Small for gestational age: Growth and puberty issues

Yadav, Sangita; Rustogi, Deepika

doi:10.1007/s13312-015-0588-z

Cited by 26 publications

(21 citation statements)

References 30 publications

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“…This effect is similar to what is found in other children born small for gestational age [25, 34] and in prematurely born children [35]. Prenatal starvation is associated with epigenetic changes that could persist throughout life, causing a tendency for energy conservation and thus overweight [36, 37].…”

Section: Discussionsupporting

confidence: 79%

“…Similar results have been found in children born small for gestational age, who continue to gain excess body fat even after catch-up in weight [25]. A high waist-to-height ratio is a known risk factor for insulin resistance and metabolic syndrome [34]. As severe PE is characterized by inflammation [40, 41], and studies indicate an association between inflammatory disorders in adults and metabolic syndrome [42] one can speculate that exposure to severe PE might indirectly and via inflammation be a risk factor for metabolic syndrome.…”

Section: Discussionsupporting

confidence: 61%

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Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

et al. 2017

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Background and objectiveAn adverse intrauterine environment may affect offspring growth and development. Our aim was to explore whether preeclampsia (PE) exposure in utero influences growth from birth to 13 years.MethodsIn a nested case-control study, 229 children were exposed to PE (mild/moderate: n = 164, severe: n = 54) and 385 were unexposed. Length/height and weight were abstracted from records at birth, 3 and 6 months, 1 and 4 years, and measured along with waist circumference and skinfolds at follow-up at 11/12 (girls/boys) and 13 years (both sexes). Associations between PE and z-scores for growth were analyzed by multiple linear and fractional polynomial regression with adjustment for potential confounders.ResultsIn boys, exposure to mild/moderate PE was positively associated with linear growth after 0.5 years, but severe PE was negatively associated with linear growth in all ages. In girls, both exposure to mild/moderate and severe PE were negatively associated with linear growth. Exposure to PE was negatively associated with weight and body mass index (BMI) during infancy, but positively associated with weight and BMI thereafter, except that boys exposed to severe PE consistently had a lower weight and BMI compared to the unexposed. Exposure to severe PE only was positively associated with waist-to-height ratio at 11/12 (girls/boys) and 13 years (both sexes).ConclusionsFrom birth to adolescence, linear growth, weight and BMI trajectories differed between the sexes by severity of exposure to PE. In general, PE exposure was negatively associated with linear growth, while in girls; positive associations with weight and BMI were observed. This underlines fetal life as a particularly sensitive period affecting subsequent growth and this may have implications for targeted approaches for healthy growth and development.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 61%

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

et al. 2017

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“…There are two types of NBW abnormalities according to the gestational age and sex-specific INTERGROWTH-21st curves: small for gestational age (SGA; birth weight \ 10th percentile) and large for gestational age (LGA; birth weight [ 90th percentile) [1]. SGA is associated with increased newborn morbidity and mortality and an increased risk of developmental dysfunction and metabolic disease in later life [2].…”

Section: Introductionmentioning

confidence: 99%

Association Between Maternal Glucose/Lipid Metabolism Parameters and Abnormal Newborn Birth Weight in Gestational Diabetes Complicated by Preeclampsia: A Retrospective Analysis of 248 Cases

Xiao

Zhang

2020

Diabetes Ther

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Introduction: Women with gestational diabetes mellitus (GDM) with co-existent preeclampsia (GCP) are at increased risk of giving birth to a baby with an abnormal birth weight. We have analyzed the risk factors for abnormal newborn birth weight (NBW) in women with co-presence of GDM and GCP, focusing on maternal glucose/lipid metabolism, with the aim to optimize the clinical intervention strategy. Methods: The clinical data of 248 pregnant women with GCP and their infants were retrospectively analyzed through a comprehensive review of the electronic medical records of Women and Children's Hospital, Xiamen University (Xiamen, China). These women had received prenatal care and had their baby delivered in the hospital between January 2016 and November 2018. Major characteristics assessed were large for gestational age (LGA), small for gestational age (SGA), severe preeclampsia (S-PE), and maternal plasma glucose/lipid profile in late pregnancy. Secondary characteristics were maternal age, height, body mass index (BMI), gestational weight gain (GWG), abortion history, education level, primipara or not, preterm or not, and fetal gender. Regression analysis was used to analyze the association between maternal glucose/lipid metabolism parameters and LGA or SGA. Results: There was no difference in the ratio of advanced maternal age, primipara, abortion history, preterm delivery, and newborn sex between the control group and the LGA or SGA group. Logistic regression analysis, with such factors as maternal stature, BMI, among others, was applied. Multivariate analysis of SGA infants revealed the following associations: S-PE (odds ratio [OR] 3.226, 95% confidence interval [CI] 1.385-7.515; adjusted OR [AOR] 3.675, 95% CI 1.467-9.207; p \ 0.05); high levels of glycated hemoglobin (HbA1c [ 6.5%) (OR 0.436, 95% CI 0.187-1.017; AOR 0.459, 95% CI 0.179-1.173; p [ 0.05); low levels of high-density lipoprotein cholesterol (HDL-C \ 1.0 mmol/L) (OR 0.625, 95% CI 0.287-1.361; AOR 0.637, 95% CI 0.267-1.520; p [ 0.05). Multivariate analysis of LGA revealed the following associations: S-PE (OR 30.885, 95% CI 0.398-2.013; AOR 0.974, 95% CI 0.400-2.371; p [ 0.05); high levels of HbA1c (OR 4.542, 95% CI 0.187-11.824; AOR 3.997, 95% CI 1.452-10.998; p \ 0.05); low Yunshan Xiao and Xueqin Zhang contributed equally to this work and should be considered co-first authors.

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“…The causes of death in LBW neonates include respiratory and brain immaturity, hypothermia, hypoglycemia, and infection [1]. In addition, LBW infants are at high risk of impaired growth and development [4]. A recent review of available interventions suggested that breastfeeding, hygiene, antenatal corticosteroids to prevent preterm birth complications, case management of suspected infections, and hospital care of small babies that includes Kangaroo Mother Care (KMC) are the most effective interventions for improving survival of LBW infants [5].…”

Section: Introductionmentioning

confidence: 99%

Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial

Mazumder

Taneja

Dalpath³

et al. 2017

Trials

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BackgroundAround 70% neonatal deaths occur in low birth weight (LBW) babies. Globally, 15% of babies are born with LBW. Kangaroo Mother Care (KMC) appears to be an effective way to reduce mortality and morbidity among LBW babies. KMC comprises of early and continuous skin-to-skin contact between mother and baby as well as exclusive breastfeeding. Evidence derived from hospital-based studies shows that KMC results in a 40% relative reduction in mortality, a 58% relative reduction in the risk of nosocomial infections or sepsis, shorter hospital stay, and a lower risk of lower respiratory tract infections in babies with birth weight <2000 g. There has been considerable interest in KMC initiated outside health facilities for LBW babies born at home or discharged early. Currently, there is insufficient evidence to support initiation of KMC in the community (cKMC). Formative research in our study setting, where 24% of babies are born with LBW, demonstrated that KMC is feasible and acceptable when initiated at home for LBW babies. The aim of this trial is to determine the impact of cKMC on the survival of these babies.Methods/designThis randomized controlled trial is being undertaken in the Palwal and Faridabad districts in the State of Haryana, India. Neonates weighing 1500–2250 g identified within 3 days of birth and their mothers are being enrolled. Other inclusion criteria are that the family is likely to be available in the study area over the next 6 months, that KMC was not initiated in the delivery facility, and that the infant does not have an illness requiring hospitalization. Eligible neonates are randomized into intervention and control groups. The intervention is delivered through home visits during the first month of life by study workers with a background and education similar to that of workers in the government health system. An independent study team collects mortality and morbidity data as well as anthropometric measurements during periodic home visits. The primary outcomes of the study are postenrollment neonatal mortality and mortality between enrollment and 6 months of age. The secondary outcomes are breastfeeding practices; prevalence of illnesses and care-seeking practices for the same; hospitalizations; weight and length gain; and, in a subsample, neurodevelopment.DiscussionThis efficacy trial will answer the question whether the benefits of KMC observed in hospital settings can also be observed when KMC is started in the community. The formative research used for intervention development suggests that the necessary high level of KMC adoption can be reached in the community, addressing a problem that seriously constrained conclusions in the only other trial in which researchers examined the benefits of cKMC.Trial registrationClinicalTrials.gov identifier: NCT02653534. Registered on 26 December 2015 (retrospectively registered).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1991-7) contains supplementary material, which is available to authorized users.

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Small for gestational age: Growth and puberty issues

Abstract: Being born small for gestational age predisposes to many metabolic and pubertal disorders. Special emphasis is needed for early detection and management through early surveillance in growth clinics, and regular follow-up to prevent associated comorbidities.

Cited by 26 publications

References 30 publications

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

Association Between Maternal Glucose/Lipid Metabolism Parameters and Abnormal Newborn Birth Weight in Gestational Diabetes Complicated by Preeclampsia: A Retrospective Analysis of 248 Cases

Impact of community-initiated Kangaroo Mother Care on survival of low birth weight infants: study protocol for a randomized controlled trial

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