Disparity in circulating adiponectin multimers between term and preterm infants
Tania SiahanidouAlexandra MargeliMaria GaratziotiMaria DavradouFilia ApostolakouIoannis PapassotiriouHelen Mandyla
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Abstract Aims: To study circulating levels and distribution of adiponectin multimers [low molecular weight (LMW)-, medium molecular weight (MMW)- and high molecular weight (HMW)-adiponectin] in preterm and full-term infants. Methods: Total serum adiponectin and its multimers were measured in 40 healthy infants at the age of one month and associations with anthropometric parameters [body weight and length, body mass index (BMI)], weight gain and metabolic indices (glucose, insulin) were examined. Twenty of the infants were born preterm (gestational age 33.2±1.6 weeks). Results: LMW-adiponectin level and its fractional ratio to total adiponectin were significantly higher in full-term than in preterm infants (P<0.001 and P<0.01, respectively), whereas, MMW-adiponectin level and its ratio were significantly lower (P=0.03 and P=0.01, respectively). HMW-adiponectin did not differ significantly between full-term and preterm infants and accounted for almost 60% of total adiponectin levels in both groups. HMW-adiponectin, but not MMW adiponectin or LMW adiponectin, correlated significantly with anthropometric measurements, similarly to total adiponectin; in addition, HMW adiponectin correlated significantly with weight gain. Conclusions: HMW adiponectin is the most prevalent form in infants. Circulating levels and distribution of MMW- and LMW-adiponectin differ between full-term and preterm infants, but the role of these adiponectin multimers needs to be studied further.The mortality risk of very low birth weight (VLBW) (<1500 g) infants has been estimated by the Clinical Risk Index for Babies (CRIB). Superior discriminatory power has been claimed for the revised CRIB-II score based on birth weight, gestational age, sex, temperature and base excess (BE) at admission. This analysis compared the power of CRIB, CRIB-II, birth weight and gestational age to predict death prior to discharge.Of 1485 consecutive VLBW infants admitted between January 1, 1991 and December 31, 2006, who survived for >or=12 h, CRIB and CRIB-II calculations were possible in 1358 infants (92%). Predictive power of variables was assessed by comparing areas under receiver operator characteristics curves (AUC).CRIB (AUC [95% confidence intervals] 0.82 [0.78-0.86]) performed significantly better than birth weight (0.74 [0.69-0.79]) or gestational age (0.71 [0.66-0.76]), while CRIB-II (0.69 [0.64-0.74]) was rather inferior to CRIB and did not differ significantly from birth weight or gestational age. No substantial changes were seen when substituting worst BE during the first 12 h of life for BE at admission when calculating CRIB-II.CRIB-II does not result in improved estimation of mortality risk in VLBW infants as compared to CRIB, birth weight or gestational age.
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Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.
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The size of the cornea is important in the diagnosis of primary infantile glaucoma. Reference values regarding eyes of premature infants are scarce. Such data are of special importance in areas such as the Middle East where infantile glaucoma is common and often evident already at birth. The authors have measured the horizontal corneal diameter of the eyes of 127 premature Saudi infants with a gestational age between 23 and 36 weeks and a birth weight ranging from 540 g to 4720 g. The corneal diameter ranged from 7.75 mm to 10 mm. The smallest diameter (7.75 mm) was found in an infant with a gestational age of 23 weeks and having a birth weight of 520 g. The largest diameter (10 mm) belonged to two infants with a gestational age of 34 and 35 weeks and a birth weight of 2250 g and 2240 g respectively. Corneal diameter was positively correlated (p < 0.001) with gestational age and birth weight. Graphs depicting the regression line of corneal diameter on gestational age and of corneal diameter on birth weight together with the 95% confidence limits for individual values are provided for reference.
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Objective: To investigate the characteristics and associated factors of early refractive parameters in premature infants. Methods: Case-control study. Premature infants who underwent the first fundus screening in the ophthalmic clinic of Xiamen children's Hospital from May 2018 to February 2019 were collected. The screening time was 4 to 6 weeks after birth or corrected gestational age from 31 to 32 weeks. The premature infants who were diagnosed with mild retinopathy of prematurity (ROP) in one eye or both eyes but did not receive any treatment were divided into ROP group and divided into zone Ⅱ subgroup and zone Ⅲ subgroup according to the region of ROP; the premature infants without ROP were divided into non-ROP group. The gestational age, birth weight, spherical equivalent, anterior chamber depth, vitreous depth, axial length, lens thickness and corneal refractive power were recorded and compared. Independent sample t-test, multiple linear regression analysis and Pearson correlation analysis were used. Results: A total of 180 premature infants, 101 males and 79 females, with gestational age of (30.82±3.10) weeks, corrected gestational age of (37.21±1.44) weeks and birth weight of (1 577.85±572.12) g were included in this study. Ninety premature infants were included in the ROP group (162 eyes, of which 85 right eyes were included in the analysis) and 90 in the non-ROP group (90 right eyes). There was no significant difference in the distribution of gestational age, birth weight and corrected gestational age between the ROP group and non-ROP group (all P>0.05), but there was significant difference in the spherical equivalent between the two groups [(1.90±1.39) D vs. (3.04±1.88) D, t=-4.653, P<0.01], and ROP group was relatively smaller. In the ROP group, the anterior chamber depth was (1.82±0.23) mm, the lens thickness was (4.54±0.18) mm, and the corneal refractive power was (43.99±0.99) D. In the non-ROP group, the anterior chamber depth was (1.91±0.94) mm, the lens thickness was (4.23±0.50) mm, and the corneal refractive power was (43.72±0.92) D. The difference between the two groups was statistically significant (all P<0.01). In ROP group, the anterior chamber depth was shallower, the lens was thicker, and the corneal refractive power was higher. In ROP group, the corneal refractive power of 48 right eyes in zone Ⅱ subgroup and 37 right eyes in Zone Ⅲ subgroup were (43.92±0.78) D and (43.39±1.05) D respectively, and the spherical equivalent were (2.08±0.95) D and (2.52±1.12) D respectively. The corneal refractive power of zone Ⅱ subgroup was higher and the spherical equivalent was smaller, and the differences were statistically significant (all P<0.05). Multiple regression analysis showed that birth weight, gestational age and corneal refractive power were the influencing factors of spherical equivalent (P<0.01). The results of Pearson correlation analysis showed that the gestational age (r=0.182), birth weight (r=0.223) and corneal refractive power (r=-0.125) of premature infants were closely related to the spherical equivalent (all P<0.05). Conclusions: In premature infants, the larger spherical equivalent is related to greater gestational age and heavier birth weight. The refractive parameters of mild ROP are characterized by shallow anterior chamber, thick lens, high corneal refractive power and small spherical equivalent. The spherical equivalent is closely related to the development of ROP. (Chin J Ophthalmol, 2021, 57: 353-357).
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Prospective observational study was conducted in a tertiary care hospital of India over 8 months to measure blood pressure (BP) in healthy term and preterm neonates using oscillometric method and explore the associations with gestational age and birth weight. Consecutive BP measurements were taken by standard oscillometric method on 1617 neonates on day 4, 7 and 14 of life. Mean birth weight was 2.7 ± 0.46 kg, and mean gestational age was 38.2 ± 2.12 weeks. The mean arterial pressure (MAP) on day 4, 7 and 14 were 59.3 ± 7.33, 63.2 ± 6.55 and 66.4 ± 6.13 mmHg, respectively. Larger and mature newborns had significantly higher BP than those who were smaller and premature. Birth weight more strongly correlated with MAP than gestational age. Predictive equations linking MAP with gestational age and birth weight were deduced, which can be used for judicious fluid inotrope management.
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Purpose: To determine relationship between head circumference, gestational age and birth weight with stage of Retinopathy of Prematurity (ROP). Study Design: Descriptive observational. Place and Duration of Study: Jinnah Postgraduate Medical Centre (JPMC), Karachi from January 2022 to June 2022. Methods: Infants born at or before 32 weeks of gestation, birth weight of less than or equal to 1500 grams at birth were enrolled. Their head circumference, gestational age and birth weight was measured and Fundoscopy was done to find out ROP. Staging of ROP was recorded four weeks after birth. The severity of ROP was correlated with head circumference, gestational age and birth weight. Results: Of the 82 infants with ROP, 44 (54%) were male and 38 (46%) were female. Mean gestational age was 30 ± 1.4 weeks (range 27-32 weeks),mean birth weight was 1275 ± 155 gram (range 800-1500), and mean Fronto Occipital Circumference (FOC) was 29 ± 1.6 cm (range 25-32 cm). Degree (stage) of ROP was as follows; 14 (17.1%) infants had stage 1 disease, 24 (29.3%) had stage 2 disease, 28 (34.1%) had stage 3 disease, 13 (15.9%) had stage 4 disease and 3 (3.7%) had stage 5 disease. There was statistically significant association of gestational age, birth weight and head circumference (FOC) with the degree of ROP (P<0.001) Conclusion: Head circumference, gestational age and birth weight had a significant association with degree of ROP (P<0.001).
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Survival rates specific for birth weight, gestational age, sex, and race are described for 6676 inborn neonates who weighed less than 1251 g at birth and were born during 1986 through 1987. Overall 28-day survival increased with gestational age and birth weight, from 36.5% at 24 weeks' gestation to 89.9% at 29 weeks' gestation, or from 30.0% for neonates of 500 through 599 g birth weight to 91.3% for neonates of 1200 through 1250 g. The expected birth weight-specific survival advantage for female neonates and black neonates diminished when the data were controlled for gestational age, showing that certain previously reported survival advantages are based on lower birth weight for a given gestational age. Multivariate analysis showed that all tested variables were significant predictors for survival, in order of descending significance: gestational age and birth weight, sex, race, single birth, and small-for-gestational-age status. The powerful effect of gestational age on survival highlights the need for an accurate neonatal tool to assess the gestational age of very low birth weight neonates after birth.
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