Change of BMI in catch-up growth of low birth weight infants aged 0-24 months / 上海预防医学

Objective To investigate the changes and characteristics of body mass index (BMI) of low birth weight infants during catch-up growth within 24 months of life. Methods Using the birth cohort method, 126 low birth weight children (birth weight less than 2 500 g) among the registered and permanent born in Jiading District from January 2016 to December 2016, were enrolled in the study voluntarily.According to the calculation of birth weight and gestational week, 73 children were included in the preterm appropriate for gestational age group and 53 in the full-term small for gestational age group.105 children with gestational age of 37-41 weeks and birth weight of 2 500-3 999 g were included as the control group.The differences of BMI mean and standard deviation were compared between 0-24 months old in three groups, and the changes of BMI curve analyzed between 0-24 months old in boys and girls. Results ① There were 231 infants investigated, who were composed by 111 boys and 120 girls; ② The BMI of the two groups of low birth weight infants at birth and at 2 months old were lower than those of the control group.There was no significant difference between the BMI of preterm appropriate for gestational age group and the control group since the age of 4 months.The BMI of the term small for gestational age group was less than the other two groups between 4 and 18 months of age, the difference was statistically significant (P < 0.05);③ The BMI index of the three groups showed a rapid rise after birth.It peaked at 4-6 months of age, and the BMI value of 7-9 months of age began to fall.Preterm appropriate for gestational age group infants caught up with the BMI of normal-weight infants at 6 months of age.Until the age of 24 months, the BMI of small for gestational age group was still different from normal weight infants, but the difference between the three groups decreased.The rising curves of BMI between boys and girls were similar, but the peak of preterm appropriate for gestational age group girls was lengthened. Conclusion There is a significant catch-up growth for low birth weight infants aged 0-24 months, having a similar trend of normal infants in the late stage.It is necessary to deliver proper breeding education and intervention to the low birth weight infants in their early stages.

Variation of maternal milk adiponectin and its correlation with infant growth / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the variation of human breast milk adiponectin (APN) concentration during lactation, analyze the relationship of APN concentrations in human breast milk with APN in infant serum, determine the association between maternal milk APN and infant body proportionality in the first year of life, and the period of greatest human milk exposure.</p><p><b>METHOD</b>Subjects included 73 mother-infant pairs from Shanghai International Peace Maternity & Child Health Hospital. Maternal milk was collected at 2, 4, 13, 26 weeks and infant serum was collected at 26 weeks. The concentration of APN in maternal milk and infant serum were measured with commercially available ELISAs (R&D Systems). Weight-for-age Z-scores (WAZ), length-for-age Z-scores (LAZ), weight-for-length Z-scores (WLZ) and body mass index Z-scores (zBMI) of infants up to 1 year of age were calculated using World Health Organization (WHO) standards. Then the variation of maternal milk APN was investigated, the correlation between maternal milk APN and infant serum APN was analyzed; multivariate regression analysis was used to analyze covariates correlated with infant body proportionality, meanwhile determined the association between maternal milk APN and infant anthropometrics.</p><p><b>RESULT</b>The concentration of APN in maternal milk at 2, 4, 13, 26 weeks was respectively (14.62 µg/L, 5.93 - 140.40 µg/L), (7.32 µg/L, 2.04 - 29.35 µg/L), (6.84 µg/L, 2.72 - 15.65 µg/L) and (4.88 µg/L, 1.12 - 13.38 µg/L). Higher milk APN in postpartum 2 weeks was associated with lower infant WAZ at 13, 26 and 52 weeks (P < 0.05). Milk APN in postpartum 4 weeks was inversely related to infant WAZ, WLZ, zBMI at 13, 26 and 52 weeks (all P < 0.05). Meanwhile, milk APN in postpartum 13 weeks had significantly negative correlation with infant WAZ, WLZ, zBMI at 13, 26 and 52 weeks (P < 0.01). Milk APN in postpartum 26 weeks also was inversely associated with infant WAZ, WLZ and zBMI at 52 weeks (P < 0.05). After adjusting covariates like birth weight using multivariate regression analysis, milk APN level is the most important influence factor to infant WAZ, WLZ, zBMI at 13, 26 and 52 weeks. There was a positive correlation between maternal milk APN and infant serum APN at 13, 26 weeks.</p><p><b>CONCLUSION</b>Milk APN concentration declines throughout lactation. Maternal milk APN may play a vital role in the growth and development of breastfed infants, particularly closely associated with infant weight. Infant serum APN clearly correlated with maternal milk APN.</p>

Establishing the norm of cognitive adaptive test/clinical linguistic and auditory milestone scale in the children from 4 to 36 months of age in Shanghai, China / 中华儿科杂志

<p><b>OBJECTIVE</b>To meet the need for instrument assessing the cognitive abilities of infants and young children as well as discriminating between global developmental delay and particular deficits in either language or problem-solving skills, we intended to introduce Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) into China.</p><p><b>METHODS</b>CAT/CLAMS were administered to 1604 normative children aged 4-36 months (in 16 age groups, about 100 children per age group) in Shanghai during the period from December 2003 to June 2004. In the meantime, Gesell Developmental Diagnosis was applied for 100 of these children, respectively aged 4, 6, 12, 18 and 30 months (20 children per age group). Interclass correlation coefficients (ICC) were adopted to analyze data in terms of inter-rater reliability and re-test reliability of the scales of CAT/CLAMS. Cronbach alpha coefficients were calculated to assess the inter consistency of the scales. Pearson correlation coefficients(r) were adopted to analyze the concurrent validity of the scales. The normative percentile graphs of CAT/CLAMS in the children from 4 to 36 Months of age in Shanghai, China were adopted.</p><p><b>RESULTS</b>Administrations of the CAT/CLAMS for each subject usually took 10-20 minutes. Individual scores (CLAMS, CAT, and CAT/CLAMS) increased with ages (Pearson correlation coefficients were 0.96, 0.98 and 0.98, respectively, P < 0.01 for all). ICCs (intraclass correlation coefficient) in terms of individual scores for the inter-rater reliability test and the re-test reliability test were respectively > or = 0.96 (P < 0.01) and > or = 0.95 (P < 0.01), all the Cronbach alpha coefficients were > or = 0.98; in 100 children of the 5 age groups, there was significantly positive correlation between CAT/CLAMS and Gesell Developmental Diagnosis in terms of language skill DQ and adaptive skill DQ, and Full Scale DQ (r = 0.517, 0.703, 0.613, respectively, P < 0.01 for all). Moreover, this significant positive correlation was observed in each of the 5 age groups (r = 0.455-0.827, P < 0.05).</p><p><b>CONCLUSION</b>CAT/CLAMS is suitable for discriminating between global developmental delay and particular deficits in either language or problem-solving skills. It is a quick, reliable, and valid instrument, with refined and quantified results. It is a good tool for developmental surveillance and screening of infants and young children.</p>