Sex-Specific Effects of Birth Weight on Longitudinal Behavioral Outcomes: A Mendelian Randomization Approach Using Polygenic Scores.

Background: It is unclear whether sex differences in behavior arising from birth weight (BW) are genuine because of the cross-sectional nature and potential confounding in previous studies. We aimed to test whether sex differences associated with BW phenotype were reproducible using a Mendelian randomization approach, i.e., association between polygenic score (PGS) for BW and behavior outcomes across childhood and adolescence. Methods: Using data from the Raine Study, we had 1484 genotyped participants with a total of 6446 Child Behavior Checklist assessments from ages 5 to 17 years. We used BW-PGSs in linear mixed-effect models to predict parentally assessed attention, aggression, and social problems scales; we also derived estimates and significance for a sex-by-genotype interaction. We used a Bonferroni-corrected significance threshold and tested robustness of the results with teacher assessments of behavior and a second PGS. Results: We found a sex-by-genotype interaction with lower BW-PGSs associated with increased aggression in males compared with females. These findings were consistent across various analyses, including teacher assessments. Surprisingly, a lower BW-PGS showed protective effects in females, while a lower BW phenotype had detrimental effects in males with evidence of a genotype-phenotype mismatch increasing aggression problems in males only. Conclusions: This study underscores the genuine nature of behavioral sex differences arising from low BW and highlights the sex-dependent and diverging effects of environmental and genetic BW determinants.

Previous studies have suggested a link between low birth weight and poor behavioral outcomes in children and adolescents, but it is unclear if these effects differ between males and females. We demonstrated that genes influencing birth weight had different effects on aggressive behavior in males and females with effects throughout childhood and adolescence; furthermore, our study suggests that birth weight environment and birth weight genes have different effects on behavior. In males, a mismatch between the genetically determined birth weight and the measured birth weight resulted in more aggressive behavior.

Association Between Household Food Insecurity and Low Birth Weight: A Population-Based Case-Control Study.

BACKGROUND: Low birth weight (LBW) is a major public health issue associated with increased neonatal morbidity and mortality. This study aimed to examine the association between household food insecurity and LBW in Mashhad, Iran. Study Design: A population-based case-control study. METHODS: This study involved 6294 mothers (3247 cases and 3247 controls) who visited healthcare centers affiliated with Mashhad University of Medical Sciences for term births between March 2019 and March 2022. Cases included women who delivered neonates weighing<2500 g, while controls delivered babies≥2500 g. Food security was measured using the validated Household Food Insecurity Access Scale. Logistic regression models examined the associations between food insecurity and LBW. Geographic information system techniques mapped LBW distribution in Mashhad. RESULTS: Household food insecurity was significantly associated with higher odds of LBW (adjusted odds ratio [AOR]=1.25, 95% confidence interval [CI]: 1.03, 1.53). Other risk factors included younger maternal age (AOR=1.03, 95% CI: 1.01, 1.04), lower maternal education (AOR=0.55, 95% CI: 0.43, 0.71), cesarean delivery (AOR=1.70, 95% CI: 1.40, 2.06), and exposure to secondhand smoke (AOR=1.68, 95% CI: 1.02, 2.75). Gestational diabetes demonstrated a protective effect (AOR=0.37, 95% CI: 0.15, 0.91). Geographic mapping revealed that regions with higher food insecurity had elevated LBW prevalence. CONCLUSION: These findings underscore the importance of addressing food insecurity among pregnant women to reduce the risk of LBW and improve newborn outcomes.

Comparing Perinatal Outcomes of Assisted Reproductive Technology (ART)-Induced vs. Naturally Conceived Twin Pregnancies.

The occurrence of multiple pregnancies is consistently and significantly linked to the growing use of assisted reproductive technology (ART). Even very young women opt for having multiple embryos implanted by medical professionals in order to increase the chances of a successful outcome. Our aim is to review the research on cesarean section rates and perinatal outcomes, like perinatal morbidity, risk of preterm delivery, and low birth weight (LBW) of neonates in multiple pregnancies that resulted from ART in comparison to those that were naturally conceived. We conducted a comprehensive search of the PubMed, Crossref, and Google Scholar electronic databases for related articles up to January 2024 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We found that most studies found no relationship between ART procedures and poor perinatal outcomes in multiple pregnancies compared to naturally conceived ones. A few studies have linked ART services to preterm birth (PTB) and LBW. Careful interpretation of these findings is necessary since confounding factors may invalidate the putative link. Although perinatal death rates are similar, ART increases cesarean section rates. When a statistically significant difference was detected, it was typically attributable to confounding variables such as maternal age, subfertility reasons, or maternal comorbidities like gestational diabetes or hypertension.

Clinical Profile and Outcome of Bronchiolitis in Children With 1-24 Months of Age.

Introduction Bronchiolitis poses a significant challenge in pediatric critical care. It is an acute illness affecting the lower respiratory tract in children under the age of two. The most common cause of bronchiolitis is the seasonal respiratory syncytial virus, with influenza and adenovirus also notable contributors. It is characterized by various clinical symptoms and indicators, such as an upper respiratory prodrome, increased respiratory effort, and wheezing in younger children under two years old. This study primarily examines the clinical profile, risk factors, severity, and outcomes of bronchiolitis in children under two years, excluding the neonatal age group.  Materials and methods Children under two years of age who presented with upper respiratory symptoms and their first episode of wheezing were evaluated. Those with pre-existing systemic conditions such as cardiac, respiratory, or immunodeficiency disorders were excluded. A detailed history was gathered using a questionnaire, and risk factors were analyzed. The severity of the condition was measured using the Wood-Downes-Ferres score. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). The relationship between risk factors, severity, and outcomes was examined using the chi-squared test. A two-sided probability of p<0.05 was considered statistically significant for all tests. Results Among 54 children aged 1-24 months with bronchiolitis, the average age was 10.18 months, with a standard deviation of 4.8 months. The severity of the condition was greater in younger children (1-12 months) and tended to decrease with age. Bronchiolitis was more common in males (33 cases) than females (21 cases). Approximately 50 children (92.6%) exhibited signs of respiratory distress, and 45 children (83.3%) showed cough as an initial symptom. Severity was notably higher in children with a history of irritability, which was statistically significant (chi-squared value: 8.169; p-value: 0.017). Only 16 children (29.65%) had a history of poor feeding. Bronchiolitis was more prevalent among infants with a birth weight under 1500 grams (63%). Non-exclusive breastfeeding and early bottle feeding were significant risk factors for bronchiolitis and its severity (chi-squared values: 18.794; p-value: 0.000 and 7.795; p-value: 0.020, respectively). Only two children (3.7%) had been exposed to passive smoke, and the severity was slightly higher in these cases. There was also a statistically significant association between socioeconomic status and bronchiolitis (chi-squared value: 11.917; p-value: 0.018). Conclusion This study aims to raise awareness among parents and clinicians about the high-risk age group for bronchiolitis, its typical presentations, and predictors of severity. It underscores the impact of both biological and environmental risk factors, such as bottle feeding, non-exclusive breastfeeding, and socioeconomic status, on the severity of the condition.

Accurate birth weight prediction from fetal biometry using the Gompertz model.

Objectives: Monitoring of fetal growth and estimation of birth weight is of clinical importance. During pregnancy, ultrasound fetal biometry values including femur length, head circumference, abdominal circumference, biparietal diameter are measured and used to place fetuses on "growth charts". There is no simple growth-model-based, predictive formula in use for fetal biometry. Estimation of fetal weight at birth currently depends on ultrasound data taken a short time before birth. Study design: Our cohort ("Seethapathy cohort") consists of ultrasound biometry measurements and other data for 774 pregnant women in Chennai, India, 2015-2017. We use the Gompertz model, a standard model for constrained growth, with just three intuitive parameters, to model the growth of fetal biometry, and a machine learning (ML) model trained on these parameters to predict birth weight (BW). Results: The Gompertz model convincingly fits the growth of fetal biometry values. Two Gompertz parameters- t 0 (inflection time) and c (rate of decrease of growth rate)-seem universal to all fetuses, while the third, A , is an overall scale specific to each fetus, capturing individual variation. On the Seethapathy cohort we can infer A for each fetus from ultrasound data available by the 24 or 35 weeks. Our ML model predicts birth weight with < 8 % error, outperforming published methods that have access to late-term ultrasound data. The same model gives an 8.4 % error in BW prediction on an independent validation cohort of 365 women. Conclusions: The Gompertz model fits fetal biometry growth and enables birth weight estimation without need of late-term ultrasounds. Aside from its clinical predictive value, we suggest its use for future growth standards, with almost all variation described by a single scale parameter A .

Providing very low-birth-weight infants with fast enteral feeding reduced how long they needed a central venous catheter.

AIM: To determine the impact of the protocol change from slow to fast enteral feeding progression on duration of central venous catheter placement, and the rates of late-onset sepsis and necrotising enterocolitis. METHODS: We compared the evolution of all very low-birth-weight infants admitted on their first postnatal day in neonatal intensive care unit during a 12-month period, before (2021 Cohort) and after (2022 Cohort) implementation of a new feeding protocol. Linear regression model was used to adjust for confounding factors. RESULTS: A total of 343 VLBW infants were included (median gestational age ± SD 28.3 ± 1.7 weeks; median birth weight ± SD 980 ± 300 g). Median initial duration of central venous catheter was 5 days in 2022 cohort compared with 9 days in 2021 cohort (unadjusted p = 0.006, adjusted p = 0.001). Median time to achieve full enteral feeding was 8 days versus 12 days, p < 0.001, with no significant difference in late-onset sepsis or necrotising enterocolitis rates. CONCLUSION: The change from slow to fast enteral feeding progression for very low-birth-weight infants significantly decreased the central venous catheter duration with no adverse outcomes. This is consistent with recent randomised study results and supports the safe implementation in neonatal intensive care units.

Association between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study.

Objective: To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants. Methods: Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models. Results: The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates. Conclusion: No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.

Association of Anti-Annexin A5 Antibody With Pregnancy Outcomes: A Cohort Study: Anti-annexin A5 antibody with pregnancy outcomes.

OBJECTIVE: This study aims to evaluate the correlation between anti-annexin A5 (aANXA5) antibody in the blood and pregnancy outcomes . METHODS: This study is a retrospective cohort study based on singleton pregnancies of the Third Affiliated Hospital of Wenzhou Medical University from May 2018 to December 2022. Baseline characteristics were collected from all participants. Logistic regression and interaction effect analyses were utilized to examine the risk impact of aANXA5 on pregnancy complications, adjusting for age, BMI, abortion, ANA, and aCL. Restricted cubic spline (RCS) and threshold effect analysis were applied to explore the relationship between aANXA5 levels and preterm birth (PTB), as well as pregnancy-induced hypertension (PIH). RESULTS: The study included 501 participants, with 51 (10.2%) testing positive for aANXA5 and 450 (89.8%) testing negative. The aANXA5 positive group exhibited higher rates of ANA and antibodies to thyroglobulin (TGAb), along with increased incidences of PTB and PIH. Positive aANXA5 status was independently linked to an elevated risk of PTB (OR: 2.53, 95% CI: 1.30-4.94) and PIH (OR: 4.23, 95% CI: 1.54-11.62). Subsequent subgroup analysis indicated no significant interaction between the groups (p > 0.05). Threshold analysis revealed that the OR for PTB was 1.20 (95% CI: 1.03-1.39) in participants with aANXA5 levels ≥ 32.77 ng/mL, and the OR for PIH was 1.62 (95% CI: 1.15-2.28) in those with aANXA5 levels ≥ 33.20 ng/mL. CONCLUSION: AANXA5 is independently associated with an increased risk of PTB and PIH. The identified optimal predictive cutoff values are 32.77 ng/mL for PTB and 33.20 ng/mL for PIH.

Ambient air pollution and low birth weight in Brazil: A nationwide study of more than 10 million births between 2001 and 2018.

Low birth weight (LBW) is a global health concern. While it is commonly associated with maternal health and behavior, exposure to ambient air pollution, can also play a role in contributing to LBW. In Brazil, where diverse environmental conditions and regional disparities exist, assessing the impact of ambient air pollution on LBW becomes particularly pertinent. To our knowledge, there is a gap in the existing literature, as no previous study has specifically investigated the relationship between ambient air pollution and LBW nationwide in Brazil. This study aims to fill this gap by examining the association between ambient air pollution and LBW in each trimester of pregnancy across the Brazilian states. In this work, birth data from January 1, 2001, to December 31, 2018 has been used. We utilized logistic regression models to estimate the odds ratio (OR) for low birth weight (LBW) associated with ambient air pollution (PM2.5, NO2, and O3) during each trimester of pregnancy (1st to 3rd trimester) across all 27 Brazilian states in our nationwide case-control study. We adjusted our model for several variables, including ambient temperature, relative humidity, and socioeconomic status (SES) variables at the individual level. We also conducted effect modification analyses by infant sex, mother's age, and the number of prenatal visits. Our study comprises over 10,213,144 birth records nationwide. Of these, 479,204 (4.92%) infants were included as cases of LBW. Our results indicate positive associations between PM2.5 and LBW, mainly in the Southern region. For example, in the state of Santa Catarina (South region), ORs were 1.003 (95% CI: 1.002, 1.004), 1.003 (95% CI: 1.002, 1.004), and 1.005 (95% CI: 1.003, 1.007) for the 1st, 2nd, and 3rd trimesters of exposure, respectively. NO2 had a robust association with LBW in the Northern and Northeastern states, including the state of Amapá (North region, where the Amazon Forest is located) with ORs of 1.377 (95% CI: 1.010, 1.878), 1.390 (95% CI: 1.020, 1.894), and 1.747 (95% CI: 1.297, 2.352) for the 1st, 2nd, and 3rd trimesters of exposure, respectively. Similarly, O3 had a robust association in the North and Midwest states, as observed in the state of Amapá with ORs of 1.033 (95% CI: 1.012, 1.054), and 1.033 (95% CI: 1.013, 1.053) for the 2nd, and 3rd trimesters, respectively. In the stratified analysis, boys were more vulnerable than girls, and the lower number of prenatal visits was associated with higher OR. Our findings are essential to the development of guidelines to prevent maternal exposure and protection of newborns in Brazil. This study provides valuable insights for region-specific strategies to improve maternal and neonatal health.

Prevalence and associated risk factors of intraventricular hemorrhage in preterm newborns in Southwestern Iran.

PURPOSE: The purpose of this study was to investigate the prevalence of IVH and its associated risk factors in premature newborn admitted to NICU in Southwestern Iran. METHODS AND MATERIALS: This cross-sectional study involved all premature newborn admitted to Namazee NICU, Southwestern Iran, during the year 2022. The diagnosis of IVH was confirmed using brain ultrasonography, following Papille's criteria. Demographic data and potential risk factors were collected and analyzed for two groups: neonate diagnosed with IVH and those without the condition. RESULTS: Among the 275 preterm neonates studied (125 girls, 150 boys), the mean gestational age was 29.22 ± 1.44 weeks. The prevalence of IVH was found to be 20.4% within the first 7th day after birth. The recognized risk factors of IVH in our study were gestational age, pneumothorax, hypoxia, antenatal steroids, and transfusion of packed red blood cell. Duration of intubation and CPAP therapy were found to be other risk factors, too. The logistic regression model showed preterm newborns born between gestational age of 28+1 and 30+6 weeks had a twofold increased risk of developing IVH. CONCLUSION: The prevalence of IVH in NICU hospitalized newborns with a gestational age of ≤ 32 weeks was around 20%, which is consistent with other studies conducted in Iran. The findings emphasize the importance of enhanced antenatal care for early intervention for neonates born at early gestational age to reduce or prevent the risk of IVH.

Childhood growth of singletons conceived following intracytoplasmic sperm injection - irrelevance of gonadotropin stimulation.

Background: In conventional, gonadotropin stimulated, in vitro fertilization or intracytoplasmic sperm injection (c-IVF/ICSI) growth and development of multiple follicles is induced by gonadotropins, combined with gonadotropin-releasing hormone agonist or antagonist. In recent studies, singletons conceived after c-IVF/ICSI cycles had lower birth weight not only than spontaneously conceived children but also children born after unstimulated natural IVF/ICSI cycles (NC-IVF/ICSI). Lower birth weight is associated with a catch-up growth within the first years of life. Following the Barker hypothesis accelerated growth has been associated with a higher risk of cardiovascular diseases later in life. The aim of the study is to assess, if children conceived with NC-IVF/ICSI have a higher birthweight and therefore do not show a catch-up growth within the first two years. Therefore, we assume that children born after NC-IVF/ICSI have a better long-term cardiometabolic risk profile. Whether the weight- and height gain is comparable to spontaneously conceived children is unknown, since to our knowledge we are the first study to investigate the longitudinal growth of children born after unstimulated natural cycle ICSI (NC-ICSI). Material and methods: We conducted a single-center, prospective cohort study (2010-2017) including children (n = 139) born after NC-ICSI or c-ICSI treatment. Growth parameters up to 24 months were collected. Standard deviation scores based on growth references were calculated. Results: The study included 98 children in the NC-ICSI and 41 children in the c-ICSI group. The median birth weight in NC-ICSI children was 3.4 kg [0.1 standard deviation score (SDS)] compared to 3.3 kg (-0.3 SDS) in c-ICSI children (p = 0.61). Median length at birth was 50 cm in both groups (NC-ICSI (-0.5 SDS), c-ICSI children (-0.8 SDS), p = 0.48). At age 24 months, median weight in NC-ICSI children was 12.2 kg (0.3 SDS) versus 12.2 kg (0.2 SDS) in c-ICSI children (p = 0.82) and median length 87.5 cm (0.1 SDS) versus 88.0 cm (0.4 SDS) (p = 0.43). Conclusion: We found no difference in growth between children conceived after stimulated and unstimulated ICSI. Growth parameters of both treatment groups did not differ from Swiss national growth references (N = 8500). One of the main limitations of our study was the small sample size (N = 139) of complete data sets over time and the high drop-out rate of 49% (68/139). Nevertheless, with the increasing number of children born after IVF/ICSI every year it is of immense importance to search for possibilities to reduce their long-term cardiometabolic risk and we want our data to contribute to this discussion.

Exploring predictors of interaction among low-birth-weight infants and their caregivers: a machine learning-based random forest approach.

BACKGROUND: Quality caregiver-infant interaction is crucial for infant growth, health, and development. Traditional methods for evaluating the quality of caregiver-infant interaction have predominantly relied on rating scales or observational techniques. However, rating scales are prone to inaccuracies, while observational techniques are resource-intensive. The utilization of easily collected medical records in conjunction with machine learning techniques offers a promising and viable strategy for accurate and efficient assessment of caregiver-infant interaction quality. METHODS: This study was conducted at a follow-up outpatient clinic at two tertiary maternal and infant health centers located in Shanghai, China. 68 caregivers and their 3-15-month-old infants were videotaped for 3-5 min during playing interactions in non-threatening environment. Two trained experts utilized the Infant CARE-Index (ICI) procedure to assess whether the caregivers were sensitive or not in a dyadic context. This served as the gold standard. Predictors were collected through Health Information Systems (HIS) and questionnaires, which included accessible features such as demographic information, parental coping ability, infant neuropsychological development, maternal depression, parent-infant interaction, and infant temperament. Four classification models with fivefold cross-validation and grid search hyperparameter tuning techniques were employed to yield prediction metrics. Interpretable analyses were conducted to explain the results. RESULTS: The score of sensitive caregiver-infant interaction was 6.34 ± 2.62. The Random Forest model gave the best accuracy (83.85%±6.93%). Convergent findings identified infant age, care skills of infants, mother age, infant temperament-regulatory capacity, birth weight, positive coping, health-care-knowledge-of-infants, type of caregiver, MABIS-bonding issues, ASQ-Fine Motor as the strongest predictors of interaction sensitivity between infants and their caregiver. CONCLUSIONS: The proposed method presents a promising and efficient approach that synergistically combines rating scales and artificial technology to detect important features of caregiver-infant interactions. This novel approach holds several implications for the development of automatic computational assessment tools in the field of nursing studies.

Prediction and feature selection of low birth weight using machine learning algorithms.

BACKGROUND AND AIMS: The birth weight of a newborn is a crucial factor that affects their overall health and future well-being. Low birth weight (LBW) is a widespread global issue, which the World Health Organization defines as weighing less than 2,500 g. LBW can have severe negative consequences on an individual's health, including neonatal mortality and various health concerns throughout their life. To address this problem, this study has been conducted using BDHS 2017-2018 data to uncover important aspects of LBW using a variety of machine learning (ML) approaches and to determine the best feature selection technique and best predictive ML model. METHODS: To pick out the key features, the Boruta algorithm and wrapper method were used. Logistic Regression (LR) used as traditional method and several machine learning classifiers were then used, including, DT (Decision Tree), SVM (Support Vector Machine), NB (Naïve Bayes), RF (Random Forest), XGBoost (eXtreme Gradient Boosting), and AdaBoost (Adaptive Boosting), to determine the best model for predicting LBW. The model's performance was evaluated based on the specificity, sensitivity, accuracy, F1 score and AUC value. RESULTS: Result shows, Boruta algorithm identifies eleven significant features including respondent's age, highest education level, educational attainment, wealth index, age at first birth, weight, height, BMI, age at first sexual intercourse, birth order number, and whether the child is a twin. Incorporating Boruta algorithm's significant features, the performance of traditional LR and ML methods including DT, SVM, NB, RF, XGBoost, and AB were evaluated where LR, had a specificity, sensitivity, accuracy and F1 score of 0.85, 0.5, 85.15% and 0.915. While the ML methods DT, SVM, NB, RF, XGBoost, and AB model's respective accuracy values were 85.35%, 85.15%, 84.54%, 81.18%, and 84.41%. Based on the specificity, sensitivity, accuracy, F1 score and AUC, RF (specificity = 0.99, sensitivity = 0.58, accuracy = 85.86%, F1 score = 0.9243, AUC = 0.549) outperformed the other methods. Both the classical (LR) and machine learning (ML) models' performance has improved dramatically when important characteristics are extracted using the wrapper method. The LR method identified five significant features with a specificity, sensitivity, accuracy and F1 score of 0.87, 0.33, 87.12% and 0.9309. The region, whether the infant is a twin, and cesarean delivery were the three key features discovered by the DT and RF models, which were implemented using the wrapper technique. All three models had the identical F1 score of 0.9318. However, "child is twin" was recognized as a significant feature by the SVM, NB, and AB models, with an F1 score of 0.9315. Ultimately, with an F1 score of 0.9315, the XGBoost model recognized "child is twin" and "age at first sex" as relevant features. Random Forest again beat the other approaches in this instance. CONCLUSIONS: The study reveals Wrapper method as the optimal feature selection technique. The ML method outperforms traditional methods, with Random Forest (RF) being the most effective predictive model for Low-Birth-Weight prediction. The study suggests that policymakers in Bangladesh can mitigate low birth weight newborns by considering identified risk factors.

Soil-transmitted Helminth Infection and Perinatal Outcomes in Pregnant Women in Primary Care Settings in South India: A Cohort Study.

Background: Soil-transmitted helminth infections (STHs) in pregnancy have been linked to maternal anemia, low birth weight, and adverse perinatal outcomes. STH includes Ascaris lumbricoides, hookworm, and Trichuris trichiura. However, conflicting evidence exists regarding these effects. Hence, we aimed to assess the association of STH infections with perinatal outcomes. Methods and Materials: A community-based cohort study was conducted among pregnant women in primary care settings in Puducherry, South India, during December 2019 to April 2021. Stool samples were collected for STH screening and confirmed using polymerase chain reaction. Information on perinatal outcomes and hemoglobin levels were extracted from case records. The association of pre-term birth, low birth weight, anemia, and miscarriages with STH infection was analyzed using the Chi-square test. Results: Among the 650 women enrolled, 58 (8.9%) had one of the STH infections. At the time of recruitment, 336 (52.0%) women had anemia. Twenty-four women (3.7%) had miscarriages, 14 (2.2%) had pre-term birth, and 65 (10.4%) had low-birth-weight (LBW) babies. All 14 pre-term babies had LBW, and out of 65 LBW, 40 were in mothers with anemia. Incidence of LBW, pre-term deliveries, and anemia were higher in women with STH than in those without STH (LBW: 12.3% vs 10.2%, P = 0.62; pre-term: 3.5% vs 2.1%, P = 0.5; and anemia: 54.4% vs 51.85, P = 0.7). Conclusion: Though the incidence of anemia, LBW, and pre-term delivery was higher in women with STH infections compared to those without STH, we did not find any significant association between the presence of STH infections and perinatal outcomes.

Higher sweet beverage consumption was associated with increased gestational weight gain and birth weight: A Chinese cohort study.

Diet during pregnancy is crucial to maternal metabolism and fetal development, so exploring the most potent food risk factor could improve maternal and child health. In this study, we investigated the diet and lifestyle of 833 healthy pregnant women in the second trimester from November 2020 to August 2021. Based on the Tianjin Antenatal Care System in China, we followed up with these women and recorded their gestational weight gain (GWG) and newborn birth weight. We conducted a dietary survey through FFQ based on the food groups recommended by the Chinese Dietary Guidelines and included common ultra-processed foods. We collected 219 semi-quantitative FFQs and 614 self-reported FFQs for analysis. According to the consumption frequency of 12 food groups, 4 dietary patterns were extracted by principal component analysis. We analyzed the associations of food energy, consumption frequency, and dietary patterns with GWG and birth weight, especially GWG in the first and second trimesters (f-GWG). The results showed that f-GWG was positively correlated with food energy. Beverage consumption was associated with f-GWG (r = 0.288, P = .026) in obese pregnant women. A dietary pattern that favors high consumption of ultra-processed foods (fried foods, baked desserts, and sweet beverages) was associated with increased GWGs. Non-obesity women with high consumption of baked desserts and sweet beverages had higher GWGs (P < .05). After adjusting for confounding factors (including total energy, physical activity, and sleep quality), only sweet beverage consumption was associated with f-GWG (ß 0.498, 95%CI 0.153-0.843) and birth weight (ß 0.124, 95%CI 0.009-0.240). Sweet beverage consumption is a key adjustable risk factor for prenatal care.

Prenatal Vitamin D Deficiency and Maternal and Fetal Health Outcomes.

Vitamin D deficiency (VDD) is a significant health issue that could have serious implications for the well-being of women and their offspring. Prenatal vitamins are widely used, but deficiency still occurs frequently in the preconception period, during pregnancy, and in breastfed infants. We analyzed the association between prenatal VDD and maternal and fetal health outcomes by reviewing studies conducted in Europe. The literature was searched for articles published in the last 10 years focusing on preeclampsia, gestational diabetes mellitus, preterm birth, low birth weight, asthma, and autism spectrum disorder. We identified a total of 43 review articles, 31 original articles, and two guidelines. During pregnancy, VDD is associated with a higher likelihood of developing gestational diabetes mellitus and preeclampsia. It may also lead to an increase in the risk of preterm birth, low birth weight, as well as asthma, and autism spectrum disorder in the offspring. While the official guidelines for vitamin D dosage differ in various countries, health authorities usually recommend a total daily supplement intake of 400-2,000 IU. In conclusion, this review emphasizes the importance of establishing guidelines for vitamin D supplementation as well as the requirement of official standards for the consumption of vitamin D in the prenatal period. Future research should concentrate on developing more unified approaches to vitamin D assessment and establishing preventative measures that can be incorporated into prenatal care programs.

Effect modification of pre-pregnancy body mass index on association of gestational weight gain with birth weight.

Background: Maternal weight status, before or during pregnancy, is a significant determinant of fetus development, birth weight, and the short-term and long-term health outcomes of the offspring. Objective: This study aimed to evaluate the effect modification of pre-pregnancy body mass index (BMI) on the associations of gestational weight gain (GWG) and birth weight, as per the latest guidelines from the Chinese Nutrition Society. Methods: This is a retrospective cohort study performed in a tertiary hospital with the largest deliveries in Shanghai, China. This study included all women who had singleton live births from 2021 to 2022 (n = 50,391). Data on pre-pregnancy weight, GWG, and birth weight were extracted from the medical register system. Logistic regression models were used to estimate the associations of pre-pregnancy BMI and GWG with the risks of being small for gestational age (SGA) and large for gestational age (LGA). The potential for effect modification by BMI on the associations of GWG and birth weight was assessed using both additive and multiplicative scales. Results: Pre-pregnancy BMI and GWG were consistently associated with birth weight. We observed a positive effect modification by underweight on the relationships between insufficient GWG and SGA both in multiplicative (adjusted odds ratio (OR), 2.49, 95 % confidence interval (CI): 2.06-2.99), and additive (relative excess risk due to interaction (RERI), 3.04, 95 % CI: 1.70-4.37) scales. Similarly, obesity was found to modify the effect of excessive GWG on the risk of LGA (adjusted OR, 3.82, 95 % CI, 3.14-4.63; RERI, 14.67, 95 % CI: 7.92-21.41). Conclusion: Our findings indicate that increased GWG is associated with a higher risk of abnormal birth weight in singleton pregnancies. Additionally, there is evidence of an additive interaction between pre-pregnancy BMI and GWG on the risk of small for gestational age or large for gestational age.

Imprint of preterm birth with very low birth weight on optic disc OCT in adulthood-A two-country birth cohort study.

PURPOSE: To determine the pattern, degree and prevalence of optic disc optical coherence tomography (OCT) alterations in adults born preterm with very low birth weight (VLBW; birth weight < 1500 g). METHODS: Optic disc OCT was assessed in 98 VLBW participants and 139 term-born controls from birth cohorts in Finland and Norway at the mean age of 36 years. The participants had not been treated for retinopathy of prematurity and had no diagnosed brain abnormality. OCT assessment included parameters for optic disc size, neural rim and peripapillary retinal nerve fibre layer thickness (pRNFLT), and for the foveal developmental stage. Background data, visual acuity, refractive error and intraocular pressure were recorded. RESULTS: In the VLBW group, optic disc neural rim and pRNFLT were significantly decreased, most frequently in the nasal and inferior sectors. In 40% (95% CI: 33-47) of the VLBW eyes, nerve fibre thickness of at least one optic disc sector was below the fifth percentile of the control group, including 9% (95% CI: 6-14) subgroup falling below the first percentile, that is, clinically below normal limits. VLBW participants with nerve fibre thickness below the fifth percentile did not differ by perinatal data or foveal developmental stage from the other VLBW participants. All participants had normal visual acuity. CONCLUSION: A moderate decrease of the optic disc neural rim and pRNFLT is frequently seen in clinically healthy adults born preterm with VLBW. Awareness of the VLBW-related optic disc nerve fibre shallowness especially in the inferior and nasal sectors is important while evaluating acquired optic disc pathology in adulthood.

Association of neonatal outcome with birth weight for gestational age in Chinese very preterm infants: a retrospective cohort study.

BACKGROUND: The neonatal outcomes across different percentiles of birth weight for gestational age are still unclear. METHODS: This retrospective cohort study was conducted within 57 tertiary hospitals participating in the Chinese Neonatal Network (CHNN) from 25 provinces throughout China. Infants with gestational age (GA) 24+0-31+6 weeks who were admitted within 7 days after birth were included. The composite outcome was defined as mortality or any one of neonatal major morbidities, including necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH), cystic periventricular leukomalacia (cPVL), severe retinopathy of prematurity (ROP), and sepsis. Multivariable logistic regressions using generalized estimating equation approach were conducted. RESULTS: A total of 8380 infants were included with a mean GA of 30 (28-31) weeks. Of these, 1373 (16.5%) were born at less than 28 weeks, while 6997 (83.5%) had a GA between 28 and 32 weeks. Our analysis indicated that the risk of composite outcomes was negatively associated with birth weight for gestational age, and compared to the reference group, the multiple-adjusted ORs (95%CI) of composite outcomes were 4.89 (3.51-6.81) and 2.16 (1.77-2.63) for infants with birth weight for gestational less than 10th percentile and 10th -30th percentile, respectively. The ORs (95%CI) of mortality, NEC, BPD, severe ROP, and sepsis in infants with birth weight for gestational age at 10th-30th percentile were 1.94 (1.56-2.41), 1.08 (0.79-1.47), 2.48 (2.03-3.04), 2.35 (1.63-3.39), and 1.39 (1.10-1.77), respectively. CONCLUSION: Our study suggested that the risk of adverse neonatal outcomes increased significantly when the birth weight for gestational age was below the 30th percentile. Regular monitoring and early intervention are crucial for these high-risk infants.

Meconium Ileal Obstruction and Functional Immaturity: Review.

INTRODUCTION: Ileal obstruction caused by thick meconium associated with functional immaturity (IOMFI) is an uncommon disease associated with prematurity. IOMFI is not well known, and late or wrong diagnosis is a problem. In this research, we review the clinical characteristics and therapeutic methods of IOMFI. METHODS: Critical descriptive literature review. RESULTS: Most patients eliminate meconium previously to IOMFI. More premature babies tend to become symptomatic in their second week of life, with progressive abdominal distension. The most frequent complication is perforation. Radiologically there is diffuse intestinal distention without air-fluid levels. In contrast enema a caliber transition zone is observed in the distal ileum with multiple filling defects in the ileum and colon. Neural ganglia are present in biopsies from the rectum, colon, and stoma, mostly with characteristics of immature ganglia. Most patients respond to treatment with water soluble contrast enemas. Surgery is needed for patients who do not respond to enemas and those presenting perforations. DISCUSSION: IOMFI literature is limited to retrospective mainly small and heterogeneous cohorts. Patients usually respond promptly to water soluble enemas, but a favorable response is highly dependent in contrast reflux through the ileocecal valve and success is related to early treatment. Contrast inflow may be controlled by intermittent radiographies or real time ultrasound.