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THE CONTINUUM OF FETAL ALCOHOL SPECTRUM DISORDERS IN FOUR RURAL COMMUNITIES IN SOUTH AFRICA: PREVALENCE AND CHARACTERISTICS Prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in previously unstudied rural, agricultural, lower socioeconomic populations in South Africa (ZA).Using an active case ascertainment approach among first grade learners, 1354 (72.6%) were consented into the study via: height, weight, and/or head (...) circumference ≤ 25th centile and/or random selection as normal control candidates. Final diagnoses were made following: examination by pediatric dysmorphologists/geneticists, cognitive/behavioral testing, and maternal risk factor interviews.FASD children were significantly growth deficient and dysmorphic: physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories from severe to mild to normal in a consistent, linear fashion
percentile: OGTT-NEGATIVE = odds ratio (OR), 1.5; 95% confidence interval (CI), 1.07-2.2; GDM-IADPSG = OR, 1.7; 95% CI, 1.1-2.6; and GDM-CDA = OR, 1.9, 95% CI, 1.3-3.1 (using the GCT-NEGATIVE group as reference). Fetuses of women with glucose intolerance were more likely to experience asymmetric growth as reflected by an elevated abdominal circumference to headcircumference ratio.GDM and milder degrees of glucose intolerance in twin pregnancies are associated with an increased risk of asymmetric (...) Does Gestational Diabetes Affect Fetal Growth and Pregnancy Outcome in Twin Pregnancies? Women with twin pregnancies are at increased risk for fetal growth restriction, which might be attributed to the limited maternal resources that are being shared by >1 fetus. Based on that, it may be hypothesized that the fetal effects of gestational diabetes mellitus (GDM) with respect to accelerated fetal growth may be less pronounced in twin gestations or alternatively may even have a beneficial role
done at birth. Retinal microvasculature was measured using computer software from the retinal photographs.In multiple linear regression models, each 10 μm narrowing in maternal retinal arteriolar caliber was associated with decreases of 1.36 mm in fetalheadcircumference at 32-34 weeks gestation, as well as decreases of 1.50 mm and 2.30 mm in infant headcircumference and birth length at delivery, respectively. Each standard deviation decrease in maternal retinal arteriolar fractal dimension (...) was associated with decreases of 1.55 mm in fetalheadcircumference at 32-34 weeks gestation, as well as decreases of 1.08 mm and 46.42 g in infant headcircumference and birth weight at delivery, respectively.Narrower retinal arteriolar caliber and a sparser retinal vascular network in mothers, reflecting a suboptimal uteroplacental microvasculature during mid-pregnancy, were associated with poorer fetal growth and birth size.
Disproportionate Fetal Growth and the Risk for Congenital Cerebral Palsy in Singleton Births To investigate the association between proportionality of fetal and placental growth measured at birth and the risk for congenital cerebral palsy (CP).We identified all live-born singletons born in Denmark between 1995 and 2003 and followed them from 1 year of age until December 31st, 2008. Information on four indices of fetal growth: ponderal index, headcircumference/ abdominal circumference ratio (...) , placental weight and headcircumference suggesting pre and perinatal conditions contribute to fetal growth restriction in children with CP.
of diagnosis.This was a prospective cohort study including 58 fetuses with CHD, diagnosed at 20-24 weeks' gestation, and 58 normal control fetuses. At the time of diagnosis, we recorded fetalheadcircumference (HC), biparietal diameter, middle cerebral artery pulsatility index (MCA-PI), cerebroplacental ratio (CPR) and brain perfusion by fractional moving blood volume. We classified cases into one of two clinical types defined by the expected levels (high or low) of placental (well-oxygenated) blood perfusion (...) Fetal brain Doppler and biometry at mid-gestation for the early prediction of abnormal brain development at birth in congenital heart disease. Fetuses with congenital heart disease (CHD) show evidence of abnormal brain development before birth, which is thought to contribute to adverse neurodevelopment during childhood. Our aim was to evaluate whether brain development in late pregnancy can be predicted by fetal brain Doppler, head biometry and the clinical form of CHD at the time
a subset of 82 infants in whom ND was assessed at 14 months using mental (MDI) and psychomotor (PDI) developmental indices. US examinations were assigned to one of four gestational time periods: (1) 20-23 weeks, (2) 24-29 weeks, (3) 30-33 weeks and (4) ≥ 34 weeks. Middle cerebral artery (MCA) flow velocity was measured and pulsatility index (PI), a measure of downstream resistance, was calculated. Data on fetalheadcircumference (HC), femur length, abdominal circumference (AC) and estimated fetal (...) The association of fetal growth, cerebral blood flow, and neurodevelopmental outcome in single ventricle fetuses. To investigate the association of fetal growth and cerebrovascular resistance at different periods in gestation with neurodevelopment (ND) at 14 months in the univentricular subject.We reviewed serial prenatal ultrasound (US) examinations from 133 infants enrolled in the Pediatric Heart Network's Single Ventricle Reconstruction or Infants with Single Ventricle trials, including
regression analyses were carried out to identify risk factors for cesarean section. Diagnostic accuracy was tested with a receiver operating characteristic curve, and the optimal cut-off value for fetal pelvic index was calculated.Cesarean section rates.A total of 242 women delivered vaginally, and 32 delivered with cesarean section caused by labor arrest. In multivariable modeling, the fetal pelvic index, maternal pelvic inlet size, fetalheadcircumference and maternal age were significantly associated (...) Fetal Pelvic index to predict cephalopelvic disproportion- a retrospective clinical cohort study. To investigate the diagnostic accuracy of the fetal pelvic index to predict cephalopelvic disproportion.Retrospective observational cohort study.Pregnant women who had been examined by X-ray or magnetic resonance imaging pelvimetry because of an increased risk of fetal-pelvic disproportion during 2000-2008 in North Karelia Central Hospital.A total of 274 pregnant women.Univariable and multivariable
Fetal Growth and Neurodevelopmental Outcome in Congenital Heart Disease. We evaluated differences in growth between fetuses with and without congenital heart disease (CHD) and tested associations between growth and early childhood neurodevelopment (ND). In this prospective cohort study, fetuses with hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and tetralogy of Fallot (TOF) and controls had biparietal diameter (BPD), head (HC) and abdominal circumference (AC (...) at F2 predicted Language score (B = 127, P = 0.03, R (2) = 0.12). Differences in growth between CHD fetuses and controls can be measured early in pregnancy. In CHD fetuses, larger abdominal relative to headcircumference is associated with better 18-month neurodevelopment.
. Multivariable logistic regression analysis was used to determine if screening by a combination of maternal factors and Z-scores of fetalheadcircumference (HC), abdominal circumference (AC) and femur length (FL) or estimated fetal weight (EFW) had a significant contribution to the prediction of SGA neonates.Multivariable logistic regression analysis demonstrated that the likelihood of delivering a SGA neonate with a birth weight < 5th percentile decreased with maternal weight and height, and in parous (...) Prediction of small for gestational age neonates: Screening by fetal biometry at 35-37 weeks. To investigate the value of fetal biometry at 35-37 weeks' gestation in the prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE).This was a screening study in singleton pregnancies at 35-37 weeks' gestation, comprising 278 that delivered SGA neonates with a birth weight < 5th percentile and 5237 cases unaffected by SGA, PE or gestational hypertension
%) that delivered SGA neonates with birth weight < 5(th) percentile (SGA < 5(th)). Multivariable logistic regression analysis was used to determine if screening by a combination of maternal characteristics and medical history and Z-scores of fetalheadcircumference (HC), abdominal circumference (AC) and femur length (FL) had significant contribution in predicting SGA neonates. A model was developed for selecting the gestational age for third-trimester assessment, at 32 and/or 36 weeks, based on the results (...) Prediction of small for gestational age neonates: screening by fetal biometry at 19-24 weeks. To investigate the value of fetal biometry at 19-24 weeks' gestation in the prediction of delivery of small-for-gestational-age (SGA) neonates, in the absence of pre-eclampsia (PE), and examine the potential value of such assessment in deciding whether the third-trimester scan should be at 32 and/or 36 weeks' gestation.This was a screening study in 88,187 singleton pregnancies, including 5003 (5.7
Measuring the Perimeter and Area of the Sylvian Fissure in Fetal Brain during Normal Pregnancies Using 3-Dimensional Ultrasound. The purpose of this study was to demonstrate the normal perimeter and area of the three orthogonal planes (axial, sagittal and coronal) of the fetal Sylvian fissure along pregnancy using 3-dimensional (3D) ultrasound.Ultrasound volumes of fetalhead were acquired prospectively in 55 fetuses between 12 and 33 gestational weeks. All volumes were analyzed offline by two (...) examiners separately. The largest axial, sagittal and coronal planes of the Sylvian fissure were identified, and the area and perimeter were measured.Measurements of the Sylvian fissure were demonstrated in 54 out of 55 volumes (98%). In all three planes, a linear growth was demonstrated along gestation. All measurements significantly correlated to gestational age and headcircumference (p < 0.01). The Sylvian fissure was found to grow asymmetrically, more at the anterior-posterior direction than
into frequencies of: <0.2 servings/month, 0.2 servings/month -<0.5 servings/week, 0.5-1 servings/week, and >1 servings/week. We abstracted birthweight, birth length, and headcircumference from medical records. Using generalised linear models with a log link, the Poisson family, and robust standard errors, we estimated relative risks and 95% confidence intervals (CI) for low birthweight (LBW, <2500 g) and linear regression models to estimate mean differences for continuous fetal growth indices across seafood (...) Periconceptional Seafood Intake and Fetal Growth. Previous reports of associations of maternal seafood intake with fetal growth were inconsistent. Further, little is known whether associations differ across seafood subtypes or fetal growth indices.Among 3141 participants of the Omega study, a pregnancy cohort study, we investigated associations of periconceptional shell, lean, and fatty fish intake with fetal growth indices. We categorised food frequency questionnaire reported seafood intake
of structured experiences were recorded during a 25-h separation of the infants from their mothers.Infant monkeys with low-transcription MAOA polymorphisms more clearly demonstrated the following ID effects suggested in earlier studies: a 4% smaller headcircumference, a 39% lower cortisol response to social separation, a 129% longer engagement with novel visual stimuli, and 33% lesser withdrawal in response to a human intruder. The high MAOA genotype ID monkeys demonstrated other ID effects: less (...) Fetal iron deficiency and genotype influence emotionality in infant rhesus monkeys. Anemia during the third trimester of fetal development affects one-third of the pregnancies in the United States and has been associated with postnatal behavioral outcomes. This study examines how fetal iron deficiency (ID) interacts with the fetal monoamine oxidase A (MAOA) genotype. MAOA metabolizes monoamine neurotransmitters. MAOA polymorphisms in humans affect temperament and modify the influence of early
of the growth factor receptor-bound protein 10 (GRB10) in term placenta is significantly negatively correlated with headcircumference. Analysis of the paternally expressing delta-like 1 homologue (DLK1) shows that the paternal transmission of type 1 diabetes protective G allele of rs941576 single nucleotide polymorphism (SNP) results in significantly reduced birth weight (-132 g). In conclusion, we have found that the expression of key imprinted genes show a strong correlation with fetal growth (...) The role and interaction of imprinted genes in human fetal growth Identifying the genetic input for fetal growth will help to understand common, serious complications of pregnancy such as fetal growth restriction. Genomic imprinting is an epigenetic process that silences one parental allele, resulting in monoallelic expression. Imprinted genes are important in mammalian fetal growth and development. Evidence has emerged showing that genes that are paternally expressed promote fetal growth
, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage.Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions: fetal weight (FW), birth length (BL), head and abdominal (...) PRETERM BIRTH AND FETAL GROWTH RESTRICTION IN HIV-INFECTED BRAZILIAN PREGNANT WOMEN Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health: mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR).To determine the prevalence of PTB and IUGR in low income
are shown. Biometric data were transformed into z-values.Median gestational age at the time of examination was 22.6 (range 19.0-29.7) weeks of gestation. In all cases, the headcircumference (HC) and the femur length (FL) were within the normal range, but the HC-FL ratio was above the 95th centile in 75% of the cases. An exomphalos, macroglossia, and visceromegaly were observed in 67%, 50%, and 83% of the cases, and in 58% and 83%, there were polyhydramnios and placentamegaly respectively. The fetal (...) Novel fetal and maternal sonographic findings in confirmed cases of Beckwith-Wiedemann syndrome. The objective of the study was to examine the prenatal anomalies in fetuses with Beckwith-Wiedemann syndrome (BWS).The study included a retrospective assessment of 12 pregnancies that were seen at three tertiary referral centres (Universities of Tübingen, Bonn, and Cologne/Germany). The genetic mutation, the results of the second trimester ultrasound examination, and the outcome of the pregnancies
pregnant women were randomized into yoga (n = 27) and control (n = 32) groups. The yoga group received standard care plus yoga sessions (1 hour/day, 3 times/week), from 12th to 28th week of gestation. The control group received standard care plus conventional antenatal exercises (walking). Measurements were assessed at 12th, 20th, and 28th weeks of gestation. Results. RM-ANOVA showed significantly higher values in the yoga group (28th week) for biparietal diameter (P = 0.001), headcircumference (P (...) Effects of yoga on utero-fetal-placental circulation in high-risk pregnancy: a randomized controlled trial. Introduction. Impaired placentation and inadequate trophoblast invasion have been associated with the etiology of many pregnancy complications and have been correlated with the first trimester uterine artery resistance. Previous studies have shown the benefits of yoga in improving pregnancy outcomes and those of yogic visualization in revitalizing the human tissues. Methods. 59 high-risk
randomized controlled trial of single compared with multiple courses of antenatal corticosteroids in women at risk for preterm birth and in which fetuses administered multiple courses of antenatal corticosteroids weighed less, were shorter, and had smaller headcircumferences at birth. All women (n=1,858) and children (n=2,304) enrolled in the Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study were included in the current analysis. Multiple linear regression analyses were (...) undertaken.Compared with placebo, neonates in the antenatal corticosteroids group were born earlier (estimated difference and confidence interval [CI]: -0.428 weeks, CI -0.10264 to -0.75336; P=.01). Controlling for gestational age at birth and confounding factors, multiple courses of antenatal corticosteroids were associated with a decrease in birth weight (-33.50 g, CI -66.27120 to -0.72880; P=.045), length (-0.339 cm, CI -0.6212 to -0.05676]; P=.019), and headcircumference (-0.296 cm, -0.45672 to -0.13528; P
length, and headcircumference, even after women who developed preeclampsia were excluded. Infants born to gravidae with insufficient 25(OH)D or very low calcium intake without elevated PTH or with elevated PTH alone were unaffected.Maternal calcium metabolic stress, rather than low calcium intake or insufficient vitamin D, has an adverse influence on fetal growth. This trial was registered at clinicaltrials.gov as NIH 0320070046. (...) Maternal calcium metabolic stress and fetal growth. Suboptimal maternal calcium intake and vitamin D status may or may not adversely influence fetal growth.It was hypothesized that maternal calcium metabolic stress in early pregnancy, rather than suboptimal calcium intake or insufficient vitamin D, influences the risk of small-for-gestational-age (SGA) births and other aspects of fetal growth. Stress to calcium metabolism was defined as elevated intact parathyroid hormone (PTH) (>62 pg/mL