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  1. Premature infant

    MedlinePlus

    Preterm infant; Preemie; Premie ... The infant may have trouble breathing and keeping a constant body temperature. ... A premature infant may have signs of the following problems: Anemia Bleeding into the brain or damage to the brain's white ...

  2. Premature infant

    MedlinePlus

    ... infant. Common signs of prematurity include: Abnormal breathing patterns (shallow, irregular pauses in breathing called apnea) Body hair (lanugo) Enlarged clitoris (in female infants) Less body fat Lower muscle tone and ...

  3. Osteopenia - premature infants

    MedlinePlus

    Neonatal rickets; Brittle bones - premature infants; Weak bones - premature infants; Osteopenia of prematurity ... baby. This helps the baby grow. A premature infant may not receive the proper amount of calcium ...

  4. Osteopenia - premature infants

    MedlinePlus

    Neonatal rickets; Brittle bones - premature infants; Weak bones - premature infants; Osteopenia of prematurity ... the amount of calcium and phosphorus in the bone. This can cause bones to be weak and ...

  5. Outcomes for extremely premature infants.

    PubMed

    Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

    2015-06-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (<1000 g) remain at high risk for death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address

  6. Music Therapy with Premature Infants

    ERIC Educational Resources Information Center

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  7. Defining Protein Requirements of Preterm Infants by Using Metabolic Studies in Fetuses and Preterm Infants.

    PubMed

    van den Akker, Chris H P; van Goudoever, Johannes B

    2016-01-01

    Amino acids form one of the main building blocks for fetal and neonatal growth. Despite improvements in neonatal care, including postnatal nutrition, growth faltering and suboptimal outcome after premature birth are still frequently encountered. Nutrition can partly be held responsible. Over the years, there has been a trend in delivering amino acids earlier from birth on and in larger quantities. Unfortunately, little is known about the specific metabolism of proteins, especially during fetal life or during disease. This review gives an overview of different methods of studying metabolism during early life and what we have come to learn so far. Different examples are given on the complex interplay between the placenta and the fetus. From both ovine and human studies, we know that amino acids are not only used for protein synthesis in the fetus, they are also oxidized to a large extent. Postnatally, we have succeeded in improving the nitrogen balance in preterm infants, but the preconditions need also to be improved before concluding that today's policy is optimal. Only by gaining more knowledge on both fetal and neonatal physiology and disease will we be able to further optimize growth and functional outcome in premature infants. PMID:27336406

  8. A physiologic method for monitoring premature infants.

    PubMed

    Ludington-Hoe, S; Kasper, C E

    1995-01-01

    Instrumentation capable of handling 12 continuous hours of nine-channel real-time physiologic data sampled at 10Hz was needed to test within and between subject variability and preterm infant responses to skin-to-skin contact with the mother. A review of basic electrical components, electrical principles related to physiologic monitoring, and electrophysiology concepts generic to physiologic monitoring is presented. The development, specifications and applications of a new instrument to monitor premature infant cardiorespiratory adaptations are discussed. PMID:7493185

  9. Birthing and Parenting a Premature Infant in a Cultural Context

    PubMed Central

    Brooks, Jada L.; Holdtich-Davis, Diane; Docherty, Sharron L.; Theodorou, Christina S.

    2015-01-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian (AI) mothers’ perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 AI mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of AI culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that healthcare providers deliver culturally appropriate care that fully supports AI mothers and their premature infants. PMID:25721716

  10. Birthing and Parenting a Premature Infant in a Cultural Context.

    PubMed

    Brooks, Jada L; Holdtich-Davis, Diane; Docherty, Sharron L; Theodorou, Christina S

    2016-02-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian mothers' perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 American Indian mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of American Indian culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that health care providers deliver culturally appropriate care that fully supports American Indian mothers and their premature infants. PMID:25721716

  11. Impact of rotavirus vaccine on premature infants.

    PubMed

    Roué, Jean-Michel; Nowak, Emmanuel; Le Gal, Grégoire; Lemaitre, Thomas; Oger, Emmanuel; Poulhazan, Elise; Giroux, Jean-Dominique; Garenne, Armelle; Gagneur, Arnaud

    2014-10-01

    Infants born preterm are at a higher risk of complications and hospitalization in cases of rotavirus diarrhea than children born at term. We evaluated the impact of a rotavirus vaccination campaign (May 2007 to May 2010) on hospitalizations for rotavirus gastroenteritis in a population of children under 3 years old born prematurely (before 37 weeks of gestation) in the Brest University Hospital birth zone. Active surveillance from 2002 to 2006 and a prospective collection of hospitalizations for rotavirus diarrhea were initiated in the pediatric units of Brest University Hospital until May 2010. Numbers of hospitalizations for rotavirus diarrhea among the population of children born prematurely, before and after the start of the vaccination program, were compared using a Poisson regression model controlling for epidemic-to-epidemic variation. A total of 217 premature infants were vaccinated from 2007 to 2010. Vaccine coverage for a complete course of three doses was 41.9%. The vaccine safety in premature infants was similar to that in term infants. The vaccination program led to a division by a factor of 2.6 (95% confidence interval [CI], 1.3 to 5.2) in the number of hospitalizations for rotavirus diarrhea during the first two epidemic seasons following vaccine introduction and by a factor of 11 (95% CI, 3.5 to 34.8) during the third season. We observed significant effectiveness of the pentavalent rotavirus vaccine on the number of hospitalizations in a population of prematurely born infants younger than 3 years of age. A multicenter national study would provide better assessment of this impact. (This study [Impact of Systematic Infants Vaccination Against Rotavirus on Gastroenteritis Hospitalization: a Prospective Study in Brest District, France (IVANHOE)] has been registered at ClinicalTrials.gov under registration no. NCT00740935.). PMID:25080553

  12. [Skin antisepsis in premature infants].

    PubMed

    Agolini, G; Faldella, G; Janes, E; Raitano, A; Spinelli, M; Vitali, M

    2011-01-01

    In some premature newborns, 7 months old and with less than 1 kg of body wheight, total parenteral nutrition is used for weeks, so that good antiseptics can cooperate to the prevention of nosocomial infections, associating the best biocide effects to the best topical tolerability. Details are reported on the biocide cutaneous properties of some chloro-derivates, as sodium hypochlorite and NaDCC, of ethyl and propyl alcohols, of chlorhexidine, of iodophors and also of triclosan and octenidine (even if these latter biocids are not normally available in Italy as cutaneous antiseptics). PMID:22423476

  13. Extra tactile stimulation of the premature infant.

    PubMed

    Kramer, M; Chamorro, I; Green, D; Knudtson, F

    1975-01-01

    To ascertain whether touch, in the form of extra tactile stimulation, would result in more rapid physical and social development and a greater degree of social development of the premature infant, 48 minutes of extra tactile stimulation, defines as a gentle, nonrhythmic stroking of the greatest possible area of skin surface of the infant's body by the nurse's hand, was given to eight experimental group premature infants daily for a minimum of two weeks while they were confined to an isolette. Six infants formed a control group. Regain of birth weight was used to assess physical development. Scores on the applicable portions of the Gesell Development Schedule and Bayley Scales of Infant Development and plasma cortisol levels were used to measure rate and degree of social development. Data were analyzed in terms of the total group and for pairs of infants matched for gestational age, birth weight, and Apgar score. No significant difference was found between control and experimental groups in rate of physical development as measured by regain of birth weight. Analysis of the relationship between weight gain and gestational age, sex, and Apgar scores indicated that none was a substantial indicator of the rate at which infants gained weight while in the hospital. There was no significant difference in the degree of social development between experimental and control infants, but, as hypothesized, there was significant difference in rate of social development. Plasma cortisol levels as an indication of the infant's adrenocorticol development as evidenced by his ability to respond to stressful situations, and hence indirectly his social development, revealed no significant difference between the two groups. PMID:1041616

  14. Vestibular Stimulation and Development of the Small Premature Infant.

    ERIC Educational Resources Information Center

    Neal, Mary V.

    This study was designed to explore the effects of vestibular stimulation on the developmental behavior, respiratory functioning, weight and length gains, and morbidity and mortality rates of premature infants. A total of 20 infants participated in this study in 4 groups of 5 infants each. Group A infants were placed in a motorized hammock within…

  15. Neurodevelopmental outcomes of infants born prematurely.

    PubMed

    Aylward, Glen P

    2014-01-01

    Long-term follow-up of infants born prematurely is necessary to determine neurodevelopmental outcomes, particularly with the expansion of interest from major disabilities to high prevalence/low severity dysfunctions. Models of pathogenesis include changes due to developmental disruptions and to injury, the magnitude and type of change influenced by the infant's age, and central nervous system recovery and reorganization. Alterations in neurogenesis, migration, myelination, cell death, and synaptogenesis occur even in the absence of insult. Despite increased knowledge regarding these processes, the functional significance of brain abnormalities is unclear. Because of methodologic problems in follow-up studies, it is difficult to characterize outcome definitively. Nonetheless, an acceptable degree of agreement across studies is found with regard to specific neurodevelopmental outcomes: motor/neurologic function, visuomotor integrative skills, IQ, academic achievement, language, executive function, and attention-deficit hyperactivity disorder/behavioral issues. In general, children born prematurely have more problems in these areas than do their normal birth weight counterparts. Suggestions for improved analyses and clarification of outcomes include use of cluster analysis, structural equation modeling, growth curve analysis, developmental epidemiologic approaches, and better control of background variables using risk indexes and factor scores. Better assessment techniques measuring functions documented to be at higher risk of problems are discussed. PMID:25007063

  16. Interactive Behaviors of Ethnic Minority Mothers and their Premature Infants

    PubMed Central

    Brooks, Jada L.; Holditch-Davis, Diane; Landerman, Lawrence R.

    2013-01-01

    Objective To compare the interactive behaviors of American Indian mothers and their premature infants with those of African American mothers and their premature infants. Design Descriptive, comparative study. Setting Three neonatal intensive care units and two pediatric clinics in the southeast. Participants Seventy-seven mother-infant dyads: 17 American Indian mother-infant dyads and 60 African American mother-infant dyads. Methods Videotapes of mother-infant interactions and the Home Observation for Measurement of the Environment (HOME) were used to assess the interactions of the mothers and their premature infants at six months corrected age. Results American Indian mothers looked more, gestured more, and were more often the primary caregivers to their infants than the African American mothers. American Indian infants expressed more positive affect and gestured more to their mothers, whereas African American infants engaged in more non-negative vocalization toward their mothers. African American mothers scored higher on the HOME subscales of provision of appropriate play materials and parental involvement with the infant. American Indian mothers scored higher on the opportunities for variety in daily living subscale. Conclusion Although many of the interactive behaviors of American Indian and African American mother-infant dyads were similar, some differences did occur. Clinicians need to be aware of the cultural differences in mother-infant interactions. To optimize child developmental outcomes, nurses need to support mothers in their continuation or adoption of positive interactive behaviors. PMID:23682698

  17. New Perspectives on Premature Infants and Their Parents

    ERIC Educational Resources Information Center

    Browne, Joy V.

    2003-01-01

    More than 485,000 low-birth-weight, premature babies are born in the U.S. each year. The increase in preterm births since 1990 may be due to assisted pregnancies and births to older mothers. Although their survival rates are improving, many premature infants experience long-lasting developmental and behavioral problems. The author describes recent…

  18. Feeding premature infants banked human milk homogenized by ultrasonic treatment.

    PubMed

    Rayol, M R; Martinez, F E; Jorge, S M; Gonçalves, A L; Desai, I D

    1993-12-01

    Premature neonates fed ultrasonically homogenized human milk had better weight gain and triceps skin-fold thickness than did a control group given untreated human milk (p < 0.01) and also had lower fat loss during tube feeding (p < 0.01). Ultrasonic homogenization of human milk appears to minimize loss of fat and thus allows better growth of premature infants. PMID:8229535

  19. Palliative Care for Extremely Premature Infants and Their Families

    ERIC Educational Resources Information Center

    Boss, Renee D.

    2010-01-01

    Extremely premature infants face multiple acute and chronic life-threatening conditions. In addition, the treatments to ameliorate or cure these conditions often entail pain and discomfort. Integrating palliative care from the moment that extremely premature labor is diagnosed offers families and clinicians support through the process of defining…

  20. Digestion of Protein in Premature and Term Infants.

    PubMed

    Dallas, David C; Underwood, Mark A; Zivkovic, Angela M; German, J Bruce

    2012-04-23

    Premature birth rates and premature infant morbidity remain discouragingly high. Improving nourishment for these infants is the key for accelerating their development and decreasing disease risk. Dietary protein is essential for growth and development of infants. Studies on protein nourishment for premature infants have focused on protein requirements for catch-up growth, nitrogen balance, and digestive protease concentrations and activities. However, little is known about the processes and products of protein digestion in the premature infant. This review briefly summarizes the protein requirements of term and preterm infants, and the protein content of milk from women delivering preterm and at term. An in-depth review is presented of the current knowledge of term and preterm infant dietary protein digestion, including human milk protease and anti-protease concentrations; neonatal intestinal pH, and enzyme activities and concentrations; and protein fermentation by intestinal bacteria. The advantages and disadvantages of incomplete protein digestion as well as factors that increase resistance to proteolysis of particular proteins are discussed. In order to better understand protein digestion in preterm and term infants, future studies should examine protein and peptide fragment products of digestion in saliva, gastric, intestinal and fecal samples, as well as the effects of the gut micro biome on protein degradation. The confluence of new mass spectrometry technology and new bioinformatics programs will now allow thorough identification of the array of peptides produced in the infant as they are digested. PMID:24744976

  1. The Epidemiology and Diagnosis of Invasive Candidiasis Among Premature Infants

    PubMed Central

    Kelly, Matthew S.; Benjamin, Daniel K.; Smith, P. Brian

    2015-01-01

    Invasive candidiasis is a leading infectious cause of morbidity and mortality in premature infants. Improved recognition of modifiable risk factors and antifungal prophylaxis have contributed to the recent decline in the incidence of this infection among infants. Invasive candidiasis typically occurs in the first six weeks of life and presents with non-specific signs of sepsis. Definitive diagnosis relies on growth of Candida in blood culture or cultures from other normally sterile sites, but this may identify fewer than half of cases. Improved diagnostics are needed to guide initiation of antifungal therapy in premature infants. PMID:25677999

  2. Clinical assessment of bilirubin-induced neurotoxicity in premature infants.

    PubMed

    Amin, Sanjiv B

    2004-10-01

    The clinical assessment of bilirubin-induced neurotoxicity in premature infants remains difficult in the absence of a gestational age-specific total or free (unbound) bilirubin level that predicts bilirubin-induced neurotoxicity. Because the total serum bilirubin concentration is an unreliable predictor of bilirubin-induced neurotoxicity in premature infants, alternative mean for predicting bilirubin-induced neurotoxicity in jaundiced preterm newborns is needed. Over the last few years, we have witnessed substantial gain in our knowledge involving usefulness of bilirubin-binding variables (total bilirubin, free bilirubin, bilirubin:albumin molar ratio) for clinical assessment of bilirubin-induced neurotoxicity in preterm infants. The knowledge gained has provided impetus for more clinical studies that are geared toward confirming the usefulness of free bilirubin as a predictor of bilirubin-induced neurotoxicity and identifying the gestational age-specific free bilirubin level that may increase the risk of bilirubin-induced neurotoxicity in premature infants. The paper has attempted to provide an overview of bilirubin-induced auditory toxicity along with the existing clinical evidence in favor of free bilirubin assay and usefulness of auditory brainstem evoked response for evaluation of bilirubin-induced neurotoxicity in premature infants. In addition, the author has described findings that suggest an association of apnea, a clinical manifestation, with acute bilirubin encephalopathy in premature infants. PMID:15686265

  3. [Vitamin A level and diseases of premature infants].

    PubMed

    Tao, En-Fu; Yuan, Tian-Ming

    2016-02-01

    Vitamin A is a fat-soluble vitamin, and it is not only necessary for the normal growth and development of epithelial cells, but also plays a very important role in the normal growth and development of the retina, lungs, gastrointestinal tract, brain, and immune system. Studies have confirmed that the low level of vitamin A in premature infants at birth can last through the entire infancy. Recently, there have been particular concerns about the level of vitamin A and development of diseases in premature infants, with major focuses on the related mechanisms of action of vitamin A in respiratory distress syndrome, chronic lung disease, retinopathy of prematurity, necrotizing enterocolitis, patent ductus arteriosus, and infections in premature infants, which still awaits further investigation.This paper summarizes and analyzes the current status of research on vitamin A level and diseases of premature infants at home and abroad. In addition, although enough evidence suggests that vitamin A supplementation is beneficial to preterm infants, evidence is still lacking for recommended methods for supplementation and dose of vitamin A, and further studies are needed. PMID:26903067

  4. Interactions of mothers and nurses with premature infants.

    PubMed Central

    Minde, K.; Ford, L.; Celhoffer, L.; Boukydis, C.

    1975-01-01

    The initial attachment of three mothers to three premature infants weighing less than 1500 g was assessed by observation of the mother's behaviour during visits to her child in the hospital nursery. Interactions of mothers and infants were compared with those of nurses and infants. Premature infants, during a stay in hospital of approximately 7 weeks, have to adapt to up to 70 different nurses and receive generally little contact stimulation from them. Mothers change in their interactional behaviour over time but show persistent individual differences in amount of touching, smiling and talking to their infants. Follow-up investigation will determine if the maternal behaviour as demonstrated in the nursery is predictive of later parenting disorders. PMID:803124

  5. SIGIRR Genetic Variants in Premature Infants With Necrotizing Enterocolitis

    PubMed Central

    Menden, Heather; Helbling, Daniel; Li, Keguo; Gastonguay, Adam; Ramchandran, Ramani; Dimmock, David P.

    2015-01-01

    Necrotizing enterocolitis (NEC) is a severe form of bowel disease that develops in premature infants. Although animal data and human studies suggest that aberrant activation of the intestinal immune system contributes to NEC, the pathogenesis remains unclear. We hypothesized that inherited defects in the regulation of Toll-like receptor signaling can contribute to NEC susceptibility in premature infants. A forward genetic screen done in an infant with lethal NEC using exome sequencing identified a novel stop mutation (p.Y168X) and a rare missense variant (p.S80Y) in SIGIRR, a gene that inhibits intestinal Toll-like receptor signaling. Functional studies carried out in human embryonic kidney cells and intestinal epithelial cells demonstrated that SIGIRR inhibited inflammation induced by lipopolysaccharide, a cell wall component of Gram-negative bacteria implicated in NEC. The genetic variants identified in the infant with NEC resulted in loss of SIGIRR function and exaggerated inflammation in response to lipopolysaccharide. Additionally, Sanger sequencing identified missense, stop, or splice region SIGIRR variants in 10 of 17 premature infants with stage II+ NEC. To the best of our knowledge, this is one of the first reports of a phenotype associated with SIGIRR in humans. Our data provide novel mechanistic insight into the probable causation of NEC and support additional investigation of the hypothesis that inherited defects in the regulation of innate immune signaling can contribute to NEC susceptibility in premature infants. PMID:25963006

  6. [Unemployment during pregnancy: direct or indirect risk factor of prematurity and fetus hypotrophy?].

    PubMed

    Hanke, W

    1999-01-01

    The question as to whether in a transitional phase in the political and socio-economic development in Poland, an increased threat of unemployment may also produce health effects manifested by an elevated risk for prematurity and fetus hypotrophy is one of important challenges. If the answer is positive then this issue should have much stronger impact on political and economic decisions. The data obtained from numerous studies carried out in countries of western Europe and the United States shows that the job performance during pregnancy under conditions free from occupational exposure and arduousness does not directly augment the risk of detrimental effect to the health of pregnant woman or her fetus. Just on the contrary, it was found that job performance during pregnancy, and strictly speaking steady employment during this period may somewhat become a 'protective factor'. In Poland, the highest rate of unemployment is observed among women in the 18-24 age group, that is at the age most suitable for procreation. Nowadays it is common that the decision on child-bearing is postponed until the economic status of the woman or her family comes to be more stable. On the other hand, in the population of women looking for a job but determined to set up a family prematurity is quite common that results only in part from an excessive effect of risk factors for this pathology very typical of this social group, like smoking, single parenthood, early or late child-bearing age. After adjusting these factors, the risk of prematurity decreased considerably but it was still high. It is thought that stress and the sense of threat and uncertainty is mostly responsible for this phenomenon. An increased risk of fetus hypotrophy among unemployed women after considering all confounding factors, was not observed. PMID:10746241

  7. Atrial flutter in the fetus and young infant: an association with accessory connections.

    PubMed Central

    Till, J; Wren, C

    1992-01-01

    OBJECTIVE--To highlight the association between atrial flutter and accessory connections in the fetus and young infant. DESIGN--A retrospective review from January 1985 to January 1990. PATIENTS--Fetuses, neonates, and young infants with atrial flutter. RESULTS--Four fetuses and five infants presented with atrial flutter. In two fetuses and one infant sinus rhythm returned spontaneously. The other six required cardioversion. Three of them developed orthodromic atrioventricular re-entry tachycardia and each had evidence of an accessory connection. CONCLUSIONS--Because atrial flutter in the fetus and neonate is rare, the high incidence of accessory connections in this group points to a possible aetiology of "idiopathic" atrial flutter in this age group. PMID:1739532

  8. [Enteral nutrition in premature newborn infants with sepsis].

    PubMed

    Pawlik, Dorota; Lauterbach, Ryszard

    2008-01-01

    The authors present beneficial effects and possible disadvantages of early enteral feeding of prematurely born infants. Also, the indications for maintaining enteral feeding in patients with sepsis are discussed. Breast milk is known to accelerate the process of maturation of alimentary tract as well as to improve the digestion of food compounds. Additionally, it protects the infant against bacterial translocations from gut to the blood stream and reduces the risk of sepsis in newborns, especially in very low birth weight infants. Finally, the authors formulate preliminary recommendations for enteral feeding of septic newborn infants. PMID:19471066

  9. Altered Amygdala Development and Fear Processing in Prematurely Born Infants

    PubMed Central

    Cismaru, Anca Liliana; Gui, Laura; Vasung, Lana; Lejeune, Fleur; Barisnikov, Koviljka; Truttmann, Anita; Borradori Tolsa, Cristina; Hüppi, Petra S.

    2016-01-01

    Context: Prematurely born children have a high risk of developmental and behavioral disabilities. Cerebral abnormalities at term age have been clearly linked with later behavior alterations, but existing studies did not focus on the amygdala. Moreover, studies of early amygdala development after premature birth in humans are scarce. Objective: To compare amygdala volumes in very preterm infants at term equivalent age (TEA) and term born infants, and to relate premature infants’ amygdala volumes with their performance on the Laboratory Temperament Assessment Battery (Lab-TAB) fear episode at 12 months. Participants: Eighty one infants born between 2008 and 2014 at the University Hospitals of Geneva and Lausanne, taking part in longitudinal and functional imaging studies, who had undergone a magnetic resonance imaging (MRI) scan at TEA enabling manual amygdala delineation. Outcomes: Amygdala volumes assessed by manual segmentation of MRI scans; volumes of cortical and subcortical gray matter, white matter and cerebrospinal fluid (CSF) automatically segmented in 66 infants; scores for the Lab-TAB fear episode for 42 premature infants at 12 months. Results: Amygdala volumes were smaller in preterm infants at TEA than term infants (mean difference 138.03 mm3, p < 0.001), and overall right amygdala volumes were larger than left amygdala volumes (mean difference 36.88 mm3, p < 0.001). White matter volumes were significantly smaller (p < 0.001) and CSF volumes significantly larger (p < 0.001) in preterm than in term born infants, while cortical and subcortical gray matter volumes were not significantly different between groups. Amygdala volumes showed significant correlation with the intensity of the escape response to a fearsome toy (rs = 0.38, p = 0.013), and were larger in infants showing an escape response compared to the infants showing no escape response (mean difference 120.97 mm3, p = 0.005). Amygdala volumes were not significantly correlated with the intensity

  10. Parents' Responses to Normal and Premature Infants.

    ERIC Educational Resources Information Center

    Frodi, Ann; Willie, Diana

    This paper discusses a series of three studies investigating the influence of infants' characteristics and signaling behavior on parents. Videotapes of either smiling/cooing/gurgling or crying infants were used to elicit parents' physiological and affective responses. Measured physiological responses included skin conductance, heart rate, and…

  11. Brain Maturity and Variation of Oxygen Extraction in Premature Infants.

    PubMed

    El-Dib, Mohamed; Aly, Safwat; Govindan, Rathinaswamy; Mohamed, Mohamed; du Plessis, Adre; Aly, Hany

    2016-07-01

    Objectives The ability of the premature brain to extract and use oxygen has not been studied adequately. This study aimed to determine factors that influence fractional tissue oxygen extraction (FTOE) of the brain in premature infants using near-infrared spectroscopy (NIRS) and pulse oximetry. Study Design We prospectively studied FTOE in very low birth weight (BW) infants (< 1,500 g and ≤ 34 weeks' gestation). Factors affecting FTOE and its variability were examined using bivariate and linear regression models. FTOE variability was measured on two scales: short scales (3-20 seconds) and long scales (20-150 seconds). Results We examined 147 simultaneous NIRS and pulse oximetry recordings that were collected from 72 premature infants (gestational age [GA] = 28 weeks and BW = 1,036 g). In regression models, average FTOE correlated negatively with hemoglobin (Hb) and increased significantly in patients with severe intraventricular hemorrhage/periventricular leukomalacia. Both FTOE short- and long-scale variabilities correlated negatively with GA and positively with postnatal age (PNA). Moreover, FTOE long-scale variability was significantly reduced in infants supported with invasive ventilation. Conclusions In premature infants, cerebral oxygen extraction increased with reduced Hb and severe brain injury. Variability in oxygen extraction showed differential changes with GA and PNAs and was affected by invasive ventilation. PMID:26906179

  12. Common questions about outpatient care of premature infants.

    PubMed

    Gauer, Robert L; Burket, Jeffrey; Horowitz, Eric

    2014-08-15

    Preterm births (deliveries before 37 weeks' gestation) comprise 12% of all U.S. births and are responsible for onethird of all infant deaths. Neonatal medical advances have increased survival, and primary care physicians often care for infants who were in the neonatal intensive care unit after birth. Functions of the primary care physician include coordination of medical and social services, nutritional surveillance, and managing conditions associated with prematurity. Parental guidance and encouragement are often necessary to ensure appropriate feeding and infant weight gain. Enriched formula and nutrient fortifiers are used for infants with extrauterine growth restriction. Iron supplementation is recommended for breastfed infants, and iron-fortified formula for formula-fed infants. Screening for iron deficiency anemia in preterm infants should occur at four months of age and at nine to 12 months of age. Gastroesophageal reflux is best treated with nonpharmacologic options because medications provide no long-term benefits. Neurodevelopmental delay occurs in up to 50% of preterm infants. Developmental screening should be performed at every well-child visit. If developmental delay is suspected, more formalized testing may be required with appropriate referral. To prevent complications from respiratory syncytial virus infection, palivizumab is recommended in the first year of life during the respiratory syncytial virus season for all infants born before 29 weeks' gestation and for infants born between 29 and 32 weeks' gestation who have chronic lung disease. Most preterm infants have minimal longterm sequelae. PMID:25250998

  13. [Arterial thrombosis in a premature infant].

    PubMed

    Schulz-Lell, G; Schröder, H; Schaub, J

    1990-12-01

    A preterm infant of 30 weeks gestation developed thrombosis of the left arteria femoralis on his fourth day of life. Continuous intravenous heparinization with 350 to 750 U/kg bw/d was performed during the course of several weeks. Although arterial thrombosis in term and preterm infants is not a rare event, there are no generally accepted guidelines for treatment. In this article alternatives of treatment--namely surgical management, thrombolytic therapy, heparinization and supportive therapy are discussed. PMID:2087243

  14. Nutritional care of premature infants: microminerals.

    PubMed

    Domellöf, Magnus

    2014-01-01

    Microminerals, including iron, zinc, copper, selenium, manganese, iodine, chromium and molybdenum, are essential for a remarkable array of critical functions and need to be supplied in adequate amounts to preterm infants. Very low birth weight (VLBW) infants carry a very high risk of developing iron deficiency which can adversely affect neurodevelopment. However, a too high iron supply in iron-replete VLBW infants may induce adverse effects such as increased infection risks and impaired growth. Iron needs are influenced by birth weight, growth rates, blood losses (phlebotomy) and blood transfusions. An enteral iron intake of 2 mg/kg/day for infants with a birth weight of 1,500-2,500 g and 2-3 mg/kg/day for VLBW infants is recommended. Higher doses up to 6 mg/kg/day are needed in infants receiving erythropoietin treatment. Regular monitoring of serum ferritin during the hospital stay is advisable. Routine provision of iron with parenteral nutrition for VLBW infants is not recommended. Less certainty exists for the advisable intakes of other microminerals. It appears prudent to provide enterally fed VLBW infants with daily amounts per kilogram body weight of 1.4-2.5 mg zinc, 100-230 μg copper, 5-10 μg selenium, 1-15 μg manganese, 10-55 μg iodine, 0.03-2.25 μg chromium, and 0.3-5 μg molybdenum. Future scientific findings may justify deviations from these suggested ranges. PMID:24751625

  15. Quantification of periodic breathing in premature infants

    PubMed Central

    Mohr, Mary A.; Fairchild, Karen D.; Patel, Manisha; Sinkin, Robert A.; Clark, Matthew T.; Moorman, J. Randall; Lake, Douglas E.; Kattwinkel, John; Delos, John B.

    2015-01-01

    Background Periodic breathing (PB), regular cycles of short apneic pauses and breaths, is common in newborn infants. To characterize normal and potentially pathologic PB, we used our automated apnea detection system and developed a novel method for quantifying PB. We identified a preterm infant who died of SIDS and who, on review of her breathing pattern while in the NICU, had exaggerated PB. Methods We analyzed the chest impedance signal for short apneic pauses and developed a wavelet transform method to identify repetitive 10–40 second cycles of apnea/breathing. Clinical validation was performed to distinguish PB from apnea clusters and determine the wavelet coefficient cutoff having optimum diagnostic utility. We applied this method to analyze the chest impedance signals throughout the entire NICU stays of all 70 infants born at 32 weeks’ gestation admitted over a two-and-a-half year period. This group includes an infant who died of SIDS and her twin. Results For infants of 32 weeks’ gestation, the fraction of time spent in PB peaks 7–14 days after birth at 6.5%. During that time the infant that died of SIDS spent 40% of each day in PB and her twin spent 15% of each day in PB. Conclusions This wavelet transform method allows quantification of normal and potentially pathologic PB in NICU patients. PMID:26012526

  16. The Effect of Peribulbar Block with General Anesthesia for Vitreoretinal Surgery in Premature and Ex-Premature Infants with Retinopathy of Prematurity.

    PubMed

    Sinha, Renu; Maitra, Souvik

    2016-01-15

    Safe anesthesia in premature and ex-premature infants remains a challenge for the anesthesiologist. These infants are at risk of postoperative apnea, desaturation, and bradycardia after general anesthesia. We describe our experience of peribulbar block in 24 infants who underwent vitreoretinal surgery for retinopathy of prematurity. None of our patients had postoperative apnea or required neonatal intensive care admission. A possible opioid and muscle relaxant-sparing effect of peribulbar block might have reduced the incidence of postoperative complications. PMID:26556110

  17. A Program of Stimulation for Infants Born Prematurely.

    ERIC Educational Resources Information Center

    Barnard, Kathryn

    Examined was the effect of low frequency auditory and kinesthetic stimulation on the sleep behavior of seven premature normal infants. Stimulation consisted of positioning in a rockerbed and exposure to a recorded heartbeat for 15 minutes an hour. Measured were Ss's sleep wakefulness, weight change, and gestational development. Analysis of the…

  18. Current Concepts in Nutrition--Pregnant Women and Premature Infants.

    ERIC Educational Resources Information Center

    King, Janet C.; Charlet, Sara

    1978-01-01

    Discusses energy and nutrient requirements of pregnant women with respect to kcal needs and vitamins B-6, folacin, vitamin E, and intake of certain trace elements. Also discusses nutritional needs of the premature infant and the ways of supplying these nutrients. (MA)

  19. Metabolic studies of transient tyrosinemia in premature infants

    NASA Technical Reports Server (NTRS)

    Fernbach, S. A.; Summons, R. E.; Pereira, W. E.; Duffield, A. M.

    1975-01-01

    The recently developed technique of gas chromatography-mass spectrometry supported by computer has considerably improved the analysis of physiologic fluids. This study attempted to demonstrate the value of this system in the investigation of metabolite patterns in urine in two metabolic problems of prematurity, transient tyrosinemia and late metabolic acidosis. Serial 24-hr urine specimens were analyzed in 9 infants. Transient tyrosinemia, characterized by 5- 10-fold increases over basal excretion of tyrosine, p-hydroxyphenyllactate, and p-hydroxyphenylpyruvate in urine, was noted in five of the infants. Late metabolic acidosis was seen in four infants, but bore no relation to transient tyrosinemia.

  20. Central corneal thickness and intraocular pressure in premature infants.

    PubMed

    Sekeroglu, Mehmet Ali; Hekimoglu, Emre; Petricli, İkbal Seza; Karakaya, Jale; Ozcan, Beyza; Yucel, Husniye; Kavurt, Aysen Sumru; Bas, Ahmet Yagmur

    2015-12-01

    To evaluate the central corneal thickness (CCT) and intraocular pressure (IOP) of premature infants and to document correlation of them with gestational age, chronological age, and birth weight of infants. Using a hand-held applanation tonometer and a portable pachymeter, IOP and CCT of 170 premature infants were measured just before initial retinopathy of prematurity screening examination and re-measured 4 weeks after the first visit. The CCT and IOP were positively correlated during the first (r = 0.616, p < 0.001) and second (r = 0.564, p < 0.001) visits. The mean CCT at first and second visits were 568.1 ± 22.1 (527-628) and 561.6 ± 21.4 (520-619) µm, consecutively (p < 0.001). Gestational age, chronological age and birth weight of infants were found to be negatively correlated with CCT at first (r = -0.751, p < 0.001; r = -0.745, p < 0.001; r = -0.581, p < 0.001, consecutively) and second (r = -0.729, p < 0.001; r = -0.729, p < 0.001; r = -0.555, p < 0.001, consecutively) visits. The mean IOP at first and second visits were 14.1 ± 1.9 (11-19) and 13.7 ± 1.7 (11-18) mmHg, consecutively (p < 0.001). Gestational age, chronological age, and birth weight of infants were found to be negatively correlated with IOP at first (r = -0.724, p < 0.001; r = -0.715, p < 0.001; r = -0.558, p < 0.001, consecutively) and second (r = -0.704, p < 0.001; r = -0.703, p < 0.001; r = -0.518, p < 0.001, consecutively) visits. CCT and IOP of the premature infants with a smaller gestational age were found to be higher (p < 0.001 for both). Premature infants with smaller gestational age have higher CCT and IOP values when compared to older infants. These values tend to become lower 4 weeks after the first examination as infants become older. The CCT and IOP were positively correlated with each other and both were negatively correlated with gestational age, chronological age, and birth weight during first and second visits. PMID:26286757

  1. Impact of Premature Birth on the Development of the Infant in the Family.

    ERIC Educational Resources Information Center

    Macey, Terri J.; And Others

    1987-01-01

    Examined effects of birth of premature infant on the family system , focusing on how problems associated with premature birth place family at risk. Mothers of preterm infants felt overprotective, were unwilling to leave infants with babysitters, and perceived initial negative effect on the family. Preterm infants showed less exploratory play and…

  2. Antecedents of Emotional Involvement in Mothers of Premature and Fullterm Infants.

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Bakeman, Roger

    This study examined differences between premature and fullterm infants and their mothers in three areas: infant characteristics, early mother-infant interaction and mothers' emotional involvement when the child was 9 months old. Forty-nine low-income black mothers and their infants (26 prematures, 23 fullterms) participated in the study. In…

  3. Long latency auditory evoked potential in term and premature infants.

    PubMed

    Didoné, Dayane Domeneghini; Garcia, Michele Vargas; da Silveira, Aron Ferreira

    2014-01-01

    Introduction The research in long latency auditory evokes potentials (LLAEP) in newborns is recent because of the cortical structure maturation, but studies note that these potentials may be evidenced at this age and could be considered as indicators of cognitive development. Purpose To research the exogenous potentials in term and premature infants during their first month of life. Materials and Methods The sample consisted of 25 newborns, 15 term and 10 premature infants. The infants with gestational age under 37 weeks were considered premature. To evaluate the cortical potentials, the infants remained in natural sleep. The LLAEPs were researched binaurally, through insertion earphones, with frequent /ba/ and rare /ga/ speech stimuli in the intensity of 80 dB HL (decibel hearing level). The frequent stimuli presented a total of 80% of the presentations, and the rare, 20%. The data were statistically analyzed. Results The average gestational age of the term infants was 38.9 weeks (± 1.3) and for the premature group, 33.9 weeks (± 1.6). It was possible to observe only the potentials P1 and N1 in both groups, but there was no statistically significant difference for the latencies of the components P1 and N1 (p > 0.05) between the groups. Conclusion It was possible to observe the exogenous components P1 and N1 of the cortical potentials in both term and preterm newborns of no more than 1 month of age. However, there was no difference between the groups. PMID:25992057

  4. [Neurodevelopmental outcome of very premature infants].

    PubMed

    Bickle Graz, M; Newman, C J; Borradori-Tolsa, C

    2014-02-19

    Very preterm infants are at risk of neurodevelopmental impairments, which may affect motor development, intelligence and behavior. Neurodevelopmental follow-up is offered to these children who represent 1% of Swiss births, and may show abnormal motor tone, which sometimes resolves spontaneously or evolves in cerebral palsy. Standardized tests explore intellectual functioning and may allow the diagnosis of specific learning impediments. Finally, behavior is assessed with standardized questionnaires which can reveal hyperactivity with or without attention deficit, impaired social relations, psychiatric troubles or autism, all more frequent amongst preterm children. PMID:24640281

  5. Dysbiosis Anticipating Necrotizing Enterocolitis in Very Premature Infants

    PubMed Central

    Sim, Kathleen; Shaw, Alexander G.; Randell, Paul; Cox, Michael J.; McClure, Zoë E.; Li, Ming-Shi; Haddad, Munther; Langford, Paul R.; Cookson, William O. C. M.; Moffatt, Miriam F.; Kroll, J. Simon

    2015-01-01

    Background. Necrotizing enterocolitis (NEC) is a devastating inflammatory bowel disease of premature infants speculatively associated with infection. Suspected NEC can be indistinguishable from sepsis, and in established cases an infant may die within hours of diagnosis. Present treatment is supportive. A means of presymptomatic diagnosis is urgently needed. We aimed to identify microbial signatures in the gastrointestinal microbiota preceding NEC diagnosis in premature infants. Methods. Fecal samples and clinical data were collected from a 2-year cohort of 369 premature neonates. Next-generation sequencing of 16S ribosomal RNA gene regions was used to characterize the microbiota of prediagnosis fecal samples from 12 neonates with NEC, 8 with suspected NEC, and 44 controls. Logistic regression was used to determine clinical characteristics and operational taxonomic units (OTUs) discriminating cases from controls. Samples were cultured and isolates identified using matrix-assisted laser desorption/ionization–time of flight. Clostridial isolates were typed and toxin genes detected. Results. A clostridial OTU was overabundant in prediagnosis samples from infants with established NEC (P = .006). Culture confirmed the presence of Clostridium perfringens type A. Fluorescent amplified fragment-length polymorphism typing established that no isolates were identical. Prediagnosis samples from NEC infants not carrying profuse C. perfringens revealed an overabundance of a Klebsiella OTU (P = .049). Prolonged continuous positive airway pressure (CPAP) therapy with supplemental oxygen was also associated with increased NEC risk. Conclusions. Two fecal microbiota signatures (Clostridium and Klebsiella OTUs) and need for prolonged CPAP oxygen signal increased risk of NEC in presymptomatic infants. These biomarkers will assist development of a screening tool to allow very early diagnosis of NEC. Clinical Trials Registration. NCT01102738. PMID:25344536

  6. Why do premature newborn infants display elevated blood adenosine levels?

    PubMed

    Panfoli, Isabella; Cassanello, Michela; Bruschettini, Matteo; Colella, Marina; Cerone, Roberto; Ravera, Silvia; Calzia, Daniela; Candiano, Giovanni; Ramenghi, Luca

    2016-05-01

    Our preliminary data show high levels of adenosine in the blood of very low birth weight (VLBW) infants, positively correlating to their prematurity (i.e. body weight class). This prompted us to look for a mechanism promoting such impressive adenosine increase. We hypothesized a correlation with oxygen challenge. In fact, it is recognized that either oxygen lack or its excess contribute to the pathogenesis of the injuries of prematurity, such as retinopathy (ROP) and periventricular white matter lesions (PWMI). The optimal concentration of oxygen for resuscitation of VLBW infants is currently under revision. We propose that the elevated adenosine blood concentrations of VLBW infants recognizes two sources. The first could be its activity-dependent release from unmyelinated brain axons. Adenosine in this respect would be an end-product of the hypometabolic VLBW newborn unmyelinated axon intensely firing in response to the environmental stimuli consequent to premature birth. Adenosine would be eventually found in the blood due to blood-brain barrier immaturity. In fact, adenosine is the primary activity-dependent signal promoting differentiation of premyelinating oligodendrocyte progenitor cells (OPC) into myelinating cells in the Central Nervous System, while inhibiting their proliferation and inhibiting synaptic function. The second, would be the ecto-cellular ATP synthesized by the endothelial cell plasmalemma exposed to ambient oxygen concentrations due to premature breathing, especially in lung. ATP would be rapidly transformed into adenosine by the ectonucleotidase activities such as NTPDase I (CD39), and NT5E (CD73). An ectopic extra-mitochondrial aerobic ATP synthetic ability was reported in many cell plasma-membranes, among which endothelial cells. The potential implications of the cited hypotheses for the neonatology area would be great. The amount of oxygen administration for reviving of newborns would find a molecular basis for its assessment. VLBW

  7. Tick-borne relapsing fever in a premature infant.

    PubMed

    Brasseur, D

    1985-09-01

    Relapsing fever is caused by the Borrelia species of spirochetes. Louse-born epidemics of the disease may occur but the endemic disease is usually transmitted to humans by the bite of an infected tick (Ornithodorus). Transplacental infection was suggested more than 75 years ago (1) but has been rarely documented (2). We describe a case of neonatal relapsing fever where maternal infection was the probable cause of the premature delivery and infection in the infant. PMID:2415056

  8. Duration of continuous positive airway pressure in premature infants.

    PubMed

    Bamat, Nicolas; Jensen, Erik A; Kirpalani, Haresh

    2016-06-01

    Continuous positive airway pressure (CPAP) has been used for respiratory support in premature infants for more than 40 years and is now a cornerstone of modern neonatal care. Clinical research on CPAP has primarily focused on understanding which devices and pressure sources best implement this therapy. In contrast, less research has examined the optimal duration over which CPAP is administered. We review this aspect of CPAP therapy. PMID:26948885

  9. Three-dimensional optical tomography of the premature infant brain

    NASA Astrophysics Data System (ADS)

    Hebden, Jeremy C.; Gibson, Adam; Yusof, Rozarina Md; Everdell, Nick; Hillman, Elizabeth M. C.; Delpy, David T.; Arridge, Simon R.; Austin, Topun; Meek, Judith H.; Wyatt, John S.

    2002-12-01

    For the first time, three-dimensional images of the newborn infant brain have been generated using measurements of transmitted light. A 32-channel time-resolved imaging system was employed, and data were acquired using custom-made helmets which couple source fibres and detector bundles to the infant head. Images have been reconstructed using measurements of mean flight time relative to those acquired on a homogeneous reference phantom, and using a head-shaped 3D finite-element-based forward model with an external boundary constrained to match the measured positions of the sources and detectors. Results are presented for a premature infant with a cerebral haemorrhage predominantly located within the left ventricle. Images representing the distribution of absorption at 780 nm and 815 nm reveal an asymmetry consistent with the haemorrhage, and corresponding maps of blood volume and fractional oxygen saturation are generally within expected physiological values.

  10. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

    PubMed Central

    Janaillac, Marie; Labarinas, Sonia

    2016-01-01

    Background. In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2) value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2), compared to blood partial pressure of carbon dioxide (pCO2). Methods. Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2 and transcutaneous values and the accuracy between the trends of blood pCO2 and TcpCO2 in all consecutive premature infants born at <33 weeks' gestational age. Results. 248 infants were included (median gestational age: 29 + 5 weeks and median birth weight: 1250 g), providing 1365 pairs of TcpCO2 and blood pCO2 values. Pearson's R correlation between these values was 0.58. The mean bias was −0.93 kPa with a 95% confidence limit of agreement of −4.05 to +2.16 kPa. Correlation between the trends of TcpCO2 and blood pCO2 values was good in only 39.6%. Conclusions. In premature infants, TcpCO2 was poorly correlated to blood pCO2, with a wide limit of agreement. Furthermore, concordance between trends was equally low. We warn about clinical decision-making on TcpCO2 alone when used as continuous monitoring. PMID:27375901

  11. Comparative Effectiveness of Three Surfactant Preparations in Premature Infants

    PubMed Central

    Trembath, Andrea; Hornik, Christoph P.; Clark, Reese; Smith, P. Brian; Daniels, Julie; Laughon, Matthew

    2013-01-01

    Objective To compare effectiveness of three surfactant preparations (beractant, calfactant, and poractant alpha) in premature infants for preventing three outcomes: (1) air leak syndromes; (2) death; and (3) bronchopulmonary dysplasia (BPD) or death (composite outcomes). Study design We conducted a comparative effectiveness study of premature infants admitted to 322 neonatal intensive care units in the U.S. from 2005–2010 who were treated with beractant, calfactant, or poractant alfa. We compared the incidence of air leak syndromes, death, and bronchopulmonary dysplasia (BPD) or death, adjusting for gestational age, antenatal steroids, discharge year, and small-for-gestational-age status. Results 51,282 infants received surfactant; 40% received beractant, 30% calfactant, and 30% poractant alfa. Median birth weight was 1435 g (interquartile range 966–2065); median gestational age was 30 weeks (27–33). On adjusted analysis, we observed a similar risk of air leak syndromes (calfactant vs. beractant odds ratio [OR]=1.17 [95% confidence interval: 0.95, 1.43]; calfactant vs. poractant OR=1.23 [0.98, 1.56]; beractant vs. poractant OR=1.06 [0.87, 1.29]), death (calfactant vs. beractant OR=1.14 [0.93, 1.39]; calfactant vs. poractant OR=0.98 [0.78, 1.23]; beractant vs. poractant OR=0.86 [0.72, 1.04]), and BPD or death (calfactant vs. beractant OR=1.08 [0.93, 1.26]; calfactant vs. poractant OR=1.19 [1.00, 1.41]; beractant vs. poractant OR=1.10 [0.96, 1.27]). Conclusions Beractant, calfactant, and poractant alfa demonstrated similar effectiveness in prevention of air leak syndromes, death, and BPD or death in premature infants when adjusted for site. Previously described differences in mortality between surfactants likely do not represent true differences in effectiveness but may relate to site variation in outcomes. PMID:23769501

  12. [Model for simulation of heat loss by premature infants].

    PubMed

    Frankenberger, R T; Bussmann, O; Nahm, W; Konecny, E

    1998-05-01

    A prerequisite for the further improvement in the quality of warming therapy is an accurate knowledge of the interactions between the microclimate in warming therapy devices and the thermal balance of the infant. For generating this knowledge, thermal manikins can be helpful. Suitable models capable of also simulating evaporative heat loss in preterm infants have, however, not been available to date. A thermal manikin representing an infant weighing 530 g and capable of simulating convective, radiative and also evaporative heat loss has now been developed. It comprises an outer shell made of porous, anatomically shaped clay, and is divided into six compartments each of which can be heated individually. Water-filled Gore-Tex bags located immediately beneath the shell are provided to simulate evaporation. In a clinical study, temperature profiles of 8 very small preterm infants were measured thermographically. Measurements in the manikin showed that highly comparable temperature profiles with only minor differences could be obtained. Total heat and water losses by the manikin were in good agreement with clinical values. Using the model described here it is possible to simulate the heat exchange of premature infants under extreme and accurately reproducible environmental conditions. This manikin may thus serve as a tool for comparative studies, for the development of warming therapy equipment, or for training purposes. PMID:9616993

  13. Sustained Neuromuscular Blockade after Vecuronium Use in a Premature Infant

    PubMed Central

    Sahni, Mitali; Richardson, C. Joan; Jain, Sunil K.

    2015-01-01

    Background Prolonged use of neuromuscular blocking agents (NMBAs) is very common in critically ill children both in pediatric and neonatal intensive care units. There are no guidelines available for use of NMBAs in children or neonates in the US, and the data for their safety in this age group is limited. Case Description Our case describes prolonged neuromuscular blockade following concurrent use of a NMBA along with aminoglycosides and steroids in the setting of renal failure in a premature infant. Conclusion Prolonged use of NMBAs in preterm infants should be avoided if possible or should be restricted to the shortest possible duration and the smallest possible physiologically effective dose. Concurrent use of NMBAs with aminoglycoside and steroids should be avoided, especially in the setting of renal failure. PMID:26495168

  14. Patterned progression of bacterial populations in the premature infant gut.

    PubMed

    La Rosa, Patricio S; Warner, Barbara B; Zhou, Yanjiao; Weinstock, George M; Sodergren, Erica; Hall-Moore, Carla M; Stevens, Harold J; Bennett, William E; Shaikh, Nurmohammad; Linneman, Laura A; Hoffmann, Julie A; Hamvas, Aaron; Deych, Elena; Shands, Berkley A; Shannon, William D; Tarr, Phillip I

    2014-08-26

    In the weeks after birth, the gut acquires a nascent microbiome, and starts its transition to bacterial population equilibrium. This early-in-life microbial population quite likely influences later-in-life host biology. However, we know little about the governance of community development: does the gut serve as a passive incubator where the first organisms randomly encountered gain entry and predominate, or is there an orderly progression of members joining the community of bacteria? We used fine interval enumeration of microbes in stools from multiple subjects to answer this question. We demonstrate via 16S rRNA gene pyrosequencing of 922 specimens from 58 subjects that the gut microbiota of premature infants residing in a tightly controlled microbial environment progresses through a choreographed succession of bacterial classes from Bacilli to Gammaproteobacteria to Clostridia, interrupted by abrupt population changes. As infants approach 33-36 wk postconceptional age (corresponding to the third to the twelfth weeks of life depending on gestational age at birth), the gut is well colonized by anaerobes. Antibiotics, vaginal vs. Caesarian birth, diet, and age of the infants when sampled influence the pace, but not the sequence, of progression. Our results suggest that in infants in a microbiologically constrained ecosphere of a neonatal intensive care unit, gut bacterial communities have an overall nonrandom assembly that is punctuated by microbial population abruptions. The possibility that the pace of this assembly depends more on host biology (chiefly gestational age at birth) than identifiable exogenous factors warrants further consideration. PMID:25114261

  15. Design of wireless multi-parameter monitoring system for oral feeding of premature infants.

    PubMed

    Wang, Yu-Lin; Kuo, Hsing-Chien; Wang, Lin-Yu; Ko, Mei-Ju; Lin, Bor-Shyh

    2016-07-01

    Premature infants often cannot successfully and coordinately complete their oral feeding. Mature sucking, swallowing, and respiration activities are crucial indicators for the survival of newborn infants. Due to the vulnerability and unobvious muscle activities of premature infants, current clinical care givers mainly depend on the subjective behavioral observation of infants during oral feeding. There is still lack of an integrated oral feeding monitoring system to objectively and quantifiably monitor the related physiological parameters of premature infants. In this study, a wireless multi-parameter monitoring system for oral feeding of premature infants was proposed to monitor the sucking-swallowing-respiratory activities and the heart rate variability to provide quantitative indices of oral feeding. Here, a novel sucking pressure sensing module was also developed to monitor the premature infant's sucking pressure under oral feeding to avoid the immersion influence of milk. The experimental results showed that the proposed system detected the related physiological parameters of premature infants during oral feeding effectively and may provide an objective clinical evaluation tool for oral feeding ability and safety of premature infants in the future. PMID:26429347

  16. INFUSION RATE OF GLUCOSE IS THE MAJOR PREDICTOR OF HYEPRGLYCEMIA IN VERY PREMATURE INFANTS RECEIVING TOTAL PARENTERAL NUTRITION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Hyperglycemia is frequently occurring in very premature infants receiving total parenteral nutrition. In adult intensive care patients, hyperglycemia has been associated with increased mortality. Although no such data are available in premature infants, it is conceivable that nutritional...

  17. Premature lactation and retention of a mummified fetus with live birth of the co-twin in a primiparous Morgan mare

    PubMed Central

    Robinson, Katherine A.; Manning, Stephen T.

    2011-01-01

    This report describes a primiparous 8-year-old Morgan mare, which displayed premature lactation that began at approximately 240 d of gestation and lasted approximately 4 wk. The premature lactation resolved spontaneously, and the pregnancy was subsequently carried to full term with the delivery of a live foal and a mummified fetus. PMID:21731099

  18. Early discharge of premature infants. A critical analysis.

    PubMed

    Raddish, M; Merritt, T A

    1998-06-01

    Although significant advances in the medical management of acutely ill preterm infants have resulted in unprecedented rates of survival, issues surrounding the convalescent care, discharge preparation, and readiness of parents or other caregivers have been less well studied and represent the art of medicine. Recent consensus statements provide a degree of content validity; however, important areas of scientific inquiry remain. Much is left to understand about the pathophysiology, management, and outcomes of apnea, bradycardia, and oxygen desaturation episodes continuing at term. Why do the most immature infants have a delay in the maturation of respiratory control? Do breathing studies really provide information that predicts subsequent respiratory control abnormalities? If methylxanthines are used at discharge, what criteria should be adhered to regarding their discontinuation? How is nutrition best provided while transitioning to home? In infants whose mothers desire exclusive breast-feeding, should gavage feeds be used to supplement in order to avoid bottle-feedings? How long should breast milk be fortified, and when should supplemented artificial milks be used and for what period of time postdischarge should these more expensive special-discharge artificial milks be used? What other supplements, such as inositol, vitamins, or antioxidants, should be provided in order to achieve optimal growth and development? Technology-dependent infants pose even greater complexities. Some infants and families adapt to extensive use of technology in the home. In other situations, basic infant care is difficult to achieve. What are the essential components for successful early discharge, and how can the studies involving selected families be made universal? How can NICUs better prepare fathers and mothers for premature parenthood? To what extent are we overwhelming families with additional responsibilities and expectations that may compromise their competency in basic parenting

  19. Sex ratios in fetuses and liveborn infants with autosomal aneuploidy

    SciTech Connect

    Heuther, C.A.; Martin, R.L.M.; Stoppelman, S.M.

    1996-06-14

    Ten data sources were used substantially to increase the available data for estimating fetal and livebirth sex ratios for Patau (trisomy 13), Edwards (trisomy 18), and Down (trisomy 21) syndromes and controls. The fetal sex ratio estimate was 0.88 (N = 584) for trisomy 13, 0.90 (N = 1702) for trisomy 18, and 1.16 (N = 3154) for trisomy 21. All were significantly different from prenatal controls (1.07). The estimated ratios in prenatal controls were 1.28 (N = 1409) for CVSs and 1.06 (N = 49427) for amniocenteses, indicating a clear differential selection against males, mostly during the first half of fetal development. By contrast, there were no sex ratio differences for any of the trisomies when comparing gestational ages <16 and >16 weeks. The livebirth sex ratio estimate was 0.90 (N = 293) for trisomy 13, 0.63 (N = 497) for trisomy 18, and 1.15 (N = 6424) for trisomy 21, the latter two being statistically different than controls (1.05) (N = 3660707). These ratios for trisomies 13 and 18 were also statistically different than the ratio for trisomy 21. Only in trisomy 18 did the sex ratios in fetuses and livebirths differ, indicating a prenatal selection against males >16 weeks. No effects of maternal age or race were found on these estimates for any of the fetal or livebirth trisomies. Sex ratios for translocations and mosaics were also estimated for these aneuploids. Compared to previous estimates, these results are less extreme, most likely because of larger sample sizes and less sample bias. They support the hypothesis that these trisomy sex ratios are skewed at conception, or become so during embryonic development through differential intrauterine selection. The estimate for Down syndrome livebirths is also consistent with the hypothesis that its higher sex ratio is associated with paternal nondisjunction. 36 refs., 5 tabs.

  20. Sildenafil and Retinopathy of Prematurity Risk in Very Low Birth Weight Infants

    PubMed Central

    Samiee-Zafarghandy, Samira; van den Anker, John N.; Laughon, Matthew M.; Clark, Reese H.; Smith, P. Brian; Hornik, Christoph P.

    2015-01-01

    Objective To examine the effect of sildenafil therapy on development of severe retinopathy of prematurity (ROP) requiring surgical intervention in premature infants. Study Design We identified premature infants who were discharged from Pediatrix Medical Group neonatal intensive care units from 2003–2012 and who received an ophthalmologic exam. We matched each infant exposed to sildenafil prior to first eye exam to three non-exposed infants using propensity scoring to control for differences in baseline infant characteristics. We evaluated the association between sildenafil exposure and development of severe ROP using conditional logistic regression. Result Of the 57815 infants meeting inclusion criteria, 88 were exposed to sildenafil. We matched 81/88 (92%) sildenafil-exposed with 243 non-exposed infants. There was no difference in the proportion of infants who developed severe ROP in the sildenafil-exposed vs. non-exposed groups (17/81 [21%] vs. 38/243 [16%], P=0.27). On adjusted analysis, there was no difference in severe ROP in the sildenafil-exposed versus non-exposed infants (odds ratio=1.46, 95% confidence interval=0.76–2.82, P=0.26). Conclusion We did not observe an association between risk of severe ROP and sildenafil exposure prior to first eye exam in this cohort of premature infants. PMID:26491852

  1. Genomics In Premature Infants: A Non-Invasive Strategy To Obtain High-Quality DNA

    PubMed Central

    Said, Mariam; Cappiello, Clint; Devaney, Joseph M.; Podini, Daniele; Beres, Alana L.; Vukmanovic, Stanislav; Rais-Bahrami, Khodayar; Luban, Naomi C.; Sandler, Anthony D.; Tatari-Calderone, Zohreh

    2014-01-01

    We used a cost-effective, non-invasive method to obtain high-quality DNA from buccal epithelial-cells (BEC) of premature infants for genomic analysis. DNAs from BEC were obtained from premature infants with gestational age ≤ 36 weeks. Short terminal repeats (STRs) were performed simultaneously on DNA obtained from the buccal swabs and blood from the same patient. The STR profiles demonstrated that the samples originated from the same individual and exclude any contamination by external DNAs. Whole exome sequencing was performed on DNAs obtained from BEC on premature infants with and without necrotizing enterocolitis, and successfully provided a total number of reads and variants corroborating with those obtained from healthy blood donors. We provide a proof of concept that BEC is a reliable and preferable source of DNA for high-throughput sequencing in premature infants. PMID:24598548

  2. The Challenge of Understanding Cerebral White Matter Injury in the Premature Infant

    PubMed Central

    Elitt, Christopher M.; Rosenberg, Paul A.

    2014-01-01

    White matter injury in the premature infant leads to motor and more commonly behavioral and cognitive problems that are a tremendous burden to society. While there has been much progress in understanding unique vulnerabilities of developing oligodendrocytes over the past 30 years, there remain no proven therapies for the premature infant beyond supportive care. The lack of translational progress may be partially explained by the challenge of developing relevant animal models when the etiology remains unclear, as is the case in this disorder. There has been an emphasis on hypoxia-ischemia and infection/inflammation as upstream etiologies, but less consideration of other contributory factors. This review highlights the evolution of white matter pathology in the premature infant, discusses the prevailing proposed etiologies, critically analyzes a sampling of common animal models and provides detailed support for our hypothesis that nutritional and hormonal deprivation may be additional factors playing critical and overlooked roles in white matter pathology in the premature infant. PMID:24838063

  3. Effects of Early Sensory Stimulation on the Premature Infant as Measured by the Bayley Scales of Infant Development.

    ERIC Educational Resources Information Center

    Stone, Kathy Kees; And Others

    Looking beyond the overall effectiveness of sensory stimulation, this study aimed to identify specific aspects of infant behavior most responsive to early stimulation. Subjects were 65 premature infants with a birth weight of less than 5 pounds, 8 ounces and a gestational age under 37 weeks. Experimental group members had completed a multimodal…

  4. Music and 25% glucose pain relief for the premature infant: a randomized clinical trial 1

    PubMed Central

    Cardoso, Maria Vera Lúcia Moreira Leitão; Farias, Leiliane Martins; de Melo, Gleicia Martins

    2014-01-01

    OBJECTIVE: to analyze the total Premature Infant Pain Profile scores of premature infants undergoing arterial puncture during music and 25% glucose interventions, and to assess their association with neonatal and therapeutic variables. METHOD: a randomized clinical trial with 80 premature infants; 24 in the Experimental Group 1 (music), 33 in the Experimental Group 2 (music and 25% glucose), 23 in the Positive Control Group (25% glucose). All premature infants were videotaped and a lullaby was played for ten minutes before puncture in Experimental Groups 1 and 2; 25% glucose administered in Experimental Group 2 and the Positive Control Group two minutes before puncture. RESULTS: 60.0% of premature infants had moderate or maximum pain; pain scores and intervention groups were not statistically significant. Statistically significant variables: Experimental Group 1: head and chest circumference, Apgar scores, corrected gestational age; Experimental Group 2: chest circumference, Apgar scores, oxygen therapy; Positive Control group: birth weight, head circumference. CONCLUSION: neonatal variables are associated with pain in premature infants. Brazilian Registry of Clinical Trials: UTN: U1111-1123-4821. PMID:25493677

  5. Percutaneous removal of a nonopaque silastic catheter from the pulmonary artery in two premature infants

    SciTech Connect

    Hwang Betau; Hsieng, J.-H.; Lee, B.-C.; Lu, J.-H.; Soong, W.-J.; Chen, S.-J.; Meng, C. C. Laura

    1997-07-15

    A modified snare was made from a 0.016'' guidewire and a 0.1-mm fishing string to remove a nonopaque Silastic catheter via a femoral vein approach in 2 premature infants at the 44th and 120th day of life, respectively. A foldover guidewire loop snare had failed in 1 infant before this technique was successfully applied.

  6. The Effects of Prematurity and Illness on Parents' Perceptions of Their Infants.

    ERIC Educational Resources Information Center

    Danko, Maribeth; And Others

    Part of a larger study investigating the longitudinal effects of prematurity, illness, and hospitalization, this study focuses on parent perceptions of their infants at 2, 4, and 6 months of age, with age being corrected for conceptional age at birth. It was hypothesized that neonatal condition and age of infant at the time of measurement would…

  7. Environmental pollution and pregnancy: risks and uncertainties for the fetus and infant.

    PubMed

    Longo, L D

    1980-05-15

    Numerous environmental contaminants can affect the developing embryo, fetus, or infant. This essay explores such questions as these: What is the importance in mutagenesis and teratogenesis of macroenvironmental pollutants such as the heavy metals, dioxin derivatives, polychlorinated diphenyl compounds, and pesticides? What is the significance of microenvironmental pollutants (or social environmental factors) such as tobacco smoke, alcohol, and pharmacologic agents over which exposed individuals have considerable control? What are some of the ethical and legal implications of these toxins of which clinicians should be aware? PMID:6246801

  8. Mean organ weights of an Australian population of fetuses and infants.

    PubMed

    Cussen, L; Scurry, J; Mitropoulos, G; McTigue, C; Gross, J

    1990-04-01

    Charts of organ weights for an Australian population of fetuses and infants are presented. The organ-weight charts were compiled from 1337 stillbirths and liveborn babies whose gestational age ranged from 20 to 43 weeks, and who lived less than 72 h. Macerated stillbirths, multiple births and malformed organs were excluded. Pathological conditions aside from malformations were not excluded, leading to higher standard deviations compared with currently used charts. The organ weights are presented in two-week increments from 20 to 43 weeks' gestation as means, with standard deviations. PMID:2361065

  9. Bronchoconstriction following instillation of phenylephrine eye drops in premature infants with bronchopulmonary dysplasia: two cases report.

    PubMed

    Kim, Hyun Jee; Choi, Jin Guk; Kwak, Kyung-Hwa

    2015-12-01

    Premature infants requiring an ophthalmic examination or even surgery for retinopathy of prematurity (ROP) have a high prevalence of co-existing bronchopulmonary dysplasia (BPD). Reactive airway is one of the clinical presentations of BPD. We report two cases of bronchoconstriction following instillation of mydriatic eye drops. One occurred during induction of anesthesia for laser photocoagulation and the other before screening of ROP. The most likely cause in each case was phenylephrine eye drops. We recommend that the minimal dosage of phenylephrine needed to attain proper mydriasis should be instilled to infant patients, and the possibility of bronchoconstriction occurrence kept in mind, especially for infants with low body weight with BPD. PMID:26634087

  10. Osteopenia of Prematurity: Does Physical Activity Improve Bone Mineralization in Preterm Infants?

    PubMed

    Stalnaker, Kelsey A; Poskey, Gail A

    2016-01-01

    Bone mineralization of preterm infants is significantly less than full-term infants at birth, placing preterm infants at risk for osteopenia of prematurity and other metabolic bone diseases. Advances in nutritional supplementation and standard nursing care alone have been unsuccessful in improving bone mineralization postnatally. Research supports a daily physical activity protocol of passive range of motion and gentle joint compression when combined with adequate nutritional supplementation reduces osteopenia of prematurity. This article provides a systematic review of the current evidence surrounding early physical activity and neonatal massage for the treatment of osteopenia and indicates the need for universal handling protocols in caring for this unique population. PMID:27052984

  11. Intervention programs for premature infants. How and do they affect development?

    PubMed

    Feldman, R; Eidelman, A I

    1998-09-01

    Over the past 30 years, a variety of intervention programs for the enhancement of the neurodevelopmental status of premature infants have been implemented with confusing outcomes. In addition, diametrically different forms of therapy that rest on contrasting theories have led, paradoxically, to similar results. This article systematically examines and analyses the various modes of therapy and their underlying theoretical mechanisms. Skin-to-skin contact (kangaroo care) is suggested as the intervention that most logically meshes the premature infant's need to develop state regulation while facilitating sequential sensory development and promoting mother-infant attachment. PMID:9779337

  12. Adjusting to being a father to an infant born prematurely: experiences from Swedish fathers.

    PubMed

    Lindberg, Birgitta; Axelsson, Karin; Ohrling, Kerstin

    2008-03-01

    The aim of this study was to describe the experiences of being a father to a prematurely born infant. Eight fathers of prematurely born children were interviewed using a narrative approach, and a thematic content analysis was used to analyse the interviews. The fathers described that the preterm birth gave them the chance to get to know their infant as they had to spend time at the intensive care unit. They also felt better educated by professionals who helped them take care of their infant. Their feelings and attachment for their infant increased over time and the fathers felt that they had a stronger bond with their child compared with friends who had babies born at term. As time passed, they became more confident as a father. In spite of the strain, the experience made them change as a person and they expressed having different values. The relationship with their partner was strengthened as they handled this situation together as a couple. However, the fathers felt fortunate despite everything and described having managed a prematurely born infant rather well. Although there are similarities between being a father to a child born at term and to one born preterm, it is significant to gain further knowledge about the specific experiences of fathers of prematurely born infants. The results of this study have implications for nurses working with families who have children born prematurely. PMID:18269426

  13. Intraventricular hemorrhage and long-term outcome in the premature infant.

    PubMed

    Wildrick, D

    1997-10-01

    Intraventricular hemorrhage (IVH) is a common, serious problem among premature infants. With advances in neonatal care, improved survival rates of small premature infants and improved diagnostic capabilities, IVH is seen with increased frequency in the high-risk nursery. Studies indicate 15-20% of premature infants (birth weight less than 1,500 gms), have been noted to have IVH Many of these neonates survive beyond infancy and may subsequently be seen in pediatric neurosurgery and neurology clinics with long-term problems such as hydrocephalus, cerebral palsy, mental retardation and seizures. Although long-term sequelae are not always present, it is beneficial for the neuroscience nurse to be able to understand the mechanisms of brain injury with IVH in order to anticipate long-term problems and provide comprehensive follow-up care for infants and children with this diagnosis. PMID:9361998

  14. The effectiveness of video interaction guidance in parents of premature infants: A multicenter randomised controlled trial

    PubMed Central

    2012-01-01

    Background Studies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children. One of the explanations proposed for the relation between neonatal problems and adverse parenting is a possible delay or disturbance in the bonding process between the parent and infant. This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded. The disruption of an optimal parent-infant bond -on its turn- may predispose to distorted parent-infant interactions and thus facilitate abusive or neglectful behaviours. Video Interaction Guidance (VIG) is expected to promote the bond between parents and newborns and is expected to diminish non-optimal parenting behaviour. Methods/design This study is a multi-center randomised controlled trial to evaluate the effectiveness of Video Interaction Guidance in parents of premature infants. In this study 210 newborn infants with their parents will be included: n = 70 healthy term infants (>37 weeks GA), n = 70 moderate term infants (32–37 weeks GA) which are recruited from maternity wards of 6 general hospitals and n = 70 extremely preterm infants or very low birth weight infants (<32 weeks GA) recruited by the NICU of 2 specialized hospitals. The participating families will be divided into 3 groups: a reference group (i.e. full term infants and their parents, receiving care as usual), a control group (i.e. premature infants and their parents, receiving care as usual) and an intervention group (i.e. premature infants and their parents, receiving VIG). The data will be collected during the first six months after birth using observations of parent-infant interactions, questionnaires and semi-structured interviews. Primary outcomes are the quality of parental bonding and parent-infant interactive behaviour. Parental secondary outcomes are (posttraumatic) stress symptoms

  15. Gluconeogenesis continues in premature infants receiving total parenteral nutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To determine the contribution of total gluconeogenesis, to glucose production in preterm infants receiving total parenteral nutrition (TPN) providing glucose exceeding normal infant glucose turnover rate, eight infants (0.955 +/- 0.066 kg, 26.5 - 0.5 wks, 4-1 d) were studied while receiving routine ...

  16. Influence of Labeling on Ratings of Infants: A Prematurity Prejudice.

    ERIC Educational Resources Information Center

    Miller, Michael D.; Ottinger, Donald R.

    Two full term and two preterm infants were videotaped while being administered six items from the Brazelton Scale. Infants were assigned alternately the labels "preterm" and "fullterm" and shown to a group of 256 undergraduate students. It was hypothesized that: (1) subjects who view infants labeled as preterm would rate them lower on objective…

  17. Mothers' Strategies in Handling the Prematurely Born Infant: a Qualitative Study

    PubMed Central

    Arzani, Afsaneh; Valizadeh, Leila; Zamanzadeh, Vahid; Mohammadi, Easa

    2015-01-01

    Introduction: Family, especially mother, is faced with numerous challenges by experiencing a premature birth. Since knowing about mother's efforts regarding prematurely born infant helps us in our comprehensive understanding of the impact of this incident on the family system and its performance. The present study was carried out to explore the mothers' strategies regarding prematurely born infant. Methods: In a conventional qualitative content analysis, data was collected through purposive sampling by semi-structured deep interviews with 18 mothers who had prematurely born infant during 2012-2013 in the teaching hospitals of the north and northwest of Iran. All the interviews were recorded, typed, and finally analyzed. Results: Data analysis resulted in the extraction of categories of "asking for help, elevating capacity and reducing personal responsibilities and commitments". These categories were revealed in mothers respectively by the different sub-categories of "religious appeal and relying on beliefs, seeking information from the treatment and caring team, participating in infant's care, companionship and support of family and friends","focusing on positive thinking and imagination, patience and strength " and "ignoring some routine affairs and reducing role-related activities and duties".Conclusion: Considering the uniqueness of the mother's role in responding to the needs of infants, healthcare system should consider mothers as real target in the intervention strategies in order to promote health and quality of life, so maybe this way, the burden of care and management of critical situations caused by a premature birth on the mother can be reduced. PMID:25821755

  18. Epidemiological characteristics and deaths of premature infants in a referral hospital for high-risk pregnancies

    PubMed Central

    de Freitas, Brunnella Alcantara Chagas; Sant'Ana, Luciana Ferreira da Rocha; Longo, Giana Zarbato; Siqueira-Batista, Rodrigo; Priore, Silvia Eloiza; Franceschin, Sylvia do Carmo Castro

    2012-01-01

    Objective To analyze the process of care provided to premature infants in a neonatal intensive care unit and the factors associated with their mortality. Methods Cross-sectional retrospective study of premature infants in an intensive care unit between 2008 and 2010. The characteristics of the mothers and premature infants were described, and a bivariate analysis was performed on the following characteristics: the study period and the "death" outcome (hospital, neonatal and early) using Pearson's chi-square test, Fisher's exact test or a chi-square test for linear trends. Bivariate and multivariable logistic regression analyses were performed using a stepwise backward logistic regression method between the variables with p<0.20 and the "death" outcome. A p value <0.05 was considered to be significant. Results In total, 293 preterm infants were studied. Increased access to complementary tests (transfontanellar ultrasound and Doppler echocardiogram) and breastfeeding rates were indicators of improving care. Mortality was concentrated in the neonatal period, especially in the early neonatal period, and was associated with extreme prematurity, small size for gestational age and an Apgar score <7 at 5 minutes after birth. The late-onset sepsis was also associated with a greater chance of neonatal death, and antenatal corticosteroids were protective against neonatal and early deaths. Conclusions Although these results are comparable to previous findings regarding mortality among premature infants in Brazil, the study emphasizes the need to implement strategies that promote breastfeeding and reduce neonatal mortality and its early component. PMID:23917938

  19. Intravenous lipid and amino acids briskly increase plasma glucose concentrations in small premature infants.

    PubMed

    Savich, R D; Finley, S L; Ogata, E S

    1988-07-01

    We determined the glycemic response to intravenous lipid infusion alone, lipid with amino acids, or amino acids alone in 15 very small premature infants receiving constant glucose infusion during early life. Infants who received lipid or lipid and amino acids demonstrated significant increases in glucose compared with infants who received amino acids. The combination of lipid and amino acids resulted in an earlier increase than lipid alone. Although plasma insulin did not change in all three groups, infants who received amino acids alone demonstrated an appropriate increase in glucagon. These data suggest that lipid infusion, a commonly used means of providing nutrition to premature infants, may cause significant disturbances in glucoregulation, particularly when administered with amino acids. PMID:3132930

  20. Synaptogenesis and Myelination in the Nucleus/Tractus Solitarius: Potential Role in Apnea of Prematurity, Congenital Central Hypoventilation, and Sudden Infant Death Syndrome.

    PubMed

    Sarnat, Harvey B; Flores-Sarnat, Laura

    2016-05-01

    Fetuses as early as 15 weeks' gestation exhibit rhythmical respiratory movements shown by real-time ultrasonography. The nucleus/tractus solitarius is the principal brainstem respiratory center; other medullary nuclei also participate. The purpose was to determine temporal maturation of synaptogenesis. Delayed synaptic maturation may explain neurogenic apnea or hypoventilation of prematurity and some cases of sudden infant death syndrome. Sections of medulla oblongata were studied from 30 human fetal and neonatal brains 9 to 41 weeks' gestation. Synaptophysin demonstrated the immunocytochemical sequence of synaptogenesis. Other neuronal markers and myelin stain also were applied. The nucleus/tractus solitarius was similarly studied in fetuses with chromosomopathies, metabolic encephalopathies, and brain malformations. Synapse formation in the nucleus solitarius begins at about 12 weeks' gestation and matures by 15 weeks; myelination initiated at 33 weeks. Synaptogenesis was delayed in 3 fetuses with different conditions, but was not specific for only nucleus solitarius. Delayed synaptogenesis or myelination in the nucleus solitarius may play a role in neonatal hypoventilation, especially in preterm infants and in some sudden infant death syndrome cases. PMID:26661483

  1. Serum Phosphorus Levels in Premature Infants Receiving a Donor Human Milk Derived Fortifier

    PubMed Central

    Chetta, Katherine E.; Hair, Amy B.; Hawthorne, Keli M.; Abrams, Steven A.

    2015-01-01

    An elevated serum phosphorus (P) has been anecdotally described in premature infants receiving human milk fortified with donor human milk-derived fortifier (HMDF). No studies have prospectively investigated serum P in premature infants receiving this fortification strategy. In this single center prospective observational cohort study, extremely premature infants ≤1250 grams (g) birth weight (BW) were fed an exclusive human milk-based diet receiving HMDF and serum P levels were obtained. We evaluated 93 infants with a mean gestational age of 27.5 ± 2.0 weeks (Mean ± SD) and BW of 904 ± 178 g. Seventeen infants (18.3%) had at least one high serum P level with a mean serum P of 9.2 ± 1.1 mg/dL occurring at 19 ± 11 days of life. For all infants, the highest serum P was inversely correlated to the day of life of the infant (p < 0.001, R2 = 0.175) and positively correlated with energy density of HMDF (p = 0.035). Serum P was not significantly related to gender, BW, gestational age, or days to full feeds. We conclude that the incidence of hyperphosphatemia was mild and transient in this population. The risk decreased with infant age and was unrelated to gender, BW, or ethnicity. PMID:25912036

  2. Serum phosphorus levels in premature infants receiving a donor human milk derived fortifier.

    PubMed

    Chetta, Katherine E; Hair, Amy B; Hawthorne, Keli M; Abrams, Steven A

    2015-04-01

    An elevated serum phosphorus (P) has been anecdotally described in premature infants receiving human milk fortified with donor human milk-derived fortifier (HMDF). No studies have prospectively investigated serum P in premature infants receiving this fortification strategy. In this single center prospective observational cohort study, extremely premature infants ≤ 1250 grams (g) birth weight (BW) were fed an exclusive human milk-based diet receiving HMDF and serum P levels were obtained. We evaluated 93 infants with a mean gestational age of 27.5 ± 2.0 weeks (Mean ± SD) and BW of 904 ± 178 g. Seventeen infants (18.3%) had at least one high serum P level with a mean serum P of 9.2 ± 1.1 mg/dL occurring at 19 ± 11 days of life. For all infants, the highest serum P was inversely correlated to the day of life of the infant (p < 0.001, R2 = 0.175) and positively correlated with energy density of HMDF (p = 0.035). Serum P was not significantly related to gender, BW, gestational age, or days to full feeds. We conclude that the incidence of hyperphosphatemia was mild and transient in this population. The risk decreased with infant age and was unrelated to gender, BW, or ethnicity. PMID:25912036

  3. An Evaluation of the Pea Pod System for Assessing Body Composition of Moderately Premature Infants

    PubMed Central

    Forsum, Elisabet; Olhager, Elisabeth; Törnqvist, Caroline

    2016-01-01

    (1) Background: Assessing the quality of growth in premature infants is important in order to be able to provide them with optimal nutrition. The Pea Pod device, based on air displacement plethysmography, is able to assess body composition of infants. However, this method has not been sufficiently evaluated in premature infants; (2) Methods: In 14 infants in an age range of 3–7 days, born after 32–35 completed weeks of gestation, body weight, body volume, fat-free mass density (predicted by the Pea Pod software), and total body water (isotope dilution) were assessed. Reference estimates of fat-free mass density and body composition were obtained using a three-component model; (3) Results: Fat-free mass density values, predicted using Pea Pod, were biased but not significantly (p > 0.05) different from reference estimates. Body fat (%), assessed using Pea Pod, was not significantly different from reference estimates. The biological variability of fat-free mass density was 0.55% of the average value (1.0627 g/mL); (4) Conclusion: The results indicate that the Pea Pod system is accurate for groups of newborn, moderately premature infants. However, more studies where this system is used for premature infants are needed, and we provide suggestions regarding how to develop this area. PMID:27110820

  4. Magnetic influences on fetus and infant as reason for sudden infant death syndrome: a new testable hypothesis.

    PubMed

    Eckert, E E

    1992-05-01

    The hypothesis is based upon: a) My observed clustering of Sudden Infant Death Syndrome (SIDS) cases at places with abnormal geomagnetic fields (GMF) and/or electromagnetic fields (EMF); b) recorded GMF with pulsations matching the breathing frequencies of infants; c) the reported immature development of increased dendritic spine density in the brain stem of SIDS cases and; d) the increased dendrite arborization in the brains of rats exposed to magnetic fields (MF). The hypothesis consists of two parts: 1. A disturbed GMF in the residence or surroundings of a pregnant woman may interrupt the normal development of the central organ which controls respiration (brain stem) of the fetus. This is termed the 'Selection Factor'. 2. If such an infant with a functional disturbance of the control organ is then exposed to a GMF or EMF with pulsations similar to his own breathing frequency, but inverted in phase, value, form etc then the vital nerve impulses from the respiration control organ to the breathing organs may be disturbed or blocked with fatal effect. This is termed the 'Trigger Factor'. The elements of the 'Selection Factor' and the 'Trigger Factor' together produce SIDS. A program to test such a supposed 'Trigger Factor' is included. PMID:1614359

  5. Risk Factors and Prevention of Late Onset Sepsis in Premature Infants

    PubMed Central

    Downey, L Corbin; Smith, P Brian; Benjamin, Daniel K

    2010-01-01

    Late-onset sepsis in premature infants is a major cause of morbidity, mortality, and increased medical costs. Risk factors include low birth weight, low gestational age, previous antimicrobial exposure, poor hand hygiene, and central venous catheters. Methods studied to prevent late-onset sepsis include early feedings, immune globulin administration, prophylactic antimicrobial administration, and improved hand hygiene. In this review, we will outline the risk factors for development of late-onset sepsis and evidence supporting methods for prevention of late-onset sepsis in premature infants. PMID:20116186

  6. Human Milk Oligosaccharides in Premature Infants: Absorption, Excretion and Influence on the Intestinal Microbiota

    PubMed Central

    Underwood, Mark A.; Gaerlan, Stephanie; De Leoz, M. Lorna A.; Dimapasoc, Lauren; Kalanetra, Karen M.; Lemay, Danielle G.; German, J. Bruce; Mills, David A.; Lebrilla, Carlito B.

    2015-01-01

    Background Human milk oligosaccharides (HMOs) shape the intestinal microbiota in term infants. In premature infants, alterations in the intestinal microbiota (dysbiosis) are associated with risk of necrotizing enterocolitis and sepsis and the influence of HMOs on the microbiota is unclear. Methods Milk, urine, and stool specimens from 14 mother-premature infant dyads were investigated by mass spectrometry for HMO composition. The stools were analyzed by next-generation sequencing (NGS) to complement a previous analysis. Results Percentages of fucosylated and sialylated HMOs were highly variable between individuals but similar in urine, feces and milk within dyads. Differences in urine and fecal HMO composition suggest variability in absorption. Secretor status of the mother correlated with the urine and fecal content of specific HMO structures. Trends toward higher levels of Proteobacteria and lower levels of Firmicutes, were noted in premature infants of non-secretor mothers. Specific HMO structures in the milk, urine and feces were associated with alterations in fecal Proteobacteria and Firmicutes. Conclusion HMOs may influence the intestinal microbiota in premature infants. Specific HMOs, for example those associated with secretor mothers, may have a protective effect by decreasing pathogens associated with sepsis and necrotizing enterocolitis while other HMOs may increase dysbiosis in this population. PMID:26322410

  7. Resting-State Network Complexity and Magnitude Are Reduced in Prematurely Born Infants.

    PubMed

    Smyser, Christopher D; Snyder, Abraham Z; Shimony, Joshua S; Mitra, Anish; Inder, Terrie E; Neil, Jeffrey J

    2016-01-01

    Premature birth is associated with high rates of motor and cognitive disability. Investigations have described resting-state functional magnetic resonance imaging (rs-fMRI) correlates of prematurity in older children, but comparable data in the neonatal period remain scarce. We studied 25 term-born control infants within the first week of life and 25 very preterm infants (born at gestational ages ranging from 23 to 29 weeks) without evident structural injury at term equivalent postmenstrual age. Conventional resting-state network (RSN) mapping revealed only modest differences between the term and prematurely born infants, in accordance with previous work. However, clear group differences were observed in quantitative analyses based on correlation and covariance matrices representing the functional MRI time series extracted from 31 regions of interest in 7 RSNs. In addition, the maximum likelihood dimensionality estimates of the group-averaged covariance matrices in the term and preterm infants were 5 and 3, respectively, indicating that prematurity leads to a reduction in the complexity of rs-fMRI covariance structure. These findings highlight the importance of quantitative analyses of rs-fMRI data and suggest a more sensitive method for delineating the effects of preterm birth in infants without evident structural injury. PMID:25331596

  8. Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes

    PubMed Central

    Yu, Lingling; Tian, Jianmei; Zhao, Xingli; Cheng, Ping; Chen, Xiaoqian; Yu, Yun; Ding, Xiaochun; Zhu, Xueping; Xiao, Zhihui

    2016-01-01

    We aim to determine risk factors and clinical outcomes for bowel perforation in premature infants with NEC. We analyzed clinical data of 57 cases of premature infants with NEC at our NICU between January 2010 and December 2012. Based on the presence of bowel perforation, we divided these infants into two groups: perforated NEC group (n = 10) and nonperforated NEC group (n = 47). We compared general information, clinical characteristics, and laboratory findings between groups. The perforated NEC group, compared to the nonperforated NEC group, had significantly lesser gestational age, lower birth weight, higher prevalence of apnea, mechanical ventilation, sepsis and shock, lower blood pH, higher levels of blood glucose, abnormal WBC count and thrombocytopenia, and elevated CRP (all P < 0.05). Moreover, the perforated NEC group had significantly longer durations of fasting and TPN usage, higher incidences of EUGR and cholestasis, longer duration of antibiotics, higher frequency of advanced antibiotics use, and poorer prognosis than the nonperforated NEC group (all P < 0.05). Bowel perforation in premature infants with NEC was associated with multiple risk factors. Early identification of some of these risk factors in premature infants with NEC may help implement early intervention to reduce the incidence of bowel perforation and thereby improve the prognosis. PMID:27375739

  9. Mathematical modelling of thermoregulation processes for premature infants in closed convectively heated incubators.

    PubMed

    Fraguela, Andrés; Matlalcuatzi, Francisca D; Ramos, Ángel M

    2015-02-01

    The low-weight newborns and especially the premature infants have difficulty in maintaining their temperature in the range considered to be normal. Several studies revealed the importance of thermal environment and moisture to increase the survival rate of newborns. This work models the process of heat exchange and energy balance in premature newborns during the first hours of life in a closed incubator. In addition, a control problem was proposed and solved in order to maintain thermal stability of premature newborns to increase their rate of survival and weight. For this purpose, we propose an algorithm to control the temperature inside the incubator. It takes into account the measurements of the body temperature of a premature newborn which are recorded continuously. We show that using this model the temperature of a premature newborn inside the incubator can be kept in a thermal stability range. PMID:25557201

  10. ATTENUATION OF THE GANGLION CELL LAYER IN A PREMATURE INFANT REVEALED WITH HANDHELD SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY

    PubMed Central

    Goldberg, Mara R.; Zakka, Fouad R.; Carroll, Joseph J.

    2016-01-01

    Purpose: To report on subclinical retinal abnormalities shown through handheld spectral domain optical coherence tomography on a premature infant. Methods: Case report. Results: The initial and follow-up exams on a premature infant revealed severely attenuated ganglion cell and nerve fiber layers. There was cystoid macular edema in both eyes at the initial visits, which resolved by the 1-year follow-up. Discussion: Optical coherence tomography can reveal significant retinal abnormalities in premature infants which are not detectable through funduscopic exam. Documenting such findings may be useful for the comprehensive management of vision problems in children with a history of premature birth. PMID:26529438

  11. Ascending in utero herpes simplex virus infection in an initially healthy-appearing premature infant.

    PubMed

    Edwards, Morven S; Popek, Edwina J; Wise, Brittany; Hatzenbuehler, Lindsay; Arunachalam, Athis R; Hair, Amy B

    2015-01-01

    The usual route of acquisition for intrauterine herpes simplex virus (HSV) infection is transplacental. We evaluated a premature infant with in utero acquisition of HSV resulting from ascending infection. Histopathologic evidence of chronic chorioamnionitis and positive staining with immunohistochemistry for HSV in the placenta and umbilical cord established the diagnosis. The clinical presentation was also of interest in that the infant was initially healthy appearing. PMID:25535792

  12. Gut bacteria are rarely shared by co-hospitalized premature infants, regardless of necrotizing enterocolitis development

    PubMed Central

    Raveh-Sadka, Tali; Thomas, Brian C; Singh, Andrea; Firek, Brian; Brooks, Brandon; Castelle, Cindy J; Sharon, Itai; Baker, Robyn; Good, Misty; Morowitz, Michael J; Banfield, Jillian F

    2015-01-01

    Premature infants are highly vulnerable to aberrant gastrointestinal tract colonization, a process that may lead to diseases like necrotizing enterocolitis. Thus, spread of potential pathogens among hospitalized infants is of great concern. Here, we reconstructed hundreds of high-quality genomes of microorganisms that colonized co-hospitalized premature infants, assessed their metabolic potential, and tracked them over time to evaluate bacterial strain dispersal among infants. We compared microbial communities in infants who did and did not develop necrotizing enterocolitis. Surprisingly, while potentially pathogenic bacteria of the same species colonized many infants, our genome-resolved analysis revealed that strains colonizing each baby were typically distinct. In particular, no strain was common to all infants who developed necrotizing enterocolitis. The paucity of shared gut colonizers suggests the existence of significant barriers to the spread of bacteria among infants. Importantly, we demonstrate that strain-resolved comprehensive community analysis can be accomplished on potentially medically relevant time scales. DOI: http://dx.doi.org/10.7554/eLife.05477.001 PMID:25735037

  13. [Photoprevention or phototherapy in newborn infants born prematurely?].

    PubMed

    Romagnoli, C; Muzii, U; Maggio, L; De Carolis, M P; Zecca, E; Zuppa, A A; Tortorolo, G

    1987-01-01

    The authors studied the effects of different kinds of phototherapy in 186 newborns with a gestational age less than 33 weeks and weighing less than 2500 g. A control group of 60 infants was compared with a group of 31 infants submitted to photoprophylaxis, a group of 54 infants treated with day light, and a group of 41 infants treated with day light + special blue light. As far as the serum bilirubin variations in the first week, the maximum levels attained and the number of exchange transfusions are concerned, phototherapy always proved effective in reducing potentially neurotoxic serum bilirubin concentrations. Among the infants subjected to treatment, those treated with the day light showed a significant smaller decrease of serum bilirubin compared to those treated with the day light + special blue light, even if levels above 15 mg/dl were found in a similar percentage. Only 3.2% of the babies treated with photoprophylaxis showed serum bilirubin values above 15 mg/dl. The authors conclude that prophylaxis seems to be preferable to other phototherapeutic schedules used in the treatment of hyperbilirubinemia in low gestational age infants. PMID:3658802

  14. Comparison the effect of Sleep Positioning on Cardiorespiratory Rate in Noninvasive Ventilated Premature Infants

    PubMed Central

    Ghorbani, Fatemeh; Asadollahi, Maliheh; Valizadeh, Sousan

    2013-01-01

    Background: Results of several studies suggest that prone position is beneficial in improving the preterm infants’ cardio-respiratory status. Previous studies showed opposite results, and also there is not any available clear study about the effect of this position on cardio-respiratory rates of Nasal Continuous Positive Airway Pressure (N-CPAP) treating premature infants. Objectives: This study aimed at comparing supine and prone positions on cardio-respiratory rates of premature infants with respiratory distress syndrome (RDS) who were treated using N-CPAP. Patients and Methods: This was a cross over study which was performed in 2010 on 44 hospitalized 29-34 weeks gestation premature infants who were receiving N-CPAP in Neonatal Intensive Care Unit of Al-Zahra Hospital of Tabriz University of Medical Sciences. Infants were randomly assigned into two groups, and the first group was placed in prone at first and then in supine, and the position of second group was at first supine and then prone. Infants’ Heart Rate (HR) and Respiratory Rate (RR) were assessed three times in each position for 30 minutes. The data was recorded in a data-collection form, and demographic data was analyzed using t test, Chi square and Fisher exact test. Also, repeated measurement ANOVA and Tukey post-hoc tests were used. Results: There was a significant difference in HR and RR of premature infants who were similar in gestational age and clinical condition and placed in two positions. Premature infants’ HR and RR became lower at prone position than supine in both groups. So it can be concluded that prone position could decrease infants HR and RR, but supine position might increase them (P < 0.05). Conclusion: Our findings support prone positioning for premature infants. Therefore, it is advisable to NICU staff that if there is no obstacle for changing the infant’s position, prone position in infants with respiratory complications during receiving N-CPAP in NICU can be useful

  15. Importance of close follow-up in the fetus with premature atrial contractions accompanied by atrial septal aneurysm: a case report.

    PubMed

    Yozgat, Yilmaz; Kilic, Ayhan; Karadeniz, Cem; Ozdemir, Rahmi; Doksoz, Onder; Mese, Timur; Unal, Nurettin

    2013-01-01

    Rhythms that derive from parts of atria other than the sinus node are called premature atrial contractions (PACs). Vast majority of fetal PACs are idiopathic. Fetal PACs usually have a good prognosis and disappear spontaneously during pregnancy or after delivery. Development of fetal tachycardia or fetal bradycardia is rarely reported during follow-up of fetuses diagnosed with PACs. To the best of our knowledge, coexistence of tachycardia and bradycardia leading to hemodynamic impairment has not yet been reported. We present a fetus diagnosed with PACs and atrial septal aneurysm (ASA) on the 23rd week of gestation proceeding to fetal bradycardia and fetal tachycardia and consequently hemodynamic impairment. We suggest closer follow-up of fetuses with PACs accompanied by ASA. PMID:24455349

  16. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to compare the duration of parenteral nutrition, growth, and morbidity in extremely premature infants fed exclusive diets of either bovine milk-based preterm formula (BOV) or donor human milk and human milk-based human milk fortifier (HUM), in a randomized trial of formula vs human...

  17. Impact of Tactile Stimulation on Neurobehavioral Development of Premature Infants in Assiut City

    ERIC Educational Resources Information Center

    Sayed, Atyat Mohammed Hassan; Youssef, Magda Mohamed E.; Hassanein, Farouk El-Sayed; Mobarak, Amal Ahmed

    2015-01-01

    Objective: To assess impact of tactile stimulation on neurobehavioral development of premature infants in Assiut City. Design: Quasi-experimental research design. Setting: The study was conducted in the Neonatal Intensive Care Unit at Assiut University Children Hospital, Assiut General Hospital, Health Insurance Hospital (ElMabarah Hospital) and…

  18. B-type natriuretic peptide for assessment of haemodynamically significant patent ductus arteriosus in premature infants

    PubMed Central

    Mine, Kenji; Ohashi, Atsushi; Tsuji, Shoji; Nakashima, Jun-ichi; Hirabayashi, Masato; Kaneko, Kazunari

    2013-01-01

    Aim: Haemodynamically significant patent ductus arteriosus (hsPDA) is frequently observed in premature infants. This study was conducted to explore whether the blood BNP can be a valuable biomarker to assess the necessity of treatment for hsPDA in premature infants. Methods: Serial measurements of the blood BNP were performed during the first 5 days of life in premature infants with hsPDA (Group I) and those without hsPDA (Group N). The definition of the hsPDA was the PDA requiring treatment, such as indomethacin administration and/or surgical ligation. Results: Forty-six subjects were enrolled. Compared with Group N, Group I showed significantly higher level of blood BNP at postnatal 24–96 h and demonstrated the peak value at postnatal 24–48 h. With the ROC curve using the data at postnatal 24–48 h in Group I, we deduced the predictive value of 250 pg/mL of blood BNP for indomethacin treatment. Similarly, with the ROC curve using the maximal value of blood BNP within the first 5 days of life, the predictive value of 2000 pg/mL for surgical ligation was deduced. Conclusions: Blood BNP during early postnatal period can be a useful biomarker to assess the necessity of treatment for hsPDA in premature infants. PMID:23611593

  19. Intervention with African American Premature Infants: Four-Month Results of an Early Intervention Program

    ERIC Educational Resources Information Center

    Teti, Douglas M.; Black, Maureen M.; Viscardi, Rose; Glass, Penny; O'Connell, Melissa A.; Baker, Linda; Cusson, Regina; Reiner Hess, Christine

    2009-01-01

    This study evaluates the efficacy of an early intervention program targeting African American mothers and their premature, low birth weight infants at 3 to 4 months' corrected age from four neonatal intensive care units, 173 families are recruited (84 intervention, 89 control). The 8-session, 20-week intervention consists of a psychoeducational…

  20. Contrasts in Infant Classical Eyeblink Conditioning as a Function of Premature Birth

    ERIC Educational Resources Information Center

    Herbert, Jane S.; Eckerman, Carol O.; Goldstein, Ricki F.; Stanton, Mark E.

    2004-01-01

    The impact of premature birth on associative learning was evaluated using simple delay eyeblink conditioning in which a tone conditional stimulus was paired with an air puff unconditional stimulus. Fourteen preterm (28-31 weeks gestation) and 11 full-term infants completed at least 3 conditioning sessions, 1 week apart, at 5 months of age…

  1. Identification of Extremely Premature Infants at High Risk of Rehospitalization

    PubMed Central

    Carlo, Waldemar A.; McDonald, Scott A.; Yao, Qing; Das, Abhik; Higgins, Rosemary D.

    2011-01-01

    OBJECTIVE: Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. METHODS: Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002–2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. RESULTS: A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%–42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. CONCLUSIONS: The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after

  2. Environmental influences on the developing premature infant: theoretical issues and applications to practice.

    PubMed

    White-Traut, R C; Nelson, M N; Burns, K; Cunningham, N

    1994-06-01

    The neonatal intensive-care unit (NICU) environment may interfere with the maturation and organization of premature infants' central nervous systems and may fail to meet these infants' developmental needs. In particular, immature distance receptors (i.e., hearing and vision) may receive overwhelming stimulation, whereas more mature tactile and vestibular pathways receive little stimulation. Furthermore, research on fetal learning suggests that the NICU environment should sensitively address requirements for learning by providing contingent experience. Nurses are ideally suited to reorganize the NICU and intervene to optimize infants' growth and development. PMID:8083780

  3. Clinical observation of antibiotics in preventing nosocomial infection in premature infants

    PubMed Central

    Yan, Jiaxiu; Liu, Xuehua; Lin, Yi; Yan, Chaoying

    2015-01-01

    Objective: To study the possibility of lower the nosocomial infection rate among the premature infants by prophylactic use of antibiotics. Methods: Retrospectively collect 409 premature infants admitted to the neonatal intensive care unit (NICU) of First Hospital of Jilin University between 1st January in 2009 and 31th December in 2011, who meet inclusion criteria. There were prohylactic group and nonprohylactic group randomly divided and compared the nosocomial infection rates of two groups. Results: The hospital infection rate of the prophylactic group was 62.9%, and the rate of the non-prophylactic group was 47.3%. There was a significant difference between the two groups (P<0.05). On the countrary, the prophylactic use of antibiotics could increase the incidence of the nosocomial infection. Conclusion: It does more harm than good that proghylactic use of antibiotics to prevent premature nosocomial infection. PMID:26629165

  4. Drug transfer to the fetus and to the breastfeeding infant: what do we know?

    PubMed

    Bernick, Steven J; Kane, Sunanda

    2012-07-01

    The pregnant patient with inflammatory bowel disease presents a number of challenges to the clinician. In addition to the management of the patient's disease activity and the potential effects of disease on pregnancy, the clinician must also take into consideration any iatrogenic complications that may arise from the medical management of these conditions. Furthermore, should the patient elect to breastfeed her infant, the effect of drugs that may be passed through the breast milk must also be considered. This article focuses specifically on the issues of drug transfer to the fetus and to the breastfeeding infant. Meperidine is the sedative of choice for endoscopic procedures on pregnant patients, while benzodiazepines and propofol may be used with certain caveats. Amoxicillin/clavulanic acid and metronidazole are preferred if antibiotics are indicated for perianal Crohn's disease or pouchitis. The majority of medications used in the treatment of luminal IBD in pregnancy are not associated with significant adverse effects, and thus can generally be used safely. Certain medications, such as aminosalicylates, corticosteroids, and cyclosporine, appear low risk, while others such as methotrexate and thalidomide are clearly contraindicated. The role of other immunomodulators and biologics remains to be clearly defined, although early experience with infliximab and similar agents appear to be low risk. Safety in breastfeeding varies considerably among medications. There are many issues to address when considering pharmaceutical intervention in the pregnant patient, and patients should be carefully counseled regarding potential teratogenicity or adverse outcomes of medication used during pregnancy and breastfeeding. PMID:22762278

  5. Umbilical Cord Milking Improves Transition in Premature Infants at Birth

    PubMed Central

    Katheria, Anup; Blank, Doug; Rich, Wade; Finer, Neil

    2014-01-01

    Background Umbilical cord milking (UCM) improves blood pressure and urine output, and decreases the need for transfusions in comparison to immediate cord clamping (ICC). The immediate effect of UCM in the first few minutes of life and the impact on neonatal resuscitation has not been described. Methods Women admitted to a tertiary care center and delivering before 32 weeks gestation were randomized to receive UCM or ICC. A blinded analysis of physiologic data collected on the newborns in the delivery room was performed using a data acquisition system. Heart rate (HR), SpO2, mean airway pressure (MAP), and FiO2 in the delivery room were compared between infants receiving UCM and infants with ICC. Results 41 of 60 neonates who were enrolled and randomized had data from analog tracings at birth. 20 of these infants received UCM and 21 had ICC. Infants receiving UCM had higher heart rates and higher SpO2 over the first 5 minutes of life, were exposed to less FiO2 over the first 10 minutes of life than infants with ICC. Conclusions UCM when compared to ICC had decreased need for support immediately following delivery, and in situations where resuscitation interventions were needed immediately, UCM has the advantage of being completed in a very short time to improve stability following delivery. Trial Registration ClinicalTrials.gov NCT01434732 PMID:24709780

  6. [Measuring skin temperature in premature infants. Comparison of infrared telethermography and electric contact thermometry].

    PubMed

    Hanssler, L; Breukmann, H

    1992-01-01

    In a group of 6 premature infants, mean weight 1776 g, we measured skin surface temperatures, comparing infrared telethermography (San-ei Thermo-Tracer 6T62) and conventional skin thermometry (Eidatherm). Surface temperatures were measured at 10 different sites, with the infants nursed in an incubator. The same methods were used to compare temperatures on the lower arm of an adult. The results of the two different techniques showed only minor differences of approximately 0,2 degrees C. These discrepancies could be explained by problems of either method. They could also be attributed to the fact, that the emissivity of human skin is not exactly identical with the emissivity of a perfect black body. In clinical practice, infrared thermography and conductive thermometry can be used for determinations of body surface temperature of premature infants, also under the condition of high temperatures and high humidity within an incubator. PMID:1405422

  7. Reevaluation of the DHA requirement for the premature infant

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The long-chain polyunsaturated fatty acid (LC-PUFA) intake in preterm infants is crucial for normal central nervous system development and has the potential for long-lasting effects that extend beyond the period of dietary insufficiency. While much attention has focused on improving their nutritiona...

  8. Risk Factors for Periventricular-Intraventricular Hemorrhage in Premature Infants

    PubMed Central

    Lee, Ju Young; Jung, Euiseok; Kim, Eun Sun; Shim, Gyu Hong; Lee, Hyun Joo; Lee, Jin A; Choi, Chang Won; Kim, Ee-Kyung; Kim, Beyong Il; Choi, Jung-Hwan

    2010-01-01

    Periventricular-intraventricular hemorrhage (PV-IVH) is a major cause of neurological disabilities in preterm newborns. This study aimed to determine the perinatal factors associated with PV-IVH. We conducted a retrospective case-control study from preterm infants born at ≤34 weeks of gestation and admitted to Neonatal Intensive Care Units of Seoul National University Children's Hospital and Seoul National University Bundang Hospital between June 2003 and December 2007. Neonates with no cranial sonographic data or infants transferred from other centers after three days of age were excluded. Of 1,044 eligible subjects, 59 infants with PV-IVH grade 2, 3, and 4 were allocated to the case group. The control group consisted of 118 infants without PV-IVH who were matched for gestational age and birth weight to each case of PV-IVH. At the multivariate logistic regression model, metabolic acidosis (odds ratio [OR]: 6.94; 95% confidence interval [CI]: 1.12-43.23) and use of inotropes (OR: 3.70; 95% CI: 1.16-11.84) were associated with an increased risk of PV-IVH. Maternal use of antenatal corticosteroids decreases the risk of PV-IVH (OR: 0.36; 95% CI: 0.14-0.92). PMID:20191041

  9. Premature infant responses to noise reduction by earmuffs: effects on behavioral and physiologic measures.

    PubMed

    Zahr, L K; de Traversay, J

    1995-01-01

    The continuous high-intensity noise in the neonatal intensive care unit (NICU) is both stressful and harmful for the premature infant. Although some researchers have found evidence that loud noise can cause hearing loss and alter physiologic and behavioral responses, no study to date has investigated the benefits of noise reduction by the use of earmuffs. In this study earmuffs were placed over the premature infants' ears to reduce noise intensity in the NICU while physiologic and behavioral responses were measured. Two sites were used to collect data: in the first setting, 17 low birth weight infants were randomly assigned to an experimental and a control group, whereas 13 infants from a second hospital acted as their own controls and were tested with and without earmuffs. Earmuffs that reduced the intensity of noise by 7 to 12 dB were worn by infants in the experimental group only during the observation periods. Infants in the control group were exposed to the usual noise in the NICU. The infant's physiologic and behavioral responses were observed for four 2-hour intervals, morning and evening, on two consecutive days. Most of the significant results were from the site at which infants acted as their own controls. When infants wore the earmuffs, they had significantly higher mean oxygen saturation levels and less fluctuation in oxygen saturation. Furthermore, these infants had less frequent behavioral state changes, spent more time in the quiet sleep state, and had longer bouts in the sleep state. It is imperative that NICUs develop aggressive antinoise policies to substantially and consistently reduce noise. PMID:8648453

  10. Nonylphenol in pregnant women and their matching fetuses: Placental transfer and potential risks of infants

    SciTech Connect

    Huang, Yu-Fang; Wang, Pei-Wei; Huang, Li-Wei; Yang, Winnie; Yu, Ching-Jung; Yang, Shang-Han; Chiu, Hsin-Hao; Chen, Mei-Lien

    2014-10-15

    As the predominant environmental biodegradation product of nonylphenol (NP) ethoxylates and with proven estrogenic effects, NP is formed during the alkylation process of phenols. The purposes of this study were (1) to examine maternal and prenatal exposure to NP in Taiwan, (2) to determine the level of placental protection against NP exposure as well as the level of NP in breast milk, and (3) to assess the potential risk for breastfed newborns exposed to NP through the milk. Thirty pairs of maternal and fetal blood samples, placenta, and breast milk during the 1st and the 3rd months of lactation were collected. External NP exposures of these specimens were then analyzed by using high-performance liquid chromatography coupling with fluorescence detection. Next, the socio-demographics, lifestyle, delivery method, dietary and work history were collected using a questionnaire. In addition, the daily intake of NP from consuming breast milk in the 1st and 3rd months for newborns was studied through deterministic and probabilistic risk assessment methods. The geometric means and geometric standard deviation of NP levels in maternal blood, fetal cord blood, placenta, and breast milk in the 1st and 3rd months were 14.6 (1.7) ng/ml, 18.8 (1.8) ng/ml, 19.8 (1.9) ng/g, 23.5 (3.2) ng/ml, and 57.3 (1.4) ng/ml, respectively. The probabilistic percentiles (50th, 75th, and 95th) of daily intake NP in breast milk were 4.33, 7.79, and 18.39 μg/kg-bw/day in the 1st month, respectively, and were 8.11, 10.78, 16.08 μg/kg-bw/day in the 3rd month, respectively. The probabilistic distributions (5th, 25th, and 50th) of risk for infants aged 1 month old were 0.27, 0.64, and 1.15, respectively, and that for infants aged 3 month old were 0.31, 0.46, and 0.62, respectively. Through repeated exposure from the dietary intake of expectant mothers, fetuses could encounter a high NP exposure level due to transplacental absorption, partitioning between the maternal and fetal compartments. Daily NP

  11. Population Pharmacokinetics of Fluconazole in Premature Infants with Birth Weights Less than 750 Grams.

    PubMed

    Momper, Jeremiah D; Capparelli, Edmund V; Wade, Kelly C; Kantak, Anand; Dhanireddy, Ramasubbareddy; Cummings, James J; Nedrelow, Jonathan H; Hudak, Mark L; Mundakel, Gratias T; Natarajan, Girija; Gao, Jamie; Laughon, Matt; Smith, P Brian; Benjamin, Daniel K

    2016-09-01

    Fluconazole is an effective agent for prophylaxis of invasive candidiasis in premature infants. The objective of this study was to characterize the population pharmacokinetics (PK) and dosing requirements of fluconazole in infants with birth weights of <750 g. As part of a randomized clinical trial, infants born at <750 g birth weight received intravenous (i.v.) or oral fluconazole at 6 mg/kg of body weight twice weekly. Fluconazole plasma concentrations from samples obtained by either scheduled or scavenged sampling were measured using a liquid chromatography-tandem mass spectrometry assay. Population PK analysis was conducted using NONMEM 7.2. Population PK parameters were allometrically scaled by body weight. Covariates were evaluated by univariable screening followed by multivariable assessment. Fluconazole exposures were simulated in premature infants using the final PK model. A population PK model was developed from 141 infants using 604 plasma samples. Plasma fluconazole PK were best described by a one-compartment model with first-order elimination. Only serum creatinine was an independent predictor for clearance in the final model. The typical population parameter estimate for oral bioavailability in the final model was 99.5%. Scavenged samples did not bias the parameter estimates and were as informative as scheduled samples. Simulations indicated that the study dose maintained fluconazole troughs of >2,000 ng/ml in 80% of simulated infants at week 1 and 59% at week 4 of treatment. Developmental changes in fluconazole clearance are best predicted by serum creatinine in this population. A twice-weekly dose of 6 mg/kg achieves appropriate levels for prevention of invasive candidiasis in extremely premature infants. PMID:27401564

  12. Radiant energy and insensible water loss in the premature newborn infant nursed under a radiant warmer.

    PubMed

    Baumgart, S

    1982-10-01

    Radiant warmers are a powerful and efficient source of heat serving to warm the cold-stressed infant acutely and to provide uninterrupted maintenance of body temperature despite a multiplicity of nursing, medical, and surgical procedures required to care for the critically ill premature newborn in today's intensive care nursery. A recognized side-effect of radiant warmer beds is the now well-documented increase in insensible water loss through evaporation from an infant's skin. Particularly the very-low-birth-weight, severely premature, and critically ill neonate is subject to this increase in evaporative water loss. The clinician caring for the infant is faced with the difficult problem of fluid and electrolyte balance, which requires vigilant monitoring of all parameters of fluid homeostasis. Compounding these difficulties, other portions of the electromagnetic spectrum (for example, phototherapy) may affect an infant's fluid metabolism by mechanisms that are not well understood. The role of plastic heat shielding in reducing large insensible losses in infants nursed on radiant warmer beds is currently under intense investigation. Apparently, convective air currents and not radiant heat energy may be the cause of the observed increase in insensible water loss in the intensive care nursery. A thin plastic blanket may be effective in reducing evaporative water loss by diminishing an infant's exposure to convective air currents while being nursed on an open radiant warmer bed. A rigid plastic body hood, although effective as a radiant heat shield, is not as effective in preventing exposure to convection in the intensive care nursery and, therefore, is not as effective as the thin plastic blanket in reducing insensible water loss. Care should be exercised in determining the effect of heat shielding on all parameters of heat exchange (convection, evaporation, and radiation) before application is made to the critically ill premature infant nursed on an open radiant

  13. Can Machine Learning Methods Predict Extubation Outcome in Premature Infants as well as Clinicians?

    PubMed Central

    Mueller, Martina; Almeida, Jonas S.; Stanislaus, Romesh; Wagner, Carol L.

    2014-01-01

    Rationale Though treatment of the prematurely born infant breathing with assistance of a mechanical ventilator has much advanced in the past decades, predicting extubation outcome at a given point in time remains challenging. Numerous studies have been conducted to identify predictors for extubation outcome; however, the rate of infants failing extubation attempts has not declined. Objective To develop a decision-support tool for the prediction of extubation outcome in premature infants using a set of machine learning algorithms Methods A dataset assembled from 486 premature infants on mechanical ventilation was used to develop predictive models using machine learning algorithms such as artificial neural networks (ANN), support vector machine (SVM), naïve Bayesian classifier (NBC), boosted decision trees (BDT), and multivariable logistic regression (MLR). Performance of all models was evaluated using area under the curve (AUC). Results For some of the models (ANN, MLR and NBC) results were satisfactory (AUC: 0.63–0.76); however, two algorithms (SVM and BDT) showed poor performance with AUCs of ~0.5. Conclusion Clinician's predictions still outperform machine learning due to the complexity of the data and contextual information that may not be captured in clinical data used as input for the development of the machine learning algorithms. Inclusion of preprocessing steps in future studies may improve the performance of prediction models. PMID:25419493

  14. Effectiveness of therapeutic behavioral interventions for parents of low birth weight premature infants: A review.

    PubMed

    Brecht, Carrie; Shaw, Richard J; Horwitz, Sarah M; John, Nicholas H St

    2012-11-01

    Premature birth has been associated with a number of adverse maternal psychological outcomes that include depression, anxiety, and trauma as well as adverse effects on maternal coping ability and parenting style. Infants and children who were premature are more likely to have poorer cognitive and developmental functioning and, thus, may be harder to parent. In response to these findings, there have been a number of educational and behavioral interventions developed that target maternal psychological functioning, parenting and aspects of the parent-infant relationship. Since the last comprehensive review of this topic in 2002, there have been a significant number of developments in the quality of the studies conducted and the theoretical models that address the experience of parents of premature infants. In the current review, eighteen new interventions were identified and grouped into four categories based on treatment length and the target of the intervention. Findings suggest a trend towards early, brief interventions that are theoretically based, specifically target parent trauma, and utilize cognitive behavioral techniques. Although it is difficult to generalize study findings, conclusions from the review suggest that targeted interventions may have positive effects on both maternal and infant outcomes. PMID:24532861

  15. Management of post-haemorrhagic hydrocephalus in premature infants.

    PubMed

    Ellenbogen, Jonathan R; Waqar, Mueez; Pettorini, Benedetta

    2016-09-01

    Post-haemorrhagic hydrocephalus (PHH) is the most common neurological complication of preterm birth and can result in severe and life-long psychomotor and cognitive sequelae. Cerebrospinal fluid diversion is often required but the optimum time for intervention is unclear. Numerous neurosurgical procedures exist to temporise PHH but it is not clear which is the optimum method. Approximately 15% of preterm infants who suffer intraventricular haemorrhage (IVH) will require permanent cerebrospinal fluid diversion with a ventriculoperitoneal shunt. It is likely that earlier intervention may result in reduced neurological disability and ventriculoperitoneal shunt dependency. In this review we discuss the current methods of PHH management. PMID:27369088

  16. The biological clock of very premature primate infants is responsive to light

    PubMed Central

    Hao, Haiping; Rivkees, Scott A.

    1999-01-01

    Each year more than 250,000 infants in the United States are exposed to artificial lighting in hospital nurseries with little consideration given to environmental lighting cycles. Essential in determining whether environmental lighting cycles need to be considered in hospital nurseries is identifying when the infant’s endogenous circadian clock becomes responsive to light. Using a non-human primate model of the developing human, we examined when the circadian clock, located in the hypothalamic suprachiasmatic nuclei (SCN), becomes responsive to light. Preterm infant baboons of different ages were exposed to light (5,000 lux) at night, and then changes in SCN metabolic activity and gene expression were assessed. After exposure to bright light at night, robust increases in SCN metabolic activity and gene expression were seen at ages that were equivalent to human infants at 24 weeks after conception. These data provide direct evidence that the biological clock of very premature primate infants is responsive to light. PMID:10051658

  17. The benefits of influenza vaccine in pregnancy for the fetus and the infant younger than six months of age

    PubMed Central

    MacDonald, Noni E; McDonald, Jane C

    2014-01-01

    Influenza is a serious problem for infants <6 months of age, whose hospitalization rates for influenza and associated illness are comparable with rates in the elderly. Because influenza vaccines are not effective in this age group, the optimal evidence-based strategy is to administer trivalent inactivated influenza vaccines during pregnancy. Immunizing with trivalent inactivated influenza vaccines in the second and third trimester is well studied and safe, not only providing protection for the pregnant woman and her infant <6 months of age, but also for the fetus by decreasing the risk for low birth weight. PMID:25587237

  18. The macular findings on spectral-domain optical coherence tomography in premature infants with or without retinopathy of prematurity.

    PubMed

    Gursoy, Huseyin; Bilgec, Mustafa Deger; Erol, Nazmiye; Basmak, Hikmet; Colak, Ertugrul

    2016-08-01

    The purpose of the study was to present spectral-domain optical coherence tomography (OCT) findings in premature infants with or without mild-to-severe retinopathy of prematurity (ROP). Seventy-two infants born <37 weeks of gestation were analyzed, prospectively. Group 1 (n = 18) included infants without ROP. Infants with stage 1, 2, or 3 ROP without indication for treatment formed the second group (n = 15). Group 3 (n = 21) included threshold cases, who would receive laser photocoagulation (LPC) after OCT examinations. Group 4 (n = 18) had already received LPC. The mean central foveal thickness (CFT) (μm) in right eyes was 194.27 ± 19.93, 207.67 ± 25.44, 224.29 ± 21.42, and 222.00 ± 37.80, for groups 1, 2, 3, and 4, respectively (p = 0.01). The presence of a well-formed foveal pit was documented in 60 % of right and 67 % of left eyes in group 1, while a well-formed foveal pit was observed in 14 % of right and 16 % of left eyes in group 3 (p < 0.05). Cystoid macular edema (CME) was shown in 29 % of right and 21 % of left eyes in group 3 (p < 0.05 for right eyes). CME was observed in two of right and left eyes in group 4. Epiretinal membrane (ERM) was shown in one right eye in group 3, two right and four left eyes in group 4 (p < 0.05 for left eyes). Thicker CFT, CME, and failure of a well-formed foveal pit could be related to the severity of ROP. The development of ERM could be the consequence of LPC. PMID:26750097

  19. Urinary Metabolite Profiles in Premature Infants Show Early Postnatal Metabolic Adaptation and Maturation

    PubMed Central

    Moltu, Sissel J.; Sachse, Daniel; Blakstad, Elin W.; Strømmen, Kenneth; Nakstad, Britt; Almaas, Astrid N.; Westerberg, Ane C.; Rønnestad, Arild; Brække, Kristin; Veierød, Marit B.; Iversen, Per O.; Rise, Frode; Berg, Jens P.; Drevon, Christian A.

    2014-01-01

    Objectives: Early nutrition influences metabolic programming and long-term health. We explored the urinary metabolite profiles of 48 premature infants (birth weight < 1500 g) randomized to an enhanced or a standard diet during neonatal hospitalization. Methods: Metabolomics using nuclear magnetic resonance spectroscopy (NMR) was conducted on urine samples obtained during the first week of life and thereafter fortnightly. Results: The intervention group received significantly higher amounts of energy, protein, lipids, vitamin A, arachidonic acid and docosahexaenoic acid as compared to the control group. Enhanced nutrition did not appear to affect the urine profiles to an extent exceeding individual variation. However, in all infants the glucogenic amino acids glycine, threonine, hydroxyproline and tyrosine increased substantially during the early postnatal period, along with metabolites of the tricarboxylic acid cycle (succinate, oxoglutarate, fumarate and citrate). The metabolite changes correlated with postmenstrual age. Moreover, we observed elevated threonine and glycine levels in first-week urine samples of the small for gestational age (SGA; birth weight < 10th percentile for gestational age) as compared to the appropriate for gestational age infants. Conclusion: This first nutri-metabolomics study in premature infants demonstrates that the physiological adaptation during the fetal-postnatal transition as well as maturation influences metabolism during the breastfeeding period. Elevated glycine and threonine levels were found in the first week urine samples of the SGA infants and emerged as potential biomarkers of an altered metabolic phenotype. PMID:24824288

  20. Delayed Luminance and Chromatic Contrast Sensitivity in Infants with Spontaneously Regressed Retinopathy of Prematurity

    PubMed Central

    Bosworth, Rain; Robbins, Shira L.; Granet, David B.; Dobkins, Karen

    2013-01-01

    Background The current study assessed whether contrast sensitivity is affected in preterm infants with a history of spontaneously regressed retinopathy of prematurity (ROP, Stages 1–3). Specifically, we employed luminance (light/dark) and chromatic (red/green) stimuli, which are mediated by the magnocellular (M) and parvocellular (P) subcortical pathways, respectively. Methods Contrast sensitivity (CS) was measured using forced choice preferential looking testing in 21 infants with a history of ROP and 41 control preterm infants who were born prematurely but did not develop ROP, tested between 8 and 47 weeks (2–11 months) postterm age. Infants were presented with chromatic and luminance drifting sinusoidal gratings, which appeared randomly on the left or right side of the monitor on each trial. The contrast of the stimuli varied across trials and was defined in terms of root mean squared cone contrast for long- and medium-wavelength cones. Results Between 8 and 25 weeks postterm, ROP infants had significantly worse CS, and there was a trend for greater impairment for Luminance than Chromatic CS. This delay was not seen at older ages between 26 and 47 weeks postterm. Conclusions These findings are consistent with the concept that early maturation of the M pathway is vulnerable to biological insult, as in the case of ROP, to a greater extent than is the P pathway. PMID:23744448

  1. Lang and Goulet Hardiness Scale: development and testing on bereaved parents following the death of their fetus/infant.

    PubMed

    Lang, Ariella; Goulet, Celine; Amsel, Rhonda

    2003-12-01

    The process of development and testing of the Lang and Goulet Hardiness Scale (LGHS), a self-report instrument designed to measure hardiness in bereaved parents following the death of their fetus/infant, is presented. Hardiness is a personal resource, composed of 3 interdependent components that are characterized by a sense of personal control over the outcome of life events and hardships such as the death of a fetus/infant, an active orientation toward meeting the challenges brought on by the loss, and a belief in the ability to make sense of one's own existence following such a tragedy. The concept of hardiness has been studied by various disciplines and in a multitude of settings to understand its ability to lessen potentially negative effects of life stress. However, it has never been studied within the context of parental bereavement. The LGHS was developed systematically, originating from a concept analysis. A panel of 15 experts was used to establish content validity.A pretest was conducted on 73 bereaved individuals to assess convergent and discriminant validity of the LGHS. Subsequently, a validation study on 220 bereaved parents who had experienced the death of their fetus/infant 2 months previously was conducted including a retest 6 months after the loss with 192 of the remaining participants. Analyses reveal that the LGHS is a valid and reliable instrument for measuring hardiness and that it is sensitive enough to detect changes in the construct over time. PMID:14610777

  2. A risk factor analysis on disease severity in 47 premature infants with bronchopulmonary dysplasia

    PubMed Central

    Li, Yan; Cui, Yazhou; Wang, Chao; Liu, Xiao; Han, Jinxiang

    2015-01-01

    Summary Bronchopulmonary Dysplasia (BPD) is a rare chronic lung disease and one of the most difficult complications to treat in premature infants. With the progress at the medical treatment level, an increasing number of BPD premature infants are born, meanwhile, they would be at an increasing risk for numerous complications and rehospitalization because BPD affects many vital organ systems. The pathogenesis of BPD is clearly multifactorial. As the prognosis is closely connected with the severity of BPD, early diagnosis and treatment are of great help to control the development of BPD. This article focuses on risk factors that could influence the severity of BPD in order to provide a reliable basis for early diagnosis, treatment, and better patient assessment. PMID:25984426

  3. Iodine content of infant formulas and iodine intake of premature babies: high risk of iodine deficiency.

    PubMed

    Ares, S; Quero, J; Durán, S; Presas, M J; Herruzo, R; Morreale de Escobar, G

    1994-11-01

    As part of a study of thyroid function in premature babies, the iodine content of their mothers' breast milk, that of 32 formulas from different brands used in Spain, and that of 127 formulas used in other countries was determined. Breast milk contained more iodine--mean (SEM) 10 (1) microgram/dl--than most of the formulas, especially those for premature babies. Iodine intakes were therefore below the recommended daily amount (RDA) for newborns: babies of 27-30 weeks' gestational age took 3.1 (1.1) micrograms/day at 5 days of age and 29.8 (2.7) micrograms by 2 months of age. This problem is not exclusive to Spanish premature babies as the iodine content of many of the formulas on sale in other countries was also inadequate. It is concluded that preterm infants who are formula fed are at high risk of iodine deficiency. PMID:7820714

  4. Iodine content of infant formulas and iodine intake of premature babies: high risk of iodine deficiency.

    PubMed Central

    Ares, S; Quero, J; Durán, S; Presas, M J; Herruzo, R; Morreale de Escobar, G

    1994-01-01

    As part of a study of thyroid function in premature babies, the iodine content of their mothers' breast milk, that of 32 formulas from different brands used in Spain, and that of 127 formulas used in other countries was determined. Breast milk contained more iodine--mean (SEM) 10 (1) microgram/dl--than most of the formulas, especially those for premature babies. Iodine intakes were therefore below the recommended daily amount (RDA) for newborns: babies of 27-30 weeks' gestational age took 3.1 (1.1) micrograms/day at 5 days of age and 29.8 (2.7) micrograms by 2 months of age. This problem is not exclusive to Spanish premature babies as the iodine content of many of the formulas on sale in other countries was also inadequate. It is concluded that preterm infants who are formula fed are at high risk of iodine deficiency. PMID:7820714

  5. Respiratory Syncytial Virus-Associated Hospitalizations in Pre-Mature Infants in Lima, Peru

    PubMed Central

    Ochoa, Theresa J.; Bautista, Rossana; Dávila, Carmen; Salazar, José Antonio; Bazán, Carlos; Guerra, Oscar; Llanos, Jean Pierre; López, Luis; Zea-Vera, Alonso; Ecker, Lucie

    2014-01-01

    We conducted a prospective cohort study in four hospitals in Lima, Peru in infants with a birth weight ≤ 1,500 g followed from birth hospital discharge up to 1 year of age to determine the incidence of respiratory syncytial virus (RSV) hospitalizations. We enrolled 222 infants from March of 2009 to March of 2010: 48 infants with a birth weight < 1,000 g and 174 infants with a birth weight of 1,000–1,500 g (birth weight = 1,197 ± 224 g; gestational age = 30.1 ± 2.6 weeks). There were 936 episodes of respiratory infections; the incidence of respiratory infections during the first 1 year of life was 5.7 episodes/child-years. The incidence of RSV respiratory infections that required emergency room management was 103.9 per 1,000 child-years, and the incidence of RSV hospitalizations was 116.2 per 1,000 child-years (244.9 in infants with a birth weight < 1,000 g and 88.9 in infants 1,000–1,500 g; P < 0.05). The incidence of RSV respiratory infections that required emergency management or hospitalization is high among pre-mature infants in Lima. PMID:25294617

  6. A calibration system of O2 consumption and CO2 production for premature infants

    NASA Astrophysics Data System (ADS)

    Lin, Shih-Ching; Luo, Ching-Hsing; Yeh, Tsu-Fuh

    2001-03-01

    An apparatus to calibrate the system of measuring O2 consumption and CO2 production has been developed for premature infants. This system is based on the alcohol combustion principal. The alcohol combustion is used to test the indirect calorimetric system due to its simplicity and reliability. In the previous studies, the O2 consumption rate of alcoholic combustion is too large to simulate the breath of premature infants. A new design is proposed to burn alcohol continuously at a rate as low as 0.004 ml min-1, equivalent to an O2 consumption rate of only 3.9 ml min-1, a level in the breath range of preterms of about 660 g based on the measurement 5.9 ml kg-1 min-1. The alcohol combusts with various steady-state rates to imitate the breath of premature infants, and it is useful for a canopy open-circuit system. The calibration tool proposed here would be helpful in the clinical study of energy expenditure for preterms.

  7. Higher Rates of Retinopathy of Prematurity after Increasing Oxygen Saturation Targets for Very Preterm Infants: Experience in a Single Center.

    PubMed

    Manley, Brett J; Kuschel, Carl A; Elder, James E; Doyle, Lex W; Davis, Peter G

    2016-01-01

    Randomized trials of oxygen saturation target ranges for extremely preterm infants showed increased survival but increased retinopathy of prematurity with higher compared with lower target ranges. In our center, changing from a target range of 88%-92% to 91%-95% has been associated with increased rates and severity of retinopathy of prematurity. PMID:26548746

  8. Remifentanil for endotracheal intubation in premature infants: A randomized controlled trial

    PubMed Central

    Badiee, Zohreh; Vakiliamini, Mazyar; Mohammadizadeh, Majid

    2013-01-01

    Objective: Endotracheal intubation is a common procedure in neonatal care. The objective of this study was to determine whether the premedication with remifentanil before intubation has analgesic effects in newborn infants. Methods: A total of 40 premature infants who needed endotracheal intubation for intubation-surfactant-extubation method were randomly assigned in two groups of an equal number at two university hospitals. The control group was given 10 μg/kg atropine IV infusions in 1 min and then 2 ml normal saline. In the case group, the atropine was given with the same method and then remifentanil was administered 2 μg/kg IV infusions in 2 min. Findings: For remifentanil and control groups, the mean birth weight were 1761 ± 64 and 1447 ± 63 grams (P = 0.29), and the mean gestational ages were 31.69 ± 3.5 and 30.56 ± 2.8 weeks (P = 0.28), respectively. Using premature infant pain profile score, infants who received remifentanil felt significantly less pain than the control group (15.1 ± 1.6 vs. 7.5 ± 1.4; P < 0.001). There were no significant differences in the duration of endotracheal intubation procedure (20.8 ± 6 vs. 22.8 ± 7.3 s; P = 0.33), the number of attempts for successful intubation and oxygen desaturation between groups. Conclusion: Premedication with remifentanil has good analgesic effects for endotracheal intubation in premature infants without significant derangements in mean blood pressure and oxygen saturation. PMID:24991608

  9. Aggressive posterior retinopathy of prematurity in infants ≥ 1500 g birth weight.

    PubMed

    Sanghi, Gaurav; Dogra, Mangat R; Katoch, Deeksha; Gupta, Amod

    2014-02-01

    In this retrospective case series, we report the spectrum and outcomes of aggressive posterior retinopathy of prematurity (APROP) in infants ≥ 1500 g birth weight. Twenty-nine eyes of 15 infants are included. All infants were referred from level I or II nurseries, received supplemental unmonitored oxygen for prolonged duration (>1 week) and had multiple systemic co-morbidities. Of the 29 eyes, 10 (34.5%) had zone 1 and 19 (65.5%) had posterior zone 2 disease. Twenty-five (86.2%) eyes had flat neovascularization and 4 (13.8%) eyes had brush like proliferation. We noticed large vascular loops in 10 (34.5%) eyes. After confluent laser photocoagulation, 22 (75.9%) eyes had a favorable outcome. The study concludes that APROP in heavier (≥ 1500 g birth weight) premature infants occurs mostly in posterior zone 2 with flat neovascularization and atypical features like large vascular loops. Supplemental unmonitored oxygen for prolonged duration and multiple systemic co-morbidities could be a contributing factor. PMID:24618495

  10. Novel heart rate parameters for the assessment of autonomic nervous system function in premature infants.

    PubMed

    Lucchini, M; Fifer, W P; Sahni, R; Signorini, M G

    2016-09-01

    Autonomic nervous system (ANS) balance is a key factor in homeostatic control of cardiac activity, breathing and certain reflex reactions such as coughing, sneezing and swallowing and thus plays a crucial role for survival. ANS impairment has been related to many neonatal pathologies, including sudden infant death syndrome (SIDS). Moreover, some conditions have been identified as risk factors for SIDS, such as prone sleep position. There is an urgent need for timely and non-invasive assessment of ANS function in at-risk infants. Systematic measurement of heart rate variability (HRV) offers an optimal approach to access indirectly both sympathetic and parasympathetic influences on ANS functioning. In this paper, data from premature infants collected in a sleep physiology laboratory in the NICU are presented: traditional and novel approaches to HRV analyses are applied and compared in order to evaluate their relative merits in the assessment of ANS activity and the influence of sleep position. Indices from time domain and nonlinear approaches contributed as markers of physiological development in premature infants. Moreover, significant differences were observed as a function of sleep position. PMID:27480495

  11. Insulin-like growth factor binding protein-3 in preterm infants with retinopathy of prematurity

    PubMed Central

    Gharehbaghi, Manizheh Mostafa; Peirovifar, Ali; Sadeghi, Karim; Mostafidi, Haleh

    2012-01-01

    Background: Retinopathy of prematurity (ROP) is the main cause of visual impairment in preterm newborn infants. Objective: This study was conducted to determine whether insulin-like growth factor binding protein -3 (IGFBP-3) is associated with proliferative ROP and has a role in pathogenesis of the disease in premature infants. Materials and Methods: A total of 71 preterm infants born at or before 32 weeks of gestation participated in this study. Studied patients consisted of 41 neonates without vaso-proliferative findings of ROP as the control group and 30 preterm infants with evidence of severe ROP in follow up eye examination as the case group. Blood samples obtained from these infants 6-8 weeks after birth and blood levels of IGFBP-3 were measured using enzyme-linked immunosorbent assay (ELISA). Results: The mean gestation age and birth weight of the studied patients were 28.2±1.6 weeks and 1120.7±197 gram in the case group and 28.4±1.6 weeks and 1189.4±454 gram in the control group (P=0.25 and P=0.44 respectively). The infants in the case group had significantly lower Apgar score at first and 5 min after birth. Insulin-like growth factor binding protein -3 (IGFBP-3) was significantly lower in the patients with proliferative ROP than the patients without ROP [592.5±472.9 vs. 995.5±422.2 ng/ml (P=0.009)]. Using a cut-off point 770.45 ng/ml for the plasma IGFBP-3, we obtained a sensitivity of 65.9% and a specificity of 66.7% in the preterm infants with vasoproliferative ROP. Conclusion: Our data demonstrated that the blood levels IGFBP-3 was significantly lower in the patients with ROP and it is suspected that IGFBP-3 deficiency in the premature infants may have a pathogenetic role in proliferative ROP. PMID:23202391

  12. Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants: A randomized clinical trial

    PubMed Central

    Benjamin, Daniel K.; Hudak, Mark L.; Duara, Shahnaz; Randolph, David A.; Bidegain, Margarita; Mundakel, Gratias T.; Natarajan, Girija; Burchfield, David J.; White, Robert D.; Shattuck, Karen E.; Neu, Natalie; Bendel, Catherine M.; Kim, M. Roger; Finer, Neil N.; Stewart, Dan L.; Arrieta, Antonio C.; Wade, Kelly C.; Kaufman, David A.; Manzoni, Paolo; Prather, Kristi O.; Testoni, Daniela; Berezny, Katherine Y.; Smith, P. Brian

    2014-01-01

    IMPORTANCE Invasive candidiasis in premature infants causes mortality and neurodevelopmental impairment. Fluconazole prophylaxis reduces candidiasis, but its effect on mortality and the safety of fluconazole is unknown. OBJECTIVE To evaluate the efficacy and safety of fluconazole in preventing death or invasive candidiasis in extremely low-birth-weight infants. DESIGN, SETTING, AND PATIENTS This study was a randomized, blinded, placebo-controlled trial of fluconazole in premature infants. Infants weighing less than 750 g at birth (N = 361) from 32 neonatal intensive care units (NICUs) in the United States were randomly assigned to receive either fluconazole or placebo twice weekly for 42 days. Surviving infants were evaluated at 18 to 22 months corrected age for neurodevelopmental outcomes. The study was conducted between November 2008 and February 2013. INTERVENTIONS Fluconazole (6 mg/kg of body weight) or placebo. MAIN OUTCOMES AND MEASURES The primary end point was a composite of death or definite or probable invasive candidiasis prior to study day 49 (1 week after completion of study drug). Secondary and safety outcomes included invasive candidiasis, liver function, bacterial infection, length of stay, intracranial hemorrhage, periventricular leukomalacia, chronic lung disease, patent ductus arteriosus requiring surgery, retinopathy of prematurity requiring surgery, necrotizing enterocolitis, spontaneous intestinal perforation, and neurodevelopmental outcomes—defined as a Bayley-III cognition composite score of less than 70, blindness, deafness, or cerebral palsy at 18–22-months corrected age. RESULTS Among infants receiving fluconazole, the composite primary end point of death or invasive candidiasis was 16% (95% CI, 11%–22%) vs 21% in the placebo group (95% CI, 15%–28%; odds ratio 0.73 [95% CI 0.43–1.23]; P=.24; treatment difference −5% [95% CI, −13%–3%]). Invasive candidiasis occurred less frequently in the fluconazole group (3% [95% CI, 1%

  13. Effects of White Matter Injury on Resting State fMRI Measures in Prematurely Born Infants

    PubMed Central

    Smyser, Christopher D.; Snyder, Abraham Z.; Shimony, Joshua S.; Blazey, Tyler M.; Inder, Terrie E.; Neil, Jeffrey J.

    2013-01-01

    The cerebral white matter is vulnerable to injury in very preterm infants (born prior to 30 weeks gestation), resulting in a spectrum of lesions. These range from severe forms, including cystic periventricular leukomalacia and periventricular hemorrhagic infarction, to minor focal punctate lesions. Moderate to severe white matter injury in preterm infants has been shown to predict later neurodevelopmental disability, although outcomes can vary widely in infants with qualitatively comparable lesions. Resting state functional connectivity magnetic resonance imaging has been increasingly utilized in neurodevelopmental investigations and may provide complementary information regarding the impact of white matter injury on the developing brain. We performed resting state functional connectivity magnetic resonance imaging at term equivalent postmenstrual age in fourteen preterm infants with moderate to severe white matter injury secondary to periventricular hemorrhagic infarction. In these subjects, resting state networks were identifiable throughout the brain. Patterns of aberrant functional connectivity were observed and depended upon injury severity. Comparisons were performed against data obtained from prematurely-born infants with mild white matter injury and healthy, term-born infants and demonstrated group differences. These results reveal structural-functional correlates of preterm white matter injury and carry implications for future investigations of neurodevelopmental disability. PMID:23874510

  14. Auditory Stimuli Mimicking Ambient Sounds Drive Temporal “Delta-Brushes” in Premature Infants

    PubMed Central

    Chipaux, Mathilde; Colonnese, Matthew T.; Mauguen, Audrey; Fellous, Laure; Mokhtari, Mostafa; Lezcano, Oscar; Milh, Mathieu; Dulac, Olivier; Chiron, Catherine; Khazipov, Rustem; Kaminska, Anna

    2013-01-01

    In the premature infant, somatosensory and visual stimuli trigger an immature electroencephalographic (EEG) pattern, “delta-brushes,” in the corresponding sensory cortical areas. Whether auditory stimuli evoke delta-brushes in the premature auditory cortex has not been reported. Here, responses to auditory stimuli were studied in 46 premature infants without neurologic risk aged 31 to 38 postmenstrual weeks (PMW) during routine EEG recording. Stimuli consisted of either low-volume technogenic “clicks” near the background noise level of the neonatal care unit, or a human voice at conversational sound level. Stimuli were administrated pseudo-randomly during quiet and active sleep. In another protocol, the cortical response to a composite stimulus (“click” and voice) was manually triggered during EEG hypoactive periods of quiet sleep. Cortical responses were analyzed by event detection, power frequency analysis and stimulus locked averaging. Before 34 PMW, both voice and “click” stimuli evoked cortical responses with similar frequency-power topographic characteristics, namely a temporal negative slow-wave and rapid oscillations similar to spontaneous delta-brushes. Responses to composite stimuli also showed a maximal frequency-power increase in temporal areas before 35 PMW. From 34 PMW the topography of responses in quiet sleep was different for “click” and voice stimuli: responses to “clicks” became diffuse but responses to voice remained limited to temporal areas. After the age of 35 PMW auditory evoked delta-brushes progressively disappeared and were replaced by a low amplitude response in the same location. Our data show that auditory stimuli mimicking ambient sounds efficiently evoke delta-brushes in temporal areas in the premature infant before 35 PMW. Along with findings in other sensory modalities (visual and somatosensory), these findings suggest that sensory driven delta-brushes represent a ubiquitous feature of the human sensory

  15. A Century of Germinal Matrix Intraventricular Hemorrhage in Autopsied Premature Infants: A Historical Account.

    PubMed

    Hefti, Marco M; Trachtenberg, Felicia L; Haynes, Robin L; Hassett, Catherine; Volpe, Joseph J; Kinney, Hannah C

    2016-01-01

    The care of premature infants in the 20th century is remarkable for technical advances that have dramatically improved survival, but little is known about temporal changes in the neuropathology of the premature infant over this time frame. We hypothesize that the autopsy rate of germinal matrix hemorrhage changed in the 20th century relative to combined influences of clinical interventions that were both harmful and helpful. We examined germinal matrix hemorrhage with intraventricular hemorrhage (GMH-IVH) in 345 premature infants (gestational age 25-36 weeks) autopsied at Boston Children's Hospital from 1914 to 2015. There was a median of 19 cases/decade (range 7-68). Over the course of the study median gestational age decreased from 33 to 27 gestational weeks (P<0.001), and median postnatal survival increased from 2 to 26 days (P=0.02). The incidence of GMH-IVH increased from 4.7% before 1960 to 50.0% from 1975 to 1980, and then decreased to 12.5% after 2005 (P<0.001). The incidence of GMH-IVH increased >3-fold around the time of the introduction of positive pressure ventilation into premature intensive care in the mid-1960s. The increased incidence of GMH-IVH in the 1970s-1980s likely reflects respiratory and hemodynamic imbalances complicating mechanical ventilation. We speculate that the subsequent decreased incidence of GMH-IVH likely reflects stabilization of respiratory function with improvements in ventilators and in ventilator management beginning in the 1970s and the use of surfactant and antenatal steroids in the 1980s. PMID:26372101

  16. Prospective study of healthcare utilisation and respiratory morbidity due to RSV infection in prematurely born infants

    PubMed Central

    Broughton, S; Roberts, A; Fox, G; Pollina, E; Zuckerman, M; Chaudhry, S; Greenough, A

    2005-01-01

    Background: A study was undertaken to determine the impact of respiratory syncytial virus (RSV) infection, both in hospital and the community, on healthcare utilisation and respiratory morbidity in prematurely born infants and to identify risk factors for symptomatic RSV infection. Methods: A hospital and community follow up study was undertaken of 126 infants born before 32 weeks of gestational age. Healthcare utilisation (hospital admissions and general practitioner attendances) in the first year, respiratory morbidity at follow up (wheeze and cough documented by parent completed diary cards), and RSV positive lower respiratory tract infections (LRTIs) were documented. Nasopharyngeal aspirates were obtained for immunofluorescence and culture for RSV whenever the infants had an LRTI, either in the community or in hospital. Results: Forty two infants had an RSV positive LRTI (RSV group), 50 had an RSV negative LRTI (RSV negative LRTI group), and 32 infants had no LRTI (no LRTI group). Compared with the RSV negative LRTI and the no LRTI groups, the RSV group required more admissions (p = 0.392, p<0.001) and days in hospital (p = 0.049, p = 0.006) and had more cough (p = 0.05, p = 0.038) and wheeze (p = 0.003, p = 0.003) at follow up. Significant risk factors for symptomatic RSV LRTI were number of siblings (p = 0.035) and maternal smoking in pregnancy (p = 0.005), for cough were number of siblings (p = 0.002) and RSV LRTI (p = 0.02), and for wheeze was RSV LRTI (p = 0.019). Conclusion: RSV infection, even if hospital admission is not required, is associated with increased subsequent respiratory morbidity in prematurely born infants. PMID:16227330

  17. The Mother-Infant Feeding Relationship across the First Year and the Development of Feeding Difficulties in Low-Risk Premature Infants

    ERIC Educational Resources Information Center

    Silberstein, Dalia; Feldman, Ruth; Gardner, Judith M.; Karmel, Bernard Z.; Kuint, Jacob; Geva, Ronny

    2009-01-01

    Although feeding problems are common during infancy and are typically accompanied by relational difficulties, little research observed the mother-infant feeding relationship across the first year as an antecedent to the development of feeding difficulties. We followed 76 low-risk premature infants and their mothers from the transition to oral…

  18. Skin-to-Skin Contact (Kangaroo Care) Promotes Self-Regulation in Premature Infants: Sleep-Wake Cyclicity, Arousal Modulation, and Sustained Exploration.

    ERIC Educational Resources Information Center

    Feldman, Ruth; Weller, Aron; Sirota, Lea; Eidelman, Arthur I.

    2002-01-01

    Investigated the effect of mother-infant skin-to-skin contact on self-regulatory processes of premature infants. Found that infants treated with prolonged skin-to-skin contact showed improvements in state distribution, sleep-wake cyclicity, emotionality thresholds, arousal modulation, mother-infant shared attention, and infant sustained…

  19. Late-Onset Bloodstream Infection and Perturbed Maturation of the Gastrointestinal Microbiota in Premature Infants

    PubMed Central

    Randell, Paul; Cox, Michael J.; McClure, Zoë E.; Li, Ming-Shi; Donaldson, Hugo; Langford, Paul R.; Cookson, William O. C. M.; Moffatt, Miriam F.; Kroll, J. Simon

    2015-01-01

    Background Late-onset bloodstream infection (LO-BSI) is a common complication of prematurity, and lack of timely diagnosis and treatment can have life-threatening consequences. We sought to identify clinical characteristics and microbial signatures in the gastrointestinal microbiota preceding diagnosis of LO-BSI in premature infants. Method Daily faecal samples and clinical data were collected over two years from 369 premature neonates (<32 weeks gestation). We analysed samples from 22 neonates who developed LO-BSI and 44 matched control infants. Next-generation sequencing of 16S rRNA gene regions amplified by PCR from total faecal DNA was used to characterise the microbiota of faecal samples preceding diagnosis from infants with LO-BSI and controls. Culture of selected samples was undertaken, and bacterial isolates identified using MALDI-TOF. Antibiograms from bloodstream and faecal isolates were compared to explore strain similarity. Results From the week prior to diagnosis, infants with LO-BSI had higher proportions of faecal aerobes/facultative anaerobes compared to controls. Risk factors for LO-BSI were identified by multivariate analysis. Enterobacteriaceal sepsis was associated with antecedent multiple lines, low birth weight and a faecal microbiota with prominent Enterobacteriaceae. Staphylococcal sepsis was associated with Staphylococcus OTU faecal over-abundance, and the number of days prior to diagnosis of mechanical ventilation and of the presence of centrally-placed lines. In 12 cases, the antibiogram of the bloodstream isolate matched that of a component of the faecal microbiota in the sample collected closest to diagnosis. Conclusions The gastrointestinal tract is an important reservoir for LO-BSI organisms, pathogens translocating across the epithelial barrier. LO-BSI is associated with an aberrant microbiota, with abundant staphylococci and Enterobacteriaceae and a failure to mature towards predominance of obligate anaerobes. PMID:26167683

  20. Relationship Between Hemodynamically Significant Ductus Arteriosus and Ischemia-Modified Albumin in Premature Infants.

    PubMed

    Kahveci, Hasan; Tayman, Cüneyt; Laloğlu, Fuat; Kavas, Nazan; Ciftel, Murat; Yılmaz, Osman; Laloğlu, Esra; Erdil, Abdulah; Aksoy, Hülya; Aydemir, Salih

    2016-04-01

    Hemodynamically significant ductus arteriosus (hsPDA) may alter organ perfusion by interfering blood flow to the tissues. Therefore, in infants with hsPDA, hypoxia occurs in many tissues. In this study, we aimed to investigate the diagnostic significance of serum (ischemia-modified albumin) IMA levels as a screening tool for hsPDA, and its relation to the severity of the disease in the preterm neonates. For this purpose, seventy-two premature infants with gestation age <34 weeks were included in the study. Thirty premature infants with hsPDA were assigned as the study group and 42 premature infants without PDA were determined as the control group. Blood samples were collected before the treatment and 24 h after the treatment, and analyzed for IMA levels. IMA levels in the study group (1.26 ± 0.36 ABSU) were found to be significantly higher than control group (0.65 ± 0.12 ABSU) (p < 0.05). In infants with hsPDA, a positive correlation was found between IMA and PDA diameter (ρ = 0.876, p = 0.022), and LA/Ao ratio (ρ = 0.863, p = 0.014). The cut-off value of IMA for hsPDA was measured as 0.78 ABSU with 88.89 % sensitivity, and 90.24 % specificity, 85.71 % positive predictive, 92.5 % negative predictive value [area under the curve (AUC) = 0.96; p < 0.001]. The mean IMA value of the infants with hsPDA before treatment was 1.26 ± 0.36 ABSU, and the mean IMA value of infants after medical treatment was 0.67 ± 0.27 ABSU (p = 0.03). We concluded that IMA can be used as a marker for the diagnosis and monitoring of a successful treatment of hsPDA. PMID:27069332

  1. [Mothers' experiences and perspectives regarding their premature infant's stay at the neonatal intensive care unit].

    PubMed

    de Araújo, Bárbara Bertolossi Marta; Rodrigues, Benedita Maria Rêgo Deusdará

    2010-12-01

    The purpose of this study was to learn the reason why mothers remain at the hospital throughout the stay of their premature infant at the Neonatal Intensive Care Unit. The study was performed with twelve mothers to premature newborns at a municipal maternity hospital in Rio de Janeiro, in 2007. The methodological support used in the study was the Sociological Phenomenology of Alfred Schütz. The phenomenological interview was used to capture the mothers' discourse, whose intentional action was unveiled through the following categories: Taking care of the child--dealing with the challenge of having a small baby; Staying near the premature child--the mother's presence helps the child's recovery to be faster; Reciprocal help among mothers--reinforcing hope every day. Rooming-in care stands out as an innovative and relevant initiative during the hospital stay of preterm infants, and it is considered an environment for living together, sharing experiences, and giving mutual support throughout the long and difficult stay at the hospital. PMID:21337767

  2. Retinopathy of prematurity

    MedlinePlus

    Retinopathy of prematurity (ROP) is abnormal blood vessel development in the retina of the eye. It occurs in infants ... Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics . 2013;131(1):189-95. PMID: 23277315 ...

  3. Macular edema in Asian Indian premature infants with retinopathy of prematurity: Impact on visual acuity and refractive status after 1-year

    PubMed Central

    Vinekar, Anand; Mangalesh, Shwetha; Jayadev, Chaitra; Bauer, Noel; Munusamy, Sivakumar; Kemmanu, Vasudha; Kurian, Mathew; Mahendradas, Padmamalini; Avadhani, Kavitha; Shetty, Bhujang

    2015-01-01

    Purpose: To report the impact of transient, self-resolving, untreated “macular edema” detected on spectral domain optical coherence tomography in Asian Indian premature infants with retinopathy of prematurity (ROP) on visual acuity (VA) and refraction at 1-year of corrected age. Materials and Methods: Visual acuity and refraction of 11 infants with bilateral macular edema (Group A) was compared with gestational age-matched 16 infants with ROP without edema (Group B) and 17 preterms infants without ROP and without edema (Group C) at 3, 6, 9 and 12 months of corrected age using Teller Acuity Cards and cycloplegic retinoscopy. Sub-group analysis of the previously described pattern A and B macular edema was performed. Results: Visual acuity was lower in infants with macular edema compared with the other two control groups throughout the study period, but statistically significant only at 3 months. Visual improvement in these infants was highest between the 3rd and 6th month and plateaued by the end of the 1st year with acuity comparable to the other two groups. The edema cohort was more hyperopic compared to the other two groups between 3 and 12 months of age. Pattern A edema had worse VA compared to pattern B, although not statistically significant. Conclusion: Macular edema, although transient, caused reduced VA as early as 3 months of corrected age in Asian Indian premature infants weighing <2000 g at birth. The higher hyperopia in these infants is possibly due to visual disturbances caused at a critical time of fovealization. We hypothesize a recovery and feedback mechanism based on the principles of active emmetropization to explain our findings. PMID:26139806

  4. Results of screening low-birth-weight infants for retinopathy of prematurity.

    PubMed

    Clemett, R; Darlow, B

    1999-06-01

    Retinopathy of prematurity (ROP) continues to be an important cause of potentially preventable blindness worldwide. The pattern of visual impairment from ROP in some middle-income countries--high rates affecting larger and more mature infants--resembles that seen in more developed countries two decades ago and has been called a "third epidemic" of the disease. Expert bodies in the United Kingdom and the United States have recently issued new guidelines for screening for ROP that utilize both birth weight and gestational age criteria. Studies in both countries suggest these criteria might be further revised to decrease time spent on screening without missing any significant disease. Population-based follow-up studies of extremely preterm infants suggest that although more preterm infants are surviving, with adequate screening and treatment, rates of blindness from ROP may be declining. Further information on the longer-term impact of ROP comes from a number of studies and particularly the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study. The risk of both myopia and strabismus is increased with any and each higher stage of ROP. Evidence is emerging that laser therapy for threshold disease may be associated with better visual outcome than cryotherapy, although complications following the former remain a concern. The fight against ROP may be enhanced by new information on the pathogenesis, including possible genetic predisposition and the role of vascular endothelial growth factor. PMID:10537772

  5. Salivary FOXP2 expression and oral feeding success in premature infants

    PubMed Central

    Zimmerman, Emily; Maki, Monika; Maron, Jill

    2016-01-01

    The objective of the study is to determine whether salivary FOXP2 gene expression levels at the initiation of oral feeding attempts are predictive of oral feeding success in the premature newborn. In this prospective study, saliva samples from 21 premature infants (13 males; birth gestational age [GA]: 30–34 wk) were collected around the initiation of oral feeding trials. Total RNA was extracted and underwent reverse transcription-quantitative polymerase chain reaction amplification for FOXP2. Oral feeding success was denoted by the days required to attain full oral feeds. A linear regression model, controlling for sex, birth GA, and weight at salivary collection, revealed that FOXP2 expression was significantly associated with oral feeding success (P = 0.002). The higher the expression level of FOXP2, the shorter the duration to feed. Salivary FOXP2 expression levels are significantly associated with oral feeding success in the preterm infant. FOXP2 may serve as a novel and informative biomarker to noninvasively assess infant feeding skills to reduce morbidities and length of stay. PMID:27148579

  6. Late onset haemorrhagic disease in premature infants who received intravenous vitamin K1.

    PubMed

    Loughnan, P M; McDougall, P N; Balvin, H; Doyle, L W; Smith, A L

    1996-06-01

    The clinical details are reported of two premature infants who developed late onset haemorrhagic disease after receiving their initial doses of vitamin K1 prophylaxis intravenously. Both reported infants had received two doses of intravenous vitamin K1, 0.1 mg, in the 1st week of life, and a further oral dose, 1.0 mg, at 4 weeks. Bleeding due to vitamin K deficiency occurred on days 74 and 84, respectively. Vitamin K deficiency bleeding is rare in low birthweight infants, probably because it has been routine practice to give such infants intramuscular vitamin K1. One of the reported infants had cytomegalovirus hepatitis, the other did not have liver disease. These findings could be explained if intramuscular vitamin K1 were to have a longer duration of effect than intravenous vitamin K1. This may be because intramuscular vitamin K1 acts as a depot preparation. The findings suggest that intravenous vitamin K1 is less effective than intramuscular for long-term prophylaxis against late onset haemorrhagic disease. Intravenous vitamin K1 should not be used for long-term prophylaxis in the prevention of late onset haemorrhagic disease. PMID:8827551

  7. Parental Leave Policy as a Strategy to Improve Outcomes among Premature Infants.

    PubMed

    Greenfield, Jennifer C; Klawetter, Susanne

    2016-02-01

    Although gains have been made in premature birth rates among racial and ethnic minority and low socioeconomic status populations, tremendous disparities still exist in both prematurity rates and health outcomes for preterm infants. Parental involvement is known to improve health outcomes for preterm babies. However, a gap in evidence exists around whether parental involvement can help ameliorate the disparities in both short- and long-term out-comes for their preterm children. Families more likely to experience preterm birth are also less likely to have access to paid leave and thus experience significant systemic barriers to involvement, especially when their newborns are hospitalized. This article describes the research gap in this area and explores pathways by which social workers may ameliorate disparities in preterm birth outcomes through practice, policy, and research. PMID:26946882

  8. Effects of developmental music groups for parents and premature or typical infants under two years on parental responsiveness and infant social development.

    PubMed

    Walworth, Darcy D

    2009-01-01

    The purpose of this study was to examine the effect of music therapy intervention on premature infants' and full term infants' developmental responses and parents' responsiveness. Subjects (n=56) were parent-infant dyads who attended developmental music groups or a control condition assessing responsiveness during toy play. All subjects were matched according to developmental age and were also matched by group for socioeconomic status and for maternal depression. Types of infant play and parent responsiveness were measured using observation of a standardized toy play for parent-infant dyads. Observations were coded with the number of seconds spent in each behavior using the SCRIBE observation program. Parents completed a questionnaire on the perception of their infant's general development, interpretations of their child's needs, the purpose of using music with their child, and their child's response to music. The infants attending the developmental music groups with their parents demonstrated significantly more social toy play (p < .05) during the standardized parent-infant toy play than infants who did not attend the music groups. While not significant, graphic analysis of parent responsiveness showed parents who attended the developmental music groups engaged in more positive and less negative play behaviors with their infants than parents who did not attend the music groups. This study demonstrates the first findings of positive effects of developmental music groups on social behaviors for both premature and full term infants under 2 years old. PMID:19256731

  9. SFTPC gene mutation p.R167Q in a premature infant.

    PubMed

    Jon, Cindy; Nolan, Paul K; Ekong, Mfon; Mosquera, Ricardo A; Stark, James M

    2014-03-01

    We present an infant who was born premature at 23 weeks gestation with bronchopulmonary dysplasia and a SFTPC gene mutation, p.R167Q, who had a complicated neonatal course requiring 4 months of mechanical ventilation. Over time, his clinical course has improved, and he only requires oxygen by nasal cannula and low dose hydroxychloroquine, suggesting that p.R167Q mutation contributed to his clinical course and may manifest with a variable disease pattern making long-term prognostication difficult in the immediate newborn period. PMID:23775869

  10. Fulminant transfusion-associated graft-versus-host disease in a premature infant

    SciTech Connect

    Berger, R.S.; Dixon, S.L.

    1989-05-01

    A fatal case of transfusion-associated graft-versus-host disease developed in a premature infant after receiving several blood products, including nonirradiated white blood cells. Transfusion-associated graft-versus-host disease can be prevented. Irradiation of blood products is the least controversial and most effective method. Treatment was unsuccessful in most reported cases of transfusion-associated graft-versus-host disease. Therefore irradiation of blood products before transfusing to patients susceptible to transfusion-associated graft-versus-host disease is strongly recommended.

  11. Premature infants display increased noxious-evoked neuronal activity in the brain compared to healthy age-matched term-born infants.

    PubMed

    Slater, Rebeccah; Fabrizi, Lorenzo; Worley, Alan; Meek, Judith; Boyd, Stewart; Fitzgerald, Maria

    2010-08-15

    This study demonstrates that infants who are born prematurely and who have experienced at least 40days of intensive or special care have increased brain neuronal responses to noxious stimuli compared to healthy newborns at the same postmenstrual age. We have measured evoked potentials generated by noxious clinically-essential heel lances in infants born at term (8 infants; born 37-40weeks) and in infants born prematurely (7 infants; born 24-32weeks) who had reached the same postmenstrual age (mean age at time of heel lance 39.2+/-1.2weeks). These noxious-evoked potentials are clearly distinguishable from shorter latency potentials evoked by non-noxious tactile sensory stimulation. While the shorter latency touch potentials are not dependent on the age of the infant at birth, the noxious-evoked potentials are significantly larger in prematurely-born infants. This enhancement is not associated with specific brain lesions but reflects a functional change in pain processing in the brain that is likely to underlie previously reported changes in pain sensitivity in older ex-preterm children. Our ability to quantify and measure experience-dependent changes in infant cortical pain processing will allow us to develop a more rational approach to pain management in neonatal intensive care. PMID:20438855

  12. Persistence of Retinopathy of Prematurity in an Infant with Tetralogy of Fallot.

    PubMed

    Gunay, Murat; Yavuz, Taner; Celik, Gokhan; Uludag, Gunay

    2016-01-01

    We report an infant with tetralogy of fallot (TOF) who was born at 35 weeks of gestation and of 1700 g birth weight and presented with persistent retinopathy of prematurity (ROP) at 6 months of age. Follow-up ophthalmic examinations were done at 2, 3, and 4 weeks of age. A demarcation line in Zone II was noticed on the first ocular examination done at 4 weeks of postnatal age. At 6 months of postnatal age, the infant still had an avascular peripheral retina with the demarcation line in Zone II. Even though this index subject did not have any typical risk factors for ROP, TOF seems to be the probable reason for developing as well as persistence of avascular retina. PMID:27525147

  13. Persistence of Retinopathy of Prematurity in an Infant with Tetralogy of Fallot

    PubMed Central

    Celik, Gokhan; Uludag, Gunay

    2016-01-01

    We report an infant with tetralogy of fallot (TOF) who was born at 35 weeks of gestation and of 1700 g birth weight and presented with persistent retinopathy of prematurity (ROP) at 6 months of age. Follow-up ophthalmic examinations were done at 2, 3, and 4 weeks of age. A demarcation line in Zone II was noticed on the first ocular examination done at 4 weeks of postnatal age. At 6 months of postnatal age, the infant still had an avascular peripheral retina with the demarcation line in Zone II. Even though this index subject did not have any typical risk factors for ROP, TOF seems to be the probable reason for developing as well as persistence of avascular retina. PMID:27525147

  14. How to Help Parents, Couples, and Clinicians When an Extremely Premature Infant Is Born.

    PubMed

    Howe, Edmund G

    2015-01-01

    Parents may experience profound stress when their infant is extremely premature or has exceptionally low birth weight. This article presents several approaches that clinicians and ethics consultants can use to reduce this stress when a parent is single and alone, as well as when both parents are present. Offering parents additional options, taking preventative measures, and using approaches based on recent innovations in psychotherapies are emphasized. Since the clinicians who care for these neonates may find it exceptionally stressful and may experience "burn out," especially over time, this article also addresses what may work best for them. Finally it will discuss clinicians, who, despite their best efforts, find that caring for these infants is simply too painful to bear. PMID:26399669

  15. Serum erythropoietin concentrations in symptomatic infants during the anaemia of prematurity.

    PubMed

    Meyer, J; Sive, A; Jacobs, P

    1992-07-01

    A comparison was carried out between a series of neonates who weighed less than 1500 g at birth and received red cell transfusions for symptomatic anaemia of prematurity (group 1, n = 14) and controls of similar gestational age and weight, who remained well and were not transfused during their nursery stay (group 2, n = 10). Mean (SD) haemoglobin concentrations at birth were 163 (12) g/l and 183 (17) g/l (p = 0.004), respectively. Transfusion resulted in significantly better weight gain in six infants who had been growing poorly:mean (SE) 8.8 (2.8) g/day improved to 23.3 (2.1) g/day (p less than 0.002). Geometric mean (SD) serum immunoreactive erythropoietin (SiEp) concentrations (17.7 (1.3) U/l) for the whole group of infants were similar to those of normal adults (17.4 (4.7) U/l) despite considerably reduced haemoglobin values. There was a significant inverse correlation between haemoglobin and log SiEp concentrations in the infants requiring transfusion (r = -0.43; p less than 0.01), but this was not apparent in the untransfused babies. Moreover, at haemoglobin concentrations below 120 g/l the mean (SE) SiEp concentration of 20 (1.08) U/l in group 1 was significantly higher than in group 2 (14 (1.06) U/l; p = 0.002). These data suggest that an increased concentration of SiEp early in the course of the anaemia of prematurity helps to identify those infants who would benefit from red cell transfusions, but that clinical criteria, although ill defined, do so equally well. PMID:1519982

  16. Measurement of total body potassium in premature infants by means of a whole-body counter

    SciTech Connect

    Spady, D.W.; Filipow, L.J.; Overton, T.R.; Szymanski, W.A.

    1986-09-01

    This paper describes a whole-body counter (WBC) specially designed to measured total body potassium (TBK) infants under 4500 g. The counter is a ''shadow shield'' design and consists of a single 10 cm X 10 cm X 45 cm NaI(Tl) crystal, positioned lengthwise and shielded from environmental background radiation by a minimum of 10 cm of lead. The standard error of counting for a 2000-s counting period is 19.9% for a 1000-g infant and 11.9% for a 2000-g infant. TBK of stillborn pigs, measured by the WBC, agreed to an average of 3% of TBK determined by carcass analysis in the same animals. A total of 118 measurements of TBK have been made in 50 premature infants ranging in weight between 1100 and 3600 g and in age between 2 and 75 days. The observed relationship of TBK with weight is described by the equation: TBK (mEq) = 0.0433Wt (g + 1.57 r = 0.92. Potassium retention per gram weight gain is estimated to be 0.043 mEq. The obtained TBK values agree well with values published by other workers but extend the range of measurement to 1100 g.

  17. Insulin, Hyperglycemia, and Severe Retinopathy of Prematurity in Extremely Low-Birth-Weight Infants.

    PubMed

    Lee, Jan Hau; Hornik, Christoph P; Testoni, Daniela; Laughon, Matthew M; Cotten, C Michael; Maldonado, Ramiro S; Belcastro, Marc R; Clark, Reese H; Smith, P Brian

    2016-03-01

    Objective This study aims to determine the association between hyperglycemia, insulin therapy, and severe retinopathy of prematurity (ROP) in extremely low-birth-weight (ELBW) infants. Study Design In this retrospective database study, we included all ELBW infants who were ≤ 32 weeks gestational age (GA). We excluded infants without any ophthalmology evaluation and infants who died before 28 days of life. A multivariable model was constructed to determine the association between hyperglycemia, insulin use, and severe ROP. We defined hyperglycemia as blood glucose (BG) > 180 mg/dL. Covariates were GA, small for GA status, discharge year, sex, Apgar score at 5 minutes, mechanical ventilation, oxygen use, bacteremia, and postnatal steroid exposure. We defined severe ROP as ROP requiring bevacizumab, cryotherapy, laser therapy, or vitrectomy. Sensitivity analysis using BG > 150 mg/dL and > 200 mg/dL was performed. Results A total of 24,548 infants were included; 2,547 (10%) had severe ROP. Hyperglycemia alone was not associated with severe ROP (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.66-1.17). Hyperglycemia and insulin use were not associated with severe ROP (OR, 1.43; 95% CI, 0.91-2.23). BG > 150 mg/dL and insulin use were associated with severe ROP (OR, 1.34; 95% CI, 1.02-1.76). Conclusions Hyperglycemia alone was not associated with severe ROP in ELBW infants. However, we did observe a possible trend between the use of insulin and severe ROP. PMID:26485249

  18. Recognition of the efficacy of relaxation program on sleep quality of mothers with premature infants

    PubMed Central

    Karbandi, Soheila; Hosseini, Seyedeh Maryam; Masoudi, Reza; Hosseini, Seyedeh Asieh; Sadeghi, Farshad; Moghaddam, Maryam Hesari

    2015-01-01

    Background and Aim: The postpartum period is a critical then effects on the structure of the family. Most women in the postpartum period may place at risk of undesirable experiences such as changes in sleep patterns. Therefore, this study aimed to identify the efficacy of the relaxation program on sleep quality of mothers with premature infants. Materials and Methods: This study is a clinical trial that 60 mothers with premature infants. The mothers in the intervention group were trained for muscle progressive relaxation by Jacobson method within 24–72 h after delivery. Research tool was the Pittsburgh Sleep Quality Index, which was completed by the mother at the beginning of the study, end of the first and the second 4-week. Data were analyzed using parametric statistics tests by SPSS software version 16. Results: No significant difference was observed between two groups in terms of underlying characteristics (P < 0.05). The independent t-test at the beginning of the study showed that the comparison of the mean scores of mothers’ sleep quality has no significant difference between two groups (P = 0.43). But, 1-month after the intervention (P = 0.024) and 2 months after the intervention (P > 0.001), mean sleep quality score in the intervention group was significantly less than the control group. Conclusion: Relaxation training can improve mothers’ sleep quality at postpartum period. PMID:27462639

  19. Regulation of end-expiratory lung volume during sleep in premature infants.

    PubMed

    Stark, A R; Cohlan, B A; Waggener, T B; Frantz, I D; Kosch, P C

    1987-03-01

    To investigate the regulation of end-expiratory lung volume (EEV) in premature infants, we recorded airflow, tidal volume, diaphragm electromyogram (EMG), and chest wall displacement during sleep. In quiet sleep, EEV during breathing was 10.8 +/- 3.6 (SD) ml greater than the minimum volume reached during unobstructed apneas. In active sleep, no decrease in EEV was observed during 28 of 35 unobstructed apneas. Breaths during quiet sleep had a variable extent of expiratory airflow retardation (braking), and inspiratory interruption occurred at substantial expiratory flow rates. During active sleep, the expiratory flow-volume curve was nearly linear, proceeding nearly to the volume axis at zero flow, and diaphragm EMG activity terminated near the peak of mechanical inspiration. Expiratory duration (TE) and inspiratory duration (TI) were significantly shortened in quiet sleep vs. active sleep although tidal volume was not significantly different. In quiet sleep, diaphragmatic braking activity and shortened TE combined to maintain EEV during breathing substantially above relaxation volume. In active sleep, reduced expiratory braking and prolongation of TE resulted in an EEV that was close to relaxation volume. We conclude that breathing strategy to regulate EEV in premature infants appears to be strongly influenced by sleep state. PMID:3571069

  20. Gray matter injury associated with periventricular leukomalacia in the premature infant

    PubMed Central

    Folkerth, Rebecca D.; Billiards, Saraid S.; Trachtenberg, Felicia L.; Drinkwater, Mark E.; Volpe, Joseph J.; Kinney, Hannah C.

    2007-01-01

    Neuroimaging studies indicate reduced volumes of certain gray matter regions in survivors of prematurity with periventricular leukomalacia (PVL). We hypothesized that subacute and/or chronic gray matter lesions are increased in incidence and severity in PVL cases compared to non-PVL cases at autopsy. Forty-one cases of premature infants were divided based on cerebral white matter histology: PVL (n = 17) with cerebral white matter gliosis and focal periventricular necrosis; diffuse white matter gliosis (DWMG) (n = 17) without necrosis; and “ Negative” group (n = 7) with no abnormalities. Neuronal loss was found almost exclusively in PVL, with significantly increased incidence and severity in the thalamus (38%), globus pallidus (33%), and cerebellar dentate nucleus (29%) compared to DWMG cases. The incidence of gliosis was significantly increased in PVL compared to DWMG cases in the deep gray nuclei (thalamus/basal ganglia; 50–60% of PVL cases), and basis pontis (100% of PVL cases). Thalamic and basal ganglionic lesions occur almost exclusively in infants with PVL. Gray matter lesions occur in a third or more of PVL cases suggesting that white matter injury generally does not occur in isolation, and that the term “perinatal panencephalopathy” may better describe the scope of the neuropathology. PMID:17912538

  1. A premature low-birth-weight infant with congenital complete atrioventricular block and myocarditis successfully treated by staged pacemaker implantation.

    PubMed

    Fujioka, Tao; Nii, Masaki; Tanaka, Yasuhiko

    2016-06-01

    Congenital complete atrioventricular block is a known lethal condition. Although antenatal diagnosis and the technical advances of pacemaker treatment have reduced its mortality, treatment of premature babies with significant myocardial damage remains a challenge. In this paper, we report the case of a premature low-birth-weight infant with congenital complete atrioventricular block and extremely low ventricular rate, fetal hydrops, and myocarditis who was successfully treated with staged permanent pacemaker implantation. PMID:27071550

  2. Early electrophysiological markers of atypical language processing in prematurely born infants.

    PubMed

    Paquette, Natacha; Vannasing, Phetsamone; Tremblay, Julie; Lefebvre, Francine; Roy, Marie-Sylvie; McKerral, Michelle; Lepore, Franco; Lassonde, Maryse; Gallagher, Anne

    2015-12-01

    Because nervous system development may be affected by prematurity, many prematurely born children present language or cognitive disorders at school age. The goal of this study is to investigate whether these impairments can be identified early in life using electrophysiological auditory event-related potentials (AERPs) and mismatch negativity (MMN). Brain responses to speech and non-speech stimuli were assessed in prematurely born children to identify early electrophysiological markers of language and cognitive impairments. Participants were 74 children (41 full-term, 33 preterm) aged 3, 12, and 36 months. Pre-attentional auditory responses (MMN and AERPs) were assessed using an oddball paradigm, with speech and non-speech stimuli presented in counterbalanced order between participants. Language and cognitive development were assessed using the Bayley Scale of Infant Development, Third Edition (BSID-III). Results show that preterms as young as 3 months old had delayed MMN response to speech stimuli compared to full-terms. A significant negative correlation was also found between MMN latency to speech sounds and the BSID-III expressive language subscale. However, no significant differences between full-terms and preterms were found for the MMN to non-speech stimuli, suggesting preserved pre-attentional auditory discrimination abilities in these children. Identification of early electrophysiological markers for delayed language development could facilitate timely interventions. PMID:26476371

  3. Highest Plasma Phenylalanine Levels in (Very) Premature Infants on Intravenous Feeding; A Need for Concern

    PubMed Central

    Cortés-Castell, Ernesto; Sánchez-González, Pablo; Palazón-Bru, Antonio; Bosch-Giménez, Vicente; Manero-Soler, Herminia; Juste-Ruiz, Mercedes; Rizo-Baeza, María Mercedes; Gil-Guillén, Vicente Francisco

    2015-01-01

    Objective To analyse the association in newborns between blood levels of phenylalanine and feeding method and gestational age. Study Design This observational, cross-sectional study included a sample of 11,829 infants between 2008 and 2013 in a Spanish region. Data were recorded on phenylalanine values, feeding method [breast, formula, mixed (breast plus formula), or partial or fully intravenous feeding], gestational age in weeks (<32, 32–37, ≥37), gender and days since birth at the moment of blood collection. Outcomes were [phenylalanine] and [phenylalanine] ≥95th percentile. Associations were analysed using multivariate models [linear (means difference) and logistic regression (adjusted odds ratios)]. Results Higher phenylalanine values were associated with lower gestational age (p<0.001) and with intravenous feeding (p<0.001). Conclusion The degree of prematurity and intravenous feeding influenced the plasma concentration of phenylalanine in the newborn. Caution should be taken in [phenylalanine] for newborns with intravenous feeding, monitoring them carefully. Very preterm infants given the recommended amount of amino acids should also be strictly monitored. These findings should be taken into consideration and call for adapting the amounts to the needs of the infant. PMID:26389596

  4. Late clinical characteristics of infants with retinopathy of prematurity and treated with cryotherapy

    PubMed Central

    Cerman, Eren; Ozarslan Ozcan, Deniz; Celiker, Hande; Eraslan, Muhsin; Sahin, Ozlem; Kazokoglu, Haluk

    2016-01-01

    AIM To describe the clinical characteristics and late results of patients with retinopathy of prematurity (ROP) treated with “6h cryotherapy”. METHODS Out of 1252 infants screened for ROP, 52 patients were treated with temporal 6h cryotherapy from 1997 to 2005 were recalled to our clinic. Among these 23 patients were available and 46 eyes of 23 infants were included to evaluate for visual acuity, refractive error, ocular alignment, nystagmus, retinal examination (abnormal branching of retinal vessels, retinal thinning, latis degenerations, tortuosity of vessels, straightening of temporal vessels, narrowing of the angle of vessel in the juxtapapillary entrance, pigment changes, macular heterotopia), optic atrophy and optic disc cupping, axial length at birth and axial length at 1y. RESULTS The median age at examination was 7 (5-18)y. In 32.6% of patients, the visual acuity was ≤20/200 and the mean best corrected visual acuity was 20/35 as measured with a Snellen chart. Mean spherical refractive error was -1.76±2.69 D. The degree of myopia at the last examination was found to be correlated with the elongation of the eye in the first year of life. Exotropia was present in 17.4% (n=8) of infants and esotropia in 13% (n=6). The most common retinal abnormality was abnormal branching of retinal vessels (82.6%) followed by retinal thinning (52.2%). CONCLUSION The late clinical outcomes of infants with ROP treated in our clinic with cryotherapy seems to comparable with results of laser treatment. PMID:27162730

  5. The History of Care of Premature Infants: From Neonate Intensive Care to Special Care Baby Unit (SCBU).

    ERIC Educational Resources Information Center

    Douret, L.; And Others

    1994-01-01

    Outlines the history of and reviews the literature on the care of premature infants. Focuses on the medicalization of birth; early neonatology; the effect of advances in medicine on the survival and safety of neonates; and the importance of early mother-neonate interactions. (BC)

  6. Plasma D-lactate Levels in Necrotizing Enterocolitis in Premature Infants

    PubMed Central

    Lei, Guofeng; Zhang, Junping; Wang, Xiaobing; Chen, Meiling

    2016-01-01

    Background D-Lactate is normally present in the blood of humans at nanomolar concentrations due to methylglyoxal metabolism; millimolar D-lactate concentrations can arise due to excess gastrointestinal microbial production. Objectives To examine the levels of plasma D-lactate in the necrotizing enterocolitis in premature infants. Patients and Methods 128 premature infants were divided into control (group I, n = 69), feeding intolerance (group II, n = 42) and NEC (group III, n = 27) groups. Plasma D-lactate levels were measured at the onset of feeding intolerance or NEC and at weeks 2-3 in control infants (group I) by ELISA. Data were analyzed using descriptive statistics, non-parametric tests and Student’s t-test. Results In groups I, II, III, median birth weights were 1845.7 ± 267.5 g, 1913.1 ± 306.5 g, and 1898.4 ± 285.3 g, median gestational ages were 34.3 ± 1.7 weeks, 33.9 ± 2.2 weeks and 35.1 ± 2.6 weeks, ages of sampling were 12.3 ± 2.9 days, 14.6 ± 3.7 days and 15.1 ± 1.8 days, respectively. The differences of median birth weights, median gestational ages and ages of sampling were not statistically significant (P > 0.05). The plasma D-lactate levels in groups I, II, III were 3.6 ± 1.9 μg/mL, 12.7 ± 8.3 μg/mL, and 35.4 ± 29.1 μg/mL, respectively, group III had higher plasma D-lactate level than groups I, II, and the difference among these groups was significant (x2 = 21.6, P < 0.01). Conclusions Plasma D-lactate significantly increased early in NEC. Plasma D-lactate levels were associated with extensive disease in NEC infants. Therefore, it could be used as a diagnosis indicator in the early stage of NEC. PMID:27307969

  7. Congenital skin aplasia on the lower limb in a premature infant with ELBW--case report.

    PubMed

    Pająk, Agata; Szczygieł, Anna; Paluszyńska, Dorota; Królak-Olejnik, Barbara

    2014-01-01

    Aplasia cutis congenita (ACC) is usually located on the hairy scalp, on the vertex of the head, but can also occur in other locations, such as limbs, trunk. Congenital skin aplasia on the lower limb is very rare disorder. The exact etiopathogenesis is not known, but intrauterine conditions play a role in its development. ACC visually resembles an ulceration, with a smooth pink surface, which in most cases heals spontaneously. Depending on the wound size and whether signs of inflammation are present, the lesion may require local treatment. In the described case, surgical treatment was carried out because of the extreme prematurity of the infant. The outcome was satisfactory, causing no adverse impact on the child's development during the infancy. PMID:25420905

  8. Comparison of a Powdered, Acidified Liquid, and Non-Acidified Liquid Human Milk Fortifier on Clinical Outcomes in Premature Infants

    PubMed Central

    Thoene, Melissa; Lyden, Elizabeth; Weishaar, Kara; Elliott, Elizabeth; Wu, Ruomei; White, Katelyn; Timm, Hayley; Anderson-Berry, Ann

    2016-01-01

    We previously compared infant outcomes between a powdered human milk fortifier (P-HMF) vs. acidified liquid HMF (AL-HMF). A non-acidified liquid HMF (NAL-HMF) is now commercially available. The purpose of this study is to compare growth and outcomes of premature infants receiving P-HMF, AL-HMF or NAL-HMF. An Institutional Review Board (IRB) approved retrospective chart review compared infant outcomes (born < 2000 g) who received one of three HMF. Growth, enteral nutrition, laboratory and demographic data were compared. 120 infants were included (P-HMF = 46, AL-HMF = 23, NAL-HMF = 51). AL-HMF infants grew slower in g/day (median 23.66 vs. P-HMF 31.27, NAL-HMF 31.74 (p < 0.05)) and in g/kg/day, median 10.59 vs. 15.37, 14.03 (p < 0.0001). AL-HMF vs. NAL-HMF infants were smaller at 36 weeks gestational age (median 2046 vs. 2404 g, p < 0.05). However AL-HMF infants received more daily calories (p = 0.21) and protein (p < 0.0001), mean 129 cal/kg, 4.2 g protein/kg vs. P-HMF 117 cal/kg, 3.7 g protein/kg , NAL-HMF 120 cal/kg, 4.0 g protein/kg. AL-HMF infants exhibited lower carbon dioxide levels after day of life 14 and 30 (p < 0.0001, p = 0.0038). Three AL-HMF infants (13%) developed necrotizing enterocolitis (NEC) vs. no infants in the remaining groups (p = 0.0056). A NAL-HMF is the most optimal choice for premature human milk-fed infants in a high acuity neonatal intensive care unit (NICU). PMID:27472359

  9. Comparison of a Powdered, Acidified Liquid, and Non-Acidified Liquid Human Milk Fortifier on Clinical Outcomes in Premature Infants.

    PubMed

    Thoene, Melissa; Lyden, Elizabeth; Weishaar, Kara; Elliott, Elizabeth; Wu, Ruomei; White, Katelyn; Timm, Hayley; Anderson-Berry, Ann

    2016-01-01

    We previously compared infant outcomes between a powdered human milk fortifier (P-HMF) vs. acidified liquid HMF (AL-HMF). A non-acidified liquid HMF (NAL-HMF) is now commercially available. The purpose of this study is to compare growth and outcomes of premature infants receiving P-HMF, AL-HMF or NAL-HMF. An Institutional Review Board (IRB) approved retrospective chart review compared infant outcomes (born < 2000 g) who received one of three HMF. Growth, enteral nutrition, laboratory and demographic data were compared. 120 infants were included (P-HMF = 46, AL-HMF = 23, NAL-HMF = 51). AL-HMF infants grew slower in g/day (median 23.66 vs. P-HMF 31.27, NAL-HMF 31.74 (p < 0.05)) and in g/kg/day, median 10.59 vs. 15.37, 14.03 (p < 0.0001). AL-HMF vs. NAL-HMF infants were smaller at 36 weeks gestational age (median 2046 vs. 2404 g, p < 0.05). However AL-HMF infants received more daily calories (p = 0.21) and protein (p < 0.0001), mean 129 cal/kg, 4.2 g protein/kg vs. P-HMF 117 cal/kg, 3.7 g protein/kg , NAL-HMF 120 cal/kg, 4.0 g protein/kg. AL-HMF infants exhibited lower carbon dioxide levels after day of life 14 and 30 (p < 0.0001, p = 0.0038). Three AL-HMF infants (13%) developed necrotizing enterocolitis (NEC) vs. no infants in the remaining groups (p = 0.0056). A NAL-HMF is the most optimal choice for premature human milk-fed infants in a high acuity neonatal intensive care unit (NICU). PMID:27472359

  10. Microbes in the neonatal intensive care unit resemble those found in the gut of premature infants

    PubMed Central

    2014-01-01

    Background The source inoculum of gastrointestinal tract (GIT) microbes is largely influenced by delivery mode in full-term infants, but these influences may be decoupled in very low birth weight (VLBW, <1,500 g) neonates via conventional broad-spectrum antibiotic treatment. We hypothesize the built environment (BE), specifically room surfaces frequently touched by humans, is a predominant source of colonizing microbes in the gut of premature VLBW infants. Here, we present the first matched fecal-BE time series analysis of two preterm VLBW neonates housed in a neonatal intensive care unit (NICU) over the first month of life. Results Fresh fecal samples were collected every 3 days and metagenomes sequenced on an Illumina HiSeq2000 device. For each fecal sample, approximately 33 swabs were collected from each NICU room from 6 specified areas: sink, feeding and intubation tubing, hands of healthcare providers and parents, general surfaces, and nurse station electronics (keyboard, mouse, and cell phone). Swabs were processed using a recently developed ‘expectation maximization iterative reconstruction of genes from the environment’ (EMIRGE) amplicon pipeline in which full-length 16S rRNA amplicons were sheared and sequenced using an Illumina platform, and short reads reassembled into full-length genes. Over 24,000 full-length 16S rRNA sequences were produced, generating an average of approximately 12,000 operational taxonomic units (OTUs) (clustered at 97% nucleotide identity) per room-infant pair. Dominant gut taxa, including Staphylococcus epidermidis, Klebsiella pneumoniae, Bacteroides fragilis, and Escherichia coli, were widely distributed throughout the room environment with many gut colonizers detected in more than half of samples. Reconstructed genomes from infant gut colonizers revealed a suite of genes that confer resistance to antibiotics (for example, tetracycline, fluoroquinolone, and aminoglycoside) and sterilizing agents, which likely offer a

  11. Genetic Variants Associated With Severe Retinopathy of Prematurity in Extremely Low Birth Weight Infants

    PubMed Central

    Hartnett, M. Elizabeth; Morrison, Margaux A.; Smith, Silvia; Yanovitch, Tammy L.; Young, Terri L.; Colaizy, Tarah; Momany, Allison; Dagle, John; Carlo, Waldemar A.; Clark, Erin A. S.; Page, Grier; Murray, Jeff; DeAngelis, Margaret M.; Cotten, C. Michael

    2014-01-01

    Purpose. To determine genetic variants associated with severe retinopathy of prematurity (ROP) in a candidate gene cohort study of US preterm infants. Methods. Preterm infants in the discovery cohort were enrolled through the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, and those in the replication cohort were from the University of Iowa. All infants were phenotyped for ROP severity. Because of differences in the durations of enrollment between cohorts, severe ROP was defined as threshold disease in the discovery cohort and as threshold disease or type 1 ROP in the replication cohort. Whole genome amplified DNA from stored blood spot samples from the Neonatal Research Network biorepository was genotyped using an Illumina GoldenGate platform for candidate gene single nucleotide polymorphisms (SNPs) involving angiogenic, developmental, inflammatory, and oxidative pathways. Three analyses were performed to determine significant epidemiologic variables and SNPs associated with levels of ROP severity. Analyses controlled for multiple comparisons, ancestral eigenvalues, family relatedness, and significant epidemiologic variables. Single nucleotide polymorphisms significantly associated with ROP severity from the discovery cohort were analyzed in the replication cohort and in meta-analysis. Results. Eight hundred seventeen infants in the discovery cohort and 543 in the replication cohort were analyzed. Severe ROP occurred in 126 infants in the discovery and in 14 in the replication cohort. In both cohorts, ventilation days and seizure occurrence were associated with severe ROP. After controlling for significant factors and multiple comparisons, two intronic SNPs in the gene BDNF (rs7934165 and rs2049046, P < 3.1 × 10−5) were associated with severe ROP in the discovery cohort and were not associated with severe ROP in the replication cohort. However, when the cohorts were analyzed together in an exploratory

  12. Risk Factors Affecting School Readiness in Premature Infants With Respiratory Distress Syndrome

    PubMed Central

    Patrianakos-Hoobler, Athena I.; Msall, Michael E.; Marks, Jeremy D.; Huo, Dezheng; Schreiber, Michael D.

    2009-01-01

    OBJECTIVE Advances in neonatal care have resulted in children born pre-maturely with respiratory distress syndrome (RDS) successfully reaching school age. It is unknown how many will be ready for school and what factors affect school readiness in these children at high risk. Our objective was to assess readiness of children born prematurely with RDS in the last decade for entry into public school, and determine risk factors associated with lack of school readiness in this population. METHODS This was a single-center prospective cohort study. Follow-up data were collected for 135 of 167 (81%) surviving premature infants with RDS requiring surfactant-replacement therapy and mechanical ventilation. The children were seen between July 2005 and September 2006 (average age: 5.7 ± 1.0 years) and underwent standardized neurodevelopmental and health assessments and socioeconomic status classification. A 4-level school-readiness score was constructed by using each child’s standardized scores on assessments of basic concepts (Bracken School-Readiness Assessment), perceptual skills (Visual-Motor Integration Test), receptive vocabulary (Peabody Picture Vocabulary Test, Third Edition), daily living functional skills (Pediatric Functional Independence Measure), and presence of sensory impairments or autism. Proportional odds models were used to identify risk factors predicting lower school-readiness levels. RESULTS Of the children examined, the mean birth weight was 1016 ± 391 g, and the mean gestational age was 27.5 ± 2.6 weeks. Ninety-one (67%) children were school-ready. Using multivariate analysis, male gender, chronic lung disease, and severe intraventricular hemorrhage or periventricular leukomalacia were associated with lower school-readiness levels. However, the most powerful factor determining school-readiness level was low socioeconomic status. CONCLUSION Interventions targeting neonatal morbidities may be much less effective at improving overall performance at

  13. Influence of H-HOPE Intervention for Premature Infants on Growth, Feeding Progression, and Length of Stay during Initial Hospitalization

    PubMed Central

    White-Traut, Rosemary C.; Rankin, Kristin M.; Yoder, Joseph C.; Liu, Li; Vasa, Rohitkumar; Geraldo, Victoria; Norr, Kathleen F.

    2015-01-01

    Objective To examine whether premature infants receiving the maternally administered H-HOPE intervention had more rapid weight gain and growth, improved feeding progression, and reduced length of hospital stay, compared to controls. Study Design Premature infants born at 29–34 GA and their mothers with at least 2 social-environmental risk factors, were randomly assigned to H-HOPE intervention (n = 88) or an attention control (n = 94) groups. H-HOPE consists of a 15-minute multisensory intervention (auditory, tactile, visual and vestibular stimuli) performed twice daily prior to feeding plus maternal participatory guidance on preterm infant behavioral cues. Results H-HOPE group infants gained weight more rapidly over time than infants in the control group and grew in length more rapidly than control infants, especially during the latter part of the hospital stay. Conclusions For healthy preterm infants, the H-HOPE intervention appears to improve weight gain and length over time from birth to hospital discharge. PMID:25742287

  14. Periodontitis: A risk for delivery of premature labor and low-birth-weight infants.

    PubMed

    Saini, Rajiv; Saini, Santosh; Saini, Sugandha R

    2010-07-01

    Periodontitis is a destructive inflammatory disease of the supporting tissues of the teeth and is caused by specific microorganisms or group of specific microorganisms. The association of periodontal infection with organ systems like cardiovascular system, endocrine system, reproductive system, and respiratory system makes periodontal infection a complex multiphase disease. Inflamed periodontal tissues produce significant amounts of proinflammatory cytokines, mainly interleukin 1-beta (IL-1β), IL-6, prostaglandin E2, and tumor necrosis factor-alpha (TNF-α), which may have systemic effects on the host. Low birth weight, defined as birth weight less than 2,500 g, continues to be a significant public health issue in both developed and developing countries. Research suggests that the bacteria that cause inflammation in the gums can actually get into the bloodstream and target the fetus, potentially leading to premature labor and low-birth-weight (PLBW) babies. One reasonable mechanism begins with deleterious effects of endotoxins released from Gram-negative bacteria responsible for periodontal disease. Hence periodontal disease appears to be an independent risk factor for PLBW and there is a need to expand preventive measures for pregnant women in harmonization with the gynecological and dental professions. PMID:22096335

  15. Periodontitis: A risk for delivery of premature labor and low birth weight infants.

    PubMed

    Saini, Rajiv; Saini, Santosh; Saini, Sugandha R

    2011-01-01

    Periodontitis is a destructive inflammatory disease of the supporting tissues of the teeth and is caused by specific microorganisms or a group of specific microorganisms. Association of periodontal infection with organ systems like cardiovascular system, endocrine system, reproductive system, and respiratory system makes periodontal infection a complex multiphase disease. Inflamed periodontal tissues produce significant amounts of pro-inflammatory cytokines, mainly interleukin 1 beta (IL-1β), IL-6, prostaglandin E2 (PGE2), and tumor necrosis factor alpha (TNF-α), which may have systemic effects on the host. Low birth weight, defined as birth weight less than 2500 g, continues to be a significant public health issue in both developed and developing countries. Research suggests that the bacteria that cause inflammation in the gums can actually get into the bloodstream and target the fetus, potentially leading to premature labor and low birth weight (PLBW) babies. One reasonable mechanism for this is the deleterious effect of endotoxin released from gram-negative bacteria responsible for periodontal disease. Hence, periodontal disease appears to be an independent risk factor for PLBW and there is a need to expand preventive measures for pregnant women in coordination with the gynecological and dental professions. PMID:22470234

  16. Conservative Treatment of Lung Perforation Secondary to Retained Catheter in an Extremely Low-Birth-Weight Premature Infant.

    PubMed

    Arda, Mehmet Surhan; Hamrick, Miller C; Kane, Timothy D

    2015-12-01

    Airway injury may occur during the use of any instrumentation in premature infants. A surgical approach for the treatment of lung perforation in extremely low-birth-weight infants has been recommended in the past. Here, we present a case of lung perforation in an ex-28-week, 730-g premature infant, who sustained lung perforation, secondary to an 8-Fr suction catheter used to administer surfactant, in which the broken catheter was retained in the airway. Following removal of catheter by endoscopy, tension pneumothorax had occurred. Attempts were made to treat the patient with single chest tube, unfortunately as it was not efficacious, the second one was placed on the ipsilateral side of hemithorax and the patient recovered without further surgery. PMID:26788450

  17. Critical issues with clinical research in children: The example of premature infants

    SciTech Connect

    Welty, Stephen E. . E-mail: weltys@pediatrics.ohio-state.edu

    2005-09-01

    Research in pediatrics has led to marked improvements in survival in pediatric patients. In no other age group have these improvements been more dramatic than in neonatology, where antenatal steroid administration to mothers and postnatal utilization of surfactant have led to marked improvements in survival so that infants born at 24 weeks gestation now have a greater than 50% chance of survival. Unfortunately, more than 50% of these patients develop significant complications of prematurity with potential long-term impact on the health of these infants. Therefore, additional research must be done in these patients to prevent these complications or reduce the impact of these complications. There are many practical and some ethical issues that could impede research in the area. Interventional studies have succeeded because literally decades of research defined unequivocally the pathophysiology of diseases such as surfactant deficiency in RDS. Unfortunately, the pathophysiology leading to the complications of prematurity has been extrapolated from old concepts without verification as the population has become smaller and more premature than the previous era. Thus, an extremely important practical issue in pediatric research is whether to design interventions to address the extrapolated pathophysiology risking misinterpretations of the results of such studies. Or should our efforts be focused on defining endpoints associated with the development of diseases and complications which may define pathophysiology more completely but delay the design of interventions to improve the outcomes of patients. Another crucial practical issue in pediatric research is how to power studies so that interventions can be studied adequately. In the US, large neonatal networks have been formed so that large databases can be created and large multi-center trials can be performed. The practical issues associated with these network studies is the center to center variability in patient care

  18. Liberalized abortion in Oregon: effects on fertility, prematurity, fetal death, and infant death.

    PubMed Central

    Quick, J D

    1978-01-01

    An analysis of Oregon Vital Statistics data from 1965 to 1975 was conducted to assess the impact of Oregon's 1969 abortion legislation, which substantially increased the number of reported medically induced abortions. This increase was associated with a slight increase in the age-adjusted 1970 fertility rate and there was no decrease in births to women in the age groups obtaining proportionately the most abortions. A significant and persistent 11 per cent reduction in premature births to women over age 20 (p less than .001) and a 22 per cent reduction in spontaneous fetal deaths (p less than .05) were associated with liberalized abortion. Decreases in neonatal and postneonatal infant mortality were observed, but were indistinguishable from an ongoing trend toward improved infant health. A gradual 25 per cent decline in the age-adjusted fertility rate occurred between 1969 and 1975, but the increase in the number of reported abortions could account for only one-fourth of this decrease. A seven-fold increase in the use of family planning clinics between 1970 and 1973 and more liberalized laws regarding provision of family planning service appeared to account for a much higher proportion of the decreased fertility than did liberalized abortion. PMID:568892

  19. Minimizing blood loss and the need for transfusions in very premature infants

    PubMed Central

    Lemyre, Brigitte; Sample, Megan; Lacaze-Masmonteil, Thierry

    2015-01-01

    Reducing blood loss and the need for blood transfusions in extremely preterm infants is part of effective care. Delayed cord clamping is well supported by the evidence and is recommended for infants who do not immediately require resuscitation. Cord milking may be an alternative to delayed cord clamping; however, more research is needed to support its use. In view of concerns regarding the increased risk for cognitive delay, clinicians should avoid using hemoglobin transfusion thresholds lower than those tested in clinical trials. Higher transfusion volumes (15 mL/kg to 20 mL/kg) may decrease exposure to multiple donors. Erythropoietin is not recommended for routine use due to concerns about retinopathy of prematurity. Elemental iron supplementation (2 mg/kg/day to 3 mg/kg/day once full oral feeds are achieved) is recommended to prevent later iron deficiency anemia. Noninvasive monitoring (eg, for carbon dioxide, bilirubin) and point-of-care testing reduce the need for blood sampling. Clinicians should strive to order the minimal amount of blood sampling required for safe patient care, and cluster samplings to avoid unnecessary skin breaks. PMID:26744559

  20. Increasing breast milk production for premature infants with a relaxation/imagery audiotape.

    PubMed

    Feher, S D; Berger, L R; Johnson, J D; Wilde, J B

    1989-01-01

    Many women whose premature infants are hospitalized in a newborn intensive care unit choose to express breast milk for their babies. Yet anxiety, fatigue, and emotional stress are powerful inhibitors of lactation. To facilitate the breast-feeding experience, intervention mothers were given a 20-minute audio cassette tape based on relaxation and visual imagery techniques. At a single follow-up expression of milk at the hospital approximately 1 week after enrollment, they expressed 63% more breast milk than a randomized group of control mothers. The fat content of the breast milk in the two groups was not significantly different. Among a small group of mothers whose infants were receiving mechanical ventilation, the increase in milk volume compared with that of control mothers was 121%. Longer-term effects of the relaxation/imagery approach (such as extending the duration of breast-feeding or reducing parental stress after hospital discharge) and the physiologic basis for the increased volume of expressed milk (improved milk production v more efficient milk ejection) are appropriate topics for future research. PMID:2642620

  1. Incidence and risk factors for retinopathy of prematurity in extreme low birth weight Chinese infants.

    PubMed

    Yau, Gordon S K; Lee, Jacky W Y; Tam, Victor T Y; Liu, Catherine C L; Chu, Benjamin C Y; Yuen, Can Y F

    2015-06-01

    The objective of this study is to determine the incidence and risk factors of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) Chinese infants. A retrospective medical record review of all ELBW (≤1,000 g) neonates screened for ROP from 2007 to 2012 was performed in Hong Kong. ROP screening was conducted at 2 neonatal intensive care units by 3 pediatric ophthalmologists using the Royal College of Ophthalmologists ROP guideline and the International Classification of ROP. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP. In 131 ELBW Chinese infants, the mean gestational age (GA) and birth weight (BW) were 27.3 ± 3.3 weeks and 806.9 ± 133.7 g, respectively. The incidence of ROP and Type 1 ROP was 53.4 and 14.5 %, respectively. For ROP, a lighter BW, smaller GA, vaginal delivery, postnatal hypotension, inotrope use, bronchopulmonary dysplasia, surfactant use, invasive mechanical ventilation, and supplementary oxygen were independent risk factors for ROP, while PET was protective (P ≤ 0.02). On multivariate analysis, a smaller GA was a risk factor, while PET and congenital heart disease were protective for ROP development (P ≤ 0.01). For Type 1 ROP, a lighter BW, smaller GA, surfactant use, and invasive mechanical ventilation were independent risk factors for ROP, while PET was protective (P ≤ 0.02). There were no significant covariates on multivariate analysis for Type 1 ROP. In ELBW, preterm Chinese infants, a smaller GA was a risk factor for ROP, while PET and congenital heart disease were protective for ROP development in multivariate analysis. PMID:24898774

  2. MHC class II compatibility in aborted fetuses and term infants of couples with recurrent spontaneous abortion.

    PubMed

    Ober, C; Steck, T; van der Ven, K; Billstrand, C; Messer, L; Kwak, J; Beaman, K; Beer, A

    1993-12-01

    Maternal-fetal histocompatibility for alleles at HLA class II loci, HLA-DQA1 and HLA-DQB1, was examined in 40 abortuses and 31 liveborn children of 68 couples with a history of idiopathic recurrent spontaneous abortion (RSAB) who underwent leukocyte immunization prior to the index pregnancy. Significantly more couples with RSAB shared two HLA-DQA1 alleles as compared with fertile control couples (0.18 vs. 0.03, respectively; P = 0.031). There were no differences in HLA sharing between couples with RSAB who experienced a repeat abortion in the index pregnancy as compared with couples with RSAB who were delivered of a liveborn child. Non-significant deficits of abortuses who were compatible for alleles at the HLA-DQA1 (6 observed vs. 8.5 expected; P = 0.225) and the HLA-DQB1 (7 observed vs. 9.2 expected; P = 0.254) loci were observed. A significant deficit of HLA-DQA1 compatible liveborn children was observed (1 observed vs. 5.5 expected; P = 0.0069). The overall deficit of HLA-DQA1 compatible fetuses (7 observed vs. 14.0 expected; P = 0.0018) after approximately 8 weeks gestation suggests that HLA-DQA1 compatible fetuses may be aborted early in pregnancy, prior to the time when fetal tissue can be recovered for genetic studies. PMID:8207709

  3. Diagnosis and management of human cytomegalovirus infection in the mother, fetus, and newborn infant.

    PubMed

    Revello, Maria Grazia; Gerna, Giuseppe

    2002-10-01

    Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection and mental retardation. HCMV infection, while causing asymptomatic infections in most immunocompetent subjects, can be transmitted during pregnancy from the mother with primary (and also recurrent) infection to the fetus. Hence, careful diagnosis of primary infection is required in the pregnant woman based on the most sensitive serologic assays (immunoglobulin M [IgM] and IgG avidity assays) and conventional virologic and molecular procedures for virus detection in blood. Maternal prognostic markers of fetal infection are still under investigation. If primary infection is diagnosed in a timely manner, prenatal diagnosis can be offered, including the search for virus and virus components in fetal blood and amniotic fluid, with fetal prognostic markers of HCMV disease still to be defined. However, the final step for definite diagnosis of congenital HCMV infection is detection of virus in the blood or urine in the first 1 to 2 weeks of life. To date, treatment of congenital infection with antiviral drugs is only palliative both prior to and after birth, whereas the only efficacious preventive measure seems to be the development of a safe and immunogenic vaccine, including recombinant, subunit, DNA, and peptide-based vaccines now under investigation. The following controversial issues are discussed in the light of the most recent advances in the field: the actual perception of the problem; universal serologic screening before pregnancy; the impact of correct counseling on decision making by the couple involved; the role of prenatal diagnosis in ascertaining transmission of virus to the fetus; the impact of preconceptional and periconceptional infections on the prevalence of congenital infection; and the prevalence of congenitally infected babies born to mothers who were immune prior to pregnancy compared to the number born to mothers undergoing primary infection during pregnancy. PMID

  4. ["Medical Texts and Jorunals," and Resources on "Prenatal Risk,""Premature and Low Birthweight Infants,""Infant Nutrition and Breastfeeding"; "Effectiveness of Early Intervention." IPHA Birth-to-Three Clearinghouse Bibliographies 5, 6, 7, 8, and 10.

    ERIC Educational Resources Information Center

    Illinois Public Health Association, Springfield.

    Five separate bibliographies present citations of resources regarding prenatal risk, premature and low birthweight infants, infant nutrition and breastfeeding, and early intervention for infants with disabilities. The first bibliography lists 133 references from medical texts and journals regarding child development, disabilities, diagnosis, and…

  5. Emotional Reactions of Mothers Facing Premature Births: Study of 100 Mother-Infant Dyads 32 Gestational Weeks

    PubMed Central

    Eutrope, Julien; Thierry, Aurore; Lempp, Franziska; Aupetit, Laurence; Saad, Stéphanie; Dodane, Catherine; Bednarek, Nathalie; De Mare, Laurence; Sibertin-Blanc, Daniel; Nezelof, Sylvie; Rolland, Anne-Catherine

    2014-01-01

    Objectives This current study has been conducted to clarify the relationship between the mother's post-traumatic reaction triggered by premature birth and the mother-infant interactions. In this article, the precocious maternal feelings are described. Methods A multicenter prospective study was performed in three French hospitals. 100 dyads with 100 very premature infants and their mothers were recruited. Mothers completed, at two different times self-questionnaires of depression/anxiety, trauma and social support. The quality of interactions in the dyads was evaluated. Results Thirty-nine percent of the mothers obtained a score at HADS suggesting a high risk of depression at the first visit and approximately one-third at visit two. Seventy-five percent of the mothers were at risk of suffering from an anxiety disorder at visit one and half remained so at visit two. A “depressed” score at visits one and two correlated with a hospitalization for a threatened premature labor. We noted a high risk of trauma for 35% of the mothers and high interactional synchrony was observed for approximately two-thirds of the dyads. The mothers' psychological reactions such as depression and anxiety or postnatal depression correlate strongly with the presence of an initial trauma. At visit one and visit two, a high score of satisfaction concerning social support correlates negatively with presence of a trauma. A maternal risk of trauma is more frequent with a C-section delivery. Conclusions Mothers' psychological reactions such as depression and anxiety correlate greatly with the presence of an initial trauma. The maternal traumatic reaction linked to premature birth does not correlate with the term at birth, but rather with the weight of the baby. Social support perceived by the mother is correlated with the absence of maternal trauma before returning home, and also seems to inhibit from depressive symptoms from the time of the infant's premature birth. PMID:25153825

  6. Counseling patients when abortion is legal and the fetus is viable.

    PubMed

    Minkoff, H; Powderly, K E

    2000-01-01

    In the wake of the 1973 US Supreme Court decision legalizing abortion, many states instituted laws allowing voluntary termination of pregnancy up to 24 weeks. Improvements in neonatal medicine since then mean that some fetuses may be viable at gestational ages less than 24 weeks. Thus clinicians and patients may confront the dilemma of the fetus that is both legally "abortable" and potentially viable. If the obstetrical team automatically (without considering all reproductive options) attempts to salvage the fetus, they abrogate the woman's right not to deliver an extremely premature infant. In this clinical opinion, we review the ethical issues that should be considered in the management of these situations. PMID:11070642

  7. Correlation of serum KL-6 and CC16 levels with neurodevelopmental outcome in premature infants at 12 months corrected age

    PubMed Central

    Zhang, Zhiqun; Lu, Hui; Zhu, Yunxia; Xiang, Junhua; Huang, Xianmei

    2015-01-01

    The aim of this study was to evaluate KL-6 and CC16 levels and their correlation with neurodevelopmental outcome among very low birth weight pre-term infants at 12 months corrected age. This prospective cohort study was performed from 2011 to 2013 by enrolling pre-term neonates of gestational age ≤ 32 weeks and birth weight ≤ 1500 g. Serum KL-6 and CC16 levels were determined 7 days after birth and their correlation with neurodevelopment was evaluated using Gesell Mental Developmental Scales. Of the 86 eligible pre-term infants, 63 completed follow-up, of which 15 had bronchopulmonary dysplasia. At 12 months corrected age, 49 infants had favorable outcomes and 14 infants had poor neurodevelopmental outcome. KL-6 levels were higher and CC16 levels were lower in infants with poor neurodevelopmental outcome compared with those infants who had favourable neurodevelopmental outcome. Serum KL-6 levels less than 90.0 ng/ml and CC16 levels greater than 320.0 pg/ml at 7 days of life were found to be predictive of a favourable outcome at 12 months corrected age. These biological markers could predict neurodevelopmental outcome at 12 months corrected age in very low birth weight premature infants, and help the clinician plan early therapeutic interventions to minimize or avoid poor neurodevelopmental outcome. PMID:25631862

  8. Correlation of serum KL-6 and CC16 levels with neurodevelopmental outcome in premature infants at 12 months corrected age.

    PubMed

    Zhang, Zhiqun; Lu, Hui; Zhu, Yunxia; Xiang, Junhua; Huang, Xianmei

    2015-01-01

    The aim of this study was to evaluate KL-6 and CC16 levels and their correlation with neurodevelopmental outcome among very low birth weight pre-term infants at 12 months corrected age. This prospective cohort study was performed from 2011 to 2013 by enrolling pre-term neonates of gestational age ≤ 32 weeks and birth weight ≤ 1500 g. Serum KL-6 and CC16 levels were determined 7 days after birth and their correlation with neurodevelopment was evaluated using Gesell Mental Developmental Scales. Of the 86 eligible pre-term infants, 63 completed follow-up, of which 15 had bronchopulmonary dysplasia. At 12 months corrected age, 49 infants had favorable outcomes and 14 infants had poor neurodevelopmental outcome. KL-6 levels were higher and CC16 levels were lower in infants with poor neurodevelopmental outcome compared with those infants who had favourable neurodevelopmental outcome. Serum KL-6 levels less than 90.0 ng/ml and CC16 levels greater than 320.0 pg/ml at 7 days of life were found to be predictive of a favourable outcome at 12 months corrected age. These biological markers could predict neurodevelopmental outcome at 12 months corrected age in very low birth weight premature infants, and help the clinician plan early therapeutic interventions to minimize or avoid poor neurodevelopmental outcome. PMID:25631862

  9. Amylase in the saliva and in the gastric aspirates of premature infants: its potential role in glucose polymer hydrolysis.

    PubMed

    Hodge, C; Lebenthal, E; Lee, P C; Topper, W

    1983-12-01

    Amylase activity was found in saliva from 13 infants, 26-42 wk corrected gestational age. The levels of salivary amylase activity increased with advancing age. In 10 infants, 31-38 wk corrected gestational age (estimated gestational age in wk plus age in wk after birth), gastric aspirates collected before a feeding and sequentially at 30-min intervals after two consecutive feedings were analyzed for amylase activity and pH. Two different postprandial patterns were obtained. For six of the 10 infants, both the pH and amylase activities of their gastric aspirates showed a distinct maxima at about 60 min after a feeding and a minima at 180 min just before the second feeding. In the remaining four infants, the pHs of their gastric aspirates remained relatively high (5.0-6.0) for the entire postprandial period. In these infants, there was a persistently high level of the amylase activity. In all 10 infants, amylase activity was found in their gastric aspirate samples when the pH was above 3.0. Comparison of the amylase in the gastric aspirate with purified pancreatic and salivary amylases by polyacrylamide gel electrophoresis showed that the amylase in the gastric aspirate has an electrophoretic mobility similar to that of salivary amylase, which suggests a salivary origin. This study supports the possibility that salivary amylase could enter the stomach and retain a significant amount of its activity in premature infants. PMID:6197692

  10. Characteristics of Severe Retinopathy of Prematurity in Infants with Birth Weight above 1500 Grams at a Referral Center in Turkey

    PubMed Central

    Gunay, Murat; Celik, Gokhan; Tuten, Abdulhamit; Karatekin, Guner; Bardak, Handan; Ovali, Fahri

    2016-01-01

    Purpose To demonstrate the clinical characteristics and treatment outcomes of severe retinopathy of prematurity (ROP) in preterm infants with birth weight (BW) above 1500 g in Turkey. Methods A retrospective review of 5920 ROP records was performed in Zeynep Kamil Maternity and Children’s Diseases Training and Research Hospital. The records were obtained from ROP treatment center of the same institute between 2011 and 2016. The data comprised the demographic and clinical characteristics including, gestational age, BW, systemic risk factors, zone and stage of ROP, ROP type, treatment modality, treatment outcomes and inborn/outborn status of the babies. Results A total of 36 infants (71 eyes) with severe ROP and BW> 1500 g were retrieved. There were 30 infants (83.3%) with type 1 ROP and 6 infants (16.7%) with aggressive posterior ROP (APROP). 3 infants (8.3%) were born at our hospital whereas 33 (91.7%) were referred from outer private neonatal intensive care unit (NICU) centers. Zone I APROP was detected during the initial screening. 21 infants (58.3%) underwent laser treatment while 15 (41.7%) received intravitreal bevacizumab (IVB) injections. No unfavorable structural outcome was observed following either treatment modality. Conclusion Severe ROP may occur in heavier preterm infants. Laser treatment and IVB injections were useful in selected cases. Presence of APROP at first examination suggests an earlier screening in heavier babies. Standardization of private NICU centers as well as establishing a national ROP protocol is necessary in Turkey. PMID:27548628

  11. Residence, delivery and referral patterns of infants and fetuses with birth defects delivered in Hawaii, 1986-1999.

    PubMed

    Forrester, M B; Merz, R D

    2003-03-01

    Information on residence, delivery and referral patterns is useful to a birth defects program for allocation of resources, predicting where deliveries may have occurred, and estimating the impact of altering geographic inclusion criteria. The purpose of this study was to describe the residence, delivery and referral patterns for infants and fetuses with birth defects delivered in Hawaii. Data were obtained from the Hawaii Birth Defects Program and included birth defects cases delivered between 1986 and 1999 with known delivery residence and place of delivery. Of 12,873 total cases, 171 (1%) were delivered to out-of-state residents. Of the remaining 12,702 cases delivered to residents in the four Counties of Hawaii, 9905 (78%) were to City and County of Honolulu residents and 2797 (22%) were to residents of Hawaii, Kauai and Maui Counties. Of the cases delivered to City and County of Honolulu residents, 9903 were delivered in that County. Of the cases delivered to residents of the other three Counties, 591 (21%) were referred to the City and County of Honolulu for delivery, and 1602 (57%) were referred to the City and County of Honolulu for any reason. Honolulu delivery referral rates and total referral rates for cases delivered to Hawaii, Kauai and Maui County residents were higher with prenatal diagnosis of a birth defect (59 and 87%, respectively) and elective termination (70 and 85%, respectively), and varied among 53 different types of birth defect (0-83% and 23-100%, respectively). PMID:12802980

  12. Is ingestion of milk-associated bacteria by premature infants fed raw human milk controlled by routine bacteriologic screening?

    PubMed Central

    Law, B J; Urias, B A; Lertzman, J; Robson, D; Romance, L

    1989-01-01

    Expressed human milk is often used to feed premature infants. Raw milk contains bacteria which may be a source of infection. Milk banks have developed screening programs which combine periodic quantitative milk cultures with arbitrary rules specifying limits of bacterial concentration. It is unknown whether such programs succeed in preventing infants from being fed milk containing bacteria. At the Health Sciences Centre (Winnipeg, Manitoba, Canada), milk is screened once weekly. When a woman's milk is found to have excess bacteria, it is discarded only if she is an unrelated donor (as opposed to an infant's mother). To assess the effectiveness of this screening program, we determined the frequency at which infants fed raw human milk were exposed to milk-associated bacteria and compared the bacterial contents of donor and maternal milk. From February 1986 to April 1987, all human milk fed to 98 premature infants during the first 2 weeks of feeding (n = 10,128 feeds) was cultured quantitatively. Among study infants, 100% were exposed at least once to coagulase-negative staphylococci, 41% were exposed to Staphylococcus aureus, and 64% were exposed to gram-negative bacilli. The proportions of feeds containing bacteria and the quantities (log10 CFU [mean +/- standard deviation]) ingested per positive feed were: 39% and 5.9 +/- 0.5 for coagulase-negative staphylococci; 2.4% and 5.1 +/- 1.0 for S. aureus; and 5.2% and 4.8 +/- 1.1 for gram-negative bacilli. There were no adverse events attributable to ingestion of milk-associated bacteria. Milk coagulase-negative staphylococcal isolates were multiply antibiotic susceptible, whereas infant isolates were antibiotic resistant. Donor milk was significantly less likely than maternal milk to contain coagulase-negative staphylococcal species in any quantity (40 versus 93% of samples, respectively [P < 0.001]) or in concentrations exceeding 10(8) CFU/liter (3 versus 27% of samples, respectively [P < 0.0001]). There was no

  13. Eating in "SINC": Safe Individualized Nipple-Feeding Competence, a Quality Improvement Project to Explore Infant-Driven Oral Feeding for Very Premature Infants Requiring Noninvasive Respiratory Support.

    PubMed

    Dalgleish, Stacey R; Kostecky, Linda L; Blachly, Noreen

    2016-01-01

    Oral feeding is a developmental task for all premature infants. often, independent nipple feeding is the last barrier to discharge home from the NICU. A relationship exists between consistent, infant-driven feeding management practices and improved feeding performance. Conversely, a random approach to feeding may contribute to poor short-term and long-term clinical outcomes. We report a quality improvement project that was undertaken across five NICUs in an urban setting. our aim was to safely initiate and advance nipple feeding for very preterm neonates (born at <32 weeks gestation) who had a respiratory morbidity requiring nasal continuous positive airway pressure therapy. A novel algorithm entitled "eating in SINC: Safe individualized nipple-Feeding Competence" was developed. Safe individualized nipple-feeding competence involves the baby, the parents, and the health care team by using infant-driven strategies, common language, and developmentally appropriate goals while supporting fragile neonates to be skilled feeders. PMID:27461200

  14. Predictive Factors for Efficacy and Safety of Prophylactic Theophylline for Extubation in Infants with Apnea of Prematurity

    PubMed Central

    Orita, Yuji; Mitarai, Fumi; Ishitsuka, Yoichi; Irikura, Mitsuru; Shimodozono, Yoshihiro; Douchi, Tsutomu; Takeda, Yasuo; Irie, Tetsumi

    2016-01-01

    Purpose This study aimed to evaluate predictive factors involved in efficacy and safety in Japanese infants who received theophylline therapy to prevent apnea of prematurity (AOP) after weaning from mechanical ventilation. Methods We retrospectively reviewed the medical records of infants who were administered intravenous aminophylline (theophylline ethylenediamine) for AOP at the neonatal intensive care unit, Kagoshima University Hospital, Japan, between January 2009 and June 2013. Results A total of 100 infants were evaluated as two separate groups in terms of efficacy and safety of theophylline. Sixty-seven (67.0%) infants had effective theophylline therapy. Multivariate logistic regression analysis showed that gestational age at birth was significant, with an odds ratio of 0.59 (p < 0.001). Receiver operating characteristic analysis showed that the cut-off value was 31.1 weeks old for predicting the efficacy of theophylline (specificity, 66.7%; sensitivity, 86.6%; p < 0.001; area under the curve, 0.750; 95% confidence interval, 0.45–0.74). Adverse reactions were identified in 21 (21.0%) infants. Multivariate logistic regression analysis showed that the number of days of theophylline administration from birth was associated with an increased risk of adverse reactions after theophylline administration (p = 0.01). Conclusions Physicians need to be aware of the possibility that theophylline fails to produce therapeutic effects for extubation in infants aged less than 31.1 weeks old, and adverse reactions can easily develop when theophylline is administered soon after birth. PMID:27388444

  15. n-3 polyunsaturated fatty acids in milk is associate to weight gain and growth in premature infants

    PubMed Central

    Tinoco, Sandra M Barboza; Sichieri, Rosely; Setta, Cecília L; Moura, Anibal S; Carmo, Maria G Tavares do

    2009-01-01

    Background Linoleic 18:2 (n-6) and α-linolenic 18:3 (n-3) essential fatty acids and long-chain polyunsaturated fatty acids (LC-PUFA) are essential nutrients for growth and neonatal development. Consumption of preformed n-3 LC-PUFA has been shown to increase gestational duration and to decrease the incidence of premature birth in human studies. This study evaluated the association of essential fatty acids and LC-PUFA in breast milk on the growth of premature children (weight, height and head circumference). Study design Thirty-seven premature infants with a gestational age of 37 weeks or less were followed until 6 months of gestational age, adjusted for prematurity. The milk from mothers, weight, height and head circumference measures of children were collected during the follow up. The breast milk fatty acids were quantified by gas-liquid chromatography. Results Our results showed that total n-3 PUFA was positively associated with weight gain (p = 0.05), height (p = 0.04) and body mass index (BMI) of children (p = 0.05). Our results also indicate that both linoleic acid and total essential fatty acids were positively associated with BMI and head circumference, whereas oleic acid was positively associated only with head circumference. Conclusion These results suggest that the n-3 PUFA composition of milk may be associated with weight gain and growth. Considering the advantages of n-3 LC-PUFA consumption on infant growth and visual function and its association with reduced incidence of premature birth, dietitians should advise pregnant women to increase their intake of foods high in n-3 LC-PUFA. PMID:19558659

  16. Usual Care and Informed Consent in Clinical Trials of Oxygen Management in Extremely Premature Infants

    PubMed Central

    Cortés-Puch, Irene; Wesley, Robert A.; Carome, Michael A.; Danner, Robert L.; Wolfe, Sidney M.; Natanson, Charles

    2016-01-01

    Objective The adequacy of informed consent in the Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial (SUPPORT) has been questioned. SUPPORT investigators and publishing editors, heads of government study funding agencies, and many ethicists have argued that informed consent was adequate because the two oxygen saturation target ranges studied fell within a range commonly recommended in guidelines. We sought to determine whether each oxygen target as studied in SUPPORT and four similar randomized controlled trials (RCTs) was consistent with usual care. Design/Participants/Setting PubMed, EMBASE, Web of Science, and Scopus were searched for English articles back to 1990 providing information on usual care oxygen management in extremely premature infants. Data were extracted on intended and achieved oxygen saturation levels as determined by pulse oximetry. Twenty-two SUPPORT consent forms were examined for statements about oxygen interventions. Results While the high oxygen saturation target range (91 to 95%) was consistent with usual care, the low range (85 to 89%) was not used outside of the SUPPORT trial according to surveys and clinical studies of usual care. During usual care, similar lower limits (< 88%) were universally paired with higher upper limits (≥ 92%) and providers skewed achieved oxygen saturations toward the upper-end of these intended ranges. Blinded targeting of a low narrow range resulted in significantly lower achieved oxygen saturations and a doubling of time spent below the lower limit of the intended range compared to usual care practices. The SUPPORT consent forms suggested that the low oxygen saturation arm was a widely practiced subset of usual care. Conclusions SUPPORT does not exemplify comparative effectiveness research studying practices or therapies in common use. Descriptions of major differences between the interventions studied and commonly practiced usual care, as well as potential risks associated with these

  17. Long-Term Maternal Stress and Post-traumatic Stress Symptoms Related to Developmental Outcome of Extremely Premature Infants.

    PubMed

    Zerach, Gadi; Elsayag, Adi; Shefer, Shahar; Gabis, Lidia

    2015-08-01

    In this study, we examined the relations between the severity of developmental outcomes of extremely low birth weight (ELBW) children and their mothers' stress and post-traumatic stress disorder (PTSD) symptoms, 4-16 years after birth. Israeli mothers (N = 78) of a cohort of extremely premature infants (24-27 weeks) born 4-16 years earlier were asked to report about the medical and developmental condition of their child and their current perceived stress and PTSD symptoms. Results show that mothers of ELBW children with normal development reported the lowest perceived stress compared with mothers of ELBW children with developmental difficulties. We also found that 25.6% of the mothers had the potential to suffer from PTSD following the birth of an ELBW child. Furthermore, the severity of prematurity developmental outcomes made a significant contribution to mothers' perceived stress. To sum, mothers of ELBW infants' perceived stress is related to their children's severity of prematurity developmental outcomes, 4-16 years after birth. Clinical implications of these findings are discussed. PMID:26252160

  18. Terminal deletion of the long arm of chromosome 2 in a premature infant with karyotype: 46,XY, del(2)(q37)

    SciTech Connect

    Wang, T.H.; Johnston, K.; Hsieh, C.L.; Dennery, P.A.

    1994-02-15

    The authors present a premature newborn boy with multiple congenital anomalies, including craniofacial anomalies, syndactyly, cardiac defects, and a horseshoe kidney associated with terminal deletion of 2q. The infant`s karyotype was 46,XY,del(2)(q37). Clinical, cytogenetic, and autopsy findings are presented in this report. Clinical manifestations in this infant are compared with those four other known patients with terminal deletion of chromosome 2. 5 refs., 1 fig., 1 tab.

  19. THE FEASIBILITY OF USING "PREMIESTART," A MOTHER-PREMATURE INFANT INTERACTION PROGRAM, ON A NEONATAL UNIT IN ENGLAND.

    PubMed

    Dibley, Alexandra L; Rydin-Orwin, Tracy; Stedmon, Jacqui; Dallos, Rudi

    2016-07-01

    This article explores the feasibility of running "PremieStart," a nine-individual-session maternal-premature infant interaction program, within a neonatal unit (NNU) in England. Four mothers of premature infants completed seven sessions on the NNU and two at home. Mothers and NNU staff provided feedback on PremieStart. Measures of maternal-infant relationship, maternal well-being, and maternal reflective functioning were completed before and after intervention. Thematic analysis of mothers' feedback highlighted the emotional, but cathartic, experience of engaging with PremieStart. NNU staff feedback indicated the need to include them more in PremieStart. Both mothers and staff were supportive of future implementation of PremieStart and highlighted the ongoing need for psychological support on the NNU. PremieStart was implemented with positive feedback from mothers and staff, with support shown for the continued use of PremieStart in the NNU. However, for future implementation, the self-report outcome measures need reviewing, and more involvement of fathers and NNU staff is needed. In addition, a larger sample with a control group should be utilized. PMID:27348583

  20. Preeclampsia and Retinopathy of Prematurity in Very-Low-Birth-Weight Infants: A Population-Based Study

    PubMed Central

    Chou, Hung-Chieh; Chen, Chien-Yi; Hsieh, Wu-Shiun; Tsou, Kuo-Inn; Tsao, Po-Nien

    2015-01-01

    Preeclampsia and retinopathy of prematurity (ROP) are associated with impaired angiogenesis. Previous studies on the relationship between preeclampsia and ROP have produced conflicting results. The goal of this study was to evaluate the association between maternal preeclampsia and ROP using a large population-based cohort of very-low-birth-weight (VLBW) infants from 21 neonatal departments registered in the database of the Premature Baby Foundation of Taiwan. Multivariable logistic regression analysis was used to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) for preeclampsia with reference to ROP and severe ROP. A total of 5,718 VLBW infants (844 cases with maternal preeclampsia) were included for analysis. The overall incidences of mild and severe ROP were 36.0% and 12.2%, respectively. Univariable analysis showed lower GA and lower birth weight, vaginal delivery, non-SGA, RDS, PDA, sepsis, transfusion, and absence of maternal preeclampsia to be associated with mild and severe ROP development. However, OR (95% CI) adjusted for the variables that were significant according to univariable analysis showed the risks of developing any-stage ROP and severe ROP for maternal preeclampsia to be 1.00 (0.84–1.20) and 0.89 (0.63–1.25), respectively. The results remained unchanged in stratified analyses according to SGA status. Our data showed that maternal preeclampsia was not associated with the subsequent development of any stage or severe ROP in VLBW infants. PMID:26588850

  1. Retinopathy of Prematurity among Very-Low-Birth-Weight Infants in Korea: Incidence, Treatment, and Risk Factors.

    PubMed

    Hwang, Jong Hee; Lee, Eun Hee; Kim, Ellen Ai-Rhan

    2015-10-01

    This study was conducted to describe the incidence, risk factors, and current treatment status of retinopathy of prematurity (ROP) in very-low-birth-weight (VLBW) infants registered in the Korean Neonatal Network database. Medical records of 2,009 VLBW infants born between January 2013 and June 2014 who underwent examination by an ophthalmologist were reviewed. The total incidence of ROP was 34.1%. Of the patients, 11.6% showed ROP stage ≥ 3 and 11.5% received treatment of VLBW. Among all infants who received treatment of ROP, 63.6% underwent operation only; 16.9%, anti-vascular endothelial growth factor (anti-VEGF) treatment only; and 19.5%, both operation and anti-VEGF treatment. The mean gestational age (GA) and birth weight (BW) were significantly lower and the prevalence rates of respiratory distress syndrome, patent ductus arteriosus (PDA), invasive ventilator duration, and sepsis were significantly higher in the VLBW infants with ROP than in those without ROP. In the multivariable logistic regression analysis, PDA (odd ratio [OR], 2.1; 95% confidence interval [CI], 1.11-3.79) and invasive ventilator duration (OR, 1.0; 95% CI, 1.00-1.02) were significant risk factors of ROP and ROP stage ≥ 3. In conclusion, the high incidence of ROP is associated with low GA and BW, and attempt to reduce the aforementioned risk factors could reduce the incidence of ROP stage ≥ 3 in VLBW infants. PMID:26566363

  2. Retinopathy of Prematurity among Very-Low-Birth-Weight Infants in Korea: Incidence, Treatment, and Risk Factors

    PubMed Central

    Hwang, Jong Hee; Lee, Eun Hee

    2015-01-01

    This study was conducted to describe the incidence, risk factors, and current treatment status of retinopathy of prematurity (ROP) in very-low-birth-weight (VLBW) infants registered in the Korean Neonatal Network database. Medical records of 2,009 VLBW infants born between January 2013 and June 2014 who underwent examination by an ophthalmologist were reviewed. The total incidence of ROP was 34.1%. Of the patients, 11.6% showed ROP stage ≥ 3 and 11.5% received treatment of VLBW. Among all infants who received treatment of ROP, 63.6% underwent operation only; 16.9%, anti-vascular endothelial growth factor (anti-VEGF) treatment only; and 19.5%, both operation and anti-VEGF treatment. The mean gestational age (GA) and birth weight (BW) were significantly lower and the prevalence rates of respiratory distress syndrome, patent ductus arteriosus (PDA), invasive ventilator duration, and sepsis were significantly higher in the VLBW infants with ROP than in those without ROP. In the multivariable logistic regression analysis, PDA (odd ratio [OR], 2.1; 95% confidence interval [CI], 1.11-3.79) and invasive ventilator duration (OR, 1.0; 95% CI, 1.00-1.02) were significant risk factors of ROP and ROP stage ≥ 3. In conclusion, the high incidence of ROP is associated with low GA and BW, and attempt to reduce the aforementioned risk factors could reduce the incidence of ROP stage ≥ 3 in VLBW infants. PMID:26566363

  3. Retinopathy of prematurity in infants born before 25 weeks gestation in a Korean single neonatal intensive care unit: incidence, natural history and risk factors.

    PubMed

    Kong, Mingui; Shin, Dong Hoon; Kim, Sang Jin; Ham, Don Il; Kang, Se Woong; Chang, Yun Sil; Park, Won Soon

    2012-12-01

    As younger preterm infants are able to survive, more extremely preterm infants are at risk of developing retinopathy of prematurity (ROP). To investigate the incidence, progression and risk factors of ROP in extremely preterm infants in Korea, the medical records of infants born before 25 weeks gestation were retrospectively reviewed. The criteria for laser treatment agreed with type 1 ROP as defined by the Early Treatment for Retinopathy of Prematurity study. Of the 121 infants included in the analysis, 119 (98.4%) infants developed any stage ROP, including 78 infants (64.5%) with type 1 ROP. The mean postmenstrual age (PMA) at the onset of any ROP and type 1 ROP were 33.5 and 36.1 weeks, respectively. All but one infant developed type 1 ROP after 31 weeks PMA. Univariate analysis showed that duration of total parenteral nutrition and onset of any ROP (PMA) were associated with the development of type 1 ROP. In conclusion, this study shows high incidence of ROP in extremely preterm infants and suggests that, although current screening protocols are feasible for most preterm infants born before 25 weeks gestation, earlier screening before 31 weeks PMA may be necessary in infants with an unstable clinical course. PMID:23255858

  4. Retinopathy of Prematurity

    ERIC Educational Resources Information Center

    Steinweg, Sue Byrd; Griffin, Harold C.; Griffin, Linda W.; Gingras, Happy

    2005-01-01

    The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, which is the nerve tissue at the…

  5. Urinary ET-1, AVP and sodium in premature infants treated with indomethacin and ibuprofen for patent ductus arteriosus.

    PubMed

    Zanardo, Vincenzo; Vedovato, Stefania; Lago, Paola; Trevisanuto, Daniele; Favaro, Flaviano; Faggian, Diego; Plebani, Mario

    2005-11-01

    The relative potency and interrelationship between vasoactive and natriuretic mediators are thought to be important in the transition from fetal to neonatal life. The relationship between urinary vasoactive factors and sodium excretion has not been adequately addressed in premature infants receiving indomethacin and ibuprofen for therapy of patent ductus arteriosus. Excretion rates of AVP, ET-1 and sodium were measured in premature infants with RDS receiving indomethacin or ibuprofen. Forty-four RDS premature infants (<34-week gestation) with PDA received either ibuprofen (n=22) in an initial dose of 10 mg/kg followed by two doses of 5 mg/kg each after 24 and 48 h or 3 doses at 12-h intervals of indomethacin (n=24), 0.2 mg/kg, infused continuously over a period of 15 min. Urinary ET-1, AVP and sodium excretion were measured before and after treatment. Indomethacin treatment caused a significant decrease in urinary ET-1 and AVP excretion (UET-1/Ucr 0.14+/-0.01 vs. 0.10+/-0.05 fenton/mmol; P<0.05; 24.42+/-6.18 vs. 12.63+/-3.06 pg/mmol; P<0.05, respectively), along with a significant reduction in urinary sodium (92.1+/-36.1 vs. 64.8+/-35.6 mmol/l; P<0.01), fractional excretion of sodium (6.8+/-37.1 vs. 4.5+/-37.1%; P<0.01) and urinary osmolality (276.2+/-103.9 vs. 226.4+/-60.3 mOsmol/kg; P<0.05). Ibuprofen treatment caused a significant decrease in urinary AVP (UAVP/Ucr 24.5+/-3.4 vs. 16.3+/-2.04 pg/mmol; P<0.01), along with a significant decrease in urinary sodium (78.0+/-8.4 vs. 57.0+/-8.0 mmol/l; P<0.05) and in fractional excretion of sodium (7.5+/-1.3 vs. 3.9+/-3.0%; P<0.05), while it did not modify urinary ET-1 excretion. The association of renal ET-1 and AVP activity with sodium excretion in premature infants treated with indomethacin and ibuprofen supports the hypothesis that these factors may play a role in the physiologic changes in sodium excretion. PMID:16133044

  6. The Effect of Fish Oil-Based Lipid Emulsion and Soybean Oil-Based Lipid Emulsion on Cholestasis Associated with Long-Term Parenteral Nutrition in Premature Infants

    PubMed Central

    Wang, Leilei; Zhang, Jing; Gao, Jiejin; Qian, Yan; Ling, Ya

    2016-01-01

    Purpose. To retrospectively study the effect of fish oil-based lipid emulsion and soybean oil-based lipid emulsion on cholestasis associated with long-term parenteral nutrition in premature infants. Methods. Soybean oil-based lipid emulsion and fish oil-based lipid emulsion had been applied in our neonatology department clinically between 2010 and 2014. There were 61 qualified premature infants included in this study and divided into two groups. Soybean oil group was made up of 32 premature infants, while fish oil group was made up of 29 premature infants. Analysis was made on the gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, age at which feeding began, usage of lipid emulsions, and incidence of cholestasis between the two groups. Results. There were no statistical differences in terms of gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, and age at which feeding began. Besides, total incidence of cholestasis was 21.3%, and the days of life of occurrence of cholestasis were 53 ± 5.0 days. Incidence of cholestasis had no statistical difference in the two groups. Conclusion. This study did not find the different role of fish oil-based lipid emulsions and soybean oil-based lipid emulsions in cholestasis associated with long-term parenteral nutrition in premature infants. PMID:27110237

  7. [Assessing the impact of risk factors and polymorphisms GST genes on the development of bronchopulmonary dysplasia in premature infants].

    PubMed

    2014-09-01

    An increasing incidence of bronchopulmonary dysplasia (BPD) in premature infants has been reported in recent years. In the present study we analyzed the risk factors for BPD. It was revealed that the most significant factors are the low gestational age and birth weight, as well as prolonged use of mechanical ventilation and late neonatal infection. Polymorphism of studied genes and various combinations of polymorphic variants did not affect the risk of BPD developing. The influence of genetic polymorphisms on the duration of mechanical ventilation, the occurrence of late neonatal infection. For proper evaluation of the contribution of genetic polymorphism is necessary to conduct a preliminary analysis of all possible clinical and laboratory parameters to identify strong independent predictors and then analyze the indirect effects of genetic factors. Further research and development of new approaches to ventilation mode in preterm infants, based on the genetic polymorphism, will create a set of preventive measures and reduce the incidence of BPD. PMID:25341249

  8. Effects of music therapy on pain responses induced by blood sampling in premature infants: A randomized cross-over trial

    PubMed Central

    Shabani, Fidan; Nayeri, Nahid Dehghan; Karimi, Roghiyeh; Zarei, Khadijeh; Chehrazi, Mohammad

    2016-01-01

    Background: Premature infants are subjected to many painful procedures during care and treatment. The aim of this study was to assess the effect of music therapy on physiological and behavioral pain responses of premature infants during and after blood sampling. Materials and Methods: This study was a cross-over clinical trial conducted on 20 infants in a hospital affiliated to Tehran University of Medical Sciences for a 5-month period in 2011. In the experimental group, Transitions music was played from 5 min before until 10 min after blood sampling. The infants’ facial expressions and physiological measures were recorded from 10 min before until 10 min after sampling. All steps and measurements, except music therapy, were the same for the control group. Data were analyzed using SAS and SPSS software through analysis of variance (ANOVA) and Chi-square tests. Results: There were significant differences between the experimental and control groups (P = 0.022) in terms of heart rate during needle extraction and at the first 5 min after sampling (P = 0.005). Considering the infant's sleep–wake state in the second 5 min before sampling, the statistical difference was significant (P = 0.044). Difference was significant (P = 0.045) during injection of the needle, in the first 5 min after sampling (P = 0.002), and in the second 5 min after sampling (P = 0.005). There were significant difference in infants’ facial expressions of pain in the first 5 min after sampling (P = 0.001). Conclusions: Music therapy reduces the physiological and behavioral responses of pain during and after blood sampling. PMID:27563323

  9. Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant

    SciTech Connect

    Baumgart, S.; Engle, W.D.; Fox, W.W.; Polin, R.A.

    1981-12-01

    Ten premature infants nursed on servocontrolled radiant warmer beds were studied in three environments designed to alter one or more factors affecting heat transfer (convection, evaporation, and radiation). In the control environment, infants were nursed supine on an open warmer bed. The second environment (walled chamber) was designed to reduce convection and evaporation by placing plastic walls circumferentially around the bed. In the third environment convection and evaporation were minimized by covering infants with a plastic blanket. Air turbulence, insensible water loss, and radiant warmer power were measured in each environment. There was a significant reduction in mean air velocity in the walled chamber and under the plastic blanket when compared to the control environment. A parallel decrease in insensible water loss occurred. In contrast, radiant power demand was the same for control and walled environments, but decreased significantly when infants were covered by the plastic blanket. This study suggests that convection is an important factor influencing evaporation in neonates nursed under radiant warmers. The thin plastic blanket was the most effective shield, significantly reducing radiant power demand.

  10. Effects of caffeine treatment for apnea of prematurity on cortical speech-sound differentiation in preterm infants.

    PubMed

    Maitre, Nathalie L; Chan, Jeremy; Stark, Ann R; Lambert, Warren E; Aschner, Judy L; Key, Alexandra P

    2015-03-01

    Caffeine, standard treatment for apnea of prematurity, improves brainstem auditory processing. We hypothesized that caffeine also improves cortical differentiation of complex speech sounds. We used event-related potential methodology to measure responses to speech-sound contrasts in 45 intensive care neonates, stratified by cumulative exposure as no-, low-, and high-caffeine groups. Sound differentiation in the low-caffeine group and near-term no-caffeine infants was similar with repeated measures analysis of variance controlling for gestational and postnatal age. However, a generalized estimating equation approach demonstrated that, at equivalent postnatal age, differentiation was reduced in the high-caffeine (gestational age 25 weeks) compared to the low-caffeine group (gestational age 28 weeks), reflecting the importance of maturity at birth (Z = 2.77, P < .006). We conclude that caffeine improves measures of auditory processing associated with improved neurodevelopmental outcomes in preterm infants. However, current usage of caffeine for apnea of prematurity cannot fully compensate for the effects of brain immaturity on speech sound processing. PMID:24939976

  11. Taste-Mediated Calming in Premature, Preterm, and Full-Term Human Infants.

    ERIC Educational Resources Information Center

    Smith, Barbara A.; Blass, Elliott M.

    1996-01-01

    Preterm and term infants were given a sucrose solution, a glucose solution, or water during a test period in which the amount of their crying was measured. Sucrose reduced crying in preterm and term infants by 91% and 93%, respectively, and glucose by 86% and 81%, respectively. Water was ineffective in reducing crying in both preterm and term…

  12. Predictors of parenting stress trajectories in premature infant-mother dyads.

    PubMed

    Spinelli, Maria; Poehlmann, Julie; Bolt, Daniel

    2013-12-01

    This prospective longitudinal study examined predictors of parenting stress trajectories over time in a sample of 125 mothers and their preterm infants. Infant (multiple birth, gestational age, days hospitalized, and neonatal health risks) and maternal (socioeconomic, education, depressive symptoms, social support, and quality of interaction during infant feeding) characteristics were collected just prior to infant hospital discharge. Parenting stress and maternal interaction quality during play were measured at 4, 24, and 36 months corrected age. Hierarchical linear modeling was used to analyze infant and maternal characteristics as predictors of parenting stress scores and change over time. Results indicated significant variability across individuals in parenting stress at 4 months and in change trajectories. Mothers of multiples and infants with more medical risks and shorter hospitalization, and mothers with lower education and more depressive symptoms, reported more parenting stress at 4 months of age. Parenting stress decreased over time for mothers of multiples and for mothers with lower education more than for mothers of singletons or for mothers with higher educational levels. Changes in parenting stress scores over time were negatively associated with maternal behaviors during mother-infant interactions. Results are interpreted for their implications for preventive interventions. PMID:24188086

  13. Premature labour

    PubMed Central

    Koh, K.S.

    1976-01-01

    Prematurity is by far the commonest cause of neonatal morbidity and mortality. The management of premature labour is empirical because little is understood about the mechanism of labour. Effective uterine relaxant drugs have an important, albeit minor role. Phototherapy has reduced the complications of neonatal hyperbilirubinemia, and the beneficial effect of antepartum corticosteroid therapy in minimizing the risk of respiratory distress syndrome is now convincing. Prophylactic antibiotic therapy in premature rupture of the membranes does not alter perinatal mortality, although postpartum maternal morbidity is reduced. The introduction of neonatal intensive care units has improved the survival rate of premature infants. Sound clinical judgement remains the mainstay in the management of premature labour. PMID:4217

  14. Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants

    PubMed Central

    Hanson, Corrine; Thoene, Melissa; Wagner, Julie; Collier, Dean; Lecci, Kassandra; Anderson-Berry, Ann

    2012-01-01

    Nutrition support practitioners are currently dealing with shortages of parenteral nutrition micronutrients, including multivitamins (MVI), selenium and zinc. A recent survey from the American Society of Enteral and Parenteral Nutrition (ASPEN) indicates that this shortage is having a profound effect on clinical practice. A majority of respondents reported taking some aggressive measures to ration existing supplies. Most premature infants and many infants with congenital anomalies are dependent on parenteral nutrition for the first weeks of life to meet nutritional needs. Because of fragile health and poor reserves, they are uniquely susceptible to this problem. It should be understood that shortages and rationing have been associated with adverse outcomes, such as lactic acidosis and Wernicke encephalopathy from thiamine deficiency or pulmonary and skeletal development concerns related to inadequate stores of Vitamin A and D. In this review, we will discuss the current parenteral shortages and the possible impact on a population of very low birth weight infants. This review will also present a case study of a neonate who was impacted by these current shortages. PMID:23223000

  15. [Metabolic therapy of premature infants with very low and extremely low birth weight].

    PubMed

    Vinogradova, I V

    2013-01-01

    The efficiency of a metabolic therapy for premature newborns has been assessed. It is established that early metabolic therapy leads to improvement of tissue perfusion, normalization of and alkalipenia indices, and rapid decrease in requirement for high oxygen concentration in carrying out respiratory support, thus producing fast cardiocytoprotective effect. PMID:24605426

  16. An exclusive human milk-based diet in extremely premature infants reduces the probability of remaining on total parenteral nutrition: A reanalysis of the data

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We have previously shown that an exclusively human-milk-based diet is beneficial for extremely premature infants who are at risk for necrotizing enterocolitis (NEC). However, no significant difference in the other primary study endpoint, the length of time on total parenteral nutrition (TPN), was fo...

  17. Convergence and accommodation development is pre-programmed in premature infants

    PubMed Central

    Horwood, Anna M; Toor, Sonia S; Riddell, Patricia M

    2015-01-01

    Purpose This study investigated whether vergence and accommodation development in pre-term infants is pre-programmed or is driven by experience. Methods 32 healthy infants, born at mean 34 weeks gestation (range 31.2-36 weeks) were compared with 45 healthy full-term infants (mean 40.0 weeks) over a 6 month period, starting at 4-6 weeks post-natally. Simultaneous accommodation and convergence to a detailed target were measured using a Plusoptix PowerRefII infra-red photorefractor as a target moved between 0.33m and 2m. Stimulus/response gains and responses at 0.33m and 2m were compared by both corrected (gestational) age and chronological (post-natal) age. Results When compared by their corrected age, pre-term and full-term infants showed few significant differences in vergence and accommodation responses after 6-7 weeks of age. However, when compared by chronological age, pre-term infants’ responses were more variable, with significantly reduced vergence gains, reduced vergence response at 0.33m, reduced accommodation gain, and increased accommodation at 2m, compared to full-term infants between 8-13 weeks after birth. Conclusions When matched by corrected age, vergence and accommodation in pre-term infants show few differences from full-term infants’ responses. Maturation appears pre-programmed and is not advanced by visual experience. Longer periods of immature visual responses might leave pre-term infants more at risk of development of oculomotor deficits such as strabismus. PMID:26275135

  18. Rigidity, sensitivity and quality of attachment: the role of maternal rigidity in the early socio-emotional development of premature infants.

    PubMed

    Butcher, P R; Kalverboer, A F; Minderaa, R B; van Doormaal, E F; ten Wolde, Y

    1993-01-01

    The associations between a mother's rigidity, her sensitivity in early (3 month) interaction and the quality of her premature infant's attachment at 13 months were investigated. Rigidity as a personality characteristic was not found to be significantly associated with sensitivity or quality of attachment. Rigid attitudes to child rearing were related to sensitivity and to the responsivity of the infant. Rigid attitudes were not related to security of attachment. Infants who were rated less responsive at 3 months, however, tended to be less securely attached, and high Attitude Rigidity in the mother increased their chances of an insecure attachment. PMID:8154297

  19. Parents' experiences of their premature infants' transportation from a university hospital NICU to the NICU at two local hospitals.

    PubMed

    Granrud, Marie Dahlen; Ludvigsen, Elin; Andershed, Birgitta

    2014-01-01

    The aim of this study was to describe how the parents of premature infants experience the transportation of their baby from the neonatal intensive care unit at a university hospital (NICU-U) to such a unit at a local hospital (NICU-L). This descriptive qualitative study comprises interviews with nine sets of parents and two mothers. The qualitative content analysis resulted in one theme: living in uncertainty about whether the baby will survive, and three categories: being distanced from the baby; fearing that something would happen to the baby during transportation; and experiencing closeness to the baby. The results also revealed that the parents experienced developmental, situational and health-illness transitions. PMID:24582644

  20. Role of Insulinlike Growth Factor 1 in Fetal Development and in the Early Postnatal Life of Premature Infants.

    PubMed

    Hellström, Ann; Ley, David; Hansen-Pupp, Ingrid; Hallberg, Boubou; Ramenghi, Luca A; Löfqvist, Chatarina; Smith, Lois E H; Hård, Anna-Lena

    2016-09-01

    The neonatal period of very preterm infants is often characterized by a difficult adjustment to extrauterine life, with an inadequate nutrient supply and insufficient levels of growth factors, resulting in poor growth and a high morbidity rate. Long-term multisystem complications include cognitive, behavioral, and motor dysfunction as a result of brain damage as well as visual and hearing deficits and metabolic disorders that persist into adulthood. Insulinlike growth factor 1 (IGF-1) is a major regulator of fetal growth and development of most organs especially the central nervous system including the retina. Glucose metabolism in the developing brain is controlled by IGF-1 which also stimulates differentiation and prevents apoptosis. Serum concentrations of IGF-1 decrease to very low levels after very preterm birth and remain low for most of the perinatal development. Strong correlations have been found between low neonatal serum concentrations of IGF-1 and poor brain and retinal growth as well as poor general growth with multiorgan morbidities, such as intraventricular hemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia, and necrotizing enterocolitis. Experimental and clinical studies indicate that early supplementation with IGF-1 can improve growth in catabolic states and reduce brain injury after hypoxic/ischemic events. A multicenter phase II study is currently underway to determine whether intravenous replacement of human recombinant IGF-1 up to normal intrauterine serum concentrations can improve growth and development and reduce prematurity-associated morbidities. PMID:27603537

  1. Treatment for retinopathy of prematurity in an infant with adenoviral conjunctivitis.

    PubMed

    Gunay, Murat; Celik, Gokhan; Con, Rahim

    2015-01-01

    Retinopathy of prematurity (ROP) has been a major problematic disorder during childhood. Laser photocoagulation (LPC) has been proven to be effective in most of the ROP cases. Adenoviral conjunctivitis (AVC) is responsible for epidemics among adult and pediatric population. It has also been reported to be a cause of outbreaks in neonatal intensive care units (NICU) several times. We herein demonstrate a case with AVC who underwent LPC for ROP. And we discuss the treatment methodology in such cases. PMID:25874149

  2. 75 FR 43535 - NIH Consensus Development Conference on Inhaled Nitric Oxide Therapy for Premature Infants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... week of pregnancy) with respiratory failure. Inhaled nitric oxide therapy is typically administered in...-term infants, use of this therapy may shorten the length of time respiratory support is required... receive respiratory support? Are there short-term risks of inhaled nitric oxide therapy among...

  3. Magnetic Resonance Imaging--Insights into Brain Injury and Outcomes in Premature Infants

    ERIC Educational Resources Information Center

    Mathur, Amit; Inder, Terrie

    2009-01-01

    Preterm birth is a major public-health issue because of its increasing incidence combined with the frequent occurrence of subsequent behavioral, neurological, and psychiatric challenges faced by surviving infants. Approximately 10-15% of very preterm children (born less than 30 weeks gestational age) develop cerebral palsy, and 30-60% of them…

  4. The Development of Regulatory Functions from Birth to 5 Years: Insights from Premature Infants

    ERIC Educational Resources Information Center

    Feldman, Ruth

    2009-01-01

    This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation…

  5. Cost of care and social consequences of very low birth weight infants without premature- related morbidities in Italy.

    PubMed

    Cavallo, Maria Caterina; Gugiatti, Attilio; Fattore, Giovanni; Gerzeli, Simone; Barbieri, Dario; Zanini, Rinaldo

    2015-01-01

    Aim of this study was to estimate the cost that is borne by the Italian National Health Service, families, and social security due to very low birth weight infants (VLBWIs) without prematurity-related morbidities up to the age of 18 months. We followed up on 150 VLBWIs and 145 comparable full-term infants (FTIs) who were born in one of 25 different neonatal intensive care units upon discharge from the hospital and at six and 18 months of age. The average length of the primary hospitalisation of the VLBWIs was 59.7 days (SD 21.6 days), with a total cost of €20,502 (SD €8409), compared with three days (SD 0.4 days) with a total cost of €907 (SD €304) for the FTIs. The total societal cost of the VLBWIs for the first 18 months of life was €58,098 (SD €21,625), while the corresponding figure for FTIs was €24,209 (SD €15,557). Among VLBWIs, both low birth weight and gestational age were correlated with the length of hospitalisation after birth (r(2) = 0.61 and r(2) = 0.57, respectively; p values < 0.0005). Our findings highlight that the existing DRGs and tariffs inadequately reflect the actual costs for Italian National Health Service. PMID:26286526

  6. Patterns of Respiratory Disease During the First 2 Postnatal Weeks in Extremely Premature Infants

    PubMed Central

    Laughon, Matthew; Allred, Elizabeth N.; Bose, Carl; O'Shea, T. Michael; Van Marter, Linda J.; Ehrenkranz, Richard A.; Leviton, Alan

    2009-01-01

    Background Pulmonary disease among infants of <28 weeks' gestation (extremely low gestational age newborns) often has the following pattern: the infant starts out with little need for supplemental oxygen and ventilatory support in the first postnatal week but then has pulmonary deterioration in the second postnatal week, with an increased need for supplemental oxygen and respiratory support. We evaluated the antecedents and correlates of patterns of early lung disease, with particular emphasis on pulmonary deterioration, in a large cohort study (the Extremely Low Gestational Age Newborn [ELGAN] study). Patients and Methods We examined data collected prospectively on 1340 infants born between 2002 and 2004 at 23 to 27 completed weeks of gestation and who survived to 14 days. Pulmonary deterioration was defined as receipt of fraction of inspired oxygen <0.23 on any day between days 3 and 7 and receipt of fraction of inspired oxygen ≥ 0.25 on day 14. Results One fifth (20%) of the infants had consistently low fraction of inspired oxygen, approximately two fifths (38%) had pulmonary deterioration, and the remaining approximately two fifths (43%) had consistently high fraction of inspired oxygen (early and persistent lung dysfunction). Compared with infants who had consistently low fraction of inspired oxygen, infants who experienced pulmonary deterioration had lower gestational ages and lower birth weights, had higher scores for neonatal acute physiology, and received more intensive modes of respiratory support. Gender, multifetal pregnancy, cesarean delivery, antenatal steroids, chorioamnionitis, and funisitis were not associated with pulmonary deterioration. The incidence of chronic lung disease, defined as oxygen therapy at 36 weeks' postmenstrual age, was 17% in the consistently low fraction of inspired oxygen group, 51% in the pulmonary deterioration group, and 67% in the early and persistent pulmonary dysfunction group. The incidence of death in these 3 groups

  7. Increased level/dose ratio of amphotericin-B in premature infants with renal failure.

    PubMed

    Higuchi, R; Kusumoto, S; Ban, H; Iwahashi, S; Kobayashi, M; Sumiyama, K; Koike, M

    1993-06-01

    We introduced continuous intravenous infusion of amphotericin-B (AMPH-B) to extremely low birthweight (ELBW) infants (< 1000 g) with or without renal failure as a single agent for treating definite or probable systemic candidiasis. The species of Candida isolated from blood or tracheal aspirate or urine were C. albicans in seven infants, C glabrata in two, C. tropicalis in one and C. parapsilosis in one. The minimal inhibitory concentrations (MIC) of AMPH-B required against these isolates were less than 0.2 micrograms/mL except for that against one strain of C. albicans (0.78 microgram/mL). Serum AMPH-B levels were 0.31-0.78 (0.51 +/- 0.14) micrograms/mL when doses of 0.2-0.55 (0.32 +/- 0.11) mg/kg per day were being administered. The serum level was higher than the MIC of each isolate in all but one infant who died of disseminated intravascular coagulation and Candida pneumonia. Another infant died of congenital heart disease. The other nine infants survived. The serum level showed no correlation with the daily dose. The ratio of the serum level to the daily dose (L/D ratio) showed a significant correlation to serum creatinine (r = 0.787) and the linear regression curve followed the equation: L/D ratio = 0.223 x serum creatinine + 1.11 (P < 0.01). Few adverse effects due to AMPH-B were noted. Our data may give a simple reference to serum AMPH-B levels during continuous intravenous infusion from the dose and the serum creatinine level. PMID:8351992

  8. Radiation Exposure to Premature Infants in a Neonatal Intensive Care Unit in Turkey

    PubMed Central

    Onal, Esra; Bor, Dogan; Okumus, Nurullah; Atalay, Yildiz; Turkyilmaz, Canan; Ergenekon, Ebru; Koc, Esin

    2008-01-01

    Objective The aim of this work was to determine the radiation dose received by infants from radiographic exposure and the contribution from scatter radiation due to radiographic exposure of other infants in the same room. Materials and Methods We retrospectively evaluated the entrance skin doses (ESDs) and effective doses of 23 infants with a gestational age as low as 28 weeks. ESDs were determined from tube output measurements (ESDTO) (n = 23) and from the use of thermoluminescent dosimetry (ESDTLD) (n = 16). Scattered radiation was evaluated using a 5 cm Perspex phantom. Effective doses were estimated from ESDTO by Monte Carlo computed software and radiation risks were estimated from the effective dose. ESDTO and ESDTLD were correlated using linear regression analysis. Results The mean ESDTO for the chest and abdomen were 67 µGy and 65 µGy per procedure, respectively. The mean ESDTLD per radiograph was 70 µGy. The measured scattered radiation range at a 2 m distance from the neonatal intensive care unit (NICU) was (11-17 µGy) per radiograph. Mean effective doses were 16 and 27 µSv per procedure for the chest and abdomen, respectively. ESDTLD was well correlated with ESDTO obtained from the total chest and abdomen radiographs for each infant (R2 = 0.86). The radiation risks for childhood cancer estimated from the effective dose were 0.4 × 10-6 to 2 × 10-6 and 0.6 × 10-6 to 2.9 × 10-6 for chest and abdomen radiographs, respectively. Conclusion The results of our study show that neonates received acceptable doses from common radiological examinations. Although the contribution of scatter radiation to the neonatal dose is low, considering the sensitivity of the neonates to radiation, further protective action was performed by increasing the distance of the infants from each other. PMID:18838850

  9. Placental Villous Vascularity Is Decreased in Premature Infants with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension.

    PubMed

    Yallapragada, Sushmita G; Mestan, Karen K; Palac, Hannah; Porta, Nicolas; Gotteiner, Nina; Hamvas, Aaron; Grobman, William; Ernst, Linda M

    2016-01-01

    The development of pulmonary hypertension (PH) is a serious complication of bronchopulmonary dysplasia (BPD) among infants born at extremely low gestational ages. Bronchopulmonary dysplasia-associated PH is characterized by persistent pulmonary vasoconstriction, progressive right heart dysfunction, and an increased risk of death. We have shown previously that certain placental vascular lesions are associated with BPD-associated PH. Further evaluation of the villous and vascular morphometry of these placentas is warranted. Using digital image analysis (DIA), we compared villous and vascular morphometric parameters of placentas from infants with and without BPD-associated PH. We conducted a case-control study of placentas from 14 infants born at ≤28 weeks' gestational age (GA). Cases with PH (N=7) and non-PH controls (N=7) were identified using echocardiogram screening at 36 weeks' corrected GA. Central parenchymal sections from each placenta were stained for CD31. Digital image analysis was used to measure vessel and villous capillary number, perimeter, diameter, and area. Mean villous vascularity (number of vessels per villus) was calculated for each patient. Mean vessel and villous number as well as area were similar between the two groups. Villous vascularity was decreased in placentas from infants who ultimately had PH disease compared to non-PH controls (5.5±1.0 vs 7.1±1.6; P<0.05). Placental villous vascularity is decreased in infants with BPD-associated PH. Further studies should assess whether placental morphometric markers may allow clinicians to better predict BPD and provide earlier and more targeted management. PMID:26366786

  10. Influence of formulas with borage oil or borage oil plus fish oil on the arachidonic acid status in premature infants.

    PubMed

    Demmelmair, H; Feldl, F; Horváth, I; Niederland, T; Ruszinkó, V; Raederstorff, D; De Min, C; Muggli, R; Koletzko, B

    2001-06-01

    Several studies have reported that feeding gamma-linolenic acid (GLA) has resulted in no increase in arachidonic acid (AA) in newborns. This result was ascribed to the eicosapentaenoic acid (EPA)-rich fish oil used in these formulas. Docosahexaenoic acid (DHA) sources with only minor amounts of EPA are now available, thus the addition of GLA to infant formulas might be considered an alternative to AA supplementation. Sixty-six premature infants were randomized to feeding one of four formulas [ST: no GLA, no long-chain polyunsaturated fatty acids; BO: 0.6% GLA (borage oil); BO + FOLOW: 0.6% GLA, 0.3% DHA, 0.06% EPA; BO + FOHIGH: 0.6% GLA, 0.3% DHA, 0.2% EPA] or human milk (HM, nonrandomized) for 4 wk. Anthropometric measures and blood samples were obtained at study entry and after 14 and 28 d. There were no significant differences between groups in anthropometric measures, tocopherol, and retinol status at any of the studied time points. The AA content of plasma phospholipids was similar between groups at study start and decreased significantly until day 28 in all formulafed groups, but not in the breast-fed infants [ST: 6.6 +/- 0.2%, BO: 6.9 +/- 0.3%, BO + FOLOW: 6.9 +/- 0.4%, BO + FOHIGH: 6.7 +/- 0.2%, HM: 8.6 +/- 0.5%, where values are reported as mean +/- standard error; all formulas significantly different (P< 0.05) from HM]. There was no significant influence of GLA or fish oil addition to the diet. GLA had only a very limited effect on AA status which was too small to obtain satisfactory concentrations (concentrations similar to breast-fed babies) under the circumstances tested. The effect of GLA on AA is independent of the EPA and DHA content in the diet within the dose ranges studied. PMID:11485158

  11. Auditory brain development in premature infants: the importance of early experience.

    PubMed

    McMahon, Erin; Wintermark, Pia; Lahav, Amir

    2012-04-01

    Preterm infants in the neonatal intensive care unit (NICU) often close their eyes in response to bright lights, but they cannot close their ears in response to loud sounds. The sudden transition from the womb to the overly noisy world of the NICU increases the vulnerability of these high-risk newborns. There is a growing concern that the excess noise typically experienced by NICU infants disrupts their growth and development, putting them at risk for hearing, language, and cognitive disabilities. Preterm neonates are especially sensitive to noise because their auditory system is at a critical period of neurodevelopment, and they are no longer shielded by maternal tissue. This paper discusses the developmental milestones of the auditory system and suggests ways to enhance the quality control and type of sounds delivered to NICU infants. We argue that positive auditory experience is essential for early brain maturation and may be a contributing factor for healthy neurodevelopment. Further research is needed to optimize the hospital environment for preterm newborns and to increase their potential to develop into healthy children. PMID:22524335

  12. To-and-for extracorporeal lung assist (ECLA) through a single catheter-in premature goats as an experimental model of infant respiratory Insufficiency.

    PubMed

    Tanoue, T; Terasaki, H; Sadanaga, M A; Tsuno, K; Morioka, T

    1988-09-01

    A new to-and-fro V-V bypass extracorporeal lung assist (ECLA) through a single catheter as a blood access was investigated for its efficacy on six premature goats delivered by Cesarean section at a gestational age of 118 approximately 139 days as an experimental model of infant respiratory insufficiency, then applied to a human premature infant suffering from life threatening barotrauma that had developed from mechanical pulmonary ventilation. The extracorporeal bypass flow and the gas flow to the artificial membrane lung were controlled to keep Pa(O)(2) above 40 mmHg and Pa(CO)(2) within normal limits. The neonate's own lungs were treated with a continuous positive airway pressure of 5 approximately 12 cmH(2)O, apneic oxygenation or IMV. Two goats weighing 1250 g and 700 g died 2 approximately 2.5 hours after birth from severe circulatory distress. However, the other four neonates which were heavier than 2000 g, were successfully weaned from ECLA, and three of these could be weaned from mechanical ventilation as well. A human infant also survived and was weaned from ECLA on the third day.(Tanoue T, Terasaki H, Sadanaga M et al.: To-and-fro extracorporeal lung assist (ECLA) through a single catheter-in premature goats as an experimental model of infant respiratory insufficiency. PMID:15236069

  13. Surgical Ligation for Patent Ductus Arteriosus in Extremely Premature Infants: Strategy to Reduce their Risk of Neurodevelopmental Impairment.

    PubMed

    Ito, Satoko; Matsuda, Tadashi; Usuda, Haruo; Watanabe, Shimpei; Kitanishi, Ryuta; Hanita, Takushi; Watanabe, Tatsuya; Adachi, Osamu

    2016-01-01

    Surgical ligation for patent ductus arteriosus (PDA) in extremely low birth weight infants (ELBWIs) has been shown a possible association with neurodevelopmental impairment (NDI) because of its invasiveness. However, we have undergone surgical ligation for ELBWIs immediately after cyclooxygenase inhibitor failed to close a hemodynamically significant PDA (hsPDA) to maintain proper systemic circulation. We aimed to determine the effect of surgical ligation for hsPDA on NDI in ELBWIs. In enrolled 71 ELBWIs, the clinical parameters, including the developmental quotient (DQ), were collected and compared among three groups that were divided by closure mode: spontaneous closure (n = 11), cyclooxygenase inhibitor therapy (n = 37) and surgical ligation (n = 23). No significant differences in DQ at the age of 36 months among the three groups were found: Median (interquartile range): 92.0 (31.0), 89.0 (22.0) and 92.0 (24.5), respectively. In a comparison between groups of DQ < 70 (n = 15) and DQ ≥ 70 (n = 56), a significant difference was found in the parameters related to prematurity (p < 0.05 for each): gestational age [23.9 (1.70) vs. 25.4 (2.50) weeks], birth weight [595 (183) vs. 714 (192) g], Apgar score < 5 (1 min) (67% vs. 36%), and laser photocoagulation for retinopathy of prematurity (73% vs. 43%), but there was no significant association with hsPDA. Therefore, we propose that surgical ligation for hsPDA in ELBWIs should be immediately carried out for preventing future neurodevelopmental deterioration if the cyclooxygenase inhibitor failed to close hsPDA. PMID:27558322

  14. Use of Biphasic Continuous Positive Airway Pressure in Premature Infant with Cleft Lip–Cleft Palate

    PubMed Central

    George, Lovya; Jain, Sunil K.

    2015-01-01

    Preterm infants (PIs) often require respiratory support due to surfactant deficiency. Early weaning from mechanical ventilation to noninvasive respiratory support decreases ventilation-associated irreversible lung damage. This wean is particularly challenging in PIs with cleft lip and cleft palate due to anatomical difficulties encountered in maintaining an adequate seal for positive pressure ventilation. PI with a cleft lip and palate often fail noninvasive respiratory support and require continued intubation and mechanical ventilation. We are presenting the first case report of a PI with cleft lip and palate who was managed by biphasic nasal continuous positive airway pressure. PMID:26495158

  15. Non-invasive Ventilation in Premature Infants: Based on Evidence or Habit

    PubMed Central

    Garg, Shalabh; Sinha, Sunil

    2013-01-01

    Despite surfactant and mechanical ventilation being the standard of care for preterm infants with respiratory failure, non-invasive respiratory support is increasingly being employed in neonatal units. The latter can be accomplished in a variety of ways but none of them have been proven so far to be superior to intubation and mechanical ventilation. Nonetheless, they appear to be safe and effective in experienced hands. This article relates to the use of non-invasive forms of respiratory support and evidence is reviewed from the clinical trials which have evaluated the use of these techniques. PMID:24404523

  16. Use of Biphasic Continuous Positive Airway Pressure in Premature Infant with Cleft Lip-Cleft Palate.

    PubMed

    George, Lovya; Jain, Sunil K

    2015-10-01

    Preterm infants (PIs) often require respiratory support due to surfactant deficiency. Early weaning from mechanical ventilation to noninvasive respiratory support decreases ventilation-associated irreversible lung damage. This wean is particularly challenging in PIs with cleft lip and cleft palate due to anatomical difficulties encountered in maintaining an adequate seal for positive pressure ventilation. PI with a cleft lip and palate often fail noninvasive respiratory support and require continued intubation and mechanical ventilation. We are presenting the first case report of a PI with cleft lip and palate who was managed by biphasic nasal continuous positive airway pressure. PMID:26495158

  17. A Bayesian approach to the characterization of electroencephalographic recordings in premature infants

    NASA Astrophysics Data System (ADS)

    Mitchell, Timothy J.

    Preterm infants are particularly susceptible to cerebral injury, and electroencephalographic (EEG) recordings provide an important diagnostic tool for determining cerebral health. However, interpreting these EEG recordings is challenging and requires the skills of a trained electroencephalographer. Because these EEG specialists are rare, an automated interpretation of newborn EEG recordings would increase access to an important diagnostic tool for physicians. To automate this procedure, we employ a novel Bayesian approach to compute the probability of EEG features (waveforms) including suppression, delta brushes, and delta waves. The power of this approach lies not only in its ability to closely mimic the techniques used by EEG specialists, but also its ability to be generalized to identify other waveforms that may be of interest for future work. The results of these calculations are used in a program designed to output simple statistics related to the presence or absence of such features. Direct comparison of the software with expert human readers has indicated satisfactory performance, and the algorithm has shown promise in its ability to distinguish between infants with normal neurodevelopmental outcome and those with poor neurodevelopmental outcome.

  18. [Comparative study of two methods of holding premature infants: the kangaroo method versus the traditional method].

    PubMed

    Legault, M; Goulet, C

    1993-01-01

    This study compared two methods of holding preterm infants: 1) the kangaroo, or skin-to-skin method (K) and 2) the traditional method, or normal handling (T). Skin temperature, heart rate, respiratory rate and oxygen saturation were monitored during both the kangaroo and the traditional handling methods. After testing with the two methods, the mothers indicated their satisfaction and preference. Sixty-one pairs of mothers and babies were tested once with the K method and once with the T method. The first method tested was determined at random: 50% began with K and 50% with T. Skin temperature, heart rate and respiratory rate were similar with both K and T methods. Whereas oxygen saturation was significantly lower (92.8% vs 90.5%, p < 0.0001) under the T method, time of testing was longer (29.5 min vs 25.3 min, p = 0.02) for the K method than for T method. In summary, the findings suggested that mothers preferred the K method because the cold stress factor was avoided, oxygenation was better maintained, and mothers felt closer to their infants. PMID:10603808

  19. Neurobehavioral Assessment from Fetus to Infant: The NICU Network Neurobehavioral Scale and the Fetal Neurobehavior Coding Scale

    ERIC Educational Resources Information Center

    Salisbury, Amy L.; Fallone, Melissa Duncan; Lester, Barry

    2005-01-01

    This review provides an overview and definition of the concept of neurobehavior in human development. Two neurobehavioral assessments used by the authors in current fetal and infant research are discussed: the NICU Network Neurobehavioral Assessment Scale and the Fetal Neurobehavior Coding System. This review will present how the two assessments…

  20. Postnatal weight gain in very low birth weight infants in Beijing and the risk of retinopathy of prematurity

    PubMed Central

    Wang, Zong-Hua; Gao, Peng-Fen; Bai, Hua; Li, Yao-Yu

    2015-01-01

    AIM To analyze the low weight gain (WG) from birth to 4 and 6wk of life to predict the development of retinopathy of prematurity (ROP) among very low birth weight (VLBW) preterm babies. METHODS Three hundred and three newborns with VLBW were analyzed. Body weight measurements were recorded weekly. In all patients, the proportion of the WG was defined as the preterm weight measured at the 4th and 6th weeks of life minus the birth weight (BW) divided by the BW. Other risk factors for ROP were also analyzed. RESULTS Mean gestational age and mean BW of the whole cohort were 29.56±1.44wk and 1270.58±176.18g respectively. WG proportion at 4wk postnatal age (18.89%±13.58%) were significantly lower in infants with ROP (P=0.003). WG proportion at 6wk was not different between ROP and no ROP group (42.48%±20.36% vs 46.43%±15.65% P=0.118). When all the other risk factors significant for ROP were included in the logistic regression poor WG did not arise as an independent risk factor. Area under the ROC curve was 0.591 (95%CI: 0.515-0.666; P=0.016). For ROP, the best discriminative cutoff of 18.06% of the proportional WG at the 4th week over the BW, sensitivity and specificity values were 67.3% and 50.0% respectively. CONCLUSION Low WG proportion in the first 4wk of life is maybe an additional predictor of ROP in very low BW infants. Preterm babies with low BW and low WG proportion should be followed closely for ROP. PMID:26682174

  1. Cyclooxygenase-2 Inhibition Provides Lasting Protection Following Germinal Matrix Hemorrhage in Premature Infant Rats.

    PubMed

    Lekic, Tim; Krafft, Paul R; Klebe, Damon; Rolland, William B; Flores, Jerry; Tang, Jiping; Zhang, John H

    2016-01-01

    Germinal matrix hemorrhage (GMH) is a major cause of brain damage in prematurity and has long-lasting neurological implications. The development of brain inflammation contributes to brain injury, leading to a lifetime of neurologic deficits. PAR-1 and 4 receptors are involved with inflammatory pathways after brain hemorrhage in adult models of stroke, of which cyclooxygenase-2 (COX-2) is a potential mediator. We therefore hypothesized a role for PAR-1, 4/ COX-2 signaling following GMH. Postnatal day 7 Sprague-Dawley rats were subjected to GMH induction, which entailed stereotactic collagenase infusion into the ganglionic eminence. Animals were euthanized at two time points: 72 h (short-term) or 4 weeks (long-term). Short-term COX-2 expression was evaluated in the context of PAR-1 (SCH-79797) and PAR-4 (P4pal10) inhibition. Pups in the long-term group were administered the selective COX-2 inhibitor (NS-398); and the neurobehavioral and pathological examinations were performed 4 weeks later. Pharmacological PAR-1, 4 antagonism normalized COX-2 expression following GMH and reduced hydrocephalus. Early inhibition of COX-2 by NS-398 improved long-term neurobehavioral outcomes. COX-2 signaling plays an important role in brain injury following neonatal GMH, possibly through upstream PAR-1, 4 receptor mechanisms. PMID:26463949

  2. Managing the remains of fetuses and abandoned infants: A call to urgently review South African law and medicolegal practice.

    PubMed

    Du Toit-Prinsloo, Lorraine; Pickles, Camilla; Saayman, Gert

    2016-01-01

    This article reviews South African (SA) law and its impact on the medicolegal management of fetal remains emanating from elective and therapeutic termination of pregnancies, stillbirths and miscarriages and the remains of abandoned or exposed infants. It was found that remains are treated differently, some constituting medical waste while others have sufficient status in law to allow for burial. This approach results in some women or couples being denied a choice with regard to disposal via culturally relevant practices, and is insensitive to the fact that all remains ultimately constitute human remains. The article argues that SA law is in urgent need of reform, and turns to foreign law and forensic practice to shed light on possible alternative approaches that could assist with developing the SA position and thereby improve the practical management of fetal and infant remains in SA. PMID:27245721

  3. The effect of neutral oligosaccharides on fecal microbiota in premature infants fed exclusively with breast milk: A randomized clinical trial

    PubMed Central

    Armanian, Amir-Mohammad; Sadeghnia, Alireza; Hoseinzadeh, Maryam; Mirlohi, Maryam; Feizi, Awat; Salehimehr, Nima; Torkan, Moloud; Shirani, Zahra

    2016-01-01

    Objective: This study was designed to compare the efficacy and safety of enteral supplementation of a prebiotic mixture (SCGOS/LCFOS) on faecal microbiota in very premature infants who fed exclusively with human-milk. Methods: This double-center randomized control trial was conducted from December 2012 to November 2013 in the tertiary Neonatal Intensive Care Units of the Isfahan University of Medical Sciences. Fifty preterm infants (birth weight ≤1500 g who were not fed with formula) were randomly allocated to have enteral (tube feeding) supplementation with a prebiotic mixture (SCGOS/LCFOS; 9:1) or receive no prebiotics. Findings: The primary outcome (e.g., the effect of the prebiotic mixture on fecal microbiota pattern) was clearly different between the two groups. Despite greater coliforms colony counts in first stool cultures in the prebiotic group (Group P) (P = 0.67), coliforms were significantly lower in the third stool cultures in the Group P (P < 0.001). Furthermore, despite the much higher Lactobacillus colony counts, in the first stool cultures, in the control group (Group C) (P = 0.005); there was a trend toward significantly increased Lactobacillus colony counts in the Group P during the study, but the difference between Lactobacillus colony counts, in the third stool cultures, between two groups was no longer statistically significant (P = 0.11). Interestingly, the median length of hospital stay was significantly less in the Group P (16 [12.50–23.50] vs. 25 [19.50–33.00] days; P = 0.003). Conclusion: This suggests that it might have been “the complete removal of formula” which manifests a synergistic effect between nonhuman neutral oligosaccharides (prebiotics) and human oligosaccharides, which in turn, led to the rapid growth of beneficial Lactobacillus colonies in the gut of breast milk-fed preterm infants, while decreasing the number of pathogenic coliforms microorganisms. Therefore, further studies with larger sample sizes are

  4. Retinopathy of prematurity.

    PubMed

    Jordan, Catherine O

    2014-06-01

    Premature infants born at 30 weeks' gestational age or younger, or 1500 g or smaller, are screened for retinopathy of prematurity (ROP). Guidelines for supplemental oxygen in neonatal intensive care units have decreased but not eliminated the incidence of severe ROP. The underlying cause for ROP is prematurity and low birth weight, and with the survival of smaller and younger babies, ROP continues to be a significant problem facing premature infants. Threshold ROP is treated with retinal photocoagulation, but newer treatments such as intraocular injections of bevacizumab (Avastin) are being used alone or in conjunction with laser. PMID:24852153

  5. Irreducible indirect inguinal hernia containing uterus and bilateral adnexa in a premature female infant: report of an exceptional case and review of the literature.

    PubMed

    Cascini, Valentina; Lisi, Gabriele; Di Renzo, Dacia; Pappalepore, Nicola; Lelli Chiesa, Pierluigi

    2013-01-01

    Indirect inguinal hernia is the most common congenital anomaly in the pediatric age group. About 15-20% of hernias in infant girls contain ovary, sometimes with a Fallopian tube. The presence of the uterus incarcerated with the adnexa is a very unusual occurrence in female infants with normal kariotype and phenotype, being commonly associated with several disorders of sex development. The surgical repair of this form of hernia is more difficult than a common herniorrhaphy because of the adhesions between the organs and the wall of the sac and the risk of damage during their freeing. We present a rare case of irreducible indirect inguinal hernia containing uterus and bilateral adnexa (fallopian tubes and ovaries) in a premature female infant, discussing the etiopathogenesis and the surgical features of this disorder. PMID:23331833

  6. Double-blind clinical trial of calf lung surfactant extract for the prevention of hyaline membrane disease in extremely premature infants.

    PubMed

    Kwong, M S; Egan, E A; Notter, R H; Shapiro, D L

    1985-10-01

    A prospective, double-blind, controlled trial was conducted to determine whether instillation of an exogenous surfactant into the lungs before the first breath could prevent hyaline membrane disease. The surfactant is calf lung lipid extracted from saline lung lavage. Entry was limited to infants who were 24 to 28 weeks' gestation, who were born at Children's Hospital of Buffalo, and whose mothers had not received betamethasone for more than 24 hours before birth. Treated infants received 3 mL (90 mg) of calf lung surfactant extract instilled into their trachea before the first breath; control infants received 3 mL of normal saline. A prospective scoring system and respiratory support variables were used to compare the groups. At 48 hours of age, only two of 14 calf lung surfactant extract-treated infants (14%) had hyaline membrane disease compared with seven of 13 control infants (54%) (P = .033). Inspired oxygen, mean airway pressure, ventilator rate and ventilator efficiency index were also lower in the treated group during the first 48 hours of life (P less than .01 to P less than .001). Calf lung surfactant extract instillation at birth appears to be an effective material and method of preventing hyaline membrane disease in extremely premature infants. PMID:3900906

  7. The Effects of Massage with Coconut and Sunflower Oils on Oxygen Saturation of Premature Infants with Respiratory Distress Syndrome Treated With Nasal Continuous Positive Airway Pressure

    PubMed Central

    Valizadeh, Sousan; Hosseini, Mohammad Bagher; Asghari Jafarabadi, Mohammad; Ajoodanian, Najmeh

    2012-01-01

    Introduction: Nowadays particular emphasis is placed on the developmental aspects of premature infants care. Massage therapy is one of the best-known methods of caring. Due to the minimal touch policy in neonatal intensive care units (NICUs), massaging is not usually performed on premature infants. However, there is not sufficient evidence to support the claim that newborn infants with complex medical conditions should not be massaged. This study aimed to determine the effects of massage with coconut and sunflower oils on oxygen saturation of infants with respiratory distress syndrome (RDS) treated with nasal continuous positive airway pressure (NCPAP). Methods: This was a randomized controlled trial on 90 newborns who were admitted to Alzahra Hospital (Tabriz, Iran). The infants were divided into control and massage therapy groups (massage with coconut and sunflower oils). Data was collected using a hospital documentation form. A 15-minute daily massage was performed for 3 days. Respiratory rate (RR), fraction of inspired oxygen (FiO2) and oxygen saturation were measured 5 minutes before the massage, 3 times during the massage, and 5 minutes after the massage. The collected data was analyzed using a mixed model. Results: In comparison to coconut oil and control groups, mean oxygen saturation of sunflower oil group was improved. In addition, the coconut massage group showed lower oxygen saturation than the control group but was all values were within the normal range. Although massage decreased oxygen saturation, there was no need to increase FiO2. Conclusion: Massage therapy can provide developmental care for infants treated with NCPAP. PMID:25276695

  8. The last and first frontier – emerging challenges for HIV treatment and prevention in the first week of life with emphasis on premature and low birth weight infants

    PubMed Central

    Cotton, Mark F; Holgate, Sandi; Nelson, Aurelie; Rabie, Helena; Wedderburn, Catherine; Mirochnick, Mark

    2015-01-01

    Introduction There is new emphasis on identifying and treating HIV in the first days of life and also an appreciation that low birth weight (LBW) and preterm delivery (PTD) frequently accompany HIV-related pregnancy. Even in the absence of HIV, PTD and LBW contribute substantially to neonatal and infant mortality. HIV-exposed and -infected infants with these characteristics have received little attention thus far. As HIV programs expand to meet the 90-90-90 target for ending the HIV pandemic, attention should focus on newborn infants, including those delivered preterm or of LBW. Discussion In high prevalence settings, infant diagnosis of HIV is usually undertaken after the neonatal period. However, as in utero infection may be diagnosed at birth, earlier initiation of therapy may limit viral replication and prevent early damage. Globally, there is growing awareness that preterm and LBW infants constitute a substantial proportion of births each year. Preterm infants are at high risk for vertical transmission. Feeding difficulties, apnoea of prematurity and vulnerability to sepsis occur commonly. Feeding intolerance, a frequent occurrence, may compromise oral administration of medications. Although there is growing experience with post-exposure prophylaxis for HIV-exposed term newborn infants, there is less experience with preterm and LBW infants. For treatment, there are even fewer options for preterm infants. Only zidovudine has adequate dosing recommendations for treating term and preterm infants and has an intravenous formulation, essential if feeding intolerance occurs. Nevirapine dosing for prevention, but not treatment, is well established for both term and preterm infants. HIV diagnosis at birth is likely to be extremely stressful for new parents, more so if caring for preterm or LBW infants. Programs need to adapt to support the medical and emotional needs of young infants and their parents, where interventions may be lifesaving. Conclusions New focus is

  9. [Spontaneus ductal closure in a fetus postnatally diagnosed as Adams-Olivier syndrome].

    PubMed

    Włoch, Agata; Borowski, Dariusz; Czuba, Bartosz; Włoch, Stanisław; Sodowski, Krzysztof

    2006-08-01

    In utero isolated ductal closure is uncommon and can lead to congestive heart failure, fetal hydrops and death if not recognized. A case report of premature spontaneus ductal closure in the third trimester of pregnancy in a fetus postnatally diagnosed as Adams-Olivier Syndrome is presented. On ultrasound examination an intrauterine growth restriction, defects of bones of hands and feet as well as ventriculomegaly were found. No nonsteroid drug treatment during pregnancy was applied. Fetal echocardiography was performed following an abnormal four-chamber view. Premature ductal closure was diagnosed. Fetal echocardiogram showed absent flow in the ductus arteriosus, dilated right ventricle with decreased function, and moderate tricuspid and pulmonary valve insufficiency with no signs of fetal hydrops. An elective cesarean section was performed. All abnormalities observed on former echocardiogram exam withdrew within 3 months of infant's life. The infant stays in the tertiary care centre due to the extracardiac malformations. PMID:17076195

  10. Effects of L-carnitine supplementation on respiratory distress syndrome development and prognosis in premature infants: A single blind randomized controlled trial

    PubMed Central

    OZTURK, MEHMET ADNAN; KARDAS, ZEHRA; KARDAS, FATİH; GUNES, TAMER; KURTOGLU, SELİM

    2016-01-01

    The aim of the present study was to investigate the efficacy of L-carnitine therapy on the occurrence and prognosis of respiratory distress syndrome (RDS). A single blind, randomized controlled trial study was conducted on 130 infants with gestational ages of 28–36 weeks. Infants were assigned to experimental groups (groups 1 and 2) and control groups (groups 3 and 4). Groups 1 and 3 consisted of infants with RDS, and groups 2 and 4 groups were composed of infants without RDS. The experimental groups were treated with carnitine. No statistically significant differences in serum carnitine levels were detected between the study and the control groups on day 1 of treatment (P=0.06). However, on day 7 of treatment, serum carnitine levels in the experimental groups were significantly increased (P=0.02), as compared with the control groups. The surfactant requirement value, which is how many rounds of surfactant therapy were required, was 1.56±0.97 in group 1, and 2.12±0.99 in group 3 (P<0.001). The mean duration of mechanical ventilation required was 3.04±3.60 days in group 1, and 4.73±5.63 days in group 3 (P<0.001). The present results indicate that carnitine supplementation in premature infants with RDS may help to increase carnitine levels, thus decreasing the duration of mechanical ventilation and surfactant requirement. PMID:26998047