Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC). The prevalence of both in pediatric populations has been constantly increasing. This study aimed to analyze the diet of adolescent patients with IBD in comparison to healthy controls and the current dietary standards for the Polish population to further their optimal supplementation regimen. The study group consisted of 53 patients (21 girls and 32 boys) with IBD (CD: n = 27; UC: n = 26) at a mean age of 15.4 ± 2.4 and 14.7 ± 2.2, years for girls and boys, respectively. The control group (CG) consisted of 20 patients, and 72 h of recall diaries on nutrition were collected. The nutritional data were analyzed in the Dieta 6D dietary program. When compared to Polish dietary standards, the largest differences girls with IBD and boys with IBD were found for the intake of energy (61.9 and 71.9%), iodine (61.9 and 62.6%), folates (76.2 and 87.5%), vitamin D (100 and 96.9%), potassium (61.9 and 59.4%), and calcium (85.7 and 93.8%). The overconsumption of saturated fatty acids (SFA) (61.9 and 56.3%) and sodium (76.2 and 90.6%) in girls and boys, respectively, was noted. In relation to girls with CG, girls with IBD showed a significantly higher intake of energy (1751. 3 vs. 1558.6 p = 0.0224), total protein (71.3 vs. 56.2 p = 0.0217), animal protein (47.8 vs. 34.5 p = 0.0183), total carbohydrates (237.3 vs. 196.1 p = 0.0442), and assimilable carbohydrates (219.8 vs. 180.5 p = 0.7921). Boys in the CG consumed significantly more calcium (851.8 vs. 432 p = 0.0006), phosphorus (1024.3 vs. 1357.5 p = 0.0431), lactose (11.6 vs. 6.1 p = 0.0016), and riboflavin (1.7 vs. 1.3 p = 0.0123) compared to boys with IBD. Dietician care should therefore be mandatorily provided alongside outpatient care. Based on our results, we suggest that supplementation with the selected components be considered.

Background: The intestinal microbiota of pregnant women and factors disturbing the microbial balance of their gastrointestinal tract during the perinatal period may be the cause of dysbiosis and thus intestinal permeability syndrome in their children. The purpose of this study was to analyze the implications of intestinal permeability parameters in the stools of newborns and infants with perinatal risk factors for intestinal colonization disorders (the route of delivery, antibiotic therapy in the neonatal period and the abandonment of breastfeeding). Methods: The study included 100 mother–child pairs. All children were born from uncomplicated and term pregnancies (between 37 and 42 weeks of gestation). In order to determine the parameters of dysbiosis and intestinal permeability, we determined the concentrations of zonulin and occludin in stool samples taken from all children at 0 (i.e., at birth), 3, 6 and 12 months of age. Elevated levels of lipopolysaccharide (LPS) are associated with metabolic diseases and its presence may be indicative of TJ injury and the onset of leaky gut syndrome. To indirectly determine the presence of endotoxemia, the concentrations of lipopolysaccharide were also measured in stool samples taken from all children at 0, 3, 6 and 12 months of age. We analyzed the relationship between the markers studied and perinatal risk factors for impaired intestinal colonization, including the mode of delivery, the method of feeding, and a family history of allergy. Results: During the first 3 months of infant life, higher concentrations of fecal occludin and zonulin were most often accompanied by higher values of fecal LPS. Similarly, higher concentrations of zonulin were accompanied by higher values of occludin. There were no significant differences in the stool concentrations of the studied markers during the first year of life between children born by caesarean section and those born naturally. In addition, the method of feeding had no significant effect on the changes in the concentrations of the determined fractions. Antibiotic therapy was associated only with an increase in the fecal occludin concentration after birth, without any effect on zonulin, occludin or LPS levels. The use of probiotic therapy in infants resulted in a decrease in only LPS concentrations at 3 months of age, with no effect on zonulin or occludin concentrations at 0, 6 and 12 months. Conclusions: Perinatal factors related to intestinal permeability are important during the first 3 months of infant life. However, we found that the mode of delivery had no influence on the parameters of infant intestinal leakage during the first year of life. In addition, the mode of infant feeding—breast or exclusively formula—did not significantly affect the changes in the concentrations of LPS, zonulin or occludin in the stools of children. A short-term increase in occludin concentrations after delivery in the stools of children from mothers undergoing antibiotic therapy indicates a negative but reversible influence of intrapartum antibiotics on the intestinal integrity of children in the perinatal period. Probiotic therapy seems to have a positive effect on reducing endotoxemia in children during the first 3 months of life. The presence of LPS at 3 months did not affect intestinal tightness at any of the later measured periods of the infants’ lives.

This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Ginekologia Polska" are listed in PubMed.

Background: Neonatal lupus erythematosus (NLE) is an uncommon autoimmune disease caused by transplacental passage of maternal antibodies. The aim of the study was to investigate whether antinuclear antibodies (ANA) detected in newborns of mothers with systemic connective tissue disease (SCTD) are present after 6 months of age, and whether they are accompanied by clinical symptoms, the so-called NLE. Material and methods: A prospective pilot study was conducted in a group of 20 full-term newborns (11 males and 9 females) consequently born to mothers with SCTD and 6 newborns (3 males and 3 females) of mothers without autoimmune disease. The infants were examined for symptoms of NLE. The ANA profile was evaluated in newborns and repeated at the age of 7 months by using the indirect immunofluorescence technique. Results: ANA was detected in 16/20 newborns from the study group in titre 1 : 40 to 1 : 2560 and in 4/6 newborns from the control group in titre 1 : 40 to 1 : 320, as well as in 9 of 19 7-months-old babies of SCTD mothers. There were no skin lesions, and elevated liver enzymes were found in 8 newborns and haematological changes in 7 newborns. No pathological changes were found in the ECG examination in the neonatal period in any of the children. Conclusions: Maternal ANAs are detected in newborns and in 7-month-old babies. Despite 80% of ANA detection in the neonatal period of infants of SCTD mothers and 47% detection in 7-month-old babies, there were no evident symptoms of NLE besides some elevated levels of liver enzymes and haematological changes.

Introduction: Not only late-preterm newborns but also those born as near-term are at increased risk of complications in the first hours of postnatal adaptation. Aim of the study: The aim of the retrospective study was to compare the postnatal status and adaptation disorders in neonates born with elective caesarean section at 36, 37, 38, and 39 weeks of pregnancy in a level-three perinatal care department. Material and methods: The research was carried out in a group of 200 newborns born in one year, 2015, and hospitalised from birth in the Department of Neonatology, Pomeranian Medical University in Szczecin. Postnatal status and occurrence of complications during the adaptation period were compared. The obtained results were compared between subgroups using appropriate statistical analysis methods. Results: In the group of newborns born in weeks 36 and 37 of pregnancy, significantly lower (p < 0.00001, p < 0.0002) birthweight (2688 g, 3208 g vs. 3524 g), lower Apgar score in the first and fifth minute of life (Me 9, 10 vs. 10; p < 0.00001, p < 0.05), and lower frequency of breastfeeding from birth (p < 0.0001, p < 0.002) were found in comparison to those born in the 39 th week of pregnancy (22%, 70% vs. 94%). In addition, the tendency for hypothermia was significantly more frequently (p < 0.001, p < 0.02) observed (36%, 26% vs. 8%), these newborns were more often required to stay in the observation room (80%, 28% vs. 8%; p < 0.0001, p < 0.01) and in the incubator (74%, 26% vs. 8%; p < 0.0001, p < 0.02), and significantly more often demonstrated symptoms of respiratory failure (48%, 18% vs. 4%; p < 0.0001, p < 0.05). The length of hospitalisation was also significantly longer (7.18, 5.42 vs. 4.46 days; p < 0.0002, p < 0.05). Conclusions: Due to the high risk of complications during the adaptation period, especially from the respiratory system, an elective caesarean section performed before the 38 th week of pregnancy is not an optimal solution for the newborn, unless there are important medical indications for such a termination of pregnancy. The most optimal term for elective caesarean section from the point of view of the newborn's interests is the 38 th or 39 th week of pregnancy.