Search Results (5)

Background/Objectives: Postnatal growth faltering (PGF) significantly affects premature neonates, leading to compromised neurodevelopment and an increased risk of long-term health complications. Methods: This retrospective study at a level III NICU of a tertiary hospital analyzed 650 preterm neonates born before 33 weeks. Postnatal growth was evaluated using the Fenton2013 and INTERGROWTH-21st growth charts, with changes in weight z-scores from birth to discharge classified as normal growth (ΔZ ≥ −1), non-severe PGF (−2 ≤ ΔZ < −1), and severe PGF (ΔZ < −2). Results: Mean gestational and postmenstrual age at discharge was 30 weeks (SD 1.9) and 37.1 weeks (SD 2.7), respectively. Fenton2013 growth curves revealed a higher prevalence of non-severe and severe PGF (43% and 14.6%) compared to INTERGROWTH-21st (24.5% and 10.3%). A more rapid establishment of full enteral feeds was strongly associated with reduced severe PGF prevalence in both growth charts (p < 0.001), as was shorter hospitalization. Late-onset sepsis was associated with an increased risk of severe PGF, while being small for gestational age (SGA) was protective against severe PGF across both growth charts (p < 0.001). A trend of decreasing PGF prevalence was noted over the study years, most probably attributed to the implementation of updated nutritional guidelines. Interestingly, when machine learning classification models were evaluated in our Greek cohort, a notable decline in predictive accuracy depending on the growth standard applied was observed. Conclusions: Our study highlights the need for standardizing PGF definition in an attempt to enhance nutritional management and further investigate the long-term impacts of nutritional interventions on growth, neurodevelopment, and overall health outcomes. Full article

Background/Objectives: Postnatal growth faltering (PGF) is a risk factor for adverse neurodevelopment in very preterm neonates. The aim of this retrospective study was to determine which infants’ baseline characteristics, prenatal risk factors and neonatal morbidities are associated with two definitions of PGF: defined as loss of >2 weight z-scores (severe PGF) or as loss of >1 weight, length, and head circumference z-scores between birth and discharge (complex PGF); Methods: 146 premature newborns (<32 weeks of gestational age, <1500 g) were included in the study. Anonymized data including anthropometric measurements (weight, length, and head circumference), perinatal and neonatal data (demographics, maternal morbidities and previous pregnancies, and neonatal and perinatal morbidities) were extracted from the clinical electronic database. Changes in anthropometric age- and sex-specific z-scores using the Fenton 2013 preterm growth charts were calculated to diagnose severe PGF and complex PGF; Results: The incidence of severe PGF was 11% and complex PGF was 24%. Both PGF definitions were associated with bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (ROP), longer respiratory support, and longer hospital stay. Severe PGF was associated with surgical necrotizing enterocolitis at 25% vs. 1.5%, p = 0.001. Complex PGF was associated with severe brain injury at 51% versus 27%, p = 0.007. Complex PGF was more common in newborns born most prematurely, while severe PGF was more common in newborns born small for gestational age (SGA); Conclusions: Both severe and complex PGF are associated with several important neonatal morbidities, which might explain why growth faltering is associated with suboptimal neurodevelopment. Appropriate early identification of faltered growth may influence medical and nutrition interventions which in turn could improve the outcome of very preterm newborns. Full article

Background/Objectives: Extrauterine growth restriction (EUGR) is associated with high mortality and an increased incidence of poor neurodevelopmental outcomes in preterm infants. In this study, we aimed to compare the Intergrowth-21^ST (IG-21^ST) and Fenton charts in predicting long-term neurodevelopmental and anthropometric outcomes of very low birth weight (VLBW) infants. Methods: Data were collected from 2649 VLBW infants registered in the Korean Neonatal Network born between 24^0/7 and 31^6/7 weeks of gestational age from January 2013 to December 2017. Follow-up assessments were conducted at 18–24 months of age, corrected for prematurity. Multiple logistic regression analysis was performed to evaluate the association between EUGR and long-term outcomes. Results: Among the 2649 VLBW infants, 60.0% (1606/2649) and 36.9% (977/2649) were diagnosed as having EUGR defined by the Fenton chart (EUGR_F) and by the IG-21^ST chart (EUGR_IG), respectively. The EUGR_IG group exhibited a higher proportion of infants with cerebral palsy, neurodevelopmental impairment (NDI), and growth failure. In multiple logistic regression analysis, adjusted for risk factors for long-term outcome, the EUGR_IG group showed higher risk of cerebral palsy (adjusted odds ratio [aOR], 1.66; 95% confidence interval [CI], 1.04–2.65), NDI (aOR, 2.09; 95% CI, 1.71–2.55), and growth failure (aOR, 1.57; 95% CI, 1.16–2.13). Infants with EUGR_F tended to develop NDI (aOR, 1.29; 95%CI, 1.03–1.63) and experience growth failure (aOR, 2.44; 95% CI, 1.77–3.40). Conclusions: The IG-21^ST chart demonstrated a more effective prediction of long-term neurodevelopmental outcomes, whereas the Fenton chart may be more suitable for predicting growth failure at 18–24 months. Full article

The use of new technologies for the removal of pollutants from wastewater has become globally necessary due to the complexity and facilities defined by conventional treatments. Advanced oxidative processes, specifically the Fenton process, have become widely applied given their low cost and ease of use. Therefore, this study aimed to evaluate the progression of the scientific publications on the implementation of Fenton process, investigating their space–time evolution. Additionally, useful solutions, trends, and gaps in the applications for the removal of pollutants with this methodology were identified, and also different remediation strategies and the design of new treatments for wastewaters were identified within this scientometric analysis. Bibliometric research was conducted in two scientific databases, Web of Science and Scopus, from 2011 to 2022, and we identified 932 and 1263 studies with the word “Fenton,” respectively. When these publications are associated with the treatment of alternative effluents, an increase in publications from 2011 (r = 0.95, p < 0.001) and 2013 (r = 0.93, p < 0.001) was observed when analyzing both databases, indicating the relevance of the theme. Among these studies, several of them were conducted on the bench scale (89.8% and 98.3%, Web of Science and Scopus, respectively) and in aqueous matrix (97.8% and 98.4%, Web of Science and Scopus, respectively), with being China the main country with publications associated with these words (28.33% and 41.9%), while Brazil is related to 3.65% and 2.29% of the total studies in Web of Science and Scopus, respectively. In addition, this review provides a guideline for new applications for different species in the matrices and describes the evolution of technological solutions to meet Sustainable Development Goal 6: clean water and sanitation. Full article

A practical approach for nutritional assessment in preterm infants under intensive care, based on anthropometric measurements and commonly used biochemical markers, is suggested. The choice of anthropometric charts depends on the purpose: Fenton 2013 charts to assess intrauterine growth, an online growth calculator to monitor intra-hospital weight gain, and Intergrowth-21st standards to monitor growth after discharge. Body weight, though largely used, does not inform on body compartment sizes. Mid-upper arm circumference estimates body adiposity and is easy to measure. Body length reflects skeletal growth and fat-free mass, provided it is accurately measured. Head circumference indicates brain growth. Skinfolds estimate reasonably body fat. Weight-to-length ratio, body mass index, and ponderal index can assess body proportionality at birth. These and other derived indices, such as the mid-upper arm circumference to head circumference ratio, could be proxies of body composition but need validation. Low blood urea nitrogen may indicate insufficient protein intake. Prealbumin and retinol binding protein are good markers of current protein status, but they may be affected by non-nutritional factors. The combination of a high serum alkaline phosphatase level and a low serum phosphate level is the best biochemical marker for the early detection of metabolic bone disease. Full article