Testing the Institute of Medicine (IOM) recommendations on maternal reproductive health and associated neonatal characteristics in a transitional, Mediterranean population.

BACKGROUND: High pre-pregnancy body mass index (BMI) and excessive gestational weight gain (GWG) are significant risk factors for maternal and neonatal health. AIM: To assess pre-pregnancy BMI and GWG during pregnancy and their association with different maternal and neonatal characteristics in the transitional Mediterranean population from the Eastern Adriatic islands. SUBJECTS AND METHODS: Two hundred and sixty-two mother-child dyads from the CRoatian Islands' Birth Cohort Study (CRIBS) were included in the study. Chi-square test, ANOVA, and regression analysis were used to test the association between selected characteristics. RESULTS: In total, 22% of women entered pregnancy as overweight/obese and 46.6% had excessive GWG. Pre-pregnancy overweight and obesity were significantly associated with elevated triglycerides uric acid levels, and decreased HDL cholesterol in pregnancy. Excessive GWG was associated with elevated fibrinogen and lipoprotein A levels. Women with high pre-pregnancy BMI and GWG values were more likely to give birth to babies that were large for gestational age (LGA), additionally confirmed in the multiple logistic regression model. CONCLUSION: High maternal pre-pregnancy BMI and excessive GWG were both significantly associated with deviated biochemical parameters and neonatal size. More careful monitoring of maternal nutritional status can lead to better pre- and perinatal maternal healthcare.

Influence of distribution of mother's abdominal body fat on first trimester fetal growth.

Objective: Fetal growth in the first trimester is estimated by measuring the crown to rump length of the fetus (CRL). There are no data on the relation between fetal growth and fat distribution in pregnant women. The objective was to investigate the influence of fat distribution in pregnant women on fetal growth in the first trimester of pregnancy.Methods: This was a controlled observation using a random sampling method. Newly registered pregnant women were included in the sample during a 12-18-month period. The study included 400 pregnant women from Bjelovarsko-bilogorska County, Croatia. Participants were divided into three groups according to their pregravid BMI values, normal weight (n = 254), overweight (n = 103), and obese (n = 43). In the 12th week of pregnancy, the CRL was measured by transvaginal ultrasound. The subcutaneous and preperitoneal fat was measured by transabdominal ultrasound, using the Suzuki method. The correlation was tested by the Pearson's coefficient, and a linear regression analysis was performed on the variables with good correlation.Results: In normal weight pregnant women, there is no correlation between the adipose tissue and fetal length, but there is a significant correlation between overweight and obese ones.Conclusion: The distribution of adipose tissue in obese and overweight pregnant women is associated with fetal length in the first trimester of pregnancy, with a stronger correlation between visceral fat and fetal length. The influence of this correlation on the overall fetal growth should be investigated by longitudinal monitoring of these variables during the entire pregnancy.

Changes in adipose tissue distribution during pregnancy estimated by ultrasonography.

OBJECTIVES: To investigate changes in adipose tissue distribution using ultrasonography of the subcutaneous and preperitoneal adipose tissue during pregnancy. METHODS: The sample included 400 pregnant women. The research was prospective and statistically designed as a controlled observation using a random sampling method. The adipose tissue was estimated by ultrasonography, five times during the pregnancy. The minimal thickness of the subcutaneous (Smin) and maximal thickness of the preperitoneal (Pmax) was obtained using the Suzuki method. Analysis of variance and the Bonferroni post hoc test for multiple comparisons were calculated. RESULTS: Smin values have a decreasing trend, while Pmax values have an increasing trend, independent of the body mass index. No statistically significant differences in Smin and Pmax have been noted for the observed week intervals until the 20th pregnanacy week. Smin values for the week intervals 12 and 16, as well as for the Pmax week intervals 12, 16, and 20, were statistically significantly different when compared with the values obtained for the week intervals 32 and 37 (p < 0.05). No difference has been observed between nulliparous and multiparous pregnancies. CONCLUSION: The adipose tissue distribution during pregnancy shows a tendency towards a decreased accumulation of subcutaneous and increased accumulation of preperitoneal adipose tissue.

Relationship between axial length of the emmetropic eye and the age, body height, and body weight of schoolchildren.

This report assesses the relationship of axial length of emmetropic (without refractive error) eyes to age, height, and weight in 1,600 Croatian schoolchildren. Axial eye lengths were determined by an ultrasonic eye biometry (A scan). Axial length of both eyes increases with age, height, and weight but shows a closer correlation to height and weight than to age. Boys have a significantly longer axial eye length than girls (P < 0.01). Boys or girls of similar or nearing body height and body weight and with emmetropic eyes have close linear measures of anatomic eye structures within their sex, regardless their age. Body height demonstrates the closest correlation to the growth and development of the emmetropic eye.

[Ability of a child with Pierre-Robin syndrome to attend school]. / Sposobnost za skolu djeteta s Pierre-Robinovim sindromom.

A boy with Pierre Robin syndrome and his capability to attend elementary school are presented. In addition to basic features of the syndrome (micrognathia, glossoptosis, cleft palate), the boy had a congenital heart anomaly (atrial and ventricular septal defect) and hearing impairment. Results of the testing before enrollment in the elementary school showed motor deficit, lover than average level of intellectual functioning (IQ = 80-85), hyperactivity and attention deficit. The boy was enrolled in the regular elementary school, with adapted teaching program.