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Fetal hypotrophy and pregnancies in women experienced hypogonadotrophic hypogonadism after biliopancreatic diversion with duodenal switch
S108
Abstracts
Conclusions
Background and aim
The study in infants at low risk confirms the previous findings in infants at risk for development of allergy and indicates an immune modulatory effect of the tested prebiotic mixture added to a formula with intact protein which suggests the opportunity for allergy prevention by specific prebiotics. This cohort will be followed to investigate the course of AD and other allergic manifestations.
Superobesity has deleterious effects on reproductive function and pregnancy outcomes in women. Although bariatric surgery is the best long-term treatment in severely obese women, there is a high risk of gestational undernutrition in mothers caused by this surgery, which may reduces nutrient availability. This may be one of the factors leading to malnutrition and finally to fetal hypotrophy.
doi:10.1016/j.earlhumdev.2008.09.277
Materials and methods Abstract UENPS.262 Postdischarge growth monitoring in preterm infants fed with different milk formulas Eva Maria Garcia Canto⁎a, Marie-Anne Feret Siguileb, Jose Sanchez Payab, Maria Remedios Garcia Martinezb, Bartolome Jimenez Cobob a Hospital de Villajoyosa, Villajoyosa, Spain b Hospital de Alicante, Alicante, Spain Background and aim Objective: Compare postdischarge growth of preterm infants until 24 months, feeding from 40 w. Postconceptonal (P.C.) to 6 months corrected age (C.A) with 3 different milk formulas: Formula “A”: standart term formula (67 kcal–1.4 g protein/100 ml); Formula “PDL-PUFAS” enriched formula (74 kcal–1.77 g/100 ml, supplemented with AA y DHA); Formula “PDZ” enriched formula (75 kcal–1.95 g protein/100 ml), supplemented with Zinc (1.2 mg/100 ml) vs 0.7 mg/100 ml for the other 2 formulas. Materials and methods Methodology: Double blind trial with randomised assignation of milk formula. All preterm infants care in Alicante General University Hospital (HGUA) with gestational age until 34 w and B.W. until 1750 g, all adequate for date at birth, without systemic illness evidence at discharge. We randomised 146 babies of which 116 were followed until 3 months and 92 until 24 months for C.A. All of them had a similar introduction of beikost (date and nutrients).
We present two cases of pregnant women with intrauterine fetal hypotrophy following earlier fertility problems caused by hypogonadotrophic hypogonadism after biliopancreatic diversion with duodenal switch operation for superobesity. Results Two women, who underwent biliopancreatic diversion with duodenal switch operation for superobesity. After this bariatric procedure, they started to lose weight and become amenorrhoeic when their weight loss approaches 25% (but were still overweight). In both cases amenorrhoea mimicked the hormonal picture of hypogonadotrophic hypogonadism with clinical infertility. Menses recur spontaneously and it resulted in pregnancies occurred in first 6 cycles. Although both patients, presented no clinical signs of undernutrition, intrauterine fetal hypotrophy were presented. Conclusions Major weight loss following biliopancreatic diversion with duodenal switch improves the reproductive function of severely obese women and provides major beneficial perinatological effects. Althouht bariatric procedures benefits for both mother and child, in some cases might lead to fetal hypotrophy. All pregnant women after biliopancreatic diversion with duodenal switch need a closer perinatal care during pregnancy. In all cases increase of pregnancy and labor risk has to be considered. doi:10.1016/j.earlhumdev.2008.09.279
Results All babies have been fed preterm formula (80 kcal–2.4 g protein–0.87 mg Zinc/100 ml) until randomisation, showing good growth in the 3 parameters with highest percentiles than at discharge. Even without statistical differences between the 3 groups during our follow-up, the PDZ group starting from lower values and percentiles for the 3 parameters concludes (together with group “A”) with higher percentiles in the 3 parameters. At 24 m, group “A” and “PDZ” shows better nutritional markers (BMI and Skin fold). There is no difference in growth velocity for the 3 parameters in the 3 groups. We studied the corrected age of Catch-Up (C U): group “PDZ” reached per 10th chronologic age earlier in length (p = 0.048) and Head Circumference (HC). About nutrient intakes children who reached length catch-up before 3 months (CA) were fed with higher intakes of proteins, phosphorus, and zinc (p = 0.07 for Zinc). We are very surprised about similar intakes of calcium in all babies being catch-up before or after 3 m. Conclusions “PDZ” group (enriched and with zinc), with more evident extrauterine growth restriction, reaches catch-up earlier and nutritional markers equalize at 24 m “A” group with better initial anthropometry and exceeded the PDLPUFAS group which had shown and earlier and greater weight growth. doi:10.1016/j.earlhumdev.2008.09.278
Abstract UENPS.263 Fetal hypotrophy and pregnancies in women experienced hypogonadotrophic hypogonadism after biliopancreatic diversion with duodenal switch Maciej W. Socha⁎, Bartlomiej Wolski, Jolanta Zegarska, Rafal Adamczak, Wieslaw Szymanski Department of Obstetrics and gynecology, Bydgoszcz, Poland
Abstract UENPS.264 Regular electronic monitoring and correction of nutritional intake supports adequate growth of very low birthweight infants Marja-Liis Mägi⁎a, Kärsin Maarjaa, Jaanika Kulda, Heili Varendib, Anne Ormissonb a Children's Clinic, Tartu University Hospital, Tartu, Estonia b Department of Pediatrics, University of Tartu, Tartu, Estonia Background and aim Extrauterine growth retardation is a major clinical problem in preterm infants. Adequate nutrition during the critical period of brain growth may have a positive impact on outcome. We studied if regular electronic monitoring and correction of nutritional intake result in optimal growth of VLBW infants. Materials and methods A special electronic system was created in our ward, which assured a quick calculation of nutritional intake and correction of feeding regimens according to the demands of VLBW infants. Nutritional intake and growth parameters of VLBW infants (< 32 GW, birth weight <1500 g) were compared: historical Control group (n = 33), born in 2002–2003, and Study group (n = 22), born in 2007. Nutritional intake for the control group at day 30 was assessed by the electronic calculator retrospectively. To evaluate if growth parameters are appropriate for corrected gestational age, Fetal–Infant Growth Chart for Preterm Infants (Fenton, 2003) was used. Weight and head circumference below 10th percentile at discharge were considered as suboptimal.
Abstracts
Conclusions
Background and aim
The study in infants at low risk confirms the previous findings in infants at risk for development of allergy and indicates an immune modulatory effect of the tested prebiotic mixture added to a formula with intact protein which suggests the opportunity for allergy prevention by specific prebiotics. This cohort will be followed to investigate the course of AD and other allergic manifestations.
Superobesity has deleterious effects on reproductive function and pregnancy outcomes in women. Although bariatric surgery is the best long-term treatment in severely obese women, there is a high risk of gestational undernutrition in mothers caused by this surgery, which may reduces nutrient availability. This may be one of the factors leading to malnutrition and finally to fetal hypotrophy.
doi:10.1016/j.earlhumdev.2008.09.277
Materials and methods Abstract UENPS.262 Postdischarge growth monitoring in preterm infants fed with different milk formulas Eva Maria Garcia Canto⁎a, Marie-Anne Feret Siguileb, Jose Sanchez Payab, Maria Remedios Garcia Martinezb, Bartolome Jimenez Cobob a Hospital de Villajoyosa, Villajoyosa, Spain b Hospital de Alicante, Alicante, Spain Background and aim Objective: Compare postdischarge growth of preterm infants until 24 months, feeding from 40 w. Postconceptonal (P.C.) to 6 months corrected age (C.A) with 3 different milk formulas: Formula “A”: standart term formula (67 kcal–1.4 g protein/100 ml); Formula “PDL-PUFAS” enriched formula (74 kcal–1.77 g/100 ml, supplemented with AA y DHA); Formula “PDZ” enriched formula (75 kcal–1.95 g protein/100 ml), supplemented with Zinc (1.2 mg/100 ml) vs 0.7 mg/100 ml for the other 2 formulas. Materials and methods Methodology: Double blind trial with randomised assignation of milk formula. All preterm infants care in Alicante General University Hospital (HGUA) with gestational age until 34 w and B.W. until 1750 g, all adequate for date at birth, without systemic illness evidence at discharge. We randomised 146 babies of which 116 were followed until 3 months and 92 until 24 months for C.A. All of them had a similar introduction of beikost (date and nutrients).
We present two cases of pregnant women with intrauterine fetal hypotrophy following earlier fertility problems caused by hypogonadotrophic hypogonadism after biliopancreatic diversion with duodenal switch operation for superobesity. Results Two women, who underwent biliopancreatic diversion with duodenal switch operation for superobesity. After this bariatric procedure, they started to lose weight and become amenorrhoeic when their weight loss approaches 25% (but were still overweight). In both cases amenorrhoea mimicked the hormonal picture of hypogonadotrophic hypogonadism with clinical infertility. Menses recur spontaneously and it resulted in pregnancies occurred in first 6 cycles. Although both patients, presented no clinical signs of undernutrition, intrauterine fetal hypotrophy were presented. Conclusions Major weight loss following biliopancreatic diversion with duodenal switch improves the reproductive function of severely obese women and provides major beneficial perinatological effects. Althouht bariatric procedures benefits for both mother and child, in some cases might lead to fetal hypotrophy. All pregnant women after biliopancreatic diversion with duodenal switch need a closer perinatal care during pregnancy. In all cases increase of pregnancy and labor risk has to be considered. doi:10.1016/j.earlhumdev.2008.09.279
Results All babies have been fed preterm formula (80 kcal–2.4 g protein–0.87 mg Zinc/100 ml) until randomisation, showing good growth in the 3 parameters with highest percentiles than at discharge. Even without statistical differences between the 3 groups during our follow-up, the PDZ group starting from lower values and percentiles for the 3 parameters concludes (together with group “A”) with higher percentiles in the 3 parameters. At 24 m, group “A” and “PDZ” shows better nutritional markers (BMI and Skin fold). There is no difference in growth velocity for the 3 parameters in the 3 groups. We studied the corrected age of Catch-Up (C U): group “PDZ” reached per 10th chronologic age earlier in length (p = 0.048) and Head Circumference (HC). About nutrient intakes children who reached length catch-up before 3 months (CA) were fed with higher intakes of proteins, phosphorus, and zinc (p = 0.07 for Zinc). We are very surprised about similar intakes of calcium in all babies being catch-up before or after 3 m. Conclusions “PDZ” group (enriched and with zinc), with more evident extrauterine growth restriction, reaches catch-up earlier and nutritional markers equalize at 24 m “A” group with better initial anthropometry and exceeded the PDLPUFAS group which had shown and earlier and greater weight growth. doi:10.1016/j.earlhumdev.2008.09.278
Abstract UENPS.263 Fetal hypotrophy and pregnancies in women experienced hypogonadotrophic hypogonadism after biliopancreatic diversion with duodenal switch Maciej W. Socha⁎, Bartlomiej Wolski, Jolanta Zegarska, Rafal Adamczak, Wieslaw Szymanski Department of Obstetrics and gynecology, Bydgoszcz, Poland
Abstract UENPS.264 Regular electronic monitoring and correction of nutritional intake supports adequate growth of very low birthweight infants Marja-Liis Mägi⁎a, Kärsin Maarjaa, Jaanika Kulda, Heili Varendib, Anne Ormissonb a Children's Clinic, Tartu University Hospital, Tartu, Estonia b Department of Pediatrics, University of Tartu, Tartu, Estonia Background and aim Extrauterine growth retardation is a major clinical problem in preterm infants. Adequate nutrition during the critical period of brain growth may have a positive impact on outcome. We studied if regular electronic monitoring and correction of nutritional intake result in optimal growth of VLBW infants. Materials and methods A special electronic system was created in our ward, which assured a quick calculation of nutritional intake and correction of feeding regimens according to the demands of VLBW infants. Nutritional intake and growth parameters of VLBW infants (< 32 GW, birth weight <1500 g) were compared: historical Control group (n = 33), born in 2002–2003, and Study group (n = 22), born in 2007. Nutritional intake for the control group at day 30 was assessed by the electronic calculator retrospectively. To evaluate if growth parameters are appropriate for corrected gestational age, Fetal–Infant Growth Chart for Preterm Infants (Fenton, 2003) was used. Weight and head circumference below 10th percentile at discharge were considered as suboptimal.