Gestational age - the most important factor of neonatal ponderal index

Damir Roje,Banovic Ivo,Tadin Ivica,Vucinovic Mirjana,Capkun Vesna,Barisic Aljosa,Vulic Marko,Mestrovic Zoran,Mimica Marko,Miletic Tomislav 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.2

Ponderal index (fetal weight in grams×100/ (fetal length in centimeters)3) (PI) is one of the anthropometric methods used to diagnose impaired fetal growth. Irrespective of the infant's position on the growth-weight-for-gestational age charts, PI is low in malnourished infants and high in obese ones. As fetal growth is affected by ethnicity, geographic location and socioeconomic status, we developed standards for neonatal PI, and assessed the effects of gestational age, sex and maternal parity. Data on 5798 newborns from singleton pregnancies born in the Department of Gynecology and Obstetrics, Split University Hospital, were retrospectively analyzed. Over a 15-month period in 2000/2001, 5596 newborns from 24 to 42 weeks of gestation were born. The other 202 newborns, born from 24 to 34 weeks of gestation in the ten year period, 1990-1999, were added because of the small number of preterm infants; ensuring a minimum of 30 to fill up at least infants in each gestational week. All mothers were of Caucasian origin. Stillbirths and fetuses with congenital malformations were excluded. The 10th, 50th and 90th percentiles, mean values with standard deviation of PI and the 10th, 50th, and 90th percentiles of birth weight and birth length are presented separately at weekly intervals. PI showed linear correlation with gestational age from 24 to 39 weeks, after witch the data plateaued. Sex and parity had no impact on PI in infants born between 24 and 37 weeks. Analysis of variance revealed PI to be significantly higher in female than in male newborns, and in multiparous than in nulliparous infants after 37 weeks of gestation. In conclusion, gestational age is the most important factor of neonatal PI. The effects of sex and parity on PI should only be considered in term neonates.

Vitamin B12 Supplementation in Addition to Folic Acid and Iron Improves Hematological and Biochemical Markers in Pregnancy: A Randomized Controlled Trial

Mirela Zec,Damir Roje,Martina Matovinovic,Vesna Anti cevic,Ljubica Librenjak Skare,Ana Jeron cic,Livia Puljak,Sanja Madunic,Zoran Mestrovic 한국식품영양과학회 2020 Journal of medicinal food Vol.23 No.10

Vitamin B12 plays an important role in cell division and is of vital importance during pregnancy. Iron and B12 deficiency increase the risk of neonatal morbidity and the outcome of the overall pregnancy. The aim of our study was to analyze whether the use of vitamin B12, with standard supplements of folic acid and iron among nonanemic pregnant women, will result in improvements of hemogram parameters in terms of hematological and biochemical markers. Study participants were 200 healthy pregnant women, randomized into an intervention group and a control group, recruited from gynecological primary care practices in Split, Croatia. In addition to standard supplementation (350 mg/day ferrous iron, 5 mg folic acid), participants in the intervention group were given 5 μg of vitamin B12 each morning for 100 days. Both biochemical and hematological measurings were conducted in two intervals: 8th–10th week of gestation and then again in the 34th–36th week of gestation. Participants in the control group were given only standard-of-care iron and folic acid supplementation. Significantly lower values of haptoglobin postintervention, compared with baseline, were found only in the intervention group; for erythrocytes, significantly lower values postintervention were found only in the control group. For parameter hematocrit, we found decreased values postintervention, compared with baseline, in both intervention and control group; however, this decrease was within the reference range for the control group, whereas it was above the reference range for the intervention group. The results of this study indicated that intervention with vitamin B12 in pregnancy reduces possibilities of the onset of anemia, but within reference range.

Maternal and Neonatal Effects of Substance Abuse during Pregnancy: Our Ten-year Experience

Mirjana Vucinovic,Damir Roje,Zoran Vučinović,Vesna Capkun,Marija Bucat,Ivo Banović 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.5

Purpose: The aim of the study was to assess perinatal outcome of pregnancy burdened with maternal addiction in comparison with an unselected population from a European transition country. Materials and Methods: Data on pregnancies complicated by illicit drug abuse (n=85) managed during a 10-year period (1997-2007) at Split University Hospital were analyzed. Data on the type of drug, course of gestation and labor, and on perinatal outcome were considered. Data on all non-dependence pregnancies recorded during the study period were used as a control group. Results: During the study period, there were 85 dependence-complicated pregnancies (0.2%). Use of heroin alone during pregnancy was recorded in 51 women (50%), methadone alone in 6 (7%), and a combination of heroin and methadone in 9 (11%). Premature delivery was significantly more common in the group of pregnant addicts (21% vs. 6%); 49% of pregnant addicts were carriers of hepatitis C virus (HCV) and 14% of hepatitis B virus (HBV). Neonatal abstinence syndrome developed in 61 infants (7%) born to addicted mothers. There were 4 cases (4.6%) of early neonatal death; 7 neonates had 5-minute Apgar score ≤7 (8%); 29 neonates had low birth weight for age (33%); and 7 neonates had congenital anomalies (8%). The risk of various congenital anomalies was 3-fold in the group of children born to addicted mothers. Conclusion: Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome.

The Impact of Inherited Thrombophilia Types and Low Molecular Weight Heparin Treatment on Pregnancy Complications in Women with Previous Adverse Outcome

Vedran Stefanovic,Nada Aracic,Damir Roje,Ivana Alujevic Jakus,Marinela Bakotin 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.5

Purpose: To assess the distribution of births and spontaneous abortions, first-trimester abortion (FTA) and mid-trimester abortion(MTA), in untreated (n=128) and low molecular weight heparin (LMWH) treated pregnancies (n=50) of the same women with inheritedthrombophilias and adverse pregnancy outcome (APO) in previous pregnancies. We particularly investigated the impact ofLMWH on reducing the pregnancy complications in two thrombophilia types, “Conventional” and “Novel”. Materials and Methods: 50 women with inherited thrombophilia (26 Conventional and 24 Novel) and APO in previous pregnancieswere included in the study. Conventional group included factor V Leiden (FVL), prothrombin G20210A (PT) mutations and antithrombin(AT), protein S (PS), and protein C (PC) deficiency, while the Novel group included methylentetrahydrofolate-reductase(MTHFR), plasminogen activator inhibitor-1 (PAI-1), and angiotensin converting enzyme (ACE) polymorphism. APO was definedas one of the following: preterm birth (PTB), fetal growth restriction (FGR), preeclampsia (PE), intrauterine fetal death (IUFD), placentalabruption (PA) and deep venous thrombosis (DVT). Results: There was no difference in distribution of births and spontaneous abortions between Conventional and Novel thrombophiliain untreated pregnancies (χ2=2.7; p=0.100) and LMWH treated pregnancies (χ2=0.442; p=0.506). In untreaed pregnancies thrombophiliatype did not have any impact on the frequency of FTA and MTA (χ2=0.14; p=0.711). In birth-ended pregnancies LMWH treatementreduced the incidence of IUFD (p=0.011) in Conventional and FGR, IUFD, and PTB in Novel thrombophilia group. Conclusion: The equal impact of two thrombophilia types on the pregnancy outcomes and a more favorable effect of LMWH therapyon pregnancy complications in Novel thrombophilia group point the need for Novel thrombophilias screening and the futurestudies on this issue should be recommended.