Determinants
Genetics
There are two genetic loci that have been strongly linked to birth weight, ADCY5 and CCNL1, as well four that show some evidence (CDKAL1, HHEX-IDE, GCK, and TCF7L2). The heritability of birth weight ranges from 25 to 40%. There is a complex relationship between a babys genes and the maternal environment that the child is developing in. Foetal genes influence how the fetus grows in utero, and the maternal genes influence how the environment affects the growing fetus. Maternal health
The health of the mother during the pregnancy can affect birth weight. A pre-existing disease or acquired disease in pregnancy is sometimes associated with decreased birth weight. For example, celiac disease confers an odds ratio of low birth weight of approximately 1.8. Certain medications (e.g. for high blood pressure or epilepsy) can put a mother at a higher risk for delivering a low birth weight baby. Women younger than 15 or older than 35 are at a higher risk to have a low-birth weight baby. Multiple births, where a mother has more than one child at one time, can also be a determinant in birth weight as each baby is likely to be outside the AGA (appropriate for gestational age). Multiple births put children at a higher rate to have low birth weight (56.6%) compared to children born in a single birth ( 6.2%). Low birth weight can also vary by maternal age. In 2008 the rate of low birth weight was the highest in babies born to women younger than 15 years old (12.4%).
Diagnosis of Behçets disease is based on clinical findings including oral and genital ulcers, skin lesions such as erythema nodosum, acne, or folliculitis, ocular inflammatory findings and a pathergy reaction. Inflammatory markers such ESR, and CRP may be elevated. A complete ophthalmic examination may include a slit lamp examination, optical coherence tomography to detect nerve loss, visual field examinations, fundoscopic examination to assess optic disc atrophy and retinal disease, fundoscopic angiography, and visual evoked potentials, which may demonstrate increased latency. Optic nerve enhancement may be identified on Magnetic Resonance Imaging (MRI) in some patients with acute optic neuropathy. However, a normal study does not rule out optic neuropathy. Cerebrospinal fluid (CSF) analysis may demonstrate elevated protein level with or without pleocytosis. Imaging including angiography may be indicated to identify dural venous sinus thrombosis as a cause of intracranial hypertension and optic atrophy. Diagnostic guidelines
According to the International Study Group guidelines, for a patient to be diagnosed with Behçets disease, the patient must have oral (aphthous) ulcers (any shape, size, or number at least 3 times in any 12 months period) along with 2 out of the following 4 "hallmark" symptoms:
eye inflammation (iritis, uveitis, retinal vasculitis, cells in the vitreous)
genital ulcers (including anal ulcers and spots in the genital region and swollen testicles or epididymitis in men)
pathergy reaction (papule >2 mm dia. 24–48 hrs or more after needle-prick).