scholarly journals Higher Incidence of Hypospadias in Monochorionic Twins

2015 ◽  
Vol 18 (5) ◽  
pp. 591-594 ◽  
Author(s):  
Remco Visser ◽  
Nienke C. M. Burger ◽  
Erik W. van Zwet ◽  
Yvonne Hilhorst-Hofstee ◽  
Monique C. Haak ◽  
...  

Background:Hypospadias is associated with twinning. The incidence of hypospadias in monochorionic and dichorionic male twins is, however, yet to be determined.Methods:All medical records of monochorionic and dichorionic twins admitted to our neonatal nursery between January 2004 and August 2013 were reviewed for the presence of hypospadias.Results:A total of 350 monochorionic and 303 dichorionic male twins were included in the study. The incidence of hypospadias in monochorionic and dichorionic groups was 4% (14/350) and 1% (3/303) (p= .016) respectively. In 11 of the 15 twin couples, hypospadias occurred in the twin with the lowest birth weight. The rate of hypospadias in twin infants small-for-gestational-age group was 10% (6/60) compared with 2% (11/593) in the appropriate-for-gestational-age group (p= .002). In a multivariate analysis, both monochorionicity and small-for-gestational-age were independently associated with hypospadias, odds ratio 4.1 (95% confidence interval (CI): 1.1–14.7) and 6.1 (95% CI: 2.2–17.2) respectively.Conclusions: The incidence of hypospadias is four-fold higher in monochorionic twins compared with dichorionic twins. Hypospadias is also independently associated with small-for-gestational-age.

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 413-441
Author(s):  
Joan E. Hodgman ◽  
Paul Y. K. Wu ◽  
Nathaniel B. White ◽  
Dolores A. Bryla

The infant who is small for gestational age (SGA) is more mature at birth than similar weight infants who are appropriate for gestational age (AGA). Whether the SGA infant behaves as does the larger gestationally equivalent infant, or whether there are specific changes related to intrauterine growth retardation is a matter of some interest in the understanding of the special needs of these infants. The National Institute of Child Health and Human Development (NICHD) phototherapy study provided a large newborn population for whom birth weight, gestational age at birth, and, thereby, intrauterine growth were carefully assessed. Infants who weighed 2,000 g or more at birth were included in the study only when they became jaundiced, whereas infants who weighed less than 2,000 g at birth were routinely entered into the study. Consequently, this report will be limited to the lowbirth-weight population selected by birth weight. Too few SGA babies were present in the groups with greater birth weight to allow meaningful comparisons. PATIENT SELECTIQN All infants whose birth weight was less than 2,000 g were entered into the study at 24 ± 12 hours. Those excluded from the study were: (1) infants who died before 24 hours, (2) infants with serious congenital defects, and (3) infants whose mothers refused consent for study. The study population consisted of 922 infants surviving at 24 hours. Gestational age was calculated from the first day of the last menstrual period obtained from maternal history and also by the evaluation techniques of Dubowitz.25 Intrauterine growth was determined by plotting birth weight and gestational age on the Denver Intrauterine Growth Curves8; infants below the 10th percentile were considered SGA.


2014 ◽  
Vol 32 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Pedro Garcia F. Neto ◽  
Mario Cicero Falcao

Objective: To describe the eruption chronology of the first deciduous teeth in premature infants with birth weight less than 1500g and to compare it according to gender and nutritional status at birth. Methods: Longitudinal study including 40 low birth weight premature infants of both genders. The tooth was considered erupted when the crown went through the gum and became part of the oral environment. The comparison of the eruption chronology in relation to gender and among children appropriate or small for gestational age was done by Student's t-test, being significant p<0.05. Results: The eruption of the first tooth (teeth) occurred, on average, with 11.0±2.1 months of chronological age and with 9.6±1.9 months corrected for prematurity. The first erupted teeth were the lower central incisors. The average eruption for males was 9.7±1.9 and, for females, 9.5±1.9 months, both corrected for prematurity (p=0.98). The average eruption in children with birth weight appropriate for gestational age was 10.1±1.4 months; for small for gestational age, it was 9.4±2.2, also corrected for prematurity (p=0.07). Conclusions: The average eruption age of the first teeth, corrected for prematurity, was 9.6 months. Sex and nutritional status at birth did not change the eruption chronology.


PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 407-411
Author(s):  
R. K. Chandra

Groups of healthy, small-for-gestational age (SGA) and preterm appropriate-for-gestational age (AGA) infants were studied at birth, 1 month, 3 months, and 12 months of age. Serum thymic hormone (TH) activity was assayed, the number of T lymphocytes in the peripheral blood was counted, and in vitro lymphocyte stimulation responses to phytohemagglutinin (PHA) were evaluated. TH activity was decreased in 1-month-old SGA infants. T cells were reduced in all low birth weight infants; the number reverted to normal by 3 months of age in preterm AGA infants, whereas it remained low for at least 12 months in the SGA group. Lymphocyte stimulation response was decreased in low birth weight infants; the extent of depression paralleled reduction in T lymphocyte number. These observations indicate that cell-mediated immunity is impaired in low birth weight newborns and reduced TH activity may be one of the pathogenetic factors involved. Persistent depression of immunocompetence may underlie the increased susceptibility of SGA infants to infection-related morbidity and mortality.


PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 7-17
Author(s):  
Dale L. Phelps ◽  
David R. Brown ◽  
Betty Tung ◽  
George Cassady ◽  
Richard E. McClead ◽  
...  

Survival rates specific for birth weight, gestational age, sex, and race are described for 6676 inborn neonates who weighed less than 1251 g at birth and were born during 1986 through 1987. Overall 28-day survival increased with gestational age and birth weight, from 36.5% at 24 weeks' gestation to 89.9% at 29 weeks' gestation, or from 30.0% for neonates of 500 through 599 g birth weight to 91.3% for neonates of 1200 through 1250 g. The expected birth weight-specific survival advantage for female neonates and black neonates diminished when the data were controlled for gestational age, showing that certain previously reported survival advantages are based on lower birth weight for a given gestational age. Multivariate analysis showed that all tested variables were significant predictors for survival, in order of descending significance: gestational age and birth weight, sex, race, single birth, and small-for-gestational-age status. The powerful effect of gestational age on survival highlights the need for an accurate neonatal tool to assess the gestational age of very low birth weight neonates after birth.


Medicina ◽  
2007 ◽  
Vol 43 (10) ◽  
pp. 784 ◽  
Author(s):  
Margarita Valūnienė ◽  
Rasa Verkauskienė ◽  
Margaret Boguszewski ◽  
Jovanna Dahlgren ◽  
Danutė Lašienė ◽  
...  

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.


2016 ◽  
Vol 27 (4) ◽  
pp. 663-670 ◽  
Author(s):  
Agata Zamecznik ◽  
Jerzy Stańczyk ◽  
Agnieszka Wosiak ◽  
Katarzyna Niewiadomska-Jarosik

AbstractAccording to metabolic programming theory, small-for-gestational age patients are at high risk of cardiovascular diseases also because of the possible malfunction of the autonomic nervous system. Autonomic disorders can be assessed by heart rate variability. The aims of this study were to compare time domain parameters of heart rate variability in children born as small-for-gestational age and appropriate-for-gestational age and to assess the correlation of the postnatal and current somatic parameters with the time domain parameters. The small-for-gestational age group consisted of 68 children aged 5–10 years who were born with birth weight below the 10th percentile. The appropriate-for-gestational age group consisted of 30 healthy peers, matched in terms of gender and age. On the basis of Holter monitoring, slightly higher average heart rate was observed in the small-for-gestational age group than in the appropriate-for-gestational age group. It was found that all the time domain parameters (SDNN, SDNNi, SDANNi, rMSSD, pNN50) were lower in the small-for-gestational age group than in the appropriate-for-gestational age group. In the small-for-gestational age group, girls had lower heart rate and some of the heart rate variability parameters (SDNN, SDNNi, SDANNi) in comparison with boys.Children born as small-for-gestational age have impaired function of the autonomic nervous system. Moreover, in the small-for-gestational age group, autonomic balance moved towards the sympathetic component, which was evidenced by higher heart rate. Children with faster heart rate and lower heart rate variability parameters may be at risk of cardiovascular disease.


2014 ◽  
Vol 27 (2) ◽  
pp. 191
Author(s):  
Cláudia Andrade ◽  
Joana Santos ◽  
Ana Rita Pinto ◽  
Pedro Manso ◽  
Susana Pereira

<strong>Introduction:</strong> Several studies suggested an association between first trimester biochemical markers (PAPP-A and β- HCG) and infants below 10th percentile. Our goal was to describe this relationship of biochemical markers with small-for- gestational-age fetuses in our population.<br /><strong>Material and Methods:</strong> Retrospective analytic study of 2 035 pregnant women that underwent first-trimester screening in the period between March 2009 and September 2011. Small-for-gestational-age infants below 10th percentile were compared with control group (term newborn with birth weight above 10th percentile). Infants below 3rd percentile and control group were also compared. Multiple and logistic regression analysis were done with PAPP-A, β-HCG (multiples of the expected normal median) and demographic maternal characteristics (ethnicity, weight and smoker status).<br /><strong>Results:</strong> This study demonstrated an independent contribution of PAPP-A, maternal weight and smoker status in predicting small-for-gestational-age infants. For PAPP-A, the odds ratio for small-for-gestational age below 10th and 3rd percentile was 2.41 and 3.41, respectively (p &lt; 0.01). For β-HCG, odds ratio below 10th percentile was 1.70 (p = 0.03) and for birth weight below the 3rd percentile, the odds ratio was 3.22 (p &lt; 0.01).<br /><strong>Conclusions:</strong> Low levels of PAPP-A and β-HCG (values below 5th percentile of the study population) were associated with an increased risk of small-for-gestational-age infants in the pregnant population included in this study.


2008 ◽  
Vol 1 ◽  
pp. CMPed.S980 ◽  
Author(s):  
Takeo Fujiwara ◽  
Makiko Okuyama ◽  
Haley Tsui ◽  
Karestan C. Koenen

Background The association between birth outcomes and child maltreatment remains controversial. The purpose of this study is to test whether infants without congenital or chronic disease who are low birth weight (LBW), preterm, or small for gestational age (SGA) are at an increased risk of being maltreated. Methods A hospital-based case-control study of infants without congenital or chronic diseases who visited the National Center for Child Health and Development, Tokyo, between April 1, 2002 and March 31, 2005 was conducted. Cases (N = 35) and controls (N = 29) were compared on mean birth weight, gestational age, and z-score of birth weight. Results SGA was significantly associated with infant maltreatment after adjusting for other risk factors (adjusted odds ratio: 4.45, 95% CI: 1.29–15.3). LBW and preterm births were not associated with infant maltreatment. Conclusion Infants born as SGA are 4.5 times more at risk of maltreatment, even if they do not have a congenital or chronic disease. This may be because SGA infants tend to have poorer neurological development which leads them to be hard-to-soothe and places them at risk for maltreatment. Abbreviations SCAN, Suspected Child Abuse and Neglect; LBW, low birth weight; ZBW, z-score of birth weight adjusted for gestational age, sex, and parity; SGA, small for gestational age; SD, standard deviation; OR, odds ratio; aOR, adjusted odds ratio; CI, confidence interval; IPV, intimate partner violence.


2017 ◽  
Vol 35 (08) ◽  
pp. 703-706
Author(s):  
Katherine Himes ◽  
Adriane Haragan

Objective Clinicians use estimated fetal weight (EFW) as a proxy for birth weight (BW) in the antenatal period. Our objective was to compare the accuracy of EFW obtained by ultrasound to BW among infants born during the periviable period and determine if accuracy of EFW varied among small for gestational age (SGA) versus appropriate for gestational age (AGA) grown neonates. Study Design We included women who delivered between 230/7 and 256/7 weeks' gestation and had an EFW within 7 days of delivery. Mean percentage difference and median absolute percentage difference between EFW and BW were calculated. Results Our cohort included 226 neonates with a mean gestational age of 241/7 ± 0.8 weeks and median BW of 653 g (interquartile range [IQR]: 580–750 g). The median absolute percentage difference between EFW and BW of fetal weight estimates was 9.2% (IQR: 3.6–17.2). EFW overestimated BW for 75% (n = 171) of the cohort. Among SGA infants, the mean percentage difference in EFW and BW was 16.2 ± 19.4% versus 6.9% ± 13.1% in AGA infants (p = 0.019). Conclusion EFW overestimated BW in this cohort. In addition, ultrasound was less accurate among infants born SGA. These data are important to consider when counseling families facing periviable delivery.


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