This retrospective case-control study was designed to investigate the relationship between placental localization and intrauterine growth restriction (IUGR). Pregnant women with an anatomic survey from January 1, 2000, to December 31, 2005, and delivery of the pregnancy at Yale-New Haven Hospital (YNHH) were identified using clinical and billing records. Multiple gestation, fetal anomaly, and incomplete medical information were reasons for exclusion. Cases (N=69) were consecutive pregnancies with evidence of IUGR (estimated fetal weight <10th percentile for gestational age) at last follow-up ultrasound. Randomly selected controls (N=258) from the same time period had no evidence of IUGR. Maternal, ultrasound, delivery, and perinatal data were collected by retrospective medical record review, and IUGR cases and non-IUGR controls were compared using the Students t-test, Wilcoxon test, Chi-square analysis, Fishers exact test, and ANOVA. Placental location was determined from the anatomic survey record (obtained at 18.4 ± 1.2 weeks gestation in the IUGR group and 18.2 ± 1.0 weeks gestation in the control group; P=0.18). Multivariate logistic regression with adjustment for confounders was used to investigate the association between IUGR and placental localization. Consistent with known predictors of IUGR, the IUGR group had a higher proportion of black women (36.4% vs. 19.8%, P=0.03), chronic hypertension (26.0% vs. 3.5%, P<0.001), and hypertensive disorders of pregnancy (36.2% vs. 5.0%, P<0.001). Mean birth weights of IUGR and non-IUGR pregnancies differed by 2 kilograms (3244 ± 625 grams vs. 1277 ± 637 grams, P<0.001). IUGR infants were more likely to receive antenatal steroids, deliver preterm, deliver by cesarean section, and be admitted to neonatal intensive care. In both IUGR and non-IUGR pregnancies, the placenta was most commonly anterior or posterior. Unilateral placentas were three times more common in the IUGR group than in the non-IUGR group (17.4% vs. 5.0%, P=0.01). IUGR pregnancies were over four times as likely as control subjects to have unilaterally-located placentas compared to anterior placentas (OR 4.8, 95% confidence interval, 1.9-11.7). Adjusting for ethnicity, chronic hypertension, and hypertensive disorders of pregnancy did not affect this finding (OR 4.6, 95% confidence interval 1.6-13.5). In conclusion, we compared a group of 69 IUGR pregnancies to 258 non-IUGR controls and found intrauterine growth restriction to be associated with unilateral placentation.

Thesis (M.Sc.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science, Centre for Neuroscience. Title from pdf file main screen (viewed on January 27, 2010). Includes bibliographical references.

Intrauterine growth restriction (IUGR) reduces bone mass by 10-30% and impairs arachidonic (AA) and docosahexaenoic (DHA) acid status in infants. Because AA and DHA enhance neonatal bone mass, the aim of this study was to determine the effects of dietary 0.5% AA and 0.2% DHA (w/w) prior to weaning on bone and growth. 40 guinea pigs were randomized to either a control (C) or low-protein diet (LP) during pregnancy and the C diet or the C diet with AA+DHA during lactation. Measurements included bone mass, metabolism, and strength, and erythrocyte lipid of sows and offspring from birth to 16 wk post-partum. The LP diet induced IUGR, while the AA+DHA increased bone mass by 5-20% in sows and offspring and corrected growth and bone mass in IUGR pups. Thus, AA+DHA provided in lactation rescues the growth trajectory in an IUGR state and is beneficial to maternal and neonatal bone mass.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 4 uppsatser.

Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, 2008. / "March 2008" Bibliography: leaves xxvi-xliii. Also available in print form.

Thesis (Ph. D.)--University of Missouri-Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 175-188). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 175-188). Also available on the Internet.

Introduction: fetal growth restriction, also called intrauterine growth restriction (IUGR) is a major complication of pregnancy. It is associated with high rates of perinatal morbidity and mortality and childhood, requiring high financial investments to enable adequate care for these newborns. Justification: need for a clinical and sonographic marker, through which one can predict the risk of a fetus likely to have impaired growth, enabling early, and better perinatal care intervention. Purpose: Check the relationship between the measure the placental volume obtained by antenatal ultrasonography, and immediately after birth by macroscopic in fetuses of pregnant women with suspected IUGR and low-risk pregnant women, and perinatal outcomes. Methods: Cross-sectional, prospective, observational study involving 30 low-risk pregnant women and 19 pregnant women of fetuses with suspected IUGR (weigth and/or waist circumference below the 10th percentile for gestational age), treated at Hospital Universitário de Santa Maria (HUSM). The antepartum placental volume, in cm3, was measured by the method described by Azpurua et al, which uses the measurements of length, height and thickness placenta; through the application provided by the same author, it was determined that percentile is the volume found for the given gestational age. The postpartum volume was measured by Archimedes Principle. Perinatal data were obtained from birth records and medical records of newborns. The measures of the variables were analyzed in the form of mean and standard deviation (parametric data), median and quartiles (nonparametric data). Statistical tests: t-Student, Mann-Whitney test, Pearson correlation; It was satisfactory a significance level of 5%, and the data stored and analyzed using the SPSS version 21.0. Results: There was a highly significant difference between the ultrasound and macroscopic placental volume in both groups (p<0,001); was a correlation between placental volume and Apgar in the first minute in the IUGR group (p<0,02); there was a highly significant association between admission to the neonatal intensive care unit, being higher in IUGR group (p<0,01); 94,7% of patients in the group IUGR had placentas with volume below the p10, used in the application. Conclusions: the volume of the placenta after delivery was lower than calculated before birth, in both groups, which is expected, due to the loss of blood through the placenta after placental delivery Adverse perinatal outcomes were present when the placental volume is small but that could be justified by prematurity. Thus, the findings of this study are suggestive of the placental volume in fetuses with IUGR is decreased and associated with few adverse perinatal outcomes. Studies with larger samples may confirm these assumptions. / Introdução: A restrição do crescimento fetal, também denominada crescimento intrauterino restrito (CIUR), é uma das principais complicações da gravidez. Está associada a elevados índices de morbimortalidade perinatal e na infância, requerendo investimentos financeiros elevados para possibilitar assistência adequada a esses recém-nascidos. Justificativa: Necessidade de pesquisa de marcador clínico-ecográfico, através do qual se possa predizer o risco de um feto vir a ter restrição do crescimento ou desfecho gestacional desfavorável, possibilitando intervenção precoce, e melhor assistência perinatal. Objetivos: Verificar relação entre a medida do volume placentário obtida pela ultrassonografia antenatal, e imediatamente após o nascimento pela macroscopia, em gestantes de fetos com suspeita de CIUR e gestantes de baixo risco, e os achados perinatais. Materiais e métodos: estudo transversal, prospectivo e observacional, realizado com 30 gestantes de baixo risco e 19 gestantes de fetos com suspeita de CIUR (peso fetal estimado e/ou circunferência abdominal abaixo do percentil 10 para a idade gestacional), atendidas no Hospital Universitário de Santa Maria (HUSM). O volume placentário anteparto, em cm3, foi mensurado pelo método descrito por Azpurua et al, que utiliza as medidas do comprimento, altura e espessura placentários; através do aplicativo disponibilizado pelo mesmo autor, determinou-se o percentil em que se encontrava o volume, para a determinada idade gestacional. O volume pós-parto foi medido pelo Princípio de Arquimedes. Dados perinatais foram obtidos dos registros de nascimento e prontuários dos recém-nascidos. As medidas das variáveis estudadas foram analisadas sob a forma de média e desvio padrão (dados paramétricos), mediana e quartis (dados não paramétricos). Testes estatísticos: t-Student, Mann-Whitney, correlação de Pearson; foi considerado satisfatório um nível de significância de 5%, e os dados armazenados e analisados no pacote estatístico SPSS versão 21.0. Resultados: houve diferença altamente significante entre o volume placentário ecográfico e macroscópico, em ambos os grupos (p<0,001); foi verificada correlação entre o volume placentário e o APGAR no primeiro minuto no grupo CIUR (p<0,02); existiu associação altamente significante entre internação na UTI-Neonatal, sendo maior no grupo CIUR (p<0,01); 94,7% das pacientes do grupo CIUR tinham placentas com volume abaixo do p10, no aplicativo utilizado. Conclusões: o volume da placenta no pós-parto foi menor que o calculado antes do nascimento, em ambos os grupos, o que é esperado, em razão da perda de sangue pela placenta após dequitação. Desfechos perinatais desfavoráveis estiveram presentes quando o volume placentário é pequeno, mas que poderiam ser justificados pela prematuridade. Assim, os achados do presente estudo são sugestivos de que o volume placentário em fetos com CIUR é reduzido, e associado a alguns desfechos perinatais adversos, mas estudos com amostras maiores são necessários para confirmar essas hipóteses.

O objetivo deste estudo foi comparar a morbidade e a mortalidade entre prematuros tardios (34 a 36 semanas e 6 dias de idade gestacional ao nascimento) com e sem restrição do crescimento fetal (RCF). O estudo foi desenvolvido longitudinalmente, envolvendo gestantes que apresentaram parto prematuro, sendo 50 com RCF (Grupo I) e 36, sem RCF (Grupo II), no período de outubro de 2004 a outubro de 2006. Foram avaliados os seguintes resultados pós-natais: peso e idade gestacional (IG) ao nascimento, cesárea, Apgar de quinto minuto, pH do sangue da artéria umbilical ao nascimento, necessidade e tempo de intubação orotraqueal (IOT) e de internação na unidade de terapia intensiva neonatal (UTI). Foram também avaliados: síndrome do desconforto respiratório (SDR), sepse, plaquetopenia, hipoglicemia, hemorragia intracraniana (HIC), icterícia e necessidade de fototerapia, tempo de internação e ocorrência de óbito. Para análise estatística foram utilizados os testes de Qui-Quadrado, exato de Fisher e teste não paramétrico de Kruskal Wallis, adotado nível de significância de 5%. As idades gestacionais avaliadas foram semelhantes nos dois grupos, com média de 35,5 semanas. Observou-se, no grupo I, maior freqüência dos seguintes resultados pós-natais adversos: menor peso ao nascimento (p<0,001), maior incidência de cesárea (92% versus 25% do grupo II; p<0,0001), maior necessidade de internação em UTI (58% versus 33%; p=0,041), maior tempo de internação (p<0,001) e de internação em UTI neonatal (p<0,001), maior ocorrência de HIC (12% versus 0; p=0,037), maior ocorrência de hipoglicemia (p= 24% versus 6%; 0,047) e maior tempo de fototerapia (p=0,005). Os grupos não apresentaram diferenças nos índices de Apgar, pH de cordão, IOT, SDR, plaquetopenia, sepse e icterícia. Não houve casos de doença de membrana hialina, displasia broncopulmonar, hemorragia pulmonar ou óbito neonatal. Pode-se concluir que o grupo de prematuros tardios com RCF apresentou mais complicações neonatais do que o grupo sem RCF / The objective of this study was to compare neonatal morbidity and mortality between late-preterm infants (gestational age at birth: 34 to 36 weeks and 6 days) with and without fetal growth restriction (FGR). A longitudinal study was conducted between October 2004 and October 2006 involving 50 pregnant women with pre-term delivery associated with FGR (group I) and 36 women with spontaneous preterm delivery not associated with FGR (group II). The following postnatal outcomes were evaluated: weight and gestational age at birth, cesarean section rate, 5-minute Apgar score, umbilical artery pH at birth, and need for and duration of orotracheal intubation and hospitalization in the neonatal intensive care unit (NICU), as well as the presence of respiratory distress syndrome (RDS), sepsis, thrombocytopenia, hypoglycemia, intracranial hemorrhage (ICH) and jaundice, need for phototherapy, length of hospital stay, and occurrence of death. The chi-square test, Fishers exact test and nonparametric Kruskal-Wallis test were used for statistical analysis, adopting a level of significance of 5%. Gestational age was similar in groups I and II, with a mean of 35.5 weeks in both groups. A higher frequency of the following adverse postnatal outcomes was observed in group I: lower birth weight (p<0.001), higher incidence of cesarean section (92% versus 25% in group II; p<0.0001), greater need for NICU treatment (58% versus 33%; p=0.041), longer hospital (p<0.001) and NICU stay (p<0.001), higher frequency of ICH (12% versus 0; p=0.037) and hypoglycemia (24% versus 6%; p=0.047), and longer duration of phototherapy (p=0.005). No differences in Apgar scores, cord pH, orotracheal intubation, RDS, thrombocytopenia, sepsis, or jaundice were observed between groups. There were no cases of hyaline membrane disease, bronchopulmonary dysplasia, pulmonary hemorrhage, or neonatal death. In conclusion, the group of late-preterm infants with FGR presented more neonatal complications than the group without FGR

Orientador: Vanda Maria Gimenes Gonçalves / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T03:53:56Z (GMT). No. of bitstreams: 1 Brianeze_AnaCarolinaGamaeSilva_M.pdf: 2266577 bytes, checksum: 0438ce034e299c96f18820665012448d (MD5) Previous issue date: 2006 / Resumo: O objetivo deste estudo foi avaliar e comparar o desempenho mental e o controle motor em lactentes nascidos a termo, pequenos (PIG) ou adequados (AIG) para idade gestacional no 12º mês de vida. Estudo prospectivo durante o 1º ano de vida. A análise dos resultados foi realizada em um corte seccional no 12º mês de vida. Os recém-nascidos (RN) foram selecionados no Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas (Unicamp), entre Maio de 2000 e Julho de 2003. Para cada neonato PIG foram selecionados os dois próximos neonatos AIG. Foram incluídos nesta pesquisa: RN nascidos a termo, idade gestacional entre 37 e 41 semanas; peso de nascimento abaixo do percentil 10 para o grupo PIG ou entre os percentis 10 e 90 para o grupo AIG; residentes na região metropolitana de Campinas. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Unicamp. Foram excluídos RN com síndromes genéticas, malformações ou infecções congênitas diagnosticadas no período neonatal; peso de nascimento acima do percentil 90 e os que necessitaram de internação em unidade de terapia intensiva neonatal. Foram utilizadas as Escalas Bayley de Desenvolvimento Infantil II (BSID-II) (1993), aplicadas no 12º mês de vida, com ênfase em provas motoras de controle postural. Os dados registrados nos roteiros de avaliação foram transcritos e armazenados nos moldes de arquivo para o banco de dados do programa ¿Statistical Package for Social Sciences for Personal Computer¿ (SPSS/PC), versão 11 e analisados através do ¿Statistical Analysis System¿ (¿SAS System for Windows¿), versão 8.02. A população de 95 lactentes compareceu a pelo menos uma avaliação programada no 1º ano de vida e a amostra seccional avaliada no 12º mês foi composta por 70 lactentes (23 PIG e 47 AIG). No estudo da população, o grupo PIG apresentou peso ao nascimento significativamente menor que o grupo AIG. Os grupos apresentaram diferenças na distribuição de algumas variáveis maternas. A escolaridade menor que 8 anos esteve 3,71 vezes mais associada ao grupo PIG e a ocupação esteve 0,18 vezes mais associada ao grupo PIG. No estudo amostral, o grupo PIG apresentou peso ao nascimento significativamente menor que o grupo AIG. Ocupação materna foi 0,22 vezes mais associada ao grupo PIG. Os valores de ¿index score¿ na escala motora foram significativamente menores no grupo PIG (p= 0,046). No estudo do controle postural da amostra, observou-se diferença significativa entre os grupos, nas provas MO 61: fica em pé sozinho, (p= 0,019) e MO 71: caminha para o lado, (p= 0,020), com maior freqüência de execução no grupo AIG. Concluiu-se que lactentes nascidos PIG apresentaram pontuações significativamente mais baixas na escala motora, sendo que as provas: fica em pé sozinho e caminha para o lado, mostraram diferença significativa, executada por menor proporção de lactentes do grupo PIG / Abstract: The objective of this study was to assess and to compare the mental performance and motor control in infants born at term, small (SGA) or appropriate (AGA) for gestational age in the 12th month of life. It was a prospective study during the 1st year of life. The analysis of the results was done in a sectional cohort in the 12th month of life. The neonates were selected in the Center of Integral Attention to the Woman's Health at Universidade Estadual de Campinas (Unicamp) from May 2000 to July 2003. To each SGA neonate, the next two AIG neonates were selected. In this research were included: neonates at term, gestational age between 37 and 41 weeks, birth weight below the 10 percentile for the SGA group or between the 10 and 90 percentiles for the AGA group; living in the Campinas metropolitan area. Ethical permission was obtained from the Research Ethics Committee at Unicamp. Genetic syndromes, multiple congenital malformations or verified congenital infections; birth weight above the 90 percentile and those who needed neonatal intensive care were excluded. The Bayley Scales of Infant Development-II (BSID-II) (1993) were used in the 12th month of life, with emphasis in items for the motor postural control. The data registered in the record form were transcribed and stored in the data bank of the Statistical Package for Social Sciences for Personal Computer (SPSS/PC), version 11, and were analyzed through the Statistical Analysis System (SAS System for Windows), version 8.02. A population of 95 infants was assessed at least once in the 1st year of life. The sectional sample in the 12th month was composed of 70 infants (23 SGA and 47 AGA). In the population study, the SGA group showed birth weight significantly lower than the AGA group. There was difference in the distribution of some maternal variables. The scholarship below 8 years was 3.71 times more associated to the SGA group and the maternal occupation was 0.18 times more associated to the SGA group. In the sample study, the SGA group showed birth weight significantly lower than the AGA group. Maternal occupation was 0.22 times more associated to the SGA group. The motor index score was significantly lower in the SGA group (p= 0.046). In the study of the postural control of the sample, there was significant difference between the groups in the item MO 61: stands up alone (p= 0.019) and MO 71: walks sideways (p= 0.020), with lower frequency for the SGA / Mestrado / Ciencias Biomedicas / Mestre em Ciências Médicas