RESUMO
We conducted a double-blind, randomized study to test the hypothesis that a whey-dominant formula permits a growth and metabolic advantage over a casein-dominant formula in preterm infants after hospital discharge. Nineteen low birth weight infants were studied for 6 months from the time of discharge. Ten received a casein-dominant formula, and nine received a whey-dominant formula. Growth (weight, length, head circumference, mid-arm circumference, and skin-fold thickness), biochemical measurements (alkaline phosphatase activity, acid-base status, and hemoglobin, serum total protein, albumin, and urea nitrogen levels), and quantity of formula intake did not differ significantly between the groups over a 6-month study period. Serum transthyretin and urea nitrogen concentrations differed significantly between the two feeding groups at the day of entry into the study only. The results indicate that, after hospital discharge, premature infants fed a whey-dominant formula do not differ in growth or biochemical measurements from those fed a casein-dominant formula.
Assuntos
Caseínas/farmacologia , Alimentos Infantis , Recém-Nascido Prematuro/crescimento & desenvolvimento , Proteínas do Leite/farmacologia , Fosfatase Alcalina/sangue , Proteínas Sanguíneas/análise , Nitrogênio da Ureia Sanguínea , Método Duplo-Cego , Ingestão de Energia , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Recém-Nascido de Baixo Peso/metabolismo , Recém-Nascido , Recém-Nascido Prematuro/metabolismo , Pré-Albumina/análise , Distribuição Aleatória , Proteínas do Soro do LeiteRESUMO
A study of growth and nutrition was conducted with 20 growth-retarded (GR) and 20 growth-normal (GN) preadolescent children with sickle cell disease (SCD). All children were matched for age, sex, hemoglobin disorder, and hematologic values. Ten normal children served as control subjects. Mean serum levels of retinol, retinol-binding protein, prealbumin, and zinc were significantly lower in the children with SCD than in normal children. Mean serum retinol and prealbumin levels were similar in the GR and GN sickle cell groups. Mean serum retinol-binding protein levels were lower in GR than in GN patients. Serum zinc levels, somatomedin C levels, and bone age were frequently abnormal in the patients with SCD, but these factors did not correlate with growth status. It was not possible to explain the poor growth in patients with SCD in this study solely on the basis of nutritional factors.
Assuntos
Anemia Falciforme/complicações , Transtornos do Crescimento/etiologia , Estado Nutricional , Anemia Falciforme/fisiopatologia , Criança , Feminino , Humanos , Masculino , Pré-Albumina/análise , Proteínas de Ligação ao Retinol/análise , Vitamina A/sangue , Zinco/sangueRESUMO
Two hundred four neonates, 25 to 42 weeks estimated gestational age (EGA), were measured on day 2 or 3 of life for upper mid-arm circumference (MAC) and head circumference. Regression analysis was used to construct standard curves for MAC versus EGA and mid-arm circumference/head circumference ratio (MAC/HC) versus EGA. Correlation coefficients were 0.93 for MAC versus EGA, and 0.84 for MAC/HC versus EGA. MAC, MAC/HC, and head circumference were also highly correlated with birth weight. These measurements may more accurately assess intrauterine growth and body proportionality at birth than weight, length, and head circumference.
Assuntos
Braço/anatomia & histologia , Peso ao Nascer , Retardo do Crescimento Fetal/diagnóstico , Cabeça/anatomia & histologia , Recém-Nascido , Antropometria , Feminino , Idade Gestacional , Humanos , Gravidez , Valores de Referência , Análise de RegressãoRESUMO
Mid-arm circumference/head circumference ratios (MAC/HC) and birth weights obtained in 73 neonates were studied to compare which of these growth measurements could more accurately predict risk of metabolic complications resulting from either acceleration or retardation of fetal growth. The MAC/HC ratio was more sensitive than birth weight in distinguishing symptomatic large for gestational age (LGA) infants who were born to diabetic mothers from other LGA infants who were asymptomatic, and symptomatic from asymptomatic small for gestational age infants. In addition, the MAC/HC ratio identified symptomatic appropriate for gestational age (AGA) infants born to diabetic mothers and AGA infants with signs and symptoms of growth retardation. The MAC/HC is more useful than birth weight in assessing newborn infants at risk for the metabolic complications associated with fetal growth disorders.
Assuntos
Braço/anatomia & histologia , Peso ao Nascer , Retardo do Crescimento Fetal/diagnóstico , Cabeça/anatomia & histologia , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Antropometria , Feminino , Idade Gestacional , Humanos , Gravidez , Gravidez em Diabéticas , RiscoRESUMO
We assessed cord prealbumin concentrations in 214 appropriate for gestational age newborn infants, 21 small for gestational age infants, and 27 large for gestational age infants to establish normal values and to assess the effect of intrauterine growth, prenatal steroids, and pulmonary maturity on prealbumin levels. Cord prealbumin values were significantly correlated with increasing gestational age (r = 0.33; P less than 0.001) and birth weight (r = 0.40, P less than 0.001) in the AGA neonates. Neonates born before 37 weeks gestation had significantly lower prealbumin levels than those born at term (P less than 0.001). The SGA infants had significantly lower levels than age-matched AGA controls (P less than 0.01), and LGA infants had significantly higher levels than age-matched AGA controls (P less than 0.001). In preterm infants, those with exposure to prenatal steroids (betamethasone or premature rupture of membranes) had significantly higher prealbumin values than control infants of comparable age and weight (P less than 0.001). Infants without respiratory distress syndrome had higher levels than those of comparable age and weight with hyaline membrane disease (P less than 0.05). This study demonstrates that a correlation of gestational age and birth weight exists with cord prealbumin levels, and that the large variability at each gestational age may be accounted for in part by appropriateness of size for dates, prenatal steroid exposure, and pulmonary maturity.