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1.
BMC Pregnancy Childbirth ; 22(1): 241, 2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35321691

RESUMO

BACKGROUND: Sonography based estimate of fetal weight is a considerable issue for delivery planning. The study evaluated the influence of diabetes, obesity, excess weight gain, fetal and neonatal anthropometrics on accuracy of estimated fetal weight with respect to the extent of the percent error of estimated fetal weight to birth weight for different categories. METHODS: Multicenter retrospective analysis from 11,049 term deliveries and fetal ultrasound biometry performed within 14 days to delivery. Estimated fetal weight was calculated by Hadlock IV. Percent error from birth weight was determined for categories in 250 g increments between 2500 g and 4500 g. Estimated fetal weight accuracy was categorized as accurate ≤ 10% of birth weight, under- and overestimated by > ± 10% - ± 20% and > 20%. RESULTS: Diabetes was diagnosed in 12.5%, obesity in 12.6% and weight gain exceeding IOM recommendation in 49.1% of the women. The percentage of accurate estimated fetal weight was not significantly different in the presence of maternal diabetes (70.0% vs. 71.8%, p = 0.17), obesity (69.6% vs. 71.9%, p = 0.08) or excess weight gain (71.2% vs. 72%, p = 0.352) but of preexisting diabetes (61.1% vs. 71.7%; p = 0.007) that was associated with the highest macrosomia rate (26.9%). Mean percent error of estimated fetal weight from birth weight was 2.39% ± 9.13%. The extent of percent error varied with birth weight with the lowest numbers for 3000 g-3249 g and increasing with the extent of birth weight variation: 5% ± 11% overestimation in the lowest and 12% ± 8% underestimation in the highest ranges. CONCLUSION: Diabetes, obesity and excess weight gain are not necessarily confounders of estimated fetal weight accuracy. Percent error of estimated fetal weight is closely related to birth weight with clinically relevant over- and underestimation at both extremes. This work provides detailed data regarding the extent of percent error for different birth weight categories and may therefore improve delivery planning.


Assuntos
Diabetes Gestacional , Peso Fetal , Peso ao Nascer , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Recém-Nascido , Obesidade/epidemiologia , Gravidez , Estudos Retrospectivos
2.
BMC Med Inform Decis Mak ; 22(1): 232, 2022 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064400

RESUMO

BACKGROUND: Birth weight is a significant determinant of the likelihood of survival of an infant. Babies born at low birth weight are 25 times more likely to die than at normal birth weight. Low birth weight (LBW) affects one out of every seven newborns, accounting for about 14.6 percent of the babies born worldwide. Moreover, the prevalence of LBW varies substantially by region, with 7.2 per cent in the developed regions and 13.7 per cent in Africa, respectively. Ethiopia has a large burden of LBW, around half of Africa. These newborns were more likely to die within the first month of birth or to have long-term implications. These are stunted growth, low IQ, overweight or obesity, developing heart disease, diabetes, and early death. Therefore, the ability to predict the LBW is the better preventive measure and indicator of infant health risks. METHOD: This study implemented predictive LBW models based on the data obtained from the Ethiopia Demographic and Health Survey 2016. This study was employed to compare and identify the best-suited classifier for predictive classification among Logistic Regression, Decision Tree, Naive Bayes, K-Nearest Neighbor, Random Forest (RF), Support Vector Machine, Gradient Boosting, and Extreme Gradient Boosting. RESULTS: Data preprocessing is conducted, including data cleaning. The Normal and LBW are the binary target category in this study. The study reveals that RF was the best classifier and predicts LBW with 91.60 percent accuracy, 91.60 percent Recall, 96.80 percent ROC-AUC, 91.60 percent F1 Score, 1.05 percent Hamming loss, and 81.86 percent Jaccard score. CONCLUSION: The RF predicted the occurrence of LBW more accurately and effectively than other classifiers in Ethiopia Demographic Health Survey. Gender of the child, marriage to birth interval, mother's occupation and mother's age were Ethiopia's top four critical predictors of low birth weight in Ethiopia.


Assuntos
Algoritmos , Recém-Nascido de Baixo Peso , Teorema de Bayes , Peso ao Nascer , Criança , Etiópia/epidemiologia , Humanos , Lactente , Recém-Nascido , Máquina de Vetores de Suporte
3.
Ital J Pediatr ; 48(1): 162, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064427

RESUMO

BACKGROUND: The majority of studies are limited to adverse perinatal outcomes and poor cognitive abilities in the short term in discordant monochorionic twins. METHODS: To determine whether small and large discordant dizygotic twins differ in physical growth and intelligence development and weight and height from birth up to 6 years of age were measured in 34 dizygotic twin pairs with ≥ 20% birth weight discordance. Mental developmental index (MDI) and psychomotor developmental index (PDI) were calculated at 1 year, while the Wechsler Intelligence Scale for Children-IV (WISC-IV) full-scale intelligence quotient (IQ) was assessed at the age of 6. RESULTS: The difference in height and weight in each stage differed significantly from birth to 72-months-old (P < 0.05), although there was disappointing catch-up growth in smaller twins. PDI but not MDI at 1 year of age was significantly different between the two groups (P < 0.05), and smaller twins experienced higher psychomotor retardation rates (P < 0.05). Also, the influence of height and weight on PDI was statistically significant (P < 0.05). No significant difference was detected in the WISC-IV full-scale IQ at the age of 6; however, the full-scale IQ may be affected by the history of suffocation and the S/D value (P = 0.011, P = 0.022). CONCLUSIONS: Intrauterine fetal growth and development lead to birth weight differences in twins and sustain an impact on the children's physical growth in height and weight from birth to preschool age, causing psychomotor developmental differences at 1 year of age. However, the differences in psychomotor development decrease gradually by the age of 6.


Assuntos
Parto , Gêmeos Dizigóticos , Peso ao Nascer , Criança , Pré-Escolar , Feminino , Humanos , Inteligência , Gravidez , Estudos Prospectivos
4.
Wei Sheng Yan Jiu ; 51(4): 656-661, 2022 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-36047274

RESUMO

OBJECTIVE: To explore the risk factors of obesity in children aged 3-6 years in China. METHODS: Using search terms, preschooler, obesity, risk factors/influence factors, case-control studies, and language limited to Chinese and English, search databases(CNKI, Wanfang, VIP, CBM, PubMed, Web of science, Embase, The Cochrane library). To collect domestic and foreign literature on the case-control study design of obesity risk factors in preschool children in China published from January 1, 2000 to June 30, 2021. Stata 14.0 software was used for Meta-analysis of the included literature, and publication bias test and sensitivity analysis were performed. RESULTS: A total of 11 770 people were included in 12 papers, including 4092 in the case group and 7678 in the control group. Meta analysis shows: birth weight ≥4000 g OR=2.176, 95% CI 1.507-3.143; strong appetite OR=3.860, 95%CI 2.991-4.980; fast eating OR=2.836, 95%CI 2.552-3.152; mother overweight and obesity OR=1.903, 95%CI 1.213-2.986; mother's low level of education OR=1.744, 95%CI 1.100-2.766; Physical inactivity OR=1.488, 95%CI 1.267-1.748. CONCLUSION: Birth weight ≥ 4000 g, fast eating speed, strong appetite, mother overweight and obesity, mother's low level of education, and physical inactivity are risk factors for obesity in children aged 3-6 years.


Assuntos
Sobrepeso , Obesidade Pediátrica , Peso ao Nascer , Estudos de Casos e Controles , Pré-Escolar , China/epidemiologia , Humanos , Obesidade Pediátrica/epidemiologia , Fatores de Risco
5.
PLoS Med ; 19(9): e1004078, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36048761

RESUMO

BACKGROUND: The aim was to investigate whether children born after assisted reproduction technology (ART), particularly after frozen-thawed embryo transfer (FET), are at higher risk of childhood cancer than children born after fresh embryo transfer and spontaneous conception. METHODS AND FINDINGS: We performed a registry-based cohort study using data from the 4 Nordic countries: Denmark, Finland, Norway, and Sweden. The study included 7,944,248 children, out of whom 171,774 children were born after use of ART (2.2%) and 7,772,474 children were born after spontaneous conception, representing all children born between the years 1994 to 2014 in Denmark, 1990 to 2014 in Finland, 1984 to 2015 in Norway, and 1985 to 2015 in Sweden. Rates for any cancer and specific cancer groups in children born after each conception method were determined by cross-linking national ART registry data with national cancer and health data registries and population registries. We used Cox proportional hazards models to estimate the risk of any cancer, with age as the time scale. After a mean follow-up of 9.9 and 12.5 years, the incidence rate (IR) of cancer before age 18 years was 19.3/100,000 person-years for children born after ART (329 cases) and 16.7/100,000 person-years for children born after spontaneous conception (16,184 cases). Adjusted hazard ratio (aHR) was 1.08, 95% confidence interval (CI) 0.96 to 1.21, p = 0.18. Adjustment was performed for sex, plurality, year of birth, country of birth, maternal age at birth, and parity. Children born after FET had a higher risk of cancer (48 cases; IR 30.1/100,000 person-years) compared to both fresh embryo transfer (IR 18.8/100,000 person-years), aHR 1.59, 95% CI 1.15 to 2.20, p = 0.005, and spontaneous conception, aHR 1.65, 95% CI 1.24 to 2.19, p = 0.001. Adjustment either for macrosomia, birth weight, or major birth defects attenuated the association marginally. Higher risks of epithelial tumors and melanoma after any assisted reproductive method and of leukemia after FET were observed. The main limitation of this study is the small number of children with cancer in the FET group. CONCLUSIONS: Children born after FET had a higher risk of childhood cancer than children born after fresh embryo transfer and spontaneous conception. The results should be interpreted cautiously based on the small number of children with cancer, but the findings raise concerns considering the increasing use of FET, in particular freeze-all strategies without clear medical indications. TRIAL REGISTRATION: Trial registration number: ISRCTN 11780826.


Assuntos
Transferência Embrionária , Neoplasias , Adolescente , Peso ao Nascer , Criança , Estudos de Coortes , Transferência Embrionária/efeitos adversos , Feminino , Humanos , Recém-Nascido , Neoplasias/epidemiologia , Neoplasias/etiologia , Gravidez , Técnicas de Reprodução Assistida/efeitos adversos , Estudos Retrospectivos
6.
Sci Rep ; 12(1): 14895, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050341

RESUMO

Transplacental docosahexaenoic-acid (DHA) supply for fetal development is regulated by placental DHA-lipid metabolism. Both maternal diabetes and obesity are linked to possible decreased fetal circulating DHA and increased placental DHA-lipids. Since myo-inositol is a promising intervention for gestational diabetes (GDM), we aimed to determine whether myo-inositol could rectify perturbations in placental DHA metabolism associated with maternal increasing glycemia and obesity and examine links with birthweight. Term placental villous explants from 17 women representing a range of BMIs and mid-gestational glycemia, were incubated with 13C-labeled-DHA for 48 h, in 0.3 µmol/L (control) or 60 µmol/L myo-inositol. Individual newly synthesized 13C-DHA-labeled lipid species were quantified by liquid-chromatography-mass-spectrometry. Compared with controls, incubation with myo-inositol decreased most 13C-DHA-lipids in placental explants from women with higher BMI or higher glycemia, but increased 13C-DHA-lipids with normal BMI or lower glycemia. Myo-inositol also increased 13C-DHA-labeled lipids in cases of lower birthweight centile, but induced decreases at higher centiles. Myo-inositol therefore lowered DHA-lipids in placenta with high basal placental DHA-lipid production (higher BMI and glycemia) but increased DHA-lipids where basal processing capacity is low. Myo-inositol thus moderates placental DHA metabolism towards a physiological mean which may in turn moderate birthweight.


Assuntos
Diabetes Gestacional , Placenta , Peso ao Nascer , Glicemia/metabolismo , Índice de Massa Corporal , Diabetes Gestacional/metabolismo , Ácidos Docosa-Hexaenoicos/metabolismo , Feminino , Humanos , Inositol/metabolismo , Obesidade/metabolismo , Placenta/metabolismo , Gravidez
7.
Sci Rep ; 12(1): 14889, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050432

RESUMO

This study aimed to determine the relationship between estimated fetal weight discordance by ultrasonography and maternal and neonatal outcomes in dichorionic diamniotic twin pregnancies. We conducted a retrospective review of the medical records of 106 twin pregnancies delivered at a single tertiary center between January 2011 and February 2020. At 20-24 and 28-32 weeks of gestation, participants were divided into two groups: discordant twins with an estimated fetal weight difference of more than 20% and concordant twins with a weight difference of less than 20%. Maternal complications and neonatal outcomes were compared between the two groups. Although the incidences of preeclampsia and placenta previa were significantly higher in discordant twins measured between 20 and 24 weeks, no statistical significance was found in neonatal outcomes. Delivery times were earlier, and neonatal weights were lower in discordant twins measured between 28 and 32 weeks. Neonatal outcomes such as ventilator use and neurodevelopment were also significantly different. Discordance in estimated fetal weight measured using ultrasonography between 20 and 24 weeks can be a risk factor for maternal preeclampsia and placenta previa, whereas discordance at 28-32 weeks may predict poor neonatal outcomes.


Assuntos
Placenta Prévia , Pré-Eclâmpsia , Peso ao Nascer , Feminino , Peso Fetal , Humanos , Recém-Nascido , Pré-Eclâmpsia/diagnóstico por imagem , Pré-Eclâmpsia/epidemiologia , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Gêmeos Dizigóticos , Ultrassonografia , Ultrassonografia Pré-Natal
8.
Trop Anim Health Prod ; 54(5): 285, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076096

RESUMO

This study was carried out to find the environmental factors which have a significant effect on the productive and reproductive characteristics of the Balochi sheep. The study used data from 729 ewes and 71 rams for a period of 13 years (2003 to 2016) at the Sheep Research Center, Yet Abad, Balochistan, Pakistan. The productive characteristics considered for current study were weight, birth weight (BW), 90 days weight (3 MW), 180 days weight (6 MW), 270 days weight (9 MW), 365 days (12 MW), and 2 years weight (24 MW). Reproductive characteristics measured were ewe age at first service (AFS), service period (SP) of ewe, age at 1st lambing (AFL) of ewe, lambing interval (LI), and sex ratio. Restricted maximum likelihood (REML) assessments of different characteristics were analyzed for the Balochi sheep on the basis of location, birth year (YOB), season of birth (SOB), type of birth (TOB), and sex of lamb. The average means ± SE for BW, WW, 6 MW, 9 MW, 12 MW, and 24 MW, were 3.28 ± 0.83, 17.20 ± 2.04, 21.94 ± 1.60, 26.20 ± 2.87, 30.21 ± 3.58, and 37.11 ± 2.84 for ram and 2.56 ± 0.53, 15.69 ± 1.45, 19.57 ± 1.77, 24.07 ± 2.70, 27.46 ± 2.09, and 34.61 ± 2.32 for ewes respectively. The results of reproductive performance of the Balochi sheep age of ewe at the time of breeding, age at first service (AFS), service period (SP), age at first lambing (AFL), and lambing interval (LI) were 1078 ± 2.2, 579.61 ± 0.6, 206.25 ± 0.2, 731.67 ± 0.3, and 256.60 ± 0.3 days respectively. The twining and lambing rates were 10.12% and 86.78%, while the sex proportion for ram and ewes was 50.12:49.37. Area, sex, and TOB had a significant (p < 0.05) effect on weight while TOB (twinning rate) was higher in Balochi sheep. These conditions affected the productive and reproductive performance of the Balochi sheep. At Sheep Research Center, Yet Abad, Balochistan, Pakistan, performed fundamentally better in all qualities such as weight gain and reproductive performance. Supplements were given with feed to get maximum profit from the sheep of Yet Abad farm. The birth weight of males was higher than that of females and single conceived Balochi sheep were heavier than that of twins. Thus, it was concluded that the Balochi sheep can be improved with better management practices, feeding, and disease control.


Assuntos
Reprodução , Carneiro Doméstico , Animais , Peso ao Nascer , Feminino , Masculino , Parto , Gravidez , Estações do Ano , Ovinos
9.
BMC Pediatr ; 22(1): 552, 2022 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-36115974

RESUMO

BACKGROUND: To explore the prevalence, outcome and perinatal risks of neonatal hypoxemic respiratory failure (NRF) in a survey of all livebirths from a regional network of perinatal-neonatal care during the transition period after 5-year universal health insurance implemented in China. METHODS: Clinical data of all neonatal respiratory morbidities in Huai'an were retrospectively collected in the regional perinatal network database of all livebirths as vital statistics in 2015. NRF was defined as hypoxemia requiring continuous positive airway pressure (CPAP) and/or mechanical ventilation (MV) for at least 24 h. Mortality risks of antenatal and perinatal morbidities, major respiratory therapies and complications were analyzed by multivariable logistic regression model. RESULTS: There were 788 NRF cases identified in 9.9% (7960) hospitalized, or 13.3‰ (59056) livebirths, in which 6.7% received intensive care and 93.0% critical care. The major underlying morbidities were respiratory distress syndrome (RDS, 36.4%) and pneumonia/sepsis (35.3%), treated mainly by CPAP, MV and surfactant. Significantly improved outcomes by surfactant in RDS were in patients with birthweight (BW) < 1500 g or gestational age (GA) < 32 weeks. The overall mortality rate in NRF was 18.4% whereas for those of BW < 1000 g and GA < 28 weeks, 70% and 54%, respectively. The multivariable regression analysis showed the highest odds for NRF death among meconium aspiration syndrome, congenital anomalies, BW < 1500 g and necrotizing enterocolitis, whereas born in level III hospitals, cesarean delivery, CPAP and MV were associated with markedly reduced death odds. CONCLUSIONS: The salient findings with associated risk estimates reflected efficiency of respiratory support as critical care in a prefectural regional network infrastructure for annual livebirths in 5.6 million inhabitants. It implicated the representativeness of contemporaneous perinatal-neonatal care standard at medium to medium-high level, in one/fourth of the population of China, aiming at saving more life of very critical and preterm infants for better survival.


Assuntos
Doenças do Recém-Nascido , Síndrome de Aspiração de Mecônio , Surfactantes Pulmonares , Síndrome do Desconforto Respiratório do Recém-Nascido , Insuficiência Respiratória , Peso ao Nascer , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Gravidez , Surfactantes Pulmonares/uso terapêutico , Síndrome do Desconforto Respiratório do Recém-Nascido/tratamento farmacológico , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Insuficiência Respiratória/tratamento farmacológico , Estudos Retrospectivos , Tensoativos/uso terapêutico
10.
BMJ Open ; 12(9): e057567, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104125

RESUMO

OBJECTIVE: The institutional-based cross-sectional study was designed to assess the magnitude of birth trauma and its associated factors in South Wollo, northeast Ethiopia. SETTING: This study was conducted in the public hospitals of South Wollo, northeast Ethiopia. South Wollo is one of the 12 zones in the Amhara regional state with a total population of >3 million. There are 13 hospitals in South Wollo, of these 4 hospitals were selected randomly. PARTICIPANTS: A total of 612 mother-newborn pairs were selected to conduct the study. However, data were collected from 594 mother-neonate pairs giving a response rate of 97%. The study participants were selected by applying a simple random sampling technique after proportional allocation of the total sample to each study hospital. Live neonates delivered during the study period were included, whereas stillborn, neonates born with major congenital malformation and neonates whose mothers died during the birth process were excluded. RESULT: A total of 594 mother-newborn pairs were involved with a response rate of 97%. Seventy-eight newborns 13.13% (95% CI: 10.30 to 16.00) had experienced birth trauma. Prolonged labour (AOR: 5.78, 95% CI: 3.00 to 11.15), birth weight >4 kg (AOR: 9.18, 95% CI: 3.92 to 21.50), vacuum delivery (AOR: 6.74, 95% CI: 2.01 to 22.56), forceps delivery (AOR: 7.36, 95% CI: 1.96 to 27.58) and shoulder dystocia (AOR: 9.83, 95% CI: 4.13 to 23.50) were risk factors of birth trauma. CONCLUSION: The prevalence of birth trauma was higher than the report from most of the African countries. Prolonged labour, instrumental deliveries, large birth weight and shoulder dystocia were the identified risk factors of birth trauma. The ministry of health and the local healthcare system should give attention to the maternal health services.


Assuntos
Distocia do Ombro , Peso ao Nascer , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Públicos , Humanos , Recém-Nascido , Gravidez
11.
Zhongguo Dang Dai Er Ke Za Zhi ; 24(9): 994-1000, 2022.
Artigo em Chinês | MEDLINE | ID: mdl-36111717

RESUMO

OBJECTIVES: To study the changes in the mortality rate and cause of death of hospitalized neonates in grade A tertiary hospitals in Weifang City of Shandong Province during a 10-year period. METHODS: A retrospective analysis was performed on 461 neonates who died in three grade A tertiary hospitals in Weifang City of Shandong Province from January 1, 2012 to December 31, 2021. The related clinical data were collected to examine the changes of neonatal mortality with time, gestational age (GA) and birth weight (BW). The main causes of death of the neonates were compared between the first 5 years (2012-2016) and the last 5 years (2017-2021) in the period. RESULTS: A total of 43 037 neonates were admitted from 2012 to 2021, among whom 461 died, resulting in a mortality rate of 1.07%. The mortality rate in the last 5 years was significantly lower than that in the first 5 years [0.96% (211/22 059 vs 1.19% (250/20 978); P<0.05]. The mortality rate of neonates decreased with the increases in GA and BW (P<0.05). In the first 5 years, the top three main causes of neonatal death were respiratory distress syndrome (RDS), sepsis, and pneumorrhagia, while in the last 5 years, the top three causes were sepsis, pneumorrhagia, and RDS. The leading cause of death was severe asphyxia for the neonates with a GA of <26 weeks and a BW of <750 g in both the first and last 5 years. For the neonates with a GA of 26-<28 weeks, the leading cause of death changed from RDS in the first 5 years to pneumorrhagia in the last 5 years. For the neonates with a BW of 750-<1 000 g, the leading cause of death changed from pneumorrhagia in the first 5 years to RDS in the last 5 years. For the neonates with a GA of 28-<32 weeks and a BW of 1 000-<1 500 g, the leading cause of death was RDS in both the first and last 5 years. For the neonates with a GA of 32-<37 weeks and a BW of 1 500-<2 500 g, the leading cause of death changed from RDS in the first 5 years to sepsis in the last 5 years. The leading cause of death was sepsis for the neonates with a GA of 37-<42 weeks and a BW of 2 500-<4 000 g in both the first and last 5 years. CONCLUSIONS: The mortality rate of neonates in the grade A tertiary hospitals in Weifang City of Shandong Province has been decreasing in the past 10 years, and it decreases with the increases in GA and BW. Sepsis, RDS, and pneumorrhagia are the leading causes of neonatal death. The mortality rate caused by RDS decreases from the first 5 years to the last 5 years, while the mortality rate caused by sepsis or pneumorrhagia increases from the first 5 years to the last 5 years. Therefore, reducing the incidence rates of sepsis, RDS, and pneumorrhagia is the key to reducing neonatal mortality.


Assuntos
Morte Perinatal , Síndrome do Desconforto Respiratório do Recém-Nascido , Sepse , Peso ao Nascer , Causas de Morte , Feminino , Humanos , Recém-Nascido , Estudos Retrospectivos
12.
BMC Med ; 20(1): 288, 2022 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-36064525

RESUMO

BACKGROUND: Beta-blocker (BB) and calcium channel blocker (CCB) antihypertensive drugs are commonly used in pregnancy. However, data on their relative impact on maternal and foetal outcomes are limited. We leveraged genetic variants mimicking BB and CCB antihypertensive drugs to investigate their effects on risk of pre-eclampsia, gestational diabetes and birthweight using the Mendelian randomization paradigm. METHODS: Genetic association estimates for systolic blood pressure (SBP) were extracted from summary data of a genome-wide association study (GWAS) on 757,601 participants. Uncorrelated single-nucleotide polymorphisms (SNPs) associated with SBP (p < 5 × 10-8) in BB and CCB drug target gene regions were selected as proxies for drug target perturbation. Genetic association estimates for the outcomes were extracted from GWASs on 4743 cases and 136,325 controls (women without a hypertensive disorder in pregnancy) for pre-eclampsia or eclampsia, 7676 cases and 130,424 controls (women without any pregnancy-related morbidity) for gestational diabetes, and 155,202 women (who have given birth at least once) for birthweight of the first child. All studies were in European ancestry populations. Mendelian randomization estimates were generated using the two-sample inverse-variance weighted model. RESULTS: Although not reaching the conventional threshold for statistical significance, genetically-proxied BB was associated with reduced risk of pre-eclampsia (OR per 10 mmHg SBP reduction 0.27, 95%CI 0.06-1.19, p = 0.08) and increased risk of gestational diabetes (OR per 10 mmHg SBP reduction 2.01, 95%CI 0.91-4.42, p = 0.08), and significantly associated with lower birthweight of first child (beta per 10 mmHg SBP reduction - 0.27, 95%CI - 0.39 to - 0.15, p = 1.90 × 10-5). Genetically-proxied CCB was associated with reduced risk of pre-eclampsia and eclampsia (OR 0.62, 95%CI 0.43-0.89, p = 9.33 × 10-3), and was not associated with gestational diabetes (OR 1.05, 95% CI 0.76-1.45, p = 0.76) or changes in birthweight of first child (beta per 10 mmHg SBP reduction 0.02, 95%CI - 0.04-0.07, p = 0.54). CONCLUSIONS: While BB and CCB antihypertensive drugs may both be efficacious for lowering blood pressure in pregnancy, this genetic evidence suggests that BB use may lower birthweight. Conversely, CCB use may reduce risk of pre-eclampsia and eclampsia without impacting gestational diabetes risk or birthweight. These data support further study on the effects of BBs on birthweight.


Assuntos
Antagonistas Adrenérgicos beta , Anti-Hipertensivos , Bloqueadores dos Canais de Cálcio , Diabetes Gestacional , Hipertensão , Pré-Eclâmpsia , Antagonistas Adrenérgicos beta/efeitos adversos , Antagonistas Adrenérgicos beta/farmacologia , Antagonistas Adrenérgicos beta/uso terapêutico , Anti-Hipertensivos/efeitos adversos , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Peso ao Nascer/efeitos dos fármacos , Bloqueadores dos Canais de Cálcio/efeitos adversos , Bloqueadores dos Canais de Cálcio/farmacologia , Bloqueadores dos Canais de Cálcio/uso terapêutico , Criança , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/genética , Eclampsia/epidemiologia , Eclampsia/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipertensão/genética , Análise da Randomização Mendeliana , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/genética , Gravidez , Complicações na Gravidez/tratamento farmacológico , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/genética
13.
Pak J Biol Sci ; 25(9): 827-834, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36098085

RESUMO

<b>Background and Objective:</b> There is very rare information regarding data of reproduction performance of small ruminant with different management flushing program in Asian countries. The aim of this study was to evaluate the implementation of flushing diet program containing lemuru fish oil with time management difference, by evaluating the reproductive performance of local Garut ewes. <b>Materials and Methods:</b> Twenty of garut ewes (average body weight 30.06±6.20 kg) were used in this experiment using Completely Randomized Block Design (CRBD), in four treatments with five animals of each treatment. The treatments were without flushing (F0 as control), flushing at the beginning of mating (F1 = 2 weeks pre-mating until 2 weeks just after-mating), two times flushing (F2 = F1 plus 4 weeks flushing during mid gestation) and three times flushing (F3 = F2 plus 2 weeks flushing at the end of gestation and 2 weeks after parturition). The ratio of flushing or basal concentrate to forage was 70:30. Basal concentrate was given during untreated. Nutrients consumption, body condition score (BCS), average daily gain (ADG), feed efficiency ratio (FER) and reproduction parameters were evaluated. The data of sex ratio and birth type were expressed descriptively. <b>Results:</b> The results showed that the treatment had significant effect (p<0.05) on crude fat consumption, total digestible nutrients (TDN) and changes of BCS values, but had no effect on other nutrients consumptions. All treatments did not affect to total birth weight, the number of embryo, litter size, gestation period and sex ratio. The percentage of ewes pregnancy with the flushing treatment was 25% higher than the control. The flushing treatments were significantly effect on partus weight of ewes (p<0.05). <b>Conclusion:</b> It was concluded that three times flushing program at early, middle and late of gestation could improve the nutritional status and reproductive performance of ewes, such as fat intake, partus weight, improved percentage of pregnancy and type of birth, but did not affect to total birth weight, litter size, pregnant period and sex ratio.


Assuntos
Ração Animal , Reprodução , Ração Animal/análise , Animais , Peso ao Nascer , Dieta/veterinária , Feminino , Estado Nutricional , Gravidez , Ovinos
14.
Nutr J ; 21(1): 57, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36114492

RESUMO

BACKGROUND: Although small for gestational age (SGA) is a serious problem worldwide, the association of dietary patterns before and during pregnancy with SGA risk is unclear. We evaluated this association among Japanese pregnant women using three methods: reduced rank regression (RRR) and partial least squares (PLS), methods for extracting dietary patterns that can explain the variation of response variables, and principal component analysis (PCA), a method for extracting dietary patterns of the population. METHODS: Between July 2013 and March 2017, 22,493 pregnant women were recruited to the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study, a population-based prospective birth cohort study in Japan. Information on dietary intake was obtained using food frequency questionnaires, and dietary patterns were extracted using RRR, PLS, and PCA. Information on birth weight was obtained from obstetric records, and the birth weight SD score and SGA were defined by the method of the Japan Pediatric Society. The associations of dietary patterns with birth weight SD score and SGA risk were investigated using multiple linear regression and multiple logistic regression, respectively. RESULTS: A total of 17,728 mother-child pairs were included. The birth weight SD score was 0.15 ± 0.96, and the prevalence of SGA was 6.3%. The dietary patterns extracted by RRR and PLS were similar and characterized by a high intake of cereals and fruits and a low intake of alcoholic and non-alcoholic beverages in both pre- to early pregnancy and from early to mid-pregnancy. Higher adoption of the RRR and PLS patterns in both periods was associated with an increased birth weight SD score and lower risk of SGA. In contrast, the PCA1 pattern was not associated with birth weight SD score or SGA risk in either period. Although the PCA2 pattern was associated with increased birth weight SD score from early to mid-pregnancy, no other associations with birth weight SD score or SGA risk were observed. CONCLUSIONS: The dietary pattern with a high intake of cereals and fruits and a low intake of alcoholic and non-alcoholic beverages before and during pregnancy was associated with a decreased SGA risk in Japan.


Assuntos
Coorte de Nascimento , Peso ao Nascer , Criança , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Japão/epidemiologia , Gravidez , Estudos Prospectivos
15.
J Dairy Sci ; 105(10): 7998-8007, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36055849

RESUMO

Studies have shown that ß-glucans extracted from the cell wall of cereals, algae, and yeasts have been associated with improved immune function. However, it is unknown whether algae ß-glucan supplementation affects the performance, blood metabolites, or cell counts of immune cells in dairy calves. The objective of this randomized clinical trial was to evaluate whether supplementation of ß-glucans to milk replacer in dairy calves fed 6 L/d improved growth performance and fecal status and altered the blood metabolite profile. In this trial, we enrolled Holstein calves (n = 34) at birth (body weight 36.38 ± 1.33 kg; mean ± standard deviation) to receive, from 1 d of age, either 2 g/d algae ß-glucans mixed into 6 L/d of milk replacer (22.4% crude protein and 16.2% fat) or an unsupplemented milk replacer (control). The calves were blocked in pairs according to birth weight, sex, and date of birth (up to 5 d difference). Calves were housed individually, and calf starter (24.7% crude protein and 13.9% neutral detergent fiber) was offered ad libitum based on orts of the previous day until 56 d of age (end of the trial). Body weight was measured weekly, and health checks and daily fecal consistency were evaluated daily in every calf by the same observer. Calves with 2 consecutive days of loose feces that sifted through bedding were considered diarrhea positive. We used a linear mixed effects model to evaluate the effects of ß-glucan supplementation fed during the preweaning period on performance (average daily gain), final weight, feed efficiency (FE), white blood cell count, and selected blood metabolites, repeated by time. A generalized linear mixed effects model was also run to evaluate the likelihood of a diarrhea bout in the first 28 d of life, controlling for the calf as the subject with a logistic distribution. We included age, serum total protein at 48 h, and birth weight as covariates. At 56 d, ß-glucan-supplemented calves weighed more than control calves (56.3 vs. 51.5 kg). Treatment had no effect on total starter intake, but there was a treatment by age interaction for FE, with greater FE for ß-glucan-supplemented calves in wk 3 and 5 of age. There was only a tendency for average daily gain to be greater in supplemented calves than in control calves for the duration of the study. Furthermore, control calves had 14.66 [95% confidence interval (95% CI): 9.87-21.77] times greater odds of having a diarrheal bout than ß-glucan-supplemented calves. Control calves had 12.70 (95% CI: 8.82-18.28) times greater odds of having an additional day with an abnormal fecal score compared with ß-glucan-supplemented calves, suggesting that supplementation ameliorated diarrhea severity. We found no association of treatment with concentrations of serum total protein, albumin, creatinine, or glucose during the preweaning period. Our findings suggest that dietary supplementation of 2 g/d of algae ß-glucans to milk replacer improved fecal status and may affect growth, as evidenced by a higher weaning weight, compared with control calves. Future studies should explore the effect of algae ß-glucans on lower-gut physiology and digestibility in dairy calves.


Assuntos
Ração Animal , beta-Glucanas , Albuminas , Ração Animal/análise , Animais , Peso ao Nascer , Peso Corporal , Bovinos , Creatinina , Detergentes , Diarreia/veterinária , Dieta/veterinária , Suplementos Nutricionais , Glucose , Leite , Desmame , beta-Glucanas/farmacologia
16.
Rev Paul Pediatr ; 41: e2021294, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36102403

RESUMO

OBJECTIVE: To compare pulmonary function parameters and the prevalence of altered pulmonary function in children born preterm and full-term, using the Global Lung Initiative reference values. METHODS: This is a cross-sectional study with 6-9-year-old children submitted to measurement of airway resistance (Rint) and spirometry according to the American Thoracic Society and European Respiratory Society Technical Statement. The inclusion criteria were, among the preterm group: gestational age <37 weeks and birth weight <2000g; among the full-term group: schoolchildren born full-term with birth weight >2500g, recruited at two public schools in São Paulo, Brazil, matched by sex and age with the preterm group. As exclusion criteria, congenital malformations, cognitive deficit, and respiratory problems in the past 15 days were considered. RESULTS: A total of 112 children were included in each group. Preterm children had gestational age of 30.8±2.8 weeks and birth weight of 1349±334g. Among them, 46.6% were boys, 46.4% presented respiratory distress syndrome, 19.6% bronchopulmonary dysplasia, and 65.2% were submitted to mechanical ventilation in the neonatal unit. At study entry, both groups were similar in age and anthropometric parameters. Parameters of pulmonary function (Z scores) in preterm and full-term groups were: Rint (0.13±2.24 vs. -1.02±1.29; p<0.001); forced vital capacity (FVC) (-0.39±1.27 vs. -0.15±1.03; p=0.106), forced expiratory volume in one second (FEV1)/FVC (-0.23±1.22 vs. 0.14±1.11; p=0.003), FEV1 (-0.48±1.29 vs. -0.04±1.08; p=0.071), and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) (1.16±1.37 vs. 2.08±1.26; p=0.005), respectively. The prevalence values of altered airway resistance (16.1 vs. 1.8%; p<0.001) and spirometry (26.8 vs. 13.4%, p=0.012) were higher in preterm infants than in full-term ones. CONCLUSIONS: Preterm children had higher prevalence of altered pulmonary function, higher Z scores of airway resistance, and lower Z scores of FEV1/FVC and FEF25-75 compared with those born full-term.


Assuntos
Recém-Nascido Prematuro , Pulmão , Peso ao Nascer , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
17.
BMC Med ; 20(1): 295, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-36089592

RESUMO

BACKGROUND: Observational studies have reported maternal short/long sleep duration to be associated with adverse pregnancy and perinatal outcomes. However, it remains unclear whether there are nonlinear causal effects. Our aim was to use Mendelian randomization (MR) and multivariable regression to examine nonlinear effects of sleep duration on stillbirth (MR only), miscarriage (MR only), gestational diabetes, hypertensive disorders of pregnancy, perinatal depression, preterm birth and low/high offspring birthweight. METHODS: We used data from European women in UK Biobank (N=176,897), FinnGen (N=~123,579), Avon Longitudinal Study of Parents and Children (N=6826), Born in Bradford (N=2940) and Norwegian Mother, Father and Child Cohort Study (MoBa, N=14,584). We used 78 previously identified genetic variants as instruments for sleep duration and investigated its effects using two-sample, and one-sample nonlinear (UK Biobank only), MR. We compared MR findings with multivariable regression in MoBa (N=76,669), where maternal sleep duration was measured at 30 weeks. RESULTS: In UK Biobank, MR provided evidence of nonlinear effects of sleep duration on stillbirth, perinatal depression and low offspring birthweight. Shorter and longer duration increased stillbirth and low offspring birthweight; shorter duration increased perinatal depression. For example, longer sleep duration was related to lower risk of low offspring birthweight (odds ratio 0.79 per 1 h/day (95% confidence interval: 0.67, 0.93)) in the shortest duration group and higher risk (odds ratio 1.40 (95% confidence interval: 1.06, 1.84)) in the longest duration group, suggesting shorter and longer duration increased the risk. These were supported by the lack of evidence of a linear effect of sleep duration on any outcome using two-sample MR. In multivariable regression, risks of all outcomes were higher in the women reporting <5 and ≥10 h/day sleep compared with the reference category of 8-9 h/day, despite some wide confidence intervals. Nonlinear models fitted the data better than linear models for most outcomes (likelihood ratio P-value=0.02 to 3.2×10-52), except for gestational diabetes. CONCLUSIONS: Our results show shorter and longer sleep duration potentially causing higher risks of stillbirth, perinatal depression and low offspring birthweight. Larger studies with more cases are needed to detect potential nonlinear effects on hypertensive disorders of pregnancy, preterm birth and high offspring birthweight.


Assuntos
Diabetes Gestacional , Hipertensão Induzida pela Gravidez , Nascimento Prematuro , Transtornos do Sono-Vigília , Peso ao Nascer , Criança , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Análise da Randomização Mendeliana , Gravidez , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/genética , Sono/genética , Natimorto/epidemiologia , Natimorto/genética
18.
Front Endocrinol (Lausanne) ; 13: 986650, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36093109

RESUMO

Background: Low-birth-weight infants exhibit a high risk for postnatal morbidity. Cytochrome P450 (CYP) and epoxide hydrolase (EH) are involved in the metabolism of factors responsible for low-birth-weight in infants. Both CYPs and EHs have high substrate specificity and are involved in polyunsaturated fatty acid (PUFA) metabolism. The CYP pathway produces epoxy fatty acids (EpFAs), which are further degraded by soluble EH (sEH). Additionally, sEH inhibition enhances the action of EpFAs and suppresses inflammatory responses. During pregnancy, excessive activation of maternal inflammatory response is a significant factor associated with low-birth-weight. However, the association of EpFAs, which have potential anti-inflammatory properties, with the low-birth-weight of infants remains uninvestigated. This study aimed to clarify the association between the umbilical cord serum EpFA and low-birth-weight using data obtained from the Hamamatsu Birth Cohort for Mothers and Children (HBC Study) by analyzing the umbilical cord blood samples. Method: We selected a subgroup of 200 infants (106 boys and 94 girls), quantified EpFA concentration in their cord blood samples collected at birth, and examined its correlation with birth weight. Results: The comparison between the low-birth-weight and normal-birth-weight groups revealed no significant correlation between PUFA and EpFA concentrations, but a significant correlation was observed in the linoleate diol concentrations of the two groups. Furthermore, birth weight did not significantly correlate with PUFA, EpFA, and diol concentrations in cord blood; however, multiple regression analysis showed a significant negative correlation of birth weight with the concentration of linoleic acid (LA) (r = -0.101, p = 0.016) as well as LA-derived dihydroxyoctadecenoic acid (diHOME) (r = -0.126, p = 0.007), 9,10-diHOME (r = -0.115, p = 0.014), and 12,13-diHOME (r = -0.126, p = 0.007) after adjusting for obstetric factors, including gestational age, infant's sex, childbirth history, delivery method, and maternal height. Conclusions: Birth weight was significantly correlated with the concentration of LA and linoleate diol diHOME after adjusting for obstetric confounders. Our results show that CYP and sEH involved in PUFA metabolism may influence the birth weight of infants. Further validation is needed to provide insights regarding maternal intervention strategies required to avoid low-birth-weight in infants in the future.


Assuntos
Sangue Fetal , Ácido Linoleico , Peso ao Nascer , Criança , Sistema Enzimático do Citocromo P-450/metabolismo , Ácidos Graxos/metabolismo , Feminino , Sangue Fetal/metabolismo , Idade Gestacional , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Ácido Linoleico/metabolismo , Masculino , Gravidez
19.
Artigo em Inglês | MEDLINE | ID: mdl-36078404

RESUMO

(1) Background: Methylmercury (MeHg) exposure during pregnancy is an important issue due to its possible adverse health effects on fetus. To contribute the development of assessment system of Hg exposure through fish consumption and health effects on children, we examined the hair Hg levels in pregnant women and birth weight and length. (2) Methods: In 2018, a cohort study was conducted on 118 pregnant women-infant pairs from six community health centers in the northern coastal area in Central Java Indonesia. Data on mothers' characteristics during pregnancy, birth outcomes, and fish consumption were collected. Total Hg concentrations were determined from hair samples. (3) Results: The median (min-max) of the maternal hair Hg level was 0.434 (0.146-8.105) µg/g. Pregnant women living in lowland areas, near the sea, showed higher hair Hg concentration and fish consumption than those in highland areas {[0.465 (0.146-8.105) vs. 0.385 (0.150-1.956) µg/g; p = 0.043] and [(85.71 (0-500.0) vs. 49.76 (0.0-428.57) g/day; p < 0.01], respectively}. The maternal hair Hg level had no association with baby's birth weight and length. (4) Conclusions: The median maternal hair Hg is at a low level and had no association with infant birth weight and length in this study subjects.


Assuntos
Mercúrio , Compostos de Metilmercúrio , Animais , Peso ao Nascer , Estudos de Coortes , Feminino , Peixes , Contaminação de Alimentos , Cabelo/química , Humanos , Indonésia , Mercúrio/análise , Compostos de Metilmercúrio/análise , Gravidez , Gestantes
20.
Artigo em Inglês | MEDLINE | ID: mdl-36078758

RESUMO

OBJECTIVE: This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support. METHOD: It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied. RESULTS: The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient. CONCLUSIONS: We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.


Assuntos
Retardo do Crescimento Fetal , Artérias Umbilicais , Peso ao Nascer , Criança , Pré-Escolar , Feminino , Retardo do Crescimento Fetal/epidemiologia , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem
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