Changes in Total Number of Births and Birth Size during the 1995-2013: The Reflection of Socio-Economic Fluctuations in Lithuania?

The aim of the study was to examine changes of total number of births and birth weight of Lithuanian newborns during the 1995–2013 in relation to the national and regional socio-economic welfare and governmental maternity support. The present results were based on Lithuanian Medical Data of Births Register. Only data of single newborns of identifiable sex, whose mothers were citizens of Lithuania, were included into the present analysis, and total number of analysed cases was N=597091. The total number of births dramatically decreased during the 1995-2002, slightly increased in the 2007-2009, and decreased again in the 2010-2013. Diminishing index was in line with increase of unemployment rate and decline of total Lithuanian population. Increase in number of births was estimated only in the 2007-2009, when maternity benefits were increased very evidently. The significant differences of mean birth weight by year were observed: the decrease in boys’ weight was detected in the 2001-2003, and the decrease in girls’ weight was detected in the 1995-1996 and in the 2001-2003 (p<0.05). However, the increase in weight of both sexes was observed in the 2008-2010 (right after raised maternal allowance). The prevalence of low and suboptimal birth weight was the highest in the 2002 and the lowest – in the 2008-2010 years. The obvious regional differences in changes of total number of births and birth weight were estimated

Changes in Body Size of Newborns in Lithuania, 1974–2004

The purpose of this study was to analyse body size of Lithuanian newborns born in 1998 and 2004, and to compare results with the data from 1974. The main body size measurements – body weight, body length and body mass index (BMI) of 3,281 (1,705 boys and 1,576 girls) live term singleton Lithuanian newborns’ were analysed according to gestational age, sex and health status. The data were collected in the Clinic of Obstetrics and Gynaecology of Vilnius University (VU COG), and the comparison with the data of Lithuanian Medical Birth Register of (LMBR) was performed. No significant differences between height, weight and body mass index in 1998 and the same characteristics in 2004 were observed. Means and principal percentiles (10th, 50th, 90th) of body measurements of 37–42 weeks of gestational age newborns were obtained. The mean body length was 52.8/52.19 cm (boys/girls), body weight – 3,589/3,454 g, BMI 12.82/12.64 correspondingly. The recent data were compared with the similar data from 1974 cohort. Statistically significant increment of body length of Lithuanian newborns was observed in all age and sex groups, whereas weight changes were less evident. The analysis of BMI demonstrated the following trend: newborns became longer, but not relatively heavier in comparison with the similar data 30 years ago. Hence, it is important to evaluate weight changes of neonate in relation with the changes in height. Further investigation of prevalence of neonatal macrosomia, possible factors of body size changes, their relationship to general health status and further health issues of the child should be explored

Changes in Total Number of Births and Birth Size during the 1995-2013: The Reflection of Socio-Economic Fluctuations in Lithuania?

The aim of the study was to examine changes of total number of births and birth weight of Lithuanian newborns during the 1995–2013 in relation to the national and regional socio-economic welfare and governmental maternity support. The present results were based on Lithuanian Medical Data of Births Register. Only data of single newborns of identifiable sex, whose mothers were citizens of Lithuania, were included into the present analysis, and total number of analysed cases was N=597091. The total number of births dramatically decreased during the 1995-2002, slightly increased in the 2007-2009, and decreased again in the 2010-2013. Diminishing index was in line with increase of unemployment rate and decline of total Lithuanian population. Increase in number of births was estimated only in the 2007-2009, when maternity benefits were increased very evidently. The significant differences of mean birth weight by year were observed: the decrease in boys’ weight was detected in the 2001-2003, and the decrease in girls’ weight was detected in the 1995-1996 and in the 2001-2003 (p<0.05). However, the increase in weight of both sexes was observed in the 2008-2010 (right after raised maternal allowance). The prevalence of low and suboptimal birth weight was the highest in the 2002 and the lowest – in the 2008-2010 years. The obvious regional differences in changes of total number of births and birth weight were estimated

Neonatal head circumference by gestation reflects adaptation to maternal body size: comparison of different standards

Neonatal head circumference (HC) not only represents the brain size of Homo sapiens, but is also an important health risk indicator. Addressing a lack of comparative studies on head size and its variability in term and preterm neonates from different populations, we aimed to examine neonatal HC by gestation according to a regional reference and a global standard. Retrospective analysis of data on neonatal HC obtained from the Lithuanian Medical Birth Register from 2001 to 2015 (423 999 newborns of 24-42 gestational weeks). The varying distribution by gestation and sex was estimated using GAMLSS, and the results were compared with the INTERGROWTH-21st standard. Mean HC increased with gestation in both sexes, while its fractional variability fell. The 3rd percentile matched that for INTERGROWTH-21st at all gestations, while the 50th and 97th percentiles were similar up to 27 weeks, but a full channel width higher than INTERGROWTH-21st at term. INTERGROWTH-21st facilitates the evaluation of neonatal HC in early gestations, while in later gestations, the specific features of neonatal HC of a particular population tend to be more precisely represented by regional references

Regional references vs. international standards for assessing weight and length by gestational age in Lithuanian neonates

INTRODUCTION: There is no global consensus as to which standards are the most appropriate for the assessment of birth weight and length. The study aimed to compare the applicability of regional and global standards to the Lithuanian newborn population by sex and gestational age, based on the prevalence of small or large for gestational age (SGA/LGA). MATERIALS AND METHODS: Analysis was performed on neonatal length and weight data obtained from the Lithuanian Medical Birth Register from 1995 to 2015 (618,235 newborns of 24-42 gestational weeks). Their distributions by gestation and sex were estimated using generalized additive models for location, scale, and shape (GAMLSS), and the results were compared with the INTERGROWTH-21st (IG-21) standard to evaluate the prevalence of SGA/LGA (10th/90th centile) at different gestational ages. RESULTS: The difference in median length at term between the local reference and IG-21 was 3 cm-4 cm, while median weight at term differed by 200 g. The Lithuanian median weight at term was higher than in IG-21 by a full centile channel width, while the median length at term was higher by two channel widths. Based on the regional reference, the prevalence rates of SGA/LGA were 9.7%/10.1% for boys and 10.1%/9.9% for girls, close to the nominal 10%. Conversely, based on IG-21, the prevalence of SGA in boys/girls was less than half (4.1%/4.4%), while the prevalence of LGA was double (20.7%/19.1%). DISCUSSION: Regional population-based neonatal references represent Lithuanian neonatal weight and length much more accurately than the global standard IG-21 which provides the prevalence rates for SGA/LGA that differ from the true values by a factor of two

Plasma and CSF pharmacokinetics of meropenem in neonates and young infants: results from the NeoMero studies.

Background: Sepsis and bacterial meningitis are major causes of mortality and morbidity in neonates and infants. Meropenem, a broad-spectrum antibiotic, is not licensed for use in neonates and infants below 3 months of age and sufficient information on its plasma and CSF disposition and dosing in neonates and infants is lacking. Objectives: To determine plasma and CSF pharmacokinetics of meropenem in neonates and young infants and the link between pharmacokinetics and clinical outcomes in babies with late-onset sepsis (LOS). Methods: Data were collected in two recently conducted studies, i.e. NeoMero-1 (neonatal LOS) and NeoMero-2 (neonatal meningitis). Optimally timed plasma samples (n = 401) from 167 patients and opportunistic CSF samples (n = 78) from 56 patients were analysed. Results: A one-compartment model with allometric scaling and fixed maturation gave adequate fit to both plasma and CSF data; the CL and volume (standardized to 70 kg) were 16.7 (95% CI 14.7, 18.9) L/h and 38.6 (95% CI 34.9, 43.4) L, respectively. CSF penetration was low (8%), but rose with increasing CSF protein, with 40% penetration predicted at a protein concentration of 6 g/L. Increased infusion time improved plasma target attainment, but lowered CSF concentrations. For 24 patients with culture-proven Gram-negative LOS, pharmacodynamic target attainment was similar regardless of the test-of-cure visit outcome. Conclusions: Simulations showed that longer infusions increase plasma PTA but decrease CSF PTA. CSF penetration is worsened with long infusions so increasing dose frequency to achieve therapeutic targets should be considered