114 results for 2000, Harding, Jane, Journal article

  • Multi-nutrient fortification of human milk for preterm infants

    Brown, JVE; Embleton, ND; Harding, Jane; McGuire, W (2016)

    Journal article
    The University of Auckland Library

    Exclusively breast milk-fed preterm infants may accumulate nutrient deficits leading to extrauterine growth restriction. Feeding preterm infants with multi-nutrient fortified human breast milk rather than unfortified breast milk may increase nutrient accretion and growth rates and may improve neurodevelopmental outcomes. Objectives To determine whether multi-nutrient fortified human breast milk improves important outcomes (including growth and development) over unfortified breast milk for preterm infants without increasing the risk of adverse effects (such as feed intolerance and necrotising enterocolitis). Search methods We used the standard search strategy of the Cochrane Neonatal Review Group. This included electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 2), MEDLINE, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (until February 2016), as well as conference proceedings and previous reviews. Selection criteria Randomised and quasi-randomised controlled trials that compared feeding preterm infants with multi-nutrient (protein and energy plus minerals, vitamins or other nutrients) fortified human breast milk versus unfortified (no added protein or energy) breast milk. Data collection and analysis We extracted data using the standard methods of the Cochrane Neonatal Review Group. We separately evaluated trial quality, data extracted by two review authors and data synthesised using risk ratios (RRs), risk differences and mean differences (MDs). We assessed the quality of evidence at the outcome level using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Main results We identified 14 trials in which a total of 1071 infants participated. The trials were generally small and weak methodologically. Meta-analyses provided low-quality evidence that multi-nutrient fortification of breast milk increases in-hospital rates of growth (MD 1.81 g/kg/d, 95% confidence interval (CI) 1.23 to 2.40); length (MD 0.12 cm/wk, 95% CI 0.07 to 0.17); and head circumference (MD 0.08 cm/wk, 95% CI 0.04 to 0.12). Only very limited data are available for growth and developmental outcomes assessed beyond infancy, and these show no effects of fortification. The data did not indicate other potential benefits or harms and provided low-quality evidence that fortification does not increase the risk of necrotising enterocolitis in preterm infants (typical RR 1.57, 95% CI 0.76 to 3.23; 11 studies, 882 infants). Authors' conclusions Limited available data do not provide strong evidence that feeding preterm infants with multi-nutrient fortified breast milk compared with unfortified breast milk affects important outcomes, except that it leads to slightly increased in-hospital growth rates.

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  • Global Motion Perception in 2-Year-Old Children: A Method for Psychophysical Assessment and Relationships With Clinical Measures of Visual Function

    Yu, Tzu-Ying; Jacobs, Robert; Anstice, Nicola; Paudel, Nabin; Harding, Jane; Thompson, Benjamin; CHYLD Study Team (2013-12)

    Journal article
    The University of Auckland Library

    Purpose. We developed and validated a technique for measuring global motion perception in 2-year-old children, and assessed the relationship between global motion perception and other measures of visual function. Methods. Random dot kinematogram (RDK) stimuli were used to measure motion coherence thresholds in 366 children at risk of neurodevelopmental problems at 24 ?? 1 months of age. RDKs of variable coherence were presented and eye movements were analyzed offline to grade the direction of the optokinetic reflex (OKR) for each trial. Motion coherence thresholds were calculated by fitting psychometric functions to the resulting datasets. Test???retest reliability was assessed in 15 children, and motion coherence thresholds were measured in a group of 10 adults using OKR and behavioral responses. Standard age-appropriate optometric tests also were performed. Results. Motion coherence thresholds were measured successfully in 336 (91.8%) children using the OKR technique, but only 31 (8.5%) using behavioral responses. The mean threshold was 41.7 ?? 13.5% for 2-year-old children and 3.3 ?? 1.2% for adults. Within-assessor reliability and test???retest reliability were high in children. Children's motion coherence thresholds were significantly correlated with stereoacuity (LANG I & II test, ?? = 0.29, P < 0.001; Frisby, ?? = 0.17, P = 0.022), but not with binocular visual acuity (?? = 0.11, P = 0.07). In adults OKR and behavioral motion coherence thresholds were highly correlated (intraclass correlation = 0.81, P = 0.001). Conclusions. Global motion perception can be measured in 2-year-old children using the OKR. This technique is reliable and data from adults suggest that motion coherence thresholds based on the OKR are related to motion perception. Global motion perception was related to stereoacuity in children.

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  • Preterm birth is associated with an intergenerational effect on cardio-metabolic risk

    Behrensdorf Derraik, Jose; Mathai, S; Chiavaroli, Valentina; Dalziel, SR; Harding, Jane; Biggs, J; Jefferies, C; Cutfield, Wayne; Hofman, Paul (2015-09)

    Journal article
    The University of Auckland Library

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  • Neonatal Hyperglycaemia Increases Mortality and Morbidity in Preterm Lambs.

    Alsweiler, Jane; Harding, Jane; Bloomfield, Francis (2012-10-31)

    Journal article
    The University of Auckland Library

    Background: Hyperglycaemic preterm babies suffer increased mortality and morbidity, but it is not known if these associations are causal or if treatment with insulin improves outcome. Objectives: We aimed to investigate the effect of neonatal hyperglycaemia, and its treatment with insulin, on mortality and morbidity in preterm lambs. Methods: Preterm lambs (137 days' gestation; term = 148 days) were randomised to a 12-day intravenous infusion of saline (PremC; n = 39), 50% dextrose (HYPER; n = 47), or 50% dextrose + insulin (INS; n = 21). Term controls (TermC; n = 19) received saline. Dextrose and insulin infusions were titrated to maintain blood glucose concentrations (BGC) at 10-12 mmol??l(-1) (HYPER) or 4-6 mmol??l(-1) (INS). Results: HYPER lambs had higher BGC (mean (SEM); TermC: 5.6 (0.1), PremC: 5.5 (0.1), HYPER: 10.8 (0.6), INS: 6.2 (0.3) mmol??l(-1); p < 0.0001), higher mortality (n (%); TermC: 0, PremC: 2 (5), HYPER: 11 (23), INS: 0; p < 0.001), higher incidence of fever (n (%); TermC: 3 (16), PremC: 13 (33), HYPER: 26 (55), INS: 6 (29); p = 0.01) and lower weight gain (mean (SEM); TermC: 45.9 (2.9), PremC: 44.2 (2.1), HYPER: 28.4 (1.9), INS: 28.7 (2.8) g??kg(-1)??day(-1); p < 0.0001). Conclusions: Neonatal hyperglycaemia in preterm lambs causes increased mortality and morbidity, and decreases growth. Insulin treatment to restore euglycaemia attenuated the increased mortality and morbidity, but not the decreased growth.

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  • Maternal undernutrition and endocrine development

    Harding, Jane; Behrensdorf Derraik, Jose; Bloomfield, Francis (2010)

    Journal article
    The University of Auckland Library

    Maternal undernutrition, whether it occurs before conception, throughout gestation or during lactation, may lead to physiological adaptations in the fetus that will affect the health of the offspring in adult life. The timing, severity, duration and nature of the maternal nutritional insult may affect the offspring differently. Other factors determining outcome following maternal undernutrition are fetal number and gender. Importantly, effects of maternal undernutrition may be carried over into subsequent generations. This review examines the endocrine pathways disrupted by maternal undernutrition that affect the long-term postnatal health of the offspring. Maternal and childhood undernutrition are highly prevalent in low- and middle-income countries, and, in developed countries, unintentional undernutrition may arise from maternal dieting. It is, therefore, important that we better understand the mechanisms driving the long-term effects of maternal undernutrition, as well as identifying treatments to ameliorate the associated mortality and morbidity.

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  • Different Periods of Periconceptional Undernutrition Have Different Effects on Growth, Metabolic and Endocrine Status in Fetal Sheep

    Rumball, CWH; Bloomfield, Francis; Oliver, Mark; Harding, Jane (2009-12)

    Journal article
    The University of Auckland Library

    Periconceptional undernutrition alters fetal growth and development. However, there are no data on separate effects of undernutrition before and after conception and few on underlying mechanisms. We determined the effects of mild periconceptional undernutrition on late gestation fetal growth, glucose-insulin axis, and maternal and fetal hypothalamic-pituitary-adrenal axes. Ewes were undernourished for 60 d before conception, 30 d after, or both, compared with well-nourished controls. Undernutrition before conception resulted in smaller, slower-growing fetuses with relatively larger placentae. Ewes that gained weight before, but lost weight after mating, or vice versa, had the smallest fetuses. Fetuses of ewes undernourished only before conception grew more slowly following instrumentation, and fetuses in both preconception undernutrition groups slowed their growth with a maternal fast. The fetal glucose-insulin axes and maternal and fetal hypothalamic-pituitary-adrenal axis were not different among groups. Maternal undernutrition at different periods around conception has different effects on fetal growth trajectory that are not reflected in size in late gestation. Preconceptional undernutrition alone alters fetal growth responses to late gestation stressors, suggesting that maternal nutrition is important at both times, and that fetal effects are neither due solely to substrate limitation, nor to excess fetal glucocorticoid exposure at the time of undernutrition. (Pediatr Res 66: 605-613, 2009)

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  • Periconceptional undernutrition of ewes impairs glucose tolerance in their adult offspring

    Todd, SE; Oliver, Mark; Jaquiery, Anne; Bloomfield, Francis; Harding, Jane (2009)

    Journal article
    The University of Auckland Library

    Maternal undernutrition throughout pregnancy can have long-term effects on the health of adult offspring. Undernutrition around the time of conception alters growth, metabolism, and endocrinology of the sheep fetus. bill the impact on offspring after birth is largely unknown. We determined the effect of maternal periconceptional Undernutrition in sheep oil glucose tolerance in the offspring before and after puberty. Undernourished (UN) ewes were fed individually to maintain weight loss of 10-15%, bodyweight from 61 d before until 30 d after mating. 08-spring (24 UN, 30 control) underwent an i.v. glucose tolerance test at 4 and 10 mo of awe. Glucose tolerance was similar in both groups at 4 mo. Insulin area under the curve increased by 33% between 4 and 10 mo (101 +/- 8 versus 154 +/- 12 ng . min . mL(-1), p < 0.0001). At 10 mo. UN offspring had a 10% greater glucose area under the curve than controls (809 +/- 22 versos 712 +/- 20 mM . min, p < 0.01), a reduced first phase insulin response (p = 0.003) which was particularly apparent in females and in singletons, and a decreased insulin:glucose ratio (p = 0.01). We conclude that maternal undernutrition around the time of conception results in impaired glucose tolerance in postpubertal offspring.

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  • Variable interpretation of ultrasonograms may contribute to variation in the reported incidence of white matter damage between newborn intensive care units in New Zealand

    Harris, Deborah; Bloomfield, Francis; Teele, R; Harding, Jane; Australian New Zealand Neonatal Ne (2006-01)

    Journal article
    The University of Auckland Library

    Background: The incidence of cerebral white matter damage reported to the Australian and New Zealand Neonatal Network (ANZNN) varies between neonatal intensive care units (NICUs).Hypothesis: Differences in the capture, storage, and interpretation of the cerebral ultrasound scans could account for some of this variation.Methods: A total of 255 infants of birth weight < 1500 g and gestation < 32 weeks born between 1997 and 2002 and drawn equally from each of the six NICUs in New Zealand were randomly selected from the ANZNN database. Half had early cerebral ultrasound scans previously reported to ANZNN as normal, and half had scans reported as abnormal. The original scans were copied, anonymised, and independently read by a panel of three experts using a standardised method of reviewing and reporting.Results: There was considerable variation between NICUs in methods of image capture, quality, and completeness of the scans. There was only moderate agreement between the reviewers' reports and the original reports to the ANZNN (kappa 0.45-0.51) and between the reviewers (kappa 0.54-0.64). The reviewers reported three to six times more white matter damage than had been reported to the ANZNN.Conclusion: Some of the reported variation in white matter damage between NICUs may be due to differences in capture and interpretation of cerebral ultrasound scans.

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  • Amniotic IGF-I supplementation of growth-restricted fetal sheep alters IGF-I and IGF receptor type 1 mRNA and protein levels in placental and fetal tissues

    Shaikh, Shamim; Bloomfield, Francis; Bauer, Michael; Phua, Hui; Gilmour, RS; Harding, Jane (2005-07)

    Journal article
    The University of Auckland Library

    We have previously reported that chronic intra-amniotic supplementation of the late gestation growth-restricted (IUGR) ovine fetus with IGF-I (20 mu g/day) increased gut growth but reduced liver weight and circulating IGF-I concentrations. Here we report mRNA and protein levels of IGF-I, the type I IGF receptor (IGF-1R) and IGF-binding proteins (IGFBP)-1, -2 and -3 in fetal gut, liver, muscle and placenta from fetuses in that earlier study in an attempt to explain these contrasting results. mRNA and protein were extracted from tissues obtained at post mortem at 131 days of gestation (term, 145 days) from three groups of fetuses (control, IUGR+saline and IUGP,+IGF-I, n=9 per group). Control fetuses were unembolised and untreated. In the IUGR groups, growth restriction was induced from 113 to 120 days by placental embolisation; from 120 to 130 days fetuses were treated with daily intra-amnotic injections of either saline or 20 mu g IGF-I mRNA was measured by RT-PCR or real-time RT-PCR, and protein by Western blot. In liver, muscle and placenta, IGF-I mRNA and protein levels were reduced by between 8 and 30% in IGF-I-treated fetuses compared with saline-treated fetuses and controls with no change in IGF-I R mRNA or protein levels. In contrast, in the gut, IGF-I mRNA and protein levels were not significantly altered with IGF-I treatment, but IGF-1R levels were increased, especially in the jejunum. Immunolocalisation demonstrated that IGF-1R expression was confined to the luminal aspect of the gut. mRNA levels of all three IGFBPs were reduced in the gut of IGF-I-treated fetuses, but hepatic expression was significantly increased. These data demonstrated tissue-specific regulation of IGF-I, IGF-1R and IGFBPs-1, -2 and -3 in response to intra-amniotic IGF-I supplementation, though the underlying mechanisms remain obscure.

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  • Blood pressure at 6 years of age after prenatal exposure to betamethasone: Follow-up results of a randomized, controlled trial

    Dalziel, Stuart; Liang, Allen; Parag, Varsha; Rodgers, Anthony; Harding, Jane (2004-09)

    Journal article
    The University of Auckland Library

    Objective. To determine whether prenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome (RDS) alters blood pressure in childhood.Design. Prospective follow-up study of a randomized, double-blind, placebo-controlled trial.Setting. National Women's Hospital ( Auckland, New Zealand).Participants. Two hundred twenty-three 6-year-old children of mothers who presented with unplanned premature labor and took part in a randomized, controlled trial of prenatal betamethasone therapy for the prevention of neonatal RDS.Intervention. Mothers received 2 doses of betamethasone ( 12 mg) or placebo, administered through intramuscular injection, 24 hours apart. Main Outcome Measures. Systolic and diastolic blood pressure at 6 years of age.Results. Children exposed prenatally to betamethasone ( n = 121) did not differ in systolic or diastolic blood pressure from children exposed to placebo ( n = 102) ( mean difference: systolic: - 1.6 mm Hg; 95% confidence interval: - 4.1 to 0.8 mm Hg; diastolic: - 0.3 mm Hg; 95% confidence interval: - 2.5 to 1.8 mm Hg).Conclusion. Prenatal exposure to betamethasone for prevention of neonatal RDS does not alter blood pressure at 6 years of age.

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  • Does radio-opaque contrast improve radiographic localisation of percutaneous central venous lines?

    Odd, DE; Page, B; Battin, Malcolm; Harding, Jane (2004-01)

    Journal article
    The University of Auckland Library

    Background: Percutaneous central venous lines (long lines) are commonly used in neonatal practice. The position of these lines is important, because incorrect placement may be associated with complications.Aims: To determine whether the addition of radio-opaque contrast material improves the localisation of long line tips over plain radiography.Methods: Radiographs taken to identify long line position were identified in two periods; 106 radiographs without contrast taken between October 1999 and August 2000, and 96 radiographs with contrast between September 2001 and July 2002. Two observers independently reviewed each radiograph to identify the position of the line tip. The formal radiology report was recorded as a third observer.Results: The use of contrast increased the proportion of radiographs in which all observers reported they could see the long line tip (53 (55%) v 41 (39%)). It also increased the proportion where they agreed on anatomical position (57 (59%) v 39 (37%)) and there was a higher kappa coefficient for agreement (0.56 v 0.33).Conclusions: The use of contrast while taking radiographs for the localisation of long line position improves the likelihood that an observer can see a long line tip and reduces inter-observer variability. Even using contrast, precise localisation of a long line tip can be difficult.

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  • Protein metabolism in preterm infants with particular reference to intrauterine growth restriction

    De Boo, Hendrina; Harding, Jane (2007-07)

    Journal article
    The University of Auckland Library

    There is growing evidence that neonatal and long-term morbidity in preterm infants, particularly those born before 32 weeks' gestation, can be modified by attained growth rate in the neonatal period. Guidelines for optimal growth and the nutritional intakes, particular of protein, required to achieve this are not well defined. Due to delays in postnatal feeding and a lack of energy stores developed in the last trimester of pregnancy, preterm infants often suffer early postnatal catabolism until feeding is established. There are indications that infants born with intrauterine growth restriction have perturbations in protein metabolism. Therefore, they may have different protein requirements than appropriate for gestational age infants. This review summarises what is known about protein requirements and metabolism in the fetus and preterm infant, with particular emphasis on the distinct requirements of the growth-restricted infant.

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  • Periconceptional undernutrition supresses cortisol response to arginine vasopressin and corticotropin-releasing hormone challenge in adult sheep offpring.

    Oliver, Mark; Bloomfield, Francis; Jaquiery, Anne; Todd, SE; Thorstensen, Eric; Harding, Jane (2012)

    Journal article
    The University of Auckland Library

    Poor maternal nutrition during pregnancy can result in increased disease risk in adult offspring. Many of these effects are proposed to be mediated via altered hypothalamo???pituitary???adrenal axis (HPAA) function, and are sex and age specific. Maternal undernutrition around the time of conception alters HPAA function in foetal and early postnatal life, but there are limited conflicting data about later effects. The aim of this study was to investigate the effect of moderate periconceptional undernutrition on HPAA function of offspring of both sexes longitudinally, from juvenile to adult life. Ewes were undernourished from 61 days before until 30 days after conception or fed ad libitum. HPAA function in offspring was assessed by arginine vasopressin plus corticotropin-releasing hormone challenge at 4, 10 and 18 months. Plasma cortisol response was lower in males than in females, and was not different between singles and twins. Periconceptional undernutrition suppressed offspring plasma cortisol but not adrenocorticotropic hormone responses. In males, this suppression was apparent by 4 months, and was more profound by 10 months, with no further change by 18 months. In females, suppression was first observed at 10 months and became more profound by 18 months. Maternal undernutrition limited to the periconceptional period has a prolonged, sex-dependent effect on adrenal function in the offspring.

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  • Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): A randomised, double-blind, placebo-controlled trial

    Harris, Deborah; Weston, PJ; Signal, M; Chase, JG; Harding, Jane (2013)

    Journal article
    The University of Auckland Library

    Background: Neonatal hypoglycaemia is common, and a preventable cause of brain damage. Dextrose gel is used to reverse hypoglycaemia in individuals with diabetes; however, little evidence exists for its use in babies. We aimed to assess whether treatment with dextrose gel was more effective than feeding alone for reversal of neonatal hypoglycaemia in at-risk babies. Methods: We undertook a randomised, double-blind, placebo-controlled trial at a tertiary centre in New Zealand between Dec 1, 2008, and Nov 31, 2010. Babies aged 35-42 weeks' gestation, younger than 48-h-old, and at risk of hypoglycaemia were randomly assigned (1:1), via computer-generated blocked randomisation, to 40% dextrose gel 200 mg/kg or placebo gel. Randomisation was stratified by maternal diabetes and birthweight. Group allocation was concealed from clinicians, families, and all study investigators. The primary outcome was treatment failure, defined as a blood glucose concentration of less than 2??6 mmol/L after two treatment attempts. Analysis was by intention to treat. The trial is registered with Australian New Zealand Clinical Trials Registry, number ACTRN12608000623392. Findings: Of 514 enrolled babies, 242 (47%) became hypoglycaemic and were randomised. Five babies were randomised in error, leaving 237 for analysis: 118 (50%) in the dextrose group and 119 (50%) in the placebo group. Dextrose gel reduced the frequency of treatment failure compared with placebo (16 [14%] vs 29 [24%]; relative risk 0??57, 95% CI 0??33-0??98; p=0??04). We noted no serious adverse events. Three (3%) babies in the placebo group each had one blood glucose concentration of 0??9 mmol/L. No other adverse events took place. Interpretation: Treatment with dextrose gel is inexpensive and simple to administer. Dextrose gel should be considered for first-line treatment to manage hypoglycaemia in late preterm and term babies in the first 48 h after birth. Funding: Waikato Medical Research Foundation, the Auckland Medical Research Foundation, the Maurice and Phyllis Paykel Trust, the Health Research Council of New Zealand, and the Rebecca Roberts Scholarship.

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  • Maternal Undernutrition Programs Tissue-Specific Epigenetic Changes in the Glucocorticoid Receptor in Adult Offspring

    Begum, G; Davies, A; Stevens, A; Oliver, Mark; Jaquiery, Anne; Challis, J; Harding, Jane; Bloomfield, Francis; White, A (2013-12)

    Journal article
    The University of Auckland Library

    Epidemiological data indicate that an adverse maternal environment during pregnancy predisposes offspring to metabolic syndrome with increased obesity, and type 2 diabetes. The mechanisms are still unclear although epigenetic modifications are implicated and the hypothalamus is a likely target. We hypothesized that maternal undernutrition (UN) around conception in sheep would lead to epigenetic changes in hypothalamic neurons regulating energy balance in the offspring, up to 5 years after the maternal insult. We found striking evidence of decreased glucocorticoid receptor (GR) promoter methylation, decreased histone lysine 27 trimethylation, and increased histone H3 lysine 9 acetylation in hypothalami from male and female adult offspring of UN mothers. These findings are entirely compatible with the increased GR mRNA and protein observed in the hypothalami. The increased GR predicted the decreased hypothalamic proopiomelanocortin expression and increased obesity that we observed in the 5-year-old adult males. The epigenetic and expression changes in GR were specific to the hypothalamus. Hippocampal GR mRNA and protein were decreased in UN offspring, whereas pituitary GR was altered in a sex-specific manner. In peripheral polymorphonuclear leukocytes there were no changes in GR methylation or protein, indicating that this epigenetic analysis did not predict changes in the brain. Overall, these results suggest that moderate changes in maternal nutrition, around the time of conception, signal life-long and tissue-specific epigenetic alterations in a key gene regulating energy balance in the hypothalamus.

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  • Fetal growth factors and fetal nutrition

    Bloomfield, Francis; Spiroski, Ana-Mishel; Harding, Jane (2013)

    Journal article
    The University of Auckland Library

    Optimal fetal growth is important for a healthy pregnancy outcome and also for lifelong health. Fetal growth is largely regulated by fetal nutrition, and mediated via the maternal and fetal glucose/insulin/insulin-like growth factor axes. Fetal nutrition may reflect maternal nutrition, but abnormalities of placental function can also affect fetal growth, as the placenta plays a key intermediary role in nutritional signalling between mother and fetus. Fetal nutrition also impacts on the development of key fetal endocrine systems such as the glucose-insulin and insulin-like growth factor axes. This is likely to contribute to the link between both fetal growth restriction and fetal overgrowth, and increased risks of obesity and impaired glucose tolerance in later life. This review focuses on the associations between maternal and fetal nutrition, fetal growth and later disease risk, with particular emphasis on the role of insulin-like growth factors and the importance of the periconceptional period.

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  • Increased Adiposity in Adults Born Preterm and Their Children

    Mathai, S; Behrensdorf Derraik, Jose; Cutfield, Wayne; Dalziel, SR; Harding, Jane; Biggs, J; Jefferies, C; Hofman, Paul (2013)

    Journal article
    The University of Auckland Library

    Background Preterm birth is associated with abnormalities in growth, body composition, and metabolism during childhood, but adult data are scarce and none exist for their offspring. We therefore aimed to examine body composition and cardiovascular risk factors in adults born preterm and their children. Methods A cohort of 52 adults (aged 35.7 years, 54% female, 31 born preterm) and their term-born children (n=61, aged 8.0 years, 54% female, 60% from a preterm parent) were studied. Auxology and body composition (whole-body dual-energy X-ray absorptiometry) were measured, and fasting blood samples taken for metabolic and hormonal assessments. Results Adults born preterm had greater abdominal adiposity, displaying more truncal fat (p=0.006) and higher android to gynoid fat ratio (p=0.004). Although women born preterm and at term were of similar weight and BMI, men born preterm (n=8) were on average 20 kg heavier (p=0.010) and of greater BMI (34.2 vs 28.4 kg/m2; p=0.021) than men born at term (n=16). Adults born preterm also displayed a less favourable lipid profile, including lower HDL-C concentrations (p=0.007) and greater total cholesterol to HDL-C ratio (p=0.047). Children of parents born preterm tended to have more body fat than the children of parents born at term (21.3 vs 17.6%; p=0.055). Even after adjustment for mean parental BMI, children of parents born preterm had altered fat distribution, with more truncal fat (p=0.048) and greater android to gynoid fat ratio (p=0.009). Conclusions Adults born preterm, particularly men, have markedly increased fat mass and altered fat distribution. A similar increase in abdominal adiposity was observed in the term born offspring of parents born preterm, indicating that adverse outcomes associated with preterm birth may extend to the next generation.

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  • Growth in the neonatal period after repeat courses of antenatal corticosteroids: data from the ACTORDS randomised trial

    Battin, Malcolm; Bevan, C; Harding, Jane (2012-03)

    Journal article
    The University of Auckland Library

    Objective To determine the effect of repeated antenatal corticosteroids on postnatal changes in weight, linear growth and head circumference. Methods Mothers who entered the repeated dose of antenatal steroids (ACTORDS) trial were randomised to additional weekly steroid or placebo. Infant occipital-frontal head circumference, weight and crown-heel length were measured at birth and weekly for 4 weeks or until discharge, whichever was later. Lower leg length was measured using a knemometer daily for the first week, then thrice weekly. Results Of 145 babies studied (77.5% of the ACTORDS study infants from this centre), 70 were exposed to repeated antenatal steroids and 75 to placebo. There were no significant differences in prerandomisation demographic and pregnancy data. The mean gestational age at ACTORDS entry was 28.7 weeks and at birth was 31.4 weeks. The mean birth weight was 1618 g. There were no significant differences in postmenstrual age, weight, length or head circumference, nor in z-scores for these measurements, at birth, 4 weeks or discharge. In the first 2 weeks after birth, babies in both groups showed a decrease in z-scores for weight and length. After week 2, growth improved in both groups but babies exposed to repeat antenatal corticosteroids grew more rapidly, as measured by weight gain, increasing head circumference and increasing lower leg length knemometry. This rapid growth was most apparent around weeks 3???5 after birth. Conclusion Babies exposed to weekly doses of repeat antenatal corticosteroids demonstrate postnatal growth acceleration 3???5 weeks after birth.

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  • Periconceptional undernutrition in sheep leads to decreased locomotor activity in a natural environment

    Donovan, Elise; Hernandez, CE; Matthews, LR; Oliver, Mark; Jaquiery, Anne; Bloomfield, Francis; Harding, Jane (2013-08)

    Journal article
    The University of Auckland Library

    Maternal undernutrition during pregnancy increases offspring obesity and metabolic disease risk. We hypothesized that periconceptional undernutrition in sheep from 60 days before conception through to day 30 of gestation (UN) would decrease voluntary locomotor activity in adult offspring. Distance travelled was measured at 18 months of age for ???48 h in the paddock. Data were analysed using multiple regression analysis, with explanatory variables including sex, nutrition group, birth weight, average time between GPS measurements and percentage of time during the measurement period spent in daylight. Mean (??s.e.) distance walked (m/h) was greater for control (CON) than UN animals, and greater for females than males [110.2 (6.5), CON females; 110.7 (6.3), CON males; 105.1 (5.3), UN females and 95.5 (5.8), UN males; P = 0.02 for nutrition group effect and for sex effect]. Periconceptional undernutrition may lead to a significant decrease in voluntary physical activity in adult offspring.

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  • Antenatal corticosteroid exposure at term increases adult adiposity: an experimental study in sheep

    Berry, MJ; Jaquiery, Anne; Oliver, Mark; Harding, Jane; Bloomfield, Francis (2013-07)

    Journal article
    The University of Auckland Library

    Clinical practice guidelines for elective cesarean section at early-term gestation (37-38??weeks) recommend antenatal corticosteroids to reduce neonatal respiratory morbidity. However, the long-term health implications for offspring exposed to corticosteroids at term are unknown and may differ from the effects of preterm corticosteroid exposure. We therefore randomized singleton-bearing ewes (n??=??64) to receive a clinically relevant dose of corticosteroids at term or no treatment. Body composition was assessed in adult offspring using dual-energy X-ray absorptiometry. Relative to skeletal size female, but not male, offspring of steroid-treated ewes had increased weight and a greater fat mass than controls (relative weight: 49.1??????1.1 vs. 52.9??????1.2??kg/m(2) , p??=??0.02; relative fat mass: 5.4??????0.7 vs. 3.4??????0.7??kg/m(2) , p??=??0.04). Whether corticosteroid exposure at early-term gestation increases adult adiposity in humans is unknown and needs further investigation.

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