Human Fetal Kidney Morphometry during Gestation and the Relationship between Weight, Kidney Morphometry and Plasma Active Renin Concentration at Birth

1996 ◽  
Vol 91 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Justin C. Konje ◽  
Stephen C. Bell ◽  
James J. Morton ◽  
Richard De Chazal ◽  
David J. Taylor
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Umbilical Vein ◽  
Plasma Renin ◽  
Age Group ◽  
Renal Growth ◽  
Active Renin ◽  
Plasma Active Renin ◽  
Appropriate For Gestational Age ◽  
The Relationship

1. This study was designed to examine the changes in kidney morphometry during gestation in fetuses that were either appropriate or small for gestational age and the relationship between umbilical vein plasma active renin and kidney morphometry. 2. Serial ultrasound measurements of various morphometric and renal indices were performed in a cohort of 87 singleton fetuses from 22 to 38 weeks gestation. Blood was collected from the umbilical vein at delivery and active renin was measured from the plasma based on angiotensinogen I generated during incubation with plasma and ox renin substrate. 3. Growth in the longitudinal plane of fetal kidneys was similar in the small- and appropriate-for-gestational age groups; however, growth in the anterio-posterior, transverse and circumference planes of the kidneys was significantly slower in the small-for-gestational-age group after 26 weeks gestation. Differences in growth rate in the two groups were most marked between 26 and 34 weeks and persisted until delivery when the anterior-posterior diameter was significantly larger (P < 0.00001) in the appropriate-for-gestational-age group (26.1 ± 2.5 mm compared with 19.8 ± 2.6 mm). The mean umbilical vein active plasma renin concentration at delivery was significantly higher (P < 0.05) in the small-for-gestational-age group (274.4 ± 32.9 μ-units/ml plasma) than in the appropriate-for-gestational-age group (164.9 ± 28.3 μ-units/ml plasma). In addition, there were statistically significant inverse correlations between renin concentration and birthweight (r = − 0.55, P < 0.001) and between renin concentration and kidney anterior-posterior diameter (r = −0.67, P < 0.001). 4. Fetal renal growth was slower in small than in appropriate-for-gestational-age fetuses. The period of 26–34 weeks gestation was that during which maximum fetal renal growth occurred. Umbilical vein plasma renin levels were higher in small-for-gestational-age fetuses. The findings of slow fetal renal growth rate and associated high renin concentrations seen in small-for-gestational-age fetuses could be implicated in an irreversible reno-vascular pathology leading to adult hypertension. We suggest that 26 to 34 weeks could be the ‘critical period’ during which the insult that leads to in-utero programming for the development of adult hypertension occurs.

Time domain parameters of heart rate variability in children born as small-for-gestational age

2016 ◽  
Vol 27 (4) ◽  
pp. 663-670 ◽  
Author(s):  
Agata Zamecznik ◽  
Jerzy Stańczyk ◽  
Agnieszka Wosiak ◽  
Katarzyna Niewiadomska-Jarosik
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Gestational Age ◽  
Time Domain ◽  
Small For Gestational Age ◽  
Age Group ◽  
Lower Heart Rate ◽  
Appropriate For Gestational Age ◽  
The Time Domain

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.

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 ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Birth Weight ◽  
Confidence Interval ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Medical Records ◽  
Odds Ratio ◽  
Age Group ◽  
Monochorionic Twins ◽  
Appropriate For Gestational Age

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.

284 Umbilical vein flow in fetal growth restriction versus small for gestational age fetuses

2021 ◽  
Vol 224 (2) ◽  
pp. S186
Author(s):  
Odessa P. Hamidi ◽  
Camille Driver ◽  
Tamara Stampalija ◽  
Sarah Martinez ◽  
Diana Gumina ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Umbilical Vein ◽  
Growth Restriction

Comparison of Phototherapy Results in Small-for-Gestational-Age and Appropriate-for-Gestational-Age Infants Weighing Less Than 2,000 Grams

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 413-441
Author(s):  
Joan E. Hodgman ◽  
Paul Y. K. Wu ◽  
Nathaniel B. White ◽  
Dolores A. Bryla
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Congenital Defects ◽  
Intrauterine Growth ◽  
Appropriate For Gestational Age ◽  
Study Population ◽  
Similar Weight ◽  
Gestational Age At Birth ◽  
Evaluation Techniques

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.

GROWTH HORMONE LEVELS IN NORMOGLYCEMIC AND HYPOGLYCEMIC INFANTS BORN SMALL FOR GESTATIONAL AGE

PEDIATRICS ◽  
1971 ◽  
Vol 48 (2) ◽  
pp. 190-199
Author(s):  
James R. Humbert ◽  
Ronald W. Gotlin
Keyword(s):  
Growth Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gh Deficiency ◽  
Newborn Infants ◽  
Significant Rise ◽  
Glucose Levels ◽  
Appropriate For Gestational Age ◽  
A Prospective Study ◽  
Serum Gh

Recent investigations have raised the possibility that growth hormone (GH) influences intra-uterine weight and length. Moreover, the hypoglycemic tendency of small for gestational age (FSGA) infants and their small size could result from GH deficiency. To verify these hypotheses, a prospective study of daily serum GH and glucose levels was conducted in 46 newborn infants, including 18 FSCA infants, 18-full-term, appropriate for gestational age (FAGA), and 10 premature (PR) infants. Two FSGA babies became hypoglycemic. Both manifested normal GH competence as evidenced by normal daily GH levels, adequate GH response to arginine provocation, and satisfactory growth for over 2 years. Eleven of 12 FSGA babies followed from 14 to 26 months showed no evidence of impaired linear growth. The FSGA babies had GH values similar in magnitude and pattern to those of FAGA and PR infants. During the second half of the first postnatal day, a significant rise in serum GH occurred in all infants regardless of their size or gestational age; this rise may be the result of the stimulating effect of early milk feedings. GH deficiency does not appear to contribute to either the small size or hypoglycemic tendency of FSGA newborn infants.

scholarly journals Neurodevelopment of small-for-gestational age infants: behavioral aspects in first year

2014 ◽  
Vol 72 (7) ◽  
pp. 517-523 ◽  
Author(s):  
Bernadete Mello ◽  
Heloisa Gagliardo ◽  
Vanda Gonçalves
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Infant Development ◽  
Rating Scale ◽  
Full Term ◽  
First Year ◽  
Behavior Rating Scale ◽  
Appropriate For Gestational Age ◽  
Test Materials ◽  
State Liability

The purpose of this study was to compare the behavior of full-term small-for-gestational age (SGA) with full-term appropriate-for gestational age (AGA) infants in the first year of life. We prospectively evaluated 68 infants in the 2nd month, 67 in the 6th month and 69 in the 12th month. The Bayley Scales of Infant Development-II were used, with emphasis on the Behavior Rating Scale (BRS). The groups were similar concerning the item “interest in test materials and stimuli”; there was a trend toward differences in the items “negative affect”, “hypersensitivity to test materials” and “adaptation to change in test materials”. The mean of Raw Score was significantly lower for the SGA group in the items “predominant state”, “liability of state of arousal”, “positive affect”, “soothability when upset”, “energy”, “exploration of objects and surroundings”, “orientation toward examiner”. A lower BRS score was associated with the SGA group in the 2nd month.

scholarly journals Comparison of neonatal outcomes of small for gestational age and appropriate for gestational age preterm infants born at 28–36 weeks of gestation: a multicentre study in Ethiopia

2020 ◽  
Vol 4 (1) ◽  
pp. e000740
Author(s):  
Netsanet Workneh Gidi ◽  
Robert L Goldenberg ◽  
Assaye K Nigussie ◽  
Elizabeth McClure ◽  
Amha Mekasha ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Late Onset ◽  
Early Recognition ◽  
Neonatal Outcomes ◽  
P Value ◽  
Prolonged Hospitalisation ◽  
Increased Risk ◽  
Appropriate For Gestational Age

PurposeThe aim of this study was to assess morbidity and mortality pattern of small for gestational age (SGA) preterm infants in comparison to appropriate for gestational age (AGA) preterm infants of similar gestational age.MethodWe compared neonatal outcomes of 1336, 1:1 matched, singleton SGA and AGA preterm infants based on their gestational age using data from the study ‘Causes of Illness and Death of Preterm Infants in Ethiopia (SIP)’. Data were analysed using SPSS V.23. ORs and 95% CIs and χ2 tests were done, p value of <0.05 was considered statistically significant.ResultThe majority of the infants (1194, 89%) were moderate to late preterm (32–36 weeks of gestation), 763 (57%) were females. Male preterm infants had higher risk of being SGA than female infants (p<0.001). SGA infants had increased risk of hypoglycaemic (OR and 95% CI 1.6 (1.2 to 2.0), necrotising enterocolitis (NEC) 2.3 (1.2 to 4.1), polycythaemia 3.0 (1.6 to 5.4), late-onset neonatal sepsis (LOS) 3.6 (1.1 to 10.9)) and prolonged hospitalisation 2.9 (2.0 to 4.2). The rates of respiratory distress syndrome (RDS), apnoea and mortality were similar in the SGA and AGA groups.ConclusionNeonatal complications such as hypoglycaemic, NEC, LOS, polycythaemia and prolonged hospitalisation are more common in SGA infants, while rates of RDS and mortality are similar in SGA and AGA groups. Early recognition of SGA status, high index of suspicion and screening for complications associated and timely intervention to prevent complications need due consideration.

scholarly journals Eruption chronology of the first deciduous teeth in children born prematurely with birth weight less than 1500g

2014 ◽  
Vol 32 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Pedro Garcia F. Neto ◽  
Mario Cicero Falcao
Keyword(s):  
Birth Weight ◽  
Nutritional Status ◽  
Premature Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Deciduous Teeth ◽  
Appropriate For Gestational Age ◽  
Eruption Age ◽  
Student’S T ◽  
Student’S T Test

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.

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