normal birth weight

M others living in areas exposed to ongoing military conflict are at higher risk for psychological difficulties, such as posttraumatic stress disorder, than those not living in such areas. The aim of this two-part exploratory study was twofold. The first aim was to examine differences between mothers who grew up under ongoing military conflict in childhood and mothers who did not grow up in affected areas in terms of their levels of differentiation of self and parental self-efficacy (PSE). The second aim was to identify and describe the parenting experiences of mothers who were exposed to military conflict in childhood. In Part 1 of the study, the sample included 120 mothers (half of whom reported on being exposed to ongoing military conflict in childhood). Findings showed that mothers exposed to ongoing military conflict in childhood reported lower levels of differentiation of self and PSE than their counterparts. In Part 2, 10 mothers who were exposed to ongoing military conflict as children were interviewed about their experience as parents and their PSE. Results indicated that the mothers felt their childhood experiences affected their parenting and PSE negatively, resulting in anxiety, difficulty dealing with stress and sometimes posttraumatic symptoms as well as parental patterns of overprotectiveness, separation anxiety and intergenerational transmission of anxiety. The results highlight the consequences of exposure to ongoing military conflict during childhood on levels of differentiation of self and parenting practices.

In two groups of children with and without the history of low birth weight (LBW), Intelligence Quotient (IQ) and growth indices including weight and height are compared. In this historical cohort study performed in Zanjan City (Iran), 130 six-year-old children of both sexes in two equal groups, 65 with LBW history and 65 with normal birth weight (NBW), were selected randomly to be assessed for IQ, utilizing Wechsler Intelligence Scale for Children-Revised (WISC-R) and physical growth indices, including weight and height. The results were analyzed statistically and P-values less than 0.05 were considered as significant. Findings: Verbal, non-verbal and total IQ, all were significantly different between LBW and NBW groups (P=0.02, P=0.04 and P=0.01, respectively). Mean total IQ was 93.66±8.27 and 99.32±11.05, respectively. Weight and height between case and control groups showed significant differences, too (P=0.001 and P= 0.005, respectively). The results of this study and similar studies emphasize paying special attention to the problem of low birth weight deliveries, recognizing related risk factors and trying to reduce them.

Maternal nutrition, especially LCPUFA, is an important factor in determining fetal growth and development. Our earlier cross sectional study reports lower docosahexanoic acid (DHA) levels at the time of delivery in mothers delivering low birth weight (LBW) babies. This study was undertaken to examine the role of the maternal omega-3 and omega-6 fatty acid profile across the gestation in fetal growth. This is a hospital based study where women were recruited in early gestation. Maternal blood was collected at 3 time points, i.e., T1 = 16th-20th week, T2 = 26th-30th week and T3 = at delivery. Cord blood was collected at delivery. At delivery, these women were divided into 2 groups: those delivering at term a baby weighing >2.5kg [Normal birth weight (NBW) group] and those delivering at term a baby weighing <2.5kg [LBW group]. The study reports data on 111 women recruited at T1, out of which 60 women delivered an NBW baby at term and 51 women delivered an LBW baby at term. Fatty ...

Objective: Two-thirds of women globally give birth at home, yet little data are available on use of skin-to-skin care (STSC) in the community. We describe the acceptability of STSC in rural Uttar Pradesh, India, and measured maternal, newborn, and ambient temperature in the home in order to inform strategies for introduction of STSC in the community. Study design: Community-based workers in intervention clusters implemented a community mobilization and behavior change communication program that promoted birth preparedness and essential newborn care, including adoption of STSC, with pregnant mothers, their families, and key influential community members. Acceptance of STSC was assessed through in-depth interviews and focus groups, and temperature was measured during home visits on day of life 0 or 1. Results: Incidence of hypothermia (<36.51C) was high in both low birth weight (LBW) and normal birth weight (NBW) infants (49.2%, (361/733) and 43% (418/971), respectively). Mean body temperature of newborns was lower (P<0.01) in ambient temperatures <201C (35.9±1.41C, n ¼ 225) compared to X201C (36.5±0.91C, n ¼ 1450). Among hypothermic newborns, 42% (331/787) of their mothers had a lower temperature (range À6.7 to 0.11C, mean difference 0.4±1.21C). Acceptance of STSC was nearly universal. No adverse events from STSC were reported. STSC was perceived to prevent newborn hypothermia, enhance mother's capability to protect her baby from evil spirits, and make the baby more content. Conclusion: STSC was highly acceptable in rural India when introduced through appropriate cultural paradigms. STSC may be of benefit for all newborns and for many mothers as well. New approaches are needed for introduction of STSC in the community compared to the hospital.

Background: Low birth weight (LBW or birth weight < 2500 g) is one of the most serious children problems in today's world. The purpose of this study was to evaluate and compare developmental status of moderately LBW (birth weight: 1500-2499 g) children at the age of five to that of normal birth weight (NBW: birth weight: 2500-4000 g) ones. Methods: In a case-control study, developmental status of five year old children referred for vaccination between December 2008 and June 2009 in Yazd-Iran, evaluated via Persian version of 60-month Ages and Stages Questionnaires (ASQ). NBW and MLBW children were selected as control and case groups, respectively. Results: Frequency of developmental delay in gross motor, fine motor and problem solving domains were significantly higher in MLBW group and mean score in all developmental domains was statistically significant lower in case group. Conclusion: LBW is one of risk factors for developmental delay. So, evaluation and monitoring of development status of LBW should be emphasized for early and timely diagnosis, investigation, management and also rehabilitation.

Pituitary adenylyl cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) are two closely related neuropeptides exhibiting overlapping activities which have actions on almost every organ system of the body. To determine if these peptides exert essential but redundant functions, we interbred VIP-and PACAPdeficient mice to obtain VIP/PACAP double knockout (DKO) mice. DKO mice had normal birth weights and survived to weaning, but exhibited a dramatic postnatal growth rate reduction. Analyses at postnatal day 16 indicated that all organs examined except the brain were reduced in mass by 40-70% compared to mixed background controls, with the thymus and spleen most profoundly affected. Brain size was also significantly reduced, but by only 10%. The reduced growth rate of DKO mice was associated with reduced serum concentrations of insulin-like growth hormone-1 (IGF-1), but unchanged levels of growth hormone. Despite the normal survival of DKO mice up to the weaning stage, many subsequently experienced early sudden death, with only 48% of females and 82% of males surviving past 6 months. The results indicate that a significant percentage of mice deficient in both VIP and PACAP survive to adulthood, but their growth rate is profoundly affected, and that females in particular exhibit high rate of mortality after about 3 months of age.

Background. Low birth weight (LBW) has been shown to lead to a low nephron endowment with subsequent glomerular hyperfiltration. Additional renal disease can therefore be expected to have a more severe course. Minimal change nephrotic syndrome (MCNS) is a common chronic illness in childhood. As it is important to be able to predict prognosis in MCNS, we set out to study the effect of LBW on MCNS in a cohort of patients from our University Medical Center, and performed a meta-analysis. Methods. A retrospective chart review of children with MCNS treated at the VU University Medical Center was performed, identifying 55 patients of whom 4 had LBW. The meta-analysis was performed using Review Manager (The Cochrane Collaboration). Results. The meta-analysis consisted of 201 patients (25 LBW, 176 normal birth weight). More LBW patients were classified as steroid resistant [odds ratio (OR) 6.97 (95% confidence interval [CI] 2.02-24.04), P = 0.002]. The number of relapses per year of follow-up was significantly higher in the LBW patients with MCNS [weighted mean difference 0.93 (95% CI 0.71-1.15) relapse per year, P < 0.0001]. MCNS patients with LBW were significantly more likely to be treated with cyclosporine [OR 4.4 (95% CI 1.7-11.8), P = 0.003] or cytotoxic agents [OR 4.2 (95% CI 1.8-10.2), P = 0.001] during the course of their disease, and they had a higher chance of developing several complications during the follow-up period, including hypertension. Conclusions. This meta-analysis provides support for an adverse effect of LBW on the course and prognosis of MCNS in children, which can aid clinicians and parents in assessing the expected clinical course.

Background: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. Methods and Findings: We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG only. At age 6 weeks, the in vitro cytokine response to purified protein derivate (PPD) of M. Tuberculosis was reduced in LBW and NBW infants who had received OPV with BCG. In a pooled analysis receiving OPV with BCG at birth was associated with significantly lower IL-13 (p = 0.041) and IFN-c (p = 0.004) and a tendency for lower IL-10 (p = 0.054) in response to PPD. Furthermore, OPV was associated with reduced in vivo response to PPD at age 2 months, the prevalence ratio (PR) of having a PPD reaction being 0.75 (0.58-0.98), p = 0.033, and with a tendency for reduced likelihood of having a BCG scar (0.95 (0.91-1.00), p = 0.057)). Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being 20.24 (20.43-0.05), p = 0.012. Conclusions: This study is the first to address the consequences for the immune response to BCG of simultaneous administration with OPV. Worryingly, the results indicate that the common practice in low-income countries of administering OPV together with BCG at birth may down-regulate the response to BCG vaccine.

Objective: To determine whether the combined intervention of 50 000 IU vitamin A administered together with Bacille Calmette-Guerin (BCG) vaccination at birth was associated with adverse events, in particular bulging fontanels and adverse reactions to BCG. Subjects/Methods: From an ongoing trial, 2145 infants randomized to 50 000 IU vitamin A or placebo with BCG vaccination were recruited. Adverse events were monitored in two different ways: (A) daily clinical examinations by a medical doctor during the first 3 days post supplementation; (B) weekly interviews by a trained assistant during the first month post supplementation. Results: In part A, 1271 infants were enrolled, in part B 2078. Vitamin A supplementation (VAS) was associated with a relative risk (RR) of bulging fontanels of 1.16 (95% confidence interval (CI) ¼ 0.82-1.65). The rate of health care contacts and various symptoms during the first month were comparable between the groups. VAS was associated with larger peak local reactions to BCG vaccination in boys, but not in girls (P-value for test of interaction between VAS and sex ¼ 0.02). Conclusion: 50 000 IU vitamin A with BCG was not associated with adverse events. The observed sex-differential effect of VAS on local reaction to BCG is in line with other observations of sex-differential effects of VAS.

Aim-To evaluate the energy requirements of breast fed infants. Methods-The study was conducted in 17 healthy exclusively breast fed infants of normal birth weight (mean (SD) 3332 (280) g). Energy expenditure by the doubly labelled water method and milk intake by the dose to infant method were measured at 34 (4) days. A dose of 0.2 g/kg deuterium oxide (99.8%) and 2.0 g/kg 10% 18 O labelled water was given to the infants, and urine samples were collected for seven consecutive days after dosing. Results-The mean (SD) weight of the infants during the period of evaluation was 4617 (343) g and weight gain 34.0 (7.5) g/day. Daily milk intake was 728 (101) g and its metabolisable energy content 2.71 kJ/g. The energy expenditure of the infants was 1205 (312) kJ/day and energy required for growth was 607 (130) kJ/day. When combined this produced an energy requirement of 391 kJ/kg/day for these infants. Conclusion-These data agree with those from other studies in the United Kingdom and the United States and suggest that adequate growth can be achieved with 19.4% less energy than recommended by FAO/WHO/UNU.

During the study period there were 2063 live births. Of these 573 (27.8%) were low birth weight (LBW), 277 (13.4%) preterm and 148 (7.1%) small for date (SFD) babies. In all, 263 (12.7%) newborns suffered from one or the other morbidity. Birth asphyxia of varying severity developed in 130 (6.3%) babies [88 LBW and 42 normal birth weight (NBW) (p < 0.001)]. Respiratory distress syndrome was diagnosed in 82 (3.9%) babies, most being due to hyaline membrane diseases (31,7%), which affected 26 (9.4%) of preterm babies. Deep infections were seen in 109 (5.3%) newborns [60 LBW and 49 NBW, (p < 0.001)] and superficial infections were seen in 79 (3.8%) babies [46 LBW and 33 NBW, (p< 0.001)]. Hyperbilirubinemia was detected in 78 (3.8%) babies. In one fifth of the babies, the cause of hyperbilirubinemia remained unidentified even after detailed investigations. Hypothermia was observed in 59 (2.9%)~ newborns [48 LBW and 11 NBW, (p < 0.001)] and congenital malformations were seen in 24 (1.7%) babies. Morbidity was found to be high amongst LBW and preterm babies, The incidence of deepinfections and hypothermia was high in our study.

Maternal nutrition, especially LCPUFA, is an important factor in determining fetal growth and development. Our earlier cross sectional study reports lower docosahexanoic acid (DHA) levels at the time of delivery in mothers delivering low birth weight (LBW) babies. This study was undertaken to examine the role of the maternal omega-3 and omega-6 fatty acid profile across the gestation in fetal growth. This is a hospital based study where women were recruited in early gestation. Maternal blood was collected at 3 time points, i.e., T1 = 16 th-20 th week, T2 = 26 th-30 th week and T3 = at delivery. Cord blood was collected at delivery. At delivery, these women were divided into 2 groups: those delivering at term a baby weighing >2.5kg [Normal birth weight (NBW) group] and those delivering at term a baby weighing <2.5kg [LBW group]. The study reports data on 111 women recruited at T1, out of which 60 women delivered an NBW baby at term and 51 women delivered an LBW baby at term. Fatty acids were analysed using gas chromatography. At T1 of gestation, maternal erythrocyte DHA levels were positively (p<0.05) associated with baby weight. Maternal plasma and erythrocyte arachidonic acid and total erythrocyte omega-6 fatty acid levels at T2 were higher (p<0.05 for both) in the LBW group. Total erythrocyte omega-3 fatty acid levels were lower (p<0.05) while total erythrocyte omega-6 fatty acid levels were higher (p<0.05) in the LBW group at delivery. Our data demonstrates the possible role of LCPUFA in the etiology of LBW babies right from early pregnancy.

The ''small baby syndrome hypothesis'' suggests that an inverse linear relation exists between birth weight and risk of type 2 diabetes. The authors conducted a meta-analysis to examine this association. They included studies that reported odds ratios and 95% confidence intervals (or data with which to calculate them) for the association of type 2 diabetes with birth weight. Fourteen studies involving a total of 132,180 persons were identified. Low birth weight (<2,500 g), as compared with a birth weight of 2,500 g, was associated with increased risk of type 2 diabetes (odds ratio (OR) ¼ 1.32, 95% confidence interval (CI): 1.06, 1.64). High birth weight (>4,000 g), as compared with a birth weight of 4,000 g, was associated with increased risk to the same extent (OR ¼ 1.27, 95% CI: 1.01, 1.59). Pooled estimates increased further when normal birth weight (2,500-4,000 g) was used as the reference category (low birth weight:

We investigated the effect of methanolic extract of Asparagus pubescens root on sexual behavior and on pituitary hormone secretion during pregnancy and lactation on Wistar rats. Different doses (0.25, 0.5, 1.0 and 1.5 g/kg) of the extract, given in a single bolus dose or in four (divided) daily injections (0.0625, 0.125, 0.25 and 0.375 mg/(kg day)), inhibited sexual behavior when given to proestrous females in a dose-dependent manner, with the high doses (1.0-1.5 g/kg) inhibiting significantly the lordosis quotient. All treated females showed aggressive behavior towards the males to a similar extent irrespective of dose. Fertilization rate, pregnancy, delivery and litter size were normal. Birth weight and growth rates of the pups were also unaffected indicating no deleterious effects of extract on offspring development. The extract had significant effects on preovulatory luteinizing hormone (LH), prolactin (PRL) and progesterone (P4) release. Divided doses of 1.0 and 1.5 g/kg significantly decreased preovulatory LH, PRL and P4 release. Administration of 0.5 or 1.5 g/kg in bolus dose, produced significant inhibition of preovulatory LH and PRL while 1.5 g/kg had no effect. Progesterone was not modified while 1.0 g/kg dose caused a decrease in GH. 0.25 g/kg produced a paradoxical increase in preovulatory PRL secretion, also seen on day 4 of pregnancy. During pregnancy, both dose regimens were effective in inhibiting the afternoon peaks in prolactin secretion at all dose levels with the exception of 0.25 g/kg. There were no effects on the second half of pregnancy or on the suckling-induced PRL release on day 3 postpartum. Circulating GH was scarcely affected on day 3 postpartum. All the results taken together, indicate that the contraceptive effects of the extract may be exerted through interference with neural mechanisms that control preovulatory hormone release and sexual behavior.

This was a prospective study conducted in a cohort of live normal full term singleton newborns delivered in Rajshahi Medical College Hospital with the objective to explore their early neonatal health as well as the role of low birth weight on it. A total 770 live normal newborns were Included in this study. For data collection APGAR Score Estimating Checklist and one protested structured questionnaire were used. Simple descriptive as well as analytical techniques including Chi-square t test were done. The results of this study suggested that low weight (LBW) babies were more prone to develop early neonatal morbidity and mortality than normal birth weight (NBW) babies. LBW infants needed more resuscitation and responded less to resuscitative effort than the infants of NBW. Birth asphyxia was the commonest cause of early neonatal morbidity and mortality.    doi: 10.3329/taj.v21i1.3216 TAJ 2008; 21(1): 35-39

A register of infants with cerebral palsy born to mothers resident in the Mersey region from 1967-84 has been maintained using various sources of information. A total of 1056 patients are registered of whom 331 (31%) have hemiplegia or mixed hemiplegia, 236 (22%) have diplegias or mixed diplegia, and 369 (35%) have quadriplegia or mixed quadriplegia. The remainder have dyskinetic or dystonic forms except for seven, who are unclassified. There has been no significant change in the prevalence of cerebral palsy among infants of normal birth weight (>2500 g). Among low birthweight infants (-2500 g) there has been a significant increase in prevalence of all the main clinical types. This increase started later among the very low birthweight infants (-1500 g) than among those weighing 1501-2500 g. These changes in prevalence could be the result of either improved survival of prenatally impaired infants because of improvements in medical care, or a reflection of failure to maintain optimal conditions at or around the time of birth.

Background: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. Methods and Findings: We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG only. At age 6 weeks, the in vitro cytokine response to purified protein derivate (PPD) of M. Tuberculosis was reduced in LBW and NBW infants who had received OPV with BCG. In a pooled analysis receiving OPV with BCG at birth was associated with significantly lower IL-13 (p = 0.041) and IFN-c (p = 0.004) and a tendency for lower IL-10 (p = 0.054) in response to PPD. Furthermore, OPV was associated with reduced in vivo response to PPD at age 2 months, the prevalence ratio (PR) of having a PPD reaction being 0.75 (0.58-0.98), p = 0.033, and with a tendency for reduced likelihood of having a BCG scar (0.95 (0.91-1.00), p = 0.057)). Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being 20.24 (20.43-0.05), p = 0.012. Conclusions: This study is the first to address the consequences for the immune response to BCG of simultaneous administration with OPV. Worryingly, the results indicate that the common practice in low-income countries of administering OPV together with BCG at birth may down-regulate the response to BCG vaccine.

Background: Low birth weight (LBW) is associated with increased future risk of insulin resistance and type 2 diabetes mellitus. The underlying molecular mechanisms remain poorly understood. We have previously shown that young LBW men have reduced skeletal muscle expression of PI3K p85a regulatory subunit and p110b catalytic subunit, PKCf and GLUT4 in the fasting state. The aim of this study was to determine whether insulin activation of the PI3K/Akt and MAPK signalling pathways is altered in skeletal muscle of young adult men with LBW. Methods: Vastus lateralis muscle biopsies were obtained from 20 healthy 19-yr old men with BW,/ = 10 th percentile for gestational age (LBW) and 20 normal birth weight controls (NBW), matched for physical fitness and whole-body glucose disposal, prior to (fasting state) and following a 4-hr hyperinsulinemic euglycemic clamp (insulin stimulated state). Expression and phosphorylation of selected proteins was determined by Western blotting.

Objective: To examine the relationship between infant survival and the rates of sudden infant death syndrome (SIDS) in very low birth weight (VLBW), low birth weight (LBW), and normal birth weight (NBW) infants from 1985 to 1991. Methods: The National Center for Health Statistics Birth Cohort Linked Birth/Infant Death Data Sets were used to determine birth weight, age at death, and cause of death for US-born singleton infants with birth weights of 500 g or more. Results: Increasing infant and postneonatal survival rates were greatest in VLBW infants. In contrast, SIDS rates did not change in VLBW infants (3.66 to 3.69; P = .70) but declined in both LBW (3.51 to 3.32; P = .041) and NBW (1.07 to 1.03; P = .008) infants. Postneonatal SIDS rates (per 1000 neonatal survivors) did not change in VLBW (4.93 to 4.58; P = .58) or LBW (3.36 to 3.22; P = .07) infants but declined in NBW infants (1.00 to 0.97; P = .018). Although there were differences among the slopes of survival rates, there was no statistical evidence of differences in the slope of SIDS rates among the three groups. Conclusions: The marked increase in survival of VLBW infants increased the pool of babies at potential risk for SIDS. VLBW infants' SIDS rates have not changed while they have declined in NBW and LBW infants.

Background: Low birth weight (LBW or birth weight < 2500 g) is one of the most serious children problems in today's world. The purpose of this study was to evaluate and compare developmental status of moderately LBW (birth weight: 1500-2499 g) children at the age of five to that of normal birth weight (NBW: birth weight: 2500-4000 g) ones. Methods: In a case-control study, developmental status of five year old children referred for vaccination between December 2008 and June 2009 in Yazd-Iran, evaluated via Persian version of 60-month Ages and Stages Questionnaires (ASQ). NBW and MLBW children were selected as control and case groups, respectively. Results: Frequency of developmental delay in gross motor, fine motor and problem solving domains were significantly higher in MLBW group and mean score in all developmental domains was statistically significant lower in case group. Conclusion: LBW is one of risk factors for developmental delay. So, evaluation and monitoring of development status of LBW should be emphasized for early and timely diagnosis, investigation, management and also rehabilitation.

Background— Low birth weight predisposes to later coronary disease. To further elucidate the mechanisms behind this association and their timing, vascular endothelial function—a key factor in early pathophysiology of atherosclerosis—was studied in 54 infants born either before the third trimester or at term. Methods and Results— All subjects were studied at 3 months of postnatal age. A laser-Doppler technique was used to measure skin perfusion before and after transdermal iontophoresis of acetylcholine (ACh; an endothelium-dependent vasodilator). In infants born at term (n=19; birth weight range: 2230 to 4205 g), maximum perfusion after ACh was 109±8 perfusion units (PU, mean±SEM) in normal–birth weight controls compared with 56±13 PU among those who had been small for gestational age at birth ( P &lt;0.01). In infants born preterm (n=35; birth weight range, 722 to 1868 g), ACh induced similar perfusion responses among subjects appropriate for gestational age (113±16 PU) and in thos...

A register of children with cerebral palsy born to mothers resident in the Mersey region from 1966 to 1977 was compiled from health service records. Frequency distributions and prevalences of birth weight and gestational age differed for those with hemiplegia, diplegia, and quadriplegia. In particular, the children with diplegia showed a bimodal frequency distribution. Children of normal birth weight with diplegia had a higher prevalence of severe mental retardation than those of low birth weight. These differences may be due to survival bias and may not be of aetiological importance. Furthermore, the mothers of diplegic infants had a significantly higher proportion of spontaneous abortions, stillbirths, and low birthweight infants in their obstetric history. This suggests that prenatal factors predominate in the aetiology of diplegia. including the handicap registers of all health districts 1035

Maternal factors comprising of social, obstetric and anthropometric are fund to influence LBW. The present study had found association between obstetric risk factors like age of the mother, parity and gravida with LBW. Similar association was also observed between maternal height, and maternal weight with LBW. However, social factors were not found to be associated with LBW. This could probably be due to RUHSA's intervention which requires a further inquiry.

Pituitary adenylyl cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) are two closely related neuropeptides exhibiting overlapping activities which have actions on almost every organ system of the body. To determine if these peptides exert essential but redundant functions, we interbred VIP-and PACAPdeficient mice to obtain VIP/PACAP double knockout (DKO) mice. DKO mice had normal birth weights and survived to weaning, but exhibited a dramatic postnatal growth rate reduction. Analyses at postnatal day 16 indicated that all organs examined except the brain were reduced in mass by 40-70% compared to mixed background controls, with the thymus and spleen most profoundly affected. Brain size was also significantly reduced, but by only 10%. The reduced growth rate of DKO mice was associated with reduced serum concentrations of insulin-like growth hormone-1 (IGF-1), but unchanged levels of growth hormone. Despite the normal survival of DKO mice up to the weaning stage, many subsequently experienced early sudden death, with only 48% of females and 82% of males surviving past 6 months. The results indicate that a significant percentage of mice deficient in both VIP and PACAP survive to adulthood, but their growth rate is profoundly affected, and that females in particular exhibit high rate of mortality after about 3 months of age.

Maternal factors comprising of social, obstetric and anthropometric are fund to influence LBW. The present study had found association between obstetric risk factors like age of the mother, parity and gravida with LBW. Similar association was also observed between maternal height, and maternal weight with LBW. However, social factors were not found to be associated with LBW. This could probably be due to RUHSA's intervention which requires a further inquiry.

Several cardiovascular diseases (CVD) observed in adulthood have been associated with environmental influences during fetal growth. Here, we show that maternal exposure to cadmium, a ubiquitously distributed heavy metal and main component of cigarette smoke is able to induce cardiovascular morpho-functional changes in the offspring at adult age. Heart morphology and vascular reactivity were evaluated in the adult offspring of rats exposed to 30 ppm of cadmium during pregnancy. Echocardiographic examination shows altered heart morphology characterized by a concentric left ventricular hypertrophy. Also, we observed a reduced endothelium-dependent reactivity in isolated aortic rings of adult offspring, while endotheliumindependent reactivity remained unaltered. These effects were associated with an increase of hem-oxygenase 1 (HO-1) expression in the aortas of adult offspring. The expression of HO-1 was higher in females than males, a finding likely related to the sex-dependent expression of the vascular cell adhesion molecule 1 (VCAM-1), which was lower in the adult female. All these long-term consequences were observed along with normal birth weights and absence of detectable levels of cadmium in fetal and adult tissues of the offspring. In placental tissues however, cadmium levels were detected and correlated with increased NF-κB expressiona transcription factor sensitive to inflammation and oxidative stresssuggesting a placentary mechanism that affect genes related to the development of the cardiovascular system. Our results provide, for the first time, direct experimental evidence supporting that exposure to cadmium during pregnancy reprograms cardiovascular development of the offspring which in turn may conduce to a long term increased risk of CVD.

Maternal factors comprising of social, obstetric and anthropometric are fund to influence LBW. The present study had found association between obstetric risk factors like age of the mother, parity and gravida with LBW. Similar association was also observed between maternal height, and maternal weight with LBW. However, social factors were not found to be associated with LBW. This could probably be due to RUHSA's intervention which requires a further inquiry.

We investigated the effect of methanolic extract of Asparagus pubescens root on sexual behavior and on pituitary hormone secretion during pregnancy and lactation on Wistar rats. Different doses (0.25, 0.5, 1.0 and 1.5 g/kg) of the extract, given in a single bolus dose or in four (divided) daily injections (0.0625, 0.125, 0.25 and 0.375 mg/(kg day)), inhibited sexual behavior when given to proestrous females in a dose-dependent manner, with the high doses (1.0-1.5 g/kg) inhibiting significantly the lordosis quotient. All treated females showed aggressive behavior towards the males to a similar extent irrespective of dose. Fertilization rate, pregnancy, delivery and litter size were normal. Birth weight and growth rates of the pups were also unaffected indicating no deleterious effects of extract on offspring development. The extract had significant effects on preovulatory luteinizing hormone (LH), prolactin (PRL) and progesterone (P4) release. Divided doses of 1.0 and 1.5 g/kg significantly decreased preovulatory LH, PRL and P4 release. Administration of 0.5 or 1.5 g/kg in bolus dose, produced significant inhibition of preovulatory LH and PRL while 1.5 g/kg had no effect. Progesterone was not modified while 1.0 g/kg dose caused a decrease in GH. 0.25 g/kg produced a paradoxical increase in preovulatory PRL secretion, also seen on day 4 of pregnancy. During pregnancy, both dose regimens were effective in inhibiting the afternoon peaks in prolactin secretion at all dose levels with the exception of 0.25 g/kg. There were no effects on the second half of pregnancy or on the suckling-induced PRL release on day 3 postpartum. Circulating GH was scarcely affected on day 3 postpartum. All the results taken together, indicate that the contraceptive effects of the extract may be exerted through interference with neural mechanisms that control preovulatory hormone release and sexual behavior.

Being able to describe growth appropriately and succinctly is important in many contexts, including biology, epidemiology and statistics. Various approaches are used varying from differential equations, deterministic modeling and statistical approaches like regression. Often, with epidemiologic data we want to model growth in the context of demographic variables and other potential mediators. However, growth is non-linear, so the addition of covariates may be problematic. Additionally, measurements may be unevenly spaced and there may even be missing data so some form of modeling that will deal with this is needed. We investigate growth models implemented in SAS/STAT® using anthropometric data (height, weight, and body mass index,) from the Infant Health and Development Program (IHDP). This program was an eight-site randomized controlled trial testing the efficacy of early intervention to enhance the cognitive, behavioral, and health status of low birth weight, premature infants. Th...

Blood samples from 813 newborns were spotted on to filter paper and the 17hydroxyprogesterone concentration was measured using the Delfia (R) fluorometric immunoassay. The median, mean, and standard deviation (SD) for the total population were 20, 21 and (11) nmol/L respectively. Males had significantly higher levees than females with median, mean and (SD) of 22, 22 and (12) nmol/L. Similarly, low birth weight babies were found to have significantly higher levels than normal birth weight babies with median, mean and (SD) of 21,24 (12) nmol/L. Preterm babies were also found to have significantly higher levels than full term babies, with median, mean and (SD) of 25, 29 (16) nmol/L. As experienced elsewhere, those factors should be taken into consideration when considering a cutoff point in any neonatal screening program for congenital adrenal hyperplasia.

Maternal factors comprising of social, obstetric and anthropometric are fund to influence LBW. The present study had found association between obstetric risk factors like age of the mother, parity and gravida with LBW. Similar association was also observed between maternal height, and maternal weight with LBW. However, social factors were not found to be associated with LBW. This could probably be due to RUHSA's intervention which requires a further inquiry.

Blood samples from 813 newborns were spotted on to filter paper and the 17hydroxyprogesterone concentration was measured using the Delfia (R) fluorometric immunoassay. The median, mean, and standard deviation (SD) for the total population were 20, 21 and (11) nmol/L respectively. Males had significantly higher levees than females with median, mean and (SD) of 22, 22 and (12) nmol/L. Similarly, low birth weight babies were found to have significantly higher levels than normal birth weight babies with median, mean and (SD) of 21,24 (12) nmol/L. Preterm babies were also found to have significantly higher levels than full term babies, with median, mean and (SD) of 25, 29 (16) nmol/L. As experienced elsewhere, those factors should be taken into consideration when considering a cutoff point in any neonatal screening program for congenital adrenal hyperplasia.

Objective: There are limited data on the prevalence of oral health problems in pregnant Saudi Arabian women; therefore, the aim of this study was to estimate the prevalence of their oral health problems and related factors. Materials and Methods: A self-administered survey was conducted between August 14 and August 31, 2016, on 438 pregnant women at the Ministry of National Guard Health Affairs Primary Health Care Centers, Riyadh. A standardized and reliable questionnaire was used to collect data. We collected data on sociodemographic data, lifestyles, and use of dental services during pregnancy. The main outcomes were oral health problems including self-reported dry mouth, gingival bleeding, dental pain, and dental caries. A logistic regression model was used to identify factors associated with each of the oral health problems. Results: Of the sample, 56.7% reported dry mouth, 55.8% gingival bleeding, 35.3% dental pain, and 35% dental caries. Women with low-income sleep deprivation, irregular eating patterns, and those who did receive dental services during pregnancy were most likely to have dental pain. Infrequent consumption of fruits and vegetables, vomiting, and having high stress increased the odds of dry mouth. The risk of gingival bleeding was high in women in the second trimester and those with gestational diabetes. Conclusion: We noted a high prevalence of oral health problems among pregnant Saudi women. Income, sleep deprivation, dental care utilization, and irregular eating patterns are factors that could impact perception of oral health conditions of pregnant women. Studies are needed to investigate the best approach to promote and maintain healthy lifestyles in pregnant women. This may help in developing related health policies or programs to promote oral health in this population.

Low birth weight (LBW) is a public health problem, because it is associated with increased risk of morbidity and mortality. The principal aim of this study was to assess risk factors for LBW in a large multi-ethnic and socioeconomically disadvantaged population. Data from 3242 mothers, who attended the Well Baby Clinic (Southwestern Sydney, Australia) for the first time, were analysed in relation to their demographic characteristics and socioeconomic indices. The overall birthweight was 3377 ± 577 g (mean ± SD). In multiple linear regression analysis, smoking during pregnancy, marital status, parity, and country of birth were independently associated with birth weight. According to this analysis, lower birth weight was associated with mothers who had smoked during pregnancy (by 215.2 ± 18.6 g), who were single (46.9 ± 21 g), and of Asian background (108.5 ± 38.2 g). However, higher parity was associated with significantly higher birth weight. The presence of each factor was coded as 1 and the absence, 0. A 'risk score' was then derived by summing up the individual scores. When birth weight was classified as 'low birth weight' (defined as those with birth weight being less than 2500 g) or normal birth weight, the overall prevalence of LBW was 1.9%. Each unit increase in the risk score was associated with a 1.9-fold (95% confidence interval: 1.5-2.6) increase in the risk of LBW. These data suggest that apart from marital status, ethnicity and parity, maternal smoking is the single most important preventable risk factors for LBW.

glomerular volume (r ϭ Ϫ0.848, P Ͻ 0.0001). These findings Relationship between weight at birth and the number and size were independent of sex and race (black vs. white). Essential of renal glomeruli in humans: A histomorphometric study. arterial hypertension existed in 38.9% of the mothers of chil-Background. The number of nephrons in humans varies considerably under normal circumstances, and retarded intrauter-dren with LBW and in 5.9% of the mothers of children with ine growth has been reported to be associated with a significant NBW (P Ͻ 0.05). Smoking habits existed in 50% of the mothers reduction in nephron number. Low nephron number may be an of LBW children and in 11.8% of the mothers of NBW children independent risk factor for the development of hypertension. (P Ͻ 0.05). We therefore decided to evaluate the relationship between body Conclusion. There are strong correlations between glomeruweight at birth and the number and size of nephron units. lar number (direct) and size (inverse) with LBW in this cohort. Methods. We examined coronal sections of the kidneys of Endowment with decreased nephron numbers may be a risk 35 neonates who died within two weeks of birth because of factor for hypertension and the rate of progression of renal hyaline membrane, infectious complications, brain hemordisease. rhage, or perinatal hypoxia and had no urinary congenital malformations. Nine of them (5 males and 4 females) were between 36 and 37 weeks of gestation, and the rest had 38 or more weeks of gestation. Eighteen neonates weighed less than 2500 Low birthweight (LBW) is an important public health g at birth [low birth weight (LBW); 9 females and 9 males], and problem in developing countries [1]. In 1988, Brenner, 17 had weights above this value [normal birth weight (NBW); 8 García, and Anderson noted that the number of nephfemales and 9 males]. In each section, glomeruli present in rons was inversely correlated with the risk of developing four sequential subcapsular microscopic fields, corresponding to 0.6 mm 2 , were counted; in addition, the area of each of hypertension in rats and, taking into account the popula-65 consecutive glomeruli was determined by a computerized

Spinal cord injury with or without trauma has been reported in the perinatal period. The prognosis depends primarily on diagnosis of the level, extent and nature of the lesion, established by correlations between clinical, imaging and electrophysiological data. A 25-day-old boy with normal birth weight delivered at term by cesarean section was transferred to Inönü University Turgut Özal Medical Center because of respiratory distress and brachial diplegia. A suspicious medullary lesion on cervical computerized tomography was confirmed as an intramedullary lesion extending from C3 to D1 on magnetic resonance imaging (MRI). Emergent surgery consisting of exposure of the lesion site and interlaminar direct puncture of the lesion under fluoroscopy revealed that the pathology was an intramedullary hematoma. The partial evacuation of the lesion with direct puncture, the patient’s neurological improvement and close follow-up of the patient with ultrasonography, electrophysiology and MRI are...

Objective: Two-thirds of women globally give birth at home, yet little data are available on use of skin-to-skin care (STSC) in the community. We describe the acceptability of STSC in rural Uttar Pradesh, India, and measured maternal, newborn, and ambient temperature in the home in order to inform strategies for introduction of STSC in the community. Study design: Community-based workers in intervention clusters implemented a community mobilization and behavior change communication program that promoted birth preparedness and essential newborn care, including adoption of STSC, with pregnant mothers, their families, and key influential community members. Acceptance of STSC was assessed through in-depth interviews and focus groups, and temperature was measured during home visits on day of life 0 or 1. Results: Incidence of hypothermia (<36.51C) was high in both low birth weight (LBW) and normal birth weight (NBW) infants (49.2%, (361/733) and 43% (418/971), respectively). Mean body temperature of newborns was lower (P<0.01) in ambient temperatures <201C (35.9±1.41C, n ¼ 225) compared to X201C (36.5±0.91C, n ¼ 1450). Among hypothermic newborns, 42% (331/787) of their mothers had a lower temperature (range À6.7 to 0.11C, mean difference 0.4±1.21C). Acceptance of STSC was nearly universal. No adverse events from STSC were reported. STSC was perceived to prevent newborn hypothermia, enhance mother's capability to protect her baby from evil spirits, and make the baby more content. Conclusion: STSC was highly acceptable in rural India when introduced through appropriate cultural paradigms. STSC may be of benefit for all newborns and for many mothers as well. New approaches are needed for introduction of STSC in the community compared to the hospital.

Objectifs.-Comparer l'évolution pondérale et la mortalité des enfants de petit poids de naissance (PPN) par rapport à ceux de poids normal (PN). Méthodes.-Cent cinquante-cinq enfants de PPN (< 2500 g) nés à terme et 280 enfants de PN ont été recrutés de manière rétrospective dans un district rural du Burkina. Des données relatives à l'évolution pondérale, à la mortalité, aux antécédents de la mère et aux caractéristiques socioéconomiques des ménages ont été récoltées. Résultats.-L'écart de poids entre les PPN et les PN s'est réduit graduellement à partir du troisième mois pour devenir non significatif à huit mois (p = 0,213). Le PPN était un des principaux facteurs prédictifs d'un bon gain pondéral à sept mois (b = 64,072 ; p = 0,013) de même que l'indice de masse corporelle (IMC) élevé de la mère et un nombre de consultations prénatales plus important. L'analphabétisme maternel et une grande parité étaient des facteurs préjudiciables à un bon gain de poids. Le risque de décès des PPN, avant un an, était très élevé par rapport aux PN (RR = 4,53 ; p = 0,005). Les PPN avaient un meilleur gain pondéral à partir de trois mois que les PN. Ils avaient néanmoins un risque accru de mortalité avant l'âge d'un an. Conclusion.-Nos résultats suggèrent l'intérêt d'identifier précocement les PPN n'ayant pas un potentiel spontané de croissance, de promouvoir un statut nutritionnel adéquat chez les femmes, ainsi que leur instruction.

Objectives: While the importance of exploring and better measuring elements of prenatal care have been noted in the public health literature, the components and timing of such services have been poorly examined for the overall pregnant population and specifically for African-Americans, who traditionally have had higher rates of low birth weight and premature delivery. This study explores the association between patient receipt of selected recommended prenatal care interventions and infant birth weight in a nationally representative sample of African-American women, while controlling for the influence of low birth weight risk indicators. Method: This is a retrospective case-control analysis using survey data of women who delivered normal birth weight, moderate low birth weight, and very low birth weight newborns in 1988. A sample of 3905 African-American women who responded to the 1988 National Maternal and Infant Health Survey is examined based on maternal recall of receipt of six clinical screening procedures and seven health-promotion recommendations. Birth weight measures were obtained from linked 1988 birth certificate data. Results: The initial results indicated that women who do not receive all of the recommended health-promotion advice are more likely to deliver very low birth weight infants than women who receive all of the advice in the content of their prenatal care, after controlling for low birth weight risks (OR = 1.28; 95% CI = 1.01, 1.7). However, when breast-feeding advice is removed from the aggregation of health-promotion advice, the significant effect of advice on very low birth weight is negated. No other significant group variations in the receipt of clinical screening procedures or health-promotion advice for women who gave birth in the remaining birth weight categories are observed. Conclusions: Nationally recommended initial clinical screening procedures and health-promotion advice in prenatal care content do not appear to be associated with a reduction in low birth weight for African-American women. More research is needed to better assess the impact of other antenatal interventions, particularly those given to women with a higher prevalence of poor birth outcomes.

Background: The policy to provide oral polio vaccine (OPV) at birth was introduced in low-income countries to increase coverage. The effect of OPV at birth on overall child mortality was never studied. During a trial of vitamin A supplementation (VAS) at birth in Guinea-Bissau, OPV was not available during several periods. We took advantage of this ''natural experiment'' to test the effect on mortality of receiving OPV at birth. Methodology: Between 2002 and 2004, the VAS trial randomised normal-birth-weight infants to 50,000 IU VAS or placebo administered with BCG. Provision of OPV at birth was not part of the trial, but we noted whether the infants received OPV or not. OPV was missing during several periods in 2004. We used Cox proportional hazards models to compute mortality rate ratios (MRR) of children who had received or not received OPV at birth.

In mammals fertilization triggers a series of Ca 2+ oscillations that not only are essential for events of egg activation but also stimulate oxidative phosphorylation. Little is known, however, about the relationship between quantitative changes in egg metabolism and specific long-term effects in offspring. This study assessed whether post-natal growth is modulated by early transient changes in NAD(P)H and FAD 2+ in zygotes. We report that experimentally manipulating the redox potential of fertilized eggs during the pronuclear (PN) stage affects post-natal body weight. Exogenous pyruvate induces NAD(P)H oxidation and stimulates mitochondrial activity with resulting offspring that are persistently and significantly smaller than controls. Exogenous lactate stimulates NAD + reduction and impairs mitochondrial activity, and produces offspring that are smaller than controls at weaning but catch up after weaning. Cytosolic alkalization increases NAD(P) + reduction and offspring of normal birth-weight become significantly and persistently larger than controls. These results constitute the first report that post-natal growth rate is ultimately linked to modulation of NAD(P)H and FAD 2+ concentration as early as the PN stage.

A prospective study was conducted at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, between 3 January and 31May 2004, to compare the accuracy of clinical and ultrasonographic estimation of foetal weight at term. One hundred pregnant women who fulfilled the inclusion criteria had their foetal weight estimated independently using clinical and ultrasonographic methods. Accuracy was determined by percentage error, absolute percentage error, and proportion of estimates within 10% of actual birthweight (birthweight of +10%). Statistical analysis was done using the paired t-test, the Wilcoxon signed-rank test, and the chi-square test. The study sample had an actual average birthweight of 3,255+622 (range 2,150–4,950) g. Overall, the clinical method overestimated birthweight, while ultrasound underestimated it. The mean absolute percentage error of the clinical method was smaller than that of the sonographic method, and the number of estimates within 10% of actual b...

Several cardiovascular diseases (CVD) observed in adulthood have been associated with environmental influences during fetal growth. Here, we show that maternal exposure to cadmium, a ubiquitously distributed heavy metal and main component of cigarette smoke is able to induce cardiovascular morpho-functional changes in the offspring at adult age. Heart morphology and vascular reactivity were evaluated in the adult offspring of rats exposed to 30 ppm of cadmium during pregnancy. Echocardiographic examination shows altered heart morphology characterized by a concentric left ventricular hypertrophy. Also, we observed a reduced endothelium-dependent reactivity in isolated aortic rings of adult offspring, while endotheliumindependent reactivity remained unaltered. These effects were associated with an increase of hem-oxygenase 1 (HO-1) expression in the aortas of adult offspring. The expression of HO-1 was higher in females than males, a finding likely related to the sex-dependent expression of the vascular cell adhesion molecule 1 (VCAM-1), which was lower in the adult female. All these long-term consequences were observed along with normal birth weights and absence of detectable levels of cadmium in fetal and adult tissues of the offspring. In placental tissues however, cadmium levels were detected and correlated with increased NF-κB expressiona transcription factor sensitive to inflammation and oxidative stresssuggesting a placentary mechanism that affect genes related to the development of the cardiovascular system. Our results provide, for the first time, direct experimental evidence supporting that exposure to cadmium during pregnancy reprograms cardiovascular development of the offspring which in turn may conduce to a long term increased risk of CVD.

Objective: Two-thirds of women globally give birth at home, yet little data are available on use of skin-to-skin care (STSC) in the community. We describe the acceptability of STSC in rural Uttar Pradesh, India, and measured maternal, newborn, and ambient temperature in the home in order to inform strategies for introduction of STSC in the community. Study design: Community-based workers in intervention clusters implemented a community mobilization and behavior change communication program that promoted birth preparedness and essential newborn care, including adoption of STSC, with pregnant mothers, their families, and key influential community members. Acceptance of STSC was assessed through in-depth interviews and focus groups, and temperature was measured during home visits on day of life 0 or 1. Results: Incidence of hypothermia (<36.51C) was high in both low birth weight (LBW) and normal birth weight (NBW) infants (49.2%, (361/733) and 43% (418/971), respectively). Mean body temperature of newborns was lower (P<0.01) in ambient temperatures <201C (35.9±1.41C, n ¼ 225) compared to X201C (36.5±0.91C, n ¼ 1450). Among hypothermic newborns, 42% (331/787) of their mothers had a lower temperature (range À6.7 to 0.11C, mean difference 0.4±1.21C). Acceptance of STSC was nearly universal. No adverse events from STSC were reported. STSC was perceived to prevent newborn hypothermia, enhance mother's capability to protect her baby from evil spirits, and make the baby more content. Conclusion: STSC was highly acceptable in rural India when introduced through appropriate cultural paradigms. STSC may be of benefit for all newborns and for many mothers as well. New approaches are needed for introduction of STSC in the community compared to the hospital.

Background: Hypospadias is a congenital displacement of the urethral meatus in male newborns, being either an isolated defect at birth or a sign of sexual development disorders. The aim of this study was to assess the prevalence rate of hypospadias in different Districts of Italy, in order to make a comparison with other countries all over the world. Methods: We reviewed all the newborns file records (years 2001-2004) in 15 Italian Hospitals. Results: We found an overall hypospadias prevalence rate of 3.066 ± 0.99 per 1000 live births (82.48% mild hypospadias, 17.52% moderate-severe). In newborns Small for Gestational Age (birthweight < 10 th percentile) of any gestational age the prevalence rate of hypospadias was 6.25 per 1000 live births. Performing multivariate logistic regression analysis for different degrees of hypospadias according to severity, being born SGA remained the only risk factor for moderatesevere hypospadias (p = 0.00898) but not for mild forms (p > 0.1).