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Sample records for healthy infants born

  1. Sensitive Quantitative Analysis of the Meconium Bacterial Microbiota in Healthy Term Infants Born Vaginally or by Cesarean Section.

    PubMed

    Nagpal, Ravinder; Tsuji, Hirokazu; Takahashi, Takuya; Kawashima, Kazunari; Nagata, Satoru; Nomoto, Koji; Yamashiro, Yuichiro

    2016-01-01

    For decades, babies were thought to be born germ-free, but recent evidences suggest that they are already exposed to various bacteria in utero. However, the data on population levels of such pioneer gut bacteria, particularly in context to birth mode, is sparse. We herein aimed to quantify such bacteria from the meconium of 151 healthy term Japanese infants born vaginally or by C-section. Neonatal first meconium was obtained within 24-48 h of delivery; RNA was extracted and subjected to reverse-transcription-quantitative PCR using specific primers for Clostridium coccoides group, C. leptum subgroup, Bacteroides fragilis group, Atopobium cluster, Prevotella, Bifidobacterium, Lactobacillus, Enterococcus, Enterobacteriaceae, Staphylococcus, Enterococcus, Streptococcus, C. perfringens, and C. difficile. We detected several bacterial groups in both vaginally- and cesarean-born infants. B. fragilis group, Enterobacteriaceae, Enterococcus, Streptococcus, and Staphylococcus were detected in more than 50% of infants, with counts ranging from 10(5) to 10(8) cells/g sample. About 30-35% samples harbored Bifidobacterium and Lactobacillus (10(4)-10(5) cells/g); whereas C. coccoides group, C. leptum subgroup and C. perfringens were detected in 10-20% infants (10(3)-10(5) cells/g). Compared to vaginally-born babies, cesarean-born babies were significantly less often colonized with Lactobacillus genus (6% vs. 37%; P = 0.01) and Lactobacillus gasseri subgroup (6% vs. 31%; P = 0.04). Overall, seven Lactobacillus subgroups/species, i.e., L. gasseri subgroup, L. ruminis subgroup, L. casei subgroup, L. reuteri subgroup, L. sakei subgroup, L. plantarum subgroup, and L. brevis were detected in the samples from vaginally-born group, whereas only two members, i.e., L. gasseri subgroup and L. brevis were detected in the cesarean group. These data corroborate that several bacterial clades may already be present before birth in term infants' gut. Further, lower detection rate of lactobacilli

  2. Sensitive Quantitative Analysis of the Meconium Bacterial Microbiota in Healthy Term Infants Born Vaginally or by Cesarean Section

    PubMed Central

    Nagpal, Ravinder; Tsuji, Hirokazu; Takahashi, Takuya; Kawashima, Kazunari; Nagata, Satoru; Nomoto, Koji; Yamashiro, Yuichiro

    2016-01-01

    For decades, babies were thought to be born germ-free, but recent evidences suggest that they are already exposed to various bacteria in utero. However, the data on population levels of such pioneer gut bacteria, particularly in context to birth mode, is sparse. We herein aimed to quantify such bacteria from the meconium of 151 healthy term Japanese infants born vaginally or by C-section. Neonatal first meconium was obtained within 24–48 h of delivery; RNA was extracted and subjected to reverse-transcription-quantitative PCR using specific primers for Clostridium coccoides group, C. leptum subgroup, Bacteroides fragilis group, Atopobium cluster, Prevotella, Bifidobacterium, Lactobacillus, Enterococcus, Enterobacteriaceae, Staphylococcus, Enterococcus, Streptococcus, C. perfringens, and C. difficile. We detected several bacterial groups in both vaginally- and cesarean-born infants. B. fragilis group, Enterobacteriaceae, Enterococcus, Streptococcus, and Staphylococcus were detected in more than 50% of infants, with counts ranging from 105 to 108 cells/g sample. About 30–35% samples harbored Bifidobacterium and Lactobacillus (104–105 cells/g); whereas C. coccoides group, C. leptum subgroup and C. perfringens were detected in 10–20% infants (103–105 cells/g). Compared to vaginally-born babies, cesarean-born babies were significantly less often colonized with Lactobacillus genus (6% vs. 37%; P = 0.01) and Lactobacillus gasseri subgroup (6% vs. 31%; P = 0.04). Overall, seven Lactobacillus subgroups/species, i.e., L. gasseri subgroup, L. ruminis subgroup, L. casei subgroup, L. reuteri subgroup, L. sakei subgroup, L. plantarum subgroup, and L. brevis were detected in the samples from vaginally-born group, whereas only two members, i.e., L. gasseri subgroup and L. brevis were detected in the cesarean group. These data corroborate that several bacterial clades may already be present before birth in term infants’ gut. Further, lower detection rate of lactobacilli

  3. Linkage to Care, Early Infant Diagnosis, and Perinatal Transmission Among Infants Born to HIV-Infected Nigerian Mothers: Evidence From the Healthy Beginning Initiative

    PubMed Central

    Pharr, Jennifer R.; Obiefune, Michael C.; Ezeanolue, Chinenye O.; Osuji, Alice; Ogidi, Amaka G.; Gbadamosi, Semiu; Patel, Dina; Iwelunmor, Juliet; Yang, Wei; Ogedegbe, Gbenga; Ehiri, John E.; Sam-Agudu, Nadia A.

    2016-01-01

    Background: In 2014, Nigeria accounted for 33% of all new childhood HIV infections that occurred among the 22 Global Plan priority countries where 80% of HIV-infected women reside. Even with a vertical HIV transmission rate of 27%, only 6% of infants born to HIV-infected women in Nigeria receive early infant diagnosis (EID). This article reports rates of antiretroviral prophylaxis, EID, and mother-to-child transmission in a congregation-based Healthy Beginning Initiative (HBI) designed to increase HIV testing among pregnant women in southeast Nigeria. Methods: This is a nested cohort study of HIV-exposed infants (HEI) within the HBI trial originally designed as a 2-arm cluster randomized trial. HIV-infected mothers and infants were followed between January 2013 and August 2014. Results: Across both arms of the study, 72 HIV-infected women delivered 69 live infants (1 set of twins) and 4 had miscarriages. Of the 69 live-born HEI, HIV status was known for 71% (49/69), 16% (11/69) died before sample collection, and 13% (9/69) were lost to follow-up. Complete information was available for 84% of HEI (58/69), of which 64% (37/58) received antiretroviral prophylaxis. Among the 49 infants tested for HIV, 88% (43/49) received EID within 2 months and 12% (6/49) received antibody testing after 18 months. The mother-to-child transmission rate was 8.2% (4/49). Conclusions: EID was higher and HIV transmission rate was lower among the HBI participants compared to reported rates in 2014. However, further progress is needed to achieve goals of elimination of infant HIV infection. PMID:27355503

  4. Case of a healthy infant born following antenatal enterovirus myocarditis and hydrops.

    PubMed

    Bonnin, Aurore; Tassin, Mikael; Vauloup-Fellous, Christelle; Letamendia, Emmanuelle; Stos, Bertrand; Bonnet, Damien; Gajdos, Vincent; Mabille, Mylène; Benachi, Alexandra

    2014-11-01

    Fetal hydrops and myocarditis were diagnosed in a woman at 32 weeks of gestation (WG). Transplacental enterovirus infection was suspected because all other causes of myocarditis and hydrops were excluded, it was during an endemic period, and there was a setting of maternal infection (fever a few days before). We opted for in utero treatment because of the risk of resuscitating a neonate with myocarditis and hydrops. We administered dexamethasone 12mg twice for pulmonary maturation and presumed it would partially improve the myocarditis. Fetal arrhythmia was noted at 35 WG and we decided to deliver the infant as postnatal treatment of the heart disorder would be more effective. RT-PCR (ARGENE(®)) showed that the neonate's throat and anal tissues and cord blood sampled on the day of birth contained enterovirus ribonucleic acid and coxsackievirus B5, as did the mother's anal sample. Laboratory tests, heart MRI and probably brain MRI indicated neonatal enterovirus infection. Findings were normal at two-year follow-up.

  5. Overnight Polysomnographic Characteristics and Oxygen Saturation of Healthy Infants, 1 to 18 Months of Age, Born and Residing At High Altitude (2,640 Meters)

    PubMed Central

    Bazurto-Zapata, María A.; Gozal, David; González-García, Mauricio; Durán-Cantolla, Joaquín; Torres-Duque, Carlos A.

    2015-01-01

    BACKGROUND: Approximately 8% of the world population resides above 1,600 m, with about 10 million people living above 2,500 m in Colombia. However, reference values for polysomnography (PSG) and oxygen saturation (Spo2) of children < 2 years old residing at high altitude are currently unavailable. METHODS: Healthy infants aged 1 to 18 months born and residing at high altitude (Bogotá: 2,640 m) underwent overnight PSG. Four age groups were defined: group 1, < 45 days; group 2, 3 to 4 months; group 3, 6 to 7 months; and group 4, 10 to 18 months. Of 122 children enrolled, 50 had three consecutive PSG tests and were analyzed as a longitudinal subcohort. RESULTS: A total of 281 PSG tests were performed in 122 infants (56% girls): group 1, 106 PSG tests; group 2, 89 PSG tests; group 3, 61 PSG tests; and group 4, 25 PSG tests. Active sleep diminished and quiet sleep increased with maturation. Apnea-hypopnea indexes (total, central, and obstructive) were highest in group 1 (21.4, 12.4, and 6.8/h total sleep time, respectively) and diminished with age (P < .001). Mean Spo2 during waking and sleep increased with age (P < .001). Nadir Spo2 values during respiratory events were lower in younger infants. Longitudinal assessments of 50 infants confirmed the temporal trends described for the cross-sectional dataset. CONCLUSIONS: Healthy infants (≤ 18 months old) born and residing at high altitude show preserved sleep architecture but higher apnea-hypopnea indexes and more prominent desaturation with respiratory events than do those living at low altitude. The current study findings can be used as reference values for infants at high altitude. PMID:25811138

  6. Normal Growth of Healthy Infants Born from HIV+ Mothers Fed a Reduced Protein Infant Formula Containing the Prebiotics Galacto-Oligosaccharides and Fructo-Oligosaccharides: A Randomized Controlled Trial

    PubMed Central

    da Costa Ribeiro, Hugo; Ribeiro, Tereza Cristina Medrado; de Mattos, Angela Peixoto; Pontes, Mariana; Sarni, Roseli Oselka Saccardo; Cruz, Maria Letícia Santos; Nogueira-de-Almeida, Carlos Alberto; Mussi-Pinhata, Marisa M; de Carvalho Norton, Rocksane; Steenhout, Philippe

    2015-01-01

    OBJECTIVE The aim of the current study was to evaluate the safety of a new reduced protein (2.1 g/100 kcal) infant formula containing 4 g/L of 90% galacto-oligosaccharides (GOS) and 10% fructo-oligosaccharides (FOS). METHODS Healthy term infants from Brazil were enrolled. Those born to human immunodeficiency virus (HIV)-positive mothers were randomized to a test (n = 65) or control (n = 63) formula group. Infants born to HIV-negative mothers were either exclusively breast-fed (n = 79) or received a mixed diet (breast milk and test formula, n = 65). Between 2 weeks and 4 months of age, infants were exclusively fed according to their assigned group. Anthropometric measurements were taken at baseline, 1, 2, 3, 4, 6, 8, 10, and 12 months. Digestive tolerance was evaluated during the first 4 months. The primary outcome was mean daily weight gain between 2 weeks and 4 months in the test formula and breast-fed groups. RESULTS Data from all infants (N = 272) were used in the intention-to-treat (ITT) analysis and data from 230 infants were used in the per-protocol (PP) analysis. The difference in mean daily weight gain between 2 weeks and 4 months in the test formula and breast-fed groups was 1.257 g/day (one-sided 95% confidence interval [CI]: −0.705 to inf, P < 0.001) in the PP analysis, showing that the lower bound of the 95% CI was above the −3.0 g/day non-inferiority margin. Results were similar in the ITT analysis. Symptoms of digestive tolerance and frequency of adverse events were similar in the two groups. CONCLUSIONS The formula containing 2.1 g/100 kcal protein and GOS and FOS was safe and tolerated well. PMID:25788839

  7. Mesenchymal Stem Cells From Infants Born to Obese Mothers Exhibit Greater Potential for Adipogenesis: The Healthy Start BabyBUMP Project.

    PubMed

    Boyle, Kristen E; Patinkin, Zachary W; Shapiro, Allison L B; Baker, Peter R; Dabelea, Dana; Friedman, Jacob E

    2016-03-01

    Maternal obesity increases the risk for pediatric obesity; however, the molecular mechanisms in human infants remain poorly understood. We hypothesized that mesenchymal stem cells (MSCs) from infants born to obese mothers would demonstrate greater potential for adipogenesis and less potential for myogenesis, driven by differences in β-catenin, a regulator of MSC commitment. MSCs were cultured from the umbilical cords of infants born to normal-weight (prepregnancy [pp] BMI 21.1 ± 0.3 kg/m(2); n = 15; NW-MSCs) and obese mothers (ppBMI 34.6 ± 1.0 kg/m(2); n = 14; Ob-MSCs). Upon differentiation, Ob-MSCs exhibit evidence of greater adipogenesis (+30% Oil Red O stain [ORO], +50% peroxisome proliferator-activated receptor (PPAR)-γ protein; P < 0.05) compared with NW-MSCs. In undifferentiated cells, total β-catenin protein content was 10% lower and phosphorylated Thr41Ser45/total β-catenin was 25% higher (P < 0.05) in Ob-MSCs versus NW-MSCs (P < 0.05). Coupled with 25% lower inhibitory phosphorylation of GSK-3β in Ob-MSCs (P < 0.05), these data suggest greater β-catenin degradation in Ob-MSCs. Lithium chloride inhibition of GSK-3β increased nuclear β-catenin content and normalized nuclear PPAR-γ in Ob-MSCs. Last, ORO in adipogenic differentiating cells was positively correlated with the percent fat mass in infants (r = 0.475; P < 0.05). These results suggest that altered GSK-3β/β-catenin signaling in MSCs of infants exposed to maternal obesity may have important consequences for MSC lineage commitment, fetal fat accrual, and offspring obesity risk. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  8. Mesenchymal Stem Cells From Infants Born to Obese Mothers Exhibit Greater Potential for Adipogenesis: The Healthy Start BabyBUMP Project

    PubMed Central

    Patinkin, Zachary W.; Shapiro, Allison L.B.; Baker, Peter R.; Dabelea, Dana; Friedman, Jacob E.

    2016-01-01

    Maternal obesity increases the risk for pediatric obesity; however, the molecular mechanisms in human infants remain poorly understood. We hypothesized that mesenchymal stem cells (MSCs) from infants born to obese mothers would demonstrate greater potential for adipogenesis and less potential for myogenesis, driven by differences in β-catenin, a regulator of MSC commitment. MSCs were cultured from the umbilical cords of infants born to normal-weight (prepregnancy [pp] BMI 21.1 ± 0.3 kg/m2; n = 15; NW-MSCs) and obese mothers (ppBMI 34.6 ± 1.0 kg/m2; n = 14; Ob-MSCs). Upon differentiation, Ob-MSCs exhibit evidence of greater adipogenesis (+30% Oil Red O stain [ORO], +50% peroxisome proliferator–activated receptor (PPAR)-γ protein; P < 0.05) compared with NW-MSCs. In undifferentiated cells, total β-catenin protein content was 10% lower and phosphorylated Thr41Ser45/total β-catenin was 25% higher (P < 0.05) in Ob-MSCs versus NW-MSCs (P < 0.05). Coupled with 25% lower inhibitory phosphorylation of GSK-3β in Ob-MSCs (P < 0.05), these data suggest greater β-catenin degradation in Ob-MSCs. Lithium chloride inhibition of GSK-3β increased nuclear β-catenin content and normalized nuclear PPAR-γ in Ob-MSCs. Last, ORO in adipogenic differentiating cells was positively correlated with the percent fat mass in infants (r = 0.475; P < 0.05). These results suggest that altered GSK-3β/β-catenin signaling in MSCs of infants exposed to maternal obesity may have important consequences for MSC lineage commitment, fetal fat accrual, and offspring obesity risk. PMID:26631736

  9. When Will Life Be Normal? The Healthy Beginnings Program for Parents of Premature Infants.

    ERIC Educational Resources Information Center

    Sledden, Elizabeth

    The Healthy Beginnings program is designed to help parents of prematurely born infants adjust to parenting challenges and opportunities of the first 2 years of the infant's life. The Healthy Beginnings Program provides parents of premature infants with support and guidance by offering: (1) monthly education and support meetings; (2) evaluations…

  10. Early Benefits of a Starter Formula Enriched in Prebiotics and Probiotics on the Gut Microbiota of Healthy Infants Born to HIV+ Mothers: A Randomized Double-Blind Controlled Trial.

    PubMed

    Cooper, Peter; Bolton, Keith D; Velaphi, Sithembiso; de Groot, Nanda; Emady-Azar, Shahram; Pecquet, Sophie; Steenhout, Philippe

    2016-01-01

    The gut microbiota of infants is shaped by both the mode of delivery and the type of feeding. The gut of vaginally and cesarean-delivered infants is colonized at different rates and with different bacterial species, leading to differences in the gut microbial composition, which may persist up to 6 months. In a multicenter, randomized, controlled, double-blind trial conducted in South Africa, we tested the effect of a formula supplemented with a prebiotic (a mixture of bovine milk-derived oligosaccharides [BMOS] generated from whey permeate and containing galactooligosaccharides and milk oligosaccharides such as 3'- and 6'-sialyllactose) and the probiotic Bifidobacterium animalis subsp. lactis (B. lactis) strain CNCM I-3446 on the bifidobacteria levels in the gut of infants born vaginally or via cesarean section in early life. Additionally, the safety of the new formulation was evaluated. A total of 430 healthy, full-term infants born to HIV-positive mothers who had elected to feed their child beginning from birth (≤3 days old) exclusively with formula were randomized into this multicenter trial of four parallel groups. A total of 421 infants who had any study formula intake were included in the full analysis set (FAS). The first two groups consisted of cesarean-delivered infants assigned to the Test formula (n = 92) (a starter infant formula [IF] containing BMOS at a total oligosaccharide concentration of 5.8 ± 1.0 g/100 g of powder formula [8 g/L in the reconstituted formula] + B. lactis [1 × 10(7) colony-forming units {cfu}/g]) or a Control IF (n = 101); the second two groups consisted of vaginally delivered infants randomized to the same Test (n = 115) or Control (n = 113) formulas from the time of enrollment to 6 months. The primary efficacy outcome was fecal bifidobacteria count at 10 days, and the primary safety outcome was daily weight gain (g/d) between 10 days and 4 months. At 10 days, fecal bifidobacteria counts were significantly higher in the Test

  11. Early Benefits of a Starter Formula Enriched in Prebiotics and Probiotics on the Gut Microbiota of Healthy Infants Born to HIV+ Mothers: A Randomized Double-Blind Controlled Trial

    PubMed Central

    Cooper, Peter; Bolton, Keith D.; Velaphi, Sithembiso; de Groot, Nanda; Emady-Azar, Shahram; Pecquet, Sophie; Steenhout, Philippe

    2016-01-01

    The gut microbiota of infants is shaped by both the mode of delivery and the type of feeding. The gut of vaginally and cesarean-delivered infants is colonized at different rates and with different bacterial species, leading to differences in the gut microbial composition, which may persist up to 6 months. In a multicenter, randomized, controlled, double-blind trial conducted in South Africa, we tested the effect of a formula supplemented with a prebiotic (a mixture of bovine milk-derived oligosaccharides [BMOS] generated from whey permeate and containing galactooligosaccharides and milk oligosaccharides such as 3′- and 6′-sialyllactose) and the probiotic Bifidobacterium animalis subsp. lactis (B. lactis) strain CNCM I-3446 on the bifidobacteria levels in the gut of infants born vaginally or via cesarean section in early life. Additionally, the safety of the new formulation was evaluated. A total of 430 healthy, full-term infants born to HIV-positive mothers who had elected to feed their child beginning from birth (≤3 days old) exclusively with formula were randomized into this multicenter trial of four parallel groups. A total of 421 infants who had any study formula intake were included in the full analysis set (FAS). The first two groups consisted of cesarean-delivered infants assigned to the Test formula (n = 92) (a starter infant formula [IF] containing BMOS at a total oligosaccharide concentration of 5.8 ± 1.0 g/100 g of powder formula [8 g/L in the reconstituted formula] + B. lactis [1 × 107 colony-forming units {cfu}/g]) or a Control IF (n = 101); the second two groups consisted of vaginally delivered infants randomized to the same Test (n = 115) or Control (n = 113) formulas from the time of enrollment to 6 months. The primary efficacy outcome was fecal bifidobacteria count at 10 days, and the primary safety outcome was daily weight gain (g/d) between 10 days and 4 months. At 10 days, fecal bifidobacteria counts were significantly higher in the Test

  12. 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.

  13. DXA performance in a pediatric population: precision of body composition measurements in healthy term-born infants using dual-energy X-ray absorptiometry.

    PubMed

    de Knegt, Victoria Elizabeth; Carlsen, Emma Malchau; Bech Jensen, Jens-Erik; Lade Rasmussen, Anne Mette; Pryds, Ole

    2015-01-01

    Dual-energy X-ray absorptiometry (DXA) has been hailed as a golden standard for measuring body composition in adults but remains to be fully assessed for the infant population. A total of 64 newborn infants were allocated to 1 of 3 groups. All underwent 2 Hologic Discovery A DXA scans. Suboptimal scans were reconstructed, and an investigation into the success of adjustment was carried out. Depending on group, the factors of weight change and repositioning were investigated. Test-retest variation and coefficients of variation for DXA body composition estimates were calculated. Furthermore, the effects of flannel sheets and breast milk were investigated using a pediatric phantom. Reconstruction of suboptimal scans resulted in more accurate body weight estimates. Moderate weight change and repositioning had no significant effect on the variation between scans. No significant body composition changes occurred between scans. The test-retest variation varied between 6.3% and 11.8%. Flannel sheets and breast milk affected DXA results significantly. High precision of DXA measurements was obtained in our newborn population. Reconstructing scans is a viable way of correcting minor movement artifacts. Moderate weight changes and repositioning have no significant effect on DXA results, whereas flannel sheets and milk do.

  14. Ontogenesis of the Gut Microbiota Composition in Healthy, Full-Term, Vaginally Born and Breast-Fed Infants over the First 3 Years of Life: A Quantitative Bird's-Eye View.

    PubMed

    Nagpal, Ravinder; Tsuji, Hirokazu; Takahashi, Takuya; Nomoto, Koji; Kawashima, Kazunari; Nagata, Satoru; Yamashiro, Yuichiro

    2017-01-01

    Early-life intestinal microbiota development is crucial for host's long-term health and is influenced by many factors including gestational age, birth and feeding modes, birth environment, ethnic/geographical background, etc. However, 'quantitative' data on the actual population levels of gut bacterial communities when these influences are controlled for is relatively rare. Herein, we demonstrate a quantitative perspective of microbiota development in natural and healthy milieus, i.e., in healthy, full-term, vaginally born and breast-fed infants (n = 19) born at same clinic. Fecal microbiota at age 1 and 7 days, 1, 3, and 6 months and 3 years is quantified using highly sensitive reverse-transcription-quantitative-PCR assays targeting bacterial rRNA molecules. At day 1, we detect one or more bacteria in all (100%) of the babies, wherein the microbiota is composed mainly of enterobacteria (35%), Bacteroides fragilis group (23%), enterococci (18%), staphylococci (13%), and bifidobacteria (9%). Altogether, facultative anaerobes predominate during first few weeks whereafter obligate anaerobes including bifidobacteria, B. fragilis group, Clostridium coccoides group, and Clostridium leptum subgroup gradually start prevailing. At 3 years, the composition is represented almost entirely (99%) by obligate anaerobes including C. leptum subgroup (34%), bifidobacteria (22%), B. fragilis group (21%), C. coccoides group (17%), Atopobium cluster (4%), and Prevotella (1%). The overall obligate/facultative proportion is 32/68, 37/63, 54/46, 70/30, 64/36, and 99/1% at 1 and 7 days, 1, 3, and 6 months and 3 years, respectively. However, interestingly, considerable individual-specific variations in the obligate/facultative ratios as well as in the proportions of Firmicutes, Bacteroides, Actinobacteria, and Proteobacteria communities are seen among these babies. This disparity even within this highly homogenous cohort manifests the magnitude of diverse patterns of gut microbiota

  15. Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months

    PubMed Central

    Azad, Meghan B.; Konya, Theodore; Maughan, Heather; Guttman, David S.; Field, Catherine J.; Chari, Radha S.; Sears, Malcolm R.; Becker, Allan B.; Scott, James A.; Kozyrskyj, Anita L.

    2013-01-01

    Background: The gut microbiota is essential to human health throughout life, yet the acquisition and development of this microbial community during infancy remains poorly understood. Meanwhile, there is increasing concern over rising rates of cesarean delivery and insufficient exclusive breastfeeding of infants in developed countries. In this article, we characterize the gut microbiota of healthy Canadian infants and describe the influence of cesarean delivery and formula feeding. Methods: We included a subset of 24 term infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Mode of delivery was obtained from medical records, and mothers were asked to report on infant diet and medication use. Fecal samples were collected at 4 months of age, and we characterized the microbiota composition using high-throughput DNA sequencing. Results: We observed high variability in the profiles of fecal microbiota among the infants. The profiles were generally dominated by Actinobacteria (mainly the genus Bifidobacterium) and Firmicutes (with diverse representation from numerous genera). Compared with breastfed infants, formula-fed infants had increased richness of species, with overrepresentation of Clostridium difficile. Escherichia–Shigella and Bacteroides species were underrepresented in infants born by cesarean delivery. Infants born by elective cesarean delivery had particularly low bacterial richness and diversity. Interpretation: These findings advance our understanding of the gut microbiota in healthy infants. They also provide new evidence for the effects of delivery mode and infant diet as determinants of this essential microbial community in early life. PMID:23401405

  16. Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months.

    PubMed

    Azad, Meghan B; Konya, Theodore; Maughan, Heather; Guttman, David S; Field, Catherine J; Chari, Radha S; Sears, Malcolm R; Becker, Allan B; Scott, James A; Kozyrskyj, Anita L

    2013-03-19

    The gut microbiota is essential to human health throughout life, yet the acquisition and development of this microbial community during infancy remains poorly understood. Meanwhile, there is increasing concern over rising rates of cesarean delivery and insufficient exclusive breastfeeding of infants in developed countries. In this article, we characterize the gut microbiota of healthy Canadian infants and describe the influence of cesarean delivery and formula feeding. We included a subset of 24 term infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Mode of delivery was obtained from medical records, and mothers were asked to report on infant diet and medication use. Fecal samples were collected at 4 months of age, and we characterized the microbiota composition using high-throughput DNA sequencing. We observed high variability in the profiles of fecal microbiota among the infants. The profiles were generally dominated by Actinobacteria (mainly the genus Bifidobacterium) and Firmicutes (with diverse representation from numerous genera). Compared with breastfed infants, formula-fed infants had increased richness of species, with overrepresentation of Clostridium difficile. Escherichia-Shigella and Bacteroides species were underrepresented in infants born by cesarean delivery. Infants born by elective cesarean delivery had particularly low bacterial richness and diversity. These findings advance our understanding of the gut microbiota in healthy infants. They also provide new evidence for the effects of delivery mode and infant diet as determinants of this essential microbial community in early life.

  17. The healthy migrant theory: variations in pregnancy outcomes among US-born migrants.

    PubMed

    Wingate, Martha S; Alexander, Greg R

    2006-01-01

    Various studies have observed that infants born to foreign-born women have better birth outcomes (lower rates of preterm, low birth weight, and infant mortality) than those delivered to US-born women. While much attention has been given to the "healthy migrant effect" as an explanation for these positive outcomes, this theory has not been examined in an internally migrant population. The purpose of this study is to examine the relationship between maternal mobility history and birth outcomes among infants born to US resident mothers of Mexican origin. The study used 1995-1999 National Center for Health Statistics (NCHS) live birth/infant death cohort files of singleton infants delivered in the US to white women of Mexican origin (n = 2,446,253). Maternal mobility history (MMH), which refers to the relationship between the maternal place of birth and the state of residence at delivery, was categorized into the four following groups: (a) foreign-born-place of birth outside the US and delivery in the US; (b) outside-region-place of birth in one US region and delivery in another US region; (c) within-region-place of birth in one US region and delivery in a different state in the same US region; and (d) within-state-place of birth and delivery in the same US state. Consistently, there is evidence to support the healthy migrant effect in an internally migrant population. Unique to this study are the findings that infants born to mothers with outside-region MMH had a lower risk of low birth weight (LBW) and small-for-gestational age (SGA) compared to those who did not move. Overall, this study provides evidence that the healthy migrant effect and its relationship to birth outcomes can be applied to an internally migrant population.

  18. Characterization of the Sensorimotor Rhythm in 4-Month-Old Infants Born at Term and Premature.

    PubMed

    Roca-Stappung, Milene; Moguel-González, Minerva; Fernández, Thalía; Harmony, Thalía; Mendoza-Montoya, Omar; Marroquín, José Luis; Ruiz-Correa, Salvador; Díaz-Comas, Lourdes; Otero-Ojeda, Gloria

    2017-07-22

    The sensorimotor rhythm (SMR) is an electroencephalographic rhythm associated with motor and cognitive development observed in the central brain regions during wakefulness in the absence of movement, and it reacts contralaterally to generalized and hemibody movements. The purpose of this work was to characterize the SMR of 4-month-old infants, born either healthy at term or prematurely with periventricular leukomalacia (PVL). Two groups of infants were formed: healthy and premature with PVL. Their electroencephalograms (EEGs) were recorded in four conditions: rest, free movement, right-hand grasping and left-hand grasping, in order to explore general reactivity to free movement and contralateral reactivity in hand-grasping conditions. Associations between SMR, and cognitive and motor performance were analyzed. The healthy infants showed a SMR between 5.47 and 7.03 Hz, with clear contralateral reactivity to free movement and right-hand grasping. However, the premature infants with PVL did not show enough electroencephalographic characteristics to evidence the presence of SMR. Poor performance, characteristic of children with PVL, was related to low-frequency SMR, while good performance was associated with a higher frequency rhythm in the left hemisphere. The presence of SMR in the group of healthy infants could be considered a sign of health at this age. Thus, poor SMR evidence in the EEG of infants with PVL is probably a sign of brain immaturity or brain dysfunction. Our results provide data on infant SMR development that is needed to design neurofeedback protocols for infants with PVL.

  19. Melatonin production in healthy infants: evidence for seasonal variations.

    PubMed

    Sivan, Y; Laudon, M; Tauman, R; Zisapel, N

    2001-01-01

    The objective of this study was to determine the normal range of nocturnal urinary excretion of the major melatonin metabolite, 6-sulfatoxymelatonin (6SMT) in a large sample of healthy full-term infants (8 and 16 wk old) and assess whether the endogenous production of melatonin changes with season. 6SMT was assessed in urine samples extracted from disposable diapers removed from full-term, 8- (n = 317) and 16-wk-old (n = 93) infants over the nocturnal period (19:00-08:00 h). In addition, 6SMT was assessed in 8-wk-old (n = 35) healthy infants over the entire 24-h period. 6SMT was determined by an ELISA assay. 6SMT excretion at 8 wk of age exhibited diurnal variations with (mean +/- SD) 61 +/- 18% of the daily production excreted during the nocturnal period regardless of season. The nocturnal 6SMT values in the entire cohort (at 8 as well as 16 wk of age) were found to significantly depart from normal distribution (Kolmogorov-Smirnov test). A normal distribution was obtained using a natural base logarithmic (ln) transformation of the data. The normal range (2.5-97.5 percentile of the ln 6SMT excretion per night) was thus defined as 4.66-8.64 (106-5646 ng/night) for 8-wk-old and 5.19-9.67 (180-15,820 ng/night) for 16-wk-old infants. A significant effect of the month of birth on 6SMT production at the age of 8 wk was found (ANOVA, p < 0.002) with maximal levels produced by infants born in June (summer solstice) and minimal excretion in infants born in December (winter solstice). Short-photoperiod-born infants excreted on average about threefold less 6SMT compared with long-photoperiod-born infants (t test, p = 0. 01). The seasonal variations were no longer present at 16 wk of age. No effect of breast-feeding at the time of sampling on seasonality of 6SMT was found. Normal ranges for the nocturnal urinary excretion of 6SMT in full-term infants at 8 and 16 wk of age are defined. This enables the evaluation of nocturnal 6SMT excretion as a prognostic and diagnostic factor

  20. Responses to a Modified Visual Cliff by Pre-Walking Infants Born Preterm and at Term

    ERIC Educational Resources Information Center

    Lin, Yuan-Shan; Reilly, Marie; Mercer, Vicki S.

    2010-01-01

    The purpose of this study was to examine, using a modified visual cliff apparatus, possible perceptual differences at crawling age between infants born preterm and infants born at term without documented visual or motor impairments. Sixteen infants born at term and 16 born preterm were encouraged to crawl to their caregivers on a modified visual…

  1. Responses to a Modified Visual Cliff by Pre-Walking Infants Born Preterm and at Term

    ERIC Educational Resources Information Center

    Lin, Yuan-Shan; Reilly, Marie; Mercer, Vicki S.

    2010-01-01

    The purpose of this study was to examine, using a modified visual cliff apparatus, possible perceptual differences at crawling age between infants born preterm and infants born at term without documented visual or motor impairments. Sixteen infants born at term and 16 born preterm were encouraged to crawl to their caregivers on a modified visual…

  2. Daytime Sleep and Parenting Interactions in Infants Born Preterm

    PubMed Central

    Schwichtenberg, A. J.; Anders, Thomas F.; Vollbrecht, Melissa; Poehlmann, Julie

    2010-01-01

    Objective Following a transactional perspective, this longitudinal study assessed concurrent and time-lagged associations between infant daytime sleep behaviors and maternal play interactions within a sample of infants born preterm. Method Data were collected from 134 families recruited from 3 Wisconsin NICUs. Multiple methods were used to collect data at infant NICU discharge and when infants were 4, 9, and 24 months postterm, including parent-report infant sleep logs, family sociodemographic assets and a 15 minute video-taped play session. Results Within time points, infants who napped more had mothers who were rated as more positive and communicative or less negative during play interactions at 4, 9 and 24 months compared to infants who napped less. Time-lagged findings indicated that infants who took more naps experienced more optimal maternal interactive behaviors later in development than infants who took fewer naps. Additionally, mothers who expressed more negative affect at 4 months or 9 months predicted more infant daytime sleep later in development. Conclusion Previous studies document that nighttime parent-child interactions influence nighttime sleep. This study presents the natural extension that daytime sleep influences daytime interactions. The present study draws attention to the understudied area of daytime naps in young children and provides support for the longitudinal bi-directional processes between sleep and parenting interactions. PMID:20978444

  3. Maternal mental health and infant mortality for healthy-weight infants.

    PubMed

    White, Susan E; Gladden, Robert W

    2016-11-01

    The objective of this study was to determine if severe mental illness and/or a history of substance use in mothers of babies of a healthy weight was associated with infant mortality. This was a cross-sectional observational study using CareSource historical billed Medicaid Managed Care plan (MMC) claims in Ohio. CareSource is Ohio's largest MMCP, serving approximately 1.2 million Medicaid consumers. Claims from 89,159 babies of a healthy weight (≥ 2500 grams) and their mothers were selected from the CareSource Ohio MMCP population from January 2011 through December 2014. The mental health and substance abuse status of the mother was identified from claim history. A logistic regression model was used to estimate the odds ratio for infant mortality based on the presence or absence of maternal severe mental illness (MSMI) or maternal substance abuse (MSU). The logistic regression model fit showed that the odds of infant mortality for infants born weighing 2500 grams or more was significantly higher when the mother was treated either for MSMI (χ2(1): P = .026) or MSU (χ2(1): P = .006) at any time before or after delivery. Findings indicate that to address infant mortality, a focus on only babies born premature or low birth weight will result in missing a notable segment of the population that requires attention. Mothers who have babies with a healthy weight of at least 2500 grams, but who are diagnosed with either MSMI or MSU, need at least equal attention if inroads are to be made in reducing infant mortality.

  4. Prem Baby Triple P a new parenting intervention for parents of infants born very preterm: acceptability and barriers.

    PubMed

    Ferrari, Alize J; Whittingham, Koa; Boyd, Roslyn; Sanders, Matthew; Colditz, Paul

    2011-12-01

    Over 10% of preterm infants develop major disabilities, 50% develop behavioural problems and 40% need special education (Huddy et al., 2001; Webster, 2003). Prem Baby Triple P is a new variant of the Positive Parenting Program (Triple P) adapted specifically for parents of very preterm infants. The aim of this study is to assess the acceptability of Prem Baby Triple P to parents of infants born preterm and to test whether parental attributions and parental perception of infant health/developmental status are barriers to intervention acceptability. One hundred and twenty-three parents of preterm infants participated, 83 parents of very preterm infants and 40 parents of preterm infants. In addition, 32 parents of term infants participated as a comparison group. The acceptability of Prem Baby Triple P was moderately high and did not differ significantly across the three groups. Parental attributions were not found to be barriers to intervention acceptability and parental perceptions that their infant is less healthy/developmentally delayed facilitated Prem Baby Triple P acceptance in parents of infants born very preterm. This suggests that the planned Prem Baby Triple P content is acceptable to parents of infants born very preterm and sensitised to medical and developmental issues. These findings, as social validation data, will contribute towards the further development of Prem Baby Triple P and a future randomised controlled trial.

  5. Southeast Missouri Minority Infant Mortality Reduction Project: Healthy Mothers, Healthy Fathers, Healthy Babies.

    ERIC Educational Resources Information Center

    Jones, Larry D.

    This text is designed to accompany a series of slides that present information on Missouri's attempts to reduce minority infant mortality. In Missouri, the rate of black infant mortality is twice that for whites, and blacks are twice as likely as whites to be born with low birthweight. Only 64.9 percent of black women receive prenatal care in the…

  6. Gestational Age and Neonatal Brain Microstructure in Term Born Infants: A Birth Cohort Study

    PubMed Central

    Broekman, Birit F. P.; Wang, Changqing; Li, Yue; Rifkin-Graboi, Anne; Saw, Seang Mei; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter D.; Fortier, Marielle V.; Meaney, Michael J.; Qiu, Anqi

    2014-01-01

    Objective Understanding healthy brain development in utero is crucial in order to detect abnormal developmental trajectories due to developmental disorders. However, in most studies neuroimaging was done after a significant postnatal period, and in those studies that performed neuroimaging on fetuses, the quality of data has been affected due to complications of scanning during pregnancy. To understand healthy brain development between 37–41 weeks of gestational age, our study assessed the in utero growth of the brain in healthy term born babies with DTI scanning soon after birth. Methods A cohort of 93 infants recruited from maternity hospitals in Singapore underwent diffusion tensor imaging between 5 to 17 days after birth. We did a cross-sectional examination of white matter microstructure of the brain among healthy term infants as a function of gestational age via voxel-based analysis on fractional anisotropy. Results Greater gestational age at birth in term infants was associated with larger fractional anisotropy values in early developing brain regions, when corrected for age at scan. Specifically, it was associated with a cluster located at the corpus callosum (corrected p<0.001), as well as another cluster spanning areas of the anterior corona radiata, anterior limb of internal capsule, and external capsule (corrected p<0.001). Conclusions Our findings show variation in brain maturation associated with gestational age amongst ‘term’ infants, with increased brain maturation when born with a relatively higher gestational age in comparison to those infants born with a relatively younger gestational age. Future studies should explore if these differences in brain maturation between 37 and 41 weeks of gestational age will persist over time due to development outside the womb. PMID:25535959

  7. Early executive function differences in infants born moderate-to-late preterm.

    PubMed

    Hodel, Amanda S; Senich, Kate L; Jokinen, Claire; Sasson, Oren; Morris, Alyssa R; Thomas, Kathleen M

    2017-07-13

    Individuals who are born very preterm (<32weeks gestation) show differential development of prefrontal cortex structure, function, and dependent behaviors, including executive function (EF) skills, beginning during late infancy and extending into adulthood. Preschool-aged children born moderate-to-late preterm (PT; 32-36weeks gestation) show smaller discrepancies in EF development, but it is unclear whether these differences first emerge during the early childhood years, when EF is rapidly developing, or if they arise from alterations in complex cognitive skills measurable in late infancy. In the current study, we examined whether differences in complex attention, memory, and inhibition skills (precursor skills to EF) are altered in healthy infants born moderate-to-late PT at 9-months corrected age. Infants born PT demonstrated poorer memory at test following habituation than their full-term peers. Furthermore, lower gestational age at birth was associated with poorer performance on five of the six early EF tasks. Results indicate that even in the context of low medical and environmental risk, performance on the Bayley within the normal range, and no group-level differences in processing speed, infants born moderate-to-late PT show subtle alterations in cognitive skills presumed to be dependent on prefrontal cortex by 9-months of age, likely setting the stage for long-term differences in EF development. Copyright © 2017. Published by Elsevier B.V.

  8. Brain development in infants born preterm: looking beyond injury.

    PubMed

    Duerden, Emma G; Taylor, Margot J; Miller, Steven P

    2013-06-01

    Infants born very preterm are high risk for acquired brain injury and disturbances in brain maturation. Although survival rates for preterm infants have increased in the last decades owing to improved neonatal intensive care, motor disabilities including cerebral palsy persist, and impairments in cognitive, language, social, and executive functions have not decreased. Evidence from neuroimaging studies exploring brain structure, function, and metabolism has indicated abnormalities in the brain development trajectory of very preterm-born infants that persist through to adulthood. In this chapter, we review neuroimaging approaches for the identification of brain injury in the preterm neonate. Advances in medical imaging and availability of specialized equipment necessary to scan infants have facilitated the feasibility of conducting longitudinal studies to provide greater understanding of early brain injury and atypical brain development and their effects on neurodevelopmental outcome. Improved understanding of the risk factors for acquired brain injury and associated factors that affect brain development in this population is setting the stage for improving the brain health of children born preterm.

  9. Developmental Outcomes of Extremely Preterm Infants Born to Adolescent Mothers

    PubMed Central

    Bann, Carla; Higgins, Rosemary; Vohr, Betty

    2015-01-01

    BACKGROUND AND OBJECTIVES: Extremely preterm infants and infants born to adolescent mothers are at risk for adverse developmental. The objectives were to evaluate development and behavior outcomes of extremely low birth weight (ELBW) infants born to adolescent mothers <20 compared with adult mothers ≥20 years and to identify socioeconomic risk factors that affect outcomes. METHODS: Retrospective cohort analysis of 211 infants >27 weeks of adolescent mothers and 1723 infants of adult mothers at Neonatal Research Network centers from 2008 to 2011. Groups were compared and regression models were run to predict 18- to 22-month adverse outcomes. Primary outcomes were Bayley-III scores, neurodevelopmental impairment, and Brief Infant Toddler Social Emotional Assessment problem scores (BITSEA/P) ≥75th percentile. RESULTS: Adolescent mothers were more often single, Hispanic, less educated, and had public insurance. By 18 to 22 months, their children had significantly increased rates of having lived ≥3 places (21% vs 9%), state supervision (7% vs 3%), rehospitalization (56% vs 46%), and BITSEA/P ≥75th percentile (50% vs 32%) and nonsignificant Bayley-III language scores <85 (56% vs 49%, P = .07). In regression analysis, children of adolescent mothers were more likely to have BITSEA/P ≥75th percentile (relative risk 1.50, 95% confidence interval 1.08–2.07). Living ≥3 places and nonwhite race were predictors of adverse behavior. State supervision was an independent predictor of each Bayley-III composite <70 and neurodevelopmental impairment. CONCLUSIONS: ELBW infants of adolescent mothers experience high social and environmental risks that are associated with adverse behavior outcomes. These findings inform the need for comprehensive follow-up, coordinated care services, and behavior interventions for ELBW infants of adolescent mothers. PMID:25963007

  10. Developmental outcomes of extremely preterm infants born to adolescent mothers.

    PubMed

    Hoffman, Laurie; Bann, Carla; Higgins, Rosemary; Vohr, Betty

    2015-06-01

    Extremely preterm infants and infants born to adolescent mothers are at risk for adverse developmental. The objectives were to evaluate development and behavior outcomes of extremely low birth weight (ELBW) infants born to adolescent mothers <20 compared with adult mothers ≥20 years and to identify socioeconomic risk factors that affect outcomes. Retrospective cohort analysis of 211 infants >27 weeks of adolescent mothers and 1723 infants of adult mothers at Neonatal Research Network centers from 2008 to 2011. Groups were compared and regression models were run to predict 18- to 22-month adverse outcomes. Primary outcomes were Bayley-III scores, neurodevelopmental impairment, and Brief Infant Toddler Social Emotional Assessment problem scores (BITSEA/P) ≥75th percentile. Adolescent mothers were more often single, Hispanic, less educated, and had public insurance. By 18 to 22 months, their children had significantly increased rates of having lived ≥3 places (21% vs 9%), state supervision (7% vs 3%), rehospitalization (56% vs 46%), and BITSEA/P ≥75th percentile (50% vs 32%) and nonsignificant Bayley-III language scores <85 (56% vs 49%, P = .07). In regression analysis, children of adolescent mothers were more likely to have BITSEA/P ≥75th percentile (relative risk 1.50, 95% confidence interval 1.08-2.07). Living ≥3 places and nonwhite race were predictors of adverse behavior. State supervision was an independent predictor of each Bayley-III composite <70 and neurodevelopmental impairment. ELBW infants of adolescent mothers experience high social and environmental risks that are associated with adverse behavior outcomes. These findings inform the need for comprehensive follow-up, coordinated care services, and behavior interventions for ELBW infants of adolescent mothers. Copyright © 2015 by the American Academy of Pediatrics.

  11. Atypical perceptual narrowing in prematurely born infants is associated with compromised language acquisition at 2 years of age.

    PubMed

    Jansson-Verkasalo, Eira; Ruusuvirta, Timo; Huotilainen, Minna; Alku, Paavo; Kushnerenko, Elena; Suominen, Kalervo; Rytky, Seppo; Luotonen, Mirja; Kaukola, Tuula; Tolonen, Uolevi; Hallman, Mikko

    2010-07-30

    Early auditory experiences are a prerequisite for speech and language acquisition. In healthy children, phoneme discrimination abilities improve for native and degrade for unfamiliar, socially irrelevant phoneme contrasts between 6 and 12 months of age as the brain tunes itself to, and specializes in the native spoken language. This process is known as perceptual narrowing, and has been found to predict normal native language acquisition. Prematurely born infants are known to be at an elevated risk for later language problems, but it remains unclear whether these problems relate to early perceptual narrowing. To address this question, we investigated early neurophysiological phoneme discrimination abilities and later language skills in prematurely born infants and in healthy, full-term infants. Our follow-up study shows for the first time that perceptual narrowing for non-native phoneme contrasts found in the healthy controls at 12 months was not observed in very prematurely born infants. An electric mismatch response of the brain indicated that whereas full-term infants gradually lost their ability to discriminate non-native phonemes from 6 to 12 months of age, prematurely born infants kept on this ability. Language performance tested at the age of 2 years showed a significant delay in the prematurely born group. Moreover, those infants who did not become specialized in native phonemes at the age of one year, performed worse in the communicative language test (MacArthur Communicative Development Inventories) at the age of two years. Thus, decline in sensitivity to non-native phonemes served as a predictor for further language development. Our data suggest that detrimental effects of prematurity on language skills are based on the low degree of specialization to native language early in development. Moreover, delayed or atypical perceptual narrowing was associated with slower language acquisition. The results hence suggest that language problems related to

  12. Responses to a modified visual cliff by pre-walking infants born preterm and at term.

    PubMed

    Lin, Yuan-Shan; Reilly, Marie; Mercer, Vicki S

    2010-02-01

    The purpose of this study was to examine, using a modified visual cliff apparatus, possible perceptual differences at crawling age between infants born preterm and infants born at term without documented visual or motor impairments. Sixteen infants born at term and 16 born preterm were encouraged to crawl to their caregivers on a modified visual cliff. Successful trials, crossing time, duration of visual attention, duration of tactile exploration, motor strategies, and avoidance behaviors were analyzed. A significant surface effect was found, with longer crossing times and longer durations of visual attention and tactile exploration in the condition with the visual appearance of a deep cliff. Although the two groups of infants did not differ on any of the timed measures, infants born at term demonstrated a larger number of motor strategies and avoidance behaviors by simple tally. This study indicates that infants born at term and those born preterm can perceive a visual cliff and adapt their responses accordingly.

  13. Hypothyroidism Among Military Infants Born in Countries of Varied Iodine Nutrition Status

    DTIC Science & Technology

    2010-02-01

    Naval Health Research Center Hypothyroidism among Military Infants Born in Countries of Varied Iodine Nutrition Status . M. M. Cranston...Naval Health Research Center 140 Sylvester Road San Diego, California 92106 RESEARCH ARTICLE Open Access Hypothyroidism among military infants born...deficiencies in iodine intake on children and pregnant women has been questioned. This study was designed to compare hypothyroidism among infants

  14. Predicting Individual Differences in Recall by Infants Born Preterm and Full Term

    ERIC Educational Resources Information Center

    Cheatham, Carol L.; Bauer, Patricia J.; Georgieff, Michael K.

    2006-01-01

    A heterogeneous sample of infants with preterm histories and infants born full term participated in a study of declarative memory and rate of encoding, as measured in an imitation task and an examining task, respectively. Here we report the comparisons of the performances of infants born very preterm (27-34 weeks gestation) and moderately preterm…

  15. Morbidity and mortality of infants born before arrival at the hospital.

    PubMed

    Beeram, M; Solarin, K; Young, M; Abedin, M

    1995-06-01

    Recently, a number of infants have been born at home, in an ambulance, car, etc., before arrival at the District of Columbia General Hospital. Many of these infants had poor outcome. To evaluate the prevalence and outcome of these infants, we reviewed medical records of all infants born before arrival at the hospital (out-born infants) and compared them with in-hospital deliveries from July 1988 to June 1992. Data were analyzed using Fisher's Exact Test and chi-square test. There were 151 (1.8%) out-born infants and 8,169 (98.2%) in-born infants during this 4-year period. Infants in both groups were predominantly black (85%). The following were significant differences (P < 0.001) between out-born and in-hospital deliveries, respectively: illicit drug exposure 35% vs 21%; low-birth-weight (< 2,500 g) infants 39% vs 16%; intensive care unit admissions 29% vs 15%; and neonatal deaths per 1,000 live births 80 vs 7. We conclude that there is a twofold increase in the morbidity (required intensive care) and an 11-fold increase in the mortality among out-born infants compared with infants delivered in-hospital. Even though out-born infants were < 2% of the total deliveries, they accounted for 17% of total neonatal mortality.

  16. Rhinovirus infection and healthcare utilisation in prematurely born infants.

    PubMed

    Drysdale, Simon B; Alcazar-Paris, Mireia; Wilson, Theresa; Smith, Melvyn; Zuckerman, Mark; Broughton, Simon; Rafferty, Gerrard F; Peacock, Janet L; Johnston, Sebastian L; Greenough, Anne

    2013-10-01

    Our aim was to determine whether rhinovirus (RV) lower respiratory tract infections (LRTIs) in prematurely born infants increase health-related cost of care during infancy. 153 infants born at <36 weeks of gestation were prospectively followed to 1 year. Cost of care was calculated from the National Health Service reference costing scheme and healthcare utilisation determined by examining hospital/general practitioner records. 20 infants developed RV LRTIs (RV group), 17 respiratory syncytial virus (RSV) LRTIs (RSV group), 12 both RV and RSV LRTIs (RV/RSV group) and 74 had no LRTI (no LRTI group). Compared with the no LRTI group, the RV/RSV LRTI group had the greatest increase in adjusted mean cost (difference GBP 5769), followed by the RV LRTI group (difference GBP 278) and, finally, the RSV LRTI group (difference GBP 172) (p=0.045). The RV group had more outpatient (p<0.05) and respiratory-related general practitioner (p<0.05) attendances, more wheezed at follow-up (p<0.001) than the no LRTI group and more had respiratory-related outpatient attendances than the RSV LRTI group (p<0.05). We conclude that RV LRTIs were associated with increased health-related cost of care during infancy; our results suggest that the RV group compared with the RSV group suffered greater chronic respiratory morbidity.

  17. Hospital stay for healthy term newborn infants.

    PubMed

    Benitz, William E

    2015-05-01

    The hospital stay of the mother and her healthy term newborn infant should be long enough to allow identification of problems and to ensure that the mother is sufficiently recovered and prepared to care for herself and her newborn at home. The length of stay should be based on the unique characteristics of each mother-infant dyad, including the health of the mother, the health and stability of the newborn, the ability and confidence of the mother to care for herself and her newborn, the adequacy of support systems at home, and access to appropriate follow-up care in a medical home. Input from the mother and her obstetrical care provider should be considered before a decision to discharge a newborn is made, and all efforts should be made to keep a mother and her newborn together to ensure simultaneous discharge.

  18. Disparities in mortality rates among US infants born late preterm or early term, 2003-2005.

    PubMed

    King, Jennifer P; Gazmararian, Julie A; Shapiro-Mendoza, Carrie K

    2014-01-01

    The purpose of this study was to identify disparities in neonatal, post-neonatal, and overall infant mortality rates among infants born late preterm (34-36 weeks gestation) and early term (37-38 weeks gestation) by race/ethnicity, maternal age, and plurality. In analyses of 2003-2005 data from US period linked birth/infant death datasets, we compared infant mortality rates by race/ethnicity, maternal age, and plurality among infants born late preterm or early term and also determined the leading causes of death among these infants. Among infants born late preterm, infants born to American Indian/Alaskan Native, non-Hispanic black, or teenage mothers had the highest infant mortality rates per 1,000 live births (14.85, 9.90, and 11.88 respectively). Among infants born early term, corresponding mortality rates were 5.69, 4.49, and 4.82, respectively. Among infants born late preterm, singletons had a higher infant mortality rate than twins (8.59 vs. 5.62), whereas among infants born early term, the rate was higher among twins (3.67 vs. 3.15). Congenital malformations and sudden infant death syndrome were the leading causes of death among both late preterm and early term infants. Infant mortality rates among infants born late preterm or early term varied substantially by maternal race/ethnicity, maternal age, and plurality. Information about these disparities may help in the development of clinical practice and prevention strategies targeting infants at highest risk.

  19. Disparities in Mortality Rates Among US Infants Born Late Preterm or Early Term, 2003–2005

    PubMed Central

    Gazmararian, Julie A.; Shapiro-Mendoza, Carrie K.

    2015-01-01

    The purpose of this study was to identify disparities in neonatal, post-neonatal, and overall infant mortality rates among infants born late preterm (34–36 weeks gestation) and early term (37–38 weeks gestation) by race/ethnicity, maternal age, and plurality. In analyses of 2003–2005 data from US period linked birth/infant death datasets, we compared infant mortality rates by race/ethnicity, maternal age, and plurality among infants born late preterm or early term and also determined the leading causes of death among these infants. Among infants born late preterm, infants born to American Indian/Alaskan Native, non-Hispanic black, or teenage mothers had the highest infant mortality rates per 1,000 live births (14.85,9.90, and 11.88 respectively). Among infants born early term, corresponding mortality rates were 5.69, 4.49, and 4.82, respectively. Among infants born late preterm, singletons had a higher infant mortality rate than twins (8.59 vs. 5.62), whereas among infants born early term, the rate was higher among twins (3.67 vs. 3.15). Congenital malformations and sudden infant death syndrome were the leading causes of death among both late preterm and early term infants. Infant mortality rates among infants born late preterm or early term varied substantially by maternal race/ ethnicity, maternal age, and plurality. Information about these disparities may help in the development of clinical practice and prevention strategies targeting infants at highest risk. PMID:23519825

  20. Infants and Toddlers (Ages 0-3) - Raising Healthy Children

    MedlinePlus

    ... will help you raise a healthy baby. Topics Breastfeeding Developmental Milestones Fruits & Vegetables Hand Washing Hearing Screening Infant & Toddler Health Maternal and Infant Health Newborn Screening Nutrition, Physical Activity, and Obesity Parenting Tips Perchlorate in ...

  1. Delivery room management of term and preterm newly born infants.

    PubMed

    Saugstad, Ola Didrik

    2015-01-01

    Delivery room management, especially in the first 'golden' minute, is of the utmost importance. An exact and universal definition of when a baby is born is needed to obtain agreement on what is meant by the first minute of life. Education of young girls is a basic requirement to optimize the health of the mother and baby. Interventions in pregnancy should as far as possible be evidence based. Antenatal care, the selection of birth mode and antenatal steroid therapy when indicated also contribute to obtaining the best outcome. Delayed cord clamping is recommended for both preterm and term infants. However, more data are needed regarding the most immature infants. Routine suctioning of the mouth and airways is not required. Thermal control is important - keep the temperature in the delivery room at 26°C and wrap infants <28 weeks of gestation in plastic. However, this procedure does not reduce mortality. Since delayed cord clamping increases mean birth weight by approximately 30 g/kg, the present birth weight charts based on early clamping need to be corrected. Preterm infants in need of ventilatory support should start with CPAP from the first breath. A T-piece device seems to have some advantages compared to self-inflating bags. Surfactant instillation is often not needed prophylactically provided the mother has received antenatal steroids. Less invasive methods for administering surfactant may be useful. If ventilatory support is needed, start with air in term and near-term infants. For babies of 29-33 weeks of gestation start with 21-30% oxygen and for infants <29 weeks start with 30% oxygen and adjust according to the response obtained. © 2015 S. Karger AG, Basel.

  2. Eosinophilia in Preterm Born Infants Infected with Chlamydia trachomatis.

    PubMed

    López-Hurtado, Marcela; Arteaga-Troncoso, Gabriel; Sosa-González, Irma E; de Haro-Cruz, Maria de Jesus; Flores-Salazar, Veronica R; Guerra-Infante, Fernando Martín

    2016-01-01

    A higher than 350 eosinophils/mm(3) is strongly associated with Chlamydia trachomatis in term born babies coursing with respiratory distress. However, in preterm newborns infected with this pathogen, the levels of eosinophils are unknown. Forty newborn infants with clinical data of respiratory problems and/or sepsis were analyzed. DNA of leukocytes from peripheral blood was used to identify C. trachomatis. Detection of chlamydial infection was performed by amplifying the ompA gene by an in-house PCR, and eosinophil levels were evaluated in an XT-2000-hematology analyzer. Eighteen infants showed chlamydial infection and 14 of them showed pneumonia (RR = 2.6; CI95% 1.03-6.5; p =.027). Their eosinophil levels were 719 ± 614 cells/mm(3). A significant association between eosinophilia ≥1250 cells/mm(3) and gestational age of less than 29 weeks (RR = 5.8; 1.35; CI95% [1.4-24.5], p <.008) was observed. The preterm infants with chlamydial infection did not show higher eosinophil levels than uninfected infants.

  3. Postural Complexity Differs Between Infant Born Full Term and Preterm During the Development of Early Behaviors

    PubMed Central

    Dusing, Stacey C; Izzo, Theresa A.; Thacker, Leroy R.; Galloway, James C

    2014-01-01

    Background and Aims Postural control differs between infants born preterm and full term at 1–3 weeks of age. It is unclear if differences persist or alter the development of early behaviors. The aim of this longitudinal study was to compare changes in postural control variability during development of head control and reaching in infants born preterm and full term. Methods Eighteen infants born preterm (mean gestational age 28.3±3.1 weeks) were included in this study and compared to existing data from 22 infants born full term. Postural variability was assessed longitudinally using root mean squared displacement and approximate entropy of the center of pressure displacement from birth to 6 months as measures of the magnitude of the variability and complexity of postural control. Behavioral coding was used to quantify development of head control and reaching. Results Group differences were identified in postural complexity during the development of head control and reaching. Infants born preterm used more repetitive and less adaptive postural control strategies than infants born full term. Both groups changed their postural complexity utilized during the development of head control and reaching. Discussion Early postural complexity was decreased in infants born preterm, compared to infants born full term. Commonly used clinical assessments did not identify these early differences in postural control. Altered postural control in infants born preterm influenced ongoing skill development in the first six months of life. PMID:24485170

  4. Maternal depression and anxiety and infant development: a comparison of foreign-born and native-born mothers.

    PubMed

    Foss, Gwendolyn F; Chantal, Andjukenda W; Hendrickson, Simone

    2004-01-01

    Studies that investigate infant and/or child development in families of depressed or anxious mothers do not include samples of foreign-born non-English-speaking mothers. This article describes a pilot study investigating infant development, maternal depression, and anxiety in comparison samples of native-born and foreign-born mothers and children from Vietnam, Laos (Hmong), and the Democratic Republic of Congo. Maternal depression and anxiety were measured with the Hopkins Symptom Checklist-25, and the developmental status of children 0-25 months of age was measured with the Denver II. Foreign-born mothers were more anxious than native-born mothers. Non-English-speaking foreign-born mothers were clinically depressed (1.83) and moderately anxious (1.62). Infants of native-born mothers and English-speaking foreign-born mothers performed better on the Denver II than children of foreign-born non-English-speaking mothers. Infants and toddlers of non-English-speaking mothers appear to be at high risk for delays during their first 25 months of life. Public health nurses need to advocate for appropriate interpreter services and mental health resources for non-English-speaking mothers of young children. Developmental screening should reflect cultural variations in parental expectations of how and when children meet developmental milestones. Replication studies and investigation about the long-term development of this high-risk group of children are needed.

  5. Phonotactic acquisition in healthy preterm infants.

    PubMed

    Gonzalez-Gomez, Nayeli; Nazzi, Thierry

    2012-11-01

    Previous work has shown that preterm infants are at higher risk for cognitive/language delays than full-term infants. Recent studies, focusing on prosody (i.e. rhythm, intonation), have suggested that prosodic perception development in preterms is indexed by maturational rather than postnatal/listening age. However, because prosody is heard in-utero, and preterms thus lose significant amounts of prenatal prosodic experience, both their maturation level and their prosodic experience (listening age) are shorter than that of full-terms for the same postnatal age. This confound does not apply to the acquisition of phonetics/phonotactics (i.e. identity and order of consonants/vowels), given that consonant differences in particular are only perceived after birth, which could lead to a different developmental pattern. Accordingly, we explore the possibility that consonant-based phonotactic perception develops according to listening age. Healthy French-learning full-term and preterm infants were tested on the perception of consonant sequences in a behavioral paradigm. The pattern of development for full-term infants revealed that 7-month-olds look equally at labial-coronal (i.e. /pat/) compared to coronal-labial sequences (i.e. /tap/), but that 10-month-olds prefer the labial-coronal sequences that are more frequent in the French lexicon. Preterm 10-month-olds (having 10 months of phonetic listening experience but 7 months of maturational age) behaved as full-term 10-month-olds. These results establish that preterm developmental timing for consonant-based phonotactic acquisition is based on listening age (experience with input). This questions the interpretation of previous results on prosodic acquisition in terms of maturational constraints, and raises the possibility that different constraints apply to the acquisition of different phonological subcomponents. © 2012 Blackwell Publishing Ltd.

  6. Lung function and exhaled nitric oxide in healthy unsedated African infants.

    PubMed

    Gray, Diane; Willemse, Lauren; Visagie, Ane; Smith, Emilee; Czövek, Dorottya; Sly, Peter D; Hantos, Zoltán; Hall, Graham L; Zar, Heather J

    2015-10-01

    Population-appropriate lung function reference data are essential to accurately identify respiratory disease and measure response to interventions. There are currently no reference data in African infants. The aim was to describe normal lung function in healthy African infants. Lung function was performed on healthy South African infants enrolled in a birth cohort study, the Drakenstein child health study. Infants were excluded if they were born preterm or had a history of neonatal respiratory distress or prior respiratory tract infection. Measurements, made during natural sleep, included the forced oscillation technique, tidal breathing, exhaled nitric oxide and multiple breath washout measures. Three hundred sixty-three infants were tested. Acceptable and repeatable measurements were obtained in 356 (98%) and 352 (97%) infants for tidal breathing analysis and exhaled nitric oxide outcomes, 345 (95%) infants for multiple breath washout and 293 of the 333 (88%) infants for the forced oscillation technique. Age, sex and weight-for-age z score were significantly associated with lung function measures. This study provides reference data for unsedated infant lung function in African infants and highlights the importance of using population-specific data. © 2015 The Authors. Respirology published by Wiley Publishing Asia Pty Ltd on behalf of Asian Pacific Society of Respirology.

  7. Maternal-infant interaction and autonomic function in healthy infants and infants with transposition of the great arteries.

    PubMed

    Harrison, Tondi M; Ferree, Allison

    2014-12-01

    The quality of maternal-infant interaction is a critical factor in the development of infants' autonomic function and social engagement skills. In this secondary data analysis, relationships among infant and maternal affect and behavior and quality of dyadic interaction, as measured by the Parent-Child Early Relational Assessment, and infant autonomic function, as measured by heart rate variability, were examined during feeding at 2 weeks and 2 months of age in 16 healthy infants and in 15 infants with transposition of the great arteries (TGA). Contrary to previous research, at 2 weeks infant age, mothers of infants with TGA had significantly higher scores in affect and behavior than did mothers of healthy infants. The affect and behavior and quality of dyadic interaction of infants with TGA also did not differ from that of healthy infants. Although infants' social engagement skills did not differ by health condition (TGA or healthy), these skills did differ by parasympathetic nervous system function: infants better able to suppress vagal activity with challenge had more positive and less dysregulated affect and behavior, regardless of health status. These findings suggest that maternal-infant interactions for some cardiac disease subgroups may not differ from healthy dyads. Additional research is required to identify both healthy and ill infants with delayed autonomic maturation and to develop and test interventions to enhance critical interactive functions.

  8. Infants Born Preterm Demonstrate Impaired Object Exploration Behaviors Throughout Infancy and Toddlerhood

    PubMed Central

    Kokkoni, Elena; Cunha, Andrea Baraldi; Galloway, James Cole

    2015-01-01

    Background Object exploration behaviors form the foundation for future global development, but little is known about how these behaviors are exhibited by infants born preterm. Objective The study objective was to longitudinally compare a comprehensive set of object exploration behaviors in infants born preterm and infants born full-term from infancy into toddlerhood. Design Twenty-two infants born full-term and 28 infants born preterm were monitored as they interacted with objects throughout their first 2 years. Methods Infants were provided up to 30 seconds to interact with each of 7 objects across 9 visits. Experimenters coded videos of infants' behaviors. Growth modeling and t tests were used to compare how much infants exhibited behaviors and how well they matched their behaviors to the properties of objects. Results Infants born preterm explored objects less in the first 6 months, exhibited less visual-haptic multimodal exploration, displayed reduced variability of exploratory behavior in a manner that reflected severity of risk, and were less able to match their behaviors to the properties of objects in a manner that reflected severity of risk. Infants born preterm with significant brain injury also had impaired bimanual abilities. Limitations There was a limited sample of infants born preterm with significant brain injury. Conclusions Infants born preterm have impaired abilities to interact with objects even in the first months of life. This impairment likely limits the knowledge they acquire about objects and about how they can act on them; this limited knowledge may, in turn, impair their early learning abilities. These results highlight the need for assessment and intervention tools specific for object exploration in young infants. PMID:25169919

  9. Long-Term Cognitive Outcomes of Infants Born Moderately and Late Preterm

    ERIC Educational Resources Information Center

    Odd, David Edward; Emond, Alan; Whitelaw, Andrew

    2012-01-01

    Aim: To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. Method: A cohort study based on the Avon Longitudinal Study of Parents and Children. Cognitive measures were assessed between the ages of 8 and 11 years. Exposure groups were defined as moderate/late preterm (32-36 weeks' gestation) or term…

  10. Long-Term Cognitive Outcomes of Infants Born Moderately and Late Preterm

    ERIC Educational Resources Information Center

    Odd, David Edward; Emond, Alan; Whitelaw, Andrew

    2012-01-01

    Aim: To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. Method: A cohort study based on the Avon Longitudinal Study of Parents and Children. Cognitive measures were assessed between the ages of 8 and 11 years. Exposure groups were defined as moderate/late preterm (32-36 weeks' gestation) or term…

  11. Massage Interventions and Developmental Skills in Infants Born with Low Birth Weight

    ERIC Educational Resources Information Center

    Kelmanson, I. A.; Adulas, E. I.

    2009-01-01

    This study aimed at evaluating possible effects of massage interventions on developmental progress in the infants born with low birth weight (LBW). Forty infants (17 boys, 23 girls) who were born in St. Petersburg in 2000 through 2002 and met a conventional definition of LBW (less than 2500 g at birth) entered the study. Of these, 36 (17 boys, 19…

  12. Massage Interventions and Developmental Skills in Infants Born with Low Birth Weight

    ERIC Educational Resources Information Center

    Kelmanson, I. A.; Adulas, E. I.

    2009-01-01

    This study aimed at evaluating possible effects of massage interventions on developmental progress in the infants born with low birth weight (LBW). Forty infants (17 boys, 23 girls) who were born in St. Petersburg in 2000 through 2002 and met a conventional definition of LBW (less than 2500 g at birth) entered the study. Of these, 36 (17 boys, 19…

  13. Respiratory muscle strength in healthy infants and those with surgically correctable anomalies.

    PubMed

    Kassim, Zainab; Moxham, John; Davenport, Mark; Nicolaides, Kypros; Greenough, Anne; Rafferty, Gerrard F

    2015-01-01

    Assessment of respiratory muscle strength provides important diagnostic and prognostic information. Normative data in healthy, term infants is, however, limited. Surgically correctable birth defects, congenital diaphragmatic hernia (CDH) and abdominal wall defects (AWD), commonly have impaired diaphragm function. The study aims were to obtain normative data for respiratory muscle strength in healthy, term born infants at birth and at 6 weeks postnatal age (PNA) and to investigate the influence of growth and maturation on inspiratory muscle strength in CDH/AWD infants. Maximal inspiratory (cPimax) and expiratory (cPemax) pressures during crying were measured at birth in 67 healthy, term born infants (mean (SD) gestational age (GA) 39.4 (1.7) weeks) and reassessed in 27 at 6 weeks PNA. cPimax and functional residual capacity (FRC) (22.3 (4.2) ml/kg) were also measured in 23 infants with AWD/CDH (mean (SD) GA 36.9 (2.1) weeks) and reassessed in 16 at median (range) 6.5 (1.5-15) months PNA. In healthy infants, mean (SD) cPimax was 88.8 (19.33) cmH2 O and cPemax 61.8 (13.5) cmH2 O at birth, increasing significantly at followup to 100.9 (15.2) cmH2 O (P < 0.05) and 82.6 (19.4) cmH2 O (P < 0.001) respectively. Mean (SD) cPimax was significantly lower (47.5 (22.4) cmH2 O, P < 0.0001) in AWD/CDH infants compared to healthy infants at birth but had increased significantly to 88.1 (27.6) cmH2 O (P < 0.0001) at followup which correlated significantly with increases in FRC (r(2)  = 0.33, P = 0.0263). Infants with AWD and CDH have significantly reduced inspiratory muscle strength compared to healthy term born infants but strength increases markedly in early life.

  14. Unexpected collapse of healthy newborn infants: risk factors, supervision and hypothermia treatment

    PubMed Central

    Pejovic, Nicolas J; Herlenius, Eric

    2013-01-01

    Aim To determine the occurrence and risk factors of sudden unexpected postnatal collapse (SUPC) in presumably healthy newborn infants. Methods All live-born infants during a 30-month period, in five major delivery wards in Stockholm, were screened, and possible cases of SUPC thoroughly investigated. Infants were ≥35 weeks of gestation, had an Apgar score >8 at 10 min and collapsed within 24 h after birth. Maternal, infant, event characteristics and outcome data were collected. Results Twenty-six cases of SUPC were found among 68 364 live-born infants, an incidence of 38/100 000 live births. Sixteen of these cases of SUPC required resuscitation with ventilation >1 min, and 14 of these remained unexplained (21/100 000). Fifteen of the 26 children were found in a prone position, during skin-to-skin contact, 18 were primipara, and 13 occurred during unsupervised breastfeeding at <2 h of age. Three cases occurred during smart cellular phone use by the mother. Five developed hypoxic–ischaemic encephalopathy (HIE) grade 2, and 4 underwent hypothermia treatment. Twenty-five infants had a favourable neurological outcome. Conclusion SUPC in apparent healthy babies is associated with initial, unsupervised breastfeeding, prone position, primiparity and distractions. Guidelines outlining the appropriate monitoring of newborns and safe early skin-to-skin contact should be implemented. PMID:23551812

  15. Increased postnatal inflammation in mechanically ventilated preterm infants born to mothers with early-onset preeclampsia.

    PubMed

    Turunen, Riikka; Andersson, Sture; Laivuori, Hannele; Kajantie, Eero; Siitonen, Sanna; Repo, Heikki; Nupponen, Irmeli

    2011-01-01

    Preeclampsia and preterm labor often underlie preterm birth, and are associated with maternal inflammation. In preterm infants, respiratory distress syndrome (RDS) and mechanical ventilation are associated with systemic inflammation. We aimed to study whether early-onset preeclampsia or preterm labor modulate the systemic inflammation affecting preterm infants with RDS. We recruited mechanically ventilated infants with gestational ages <32 weeks; 11 infants were born after early-onset preeclampsia and 25 after preterm labor. Blood was drawn during postnatal days 1-7, and the mean values of days 1-2, 3-4 and 5-6 were used. Phagocyte CD11b expression was analyzed with flow cytometry, and plasma C-reactive protein (CRP) concentrations with immunoturbidimetry. As compared with infants born after preterm labor, infants born after early-onset preeclampsia had higher CD11b expression on days 1-6 on both neutrophils and monocytes. In addition, infants born after early-onset preeclampsia had higher CRP concentrations on days 2-6 (all p < 0.05). As compared with infants born after preterm labor to mothers without preeclampsia, infants born after early-onset preeclampsia presented with a stronger postnatal systemic inflammatory reaction. Antenatal exposure to preeclampsia may induce fetal leukocyte priming and regulation of inflammation, and thereby modify postnatal inflammatory reactions and morbidity. Copyright © 2011 S. Karger AG, Basel.

  16. Increased risk of peanut allergy in infants of Asian-born parents compared to those of Australian-born parents.

    PubMed

    Koplin, J J; Peters, R L; Ponsonby, A-L; Gurrin, L C; Hill, D; Tang, M L K; Dharmage, S C; Allen, K J

    2014-12-01

    Asian infants appear to be over-represented among patients with clinical food allergy in Australia, but this has not been formally examined at the population level. Any difference in prevalence according to parental country of birth may be secondary to modifiable lifestyle factors. We aimed to quantify (i) differences in the prevalence of peanut allergy by parental country of birth and (ii) contribution of measured environmental exposures to these differences. The population-based HealthNuts study in Melbourne, Australia, screened 5276 infants (74% participation) with skin prick tests and sensitized infants underwent food challenge. Of these, 535 had a parent born in East Asia and 574 in UK/Europe. Associations between parents' country of birth and offspring peanut allergy were examined using multiple logistic regression. Compared to infants with two Australian-born parents, peanut allergy was more common among infants with parent/s born in East Asia (OR 3.4, 95% CI 2.2-5.1) but not those with parent/s born in the UK/Europe (OR 0.8, 95% CI 0.4-1.5). Paradoxically rates of allergic disease were lower among Asian parents. A higher prevalence of eczema among infants of Asian parents explained around 30% of the increase in peanut allergy, while differences in dog ownership explained around 18%. The high peanut allergy prevalence among infants of Asian-born parents appears to have occurred in a single generation and was not present among infants with parents migrating from other countries, suggesting gene-environment interactions are important. The role of eczema and microbial exposure in food allergy prevention warrants exploration. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Mode of delivery and infant respiratory morbidity among infants born to HIV-1-infected women.

    PubMed

    Livingston, Elizabeth G; Huo, Yanling; Patel, Kunjal; Brogly, Susan B; Tuomala, Ruth; Scott, Gwendolyn B; Bardeguez, Arlene; Stek, Alice; Read, Jennifer S

    2010-08-01

    -term infants born by elective cesarean delivery to HIV-1-infected women. II.

  18. Enigma of maternal race and infant birth weight: a population-based study of US-born Black and Caribbean-born Black women.

    PubMed

    Pallotto, E K; Collins, J W; David, R J

    2000-06-01

    The authors used 1985-1990 Illinois' vital records to determine the low birth weight components of infants delivered to US-born Black women, Caribbean-born Black women, and US-born White women. The moderately low birth weight rate (1,500-2,499 g) was 10% for infants with US-born Black mothers (n = 67,357) and 6% for infants with Caribbean-born mothers (n = 2,265) compared with 4% for infants with US-born White mothers (n = 34,124); the relative risk equaled 2.7 (95% confidence interval (CI): 2.5, 2.8) and 1.7 (95% CI: 1.4, 2.0), respectively. The very low birth weight rate (<1,500 g) was 2.6% for infants delivered to US-born Black women and 2.4% for infants to Caribbean-born women compared with 0.7% for infants to US-born White women; the relative risk equaled 3.6 (95% CI: 3.1, 4.1) and 3.3 (95% CI: 2.5, 4.4), respectively. Among the lowest risk mothers, the relative risk of moderately low birth weight for infants with US-born Black mothers and Caribbean-born mothers (compared with US-born White mothers) was 2.7 (95% CI: 2.1, 3.4) and 1.2 (95% CI: 0.4, 3.1), respectively; the relative risk of very low birth weight for infants with US-born Black mothers and Caribbean-born mothers was 6.7 (95% CI: 3.8, 12) and 4.2 (95% CI: 1.0, 18), respectively. The authors conclude that Caribbean-born women and US-born Black women have disparate moderate rates but equivalent very low birth weight rates.

  19. Differences in the Biodiversity of the Fecal Microbiota of Infants With Rotaviral Diarrhea and Healthy Infants

    PubMed Central

    Fei, Peng; Li, Lin; Cai, Xiaolin; Zhang, Xinjie; Bai, Hong Jian; Jiang, Yu Jun; Feng, Zhen; Guo, Ling

    2016-01-01

    Background Rotaviral diarrhea (RD) has been associated with the biodiversity of the fecal microbiota in infants; however, the differences in the biodiversity of the fecal microbiota between infants with RD and healthy (H) infants have not been clearly elucidated. Objectives This study aimed to reveal the changes in the biodiversity of the fecal microbiota of infants with RD. Patients and Methods For this study, 30 fecal samples from 15 RD infants and 15 H infants were collected. The biodiversity of the fecal microbiota from the two groups was compared via polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and gene sequencing. Results The Shannon-Weaver index showed that the biodiversity of the fecal microbiota from the RD infants was significantly lower (P < 0.05) than that from the H infants. All fifteen RD infants were grouped into one cluster and were separated from the H infants by the un weighted-pair group method, with the arithmetic average (UPGMA) clustering algorithm. In addition, when compared with the healthy infants, the communities of the dominant microbes, Lactobacillus and Bifidobacterium, in the fecal microbiota from the RD infants have obviously changed. Conclusions With regard to improving the understanding of the differences in the biodiversity of the fecal microbiota between RD infants and H infants, the findings of this study can provide a possible basis to reveal the relationship between RD and intestinal microbiota. PMID:27279991

  20. Birth weight and fetal growth in infants born to female hairdressers and their sisters.

    PubMed

    Axmon, A; Rylander, L

    2009-03-01

    To investigate birth weight and fetal growth in female hairdressers, while controlling for intergenerational effects and effects related to childhood exposures. A cohort of women who had attended vocational schools for hairdressers were compared to their sisters with respect to birth weight and fetal growth (measured as small for gestational age (SGA) or large for gestational age (LGA), respectively) in their infants. In total, 6223 infants born to 3137 hairdressers and 8388 infants born to 3952 hairdressers' sisters were studied. Among the infants born to the hairdressers' sisters, the distribution of birth weights were wider than that among the infants born to the hairdressers. This was also reflected in that hairdresser cohort affiliation tended to be protective against both SGA (odds ratio 0.80; 95% confidence interval 0.49 to 1.31) and LGA (0.77; 0.54 to 1.09). For LGA, this effect was even more pronounced among women who had actually worked as hairdressers during at least one pregnancy (0.60; 0.39 to 0.92). The infants born to these women also had a significantly lower mean birth weight (3387 g vs 3419 g; p = 0.033). The results from the present study suggest that infants born to hairdressers have a decreased risk of being LGA. This is most likely not caused by a shift in birth weight distribution or abnormal glucose metabolism.

  1. Phonotactic Acquisition in Healthy Preterm Infants

    ERIC Educational Resources Information Center

    Gonzalez-Gomez, Nayeli; Nazzi, Thierry

    2012-01-01

    Previous work has shown that preterm infants are at higher risk for cognitive/language delays than full-term infants. Recent studies, focusing on prosody (i.e. rhythm, intonation), have suggested that prosodic perception development in preterms is indexed by maturational rather than postnatal/listening age. However, because prosody is heard…

  2. Evaluating hypoxia during air travel in healthy infants.

    PubMed

    Khanna, Mansi; Shackleton, Claire; Verheggen, Maureen; Sharp, Mary; Wilson, Andrew C; Hall, Graham L

    2013-12-01

    Up to a third of ex-preterm infants flying near term exhibit pulse oxygen saturation (SpO2) of less than 85% during air travel. A hypoxia challenge test (HCT) is recommended to evaluate the requirement for in-flight supplemental O2. The validity of the HCT in healthy, term infants has not been reported. This study aimed to characterise the in-flight hypoxia response and the accuracy of the HCT to predict this response in healthy, term infants in the first year of life. Infants (n=24: (15 male)) underwent a HCT prior to commercial air travel during which parents monitored SpO2. Thirty-two flights were undertaken with six infants completing multiple flights. The median in-flight SpO2 nadir was 87% and significantly lower than the HCT SpO2 nadir (92%: p<0.001). Infants on seven flights recorded SpO2<85% with one infant recording a HCT with a SpO2 less than 85%. There was marked variability in the in-flight SpO2 in the six infants who undertook multiple flights, and for three of these infants, the SpO2 nadir was both above and below 85%. We report that in healthy term infants an in-flight SpO2 below 85% is common and can vary considerably between flights and that the HCT poorly predicts the risk of in-flight hypoxia (SpO2<85%). As it is common for healthy term infants to have SpO2 less than 85% during air travel further research is needed to clarify whether this is an appropriate cut-off in this age group.

  3. The Effects of Massage Therapy to Induce Sleep in Infants Born Preterm

    PubMed Central

    Yates, Charlotte C.; Mitchell, Anita J.; Booth, Melissa Y.; Williams, D. Keith; Lowe, Leah M.; Hall, Richard Whit

    2014-01-01

    Purpose The aim of this study was to determine if massage therapy can be used as an adjunct intervention to induce sleep in infants born preterm. Methods Thirty infants born at a minimum of 28 weeks gestational age (GA), who were at the time of the study between 32-48 weeks adjusted GA, were randomly assigned to receive massage therapy on 1 day and not receive massage on an alternate day. The Motionlogger® Micro Sleep Watch® Actigraph recorded lower extremity activity on the morning of each day. Results No significant difference was found between groups for sleep efficiency (P=.13) for the time period evaluated. Groups differed significantly during the time period after the massage ended with more infants sleeping on the non-massage day (Χ2= 4.9802, P=.026). Conclusions Massage is well tolerated in infants born preterm and infants do not fall asleep faster after massage than without massage. PMID:25251794

  4. Feasibility of pulse oximetry for assessment of infants born in community based midwifery care.

    PubMed

    Smit, Marrit; Ganzeboom, Angelina; Dawson, Jennifer A; Walther, Frans J; Bustraan, Jacqueline; van Roosmalen, Jos J M; te Pas, Arjan B

    2014-05-01

    to evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care. a prospective, observational study of infants born after midwifery supervised (home) births. 27 midwives from seven practices providing primary care in (home) births used PO at birth or the early puerperal period over a ten-month period. Data were obtained on the effect of PO on outcome, interventions and decision-making. Midwives were surveyed about applicability and usefulness of PO. 153 infants born in primary midwifery care. all births were uncomplicated except for one infant receiving supplemental oxygen and another was mask ventilated. In 138/153 (90%) infants PO was successfully used and 88% of midwives found PO easy to use. In 148/153 (97%) infants PO did not influence midwives' clinical judgment and referral policy. In 5/153 (3%) infants, midwives were uncertain of the infant's condition, but PO measurements were reassuring. In case of suboptimal neonatal condition or resuscitation, 100% of midwives declared they would use PO again. it is feasible to use PO in community based midwifery care, but not considered an important contribution to routine evaluation of infants. Midwives would like to have PO available during suboptimal neonatal condition or when resuscitation is required. PO can be applied in community based midwifery care; it does not lead to insecurity or extra referral. Further research on a larger group of infants must show the effect of PO on neonatal outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Gestational age at birth and brain white matter development in term-born infants and children

    USDA-ARS?s Scientific Manuscript database

    Studies on infants/children born preterm have shown that adequate gestational length is critical for brain white matter development. Less is known regarding how variations in gestational age at birth in term infants/children affect white matter development, which was evaluated in this study. Using d...

  6. Sequela of preterm versus term infants born to mothers on a methadone maintenance program: differential course of neonatal abstinence syndrome.

    PubMed

    Dysart, Kevin; Hsieh, Hui-Chen; Kaltenbach, Karol; Greenspan, Jay S

    2007-01-01

    We determined the effect of preterm delivery on the course of neonatal abstinence syndrome (NAS) in infants born to mothers participating in a methadone maintenance program. A retrospective cohort study was conducted in which infant and maternal data were collected from the medical records of 53 preterm and 66 term infants. Infants were selected from all infants admitted to Thomas Jefferson University hospital born between 1998 and 2002 whose mothers were enrolled in the methadone maintenance program. All infants were managed by a standard protocol utilizing the Neonatal Abstinence Scoring System (NASS) and neonatal opiate solution (NOS). Preterm and term infants were compared. Preterm infants had shorter lengths of stay, treatment courses and required less medication than did term infants during the same time period. These data indicate that following exposure to maternal methadone, preterm infants have a different neonatal course than do infants born at term.

  7. Antibiotic resistance potential of the healthy preterm infant gut microbiome

    PubMed Central

    Shaw, Alexander G.; Sim, Kathleen; Wooldridge, David J.; Li, Ming-Shi; Gharbia, Saheer; Misra, Raju; Kroll, John Simon

    2017-01-01

    Background Few studies have investigated the gut microbiome of infants, fewer still preterm infants. In this study we sought to quantify and interrogate the resistome within a cohort of premature infants using shotgun metagenomic sequencing. We describe the gut microbiomes from preterm but healthy infants, characterising the taxonomic diversity identified and frequency of antibiotic resistance genes detected. Results Dominant clinically important species identified within the microbiomes included C. perfringens, K. pneumoniae and members of the Staphylococci and Enterobacter genera. Screening at the gene level we identified an average of 13 antimicrobial resistance genes per preterm infant, ranging across eight different antibiotic classes, including aminoglycosides and fluoroquinolones. Some antibiotic resistance genes were associated with clinically relevant bacteria, including the identification of mecA and high levels of Staphylococci within some infants. We were able to demonstrate that in a third of the infants the S. aureus identified was unrelated using MLST or metagenome assembly, but low abundance prevented such analysis within the remaining samples. Conclusions We found that the healthy preterm infant gut microbiomes in this study harboured a significant diversity of antibiotic resistance genes. This broad picture of resistances and the wider taxonomic diversity identified raises further caution to the use of antibiotics without consideration of the resident microbial communities. PMID:28149696

  8. Blood glucose levels in a population of healthy, breast fed, term infants of appropriate size for gestational age

    PubMed Central

    Hoseth, E.; Joergensen, A.; Ebbesen, F.; Moeller, M.

    2000-01-01

    AIM—To determine blood glucose levels in a population of healthy, breast fed, term infants of appropriate size for gestational age.
METHODS—In a cross sectional study, the blood glucose concentration of 223 healthy, breast fed, term infants of appropriate size for gestational age was determined at different times (between one and 96 hours) after delivery. One sample of blood glucose was taken from each infant independent of the feeding time. The glucose concentration was correlated with sex, method of delivery, delivery with or without analgesia, smoking status of the mother, gestational age, umbilical cord pH, and Apgar score. Infants suspected of suffering from intrapartum hypoxia were excluded.
RESULTS—Blood glucose concentration one hour after delivery was not significantly lower than at any other time. Only two infants had low blood glucose concentrations one hour after delivery (1.4and 1.9 mmol/l). There were no significant differences in blood glucose concentration between sexes, methods of delivery, infants delivered with or without analgesia, and infants born to smokers or non-smokers, and there was no further correlation between blood glucose concentration and gestational age, umbilical cord pH, or Apgar score.
DISCUSSION—Very few healthy, breast fed, term infants of appropriate size for gestational age have low blood glucose levels, and there is no indication for blood glucose monitoring in these infants.

 PMID:10952705

  9. Outcomes of small for gestational age infants born at <27 weeks' gestation.

    PubMed

    De Jesus, Lilia C; Pappas, Athina; Shankaran, Seetha; Li, Lei; Das, Abhik; Bell, Edward F; Stoll, Barbara J; Laptook, Abbot R; Walsh, Michele C; Hale, Ellen C; Newman, Nancy S; Bara, Rebecca; Higgins, Rosemary D

    2013-07-01

    To determine whether small for gestational age (SGA) infants born at <27 weeks gestational age (GA) are at increased risk for mortality, morbidity, and growth and neurodevelopmental impairment at 18-22 months corrected age. This was a retrospective cohort study from National Institute of Child Health and Human Development Neonatal Research Network's Generic Database and Follow-Up Studies. Infants born at <27 weeks GA between January 2006 and July 2008 were included. SGA was defined as birth weight <10th percentile for GA based on Olsen growth curves. Infants with birth weight ≥ 10th percentile for GA were classified as non-SGA. Maternal and infant characteristics, neonatal outcomes, and neurodevelopmental data were compared in SGA and non-SGA infants. Neurodevelopmental impairment was defined as any of the following: cognitive score <70 on the Bayley Scales of Infant Development III, moderate or severe cerebral palsy, bilateral hearing loss (with and without amplification), or blindness (bilateral vision <20/200). Logistic regression analysis was applied to evaluate the associations between SGA status and death or neurodevelopmental impairment. The SGA group comprised 385 infants; the non-SGA group, 2586 infants. Compared with mothers of non-SGA infants, mothers of SGA infants were more likely to have a high school education, prenatal care, cesarean delivery, pregnancy-induced hypertension, and antenatal corticosteroid exposure. Compared with non-SGA infants, SGA infants had higher mortality and were more likely to have postnatal growth failure, prolonged mechanical ventilation, and postnatal steroid use. SGA status was associated with increased risk of death or neurodevelopmental impairment (OR, 3.91; 95% CI, 2.91-5.25; P < .001). SGA status in infants born at <27 weeks GA is associated with an increased likelihood of postnatal steroid use, mortality, growth failure, and neurodevelopmental impairment at 18-22 months corrected age. Copyright © 2013. Published by

  10. Probabilistic maps of the white matter tracts with known associated functions on the neonatal brain atlas: Application to evaluate longitudinal developmental trajectories in term-born and preterm-born infants.

    PubMed

    Akazawa, Kentaro; Chang, Linda; Yamakawa, Robyn; Hayama, Sara; Buchthal, Steven; Alicata, Daniel; Andres, Tamara; Castillo, Deborrah; Oishi, Kumiko; Skranes, Jon; Ernst, Thomas; Oishi, Kenichi

    2016-03-01

    Diffusion tensor imaging (DTI) has been widely used to investigate the development of the neonatal and infant brain, and deviations related to various diseases or medical conditions like preterm birth. In this study, we created a probabilistic map of fiber pathways with known associated functions, on a published neonatal multimodal atlas. The pathways-of-interest include the superficial white matter (SWM) fibers just beneath the specific cytoarchitectonically defined cortical areas, which were difficult to evaluate with existing DTI analysis methods. The Jülich cytoarchitectonic atlas was applied to define cortical areas related to specific brain functions, and the Dynamic Programming (DP) method was applied to delineate the white matter pathways traversing through the SWM. Probabilistic maps were created for pathways related to motor, somatosensory, auditory, visual, and limbic functions, as well as major white matter tracts, such as the corpus callosum, the inferior fronto-occipital fasciculus, and the middle cerebellar peduncle, by delineating these structures in eleven healthy term-born neonates. In order to characterize maturation-related changes in diffusivity measures of these pathways, the probabilistic maps were then applied to DTIs of 49 healthy infants who were longitudinally scanned at three time-points, approximately five weeks apart. First, we investigated the normal developmental pattern based on 19 term-born infants. Next, we analyzed 30 preterm-born infants to identify developmental patterns related to preterm birth. Last, we investigated the difference in diffusion measures between these groups to evaluate the effects of preterm birth on the development of these functional pathways. Term-born and preterm-born infants both demonstrated a time-dependent decrease in diffusivity, indicating postnatal maturation in these pathways, with laterality seen in the corticospinal tract and the optic radiation. The comparison between term- and preterm-born

  11. The comparison of intelligence levels of children born to kidney or liver transplant women with children of healthy mothers.

    PubMed

    Kociszewska-Najman, Bozena; Szpotanska-Sikorska, Monika; Mazanowska, Natalia; Wielgos, Miroslaw; Pietrzak, Bronislawa

    2017-08-16

    Pregnancy after transplantation is associated with high risk of complications and prenatal exposure to immunosuppressants. The purpose of the study was to evaluate the intellectual development of children born to women after organ transplantation. A comparison of intelligence levels in 78 children of kidney or liver transplant women of 78 children born to healthy mothers. The assessment of intellectual level in children was conducted by psychologists and evaluated using age-adjusted intelligence tests (Psyche Cattell Infant Intelligence Scale, Terman-Merril Intelligence Scale or the Scales of Raven's Progressive Matrices). No significant differences in the distribution of the quotient of intelligence between children born to kidney and liver transplant women were noted (Chi(2) = 5.037; p = .284). Also no differences in the distribution of intelligence levels were noted between the children of transplanted and healthy mothers in infants and toddlers (Chi(2) = 3.125; p = .537); preschool (Chi(2) = 1.440; p = .692), and school age children (Chi(2) = 4.079; p = .395). The intellectual development of children of post-transplant women is similar to the general population. These results provide information on the low risk of intellectual disability in children of transplanted mothers and may improve counseling on the planning of pregnancy in this group of women.

  12. Infants born to mothers under phenobarbital treatment: correlation between serum levels and clinical features of neonates.

    PubMed

    Zuppa, Antonio A; Carducci, Chiara; Scorrano, Antonio; Antichi, Eleonora; Catenazzi, Piero; Piras, Andrea; Pozzoli, Giacomo; Cardiello, Valentina; D'Antuono, Annamaria; Romagnoli, Costantino

    2011-11-01

    Phenobarbital crosses the placenta quickly, and the balance between maternal and fetal blood is achieved in a few minutes. Data on the clinical outcomes of infants born to mothers under phenobarbital treatment during pregnancy show that they are at risk of adverse events, such as sedation and abstinence syndrome. The aim of this study was to analyse the correlation between serum levels of phenobarbital and clinical features of neonates. Twenty-three infants born between 2001 and 2008 were studied. Maternal, neonatal and pharmacological variables were considered. Eleven infants displayed symptoms related to phenobarbital. Withdrawal syndrome was seen in seven infants and sedation syndrome was seen in four infants. One infant had severe cardiorespiratory depression at birth. None of the infants had severe neonatal abstinence syndrome. No statistically significant differences were found between symptomatic and asymptomatic infants. At birth, the mean serum level of phenobarbital of the 23 infants was 15.4 [standard deviation (SD) 6.2] μg/ml. A peak (16.1 μg/ml, SD 5.5) was seen on Day 3, followed by a gradual decrease to non-therapeutic levels (<10 μg/ml) by Day 8 (9.3 μg/ml, SD 1.0). Phenobarbital levels were higher in symptomatic infants than asymptomatic infants, although the difference was not statistically significant. Serum levels of phenobarbital remained in the therapeutic range for both mothers and infants, and reduced gradually in infants. However, some infants displayed symptoms related to phenobarbital. As such, a clinical pharmacological surveillance protocol is necessary. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. [Hepatotoxicity in healthy infants exposed to nevirapine during pregnancy].

    PubMed

    Iveli, Pablo; Noguera-Julian, Antoni; Soler-Palacín, Pere; Martín-Nalda, Andrea; Rovira-Girabal, Núria; Fortuny-Guasch, Clàudia; Figueras-Nadal, Concepció

    2016-01-01

    The use of nevirapine in HIV-infected pregnant women is discouraged due to its potential to cause hepatotoxicity. There is limited information available on the toxicity in non-HIV infected newborn exposed to this drug during pregnancy. The aim of the study is to determine the extent of hepatotoxicity in the newborn exposed to nevirapine and HIV during pregnancy. A cross-sectional, observational, multicenter study was conducted on a cohort of healthy infants born to HIV-infected mothers, in whom the first determination of alanine aminotransferase (ALT), before 6weeks of age, was collected. Patients were allocated to 2groups according to exposure to nevirapine during pregnancy. Hepatotoxicity was rated according to the AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS). This study included 160newborns from 159pregnancies (88exposed to nevirapine-based regimens and 71 exposed to protease inhibitors-based therapies). No cases of hepatotoxicity were observed according to the DAIDS Table for Grading. Two cases of ALT above normal values (2.8%; 95%CI: 0.3-9.8%) were observed in patients not exposed to nevirapine, and one case (1.1%; 95%CI: 0.0-6.1%) in the group exposed to nevirapine (P=.585). The lack of differences between groups suggests that highly active antiretroviral treatment regimens including nevirapine administered during pregnancy do not involve a higher risk of liver disease compared to other treatment combinations. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. Birth defects among infants born to women who received anthrax vaccine in pregnancy.

    PubMed

    Ryan, Margaret A K; Smith, Tyler C; Sevick, Carter J; Honner, William K; Loach, Rosha A; Moore, Cynthia A; Erickson, J David

    2008-08-15

    In response to bioterrorism threats, anthrax vaccine has been used by the US military and considered for civilian use. Concerns exist about the potential for adverse reproductive health effects among vaccine recipients. This retrospective cohort evaluated birth defects, in relation to maternal anthrax vaccination, among all infants born to US military service women between 1998 and 2004. Department of Defense databases defined maternal vaccination and infant diagnoses; multivariable regression models described potential associations between anthrax vaccination and birth defects in liveborn infants. Among 115,169 infants born to military women during this period, 37,140 were born to women ever vaccinated against anthrax, and 3,465 were born to women vaccinated in the first trimester of pregnancy. Birth defects were slightly more common in first trimester-exposed infants (odds ratio = 1.18, 95% confidence interval: 0.997, 1.41) when compared with infants of women vaccinated outside of the first trimester, but this association was statistically significant only when alternative referent groups were used. Although the small observed association may be unlikely to represent a causal relation between vaccination in early pregnancy and birth defects, this information should be considered when making decisions about administering anthrax vaccine to pregnant women.

  15. The Development of Extremely Preterm Infants Born to Women Who Had Genitourinary Infections During Pregnancy

    PubMed Central

    Leviton, Alan; Allred, Elizabeth N.; Kuban, Karl C. K.; O'Shea, T. Michael; Paneth, Nigel; Onderdonk, Andrew B.; Fichorova, Raina N.; Dammann, Olaf

    2016-01-01

    Gestational genitourinary infections, which have been associated with neurodevelopmental impairments among infants born near term, have not been studied among very preterm infants. The mothers of 989 infants born before 28 weeks of gestation were interviewed about urine, bladder, or kidney infections (UTIs) and cervical or vaginal infections (CVIs) during pregnancy, as well as other exposures and characteristics, and their charts were reviewed for the Extremely Low Gestational Age Newborns (ELGAN) Study (2002–2004). At 2 years of age, these infants underwent a neurodevelopmental assessment. Generalized estimating equation logistic regression models of developmental adversities were used to adjust for potential confounders. Infants born to women who reported a UTI were less likely than were others to have a very low Mental Development Index (adjusted odds ratio = 0.5; 95% confidence interval: 0.3, 0.8), whereas infants born to women who reported a CVI were more likely than others to have a low Psychomotor Development Index (adjusted odds ratio = 1.7; 95% confidence interval: 1.04, 2.7). In this high-risk sample, maternal gestational CVI, but not UTI, was associated with a higher risk of impaired motor development at 2 years of age. The apparent protective effect of UTI might be spurious, reflect confounding due to untreated asymptomatic bacteriuria among women who were not given a diagnosis of UTI, or reflect preconditioning. PMID:26667255

  16. Early Emergence of Delayed Social Competence in Infants Born Late and Moderately Preterm.

    PubMed

    Johnson, Samantha; Matthews, Ruth; Draper, Elizabeth S; Field, David J; Manktelow, Bradley N; Marlow, Neil; Smith, Lucy K; Boyle, Elaine M

    2015-01-01

    To assess behavioral outcomes and social competence at 2 years of age in infants born late and moderately preterm (LMPT; 32-36 wk gestation). One thousand one hundred and thirty LMPT infants and 1255 term-born (≥37 wk) controls were recruited at birth to a prospective geographical population-based study. Parents completed the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 2 years corrected age to assess infants' behavior problems and social competence. Cognitive development was assessed using the Parent Report of Children's Abilities-Revised. Parent questionnaires at 2 years were completed for 638 (57%) LMPT and 765 (62%) term-born infants. Group differences in the prevalence of behavior problems and delayed social competence between LMPT infants and term-born controls were adjusted for age, sex, small-for-gestational-age, socioeconomic status and cognitive impairment. Late and moderately preterm infants were at significantly increased risk of delayed social competence compared with term-born controls (26.4% vs. 18.4%; adjusted-relative risk [RR] 1.28; 95% CI, 1.03-1.58), but there was no significant group difference in the prevalence of behavior problems (21.0% vs. 17.6%; adjusted-RR 1.13, 0.89-1.42). Non-white ethnicity (RR 1.68, 1.26-2.24), medium (RR 1.60, 1.14-2.24) and high (RR 1.98, 1.41-2.75) socioeconomic risk and recreational drug use during pregnancy (RR 1.70, 1.03-2.82) were significant independent predictors of delayed social competence in LMPT infants. Birth at 32 to 36 weeks of gestation confers a specific risk for delayed social competence at 2 years of age. This may be indicative of an increased risk for psychiatric disorders later in childhood.

  17. Habituation as Parameter for Prediction of Mental Development in Healthy Preterm Infants: An Electrophysiological Pilot Study.

    PubMed

    Weber, Peter; Depoorter, Antoinette; Hetzel, Patrick; Lemola, Sakari

    2016-12-01

    The aim of this prospective pilot study was to evaluate the predictive value of discrimination and habituation, which was measured by mismatch negativity in 17 healthy very preterm (mean gestational age 27.4 weeks; range 25.0-31.3) and 16 term (mean gestational age 40.3 weeks; range 37.9-41.7) born infants at term equivalent age. Developmental outcome was measured by Bayley Scales of Infant Development-I in 13 preterm and 13 term-born children at a mean age of 21.7 months (±2.18) and 18.5 months (±1.9), respectively. No differences in amplitude and latency of the mismatch negativity were found between both groups at term equivalent age. Within the preterm group habituation capacity was positively correlated with the Mental Developmental Index (r = .654, P = .008) and Performance Developmental Index (r = .482, P = .048) at 21 months. Early learning capability, as measured by habituation, may be associated with a better prognosis for early mental development in healthy preterm infants. © The Author(s) 2016.

  18. Serum Reference Values for Leptin in Healthy Infants

    PubMed Central

    Savino, Francesco; Rossi, Lorenza; Benetti, Stefania; Petrucci, Elisa; Sorrenti, Miriam; Silvestro, Leandra

    2014-01-01

    Objective Reports on leptin concentrations in pediatric populations lack reference values for infants in the first months of life. Our study was conducted on healthy full-term infants between 2002 and 2012 to determine serum leptin reference values in subjects less than 18 months old. Methods Routine outpatient blood tests for serum leptin were performed on 317 infants using a radioimmunoassay method. The median and 10th–90th percentiles were calculated to obtain reference values using quantile regression. Values established in this study were compared with another independent cohort of 110 infants. Results The median (IQR) serum leptin concentration in the infants was 2.37 (3.26) ng/ml (n = 317). The median leptin concentration was 2.81 (3.49) ng/ml (n = 202) in infants younger than 6 months of age, 1.44 (2.27) ng/ml (n = 59) in infants between 6–12 months of age and 1.77 (2.05) ng/ml (n = 56) in infants between 12–18 months of age. We obtained leptin reference values based on age by estimating the lower and upper percentiles. In the entire cohort, the median (IQR) leptin concentration was 2.22 (3.11) ng/ml in males (n = 168) and 2.60 (3.32) ng/ml in females (n = 149). According to the type of feeding median serum leptin concentration was higher in breast-fed infants (n = 188) than in formula-fed infants (n = 129) (2.63 (3.34) ng/ml vs. 2.12 (2.77) ng/ml; p<0.05). Conclusions Our data revealed no gender difference in leptin concentration in early infancy. After 6 months of life, leptin concentrations decreased slightly. We used a large cohort to confirm that breast-fed infants had significantly higher serum leptin levels than formula-fed infants during the first 6 months of life, although this difference disappeared later in life. In this study, we defined the leptin reference range in healthy infants in the first 18 months of life according to the Clinical and Laboratory Standards Institute (CLSI). PMID:25415449

  19. Neurobehaviour between birth and 40 weeks' gestation in infants born <30 weeks' gestation and parental psychological wellbeing: predictors of brain development and child outcomes.

    PubMed

    Spittle, Alicia J; Thompson, Deanne K; Brown, Nisha C; Treyvaud, Karli; Cheong, Jeanie L Y; Lee, Katherine J; Pace, Carmen C; Olsen, Joy; Allinson, Leesa G; Morgan, Angela T; Seal, Marc; Eeles, Abbey; Judd, Fiona; Doyle, Lex W; Anderson, Peter J

    2014-04-24

    Infants born <30 weeks' gestation are at increased risk of long term neurodevelopmental problems compared with term born peers. The predictive value of neurobehavioural examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Yet there is little knowledge surrounding earlier neurobehavioural development in preterm infants prior to term equivalent age, and how it relates to perinatal factors, cerebral structure, and later developmental outcomes. In addition, maternal psychological wellbeing has been associated with child development. Given the high rate of psychological distress reported by parents of preterm children, it is vital we understand maternal and paternal wellbeing in the early weeks and months after preterm birth and how this influences the parent-child relationship and children's outcomes. Therefore this study aims to examine how 1) early neurobehaviour and 2) parental mental health relate to developmental outcomes for infants born preterm compared with infants born at term. This prospective cohort study will describe the neurobehaviour of 150 infants born at <30 weeks' gestational age from birth to term equivalent age, and explore how early neurobehavioural deficits relate to brain growth or injury determined by magnetic resonance imaging, perinatal factors, parental mental health and later developmental outcomes measured using standardised assessment tools at term, one and two years' corrected age. A control group of 150 healthy term-born infants will also be recruited for comparison of outcomes. To examine the effects of parental mental health on developmental outcomes, both parents of preterm and term-born infants will complete standardised questionnaires related to symptoms of anxiety, depression and post-traumatic stress at regular intervals from the first week of their child's birth until their child's second birthday. The parent-child relationship will be assessed at one and two years' corrected

  20. Neurobehaviour between birth and 40 weeks’ gestation in infants born <30 weeks’ gestation and parental psychological wellbeing: predictors of brain development and child outcomes

    PubMed Central

    2014-01-01

    Background Infants born <30 weeks’ gestation are at increased risk of long term neurodevelopmental problems compared with term born peers. The predictive value of neurobehavioural examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Yet there is little knowledge surrounding earlier neurobehavioural development in preterm infants prior to term equivalent age, and how it relates to perinatal factors, cerebral structure, and later developmental outcomes. In addition, maternal psychological wellbeing has been associated with child development. Given the high rate of psychological distress reported by parents of preterm children, it is vital we understand maternal and paternal wellbeing in the early weeks and months after preterm birth and how this influences the parent–child relationship and children’s outcomes. Therefore this study aims to examine how 1) early neurobehaviour and 2) parental mental health relate to developmental outcomes for infants born preterm compared with infants born at term. Methods/Design This prospective cohort study will describe the neurobehaviour of 150 infants born at <30 weeks’ gestational age from birth to term equivalent age, and explore how early neurobehavioural deficits relate to brain growth or injury determined by magnetic resonance imaging, perinatal factors, parental mental health and later developmental outcomes measured using standardised assessment tools at term, one and two years’ corrected age. A control group of 150 healthy term-born infants will also be recruited for comparison of outcomes. To examine the effects of parental mental health on developmental outcomes, both parents of preterm and term-born infants will complete standardised questionnaires related to symptoms of anxiety, depression and post-traumatic stress at regular intervals from the first week of their child’s birth until their child’s second birthday. The parent–child relationship will be

  1. Estimated Perinatal HIV Infection Among Infants Born in the United States, 2002-2013.

    PubMed

    Taylor, Allan W; Nesheim, Steven R; Zhang, Xinjian; Song, Ruiguang; FitzHarris, Lauren F; Lampe, Margaret A; Weidle, Paul J; Sweeney, Patricia

    2017-05-01

    Perinatal transmission of human immunodeficiency virus (HIV) can be reduced through services including antiretroviral treatment and prophylaxis. Data on the national incidence of perinatal HIV transmission and missed prevention opportunities are needed to monitor progress toward elimination of mother-to-child HIV transmission. To estimate the number of perinatal HIV cases among infants born in the United States. Data were obtained from the National HIV Surveillance System on infants with HIV born in the United States (including the District of Columbia) and their mothers between 2002 and 2013 (reported through December 31, 2015). Estimates were adjusted for delay in diagnosis and reporting by weighting each reported case based on a model incorporating time from birth to diagnosis and report. Analysis was performed from April 1 to August 15, 2016. Maternal HIV infection and antiretroviral medication, including maternal receipt prenatally or during labor/delivery and infant receipt postnatally. Diagnosis of perinatally acquired HIV infection in infants born in the United States. Infant and maternal characteristics, including receipt of perinatal HIV testing, treatment, and prophylaxis. The estimated annual number of perinatally infected infants born in the United States decreased from 216 (95% CI, 206-230) in 2002 to 69 (95% CI, 60-83) in 2013. Among perinatally HIV-infected children born in 2002-2013, 836 (63.0%) of the mothers identified as black or African American and 243 (18.3%) as Hispanic or Latino. A total of 236 (37.5%) of the mothers had HIV infection diagnosed before pregnancy in 2002-2005 compared with 120 (51.5%) in 2010-2013; the proportion of mother-infant pairs receiving all 3 recommended arms of antiretroviral prophylaxis or treatment (prenatal, intrapartum, and postnatal) was 22.4% in 2002-2005 and 31.8% in 2010-2013, with approximately 179 (28.4%) (2002-2005) and 94 (40.3%) (2010-2013) receiving antiretroviral prophylaxis or treatment during

  2. [Singing for preterm born infants music therapy in neonatology].

    PubMed

    Desquiotz-Sunnen, N

    2008-01-01

    The use of music as part of a stress reduction therapy has been applied both to premature infants and their parents in the Neonatal Reanimation Service. This aim of music therapy amounts to an attempt to help the premature infant regaining its physical and neurological balance, so important to its psychological and physical development, mainly by masking the sometimes excessive noise present in the intensive care unit and/or in the incubator. Studies have demonstrated the positive impact of music therapy on oxygen saturation, heartbeat, and on the general level of relaxation experienced by premature infants. In this project, the palliative technique used was that of live singing, directly to the infant, accompanied by a pentatonic harp. The aim was to improve the state of health, both physical and psychological, of a group of premature infants, whose gestation period varied between 23 and 36 weeks. The technique used was to apply what amounts to a protective cocoon of sounds to a premature infant in the neonatal unit, which measurably reduced the level of stress as indicated by the babies' increasingly relaxed demeanour and induced a measurable increase on the level of oxygen saturation and a reduction of heart rate.

  3. Predicting Treatment for Neonatal Abstinence Syndrome in Infants Born to Women Maintained on Opioid Agonist Medication

    PubMed Central

    Kaltenbach, Karol; Holbrook, Amber; Coyle, Mara G.; Heil, Sarah H.; Salisbury, Amy; Stine, Susan; Martin, Peter; Jones, Hendrée

    2014-01-01

    Aim To identify factors that predict the expression of neonatal abstinence syndrome (NAS) in infants exposed to methadone or buprenorphine in utero. Design and Setting Multi-site randomized clinical trial in which infants were observed for a minimum of 10 days following birth, and assessed for NAS symptoms by trained raters. Participants n = 131 infants born to opioid dependent mothers, 129 of which were available for NAS assessment. Measurements Generalized linear modeling was performed using maternal and infant characteristics to predict: peak NAS score prior to treatment, whether an infant required NAS treatment, length of NAS treatment, and total dose of morphine required for treatment of NAS symptoms. Findings 53% of the sample (68 infants) required treatment for NAS. Lower maternal weight at delivery, later estimated gestational age (EGA), maternal use of selective serotonin reuptake inhibitors (SSRIs), vaginal delivery, and higher infant birth weight predicted higher peak NAS scores. Higher infant birth weight and greater maternal nicotine use at delivery predicted receipt of NAS treatment for infants. Maternal use of SSRIs, higher nicotine use, and fewer days of study medication received also predicted total dose of medication required to treat NAS symptoms. No variables predicted length of treatment for NAS. Conclusions Maternal weight at delivery, estimated gestational age, infant birth weight, delivery type, maternal nicotine use, and days of maternal study medication received, and the use of psychotropic medications in pregnancy may play a role in the expression of neonatal abstinence syndrome severity in infants exposed to either methadone or buprenorphine. PMID:23106926

  4. Biomedical assessment and instrumental evaluation of healthy infant skin.

    PubMed

    Visscher, Marty O; Chatterjee, Ranjit; Ebel, James P; LaRuffa, Angela A; Hoath, Steven B

    2002-01-01

    The skin forms a critical structural boundary and a perceptual interface for the organism, yet the definition "healthy skin" is surprisingly difficult to describe. The present study's goal was to generate a technical definition of healthy infant skin by quantifying specific biophysical parameters before and after bathing in infants and correlating such parameters to a perceptual maternal evaluation. Fifty-two healthy infants, 3-6 months old, were evaluated before and after freshwater bathing. Diapered skin had a higher transepidermal water loss (TEWL), surface hydration, moisture accumulation rate (MAT), and friction than nondiapered skin before the bath (p < 0.01). Bathing dramatically altered the biophysical properties at both skin sites, with decreased MAT and lower friction, indicating a drier skin surface (p < 0.01). Visual redness and dryness decreased after bathing (p < 0.01). Blinded grading of optical images showed a significant preference for the skin after bathing (p < 0.01). This study provides the first quantitative technical definition of healthy infant skin with positive correlation to perceptual assessment by independent observers (mothers). The findings support the hypothesis that water binding properties of the stratum corneum are altered by occlusion (diapering) and that bathing introduces acute changes in stratum corneum water interactions, leading to a drier skin surface and a preferred skin appearance.

  5. Preterm infants have significantly longer telomeres than their term born counterparts

    PubMed Central

    Turner, Kara J.; George, Shermi; Greenall, John; Slijepcevic, Predrag; Griffin, Darren K.

    2017-01-01

    There are well-established morbidities associated with preterm birth including respiratory, neurocognitive and developmental disorders. However several others have recently emerged that characterise an ‘aged’ phenotype in the preterm infant by term-equivalent age. These include hypertension, insulin resistance and altered body fat distribution. Evidence shows that these morbidities persist into adult life, posing a significant public health concern. In this study, we measured relative telomere length in leukocytes as an indicator of biological ageing in 25 preterm infants at term equivalent age. Comparing our measurements with those from 22 preterm infants sampled at birth and from 31 term-born infants, we tested the hypothesis that by term equivalent age, preterm infants have significantly shorter telomeres (thus suggesting that they are prematurely aged). Our results demonstrate that relative telomere length is highly variable in newborn infants and is significantly negatively correlated with gestational age and birth weight in preterm infants. Further, longitudinal assessment in preterm infants who had telomere length measurements available at both birth and term age (n = 5) suggests that telomere attrition rate is negatively correlated with increasing gestational age. Contrary to our initial hypothesis however, relative telomere length was significantly shortest in the term born control group compared to both preterm groups and longest in the preterm at birth group. In addition, telomere lengths were not significantly different between preterm infants sampled at birth and those sampled at term equivalent age. These results indicate that other, as yet undetermined, factors may influence telomere length in the preterm born infant and raise the intriguing hypothesis that as preterm gestation declines, telomere attrition rate increases. PMID:28658264

  6. Outcomes of Extremely Preterm Infants Born to Insulin-Dependent Diabetic Mothers

    PubMed Central

    Boghossian, Nansi S.; Hansen, Nellie I.; Brumbaugh, Jane E.; Stoll, Barbara J.; Laptook, Abbot R.; Shankaran, Seetha; Wyckoff, Myra H.; Colaizy, Tarah T.; Das, Abhik; Higgins, Rosemary D.

    2016-01-01

    BACKGROUND AND OBJECTIVE: Little is known about in-hospital morbidities and neurodevelopmental outcomes among extremely preterm infants born to women with insulin-dependent diabetes mellitus (IDDM). We examined risks of mortality, in-hospital morbidities, and neurodevelopmental outcomes at 18 to 22 months’ corrected age between extremely preterm infants of women with insulin use before pregnancy (IBP), with insulin use started during pregnancy (IDP), and without IDDM. METHODS: Infants 22 to 28 weeks’ gestation born or cared for at a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network center (2006–2011) were studied. Regression models compared the association between maternal IDDM and timing of insulin use and the outcomes of the 3 groups. RESULTS: Of 10 781 infants, 536 (5%) were born to women with IDDM; 58% had IBP, and 36% had IDP. Infants of mothers with IBP had higher risks of necrotizing enterocolitis (adjusted relative risk [RR] = 1.55 [95% confidence interval (CI) 1.17–2.05]) and late-onset sepsis (adjusted RR = 1.26 [95% CI 1.07–1.48]) than infants of mothers without IDDM. There was some indication of higher in-hospital mortality risk among infants of mothers with IBP compared with those with IDP (adjusted RR = 1.33 [95% CI 1.00–1.79]). Among survivors evaluated at 18 to 22 months’ corrected age, average head circumference z score was lower for infants of mothers with IBP compared with those without IDDM, but there were no differences in risk of neurodevelopmental impairment. CONCLUSIONS: In this cohort of extremely preterm infants, infants of mothers with IBP had higher risks of necrotizing enterocolitis, sepsis, and small head circumference. PMID:27244849

  7. Habituation of visual evoked potentials in healthy infants and in infants with periventricular leukomalacia.

    PubMed

    González-Frankenberger, Berta; Harmony, Thalía; Ricardo-Garcell, Josefina; Porras-Kattz, Eneida; Fernández-Bouzas, Antonio; Santiago, Efraín; Avecilla-Ramírez, Gloria

    2008-12-01

    To investigate whether habituation of flash visual evoked potentials is already present during the first 3 months of life, and to explore differences between healthy infants, term infants with periventricular leukomalacia (PVL), and preterm infants with PVL. Referential recordings to stimuli consisting of photic stimulation presented in blocks were obtained. A total of 25 blocks, 15-stimuli each, were presented. Intrablock and interblock habituation effects were analyzed. In healthy infants of 42-50 and 51-58 weeks of post-conceptional age (PCA), a negative central component (NCC) showed a significant decrease in amplitude due to stimulus repetition. NCC habituation was also observed in term infants with PVL at 51-58 weeks of PCA, but not in term infants with PVL at 42-50 weeks of PCA. NCC habituation was not apparent in preterm infants with PVL. These results suggest that the neural mechanisms of visual habituation are normally present during the first month of life, but the presence of PVL delays the emergence of these mechanisms, particularly in preterm infants. The habituation of flash visual evoked potentials may be developed into a reliable tool to examine normal and abnormal development of early neural processes.

  8. Infants born at the threshold of viability in relation to neonatal mortality: Colorado, 1991 to 2003.

    PubMed

    Kamath, B D; Box, T L; Simpson, M; Hernández, J A

    2008-05-01

    To determine the contribution of infants born at the threshold of viability (defined as <750 g birth weight) and the role of regionalization of perinatal care on the neonatal mortality rate (NMR) in Colorado. We performed a retrospective cohort study, evaluating all live births in Colorado from 1991 to 2003, and comparing the periods 1991 to 1996 versus 1997 to 2003. The overall unadjusted NMR of the two time periods was 4.3 and 4.4 per 1000 live births, respectively (P=0.42). The contribution of infants with birth weights<750 g to the overall NMR increased from 45.0 to 54.5% (P<0.01). The odds of death for infants<750 g increased between time periods (Odd ratio 1.3, 95% Confidence interval 1.11, 1.61). However, NMR decreased between time periods for all birth weight categories, until infants<600 g. With respect to regionalization, the number of infants<750 g born in a level III care center increased slightly between the two time periods (69.6 versus 73.3%; P=0.04); however, adjusted analysis showed no difference in the practice of regionalization between time periods. Regardless of time period, infants who weighed <750 g born in a level III center had 60% lower mortality risk when compared to <750 g infants born in a non-level III center (P<0.01; 95% CI 0.30, 0.52). Despite advances in neonatal medicine, the overall NMR in the state of Colorado remained unchanged between the time periods of 1991 to 1996 and 1997 to 2003. Infants at the threshold of viability continue to have a large impact on the Colorado NMR, making up a larger proportion of overall neonatal deaths. While the results demonstrate that the risk of mortality is significantly reduced for <750 g infants born in a level III center, the practice of regionalization has not changed between the two time periods. Improved efforts to standardize the referral practices to ensure delivery of <750 g infants in level III centers could potentially reduce the impact of these infants on the NMR. While the overall

  9. Infants born at the threshold of viability in relation to neonatal mortality: Colorado, 1991 to 2003

    PubMed Central

    Kamath, BD; Box, TL; Simpson, M; Hernández, JA

    2013-01-01

    Objective To determine the contribution of infants born at the threshold of viability (defined as <750 g birth weight) and the role of regionalization of perinatal care on the neonatal mortality rate (NMR) in Colorado. Study Design We performed a retrospective cohort study, evaluating all live births in Colorado from 1991 to 2003, and comparing the periods 1991 to 1996 versus 1997 to 2003. Result The overall unadjusted NMR of the two time periods was 4.3 and 4.4 per 1000 live births, respectively (P=0.42). The contribution of infants with birth weights <750 g to the overall NMR increased from 45.0 to 54.5% (P<0.01). The odds of death for infants <750 g increased between time periods (Odd ratio 1.3, 95% Confidence interval 1.11, 1.61). However, NMR decreased between time periods for all birth weight categories, until infants <600 g. With respect to regionalization, the number of infants <750 g born in a level III care center increased slightly between the two time periods (69.6 versus 73.3%; P=0.04); however, adjusted analysis showed no difference in the practice of regionalization between time periods. Regardless of time period, infants who weighed <750 g born in a level III center had 60% lower mortality risk when compared to <750 g infants born in a non-level III center (P<0.01; 95% CI 0.30, 0.52). Conclusion Despite advances in neonatal medicine, the overall NMR in the state of Colorado remained unchanged between the time periods of 1991 to 1996 and 1997 to 2003. Infants at the threshold of viability continue to have a large impact on the Colorado NMR, making up a larger proportion of overall neonatal deaths. While the results demonstrate that the risk of mortality is significantly reduced for <750 g infants born in a level III center, the practice of regionalization has not changed between the two time periods. Improved efforts to standardize the referral practices to ensure delivery of <750 g infants in level III centers could potentially reduce the impact of

  10. Intervention in the First Weeks of Life for Infants Born Late Preterm: A Case Series

    PubMed Central

    Dusing, Stacey C.; Lobo, Michele A.; Lee, Hui-Min; Galloway, James Cole

    2013-01-01

    Infants born late preterm (34–36 weeks of gestation) account for 350,000 US births per year, are at risk for developmental delays, and are rarely included in intervention studies. Purpose To describe a novel parent delivered movement intervention program for very young infants and outcomes following intervention and to evaluate the feasibility of using a comprehensive set of outcome measures. Summary of Key Points Two infants born late preterm received intervention from 0.5 to 2.0 months of adjusted age. Development, postural control, reaching, and object exploration assessments were completed at 3 time points. The intervention was well tolerated by the family. Improvements in developmental outcomes, postural control, and object exploration are presented. Statement of Conclusion Very early movement experience provided daily by parents may improve development. In combination, norm-referenced and behavioral measures appear sensitive to changes in infant behaviors. PMID:23542201

  11. Challenges in vaccinating infants born to mothers taking immunoglobulin biologicals during pregnancy.

    PubMed

    Ling, Juejing; Koren, Gideon

    2016-01-01

    While immunoglobulin biologicals are increasingly used during pregnancy, there have been concerns on the immune function and vaccination of infants born to mothers taking immunoglobulin biologicals. In addition to the detection of biologicals in cord blood, cases of severe neonatal neutropenia and fatal dissemination of Bacillus Calmette-Guérin (BCG) have been reported. With increasing number of infants exposed to immunoglobulin biologicals in utero, there is a need to address the challenges in vaccinating these infants. This review summarizes the available evidence to discuss the issues of immunoglobulin biological exposure in utero, neonatal immune function, long-term immune development, and the challenges and strategies of vaccinating newborns and infants who were born to mothers taking biologicals during pregnancy.

  12. Policy change for infants born at the "cusp of viability": a Canadian NICU experience.

    PubMed

    Mahgoub, Linda; van Manen, Michael; Byrne, Paul; Tyebkhan, Juzer M

    2014-11-01

    Resuscitation and life-support treatments for infants born at the "cusp of viability" continue to be subject to clinical and ethical debate. Reported positive outcomes for these infants led our Neonatal Program to critically review our historic practice of discouraging resuscitation of infants born at <24 weeks' gestational age. This practice change required a multifaceted, collaborative approach including neonatal, perinatal, and obstetric efforts. An exceptional experience was the formation of a dedicated working group that included invaluable input from parents who had lived the NICU experience. The inclusion of family members in the development of clinical policy was a novel experience for NICU staff, which we feel ultimately resulted in a more ethically sound approach to the care of these infants and their families. In this article, we explore our experience of the process of policy change, which although detailed and transparent was also complex and challenging in development and implementation. Copyright © 2014 by the American Academy of Pediatrics.

  13. Individual differences in developmental trajectories of A-not-B performance in infants born preterm.

    PubMed

    van de Weijer-Bergsma, Eva; Wijnroks, Lex; Boom, Jan; de Vries, Linda S; van Haastert, Ingrid C; Jongmans, Marian J

    2010-01-01

    Because early executive functioning is a potentially important predictor of developmental delay and learning difficulties in infants born preterm, this study assessed the effect of several perinatal predictors on the development of A-not-B performance between 7 and 14 months corrected age in 76 infants born preterm, and its relationship to subsequent global cognitive functioning. Latent Growth Modeling showed that gestational age was a predictor of initial level, and that birth weight and gender were predictors of the rate of developmental change in A-not-B performance. Moreover, initial level and rate of developmental change in A-not-B performance were predictive of global cognitive functioning.

  14. Pertussis Antibody Concentrations in Infants Born Prematurely to Mothers Vaccinated in Pregnancy.

    PubMed

    Kent, Alison; Ladhani, Shamez N; Andrews, Nick J; Matheson, Mary; England, Anna; Miller, Elizabeth; Heath, Paul T

    2016-07-01

    Maternal antenatal pertussis-containing vaccination is recommended for the prevention of neonatal pertussis, but the ability of maternal vaccination to protect premature infants is unknown. We hypothesized that that infants born prematurely to antenatally vaccinated women would have higher pertussis antibody concentrations than those born to unvaccinated women. Mothers had been offered a combined tetanus, diphtheria, 5-component acellular pertussis, inactivated polio vaccine from 28 weeks' gestation as part of their routine antenatal care. Premature infants of vaccinated and unvaccinated mothers enrolled in a randomized controlled trial of pneumococcal conjugate vaccine schedules had antibody concentrations (pertussis toxin, filamentous hemoagglutinin [FHA], and fimbriae 2 and 3) measured at 2 months (before primary vaccination), 5 months (1 month after primary vaccination), and 12 months of age. Mothers of 31 (19%) of 160 premature infants had received combined tetanus, diphtheria, 5-component acellular pertussis, inactivated polio vaccine in pregnancy. Compared with infants of unvaccinated mothers, those born to vaccinated mothers had significantly higher antibody concentrations at 2 months for all measured vaccine antigens (P < .001). The number of days between maternal vaccination and delivery and immunoglobulin G concentration at 2 months of age was positively correlated for pertussis toxin (P = .011) and FHA (P = .001). After primary immunization, infants of vaccinated mothers had significantly lower antibody concentrations for FHA (P = .003) compared with infants of unvaccinated mothers; these differences had resolved by 12 months of age. Maternal vaccination administered early in the third trimester may provide protection for infants born prematurely. Copyright © 2016 by the American Academy of Pediatrics.

  15. The incidence of cardiac lesions in infants born with major gastrointestinal malformations in Northern Ireland.

    PubMed Central

    Thompson, A. J.; Mulholland, H. C.

    2000-01-01

    There is a recognised association between major gastrointestinal (GI) malformations and congenital heart disease (CHD). A retrospective study over 10 years involving 240 infants born with gastrointestinal malformations was conducted in the Royal Belfast Hospital For Sick Children (RBHSC). We felt it was important to look at the incidence of CHD diagnosed in the infants presenting to the tertiary referral centre in Belfast. Comparable figures for the incidence of CHD associated with major GI malformations was found in the literature. PMID:10881641

  16. In utero drug and alcohol exposure in infants born to mothers prescribed maintenance methadone.

    PubMed

    McGlone, Laura; Mactier, Helen; Hassan, Huda; Cooper, Gail

    2013-11-01

    To describe the prevalence of in utero alcohol and illicit drug exposure in infants born to mothers prescribed methadone in pregnancy, and to compare the accuracy of maternal interview with infant toxicology. Urine and meconium samples were collected from 56 infants born to mothers prescribed methadone during pregnancy and a confidential interview conducted soon after delivery. Samples were screened for drugs of misuse and meconium samples analysed for the presence of fatty acid ethyl esters (FAEEs) to detect prenatal alcohol exposure. 91% of infants had been exposed to illicit drugs in utero, including opiates (73%), benzodiazepines (70%) and cannabinoids (59%). 47% of infants had elevated FAEEs. Meconium was more sensitive at detecting in utero drug exposure than urine toxicology (p<0.01 for opiates, benzodiazepines, cannabinoids) or maternal interview (p=0.03 for opiates, p<0.01 for cannabinoids). The majority of infants born to mothers prescribed methadone during pregnancy are exposed to polysubstance misuse, and almost one-half additionally exposed to excess alcohol.

  17. Reportable Bacterial Infections among New York City-Born Infants, 2001-2009.

    PubMed

    Isaac, Beth M; Masonbrink, Abbey; Kennedy, Joseph; Greene, Sharon K; Hennessy, Robin R; Rosen, Jennifer B; Trieu, Lisa; Ngai, Stephanie; Morse, Stephen S; Weiss, Don

    2016-07-01

    To determine rates of reportable bacterial infections among infants in New York City and identify populations at risk and preventable causes of morbidity. This retrospective cohort study matched live births in New York City from 2001-2009 to reported cases of bacterial infections among infants less than 1 year of age. Characteristics recorded on birth certificates were compared between infants with bacterial enteric infection, bacterial nonenteric infection, and no reportable bacterial infection. Multinomial logistic regression and multivariable logistic regression were used to identify risk factors for infection. Bacterial infection was reported in 4.6 cases per 1000 live births. Of 4524 infants with a reportable infection, the majority (2880, 63%) had an enteric infection. Asian/Pacific Islanders in Brooklyn were the borough-level race/ethnic group with the highest enteric infection rate (8.5 per 1000 live births). Citywide, infants with enteric infections were disproportionately male, from higher poverty neighborhoods, born to foreign-born mothers, and enrolled in Special Supplemental Food Program for Women, Infants, and Children or Medicaid. In contrast, infants with nonenteric infections were more likely to have low birthweight and mothers characterized by US birth and black race or white Hispanic race/ethnicity. Distinct patterns of risk factors for enteric and nonenteric bacterial infections among infants were identified. The results suggest that infants born to Asian/Pacific Islander mothers residing in Brooklyn should be a focus of enteric disease prevention. More research is necessary to better understand what behaviors increase the risk of enteric disease in this population. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Neonatal pain in relation to postnatal growth in infants born very preterm.

    PubMed

    Vinall, Jillian; Miller, Steven P; Chau, Vann; Brummelte, Susanne; Synnes, Anne R; Grunau, Ruth E

    2012-07-01

    Procedural pain is associated with poorer neurodevelopment in infants born very preterm (≤ 32 weeks gestational age), however, the etiology is unclear. Animal studies have demonstrated that early environmental stress leads to slower postnatal growth; however, it is unknown whether neonatal pain-related stress affects postnatal growth in infants born very preterm. The aim of this study was to examine whether greater neonatal pain (number of skin-breaking procedures adjusted for medical confounders) is related to decreased postnatal growth (weight and head circumference [HC] percentiles) early in life and at term-equivalent age in infants born very preterm. Participants were n=78 preterm infants born ≤ 32 weeks gestational age, followed prospectively since birth. Infants were weighed and HC measured at birth, early in life (median: 32 weeks [interquartile range 30.7-33.6]) and at term-equivalent age (40 weeks [interquartile range 38.6-42.6]). Weight and HC percentiles were computed from sex-specific British Columbia population-based data. Greater neonatal pain predicted lower body weight (Wald χ(2)=7.36, P=0.01) and HC (Wald χ(2)=4.36, P=0.04) percentiles at 32 weeks postconceptional age, after adjusting for birth weight percentile and postnatal risk factors of illness severity, duration of mechanical ventilation, infection, and morphine and corticosteroid exposure. However, later neonatal infection predicted lower weight percentile at term (Wald χ(2)=5.09, P=0.02). Infants born very preterm undergo repetitive procedural pain during a period of physiological immaturity that appears to impact postnatal growth, and may activate a downstream cascade of stress signaling that affects later growth in the neonatal intensive care unit.

  19. 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…

  20. Risk factors for wheezing in infants born in Cuba

    PubMed Central

    Suárez-Medina, R.; Mora-Faife, E. C.; García-García, G.; Valle-Infante, I.; Gómez-Marrero, L.; Abreu-Suárez, G.; González-Valdez, J.; Fabró-Ortiz, D. Dania; Fundora-Hernández, H.; Venn, A.; Britton, J.; Fogarty, A. W.

    2013-01-01

    Background: Cuba is a unique country, and despite limited economic development, has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high. Aim: As early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheezing in Cuban infants. Design: Cross-sectional study. Methods: A random sample of 2032 children aged 12–15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers. Results: Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of emergency services was 30% and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema [odds ratio (OR) 2.09; 95% confidence interval (CI) 1.48–2.94], family history of asthma (OR 2.05; 95% CI 1.60–2.62), poor ventilation in the house (OR 1.99; 95% CI 1.48–2.67), attendance at nursery (OR 1.78; 95% CI 1.24–2.57), male sex (OR1.52; 95% CI 1.19–1.96) and the number of smokers in the house (P < 0.03 for trend), OR 1.64 (95% CI 1.17–2.31) for three or more smokers in the house compared to no smokers in the household. Conclusion: We have identified several risk factors for any wheeze in young infants living in modern day Cuba. As the prevalence of smoking in the house is high (51%), intervention studies are required to determine effective strategies to improve infant health. PMID:23824939

  1. Risk factors for wheezing in infants born in Cuba.

    PubMed

    Venero-Fernández, S J; Suárez-Medina, R; Mora-Faife, E C; García-García, G; Valle-Infante, I; Gómez-Marrero, L; Abreu-Suárez, G; González-Valdez, J; Fabró-Ortiz, D Dania; Fundora-Hernández, H; Venn, A; Britton, J; Fogarty, A W

    2013-11-01

    Cuba is a unique country, and despite limited economic development, has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high. As early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheezing in Cuban infants. Cross-sectional study. A random sample of 2032 children aged 12-15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers. Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of emergency services was 30% and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema [odds ratio (OR) 2.09; 95% confidence interval (CI) 1.48-2.94], family history of asthma (OR 2.05; 95% CI 1.60-2.62), poor ventilation in the house (OR 1.99; 95% CI 1.48-2.67), attendance at nursery (OR 1.78; 95% CI 1.24-2.57), male sex (OR1.52; 95% CI 1.19-1.96) and the number of smokers in the house (P < 0.03 for trend), OR 1.64 (95% CI 1.17-2.31) for three or more smokers in the house compared to no smokers in the household. We have identified several risk factors for any wheeze in young infants living in modern day Cuba. As the prevalence of smoking in the house is high (51%), intervention studies are required to determine effective strategies to improve infant health.

  2. Congenital anomalies identified at birth among infants born following assisted reproductive technology in Colorado.

    PubMed

    Moses, X J Ethan; Torres, Tirsa; Rasmussen, Anna; George, Christopher

    2014-02-01

    Assisted reproductive technology (ART) has assisted many infertile couples in conceiving. Despite increasing use in the United States, the association between ART and congenital anomalies remains a highly contested subject. We conducted a study to examine the risk of congenital anomalies among infants conceived using ART. A retrospective cohort study of 344,567 infants born in Colorado from 2007 to 2011 was conducted using data obtained from the Colorado Birth Certificate Database. The incidence of congenital anomalies identified at birth following conception with ART was assessed and compared with all naturally conceived infants born during the same time period. The odds ratio was calculated using multiple logistic regression after adjusting for multiple confounders. Of 2071 infants, 23 (1.11%) conceived using ART had a congenital anomaly identified at birth compared with 3826 (1.12%) of 342,496 infants conceived naturally. The adjusted odds ratio of a congenital anomaly among infants born following conception with ART was 1.01 (95% confidence interval, 0.67-1.52). The proportion of infants born following usage of ART in Colorado has not changed significantly (p = 0.20) from 2007 to 2011 with an overall proportion of 0.60% (range 0.52-0.64%), while the incidence of congenital anomalies has decreased significantly (p = 0.002) during the study years with an average of 1.12% (range, 0.92-1.25%). This study suggests that conception by means of ART is not associated with an increased risk of congenital abnormalities identified by birth certificate data in Colorado when compared with births following natural conception. Copyright © 2014 Wiley Periodicals, Inc.

  3. Spontaneous brain activity in the newborn brain during natural sleep--an fMRI study in infants born at full term.

    PubMed

    Fransson, Peter; Skiöld, Beatrice; Engström, Mathias; Hallberg, Boubou; Mosskin, Mikael; Aden, Ulrika; Lagercrantz, Hugo; Blennow, Mats

    2009-09-01

    Recent progress in functional neuroimaging research has provided the opportunity to probe at the brain's intrinsic functional architecture. Synchronized spontaneous neuronal activity is present in the form of resting-state networks in the brain even in the absence of external stimuli. The objective of this study was to investigate the presence of resting-state networks in the unsedated infant brain born at full term. Using functional MRI, we investigated spontaneous low-frequency signal fluctuations in 19 healthy full-term infants. Resting-state functional MRI data acquired during natural sleep was analyzed using independent component analysis. We found five resting-state networks in the unsedated infant brain born at full term, encompassing sensory cortices, parietal and temporal areas, and the prefrontal cortex. In addition, we found evidence for a resting-state network that enclosed the bilateral basal ganglia.

  4. Profile of infants born to drug-using mothers: a state-wide audit.

    PubMed

    Abdel-Latif, Mohamed E; Oei, Julee; Craig, Fiona; Lui, Kei

    2013-01-01

    To ascertain the characteristics and short-term outcomes of infants born to illicit drug-using mothers in public hospitals in the state of New South Wales and the Australian Capital Territory during 2004. Patients were identified retrospectively by hospital records searches using ICD-10 morbidity codes and records of local Drug and Alcohol Services. Records were reviewed on site. All public hospitals (n= 101) with obstetric services were included. A total of 879 (1.4%, 95% confidence interval: 1.3-1.5%) drug-using mothers were identified from 62,682 confinements. Opiates (46.8%), amphetamines (23.0%) and polydrug (16.4%) exposure were most common. There were eight stillbirths. Among these 871 infants, prematurity (23.6%) and low birthweight (27.1%) were common and 51.1% were admitted to nurseries for further care. Two infants died. Major congenital anomalies were detected in 15 infants. Pharmacological treatment for withdrawal was required for 202 (23.2%), and 143 (70.8%) infants were discharged home on medication. Infants who completed inpatient pharmacological treatment were hospitalised longer (median 26.0 vs. 12.0 days) and were more likely to be premature (37.3 vs. 14.0%). Child-at-risk notifications affected 40.6% of the infants, and 7.6% were fostered prior to discharge. A total of 333 (38.2%) infants were breastfed at discharge. Our regional study highlights a substantial prevalence of drug use in pregnancy with considerable adverse perinatal and hospital outcomes in infants born to these mothers. Coordinated health care and resources are needed to support these mother-infant pairs because of their social, medical and mental-health issues. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  5. Congenital toxoplasmosis infection in an infant born to an HIV-1-infected mother.

    PubMed

    Cruz, Maria Letícia Santos; Cardoso, Claudete Araújo; Saavedra, Mariza C; Santos, Eliane Dos; Melino, Tatiana

    2007-12-01

    We report the occurrence of congenital toxoplasmosis in an infant born to an HIV infected mother who had high anti-toxoplasma IgG and negative IgM at nine weeks of gestation. We briefly review available literature and discuss the possible mechanisms of transmission of congenital toxoplasmosis among HIV infected pregnant women.

  6. Disposition and Health Outcomes among Infants Born to Mothers with No Prenatal Care

    ERIC Educational Resources Information Center

    Friedman, Susan Hatters; Heneghan, Amy; Rosenthal, Miriam

    2009-01-01

    Objective: This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity). Methods: A retrospective record…

  7. Disposition and Health Outcomes among Infants Born to Mothers with No Prenatal Care

    ERIC Educational Resources Information Center

    Friedman, Susan Hatters; Heneghan, Amy; Rosenthal, Miriam

    2009-01-01

    Objective: This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity). Methods: A retrospective record…

  8. Risk factors for macrosomia in infants born to Latina women

    PubMed Central

    Wojcicki, JM.; Hessol, NA.; Heyman, MB.; Fuentes-Afflick, E.

    2015-01-01

    Objective To assess risk factors for macrosomic infant birth among Latina women. Study Design Prospective study of Latina women recruited during pregnancy from prenatal clinic at San Francisco General Hospital. Information was obtained through a structured interview and review of medical records. Result A total of 11% of women delivered macrosomic infants (birth weight >4000 g). In unadjusted analyses, significant risk factors for macrosomia included older maternal age, increasing gravidity, previous history of macrosomic birth and pre-pregnancy overweight. After adjusting for confounders using multivariate analyses, older mothers (10-year increments) had an elevated risk of macrosomia (odds ratio (OR) 2.59; 95% confidence interval (CI) 1.28 to 5.24). Conclusion Efforts to reduce macrosomia in Latina women should focus on older mothers. PMID:18596709

  9. The Infant Born to a Woman with Gestational Diabetes.

    PubMed

    Povinelli, Theresa; Lim, Caitlin; Raines, Deborah A

    2017-07-01

    Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. During pregnancy, women with GDM develop insulin resistance, which results in altered glucose tolerance. As a result, there are frequent episodes of hyperglycemia and high levels of circulating amino acids, increasing the transfer of nutrients to the fetus. This article discusses the role of the mother-baby nursing in the care of neonates born to women with gestational diabetes.

  10. Effect of caffeine on respiratory muscle strength and lung function in prematurely born, ventilated infants.

    PubMed

    Kassim, Zainab; Greenough, Anne; Rafferty, Gerrard F

    2009-12-01

    The aims of this study were to determine whether caffeine administration increased respiratory muscle function and if this was associated with lung function improvement in prematurely born infants being weaned from mechanical ventilation. Respiratory muscle function was assessed by measurement of the maximum pressures generated during occlusions at end inspiration (Pemax) and end expiration (Pimax) and lung function by measurement of lung volume (functional residual capacity (FRC)) and respiratory system compliance (CRS) and resistance (RRS) in 18 infants with a median gestational age of 28 (range 24-36) weeks. Measurements were made immediately prior to caffeine administration (baseline) and 6 h later. Six hours after caffeine administration compared to baseline, the median Pemax (p = 0.017), Pimax (p = 0.004), FRC (p < 0.001), CRS (p = 0.002) and RRS (p = 0.004) had significantly improved. Our results suggest that caffeine administration facilitates weaning of prematurely born infants from mechanical ventilation by improving respiratory muscle strength.

  11. Body fat mass of exclusively breastfed infants born to overweight mothers.

    PubMed

    Andres, Aline; Shankar, Kartik; Badger, Thomas M

    2012-07-01

    Although there is evidence that maternal prepregnancy obesity (body mass index [BMI; calculated as kg/m(2)] ≥30) results in elevated risk of obesity in the offspring later in life, maternal prepregnancy overweight (BMI 25 to 29.9) has not been clearly demonstrated as a risk factor for the future development of obesity in the offspring. Our objective was to determine if body composition differs between infants born to lean or overweight breastfeeding women. Body composition (PeaPod, COSMED USA, Inc) and anthropometric outcomes were measured in 65 infants born to lean mothers (n=46) (BMI 18.5 to 24.9) or overweight mothers (n=19) (BMI 25 to 29.9) between 2006 and 2007. Maternal body composition (BodPod, COSMED USA, Inc) was also measured. Body fat mass was higher in infants born to overweight mothers compared with infants born to lean mothers at age 2 weeks and 3 months (11.9% vs 15.3% and 24.1% vs 26.8%, respectively; P<0.05). After adjusting for gestational weight gain and birth weight, body fat mass was significantly greater only at age 2 weeks. Infants of overweight mothers have greater body fat mass in the neonatal period compared with infants of lean mothers, suggesting that maternal overweight may predispose fetal metabolism to favor fat storage. Although our data suggest that this effect is short lived, future studies are needed to investigate children beyond the infancy period to test if body composition is greater in offspring of overweight women. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  12. The Development of Extremely Preterm Infants Born to Women Who Had Genitourinary Infections During Pregnancy.

    PubMed

    Leviton, Alan; Allred, Elizabeth N; Kuban, Karl C K; O'Shea, T Michael; Paneth, Nigel; Onderdonk, Andrew B; Fichorova, Raina N; Dammann, Olaf

    2016-01-01

    Gestational genitourinary infections, which have been associated with neurodevelopmental impairments among infants born near term, have not been studied among very preterm infants. The mothers of 989 infants born before 28 weeks of gestation were interviewed about urine, bladder, or kidney infections (UTIs) and cervical or vaginal infections (CVIs) during pregnancy, as well as other exposures and characteristics, and their charts were reviewed for the Extremely Low Gestational Age Newborns (ELGAN) Study (2002-2004). At 2 years of age, these infants underwent a neurodevelopmental assessment. Generalized estimating equation logistic regression models of developmental adversities were used to adjust for potential confounders. Infants born to women who reported a UTI were less likely than were others to have a very low Mental Development Index (adjusted odds ratio = 0.5; 95% confidence interval: 0.3, 0.8), whereas infants born to women who reported a CVI were more likely than others to have a low Psychomotor Development Index (adjusted odds ratio = 1.7; 95% confidence interval: 1.04, 2.7). In this high-risk sample, maternal gestational CVI, but not UTI, was associated with a higher risk of impaired motor development at 2 years of age. The apparent protective effect of UTI might be spurious, reflect confounding due to untreated asymptomatic bacteriuria among women who were not given a diagnosis of UTI, or reflect preconditioning. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Correcting for prematurity affects developmental test scores in infants born late and moderately preterm.

    PubMed

    Parekh, Shalin A; Boyle, Elaine M; Guy, Alexa; Blaggan, Samarita; Manktelow, Bradley N; Wolke, Dieter; Johnson, Samantha

    2016-03-01

    Corrected age is typically applied when assessing the development of children born <32 weeks of gestation. There is no consensus as to whether corrected age should be applied when assessing children born late/moderately preterm (LMPT; 32-36 weeks of gestation). This study explored the impact of corrected age on developmental test scores in infants born LMPT. 221 LMPT infants were assessed at two years corrected age using the Bayley-III cognitive and language scales, from which cognitive and language composite scores were derived (Normative Mean 100; SD 15). Assessments were then re-scored using chronological age. Bayley-III composite scores <80 were used to define developmental delay. Paired sample t-tests were used to assess the difference in mean test scores derived using corrected versus chronological age, and McNemar's tests to assess the difference in the proportion of infants with developmental delay using corrected versus chronological age. Mean corrected age scores were significantly higher than chronological age scores (cognitive: 2.1 points; 95% CI 1.6, 2.5; language 2.5; 95% CI 2.1, 2.8). Overall, significantly more LMPT infants were classified with developmental delay when chronological (18.3%) versus corrected (15.0%) age was used (p=0.016). Correcting for prematurity results in significantly higher developmental test scores and a significantly lower prevalence of developmental delay in LMPT infants and may affect eligibility for intervention services. Researchers and clinicians should be aware that the use of corrected age may impact on developmental test scores at both an individual and population level among infants born LMPT. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Disposition and health outcomes among infants born to mothers with no prenatal care.

    PubMed

    Friedman, Susan Hatters; Heneghan, Amy; Rosenthal, Miriam

    2009-02-01

    This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity). A retrospective record review was completed at an urban academic medical center. Subjects were women who presented at delivery or immediately postpartum with no history of prenatal care (N=211), and their infants. Infants of mothers with substance use problems had the highest rates of referral to child protective services and out-of-home placement at discharge, though mothers with other reasons for no prenatal care also experienced both referral and placement. Infants born to mothers using substances experienced the highest rates of neonatal intensive care unit admission, and the lowest mean birth weight. Though those without prenatal care experienced a variety of adverse outcomes, substance use problems were most frequently correlated with adverse infant outcomes. Mothers who either had lost custody of other children or with substance use problems were at highest risk of losing custody of their infants. Those who denied or concealed their pregnancy still frequently retained custody. Among mothers without prenatal care, those with substance use problems were least likely to retain custody of their infant at hospital discharge. Custody status of the mother's other children was also independently associated with infant custody. Mothers who denied or concealed their pregnancy still often retained custody. Referrals of mothers with no prenatal care for psychiatric evaluation were rare, though referrals to social work were frequent. Child protective services occasionally did not investigate referrals in the denial and concealment groups. Healthcare providers should be aware of the medical and psychological needs of this vulnerable population of infants and mothers.

  15. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study

    PubMed Central

    2014-01-01

    Background Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This “parenting” intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT’s central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent–child responsibility for feeding, reducing subsequent risk for overeating and overweight. Methods/Design 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the “parenting” or “safety” groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3–4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic

  16. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study.

    PubMed

    Paul, Ian M; Williams, Jennifer S; Anzman-Frasca, Stephanie; Beiler, Jessica S; Makova, Kateryna D; Marini, Michele E; Hess, Lindsey B; Rzucidlo, Susan E; Verdiglione, Nicole; Mindell, Jodi A; Birch, Leann L

    2014-07-18

    Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This "parenting" intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT's central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent-child responsibility for feeding, reducing subsequent risk for overeating and overweight. 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the "parenting" or "safety" groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3-4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic predictors of weight status. Finally, second-born

  17. Predicting treatment for neonatal abstinence syndrome in infants born to women maintained on opioid agonist medication.

    PubMed

    Kaltenbach, Karol; Holbrook, Amber M; Coyle, Mara G; Heil, Sarah H; Salisbury, Amy L; Stine, Susan M; Martin, Peter R; Jones, Hendrée E

    2012-11-01

    To identify factors that predict the expression of neonatal abstinence syndrome (NAS) in infants exposed to methadone or buprenorphine in utero. Multi-site randomized clinical trial in which infants were observed for a minimum of 10 days following birth, and assessed for NAS symptoms by trained raters. A total of 131 infants born to opioid dependent mothers, 129 of whom were available for NAS assessment. Generalized linear modeling was performed using maternal and infant characteristics to predict: peak NAS score prior to treatment, whether an infant required NAS treatment, length of NAS treatment and total dose of morphine required for treatment of NAS symptoms. Of the sample, 53% (68 infants) required treatment for NAS. Lower maternal weight at delivery, later estimated gestational age (EGA), maternal use of selective serotonin re-uptake inhibitors (SSRIs), vaginal delivery and higher infant birthweight predicted higher peak NAS scores. Higher infant birthweight and greater maternal nicotine use at delivery predicted receipt of NAS treatment for infants. Maternal use of SSRIs, higher nicotine use and fewer days of study medication received also predicted total dose of medication required to treat NAS symptoms. No variables predicted length of treatment for NAS. Maternal weight at delivery, estimated gestational age, infant birthweight, delivery type, maternal nicotine use and days of maternal study medication received and the use of psychotropic medications in pregnancy may play a role in the expression of neonatal abstinence syndrome severity in infants exposed to either methadone or buprenorphine. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  18. Preventing obesity in infants: the Growing healthy feasibility trial protocol

    PubMed Central

    Denney-Wilson, Elizabeth; Laws, Rachel; Russell, Catherine Georgina; Ong, Kok-leong; Taki, Sarah; Elliot, Roz; Azadi, Leva; Lymer, Sharyn; Taylor, Rachael; Lynch, John; Crawford, David; Ball, Kylie; Askew, Deborah; Litterbach, Eloise Kate; J Campbell, Karen

    2015-01-01

    Introduction Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course. Early feeding choices, including breast and/or formula, timing of introduction of solids, physical activity and electronic media use among infants and young children are considered likely determinants of childhood obesity. Parents play a primary role in shaping these behaviours through parental modelling, feeding styles, and the food and physical activity environments provided. Children from low socio-economic backgrounds have higher rates of obesity, making early intervention particularly important. However, such families are often more difficult to reach and may be less likely to participate in traditional programs that support healthy behaviours. Parents across all socio-demographic groups frequently access primary health care (PHC) services, including nurses in community health services and general medical practices, providing unparalleled opportunity for engagement to influence family behaviours. One emerging and promising area that might maximise engagement at a low cost is the provision of support for healthy parenting through electronic media such as the Internet or smart phones. The Growing healthy study explores the feasibility of delivering such support via primary health care services. Methods This paper describes the Growing healthy study, a non-randomised quasi experimental study examining the feasibility of an intervention delivered via a smartphone app (or website) for parents living in socioeconomically disadvantaged areas, for promoting infant feeding and parenting behaviours that promote healthy rather than excessive weight gain. Participants will be recruited via their primary health care practitioner and followed until their infant is 9 months old. Data will be collected via web-based questionnaires and the data collected inherently by the app itself. Ethics and dissemination This study received

  19. Prevalence of low birth weight among Hispanic infants with United States-born and foreign-born mothers: the effect of urban poverty.

    PubMed

    Collins, J W; Shay, D K

    1994-01-15

    Although Hispanics are a poorly educated and medically underserved minority, the incidence of low birth weight (less than 2,500 g) Hispanic infants is similar to that of non-Hispanic whites. The authors used 1982-1983 Illinois vital records and 1980 US census income data to determine the contribution of maternal nativity and place of residence to this epidemiologic paradox. The proportion of low birth weight Hispanic (n = 22,892) infants ranged from 4.3% for Mexicans to 9.1% for Puerto Ricans. Maternal age, education, trimester of prenatal care initiation, and place of residence were associated with the prevalence of low birth weight infants among Puerto Rican but not foreign-born Mexican or Central-South American mothers. In very low-income (less than $10,000/year) census tracts, Mexican and other Hispanic infants with US-born mothers had low birth weight rates of 14 and 15%, respectively. In contrast, Mexican and other Hispanic infants with foreign-born mothers who resided in these areas had low birth weight rates of 3 and 7%, respectively. In a logistic model that included only impoverished infants, the adjusted odds ratio of low birth weight for those with US-born mothers equalled 6.3 (95 percent confidence interval 2.3-16.9). The authors conclude that urban poverty is negatively associated with Hispanic birth weight only when the mother is Puerto Rican or a US-born member of another subgroup.

  20. Neonatal health of infants born to mothers with asthma.

    PubMed

    Mendola, Pauline; Männistö, Tuija I; Leishear, Kira; Reddy, Uma M; Chen, Zhen; Laughon, S Katherine

    2014-01-01

    Maternal asthma is associated with serious pregnancy complications, but newborn morbidity is understudied. We wanted to determine whether infants of asthmatic mothers have more neonatal complications. The Consortium on Safe Labor (2002-2008), a retrospective cohort, included 223,512 singleton deliveries at ≥ 23 weeks' gestation. Newborns of mothers with asthma (n = 17,044) were compared with newborns of women without asthma by using logistic regression models with generalized estimating equations to calculate adjusted odds ratios (ORs) and 95% CIs. Electronic medical record data included gestational week at delivery, birth weight, resuscitation, neonatal intensive care unit (NICU) admission, NICU length of stay, hyperbilirubinemia, respiratory distress syndrome, apnea, sepsis, anemia, transient tachypnea of the newborn, infective pneumonia, asphyxia, intracerebral hemorrhage, seizure, cardiomyopathy, periventricular or intraventricular hemorrhage, necrotizing enterocolitis, aspiration, retinopathy of prematurity, and perinatal mortality. Preterm delivery was associated with maternal asthma for each week after 33 completed weeks of gestation and not earlier. Maternal asthma also increased the adjusted odds of small for gestational age (OR = 1.10; 95% CI, 1.05-1.16), NICU admission (OR = 1.12; 95% CI, 1.07-1.17), hyperbilirubinemia (OR = 1.09; 95% CI, 1.04-1.14), respiratory distress syndrome (OR = 1.09; 95% CI, 1.01-1.19), transient tachypnea of the newborn (OR = 1.10; 95% CI, 1.02-1.19), and asphyxia (OR = 1.34; 95% CI, 1.03-1.75). Findings persisted for term infants (≥ 37 weeks) who had additional increased odds of intracerebral hemorrhage (OR = 1.84; 95% CI, 1.11-3.03) and anemia (OR = 1.30; 95% CI, 1.04-1.62). Maternal asthma was associated with prematurity and small for gestational age. Adverse neonatal outcomes, including respiratory complications, hyperbilirubinemia, and NICU admission, were increased in association with maternal asthma even among term

  1. Timing of umbilical cord clamping among infants born at 22 through 27 weeks' gestation

    PubMed Central

    Backes, CH; Huang, H; Iams, JD; Bauer, JA; Giannone, PJ

    2016-01-01

    Objective To investigate the safety, feasibility and efficacy of delayed cord clamping (DCC) compared with immediate cord clamping (ICC) at delivery among infants born at 22 to 27 weeks' gestation. Study Design This was a pilot, randomized, controlled trial in which women in labor with singleton pregnancies at 22 to 27 weeks' gestation were randomly assigned to ICC (cord clamped at 5 to 10 s) or DCC (30 to 45 s). Results Forty mother–infant pairs were randomized. Infants in the ICC and DCC groups had mean gestational ages (GA) of 24.6 and 24.4 weeks, respectively. No differences were observed between the groups across all available safety measures, although infants in the DCC group had higher admission temperatures than infants in the ICC group (97.4 vs 96.2 °F, P =0.04). During the first 24 h of life, blood pressures were lower in the ICC group than in the DCC group (P < 0.05), despite a threefold greater incidence of treatment for hypotension (45% vs 12%, P < 0.01). Infants in the ICC group had increased numbers of red blood transfusions (in first 28 days of life) than infants in DCC group (4.1 ± 3.9 vs 2.8 ± 2.2, P = 0.04). Conclusion Among infants born at an average GA of 24 weeks', DCC appears safe, logistically feasible, and offers hematological and circulatory advantages compared with ICC. A more comprehensive appraisal of this practice is needed. PMID:26401752

  2. Timing of umbilical cord clamping among infants born at 22 through 27 weeks' gestation.

    PubMed

    Backes, C H; Huang, H; Iams, J D; Bauer, J A; Giannone, P J

    2016-01-01

    To investigate the safety, feasibility and efficacy of delayed cord clamping (DCC) compared with immediate cord clamping (ICC) at delivery among infants born at 22 to 27 weeks' gestation. This was a pilot, randomized, controlled trial in which women in labor with singleton pregnancies at 22 to 27 weeks' gestation were randomly assigned to ICC (cord clamped at 5 to 10 s) or DCC (30 to 45 s). Forty mother-infant pairs were randomized. Infants in the ICC and DCC groups had mean gestational ages (GA) of 24.6 and 24.4 weeks, respectively. No differences were observed between the groups across all available safety measures, although infants in the DCC group had higher admission temperatures than infants in the ICC group (97.4 vs. 96.2 °F, P=0.04). During the first 24 h of life, blood pressures were lower in the ICC group than in the DCC group (P<0.05), despite a threefold greater incidence of treatment for hypotension (45% vs. 12%, P<0.01). Infants in the ICC group had increased numbers of red blood transfusions (in first 28 days of life) than infants in DCC group (4.1±3.9 vs. 2.8±2.2, P=0.04). Among infants born at an average GA of 24 weeks', DCC appears safe, logistically feasible, and offers hematological and circulatory advantages compared with ICC. A more comprehensive appraisal of this practice is needed.

  3. Heart rate changes during resuscitation of newly born infants <30 weeks gestation: an observational study.

    PubMed

    Yam, Charmaine H; Dawson, Jennifer A; Schmölzer, Georg M; Morley, Colin J; Davis, Peter G

    2011-03-01

    The International Liaison Committee on Resuscitation recommends starting positive pressure ventilation (PPV) in the delivery room when heart rate (HR) <100 beats per min (bpm) and giving cardiac compressions when HR <60 bpm. To describe the effect of PPV on HR in infants <30 weeks gestation with HR <100 bpm in the first minutes after birth. Retrospective observational study of infants, <30 weeks gestation, born between 14 February 2007 and 28 February 2009 with HR <100 bpm soon after birth. Infants with a HR <100 bpm receiving PPV at birth were eligible for the study. Video recordings and respiratory physiological data were obtained during delivery room resuscitation and analysed to determine if the rate of change in HR varied with measures of PPV, for example, expiratory tidal volume. It took a median (IQR) 73 (24-165) seconds of PPV for infants' HR to rise above 100 bpm and a median (IQR) 243 (191-351) seconds to rise above 120 bpm. There were large fluctuations in HR after reaching 100 bpm and before reaching 120 bpm. In 18/27 (67%) of infants the HR did not remain stable until a threshold of approximately 150 bpm was reached. In 6/27 (20%) of the infants the rise in HR was almost instantaneous. In the remaining 21/27 (80%) HR rise was more gradual. There was a poor correlation between time of HR increase to 120 bpm and tidal volume (p=0.13). It takes more than a minute for newly born infants <30 weeks gestation with a HR <100 bpm to achieve a HR above 100 bpm. In these infants HR does not stabilise until it reaches 120 bpm.

  4. Extremely Preterm-Born Infants Demonstrate Different Facial Recognition Processes at 6-10 Months of Corrected Age.

    PubMed

    Frie, Jakob; Padilla, Nelly; Ådén, Ulrika; Lagercrantz, Hugo; Bartocci, Marco

    2016-05-01

    To compare cortical hemodynamic responses to known and unknown facial stimuli between infants born extremely preterm and term-born infants, and to correlate the responses of the extremely preterm-born infants to regional cortical volumes at term-equivalent age. We compared 27 infants born extremely preterm (<28 gestational weeks) with 26 term-born infants. Corrected age and chronological age at testing were between 6 and 10 months, respectively. Both groups were exposed to a gray background, their mother's face, and an unknown face. Cerebral regional concentrations of oxygenated and deoxygenated hemoglobin were measured with near-infrared spectroscopy. In the preterm group, we also performed structural brain magnetic resonance imaging and correlated regional cortical volumes to hemodynamic responses. The preterm-born infants demonstrated different cortical face recognition processes than the term-born infants. They had a significantly smaller hemodynamic response in the right frontotemporal areas while watching their mother's face (0.13 μmol/L vs 0.63 μmol/L; P < .001). We also found a negative correlation between the magnitude of the oxygenated hemoglobin increase in the right frontotemporal cortex and regional gray matter volume in the left fusiform gyrus and amygdala (voxels, 25; r = 0.86; P < .005). At 6-10 months corrected age, the preterm-born infants demonstrated a different pattern in the maturation of their cortical face recognition process compared with term-born infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The Healthy Infant Nasal Transcriptome: A Benchmark Study

    PubMed Central

    Chu, Chin-Yi; Qiu, Xing; Wang, Lu; Bhattacharya, Soumyaroop; Lofthus, Gerry; Corbett, Anthony; Holden-Wiltse, Jeanne; Grier, Alex; Tesini, Brenda; Gill, Steven R.; Falsey, Ann R.; Caserta, Mary T.; Walsh, Edward E.; Mariani, Thomas J.

    2016-01-01

    Responses by resident cells are likely to play a key role in determining the severity of respiratory disease. However, sampling of the airways poses a significant challenge, particularly in infants and children. Here, we report a reliable method for obtaining nasal epithelial cell RNA from infants for genome-wide transcriptomic analysis, and describe baseline expression characteristics in an asymptomatic cohort. Nasal epithelial cells were collected by brushing of the inferior turbinates, and gene expression was interrogated by RNA-seq analysis. Reliable recovery of RNA occurred in the absence of adverse events. We observed high expression of epithelial cell markers and similarity to the transcriptome for intrapulmonary airway epithelial cells. We identified genes displaying low and high expression variability, both inherently, and in response to environmental exposures. The greatest gene expression differences in this asymptomatic cohort were associated with the presence of known pathogenic viruses and/or bacteria. Robust bacteria-associated gene expression patterns were significantly associated with the presence of Moraxella. In summary, we have developed a reliable method for interrogating the infant airway transcriptome by sampling the nasal epithelium. Our data demonstrates both the fidelity and feasibility of our methodology, and describes normal gene expression and variation within a healthy infant cohort. PMID:27658638

  6. [Influencing factors on the death of infants born to HIV infected mothers].

    PubMed

    Fang, Li-wen; Xing, Zai-ling; Wang, Lin-hong; Wang, Qian; Zhang, Wei; Sun, Ding-yong; Huang, Yue-hua; Zhang, Yan

    2009-11-01

    To understand the influencing factors on the death of infants born to HIV infected mothers in areas with high prevalence of HIV/AIDS in China. Based on the follow-up cohort study targeting at HIV/AIDS infected pregnant women and their babies initiated in 2004, a survey on the death status and influencing factors on the infants born to HIV/AIDS infected mothers enrolled in this cohort from Jan.2004 to Nov.2007 was carried out during Aug.to Nov.2008 in seven counties of four provinces in China. A total of 498 pairs of HIV-infected mothers and their infants were enrolled and their related information was collected. Single factor and multiple factors Cox model methods were adopted for data analysis. The total observed person-years of 498 infants was 406.22, among which, 45 infants died, and the mortality density was 110.78 per 1000 child-year. A single factor Cox model showed, the pregnancy in pre-period of HIV/AIDS and HIV/AIDS period (RR = 1.971, 95%CI: 1.143 - 3.396), living status of the pregnancy (RR = 3.062, 95%CI: 1.097 - 8.550), multipara women (RR = 0.517, 95%CI: 0.278 - 0.961), natural childbirth (RR = 0.561, 95%CI: 0.345 - 0.910), premature labor (RR = 5.302, 95%CI: 2.944 - 9.547), low birth weight (RR = 4.920, 95%CI: 2.691 - 8.994), mother-child pairs taking antiretroviral drugs (RR = 0.227, 95%CI: 0.121 - 0.428) and infants infected HIV (RR = 5.870, 95%CI: 3.232 - 10.660) could affect the infants death. The death of HIV-exposed infants was influenced by various factors. The death risk of infants born to HIV infected mothers who were in the danger of pre-period of HIV/AIDS and HIV/AIDS period was greater than the infants delivered by HIV infected mothers who were in preclinical period of HIV/AIDS (RR = 6.99, 95%CI: 1.92 - 25.64). The death risks were greater in the group that the women whose CD4(+)TLC count number lower than 200 cells/microl (RR = 2.05, 95%CI: 1.01 - 4.15). The infants whose mothers had no ARV treatment had higher possibility to die than

  7. Severe bronchiolitis in infants born very preterm and neurodevelopmental outcome at 2 years.

    PubMed

    Gouin, Marion; Nguyen, Sylvie; Savagner, Christophe; Troussier, Francoise; Gascouin, Géraldine; Rozé, Jean-Christophe; Flamant, Cyril

    2013-05-01

    Preterm infants are at greater risk of bronchopulmonary dysplasia, which is associated with neurodevelopmental impairment. These infants are also more likely to develop severe bronchiolitis, which can contribute to neurodevelopmental impairment. The aim of this study was to determine whether severe bronchiolitis in very preterm infants (born before 33 weeks of gestation) was associated with an increased risk of neurodevelopmental impairment at 2 years of age. We analyzed a population-based cohort of infants (the Loire Infant Follow-up Team cohort) born between 1 January 2003 and 31 December 2009. Severe bronchiolitis was defined as hospitalization due to bronchiolitis during the first year of life. Neurodevelopmental outcome was assessed at 2 years of corrected age. A total of 2,405 infants were included in this analysis and categorized based on neonatal respiratory status: 1,308 (54.4 %) received no respiratory assistance, 864(35.9 %) received oxygen for <28 days, and 167 (6.9 %) had mild and 66 (2.7) moderate or severe bronchopulmonary dysplasia. At 2 years, 502 children displayed non-optimal neurodevelopmental outcome (20.9 %). Moderate or severe bronchopulmonary dysplasia was significantly associated with non-optimal neurodevelopmental outcome at 2 years (adjusted odds ratios (OR) = 2.3 [95 % confidence interval (CI): 1.3-3.9], p = 0.003). In the first year, 318 infants acquired severe bronchiolitis (13.2 %), which was not associated with non-optimal neurodevelopmental outcome (adjusted OR = 1.0 [95 % CI: 0.8-1.4]; p = 0.88). In conclusion, respiratory status in the neonatal period was significantly associated with non-optimal neurodevelopmental outcome at 2 years, while severe bronchiolitis was not.

  8. Neonatal visual evoked potentials in infants born to mothers prescribed methadone.

    PubMed

    McGlone, Laura; Hamilton, Ruth; McCulloch, Daphne L; Boulton, Richard; Bradnam, Michael S; Weaver, Lawrence T; Mactier, Helen

    2013-03-01

    Drug misuse in pregnancy is associated with impaired infant visual development. Pilot data showed abnormal flash visual evoked potentials (VEPs) in neonates exposed to methadone in utero, but results were confounded by intrauterine growth restriction, gestation, and ongoing drug misuse. This large cohort study aimed to clarify the effects on neonatal flash VEPs of maternal drug misuse in pregnancy, including prescription of substitute methadone and subsequent development of neonatal abstinence syndrome. This was a prospective cohort study. Flash VEPs were recorded within 3 days of birth from 100 healthy infants of drug-misusing mothers prescribed substitute methadone during pregnancy and 50 comparison infants matched for birth weight, gestation, and socioeconomic deprivation. VEP morphology was classified as mature, typical, or immature, and amplitudes and implicit times of the major waveform components measured. Drug exposure was determined by maternal history, maternal and infant urine, and meconium toxicology. VEPs from maternal drug-exposed infants were more likely to be of immature waveform (P < .001) and were smaller in overall amplitude (median 27 µV vs 39 µV, P < .001) compared with non-drug-exposed infants. Most infants were exposed to illicit drugs in addition to prescribed methadone; differences in VEP parameters were independently associated with maternal prescribed methadone and persisted after correcting for birth weight, cigarette smoking, and excess in utero alcohol exposure. In utero exposure to prescribed substitute methadone is associated with altered flash VEPs in the newborn period and these infants may warrant early clinical visual assessment.

  9. Does Neighborhood Risk Explain Racial Disparities in Low Birth Weight among Infants Born to Adolescent Mothers?

    PubMed

    Coley, Sheryl L; Nichols, Tracy R; Rulison, Kelly L; Aronson, Robert E; Brown-Jeffy, Shelly L; Morrison, Sharon D

    2016-04-01

    To test associations and interactions between racial identification, neighborhood risk, and low birth weight disparities between infants born to African-American and white adolescent mothers. Retrospective cross-sectional study. Birth cases were geocoded and linked to census tract information from the 2010 US Census and the 2007-2011 American Community Survey. A "neighborhood risk" index was created using principal component analysis, and mothers were grouped into 3 neighborhood risk levels (low, medium, high). Multilevel models with cross-level interactions were used to identify variation in racial differences in low birth weight outcomes across neighborhood risk levels when controlling for maternal demographic characteristics and pregnancy behaviors (smoking, prenatal care use). North Carolina, United States. Singleton infants (n = 7923 cases) born to non-Hispanic African American and white adolescent mothers from the North Carolina State Center of Health Statistics for 2011. Low birth weight. African American mothers were significantly more likely to have infants of low birth weight than white mothers in this sample (odds ratio = 1.89; 95% confidence interval, 1.53-2.34). Mothers that resided in areas of high neighborhood risk were significantly more likely to have infants of low birth weight than mothers residing in areas of low neighborhood risk (odds ratio = 1.55; 95% confidence interval, 1.25-1.93). Even when controlling for confounding factors, racial disparities in low birth weight odds did not significantly vary according to neighborhood risk level. Racial disparities can remain in low birth weight odds among infants born to adolescent mothers when controlling for maternal characteristics, pregnancy behaviors, and neighborhood risk. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  10. Neighborhood Disadvantage, Racial Concentration and the Birthweight of Infants born to Adolescent Mothers

    PubMed Central

    Madkour, Aubrey Spriggs; Harville, Emily Wheeler; Xie, Yiqiong

    2013-01-01

    Objective To study the relationship between neighborhood demographic characteristics (disadvantage, racial concentration) and the birthweight of infants born to adolescent mothers, potentially as mediated by smoking, prenatal care use, or perceptions of neighborhood safety. Methods Data from Waves I and IV of the National Longitudinal Survey of Adolescent Health were analyzed. Birthweight (continuous) and low birthweight (<2.5 kg) of singleton infants born to non-Hispanic Black and non-Hispanic White adolescent mothers (<20 years) after Wave I were examined as outcomes. Neighborhood demographic characteristics included Census Block Group socioeconomic disadvantage and Black racial concentration. Possible mediators (smoking during pregnancy, early initiation of prenatal care, and perceptions of safety) were also examined. Controls for adolescent baseline age, age at pregnancy, body mass index (BMI) and parental education were included. Analyses were run stratified on race. Results Baseline continuous birthweight, BMI and neighborhood demographics varied significantly between non-Hispanic Black and White adolescent mothers, with Black adolescent mothers evidencing lower birthweight and higher BMI, neighborhood disadvantage and Black racial concentration. In multivariable analyses among Black adolescent mothers, Black racial concentration was positively associated with birthweight, and negatively associated with low birthweight; no mediators were supported. Neighborhood disadvantage and Black racial concentration were unassociated with birthweight outcomes among White adolescent mothers. Conclusions Infants born to Black adolescent mothers evidenced higher birthweight with increasing Black neighborhood concentration. Further exploration of mechanisms by which Black racial concentration may positively impact birthweight is warranted. PMID:23771237

  11. Neighborhood disadvantage, racial concentration and the birthweight of infants born to adolescent mothers.

    PubMed

    Madkour, Aubrey Spriggs; Harville, Emily Wheeler; Xie, Yiqiong

    2014-04-01

    To study the relationship between neighborhood demographic characteristics (disadvantage, racial concentration) and the birthweight of infants born to adolescent mothers, potentially as mediated by smoking, prenatal care use, or perceptions of neighborhood safety. Data from Waves I and IV of the National Longitudinal Survey of Adolescent Health were analyzed. Birthweight (continuous) and low birthweight (<2.5 kg) of singleton infants born to non-Hispanic Black and non-Hispanic White adolescent mothers (<20 years) after Wave I were examined as outcomes. Neighborhood demographic characteristics included Census Block Group socioeconomic disadvantage and Black racial concentration. Possible mediators (smoking during pregnancy, early initiation of prenatal care, and perceptions of safety) were also examined. Controls for adolescent baseline age, age at pregnancy, body mass index (BMI) and parental education were included. Analyses were run stratified on race. Baseline continuous birthweight, BMI and neighborhood demographics varied significantly between non-Hispanic Black and White adolescent mothers, with Black adolescent mothers evidencing lower birthweight and higher BMI, neighborhood disadvantage and Black racial concentration. In multivariable analyses among Black adolescent mothers, Black racial concentration was positively associated with birthweight, and negatively associated with low birthweight; no mediators were supported. Neighborhood disadvantage and Black racial concentration were unassociated with birthweight outcomes among White adolescent mothers. Infants born to Black adolescent mothers evidenced higher birthweight with increasing Black neighborhood concentration. Further exploration of mechanisms by which Black racial concentration may positively impact birthweight is warranted.

  12. Neurobehavioral assessment of infants born at term and in utero exposure to serotonin reuptake inhibitors

    PubMed Central

    Smith, Megan V.; Sung, Anita; Shah, Bhavesh; Mayes, Linda; Klein, Deborah S.; Yonkers, Kimberly A.

    2013-01-01

    Background Some studies report neurobehavioral symptoms in neonates exposed to serotonin reuptake inhibitors (SRIs) in utero. However, maternal psychiatric illness during the last trimester of pregnancy, as a confounding factor, has not always been assessed. Aims In this prospective study we compared neurobehavioral complications among neonates who were born to euthymic women who either took or did not take an SRI during the last trimester of pregnancy. Study design Exposed and unexposed infants were assessed for: 1) temperament as measured by the Neonatal Behavioral Assessment Scale (NBAS); 2) activity via Actiwatch electronic monitoring; 3) sleep state using trained observer ratings; and 4) perinatal complications through medical record review. T-tests, Fisher's exact tests, and analyses of covariance were used to assess the relationship between clinical and neurobehavioral factors and exposure status. Subjects 67 infants (61 controls and 6 exposed to SRIs). Outcome measures Neonatal Assessment Behavioral Scale, APGAR scores, infant sleep state (% sleep, % wakeful), startles and tremulousness, gestational age, birth weight, and head circumference. Results Infants exposed to SRIs in the third trimester had poorer motor development, lower 5-minute APGAR scores, and shorter mean gestational age as compared to unexposed infants. Conclusion Results of this study show differences in autonomic and gross motor activity between neonates who were or were not exposed to SRIs in utero after controlling for active maternal psychiatric illness. Future longitudinal work should compare longer term outcomes of exposed and unexposed infants of depressed mothers. PMID:22999988

  13. Compromised immune response in infants at risk for type 1 diabetes born by Caesarean Section.

    PubMed

    Puff, R; D'Orlando, O; Heninger, A-K; Kühn, D; Krause, S; Winkler, C; Beyerlein, A; Bonifacio, E; Ziegler, A-G

    2015-10-01

    Children born by Caesarean Section have a higher risk for type 1 diabetes. We aimed to investigate whether Caesarean Section leads to alterations of the immune response in children with familial risk for type 1 diabetes. We examined measures of innate and adaptive immune responses in 94 prospectively followed children, including 40 born by Caesarean Section. Proinflammatory serum cytokine concentrations were determined at age 6 months. As a measure of vaccine response, IgG1, IgG2, and IgG4 tetanus antibody titers and CD4(+) T cell proliferation against tetanus toxoid were quantified. Compared to infants born by vaginal delivery, infants born by Caesarean Section had lower concentrations of the cytokines IFN-ɣ (p=0.014) and IL-8 (p=0.005), and weaker CD4(+) T cell responses to tetanus measured in the first (p=0.007) and second year (p=0.047) of life. Overall, our findings provide evidence that the mode of delivery influences the immune status and responsiveness during childhood. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Harlequin ichthyosis in an infant born to a father with eczema.

    PubMed

    Fatima, Saba; Rafiq, Ali; Majid, Zain

    2015-04-01

    Harlequin ichthyosis is characterized by thickening of the layer of the skin which contains keratin. Eczema is a chronic relapsing skin disorder which is also associated with disrupted epidermal barrier. We report the case of a 6-hour-old male patient who was brought to the neonatal intensive care unit of our hospital with crusting skin lesions all over the body, presence of a severe ectropion and deranged electrolytes. A diagnosis of harlequin ichthyosis was made, and the neonate was managed accordingly. However, the infant eventually expired on the seventh day of life. The infant's father was a patient of eczema with a chronic relapsing course and was on oral steroid therapy. As per our knowledge, this is the first reported case of an infant with harlequin ichthyosis born to a father suffering from eczema. The similarities in the pathogenesis of the two diseases and the genetic mutation of filaggrin might suggest an association between the two conditions. Harlequin ichthyosis can hence be looked out for in infants born of parents with eczema.

  15. The performance of infants born preterm and full-term in the mobile paradigm: learning and memory.

    PubMed

    Heathcock, Jill C; Bhat, Anjana N; Lobo, Michele A; Galloway, James C

    2004-09-01

    By 3 to 4 months of age, infants born full-term and without known disease display associative learning and memory abilities in the mobile paradigm, where an infant's leg is tethered to a mobile such that leg kicks result in proportional mobile movement. The first purpose of this study was to examine the learning and memory abilities of a group of infants born full-term compared with those of a comparison group. Little is known about the learning and memory abilities in infants born preterm, a group at known risk for future impairments in learning and movement. The second purpose of this study was to determine if and when an age-adjusted group of infants born prematurely display associative learning and memory abilities over a 6-week period. Ten infants born full-term (38-42 weeks gestational age [GA]) and 10 infants born preterm (<33 weeks GA and <2,500 g) who were tethered and had control over the mobile movement were independently compared with a comparison group of 10 infants born full-term who were tethered and viewed a moving mobile but did not have control over the mobile movement. Infants in all 3 groups were seen at 3 to 4 months of age and were excluded from participation for any known visual or orthopedic diagnoses. Infants were tested using the mobile conjugate reinforcement paradigm, where one leg is tethered to an overhead mobile such that kicking with that leg results in proportional mobile movement. The kicking rates of the full-term group and the preterm group were compared with their own initial (baseline) kicking rates and with those of the comparison group. After exposure to the conjugate relationship between kicking and mobile movement, the full-term group kicked more frequently compared with their own baseline levels and compared with the comparison group, fulfilling both criteria for learning and memory. In contrast, the preterm group did not increase their kicking rate according to both criteria. These results suggest that infants born

  16. Body mass index curves for Italian preterm infants are comparable with American curves for infants born before 34 weeks of gestational age.

    PubMed

    Paviotti, Giulia; Monasta, Lorenzo; Ronfani, Luca; Montico, Marcella; Copertino, Marco; De Cunto, Angela; Demarini, Sergio

    2016-05-01

    Body mass index (BMI)-for-age curves have been developed in the USA, but not compared with other populations. This study created gender-specific intrauterine BMI-for-age curves for Italian preterm infants and compared them with the USA version. Data on 92 262 newborn infants, born at 26-42 weeks of gestational age in the north-eastern Italian region of Friuli Venezia Giulia between 2005 and 2013, were analysed to create gender-specific BMI-for-age curves. Gender-specific and age-specific BMI Z scores for Italian infants were calculated using the parameters of the USA growth curves and the World Health Organization charts. Gender-specific BMI-for-age at birth curves were developed for premature Italian infants from 26 gestational weeks. The comparison with the USA charts showed no significant difference in BMI percentiles in Italian infants born at ≤33 gestational weeks, but infants born at ≥34 gestational weeks had a significantly higher BMI than the USA population, by 0.2 standard deviations. We developed the first European BMI-for-age at birth curves for premature infants. According to our findings, the Italian curves were comparable to the USA curves for the subgroup of infants born at ≤33 gestational weeks, but not ≥34 gestational weeks. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Hypothyroidism among military infants born in countries of varied iodine nutrition status

    PubMed Central

    2010-01-01

    Background Iodine deficiency is a global problem representing the most common preventable cause of mental retardation. Recently, the impact of subtle deficiencies in iodine intake on children and pregnant women has been questioned. This study was designed to compare hypothyroidism among infants born to US military families in countries of varied iodine nutrition status. Methods A cohort design was used to analyze data from the Department of Defense Birth and Infant Health Registry for infants born in 2000-04 (n = 447,691). Hypothyroidism was defined using ICD-9-CM codes from the first year of life (n = 698). The impact of birth location on hypothyroidism was assessed by comparing rates in Germany, Japan, and US territories with the United States, while controlling for infant gender, plurality, gestational age, maternal age, maternal military status, and military parent's race/ethnicity. Results Hypothyroidism did not vary by birth location with adjusted odds ratios (OR) as follows: Germany (OR 0.82, [95% CI 0.50, 1.35]), Japan (OR 0.67, [95% CI 0.37, 1.22]), and US territories (OR 1.29, [95% CI 0.57, 2.89]). Hypothyroidism was strongly associated with preterm birth (OR 5.44, [95% CI 4.60, 6.42]). Hypothyroidism was also increased among infants with civilian mothers (OR 1.24, [95% CI 1.00, 1.54]), and older mothers, especially ages 40 years and older (OR 2.09, [95% CI 1.33, 3.30]). Conclusions In this study, hypothyroidism in military-dependent infants did not vary by birth location, but was associated with other risk factors, including preterm birth, civilian maternal status, and advanced maternal age. PMID:20205833

  18. Prematurely born infants' response to resuscitation via an endotracheal tube or a face mask.

    PubMed

    Murthy, Vadivelam; D'Costa, Walton; Shah, Raajul; Fox, Grenville F; Campbell, Morag E; Milner, Anthony D; Greenough, Anne

    2015-03-01

    Prematurely born infants may be resuscitated in the labour suite via a face mask or an endotracheal tube. To assess prematurely born infants' initial responses to resuscitation delivered via an endotracheal tube or a face mask, to determine if the first five inflations via an endotracheal tube produced expired tidal volumes greater than 4.4ml/kg (twice the anatomical dead space) and whether the outcome of initial resuscitation via an endotracheal tube or via a face mask differed according to the first active inflation (the infant's inspiratory effort coinciding with an inflation). Prospective observational study. Thirty-five infants (median gestational age 25, range 23-27weeks) requiring resuscitation via an endotracheal tube (n=20) or a face mask (n=15) were studied. Inflation pressures, inflation times, expiratory tidal volumes, end tidal carbon dioxide (ETCO2) and leak were recorded. Before the first active inflation, only 27% of infants receiving resuscitation via an endotracheal tube had expiratory volumes greater than 4.4ml/kg. During, both endotracheal and face mask initial resuscitations, during the first active inflation the expired tidal volumes (7.7ml/kg, 5.2ml/kg) and ETCO2 levels (4.8kPa, 3.2kPa) were significantly higher than during the inflations before the first active inflation (2.8ml/kg, 1.6ml/kg; 0.36kPa, 0.2kPa respectively) (all p<0.001). Initial resuscitation via an endotracheal tube using currently recommended pressures, rarely produced adequate tidal volumes. Resuscitation via an endotracheal tube or a face mask was most effective when the infant's inspiratory effort coincided with an inflation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Does Acute Maternal Stress in Pregnancy Affect Infant Health Outcomes? Examination of a Large Cohort of Infants Born After the Terrorist Attacks of September 11, 2001

    DTIC Science & Technology

    2009-01-01

    Spandorfer S, Grill E, Davis O, Fasouliotis S, Rosenwaks Z: Septem- ber 11th in New York City (NYC): the effect of a catastrophe on IVF outcome in a...Naval Health Research Center Does acute maternal stress in pregnancy affect infant health outcomes ? Examination of A Large Cohort of Infants Born...California 92106 BioMed CentralBMC Public Health ssOpen AcceResearch article Does acute maternal stress in pregnancy affect infant health outcomes

  20. Vocal Development of Infants with Very Low Birth Weight

    ERIC Educational Resources Information Center

    Rvachew, Susan; Creighton, Dianne; Feldman, Naida; Sauve, Reg

    2005-01-01

    This study describes the vocal development of infants born with very low birth weights (VLBW). Samples of vocalizations were recorded from three groups of infants when they were 8, 12 and 18 months of age: preterm VLBW infants with bronchopulmonary dysplasia (BPD), preterm VLBW infants without BPD, and healthy full-term infants. Infants with BPD…

  1. Vocal Development of Infants with Very Low Birth Weight

    ERIC Educational Resources Information Center

    Rvachew, Susan; Creighton, Dianne; Feldman, Naida; Sauve, Reg

    2005-01-01

    This study describes the vocal development of infants born with very low birth weights (VLBW). Samples of vocalizations were recorded from three groups of infants when they were 8, 12 and 18 months of age: preterm VLBW infants with bronchopulmonary dysplasia (BPD), preterm VLBW infants without BPD, and healthy full-term infants. Infants with BPD…

  2. Brain metabolite alterations in infants born preterm with intrauterine growth restriction: association with structural changes and neurodevelopmental outcome.

    PubMed

    Simões, Rui V; Muñoz-Moreno, Emma; Cruz-Lemini, Mónica; Eixarch, Elisenda; Bargalló, Núria; Sanz-Cortés, Magdalena; Gratacós, Eduard

    2017-01-01

    Intrauterine growth restriction and premature birth represent 2 independent problems that may occur simultaneously and contribute to impaired neurodevelopment. The objective of the study was to assess changes in the frontal lobe metabolic profiles of 1 year old intrauterine growth restriction infants born prematurely and adequate-for-gestational-age controls, both premature and term adequate for gestational age and their association with brain structural and biophysical parameters and neurodevelopmental outcome at 2 years. A total of 26 prematurely born intrauterine growth restriction infants (birthweight <10th centile for gestational age), 22 prematurely born but adequate for gestational age controls, and 26 term adequate-for-gestational-age infants underwent brain magnetic resonance imaging and magnetic resonance spectroscopy at 1 year of age during natural sleep, on a 3 Tesla scanner. All brain T1-weighted and diffusion-weighted images were acquired along with short echo time single-voxel proton spectra from the frontal lobe. Magnetic resonance imaging/magnetic resonance spectroscopy data were processed to derive structural, biophysical, and metabolic information, respectively. Neurodevelopment was evaluated at 2 years of age using the Bayley Scales 3rd edition, assessing cognitive, language, motor, socioemotional, and adaptive behavior. Prematurely born intrauterine growth restriction infants had slightly smaller brain volumes and increased frontal lobe white matter mean diffusivity compared with both prematurely born but adequate for gestational age and term adequate for gestational age controls. Frontal lobe N-acetylaspartate levels were significantly lower in prematurely born intrauterine growth restriction than in prematurely born but adequate for gestational age infants but increased in prematurely born but adequate for gestational age compared with term adequate-for-gestational-age infants. The prematurely born intrauterine growth restriction group also

  3. Effects of prenatal methamphetamine exposure on fetal growth and drug withdrawal symptoms in infants born at term.

    PubMed

    Smith, Lynne; Yonekura, M Lynn; Wallace, Toni; Berman, Nancy; Kuo, Jennifer; Berkowitz, Carol

    2003-02-01

    To determine fetal growth and the incidence of withdrawal symptoms in term infants exposed to methamphetamine in utero, we retrospectively identified neonates whose mothers used methamphetamine during pregnancy and matched them to unexposed newborns. Exclusion criteria included multiple and preterm gestations. Although there were no differences in infant growth parameters between the methamphetamine-exposed and methamphetamine-unexposed neonates, methamphetamine exposure throughout gestation was associated with decreased growth relative to infants exposed only for the first two trimesters. In addition, there were significantly more small for gestational age infants in the methamphetamine group compared with the unexposed group. Methamphetamine-exposed infants whose mothers smoked had significantly decreased growth relative to infants exposed to methamphetamine alone. Withdrawal symptoms (as determined by a previously reported scoring system) requiring pharmacologic intervention were observed in 4% of methamphetamine-exposed infants. These preliminary findings indicate that methamphetamine use is associated with growth restriction in infants born at term.

  4. Brain metabolite differences in one-year-old infants born small at term and association with neurodevelopmental outcome.

    PubMed

    Simões, Rui V; Cruz-Lemini, Mónica; Bargalló, Núria; Gratacós, Eduard; Sanz-Cortés, Magdalena

    2015-08-01

    We assessed brain metabolite levels by magnetic resonance spectroscopy (MRS) in 1-year-old infants born small at term, as compared with infants born appropriate for gestational age (AGA), and their association with neurodevelopment at 2 years of age. A total of 40 infants born small (birthweight <10th centile for gestational age) and 30 AGA infants underwent brain MRS at age 1 year on a 3-T scanner. Small-born infants were subclassified as late intrauterine growth restriction or as small for gestational age, based on the presence or absence of prenatal Doppler and birthweight predictors of an adverse perinatal outcome, respectively. Single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) data were acquired from the frontal lobe at short echo time. Neurodevelopment was evaluated at 2 years of age using the Bayley Scales of Infant and Toddler Development, Third Edition, assessing cognitive, language, motor, social-emotional, and adaptive behavior scales. As compared with AGA controls, infants born small showed significantly higher levels of glutamate and total N-acetylaspartate (NAAt) to creatine (Cr) ratio at age 1 year, and lower Bayley Scales of Infant and Toddler Development, Third Edition scores at 2 years. The subgroup with late intrauterine growth restriction further showed lower estimated glutathione levels at age 1 year. Significant correlations were observed for estimated glutathione levels with adaptive scores, and for myo-inositol with language scores. Significant associations were also noticed for NAA/Cr with cognitive scores, and for glutamate/Cr with motor scores. Infants born small show brain metabolite differences at 1 year of age, which are correlated with later neurodevelopment. These results support further research on MRS to develop imaging biomarkers of abnormal neurodevelopment. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Early-Childhood Neurodevelopmental Outcomes Are Not Improving for Infants Born at <25 Weeks' Gestational Age

    PubMed Central

    Kendrick, Douglas E.; Wilson-Costello, Deanne E.; Das, Abhik; Bell, Edward F.; Vohr, Betty R.; Higgins, Rosemary D.

    2011-01-01

    OBJECTIVE: We compared neurodevelopmental outcomes at 18 to 22 months' corrected age of infants born with extremely low birth weight at an estimated gestational age of <25 weeks during 2 periods: 1999–2001 (epoch 1) and 2002–2004 (epoch 2). PATIENTS AND METHODS: We conducted a multicenter, retrospective analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Perinatal and neonatal variables and outcomes were compared between epochs. Neurodevelopmental outcomes at 18 to 22 months' corrected age were evaluated with neurologic exams and Bayley Scales of Infant Development II. Logistic regression analyses determined the independent risk of epoch for adverse outcomes. RESULTS: Infant survival was similar between epochs (epoch 1, 35.4%, vs epoch 2, 32.3%; P = .09). A total of 411 of 452 surviving infants in epoch 1 and 405 of 438 surviving infants in epoch 2 were evaluated at 18 to 22 months' corrected age. Cesarean delivery (P = .03), surgery for patent ductus arteriosus (P = .004), and late sepsis (P = .01) were more common in epoch 2, but postnatal steroid use was dramatically reduced (63.5% vs 32.8%; P < .0001). Adverse outcomes at 18 to 22 months' corrected age were common in both epochs. Moderate-to-severe cerebral palsy was diagnosed in 11.1% of surviving infants in epoch 1 and 14.9% in epoch 2 (adjusted odds ratio [OR]: 1.52 [95% confidence interval (CI): 0.86–2.71]; P = .15), the Mental Developmental Index was <70 in 44.9% in epoch 1 and 51% in epoch 2 (OR: 1.30 [95% CI: 0.91–1.87]; P = .15), and neurodevelopmental impairment was diagnosed in 50.1% of surviving infants in epoch 1 and 58.7% in epoch 2 (OR: 1.4 [95% CI: 0.98–2.04]; P = .07). CONCLUSIONS: Early-childhood outcomes for infants born at <25 weeks' estimated gestational age were unchanged between the 2 periods. PMID:21187312

  6. The Born-Alive Infant Protection Act: impact on fetal and live birth mortality.

    PubMed

    Malloy, Michael H

    2011-05-01

    The Born-Alive Infant Protection Act (BAIPA) of 2002 defined a live birth in the United States without regard to gestation. The objective of this analysis was to determine if a significant decline in the fetal death rate or an increase in the live born death rate at previable gestational ages of 17 to 22 weeks has occurred. U.S. public use fetal death files and linked birth and infant death files were obtained for the years 2000 to 2005 for gestations of 17 to 22 weeks. The fetal death rate declined from 53.8% in the 2000 to 2002 period to 52.6% for the period 2003 to 2005 and the live birth mortality rate increased from 46.2 to 47.4% ( P < 0.02). The average annual live birth death rate increased significantly only at 17 weeks gestation ( P < 0.02). Although there was a small but statistically significant change in the fetal and live birth death rates for infants considered to be previable for the period following the passage of the BAIPA, the change appears to be isolated to only the most immature at 17 weeks gestation.

  7. Neonatal intensive care utilization and neonatal outcome of infants born to women aged 40 years and over in New Zealand.

    PubMed

    Battin, M; Sadler, L

    2010-02-01

    Increased maternal age is associated with pregnancy complications and there are few data available on neonatal outcome and utilization of neonatal resources. Our first aim was to use national New Zealand data to determine if the outcomes following admission to NICU are different for infants born to women aged 40 years and over, compared with those born to women under 40 years of age. The second aim was to document trends in the requirement of neonatal intensive care in infants born to women aged 40 years and older. Eligible infants were identified from registration with the Australian and New Zealand Neonatal Network for 1995-2004 inclusive. The relationship between maternal age and neonatal outcome was tested using univariate and multivariate analysis, and trends in the number of infants in maternal age groups below 35 years, 35-39 years and over 40 years were determined. On multivariate analysis using logistic regression, maternal age over 40 years was not found to be associated with a significant increase in the odds ratio for the composite poor outcome. However, over the 10-year period, there was an increase in the number of admissions and the percentage of admissions of infants born to women over 40 years of age. Although the number of infants admitted for neonatal care following birth to women over 40 years of age has increased, these infants do not appear to have an increased risk of severe abnormal outcome.

  8. Neurobehavioural and cognitive development in infants born to mothers with eating disorders.

    PubMed

    Barona, Manuela; Taborelli, Emma; Corfield, Freya; Pawlby, Susan; Easter, Abigail; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

    2017-08-01

    Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with EDs. Women with an active and past ED and healthy controls were recruited to a prospective longitudinal study during their first trimester or second trimester of pregnancy. Newborns and infants of mothers with ED were compared with newborns and infants of healthy controls on (a) neurobehavioural dysregulation using the Brazelton Neonatal Behavioural Assessment Scale at 8 days postpartum (active ED, n = 15; past ED, n = 20; healthy controls, n = 28); and (b) cognitive development using the Bayley Scales of Infant and Toddler Development at 1-year postpartum (active ED, n = 18; past ED, n = 19; healthy controls, n = 28). In order to maintain the largest possible sample at each time point, sample size varied across time points. Newborns of mothers with an active ED had worse autonomic stability when compared with newborns of healthy controls [B = -0.34 (-1.81, -0.26)]. Infants of mothers with a past ED had poorer language [B = -0.33 (-13.6, -1.9)] and motor development [B = -0.32 (-18.4, -1.3)] compared with healthy controls. Children of mothers with ED display neurobehavioural dysregulation early after birth and poorer language and motor development at 1 year. These characteristics suggest evidence of early neurobiological markers in children at risk. Differential outcomes in children of women with active versus past ED suggest that active symptomatology during pregnancy might have an effect on physiological reactivity while cognitive characteristics might be more stable markers of risk for ED. © 2017 Association for Child and Adolescent Mental Health.

  9. UK-born ethnic minority women and their experiences of feeding their newborn infant.

    PubMed

    Twamley, Katherine; Puthussery, Shuby; Harding, Seeromanie; Baron, Maurina; Macfarlane, Alison

    2011-10-01

    to explore the factors that impact on UK-born ethnic minority women's experiences of and decisions around feeding their infant. in-depth semi-structured interviews. 34 UK-born women of Black African, Black Caribbean, Pakistani, Bangladeshi, Indian and Irish parentage and 30 health-care professionals. women and health-care professionals were recruited primarily from hospitals serving large numbers of ethnic minority women in London and Birmingham. despite being aware of the benefits of exclusive breast feeding, many women chose to feed their infant with formula. The main barriers to breast feeding were the perceived difficulties of breast feeding, a family preference for formula feed, and embarrassment about breast feeding in front of others. Reports from women of South Asian parentage, particularly those who lived with an extended family, suggested that their intentions to breast feed were compromised by the context of their family life. The lack of privacy in these households and grandparental pressure appeared to be key issues. Unlike other participants, Irish women reported an intention to feed their infant with formula before giving birth. The key facilitators to breast feeding were the self-confidence and determination of women and the supportive role of health-care professionals. these findings point to common but also culturally specific mechanisms that may hinder both the initiation and maintenance of breast feeding in UK-born ethnic minority women. They signal potential benefits from the inclusion of family members in breast-feeding support programmes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Body Composition and Circulating High-Molecular-Weight Adiponectin and IGF-I in Infants Born Small for Gestational Age

    PubMed Central

    de Zegher, Francis; Sebastiani, Giorgia; Diaz, Marta; Sánchez-Infantes, David; Lopez-Bermejo, Abel; Ibáñez, Lourdes

    2012-01-01

    Prenatal growth restraint, if followed by postnatal overweight, confers risk for adult disease including diabetes. The mechanisms whereby neonatal nutrition may modulate such risk are poorly understood. We studied the effects of nutrition (breast-feeding [BRF] vs. formula-feeding [FOF]) on weight partitioning and endocrine state (as judged by high-molecular-weight [HMW] adiponectin and IGF-I) of infants born small for gestational age (SGA). Body composition (by absorptiometry), HMW adiponectin, and IGF-I were assessed at birth and 4 months in BRF infants born appropriate for gestational age (AGA; n = 72) and SGA infants receiving BRF (n = 46) or FOF (n = 56), the latter being randomized to receive a standard (FOF1) or protein-rich formula (FOF2). Compared with AGA-BRF infants, the catchup growth of SGA infants was confined to lean mass, independently of nutrition. Compared with AGA-BRF infants, SGA-BRF infants had normal HMW adiponectin and IGF-I levels at 4 months, whereas SGA-FOF infants had elevated levels of HMW adiponectin (particularly SGA-FOF1) and IGF-I (particularly SGA-FOF2). In conclusion, neonatal nutrition seems to influence endocrinology more readily than body composition of SGA infants. Follow-up will disclose whether the endocrine abnormalities in SGA-FOF infants can serve as early markers of an unfavorable metabolic course and whether they may contribute to design early interventions that prevent subsequent disease, including diabetes. PMID:22648385

  11. Factors associated with small head circumference at birth among infants born before the 28th week

    PubMed Central

    McElrath, Thomas F.; Allred, Elizabeth N.; Kuban, Karl; Hecht, Jonathan L.; Onderdonk, Andrew; O’Shea, T. Michael; Paneth, Nigel; Leviton, Alan

    2010-01-01

    OBJECTIVE We sought to identify risk factors for congenital microcephaly in extremely low gestational age newborns. STUDY DESIGN Demographic, clinical, and placental characteristics of 1445 infants born before the 28th week were gathered and evaluated for their relationship with congenital microcephaly. RESULTS Almost 10% of newborns (n = 138), rather than the expected 2.2%, had microcephaly defined as a head circumference >2 SD below the median. In multivariable models, microcephaly was associated with nonwhite race, severe intrauterine growth restriction, delivery for preeclampsia, placental infarction, and being female. The risk factors for a head circumference between <1 and >2 SD below the median were similar to those of microcephaly. CONCLUSION Characteristics associated with fetal growth restriction and preeclampsia are among the strongest correlates of microcephaly among children born at extremely low gestational ages. The elevated risk of a small head among nonwhites and females might reflect the lack of appropriate head circumference standards. PMID:20541727

  12. End tidal carbon dioxide levels during the resuscitation of prematurely born infants.

    PubMed

    Murthy, Vadivelam; O'Rourke-Potocki, Anthony; Dattani, Nikesh; Fox, Grenville F; Campbell, Morag E; Milner, Anthony D; Greenough, Anne

    2012-10-01

    Successful resuscitation of prematurely born infants is dependent on achieving adequate alveolar ventilation and vasodilation of the pulmonary vascular bed. Elevation of end-tidal carbon dioxide (ETCO(2)) levels may indicate pulmonary vasodilation. This research aims to study the temporal changes in ETCO(2) levels and the infant's respiratory efforts during face mask resuscitation in the labour suite, and to determine if the infant's first inspiratory effort was associated with a rise in the ETCO(2) levels, suggesting pulmonary vasodilation had occurred. This study is an observational one. The subjects of the study are forty infants with a median gestational age of 30 weeks (range 23-34). Inflation pressures, expiratory tidal volumes and ETCO(2) levels were measured. The median expiratory tidal volume of inflations prior to the onset of the infant's respiratory efforts (passive inflations) was lower than that of the inflation associated with the first inspiratory effort (active inflation) (1.8 (range 0.1-7.3) versus 6.3 ml/kg (range 1.9-18.4), p<0.001), as were the median ETCO(2) levels (0.3 (range 0.1-2.1) versus 3.4 kPa (0.4-11.5), p<0.001). The median expiratory tidal volume (4.5 ml/kg (range 0.5-18.3)) and ETCO(2) level (2.2 kPa (range 0.3-9.3)) of the two passive inflations following the first active inflation were also higher than the median expiratory tidal volume and ETCO(2) levels of the previous passive inflations (p<0.001, p<0.0001 respectively). These results suggest that during face mask resuscitation, improved carbon dioxide elimination, likely due to pulmonary vasodilation, occurred with the onset of the infant's respiratory efforts. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Neurodevelopmental outcome of extremely preterm infants born to rural and urban residents' mothers in Australia.

    PubMed

    Rodrigues, Andrea N; Bajuk, Barbara; Oei, Julee; Lui, Kei; Abdel-Latif, Mohamed E

    2015-08-01

    Rural and remote residents in Australia have long experienced unfavourable health outcomes compared to their urban counterparts. To study neurodevelopmental outcome at 2-3 years of age, corrected for prematurity of extremely preterm infants admitted to a regional neonatal Australian network from rural and urban regions (based on usual location of maternal residence). A multicenter population-based cohort study in which surviving urban and rural infants <29 weeks of gestation born between 1998 and 2004 underwent neurodevelopmental assessment at 2-3 years of age, corrected for prematurity by a developmental assessment team. Moderate/severe functional disability was defined as developmental delay (GQ or MDI>2 SD below the mean), cerebral palsy (aided for walking), sensorineural or conductive deafness (requiring amplification), and bilateral blindness (visual acuity <6/60 in the better eye). Of the 1970 infants alive at 2-3 years of age, 268 (63.8%) rural and 1205 (77.7%) urban infants were evaluated. Infants lost to follow-up were of slightly higher gestational age and birth weight. Both rural and urban assessed groups were comparable in gestation and birth weight percentile. In comparison to their urban counterparts, the rural group had more outborn infants (19.8% vs. 4.6%, p<0.001). They, however, did not have an increased risk of moderate/severe functional disability (OR 0.77, 95% CI 0.52-1.23, p=0.176). This finding was not significantly altered by limiting the analysis to different gestational ages. Extremely premature surviving young children from rural areas of residence do not seem to have an increased risk for moderate/severe functional disability. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Differential associations between infant affective and cortisol responses during the still face paradigm among infants born very low birth weight versus full-term.

    PubMed

    Erickson, Sarah J; Maclean, Peggy; Qualls, Clifford; Lowe, Jean R

    2013-06-01

    Psychological stress responses may have both emotional and cortisol reactivity correlates, but there are limited data addressing the association between generalized negative and positive emotional states and cortisol reactivity to a psychological stressor among infants born very low birth weight (VLBW; <1250 g) compared to infants born full-term. Examining this relationship between behavioral (affect) and physiological (cortisol) responses may provide insight into the nature of regulation difficulties identified in infants born VLBW. The purpose of this study was to assess the association between infant affective and cortisol responses to the Still Face paradigm (SF) in a cohort of six- to eight-month old infants born VLBW compared with infants born full-term (N=53 total; N=29 and N=24, respectively). Infant affect was coded in 1-s intervals while mother-infant dyads participated in the SF paradigm, and percent positive affect and percent negative affect were calculated separately for each SF episode. We had hypothesized that because infants born VLBW are at increased risk for dysregulation, they would show, compared to full-term controls, greater dysregulation in the form of less synchrony (i.e., less correlated affective and cortisol responses) across the two SF stressors (episodes 2 and 4). This hypothesis was largely supported: the associations between affective and cortisol responses were different for the two groups across the two stressors for percent positive affect (both stressor episodes 2 and 4) and percent negative affect (episode 4 only). For the full-term group, follow up correlations revealed significant negative associations between percent positive affective and cortisol responses for both stressors. Mothers' responsiveness did not explain the term group association differences between infant affective and cortisol responses across stressors. The (lack of) association of stress reactivity systems may index dysregulation or dysregulation correlates

  15. Antenatal magnesium sulfate and neurodevelopmental outcome of preterm infants born to preeclamptic mothers.

    PubMed

    Bozkurt, Ozlem; Eras, Zeynep; Canpolat, Fuat Emre; Oguz, Serife Suna; Uras, Nurdan; Dilmen, Ugur

    2016-01-01

    Previous studies demonstrated that magnesium sulfate is associated with better neurological outcome and decreased cerebral palsy rates in preterm newborns. The aim of this study is to assess the effects of antenatal magnesium sulfate on neurodevelopmental outcomes of preterm infants. Preterm newborns with a gestational age of <32 weeks whose mothers were diagnosed with preeclampsia were extracted from the hospital records and files retrospectively. The neurodevelopmental assessment was performed at 2 years of age by developmental pediatrician. The results of the infants exposed to antenatal magnesium sulfate were compared with the control group. Between the years 2010 and 2012, 387 preterm babies were born to preeclamptic mothers. Fifty-nine (15.2%) of them were exposed to antenatal magnesium sulfate. The main clinical characteristics did not differ between the groups. On the other hand, cerebral palsy was significantly lower in preterm infants exposed to magnesium sulfate compared to the control group (3.3% and 12.2%, respectively, p = 0.004). On multinominal logistic regression analysis, magnesium sulfate was not an independent significant factor to reduce CP on its own. Antenatal magnesium sulfate can be used as a neuroprotective strategy especially for the prevention of cerebral palsy in preterm infants. Future studies should be designed to support the positive effect of antenatal magnesium sulfate on neurologic development.

  16. Prevalence and risk factors For vitamin D deficiency among healthy infants in Sacramento, California

    USDA-ARS?s Scientific Manuscript database

    Objective: The purpose of this study was to assess the vitamin D status of healthy infants 6-18 months of age in Sacramento, CA. Patients and Methods: This was a one-year, cross-sectional study among a convenience sample of healthy infants seen at routine “well child” or follow-up appointments at t...

  17. [Perinatal aspects, growth and feeding of infants born small for gestational age].

    PubMed

    Biosca Pàmies, M; Rodríguez Martínez, G; Samper Villagrasa, M P; Odriozola Grijalba, M; Cuadrón Andrés, L; Álvarez Sauras, M L; Moreno Aznar, L A; Olivares López, J L

    2013-01-01

    Being born small for gestational age (SGA) has short and long term risks. The aim of this study was to describe perinatal and socio-cultural characteristics, and the pattern of growth and diet of SGA infants during their first 6 months of life. Anthropometry and diet were evaluated during six months in a representative sample of 1596 newborns the population of Aragon (Spain). Mothers of SGA (N=94) infants gained less weight during pregnancy (10.5±5.8 vs 12.0±5.07 kg, P=.012), gestational age at birth was lower (37.84±1.7 vs 39.06±1.6 weeks, P<.001), and the probability of cesarean delivery was higher (37.2% vs 20.5%, P=.001). The height of the mother was lower in the SGA group (1.61±0.58 vs 1.63±0.06 metres, P=.004), but their body mass index was similar. No differences were found between groups in social or cultural aspects. Mothers of SGA infants smoked more during pregnancy (32.3% vs 18.5%, P=.003) (RR = 1.92; 95% CI; 1.31 to 3.02). Infants born SGA remained smaller during the first 6 months of life, and the monthly weight gain was similar to the rest. In the SGA group, the prevalence of breastfeeding was lower at 4 months of age (54.9% vs 68.2%, RR = 0.58, 95% CI; 0.38 to 0.89). Infants born SGA are more likely to converge a number of characteristics that must be considered together because they may lead to health risks. SGA do not show a rapid recovery pattern of postnatal growth, and their smaller size persists at six months. Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier España. All rights reserved.

  18. A systematic review of controlled trials of lower-protein or energy-containing infant formulas for use by healthy full-term infants.

    PubMed

    Abrams, Steven A; Hawthorne, Keli M; Pammi, Mohan

    2015-03-01

    Infant formulas have historically been developed based on providing macronutrients at intake concentrations approximately matching the composition of human milk. In most countries, targets of 1.4-1.5 g of protein/dL and 20 kcal/oz (67-68 kcal/dL) have been set as the protein and energy concentrations for formulas during the first year of life, although this may be an overestimation of these contents. Recent introduction of lower-protein and -energy formulas in full-term infants led us to systematically review the literature for its effects on growth. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, our inclusion criteria were studies that enrolled healthy full-term infants and evaluated lower-protein or lower-energy formula, reported anthropometric outcomes including weight and length, and followed infants for at least 6 mo. Six studies were eligible for inclusion. These studies varied in the content of nutrients provided in the intervention and control groups, by additional dietary components in the study groups, and the timing and length of the intervention, which limit their usefulness for interpreting newly introduced lower-protein and -energy formulas in the United States. These studies suggest adequate growth during infancy and early childhood with infant formulas with concentrations of protein and energy slightly below historical standards in the United States. Further long-term research is needed to assess the impact of the use of lower-protein and/or lower-energy products, especially for nutritionally at-risk populations such as preterm infants and infants who are born small for gestational age. © 2015 American Society for Nutrition.

  19. A Systematic Review of Controlled Trials of Lower-Protein or Energy-Containing Infant Formulas for Use by Healthy Full-Term Infants123

    PubMed Central

    Abrams, Steven A; Hawthorne, Keli M; Pammi, Mohan

    2015-01-01

    Infant formulas have historically been developed based on providing macronutrients at intake concentrations approximately matching the composition of human milk. In most countries, targets of 1.4–1.5 g of protein/dL and 20 kcal/oz (67–68 kcal/dL) have been set as the protein and energy concentrations for formulas during the first year of life, although this may be an overestimation of these contents. Recent introduction of lower-protein and -energy formulas in full-term infants led us to systematically review the literature for its effects on growth. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, our inclusion criteria were studies that enrolled healthy full-term infants and evaluated lower-protein or lower-energy formula, reported anthropometric outcomes including weight and length, and followed infants for at least 6 mo. Six studies were eligible for inclusion. These studies varied in the content of nutrients provided in the intervention and control groups, by additional dietary components in the study groups, and the timing and length of the intervention, which limit their usefulness for interpreting newly introduced lower-protein and -energy formulas in the United States. These studies suggest adequate growth during infancy and early childhood with infant formulas with concentrations of protein and energy slightly below historical standards in the United States. Further long-term research is needed to assess the impact of the use of lower-protein and/or lower-energy products, especially for nutritionally at-risk populations such as preterm infants and infants who are born small for gestational age. PMID:25770256

  20. Suburban migration and the birth outcome of Chicago-born white and African-American women: the merit of the healthy migrant theory?

    PubMed

    Collins, James W; Rankin, Kristin M; Janowiak, Christine M

    2013-11-01

    The healthy migrant theory posits that women who migrate before pregnancy are intrinsically healthier and therefore have better birth outcomes than those who don't move. Objective. To determine whether migration to the suburbs is associated with lower rates of preterm (<37 weeks) birth among Chicago-born White and African-American mothers. We performed stratified and multilevel logistic regression analyses on an Illinois transgenerational dataset of non-Latino White and African-American infants (1989-1991) and their mothers (1956-1976) with appended US census income information. Forty percent of Chicago-born White mothers (N = 45,135) migrated to Suburban Cook County and 30 % migrated to the more geographically distant collar counties. In contrast, 10 % of Chicago-born African-American mothers (N = 41,221) migrated to Suburban Cook and only two percent migrated to the collar counties. Chicago-born White and African-American migrant mothers to Suburban Cook County had lower preterm birth rates than their non-migrant counterparts; RR = 0.8 (0.8-0.9) and 0.8 (0.7-0.8), respectively. When neighborhood income was singularly taken into account, the protective association of suburban migration and preterm birth disappeared among Chicago-born Whites. In race-specific multilevel multivariate regression models which included neighborhood income, the adjusted odds ratio of preterm birth, low birth weight, and small for gestational-age for Chicago-born White and African-American migrant (compared to non-migrant) mothers approximated unity. Neighborhood income underlies the protective association of suburban migration and birth outcome among Chicago-born White and African-American mothers. These findings do not support the healthy migrant hypothesis of reproductive outcome.

  1. Serological follow-up of infants born to mothers with positive syphilis serology - real-world experiences.

    PubMed

    Wallace, Harriet E; Broomhall, Harriet M; Isitt, Catherine E; Miall, Lawrence S; Wilson, Janet D

    2016-11-01

    The 2008 UK syphilis guideline recommends infants born to women with any positive syphilis serology be followed up until both treponemal and nontreponemal tests are negative to exclude congenital syphilis, whereas Centers for Disease Control and Prevention guidelines recommend using only nontreponemal tests. Historically, we had low infant follow-up rates with no coherent pathways. We initiated a change in multidisciplinary team practice of infant testing for syphilis in 2011 and evaluated the results before and after by retrospective review of testing of infants born to women with positive syphilis serology between 2005 and 2012. A total of 28 infants' mothers were treated in pregnancy (termed 'high risk'); 26 had adequate treatment prior to pregnancy (termed 'low risk'). There was a significant increase in serological testing after 2011 compared with before (83% versus 48%; OR 5.07 [95% CI 1.22-22.77] p = 0.01) but mainly in low risk infants with no significant improvement in high risk infants who are the priority group. Using nontreponemal tests only in the infants would have reduced the tests required by at least 50%, allowing health resources to be concentrated on achieving adequate follow-up for those infants most at risk. © The Author(s) 2015.

  2. Vitamin D deficiency in healthy breastfed term infants at 3 months & their mothers in India: Seasonal variation & determinants

    PubMed Central

    Jain, Vandana; Gupta, Nandita; Kalaivani, Mani; Jain, Anurag; Sinha, Aditi; Agarwal, Ramesh

    2011-01-01

    Background & objectives: Vitamin D deficiency with a resurgence of rickets and tetany are increasingly being reported in young infants from temperate regions, African Americans and also from India. The data on vitamin D status of healthy term breastfed Indian infants and mothers are scant. Therefore, we undertook this study to determine the prevalence of vitamin D deficiency and insufficiency [serum 25 hydroxyvitamin D (25OHD) ≤ 15 ng/ml and 15-20 ng/ml, respectively] among healthy term breastfed 3 month old infants and their mothers, evaluate for clinical and radiological rickets in those infants having 25OHD < 10 ng/ml, and check for seasonal variation and predictors of infants’ vitamin D status. Methods: A total of 98 infants aged 2.5 to 3.5 months, born at term with appropriate weight and their mothers were enrolled; 47 in winter (November- January) and 51 in summer (April-June). Details of infants’ feeding, vitamin D supplementation, sunlight exposure and mothers’ calcium and vitamin D intake were recorded. Serum calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone were estimated. Results: Vitamin D deficiency was found in 66.7 per cent of infants and 81.1 per cent of mothers; and insufficiency in an additional 19.8 per cent of infants and 11.6 per cent of mothers. Radiological rickets was present in 30.3 per cent of infants with 25OHD < 10 ng/ml. 25OHD did not show seasonal variation in infants but maternal concentrations were higher in summer [11.3 (2.5 - 31) ng/ml] compared to winter [5.9 (2.5-25) ng/ml, P=0.003]. Intake of vitamin supplement, sunlight exposure and mother’s 25OHD were predictors of infants’ 25OHD levels. Interpretation & conclusions: Prevalence of vitamin D deficiency and insufficiency was found to be high in breastfed infants and their mothers, with radiological rickets in a third of infants with 25OHD < 10 ng/ml in this study. Studies with large sample need to be done in different parts of the

  3. Hemodynamic disturbances in premature infants born after chorioamnionitis: association with cord blood cytokine concentrations.

    PubMed

    Yanowitz, Toby Debra; Jordan, Jeanne Ann; Gilmour, Carol Huntress; Towbin, Richard; Bowen, A'Delbert; Roberts, James Michael; Brozanski, Beverly Sobchak

    2002-03-01

    Chorioamnionitis and elevated cord blood inflammatory cytokine concentrations are associated with detectable disturbances of systemic and cerebral hemodynamics in premature newborns. Fifty-five infants (25-31 wk gestation) were enrolled. Chorioamnionitis was defined by placental histology. IL-6, IL-1beta, and tumor necrosis factor-alpha were quantified by ELISA. Blood pressure, heart rate, cardiac output, stroke volume, fractional shortening, and middle cerebral artery blood flow velocities were measured at 3 +/- 1 h after birth. Chorioamnionitis was evident in 22 placentas and was associated with increased IL-6 (p < 0.001), IL-1beta (p = 0.035), and heart rate (p = 0.027); and with decreased mean and diastolic blood pressure (p = 0.026 and p = 0.019, respectively). IL-6 concentration correlated inversely with systolic, mean, and diastolic blood pressures. Right ventricular cardiac output was elevated (p = 0.028) in infants with fetal vessel inflammation. Maternal temperature >or=38.0 degrees C and newborn immature-to-total white blood cell ratio >or=0.4 were associated with significant decreases in left ventricular fractional shortening (p = 0.001 and p = 0.005, respectively). Neither chorioamnionitis nor elevated cytokine concentrations were associated with changes in middle cerebral artery Doppler blood flow velocities. Chorioamnionitis and elevated cord blood IL-6 concentrations are associated with decreased blood pressure in premature newborns. Inflammation of the fetal vessels and nonspecific indicators of infection are associated with disturbances in cardiac function. Infants with chorioamnionitis and elevated cytokine concentrations do not manifest changes in cerebral Doppler indices within the first few postnatal hours. We speculate that cytokine-associated systemic hemodynamic disturbances in premature infants born after chorioamnionitis predispose such infants to perinatal brain injury.

  4. Tubular Dysfunction Mimicking Dent's Disease in 2 Infants Born with Extremely Low Birth Weight

    PubMed Central

    Awazu, Midori; Arai, Mie; Ohashi, Shoko; Takahashi, Hirotaka; Sekine, Takashi; Ikeda, Kazushige

    2017-01-01

    Two preterm infants, with extremely low birth weight born at gestational weeks 24 and 25, showed generalized proximal tubular dysfunction during their stay in the neonatal intensive care unit, including glucosuria, low molecular weight proteinuria, phosphaturia, uricosuria, enzymuria (elevated urine N-acetyl-β-D-glucosaminidase), panaminoaciduria, and hypercalciuria, associated with renal calcification. Renal tubular acidosis was not present in either patient. DNA mutation analysis for Dent's disease, performed in patient 1, was negative. Although both patients had rickets of prematurity, tubular dysfunction persisted after its resolution. Patient 2, who had severe chronic lung disease, also had elevated serum creatinine, proteinuria, and hypertension, suggesting glomerular damage. In patient 1, low molecular weight proteinuria, enzymuria, panaminoaciduria, hypercalciuria, and renal calcification were still present at the age of 8 years. In patient 2, tubular dysfunction resolved except for β2 microglobulinuria at the age of 5 years. While a reduced nephron number resulting in focal segmental glomerulosclerosis is well-known, generalized proximal tubular dysfunction can also occur in infants born preterm and/or with extremely low birth weight. PMID:28203565

  5. Effect of Early Physical Activity Programs on Motor Performance and Neuromuscular Development in Infants Born Preterm: A Randomized Clinical Trial.

    PubMed

    Valizadeh, Leila; Sanaeefar, Mahnaz; Hosseini, Mohammad Bager; Asgari Jafarabadi, Mohammad; Shamili, Aryan

    2017-03-01

    Introduction: Although the survival rate of infants born preterm has increased, the prevalence of developmental problems and motor disorders among this population of infants remains the same. This study investigated the effect of physical activity programs in and out of water on motor performance and neuromuscular development of infants born preterm and had induced immobility by mechanical ventilation. Methods: This study was carried out in Al-Zahra hospital, Tabriz. 76 premature infants were randomly assigned into four groups. One group received daily passive range of motion to all extremities based on the Moyer-Mileur protocol. Hydrotherapy group received exercises for shoulders and pelvic area in water every other day. A combination group received physical activity programs in and out of water on alternating days. Infants in a containment group were held in a fetal position. Duration of study was two weeks 'from 32 through 33 weeks post menstrual age (PMA). Motor outcomes were measured by the Test of Infant Motor Performance. Neuromuscular developmental was assessed by New Ballard scale and leg recoil and Ankle dorsiflexion items from Dubowitz scale. Data were analyzed using SPSS version 13. Results: TIMP and neuromuscular scores improved in all groups. Motor performance did not differ between groups at 34 weeks PMA. Postural tone of leg recoil was significantly higher in physical activity groups post intervention. Conclusion: Physical activities and containment didn't have different effects on motor performance in infants born preterm. Leg recoil of neuromuscular development items was affected by physical activity programs.

  6. Effect of Early Physical Activity Programs on Motor Performance and Neuromuscular Development in Infants Born Preterm: A Randomized Clinical Trial

    PubMed Central

    Valizadeh, Leila; Sanaeefar, Mahnaz; Hosseini, Mohammad Bager; Asgari Jafarabadi, Mohammad; Shamili, Aryan

    2017-01-01

    Introduction: Although the survival rate of infants born preterm has increased, the prevalence of developmental problems and motor disorders among this population of infants remains the same. This study investigated the effect of physical activity programs in and out of water on motor performance and neuromuscular development of infants born preterm and had induced immobility by mechanical ventilation. Methods: This study was carried out in Al-Zahra hospital, Tabriz. 76 premature infants were randomly assigned into four groups. One group received daily passive range of motion to all extremities based on the Moyer-Mileur protocol. Hydrotherapy group received exercises for shoulders and pelvic area in water every other day. A combination group received physical activity programs in and out of water on alternating days. Infants in a containment group were held in a fetal position. Duration of study was two weeks ‘from 32 through 33 weeks post menstrual age (PMA). Motor outcomes were measured by the Test of Infant Motor Performance. Neuromuscular developmental was assessed by New Ballard scale and leg recoil and Ankle dorsiflexion items from Dubowitz scale. Data were analyzed using SPSS version 13. Results: TIMP and neuromuscular scores improved in all groups. Motor performance did not differ between groups at 34 weeks PMA. Postural tone of leg recoil was significantly higher in physical activity groups post intervention. Conclusion: Physical activities and containment didn’t have different effects on motor performance in infants born preterm. Leg recoil of neuromuscular development items was affected by physical activity programs. PMID:28299299

  7. The relative kicking frequency of infants born full-term and preterm during learning and short-term and long-term memory periods of the mobile paradigm.

    PubMed

    Heathcock, Jill C; Bhat, Anjana N; Lobo, Michele A; Galloway, James C

    2005-01-01

    Infants born preterm differ in their spontaneous kicking, as well as their learning and memory abilities in the mobile paradigm, compared with infants born full-term. In the mobile paradigm, a supine infant's ankle is tethered to a mobile so that leg kicks cause a proportional amount of mobile movement. The purpose of this study was to investigate the relative kicking frequency of the tethered (right) and nontethered (left) legs in these 2 groups of infants. Ten infants born full-term and 10 infants born preterm (<33 weeks gestational age, <2,500 g) and 10 comparison infants participated in the study. The relative kicking frequencies of the tethered and nontethered legs were analyzed during learning and short-term and long-term memory periods of the mobile paradigm. Infants born full-term showed an increase in the relative kicking frequency of the tethered leg during the learning period and the short-term memory period but not for the long-term memory period. Infants born preterm did not show a change in kicking pattern for learning or memory periods, and consistently kicked both legs in relatively equal amounts. Infants born full-term adapted their baseline kicking frequencies in a task-specific manner to move the mobile and then retained this adaptation for the short-term memory period. In contrast, infants born preterm showed no adaptation, suggesting a lack of purposeful leg control. This lack of control may reflect a general decrease in the ability of infants born preterm to use their limb movements to interact with their environment. As such, the mobile paradigm may be clinically useful in the early assessment and intervention of infants born preterm and at risk for future impairment.

  8. Long-chain polyunsaturated fatty acid supplementation in infants born at term.

    PubMed

    Simmer, K; Patole, S K; Rao, S C

    2008-01-23

    visual acuity in five studies. The remaining four used Teller visual acuity cards. The results were inconsistent. Three studies reported beneficial effect of LCPUFA supplementation on visual acuity while the remaining six did not. Neurodevelopmental outcome was measured at different ages throughout the first two years by eleven studies. Bayley scales of infant development (BSID) was used in eight studies. Only one showed beneficial effect of LCPUFA supplementation on BSID scales. Pooled meta-analysis of the data also did not show any statistically significant benefit of LCPUFA supplementation on either mental or psychomotor developmental index of BSID. One study reported better novelty preference measured by Fagan Infant test at nine months in supplemented infants compared with controls. Another study reported better problem solving at 10 months with supplementation. One study used Brunet and Lezine developmental test to assess the developmental quotient and did not find beneficial effects of LCPUFA supplementation. Physical growth was measured at various ages throughout first three years of life by twelve studies. Some studies reported the actual measurements while some reported the rate of growth over a time period. Some studies z scores. Irrespective of the type of LCPUFA supplementation, duration of supplementation and method of assessment, none of the individual studies found beneficial or harmful effects of LCPUFA supplementation. Meta-analysis of relevant studies also did not show any effect of LCPUFA supplementation on growth of term infants. The results of most of the well conducted RCTS have not shown beneficial effects of LCPUFA supplementation of formula milk on the physical, visual and neurodevelopmental outcomes of infants born at term. Only one group of researchers have shown some beneficial effects on VEP acuity. Two groups of researchers have shown some beneficial effect on mental development. Routine supplementation of milk formula with LCPUFA to

  9. Infants Born to Opioid-Dependent Women in Ontario, 2002-2014.

    PubMed

    Brogly, Susan B; Turner, Suzanne; Lajkosz, Katherine; Davies, Greg; Newman, Adam; Johnson, Ana; Dow, Kimberly

    2017-03-01

    There is a paucity of data characterizing mother-infant pairs with prenatal opioid dependence in Canada. We therefore conducted a study of relevant births in Ontario from 2002 to 2014. We used data from the Institute for Clinical Evaluative Sciences, the linked databases of coded population-based Ontario health services records. Differences in characteristics of opioid-dependent mother-neonate pairs and infant hospital costs by year were assessed using linear regression, and we calculated rates of preterm birth, low birth weight, birth defects, mortality, and neonatal abstinence syndrome. The number of infants born to opioid-dependent women in Ontario rose from 46 in 2002 to almost 800 in 2014. Methadone was most frequently used for prenatal opioid dependence; there was little buprenorphine or buprenorphine + naloxone use. Rates of preterm birth and low birth weight were high. The proportion of neonates with neonatal abstinence syndrome (58%) was stable over the study period. The mean length of neonatal hospital stay was 13.96 days. Infant hospital costs increased from $724 774 in 2003 to $10 539 988 in 2013, and the mean cost per infant grew from $9928 to $12 917. Birth defect prevalence was 75.84/1000 live births (95% CI 68.12/1000 to 84.10/1000). The stillbirth rate was 11.39/1000 births (95% CI 8.47/1000 to 14.99/1000), and the infant mortality rate was 12.21/1000 live births (95% CI 9.16/1000 to 15.95/1000). We observed a 16-fold increase in the number of mother-infant pairs affected by opioid dependence in Ontario over the past decade. Adverse birth outcome rates were high. Expanded services for opioid-dependent women and their children are needed. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  10. Congenital nystagmus in two infants born from mothers exposed to methadone during pregnancy.

    PubMed

    Tinelli, Francesca; Gamucci, Alessandra; Battini, Roberta; Cioni, Giovanni

    2013-07-03

    Methadone is commonly prescribed as a substitute for illicit opioids. Use of methadone during pregnancy is associated with neonatal abstinence syndrome (NAS), reduced head circumference as well as a slight increase in neonatal mortality and morbidity. Less is known about the effects of methadone on the visual system. We report two Italian cases of nystagmus in infants born from mothers exposed to methadone during pregnancy. Ophthalmic or central disorders were excluded as a cause of nystagmus in both infants. The first case was followed at 3, 6 and 12 months while the second one was evaluated at 5 and 8 months. Both infants had normal neurological and cognitive development. Their first evaluation revealed different characteristics but both showed progressive improvement in ocular disorder, persistence of pendular horizontal nystagmus and nearly normal visual acuity. This report, the first description of Italian cases of nystagmus related to use of methadone during pregnancy, underlies the importance of a careful investigation of drug use in pregnancy in cases of unexplained congenital nystagmus.

  11. Survival of Texas infants born with trisomies 21, 18, and 13.

    PubMed

    Vendola, Catherine; Canfield, Mark; Daiger, Stephen P; Gambello, Michael; Hashmi, S Shahrukh; King, Terri; Noblin, Sarah J; Waller, D Kim; Hecht, Jacqueline T

    2010-02-01

    Trisomies 21, 18, and 13 are the three most common trisomies among infants who survive to 20 weeks gestation or more. Overall information about birth prevalence, natural history, and mortality for all three trisomies is well defined, but information about ethnic-specific rates is limited. Only a few studies have examined mortality rates of trisomies 18 and 13 because so few cases are liveborn and most have very short life spans. This study assessed ethnic-specific population-based survival probabilities among infants for each trisomy. All cases of trisomies 21, 18, and 13 born in Texas between 1999 and 2003 were obtained from the Texas Birth Defects Registry and included 2,260 cases of trisomy 21, 398 cases of trisomy 18, and 213 cases of trisomy 13. Date and cause of death were obtained from the Texas vital statistics records and the National Death Index. Overall, birth prevalence rates (per 10,000 adjusted live births) for the three trisomies were 11.74 (95% CI: 11.25-12.25), 1.34 (95% CI: 1.18-1.52), 0.92 (95% CI: 0.79-1.07), respectively, and are consistent with previously reported rates. There were no differences in survival rates by ethnicity and the median survival for each trisomy was consistent with previous reports. The results of this study provide comprehensive population-based information for survival of infants with trisomies 21, 18, and 13.

  12. Congenital cytomegalovirus infections and glycoprotein B genotypes in live-born infants: a prevalence study in Turkey.

    PubMed

    Sahiner, Fatih; Cekmez, Ferhat; Cetinkaya, Merih; Kaya, Guven; Kalayci, Tugce; Gunes, Omer; Sener, Kenan; Yapar, Mehmet; Tunc, Turan; Ecemis, Tolga; Cekmez, Yasemin; Kubar, Ayhan

    2015-07-01

    Cytomegalovirus (CMV) infections are the leading cause of infectious hearing loss and central nervous system disease among children worldwide. In this study, we aimed to determine the birth prevalence of congenital CMV infection in live-born infants in Turkey. In total, 944 consecutive live-born infants born from 926 pregnant women were included in this study. CMV-DNA was investigated in saliva samples of all newborns within the first 3 days after birth using TaqMan-based real-time PCR. The birth prevalence of congenital CMV infection in live-born infants was 1.91% (18/944), and all congenitally infected infants were asymptomatic at birth. The prevalence of congenital CMV infection was 16.7% (3/18) in twin pregnancies and 1.32% (12/908) in single pregnancies (p = 0.002). Genotyping analysis showed glycoprotein B-1 (gB1) to be the most frequently detected genotype at 83.3%. The study results suggest that the majority of congenital CMV infection in Turkey occurs following nonprimary maternal infection. We believe that congenital CMV infection and its long-term effects have been underestimated in our country, as infected infants are usually asymptomatic at birth.

  13. Birth defects among a cohort of infants born to HIV-infected women on antiretroviral medication

    PubMed Central

    Watts, D. Heather; Huang, Sharon; Culnane, Mary; Kaiser, Kathleen A.; Scheuerle, Angela; Mofenson, Lynne; Stanley, Kenneth; Newell, Marie-Louise; Mandelbrot, Laurent; Delfraissy, Jean-Francois; Cunningham, Coleen K.

    2011-01-01

    Objective To determine rate of and risk factors for birth defects in infants born to HIV-infected women receiving nucleoside and protease inhibitor antiretroviral (ARV) therapy. Methods Birth defects were evaluated among infants on the Pediatric AIDS Clinical Trials Group 316 trial that studied addition of peripartum nevirapine to established ARV regimen for prevention of mother-to-child transmission. Maternal therapy was categorized by trimester of earliest exposure. Birth defects were coded using conventions of the Antiretroviral Pregnancy Registry. Results Birth defects were detected in 60/1414 (4.2%; 95% CI 3.3–5.4%) infants including 30/636 (4.7%; 95% CI 3.2–6.7%) with first trimester ARV exposure and 30/778 (3.9%; 95% CI 2.6–5.5%) with exposure only after the first trimester (P=0.51). Rates of classes of defects were similar between first trimester compared to later exposure groups except heart defects which occurred in 16 (2.5%; 95% CI 1.4–4.1%) with first trimester ARV exposure and in six (0.8%; 95% CI 0.3–1.7%) infants with later exposure (P=0.02). Exposure to ARV was not associated with specific types of heart defects. Two cases of cardiomyopathy were noted. Conclusion ARV use in early pregnancy was not associated with an increased risk of birth defects overall. The possible association of ARV exposure with heart defects requires further surveillance. PMID:21142844

  14. Academic, social, and behavioral outcomes at age 12 of infants born preterm.

    PubMed

    Winchester, Suzy Barcelos; Sullivan, Mary C; Marks, Amy Kerivan; Doyle, Thomas; DePalma, Jennifer; McGrath, Margaret M

    2009-11-01

    The effects of gradient levels of perinatal morbidity on school outcomes have been investigated at age 12 in four preterm groups, classified as healthy (no medical or neurological illness), medical morbidity, neurological morbidity, and small-for-gestational-age (SGA), and a full-term comparison group. Teachers report on academic competence, social skills, and problem behaviors. Data on school type, classroom setting, and school service use are gathered from school records. Preterm groups are found to be equivalent to full-term peers in social skills and problem behavior. Preterm groups with neurological and SGA morbidity have the lowest academic competence scores. Unexpectedly, preterm infants with medical morbidity have higher academic competence scores compared with the other preterm groups. School service use increases with greater perinatal morbidity and is contingent on multiple rather than single indicators of perinatal morbidity. Continued monitoring of preterm infants through early adolescence will ensure that appropriate school services and resources are available to maximize their school success.

  15. Does acute maternal stress in pregnancy affect infant health outcomes? Examination of a large cohort of infants born after the terrorist attacks of September 11, 2001

    PubMed Central

    Endara, Skye M; Ryan, Margaret AK; Sevick, Carter J; Conlin, Ava Marie S; Macera, Caroline A; Smith, Tyler C

    2009-01-01

    Background Infants in utero during the terrorist attacks of September 11, 2001 may have been negatively affected by maternal stress. Studies to date have produced contradictory results. Methods Data for this retrospective cohort study were obtained from the Department of Defense Birth and Infant Health Registry and included up to 164,743 infants born to active-duty military families. Infants were considered exposed if they were in utero on September 11, 2001, while the referent group included infants gestating in the same period in the preceding and following year (2000 and 2002). We investigated the association of this acute stress during pregnancy with the infant health outcomes of male:female sex ratio, birth defects, preterm birth, and growth deficiencies in utero and in infancy. Results No difference in sex ratio was observed between infants in utero in the first trimester of pregnancy on September 11, 2001 and infants in the referent population. Examination of the relationship between first-trimester exposure and birth defects also revealed no significant associations. In adjusted multivariable models, neither preterm birth nor growth deficiencies were significantly associated with the maternal exposure to the stress of September 11 during pregnancy. Conclusion The findings from this large population-based study suggest that women who were pregnant during the terrorist attacks of September 11, 2001 had no increased risk of adverse infant health outcomes. PMID:19619310

  16. Unique mosaicism of tetraploidy and trisomy 8: Clinical, cytogenetic, and molecular findings in a live-born infant

    SciTech Connect

    Roberts, H.E.; Saxe, D.F.; Muralidharan, K.

    1996-03-29

    We report on a live-born infant with mosaicism of tetraploidy and trisomy 8 who had craniofacial abnormalities, cardiac and genitourinary defects, agenesis of the corpus callosum, and anomalies of limbs. The infant died at age 14 weeks. Molecular studies were done on peripheral blood lymphocytes and cultured amniocytes to determine the origin of the cytogenetic abnormalities. On the basis of the results, we describe a possible mechanism to explain these abnormalities. To our knowledge, this infant represents the first reported case of mosaic trisomy 8 with a tetraploid cell line. 14 refs., 4 figs., 2 tabs.

  17. Developmental Care Rounds: An Interdisciplinary Approach to Support Developmentally Appropriate Care of Infants Born with Complex Congenital Heart Disease.

    PubMed

    Lisanti, Amy Jo; Cribben, Jeanne; Connock, Erin McManus; Lessen, Rachelle; Medoff-Cooper, Barbara

    2016-03-01

    Newborn infants with complex congenital heart disease are at risk for developmental delay. Developmental care practices benefit prematurely born infants in neonatal intensive care units. Cardiac intensive care units until recently had not integrated developmental care practices into their care framework. Interdisciplinary developmental care rounds in our center have helped in the promotion of developmentally supportive care for infants before and after cardiac surgery. This article discusses basic principles of developmental care, the role of each member of the interdisciplinary team on rounds, common developmental care practices integrated into care from rounds, and impacts to patients, families, and staff.

  18. Sucking behaviour in infants born preterm and developmental outcomes at primary school age.

    PubMed

    Wolthuis-Stigter, Mechteld I; Da Costa, Saakje P; Bos, Arend F; Krijnen, Wim P; Van Der Schans, Cees P; Luinge, Margreet R

    2017-08-01

    To determine the association between sucking in infants born preterm and developmental outcomes at 5 years. Thirty-four infants were included (mean gestational age 30wks 4d, mean birthweight 1407g). The Neonatal Oral-Motor Assessment Scale was used longitudinally from 37 to 50 weeks postmenstrual age. At 5 years, we assessed motor skills, intelligence, language, verbal memory, and behavioural problems. Linear regression analyses were performed to test whether aspects of sucking behaviour predicted these developmental outcomes. Where linear regression was not appropriate, Spearman's correlation coefficients were calculated between sucking and developmental outcomes. Sucking was associated with total motor skills (B [unstandardized correlation coefficient for normally distributed data]=22.66, 95% confidence interval [CI] 6.61 to 38.71), balance (Spearman's ρ=0.64, p<0.001), total intelligence (B=-1.16, 95% CI -1.89 to -0.44, B=10.48, 95% CI 0.39 to 20.71, B=-2.22, 95% CI -3.42 to -1.02), verbal intelligence (B=-0.95; 95% CI -1.83 to -0.07, B=-2.02; 95% CI -3.55 to -0.49), performance intelligence (B=-1.34, 95% CI -2.13 to -0.54, B=12.36, 95% CI 1.13 to 23.60, B=-2.37, 95% CI -3.75 to -0.96), and language (B=-1.78, 95% CI -3.36 to -0.19). All associations were in the same direction: the better the sucking, the higher the test scores. Verbal memory and behavioural problems were not associated with sucking. Abnormal sucking between 42 weeks and 50 weeks postmenstrual age may reflect abnormal neurological functioning in children born preterm. © 2017 Mac Keith Press.

  19. Parental psychological distress and confidence after an infant's birth: the role of attachment representations in parents of infants with congenital anomalies and parents of healthy infants.

    PubMed

    Fonseca, Ana; Nazaré, Bárbara; Canavarro, Maria Cristina

    2013-06-01

    The present study aimed to examine parental psychological distress and confidence after an infant's birth, when parenting an infant with a diagnosis of a congenital anomaly, and to understand the role of attachment representations on parental adjustment. Parents of infants with a congenital anomaly (44 couples) and parents of healthy infants (46 couples) completed measures of adult attachment representations and of psychological distress and parental confidence (one month after the infant's birth). Results showed no group differences in psychological distress. Mothers in the clinical group presented lower confidence than mothers in the comparison group, while for fathers the inverse pattern was found, showing their involvement in the caretaking of the infant. Insecure attachment representations predicted parental psychological distress, and a moderator role of group was found only for fathers. These results highlight the role of secure attachment representations as an individual resource in stress-inducing situations.

  20. Postural Complexity Influences Development in Infants Born Preterm With Brain Injury: Relating Perception-Action Theory to 3 Cases

    PubMed Central

    Izzo, Theresa; Thacker, Leroy R.; Galloway, James Cole

    2014-01-01

    Background and Purpose Perception-action theory suggests a cyclical relationship between movement and perceptual information. In this case series, changes in postural complexity were used to quantify an infant's action and perception during the development of early motor behaviors. Case Description Three infants born preterm with periventricular white matter injury were included. Outcomes Longitudinal changes in postural complexity (approximate entropy of the center of pressure), head control, reaching, and global development, measured with the Test of Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, were assessed every 0.5 to 3 months during the first year of life. All 3 infants demonstrated altered postural complexity and developmental delays. However, the timing of the altered postural complexity and the type of delays varied among the infants. For infant 1, reduced postural complexity or limited action while learning to control her head in the midline position may have contributed to her motor delay. However, her ability to adapt her postural complexity eventually may have supported her ability to learn from her environment, as reflected in her relative cognitive strength. For infant 2, limited early postural complexity may have negatively affected his learning through action, resulting in cognitive delay. For infant 3, an increase in postural complexity above typical levels was associated with declining neurological status. Discussion Postural complexity is proposed as a measure of perception and action in the postural control system during the development of early behaviors. An optimal, intermediate level of postural complexity supports the use of a variety of postural control strategies and enhances the perception-action cycle. Either excessive or reduced postural complexity may contribute to developmental delays in infants born preterm with white matter injury. PMID:24903116

  1. ALTERED BASAL CORTISOL LEVELS AT 3, 6, 8 AND 18 MONTHS IN INFANTS BORN AT EXTREMELY LOW GESTATIONAL AGE

    PubMed Central

    GRUNAU, RUTH E.; HALEY, DAVID W.; WHITFIELD, MICHAEL F.; WEINBERG, JOANNE; YU, WAYNE; THIESSEN, PAUL

    2007-01-01

    Objective Little is known about the developmental trajectory of cortisol levels in preterm infants after hospital discharge. Study design In a cohort of 225 infants (gestational age at birth <33 weeks) basal salivary cortisol levels were compared in infants born at extremely low gestational age (ELGA, 23-28 weeks), very low gestational age (VLGA, 29-32 weeks) and full-term (37-42 weeks), at 3, 6, 8 and 18 months corrected age (CA). Infants with major neurosensory and/or motor impairment were excluded. Results At 3 months CA, salivary cortisol levels were lower in both preterm groups compared to the full-term infants (p = .003). Conversely, at 8 and 18 months CA, the ELGA infants had significantly higher basal cortisol levels than the VLGA and full-term infants (p = .016; p = .006 respectively). Conclusions In ELGA infants, the shift from low basal cortisol levels at 3 months to significantly high levels at 8 and 18 months CA suggests long-term ‘re-setting’ of endocrine stress systems. Multiple factors may contribute to these higher cortisol levels in the ELGA infants, including physiological immaturity at birth, cumulative stress related to multiple procedures and mechanical ventilation during lengthy hospitalization. Prolonged elevation of the cortisol “set-point” may have negative implications for neurodevelopment and later health. PMID:17236892

  2. Infants born large-for-gestational-age display slower growth in early infancy, but no epigenetic changes at birth.

    PubMed

    Chiavaroli, Valentina; Cutfield, Wayne S; Derraik, José G B; Pan, Zengxiang; Ngo, Sherry; Sheppard, Allan; Craigie, Susan; Stone, Peter; Sadler, Lynn; Ahlsson, Fredrik

    2015-09-30

    We evaluated the growth patterns of infants born large-for-gestational-age (LGA) from birth to age 1 year compared to those born appropriate-for-gestational-age (AGA). In addition, we investigated possible epigenetic changes associated with being born LGA. Seventy-one newborns were classified by birth weight as AGA (10(th)-90(th) percentile; n = 42) or LGA (>90(th) percentile; n = 29). Post-natal follow-up until age 1 year was performed with clinical assessments at 3, 6, and 12 months. Genome-wide DNA methylation was analysed on umbilical tissue in 19 AGA and 27 LGA infants. At birth, LGA infants had greater weight (p < 0.0001), length (p < 0.0001), ponderal index (p = 0.020), as well as greater head (p < 0.0001), chest (p = 0.044), and abdominal (p = 0.007) circumferences than AGA newborns. LGA infants were still larger at the age of 3 months, but by age 6 months there were no more differences between groups, due to higher length and weight increments in AGA infants between 0 and 6 months (p < 0.0001 and p = 0.002, respectively). Genome-wide analysis showed no epigenetic differences between LGA and AGA infants. Overall, LGA infants had slower growth in early infancy, being anthropometrically similar to AGA infants by 6 months of age. In addition, differences between AGA and LGA newborns were not associated with epigenetic changes.

  3. The role of infant feeding practices in the explanation for ethnic differences in infant growth: the Amsterdam Born Children and their Development study.

    PubMed

    de Hoog, Marieke L A; van Eijsden, Manon; Stronks, Karien; Gemke, Reinoud J B J; Vrijkotte, Tanja G M

    2011-11-01

    Rapid early growth in infants may influence overweight and CVD in later life. Both rapid growth and these disease outcomes disproportionately affect some ethnic minorities. We determined ethnic differences in growth rate (Δ standard deviation scores, ΔSDS) during the first 6 months of life and assessed the explanatory role of infant feeding. Data were derived from a multiethnic cohort for the Amsterdam Born Children and their Development study (The Netherlands). Growth data (weight and length) of 2998 term-born singleton infants with no fetal growth restriction were available for five ethnic populations: Dutch (n 1619), African descent (n 174), Turkish (n 167), Moroccan (n 232) and other non-Dutch (n 806). ΔSDS for weight, length and weight-for-length between 4 weeks and 6 months were defined using internal references. Infant feeding pattern (breast-feeding duration, introduction of formula feeding and complementary feeding) in relation to ethnic differences in growth rate was examined by multivariate linear regression. Results showed that the growth rate was higher in almost all ethnic minorities, with β between 0·07 and 0·41 for ΔSDS weight and between 0·12 and 0·42 for ΔSDS length, compared with ethnic Dutch infants. ΔSDS weight-for-length was similar across groups, except for Moroccan infants (β 0·25, P < 0·05) after correction for confounders. In general, exclusive breast-feeding for 4 months was associated with slower growth for all three growth measures. Feeding factors explained, to a small degree, the higher weight and length gain in African descent infants, but not the higher ΔSDS weight-for-length in the Moroccan population. More research is needed to elucidate the underlying mechanisms of the high infant growth rate in Turkish and Moroccan infants.

  4. Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22–25 weeks gestation

    PubMed Central

    Carlo, Waldemar A.; McDonald, Scott A.; Fanaroff, Avroy A.; Vohr, Betty R.; Stoll, Barbara J.; Ehrenkranz, Richard A.; Andrews, William W.; Wallace, Dennis; Das, Abhik; Bell, Edward F.; Walsh, Michele C.; Laptook, Abbot R.; Shankaran, Seetha; Poindexter, Brenda B.; Hale, Ellen C.; Newman, Nancy S.; Davis, Alexis S.; Schibler, Kurt; Kennedy, Kathleen A.; Sanchez, Pablo J.; Van Meurs, Krisa P.; Goldberg, Ronald N.; Watterberg, Kristi L.; Faix, Roger G.; Frantz, Ivan D.; Higgins, Rosemary D.

    2013-01-01

    Context Current guidelines, initially published in 1995, recommend antenatal corticosteroids for mothers with preterm labor from 24–34 weeks gestational age, but not before 24 weeks because of lack of data. However, many infants born before 24 weeks are provided intensive care now. Objective To determine if antenatal corticosteroids are associated with improvement in major outcomes in infants born at 22 and 23 weeks. Design, Setting, Participants Data for this cohort study were collected prospectively on 401–1000 gram inborn infants (N=10,541) of 22–25 weeks gestation born between 1993–2009 at 23 academic perinatal centers in the United States. Certified examiners unaware of exposure to antenatal corticosteroids performed follow-up examinations on 4,924 (86.5%) of the infants born in 1993–2008 who survived to 18–22 months. Logistic regression models generated adjusted odds ratios, controlling for maternal and neonatal variables. Main Outcome Measures Mortality and neurodevelopmental impairment at 18–22 months corrected age RESULTS Death or neurodevelopmental impairment at 18–22 months was lower for infants whose mothers received antenatal corticosteroids born at 23 weeks (antenatal corticosteroids, 83.4% vs no antenatal corticosteroids, 90.5%; adjusted odds ratio 0.58; 95% CI, 0.42–0.80), at 24 weeks (antenatal corticosteroids, 68.4% vs no antenatal corticosteroids, 80.3%; adjusted odds ratio 0.62; 95% CI, 0.49–0.78), and at 25 weeks (antenatal corticosteroids, 52.7% vs no antenatal corticosteroids, 67.9%; adjusted odds ratio 0.61; 95% CI, 0.50–0.74) but not at 22 weeks (antenatal corticosteroids, 90.2% vs no antenatal corticosteroids, 93.1%; adjusted odds ratio 0.80; 95% CI, 0.29–12.21). Death by 18–22 months, hospital death, death/intraventricular hemorrhage/periventricular leukomalacia, and death/necrotizing enterocolitis were significantly lower for infants born at 23, 24, and 25 weeks gestational age if the mothers had received

  5. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Infant feeding and health-related quality of life in healthy Chinese infants: results from a prospective, observational cohort study.

    PubMed

    Hays, Nicholas P; Mao, Meng; Zhang, Lan; Ge, John; Northington, Robert; Yao, Manjiang; Volger, Sheri

    2016-08-08

    Infant feeding regimens, including breastfeeding, formula-feeding, or a combination of the two, may influence infant health-related quality of life (HRQOL). However, few studies have examined this association. This prospective cohort study assessed HRQOL in relation to three parent-selected feeding regimens: exclusively breastfed (n = 136), exclusively study formula-fed (n = 140), and mixed-fed with study formula and breast milk (n = 151). Healthy Chinese infants were enrolled at their first normally scheduled well infant clinic visit at age 42 days (study day 1). Parents independently chose their infants' feeding regimens prior to recruitment into the study, with infants in the formula and mixed-fed groups already consuming an infant formula enriched with α-lactalbumin and increased sn-2 palmitate and oligofructose. The Infant and Toddler Quality of Life Questionnaire, which includes six infant-focused and three parent-focused concepts, was used to assess HRQOL at day 1 and at a follow-up visit 48 days later. Scores for each concept ranged from 0 to 100. Parent quality of life (assessed using the Mental Component Summary score of the SF-12v2 Health Survey) was included in the ANCOVA model to adjust for its potential effect on parent's perception of infant HRQOL. HRQOL concept scores were high in all three study groups at both visits (mean scores 71-95). Day 1 HRQOL scores were not significantly different between groups. At day 48, 5 of 9 HRQOL scores were not significantly different between groups. However, scores for Temperament and Moods, General Health Perceptions and Parent Impact-Time were slightly but statistically significantly lower in the formula-fed group (mean scores 75-86; all p ≤ 0.01) compared to the breastfed (78-90) and mixed-fed (77-91) groups. Day 48 Parent Impact-Emotional scores were also significantly lower by a small margin (4 points; p = 0.003) in the formula-fed group compared with the breastfed group. HRQOL was

  7. Birth defects in infants born to employees of a microelectronics and business machine manufacturing facility.

    PubMed

    Silver, Sharon R; Pinkerton, Lynne E; Rocheleau, Carissa M; Deddens, James A; Michalski, Adrian M; Van Zutphen, Alissa R

    2016-08-01

    Concerns about solvent releases from a microelectronics/business machine manufacturing facility in upstate New York led to interest in the health of former workers, including this investigation of birth defects in children of male and female employees. Children born 1983 to 2001 to facility employees were enumerated and matched to New York State's Congenital Malformations Registry. Reported structural birth defects were compared with numbers expected from state rates (excluding New York City), generating standardized prevalence ratios (SPRs). Exposure assessors classified employees as ever/never potentially exposed at the facility to metals, chlorinated hydrocarbons, and other hydrocarbons during windows critical to organogenesis (female workers) or spermatogenesis (male workers). Among workers, adjusted prevalence ratios were generated to evaluate associations between potential exposures and specific birth defects. External comparisons for structural defects were at expectation for infants of male workers (SPR = 1.01; 95% confidence interval [CI], 0.77-1.29; n = 60) and lower for births to female workers (SPR = 0.84; 95% CI, 0.50-1.33; n = 18). Among full-term infants of male workers, ventricular septal defects (VSDs) were somewhat elevated compared with the general population (SPR = 1.58; 95% CI, 0.99-2.39; n = 22). Within the cohort, potential paternal metal exposure was associated with increased VSD risk (adjusted prevalence ratio = 2.70; 95% CI, = 1.09-6.67; n = 7). While overall SPRs were near expectation, paternal exposure to metals (primarily lead) appeared to be associated with increased VSD risk in infants. Take-home of occupational exposures, nonoccupational exposures, and chance could not be ruled out as causes. Case numbers for many defects were small, limiting assessment of the role of occupational exposures. Birth Defects Research (Part A) 106:696-707, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. Normative Data for Bone Mass in Healthy Term Infants from Birth to 1 Year of Age

    PubMed Central

    Gallo, Sina; Vanstone, Catherine A.; Weiler, Hope A.

    2012-01-01

    For over 2 decades, dual-energy X-ray absorptiometry (DXA) has been the gold standard for estimating bone mineral density (BMD) and facture risk in adults. More recently DXA has been used to evaluate BMD in pediatrics. However, BMD is usually assessed against reference data for which none currently exists in infancy. A prospective study was conducted to assess bone mass of term infants (37 to 42 weeks of gestation), weight appropriate for gestational age, and born to healthy mothers. The group consisted of 33 boys and 26 girls recruited from the Winnipeg Health Sciences Center (Manitoba, Canada). Whole body (WB) as well as regional sites of the lumbar spine (LS 1–4) and femur was measured using DXA (QDR 4500A, Hologic Inc.) providing bone mineral content (BMC) for all sites and BMD for spine. During the year, WB BMC increased by 200% (76.0 ± 14.2 versus 227.0 ± 29.7 g), spine BMC by 130% (2.35 ± 0.42 versus 5.37 ± 1.02 g), and femur BMC by 190% (2.94 ± 0.54 versus 8.50 ± 1.84 g). Spine BMD increased by 14% (0.266 ± 0.044 versus 0.304 ± 0.044 g/cm2) during the year. This data, representing the accretion of bone mass during the first year of life, is based on a representative sample of infants and will aid in the interpretation of diagnostic DXA scans by researchers and health professionals. PMID:23091773

  9. Fidgety movements in infants born very preterm: predictive value for cerebral palsy in a clinical multicentre setting.

    PubMed

    Datta, Alexandre N; Furrer, Mark A; Bernhardt, Iris; Hüppi, Petra S; Borradori-Tolsa, Cristina; Bucher, Hans Ulrich; Latal, Beatrice; Grunt, Sebastian; Natalucci, Giancarlo

    2017-06-01

    This study assessed predictive values of fidgety movement assessment (FMA) in a large sample of infants born very preterm for developmental abnormalities, in particular for cerebral palsy (CP) at 2 years in an everyday clinical setting. This is a multicentre study of infants born preterm with gestational age lower than 32.0 weeks. FMA was performed at 3 months corrected age; neurodevelopment (Bayley Scales of Infant Development, 2nd edition) and neurological abnormalities were assessed at 2 years. Predictive values of FMA for the development of CP were calculated and combined with abnormalities at cerebral ultrasound. Five hundred and thirty-five infants (gestational age 28.2wks [standard deviation 1.3wks]) were included. Eighty-one percent showed normal fidgety movements and 19% atypical (82 absent, 21 abnormal) fidgety movements. Absent fidgety movements predicted CP at 2 years with an odds ratio (OR) of 8.9 (95% confidence interval [CI] 4.1-17.0), a combination of atypical fidgety movements and major brain lesion on cerebral ultrasound predicted it with an OR of 17.8 (95% CI 5.2-61.6). Mean mental developmental index of infants with absent fidgety movements was significantly lower (p=0.012) than with normal fidgety movements. Detection of infants at risk for later CP through FMA was good, but less robust when performed in a routine clinical setting; prediction improved when combined with neonatal cerebral ultrasound. © 2017 Mac Keith Press.

  10. The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts

    PubMed Central

    2011-01-01

    Background Cleft lip and/or palate (CL/P) increase mortality and morbidity risks for affected infants especially in less developed countries. This study aimed at assessing the effects of systematic pediatric care on neonatal mortality and hospitalizations of infants with cleft lip and/or palate (CL/P) in South America. Methods The intervention group included live-born infants with isolated or associated CL/P in 47 hospitals between 2003 and 2005. The control group included live-born infants with CL/P between 2001 and 2002 in the same hospitals. The intervention group received systematic pediatric care between the 7th and 28th day of life. The primary outcomes were mortality between the 7th and 28th day of life and hospitalization days in this period among survivors adjusted for relevant baseline covariates. Results There were no significant mortality differences between the intervention and control groups. However, surviving infants with associated CL/P in the intervention group had fewer hospitalization days by about six days compared to the associated control group. Conclusions Early systematic pediatric care may significantly reduce neonatal hospitalizations of infants with CL/P and additional birth defects in South America. Given the large healthcare and financial burden of CL/P on affected families and the relatively low cost of systematic pediatric care, improving access to such care may be a cost-effective public policy intervention. Trial Registration ClinicalTrials.gov: NCT00097149 PMID:22204448

  11. Term infants born at home in Peru are less likely to be hospitalised in the neonatal period than those born in hospital.

    PubMed

    Lavin, Tina; Preen, David B

    2017-08-01

    More than 50% of women worldwide give birth at home, but little is known about home birth and subsequent neonatal hospitalisation. The objective of the study was to investigate home birth and neonatal hospitalisation of term neonates in Peru. The relationship between birth setting [home - with or without skilled birth attendant (SBA), health centre, hospital] and neonatal hospitalisation (n = 1656) and incubator care (n = 1651) was investigated using data from the 2002 Young Lives Study. Infants were sampled from 20 sentinel sites across Peru. At each sentinel site 100 households with children aged 6-18 months were randomly sampled (therefore the sample only captured children surviving to 6 months of age). Multivariate regression modelling was used with models adjusted for a range of demographic and clinical factors. After adjustment, the odds of hospitalisation were lower in neonates born at home (with SBA OR 0.20, 95% CI 0.0-0.8, p = 0.021; without SBA OR = 0.4, 95% CI 0.2-0.7, p = 0.002) than in those born in hospital. Socio-demographic factors such as ethnicity, rural living, education, socio-economic status and access to transport did not influence neonatal hospitalisation, time in hospital, incubator care or time under incubator care. Neonates born at home were less likely to be hospitalised after birth owing to neonatal morbidity than neonates born in hospital. It is unclear whether this finding reflects poorer accessibility to hospital care for neonates born at home, or if neonates born at home required hospitalisation less frequently than neonates born in hospital owing to lower neonatal morbidity or other factors such as lower rates of medical intervention for home births. Further research is needed to explore the underlying mechanisms of these findings.

  12. Evaluating Latino WIC Mothers' Perceptions of Infant's Healthy Growth: A Formative Assessment.

    PubMed

    Valencia, Angela C; Thomson, Cynthia A; Duncan, Burris; Arthur, Andrew

    2016-03-01

    This article reports on a formative assessment with Latino mothers in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) evaluating knowledge, attitudes and behaviors regarding healthy growth for infants and their understanding of infant growth monitoring. Further, we explored the acceptability and feasibility of mothers' monitoring their infants' growth. This assessment includes healthy growth perceptions from mothers, caregivers and from WIC staff. Utilizing a mixed method approach, this assessment included qualitative focus groups with WIC mothers that included a growth chart plotting exercise and a quantitative survey. In-depth interviews with clinic staff discussing protocols used in assessing children's growth were also conducted in one WIC clinic. Focus group participants included 34 mothers and 19 caregivers with a mean age of 32 years; 90 % identified as Latino. Themes included concern for underweight status, and reports of limited conversations between mothers and healthcare providers regarding overweight status, and infant feeding practices/beliefs that may contribute to feeding behaviors associated with risk for excess weight gain during infancy. Growth charts were well received, mothers were able to plot with modest accuracy; but effectiveness of growth plotting might be limited without refinement for health literacy and the provision of culturally-sensitive education in relation to feeding behaviors to support healthy infant growth. This represents a first effort in evaluating Latino mothers' perceptions of infants' healthy growth and use growth charts as a potential tool that can help prevent excess weight gain in early infancy.

  13. Macrosomia Predictors in Infants Born to Cuban Mothers with Gestational Diabetes.

    PubMed

    Cruz, Jeddú; Grandía, Raiden; Padilla, Liset; Rodríguez, Suilbert; Hernández García, Pilar; Lang Prieto, Jacinto; Márquez-Guillén, Antonio

    2015-07-01

    INTRODUCTION Fetal macrosomia is the most important complication in infants of women with diabetes, whether preconceptional or gestational. Its occurrence is related to certain maternal and fetal conditions and negatively affects maternal and perinatal outcomes. The definitive diagnosis is made at birth if a newborn weighs >4000 g. OBJECTIVE Identify which maternal and fetal conditions could be macrosomia predictors in infants born to Cuban mothers with gestational diabetes. METHODS A case-control study comprising 236 women with gestational diabetes who bore live infants (118 with macrosomia and 118 without) was conducted in the América Arias University Maternity Hospital, Havana, Cuba, during 2002-2012. The dependent variable was macrosomia (birth weight >4000 g). Independent maternal variables included body mass index at pregnancy onset, overweight or obesity at pregnancy onset, gestational age at diabetes diagnosis, pregnancy weight gain, glycemic control, triglycerides and cholesterol. Fetal variables examined included third-semester fetal abdominal circumference, estimated fetal weight at ≥28 weeks (absolute and percentilized by Campbell and Wilkin, and Usher and McLean curves). Chi square was used to compare continuous variables (proportions) and the student t test (X ± SD) for categorical variables, with significance threshold set at p <0.05. ORs and their 95% CIs were calculated. RESULTS Significant differences between cases and controls were found in most variables studied, with the exception of late gestational diabetes diagnosis, total fasting cholesterol and hypercholesterolemia. The highest OR for macrosomia were for maternal hypertriglyceridemia (OR 4.80, CI 2.34-9.84), third-trimester fetal abdominal circumference >75th percentile (OR 7.54, CI 4.04-14.06), and estimated fetal weight >90th percentile by Campbell and Wilkin curves (OR 4.75, CI 1.42-15.84) and by Usher and McLean curves (OR 8.81, CI 4.25-18.26). CONCLUSIONS Most variables assessed

  14. A program to provide hepatitis B immunoprophylaxis to infants born to HBsAg-positive Asian and Pacific Island women.

    PubMed

    Klontz, K C

    1987-02-01

    Between January 1, 1984, and December 31, 1985, there were 545 women from Asia and the Pacific Islands who gave birth to a total of 572 infants at Highland General Hospital in Oakland, California (accounting for 20% of all deliveries at that hospital). For countries having more than ten women giving birth during the study period, the percentage of women screened prenatally for HBs antigen (Ag) ranged from a high of 100% (Laos) to a low of 54% (Philippines). HBsAg-positivity rates ranged from a high of 21% (Tonga) to a low of 0% (India). A total of 52 infants was born to 49 HBsAg-positive mothers, and 40 (77%) of the infants received hepatitis B immune globulin (HBIG) within 12 hours of birth. While 80% of the infants received HBIG and at least one dose of hepatitis B vaccine, only 35% received the recommended schedule of HBIG and three doses of vaccine.

  15. HIV testing and retention in care of infants born to HIV- infected women enrolled in 'Option B+', Thyolo, Malawi.

    PubMed

    Martínez Pérez, G; Metcalf, C; Garone, D; Coulborn, R; Harries, A D; Hedt-Gauthier, B; Murowa, M; Mwenelupembe, G S; Van den Bergh, R; Triviño Durán, L

    2014-06-21

    Prevention of mother-to-child transmission 'Option B+' originated in Malawi in 2011 to prevent new infections in infants exposed to the human immunodeficiency virus (HIV). We assessed 12-month programme retention and HIV testing uptake among infants born to HIV-infected mothers from September 2011 to June 2012 in Thyolo District Hospital. Of 513 infants, 368 (71.7%) remained in care at 12 months. Altogether, 412 (80.3%) underwent HIV DNA polymerase chain reaction testing, with 267 (52.0%) tested at 6-12 weeks, and 255 (49.7%) underwent rapid HIV testing, with 144 (28.1%) tested at 12 months. Eighty-eight (17.2%) infants had both tests as scheduled. Measures are needed to improve adherence to national testing protocols.

  16. Growth of the hard palate in infants with Down syndrome compared with healthy infants-A retrospective case control study.

    PubMed

    Klingel, Daniel; Hohoff, Ariane; Kwiecien, Robert; Wiechmann, Dirk; Stamm, Thomas

    2017-01-01

    To investigate morphological differences of the hard palate in infants with Down syndrome (DS) compared with a volumetric-matched control group (CG). Trial design: retrospective case control study. Based on inclusion and exclusion criteria, plaster casts of edentulous maxillae of 40 DS infants (20 females and 20 males, aged 221.3 ± 132.4 days) and 40 CG infants (20 females and 20 males, aged 53.9 ± 87.2 days) were digitized and converted into 3-dimensional stereolithography data. An automated landmark- and investigator-independent method for assessing two-dimensional measurements such as width, depth, and length of palate, as well as palatal index and the 3-dimensional volume, were used. Matching DS and healthy CG infants by age, we found reduced sizes in all linear and volumetric measurements in the DS group. Matching both groups by palatal volume, we found no differences between the groups according to palatal width (p = .93), palatal depth (p = .32), and palatal index (p = .31). Control infants with the same palatal volume compared with the DS infants were about 151 days younger, 95%-CI = [102, 200] (Hodges-Lehmann estimator). Except for palatal length and palatal volume, the growth pattern of DS palates decreased irregularly at age 6 to 9 months. The palate of DS infants in the first 6 to 9 month of life is of normal shape but considerably smaller compared with healthy normals. From 6 to 9 months onward, the growth pattern of the hard palate in DS infants decreases irregularly. High-arch-constricted palates could, therefore, be interpreted as secondarily acquired in later life. We therefore speculate that it could be advantageous to begin oral muscular stimulating therapy between 6 and 9 months of age which may prevent palatal shape alterations and enhance oral function which also contributes to maxillary development.

  17. Zinc for preterm infants: Who needs it and how much is needed?

    USDA-ARS?s Scientific Manuscript database

    The establishment of micronutrient requirements for infants remains a challenge. For healthy full-term infants, breast milk is an appropriate standard for virtually all nutrients. In contrast, guidelines for infants who are not healthy, and infants who are born preterm, are much more tenuous....

  18. Influence of Socioeconomic Context on the Rehospitalization Rates of Infants Born Preterm.

    PubMed

    Laugier, Olivia; Garcia, Patricia; Boucékine, Mohamed; Daguzan, Alexandre; Tardieu, Sophie; Sambuc, Roland; Boubred, Farid

    2017-09-08

    To investigate the impact of social inequalities on the risk of rehospitalization in the first year after discharge from the neonatal unit in a population of preterm-born children. Preterm infants were included if they were born between 2006 and 2013 at ≤32 + 6 weeks of gestation and who received follow-up in a French regional medical network with a high level of healthcare. Socioeconomic context was estimated using a neighborhood-based socioeconomic deprivation index. Univariate and logistic regression analyses were used to identify risk factors associated with rehospitalization. For the 2325 children, the mean gestational age was 29 ± 2 weeks and the mean birth weight was 1315 ± 395 g. In the first year, 22% were rehospitalized (n = 589); respiratory diseases were the primary cause (44%). The multiple rehospitalization rate was 18%. Multivariable analysis showed that living in the most deprived neighborhoods (socioeconomic deprivation index of 5) was associated with overall rehospitalization (OR, 2.2; 95% CI, 1.5-3.6; P <.001), and multiple rehospitalizations (OR, 2.5; 95% CI, 1.2-4.9; P <.01); with socioeconomic deprivation index of 1 (least deprived) as reference. Deprivation was associated with all causes of hospitalization. Female sex (P <.001) and living in an urban area (P = .001) were protective factors. Despite regional routine follow-up for all children, rehospitalization after very preterm birth was higher for children living in deprived neighborhoods. Families' social circumstances need to be considered when evaluating the health consequences of very preterm birth. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Screening for language delay after life-saving therapies in term-born infants.

    PubMed

    Clark, Brenda G; Acton, Bryan V; Alton, Gwen Y; Joffe, Ari R; Dinu, Irina A; Robertson, Charlene M T

    2016-10-01

    Strong recommendations have been made for the periodic developmental surveillance, screening, and evaluation of children with CHD. This supports similar calls for all at-risk children in order to provide timely, structured early developmental intervention that may improve outcomes. The aim of this study was to determine the accuracy of screening for language delay after life-saving therapies using the parent-completed vocabulary screen of the language Development Survey, by comparing screening with the individually administered language scores of the Bayley Scales of Infant and Toddler Development, Third edition. In total, 310 (92.5%) of 335 eligible term-born children, born between 2004 and 2011, receiving complex cardiac surgery, heart or liver transplantation, or extracorporeal membrane oxygenation in infancy, were assessed at 21.5 (2.8) months of age (lost, 25 (7.5%)), through developmental/rehabilitation centres at six sites as part of the Western Canadian Complex Pediatric Therapies Follow-up Group. Vocabulary screening delay was defined as scores ⩽15th percentile. Language delay defined as scores >1 SD below the mean was calculated for language composite score, receptive and expressive communication scores of the Bayley-III. Delayed scores for the 310 children were as follows: vocabulary, 144 (46.5%); language composite, 125 (40.3%); receptive communication, 98 (31.6%); and expressive communication, 124 (40%). Sensitivity, specificity, positive predictive values, and negative predictive values of screened vocabulary delay for tested language composite delay were 79.2, 75.7, 68.8, and 84.3%, respectively. High rates of language delay after life-saving therapies are concerning. Although the screening test appears to over-identify language delay relative to the tested Bayley-III, it may be a useful screening tool for early language development leading to earlier referral for intervention.

  20. [Sensory system development and the physical environment of infants born very preterm].

    PubMed

    Kuhn, P; Zores, C; Astruc, D; Dufour, A; Casper, Ch

    2011-07-01

    The sensory systems develop in several sequences, with a process specific to each system and with a transnatal continuum. This development is based partly on interactions between the fetus and the newborn and their physical and human environments. These interactions are key drivers of the child development. The adaptation of the newborn's environment is crucial for his survival, his well-being and his development, especially if he is born prematurely. The physical environment of the hospital where immature infants are immersed differs greatly from the uterine environment from which they were extracted prematurely. There are discrepancies between their sensory expectations originating in the antenatal period and the atypical stimuli that newborns encounter in their postnatal nosocomial environment. These assertions are valid for all sensory modalities. Many studies have proven that very preterm infants are highly sensitive to this environment which can affect their physiological and behavioural well being. Moreover, it can alter their perception of important human sensory signals, particularly the ones coming from their mother. The long term impacts of this environment are more difficult to identify due to the multi-sensory nature of these stimuli and the multifactorial origin of the neurological disorders that these children may develop. However, the adaptation of their physical environment is one of the corner stones of specific developmental care programs, like the NIDCAP program that has been shown to be successful to improve their short and medium term outcomes. The architectural design, technical equipment and used health-care products, and the strategies and organizations of care are the main determinants of the physical environment of these children. Recommendations for the hospital environment, integrating a newborn's developmental perspective, have been made available. They should be applied more widely and should be completed. Technological equipment

  1. Mother-to-infant transmission of multiple blood-borne viral infections from multi-infected mothers.

    PubMed

    Indolfi, Giuseppe; Moriondo, Maria; Galli, Luisa; Azzari, Chiara; Poggi, Giovanni Maria; Resti, Massimo; de Martino, Maurizio

    2007-06-01

    Infants born from mothers with multiple blood-borne viral infections are at risk of multiple transmissions. Whether the risk of transmission of multiple infections increases with the number of viruses infecting the mother is still unknown. The aim of this study was to describe the risk of mother-to-infant transmission of multiple infections from multi-infected mothers. Sixty-four pregnant women infected by at least two viruses among human immunodeficiency virus-type 1 (HIV-1), hepatitis C virus, TT virus, and GB virus type C, together with their 64 infants, were studied. Maternal blood samples were collected in the third trimester of pregnancy and all infants were prospectively followed for evaluation of transmission within 3 months after birth and two times in the subsequent 24 months. Transmission of single and of dual infection from mothers infected by two viruses was, respectively, 10/40 (25%) and 5/40 (12.5%) and from mothers infected by three viruses 9/20 (45%) and 2/20 (10%). One (25%) infant infected by one virus was born from the four mothers infected by four viruses. Transmission of single or dual infection was not significantly associated with the number of viruses infecting the mother (P = 0.9) in the linear regression analysis. Present study suggests the absence of a synergistic effect from viral interactions toward mother-to-infant transmission of multiple infections and supports the hypothesis that transmission from multi-infected mothers is the result of the specific interaction between each virus and the host. These observations may be of clinical relevance in perinatal counseling. (c) 2007 Wiley-Liss, Inc.

  2. Circulating GLP-1 in infants born small-for-gestational-age: breast-feeding versus formula-feeding.

    PubMed

    Díaz, M; Bassols, J; Sebastiani, G; López-Bermejo, A; Ibáñez, L; de Zegher, F

    2015-10-01

    Prenatal growth restraint associates with the risk for later diabetes, particularly if such restraint is followed by postnatal formula-feeding (FOF) rather than breast-feeding (BRF). Circulating incretins can influence the neonatal programming of hypothalamic setpoints for appetite and energy expenditure, and are thus candidate mediators of the long-term effects exerted by early nutrition. We have tested this concept by measuring (at birth and at age 4 months) the circulating concentrations of glucagon-like peptide-1 (GLP-1) in BRF infants born appropriate-for-gestational-age (AGA; n=63) and in small-for-gestational-age (SGA) infants receiving either BRF (n=28) or FOF (n=26). At birth, concentrations of GLP-1 were similar in AGA and SGA infants. At 4 months, pre-feeding GLP-1 concentrations were higher than at birth; SGA-BRF infants had GLP-1 concentrations similar to those in AGA-BRF infants but SGA-FOF infants had higher concentrations. In conclusion, nutrition appears to influence the circulating GLP-1 concentrations in SGA infants and may thereby modulate long-term diabetes risk.

  3. Comparison at 32-37 Weeks Postconception of Infants Born 1983-1989 and 1995-2004 on the Neurobehavioral Assessment of the Preterm Infant

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Bakeman, Roger; Sampers, Jackie S.; Korner, Anneliese F.; Constantinou, Janet C.; Anand, K. J. S.

    2008-01-01

    In spite of numerous recent outcome studies of extremely low birth weight (ELBW) infants, no data exist on their development prior to term. In this study we traced and compared the neurobehavioral development of 251 ELBW (less than 1,000 g) and 240 low birth weight (LBW; 1,000 g-2,500 g) preterms born between 1995 and 2004 from 32 to 37 weeks…

  4. Body composition in full-term healthy infants measured with air displacement plethysmography at 1 and 12 weeks of age.

    PubMed

    Eriksson, Britt; Löf, Marie; Forsum, Elisabet

    2010-04-01

    To use Pea Pod, a device based on air displacement plethysmography, to study body composition of healthy, full-term infants born to well-nourished women with a western life-style. Body composition was assessed in 53 girls and 55 boys at 1 week (before 10 days of age) and at 12 weeks (between 77 and 91 days of age). At 1 week girls contained 13.4 +/- 3.7% body fat and boys 12.5 +/- 4.0%. At 12 weeks, these figures were 26.3 +/- 4.2% (girls) and 26.4 +/- 5.1% (boys). Body fat (%) did not differ significantly between the genders. Body fat (%) at the two measurements was not correlated. At 1 week, the weight (r = 0.20, p = 0.044) and BMI (r = 0.26, p = 0.007) of the infants, but not their body fat (g, %) or fat free mass (g), correlated with BMI before pregnancy in their mothers. Pea Pod has potential for use in studies investigating the effect of external (i.e. nutritional status) and internal (i.e. age, gender, gestational age at birth) factors on infant body composition. This may be of value when studying relationships between the nutritional situation during early life and adult health.

  5. Infants born to narcotic dependent mothers: physical growth patterns in the first 12 months of life.

    PubMed

    Vance, J C; Chant, D C; Tudehope, D I; Gray, P H; Hayes, A J

    1997-12-01

    To describe the physical growth patterns of infants born to narcotic dependent mothers (INDM) over a 12 months period and, if possible, to relate the growth to drug taking patterns during pregnancy. The growth of a cohort of 43 INDM was measured during the first 12 months of life. Weight and length measurements were compared with percentile charts and converted to Z scores. Questionnaire data about drug taking practices, demographic variables and the neonatal period (including withdrawal scores) were obtained. Twenty-four (55.8%) of INDM had evidence of neonatal drug withdrawal requiring treatment with phenobarbitone. At birth, Z scores for weight and length indicated relative intrauterine growth retardation. By 12 months, there had been some catch up growth, but Z scores for weight and length were still below zero. Persistent weight retardation at 12 months was correlated with methadone dosage during pregnancy, but not the need for phenobarbitone therapy. The growth patterns of INDM in the first 12 months of life indicated that at birth there was evidence of intrauterine growth retardation, but by 12 months the growth was little different from the rest of the community. There appears to be some influence of narcotic agents taken while pregnant on subsequent growth of INDM.

  6. Assessment of congenital anomalies in infants born to pregnant women enrolled in clinical trials.

    PubMed

    Rasmussen, Sonja A; Hernandez-Diaz, Sonia; Abdul-Rahman, Omar A; Sahin, Leyla; Petrie, Carey R; Keppler-Noreuil, Kim M; Frey, Sharon E; Mason, Robin M; Nesin, Mirjana; Carey, John C

    2014-12-15

    In 2011 and 2012, the Division of Microbiology and Infectious Diseases at the National Institute of Allergy and Infectious Diseases, National Institutes of Health, held a series of meetings to provide guidance to investigators regarding study design of clinical trials of vaccines and antimicrobial medications that enroll pregnant women. Assessment of congenital anomalies among infants born to women enrolled in these trials was recognized as a challenging issue, and a workgroup with expertise in epidemiology, pediatrics, genetics, dysmorphology, clinical trials, and infectious diseases was formed to address this issue. The workgroup considered 3 approaches for congenital anomalies assessment that have been developed for use in other studies: (1) maternal report combined with medical records review, (2) standardized photographic assessment and physical examination by a health professional who has received specific training in congenital anomalies, and (3) standardized physical examination by a trained dysmorphologist (combined with maternal interview and medical records review). The strengths and limitations of these approaches were discussed with regard to their use in clinical trials. None of the approaches was deemed appropriate for use in all clinical trials. Instead, the workgroup acknowledged that decisions regarding the optimal method of assessment of congenital anomalies will likely vary depending on the clinical trial, its setting, and the agent under study; in some cases, a combination of approaches may be appropriate. The workgroup recognized the need for more research on approaches to the assessment of congenital anomalies to better guide investigators in optimal design of clinical trials that enroll pregnant women.

  7. A randomized controlled trial of feeding a concentrated formula to infants born to women infected by Human Immunodeficiency Virus

    PubMed Central

    Winter, Harland S.; Oleske, James M.; Hughes, Michael D.; McKinney, Ross E.; Elgie, Carol; Powell, Christine; Purdue, Lynette; Puga, Ana M.; Jimenez, Eleanor; Scott, Gwendolyn B.; Cruz, Maria Leticia Santos; Moye, Jack

    2014-01-01

    Objective We tested the hypothesis that concentrated formula begun within the first two weeks of life increases growth in infants born to HIV-infected mothers. Study Design HIV-exposed infants from the U.S., Bahamas, and Brazil were randomized in a double-blind controlled trial to receive either a concentrated 87 kcal/100 ml (26 kcal/oz) formula (CF) or standard 67 kcal/100 ml (20 kcal/oz) formula (SF) for 8 weeks. This paper presents results for infants who were not determined to be HIV-infected based on testing at 4 weeks. Primary outcomes were safety, tolerability, and growth in weight and length. Results 2,097 infants were enrolled, of whom 1998 were uninfected and had study formula dispensed. At weeks 4 and 8, uninfected infants receiving CF showed higher energy intake compared with uninfected infants receiving SF (P<0.001). By week 8, uninfected infants assigned to CF weighed more than infants on SF. There were no consistent differences in measures of tolerability, and rates of discontinuation or perceived formula intolerance were similar between treatment groups. Conclusions A concentrated formula is well tolerated and results in increased weight gain compared with SF. Until the HIV-status of an infant is reliably determined, early introduction of a concentrated formula in HIV-exposed children may have beneficial effects on growth. The role of early nutritional intervention remains to be determined for individuals living in countries with endemic malnutrition for whom formula feeding is a viable option. PMID:19543114

  8. 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.

  9. Approach to infants born at 22 to 24 weeks' gestation: relationship to outcomes of more-mature infants.

    PubMed

    Smith, P Brian; Ambalavanan, Namasivayam; Li, Lei; Cotten, C Michael; Laughon, Matthew; Walsh, Michele C; Das, Abhik; Bell, Edward F; Carlo, Waldemar A; Stoll, Barbara J; Shankaran, Seetha; Laptook, Abbot R; Higgins, Rosemary D; Goldberg, Ronald N

    2012-06-01

    We sought to determine if a center's approach to care of premature infants at the youngest gestational ages (22-24 weeks' gestation) is associated with clinical outcomes among infants of older gestational ages (25-27 weeks' gestation). Inborn infants of 401 to 1000 g birth weight and 22 0/7 to 27 6/7 weeks' gestation at birth from 2002 to 2008 were enrolled into a prospectively collected database at 20 centers participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Markers of an aggressive approach to care for 22- to 24-week infants included use of antenatal corticosteroids, cesarean delivery, and resuscitation. The primary outcome was death before postnatal day 120 for infants of 25 to 27 weeks' gestation. Secondary outcomes were the combined outcomes of death or a number of morbidities associated with prematurity. Our study included 3631 infants 22 to 24 weeks' gestation and 5227 infants 25 to 27 weeks' gestation. Among the 22- to 24-week infants, use of antenatal corticosteroids ranged from 28% to 100%, cesarean delivery from 13% to 65%, and resuscitation from 30% to 100% by center. Centers with higher rates of antenatal corticosteroid use in 22- to 24-week infants had reduced rates of death, death or retinopathy of prematurity, death or late-onset sepsis, death or necrotizing enterocolitis, and death or neurodevelopmental impairment in 25- to 27-week infants. This study suggests that physicians' willingness to provide care to extremely low gestation infants as measured by frequency of use of antenatal corticosteroids is associated with improved outcomes for more-mature infants.

  10. Nutrition for healthy term infants, six to 24 months: An overview.

    PubMed

    Critch, Jeffrey N

    2014-12-01

    Nutrition for Healthy Term Infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada. It was republished in September 2012, with recommendations on infant feeding from birth to six months of age. The statement was most recently updated in April 2014, with recommendations for feeding older infants and young children from six to 24 months of age. The present practice point outlines the statement development process and principles of feeding, with specific recommendations for clinicians. Health professionals who counsel families on nutrition in infants and young children are advised to read the statement in its entirety because discussion in the longer document expands on and clarifies advice summarized in the principles and recommendations given here. The complete statement is available on Health Canada's website: www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/index-eng.php.

  11. UK-born Pakistani-origin infants are relatively more adipose than white British infants: findings from 8704 mother-offspring pairs in the Born-in-Bradford prospective birth cohort

    PubMed Central

    West, Jane; Lawlor, Debbie A; Fairley, Lesley; Bhopal, Raj; Cameron, Noel; McKinney, Patricia A; Sattar, Naveed; Wright, John

    2013-01-01

    Background Previous studies have shown markedly lower birth weight among infants of South Asian origin compared with those of White European origin. Whether such differences mask greater adiposity in South Asian infants and whether they persist across generations in contemporary UK populations is unclear. Our aim was to compare birth weight, skinfold thickness and cord leptin between Pakistani and White British infants and to investigate the explanatory factors, including parental and grandparental birthplace. Methods We examined the differences in birth weight and skinfold thickness between 4649 Pakistani and 4055 White British infants born at term in the same UK maternity unit and compared cord leptin in a subgroup of 775 Pakistani and 612 White British infants. Results Pakistani infants were lighter (adjusted mean difference −234 g 95% CI −258 to −210) and were smaller in both subscapular and triceps skinfold measurements. The differences for subscapular and triceps skinfold thickness (mean z-score difference −0.27 95% CI −0.34 to −0.20 and −0.23 95% CI −0.30 to −0.16, respectively) were smaller than the difference in birth weight (mean z-score difference −0.52 95% CI −0.58 to −0.47) and attenuated to the null with adjustment for birth weight (0.03 95% CI −0.03 to 0.09 and −0.01 95% CI −0.08 to 0.05, respectively). Cord leptin concentration (indicator of fat mass) was similar in Pakistani and White British infants without adjustment for birth weight, but with adjustment became 30% higher (95% CI 17% to 44%) among Pakistani infants compared with White British infants. The magnitudes of difference did not differ by generation. Conclusions Despite being markedly lighter, Pakistani infants had similar skinfold thicknesses and greater total fat mass, as indicated by cord leptin, for a given birth weight than White British infants. Any efforts to reduce ethnic inequalities in birth weight need to consider differences in adiposity and

  12. Small-for-gestational-age preterm-born infants already have lower bone mass during early infancy.

    PubMed

    van de Lagemaat, Monique; Rotteveel, Joost; van Weissenbruch, Mirjam M; Lafeber, Harrie N

    2012-09-01

    In preterm-born infants, low birth weight and diminished bone accretion deteriorate peak bone mass. Whether low birth weight is already associated with decreased bone mass during infancy is unknown. To study the effect of birth weight on bone accretion between term age (40 weeks postmenstrual age) and six months post-term in preterm-born infants. In 139 preterm-born infants (51% male, gestational age 30.3±1.5 weeks, birth weight 1341±288g) weight and whole-body bone mineral content (BMC, gram) were measured at term age and six months post-term. At birth, infants were small-for-gestational-age (SGA, n=33, weight and/or length<-2 SDS) or appropriate-for-gestational-age (AGA, n=98, weight and length≥-2 SDS). At term age and six months post-term, BMC adjusted for gender and gestational age was lower in SGA than AGA infants (term age: 38.1±9.5 versus 48.6±10.1g, β=-0.26, 95% CI -0.37; -0.16, p<0.001; six months: 130.1±25.7 versus 145.4±22.9g, β=-0.16, 95% CI -0.25; -0.08, p<0.001). At six months post-term, BMC remained lower in SGA infants after adjustment for actual weight and length. Between term age and six months post-term, BMC gain adjusted for gender and gestational age was lower in SGA than AGA infants (91.7±22.8 versus 98.2±20.7g; β=-0.12, 95% CI -0.24; -0.003, p=0.044). BMC gain remained lower in SGA infants after adjustment for weight and length gain. The first six months post-term, SGA preterms have lower bone accretion, independent of body size, suggesting that prenatal conditions for bone accretion cannot be replicated postnatally. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Body Composition Is Normal in Term Infants Born to Mothers With Well-Controlled Gestational Diabetes Mellitus

    PubMed Central

    Au, Cheryl P.; Raynes-Greenow, Camille H.; Turner, Robin M.; Carberry, Angela E.; Jeffery, Heather E.

    2013-01-01

    OBJECTIVE This study aims to describe body composition in term infants of mothers with gestational diabetes mellitus (GDM) compared with infants of mothers with normal glucose tolerance (NGT). RESEARCH DESIGN AND METHODS This cross-sectional study included 599 term babies born at Royal Prince Alfred Hospital, Sydney, Australia. Neonatal body fat percentage (BF%) was measured within 48 h of birth using air-displacement plethysmography. Glycemic control data were based on third-trimester HbA1c levels and self-monitoring blood glucose levels. Associations between GDM status and BF% were investigated using linear regression adjusted for relevant maternal and neonatal variables. RESULTS Of 599 babies, 67 (11%) were born to mothers with GDM. Mean ± SD neonatal BF% was 7.9 ± 4.5% in infants with GDM and 9.3 ± 4.3% in infants with NGT, and this difference was not statistically significant after adjustment. Good glycemic control was achieved in 90% of mothers with GDM. CONCLUSIONS In this study, neonatal BF% did not differ by maternal GDM status, and this may be attributed to good maternal glycemic control. PMID:23223404

  14. IGF-I and relation to growth in infancy and early childhood in very-low-birth-weight infants and term born infants.

    PubMed

    de Jong, Miranda; Cranendonk, Anneke; Twisk, Jos W R; van Weissenbruch, Mirjam M

    2017-01-01

    In very-low-birth-weight infants IGF-I plays an important role in postnatal growth restriction and is probably also involved in growth restriction in childhood. We compared IGF-I and its relation to growth in early childhood in very-low-birth-weight infants and term appropriate for gestational age born infants. We included 41 very-low-birth-weight and 64 term infants. Anthropometry was performed at all visits to the outpatient clinic. IGF-I and insulin were measured in blood samples taken at 6 months and 2 years corrected age (very-low-birth-weight children) and at 3 months, 1 and 2 years (term children). Over the first 2 years of life growth parameters are lower in very-low-birth-weight children compared to term children, but the difference in length decreases significantly. During the first 2 years of life IGF-I is higher in very-low-birth-weight children compared to term children. In both groups there is a significant relationship between IGF-I and (change in) length and weight over the first 2 years of life and between insulin and change in total body fat. Considering the relation of IGF-I to growth and the decrease in difference in length, higher IGF-I levels in very-low-birth-weight infants in early childhood probably have an important role in catch-up growth in length.

  15. IGF-I and relation to growth in infancy and early childhood in very-low-birth-weight infants and term born infants

    PubMed Central

    de Jong, Miranda; Cranendonk, Anneke; Twisk, Jos W. R.; van Weissenbruch, Mirjam M.

    2017-01-01

    Background In very-low-birth-weight infants IGF-I plays an important role in postnatal growth restriction and is probably also involved in growth restriction in childhood. We compared IGF-I and its relation to growth in early childhood in very-low-birth-weight infants and term appropriate for gestational age born infants. Methods We included 41 very-low-birth-weight and 64 term infants. Anthropometry was performed at all visits to the outpatient clinic. IGF-I and insulin were measured in blood samples taken at 6 months and 2 years corrected age (very-low-birth-weight children) and at 3 months, 1 and 2 years (term children). Results Over the first 2 years of life growth parameters are lower in very-low-birth-weight children compared to term children, but the difference in length decreases significantly. During the first 2 years of life IGF-I is higher in very-low-birth-weight children compared to term children. In both groups there is a significant relationship between IGF-I and (change in) length and weight over the first 2 years of life and between insulin and change in total body fat. Conclusions Considering the relation of IGF-I to growth and the decrease in difference in length, higher IGF-I levels in very-low-birth-weight infants in early childhood probably have an important role in catch-up growth in length. PMID:28182752

  16. Randomized controlled trial of feeding a concentrated formula to infants born to women infected by human immunodeficiency virus.

    PubMed

    Winter, Harland S; Oleske, James M; Hughes, Michael D; McKinney, Ross E; Elgie, Carol; Powell, Christine; Purdue, Lynette; Puga, Ana M; Jimenez, Eleanor; Scott, Gwendolyn B; Cruz, Maria Leticia Santos; Moye, Jack

    2009-08-01

    We tested the hypothesis that concentrated formula (CF) begun within the first 2 weeks of life increases growth in infants born to human immunodeficiency virus (HIV)-infected mothers. HIV-exposed infants from the United States, the Bahamas, and Brazil were randomized in a double-blind, controlled trial to receive either a CF (87 kcal/100 mL [26 kcal/oz]) or a standard formula (SF; 67 kcal/100 mL [20 kcal/oz]) for 8 weeks. This article presents results for infants who were not determined to be HIV infected based on testing at 4 weeks. Primary outcomes were safety, tolerability, and growth in weight and length. Two thousand ninety-seven infants were enrolled, of whom 1998 were uninfected and had study formula dispensed. At weeks 4 and 8, uninfected infants receiving CF showed higher energy intake than those who were receiving SF (P < 0.001). By week 8, uninfected infants assigned to CF weighed more than infants receiving SF. There were no consistent differences in measures of tolerability, and rates of discontinuation or perceived formula intolerance were similar between treatment groups. A CF is well tolerated and results in increased weight gain compared with SF. Until the HIV status of an infant is reliably determined, early introduction of a CF in HIV-exposed children may have beneficial effects on growth. The role of early nutritional intervention remains to be determined for individuals living in countries with endemic malnutrition for whom formula feeding is a viable option.

  17. Neonatal Group B Streptococcal Disease in Otherwise Healthy Infants: Failure of Specific Neonatal Immune Responses

    PubMed Central

    Borghesi, Alessandro; Stronati, Mauro; Fellay, Jacques

    2017-01-01

    Only a small proportion of newborn infants exposed to a pathogenic microorganism develop overt infection. Susceptibility to infection in preterm infants and infants with known comorbidities has a likely multifactorial origin and can be often attributed to the concurrence of iatrogenic factors, environmental determinants, underlying pathogenic processes, and probably genetic predisposition. Conversely, infection occurring in otherwise healthy full-term newborn infants is unexplained in most cases. Microbial virulence factors and the unique characteristics of the neonatal immune system only partially account for the interindividual variability in the neonatal immune responses to pathogens. We here suggest that neonatal infection occurring in otherwise healthy infants is caused by a failure of the specific protective immunity to the microorganism. To explain infection in term and preterm infants, we propose an extension of the previously proposed model of the genetic architecture of infectious diseases in humans. We then focus on group B streptococcus (GBS) disease, the best characterized neonatal infection, and outline the potential molecular mechanisms underlying the selective failure of the immune responses against GBS. In light of the recent discoveries of pathogen-specific primary immunodeficiencies and of the role of anticytokine autoantibodies in increasing susceptibility to specific infections, we hypothesize that GBS disease occurring in otherwise healthy infants could reflect an immunodeficiency caused either by rare genetic defects in the infant or by transmitted maternal neutralizing antibodies. These hypotheses are consistent with available epidemiological data, with clinical and epidemiological observations, and with the state of the art of neonatal physiology and disease. Studies should now be designed to comprehensively search for genetic or immunological factors involved in susceptibility to severe neonatal infections. PMID:28326082

  18. Prediction of outcome in new-born infants with arterial ischaemic stroke using diffusion-weighted magnetic resonance imaging.

    PubMed

    De Vries, L S; Van der Grond, J; Van Haastert, I C; Groenendaal, F

    2005-02-01

    The aim of this study was to assess the additional value of diffusion-weighted magnetic resonance imaging (DW-MRI) compared to conventional magnetic resonance imaging (MRI) in new-born infants with arterial ischaemic stroke, with regard to the prediction of neurodevelopmental outcome. Neonatal DW-MRI data were available in 15 infants with a gestational age of > or = 35 weeks and repeat MRI data were obtained in 12 of the 14 survivors. T(1)- and T(2)-weighted transverse images were obtained as well as 4-mm DWI slices. ADC maps were calculated in manually selected regions on the basis of the DWI scans. All 14 survivors were seen in the follow-up clinic and 12 were > 18 months when last seen. T (2) hyperintensity was detected in the descending white matter tracts at the level of the internal capsule in 7 infants and in only one of these also at the level of the cerebral peduncles. Increased signal intensity (SI) was seen on DW-MRI in 8 infants in the descending white matter tract ipsilateral to the territorial infarct at the level of the internal capsule and in 5 of these also at the level of the cerebral peduncles. ADC maps were available in 12 infants. ADC values were calculated at the level of the cerebral peduncles, using the contralateral side as a reference value. A significantly reduced value was found in 3 of the 5 infants who showed an increased SI on DW-MRI. ADC maps were not available in the other two. Five of the seven infants with abnormalities on DW-MRI/ADC of the corticospinal tracts developed a mild to moderate hemiplegia, one showed an asymmetry of tone and one with only involvement of the anterior part of the internal capsule was normal at follow-up. Wallerian degeneration, seen at the level of the cerebral peduncles and/or the PLIC on the repeat MRI, was seen in the 5 infants who had shown acute changes of the corticospinal tracts in the neonatal period and who went on to develop motor sequelae. Compared to MRI, DW-MRI and ADC maps provided

  19. Alpha-lactalbumin and casein-glycomacropeptide do not affect iron absorption from formula in healthy term infants

    USDA-ARS?s Scientific Manuscript database

    Iron absorption from infant formula is relatively low. Alpha-lactalbumin and casein-glycomacropeptide have been suggested to enhance mineral absorption. We therefore assessed the effect of alpha-lactalbumin and casein-glycomacropeptide on iron absorption from infant formula in healthy term infants. ...

  20. The Children Should Lead Us: Diane Ehrensaft's "Gender Born, Gender Made--Raising Healthy Gender-Nonconforming Children"

    ERIC Educational Resources Information Center

    Beemyn, Genny

    2013-01-01

    This article reviews Diane Ehrensaft's "Gender Born, Gender Made: Raising Healthy Gender-Nonconforming Children", a thoughtful and practical guide that can help parents, other family members, and therapists better understand and support children and youth whom the author refers to as "gender creative." Ehrensaft's work is at the forefront of a…

  1. The Children Should Lead Us: Diane Ehrensaft's "Gender Born, Gender Made--Raising Healthy Gender-Nonconforming Children"

    ERIC Educational Resources Information Center

    Beemyn, Genny

    2013-01-01

    This article reviews Diane Ehrensaft's "Gender Born, Gender Made: Raising Healthy Gender-Nonconforming Children", a thoughtful and practical guide that can help parents, other family members, and therapists better understand and support children and youth whom the author refers to as "gender creative." Ehrensaft's work is at the forefront of a…

  2. Perinatal risk factors for the neonatal abstinence syndrome in infants born to women on methadone maintenance therapy.

    PubMed

    Liu, Anthony J W; Jones, Michael P; Murray, Henry; Cook, Colleen-Maree; Nanan, Ralph

    2010-06-01

    Neonatal abstinence syndrome (NAS) occurs in more than 50% of infants exposed to intrauterine opiates. Maternal opiate dosing has been investigated with conflicting results. The aims of this study were to correlate maternal methadone dose and other risk factors with the development of NAS requiring pharmacological treatment by using easily accessible clinical parameters. Retrospective medical record review of data from 228 opioid dependent pregnant women who delivered 232 live-born infants. Logistic regression analysis was performed on maternal, perinatal and neonatal parameters to identify risk factors for NAS requiring treatment. A prediction model was developed and validated on a separate independent cohort of 188 infants. Of the 232 infants, 172 (74%) infants were treated for NAS. The risk of withdrawal increased by 17% per 5 mg increment of the last maternal methadone dose. The risk was lower for younger gestational ages and for those delivered by Caesarean section compared to those delivered by normal vaginal delivery. Through predictive modeling, gestational age, mode of delivery and last methadone dose were established as risk factors for withdrawal. The model was validated by other statistical measures and its diagnostic performance confirmed on the separate independent cohort. Our data suggests that timing and mode of delivery as well as last maternal methadone dose are significant risk factors for the development of NAS requiring treatment. Based on these clinical parameters, risk stratification for perinatal management of pregnancies associated with opioid dependency and risk prediction for the neonate might now be possible.

  3. Sleep-wake cycle of the healthy term newborn infant in the immediate postnatal period.

    PubMed

    Korotchikova, Irina; Stevenson, Nathan J; Livingstone, Vicki; Ryan, C Anthony; Boylan, Geraldine B

    2016-04-01

    To examine sleep-wake cycle (SWC) composition of healthy term infants in the immediate postnatal period using EEG, and investigate factors that might influence it. Multichannel video-EEG was recorded for a median of 61.9 min (IQR: 60.0-69.3). The absolute and relative scores of sleep states were calculated for each infant's recording. Parametric/non-parametric statistical tests and multiple linear regression analysis were used to investigate the influence of perinatal factors on SWC composition. Eighty healthy term infants aged 1-36 h were studied. A well-developed SWC was evident as early as within the first 6h after birth. The mean (SD) percentage of active sleep (AS) was 52.1% (12.9) and quiet sleep (QS) was 38.6% (12.5). AS was longer and QS shorter in infants delivered by elective caesarean section (CS) compared to infants delivered by vaginal delivery or emergency CS. This is the first large cohort EEG study that has quantified neonatal sleep. SWC is clearly present immediately after birth, it is dominated by AS, and is influenced by mode of delivery. This knowledge of the early neonatal EEG/SWC can be used as reference data for EEG studies of neurologically compromised infants. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  4. Recommendations on complementary feeding for healthy, full-term infants.

    PubMed

    Alvisi, Patrizia; Brusa, Sandra; Alboresi, Stefano; Amarri, Sergio; Bottau, Paolo; Cavagni, Giovanni; Corradini, Barbara; Landi, Linda; Loroni, Leonardo; Marani, Miris; Osti, Irene M; Povesi-Dascola, Carlotta; Caffarelli, Carlo; Valeriani, Luca; Agostoni, Carlo

    2015-04-28

    Weaning (or introduction of complementary feeding) is a special and important moment in the growth of a child, both for the family and the infant itself, and it can play a major role in the child's future health. Throughout the years, various weaning modes have come in succession, the latest being baby-led weaning; the timing for introducing foods and the requirements of which sort of nutrient for weaning have also changed over time. Furthermore, the role played by nutrition, especially in the early stages of life, for the onset of later non-communicable disorders, such as diabetes, obesity or coeliac disease has also been increasingly highlighted.Members of Italian Society of Gastroenterology, Hepathology and Pediatric Nutrition (SIGENP) and the Italian Society of Allergology and Pediatric Immunology (SIAIP) Emilia Romagna here propose a practical approach for pediatricians to deal with daily practice. The four main areas for discussion were weaning in relation with the onset of allergic diseases, coeliac disease, diabetes and metabolic syndrome, the nutrition requirements to take into account for assessing the diet of infants under one year of age and about the practice of baby-led weaning focusing on limits and benefits, respectively.

  5. Birth weight and longitudinal growth in infants born below 32 weeks’ gestation: a UK population study

    PubMed Central

    Cole, Tim J; Statnikov, Yevgeniy; Santhakumaran, Shalini; Pan, Huiqi; Modi, Neena

    2014-01-01

    Objective To describe birth weight and postnatal weight gain in a contemporaneous population of babies born <32 weeks’ gestation, using routinely captured electronic clinical data. Design Anonymised longitudinal weight data from 2006 to 2011. Setting National Health Service neonatal units in England. Methods Birth weight centiles were constructed using the LMS method, and longitudinal weight gain was summarised as mean growth curves for each week of gestation until discharge, using SITAR (Superimposition by Translation and Rotation) growth curve analysis. Results Data on 103 194 weights of 5009 babies born from 22–31 weeks’ gestation were received from 40 neonatal units. At birth, girls weighed 6.6% (SE 0.4%) less than boys (p<0.0001). For babies born at 31 weeks’ gestation, weight fell after birth by an average of 258 g, with the nadir on the 8th postnatal day. The rate of weight gain then increased to a maximum of 28.4 g/d or 16.0 g/kg/d after 3 weeks. Conversely for babies of 22 to 28 weeks’ gestation, there was on average no weight loss after birth. At all gestations, babies tended to cross weight centiles downwards for at least 2 weeks. Conclusions In very preterm infants, mean weight crosses centiles downwards by at least two centile channel widths. Postnatal weight loss is generally absent in those born before 29 weeks, but marked in those born later. Assigning an infant's target centile at birth is potentially harmful as it requires rapid weight gain and should only be done once weight gain has stabilised. The use of electronic data reflects contemporary medical management. PMID:23934365

  6. Improving the outcome of infants born at <30 weeks' gestation - a randomized controlled trial of preventative care at home

    PubMed Central

    2009-01-01

    Background Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems. Methods/Design We have designed a randomized controlled trial to assess the effectiveness of a preventative care program delivered at home over the first 12 months of life for infants born very preterm (<30 weeks of gestational age) and their families, compared with standard medical follow-up. The aim of the program, delivered over nine sessions by a team comprising a physiotherapist and psychologist, is to improve infant development (cognitive, motor and language), behavioral regulation, caregiver-child interactions and caregiver mental health at 24 months' corrected age. The infants will be stratified by severity of brain white matter injury (assessed by magnetic resonance imaging) at term equivalent age, and then randomized. At 12 months' corrected age interim outcome measures will include motor development assessed using the Alberta Infant Motor Scale and the Neurological Sensory Motor Developmental Assessment. Caregivers will also complete a questionnaire at this time to obtain information on behavior, parenting, caregiver mental health, and social support. The primary outcomes are at 24 months' corrected age and include cognitive, motor and language development assessed with the Bayley Scales of Infant and Toddler Development (Bayley-III). Secondary outcomes at 24 months include caregiver-child interaction measured using an observational task, and infant behavior, parenting, caregiver mental health and social support measured via standardized parental questionnaires. Discussion This paper presents the background, study design and protocol for a randomized controlled trial in very preterm infants utilizing a preventative care program

  7. Visual Preferences of Students with Profound Mental Retardation and Healthy, Full-Term Infants.

    ERIC Educational Resources Information Center

    Buhrow, Melissa; Bradley-Johnson, Sharon

    2003-01-01

    Thirty students (ages 3-20) with profound mental retardation and 30 healthy, full-term infants (5-8 months) were shown 12 patterned stimuli, three times each. Both groups looked significantly longer at face patterns than other patterns. However, the students with mental retardation looked longer at black and white patterns than colored patterns,…

  8. Early skin-to-skin contact for healthy full-term infants after vaginal and caesarean delivery: a qualitative study on clinician perspectives.

    PubMed

    Koopman, Inez; Callaghan-Koru, Jennifer A; Alaofin, Oluwatope; Argani, Cynthia H; Farzin, Azadeh

    2016-05-01

    This study aims to provide insight into key factors from a clinician's perspective that influence uninterrupted early skin-to-skin contact after vaginal and caesarean delivery of healthy full-term infants. Early skin-to-skin contact of healthy full-term infants ideally begins immediately after birth and continues for the first hour or the first breastfeed as recommended by the Baby Friendly Hospital Initiative. However, adoption of early skin-to-skin contact is low in many settings and the barriers that hinder its universal use are not well understood. An exploratory qualitative research design using semi-structured interviews. Eleven clinicians were interviewed, including five registered nurses and one medical doctor from the obstetrics and gynaecology unit as well as four registered nurses and one medical doctor from the neonatal intensive care unit. Core topics that were discussed included perceptions on early skin-to-skin contact and facilitating factors and barriers to early skin-to-skin contact after vaginal and caesarean delivery. Interview sessions were recorded, transcribed and analysed using a thematic analysis approach. A coding framework was developed from which subthemes emerged. The overall themes were adopted from Lee et al.'s thematic framework to categorise factors into institutional, familial-level and implementation factors. Critical institutional factors included inadequate staffing and education of clinicians on early skin-to-skin contact. On a familial level, parental education and motivation were identified as important factors. Barriers to implementation included the absence of a clinical algorithm and unclear definitions for eligible mothers and infants. Various facilitating factors and barriers to early skin-to-skin contact of healthy full-term infants born via vaginal and caesarean delivery were identified. Addressing these factors can help to provide a better understanding of clinician perspectives on early skin-to-skin contact and help

  9. Environmental change and water-related, vector borne diseases in eastern Africa: the HEALTHY FUTURES project

    NASA Astrophysics Data System (ADS)

    Taylor, David; Kienberger, Stefan; Tompkins, Adrian

    2015-04-01

    Pathogens that spend time outside the human body, and any organisms involved in their transmission, have particular ecological requirements; as environment, including climate, conditions change, then the transmission characteristics of associated pathogens - and the diseases caused - are also likely to vary. Relationships between environment and health in many parts of the world remain poorly studied and are often overlooked, however. This is particularly the case in developing countries, because of budgetary and available expertise constraints. Moreover the relationship is often confounded by other factors. These other factors contribute to human vulnerability, and thus to the overall disease risk due to environmental change. This presentation will highlight the importance of environmental, including climate, change information to a better understanding of the risks to health of projected future environmental changes, and to the more efficient and effective use of scarce health resources in the developing world. The paper will focus on eastern Africa, and in particular the health effects of future projected environmental change impacts on water-related, vector borne diseases in the East African Community region. Moreover the paper will highlight how the EU FP7-funded project HEALTHY FUTURES is, through a broadly-based, integrative approach that distinguishes environmental change-induced health hazard from health risk aims to support the health decisions making process, thereby attempting to help mitigate negative health impacts.

  10. [Effects of deformational plagiocephaly during the first 12 months on the psychomotor development of prematurely born infants].

    PubMed

    Fabre-Grenet, M; Garcia-Méric, P; Bernard-Niel, V; Guagliardo, V; Cortaredona, S; Aymeric-Ponsonnet, M

    2017-09-01

    The link between deformational plagiocephaly and psychomotor development is a recurrent question in medical publications. Main publications concentrate on term infants, but there is a lack of data on the impact of deformational plagiocephaly on the long-term neurodevelopment of premature infants. We attempted to establish a possible relation between deformational plagiocephaly during the 1st year of life and the psychomotor score at 4 years in prematurely born infants. Other risk factors potentially impacting the psychomotor score were also studied. A retrospective study of the files of the children followed by the "Naître et Devenir Région PACA Ouest Corse Sud" healthcare network and included in the database allowed us to select a cohort of 594 infants born prematurely at under 33 weeks of gestational age. These children were developmentally evaluated during the 1st year of life and at 4 years or age using the "EVAL Mater" test. The "Naître et Devenir" network is following up infants born prematurely at under 33 weeks of gestation in the West Provence Alpes Côte d'Azur and South Corsica region, from discharge to 7 years. A group of 170 specially trained pediatricians follow these infants developmentally at term, 3, 6, 9, 12, 18, and 24 months of corrected age and 3, 4 5, 6, and 7 years. Data are collected in a specially designed database. There was no significant link between deformational plagiocephaly during the 1st year of life and a pathological psychomotor score at age 4, but some risk factors were demonstrated: male gender, birth at under 28 weeks of gestational age, weight at birth under 1000g, having a Latal and Ferriero neuromotor score equal to or greater than 2 at 3 months of corrected age, and to a lesser extent having a prescription for physiotherapy during the 1st year. The research on deformational plagiocephaly in the full-term infant suggests a relation between deformational plagiocephaly and developmental delay predominantly

  11. High frequency oscillatory ventilation versus conventional ventilation for infants with severe pulmonary dysfunction born at or near term.

    PubMed

    Henderson-Smart, David J; De Paoli, Antonio G; Clark, Reese H; Bhuta, Tushar

    2009-07-08

    Pulmonary disease is a major cause of mortality and morbidity in term and near term infants. Conventional ventilation (CV) has been used for many years but may lead to lung injury, require the subsequent use of more invasive treatment such as extracorporeal membrane oxygenation (ECMO), or result in death. There are some observational studies indicating that high frequency oscillatory ventilation (HFOV) may be more effective in these infants as compared to CV. To determine the effect of HFOV as compared with CV on mortality and morbidity in infants born at 35 weeks gestational age or more with severe respiratory failure requiring mechanical ventilation. Standard search methods of the Cochrane Neonatal Review group were used. These included searches in January 2009 of The Cochrane Library, MEDLINE, EMBASE, previous reviews including cross references, abstracts, conferences and symposia proceedings, expert informants, and journal hand searching by the Cochrane Collaboration. Randomized or quasi-randomized trials comparing HFOV and CV in term or near term infants with intractable respiratory failure were included in this review. The standard methods of the Cochrane Neonatal Review Group were used. The investigators separately extracted, assessed and coded all data for each study. Any disagreement was resolved by discussion. Data were synthesized using risk ratio [RR with (95% confidence intervals, CI)] and mean difference (with standard deviation, SD). Two trials met the inclusion criteria. One trial involving the "elective" use of HFOV randomized 118 infants at the start of CV. The other trial of "rescue" HFOV randomized 81 infants with later respiratory failure on CV. Neither trial showed evidence of a reduction in mortality at 28 days or in failed therapy on the assigned mode of ventilation requiring cross-over to the other mode. Neither study reported significant differences in the risk of pulmonary air leak, chronic lung disease (28 days or more in oxygen) or

  12. Body composition and circulating high-molecular-weight adiponectin and IGF-I in infants born small for gestational age: breast- versus formula-feeding.

    PubMed

    de Zegher, Francis; Sebastiani, Giorgia; Diaz, Marta; Sánchez-Infantes, David; Lopez-Bermejo, Abel; Ibáñez, Lourdes

    2012-08-01

    Prenatal growth restraint, if followed by postnatal overweight, confers risk for adult disease including diabetes. The mechanisms whereby neonatal nutrition may modulate such risk are poorly understood. We studied the effects of nutrition (breast-feeding [BRF] vs. formula-feeding [FOF]) on weight partitioning and endocrine state (as judged by high-molecular-weight [HMW] adiponectin and IGF-I) of infants born small for gestational age (SGA). Body composition (by absorptiometry), HMW adiponectin, and IGF-I were assessed at birth and 4 months in BRF infants born appropriate for gestational age (AGA; n = 72) and SGA infants receiving BRF (n = 46) or FOF (n = 56), the latter being randomized to receive a standard (FOF1) or protein-rich formula (FOF2). Compared with AGA-BRF infants, the catchup growth of SGA infants was confined to lean mass, independently of nutrition. Compared with AGA-BRF infants, SGA-BRF infants had normal HMW adiponectin and IGF-I levels at 4 months, whereas SGA-FOF infants had elevated levels of HMW adiponectin (particularly SGA-FOF1) and IGF-I (particularly SGA-FOF2). In conclusion, neonatal nutrition seems to influence endocrinology more readily than body composition of SGA infants. Follow-up will disclose whether the endocrine abnormalities in SGA-FOF infants can serve as early markers of an unfavorable metabolic course and whether they may contribute to design early interventions that prevent subsequent disease, including diabetes.

  13. Healthy Mothers, Healthy Infants: Reducing Racial and Ethnic Disparities. Rhode Island KIDS COUNT Issue Brief.

    ERIC Educational Resources Information Center

    Rhode Island KIDS COUNT, Providence.

    This Kids Count issue brief details the strides made in Rhode Island over the last 10 years to improve maternal and child health, focusing on efforts to reduce racial and ethnic disparities. The brief notes that Rhode Island has made significant progress in several areas of maternal and infant care, most notably in access to insurance and early…

  14. Measurement of lung volume and ventilation distribution with an ultrasonic flow meter in healthy infants.

    PubMed

    Schibler, A; Hall, G L; Businger, F; Reinmann, B; Wildhaber, J H; Cernelc, M; Frey, U

    2002-10-01

    Small airway disease in infants is characterised by abnormal lung volume and uneven ventilation distribution. An inert tracer gas washin/washout technique using a pulsed ultrasonic flow meter is presented to measure functional residual capacity (FRC) and ventilation distribution in spontaneously breathing and unsedated infants. With a pulsed ultrasound sent through the main stream of the flow meter, flow, volume and MM of the breathing gas can be calculated. Sulphur hexafluoride was used as a tracer gas. In a mechanical lung model (volume range 53-188 mL) and in 12 healthy infants (aged 38.3+/-9.2 days; mean+/-SD) accuracy and reproducibility of the technique was assessed. Indices of ventilation distribution such as alveolar-based mean dilution number (AMDN) and pulmonary clearance delay (PCD) were calculated. Mean error of volume measurement in the lung model was 0.58% (coefficient of variance (CV) 1.3%). FRC was in the low predicted range for normal infants (18.0+/-2.0 mL x kg(-1)) and highly reproducible (5.5+/-1.7% intra-subject CV). AMDN was 1.63+/-0.15 and PCD was 52.9+/-11.1%. Measurement of functional residual capacity and ventilation distribution using a sulphur hexafluoride washin/washout and an ultrasonic flow meter proved to be highly accurate and reproducible in a lung model and in healthy, spontaneously breathing and unsedated infants.

  15. Bilirubin production in healthy term infants as measured by carbon monoxide in breath.

    PubMed

    Stevenson, D K; Vreman, H J; Oh, W; Fanaroff, A A; Wright, L L; Lemons, J A; Verter, J; Shankaran, S; Tyson, J E; Korones, S B

    1994-10-01

    To describe total bilirubin production in healthy term infants, we measured the end-tidal breath CO, corrected for ambient CO (ETCOc), with an automated sampler and electrochemical (EC) CO instrument. For infants of mothers with a negative Coombs' test, the ETCOc was 1.3 +/- 0.7 microL/L (n = 397) and the serum bilirubin on day 3 postpartum was 73 +/- 35 mg/L (n = 381). In contrast, the ETCOc for infants with ABO or Rh incompatibility, a positive direct Coombs' test, and bilirubin > 130 mg/L (n = 9) was significantly higher, 1.8 +/- 0.8 microL/L, than for those who had a positive Coombs' test result but whose bilirubin was < or = 130 mg/L (n = 12), 1.0 +/- 0.5 microL/L (P < 0.05). At 2 to 8 h postpartum seven term babies from mothers with insulin-dependent diabetes had ETCOc of 1.8 +/- 0.7 microL/L, significantly higher than that in the other term infants [1.3 +/- 0.7 microL/L (n = 390), P < 0.04]. Their bilirubin concentration at 72 +/- 12 h was also higher: 121 +/- 45 mg/L (n = 7) vs 73 +/- 34 mg/L (n = 374; P = 0.03). We conclude that ETCOc measurements may be helpful in understanding the mechanisms of jaundice in healthy term infants in a variety of conditions.

  16. [Functional state feature of erythrocytes in healthy term newborn infants].

    PubMed

    Evsiukova, I I; Iakushenko, N S; Andreeva, A A; Shevel'kova, A A; Kolesova, T A; Katiukhin, L N; Dobrylko, I A; Mandukshev, I V

    2014-01-01

    Hematological parameters and functional status of erythrocytes were studied by the osmotic and ammonium loads in healthy newborns and in adults. Mean erythrocyte volume of newborns more than in adults. Significant difference index of osmotic fragility of neonates were observed in the transition from swelling to hemolysis. Kinetic of erythrocyte's hemolysis in the ammonium load was studied by low-angle light scattering (LaSca-analyzer). The percentage of erythrocyte hemolysis is lower and the velocity of hemolysis is 2.5 times slower in newborns than in adults.

  17. Decline of maternal hepatitis a antibodies during the first 2 years of life in infants born in Turkey.

    PubMed

    Derya, Alabaz; Necmi, Aksaray; Emre, Alhan; Akgün, Yaman

    2005-08-01

    Selective immunization of at-risk groups may reduce the incidence of hepatitis A infection, but only the inclusion of hepatitis A vaccine in a routine universal childhood immunization schedule would guarantee control of the infection. But the interference by maternally derived hepatitis A antibodies (anti-HAV) with the immunogenicity of inactivated hepatitis A vaccine is still important in the determination of the optimal age for hepatitis A vaccination. The hepatitis A vaccines have not been assessed widely in children under the age of 2 years and are not currently licensed for this age group in many countries. A prospective trial was performed to detect seroprevalence of maternal hepatitis A antibodies during the first 2 years of life among young infants born to hepatitis A antibody positive mothers in Turkey. We measured at-birth anti-HAV in 147 infants born in our hospital and in their mothers and then from the offspring at months 3, 6, 9, 12, 15, 18, 21, and 24. The prevalence of seropositivity among the mothers at birth were found similarly high (93.9%) to the studies previously done among the adults in our area. The prevalence of anti-HAV among children aged 0, 9, 12, 15, 18, and 21 months were 93.9%, 62.6%, 36.1%, 13.6%, 6.1%, and 0.7%, respectively. Although a proportion of infants still had measurable antibodies at 9 and 12 month of age, two thirds of the infants over the age of 12 months were at high risk of acquiring hepatitis A infection, as living in a endemic region.

  18. Mild maternal thyroid dysfunction at delivery of infants born ≤34 weeks and neurodevelopmental outcome at 5.5 years.

    PubMed

    Williams, Fiona; Watson, Jennifer; Ogston, Simon; Hume, Robert; Willatts, Peter; Visser, Theo

    2012-06-01

    Mild maternal thyroid dysfunction during early pregnancy is associated with poor neurodevelopment in affected offspring. Most studies are population based or are smaller populations of term/late preterm infants. No studies were found that focused on more preterm infants. Our objective was to describe the relationship between mild maternal thyroid dysfunction at delivery of infants born ≤34 wk and neurodevelopment at 5.5 yr. The study design was follow-up of women and children recruited in Scotland between 1998 and 2001. We evaluated delivery levels of maternal TSH, free T(4) (FT(4)), and T(4) and the association with McCarthy Scale scores adjusted for 26 confounders of neurodevelopment. Maternal serum levels and McCarthy scores were available for 143 women and 166 children. After adjustment for confounders, there were significant 3.2, 2.1, and 1.8 point decrements, respectively, in general cognitive index, verbal subscale, and the perceptual performance subscale for each milliunit per liter increment in maternal TSH. Maternal FT(4) levels were variably associated with neurodevelopment. After adjustment, significant associations were found for the general cognitive index, motor scale, and quantitative subscale; each picomole per liter decrease in FT(4) was associated with an increase of 1.5, 1.7, and 0.9 points, respectively. Maternal T(4) levels showed little relationship with neurodevelopment. None of the women in this analysis had overt hypothyroidism, but mild hypothyroidism was evident in 27%; thyroglobulin antibody (TgAb) was ≥ 40 U/ml in 28% of the women. Higher maternal levels of TSH at delivery of infants born preterm were associated with significantly lower scores on the general cognitive index at 5.5 yr.

  19. Reliability of Neurobehavioral Assessments from Birth to Term Equivalent Age in Preterm and Term Born Infants.

    PubMed

    Eeles, Abbey L; Olsen, Joy E; Walsh, Jennifer M; McInnes, Emma K; Molesworth, Charlotte M L; Cheong, Jeanie L Y; Doyle, Lex W; Spittle, Alicia J

    2017-02-01

    Neurobehavioral assessments provide insight into the functional integrity of the developing brain and help guide early intervention for preterm (<37 weeks' gestation) infants. In the context of shorter hospital stays, clinicians often need to assess preterm infants prior to term equivalent age. Few neurobehavioral assessments used in the preterm period have established interrater reliability.

  20. Evaluation of Liver, Kidney, and Spleen Elasticity in Healthy Newborns and Infants Using Shear Wave Elastography.

    PubMed

    Palabiyik, Figen Bakirtas; Inci, Ercan; Turkay, Rustu; Bas, Derya

    2017-10-01

    Elasticity measurements of tissues can be valuable in the diagnosis and management of various diseases. The aim of this study was to determine the elasticity values for normal liver, kidney, and spleen of healthy newborns and infants using shear wave elastography (SWE) imaging. A total of 50 healthy term newborns and infants (19 girls and 31 boys; mean age 20.1 days, range 1 to 70 days) were examined by an experienced pediatric radiologist using SWE. None of them had any liver, kidney or spleen disease, or any other systemic disease that could affect these organs secondarily. All newborns and infants had a normal abdominal ultrasound scan. Age, sex, weight, height, and body mass index had no significant effects on shear wave velocity (SWV) values of liver and spleen. The SWV values of both kidneys decreased with age, weight, height, and body mass index. The mean SWV values were 1.70 m/s (range: 1.23-2.43 m/s) for the liver, 1.69 m/s (range: 0.8-2.40 m/s) for the right kidney, 1.70 m/s (range: 0.9-2.49 m/s) for the left kidney, and 2.03 m/s (range: 1.28-2.48 m/s) for the spleen. Shear wave elastography can be used to measure liver, kidney, and spleen elasticity in newborns and infants. The standard values for abdominal organs allow differentiation of healthy versus pathological tissue. We measured the normal values of SWE in healthy newborns and infants as reference data. © 2017 by the American Institute of Ultrasound in Medicine.

  1. Impact of Enhanced Sensory Input on Treadmill Step Frequency: Infants Born With Myelomeningocele

    PubMed Central

    Pantall, Annette; Teulier, Caroline; Smith, Beth A; Moerchen, Victoria; Ulrich, Beverly D.

    2012-01-01

    Purpose To determine the effect of enhanced sensory input on the step frequency of infants with myelomeningocele (MMC) when supported on a motorized treadmill. Methods Twenty seven infants aged 2 to 10 months with MMC lesions at or caudal to L1 participated. We supported infants upright on the treadmill for 2 sets of 6 trials, each 30s long. Enhanced sensory inputs within each set were presented in random order and included: baseline, visual flow, unloading, weights, Velcro and friction. Results Overall friction and visual flow significantly increased step rate, particularly for the older group. Friction and Velcro increased stance phase duration. Enhanced sensory input had minimal effect on leg activity when infants were not stepping. Conclusions Increased friction via Dycem and enhancing visual flow via a checkerboard pattern on the treadmill belt appear more effective than the traditional smooth black belt surface for eliciting stepping patterns in infants with MMC. PMID:21266940

  2. Outbreak of Late-onset Group B Streptococcal Infections in Healthy Newborn Infants after Discharge from a Maternity Hospital: A Case Report

    PubMed Central

    Kim, Hyung Jin; Kim, Soo Young; Seo, Won Hee; Yoo, Young; Lee, Kee Hyoung; Eun, Baik Lin; Kim, Hai Joong

    2006-01-01

    During a four-week period, four healthy term newborn infants born at a regional maternity hospital in Korea developed late-onset neonatal group B Streptococcus (GBS) infections, after being discharged from the same nursery. More than 10 days after their discharge, all of the infants developed fever, lethargy, and poor feeding behavior, and were subsequently admitted to the Korea University Medical Center, Ansan Hospital. GBS was isolated from the blood cultures of three babies; furthermore, GBS was isolated from 2 cerebral spinal fluid cultures. Three babies had meningitis, and GBS was isolated from their cerebral spinal fluid cultures. This outbreak was believed to reflect delayed infection after early colonization, originating from nosocomial sources within the hospital environment. This report underlines the necessity for Korean obstetricians and pediatricians to be aware of the risk of nosocomial transmissions of GBS infection in the delivery room and/or the nursery. PMID:16614527

  3. Risk Factors for Respiratory Decompensation Among Healthy Infants With Bronchiolitis.

    PubMed

    Dadlez, Nina M; Esteban-Cruciani, Nora; Khan, Asama; Douglas, Lindsey C; Shi, Yi; Southern, William N

    2017-09-01

    Although most children with bronchiolitis only require supportive care, some decompensate and require ventilatory support. We examined predictors of respiratory decompensation among hospitalized children to identify which patients may benefit from expectant monitoring. We examined children ≤24 months old with bronchiolitis admitted to the general infant and toddler floor. Children with pneumonia or comorbidities were excluded. Demographic and clinical characteristics were abstracted from a clinical database and medical records. Respiratory decompensation was defined as the need for initiating high-flow nasal cannula oxygen, continuous positive airway pressure, nasal intermittent mandatory ventilation, bilevel positive airway pressure, or intubation. A multivariable logistic regression model was constructed to identify independent predictors of respiratory decompensation. A total of 1217 children were included. The median age was 6.9 months, 41% were girls, 49% were Hispanic, 21% were black, and 18% were premature. Significant independent predictors of respiratory decompensation were age ≤3 months (odds ratio [OR]: 3.25; 95% confidence interval [CI]: 2.09-5.07), age 3 to 6 months (OR: 1.76; 95% CI: 1.04-3.0), black race (OR: 1.94; 95% CI: 1.27-2.95), emergency department hypoxemia (OR: 2.34; 95% CI: 1.30-4.21), and retractions or accessory muscle use (OR: 2.26; 95% CI: 1.48-3.46). Children with 0 of 4 predictors were found to have a low risk of decompensation (3%). Young age, black race, emergency department hypoxemia, and retractions or accessory muscle use were associated with respiratory decompensation in children with bronchiolitis. These factors should be considered at presentation, as they identify children who require a higher level of respiratory monitoring and support and others who may not benefit. Copyright © 2017 by the American Academy of Pediatrics.

  4. [Recommendations for the care of healthy newborn infants].

    PubMed

    Figueras Aloy, J; García Alix, A; Alomar Ribes, A; Blanco Bravo, D; Esqué Ruiz, M T; Fernández Lorenzo, J R

    2001-08-01

    This article makes certain recommendations on the care of the healthy newborn. Firstly, we discuss the situations that should be reported to the pediatrician/neonatologist and the reasons why the presence of these specialists is required in the delivery room (urgent or elective cesarean section, preterm labor). Secondly, we discuss the most important guidelines to follow in the delivery room and after birth. Concerning care in the delivery room, we stress the importance of care of the newborn (especially of the umbilical cord), bonding between the mother and child, identification of the newborn, assessment of neonatal adaptation to extrauterine life, prevention of ophthalmia neonatorum and hypoprothrombinemia, placing the baby correctly in the crib and hepatitis B prophylaxis. Concerning the postnatal period, we recommend feeding (promotion of breast feeding), rooming-in with the mother if the newborn is hospitalized in the nursery screening for hypoacousia and metabolic diseases, and discharge with special surveillance in cases of early discharge.

  5. Early additional food and fluids for healthy breastfed full-term infants.

    PubMed

    Becker, Genevieve E; Remmington, Tracey

    2014-11-25

    Widespread recommendations from health organisations encourage exclusive breastfeeding for six months. However, the addition of other fluids or foods before six months is common in many countries and communities. This practice suggests perceived benefits of early supplementation or lack of awareness of the possible risks. To assess the benefits and harms of supplementation for full-term healthy breastfed infants and to examine the timing and type of supplementation. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (21 March 2014) and reference lists of all relevant retrieved papers. Randomised or quasi-randomised controlled trials in infants under six months of age comparing exclusive breastfeeding versus breastfeeding with any additional food or fluids. Two review authors independently selected the trials, extracted data and assessed risk of bias. We included eight trials (984 randomised infants/mothers). Six trials (n = 613 analysed) provided data on outcomes of interest to this review. The variation in outcome measures and time points made it difficult to pool results from trials. Data could only be combined in a meta-analysis for one secondary outcome (weight change). The trials that provided outcome data compared exclusively breastfed infants with breastfed infants who were allowed additional nutrients in the form of artificial milk, glucose, water or solid foods.In relation to the majority of the older trials, the description of study methods was inadequate to assess the risk of bias. The two more recent trials, were found to be at low risk of bias for selection and detection bias. The overall quality of the evidence for the main comparison was low.In one trial (170 infants) comparing exclusively breastfeeding infants with infants who were allowed additional glucose water, there was a significant difference favouring exclusive breastfeeding up to and including week 20 (risk ratio (RR) 1.45, 95% confidence interval (CI) 1.05 to 1

  6. The Healthy Immigrant (Migrant) Effect: In Search of a Better Native-Born Comparison Group*

    PubMed Central

    Hamilton, Tod G.

    2016-01-01

    This paper evaluates whether immigrants’ initial health advantage over their U.S.-born counterparts results primarily from characteristics correlated with their birth countries (e.g., immigrant culture) or from selective migration (e.g., unobserved characteristics such as motivation and ambition) by comparing recent immigrants’ health to that of recent U.S.-born interstate migrants (“U.S.-born movers”). Using data from the 1999–2013 waves of the March Current Population Survey, I find that, relative to U.S.-born adults (collectively), recent immigrants have a 6.1 percentage point lower probability of reporting their health as fair or poor. Changing the reference group to U.S.-born movers, however, reduces the recent immigrant health advantage by 28%. Similar reductions in the immigrant health advantage occurs in models estimated separately by either race/ethnicity or education level. Models that examine health differences between recent immigrants and U.S-born movers who both moved for a new job—a primary motivation behind moving for both immigrants and the U.S.-born—show that such immigrants have only a 1.9 percentage point lower probability of reporting their health as fair or poor. Together, the findings suggest that changing the reference group from U.S.-born adults collectively to U.S.-born movers reduces the identified immigrant health advantage, indicating that selective migration plays a significant role in explaining the initial health advantage of immigrants in the United States. PMID:26463553

  7. Factors influencing parents' decision to donate their healthy infant's DNA for minimal-risk genetic research.

    PubMed

    Hatfield, Linda A; Pearce, Margaret M

    2014-11-01

    To examine factors that influence a parent's decision to donate their healthy infant's DNA for minimal-risk genetic research. Grounded theory, using semi-structured interviews conducted with 35 postpartum mother or mother-father dyads in an urban teaching hospital. Data were collected from July 2011 to January 2012. Audiorecorded semistructured interviews were conducted in private rooms with mothers or mother-father dyads 24 to 48 hr after the birth of their healthy, full-term infant. Data-driven content analysis using selected principles of grounded theory was performed. Parents' willingness to donate their healthy infant's DNA for minimal-risk pediatric genetic research emerged as a process involving three interacting components: the parents, the scientist, and the comfort of the child embedded within the context of benefit to the child. The purpose of the study and parents' perception of their commitment of time and resources determined their willingness to participate. The scientist's ability to communicate trust in the research process influenced parents' decisions. Physical discomfort of the child shaped parents' decision to donate DNA. Parental perception of a direct benefit to their child affected their willingness to discuss genetic research and its outcomes. Significant gaps and misunderstandings in parental knowledge of pediatric genetic research may affect parental willingness to donate their healthy child's DNA. Nurses knowledgeable about the decision-making process parents utilize to donate their healthy infant's DNA for minimal-risk genetic research and the factors influencing that decision are well positioned to educate parents about the role of genetics in health and illness and reassure potential research participants of the value and safeguards in pediatric genetic research. © 2014 Sigma Theta Tau International.

  8. Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women✩

    PubMed Central

    Minnes, Sonia; Singer, Lynn T.; Humphrey-Wall, Rashida; Satayathum, Sudtida

    2010-01-01

    Objective One objective was to determine if cocaine-using women who did not maintain infant custody (NMC) would report more psychological distress, domestic violence, negative coping skills, lower social support and more childhood trauma than cocaine-using women who maintained custody (MC) of their infant. A second objective was to evaluate the relative contribution of psychosocial factors to infant placement. Methods Psychosocial profiles of MC women (n = 144) were compared with NMC (n = 66) cocaine-using women. Subjects were low income, urban, African-American women who delivered an infant at a county teaching hospital. The Brief Symptom Inventory (BSI), an assessment of coping strategies (COPE), Multidimensional Scale of Perceived Social Support (MSPSS), Conflict Tactics Scale (CTS) and Childhood Trauma Questionnaire (CTQ) were administered. The associations of infant placement status to demographic factors, drug use and psychosocial measures were evaluated. Results The NMC group reported greater overall psychological distress, psychoticism, somatization, anxiety and hostility than the MC group. The NMC group had more childhood neglect and physical abuse and used more negative coping strategies than the MC group. Lack of prenatal care [OR = .83, CI (.75–.91), p < .0001], heavier prenatal cocaine use [OR = 2.55, CI (1.13–4.34), p < .007], greater psychological distress [OR = 2.21, CI (1.13–4.34), p < .02] and a childhood history of emotional neglect [OR = 1.10, CI (1.02–1.19), p < .02] were associated with increased likelihood of loss of infant custody after control for other substance use and demographic variables. Conclusions NMC women have more negative psychological and behavioral functioning post-partum than MC women. Less prenatal care and greater cocaine use, psychological distress and maternal childhood emotional neglect are associated with the post-partum placement of infants born to cocaine-using women. Practice implications Results of this

  9. Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women.

    PubMed

    Minnes, Sonia; Singer, Lynn T; Humphrey-Wall, Rashida; Satayathum, Sudtida

    2008-03-01

    One objective was to determine if cocaine-using women who did not maintain infant custody (NMC) would report more psychological distress, domestic violence, negative coping skills, lower social support and more childhood trauma than cocaine-using women who maintained custody (MC) of their infant. A second objective was to evaluate the relative contribution of psychosocial factors to infant placement. Psychosocial profiles of MC women (n=144) were compared with NMC (n=66) cocaine-using women. Subjects were low income, urban, African-American women who delivered an infant at a county teaching hospital. The Brief Symptom Inventory (BSI), an assessment of coping strategies (COPE), Multidimensional Scale of Perceived Social Support (MSPSS), Conflict Tactics Scale (CTS) and Childhood Trauma Questionnaire (CTQ) were administered. The associations of infant placement status to demographic factors, drug use and psychosocial measures were evaluated. The NMC group reported greater overall psychological distress, psychoticism, somatization, anxiety and hostility than the MC group. The NMC group had more childhood neglect and physical abuse and used more negative coping strategies than the MC group. Lack of prenatal care [OR=.83, CI (.75-.91), p<.0001], heavier prenatal cocaine use [OR=2.55, CI (1.13-4.34), p<.007], greater psychological distress [OR=2.21, CI (1.13-4.34), p<.02] and a childhood history of emotional neglect [OR=1.10, CI (1.02-1.19), p<.02] were associated with increased likelihood of loss of infant custody after control for other substance use and demographic variables. NMC women have more negative psychological and behavioral functioning post-partum than MC women. Less prenatal care and greater cocaine use, psychological distress and maternal childhood emotional neglect are associated with the post-partum placement of infants born to cocaine-using women. Results of this study indicate that poor, urban women who use cocaine prenatally display several measurable

  10. Birth defects in infants born in 1998-2004 to men and women serving in the U.S. military during the 1990-1991 Gulf War era.

    PubMed

    Bukowinski, Anna T; DeScisciolo, Connie; Conlin, Ava Marie S; K Ryan, Margaret A; Sevick, Carter J; Smith, Tyler C

    2012-09-01

    Concerns about reproductive health persist among U.S. military members who served in the 1990-1991 Gulf War. This study explores the long-term impact of 1990-1991 Gulf War deployment on the prevalence of birth defects among infants of Gulf War veterans. Health care data from the Department of Defense Birth and Infant Health Registry and demographic and deployment information from the Defense Manpower Data Center were used to identify infants born between 1998 and 2004 to both male and female 1990-1991 Gulf War veterans. Multivariable logistic regression models estimated the adjusted odds of any birth defect and eight specific birth defects among infants of deployers versus non-deployers. In addition, birth defects were evaluated among infants born to 1990-1991 Gulf War veterans with deployment-specific exposures. Among 178,766 infants identified for these analyses, 3.4% were diagnosed with a birth defect in the first year of life. Compared to infants of non-deployers, infants of deployers were not at increased odds of being diagnosed with a birth defect, or any of eight specific birth defects, in the first year of life. A slightly increased prevalence of birth defects was observed among infants born to men who deployed to the 1990-1991 Gulf War for 153 to 200 days compared to those who deployed for 1 to 92 days. No other deployment-specific exposures were associated with birth defects in these infants. The 1990-1991 Gulf War deployers, including those with specific exposures of concern, were not found to be at increased risk for having infants with birth defects 7 to 14 years after deployment. Published 2012 Wiley Periodicals, Inc.

  11. Clinical and Virologic Manifestations of Primary Epstein-Barr Virus (EBV) Infection in Kenyan Infants Born to HIV-Infected Women

    PubMed Central

    Slyker, Jennifer A.; Casper, Corey; Tapia, Kenneth; Richardson, Barbra; Bunts, Lisa; Huang, Meei-Li; Maleche-Obimbo, Elizabeth; Nduati, Ruth; John-Stewart, Grace

    2013-01-01

    Background. Human immunodeficiency virus (HIV) infection is a risk factor for Epstein-Barr virus (EBV)–associated lymphomas. Characterizing primary infection may elucidate risk factors for malignancy. Methods. To describe clinical and virologic manifestations of primary EBV infection among infants born to HIV-infected women, specimens were utilized from a cohort study conducted in Nairobi, Kenya. HIV and EBV viral loads were measured serially in plasma. EBV serology was performed on EBV DNA–negative infants. Monthly clinical examinations were performed by pediatricians. Results. The probability of EBV infection by 1 year of age was .78 (95% CI, .67–.88) in HIV-infected and .49 (95% CI, .35–.65) in HIV-uninfected infants (P < .0001). At 2 years, probability of EBV infection was .96 (95% CI, .89–.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 vs 2.1 log10 copies/mL; P < .0001). The majority of HIV-infected infants had detectable EBV DNA for >3 months (79%). Primary EBV infection was associated with cough, fever, otitis media, pneumonia, hepatomegaly, splenomegaly, and hospitalization in HIV-infected infants; conjunctivitis and rhinorrhea in HIV-uninfected infants. Conclusions. EBV infection occurs early in infants born to HIV-infected women. HIV infection was associated with more frequent and higher quantity EBV DNA detection. PMID:23493724

  12. Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women.

    PubMed

    Slyker, Jennifer A; Casper, Corey; Tapia, Kenneth; Richardson, Barbra; Bunts, Lisa; Huang, Meei-Li; Maleche-Obimbo, Elizabeth; Nduati, Ruth; John-Stewart, Grace

    2013-06-15

    Human immunodeficiency virus (HIV) infection is a risk factor for Epstein-Barr virus (EBV)-associated lymphomas. Characterizing primary infection may elucidate risk factors for malignancy. To describe clinical and virologic manifestations of primary EBV infection among infants born to HIV-infected women, specimens were utilized from a cohort study conducted in Nairobi, Kenya. HIV and EBV viral loads were measured serially in plasma. EBV serology was performed on EBV DNA-negative infants. Monthly clinical examinations were performed by pediatricians. The probability of EBV infection by 1 year of age was .78 (95% CI, .67-.88) in HIV-infected and .49 (95% CI, .35-.65) in HIV-uninfected infants (P < .0001). At 2 years, probability of EBV infection was .96 (95% CI, .89-.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 vs 2.1 log10 copies/mL; P < .0001). The majority of HIV-infected infants had detectable EBV DNA for >3 months (79%). Primary EBV infection was associated with cough, fever, otitis media, pneumonia, hepatomegaly, splenomegaly, and hospitalization in HIV-infected infants; conjunctivitis and rhinorrhea in HIV-uninfected infants. EBV infection occurs early in infants born to HIV-infected women. HIV infection was associated with more frequent and higher quantity EBV DNA detection.

  13. Obstetric risk factors associated with the development of periventricular leukomalacia in preterm infants born to mothers complicated by placenta previa.

    PubMed

    Oda, Nanae; Takeuchi, Kyousuke; Tanaka, Ayumi; Maruo, Takeshi

    2008-01-01

    This study was designed to evaluate the effect of antenatal risk factors on the occurrence of periventricular leukomalacia (PVL) in preterm infants from pregnancies complicated by placenta previa. The association between obstetric risk factors and PVL was assessed in 30 singleton live births complicated with placenta previa delivered between 24 and 33 completed weeks of gestation. Each infant underwent at least two cranial ultrasounds: the first before 72 h and the second around 14 days of life. Analysis of variance was used to compare continuous variables across groups. Comparison of groups for categorical data was analyzed with Pearson chi(2) test. The obstetric factors in infants with PVL were compared to those in infants with negative cranial ultrasonographic findings. The main risk factors for PVL in preterm placenta previa were initial antepartum hemorrhage <28 weeks of gestation (OR 13.7; 95% CI 1.38-136.2), although the differences of gestational age of delivery between two groups were not statistically significant. Low Apgar score (<7) at 1 min increased the risk of PVL (OR 8.89; 95% CI 12.9-61.1), while no associations with PVL were observed in low Apgar score at 5 min, neonatal acidosis (pH <7.2), and neonatal anemia (Hb <14 g/dl). This study demonstrates that initial antepartum hemorrhage during the second trimester and low Apgar score at birth increase the risk of PVL in preterm infants born to mothers with placenta previa. We speculate that the pathophysiologic mechanisms for this finding may be due to decreased placental perfusion in the second trimester of pregnancy, which is the developmental window of vulnerability for PVL. Copyright 2008 S. Karger AG, Basel.

  14. Department of Defense Birth and Infant Health Registry: Birth Defects Among Infants Born to US Military Families: 2001 Annual Report

    DTIC Science & Technology

    2008-05-30

    occurred in US military families worldwide. Data on birth defects were gathered using nationally standardized definitions for major congenital ...calculation of the prevalence of birth defects in all major malformation categories. The DoD Birth and Infant Health Registry reports birth defects...Health Registry 4 Definitions of Birth Defects According to the NBDPN, birth defects are conditions that can result in physical malformations

  15. Differences in tidal breathing between infants with chronic lung diseases and healthy controls.

    PubMed

    Schmalisch, G; Wilitzki, S; Wauer, R R

    2005-09-08

    The diagnostic value of tidal breathing (TB) measurements in infants is controversially discussed. The aim of this study was to investigate to what extent the breathing pattern of sleeping infants with chronic lung diseases (CLD) differ from healthy controls with the same postconceptional age and to assess the predictive value of TB parameters. In the age of 36-42 postconceptional weeks TB measurements were performed in 48 healthy newborns (median age and weight 7d, 3100 g) and 48 infants with CLD (80d, 2465 g)) using the deadspace-free flow-through technique. Once the infants had adapted to the mask and were sleeping quietly and breathing regularly, 20-60 breathing cycles were evaluated. Beside the shape of the tidal breathing flow-volume loop (TBFVL) 18 TB parameters were analyzed using ANOVA with Bonferroni correction. Receiver-operator characteristic (ROC) curves were calculated to investigate the discriminative ability of TB parameters. The incidence of concave expiratory limbs in CLD infants was 31% and significantly higher compared to controls (2%) (p < 0.001). Significant differences between CLD infants and controls were found in 11/18 TB parameters. The largest differences were seen in the mean (SD) inspiratory time 0.45(0.11)s vs. 0.65(0.14)s (p < 0.0001) and respiratory rate (RR) 55.4(14.2)/min vs. 39.2(8.6)/min (p < 0.0001) without statistically significant difference in the discriminative power between both time parameters. Most flow parameters were strongly correlated with RR so that there is no additional diagnostic value. No significant differences were found in the tidal volume and commonly used TB parameters describing the expiratory flow profile. The breathing pattern of CLD infants differs significantly from that of healthy controls. Concave TBFVL and an increased RR measured during quiet sleep and under standardized conditions may indicate diminished respiratory functions in CLD infants whereas most of the commonly used TB parameters are poorly

  16. Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review.

    PubMed

    Johns, Helene M; Forster, Della A; Amir, Lisa H; McLachlan, Helen L

    2013-11-19

    Expressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing. Databases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression. A total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded by imprecise definitions of

  17. Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review

    PubMed Central

    2013-01-01

    Background Expressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing. Methods Databases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression. Results A total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded

  18. PedVacc 002: a phase I/II randomized clinical trial of MVA.HIVA vaccine administered to infants born to human immunodeficiency virus type 1-positive mothers in Nairobi.

    PubMed

    Njuguna, Irene N; Ambler, Gwen; Reilly, Marie; Ondondo, Beatrice; Kanyugo, Mercy; Lohman-Payne, Barbara; Gichuhi, Christine; Borthwick, Nicola; Black, Antony; Mehedi, Shams-Rony; Sun, Jiyu; Maleche-Obimbo, Elizabeth; Chohan, Bhavna; John-Stewart, Grace C; Jaoko, Walter; Hanke, Tomáš

    2014-10-07

    A safe, effective vaccine for breastfeeding infants born to HIV-1-positive mothers could complement antiretroviral therapy (ART) for prevention of mother-to-child transmission of HIV-1. To date, only a few HIV-1 vaccine candidates have been tested in infants. A phase I/II randomized controlled trial PedVacc 002 was conducted to determine the safety and immunogenicity of a single, low dose of MVA.HIVA vaccine delivered intramuscularly to healthy 20-week-old infants born to HIV-1-positive mothers in Nairobi, Kenya. Pregnant HIV-1-positive women in the 2nd/3rd trimester of gestation were enrolled, provided with ART and self-selected their infant-feeding modality. Infants received nevirapine and cotrimoxazole prophylaxis. At 20 weeks of age, eligible HIV-1-negative infants were randomized to vaccine versus no-treatment arms and followed to 48 weeks of age for assessments of vaccine safety, HIV-1-specific T-cell responses and antibodies to routine childhood vaccines. Between February and November 2010, 182 mothers were screened, 104 were eligible and followed on ART during pregnancy/postpartum, of whom 73 had eligible infants at 20 weeks postpartum. Thirty-six infants were randomized to vaccine and 37 to no treatment. Eighty-four percent of infants breastfed, and retention at 48 weeks was 99%. Adverse events were rare and similar between the two arms. HIV-1-specific T-cell frequencies in interferon-γ ELISPOT assay were transiently higher in the MVA.HIVA arm (p=0.002), but not above the threshold for a positive assay. Protective antibody levels were adequate and similar between arms for all routine childhood vaccines except HBV, where 71% of MVA.HIVA subjects compared to 92% of control subjects were protected (p=0.05). This trial tested for the first time an MVA-vectored candidate HIV-1 vaccine in HIV-1-exposed infants in Africa, demonstrating trial feasibility and vaccine safety, low immunogenicity, and compatibility with routine childhood vaccinations. These results

  19. PedVacc 002: A phase I/II randomized clinical trial of MVA.HIVA vaccine administered to infants born to human immunodeficiency virus type 1-positive mothers in Nairobi

    PubMed Central

    Njuguna, Irene N.; Ambler, Gwen; Reilly, Marie; Ondondo, Beatrice; Kanyugo, Mercy; Lohman-Payne, Barbara; Gichuhi, Christine; Borthwick, Nicola; Black, Antony; Mehedi, Shams-Rony; Sun, Jiyu; Maleche-Obimbo, Elizabeth; Chohan, Bhavna; John-Stewart, Grace C.; Jaoko, Walter; Hanke, Tomáš

    2014-01-01

    Background A safe, effective vaccine for breastfeeding infants born to HIV-1-positive mothers could complement antiretroviral therapy (ART) for prevention of mother-to-child transmission of HIV-1. To date, only a few HIV-1 vaccine candidates have been tested in infants. Trial design A phase I/II randomized controlled trial PedVacc 002 was conducted to determine the safety and immunogenicity of a single, low dose of MVA.HIVA vaccine delivered intramuscularly to healthy 20-week-old infants born to HIV-1-positive mothers in Nairobi, Kenya. Methods Pregnant HIV-1-positive women in the 2nd/3rd trimester of gestation were enrolled, provided with ART and self-selected their infant-feeding modality. Infants received nevirapine and cotrimoxazole prophylaxis. At 20 weeks of age, eligible HIV-1-negative infants were randomized to vaccine versus no-treatment arms and followed to 48 weeks of age for assessments of vaccine safety, HIV-1-specific T-cell responses and antibodies to routine childhood vaccines. Results Between February and November 2010, 182 mothers were screened, 104 were eligible and followed on ART during pregnancy/postpartum, of whom 73 had eligible infants at 20 weeks postpartum. Thirty-six infants were randomized to vaccine and 37 to no treatment. Eighty-four percent of infants breastfed, and retention at 48 weeks was 99%. Adverse events were rare and similar between the two arms. HIV-1-specific T-cell frequencies in interferon-γ ELISPOT assay were transiently higher in the MVA.HIVA arm (p = 0.002), but not above the threshold for a positive assay. Protective antibody levels were adequate and similar between arms for all routine childhood vaccines except HBV, where 71% of MVA.HIVA subjects compared to 92% of control subjects were protected (p = 0.05). Conclusions This trial tested for the first time an MVA-vectored candidate HIV-1 vaccine in HIV-1-exposed infants in Africa, demonstrating trial feasibility and vaccine safety, low immunogenicity, and

  20. Healthy start program and feto-infant morbidity outcomes: evaluation of program effectiveness.

    PubMed

    Salihu, Hamisu M; Mbah, Alfred K; Jeffers, Delores; Alio, Amina P; Berry, Lo

    2009-01-01

    We evaluate the impact of the Healthy Start intervention program on feto-infant morbidity within a community setting. Prospective data from 2002 to 2007 within the ongoing Federally funded Healthy Start intervention project in Central Hillsborough County were merged with corresponding birth outcomes data from the Florida Department of Health. The impact of the project on the following feto-infant morbidity indices was assessed among service recipients: low birth weight (LBW), very low birth weight (VLBW), preterm, very preterm, small for gestational age (SGA) and a composite feto-infant morbidity outcome. Program effectiveness and impact were measured using odds ratios from logistic regression models and number needed to treat (NNT). The risk for low birth weight (OR = 0.7; 95% CI = 0.5-1.0), preterm (OR = 0.7; 95% CI = 0.5-0.9) and the composite feto-infant morbidity outcome (OR = 0.8; 95% CI = 0.6-0.9) was reduced among service recipients (N = 536) as compared to non-recipients (N = 2,815). A clinically important level of risk reduction was also noted for very low birth weight (OR = 0.5; 95% CI = 0.2-1.1) and very preterm (OR = 0.6; 95% CI = 0.3-1.2) although these did not reach statistical significance. The adjusted NNT was lowest for the composite feto-infant morbidity outcome (18), preterm birth (21) and low birth weight (24), and highest for very preterm (86) and very low birth weight (74) events. In a disadvantaged community setting, the Healthy Start intervention program was found to reduce the risk for very low birth weight and preterm births by about one-third.

  1. Establishment of Biochemistry Reference Values for Healthy Tanzanian Infants, Children, and Adolescents in Kilimanjaro Region

    PubMed Central

    Buchanan, Ann M.; Fiorillo, Suzanne P.; Omondi, Michael W.; Cunningham, Coleen K.; Crump, John A.

    2015-01-01

    Objective To establish common biochemistry reference intervals for Tanzanian infants, children, and adolescents living in the Kilimanjaro Region. Methods We recruited healthy, HIV-uninfected Tanzanian infants, children, and youth between the ages of one month and 17 years from local schools and clinics to participate in this study. Only afebrile children without signs of physical or chronic illness were enrolled. Nonparametric methods were used to determine 95% reference limits and their 90% confidence intervals, with outliers removed by the Tukey method. Results A total of 619 healthy infants, children, and adolescents were enrolled into the study. Twenty-three biochemistry parameters were measured. Compared to U.S. reference intervals, several of the biochemistry parameters showed notable differences; namely, alkaline phosphatase, phosphorus, amylase, and lipase. Comparing our data to the U.S. National Institutes of Health (NIH) Division of AIDS (DAIDS) grading criteria for classification of adverse events, we found that for select parameters, up to 15% of infants or children in certain age groups would have been categorized as having an adverse event as defined by DAIDS. Conclusions Our study further confirms the need to use locally established reference intervals to define reference laboratory parameters among children in Africa, rather than relying on those derived from U.S. or European populations. To our knowledge, this study provides the first set of locally validated biochemistry reference ranges for a pediatric population in Tanzania. PMID:26224122

  2. Establishment of biochemistry reference values for healthy Tanzanian infants, children and adolescents in Kilimanjaro Region.

    PubMed

    Buchanan, Ann M; Fiorillo, Suzanne P; Omondi, Michael W; Cunningham, Coleen K; Crump, John A

    2015-11-01

    To establish common biochemistry reference intervals for Tanzanian infants, children and adolescents living in the Kilimanjaro Region. We recruited healthy, HIV-uninfected Tanzanian infants, children and youth between the ages of 1 month and 17 years from local schools and clinics to participate in this study. Only afebrile children without signs of physical or chronic illness were enrolled. Nonparametric methods were used to determine 95% reference limits and their 90% confidence intervals, with outliers removed by the Tukey method. A total of 619 healthy infants, children and adolescents were enrolled into the study. Twenty-three biochemistry parameters were measured. Compared to US reference intervals, several of the biochemistry parameters showed notable differences, namely alkaline phosphatase, phosphorus, amylase and lipase. Comparing our data to the US National Institutes of Health (NIH) Division of AIDS (DAIDS) grading criteria for classification of adverse events, we found that for selected parameters, up to 15% of infants or children in certain age groups would have been categorised as having an adverse event as defined by DAIDS. Our study further confirms the need to use locally established reference intervals to define reference laboratory parameters among children in Africa, rather than relying on those derived from US or European populations. To our knowledge, this study provides the first set of locally validated biochemistry reference ranges for a paediatric population in Tanzania. © 2015 John Wiley & Sons Ltd.

  3. Comparison in Outcomes at Two-Years of Age of Very Preterm Infants Born in 2000, 2005 and 2010

    PubMed Central

    Abily-Donval, Lénaïg; Pinto-Cardoso, Gaëlle; Chadie, Alexandra; Guerrot, Anne-Marie; Torre, Stéphanie; Rondeau, Stéphane; Marret, Stéphane

    2015-01-01

    Objective To investigate alteration in 2-year neurological/behavioral outcomes of very preterm infants born in a French level three neonatal intensive care unit. Methods We conducted a prospective, comparative study of very preterm infants born before 33 weeks’ gestation at 5-year intervals in 2000, 2005 and 2010 at Rouen University Hospital. Neonatal mortality/morbidities, ante- and neonatal treatments, and at age 2 years motor, cognitive and behavioral data were collected by standardized questionnaires. Results We included 536 very preterm infants. Follow-up rates at two years old were 78% in 2000, 93% in 2005 and 92% in 2010 respectively. No difference in gestational age, birthweight, neonatal mortality/morbidities was observed except a decrease in low grade subependymal/intraventricular hemorrhages. Care modifications concerned use of antenatal magnesium sulfate, breast-feeding and post-natal corticosteroid therapy. Significant improvement in motor outcome and dramatic decrease in cerebral palsy rates (12% in 2000, 6% in 2005, 1% in 2010, p<0.001) were observed, as were improvements in feeding behavior. Although a non significant difference to better psychosocial behavior was reported, there was no difference in cognitive outcome. Conclusions Improvement in neuromotor outcome and behavior was reported. This could be due to multiple modifications in care: including administration of magnesium sulfate to women at risk of preterm birth, increase in breast-feeding, decrease in low grade subependymal/intraventricular hemorrhages, and decrease in post-natal corticosteroid therapy, all of which require further investigation in other studies. Extended follow-up until school age is mandatory for better detection of cognitive, learning and behavioral disorders. PMID:25658321

  4. Live-born infants of 24 to 28 weeks' gestation: survival and sequelae at two years of age.

    PubMed

    Kitchen, W H; Rickards, A L; Ford, G W; Ryan, M M; Lissenden, J V

    1985-01-01

    The survival rate of infants born alive between 24 and 28 weeks of gestation has increased significantly in this tertiary care centre, from about 9% in the first cohort studied (1966-1970), to 19.5% in the second cohort (1971-1974) and 50.3% in the third cohort (1977-1982); the borderline of practical viability decreased from 27 to 24 weeks over the years of the study. The number of mothers with a history of prior termination of pregnancy increased about sixfold from the second to the third cohorts but the rate of premature births increased by only 50%. The augmented survival rate was accompanied by an increase in the prevalence and total number of children with cerebral palsy, but bilateral blindness due to retinopathy of prematurity and severe sensorineural deafness were reduced. When 96% of children in the third cohort were assessed at two years of age. 13% had severe handicaps, 59% were considered normal and in 24% some handicap was suspected. The serious handicap rate was 28% for children born at 24-26 weeks compared with 8.5% for those born at 27-28 weeks of gestation.

  5. Relationships of Maternal Stress with Milk Immune Components in African American Mothers of Healthy Term Infants

    PubMed Central

    D'Apolito, Karen; Minnick, Ann F.; Dietrich, Mary S.; Kane, Bradley; Cooley, Shaun; Groer, Maureen

    2016-01-01

    Abstract Background: In the United States, African American infants experience the highest mortality, and their mothers report the lowest breastfeeding rates. Science reports decreased infant mortality among breastfed infants and suggests that milk immune component (MIC) levels are associated with maternal stressors. Little is known about these relationships among African Americans; therefore the aim was to explore the relationships of African American mothers' stressors and MICs 1–14 days postdelivery. Materials and Methods: Mothers meeting eligibility requirements were approached for consent 48–72 hours postdelivery of a healthy term infant and given instructions to collect milk (Days 3, 9, and 14) and saliva (Day 9), as well as complete three Perceived Stress Scale questionnaires (Days 3, 9, and 14) and a survey of pregnancy stressors experiences. Pearson correlations and linear regressions were performed to assess the relationships of maternal stressors with MICs. Results: There was at least one statistically significant correlation of a maternal stressor with nine of the 10 MICs (effect sizes ranging from r = 0.22 to 0.38) on Days 3 and 9. Of all MICs, epidermal growth factor had the most associations with maternal stress indicators. No mediational relationship of cortisol with MICs was observed. Conclusions: Many of the MIC changes observed could potentially impact the health of term and preterm infants. Further research is warranted. PMID:26701800

  6. [Prevalence of iron deficiency in healthy 12-month-old infants].

    PubMed

    Durá Travé, T; Díaz Vélaz, L

    2002-09-01

    Iron deficiency is the most prevalent nutritional deficiency among infants in industrialized countries. There is ample documentation of both short- and long-term adverse effects of iron deficiency. To study the prevalence of iron deficiency in 12-month-old infants and to investigate the influence of several factors (dietary, growth, etc.) on iron status. A random sample of 94 healthy infants from a basic health district was studied. Maternal and perinatal variables, dietary intake and anthropometry were assessed at regular intervals from birth to the age of 12 months. Hemoglobin, mean corpuscular volume, transferrin saturation and serum ferritin were also evaluated. The prevalence of iron deficiency was 9.6 % and that of iron deficiency anemia was 4.3 %. Of the nine infants with iron deficiency, four had been breast-fed for more than 6 months with late introduction of complementary foods and another had not been fed an iron-fortified formula while the 85 children without iron deficiency had received an appropriate diet (p < 0.05). Weight increase in the first year of life was significantly and positively correlated with hemoglobin and serum ferritin. Iron deficiency is relatively common in 12-month-old-infants but is limited to groups with inadequate feeding practices. Iron deficiency screening should be performed only in children with risk factors and/or inadequate diets.

  7. Relationships of Maternal Stress with Milk Immune Components in African American Mothers of Healthy Term Infants.

    PubMed

    Thibeau, Shelley; D'Apolito, Karen; Minnick, Ann F; Dietrich, Mary S; Kane, Bradley; Cooley, Shaun; Groer, Maureen

    2016-01-01

    In the United States, African American infants experience the highest mortality, and their mothers report the lowest breastfeeding rates. Science reports decreased infant mortality among breastfed infants and suggests that milk immune component (MIC) levels are associated with maternal stressors. Little is known about these relationships among African Americans; therefore the aim was to explore the relationships of African American mothers' stressors and MICs 1-14 days postdelivery. Mothers meeting eligibility requirements were approached for consent 48-72 hours postdelivery of a healthy term infant and given instructions to collect milk (Days 3, 9, and 14) and saliva (Day 9), as well as complete three Perceived Stress Scale questionnaires (Days 3, 9, and 14) and a survey of pregnancy stressors experiences. Pearson correlations and linear regressions were performed to assess the relationships of maternal stressors with MICs. There was at least one statistically significant correlation of a maternal stressor with nine of the 10 MICs (effect sizes ranging from r = 0.22 to 0.38) on Days 3 and 9. Of all MICs, epidermal growth factor had the most associations with maternal stress indicators. No mediational relationship of cortisol with MICs was observed. Many of the MIC changes observed could potentially impact the health of term and preterm infants. Further research is warranted.

  8. Maternal dietary omega fatty acid intake and auditory brainstem-evoked potentials in Mexican infants born at term: cluster analysis.

    PubMed

    Parra-Cabrera, Socorro; Moreno-Macias, Hortensia; Mendez-Ramirez, Ignacio; Schnaas, Lourdes; Romieu, Isabelle

    2008-01-01

    To identify biological and socioeconomic factors associated with the neurological development of Mexican infants born at term, as measured by brainstem auditory-evoked potentials (BAEPs). We conducted a cohort study among 76 women with low risk pregnancies recruited in their third trimester of pregnancy and followed their infants until 12 months of age. BAEP tests were conducted on the infants before 3 months of age during physiologic sleep, using 100 msec bipolar clicks. Maternal dietary intake was evaluated by food frequency questionnaire. Two BAEP groups (short latency, long latency) were identified by cluster analysis. The association between BAEP group and maternal PUFAs was estimated using logistic regression models adjusted for socioeconomic and biological factors. Short latency BAEPs were associated with a maternal diet rich in arachidonic acid (OR=3.63, 95% CI 1.23-10.67) after adjusting for age (in days) sex, head circumference and gestational age but was not significantly associated to a maternal diet rich in docosahexaenoic acid (DHA). Our results suggest the importance of arachidonic acid intake during pregnancy for short latency BAEPs and adequate fetal myelination.

  9. Prevalence and Geographic Distribution of Vector-Borne Pathogens in Apparently Healthy Dogs in Croatia.

    PubMed

    Mrljak, Vladimir; Kuleš, Josipa; Mihaljević, Željko; Torti, Marin; Gotić, Jelena; Crnogaj, Martina; Živičnjak, Tatjana; Mayer, Iva; Šmit, Iva; Bhide, Mangesh; Barić Rafaj, Renata

    2017-06-01

    Vector-borne pathogens (VBPs) are a group of globally extended and quickly spreading pathogens that are transmitted by various arthropod vectors. The aim of the present study was to investigate the seroprevalence against Babesia canis, Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Leishmania infantum, Dirofilaria immitis, and Ehrlichia canis in dogs in Croatia. We investigated 435 randomly selected apparently healthy dogs in 13 different locations of Croatia for antibodies to B. canis by indirect immunofluorescence using a commercial IFA IgG Antibody Kit. All samples were also tested for qualitative detection of D. immitis antigen and for antibodies to A. phagocytophilum, B. burgdorferi sensu lato, L. infantum, and E. canis with two point-of-care assays. Overall, 112 dogs (25.74%, 95% confidence interval [CI] 21.70-30.12) were serologically positive for one or more of the pathogens. B. canis was the most prevalent pathogen (20.00%, 95% CI 16.34-24.07), followed by A. phagocytophilum (6.21%, 95% CI 4.12-8.90), L. infantum, (1.38%, 95% CI 0.51-2.97), and B. burgdorferi sensu lato (0.69%, 95% CI 0.01-2.00). The lowest seroprevalence was for D. immitis and E. canis (0.46%, 95% CI 0.01-1.65). Coinfection was determined in 12 dogs (2.76%, 95% CI 1.43-4.77), of which 10 were positive to two pathogens (7 with B. canis and A. phagocytophilum and 1 B. canis with B. burgdorferi sensu lato or L. infantum or E. canis). One dog was positive to three pathogens and another dog to four pathogens. Seroprevalence for babesia was age, breed, and lifestyle/use dependent. Purebred dogs had almost half the chance of developing disease than crossbred (OR = 0.58, p < 0.026, 95% CI 0.37-0.94). Seropositivity to B. canis was 3.41 times higher for dogs that lived outdoors/shelter (p < 0.006) or 4.57 times higher in mixed/hunting (p < 0.001) compared to indoor/companion dogs. This is the first comprehensive survey of VBP seropositivity conducted in Croatia. Some

  10. Functional residual capacity measurements in healthy infants: ultrasonic flow meter versus a mass spectrometer.

    PubMed

    Pillow, J J; Ljungberg, H; Hülskamp, G; Stocks, J

    2004-05-01

    Accurate, reproducible and portable bedside monitoring of lung volume could potentially facilitate the early recognition of both under and overinflation of the lungs in ventilated and nonventilated subjects. This study asked whether a prototype portable ultrasonic flow meter provided valid and reliable measurements of functional residual capacity (FRCUS) when compared to those obtained using a mass spectrometer (FRCMS) in nonventilated healthy infants. Paired, randomised measurements of FRCMS and FRCUS were obtained using the sulphur hexafluoride (SF6) multiple-breath washout technique in 23 healthy infants with a median (range) postnatal age of 34.6 (1.3-92.6) weeks and weight of 8.3 (3.9-11.7) kg. FRCUS was on average 5.7%, (95% CI: 1.0-10.4%) less than FRCMS equating to a difference of approximately 1 mL x kg(-1). The 95% limits of agreement (LA) between the two techniques were relatively wide (95% LA: -17.5% to 29%), although in keeping with previously reported within-patient variability for lung volume measurements. There was no significant difference between the within subject coefficient of variation for FRCMS (3.7%) and FRCUS (5.2%). The ultrasonic flow meter used in this study provides repeatable measurements of functional residual capacity in spontaneously breathing healthy infants that approximate those obtained during mass spectrometry.

  11. Mother, Father, and Infant as an Interactive System.

    ERIC Educational Resources Information Center

    Pedersen, Frank A.

    This study investigates three types of reciprocal interactions among members of the family unit (father, mother and infant): father-infant interaction affecting child's development, father-infant interaction affecting mother's behavior, and husband-wife interaction affecting mother's behavior. Data from a sample of 39 healthy first-born infants…

  12. Early skin-to-skin contact for mothers and their healthy newborn infants.

    PubMed

    Moore, Elizabeth R; Bergman, Nils; Anderson, Gene C; Medley, Nancy

    2016-11-25

    Mother-infant separation post birth is common. In standard hospital care, newborn infants are held wrapped or dressed in their mother's arms, placed in open cribs or under radiant warmers. Skin-to-skin contact (SSC) begins ideally at birth and should last continually until the end of the first breastfeeding. SSC involves placing the dried, naked baby prone on the mother's bare chest, often covered with a warm blanket. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neuro-behaviors ensuring fulfillment of basic biological needs. This time frame immediately post birth may represent a 'sensitive period' for programming future physiology and behavior. To assess the effects of immediate or early SSC for healthy newborn infants compared to standard contact on establishment and maintenance of breastfeeding and infant physiology. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (17 December 2015), made personal contact with trialists, consulted the bibliography on kangaroo mother care (KMC) maintained by Dr Susan Ludington, and reviewed reference lists of retrieved studies. Randomized controlled trials that compared immediate or early SSC with usual hospital care. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Quality of the evidence was assessed using the GRADE approach. We included 46 trials with 3850 women and their infants; 38 trials with 3472 women and infants contributed data to our analyses. Trials took place in 21 countries, and most recruited small samples (just 12 trials randomized more than 100 women). Eight trials included women who had SSC after cesarean birth. All infants recruited to trials were healthy, and the majority were full term. Six trials studied late preterm infants (greater than 35 weeks' gestation). No included trial met all criteria for good quality with respect to methodology and reporting

  13. Healthy babies through infant-centered feeding protocol: an intervention targeting early childhood obesity in vulnerable populations.

    PubMed

    Horodynski, Mildred A; Olson, Beth; Baker, Susan; Brophy-Herb, Holly; Auld, Garry; Van Egeren, Laurie; Lindau, Joel; Singleterry, Lisa

    2011-11-15

    Poor feeding practices during infancy contribute to obesity risk. As infants transition from human milk and/or formula-based diets to solid foods, these practices interfere with infant feeding self-regulation and healthy growth patterns. Compared with other socioeconomic groups, lower-income mothers are more likely to experience difficulty feeding their infants. This may include misinterpreting feeding cues and using less-than-optimal feeding styles and practices, such as pressuring infants during mealtimes and prematurely introducing solid food and sweetened beverages. The Healthy Babies trial aims to determine the efficacy of a community-based randomized controlled trial of an in-home intervention with economically and educationally disadvantaged mother-infant dyads. The educational intervention is being conducted during the infant's first 6 months of life to promote healthy transition to solids during their first year and is based on the theory of planned behavior. We will describe our study protocol for a multisite randomized control trial being conducted in Colorado and Michigan with an anticipated sample of 372 economically and educationally disadvantaged African American, Hispanic, and Caucasian mothers with infants. Participants are being recruited by county community agency staff. Participants are randomly assigned to the intervention or the control group. The intervention consists of six in-home visits by a trained paraprofessional instructor followed by three reinforcement telephone contacts when the baby is 6, 8, and 10 months old. Main maternal outcomes include a) maternal responsiveness, b) feeding style, and c) feeding practices. Main infant outcome is infant growth pattern. All measures occur at baseline and when the infant is 6 and 12 months old. If this project is successful, the expected outcomes will address whether the home-based early nutrition education intervention is effective in helping mothers develop healthy infant feeding practices that

  14. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer.

    PubMed

    Dominguez-Bello, Maria G; De Jesus-Laboy, Kassandra M; Shen, Nan; Cox, Laura M; Amir, Amnon; Gonzalez, Antonio; Bokulich, Nicholas A; Song, Se Jin; Hoashi, Marina; Rivera-Vinas, Juana I; Mendez, Keimari; Knight, Rob; Clemente, Jose C

    2016-03-01

    Exposure of newborns to the maternal vaginal microbiota is interrupted with cesarean birthing. Babies delivered by cesarean section (C-section) acquire a microbiota that differs from that of vaginally delivered infants, and C-section delivery has been associated with increased risk for immune and metabolic disorders. Here we conducted a pilot study in which infants delivered by C-section were exposed to maternal vaginal fluids at birth. Similarly to vaginally delivered babies, the gut, oral and skin bacterial communities of these newborns during the first 30 d of life was enriched in vaginal bacteria--which were underrepresented in unexposed C-section-delivered infants--and the microbiome similarity to those of vaginally delivered infants was greater in oral and skin samples than in anal samples. Although the long-term health consequences of restoring the microbiota of C-section-delivered infants remain unclear, our results demonstrate that vaginal microbes can be partially restored at birth in C-section-delivered babies.

  15. Thyroxine values from newborn screening of 919 infants born before 29 weeks' gestation.

    PubMed Central

    Reuss, M L; Leviton, A; Paneth, N; Susser, M

    1997-01-01

    OBJECTIVES: Severe transient hypothyroxinemia in premature infants is associated with cerebral palsy and mental retardation: this study assessed its prevalence in very premature infants. METHODS: Congenital hypothyroidism screening programs in three states provided thyroxine values for 919 newborn infants younger than 29 weeks who were enrolled in a multicenter study. RESULTS: Thyroxine values were lower than 4.0 micrograms/dL in 21% of survivors and increased each week by 0.6 microgram/dL (95% confidence interval [CI] = 0.4, 0.7). At tests done 1 to 2 days after birth, levels were 2.5 micrograms/dL higher (95% CI = 1.8, 3.3) than at tests done at 8 to 14 days. In New York, levels were 1.0 microgram/dL higher (95% CI = 0.3, 1.6) than elsewhere. The levels of infants who died were 1.3 micrograms/dL lower (95% CI = 0.6, 2.0) than those of survivors. CONCLUSIONS: Severe transient hypothyroxinemia is common in very premature infants and deserves further study. PMID:9357357

  16. Effects of Chronologic Age and Young Child Exposure on Respiratory Syncytial Virus Disease among US Preterm Infants Born at 32 to 35 Weeks Gestation

    PubMed Central

    Simões, Eric A. F.; Anderson, Evan J.; Wu, Xionghua; Ambrose, Christopher S.

    2016-01-01

    Objective To estimate the incidence of respiratory syncytial virus (RSV) disease as a function of chronologic age and exposure to young children in US preterm infants. Methods In the RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study, preterm infants born at 32–35 weeks gestational age (wGA) were enrolled from 188 US clinics and followed September-May of 2009–2010 or 2010–2011. Infants with medically-attended acute respiratory illness had nasal/pharyngeal swabs collected for viral testing. Results of RSV tests conducted during routine clinical care were also collected. Event rates during November-March were modeled as a function of chronologic age and birth month using Poisson regression and adjusting for other covariates. Rates were calculated overall and for infants with and without exposure to young siblings or daycare attendance. Of 3317 infants screened, 1646 were enrolled as a consecutive sample. Infants with chronic lung disease of prematurity, hemodynamically significant congenital heart disease, life expectancy <6 months, or receiving or being considered for RSV immunoprophylaxis were excluded. 84% of patients completed the study. Demographics of the enrolled cohort were generally similar to those of US infants born at 32–35 wGA; infants 32–34 wGA, Hispanic infants, and infants of less-educated mothers were under-represented. Results Among 1642 evaluable infants, outpatient RSV lower respiratory illness incidence was highest at older ages, whereas RSV hospitalization and intensive care unit (ICU) admission were highest at younger ages. In all instances, young child exposure was associated with higher RSV incidence. The highest RSV hospitalization and ICU rates occurred among February-born infants with young child exposure, at 19.0 (95% CI, 13.5–27.0) and 6.5 (95% CI, 5.6–7.6) per 100 infant-seasons, respectively. Conclusions Preterm infants have a substantially elevated risk of RSV disease. Young age and

  17. Survival and neonatal morbidity among extremely preterm born infants in relation to gestational age based on the last menstrual period or ultrasonographic examination.

    PubMed

    Simic, Marija; Amer-Wåhlin, Isis; Lagercrantz, Hugo; Maršál, Karel; Källén, Karin

    2014-03-01

    The aim of this study was to investigate the potential impact of gestational age (GA) estimation on the basis of the last menstrual period (LMP) in comparison with GA based on ultrasound examination on rates of survival and neonatal morbidity among extremely preterm infants. The Swedish national registry of infants born extremely preterm (Extremely Preterm Infants in Sweden Study), including infants born before 27 weeks of gestation, was used to identify 645 infants with available information. Incidences of stillbirth, survival, small for GA (SGA), and major neonatal morbidity were calculated in relationship to the GA estimated by each of the approaches. Pregnancies, in general, appeared to be longer when GA was estimated by LMP than by ultrasound (17.2% of the pregnancies were longer than 27 weeks). The incidences of stillbirth, neonatal death, and major neonatal morbidity in relationship to GA were similar for both groups. The risks for SGA were elevated when GA according to ultrasound examination was at least 7 days shorter than GA based on the LMP. In our cohort of infants born extremely preterm, estimation of GA on the basis of LMP indicated a longer pregnancy than estimated by ultrasound but did not influence the incidences of neonatal survival and morbidity.

  18. Background electroencephalographic (EEG) activities of very preterm infants born at less than 27 weeks gestation: a study on the degree of continuity

    PubMed Central

    Hayakawa, M; Okumura, A; Hayakawa, F; Watanabe, K; Ohshiro, M; Kato, Y; Takahashi, R; Tauchi, N

    2001-01-01

    AIMS—To clarify the features of the background electroencephalographic (EEG) activities in clinically well preterm infants born at less than 27 weeks gestation and to outline their chronological changes with increasing postconceptional age (PCA).
METHODS—EEGs of clinically well premature infants born at less than 27 weeks gestation were recorded during the early postnatal period. The infants were separated into three groups according to their PCA at the time of EEG recording (21-22 weeks PCA, 23-24 weeks PCA, and 25-26 weeks PCA). The mean and maximum duration of interburst intervals (IBIs), the mean duration of bursts, and the percentage of continuous and discontinuous patterns in each PCA group were evaluated.
RESULTS—There were three infants at 21-22 weeks PCA, seven at 23-24 weeks PCA, and five at 25-26 weeks PCA. Eighteen EEG recordings were obtained. The mean and maximum IBI duration decreased with increasing PCA. The percentage of continuous patterns increased with increasing PCA. Conversely, the percentage of discontinuous patterns decreased with increasing PCA.
CONCLUSIONS—In premature infants born at less than 27 weeks gestation, the characteristics of the background EEG activities were similar to those of older premature infants. These changes reflect the development of the central nervous system in this period.
 At less than 27 weeks gestational age, the characteristics of background EEG activities were found to be as follows: PMID:11320041

  19. [Feeding, morbidity, and growth in infants born to a a group of primiparous mothers].

    PubMed

    Jiménez-Guerra, F; Román-Pérez, R

    1994-01-01

    This study describes the feeding pattern, morbidity and the growth of an infant group from birth to six months old. A sample of 14 primiparous mother-infant dyads were selected in three public hospitals of Hermosillo, Sonora, Mexico. The design included the "study case" technique. The planned feeding pattern at 24 hours post-delivery was different from the one practiced at home. Frequency of mixed-feeding was higher in the first three months. Half of the participants weaned gradually before the recommended period, with high consumption of industrialized cereals and pap of natural fruits at the beginning. Incidence and prevalence of gastrointestinal disorders and respiratory illness were high since the first 15 days of life. The weight/length, weight/age and length/age values were within the 50th percentile of the NCHS standard (1977). In spite of the difference in the feeding and morbidity patterns among the infants, their growth patterns were considered normal.

  20. [Delayed umbilical cord clamping in preterm infants born before 37 weeks of gestation: A prospective observational study].

    PubMed

    Dicky, O; Ehlinger, V; Guyard-Boileau, B; Assouline, C; Arnaud, C; Casper, C

    2017-02-01

    Many international studies have demonstrated that delayed umbilical cord clamping reduces neonatal morbidity. However, in France, delayed umbilical cord clamping is still not performed in many neonatal units. The aims of this study were to evaluate the feasibility of developing a protocol of delayed umbilical cord clamping in the maternity ward of the Toulouse university hospital and to evaluate the impact of this new protocol on neonatal mortality. We conducted a prospective observational study including 123 preterm infants born before 37 weeks of gestation between June 2012 and June 2013 and hospitalized at birth. Delayed cord clamping was performed for at least 30s after birth; otherwise, it was evaluated as early cord clamping. We excluded twin-to-twin transfusion syndrome, congenital abnormalities, alloimmunization, and perinatal asphyxia. We analyzed the reasons why delayed umbilical cord clamping was not performed and then neonatal morbidity in our population. Delayed umbilical cord clamping was performed on 79 infants and 44 infants had early umbilical cord clamping. The two groups had similar baseline characteristics. Preterm infants in the delayed cord-clamping group had a higher level of hemoglobin during the first 24h of life (17.9g/dL versus 16.6g/dL, P=0.005), fewer of them required transfusion (14% versus 35%, P=0.03), and fewer presented late-onset sepsis (8% versus 26%, P=0.02) or bronchopulmonary dysplasia (9% versus 26%, P=0.03). There was no statistically significant increase of hyperbilirubinemia requiring phototherapy. Implanting a new protocol of delayed umbilical cord clamping in our maternity ward proved to be possible without difficulty. The advantages of delayed umbilical cord clamping were observed in this prospective study. Today, delayed cord clamping has become a common practice in our maternity unit. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Outcome at Two Years of Very Preterm Infants Born after Rupture of Membranes before Viability.

    PubMed

    Kieffer, Amelie; Pinto Cardoso, Gaelle; Thill, Caroline; Verspyck, Eric; Marret, Stéphane

    2016-01-01

    To compare the respiratory and neurological outcomes at two years of age of preterm children born before 33 weeks of gestation (WG) after early preterm premature rupture of membranes (EPPROM) between 14 and 24 WG with preterm children without EPPROM. This single-center case-control retrospective study was conducted at Rouen University Hospital between 1st January 2000 and 31st December 2010. All the cases with EPPROM born from 26WG to 32WG were included. Each newborn was matched by sex, gestational age (GA) and year of birth to two very preterm children, born without EPPROM. At two years of corrected age, motor and cognitive abilities were assessed by routine score based on the Amiel-Tison and Denver developmental scales. Ninety-four cases with EPPROM before 24WG have been included. The 31 children born from 26WG to 32WG were matched with 62 controls. The EPPROM group had poorer clinical evaluation at one year for motor (p = 0.003) and cognitive developmental scores (p = 0.016). Neuromotor rehabilitation was performed more often (p = 0.013). However, there was no difference at 2 years of age. Children born after EPPROM were hospitalized more often for bronchiolitis (p<0.001) during their first 2 years, which correlates with increased incidence of pneumothorax (p = 0.017), pulmonary hypoplasia (p = 0.004) and bronchopulmonary dysplasia (p = 0.005) during neonatal period. At two years, despite an increase in severe bronchiolitis and the need for more neuromotor rehabilitation during the first month of the life after discharge, there was no difference in neurological outcomes in the very preterm children of the EPPROM group compared to those born at a similar GA without EPPROM.

  2. Outcome at Two Years of Very Preterm Infants Born after Rupture of Membranes before Viability

    PubMed Central

    Thill, Caroline

    2016-01-01

    Purpose To compare the respiratory and neurological outcomes at two years of age of preterm children born before 33 weeks of gestation (WG) after early preterm premature rupture of membranes (EPPROM) between 14 and 24 WG with preterm children without EPPROM. Design and Patients This single-center case-control retrospective study was conducted at Rouen University Hospital between 1st January 2000 and 31st December 2010. All the cases with EPPROM born from 26WG to 32WG were included. Each newborn was matched by sex, gestational age (GA) and year of birth to two very preterm children, born without EPPROM. At two years of corrected age, motor and cognitive abilities were assessed by routine score based on the Amiel-Tison and Denver developmental scales. Results Ninety-four cases with EPPROM before 24WG have been included. The 31 children born from 26WG to 32WG were matched with 62 controls. The EPPROM group had poorer clinical evaluation at one year for motor (p = 0.003) and cognitive developmental scores (p = 0.016). Neuromotor rehabilitation was performed more often (p = 0.013). However, there was no difference at 2 years of age. Children born after EPPROM were hospitalized more often for bronchiolitis (p<0.001) during their first 2 years, which correlates with increased incidence of pneumothorax (p = 0.017), pulmonary hypoplasia (p = 0.004) and bronchopulmonary dysplasia (p = 0.005) during neonatal period. Conclusion At two years, despite an increase in severe bronchiolitis and the need for more neuromotor rehabilitation during the first month of the life after discharge, there was no difference in neurological outcomes in the very preterm children of the EPPROM group compared to those born at a similar GA without EPPROM. PMID:27829004

  3. Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas.

    PubMed

    Eggink, B Hannie; Richardson, C Joan; Malloy, Michael H; Angel, Carlos A

    2006-06-01

    In the past decade, the preferred method of closure of gastroschisis at our institution has been staged reduction using a silo with repair on an elective basis (SR) rather than primary surgical closure (PC). We performed a 20-year case review of infants with gastroschisis at a university hospital to compare these shifts in management and to determine factors affecting outcome. Seventy-two cases were reviewed from 1983 to 2003. Times to first and full feeds were outcome variables for statistical analysis. The prevalence of gastroschisis increased from 0.03% to 0.1% since 1983. Patients had low birth weights (mean = 2294 g) and were borderline premature (mean = 35.8 weeks). Only 3% of the infants were African American. There was a high rate of cesarean deliveries (57%). Ten patients (15%) had gastroschisis complicated by liver herniation, intestinal atresia(s), and/or necrosis/perforation. Most patients were managed by SR (67%). Eight percent of the infants died, 9% developed necrotizing enterocolitis, and 50% had other gastrointestinal complications. Twenty-seven percent of the infants managed with SR did not need initial mechanical ventilation. However, the patients who underwent SR were ventilated longer after birth as compared with those who underwent PC (P < .08). Infants with a complicated gastroschisis had significantly longer times to first and full feeds (P < .001). Patients managed with SR took significantly longer to reach full feeds (P = .001), and there was a trend of starting feeds later (P = .06). When patients with a complicated gastroschisis were excluded, the differences between the SR and PC groups were even greater (P = .01; P < .001). In our patient population, the prevalence of gastroschisis increased by more than 400% since 1983. The defect was rare in African-American infants. Management by SR was associated with longer ventilation times and longer times to first and full feeds for both uncomplicated and complicated gastroschisis cases.

  4. Long-chain polyunsaturated fatty acid supplementation in infants born at term.

    PubMed

    Simmer, Karen; Patole, Sanjay K; Rao, Shripada C

    2011-12-07

    The n-3 and n-6 fatty acids linolenic acid and linoleic acid are precursors of the n-3 and n-6 long chain fatty acids (LCPUFA). Infant formula has historically only contained the precursor fatty acids. Over the last few years, some manufacturers have added LCPUFA to formulae and marketed them as providing an advantage for the development of term infants. To assess whether supplementation of formula with LCPUFA is safe and of benefit to term infants. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, April, 2011), MEDLINE (1966 to April 2011), EMBASE (1980 to April 2011), CINAHL (December 1982 to April 2011) and abstracts of the Society for Pediatric Research (1980 to 2010). No language restrictions were applied. Randomised and quasi randomised trials comparing LCPUFA supplemented vs. non-supplemented formula milk and with clinical endpoints were reviewed. Methodological quality of studies was assessed using the guidelines of Cochrane neonatal review group. Data were sought regarding effects on visual acuity, neurodevelopmental outcomes and physical growth. When appropriate, meta-analysis was conducted to provide a pooled estimate of effect. Twenty-five randomised studies were identified; fifteen were included (n = 1889) and ten excluded.Visual acuity was assessed by nine studies. Visual evoked potential was used in six studies, two used Teller cards and one used both. Four studies reported beneficial effects while the remaining five did not.Neurodevelopmental outcome was measured by eleven studies. Bayley scales of infant development (BSID) was used in nine studies; only two showed beneficial effects. Meta-analysis did not show significant benefits of supplementation. One study followed the infants up to nine years of age and did not find benefit of supplementation. One study reported better novelty preference measured by Fagan Infant test at nine months. Another study reported better problem solving at 10 months. One study used

  5. Early additional food and fluids for healthy breastfed full-term infants.

    PubMed

    Smith, Hazel A; Becker, Genevieve E

    2016-08-30

    Health organisations recommend exclusive breastfeeding for six months. However, the addition of other fluids or foods before six months is common in many countries. Recently, research has suggested that introducing solid food at around four months of age while the baby continues to breastfeed is more protective against developing food allergies compared to exclusive breastfeeding for six months. Other studies have shown that the risks associated with non-exclusive breastfeeding are dependent on the type of additional food or fluid given. Given this background we felt it was important to update the previous version of this review to incorporate the latest findings from studies examining exclusive compared to non-exclusive breastfeeding. To assess the benefits and harms of additional food or fluid for full-term healthy breastfeeding infants and to examine the timing and type of additional food or fluid. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 March 2016) and reference lists of all relevant retrieved papers. Randomised or quasi-randomised controlled trials in infants under six months of age comparing exclusive breastfeeding versus breastfeeding with any additional food or fluids. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two review authors assessed the quality of the evidence using the GRADE approach. We included 11 trials (2542 randomised infants/mothers). Nine trials (2226 analysed) provided data on outcomes of interest to this review. The variation in outcome measures and time points made it difficult to pool results from trials. Data could only be combined in a meta-analysis for one primary (breastfeeding duration) and one secondary (weight change) outcome. None of the trials reported on physiological jaundice. Infant mortality was only reported in one trial.For the majority of older trials, the description of study methods was inadequate to

  6. Factors associated with abandonment of infants born to HIV positive women: results from a Ukrainian birth cohort

    PubMed Central

    Bailey, Heather; Semenenko, Igor; Pilipenko, Tatyana; Malyuta, Ruslan; Thorne, Claire

    2012-01-01

    Social marginalisation and other challenges facing HIV-positive pregnant women in Ukraine may put them at increased risk of relinquishing their infants to the state. We described rates of infant abandonment (exclusive non-parental care to most recent follow up, censored at two years of age) and investigated associated factors using logistic regression models, in 4759 mother-infant pairs enrolled across six Ukrainian sites in the European Collaborative Study from 2000 to May 2009. Median maternal age was 26.0 years, 81.8% were married or cohabiting and 60.6% were nulliparous at enrolment. An injecting drug use (IDU) history was reported by 18.4%, 80.2% took antiretroviral therapy (ART) antenatally and most deliveries were vaginal. A small but significant proportion of infants had been cared for exclusively in institutions by their second birthday (2.1% overall), decreasing from 3.8% (15/393) in 2000-02 to 1.6% (49/3136) in 2006-09 (p<0.01), concurrent with prevention of mother-to-child transmission (PMTCT) scale-up. A further 1% of infants spent some time in non-parental care. Antenatal ART was associated with an 88% reduced abandonment risk (AOR 0.12), versus receipt of single dose nevirapine only, and this was reflected in HIV infection prevalence in the two groups (17.1% of abandoned infants versus 6.6% in parental care). Mothers without a cohabiting partner or husband were more likely to abandon (AOR 4.08), as were active IDUs (AOR 3.27) and those with ≥1 previous children (AOR 1.89 for second-born, AOR 2.56 for subsequent births). Women delivering by elective caesarean section were less likely to abandon (AOR 0.37 versus vaginal), as were those leaving full time education later (AOR 0.61 for 17-18 years versus ≤16 years, AOR 0.23 for ≥19 years versus ≤16 years). Interventions to extend family planning and IDU harm reduction services along with non-stigmatising antenatal care to marginalised women are needed, and may reduce abandonment. PMID:20824547

  7. Positional plagiocephaly is associated with sternocleidomastoid muscle activation in healthy term infants.

    PubMed

    Leung, Amy; Mandrusiak, Allison; Watter, Pauline; Gavranich, John; Johnston, Leanne

    2017-04-01

    To explore the relationship between sternocleidomastoid activation and positional plagiocephaly in healthy full term infants. Participants were 82 infants from a regionally based-longitudinal study of infant development. Sternocleidomastoid (SCM) activation was assessed using active head-righting responses of body-on-head with and against gravity and head-on-body against gravity at 3, 6 and 9 weeks. Plagiocephaly was assessed using the Modified Cranial Vault Asymmetry Index (mCVAI) at 9 weeks. More severe plagiocephaly was associated with more severe asymmetry in active head-righting responses at all ages (p < 0.001). Greater right-sided occipital flatness was related to stronger contralateral/left SCM activation at 3 and at 9 weeks (p = 0.008). Greater left-sided occipital flatness was related to stronger contralateral/right SCM activation at 3 weeks (p = 0.004). In infants with any right-sided occipital flatness, the mCVAI was greater in infants with asymmetrical gravity assisted body-on-head responses at 3 weeks (mCVAI = 4.31 (2.01)%, 95% CI 2.87-5.75) compared to those with symmetrical responses (mCVAI = 2.64 (1.66)%, 95% CI 2.06-3.22) (p = 0.011). Sternocleidomastoid activation asymmetry is a significant contributor to plagiocephaly development by 9 weeks of age due to stronger contralateral SCM activation. Active head-righting responses are appropriate to assess sternocleidomastoid activation in infants under 2 months of age.

  8. ADHD and Infant Disorganized Attachment: A Prospective Study of Children Next-Born after Stillbirth

    ERIC Educational Resources Information Center

    Pinto, Carmen; Turton, Penelope; Hughes, Patricia; White, Sarah; Gillberg, Christopher

    2006-01-01

    Objective: To examine whether infant disorganized attachment predicts ADHD at school age. Method: A cohort of 53 children who had been identified as having significant levels of disorganized attachment in infancy is compared to a control group. Symptoms and signs of ADHD at age 7 are evaluated together with a range of relevant maternal variables.…

  9. Developmental Profile of Infants Born to Mothers with Postpartum Depression and Anxiety: A Comparative Study

    ERIC Educational Resources Information Center

    Kalita, Kamal Narayan

    2010-01-01

    Background: Postpartum period is associated with higher rates for depression, blues and psychosis. Anxiety is also significant. These disorders may have serious implications in the cognitive development of the infant. There is relative lack of data in this area. So we tried to estimate postpartum anxiety and depression in a group of women and…

  10. Nitric oxide for respiratory failure in infants born at or near term.

    PubMed

    Barrington, Keith J; Finer, Neil; Pennaforte, Thomas; Altit, Gabriel

    2017-01-05

    Nitric oxide (NO) is a major endogenous regulator of vascular tone. Inhaled nitric oxide (iNO) gas has been investigated as treatment for persistent pulmonary hypertension of the newborn. To determine whether treatment of hypoxaemic term and near-term newborn infants with iNO improves oxygenation and reduces rate of death and use of extracorporeal membrane oxygenation (ECMO), or affects long-term neurodevelopmental outcomes. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), MEDLINE via PubMed (1966 to January 2016), Embase (1980 to January 2016) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to January 2016). We searched clinical trials databases, conference proceedings and reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. We contacted the principal investigators of studies published as abstracts to ascertain the necessary information. Randomised studies of iNO in term and near-term infants with hypoxic respiratory failure, with clinically relevant outcomes, including death, use of ECMO and oxygenation. We analysed trial reports to assess methodological quality using the criteria of the Cochrane Neonatal Review Group. We tabulated mortality, oxygenation, short-term clinical outcomes (particularly use of ECMO) and long-term developmental outcomes. For categorical outcomes, we calculated typical estimates for risk ratios and risk differences. For continuous variables, we calculated typical estimates for weighted mean differences. We used 95% confidence intervals and assumed a fixed-effect model for meta-analysis. We found 17 eligible randomised controlled studies that included term and near-term infants with hypoxia.Ten trials compared iNO versus control (placebo or standard care without iNO) in infants with moderate or severe severity of illness scores (Ninos 1996; Roberts

  11. Attempting to Honor Beliefs of Jehovah’s Witnesses at the Edge of Viability in an Infant Born at 23 Weeks’ Gestational Age

    PubMed Central

    Sauer, Charles W.; Marc-Aurele, Krishelle L.

    2016-01-01

    Patient: Male, 23 weeks’ gestational age newborn Final Diagnosis: 23 weeks’ extreme prematurity • intraventricular hemorrhage • anemia • respiratory distress syndrome Symptoms: Hypotension • metabolic acidosis • tachycardia Medication: — Clinical Procedure: Transfusion of packed red blood cells Specialty: Pediatrics and Neonatology Objective: Rare disease Background: Infants born at 23 weeks’ gestation have a poor prognosis and require intensive care, including blood transfusions, to survive. Generally speaking, the decision to forgo life support is acceptable. Jehovah’s Witnesses believe that life is sacred and want lifesaving interventions except for blood transfusions. Therefore, an ethical dilemma exists when a baby is born on the edge of viability to parents that are Jehovah’s Witnesses. In this case, if parents and healthcare professionals disagree on the best interests of the child, the medical team should obtain a court order from the state to intervene. Case Report: We present the case of an infant born at 23 weeks’ gestation to parents who are Jehovah’s Witnesses. The parents wanted full life-support, except for blood transfusions, to be given. The clinical team obtained a court order to transfuse the infant. The infant unfortunately died despite all efforts. Conclusions: Currently, it is nearly impossible to honor the beliefs of Jehovah’s Witnesses to provide lifesaving treatments without blood transfusions for infants born at the border of viability. If the goal is to prolong life, the standard of care for a premature infant is for a doctor to obtain a court order to override the beliefs and wishes of Jehovah’s Witness parents and transfuse blood products as medically indicated. Although bloodless techniques for high-risk surgeries are under development, care for premature infants at 23 weeks’ gestation necessitates red cell transfusions. PMID:27255268

  12. A randomized controlled trial of burping for the prevention of colic and regurgitation in healthy infants.

    PubMed

    Kaur, R; Bharti, B; Saini, S K

    2015-01-01

    Efficacy of burping in lowering colic and regurgitation episodes in healthy term babies lacks evidence in literature. We conducted a randomized controlled trial to compare efficacy of burping versus no-burping in 71 mother-baby dyads in community setting. Primary outcome was reduction in event rates of colic and regurgitation episodes over 3 months. Baseline characteristics were similar in two groups. Difference in incidence rates of colic between the control and burping group was 1.57 episodes/infant/100 weeks [95% confidence interval (CI): -0.63 to 3.76]. There was statistically no significant reduction in colic episodes between burping and non-burping study subjects during 3 months of follow-up (adjusted relative risk 0.64; 95% CI: 0.22-1.86, P-value 0.41). Incidence rate difference of regurgitation episodes/infant/week between burping and control group was 4.36 (95% CI: 4.04 to 4.69) and there was statistically significant increase in burping group (adjusted relative risk 2.05; 95% CI: 1.92-2.18, P-value < 0.0001). Although burping is a rite of passage, our study showed that burping did not significantly lower colic events and there was significant increase in regurgitation episodes in healthy term infants up to 3 months of follow-up. © 2014 John Wiley & Sons Ltd.

  13. Randomised controlled trial of eutectic mixture of local anaesthetics cream for venepuncture in healthy preterm infants

    PubMed Central

    Acharya, A; Bustani, P; Phillips, J; Taub, N; Beattie, R

    1998-01-01

    AIM—To assess the safety and efficacy of EMLA cream (eutectic mixture of local anaesthetics) used to induce surface anaesthesia for venepuncture in healthy preterm infants.
METHODS—Nineteen infants, median gestational age 31 weeks (range 26-33 weeks) were assessed in a randomised, double blind, placebo controlled, cross-over trial. Changes in physiological variables (heart rate, blood pressure, oxygen saturation) and behavioural responses (neonatal facial coding system score, crying time) before and after venepuncture with EMLA cream were compared with those obtained with a placebo cream to assess efficacy. Toxicity was assessed by comparing methaemoglobin concentrations at 1 hour and 8 hours after application.
RESULTS—There was no significant difference in efficacy between EMLA and placebo creams in physiological and behavioural responses. There was no significant difference in methaemoglobin concentrations one hour after the cream had been applied. At eight hours, however, concentrations were significantly higher after EMLA than placebo (p=0.016). There was no evidence of clinical toxicity.
CONCLUSION—This study does not support the routine use of EMLA for venepuncture in healthy preterm infants.

 PMID:9577286

  14. Vitamin B12 deficiency among asymptomatic healthy infants: its impact on the immune system.

    PubMed

    Boran, Perran; Yildirim, Selin; Karakoc-Aydiner, Elif; Ogulur, Ismail; Ozen, Ahmet; Haklar, Goncagul; Koc, Ahmet; Akkoc, Tunc; Barlan, Isil

    2016-01-13

    The immunomodulatory effects of vitamin B12 deficiency in children have not yet been established in the literature. In the current study, the effects of vitamin B12 on the immune system in asymptomatic and otherwise healthy infants have been studied. The study was conducted at Marmara University, "well-child" outpatient clinic. Vitamin B12 level was measured in a cohort of 611 healthy term infants, followed regularly for at least 6 months. Immunoglobulin measurements, lymphocyte subset analysis, cytokine production analysis, lymphocyte proliferation assays and evaluation of lymphocyte apoptosis were performed in a subset of 60 infants. In this cohort, one out of three babies displayed vitamin B12 deficiency. The percentage of CD4+CD25+ regulatory T cells (Tregs) was lower in vitamin B12 deficient babies than in controls. Although the percentage of Tregs increased after treatment, the change was not significant. There was no difference of cytokine levels between vitamin B12 deficient and control groups. However, proinflammatory cytokines were reduced after treatment. No significant difference was observed for immunoglobulins, early apoptosis and lymphocyte proliferation. Vitamin B12 deficiency is an underestimated health problem among the developing countries. The clinical consequences of the decreased percentage of Tregs associated with vitamin B12 deficiency, and reduction of proinflammatory cytokines after vitamin supplementation needs to be further studied, especially in terms of emerging allergies, autoimmune disorders and anti-inflammatory effects.

  15. The risk of malaria in Ghanaian infants born to women managed in pregnancy with intermittent screening and treatment for malaria or intermittent preventive treatment with sulfadoxine/pyrimethamine.

    PubMed

    Awine, Timothy; Belko, Mark M; Oduro, Abraham R; Oyakhirome, Sunny; Tagbor, Harry; Chandramohan, Daniel; Milligan, Paul; Cairns, Matthew; Greenwood, Brian; Williams, John E

    2016-01-28

    Several studies have reported an association between malaria infection of the placenta and the risk of malaria in young children in the first year of life, but it is not known if this is causal, or influenced by malaria control measures during pregnancy. This paper compares the incidence of malaria in infants born to mothers who received either intermittent preventive treatment with sulfadoxine/pyrimethamine (IPTp-SP) or screening with a rapid diagnostic test and treatment with artemether-lumefantrine (ISTp-AL) during their pregnancy. From July 2011 to April 2013, 988 infants of women enrolled in a trial of IPTp-SP versus ISTp-AL in the Kassena-Nankana districts of northern Ghana were followed to determine the risk of clinical malaria during early life, and their risk of parasitaemia and anaemia at 6 and 12 months of age. In addition, the incidence of clinical malaria in infants whose mothers had malaria infection of the placenta was compared with that in infants born to women free of placental malaria. The incidence of clinical malaria was 0.237 and 0.211 episodes per child year in infants whose mothers had received ISTp-AL or IPTp-SP, respectively. The adjusted incidence rate ratio and the adjusted rate difference were 0.94 (95% CI 0.68, 1.33) and 0.029 (95% CI -0.053, 0.110) cases per child year at risk respectively. The incidence of clinical malaria was similar in infants born to women with placental malaria (0.195 episodes per child year) and in infants of women without placental malaria (0.224 episodes per child year) (rate ratio = 0.86 [95% CI 0.54, 1.37]). Infants born to women managed with ISTp-AL during pregnancy were not at greatly increased risk of malaria compared with infants born to women who had received IPTp-SP. The incidence of malaria in infants was similar whether or not their mother had had placental malaria.

  16. Evaluation of functional aspects of Lactobacillus fermentum CFR 2195 isolated from breast fed healthy infants' fecal matter.

    PubMed

    Basavanna, Girishkumar; Prapulla, Siddalingaiya Gurudutt

    2013-04-01

    Functional properties of the Lactobacillus fermentum CFR 2195, isolated from healthy infant feces have been evaluated. The adherence of L. fermentum to HT-29 and Caco-2 cell-lines were found to be 197.66 ± 15.62 and 100.33 ± 15.69 per 100 cells, respectively. The effect of different concentrations of FOS (0.5, 1.0, 1.5, 2.0 and 2.5%) on the growth rate of L. fermentum was checked and 2.0% FOS was selected for further studies. The synbiotic preparation containing L. fermentum and FOS exhibited significant antimicrobial activity against a few tested common food borne pathogens. The proteolytic activity of the L. fermentum was significant and the total amino acid content in milk fermented with L. fermentum was 555 mg/l. In addition, it was found to produce 29.45 ng vitamin B12/g dry biomass in submerged fermentation (96 h) with successive anaerobic and aerobic phases of 48 h.

  17. Outcomes of management decisions by parents for their infants with hypoplastic left heart syndrome born with and without a prenatal diagnosis.

    PubMed

    Tibballs, James; Cantwell-Bartl, Annie

    2008-06-01

    To study the influence of a prenatal diagnosis on parental choice of treatment for infants born with hypoplastic left heart syndrome (HLHS). Retrospective review of medical records of infants admitted to a paediatric tertiary hospital 1983-2004 with a diagnosis of HLHS. A total of 201 infants had HLHS diagnosed by echocardiography after birth with 129 subsequently undergoing surgery and 72 non-surgical management (compassionate/comfort care). When the diagnosis of HLHS was made prenatally, 68 of 71 (96%) infants underwent surgery whereas when the diagnosis was made post-natally 61 of 130 (47%) infants underwent surgery. Prenatal diagnosis was significantly associated with a parental choice of surgery (P < 0.001). Among 72 infants managed non-surgically, compassionate care was chosen by parents for 49 (68%) despite being fit for surgery, 20 (28%) were deemed unfit for surgery and in three (4%) the reasons for non-surgical management were unknown. Of the total 178 infants considered fit for surgery, 68 (38%) had had a prenatal diagnosis and 110 (62%) did not. Of 20 considered unfit for surgery, none had had a prenatal diagnosis. A prenatal diagnosis was significantly associated with fitness for surgery (P < 0.001). Approximately half of parents chose non-surgical management (compassionate care) of their infant if the diagnosis was post-natal. Although most parents of infants born with a prenatal diagnosis of HLHS chose surgical management of their infant, this is the likely influence of termination of pregnancy for this condition. Lack of prenatal diagnosis compromised fitness for surgery.

  18. Perinatal mortality among infants born during health user-fees (Cash & Carry) and the national health insurance scheme (NHIS) eras in Ghana: a cross-sectional study.

    PubMed

    Ibrahim, Abdallah; Maya, Ernest T; Donkor, Ernestina; Agyepong, Irene A; Adanu, Richard M

    2016-12-08

    This research determined the rates of perinatal mortality among infants delivered under Ghana's national health insurance scheme (NHIS) compared to infants delivered under the previous "Cash and Carry" system in Northern Region, especially as the country takes stock of its progress toward meeting the Millennium Development Goals (MDG) 4 and 5. The labor and maternity wards delivery records of infants delivered before and after the implementation of the NHIS in Northern Region were examined. Records of available daily deliveries during the two health systems were extracted. Fisher's exact tests of non-random association were used to examine the bivariate association between categorical independent variables and perinatal mortality. On average, 8% of infants delivered during the health user-fee (Cash & Carry) died compared to about 4% infant deaths during the NHIS delivery fee exemption period in Northern Region, Ghana. There were no remarkable difference in the rate of infant deaths among mothers in almost all age categories in both the Cash and Carry and the NHIS periods except in mothers age 35 years and older. Infants born to multiparous mothers were significantly more likely to die than those born to first time mothers. There were more twin deaths during the Cash and Carry system (p = 0.001) compared to the NHIS system. Deliveries by caesarean section increased from an average of 14% in the "Cash and Carry" era to an average of 20% in the NHIS era. The overall rate of perinatal mortality declined by half (50%) in infants born during the NHIS era compared to the Cash and Carry era. However, caesarean deliveries increased during the NHIS era. These findings suggest that pregnant women in the Northern Region of Ghana were able to access the opportunity to utilize the NHIS for antenatal visits and possibly utilized skilled care at delivery at no cost or very minimal cost to them, which therefore improved Ghana's progress towards meeting the MDG 4, (reducing

  19. ADHD and infant disorganized attachment: a prospective study of children next-born after stillbirth.

    PubMed

    Pinto, Carmen; Turton, Penelope; Hughes, Patricia; White, Sarah; Gillberg, Christopher

    2006-08-01

    To examine whether infant disorganized attachment predicts ADHD at school age. A cohort of 53 children who had been identified as having significant levels of disorganized attachment in infancy is compared to a control group. Symptoms and signs of ADHD at age 7 are evaluated together with a range of relevant maternal variables. An association is found between infant disorganized attachment scores and teacher-rated symptoms of ADHD (but not ADHD caseness). Probable ADHD caseness in the child is associated with self-rated retrospective ADHD scores in mothers. Possible ADHD caseness is associated with a measure of unresolved mourning in mothers. Mother-rated ADHD in the child was associated with low overall maternal psychosocial functioning. The finding of a link between scores for disorganized attachment at 1 year and later teacher-rated symptoms of ADHD suggests the need for further studies.

  20. Milk protein-based infant formula containing rice starch and low lactose reduces common regurgitation in healthy term infants: a randomized, blinded, and prospective trial.

    PubMed

    Lasekan, John B; Linke, Hawley K; Oliver, Jeffery S; Carver, Jane D; Blatter, Mark M; Kuchan, Matthew J; Cramer, Jenna M; Pollack, Paul F

    2014-01-01

    Spit-up (regurgitation) reduction with prethickened milk protein-based infant formulas containing rice starch has been clinically demonstrated in infants with heavy spit-ups but not in otherwise healthy normal infants with common spit-ups. The objective of this study was to evaluate growth, gastrointestinal tolerance, and efficacy to reduce common spit-up in normal, healthy term infants fed an investigational rice starch prethickened lactose-free milk protein-based infant formula. This double-blind, randomized, parallel study evaluated the investigational rice starch prethickened lactose-free (low lactose < 100 mg/L) milk protein-based infant formula compared to a standard, commercially available, iso-nutrient, lactose-containing (100% of carbohydrate) milk-based infant formula (control) for growth and gastrointestinal tolerance in healthy term infants (n = 132/group) fed from 14 ± 3 days to 112 days of age. Data were classified and analyzed as evaluable (EV; subjects completing study per protocol) or intent-to-treat data (ITT; all subjects with available data). Growth as indicated by weight gain (primary variable) and formula intake were not significantly different (p > 0.05) between feeding groups (EV or ITT). Though both formulas were well tolerated, spit-up frequency was significantly lower (p < 0.05) in the rice versus control group by 53% at 28 days of age, 54% at 56 days, 48% at 84 days, and 32% at 112 days (EV). Importantly, infants in the rice group were 1.6 to 1.8 times more likely to report zero spit-up than infants in the control group. The rice group also had higher percentages of soft and yellow stools. The rice starch prethickened lactose-free milk protein-based formula (rice) supported normal growth and safe use as the sole source of feeding for normal infants over the first 4 months of life. The rice formula was efficacious in providing a clinically relevant reduction of spit-up frequency in otherwise healthy term infants.

  1. Predictive factors for survival for out-born infants born between 23 and 24 weeks of gestation in the post-surfactant era: fourteen years' experience in a single neonatal care unit, 1987-2000.

    PubMed

    Hosono, Shigeharu; Ohno, Tsutomu; Kimoto, Hirofumi; Shimizu, Masaki; Takahashi, Shigeru; Harada, Kensuke

    2008-10-01

    The purpose of the present paper was to identify the predictive factors for survival for out-born infants born between 23 and 24 weeks of gestation. Ninety-two infants born between 23 and 24 weeks' gestation who were admitted to a level III neonatal intensive care unit from 1987 to 2000, were retrospectively studied. Survival was defined as discharge from the neonatal intensive care unit. Logistic regression was done to determine which clinical factors were most predictive of survival. The independent variables that were entered into the models were determined by preliminary univariate analysis. Ninety-two infants were enrolled in the present study, 49 of whom survived in the surfactant era. The four variables that were found to be most predictive for survival on logistic regression were systolic blood pressure at 6 h (odds ratio [OR], 1.3; 95% confidence interval [CI]: 1.11-1.44 1 mmHg), ventilatory index < 0.047 (OR, 4.8; 95%CI: 1.07-21.65), initial hemoglobin value (OR, 1.6; 95%CI: 1.09-2.34/1 g/dL), and base excess at 6 h (OR, 2.1; 95%CI: 1.08-1.84/5 mEq/L). A total of 53.2% of infants delivered between 23 and 24 weeks of gestation survived at discharge after introduction of surfactant replacement therapy. Early cardiopulmonary adaptation and initial hemoglobin value are key factors for survival in infants born at 23-24 weeks of gestation.

  2. Hypersecretion of FSH in infant boys and girls born small for gestational age.

    PubMed

    Ibáñez, Lourdes; Valls, Carme; Cols, Maria; Ferrer, Angela; Marcos, Maria Victoria; De Zegher, Francis

    2002-05-01

    Prenatal growth restraint, as reflected in a low birthweight for gestational age, is a risk factor for postpubertal FSH hypersecretion and for reduced gonadal size. The ontogeny of the low-birthweight effect on the FSH-inhibin B feedback loop is unknown. Infancy is an episode of choice to study the possibility of an early low-birthweight effect on the FSH-inhibin B loop because this phase is characterized by high activity within the gonadal axis. We assessed serum concentrations of FSH and inhibin B in 46 infants [26 girls and 20 boys; mean age, 4 months; range, 3-6 months; 17 appropriate for gestational age (AGA), 29 small for gestational age (SGA); mean birthweight, 3.2 kg for AGA vs. 2.3 kg for SGA], together with circulating levels of LH, E2, and free androgen index. In SGA girls and boys, serum FSH levels were 2- and 4-fold higher (P < 0.001), respectively, than in AGA controls of the same gender (7.3 +/- 0.9 vs. 3.8 +/- 0.4 IU/ml and 2.9 +/- 0.5 vs. 0.7 +/- 0.2 IU/ml). Serum LH, inhibin B, and free androgen index/E2 concentrations were similar in AGA and SGA infants. In conclusion, prenatal growth restraint was found to be followed by elevated serum FSH concentrations in infant girls and boys. SGA infants seem to need an augmented FSH drive to fulfill inhibin B requirements on the afferent side of the feedback loop. The late-endocrine correlates of early growth restraint are herewith extended to include the main axis of reproduction in both genders. It remains to be studied whether FSH hypersecretion in infancy is a marker of subsequent subfertility.

  3. Dual role of cerebral blood flow in regional brain temperature control in the healthy newborn infant.

    PubMed

    Iwata, Sachiko; Tachtsidis, Ilias; Takashima, Sachio; Matsuishi, Toyojiro; Robertson, Nicola J; Iwata, Osuke

    2014-10-01

    Small shifts in brain temperature after hypoxia-ischaemia affect cell viability. The main determinants of brain temperature are cerebral metabolism, which contributes to local heat production, and brain perfusion, which removes heat. However, few studies have addressed the effect of cerebral metabolism and perfusion on regional brain temperature in human neonates because of the lack of non-invasive cot-side monitors. This study aimed (i) to determine non-invasive monitoring tools of cerebral metabolism and perfusion by combining near-infrared spectroscopy and echocardiography, and (ii) to investigate the dependence of brain temperature on cerebral metabolism and perfusion in unsedated newborn infants. Thirty-two healthy newborn infants were recruited. They were studied with cerebral near-infrared spectroscopy, echocardiography, and a zero-heat flux tissue thermometer. A surrogate of cerebral blood flow (CBF) was measured using superior vena cava flow adjusted for cerebral volume (rSVC flow). The tissue oxygenation index, fractional oxygen extraction (FOE), and the cerebral metabolic rate of oxygen relative to rSVC flow (CMRO₂ index) were also estimated. A greater rSVC flow was positively associated with higher brain temperatures, particularly for superficial structures. The CMRO₂ index and rSVC flow were positively coupled. However, brain temperature was independent of FOE and the CMRO₂ index. A cooler ambient temperature was associated with a greater temperature gradient between the scalp surface and the body core. Cerebral oxygen metabolism and perfusion were monitored in newborn infants without using tracers. In these healthy newborn infants, cerebral perfusion and ambient temperature were significant independent variables of brain temperature. CBF has primarily been associated with heat removal from the brain. However, our results suggest that CBF is likely to deliver heat specifically to the superficial brain. Further studies are required to assess the

  4. Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants.

    PubMed

    Bai, Dorothy Li; Fong, Daniel Yee Tak; Lok, Kris Yuet Wan; Wong, Janet Yuen Ha; Tarrant, Marie

    2017-02-01

    To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. A total of 2450 mother-infant pairs were recruited in 2006-2007 and 2011-2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped. Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006-2007 and from 18·0 to 19·8 % in 2011-2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months. Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers' reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.

  5. Longitudinal standards for growth velocity of infants from birth to 4 years born in West Azerbaijan Province of northwest Iran.

    PubMed

    Ghaemmaghami, Parvin; Ayatollahi, Seyyed Mohammad Taghi; Alinejad, Vahid; Haem, Elham

    2015-01-01

    Growth velocity is an important factor to monitor for appropriate child growth. This study presents the growth velocity of infants based on length, weight, and head circumference. The subjects of this study were 308 neonates (160 boys and 148 girls) born in West Azerbaijan Province of northwestern Iran who were followed from birth for 4 years. The weights and lengths of the subjects were recorded at birth, 1, 2, 4, 6, and 9 months, and 1, 1.5, 2, 3, and 4 years of age, while the head circumferences were measured just up to 1.5 years of age. In this study, the Lambda-Mu-Sigma (LMS) method using LMS Chartmaker Pro (Institute of Child Health, London, UK) was utilized to obtain growth velocity percentiles. After obtaining growth velocity charts for weight, length, and head circumference (5th, 50th, and 95th percentiles), the researchers could deduce that there was a sharp decrease in the velocity growth charts from birth to 2 years of age but these charts remained relatively stable up to 4 years for both sexes. Growth velocities for the length and weight of boys in the present sample are slightly but not significantly greater than those in girls through the first months of infancy and there was no significant difference between girls and boys up to 4 years. This paper provided the first local growth velocity standards of length, weight, and head circumference for infants by analyzing longitudinal measurements produced for West Azerbaijan Province, which should be updated periodically. It seems that there has been a significant difference between the growth velocity of infants in northwestern Iran and southern Iran within the past few years.

  6. Systematic review indicates postnatal growth in term infants born small-for-gestational-age being associated with later neurocognitive and metabolic outcomes.

    PubMed

    Castanys-Muñoz, Esther; Kennedy, Kathy; Castañeda-Gutiérrez, Eurídice; Forsyth, Stewart; Godfrey, Keith M; Koletzko, Berthold; Ozanne, Susan E; Rueda, Ricardo; Schoemaker, Marieke; van der Beek, Eline M; van Buuren, Stef; Ong, Ken K

    2017-08-01

    We systematically reviewed papers published in English between 1994 and October 2015 on how postnatal weight gain and growth affect neurodevelopment and metabolic outcomes in term-born small-for-gestational-age (SGA) infants. Two randomised trials reported that enriched infant formulas that promoted early growth also increased fat mass, lean mass and blood pressure (BP), but had no effect on early neurocognitive outcomes. Meanwhile, 31 observational studies reported consistent positive associations between postnatal weight gain and growth with neurocognitive outcomes, adiposity, insulin resistance and BP. Few intervention studies exist, despite consistent positive associations between early growth and neurocognition in term-born SGA infants. ©2017 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  7. α-Lactalbumin and casein-glycomacropeptide do not affect iron absorption from formula in healthy term infants.

    PubMed

    Szymlek-Gay, Ewa A; Lönnerdal, Bo; Abrams, Steven A; Kvistgaard, Anne S; Domellöf, Magnus; Hernell, Olle

    2012-07-01

    Iron absorption from infant formula is relatively low. α-Lactalbumin and casein-glycomacropeptide have been suggested to enhance mineral absorption. We therefore assessed the effect of α-lactalbumin and casein-glycomacropeptide on iron absorption from infant formula in healthy term infants. Thirty-one infants were randomly assigned to receive 1 of 3 formulas (4 mg iron/L, 13.1 g protein/L) from 4-8 wk to 6 mo of age: commercially available whey-predominant standard infant formula (standard formula), α-lactalbumin-enriched infant formula (α-LAC), or α-lactalbumin-enriched/casein-glycomacropeptide-reduced infant formula (α-LAC/RGMP). Nine breast-fed infants served as a reference. At 5.5 mo of age, (58)Fe was administered to all infants in a meal. Blood samples were collected 14 d later for iron absorption and iron status indices. Iron deficiency was defined as depleted iron stores, iron-deficient erythropoiesis, or iron deficiency anemia. Iron absorption (mean ± SD) was 10.3 ± 7.0% from standard formula, 8.6 ± 3.8% from α-LAC, 9.2 ± 6.5% from α-LAC/RGMP, and 12.9 ± 6.5% from breast milk, with no difference between the formula groups (P = 0.79) or all groups (P = 0.44). In the formula-fed infants only, iron absorption was negatively correlated with serum ferritin (r = -0.49; P = 0.005) and was higher (P = 0.023) in iron-deficient infants (16.4 ± 12.4%) compared with those with adequate iron status (8.6 ± 4.4%). Our findings indicate that α-lactalbumin and casein-glycomacropeptide do not affect iron absorption from infant formula in infants. Low serum ferritin concentrations are correlated with increased iron absorption from infant formula.

  8. Long chain polyunsaturated fatty acid supplementation in infants born at term.

    PubMed

    Jasani, Bonny; Simmer, Karen; Patole, Sanjay K; Rao, Shripada C

    2017-03-10

    The long chain polyunsaturated fatty acids (LCPUFA) docosahexaenoic acid (DHA) and arachidonic acid (AA) are considered essential for maturation of the developing brain, retina and other organs in newborn infants. Standard infant milk formulae are not supplemented with LCPUFA; they contain only alpha-linolenic acid and linoleic acid, from which formula-fed infants must synthesise their own DHA and AA, respectively. Over the past few years, some manufacturers have added LCPUFA to formula milk and have marketed these products as providing an advantage for the overall development of full-term infants. To assess whether supplementation of formula milk with LCPUFA is both safe and beneficial for full-term infants, while focusing on effects on visual function, neurodevelopment and physical growth. Two review authors independently searched the Cochrane Central Register of Controlled Trials (CENTRAL; December 2016), MEDLINE (Ovid, 1966 to December 2016), Embase (Ovid, 1980 to December 2016), the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1980 to December 2016) and abstracts of the Pediatric Academic Societies (2000 to 2016). We applied no language restrictions. We reviewed all randomised controlled trials (RCTs) evaluating effects of LCPUFA supplemented versus non-supplemented formula milk on visual function, neurodevelopment and physical growth. We did not include trials reporting only biochemical outcomes. Two review authors extracted data independently. We assessed risk of bias of included studies using the guidelines of the Cochrane Neonatal Review Group. When appropriate, we conducted meta-analysis to determine a pooled estimate of effect. We identified 31 RCTs and included 15 of these in the review (N = 1889).Nine studies assessed visual acuity, six of which used visual evoked potentials (VEP), two Teller cards and one both. Four studies reported beneficial effects, and the remaining five did not. Meta-analysis of three RCTs showed significant

  9. Separation Anxiety and Bedtime Resistance in Eight-Month-Old Infants

    ERIC Educational Resources Information Center

    Kelmanson, Igor A.

    2012-01-01

    The study aimed to examine possible association between degree of maternally reported eight-month-old infants' separation anxiety and their bedtime resistance. It comprised 114 apparently healthy babies (50 boys and 64 girls), who were born in St Petersburg in 2007. The infants were born at term (gestational age greater than or equal to 37 weeks),…

  10. Separation Anxiety and Bedtime Resistance in Eight-Month-Old Infants

    ERIC Educational Resources Information Center

    Kelmanson, Igor A.

    2012-01-01

    The study aimed to examine possible association between degree of maternally reported eight-month-old infants' separation anxiety and their bedtime resistance. It comprised 114 apparently healthy babies (50 boys and 64 girls), who were born in St Petersburg in 2007. The infants were born at term (gestational age greater than or equal to 37 weeks),…

  11. The Canadian Healthy Infant Longitudinal Development (CHILD) Study: examining developmental origins of allergy and asthma.

    PubMed

    Subbarao, Padmaja; Anand, Sonia S; Becker, Allan B; Befus, A Dean; Brauer, Michael; Brook, Jeffrey R; Denburg, Judah A; HayGlass, Kent T; Kobor, Michael S; Kollmann, Tobias R; Kozyrskyj, Anita L; Lou, W Y Wendy; Mandhane, Piushkumar J; Miller, Gregory E; Moraes, Theo J; Pare, Peter D; Scott, James A; Takaro, Tim K; Turvey, Stuart E; Duncan, Joanne M; Lefebvre, Diana L; Sears, Malcolm R

    2015-10-01

    The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study recruited 3624 pregnant women, most partners and 3542 eligible offspring. We hypothesise that early life physical and psychosocial environments, immunological, physiological, nutritional, hormonal and metabolic influences interact with genetics influencing allergic diseases, including asthma. Environmental and biological sampling, innate and adaptive immune responses, gene expression, DNA methylation, gut microbiome and nutrition studies complement repeated environmental and clinical assessments to age 5. This rich data set, linking prenatal and postnatal environments, diverse biological samples and rigorous phenotyping, will inform early developmental pathways to allergy, asthma and other chronic inflammatory diseases.

  12. Perinatal loss and parental distress after the birth of a healthy infant.

    PubMed

    Armstrong, Deborah S

    2007-08-01

    Determine whether levels of depressive symptoms and current stress related to prior perinatal loss differ from similar prenatal evaluations after the birth of a subsequent healthy full-term infant and investigate differences in depressive symptoms in the postpartum period among parents with and without a history of perinatal loss. Seventy-four of the original 206 parents who participated in an earlier prenatal study agreed to participate at follow-up and were divided into 2 groups (38 parents with a history of perinatal loss and 36 parents with no prior losses). A 2-wave, 2-group comparative design was used. Both mothers and fathers were recruited for this study. Surveys were completed via telephone interviews. Data were analyzed using descriptive statistics, chi-square tests, t tests and Pearson correlations. The Impact of the Event Scale (IES) is broadly used to evaluate the continuing influence of a past stressful life event. In the current study, the items were anchored to the traumatic event of perinatal loss. The IES contains 2 subscales: Intrusion and Avoidance. Cronbach's alphas for the current study were .80 (total scale), .85 (Intrusion subscale), and .69 (Avoidance subscale). The Center for Epidemiologic Studies-Depression Scale (CES-D) is used to identify the duration and frequency of depressive symptoms experienced by the respondent during the previous week. The Cronbach's alpha for the current study was .92. There was a significant overall decrease in depressive symptoms after the birth of a healthy infant for fathers but not for mothers with prior perinatal losses. Nevertheless, approximately one third of the mothers with a history of loss continued to report CES-D scores that placed them at high risk for depression. There also was a significant decrease in stress related to the prior loss for both mother and fathers. The greater the stress associated with the prior loss, the greater were parents' depressive symptoms after birth. In contrast to the

  13. Healthy late preterm infants and supplementary artificial milk feeds: effects on breast feeding and associated clinical parameters.

    PubMed

    Mattsson, Elisabet; Funkquist, Eva-Lotta; Wickström, Maria; Nyqvist, Kerstin H; Volgsten, Helena

    2015-04-01

    to compare the influence of supplementary artificial milk feeds on breast feeding and certain clinical parameters among healthy late preterm infants given regular supplementary artificial milk feeds versus being exclusively breast fed from birth. a comparative study using quantitative methods. Data were collected via a parental diary and medical records. parents of 77 late preterm infants (34 5/7-36 6/7 weeks), whose mothers intended to breast feed, completed a diary during the infants׳ hospital stay. infants who received regular supplementary artificial milk feeds experienced a longer delay before initiation of breast feeding, were breast fed less frequently and had longer hospital stays than infants exclusively breast fed from birth. Exclusively breast-fed infants had a greater weight loss than infants with regular artificial milk supplementation. A majority of the mothers (65%) with an infant prescribed artificial milk never expressed their milk and among the mothers who used a breast-pump, milk expression commenced late (10-84 hours after birth). At discharge, all infants were breast fed to some extent, 43% were exclusively breast fed. clinical practice and routines influence the initiation of breast feeding among late preterm infants and may act as barriers to the mothers׳ establishment of exclusive breast feeding. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Does a parent-administrated early motor intervention influence general movements and movement character at 3months of age in infants born preterm?

    PubMed

    Fjørtoft, Toril; Ustad, Tordis; Follestad, Turid; Kaaresen, Per Ivar; Øberg, Gunn Kristin

    2017-09-01

    Studies of preterm and term-born infants have shown absent fidgety movements and an abnormal movement character to be related to brain lesions and unfavourable neurological outcomes. The present study examines what effect a parent-administered early intervention program applied to preterm infants in a randomised control trial (RCT) between 34 and 36weeks gestational age has on their fidgety movements and overall movement character at three months of age. The study was part of the RCT in an early intervention programme including preterm infants born between 2010 and 2014 at three Norwegian university hospitals. 130 preterm infants participated in the study, with 59 of them in the control group and 71 in the intervention group. Fidgety movements and overall movement character at three months corrected age. No difference was found between the intervention group and the control group in terms of fidgety movements or movement character. Approximately half of the infants in both groups showed an abnormal movement character. No evidence was found in this RCT to suggest that an intervention at 34 to 37weeks gestational age has a significant effect on the fidgety movements or overall movement character of preterm infants. This is in line with the assumption that absent fidgety movements and an abnormal movement character are due to permanent brain injury and are therefore good predictors for later neurological impairments. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Dendritic cells in uninfected infants born to hepatitis B virus-positive mothers.

    PubMed

    Koumbi, Lemonica J; Papadopoulos, Nikolaos G; Anastassiadou, Vassiliki; Machaira, Maria; Kafetzis, Dimitris A; Papaevangelou, Vassiliki

    2010-07-01

    Plasmacytoid dendritic cells (pDCs) play a central role in antiviral immunity, detecting viruses via Toll-like receptors (TLR) and producing in response vast amounts of type I interferons (IFNs). Hepatitis B virus (HBV) causes chronic infection after vertical transmission. This study investigated whether an HBV-infected maternal environment might influence DC numbers and pDC function in uninfected infants. Blood was collected from inactive HBsAg carrier and control mothers and their infants at birth and 1 and 6 months of age. HBV DNA was measured in maternal and neonatal perinatal sera using real-time PCR. The circulating frequencies of myeloid DCs (mDCs) and pDCs were determined in the babies by flow cytometry. Peripheral blood mononuclear cells (PBMCs) and cord blood pDCs were stimulated with resiquimod, and alpha interferon (IFN-alpha) production and the pDC phenotype were assessed. The effect of the common-cold virus, rhinovirus (RV), on resiquimod stimulation was also determined. HBV DNA was detected in 62.3% of the mothers and 41% of their infants. DC numbers and pDC functions were similar between subjects and controls and were not correlated with maternal or neonatal viremia. RV infection did not induce pDC maturation until the age of 6 months, and it reduced TLR7-dependent resiquimod-induced IFN-alpha production similarly in both groups. Although the DC system is immature at birth, DCs of uninfected neonates of HBV-positive mothers are competent to initiate and maintain T-cell responses. RV is a weak inducer of IFN-alpha production until the age of 6 months and inhibits IFN-alpha responses triggered by the TLR7 pathway.

  16. Long-chain polyunsaturated fatty acid supplementation in infants born at term.

    PubMed

    Simmer, K

    2001-01-01

    The n-3 and n-6 fatty acids linolenic acid and linoleic acid are precursors of the n-3 and n-6 longchain fatty acids (LCPUFA). Infant formula has historically only contained the precursor fatty acids. Controversy exists over whether LCPUFA are also essential nutrients in infancy. Over the last few years some manufacturers have added LCPUFA to formulae and marketed them as providing an advantage for the development of term infants. The aim of this review is to assess whether supplementation of formula with LCPUFA is safe and of benefit to term infants. Trials were identified by MEDLINE, checking reference lists of articles and conference proceedings, and by personal communication. All randomised trials of formula supplemented with LCPUFA and with clinical endpoints were reviewed. Ten randomised studies were identified. One of these studies was excluded due to supplementation commencing after three weeks of age. Eight of the nine included trials were assessed to be of good quality. There was insufficient information available to assess the quality of the other included trial. Visual acuity was assessed by visual evoked potentials (VEP) at 4 and 7-8 months in the studies of Makrides et al (1995 & 1996). The supplemented infants had an improved rate of visual maturation at both time points in the first study, but no difference was found between the groups at the same time points in the second study. VEP acuity was also assessed in the study of Austed et al (1997) and no effect of supplementation was found at any time point over the first year. This contrasts with the study of Birch et al (1998) where VEP acuity was better in the supplemented group compared with the control group at 6 weeks, 4 and 12 months but not at 6 months. Visual acuity was assessed by Teller acuity cards in the study of Carlson et al (1996), Clausen et al (1996), Austed et al (1997) and Birch et al (1998). Supplementation had no effect on visual acuity over the first year of life except at one of

  17. Dynamic oropharyngeal and faecal microbiota during treatment in infants hospitalized for bronchiolitis compared with age-matched healthy subjects.

    PubMed

    Hu, Qian; Dai, Wenkui; Zhou, Qian; Fu, Dan; Zheng, Yuejie; Wang, Wenjian; Liu, Yanhong; Yang, Qin; Dai, Dongling; Liu, Sixi; Liu, Guosheng; Li, Shuaicheng; Wen, Feiqiu

    2017-09-12

    Bronchiolitis is one of the most severe diseases affecting infants worldwide. An imbalanced oropharynx (OP) microbiota has been reported in infants hospitalized with bronchiolitis; however, the microbiota dynamics in the OP and faeces during therapy remain unexplored. In total, 27 infants who were hospitalized with bronchiolitis were selected for this study, and sampling was conducted before therapy and after clinical recovery. We also recruited 22 age-matched healthy infants for this study. The faecal and OP microbiota diversity in the patients was lower than that in the healthy children. The faecal microbiota (FM) in the diseased children significantly differed from that in the healthy subjects and contained accumulated Bacteroides and Streptococcus. The OP microbiota in both the healthy and diseased infants was dominated by Streptococcus. After the treatment, the FM and OP microbiota in the patients was comparable to that before the treatment. This study may serve as an additional reference for future bronchiolitis studies, and the "risk microbiota model" of clinically recovered infants suggests an increased susceptibility to pathogen intrusion.

  18. The risk of neurodisability and other long-term outcomes for infants born following ART.

    PubMed

    Källén, Bengt

    2014-08-01

    Children born after assisted reproductive technologies (ART) have an increased morbidity. The risk of developing cerebral palsy is nearly doubled and the risk of developing epilepsy is also higher. Behavioural problems including attention deficit/hyperactivity disorder may be more common in children born following ART than among naturally conceived children but the finding is uncertain. Data on autism are difficult to interpret. There may exist a small increase in the incidence of childhood cancer and there is greater evidence of an elevated risk of asthma. To some extent, these risks are mediated by neonatal complications including prematurity and low birth weight but some effects such as cerebral palsy are likely to be linked to the increased rate of multiple births after ART. Many of the neonatal complications after ART are most likely linked to parental subfertility and are less an effect of the ART technology. The possibility exists that imprinting errors, associated with subfertility and/or ART, may result in long-term morbidity.

  19. Risk factors for adverse events after vaccinations performed during the initial hospitalization of infants born prematurely.

    PubMed

    Wilińska, Maria; Warakomska, Małgorzata; Głuszczak-Idziakowska, Ewa; Jackowska, Teresa

    There are significant delays in implementing vaccination among preterm infants. Description of the frequency and kinds of adverse events following immunization in preterms. Establishment of the group of preterms who will distinctively be susceptible to adverse events. Demographical, clinical data and the occurrence of adverse events after DTaP, HIB and pneumococcal vaccination among preterms during their initial hospitalization were prospectively collected with the use of an electronic data form between 1st June 2011 and 31st May 2015. The analysis was conducted on 138 patients. The groups were divided according to maturity (I: ≤ GA 28w n=73 and GA 29-36 w n=65). There were no statistically significant differences between the groups in the occurrence of adverse events. Out of the total group, following vaccination apnoea developed in 6 newborns (4%) and activity dysfunctions were observed in 13 newborns (10%). The occurrence of apnoea after vaccination positively correlated with the time of non-invasive ventilation and the occurrence of late infection. There were no statistically significant demographical or clinical risk factors for the development of activity dysfunctions following vaccination. Term vaccination in clinically stable preterm infants is a safe medical procedure. However, long-term non-invasive respiratory support and late infections are risk factors for apnea following vaccinations. In these patients vaccinations should be considered during hospitalization.

  20. [Newborn Hearing Screening and Subsequent Diagnostic Evaluation: Analysis and Outcomes of 6,063 Infants Born in a Community Hospital].

    PubMed

    Tanaka, Yasuko; Enomoto, Hiroyuki; Takada, Kentaro; Inoue, Maki; Ogawara, Noboru; Takahashi, Masahiro; Oridate, Nobuhiko

    2016-03-01

    A retrospective study was conducted to examine the implementation status of newborn hearing screening (NHS) of 6,063 infants born in a single community hospital in Japan between 2005 and 2013. An automated auditory brainstem response device was used for NHS and an auditory brainstem response was mainly used for further diagnostic evaluation. Although the participation rate in the NHS was 88.8% in 2013, increasing year by year, it failed to reach 100% probably because NHS is a charged option under the current Japanese healthcare system. Among 40 (0.66%) infants who finally failed their NHS, 34 were referred for subsequent diagnostic evaluation and the remaining 6 were lost to follow-up. Thirty-one of these 34 were diagnosed as having hearing impairment and 3 (0.05%) were identified as having normal hearing, which is considered as a false positive. Both the final referral rate and the hearing impairment rate were significantly higher in the high-risk than in the low-risk group. Compared to the previous national report, the rate of bilateral hearing impairment (0.33%) was significantly higher in this study. Ten (38.5%) out of 26 in the high-risk group were most often diagnosed with otitis media with effusion (OME), while 4 (50%) out of 8 in the low-risk group were diagnosed as having sensorineural hearing loss. Seven (35%) out of 20 with bilateral hearing impairment attained a normal hearing level at a median age of 18 months. Although the primary aim of NHS is early detection of congenital permanent hearing loss, OME is observed commonly in NHS-failed infants. It is therefore important to examine the middle ear status carefully as part of the diagnostic evaluation. Thirty-four infants underwent further diagnostic evaluation at a median age of 46 days, and hearing aids were given in 10 of them at a median age of 5.6 months without delay. Because high-risk patients often tend to be lost to follow-up, otolaryngologists have to give a detailed explanation to caregivers

  1. Biological risk versus socio-economic advantage: low birth-weight, multiple births and income variations among Irish infants born following fertility treatments.

    PubMed

    Murray, Aisling

    2014-12-01

    The Growing Up in Ireland Infant Cohort dataset (n = 11,134) includes information on fertility treatments for over 400 infants. IVF (28.1 %) and IVF-related treatments (17.8 %) were the most frequent, but there was also a high percentage following clomiphene citrate alone (31.5 %). Infants born following fertility treatment were much more likely to be in higher income families, and this relationship was not accounted for by older mothers in wealthier families. Analysis of fertility-treatment pregnancies among Irish infants, controlling for income and maternal age, shows a greater risk of multiple birth and low birth-weight, although the latter appears to be largely related to the former especially for IVF-type treatments.

  2. Trends in infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight.

    PubMed

    Barría-Pailaquilén, René Mauricio; Mendoza-Maldonado, Yessy; Urrutia-Toro, Yohana; Castro-Mora, Cristian; Santander-Manríquez, Gema

    2011-01-01

    The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at <32 weeks and <1500g was calculated, establishing causes of death and evaluating its relation with specific interventions, such as the use of surfactant and antenatal corticoids. Since the year 2000, infant mortality rates have stopped their decrease in comparison to the preceding decade and the gap between national and local rates before 2000 was drastically reduced. Mortality at <32 weeks and <1500g varied between 88% and 200% of liveborns, emphasizing respiratory distress as the main cause of death. The use of corticoids and surfactant was in line with reductions in mortality rates.

  3. Cardiovascular risk factors in healthy women with previous small for gestational age infants.

    PubMed

    Paradisi, Giancarlo; Mattoli, Maria Vittoria; Tomei, Claudia; Zuppi, Cecilia; Lulli, Paola; Quagliozzi, Lorena; Caruso, Alessandro

    2011-10-01

    To investigate whether healthy women with a previous pregnancy complicated by a small for gestational age (SGA) infant have normal endothelial function, carbohydrate and lipid metabolism, and normal inflammation parameters. Brachial artery flow-mediated dilatation (FMD, endothelium-dependent) was measured in 16 subjects with previous SGA, and in 15 controls (CTR) with previous normal pregnancies. Lipid panel, glucose, insulin, tumor necrosis factor alpha (TNF-alpha), soluble intercellular adhesion molecule-1 (s-ICAM), soluble vascular (s-VCAM-1) adhesion molecule-1 (s-VCAM-1), and androgens were also measured. FMD was reduced in women with previous SGA compared to controls (P < 0.0001). SGA women showed increased insulin resistance (P < 0.0001), s-ICAM-1 (P = 0.008), TNF-alpha (P = 0.02), testosterone (P = 0.03), and diastolic blood pressure (P = 0.01) than CTR. Endothelial dysfunction, reduced insulin sensitivity and subclinical inflammation are present in otherwise healthy women with previous SGA. These abnormalities show that the presence of a SGA infant in the obstetric history should be considered as a risk factor for cardiovascular disease later in life. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

  4. Antibacterial activity of Lactobacillus spp. isolated from the feces of healthy infants against enteropathogenic bacteria.

    PubMed

    Davoodabadi, Abolfazl; Soltan Dallal, Mohammad Mehdi; Rahimi Foroushani, Abbas; Douraghi, Masoumeh; Sharifi Yazdi, Mohammad Kazem; Amin Harati, Farzaneh

    2015-08-01

    Lactobacilli are normal microflora of the gastrointestinal (GI) tract and are a heterogeneous group of lactic acid bacteria (LAB). Lactobacillus strains with Probiotic activity may have health Benefits for human. This study investigates the probiotic potential of Lactobacillus strains obtained from the feces of healthy infants and also explores antibacterial activity of Lactobacillus strains with probiotic potential against enteropathogenic bacteria. Fecal samples were collected from 95 healthy infants younger than 18 months. Two hundred and ninety Lactobacillus strains were isolated and assessed for probiotic potential properties including ability to survive in gastrointestinal conditions (pH 2.0, 0.3% oxgall), adherence to HT-29 cells and antibiotic resistance. Six strains including Lactobacillus fermentum (4 strains), Lactobacillus paracasei and Lactobacillus plantarum showed good probiotic potential and inhibited the growth of enteropathogenic bacteria including ETEC H10407, Shigella flexneri ATCC 12022, Shigella sonnei ATCC 9290, Salmonella enteritidis H7 and Yersinia enterocolitica ATCC 23715. These Lactobacillus strains with probiotic potential may be useful for prevention or treatment of diarrhea, but further in vitro and in vivo studies on these strains are still required.

  5. Oxygen saturation in healthy newborn infants immediately after birth measured by pulse oximetry.

    PubMed

    Toth, B; Becker, A; Seelbach-Göbel, B

    2002-04-01

    Pre- and postductal arterial oxygen saturation (SpO2) rates were measured in 50 healthy vaginally delivered newborn infants to establish reference values of SpO2 rates immediately after birth. We compared the SpO2 values in the pre- and postductal areas and assessed the influence of oxitocin and analgetics applied during delivery. Fifty neonates were examined by the 2nd minute (min) of life using Nellcor N-3000 pulse oximeters on the right hand and foot. Measurements were carried out until a SpO2 of 95% was achieved. Heart rates were registered simultaneously. Two min after birth the mean preductal SpO2 was 73% (44-95%) and 67% (34-93%) in the postductal region. SpO2 rates of > 95% were reached after 12 min (2-55 min) preductally and after 14 min (3-55 min) postductally. Our results demonstrate that it takes 12-14 min for healthy neonates to reach an oxygen saturation of 95% prerespectively postductal, in some cases even 55 min. All neonates were in good clinical condition and didn't require any supplemental oxygen. Additionally, we were able to show that epidural anaesthesia (PDA) during delivery increases the heart rate of the newborn infant.

  6. Infant born with Robert's syndrome without prenatal care in a developing nation.

    PubMed

    Benardete, Denise; Chandrasekaran, Neeraja; Cariello, Lisa; Meraz, Diego

    2016-10-25

    Maternal and child well-being during pregnancy can be attributed to receiving optimal prenatal care. However, in developing nations, there are many barriers to receiving this. We present a primigravid female aged 29 years with severe abdominal pain. She was in active labour at 40 weeks and completely unaware of her pregnancy; hence, she did not receive any prenatal care. The baby was born with significant birth deformities that were consistent with Robert's syndrome. Although early detection could not preclude the development of this disorder, proper care would have facilitated in receiving genetic counselling and proper understanding of the prognosis. In this case, we discuss the various barriers to receiving prenatal care and measures taken for improvement in developing nations.

  7. Importance of gut microbiota in health and diseases of new born infants.

    PubMed

    Gao, Jisheng; Wu, Hongwei; Liu, Jinfeng

    2016-07-01

    The multifarious assortment of microorganisms present in gut of humans is termed as gut microbiota. These include 1,000 species accompanied by approximately 2 million genes in an individual adult. The gut microbiota has multifactorial protective roles against allergic reactions, inflammation, cardiac pathological states and even in the state of malignant carcinogenesis existing in humans. By contrast, adverse alterations in the microbiota result in chronic pathological states, including autoimmune diseases, cancer and circulatory system obstructions. Gut bacteria also maintain sensitivity towards nutritional changes as well as antibiotics. The present review article focused on the importance of gut bacteria in newborn infants with special reference to their protective role in various pediatric pathological states linked with gut bacteria. In addition, the importance of probiotics in relation to gut microbiota are to be discussed.

  8. Early skin-to-skin contact for mothers and their healthy newborn infants

    PubMed Central

    Moore, Elizabeth R; Anderson, Gene C; Bergman, Nils; Dowswell, Therese

    2014-01-01

    Background Mother-infant separation postbirth is common in Western culture. Early skin-to-skin contact (SSC) begins ideally at birth and involves placing the naked baby, head covered with a dry cap and a warm blanket across the back, prone on the mother’s bare chest. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neurobehaviors ensuring fulfillment of basic biological needs. This time may represent a psychophysiologically ‘sensitive period’ for programming future physiology and behavior. Objectives To assess the effects of early SSC on breastfeeding, physiological adaptation, and behavior in healthy mother-newborn dyads. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 November 2011), made personal contact with trialists, and consulted the bibliography on kangaroo mother care (KMC) maintained by Dr. Susan Ludington. Selection criteria Randomized controlled trials comparing early SSC with usual hospital care. Data collection and analysis We independently assessed trial quality and extracted data. Study authors were contacted for additional information. Main results Thirty-four randomized controlled trials were included involving 2177 participants (mother-infant dyads). Data from more than two trials were available for only eight outcome measures. For primary outcomes, we found a statistically significant positive effect of early SSC on breastfeeding at one to four months postbirth (13 trials; 702 participants) (risk ratio (RR) 1.27, 95% confidence interval (CI) 1.06 to 1.53, and SSC increased breastfeeding duration (seven trials; 324 participants) (mean difference (MD) 42.55 days, 95% CI −1.69 to 86.79) but the results did not quite reach statistical significance (P = 0.06). Late preterm infants had better cardio-respiratory stability with early SSC (one trial; 31 participants) (MD 2.88, 95% CI 0.53 to 5.23). Blood glucose 75 to 90 minutes following the birth was

  9. Effects of gestational age on brain volume and cognitive functions in generally healthy very preterm born children during school-age: A voxel-based morphometry study.

    PubMed

    Lemola, Sakari; Oser, Nadine; Urfer-Maurer, Natalie; Brand, Serge; Holsboer-Trachsler, Edith; Bechtel, Nina; Grob, Alexander; Weber, Peter; Datta, Alexandre N

    2017-01-01

    To determine whether the relationship of gestational age (GA) with brain volumes and cognitive functions is linear or whether it follows a threshold model in preterm and term born children during school-age. We studied 106 children (M = 10 years 1 month, SD = 16 months; 40 females) enrolled in primary school: 57 were healthy very preterm children (10 children born 24-27 completed weeks' gestation (extremely preterm), 14 children born 28-29 completed weeks' gestation, 19 children born 30-31 completed weeks' gestation (very preterm), and 14 born 32 completed weeks' gestation (moderately preterm)) all born appropriate for GA (AGA) and 49 term-born children. Neuroimaging involved voxel-based morphometry with the statistical parametric mapping software. Cognitive functions were assessed with the WISC-IV. General Linear Models and multiple regressions were conducted controlling age, sex, and maternal education. Compared to groups of children born 30 completed weeks' gestation and later, children born <28 completed weeks' gestation had less gray matter volume (GMV) and white matter volume (WMV) and poorer cognitive functions including decreased full scale IQ, and processing speed. Differences in GMV partially mediated the relationship between GA and full scale IQ in preterm born children. In preterm children who are born AGA and without major complications GA is associated with brain volume and cognitive functions. In particular, decreased brain volume becomes evident in the extremely preterm group (born <28 completed weeks' gestation). In preterm children born 30 completed weeks' gestation and later the relationship of GA with brain volume and cognitive functions may be less strong as previously thought.

  10. Carbon Dioxide Fluctuations Are Associated with Changes in Cerebral Oxygenation and Electrical Activity in Infants Born Preterm.

    PubMed

    Dix, Laura Marie Louise; Weeke, Lauren Carleen; de Vries, Linda Simone; Groenendaal, Floris; Baerts, Willem; van Bel, Frank; Lemmers, Petra Maria Anna

    2017-08-01

    To evaluate the effects of acute arterial carbon dioxide partial pressure changes on cerebral oxygenation and electrical activity in infants born preterm. This retrospective observational study included ventilated infants born preterm with acute fluctuations of continuous end-tidal CO2 (etCO2) as a surrogate marker for arterial carbon dioxide partial pressure, during the first 72 hours of life. Regional cerebral oxygen saturation and fractional tissue oxygen extraction were monitored with near-infrared spectroscopy. Brain activity was monitored with 2-channel electroencephalography. Spontaneous activity transients (SATs) rate (SATs/minute) and interval between SATs (in seconds) were calculated. Ten-minute periods were selected for analysis: before, during, and after etCO2 fluctuations of ≥5  mm Hg. Thirty-eight patients (mean ± SD gestational age of 29 ± 1.8 weeks) were included, with 60 episodes of etCO2 increase and 70 episodes of etCO2 decrease. During etCO2 increases, brain oxygenation increased (regional cerebral oxygen saturation increased, fractional tissue oxygen extraction decreased; P < .01) and electrical activity decreased (SATs/minute decreased, interval between SATs increased; P < .01). All measures recovered when etCO2 returned to baseline. During etCO2 decreases, brain oxygenation decreased (regional cerebral oxygen saturation decreased, fractional tissue oxygen extraction decreased; P < .01) and brain activity increased (SATs/minute increased, P < .05), also with recovery after return of etCO2 to baseline. An acute increase in etCO2 is associated with increased cerebral oxygenation and decreased brain activity, whereas an acute decrease is associated with decreased cerebral oxygenation and slightly increased brain activity. Combining continuous CO2 monitoring with near-infrared spectroscopy may enable the detection of otherwise undetected fluctuations in arterial carbon dioxide partial pressure that may be harmful to

  11. Trends in pre-existing mental health disorders among parents of infants born in Western Australia from 1990 to 2005.

    PubMed

    O'Donnell, Melissa; Anderson, Denise; Morgan, Vera A; Nassar, Natasha; Leonard, Helen M; Stanley, Fiona J

    2013-05-20

    To determine the prevalence of prior and current mental health disorders in parents, including trends over time. retrospective population cohort study using de-identified linked health data. Population of Western Australia. All parents of infants born in WA between 1990 and 2005. Prevalence of prior mental health disorders in parents by birth 2013 and by parent and child characteristics, including Aboriginality, maternal age, socioeconomic status and diagnostic groups. From 1990 to 2005, there was an increase in prevalence of prior mental health disorders in mothers, from 76 per 1000 births in 1990 to 131 per 1000 births in 2005 (3.7% increase per 2013 in the odds of children being born to mothers with a prior mental health disorder). There was also a 4.7% increase in odds per 2013 in the prevalence of mental health contacts that had taken place in the 12 months before the birth 2013 in mothers. In addition, there was an increase in prevalence of prior mental health disorders in fathers, from 56 per 1000 births in 1990 to 88 per 1000 births in 2005 (3.1% increase in odds per 2013). The diagnostic group with the highest prevalence in both mothers and fathers was substance-related disorders. From 1990 to 2005, there was an increase in prevalence of parents with a prior history of mental health disorders in WA. General practitioners and mental health workers can play an important role in identifying mental illness and in working with families to offer early intervention, referral and support.

  12. The cumulative incidence of atopic dermatitis in the first 12 months among Chinese, Vietnamese, and Caucasian infants born in Melbourne, Australia.

    PubMed

    Mar, A; Tam, M; Jolley, D; Marks, R

    1999-04-01

    Atopic dermatitis (AD), a disease with both inherited and environmental components determining its clinical expression, has been reported to be more frequent in people of Asian origin. Our purpose was to compare the 12-month cumulative incidence of AD in Caucasian, Chinese, and Vietnamese babies born in Australia. Sixty-two Caucasian, 61 Chinese, and 59 Vietnamese babies born in Melbourne, Australia were examined soon after birth and then followed up for 12 months to assess the frequency of AD. Parental education, employment history, and housing conditions were also recorded. AD developed in 21% of Caucasians, 44% of Chinese, and 17% of Vietnamese infants. Parents of the Chinese and Caucasian infants had similar socioeconomic and housing conditions compared with the parents of the Vietnamese infants, who tended to be of lower socioeconomic status with communal housing and lack of plush-pile carpeting. The high incidence of AD in Chinese compared with Caucasian infants tends to reflect genetic differences between the two populations, whereas the difference in incidence between the Chinese and Vietnamese infants possibly reflects more the environmental contribution to disease expression.

  13. Skin Barrier Function and Staphylococcus aureus Colonization in Vestibulum Nasi and Fauces in Healthy Infants and Infants with Eczema: A Population-Based Cohort Study.

    PubMed

    Berents, Teresa Løvold; Carlsen, Karin Cecilie Lødrup; Mowinckel, Petter; Skjerven, Håvard Ove; Kvenshagen, Bente; Rolfsjord, Leif Bjarte; Bradley, Maria; Lieden, Agne; Carlsen, Kai-Håkon; Gaustad, Peter; Gjersvik, Petter

    2015-01-01

    Atopic eczema (AE) is associated with Staphylococcus aureus (S. aureus) colonization and skin barrier dysfunction, often measured by increased transepidermal water loss (TEWL). In the present study, the primary aim was to see whether S. aureus colonization in the vestibulum nasi and/or fauces was associated with increased TEWL in infants with healthy skin and infants with eczema. Secondarily, we aimed to investigate whether TEWL measurements on non-lesional skin on the lateral upper arm is equivalent to volar forearm in infants. In 167 of 240 infants, recruited from the general population, TEWL measurements on the lateral upper arm and volar forearm, using a DermaLab USB, fulfilled our environmental requirements. The mean of three TEWL measurements from each site was used for analysis. The infants were diagnosed with no eczema (n = 110), possible AE (n = 28) or AE (n = 29). DNA samples were analysed for mutations in the filaggrin gene (FLG). Bacterial cultures were reported positive with the identification of at least one culture with S. aureus from vestibulum nasi and/or fauces. S. aureus colonization, found in 89 infants (53%), was not associated with increased TEWL (i.e. TEWL in the upper quartile), neither on the lateral upper arm or volar forearm (p = 0.08 and p = 0.98, respectively), nor with AE (p = 0.10) or FLG mutation (p = 0.17). TEWL was significantly higher on both measuring sites in infants with AE compared to infants with possible AE and no eczema. FLG mutation was significantly associated with increased TEWL, with a 47% difference in TEWL. We conclude that S. aureus in vestibulum nasi and/or fauces was not associated with TEWL, whereas TEWL measurements on the lateral upper arm and volar forearm appear equally appropriate in infants.

  14. Seroprevalence of antibodies to tick-borne encephalitis virus and Anaplasma phagocytophilum in healthy adults from western Norway.

    PubMed

    Hjetland, Reidar; Henningsson, Anna J; Vainio, Kirsti; Dudman, Susanne G; Grude, Nils; Ulvestad, Elling

    2015-01-01

    The aim of this study was to assess the seroprevalence of antibodies to tick-borne encephalitis virus (TBEV) and Anaplasma phagocytophilum in a healthy adult population from Sogn and Fjordane county in western Norway. Sera from 1, 213 blood donors were analysed for IgG-antibodies to TBEV, and a random subgroup of 301 donors for IgG to A. phagocytophilum. In the TBEV ELISA, five (0.4%) sera were positive. These were all interpreted as "false" positives, as four had received vaccines against flaviviruses, and the remaining was negative for neutralizing antibodies to TBEV. Antibodies to A. phagocytophilum were detected by indirect immunofluorescence in 49 (16.2%) subjects (titer range 80-1280). The results indicate that TBE currently is not endemic in this part of western Norway. However, there is serological evidence of the existence of human granulocytic anaplasmosis in the population.

  15. Protest or Pleasure? The Response of First-Born Children to Interactions between Their Mothers and Infant Siblings.

    ERIC Educational Resources Information Center

    Kendrick, Carol; Dunn, Judy

    1982-01-01

    Triadic interactions between mother, preschool-age first-born, and 14-month-old second-born siblings were studied in 40 families as part of a longitudinal study using home observations. Interaction between mother and second-born exerted an important influence on the behavior of the first-born. (Author/RH)

  16. Protective immune barrier against hepatitis B is needed in individuals born before infant HBV vaccination program in China.

    PubMed

    Yang, Shigui; Yu, Chengbo; Chen, Ping; Deng, Min; Cao, Qing; Li, Yiping; Ren, Jingjing; Xu, Kaijin; Yao, Jun; Xie, Tiansheng; Wang, Chencheng; Cui, Yuanxia; Ding, Cheng; Tian, Guo; Wang, Bing; Zhang, Xiaoyan; Ruan, Bing; Li, Lanjuan

    2015-12-14

    The hepatitis B prevalence rate in adults is still at a high to intermediate level in China. Our purpose was to explore the incidence rate and protective immune barrier against hepatitis B in adults in China. A sample of 317961 participants was multi-screened for hepatitis B surface antigens (HBsAg) in a large-scale cohort of the National Hepatitis B Demonstration Project. A total of 5401 persons were newly-infected, representing an incidence rate of 0.81 (95% CI: 0.77-0.85) per 100 person-years after adjusted by gender and age. History of acquired immune deficiency syndrome, birth prior to 1992, coastal residence, family history of HBV, and migrant worker status were significantly associated with higher incidence, while HBV vaccination and greater exercise with lower incidence. The hepatitis B surface antibody (HBsAb) positive rate was negatively correlated with the incidence rate of hepatitis B (r = -0.826). Linear fitting yielded an incidence rate of 1.23 plus 0.02 multiplied by HBsAb positive rate. The study firstly identified the HBsAg incidence rate, which was reduced to 0.1 per 100 person-years after vaccination coverage of about 64%. The protective immune barrier against hepatitis B needs to be established in individuals born prior to the advent of infant HBV vaccination.

  17. Protective immune barrier against hepatitis B is needed in individuals born before infant HBV vaccination program in China

    PubMed Central

    Yang, Shigui; Yu, Chengbo; Chen, Ping; Deng, Min; Cao, Qing; Li, Yiping; Ren, Jingjing; Xu, Kaijin; Yao, Jun; Xie, Tiansheng; Wang, Chencheng; Cui, Yuanxia; Ding, Cheng; Tian, Guo; Wang, Bing; Zhang, Xiaoyan; Ruan, Bing; Li, Lanjuan

    2015-01-01

    The hepatitis B prevalence rate in adults is still at a high to intermediate level in China. Our purpose was to explore the incidence rate and protective immune barrier against hepatitis B in adults in China. A sample of 317961 participants was multi-screened for hepatitis B surface antigens (HBsAg) in a large-scale cohort of the National Hepatitis B Demonstration Project. A total of 5401 persons were newly-infected, representing an incidence rate of 0.81 (95% CI: 0.77–0.85) per 100 person-years after adjusted by gender and age. History of acquired immune deficiency syndrome, birth prior to 1992, coastal residence, family history of HBV, and migrant worker status were significantly associated with higher incidence, while HBV vaccination and greater exercise with lower incidence. The hepatitis B surface antibody (HBsAb) positive rate was negatively correlated with the incidence rate of hepatitis B (r = −0.826). Linear fitting yielded an incidence rate of 1.23 plus 0.02 multiplied by HBsAb positive rate. The study firstly identified the HBsAg incidence rate, which was reduced to 0.1 per 100 person-years after vaccination coverage of about 64%. The protective immune barrier against hepatitis B needs to be established in individuals born prior to the advent of infant HBV vaccination. PMID:26655735

  18. Effects of baby massage on neonatal jaundice in healthy Iranian infants: A pilot study.

    PubMed

    Dalili, Hosein; Sheikhi, Sanaz; Shariat, Mamak; Haghnazarian, Edith

    2016-02-01

    To evaluate the effects of baby massage on transcutaneous bilirubin levels and stool frequency of healthy term newborns. This Pilot study was conducted on 50 healthy newborns in Valiasr Hospital of IKHC. The infants were randomly allocated to two treatment (massage) and control group. The massage group received massage therapy (according to Touch Therapy) for four days from the first day postnatal while the control group received routine care. Main variable studied were transcutaneous bilirubin level (TCB) and stool frequency which were compared in two groups. There were 50 newborns in the study 25 in each group (50%). There was a significant difference in the TCB levels between two groups (p=0.000) with those in the massage group having lower bilirubin levels. As for the stool frequency there was a significant difference in two groups on the first day showing more defecation in the control group (p=0.042) which on the consequent days was not significant and the frequencies were almost similar. Massage group had a lower transcutaneous billirubin levels compared to the control group, thus, these pilot results indicate that massaging the newborns can be accompanied by a lower bilirubin level in the healthy term newborn. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Tolerance of natural baby skin-care products on healthy, full-term infants and toddlers

    PubMed Central

    Coret, Catherine D; Suero, Michael B; Tierney, Neena K

    2014-01-01

    Purpose To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. Materials and methods Healthy, full-term infants and toddlers aged 1–36 months were enrolled. In study 1, a lightly fragranced natural baby hair and body wash (n=30), a lightly fragranced natural baby shampoo (n=30), or a lightly fragranced natural baby lotion (n=32) were assessed over 2 weeks. In study 2, a lightly fragranced natural baby hair and body wash and a lightly fragranced natural baby lotion (n=33) were assessed as a regimen over 4 weeks. The wash and shampoo were used three or more times per week, but not more than once daily. Lotions were applied in the morning or after a bath. Clinicians assessed the arms, legs, torso, or scalp for erythema, dryness, peeling/flakiness (study 1 only), tactile roughness, edema (study 1 only), rash/irritation (study 2 only), and overall skin condition (study 2 only) at baseline, week 1, and weeks 2 or 4. Parents completed skin assessment questionnaires. In study 2, stratum corneum hydration was measured. Subjects were monitored for adverse events. Results No significant changes in clinical grading scores were observed, indicating that all products were well tolerated. By the end of each study, >90% of parents/caregivers believed each product was mild and gentle. In study 2, improvement in stratum corneum hydration was observed (+37% at week 1 and +48% at week 4, P<0.05 for both). In study 1, one baby experienced mild erythema on the neck and scalp after using the shampoo (possibly related to treatment). In study 2, there were no product-related adverse events. Conclusion The natural baby skin-care products were well tolerated by infants and toddlers when used alone or as part of a skin-care regimen. PMID:24523593

  20. Estimating the age of healthy infants from quantitative myelin water fraction maps.

    PubMed

    Dean, Douglas C; O'Muircheartaigh, Jonathan; Dirks, Holly; Waskiewicz, Nicole; Lehman, Katie; Walker, Lindsay; Piryatinsky, Irene; Deoni, Sean C L

    2015-04-01

    The trajectory of the developing brain is characterized by a sequence of complex, nonlinear patterns that occur at systematic stages of maturation. Although significant prior neuroimaging research has shed light on these patterns, the challenge of accurately characterizing brain maturation, and identifying areas of accelerated or delayed development, remains. Altered brain development, particularly during the earliest stages of life, is believed to be associated with many neurological and neuropsychiatric disorders. In this work, we develop a framework to construct voxel-wise estimates of brain age based on magnetic resonance imaging measures sensitive to myelin content. 198 myelin water fraction (VF(M) ) maps were acquired from healthy male and female infants and toddlers, 3 to 48 months of age, and used to train a sigmoidal-based maturational model. The validity of the approach was then established by testing the model on 129 different VF(M) datasets. Results revealed the approach to have high accuracy, with a mean absolute percent error of 13% in males and 14% in females, and high predictive ability, with correlation coefficients between estimated and true ages of 0.945 in males and 0.94 in females. This work represents a new approach toward mapping brain maturity, and may provide a more faithful staging of brain maturation in infants beyond chronological or gestation-corrected age, allowing earlier identification of atypical regional brain development.

  1. Does the epidemiologic paradox hold in the presence of risk factors for low birth weight infants among Mexican-born women in Colorado?

    PubMed

    Romero, Camila X; Duke, Jodi K; Dabelea, Dana; Romero, Tomas E; Ogden, Lorraine G

    2012-05-01

    To test whether foreign-born status confers a protective effect against low birth weight (LBW) outcomes among Mexican-origin women in Colorado. Retrospective cohort study utilizing Colorado birth records from 1989-2004 for multivariate logistic regression analysis. The study population was 66,422 U.S.-born women of Mexican origin (USB) and 85,000 Mexican-born (MB) women with singleton births. Mexican-born women had 24.9% lower odds of LBW (OR 0.751 95% CI 0.782) than USB women. Mexican-born women had a higher prevalence of risk factors for LBW than their USB counterparts (anemia, cardiac disease, hypertension, inadequate prenatal care, less than high school education). After adjusting for these risk factors, MB women had 22.5% lower odds of having LBW infants than USB women (OR 0.775, 95% CI 0.73-0.81). This study supports the epidemiologic paradox of LBW; despite higher prevalence of risk factors, foreign-born status confers an overall protective effect against low birth weight outcomes.

  2. Developmental variations in plasma leptin, leptin soluble receptor and their molar ratio in healthy infants.

    PubMed

    Koo, Winston W K; Hammami, Mouhanad; Hockman, Elaine M

    2007-06-04

    Leptin and its soluble receptor (sOB-R) are important to regulation of body composition but there are no data on the developmental variations in these plasma variables and their relationship with body composition measurements, Weight, length, and body composition (bone, fat and lean mass) by dual energy absorptiometry, and plasma variables were measured in healthy infants at 2, 4, 8 and 12 months. 15 whites and 29 African Americans (21 males and 23 females) with mean birth weight 3357 +/- 45 (SEM) g and gestation of 39.3 +/- 0.17 weeks were studied. The overall Z score for weight, length and weight for length during the study were 0.00 +/- 0.15, -0.08 +/- 0.11 and 0.12 +/- 0.14 respectively. With increasing age, plasma leptin (1.0 to 18.2, median 5.5 ng/mL) and sOB-R:leptin molar ratio (10.1 to 247.4, median 59.9) were lowered (r = -0.47, p < 0.01; and r = -0.37, p < 0.05 respectively), best predicted by weight Z score and percentage of fat mass, and higher in African American and female. Presence of body composition measurements eliminated the race and gender effect on the plasma variables. Plasma sOB-R (49.5 to 173.9, median 81.3 ng/mL) did not change significantly with age and was correlated and predicted only by body composition measurements. In healthy growing infants, plasma leptin but not sOB-R decreases with age. Gender, race and anthropometric measurements are additional physiological determinants predictive of plasma leptin and the receptor:ligand ratio. However, body composition is the only variable that can predict plasma leptin and its soluble receptor and the receptor: ligand ratio; and body composition measurements eliminated the race and gender effect on these plasma variables.

  3. Considerations in Using US-Based Laboratory Toxicity Tables to Evaluate Laboratory Toxicities Among Healthy Malawian and Ugandan Infants

    PubMed Central

    Lubega, Irene R.; Fowler, Mary Glenn; Musoke, Philippa M.; Elbireer, Ali; Bagenda, Danstan; Kafulafula, George; Ko, Jeanne; Mipando, Linda; Mubiru, Mike; Kumwenda, Newton; Taha, Taha; Jackson, J. Brooks; Guay, Laura

    2011-01-01

    Objectives To determine normal hematologic and selected blood chemistry values among healthy, full-term, non–HIV-exposed infants in Uganda and Malawi, and to determine the proportion of healthy babies with an apparent laboratory toxicity based on Division of AIDS toxicity tables. Design This was a cross-sectional laboratory study of infants from birth to 6 months of age. Methods Blood samples were collected from a total of 561 infants and analyzed according to age categories similar to those in the 2004 Division of AIDS toxicity tables. Select chemistry and hematology parameters were determined and values compared with those in the toxicity tables. Results In the first 56 days of life, there were few graded toxicities except for neutropenia in 2 of 10 (20%) Ugandan and 13 of 45 (29%) Malawian infants at birth. After 7 days, about 20% of the infants in Uganda and Malawi would have been classified as having a neutropenia whereas 47% and 53% of those more than 2 months of age in Uganda and Malawi respectively, would have been reported as having an abnormal hemoglobin. Chemistry findings were not different from US norms. Conclusions These findings underscore the importance of establishing relevant local laboratory norms for infants. PMID:20588184

  4. Outcomes of intraventricular hemorrhage and posthemorrhagic hydrocephalus in a population-based cohort of very preterm infants born to residents of Nova Scotia from 1993 to 2010.

    PubMed

    Radic, Julia A E; Vincer, Michael; McNeely, P Daniel

    2015-06-01

    OBJECT Intraventicular hemorrhage (IVH) is a common complication of preterm birth, and the prognosis of IVH is incompletely characterized. The objective of this study was to describe the outcomes of IVH in a population-based cohort with minimal selection bias. METHODS All very preterm (≥ 30 completed weeks) patients born in the province of Nova Scotia were included in a comprehensive database. This database was screened for infants born to residents of Nova Scotia from January 1, 1993, to December 31, 2010. Among very preterm infants successfully resuscitated at birth, the numbers of infants who died, were disabled, developed cerebral palsy, developed hydrocephalus, were blind, were deaf, or had cognitive/language scores assessed were analyzed by IVH grade. The relative risk of each outcome was calculated (relative to the risk for infants without IVH). RESULTS Grades 2, 3, and 4 IVH were significantly associated with an increased overall mortality, primarily in the neonatal period, and the risk increased with increasing grade of IVH. Grade 4 IVH was significantly associated with an increased risk of disability (RR 2.00, p < 0.001), and the disability appeared to be primarily due to cerebral palsy (RR 6.07, p < 0.001) and cognitive impairment (difference in mean MDI scores between Grade 4 IVH and no IVH: -19.7, p < 0.001). No infants with Grade 1 or 2 IVH developed hydrocephalus, and hydrocephalus and CSF shunting were not associated with poorer outcomes when controlling for IVH grade. CONCLUSIONS Grades 1 and 2 IVH have much better outcomes than Grades 3 or 4, including a 0% risk of hydrocephalus in the Grade 1 and 2 IVH cohort. Given the low risk of selection bias, the results of this study may be helpful in discussing prognosis with families of very preterm infants diagnosed with IVH.

  5. The Healthy Start Initiative: A Community-Driven Approach to Infant Mortality Reduction--Vol. I. Consortia Development.

    ERIC Educational Resources Information Center

    McCoy-Thompson, Meri

    The purpose of the Healthy Start Initiative, a national demonstration program, is to reduce infant mortality by 50 percent in 15 communities. At the heart of the initiative is the belief that the community, guided by a consortium of individuals and organizations from many sectors, can best design and implement the services needed by the women and…

  6. The Healthy Start Initiative: A Community-Driven Approach to Infant Mortality Reduction. Volume II. Early Implementation: Lessons Learned.

    ERIC Educational Resources Information Center

    McCoy-Thompson, M.; And Others

    This volume describes the experiences of each of the 15 rural and urban Healthy Start initiatives. These projects were set up in areas that had infant mortality rates that were 1.5 to 2.5 times the national average. Project locations include major cities such as Chicago, Illinois; Boston, Massachusetts; and Oakland, California, and rural areas in…

  7. Mercury Exposure in Healthy Korean Weaning-Age Infants: Association with Growth, Feeding and Fish Intake

    PubMed Central

    Chang, Ju Young; Park, Jeong Su; Shin, Sue; Yang, Hye Ran; Moon, Jin Soo; Ko, Jae Sung

    2015-01-01

    Low-level mercury (Hg) exposure in infancy might be harmful to the physical growth as well as neurodevelopment of children. The aim of this study was to investigate postnatal Hg exposure and its relationship with anthropometry and dietary factors in late infancy. We recruited 252 healthy Korean infants between six and 24 months of age from an outpatient clinic during the 2009/2010 and 2013/2014 seasons. We measured the weight and height of the infants and collected dietary information using questionnaires. The Hg content of the hair and blood was assessed using inductively coupled plasma mass spectroscopy. The geometric mean Hg concentration in the hair and blood was 0.22 (95% confidence interval: 0.20–0.24) µg/g and 0.94 (n = 109, 95% confidence interval: 0.89–0.99) µg/L, respectively. The hair Hg concentration showed a good correlation with the blood Hg concentration (median hair-to-blood Hg ratio: 202.7, r = 0.462, p < 0.001) and was >1 µg/g in five infants. The hair Hg concentration showed significant correlations with weight gain after birth (Z-score of the weight for age—Z-score of the birthweight; r = −0.156, p = 0.015), the duration (months) of breastfeeding as the dominant method of feeding (r = 0.274, p < 0.001), and the duration of fish intake more than once per week (r = 0.138, p = 0.033). In an ordinal logistic regression analysis with categorical hair Hg content (quartiles), dietary factors, including breastfeeding as the dominant method of feeding in late infancy (cumulative odds ratio: 6.235, 95% confidence interval: 3.086–12.597, p < 0.001) and the monthly duration of fish intake more than once per week (cumulative odds ratio: 1.203, 95% confidence interval: 1.034–1.401; p = 0.017), were significantly associated with higher hair Hg content. Weight gain after birth was not, however, significantly associated with hair Hg content after adjustment for the duration of breastfeeding as the dominant method of feeding. Low-level Hg exposure

  8. Mercury Exposure in Healthy Korean Weaning-Age Infants: Association with Growth, Feeding and Fish Intake.

    PubMed

    Chang, Ju Young; Park, Jeong Su; Shin, Sue; Yang, Hye Ran; Moon, Jin Soo; Ko, Jae Sung

    2015-11-17

    Low-level mercury (Hg) exposure in infancy might be harmful to the physical growth as well as neurodevelopment of children. The aim of this study was to investigate postnatal Hg exposure and its relationship with anthropometry and dietary factors in late infancy. We recruited 252 healthy Korean infants between six and 24 months of age from an outpatient clinic during the 2009/2010 and 2013/2014 seasons. We measured the weight and height of the infants and collected dietary information using questionnaires. The Hg content of the hair and blood was assessed using inductively coupled plasma mass spectroscopy. The geometric mean Hg concentration in the hair and blood was 0.22 (95% confidence interval: 0.20-0.24) µg/g and 0.94 (n = 109, 95% confidence interval: 0.89-0.99) µg/L, respectively. The hair Hg concentration showed a good correlation with the blood Hg concentration (median hair-to-blood Hg ratio: 202.7, r = 0.462, p < 0.001) and was >1 µg/g in five infants. The hair Hg concentration showed significant correlations with weight gain after birth (Z-score of the weight for age-Z-score of the birthweight; r = -0.156, p = 0.015), the duration (months) of breastfeeding as the dominant method of feeding (r = 0.274, p < 0.001), and the duration of fish intake more than once per week (r = 0.138, p = 0.033). In an ordinal logistic regression analysis with categorical hair Hg content (quartiles), dietary factors, including breastfeeding as the dominant method of feeding in late infancy (cumulative odds ratio: 6.235, 95% confidence interval: 3.086-12.597, p < 0.001) and the monthly duration of fish intake more than once per week (cumulative odds ratio: 1.203, 95% confidence interval: 1.034-1.401; p = 0.017), were significantly associated with higher hair Hg content. Weight gain after birth was not, however, significantly associated with hair Hg content after adjustment for the duration of breastfeeding as the dominant method of feeding. Low-level Hg exposure through

  9. Can typical US home visits affect infant attachment? Preliminary findings from a randomized trial of Healthy Families Durham.

    PubMed

    Berlin, Lisa J; Martoccio, Tiffany L; Appleyard Carmody, Karen; Goodman, W Benjamin; O'Donnell, Karen; Williams, Janis; Murphy, Robert A; Dodge, Kenneth A

    2017-07-17

    US government-funded early home visiting services are expanding significantly. The most widely implemented home visiting models target at-risk new mothers and their infants. Such home visiting programs typically aim to support infant-parent relationships; yet, such programs' effects on infant attachment quality per se are as yet untested. Given these programs' aims, and the crucial role of early attachments in human development, it is important to understand attachment processes in home visited families. The current, preliminary study examined 94 high-risk mother-infant dyads participating in a randomized evaluation of the Healthy Families Durham (HFD) home visiting program. We tested (a) infant attachment security and disorganization as predictors of toddler behavior problems and (b) program effects on attachment security and disorganization. We found that (a) infant attachment disorganization (but not security) predicted toddler behavior problems and (b) participation in HFD did not significantly affect infant attachment security or disorganization. Findings are discussed in terms of the potential for attachment-specific interventions to enhance the typical array of home visiting services.

  10. Lower resting energy expenditure and fat oxidation in Native American and Hispanic infants born to mothers with diabetes.

    PubMed

    Short, Kevin R; Teague, April M; Fields, David A; Lyons, Timothy; Chernausek, Steven D

    2015-04-01

    To determine whether exposure to diabetes in utero affects resting energy expenditure (REE) and fuel oxidation in infants. At 35 ± 5 days after birth, body composition and REE were measured in full-term offspring of Native American and Hispanic women with either well-controlled diabetes (13 girls, 11 boys) or normal healthy pregnancies (18 girls, 17 boys). Control of dysglycemia during gestation in the women with diabetes mellitus met current clinical standards, shown by average glycated hemoglobin (5.9 ± 0.2%; 40.6 ± 2.3 mmol/mol). Infant body mass (offspring of women with diabetes: 4.78 ± 0.13, control offspring: 4.56 ± 0.08 kg) and body fatness (offspring of women with diabetes: 25.2 ± 0.6, control offspring: 24.2 ± 0.5 %) did not differ between groups. REE, adjusted for lean body mass, was 14% lower in offspring of women with diabetes (41.7 ± 2.3 kJ/h) than control offspring (48.6 ± 2.0, P = .025). Fat oxidation was 26% lower in offspring of women with diabetes (0.54 ± 0.05 g/h) than control offspring (0.76 ± 0.04, P < .01) but carbohydrate oxidation did not differ. Thus, fat oxidation accounted for a lower fraction of REE in the offspring of women with diabetes (49 ± 4%) than control offspring (60 ± 3%, P = .022). Mothers with diabetes were older and had higher prepregnancy body mass index than control mothers. Well-controlled maternal diabetes did not significantly affect body mass or composition of offspring at 1-month old. However, infants with mothers with diabetes had reduced REE and fat oxidation, which could contribute to adiposity and future disease risk. Further studies are needed to assess the impact differences in age and higher prepregnancy body mass index. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Lower resting energy expenditure and fat oxidation in Native American and Hispanic infants born to mothers with diabetes

    PubMed Central

    Short, Kevin R.; Teague, April M.; Fields, David A.; Lyons, Timothy; Chernausek, Steven D.

    2014-01-01

    Objective To determine whether exposure to diabetes in utero affects resting energy expenditure (REE) and fuel oxidation in infants. Study design At 35 ± 5 days after birth, body composition and REE were measured in full-term offspring of Native American and Hispanic women with either well-controlled diabetes (13 girls, 11 boys) or normal healthy pregnancies (18 girls, 17 boys). Results Control of dysglycemia during gestation in the women with diabetes mellitus met current clinical standards shown by average glycated hemoglobin (5.9 ± 0.2%; 40.6 ± 2.3 mmol/mol). Infant body mass (offspring of women with diabetes: 4.78 ± 0.13, control offspring: 4.56 ± 0.08 kg) and body fatness (offspring of women with diabetes: 25.2 ± 0.6, control offspring: 24.2 ± 0.5 %) did not differ between groups. REE, adjusted for lean body mass, was 14% lower in offspring of women with diabetes (41.7 ± 2.3 kJ/h) than control offspring (48.6 ± 2.0, p=0.025). Fat oxidation was 26% lower in offspring of women with diabetes (0.54 ± 0.05 g/h) than control offspring (0.76 ± 0.04, p < 0.01) but carbohydrate oxidation did not differ. Thus, fat oxidation accounted for a lower fraction of REE in the offspring of women with diabetes (49 ± 4%) than control offspring (60 ± 3%, p = 0.022). Mothers with diabetes were older and had higher pre-pregnancy BMI than control mothers. Conclusion Well-controlled maternal diabetes did not significantly affect body mass or composition of offspring at 1-month old. However, infants with diabetic mothers had reduced REE and fat oxidation, which could contribute to adiposity, and future disease risk. Further studies are needed to assess the impact differences in age and higher prepregnancy BMI. PMID:25648295

  12. Insurance Status and the Risk of Severe Respiratory Syncytial Virus Disease in United States Preterm Infants Born at 32-35 Weeks Gestational Age.

    PubMed

    Franklin, Jeremy A; Anderson, Evan J; Wu, Xionghua; Ambrose, Christopher S; Simões, Eric A F

    2016-09-01

    Background.  Database studies have identified that public health insurance status is associated with an increased risk of severe respiratory syncytial virus (RSV) disease in US infants. However, these studies did not adjust for the presence of other risk factors and did not evaluate the risk in preterm infants. Methods.  In this study, we evaluate the independent association between public insurance and severe RSV disease outcomes adjusting for other risk factors. The prospective, observational RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study was conducted over 2 consecutive RSV seasons at 188 US clinical sites that enrolled preterm infants born at 32-35 wGA who had not received RSV immunoprophylaxis with palivizumab. Adjusted incidence rates per 100 infant-seasons of the RSV-associated endpoints of outpatient lower respiratory tract infection (LRI), emergency department (ED) visits, RSV hospitalizations (RSVHs), and intensive care unit admissions during peak RSV season (November-March) were compared for infants with private and public insurance. Results.  Of 1642 evaluable infants enrolled in the REPORT study, 50.1% had private insurance and 49.9% had public health insurance. Adjusted rates of RSV outpatient LRIs were similar; however, rates of ED visits (hazard ratio [HR], 2.04; 95% confidence interval [CI], 1.20-3.45) were higher for subjects with public insurance, with a similar but nonsignificant trend observed for hospitalization (HR, 1.61; 95% CI, .93-2.78). Conclusions.  Socioeconomic status, as evaluated by public versus private healthcare insurance, is a significant independent risk factor for ED use in US preterm infants and may contribute to increased RSVHs in this population.

  13. The role of pancreatic insulin secretion in neonatal glucoregulation. I. Healthy term and preterm infants.

    PubMed Central

    Hawdon, J M; Aynsley-Green, A; Alberti, K G; Ward Platt, M P

    1993-01-01

    The glucoregulatory role of insulin in adult subjects is undisputed. However, less is known about the secretion of insulin and its actions in the neonatal period, either for healthy subjects, or for those at risk of disordered blood glucose homoeostasis. The relationships between blood glucose and plasma immunoreactive insulin concentrations were therefore examined in 52 healthy children (aged 1 month-10 years), 67 appropriate birth weight for gestational age (AGA) term infants, and 39 AGA preterm neonates. In children and AGA neonates, plasma immunoreactive insulin concentration was positively related to blood glucose concentration. However, although both groups of neonates had significantly lower blood glucose concentrations than children, plasma immunoreactive insulin concentrations were significantly higher in both term and preterm neonates, when compared with children. The variation in plasma immunoreactive insulin concentrations was greater for neonates than for children. These data suggest, that compared with older subjects, plasma immunoreactive insulin concentrations are high in newborn babies and that neonatal pancreatic insulin secretion is less closely linked to circulating blood glucose concentrations. There are important implications for the interpretation of studies in hypoglycaemic and hyperglycaemic neonates. PMID:8466262

  14. Improved Birth Weight for Black Infants: Outcomes of a Healthy Start Program

    PubMed Central

    Zielinski, Ruth; James, Arthur; Charoth, Remitha M.; del Carmen Sweezy, Luz

    2014-01-01

    Objectives. We determined whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women. Methods. We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan state- and Kalamazoo County–level birth certificate records for 2008 to 2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model. Results. Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than did Black nonparticipants (P = .05). White HBHS participants had significantly more prenatal care than did White nonparticipants, but they had similar birth outcomes (P = .7 for birth weight; P = .55 for gestation). Conclusions. HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women. PMID:24354844

  15. Growth of healthy term infants fed partially hydrolyzed whey-based infant formula: a randomized, blinded, controlled trial.

    PubMed

    Borschel, Marlene W; Choe, Yong S; Kajzer, Janice A

    2014-12-01

    Partially hydrolyzed formulas (pHF) represent a significant percentage of the infant formula market. A new whey-based, palm olein oil (PO)-free pHF was developed and a masked, randomized, parallel growth study was conducted in infants fed this formula or a commercially available whey-based pHF with PO. Infants between 0 and 8 days were to be enrolled and studied to 119 days of age. Growth and tolerance of infants were evaluated. Mean weight gain from 14 to 119 days of age was similar between groups. There were no significant differences between groups in weight, length, head circumference (HC), or length or HC gains. Infants fed the new PO-free pHF had significantly softer stools than those fed the PO-containing formula except at 119 days of age. This study demonstrates that whereas growth of infants fed different formulas during the first 4 months of life may be similar, infants may tolerate individual formulas differently.

  16. Neonatal outcome of preterm infants born to mothers with abnormal genital tract colonisation and chorioamnionitis: a cohort study.

    PubMed

    Seliga-Siwecka, Joanna P; Kornacka, Maria K

    2013-05-01

    We hypothesised that abnormal genital tract colonisation leading to an in utero inflammation/infection process, contributes to the risk of respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), intra ventricular haemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC) in preterm infants. 396 placentas and umbilical cords of neonates born at 22-32weeks of gestation were evaluated. Genital tract and amniotic fluid swabs were cultured for aerobic and anaerobic bacteria. Chorioamnionitis significantly increases the risk for RDS (OR 1.74, 95% CI 1.14-2.65), NEC (OR 3.22, 95% CI 1.36-3.28) and ROP>2 (OR 2.12, 95% CI 1.33-3.36). But the risk for IVH, PDA and BPD did not differ between the groups. Klebsiella pneumoniae (OR 5.33, 95% CI 1.06-26.79), Staphylococcus sp. (OR 18.39, 95% CI 2.32-145.2) and Enterococcus faecalis (OR 10.7, 95% CI 1.27-89.9) showed a significant relationship with intrauterine inflammation processes. E. faecalis increased the risk for NEC (OR 6.13, 95% CI 1.059-37.6). We did not note a link between ROP and genital tract colonisation. Interestingly PDA seems to be triggered by the presence of Pseudomonas aeruginosa (OR 2.38 95% CI 1.83-3.82). Our results show a link between K. pneumoniae, Staphylococcus sp., E. faecalis and intrauterine infection. E. faecalis increases the risk for NEC, and suggests a direct link between gram + bacteria, chorioamnionitis and NEC. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Risk of HIV and associated factors among infants born to HIV positive women in Amhara region, Ethiopia: a facility based retrospective study.

    PubMed

    Berhan, Zelalem; Abebe, Fantu; Gedefaw, Molla; Tesfa, Mulugeta; Assefa, Muluken; Tafere, Yilkal

    2014-12-04

    The estimated HIV prevalence among pregnant women in Ethiopia is 1.2 percent and unfortunately one of every 3 children born to these women gets infected with HIV. Elimination of these mother-to-child transmissions (MTCT) of HIV is possible through HIV testing during pregnancy and taking antiretroviral medications. However, only 24 percent of the pregnant women living with HIV have yet received the medication needed to prevent the transmission of HIV. Hence, there exists a concern that the rate of HIV infection among infants born to HIV positive mothers is increasing. This study assessed the prevalence of HIV infection and associated factors among infants born to women living with HIV, in South Gondar zone, Amhara region, Ethiopia. Facility based document review was conducted upon 434 charts. The study participants were HIV exposed infants enrolled from January to December 2012. The data were reviewed from all the 17 health facilities which were providing PMTCT services in the zone. The study included 434 HIV exposed infants having an HIV Deoxyribonucleic Acid (DNA) Polymerase Chain Reaction (PCR) test result. The data were collected using structured data extraction tool. Binary logistic regression analysis was employed to assess the putative association of independent variables with the outcome variable. Significance was taken at a P value<0.05 and 95% confidence level. The prevalence of HIV among HIV exposed infants was 10.1% (95% CI=7.3-13%). Delayed diagnosis (AOR=2.7, 95% CI=1.3, 29.4), mixed infant feeding (AOR=8.8, 95% CI=4.5, 22.8), failure to receive either antiretroviral therapy or prophylaxis during pregnancy or breast feeding (AOR=21.6, 95% CI=14.5, 39.8) and shorter duration of HIV treatment (AOR=12, 95% CI=(4.2, 45.0) were the factors that increase the risk of mother- to- child transmission of HIV. The prevalence of HIV infection among HIV exposed infants is strikingly high. Inadequate use of antiretroviral therapy and skilled delivery care were the

  18. Nonresponse bias in a follow-up study of 19-year-old adolescents born as preterm infants.

    PubMed

    Hille, E T M; Elbertse, L; Gravenhorst, J Bennebroek; Brand, R; Verloove-Vanhorick, S P

    2005-11-01

    To assess the effect of demographic and neonatal risk factors and outcome at the last available assessment on the probability of full responders, postal responders (those who only responded to the mailed questionnaire), or nonresponders in a follow-up study of 19-year-old adolescents who were born as preterm infants. The 19-year follow-up program was part of a large ongoing collaborative study in The Netherlands on the long-term effect of prematurity and dysmaturity on various medical, psychological, and social parameters. In the original cohort, 1338 infants (94%) with a gestational age of < 32 weeks and/or a birth weight of < 1500 g were enrolled. Neonatal mortality was 23% (n = 312), and another 67 children had died between the ages of 28 days and 19 years, leaving 959 survivors (72% of the original cohort) for follow-up at the present assessment. To study the effect of nonresponse, we divided the 959 survivors into 3 groups: full responders (596 [62.1%]), postal responders (109 [11.4%]), and nonresponders (254 [26.5%]). In the 3 groups we compared demographic and neonatal data, as well as outcome at the last available assessment. The odds ratios (ORs) for male versus female for the probabilities of nonresponse and postal response were statistically significant: 2.7 (95% CI: 1.9-3.9) and 1.6 (95% CI: 1.0-2.5), respectively. The same holds for the ORs for non-Dutch versus Dutch and low versus high maternal education for nonresponse: 2.0 (95% CI: 1.3-3.2) and 3.7 (95% CI: 2.0-6.7), respectively. Special education and severe handicap showed a statistically significant influence on nonresponse (OR: 1.6; 95% CI: 1.1-2.4 and OR: 2.6; 95% CI: 1.3-5.2) and postal response (OR: 2.0; 95% CI: 1.2-3.3 and OR: 4.4; 95% CI: 2.0-9.9), respectively. At the age of 19 years, primary school and special education were found significantly more frequent in the postal responders than in the full-response group (20% and 21% vs 6% and 12%). The full responders, on the other hand, were

  19. Self-reported maternal parenting style and confidence and infant temperament in a multi-ethnic community: results from the Born in Bradford cohort.

    PubMed

    Prady, Stephanie L; Kiernan, Kathleen; Fairley, Lesley; Wilson, Sarah; Wright, John

    2014-03-01

    Ethnic minority children in the United Kingdom often experience health disadvantage. Parenting influences children's current and future health, but little is known about whether parenting behaviours and mother's perception of her infant vary by ethnicity. Using the Born in Bradford (BiB) birth cohort, which is located in an ethnically diverse and economically deprived UK city, we conducted a cross-sectional analysis of mother's self-reported parenting confidence, self-efficacy, hostility and warmth, and infant temperament at six months of age. We examined responses from women of Pakistani (N = 554) and White British (N = 439) origin. Pakistani mothers reported feeling more confident about their abilities as a parent. Significantly fewer Pakistani women adopted a hostile approach to parenting, an effect that was attenuated after adjustment for socioeconomic status and mental health. Overall, women with more self-efficacious, warm and less hostile parenting styles reported significantly fewer problems with their infant's temperaments. Of women with higher self-efficacy parenting styles, Pakistani mothers were significantly more likely than White British mothers to report more problematic infant temperaments, although absolute differences were small. It is unlikely that the ethnic variation seen in children's cognitive and behavioural outcomes in childhood is attributable to differences in parenting or infant characteristics reported at six months.

  20. Perinatal or early-postnatal cytomegalovirus infection in preterm infants under 34 weeks gestation born to CMV-seropositive mothers within a high-seroprevalence population.

    PubMed

    Mussi-Pinhata, Marisa Márcia; Yamamoto, Aparecida Yulie; do Carmo Rego, Maria Aparecida; Pinto, Patrícia Cristina Gomes; da Motta, Márcia Soares Freitas; Calixto, Cristina

    2004-11-01

    In a prospective study, we evaluated the frequency, correlates, and clinical significance of perinatal or early-postnatal cytomegalovirus (CMV) infection in <34-week-gestation infants (n=95) born to CMV-seropositive mothers. None had congenital CMV infection. Overall, 21 (22.1%; 95% CI=14.2-31.8) infants were found to be infected; 10 excreted CMV at <60 days, and 11 had later excretion. Blood transfusion, birth weight, and vaginal delivery were not associated factors. Receiving natural breast milk within the first 30 days (OR=4.5, P=.02) or for >30 days (OR=7.9, P <.01) was associated with infection. Only one (4.8%) of the infected infants was symptomatic. For <34-week-gestation infants, frequency of perinatal and early-postnatal CMV infection is high. Early or prolonged exposure to breast milk is an associated factor. However, most infections are asymptomatic, indicating that CMV infection in preterm infants within such a population is a serious problem infrequently.

  1. Inhibition of Cronobacter sakazakii by heat labile bacteriocins produced by probiotic LAB isolated from healthy infants.

    PubMed

    Awaisheh, Saddam S; Al-Nabulsi, Anas A; Osaili, Tareq M; Ibrahim, Salam; Holley, Richard

    2013-09-01

    Cronobacter sakazakii is an opportunistic pathogen that can cause bacteremia, meningitis, and necrotizing enterocolitis, most often in neonates with case-fatality rates that may reach 80%. The antimicrobial activity of lactic acid bacteria against a wide range of foodborne pathogens is well-established in different types of food products. The objective of the current study was to investigate the antibacterial activity of Lactobacillus acidophilus and L. casei isolated from feces of healthy infants against different strains of C. sakazakii in agar and a rehydrated infant milk formula (RIMF) model. The inhibition zones of C. sakazakii around L. acidophilus or L. casei ranged from 22 to 32 mm on eMan Rogosa Sharpe (MRS) agar under aerobic conditions, while a slight reduction in antibacterial activity was noted on modified MRS (0.2% glucose) under anaerobic conditions. It was observed that pH-neutralized cell-free supernatant (CFS) of L. acidophilus or L. casei was inhibitory against tested C. sakazakii strains. The inhibition zones of neutralized CFS were lower than the antibacterial activities of live cultures. The antibacterial activity of CFS was abolished when CFS from L. acidophilus or L. casei was heated at 60 or 80 °C for either 10 min or 2 h, or treated with trypsin or pepsin. This was considered strong evidence that the inhibition was due to the production of bacteriocins by L. casei and L. acidophilus. Both the CFS and active growing cells of L. casei and L. acidophilus were able to reduce the viability of C. sakazakii in the RIMF model. The results may extend the use of natural antimicrobials instead of conventional preservation methods to improve the safety of RIMF.

  2. Burden of Severe Respiratory Syncytial Virus Disease Among 33–35 Weeks’ Gestational Age Infants Born During Multiple Respiratory Syncytial Virus Seasons

    PubMed Central

    Carbonell-Estrany, Xavier; Blanken, Maarten; Lanari, Marcello; Sheridan-Pereira, Margaret; Rodgers-Gray, Barry; Fullarton, John; Rouffiac, Elisabeth; Vo, Pamela; Notario, Gerard; Campbell, Fiona; Paes, Bosco

    2017-01-01

    Background: Moderate-late preterm infants, 33–35 weeks’ gestational age (wGA), are at increased risk for respiratory syncytial virus hospitalization (RSVH). The objective of this study is to quantify the burden of RSVH in moderate-late preterm infants. Methods: A pooled analysis was conducted on RSVH from 7 prospective, observational studies in the Northern Hemisphere from 2000 to 2014. Infants’ 330–356 wGA without comorbidity born during the respiratory syncytial virus season who did not receive respiratory syncytial virus immunoprophylaxis were enrolled. Data for the first confirmed RSVH during the season (+1 month) were analyzed. Incidence and hospitalization rate per 100 patient-seasons, intensive care unit admission and length of stay (LOS), oxygen support, mechanical ventilation and overall hospital LOS were assessed. Results: The pooled analysis comprised 7,820 infants; 267 experienced a confirmed RSVH at a median age of 8.4 weeks. The crude pooled RSVH incidence rate was 3.41% and the rate per 100 patient-seasons was 4.52. Median hospital LOS was 5.7 days. A total of 22.2% of infants required intensive care unit admission for a median LOS of 8.3 days. A total of 70.4% received supplemental oxygen support for a median of 4.9 days, and 12.7% required mechanical ventilation for a median of 4.8 days. Conclusions: The burden of RSVH in moderate-late, 33–35 weeks’ wGA preterm infants without comorbidities born during the viral season in Northern Hemisphere countries is substantial. Severe cases required prolonged and invasive supportive therapy. PMID:27755464

  3. Effect of increasing protein content of human milk fortifier on growth in preterm infants born at <31 wk gestation: a randomized controlled trial.

    PubMed

    Miller, Jacqueline; Makrides, Maria; Gibson, Robert A; McPhee, Andrew J; Stanford, Tyman E; Morris, Scott; Ryan, Philip; Collins, Carmel T

    2012-03-01

    Preterm human milk-fed infants often experience suboptimal growth despite the use of human milk fortifier (HMF). The extra protein supplied in fortifiers may be inadequate to meet dietary protein requirements for preterm infants. We assessed the effect of human milk fortified with a higher-protein HMF on growth in preterm infants. This is a randomized controlled trial in 92 preterm infants born at <31 wk gestation who received maternal breast milk that was fortified with HMF containing 1.4 g protein/100 mL (higher-protein group) or 1.0 g protein/100 mL (current practice) until discharge or estimated due date, whichever came first. The HMFs used were isocaloric and differed only in the amount of protein or carbohydrate. Length, weight, and head-circumference gains were assessed over the study duration. Length gains did not differ between the higher- and standard-protein groups (mean difference: 0.06 cm/wk; 95% CI: -0.01, 0.12 cm/wk; P = 0.08). Infants in the higher-protein group achieved a greater weight at study end (mean difference: 220 g; 95% CI: 23, 419 g; P = 0.03). Secondary analyses showed a significant reduction in the proportion of infants who were less than the 10th percentile for length at the study end in the higher-protein group (risk difference: 0.186; 95% CI: 0.370, 0.003; P = 0.047). A higher protein intake results in less growth faltering in human milk-fed preterm infants. It is possible that a higher-protein fortifier than used in this study is needed. This trial was registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au/) as ACTRN12606000525583.

  4. Identifying risk factors for severe respiratory syncytial virus among infants born after 33 through 35 completed weeks of gestation: different methodologies yield consistent findings.

    PubMed

    Carbonell-Estrany, Xavier; Figueras-Aloy, José; Law, Barbara J

    2004-11-01

    Prematurity is a proven risk factor for severe respiratory syncytial virus (RSV) infection. Prematurity leads to an increased need for, and duration of, hospital admission, intensive care, mechanical ventilation and supplemental oxygen, as well as increased mortality. The Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study was a prospective, multicenter, cohort study conducted in 16 regions across Canada during 2 successive RSV seasons: November 2000-June 2001, and November 2001-June 2002. The study regions were defined to capture all births and all hospital admissions. The FLIP [identify those risk Factors that most Likely may lead to development of RSV-related respiratory Infection and subsequent hospital admission among Premature infants born 33-35 weeks gestational age (GA)] study was a prospective, case-control study comparison of premature infants hospitalized for RSV infection and infants who had not been hospitalized to identify the risk factors that most likely would lead to development of RSV infection and subsequent hospital admission in this population. The overall hospitalization rate for RSV in the PICNIC study was 3.6% for infants of 33-35 weeks GA. In the FLIP study, the severity of RSV infection in the 33- to 35-week GA infants was similar to that in the younger infants of <33-week GA studied previously by the Infeccion Respiratoria Infantil por Virus Respiratorio Sincitial Study Group. Similar risk factors were noted in both studies. RSV is a major cause of hospitalization in preterm infants. There is great variability among hospital admission rates globally, despite the commonality of severe RSV in many countries. Furthermore there are numerous independent risk factors for severe RSV, including socioeconomic and environmental factors, that merit further investigation. There is likely an additive effect when multiple risk factors are present. More research is needed on the various risk factors and their

  5. State child care regulations regarding infant sleep environment since the Healthy Child Care America-Back to Sleep campaign.

    PubMed

    Moon, Rachel Y; Kotch, Lauren; Aird, Laura

    2006-07-01

    Despite overall decreases in sudden infant death syndrome deaths and prone sleeping, the proportion of sudden infant death syndrome deaths that occurs in child care settings has remained constant at approximately 20%. In 2003, the American Academy of Pediatrics' Healthy Child Care America program launched its own Back to Sleep campaign to promote the Back to Sleep message for those who care for young children. The purpose of this study was to evaluate the effectiveness of the first 2 years of the Healthy Child Care America-Back to Sleep campaign in improving child care regulations by assessing the inclusion of the elements of a safe sleep environment in the individual state regulations for child care centers and family child care homes. We examined regulations available in October 2005 for licensed child care centers and family child care homes in the 50 states and the District of Columbia for specific regulations pertaining to (1) sudden infant death syndrome risk-reduction training for child care providers, (2) infant sleep position, (3) crib safety, (4) bedding safety, (5) smoking, and (6) provision of information about sleep positioning policies and arrangements to parents before the infant is enrolled in child care. Since 2003, when the Healthy Child Care America-Back to Sleep campaign began, 60 of the 101 state regulations for either child care centers or FCCHs have been revised. More than half of these regulations written since 2003 mandate a nonprone sleep position and restrictions on soft bedding in the crib, and the change in these regulations since 2003 is statistically significant. However, of the 101 existing state regulations, only 49 require that infants sleep nonprone, 18 mandate sudden infant death syndrome training for child care providers, 81 have > or = 1 crib safety standard, and 43 restrict soft bedding in the crib. Only 4 regulations require that parents be provided with sleep policy information. The initial 2 years of the Healthy Child Care

  6. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: analysis of CHERG datasets

    PubMed Central

    Kozuki, Naoko; Cousens, Simon; Stevens, Gretchen A; Blencowe, Hannah; Silveira, Mariangela F; Sania, Ayesha; Rosen, Heather E; Schmiegelow, Christentze; Adair, Linda S; Baqui, Abdullah H; Barros, Fernando C; Bhutta, Zulfiqar A; Caulfield, Laura E; Christian, Parul; Clarke, Siân E; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kariuki, Simon; Kolsteren, Patrick; Lusingu, John; Manandhar, Dharma; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Roberfroid, Dominique; Saville, Naomi; Terlouw, Dianne J; Tielsch, James M; Victora, Cesar G; Velaphi, Sithembiso C; Watson-Jones, Deborah; Willey, Barbara A; Ezzati, Majid; Lawn, Joy E; Black, Robert E; Katz, Joanne

    2017-01-01

    Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the

  7. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21(st) standard: analysis of CHERG datasets.

    PubMed

    Lee, Anne Cc; Kozuki, Naoko; Cousens, Simon; Stevens, Gretchen A; Blencowe, Hannah; Silveira, Mariangela F; Sania, Ayesha; Rosen, Heather E; Schmiegelow, Christentze; Adair, Linda S; Baqui, Abdullah H; Barros, Fernando C; Bhutta, Zulfiqar A; Caulfield, Laura E; Christian, Parul; Clarke, Siân E; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kariuki, Simon; Kolsteren, Patrick; Lusingu, John; Manandhar, Dharma; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Roberfroid, Dominique; Saville, Naomi; Terlouw, Dianne J; Tielsch, James M; Victora, Cesar G; Velaphi, Sithembiso C; Watson-Jones, Deborah; Willey, Barbara A; Ezzati, Majid; Lawn, Joy E; Black, Robert E; Katz, Joanne

    2017-08-17

    Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21(st) birth weight standard.Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21(st) birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated.Setting CHERG birth cohorts from 14 population based sites in low and middle income countries.Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%.Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the

  8. Unaltered development of the archi- and neocortex in prematurely born infants: genetic control dominates in proliferation, differentiation and maturation of cortical neurons.

    PubMed

    Abrahám, Hajnalka; Veszprémi, Béla; Gömöri, Eva; Kovács, Krisztina; Kravják, András; Seress, László

    2007-01-01

    The development of cerebral cortex includes highly organized, elaborate and long-lasting series of events, which do not come to an end by the time of birth. Indeed, many developmental events continue after the 40th postconceptual week resulting in a long morphological, behavioral and cognitive development of children. Premature birth causes an untimely dramatic change in the environment of the human fetus and often results in serious threats for life. Cognitive abilities of prematurely born children vary, but a correlation between cognitive impairment and the time of birth is evident. In this study we review the morphological evidence of cortical maturation in preterm and full-term infants. Various aspects of postnatal cortical development including cell proliferation and maturation of neurons in the temporal archi- and neocortex are discussed and compared in preterm infants and age-matched full-term controls. Our results suggest that cell proliferation and maturation are not influenced by the preterm delivery. In contrast, the perinatal decrease of the number of Cajal-Retzius cells might be regulated by a mechanism that is affected by preterm birth. We demonstrate that cognitive deficiencies of the prematurely born infants cannot be explained with light microscopically observed alteration of proliferation and maturation of neurons.

  9. Analysis of the relationship of insulin-like growth factor-1 to the growth velocity and feeding of healthy infants.

    PubMed

    Wang, Xinli; Xing, Katharine He; Qi, Jing; Guan, Yuhong; Zhang, Juan

    2013-12-01

    Infancy is the fastest growth period in a child's development after birth, but little is known about hormonal regulation mechanism for the growth and development of this period. The objective of this study is to analyze the trend of serum IGF-1 levels in healthy infants and the relationship of IGF-1 to the growth velocity and feeding method of infants. Population-based birth cohort study. The study was conducted in the Third Hospital of Peking University. Study participants were 484 healthy infants, all of whom were full-term and appropriate for gestational age (238 boys and 246 girls). Interventions were anthropometrical measurements, feeding methods recorded every 1 to 2 months and serum samples (2, 4, 6, 8, 10,12 months). Height, weight, feeding methods and serum IGF-1 were the main outcome measures. Serum IGF-1 levels decreased in the following 2 months in boys but in females levels remained relatively high between 2 to 3 months after birth and then started to decrease. It reached the lowest point at Months 7-8, and was on a slow rise in both male infants and female infants thereafter. Serum IGF-1 levels were significantly higher in female infants [112.65 ng/ml (CI 91.82, 133.89)] than in male infants [74.38 ng/ml (CI 53.14, 95.61)] at early infancy. Infants fed with human milk had lower serum IGF-1 levels than infants fed with formula milk or human milk plus formula milk (66.94 ± 45.85 ng/ml, 72.56 ± 36.55 ng/ml, 79.89 ± 51.79 ng/ml, respectively; P = 0.019). IGF-1 levels were positively correlated to the growth velocity of body length (P<0.01). This study provides the trend for IGF-1 levels at infancy. It is highly possible that IGF-1 plays an important role in the regulation and control of length increases in infants, and feeding method influences serum IGF-1 levels. © 2013. Published by Elsevier Ltd. All rights reserved.

  10. The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study: assessment of environmental exposures

    PubMed Central

    Takaro, Tim K; Scott, James A; Allen, Ryan W; Anand, Sonia S; Becker, Allan B; Befus, A Dean; Brauer, Michael; Duncan, Joanne; Lefebvre, Diana L; Lou, Wendy; Mandhane, Piush J; McLean, Kathleen E; Miller, Gregory; Sbihi, Hind; Shu, Huan; Subbarao, Padmaja; Turvey, Stuart E; Wheeler, Amanda J; Zeng, Leilei; Sears, Malcolm R; Brook, Jeffrey R

    2015-01-01

    The Canadian Healthy Infant Longitudinal Development birth cohort was designed to elucidate interactions between environment and genetics underlying development of asthma and allergy. Over 3600 pregnant mothers were recruited from the general population in four provinces with diverse environments. The child is followed to age 5 years, with prospective characterization of diverse exposures during this critical period. Key exposure domains include indoor and outdoor air pollutants, inhalation, ingestion and dermal uptake of chemicals, mold, dampness, biological allergens, pets and pests, housing structure, and living behavior, together with infections, nutrition, psychosocial environment, and medications. Assessments of early life exposures are focused on those linked to inflammatory responses driven by the acquired and innate immune systems. Mothers complete extensive environmental questionnaires including time-activity behavior at recruitment and when the child is 3, 6, 12, 24, 30, 36, 48, and 60 months old. House dust collected during a thorough home assessment at 3–4 months, and biological specimens obtained for multiple exposure-related measurements, are archived for analyses. Geo-locations of homes and daycares and land-use regression for estimating traffic-related air pollution complement time-activity-behavior data to provide comprehensive individual exposure profiles. Several analytical frameworks are proposed to address the many interacting exposure variables and potential issues of co-linearity in this complex data set. PMID:25805254

  11. Safety Assessment of Bacteroides uniformis CECT 7771 Isolated from Stools of Healthy Breast-Fed Infants.

    PubMed

    Fernández-Murga, M Leonor; Sanz, Yolanda

    2016-01-01

    Bacteroides uniformis CECT 7771 is a potential probiotic strain, originally isolated from the stools of healthy breast-feed infants. The strain showed pre-clinical efficacy in a mouse obesity model. The objective of this study was to evaluate its potential toxicity and translocation ability after acute oral administration to mice. A safety study was conducted in immunocompetent and immunosuppressed C57BL-6 mice. Both mouse groups (n = 10 per group) were fed orally 2 x 10(9) colony forming units (cfu)/day of B. uniformis CECT 7771 or placebo by gavage for 6 days. Throughout this time, feed and water intake and body weight were monitored. Afterwards, mice were sacrificed and biological samples were collected to analyze blood and urine biochemistry, inflammatory and immune markers; gut mucosal histology and bacterial translocation to peripheral tissues. The results demonstrated that acute ingestion of this Bacteroides strain had no adverse effects on the animals' general health status or food intake, nor did it affect biochemical indicators of liver, kidney and pancreatic function or gut mucosal histology. Findings also demonstrated that administration did not lead to bacterial translocation to blood, liver or mesenteric lymph nodes. B. uniformis CECT 7771 also downregulated gene and protein expression (iNOS and PPAR-γ) and inflammatory cytokines induced by immunosuppression. The findings indicate that the acute oral consumption of B. uniformis CECT 7771 does not raise safety concerns in mice. Further studies in humans should be conducted.

  12. The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study: assessment of environmental exposures.

    PubMed

    Takaro, Tim K; Scott, James A; Allen, Ryan W; Anand, Sonia S; Becker, Allan B; Befus, A Dean; Brauer, Michael; Duncan, Joanne; Lefebvre, Diana L; Lou, Wendy; Mandhane, Piush J; McLean, Kathleen E; Miller, Gregory; Sbihi, Hind; Shu, Huan; Subbarao, Padmaja; Turvey, Stuart E; Wheeler, Amanda J; Zeng, Leilei; Sears, Malcolm R; Brook, Jeffrey R

    2015-01-01

    The Canadian Healthy Infant Longitudinal Development birth cohort was designed to elucidate interactions between environment and genetics underlying development of asthma and allergy. Over 3600 pregnant mothers were recruited from the general population in four provinces with diverse environments. The child is followed to age 5 years, with prospective characterization of diverse exposures during this critical period. Key exposure domains include indoor and outdoor air pollutants, inhalation, ingestion and dermal uptake of chemicals, mold, dampness, biological allergens, pets and pests, housing structure, and living behavior, together with infections, nutrition, psychosocial environment, and medications. Assessments of early life exposures are focused on those linked to inflammatory responses driven by the acquired and innate immune systems. Mothers complete extensive environmental questionnaires including time-activity behavior at recruitment and when the child is 3, 6, 12, 24, 30, 36, 48, and 60 months old. House dust collected during a thorough home assessment at 3-4 months, and biological specimens obtained for multiple exposure-related measurements, are archived for analyses. Geo-locations of homes and daycares and land-use regression for estimating traffic-related air pollution complement time-activity-behavior data to provide comprehensive individual exposure profiles. Several analytical frameworks are proposed to address the many interacting exposure variables and potential issues of co-linearity in this complex data set.

  13. Safety Assessment of Bacteroides uniformis CECT 7771 Isolated from Stools of Healthy Breast-Fed Infants

    PubMed Central

    Fernández-Murga, M. Leonor; Sanz, Yolanda

    2016-01-01

    Background Bacteroides uniformis CECT 7771 is a potential probiotic strain, originally isolated from the stools of healthy breast-feed infants. The strain showed pre-clinical efficacy in a mouse obesity model. The objective of this study was to evaluate its potential toxicity and translocation ability after acute oral administration to mice. Methods and Findings A safety study was conducted in immunocompetent and immunosuppressed C57BL-6 mice. Both mouse groups (n = 10 per group) were fed orally 2 x 109 colony forming units (cfu)/day of B. uniformis CECT 7771 or placebo by gavage for 6 days. Throughout this time, feed and water intake and body weight were monitored. Afterwards, mice were sacrificed and biological samples were collected to analyze blood and urine biochemistry, inflammatory and immune markers; gut mucosal histology and bacterial translocation to peripheral tissues. The results demonstrated that acute ingestion of this Bacteroides strain had no adverse effects on the animals’ general health status or food intake, nor did it affect biochemical indicators of liver, kidney and pancreatic function or gut mucosal histology. Findings also demonstrated that administration did not lead to bacterial translocation to blood, liver or mesenteric lymph nodes. B. uniformis CECT 7771 also downregulated gene and protein expression (iNOS and PPAR-γ) and inflammatory cytokines induced by immunosuppression. Conclusions The findings indicate that the acute oral consumption of B. uniformis CECT 7771 does not raise safety concerns in mice. Further studies in humans should be conducted. PMID:26784747

  14. Breast Milk Feeding, Brain Development, and Neurocognitive Outcomes: A 7-Year Longitudinal Study in Infants Born at Less Than 30 Weeks' Gestation.

    PubMed

    Belfort, Mandy B; Anderson, Peter J; Nowak, Victoria A; Lee, Katherine J; Molesworth, Charlotte; Thompson, Deanne K; Doyle, Lex W; Inder, Terrie E

    2016-10-01

    To determine the associations of breast milk intake after birth with neurological outcomes at term equivalent and 7 years of age in very preterm infants We studied 180 infants born at <30 weeks' gestation or <1250 grams birth weight enrolled in the Victorian Infant Brain Studies cohort from 2001-2003. We calculated the number of days on which infants received >50% of enteral intake as breast milk from 0-28 days of life. Outcomes included brain volumes measured by magnetic resonance imaging at term equivalent and 7 years of age, and cognitive (IQ, reading, mathematics, attention, working memory, language, visual perception) and motor testing at 7 years of age. We adjusted for age, sex, social risk, and neonatal illness in linear regression. A greater number of days on which infants received >50% breast milk was associated with greater deep nuclear gray matter volume at term equivalent age (0.15 cc/d; 95% CI, 0.05-0.25); and with better performance at age 7 years of age on IQ (0.5 points/d; 95% CI, 0.2-0.8), mathematics (0.5; 95% CI, 0.1-0.9), working memory (0.5; 95% CI, 0.1-0.9), and motor function (0.1; 95% CI, 0.0-0.2) tests. No differences in regional brain volumes at 7 years of age in relation to breast milk intake were observed. Predominant breast milk feeding in the first 28 days of life was associated with a greater deep nuclear gray matter volume at term equivalent age and better IQ, academic achievement, working memory, and motor function at 7 years of age in very preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. The Forced Surrender of Infants Born to Unwed Mothers in Southern Italy. A Case Study of Late Nineteenth Century Practices in the Town of Forio d'Ischia.

    PubMed

    Imperato, Pascal James

    2015-10-01

    For many centuries, unwed mothers in southern Italy were forced to surrender their infants because of a number of social, religious, economic, and political pressures. This study focuses on the policies and practices that were in place in southern Italy regarding illegitimate infants in the late nineteenth century. A detailed analysis of the policies and practices present in the town of Forio d'Ischia during the 20-year period 1880-1899 is also presented. During these two decades, there were 37 illegitimate live births representing 0.70% of the 5249 live births recorded in this town. Although small in number, these illegitimate births, referred to as spuri in Italian, from the Latin spurius, meaning bastard, were managed by standard predetermined procedures. These included anonymity for the parents, the transfer of such infants to an official town receiver of foundlings, and their transport to Naples' orphanage, the Real Casa Santa dell'Annunziata. This orphanage maintained fairly detailed records about the children who were delivered to it. After a few days at the orphanage, infants were often entrusted to the care of external wet nurses, preferably outside of Naples. This was done in the belief that infant survival was better assured in more rural environments. The case of an illegitimate infant, Antonino Spinalbese, is presented in detail. Born on 14 February 1882 in the town of Forio d'Ischia, he was brought to the orphanage 4 days later. Following a two-day stay at the orphanage, he was entrusted to an external wet nurse, Michele Mondella, and her husband, Ciro Fiscale di Felice, a mariner in the town of Torre del Greco. The available evidence indicates that Antonino Spinalbese became a mariner like his stepfather. As a crew member of the passenger ship, Vulcano, he made three trips from Naples to New York City in 1922 and 1923.

  16. Tolerance and Safety Evaluation in a Large Cohort of Healthy Infants Fed an Innovative Prebiotic Formula: A Randomized Controlled Trial

    PubMed Central

    Piemontese, Pasqua; Giannì, Maria L.; Braegger, Christian P.; Chirico, Gaetano; Grüber, Christoph; Riedler, Josef; Arslanoglu, Sertac; van Stuijvenberg, Margriet; Boehm, Günther; Jelinek, Jürgen; Roggero, Paola

    2011-01-01

    Background the addition of oligosaccharides to infant formula has been shown to mimic some of the beneficial effects of human milk. The aim of the study was to assess the tolerance and safety of a formula containing an innovative mixture of oligosaccharides in early infancy. Methodology/Principal Findings this study was performed as a multi-center, randomized, double-blind, placebo-controlled trial including healthy term infants. Infants were recruited before the age of 8 weeks, either having started with formula feeding or being fully breast-fed (breastfeeding group). Formula-fed infants were randomized to feeding with a regular formula containing a mixture of neutral oligosaccharides and pectin-derived acidic oligosaccharides (prebiotic formula group) or regular formula without oligosaccharides (control formula group). Growth, tolerance and adverse events were assessed at 8, 16, 24 and 52 weeks of age. The prebiotic and control groups showed similar mean weight, length and head circumference, skin fold thicknesses, arm circumference gains and stool frequency at each study point. As far as the anthropometric parameters are concerned, the prebiotic group and the control group did not attain the values shown by the breastfeeding group at any study point. The skin fold thicknesses assessed in the breastfeeding group at 8 weeks were strikingly larger than those in formula fed infants, whereas at 52 weeks were strikingly smaller. The stool consistency in the prebiotic group was softer than in the control group at 8, 16 and 24 weeks (p<0.001) and closer to that of the breastfeeding group. There was no difference in the incidence of adverse events between the two formula groups. Conclusions our findings demonstrate the tolerability and the long term safety of a formula containing an innovative mixture of oligosaccharides in a large cohort of healthy infants. Trial Registration: drks-neu.uniklinik-freiburg.de DRKS 00000201 PMID:22140499

  17. Correlation properties of spontaneous motor activity in healthy infants: a new computer-assisted method to evaluate neurological maturation.

    PubMed

    Waldmeier, Sandra; Grunt, Sebastian; Delgado-Eckert, Edgar; Latzin, Philipp; Steinlin, Maja; Fuhrer, Katharina; Frey, Urs

    2013-06-01

    Qualitative assessment of spontaneous motor activity in early infancy is widely used in clinical practice. It enables the description of maturational changes of motor behavior in both healthy infants and infants who are at risk for later neurological impairment. These assessments are, however, time-consuming and are dependent upon professional experience. Therefore, a simple physiological method that describes the complex behavior of spontaneous movements (SMs) in infants would be helpful. In this methodological study, we aimed to determine whether time series of motor acceleration measurements at 40-44 weeks and 50-55 weeks gestational age in healthy infants exhibit fractal-like properties and if this self-affinity of the acceleration signal is sensitive to maturation. Healthy motor state was ensured by General Movement assessment. We assessed statistical persistence in the acceleration time series by calculating the scaling exponent α via detrended fluctuation analysis of the time series. In hand trajectories of SMs in infants we found a mean α value of 1.198 (95 % CI 1.167-1.230) at 40-44 weeks. Alpha changed significantly (p = 0.001) at 50-55 weeks to a mean of 1.102 (1.055-1.149). Complementary multilevel regression analysis confirmed a decreasing trend of α with increasing age. Statistical persistence of fluctuation in hand trajectories of SMs is sensitive to neurological maturation and can be characterized by a simple parameter α in an automated and observer-independent fashion. Future studies including children at risk for neurological impairment should evaluate whether this method could be used as an early clinical screening tool for later neurological compromise.

  18. SNAP-II and SNAPPE-II as predictors of death among infants born before the 28th week of gestation. Inter-institutional variations

    PubMed Central

    Dammann, Olaf; Shah, Bhavesh; Naples, Mary; Bednarek, Francis; Zupancic, John; Allred, Elizabeth N.; Leviton, Alan

    2009-01-01

    Background Illness severity scores predict death among infants admitted to neonatal intensive care units. We know of no study limited to a population defined by an extremely low gestational age. Methods A total of 1467 infants born before the 28th postmenstrual week at 14 institutions were given Scores for Neonatal Acute Physiology (SNAP-II and SNAPPE-II) based on data collected within the first 12 postnatal hours. All deaths in the intensive care nursery were identified. Results The mortality rate before postnatal day 28 was 13% (inter-institutional range: 7–20%), while the overall mortality was 18% (8–31%). SNAP-IIs, SNAPPE-IIs, and death rates tended to decrease with increasing gestational age. However, even within gestational age strata, the risk of death declined with decreasing SNAP-IIs and SNAPPE-IIs. The predictive value positive of most SNAP-II and SNAPPE-II cut-offs was close to 30. In general an institution’s death rate increased with the proportion of infants whose SNAP-II was 30 or more. Conclusion The physiologic instability in the first 12 post-natal hours identified by illness severity scores conveys information about the risk of death among infants at the lowest gestational ages. PMID:19858146

  19. Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG-administered infants born to HBsAg positive mothers.

    PubMed

    Zhou, Shan; Li, Tingting; Allain, Jean-Pierre; Zhou, Bin; Zhang, Yuming; Zhong, Mei; Fu, Yongshui; Li, Chengyao

    2017-05-23

    The status of chronic and occult HBV infection (OBI) in neonatal hepatitis B vaccine and immunoglobulin (HBIG) vaccinated infants born to HBsAg+ mothers was investigated at a major hospital in China. Seventy-seven and 15 blood samples were collected in first or second follow-up detection from the vaccinated babies aged 3-36 months born to 43 HBsAg+ or plus 25 HBeAg+ mothers. HBV infection was analyzed between the paired baby and mother by serology and DNA analysis. Among 77 children born to 68 HBsAg+ mothers, 3.9% (3/77) were HBsAg+, and 36.4% (28/77) were HBV DNA+/HBsAg- (OBIs) by a single PCR, respectively. Thirteen of 28 HBV DNA+/HBsAg- samples were conformed by two PCRs or S sequence, which accounted for 16.9% (13/77) of children. Three HBsAg+ and six OBIs were genotyped in consistent with their mother's HBV strains. Of 77 babies' blood samples, anti-HBs reactivity varied slightly according to age groups, while passively transmitted anti-HBc reactivity declined from 100% high reactivity at age 3-5 months to mostly negative at age ≥12 months. Babies with apparent OBI had higher levels of anti-HBc and lower levels of anti-HBs than those without OBI but all eight OBI babies with second follow-up samples became HBV DNA negative beyond 1 year of age. The vaccinated infants born to HBsAg+ mothers presented the low rate of HBsAg occurrence as vaccination failure and high frequency of viral persistence in the form of transient OBIs since no evidence of active HBV infection occurred beyond 1 year of age. © 2017 Wiley Periodicals, Inc.

  20. Psychosocial and Behavioral Factors Related to the Post-Partum Placements of Infants Born to Cocaine-Using Women

    ERIC Educational Resources Information Center

    Minnes, Sonia; Singer, Lynn T.; Humphrey-Wall, Rashida; Satayathum, Sudtida

    2008-01-01

    Objective: One objective was to determine if cocaine-using women who did not maintain infant custody (NMC) would report more psychological distress, domestic violence, negative coping skills, lower social support and more childhood trauma than cocaine-using women who maintained custody (MC) of their infant. A second objective was to evaluate the…

  1. Psychosocial and Behavioral Factors Related to the Post-Partum Placements of Infants Born to Cocaine-Using Women

    ERIC Educational Resources Information Center

    Minnes, Sonia; Singer, Lynn T.; Humphrey-Wall, Rashida; Satayathum, Sudtida

    2008-01-01

    Objective: One objective was to determine if cocaine-using women who did not maintain infant custody (NMC) would report more psychological distress, domestic violence, negative coping skills, lower social support and more childhood trauma than cocaine-using women who maintained custody (MC) of their infant. A second objective was to evaluate the…

  2. Effect of various milk feeds on numbers of Escherichia coli and Bidifobacterium in the stools of new-born infants.

    PubMed Central

    Hewitt, J. H.; Rigby, J.

    1976-01-01

    Escherichia coli was found in a similar proportion of stool specimens from infants who were breast-fed and from others fed on three different artificial-milk preparations. When E. coli was present its mean colony count in the stools of breast-fed infants was within the range of the mean counts for infants receiving the artificial -milk feeds. There was no consistent relation between high counts of bifidobacteria (Lactobacillus bifidus) and low counts of E. coli. This suggests that measures aimed at implanting or stimulating the growth of bifidobacteria in the large intestine of artificially fed infants may not greatly influence the E. coli population therein. The results are discussed in relation to the protection of artifically fed infants from E. coli enteritis. PMID:789762

  3. Description of 13 Infants Born During October 2015-January 2016 With Congenital Zika Virus Infection Without Microcephaly at Birth - Brazil.

    PubMed

    van der Linden, Vanessa; Pessoa, André; Dobyns, William; Barkovich, A James; Júnior, Hélio van der Linden; Filho, Epitacio Leite Rolim; Ribeiro, Erlane Marques; Leal, Mariana de Carvalho; Coimbra, Pablo Picasso de Araújo; Aragão, Maria de Fátima Viana Vasco; Verçosa, Islane; Ventura, Camila; Ramos, Regina Coeli; Cruz, Danielle Di Cavalcanti Sousa; Cordeiro, Marli Tenório; Mota, Vivian Maria Ribeiro; Dott, Mary; Hillard, Christina; Moore, Cynthia A

    2016-12-02

    Congenital Zika virus infection can cause microcephaly and severe brain abnormalities (1). Congenital Zika syndrome comprises a spectrum of clinical features (2); however, as is the case with most newly recognized teratogens, the earliest documented clinical presentation is expected to be the most severe. Initial descriptions of the effects of in utero Zika virus infection centered prominently on the finding of congenital microcephaly (3). To assess the possibility of clinical presentations that do not include congenital microcephaly, a retrospective assessment of 13 infants from the Brazilian states of Pernambuco and Ceará with normal head size at birth and laboratory evidence of congenital Zika virus infection was conducted. All infants had brain abnormalities on neuroimaging consistent with congenital Zika syndrome, including decreased brain volume, ventriculomegaly, subcortical calcifications, and cortical malformations. The earliest evaluation occurred on the second day of life. Among all infants, head growth was documented to have decelerated as early as 5 months of age, and 11 infants had microcephaly. These findings provide evidence that among infants with prenatal exposure to Zika virus, the absence of microcephaly at birth does not exclude congenital Zika virus infection or the presence of Zika-related brain and other abnormalities. These findings support the recommendation for comprehensive medical and developmental follow-up of infants exposed to Zika virus prenatally. Early neuroimaging might identify brain abnormalities related to congenital Zika infection even among infants with a normal head circumference (4).

  4. Basic values for heart and respiratory rates during different sleep stages in healthy infants.

    PubMed

    Heimann, Konrad; Heussen, Nicole; Vaeßen, Peter; Wallmeier, Cathrin; Orlikowsky, Thorsten; Wenzl, Tobias G

    2013-02-01

    The aim of this study was to systematically register data for respiratory and heart rates (RR and HR, respectively) during different sleep stages [active (AS, i.e., rapid eye movement) and quiet (QS, i.e., non-rapid eye movement) sleep] and age in a large number of healthy infants (277) during the first year of life to simplify polysomnography. The reference values in this age group differ significantly between the number of patients and age at time of investigation. According to strict inclusion and exclusion criteria, the measurement of polysomnography included HR (beats per minute, or bpm), RR (breaths per minute, or breaths/min), brain waves, SO2, sound, and video. Data recording and evaluation occurred via Alice 3®/3.5®(Respironics®), classification into AS and QS sleep according to maturity. For RR, the 5th-95th percentiles during AS decreased from 25.8-47.7 breaths/min (1st month) to 17.8-27.7 breaths/min (>9 months). During QS, RR ranged from 27.4-51.5 breaths/min (1st month) to 17.8-29.2 breaths/min (>9 months). HR decreased during AS from 118.3-150.6 bpm (1st month) to 100.9-126.4 bpm (>9 months). During QS, HR decreased from 116.0-149.9 bpm (1st month) to 93.7-119.8 bpm (>9 months). The mean HR and RR significantly decreased with age in both sleep stages (p<0.05). The mean HR is significantly lower during QS compared with AS (p<0.05). Our data may serve as basic values for HR and RR in different sleep stages during the first year of life.

  5. Macronutrient composition of human milk from Korean mothers of full term infants born at 37-42 gestational weeks

    PubMed Central

    Jung, Ji A; Kim, Hyesook; Jo, Ara; Kang, Sujeong; Lee, Si-Won; Yi, Hyunju; Kim, Jihee; Yim, Jong-Gap; Jung, Byung-Moon

    2015-01-01

    BACKGROUND/OBJECTIVES Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS Milk samples were obtained from 2,632 healthy lactating women (mean age; 32.0 ± 3.3 years), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk. PMID:26244084

  6. Disparities in influenza vaccination coverage among women with live-born infants: PRAMS surveillance during the 2009-2010 influenza season.

    PubMed

    Ahluwalia, Indu B; Ding, Helen; Harrison, Leslie; D'Angelo, Denise; Singleton, James A; Bridges, Carolyn

    2014-01-01

    Vaccination during pregnancy significantly reduces the risk of influenza illness among pregnant women and their infants up to 6 months of age; however, many women do not get vaccinated. We examined disparities in vaccination coverage among women who delivered a live-born infant during the 2009-2010 influenza season, when two separate influenza vaccinations were recommended. Pregnancy Risk Assessment Monitoring System (PRAMS) data from 29 states and New York City, collected during the 2009-2010 influenza season, were used to examine uptake of seasonal (unweighted n=27,153) and pandemic influenza A(H1N1)pdm09 (pH1N1) (n=27,372) vaccination by racially/ethnically diverse women who delivered a live-born infant from September 1, 2009, through May 31, 2010. PRAMS data showed variation in seasonal and pH1N1 influenza vaccination coverage among women with live-born infants by racial/ethnic group. For seasonal influenza vaccination, coverage was 50.5% for non-Hispanic white, 30.2% for non-Hispanic black, 42.1% for Hispanic, and 48.2% for non-Hispanic other women. For pH1N1, vaccination coverage was 41.4% for non-Hispanic white, 25.5% for non-Hispanic black, 41.1% for Hispanic, and 43.3% for non-Hispanic other women. Compared with non-Hispanic white women, non-Hispanic black women had lower seasonal (crude prevalence ratio [cPR] = 0.60, 95% confidence interval [CI] 0.55, 0.64) and pH1N1 (cPR=0.62, 95% CI 0.57, 0.67) vaccination coverage; these disparities diminished but remained after adjusting for provider recommendation or offer for influenza vaccination, insurance status, and demographic factors (seasonal vaccine: adjusted PR [aPR] = 0.80, 95% CI 0.74, 0.86; and pH1N1 vaccine: aPR=0.75, 95% CI 0.68, 0.82). To reduce disparities in influenza vaccination uptake by pregnant women, targeted efforts toward providers and interventions focusing on pregnant and postpartum women may be needed.

  7. [Hepatitis B with a fatal outcome in a 3-month-old infant of a healthy chronic carrier mother].

    PubMed

    Le Luyer, B; Bastard, C; Devaux, A M; Ensel, P

    1983-01-01

    A 81 day old male infant developed an acute hepatitic failure and died shortly thereafter. Determinations of HBs antigen and antibody (AB) and HBeAg and AB were performed in the parents and sibling of the infected child. The mother and a sister were an asymptomatic carrier of HBsAg, the first HBeAg positive and the second HBeAB positive. An elder sibling was HBsAg and HBeAg positive in this serum. The father was anti-HBs positive. In the family of the sister, the man and two childs were HBsAg and anti-HBsAB negative. A new baby in the family of the propositus born and a combination of HB vaccine and HBIg (hepatite B immuno-globulin) was started at birth. Unfortunately the child died of S.D.I.S. (Sudden Death Infant Syndrome). The HB vaccine was immuno-genetic in this infant and the anti-HBs in the immuno-globulin M (IgM) was positive as in several adults controls. This case allow us to discuss vertical transmission of hepatitis B, the clinical aspect of neonatal hepatitis and the preventing HB infection by combinaison of HB vaccine and HBIg.

  8. Changes in muscle activation patterns in response to enhanced sensory input during treadmill stepping in infants born with myelomeningocele

    PubMed Central

    Pantall, Annette; Teulier, Caroline; Ulrich, Beverly D.

    2013-01-01

    Infants with myelomeningocele (MMC) increase step frequency in response to modifications to the treadmill surface. The aim was to investigate how these modifications impacted the electromyographic (EMG) patterns. We analyzed EMG from 19 infants aged 2–10 months, with MMC at the lumbosacral level. We supported infants upright on the treadmill for 12 trials, each 30 seconds long. Modifications included visual flow, unloading, weights, Velcro and lcriction. Surface electrodes recorded EMG from tibialis anterior, lateral gastrocnemius, rectus femoris and biceps femoris. We determined muscle bursts for each stride cycle and from these calculated various parameters. Results indicated that each of the five sensory conditions generated different motor patterns. Visual flow and friction which we previously reported increased step frequency impacted lateral gastrocnemius most. Weights, which significantly decreased step frequency increased burst duration and co-activity of the proximal muscles. We also observed an age effect, with all conditions increasing muscle activity in younger infants whereas in older infants visual flow and unloading stimulated most activity. In conclusion, we have demonstrated that infants with myelomeningocele at levels which impact the myotomes of major locomotor muscles find ways to respond and adapt their motor output to changes in sensory input. PMID:23158017

  9. Breastfeeding and Red Meat Intake Are Associated with Iron Status in Healthy Korean Weaning-age Infants.

    PubMed

    Hong, Jeana; Chang, Ju Young; Shin, Sue; Oh, Sohee

    2017-06-01

    The present study investigated risk factors for iron deficiency (ID) and iron deficiency anemia (IDA) during late infancy, including feeding type and complementary feeding (CF) practice. Healthy term Korean infants (8-15 months) were weighed, and questionnaires regarding delivery, feeding, and weaning were completed by their caregivers. We also examined levels of hemoglobin, serum iron/total iron-binding capacity, serum ferritin, and mean corpuscular volume (MCV). Among 619 infants, ID and IDA were present in 174 infants (28.1%) and 87 infants (14.0%), respectively. The 288 infants with exclusively/mostly breastfeeding until late infancy (BFL) were most likely to exhibit ID (53.1%) and IDA (28.1%). The risk of ID was independently associated with BFL (adjusted odds ratio [aOR], 47.5; 95% confidence interval [CI], 18.3-122.9), male sex (aOR, 1.9; 95% CI, 1.2-2.9), fold weight gain (aOR, 2.6; 95% CI, 1.5-4.6), and perceived inadequacy of red meat intake (aOR, 1.7; 95% CI, 1.0-2.7). In addition to the risk factors for ID, Cesarean section delivery (aOR, 1.9; 95% CI, 1.1-3.2) and low parental CF-related knowledge (aOR, 2.8; 95% CI, 1.5-5.2) were risk factors for IDA. In conclusion, prolonged breastfeeding and perceived inadequacy of red meat intake may be among the important feeding-related risk factors of ID and IDA. Therefore, more meticulous education and monitoring of iron-rich food intake, such as red meat, with iron supplementation or iron status testing during late infancy if necessary, should be considered for breastfed Korean infants, especially for those with additional risk factors for ID or IDA. © 2017 The Korean Academy of Medical Sciences.

  10. Breastfeeding and Red Meat Intake Are Associated with Iron Status in Healthy Korean Weaning-age Infants

    PubMed Central

    2017-01-01

    The present study investigated risk factors for iron deficiency (ID) and iron deficiency anemia (IDA) during late infancy, including feeding type and complementary feeding (CF) practice. Healthy term Korean infants (8–15 months) were weighed, and questionnaires regarding delivery, feeding, and weaning were completed by their caregivers. We also examined levels of hemoglobin, serum iron/total iron-binding capacity, serum ferritin, and mean corpuscular volume (MCV). Among 619 infants, ID and IDA were present in 174 infants (28.1%) and 87 infants (14.0%), respectively. The 288 infants with exclusively/mostly breastfeeding until late infancy (BFL) were most likely to exhibit ID (53.1%) and IDA (28.1%). The risk of ID was independently associated with BFL (adjusted odds ratio [aOR], 47.5; 95% confidence interval [CI], 18.3–122.9), male sex (aOR, 1.9; 95% CI, 1.2–2.9), fold weight gain (aOR, 2.6; 95% CI, 1.5–4.6), and perceived inadequacy of red meat intake (aOR, 1.7; 95% CI, 1.0–2.7). In addition to the risk factors for ID, Cesarean section delivery (aOR, 1.9; 95% CI, 1.1–3.2) and low parental CF-related knowledge (aOR, 2.8; 95% CI, 1.5–5.2) were risk factors for IDA. In conclusion, prolonged breastfeeding and perceived inadequacy of red meat intake may be among the important feeding-related risk factors of ID and IDA. Therefore, more meticulous education and monitoring of iron-rich food intake, such as red meat, with iron supplementation or iron status testing during late infancy if necessary, should be considered for breastfed Korean infants, especially for those with additional risk factors for ID or IDA. PMID:28480656

  11. Decision-making for postpartum discharge of 4300 mothers and their healthy infants: the Life Around Newborn Discharge study.

    PubMed

    Bernstein, Henry H; Spino, Cathie; Finch, Stacia; Wasserman, Richard; Slora, Eric; Lalama, Christina; Touloukian, Carol Litten; Lilienfeld, Harris; McCormick, Marie C

    2007-08-01

    Postpartum discharge of mothers and infants who are not medically or psychosocially ready may place the family at risk. Most studies of postpartum length of stay, however, do not reflect the necessary complexity of decision-making. With this study we aimed to characterize decision-making on the day of postpartum discharge from the perspective of multiple key informants and identify correlates of maternal and newborn unreadiness for discharge. This was a prospective observational cohort study of healthy term infants with mothers, pediatric providers, and obstetricians as key informants to assess the decision-making process regarding mother-infant dyad unreadiness for discharge. A mother-infant dyad was defined as unready for postpartum hospital discharge if > or = 1 of 3 informants perceived that either the mother or infant should stay longer at time of nursery discharge. Data were collected through self-administered questionnaires on the day of discharge. Of 4300 mother-infant dyads, unreadiness was identified in 17% as determined by the mother (11%), pediatrician (5%), obstetrician (1%), and > or = 2 informants (< 1%). Significant correlates of unreadiness were as follows: black non-Hispanic maternal race/ethnicity, maternal history of chronic disease, primigravid status, inadequate prenatal care as determined by the Kotelchuck Adequacy of Prenatal Care Utilization Index, delivering during nonroutine hours, in-hospital neonatal problems, receiving a limited number of in-hospital classes, and intent to breastfeed. Mothers, pediatricians, and obstetricians must make decisions about postpartum discharge jointly, because perceptions of unreadiness often differ. Sensitivity toward specific maternal vulnerabilities and an emphasis on perinatal education to insure individualized discharge plans may increase readiness and determine optimal timing for discharge and follow-up care.

  12. Early diet and peak bone mass: 20 year follow-up of a randomized trial of early diet in infants born preterm.

    PubMed

    Fewtrell, Mary S; Williams, Jane E; Singhal, Atul; Murgatroyd, Peter R; Fuller, Nigel; Lucas, Alan

    2009-07-01

    Preterm infants are at risk of metabolic bone disease due to inadequate mineral intake with unknown consequences for later bone health. To test the hypotheses that (1) early diet programs peak bone mass and bone turnover; (2) human milk has a beneficial effect on these outcomes; (3) preterm subjects have reduced peak bone mass compared to population reference data. 20 year follow-up of 202 subjects (43% male; 24% of survivors) who were born preterm and randomized to: (i) preterm formula versus banked breast milk or (ii) preterm versus term formula; as sole diet or supplement to maternal milk. Outcome measures were (i) anthropometry; (ii) hip, lumbar spine (LS) and whole body (WB) bone mineral content (BMC) and bone area (BA) measured using DXA; (iii) bone turnover markers. Infant dietary randomization group did not influence peak bone mass or turnover. The proportion of human milk in the diet was significantly positively associated with WBBA and BMC. Subjects receiving >90% human milk had significantly higher WBBA (by 3.5%, p=0.01) and BMC (by 4.8%, p=0.03) than those receiving <10%. Compared to population data, subjects had significantly lower height SDS (-0.41 (SD 1.05)), higher BMI SDS (0.31 (1.33)) and lower LSBMD SDS (-0.29 (1.16)); height and bone mass deficits were greatest in those born SGA with birthweight <1250 g (height SDS -0.81 (0.95), LSBMD SDS -0.61 (1.3)). Infant dietary randomization group did not affect peak bone mass or turnover suggesting the observed reduced final height and LS bone mass, most marked in growth restricted subjects with the lowest birthweight, may not be related to sub-optimal early nutrition. The higher WB bone mass associated with human milk intake, despite its low nutrient content, may reflect non-nutritive factors in breast milk. These findings may have implications for later osteoporosis risk and require further investigation.

  13. Retrospective cohort study of all deaths among infants born between 22 and 27 completed weeks of gestation in Switzerland over a 3-year period.

    PubMed

    Berger, T M; Steurer, M A; Bucher, H U; Fauchère, J C; Adams, M; Pfister, R E; Baumann-Hölzle, R; Bassler, D

    2017-06-15

    The aim of this research is to assess causes and circumstances of deaths in extremely low gestational age neonates (ELGANs) born in Switzerland over a 3-year period. Population-based, retrospective cohort study. All nine level III perinatal centres (neonatal intensive care units (NICUs) and affiliated obstetrical services) in Switzerland. ELGANs with a gestational age (GA) <28 weeks who died between 1 July 2012 and 30 June 2015. A total of 594 deaths were recorded with 280 (47%) stillbirths and 314 (53%) deaths after live birth. Of the latter, 185 (59%) occurred in the delivery room and 129 (41%) following admission to an NICU. Most liveborn infants dying in the delivery room had a GA ≤24 weeks and died following primary non-intervention. In contrast, NICU deaths occurred following unrestricted life support regardless of GA. End-of-life decision-making and redirection of care were based on medical futility and anticipated poor quality of life in 69% and 28% of patients, respectively. Most infants were extubated before death (87%). In Switzerland, most deaths among infants born at less than 24 weeks of gestation occurred in the delivery room. In contrast, most deaths of ELGANs with a GA ≥24 weeks were observed following unrestricted provisional intensive care, end-of-life decision-making and redirection of care in the NICU regardless of the degree of immaturity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. [Iatrogenic skin lesions: a prospective study in premature infants born at less than 33 weeks of amenorrhea at Besançon university hospital].

    PubMed

    Roche-Kubler, B; Puzenat, E; Mariet, A-S; Thiriez, G; Aubin, F; Humbert, P

    2015-01-01

    Advances in neonatology have markedly improved prognosis for premature babies in recent years. However, they have also entailed the need for recourse to considerable intensive care involving potentially iatrogenic diagnostic and therapeutic acts. Among the resulting iatrogenic events, cutaneous lesions are the most frequent but have been the subject of very few studies. Our own study thus aimed to assess the rate of iatrogenic cutaneous events in premature infants born at less than 33 weeks of amenorrhea and hospitalised at Besançon university hospital and to identify the factors associated with the occurrence of these events. This was a prospective study carried out in the department of paediatric intensive care and neonatology at Besançon university hospital between May 2011 and April 2012. All babies born before 33 weeks of amenorrhea hospitalised over this period were included. An iatrogenic event was defined as "an adverse event related to a medical procedure". Iatrogenic cutaneous events were reported to the dermatologist by medical and paramedical staff. One hundred and thirthteen newborn babies were included during the study period. Twenty-six iatrogenic cutaneous events were recorded in 19 infants, representing 16.8% of the population involved: nine were associated with ventilation techniques, six with the use of intravenous catheters, five with electrodes, two involved pressure sores, two were linked to the birth, one to disinfectants and one to dressings. The main risk factor was low birth weight (P=0.016). High prematurity and the duration of ventilation increased the risk, although not significantly. The death rate was higher in children with iatrogenic events but the difference was not significant. The duration of hospitalisation was unaffected by the presence or absence of an iatrogenic event. The frequency of iatrogenic cutaneous events is high in hospital departments in charge of very premature infants. Awareness by the medical and paramedical

  15. Predictors of RSV LRTI Hospitalization in Infants Born at 33 to 35 Weeks Gestational Age: A Large Multinational Study (PONI)

    PubMed Central

    Saliba, Elie; Kosma, Paraskevi; Posfay-Barbe, Klara; Yunis, Khalid; Farstad, Teresa; Unnebrink, Kristina; van Wyk, Jean; Wegzyn, Colleen; Notario, Gerard; Kalus, Stefanie; Campbell, Fiona J.

    2016-01-01

    Background Preterm infants are at high risk of developing respiratory syncytial virus (RSV)-associated lower respiratory tract infection (LRTI). This observational epidemiologic study evaluated RSV disease burden and risk factors for RSV-associated LRTI hospitalization in preterm infants 33 weeks+0 days to 35 weeks+6 days gestational age not receiving RSV prophylaxis. Methods Preterm infants ≤6 months of age during RSV season (1 October 2013–30 April 2014) were followed at 72 sites across 23 countries from September 2013–July 2014 (study period). RSV testing was performed according to local clinical practice. Factors related to RSV-associated hospitalization for LRTI were identified using multivariable logistic regression with backward selection. Results Of the 2390 evaluable infants, 204 and 127 were hospitalized for LRTI during the study period and RSV season, respectively. Among these subjects, 64/204 and 46/127, respectively, were hospitalized for confirmed RSV LRTI. Study period and RSV season normalized RSV hospitalization rates (per 100 infant years) were 4.1 and 6.1, respectively. Factors associated with an increased risk of RSV-related LRTI hospitalization in multivariable analyses were smoking of family members (P<0.0001), non-hemodynamically significant congenital heart disease diagnosis (P = 0.0077), maternal age of ≤25 years at delivery (P = 0.0009), low maternal educational level (P = 0.0426), household presence of children aged 4 to 5 years (P = 0.0038), age on 1 October ≤3 months (P = 0.0422), and presence of paternal atopy (P<0.0001). Conclusions During the 2013–2014 RSV season across 23 countries, for preterm infants 33–35 weeks gestation ≤6 months old on 1 October not receiving RSV prophylaxis, confirmed RSV LRTI hospitalization incidence was 4.1 per 100 infant years during the study period and 6.1 per 100 infant years during the RSV season. This study enhances the findings of single-country studies of common risk factors for

  16. Low-Level Toxic Metal Exposure in Healthy Weaning-Age Infants: Association with Growth, Dietary Intake, and Iron Deficiency.

    PubMed

    Choi, Jungil; Chang, Ju Young; Hong, Jeana; Shin, Sue; Park, Jeong Su; Oh, Sohee

    2017-04-06

    Even low levels of toxic metal exposure (As, Cd, Hg, and Pb) in infancy might be harmful to children's development. This study investigated toxic metal exposure on healthy weaning-age infants and its relationship with growth, diet, and iron/anemia status. The weight, height, head circumference, whole blood levels of four toxic metals, hemoglobin, and serum ferritin of healthy infants was measured. Among 210 infants with a median age of 11.4 months (interquartile range: 10.5-12.0), the median levels of As, Cd, Hg, and Pb were 1.2 μg/L, 0.05 μg/L, 0.8 μg/L, and 0.83 μg/dL, respectively. In adjusted linear regression models, post-birth weight gain (Pb) and current head circumference (As, Pb) were negatively associated with toxic metal levels. In multiple linear regression or logistic regression analysis, the duration of breastfeeding (all four metals), perceived adequacy of rice-based food intake (As), regular fish intake (As, Hg), and iron deficiency with/without anemia (Cd, Pb) were associated with increased toxic metal levels. Although levels of toxic metals may not usually be high in this population, individual exposure risk may need to be assessed after considering the type of feeding or intake of complementary foods and the iron/anemia status while evaluating growth status during late infancy.

  17. Creatine kinase isoenzymes in serum from cord blood and the blood of healthy full-term infants during the first three postnatal days.

    PubMed

    Jedeikin, R; Makela, S K; Shennan, A T; Rowe, R D; Ellis, G

    1982-02-01

    Isoenzymes of creatine kinase (ATP:creatine phosphotransferase; EC 2.7.3.2; CK) were measured by electrophoresis in serum from cord blood and skin-puncture blood taken from 45 healthy full-term infants during the first three postnatal days. Mean total CK activities (in U/L at 30 degrees C) were 185 in cord samples, 536 in samples taken between 5--8 h postnatally, 494 between 24--33 h, and 288 in the 72-100 h samples. Values for all three isoenzymes increased to a peak over this period, with the highest values generally being found in the samples taken 5--33 h after birth; the subsequent decline was most rapid for CK-BB. Serum CK isoenzymes in cord samples and those taken at 72--100 h in the 11 babies delivered by cesarian section did not differ significantly from those of babies delivered vaginally. However the postnatal increases in total CK, CK-MM, and CK-MB (but not in CK-BB) were significantly greater in those patients born by vaginal delivery. The reasons for the increases in CK isoenzymes after birth are not clear, but our results and reported studies on the ontogeny of CK suggest that CK-MB cannot be regarded as a "cardiac-specific" isoenzyme in the neonatal period.

  18. Birth of a healthy infant after preimplantation genetic diagnosis by sequential blastomere and trophectoderm biopsy for β-thalassemia and HLA genotyping.

    PubMed

    Milachich, Tanya; Timeva, Tanya; Ekmekci, Cumhur; Beyazyurek, Cagri; Tac, Huseyin Avni; Shterev, Atanas; Kahraman, Semra

    2013-07-01

    Preimplantation genetic diagnosis (PGD) is a widely used technique for couples at genetic risk and involves the diagnosis and transfer of unaffected embryos generated through in vitro fertilization (IVF) techniques. For those couples who are at risk of transmitting a genetic disease to their offspring, preimplantation embryos can be selected according to their genetic status as well as human leukocyte antigen (HLA) compatibility with the affected child. Stem cells from the resulting baby's umbilical cord blood can be used for transplantation to the affected sibling without graft rejection. Here we report successful hematopoietic stem cell transplantation (HSCT) after the birth of a healthy infant, who was born after successful PGD testing with both cleavage stage and blastocyst stage biopsy for the purpose of diagnosis of β-thalassemia and HLA compatibility. The specific feature of this work is not only to have the first successful HSCT achieved in Bulgaria after using preimplantation HLA typing technique, it also demonstrates how to accomplish this success via cross-border collaboration of different units, which makes the application of these sophisticated methods possible in hospitals not having the necessary equipments and expertise. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Short-Term Outcomes of Very Low Birth Weight Infants Born at a Tertiary Care Hospital, Istanbul, Turkey

    PubMed Central

    Atalay, Deniz; Salihoğlu, Özgül; Can, Emrah; Beşkardeş, Ayşegül; Hatipoğlu, Sami

    2013-01-01

    Objective To evaluate mortality and short-term outcomes in very low birth weight infants admitted to the tertiary neonatal intensive care unit, Istanbul, Turkey. Methods Study data were recorded prospectively from January 1, 2010, to December 31, 2010. The clinical findings in neonates with birth weights <1000g were compared with infants with birth weights of between 1000g and 1499g. Findings In the present study, survival rates were 40% and 86.2% for infants weighing <1000g and 1000g to 1499g, respectively. There was no difference between males and females with respect to mortality (P>0.05). The mean (±standard deviation) birth weight was 985.6±150.15 g and mean gestational age was 27.5±2.04 weeks. The antenatal steroid rate was 37.2%, and the Cesarean section rate was 73%. Respiratory distress syndrome was diagnosed in 89% of the infants, with a 69% surfactant administration rate. Severe intracranial hemorrhage (IVH) (grade >II) was 14%. Grade 4 periventricular leukomalacia was 10%. Twelve (24%) infants had evidence of bronchopulmonary dysplasia (BPD). Retinopathy of prematurity (stage >II) was 4%. The correlation between ROP rate and need for ventilation therapy was present (r=0.52). Proven necrotizing enterocolitis (stage >2) was not observed. Patent ductus arteriosus (PDA) was diagnosed in 67% of the neonates. BPD, IVH, and PDA were statistically higher in neonates with a birth weight <1000g. Conclusion Survival rate of VLBW infants increased with increasing BW. Sex was not a risk factor for mortality. The need for ventilatory therapy may be an important risk factor for ROP in infants <1500g. PMID:23724184

  20. Swaddling: Maternal Option and Sleep Behaviour in Two-Month-Old Infants

    ERIC Educational Resources Information Center

    Kelmanson, Igor

    2013-01-01

    This study aimed to assess possible association between swaddling and sleep behaviour in two-month-old infants. It comprised 198 apparently healthy infants from the community setting selected by chance (86 boys, 112 girls), aged two months, who were singletons born in St Petersburg in 2007. The mothers were asked to complete the questionnaires…

  1. Swaddling: Maternal Option and Sleep Behaviour in Two-Month-Old Infants

    ERIC Educational Resources Information Center

    Kelmanson, Igor

    2013-01-01

    This study aimed to assess possible association between swaddling and sleep behaviour in two-month-old infants. It comprised 198 apparently healthy infants from the community setting selected by chance (86 boys, 112 girls), aged two months, who were singletons born in St Petersburg in 2007. The mothers were asked to complete the questionnaires…

  2. Functional magnetic resonance connectivity studies in infants born preterm: suggestions of proximate and long-lasting changes in language organization.

    PubMed

    Kwon, Soo Hyun; Scheinost, Dustin; Vohr, Betty; Lacadie, Cheryl; Schneider, Karen; Dai, Feng; Sze, Gordon; Constable, R Todd; Ment, Laura R

    2016-03-01

    Sophisticated neuroimaging strategies demonstrate alterations in functional connectivity at school age, adolescence, and young adulthood in individuals born preterm. Recent data suggest these alterations are present in the postnatal period prior to term-equivalent age in neonates born preterm. Likewise, functional organization increases across development, but the influence of preterm birth on this fundamental infrastructure is immediate and unchanging. This article briefly reviews the current methods of measuring functional connectivity throughout development in those born preterm, and the association of functional connectivity with language disorders. Taken together, these data suggest that the effects of preterm birth on the functional organization of language in the developing brain are both proximate and long-lasting.

  3. Infant mortality at time of birth and cause-specific adult mortality among residents of the Region of Madrid born elsewhere in Spain.

    PubMed

    Regidor, Enrique; Gutiérrez-Fisac, Juan L; Calle, M Elisa; Navarro, Pedro; Domínguez, Vicente

    2002-04-01

    To investigate the association between infant mortality at time of birth and mortality from various causes of death in adulthood in men and women. Linked mortality study based on mortality records for 1996 and 1997 and on 1996 population census data of the Region of Madrid (Spain). Deaths from five cancer sites and from five chronic diseases were estimated for 1 224 894 people aged 35-74 years residing in the Region of Madrid who were born elsewhere in Spain. A gradient in mortality by infant mortality quartile was seen for mortality from stomach cancer, colon cancer, diabetes mellitus and chronic liver disease in men, and for stomach cancer, ischaemic heart disease and chronic liver disease in women. The association was positive for stomach cancer and negative for all other causes. The relative mortality rates adjusted for age and adult socioeconomic factors for men belonging to infant mortality quartiles 3 and 4 (highest) versus those belonging to quartiles 1 and 2 as baseline were 1.06 (95% CI : 0.75-1.56) for stomach cancer, 0.67 (95% CI : 0.47-0.95) for colon cancer, 0.59 (95% CI : 0.35- 1.00) for diabetes mellitus, and 0.70 (95% CI : 0.49-0.99) for chronic heart disease. The relative mortality rates for women were 2.06 (95% CI : 1.09-3.88) for stomach cancer, 0.58 (95% CI : 0.41-0.80) for ischaemic heart disease, and 0.44 (95% CI : 0.27-0.70) for chronic liver disease. Higher infant mortality at time of birth is associated with adult mortality from diabetes mellitus and colon cancer in men, from ischaemic heart disease in women, and from stomach cancer and chronic liver disease in both sexes. These results most likely reflect adverse living conditions and/or nutritional deprivation in childhood.

  4. A new topical panthenol-containing emollient: skin-moisturizing effect following single and prolonged usage in healthy adults, and tolerability in healthy infants.

    PubMed

    Stettler, Hans; Kurka, Peter; Wagner, Christine; Sznurkowska, Katarzyna; Czernicka, Olga; Böhling, Arne; Bielfeldt, Stephan; Wilhelm, Klaus-Peter; Lenz, Holger

    2017-05-01

    Two studies were conducted with a new topical panthenol-containing emollient (NTP-CE) to investigate the skin-moisturizing effect in healthy adults and tolerability in healthy infants. In Study 1 (N = 44), a single skin application of NTP-CE was performed followed by a 4-week twice-daily application. Skin hydration and stratum corneum (SC) water content change (using Raman spectroscopy) were measured. In the 4-week Study 2 (N = 65, aged 3-25 months), NTP-CE tolerability was assessed using a 5-point scoring system; skin hydration was determined in a subset (N = 21). In Study 1, mean AUC0 - 24 h for skin capacitance change from baseline was 302.03 i.u. with NTP-CE and -15.90 i.u. in control areas (p < .001). With NTP-CE (at 4 h), the water content within the upper SC part was reduced (-45.10 vs. -13.39 g/cm(2), p = .013) and the water gradient increased (0.51 vs. 0.11 g/cm(4), p = .036), indicating relocation of water into deeper layers. In Study 2, there was no statistically significant change from baseline in mean cutaneous tolerability scores. At days 7, 14, and 28, skin hydration had increased by 42%, 54%, and 49%, respectively (all p < .001). Single and prolonged NTP-CE usage is associated with sustained and deep skin moisturization. NTP-CE is well tolerated by healthy infants.

  5. Development of energy and time parameters in the walking of healthy human infants.

    PubMed

    Kimura, Tasuku; Yaguramaki, Naoko; Fujita, Masaki; Ogiue-Ikeda, Mari; Nishizawa, Satoshi; Ueda, Yutaka

    2005-11-01

    Sixteen infants were analyzed longitudinally from the onset of independent walking to 3 years of age using time parameters, speed and energy recovery. Considerable variation and irregularities were observed in many parameters of infant walking, especially until 13 months of age when infants had difficulty in walking steadily step by step. Infant walking until 3 years of age was characterized by a small braking duration, caused mainly by the forward inclination of the trunk, a large relative stance phase duration, which maintained static balance, short stride length, due to the small range of the lower limb joint angle, and a small recovery of external energy. These characteristics were also predominantly evident until 13 months of age. The small recovery characteristic of infants was caused by flexed lower limb joints, pronounced irregularities in energy output, and in younger infants, slow speed. The maximum recovery up until 2 years of age, though smaller than in adults, appeared at about 0.45 dimensionless speed, which is about the same speed that adults in particular naturally and at which their maximum recovery appeared. The forward inclination of the trunk and the lower limb joint angle, influenced the development of many characteristics of bipedal walking.

  6. HIV-1 drug resistance emergence among breastfeeding infants born to HIV-infected mothers during a single-arm trial of triple-antiretroviral prophylaxis for prevention of mother-to-child transmission: a secondary analysis.

    PubMed

    Zeh, Clement; Weidle, Paul J; Nafisa, Lillian; Lwamba, Humphrey M; Okonji, Jully; Anyango, Emily; Bondo, Philip; Masaba, Rose; Fowler, Mary Glenn; Nkengasong, John N; Thigpen, Michael C; Thomas, Timothy

    2011-03-01

    Nevirapine and lamivudine given to mothers are transmitted to infants via breastfeeding in quantities sufficient to have biologic effects on the virus; this may lead to an increased risk of a breastfed infant's development of resistance to maternal antiretrovirals. The Kisumu Breastfeeding Study (KiBS), a single-arm open-label prevention of mother-to-child HIV transmission (PMTCT) trial, assessed the safety and efficacy of zidovudine, lamivudine, and either nevirapine or nelfinavir given to HIV-infected women from 34 wk gestation through 6 mo of breastfeeding. Here, we present findings from a KiBS trial secondary analysis that evaluated the emergence of maternal ARV-associated resistance among 32 HIV-infected breastfed infants. All infants in the cohort were tested for HIV infection using DNA PCR at multiple study visits during the 24 mo of the study, and plasma RNA viral load for all HIV-PCR-positive infants was evaluated retrospectively. Specimens from mothers and infants with viral load >1,000 copies/ml were tested for HIV drug resistance mutations. Overall, 32 infants were HIV infected by 24 mo of age, and of this group, 24 (75%) infants were HIV infected by 6 mo of age. Of the 24 infants infected by 6 mo, nine were born to mothers on a nelfinavir-based regimen, whereas the remaining 15 were born to mothers on a nevirapine-based regimen. All infants were also given single-dose nevirapine within 48 hours of birth. We detected genotypic resistance mutations in none of eight infants who were HIV-PCR positive by 2 wk of age (specimens from six infants were not amplifiable), for 30% (6/20) at 6 wk, 63% (14/22) positive at 14 wk, and 67% (16/24) at 6 mo post partum. Among the 16 infants with resistance mutations by 6 mo post partum, the common mutations were M184V and K103N, conferring resistance to lamivudine and nevirapine, respectively. Genotypic resistance was detected among 9/9 (100%) and 7/15 (47%) infected infants whose mothers were on nelfinavir and

  7. Do Healthy Preterm Children Need Neuropsychological Follow-Up? Preschool Outcomes Compared with Term Peers

    ERIC Educational Resources Information Center

    Dall'Oglio, Anna M.; Rossiello, Barbara; Coletti, Maria F.; Bultrini, Massimiliano; De Marchis, Chiara; Rava, Lucilla; Caselli, Cristina; Paris, Silvana; Cuttini, Marina

    2010-01-01

    Aim: The aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term. Method : A total of 35 infants who were born at less than 33…

  8. Do Healthy Preterm Children Need Neuropsychological Follow-Up? Preschool Outcomes Compared with Term Peers

    ERIC Educational Resources Information Center

    Dall'Oglio, Anna M.; Rossiello, Barbara; Coletti, Maria F.; Bultrini, Massimiliano; De Marchis, Chiara; Rava, Lucilla; Caselli, Cristina; Paris, Silvana; Cuttini, Marina

    2010-01-01

    Aim: The aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term. Method : A total of 35 infants who were born at less than 33…

  9. Why birthplace still matters for infants born before 32 weeks: Infant mortality associated with birth at 22-31 weeks' gestation in non-tertiary hospitals in Victoria over two decades.

    PubMed

    Boland, Rosemarie Anne; Dawson, Jennifer Anne; Davis, Peter Graham; Doyle, Lex William

    2015-04-01

    Very preterm infants born in non-tertiary hospitals ('outborn') are known to have higher mortality rates compared with infants 'inborn' in tertiary centres. The aim of this study was to report changes over time in the incidence of outborn livebirths, 22-31 weeks and infant mortality rates for outborn compared with inborn births. We conducted a population-based cohort study of consecutive livebirths, 22-31 weeks' gestation in Victoria from 1990 to 2009. The relationship between birthplace, gestational age, birthweight, sex and infant mortality were analysed by logistic regression. There were 13,760 livebirths, 22-31 weeks: 14% were outborn. The proportion of outborn livebirths fell from 19% in 1991 to a nadir of 9% in 1997, but climbed to 17% by 2009. At all times, outborns had higher mortality rates compared with inborns. The overall infant mortality rate was 250.6 per 1000 outborn compared with 113.3 per 1000 inborn livebirths (adjusted odds ratio (aOR) 2.76 (95% CI 2.32, 3.27, P < 0.001). There were no differences between outborn and inborn mortality risks for 22-week livebirths (OR 7.04, 95% CI 0.87, 56.8, P = 0.067), but there were at 23-27 weeks (aOR 3.16, 95% CI 2.52, 3.96, P < 0.001) and at 28-31 weeks (aOR 1.66, 95% CI 1.19, 2.31, P = 0.003). Over time, mortality rates fell for inborn 23-27 week infants. Mortality rates fell for outborn 23-27 week infants in 1990-2005, but rose in 2006-2009. Outborn livebirths at 22-31 weeks' gestation occur too frequently and are associated with a significantly increased risk of mortality. Strategies to reduce outborn livebirths are required. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. Predicting School Readiness from Neurodevelopmental Assessments at Age 2 Years after Respiratory Distress Syndrome in Infants Born Preterm

    ERIC Educational Resources Information Center

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

    2010-01-01

    Aim: To determine whether neurodevelopmental outcomes at the age of 2 years accurately predict school readiness in children who survived respiratory distress syndrome after preterm birth. Method: Our cohort included 121 preterm infants who received surfactant and ventilation and were enrolled in a randomized controlled study of inhaled nitric…

  11. Predicting School Readiness from Neurodevelopmental Assessments at Age 2 Years after Respiratory Distress Syndrome in Infants Born Preterm

    ERIC Educational Resources Information Center

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

    2010-01-01

    Aim: To determine whether neurodevelopmental outcomes at the age of 2 years accurately predict school readiness in children who survived respiratory distress syndrome after preterm birth. Method: Our cohort included 121 preterm infants who received surfactant and ventilation and were enrolled in a randomized controlled study of inhaled nitric…

  12. Baby doe redux? The Department of Health and Human Services and the Born-Alive Infants Protection Act of 2002: a cautionary note on normative neonatal practice.

    PubMed

    Sayeed, Sadath A

    2005-10-01

    The Born-Alive Infants Protection Act (BAIPA), passed by Congress in 2002, has attracted little publicity. Its purposes were, in part, "to repudiate the flawed notion that a child's entitlement to the protections of the law is dependent on whether that child's mother or others want him or her." Understood as antiabortion rhetoric, the bill raised little concern among physicians at the time of legislative hearings and passed in both Houses by overwhelming majorities, hardly suggesting contentious legislation. After its signing into law, the Neonatal Resuscitation Program (NRP) Steering Committee issued an opinion stating that "[BAIPA] should not in any way affect the approach that physicians currently follow with respect to the extremely premature infant." This interpretation of the law, however, may have been short sighted. In April 2005, the US Department of Health and Human Services (DHHS) brought life to the BAIPA, announcing: "As a matter of law and policy, [DHHS] will investigate all circumstances where individuals and entities are reported to be withholding medical care from an infant born alive in potential violation of federal statutes." The agency issued instructions to state officials on how the definitional provision within the BAIPA interacts with the Emergency Medical Treatment and Labor Act (EMTALA) and the Child Abuse Prevention and Treatment Act (CAPTA). These interagency memoranda potentially resurrect dormant governmental oversight of newborn-treatment decisions and thus may have influence over normative neonatal practice. Under the BAIPA, the DHHS interprets EMTALA to protect all "born-alive" infants; hospitals and physicians violating regulatory requirements face agency-sanctioned monetary penalties or a "private right of action by any individual harmed as a direct result." According to its memorandum, the DHHS will investigate allegations of EMTALA violations whenever it finds evidence that a newborn was not provided with at least a medical

  13. Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

    PubMed Central

    Lampl, Michelle; Mummert, Amanda; Schoen, Meriah

    2016-01-01

    The Developmental Origins of Health and Disease (DOHaD) model recognizes growth in infancy and childhood as a fundamental determinant of lifespan health. Evidence of long-term health risks among small neonates who subsequently grow rapidly poses a challenge for interventions aiming to support healthy growth, not merely drive weight gain. Defining healthy growth beyond “getting bigger” is essential as infant and young child feeding industries expand. Liquid-based nutritional supplements, originally formulated for undernourished children, are increasingly marketed for and consumed by children generally. Clarifying the nature of the evidentiary base on which structure/function claims promoting “healthy growth” are constructed is important to curb invalid generalizations. Evidence points to changing social beliefs and cultural practices surrounding supplementary feeding, raising specific concerns about the long-term health consequences of an associated altered feeding culture, including reduced dietary variety and weight gain. Reassessing the evidence for and relevance of dietary supplements’ “promoting healthy growth” claims for otherwise healthy children is both needed in a time of global obesity and an opportunity to refine intervention approaches among small children for whom rapid subsequent growth in early life augments risk for chronic disease. Scientific and health care partnerships are needed to consider current governmental oversight shortfalls in protecting vulnerable populations from overconsumption. This is important because we may be doing more harm than good. PMID:27845744

  14. Association between Asian Dust-Borne Air Pollutants and Daily Symptoms on Healthy Subjects: A Web-Based Pilot Study in Yonago, Japan

    PubMed Central

    Onishi, Kazunari; Otani, Shinji; Kurosaki, Yasunori; Kurozawa, Youichi

    2016-01-01

    During the spring, Asian dust (AD) repeatedly makes its way to Japan, originating from drylands. We evaluated the association between AD-borne air pollutants and daily reported subjective symptoms in healthy subjects. We constructed an Internet questionnaire on daily ocular, nasal, respiratory, and skin symptoms. Forty-two healthy volunteers residents of Yonago (mean age, 33.57) were selected from the self-reporting web-based survey and recorded their symptoms between 1 and 31 of March 2013. We also collected information on levels of suspended particulate matter (SPM), particulate matter < 2.5 µm (PM2.5), sulfur dioxide (SO2), and nitrogen oxide (NOx) per hour on each of those days. SPM and PM2.5 were the dominant pollutants recorded throughout the month. A positive correlation was observed between SPM and ocular (r = 0.475, p < 0.01), nasal (r = 0.614, p < 0.001), and skin (r = 0.445, p < 0.05) symptoms. PM2.5 correlations were significant for ocular (r = 0.428, p < 0.05), nasal (r = 0.560, p < 0.01), and skin (r = 0.437, p < 0.05) symptoms. Our findings provide introductory evidence of AD-borne air pollutants and their association with several bodily symptoms in healthy subjects with the implementation of a self-administrated web-based survey application. PMID:28053609

  15. A comparison of dyadic interactions and coping with still-face in healthy pre-term and full-term infants.

    PubMed

    Montirosso, Rosario; Borgatti, Renato; Trojan, Sabina; Zanini, Rinaldo; Tronick, Ed

    2010-06-01

    Pre-term birth has a significant impact on infants' social and emotional competence, however, little is known about regulatory processes in pre-term mother-infant dyads during normal or stressful interactions. The primary goals of this study were to investigate the differences in infant and caregiver interactive behaviour and dyadic coordination of clinically healthy pre-term compared to full-term infant-mother dyads and to examine pre-term infants' capacity for coping with stress using the face-to-face still-face paradigm (FFSF). Fifty mother-infant dyads, including 25 pre-term infants and 25 full-term infants were videotaped during the FFSF. All infants were 6-9 months of age (corrected for gestational age in the pre-term group). Infant and maternal socio-emotional expressivity and self-regulatory behaviours were coded and measures of dyadic coordination (Matching, Reparation Rate, and Synchrony) were calculated. There were no significant differences in infant and caregiver socio-emotional behaviours between the two groups and both groups demonstrated the still-face (SF) effect and the reunion effect. There was a difference in self-regulatory behaviour. Pre-term infants were more likely than full-term infants to use distancing (e.g., by turning away, twisting, or arching) from their mothers during the FFSF. Additionally, during the Reunion episode of the FFSF pre-term infants showed more social monitoring compared to full-term infants. Regardless of the birth status, the dyads showed less coordination and a slower rate of reparation during the Reunion episode than during the Play episode. The higher proportion of distancing in the pre-term group and the increase in social monitoring suggest that even in normal interactions pre-term infants may experience a higher level of stress and have less capacity for self-regulation compared to the full-terms and that pre-term infants appear to use a compensatory strategy of increased social monitoring to cope with the

  16. Cognitive and language development of healthy preterm infants at 10 years of age.

    PubMed

    Magill-Evans, Joyce; Harrison, Margaret J; Van der Zalm, Jeanne; Holdgrafer, Gary

    2002-01-01

    In this longitudinal study, forty-three Canadian 10-year-olds, 20 born preterm without significant health problems and 23 born at term, were compared. Cognitive development was measured by the Wechsler Intelligence Scale for Children-III. Language development was measured by the Clinical Evaluation of Language Fundamentals-3 (CELF-3) and language used in a 5 minute interview. The children born preterm had subtle delays. They scored significantly lower on Performance IQ and the CELF-3. The subtests on which they had lower scores appear to require visual-spatial skills. Early intervention focusing on parent behaviours that encourage language development and early screening for delays in visual-spatial skills may be useful.

  17. Nontyphoidal Salmonella septic arthritis of the elbow in a healthy infant.

    PubMed

    Al Nafeesah, Abdullah Saleh

    2015-01-01

    A case of rarely encountered nontyphoidal Salmonella septic arthritis of the elbow in an infant with no preexisting disease is reported. Salmonella etiology was not suspected in this case, and the diagnosis was made only after bacterial isolation. Aspiration of the infected joint with radiological guidance initially failed to give a good clinical response. Arthrotomy was done with intravenous cefotaxime for 4 weeks followed by 2 weeks oral ciprofloxacin therapy to which the child responded favorably. Up to our knowledge this is the first case of nontyphoidal salmonella elbow septic arthritis in an infant in Saudi Arabia to be reported in the English literature.

  18. Nontyphoidal Salmonella Septic arthritis of the elbow in a healthy infant

    PubMed Central

    Nafeesah, Abdullah Saleh Al

    2015-01-01

    A case of rarely encountered nontyphoidal Salmonella septic arthritis of the elbow in an infant with no preexisting disease is reported. Salmonella etiology was not suspected in this case, and the diagnosis was made only after bacterial isolation. Aspiration of the infected joint with radiological guidance initially failed to give a good clinical response. Arthrotomy was done with intravenous cefotaxime for 4 weeks followed by 2 weeks oral ciprofloxacin therapy to which the child responded favorably. Up to our knowledge this is the first case of nontyphoidal salmonella elbow septic arthritis in an infant in Saudi Arabia to be reported in the English literature. PMID:26985275

  19. [Aspiration of milk in healthy infant--cause of acute respiratory arrest?].

    PubMed

    Erler, Thomas

    2007-02-01

    We present the case of 4month old female infant, who obviously suffered from a respiratory arrest during bottle-feed ing. After primary successful resuscitation the baby died after 49 days due to large intracranial hemorrages. The diagnosis of shaking trauma was based on the detailed medical examinations and on the case history taken from the police file. The life-threatening shaking trauma is rare as an emergency. Therefore every doctor should be aware of a potential victim in cases of infants who are normal developed without signs of injuries, have no history of a severe disease and show life-threatening symptomes.

  20. Anti-Group B Streptococcus antibody in infants born to mothers with human immunodeficiency virus (HIV) infection☆

    PubMed Central

    Le Doare, Kirsty; Allen, Lauren; Kampmann, Beate; Heath, Paul Trafford; Taylor, Stephen; Hesseling, Anneke C.; Gorringe, Andrew; Jones, Christine Elizabeth

    2015-01-01

    Background HIV-exposed uninfected infants have increased infection risk and mortality compared to HIV-unexposed infants. HIV-exposed infants may be at increased risk of invasive GBS disease due to reduced maternal antibody against GBS. Methods We quantified antibodies that bind to the surface of whole Group B Streptococcus (GBS) of serotypes Ia, Ib, II, III and V using novel flow cytometry assays in South African HIV-infected and non-infected mothers and their uninfected infants. Antibody-mediated complement C3b/iC3b deposition onto GBS of these serotypes was also quantified by a novel flow cytometry assay. Results Geometric mean concentration (GMC) of both surface-binding anti-GBS antibody and antibody-mediated complement deposition onto GBS were reduced in HIV-infected women (n = 46) compared to HIV-uninfected women (n = 58) for ST1a (surface-binding: 19.3 vs 29.3; p = 0.003; complement deposition: 2.9 vs 5.3 SU/mL; p = 0.003), STIb (24.9 vs 47.6; p = 0.003; 2.6 vs 4.9 SU/mL; p = 0.003), STII (19.8 vs 50.0; p = 0.001; 3.1 vs 6.2 SU/mL; p = 0.001), STIII (27.8 vs 60.1; p = 0.001; 2.8 vs 5.3 SU/mL; p = 0.001) and STV (121.9 vs 185.6 SU/mL; p < 0.001) and in their infants for STIa (complement deposition 9.4 vs 27.0 SU/mL; p = 0.02), STIb (13.4 vs 24.5 SU/mL; p = 0.02), STII (14.6 vs 42.7 SU/mL; p = 0.03), STIII (26.6 vs 62.7 SU/mL; p = 0.03) and STV (90.4 vs 165.8 SU/mL; p = 0.04). Median transplacental transfer of antibody from HIV-infected women to their infants was reduced compared to HIV-uninfected women for GBS serotypes II (0.42 [IQR 0.22–0.59] vs 1.0 SU/mL [0.42–1.66]; p < 0.001), III (0.54 [0.31–1.03] vs 0.95 SU/mL [0.42–3.05], p = 0.05) and V (0.51 [0.28–0.79] vs 0.75 SU/mL [0.26–2.9], p = 0.04). The differences between infants remained significant at 16 weeks of age. Conclusions Maternal HIV infection was associated with lower anti-GBS surface binding antibody concentration and antibody

  1. Premature infant

    MedlinePlus

    ... infant is a baby born before 37 completed weeks of gestation (more than 3 weeks before the due date). ... one of the following: Premature (less than 37 weeks gestation) Full term (37 to 42 weeks gestation) ...

  2. [EEG of the very premature infant born at 24 to 30 weeks gestational age. Definitions and normal area].

    PubMed

    Vecchierini, M-F; André, M; d'Allest, A-M

    2007-01-01

    This article aims at summarizing normal EEG criteria and their maturational pattern in premature infants of 24 to 30 weeks gestational age. Although very premature infants with a normal outcome are not numerous, their normal EEG patterns must be known, as EEG constitutes a basis for neurological prognosis. Background activity is first discontinuous. Discontinuity decreases thereafter with increasing age, so that some long periods of continuous activity may be observed in active sleep, around 30 weeks of age. Conversely, interburst intervals become shorter and the proportion of time without EEG activity is decreasing. Based on EEG activity and eye movements, a rough sleep-state differentiation was described as soon as 25 weeks of gestational age and is completely achieved at 30 weeks. The main EEG figures are high-voltage delta waves of higher amplitude and slower frequency in younger infants. Temporal delta waves occur in sequences, these are very characteristic of the very premature infant; thereafter, they become smaller, less numerous and eventually disappear around 27-28 weeks. In contrast, occipital delta waves remain numerous and of high voltage, are usually bilateral and superimposed with fast rhythms. The two types of frontal delta waves that are observed in 24-27 weeks prematures disappear with maturation. Bursts of synchronized delta waves are less numerous than localized delta waves and also disappear before 28 weeks of age. Finally, diffuse theta bursts are mainly recorded at 26-27 weeks GA and become more localized in temporal areas with maturation. At 30 weeks, they are observed on temporal areas, mainly during slow-wave sleep.

  3. Mapping the critical gestational age at birth that alters brain development in preterm-born infants using multi-modal MRI.

    PubMed

    Wu, Dan; Chang, Linda; Akazawa, Kentaro; Oishi, Kumiko; Skranes, Jon; Ernst, Thomas; Oishi, Kenichi

    2017-04-01

    Preterm birth adversely affects postnatal brain development. In order to investigate the critical gestational age at birth (GAB) that alters the developmental trajectory of gray and white matter structures in the brain, we investigated diffusion tensor and quantitative T2 mapping data in 43 term-born and 43 preterm-born infants. A novel multivariate linear model-the change point model, was applied to detect change points in fractional anisotropy, mean diffusivity, and T2 relaxation time. Change points captured the "critical" GAB value associated with a change in the linear relation between GAB and MRI measures. The analysis was performed in 126 regions across the whole brain using an atlas-based image quantification approach to investigate the spatial pattern of the critical GAB. Our results demonstrate that the critical GABs are region- and modality-specific, generally following a central-to-peripheral and bottom-to-top order of structural development. This study may offer unique insights into the postnatal neurological development associated with differential degrees of preterm birth.