INTRODUCTION: In the face of unchanging high rates of stunting among 12-23 months old Filipino babies, sustaining exclusive breastfeeding up to 6 months old remains a challenge. This study determined the effect of a breastfeeding reminder system on breastfeeding. METHODS: This is a quasi-experimental study. Mothers were regularly given breastfeeding reminders by SMS and phone call. The weight, body length, episodes of upper respiratory tract infection and diarrhea were compared between the babies who were given exclusive breastfeeding and those whose exclusive breastfeeding was not sustained. Pearson Chi – square test and t-test at p=0.05 determined significance of differences of variables. RESULTS: From March- October 2020, there were 450 babies included in the study. Of these babies, 44.8% were given exclusive breastfeeding up to 6 months. Timely initiation of breastfeeding was practiced by 91.95% of the mothers in the study. Babies who did not receive exclusive breastfeeding were shorter than those who received exclusive breastfeeding at 1 year old (70.11cm +2.78 vs.75.47cm +1.41, p<0.001) and at 2 years old (80.89 cm +2.30 vs. 87.29cm +1.47, p<0.001). At 2 years old, babies who received exclusive breastfeeding had no episodes of diarrhea and minimal (2%, p<0.001) episodes of acute respiratory infections. CONCLUSION Due to the implementation of the reminder system, the percentage of babies exclusively breastfed up to 6 months of age increased to 44%. This is a significant improvement compared to a previous study where only 29% of the babies were exclusively breastfed.At one and two years old, babies who were not exclusively breastfed had stunting, weighed less and had more infections (diarrhea and URTI).
exclusive breastfeeding ; infants ; stunting

Birth Weight ; Body Height ; Fetal Growth Retardation ; Growth Disorders ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases

The teratogenic effects of alcohol have been recognized in fetal alcohol syndrome (FAS). FAS is a collection of signs and symptoms seen in some children exposed to alcohol in the prenatal period. An 8 month-old-male with an alcoholic mother was diagnosed as a case of FAS according to the following : 1) early-onset intrauterine growth retardation and persistent postnatal growth failure 2) psychomotor retardation 3) craniofacial dysmorphism. Early diagnosis and continued education are advantageous at all levels, benefiting both the individual and all of society. We present this case with a brief review of related literatures.
Alcoholics ; Child ; Early Diagnosis ; Education ; Fetal Alcohol Spectrum Disorders* ; Fetal Growth Retardation ; Humans ; Mothers

Thrombophilia refers to inherited or acquired hemostatic disorders that result in a predisposition to blood clot formation. When combined with the hypercoagulable state that is characteristic of pregnancy, there is an increased risk of severe and recurrent pregnancy complications. Activated protein C resistance caused by factor V Leiden (FVL) mutation is known to be the most common cause of inherited thrombophilia in Caucasian population. FVL mutation has been related to pregnancy complications associated with hypercoagulation, e.g. miscarriage, intrauterine fetal demise, placental abruption, and intrauterine growth retardation. Although the FVL mutation is easily detected using molecular DNA techniques, patients who are heterozygous for this disorder often remain asymptomatic until they develop a concurrent prothrombotic condition. Because there are potentially serious effects of FVL mutation for pregnancy, and because effective treatment strategies exist, early detection and treatment of this condition might be considered.
Abortion, Spontaneous ; Abruptio Placentae ; Activated Protein C Resistance ; DNA ; Factor V ; Female ; Fetal Death ; Fetal Growth Retardation ; Hemostatic Disorders ; Humans ; Pregnancy Complications ; Pregnancy ; Pregnant Women ; Thrombophilia

To investigate the incidence and risk factors of extrauterine growth retardation (EUGR) in very low birth weight infants (VLBWI). This prospective, multicenter observational cohort study was conducted based on Shandong Neonatal Network (SNN). The clinical data of the VLBWI (=1 051), who were admitted to 27 neonatal intensive care units from January 1, 2018 to December 31, 2018, were collected and analyzed. According to the weight at discharge or 36 weeks of postmenstrual age, all the enrolled VLBWI were assigned into EUGR group and non-EUGR group. Univariate and multivariate logistic regression analyses were used to detect the risk factors for EUGR in preterm small for gestational age (SGA) and non-SGA infants. A total of 1 051 VLBWI were enrolled, with 51.7% (543/1 051) male. The incidence of EUGR in the whole group was 60.7% (638/1 051), and were 78.3% (90/115) and 46.9% (53/113) in extremely low birth weight infant (ELBWI) and extremely preterm infants (EPI), respectively. The incidence of EUGR in SGA and non-SGA infants were 87.6% (190/217) and 53.7% (448/834), respectively. Logistic regression analysis showed that, withholding feeds (1.531, 1.237, 95: 1.180-1.987, 1.132-1.353, both <0.01) and time to achieve full enteral feeding (1.090, 1.023, 95: 1.017-1.167, 1.002-1.045, 0.014, 0.034) were independent risk factors of EUGR in both SGA and non-SGA infants. For SGA infants, cesarean delivery was an independent risk factor for EUGR (8.147, 95: 2.127-31.212, 0.002); while for non-SGA infants, hypertensive disorders during pregnancy (2.572, 95: 1.496-4.421, 0.001) and the duration of invasive ventilation (1.050, 95: 1.009 - 1.092, 0.016) were independent risk factors of EUGR. Besides, moderate and severe bronchopulmonary dysplasia (2.241, 95: 1.173-4.281, 0.015), necrotizing enterocolitis (5.633, 95: 1.333-23.796, 0.019) and retinopathy of prematurity (2.219, 95: 1.268-3.885, 0.005) were associated with EUGR. The incidence of weight-defined EUGR is high in VLBWI, especially in preterm SGA infants. Avoiding delaying feeds after birth and achieving full enteral feeding early may reduce the incidence of EUGR.
Birth Weight ; China ; epidemiology ; Cohort Studies ; Female ; Fetal Growth Retardation ; epidemiology ; Gestational Age ; Growth Disorders ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Male ; Pregnancy ; Prospective Studies ; Risk Factors

Fetal alcohol syndrome can be suspected in infants born to mothers with a prenatal history of alcohol abuse if the child exhibits characteristic facial features, together with intrauterine growth retardation, multiple neurological abnormalities, and multiorgan defects. If only a few of the above criteria are satisfied, the term fetal alcohol effects is used. We experienced a neonate who presented with hydrocephalus, low birth weight, seizure, right renal agenesis, characteristic facial features and a maternal history of alcohol abuse, and diagnosed him as fetal alcohol syndrome(FAS), with accompanying meconium aspiration syndrome, and persistent pulmonary hypertension of the newborn. There is no definite cure for FAS, but it can be prevented by maternal abstinence from drinking; thus maternal education, understanding and early diagnosis of those affected are of importance.
Alcoholism ; Child ; Drinking ; Early Diagnosis ; Education ; Fetal Alcohol Spectrum Disorders* ; Fetal Growth Retardation ; Humans ; Hydrocephalus ; Hypertension, Pulmonary* ; Infant ; Infant, Low Birth Weight ; Infant, Newborn* ; Meconium Aspiration Syndrome ; Mothers ; Seizures

Essential thrombocythaemia (ET) is a chronic myeloproliferative disorder characterized by markedly elevated platelet count in the peripheral blood due to an excessive proliferation of bone marrow megakaryocytes. The pregnancy outcome among patients with ET is mostly successful but adverse outcome due to thrombotic and bleeding complications is a matter of concern: miscarriage, intrauterine growth retardation, abruptio placenta, intrauterine fetal death and preterm delivery. Various treatments such as acetylsalicylic acid, hydroxyurea, anagrelide, heparin, interferon alpha and plateletpheresis have been proposed to improve the pregnancy outcome. We report a case of pregnant woman in condition of ET who succeeded in normal vaginal delivery without specific obstetric complications after low dose aspirin therapy during pregnancy.
Abortion, Spontaneous ; Aspirin* ; Bone Marrow ; Female ; Fetal Death ; Fetal Growth Retardation ; Hemorrhage ; Heparin ; Humans ; Hydroxyurea ; Interferon-alpha ; Megakaryocytes ; Myeloproliferative Disorders ; Placenta ; Platelet Count ; Plateletpheresis ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women

It has been estimated that chromosomal aberrations account for 2.3% to 3% of normal pregnancies, and of them, 85% are aborted. Therefore, the survival rate of neonates with chromosomal aberrations is very low. Among them, patients with partial deletion of the long arm of chromosome 13 are very rare. The natural history of deletion of the long arm is dependent on the deleted segment. It has been known that patients with proximal deletions not extending into q32 usually show mild to moderate mental retardation, variable minor anomalies, and growth retardation. Patients with more distal deletions, including at least part of q32, usually have severe mental retardation, growth deficiency, and major malformations including microcephaly and CNS defects, distal limb anomalies, eye defects, and gastrointestinal malformation. We report a case of a 13(q24) deletion male infant who showed intrauterine growth retardation, imperforate anus, CNS anomalies, hydronephrosis, clubfoot, clinodactyly and developmental delay, although his deletion site was proximal to q32.
Anus, Imperforate ; Arm ; Chromosome Aberrations ; Chromosome Disorders ; Chromosomes, Human, Pair 13 ; Clubfoot ; Extremities ; Fetal Growth Retardation ; Humans ; Hydronephrosis ; Infant ; Infant, Newborn ; Intellectual Disability ; Male ; Microcephaly ; Natural History ; Pregnancy ; Survival Rate

OBJECTIVETo explore the reason for discordant results of karyotyping and microarray analysis in a fetus with mosaic tetrasomy 9p.

METHODSAmniocentesis was carried out for a pregnant woman with advanced age for whom ultrasound scan has indicated fetal ventricular expansion, intrauterine growth retardation and persistent upper venous cavity. G-banded karyotyping and single nucleotide polymorphism-based arrays (SNP-array) analysis were performed at the same time.

RESULTSAnalysis of amniocytic chromosome has suggested mosaic tetrasomy 9p (47,XX,+psu idic(9)(q21)[23]/46,XX[27]). While SNP-array has detected a non-mosaic trisomy 9p with a 68.7 Mb duplication at 9p24.3q21.11. The results of the two methods were therefore discordant.

CONCLUSIONSNP-array will analyze genetic material in the form of numbers rather than morphology. For chimeras containing two types of cell lines, when the mosaic rate was close to 50% and the average amount of genetic material of the chimeras was equivalent to the amount of genetic material of non-chimeras, microarray analysis may come to the conclusion of a non-mosaic heteroploidy. Therefore, microarray results for large segment chromosome abnormalities should be combined with the results of G-banded karyotyping for genetic counseling.

Adult ; Amniocentesis ; methods ; Aneuploidy ; Chromosome Banding ; Chromosome Disorders ; diagnosis ; genetics ; Chromosomes, Human, Pair 9 ; Diagnostic Errors ; Female ; Fetal Growth Retardation ; diagnosis ; genetics ; Humans ; Infant, Newborn ; Karyotyping ; Male ; Mosaicism ; Oligonucleotide Array Sequence Analysis ; methods ; Polymorphism, Single Nucleotide ; Pregnancy ; Pregnancy Outcome ; Trisomy

The small baby is a major challenge of modern obstetrics. Not only is low birth weight the most important factor associated with perinatal mortality but there are also dangers of short and long term mental or physical handicap in survivors. General management includes treatment of maternal disease, cessation of substance abuse, good nutrition and institution of bed rest. Although not of proven benefit, bed rest may maximize uterine blood flow. In any case, antenatal testing should be instituted. Because the task of the obstetrician is to deliver the baby in the best possible condition, which is possible only if the baby at risk has been recognized during the antenatal period, the place of intrapartum monitoring and the use of cesarean section in the management of the small baby are questions of everyday relevance to the practicing obstetrician. Delivery should be in a hospital capable of dealing with the various neonatal morbidities associated with growth restriction, including asphyxia, sepsis and malformations. Minimizing hypoxic episodes during labor and delivery, as well as optimizing neonatal care for these infants, will likely produce the healthiest outcome.
Asphyxia ; Bed Rest ; Cesarean Section ; Female ; Fetal Growth Retardation ; Humans ; Hypogonadism ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Mitochondrial Diseases ; Obstetrics ; Ophthalmoplegia ; Perinatal Mortality ; Pregnancy ; Premature Birth ; Sepsis ; Substance-Related Disorders ; Survivors