scholarly journals P01.07: Perinatal outcome of term small for gestational age infants: the impact of antenatal oligohydramnios

2010 ◽  
Vol 36 (S1) ◽  
pp. 169-169
Author(s):  
T. Kong ◽  
J. Park ◽  
J. Yang ◽  
H. Kim
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Outcome ◽  
The Impact

Perinatal Outcome and its Prediction Using Longitudinal Feto-Maternal Doppler Follow-Up in Late Onset Small for Gestational Age Fetuses – A Prospective Cohort Study

2021 ◽  
Author(s):  
Silvia M. Lobmaier ◽  
Oliver Graupner ◽  
Javier U. Ortiz ◽  
Bernhard Haller ◽  
Christina Ried ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Prospective Cohort ◽  
Perinatal Outcome ◽  
Late Onset ◽  
Induction Of Labor ◽  
University Hospital ◽  
Operative Delivery ◽  
Longitudinal Measurements ◽  
Cesarean Delivery Rate

Abstract Purpose To describe the perinatal outcome of a prospective cohort of late-onset small-for-gestational-age (SGA) fetuses and to test adverse perinatal outcome (APO) prediction using Doppler measurements. Methods Singleton pregnancies from 32 weeks with suspicion of SGA (followed-up each 2 weeks) and randomly selected healthy controls at a university hospital were included. The whole SGA group was divided into the FGR subgroup or SGA percentile 3–10 subgroup. The following Doppler measurements were evaluated prospectively: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, cerebro-placental ratio (CPR), and mean uterine artery (mUtA) PI. APO was defined as arterial cord blood pH ≤ 7.15 and/or 5-minute Apgar ≤ 7 and/or emergency operative delivery and/or admission to the neonatal unit. Induction of labor was indicated according to a stage-based protocol. Results A total of 149 SGA and 143 control fetuses were included. The number of operative deliveries was similar between both groups (control: 29 %, SGA: 28 %), especially the cesarean delivery rate after the onset of labor (11 % vs. 10 %). Most SGA cases ended up in induction of labor (61 % vs. 31 %, p < 0.001). The areas under the curve (AUC) for APO prediction were similar using the last UA PI, MCA PI, CPR, and mUtA PI and barely reached 0.60. The AUC was best for the FGR subgroup, using the minimal CPR or maximum mUtA PI z-score of all longitudinal measurements (AUC = 0.63). Conclusion SGA fetuses do not have a higher rate of operative delivery if managed according to a risk stratification protocol. Prediction of APO is best for SGA and FGR using the “worst” CPR or mUtA PI but it remains moderate.

scholarly journals Birth outcomes, pregnancy complications, and postpartum mental health after the 2013 Calgary flood: A difference in difference analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246670
Author(s):  
Erin Hetherington ◽  
Kamala Adhikari ◽  
Lianne Tomfohr-Madsen ◽  
Scott Patten ◽  
Amy Metcalfe
Keyword(s):  
Mental Health ◽  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gestational Hypertension ◽  
Difference In Difference ◽  
Postpartum Mental Health ◽  
Nulliparous Women ◽  
The Impact

Background In June 2013, the city of Calgary, Alberta and surrounding areas sustained significant flooding which resulted in large scale evacuations and closure of businesses and schools. Floods can increase stress which may negatively impact perinatal outcomes and mental health, but previous research is inconsistent. The objectives of this study are to examine the impact of the flood on pregnancy health, birth outcomes and postpartum mental health. Methods Linked administrative data from the province of Alberta were used. Outcomes included preterm birth, small for gestational age, a new diagnoses of preeclampsia or gestational hypertension, and a diagnosis of, or drug prescription for, depression or anxiety. Data were analyzed using a quasi-experimental difference in difference design, comparing flooded and non-flooded areas and in affected and unaffected time periods. Multivariable log binomial regression models were used to estimate risk ratios, adjusted for maternal age. Marginal probabilities for the difference in difference term were used to show the potential effect of the flood. Results Participants included 18,266 nulliparous women for the pregnancy outcomes, and 26,956 women with infants for the mental health analysis. There were no effects for preterm birth (DID 0.00, CI: -0.02, 0.02), small for gestational age (DID 0.00, CI: -0.02, 0.02), or new cases of preeclampsia (DID 0.00, CI: -0.01, 0.01). There was a small increase in new cases of gestational hypertension (DID 0.02, CI: 0.01, 0.03) in flood affected areas. There were no differences in postpartum anxiety or depression prescriptions or diagnoses. Conclusion The Calgary 2013 flood was associated with a minor increase in gestational hypertension and not other health outcomes. Universal prenatal care and magnitude of the disaster may have minimized impacts of the flood on pregnant women.

Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants

2018 ◽  
Vol 35 (12) ◽  
pp. 1178-1185
Author(s):  
Shoko Yamazaki ◽  
Haruka Obinata ◽  
Akira Hachiya ◽  
Motoko Kamiya ◽  
Noriko Motoki ◽  
...  
Keyword(s):  
Growth Factor ◽  
Diastolic Dysfunction ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Linear Regression Analysis ◽  
Entire Population ◽  
Doppler Imaging ◽  
Multivariate Linear Regression Analysis ◽  
Insulin Like Growth Factor ◽  
The Impact

Objective To evaluate the impact of serum insulin-like growth factor-1 (IGF-1) levels on cardiac function in small for gestational age (SGA) infants. Study Design This is a prospective, observational study. Serum IGF-1 levels at birth and echocardiography measurements at 1 week of age were compared between SGA and appropriate for gestational age (AGA) infants. Results Thirty-one SGA infants and 27 AGA infants were enrolled. Serum IGF-1 levels were lower in the SGA infants than in the AGA infants. SGA infants had lower mitral lateral annular systolic (S') and early diastolic (E') tissue Doppler imaging velocities compared with AGA infants (S', 5.1 ± 0.9 vs 5.7 ± 1.2 cm/s; E', 6.1 ± 1.5 cm/s vs 7.1 ± 1.3 cm/s; p < 0.05). Serum IGF-1 levels positively correlated with E' velocity in the entire population (r = 0.44, p < 0.001) and in SGA infants (r = 0.39, p < 0.05). In multivariate linear regression analysis, serum IGF-1 and S' velocity were independently associated with E' velocity in the entire population and in SGA infants. Conclusion Decreased serum IGF-I levels could account for cardiac diastolic dysfunction in SGA infants.

Respiratory Characteristics During Sleep in Healthy Small-for-Gestational Age Newborns

PEDIATRICS ◽  
1996 ◽  
Vol 97 (4) ◽  
pp. 554-559
Author(s):  
Lilia Curzi-Dascalova ◽  
Patricio Peirano ◽  
Emilia Christova
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Respiratory Function ◽  
Respiratory Rhythm ◽  
Periodic Breathing ◽  
Respiratory Frequency ◽  
Quiet Sleep ◽  
Age Related ◽  
Appropriate For Gestational Age ◽  
The Impact

Objective. Small-for-gestational age (SGA) infants born with intrauterine growth retardation (IUGR) differ from appropriate-for-gestational age (AGA) infants by: a) alterations in a number of neurologic and neurophysiologic characteristics; b) modified heart rate variability during the neonatal period; and c) increased morbidity rates during the first months of life. However, there are no data on the impact of IUGR on respiratory function control at birth. Methods. We studied 57 newborns who were 35 to 36, 37 to 38, and 39 to 41 weeks' conceptional age (CA): 31 were AGA and 26 were SGA. All were clinically and neurologically normal at birth and none exhibited abnormal events during the first year of life. Polygraphic recordings were performed between two meals during the normal postnatal stay in the maternity ward. Results. During both active sleep (AS) and quiet sleep (QS), SGA infants in all CA groups had significently higher values for the incidence of 2 to 4.9 seconds and 5 to 9.9 seconds central respiratory pauses (RP), the apnea index (AI) [AI = % of nonbreathing time], and the time spent with periodic breathing (PB), as compared with AGA infants Respiratory frequency was usually similar in SGA and AGA infants. In addition, the trend of age-related respiratory modifications was disturbed in SGA infants, as compared with AGA infants: at 39 to 41 weeks CA, SGA infants had no significant decreases in RP, AI, or PB, and no increase in respiratory frequency. However, between-state differences were similar in both groups. In all AGA and SGA infant groups respiratory frequency seemed to be an individual characteristic: infants who breathed faster during AS breathed faster during QS, and vice-versa. Conclusion. Our data demonstrate significant modifications in the establishment of respiratory rhythm control in SGA infants, whereas the patterns of state-related and subject-dependent breathing characteristics were similar in SGA and AGA infants. We speculate that the dysregulation of respiratory function control maturation observed in healthy SGA infants may be related to subtle brainstem modifications attributable to the decreased blood supply and chronic hypoxia associated with IUGR.

scholarly journals Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension–Associated Risks for Newborns and Mothers

2019 ◽  
Vol 125 (2) ◽  
pp. 184-194 ◽  
Author(s):  
Jie Hu ◽  
Yuanyuan Li ◽  
Bin Zhang ◽  
Tongzhang Zheng ◽  
Jun Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Preterm Delivery ◽  
High Blood Pressure ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gestational Hypertension ◽  
Blood Pressure Elevation ◽  
Early Term ◽  
Term Delivery ◽  
The Impact

Rationale: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new hypertension guideline for nonpregnant adults, using lower blood pressure values to identify hypertension. However, the impact of this new guideline on the diagnosis of gestational hypertension and the associated maternal and neonatal risks are unknown. Objective: To estimate the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations and the relationship with maternal and neonatal risk in the perinatal period using a retrospective cohort design. Methods and Results: This study included 16 345 women from China. Systolic and diastolic blood pressures of each woman were measured at up to 22 prenatal care visits across different stages of pregnancy. Logistic and linear regressions were used to estimate associations of blood pressure categories with the risk of preterm delivery, early-term delivery, and small for gestational age, and indicators of maternal liver, renal, and coagulation functions during pregnancy. We identified 4100 (25.1%) women with gestational hypertension using the 2017 ACC/AHA guideline, compared with 4.2% using the former definition. Gestational hypertension, but not elevated blood pressure (subclinical blood pressure elevation), was significantly associated with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and increased risk of adverse birth outcomes for newborns; adjusted odds ratios (95% CIs) for gestational hypertension stage 2 were 2.23 (1.18–4.24) for preterm delivery, 2.05 (1.67–2.53) for early-term delivery, and 1.43 (1.13–1.81) for small for gestational age. Conclusions: Adopting the 2017 ACC/AHA guideline would result in a substantial increase in the prevalence of gestational hypertension; subclinical blood pressure elevations during late pregnancy were not associated with increased maternal and neonatal risk in this cohort. Therefore, the 2017 ACC/AHA guideline may improve the detection of high blood pressure during pregnancy and the efforts to reduce maternal and neonatal risk. Replications in other populations are required.

scholarly journals Leptin levels at birth and in early postnatal life in small- and appropriate-for-gestational-age infants

Medicina ◽  
2007 ◽  
Vol 43 (10) ◽  
pp. 784 ◽  
Author(s):  
Margarita Valūnienė ◽  
Rasa Verkauskienė ◽  
Margaret Boguszewski ◽  
Jovanna Dahlgren ◽  
Danutė Lašienė ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Venous Blood ◽  
Postnatal Life ◽  
Abrupt Decrease ◽  
Blood Samples ◽  
Appropriate For Gestational Age ◽  
Early Postnatal Life ◽  
The Impact

The aim of this study was to evaluate leptin concentration at birth and in early postnatal life in small- and appropriate-for-gestational-age infants and to assess its relationship with infants’ anthropometry at birth and some characteristics of maternal pregnancy. Materials and methods. A total of 367 infants born after 32–42 weeks of gestation were enrolled in the study. Umbilical cord blood samples were collected from 80 small- and 287 appropriate- for-gestational-age newborns. Altogether, 166 venous blood samples were taken from these neonates on days 2–6 of life. Results. Cord leptin levels were significantly lower in small- compared to appropriate-forgestational- age infants. We observed a positive correlation between cord leptin and birth weight, all neonatal anthropometric parameters, placental weight, and some maternal nutritional factors. In multivariate analysis, cord leptin concentration explained up to 15% of the variation in sum of newborn’s skinfold thickness but only 5% of the variation in birth weight. Postnatally, leptin concentration decreased markedly to the similar low levels in both infant groups and remained so during the first postnatal week. Conclusions. Significantly lower cord leptin concentration in small-for-gestational-age neonates reflects a lower fat mass content compared to appropriate-for-gestational-age infants. However, an abrupt decrease in leptin levels shortly after birth in both groups suggests that placenta could be an important source of leptin in fetal circulation. The impact of low leptin levels at birth in small-for-gestational-age infants on their postnatal appetite and weight gain remains to be elucidated in future studies.

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