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Extrauterine growth restriction

Natsuki Ohkawa, Hiromichi Shoji, Naho Ikeda, Hiroki Suganuma, Toshiaki Shimizu
AIM: Poor post-natal growth is related to later morbidity and poor cognitive development in preterm infants. We investigated the relationship between plasma insulin-like growth factor 1 (IGF-1), leptin, active ghrelin levels and post-natal growth in preterm infants small for gestational age (SGA). METHODS: Plasma IGF-1, leptin and active ghrelin levels were measured at birth and at 2, 4, 6 and 8 weeks after birth in 42 very low birthweight (VLBW) infants (born between 27 and 31 weeks of gestation), including 14 SGA infants with extrauterine growth restriction (EUGR), 6 SGA infants without EUGR and 22 appropriate-for-gestational-age infants...
August 27, 2016: Journal of Paediatrics and Child Health
Montserrat Izquierdo, Antonio Federico Martínez-Monseny, Neus Pociello, Paloma Gonzalez, Ruth Del Rio, Martin Iriondo, Isabel Iglesias-Platas
BACKGROUND AND AIMS: Postnatal growth restriction remains a serious problem in very low-birth-weight infants. Enhanced parenteral supply of nutrients as soon as possible after birth is one of the strategies addressed to avoid extrauterine growth restriction. We aimed to analyze changes in growth patterns and in clinical outcomes in our unit after a change in our parenteral nutrition (PN) protocol. METHODS: We collected data from 2 time periods, comprising the 2 years before (period I) and the 2 years after (period II) the change of protocol...
October 2016: Nutrition in Clinical Practice
Ah Young Choi, Yong Wook Lee, Mea-Young Chang
PURPOSE: To identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants. METHODS: The study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1 (n=37); prior to the PN and EN regimen being modified, period 2 (n=50); following the PN-only regimen modification, period 3 (n=37); following both PN and EN regimen modification...
April 2016: Korean Journal of Pediatrics
Jennifer V E Brown, Nicholas D Embleton, Jane E Harding, William McGuire
BACKGROUND: Exclusively breast milk-fed preterm infants may accumulate nutrient deficits leading to extrauterine growth restriction. Feeding preterm infants with multi-nutrient fortified human breast milk rather than unfortified breast milk may increase nutrient accretion and growth rates and may improve neurodevelopmental outcomes. OBJECTIVES: To determine whether multi-nutrient fortified human breast milk improves important outcomes (including growth and development) over unfortified breast milk for preterm infants without increasing the risk of adverse effects (such as feed intolerance and necrotising enterocolitis)...
2016: Cochrane Database of Systematic Reviews
Elda Fischi-Gomez, Emma Muñoz-Moreno, Lana Vasung, Alessandra Griffa, Cristina Borradori-Tolsa, Maryline Monnier, François Lazeyras, Jean-Philippe Thiran, Petra S Hüppi
Higher risk for long-term cognitive and behavioral impairments is one of the hallmarks of extreme prematurity (EP) and pregnancy-associated fetal adverse conditions such as intrauterine growth restriction (IUGR). While neurodevelopmental delay and abnormal brain function occur in the absence of overt brain lesions, these conditions have been recently associated with changes in microstructural brain development. Recent imaging studies indicate changes in brain connectivity, in particular involving the white matter fibers belonging to the cortico-basal ganglia-thalamic loop...
2016: NeuroImage: Clinical
Ruud R G Bueters, Annelies Jeronimus-Klaasen, Nuria Maicas, Sandrine Florquin, Lambertus P van den Heuvel, Michiel F Schreuder
BACKGROUND: Diuretics are administered to neonates to control fluid balance. We studied whether clinical doses affected kidney development and function and whether extrauterine growth retardation (EUGR) could be a modulator. METHODS: Wistar rats were cross-fostered in normal food or food restricted litters at postnatal day (PND) 2 and treated daily with 0.9% NaCl, 5 mg/kg furosemide or 5 mg/kg hydrochlorothiazide (HCTZ) up to PND 8. Kidneys were evaluated on proliferation, apoptosis and a set of mRNA target genes at PND 8, glomerular- and glomerular generation count at PND 35, clinical pathology parameters at 3- and 9 months, neutrophil gelatinase-associated lipocalin at PND 8, 3 and 6 months, monthly blood pressure from 3 months onward and histopathology at study end...
2016: Nephron
Junko Ichikawa, Go Ichikawa, Yayoi Tsuboi, Ryota Kuribayashi, Yoshiyuki Watabe, Toshimi Sairenchi, Hiroshi Suzumura, Osamu Arisaka
BACKGROUND: The aim of this study was to verify whether lipid emulsion treatment aggravates infection and inflammation in very low-birthweight (VLBW) infants. STUDY DESIGN: Very low-birthweight (<1500 g) infants born at <32 weeks gestational age between October 2013 and October 2014 at Dokkyo Medical University Hospital (Mibu, Tochigi, Japan) were treated with or without i.v. nutrition with a lipid emulsion. Infants were excluded who had congenital abnormalities, could not receive i...
July 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Jingang Li, Masahisa Funato, Hiroshi Tamai, Hiroshi Wada, Masato Nishihara, Takashi Morita, Suzanne L Miller, Kayo Egashira
BACKGROUND: Very-low-birthweight infants (VLBWIs) are at high risk for suboptimal bone mineral density (BMD) and bone mineral content (BMC). Small-for-gestational-age (SGA) status also causes reduced bone mineralization in full-term infants. However, the impact of intrauterine and postnatal extrauterine growth on BMD and BMC in VLBWIs is inconclusive. METHODS: We retrospectively investigated n=68 VLBWIs, comprising 45 appropriate-for-gestational-age (AGA) and 23 SGA infants who underwent lumbar spine dual-energy X-ray absorptiometry at term-equivalent age...
January 2016: Early Human Development
José Villar, Francesca Giuliani, Zulfiqar A Bhutta, Enrico Bertino, Eric O Ohuma, Leila Cheikh Ismail, Fernando C Barros, Douglas G Altman, Cesar Victora, Julia A Noble, Michael G Gravett, Manorama Purwar, Ruyan Pang, Ann Lambert, Aris T Papageorghiou, Roseline Ochieng, Yasmin A Jaffer, Stephen H Kennedy
BACKGROUND: Charts of size at birth are used to assess the postnatal growth of preterm babies on the assumption that extrauterine growth should mimic that in the uterus. METHODS: The INTERGROWTH-21(st) Project assessed fetal, newborn, and postnatal growth in eight geographically defined populations, in which maternal health care and nutritional needs were met. From these populations, the Fetal Growth Longitudinal Study selected low-risk women starting antenatal care before 14 weeks' gestation and monitored fetal growth by ultrasonography...
November 2015: Lancet Global Health
Ruud R G Bueters, Annelies Klaasen, Nuria Maicas, Sandrine Florquin, Lambertus P van den Heuvel, Michiel F Schreuder
BACKGROUND: Prematurely born children with patent ductus arteriosus are treated with ibuprofen or indomethacin, which may inhibit kidney development. We determined whether clinical doses affected kidney development and function, with or without extrauterine growth retardation. METHODS: Wistar rats were cross-fostered in normal food (NF) or food restricted (FR) litters at postnatal day (PND) 2. On PND 3 to 4, three doses of 0.9% NaCl, 0.1 mg/kg indomethacin, or 10 mg/kg ibuprofen were administered via intraperitoneal injection with 12-hr intervals...
October 2015: Birth Defects Research. Part B, Developmental and Reproductive Toxicology
Daniel A Columbus, Julia Steinhoff-Wagner, Agus Suryawan, Hanh V Nguyen, Adriana Hernandez-Garcia, Marta L Fiorotto, Teresa A Davis
Most low-birth weight infants experience extrauterine growth failure due to reduced nutrient intake as a result of feeding intolerance. The objective of this study was to determine whether prolonged enteral leucine supplementation improves lean growth in neonatal pigs fed a restricted protein diet. Neonatal pigs (n = 14-16/diet, 5 days old, 1.8 ± 0.3 kg) were fed by gastric catheter a whey-based milk replacement diet with either a high protein (HP) or restricted protein (RP) content or RP supplemented with leucine to the same level as in the HP diet (RPL)...
September 15, 2015: American Journal of Physiology. Endocrinology and Metabolism
Chinthika Piyasena, Jessy Cartier, Batbayar Khulan, Karen French, Gopi Menon, Jonathan R Seckl, Rebecca M Reynolds, Amanda J Drake
BACKGROUND: Preterm infants are at increased risk of cardiometabolic disease in later life. Extrauterine growth restriction, catch-up growth, altered adiposity, and abnormal hypothalamic-pituitary-adrenal axis activity could be predisposing factors. Altered DNA methylation (5-methylcytosine, 5mC) might be one underlying mechanism. We hypothesised that preterm infants have altered 5mC at the linked differentially methylated region 2 (DMR2) of IGF2 and the H19 imprinting control region (H19 ICR) compared with term infants over the first year of life...
February 26, 2015: Lancet
Maissa Rayyan, Nathalie Rommel, Karel Allegaert
Deficient nutritional support and subsequent postnatal growth failure are major covariates of short- and long-term outcome in preterm neonates. Despite its relevance, extrauterine growth restriction (EUGR) is still prevalent, occurring in an important portion of extremely preterm infants. Lipids provide infants with most of their energy needs, but also cover specific supplies critical to growth, development and health. The use of human milk in preterm neonates results in practices, such as milk storage, pasteurization and administration by an infusion system...
August 2015: Nutrients
L Zhang, L Du, L Tang, L Lao, Q Hu
OBJECTIVE: Early postnatal life is considered as a critical time window for determination of long-term metabolic states and organ functions. Extrauterine growth restriction (EUGR) causes the development of adult onset chronic diseases, including pulmonary hypertension (PH). However, the mechanisms involved and the possibilities of transgenerational transmission on pulmonary vascular consequences in later life are still unclear. Epigenetic information can be inherited and represents a plausible transgenerational carrier of environmental information...
June 2015: Journal of Hypertension
Timothy P Stevens, Eileen Shields, Deborah Campbell, Adriann Combs, Michael Horgan, Edmund F La Gamma, KuangNan Xiong, Marilyn Kacica
BACKGROUND: Extrauterine growth restriction (EUGR) is inversely related to neurodevelopmental outcome. We analyzed growth outcomes and enteral nutrition practices among preterm infants at New York State (NYS) regional perinatal centers (RPCs) to identify practices associated with risk of EUGR. METHODS: Surviving infants < 31 weeks' gestation admitted to a NYS RPC during 2010 were identified and data collected on their growth and enteral nutrition from a statewide database...
January 2016: American Journal of Perinatology
Li-Li Tang, Li-Yan Zhang, Lin-Jiang Lao, Qiong-Yao Hu, Wei-Zhong Gu, Lin-Chen Fu, Li-Zhong Du
BACKGROUND: Extrauterine growth restriction (EUGR) plays an important role in the developmental origin of adult cardiovascular diseases. In an EUGR rat model, we reported an elevated pulmonary arterial pressure in adults and genome-wide epigenetic modifications in pulmonary vascular endothelial cells (PVECs). However, the underlying mechanism of the early nutritional insult that results in pulmonary vascular consequences later in life remains unclear. METHODS: A rat model was used to investigate the physiological and structural effect of EUGR on early pulmonary vasculature by evaluating right ventricular systolic pressure and pulmonary vascular density in male rats...
2015: Respiratory Research
Wei Cao, Yong-Hong Zhang, Dong-Ying Zhao, Hong-Ping Xia, Tian-Wen Zhu, Li-Juan Xie
OBJECTIVE: To investigate the correlated factors contributed to extrauterine growth restriction (EUGR) in preterm infants with the gestational age less than 34 weeks. METHODS: A total of 694 preterm infants with the gestational ages less than 34 weeks were enrolled. They were classified into EUGR and non-EUGR groups by weight on discharge. The perinatal data, growth data, nutritional information and morbidities during hospitalization were compared between the two groups...
May 2015: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Kenneth Strømmen, Elin W Blakstad, Sissel J Moltu, Astrid N Almaas, Ane C Westerberg, Inge K Amlien, Arild E Rønnestad, Britt Nakstad, Christian A Drevon, Atle Bjørnerud, Frederic Courivaud, Per K Hol, Marit B Veierød, Anders M Fjell, Kristine B Walhovd, Per O Iversen
BACKGROUND: Extrauterine growth restriction is common among very low birth weight infants (VLBW, BW <1,500 g). Optimal postnatal nutrient supply is essential to limit growth restriction and ensure adequate growth and neurodevelopment. OBJECTIVES: We compared an enhanced postnatal nutrient supply to a standard supply and evaluated the effects on growth velocity, head circumference growth and cerebral maturation - the latter by magnetic resonance diffusion tensor imaging (DTI)...
2015: Neonatology
A Miguel Larguía, María Aurelia González, Néstor Alejandro Dinerstein, Constanza Soto Conti
Over the past 10 years, there has been outstanding scientific progress related to perinatal programming and its epigenetic effects in health, and we can anticipate this trend will continue in the near future. We need to make use and apply these achievements to human neurodevelopment via prevention interventions. Based on the concept of the interaction between genome and ambiome, this chapter proposes low-cost easy-implementation preventive strategies for maternal and infant health institutions.Breastfeeding and human milk administration are the first preventive measures, as has been reviewed in the policy statement of the American Academy of Pediatrics...
2015: Advances in Neurobiology
Robert L Gauer, Jeffrey Burket, Eric Horowitz
Preterm births (deliveries before 37 weeks' gestation) comprise 12% of all U.S. births and are responsible for onethird of all infant deaths. Neonatal medical advances have increased survival, and primary care physicians often care for infants who were in the neonatal intensive care unit after birth. Functions of the primary care physician include coordination of medical and social services, nutritional surveillance, and managing conditions associated with prematurity. Parental guidance and encouragement are often necessary to ensure appropriate feeding and infant weight gain...
August 15, 2014: American Family Physician
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