A study of serum zinc levels in cord blood of neonates and their mothers

Serum zinc was estimated in the cord blood of 60 neonates of different gestational age and birth weight, and their mothers. Mean serum zinc levels in neonates FTGA, PTAGA and term SGA were 128.88±14.37, 94.32±17.79 and 111.8±9.2 ug/dl respectively. The maternal serum zinc levels in corresponding groups was 96.28±19.48, 115.44±15.41 and 93.8±7.62 ug/dl. Thus mean serum zinc level in cord blood of FT AGA newborns was significantly higher than that in PT AGA and FT SGA. Mean serum zinc level in mothers of FT AGA was significantly lower than that in mothers of PT AGA. However, there was no significant difference between the maternal serum zinc levels of FT AGA and FT SGAs. There was positive correlation between gestational age and serum zinc level in cord blood of AGAs while correlation was negative in case of their mothers. There was positive correlation between weight (keeping gestational age constant) and serum zinc level in case of neonates while corresponding maternal zinc levels did not vary. (FT AGA and FT SGA).     

Serum alpha-fetoprotein screening for hepatoblastoma in children with Beckwith-Wiedemann syndrome or isolated hemihyperplasia

An elevated risk of hepatoblastoma for children with Beckwith-Wiedemann syndrome or isolated hemihyperplasia is well established. We describe five children with Beckwith-Wiedemann syndrome or isolated hemihyperplasia for whom serial serum alpha-fetoprotein screening, usually in combination with abdominal ultrasound, led to early detection of hepatoblastoma.     

Bone Mineral Content in Preterm Infants at Age 4 to 16

Using photon absorptiometry the forearm bone mineral content (BMC) was determined in 75 children aged 4 to 16, who all had a low birth weight. Forty-five of them were born preterm AGA (27 boys, 18 girls, mean weight 1580 g; range 920-2060 g) and 30 preterm SGA (17 boys, 13 girls, mean weight 1510; range 940-2130 g). The results were compared with a control group of children of the same age, and analyses of covariance with age, height and weight as the covariant factors were performed. The BMC, weight and height did not differ between the children born AGA or SGA. Irrespective of AGA or SGA, the BMC was significantly decreased in boys but the difference was less pronounced and less significant when height and weight were used as covariant factors. Boys who had been born preterm had a less BMC than the control boys for their age but the were also somewhat shorter and lighter than expected with regard to their age.     

Serum lecithin:cholesterol acyltransferase activity, HDL2 and HDL3 composition in hypertensive mothers and their small for gestational age newborns

The aim of this study was to determine serum lecithin:cholesterol acyltransferase (LCAT) activity in parallel with HDL₂ and HDL₃ amounts and composition in pregnancy induced hypertension (PIH) and chronic hypertensive (CH) mothers and in their small for gestational age (SGA) newborns. LCAT activity was assayed by conversion of [³H] cholesterol to labelled cholesteryl ester. HDL₂ and HDL₃ were separated by ultracentrifugation. At term, cholesterol values were similar in PIH, CH and controls. However, higher levels of triglycerides were observed in PIH and CH (+20% and +21%, respectively) as compared with normotensive control mothers (NC). HDL₂ and HDL₃-phospholipids, HDL₂-cholesterol concentrations and LCAT activity were lower in PIH and CH mothers than in NC mothers. Similar changes were also observed in SGA newborns of PHI mothers and in SGA newborns of CH mothers when compared to appropriate for gestational age newborns of control mothers (AGA-NC). In addition, SGA newborns showed low HDL₂ and HDL₃ apoA-I contents. Maternal hypertension and foetal intrauterine growth retardation are associated with profound abnormalities in HDL metabolism, consistent with an atherogenic risk. SGA lipoprotein profiles appear to implicate later metabolic diseases.     

成都市9~15岁儿童出生情况与体格指标流行病学调查

目的：宫内环境可能对儿童生长发育产生影响,通过流行病学调查研究四川省成都市9~15岁儿童出生胎龄、体重与体格发育指标的关系。方法：调查9~15岁的中小学学生共7194名,根据出生胎龄及体重对儿童进行分类（包括小于胎龄儿、适于胎龄儿、大于胎龄儿）,测量身高、体重,并对其家长进行问卷调查。结果：被调查人群小于胎龄儿发生率为6.23%（448例）,其中身高未出现“追赶生长”（低于均值两个标准差）为5.13%,且多个年龄段儿童平均身高低于适于胎龄儿（P<0.05）。大于胎龄儿发生率为18.06% (1299例),大于胎龄儿中超重发生率为13.78% (179 例),肥胖发生率为4.39%（57例）,且多个年龄段儿童平均体重大于适于胎龄儿（P<0.05）。结论：出生时为小于胎龄儿、大于胎龄儿的儿童在远期生长发育中,可以出现身高和体重异于正常儿童,应关注这类孩子在学龄期的身高体重发育情况。     

Ghrelin levels from fetal life through early adulthood: relationship with endocrine and metabolic and anthropometric measures

OBJECTIVE: To establish mean plasma ghrelin levels during fetal life and childhood.Study design Cord blood was obtained at birth from premature (n=29) and full-term newborns (n=124). Fasting blood samples were taken from 224 normal subjects divided according to Tanner stage and sex. Ponderal index or body mass index was determined. Ghrelin; insulin-like growth factor (IGF)-I; IGF-II; IGF binding proteins 1, 2, and 3; insulin; glucose; and leptin levels were measured. RESULTS: Ghrelin levels did not differ between preterm and full-term newborns. Ghrelin increased significantly after birth, peaking during the first 2 years of life, then decreasing until the end of puberty. Ghrelin levels correlated negatively with anthropometric variables in full-term newborns and postnatally, but not in preterm newborns. A positive correlation between ghrelin and IGF binding protein 1 was found. CONCLUSIONS: Ghrelin changes significantly throughout development, correlating with anthropometric and metabolic parameters during extrauterine life. The highest levels of ghrelin are found during early postnatal life, when growth hormone begins to exert its effects on growth and important changes in food intake occur, suggesting that this hormone may participate in these processes.     

Nuevas curvas poblacionales de crecimiento en recién nacidos extremadamente prematuros españoles

IntroductionMost anthropometric reference data for extremely preterm infants used in Spain are outdated and based on non-Spanish populations, or are derived from small hospital-based samples that failed to include neonates of borderline viability.ObjectivesTo develop gender-specific, population-based curves for birth weight, length, and head circumference in extremely preterm Caucasian infants, using a large contemporary sample size of Spanish singletons.Patients and methodsAnthropometric data from neonates ≤ 28 weeks of gestational age were collected between January 2002 and December 2010 using the Spanish database SEN1500. Gestational age was estimated according to obstetric data (early pregnancy ultrasound). The data were analyzed with the SPSS.20 package, and centile tables were created for males and females using the Cole and Green LMS method.ResultsThis study presents the first population-based growth curves for extremely preterm infants, including those of borderline viability, in Spain. A sexual dimorphism is evident for all of the studied parameters, starting at early gestation.ConclusionsThese new gender-specific and population-based data could be useful for the improvement of growth assessments of extremely preterm infants in our country, for the development of epidemiological studies, for the evaluation of temporal trends, and for clinical or public health interventions seeking to optimize fetal growth.     

Childhood pregnancy (10-14 years old) and risk of stillbirth in singletons and twins

OBJECTIVE: To clarify the association between childhood pregnancy and risk of stillbirth. STUDY DESIGN: We analyzed singleton and twin pregnancies that occurred in children (10-14 years old) in the United States from 1989 to 2000. We estimated the absolute and relative risks of stillbirth by using 15- to19-year-old and 20- to 24-year-old mothers as comparison groups. RESULTS: The analysis involved 17.8 million singletons and 337,904 individual twins. The rate of stillbirth was highest in pediatric mothers for both singletons (12.8/1000) and twins (56/1000) compared with adolescent (6.8/1000 in singletons and 29/1000 in twins) and mature (5.5/1000 in singletons and 20/1000 in twins) mothers. After adjusting for confounding characteristics, pediatric mothers continued to exhibit significantly elevated risk for stillbirth in both singletons (odds ratio, 1.57; 95%CI, 1.49-1.66) and twins (odds ratio, 1.97; 95%CI, 1.42-2.73). Preterm birth rather than small size for gestational age was revealed by means of sequential modeling to account for the excess risk of stillbirth observed in pediatric gravidas. CONCLUSION: Pregnancy in childhood is a risk factor for stillbirth; shortened gestation rather than reduction in fetal growth is the mediating pathway.     

胎儿生长迟缓与新生儿胰岛素敏感性变化的相关性

目的探讨胎儿生长迟缓(FGR)与新生儿胰岛素敏感性变化的关系。 方法昆明医学院第一附属医院于2004年4~12月,对72例小于胎龄儿(SGA)和48例适于胎龄儿(AGA)空腹血糖(FPG)、空腹胰岛素(FINS)、C 肽、HDL C、LDL C、TG、非酯化脂肪酸(NEFA)等指标,计算葡萄糖/胰岛素比值(G/I)、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(HOMA IR)、胰岛β细胞功能(HBCI)等,探讨FGR与新生儿胰岛素敏感性变化的关系。 结果(1)SGA组FPG、HDL C低于AGA组,而FINS、LDL C、TG、NEFA高于AGA组(P<001);(2)SGA组G/I比值、ISI低于AGA组,HOMA IR高于AGA组(P<001),而HBCI两组相比差异无显著性(P>005)。 结论FGR儿在生命早期存在胰岛素敏感性降低和不同程度的胰岛素抵抗(IR),而胰岛β细胞功能无明显变化。     

匀称型和非匀称型婴儿智能发育观察

目的根据中华儿科杂志小于胎龄儿(SGA)的临床分型对43例SGA进行临床分型并观察其智能发育情况。 方法应用Bayley婴儿发育量表对不同临床分型的SGA婴儿的智能发育进行评价。 结果匀称型SGA其两种临床分型方法的符合率达到72．09％,而体重、头围和身高均在该胎龄值的第10百分位以下婴儿仅占32．56％,其精神发育指数(MDI)和心理运动发育指数(PDI)均较低。匀称型SGA的MDI和PDI高于非匀称型。 结论对目前SGA的临床分型方法尚需商榷。     

Cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers

AIM: To compare cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers. METHODS: Color Doppler echocardiography was performed in 113 (22 large for gestational age infants of diabetic mothers, 21 of nondiabetic mothers and 70 adequate for gestational age newborns) full-term infants. RESULTS: Pulmonary arterial pressure was significantly higher in infants of diabetic mothers than in those of nondiabetic mothers and normal infants at 24 h (38.5 vs. 32.5, and 35.5 mmHg, respectively). However, slow fall in this parameter was shown in all large for gestational age infants. Open ductus arteriosus was frequent in all large for gestational age infants, but its closure was significantly delayed in infants of diabetic mothers. Septal hypertrophy was higher in infants of diabetic mothers than in large for gestational age infants of nondiabetic mothers. CONCLUSION: Large for gestational age infants born from nondiabetic mothers showed delayed fall in pulmonary arterial pressure similar to those born from diabetic mothers but showed lower proportion of septal hypertrophy. Patent ductus arteriosus persisted for longer period of time in all large for gestational age infants than in normal infants, but its closure was significantly delayed in infants of diabetic mothers.