Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

Sharma, Deepak; Shastri, Sweta; Sharma, Pradeep

doi:10.4137/cmped.s40070

Cited by 665 publications

(571 citation statements)

References 98 publications

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“…There was no surprise regarding management of SGA [16] and LGA [17] neonates: respondents' practices confirmed that inadequacy for gestational age raises concerns with regard to hypoglycemia. Likewise, preterm birth (<37 weeks GA) was concerning to all respondents as a driving factor of hypoglycemia.…”

Section: Discussionmentioning

confidence: 84%

“…Although neither group demonstrated a direct concern with hypertensive disease of pregnancy, studies have raised concerns regarding increasing body mass index in pregnant women [15], and it is becoming increasingly clear that obesity and diabetes go hand in hand [16]. It is also important to address the relationship between pregnancy-induced hypertension and disorders of fetal development, from intrauterine growth restriction (IUGR) [17,18] to neonates large for gestational age (LGA) [19] and even preterm birth [20,21] all of which facilitate the development of hypoglycemia. In their answers to the open-ended questionnaire items, the respondents also noted maternal medication use as an important factor, as many drugs (beta blockers, chlorpropamide, tocolytics, benzthiazide) can suppress the catecholamine response and prevent glycogenolysis, or stimulate the pancreatic beta cells.…”

Section: Discussionmentioning

confidence: 99%

“…The wording of questionnaire items was guided by keywords selected on the basis of the recent literature on the topic. Multiple-choice questions were also based on the literature [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

Section: The Second Part Of the Questionnaire Was Subdivided Into Twomentioning

confidence: 99%

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A Concept Map of Neonatal Hypoglycemia

G¹,

Acpm²,

Ad³

et al. 2017

Neonat Pediatr Med

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Objectives: To analyze current management of neonatal hypoglycemia and establish a concept map based on testimonials from physicians who use capillary blood glucose tests to guide management. Methods:This was an observational, descriptive, mixed qualitative and quantitative study. A questionnaire was administered to physicians, seeking to characterize their responses to neonatal hypoglycemia in pregnancy, labor and delivery, and the immediate neonatal period. Data collection was performed with two groups of Brazilian physicians: neonatologists (group GN) and pediatricians (group GP). A Likert-type scale was used to collect responses. The Mann-Whitney test and Fisher's exact test were used for statistical analysis of continuous and categorical variables respectively. Statistical significance was accepted at 5%. Principal components analysis with varimax rotation and Kaiser normalization was used to verify the structure of question/answer factors in the two groups of professionals. A concept map was constructed using the Cmap Tools Knowledge Kit, version 5.05.01. Results:Of the 98 questionnaires analyzed, 34.7% were completed by neonatologists (n=34/98) and 65.3% by pediatricians (n=64/98). Mean age in the two groups (GN and GP) was 42.4 years (SD: 11.78; 95% CI: 40.10, 44.88; p=0.597), with a significant difference in age in men (mean=50 years; SD: 10.35; 95% CI: 45.20, 54.90; p<0.001); 79.2% of respondents (n=78/98) were women. Overall, 32.7% of respondents (n=32/98) claimed they did not currently work with neonates. Respondents in GN had completed more postgraduate courses (p=0.38). The two groups responded similarly to all questions. The responses highlighted the importance of values lower than 40 mg/dL in the diagnosis of neonatal hypoglycemia, as well as the indication of intravenous infusion when glucose was below 40 mg/dL in symptomatic neonates. Immediate institution of periodic capillary blood glucose measurement was recommended for the following groups of neonates: those born to diabetic mothers, those with intrauterine growth restriction, small for gestational age, large for gestational age, preterm neonates, septic neonates, and those with birth asphyxia. Conclusions:Capillary blood glucose is part of routine neonatal management, especially preventive, in light of the possibility of neonatal hypoglycemia. Our findings highlight that, in high-risk gestational groups, the entire neonatal team should be focused on the risk of hypoglycemia. The development of management algorithms based on the use of peripheral blood glucose test strips has contributed to streamlining the management of neonatal hypoglycemia.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Concept Map of Neonatal Hypoglycemia

G¹,

Acpm²,

Ad³

et al. 2017

Neonat Pediatr Med

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“…The increased minute ventilation leads to a higher PaO2 (104-108 mmHg) and lower PaCO2 (27-32 mmHg) in the maternal circulation, resulting in a state of chronic respiratory alkalosis (pH 7.4-7.45) which is compensated for by an increase in renal excretion of bicarbonate (18-21 mmol/L). A simultaneous increase in oxygen consumption (20-40% above non-pregnant levels) occurs in order to fulfill the maternal, fetal and placental requirements [1][2][3].…”

Section: Journal Of Transmitted Diseases and Immunity Issn 2573 -0320mentioning

confidence: 99%

“…Intrauterine growth restriction is associated with an increased risk of perinatal morbidity and mortality compared with their appropriately grown counterparts, and much attention has been dedicated in recent years to prediction, early recognition, improved surveillance, as well as to timely planned delivery in order to minimize some of the adverse pregnancy outcomes [2].…”

Section: Introductionmentioning

confidence: 99%

Nontuberculous Mycobacterium during Pregnancy: A Case Report

Zipori¹,

Geary²,

H³

et al. 2017

J Transm Dis Immun

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Background: The purpose of the present case report was to describe an exacerbation of maternal respiratory condition during pregnancy and its association with severe fetal growth restriction. Case:A 29-year old woman, gravida 1, para 0, at 22 weeks' gestation was admitted to due to poorly controlled asthma and nontuberculous mycobacterium pulmonary infection, namely mycobacterium kansasii. With anti-tuberculous therapy, systemic steroids, in addition to supportive care, gradual clinical improvement was noticed. An uncomplicated cesarean section was performed at 37 weeks' gestation due to minimal interval growth in a severely growth restricted fetus. Conclusion:Early symmetrical fetal growth restriction should be anticipated with underlying, uncontrolled respiratory pathology, necessitating close monitoring in order to facilitate the optimal timing of delivery.

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Growth, genetics of

Laron

2018

The International Encyclopedia of Biological Anthropology

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Short stature is defined as body length or height two standard deviations below the mean for age and sex in the specific population. It can be diagnosed in utero, at birth, or postnatally. Prenatal causes of short stature may be genetic or environmental (endocrine, chromosomal, metabolic) or of maternal or placental origin. Postnatal development of short stature is mostly due to an acquired hormone deficiency or hypersecretion leading to premature closure of the epiphyseal growth plate. A correct diagnosis is important to distinguish between treatable and untreatable conditions.

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Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

Cited by 665 publications

References 98 publications

A Concept Map of Neonatal Hypoglycemia

A Concept Map of Neonatal Hypoglycemia

Nontuberculous Mycobacterium during Pregnancy: A Case Report

Growth, genetics of

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