Short-Term Postnatal Renal Function in Twin Anemia-Polycythemia Sequence

2015 ◽  
Vol 39 (3) ◽  
pp. 192-197 ◽  
Author(s):  
Lianne Verbeek ◽  
Femke Slaghekke ◽  
Romain Favre ◽  
Marine Vieujoz ◽  
Francesco Cavigioli ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Gestational Age ◽  
Twin Pair ◽  
Control Group ◽  
Short Term ◽  
Monochorionic Twins ◽  
Gestational Age At Birth ◽  
Age At Birth

Objective: To evaluate the short-term renal function in neonates with twin anemia-polycythemia sequence (TAPS). Methods: All consecutive monochorionic twins with TAPS with double survivors admitted to three European centers were included in this retrospective study. Each twin pair was matched for gestational age at birth with a control twin pair unaffected by TAPS or twin-twin transfusion syndrome. Creatinine and urea levels in the first week after birth were recorded. Short-term postnatal renal dysfunction was defined as creatinine >100 μmol/l during the first week after birth. Results: A total of 52 TAPS twin pairs and 52 control twin pairs with a median gestational age of 31 weeks at birth were included in the study. In the TAPS group, donors had higher mean creatinine levels compared to recipients, 85 versus 71 μmol/l, respectively (p = 0.001). Short-term renal dysfunction was detected in 26.0% (13/50) of the donors versus 6.3% (3/48) of the recipients (p = 0.022). In the control group, no inter-twin differences in creatinine levels were found. Conclusions: Donor twins with TAPS have higher creatinine levels than recipient twins, suggesting that chronic inter-twin transfusion in TAPS may also cause short-term renal dysfunction. Long-term renal consequences in TAPS donors require further investigation.

Twin Pregnancies Complicated by a Single Malformed Fetus: Chorionicity, Outcome and Management

2010 ◽  
Vol 13 (5) ◽  
pp. 501-507 ◽  
Author(s):  
Ali Gedikbasi ◽  
Alpaslan Akyol ◽  
Gokhan Yildirim ◽  
Ali Ekiz ◽  
Ahmet Gul ◽  
...  
Keyword(s):  
Gestational Age ◽  
Statistical Significance ◽  
Expectant Management ◽  
Control Group ◽  
Study Group ◽  
Preliminary Evaluation ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Twin Pregnancies ◽  
Age At Birth

The objective of this study was to evaluate the impact of one abnormal fetus in a twin pregnancy, to compare impact of chorionicity and clinical outcome of intervention and expectant management. Thirty-seven dichorionic (DC) twins and 18 monochorionic (MC) twins complicated with one malformed fetus were evaluated for gestational age, birthweight and perinatal outcome. Six hundred and forty-two twin pregnancies were evaluated in the database. The control groups consisted of 429 DC and 86 MC twins without anomalous fetus. Mean birthweight and gestational age at birth for DC control group were (n= 429; 2137g and 34.71 weeks), DC study group,n= 37; 2117g (p= .338) and 33.97 weeks (p= .311), and DC study group with major malformations,n= 30; 2019g (p= .289) and 33.3 weeks (p= .01), and showed only significance for gestational age. There was no statistical significance between MC control group,n= 86; 2097g and 34.93 weeks, and MC study group,n= 18; 2237g (p= .338), and 34.42 weeks (p= .502). Because of limited data, the preliminary evaluation for expectant management and intervention, and survival of at least one normal fetus showed no impact. We conclude that, although, all DC twin pregnancies have a risk for preterm delivery, DC twins complicated with major malformation of one twin, have a lower mean gestational age at birth. Preliminary results for intervention does not improve fetal outcome for DC and MC twins and needs further evaluation with greater studies of impact or review.

Long-term outcomes of laser coagulation of feto-fetal anastomoses in monochorionic twins

2020 ◽  
Vol 15 (5) ◽  
pp. 52-56
Author(s):  
A.E. Bugerenko ◽  
◽  
Zh.Yu. Kunyakh ◽  
O.B. Panina ◽  
Yu.S. Mirakyan ◽  
...  
Keyword(s):  
Gestational Age ◽  
Laser Coagulation ◽  
Control Group ◽  
Healthy Children ◽  
Long Term Outcomes ◽  
Monochorionic Twins ◽  
Gestational Age At Delivery ◽  
One Year ◽  
Experimental Group

Objective. To evaluate long-term outcomes of fetoscopic laser coagulation (FLC) of placental anastomoses in monochorionic twins with feto-fetal transfusion syndrome (FFTS). Patients and methods. The experimental group included live infants after FLC born to 76 women between 2012 and 2017. The control group comprised monochorionic, diamniotic (MCDA) twins with no complications born to 109 women. The following criteria were used in the analysis: gestational age at FLC, FFTS stage (Quintero staging system), gestational age at delivery, and delivery method. During follow-up, we analyzed children’s data at birth and at the age of one and three years. Results. The number of healthy children and children with minimal health problems in the experimental group was 106 (84.8%) by the age of one year and 112 (89.6%) by the age of 3 years. Nineteen children (15.2%) were disabled at the age of one year; by 3 years of age, their number decreased to 13 (10.4%). In the control group, 2 participants (1.8%) had neurological disabilities. Conclusion. The majority of children born after FLC were healthy and socially adapted. The most common disorders after FLC were neurological disorders (8.8%), cardiovascular disorders (14.8%), retinopathy of prematurity (15.7%), and bronchopulmonary dysplasia (10%). The main factor affecting the development of complications in these children was gestational age at delivery. The optimal gestational age was 33–35 weeks, when the risk of disability was similar to that in MCDA twins without complications. Key words: monochorionic twins, feto-fetal transfusion syndrome, fetoscopy

Assessment of renal functional maturation and injury in preterm neonates during the first month of life

2014 ◽  
Vol 307 (2) ◽  
pp. F149-F158 ◽  
Author(s):  
Lina Gubhaju ◽  
Megan R. Sutherland ◽  
Rosemary S. C. Horne ◽  
Alison Medhurst ◽  
Alison L. Kent ◽  
...  
Keyword(s):  
Renal Function ◽  
Gestational Age ◽  
Renal Injury ◽  
High Capacity ◽  
Tubular Function ◽  
Preterm Neonates ◽  
Urinary Ngal ◽  
Term Infants ◽  
Gestational Age At Birth ◽  
Age At Birth

Worldwide, approximately 10% of neonates are born preterm. The majority of preterm neonates are born when the kidneys are still developing; therefore, during the early postnatal period renal function is likely reflective of renal immaturity and/or injury. This study evaluated glomerular and tubular function and urinary neutrophil gelatinase-associated lipocalin (NGAL; a marker of renal injury) in preterm neonates during the first month of life. Preterm and term infants were recruited from Monash Newborn (neonatal intensive care unit at Monash Medical Centre) and Jesse McPherson Private Hospital, respectively. Infants were grouped according to gestational age at birth: ≤28 wk ( n = 33), 29–31 wk ( n = 44), 32–36 wk ( n = 32), and term (≥37 wk ( n = 22)). Measures of glomerular and tubular function were assessed on postnatal days 3–7, 14, 21, and 28. Glomerular and tubular function was significantly affected by gestational age at birth, as well as by postnatal age. By postnatal day 28, creatinine clearance remained significantly lower among preterm neonates compared with term infants; however, sodium excretion was not significantly different. Pathological proteinuria and high urinary NGAL levels were observed in a number of neonates, which may be indicative of renal injury; however, there was no correlation between the two markers. Findings suggest that neonatal renal function is predominantly influenced by renal maturity, and there was high capacity for postnatal tubular maturation among preterm neonates. There is insufficient evidence to suggest that urinary NGAL is a useful marker of renal injury in the preterm neonate.

scholarly journals Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants

2021 ◽  
Vol 155 ◽  
pp. 106659
Author(s):  
Ashlinn K. Quinn ◽  
Irene Apewe Adjei ◽  
Kenneth Ayuurebobi Ae-Ngibise ◽  
Oscar Agyei ◽  
Ellen Abrafi Boamah-Kaali ◽  
...  
Keyword(s):  
Gestational Age ◽  
Air Pollutant ◽  
Gestational Age At Birth ◽  
Age At Birth

Coeliac disease presenting atypically: A much wider spectrum

2021 ◽  
pp. 004947552199134
Author(s):  
Avinash Lomash ◽  
Abhinaya Venkatakrishnan ◽  
Meenakshi Bothra ◽  
Bhavna Dhingra ◽  
Praveen Kumar ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Gestational Age ◽  
Dermatitis Herpetiformis ◽  
Mode Of Delivery ◽  
Gastrointestinal Symptoms ◽  
Stunted Growth ◽  
Significant Difference ◽  
High Index Of Suspicion ◽  
Gestational Age At Birth ◽  
Age At Birth

Atypical coeliac disease in young children is frequently missed when it presents atypically as non-gastrointestinal presentations to different specialties. There was a greater delay (54 months) in establishing the diagnosis in those with atypical coeliac disease (p < 0.001). No difference was observed in the mode of delivery or duration of breast feeding, but significant difference was observed between gestational age at birth (p < 0.001). Most cases showed stunted growth and underweight. Irritability, anaemia, rickets, dermatitis herpetiformis, alopecia and intussusception were other common predictors of atypical coeliac disease. Because of a myriad spectrum of non-gastrointestinal symptoms, at any age with diverse presentation, a high index of suspicion is therefore required.

scholarly journals Maternal biological age assessed in early pregnancy is associated with gestational age at birth

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva E. Lancaster ◽  
Dana M. Lapato ◽  
Colleen Jackson-Cook ◽  
Jerome F. Strauss ◽  
Roxann Roberson-Nay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Cellular Aging ◽  
Biological Age ◽  
Potential Candidate ◽  
A Genome ◽  
Gestational Age At Birth ◽  
Age At Birth

AbstractMaternal age is an established predictor of preterm birth independent of other recognized risk factors. The use of chronological age makes the assumption that individuals age at a similar rate. Therefore, it does not capture interindividual differences that may exist due to genetic background and environmental exposures. As a result, there is a need to identify biomarkers that more closely index the rate of cellular aging. One potential candidate is biological age (BA) estimated by the DNA methylome. This study investigated whether maternal BA, estimated in either early and/or late pregnancy, predicts gestational age at birth. BA was estimated from a genome-wide DNA methylation platform using the Horvath algorithm. Linear regression methods assessed the relationship between BA and pregnancy outcomes, including gestational age at birth and prenatal perceived stress, in a primary and replication cohort. Prenatal BA estimates from early pregnancy explained variance in gestational age at birth above and beyond the influence of other recognized preterm birth risk factors. Sensitivity analyses indicated that this signal was driven primarily by self-identified African American participants. This predictive relationship was sensitive to small variations in the BA estimation algorithm. Benefits and limitations of using BA in translational research and clinical applications for preterm birth are considered.

scholarly journals 512: Are appropriately sized fetuses who “fall off the curve” at increased risk for small-for-gestational age at birth?

2018 ◽  
Vol 218 (1) ◽  
pp. S306-S307
Author(s):  
Nathan R. Blue ◽  
Mariam Savabi ◽  
Meghan E. Beddow ◽  
Vivek R. Katukuri ◽  
Cody M. Fritts ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Increased Risk ◽  
Gestational Age At Birth ◽  
Age At Birth
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