Low birth weight children: coping in school?

AIM: To describe and compare school performance and IQ at 11 y of age in a population of 130 children weighing less than 2000 g at birth without any major handicaps (low birthweight) and a random control sample of 131 children born at term weighing over 3000 g (normal birthweight); and to evaluate the relative strength of parental factors versus child birthweight in predicting IQ. METHODS: The mothers and teachers completed validated questionnaires addressing school performance and the child's IQ was evaluated by WISC-R, prorated. In addition, socioeconomic status was investigated using different questionnaires. RESULTS: According to maternal reports, twice as many low birthweight children had school problems and three times as many of these children were referred to the School Psychological Service. Mean prorated IQ was 5 points lower in the low birthweight group. No statistically significant difference was found for mean IQ between the groups with birthweights of less than 1500 g vs 1500-2000 g. In a multivariate linear regression analysis, parental factors accounted for 13% of the variance in child IQ compared with only 3% accounted for by child birthweight. CONCLUSION: Low birthweight significantly increases the risk of school problems.     

Does low birth weight affect the presence of cardiometabolic risk factors in overweight and obese children?

Recent findings suggest that low-birth-weight children with current obesity are more likely to have higher systolic blood pressure levels and impaired β-cell function than those who are obese with normal birth weight. It seems possible, however, that concurrent low birth weight with excess weight gain can exacerbate other risk factors for cardiometabolic diseases. The purpose of this study is to investigate the influence of birth weight on the lipid/apolipoprotein profile, visfatin levels, and insulin parameters in overweight/obese children. A cross-sectional study of 68 overweight/obese children was conducted. Among these children, 28 were identified with low birth weight and 40 were of normal birth weight. Blood lipid profile, apolipoproteins, visfatin, glucose, and insulin were measured. Our results show that systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels, triglycerides (TG), very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDLc), apolipoprotein B and E, insulin, apolipoprotein B/A₁ ratio, and homeostasis model assessment insulin resistance (HOMA-IR) were significantly elevated in overweight/obese low-birth-weight (LBW) children. There was a significant association of the SBP levels with TG (P?=?0.027), LDLc (P?=?0.001), HOMA-IR (P?<?0.001), apolipoprotein B (P?=?0.001), and apolipoprotein E (P?=?0.039). Conclusion: Our findings suggest that LBW children with overweight or obesity have an additional risk factor for both atherogenic and insulinogenic profile.     

Association of adipokines with cardiovascular risk factors in low birth weight children: a case–control study

Our aim was to investigate plasma levels of adiponectin, monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) in low birth weight (LBW) children and to determine correlations among these adipokines and birth weight and cardiovascular disease risk factors. In a case–control study, the concentrations of adiponectin, MCP-1 and PAI-1 were measured in 180 schoolchildren (ages 6–11 years). MCP-1 and PAI-1 levels were significantly elevated in LBW children. Conversely, adiponectin concentration was significantly reduced in these children. Similar findings were observed after adjustment for current age, gender and abdominal circumference. Because the children with LBW had altered adipokine levels, as well as higher abdominal circumference, HOMA-IR and systolic blood pressure (SBP), we evaluated the correlation among these variables. These analyses showed that adiponectin levels were inversely correlated with systolic blood pressure (SBP) (r?=??0.501; P?<?0.001), HOMA-IR (r?=??0.293; P?=?0.023) and waist circumference (r?=??0.317; P?=?0.014). The proinflammatory markers were positively correlated with HOMA-IR (PAI-1: r?=?0.358; P?=?0.005) and waist circumference (PAI-1: r?=?0.571; P?<?0.001 and MCP-1: r?=?0.267; P?=?0.039). Conclusion: Adipokines levels were correlated with cardiovascular risk factors in LBW children, and these compounds could be involved in the mechanism that links birth weight to the development of cardiovascular diseases in adulthood.     

Are very low birth weight infants born at high altitude at greater risk for adverse outcomes?

OBJECTIVE: To determine if neonatal intensive care at higher altitudes was associated with any variation in mortality or morbidity. METHODS: We reviewed demographic and outcome data on 5450 neonates with birth weights between 500 and 1500 g cared for in 76 different level II and III neonatal intensive care units (NICUs). The altitude break point of 4300 feet was prospectively chosen. Care was provided at 63 NICUs located below 4300 feet, "low-altitude," (n = 4534 neonates) and at 13 NICUs at or above 4300 feet, "high-altitude" (n = 916 neonates). RESULTS: Compared with neonates cared for at low altitude, neonates cared for at high altitude were more often non-Hispanic white and exposed to prenatal steroids. Neonates born at high altitude were more often treated with surfactant (60% vs 53%, P <.01). At 28 days of age, neonates cared for at high altitude were less often in room air (33% vs 50%, P <.01) compared with neonates cared for at low altitude. However, when corrected for barometric pressure, the calculated partial pressure of inspired oxygen at 28 days of age was lower for neonates cared for at high altitude compared with low altitude (165 +/- 80 vs 183 +/- 57, P <.01). There were no differences in the rates of mortality, severe intraventricular hemorrhage (grades 3 and 4), severe retinopathy of prematurity (stages 3 and 4), or necrotizing enterocolitis requiring surgical treatment. CONCLUSIONS: Being cared for at NICUs located above 4300 feet above sea level was not associated with any increase in adverse events compared with NICUs located below 4300 feet.     

Risk factors for childhood obesity: Do the birth weight,type of delivery,and mother’s overweight have an implication on current weight status?

Background

The aim of this study was to identify risk factors, including the type of delivery, breastfeeding and its duration, birth weight, the timing of solid food introduction, the mother’s education level at birth, and smoking status during pregnancy, that are associated with obesity in children living in Istanbul.

Methods

This study involving 4990 healthy children aged 2-14 years, at an outpatient clinic in a tertiary care hospital from June 2012 to July 2014.

Results

The overall rates of overweight and obesity in children were 13.1% and 7.8%, respectively. Results demonstrated that 44.5% of children were delivered by caesarean section. In all age groups, 7.8% of children delivered by caesarean section were obese compared with 7.9% of children born vaginally. No significant association between caesarean section delivery and obesity in childhood was found in our study [odds ratio (OR)=0.98, 95% confidence interval (CI)=0.64-2.87, P=0.454]. There was also no association between duration of breastfeeding and the introduction of solid foods before 4 months or after 6 months of age and childhood obesity (OR=0.95, 95% CI=0.69-1.3, P=0.771; OR=0.99, 95% CI=0.64-1.53, P=0.261). Regression analyses revealed that children with birth weights greater than 3801 g or those with maternal body mass index (BMI) equal to or greater than 30 had an increased risk of being obese or overweight (OR=1.78, 95% CI=1.19-2.65; OR=3.95, 95% CI=1.94-5.81).

Conclusions

This study demonstrated that increased birth weight and maternal BMI are significant risk factors for obesity in children living in Istanbul, Turkey. No relation between caesarean section delivery and childhood obesity was found in this study.

     

Are domestic violence and the excessive use of alcohol risk factors for preterm birth?

Violence has been associated with adverse pregnancy outcome, which led us to determine whether patients who deliver preterm, experience more domestic violence than those who deliver at term. Two groups of patients were assessed, a preterm labour group and a low-risk group.A total of 229 patients were interviewed: 99 in the low-risk (LR) group and 130 in the preterm labour (PTL) group. The PTL group experienced significantly more violence throughout their lives than the LR group. Experiences of violence within the last year or during the pregnancy were also higher for the PTL group. This group smoked significantly more cigarettes per day, used more alcohol, and had a higher incidence of syphilis than the LR group. Violence alone does not seem to cause PTL directly, but is part of a low socioeconomic lifestyle. The fact that alcohol-use is so high among these women needs to be addressed and the need for education on values and respect, family planning use, and low-risk sexual behaviour is once again challenged.     

Motor skill training programs for children with developmental coordination disorder: Does gender matter?

As a section of composing an update of the motor skill training programs in children with developmental coordination disorder (DCD) according to gender, a systematic review of intervention studies in this domain, emphasizing gender differences, was made. This study aimed to (i) systematically review the available literature on the effect of a motor intervention program in children with DCD with a focus on gender differences; (ii) to find clues that possibly explain the observed outcomes according to gender. An electronic search in 4-four databases (Web of Science, Scopus, Google Scholar, and PubMed) was conducted for studies that evaluated motor-based interventions in participants of both genders with DCD assessed using the Movement Assessment Battery for Children. The systematic review followed the guidelines defined in the Preferred Reporting Items for Meta-analysis (PRISMA) and Systematic Reviews and comprised articles published from January 2000 to January 2021. Each study extracted information about methodology, participant characteristics, intervention program (characteristics, duration, and frequency), outcomes, and differences according to gender. Outcomes indicated that although activity-oriented and body function-oriented interventions can effectively affect motor function and skills in children with DCD, only a few studies indicated equal outcomes of the effectiveness of programs on both girls and boys. However, those studies did not describe the gender effect in sufficient detail to help researchers and clinicians understand what it was about the treatment that made it equivalent. Future studies need to address this.     

Substitute care in child welfare and the risk of arrest: does the reason for placement matter?

This study sought to investigate whether the reason for placement was associated with the subsequent risk of arrest. The author has focused on youth entering care for reasons of maltreatment and for child behavioral problems. The author stratified the sample based on a history of juvenile delinquency. The sample was diverse and included youth between 8 and 16 years of age with at least one episode in a substitute care child welfare setting (n = 5,528). Approximately 23% of youth were placed in child welfare for reasons others than maltreatment; specifically child behavioral problems. Youth placed for behavioral problems were significantly more likely to live in congregate care facilities, experience placement instability, and more likely to experience at least one arrest. A prevailing argument is that child welfare offers a broader range of family-based services as compared with the secure settings of juvenile justice. High rates of congregate care placement reported in the current study indicate that family-based services are infrequently associated with youth placed for behavioral problems in child welfare. High rates of subsequent arrest indicate that the congregate care approach for youth with behavioral problems in child welfare is limited.     

Clinical characteristics and risk factors for early-onset necrotizing enterocolitis in preterm infants with very/extremely low birth weight北大核心CSCD

Objective To investigate the clinical characteristics and risk factors for early-onset necrotizing enterocolitis (NEC) in preterm infants with very/extremely low birth weight (VLBW/ELBW). Methods A retrospective analysis was performed on the medical data of 194 VLBW/ELBW preterm infants with NEC who were admitted to Children's Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. These infants were divided into early-onset group (onset in the first two weeks of life; n=62) and late-onset group (onset two weeks after birth; n=132) based on their onset time. The two groups were compared in terms of perinatal conditions, clinical characteristics, laboratory examination results, and clinical outcomes. Sixty-two non-NEC infants with similar gestational age and birth weight who were hospitalized at the same period as these NEC preterm infants were selected as the control group. The risk factors for the development of early-onset NEC were identified using multivariate logistic regression analysis. Results Compared with the late-onset group, the early-onset group had significantly higher proportions of infants with 1-minute Apgar score ≤3, stage III NEC, surgical intervention, grade ≥3 intraventricular hemorrhage, apnea, and fever or hypothermia (P<0.05). The multivariate logistic regression analysis showed that feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, and hemodynamically significant patent ductus arteriosus were independent risk factors for the development of early-onset NEC in VLBW/ELBW preterm infants (P<0.05). Conclusions VLBW/ELBW preterm infants with early-onset NEC have more severe conditions compared with those with late-onset NEC. Neonates with feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, or hemodynamically significant patent ductus arteriosus have a higher risk of early-onset NEC. © 2023 Xiangya Hospital of CSU. All rights reserved.     

Age-related differences in SARS-CoV-2 binding factors: An explanation for reduced susceptibility to severe COVID-19 among children?

ContextIn contrast with other respiratory viruses, children infected with SARS-CoV-2 are largely spared from severe COVID-19.ObjectivesTo critically assess age-related differences in three host proteins involved in SARS-CoV-2 cellular entry: angiotensin-converting enzyme 2 (ACE2), transmembrane serine protease 2 (TMPRSS2) and furin.MethodsWe systematically searched Medline, Embase, and PubMed databases for relevant publications. Studies were eligible if they evaluated ACE2, TMPRSS2 or furin expression, methylation, or protein level in children.ResultsSixteen papers were included. Age-dependent differences in membrane-bound and soluble ACE2 were shown in several studies, with ACE2 expression increasing with age. TMPRSS2 and furin are key proteases involved in SARS-CoV-2 spike protein cleavage. TMPRSS2 expression is increased by circulating androgens and is thus low in pre-pubertal children. Furin has not currently been well researched.LimitationsHigh levels of study heterogeneity.ConclusionsLow expression of key host proteins may partially explain the reduced incidence of severe COVID-19 among children, although further research is needed.