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Extrauterine growth restriction

Kari Bonnar, Debbie Fraser
Extrauterine growth restriction (EUGR) affects a significant number of very low birth weight (VLBW) infants and has the potential to impact neurodevelopmental outcome as well as other aspects of long-term health. More aggressive nutritional approaches have reduced the incidence of postnatal growth failure but many questions remain about the expected rate of growth for very preterm infants, the best ways to measure growth velocity, and the optimal approaches to supporting growth. This article examines some of the outstanding issues regarding postnatal growth failure and summarizes current practice recommendations...
January 2019: Neonatal Network: NN
Maj Cory J Darrow, Hong Li, Allison Prince, Jacquelyn McClary, Michele C Walsh
OBJECTIVE: Poor extrauterine growth in very low birth weight (VLBW) neonates is common and associated with worsened long-term outcomes. We aimed to decrease growth restriction, measured by the change in weight z-score from birth to 36 weeks post menstrual age, from - 1.13 (baseline) to < -1 within 12 months. STUDY DESIGN: The Model for Improvement was used in the design and implementation of an optimized, standardized parenteral nutrition protocol. Three Plan-Do-Study-Act cycles were completed and a [Formula: see text] and S control chart was created for the primary outcome...
December 7, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Lianlian Wang, Ting-Li Han, Xiaofang Luo, Siming Li, Tim Young, Chang Chen, Li Wen, Ping Xu, Yangxi Zheng, Richard Saffery, Philip N Baker, Chao Tong, Hongbo Qi
The selective intrauterine growth restriction (sIUGR) of monochorionic diamniotic (MCDC) twins causes phenotypic growth discordance, which is correlated with metabolomic pertubations. A global, untargeted identification of the metabolic fingerprint may help elucidate the etiology of sIUGR. Umbilical cord blood and placentas collected from 15 pairs of sIUGR monochorionic twins, 24 pairs of uncomplicated twins, and 14 singletons diagnosed with intrauterine growth restriction (IUGR) were subjected to gas chromatography-mass spectrometry based metabolomic analyses...
October 29, 2018: Scientific Reports
Konstantinos Nirgianakis, Maria Luisa Gasparri, Anda-Petronela Radan, Anna Villiger, Brett McKinnon, Beatrice Mosimann, Andrea Papadia, Michael D Mueller
OBJECTIVE: To study obstetric outcomes and complications in women with previously excised posterior deep infiltrating endometriosis (DIE) in comparison with women without endometriosis. DESIGN: Matched case-control study. SETTING: Tertiary-level academic center. PATIENT(S): All surgeries for endometriosis performed in the Department of Gynecology and Gynecological Oncology, University of Bern between March 2004 and July 2015, were assessed...
August 2018: Fertility and Sterility
S Zullino, F Buzzella, T Simoncini
Nitric oxide (NO) is a key regulator of both maternal and fetal homeostasis during pregnancy, facilitating the maternal cardio-vascular changes, fetal development and growth and adaptation to extrauterine life. Dysfunction of the NO system during pregnancy is associated to placental and vascular-related diseases such as hypertensive disorders of pregnancy (HDP) and intrauterine growth restriction (IUGR). Emerging therapeutic strategies involving NO precursors, NO donors, natural derivatives or pharmacological modulators of the NO system seem hold promise for the treatment of such conditions of pregnancy...
November 2018: Vascular Pharmacology
Pedro C Marques, Gustavo Rocha, Filipa Flor-De-Lima, Hercília Guimarães
BACKGROUND: Extrauterine growth restriction (EUGR) remains a serious problem among very low birth weight (VLBW) infants and is a marker of severe nutritional deficit during the first weeks of life. It can lead to a higher risk of growth impairment during childhood and long-term medical problems. The aim of this study is to determine the prevalence and risk factors of EUGR in preterm infants below 1500 grams. METHODS: Descriptive retrospective study of all preterm infants with birth weight below 1500 grams who were born at and discharged from our center, from January 1, 2012 to December 31, 2016...
July 23, 2018: Minerva Pediatrica
Toshimitsu Takayanagi, Akinori Shichijo, Masakazu Egashira, Tomoko Egashira, Tomoko Mizukami
AIM: The effect that intrauterine or extrauterine growth restriction (EUGR) had on the build of very low birthweight (VLBW) infants was investigated before Japanese children started school. METHOD: Between 2005 and 2017, the National Hospital Organization, Saga, Japan, carried out preschool checks on 322 children born with a VLBW at approximately six years of age. Growth restriction was defined as being born small for gestational age (SGA) or EUGR if they were born at term...
June 4, 2018: Acta Paediatrica
D Darmaun, A Lapillonne, U Simeoni, J-C Picaud, J-C Rozé, E Saliba, A Bocquet, J-P Chouraqui, C Dupont, F Feillet, M-L Frelut, J-P Girardet, D Turck, A Briend
Due to transient gut immaturity, most very preterm infants receive parenteral nutrition (PN) in the first few weeks of life. Yet providing enough protein and energy to sustain optimal growth in such infants remains a challenge. Extrauterine growth restriction is frequently observed in very preterm infants at the time of discharge from hospital, and has been found to be associated with later impaired neurodevelopment. A few recent randomized trials suggest that intensified PN can improve early growth; whether or not such early PN improves long-term neurological outcome is still unclear...
May 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Alejandro Avila-Alvarez, Alfonso Solar Boga, Carmen Bermúdez-Hormigo, Jesús Fuentes Carballal
INTRODUCTION: Growth restriction in preterm infants has been related to a poor neurodevelopment outcome. OBJECTIVES: To define the incidence of postnatal growth restriction in premature babies ≤1,500 grams and to detect related clinical or biochemical markers. METHODS: Retrospective longitudinal observational study. Multivariate linear regression models were used to determine variables that can predict the change in weight z-score during admission...
April 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Yu Wang, Lingling Yan, Ziming Zhang, Eric Prado, Linchen Fu, Xuefeng Xu, Lizhong Du
Recent advances in epigenetics have made a tremendous impact on our knowledge of biological phenomena and the environmental stressors on complex diseases. Understanding the mechanism of epigenetic reprogramming during the occurrence of pulmonary hypertension (PH) is important for advanced studies and clinical therapy. In this article, we review the discovery of novel epigenetic mechanisms associated with PH including DNA methylation, histone modification, and noncoding RNA interference. In addition, we highlight the role of epigenetic mechanisms in adult PAH resulting from undesirable perinatal environments-Extrauterine growth restriction (EUGR) and Intrauterine growth retardation (IUGR)...
2018: Frontiers in Pharmacology
Michelle C Starr, Sangeeta R Hingorani
PURPOSE OF REVIEW: The purpose of this review is to describe the role prematurity plays in the development of chronic kidney disease (CKD) and to discuss potential reasons for this association including decreased nephron mass, as well as postnatal insults such as neonatal acute kidney injury (nAKI). RECENT FINDINGS: New observational studies in humans and experimental studies in animal models have strengthened the association between prematurity, low birth weight and CKD...
April 2018: Current Opinion in Pediatrics
Augusto Biasini, Fiorella Monti, Maria Chiara Laguardia, Marcello Stella, Lucia Marvulli, Erica Neri
BACKGROUND AND AIM OF THE STUDY: Extrauterine growth restriction and failure to thrive remain a major problem in Extremely Low Birth Weight infants. Nutritional support in preterm babies has the objective to improve the achieve rate of growth similar to those of the fetus in utero at the equivalent gestational age. The aim of the study was to evaluate feeding tolerance, intrahospital growth, neurological outcome and anthropometric data until 24 months of corrected age (mca) from different protein intake assumed by preterm babies <1250 g during their stay in NICU...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
Luciana Rodriguez-Guerineau, Miriam Perez-Cruz, María D Gomez Roig, Francisco J Cambra, Juan Carretero, Fredy Prada, Olga Gómez, Fátima Crispi, Joaquim Bartrons
Introduction The adaptive changes of the foetal heart in intrauterine growth restriction can persist postnatally. Data regarding its consequences for early circulatory adaptation to extrauterine life are scarce. The aim of this study was to assess cardiac morphometry and function in newborns with late-onset intrauterine growth restriction to test the hypothesis that intrauterine growth restriction causes cardiac shape and functional changes at birth. METHODS: A comprehensive echocardiographic study was performed in 25 neonates with intrauterine growth restriction and 25 adequate-for-gestational-age neonates...
February 2018: Cardiology in the Young
Briar L McKenzie, Liza Edmonds, Ruth Thomson, Jillian J Haszard, Lisa A Houghton
Premature infants are at high risk of undernutrition and extrauterine growth restriction. AIM: The aim of the study was to evaluate the relation between nutrition practices and growth rate in preterm infants from birth to 36 weeks postmenstrual age (PMA). METHODS: Longitudinal data were collected retrospectively in 103 infants born <33 weeks gestation admitted to Dunedin Neonatal Intensive Care Unit, New Zealand. Weight, length, and head circumference at birth and 36 weeks PMA z scores were calculated using the INTERGROWTH Preterm Growth Standard...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
A-S Pages, O Tandonnet, L Renesme
INTRODUCTION: Extrauterine growth restriction is associated with long-term effects on growth and neurodevelopmental outcomes in preterm infants. The objective of this study was to evaluate the effects of a change in nutritional policy on the postnatal growth of premature infants. METHOD: Prospective observational study carried out between 01/01/14 and 31/12/14 in all newborns under 33 weeks GA admitted to the Bordeaux University Hospital after modification of the nutrition policy at the beginning of January 2014...
October 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Ruud R G Bueters, Annelies Jeronimus-Klaasen, Roger J M Brüggemann, Lambertus P van den Heuvel, Michiel F Schreuder
BACKGROUND: Up to two-thirds of premature born neonates are treated for infections with aminoglycosides such as gentamicin. Although acute toxicities are well described, there is uncertainty on developmental changes after treatment of premature born neonates. We studied the effect of gentamicin and ceftazidime on kidney development in the rat. Additionally, we evaluated the modulating effect of extrauterine growth restriction. METHODS: On postnatal day (PND) 2, Wistar rats were cross-fostered into normal sized litters (12 pups) or large litters (20 pups) to create normal food (NF) or food restricted (FR) litters to simulate growth restriction and dosed daily intraperitoneally with placebo, 4 mg/kg of gentamicin or 50 mg/kg ceftazidime until PND 8...
September 1, 2017: Birth Defects Research
Giulia Genoni, Marco Binotti, Alice Monzani, Elena Bernascone, Ilaria Stasi, Gianni Bona, Federica Ferrero
AIM: This study evaluated whether an early aggressive nutrition (EAN) strategy could limit extrauterine growth restriction (EUGR) in a cohort of preterm infants. METHODS: This prospective nonrandomised interventional study was carried out in the neonatal intensive care unit of an Italian hospital from January 2013 to December 2015. The prevalence of EUGR was assessed in 100 infants with a gestational age of ≤34 weeks, 50 after the introduction of an EAN regimen in October 2014 and 50 before...
October 2017: Acta Paediatrica
Funda Tuzun, Ebru Yucesoy, Bora Baysal, Abdullah Kumral, Nuray Duman, Hasan Ozkan
AIM: This study aimed to compare the recently published prescriptive INTERGROWTH-21st standards with commonly used intrauterine based Fenton growth standards in terms of birth size classification and extrauterine growth restriction (EUGR) incidence in a sample of very preterm infants. METHODS: The anthropometric measures of preterm infants born before 32 weeks of gestation at the Dokuz Eylul University Hospital during the period from January 2012 to February 2016 were obtained at birth, at the 36th gestational weeks or at the time of discharge...
September 2018: Journal of Maternal-fetal & Neonatal Medicine
Danielle L Morton, Keli M Hawthorne, Carolyn E Moore
Objective. Infants with intestinal failure or feeding intolerance are nutritionally compromised and are at risk for extrauterine growth restriction. The aim of the study was to evaluate growth velocities of infants with intestinal failure and feeding intolerance for the first three months of age and to determine growth percentiles at birth and at 40-week postmenstrual age (PMA). Methods. A chart review of infants followed by the Texas Children's Hospital Intestinal Rehabilitation Team was conducted from April 2012 to October 2014...
2017: Journal of Nutrition and Metabolism
Tanis R Fenton, Hilton T Chan, Aiswarya Madhu, Ian J Griffin, Angela Hoyos, Ekhard E Ziegler, Sharon Groh-Wargo, Susan J Carlson, Thibault Senterre, Diane Anderson, Richard A Ehrenkranz
CONTEXT: Clinicians assess the growth of preterm infants and compare growth velocity using a variety of methods. OBJECTIVE: We determined the numerical methods used to describe weight, length, and head circumference growth velocity in preterm infants; these methods include grams/kilogram/day (g/kg/d), grams/day (g/d), centimeters/week (cm/week), and change in z scores. DATA SOURCES: A search was conducted in April 2015 of the Medline database by using PubMed for studies that measured growth as a main outcome in preterm neonates between birth and hospital discharge and/or 40 weeks' postmenstrual age...
March 2017: Pediatrics
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