Is body fat percentage a better measure of undernutrition in newborns than birth weight percentiles?

Carberry, Angela E.; Raynes‐Greenow, Camille; Turner, Robin; Askie, Lisa; Jeffery, Heather

doi:10.1038/pr.2013.156

Cited by 41 publications

(58 citation statements)

References 36 publications

(44 reference statements)

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“…This may be attributed to specific staff education targeting GDM mothers as part of the Baby Friendly Hospital Initiative at RPAH. Early initiation of breast feeding within the first hour after birth is associated with fewer feeding problems and longer duration of breast feeding which is important for long term outcomes for GDM infants (WHO and UNICEF, 2009;Carberry et al, 2013aCarberry et al, , 2013b.…”

Section: Discussionmentioning

confidence: 99%

“…RPAH is a major public teaching hospital in Sydney, Australia, with a predominantly inner urban, multicultural population and 45000 deliveries per year. This study was part of a larger body of work (Au et al, 2013, Carberry et al, 2013a. The sample size calculation was based on the main study question of estimating the number of neonates with low BF% which was our primary research outcome.…”

Section: Methodsmentioning

confidence: 99%

“…For that question we estimated that we required a minimum sample of 384 neonates to provide a 95% confidence interval 73%. This was based on the assumption of 10% prevalence of neonates with low BF% giving 95% CI 7%, 13% (Carberry et al, 2013a(Carberry et al, , 2013b.…”

Section: Methodsmentioning

confidence: 99%

“…We developed a surrogate composite measure of neonatal morbidity associated with undernutrition (Carberry et al, 2013a). This included fetal distress, Apgar scores, hypothermia, length of stay and poor feeding (Appendix 1).…”

Section: Pregnancy Outcomesmentioning

confidence: 99%

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Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Raynes‐Greenow

Turner

et al. 2016

Midwifery

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a b s t r a c tObjective: Pregnancies complicated with gestational diabetes mellitus (GDM) are at a higher risk for caesarean and instrumental deliveries as well as adverse neonatal outcomes such as fetal overgrowth, hypoglycaemia and neonatal intensive care admission. Our primary objective was to describe neonatal outcomes in a sample that included term infants of both GDM mothers and mothers with normal glucose tolerance (NGT). Design and setting: this cross-sectional study included 599 term babies born between September and October 2010 at Royal Prince Alfred Hospital, Sydney, Australia. Maternal and neonatal data were collected from medical records and a questionnaire. Glycaemic control data was based on third trimester HbA1c levels and self-monitoring blood glucose levels (BGL). Univariate associations between GDM status and maternal demographic factors, as well as pregnancy outcomes, were estimated using χ 2 tests and t-tests, as appropriate. Findings: of 599 babies, 67(11%) were born to GDM mothers. GDM mothers were more likely to be overweight/obese and of Asian ethnicity. Good glycaemic control was achieved in most GDM mothers. GDM babies were more likely to have been induced (p ¼0.013) and delivered earlier than non-GDM mothers (p o0.001), and they were also more likely to be breastfed within one hour of birth. Conclusions and implications for practice: in this study, GDM infants were more likely to be induced and delivered earlier but otherwise they did not have significantly different neonatal outcomes compared to infants of NGT mothers. This can be attributed to the good GDM control by lifestyle modification and insulin if necessary. The role of labour induction in GDM pregnancies should be further investigated. Midwives have an important role in maternal education during pregnancy and in the postnatal period.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Pregnancy Outcomesmentioning

confidence: 99%

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Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Raynes‐Greenow

Turner

et al. 2016

Midwifery

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“…above and below the mean %BF. 29 We used objective measures to identify infants at risk of early morbidity. 30 'Fetal distress' was defined as either an indication for operative delivery or thick meconium at birth from the medical record.…”

Section: Data Collectionmentioning

confidence: 99%

Antenatal predictors and body composition of large-for-gestational-age newborns: perinatal health outcomes

et al. 2014

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OBJECTIVE:To compare body composition of large-for-gestational-age (LGA) with appropriate-for-gestational-age (AGA) newborns and to identify antenatal predictors of LGA. STUDY DESIGN: This cross-sectional study included 536 term, singleton infants. Anthropometric measurements were performed within 48 h of birth and included determination of body fat percentage (%BF) by air displacement plethysmography. Associations were investigated using logistic regression. RESULT:LGA infants had greater %BF (P o 0.001) compared with AGA infants. Significant predictors of LGA infants included parity (odds ratio (OR) = 1.98, (95% confidence interval (CI) 1.00, 4.02)), paternal height (OR = 1.08, (95% CI 1.03, 1.14)), maternal pregravid weight (65 to 74.9 kg: OR = 2.77, (95% CI 1.14, 7.06)) and gestational weight gain (OR = 1.09, 95% CI (1.03, 1.16)). Gestational diabetes mellitus was not associated with LGA infants (P = 0.598). CONCLUSION: Paternal height, parity, maternal pregravid weight and gestational weight gain were strongly associated with LGA infants. These results may allow early prediction and potential modification, thereby optimising clinical outcomes.

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Fetal MRI‐Based Body and Adiposity Quantification for Small for Gestational Age Perinatal Risk Stratification

Rabinowich,

Avisdris,

Yehuda

et al. 2023

Magnetic Resonance Imaging

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BackgroundSmall for gestational age (SGA) fetuses are at risk for perinatal adverse outcomes. Fetal body composition reflects the fetal nutrition status and hold promise as potential prognostic indicator. MRI quantification of fetal anthropometrics may enhance SGA risk stratification.HypothesisSmaller, leaner fetuses are malnourished and will experience unfavorable outcomes.Study TypeProspective.Population40 SGA fetuses, 26 (61.9%) females: 10/40 (25%) had obstetric interventions due to non‐reassuring fetal status (NRFS), and 17/40 (42.5%) experienced adverse neonatal events (CANO). Participants underwent MRI between gestational ages 30 + 2 and 37 + 2.Field Strength/Sequence3‐T, True Fast Imaging with Steady State Free Precession (TruFISP) and T1‐weighted two‐point Dixon (T1W Dixon) sequences.AssessmentTotal body volume (TBV), fat signal fraction (FSF), and the fat‐to‐body volumes ratio (FBVR) were extracted from TruFISP and T1W Dixon images, and computed from automatic fetal body and subcutaneous fat segmentations by deep learning. Subjects were followed until hospital discharge, and obstetric interventions and neonatal adverse events were recorded.Statistical TestsUnivariate and multivariate logistic regressions for the association between TBV, FBVR, and FSF and interventions for NRFS and CANO. Fisher's exact test was used to measure the association between sonographic FGR criteria and perinatal outcomes. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated. A P‐value <0.05 was considered statistically significant.ResultsFBVR (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.2–0.76) and FSF (OR 0.95, CI 0.91–0.99) were linked with NRFS interventions. Furthermore, TBV (OR 0.69, CI 0.56–0.86) and FSF (OR 0.96, CI 0.93–0.99) were linked to CANO. The FBVR sensitivity/specificity for obstetric interventions was 85.7%/87.5%, and the TBV sensitivity/specificity for CANO was 82.35%/86.4%. The sonographic criteria sensitivity/specificity for obstetric interventions was 100%/33.3% and insignificant for CANO (P = 0.145).Data ConclusionReduced TBV and FBVR may be associated with higher rates of obstetric interventions for NRFS and CANO.Evidence Level2Technical EfficacyStage 5

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Is body fat percentage a better measure of undernutrition in newborns than birth weight percentiles?

Cited by 41 publications

References 36 publications

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Antenatal management of gestational diabetes mellitus can improve neonatal outcomes

Antenatal predictors and body composition of large-for-gestational-age newborns: perinatal health outcomes

Fetal MRI‐Based Body and Adiposity Quantification for Small for Gestational Age Perinatal Risk Stratification

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