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Der Index der Körperfülle als Mass des Emährungszustandes

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... In these studies, macrosomia is defined as being disproportionately heavy for length or having a disproportionately large torso to head size. In decreasing order of complexity, the methods include • Neonatal growth assessment score (Deter 2004) • Ratios of length to square root of expected and observed birthweight (Niklasson and Karlberg 1993) • Ponderal index (Rohrer 1921) • Ratios of length and weight z-scores (Niklasson and Karlberg 1993) • Weight for length • Head to torso ratios ...
... An index of weight adjusted for height was originally described in 1921 under the visually evocative term: "Rohrer's index of corpulence". (Rohrer 1921) On theoretical grounds, it is reasonable to assume that weight will relate to volume and thus be scaled to the cube of length. For this reason, the most commonly used ponderal index is calculated as P.I. = 100 x [weight (g) ÷ (length (cm)) 3 ] It was hoped that ponderal index would reliably distinguish sick from healthy, small or large infants, better than population norms. ...
... The nutritional status of the newborn was evaluated using the ponderal index (PI) of Rohrer [28] adjusting by sex and gestational age. Proposed by Rohrer, the PI indicates how heavy a newborn is relative to its length [29][30][31][32]. ...
... INTERGROWTH21st the probability drops to 32.20%. These results are consistent with those found by Gonzalez et al. [28] However, in our study, an analysis of the ROC curves shows that the AUC obtained by both methods is very similar and the small difference observed (0.70 vs. 0.68) is not statistically significant. Again, it should be noted that, with the prevalence of newborns with PI> 90th centile, the lack of significance could be due to an insufficient sample size since 1603 individuals would have been required to have a statistical power of 80%. ...
Preprint
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Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index . Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21st
... The nutritional status of the newborn was evaluated using the ponderal index (PI) of Rohrer [28] adjusting by sex and gestational age. Proposed by Rohrer, the PI indicates how heavy a newborn is relative to its length [29][30][31][32]. ...
... INTERGROWTH21st the probability drops to 32.20%. These results are consistent with those found by Gonzalez et al. [28] However, in our study, an analysis of the ROC curves shows that the AUC obtained by both methods is very similar and the small difference observed (0.70 vs. 0.68) is not statistically significant. Again, it should be noted that, with the prevalence of newborns with PI> 90th centile, the lack of significance could be due to an insufficient sample size since 1603 individuals would have been required to have a statistical power of 80%. ...
Preprint
Full-text available
Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions In pregnant women with DMG, the ability of personalized fetal growth curves to identify newborns with alterations in nutritional status could exceed that of INTERGROWTH21st.
... 15 Neonatal BMI has a relatively low association with body fat percent (r 2 ¼ 0.43, p < 0.0001). 16 The ponderal index (weight/length 3 ), 16 commonly used in neonatology to address the symmetrics of growth retardation, has an even lower association with body fat percent. 17 Weight and length data can be used in many ways to produce a wide array of anthropometric indices, some of which are routinely used in clinical settings. ...
... 15 Neonatal BMI has a relatively low association with body fat percent (r 2 ¼ 0.43, p < 0.0001). 16 The ponderal index (weight/length 3 ), 16 commonly used in neonatology to address the symmetrics of growth retardation, has an even lower association with body fat percent. 17 Weight and length data can be used in many ways to produce a wide array of anthropometric indices, some of which are routinely used in clinical settings. ...
Article
Objective Body composition provides additional information than weight alone. There is currently no accepted anthropometric measure of adiposity in infants, yet weight and length data allow calculations of a wide array of indices. The study objective was to identify the anthropometric index which best correlates with neonatal adiposity, by examining the associations between neonatal fat mass and several anthropometric indices of newborn infants. Study Design The sum of skinfolds (SSF), birth weight, and birth length were measured in 94 healthy infants (58% males) born at term to healthy mothers. Several anthropometric indices were calculated, and their relationship with SSF was assessed using linear regression adjusting for gestational age and sex. Results SSF at birth was significantly higher in females compared with males (20.7 ± 3.3 vs. 18.8 ± 4.1 mm, p = 0.019). Birth weight, birth weight-for-gestational-age percentile, birth weight percentile, and weight/length ratio had the highest associations with SSF, yet R (2) values were very low, ranging from 16 to 18%. Body mass index (BMI), BMI percentile, ponderal index, and the symmetry index had even lower associations. Conclusion No anthropometric measure can confidently assess fat mass in infants at birth, in accordance with previous research. When body composition data are needed, they should be directly measured. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
... It is to be noted at this point, however, that both assumptions have elicited criticism, e.g. [19] [20] [21], leading to proposals of alternative power-law measures such as the Benn Index [22] and Rohrer's Index [23], non-power law correlations such as [24] [25], and empirical parametric models such as [26], all purporting to determine more satisfactorily than BMI a single optimal relationship between human weight and height. ...
... Relative weight per unit body length was expressed as body mass index (BMI, kg·CRL -2 ), G 215 index (GI, kg·CRL -1.5 ) (Gootwine, 2013), and ponderal index (PI, kg·CRL -3 ) (Rohrer, 1921). ...
Article
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Key points: Fetal growth restriction increases the risk of fetal and neonatal mortality and morbidity, and contributes to increased risk of chronic disease later in life. Intra-amniotic insulin-like growth factor-1 (IGF1) treatment of the growth-restricted ovine fetus improves fetal growth, but postnatal effects are unknown. Here we report that intra-amniotic IGF1 treatment of the growth-restricted ovine fetus alters size at birth and mechanisms of early postnatal growth in a sex-specific manner. We also show that maternal plasma C-type natriuretic peptide (CNP) products are related to fetal oxygenation and size at birth, and hence may be useful for non-invasive monitoring of fetal growth restriction. Intrauterine IGF1 treatment in late gestation is a potentially clinically relevant intervention that may ameliorate the postnatal complications of fetal growth restriction. Abstract: Placental insufficiency-mediated fetal growth restriction (FGR) is associated with altered postnatal growth and metabolism, which are, in turn, associated with increased risk of adult disease. Intra-amniotic insulin-like growth factor-1 (IGF1) treatment of ovine FGR increases growth rate in late gestation, but the effects on postnatal growth and metabolism are unknown. We investigated the effects of intra-amniotic IGF1 administration to ovine fetuses with uteroplacental embolisation-induced FGR on phenotypical and physiological characteristics in the 2 weeks after birth. We measured early postnatal growth velocity, amino-terminal propeptide of C-type natriuretic peptide (NTproCNP), body composition, tissue-specific mRNA expression, and milk intake in singleton lambs treated weekly with 360 μg intra-amniotic IGF1 (FGRI; n = 13 females, 19 males) or saline (FGRS; n = 18 females, 12 males) during gestation, and in controls (CON; n = 15 females, 22 males). There was a strong positive correlation between maternal NTproCNP and fetal oxygenation, and size at birth in FGR lambs. FGR lambs were ∼20% lighter at birth and demonstrated accelerated postnatal growth velocity. IGF1 treatment did not alter perinatal mortality, partially abrogated the reduction in newborn size in females, but not males, and reduced accelerated growth in both sexes. IGF1-mediated upregulation of somatotrophic genes in males during the early postnatal period could suggest that treatment effects are associated with delayed axis maturation, whilst treatment outcomes in females may rely on the reprogramming of nutrient-dependent mechanisms of growth. These data suggest that the growth-restricted fetus is responsive to intra-amniotic intervention with IGF1, and that sex-specific somatotrophic effects persist in the early postnatal period.
... Ponderal index (PI), average neonatal weight gain and fetal growth were assessed using published standards [24,28,29]. Ponderal index was defined as weight in kg divided by length in meters cubed [23]. Gestational hypertension and pre-eclampsia were determined by the treating obstetrician's assessment and collapsed into a single group, gestational hypertension. ...
Article
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Gastroschisis patients are commonly small for gestational age (SGA, birth weight [BW] < 10th centile). However, the extent, symmetry and causes of that growth restriction remain controversial. We compared BW, crown-heel length (LT), occipitofrontal circumference (OFC) and ponderal index (PI) in 179 gastroschisis cases and 895 matched controls by univariate and multiple regression. Fetal ultrasounds (N = 80) were reviewed to determine onset of growth restriction. Placental histology was examined in 31 gastroschisis patients whose placental tissue was available and in 29 controls. Gastroschisis cases weighed less than controls (BW = 2400 ± 502 g vs. 2750 ± 532 g, p < 0.001) and their BW frequency curve was shifted to the left, indicating lower BW as a group compared to controls (p < 0.001 by Kolmogorov-Smirnov test). BW differences varied from -148 g at 33 weeks to -616 g at 38 weeks gestation. Intrauterine growth restriction was symmetric with gastroschisis patients having a shorter LT (45.7 ± 3.3 vs. 48.4 ± 2.7 cm, p < 0.001), smaller OFC (31.9 ± 1.9 vs. 32.9 ± 1.6 cm, p < 0.001), but larger ponderal index (2.51 ± 0.37 vs. 2.40 ± 0.16, p < 0.001) compared to controls. Gastroschisis patients had a similar reduction in BW (-312 g, 95% confidence interval [CI] = -367, -258) compared to those with chromosomal abnormalities (-239 g, CI = -292, -187). Growth deficits appeared early in the second trimester and worsened as gestation increased. Placental chorangiosis was more common in gastroschisis patients than controls, even after removing all SGA patients (77% vs. 42%, p = 0.02). Marked, relatively symmetric intrauterine growth restriction is an intrinsic part of gastroschisis. It begins early in the second trimester, and is associated with placental chorangiosis.
... However, it is widely recognized that Quetelet's BMI cannot be used in children under the age of 2 years, given differences in body proportions between infancy and adulthood. In 1921, to account for the problems of using the index in infants, Rohrer (1921) introduced the ponderal index (weight/stature 3 ) with stature cubed as a more appropriate adjustment for height because of the different dimensions of infants. As with adults, the formulation of the denominator (stature 3 ) was chosen to adjust for stature, such that weights from infants of different lengths could be directly compared. ...
Article
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As the global prevalence of childhood overweight and obesity spreads to low and middle income countries, there is an increasing need for researchers to assess overweight and obesity in populations where child undernutrition still prevails. Although BMI (bodymassindex) cutoffs are widely used in research and project evaluations, they have only recently been included in WHO definitions for overweight and obesity in children. This review describes the history of how and why BMI was introduced as a proxy for adiposity in children, the scientific evidence and examples from epidemio- logical studies. Overall, BMI continues to be a valuable measure in children if the underlying assumptions of the criteria and cut-off values are considered. However, where BMI is associated with height, in children, we recommend using weight for height z-scores.
... Volume is a three-dimensional value. Rohrer (1908) preferred the index weight/height 3 , which was proposed already by Buffon (1829). This index is also problematic, because weight does not grow pro rata with the value of stature on the third power. ...
... Ponderal index was calculated from size [m] and weight [kg] at birth using the formula PI = weight [kg] /size [m] 3 . Ponderal index, also called Rohrer's index, has been used as an indicator for Bfatness^ or Bthinness^ in newborns and infants because, unlike body mass index (weight/height 2 ), it is independent of height and age in the study population [29,30]. It has been shown that ponderal index provides a valuable and meaningful parameter for assessing fetal condition and nutrition in newborn infants [31][32][33]. ...
Article
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Some studies have reported that birth size is a risk factor for breast cancer, but the reasons for this observation are unknown. Ovarian hormone concentrations may be a link between birth size and breast cancer, but the few tests of this hypothesis are inconsistent, perhaps because of differences in sample composition, inclusion of anovulatory cycles, or use of one hormonal measurement per woman. We present results from the first study to use daily hormonal measurements throughout a woman's complete ovulatory cycle to test the hypothesized relationship between birth size and adult progesterone concentrations. We used a study sample and accompanying data set previously obtained for another research project in which we had collected daily urine samples from 63 healthy premenopausal women throughout a menstrual cycle. Multivariate regression was used to test for trends of individual progesterone indices (from 55 ovulatory cycles) with birth weight or ponderal index, while controlling for age, adult BMI, and age at menarche. Our main finding was that neither birth weight nor ponderal index was associated with biologically significant variation in luteal progesterone indices; the best-estimated effect sizes of birth size on these progesterone indices were small (3.7-10.2 %). BMI was the only significant predictor of mean peak urinary progesterone, but it explained <6 % of the variance. Our findings, in light of what is currently known regarding associations of breast cancer risk with birth size and adult size, suggest that environmental factors (particularly those that vary by socioeconomic status and affect growth) may underlie associations between birth size and cancer risks without there being any association of birth size with adult ovarian hormone concentrations.
... 16 In 1971, Benn described BMI's fundamental statistical relationship as ðWeight=Height PÞ where the height power P (termed the Benn Index) is estimated by log -log regression. 17 Specific examples for the value of the Benn Index include the Ponderal Index (or Rohrer Index) 18 where P ¼ 3, the Human Body Shape Index where P ¼ 2.8, 19 and the standard BMI calculation or Quetelet index where P ¼ 2. Many studies in the paediatric literature have shown that the value of the Benn Index varies with gestational age 20 and during childhood development. 21 -23 Research in adults suggests that BMI is negatively correlated with height, especially in women. ...
Article
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Body mass index (BMI) tends to be higher among shorter adults, especially women. The dependence of BMI-height correlation on age and calendar time may inform us about temporal determinants of BMI. Series of cross-sectional surveys: Health Survey for England, 1992-2011. We study the Benn Index, which is the coefficient in a regression of log(weight) on log(height). This is adjusted for age, gender and calendar time, allowing for non-linear terms and interactions. By height quartile, mean BMI decreased with increasing height, more so in women than in men (P < 0.001). The decrease in mean BMI in the tallest compared with the shortest height quartile was 0.77 in men (95% CI 0.69, 0.86) and 1.98 in women (95% CI 1.89, 2.08). Regression analysis of log(weight) on log(height) revealed that the inverse association between BMI and height was more pronounced in older adults and stronger in women than in men, with little change over calendar time. Unlike early childhood, where taller children tend to have higher BMI, adults, especially women and older people, show an inverse BMI-height association. BMI is a heterogeneous measure of weight-for-height; height may be an important and complex determinant of BMI trajectory over the life course. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
... The PI is used as an indicator of the nutritional status of the newborn. Proposed by Rohrer [12] , the PI indicates how heavy a newborn is in respect to its length [13][14][15][16] . The formula is as follows: PI = (weight in g × 100)/(length in cm) 3 . ...
Article
Full-text available
The aim of our study was to construct a model of customized birth weight curves based on a Spanish population and to compare the ability of this customized model to our population-based chart to predict a neonatal ponderal index (PI) <10th percentile. We developed a model that can predict the 10th percentile for a fetus according to gestational age and gender as well as maternal weight, height, and age. We compared the ability of this customized model to that of our own population-based model to predict a neonatal PI <10th percentile. Data from a large database were used (32,854 live newborns, from 1993 through 2012). Only singleton pregnancies with a gestational age at delivery of 32-42 weeks were included. In the entire pregnant population, the customized method was superior to the population-based method for detecting newborns with a PI <10th percentile (sensitivity: 55 vs. 40.96%; specificity: 99.6 vs. 91.23%; positive predictive value: 11.49 vs. 9.55%, and negative predictive value: 98.84 vs. 98.55%, respectively). In pregnant women with a BMI >90th percentile, the sensitivity was 75%, compared to 50% in the population-based method. In pregnant women with a height >90th percentile, the sensitivity was almost as high as in the population-based method (61.53 vs. 33.33%). The customized birth weight curve is superior to the population-based method for the detection of newborns with a PI <10th percentile. This is especially the case in women in the higher scales of height and weight as well as in preterm babies. © 2015 S. Karger AG, Basel.
... Body condition, or condition index, is the most common measure for describing animal's health state in the physiological literature. It is often measured with the weight-length coefficient or ponderal index (Rohrer, 1921;Thompson, 1961). Since weight and length are strongly correlated, body condition results as the concept of health state by removing the size effect from the correlation. ...
Article
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One of the most common relativization techniques in life sciences quantifies body condition based on residuals from the linear regression in the log–log plot of body mass against a linear measure of size. Given the network-based analogy between organisms and cities, the method is applied to comparative urban studies to formulate relativized allometric measures based on the allometry to size of metric and topological measures of street networks. The analysis of a sample of 70 cities from a confined region considered in three historical stages demonstrates that the more allometric scaling of a measure to size diverges from the linear, the more allometric measures show discrepancy to the existing relativization methods that are based on mean measures and ratios between measures. Allometric measures reflect the dynamics of specific regional samples of cities and therefore also differ from relativization methods that relate measures that grow exponentially with size against static theoretical yardsticks. The comparison involving two additional samples of cities from other regions suggests that the proposed allometric measures can be used to approximate size-invariant measures for cities with unknown allometry more reliably than existing relativization measures. The method can be applied to formulate relativized indices for any measure that displays allometry to size in various scales of the built environment.
... Maybe the most well-known parameter, that can be considered as descriptor of the body shape, is Figure 3 depicts the weight in dependence of height for the range of normal weight according to PI (11)(12)(13)(14) and BMI (18)(19)(20)(21)(22)(23)(24)(25). It can be seen, that the BMI penalizes tall people, respectively favors small individuals, the PI does vice versa. ...
Article
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Solar ultraviolet (UV) exposure of people and related health risk is mainly examined by estimating the received UV radiant exposure. However, for several effects such as DNA-damage, vitamin D photosynthesis or the probability of developing skin cancer, UV radiant energy is important and with that the size of exposed skin area. There is also a complex interaction between body shape and behavior like sun exposure habits, so that careful analysis is necessary when estimating health effects from UV exposure. In this paper, knowledge on body shape and methods of calculating the total body surface area (BSA) are summarized. BSA depends mainly on the height and weight of a person as well as on gender, ethnicity and body shape. BSA and body shape differ significantly between different populations and both change during life. This paper proposes formulas for BSA that consider height, weight, gender, ethnicity and body shape. As the exposed BSA depends on clothing, finally an approach is presented which aims to calculate the size of body parts released by real garments. In summary, this paper will enable future researchers to quantify the exposed BSA by best matching their study population and consequently investigate risks caused by solar UV exposure.
... These methods have been used consistently over the time of our review by our nursing staff. Additionally, we estimated the change in newborn Ponderal Index (PI: calculated as kg/m 3 ) over time as a marker of fetal weight for length an estimate of adiposity [33]. ...
Article
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Background Recent reports have shown a decrease in birth weight, a change from prior steady increases. Therefore we sought to describe the demographic and anthropometric changes in singleton term fetal growth. Methods This was a retrospective cohort analysis of term singleton deliveries (37–42 weeks) from January 1, 1995 to January 1, 2010 at a single tertiary obstetric unit. We included all 43,217 neonates from term, singleton, non-anomalous pregnancies. Data were grouped into five 3-year intervals. Mean and median birth weight (BW), birth length (BL), and Ponderal Index (PI) were estimated by year, race and gestational age. Our primary outcome was change in BW over time. The secondary outcomes were changes in BL and PI over time. Results Mean and median BW decreased by 72 and 70 g respectively (p < 0.0001) over the 15 year period while BL also significantly decreased by 1.0 cm (P < 0.001). This contributed to an increase in the neonatal PI by 0.11 kg/m³ (P < 0.001). Mean gestational age at delivery decreased while maternal BMI at delivery, hypertension, diabetes, and African American race increased. Adjusting for gestational age, race, infant sex, maternal BMI, smoking, diabetes, hypertension, and parity, year of birth contributed 0.1 % to the variance (−1.7 g/year; 26 g) of BW, 1.8 % (−0.06 cm/year; 0.9 cm) of BL, and 0.7 % (+0.008 kg/m³/year; 0.12 kg/m³) of PI. These findings were independent of the proportional change in race or gestational age. Conclusions We observed a crude decrease in mean BW of 72 g and BL of 1 cm over 15 years. Furthermore, once controlling for gestational age, race, infant sex, maternal BMI, smoking, diabetes, hypertension, and parity, we identified that increasing year of birth was associated with a decrease in BW of 1.7 g/year. The significant increase in PI, despite the decrease in BW emphasizes the limitation of using birth weight alone to define changes in fetal growth.
... The calculation of body condition is one of the main applications of allometric scaling in life sciences. Body condition, or condition index, results as the concept of animal's health state by removing the size effect from the weight-length coefficient, or ponderal index (Rohrer, 1921;Thompson, 1961). Body condition is usually estimated according to the residual index method by comparing residual distances of observed points from the predicted points that lie on the line of least-square linear regression of body mass against body length, where the data are usually log-transformed (Gould, 1975;Harvey and Pagel, 1991) í µí±™í µí±›í µí¼€ = í µí±™í µí±›í µí±Œ − í µí±™í µí±›í µí±Œ - or í µí¼€ = exp (í µí±™í µí±›í µí±Œ − í µí±™í µí±›í µí±Œ -), ...
Conference Paper
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In biology, allometric scaling is used to calculate the body condition by comparing measurements of individual organisms to a population average, or baseline, as defined by the allometric equation. A growing number of studies has shown that scaling laws, one of the fundamental features of complex systems, govern many characteristics of urban form. Based on the scaling analogy between organisms and cities, this paper translates the body condition method from biology to urban studies to propose new normalised measures of segment analysis: allometric length, allometric connectivity, allometric angular depth and allometric least angle choice. The study is supported by the segment analysis of street networks in 70 Adriatic and Ionian coastal cities considered in three historical stages. Baselines for the proposed relativized measures are derived from the strong and significant allometry of segment measures. The proposed measures of allometric angular depth and allometric least angle choice are compared against NAIN and NACH (Hillier et al, 2012) resulting in various degrees of compatibility. The proposed allometric normalisation depends on the comparison of a city to a large sample of cities, and thus faces the challenge of dealing with cases that are not part of a regional or typological sample already studied. Based on the results of a previous comparison involving axial maps of a few samples of cities, we speculate that for cities with unknown allometry, adopting the normalisation formulae proposed here would produce more accurate indices than the existing measures by Hillier et al. The proposed method can be used to normalise any segment analysis measure that displays allometry in others scales of the built environment.
... (1) Ponderal Index (PI) -defined as the ratio of body weight (g) to the cube of body length (cm 3 ) x 100. 17 The formula for calculation of PI was the same used by were produced for all recorded cries. To avoid artifacts because of errors in pitch determination of noisy segments, the statistical data of the cry parameters were calculated only for harmonic signals. ...
Article
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The objective of this study was to determine the influence of fetal growth on the fundamental frequency (F(0)) of neonatal crying in a group of healthy full-term infants. The spontaneous cries of 131 infants were audio recorded during the first week of life, and subsequently submitted to acoustic analyses. The individual cry utterances produced by each infant were measured for minimum, mean, and maximum F(0). The infants were placed into one of three groupings (low, average, high) based on body size indices according to the ponderal index (PI), the ratio of body weight to body length (BW/L), and body weight (BW) alone. The F(0) features of infants in each subgrouping of body size were compared and contrasted. The results indicated that features of cry F(0) were found to decrease marginally as a function of increased body size, with significant group differences confined to maximum F(0). The BW index appeared to be the most sensitive measure in differentiating infant groups according to body size. In general, neonatal body size appears to have a slight, although nonsignificant influence on the vocal F(0) of crying in healthy full-term infants. Any body size-related changes in cry F(0) are likely to be found for maximum F(0) and may reflect stress-related variations in nervous system activation.
... One can only do that if gestational age and birth weight body length is also considered (Abernathy et al., 1996, Golde, 1989, Kramer et al., 1990, Miller & Hassanein, 1971). Rohrer's Ponderal Index (Hassanein, 1971, Rohrer, 1961 was introduced for this purpose, but it was not commonly used, because the database to calculate the index was limited and the proposed mathematical formula [(gram/cm 3 )x100] was not popular. Nevertheless, more and more authors underline the need for the consideration of nutritional status. ...
Chapter
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The authors firmly believe that more accurate estimations of the survival chances and the degree of endangeredness of neonates can be achieved if the three important factors are simultaneously considered: (i) maturity (gestational age); (ii) bodily development (weight and length standard positions determined on the basis of appropriate weight and length standards); (iii) nutritional status depending upon the relative weight and length development. However, the question is how to consider all of these factors at the same time, and more importantly, how to differentiate less endangered and highly endangered neonate groups identified in this complex system of classification. The authors developed a new method to achieve this. In the present study the authors describe their novel method, the MDN system (MDN: Maturity, Development, Nutritional status) (Berkő, 1992, Berkő & Joubert, 2006, 2009) and its application: • to determine the nutritional status of a neonate on the basis of its gestational age, length and weight delopment considered simultaneously; • to differentiate the most viable and the most endangered neonates on the basis of their development and nutritional status; • to demonstrate the influence of a neonate’s bodily development and nutritional status by intrauterine, neonatal and perinatal mortality rate. The Effect of Intrauterine Development and Nutritional Status on Perinatal, Intrauterine and Neonatal Mortality: The MDN System • to identify and distinguish those retarded neonates who are likely to need growth hormone treatment in the future.
... BMI is generally independent of height in adult humans, but there is discussion whether the power of height is always two (Heymsfield, Gallagher, Mayer, Beetsch, & Pietrobelli, 2007). The Ponderal index is a WHI measure where body weight is normalized with the third power of height (weight/height 3.0 ; Rohrer, 1921). As using an inappropriate WHI can produce misleading results about the relative adiposity, some authors state that the power of height is population specific; this is incorporated in the Benn index (weight/height β ; Benn, 1971;Lee, Kolonel, & Hinds, 1982). ...
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Housing primates in naturalistic groups provides social benefits relative to solitary housing. However, food intake may vary across individuals, possibly resulting in overweight and underweight individuals. Information on relative adiposity (the amount of fat tissue relative to body weight) is needed to monitor overweight and underweight of group-housed individuals. However, the upper and lower relative adiposity boundaries are currently only known for macaques living solitarily in small cages. We determined the best measure of relative adiposity and explored the boundaries of overweight and underweight to investigate their incidence in group-housed adult male and female rhesus macaques and long-tailed macaques living in spacious enclosures at the Biomedical Primate Research Centre (BPRC), the Netherlands. During yearly health checks different relative adiposity measures were obtained. For long-tailed macaques, comparable data on founder and wild animals were also available. Weight-for-height indices (WHI) with height to the power of 3.0 (WHI3.0) for rhesus macaques and 2.7 (WHI2.7) for long-tailed macaques were optimally independent of height and were highly correlated with other relative adiposity measures. The boundary for overweight was similar in group-housed and solitary-housed macaques. A lower boundary for underweight, based on 2% body fat similar to wild primates, gave a better estimate for underweight in group-housed macaques. We propose that for captive group-housed rhesus macaques relative adiposity should range between 42 and 67 (WHI3.0) and for long-tailed macaques between 39 and 62 (WHI2.7). The majority of group-housed macaques in this facility have a normal relative adiposity, a considerable proportion (17-23%) is overweight, and a few (0-3%) are underweight.
... Intrauterine growth restriction (IUGR) is an alteration in fetal growth, measured by the relationship between the newborns weight and length, and it is correlated with lowbirth-weight (LBW) [1]. IUGR appears to have deleterious effects on adult metabolism [2]. ...
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Intrauterine growth restriction (IUGR) and low-birth-weight (LBW) are determinant factors in the development of metabolic diseases in children and adolescents. To estimate the magnitude of the association between LBW and IUGR with stunting or obesity among adolescents of two indigenous regions of the southern State of Chiapas, Mexico. We assessed a random sample of 303 adolescents selected from a birth cohort study (2003) conducted in three hospitals serving urban and rural communities of Tzotzil-Tzeltal and Selva regions of Chiapas, Mexico. Sociodemographic and anthropometric data from a sample of adolescents were correlated with their anthropometric data at birth (weight, length for age). Logistic regression models were fitted to estimate odds ratios (OR) with 95% confidence intervals to measure the magnitude of the association among the variables of interest. Models were adjusted for potential confounders. In all, 12% of the sample had LBW and 28.8% IUGR. In total, 29% of adolescents were overweight/obese and 21% were stunted. We found a statistically significant association between IUGR and a lower risk of being overweight/obese. A higher probability for stunting was observed for LBW and IUGR. Stunting and overweight/obesity prevalence in this population of adolescents was high and was associated with IUGR.
... Due to preferential perfusion of the brain and adequate linear growth, the newborn with asymmetric growth retardation is identified by either an abnormally increased head circumference (HC) to abdominal circumference (AC) ratio or an abnormal ponderal index. The neonatal ponderal index has been suggested as a measure of the proportion between neonatal body mass and length (9). This index is defined as a percentage of birth weight (in grams) divided by body length (in centimeters) cubed. ...
... For me as a physicist, it's hard to believe, but apparently it took almost a century before someone (Fritz Rohrer, CH) came up with the idea to calculate the index with h³ anyway. This number: m/h³ is then called 'Corpulence Index' (CI) or 'Ponderal Index' (PI) [Rohrer 1921]. It took another century until someone (Sultan Babar, SA) found what was to be expected: "It has the advantage that it doesn't need to be adjusted for age after adolescence." ...
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The article shows an improvement for the well-known least squares regression analysis is possible in the case of invertible functions.
... The nutritional status of the newborn was evaluated using the ponderal index (PI) of Rohrer [26] adjusting by sex and gestational age. Proposed by Rohrer, the PI indicates how heavy a newborn is relative to its length [27][28][29][30]. ...
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Background: Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods: This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results: Two hundred thirty-one pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions: In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21st.
... Pregnancy and birth outcomes included birth weight, and neonatal ponderal index (PI). PI [41,42], as an indicator of fetal nutrition, was calculated using the formula [weight (in grams) ...
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Our objective was to compare Ponderal index (PI) with birth weight centiles as predictors of perinatal morbidity and to determine which best reflects the presence of placental disease. We prospectively recruited 1,011 low-risk primigravidas and calculated PI and birth weight centiles following delivery. Perinatal morbidity was defined as: pre-term birth (PTB); fetal acidosis; an Apgar score <7 at 5 min or neonatal resuscitation. Placental disease was defined as chronic uteroplacental insufficiency (CUPI); villous dysmaturity; infection or vascular pathology. Ponderal index was statistically reduced (25.33 vs 27.79 p =0.001) and the incidence of infant birth weight <9th centile was statistically higher (11.1% vs 5.1%; p =0.004) in cases with PTB and in CUPI (26.23 vs 27.84; p =0.001 and 28.2.1% vs 10.4%; p =0.002). Both PI and infant birth weight centile <9th centile for gestational age correlate with PTB, however overall, both are poor predictors of neonatal and placental disease.
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There should be little doubt in most obstetricians’ minds that intrauterine growth retardation and smallfor-gestational-age are two different but overlapping clinical entities. The term intrauterine growth retardation (IUGR) implies failure to achieve genetic growth potential through lack of nutritional support during intrauterine life. It is widely accepted that this pathological condition is associated with an increase in perinatal mortality, neonatal morbidity and subsequent impaired neurological development including cerebral palsy. The classical picture at birth includes increased body length in relation to weight, the impression of a relatively large head with wide skull sutures, muscle wasting, prominent ribs, an alert look and a dry, wrinkled skin. However, very few infants will show all of these features. The heterogeneity of aetiological factors and clinical manifestations has led to the description of various, often poorly defined forms and types of IUGR.’ It would seem logical to use the term IUGR only when there is the clear antenatal evidence that growth has faltered, or evidence pointing to loss of fetal weight in utero.’ Small-for-gestational age (SGA), on the other hand, is a statistical concept. The 10th birthweight percentile is the most commonly used cut-off definition, but others have been applied, such as birthweight below the 5th or 3rd percentiles, or more than two standard deviations below the mean birthweight for a given gestational age. The same principle can be applied antenatally. Estimated fetal weight, abdominal circumference, fetal ponderal index or any other parameter assessing fetal size can
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The so-called 'least squares regression' for mathematical modeling is a widely used technique. It's so common that one might think nothing could be improved to the algorithm anymore. But it can. By minimizing the squares of the differences between measured and predicted values not only in the vertical, but also in the horizontal direction. I call this 'multidirectional regression'. The difference is very significant, especially for power function models, often used in biomedical sciences. And it makes the regression invariant if the dependent and independent variables are switched. This was a neglected problem with the traditional method. The Body Mass Index and the Corpulence Index and their correlation with body fat percentage are studied here as an example showing that this regression technique produces better results.
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Maternal overweight and obesity are associated with adverse offspring outcome in later life. The causal biological effectors are uncertain. Postulating that initiating events may be alterations to infant body composition established in utero, we tested the hypothesis that neonatal adipose tissue (AT) content and distribution and liver lipid are influenced by maternal BMI. We studied 105 healthy mother-neonate pairs. We assessed infant AT compartments by whole body MR imaging and intrahepatocellular lipid content by H MR spectroscopy. Maternal BMI ranged from 16.7 to 36.0. With each unit increase in maternal BMI, having adjusted for infant sex and weight, there was an increase in infant total (8 mL; 95% CI, 0.09-14.0; p = 0.03), abdominal (2 mL; 95% CI, 0.7-4.0; p = 0.005), and nonabdominal (5 mL; 95% CI, 0.09-11.0; p = 0.054) AT, and having adjusted for infant sex and postnatal age, an increase of 8.6% (95% CI, 1.1-16.8; p = 0.03) in intrahepatocellular lipid. Infant abdominal AT and liver lipid increase with increasing maternal BMI across the normal range. These effects may be the initiating determinants of a life-long trajectory leading to adverse metabolic health.
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Previous growth studies of Peruvian children have featured high stunting rates and limited information about body composition. We aimed to characterize anthropometric measures of Peruvian infants 0 to 12 months of age in relation to the international growth references and biological, environmental, and socioeconomic factors. Infants (n = 232) were followed longitudinally from birth through 12 months of age from a prenatal zinc supplementation trial conducted in Lima, Peru, between 1995 and 1997. Anthropometric measures of growth and body composition were obtained at enrollment from mothers and monthly through 1 year of age from infants. Weekly morbidity and dietary intake surveillance was carried out during the second half of infancy. The prevalence rates of stunting, underweight, and wasting did not exceed 4% based on the World Health Organization growth references. Infants of mothers from high-altitude regions had larger chest circumference (p = .006) and greater length (p = .06) by 12 months. Significant predictors of growth and body composition throughout infancy were age, sex, anthropometric measurements at birth, breastfeeding, maternal anthropometric measurements, primiparity, prevalence of diarrhea among children, and the altitude of the region of maternal origin. No associations were found for maternal education, asset ownership, or sanitation and hygiene factors. Peruvian infants in this urban setting had lower rates of stunting than expected. Proximal and familial conditions influenced growth throughout infancy.
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Objective: To assess the prevalence and risks of underweight, stunting and wasting by gestational age in newborns of the Jujuy Province, Argentina at different altitude levels. Methods: Live newborns (n=48,656) born from 2009-2014 in public facilities with a gestational age between 24+0 to 42+6 weeks. Phenotypes of underweight (<P3weight/age), stunting (<P3length/age) and wasting (<P3body mass index/age) were calculated using INTERGROWTH-21st standards. Risk factors were maternal age, education, body mass index, parity, diabetes, hypertension, preeclampsia, tuberculosis, prematurity, and congenital malformations. Data were grouped by the geographic altitude: ≥2000 or <2000m.a.s.l. Chi-squared test and a multivariate logistic regression analysis were performed to estimate the risk of the phenotypes associated with an altitudinal level ≥2000m.a.s.l. Results: The prevalence of underweight, stunting and wasting were 1.27%, 3.39% and 4.68%, respectively, and significantly higher at >2000m.a.s.l. Maternal age, body mass index >35kg/m2, hypertension, congenital malformations, and prematurity were more strongly associated with underweight rather than stunting or wasting at ≥2000m.a.s.l. Conclusions: Underweight, stunting, and wasting risks were higher at a higher altitude, and were associated with recognized maternal and fetal conditions. The use of those three phenotypes will help prioritize preventive interventions and focus the management of fetal undernutrition.
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Introduction: We examined the best-fit index for describing the constitutional or physical characteristics of Sasang typology for its universal application. Methods: Ponderal index (PI), body mass index (BMI), and basal metabolic rate (BMR) of the nationwide participants (n = 1663; age, 31–60 years) were calculated. We described and analyzed the usefulness of each index for maximizing the differences between Sasang types across age and sex using box plots, Pearson's correlation, and analysis of variance. Results: We found that the So-Eum, So-Yang, and Tae-Eum Sasang types were significantly (p
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Background and aim: Maternal smoking and body mass index (BMI) affect the somatic classifications of neonates based on birth weight, length, and head circumference. Here we investigate the somatic classifications of neonates based on weight-for-length and Rohrer's ponderal index. Material and Methods: Singleton neonates (n = 433643; data from the German perinatal survey of 1998-2000) were classified as small, appropriate or large for gestational age (SGA, AGA, LGA) based on the 10th and 90th population percentiles of weight-for-length (weight/length) and ponderal index (weight/length(3)). Maternal BMI was classified as underweight (< 18.5kg/m(2)), normal weight (18.5-24.99 kg/m(2)), overweight (25-29.99 kg/m(2)), or obese (>= 30 kg/m(2)). Smoking during pregnancy was categorized as 0, 1-7, 8-14, or >= 15 cigarettes per day. The somatic classification of neonates was compared between different maternal BMI and smoking groups. Results: Classifying neonates by weight-for-length we found that the SGA rate was greater for underweight women (16.3%) and smaller for overweight (7.5%) and obese women (7.0%) compared with the normal weight reference population (9.9%, all data for non-smokers). Furthermore, SGA rates increased with increasing cigarette consumption. The combination of smoking >= 15 cigarettes per day and being underweight was associated with a very high SGA rate of 35.7%. Classifying neonates according to ponderal index showed qualitatively similar but smaller changes: here smoking >= 15 cigarettes per day and being underweight was associated with an SGA rate of 14.4%. Conclusions: The somatic classification of neonates according to weight-for-length illustrates the effects of maternal BMI and smoking more clearly than the classification according to the ponderal index.
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The study was conducted on Boran bulls from three age groups (2, 3 and 4 years) reared at two different locations in Southern Ethiopia. The study was conducted to assess the different morphometrical measurements in Boran bulls, to estimate live weight of the bulls using step-down regression equations and also to calculate structural indices for assessment of type for which the breed was developed and thus assist in the selection of the bulls. The feedlots were situated in Meki district and varied both in location and the type of management, with the second feedlot being better managed than the first. The morphometric traits included in the study were height at withers (HW), height at rump (RH), body length (BL), heart girth (HG), head width (WFH), neck circumference (NC), neck length (NL), chest width (CW), rump length (RL), hip width (WH) and flank width (FW) and the body weight (BW). The results indicated that while the skeletal measurements HW, RH and BL did not vary (P < 0.05) between bulls of a particular age across the two feedlots, the other parameters were higher among the bulls reared in the feed lot with wind breaks and situated away from lake Ziway. The results of the step-down regression equations indicated that BW could be assessed using various morphometrical measurements viz. NL, NC, RL, WH and HG. The parameters included varied both across the age groups and locations. The results related to the structural indices indicated that the Boran bulls had posterior alignment and had higher CW than HW.
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Stunting (short length for age) and wasting (low body mass index [BMI] for age) are widely used to assess child nutrition. In contrast, newborns tend to be assessed solely based on their weight. To use recent international standards for newborn size by gestational age to assess how stunted and wasted newborns differ in terms of risk factors and prognoses. A cross-sectional study with follow-up until hospital discharge was conducted at urban sites in Brazil, China, India, Italy, Kenya, Oman, England, and the United States that are participating in the INTERGROWTH-21st Project. The study was conducted from April 27, 2009, to March 2, 2014, and the final dataset for analyses was locked on March 19, 2014. Sociodemographic and behavioral maternal risk factors, previous pregnancy history, and maternal and fetal conditions during pregnancy were investigated as risk factors for stunting and wasting. Anthropometry at birth was used to predict for neonatal prognosis. Newborn stunting and wasting were defined as birth length and BMI for gestational age below the third centiles of the INTERGROWTH-21st standards. Prognosis was assessed through mortality before hospital discharge, admission to neonatal intensive care units, and newborn complications. From the 60 206 singleton live births during the study period, we selected all newborns between 33 weeks' and 42 weeks 6 days' gestation at birth (51 200 [85%]) with reliable ultrasound dating. Stunting affected 3.8% and wasting 3.4% of all newborns; both conditions were present in 0.7% of the sample. Of the 26 conditions studied, five were more strongly associated with stunting than with wasting (reported as odds ratios [OR]; 95% CI): short maternal height (6.7; 5.1-9.0), younger maternal age (0.7; 0.5-0.9), smoking (2.8; 2.3-3.3), illicit drug use (2.3; 1.5-3.6), and clinically suspected intrauterine growth restriction (5.2; 4.5-6.0). Wasting was more strongly related than stunting with 4 newborn outcomes (neonatal intensive care stay, 6.7 [5.5-8.1]; respiratory distress syndrome, 4.0 [3.3-4.9]; transient tachypnea, 2.1 [1.5-2.9]; and no oral feeding for >24 hours, 5.0 [3.9-6.5]). Maternal gestational diabetes mellitus was protective against wasting (0.6; 0.5-0.8) but not against stunting (0.9; 0.7-1.1). Although newborn stunting and wasting share some common determinants, they are distinct phenotypes with their own risk factors and neonatal prognoses. To be consistent with the literature on infant and child nutrition, newborns should be classified using the 2 phenotypes of stunting and wasting. The distinction will help to prioritize preventive interventions and focus the management of fetal undernutrition.
Article
Introduction Fetuses that grow at rates less than their inherent growth potential have intrauterine growth restriction or IUGR. Such infants, particularly when the IUGR is severe, tend to have significant problems later in life, with structural and functional neurodevelopmental disorders. Animal models confirm that decreased brain neuronal number and dendritic arborization, cognitive capacity, and behavioral function are common when growth at critical early stages of development is restricted. Understanding the basic problems that contribute to IUGR and the characteristics of such infants, therefore, is important to complement other discussions in this textbook about fetal and neonatal brain injury. Terminology and definitions IUGR refers to a slower than normal rate of fetal growth. Several terms have been used, often interchangeably, for IUGR. These include fetal growth retardation, fetal mal- or undernutrition, small for gestational age (SGA), small or light for dates, dysmature, placental insufficiency syndrome, “runting” syndrome, and hypotrophy. The term “restriction” is preferred to “retardation,” because parents tend to link “retardation” with mental retardation. Unfortunately, these terms do not all mean the same, which has led to some confusion, both with regard to etiologic classification and to follow-up and outcome. In interpreting studies dealing with IUGR, it is important to know how the term has been defined for the particular study. Most importantly, birthweight does not always determine fetal growth rate. See Table 7.1 for a classification schema of fetal growth that now is standard.
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Objective To assess the prevalence and risks of underweight, stunting and wasting by gestational age in newborns of the Jujuy Province, Argentina at different altitude levels. Methods Live newborns (n = 48,656) born from 2009–2014 in public facilities with a gestational age between 24⁺⁰ to 42⁺⁶ weeks. Phenotypes of underweight (<P3 weight/age), stunting (<P3 length/age) and wasting (<P3 body mass index/age) were calculated using Intergrowth‐21st standards. Risk factors were maternal age, education, body mass index, parity, diabetes, hypertension, preeclampsia, tuberculosis, prematurity, and congenital malformations. Data were grouped by the geographic altitude: ≥2.000 or <2.000 m.a.s.l. Chi‐squared test and a multivariate logistic regression analysis were performed to estimate the risk of the phenotypes associated with an altitudinal level ≥2.000 m.a.s.l. Results The prevalence of underweight, stunting and wasting were 1.27%, 3.39% and 4.68%, respectively, and significantly higher at >2.000 m.a.s.l. Maternal age, body mass index >35 kg/m², hypertension, congenital malformations, and prematurity were more strongly associated with underweight rather than stunting or wasting at ≥2.000 m.a.s.l. Conclusions Underweight, stunting, and wasting risks were higher at a higher altitude, and were associated with recognized maternal and fetal conditions. The use of those three phenotypes will help prioritize preventive interventions and focus the management of fetal undernutrition.
Chapter
Linear growth of very low birth weight (VLBW) small for gestational age (SGA; < 10th percentile) preterm infants was analyzed from birth to adult age as to catch-up or no catch-up growth. These VLBW SGA preterm infants (n = 46) with primarily symmetric intrauterine growth restriction from the Bonn Longitudinal Study were compared with 62 appropriate for gestational age (AGA) VLBW preterm and 73 term infants and with their parents. Forty-six percent of VLBW SGA (21 of 46) had complete height catch-up by adult age, and most became taller than target height (TH; 15 of 21; 71%). The other 25 did not catch up (54%); most of them remained shorter than TH (18 of 25; 72%) after initial catch-up followed by catch-down growth. Their mean adult height z-score was lower than that for birth length. Mean body mass index was similar in the catch-up and no catch-up groups (21.8 and 21.3, respectively) and lower than in the controls (23.2). Approximately half of the head circumference (HC) catch-up children achieved height catch-up as well. Height catch-up extended beyond age 6 years up to adult age; it was independent of HC growth (i.e., catch-up or not). Growth of the VLBW SGA preterm infants was characterized by its great heterogeneity and intraindividual variability. Height catch-down or successful catch-up growth could not be predicted.
Chapter
Unter Wachstum versteht man im biologischen und medizinischen Sprachgebrauch gewöhnlich die Größenzunahme eines Organismus oder seiner Teile durch die Neubildung von lebender Masse aus den aufgenommenen Nährstoffen. Es spielt sich ab in Form der Zellvergrößerung, der Zellvermehrung und der Ablagerung von strukturierter Intercellu-larsubstanz.
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The characteristic of growth in infancy is its high velocity. It can be assessed properly only by repeated measurements at regular intervals in longitudinal studies. In this paper stress is laid on the growth in head circumference because of its close correlation with brain development during the first 2 years of life and because of its small variability among different ethnic groups or geographic regions (Nellhaus, 1975). In addition to general growth patterns, catch-up growth in the head circumference of small for gestational age (SGA) preterm infants will be discussed.
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