Dietary Arginine Supplementation Improves Intestinal Mitochondrial Functions in Low-Birth-Weight Piglets but Not in Normal-Birth-Weight Piglets

Our previous studies revealed that L-arginine supplementation had beneficial effects on intestinal barrier functions of low-birth-weight (LBW) piglets, which were associated with the enhanced antioxidant capacity. Moreover, mitochondrial functions are closely related to the redox state. This study was to explore potential mechanisms of L-arginine-induced beneficial effects against intestinal dysfunction by regulating mitochondrial function of LBW piglets. Twenty 4-day-old normal birth weight (NBW) piglets (BW: 2.08 ± 0.09 kg) and 20 LBW siblings (BW: 1.16 ± 0.07 kg) were artificially fed either a basal diet or a basal diet supplemented with 1.0% L-arginine for 21 d, respectively. Growth performance, intestinal morphology, redox status, mitochondrial morphology, and mitochondrial functions were examined. Data were subjected to two-way analysis of variance. LBW piglets presented lower (p < 0.05) ADG, shorter (p < 0.05) intestinal villus height, lower (p < 0.05) jejunal adenosine triphosphate (ATP) content and higher (p < 0.05) concentrations of Ca2+ and 8-OH-dG in jejunal mitochondria, compared with NBW piglets. Supplementation with 1.0% L-arginine significantly increased (p < 0.05) ADG, the activities of CAT, SOD, and GPx, intestinal villus height and mRNA abundances of ZO-1 (2-fold) in the jejunum of LBW piglets, but not in NBW piglets. Furthermore, the concentrations of ATP and the transcription of COX IV, COX V genes were up-regulated (p < 0.05) and the concentration of Ca2+ and 8-OH-dG were decreased (p < 0.05) in arginine-treated LBW piglets. The results suggest that mitochondrial morphology is affected, and mitochondrial functions are impaired in the jejunum of LBW piglets. While supplementation with 1.0% L-arginine relieved intestinal dysfunction through enhancing antioxidant capacity and improving mitochondrial functions via repairing mitochondrial morphology, normalizing mitochondrial calcium, and increasing ATP concentration in the jejunum of LBW piglets. However, supplementation with L-arginine has no significant beneficial effects on intestinal health in NBW piglets.

Frequency of Low Birth Weight in Pregnant Women with Anemia

Objective: To determine the frequency of low birth weight in pregnant women with anemia. Methodology: This descriptive cross-sectional survey, was conducted at OMC Hospital, Jail Road, Lahore and Medicine Deptt. of Lahore General Hospital during March 2020 to November 2020. We included 320pregnant females with gestational ages between 30 to 36 weeks with hemoglobin level of <10g/dl and further classified as moderate anemia with (Hb levels 8-9.9g/dl) and in severe anemia for those having Hb 8g/dl. All cases with known systemic diseases/abnormalities like hemoglobinopathies (sickle cell anemia/thalassemia), diabetes, hypertension, smoking, renal problems, oligo/polyhydramnios were excluded from the study. The neonates were examined after the delivery is done with the help of pediatrician and all protocols for neonates assessment were followed. All findings were recorded, low birth weight was considered if the neonatal weight was <2500g. These neonates were followed until they are discharged from the hospital or mortality (if any). Routine informed consent was also obtained from the patients attendants to use their data in the study. Results: In our study, 32.5% of the cases were low birth weight whereas 67.5%(n=216) cases had normal birth weight. Conclusion: Frequency of low birth weight is higher in mothers presenting with anemia. Keywords: Maternal anemia, low birth weight, association

Impact of children born with low birth weight on stunting and wasting in Sindh province of Pakistan: a propensity score matching approach

Low Birth Weight (LBW) is considered as a major public health issue and leading cause of neonatal death. Almost one in four newborns are reported as underweight in Pakistan. Children born with low birth weight are highly vulnerable to develop diseases and death and/or remain undernourished (i.e., stunted and wasted). This study determines the LBW newborns are more prone to develop stunting and wasting in province of Sindh, Pakistan. Moreover, regression-based estimation of the impact of LBW on the child health outcomes of under five years of age, may be prone to selection bias because of the nature of non-experimental data set, thus, propensity score matching methods are used in this study. Data for this study was used from Multiple Indicators Cluster Survey (MICS-2014). MICS is a two-stage, stratified cluster sampling household level data covering urban and rural areas and consists of 19,500 households from five administrative divisions and 28 districts of Sindh province of Pakistan. The total sample size of children less than five years of age after cleaning the data are 7781, of which 2095 are LBW having birth weight categorized as “smaller than average and very small” and 5686 are normal birth weight (NBW) having birth weight very large, larger than average, and average. This study employed propensity score matching (PSM) regression methods to understand whether the children born as low birth weight are more prone to stunting and wasting and/or both. In province of Sindh, moderate wasting children under five years were 21%, severe wasting 6% and both wasting and stunting 10%. The propensity score results are shown significant in all groups. Specifically, all four types of PSM methods confirm a significant difference in the potential outcome variables—meaning that a child born with LBW has a significant adverse effect on the potential child health outcome variables (stunting, wasting and both). Thus, the propensity score matching findings confirm a significant and adverse effect of LBW on potential health outcomes of under five children. Similarly, low birth weight children are significantly more likely to be moderately wasted (OR = 1.5, CI = 1.3–1.6) and severely wasted (OR = 1.6, CI = 1.3–2.0) and both (stunted and wasted, OR = 2.0, CI = 1.7–2.3) as compared to children with normal birth weight. Male children, if born with low birth weight, are significantly more likely to be moderately wasted (OR = 1.3, CI = 1.1–1.5) and both (wasted and stunted, OR = 1.3, CI = 1.1–1.5) than girls. This large data analysis finding proved that the LBW newborns are on higher risk to develop wasting and stunting in Pakistan.

The association between birth weight and proxy-reported health-related quality of life among children aged 5 − 10 years old: A linked data analysis

Background Birth weight has a substantial effect on children’s cognitive development, physical capability, and emotional development, which in turn impact on Health-Related Quality of Life (HRQoL). Generally, evidence indicates that children born with low birth weight tend to have poorer proxy-reported HRQoL, particularly at school age. However, there is limited evidence on whether variation in HRQoL exists across the entire range of possible birth weights. This study aimed to examine the association between birth weight and proxy-reported HRQoL among children aged 5–10 years old. Methods Data from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health were linked with state-based Perinatal Data Collections and the Mothers and their Children’s Health study for 1,589 mothers and 2,092 children aged 5 − 10 years old. Generalized estimating equations were used to model the association between birth weight and proxy-reported HRQoL measured by the Pediatric Quality of Life Inventory 4.0. Results are presented as odds ratios with 95 % confidence intervals. Results In this study, 15.61 % of children were at risk of impaired proxy-reported HRQoL. Each 100-gram increase in birth weight was associated with a 3 % reduction in the odds of impaired HRQoL (AOR = 0.97; 95 % CI: 0.94, 0.99). However, there was only limited evidence of an effect within the normal birth weight range (AOR = 0.97; 95 % CI: 0.94, 1.01). Conclusions The findings indicate that increased birth weight was protective against impaired HRQoL, although there was limited evidence of variability within the normal birth weight range. This study contributes to the existing literature by not only emphasizing the impact of low birth weight on children’s health and health-related outcomes but also by focusing on the variability within the normal birth weight range, particularly in a setting where low birth weight is less prevalent.

Hyperemesis Gravidarum and Hyperthyroidism

Hyperemesis gravidarum might require hospitalisation in patients, and upto two-thirds of women with hyperemesis gravidarum have transient hyperthyroidism. We undertook a study of pregnant women admitted with no known cause of vomiting. These patients were subjected to tests for TSH, Total T4, and Total T3 hormones to establish hyperthyroidism, and the values of these tests were serially monitored. We studied pregnancy outcomes such as period of gestation, and weight at birth, Apgar score at three and five minutes, and maternal TSH values at birth. The Total T4, Total T3, and TSH levels had normalised by gestational age of 14-16 weeks, and TSH at birth was found to be normal. Birth weight showed only a small deviation. The results suggest that asymptomatic patients with TSH value indicating hyperthyroidism in the first trimester need no further revaluation. Key words: Hyperemesis gravidarum, pregnancy, hyperthyroidism.

Factors Affecting Prevalence of Urinary Tract Infection in Neo-nates with Unexplained Hyperbilirubinemia: A Systematic Re-view and Meta-Analysis Study in Iran

Background: The prevalence and risk factors of urinary tract infection (UTI) in neonates with unexplained hyperbilirubinemia are not studied thoroughly. Since the prevalence of UTI is highly variable in different areas and countries, this study aimed to review the existing data of Iranian neonates with UTI presented with unexplained hyperbilirubinemia. Methods: This study is a meta-analysis of Iranian newborns with unexplained hyperbilirubinemia. We identified all studies indexed in international (Web of Science, PubMed, Scopus, Google Scholar) and national (Science Information Database, Magiran) databases from 2000-2018. Search terms included: Urinary Tract Infections OR UTI AND urine OR culture OR microbio, jaundice OR icter OR hyperbili, AND Iran. Results: Overall, 4210 neonates from 17 studies were included. The pooled prevalence of UTI in neonates with unexplained hyperbilirubinemia was 6.81% (95% CI: 4.86-8.77). Considering the subgroups analyses; the prevalence of UTI was higher in the prolonged vs. not-prolonged state (8.34% vs. 4.00%), low birth weight vs. normal birth weight (7.81% vs. 4.51%), and exclusive vs. non-exclusive breastfeeding (8.84% vs. 4.72%). Male gender and low birth weight increased the risk of UTI about two times compared to the female gender and normal birth weight, respectively. The results of the analyses in neonates with unconjugated hyperbilirubinemia also showed the above-mentioned subgroup differences.

Does Nubility Indicate More Than High Reproductive Value? Nubile Primiparas’ Pregnancy Outcomes in Evolutionary Perspective

The idea that human males are most strongly attracted to traits that peak in women in the nubile age group raises the question of how well women in that age group contend with the potential hazards of a first pregnancy. Using data for 1.7 million first births from 1990 U.S. natality and mortality records, we compared outcomes for women with first births (primiparas) aged 16–20 years (when first births typically occur in forager and subsistence groups) with those aged 21–25 years. The younger primiparas had a much lower risk of potentially life-threatening complications of labor and delivery and, when evolutionarily novel risk factors were controlled, fetuses which were significantly more likely to survive despite lower birth weights. Thus, nubile primiparas were more likely to have a successful reproductive outcome defined in an evolutionarily relevant way (an infant of normal birth weight and gestation, surviving to one year, and delivered without a medically necessary cesarean delivery). This suggests that prior to the widespread availability of surgical deliveries, men who mated with women in the nubile age group would have reaped the benefit of having a reproductive partner more likely to have a successful first pregnancy.

Distinct Roles of Perilipins in the Intramuscular Deposition of Lipids in Glutamine-Supplemented, Low-, and Normal-Birth-Weight Piglets

Piglets with low birth weight (LBW) usually have reduced muscle mass and increased lipid deposition compared with their normal-birth-weight (NBW) littermates. Supplementation of piglets with amino acids during the first days of life may improve muscle growth and simultaneously alter the intramuscular lipid deposition. The aim of the current study was to investigate the influence of glutamine (Gln) supplementation during the early suckling period on lipid deposition in the longissimus muscle (MLD) and the role of different perilipin (PLIN) family members in this process. Four groups were generated consisting of 72 male LBW piglets and 72 NBW littermates. Piglets were supplemented with either 1 g Gln/kg body weight or an isonitrogenous amount of alanine (Ala) between days post natum (dpn) 1 and 12. Twelve piglets per group were slaughtered at 5, 12, and 26 dpn, and muscle tissue was collected. Perilipins were localized by immunohistochemistry in muscle sections. The mRNA and protein abundances of PLIN family members and related lipases were quantified by quantitative RT-PCR (qPCR) and western blots, respectively. While PLIN1 was localized around lipid droplets in mature and developing adipocytes, PLIN2 was localized at intramyocellular lipid droplets, PLIN3 and 4 at cell membranes of muscle fibers and adipocytes, and PLIN5 in the cytoplasm of undefined cells. The western blot results indicated higher protein abundances of PLIN2, 3, 4, and 5 in LBW piglets (p &lt; 0.05) at 5 dpn compared with their NBW littermates independent of supplementation, while not directly reflecting the mRNA expression levels. The mRNA abundance of PLIN2 was lower while PLIN4 was higher in piglets at 26 dpn in comparison with piglets at 5 dpn (p &lt; 0.01). Relative mRNA expression of LPL and CGI-58 was lowest in piglets at 5 dpn (p &lt; 0.001). However, ATGL mRNA was not influenced by birth weight or supplementation, but the Spearman correlation coefficient analysis revealed close correlations with PLIN2, 4, and 5 mRNA at 5 and 26 dpn (r &gt; 0.5, p &lt; 0.001). The results indicated the importance of birth weight and age for intramuscular lipid deposition and different roles of PLIN family members in this process, but no clear modulating effect of Gln supplementation.

OUTCOME OF LOW BIRTH WEIGHT NEONATES WITH RELATION TO EARLY ANEMIA.

Background: Weight of newborn is a universal predictor of health during childhood. Haematological prole varies with period of gestation in low birth weight neonates i.e., <2500 grams. They have different haematological prole as compared to normal birth weight neonates. Aim of this study is to relate early morbidity and mortality of low birth weight neonates and their haemoglobin at days 1, 4 and 7. Materials and methods: A prospective cross-sectional study was conducted from January 2019 to June 2020 on children weighing below 2500 grams admitted within 24 hours of birth in Department of Paediatrics, SGRDIMSR, Amritsar. A total of 110 neonates were enrolled in this study following the inclusion and exclusion criteria. Haemoglobin levels of these were measured on days 1, 4 and 7. The data obtained was compiled and analysed to reach valid conclusions in relation to outcome in form of morbidity and mortality of the subjects. Results: Among 110 neonates majority belong to category of birth weight between 1500-2500 grams (70%). Lowest mean haemoglobin levels were seen in ELBW (<1000 grams) neonates. Fall in haemoglobin from day 1 to 7 in all the neonates was seen and was statistically signicant. Anaemia was signicantly related to PNA and mortality. Lowest mean haemoglobin values were seen in neonates with PNA as a morbidity on day 7 (13.04±2.32). Neonates who died had even lower haemoglobin level on day 7 (12.17±2.03). Conclusion: It was concluded that ELBW neonates had higher risk of early anaemia as compared to LBW and VLBW neonates. Anaemia was also signicantly present in neonates who died and those who had PNA. Thus early anaemia is associated with PNA, ELBW and Mortality.

MO480FGF-23 AND LOW BIRTH WEIGHT: IS THERE ANY ASSOCIATION?

Background and Aims According to Barker’s theory and Brenner’s hypothesis, persons were born with low birth weight (LBW) have a higher risk of CKD due to low nephron number. Also, it is well known that mineral-bone disorder (MBD) is one of the most serious complications of CKD. Views on the pathogenesis of CKD-MBD have changed considerably since Fibroblast growth factor 23 (FGF-23) was discovered. It is thought that FGF-23 increases as the nephron mass reduces. Therefore, we aimed to determine if there is an association between LBW and FGF-23. Method We conducted a cross-sectional study on 56 children with CKD stages 1-4. There were approximately equal numbers of participants in each stage. The mean age was 8.9 ±4.9 years old. We measured the concentration of FGF-23 (C-terminal) in serum by a sandwich enzyme-linked immunosorbent assay (ELISA) kit (Biomedica Medizinprodukte GmbH, Austria). The exclusion criteria: tubulopathy, active inflammatory, infectious, oncological and bone diseases, renal transplant, as well as taking steroids, calcium, and vitamin D. The informed consent was obtained from the parents. The study was conducted in accordance with the Declaration of Helsinki and approved by the Local Ethical Committee. FGF-23 concentration more than 1.5 pmol/l was considered as abnormal. Statistical analysis was performed using GraphPad Prism 9.0.0 (San Diego, USA) Results Mineral-bone disorder was diagnosed as CKD complication in 20 (35.7%) children. LBW was revealed in 14 (25%) patients. The median (IQR) eGFR among patients with normal birth weight was 65.23 (31.23-84.73) ml/min/1.73m2, among LBW – 68.93 (24.59-98.9) ml/min/1.73m2, so there were no differences in kidney function between the two groups (p=0.64). The median (IQR) level of serum FGF-23 in patients with normal birth weight was 1.75 (0.68- 2.5) pmol/l, in LBW children was 1.85 (0.78 -3.1) pmol/l. Analysis of serum level of FGF-23 in relation to weight at birth revealed no statistical differences in patients with LBW and those with normal birth weight (p=0.719), and the Spearman rank correlation was insignificant as well (r=-0.08, p=0.560). Conclusion FGF-23 is an important biomarker of CKD-MBD. FGF-23 does not depend on the birth weight although LBW is considered as a risk factor for CKD. However, further investigations and studies in this area are needed to make the right conclusions regarding the association between this bone biomarker and birth weight.