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Variation of serum ferritin in low birth weight infants with maternal ferritin, birth weight and gestational age.

Serum ferritin measured at birth in 69 low birth weight infants proved to vary with gestational age as well as with weight. The increase with gestational age was even more striking when the infants small for gestational age were excluded. The relation between maternal and infant serum ferritin concentration was investigated for 2 groups of infants and their mothers (*preterm and term infants, respectively). Neither in preterm nor in term infants was the serum ferritin found to vary with that in the respective mothers.

Birth Weight

The status at two years of low-birth-weight infants born in 1974 with birth weights of less than 1,001 gm.

A two-year follow-up study of 43 infants of birth weight less than or equal to 1,000 gm born during 1974 revealed the following: average height at two years was between the tenth and twenty-fifth percentiles; average weight between the third and tenth percentiles. Fifteen (35%) developed lower respiratory tract infections during the first two years. Seven (16%) had retrolental fibroplasia. Major neurologic defects occurred in four (9%); severe developmental delay (mean developmental quotient less than 80) was found in nine others (21%). Defects of the central nervous system were closely associated with a neonatal history of intracranial hemorrhage or seizures or both.

Body Height

Birth weight.

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Birth Weight

Folic acid supplementation in low birth weight infants.

Low birth weight infants (246) entered a trial to folic acid supplementation from 3 weeks to 12 months of age. The folic acid group had significantly higher mean hemoglobin levels at 6 and 9 months of age but the differences were only about 0.5 gm/dl, there was no significant difference in hematocrit, and in both groups of infants the mean hemoglobin levels were higher than those of normal birth weight infants. The differences in hemoglobin, although statistically significant, are of uncertain clinical significance. Median red cell folate levels remained within the normal adult range in both groups of infants. A minority of infants in the untreated group had low red cell folate levels but this was usually temporary, corrected by dietary folate, and not associated with low hemoglobin. Weight gain was not affected by folic acid supplementation. The infants in this trial were fed with a milk preparation containing 3.5 microgram/100 ml of folic acid which is a similar concentration to that of human milk and we recommend that the folate content of milks fed to low birth weight infants should not fall below this level. We do not have sufficient grounds to recommend routine folic acid supplements for all low birth weight infants throughout the first year of life but there is a possibility that their folate intake may sometimes be suboptimal.

Anemia, Macrocytic

Trans-omics integration underscores distinct roles of polyunsaturated phospholipids in bidirectional offspring birth weight deviations.

BACKGROUND: Abnormal birth weights are associated with adverse pregnancy outcomes and future metabolic consequences. We aimed to examine cord blood lipidomes from low, normal and high birth weight (LBW, NBW, HBW) infants to identify core lipid signatures associated with non-optimum birth weight, and to derive biological insights through trans-omics data integration with placental proteome, maternal plasma lipidome and clinical phenome. METHODS: We conducted quantitative lipidomics of cord blood samples from two independent cohorts: a retrospective discovery cohort (n = 147) and a prospective validation cohort (n = 73). Integration with placental proteomics, maternal plasma lipidomics and clinical phenomics was conducted to elucidate potential biological implications. FINDINGS: We identified substantial reductions in cord blood polyunsaturated phospholipids (PUFA-PLs) (FDR <0.05) associated with placental vesicle trafficking and formation in LBW, and altered neutrophil degranulation in HBW. Combinatorial analyses of paired maternal plasma and cord blood samples indicated that cord blood PUFA-PL reductions were not attributable to deficient maternal supply, but rather to impeded assimilation (LBW) and increased utilisation (HBW). INTERPRETATION: Our findings provide biological insights that may inform targetable, lipid-oriented nutritional and/or pharmacological strategies to modulate foetal growth and development, with the goal of optimising clinical outcomes for both mother and child. FUNDING: This work was supported by the National Natural Science Foundation of China (82170854, 81870579, 81870545, 82571043, 2357308); National High Level Hospital Clinical Research Funding (2022-PUMCH-C-019); Noncommunicable Chronic Diseases-National Science and Technology Major Project (2024ZD0530200 and 2024ZD0530204); Beijing Municipal Science & Technology Commission (Z201100005520011); Peking University Clinical Scientist Training Program (No. BMU2023PYJH022); Beijing Municipal Natural Science Foundation (7202163, 7184252).

Humans

Prevention of low birth weight and pre-term birth: literature review and suggestions for research policy.

Mortality during the first week of life has greatly decreased in developed countries, but the gains have been unevenly distributed across socioeconomic groups and geographic areas. Among many explanations for these differences, low birth weight is shown to be significant in the United States, Sweden, and Finland. An imbalance between potential benefits to be gained and the paucity of experiments reporting on this is noted.

Birth Rate

Increased incidence of lactobezoars in low birth weight infants.

Fifteen low birth weight infants had their conditions complicated by the formation of a lactobezoar. The mean gestational age was 30.3 weeks; mean birth weight was 1,184 g, and the mean age at the time of diagnosis was 11.8 days. Twelve of the infants were receiving an 80 kcal/dL-formula and one infant, a 40 kcal/dL-formula designed for the premature infant. Symptoms included abdominal distension, emesis or increased gastric residual, diarrhea, hematest-positive stools, abdominal mass, and gastric perforation.

Bezoars

Birth weight of Hausa infants in Northern Nigeria.

The birth weight of 1460 Hausa singleton infants was recorded and analysed. The birth weight of Hausa infants (Mean +/- SD) was 3.03 +/- 0.45 kg, being higher in males (3.08 +/- 0.47 kg) than females (2.97 +/- 0.48 kg). The difference was significant (P less than 0.001). The mean birth weight of first born children was significantly lower than the subsequent born, and increasing birth order was associated with higher birth weight irrespective of maternal age. The birth weight was influenced more by the parity as compared to maternal age. The incidence of low birth weight was 15.8 per cent, being lower in males (13.6 per cent) as compared to females (18.1 per cent). Comparison were made with studies from other parts of the country as well as from other countries.

Adolescent

Unconjugated hyperbilirubinemia in very low birth weight infants.

In very low birth weight infants, the occurrence of bilirubin-related brain damage has been repeatedly observed at low serum bilirubin concentrations in close association with altered pathophysiologic status (hypoxia, acidosis, hypothermia, and so on). This increased susceptibility is accompanied by increased severity and duration of unconjugated hyperbilirubinemia as compared with more mature infants. Clinical manifestations of kernicterus in very low birth weight infants are almost always nonspecific. No single biochemical or physiologic measurement is sufficient to predict the risk for development of the bilirubin-related brain damage in this group. Prevention of bilirubin-related brain damage in very low birth weight infants requires not only the maintenance of physiologic and biochemical milieu within normal limits, but also specific therapy to alleviate unconjugated hyperbilirubinemia. Although exchange transfusion has been the mainstay of therapy for unconjugated hyperbilirubinemia, the increased morbidity and mortality associated with exchange transfusion in these immature infants and the need to maintain very low serum bilirubin concentrations suggest that prophylactic phototherapy may be more beneficial for this group.

Bilirubin

Prevention of group-B beta-haemolytic streptococcal septicaemia in low-birth-weight neonates by penicillin administered within two hours of birth.

Between January, 1969, and May, 1974, 11 of 1208 low-birth-weight infants had early onset group-B streptococcal septicaemia. All 11 infants were of less than 35 weeks gestational age and 9 presented with the clinical and radiological signs of idiopathic respiratory distress syndrome. 10 died. Antibotics were given to 3 infants only, but not before the age of 12 h. From June, 1974, infants less than 35 weeks gestational age, and from January, 1977, infants less than 2500 g, received systemic penicillin by 2 h of age after throat, ear, umbilical, rectal, and blood cultures. Penicillin was continued for 10 days if group-B streptococci were isolated but was stopped at 48 h of age if all cultures were negative. Between June, 1974, and November, 1977, there was 1 case of septicaemia and no death from group-B streptococal infection in the 983 low-birth-weight infants born during this period. These data suggest that systemic penicillin from birth prevents low-birth-weight infants from dying of group-B streptococcal infection.

Cross Infection

Plasma concentrations of calcium, chromium, copper, iron, magnesium, and zinc in maternal and cord blood and their relationship to low birth weight.

A study of the relationship between low birth weight and concentrations of six metals in maternal and cord plasma was conducted. Maternal and cord blood were collected at delivery. Cases and controls were matched for maternal age (+/- 3 yr), race, parity, socioeconomic status, and smoking habits and the sex of the neonate. Plasma concentrations of calcium, copper, magnesium, and zinc were determined by flame atomic absorption spectrophotometry; plasma chromium and iron concentrations were determined by flameless atomic absorption techniques. Mean maternal plasma concentrations were significantly lower in the low-birth-weight group than in the controls for iron (p = 0.012) and calcium (p = 0.007). Mean cord plasma concentrations were also significantly lower for calcium (p = 0.037). There were no statistically significant differences between the low- and normal-birth-weight groups for the maternal or cord chromium, copper, magnesium, and zinc concentrations or for the cord iron concentrations. It is probably true that many factors, acting additively or synergistically, can produce low birth weight, and that low birth weight acts only as a marker for a number of biologic insults. The results of this study suggest that nutrient metals may be one of these factors.

Calcium