Periodontitis as a risk factor for preterm low birth weight

PURPOSE: There is growing evidence showing that a number of complex human diseases are caused or are at least influenced by periodontal diseases. Such diseases include cardiovascular diseases, respiratory diseases, diabetes mellitus and osteoporosis. The aim of study was to evaluate periodontal diseases as a risk factor for a preterm low birth weight. MATERIALS AND METHODS: A total of 48 mothers, 20 of who had a preterm low birth weight delivery, were examined in the Clinics of Periodontology, Faculty of Dentistry, Cumhuriyet University. The periodontal exams consisted of a full mouth pocket depth, a Loe and Sillness Gingival index score measurements, and a panoramic radiograph analysis. Information on any other factors that may cause a preterm low birth weight was obtained from the family physician. RESULTS: The study results indicated that periodontitis (OR: 3.6 95% CI: 1.06-12.18) together with bacterial vaginosis (OR: 11.57 95% CI: 1.26-105.7) were independent risk factors of a preterm low birth weight. According to the data obtained from this study, the paternal age, tobacco use and the mothers' height were not significant risk factors for a preterm low birth weight. CONCLUSION: Within the limits of this study, it is concluded that a poor periodontal health status of the mother may be a potential risk factor for a preterm low birth weight.     

Parity and maternal education are associated with low birth weight in Malawi

Background

The consequences of low birth weight (LBW) include death and long-term health sequelae. Limited attention has been made towards the study of socio-demographic factors that may be associated with LBW in Malawi.

Objectives

To assess factors that may be associated with LBW.

Methods

We used secondary data on the 2006 Malawi Multiple Indicator Cluster Survey (MICS). Logistic regression analyses were conducted.

Results

A total of 26,259 females in the age group 15–49 years participated in the survey, and of these, 5024 had children who were reported to have been weighed at birth. Most (60.5%) of the respondents were in the 20–29 years age group. In multivariate analysis, the odds of LBW delivery were lower for women in higher wealth quintiles and those who had some education. Women who previously had a child were less likely to deliver a LBW baby.

Conclusion

The higher odds of delivering a LBW baby among women with no education, and lower wealth status may suggest that there is need to tailor pre-natal care based interventions on social status. This may involve creating education level-specific health messages.     

Hypoglycaemia and hypocalcaemia as determinants of admission birth weight criteria for term stable low risk macrosomic neonates

Background

Large for gestational age (LGA) accounts for about 6.3% of admissions in kenyatta national hospital, newborn unit. As a policy all IGA''s, defined by birth weight of 4000g and above are admitted for 24hours to monitor blood glucose levels. The rational for this policy is questionable and contributes to unnecessary burden on resources needed for new born care.

Objective

To study birth weight related incidence of hypoglycemia and hypocalcaemia in stable low risk lgas in knh and use it to establish a new admission weight based criteria.

Patients and methods

prospective cohort study done in new born-unit, post natal and labour wards of knh. Term lga neonates (birth weight = 4000g) were recruited as subjects and controlled against term appropriate weight (aga) neonates.

Results

the incidence of hypoglycemia and hypocalcaemia in lgas was 21% and 9% respectively. Hypoglycemia was rarely encountered after 12 hours of life in lgas. Hypoglycemia and hypocalcaemia showed a direct upward relationship with weight beyond 4250g. No significant difference in incidence of hypoglycemia and hypocalcaemia between controls and 4000–4249g category to justify their routine admission to newborn unit.

Conclusion

the study identified 4275g as new admission birth weight criteria for stable term low risk IGA''s admission.     

Sleep quality in young adults with very low birth weight--the Helsinki study of very low birth weight adults

Objective To assess the relationship between very low birthweight (VLBW; <1,500 g) and quality and amount of sleep inyoung adults. Methods We compared 89 VLBW and 78 term-born19- to 26-year-old adults, by actigraphy and the Basic NordicSleep Questionnaire. Results There were no group differencesin sleep quality or amount (p's >.15), although VLBW adultswent to bed on average 36 min earlier (95% confidence interval6–66 min). Shorter gestational age was related to longersleep latency both within VLBW (standardized regression coefficientβ = –.36, p =.040) and term-born adults (β =–.25, p =.029). Conclusion Adults with VLBWhad similar quality and amount of sleep as those born at term,although VLBW adults went to bed earlier, suggesting an advancedsleep phase. Within each group, a lower gestational age wasrelated to a longer sleep onset.     

产妇孕期被动吸烟与低出生体重病例对照研究

为分析母亲孕期被动吸烟与低出生体重的关系,采用群体匹配病例对照研究方法,对1999年3月-2000年4月间在沈阳市妇婴医院等14家医院分娩的非主动吸烟的产妇孕期被动吸烟情况与低出生体重关系进行分析.结果表明孕期被动吸烟可能是低出生体重危险因素,且孕期被动吸烟的时间与低出生体重发生存在剂量反应关系(x2趋势=32.42;P＜0.01).在控制产妇不良孕产史等因素后,被动吸烟孕妇分娩出低出生体重儿的危险性为非被动吸烟孕妇的3.176倍(OR95%,CI,1.868-5.401),且被动吸烟与孕妇文化程度对出生体重可能存在协同作用(协同作用指数为3.16).     

极低出生体重儿“鼓励性”喂养的临床观察

目的:观察“鼓励性”喂养对极低出生体重儿的影响。方法:回顾性分析我院3年间收治的29例极低出生体重儿的临床经过。结果:鼓励性喂养组患儿生理性体重下降持续时间短于对照组犤(9.5±3.0)天与(14.0±4.5)天犦(P<0.01),恢复出生体重后的体重增长优于对照组犤(24.5±4.5)g/天与(19.0±4.5)g/天犦,过度至完全经口喂养的时间短于对照组犤(32.5±7.0)天与(4.05±9.0)天犦。结论:鼓励性喂养能促进极低出生体重儿的胃肠道的成熟,改善其临床经过。     

A comparison of AmBisome to amphotericin B for treatment of systemic candidiasis in very low birth weight infants

PURPOSE: Amphotericin B is considered the treatment of choice for systemic candidiasis, but adverse effects may limit its use. An alternative option for the treatment of candidiasis includes lipid preparations of amphotericin B. This study investigated the safety and efficacy of AmBisome, a lipid formulation of amphotericin B containing liposomal structures, for the treatment of systemic candidiasis in very low birth weight infants (VLBWI). MATERIALS AND METHODS: Data from 26 VLBWI treated with AmBisome in the study group (AmBisome group) from October 2003 to July 2006 were compared with data from 20 VLBWI treated with amphotericin B as a historical control (Amphotericin group). This study was a prospective, historical control, multi-center trial. RESULTS: Candida spp. was isolated in 73% (19/26) of the cases for the AmBisome group and 90% (18/20) of the cases for the Amphotericin group. The fungal eradication rate and the time to eradication was 84% (16/19) and 9+/-8 days in the AmBisome group, and 89% (16/18) and 10+/-9 days in the Amphotericin group, respectively (p=0.680 vs p=0.712). The major adverse effects were lower in the AmBisome group (renal toxicity, 21% vs 55%, p=0.029; hepatotoxity, 25% vs 65%, p=0.014, AmBisome group vs Amphotericin group, respectively). There was no significant difference in mortality attributed to systemic candidiasis (12% in the AmBisome group, 10% in the Amphotericin group, p=0.868). CONCLUSION: AmBisome is effective and safe for treating systemic fungal infections in VLBWI.     

Further evidence for a significant effect of fetal genes on variation in birth weight

The contribution of fetal and maternal genes to the variation in birth weight was estimated in a sample of 5 ,625 grandchildren of monozygotic and dizygotic twins. Fetal and maternal genetic effects were separated by comparing the covariance structure for offspring of daughters of twins with that for offspring of sons of twins. Only insignificant amounts (3.0%) of the total variance in birth weight could be accounted for by maternal genes, while fetal genes seemed to account for the major part (69.4%) of the variation. Environmental factors common to sibs could explain 8.6% and random environmental factors 19.0% of the total variance. The findings are consistent with the results of an earlier study of birth weight in the same population but differ from findings in other populations.     

铁剂在极低出生体重早产儿贫血治疗的意义

目的评价重组人类促红细胞生成素(rhu-EPO)治疗极低出生体重早产儿贫血中补充铁剂的临床意义。方法将56例极低出生体重早产儿按随机抽样原则分为对照组(26例)、治疗组(30例)。治疗组于生后第8天即于rhu-EPO,每次300 IU/kg,皮下注射,每周2次,共4w;第3w开始口服铁剂(力蜚能,每日5~10mg/kg)。两组均于生后7d内口服维生素E(每日5 mg/kg)、叶酸片(5 mg/d)。随访至出生后4个月。结果随年龄增大两组血红蛋白、红细胞数均逐渐下降,在7d,35d,2个月时,治疗组上述指标均较对照组高,差异有显著性意义(P<0.01或0.05);治疗结束后,两组的血清铁蛋白[(103±25μmol/Lvs(123±24)/μmol)差异有显著性(P<0.01);治疗组较对照组出现贫血率低(43%vs89%),两组比较差异有显著性(P<0.01)。结论早期大剂量rhu-EPO治疗极低出生早产儿贫血过程中补充铁剂可提高rhu-EPO的治疗效果,能减轻早产儿贫血的程度,可减少甚至替代输血。同时应延长口服铁剂的时间至出生后第3个月。     

外周血内皮祖细胞与极低出生体重早产儿并发症发生相关性

目的分析内皮祖细胞（EPCs）与极低出生体重早产儿发生支气管肺发育不良（BPD）、早产儿视网膜病（ROP）和脑室内出血（IVH）并发症的相关性。方法选取于复旦大学附属儿科医院NICU住院的胎龄〈32周、出生体重〈1500g的早产儿,分别于出生时、生后7、14、21和28d及纠正胎龄36周时收集外周血,流式细胞仪检测EPCs水平,酶联免疫法检测血管内皮生长因子（VEGF）、基质细胞衍生因子等水平。结果68例极低出生体重早产儿纳入分析,其中对照组30例,BPD组20例,ROP组10例,IVH组8例。BPD组与对照组出生时EPCs水平差异无统计学意义,生后7d时点EPCs水平较对照组明显降低,CD34＋KDR＋：（0．019±0．009）％伽（0．026±0．012）％,P〈0．05;KDR＋CDl33＋：（0．004±D．002）％傩（0．008±0．004）％,P〈0．01;CD34＋KDR＋CDl33＋：（0．005±0．002）％船（0．008±0．004）％,P〈0．05。从出生时至生后21d,BPD组血浆VEGF水平均明显低于对照组。ROP组出生时至生后28d的EPCs水平与对照组差异无统计学意义,纠正胎龄36周时KDR＋CDl33＋和CD34＋KDR＋CDl33＋EPCs与对照组相比略有升高趋势。与对照组相比,IVH组生后不同时点的EPCs水平差异均无统计学意义。结论生后早期的EPCs和VEGF水平降低可能参与了早产儿BPD的发生,但其具体机制仍需进一步研究。     

健康孕妇足月新生儿出生体重相关影响因素研究

目的探讨影响健康孕妇新生儿体重的相关因素。方法本研究为前瞻性研究,选择2013年3-8月在青岛市市立医院检查并决定在本院分娩的早孕妇女480例,排除个别妊娠合并症和并发症,共376例进入研究,追踪调查至孕妇分娩。详细记录孕妇年龄、孕前体质量、身高、分娩孕周、分娩前体质量、孕期体质量增长、新生儿体质量,并检测妊娠32~34周孕妇血脂及血糖水平,分析各因素与新生儿体质量的相关性。结果孕期体质量增长、甘油三酯水平与新生儿体质量呈正相关（r=0.213,P〈0.01;r=0.244,P〈0.001）。甘油三酯与孕前体重指数、孕期体质量增长呈正相关（r=0.172,P〈0.05;r=0.178,P〈0.01）。巨大儿组孕妇甘油三酯水平为（3.82±1.47）mmol/L,正常儿组孕妇为（3.21±1.26）mmol/L,差异有统计学意义（P〈0.05）。巨大儿组孕妇空腹血糖水平为（4.45±0.063）mmol/L,正常儿组孕妇血糖水平为（4.17±0.50）mmol/L,差异有统计学意义（P〈0.01）。结论孕妇血脂、血糖水平及孕期增重显著影响新生儿出生体重,孕期应该平衡膳食、合理增重,并进行血脂、血糖监测,对控制新生儿的体重有重要的临床意义。     

微阵列比较基因组杂交分析一例足月小样儿的染色体畸变

目的 分析一例足月小样儿的染色体畸变,探讨患儿低出生体重的原因.方法 采集临床已确诊的足月小样儿外周血并抽提基因组DNA,进行微阵列比较基因组杂交,分析患儿基因组拷贝数的改变.培养患儿及其父母外周血淋巴细胞,进行染色体核型分析并确定患儿染色体畸变的来源.结果 微阵列比较基因组杂交显示患儿在10q125.2→qter区域存在长22 Mb片段的重复,同时在15q26.2→qter区域存在长5 Mb片段的缺失.核型分析显示患儿核型为46,XY,-15,+der(15)t(10;15)(q25;q26)pat.结论 患儿在10q25.2→qter区域存在部分三体,而在15q26.2→qter区域存在部分单体,这两种染色体畸变可能均是导致患儿表现为足月小样儿的病因之一.     

A multi-year analysis of kangaroo mother care outcomes in low birth weight babies at a Nyakahanga Hospital in rural Tanzania

BackgroundKangaroo Mother Care (KMC) requires few specialized resources, reduces mortality, and can be implemented in low resource environments. It is now recommended for implementation around the globe.ObjectivesThis paper discusses KMC use with low birth weight newborns at a Tanzania hospital providing valuable outcomes assessment of KMC use in rural areas of sub-Saharan Africa.MethodsThe research used retrospective records (136 Low Birth Weight (LBW) and 33 Very Low Birth Weight (VLBW) neonates) supplemented by observations. Data included weights (longitudinal), survival period, and cause of death if it occurred. This hospital''s KMC use and study data began when the mother-baby dyad was referred, usually birth day.ResultsThis KMC group demonstrated 70% survival, but 77% of deaths occur within 24 hours. After the first 24 hours, KMC survival rate was 92%. Even VLBW neonates (<1000 g) had 37.5% survival among the KMC program. Prematurity and respiratory distress caused nearly half of the deaths, but hypothermia (19% of deaths) and infection were factors also.ConclusionOur study indicates the value of KMC in rural low resource environments. Results are comparable to KMC programs in urban areas where newborns begin KMC after stabilization and better than outcomes reported for comparable populations not practicing KMC in rural sub-Saharan Africa.     

Differences in human birth weight and corollary attributes as a result of temperature regime

Abstract

Background: Birth weight (BW) is an important attribute of human populations affecting post-natal mortality and later life morbidity, such as diabetes and reduced cognitive skills. BW is influenced by many factors, whereof temperature regime represents an important factor.

Methods: By applying a generalized linear model, the impact of temperatures, altitude, nutrition, age at motherhood and other potential causes for BW variation were evaluated in more than 60 countries worldwide. National IQ scores were analysed in the same model.

Results: This study identified a model explaining 2/3 of the global variation in BW. This model suggests that BW will decrease by 0.44–1.05% per °C increase in temperature under projected climate change. National IQ scores revealed a close relationship between IQ and BW. However, the model of IQ variation did not appear robust when challenged with variables not correlated with BW.

Conclusion: Climate change will affect BW, but it cannot be assumed that other human attributes such as IQ will change because (i) BW, in mainly being sensitive to intra-uterine conditions in the last quarter of pregnancy, is a poor predictor of intra-uterine conditions as such and (ii) developmental plasticity may require post-natal stimuli to unfold.     

Spectral analysis of heart rate fluctuations and optimum thermal management for low birth weight infants

Spectral analysis of heart rate variability is studied in 10 healthy growing premature infants to investigate the changes in autonomic balance achieved as a function of changes in skin temperature. Heart rate is obtained from ECG recordings and the power spectrum of beat-to-beat heart rate fluctuations is computed. The infants maintain mean rectal temperature within 36.3–37.2°C, while skin temperature changes. The respiratory rate does not change at the different servocontrol set points. Heart rate is found to increase slightly, but consistently. The low-frequency band (0.02–0.2 Hz), reflecting the interplay of the sympathetic and parasympathetic tone and known to be maximum at the thermoneutral zone, is maximum at 35.5 and 36°C and decreases gradually to a lower level at a servocontrol temperature of 36.5–37°C. The high-frequency band (0.2–2.0 Hz), coinciding with the respiratory peak and reflecting parasympathetic activity, is significantly elevated at 36°C (p<0.01). The minimum low: high ratio, indicating the minimum sympathetic-parasympathetic balance and possibly reflecting the most comfortable conditions, occurs at 36°C, although the differences are not statistically significant. Servocontrol skin temperature may thus be adapted, and possibly selected at 36°C for growing premature infants in an attempt to achieve thermal comfort and more balanced autonomic activity.     

Proinflammatory cytokine polymorphisms and the risk of preterm birth and low birthweight in a Japanese population

Pregnancy and parturition involve a complex and poorly understoodmolecular and biological interplay between mother and fetus.Inflammatory cytokines have been reported to be associated withfetal growth and parturition. The aim of this study was to examinewhether common proinflammatory cytokine polymorphisms are associatedwith preterm birth (PTB), low birthweight or intrauterine growthrestriction in a Japanese population. We assessed a consecutiveseries of 414 women who had singleton deliveries in Sapporo,Japan between 2001 and 2005. Genotyping of IL1A –889C/T,+4845G/T (A114S), IL1B –511C/T, –31C/T, IL2 –384T/Gand IL6 –634C/G polymorphisms was determined by an allelicdiscrimination assay. The risk of PTB significantly increasedin women carrying the IL1A –889T allele (CC genotype [reference];CT genotype, odds ratios (OR): 2.5; 95% confidence intervals(95% CI): 1.4–4.8; CT+TT genotypes [dominant genotypemodel], OR: 2.5, 95% CI: 1.3–4.6). Similarly, the riskof PTB significantly increased in women carrying the IL1A +4845Tallele (GG genotype [reference]; GT genotype, OR: 2.4, 95% CI:1.3–4.4; GT+TT genotypes [dominant genotype model], OR:2.3, 95% CI: 1.2–4.2). The frequency of the IL1A TT haplotypein mothers with PTB was significantly higher than in motherswho had a term birth (P < 0.001), whereas the frequency ofthe IL1A CG haplotype in mothers who had a PTB was significantlylower (P < 0.001). Our findings suggest that the polymorphismsand haplotypes in the IL1A gene are associated with PTB in Japanesewomen.     

Longitudinal relationships between early adolescent family functioning and youth adjustment: an examination of the moderating role of very low birth weight

OBJECTIVE: To examine longitudinal relations between early adolescent family conflict and late adolescent psychosocial adjustment, and the moderating role of low birth weight. METHODS: Three groups of adolescents (48 with birth weight <750 g, 46 with birth weight 750-1499 g, and 51 term-born controls) and their parents completed ratings of family conflict at age 11 (Time 1). Parent, teacher, and youth reports of psychosocial functioning were obtained at ages 11 and 17 (Time 2). RESULTS: Birth weight moderated the relationship between Time 1 adolescent-perceived conflict and change in adolescent behavioral functioning. For adolescents with histories of <750 g birth weight, adolescent-perceived conflict predicted less adaptive changes in teacher-reported total behavior problems and externalizing problems. CONCLUSIONS: Small disruptions to the parent-child relationship have negative implications for the later well-being of adolescents with extreme levels of low birth weight. Clinical attention to resolving early adolescent conflict may promote adaptive adjustment.     

Elevated MSAFP levels and congenital heart defects: Lack of an association

This study was undertaken to evaluate the relationship between elevated maternal serum alpha fetoprotein (MSAFP) lavels and congenital heart defects. Thirty-two infants with isolated major congenital heart defects and whose mothers had had MSAFP screening were identified. In only one case was the MSAFP greater than 2.3 multiples of the median. A review of our experience with women with elevated MSAFP levels did not document a higher rate of congenital heart malformations than would be expected based on estimated frequencies in the general population. © 1994 Wiley-Liss, Inc.