Factores de riesgo relacionados con el bajo peso al nacer

La reducción del bajo peso al nacer es importante para obtener mejores resultados en la mortalidad infantil. Por eso nos planteamos el objetivo de: identificar los factores asociados con el riesgo de bajo peso al nacer, por su incremento en el municipio Río Cauto. Se realizó un estudio descriptivo de corte transversal, que incluyó a 51 gestantes que tuvieron recién nacidos con bajo peso al nacer de enero a diciembre del año 2022. Se utilizaron las variables: edad gestacional en el momento del parto, áreas de salud, peso de los nacidos vivos y por grupos de edad materna, paridad y patologías detectadas durante el embarazo. Hubo 528 nacidos vivos y 51 tuvieron un peso inferior a 2500 gramos, con un índice de (9.66 %); el parto pretérmino predominó en el Policlínico "Camilo Cienfuegos" con 5 neonatos (5.00 %) y el crecimiento intrauterino retardado en el Policlínico "Ernesto Guevara" con 14 nacimientos (9.03 %); el mayor por ciento de bajo peso ocurrió de 20 a 34 años de edad, 35 (68.63 %), donde sobresalió el policlínico "Máximo Gómez" con 18 (75 %). En los nacimientos por grupo de edades, el índice de bajo peso fue mayor en pacientes menores de 20 años, 14 (12.84 %). En el bajo peso predominaron: las nulíparas en 25 nacimientos (49.02 %), la anemia y embarazo 27 (52.94 %) y el síndrome de flujo vaginal 20 (39.22).

Summary Reducing low birth weight is important for better outcomes in infant mortality. That is why we set ourselves the objective of: identifying the factors associated with the risk of low birth weight, due to its increase in Río Cauto. A descriptive cross-sectional study was conducted, which included 51 pregnant women who had low birth weight newborns from January to December 2022. The following variables were used: gestational age at the time of delivery, health areas, live birth weight and maternal age groups, parity and pathologies detected during pregnancy. There were 528 live births and 51 had a weight of less than 2500 grams, with a rate of (9.66%); preterm delivery predominated at the Camilo Cienfuegos Polyclinic with 5 neonates (5.00%) and intrauterine growth retardation at the Ernesto Guevara Polyclinic with 14 births (9.03%); The highest percentage of underweight occurred between 20 and 34 years of age, 35 (68.63%), where the Máximo Gómez 18 polyclinic (75%) stood out. In births by age group, the rate of low birth weight was higher in patients under 20 years of age, 14 (12.84%). Nulliparous women predominated in 25 births (49.02%), anemia and pregnancy in 27 (52.94%), and vaginal discharge syndrome in 20 (39.22).

A redução do baixo peso ao nascer é importante para melhores desfechos na mortalidade infantil. Por isso, nos propusemos a identificar os fatores associados ao risco de baixo peso ao nascer, devido ao seu aumento no Rio Cauto. Foi realizado um estudo transversal descritivo, que incluiu 51 gestantes que tiveram recém-nascidos de baixo peso ao nascer no período de janeiro a dezembro de 2022. As seguintes variáveis foram utilizadas: idade gestacional no momento do parto, áreas de saúde, peso ao vivo e faixas etárias maternas, paridade e patologias detectadas durante a gestação. Foram 528 nascidos vivos e 51 com peso inferior a 2500 gramas, com taxa de (9,66%); predomínio de parto pré-termo na Policlínica Camilo Cienfuegos com 5 neonatos (5,00%) e retardo de crescimento intrauterino na Policlínica Ernesto Guevara com 14 nascimentos (9,03%); O maior percentual de baixo peso ocorreu entre 20 e 34 anos de idade, 35 (68,63%), onde se destacou a policlínica Máximo Gómez 18 (75%). Nos nascimentos por faixa etária, a taxa de baixo peso ao nascer foi maior nas pacientes com menos de 20 anos, 14 (12,84%). Nulíparas predominaram em 25 partos (49,02%), anemia e gravidez em 27 (52,94%) e síndrome do corrimento vaginal em 20 (39,22).

Study Of Maternal Near Miss Events At The Tertiary Care Hospital

Background:A maternal near miss case is defined as a “a woman who nearly died but survived a complication that occurred during pregnancy,child birth or within 42 days of termination of pregnancy”1.MMR is defined as ratio of number of maternal deaths per 1000 live births. All pregnant women deserve a good quality of care especially Emergency Obstetric Care including proper infrastructure, human resources that can detect and manage such complications earliest. The objective of this study was to evaluate the causes of maternal near miss cases, various management modalities performed and maternal and fetal outcome in near miss cases. Material And Methods:A retrospective study was carried out in obstetrics and gynaecology department of SCL municipal general hospital, Ahmedabad for identification of MNM as per MNM-R operational guidelines (2014) in a tertiary care hospital from August 2020 to March 2022. Result:Total deliveries during our study period were 9266 out of which 535 number of patients developed complications, 75 patients ended up becoming near miss cases and 30 maternal mortalities were observed.Hypertensive disorders (38.6%) followed by severe anemia (18.6%) and haemorrhage (13.3%) were the commonest underlying causes leading to MNM. More than one management modality was followed in one case. 25% of patients required blood transfusion. Out of which 11 patients required massive blood transfusion (>5 units of blood) and 16% of patients required blood products along with blood resulting from either severe anemia or altered coagulopathy (DIC). 69.3% of patients required ICU stay of <5 days and majority of patients required hospital stay of 9-14 days.63.6% of patients required ICU stay of 1-4 days.Live birth rate was 82.6%.Conclusion:Maternal health is the direct indicator of prevailing health status in a country. Reduction in maternal mortality is one of the targets of MILLENIUM DEVELOPMENT GOALS13for 2015 but in spite of full efforts by all the health care professionals, it still remains a challenge in developing countries.There should be prompt and proper management of high-risk groups by frequent antenatal visits. Aggressive management of each complication and close monitoring of women in labour, decision making in mode and time of termination of pregnancy are important to prevent further complications.

Correlation of Lipin gene expression with hepatic fat content in rats with intrauterine growth retardation / 中国当代儿科杂志

OBJECTIVES@#To study the correlation of the expression of Lipin1 in visceral adipose tissue and Lipin2 in liver tissue with hepatic fat content in rats with intrauterine growth retardation (IUGR).@*METHODS@#Pregnant rats were given a low-protein (10% protein) diet during pregnancy to establish a model of IUGR in neonatal rats. The pregnant rats in the control group were given a normal-protein (21% protein) diet during pregnancy. The neonatal rats were weighed and liver tissue was collected on day 1 and at weeks 3, 8, and 12 after birth, and visceral adipose tissue was collected at weeks 3, 8, and 12 after birth. The 3.0T 1H-magnetic resonance spectroscopy was used to measure hepatic fat content at weeks 3, 8, and 12 after birth. Real-time PCR was used to measure mRNA expression levels of Lipin2 in liver tissue and Lipin1 in visceral adipose tissue. Western blot was used to measure protein levels of Lipin2 in liver tissue and Lipin1 in visceral adipose tissue. A Pearson correlation analysis was performed to investigate the correlation of mRNA and protein expression of Lipin with hepatic fat content.@*RESULTS@#The IUGR group had significantly higher mRNA and protein expression levels of Lipin1 in visceral adipose tissue than the control group at weeks 3, 8, and 12 after birth (P<0.05). Compared with the control group, the IUGR group had significantly lower mRNA and protein expression levels of Lipin2 in liver tissue on day 1 after birth and significantly higher mRNA and protein expression levels of Lipin2 at weeks 1, 3, 8, and 12 after birth (P<0.05). At week 3 after birth, there was no significant difference in hepatic fat content between the IUGR and control groups (P>0.05), while at weeks 8 and 12 after birth, the IUGR group had a significantly higher hepatic fat content than the control group (P<0.05). The protein and mRNA expression levels of Lipin1 were positively correlated with hepatic fat content (r=0.628 and 0.521 respectively; P<0.05), and the protein and mRNA expression levels of Lipin2 were also positively correlated with hepatic fat content (r=0.601 and 0.524 respectively; P<0.05).@*CONCLUSIONS@#Upregulation of the mRNA and protein expression levels of Lipin1 in visceral adipose tissue and Lipin2 in liver tissue can increase hepatic fat content in rats with IUGR and may be associated with obesity in adulthood.

Diagnóstico prenatal del retraso de crecimiento intrauterino, en pacientes asistidas en el Hospital Regional de Ciudad del Este, año 2018

Resumen La restricción de crecimiento intrauterino es un problema de salud que aumenta su conocimiento en la población puede generar acciones en la salud pública, asimismo se asocia a mayor riesgo en adolescentes, a bajo nivel de instrucción, población marginal, bajo peso de la madre y de atención prenatal inadecuado, el objetivo de este trabajo fue la de analizar el diagnóstico prenatal del retraso de crecimiento intrauterino mediante la ecografía, en pacientes asistidas en el Hospital Regional de Ciudad del Este, año 2018, se realizó un estudio observacional descriptivo retrospectivo, la muestra de estudio estuvo constituida por 73 historia clínica de madres que presentaron restricción de crecimiento intrauterina diagnosticada por ecografía se consignaron en un formato de recolección de datos a través de la revisión de historias clínicas, se organizaron en una base de datos en Excel y se realizó un análisis descriptivo. El 41% de las madres presentaron edades entre 19 a 34 años, se observó mayor índice con el 64 con procedencia de zonas rurales respecto a las madres con procedencias de zonas urbanas, las mayorías de las madres presentaron un nivel secundario concluida, el 52% de las madres presentaron controles prenatales entre 0 a 5 controles, las madres con edad gestacional < 37 semanas tuvieron significativamente (p=0.000) mayor frecuencia recién nacido con retardo de crecimiento intrauterino, el 29% de las madres que tuvieron bajo peso presentaron recién nacidos con retardo de crecimiento intrauterino, 21 de las madres nulíparas presentaron recién nacidos con retardo de crecimiento intrauterino y el 44% de las madres con intervalo intergenésico menor de 2 años presentaron recién nacidos con retardo de crecimiento intrauterino, y el mayor índice de hijos con retardo de crecimientos intrauterina presentaron madres con una ganancia entre 6 a 9 Kg y se concluye que el retardo de crecimiento intrauterino tiene asociación con factores sociodemográficos y obstétricos, que algunos de ellos pueden ser intervenidos.

Abstract The restriction of intrauterine growth is a health problem that increases their knowledge in the population can generate actions in public health, it is also associated with increased risk in adolescents, at a low level of education, marginal population, low mother and child weight inadequate prenatal care, the objective of this work was to analyze the prenatal diagnosis of intrauterine growth retardation by ultrasound, in patients assisted in the Regional Hospital of Ciudad del Este, year 2018, a retrospective descriptive observational study was performed, the sample The study consisted of 73 clinical records of mothers who presented intrauterine growth restriction diagnosed by ultrasound were recorded in a data collection format through the review of medical records, they were organized in a database in Excel and a descriptive analysis showing the following results 41% of the madr es presented ages between 19 and 34 years old, a higher index was observed with 64 originating from rural areas with respect to mothers from urban areas, most of the mothers presented a completed secondary level, 52% of the mothers presented controls Prenatal between 0 and 5 controls, mothers with gestational age <37 weeks had significantly (p = 0.000) higher frequency newborn with intrauterine growth retardation, 29% of mothers who were underweight presented newborns with intrauterine growth retardation , 21 of the nulliparous mothers presented newborns with intrauterine growth retardation and 44% of the mothers with intergenic interval less than 2 years presented newborns with intrauterine growth retardation, and the highest rate of children with intrauterine growth retardation presented mothers with a gain between 6 to 9 Kg and it is concluded that the intrauterine growth retardation tie Ne association with sociodemographic and obstetric factors, which some of them can be intervened.

Factores de riesgo asociado al bajo peso al nacer. Municipio Guisa. Enero- diciembre 2019 / Risk factors associated with the low birth weight. Guise municipality. January - December 2019 / Fatores de risco associados ao baixo peso ao nascer. Municipio Guisa. Enero- diciembre 2019

RESUMEN Introducción: la reducción del bajo peso al nacer constituye una prioridad en el país por ser determinante para disminuir la mortalidad infantil. Objetivo: determinar los principales factores de riesgo asociados al bajo peso al nacer Guisa, Granma. Métodos: se realizó un estudio descriptivo de corte transversal, incluyó a 37 gestantes que aportaron los nacimientos con bajo peso en el periodo de estudio. Se analizaron las variables edad materna, evaluación nutricional al inicio del embarazo, edad gestacional al momento del parto, tipo de bajo peso, antecedentes personales y enfermedades asociadas al embarazo. Resultados: se produjeron 511 nacimientos, 37 mostraron un peso inferior a 2500 g. El mayor número de nacimientos ocurrió en edades fértiles de la vida, predominando la evaluación nutricional normopeso al inicio del embarazo. La edad gestacional entre 37-42 semanas fueron las que más aportaron bajo peso, no ocurrieron nacimientos en gestantes con menos de 32 semanas. Predominaron los crecimientos intrauterinos restringidos. Entre los antecedentes patológicos resalta, la hipertensión arterial, seguida por el asma bronquial, la anemia ligera. Conclusiones: el bajo peso al nacer es un problema de salud en el municipio Guisa y por consiguiente su influencia negativa sobre la calidad de vida de los infantes. Las edades extremas no resultaron factores de incidencia en el bajo peso al nacer al igual que el estado nutricional. Las principales causales son el crecimiento intrauterino restringido y el parto pretérmino. La identificación precoz de los factores de riesgo y la adopción de medidas efectivas permitirá disminuir la incidencia de estas causas.

ABSTRACT Introduction: reducing low birth weight is a priority in the country as it is decisive for reducing infant mortality. Objective: to determine the main risk factors associated with low birth weight Guisa, Granma. Methods: a descriptive cross-sectional study was carried out, it included 37 pregnant women who provided births with low birth weight in the study period. The variables maternal age, nutritional evaluation at the beginning of pregnancy, gestational age at delivery, type of low weight, personal history and diseases associated with pregnancy were analyzed. Results: there were 511 births, 37 showed a weight less than 2500 g. The highest number of births occurred in fertile ages of life, predominating the normal weight nutritional assessment at the beginning of pregnancy. Gestational ages between 37-42 weeks were the ones that contributed the most to low weight, there were no births in pregnant women with less than 32 weeks. Restricted intrauterine growths predominated. Among the pathological antecedents, arterial hypertension stands out, followed by bronchial asthma, mild anemia. Conclusions: low birth weight is a health problem in the Guisa municipality and therefore its negative influence on the quality of life of infants. Extreme ages were not factors of incidence in low birth weight as well as nutritional status. The main causes are restricted intrauterine growth and preterm delivery. The early identification of risk factors and the adoption of effective measures will reduce the incidence of these causes.

RESUMO Introdução: a redução do baixo peso ao nascer é uma prioridade no país, pois é decisiva para a redução da mortalidade infantil. Objetivo: determinar os principais fatores de risco associados ao baixo peso ao nascer Guisa, Granma. Métodos: foi realizado um estudo transversal descritivo, com 37 gestantes que realizaram partos com baixo peso ao nascer no período do estudo. Foram analisadas as variáveis ​​idade materna, avaliação nutricional no início da gestação, idade gestacional no parto, tipo de baixo peso, antecedentes pessoais e doenças associadas à gravidez. Resultados: ocorreram 511 nascimentos, 37 apresentavam peso inferior a 2.500 g. O maior número de nascimentos ocorreu em idades férteis de vida, predominando a avaliação nutricional de peso normal no início da gestação. As idades gestacionais entre 37-42 semanas foram as que mais contribuíram para o baixo peso, não ocorrendo partos em gestantes com menos de 32 semanas. Predominaram crescimentos intrauterinos restritos. Dentre os antecedentes patológicos, destaca-se a hipertensão arterial, seguida da asma brônquica, anemia leve. Conclusões: o baixo peso ao nascer é um problema de saúde no município de Guisa e, portanto, influencia negativamente na qualidade de vida dos lactentes. As idades extremas não foram fatores de incidência no baixo peso ao nascer, bem como no estado nutricional. As principais causas são o crescimento intrauterino restrito e o parto prematuro. A identificação precoce dos fatores de risco e a adoção de medidas eficazes irão reduzir a incidência dessas causas.

A study of role of doppler in gestational hypertension and perinatal outcome

Background: Hypertensive disorder of pregnancy is one of the most common complications that affect the human pregnancy. Hence it is important to identify women at risk of developing gestational hypertension or preeclampsia, its early diagnosis and subsequent consequences due to uteroplacental insufficiency with help of Doppler ultrasound, to improve perinatal outcome. The objective of this study was to study the application of Doppler ultrasound with analysis of blood flow velocity waveform in gestational hypertension and to examine and study the perinatal outcome in pregnancy with altered Doppler indices.Methods: A prospective study was carried out in 50 antenatal patients diagnosed to have gestational hypertension during a period of 12 months to evaluate the role of color Doppler imaging in gestational hypertension in patients more than 28 weeks of gestation, the initial scan was performed immediately after the diagnosis. This study analyzed the blood flow in umbilical artery, maternal uterine artery and fetal middle cerebral artery using Doppler ultrasound.Results: In this study approximately 76% of cases were found in 20-30 years group. 58% showed abnormal umbilical artery Doppler while 42% women had normal umbilical artery Doppler. In this study 23 cases had cerebro-placental index <1 and 27 cases had cerebro-placental index >1. Cases with cerebro-placental index <1 had various complications like preterm delivery, low birth weight, increased chances of still birth, intra uterine death (IUD), increased NICU admission. In this study 31 cases had abnormal uterine artery Doppler which accounts for 62% of total cases, while 38% had normal uterine artery Doppler.Conclusions: Doppler ultrasound can reliably predict any adverse fetal outcome in hypertensive pregnancies and can be a useful tool for decision making in appropriate timing of intervention for delivery.

Aortic isthmus doppler velocimetry in fetuses with intrauterine growth restriction: A literature review / Dopplervelocimetria do istmo aórtico em fetos com crescimento intrauterino restrito: Uma revisão da literatura

Abstract Intrauterine growth restriction (IUGR) is associated with poor perinatal prognosis and a higher risk of stillbirth, neonatal death, and cerebral palsy. Its detection and the evaluation of its severity by new Doppler velocimetric parameters, such as aortic isthmus (AoI), are of great relevance for obstetrical practice. The AoI is a vascular segment that represents a point of communication between the right and left fetal circulations. It is considered to be a functional arterial shunt that reflects the relationship between the systemic and cerebral impedances, and has recently been proposed as a tool to detect the status of hemodynamic balance and prognosis of IUGR in fetuses. In the present review, we noticed that in healthy fetuses, the AoI net flow is always antegrade, but in fetuses with IUGR the deterioration of placental function leads to progressive reduction in its flow until it becomes mostly retrograde; this point is associated with a drastic reduction in oxygen delivery to the brain. The more impaired the AoI flow is, the greater is the risk of impairment in the Doppler velocimetry of other vessels; and the alterations of the AoI Doppler seem to precede other indicators of severe hypoxemia. Although there seems to be an association between the presence of retrograde flow in the AoI and the risk of long-term neurologic disability, its role in the prediction of perinatal morbi-mortality remains unclear. The AoI Doppler seems to be a promising tool in the management of fetuses with IUGR, but more studies are needed to investigate its employment in clinical practice.

Resumo O crescimento intrauterino restrito (CIUR) está associado a um prognóstico perinatal adverso, com maior risco de óbito intrauterino e neonatal, bem como de paralisia cerebral. Assim, sua detecção e a determinação de sua gravidade por novos parâmetros Dopplervelocimétricos, como o istmo aórtico (IAo), são de fundamental importância na prática obstétrica. O IAo é um segmento vascular que representa um ponto de comunicação entre os sistemas circulatórios fetais esquerdo e direito. É considerado um shunt arterial funcional, capaz de refletir a relação entre as impedâncias dos circuitos cerebral e sistêmico, e foi proposto como uma ferramenta para detecção do status do equilíbrio hemodinâmico e do prognóstico de fetos com CIUR. Na presente revisão, observou-se que, em fetos saudáveis, o fluxo predominante no IAo é sempre anterógrado; mas em fetos com CIUR a deterioração do estágio de insuficiência placentária acarreta reduções progressivas no fluxo ístmico até este apresentar sentido predominantemente retrógrado e levar a uma drástica redução no aporte de oxigênio ao sistema nervoso central. Quanto mais alterado estiver o fluxo no IAo, maior a chance de haver alteração na Dopplervelocimetria de outros vasos; e as alterações no Doppler do IAo parecem preceder outros indicadores de hipoxemia severa. Embora o fluxo retrógrado no IAo pareça se correlacionar com maior risco de alteração no desenvolvimento neurológico a longo prazo, ainda não está claro o seu papel na predição de morbimortalidade perinatal. O Doppler do IAo parece ser um parâmetro promissor no manejo do CIUR; entretanto, mais estudos são necessários para avaliar seu emprego na prática clínica.

Cognitive Outcomes of Children with Very Low Birth Weight at 3 to 5 Years of Age

Twin pregnancy, the study of maternal and perinatal outcome: what being a twin is like?

Background: Twin pregnancy is considered as a high-risk pregnancy due to associated high maternal and perinatal morbidity mortality in comparison with singleton pregnancy. The objectives of this study were to study the maternal and perinatal complications in twin pregnancies. To find out various factors that contribute to adverse perinatal outcome.Methods: This retrospective study was conducted at Kempegowda Institute of Medical Sciences Hospital, Bengaluru. 92 women with twin pregnancies admitted in KIMS Hospital from September 2014 to September 2018, both booked and referred patients were studied. Individual patient parameters like age, parity, gestational age, mode of delivery, maternal complications were tabulated. Neonatal morbidity and mortality were noted, data thus obtained was analysed and results studied.Results: In the study the incidence of twin pregnancies was more in second gravida (53%). 72% of the patients were admitted between 28-36 weeks of gestation with preterm labour (23%) as the main cause for admission. Anaemia (8.69%), hypertensive disorders of pregnancies (17.39%), PPROM (21%), single foetal demise (5%) and IUGR (5.4%) were the antenatal complications observed. Out of the 92 patients, 29 (35.4%) patients delivered by vaginal route whereas 53 (64.6%) had to undergo C-section. DCDA twin constituted 66% of twins in the study and mal presentation was the commonest indication for caesarean section (50%). Among the 164 babies out of 92 twin pregnancies 8 babies were still born and 12 babies died by the end of one week due to complications related to prematurity like hyaline membrane disease, IVH.Conclusions: Early detection of twin pregnancies and proper antenatal care reduces both maternal and perinatal complication thereby improving maternal and perinatal outcome.

Histogenesis of human fetal kidney from 14 weeks to 36 weeks: a study

Background: The knowledge of fetal human Kidney morphology and developmental anatomy is very important for prenatal diagnosis of disorders such as Wilm’s tumor, hydronephroses and congenital malformation etc.Methods: The study was carried out on 40 kidneys procured from 20 spontaneously aborted fetuses (11males and 9 females) ranging from 14wks-36wks of gestation, after confirming their age through  CRL they were grouped and then processed to form slides and stained with haemtoxylin and eosin and seen under light microscope.Results: All kidneys were lobulated at early gestational age and became fused by 36 wks. Corticomedullary junction and preformed collecting tubules were seen clearly by 18wks. Well differentiated PCT and DCT were formed by 19-23 wks. Well-formed pyramids by 28 wks and medullary rays by 29 weeks were clearly distinguished. Loop of Henle developed and distinguished by 28 wks. Increased vascularity was seen by 32-36 wks. Nephrogenic zone and undifferentiated mesenchyme decreased and matured glomeruli increased by 36 wks.Conclusions: The present study gave emphasis to the development of each component in medulla and cortex of kidney.

Histopathology of placenta in intrauterine growth restriction (IUGR)

Background: Birth of healthy term baby depends on normal placenta. IUGR is a condition associated with placental insufficiency. There is a close relationship between IUGR and placental qualitative changes. The aim of the present study was to evaluate the morphological and histological changes in placentas of IUGR fetuses and in placentas of normal uncomplicated pregnancies and to determine the relationship that exists between morphological change and frequency of IUGR.Methods: In a cross sectional study conducted in the department of Pathology, GMC Jammu, a total of 60 placenta were received, 30 placenta of IUGR fetus (group 1-case) and 30 placenta of uncomplicated pregnancy with normal single fetus (group 2-control). Exclusion criteria: Twin pregnancy, gestational hypertension, diabetes, congenital anomaly, antepartum hemorrhage and systemic disorder.Results: Placental weights in IUGR group were significantly lower than control group. Average placental weight in IUGR group was 425 gms while in the control group (normal placenta) it was 550 gms. Infarction, intervillous thrombosis, chorionic villitis, hemorrhagic endovasculitis, placental intravascular thrombi, perivillous fibrin deposition, fibrinoid necrosis and villous edema were found to be more common in IUGR group (Group 1-case group) than Normal (Group 2- control group).Conclusions: This study highlightened that significant pathological differences were found between the placentas of IUGR fetus and normal fetus. The gross and microscopic measurement of a placenta is a good way to get proper information about IUGR and helps in management of the pregnancy.

Expression of amino acid neurotransmitters and their receptors in the brain of IUGR rats / 国际儿科学杂志

Objective To investigate the expression of excitatory neurotransmitter glutamate (Glu),inhibitory neurotransmitter gamma-aminobutyric acid (GABA),glutamate receptor R1 (GluR1) and gammaaminobutyric acid receptor A (γ-aminobutyric acid A receptor,GABAA) in the brain of rats with intrauterine growth retardation.Methods Thirty-two healthy Wistar female virgin rats and eight healthy Wistar male rats were purchased from the Laboratory Animal Center of China Medical University.The pregnant rats were randomly divided into IUGR group and control group according to the order of conception.The control group was fed with normal diet,while the IUGR group was fed with low-protein diet.The offspring were named IUGR group and control group respectively.The expressions of positive cells of Glu,GluR1,GABA and GABAA in cerebral cortex of normal offspring and IUGR offspring were observed by immunohistochemistry.Results Immunohistochemical staining showed that the glutamate positive field of vision in IUGR group was more than that in control group (x2 =82.69,P ＜ 0.05).The glutamate receptor GluR1 positive field of vision in IUGR group was more than that in control group (x2 =76.91,P ＜0.05),while the gamma-aminobutyric acid and its receptors in IUGR group were lower than those in control group (x2 =91.51,x2 =24.05,respectively).The difference was statistically significant (P ＜ 0.05).Conclusion Intrauterine growth retardation can increase the expression of excitatory amino acids and receptors while decrease the expression of inhibitory amino acids and their receptors.Increased expression of excitatory amino acids and receptors and decreased expression of inhibitory amino acids and their receptors may be one of the mechanisms of epilepsy in patients with intrauterine growth retardation.

Effects of Early Life Nutritional Status on Weight Catch-up Growth，Puberty Initiation and Obesity in Female Rats with Intrauterine Growth Retardation / 中山大学学报(医学科学版)

@#【Objective】To investigate the effects of different nutritional status in early life on weight catch-up，puberty initiation and obesity in rats with intrauterine growth retardation（IUGR）.【Methods】IUGR model of newborn rats was established by limiting diet during pregnancy in SPF rats. Female newborn rats were used in the experiment. IUGR rats were divided into two groups：small litter IUGR group（SL-IUGR）and common feeding IUGR group（CF-IUGR）. Rats of normal birth weight served as normal control group（NC）. The SL-IUGR group was used to simulate overfeeding in lactation period. After weaning，the rats in the three groups were fed with basic diet. The weights were measured at postnatal 1，7，14，21，35，42 and 75 days. The time of vaginal orifice opening（VO）was recorded. The levels of estradiol（E2），luteinizing hormone（LH）and follicle estrogen（FSH）were examined on the 21 d and the 35 d.【Results】The birth weight of IUGR rats was（4.92±0.18）g，which was significantly lower than that in the control group（6.00±0.29 g，P < 0.001）. IUGR rats showed weight growth catch- up on the 14th day. The body weight of SL- IUGR group was higher than that of control group from 14 to 75 d. The body weight of CF-IUGR group lagged behind that of control group from 1 to 75 d，the difference was statistically significant（P < 0.05）. The vaginal opening time of female IUGR rats in SL- IUGR group was （29.88 ± 1.81）d，which was significantly earlier than that of CF- IUGR group（32.03 ± 2.11）days（P = 0.044）. There was a correlation between body weight of the 21 d and vaginal opening time in IUGR rats，Rs = -0.174，P = 0.039. The besity rates of puberty and adulthood of IUGR rats in SL-IUGR group were 28.33% and 21.67%，which were significantly higher than those in CF-IUGR group（7.5%，6.25%；P = 0.001，0.007）. The weight growth rate of adolescent obese IUGR rats at 7 and 21 d was higher than that of non-adolescent obese rats，and the weight growth rate of adult obese IUGR rats at 7 and 35 d was higher than that of non-adolescent obese rats. The difference was statistically significant（P < 0.05）. Binary Logistic regression analysis of vaginal opening time and adult obesity in IUGR rats′ group OR = 0.419，P = 0.24. The time of vaginal orifice opening was not an independent factor of adult obesity. 【Conclusions】The improvement of nutrition level in the early stage of life is beneficial to weight catch-up of IUGR，and the overweight catch-up during lactation can lead to puberty and adulthood obesity of IUGR rats，as well as the advance of vaginal opening time.

S100 proteins: An emerging cynosure in pregnancy & adverse reproductive outcome

S100 proteins are calcium (Ca2+)-binding proteins and these have an important function in progression, manifestation and therapeutic aspects of various inflammatory, metabolic and neurodegenerative disorders. Based on their involvement in intracellular or extracellular regulatory effects, S100 proteins are classified into three subgroups: one subgroup is specialized in exerting only intracellular effects, other performs both intracellular and extracellular functions and the third subgroup members only display extracellular regulatory effects. S100 proteins are expressed particularly in vertebrates and have cell-specific expression. Functionally, S100 proteins act through their surface receptors and regulate cell functions in autocrine or paracrine mode. Receptor for advanced glycation end products (RAGEs) and toll-like receptor 4 are the main surface receptors. S100 proteins participate in the regulation of cellular differentiation, proliferation, apoptosis and inflammation along with Ca2+ homeostasis, energy metabolism and cellular migration, and perform the respective functions through their interaction with transcription factors, nucleic acids, enzymes, receptors, cytoskeleton system, etc. Currently, their role in adverse pregnancy outcomes and compromised reproductive health is being explored. These proteins are present in amniotic fluid, endometrium tissue and foetal brain; therefore, it is quite likely that alterations in the expression levels of S100 family members will be affecting the particular function they are involved in and ultimately affecting the pregnancy in adverse manner. The current review discusses about an association of S100 proteins in pregnancy disorders such as endometriosis, intrauterine growth retardation and miscarriage.

Síndrome Rusell Silver. Presentación de caso / Russell-Silver syndrome. Presentation of a case

RESUMEN El síndrome Russell Silver es una enfermedad genética de baja frecuencia, caracterizada por retardo del crecimiento prenatal y postnatal, dismorfias faciales y digitales, así como asimetría corporal. Se presenta una paciente femenina de dos años de edad, remitida a consulta de Genética Clínica, por retardo en el desarrollo pondoestatural psicomotor, dismorfias faciales y asimetría corporal. Se realizño el diagnóstico clínico de esta afección. Es importante establecer un diagnóstico precoz para la estimulación temprana, seguimiento multidisciplinario y se brindó un adecuado asesoramiento genético a los familiares (AU).

ABSTRACT The Russell-Silver syndrome is a low-frequency genetic disease, characterized by a pre-natal growth retardation and postnatal digital and facial dysmorphia, and also body asymmetry. We present a female patient, aged 2 years, who was remitted to the consultation of Clinical Genetics because of a retardation in the psychomotor, height-weight development, facial dysmorphia and body asymmetry. The disease was clinically diagnosed. It is important to arrive to a precocious diagnosis for the early stimulation, multidisciplinary follow-up and adequate genetic advice to the relatives (AU).

Relationship of intrauterine growth retardation and retinopathy of prematurity / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze the association of intrauterine growth retardation (IUGR) and retinopathy of prematurity (ROP).METHODS:A retrospective analysis of a case series included in ROP screening from January 2011to December 2015 was performed in Suzhou Municipal Hospital.Totally 2527 children (5054 eyes) underwent screening.According to the gestational age,the data was divided into 4 groups (≤32wk,＞32 and ≤34wk,＞34 and ≤37wk,＞37wk).Every group was divided into two groups (IUGR group and no IUGR group) respectively.We compared the incidence of ROP in IUGR and non IUGR group.RESULTS:Of all the 2527 children,IUGR group were 702 including 78 ROP children,and non IUGR group were 1825 including 329 ROP children.There were 991 children were divided into ≤ 32wk group,including 63 IUGR in which 27 children were screened out ROP(42.9％) and 928 non IUGR in which 274 children were screened out ROP (29.5％),the difference on the incidence of ROP was statistically significant (X2 =4.958,P=0.026).There were 1025 children were divided into ＞ 32 and ≤ 34wk group,including 232 IUGR in which 33 children were screened out ROP(14.2％) and 793 non IUGR in which 51 children were screened out ROP (6.4％) and the difference was statistically significant (x2 =14.488,P＜0.001).There were 464 children were divided into ＞ 34 and ≤ 37wk group,including 374 IUGR in which 18 children were screened out ROP(4.8％) and 90 non IUGR in which 4 children were screened out ROP (4.4％) and the difference was not statistically significant (Fischer exact test,P=1).There were 47 children were divided into ＞37wk group,including 33 IUGR and 14 non IUGR,none were screened out in the two groups.CONCLUSION:Intrauterine growth retardation was closely related to the incidence of ROP.In the preterm infants with gestational age less than 34wk,the incidence of ROP in children with intrauterine growth retardation is significantly higher than that in children without intrauterine growth retardation.

Renal developmental retardation and the underlying mechanism induced by prenatal caffeine exposure in female fetal rats / 中国药理学通报

Aim To explore the effects of prenatal caf-feine exposure (PCE) on fetal renal growth retardation and corticosterone on the gene expression of metanephric mesenchyme stem cells.Methods Pregnant Wistar rats were administered with caffeine (30,120 mg ·kg-1) from gestational day 9 to 20.Female fetal kidney samples were collected for morphological observation and gene expression examination.The metanephric mesenchyme stem cells were harvested for cell culture,and renal related genes were detected after the treatment of corticosterone with different concentrations (250,500,1 000 μg · L-1) for 24 hours.Results Compared with the control group,the fetal kidneys in the PCE group displayed an enlarged Bowman's space and a shrunken glomerular tuft,accompanied with the repression of the gene expression of glial-cell-line-derived neurotrophic factor/tyrosine kinase receptor (GDNF/c-Ret) signaling pathway.The GDNF/c-Ret signaling pathway and angiotensin Ⅱ receptor type 1 (AT1R)/AT2R expression of metanephric mesenchyme stem cells also decreased in corticosterone groups.Conclusions PCE may induce dysplasia of female fetal kidneys.The potential mechanism is related to the repression of the gene expression of AT1R/AT2R and GDNF/c-Ret signaling pathway by PCE mediated by corticosterone in utero.

Comparison of rat models of intrauterine growth retardation established by three different methods / 中国比较医学杂志

Objective Intrauterine growth retardation (IUGR) is characterized by low birth weight of neonates. The aim of this study was to provide a reference for the establishment of IUGR models in scientific research, by comparing the experimental data of different rat models of IUGR established by three commonly-used methods. Methods A total of 20 pregnant rats on the day 0 of gestation were divided into 4 groups, with 5 rats in each group (n=5). Among them, 3 groups of rats were treated with alcohol intervention (group A), uterine artery ligation (group U), and low protein diet (LP group), respectively, to establish rat models of IUGR, and the fourth group served as the normal control group (CON group). Fetal rats were taken through cesarean section on the 20th day of gestation. The body mass, brain mass, placental mass, two-kidney mass, body length and tail length of the fetal rats were measured, and the incidence rate of IUGR, stillbirth rate and their brain to placenta ratio were calculated. The fetal rats in each group were continuously raised and the body mass, perirenal fat pad mass and some organ masses were determined at the 3rd, 6th and 12th weeks. Results The average body mass of the fetal rats in the groups A, U and LP group was significantly lower than that of the normal control group (P＜ 0. 05), and the incidence rate of IUGR of the fetal rats was significantly higher than that of the normal control group (P＜ 0. 05). In addition, the stillbirth rate of pregnant rats in the group U was significantly higher than those of the group A and LP group (P ＜ 0. 05). After raising the rats for 3 weeks, the average body mass of rats in the three experimental groups was significantly lower than that of the normal control group (P ＜ 0. 05), and after raising for 6 weeks, the average body mass in the three experimental groups was still lower than that of the normal control group, but with a non-significant difference (P＞ 0. 05). However, after raising for 12 weeks, the average body mass of the rats in the group A and LP group was significantly higher than that of the normal control group (P ＜ 0. 05). Conclusions Rat models of IUGR can be successfully established either by alcohol intervention, uterine artery ligation or low protein diet. The IUGR model established by low protein diet has the advantages of a higher incidence rate of IUGR and lower stillbirth rate, being more suitable for animal model research. As regards the catch-up growth, the average body mass of the rats during the postpartum period and lactation period after delivered by cesarean section in the group A and LP group is lower than that of the normal control group, but after lactation the rats grow faster than those in the normal control group, indicating the existence of a catch-up growth in the group A and LP group.

Strategies for feeding to small for gestational age newborns / 中国小儿急救医学

Feeding small for gestational age newborns is extremely challenging for the neonatologist. Awareness that these babies are at high risk for feeding intolerance and necrotising enterocolitis has led to a common practice of delaying the introduction of enteral feeds.Nevertheless,prolonging enteral fasting after birth is not justified on the basis of necrotising enterocolitis incidence or feeding tolerance.This review will focuse on the optimum timing for introduction of enteral feeding,increasing the amount of feeding,the importance of breastfeeding,feeding method,feeding intolerance and necrotising enterocolitis in small for gestational age infants.

TORCH (toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus) screening of small for gestational age and intrauterine growth restricted neonates: efficacy study in a single institute in Korea / 소아과

PURPOSE: Routine screening for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (TORCH) in intrauterine growth restriction (IUGR) and small for gestational age (SGA) neonates has become a common practice. However, the incidence of TORCH varies across countries, and the cost of TORCH testing may be disadvantageous compared to disease-specific screening. To evaluate the efficacy of TORCH screening, the medical charts of IUGR or SGA neonates born in a single institution in Bucheon, Korea from 2011 to 2015 were reviewed. METHODS: The clinical data of the 126 IUGR or SGA neonates were gathered, including gestational age, Apgar scores, neonatal sonographic findings, chromosome study, morbidities, developmental follow-up, and growth catch-up. Maternal factors including underlying maternal disease and fetal sonography were collected, and placental findings were recorded when available. TORCH screening was done using serum IgM, CMV urine culture, quantification of CMV DNA with real-time polymerase chain reaction, and rapid plasma reagin qualitative test for syphilis. Tests were repeated only for those with positive results. RESULTS: Of the 119 TORCH screenings, only one was positive for toxoplasmosis IgM. This result was deemed false positive due to negative IgM on repeated testing and the absence of clinical symptoms. CONCLUSION: Considering the incidence and risk of TORCH in Korea, the financial burden of TORCH screening, and the single positive TORCH finding in our study, we suggest disease-specific screening based on maternal history and the clinical symptoms of the neonate. Regarding CMV, which may present asymptomatically, universal screening may be appropriate upon cost-benefit analysis.