Maternal diabetes and neonatal macrosomia. II. Neonatal anthropometric measurements

Brans, Yves W.; Shannon, Donna L.; Hunter, Mary Ann

doi:10.1016/0378-3782(83)90012-9

Cited by 35 publications

(16 citation statements)

References 12 publications

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“…A medida das dobras cutâneas de forma seriada promove uma estimativa da incorporação de gordura 19 . No perí-odo neonatal, pode-se utilizar as dobras bicipital, tricipital e escapular e comparar os valores de acordo com a idade gestacional 18 .…”

Section: Avaliação Nutricional Do Recém-nascidounclassified

Basis of nutritional support in pediatrics

Delgado¹,

Falcão²,

Carrazza³

2000

J Pediatr (Rio J)

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ResumoObjetivo: Apresentar uma revisão sistemática e atualizada sobre os princípios gerais do suporte nutricional em Pediatria, salientando-se a importância da nutrição no paciente gravemente enfermo.Métodos: Foi realizada a seleção dos estudos relevantes, a partir de vários bancos de dados (Medline, Scielo, Lilacs, etc.), bem como de capítulos de livros e teses a respeito do assunto, além de levar-se em conta a experiência pessoal de cada um dos autores.Resultados: A terapia nutricional é parte integrante do tratamento do paciente. Para que seus objetivos sejam alcançados é importante que se estabeleça, em primeiro lugar, as necessidade nutricionais específicas, ou seja, as necessidades hídricas, energéti-cas, protéicas, de macronutrientes e de micronutrientes. Em seguida deve-se efetuar a avaliação nutricional, através de parâmetros clíni-cos, antropométricos e laboratoriais, elegendo-se a terapia nutricional mais adequada (parenteral, enteral ou mista) e finalizando-se com a monitorização do paciente para evitar as complicações.Conclusões: A terapia nutricional é parte essencial no tratamento global do paciente. Uma vez adequadamente indicada e monitorizada, a probabilidade de recuperação é maior e poderá causar impacto positivo na diminuição da morbimortalidade. J. pediatr. (Rio J.). 2000; 76 (Supl.3): S330-S338: suporte nutricional, avaliação nutricional, terapia nutricional, nutrição. AbstractObjective: To present an up-to-date and systematic review about the basis of nutritional support in pediatrics, emphasizing the importance of nutrition in critically ill patient.Methods: Relevant studies were selected by databases (Medline, Scielo, Lilacs, etc.). Textbooks and thesis were analyzed; in addition, the authors personal experience was considerated.Results: Nutritional therapy is part of the patient's treatment. In order to reach its objectives it is important to determine specific nutritional requirements of water, calories, protein, macro and micronutrients. Thereafter, nutritional evaluation should be done by clinical, anthropometric and laboratorial assessment. Finally, the best nutritional therapy (parenteral and/or enteral) is chosen, and patient monitorization is also indicated in order to prevent complications.Conclusion: Nutritional therapy is essential for the treatment. When well indicated and well monitorizated, patient recovery will be better, causing an impact in decreasing morbidity and mortality. J. pediatr. (Rio J.). 2000; 76 (Supl.3): S330-S338:nutritional support, nutritional assessment, nutritional therapy, nutrition. Princípios do suporte nutricional em Pediatria Basis of nutritional support in Pediatrics IntroduçãoA incidência de desnutrição em pacientes hospitalizados é freqüentemente subestimada 1,2 . Vários estudos demonstram a relação entre desnutrição e morbidade e mortalidade em pacientes internados 3,4 . A doença de base e situações como jejum ou estresse são também fatores potenciais de risco para o aumento dessa incidência 5 .A desnutrição pode surgir em conseqüência de ofert...

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Section: Avaliação Nutricional Do Recém-nascidounclassified

Basis of nutritional support in pediatrics

Delgado¹,

Falcão²,

Carrazza³

2000

J Pediatr (Rio J)

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“…As IDM are hyperinsulinemic, especially the LGA infants (23)(24)(25), the increase in fetal mineralization found in our study could be explained by the effect of insulin on bone formation. Indeed, insulin, which is the most important systemic hormone modulating normal skeletal growth, does not regulate bone resorption, but causes a marked stimulation of bone matrix synthesis and cartilage formation (26,27).…”

Section: Discussionmentioning

confidence: 68%

“…Brans et al found skinfold thickness values more frequently in excess of the normal range in the IDM of the higher White's diabetic class (24). On the contrary, Ballard et al found no correlation between White's classification and fetal growth category (33).…”

Section: Discussionmentioning

confidence: 94%

“…the hypothesis that the mineralization of IDM is directly dependent on growth in utero. It has been previously demonstrated that LGA infants and IDM have a significantly greater body fat mass, assessed by skinfold thickness, than controls in both absolute values and percentages of body weight (23,24). Macrosomia in IDM is presumed to be the result of fetal hyperinsulinism secondary to maternal and fetal hyperglycemia during pregnancy (25, 29 -31).…”

Section: Discussionmentioning

confidence: 99%

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Diabetes during Pregnancy Does Not Alter Whole Body Bone Mineral Content in Infants

Lapillonne

Guérin²,

Braillon

et al. 1997

The Journal of Clinical Endocrinology &Amp; Metabolism

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A previous study using single photon absorptiometry has reported low bone mineral density of the radius in infants of diabetic mothers. The aim of this study was to assess by dual x-ray absorptiometry the whole body bone mineral content (WbBMC) and the body composition of 40 infants of diabetic mothers at birth (mean gestational age Ϯ SD, 37.5 Ϯ 1.3 weeks; mean birth weight Ϯ SD, 3815 Ϯ 641 g).WbBMC was not correlated with gestational age, but was well correlated with birth weight (r ϭ 0.73; P ϭ 0.0001) and also with fat mass (r ϭ 0.87; P ϭ 0.0001) and lean mass (r ϭ 0.42; P ϭ 0.008). The z-scores Ϯ SD adjusted for weight for WbBMC and fat mass were significantly increased (1.3 Ϯ 0.9 and 2.6 Ϯ 1.3, respectively (P Ͻ 0.0001), but were not significantly influenced either by in utero growth or by the type of the diabetes mellitus of the mother.Bone mineralization and fat mass studied by whole body dual x-ray absorptiometry are increased at birth in these infants compared with reference curves. (J Clin Endocrinol Metab 82: 3993-3997, 1997)

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“…5 The macrosomic fetus has more marked development of this subcutaneous fat, particularly in cases with GDM. 6 The aim of this study was to determine the measurement of three potential ultrasound markers, namely foetal umbilical cord thickness, foetal fat layer and interventricular septal thickness for prediction of foetal macrosomia in women with Gestational diabetes.…”

mentioning

confidence: 99%

Prospective study on sonographic measurement of umbilical cord thickness, foetal fat layer, interventricular septal thickness as predictors of macrosomia in fetus of women with gestational diabetes mellitus

Janani

Vimala

Gayathri

2018

Int J Reprod Contracept Obstet Gynecol

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Background: The objectives of the study were to evaluate the Prediction of foetal macrosomia based on sonographic measurements of foetal fat layer, Interventricular septal thickness and umbilical cord thickness in Gestational Diabetes Mellitus at term.Methods: After assessment of inclusion and exclusion criteria 100 antenatal women of gestational age more than 37 weeks selected for study in the Department of Obstetrics and Gynaecology of Vinayaka Mission’s Kirupananda variyar medical college and hospital, Salem. Participants underwent a third trimester scan and three extra measurements i.e. Umbilical cord thickness, Interventricular septal thickness and foetal fat layer are measured in addition to the normal examination.Results: In present study umbilical cord thickness had good sensitivity and negative predictive value. Hence, if umbilical cord thickness is less than 90th centile the chance of macrosomia is less, the cut off of foetal fat layer ≥5 mm as predictor of macrosomia had sensitivity of 84.2% and specificity of 86.4% and cut off of Interventricular septal thickness ≥3.9mm as a predictor of macrosomia had sensitivity of 84.2%, specificity of 64.2%, negative predictive value of 95.9%. Thus, interventricular septal thickness and foetal fat layer is a reliable predictor of macrosomia.Conclusions: From this study authors concluded that Umbilical cord thickness, foetal fat layer and Interventricular septal thickness are good predictors of foetal macrosomia. In the assessment of risk of macrosomia in addition to the ultrasonographic measurements the clinical risk factors must be considered.

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Maternal diabetes and neonatal macrosomia. II. Neonatal anthropometric measurements

Cited by 35 publications

References 12 publications

Basis of nutritional support in pediatrics

Basis of nutritional support in pediatrics

Diabetes during Pregnancy Does Not Alter Whole Body Bone Mineral Content in Infants

Prospective study on sonographic measurement of umbilical cord thickness, foetal fat layer, interventricular septal thickness as predictors of macrosomia in fetus of women with gestational diabetes mellitus

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