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      Pediatric Outcome after Maternal Cancer Diagnosed during Pregnancy.

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          Abstract

          Data on the long-term outcome of children who are exposed to maternal cancer with or without treatment during pregnancy are lacking.

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          Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography.

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            Placental hormones and the control of maternal metabolism and fetal growth.

            To examine the roles of the placental and pituitary hormones in the control of maternal metabolism and fetal growth. In addition to promoting growth of maternal tissues, placental growth hormone (GH-V) induces maternal insulin resistance and thereby facilitates the mobilization of maternal nutrients for fetal growth. Human placental lactogen (hPL) and prolactin increase maternal food intake by induction of central leptin resistance and promote maternal beta-cell expansion and insulin production to defend against the development of gestational diabetes mellitus. The effects of the lactogens are mediated by diverse signaling pathways and are potentiated by glucose. Pathologic conditions of pregnancy are associated with dysregulation of GH-V and hPL gene expression. The somatogenic and lactogenic hormones of the placenta and maternal pituitary gland integrate the metabolic adaptations of pregnancy with the demands of fetal and neonatal development. Dysregulation of placental growth hormone and/or placental lactogen in pathologic conditions of pregnancy may adversely impact fetal growth and postnatal metabolic function.
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              References for growth and pubertal development from birth to 21 years in Flanders, Belgium.

              Due to the secular trend in length and height, growth references need to be updated regularly. Reference charts that were until recently used in Belgium are based on samples collected more than 30 years ago, and references for body mass index (BMI) and pubertal development have not been established before. To establish contemporary cross-sectional reference charts for height, weight, BMI, head circumference, and pubertal development from birth to 21 years of age, based on a representative sample of children from Flanders, Belgium. 15 989 healthy subjects of Belgian origin, 0-25 years of age, were measured in 2002-2004. Growth curves were fitted with the LMS method, and percentiles for the pubertal development were estimated with generalized additive models on status quo data from 8690 subjects aged 6-22 years of age. A positive secular trend in height and weight is observed in children above 5 years of age. Adult median height has increased by 1.2 cm/decade in boys and 0.8 cm/decade in girls; median weight by 0.9 kg/decade in boys, and 1.0 kg/decade in girls, and the weight distribution became more skewed. The BMI curve is comparable to that of other populations, except for higher percentiles. This reflects the increasing prevalence of overweight and obesity. Median age at menarche (13.0 years) has not advanced any more over the past 50 years. Median ages at menarche and B2 in girls and G2 or T4 in boys are comparable to other West European estimates, but approximately 10% enter G2/T4 before 9 years of age. The ongoing secular trend in height and weight makes growth charts previously used in Belgium obsolete. New representative charts for growth and pubertal development are introduced. For weight monitoring, it is advised that the now-available BMI growth charts are used.
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                Author and article information

                Journal
                N. Engl. J. Med.
                The New England journal of medicine
                New England Journal of Medicine (NEJM/MMS)
                1533-4406
                0028-4793
                Nov 05 2015
                : 373
                : 19
                Affiliations
                [1 ] From the Department of Gynecologic Oncology, University Hospitals Leuven and Department of Oncology, Katholieke Universiteit Leuven (F.A., T.V., M.V., S.H.), Departments of Cardiology (J.-U. V.), Pediatrics (G.N., L.V., L.L.), and Obstetrics (K.V.C.), University Hospitals Leuven, and the Department of Growth and Regeneration (G.N., L.L., K.V.C.) and the Faculty of Psychology and Educational Sciences (L.C.), Katholieke Universiteit Leuven, Leuven, and the Department of Obstetrics, Cliniques Universitaires St. Luc, Brussels (M.M.G.) - all in Belgium; Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano (M.F.) and Fertility and Reproduction Unit, European Institute of Oncology (F.P.) - both in Milan; the Department of Obstetrics and Gynecology, Charles University, Prague, Czech Republic (M.J.H., L.R.); the Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (I.B.), Center for Gynecologic Oncology Amsterdam, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam (F.A., C.L.), and the Department of Medical Oncology, University Medical Center Utrecht Cancer Center, Utrecht (P.W.) - all in the Netherlands; the Departments of Physics, Nuclear Physics, and Medical Physics, University of Oxford, Oxford, United Kingdom (F.V.H.); and the Department of Cardiology, Hospital for Sick Children, University of Toronto, Toronto (L.M.).
                Article
                10.1056/NEJMoa1508913
                26415085
                4fad0858-389c-48ea-bbe3-cf78648f220c

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