Increased Morbidity in Severe Early Intrauterine Growth Restriction

Aucott, Susan W.; Donohue, Pamela; Northington, Frances J.

doi:10.1038/sj.jp.7211116

Cited by 153 publications

(116 citation statements)

References 36 publications

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“…2.1.1 Intra-uterine growth restriction and susceptibility to infection and disease Low-birth-weight piglets in litters with high variation in birth weights experience intra-uterine growth restriction (IUGR), usually resulting in physiological dysfunctions and an increase in neonatal morbidity and mortality (Wootton et al, 1983;Aucott et al, 2004). In addition, IUGR neonates are more susceptible to infection or environmental changes due to an ineffective immune system (Cromi et al, 2009;Zhong et al, 2012), and IUGR animals have abnormal differences in size and histopathology of the thymus (Cromi et al, 2009).…”

Section: Pre-weaning Mortalitymentioning

confidence: 99%

Within-litter variation in birth weight: impact of nutritional status in the sow

Yuan

Zhu

Shi

et al. 2015

J. Zhejiang Univ. Sci. B

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Accompanying the beneficial improvement in litter size from genetic selection for high-prolificacy sows, within-litter variation in birth weight has increased with detrimental effects on post-natal growth and survival due to an increase in the proportion of piglets with low birth-weight. Causes of within-litter variation in birth weight include breed characteristics that affect uterine space, ovulation rate, degree of maturation of oocytes, duration of time required for ovulation, interval between ovulation and fertilization, uterine capacity for implantation and placentation, size and efficiency of placental transport of nutrients, communication between conceptus/fetus and maternal systems, as well as nutritional status and environmental influences during gestation. Because these factors contribute to within-litter variation in birth weight, nutritional status of the sow to improve fetal-placental development must focus on the following three important stages in the reproductive cycle: pre-mating or weaning to estrus, early gestation and late gestation. The goal is to increase the homogeneity of development of oocytes and conceptuses, decrease variations in conceptus development during implantation and placentation, and improve birth weights of newborn piglets. Though some progress has been made in nutritional regulation of within-litter variation in the birth weight of piglets, additional studies, with a focus on and insights into molecular mechanisms of reproductive physiology from the aspects of maternal growth and offspring development, as well as their regulation by nutrients provided to the sow, are urgently needed.

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Section: Pre-weaning Mortalitymentioning

confidence: 99%

Within-litter variation in birth weight: impact of nutritional status in the sow

Yuan

Zhu

Shi

et al. 2015

J. Zhejiang Univ. Sci. B

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“…Intrauterine growth delay appears in second place with 14% of all the stillborn and 6% of all the neonatal deaths 4. Recent studies concerning the influence of intrauterine gro w t h restriction (IUGR) in morbidity and mortality of p re t e rmnewborns have observed that each marker of IUGR was associated with increased mort a l ity and more adverse outcome [5][6][7][8] . A c c o rding to Lubchenco the importance of b i rt h weight and gestational age in the prognosis of n e w b o rnbabies is justified for the important ro l e that both re p resent in the maturation of many systems in preterm infants 9 .…”

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confidence: 99%

The influence of gestational age and birth weight in the clinical assesment of the muscle tone of healthy term and preterm newborns

Silva

Nunes

2005

Arq. Neuro-Psiquiatr.

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-Objective: To evaluate the influence of gestational age (GA) and birth weight (BW) in the clinical assessment of the muscle tone of healthy term and pre t e rm newborn s . Method: C ross sectional study. The muscle tone of healthy 42 pre t e rm and 47 term newborns was quantified and measured with a goniometer (an instrument for measuring angles) respectively between 7 th -14 th day of life and 24-48 hours of life. Newborns were grouped according to GA and BW and evaluated at fixed time intervals by one examiner. P re t e rmnewborns were matched to term at 40 weeks postconceptional age (PCA). Results: The evolution of muscle tone in the pre t e rm occurred gradually, following PCA, independent of birth weight. Pre t e rm n e w b o rns had lower scores in all muscle tone indicators when compared to term at the first assessment. D i ff e rences were observed among pre t e rm small for GA and adequate to GA for the indicator heel to ear (p<0.001). When compared at 40 weeks PCA, except for posture, all other indicators were significantly diff e rent (p< 0.001) among gro u p s . Conclusion: P rematurity and intrauterine malnutrition are influential factors in some indicators of the newborn muscle tone state. Muscle tone assessment of pre t e rm infants does not seem to be influenced by birth weight, however evolution is clearly related to postconceptional age. When we compared term newborns AGA and SGA it seems to have a clear influence of the birt h weight on some indicators of the muscle tone. The use of devices such as the goniometer allows the perf o rmance of a more objective assessment of muscle tone and helps to quantify findings.KEY WORDS: preterm newborns, muscle tone, low birth weight, intrauterine malnutrition.A influência da idade gestacional e do peso ao nascimento na avaliação clínica do tono muscular de recém nascidos a termo e prematuros hígidos RESUMO -O b j e t i v o :Verificar a i n f l u ê n c i a da idade gestacional (IG) e do peso ao nascimento (PN) na avaliação do tono muscular de recém nascidos (RN) a termo e pre m a t u ros hígidos. Método: Estudo transvers a l . O tono muscular de 42 RN pre m a t u ros e 47 termo foi quantificado e mensurado com goniômetro (instru m e nto para medir ângulos), respectivamente entre 7-14 dias de vida e 24-48 horas de vida. Os RN foram agru p ados de acordo com IG e PN, sendo avaliados em intervalos fixos. RN prematuros foram comparados aos a t e rmo na 40ª semana de idade concepcional (IC). Resultados: A evolução do tono muscular nos RN pre m at u ros ocorreu de forma gradual de acordo com IC e independente do PN. RN pre m a t u ros, na primeira avaliação apresentaram escores de tono muscular inferiores aos de RN a termo em todos os indicadore s . Foram observadas diferenças entre RN pre m a t u ros pequenos e adequados para a IG em relação ao indicador calcanhar-o relha (p<0,001). O pareamento dos grupos na 40ª semana de IC mostra, exceto pela postura, diferença significativa entre os grupos (p< 0,001) nos demais indicadores. Conclusão: A prematurid...

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“…Several other studies have researched this question as well and suggest that bleeding risk is not increased in SGA neonates, but most of these studies were also performed in small sample sizes. [13,20,28] The fact that most neonates with major IVH did not have severe thrombocytopenia should not be surprising, since multiple studies have shown that the correlation between thrombocytopenia and bleeding risk is far from clear. [1,6,29,30] Thirdly, we did not record platelet counts after the first 3 days of life, because we focused on early onset thrombocytopenia and prenatal risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings show that the incidence of thrombocytopenia is 2.7 times higher in SGA neonates compared to a group of AGA neonates matched for gestational age at birth, which is in agreement several other studies. [2,3,7,14,20] The strength of this study, besides being one of the largest studies on early onset thrombocytopenia in SGA neonates, is the study design with a control group matched for gestational age at birth. Matching for gestational age allowed for a more accurate comparison between the two groups (SGA and AGA) by eliminating the important confounding effect of prematurity.…”

Section: Discussionmentioning

confidence: 99%

Early-Onset Thrombocytopenia in Small-for-Gestational-Age Neonates: A Retrospective Cohort Study

et al. 2016

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Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to identify risk factors for thrombocytopenia. We performed a retrospective cohort study of all consecutive SGA neonates admitted to our ward and a control group of appropriate for gestational age (AGA) neonates matched for gestational age at birth. Main outcome measures were incidence and severity of thrombocytopenia, hematological and clinical risk factors for thrombocytopenia, and bleeding. A total of 330 SGA and 330 AGA neonates were included, with a mean gestational age at birth of 32.9 ± 4 weeks. Thrombocytopenia (<150x10 were not recorded. Within the SGA group, lower gestational age at birth (p = <0.01) and erythroblastosis (p<0.01) were independently associated with a decrease in platelet count. Platelet count was positively correlated with birth weight centiles. In conclusion, early-onset thrombocytopenia is present in over 50% of SGA neonates and occurs 2.7 times as often as in AGA neonates. Thrombocytopenia is seldom severe and is independently associated with lower gestational age at birth and erythroblastosis.

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Increased Morbidity in Severe Early Intrauterine Growth Restriction

Cited by 153 publications

References 36 publications

Within-litter variation in birth weight: impact of nutritional status in the sow

Within-litter variation in birth weight: impact of nutritional status in the sow

The influence of gestational age and birth weight in the clinical assesment of the muscle tone of healthy term and preterm newborns

Early-Onset Thrombocytopenia in Small-for-Gestational-Age Neonates: A Retrospective Cohort Study

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