measurement of growth parameters in a sample selected by a multistage probability procedure. A stratified listing of the Saudi population. Raw data from the previous nationally-representative sample were reanalyzed using the Lambda-Mu-Sigma (LMS) methodology to calculate the L, M, and S parameters of percentiles (from 3rd to 97th) for weight, length/height, head circumference, and body mass index-for-age, and weight for-length/height for boys and girls from birth to 60 months. Length or height and weight of Saudi preschool children. There were 15601 Saudi children younger than 60 months of age, 7896 (50.6 %) were boys. The LMS parameters for weight for age from birth to 60 months (5 years) are reported for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentiles as well as the corresponding graphs. Similarly, the LMS parameters for length/height-for-age, head circumference-for-age, weight-for-length/height and body mass index-for-age (BMi) are shown with the corresponding graphs for boys and girls. Using the data in this report, clinicians and researchers can assess the growth of Saudi preschool children. The report does not reflect interregional variations in growth.

  16. Environmental tobacco smoke exposure and perinatal outcomes: a systematic review and meta-analyses.

    PubMed

    Salmasi, Giselle; Grady, Rosheen; Jones, Jennifer; McDonald, Sarah D

    2010-01-01

    While active maternal tobacco smoking has well established adverse perinatal outcomes, the effects of passive maternal smoking, also called environmental tobacco exposure (ETS), are less well studied and less consistent. To determine to the effect of ETS on perinatal outcomes. Medline, EMBASE and reference lists were searched. Studies comparing ETS-exposed pregnant women with those unexposed which adequately addressed active maternal smoking. Two reviewers independently assessed titles, abstracts, full studies, extracted data and assessed quality. Dichotomous data were pooled using odds ratios (OR) and continuous data with weighted mean differences (WMD) using a random effects model. Seventy-six articles were included with a total of 48,439 ETS-exposed women and 90,918 unexposed women. ETS-exposed infants weighed less [WMD -60 g, 95% confidence interval (CI) -80 to -39 g], with a trend towards increased low birthweight (LBW, < 2,500 g; RR 1.16; 95% CI 0.99-1.36), although the duration of gestation and preterm delivery were similar (WMD 0.02 weeks, 95% CI -0.09 to 0.12 weeks and RR 1.07; 95% CI 0.93-1.22). ETS-exposed infants had longer infant lengths (1.75 cm; 95% CI 1.37-2.12 cm), increased risks of congenital anomalies (OR 1.17; 95% CI 1.03-1.34) and a trend towards smaller head circumferences (-0.11 cm; 95% CI -0.22 to 0.01 cm). ETS-exposed women have increased risks of infants with lower birthweight, congenital anomalies, longer lengths, and trends towards smaller head circumferences and LBW.

  17. A step towards measuring the fetal head circumference with the use of obstetric ultrasound in a low resource setting

    NASA Astrophysics Data System (ADS)

    van den Heuvel, Thomas L. A.; Petros, Hezkiel; Santini, Stefano; de Korte, Chris L.; van Ginneken, Bram

    2017-03-01

    Worldwide, 99% of all maternal deaths occur in low-resource countries. Ultrasound imaging can be used to detect maternal risk factors, but requires a well-trained sonographer to obtain the biometric parameters of the fetus. One of the most important biometric parameters is the fetal Head Circumference (HC). The HC can be used to estimate the Gestational Age (GA) and assess the growth of the fetus. In this paper we propose a method to estimate the fetal HC with the use of the Obstetric Sweep Protocol (OSP). With the OSP the abdomen of pregnant women is imaged with the use of sweeps. These sweeps can be taught to somebody without any prior knowledge of ultrasound within a day. Both the OSP and the standard two-dimensional ultrasound image for HC assessment were acquired by an experienced gynecologist from fifty pregnant women in St. Luke's Hospital in Wolisso, Ethiopia. The reference HC from the standard two-dimensional ultrasound image was compared to both the manually measured HC and the automatically measured HC from the OSP data. The median difference between the estimated GA from the manual measured HC using the OSP and the reference standard was -1.1 days (Median Absolute Deviation (MAD) 7.7 days). The median difference between the estimated GA from the automatically measured HC using the OSP and the reference standard was -6.2 days (MAD 8.6 days). Therefore, it can be concluded that it is possible to estimate the fetal GA with simple obstetric sweeps with a deviation of only one week.

  18. A new technique to expose the hypopharyngeal space: The modified Killian's method.

    PubMed

    Sakai, Akihiro; Okami, Kenji; Sugimoto, Ryousuke; Ebisumoto, Koji; Yamamoto, Hikaru; Maki, Daisuke; Saito, Kosuke; Iida, Masahiro

    2014-04-01

    Recent remarkable progress in endoscopic technology has enabled the detection of superficial cancers that were undetectable in the past. However, even though advanced endoscopic technology can detect early lesions, it is useless unless it can provide wide exposure of an area. By modifying the Killian position, it is possible to observe a wider range of the hypopharyngeal space than is possible with conventional head positions. We report a revolutionary method that uses a new head position to widely open the hypopharynx. The technique is named "the Modified Killian's method." The patient is initially placed in the Killian position and then bent further forward from the original position (i.e., the modified Killian position). While in this position, the patient's head is turned and the Valsalva maneuver is applied. These additional maneuvers constitute the Modified Killian's method and widely expands the hypopharyngeal space. The conventional head position cannot open the hypopharyngeal space sufficiently; however, the Modified Killian's method opens the hypopharyngeal space very widely. The Modified Killian's method enables observation of the entire circumference of the hypopharyngeal space and the cervical esophageal entry. The Modified Killian's method may become an indispensable technique for observing the hypopharynx and detecting hypopharyngeal cancers. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Experimental investigation of head resistance reduction in bubbly Couette-Taylor flow

    NASA Astrophysics Data System (ADS)

    Maryami, R.; Javadpoor, M.; Farahat, S.

    2016-12-01

    Small bubble experiments are carried out in a circulating vertical Couette-Taylor flow system to investigate the effect of air bubbles on head resistance. In the system with inner rotating cylinder and circulating flow, flow is combined with circumferential and axial flow. Moreover, the variation range of rotational Reynolds number is 7 × 103 ≤ {Re}_{ω } ≤ 70 × 103 and small bubbles are dispersed into fully turbulent flow which consists of Taylor vortices. The modification of head resistance is examined by measuring the pressure difference between two certain holes along the cylinders axis. The results show that head resistance is decreased in the presence of small bubbles and a head resistance reduction greater than 60 % is achieved in low {Re}_{ω } s and in all {Re}_{ax} s changing from 299.15 to 396.27. The effect of air bubbles on vortices could be possible reason for head resistance reduction. Since Taylor vortices are stable in this regime, bubbles decrease the momentum transfer by elongating vortices along the axis of cylinders and decreasing their numbers. The positive effect of air bubbles on head resistance reduction is diminished when {Re}_{ω } is increased. Moreover, in certain ranges of {Re}_{ω }, small bubbles enhance head resistance when {Re}_{ax} is increased. It is predicted that negative effect of small bubbles on head resistance reduction is due to flow turbulence enhancement when {Re}_{ω } and {Re}_{ax} are increased.

  20. A Geometric Capacity–Demand Analysis of Maternal Levator Muscle Stretch Required for Vaginal Delivery

    PubMed Central

    Tracy, Paige V.; DeLancey, John O.; Ashton-Miller, James A.

    2016-01-01

    Because levator ani (LA) muscle injuries occur in approximately 13% of all vaginal births, insights are needed to better prevent them. In Part I of this paper, we conducted an analysis of the bony and soft tissue factors contributing to the geometric “capacity” of the maternal pelvis and pelvic floor to deliver a fetal head without incurring stretch injury of the maternal soft tissue. In Part II, we quantified the range in demand, represented by the variation in fetal head size and shape, placed on the maternal pelvic floor. In Part III, we analyzed the capacity-to-demand geometric ratio, g, in order to determine whether a mother can deliver a head of given size without stretch injury. The results of a Part I sensitivity analysis showed that initial soft tissue loop length (SL) had the greatest effect on maternal capacity, followed by the length of the soft tissue loop above the inferior pubic rami at ultimate crowning, then subpubic arch angle (SPAA) and head size, and finally the levator origin separation distance. We found the more caudal origin of the puborectal portion of the levator muscle helps to protect it from the stretch injuries commonly observed in the pubovisceral portion. Part II fetal head molding index (MI) and fetal head size revealed fetal head circumference values ranging from 253 to 351 mm, which would increase up to 11 mm upon face presentation. The Part III capacity-demand analysis of g revealed that, based on geometry alone, the 10th percentile maternal capacity predicted injury for all head sizes, the 25th percentile maternal capacity could deliver half of all head sizes, while the 50th percentile maternal capacity could deliver a head of any size without injury. If ultrasound imaging could be operationalized to make measurements of ratio g, it might be used to usefully inform women on their level of risk for levator injury during vaginal birth. PMID:26746116

  1. A Geometric Capacity-Demand Analysis of Maternal Levator Muscle Stretch Required for Vaginal Delivery.

    PubMed

    Tracy, Paige V; DeLancey, John O; Ashton-Miller, James A

    2016-02-01

    Because levator ani (LA) muscle injuries occur in approximately 13% of all vaginal births, insights are needed to better prevent them. In Part I of this paper, we conducted an analysis of the bony and soft tissue factors contributing to the geometric "capacity" of the maternal pelvis and pelvic floor to deliver a fetal head without incurring stretch injury of the maternal soft tissue. In Part II, we quantified the range in demand, represented by the variation in fetal head size and shape, placed on the maternal pelvic floor. In Part III, we analyzed the capacity-to-demand geometric ratio, g, in order to determine whether a mother can deliver a head of given size without stretch injury. The results of a Part I sensitivity analysis showed that initial soft tissue loop length (SL) had the greatest effect on maternal capacity, followed by the length of the soft tissue loop above the inferior pubic rami at ultimate crowning, then subpubic arch angle (SPAA) and head size, and finally the levator origin separation distance. We found the more caudal origin of the puborectal portion of the levator muscle helps to protect it from the stretch injuries commonly observed in the pubovisceral portion. Part II fetal head molding index (MI) and fetal head size revealed fetal head circumference values ranging from 253 to 351 mm, which would increase up to 11 mm upon face presentation. The Part III capacity-demand analysis of g revealed that, based on geometry alone, the 10th percentile maternal capacity predicted injury for all head sizes, the 25th percentile maternal capacity could deliver half of all head sizes, while the 50th percentile maternal capacity could deliver a head of any size without injury. If ultrasound imaging could be operationalized to make measurements of ratio g, it might be used to usefully inform women on their level of risk for levator injury during vaginal birth.

  2. The use of ultrasound measurements in environmental epidemiological studies of air pollution and fetal growth

    PubMed Central

    Smarr, Melissa M.; Vadillo-Ortega, Felipe; Castillo-Castrejon, Marisol; O’Neill, Marie S.

    2015-01-01

    Purpose of review Recently, several international research groups have suggested that studies about environmental contaminants and adverse pregnancy outcomes should be designed to elucidate potential underlying biological mechanisms. The purpose of this review is to examine the epidemiological studies addressing maternal exposure to air pollutants and fetal growth during gestation as assessed by ultrasound measurements. Recent findings The six studies published to date found that exposure to certain ambient air pollutants during pregnancy is negatively associated with the growth rates and average attained size of fetal parameters belonging to the growth profile. Fetal parameters may respond to maternal air pollution exposures uniquely, and this response may vary by pollutant and timing of gestational exposure. Current literature suggests that mean changes in head circumference, abdominal circumference, femur length, and biparietal diameter are negatively associated with early-pregnancy exposures to ambient and vehicle-related air pollution. Summary The use of more longitudinal studies, employing ultrasound measures to assess fetal outcomes, may assist with the better understanding of mechanisms responsible for air pollution-related pregnancy outcomes. PMID:23399571

  3. ADHD and growth: anthropometric changes in medicated and non-medicated ADHD boys.

    PubMed

    Ptacek, Radek; Kuzelova, Hana; Paclt, Ivo; Zukov, Ilja; Fischer, Slavomil

    2009-12-01

    ADHD children can show changes in growth and development. Many studies describe these changes as a side effect of stimulant medication. However, changes in somatic development can also appear in non-medicated children. This suggests that the changes could be a manifestation of the disorder itself and not just a side effect of the treatment. This study compared anthropometric characteristics in medicated and non-medicated ADHD boys (n=104, age 4-16 years) with the normal non-clinical population. In contrast to most previous studies, complex anthropometrical measurements were used. The results showed significant differences between children with ADHD and those without the diagnosis, the differences found to be statistically significant (p<0.01) being signs of nutrition (percentage of fat, abdominal circumference) and growth suppression (lower body height, smaller head circumference). Differences between the medicated and non-medicated groups corresponded only to a lower value of body fat in the medicated children. These results suggest that growth changes in ADHD children may be more specific to the disorder itself than to stimulant treatment.

  4. Socioeconomic Disparities in Adverse Birth Outcomes in Urban and Rural Contexts: a French Mother-Child Cohort.

    PubMed

    Bertin, Mélanie; Viel, Jean-François; Monfort, Christine; Cordier, Sylvaine; Chevrier, Cécile

    2015-09-01

    Although adverse birth outcomes have been associated with neighbourhood deprivation in urban areas, few studies have addressed this issue in rural zones. This study examines whether associations between neighbourhood deprivation and adverse birth outcomes differ in urban and rural contexts, while taking individual characteristics and spatial accessibility of prenatal care (SAPC) into account. Pregnant women from a French mother-child cohort were recruited from 2002 to 2006 in Brittany. Their residential addresses were geocoded into their census blocks (the finest geographical resolution available). Deprivation was assessed at the same neighbourhood level. Models to assess the associations of deprivation, stratified by urban/rural status, with preterm delivery (PTD), with small for gestational age birth weight (SGA) and with small for gestational age head circumference at birth (SHC), estimated odds ratios (ORs), adjusted for maternal socioeconomic characteristics and SAPC. This study considered 2929 liveborn singleton pregnancies from 780 census blocks. Neighbourhood deprivation was associated with increased risks of SGA and SHC (P trend < 0.01 and 0.03 respectively), only among mothers residing in rural areas. Neighbourhood deprivation had statistically significantly heterogeneous effects on SGA and SHC according to the urban/rural status of maternal residence. These findings suggest that neighbourhood deprivation affects fetal growth differentially in urban and rural areas and that SAPC does not seem to be responsible for this difference. Comparison of these findings with the literature requires caution in the conceptualisation of urban and rural settings. © 2015 John Wiley & Sons Ltd.

  5. Discrepancy in fetal head biometry between ultrasound and MRI in suspected microcephalic fetuses.

    PubMed

    Yaniv, Gal; Katorza, Eldad; Tsehmaister Abitbol, Vered; Eisenkraft, Arik; Bercovitz, Ronen; Bader, Salim; Hoffmann, Chen

    2017-12-01

    Background Microcephaly is one of the most common fetal structural abnormalities, and prenatal microcephaly is considered a group I malformation of cortical development diagnosed according to ultrasound (US) skull measurements. Purpose To evaluate the agreement between fetal head US and magnetic resonance imaging (MRI) biometric measurements of suspected microcephalic fetuses. Material and Methods This institutional review board-approved retrospective study with waived informed consent included 180 pregnant women and was conducted at our medical center from March 2011 to April 2013. Biparietal diameter (BPD) and occipitofrontal diameter (OFD) results of fetal head US normograms were compared to normograms for MRI. We used Pearson and Spearman rho non-parametric correlation coefficients to assess the association between two quantitative variables, paired t-test for paired quantitative variables, and McNemar test for paired qualitative variables. Results The average BPD but not the average OFD percentiles in fetal head US differed significantly from the MRI results ( P < 0.0001). When looking at the accepted microcephaly threshold, both BPD and OFD percentiles differed significantly from MRI ( P < 0.0001 and P < 0.004, respectively). There was no correlation between US-measured skull biometry and MRI-measured brain biometry. Estimated cerebrospinal fluid volumes were significantly lower in the study group compared to 120 fetuses with normal findings in prenatal head US and MRI. Also, we have created a MRI-based normogram of fetal head circumference and gestational age. Conclusion The diagnosis of microcephaly by US alone may be insufficient and ideally should be validated by MRI before a final diagnosis is established.

  6. Modified duval procedure for small-duct chronic pancreatitis without head dominance.

    PubMed

    Oida, Takatsugu; Aramaki, Osamu; Kano, Hisao; Mimatsu, Kenji; Kawasaki, Atsushi; Kuboi, Youichi; Fukino, Nobutada; Kida, Kazutoshi; Amano, Sadao

    2011-01-01

    In the case of small-duct chronic pancreatitis, surgery for pain relief is broadly divided into resection and drainage procedures. These procedures should be selected according to the location of dominant lesion, diameter of the pancreatic duct and extent of the disease. The appropriate procedure for the treatment of small-duct chronic pancreatitis, especially small-duct chronic pancreatitis without head dominance, remains controversial. We developed the modified Duval procedure for the treatment of small-duct chronic pancreatitis without head dominance and determined the efficacy of this procedure. We retrospectively studied 14 patients who underwent surgical drainage with or without pancreatic resection for chronic pancreatitis with small pancreatic duct (<7mm) without head dominance. These patients were divided into 2 groups; the modified Puestow procedure group and the modified Duval procedure group. No complications occurred in the modified Duval group. In the modified Puestow procedure group, complete and partial pain relief were observed in 62.5%, and 37.5% of patients respectively. In contrast, complete pain relief was observed in all the patients in the modified Duval procedure group. Our modified Duval procedure is useful and should be considered the appropriate surgical technique for the treatment of small-duct chronic pancreatitis without head dominance.

  7. Infant outcomes among women with Zika virus infection during pregnancy: results of a large prenatal Zika screening program.

    PubMed

    Adhikari, Emily H; Nelson, David B; Johnson, Kathryn A; Jacobs, Sara; Rogers, Vanessa L; Roberts, Scott W; Sexton, Taylor; McIntire, Donald D; Casey, Brian M

    2017-03-01

    Zika virus infection during pregnancy is a known cause of congenital microcephaly and other neurologic morbidities. We present the results of a large-scale prenatal screening program in place at a single-center health care system since March 14, 2016. Our aims were to report the baseline prevalence of travel-associated Zika infection in our pregnant population, determine travel characteristics of women with evidence of Zika infection, and evaluate maternal and neonatal outcomes compared to women without evidence of Zika infection. This is a prospective, observational study of prenatal Zika virus screening in our health care system. We screened all pregnant women for recent travel to a Zika-affected area, and the serum was tested for those considered at risk for infection. We compared maternal demographic and travel characteristics and perinatal outcomes among women with positive and negative Zika virus tests during pregnancy. Comprehensive neurologic evaluation was performed on all infants delivered of women with evidence of possible Zika virus infection during pregnancy. Head circumference percentiles by gestational age were compared for infants delivered of women with positive and negative Zika virus test results. From March 14 through Oct. 1, 2016, a total of 14,161 pregnant women were screened for travel to a Zika-affected country. A total of 610 (4.3%) women reported travel, and test results were available in 547. Of these, evidence of possible Zika virus infection was found in 29 (5.3%). In our population, the prevalence of asymptomatic or symptomatic Zika virus infection among pregnant women was 2/1000. Women with evidence of Zika virus infection were more likely to have traveled from Central or South America (97% vs 12%, P < .001). There were 391 deliveries available for analysis. There was no significant difference in obstetric or neonatal morbidities among women with or without evidence of possible Zika virus infection. Additionally, there was no difference in mean head circumference of infants born to women with positive vs negative Zika virus testing. No microcephalic infants born to women with Zika infection were identified, although 1 infant with hydranencephaly was born to a woman with unconfirmed possible Zika disease. Long-term outcomes for infants exposed to maternal Zika infection during pregnancy are yet unknown. Based on a large-scale prenatal Zika screening program in an area with a predominantly Hispanic population, we identified that 4% were at risk from reported travel with only 2/1000 infected. Women traveling from heavily affected areas were most at risk for infection. Neonatal head circumference percentiles among infants born to women with evidence of possible Zika virus infection during pregnancy were not reduced when compared to infants born to women without infection. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Fetal growth trajectories in pregnancies of European and South Asian mothers with and without gestational diabetes, a population-based cohort study.

    PubMed

    Sletner, Line; Jenum, Anne Karen; Yajnik, Chittaranjan S; Mørkrid, Kjersti; Nakstad, Britt; Rognerud-Jensen, Odd Harald; Birkeland, Kåre I; Vangen, Siri

    2017-01-01

    Our aim was to examine the impact of gestational diabetes (GDM), from before the GDM-diagnosis is made, on fetal growth trajectories, and to compare it in Europeans and South Asians; two ethnic groups with dissimilar fetal growth patterns. We studied European (n = 349) and South Asian (n = 184) pregnant women, from the population-based STORK-Groruddalen cohort in Oslo, Norway. Mothers were enrolled in early pregnancy, screened for GDM in gestational week 28 ±2, and classified as "non-GDM", "mild GDM" or "moderate/severe GDM". We measured fetal head circumference, abdominal circumference and femur length by ultrasound, and estimated fetal weight in gestational week 24, 32 and 37, and performed corresponding measurements at birth. In non-GDM pregnancies, South Asian fetuses (n = 156) had a slower growth from gestational week 24, compared with Europeans (n = 310). More than two thirds of the European mothers later diagnosed with GDM were overweight or obese in early pregnancy, while this was not observed in South Asians. Fetuses of GDM mothers tended to be smaller than fetuses of non-GDM mothers in week 24, but thereafter grew faster until birth. This pattern was especially pronounced in fetuses of South Asian mothers with moderate/severe GDM. In week 24 these fetuses had a -0.95 SD (95% CI: -1.53, -0.36) lower estimated fetal weight than their non-GDM counterparts. In contrast, at birth they were 0.45 SD (0.09, 0.81) larger. Offspring of GDM mothers were smaller in mid pregnancy, but subsequently grew faster until birth, compared with offspring of non-GDM mothers. This pattern was most prominent in South Asian mothers with moderate to severe GDM. However, the most remarkable characteristic of these fetuses was not a large size at birth, but the small size in mid pregnancy, before the GDM diagnosis was set.

  9. The AL 333-160 fourth metatarsal from Hadar compared to that of humans, great apes, baboons and proboscis monkeys: non-conclusive evidence for pedal arches or obligate bipedality in Hadar hominins.

    PubMed

    Mitchell, P J; Sarmiento, E E; Meldrum, D J

    2012-10-01

    Based on comparisons to non-statistically representative samples of humans and two great ape species (i.e. common chimpanzees Pan troglodytes and lowland gorillas Gorilla gorilla), Ward et al. (2011) concluded that a complete hominin fourth metatarsal (4th MT) from Hadar, AL 333-160, belonged to a committed terrestrial biped with fixed transverse and longitudinal pedal arches, which was no longer under selection favoring substantial arboreal behaviors. According to Ward et al., the Hadar 4th MT had (1) a torsion value indicating a transverse arch, (2) sagittal plane angles between the diaphyseal long axis and the planes of the articular surfaces indicating a longitudinal arch, and (3) a narrow mediolateral to dorsoplantar base ratio, an ectocuneiform facet, and tarsal articular surface contours all indicating a rigid foot without an ape-like mid-tarsal break. Comparisons of the Hadar 4th MT characters to those of statistically representative samples of humans, all five great ape species, baboons and proboscis monkeys show that none of the correlations Ward et al. make to localized foot function were supported by this analysis. The Hadar 4th MT characters are common to catarrhines that have a midtarsal break and lack fixed transverse or longitudinal arches. Further comparison of the AL 333-160 4th MT length, and base, midshaft and head circumferences to those of catarrhines with field collected body weights show that this bone is uniquely short with a large base. Its length suggests the AL 333-160 individual was a poor leaper with limited arboreal behaviors and lacked a longitudinal arch, i.e. its 4th MT long axis was usually held perpendicular to gravity. Its large base implies cuboid-4th MT joint mobility. A relatively short 4th MT head circumference indicates AL 333-160 had small proximal phalanges with a restricted range of mobility. Overall, AL 333-160 is most similar to the 4th MT of eastern gorillas, a slow moving quadruped that sacrifices arboreal behaviors for terrestrial ones. This study highlights evolutionary misconceptions underlying the practice of using localized anatomy and/or a single bony element to reconstruct overall locomotor behaviors and of summarizing great ape structure and behavior based on non-statistically representative samples of only a few living great ape species. Copyright © 2012. Published by Elsevier GmbH.

  10. Volume measurements on three-dimensional photogrammetry after extended strip versus total cranial remodeling for sagittal synostosis: A comparative cohort study.

    PubMed

    van Veelen, Marie-Lise C; Jippes, Marielle; Carolina, Julius-Carl A; de Rooi, Johan; Dirven, Clemens M F; van Adrichem, Leon N A; Mathijssen, Irene M

    2016-10-01

    Surgery for sagittal synostosis aims at correction of skull shape and restoration of growth potential. Small cranial volume is associated with raised intracranial pressure (ICP). Although many techniques have been described, information on postoperative volume related to early and late remodeling is lacking. Between 2004 and 2008, a total of 95 patients were collected who underwent either early extended strip craniectomy or late total cranial remodeling according to age of presentation. Volume was measured on three-dimensional (3D) photogrammetry. Volume measurements were related to cranial index (CI), head circumference (HCsd), and signs of raised ICP. In a small subset of patients, volume measurements on 3D photogrammetry were assessed for inter- and intrarater reliability and compared to 3D computed tomography (CT). Volume was increased in all patients before and after surgery compared to normative values. Postoperatively, late total cranial remodeling resulted in a slightly larger volume than early extended strip craniectomy. Volume measurements showed a good correlation with HCsd (0.67) and a poor relationship with CI (0.13). Headache occurred more frequently in patients with a lower cranial volume. Although papilledema and reoperation showed the same trend, the numbers were too small for statistical analysis. Reproducibility of volume measurements on 3D photogrammetry was high, as was the correlation with measurements on CT. Late total cranial remodeling results in a larger postoperative volume, as measured on 3D photogrammetry, than extended strip craniectomy. Clinical signs of raised ICP occur more frequently in patients with a smaller volume. To measure volume, 3D photogrammetry is a good alternative to CT. Copyright © 2016. Published by Elsevier Ltd.

  11. Association of polycyclic aromatic hydrocarbons (PAHs) and lead co-exposure with child physical growth and development in an e-waste recycling town.

    PubMed

    Xu, Xijin; Liu, Junxiao; Huang, Chaoying; Lu, Fangfang; Chiung, Yin Mei; Huo, Xia

    2015-11-01

    Informal e-waste recycling activities results in serious environmental pollution of PAHs. We evaluated the body burden of 16 PAH congeners and potential health risks for children. A total of 167 children from exposed and reference area entered this study. Child blood samples were collected; height, weight, head and chest circumferences were measured. Blood PAH and lead concentrations were determined. The blood median of total PAHs from the exposed group was significantly higher than the reference group (68.53μg/L vs. 26.92μg/L, P<0.01). The major sources of Σ16-PAH and Σ7 carcinogenic-PAH were residence adjacent to e-waste workshop, paternal occupation related to e-waste recycling and house as a workshop. Inverse correlations were observed in the age and milk consumption with these two PAH groups, while a positive association was found between BMI and Σ7 carcinogenic-PAH, and between child height and blood lead. When divided into high and low exposure groups by Σ16-PAH, a significant negative association was found between body height and blood PAHs (β and 95%CI: -3.838, -6.469 to -1.206), while for weight and chest circumferences, negative associations were obtained only in the male subgroup before adjustment. After adjustment by sex, age, child milk products consumption per month and blood lead, child height was negatively associated with Σ16-PAH (β and 95%CI: -3.884, -6.736 to -1.033). Same trends were observed for child chest circumference (β and 95%CI: -1.147, -2.229 to -0.065). We suggest a negative association of PAHs and child height and chest circumference, while the correlation is more obvious in boys. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Assignment of boundary conditions in embedded ground water flow models

    USGS Publications Warehouse

    Leake, S.A.

    1998-01-01

    Many small-scale ground water models are too small to incorporate distant aquifer boundaries. If a larger-scale model exists for the area of interest, flow and head values can be specified for boundaries in the smaller-scale model using values from the larger-scale model. Flow components along rows and columns of a large-scale block-centered finite-difference model can be interpolated to compute horizontal flow across any segment of a perimeter of a small-scale model. Head at cell centers of the larger-scale model can be interpolated to compute head at points on a model perimeter. Simple linear interpolation is proposed for horizontal interpolation of horizontal-flow components. Bilinear interpolation is proposed for horizontal interpolation of head values. The methods of interpolation provided satisfactory boundary conditions in tests using models of hypothetical aquifers.Many small-scale ground water models are too small to incorporate distant aquifer boundaries. If a larger-scale model exists for the area of interest, flow and head values can be specified for boundaries in the smaller-scale model using values from the larger-scale model. Flow components along rows and columns of a large-scale block-centered finite-difference model can be interpolated to compute horizontal flow across any segment of a perimeter of a small-scale model. Head at cell centers of the larger.scale model can be interpolated to compute head at points on a model perimeter. Simple linear interpolation is proposed for horizontal interpolation of horizontal-flow components. Bilinear interpolation is proposed for horizontal interpolation of head values. The methods of interpolation provided satisfactory boundary conditions in tests using models of hypothetical aquifers.

  13. Recombinant Interleukin-15 in Treating Patients With Advanced Melanoma, Kidney Cancer, Non-small Cell Lung Cancer, or Squamous Cell Head and Neck Cancer

    ClinicalTrials.gov

    2017-09-14

    Head and Neck Squamous Cell Carcinoma; Recurrent Head and Neck Carcinoma; Recurrent Non-Small Cell Lung Carcinoma; Recurrent Renal Cell Carcinoma; Recurrent Skin Carcinoma; Stage III Renal Cell Cancer; Stage IIIA Cutaneous Melanoma AJCC v7; Stage IIIA Non-Small Cell Lung Cancer AJCC v7; Stage IIIB Cutaneous Melanoma AJCC v7; Stage IIIB Non-Small Cell Lung Cancer AJCC v7; Stage IIIC Cutaneous Melanoma AJCC v7; Stage IV Cutaneous Melanoma AJCC v6 and v7; Stage IV Non-Small Cell Lung Cancer AJCC v7; Stage IV Renal Cell Cancer

  14. Foot Length, Chest Circumference, and Mid Upper Arm Circumference Are Good Predictors of Low Birth Weight and Prematurity in Ethnic Minority Newborns in Vietnam: A Hospital-Based Observational Study.

    PubMed

    Thi, Hai Nguyen; Khanh, Dung Khu Thi; Thu, Ha Le Thi; Thomas, Emma G; Lee, Katherine J; Russell, Fiona M

    2015-01-01

    The evaluation of tools to accurately identify low birth weight (LBW) and/or premature newborns in resource-limited countries is a research priority. We explored the use of foot length, chest circumference, and mid-upper arm circumference (MUAC) measured within 24 h as diagnostic tools for identifying newborns who are LBW, premature, or both; and compared measurements taken at birth with those taken at five days of age. An observational study was undertaken in Hoa Binh Province General Hospital, Vietnam, in ethnic minority newborns. Birth weight, foot length, chest circumference, and MUAC were measured within 24 h of birth and in a subset of 200, were repeated on day five of life. Gestational age was estimated using the New Ballard Score. Receiver Operating Characteristic curves and optimal cut-points (the point with the highest sensitivity and specificity where the sensitivity was at least 0.8) were calculated, for predicting prematurity, LBW, and both. Measurements within 24 h and at five days of life were compared. 485 newborns were recruited. Chest circumference and MUAC measured within 24 h of birth were found to be highly predictive of LBW (both yielding area under the curve [AUC] of 0.98, 95% confidence interval [CI] 0.96-0.99), and performed marginally better than foot length (AUC 0.94, 95%CI 0.92-0.96). The optimal cut-points for measurements within 24 h of birth were ≤ 7.4 cm for foot length; ≤ 30.4 cm for chest circumference; and ≤ 9.0 cm for MUAC. There was statistical evidence that anthropometric measurements taken within 24 h of birth were higher than measurements on day five (p<0.02 for all anthropometric measurements) but the magnitude of these differences was small (at most 2mm). All measurements taken within 24 h of birth were good predictors of LBW, prematurity and both. Differences in measurements taken within 24 h and on day five were not clinically relevant. Further research will ensure that the application of these measures is reliable in community settings.

  15. Five-class height-weight model for systematization of seventeen-year-old recruits' anthropometric data.

    PubMed

    Lintsi, Mart; Kaarma, Helje

    2003-12-01

    An anthropometric study of 552 Tartu city and Tartu county recruits aged 17 years was carried out. Height and weight, 33 anthropometric measurements and 12 skinfolds were measured. Body fat percentage was assessed by Omron BF 300 hand-held segmental body fat analyzer. From anthropometric measurements bone mass was derived by the Drink-water et al. (1986) equation, and total skeletal muscle mass by the Lee et al. (2000) equation. The data were systematized into five height-weight SD-classes. There were 3 classes with harmony between height and weight class: 1--small (small height and small weight), 2--medium (medium height and medium weight), 3--large (large height and large weight), 4--weight class dominating (pyknomorphic) and 5--height class dominating (leptomorphic). It was revealed that in classes 1, 2 and 3 the height and weight increase corresponded to the increase in all heights, breadths and depths, circumferences, skinfolds, body fat, muscle and bone mass. In class 4 circumferences, skinfolds, body fat and muscle mass were bigger. In class 5 all heights and the relative bone mass were bigger. The present investigation confirms the hypothesis that the five height-weight class system is applicable to seventeen-year-old recruits.

  16. Birth weight and time spent in outdoor physical activity during adolescence.

    PubMed

    Gopinath, Bamini; Hardy, Louise L; Baur, Louise A; Burlutsky, George; Mitchell, Paul

    2013-03-01

    We investigated the association between birth parameters (weight, length, and head circumference) and time spent in physical activity (outdoor and indoor) and screen time (TV viewing, computer, and videogame usage) among adolescents. A longitudinal cohort study surveyed 1794 children in 2004-2005 (median age = 12.7 yr), and 752 were resurveyed 5 yr later in 2009-2010 (age = 17-18 yr). Adolescents completed detailed activity questionnaires. Parents extracted birth parameter data from their child's health record booklet. After adjusting for age, sex, ethnicity, gestational age, parental education, home ownership, exposure to passive smoking, and body mass index, 12-yr-old children in the highest compared with the lowest quartile of birth weight spent on average approximately 56 and 62 min more in total (Ptrend = 0.02) and outdoor physical activity (Ptrend = 0.02) per week, respectively. Similarly, 12-yr-old children in the high (>4000 g) versus very low (<2000 g) birth weight group spent approximately 1.3 h·wk more in outdoor activity (Ptrend = 0.02). Among those age 17-18 yr, increasing birth weight (lowest to highest quartile) was associated with greater time spent in outdoor physical activity (∼1 h·wk-1, Ptrend = 0.04). Significant associations were not observed between all birth parameters and recreational screen time. Also, no associations were observed between head circumference or birth length with physical activity and screen time. Birth weight could be a potential determinant of physical activity, but not of screen time during adolescence. Hence, this could be part of the underlying mechanism between prenatal influences and future disease risk and could have possible clinical implications.

  17. Impact of maternal body mass index and gestational weight gain on neonatal outcomes among healthy Middle-Eastern females

    PubMed Central

    Papazian, Tatiana; Abi Tayeh, Georges; Sibai, Darine; Hout, Hala; Melki, Imad

    2017-01-01

    Background Studies on the relative impact of body mass index in women in childbearing age and gestational weight gain on neonatal outcomes are scarce in the Middle East. Objectives The primary objective of this research was to assess the impact of maternal body mass index (BMI) and gestational weight gain (GWG) on neonatal outcomes. The effect of maternal age and folic acid supplementation before and during pregnancy was also examined. Subjects and methods This is a retrospective cross sectional observational study of 1000 full term deliveries of women enrolled thru the National Collaborative Perinatal Neonatal Network, in Lebanon. Maternal characteristics such as age, BMI and GWG and neonatal outcomes such as weight, height, head circumference and Apgar score were the primary studied variables in this study. Total maternal weight gain were compared to the guidelines depicted by the Institute of Medicine (IOM). Results The negative outcomes of newborns such as lean body weight and macrosomia were significantly present in women who gained respectively below or above the IOM’s cut-off points. Pregestational body mass index influenced significantly the infants’ birth weight, in both the underweight and obese categories. Birth height, head circumference and Apgar score were not influenced by pregestational body mass index or gestational weight gain. No significant associations were found between maternal age and pregestational body mass index and gestational weight gain. Conclusion Studies evaluating the impact of weight before and during pregnancy on neonatal outcomes and anthropometrics measurements are lacking in the Middle East. Our results highlight the importance of nutritional counseling in order to shed the extra weights before conceiving and monitor weight gain to avoid the negative impact on feto-maternal health. PMID:28715482

  18. Impact of maternal body mass index and gestational weight gain on neonatal outcomes among healthy Middle-Eastern females.

    PubMed

    Papazian, Tatiana; Abi Tayeh, Georges; Sibai, Darine; Hout, Hala; Melki, Imad; Rabbaa Khabbaz, Lydia

    2017-01-01

    Studies on the relative impact of body mass index in women in childbearing age and gestational weight gain on neonatal outcomes are scarce in the Middle East. The primary objective of this research was to assess the impact of maternal body mass index (BMI) and gestational weight gain (GWG) on neonatal outcomes. The effect of maternal age and folic acid supplementation before and during pregnancy was also examined. This is a retrospective cross sectional observational study of 1000 full term deliveries of women enrolled thru the National Collaborative Perinatal Neonatal Network, in Lebanon. Maternal characteristics such as age, BMI and GWG and neonatal outcomes such as weight, height, head circumference and Apgar score were the primary studied variables in this study. Total maternal weight gain were compared to the guidelines depicted by the Institute of Medicine (IOM). The negative outcomes of newborns such as lean body weight and macrosomia were significantly present in women who gained respectively below or above the IOM's cut-off points. Pregestational body mass index influenced significantly the infants' birth weight, in both the underweight and obese categories. Birth height, head circumference and Apgar score were not influenced by pregestational body mass index or gestational weight gain. No significant associations were found between maternal age and pregestational body mass index and gestational weight gain. Studies evaluating the impact of weight before and during pregnancy on neonatal outcomes and anthropometrics measurements are lacking in the Middle East. Our results highlight the importance of nutritional counseling in order to shed the extra weights before conceiving and monitor weight gain to avoid the negative impact on feto-maternal health.

  19. Retinal Parameters as Compared with Head Circumference, Height, Weight, and Body Mass Index in Children in Kenya and Bhutan.

    PubMed

    Grundy, Sara J; Tshering, Lhab; Wanjala, Stanley W; Diamond, Megan B; Audi, Martin S; Prasad, Sashank; Shinohara, Russell T; Rogo, Debora; Wangmo, Dechen; Wangdi, Ugyen; Aarayang, Abi; Tshering, Thukten; Burke, Thomas F; Mateen, Farrah J

    2018-06-11

    The retina shares embryological derivation with the brain and may provide a new measurement of overall growth status, especially useful in resource-limited settings. Optical coherence tomography (OCT) provides detailed quantification of retinal structures. We enrolled community-dwelling children ages 3-11 years old in Siaya, Kenya and Thimphu, Bhutan in 2016. We measured head circumference (age < 5 years only), height, and weight, and standardized these by age and gender. Research staff performed OCT ( iScan ; Optovue, Inc., Fremont, CA), measuring the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) thicknesses. A neuro-ophthalmologist performed quality control for centration, motion artifact, and algorithm-derived quality scores. Generalized estimating equations were used to determine the relationship between anthropometric and retinal measurements. Two hundred and fifty-eight children (139 females, average age 6.4 years) successfully completed at least one retinal scan, totaling 1,048 scans. Nine hundred and twenty-two scans (88.0%) were deemed usable. Fifty-three of the 258 children (20.5%) were able to complete all six scans. Kenyan children had a thinner average GCC ( P < 0.001) than Bhutanese children after adjustment for age and gender, but not RNFL ( P = 0.70). In models adjusting for age, gender, and study location, none of standardized height, weight, and body mass index (BMI) were statistically significantly associated with RNFL or GCC. We determined that OCT is feasible in some children in resource-limited settings, particularly those > 4 years old, using the iScan device. We found no evidence for GCC or RNFL as a proxy for height-, weight-, or BMI-for-age. The variation in mean GCC thickness in Asian versus African children warrants further investigation.

  20. Effects of growth hormone on body proportions in Turner syndrome compared with non-treated patients and normal women.

    PubMed

    Baldin, A D; Fabbri, T; Siviero-Miachon, A A; Spinola-Castro, A M; Lemos-Marini, S H V; Baptista, M T M; D'Souza-Li, L F R; Maciel-Guerra, A T; Guerra, G

    2010-11-01

    The majority of anthropometric assessments in Turner syndrome (TS) patients has focused on height. To analyze body proportions in young adult TS patients either treated or not treated with rhGH, and to compare them with a group of age-matched healthy women. Standing height, sitting height, weight, foot and leg lengths, arm span, head circumference, biliac and biacromial diameters were measured in 52 non-treated TS patients, 30 treated with rhGH and 133 healthy women. Age at the start of rhGH therapy varied from 7.8 to 15.1 yr (10.0±1.3 yr), the duration of treatment from 2.8 to 8.2 yr (3.7±1.5 yr) and the mean recombinant human GH (rhGH) dose was 0.42 mg/kg/week (from 0.32 to 0.50 mg/kg/week). Nontreated patients did not show any difference in anthropometric variables when compared with the treated ones, except for hand length (p=0.02) and height (p=0.05), which were increased in the treated group. All anthropometric variables, except head circumference, were different when comparing TS patients (either treated or not) with age-matched healthy women. Brazilian TS patients either treated or not with rhGH showed almost no differences in terms of their body proportions. This result is probably due to the late age at the start of treatment, and/or the short period of rhGH administration. Hand length was different between the groups, showing the importance of including the extremities in body proportion assessment during rhGH treatment of TS patients.

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