Cognitive development of term small for gestational age children at five years of age.
(25/812)
AIM: To assess the relative significance for cognitive development of small for gestational age, parental demographic factors, and factors related to the child rearing environment. METHODS: IQ of a population based cohort of 338 term infants who were small for gestational age (SGA) and without major handicap, and a random control sample of 335 appropriate for gestational age (AGA) infants were compared at 5 years of age. RESULTS: The mean non-verbal IQ was four points lower, while the mean verbal IQ was three points lower for the children in the SGA group. The results were not confounded by parental demographic or child rearing factors. However, parental factors, including maternal non-verbal problem solving abilities, and child rearing style, accounted for 20% of the variance in non-verbal IQ, while SGA versus AGA status accounted for only 2%. The comparable numbers for verbal IQ were 30 and 1%. Furthermore, we found no evidence that the cognitive development of SGA children was more sensitive to a non-optimal child rearing environment than that of AGA children. Maternal smoking at conception was associated with a reduction in mean IQ comparable to that found for SGA status, and this effect was the same for SGA and AGA children. The cognitive function of asymmetric SGA was comparable to that of symmetric SGA children. CONCLUSIONS: Our findings indicate that child cognitive development is strongly associated with parental factors, but only marginally associated with intrauterine growth retardation. (+info)
Markers of collagen metabolism and insulin-like growth factor binding protein-1 in term infants.
(26/812)
AIM: To study the relation between fetal growth and markers of collagen metabolism and insulin-like growth factor binding protein-1 (IGFBP-1) in term infants. METHODS: Cord vein plasma was obtained from 67 term infants of gestational age 37.1-41.7 weeks (39 appropriate for gestational age (AGA), 11 large for gestational age (LGA; relative birth weight >/= 2.0 SD), and 17 small for gestational age (SGA; relative birth weight 0.05). CONCLUSIONS: In the term fetus, collagen metabolism is primarily dependent on maturity and not on intrauterine growth status, whereas IGFBP-1 reflects intrauterine growth independently of maturity. (+info)
Fetal growth and infantile colic.
(27/812)
AIM: To describe how fetal growth and gestational age affect infantile colic, while considering other potential risk factors. STUDY DESIGN: A population based follow up study of 2035 healthy singleton infants without any disability born to Danish mothers. Information was collected by self administered questionnaires at 16 and 30 weeks of gestation, at delivery, and 8 months post partum. Infantile colic is defined according to Wessel's criteria, but symptoms are restricted to crying for more than three hours a day, for more than three days a week, and for more than three weeks. RESULTS: The cumulated incidence of infantile colic was 10.9%. Low birth weight babies (< 2500 g) had more than twice the risk (odds ratio = 2.7, 95% confidence interval 1.2 to 6.1) of infantile colic when controlled for gestational age, maternal height, and smoking. CONCLUSION: Low birth weight may be associated with infantile colic, and further research will be aimed to focus on fetal growth and infantile colic. (+info)
Body water content of extremely preterm infants at birth.
(28/812)
BACKGROUND: Preterm birth is often associated with impaired growth. Small for gestational age status confers additional risk. AIM: To determine the body water content of appropriately grown (AGA) and small for gestational age (SGA) preterm infants in order to provide a baseline for longitudinal studies of growth after preterm birth. METHODS: All infants born at the Hammersmith and Queen Charlotte's Hospitals between 25 and 30 weeks gestational age were eligible for entry into the study. Informed parental consent was obtained as soon after delivery as possible, after which the extracellular fluid content was determined by bromide dilution and total body water by H(2)(18)O dilution. RESULTS: Forty two preterm infants were studied. SGA infants had a significantly higher body water content than AGA infants (906 (833-954) and 844 (637-958) ml/kg respectively; median (range); p = 0.019). There were no differences in extracellular and intracellular fluid volumes, nor in the ratio of extracellular to intracellular fluid. Estimates of relative adiposity suggest a body fat content of about 7% in AGA infants, assuming negligible fat content in SGA infants and lean body tissue hydration to be equivalent in the two groups. CONCLUSIONS: Novel values for the body water composition of the SGA preterm infant at 25-30 weeks gestation are presented. The data do not support the view that SGA infants have extracellular dehydration, nor is their regulation of body water impaired. (+info)
Effects of prematurity, intrauterine growth status, and early dexamethasone treatment on postnatal bone mineralisation.
(29/812)
AIM: To examine the hypothesis that, apart from prematurity, intrauterine growth status (expressed as gestational age specific birth weight standard deviation scores), neonatal factors, and duration of dexamethasone treatment influence bone mineralisation in early infancy. METHODS: In this prospective study, groups consisted of 15 preterm small for gestational age infants (SGA group) and 43 preterm appropriate for gestational age infants (AGA group). A reference group contained 17 term infants. Body size is known to affect bone mineral content (BMC), therefore postnatal bone mineralisation was measured when the study infants and controls had attained a similar body size. Bone mineral density (BMD) and BMC were determined by dual energy x ray absorptiometer of the lumbar spine (L2-L4). RESULTS: Both preterm groups had significantly lower BMC and BMD than the weight matched term reference group, but no difference was found in BMC and BMD between preterm SGA and AGA infants. In stepwise regression analysis, bone area, duration of dexamethasone treatment, weight at examination, and weight gain per week were the most significant factors, explaining 54% of the variance of the BMC values. CONCLUSION: In particular, weight at examination, prematurity, and possibly dexamethasone treatment, but not intrauterine growth status, affect postnatal bone mineralisation. (+info)
Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity.
(30/812)
BACKGROUND: Relations between size and maturity at birth and infant growth have been studied inadequately in Bangladesh, where the incidence of low birth weight is high and most infants are breast-fed. OBJECTIVE: This study was conducted to describe infant growth patterns and their relations to birth weight, intrauterine growth retardation, and prematurity. DESIGN: A total of 1654 infants born in selected low-socioeconomic areas of Dhaka, Bangladesh, were enrolled at birth. Weight and length were measured at birth and at 1, 3, 6, 9, and 12 mo of age. RESULTS: The infants' mean birth weight was 2516 g, with 46.4% weighing <2500 g; 70% were small for gestational age (SGA) and 17% were premature. Among the SGA infants, 63% had adequate ponderal indexes. The mean weight of the study infants closely tracked the -2 SD curve of the World Health Organization pooled breast-fed sample. Weight differences by birth weight, SGA, or preterm categories were retained throughout infancy. Mean z scores based on the pooled breast-fed sample were -2.38, -1. 72, and -2.34 at birth, 3 mo, and 12 mo. Correlation analysis showed greater plasticity of growth in the first 3 mo of life than later in the first year. CONCLUSIONS: Infant growth rates were similar to those observed among breast-fed infants in developed countries. Most study infants experienced chronic intrauterine undernourishment. Catch-up growth was limited and weight at 12 mo was largely a function of weight at birth. Improvement of birth weight is likely to lead to significant gains in infant nutritional status in this population, although interventions in the first 3 mo are also likely to be beneficial. (+info)
What degree of maternal metabolic control in women with type 1 diabetes is associated with normal body size and proportions in full-term infants?
(31/812)
OBJECTIVE: To assess what degree of maternal metabolic control in women with type 1 diabetes is associated with normal fetal growth and results in normal neonatal body proportions in a group of full-term infants. RESEARCH DESIGN AND METHODS: We investigated the anthropometric characteristics of 98 full-term singleton infants born to 98 Caucasian women with type 1 diabetes enrolled within 12 weeks of gestation. The type 1 diabetic mother-infant pairs were divided into three groups on the basis of the daily glucose levels reached during the second and third trimesters of pregnancy (group 1: 37 mother-infant pairs with an average daily glucose level during the second and third trimesters of < or =95 mg/dl; group 2: 37 mother-infant pairs with an average daily glucose level during the second trimester of >95 mg/dl and during the third trimester of < or =95 mg/dl; group 3: 24 mother-infant pairs with an average daily glucose level during the second and third trimesters of >95 mg/dl; control group: 1,415 Caucasian mother-infant pairs with full-term singleton pregnancies and normal glucose challenge test screened for gestational diabetes. RESULTS: Infants of diabetic mothers in group 1 were similar to those of the control group in birth weight and in other anthropometric parameters. In contrast, offspring of diabetic mothers of groups 2 and 3 showed an increased incidence of large-for-gestational-age infants, significantly greater means of ponderal index and thoracic circumferences, and significantly smaller cranial/thoracic circumference ratios with respect to the control group. CONCLUSIONS: The results of our study suggest that, in diabetic pregnancies, only overall daily glucose values < or =95 mg/dl throughout the second and third trimesters can avoid alterations in fetal growth. (+info)
Intrauterine growth restriction and Doppler ultrasonography.
(32/812)
To clarify the difference between the fetus that is small for gestational age and the fetus with true intrauterine growth restriction, we undertook a retrospective study of singleton fetuses who had fetal weight estimation and umbilical artery Doppler velocity studies within 2 weeks of their delivery. Fetuses were divided into four categories on the basis of sonographic results from their last examination. Statistical comparisons of neonatal outcome were made for the four groups, which totaled 578 fetuses. Increased cesarean section for fetal distress, stays in the neonatal intensive care unit, and increased neonatal morbidity were seen in both small for gestational age and average for gestational age neonates with abnormal Doppler blood flow. The small for gestational age fetuses with normal Doppler studies showed no increased morbidity when compared with their average for gestational age cohorts. Umbilical artery Doppler blood flow studies were a better predictor of neonatal outcome than estimated fetal weight. Small for gestational age fetuses with normal Doppler studies most likely represent constitutionally small, not pathologically growth restricted, fetuses. (+info)