Prevalence of small for gestational age infants in 21 cities in China, 2014-2019.
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ABSTRACT:
SUBMITTER: He H
PROVIDER: S-EPMC8021546 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThrombocytopenia is common among small-for-gestational-age (SGA) neonates (birth weight <10th percentile reference range), but several aspects of this thrombocytopenia are unclear, including the incidence, typical nadir, duration, association with preeclampsia, mechanism, and risk of death.MethodsUsing 9 years of multihospital records, we studied SGA neonates with ≥2 platelet counts <150,000/μL in their first week.ResultsWe found first-week thrombocytopenia in 31% (905 of 2891) of SGA neonates versus 10% of non-SGA matched controls (P < .0001). Of the 905, 102 had a recognized cause of thrombocytopenia (disseminated intravascular coagulation, early-onset sepsis, or extracorporeal membrane oxygenation). This group had a 65% mortality rate. The remaining 803 did not have an obvious cause for their thrombocytopenia, and we called this "thrombocytopenia of SGA." They had a mortality rate of 2% (P < .0001) and a mean nadir count on day 4 of 93,000/μL (SD 51,580/μL, 10th percentile 50,000/μL, 90th percentile 175,000/μL). By day 14, platelet counts were ≥150,000/μL in more than half of the patients. Severely SGA neonates (<1st percentile) had lower counts and longer thrombocytopenia duration (P < .001). High nucleated red cell counts at birth correlated with low platelets (P < .0001). Platelet transfusions were given to 23%, and counts typically more than tripled. Thrombocytopenia was more associated with SGA status than with the diagnosis of maternal preeclampsia.ConclusionsSGA neonates with clearly recognized varieties of thrombocytopenia have a high mortality rate. In contrast, thrombocytopenia of SGA is a hyporegenerative condition of moderate severity and 2 weeks' duration and is associated with evidence of intrauterine hypoxia and a low mortality rate.
| S-EPMC4906543 | biostudies-literature
Project description:To investigate the potential risk factors for small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) late-term infants, 100 cases of single full-term SGA infants delivered in the Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University in 2017 were enrolled as the SGA group. A total of 100 healthy AGA who were born at the same time with the same gestational age were randomly included as the control group. The perinatal and postpartum adverse conditions of the two groups were recorded, and Apgar tests were performed on all newborns at 1 min (T1), 5 min (T2) and 10 min (T3) after birth. A follow-up survey was conducted in all patients at 6 and 12 months of age. At the second follow-up, the development quotient of the children was measured using the Gesell Developmental Schedule, and the perinatal risk factors of SGA were analyzed. The incidence of intrauterine distress, respiratory distress syndrome and infectious disease in the SGA group was significantly higher compared with that in the AGA group (P<0.05). The Apgar scores at T1, T2 and T3 were significantly lower in the SGA group compared with the AGA group (P<0.05). The Apgar score at T1 was lower compared with that at T2 in the SGA group (P<0.05), and the Apgar score at T2 was lower compared with that at T3 (P<0.05). The length of hospital stay in the SGA group was significantly longer compared with that in the AGA group (P<0.05). The development quotient at the 6 and 12th month in the SGA group was significantly lower compared with that in the AGA group (P<0.05). Logistic regression analysis showed that there was no correlation between SGA and maternal age, regardless of firstborn status, neonatal sex, mode of delivery and living environment. SGA was significantly associated with umbilical cord abnormalities, maternal pregnancy-induced hypertension, gestational diabetes, pregnancy infection and intrauterine distress (P<0.05). An abnormal umbilical cord, maternal pregnancy-induced hypertension, gestational diabetes, infection during pregnancy and intrauterine distress are all perinatal risk factors for SGA. Effective interventions are needed in clinical assessment to prevent the occurrence of SGA.
| S-EPMC7026981 | biostudies-literature
Project description:Small-for-gestational-age (SGA) infants are fetuses that have not reached their genetically programmed growth potential. Low birth weight predisposes these infants to an increased risk of developing cardiovascular, metabolic and neurodevelopmental conditions in later life. However, our understanding of how this pathology occurs is currently incomplete. Previous research has focused on understanding the transcriptome, epigenome and bacterial signatures separately. However, we hypothesise that interactions between moderators of gene expression are critical to understanding fetal growth restriction. Through a review of the current literature, we identify that there is evidence of modulated expression/methylation of the placental genome and the presence of bacterial DNA in the placental tissue of SGA infants. We also identify that despite limited evidence of the interactions between the above results, there are promising suggestions of a relationship between bacterial signatures and placental function. This review aims to summarise the current literature concerning fetal growth from multiple avenues and propose a novel relationship between the placental transcriptome, methylome and bacterial signature that, if characterised, may be able to improve our current understanding of the placental response to stress and the aetiology of growth restriction.
| S-EPMC7017208 | biostudies-literature
Project description:OBJECTIVE:To characterise the excess risk for death, grade 3-4 intraventricular haemorrhage (IVH), bronchopulmonary dysplasia (BPD) and stage 3-5 retinopathy of prematurity independently associated with birth small for gestational age (SGA) among very preterm infants, stratified by completed weeks of gestation. METHODS:Retrospective cohort study using the Optum Neonatal Database. Study infants were born <32 weeks gestation without severe congenital anomalies. SGA was defined as a birth weight <10th percentile. The excess outcome risk independently associated with SGA birth among SGA babies was assessed using adjusted risk differences (aRDs). RESULTS:Of 6708 infants sampled from 717 US hospitals, 743 (11.1%) were SGA. SGA compared with non-SGA infants experienced higher unadjusted rates of each study outcome except grade 3-4 IVH among survivors. The excess risk independently associated with SGA birth varied by outcome and gestational age. The highest aRD for death (0.27; 95%?CI 0.13 to 0.40) occurred among infants born at 24 weeks gestation and declined as gestational age increased. In contrast, the peak aRDs for BPD among survivors (0.32; 95%?CI 0.20 to 0.44) and the composites of death or BPD (0.35; 95%?CI 0.24 to 0.46) and death or major morbidity (0.35; 95%?CI 0.24 to 0.45) occurred at 27 weeks gestation. The risk-adjusted probability of dying or developing one or more of the evaluated morbidities among SGA infants was similar to that of non-SGA infants born approximately 2-3 weeks less mature. CONCLUSION:The excess risk for neonatal morbidity and mortality associated with being born SGA varies by adverse outcome and gestational age.
| S-EPMC6335180 | biostudies-literature
Project description:ObjectivesEvidence about the relationship between socioeconomic status (SES) and small-for-gestational-age (SGA) infants was insufficient among Chinese primiparae. In addition, factors that may mediate this relationship are poorly understood. The purpose of this study was to investigate the risk of and mediators between SES and SGA.DesignRetrospective cohort study.SettingWuhan, Hubei, China.MethodParticipants were recruited from patients who gave birth in the maternity care hospital of Wuhan between September 2012 and October 2014. Logistic regression models were used to estimate the association between SES and SGA. Pathway analysis was performed to examine the contribution of maternal lifestyles and pregnancy-induced hypertension syndrome (PIH) to the relationship between SES and SGA. Total effect, direct effect and indirect effect of SES on SGA were measured. Effect sizes were evaluated by unstandardised estimates (B) and standardised estimates (ß).ResultsAmong 8737 primiparae, 927 (10.61%) pregnant women had babies with SGA. High SES was inversely associated with risk of SGA (OR 0.856; 95%?CI 0.737 to 0.995) after adjustment for potential confounders. Maternal obstetric characteristics, lifestyles and PIH completely mediated SES and SGA (indirect effect: B=-0.067, 95% CI -0.108 to -0.026). The indirect effect of SES was strengthened by PIH (B=-0.029), a multivitamin supplement (B=-0.021), prepregnancy body mass index (BMI) ?18.50 (B=-0.009) and prepregnancy BMI ?18.50?to gestational weight gain (GWG) not below the Institute of Medicine (IOM) recommendations (B=-0.003).ConclusionsWomen from high SES predicted lower risk of PIH, more chances to take a multivitamin supplement during early pregnancy, keeping prepregnancy BMI ?18.50?kg/cm2 and gaining adequate gestational weight which was not below IOM recommendations. Furthermore, lower risk of PIH, more chances to take a multivitamin supplement, prepregnancy BMI ?18.50?kg/cm2 and GWG not below IOM recommendations were associated with a lower risk of SGA infants.
| S-EPMC6009518 | biostudies-literature
Project description:Small for gestational age (SGA) is defined as intrauterine growth retardation or small sample, referring to the 10th percentile of birth weight lower or two standard deviations less than the average weight at the same gestational age. SGA infants bring great economic and psychological burdens to families and society. The association between exposure to air pollution and SGA in underdeveloped cities with poor air quality remains unclear. Thus, this study is conducted to estimate the effects of maternal exposure to air pollutants on SGA numbers. Birth information was collected from the Huangshi Maternity and Children's Health Hospital from January 1st to December 31st in 2017. Data of pregnancy exposure were accessed using stationary monitors. These data included particulate matter less than or equal to 10 μm in aerodynamic diameter (PM10), particulate matter less than or equal to 2.5 μm in aerodynamic diameter (PM2.5), nitrogen dioxide (NO2), and sulfur dioxide (SO2). Multivariate logistic regression models were performed to estimate the association between ambient air pollution and the risk of SGA during different exposure windows. It was found that a 1 μg/m3 increase in air pollution concentrations during the entire pregnancy was associated with a higher risk of SGA, with an adjusted odds ratio (OR) and 95% confidence interval (CI) of 1.055 (1.035-1.076), 1.084 (1.053-1.116), 1.000 (0.953-1.049), and 1.051 (0.968-1.141) for PM10, PM2.5, NO2, and SO2, respectively. Thus, it is suggested that exposure to air pollution is associated with an increased risk of SGA. The effects of PM10 and PM2.5 were more stable than NO2 and SO2.
| S-EPMC6875112 | biostudies-literature
Project description:ObjectivesSmall for gestational age (SGA) infants are more susceptible to infectious morbidity and growth faltering compared to their appropriate for gestational age (AGA) counterparts. Zinc supplementation of SGA infants may be beneficial but the underlying susceptibility to zinc deficiency of SGA infants has not been examined.MethodsIn a community-based, observational, longitudinal study in a peri-urban settlement of Karachi, Pakistan, we compared the size of the exchangeable zinc pools (EZPs) in term SGA and AGA infants at birth and at 6 months of age, hypothesizing that the EZP would be lower in the SGA group. To measure EZP size, a zinc stable isotope was intravenously administered within 48 hours of birth (n = 17 and 22) at 6 months (n = 11 and 14) in SGA and AGA infants, respectively. Isotopic enrichment in urine was used to determine EZP.ResultsNo significant difference was detected in the mean (±standard deviation) EZP between SGA and AGA infants at birth, with values of 9.8 ± 3.5 and 10.1 ± 4.1 mg/kg, respectively (P = 0.86), or at 6 months. Longitudinal EZP measurements demonstrated a significant decline in EZP relative to body weight in both groups at 6 months (P < 0.001). Mean EZP (adjusted for body weight) size at birth for the combined Pakistani groups was significantly lower than AGA infants at birth in the United States (P = 0.017).ConclusionsThese results did not support a difference in zinc endowment between SGA and AGA Pakistani infants. They, however, do suggest lower in utero zinc transfer to the fetus in a setting where poor maternal nutritional status may confer a high susceptibility to postnatal zinc deficiency.
| S-EPMC6343844 | biostudies-literature
Project description:This is the first systematic review to examine the global prevalence of catch-up growth (CUG) in small for gestational age (SGA) infants who were born at full term (FT). Size at birth and subsequent growth is an important indicator of neonatal and adult health. Globally, 16% of infants are SGA at birth, ranging from 7% in industrialized countries to 41.5% in South Asia. SGA infants are at increased risk for negative developmental and adult health outcomes. Some achieve CUG but others do not. CUG has immediate and late health implications especially in low- and middle-income countries. This systematic review sought to determine the global prevalence of CUG among FT-SGA infants. We performed a literature search of MEDLINE, Pubmed, Embase, Web of Science, and Scopus, as well as grey literature databases, and identified 3137 studies. The final analysis included 11 studies. The median prevalence of CUG was 87.4% across all definitions of SGA and CUG. However, multiple definitions were used to classify SGA and CUG. Nine unique reference populations were used to classify SGA, and 6 to approximate CUG. Due to this heterogeneity, a meta-analysis could not be conducted. Program implementation for this vulnerable group of infants is dependent on proper classification. Given the wide range of definitions and reference standards used in the past, it is not possible to determine the global need for programs to address CUG for FT-SGA infants or to rationally plan any such programs. We highlight the need and propose standard definitions and references for SGA and CUG.
| S-EPMC6370265 | biostudies-literature
Project description:ObjectiveTo characterise the phenotype and genotype of neonates born small-for-gestational age (SGA; birth weight <10th centile) who developed hyperinsulinaemic hypoglycaemia (HH).MethodsClinical information was prospectively collected on 27 SGA neonates with HH, followed by sequencing of KCNJ11 and ABCC8.ResultsThere was no correlation between the maximum glucose requirement and serum insulin levels. Serum insulin level was undetectable in five infants (19%) during hypoglycaemia. Six infants (22%) required diazoxide treatment >6 months. Normoglycaemia on diazoxide <5 mg/kg/day was a safe predictor of resolved HH. Sequencing of KCNJ11/ABCC8 did not identify any mutations.ConclusionsSerum insulin levels during hypoglycaemia taken in isolation can miss the diagnosis of HH. SGA infants may continue to have hypofattyacidaemic hypoketotic HH beyond the first few weeks of life. Recognition and treatment of this group of patients are important and may have important implications for neurodevelopmental outcome of these patients.
| S-EPMC3686249 | biostudies-literature
Project description:OBJECTIVE:Our aim was to assess the changes in induced abortion in different migrant groups in China between 2007 and 2014 and the contraceptive methods used prior to induced abortion. METHODS:The studies of two population-based cross sections were conducted in urban China, involving 9146 sexually active migrant women. Within the selected sociodemographic subgroups, the changes in the percentage of women who had induced abortions, the proportion of pregnancies ending in induced abortions, the causes of induced abortions, and the methods of contraception were identified. A chi-squared test was used to calculate the differences in induced abortion in the subgroups. RESULTS:Between 2007 and 2014, in the study groups from the major cities of China, the percentage of sexually active migrant women who had induced abortions increased 10.1%, from 21.8% to 24.0%. The proportion of pregnancies ending in induced abortions increased 23.7%, from 21.5% to 26.6%. Both of the aforementioned statistics increased significantly within most of the selected sociodemographic subgroups, especially in the 18-19 and 45-49 age groups. Over 50% of pregnancies were aborted in the cohabiting group, although this figure declined by 12.3% over the course of the seven-year study period. Contraceptive failure was the primary cause of induced abortion, although its contribution to induced abortion declined from 51.3% to 42.4%. The proportion of women not using contraception prior to induced abortion increased from 30.9% to 41.2%. CONCLUSION:The prevalence of induced abortion is high and continues to increase among sexually active migrant women in China. An increasing trend is forecasted over the next few decades. Special attention should be paid to the younger cohort of migrant women, especially 18-19-year-olds, and unmarried cohabitants, who are increasingly seeking induced abortions.
| S-EPMC6765927 | biostudies-literature