Long-term Healthcare of People with Disorders of Sex Development: Predictors of Pubertal Outcomes of Partial Androgen Insensitivity Syndrome - Authors' Reply.

10.1016/j.ebiom.2018.10.035EBioMedicine373

Anogenital distance and penile length in infants with hypospadias or cryptorchidism: comparison with normative data.

BACKGROUND: Anogenital distance (AGD) in animals is a sensitive biomarker of fetal endocrine disruption and the associated testicular dysgenesis syndrome (TDS). However, AGD in human infants with cryptorchidism and hypospadias, which are potential manifestations of TDS during childhood, is not clearly described. OBJECTIVE: Our aim was to compare AGD in boys with cryptorchidism or hypospadias against normative data. METHODS: Boys with isolated cryptorchidism (n = 71, age 13.4 ± 5.8 months) or hypospadias (n = 81, age 11.4 ± 6.2 months) were recruited from a tertiary center for measurement of AGD and penile length; they were compared with 487 healthy full-term boys from a birth cohort by deriving age-specific standard deviation scores (SDS). RESULTS: Boys with cryptorchidism were older (p = 0.048) compared with boys with hypospadias. Boys with hypospadias had shorter mean AGD and penile length SDS than healthy boys (both p < 0.0001). Mean AGD and penile length SDS values in boys with cryptorchidism were longer than mean values in boys with hypospadias (both p < 0.01) and shorter than mean values in healthy boys (both p < 0.0001). Mean penile length SDS decreased as the severity of hypospadias increased (ptrend = 0.078). CONCLUSIONS: In the study population, AGD and penile length were reduced in boys with hypospadias or cryptorchidism relative to normative data derived from a longitudinal birth cohort. The findings support the use of AGD as a quantitative biomarker to examine the prenatal effects of exposure to endocrine disruptors on the development of the male reproductive tract

Unconditional and conditional standards for fetal abdominal circumference and estimated fetal weight in an ethnic Chinese population: a birth cohort study

10.1186/s12884-015-0569-1BMC Pregnancy and Childbirth151411-11GUSTO (Growing up towards Healthy Outcomes

Maternal blood pressure during pregnancy and early childhood blood pressures in the offspring

10.1097/MD.0000000000001981Medicine94451-9GUSTO (Growing up towards Healthy Outcomes

Early detection of childhood obesity through extended routine growth monitoring of children below two years of age in Asia Pacific region

Introduction: Increased body fat deposition during early life predisposes to higher obesity and metabolicdisorder risks in later life. This is particularly relevant in the Asia Pacific region where historically prevalentunder-nutrition is now been paralleled or even overruled by over-nutrition over the last few decades. Thisoverview aims to evaluate the potential of early detection of obesity (risk) among experts through additionof specific growth monitoring assessments in children during the first two years of life.Methods: A discussionamong experts from Malaysia, Singapore, Sri Lanka and Australia on infant growth and a qualitativeevaluation of current practice highlighted the need to measure body composition to assess the quality ofgrowth. Current tools are mainly directed towards simple anthropometric measures such as body weight,length and head circumference which do not adequately reflect concurrent changes in body composition todetect early life adiposity development. Recent findings have shown benefits of measurement such as thesum of four skinfold thickness (S4SFT) during the first two years of life for risk assessment of lateroverweight/obesity. We recommend this assessment for routine practice as a proxy for fat deposition inyoung children. Further studies to understand implementation hurdles and cost-effectiveness of S4SFT andhealth outcomes in young children in the Asia Pacific region are necessary.Conclusion: Inclusion of fourskinfold thickness measurements as part of routine growth monitoring assessment, in addition to weight andheight, could be recommended to assess adiposity development in early life allowing identification of infantsat risk for obesity

Unconditional and conditional standards for fetal abdominal circumference and estimated fetal weight in an ethnic Chinese population: a birth cohort study

Background Diagnosis of intrauterine fetal growth restriction and prediction of small-for-gestation age are often based on fetal abdominal circumference or estimated fetal weight (EFW). The present study aims to create unconditional (cross-sectional) and conditional (longitudinal) standards of fetal abdominal circumference and EFW for use in an ethnic Chinese population. Methods In the Growing Up in Singapore Towards healthy Outcome (GUSTO) birth cohort study in Singapore, fetal biometric measurements were obtained at enrolment to antenatal care (11-12 weeks) and up to three more time points during pregnancy. Singleton pregnancies with a healthy profile defined by maternal, pregnancy and fetal characteristics and birth outcomes were selected for this analysis. The Hadlock algorithm was used to calculate EFW. Mixed effects model was used to establish unconditional and conditional standards in z-scores and percentiles for both genders pooled and for each gender separately. Results A total of 313 women were included, of whom 294 had 3 and 19 had 2 ultrasound scans other than the gestational age dating scan. Fetal abdominal circumference showed a roughly linear trajectory from 18 to 36 weeks of gestation, while EFW showed an accelerating trajectory. Gender differences were more pronounced in the 10 th percentile than the 50 th or 90 th percentiles. As compared to other published charts, this population showed growth trajectories that started low but caught up at later gestations. Conclusions Unconditional and conditional standards for monitoring fetal size and fetal growth in terms of abdominal circumference and EFW are available for this ethnic-Chinese population. Electronic spreadsheets are provided for their implementation.BioMed Central open acces

The Growing Up in Singapore Towards Healthy Outcomes Study

Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26–28 weeks’ gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women

Internet analytics of an innovative digital educational resource of type 1 diabetes HelloType1 in local languages for people living with diabetes families and healthcare professionals in Southeast Asia.

BackgroundThere is minimal data of health outcomes for Type 1 Diabetes (T1D) in Southeast Asia (SEA) where government funding of insulin and blood glucose monitoring either do not exist or is limited. The full impact of Covid-19 pandemic on the national economies of SEA remain unknown. In the midst of the pandemic, in 2021, HelloType1 was developed by Action4Diabetes (A4D), a non-government organisation charity in collaboration with Southeast Asia local healthcare professionals as an innovative digital educational resource platform of T1D in local languages. HelloType1 was launched in Cambodia, Vietnam, Thailand and Malaysia in 2021 to 2022 with Memorandums of Understandings (MOUs) signed between A4D and each country. Internet data analytics were undertaken between the 1st of January 2022 to 31st of December 2022.AimsThe aims of this study were to explore the usability and internet data analytics of the HelloType1 online educational platform within each country.MethodsThe data analytics were extracted Google analytics that tracks data from the website hellotype1.com and Facebook analytics associated with the website.ResultsThere was a 147% increase in the number of HelloType1 users between the first 6 months versus the latter 6 months in 2022 and a 15% increase in the number of pages visited were noted. The majority of traffic source were coming from organic searches with a significant increase of 80% growth in 2022.ConclusionsThe results of the analytics provide important insights on how an innovative diabetes digital educational resource in local languages may be optimally delivered in low-middle income countries with limited resources

Singaporean Mothers’ Perception of Their Three-year-old Child’s Weight Status: A Cross-Sectional Study

OBJECTIVE: Inaccurate parental perception of their child's weight status is commonly reported in Western countries. It is unclear whether similar misperception exists in Asian populations. This study aimed to evaluate the ability of Singaporean mothers to accurately describe their three-year-old child's weight status verbally and visually. METHODS: At three years post-delivery, weight and height of the children were measured. Body mass index (BMI) was calculated and converted into actual weight status using International Obesity Task Force criteria. The mothers were blinded to their child's measurements and asked to verbally and visually describe what they perceived was their child's actual weight status. Agreement between actual and described weight status was assessed using Cohen's Kappa statistic (κ). RESULTS: Of 1237 recruited participants, 66.4% (n = 821) with complete data on mothers' verbal and visual perceptions and children's anthropometric measurements were analysed. Nearly thirty percent of the mothers were unable to describe their child's weight status accurately. In verbal description, 17.9% under-estimated and 11.8% over-estimated their child's weight status. In visual description, 10.4% under-estimated and 19.6% over-estimated their child's weight status. Many mothers of underweight children over-estimated (verbal 51.6%; visual 88.8%), and many mothers of overweight and obese children under-estimated (verbal 82.6%; visual 73.9%), their child's weight status. In contrast, significantly fewer mothers of normal-weight children were inaccurate (verbal 16.8%; visual 8.8%). Birth order (p<0.001), maternal (p = 0.004) and child's weight status (p<0.001) were associated with consistently inaccurate verbal and visual descriptions. CONCLUSIONS: Singaporean mothers, especially those of underweight and overweight children, may not be able to perceive their young child's weight status accurately. To facilitate prevention of childhood obesity, educating parents and caregivers about their child's weight status is neededPublic Library of Science open acces