scholarly journals Human Milk Virome Analysis: Changing Pattern Regarding Mode of Delivery, Birth Weight, and Lactational Stage

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1779
Author(s):  
Meltem Dinleyici ◽  
Vicente Pérez-Brocal ◽  
Sertac Arslanoglu ◽  
Ozge Aydemir ◽  
Sibel Sevuk Ozumut ◽  
...  
Keyword(s):  
Birth Weight ◽  
Human Milk ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Mode Of Delivery ◽  
Large For Gestational Age ◽  
Delivery Mode ◽  
Age Group ◽  
Spontaneous Vaginal Delivery

The human milk (HM) microbiota is a significant source of microbes that colonize the infant gut early in life. The aim of this study was to compare transient and mature HM virome compositions, and also possible changes related to the mode of delivery, gestational age, and weight for gestational age. Overall, in the 81 samples analyzed in this study, reads matching bacteriophages accounted for 79.5% (mainly Podoviridae, Myoviridae, and Siphoviridae) of the reads, far more abundant than those classified as eukaryotic viruses (20.5%, mainly Herpesviridae). In the whole study group of transient human milk, the most abundant families were Podoviridae and Myoviridae. In mature human milk, Podoviridae decreased, and Siphoviridae became the most abundant family. Bacteriophages were predominant in transient HM samples (98.4% in the normal spontaneous vaginal delivery group, 92.1% in the premature group, 89.9% in the C-section group, and 68.3% in the large for gestational age group), except in the small for gestational age group (only ~45% bacteriophages in transient HM samples). Bacteriophages were also predominant in mature HM; however, they were lower in mature HM than in transient HM (71.7% in the normal spontaneous vaginal delivery group, 60.8% in the C-section group, 56% in the premature group, and 80.6% in the large for gestational age group). Bacteriophages still represented 45% of mature HM in the small for gestational age group. In the transient HM of the normal spontaneous vaginal delivery group, the most abundant family was Podoviridae; however, in mature HM, Podoviridae became less prominent than Siphoviridae. Myoviridae was predominant in both transient and mature HM in the premature group (all C-section), and Podoviridae was predominant in transient HM, while Siphoviridae and Herpesviridae were predominant in mature HM. In the small for gestational age group, the most abundant taxa in transient HM were the family Herpesviridae and a species of the genus Roseolovirus. Bacteriophages constituted the major component of the HM virome, and we showed changes regarding the lactation period, preterm birth, delivery mode, and birth weight. Early in life, the HM virome may influence the composition of an infant’s gut microbiome, which could have short- and long-term health implications. Further longitudinal mother–newborn pair studies are required to understand the effects of these variations on the composition of the HM and the infant gut virome.

Human milk mycobiota composition: relationship with gestational age, delivery mode, and birth weight

2020 ◽  
Vol 11 (2) ◽  
pp. 151-162 ◽  
Author(s):  
M. Dinleyici ◽  
V. Pérez-Brocal ◽  
S. Arslanoglu ◽  
O. Aydemir ◽  
S. Sevuk Ozumut ◽  
...  
Keyword(s):  
Human Milk ◽  
Gestational Age ◽  
Caesarean Delivery ◽  
Abundant Species ◽  
Large For Gestational Age ◽  
Delivery Mode ◽  
Mature Milk ◽  
Milk Samples ◽  
Delivery Term ◽  
Spontaneous Delivery

Intestinal and human milk microbiota studies during infancy have shown variations according to geographical location, delivery mode, gestational age, and mother-related factors during pregnancy. In this study, we performed metagenomic mycobiota analyses of 44 transient and mature human milk among five different groups: mothers of normal spontaneous delivery-term (NS-T), caesarean delivery-term (CS-T), premature (PT), small for gestational age (SGA), and large for gestational age (LGA) infants. Fungi were detected in 80 out of the 88 samples. Regarding the number of observed fungal species, the NS-T group was more homogeneous (less variable) comparing the other groups (P<0.05). In the transient human milk samples, the most abundant species were Saccharomyces cerevisiae (33.3%) and Aspergillus glaucus (27.4%). While A. glaucus (33.7%) was second most abundant species in mature milk, S. cerevisiae disappeared (P<0.01) and Penicillium rubens became the most abundant species (35.5%) (P<0.05). Among the NS-T group, the most abundant species was Malassezia globosa in both transient and mature milk. In contrast, S. cerevisiae was the most abundant species in transient human milk (45.0%) in the CS-T group, but it disappeared in mature milk (P<0.01). In transient milk, M. globosa was only represented 6.0-9.0% of taxa in the PT, SGA, and LGA groups (P<0.05). In transient and mature milk in the PT, SGA and LGA groups, the most abundant species were A. glaucus and P. rubens. In mature milk samples, P. rubens is more abundant in CS-T group, PT group and LGA group, than the NS-T groups (P<0.05 for all). Although fungi constitute only a very small part of the human milk microbiome, we observed some changes that the human milk mycobiota composition varies in caesarean delivery, premature, SGA and LGA groups, comparing the normal spontaneous delivery, as well as differences between transient and mature human milk.

scholarly journals Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age

2018 ◽  
Vol 104 (3) ◽  
pp. F242-F247 ◽  
Author(s):  
Chonnikant Visuthranukul ◽  
Steven A Abrams ◽  
Keli M Hawthorne ◽  
Joseph L Hagan ◽  
Amy B Hair
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Birth Weight ◽  
Human Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Insulin Level ◽  
Metabolic Outcomes ◽  
Catch Up

ObjectiveTo compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit.DesignPremature infants (birth weight ≤1250 g) fed an exclusive HM-based diet were examined at 12–15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18–22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry.ResultsOf 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25±1.10 vs −0.21±0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0±3.7 vs 17.3±15.1 µU/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1±0.9 vs 4.3±4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity.ConclusionsSGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with ≤1250 g birth weight, specifically SGA.

Colloid Osmotic Pressure in Newborn Infants: Variations with Birth Weight, Gestational Age, Total Serum Solids, and Mean Arterial Pressure

PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 814-819
Author(s):  
Paul Y. K. Wu ◽  
Gary Rockwell ◽  
Linda Chan ◽  
Shu-Mei Wang ◽  
Vikram Udani
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Osmotic Pressure ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Newborn Infants ◽  
Colloid Osmotic Pressure ◽  
Large For Gestational Age ◽  
Total Serum ◽  
Arterial Blood

Colloid osmotic pressure (COP) of blood was measured directly at birth with the Wescor membrane colloid osmometer (model 4100) in 91 appropriately grown, 11 large, and nine small for gestational age "well" newborn infants. COP correlated directly with birth weight (r = .726, P &lt; .00001) and gestational age (r = .753, P &lt; .00001). COP values for small for gestational age (SGA) and large for gestational age (LGA) infants were found to fall within the 95% prediction interval with regard to birth weight and gestational age for appropriate for gestational age (AGA) infants. Simultaneous measurements of COP, total serum solids, and central arterial mean blood pressure were made. The results showed that COP correlated directly with total serum solids (r = .89, P &lt; .0001) and mean arterial blood pressure (r = .660, P &lt; .001). Among the factors evaluated, total serum solids was the best predictor of COP.

OUTCOME OF SECOND BABY OF TWIN IN A RURAL TEACHING HOSPITAL OF WEST BENGAL, INDIA

2021 ◽  
pp. 4-7
Author(s):  
Kajal Kumar Patra ◽  
Anirban Mandal ◽  
Thyadi Himabindu
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
West Bengal ◽  
Mode Of Delivery ◽  
Reproductive Technologies ◽  
Time Interval ◽  
Age Group ◽  
Multiple Pregnancies ◽  
Second Twin

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.

Vaginal Delivery and Low Gestational Age are Key Risk Factors for Hypernatremia in Neonates < 32 Weeks

2021 ◽  
Author(s):  
Nadia S. Eugster ◽  
Florence Corminboeuf ◽  
Gilbert Koch ◽  
Julia E. Vogt ◽  
Thomas Sutter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Preterm Neonates ◽  
Multiple Birth ◽  
Plasma Sodium ◽  
Delivery Mode ◽  
Antenatal Corticosteroids ◽  
Clinical Complications

Abstract Background Preterm neonates frequently experience hypernatremia (plasma sodium concentrations >145 mmol/l), which is associated with clinical complications, such as intraventricular hemorrhage. Study design In this single center retrospective observational study, the following 7 risk factors for hypernatremia were analyzed in very low gestational age (VLGA, below 32 weeks) neonates: gestational age (GA), delivery mode (DM; vaginal or caesarian section), sex, birth weight, small for GA, multiple birth, and antenatal corticosteroids. Machine learning (ML) approaches were applied to obtain probabilities for hypernatremia. Results 824 VLGA neonates were included (median GA 29.4 weeks, median birth weight 1170 g, caesarean section 83%). 38% of neonates experienced hypernatremia. Maximal sodium concentration of 144 mmol/l (interquartile range 142–147) was observed 52 hours (41–65) after birth. ML identified vaginal delivery and GA as key risk factors for hypernatremia. The risk of hypernatremia increased with lower GA from 22% for GA ≥ 31–32 weeks to 46% for GA < 31 weeks and 60% for GA < 27 weeks. A linear relationship between maximal sodium concentrations and GA was found, showing decreases of 0.29 mmol/l per increasing week GA in neonates with vaginal delivery and 0.49 mmol/l/week after cesarean section. Sex, multiple birth and antenatal corticosteroids were not associated hypernatremia. Conclusion VLGA neonates with vaginal delivery and low GA have the highest risk for hypernatremia. Early identification of neonates at risk and early intervention may prevent extreme sodium excursions and associated clinical complications.

scholarly journals Prevalence of small for gestational age newborns and associated factors in a Brazilian Northeast capital

2018 ◽  
Vol 18 (3) ◽  
pp. 539-547
Author(s):  
Micaely Cristina dos Santos Tenório ◽  
Marilene Brandão Tenório ◽  
Raphaela Costa Ferreira ◽  
Carolina Santos Mello ◽  
Alane Cabral Menezes de Oliveira
Keyword(s):  
Birth Weight ◽  
Hierarchical Model ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Associated Factors ◽  
Protective Factor ◽  
Mode Of Delivery ◽  
Low Frequency ◽  
Cross Sectional Study ◽  
Cross Sectional

Abstract Objectives: to analyze the factors associated with the birth of small for gestational age (SGA)infants, in a Northeastern Brazilian capital. Methods: a cross-sectional study was carried out with 331 pregnant women and their newborns attending the public health network in the city of Maceió, in 2014. Maternal antenatal data were collected (socioeconomic, lifestyle, clinical and nutritional) as well as data of the newborns (gestational age, mode of delivery, sex, birth weight and length), after delivery. Birth weight was classified according to the INTERGROWTH-21st curves, being considered SGA those below the 10th percentile according to gestational age and gender. The results were analyzed by Poisson regression using a hierarchical model and were expressed as prevalence ratios (PR) and their respective 95% confidence intervals (CI95%). Results: it was verified that 5.1% of the newborns were SGA. Regarding the associated factors, after adjustment of the hierarchical model, the variable working outside the home was associated with the endpoint studied [PR = 0.14; (CI95% = 0.02-0.75); p=0.022]. Conclusions: it was verified a low frequency of SGA infants in the evaluated population. The fact that the mother works outside the home proved to be a protective factor for this condition.

scholarly journals Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

2019 ◽  
Author(s):  
Annie M. Dude ◽  
William Grobman ◽  
David Haas ◽  
Brian M. Mercer ◽  
Samuel Parry ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Hypertensive Disorders

Abstract Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.

scholarly journals Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhifen Hua ◽  
Fadwa El Oualja
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Fetal Membrane ◽  
Delivery Mode ◽  
Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

scholarly journals The impact of delivery mode on the risk of neonatal intracranial haemorrhage

2019 ◽  
Vol 53 (3) ◽  
Author(s):  
Nika Buh ◽  
Miha Lučovnik
Keyword(s):  
Vaginal Delivery ◽  
Intracranial Haemorrhage ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
Vacuum Extraction ◽  
Delivery Mode ◽  
Spontaneous Vaginal Delivery ◽  
Emergency Caesarean ◽  
Vaginal Deliveries ◽  
The Impact

Introduction: The objective of the study was to examine the association between the mode of delivery and the incidence of neonatal intracranial haemorrhage.Methods: Slovenian National Perinatal Information System (NPIS) data for the period 2002 through 2016 were analysed. Nulliparous women delivering singleton neonates in cephalic presentation weighting 2,500 to 4,000g were included. Incidence of neonatal intracranial haemorrhage in vacuum delivery vs. other modes of delivery was compared using the Chi-square test (p < 0.05 significant).Results: 125,393 deliveries were included: 5,438 (4 %) planned caesarean deliveries, 9,7764 (78 %) spontaneous vaginal deliveries, 15,577 (12 %) emergency caesarean deliveries, and 6,614 (5 %) vacuum extractions. 17 (0.14/1000) neonatal intracranial haemorrhages were recorded: 12 occurred in spontaneous vaginal deliveries, two in emergency caesarean deliveries, and three in vacuum extractions. In comparison to infants born by spontaneous vaginal delivery, those delivered by vacuum extraction had higher rates of intracranial haemorrhage (odds ratio (OR) 3.70; 95% confidence interval (CI) 1.04−13.10). Risk estimates did not reach statistical significance when comparing infants born by vacuum extraction and those born by emergency caesarean delivery (OR 3.54; 95% CI 0.59−21.16).Discussion and conclusion: Infants born by vacuum extraction have significantly higher rates of intracranial haemorrhage than those born by spontaneous vaginal delivery although the absolute risk is small. There are no significant differences in the rates of intracranial haemorrhage in vacuum extraction vs. emergency caesarean delivery.

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