Background: Subnormal head circumference (HC) has been associated with poor neurologic and developmental outcomes. Aim: To examine the correlates and consequences of subnormal HC in a cohort of school age, very low bi...Background: Subnormal head circumference (HC) has been associated with poor neurologic and developmental outcomes. Aim: To examine the correlates and consequences of subnormal HC in a cohort of school age, very low birth weight (VLBW, < 1500 g) children. Study design and outcome measures: We examined developmental outcomes at a mean age of 6.8 years in a cohort of 128 VLBW children born from 1982- 1986 and 58 normal birth weight controls. The VLBW cohort included a regional sample of < 750 g birth weight children and matched children with 750- 1499 g birth weight. Outcomes included an IQ equivalent, neuropsychological skills, academic achievement, adaptive behavior, and attention problems. HC was defined along a continuum and as subnormal vs. normal. Linear and logistic regressions were employed to determine the effects of HC on the outcomes after controlling for confounding variables. Results: Thirty one VLBW children (24% ) had subnormal HC vs. none of the controls. The VLBW children with subnormal HC differed significantly from the normal HC group in birth weight (748 g vs. 977 g, p < 0.001), SGA status (52% vs. 27% , p < 0.05), high neonatal risk (57% vs 29% , P < 0.05), and neurosensory impairment (23% vs 8% , P < 0.05). Even after taking these risk factors into account, subnormal HC was associated with poorer IQ equivalent, perceptual motor skills, academic achievement, and adaptive behavior. Results were similar after excluding the children with neurosensory impairment. Conclusions: Subnormal HC is associated with adverse developmental outcomes in VLBW children, independent of other risk factors. Interventions to improve antenatal and postnatal growth may contribute to better school- age outcomes.展开更多
Our objective was to compare the blood pressure of 20- y-old very low birth weight (VLBW; < 1.5 kg) individuals with that of normal birth weight (NBW) control individuals. The population included 195 VLBW (92 femal...Our objective was to compare the blood pressure of 20- y-old very low birth weight (VLBW; < 1.5 kg) individuals with that of normal birth weight (NBW) control individuals. The population included 195 VLBW (92 female and 103 male) and 208 NBW (107 female and 101 male) individuals who were born between 1977 and 1979. Independent effects of birth weight status (VLBW versus NBW) and within the VLBW cohort of intrauterine growth (birth weight z score) were examined via multiple regression analyses. VLBW individuals had a higher mean systolic blood pressure (SBP) than NBW control individuals (114 ± 11 versus 112± 13 mm Hg). SBP for VLBW female infants was 110± 9 versus NBW 107± 12 and for VLBW male individuals was 118± 11 versus NBW 117± 11 mm Hg. After adjustment for gender, race, and maternal education, the difference in SBP between VLBW and NBW individuals was 1.9 mm Hg but was 3.5 mm after also adjustment for later size (20- y weight and height z scores), which reflects catch-up growth. For female individuals, the difference in SBP between VLBW and NBW individuals was significant both unadjusted and adjusted for later size, whereas for male individuals, the differencewas significant only after adjustment for later size. Intrauterine growth did not have a significant effect on SBP within the VLBW group, even after adjustment for later size. VLBW individuals, specifically female individuals, have a higher SBP than NBW control individuals. This is not explained by intrauterine growth failure.展开更多
OBJECTIVE: To estimate whether maternal weight changes between pregnancies i nf luence the risk for small for gestational age (SGA) births. METHODS: SGA cases ( n = 8,062) below the tenth percentile birth weight for g...OBJECTIVE: To estimate whether maternal weight changes between pregnancies i nf luence the risk for small for gestational age (SGA) births. METHODS: SGA cases ( n = 8,062) below the tenth percentile birth weight for gestational age were sele cted from liveborn singletons born of Missouri residents during 1989-1997. Norm al weight controls (n = 8,062) were selected according to birth year. The risk o f SGA from interpregnancy body mass index (BMI) change and other maternal factor s was estimated using logistic regression analysis. RESULTS: An increase in BMI between pregnancies decreased SGA risk (adjusted odds ratio = 0.8; 95%confidenc e interval 0.7, 1.0). Other risk factors were prior SGA (4.4; 4.0, 4.8), preecla mpsia/eclampsia (2.6; 2.1, 3.2), maternal cardiac disease (1.8; 1.1, 2.9), inade quate weight gain (1.9; 1.8, 2.2), and cigarette smoking (1.9; 1.7, 2.3 for 1-9 cigarettes per day; 2.5; 2.2, 2.8 for 10-19/d; and 2.8; 2.5, 3.3 for 20/d or m ore). CONCLUSION: Increase in interpregnancy BMI lowers SGA risk, but adequate w eight gain during pregnancy is more effective.展开更多
文摘Background: Subnormal head circumference (HC) has been associated with poor neurologic and developmental outcomes. Aim: To examine the correlates and consequences of subnormal HC in a cohort of school age, very low birth weight (VLBW, < 1500 g) children. Study design and outcome measures: We examined developmental outcomes at a mean age of 6.8 years in a cohort of 128 VLBW children born from 1982- 1986 and 58 normal birth weight controls. The VLBW cohort included a regional sample of < 750 g birth weight children and matched children with 750- 1499 g birth weight. Outcomes included an IQ equivalent, neuropsychological skills, academic achievement, adaptive behavior, and attention problems. HC was defined along a continuum and as subnormal vs. normal. Linear and logistic regressions were employed to determine the effects of HC on the outcomes after controlling for confounding variables. Results: Thirty one VLBW children (24% ) had subnormal HC vs. none of the controls. The VLBW children with subnormal HC differed significantly from the normal HC group in birth weight (748 g vs. 977 g, p < 0.001), SGA status (52% vs. 27% , p < 0.05), high neonatal risk (57% vs 29% , P < 0.05), and neurosensory impairment (23% vs 8% , P < 0.05). Even after taking these risk factors into account, subnormal HC was associated with poorer IQ equivalent, perceptual motor skills, academic achievement, and adaptive behavior. Results were similar after excluding the children with neurosensory impairment. Conclusions: Subnormal HC is associated with adverse developmental outcomes in VLBW children, independent of other risk factors. Interventions to improve antenatal and postnatal growth may contribute to better school- age outcomes.
文摘Our objective was to compare the blood pressure of 20- y-old very low birth weight (VLBW; < 1.5 kg) individuals with that of normal birth weight (NBW) control individuals. The population included 195 VLBW (92 female and 103 male) and 208 NBW (107 female and 101 male) individuals who were born between 1977 and 1979. Independent effects of birth weight status (VLBW versus NBW) and within the VLBW cohort of intrauterine growth (birth weight z score) were examined via multiple regression analyses. VLBW individuals had a higher mean systolic blood pressure (SBP) than NBW control individuals (114 ± 11 versus 112± 13 mm Hg). SBP for VLBW female infants was 110± 9 versus NBW 107± 12 and for VLBW male individuals was 118± 11 versus NBW 117± 11 mm Hg. After adjustment for gender, race, and maternal education, the difference in SBP between VLBW and NBW individuals was 1.9 mm Hg but was 3.5 mm after also adjustment for later size (20- y weight and height z scores), which reflects catch-up growth. For female individuals, the difference in SBP between VLBW and NBW individuals was significant both unadjusted and adjusted for later size, whereas for male individuals, the differencewas significant only after adjustment for later size. Intrauterine growth did not have a significant effect on SBP within the VLBW group, even after adjustment for later size. VLBW individuals, specifically female individuals, have a higher SBP than NBW control individuals. This is not explained by intrauterine growth failure.
文摘OBJECTIVE: To estimate whether maternal weight changes between pregnancies i nf luence the risk for small for gestational age (SGA) births. METHODS: SGA cases ( n = 8,062) below the tenth percentile birth weight for gestational age were sele cted from liveborn singletons born of Missouri residents during 1989-1997. Norm al weight controls (n = 8,062) were selected according to birth year. The risk o f SGA from interpregnancy body mass index (BMI) change and other maternal factor s was estimated using logistic regression analysis. RESULTS: An increase in BMI between pregnancies decreased SGA risk (adjusted odds ratio = 0.8; 95%confidenc e interval 0.7, 1.0). Other risk factors were prior SGA (4.4; 4.0, 4.8), preecla mpsia/eclampsia (2.6; 2.1, 3.2), maternal cardiac disease (1.8; 1.1, 2.9), inade quate weight gain (1.9; 1.8, 2.2), and cigarette smoking (1.9; 1.7, 2.3 for 1-9 cigarettes per day; 2.5; 2.2, 2.8 for 10-19/d; and 2.8; 2.5, 3.3 for 20/d or m ore). CONCLUSION: Increase in interpregnancy BMI lowers SGA risk, but adequate w eight gain during pregnancy is more effective.
