Prematurity With Extrauterine Growth Restriction Increases the Risk of Higher Levels of Glucose, Low-Grade of Inflammation and Hypertension in Prepubertal Children

Ordóñez-Díaz, María Dolores; Pérez-Navero, Juan Luís; Flores-Rojas, Katherine; Olza, Josune; Muñoz-Villanueva, María Carmen; Aguilera, Concepción M.; Gil-Campos, Mercedes

doi:10.3389/fped.2020.00180

Cited by 16 publications

(16 citation statements)

References 64 publications

(67 reference statements)

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“…Data from the National Institute of Child and Human Development (NICHD) Neonatal Research Network indicate that 16% of ELBW infants are small for gestational age (SGA) at birth, but by 36 weeks corrected age~89% have growth failure depicting high rates of poor postnatal growth during neonatal intensive care (NICU) exposures [4]. EUGR is a medical problem with long term health consequences into later childhood and adulthood [5,6]. Several studies have shown the association between poor postnatal growth and an increased morbidity and mortality both in the neonatal period and in later life [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Antenatal and neonatal factors contributing to extra uterine growth failure (EUGR) among preterm infants in Boston Birth Cohort (BBC)

Makker

Hong

et al. 2021

J Perinatol

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Objective Identify antenatal and neonatal factors associated with primary outcome of EUGR. Methods 1063 preterm infants from a subset of the BBC were included in this prospective cohort study. Regression analysis was carried out to evaluate associations of EUGR with antenatal factors and neonatal factors. Results 6.1% of the infants had in-utero growth restriction (IUGR) at birth and 21.7% of infants had EUGR. The adjusted odds ratio for EUGR status were significant for birth weight (OR 0.99, p = 0.00, CI 0.99-0.99), for GA at birth (OR 4.58, p = 0.00, CI 3.25-6.44), for PDA (OR 2.9, p = 0.02, CI 1.17-7.1), for NEC (OR 5.14, p = 0.012, CI 1.44-18.3) and for day of life of reaching full feeds (OR 1.04, p = 0.001, CI 1.01-1.06). Conclusion This study highlights important factors associated with EUGR. Additional studies are needed to gain further insight.

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Section: Introductionmentioning

confidence: 99%

Antenatal and neonatal factors contributing to extra uterine growth failure (EUGR) among preterm infants in Boston Birth Cohort (BBC)

Makker

Hong

et al. 2021

J Perinatol

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“…To help to elucidate this question, we conducted a prospective study in preterm children without FGR, with and without EUGR, which were evaluated later at prepubertal age, from 6 to 13 years old. Some of the results of this study have recently been published, showing an increased risk of cardiometabolic alterations, changes in plasma adipokines' profile and higher low-grade inflammation in preterm children with EUGR compared with those growing properly and term children (19,20). Early programming of the adipose tissue has been suggested in EUGR children.…”

Section: Introductionmentioning

confidence: 74%

“…SOD catalyzes the reduction of intracellular reactive oxygen species through the dismutation of the superoxide anion to hydrogen peroxide (8). To date, studies on preterm infants (19,20). Data show adjusted odd ratio (OR) values and 95% confidence intervals (CI).…”

Section: Discussionmentioning

confidence: 99%

“…The sample involved 211 Caucasian children born between 1996 and 2008, recruited at school age with prepubertal status (Tanner 1) and delivered in the same neonatal unit in a tertiary hospital. Children were classified into one of three groups, as reported elsewhere (19,20). Briefly, the first group, identified as the EUGR group, included prepubertal children with the following criteria: a history of prematurity: ≤32 weeks gestational age (GA); a weight above P10 for GA at birth and without the diagnosis of FGR following the international consensus of the Ultrasound Obstetrics and Gynaecology (22); the development of postnatal growth restriction or "a true EUGR, " according to the definitions proposed in the literature (weight <P3 at 36 weekspostmenstrual age and discharge from the neonatal unit) (18).…”

Section: Subjectsmentioning

confidence: 99%

“…Proinflammatory biomarker assessment and adipokine analysis method and results were previously described elsewhere (19,20), using the LINCONplex kits HADK2MAG-61K for the analysis of IL8, IL6, HGF, NFG, IL1β and TNFα; HADK1MAG-61 for the analysis of PAI-…”

Section: Sampling and Metabolic And Proinflammatory Biomarkers Analysismentioning

confidence: 99%

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Impaired Antioxidant Defence Status Is Associated With Metabolic-Inflammatory Risk Factors in Preterm Children With Extrauterine Growth Restriction: The BIORICA Cohort Study

et al. 2021

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Introduction: An impaired antioxidant status has been described during foetal growth restriction (FGR). Similarly, the antioxidant defence system can be compromised in preterm children with extrauterine growth restriction (EUGR). The aim of this prospective study was to evaluate the antioxidant status in prepubertal children with a history of prematurity without FGR, with and without EUGR, compared to a healthy group.Methods: In total, 211 children were recruited and classified into three groups: 38 with a history of prematurity and EUGR; 50 with a history of prematurity and adequate extrauterine growth (AEUG); and 123 control children born at term. Catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) activities were assessed in lysed erythrocytes with spectrophotometric methods. Plasma levels of the antioxidants α-tocopherol, retinol and β-carotene were determined through solvent extraction and ultra-high-pressure liquid chromatography coupled to mass spectrometry.Results: Children with the antecedent of EUGR and prematurity had lower CAT activity than the other two groups and lower GPx activity than the control children. Lower SOD, GPx and GR activities were observed in the AEUG group compared to the controls. However, higher concentrations of α-tocopherol and β-carotene were found in the EUGR group compared to the other groups; retinol levels were also higher in EUGR than in AEUG children. In EUGR and AEUG children, enzymatic antioxidant activities and plasma antioxidants were associated with metabolic syndrome components and pro-inflammatory biomarkers.Conclusions: This study reveals, for the first time, that the EUGR condition and prematurity appear to be linked to an impairment of the antioxidant defence status, which might condition an increased risk of adverse metabolic outcomes later in life.

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Postnatal growth and body composition in extremely low birth weight infants fed with individually adjusted fortified human milk: a cohort study

et al. 2023

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This cohort study aimed to evaluate the impact of an individualised nutritional care approach combining standardised fortification with adjustable fortification on postnatal growth and body composition in extremely low birth weight (ELBW) infants. We included ELBW infants admitted to a neonatal intensive care unit and still hospitalised at 35 weeks postmenstrual age (PMA). The fortification of human milk was standardised (multicomponent fortifier) between 70 mL/kg/day and full enteral feeding, and then individualised using adjustable fortification. When weight gain was below 20 g/kg/day, protein or energy was added when serum urea was below or above 3.5 mmol/L, respectively. Postnatal growth failure (PNGF) was defined as being small for gestational age at discharge and/or when the Z-score loss between birth and discharge was higher than 1. Body composition was assessed between 35 and 41 weeks of PMA. Among the 310 ELBW infants included, the gestational age of birth was 26.7 ± 1.8 weeks, and the birth weight was 800 ± 128 g. The mean Z-score difference between birth and discharge was moderately negative for the weight (−0.32), more strongly negative for length (−1.21), and almost nil for head circumference (+ 0.03). Only 27% of infants presented PNGF. At discharge, fat mass was 19.8 ± 3.6%. Multivariable analysis showed that the proportion of preterm formula received and gestational age at birth were independently associated with the percentage of fat mass. Conclusion: The individualised nutritional care approach applied herein prevented postnatal weight loss in most infants, limited length growth deficit, and supported excellent head circumference growth. What is Known:• At least half of extremely low birth weight infants are small for gestational age at discharge and postnatal growth deficit has been associated with impaired neurocognitive and renal development.• Human milk is the main milk used in neonatology and, although fortification of human milk is a standard of care, there is no consensus regarding the optimal fortification strategy to be adopted. What is New:• Using an approach combining standardised fortification followed by individualised adjustable fortification limited postnatal growth deficit for body weight and head circumference. Postnatal growth failure is not a fatality in extremely low birth weight infants.• Each additional gestational age week at birth resulted in a decrease in fat mass percentage at discharge, which was higher than in foetuses of the same gestational age, likely representing a necessary adaptation to extra-uterine life.

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Prematurity With Extrauterine Growth Restriction Increases the Risk of Higher Levels of Glucose, Low-Grade of Inflammation and Hypertension in Prepubertal Children

Cited by 16 publications

References 64 publications

Antenatal and neonatal factors contributing to extra uterine growth failure (EUGR) among preterm infants in Boston Birth Cohort (BBC)

Antenatal and neonatal factors contributing to extra uterine growth failure (EUGR) among preterm infants in Boston Birth Cohort (BBC)

Impaired Antioxidant Defence Status Is Associated With Metabolic-Inflammatory Risk Factors in Preterm Children With Extrauterine Growth Restriction: The BIORICA Cohort Study

Postnatal growth and body composition in extremely low birth weight infants fed with individually adjusted fortified human milk: a cohort study

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