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Sample records for healthy newborn infants

  1. 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.

  2. [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.

  3. [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.

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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

  10. Crying in Newborn and Young Infants.

    ERIC Educational Resources Information Center

    Michelsson, Katarina

    1988-01-01

    Discusses the reasons that newborns and young infants cry, the communicative effect and perception of crying, crying in sick and healthy infants, the sound spectograph, and crying for the use of clinical diagnostics. (RJC)

  11. 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.

  12. 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.

  13. Warmth is Analgesic in Healthy Newborns

    PubMed Central

    Lang, Colleen W.; Porges, Stephen W.

    2014-01-01

    This study identifies a behavioral and nonpharmacologic means of preventing and reducing newborn pain. Our objective was to determine whether warmth is analgesic in newborn infants undergoing vaccination—a routine painful hospital procedure. We used a prospective randomized controlled trial of 47 healthy full-term newborn infants. Infants were randomized into one of three conditions prior to vaccination: warmth exposure, pacifier suckling, or sucrose taste. Crying, grimacing, and heart rate differences were analyzed between groups before, during, and after vaccination as outcome measures. Warmer infants cried significantly less than sucrose taste or pacifier suckling after vaccination. Heart rate patterns reflected this analgesia. Core temperature did not differ between study groups. Providing natural warmth to newborn infants during a painful procedure decreases the crying and grimacing on par with the “gold” standard treatments of sucrose or pacifier. PMID:22424877

  14. Assessing body composition in healthy newborn infants: reliability of dual-energy x-ray absorptiometry.

    PubMed

    Godang, Kristin; Qvigstad, Elisabeth; Voldner, Nanna; Isaksen, Gunhild A; Frøslie, Kathrine F; Nøtthellen, Jacob; Henriksen, Tore; Bollerslev, Jens

    2010-01-01

    Dual-energy X-ray absorptiometry (DXA) is used to measure body composition in newborns; however, data on DXA accuracy are limited. We investigated the reliability of body composition measurements by DXA. The present study included 207 normal-term newborn babies, recruited from a larger study on the determinants of birth weight in healthy pregnancies (STORK) between 2005 and 2008. Reliability analysis of total fat mass (FM(DxA)), fat-free mass, lean mass (LM(DxA)), bone mineral content (BMC), and bone mineral density (BMD) were based on 2 DXA scans of 50 neonates. We also performed a comparison analysis for DXA (FM(DxA)) measurements and caliper (CLP) or circumference (CF) measurements of trunk and extremities (performed on all neonates, n=207). Reliability: All intraclass correlation coefficients (ICC) were satisfactory to excellent for total body and the extremity-compartment FM(DxA), LM(DxA), BMD, and BMC; ICC ranged from 0.86 to 0.96 but with a lower ICC for trunk FM(DxA). For comparison analysis, the Pearson correlation coefficients for CLP vs DXA and CF vs DXA ranged from 0.48 to 0.79 and 0.41 to 0.77, respectively. Quadriceps CLP and CF measurements correlated best with the most reliable DXA results, whereas more modest correlations were found for the trunk region. DXA measurements of body composition demonstrated good reliability and can be used as a reference method in neonates. CLP and CF measurements are appropriate for larger cohorts or when DXA is unavailable, and they provide fair rough estimations of fat mass.

  15. Hospital stay for healthy term newborns.

    PubMed

    2010-02-01

    The hospital stay of the mother and her healthy term newborn infant should be long enough to allow identification of early problems and to ensure that the family is able and prepared to care for the infant at home. The length of stay should also accommodate the unique characteristics of each mother-infant dyad, including the health of the mother, the health and stability of the infant, the ability and confidence of the mother to care for her infant, the adequacy of support systems at home, and access to appropriate follow-up care. Input from the mother and her obstetrician should be considered before a decision to discharge a newborn is made, and all efforts should be made to keep mothers and infants together to promote simultaneous discharge.

  16. Thrombosis in newborn infants.

    PubMed

    Bacciedoni, Viviana; Attie, Myriam; Donato, Hugo

    2016-04-01

    The incidence of thrombosis is higher among newborn infants than in any other stage of pediatric development. This fact is the consequence of labile characteristics of the neonatal hemostatic system, in addition to exposure to multiple risk factors and the wide use of vascular catheters. Venous thromboses, which mainly affect the limbs, the right atrium and renal veins, are more frequently seen than arterial thromboses. A stroke may be caused by the occlusion of the arterial flow entering the brain or by occlusion of its venous drainage system. Purpura fulminans is a very severe condition that should be treated as a medical emergency, and is secondary to severe protein C deficiency or, less frequently, protein S or antithrombin deficiency. Most thrombotic events should be managed with antithrombotic therapy, which is done with unfractionated and/or low molecular weight heparins. Purpura fulminans requires protein C replacement and/or fresh frozen plasma infusion. Thrombolytic therapy is done using tissue plasminogen activator and should only be used for life-, or limb-, or organ-threatening thrombosis.

  17. Newborn Infants Orient to Sounds.

    ERIC Educational Resources Information Center

    Muir, Darwin; Field, Jeffrey

    1979-01-01

    In two experiments, the majority of 21 newborn infants who were maintained in an alert state consistently turned their heads toward a continuous sound source presented 90 degrees from midline. For most infants, this orientation response was rather slow, taking median latencies of 2.5 seconds to begin and 5.5 seconds to end. (JMB)

  18. Newborn Infants Orient to Sounds.

    ERIC Educational Resources Information Center

    Muir, Darwin; Field, Jeffrey

    1979-01-01

    In two experiments, the majority of 21 newborn infants who were maintained in an alert state consistently turned their heads toward a continuous sound source presented 90 degrees from midline. For most infants, this orientation response was rather slow, taking median latencies of 2.5 seconds to begin and 5.5 seconds to end. (JMB)

  19. Jaundice in Healthy Newborns

    MedlinePlus

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... common condition in newborns, refers to the yellow color of the skin and whites of the eyes ...

  20. Jaundice in Healthy Newborns

    MedlinePlus

    ... eyes that happens when there is too much bilirubin in the blood. Bilirubin (bill-uh-ROO-bin) is produced by the ... liquid that helps with digestion). Jaundice happens when bilirubin builds up faster than a newborn's liver can ...

  1. 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

  2. Tissue Doppler, strain, and strain rate measurements assessed by two-dimensional speckle-tracking echocardiography in healthy newborns and infants.

    PubMed

    Elkiran, Ozlem; Karakurt, Cemsit; Kocak, Gulendam; Karadag, Ahmet

    2014-04-01

    To evaluate cardiac maturational and haemodynamic alteration in healthy newborns and infants and determine reference values in this period using tissue Doppler, strain, and strain rate echocardiography. The study included 149 healthy subjects. Babies from 1 day to 3 months were selected from the well-baby nursery department, and infants were selected from paediatric clinics during routine visits for health maintenance. Subjects were allocated to four groups: preterm (36-37 weeks, n = 32), term (≥ 38 weeks, n = 32), 1 month of age (n = 47), and 3 months of age (n = 38). Standard echocardiographic evaluations, pulsed wave Doppler, tissue Doppler echocardiography, strain, and strain rate studies were applied by the same person using a MyLab50 echo machine. Longitudinal and circumferential systolic strain and strain rate measurements were assessed by two-dimensional speckle-tracking echocardiography in all subjects. The longitudinal systolic velocity, strain, and strain rate values derived from left ventricle apical four-, three-, and two-chamber images, and circumferential systolic velocity, strain, and strain rate values derived from left ventricle short-axis images decreased from the base to the apex in all subjects (p < 0.001). Significant cardiac haemodynamic alterations occurred during the newborn and early infancy periods and were detected by tissue Doppler, strain, and strain rate echocardiography. Although two-dimensional speckle-tracking echocardiography is useful and can produce improved, reliable results in clinical practice, it has some limitations. Therefore, more studies on this issue are required.

  3. Newborn infants perceive abstract numbers.

    PubMed

    Izard, Véronique; Sann, Coralie; Spelke, Elizabeth S; Streri, Arlette

    2009-06-23

    Although infants and animals respond to the approximate number of elements in visual, auditory, and tactile arrays, only human children and adults have been shown to possess abstract numerical representations that apply to entities of all kinds (e.g., 7 samurai, seas, or sins). Do abstract numerical concepts depend on language or culture, or do they form a part of humans' innate, core knowledge? Here we show that newborn infants spontaneously associate stationary, visual-spatial arrays of 4-18 objects with auditory sequences of events on the basis of number. Their performance provides evidence for abstract numerical representations at the start of postnatal experience.

  4. Newborn infant skin: physiology, development, and care.

    PubMed

    Visscher, Marty O; Adam, Ralf; Brink, Susanna; Odio, Mauricio

    2015-01-01

    Infant skin is critical to the newborn child's transition from the womb environment to the journey to self-sufficiency. This review provides an integrative perspective on the skin development in full term and premature infants. There is a particular focus on the role of vernix caseosa and on the implications of skin development for epidermal penetration of exogenous compounds. Healthy full-term newborn skin is well-developed and functional at birth, with a thick epidermis and well-formed stratum corneum (SC) layers. Transepidermal water loss is very low at birth, equal to, or lower than adults, indicating a highly effective skin barrier. Vernix facilitates SC development in full-term infants through a variety of mechanisms including physical protection from amniotic fluid and enzymes, antimicrobial effects, skin surface pH lowering, provision of lipids, and hydration. Premature infants, particularly those of very low birth weight, have a poor skin barrier with few cornified layers and deficient dermal proteins. They are at increased risk for skin damage, increased permeability to exogenous agents and infection. The SC barrier develops rapidly after birth but complete maturation requires weeks to months. The best methods for caring for infant skin, particularly in the diaper region, are described and related to these developmental changes.

  5. 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 ...

  6. Diet and sleep patterns in newborn infants.

    PubMed

    Yogman, M W; Zeisel, S H

    1983-11-10

    Sleep behavior is modulated by serotonergic neurons within the brain, and the synthesis and release of serotonin by such neurons is thought to be influenced by the availability of tryptophan, the amino acid precursor of serotonin. We investigated the effects on the sleep patterns of newborn infants of variations in diet designed to affect tryptophan availability. Twenty healthy newborns (two to three days of age) were randomly assigned to receive a feeding consisting either of tryptophan in 10 per cent glucose or valine in 5 per cent glucose (valine competes with tryptophan for entry into the brain). Sleep patterns during the three hours after this feeding were compared with those after a feeding of routine formula (Similac). The infants fed tryptophan entered active sleep 14.1 minutes sooner than they did after Similac, and entered quiet sleep 20 minutes sooner. Those fed valine entered active sleep 15.8 minutes later than they did after Similac, and entered quiet sleep 39 minutes later. The differences between the tryptophan and valine groups were significant (P less than 0.01 for active sleep and P less than 0.005 for quiet sleep). We conclude that variations in the composition of the diet may influence sleep behavior in newborns.

  7. Healthy Start, Grow Smart: Your Newborn.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This booklet offers guidance to parents in caring for their newborn babies. Advice is given on the following topics: (1) newborn health screening; (2) what a healthy newborn looks like; (3) newborn reflexes; (4) baby checkups; (5) fathers' role; (6) the baby blues; (7) sleeping position; (8) breast milk; (9) breast feeding; (10) bottle feeding;…

  8. The contrast sensitivity of the newborn human infant.

    PubMed

    Brown, Angela M; Lindsey, Delwin T; Cammenga, Joanna G; Giannone, Peter J; Stenger, Michael R

    2015-01-06

    To measure the binocular contrast sensitivity (CS) of newborn infants using a fixation-and-following card procedure. The CS of 119 healthy newborn infants was measured using stimuli printed on cards under the descending method of limits (93 infants) and randomized/masked designs (26 infants). One experienced and one novice adult observer tested the infants using vertical square-wave gratings (0.06 and 0.10 cyc/deg; 20/10,000 and 20/6000 nominal Snellen equivalent); the experienced observer also tested using horizontal gratings (0.10 cyc/deg) and using the Method of Constant Stimuli while being kept unaware of the stimulus values. The CS of the newborn infant was 2.0 (contrast threshold = 0.497; 95% confidence interval: 0.475-0.524) for vertically oriented gratings and 1.74 (threshold = 0.575; 95% confidence interval: 0.523-0.633) for horizontally oriented gratings (P < 0.0006). The standard deviation of infant CS was comparable to that obtained by others on adults using the Pelli-Robson chart. The two observers showed similar practice effects. Randomization of stimulus order and masking of the adult observer had no effect on CS. The CS of individual newborn human infants can be measured using a fixation-and-following card procedure. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

  9. The Contrast Sensitivity of the Newborn Human Infant

    PubMed Central

    Brown, Angela M.; Lindsey, Delwin T.; Cammenga, Joanna G.; Giannone, Peter J.; Stenger, Michael R.

    2015-01-01

    Purpose. To measure the binocular contrast sensitivity (CS) of newborn infants using a fixation-and-following card procedure. Methods. The CS of 119 healthy newborn infants was measured using stimuli printed on cards under the descending method of limits (93 infants) and randomized/masked designs (26 infants). One experienced and one novice adult observer tested the infants using vertical square-wave gratings (0.06 and 0.10 cyc/deg; 20/10,000 and 20/6000 nominal Snellen equivalent); the experienced observer also tested using horizontal gratings (0.10 cyc/deg) and using the Method of Constant Stimuli while being kept unaware of the stimulus values. Results. The CS of the newborn infant was 2.0 (contrast threshold = 0.497; 95% confidence interval: 0.475–0.524) for vertically oriented gratings and 1.74 (threshold = 0.575; 95% confidence interval: 0.523–0.633) for horizontally oriented gratings (P < 0.0006). The standard deviation of infant CS was comparable to that obtained by others on adults using the Pelli-Robson chart. The two observers showed similar practice effects. Randomization of stimulus order and masking of the adult observer had no effect on CS. Conclusions. The CS of individual newborn human infants can be measured using a fixation-and-following card procedure. PMID:25564453

  10. Measurement and repeatability of interrupter resistance in unsedated newborn infants.

    PubMed

    Adams, A M; Olden, C; Wertheim, D; Ives, A; Bridge, P D; Lenton, J; Seddon, P

    2009-12-01

    Interrupter resistance (R(int)) is a useful measure of airway caliber in young children, but has not been well characterized in infants-in whom there are concerns about the accurate measurement of driving pressure. This study aimed to assess the feasibility and repeatability of measuring R(int) in unsedated newborn infants, and to explore alternative algorithms for calculating driving pressure. R(int) measurement was attempted in 28 healthy term newborn infants during natural sleep using the MicroRint device. Paired R(int) measurements were achieved in 24 infants, but after screening of waveforms only 15 infants had at least 5 technically acceptable waveforms on both measurements. R(int) values obtained were comparable with reported values for airflow resistance in newborns using other methods. However, the repeatability coefficient (CR) was much higher than reported values in preschool children using standard back-extrapolation algorithms, with CR 2.47 KPa L(-1) sec (unscreened) and 2.93 KPa L(-1) sec (screened). Other algorithms gave only marginally better repeatability, with all CR values over 50% of the mean R(int) value. Using current commercially available equipment, R(int) is too poorly repeatable to be a reliable measurement of airflow resistance in newborn infants. Lower deadspace equipment is needed, but anatomical and physiological factors in the infant are also important.

  11. Respiratory distress of the term newborn infant.

    PubMed

    Edwards, Martin O; Kotecha, Sarah J; Kotecha, Sailesh

    2013-03-01

    Respiratory distress is recognised as any signs of breathing difficulties in neonates. In the early neonatal period respiratory distress is common, occurring in up to 7% of newborn infants, resulting in significant numbers of term-born infants being admitted to neonatal units. Many risk factors are involved; the increasing number of term infants delivered by elective caesarean section has also increased the incidence. Additionally the risk decreases with each advancing week of gestation. At 37 weeks, the chances are three times greater than at 39-40 weeks gestation. Multiple conditions can present with features of respiratory distress. Common causes in term newborn infants include transient tachypnoea of the newborn, respiratory distress syndrome, pneumonia, meconium aspiration syndrome, persistent pulmonary hypertension of the neonate and pneumothorax. Early recognition of respiratory distress and initiation of appropriate treatment is important to ensure optimal outcomes. This review will discuss these common causes of respiratory distress in term-born infants.

  12. Chryseobacterium indologenes Meningitis in a Healthy Newborn: A Case Report

    PubMed Central

    Hendaus, Mohamed A.; Zahraldin, Khalid

    2013-01-01

    Chryseobacterium indologenes is a rare cause of infection in infants. The majority of case reports belong to hospitalized infants with indwelling devices. We are presenting a rare case of Chryseobacterium indologenes meningitis in a healthy newborn with no neonatal intensive care unit admissions or indwelling devices. The pathogen is resistant to many antibiotics and the patient was successfully treated with cefepime. This is the first case of C. indolegenes meningitis presented in a newborn with no indwelling device, NICU or long-term broad spectrum antibiotics. The choice of antibiotics can be challenging since the pathogen may exhibit resistance to a number of antibiotics. PMID:23599885

  13. Assessing infant and maternal readiness for newborn discharge.

    PubMed

    Jing, Ling; Bethancourt, Casidhe-Nicole; McDonagh, Thomas

    2017-10-01

    The review highlights the shift from prescribed length of stay (LOS) to mother-infant dyad readiness as the basis for making discharge decisions for healthy term newborns. We describe the components of readiness that should be considered in making the decision, focusing on infant clinical readiness, and maternal and familial readiness. Although the Newborns' and Mothers' Health Protection Act of 1996 aimed to protect infants and mothers by establishing a minimum LOS, the American Academy of Pediatrics 2015 policy on newborn discharge acknowledges the shift from LOS-based to readiness-based discharge decision-making. Healthcare providers must consider a variety of infant and maternal characteristics in determining the appropriate time to discharge a dyad, and mothers should be actively involved in the decision-making process. Criteria for infant clinical readiness include the following: establishment of effective feeding, evaluation of jaundice risk, review and discussion of infant and household vaccination status, obtainment of specimen for metabolic screening, tests of hearing ability, assessment of sepsis risk factors, screening for congenital heart disease, and evaluation of parental knowledge about infant safety measures. Important consideration should also be given to the mother's sociodemographic vulnerabilities, maternal confidence and perception of discharge readiness, and availability of postdischarge care continuity. The timing of newborn discharge should be a joint decision made by the mother and healthcare providers based on readiness. The decision should consider the infant's health status, the mother's health status, the mother's perception of readiness, and the availability of social and familial support for the mother and infant. Accessible and comprehensive support postdischarge is also important for helping infants achieve optimal health outcomes.

  14. Inflammatory cytokines in newborn infants.

    PubMed Central

    Sarandakou, A; Giannaki, G; Malamitsi-Puchner, A; Rizos, D; Hourdaki, E; Protonotariou, E; Phocas, I

    1998-01-01

    Serum levels of IL-1beta, IL-6 and TNF-alpha were measured in 48 healthy, termed neonates on the 1st (N1), 5th (N5) and 40th (N40) day after birth, compared with those in maternal serum (MS), umbilical cord (UC) and adult controls. Cytokine values in N1 and N5 were significantly elevated, than those in UC and in controls (P<0.0001). IL-1beta and IL-6 declined significantly from N1 to N40 (P<0.0001), while TNF-alpha increased significantly from N1 to N5 and declined thereafter. MS infinity IL-1beta and IL-6, but not MS infinity TNF-alpha, were significantly higher than those of controls (P<0.0001). IL-1beta values depended on the mode of delivery. In conclusion, the increased concentrations of IL-1beta, IL-6 and TNF-alpha during the perinatal period might suggest their involvement in an inflammation-like process during normal parturition, and reflect also a newborn immune response to the stress of delivery and environmental changes. PMID:9883964

  15. Immobility reaction at birth in newborn infant.

    PubMed

    Rousseau, Pierre Victor; Francotte, Jacques; Fabbricatore, Maria; Frischen, Caroline; Duchateau, Delphine; Perin, Marie; Gauthier, Jean-Marie; Lahaye, Willy

    2014-08-01

    To describe an immobility reaction (IR) that was not previously reported at or immediately after birth in human newborns. We analyzed 31 videos of normal term vaginal deliveries recorded from Time 0 of birth defined as the as the moment that lies between the birth of the thorax and the pelvis of the infant. We searched for perinatal factors associated with newborn's IR. IR at birth was observed in 8 of the 31 newborns. The main features of their behavior were immobilization, frozen face, shallow breathing and bradycardia. One of the 8 newborns had sudden collapse 2h after birth. We found significant relationships between maternal prenatal stress (PS) and IR (p=.037), and a close to significant one between infants' lividness at Time 0 and IR (p=.053). The first breath of the 31 newborns occurred before and was not associated with the first cry (p<.001). The main features of IR at birth are similar to those of the universal most severe response to severe stress or danger. The relationship with PS suggests that children who had IR at birth might be at risk for similar disorders as those associated with PS. Sudden neonatal collapse of one of the IR newborns needs further research to determine if they are at risk for sudden infant death syndrome. This first report of an IR reaction at birth in human infants could open up new paths for improving early neonatal care. Further research is needed for maternal PS, stress hormones, umbilical cord blood pH measurements in IR newborns. The challenge of education and support for parents of IR newborns is outlined. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Can Newborns Discriminate between Their Own Cry and the Cry of Another Newborn Infant?

    ERIC Educational Resources Information Center

    Dondi, Marco; Simion, Francesca; Caltran, Giovanna

    1999-01-01

    Two experiments tested whether newborns could discriminate their own and another newborn's cry. Results indicated that awake newborns expressed facial distress more frequently and longer to another newborn's cry than to their own. Sucking decreased significantly between pretest phase and first minute of another infant's cry. Asleep infants'…

  17. Perceptual Completion in Newborn Human Infants

    ERIC Educational Resources Information Center

    Valenza, Eloisa; Leo, Irene; Gava, Lucia; Simion, Francesca

    2006-01-01

    Despite decades of studies of human infants, a still open question concerns the role of visual experience in the development of the ability to perceive complete shapes over partial occlusion. Previous studies show that newborns fail to manifest this ability, either because they lack the visual experience required for perceptual completion or…

  18. Perceptual Completion in Newborn Human Infants

    ERIC Educational Resources Information Center

    Valenza, Eloisa; Leo, Irene; Gava, Lucia; Simion, Francesca

    2006-01-01

    Despite decades of studies of human infants, a still open question concerns the role of visual experience in the development of the ability to perceive complete shapes over partial occlusion. Previous studies show that newborns fail to manifest this ability, either because they lack the visual experience required for perceptual completion or…

  19. [Criteria for hospital discharge of the healthy term newborn after delivery].

    PubMed

    Rite Gracia, Segundo; Pérez Muñuzuri, Alejandro; Sanz López, Ester; Leante Castellanos, José Luis; Benavente Fernández, Isabel; Ruiz Campillo, César W; Sánchez Redondo, M Dolores; Sánchez Luna, Manuel

    2016-10-13

    Criteria for newborn hospital discharge have to include physiological stability and family competence to provide newborn care at home. In this document, the Committee of Standards of the Spanish Society of Neonatology reviews the minimum criteria to be met before hospital discharge of a term newborn infant. We include a review of hospital discharge criteria for the late preterm infants, as these infants are often not hospitalised and remain with their mother after birth. A shortened hospital stay (less than 48h after delivery) for healthy term newborns can be considered, but it is not appropriate for every mother and newborn. Newborn infants discharged before 48h of age, should be examined within 3-4 days of life.

  20. Transcutaneous bilirubinometry in the newborn infant: state of the art.

    PubMed

    Hegyi, T

    1986-01-01

    Hyperbilirubinemia in the newborn infant continues to challenge physicians. Clinical evaluation and treatment have evolved well-established principles over the past decade. This review examines neonatal bilirubin metabolism and focuses on a recently developed clinical diagnostic tool, the transcutaneous bilirubinometer. In spite of some limitations, the transcutaneous bilirubinometer can be best applied as a screening tool to identify healthy full-term infants who require serum bilirubin determination. With proper application, this device can eliminate most invasive diagnostic testing. Optimal use of the instrument requires the relationship between the serum bilirubin concentration and the transcutaneous bilirubinometer index to be determined for each device, institution, and population.

  1. [Cerebral Doppler ultrasonography in newborn infants].

    PubMed

    Luciano, R; Velardi, F

    1995-01-01

    Following the first study of Bada et al. (1979), Doppler assessment of cerebral blood flow has increasingly been used in newborn infants, matching the technical progress in the available equipment. The experience gathered in recent years has confirmed that Doppler US is a reliable and reproducible examination while precising the limitations and the methodology to be followed in order to prevent gross errors of assessment and interpretation. The interest this procedure has arisen, among other things, stems from being noninvasive and feasible at the patient's bed. These features enable its repeated use in newborn infants in poor clinical condition. The diagnostic and prognostic role of Doppler velocimetry has been shown in a number of neonatal diseases and the cerebral hemodynamics has been assessed in physiologic conditions as well as after drug administration. The most common equipment used in newborn infants is at present Duplex Doppler consisting of a pulsed Doppler combined with bidimensional scanner, which, with visualization of study arteries, enables precise positioning of sample volume and correction of the ultrasonic angle of incidence with respect to the direction of blood flow in the examined vessel. In this report, after a survey of the techniques and modalities of cerebral Doppler examination in newborns, a review of the present state of the art, in neonatal cerebral as well as extracranial disease, is presented.

  2. Disruption of intracardiac flow patterns in the newborn infant.

    PubMed

    Groves, Alan M; Durighel, Giuliana; Finnemore, Anna; Tusor, Nora; Merchant, Nazakat; Razavi, Reza; Hajnal, Jo V; Edwards, A David

    2012-04-01

    Consistent patterns of rotational intracardiac flow have been demonstrated in the healthy adult human heart. Intracardiac rotational flow patterns are hypothesized to assist in the maintenance of kinetic energy of inflowing blood, augmenting cardiac function. Newborn cardiac function is known to be suboptimal secondary to decreased receptor number and sympathetic innervation, increased afterload, and increased reliance on atrial contraction to support ventricular filling. Patterns of intracardiac flow in the newborn have not previously been examined. Whereas 5 of the 13 infants studied showed significant evidence of rotational flow within the right atrium, 8 infants showed little or no rotational flow. Presence or absence of rotational flow was not related to gestational age, birth weight, postnatal age, atrial size, or image quality. Despite absence of intra-atrial rotational flow, atrioventricular valve flow into the left and right ventricles later in the cardiac cycle could be seen, suggesting that visualization techniques were adequate. While further study is required to assess its exact consequences on cardiac mechanics and energetics, disruption to intracardiac flow patterns could be another contributor to the multifactorial sequence that produces newborn circulatory failure. We studied 13 newborn infants, using three-dimensional (3D) cardiac magnetic resonance phase-contrast imaging (spatial resolution 0.84 mm, temporal resolution 22.6 ms) performed without sedation/anesthesia.

  3. Colonization and infection in the newborn infant: Does chlorhexidine play a role in infection prevention?

    PubMed

    Ortegón, Lizeth; Puentes-Herrera, Marcela; Corrales, Ivohne F; Cortés, Jorge A

    2017-02-01

    Healthcare-associated infections are a major problem in newborn infants, considering their high morbidity, mortality, and long-term sequelae. In preterm infants, it has been shown that skin and gastrointestinal tract colonization undergoes variations compared to healthy term infants, and that preterm infants are more exposed to nosocomial microorganisms given their higher probability of being admitted to the neonatal intensive care unit where they are cared for. This document reviews normal colonization, the changes observed during hospitalization, prematurity, and the potential role of chlorhexidine in the prevention of resistant microorganism transmission, as well as its side effects in newborn infants admitted to the neonatal intensive care unit.

  4. Intestinal Absorption of Immunoglobulins by Newborn Infants

    PubMed Central

    Iyengar, Leela; Selvaraj, R. J.

    1972-01-01

    Intestinal absorption in newborn infants of immunoglobulins present in colostrum was studied by measuring the concentrations of immunoglobulins IgA, IgG, and IgM in cord blood and following the changes in the serum of the infant on the 5th day after birth. In infants who did not receive colostrum, a marked fall in IgG levels was observed on the 5th day after birth as compared to levels at birth. The concentrations of IgA and IgM showed marginal changes. In contrast, colostrumfed infants showed significant increases in the concentration of IgG. Levels of all 3 immunoglobulins on the 5th day were significantly higher in the serum of colostrumfed infants as compared to those who did not receive colostrum. It is suggested that immunoglobulins present in colostrum are to some extent absorbed from the intestinal tract of newborn infants, and this may have some physiological significance in the resistance to infection during the early neonatal period. PMID:4624594

  5. Sucrose and Warmth for Analgesia in Healthy Newborns: An RCT

    PubMed Central

    Garza, Elizabeth; Zageris, Danielle; Heilman, Keri J.; Porges, Stephen W.

    2015-01-01

    BACKGROUND AND OBJECTIVE: Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compared with the taste of sucrose alone during a painful procedure in healthy full-term newborns. METHODS: A randomized, controlled trial included 29 healthy, full-term newborns born at the University of Chicago Hospital. Both groups of infants were given 1.0 mL of 25% sucrose solution 2 minutes before the vaccination, and 1 group additionally was given radiant warmth from an infant warmer before the vaccination. We assessed pain by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia), and heart rate between the groups. RESULTS: The sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group (P < .05, respectively). The sucrose plus warmer group had lower heart rate and heart rate variability (ie, respiratory sinus arrhythmia) responses compared with the sucrose alone group (P < .01), reflecting a greater ability to physiologically regulate in response to the painful vaccination. CONCLUSIONS: The combination of sucrose and radiant warmth is an effective analgesic in newborns and reduces pain better than sucrose alone. The ready availability of this practical nonpharmacologic technique has the potential to reduce the burden of newborn pain. PMID:25687147

  6. Timbre-independent extraction of pitch in newborn infants.

    PubMed

    Háden, Gábor P; Stefanics, Gábor; Vestergaard, Martin D; Denham, Susan L; Sziller, István; Winkler, István

    2009-01-01

    The ability to separate pitch from other spectral sound features, such as timbre, is an important prerequisite of veridical auditory perception underlying speech acquisition and music cognition. The current study investigated whether or not newborn infants generalize pitch across different timbres. Perceived resonator size is an aspect of timbre that informs the listener about the size of the sound source, a cue that may be important already at birth. Therefore, detection of infrequent pitch changes was tested by recording event-related brain potentials in healthy newborn infants to frequent standard and infrequent pitch-deviant sounds while the perceived resonator size of all sounds was randomly varied. The elicitation of an early negative and a later positive discriminative response by deviant sounds demonstrated that the neonate auditory system represents pitch separately from timbre, thus showing advanced pitch processing capabilities.

  7. Acute inflammatory demyelinating polyradiculoneuropathy in a newborn infant.

    PubMed

    Anastasopoulou, Stavroula; Lindefeldt, Marie; Bartocci, Marco; Wickström, Ronny

    2016-09-01

    Acute inflammatory demyelinating polyneuropathy (AIDP), also known as Guillain-Barré syndrome, is an immune-mediated polyneuropathy usually triggered by infections or vaccinations. In childhood AIDP is commonly described after the first year of life. Here, we present a case of a newborn infant with AIDP manifestation directly after delivery. A newborn girl with a healthy mother, without known exposure to immunomodulating factors, was admitted to the neuropediatric department due to ascending hypotonia, weakness, pain and areflexia in the lower extremities. The clinical presentation, laboratory and neurophysiological studies supported the diagnosis of AIDP. The infant showed first signs of clinical improvement following administration of intravenous immunoglobulin and her recovery was complete at one year. AIDP should be considered as a differential diagnosis in ascending hypotonia also in the neonatal period. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  8. Pharmacology of some oral penicillins in the newborn infant.

    PubMed Central

    Cohen, M D; Raeburn, J A; Devine, J; Kirkwood, J; Elliott, B; Cockburn, F; Forfar, J O

    1975-01-01

    Serum and urine concentrations of ampicillin, amoxycillin, and flucloxacillin achieved after oral administration have been measured in 27 newborn infants. Compared with adults and children, newborn infants show a delay in achieving adequate blood concentrations, presumably due to delayed absorption. However most infants achieve therapeutic concentrations in the serum. Infected newborn infants should be given these antibiotics by intramuscular injection for the first dose, but thereafter oral therapy (25 mg/lg every 6 hours begun concomitantly) should be satisfactory. The better absorption of amoxycillin compared with ampicillin reported in adults has not been confirmed in the newborn infant. PMID:1147656

  9. Genetic Disorders in the Newborn Infant

    PubMed Central

    Meschino, Wendy S.; Summers, Anne M.

    1988-01-01

    Genetic disorders in the neonate should be suspected in a number of different clinical situations, ranging from that of an infant with dysmorphic features and multiple congenital malformations to that of a previously well newborn who becomes acutely ill. An approach for the primary-care physician to the initial investigation and management of these situations is outlined. In addition neonatal screening tests for metabolic disorders and congenital hypothyroidism are briefly discussed. PMID:21253098

  10. Advances in nutrition of the newborn infant.

    PubMed

    Harding, Jane E; Cormack, Barbara E; Alexander, Tanith; Alsweiler, Jane M; Bloomfield, Frank H

    2017-04-22

    Nutrition of newborn infants, particularly of those born preterm, has advanced substantially in recent years. Extremely preterm infants have high nutrient demands that are challenging to meet, such that growth faltering is common. Inadequate growth is associated with poor neurodevelopmental outcomes, and although improved early growth is associated with better cognitive outcomes, there might be a trade-off in terms of worse metabolic outcomes, although the contribution of early nutrition to these associations is not established. New developments include recommendations to increase protein supply, improve formulations of parenteral lipids, and provide mineral supplements while encouraging human milk feeding. However, high quality evidence of the risks and benefits of these developments is lacking. Clinical trials are also needed to assess the effect on preterm infants of experiencing the smell and taste of milk, to determine whether boys and girls should be fed differently, and to test effects of insulin and IGF-1 supplements on growth and developmental outcomes. Moderate-to-late preterm infants have neonatal nutritional challenges that are similar to those infants born at earlier gestations, but even less high quality evidence exists upon which to base clinical decisions. The focus of research in nutrition of infants born at term is largely directed at new formula products that will improve cognitive and metabolic outcomes. Providing the most effective nutrition to preterm infants should be prioritised as an important focus of neonatal care research to improve long-term metabolic and developmental outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Direct magnification radiography of the newborn infant

    SciTech Connect

    Brasch, R.C.; Gould, R.G.

    1982-03-01

    Recent advances in technology have made direct radiographic magnification of the newborn infant clinically feasible. A microfocus radiographic tube and a rare-earth, high-speed recording system were combined to obtain more than 2,000 radiographs at magnifications of 2-2.5. Special positioning devices permitted imaging of even those infants confined to incubators and connected to life-supporting systems. When quantitatively compared with three conventional contact radiographic systems with respect to resolution, contrast, and noise, magnification radiography showed overall superiority of image characteristics. Definition of subtle abnormalities and anatomically small structures permitted diagnoses which could not be made from conventional images. Furthermore, infant radiation exposure was markedly less (15 mR (3.9 mC/kg) maximum skin exposure) as compared with conventional contact radiographic systems (24 mR (6.1 mC/kg) to 45 mR (11.6 mC/kg)).

  12. Direct magnification radiography of the newborn infant

    SciTech Connect

    Brasch, R.C.; Gould, R.G.

    1982-03-01

    Recent advances in technology have made direct radiographic magnification of the newborn infant clinically feasible. A microfocus radiographic tube and a rare-earth, high-speed recording system were combined to obtain more than 2,000 radiographs at magnifications of 2 to 2.5. Special positioning devices permitted imaging of even those infants confined to incubators and connected to life-supporting systems. When quantitatively compared with three conventional contact radiographic systems with respect to resolution, contrast, and noise, magnification radiography showed overall superiority of image characteristics. Definition of subtle abnormalities and anatomically small structures permitted diagnoses which could not be made from conventional images. Furthermore, infant radiation exposure was markedly less (15 mR (3.9 mC/kg) maximum skin exposure) as compared with conventional contact radiographic systems (24 mR(6.1 mC/kg) to 45 mR (11.6 mC/kg)).

  13. Sedatives for opiate withdrawal in newborn infants.

    PubMed

    Osborn, D A; Jeffery, H E; Cole, M J

    2005-07-20

    time to regain birthweight (one study). However, the duration of supportive care given to infants was significantly reduced (MD -162.1 mins/day, 95% CI -249.2, -75.1). Comparing phenobarbitone to diazepam, meta-analysis of two studies found phenobarbitone produced a significant reduction in treatment failure (typical RR 0.39, 95% CI 0.24, 0.62). There was no significant difference in duration of treatment or hospital stay. Comparing phenobarbitone with chlorpromazine, one study found no significant difference in treatment failure rate. No data for neurodevelopment reported by treatment group of allocation were available. No trials were eligible that assessed clonidine for NAS. In infants treated with an opiate, a small quasi-random study reported a reduced severity of withdrawal. Infants were weaned from an opiate more quickly which allowed earlier hospital discharge and reduced hospital costs. These findings may reflect the low dose of opiate used for initial treatment and the policy of discharging infants home on phenobarbitone but not morphine. In newborn infants with NAS, there is no evidence that phenobarbitone compared with supportive care alone reduces treatment failure; however, phenobarbitone may reduce the daily duration of supportive care needed. Phenobarbitone, compared to diazepam, reduces treatment failure. In infants treated with an opiate, the addition of phenobarbitone may reduce withdrawal severity. Further trials are required to determine if this finding is applicable when a higher initial dose of opiate is used, and determine the effects of phenobabritone on infant development. There is insufficient evidence to support the use of chlorpromazine or clonidine in newborn infants with NAS. Clonidine and chlorpromazine should only be used in the context of a randomised clinical trial. This review should be taken in conjunction with the review "Opiate treatment for opiate withdrawal in newborn infants" (Osborn 2002a) which indicates that an opiate is the

  14. Dental lamina cysts in a newborn infant.

    PubMed

    Singh, Rajeev Kumar; Kumar, Rakesh; Pandey, Ramesh Kumar; Singh, Kamleshwar

    2012-10-09

    Cystic lesions of transient nature viz. Epstein pearls, Bohn's nodules and dental lamina cysts are frequently found in the oral cavities of newborn infants. These cysts arise from the developing dental tissues or from their remnants. These cystic lesions are not commonly seen by the dental surgeons due to their self-limiting nature and ignorance of the parents to seek the professional opinion. However, when contacted by anxious parents seeking treatment, dental surgeons should be able to explain and reassure the parents about the transient nature of these lesions and need for no treatment but regular follow-up. The present case report was written with the purpose to increase the awareness in dental surgeons about the peculiar clinical presentation and self-limiting nature of these cystic lesions, so that unnecessary surgical intervention can be avoided in such young infants.

  15. Newborn infants detect the beat in music

    PubMed Central

    Winkler, István; Háden, Gábor P.; Ladinig, Olivia; Sziller, István; Honing, Henkjan

    2009-01-01

    To shed light on how humans can learn to understand music, we need to discover what the perceptual capabilities with which infants are born. Beat induction, the detection of a regular pulse in an auditory signal, is considered a fundamental human trait that, arguably, played a decisive role in the origin of music. Theorists are divided on the issue whether this ability is innate or learned. We show that newborn infants develop expectation for the onset of rhythmic cycles (the downbeat), even when it is not marked by stress or other distinguishing spectral features. Omitting the downbeat elicits brain activity associated with violating sensory expectations. Thus, our results strongly support the view that beat perception is innate. PMID:19171894

  16. Autoimmune haemolytic anaemia in a newborn infant.

    PubMed

    Motta, M; Cavazza, A; Migliori, C; Chirico, G

    2003-07-01

    The case is reported of an infant with autoimmune haemolytic anaemia of perinatal onset. Combined treatment with steroids and cyclosporin was necessary to improve haemolysis and reduce the high transfusion requirements. Treatment was discontinued at 13 months of age. The child was healthy at the follow up at 24 and 36 months of age.

  17. Cholestasis in newborn infants with perinatal asphyxia.

    PubMed

    Vajro, P; Amelio, A; Stagni, A; Paludetto, R; Genovese, E; Giuffré, M; DeCurtis, M

    1997-08-01

    The aim of this study was to characterize the liver involvement in infants who have both neonatal asphyxia and neonatal cholestasis. We describe four asphyctic newborn infants (three born at term) who developed early (age 3.8 +/- 2.1 days) intrahepatic neonatal cholestasis and in whom tests for causes of neonatal liver damage were negative. The clinical picture and course were benign and similar to that of sporadic "idiopathic" neonatal hepatitis. Clinical signs and abnormal liver function tests tended to normalize within the first year of life in all. Conjugated bilirubin became normal at 6 months after the onset of cholestasis, while liver enzymes tended towards normal values thereafter, within 1 year of follow-up. Liver biopsy (taken in one patient) showed a typical picture of giant cell hepatitis; ultrastructure was nonspecific. Our results suggest that isolated asphyxia should be taken into account as a potential causal factor in term or pre-term asphyctic newborns who develop early "idiopathic" neonatal cholestasis.

  18. Feeding of newborns and infants (cultural aspects).

    PubMed

    Lala, V R; Desai, A B

    1970-07-01

    A total of 435 mothers in the postnatal ward of the Civil Hospital in Ahmedabad, India were interviewed to determine the cultural beliefs and traditional practices influencing the feeding of newborns and infants. A thorough physical and neurological examination of the newborns was conducted. All newborns and mothers were followed for a period varying from 3-7 days to detect any complications either in the newborn or the mother related to feeding patterns. The various methods of feeding were observed. In most of the cases the deciding factor to giving the 1st feed was the cry of the baby. As a 1st feed, various liquid preparations were used by the mothers. 66.2% of the mothers offered boiled water as a 1st feed. In the postnatal ward boiled water is an easily available preparation for newborns and is usually provided by the ward sister whenever the mother requests it. In most of the cases the mother herself was the initiator. 40.3% of the mothers began supplementing breast milk with milk or solid food before the age of 1 year, and 18% by the age of 1 1/2 years. 27.3% of the mothers kept their children on breast milk only until the age of 1 year, and 12.7% until the age of 2 years. 46.5% of the mothers did not give milk at all during infancy and childhood. The most common age for introducing solid food was 1-1 1/2 (61.4%); only 10.2% of the mothers introduced solid food during the 1st year of life. The various sweet carbohydrate preparations used as 1st feed are known as "Galthuthi." 25.9% of the mothers gave "Galthuthi" to their newborns during the 1st 3 days of life and 16.9% of the mothers used it as a 1st feed. Most mothers were giving it as a custom or community tradition. The infants exposed to "Galthuthi" are exposed to gastrointestinal infections. The common practice of giving fresh milk as a prelacteal feed during the 1st 3 days of life appears to be harmful to subsequent breastfeeding. It seems that prelacteal feed is not harmful as long as it is given in a

  19. Ventilatory response of the newborn infant to mild hypoxia.

    PubMed

    Cohen, G; Malcolm, G; Henderson-Smart, D

    1997-09-01

    The transition from an immature (biphasic) to a mature (sustained hyperpneic) response to a brief period of sustained hypoxia is believed to be well advanced by postnatal day 10 for newborn infants. However, a review of the supporting evidence convinced us that this issue warranted further, more systematic investigation. Seven healthy term infants aged 2 days to 8 weeks were studied. The ventilatory response (VR) elicited by 5 min breathing of 15% O2 was measured during quiet sleep. Arterial SaO2 (pulse oximeter) and minute ventilation (expressed as a change from control, delta V'i) were measured continuously. Infants were wrapped in their usual bedding and slept in open cots at room temperature (23 degrees-25 degrees). Infants aged 2-3 days exhibited predominantely a sustained hypopnea during the period of hypoxia (delta V'i = -2% at 1 min, -13% at 5 min). At 8 weeks of age, the mean response was typically biphasic (delta V'i = +9% at 1 min, -4% at 5 min). This age-related difference between responses was statistically significant (two-way ANOVA by time and age-group; interaction P < 0.05). These data reveal that term infants studied under ambient conditions during defined quiet sleep may exhibit an immature VR to mild, sustained hypoxia for at least 2 months after birth. This suggests that postnatal development of the O2 chemoreflex is slower than previously thought.

  20. Sedatives for opiate withdrawal in newborn infants.

    PubMed

    Osborn, D A; Jeffery, H E; Cole, M J

    2002-01-01

    duration of supportive care required to be given to infants each day was significantly reduced (MD -162.1 minutes/day, 95% CI -249.2, -75.1). Comparing phenobarbital to diazepam, meta-analysis of two studies found that phenobarbital produced a significant reduction in treatment failure (typical RR 0.39, 95% CI 0.24, 0.62). There was no significant difference in duration of treatment or duration of hospital stay. Comparing phenobarbital with chlorpromazine, one study found no significant difference in treatment failure rate. No data for neurodevelopment were available, reported by treatment group as allocated. No trials were eligible that assessed clonidine for NAS. In newborn infants with NAS, there is no evidence that phenobarbital, compared with supportive care alone, reduces treatment failure; however, phenobarbital may reduce the daily duration of supportive care needed. Phenobarbital, compared to diazepam, reduces treatment failure. There is insufficient evidence to support the use of chlorpromazine or clonidine in newborn infants with NAS. Clonidine and chlorpromazine should only be used in the context of a randomised clinical trial. The results of this review, taken in conjunction with the related review, Opiate treatment for opiate withdrawal in newborn infants (Osborn 2002), indicate that treatment with opiates is the preferred initial therapy for NAS. It is hypothesised that this is particularly true for infants whose mothers have used only opiates during pregnancy. If a sedative is used, phenobarbital is preferred to diazepam. The results of an ongoing trial of the addition of phenobarbital to an opiate are awaited.

  1. Evaluation of pain in healthy newborns and in newborns with developmental problems (Down syndrome).

    PubMed

    Aguilar Cordero, Maria José; Mur Villar, Norma; García García, Inmaculada

    2015-06-01

    Newborns are often subjected to invasive and painful medical procedures. This happens even more frequently when they require hospitalization. The aim of this paper was to evaluate pain in healthy newborns and in newborns with Down syndrome (DS). We performed a prospective cohort study in the neonatal service of the San Cecilio University Hospital in Granada (Spain) from January 2008 to September 2013. The universe of our study comprised a study group of 20 newborns with DS and a control group of 20 newborns without DS. All of the infants were hospitalized, and thus had to undergo painful medical procedures. The variables studied were basal recovery time (as reflected in crying and the normalization of biological constants), number of punctures, oxygen saturation, heartbeat, blood pressure, response to skin-to-skin contact, and gestational age. The evaluation was performed during blood extraction, vein canalization, and heel puncture. The significant differences in the basal recovery time between the two groups of newborns indicated that those with DS were slower to express pain, and when they did, their response was not as clearly defined as that of babies without DS. The oxygen saturation in babies with DS after the puncture was found to be significantly lower than that of the control group (p < .001). The results of this study revealed that babies with DS were not as quick to perceive pain after a puncture. However, when pain was finally perceived, it persisted for a longer time. This situation should be taken into account in the design of pharmacologic and nonpharmacologic therapies.

  2. [THE COMPARATIVE CHARACTERISTIC OF KAOLIN-ACTIVATED THROMBOELASTOGRAPHY IN HEALTHY NEWBORNS AND NEWBORNS WITH HEART AILMENTS].

    PubMed

    Leonov, N P; Karas'kov, A M; Litasova, E E; Strunin, O V; Karmadonova, N A; Akopov, G D; Vishegorodtseva, L I

    2016-02-01

    The study was carried out to diferentiate reference values for kaolin-activated thromboelastography in newborns with congenital heart disease. The study included two groups ofpatients. The first one consisted of 62 newborns with congenital heart disease and the second one consisted of 35 healthy newborns. The results of kaolin-activated thromboelastography implemented in groups are evaluated as condition of normal coagulation. The valuable diferences of homeostasis system in healthy newborns and newborns with congenital heart disease (without severe concomitant pathology) are not established. They have similar indicators of kaolin-activated thromboelastography. The derived results can be applied as standards in full-term newborns with congenital heart disease.

  3. Power reflectance testing in newborns and infants.

    PubMed

    Lima, Ticianna Garambone de Cerqueira; Becker, Helena Maria Gonçalves; Becker, Celso Gonçalves; Ferreira, Daniele Barreto da Cunha; Resende, Camilo Brandão de; Guimarães, Roberto Eustáquio Santos

    2015-01-01

    Auditory screening in newborns allows for detection of hearing problems early in life. However, middle ear diseases can make the diagnosis more difficult. To evaluate the power reflectance test as an indicator of the middle ear disease and to compare it to tympanometry. Case study evaluating 105 newborns and infants who participated in the audiology screening in 2013. The following exams were performed: transient otoacoustic emissions, power reflectance, and tympanometry. In the optoacoustic emission evaluation, approximately 95% of the subjects passed the test. The specificity of power reflectance in all frequencies studied ranged from 75.3% to 95.9%, and that of tympanometry at 1000Hz ranged from 83% to 87.2%; there was agreement among these exams. The outcome of power reflectance tests at 2000Hz and 3000Hz showed a correlation with tympanometry and otoacoustic emissions, and these were the most appropriate frequencies to determine middle ear disease through power reflectance measurement. It was also observed that values of power reflectance above reference levels suggested the presence of fluid in the middle ear, and thus a conductive hearing loss. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Red blood cell transfusion in newborn infants

    PubMed Central

    Whyte, Robin K; Jefferies, Ann L

    2014-01-01

    Red blood cell transfusion is an important and frequent component of neonatal intensive care. The present position statement addresses the methods and indications for red blood cell transfusion of the newborn, based on a review of the current literature. The most frequent indications for blood transfusion in the newborn are the acute treatment of perinatal hemorrhagic shock and the recurrent correction of anemia of prematurity. Perinatal hemorrhagic shock requires immediate treatment with large quantities of red blood cells; the effects of massive transfusion on other blood components must be considered. Some guidelines are now available from clinical trials investigating transfusion in anemia of prematurity; however, considerable uncertainty remains. There is weak evidence that cognitive impairment may be more severe at follow-up in extremely low birth weight infants transfused at lower hemoglobin thresholds; therefore, these thresholds should be maintained by transfusion therapy. Although the risks of transfusion have declined considerably in recent years, they can be minimized further by carefully restricting neonatal blood sampling. PMID:24855419

  5. Tear Film Volume and Protein Analysis in Full-term Newborn Infants

    PubMed Central

    Esmaeelpour, M.; Watts, P. O.; Boulton, M. E.; Cai, J.; Murphy, P. J.

    2013-01-01

    Purpose To investigate infant tear film secretion and protein profile, and to compare major tear proteins, such as immunoglobulin A, lactoferrin, and lysozyme, with those of adult controls. Methods Tears were collected, with a cellulose rod, from 40 healthy infants (19 female infants and 21 male infants, gestational duration: 39.71 ± 1.27 weeks) within 48 hours of birth and 22 adults (10 female infants and 12 male infants, mean age: 24.95 ± 3.63 years). A second collection was obtained from 14 of the infants (8 female infants and 6 male infants, postnatal age: 7.76 ± 6.14 weeks). The tear volume was measured, and protein in the samples was analyzed by Bradford assay and gel electrophoresis. Results Median tear volume (interquartile range) was 0.5μL (0.6– 2 μL) for newborn infants, 2.5μL (1.4–7.75 μL) for these infants at an older age, and 6μL (2.73–12.75 μL) in adults (P < 0.001, Kruskall–Wallis test). Immunoglobulin A concentration was significantly lower in newborns (P < 0.001, analysis of variance). Lipocalin was present in 36% of the newborn tear samples, whereas serum albumin was found in 86%. Mean protein concentration (μg/μL 6 SD) was 10.95 ± 5.51 in the newborns, 12.93 ± 3.99 in the older infants, and 13.04 ± 3.46 in the adults (P > 0.5, analysis of variance). Conclusions This is the first study reporting an investigation of unstimulated infant tears, using a noninvasive collection method. Tear protein content demonstrated that the infant tear film is different to that in adults. PMID:21045650

  6. Introduction to resuscitation of the newborn infant. ARC and NZRC Guideline 2010.

    PubMed

    2011-08-01

    • Introduction to Resuscitation of the Newborn Infant. ARC and NZRC Guideline 2010 • Planning for Neonatal Resuscitation and Identification of the Newborn Infant at Risk. ARC and NZRC Guideline 2010 • Assessment of the Newborn Infant. ARC and NZRC Guideline 2010 • Airway Management and Mask Ventilation of the Newborn Infant. ARC and NZRC Guideline 2010 • Tracheal Intubation and Ventilation of the Newborn Infant. ARC and NZRC Guideline 2010 • Chest Compressions during Resuscitation of the Newborn Infant. ARC and NZRC Guideline 2010 • Medication or Fluids for the Resuscitation of the Newborn Infant. ARC and NZRC Guideline 2010 • The Resuscitation of the Newborn Infant in Special Circumstances. ARC and NZRC Guideline 2010 • After the Resuscitation of a Newborn Infant. ARC and NZRC Guideline 2010 • Ethical Issues in Resuscitation of the Newborn Infant. ARC and NZRC Guideline 2010.

  7. Can Conditioned Responses be Established in the Newborn Infant: 1971?

    ERIC Educational Resources Information Center

    Sameroff, Arnold J.

    1971-01-01

    Evidence indicates that the newborn infant must first develop cognitive systems, through his experience with various stimuli, to differentiate each modality separately before he can integrate any two modalities in classical conditioning. (Author/NH)

  8. Can Conditioned Responses be Established in the Newborn Infant: 1971?

    ERIC Educational Resources Information Center

    Sameroff, Arnold J.

    1971-01-01

    Evidence indicates that the newborn infant must first develop cognitive systems, through his experience with various stimuli, to differentiate each modality separately before he can integrate any two modalities in classical conditioning. (Author/NH)

  9. [The intermamillary index of newborn infants].

    PubMed

    Pelz, L; Richter, C

    1989-03-01

    Using 500 healthy newly born babies age specific standard for intermamillary index was defined in order to improve objective criteria for the clinical features of 'widely spaced nipples' as it is to realize in connection with a variety of complex morphogenetic disturbances. Independent of sex and of post natalage the mean value is y mean = 23.31 and the standard deviation s = +/- 1.24. Consequently, the normal +/- 2s range is to be appraised between 21.0 and 26.0. In small-for-gestational-age infants and in babies born by breech presentation the + 2s limit is reduced to 25.0.

  10. Detecting the temporal structure of sound sequences in newborn infants.

    PubMed

    Háden, Gábor P; Honing, Henkjan; Török, Miklós; Winkler, István

    2015-04-01

    Most high-level auditory functions require one to detect the onset and offset of sound sequences as well as registering the rate at which sounds are presented within the sound trains. By recording event-related brain potentials to onsets and offsets of tone trains as well as to changes in the presentation rate, we tested whether these fundamental auditory capabilities are functional at birth. Each of these events elicited significant event-related potential components in sleeping healthy neonates. The data thus demonstrate that the newborn brain is sensitive to these acoustic features suggesting that infants are geared towards the temporal aspects of segregating sound sources, speech and music perception already at birth. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Free voiding patterns in preterm and full-term newborn infants are different between males and females.

    PubMed

    Wen, Jian Guo; Ren, Chuan Chuan; Chen, Yan; Lu, Yu Tao; Yang, Li; Cui, Lin Gang; Wen, Lu; Jia, Liang Hua; Li, Yun Long; Zhang, Qian

    2014-10-01

    The neonatal period is critical in bladder development, encompassing the transition from foetal bladder contractions to voluntary infant urination. The aim of this study was to investigate different voiding parameters between male and female newborn infants. We studied 102 healthy, single birth newborn infants - 54 preterm and 48 full-term - without lower urinary tract diseases, hospitalised in the neonatal intensive care unit from March 2011 to March 2012. Free voiding was observed from 9 a.m. to 9 p.m., and the free voiding parameters and fluid intake were recorded and compared between male and female newborn infants using the Student's t-test and chi-square test. Male preterm newborns demonstrated larger mean postvoid residual volumes and lower bladder emptying rates than female preterm newborns (p < 0.05), and male full-term newborns had lower bladder emptying rates than female full-term newborns (p < 0.05). The bladder emptying rates of newborns defecating simultaneously with voiding were not statistically different between males and females of the same gestational age (p > 0.05). Male newborns were more likely to have larger postvoid residual volumes than females, and defecating simultaneously with voiding may promote bladder emptying in male newborns. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Challenges of newborn severe combined immunodeficiency screening among premature infants.

    PubMed

    Ward, Claire E; Baptist, Alan P

    2013-04-01

    Newborn screening for severe combined immunodeficiency (SCID) is currently being performed in many states. It is important to address diagnostic challenges while outcomes are emerging from the first several years of screening. We present the case of a premature infant whose initial newborn screen was strongly positive for SCID. Subsequent lymphocyte subset analysis by flow cytometry was difficult to interpret due to the lack of age-matched reference values, a history of prenatal corticosteroid administration, and the possibility of maternal or posttransfusion engraftment. A repeat newborn screen for SCID ultimately revealed a normal result, confirming the initial newborn screen as a false positive. This case report reveals several of the diagnostic challenges unique to newborn SCID screening in premature infants and highlights the potential for states to address the feasibility of a standard protocol in this population.

  13. Neurobehavioral Syndromes in Cocaine-Exposed Newborn Infants.

    ERIC Educational Resources Information Center

    Lester, Barry M.; And Others

    1991-01-01

    The effects of fetal cocaine exposure on newborn cry characteristics were studied in 80 cocaine-exposed and 80 control infants. Findings were consistent with the notion that two neurobehavioral syndromes, excitable and depressed, can be described in cocaine-exposed infants and that these two syndromes are a result of direct neurotoxic effects and…

  14. Fathers' Affectionate Stimulation and Caregiving Behaviors with Newborn Infants.

    ERIC Educational Resources Information Center

    Sawin, Douglas B.; Parke, Ross D.

    1979-01-01

    Overall findings from this series of studies indicate that fathers are as competent as mothers in providing affection, stimulation, and the necessary care for newborn infants. During feeding in the neonatal period, fathers have been found to be just as active participants in dyadic interactions with their infants as are mothers. (Author)

  15. Fathers' Affectionate Stimulation and Caregiving Behaviors with Newborn Infants.

    ERIC Educational Resources Information Center

    Sawin, Douglas B.; Parke, Ross D.

    1979-01-01

    Overall findings from this series of studies indicate that fathers are as competent as mothers in providing affection, stimulation, and the necessary care for newborn infants. During feeding in the neonatal period, fathers have been found to be just as active participants in dyadic interactions with their infants as are mothers. (Author)

  16. Rudiments of Infant Temperament: Newborn to 9 Months.

    ERIC Educational Resources Information Center

    Matheny, Adam P. Jr.; And Others

    1985-01-01

    Assessed temperament of newborn twins using comprehensive neonatal exam that focused on irritability, resistance to soothing activity, and reinforcement value. Some infants were later assessed at 9 months. Emotional activity appeared to be core dimension stretching over ages and is discussed in relation to formulations of infant temperament.…

  17. Towards evidence-based resuscitation of the newborn infant.

    PubMed

    Manley, Brett J; Owen, Louise S; Hooper, Stuart B; Jacobs, Susan E; Cheong, Jeanie L Y; Doyle, Lex W; Davis, Peter G

    2017-04-22

    Effective resuscitation of the newborn infant has the potential to save many lives around the world and reduce disabilities in children who survive peripartum asphyxia. In this Series paper, we highlight some of the important advances in the understanding of how best to resuscitate newborn infants, which includes monitoring techniques to guide resuscitative efforts, increasing awareness of the adverse effects of hyperoxia, delayed umbilical cord clamping, the avoidance of routine endotracheal intubation for extremely preterm infants, and therapeutic hypothermia for hypoxic-ischaemic encephalopathy. Despite the challenges of performing high-quality clinical research in the delivery room, researchers continue to refine and advance our knowledge of effective resuscitation of newborn infants through scientific experiments and clinical trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. The half-life and exposure of cefuroxime varied in newborn infants after a Caesarean section.

    PubMed

    Zachariassen, G; Hyldig, N; Joergensen, J S; Nielsen, D S; Greisen, G

    2016-09-01

    No information was available on how fast intravenous cefuroxime administered to pregnant women before a Caesarean section was cleared in newborn infants. This study investigated the drug's half-life and the exposure of healthy newborn infants after their mothers received the drug. Healthy mothers received a single dose of cefuroxime 15-60 minutes before skin incision. One blood sample was drawn from the umbilical cord, and two blood samples were drawn from the infant after delivery. Total plasma cefuroxime (μg/mL) was measured using high-pressure liquid chromatography. Cefuroxime was given to 22 mothers, including two who had twins. The concentration of cefuroxime varied significantly among infants (p < 0.001), while the rate of decline did not (p = 0.24). The median cefuroxime half-life was 3.5 hours (range 2.9-5.5), which was approximately three times longer than in normal adults and seemed to clear within 24 hours. The median area under the concentration-time curve was 65.0 hour μg/mL (range 31.7-162.4). We found that the cefuroxime half-life after a Caesarean section varied among infants and was longer than in normal adults but cleared within 24 hours. Exposure to cefuroxime in newborn infants may influence the gut microbiota and should be investigated further. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Health Literacy Among Parents of Newborn Infants

    PubMed Central

    Mackley, Amy; Winter, Michael; Guillen, Ursula; Paul, David A.; Locke, Robert

    2016-01-01

    BACKGROUND Health Literacy is the ability to obtain, process, and understand health information to make knowledgeable health decisions. PURPOSE To determine baseline health literacy of NICU parents at a tertiary care hospital during periods of crucial information exchange. METHODS Health Literacy of English speaking NICU parents was assessed using the Newest vital Sign (NVS) on admission (n=121) and discharge (n=59). A quasi-control group of well newborn (WBN) parents (n=24) and prenatal obstetric clinic (PRE) parents (n=18) were included. A single, Likert-style question measured nurse’s assessment of parental comprehension with discharge teaching. Suspected limited health literacy (SLHL) was defined as NVS score of ≤3. FINDINGS / RESULTS Forty-three percent of parents on NICU admission and 32% at NICU discharge had SLHL (p<0.01). SLHL for WBN parents and PRE were 25% and 58% respectively. Parental age, gender, location, and history of healthcare related employment were not associated with health literacy status at any time point. Thirty-nine percent of NICU parents and 25% of WBN parents with SLHL at time of admission/infant birth had a college education. Nurse subjective measurement of parental comprehension of discharge instructions was not correlated to the objective measurement of health literacy (p=0.26). IMPLICATIONS FOR PRACTICE SLHL is common during peak time periods of complex health discussion in the NICU, WBN, and PRE settings. NICU providers may not accurately gauge parent’s literacy status. IMPLICATIONS FOR RESEARCH Methods for improving health communication are needed. Studies should evaluate SLHL in a larger NICU population and across different languages and cultures. PMID:27391562

  20. Interrelationships between maternal carotenoid status and newborn infant macular pigment optical density and carotenoid status.

    PubMed

    Henriksen, Bradley S; Chan, Gary; Hoffman, Robert O; Sharifzadeh, Mohsen; Ermakov, Igor V; Gellermann, Werner; Bernstein, Paul S

    2013-08-15

    Deposition of the macular pigment carotenoids lutein and zeaxanthin in the human retina occurs early in life. In this study, we examined the interrelationships of maternal carotenoid status and newborn infant macular pigment levels and systemic carotenoid status. As a secondary measure, we also evaluated the effects of intrauterine growth restriction (IUGR) on carotenoid status in term newborn infants. We measured mother and infant skin carotenoids using resonance Raman spectroscopy (RRS), serum carotenoids by HPLC, and mother breast milk carotenoids by HPLC. We measured infant macular pigment levels using noninvasive blue light reflectometry. We enrolled 30 healthy term infants, their mothers, and 10 IUGR infants and their mothers. A subset of 16 infants was imaged for macular pigment optical density (MPOD). Infant serum zeaxanthin levels correlated with MPOD (r = 0.68, P = 0.007). Mother serum zeaxanthin levels correlated with infant MPOD (r = 0.59, P = 0.032). Infant and mother serum lutein did not correlate with MPOD. Mother-infant correlations were found for total serum carotenoids (r = 0.42, P = 0.020) and skin carotenoids (r = 0.48, P = 0.001). No difference was seen between IUGR infants and controls in total serum or skin carotenoids. Mothers of IUGR infants had lower total serum carotenoids (P = 0.019) and breast milk carotenoids than controls (P = 0.006). Our findings suggest that maternal zeaxanthin status may play a more important role than lutein status in macular pigment deposition in utero. Controlled trials are needed to determine whether maternal zeaxanthin prenatal supplementation can raise infant macular pigment levels and/or improve ocular function.

  1. Interrelationships Between Maternal Carotenoid Status and Newborn Infant Macular Pigment Optical Density and Carotenoid Status

    PubMed Central

    Henriksen, Bradley S.; Chan, Gary; Hoffman, Robert O.; Sharifzadeh, Mohsen; Ermakov, Igor V.; Gellermann, Werner; Bernstein, Paul S.

    2013-01-01

    Purpose. Deposition of the macular pigment carotenoids lutein and zeaxanthin in the human retina occurs early in life. In this study, we examined the interrelationships of maternal carotenoid status and newborn infant macular pigment levels and systemic carotenoid status. As a secondary measure, we also evaluated the effects of intrauterine growth restriction (IUGR) on carotenoid status in term newborn infants. Methods. We measured mother and infant skin carotenoids using resonance Raman spectroscopy (RRS), serum carotenoids by HPLC, and mother breast milk carotenoids by HPLC. We measured infant macular pigment levels using noninvasive blue light reflectometry. Results. We enrolled 30 healthy term infants, their mothers, and 10 IUGR infants and their mothers. A subset of 16 infants was imaged for macular pigment optical density (MPOD). Infant serum zeaxanthin levels correlated with MPOD (r = 0.68, P = 0.007). Mother serum zeaxanthin levels correlated with infant MPOD (r = 0.59, P = 0.032). Infant and mother serum lutein did not correlate with MPOD. Mother–infant correlations were found for total serum carotenoids (r = 0.42, P = 0.020) and skin carotenoids (r = 0.48, P = 0.001). No difference was seen between IUGR infants and controls in total serum or skin carotenoids. Mothers of IUGR infants had lower total serum carotenoids (P = 0.019) and breast milk carotenoids than controls (P = 0.006). Conclusions. Our findings suggest that maternal zeaxanthin status may play a more important role than lutein status in macular pigment deposition in utero. Controlled trials are needed to determine whether maternal zeaxanthin prenatal supplementation can raise infant macular pigment levels and/or improve ocular function. PMID:23838770

  2. Performance of a non-contact infrared thermometer in healthy newborns.

    PubMed

    Sollai, Sara; Dani, Carlo; Berti, Elettra; Fancelli, Claudia; Galli, Luisa; de Martino, Maurizio; Chiappini, Elena

    2016-03-16

    To evaluate the performance of a non-contact infrared thermometer (NCIT) in comparison with digital axillary thermometer (DAT) and infrared tympanic thermometers (ITT) in a population of healthy at term and preterm newborns nursed in incubators. 1 level III maternity hospital, and its intensive neonatal care unit. 119 healthy at term newborns and 70 preterm newborns nursed in incubators were consecutively enrolled. Exclusion criteria were unstable/critical conditions, polymalformative congenital syndromes and severe congenital syndromes. Body temperature readings were prospectively collected. Each participant underwent bilateral axillary temperature measurement with DAT, bilateral tympanic measurement with ITT and mid-forehead temperature measurements using NCIT. Degree of agreement between methods was evaluated by the Bland and Altman method. 714 measurements in 119 healthy at term newborns and 420 measurements in 70 preterm newborns nursed in incubators were performed. Clinical reproducibility of NCIT was 0.0455 °C for infants in incubators and 0.0861 °C for infants outside an incubator. Bias was 0.029 °C for infants in incubators and <0.0001 °C for infants outside an incubator. Zero outliers were recorded. The mean difference between methods was good both for newborns at term (0.12 °C for NCIT vs DAT and 0.02 °C for NCIT vs ITT) and preterm newborns in incubators (0.10 °C for NCIT vs DAT and 0.14 °C for NCIT vs ITT). Limits of agreement were 0.99 to -0.75 and 0.78 to -0.75 in at term newborns and were particularly satisfactory in preterm newborns in incubators (95% CI: 0.48 to -0.27 and 0.68 to -0.40). Our results with Bland and Altman analysis demonstrate that NCIT is a very promising tool, especially in preterm newborns nursed in incubators. The study was approved by the Careggi University Hospital Ethics Committee (07/2011). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  3. Performance of a non-contact infrared thermometer in healthy newborns

    PubMed Central

    Dani, Carlo; Berti, Elettra; Fancelli, Claudia; Galli, Luisa; de Martino, Maurizio; Chiappini, Elena

    2016-01-01

    Objective To evaluate the performance of a non-contact infrared thermometer (NCIT) in comparison with digital axillary thermometer (DAT) and infrared tympanic thermometers (ITT) in a population of healthy at term and preterm newborns nursed in incubators. Setting 1 level III maternity hospital, and its intensive neonatal care unit. Participants 119 healthy at term newborns and 70 preterm newborns nursed in incubators were consecutively enrolled. Exclusion criteria were unstable/critical conditions, polymalformative congenital syndromes and severe congenital syndromes. Interventions Body temperature readings were prospectively collected. Each participant underwent bilateral axillary temperature measurement with DAT, bilateral tympanic measurement with ITT and mid-forehead temperature measurements using NCIT. Primary outcome measures Degree of agreement between methods was evaluated by the Bland and Altman method. Results 714 measurements in 119 healthy at term newborns and 420 measurements in 70 preterm newborns nursed in incubators were performed. Clinical reproducibility of NCIT was 0.0455°C for infants in incubators and 0.0861°C for infants outside an incubator. Bias was 0.029°C for infants in incubators and <0.0001°C for infants outside an incubator. Zero outliers were recorded. The mean difference between methods was good both for newborns at term (0.12°C for NCIT vs DAT and 0.02°C for NCIT vs ITT) and preterm newborns in incubators (0.10°C for NCIT vs DAT and 0.14°C for NCIT vs ITT). Limits of agreement were 0.99 to −0.75 and 0.78 to −0.75 in at term newborns and were particularly satisfactory in preterm newborns in incubators (95% CI: 0.48 to −0.27 and 0.68 to −0.40). Conclusions Our results with Bland and Altman analysis demonstrate that NCIT is a very promising tool, especially in preterm newborns nursed in incubators. Trial registration: The study was approved by the Careggi University Hospital Ethics Committee (07/2011). PMID:26983944

  4. Blood ferritin concentrations in newborn infants and the sudden infant death syndrome.

    PubMed Central

    Raha-Chowdhury, R; Moore, C A; Bradley, D; Henley, R; Worwood, M

    1996-01-01

    Liver iron concentrations have been shown to be higher in victims of SIDS than in postmortem controls suggesting that high levels of tissue iron may be implicated in SIDS. To determine whether infants who subsequently die from SIDS are born with greater iron stores than those who do not, the iron stores in newborn infants were assessed retrospectively by measuring blood ferritin concentration in spots from Guthrie cards (collected from almost all infants born in the UK in the first week of life). A method for extracting and measuring ferritin from stored blood spots is described. Eighteen cases of SIDS were identified in South Glamorgan along with four controls for each case. Ferritin concentrations did not differ in SIDS victims and controls suggesting that victims of SIDS are not born with abnormal concentrations of stored iron. If iron stores are found to be higher in SIDS victims than in healthy live infants of the same age then it is more likely that the iron will have been acquired after birth. PMID:8655686

  5. [Increased incidence of developmental hip dysplasia in hypertrophic newborn infants].

    PubMed

    Peschgens, T; Skopnik, H; Casser, H R; Rauschning-Sikora, K; Heimann, G

    1993-01-01

    "Lack of space" in utero is considered to be a major factor in the aetiology of the congenital dislocation of the hip. This study tries to answer the question whether hypertrophy of a newborn has to be regarded as a risk factor on the basis of the principle mentioned above. The results of postnatal clinical and sonographical examination performed on 98 large-for-gestational-age (LGA-) newborn were compared to those performed on 310 newborn children during a non selective screening program. Among the LGA-newborn pathological hip joints were found more often mainly female LGA-newborn infants were affected. It seemed that the birth weight did not correlate to the extent of the retardation of the hip joint development. It was again confirmed that the restriction to only clinical diagnostic procedures in the neonatal period is not effective in the early diagnosis of the malformation. Hypertrophy of a newborn has to be considered as a risk factor behind the development of congenital dislocation of the hip. It is recommended to examine all LGA-newborn infants post partum by clinical and most importantly also by sonographical means to recognize a retardation of hip joint development.

  6. Skin hamartoma on the hand of a newborn infant.

    PubMed

    Kaga, Akimune; Itabashi, Chieko; Kanda, Susumu; Suzuki, Yutaka; Tanabu, Muneyuki; Kure, Shigeo

    2013-06-01

    Skin hamartoma is an extremely rare disease on the hand in newborn infants. Reported herein is the case of a newborn infant who presented with a skin hamartoma on the hand. The patient was a girl born at 37 weeks of gestational age. The mass was seen on her proximal left thumb at birth. The mass had a spherical diameter of 4 cm and was pedunculated. One the day after birth, the stalk on the mass was ligated in the neonatal intensive care unit. The mass was diagnosed as skin hamartoma on histopathology. At 1 year of age, the child had good hand function, and no recurrence of the neoplasia was evident.

  7. [Advantage of delayed umbilical cord clamping in the newborn infant].

    PubMed

    Menget, A; Mougey, C; Thiriez, G; Riethmuller, D

    2013-09-01

    The timing of umbilical cord clamping remains controversial. Although most maternity wards use the early clamping (5-15s), randomized studies and meta-analyses have demonstrated the benefit of delayed clamping for term and preterm newborn infants over the past 10 years. Indeed, placentofetal transfusion of 20-30 ml/kg in 2-3 min improves the iron status of term infants and prevents infant hypochromic anemia. Infant anemia is a public health problem in many developing countries. For preterm newborns, placental transfusion for 45 s or milking the cord for 15 s improves cardiovascular adaptation, with better hemodynamic stability, as well as decreased intraventricular hemorrhages, need for transfusion, and late-onset sepsis. A new look at this symbolic act is needed and professionals need to be persuaded of the importance of the "wait a minute" policy for a better physiological delivery.

  8. Weight loss and low age are associated with intensity of rooting behaviours in newborn infants.

    PubMed

    Takahashi, Yuki; Jonas, Wibke; Ransjö-Arvidson, Anna-Berit; Lidfors, Lena; Uvnäs Moberg, Kerstin; Nissen, Eva

    2015-10-01

    Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants' prebreastfeeding behaviour during the second day of life and explores possible associations with infant characteristics. We studied 13 mothers and healthy full-term infants after normal births. At 24-48 hours of life, the newborns were placed in skin-to-skin contact with their mothers for breastfeeding and were video-filmed. The order, frequency and duration of predefined infant prefeeding behaviours and suckling were coded and analysed using computer-based video software. Prefeeding behaviours occurred in the following order: rooting, hand to mouth movements, licking of the nipple and hand to breast to mouth movements. The infants started to suckle at a median of one to two minutes. Rooting was the most common behaviour, observed in 12 infants. The duration of rooting movements during the last minute before breastfeeding was inversely related to neonatal age (p ≤ 0.001) and positively related to neonatal weight loss (p = 0.02) after birth. Infants exhibited a distinct sequence of prefeeding behaviours during the second day of life, and our findings suggest that rooting movements were governed by mechanisms involved in the regulation of food intake and weight gain. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Standards for skinfold thickness in British newborn infants.

    PubMed Central

    Oakley, J R; Parsons, R J; Whitelaw, A G

    1977-01-01

    Standards of triceps and subscapular skinfold thicknesses for 1293 Caucasian newborn infants of gestational ages 37-42 weeks, and of 0-25 kg birthweight intervals between 2-25 and 4-5 kg are presented. Female infants had a greater skinfold thickness than males, and the subscapular skinfold was greater than the triceps. The skinfold thickness in both males and females declined after 40 weeks of gestation. PMID:860873

  10. Baby massage ameliorates neonatal jaundice in full-term newborn infants.

    PubMed

    Chen, Jun; Sadakata, Mieko; Ishida, Mayumi; Sekizuka, Naoto; Sayama, Mitsuko

    2011-01-01

    Neonatal jaundice is a common physiological problem affecting over half of all full term and most preterm infants. Thus, newborn infants must be monitored for signs of hyperbilirubinemia to prevent acute bilirubin encephalopathy or kernicterus. Evidence exists supporting the benefits of baby massage as a form of mild hand to skin contact, to increase neonatal physical and mental development. In the present study, the effects of gentle baby massage on neonatal jaundice in full term newborn infants were evaluated by a controlled clinical trial. The inclusion criteria of newborn neonates were as follows: (1) gestational age of 37-41 weeks, (2) birth weight of 2,800-3,600 g, (3) Apgar score at birth of 8-10, and (4) being a healthy neonate without neonatal asphyxia and hemolytic condition. Breastfed newborns without phototherapy were included: 20 in the massage group and 22 in the control group. We found the mean stool frequency of the massaged infants on day 1 and day 2 (4.6 and 4.3) was significantly higher than that of the control group (3.3 and 2.6) (p<0.05). The transcutaneous bilirubin levels on the second to fifth day and serum total bilirubin levels on fourth day were significantly decreased in the massage group, compared to the control group. In conclusion, baby massage at an early stage after birth could reduce neonatal bilirubin levels. We suggest baby massage is beneficial for ameliorating neonatal jaundice.

  11. Newborn infant pain assessment using heart rate variability analysis.

    PubMed

    Faye, Papa M; De Jonckheere, Julien; Logier, Regis; Kuissi, Eliane; Jeanne, Mathieu; Rakza, Thameur; Storme, Laurent

    2010-01-01

    Systems controlling cardiovascular function are closely coupled with the perception of pain. Heart rate variability (HRV) is a well-established noninvasive measure of cardiac autonomic control. We hypothesized that pain may alter HRV in the newborn infant and that HRV analysis could be used as an indicator of prolonged pain in the newborn infant. To test the hypothesis, we measured the magnitude of the heart rate high-frequency variations using an innovative High Frequency Variability Index (HFVI) in newborn infants at risk of postoperative pain. We investigated newborn infants with a gestational age (GA) more than 34 weeks, and who were admitted after a major surgical procedure. Inclusions ranged from 2 to 72 hours after the surgery. The postoperative pain was scored using EDIN scale (neonatal pain and discomfort scale) at the end of the 2 hours recording period. The infants were separated in: (1) Group "Low EDIN," when EDIN<5; and (2) Group "High EDIN," when EDIN >=5. Predictive positive and negative values of a threshold value of HFVI in assessing pain have been studied. Twenty-eight newborn infants were enrolled in the study (mean GA=37.8+/-1.5 wk) at a median delay between the surgery and the recording of 5 hours. Mean EDIN were 2+/-1 and 7+/-2 in respectively the groups "Low EDIN" and "High EDIN." The 2 groups were similar for GA, basal heart and respiratory rates, SpO2, mean arterial blood pressure, and morphine infusion rate. HFVI was significantly lower in the group "High EDIN" than in the group "Low EDIN" (0.7+/-0.2 vs. 1.2+/-0.3, respectively; P<0.01). An HFVI <0.9 was able to predict an EDIN score >=5, with a sensitivity of 90%, and a specificity of 75%. The results of this study indicate that postoperative pain is associated with a decreased high-frequency HRV in full-term newborn infants. Our findings suggest that HRV could be used as an indicator to assess prolonged pain in the newborn infants.

  12. Lung function in infants with cystic fibrosis diagnosed by newborn screening.

    PubMed

    Linnane, Barry M; Hall, Graham L; Nolan, Gary; Brennan, Siobhan; Stick, Stephen M; Sly, Peter D; Robertson, Colin F; Robinson, Philip J; Franklin, Peter J; Turner, Stephen W; Ranganathan, Sarath C

    2008-12-15

    Progressive lung damage in cystic fibrosis (CF) starts in infancy, and early detection may aid preventative strategies. To measure lung function in infants with CF diagnosed by newborn screening and describe its association with pulmonary infection and inflammation. Infants with CF (n = 68, 6 weeks to 30 months of age) and healthy infants without CF (n = 49) were studied. Forced vital capacity, FEV(0.5), and forced expiratory flows at 75% of exhaled vital capacity (FEF(75)) were measured using the raised-volume rapid thoracoabdominal compression technique. Forty-eight hours later, infants with CF had bronchoalveolar lavage (BAL) for assessment of pulmonary infection and inflammation. In the CF group, the deficit in FEV(0.5) z score increased by -0.77 (95% confidence interval, -1.14 to -0.41; P < 0.001) with each year of age. The mean FEV(0.5) z score did not differ between infants with CF and healthy control subjects less than 6 months of age (-0.06 and 0.02, respectively; P = 0.87). However, the mean FEV(0.5) z score was lower by 1.15 in infants with CF who were older than 6 months of age compared with healthy infants (P < 0.001). FVC and FEF(75) followed a similar pattern. Pulmonary infection and inflammation in BAL samples did not explain the lung function results. Lung function, measured by forced expiration, is normal in infants with CF at the time of diagnosis by newborn screening but is diminished in older infants. These findings suggest that in CF the optimal timing of therapeutic interventions aimed at preserving lung function may be within the first 6 months of life.

  13. Smoking during pregnancy affects speech-processing ability in newborn infants.

    PubMed

    Key, Alexandra P F; Ferguson, Melissa; Molfese, Dennis L; Peach, Kelley; Lehman, Casey; Molfese, Victoria J

    2007-04-01

    Tobacco smoking during pregnancy is known to adversely affect development of the central nervous system in babies of smoking mothers by restricting utero-placental blood flow and the amount of oxygen available to the fetus. Behavioral data associate maternal smoking with lower verbal scores and poorer performance on specific language/auditory tests. In the current study we examined the effects of maternal smoking during pregnancy on newborns' speech processing ability as measured by event-related potentials (ERPs). High-density ERPs were recorded within 48 hr of birth in healthy newborn infants of smoking (n = 8) and nonsmoking (n = 8) mothers. Participating infants were matched on sex, gestational age, birth weight, Apgar scores, mother's education, and family income. Smoking during pregnancy was determined by parental self-report and medical records. ERPs were recorded in response to six consonant-vowel syllables presented in random order with equal probability. Brainwaves of babies of nonsmoking mothers were characterized by typical hemisphere asymmetries, with larger amplitudes over the left hemisphere, especially over temporal regions. Further, infants of nonsmokers discriminated among a greater number of syllables whereas the newborns of smokers began the discrimination process at least 150 msec later and differentiated among fewer stimuli. Our findings indicate that prenatal exposure to tobacco smoke in otherwise healthy babies is linked with significant changes in brain physiology associated with basic perceptual skills that could place the infant at risk for later developmental problems.

  14. Abandonment of newborn infants: a Danish forensic medical survey 1997-2008.

    PubMed

    Gheorghe, Alexandra; Banner, Jytte; Hansen, Steen Holger; Stolborg, Uffe; Lynnerup, Niels

    2011-12-01

    Concealment of pregnancy and newborn infant abandonment are closely associated with neonaticide, the killing of an infant within the first 24 h of life or less than 28-30 days depending on the jurisdiction. Abandonment of newborn infants occurs throughout the world and often the outcome for the infant is death. Together with neonaticide it is felt to be one of the least preventable crimes. In this retrospective study we present all forensically known Danish cases of abandoned newborn infant corpses, covering the period from 1997 to 2008. Eleven newborn infant corpses were found; we registered characteristics of the newborn infants and the circumstances of the cases based on autopsy reports. One further newborn infant was included, dating back to 1992, as it was found to be connected with one of the later cases. The mean age of the women who abandoned their newborn infants was 22 years, and five of the autopsied newborn infants were probably alive when abandoned. In two cases the newborn infants were half siblings and abandoned by the same mother. The time span from abandonment to when the newborn infant was found ranged from hours to 7 years. Two-thirds of the newborn infants were girls (66.6%). The most common means of disposal was in a plastic bag (~60%); only one newborn infant was wearing clothes when found. Causes of death were usually given as asphyxia, brain injury or simply undetermined. Two-thirds of the newborn infants showed signs of violence. None of the newborn infants had congenital malformations.

  15. [Urinary tract infection in the newborn infant].

    PubMed

    Vilanova Juanola, J M; Canos Molinos, J; Rosell Arnold, E; Figueras Aloy, J; Comas Masmitja, L L; Jiménez González, R

    1989-08-01

    Twenty-eight cases of urinary tract infection in newborns with positive urinoculture and suggestive clinical symptomatology are reviewed. The incidence was 0.24%, being most frequent in preterm and postterm newborns. Male neonates was more affected. Failure to thrive, excessive weight loss, poor feeding, diarrhoea, vomiting and jaundice are the most relevant clinical signs. E. coli and Klebsiella are the most frequent organism isolated, followed by Enterobacter and Candida. The presence of metabolic acidosis and leukocituria using a bag technique were the most accurate laboratory data to suspect a urinary tract infection.

  16. Baby, souls, name and health: traditional customs for a newborn infant among the Hmong in Melbourne.

    PubMed

    Rice, P L

    2000-03-01

    In this paper, I discuss childrearing beliefs and practices in Hmong culture. In particular I focus on issues related to souls and ceremonies for a newborn infant in Hmong society. The Hmong believe that each living body has three souls. For a newborn infant, the first soul enters his or her body when he or she is conceived in the mother's womb. The second soul enters when the baby has just emerged from the mother's body and taken its first breath. The third soul, however, will have to be called on the third morning after birth, as will be discussed in this paper. If all three souls are secured in the infant's body, he or she will be healthy and hence thrive well. On the contrary, the infant may become ill and eventually die if all three souls do not reside in his or her body. This, therefore, makes a soul calling ceremony on the third morning after birth essential in Hmong culture. I will show that for Hmong society to survive, the Hmong strongly adhere to their cultural beliefs and practices related to a newborn infant. These beliefs and practices tie the Hmong with not only their family and their society at large, but also the supernatural world.

  17. Management of Newborn Infants with Phenylketonuria.

    ERIC Educational Resources Information Center

    Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

    The booklet covers the identification, diagnosis, and clinical treatment of newborns with Phenylketonuria (PKU), an inborn error of metabolism, which, if untreated, can lead to mental retardation. An initial section considers biochemical and genetic factors of PKU including a diagram of aromatic amino acid hydroxylation systems. Screening…

  18. Management of Newborn Infants with Phenylketonuria.

    ERIC Educational Resources Information Center

    Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

    The booklet covers the identification, diagnosis, and clinical treatment of newborns with Phenylketonuria (PKU), an inborn error of metabolism, which, if untreated, can lead to mental retardation. An initial section considers biochemical and genetic factors of PKU including a diagram of aromatic amino acid hydroxylation systems. Screening…

  19. What do we really know about newborn infant pain?

    PubMed

    Fitzgerald, Maria

    2015-12-01

    What is the topic of this review? Pain in infancy. What advances does it highlight? New neurophysiological research on pain processing in the human infant brain. Increased awareness of pain in the newborn has led to the development of numerous assessment tools for use in neonatal intensive care units. Here, I argue that we still know too little about the neurophysiological basis for infant pain to interpret data from clinical observational measures. With increased understanding of how the neural activity and CNS connections that underlie pain behaviour and perception develop in the newborn will come better measurement and treatment of their pain. This review focuses upon two interconnected nociceptive circuits, the spinal cord dorsal horn and the somatosensory cortex in the brain, to highlight what we know and what we do not know about infant pain. The effectiveness of oral sucrose, widely used in clinical practice to relieve infant pain, is discussed as a specific example of what we do not know. This 'hot topic review' highlights the importance of new laboratory-based neurophysiological research for the treatment of newborn infant pain. © 2015 The Authors. Experimental Physiology © 2015 The Physiological Society.

  20. Managing drug withdrawal in the newborn infant.

    PubMed

    Kuschel, Carl

    2007-04-01

    The management of the infant exposed to drugs in utero poses significant challenges. Symptoms and signs of neonatal abstinence syndrome (NAS) are non-specific but most commonly associated with withdrawal from maternal opioids. A high index of suspicion is required when presented with an infant who could be manifesting symptoms of NAS. In the absence of a reliable history of maternal drug exposure, analysis of neonatal meconium or urine may be indicated. Approximately 90% of infants exposed to opioids will exhibit signs of NAS, although a smaller proportion will require pharmacological treatment. Although few studies have evaluated the advantages of different therapeutic agents and strategies, opioid withdrawal is best treated initially with opioid medication. Supportive care of the infant should include assessment of the adequacy of feeding, evaluation of social circumstances (particularly child protection issues) and surveillance for transmission of viral infection.

  1. Newborn Infants Imitate Adult Facial Gestures.

    ERIC Educational Resources Information Center

    Meltzoff, Andrew N.; Moore, M. Keith

    1983-01-01

    Results indicated that infants only 0.7 to 71 hours old can imitate adults' facial gestures (mouth opening and tongue protrusions). Three possible mechanisms underlying this early imitative behavior are suggested. (Author/MP)

  2. Salt and fluid balance in newborn infants.

    PubMed

    Zetterström, R

    1988-09-01

    About 5 years ago it was widely thought that preterm infants should be supplemented with extra sodium to avoid hyponatremia. It has, however, to be pointed out that VLBW infants during the first postnatal week run a risk of developing hypernatremia which makes it difficult to give general recommendations for sodium supplementation. Since the serum sodium level depends not only upon the balance between sodium intake and sodium excretion but also upon the water balance which may vary depending on the clinical condition of the baby, it seems advisable to monitor the serum sodium level in all preterm infants. Supplementation should be given in case of hyponatremia. In instances of hyponatremia it also has to be considered if the infant due to positive fluid balance has retained fluid in excess of sodium. As a general conclusion the importance of monitoring sodium balance in every preterm infant should be stressed. Disturbances are most likely to occur in VLBW infants and in infants with acute illnesses. The best way of assisting fluid balance is by repeated accurate measurements of the body weight. It should, however, be kept in ming that no reliable methods are available for the measurement of the body weight of a preterm infant who is under intensive care and who cannot be taken out of the incubator. Serum sodium levels may give information of the sodium balance but it has to be stressed that fluid and sodium balances are always interrelated and that it is desirable to have simultaneous estimations of both balances. Excess retention of fluid may be caused primarily by excess retention of sodium or by fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Risk of Wheezing Attacks in Infants With Transient Tachypnea Newborns

    PubMed Central

    Golshantafti, Mohammad; Yavari, Tahereh; Afrand, Mohammadhosain

    2016-01-01

    Background: The most common reason of respiratory distress in the newborn is transient tachypnea of the newborn (TTN). There are some reports saying that TTN is associated with increased frequencies of wheezing attacks. Objectives: The aims of this study were to determine the risk factors associated with TTN and to determine the association between TTN and the development of wheezing syndromes in early life. Materials and Methods: In a historical cohort study, we recorded the characteristics of 70 infants born at the Shohadaye Kargar Hospital in Yazd between March 2005 and March 2009 and who were hospitalized because of TTN in the neonatal intensive-care unit. We called their parents at least four years after the infants were discharged from the hospital and asked about any wheezing attacks. Seventy other infants with no health problems during the newborn period were included in the study as the control group. Results: The rate of wheezing attacks in newborns with TTN was more than patients with no TTN diagnosis (P = 0.014). TTN was found to be an independent risk factor for later wheezing attacks (relative risk [RR] = 2.8). Conclusions: The most obvious finding of this study was that TTN was an independent risk factor for wheezing attacks. So long-term medical care is suggested for these patients who may be at risk, because TTN may not be as transient as has been previously thought. PMID:26848370

  4. Scalp hair characteristics in the newborn infant.

    PubMed

    Furdon, Susan A; Clark, David A

    2003-12-01

    Scalp hair growth and patterning are closely associated with the development of the central nervous system. A number of genetic, metabolic, and neurologic disorders are associated with recognizable scalp hair abnormalities. For this reason, a systematic step-by-step assessment of the hair and scalp should be an integral part of every initial newborn physical assessment. This article reviews the clinically relevant embryology related to fetal scalp hair formation. Normal cycles of hair growth and loss are discussed. A systematic review of typical newborn scalp hair characteristics such as color, quantity, texture, direction of growth, hairlines, and hair whorls is provided. Conditions associated with abnormal hair color, quality, quantity, and distribution are presented in a series of clinical photographs, and their salient features are discussed. Abnormal hair often occurs as a constellation of findings; implications for clinical care and further investigation will be briefly described.

  5. Positive parental attitudes to participating in research involving newborn screened infants with CF.

    PubMed

    Chudleigh, Jane; Hoo, Ah-Fong; Ahmed, Deeba; Prasad, Ammani; Sheehan, Denise; Francis, Jackie; Buckingham, Sarah; Cowlard, Jacqui; Thia, Lena; Nguyen, The Thanh Diem; Stocks, Janet

    2013-05-01

    Information regarding recruitment of infants to research studies following the diagnosis of cystic fibrosis (CF) via newborn screening (NBS) is not currently available. This study aimed to assess parental attitudes and the feasibility of recruiting and retaining both NBS infants with CF and healthy control infants to a longitudinal, observational study. All infants underwent pulmonary function tests (PFTs) at ~3 and ~12months of age. Infants with CF had additional combined chest high resolution computed tomography (HRCT), bronchoscopy and broncho-alveolar lavage (BAL) at ~12months of age. Parental attitude questionnaires (PAQs) were administered to all parents following the ~3month PFTs and to parents of infants with CF after completion of all tests at ~12months. 86% (92/107) of families whose infant had CF consented to participate, of whom 92% had PFTs at ~3months of age with 99% of these having PFTs at ~12months of age. Recruitment of healthy controls was feasible but more challenging; 29% of those contacted agreed to participate; 73% of these had PFTs at ~3months of age; of whom 83% had repeated PFTs at ~12months of age. Completed PAQs were received from 71% of parents, (both of CF and healthy infants) at ~3months and from 58% parents of infants with CF at ~12months. Responses from the PAQs were generally positive, 95% of parents indicated they would recommend participation in such studies to other families. Discrepancies between responses at 3 and 12months suggested that parental understanding of what the research entailed developed during the course of the study. The high recruitment and retention rates for newly diagnosed CF NBS infants to this observational study are encouraging. These findings will help inform future study design both in the field of CF and other conditions diagnosed by NBS. Copyright © 2012 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  6. Findings of perinatal ocular examination performed on 3573, healthy full-term newborns.

    PubMed

    Li, Li-Hong; Li, Na; Zhao, Jun-Yang; Fei, Ping; Zhang, Guo-ming; Mao, Jian-bo; Rychwalski, Paul J

    2013-05-01

    To document the findings of a newborn eye examination programme for detecting ocular pathology in the healthy full-term newborn. This is a cross-sectional study of the majority of newborns born in the Kunming Maternal and Child Healthcare Hospital, China, between May 2010 and June 2011. Infants underwent ocular examination within 42 days after birth using a flashlight, retinoscope, hand-held slit lamp microscope and wide-angle digital retinal image acquisition system. The retinal fundus examination utilised the RetCam wide-field digital imaging system (Clarity Medical Systems, Pleasanton, California, USA). The external eye, pupillary light reflex, red reflex, opacity of refractive media, anterior chamber and posterior segments were also examined. A total of 3573 healthy full-term newborns were enrolled and examined in the programme. There was detection of 871 abnormal cases (24.4%). The majority of abnormal exams were 769 (21.52%) retinal haemorrhages. Of these, there were 215 cases of significant retinal haemorrhage, possible sight threatening or amblyogenic, representing 6.02% of the total. In addition, 67 cases (1.88%) involved macular haemorrhage. The other 107 cases (2.99%) with abnormal ocular findings included subconjunctival haemorrhage, congenital microphthalmos, congenital corneal leukoma, posterior synechia, persistent pupillary membrane, congenital cataract, enlarged C/D ratio, retinal hamartoma versus retinoblastoma, optic nerve defects, macular pigment disorder and non-specific peripheral retinopathy. Ocular examination of healthy newborns leads to the detection of a significant number of ocular pathologies. The most commonly discovered ocular abnormality during examination of the newborns in this study is retinal haemorrhage. The long-term impact of these findings is unknown. Although presumed by some to benign, neonatal retinal haemorrhages due to birth trauma could be involved in altering visual development. Further work, including prospective

  7. Eye disorders in newborn infants (excluding retinopathy of prematurity).

    PubMed

    Wan, Michael J; VanderVeen, Deborah K

    2015-05-01

    A screening eye examination is an essential part of the newborn assessment. The detection of many ocular disorders in newborn infants can be achieved through careful observation of the infant's visual behaviour and the use of a direct ophthalmoscope to assess the ocular structures and check the red reflex. Early diagnosis and subspecialty referral can have a critical impact on the prognosis for many ocular conditions, including potentially blinding but treatable conditions such as congenital cataracts, life-threatening malignancies such as retinoblastoma and harbingers of disease elsewhere such as sporadic aniridia and its association with the development of Wilms tumour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Premedication for endotracheal intubation in the newborn infant

    PubMed Central

    Barrington, KJ

    2011-01-01

    Endotracheal intubation, a common procedure in newborn care, is associated with pain and cardiorespiratory instability. The use of premedication reduces the adverse physiological responses of bradycardia, systemic hypertension, intracranial hypertension and hypoxia. Perhaps more importantly, premedication decreases the pain and discomfort associated with the procedure. All newborn infants, therefore, should receive analgesic premedication for endotracheal intubation except in emergency situations. Based on current evidence, an optimal protocol for premedication is to administer a vagolytic (intravenous [IV] atropine 20 μg/kg), a rapid-acting analgesic (IV fentanyl 3 μg/kg to 5 μg/kg; slow infusion) and a short-duration muscle relaxant (IV succinylcholine 2 mg/kg). Intubations should be performed or supervised by trained staff, with close monitoring of the infant throughout. PMID:22379381

  9. Nebulized racemic epinephrine for extubation of newborn infants.

    PubMed

    Davies, M W; Davis, P G

    2001-01-01

    Following a period of mechanical ventilation, post-extubation upper airway obstruction can occur in newborn infants, especially after prolonged, traumatic or multiple intubations. The subsequent increase in upper airway resistance may lead to respiratory insufficiency and failure of extubation. The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulised epinephrine immediately post-extubation in some neonatal units. It is also recommended for neonates with post-extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. The primary objective was to assess whether nebulised epinephrine administered immediately after extubation in neonates weaned from IPPV decreases the need for subsequent additional respiratory support. Searches were made using MeSH search terms 'epinephrine' and 'exp infant, newborn'. Databases searched included: MEDLINE from1966 to September 2000; CINAHL from 1982 to September 2000; Current Contents from 1994 to September 2000; and the Cochrane Controlled Trials Register, The Cochrane Library 2000 Issue 3. Previous searches up to March 1999 have included the Oxford Database of Perinatal trials, expert informants and journal hand searching mainly in the English language, expert informant searches in the Japanese language by Prof. Ogawa, previous reviews including cross references, abstracts, and conference and symposia proceedings. All randomised and quasi-randomised control trials in which nebulised epinephrine was compared with placebo immediately post-extubation in newborn infants who have been weaned from IPPV and extubated, with regard to clinically important outcomes (i.e. need for additional respiratory support, increase in oxygen requirement, respiratory distress, stridor or the occurrence of side effects). No studies met our criteria for inclusion in this review. No studies were identified which looked at the

  10. Nebulized racemic epinephrine for extubation of newborn infants.

    PubMed

    Davies, M W; Davis, P G

    2000-01-01

    Following a period of mechanical ventilation, post-extubation upper airway obstruction can occur in newborn infants, especially after prolonged, traumatic or multiple intubations. The subsequent increase in upper airway resistance may lead to respiratory insufficiency and failure of extubation. The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulised epinephrine immediately post-extubation in some neonatal units. It is also recommended for neonates with post-extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. The primary objective was to assess whether nebulised epinephrine administered immediately after extubation in neonates weaned from IPPV decreases the need for subsequent additional respiratory support. Searches were made of Medline (MeSH search terms 'epinephrine' and 'exp infant, newborn'), the Oxford Database of Perinatal trials, expert informants and journal hand searching mainly in the English language, expert informant searches in the Japanese language by Prof. Ogawa, previous reviews including cross references, abstracts, and conference and symposia proceedings. All randomised and quasi-randomised control trials in which nebulised epinephrine was compared with placebo immediately post-extubation in newborn infants who have been weaned from IPPV and extubated, with regard to clinically important outcomes (i.e. need for additional respiratory support, increase in oxygen requirement, respiratory distress, stridor or the occurrence of side effects). No studies met our criteria for inclusion in this review. No studies were identified which looked at the effect of inhaled nebulised epinephrine on clinically important outcomes in infants being extubated. There is no evidence either supporting or refuting the use of inhaled nebulised racemic epinephrine in newborn infants. randomised controlled trials are needed

  11. Phospholipid Species in Newborn and 4 Month Old Infants after Consumption of Different Formulas or Breast Milk

    PubMed Central

    Uhl, Olaf; Fleddermann, Manja; Hellmuth, Christian; Demmelmair, Hans; Koletzko, Berthold

    2016-01-01

    Introduction Arachidonic acid (AA) and docosahexaenoic acid (DHA) are important long-chain polyunsaturated fatty acids for neuronal and cognitive development and are ingredients of infant formulae that are recommended but there is no evidence based minimal supplementation level available. The aim of this analysis was to investigate the effect of supplemented AA and DHA on phospholipid metabolism. Methods Plasma samples of a randomized, double-blind infant feeding trial were used for the analyses of phospholipid species by flow-injection mass spectrometry. Healthy term infants consumed isoenergetic formulae (intervention formula with equal amounts of AA and DHA—IF, control formula without additional AA and DHA—CF) from the first month of life until the age of 120 days. A group of breast milk (BM) -fed infants was followed as a reference. Results The plasma profile detected in newborns was different from 4 month old infants, irrespective of study group. Most relevant changes were seen in higher level of LPC16:1, LPC20:4, PC32:1, PC34:1 and PC36:4 and lower level of LPC18:0, LPC18:2, PC32:2, PC36:2 and several ether-linked phosphatidylcholines in newborns. The sum of all AA and DHA species at 4 month old infants in the CF group showed level of 40% (AA) and 51% (DHA) of newborns. The supplemented amount of DHA resulted in phospholipid level comparable to BM infants, but AA phospholipids were lower than in BM infants. Interestingly, relative contribution of DHA was higher in ether-linked phosphatidylcholines in CF fed infants, but IF and BM fed infants showed higher overall ether-linked phosphatidylcholines levels. Conclusion In conclusion, we have shown that infant plasma phospholipid profile changes remarkably from newborn over time and is dependent on the dietary fatty acid composition. A supplementation of an infant formula with AA and DHA resulted in increased related phospholipid species. PMID:27571269

  12. Phospholipid Species in Newborn and 4 Month Old Infants after Consumption of Different Formulas or Breast Milk.

    PubMed

    Uhl, Olaf; Fleddermann, Manja; Hellmuth, Christian; Demmelmair, Hans; Koletzko, Berthold

    2016-01-01

    Arachidonic acid (AA) and docosahexaenoic acid (DHA) are important long-chain polyunsaturated fatty acids for neuronal and cognitive development and are ingredients of infant formulae that are recommended but there is no evidence based minimal supplementation level available. The aim of this analysis was to investigate the effect of supplemented AA and DHA on phospholipid metabolism. Plasma samples of a randomized, double-blind infant feeding trial were used for the analyses of phospholipid species by flow-injection mass spectrometry. Healthy term infants consumed isoenergetic formulae (intervention formula with equal amounts of AA and DHA-IF, control formula without additional AA and DHA-CF) from the first month of life until the age of 120 days. A group of breast milk (BM) -fed infants was followed as a reference. The plasma profile detected in newborns was different from 4 month old infants, irrespective of study group. Most relevant changes were seen in higher level of LPC16:1, LPC20:4, PC32:1, PC34:1 and PC36:4 and lower level of LPC18:0, LPC18:2, PC32:2, PC36:2 and several ether-linked phosphatidylcholines in newborns. The sum of all AA and DHA species at 4 month old infants in the CF group showed level of 40% (AA) and 51% (DHA) of newborns. The supplemented amount of DHA resulted in phospholipid level comparable to BM infants, but AA phospholipids were lower than in BM infants. Interestingly, relative contribution of DHA was higher in ether-linked phosphatidylcholines in CF fed infants, but IF and BM fed infants showed higher overall ether-linked phosphatidylcholines levels. In conclusion, we have shown that infant plasma phospholipid profile changes remarkably from newborn over time and is dependent on the dietary fatty acid composition. A supplementation of an infant formula with AA and DHA resulted in increased related phospholipid species.

  13. [Hearing screening of high risk newborn infants].

    PubMed

    Finckh-Krämer, U; Gross, M; Bartsch, M; Kewitz, G; Versmold, H; Hess, M

    2000-03-01

    This prospective study reports on the prevalence of hearing impairment in an at-risk neonatal intensive care unit (NICU) population. From 1990 to 1998, 1062 neonates were screened with the use of transitory evoked otoacoustic emissions (TEOAE) and brainstem evoked response audiometry (BERA). 934 infants passed the primary screen for both ears, 75 for one ear, adding up to 95%. 17 infants (1.6%) were lost to follow-up. In fourteen infants (1.3%), bilateral hearing impairment above 30 dB was confirmed. While all children with hearing impairment belonged to the group of 862 children receiving aminoglycosides, only one of them presented no other risk factors. In twelve of the hearing impaired children other anamnestic factors, i.e. dysmorphism, prenatal rubella or cytomegaly, family history of hearing loss or severe peri- and postnatal complications seem to be more probable causes of the identified hearing loss. In one of these children, delayed onset or progression of hearing loss is suspected. From our data, aminoglycosides are not an important risk factor for hearing impairment, when serum levels are continuously monitored, as in our cohort. After adjustment for other risk factors, birth weight between 1000 gr and 1500 gr and a gestational age between 29 and 31 weeks were no predictive markers for hearing impairment. It might be speculated that the improved medical treatment in a NICU reduces the probability of hearing impairment for those two groups. Conductive hearing loss as a possible additional cause for hearing impairment was not studied in detail, but the high percentage of malformations detected (four out of fourteen hearing impaired infants) demands further monitoring, close follow-up, adequate treatment and counselling.

  14. Confirmation of correct tracheal tube placement in newborn infants.

    PubMed

    Schmölzer, Georg M; O'Reilly, Megan; Davis, Peter G; Cheung, Po-Yin; Roehr, Charles Christoph

    2013-06-01

    Tracheal intubation remains a common procedure during neonatal intensive care. Rapid confirmation of correct tube placement is important because tube malposition is associated with serious adverse outcomes. The current gold standard test to confirm tube position is a chest radiograph, however this is often delayed until after ventilation has commenced. Hence, point of care methods to confirm correct tube placement have been developed. The aim of this article is to review the available literature on tube placement in newborn infants. We reviewed books, resuscitation manuals and articles from 1830 to the present with the search terms "Infant, Newborn", "Endotracheal intubation", "Resuscitation", "Clinical signs", "Radiography", "Respiratory Function Tests", "Laryngoscopy", "Ultrasonography", and "Bronchoscopy". Various techniques have been studied to help clinicians assess tube placement. However, despite 85 years of clinical practice, the search for higher success rates and quicker intubation continues. Currently, chest radiography remains the gold standard test to confirm tube position. However, rigorous evaluation of new techniques is required to ensure the safety of newborn infants. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Naloxone for narcotic exposed newborn infants: systematic review

    PubMed Central

    McGuire, W; Fowlie, P

    2003-01-01

    Background: Naloxone, a specific opiate antagonist, is available for the treatment of newborn infants with respiratory depression that may be due to transplacentally acquired opiates. Aims: To determine if this treatment has any clinically important benefits, and whether there are any harmful effects. Methods: Randomised controlled trials that compared naloxone with placebo or no drug for newborn infants with transplacental exposure to narcotics were systematically reviewed. The Cochrane Controlled Trials Register (CCTR; 2002, Issue 3), Medline (1966 to June 2002), and Embase (1988 to June 2002) were searched. Data were extracted, analysed, and synthesised using the standard methods of the Cochrane Neonatal Collaborative Review Group. Results: Nine trials were found that fulfilled the specified inclusion criteria. Although there was evidence that naloxone increased alveolar ventilation, no data were found on the specified primary outcomes of this review: the need for assisted ventilation or admission to a neonatal unit. Conclusions: There is a need for a randomised controlled trial to determine if naloxone confers any clinically important benefits on newborn infants with respiratory depression that may be due to transplacentally acquired narcotic. PMID:12819163

  16. Pityriasis rosea in pregnancy: report of a spousal occurrence and craniosynostosis in the healthy newborn

    PubMed Central

    Loh, Tiffany Y.; Cohen, Philip R

    2016-01-01

    Background: Pityriasis rosea is a papulosquamous disease. It may occur during pregnancy; in this setting, it has occasionally been associated with adverse outcomes. Purpose: A woman who developed pityriasis rosea at the beginning of her eighth week of gestation is described. The outcomes in newborns delivered by pregnant women who developed pityriasis rosea during gestation are summarized. Method: A 28-year-old woman developed pityriasis rosea during her eighth week of pregnancy. Her husband had pityriasis rosea two months earlier. PubMed was searched for the following terms: conjugal, craniosynostosis, newborn, pityriasis, pregnancy, rosea, sagittal, spouse. The papers were reviewed and the references cited were evaluated. Results: Our patient delivered a healthy male infant after 41 weeks of gestation. He had normal weight, height, and Apgar scores. Isolated sagittal craniosynostosis was diagnosed and was successfully treated at nine weeks after birth without complications. Conclusion: Several retrospective studies have investigated the possibility of adverse outcomes in infants born to women who developed pityriasis rosea during pregnancy, such as stillbirth, low gestational weight, hypotonia, and premature delivery. However, there are also reports of healthy newborns in women who have had pityriasis rosea during gestation. Our patient carried the fetus one week post-term and delivered a healthy boy via C-section; isolated sagittal craniosynostosis was later diagnosed and successfully repaired. The occurrence of craniosynostosis in a woman who developed pityriasis rosea during her first trimester of pregnancy may be two coincidental events. PMID:27648382

  17. Smoking during Pregnancy Affects Speech-Processing Ability in Newborn Infants

    PubMed Central

    Key, Alexandra P.F.; Ferguson, Melissa; Molfese, Dennis L.; Peach, Kelley; Lehman, Casey; Molfese, Victoria J.

    2007-01-01

    Background Tobacco smoking during pregnancy is known to adversely affect development of the central nervous system in babies of smoking mothers by restricting utero–placental blood flow and the amount of oxygen available to the fetus. Behavioral data associate maternal smoking with lower verbal scores and poorer performance on specific language/auditory tests. Objectives In the current study we examined the effects of maternal smoking during pregnancy on newborns’ speech processing ability as measured by event-related potentials (ERPs). Method High-density ERPs were recorded within 48 hr of birth in healthy newborn infants of smoking (n = 8) and nonsmoking (n = 8) mothers. Participating infants were matched on sex, gestational age, birth weight, Apgar scores, mother’s education, and family income. Smoking during pregnancy was determined by parental self-report and medical records. ERPs were recorded in response to six consonant–vowel syllables presented in random order with equal probability. Results Brainwaves of babies of nonsmoking mothers were characterized by typical hemisphere asymmetries, with larger amplitudes over the left hemisphere, especially over temporal regions. Further, infants of nonsmokers discriminated among a greater number of syllables whereas the newborns of smokers began the discrimination process at least 150 msec later and differentiated among fewer stimuli. Conclusions Our findings indicate that prenatal exposure to tobacco smoke in otherwise healthy babies is linked with significant changes in brain physiology associated with basic perceptual skills that could place the infant at risk for later developmental problems. PMID:17450234

  18. Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns.

    PubMed

    Feldman-Winter, Lori; Goldsmith, Jay P

    2016-09-01

    Skin-to-skin care (SSC) and rooming-in have become common practice in the newborn period for healthy newborns with the implementation of maternity care practices that support breastfeeding as delineated in the World Health Organization's "Ten Steps to Successful Breastfeeding." SSC and rooming-in are supported by evidence that indicates that the implementation of these practices increases overall and exclusive breastfeeding, safer and healthier transitions, and improved maternal-infant bonding. In some cases, however, the practice of SSC and rooming-in may pose safety concerns, particularly with regard to sleep. There have been several recent case reports and case series of severe and sudden unexpected postnatal collapse in the neonatal period among otherwise healthy newborns and near fatal or fatal events related to sleep, suffocation, and falls from adult hospital beds. Although these are largely case reports, there are potential dangers of unobserved SSC immediately after birth and throughout the postpartum hospital period as well as with unobserved rooming-in for at-risk situations. Moreover, behaviors that are modeled in the hospital after birth, such as sleep position, are likely to influence sleeping practices after discharge. Hospitals and birthing centers have found it difficult to develop policies that will allow SSC and rooming-in to continue in a safe manner. This clinical report is intended for birthing centers and delivery hospitals caring for healthy newborns to assist in the establishment of appropriate SSC and safe sleep policies. Copyright © 2016 by the American Academy of Pediatrics.

  19. Hemodynamic responses to speech and music in newborn infants.

    PubMed

    Kotilahti, Kalle; Nissilä, Ilkka; Näsi, Tiina; Lipiäinen, Lauri; Noponen, Tommi; Meriläinen, Pekka; Huotilainen, Minna; Fellman, Vineta

    2010-04-01

    We used near-infrared spectroscopy (NIRS) to study responses to speech and music on the auditory cortices of 13 healthy full-term newborn infants during natural sleep. The purpose of the study was to investigate the lateralization of speech and music responses at this stage of development. NIRS data was recorded from eight positions on both hemispheres simultaneously with electroencephalography, electrooculography, electrocardiography, pulse oximetry, and inclinometry. In 11 subjects, statistically significant (P < 0.02) oxygenated (HbO2) and total hemoglobin (HbT) responses were recorded. Both stimulus types elicited significant HbO2 and HbT responses on both hemispheres in five subjects. Six of the 11 subjects had positive HbO2 and HbT responses to both stimulus types, whereas one subject had negative responses. Mixed positive and negative responses were observed in four neonates. On both hemispheres, speech and music responses were significantly correlated (r = 0.64; P = 0.018 on the left hemisphere (LH) and r = 0.60; P = 0.029 on the right hemisphere (RH)). On the group level, the average response to the speech stimuli was statistically significantly greater than zero in the LH, whereas responses on the RH or to the music stimuli did not differ significantly from zero. This suggests a more coherent response to speech on the LH. However, significant differences in lateralization of the responses or mean response amplitudes of the two stimulus types were not observed on the group level. Copyright 2009 Wiley-Liss, Inc.

  20. Metabolomic Research on Newborn Infants With Intrauterine Growth Restriction

    PubMed Central

    Liu, Jing; Chen, Xin-Xin; Li, Xiang-Wen; Fu, Wei; Zhang, Wan-Qiao

    2016-01-01

    , hydroxyacetyl carnitine, and hydroxyhexadecancenyl carnitine (P < 0.05). Among newborns with IUGR, metabolites differed among males and females, mainly in aspartic acid, glutamic acid, and hexacosenoic acid (P < 0.05). Birth weight had no significant effects on free carnitine concentration or on the ratios of free carnitine and acylcarnitine to total carnitine (P < 0.05). IUGR infants exhibit significant abnormalities in amino acid and acylcarnitine metabolism, especially those with birth weight below the third percentile. With increasing birth weight, amino acids and acylcarnitines showed compensatory increases or reductions, and when birth weight reached the 10th percentile, the newborns with IUGR resembled the AGA newborns. PMID:27124067

  1. Nebulized racemic epinephrine for extubation of newborn infants.

    PubMed

    Davies, M W; Davis, P G

    2002-01-01

    Following a period of mechanical ventilation, post-extubation upper airway obstruction can occur in newborn infants, especially after prolonged, traumatic or multiple intubations. The subsequent increase in upper airway resistance may lead to respiratory insufficiency and failure of extubation. The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulized epinephrine immediately post-extubation in some neonatal units. It is also recommended for neonates with post-extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. The primary objective was to assess whether nebulized epinephrine administered immediately after extubation in neonates weaned from IPPV decreases the need for subsequent additional respiratory support. Searches were of: MEDLINE from 1966 to September 2000; CINAHL from 1982 to September 2000; Current Contents from 1994 to September 2000; and the Cochrane Controlled Trials Register (Cochrane Library Issue 3, 2000). These searches were updated to September 2001 for this review update. Previous searches up to March 1999 included the Oxford Database of Perinatal Trials, expert informants and journal hand searching mainly in the English language, previous reviews including cross references, abstracts, and conference and symposia proceedings. All randomised and quasi-randomised control trials in which nebulized epinephrine was compared with placebo immediately post-extubation in newborn infants who have been weaned from IPPV and extubated, with regard to clinically important outcomes (i.e. need for additional respiratory support, increase in oxygen requirement, respiratory distress, stridor or the occurrence of side effects). No studies met our criteria for inclusion in this review. No studies were identified which looked at the effect of inhaled nebulized epinephrine on clinically important outcomes in infants being

  2. Health Literacy Among Parents of Newborn Infants.

    PubMed

    Mackley, Amy; Winter, Michael; Guillen, Ursula; Paul, David A; Locke, Robert

    2016-08-01

    Health Literacy is the ability to obtain, process, and understand health information to make knowledgeable health decisions. To determine baseline health literacy of neonatal intensive care unit (NICU) parents at a tertiary care hospital during periods of crucial information exchange. Health literacy of English-speaking NICU parents was assessed using the Newest Vital Sign (NVS) on admission (n = 121) and discharge (n = 59). A quasi-control group of well-baby nursery (WBN) parents (n = 24) and prenatal obstetric clinic (PRE) parents (n = 18) were included. A single, Likert-style question measured nurses' assessment of parental comprehension with discharge teaching. Suspected limited health literacy (SLHL) was defined as the NVS score of 3 or less. Forty-three percent of parents on NICU admission and 32% at NICU discharge had SLHL (P < .01). SLHL for WBN and PRE parents was 25% and 58%, respectively. Parental age, gender, location, and history of healthcare-related employment were not associated with health literacy status at any time point. Thirty-nine percent of NICU parents and 25% of WBN parents with SLHL at time of admission/infant birth had a college education. Nurse subjective measurement of parental comprehension of discharge instructions was not correlated to the objective measurement of health literacy (P = .26). SLHL is common during peak time periods of complex health discussion in the NICU, WBN, and PRE settings. NICU providers may not accurately gauge parents' literacy status. Methods for improving health communication are needed. Studies should evaluate SLHL in a larger NICU population and across different languages and cultures.

  3. Obstetric Antecedents to Body Cooling Treatment of the Newborn Infant

    PubMed Central

    Nelson, David B.; Lucke, Ashley M.; McIntire, Donald D.; Sánchez, Pablo J.; Leveno, Kenneth J.; Chalak, Lina F.

    2014-01-01

    Objective Obstetric antecedents were analyzed in births where the infant received whole-body cooling for neonatal encephalopathy. Methods This retrospective cohort study included all live-born singleton infants delivered at or beyond 36 weeks gestation from October 2005 through December 2011. Infants who had received whole-body cooling identified by review of a prospective neonatal registry were compared to a control group comprising the remaining obstetric population delivered at greater than 36 weeks but not cooled. Univariable analysis was followed by a staged, stepwise selection of variables with the intent to rank significant risk factors for cooling. Results A total of 86,371 women delivered during the study period and 98 infants received whole-body cooling (1.1/1,000 livebirths). Of these 98 infants, 80 (88%) newborns had moderate encephalopathy and 10 (12%) had severe encephalopathy prior to cooling. Maternal age less than or equal to 15 years, low parity, maternal body habitus (BMI ≥ 40 kg/m2), diabetes, preeclampsia, induction, epidural analgesia, chorioamnionitis, length of labor, and mode of delivery were associated with significantly increased risk of infant cooling during univariable analysis. Catastrophic events to include umbilical cord prolapse (OR 14; 95%CI, 3–72), placental abruption (OR 17; 95%CI, 7–44), uterine rupture (OR 130; 95%CI, 11–1477) were the strongest factors associated with infant cooling after staged-stepwise logistic analysis. Conclusion A variety of intrapartum characteristics were associated with infant cooling for neonatal encephalopathy with the most powerful antecedents being umbilical cord prolapse, placental abruption, and uterine rupture. PMID:24530976

  4. [Clinical results and pharmacokinetics of cefotaxime in newborn infants].

    PubMed

    Takimoto, M; Oka, T; Yoshioka, H; Sanae, N; Maruyama, S

    1982-07-01

    One full-term newborn infant and 2 premature ones were treated with cefotaxime for the treatment of suspected sepsis and umbilical suppurative inflammation. Pathogenic organisms could not be identified in all cases. A good result was obtained with the case of suspected sepsis. But the other 2 cases were not evaluable because underlying diseases such as massive pulmonary atelectasis or respiratory distress syndrome masked the effects of this agent. Serum levels of cefotaxime in 3 of the 4 cases were determined with bioassay. Time courses of the serum levels in 2 of them resulted in peculiar biphasic disappearance curves. This fact implies the possibility that desacetylation of cefroxime proceeds also in newborns as in adults and that desacetyl metabolite accumulates in the body owing to the premature function of the neonatal kidney.

  5. Frequency of enzyme deficiency variants in erythrocytes of newborn infants

    SciTech Connect

    Mohrenweiser, H.W.

    1981-08-01

    The frequency of enzyme deficiency variants, defined as alleles whose products are either absent or almost devoid of normal activity in erythrocytes, was determined for nine erythrocyte enzymes in some 675 newborn infants and in approximately 200 adults. Examples of this type of genetic abnormality, which in the homozygous condition are often associated with significant health consequences, were detected for seven of the nine enzymes studied. Fifteen inherited enzyme deficiency variants in 1809 determinations from adults were identified. Seven of the deficiency variants involved triosephosphate isomerase, a frequency of 0.01 in the newborn population. The average frequency of 2.4/1000 is 2 to 3 times the frequency observed for rare electrophoretic variants of erythrocyte enzymes in this same population.

  6. [Pain scales used in the newborn infant: a systematic review].

    PubMed

    Pereira Da Silva, Tiago; Justo Da Silva, Lincoln

    2010-01-01

    For many years, appropriate relevance has not been given for pain in newborn infants, but research brought to light this important subject in neonatal medicine. Pain scores have been organized in scales and validated to be used in clinical practice. Currently, there are several scales based on different pain indicators. These scales should be used according to different circumstances. With the purpose of helping health professionals, a systematic review of neonatal pain scales based on gestational age, duration of painful episode and type of pain indicator was carried out. Data concerning validation of the scales were also analyzed and two scales for use in clinical practice or in research are suggested.

  7. Soy Protein-Based Infant Formulas with Supplemental Fructooligosaccharides: Gastrointestinal Tolerance and Hydration Status in Newborn Infants

    PubMed Central

    Lasekan, John; Baggs, Geraldine; Acosta, Sonja; Mackey, Amy

    2015-01-01

    Unlike milk-based infant formulas, soy-based infant formulas containing supplemental fructooligosaccharides (FOS) have not been clinically evaluated. A randomized, double-blind, 28 day parallel feeding trial compared gastrointestinal (GI) tolerance and hydration in healthy term newborn infants fed either a commercialized soy formula (with history of safe use) containing sucrose as 20% of total carbohydrate, no supplemental short-chain FOS (scFOS) and no mixed carotenoids (lutein, lycopene, beta-carotene) as a control (CF, n = 62 infants) or one of two experimental soy-based formulas, EF1 (n = 64) and EF2 (n = 62) containing scFOS (2.5 g/L) and mixed carotenoids. EF1 differed from EF2 by containing sucrose. Results indicated no significant study group differences (p > 0.05) in study completion rates (CF = 81, EF1 = 86, & EF2 = 87%), growth, mean rank stool consistency, stool frequency, formula intake, spit-up/vomit, and safety measures (urine specific gravity, USG; hydration status and adverse events). Mean USGs for study groups were normal (<1.03). The EF1 > CF group in percent yellow stools (p < 0.01 at age 14 days). In conclusion, the study suggested that term infants fed soy-based formulas supplemented with scFOS and mixed carotenoids, with or without sucrose in the 1st 35 days of infancy demonstrated good tolerance and hydration comparable to the control soy-based formula with history of safe use. PMID:25912040

  8. Soy protein-based infant formulas with supplemental fructooligosaccharides: gastrointestinal tolerance and hydration status in newborn infants.

    PubMed

    Lasekan, John; Baggs, Geraldine; Acosta, Sonja; Mackey, Amy

    2015-04-22

    Unlike milk-based infant formulas, soy-based infant formulas containing supplemental fructooligosaccharides (FOS) have not been clinically evaluated. A randomized, double-blind, 28 day parallel feeding trial compared gastrointestinal (GI) tolerance and hydration in healthy term newborn infants fed either a commercialized soy formula (with history of safe use) containing sucrose as 20% of total carbohydrate, no supplemental short-chain FOS (scFOS) and no mixed carotenoids (lutein, lycopene, beta-carotene) as a control (CF, n = 62 infants) or one of two experimental soy-based formulas, EF1 (n = 64) and EF2 (n = 62) containing scFOS (2.5 g/L) and mixed carotenoids. EF1 differed from EF2 by containing sucrose. Results indicated no significant study group differences (p > 0.05) in study completion rates (CF = 81, EF1 = 86, & EF2 = 87%), growth, mean rank stool consistency, stool frequency, formula intake, spit-up/vomit, and safety measures (urine specific gravity, USG; hydration status and adverse events). Mean USGs for study groups were normal (<1.03). The EF1 > CF group in percent yellow stools (p < 0.01 at age 14 days). In conclusion, the study suggested that term infants fed soy-based formulas supplemented with scFOS and mixed carotenoids, with or without sucrose in the 1st 35 days of infancy demonstrated good tolerance and hydration comparable to the control soy-based formula with history of safe use.

  9. Nemaline myopathy in a newborn infant: a rare muscle disorder.

    PubMed

    Olukman, O; Calkavur, S; Diniz, G; Unalp, A; Atlihan, F

    2013-01-01

    Nemaline myopathy (NM) is a genetically and clinically heterogeneous muscle disorder, defined by the presence of characteristic nemaline bodies on muscle biopsy. The disease has a wide spectrum of phenotypes, ranging from forms with neonatal onset and fatal outcome to asymptomatic forms. The neonatal form is severe and usually fatal. The clinical variability, with differing age of onset and severity of symptoms makes the diagnosis difficult during infancy. There is no curative treatment. L-tyrosine may prevent aspiration by reducing pharyngeal secretions and drooling. Most of the patients die from respiratory and cardiac failure. This article discusses a newborn infant who presented with generalized weakness and respiratory failure. Partial response to L-tyrosine treatment was noted. The case is worth presenting to remind clinicians of congenital myopathies in the differential diagnosis of floppy infant during neonatal period and to emphasize the importance of muscle biopsy in diagnosis.

  10. Skin-to-skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants.

    PubMed

    Chermont, Aurimery Gomes; Falcão, Luis Fábio Magno; de Souza Silva, Eduardo Henrique Laurindo; de Cássia Xavier Balda, Rita; Guinsburg, Ruth

    2009-12-01

    The goal was to compare the efficacy of oral 25% dextrose treatment and/or skin-to-skin contact for analgesia in term newborns during intramuscular injection of a hepatitis B vaccine. A prospective, randomized, partially blinded, clinical trial was performed with 640 healthy term newborns. Infants at 12 to 72 hours of life were assigned randomly to receive an intramuscular injection of hepatitis B vaccine in the right thigh according to 4 analgesia groups, that is, no analgesia (routine); oral 25% dextrose treatment, given 2 minutes before the injection; skin-to-skin contact, initiated 2 minutes before the injection and persisting throughout the procedure; and a combination of the oral dextrose treatment and skin-to-skin contact strategies. For all groups, Neonatal Facial Coding System and Neonatal Infant Pain Scale scores were evaluated before the procedure, during thigh cleansing, during the injection, and 2 minutes after the injection. Premature Infant Pain Profile scores also were assessed for all infants. Pain scores were compared among the 4 groups. The use of oral 25% dextrose treatment reduced the duration of procedural pain in the studied population. Skin-to-skin contact decreased injection pain and duration. The combination of the 2 analgesic measures was more effective than either measure separately for term newborns. Nonpharmacologic analgesic measures were effective for the treatment of procedural pain in term infants. The combination of oral 25% dextrose treatment and skin-to-skin contact acted synergistically to decrease acute pain in healthy neonates.

  11. Buen Comienzo, Buen Futuro: Su Recien Nacido. (Healthy Start, Grow Smart: Your Newborn).

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This booklet offers guidance to parents in caring for their newborn babies. Advice is given on the following topics: (1) newborn health screening; (2) what a healthy newborn looks like; (3) newborn reflexes; (4) baby checkups; (5) fathers' role; (6) the baby blues; (7) sleeping position; (8) breast milk; (9) breast feeding; (10) bottle feeding;…

  12. Mother-Father-Newborn Interaction: Effects of Maternal Medication, Labor, and Sex of Infant.

    ERIC Educational Resources Information Center

    Parke, Ross D.; And Others

    A research study was conducted to: (1) compare mother and father interactions with their newborn infant; (2) examine the effects of maternal drugs on mother-father infant interaction; (3) explore the impact of variations in length of labor on parent interaction; and (4) examine sex of parent and sex of newborn interactions to determine the nature…

  13. Newborn primate infants are entrained by low intensity lighting

    PubMed Central

    Rivkees, Scott A.; Hofman, Paul L.; Fortman, Jeffrey

    1997-01-01

    At the present time we do not know when the circadian timing system of human infants becomes responsive to light. Because of human study limitations, it is not currently possible to address this issue in clinical studies. Therefore, to provide insights into when the circadian system of humans becomes responsive to light, baboons were studied. We first assessed if the biological clock located in suprachiasmatic nuclei (SCN) is responsive to light at birth. When term newborn infants were exposed to bright light at night (5000 lux), SCN metabolic activity and c-fos mRNA expression increased, indicating the presence of photic responsiveness. When photic entrainment of developing rhythmicity was examined in infants, low intensity (200 lux) cycled lighting was sufficient to entrain circadian phase. However, low intensity lighting was not sufficient to induce changes in SCN metabolic activity or c-fos mRNA expression. Phase–response studies indicated that light exposure (200 lux) before the onset of activity most effectively shifted circadian phase. These data provide direct evidence that the SCN are responsive to visually mediated light information in a primate at birth. Further consideration of lighting conditions that infants are exposed to is therefore warranted. PMID:8990202

  14. Understanding newborn infant readmission: findings of the Ontario Mother and Infant Survey.

    PubMed

    Sword, W A; Watt, S; Krueger, P D; Kyong, S L; Sheehan, D D; Roberts, J G; Gafni, A

    2001-01-01

    The Ontario Mother and Infant Survey examined health and social service utilization of postpartum women and newborn infants from five hospital sites. A cross-sectional multilanguage survey design with longitudinal follow-up was used: 1,250 eligible, consenting women completed a self-report questionnaire in hospital and 875 women participated in a structured telephone interview at four weeks post-discharge. Rates of newborn infant readmission ranged from 2.4% to 6.7%. The best predictors of readmission were: main source of household income was other than employment; maternal self-rating of health was poor; mother anticipated inadequate help and support at home following discharge; mother received help from friends/neighbours following discharge; and mother had concern about infant care and behaviour. Readmission was not associated with length of postpartum hospital stay. The study findings suggest that there is a complex relationship between infant health care needs, family resources and provider practices that produces clinically important, site-specific readmission patterns.

  15. Infant Directed Speech Enhances Statistical Learning in Newborn Infants: An ERP Study.

    PubMed

    Bosseler, Alexis N; Teinonen, Tuomas; Tervaniemi, Mari; Huotilainen, Minna

    2016-01-01

    Statistical learning and the social contexts of language addressed to infants are hypothesized to play important roles in early language development. Previous behavioral work has found that the exaggerated prosodic contours of infant-directed speech (IDS) facilitate statistical learning in 8-month-old infants. Here we examined the neural processes involved in on-line statistical learning and investigated whether the use of IDS facilitates statistical learning in sleeping newborns. Event-related potentials (ERPs) were recorded while newborns were exposed to12 pseudo-words, six spoken with exaggerated pitch contours of IDS and six spoken without exaggerated pitch contours (ADS) in ten alternating blocks. We examined whether ERP amplitudes for syllable position within a pseudo-word (word-initial vs. word-medial vs. word-final, indicating statistical word learning) and speech register (ADS vs. IDS) would interact. The ADS and IDS registers elicited similar ERP patterns for syllable position in an early 0-100 ms component but elicited different ERP effects in both the polarity and topographical distribution at 200-400 ms and 450-650 ms. These results provide the first evidence that the exaggerated pitch contours of IDS result in differences in brain activity linked to on-line statistical learning in sleeping newborns.

  16. Infant Directed Speech Enhances Statistical Learning in Newborn Infants: An ERP Study

    PubMed Central

    Teinonen, Tuomas; Tervaniemi, Mari; Huotilainen, Minna

    2016-01-01

    Statistical learning and the social contexts of language addressed to infants are hypothesized to play important roles in early language development. Previous behavioral work has found that the exaggerated prosodic contours of infant-directed speech (IDS) facilitate statistical learning in 8-month-old infants. Here we examined the neural processes involved in on-line statistical learning and investigated whether the use of IDS facilitates statistical learning in sleeping newborns. Event-related potentials (ERPs) were recorded while newborns were exposed to12 pseudo-words, six spoken with exaggerated pitch contours of IDS and six spoken without exaggerated pitch contours (ADS) in ten alternating blocks. We examined whether ERP amplitudes for syllable position within a pseudo-word (word-initial vs. word-medial vs. word-final, indicating statistical word learning) and speech register (ADS vs. IDS) would interact. The ADS and IDS registers elicited similar ERP patterns for syllable position in an early 0–100 ms component but elicited different ERP effects in both the polarity and topographical distribution at 200–400 ms and 450–650 ms. These results provide the first evidence that the exaggerated pitch contours of IDS result in differences in brain activity linked to on-line statistical learning in sleeping newborns. PMID:27617967

  17. Task-oriented and bottle feeding adversely affect the quality of mother-infant interactions after abnormal newborn screens.

    PubMed

    Tluczek, Audrey; Clark, Roseanne; McKechnie, Anne Chevalier; Orland, Kate Murphy; Brown, Roger L

    2010-06-01

    To examine effects of newborn screening and neonatal diagnosis on the quality of mother-infant interactions in the context of feeding. Study compared the quality of mother-infant feeding interactions among 4 groups of infants classified by severity of newborn screening and diagnostic results: cystic fibrosis (CF), congenital hypothyroidism, heterozygote CF carrier, and healthy with normal newborn screening. The Parent-Child Early Relational Assessment and a task-oriented item measured the quality of feeding interactions for 130 dyads, infant ages 3 to 19 weeks (M = 9.19, SD = 3.28). The Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory measured maternal depression and anxiety. Composite Indicator Structure Equation Modeling showed that infant diagnostic status and, to a lesser extent, maternal education predicted feeding method. Mothers of infants with CF were most likely to bottle feed, which was associated with more task-oriented maternal behavior than breastfeeding. Mothers with low task-oriented behavior showed more sensitivity and responsiveness to infant cues, as well as less negative affect and behavior in their interactions with their infants than mothers with high task-oriented scores. Mothers of infants with CF were significantly more likely to have clinically significant anxiety and depression than the other groups. However, maternal psychological profile did not predict feeding method or interaction quality. Mothers in the CF group were the least likely to breastfeed. Research is needed to explicate long-term effects of feeding methods on quality of mother-child relationship and ways to promote continued breastfeeding after a neonatal CF diagnosis.

  18. [RV polymorphism of the chromosomes in newborn infants].

    PubMed

    Krachunova, M; Tsancheva, M; Lozanova, T

    1980-01-01

    The authors examined the routine variants (RV) of the karyotype of 100 clinically healthy newborns--49 girls and 51 boys. Secondary constriction of the long arm of one of the homologues of the chromosome I was found in 2% of the newborns; of the chromosome 9--in 4% of the chromosome 16--in 3%. Secondary constriction in both homologues was observed in the chromosome I in 1%; in the chromosome 9--in 1% and in the chromosome 16--4%. Secondary constriction of the short arm of both homologues was found only in the chromosome 16 in 3%. The large acrocentric chromosomes showed extended proximal area (p5) in 34%, but diminished (pI)--in 8%. The small acrocentrics with p5 were found in 14% of the newborns, but with pI--in 7%. Enlarged satelites were observed in 1% in the both groups of acrocentrics. Difference between the homologues in respect to the short arms was observed in 32,3% of the pairs of the great acrocentrics and in 47,5% of the small acrocentrics. Distribution of the Y chromosome according to the size in 51 boys was of Gaus character q1--0%, q2--29,4%, q3--33,3%, q4--25,5% and q5--11,7%. It is possible that Y chromosome with a size of q1 could be connected with definite pathology.

  19. Intravenous paraldehyde for seizure control in newborn infants.

    PubMed

    Koren, G; Butt, W; Rajchgot, P; Mayer, J; Whyte, H; Pape, K; MacLeod, S M

    1986-01-01

    We studied 14 newborn infants with seizures after birth asphyxia or other causes. Paraldehyde was given as a 200 mg/kg IV bolus followed by an infusion of 16 mg/kg/h (10 cases), or as a 400 mg/kg bolus (4 cases). Serum concentrations of paraldehyde were higher in periods of adequate seizure control than in periods of little or no response. Paraldehyde serum concentrations above 10 mg/dl were associated with anticonvulsant effects and were achieved in most neonates with a 2-hour infusion of 200 mg/kg/h. If there is no effect, serum concentrations are probably below 10 mg/dl and an additional 200 mg/kg can be given safely over 1 hour.

  20. [TREATMENT OF EXTREMELY PREMATURE NEWBORN INFANT WITH INO. CLINICAL CASE].

    PubMed

    Radulova, P; Slancheva, B; Marinov, R

    2015-01-01

    Prolonged inhaled nitric oxide (iNO) from birth in preterm neonates with BPD improves endogenous surfactant function as well as lung growth, angiogenesis, and alveologenesis. As a result there is a reduction in the frequency of the "new" form of BPD in neonates under 28 weeks of gestation and birth weight under 1000 gr. Delivery of inhaled nitric oxide is a new method of prevention of chronic lung disease. According to a large number of randomized trials iNO in premature neonates reduces pulmonary morbidity and leads to a reduction of the mortality in this population of patients. This new therapy does not have serious side effects. We represent a clinical case of extremely premature newborn infant with BPD treated with iNO.

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

    PubMed

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

    2016-05-01

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

  2. Estimating outcomes in newborn infants using fuzzy logic

    PubMed Central

    Chaves, Luciano Eustáquio; Nascimento, Luiz Fernando C.

    2014-01-01

    OBJECTIVE: To build a linguistic model using the properties of fuzzy logic to estimate the risk of death of neonates admitted to a Neonatal Intensive Care Unit. METHODS: Computational model using fuzzy logic. The input variables of the model were birth weight, gestational age, 5th-minute Apgar score and inspired fraction of oxygen in newborn infants admitted to a Neonatal Intensive Care Unit of Taubaté, Southeast Brazil. The output variable was the risk of death, estimated as a percentage. Three membership functions related to birth weight, gestational age and 5th-minute Apgar score were built, as well as two functions related to the inspired fraction of oxygen; the risk presented five membership functions. The model was developed using the Mandani inference by means of Matlab(r) software. The model values were compared with those provided by experts and their performance was estimated by ROC curve. RESULTS: 100 newborns were included, and eight of them died. The model estimated an average possibility of death of 49.7±29.3%, and the possibility of hospital discharge was 24±17.5%. These values are different when compared by Student's t-test (p<0.001). The correlation test revealed r=0.80 and the performance of the model was 81.9%. CONCLUSIONS: This predictive, non-invasive and low cost model showed a good accuracy and can be applied in neonatal care, given the easiness of its use. PMID:25119746

  3. Vertically transmitted cytomegalovirus infection in newborn preterm infants.

    PubMed

    Balcells, Carla; Botet, Francesc; Gayete, Sònia; Marcos, M Ángeles; Dorronsoro, Izaskun; de Alba, Concepción; Figueras-Aloy, Josep

    2016-07-01

    To determine the epidemiology of congenital and acquired cytomegalovirus (CMV) infections in preterm infants and to analyze the efficacy of breast milk freezing in decreasing the vertical transmission rate of CMV. During 2013 and 2014, preterm newborns who weighed ≤1500 g and were admitted to 22 Spanish neonatal units were included and screened for CMV infection according to the Spanish Neonatology Society recommendations. Each hospital treated the breast milk according to its own protocols. Among the 1236 preterm neonates included, 10 had a congenital infection (0.8%) and 49 had an acquired infection (4.0%) (82% demonstrated positive PCR-CMV in breast milk). The neonates who received only frozen milk presented less frequently with acquired infection (1.2%) than those fed fresh milk (5.5%) (RR=0.22; 95% CI 0.05-0.90; P=0.017). The newborns who received bank milk followed by frozen or fresh breast milk more frequently had an acquired infection (2.1% or 2.2%, respectively) than those fed only frozen breast milk. The incidence of congenital CMV infection in our sample is low, as described in the literature. To reduce acquired CMV infection, freezing breast milk might be an advisable procedure for preterm neonates born from seropositive mothers, either from the beginning of lactation or after a period of bank milk administration.

  4. [Antenatal corticosteroid use and clinical evolution of preterm newborn infants].

    PubMed

    2004-01-01

    To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal interview, analysis of medical records, and follow-up of the newborn infants. Data analysis was performed with the use of chi-square, t Student, Mann-Whitney, and ANOVA tests and multiple logistic regression, with level of significance set at 5%. Treatment was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented better Apgar scores at the 1st and 5th minute, reduced need for intervention in the delivery room and lower SNAPPE II. They were born with higher birth weight, longer gestational age and needed less surfactant use, ventilation, and oxygenation time. After multiple logistic regression, the use of antenatal corticosteroid independently improved birth conditions, decreased ventilation time, being related to increased occurrence of neonatal sepsis. The use of corticosteroid was associated with better prenatal care and birth conditions, better preterm evolution but higher risk of infection.

  5. Estimating outcomes in newborn infants using fuzzy logic.

    PubMed

    Chaves, Luciano Eustáquio; Nascimento, Luiz Fernando C

    2014-06-01

    To build a linguistic model using the properties of fuzzy logic to estimate the risk of death of neonates admitted to a Neonatal Intensive Care Unit. Computational model using fuzzy logic. The input variables of the model were birth weight, gestational age, 5th-minute Apgar score and inspired fraction of oxygen in newborn infants admitted to a Neonatal Intensive Care Unit of Taubaté, Southeast Brazil. The output variable was the risk of death, estimated as a percentage. Three membership functions related to birth weight, gestational age and 5th-minute Apgar score were built, as well as two functions related to the inspired fraction of oxygen; the risk presented five membership functions. The model was developed using the Mandani inference by means of Matlab(r) software. The model values were compared with those provided by experts and their performance was estimated by ROC curve. 100 newborns were included, and eight of them died. The model estimated an average possibility of death of 49.7±29.3%, and the possibility of hospital discharge was 24±17.5%. These values are different when compared by Student's t-test (p<0.001). The correlation test revealed r=0.80 and the performance of the model was 81.9%. This predictive, non-invasive and low cost model showed a good accuracy and can be applied in neonatal care, given the easiness of its use.

  6. [Home care for the high-risk newborn infant].

    PubMed

    Puddu, M

    2010-06-01

    With increased survival of extremely low birth weigh (ELBW) and very ill infants, a lot of them are discharged with unresolved medical issues that complicate their subsequent care. Infants born preterm with low birth weight who require neonatal intensive care experience a much higher rate of hospital readmission and death during the first year after birth compared with healthy term infants. Despite initial hospital care which is one of the most expensive of all kind of hospitalization, home care services are sometimes still sparse though the high risk of this group for failure to thrive, respiratory problems, developmental delays, parenting problems. In addition, societal and economic forces have come to bear on the timing and process of discharge and home care. Moreover it takes time for the family of a high-risk infant to prepare to care for their infant in a home setting and to obtain the necessary support services and mobilize community resources. Careful preparation for discharge, good follow-up and medical home after discharge may reduce these risks.

  7. Active Somatic and Psychic Ear Acupuncture Points in Newborn Infants with Neonatal Abstinence Syndrome.

    PubMed

    Kurath-Koller, Stefan; Pansy, Jasmin; Mileder, Lukas P; Schmölzer, Georg M; Urlesberger, Berndt; Raith, Wolfgang

    2016-10-01

    Neonatal abstinence syndrome (NAS) occurs within the first days after birth in newborns of mothers with a history of drug abuse. It may also occur in newborns whose mothers are undergoing substitution therapy. To determine the presence of active ear acupuncture points in newborn infants with NAS. Among newborn infants with NAS admitted to the Division of Neonatology at the University Hospital Graz between March 2009 and November 2014, an acupuncture-point detector (PS3 Silberbauer, Vienna, Austria) was used to identify active ear acupuncture points. An integrated optical and acoustical signal detects the ear points, which were then assigned to the ear map. A total of 31 newborn infants were assessed; 1 infant was excluded, however, because the mother had already weaned herself off opiates before admission. The excluded infant did not develop signs of NAS, had a low Finnegan score (3 points), and did not present any detectable active psychic ear acupuncture points. In all included newborn infants with NAS, active ear acupuncture points were identified: The psychovegetative rim was the most common active somatic area in each infant, followed by a few somatic and psychic ear acupuncture points. In all infants with symptoms of NAS, active psychic ear points were identified, of which the most frequently found points were the Frustration point and the R point. The activity of psychic ear acupuncture points may be specific for neonates with NAS.

  8. Neonatal facial coding system scores and spectral characteristics of infant crying during newborn circumcision.

    PubMed

    Lehr, Victoria Tutag; Zeskind, Philip Sanford; Ofenstein, John P; Cepeda, Eugene; Warrier, Indulekha; Aranda, J V

    2007-06-01

    To determine the relations between Neonatal Facial Coding System (NFCS) scores and measures of infant crying during newborn circumcision. Video and audio recordings were made of infant facial activity and cry sounds, respectively, during the lysis phase of circumcisions of 44 healthy term males (<3 d of age). All infants received topical analgesia before circumcision. NFCS scores were determined by blinded assistant from video recordings of facial activity. Measures of infant crying were determined via spectrum analysis of audio recordings by a blinded, independent researcher. Pearson product-moment correlations were used to examine relationship between NFCS scores and measures of crying. Principal component factor analysis detected dimensions underlying related measures of crying. Factor scores from a factor analysis were used in stepwise linear regression to predict NFCS scores. Higher NFCS scores correlated with lower peak fundamental frequency of crying (P<0.01) and with higher amplitudes of crying at peak fundamental frequency and dominant frequency and in overall cry sample (P<0.01). The factor analysis showed 3 significant orthogonal dimensions underlying measures of crying: Power and Velocity (amplitude and rapidity), Pitch of Crying (frequency characteristics), and Infant Arousal (turbulence and intensity) accounting for 42.3%, 17.8%, and 14.6% of variance, respectively. A regression analysis showed all 3 factor scores accounted for significant and separate portions of variance (P<0.001). The best predictor of NFCS score was Power and Velocity (P<0.002), followed by Infant Arousal (P<0.002), and Pitch of Crying (P<0.007). These data provide some of the first known evidence linking specific measures of infant crying with an independent, validated measure of pain.

  9. Normative Thyroid-Stimulating Hormone Values for Healthy Nigerian Newborns.

    PubMed

    Yarhere, Iroro E; Jaja, Tamunopriye; Oduwole, Abiola; Ibekwe, M Ugochi; Suwaid, Salma; Alkali, Yahaya; Adeniran, Kayode; Fetuga, Bolanle; Jarrett, Olumide O; Elusiyan, Jerome B; Adesiyun, Omotayo; Idris, Hafsat W; Blankenstein, Oliver; Akani, Nwadiuto A

    2016-01-01

    Congenital hypothyroidism is a common congenital endocrine disorder prevailing all over the world. No nationwide screening exists for any sub-Saharan country. We present normative cord and capillary thyroid-stimulating hormone (TSH) values for healthy Nigerian newborns. A cross-sectional study was carried out in 6 university hospitals in Nigeria between January 1 and December 31, 2013. Cord and heel blood placed on 4 concentric circles on a Whartman filter paper were analysed for TSH within 1 week of collection using AutoDelfia 1235 immunoassay (Perkin Elmer Wallace, Boston, Mass., USA) at Charité - Universitätsmedizin Berlin, Berlin, Germany. The mean TSH levels of the newborns were determined, considering their sex, birthweight, socioeconomic status, and birth city. The association between the mean TSH level and other parameters was determined by analysis of variance. A total of 2,014 subjects were recruited during the study period. The mean TSH value for the subjects was 1.86 μIU/ml, and 98.1% of the newborns were within the 2.5th and 97.5th percentiles (range: 0.09-7.90 μIU/ml) of the TSH levels. We collected 247 cord and 1,767 heel samples, respectively, and the range was slightly higher in samples from cord blood. The study highlights the normal reference values for capillary/cord TSH levels in term Nigerian newborns. TSH was higher in one region, attributable to earlier sampling, but was not influenced by gender, socioeconomic status, or birthweight. © 2015 S. Karger AG, Basel.

  10. White Cells and Bacteria in Voided Urine of Healthy Newborns

    PubMed Central

    Littlewood, James M.

    1971-01-01

    During a screening survey for urinary infection, 600 infants had one or more urines examined on the sixth or seventh day of life and 592 were subsequently shown to be uninfected. Bacterial and white cell counts on the first urine specimen to be examined from each infant are reported, comprising 363 specimens (188 from boys, 177 from girls) collected into plastic bags and 229 specimens (116 from boys, 113 from girls) collected by a clean catch technique. Bag specimens contained 5 white cells per mm3 or less in 98% of boys but in only 56% of girls, in whom 11% contained more than 100 white cells per mm3. Clean catch specimens contained up to 5 white cells per mm3 in 97% of boys and 94% of girls, suggesting perineal contamination in girls to be the cause of the higher white cell counts in urine collected into plastic bags. Total bacterial counts of 10,000 colonies per ml or less were obtained from bag urines in 41% of both boys and girls and from midstream urines of 73% of boys and 77% of girls. Midstream specimens were significantly better than bag specimens for purposes of culture. Examination of voided urine specimens from newborns allows infection to be excluded in approximately 45% of infants if only one bag specimen is examined and in approximately 75% if a single midstream specimen is obtained. Even bag specimens are therefore not without value. Suprapubic aspiration should be reserved for infants where difficulty arises due to repeated equivocal results from voided urines, when urgent confirmation is required, or when the presence of perineal lesions makes suitable voided urine collection impracticable. PMID:5576025

  11. Topical anaesthesia for needle-related pain in newborn infants.

    PubMed

    Foster, Jann P; Taylor, Christine; Spence, Kaye

    2017-02-04

    Hospitalised newborn neonates frequently undergo painful invasive procedures that involve penetration of the skin and other tissues by a needle. One intervention that can be used prior to a needle insertion procedure is application of a topical local anaesthetic. To evaluate the efficacy and safety of topical anaesthetics such as amethocaine and EMLA in newborn term or preterm infants requiring an invasive procedure involving puncture of skin and other tissues with a needle. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase and CINAHL up to 15 May 2016; previous reviews including cross-references, abstracts, and conference proceedings. We contacted expert informants. We contacted authors directly to obtain additional data. We imposed no language restrictions. Randomised, quasi-randomised controlled trials, and cluster and cross-over randomised trials that compared the topical anaesthetics amethocaine and eutectic mixture of local anaesthetics (EMLA) in terms of anaesthetic efficacy and safety in newborn term or preterm infants requiring an invasive procedure involving puncture of skin and other tissues with a needle DATA COLLECTION AND ANALYSIS: From the reports of the clinical trials we extracted data regarding clinical outcomes including pain, number of infants with methaemoglobin level 5% and above, number of needle prick attempts prior to successful needle-related procedure, crying, time taken to complete the procedure, episodes of apnoea, episodes of bradycardia, episodes of oxygen desaturation, neurodevelopmental disability and other adverse events. Eight small randomised controlled trials met the inclusion criteria (n = 506). These studies compared either EMLA and placebo or amethocaine and placebo. No studies compared EMLA and amethocaine. We were unable to meta-analyse the outcome of pain due to differing outcome measures and methods of reporting. For EMLA, two individual studies reported a statistically significant

  12. Physical therapy with newborns and infants: applying concepts of phenomenology and synactive theory to guide interventions.

    PubMed

    Blanchard, Yvette; Øberg, Gunn Kristin

    2015-01-01

    Physical therapy involving newborns and young infants is a specialized area of practice reserved for therapists who have advanced training and the competence to help newborns, young infants and their families meet their goals. Beginning at birth, infants apply a significant amount of effort to actively participate in and shape their world. Infants make their intentions and requests for support known through their behaviors during social and physical therapy encounters. The therapeutic encounter viewed from the infant's perspective has received limited attention in the physical therapy literature. The purpose of this article is to discuss concepts related to phenomenology and synactive theory that are relevant to physical therapy with newborns and young infants during the first few months of life after birth.

  13. Predictors and consequences of in-hospital formula supplementation for healthy breastfeeding newborns.

    PubMed

    Parry, Jane E; Ip, Dennis K M; Chau, Patsy Y K; Wu, Kendra M; Tarrant, Marie

    2013-11-01

    Although exclusive breastfeeding is recommended for the first 6 months, the use of breast milk substitutes is widespread around the world. To describe the patterns of infant formula supplementation among healthy breastfeeding newborns, to identify factors contributing to in-hospital formula supplementation, and to assess the dose-response relationship between the amount of in-hospital formula supplementation and the duration of any breastfeeding. A sample of 1246 breastfeeding mother-infant pairs was recruited from 4 public hospitals in Hong Kong and followed prospectively for 12 months or until weaned. Multiple logistic regression analysis was used to examine factors associated with in-hospital supplementation. Cox regression analysis was used to explore the impact of in-hospital supplementation on breastfeeding duration. Of the total, 82.5% of newborns were supplemented in the hospital; one-half received formula within 5 hours of birth. Assisted vaginal delivery (odds ratio [OR] = 2.06, 95% confidence interval [CI] 1.03, 4.15), cesarean section (OR = 3.45, 95% CI 1.75, 6.80), and higher birth weight (OR = 1.56, 95% CI 1.12, 2.18) were positively associated with in-hospital formula supplementation, whereas initiating breastfeeding in the delivery room (OR = 0.55, 95% CI 0.33, 0.89) was associated with decreased likelihood of in-hospital supplementation. Any infant formula in the first 48 hours was associated with a shorter duration of breastfeeding (hazard ratio [HR] = 1.51, 95% CI 1.27, 1.80), but there was no dose-response effect. In-hospital formula supplementation is common in Hong Kong hospitals and appears to be detrimental to breastfeeding duration. Continued efforts should be made to avoid the provision of infant formula to breastfeeding babies while in the hospital unless medically indicated.

  14. Acceptance of two liquid vitamin D₃ formulations among mothers with newborn infants: a randomized, single-blind trial.

    PubMed

    Lava, Sebastiano A G; Caccia, Giorgio; Osmetti-Gianini, Silvia; Simonetti, Giacomo D; Milani, Gregorio P; Falesi, Mattia; Bianchetti, Mario G

    2011-12-01

    In Switzerland, children are prescribed 7.5-12.5 μg per day of vitamin D(3) dissolved in alcohol, but many families do not adhere to the recommendation. The aim of the trial was to compare the acceptance of vitamin D(3) dissolved in alcohol or in medium-chain triglycerides among mothers of Swiss newborn infants. The acceptance was tested in 42 healthy newborn infants (20 girls and 22 boys) aged between 2 and 7 days. Their neonatal body weight ranged between 2.225 and 4.150 kg, and the gestational age between 36 1/7 and 41 3/7 weeks. The blinded mothers rated the facial reaction of their children by pointing on a facial hedonic scale. Thirty eight of the 41 mothers, who brought the comparison to completion, assigned a better score to the oily preparation with no difference in the remaining three cases (P < 0.0001). The acceptance for the oily preparation was significantly better both among mothers whose babies were initially presented the alcoholic preparation and among mothers whose babies were initially presented the oily preparation. Furthermore, the acceptance for the oily preparation was better irrespective of gender of the infant or parity of the mother. In conclusion, from the perspective of mothers, Swiss newborn infants prefer the taste of the oily vitamin D(3) preparation over the alcoholic preparation.

  15. Imitation in Newborn Infants: Exploring the Range of Gestures Imitated and the Underlying Mechanisms.

    ERIC Educational Resources Information Center

    Meltzoff, Andrew N.; Moore, M. Keith

    1989-01-01

    Evaluated psychological mechanisms underlying imitation of facial actions in 40 newborn infants. Results showed imitation of head movement and a tongue-protrusion gesture. Subjects imitated from memory after displays had stopped. (RJC)

  16. Imitation in Newborn Infants: Exploring the Range of Gestures Imitated and the Underlying Mechanisms.

    ERIC Educational Resources Information Center

    Meltzoff, Andrew N.; Moore, M. Keith

    1989-01-01

    Evaluated psychological mechanisms underlying imitation of facial actions in 40 newborn infants. Results showed imitation of head movement and a tongue-protrusion gesture. Subjects imitated from memory after displays had stopped. (RJC)

  17. Neurobehaviors of Japanese Newborns in Relation to the Characteristics of Early Mother-Infant Interaction

    ERIC Educational Resources Information Center

    Loo, Kek Khee; Ohgi, Shohei; Howard, Judy; Tyler, Rachelle; Hirose, Taiko

    2005-01-01

    The authors examined the relationship between newborn neurobehavioral profiles and the characteristics of early mother-infant interaction in Nagasaki, Japan. The authors administered the Brazelton Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent, 1995) in the newborn period and the Nursing Child Assessment Teaching…

  18. Neurobehaviors of Japanese Newborns in Relation to the Characteristics of Early Mother-Infant Interaction

    ERIC Educational Resources Information Center

    Loo, Kek Khee; Ohgi, Shohei; Howard, Judy; Tyler, Rachelle; Hirose, Taiko

    2005-01-01

    The authors examined the relationship between newborn neurobehavioral profiles and the characteristics of early mother-infant interaction in Nagasaki, Japan. The authors administered the Brazelton Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent, 1995) in the newborn period and the Nursing Child Assessment Teaching…

  19. Differential neutrophil chemotactic response towards IL-8 and bacterial N-formyl peptides in term newborn infants

    PubMed Central

    Stålhammar, Maria E.; Douhan Håkansson, Lena; Jonzon, Anders; Sindelar, Richard

    2017-01-01

    Background A prerequisite for an effective innate immunity is the migrative ability of neutrophils to respond to inflammatory and infectious agents such as the intermediate interleukin (IL)-8 and the end-target formyl-methionyl-leucyl-phenylalanine (fMLP) chemoattractants. The aim was to study the chemotactic capacity of neutrophils from newborn infants and adults in response to IL-8 and the bacterial peptide fMLP. Methods In the under-agarose cell migration assay, isolated leukocytes from healthy adults and from cord blood of healthy term newborn infants were studied with dose responses towards IL-8 and fMLP. The same number of leukocytes (1 × 105 cells), with the same distribution of neutrophils and monocytes, were analyzed in neonates and adults. Chemotaxis was distinguished from randomly migrating neutrophils, and the neutrophil pattern of migration, i.e. the migration distance and the number of migrating neutrophils per distance, was evaluated. Results In comparison to adults, fewer neutrophils from newborn infants migrated towards IL-8 and for a shorter distance (P < .01, respectively). The number of neutrophils migrating to different gradients of fMLP, the distance they migrated, and the correlation between the number and the distance were the same for neonates and adults. Random migration did not differ in any instance. Conclusion Chemotaxis of neutrophils from newborn infants was as co-ordinated as neutrophils from adults in response to fMLP, whereas the response to IL-8 was reduced. The differential response of neutrophils from neonates to intermediate and end-target chemoattractants could indicate a reduced infectious response. PMID:27690722

  20. Frenotomy for tongue-tie in newborn infants.

    PubMed

    O'Shea, Joyce E; Foster, Jann P; O'Donnell, Colm Pf; Breathnach, Deirdre; Jacobs, Susan E; Todd, David A; Davis, Peter G

    2017-03-11

    Tongue-tie, or ankyloglossia, is a condition whereby the lingual frenulum attaches near the tip of the tongue and may be short, tight and thick. Tongue-tie is present in 4% to 11% of newborns. Tongue-tie has been cited as a cause of poor breastfeeding and maternal nipple pain. Frenotomy, which is commonly performed, may correct the restriction to tongue movement and allow more effective breastfeeding with less maternal nipple pain. To determine whether frenotomy is safe and effective in improving ability to feed orally among infants younger than three months of age with tongue-tie (and problems feeding).Also, to perform subgroup analysis to determine the following.• Severity of tongue-tie before frenotomy as measured by a validated tool (e.g. Hazelbaker Assessment Tool for Lingual Frenulum Function (ATLFF) scores < 11; scores ≥ 11) (Hazelbaker 1993).• Gestational age at birth (< 37 weeks' gestation; 37 weeks' gestation and above).• Method of feeding (breast or bottle).• Age at frenotomy (≤ 10 days of age; > 10 days to three months of age).• Severity of feeding difficulty (infants with feeding difficulty affecting weight gain (as assessed by infant's not regaining birth weight by day 14 or falling off centiles); infants with symptomatic feeding difficulty but thriving (greater than birth weight by day 14 and tracking centiles). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and CINAHL up to January 2017, as well as previous reviews including cross-references, expert informants and journal handsearching. We searched clinical trials databases for ongoing and recently completed trials. We applied no language restrictions. Randomised, quasi-randomised controlled trials or cluster-randomised trials that compared frenotomy versus no frenotomy or frenotomy versus sham procedure in newborn infants. Review authors extracted from the reports of clinical trials data regarding clinical outcomes including infant feeding

  1. Evaluations of diapers containing absorbent gelling material with conventional disposable diapers in newborn infants.

    PubMed

    Lane, A T; Rehder, P A; Helm, K

    1990-03-01

    We evaluated 149 infants diapered in either conventional cellulose core disposable diapers or diapers containing cellulose core with absorbent gelling material. The infants were evaluated from 1 day of age to 14 weeks of age for the prevalence and severity of diaper dermatitis. We identified a low prevalence of diaper dermatitis throughout the study period. At 14 weeks of age, we noted that infants in diapers containing absorbent gelling material had significantly less diaper dermatitis than those in conventional disposable diapers. Despite the overall low prevalence of diaper dermatitis in the newborn period, 7 of 204 infants evaluated had small skin erosions in the diaper area noted within the first 4 days of age. Both diaper types were associated with infants with erosions. This surprisingly high incidence of erosions in newborn infants suggests previously undocumented increased skin fragility of full-term infants.

  2. [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.

  3. Tumor-Associated and Disease-Associated Autoantibody Repertoires in Healthy Colostrum and Maternal and Newborn Cord Sera

    PubMed Central

    Madi, Asaf; Bransburg-Zabary, Sharron; Maayan-Metzger, Ayala; Dar, Gittit; Ben-Jacob, Eshel

    2015-01-01

    In this work, we studied autoantibody repertoires and Ig isotypes in 71 mothers and their 104 healthy newborns (including twins and triplets delivered term or premature). Newborns receive maternal IgG Abs via the placenta before birth, but developing infants must produce their own IgM and IgA Abs. We used an Ag microarray analysis to detect binding to a selection of 295 self-Ags, compared with 27 standard foreign Ags. The magnitude of binding to specific self-Ags was found to be not less than that to the foreign Ags. As expected, each newborn shared with its mother a similar IgG repertoire—manifest as early as the 24th week of gestation. IgM and IgA autoantibody repertoires in cord sera were highly correlated among the newborns and differed from their mothers’ repertoires; the latter differed in sera and milk. The autoantibodies bound to self-Ags known to be associated with tumors and to autoimmune diseases. Thus, autoantibody repertoires in healthy humans—the immunological homunculus—arise congenitally, differ in maternal milk and sera, and mark the potential of the immune system to attack tumors, beneficially, or healthy tissues, harmfully; regulation of the tissue site, the dynamics, and the response phenotype of homuncular autoimmunity very likely affects health. PMID:25917091

  4. Favorable outcome in cerebral abscesses caused by Citrobacter koseri in a newborn infant.

    PubMed

    Algubaisi, Sarah; Bührer, Christoph; Thomale, Ulrich-Wilhelm; Spors, Birgit

    2015-01-01

    The treatment of brain abscesses in newborn infants is controversial. We report on a 6-week-old infant with multiple brain abscesses caused by Citrobacter koseri that resolved after treatment with combined surgical drainage and intravenous therapy with meropenem and fosfomycin.

  5. 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.

  6. 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

  7. Fathers' care of the newborn infant after caesarean section in Chile: A qualitative study.

    PubMed

    Ayala, Ana; Christensson, Kyllike; Velandia, Marianne; Erlandsson, Kerstin

    2016-06-01

    In Chilean hospitals the current model of care after caesarean section is to separate newborn infants from both parents. The care of newborn infants and the parents' experience immediately after caesarean section requires further exploration. To describe fathers' experiences and perceptions of being the primary caregiver to their newborn infant during the first 90 minutes after caesarean section in a public general maternity hospital setting in Santiago de Chile. The questionnaire was one part of a larger research programme named: "Caregiving Models after Elective Caesarean Section - Parents' perceptions and effects on infants' wellbeing". Four open ended questions were used to gather written text on the experiences and perceptions of 95 fathers who were the primary caregiver to their newborn infant. Ethical approval was obtained from the Ethics Committee, Scientific Assessment Metropolitan Health Service South East. Systematic text condensation according to Malterud's description was used for analysis of the written text. Two themes were identified: "understanding the first moment of life" and "shared responsibility for future family life" with each theme divided into six categories. This study concludes by arguing that in situations where the mother is unavailable or unable to provide basic care, the father should be supported to care for the newborn infant. Parents should be made aware of the benefits of this caring model especially when mother and baby have been separated after birth. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. 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.

  9. Birth-related retinal hemorrhages in healthy full-term newborns and their relationship to maternal, obstetric, and neonatal risk factors.

    PubMed

    Zhao, Qi; Zhang, Yanli; Yang, Yu; Li, Zijing; Lin, Yu; Liu, Ran; Wei, Chunyi; Ding, Xiaoyan

    2015-07-01

    The purpose was to explore underlying maternal, obstetric, and neonatal risk factors of retinal hemorrhages (RH) in healthy full-term newborns. A total of 1199 full-term infants, with gestational age more than 37 weeks and Apgar score of 7 or above, were included in this study. Infants with severe systemic diseases or any other eye diseases were excluded. Eye examinations with RetCamIII within 1 week of birth were performed in all infants. Maternal, obstetric, and neonatal parameters were analyzed and compared between newborns with RH and those without RH. RH was seen in 294 of the 1199 infants (24.5 %) in this study. Among factors examined in the study, spontaneous vaginal delivery (SVD) (odds ratio [OR] =3.811 [95 % CI2.649-5.483], P < 0.001) and cephalhematoma (OR = 1.823 [95 % CI1.009-3.296], P = 0.047) correlated positively with RH occurrence in newborns, while a history of cesarean delivery correlated negatively with RH occurrence (OR = 0.296 [95 % CI0.139-0.630], P = 0.002). There was no statistical correlation found between RH and the other risk factors examined in this study. These factors included gender, gestational age, birth weight, maternal age, volume, and turbidity of amniotic fluid, duration of the first or second stage of labor, anemia, hypertensive disorders complicating pregnancy (HDCP), fetal distress, intracranial hemorrhage, and neonatal hyperbilirubinemia. RH is common in full-term newborns. A lower prevalence of newborn RH was found in infants delivered by mothers with a history of cesarean delivery. In contrast, SVD and cephalhematoma were found to be potential risk factors for the development of newborn RH in full-term infants. Infants with these risk factors may, therefore, require greater attention in regard to RH development.

  10. 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.

  11. Atypical acute respiratory disorder in late preterm and term newborn infants.

    PubMed

    Lee, Seung Hyun; Choi, Chang Won; Oh, Yeon Kyun; Kim, Beyong Il

    2016-01-01

    We were to describe the clinical characteristics of late preterm and term newborn infants who needed invasive or non-invasive ventilation for respiratory distress but did not meet the diagnostic criteria of common neonatal respiratory disorders (atypical acute respiratory disorder; aRD). We retrospectively reviewed electronic medical records of 242 late preterm and term newborn infants born who were admitted to the neonatal intensive care unit for acute respiratory distress developed within 24 h after birth. Newborn infants with aRD had significantly higher mean, maximum blood PCO2 levels and maximum FiO2 levels during the first 72 h after birth than infants with transient tachypnea of the newborn (TTN). Total periods of oxygen supplementation of the infants with aRD were significantly longer than those of infants with TTN, but shorter than those of the infants with meconium aspiration syndrome (MAS). Except for definite diagnosis, higher oxygen need and PCO2 level on blood gas analysis during the initial period of their respiratory illness may be able to predict aRD, and these interventions may be able to decrease neonatal respiratory morbidity.

  12. Salivary and serum cortisol levels in newborn infants.

    PubMed

    Forclaz, María V; Moratto, Eduardo; Pennisi, Alicia; Falco, Silvina; Olsen, Graciela; Rodríguez, Patricia; Papazian, Regina; Bergadá, Ignacio

    2017-06-01

    Given that serum cortisol level interpretation in newborn infants (NBIs) is hard, the objective of this study was to correlate baseline salivary and serum cortisol levels and to describe salivary cortisol levels in the first month of life. Descriptive, prospective, longitudinal, and correlational study. Term NBIs were selected from the Division of Neonatology of Hospital Nacional Profesor Alejandro Posadas in 2014. Cortisol was measured in saliva specimens while cortisol, cortisol-binding globulin, and albumin were measured in blood specimens. A linear correlation was performed to relate serum and salivary cortisol levels; Friedman test was conducted to compare cortisol levels during the first month of life, and the difference was used to analyze the performance of values equal to or lower than the first quartile. Fifty-five NBIs were studied. Serum cortisol: 7.65 (1.0-18.1 gg/dL); salivary cortisol: 35.88 (5.52-107.64 mmol/L); cortisol-binding globulin: 22.07 (16.5-33.0 gg/mL), expressed as median and range. The correlation coefficient between serum and salivary cortisol was 0.54, P = 0.001. Cortisol performance during the first month of life showed no statistically significant differences, and the difference between the second and the first specimen of values equal to or lower than the first quartile increased in 10 out of 12 patients. The measurement of cortisol in saliva reflects serum cortisol levels in normal NBIs. Some patients had low levels of cortisol at 36 hours of life and showed a trend towards a spontaneous increase during the first month of life.

  13. Cesarean delivery and hematopoietic stem cell epigenetics in the newborn infant: implications for future health?

    PubMed

    Almgren, Malin; Schlinzig, Titus; Gomez-Cabrero, David; Gunnar, Agneta; Sundin, Mikael; Johansson, Stefan; Norman, Mikael; Ekström, Tomas J

    2014-11-01

    Cesarean section (CS) has been associated with a greater risk for asthma, diabetes, and cancer later in life. Although elective CS continues to rise, it is unclear whether and how it may contribute to compromised future health. Our aim was to investigate the influence of mode of delivery on the epigenetic state in neonatal hematopoietic stem cells. This was an observational study of 64 healthy, singleton, newborn infants (33 boys) born at term. Cord blood was sampled after elective CS (n = 27) and vaginal delivery. Global deoxyribonucleic acid (DNA) methylation in hematopoietic stem cells (CD34+) was determined by luminometric methylation assay, and genome-wide, locus-specific DNA methylation analysis was performed by Illumina Infinium 450K (Illumina, San Diego, CA), validated by bisulfite-pyrosequencing. CD34+ cells from infants delivered by CS were globally more DNA methylated (+2%) than DNA from infants delivered vaginally (P = .02). In relation to mode of delivery, a locus-specific analysis identified 343 loci with a difference in DNA methylation of 10% or greater (P < .01). A majority of the differentially methylated loci in neonatal CD34+ cells (76%) were found to be hypermethylated after vaginal delivery. In these infants, the degree of DNA methylation in 3 loci correlated to the duration of labor. The functional relevance of differentially methylated loci involved processes such as immunoglobulin biosynthetic process, regulation of glycolysis and ketone metabolism, and regulation of the response to food. A possible interpretation is that mode of delivery affects the epigenetic state of neonatal hematopoietic stem cells. Given the functional relevance indicated, our findings may have important implications for health and disease in later life. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. A dynamical system analysis of the development of spontaneous lower extremity movements in newborn and young infants.

    PubMed

    Gima, Hirotaka; Ohgi, Shohei; Morita, Satoru; Karasuno, Hiroshi; Fujiwara, Takayuki; Abe, Koji

    2011-01-01

    This study's aim was to evaluate the characteristics of newborn and young infants' spontaneous lower extremity movements by using dynamical systems analysis. Participants were 8 healthy full-term newborn infants (3 boys, 5 girls, mean birth weight and gestational age were 3070.6 g and 39 weeks). A tri-axial accelerometer measured limb movement acceleration in 3-dimensional space. Movement acceleration signals were recorded during 200 s from just below the ankle when the infant was in an active alert state and lying supine (sampling rate 200 Hz). Data were analyzed linearly and nonlinearly. As a result, the optimal embedding dimension showed more than 5 at all times. Time dependent changes started at 6 or 7, and over the next four months decreased to 5 and from 6 months old, increased. The maximal Lyapnov exponent was positive for all segments. The mutual information is at its greatest range at 0 months. Between 3 and 4 months the range in results is narrowest and lowest in value. The mean coefficient of correlation for the x-axis component was negative and y-axis component changed to a positive value between 1 month old and 4 months old. Nonlinear time series analysis suggested that newborn and young infants' spontaneous lower extremity movements are characterized by a nonlinear chaotic dynamics with 5 to 7 embedding dimensions. Developmental changes of an optimal embedding dimension showed a U-shaped phenomenon. In addition, the maximal Lyapnov exponents were positive for all segments (0.79-2.99). Infants' spontaneous movement involves chaotic dynamic systems that are capable of generating voluntary skill movements.

  15. Penile length, digit length, and anogenital distance according to birth weight in newborn male infants.

    PubMed

    Park, Jae Young; Lim, Gina; Oh, Ki Won; Ryu, Dong Soo; Park, Seonghun; Jeon, Jong Chul; Cheon, Sang Hyeon; Moon, Kyung Hyun; Park, Sejun; Park, Sungchan

    2015-03-01

    Anogential distance (AGD) and the 2:4 digit length ratio appear to provide a reliable guide to fetal androgen exposure. We intended to investigate the current status of penile size and the relationship between penile length and AGD or digit length according to birth weight in Korean newborn infants. Between May 2013 and February 2014, among a total of 78 newborn male infants, 55 infants were prospectively included in this study. Newborn male infants with a gestational age of 38 to 42 weeks and birth weight>2.5 kg were assigned to the NW group (n=24) and those with a gestational age<38 weeks and birth weight<2.5 kg were assigned to the LW group (n=31). Penile size and other variables were compared between the two groups. Stretched penile length of the NW group was 3.3 ± 0.2 cm, which did not differ significantly from that reported in 1987. All parameters including height, weight, penile length, testicular size, AGD, and digit length were significantly lower in the LW group than in the NW group. However, there were no significant differences in AGD ratio or 2:4 digit length ratio between the two groups. The penile length of newborn infants has not changed over the last quarter century in Korea. With normal penile appearance, the AGD ratio and 2:4 digit length ratio are consistent irrespective of birth weight, whereas AGD, digit length, and penile length are significantly smaller in newborns with low birth weight.

  16. Body fat differences by self-reported race/ethnicity in healthy term newborns.

    PubMed

    Paley, C; Hull, H; Ji, Y; Toro-Ramos, T; Thornton, J; Bauer, J; Matthews, P; Yu, A; Navder, K; Dorsey, K; Gallagher, D

    2016-10-01

    Ethnic differences in total body fat (fat mass [FM]) have been reported in adults and children, but the timing of when these differences manifest and whether they are present at birth are unknown. This study aimed to assess whether ethnic differences in body fat are present at birth in healthy infants born at term, where body fat is measured using air displacement plethysmography and fat distribution by skin-fold thickness. Data were from a multiracial cross-sectional convenience sample of 332 term infants from four racial or ethnic groups based on maternal self-report (A, Asian; AA, non-Hispanic Black [African-American]; C, non-Hispanic White; and H, Hispanic). The main outcome measure was infant body fat at 1-3 days after birth, with age, birth weight, gestational age and maternal pre-pregnancy weight as covariates. Significant effects for race (P = 0.0011), sex (P = 0.0051) and a race by sex interaction (P = 0.0236) were found. C females had higher FM than C males (P = 0.0001), and AA females had higher FM than AA males (P = 0.0205). C males had less FM than A males (P = 0.0353) and H males (P = 0.0001). Race/ethnic and sex differences in FM are present in healthy term newborns. Although the implications of these differences are unclear, studies beginning in utero and birth set the stage for a life course approach to understanding disease later in life. © 2015 World Obesity.

  17. Laboratory methods for early detection of human immunodeficiency virus type 1 in newborns and infants.

    PubMed Central

    Sison, A V; Campos, J M

    1992-01-01

    Cumulative data on serological testing of newborns and infants have shown that (i) maternal and newborn anti-HIV-1 IgG titers are high at delivery, which may explain the persistence of antibody in the infants of seropositive mothers; (ii) in some situations, serial HIV-1 antibody testing may identify infected infants; and (iii) detection of anti-HIV-1 IgA or IgM is specific for infection but the sensitivity of this assay may be compromised in certain situations, such as when infected infants are hypogammaglobulinemic or when the rise and fall of HIV-1-specific IgM synthesis following acute infection has been completed before delivery of the infant. Cumulative data on PCR, viral culture, and tests for antigen in newborns and infants have shown that (i) among all age groups, viral culture is probably the most specific test available for detection of HIV-1, as PCR and the p24 antigen test may (though rarely) give false-positive results; (ii) the sensitivity of these tests increases in the order of antigen, culture, and PCR, with relatively insensitive results in the first 3 months of life for all of these tests; (iii) the sensitivity of all of these tests improves and approximates 90 to 100% when infants over 6 months of age are tested; and (iv) data regarding the sensitivity, specificity, and usefulness of these virological assays in infants under 3 months of age are very scant and inconclusive. PMID:1498766

  18. Effects of Fructans from Mexican Agave in Newborns Fed with Infant Formula: A Randomized Controlled Trial.

    PubMed

    López-Velázquez, Gabriel; Parra-Ortiz, Minerva; Mora, Ignacio De la Mora-De la; García-Torres, Itzhel; Enríquez-Flores, Sergio; Alcántara-Ortigoza, Miguel Angel; Angel, Ariadna González-Del; Velázquez-Aragón, José; Ortiz-Hernández, Rosario; Cruz-Rubio, José Manuel; Villa-Barragán, Pablo; Jiménez-Gutiérrez, Carlos; Gutiérrez-Castrellón, Pedro

    2015-10-29

    The importance of prebiotics consumption is increasing all over the world due to their beneficial effects on health. Production of better prebiotics from endemic plants raises possibilities to enhance nutritional effects in vulnerable population groups. Fructans derived from Agave Plant have demonstrated their safety and efficacy as prebiotics in animal models. Recently, the safety in humans of two fructans obtained from Agave tequilana (Metlin(®) and Metlos(®)) was demonstrated. This study aimed to demonstrate the efficacy as prebiotics of Metlin(®) and Metlos(®) in newborns of a randomized, double blind, controlled trial with a pilot study design. Biological samples were taken at 20 ± 7 days, and three months of age from healthy babies. Outcomes of efficacy include impact on immune response, serum ferritin, C-reactive protein, bone metabolism, and gut bacteria changes. There were differences statistically significant for the groups of infants fed only with infant formula and with formula enriched with Metlin(®) and Metlos(®). Our results support the efficacy of Metlin(®) and Metlos(®) as prebiotics in humans, and stand the bases to recommend their consumption. ClinicalTrials.gov, NCT 01251783.

  19. Effects of Fructans from Mexican Agave in Newborns Fed with Infant Formula: A Randomized Controlled Trial

    PubMed Central

    López-Velázquez, Gabriel; Parra-Ortiz, Minerva; De la Mora-De la Mora, Ignacio; García-Torres, Itzhel; Enríquez-Flores, Sergio; Alcántara-Ortigoza, Miguel Angel; González-del Angel, Ariadna; Velázquez-Aragón, José; Ortiz-Hernández, Rosario; Cruz-Rubio, José Manuel; Villa-Barragán, Pablo; Jiménez-Gutiérrez, Carlos; Gutiérrez-Castrellón, Pedro

    2015-01-01

    Background: The importance of prebiotics consumption is increasing all over the world due to their beneficial effects on health. Production of better prebiotics from endemic plants raises possibilities to enhance nutritional effects in vulnerable population groups. Fructans derived from Agave Plant have demonstrated their safety and efficacy as prebiotics in animal models. Recently, the safety in humans of two fructans obtained from Agave tequilana (Metlin® and Metlos®) was demonstrated. Methods: This study aimed to demonstrate the efficacy as prebiotics of Metlin® and Metlos® in newborns of a randomized, double blind, controlled trial with a pilot study design. Biological samples were taken at 20 ± 7 days, and three months of age from healthy babies. Outcomes of efficacy include impact on immune response, serum ferritin, C-reactive protein, bone metabolism, and gut bacteria changes. Results: There were differences statistically significant for the groups of infants fed only with infant formula and with formula enriched with Metlin® and Metlos®. Conclusions: Our results support the efficacy of Metlin® and Metlos® as prebiotics in humans, and stand the bases to recommend their consumption. Trial Registration: ClinicalTrials.gov, NCT 01251783. PMID:26529006

  20. Imaging in the newborn: infant immobilizer obviates the need for anesthesia.

    PubMed

    Golan, Agneta; Marco, Rina; Raz, Hagit; Shany, Eilon

    2011-11-01

    Neonatal cerebral imaging is a sensitive technique for evaluating brain injury in the neonatal period. When performing computed tomography or magnetic resonance imaging, sedation is needed to prevent motion artifacts. However, general anesthesia in neonates carries significant risks and requires a complex logistic approach that often limits the use of these modalities. The development of infant immobilizers now enables imaging without general anesthesia and significantly increases clinical and research investigational opportunities. To assess the efficacy of the infant immobilizer instead of general anesthesia for infants undergoing imaging. The study group comprised all infants born over a 1 year period at Soroka University Medical Center who required imaging such as MRI, CT or bone scans. A MedVac Vacuum Splint infant immobilizer was used in all infants to prevent motion during imaging. The success rate of a single scan and the need for general anesthesia were assessed. Forty infants were examined during 1 year. The studies included 15 CT scans, 25 MRIs and 1 bone scan. The infants' gestational age at birth was 27-40 weeks and the examinations were performed at ages ranging from delivery to 6 months old. All imaging was successful and none of the infants required general anesthesia. An infant immobilizer should be used for imaging of newborns. Since this method carries a low risk and has a high success rate, general anesthesia in newborns is justified only when this non-invasive procedure fails.

  1. NORMATIVE STANDARDS AND PATTERNING OF FAT AND MUSCLE IN WHITE AND BLACK NEWBORN INFANTS

    PubMed Central

    Brandt, Jon M.; Allen, G. Andrew; Butler, Merlin G.

    2014-01-01

    Due to the lack of normative data in newborns, we report fat and muscle patterning, and standards for the sums of fat and muscle areas and muscle circumferences for arm, forearm, thigh, and calf in white and black newborn infants that may have clinical application in the assessment of body composition in newborns. Significant differences were found between white males and white females in fatness patterning: white female newborns were larger for all 21 variables except height. Statistically significant differences (t test; p < 0.05) existed for five skinfold measurements (forearm, subscapular, suprailiac, thigh, medial calf), three limb fat areas (forearm, thigh, calf), and the sums of the skinfolds and fat areas despite similar limb circumferences. Black female newborns were larger than black males for five of the eight skinfolds (with a significant difference observed in medial calf skinfold), for all of the limb fat areas, and for the sums of the skinfolds and fat areas. Despite their larger skinfolds and fat areas, black females had smaller circumferences. No sex-related trends or significantly different variables were observed in the muscle patterning of white infants. Differences in muscle patterning were observed between black males and black females, with males having larger values for all 14 variables. Statistically significant differences were found between white and black infants, with white newborns having greater height, medial calf skinfold, and calf fat area. PMID:25505363

  2. Hyperinsulinism associated with gestational exposure to bupropion in a newborn infant.

    PubMed

    Gisslen, Tate; Nathan, Brandon; Thompson, Theodore; Rao, Raghavendra

    2011-01-01

    This case report describes severe hyperinsulinism in a term newborn infant without typical perinatal risk factors for transient hyperinsulinism. The mother had received bupropion, an antidepressant and aid to smoking cessation, throughout pregnancy. The infant presented with profound hypoglycemia and seizures on the 3rd day of life. Laboratory investigation confirmed hyperinsulinism. Stable euglycemia could be achieved only after starting diazoxide. The infant was weaned from diazoxide by 10 weeks of age without recurrence of hypoglycemia, signifying the transient nature of hyperinsulinism. This is the first reported case of a potential association between maternal bupropion use during pregnancy and neonatal hyperinsulinism, and highlights the importance of close monitoring of similar infants.

  3. Clinical presentation and spectrum of neuroimaging findings in newborn infants with incontinentia pigmenti.

    PubMed

    Soltirovska Salamon, Aneta; Lichtenbelt, Klaske; Cowan, Frances M; Casaer, Alexandra; Dudink, Jeroen; Dereymaeker, Anneleen; Paro-Panjan, Darja; Groenendaal, Floris; de Vries, Linda S

    2016-10-01

    To report on the neurological presentation and neuroimaging findings in newborn infants with incontinentia pigmenti. The clinical and neurological course including neuroimaging and follow-up data of eight newborn infants with the neurological phenotype of incontinentia pigmenti were retrospectively reviewed. While the clinical picture was polymorphic, the neurological manifestations were defined as encephalopathic and comprised lethargy and seizures in all but one of the infants. Magnetic resonance imaging (MRI) abnormalities were predominantly in the white matter. Diffusion-weighted imaging (DWI) was obtained during the acute phase in seven of the eight infants, showing restricted diffusion in the deep and subcortical white matter but also in the corpus callosum, basal ganglia, thalami, cerebellum, and cerebral peduncles. Susceptibility-weighted imaging (SWI), performed in five infants, showed a variable amount of signal loss, mainly in the white matter, within areas of restricted diffusion. Extensive MRI abnormalities in newborn infants were followed by abnormal neurodevelopment, with significant motor, cognitive, and/or visual problems. To assess the extent of central nervous system involvement, MRI is recommended in the clinical evaluation of infants with incontinentia pigmenti. They have a characteristic pattern of brain lesions seen on MRI, best recognized using DWI and SWI in the acute neonatal phase, which allow the identification of and distinction between ischaemic and haemorrhagic lesions. © 2016 Mac Keith Press.

  4. Task-Oriented and Bottle Feeding Adversely Affect the Quality of Mother-Infant Interactions Following Abnormal Newborn Screens

    PubMed Central

    Tluczek, Audrey; Clark, Roseanne; McKechnie, Anne Chevalier; Orland, Kate Murphy; Brown, Roger L.

    2010-01-01

    Objective Examine effects of newborn screening (NBS) and neonatal diagnosis on the quality of mother-infant interactions in the context of feeding. Methods Study compared the quality of mother-infant feeding interactions among four groups of infants classified by severity of NBS and diagnostic results: cystic fibrosis (CF), congenital hypothyroidism, heterozygote CF carrier, and healthy with normal NBS. The Parent-Child Early Relational Assessment and a task-oriented item measured the quality of feeding interactions for 130 dyads, infant ages 3–19 weeks (M=9.19, SD=3.28). The Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory measured maternal depression and anxiety. Results Composite Indicator Structure Equation Modeling showed that infant diagnostic status and, to a lesser extent, maternal education predicted feeding method. Mothers of infants with CF were most likely to bottle feed, which was associated with more task-oriented maternal behavior than breastfeeding. Mothers with low task-oriented behavior showed more sensitivity and responsiveness to infant cues, as well as less negative affect and behavior in their interactions with their infants than mothers with high task-oriented scores. Mothers of infants with CF were significantly more likely to have clinically significant anxiety and depression than the other groups. However, maternal psychological profile did not predict feeding method or interaction quality. Conclusions Mothers in the CF group were the least likely to breastfeed. Research is needed to explicate long-term effects of feeding methods on quality of mother-child relationship and ways to promote continued breastfeeding following a neonatal CF diagnosis. PMID:20495477

  5. Crying Baby: What to Do When Your Newborn Cries

    MedlinePlus

    Healthy Lifestyle Infant and toddler health Newborn crying jags are inevitable. Here's help soothing a crying baby — and ... own can help renew your coping strength. Make healthy lifestyle choices. Eat a healthy diet. Include physical activity ...

  6. [A preliminary study of synchronous evoked potential in newborn-infant auditory and visual function test].

    PubMed

    Zhang, Wei; Qi, Yi-sheng; Han, De-min; Nie, Wen-ying; Lin, Qian; Gong, Lu-xia

    2003-08-25

    The purpose of this study is to bring out the consultable laboratory values of synchronous evoked potential in normal neonates and infants, investigate the characteristic of the electric response waveform, and explore its feasibility on applying to newborn auditory and visual function test as an electric physiology detection method. It was applied to go on measuring 19 cases of mature normal neonate (< or =4 days) and 11 cases of infants (< or =5 months), also comparing with the study of ABRs, FVEPs independently. Get the electric response wave form results of synchronous electric evoked potential in both groups of newborn-infants, through comparing with the result of independent ABRs and FVEPs, the monitoring result demonstrated that there were an extreme significant changes of the corresponding parameters (wave I, III, V latency) (P<0.01), and there were no significant changes of I-III, III-V interwave latency (P>0.05); it also shows that ABRs impact on FVEPs in N2 wave latency of newborn group and P1 wave latency of infant group (P<0.01). Auditory and vision pathway may be had communicated information by the neuron in the center. The technology of the auditory and visual synchronous evoked potential brings out the whole new electric physiology detection tools, it will definitely offer powerful technical support in step for newborn-infant auditory and visual function test.

  7. Abnormal newborn screens and acylcarnitines in HIV-exposed and ARV-exposed infants.

    PubMed

    Kirmse, Brian; Hobbs, Charlotte V; Peter, Inga; Laplante, Bryan; Caggana, Michele; Kloke, Karen; Raymond, Kimiyo; Summar, Marshall; Borkowsky, William

    2013-02-01

    Antiretroviral drugs (ARV), specifically nucleoside analogs, are toxic to mitochondrial oxidative phosphorylation. Other metabolic pathways, such as fatty acid oxidation, organic acid metabolism and amino acid metabolism, are dependent on normal oxidative phosphorylation but remain unexamined as potential points of ARV toxicity. We analyzed newborn screening data from New York and compared proportions of abnormal newborn metabolic screens in HIV antibody screen-positive and HIV screen-negative neonates. Subsequently, we compared acylcarnitine levels in ARV-exposed (n = 16) and ARV-unexposed (n = 14) HIV-exposed infants to assess for dysfunctional fatty and organic acid metabolism. : The rate of abnormal newborn metabolic screens in HIV screen-positive infants was higher than that in the general population (2.2% versus 1.2%; P = 0.00025), most of which were for disorders of mitochondria-related metabolism. Abnormal acylcarnitine levels occurred more frequently in ARV-exposed compared with ARV-unexposed infants (43% versus 0%; P = 0.02). A higher proportion of positive metabolic screens in HIV screen-positive neonates suggests that HIV or ARV exposure is associated with dysfunctional intermediary metabolism in newborns. Abnormal acylcarnitine levels were more frequent in ARV-exposed infants, suggesting that ARV may perturb normal fatty acid oxidation in some infants. Studies designed to validate and determine the clinical significance of these findings are warranted.

  8. [Presence of the rotavirus antigen in newborn infants at maternity hospitals in Moldavia].

    PubMed

    Avram, G; Constantiniu, S; Combiescu, A A; Perşu, A; Mihai, A; Alexandru, D; Macovei, V; Zavate, O

    1988-01-01

    Studies conducted on 417 feces samples collected from newborn infants from seven maternity homes revealed the presence of rotavirus in 1.2 to 9.5% of the subjects. The infants get infection during the first 24 to 48 hours of life (1.8%) and the positivity rate reaches a peak the 7th day (9.7%). Enteroviruses were found in 3.4% and enterobacteria in 11.8% of the samples.

  9. Three-dimensional refractive index tomograms and deformability of individual human red blood cells from cord blood of newborn infants and maternal blood.

    PubMed

    Park, HyunJoo; Ahn, Taegyu; Kim, Kyoohyun; Lee, Sangyun; Kook, Song-Yi; Lee, Dongheon; Suh, In Bum; Na, Sunghun; Park, YongKeun

    2015-01-01

    Red blood cells (RBCs) from the cord blood of newborn infants have distinctive functions in fetal and infant development. To systematically investigate the biophysical characteristics of individual cord RBCs in newborn infants, a comparative study was performed on RBCs from the cord blood of newborn infants and from adult mothers or nonpregnant women using optical holographic microtomography. Optical measurements of the distributions of the three-dimensional refractive indices and the dynamic membrane fluctuations of individual RBCs were used to investigate the morphological, biochemical, and mechanical properties of cord, maternal, and adult RBCs at the individual cell level. The volume and surface area of the cord RBCs were significantly larger than those of the RBCs from nonpregnant women, and the cord RBCs had more flattened shapes than that of the RBCs in adults. In addition, the hemoglobin (Hb) content in the cord RBCs from newborns was significantly higher. The Hb concentration in the cord RBCs was higher than that in the nonpregnant women or maternal RBCs, but they were within the physiological range of adults. Interestingly, the amplitudes of the dynamic membrane fluctuations in cord RBCs were comparable to those in nonpregnant women and maternal RBCs, suggesting that the deformability of cord RBCs is similar to that of healthy RBCs in adults.

  10. Three-dimensional refractive index tomograms and deformability of individual human red blood cells from cord blood of newborn infants and maternal blood

    NASA Astrophysics Data System (ADS)

    Park, HyunJoo; Ahn, Taegyu; Kim, Kyoohyun; Lee, Sangyun; Kook, Song-yi; Lee, Dongheon; Suh, In Bum; Na, Sunghun; Park, YongKeun

    2015-11-01

    Red blood cells (RBCs) from the cord blood of newborn infants have distinctive functions in fetal and infant development. To systematically investigate the biophysical characteristics of individual cord RBCs in newborn infants, a comparative study was performed on RBCs from the cord blood of newborn infants and from adult mothers or nonpregnant women using optical holographic microtomography. Optical measurements of the distributions of the three-dimensional refractive indices and the dynamic membrane fluctuations of individual RBCs were used to investigate the morphological, biochemical, and mechanical properties of cord, maternal, and adult RBCs at the individual cell level. The volume and surface area of the cord RBCs were significantly larger than those of the RBCs from nonpregnant women, and the cord RBCs had more flattened shapes than that of the RBCs in adults. In addition, the hemoglobin (Hb) content in the cord RBCs from newborns was significantly higher. The Hb concentration in the cord RBCs was higher than that in the nonpregnant women or maternal RBCs, but they were within the physiological range of adults. Interestingly, the amplitudes of the dynamic membrane fluctuations in cord RBCs were comparable to those in nonpregnant women and maternal RBCs, suggesting that the deformability of cord RBCs is similar to that of healthy RBCs in adults.

  11. Newborn jaundice

    MedlinePlus

    Jaundice of the newborn; Neonatal hyperbilirubinemia; Bili lights - jaundice; Infant - yellow skin; Newborn - yellow skin ... lasts 1 to 2 days. Sometimes special blue lights are used on infants whose levels are very ...

  12. Maternal prefrontal cortex activation by newborn infant odors.

    PubMed

    Nishitani, Shota; Kuwamoto, Saori; Takahira, Asuka; Miyamura, Tsunetake; Shinohara, Kazuyuki

    2014-03-01

    Mothers are attracted by infant cues of a variety of different modalities. To clarify the possible neural mechanisms underlying maternal attraction to infant odor cues, we used near-infrared spectroscopy to examine prefrontal cortex (PFC) activity during odor detection tasks in which 19 mothers and 19 nulliparous females (nonmothers) were presented with infant or adult male odors. They were instructed to make a judgment about whether they smelled an odor during each task. We estimated the PFC activity by measuring the relative oxyhemoglobin (oxyHb) concentrations. The results showed that while detecting the infant odors, bilateral PFC activities were increased in mothers but not in nonmothers. In contrast, adult male odors activated the PFC similarly in mothers and nonmothers. These findings suggest that maternal activation of the PFC in response to infant odors explains a part of the neural mechanisms for maternal attraction to infant odors.

  13. Postnatal Fetal and Adult Hemoglobin Synthesis in Early Preterm Newborn Infants

    PubMed Central

    Bard, Harry

    1973-01-01

    Studies were carried out during the postnatal period in infants born at or before the 32nd wk of gestation to determine the proportion of fetal hemoglobin (Hb F) and adult hemoglobin (Hb A) being synthesized, and to compare these studies to those previously reported on at birth from normal newborn infants 25-43 wk gestation. When the pretern infants reached the postconceptional age corresponding to term, their Hb A and Hb F synthesis was compared to a group of newborn infants at term. 53 blood samples from 25 preterm and 11 full-term infants were incubated in an amino acid mixture containing [14C]leucine, and column-chromatographed on DEAE-Sephadex for separation of Hb F and Hb A fractions. The completeness of the DEAE-Sephadex separation of Hb F and Hb A was confirmed by globin chain chromatography with the use of carboxymethylcellulose. The rate of transition from Hb F to Hb A synthesis postnatally in the preterm infants resembled that reflecting the in utero transition. At the postconceptional age corresponding to term, there was no difference in the relative amounts of Hb F and Hb A being synthesized by the preterm infants and by the term infants. The birth process did not alter the rate of transition from Hb F to Hb A. PMID:4719660

  14. [Newborn sleep positioners and sudden infant death syndrome risk].

    PubMed

    Rossato, Norma Elena

    2013-01-01

    The rate of sudden infant death decreased after the publication of the first guidelines regarding infant sleep position and safe environment in 1992. From 2005 onwards, infant deaths by suffocation, choking or entrapment have increased. Some of them were associated with wedges, positioning devices, and bumper pads. Media and manufacturers should follow safe sleep guidelines in their messaging and advertising, but there is a lack of control over this. We emphasize the important role of health professionals in disseminating the recommendation for a safe infant sleep environment.

  15. Steroid therapy for meconium aspiration syndrome in newborn infants.

    PubMed

    Ward, M; Sinn, J

    2003-01-01

    Meconium aspiration syndrome may cause severe respiratory distress in the newborn infant, with an associated high morbidity and mortality. A chemical pneumonitis is believed to occur secondary to bile, bile acids and pancreatic secretions contained in meconium. It has therefore been hypothesised that corticosteroids may be of benefit in the management of this condition through their anti-inflammatory properties. The objective of this review was to determine whether steroid therapy for meconium aspiration syndrome decreases the morbidity and mortality associated with this condition without adverse effects. Searches were made of PREMEDLINE and MEDLINE from 1966 to April 2003, CINAHL back to 1982, Current Contents back to 1998, The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2003) and Oxford Database of Perinatal Trials. The search included cross-referencing of previous reviews, and a review of abstracts, conference and symposia proceedings published in Pediatric Research from 1993 to 2003. Randomised controlled trials and quasi-randomised trials comparing steroid treatment to no steroid treatment for neonates with meconium aspiration syndrome were considered for this review. The methodological quality of each trial was assessed independently by each author. Data were extracted, analysed and results reviewed independently by each author. Meta-analysis was performed with RevMan 4.2, using the fixed effects model. Mean difference (MD) and weighted mean differences (WMD) with 95% confidence intervals in brackets for continuous variables and Relative Risk (RR) with 95% confidence intervals for categorical data were reported. Three randomised controlled trials were identified. Two trials, by Wu 1999 (50 participants) and Yeh 1977 (35 participants), were included in the review. The trial by Davey 1995, as yet unpublished, was excluded from this review as insufficient information about methodology and results were available. On

  16. A systematic review of novel technology for monitoring infant and newborn heart rate.

    PubMed

    Kevat, Ajay C; Bullen, Denise V R; Davis, Peter G; Kamlin, C Omar F

    2017-02-15

    Heart rate (HR) is a vital sign for assessing the need for resuscitation. We performed a systematic review of studies assessing novel methods of measuring HR in newborns and infants in the neonatal unit. Two investigators completed independent literature searches. Identified papers were independently evaluated, and relevant data were extracted and analysed.

  17. Differential Dishabituation as a Function of Magnitude of Stimulus Discrepancy and Sex of the Newborn Infant.

    ERIC Educational Resources Information Center

    Friedman, Steven; And Others

    This study uses a habituation paradigm to systematically investigate the discrepancy hypothesis with male and female new borns. In addition, multiple visual response measures are used in monitoring the habituation process and the infant's response to various degrees of novelty. Ss were 36 apparently normal newborns (half of each sex) ranging in…

  18. PHENYLKETONURIA, DETECTION IN THE NEWBORN INFANT AS A ROUTINE HOSPITAL PROCEDURE.

    ERIC Educational Resources Information Center

    GUTHRIE, ROBERT; WHITNEY, STEWART

    A FIELD TRIAL OF AN INHIBITION ASSAY METHOD FOR SCREENING FOR PHENYLKETONURIA (PKU) TESTED MORE THAN 400,000 NEWBORN INFANTS PRIOR TO DISCHARGE FROM THE HOSPTIAL. IN ALL, 39 CASES WERE FOUND, A HIGHER INCIDENCE THAN HAD PREVIOUSLY BEEN EXPECTED. THE PRACTICALITY OF THE INHIBITION ASSAY METHOD WAS ALSO DEMONSTRATED. THE REPORT DETAILS THE TRIAL'S…

  19. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.

    PubMed

    2004-07-01

    Jaundice occurs in most newborn infants. Most jaundice is benign, but because of the potential toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. The focus of this guideline is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment. Although kernicterus should almost always be preventable, cases continue to occur. These guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. In every infant, we recommend that clinicians 1) promote and support successful breastfeeding; 2) perform a systematic assessment before discharge for the risk of severe hyperbilirubinemia; 3) provide early and focused follow-up based on the risk assessment; and 4) when indicated, treat newborns with phototherapy or exchange transfusion to prevent the development of severe hyperbilirubinemia and, possibly, bilirubin encephalopathy (kernicterus).

  20. Newborn infants' auditory system is sensitive to Western music chord categories

    PubMed Central

    Virtala, Paula; Huotilainen, Minna; Partanen, Eino; Fellman, Vineta; Tervaniemi, Mari

    2013-01-01

    Neural encoding of abstract rules in the audition of newborn infants has been recently demonstrated in several studies using event-related potentials (ERPs). In the present study the neural encoding of Western music chords was investigated in newborn infants. Using ERPs, we examined whether the categorizations of major vs. minor and consonance vs. dissonance are present at the level of the change-related mismatch response (MMR). Using an oddball paradigm, root minor, dissonant and inverted major chords were presented in a context of consonant root major chords. The chords were transposed to several different frequency levels, so that the deviant chords did not include a physically deviant frequency that could result in an MMR without categorization. The results show that the newborn infants were sensitive to both dissonant and minor chords but not to inverted major chords in the context of consonant root major chords. While the dissonant chords elicited a large positive MMR, the minor chords elicited a negative MMR. This indicates that the two categories were processed differently. The results suggest newborn infants are sensitive to Western music categorizations, which is consistent with the authors' previous studies in adults and school-aged children. PMID:23966962

  1. A Comparison of Developmental Assessments of the Newborn and Young Infant

    ERIC Educational Resources Information Center

    Majnemer, Annette; Snider, Laurie

    2005-01-01

    Neonatal neurobehavioral assessments describe a newborn's spontaneous behavioural repertoire and observable responses to environmental stimuli. Infant developmental assessments document the range of developmental skills that emerge and develop over the first years of life. This review highlights two neonatal assessments (Einstein Neonatal…

  2. The Effects of Hunger on Hand-Mouth Coordination in Newborn Infants.

    ERIC Educational Resources Information Center

    Lew, Adina R.; Butterworth, George

    1995-01-01

    Examined the effects of hunger on the hand-mouth (HM) behavior of a group of newborn infants. Found that significantly more mouth opening before contacts to the mouth than those to the face occurred before but not after feeding, suggesting some link between HM behavior and hunger state. (MDM)

  3. Newborn Irritability Moderates the Association between Infant Attachment Security and Toddler Exploration and Sociability

    ERIC Educational Resources Information Center

    Stupica, Brandi; Sherman, Laura J.; Cassidy, Jude

    2011-01-01

    This longitudinal investigation of 84 infants examined whether the effect of 12-month attachment on 18- and 24-month exploration and sociability with unfamiliar adults varied as a function of newborn irritability. As expected, results revealed an interaction between attachment (secure vs. insecure) and irritability (highly irritable vs. moderately…

  4. Heart Rate Conditioning in Newborn Infants: Relationships Among Conditionability, Heart Rate Variability, and Sex

    ERIC Educational Resources Information Center

    Stamps, Leighton E.; Porges, Stephen W.

    1975-01-01

    Trace conditioning was evaluated in newborn infants by measurements of heart rate responses to a conditioned stimulus in anticipation of or in absence of the unconditioned stimulus. Data suggest females have higher levels of heart rate variability than males, which parallels their greater conditionability. (GO)

  5. Newborn infants' auditory system is sensitive to Western music chord categories.

    PubMed

    Virtala, Paula; Huotilainen, Minna; Partanen, Eino; Fellman, Vineta; Tervaniemi, Mari

    2013-01-01

    Neural encoding of abstract rules in the audition of newborn infants has been recently demonstrated in several studies using event-related potentials (ERPs). In the present study the neural encoding of Western music chords was investigated in newborn infants. Using ERPs, we examined whether the categorizations of major vs. minor and consonance vs. dissonance are present at the level of the change-related mismatch response (MMR). Using an oddball paradigm, root minor, dissonant and inverted major chords were presented in a context of consonant root major chords. The chords were transposed to several different frequency levels, so that the deviant chords did not include a physically deviant frequency that could result in an MMR without categorization. The results show that the newborn infants were sensitive to both dissonant and minor chords but not to inverted major chords in the context of consonant root major chords. While the dissonant chords elicited a large positive MMR, the minor chords elicited a negative MMR. This indicates that the two categories were processed differently. The results suggest newborn infants are sensitive to Western music categorizations, which is consistent with the authors' previous studies in adults and school-aged children.

  6. PHENYLKETONURIA, DETECTION IN THE NEWBORN INFANT AS A ROUTINE HOSPITAL PROCEDURE.

    ERIC Educational Resources Information Center

    GUTHRIE, ROBERT; WHITNEY, STEWART

    A FIELD TRIAL OF AN INHIBITION ASSAY METHOD FOR SCREENING FOR PHENYLKETONURIA (PKU) TESTED MORE THAN 400,000 NEWBORN INFANTS PRIOR TO DISCHARGE FROM THE HOSPTIAL. IN ALL, 39 CASES WERE FOUND, A HIGHER INCIDENCE THAN HAD PREVIOUSLY BEEN EXPECTED. THE PRACTICALITY OF THE INHIBITION ASSAY METHOD WAS ALSO DEMONSTRATED. THE REPORT DETAILS THE TRIAL'S…

  7. Newborn Irritability Moderates the Association between Infant Attachment Security and Toddler Exploration and Sociability

    ERIC Educational Resources Information Center

    Stupica, Brandi; Sherman, Laura J.; Cassidy, Jude

    2011-01-01

    This longitudinal investigation of 84 infants examined whether the effect of 12-month attachment on 18- and 24-month exploration and sociability with unfamiliar adults varied as a function of newborn irritability. As expected, results revealed an interaction between attachment (secure vs. insecure) and irritability (highly irritable vs. moderately…

  8. The Effects of Hunger on Hand-Mouth Coordination in Newborn Infants.

    ERIC Educational Resources Information Center

    Lew, Adina R.; Butterworth, George

    1995-01-01

    Examined the effects of hunger on the hand-mouth (HM) behavior of a group of newborn infants. Found that significantly more mouth opening before contacts to the mouth than those to the face occurred before but not after feeding, suggesting some link between HM behavior and hunger state. (MDM)

  9. Heart Rate Conditioning in Newborn Infants: Relationships Among Conditionability, Heart Rate Variability, and Sex

    ERIC Educational Resources Information Center

    Stamps, Leighton E.; Porges, Stephen W.

    1975-01-01

    Trace conditioning was evaluated in newborn infants by measurements of heart rate responses to a conditioned stimulus in anticipation of or in absence of the unconditioned stimulus. Data suggest females have higher levels of heart rate variability than males, which parallels their greater conditionability. (GO)

  10. A Comparison of Developmental Assessments of the Newborn and Young Infant

    ERIC Educational Resources Information Center

    Majnemer, Annette; Snider, Laurie

    2005-01-01

    Neonatal neurobehavioral assessments describe a newborn's spontaneous behavioural repertoire and observable responses to environmental stimuli. Infant developmental assessments document the range of developmental skills that emerge and develop over the first years of life. This review highlights two neonatal assessments (Einstein Neonatal…

  11. Trained immunity in newborn infants of HBV-infected mothers.

    PubMed

    Hong, Michelle; Sandalova, Elena; Low, Diana; Gehring, Adam J; Fieni, Stefania; Amadei, Barbara; Urbani, Simonetta; Chong, Yap-Seng; Guccione, Ernesto; Bertoletti, Antonio

    2015-03-25

    The newborn immune system is characterized by an impaired Th1-associated immune response. Hepatitis B virus (HBV) transmitted from infected mothers to newborns is thought to exploit the newborns' immune system immaturity by inducing a state of immune tolerance that facilitates HBV persistence. Contrary to this hypothesis, we demonstrate here that HBV exposure in utero triggers a state of trained immunity, characterized by innate immune cell maturation and Th1 development, which in turn enhances the ability of cord blood immune cells to respond to bacterial infection in vitro. These training effects are associated with an alteration of the cytokine environment characterized by low IL-10 and, in most cases, high IL-12p40 and IFN-α2. Our data uncover a potentially symbiotic relationship between HBV and its natural host, and highlight the plasticity of the fetal immune system following viral exposure in utero.

  12. 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

  13. Newborn Infants' Memory for Speech Sounds Retained over 24 Hours.

    ERIC Educational Resources Information Center

    Swain, Irina U.; And Others

    1993-01-01

    Neonates who were exposed to the same or different words on two consecutive days habituated to the sound on day one and recovered head turning on day two. Infants who heard the same word again on day two responded less well than infants exposed to the word for the first time on day two. (BC)

  14. Newborn Infants and the Moral Significance of Intellectual Disabilities.

    ERIC Educational Resources Information Center

    Vehmas, Simo

    1999-01-01

    Presents moral philosophical arguments regarding life-saving medical treatment that may be more available to infants without disabilities than to infants with intellectual disabilities. Argues that human well-being is not based merely on individual characteristics, but is a result of the individual's relation to other people. (Author/CR)

  15. Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-Year Results of the Newborn Eye Screen Test Study.

    PubMed

    Callaway, Natalia F; Ludwig, Cassie A; Blumenkranz, Mark S; Jones, Jennifer Michelle; Fredrick, Douglas R; Moshfeghi, Darius M

    2016-05-01

    To report the birth prevalence, risk factors, characteristics, and location of fundus hemorrhages (FHs) of the retina and optic nerve present in newborns at birth. Prospective cohort study at Stanford University School of Medicine. All infants who were 37 weeks postmenstrual age or older and stable were eligible for screening. Infants with known or suspected infectious conjunctivitis were excluded. Infants born at Lucile Packard Children's Hospital (LPCH) from July 25, 2013, through July 25, 2014, were offered universal newborn screening via wide-angle digital retinal photography in the Newborn Eye Screen Test study. Maternal, obstetric, and neonatal factors were obtained from hospital records. The location, retinal layer, and laterality of FH were recorded by 1 pediatric vitreoretinal specialist. Birth prevalence of FH. Secondary outcomes included rate of adverse events, risk factors for FH, hemorrhage characteristics, and adverse events. The birth prevalence of FH in this study was 20.3% (41/202 infants). Ninety-five percent of FHs involved the periphery, 83% involved the macula, and 71% involved multiple layers of the retina. The fovea was involved in 15% of FH cases (birth prevalence, 3.0%). No cases of bilateral foveal hemorrhage were found. Fundus hemorrhages were more common in the left eye than the right. Fundus hemorrhages were most commonly optic nerve flame hemorrhages (48%) and white-centered retinal hemorrhages (30%). Retinal hemorrhages were found most frequently in all 4 quadrants (35%) and more often were multiple than solitary. Macular hemorrhages most often were intraretinal (40%). Among the risk factors examined in this study, vaginal delivery compared with cesarean section (odds ratio [OR], 9.34; 95% confidence interval [CI], 2.57-33.97) showed the greatest level of association with FH. Self-identified ethnicity as Hispanic or Latino showed a protective effect (OR, 0.43; 95% CI, 0.20-0.94). Other study factors were not significant. Fundus

  16. [The Amben correction of disorders in the intestinal microbial colonization of newborn infants with perinatal pathology].

    PubMed

    Iakushenko, M N; Tkhagapsoeva, Zh A; Bondarenko, V M

    1998-01-01

    The examination of 49 newborn infants revealed that at the early neonatal period the character of the microbial colonization of the intestine depended on the kind of perinatal pathology: in lesions of the central nervous system and conjugation jaundice the deficiency of Bifidobacterium and Escherichia was detected; in hemolytic disease opportunistic bacteria were dominant simultaneously with the deficiency of lactoflora. The study of these infants, divided into two groups differing in the administration of Amben (an inhibitor of proteolytic enzymes), showed the efficiency of Amben which stimulated the growth and development of resident microflora in the intestine, thus contributing to the maintenance of eubiosis in a given group of infants with perinatal pathology.

  17. Serum Zinc in Mothers and from Cord Blood of Appropriate Birth-Weight Full Term and Preterm Newborn Infants, and of Low-Birth-Weight Full Term Infants.

    ERIC Educational Resources Information Center

    Trindade, Cleide Enoir Petean; And Others

    1984-01-01

    Studied the maternal plasmatic zinc behavior at delivery time and the cord blood zinc concentration from appropriate and low-birth-weight full-term infants and appropriate preterm infants. Findings indicated that neither prematurity nor fetal growth delay interfere in maternal or newborn infants' zinc levels. (BJD)

  18. Serum Zinc in Mothers and from Cord Blood of Appropriate Birth-Weight Full Term and Preterm Newborn Infants, and of Low-Birth-Weight Full Term Infants.

    ERIC Educational Resources Information Center

    Trindade, Cleide Enoir Petean; And Others

    1984-01-01

    Studied the maternal plasmatic zinc behavior at delivery time and the cord blood zinc concentration from appropriate and low-birth-weight full-term infants and appropriate preterm infants. Findings indicated that neither prematurity nor fetal growth delay interfere in maternal or newborn infants' zinc levels. (BJD)

  19. Climate change is associated with male:female ratios of fetal deaths and newborn infants in Japan.

    PubMed

    Fukuda, Misao; Fukuda, Kiyomi; Shimizu, Takashi; Nobunaga, Miho; Mamsen, Linn Salto; Yding Andersen, Claus

    2014-11-01

    To evaluate whether climate change is associated with male:female ratios (sex ratios) of fetal deaths and births in Japan. A population-based cohort study. Not applicable. Newborn infants and fetuses spontaneously aborted after 12 weeks of gestation. None. Yearly sex ratios of fetal deaths and newborn infants and monthly fetal death rates and sex ratios of newborn infants. A statistically significant positive association was found between yearly temperature differences and sex ratios of fetal deaths; a statistically significant negative association was found between temperature differences and sex ratios of newborn infants from 1968 to 2012, and between sex ratios of births and of fetal deaths. The sex ratios of fetal deaths have been increasing steadily along with temperature differences, whereas the sex ratios of newborn infants have been decreasing since the 1970s. Two climate extremes, a very hot summer in 2010 and a very cold winter in January 2011, showed not only statistically significant declines in sex ratios of newborn infants 9 months later in June 2011 and October 2011 but also statistically significant increases of fetal death rates immediately, in September 2010 and January 2011. The recent temperature fluctuations in Japan seem to be linked to a lower male:female sex ratio of newborn infants, partly via increased male fetal deaths. Male concepti seem to be especially vulnerable to external stress factors, including climate changes. Copyright © 2014. Published by Elsevier Inc.

  20. Penile length, digit length, and anogenital distance according to birth weight in newborn male infants

    PubMed Central

    Park, Jae Young; Lim, Gina; Oh, Ki Won; Ryu, Dong Soo; Park, Seonghun; Jeon, Jong Chul; Cheon, Sang Hyeon; Moon, Kyung Hyun; Park, Sejun

    2015-01-01

    Purpose Anogential distance (AGD) and the 2:4 digit length ratio appear to provide a reliable guide to fetal androgen exposure. We intended to investigate the current status of penile size and the relationship between penile length and AGD or digit length according to birth weight in Korean newborn infants. Materials and Methods Between May 2013 and February 2014, among a total of 78 newborn male infants, 55 infants were prospectively included in this study. Newborn male infants with a gestational age of 38 to 42 weeks and birth weight>2.5 kg were assigned to the NW group (n=24) and those with a gestational age<38 weeks and birth weight<2.5 kg were assigned to the LW group (n=31). Penile size and other variables were compared between the two groups. Results Stretched penile length of the NW group was 3.3±0.2 cm, which did not differ significantly from that reported in 1987. All parameters including height, weight, penile length, testicular size, AGD, and digit length were significantly lower in the LW group than in the NW group. However, there were no significant differences in AGD ratio or 2:4 digit length ratio between the two groups. Conclusions The penile length of newborn infants has not changed over the last quarter century in Korea. With normal penile appearance, the AGD ratio and 2:4 digit length ratio are consistent irrespective of birth weight, whereas AGD, digit length, and penile length are significantly smaller in newborns with low birth weight. PMID:25763130

  1. Benefits of early hepatitis B immunization programs for newborns and infants.

    PubMed

    Van Herck, Koen; Van Damme, Pierre

    2008-10-01

    Despite the availability of safe and effective hepatitis B virus (HBV) vaccines for >20 years, strategies targeting risk groups failed to sufficiently control hepatitis B disease at the population level; this is mainly because of difficulties in risk identification and in program implementation. Hence, the global burden of disease of HBV still is substantial. The World Health Organization recommends universal vaccination against hepatitis B to ultimately eliminate HBV; this recommendation had been progressively implemented to reach 168 countries with a universal program by the end of 2006. However, hepatitis B immunization is currently becoming endangered of losing its place on the agendas of governments, agencies, and international organizations, mainly because of the increasing success of these immunization programs and the interest in newer vaccine-preventable diseases and the related programs.This publication aims to show that vaccination programs targeting newborns and infants are preferable to achieve this goal. The benefits of universal HBV vaccination for newborns and infants are: higher impact on chronic carrier rate and transmission; established potential of high vaccine coverage in this age group; opportunities to combine HBV vaccination with existing universal vaccination programs for newborns and infants; and impact on perinatal transmission, if vaccination is started shortly after birth. Moreover, the safety, immunogenicity, and long-term efficacy of newborn and infant HBV vaccination have been proven extensively. In summary, newborn and infant HBV vaccination programs should be considered the preferred strategy, capable of providing important and sustained impact on global HBV incidence, even if they have a delayed impact on sexual transmission of HBV.

  2. When courts intervene: public health, legal and ethical issues surrounding HIV, pregnant women, and newborn infants.

    PubMed

    Tessmer-Tuck, Jennifer A; Poku, Joseph K; Burkle, Christopher M

    2014-11-01

    Ninety-three percent of pediatric AIDS cases are the result of perinatal HIV transmission, a disease that is almost entirely preventable with early intervention, which reduces the risk of perinatal HIV infection from 25% to <2%. The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics both recommend routine HIV testing of all pregnant women and at-risk newborn infants. When pregnant women decline HIV testing and/or treatment, public health, legal, and ethical dilemmas can result. Federal courts consistently uphold a woman's right to refuse medical testing and treatment, even though it may benefit her fetus/newborn infant. Federal courts also reliably respect the rights of parents to make health care decisions for their newborn infants, which may include declining medical testing and treatment. Confusing the issue of HIV testing and treatment, however, is the fact that there is no definitive United States Supreme Court ruling on the issue. State laws and standards vary widely and serve as guiding principles for practicing clinicians, who must be vigilant of ongoing legal challenges and changes in the states in which they practice. We present a case of an HIV-positive pregnant woman who declined treatment and then testing or treatment of her newborn infant. Ultimately, the legal system intervened. Given the rarity of such cases, we use this as a primer for the practicing clinician to highlight the public health, legal, and ethical issues surrounding prenatal and newborn infant HIV testing and treatment in the United States, including summarizing key state-to-state regulatory differences.

  3. Hospitalization of newborns and young infants for chickenpox in France.

    PubMed

    Lécuyer, Aurélie; Levy, Corinne; Gaudelus, Joel; Floret, Daniel; Soubeyrand, Benoit; Caulin, Evelyne; Cohen, Robert; Grimprel, Emmanuel

    2010-10-01

    Chickenpox is often considered more severe during the first year of life, but its course is usually mild during the first 3 months of life, presumably owing to the persistence of maternal antibodies. Hospitalization and intravenous acyclovir therapy are generally restricted to severe cases but also systematically recommended in newborns in France, irrespective of the clinical severity of the infection. This recommendation was launched in 1998 when Varicella zoster virus (VZV)-specific immunoglobulins were not available in the country and has remained unchanged since. The aim of this prospective observational study was to describe complications of varicella infection in a population of 745 children hospitalized for varicella before 1 year of age, with a specific focus on newborns. Complications occurred in 65% of cases. They were very rare before the age of 1 month (10%) but their incidence then increased progressively with age and probably the disappearance of maternal antibodies: 42% (1-2 months), 66% (3-5 months), 70% (6-8 months), and 79% (9-12 months). Conclusion Chickenpox is usually mild in newborns because most of them are protected by VZV maternal antibodies. Unless the absence of maternal VZV immunity is demonstrated, newborns with mild chickenpox should not require antiviral therapy.

  4. Frightened Versus Not Frightened Disorganized Infant Attachment: Newborn Characteristics and Maternal Caregiving

    PubMed Central

    Padrón, Elena; Carlson, Elizabeth A.; Sroufe, L. Alan

    2014-01-01

    The disorganized infant has been described as experiencing “fright without solution” (Hesse & Main, 1999, p. 484) within the attachment relationship. Using a sample at risk because of poverty (n=157), this study evaluated the role of newborn characteristics in predicting disorganized attachment and explored the existence of two subgroups of disorganized infants, based on whether they display direct indices of fear. For the entire sample, regression analyses revealed that newborn characteristics did not predict ratings of disorganization directly or via moderation by caregiving. Regarding subgroups, it was hypothesized that, if direct expressions of fear resulted from interaction with a frightening or frightened caregiver, it could be expected that infants in the Not Frightened subgroup would become disorganized in part because of other factors, such as compromised regulatory abilities at birth. Results supported this hypothesis for emotional regulation, but not for orientation; infants in the Not Frightened subgroup displayed limited emotional regulation as newborns. Findings suggest that the disorganized attachment category may be comprised of two subgroups, with direct expressions of fear as the key differentiating factor. Specifically, disorganized infants who do not display direct fear in the presence of the caregiver may have started out with compromised emotional regulation abilities at birth. PMID:24826936

  5. Acetylcholinesterase activity in the erythrocytes of newborn infants with hyperbilirubinemia and asphyxia.

    PubMed

    Mydlil, V; Tomasová, H; Cápová, E; Cerná, M

    1976-01-01

    The authors measured erythrocyte acetylcholinesterase (ACHE) activity in 51 physiologic newborn infants, 35 pregnant women and 101 infants with hyperbilirubinemia caused by hemolytic diseases in the ABO and Rh systems, or of other origin (6 children). In total, 374 examinations of erythrocyte ACHE were performed. The normal values of physiologic infants during the first hours of life were 0.162 +/- 0.03, at the age of 3 days 0.104 +/- 0.04. The values in pregnant women were 0.206 +/- 0.07. The ACHE activity was considerably decreased in newborn infants affected by erythroblastosis-ABO, and its mean value, in the case of exsanguinotransfusion indicated by the Polácek scheme, amounted to 0.060 +/- 0.051. It raised after exsanguinotransfusion and was equal to the value of red cells transfused. In newborn infants affected by erythroblastosis-Rh, the value decreased in the cases complicated with asphyxia. Low values of ACHE are sometimes found in certain cases of IRDS or of septicemia. The determination of erythrocyte ACHE activity enables assessing the state of red blood cells.

  6. Positive newborn screen in the biochemically normal infant of a mother with treated holocarboxylase synthetase deficiency.

    PubMed

    Nyhan, W L; Willis, M; Barshop, B A; Gangoiti, J

    2009-12-01

    Expanded programmes of newborn screening permit early diagnosis in time to prevent serious complications. These programmes have begun to detect patients who might otherwise remain asymptomatic. An additional confounding variable is the positive screen that results from maternal rather than neonatal disease. This was the case in an infant in whom elevated hydroxyisovalerylcarnitine (C(5)OH) in his newborn screen was the result of placental transfer from his mother, whose holocarboxylase synthetase deficiency was being successfully treated with biotin. The mother had been diagnosed and treated with biotin prenatally. She had no phenotypic feature of holocarboxylase synthetase deficiency, most importantly no episodes ever of acute metabolic acidosis. In the infant a repeat screen was also positive. On day 28 the infant's plasma C(5)OH carnitine was 0.05 mumol/L (normal) and urinary organic acids on day 39 were normal. The mother's excretion of 3-hydroxyisovaleric acid was 109 mmol/mol creatinine. These observations indicate that holocarboxylase synthetase deficiency is one more maternal metabolic disease which may lead to a positive screen in her unaffected newborn infant. They also make the point that holocarboxylase synthetase deficiency in an infant should be detectable in programmes of neonatal screening, which was not clear previously.

  7. Endogenous production of carbon monoxide in normal and erythroblastotic newborn infants

    PubMed Central

    Maisels, M. Jeffrey; Pathak, Ambadas; Nelson, Nicholas M.; Nathan, David G.; Smith, Clement A.

    1971-01-01

    The endogenous production of carbon monoxide (˙VCO) in newborn infants was measured by serial determinations of blood carboxyhemoglobin during rebreathing in a closed system. Mean ˙VCO in nine full-term infants was 13.7 ±3.6 μl CO/kg per hr (SD), and in four erythroblastotic infants ˙VCO ranged from 37 to 154 μl CO/kg per hr preceding exchange transfusion. Mean red cell life-span (MLS) and total bilirubin production were calculated from ˙VCO. MLS in normal newborns was 88 ±15 days (SD), and bilirubin production was 8.5 ±2.3 mg/kg per 24 hr. This is more than twice the amount of bilirubin normally produced in the adult per kilogram of body weight. Normal infants achieved a net excretion of bilirubin of at least 5.6 ±2.3 mg/kg per 24 hr (SD) as calculated from the bilirubin production and the measured rise in serum bilirubin concentration. The measurement of ˙VCO should prove valuable in the study of red blood cell survival and bilirubin metabolism in the newborn infant. Images PMID:5543875

  8. Frightened versus not frightened disorganized infant attachment: Newborn characteristics and maternal caregiving.

    PubMed

    Padrón, Elena; Carlson, Elizabeth A; Sroufe, L Alan

    2014-03-01

    The disorganized infant has been described as experiencing "fright without solution" (Hesse & Main, 1999, p. 484) within the attachment relationship. Using a sample at risk because of poverty (n = 157), this study evaluated the role of newborn characteristics in predicting disorganized attachment and explored the existence of 2 subgroups of disorganized infants, based on whether they display direct indices of fear. For the entire sample, regression analyses revealed that newborn characteristics did not predict ratings of disorganization directly or via moderation by caregiving. Regarding subgroups, it was hypothesized that, if direct expressions of fear resulted from interaction with a frightening or frightened caregiver, it could be expected that infants in the Not Frightened subgroup would become disorganized in part because of other factors, such as compromised regulatory abilities at birth. Results supported this hypothesis for emotional regulation, but not for orientation; infants in the Not Frightened subgroup displayed limited emotional regulation as newborns. Findings suggest that the disorganized attachment category may be comprised of 2 subgroups, with direct expressions of fear as the key differentiating factor. Specifically, disorganized infants who do not display direct fear in the presence of the caregiver may have started out with compromised emotional regulation abilities at birth.

  9. Adverse drug reactions in newborns, infants and toddlers: pediatric pharmacovigilance between present and future.

    PubMed

    Fabiano, Valentina; Mameli, Chiara; Zuccotti, Gian Vincenzo

    2012-01-01

    The detection, assessment, understanding and prevention of adverse drug reactions (ADRs) are the primary aims of pharmacovigilance activities. Pediatric patients, especially all newborns and infants, are particularly at risk for experiencing drug-related adverse events. This review briefly analyzes the physiological peculiarities of pharmacodynamic and pharmacokinetic aspects of drugs in newborns, infants and toddlers and children. It also deals with specific pediatric pharmacovigilance aspects, such as the frequent use of unlicensed and/or off-label drugs in neonatal intensive care units in European countries and in Australia. This review reports on European, American and Canadian data about the incidence and type of pediatric ADRs, particularly focusing on neonates, infants and toddlers. The awareness of pediatricians about the importance of reporting ADRs should be stimulated, new reporting systems should be encouraged and pediatric pharmacovigilance activities should be improved, first, by intensifying active post-marketing surveillance methods.

  10. Biochemical characteristics of "young" and "old" erythrocytes of the newborn infant.

    PubMed

    Komazawa, M; Oski, F A

    1975-07-01

    Cord blood samples from ten term infants were fractionated into populations of young and old erythrocytes and compared with cells prepared in a similar fashion from eight normal adults. The old cell fraction from the newborn infants had very low phosphofructokinase activity and did not display the usual decline of activity of the enzymes phosphoglycerate kinase and enolase. In addition, the old cells from the newborn infants demonstrated impaired glucose consumption, which, upon analysis of the pattern of glycolytic intermediates, appeared to be a result of the phosphofructokinase deficiency. These findings suggest that cells produced earlier in gestation possess the developmental characteristics of fetal blood to a more significant degree and that these biochemical alterations may produce functional impairment.

  11. Human serum amyloid A (SAA) and high sensitive C-reactive protein (hsCRP) in preterm newborn infants with nosocomial infections.

    PubMed

    Lannergård, A; Larsson, A; Friman, G; Ewald, U

    2008-08-01

    Human serum amyloid A (SAA) and high sensitive C-reactive protein (hsCRP) and their relation to suggestive nosocomial infections (NIs) were investigated in very preterm (VPT) newborn infants. In a retrospective analysis, information of suggestive NI was matched to levels of SAA and hsCRP in 224 serum samples from 72 VPT newborn infants. As a control group, 35 healthy-term newborn infants were chosen. Of the 224 serum samples, 145 samples were not associated with nosocomial infections. However, 79 were associated with NI: of these 79, 42 were found to be culture-proven NI. Trimmed mean (alpha= 0.05) levels for SAA and hsCRP in VPT newborn infants were higher than in control term newborn infants (1.74, 2.67 mg/L vs. 0.78, 0.16 mg/L; p = 0.01 and <0.0001, respectively), and higher in the NI group than in the non-NI group (5.14, 5.74 mg/L vs. 1.03, 1.18; p < 0.01 and <0.0001; respectively). The areas under the curve (AUC) for hsCRP, calculated from the receiver-operator characteristic (ROC) curves, was greater (0.816; 95% CI 0.759-0.864) than for SAA (0.610; 95% CI 0.543-0.675). Identifying and monitoring of bacterial and fungal infections in VPT might be further improved by the use of SAA and hsCRP.

  12. Mercury levels in newborns and infants after receipt of thimerosal-containing vaccines.

    PubMed

    Pichichero, Michael E; Gentile, Angela; Giglio, Norberto; Umido, Veronica; Clarkson, Thomas; Cernichiari, Elsa; Zareba, Grazyna; Gotelli, Carlos; Gotelli, Mariano; Yan, Lihan; Treanor, John

    2008-02-01

    Thimerosal is a mercurial preservative that was widely used in multidose vaccine vials in the United States and Europe until 2001 and continues to be used in many countries throughout the world. We conducted a pharmacokinetic study to assess blood levels and elimination of ethyl mercury after vaccination of infants with thimerosal-containing vaccines. Blood, stool, and urine samples were obtained before vaccination and 12 hours to 30 days after vaccination from 216 healthy children: 72 newborns (group 1), 72 infants aged 2 months (group 2), and 72 infants aged 6 months (group 3). Total mercury levels were measured by atomic absorption. Blood mercury pharmacokinetics were calculated by pooling the data on the group and were based on a 1-compartment first-order pharmacokinetics model. For groups 1, 2, and 3, respectively, (1) mean +/- SD weights were 3.4 +/- 0.4, 5.1 +/- 0.6, and 7.7 +/- 1.1 kg; (2) maximal mean +/- SD blood mercury levels were 5.0 +/- 1.3, 3.6 +/- 1.5, and 2.8 +/- 0.9 ng/mL occurring at 0.5 to 1 day after vaccination; (3) maximal mean +/- SD stool mercury levels were 19.1 +/- 11.8, 37.0 +/- 27.4, and 44.3 +/- 23.9 ng/g occurring on day 5 after vaccination for all groups; and (4) urine mercury levels were mostly nondetectable. The blood mercury half-life was calculated to be 3.7 days and returned to prevaccination levels by day 30. The blood half-life of intramuscular ethyl mercury from thimerosal in vaccines in infants is substantially shorter than that of oral methyl mercury in adults. Increased mercury levels were detected in stools after vaccination, suggesting that the gastrointestinal tract is involved in ethyl mercury elimination. Because of the differing pharmacokinetics of ethyl and methyl mercury, exposure guidelines based on oral methyl mercury in adults may not be accurate for risk assessments in children who receive thimerosal-containing vaccines.

  13. 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…

  14. 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.

  15. A Life Worth Giving? The Threshold for Permissible Withdrawal of Life Support From Disabled Newborn Infants

    PubMed Central

    Wilkinson, Dominic James

    2011-01-01

    When is it permissible to allow a newborn infant to die on the basis of their future quality of life? The prevailing official view is that treatment may be withdrawn only if the burdens in an infant's future life outweigh the benefits. In this paper I outline and defend an alternative view. On the Threshold View, treatment may be withdrawn from infants if their future well-being is below a threshold that is close to, but above the zero-point of well-being. I present four arguments in favor of the Threshold View, and identify and respond to several counterarguments. I conclude that it is justifiable in some circumstances for parents and doctors to decide to allow an infant to die even though the infant's life would be worth living. The Threshold View provides a justification for treatment decisions that is more consistent, more robust, and potentially more practical than the standard view. PMID:21337273

  16. Evolution of Depression and Anxiety Symptoms in Parents of Very Preterm Infants During the Newborn Period.

    PubMed

    Pace, Carmen C; Spittle, Alicia J; Molesworth, Charlotte M-L; Lee, Katherine J; Northam, Elisabeth A; Cheong, Jeanie L Y; Davis, Peter G; Doyle, Lex W; Treyvaud, Karli; Anderson, Peter J

    2016-09-01

    Mothers experience heightened depression and anxiety following very preterm (VPT) birth, but how these symptoms evolve during the first months after birth is unknown. Research on the psychological adjustment of fathers following VPT birth is limited. To describe the trajectory and predictors of distress in parents of VPT infants during the first 12 weeks after birth, and to compare rates of depression and anxiety in parents of VPT infants with those in parents of healthy full-term (FT) infants shortly after birth and at 6 months' postnatal age. Longitudinal, prospective, follow-up cohort study of depression and anxiety symptoms in parents of VPT infants (<30 weeks' gestational age; admitted to the neonatal intensive care unit at the Royal Women's Hospital, Melbourne, Australia, between January 21, 2011, and December 23, 2013), documented every 2 weeks until age 12 weeks and at age 6 months, as well as in parents of healthy FT infants (≥37 weeks' gestational age; birth weight >2499 g; born at the Royal Women's Hospital between August 15, 2012, and March 26, 2014; not admitted to the neonatal nursery) shortly after birth and at age 6 months. Birth of a VPT infant. Symptoms of depression (Center for Epidemiological Studies Depression Scale) and anxiety (Hospital Anxiety and Depression Scale). The study included 113 mothers (mean [SD] age at birth, 32.7 [5.3] years) and 101 fathers (mean [SD] age at birth, 34.7 [6.4] years) of 149 VPT infants (49% male; 84 singletons, 65 multiples; mean [SD] birth weight, 1021 [261] g) as well as 117 mothers (mean [SD] age at birth, 32.9 [4.8] years) and 110 fathers (mean [SD] age at birth, 35.9 [5.3] years) of 151 healthy FT infants (50% male; 149 singletons, 2 multiples; mean [SD] birth weight, 3503 [438] g). Mean scores and rates of depression and anxiety reduced over time for parents of VPT infants in the 12 weeks after birth: the mean (95% CI) change in depression score per week was -0.52 (-0.73 to -0.31; P < .001) for

  17. Early neonatal hyperkalaemia in the extremely premature newborn infant.

    PubMed

    Leslie, G I; Carman, G; Arnold, J D

    1990-02-01

    The incidence of hyperkalaemia in 43 consecutive infants born at less than 28 weeks gestation and cared for in our neonatal intensive care unit was documented. Plasma K levels were related to indices of renal function as well as to the degree of illness in the infants. The mean gestational age was 26.0 weeks (range 24-27 weeks) and the mean birthweight was 815 g (range 395-1170 g). Twenty-six of the infants (60%) had at least one plasma K greater than 5.5 mmol/L and 13 (30%) had a maximum plasma K greater than 7 mmol/L. The mean postnatal age at which the plasma K exceeded 7 mmol/L was 25 h (range 10-39 h). Five infants with plasma K greater than 7 mmol/L developed cardiac arrhythmias and four died of this complication. Only one infant had a large intraventricular haemorrhage. Only two of 16 infants with an initial plasma K less than 5 mmol/L had a maximum plasma K greater than 7 mmol/L, compared with eight of 10 with an initial plasma K greater than 6 mmol/L (P less than 0.005). Plasma K also correlated directly with plasma urea (P less than 0.001) and plasma creatinine (P less than 0.025), and inversely with urine volume (P less than 0.05). Plasma K did not correlate with K intake, arterial pH, presence of asphyxia, severity of respiratory illness, gestation or birthweight. The rapidity with which the plasma K concentration reached potentially hazardous levels in some infants makes it imperative to measure plasma K within 6 h of birth and to continue to monitor levels at least every 6 h for the first 48 h in all infants born at less than 28 weeks gestation.

  18. Plasma amino acids in pregnancy, placental intervillous space and preterm newborn infants.

    PubMed

    Camelo Jr, J S; Martinez, F E; Gonçalves, A L; Monteiro, J P; Jorge, S M

    2007-07-01

    Plasma amino acid levels have never been studied in the placental intervillous space of preterm gestations. Our objective was to determine the possible relationship between plasma amino acids of maternal venous blood (M), of the placental intervillous space (PIVS) and of the umbilical vein (UV) of preterm newborn infants. Plasma amino acid levels were analyzed by ion-exchange chromatography in M from 14 parturients and in the PIVS and UV of their preterm newborn infants. Mean gestational age was 34 +/- 2 weeks, weight = 1827 +/- 510 g, and all newborns were considered adequate for gestational age. The mean Apgar score was 8 and 9 at the first and fifth minutes. Plasma amino acid values were significantly lower in M than in PIVS (166%), except for aminobutyric acid. On average, plasma amino acid levels were significantly higher in UV than in M (107%) and were closer to PIVS than to M values, except for cystine and aminobutyric acid (P < 0.05). Comparison of the mean plasma amino acid concentrations in the UV of preterm to those of term newborn infants previously studied by our group showed no significant difference, except for proline (P < 0.05), preterm > term. These data suggest that the mechanisms of active amino acid transport are centralized in the syncytiotrophoblast, with their passage to the fetus being an active bidirectional process with asymmetric efflux. PIVS could be a reserve amino acid space for the protection of the fetal compartment from inadequate maternal amino acid variations.

  19. Trained immunity in newborn infants of HBV-infected mothers

    PubMed Central

    Hong, Michelle; Sandalova, Elena; Low, Diana; Gehring, Adam J.; Fieni, Stefania; Amadei, Barbara; Urbani, Simonetta; Chong, Yap-Seng; Guccione, Ernesto; Bertoletti, Antonio

    2015-01-01

    The newborn immune system is characterized by an impaired Th1-associated immune response. Hepatitis B virus (HBV) transmitted from infected mothers to newborns is thought to exploit the newborns’ immune system immaturity by inducing a state of immune tolerance that facilitates HBV persistence. Contrary to this hypothesis, we demonstrate here that HBV exposure in utero triggers a state of trained immunity, characterized by innate immune cell maturation and Th1 development, which in turn enhances the ability of cord blood immune cells to respond to bacterial infection in vitro. These training effects are associated with an alteration of the cytokine environment characterized by low IL-10 and, in most cases, high IL-12p40 and IFN-α2. Our data uncover a potentially symbiotic relationship between HBV and its natural host, and highlight the plasticity of the fetal immune system following viral exposure in utero. PMID:25807344

  20. [The newborn infant of a mother with tuberculosis].

    PubMed

    Pedicino, R; Bressan, K; Bedetta, M

    2010-06-01

    TBC is a major infectious emergency in the world. OMS suggest that there are 8 millions of affected every year and 2 millions of deaths. Italy is considered a country with low prevalence, but the increase of the immigration from Africa Asia and Est Europa (country with high risk) imposes attention to the problem. The delivery is a critical moment to investigate people at risk of disease. The infection of the newborn can happen intrauterine or in the expulsive period, but is possible also at home, from somebody affected by an active pulmonary disease. Diagnosis in the newborn is not easy for the aspecificity of clinical signs and for the frequent initial negativeness of Mantoux test. Culture of placenta, gastric aspirate, tracheal secretions, urine would be requested, cerebrospinal fluid if necessary. Neonatal disease needs therapy with isoniazide, rifampicine, pirazinamide and, or ethambutol, or streptomycin. Profilaxis of a newborn from a woman affected by an active form of tuberculosis or living with people affected by an active pulmonary form consists in giving isoniazide until diagnostic tests are negative and in removing the sicks (only with pulmonary disease). New dangerous kinds of pharmacological multiresistent tuberculosis are appeared in the last years in the world and, with the coinfection HIV-TBC and the reorganization of the surveillance system, represents the major obligation for the next years.

  1. Fetal distress and birth scores in newborn infants.

    PubMed Central

    De Souza, S W; John, R W; Richards, B; Milner, R D

    1975-01-01

    The relation between fetal distress and the subsequent condition at birth was studied in 2791 pregnancies. Fetal distress was defined as a heart rate greater than 160 or less than 120/min between uterine contractions, with or without meconium-stained liquor. Infants of 28 to 42 weeks' gestational age were examined at 1 and 5 minutes after birth when the heart rate, respiration, and skin colour was recorded. Birth scores of 0, 1, or 2 were given respectively if respirations were absent, gasping, or regular; if the heart rate was undetectable, less than 100/min, or greater than 100/min; and if the colour was white, blue, or pink. Fetal distress was associated with low birth scores in infants at 1 and 5 minutes of age. Among those who had not suffered fetal distress a significantly greater proportion of preterm infants had low birth scores compared with term or post-term infants at 5 minutes of age. Infants did not score equally for colour, heart rate, and respiration at 1 and 5 minutes of age. Colour usually gave a birth score of 5 and heart rate was recordable when infants scored 0 for colour and respiration. The reduction in birth scores was greater in the presence of meconium-stained liquor and abnormal fetal heart rate than meconium-stained liquor alone; the latter being an early sign of fetal distress. Since fetal distress was not diagnosed by conventional methods in 93 term infants who probably suffered prenatal asphyxia, more sophisticated techniques are necessary for an accurate assessment of fetal condition during labour. PMID:1220605

  2. A prime time for trained immunity: innate immune memory in newborns and infants.

    PubMed

    Levy, Ofer; Wynn, James L

    2014-01-01

    The newborn and infant periods of early life are associated with heightened vulnerability to infection. Limited antigen exposure and distinct adaptive immune function compared to the adult places a greater burden on innate immunity for host defense to microbial challenge during this time. Trained immunity describes the phenomenon of augmented innate immune function following a stimulus that is not specific to the original stimulus. We review the concept of trained immunity in the context of the newborn's unique innate immune system function, the preclinical and clinical evidence that supports the tenet of innate immune memory in early life, and potential consequences of altered innate immune host responses. © 2013 S. Karger AG, Basel.

  3. [Prognostication of immunological reactivity and the choice of the variant of reflexotherapy for a newborn infant].

    PubMed

    Filonenko, A V; Sergeeva, A I; Filonenko, V A

    2014-01-01

    The objective of the present study was to determine the classification differences in immunological reactivity and to identify its predictors in the newborn infants. The study involved 115 full-term newborn infants presenting with grade 3 prenatal hypoxic ischemic encephalopathy in the late neonatal period. The features of immunological reactivity under the influence of acupuncture were examined. Statistical processing was carried out by means of discriminant analysis. The assessment and prediction of the effectiveness of acupuncture in the neonates suffering from cerebral ischemia are based on the index of immunological reactivity and the leukocyte index of intoxication, as well as on the ratio of monocytes to band neutrophils content. For generation of the group classifier of immunological predictors in a newborn infant and development of indications for reflex therapy, nine parameters of interest were measured. The group specificity of the child was determined by three variables, viz. leukocyte index of intoxication, monocyte and band neutrophil counts with values of the Fisher's exact test (F) and reliability (Wilks Lambda 0.90894; approximation F (3.144) = 4.809; p < 0.0032). The partial Wilks Lambda values showed that the greatest contribution was provided by the leukocyte index of intoxication and monocytes. Prediction accuracy of the classification matrix in the standard treatment group reached 30.8% and 91.7% respectively when reflex therapy was included in the combined rehabilitation treatment. Overall, classification accuracy amounted to 70.3%. The presence of distinctive changes in the subgroups preconditioned a personalized approach to the prescription of reflex therapy to the newborn infants and the choice of the treatment modality on an individual basis (parent, child, or both) in the "mother-newborn" system. The variant of treatment was determined by comparing the values of the results of the formulas. The newborns were referred to the subgroup with

  4. [Clinical effect of latamoxef on newborn and premature infants].

    PubMed

    Takimoto, M; Oka, T; Yoshioka, H; Tsuchida, A; Sanae, N; Maruyama, S

    1983-09-01

    Eleven infants ranging 2 days to 3 months of age were studied for clinical evaluation. Ten of them were diagnosed as sepsis or suspected to be septic. Another one contracted umbilical infection. In 7 of 10 cases, causative bacteria were detected by blood culture, that is S. epidermidis in 3 cases, E. cloacae in 2 cases, K. pneumoniae in 1 case and A. calcoaceticus in another. Those infants were treated by parenteral LMOX. Dosage was 30 to 75 mg/kg per day. Clinical results were excellent in 6 cases (3 cases of S. epidermidis, 2 of E. cloacae and 1 of K. pneumoniae) and good in another case (A. calcoaceticus). The other 3 infants clinically diagnosed as sepsis but not proven by blood culture were also treated successfully. The result of the umbilical infection in 1 case was good. Another group of 5 infants ranging 4 to 22 days of age were also treated by LMOX because of suspected bacterial infections. With these infants pharmacokinetic study was done. Peak serum levels after 1 hour drip infusion of 20 mg/kg ranged from 43 to 53 micrograms/ml. Average of half-lives was 2.7 hours. Estimation of distribution volume resulted in 350 to 523 ml/kg body weight.

  5. Reference standard of penile size and prevalence of buried penis in Japanese newborn male infants.

    PubMed

    Matsuo, Nobutake; Ishii, Tomohiro; Takayama, John I; Miwa, Masayuki; Hasegawa, Tomonobu

    2014-01-01

    The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24 × 100(-1) (SD, 0.55 × 100(-1)), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns.

  6. Cervical auscultation of suckle feeding in newborn infants.

    PubMed

    Vice, F L; Heinz, J M; Giuriati, G; Hood, M; Bosma, J F

    1990-09-01

    The authors recorded the sound signals during suckle feeding of six normal infants within the first two postnatal days. The sounds were recorded onto a cassette tape-recorder from a small microphone attached to the infant's neck, then displayed on an oscilloscope and analysed by digital signal processing techniques. These displays demonstrated acoustic patterns and temporal relationships which are not otherwise audible. The method and findings are described in detail, and the method should be useful in the clinical investigation of feeding and swallowing problems associated with more subtle neurological impairment and preterm birth.

  7. Neurodevelopmental outcome of hypoglycaemia in healthy, large for gestational age, term newborns

    PubMed Central

    Brand, P; Molenaar, N; Kaaijk, C; Wierenga, W

    2005-01-01

    Aims: To evaluate the effects of transient hypoglycaemia on the first day of life in 75 healthy term large for gestational age (LGA) infants, born to non-diabetic mothers, on their neurodevelopmental outcome at the age of 4 years. Methods: Screening for hypoglycaemia was performed 1, 3, and 5 hours after birth, and continued if blood glucose levels were low. Treatment with intravenous glucose for hypoglycaemia was started if hypoglycaemia was severe or symptomatic. Patients' development and behaviour was examined at the age of 4 years by the Denver Developmental Scale, a non-verbal intelligence test, and the Child Behaviour Check List. Results: There were no significant differences between children with neonatal normoglycaemia (n = 15) and hypoglycaemia (plasma glucose <2.2 mmol/l 1 hour after birth, or <2.5 mmol/l subsequently; n = 60) in Denver developmental scale scores and child behaviour checklist scores. Although total IQ did not differ between hypoglycaemic and normoglycaemic children, one subscale (reasoning) did (mean difference 9.3, 95% CI 1.3 to 17.2). The correlation between reasoning IQ and neonatal blood glucose levels was weak and not statistically significant. When other definitions for hypoglycaemia were applied, the difference in reasoning IQ was not found. There were no differences in any of the test scores between hypoglycaemic children who had and who had not been treated with intravenous glucose. Conclusion: Transient mild hypoglycaemia in healthy, term LGA newborns does not appear to be harmful to psychomotor development at the age of 4 years. PMID:15613521

  8. Single-incision pediatric endosurgery in newborns and infants

    PubMed Central

    Kozlov, Yury; Novozhilov, Vladimir; Baradieva, Polina; Krasnov, Pavel; Kovalkov, Konstantin; Muensterer, Oliver J

    2015-01-01

    This study focuses on the successful application of single-incision pediatric endosurgery in the treatment of congenital anomalies and acquired diseases in neonates and infants. The purpose of this scientific review consists in highlighting the spectrum, indications, applicability, and effectiveness of single-port endosurgery in children during the first 3 postnatal months. PMID:26566478

  9. Significance of Milk pH in Newborn Infants

    PubMed Central

    Harrison, V. C.; Peat, G.

    1972-01-01

    Bottle-fed infants do not gain weight as rapidly as breast-fed babies during the first week of life. This weight lag can be corrected by the addition of a small amount of alkali (sodium bicarbonate or trometamol) to the feeds. The alkali corrects the acidity of cow's milk which now assumes some of the properties of human breast milk. It has a bacteriostatic effect on specific Escherichia coli in vitro, and in infants it produces a stool with a preponderance of lactobacilli over E. coli organisms. When alkali is removed from the milk there is a decrease in the weight of an infant and the stools contain excessive numbers of E. coli bacteria. A pH-corrected milk appears to be more physiological than unaltered cow's milk and may provide some protection against gastroenteritis in early life. Its bacteriostatic effect on specific E. coli may be of practical significance in feed preparations where terminal sterilization and refrigeration are not available. The study was conducted during the week after birth, and no conclusions are derived for older infants. The long-term effects of trometamol are unknown. No recommendation can be given for the addition of sodium bicarbonate to milks containing a higher content of sodium. PMID:4566015

  10. Dissociation between Small and Large Numerosities in Newborn Infants

    ERIC Educational Resources Information Center

    Coubart, Aurélie; Izard, Véronique; Spelke, Elizabeth S.; Marie, Julien; Streri, Arlette

    2014-01-01

    In the first year of life, infants possess two cognitive systems encoding numerical information: one for processing the numerosity of sets of 4 or more items, and the second for tracking up to 3 objects in parallel. While a previous study showed the former system to be already present a few hours after birth, it is unknown whether the latter…

  11. Dissociation between Small and Large Numerosities in Newborn Infants

    ERIC Educational Resources Information Center

    Coubart, Aurélie; Izard, Véronique; Spelke, Elizabeth S.; Marie, Julien; Streri, Arlette

    2014-01-01

    In the first year of life, infants possess two cognitive systems encoding numerical information: one for processing the numerosity of sets of 4 or more items, and the second for tracking up to 3 objects in parallel. While a previous study showed the former system to be already present a few hours after birth, it is unknown whether the latter…

  12. Opiate treatment for opiate withdrawal in newborn infants.

    PubMed

    Osborn, David A; Jeffery, Heather E; Cole, Michael J

    2010-10-06

    Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. To assess the effectiveness and safety of using an opiate compared to a sedative or non-pharmacological treatment for treatment of NAS due to withdrawal from opiates. The review was updated in 2010 with additional searches CENTRAL, MEDLINE and EMBASE supplemented by searches of conference abstracts and citation lists of published articles. Randomized or quasi-randomized controlled trials of opiate treatment in infants with NAS born to mothers with opiate dependence. Each author assessed study quality and extracted data independently. Nine studies enrolling 645 infants met inclusion criteria. There were substantial methodological concerns in all studies comparing an opiate with a sedative. Two small studies comparing different opiates were of good methodology.Opiate (morphine) versus supportive care (one study): A reduction in time to regain birth weight and duration of supportive care and a significant increase in hospital stay was noted.Opiate versus phenobarbitone (four studies): Meta-analysis found no significant difference in treatment failure. One study reported opiate treatment resulted in a significant reduction in treatment failure in infants of mothers using only opiates. One study reported a significant reduction in days treatment and admission to the nursery for infants receiving morphine. One study reported a reduction in seizures, of borderline statistical significance, with the use of opiate.Opiate versus diazepam (two studies): Meta-analysis found a significant reduction in treatment failure with the use of opiate.Different opiates (six studies): there is insufficient data to determine safety or efficacy of any specific opiate compared to another opiate. Opiates compared to supportive care may reduce time to regain birth weight and duration of supportive care

  13. Transient hyperechogenicity of the renal medullary pyramids: incidence in the healthy term newborn.

    PubMed

    Khoory, B J; Andreis, I A; Vino, L; Fanos, V

    1999-01-01

    A screening program was performed on 1881 clinically healthy term newborns, aimed at detecting eventual pathological conditions not diagnosed during pregnancy. Seventy-three cases of transient hyperechogenicity of the renal medullary pyramids were observed, involving one or both kidneys with either sectorial or diffuse pattern. None of the neonates examined had evidence of renal dysfunction and follow-up ultrasound scans demonstrated complete resolution of the sonographic picture. Medullary hyperechogenicity is not rare in healthy term newborns (3.9%); it presents rapid resolution and should be considered in differential diagnosis of pathological conditions.

  14. 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

  15. [Ethical reflections and recommendations for making clinical decisions in the care of the healthy newborn].

    PubMed

    Sánchez Escartín, M C; López de Heredia Goya, J; Aguayo Maldonado, M J; Blanco Bravo, D; Molina Morales, V

    2012-12-01

    The care of healthy newborn during their stay in health centres is not usually a problem and there are few conflicts in the relationship with the family. Conflicts may arise because the parents do not accept the care or care routines that health professionals provide. They believe that the newborn does not require testing or prophylactic measures, such as administration of vitamin K, or puncture to obtain a blood sample for newborn screening. This is because the information they have is not adequate, or because they reject some measures as they are invasive and that from their point of view, do not correspond to the care of a healthy newborn. This document seeks to reconcile the values of family and participation in the care of their child, the rights of the newborn, and the values of health professionals. It is based on adequate information, a good clinical relationship, and discussion in case of discrepancies that can lead to changes in some procedures that are not essential in the care of the newborn.

  16. Newborn Hearing Screenings in Human Immunodeficiency Virus-Exposed Uninfected Infants

    PubMed Central

    Torre, P; Zeldow, B; Yao, TJ; Hoffman, HJ; Siberry, GK; Purswani, MU; Frederick, T; Spector, SA; Williams, PL

    2017-01-01

    Perinatal HIV infection and congenital cytomegalovirus (CMV) infection may increase the risk for hearing loss. We examined 1,435 infants enrolled in the Surveillance Monitoring of ART Toxicities (SMARTT) study of the Pediatric HIV/AIDS Cohort Study (PHACS) network, a prospective study of the safety of in utero antiretroviral (ARV) exposures. We determined the proportion of perinatally HIV-exposed uninfected (HEU) newborns who were referred for additional hearing testing, and evaluated the association between in utero ARV exposures and newborn hearing screening results. Using a nested case-control design, we also examined congenital CMV infection in infants with and without screening referral. Congenital CMV infection was determined based on CMV DNA detection using a nested PCR assay in peripheral blood mononuclear cells obtained within 14 days of birth. Among the 1,435 infants (70% black, 31% Hispanic, 51% male), 45 (3.1%) did not pass the hearing screen and were referred for further hearing testing. Based on exact logistic regression models controlling for maternal use of tobacco and ototoxic medications, first trimester exposure to Tenofovir was associated with lower odds of a newborn hearing screening referral [adjusted odds ratio (aOR) = 0.41, 95% confidence interval (CI): 0.14-1.00]. Exposure to Atazanavir was linked to higher odds of newborn screening referral, although not attaining significance [aOR = 1.84, 95% CI: 0.92-3.56]. Maternal ARV use may have varying effects on newborn hearing screenings. These results highlight the importance for audiologists to be knowledgeable of in utero ARV exposures in HEU children because of the possibility of higher referrals in these children. PMID:28459118

  17. Exosomes from human mesenchymal stem cells conduct aerobic metabolism in term and preterm newborn infants.

    PubMed

    Panfoli, Isabella; Ravera, Silvia; Podestà, Marina; Cossu, Claudia; Santucci, Laura; Bartolucci, Martina; Bruschi, Maurizio; Calzia, Daniela; Sabatini, Federica; Bruschettini, Matteo; Ramenghi, Luca Antonio; Romantsik, Olga; Marimpietri, Danilo; Pistoia, Vito; Ghiggeri, Gianmarco; Frassoni, Francesco; Candiano, Giovanni

    2016-04-01

    Exosomes are secreted nanovesicles that are able to transfer RNA and proteins to target cells. The emerging role of mesenchymal stem cell (MSC) exosomes as promoters of aerobic ATP synthesis restoration in damaged cells, prompted us to assess whether they contain an extramitochondrial aerobic respiration capacity. Exosomes were isolated from culture medium of human MSCs from umbilical cord of ≥37-wk-old newborns or between 28- to 30-wk-old newborns (i.e.,term or preterm infants). Characterization of samples was conducted by cytofluorometry. Oxidative phosphorylation capacity was assessed by Western blot analysis, oximetry, and luminometric and fluorometric analyses. MSC exosomes express functional respiratory complexes I, IV, and V, consuming oxygen. ATP synthesis was only detectable in exosomes from term newborns, suggestive of a specific mechanism that is not completed at an early gestational age. Activities are outward facing and comparable to those detected in mitochondria isolated from term MSCs. MSC exosomes display an unsuspected aerobic respiratory ability independent of whole mitochondria. This may be relevant for their ability to rescue cell bioenergetics. The differential oxidative metabolism of pretermvs.term exosomes sheds new light on the preterm newborn's clinical vulnerability. A reduced ability to repair damaged tissue and an increased capability to cope with anoxic environment for preterm infants can be envisaged.-Panfoli, I., Ravera, S., Podestà, M., Cossu, C., Santucci, L., Bartolucci, M., Bruschi, M., Calzia, D., Sabatini, F., Bruschettini, M., Ramenghi, L. A., Romantsik, O., Marimpietri, D., Pistoia, V., Ghiggeri, G., Frassoni, F., Candiano, G. Exosomes from human mesenchymal stem cells conduct aerobic metabolism in term and preterm newborn infants.

  18. Cross sectional, community based study of care of newborn infants in Nepal

    PubMed Central

    Osrin, David; Tumbahangphe, Kirti M; Shrestha, Dej; Mesko, Natasha; Shrestha, Bhim P; Manandhar, Madan K; Standing, Hilary; Manandhar, Dharma S; Costello, Anthony M de L

    2002-01-01

    Objective To determine home based newborn care practices in rural Nepal in order to inform strategies to improve neonatal outcome. Design Cross sectional, retrospective study using structured interviews. Setting Makwanpur district, Nepal. Participants 5411 married women aged 15 to 49 years who had given birth to a live baby in the past year. Main outcome measures Attendance at delivery, hygiene, thermal care, and early feeding practices. Results 4893 (90%) women gave birth at home. Attendance at delivery by skilled government health workers was low (334, 6%), as was attendance by traditional birth attendants (267, 5%). Only 461 (8%) women had used a clean home delivery kit, and about half of attendants had washed their hands. Only 3482 (64%) newborn infants had been wrapped within half an hour of birth, and 4992 (92%) had been bathed within the first hour. 99% (5362) of babies were breast fed, 91% (4939) within six hours of birth. Practices with respect to colostrum and prelacteals were not a cause for anxiety. Conclusions Health promotion interventions most likely to improve newborn health in this setting include increasing attendance at delivery by skilled service providers, improving information for families about basic perinatal care, promotion of clean delivery practices, early cord cutting and wrapping of the baby, and avoidance of early bathing. What is already known on this topicMost births in rural south Asia occur at homeNeonatal mortality has remained fairly constant in developing countries despite falling infant mortalityWhat this paper addsOnly 6% of births in rural Nepal took place in the presence of a skilled attendantCord cutting implements were often unclean and drying and wrapping of newborn infants was usually delayed99% of babies were breast fed, 92% of them within six hours of birth, and colostrum was generally givenInterventions need to focus on educating women about hygiene, encouraging early wrapping, and delaying bathing of newborn babies

  19. [On the notions of "maturity" and "maturation" of a newborn infant in forensic medicine].

    PubMed

    Efimov, A A; Nekliudov, Iu A

    2012-01-01

    The notions of "maturity" and "maturation" of newborn infants are discussed in the context of forensic medical expertise based on the publications of the authors studying this problem. It is suggested that "maturation" should be considered to be a morphological notion in contrast to "maturity" to be regarded as a chronological notion. From this point of view, the solution of the maturity problem during forensic medical examination of the infant's corpse is beyond the scope of competence of the forensic medical expert. The authors emphasize the importance of differentiation between the above notions for the unambiguous interpretation of the results of examination by different experts.

  20. L-citrulline provides a novel strategy for treating chronic pulmonary hypertension in newborn infants

    PubMed Central

    Fike, Candice D.; Summar, Marshall; Aschner, Judy L.

    2014-01-01

    Effective therapies are urgently needed for infants with forms of pulmonary hypertension that develop or persist beyond the first week of life. The L-arginine nitric oxide (NO) precursor, L-citrulline, improves NO signalling and ameliorates pulmonary hypertension in newborn animal models. In vitro studies demonstrate that manipulating L-citrulline transport alters NO production. Conclusion Strategies that increase the supply and transport of L-citrulline merit pursuit as novel approaches to managing infants with chronic, progressive pulmonary hypertension. PMID:24862864

  1. Treatable newborn and infant seizures due to inborn errors of metabolism.

    PubMed

    Campistol, Jaume; Plecko, Barbara

    2015-09-01

    About 25% of seizures in the neonatal period have causes other than asphyxia, ischaemia or intracranial bleeding. Among these are primary genetic epileptic encephalopathies with sometimes poor prognosis and high mortality. In addition, some forms of neonatal infant seizures are due to inborn errors of metabolism that do not respond to common AEDs, but are amenable to specific treatment. In this situation, early recognition can allow seizure control and will prevent neurological deterioration and long-term sequelae. We review the group of inborn errors of metabolism that lead to newborn/infant seizures and epilepsy, of which the treatment with cofactors is very different to that used in typical epilepsy management.

  2. Overlap of clinical features of Smith-Magenis & Down Syndrome in newborns and infants

    SciTech Connect

    Thomson, K.A.; Finucane, B.M.; Bauer, M.S.

    1994-09-01

    Smith-Magenis Syndrome (SMS) frequently goes unrecognized in newborns and infants as these patients do not yet demonstrate the characteristic behavioral phenotype and may only present with developmental delay and physical dysmorphism. Six of Hall`s ten cardinal features of trisomy 21 in the newborn are also frequently found in newborns with SMS, leading to an early presumptive diagnosis of DS in many of these patients. CASE No. 1: Based on clinical findings, a presumptive diagnosis of DS was given to the patient in the newborn period. Chromosome analysis of peripheral blood revealed a normal 46,XX karyotype. Given this result, the possibility of mosaic DS was raised, and a skin fibroblast study done. Again, the karyotype was reported as normal. Clinical features and cytogenetic analysis confirmed a diagnosis of SMS when the patient was 8 years old. CASE No. 2: A presumptive diagnosis of DS was made in an infant with hypotonia, facial dysmorphisms and congenital heart defects. A routine chromosome analysis was ordered, which revealed a 46,XY,del(17)(p11.2p11.2) karyotype. Indeed, approximately 38% of blood samples referred to our laboratory to rule out DS in an infant failed to demonstrate trisomy for chromosome 21. Given the high degree of clinical overlap with Down Syndrome, the diagnosis of SMS should be considered in all such patients. Additional analysis should be done to look for deletion 17p11.2 when faced with a {open_quotes}normal{close_quotes} karyotype in an infant referred to rule out DS.

  3. Lethal effect of a single dose of rasburicase in a preterm newborn infant.

    PubMed

    Zaramella, Patrizia; De Salvia, Alessandra; Zaninotto, Martina; Baraldi, Maura; Capovilla, Giovanni; De Leo, Domenico; Chiandetti, Lino

    2013-01-01

    This case report describes a preterm newborn infant who was treated with a single dose of rasburicase for an increase in uric acid level. He died on the third day as a result of complications of hemolysis, which appeared to be precipitated by rasburicase. The patient's death was preceded by progressive respiratory insufficiency, lactic acidosis, and hyperbilirubinemia, culminating in refractory hypoxia and hypotension. A postmortem assay for glucose-6-phosphate dehydrogenase showed deficiency and the glucose-6-phosphate dehydrogenase Mediterranean genotype.

  4. [Colic in newborns and infants: a literature review].

    PubMed

    Kosminsky, Fanny Sarfati; Kimura, Amélia Fumiko

    2004-08-01

    This paper is a literature review on excessive crying and colic that affect babies during their first period of life. This text presents the clinical definition, etiology, colic associated factors and interventions to relief and treatment of infant colic. Articles published in medical and nursing journals indexed at MEDLINE and LILACS computerized database available in the libraries of BIREME, Universidade de São Paulo and CAPES homepage were analysed.

  5. Klebsiella pneumonia with pneumatocele formation in a newborn infant

    PubMed Central

    Papageorgiou, Apostolos; Bauer, Charles R.; Fletcher, Barry D.; Stern, Leo

    1973-01-01

    The case of a premature infant with bacteriologically proved klebsiella pneumonia in the first week of life is reported. The clinical course was complicated by the early formation of pneumatoceles and subsequent recurrent pneumothoraces. Treatment consisted of antibiotic therapy and chest tube drainage. Satisfactory clinical recovery, growth and psychomotor development were noted at 1 year of age, despite the persistence of a pneumatocele in the right lung. ImagesFIG. 2FIG. 3FIG. 4 PMID:4586073

  6. HIV-Associated Tuberculosis in the Newborn and Young Infant

    PubMed Central

    Adhikari, M.; Jeena, P.; Bobat, R.; Archary, M.; Naidoo, K.; Coutsoudis, A.; Singh, R.; Nair, N.

    2011-01-01

    Each year, approximately 250 000 women die during pregnancy, delivery, or postpartum. Maternal mortality rates due to tuberculosis (TB) and HIV in Sub-Saharan Africa now supersede obstetric-related causes of mortality. The majority of cases occur in population-dense regions of Africa and Asia where TB is endemic. The vertical transmission rate of tuberculosis is 15%, the overall vertical transmission rate of HIV in resource-limited settings with mono- or dual-ARV therapy varies from 1.9% to 10.7%. If the millennium development goals are to be achieved, both HIV and TB must be prevented. The essential aspect of TB prevention and detection in the newborn is the maternal history and a positive HIV status in the mother. Perinatal outcomes are guarded even with treatment of both diseases. Exclusive breast feeding is recommended. The community and social impact are crippling. The social issues aggravate the prognosis of these two diseases. PMID:21541068

  7. [The newborn infant with a suspected malformation syndrome].

    PubMed

    Memo, L

    2010-06-01

    Congenital malformations occur in 2-3% of live births, and often represent a special diagnostic and management challenge. Few clinical guidelines exist to assist the neonatologist in the approach to diagnosis and initial management of the malformed newborn. To provide optimal care for these children, one must employ a systematic approach to identify the likely pathogenic mechanism leading to the birth defects present. Determining how distinct anomalies relate to one another may lead to elucidation of a specific genetic etiology for the patient's condition. Genetic testing is increasingly available to allow for diagnostic confirmation. Using this systematic approach to a child with congenital anomalies permits accurate prognostic and recurrence risk counseling, informed management decisions, and the appropriate allocation of social support and medical resources.

  8. [Somatometry in the full-term newborn infant (preliminary report)].

    PubMed

    Ramos Galván, R; Díaz Graham, C; Martí Torroella, G; Pinal, A M

    1977-01-01

    As a preliminary comunication, the authors report a somatometric study carried out in 315 full term newborns from different socioeconomic situation; 152 were born at the Hospital General, S.S.A. and 163, in a private hospital where middle and high class families are attended. The information is grouped on whether measurements are related to physical growth, th state of nutrition or to physical development. Several conditions which necessarily must be taken as independent variables in a study of this sort, such as the age of the parents, but specially of the mother, the period of gestation and of course, the socioeconomic level, were analyzed. The finding of up to 17% of case with height under 47 cm. and/or weight under 2,500 g., outstands the necessity to study the homeorrhesis phenomenon as a very important detail in this type of material.

  9. Vitamin D nutrition in pregnant Nigerian women at term and their newborn infants.

    PubMed Central

    Okonofua, F; Houlder, S; Bell, J; Dandona, P

    1986-01-01

    In view of the high incidence of rickets in infants of women practising purdah (the use of veils) in northern Nigeria we conducted a study on plasma calcium, phosphate, and serum 25-hydroxyvitamin D (25 OHD) concentrations in pregnant Nigerian women and in cord blood obtained from the newborns. Plasma calcium, phosphate, and serum 25 OHD concentrations were lower in practising women and their newborns than those not practising purdah and their infants, respectively. The concentrations of 25 OHD in all Nigerian women were greater than those observed in caucasian women in the United Kingdom. These data emphasise the role of exposure to sunshine in regulating serum 25 OHD concentrations and the adverse effect of deliberate exclusion of sunshine and are consistent with previous data indicating hypovitaminosis D in purdah clad women and their newborns in Saudi Arabia. These data do not, however, provide an explanation for the pathogenesis of the high incidence of neonatal rickets and tetany in infants born of purdah clad women as these women have 25 OHD concentrations greater than those in caucasian women in the United Kingdom. PMID:3722419

  10. Manipulation and brace fixing for the treatment of congenital clubfoot in newborns and infants.

    PubMed

    Su, Yuxi; Nan, Guoxin

    2014-10-31

    As one of the most common congenital deformities in children, clubfoot has long been a challenge for orthopedic surgeons. This paper describes the experience of our team with manipulation and above-the-knee brace fixation without percutaneous Achilles tenotomy for the treatment of clubfoot in newborns and infants. In the orthopedic department of our hospital, 32 infants and newborns (56 feet) with congenital clubfoot underwent manipulation and above-the-knee brace fixation between 2008 and 2012. External rotation brace was used for 1-4 years during the night after deformity correction. Prospective follow-up for a mean duration of 29 months (range, 12-48 months) was carried out. The efficacy of the treatment was assessed by Pirani's scoring system before and after treatment. Fifty-two feet achieved a normal appearance within 3 to 6 months (average, 4.2 months) after treatment. Two patients had skin pressure sores due to improper brace care, but these healed with no scarring after timely treatment. The mean Pirani score 1 year after treatment was 0.21 ± 0.09, whereas it was 4.93 ± 1.02 before treatment (p=0.0078). No patient required treatment with percutaneous Achilles tenotomy. The manipulation and brace fixation used in this study offer an effective method for correcting clubfoot deformity in newborns and infants. This treatment can be an alternative choice to percutaneous Achilles tenotomy.

  11. [Influence of immediate newborn care on infant adaptation to the environment].

    PubMed

    Mazurek, T; Mikiel-Kostyra, K; Mazur, J; Wieczorek, P; Radwańska, B; Pachuta-Wegier, L

    1999-01-01

    The indicators of newborns' adaptation during 75 min after birth were compared in three randomised groups of full-term newborns: skin-to-skin contact (group I), swaddled newborns beside the mother (group II), swaddled and separated from the mother (group III). The changes in skin temperature, blood glucose, pH, heart rate, respiration rate and crying time were studied. All the above characteristics but pH were significantly the most favourable for infants in the skin-to-skin group. The analysis of individual trends of changes in skin temperature indicated that for all but two newborns not separated from the mother (skin-to-skin or lying besides) the temperature was growing during the observation period, whereas in the separated group, six newborns (27%) had unstable not growing temperature. The mean level of blood glucose was the highest in skin-to-skin group (60.1 mg/dl), lower in group of swaddled and lying beside mother (52.5 mg/dl) and the lowest (49.6 mg/dl) in the separated group. The mean duration of crying time in the skin-to-skin contact was a little shorter than in the group of newborns lying besides the mother and more than three times shorter than in the separated group. The observed number of episodes of crying were 7, 17 and 38 in the three groups respectively. All results indicated that skin-to-skin contact is optimal for newborns', adaptation after birth especially as a protection against hypothermia and hypoglycaemia.

  12. A survey of natal and neonatal teeth in newborn infants.

    PubMed

    Wang, Chun-Hsiang; Lin, Yai-Tin; Lin, Yng-Tzer J

    2017-03-01

    Since there is no comprehensive research of natal and neonatal teeth in Taiwan, careful investigation of natal or neonatal teeth is worthy of being studied. This retrospective study investigated the prevalence and clinical characteristics of natal or neonatal teeth in a hospital setting, and analyzed the possible relationships between investigated variables of the natal or neonatal teeth. All of the 12,019 infants born at an assigned hospital between January 1, 2008 and December 31, 2014 were investigated for natal or neonatal teeth. The identified individuals were reviewed for systemic diseases. Dental examinations included the location, clinical appearance, and degree of mobility. A positive family history of natal or neonatal teeth and mother's physical condition before delivery were also investigated. The collected data were analyzed using Fisher's exact test. Thirty infants were identified with a total of 43 natal or neonatal teeth (females, 19; males, 11). Most of the teeth were in the mandibular primary incisor position (97.6%). A radiographic examination confirmed that not all of the natal or neonatal teeth were supernumerary. No significant differences were observed between males and females in tooth morphology, positive family history, and treatment methods (p > 0.05) or between normal and conical shapes in positive family history, premature infant, mother's physical condition before delivery, and treatment methods (p > 0.05). Most of the natal or neonatal teeth were in the mandibular primary incisor position and not all of them were supernumerary. No gender differences were found in tooth morphology, positive family history, and treatment methods. The tooth morphology was not significantly related to a positive family history, premature delivery, or the mother's physical condition before delivery. Copyright © 2016. Published by Elsevier B.V.

  13. In vivo growth of retinoblastoma in a newborn infant.

    PubMed

    Shah, Parag K; Narendran, V; Kalpana, N

    2010-01-01

    Retinoblastoma is a rare malignancy of the retina seen exclusively in children. It is known to cause rapid growth inside the eye and hence treatment should be started as soon as it is diagnosed. We report a case in a five-day-old infant in whom treatment (chemotherapy) was delayed by a month due to high bilirubin levels secondary to physiological jaundice, which gave us the unique opportunity to measure the growth of the tumor over a month. This case emphasizes that immediate treatment is warranted once this rare disease is diagnosed.

  14. Achieving skin to skin contact in theatre for healthy newborns.

    PubMed

    2015-06-01

    The evidence base is supportive of early skin to skin contact (SSC) for optimal newborn-physiological adaptation, bonding and breastfeeding, and national guidelines encourage SSC as soon as possible, regardless of mode of birth. With an ever-rising caesarean (CS) rate, implementing SSC in theatre stands to benefit an increasing number of mothers and babies. While it may be best practice, in reality there is a lot of variation from trust to trust, and many hospitals do not facilitate it, citing numerous reasons as to why it is not possible. Midwives may feel that they should focus on norma birth, but it is our role to provide holistic care and normalise birth in all settings. This article looks at current evidence and the role of the midwife around facilitating SSC in theatre with an example from practice of how change has been implemented so that mothers and babies get the best start in life.

  15. [Chorioamnionitis and inflammatory disease in the premature newborn infant].

    PubMed

    Vedovato, S; Zanardo, V

    2010-06-01

    Preterm births occurs in 6-12% of all pregnancies, accounts for 75% of neonatal death and causes significant neonatal morbidity. A large number of preterm birth is associated with infection (30%), because of the release of many cytokines. In fact acute chorioamnionitis represents the inflammatory response to extracellular microorganisms that gain access to the gestational sac. Clinical signs of infection compare in the 12% of cases, while the prevalence of positive amniotic fluid cultures is approximately 50% in patients with preterm PROM. Despite the recent studies about the dosage of inflammatory biomarkers in the amniotic fluid or in fetal and maternal blood, placenta histology remains the gold standard for the diagnosis of chorioamnionitis. Histological chorioamnionitis describes the progression of the inflammatory process. Organisms first colonise the chorioamnionic surface. Then, the neutrophils migrates to the chorion (chorionitis) and to the amnion (chorioamnionitis) and, in the last stage, amnionic epithelial cells undergo necrosis (necrotising chorioamnionitis). It represents the mother inflammatory response and it differs from the fetal inflammatory response (funisitis). Funisitis first appears in vessels of the chorionic plate (chorionic vasculitis) or in the umbilical vein (umbilical phlebitis), then in the umbilical artery (umbilical arteritis), and in the Wharton's jelly (umbilical perivasculitis). The fetal inflammatory response has been associated with inflammatory diseases of preterm infants, increasing the risk of neonatal sepsis and meningitis, bronchopulmonary dysplasia and cerebral palsy. We present our experience on the relationship between histological chorioamnionitis, preterm birth and inflammatory diseases of VLBW infants.

  16. Testing for drugs of abuse in meconium of newborn infants.

    PubMed

    Moriya, F; Chan, K M; Noguchi, T T; Wu, P Y

    1994-01-01

    A reliable and sensitive screening procedure has been developed for drugs of abuse (amphetamines, cocaine metabolites, opiates, and phencyclidine [PCP]) in meconium from infants. The substances in meconium were extracted with chloroform-isopropanol (3:1) and screened by enzyme multiplied immunoassay technique (EMIT). The lower detection limits of the EMIT for benzoylecgonine, d-methamphetamine, morphine, and PCP were 250 ng/g, 730 ng/g, 110 ng/g, and 100 ng/g, respectively. This method was applied to meconium from 50 infants born to mothers suspected of using the drugs of abuse during pregnancy. Of the 50, 12 were positive for benzoylecgonine, seven for opiates, and one for PCP. The presence of benzoylecgonine and PCP in meconium was confirmed by gas chromatography/mass spectrometry and that of opiates by thin-layer chromatography. The routine analysis of meconium for drugs of abuse is recommended in cases where (A) urine can not be obtained or (B) urinalysis is negative for the substances despite a strong suspicion of maternal use of the substances during pregnancy.

  17. Validation study of the accuracy of echocardiographic measurements of systemic blood flow volume in newborn infants.

    PubMed

    Ficial, Benjamim; Finnemore, Anna E; Cox, David J; Broadhouse, Kathryn M; Price, Anthony N; Durighel, Giuliana; Ekitzidou, Georgia; Hajnal, Joseph V; Edwards, A David; Groves, Alan M

    2013-12-01

    The echocardiographic assessment of circulatory function in sick newborn infants has the potential to improve patient care. However, measurements are prone to error and have not been sufficiently validated. Phase-contrast magnetic resonance imaging (MRI) provides highly validated measures of blood flow and has recently been applied to the newborn population. The aim of this study was to validate measures of left ventricular output and superior vena caval flow volume in newborn infants. Echocardiographic and MRI assessments were performed within 1 working day of each other in a cohort of newborn infants. Examinations were performed in 49 infants with a median corrected gestational age at scan of 34.43 weeks (range, 27.43-40 weeks) and a median weight at scan of 1,880 g (range, 660-3,760 g). Echocardiographic assessment of left ventricular output showed a strong correlation with MRI assessment (R(2) = 0.83; mean bias, -9.6 mL/kg/min; limits of agreement, -79.6 to +60.0 mL/kg/min; repeatability index, 28.2%). Echocardiographic assessment of superior vena caval flow showed a poor correlation with MRI assessment (R(2) = 0.22; mean bias, -13.7 mL/kg/min; limits of agreement, -89.1 to +61.7 mL/kg/min; repeatability index, 68.0%). Calculating superior vena caval flow volume from an axial area measurement and applying a 50% reduction to stroke distance to compensate for overestimation gave a slightly improved correlation with MRI (R(2) = 0.29; mean bias, 2.6 mL/kg/min; limits of agreement, -53.4 to +58.6 mL/kg/min; repeatability index, 54.5%). Echocardiographic assessment of left ventricular output appears relatively robust in newborn infant. Echocardiographic assessment of superior vena caval flow is of limited accuracy in this population, casting doubt on the utility of the measurement for diagnostic decision making. Copyright © 2013 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  18. Validation Study of the Accuracy of Echocardiographic Measurements of Systemic Blood Flow Volume in Newborn Infants

    PubMed Central

    Ficial, Benjamim; Finnemore, Anna E.; Cox, David J.; Broadhouse, Kathryn M.; Price, Anthony N.; Durighel, Giuliana; Ekitzidou, Georgia; Hajnal, Joseph V.; Edwards, A. David; Groves, Alan M.

    2013-01-01

    Background The echocardiographic assessment of circulatory function in sick newborn infants has the potential to improve patient care. However, measurements are prone to error and have not been sufficiently validated. Phase-contrast magnetic resonance imaging (MRI) provides highly validated measures of blood flow and has recently been applied to the newborn population. The aim of this study was to validate measures of left ventricular output and superior vena caval flow volume in newborn infants. Methods Echocardiographic and MRI assessments were performed within 1 working day of each other in a cohort of newborn infants. Results Examinations were performed in 49 infants with a median corrected gestational age at scan of 34.43 weeks (range, 27.43–40 weeks) and a median weight at scan of 1,880 g (range, 660–3,760 g). Echocardiographic assessment of left ventricular output showed a strong correlation with MRI assessment (R2 = 0.83; mean bias, −9.6 mL/kg/min; limits of agreement, −79.6 to +60.0 mL/kg/min; repeatability index, 28.2%). Echocardiographic assessment of superior vena caval flow showed a poor correlation with MRI assessment (R2 = 0.22; mean bias, −13.7 mL/kg/min; limits of agreement, −89.1 to +61.7 mL/kg/min; repeatability index, 68.0%). Calculating superior vena caval flow volume from an axial area measurement and applying a 50% reduction to stroke distance to compensate for overestimation gave a slightly improved correlation with MRI (R2 = 0.29; mean bias, 2.6 mL/kg/min; limits of agreement, −53.4 to +58.6 mL/kg/min; repeatability index, 54.5%). Conclusions Echocardiographic assessment of left ventricular output appears relatively robust in newborn infant. Echocardiographic assessment of superior vena caval flow is of limited accuracy in this population, casting doubt on the utility of the measurement for diagnostic decision making. PMID:24075229

  19. Effects of Sound Frequency on Behavioral and Cardiac Orienting in Newborn and Five-Month-Old Infants.

    ERIC Educational Resources Information Center

    Morrongiello, Barbara A.; Clifton, Rachel K.

    1984-01-01

    Examines alert newborn and five-month-old infants' responsivity to variations in spectral composition of a rattle sound. Head orientation and cardiac responses to sound were recorded. Heart rate change did not vary as a function of frequency at either age, suggesting that all stimuli were equally effective in eliciting the infant's attention.…

  20. Effects of Sound Frequency on Behavioral and Cardiac Orienting in Newborn and Five-Month-Old Infants.

    ERIC Educational Resources Information Center

    Morrongiello, Barbara A.; Clifton, Rachel K.

    1984-01-01

    Examines alert newborn and five-month-old infants' responsivity to variations in spectral composition of a rattle sound. Head orientation and cardiac responses to sound were recorded. Heart rate change did not vary as a function of frequency at either age, suggesting that all stimuli were equally effective in eliciting the infant's attention.…

  1. [Late postoperative apnea in a premature newborn infant].

    PubMed

    Marco, J; Mohamed-Mabrok, M; Battich, I; Torres, J; Moral, V

    1992-01-01

    We report the case of a premature newborn child (36 weeks) who was operated on a teratoma of the sacrum when he was 12 days old and weighed 2,950 g. The patient presented a late postoperative apnea 17 hours after anesthesia. The anesthetic technique consisted of lumbar epidural blockade with 0.33% bupivacaine at a dose of 2.25 ml and superficial inhalation anesthesia with 0.5% isoflurane. Relaxing muscular agents used in this case were succinylcholine (3 mg) for orotracheal intubation and pancuronium bromide (0.3 mg) for maintaining the anesthetic level. The immediate postoperative phase was uneventful but 17 hours after surgery the patient presented apnea, bradycardia (40 beats/min), and marked cyanosis requiring assisted ventilation with bag and mask during 3 min and initial cardiac massage. Recovery of heart rate was immediate and recovery of ventilation was progressive. The patient was treated with caffeine during one week and no relapses occurred. Pneumocardiographic recordings obtained later on revealed sporadic short lasting episodes of apnea (shorter than 15 s) sometimes associated with bradycardia (40 beats/min lower than baseline). There were no apparent intercurrent or precipitating factors for this apnea. We believe that the present clinical picture corresponds to a late postoperative apnea of unknown origin which required reanimation measures and that until present, there are no reported complications of the anesthetic technique that can explain this episode.

  2. Normative Study of Wideband Acoustic Immittance Measures in Newborn Infants

    ERIC Educational Resources Information Center

    Aithal, Sreedevi; Kei, Joseph; Aithal, Venkatesh; Manuel, Alehandrea; Myers, Joshua; Driscoll, Carlie; Khan, Asaduzzaman

    2017-01-01

    Objective: The purpose of this study was to describe normative aspects of wideband acoustic immittance (WAI) measures obtained from healthy White neonates. Method: In this cross-sectional study, wideband absorbance (WBA), admittance magnitude, and admittance phase were measured under ambient pressure condition in 326 ears from 203 neonates (M age…

  3. [Liver rupture in a newborn infant; diagnosis, treatment and prognosis].

    PubMed

    Westerik, A R; Umans-Eckenhausen, M A; Madern, G C; Robben, S G; van den Anker, J N

    1993-11-20

    Between August 1989 and August 1992 four neonates with rupture of the liver were admitted to the Neonatal Intensive Care Unit of the Sophia Children's Hospital in Rotterdam, the Netherlands. Two neonates were born after breech delivery, two after caesarean section because of foetal distress. All four patients had Apgar scores < 5 after 1 minute and of < 8 after 5 minutes and required artificial ventilation for a prolonged period. All infants collapsed within 6 hours after birth. Surgical treatment was not considered because of the poor clinical condition. All patients were treated conservatively. Clinical signs were: rapid onset pallor, hypotension, tachycardia and abdominal distension. Ultrasonography of the abdomen confirmed the clinical diagnosis of rupture of the liver. Despite rapid diagnosis and maximal non-surgical treatment mortality was 75%. Surgical intervention is indicated in neonatal liver rupture with significant intra-abdominal bleeding.

  4. Newborn Irritability Moderates the Association between Infant Attachment Security and Toddler Exploration and Sociability

    PubMed Central

    Stupica, Brandi; Sherman, Laura J.; Cassidy, Jude

    2011-01-01

    This longitudinal investigation of 84 infants examined whether the effect of 12-month attachment on 18- and 24-month exploration and sociability with unfamiliar adults varied as a function of newborn irritability. As expected, results revealed an interaction between attachment (secure vs. insecure) and irritability (highly irritable vs. moderately irritable) in predicting both exploration and sociability with unfamiliar adults. For exploration, results supported a dual-risk model; that is, toddlers who had been both highly irritable and insecurely attached were less exploratory than other toddlers. For sociability, results supported the differential-susceptibility hypothesis; that is, highly irritable infants, compared to moderately irritable infants, were both less sociable as toddlers when they had been insecurely attached and more sociable when they had been securely attached. PMID:21883159

  5. Neurophysiological measures of nociceptive brain activity in the newborn infant – the next steps

    PubMed Central

    Hartley, Caroline; Slater, Rebeccah

    2014-01-01

    Infants within neonatal intensive care units can receive multiple medically essential painful procedures per day. How they respond to these events, how best to alleviate the negative effects, and the long-term consequences for the infant are all significant questions that have yet to be fully answered. In recent years, several studies have examined cortical responses to noxious stimuli in the neonate through the use of near-infrared spectroscopy (NIRS) and electroencephalography (EEG). These investigations dispel any notion that the newborn infant does not process noxious stimuli at a cortical level and open the way for future research. In this Viewpoint Article, we review these studies and discuss key clinical challenges which may be elucidated with the use of these techniques. Conclusion Simultaneously measuring the changes that are evoked in behaviour, physiology and the cortex following noxious events will provide the best approach to understanding the neonate's experience of pain. PMID:24180281

  6. Unilateral vocal cord paralysis associated with subdural haemorrhage in a newborn infant.

    PubMed

    Forbes, E; Patel, N; Kasem, K

    2010-08-01

    A term infant developed stridor, hoarse cry and respiratory distress after forceps-assisted delivery. Oral feeding resulted in aspiration. Flexible laryngoscopy showed a right-sided vocal cord paralysis (VCP). A magnetic resonance image (MRI) of the brain revealed an ovoid lesion in the posterior fossa impinging on the brainstem, which was considered to represent a subdural haematoma. Clinical signs of vocal cord palsy and the associated MRI changes resolved spontaneously by 6 weeks of age. Vocal cord palsy is a common cause of stridor in newborn infants, although in many cases it is considered idiopathic. This is the first report of vocal cord palsy associated with subdural haemorrhage after instrumental delivery, and may represent an important and previously unappreciated cause of VCP. This case highlights the importance of magnetic resonance brain imaging in those infants with VCP in whom the aetiology is uncertain.

  7. 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

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

    PubMed

    Becker, Genevieve E; Remmington, Tracey

    2014-11-25

    to fully assess the benefits or harms of supplementation or to determine the impact from timing and type of supplementation. We found no evidence of benefit to newborn infants and possible negative effects on the duration of breastfeeding from the brief use of additional water or glucose water, and the quality of the evidence from a small pilot study on formula supplementation was insufficient to suggest a change in practice away from exclusive breastfeeding. For infants at four to six months, we found no evidence of benefit from additional foods nor any risks related to morbidity or weight change. Future studies should examine the longer-term effects on infants and mothers, though randomising infants to receive supplements without medical need may be problematic.We found no evidence for disagreement with the recommendation of international health associations that exclusive breastfeeding should be recommended for healthy infants for the first six months.

  9. 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.

  10. 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.

  11. 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

  12. Dry heat loses of newborn baby in infant care bed: use of a thermal manikin

    NASA Astrophysics Data System (ADS)

    Ostrowski, Ziemowit; Rojczyk, Marek; Szczygieł, Ireneusz; Łaszczyk, Joanna; Nowak, Andrzej J.

    2016-09-01

    The energy balance and heat exchange for newborn baby in infant care bed environment (radiant warmer) are considered. The present study was performed to assess the body dry heat loss from an infant in radiant warmer, using copper cast anthropomorphic thermal manikin and controlled climate chamber laboratory setup. The total body dry heat losses were measured for varying manikin surface temperatures (nine levels between 32.5oC and 40.1oC) and ambient air temperatures (five levels between 23.5oC and 29.7oC). Radiant heat losses were estimated based on measured climate chamber wall temperatures. After subtracting radiant part, resulting convective heat loses are compared with computed ones, based on Nu correlations for common geometries. Simplified geometry of newborn baby was represented as: (a) single cylinder and (b) weighted sum of 5 cylinders and sphere. The computed values are significantly overestimated relative to measured ones by: 28.8% (23.5%) for (a) and 40.9% (25.2%) for (b). This shows that use of adopted general purpose correlations for approximation of convective heat losses of newborn baby can lead to substantial errors, hence approximation formula is proposed. The thermal manikin appears to provide a precise method for the noninvasive assessment of thermal conditions in neonatal care.

  13. Brain white matter abnormality in a newborn infant with congenital adrenal hyperplasia.

    PubMed

    Kaga, Akimune; Saito-Hakoda, Akiko; Uematsu, Mitsugu; Kamimura, Miki; Kanno, Junko; Kure, Shigeo; Fujiwara, Ikuma

    2013-10-01

    Several studies have described brain white matter abnormalities on magnetic resonance imaging (MRI) in children and adults with congenital adrenal hyperplasia (CAH), while the brain MRI findings of newborn infants with CAH have not been clarified. We report a newborn boy with CAH who presented brain white matter abnormality on MRI. He was diagnosed as having salt-wasting CAH with a high 17-OHP level at neonatal screening and was initially treated with hydrocortisone at 8 days of age. On day 11 after birth, he had a generalized tonic seizure. No evidence of serum electrolyte abnormalities was observed. Brain MRI revealed white matter abnormalities that consisted of bilateral small diffuse hyperintensities on T1-weighted images with slightly low intensity on T2-weighted images in the watershed area. Several factors associated with brain white matter abnormalities in adults with CAH, such as increasing age, hypertension, diabetes and corticosteroid replacement, were not applicable. Although the cause of the phenomenon in this case is unclear, brain white matter abnormality could be observed in newborn infants with CAH as well as in adult patients.

  14. Sucrose for analgesia in newborn infants undergoing painful procedures.

    PubMed

    Stevens, Bonnie; Yamada, Janet; Ohlsson, Arne; Haliburton, Sarah; Shorkey, Allyson

    2016-07-16

    heterogeneity by the I(2) test. We assessed the risk of bias of included trials using the Cochrane 'Risk of bias' tool, and assessed the quality of the evidence using the GRADE system. Seventy-four studies enrolling 7049 infants were included. Results from only a few studies could be combined in meta-analyses and for most analyses the GRADE assessments indicated low- or moderate-quality evidence. There was high-quality evidence for the beneficial effect of sucrose (24%) with non-nutritive sucking (pacifier dipped in sucrose) or 0.5 mL of sucrose orally in preterm and term infants: Premature Infant Pain Profile (PIPP) 30 s after heel lance WMD -1.70 (95% CI -2.13 to -1.26; I(2) = 0% (no heterogeneity); 3 studies, n = 278); PIPP 60 s after heel lance WMD -2.14 (95% CI -3.34 to -0.94; I(2) = 0% (no heterogeneity; 2 studies, n = 164). There was high-quality evidence for the use of 2 mL 24% sucrose prior to venipuncture: PIPP during venipuncture WMD -2.79 (95% CI -3.76 to -1.83; I(2) = 0% (no heterogeneity; 2 groups in 1 study, n = 213); and intramuscular injections: PIPP during intramuscular injection WMD -1.05 (95% CI -1.98 to -0.12; I(2) = 0% (2 groups in 1 study, n = 232). Evidence from studies that could not be included in RevMan-analyses supported these findings. Reported adverse effects were minor and similar in the sucrose and control groups. Sucrose is not effective in reducing pain from circumcision. The effectiveness of sucrose for reducing pain/stress from other interventions such as arterial puncture, subcutaneous injection, insertion of nasogastric or orogastric tubes, bladder catherization, eye examinations and echocardiography examinations are inconclusive. Most trials indicated some benefit of sucrose use but that the evidence for other painful procedures is of lower quality as it is based on few studies of small sample sizes. The effects of sucrose on long-term neurodevelopmental outcomes are unknown. Sucrose is effective for reducing procedural pain from single

  15. Infants with HIV-infected mothers in a universal newborn hearing screening programme in Lagos, Nigeria.

    PubMed

    Olusanya, Bolajoko O; Afe, Abayomi J; Onyia, Ngozi O

    2009-08-01

    To establish the characteristics of infants with human immunodeficiency virus (HIV)-infected mothers enrolled under a two-stage universal newborn hearing screening programme in Lagos, Nigeria. A matched case-control study from May 2005 to December 2007 in which factors associated with maternal HIV status were determined by conditional multivariable logistic regression analysis. Some 266 newborns had HIV-infected mothers and were matched with 1330 controls by age and sex. Factors independently associated with increased risk of maternal HIV status were ethnicity, religion, housing sanitation facilities and prematurity while prior or current caesarean section, admission into special care unit and hyperbilirubinaemia were associated with lower risk of maternal HIV. Maternal HIV status was not significantly associated (p = 0.082) with the risk of sensorineural hearing loss although newborns with HIV-infected mothers had more than two-fold risk (p = 0.030) of not completing the hearing tests compared with controls. HIV-infected mothers are likely to live in poor housing conditions but their newborns are not at an increased risk of sensorineural hearing loss in this setting barring the potential effect of significantly increased drop-out rate in this group.

  16. The effect of massage on neonatal jaundice in stable preterm newborn infants: a randomized controlled trial.

    PubMed

    Basiri-Moghadam, Mahdi; Basiri-Moghadam, Kokab; Kianmehr, Mojtaba; Jani, Somaye

    2015-06-01

    To evaluate the effects of massage therapy on transcutaneous bilirubin of stable preterm infants. The controlled clinical trial was conducted in 2014 at Shahid Hasheminejhad Hospital, Iran, and comprised preterm neonatal children in the neonatal intensive care unit. The newborns were divided into two groups of massage and control via random allocation. The children in the control group received the routine therapy whereas those in the massage group underwent the same four days of routine plus 20 minutes of massage twice a day. The transcutaneous bilirubin and the number of excretions of the newborns were noted from the first to the fourth day of the intervention and results were compared between the two groups. There were 40 newborns in the study l 20(50%) each in the two groups. There was a significant difference in the number of times of defecation (p=0.002) and in the level of bilirubin (p=0.003) between the groups with those in the massage group having a higher number of defecations as well as a lower level of transcutaneous bilirubin. Through massage therapy the bilirubin level in preterm newborns can be controlled and a need for phototherapy can also be delayed.

  17. Is chest CT useful in newborn screened infants with cystic fibrosis at 1 year of age?

    PubMed

    Thia, Lena P; Calder, Alistair; Stocks, Janet; Bush, Andrew; Owens, Catherine M; Wallis, Colin; Young, Carolyn; Sullivan, Yvonne; Wade, Angie; McEwan, Angus; Brody, Alan S

    2014-04-01

    Sensitive outcome measures applicable in different centres to quantify and track early pulmonary abnormalities in infants with cystic fibrosis (CF) are needed both for clinical care and interventional trials. Chest CT has been advocated as such a measure yet there is no validated scoring system in infants. The objectives of this study were to standardise CT data collection across multiple sites; ascertain the incidence of bronchial dilatation and air trapping in newborn screened (NBS) infants with CF at 1 year; and assess the reproducibility of Brody-II, the most widely used scoring system in children with CF, during infancy. A multicentre observational study of early pulmonary lung disease in NBS infants with CF at age 1 year using volume-controlled chest CT performed under general anaesthetic. 65 infants with NBS-diagnosed CF had chest CT in three centres. Small insignificant variations in lung recruitment manoeuvres but significant centre differences in radiation exposures were found. Despite experienced scorers and prior training, with the exception of air trapping, inter- and intraobserver agreement on Brody-II score was poor to fair (eg, interobserver total score mean (95% CI) κ coefficient: 0.34 (0.20 to 0.49)). Only 7 (11%) infants had a total CT score ≥ 12 (ie, ≥ 5% maximum possible) by either scorer. In NBS infants with CF, CT changes were very mild at 1 year, and assessment of air trapping was the only reproducible outcome. CT is thus of questionable value in infants of this age, unless an improved scoring system for use in mild CF disease can be developed.

  18. Obstetric antecedents to body-cooling treatment of the newborn infant.

    PubMed

    Nelson, David B; Lucke, Ashley M; McIntire, Donald D; Sánchez, Pablo J; Leveno, Kenneth J; Chalak, Lina F

    2014-08-01

    Obstetric antecedents were analyzed in births in which the infant received whole-body cooling for neonatal encephalopathy. This retrospective cohort study included all live-born singleton infants delivered at or beyond 36 weeks' gestation from October 2005 through December 2011. Infants who had received whole-body cooling identified by review of a prospective neonatal registry were compared with a control group comprising the remaining obstetric population delivered at greater than 36 weeks but not cooled. Univariable analysis was followed up by a staged, stepwise selection of variables with the intent to rank significant risk factors for cooling. A total of 86,371 women delivered during the study period and 98 infants received whole-body cooling (1.1 per 1000 live births). Of these 98 infants, 80 newborns (88%) had moderate encephalopathy and 10 (12%) had severe encephalopathy prior to cooling. Maternal age of 15 years or younger, low parity, maternal body habitus (body mass index of ≥40 kg/m(2)), diabetes, preeclampsia, induction, epidural analgesia, chorioamnionitis, length of labor, and mode of delivery were associated with significantly increased risk of infant cooling during a univariable analysis. Catastrophic events to include umbilical cord prolapse (odds ratio [OR], 14; 95% confidence interval [CI], 3-72), placental abruption (OR, 17; 95% CI, 7-44), uterine rupture (OR, 130; 95% CI, 11-1477) were the strongest factors associated with infant cooling after staged-stepwise logistic analysis. A variety of intrapartum characteristics were associated with infant cooling for neonatal encephalopathy, with the most powerful antecedents being umbilical cord prolapse, placental abruption, and uterine rupture. Copyright © 2014 Mosby, Inc. All rights reserved.

  19. Ethics, genetics and public policies in Uruguay: newborn and infant screening as a paradigm.

    PubMed

    Larrandaburu, Mariela; Matte, Ursula; Noble, Ana; Olivera, Zully; Sanseverino, Maria Teresa V; Nacul, Luis; Schuler-Faccini, Lavinia

    2015-07-01

    Uruguay is a middle-income country and the smallest in South America. Its population is under 3.3 million. The demographic and epidemiological characteristics are similar to those of developed countries, with a high burden associated with congenital anomalies. Infant mortality rate (IMR) decreased from 37/1000 live births, in 1980, to 8.8/1000, in 2013. This is largely explained by medical and social policies. IMR related to congenital anomalies, however, remained unchanged for the last 30 years. Therefore, programmes for prevention of congenital disorders were developed, such as the National Newborn Screening Programme. Mandatory, universal, free infant screening was implemented two decades ago. The Ministry of Public Health created the Comprehensive Plan on Birth Defects and Rare Diseases (PIDCER), to develop a strategic public policy tool enabling comprehensive, universal, quality care during their entire lifetime. Recent national legislation created provisions for newborn and infant screening, including for congenital hypothyroidism, phenylketonuria, congenital adrenal hyperplasia, cystic fibrosis and medium-chain acyl-CoA dehydrogenase, via blood spot test, otoacoustic emissions, systematic physical examination and hip ultrasound. We discuss how this programme was implemented, the current situation of rare diseases, the institution managing disability in Uruguay and the development of new laws based on the MPH's PIDCER. It illustrates how Uruguay is developing public policies in the genomic era, based both on science and bioethics.

  20. Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants

    PubMed Central

    Fernandez, Erika; Watterberg, Kristi L.; Faix, Roger G.; Yoder, Bradley A.; Walsh, Michele C.; Lacy, Conra Backstrom; Osborne, Karen A.; Das, Abhik; Kendrick, Douglas E.; Stoll, Barbara J.; Poindexter, Brenda B.; Laptook, Abbot R.; Kennedy, Kathleen A.; Schibler, Kurt; Bell, Edward F.; Van Meurs, Krisa P.; Frantz, Ivan D.; Goldberg, Ronald N.; Shankaran, Seetha; Carlo, Waldemar A.; Ehrenkranz, Richard A.; Sanchez, Pablo J.; Higgins, Rosemary D.

    2015-01-01

    Background We previously reported on the overall incidence, management and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short term outcomes in term and late preterm newborn infants. Objective To evaluate how 4 definitions of CVI relate to short term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short term outcomes at discharge and 4 different definitions of CVI were further analyzed. Results All 4 definitions were associated with greater number of days on MV & days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days to full feeding, days in the NICU or death. The definition based on treatment of CVI was associated with all outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short term outcomes. Using only a threshold BP to determine therapy may not improve outcomes. PMID:25825962

  1. Transplant Tolerance Induction in Newborn Infants: Mechanisms, Advantages, and Potential Strategies.

    PubMed

    Pan, Hua; Gazarian, Aram; Dubernard, Jean-Michel; Belot, Alexandre; Michallet, Marie-Cécile; Michallet, Mauricette

    2016-01-01

    Although several tolerance induction protocols have been successfully implemented in adult renal transplantation, no tolerance induction approach has, as yet, been defined for solid organ transplantations in young infants. Pediatric transplant recipients have a pressing demand for the elaboration of tolerance induction regimens. Indeed, since they display a longer survival time, they are exposed to a higher level of risks linked to long-term immunosuppression (IS) and to chronic rejection. Interestingly, central tolerance induction may be of great interest in newborns, because of their immunological immaturity and the important role of the thymus at this early stage in life. The present review aims to clarify mechanisms and strategies of tolerance induction in these immunologically premature recipients. We first introduce the discovery and mechanisms of neonatal tolerance in murine experimental models and subsequently analyze tolerance induction in human newborn infants. Hematopoietic mixed chimerism in neonates is also discussed based on in utero hematopoietic stem cell (HSC) transplant studies. Then, we review the recent advances in tolerance induction approaches in adults, including the infusion of HSCs associated with less toxic conditioning regimens, regulatory T cells/facilitating cells/mesenchymal stem cells transplantation, costimulatory blockade, and thymus manipulation. Finally, IS withdrawal in pediatric solid organ transplant is discussed. In conclusion, the establishment of transplant tolerance induction in infants is promising and deserves further investigations. Future studies could focus on the selection of patients, on less toxic conditioning regimens, and on biomarkers for IS minimization or withdrawal.

  2. Transplant Tolerance Induction in Newborn Infants: Mechanisms, Advantages, and Potential Strategies

    PubMed Central

    Pan, Hua; Gazarian, Aram; Dubernard, Jean-Michel; Belot, Alexandre; Michallet, Marie-Cécile; Michallet, Mauricette

    2016-01-01

    Although several tolerance induction protocols have been successfully implemented in adult renal transplantation, no tolerance induction approach has, as yet, been defined for solid organ transplantations in young infants. Pediatric transplant recipients have a pressing demand for the elaboration of tolerance induction regimens. Indeed, since they display a longer survival time, they are exposed to a higher level of risks linked to long-term immunosuppression (IS) and to chronic rejection. Interestingly, central tolerance induction may be of great interest in newborns, because of their immunological immaturity and the important role of the thymus at this early stage in life. The present review aims to clarify mechanisms and strategies of tolerance induction in these immunologically premature recipients. We first introduce the discovery and mechanisms of neonatal tolerance in murine experimental models and subsequently analyze tolerance induction in human newborn infants. Hematopoietic mixed chimerism in neonates is also discussed based on in utero hematopoietic stem cell (HSC) transplant studies. Then, we review the recent advances in tolerance induction approaches in adults, including the infusion of HSCs associated with less toxic conditioning regimens, regulatory T cells/facilitating cells/mesenchymal stem cells transplantation, costimulatory blockade, and thymus manipulation. Finally, IS withdrawal in pediatric solid organ transplant is discussed. In conclusion, the establishment of transplant tolerance induction in infants is promising and deserves further investigations. Future studies could focus on the selection of patients, on less toxic conditioning regimens, and on biomarkers for IS minimization or withdrawal. PMID:27092138

  3. Skinfold thickness of preterm newborns when they become late preterm infants.

    PubMed

    Simsek, Meral; Ergenekon, Ebru; Beken, Serdar; Kulalı, Ferit; Unal, Sezin; Kazancı, Ebru; Aktas, Selma; Altuntas, Nilgun; Hirfanoglu, Ibrahim; Turkyılmaz, Canan; Koç, Esin; Atalay, Yıldız

    2015-04-01

    Nutrition of very low-birth-weight newborns is important for a good physical and neurologic outcome. Body composition assessment, together with anthropometric measurements, is considered necessary to monitor adequate nutrition and growth. Objectives of this study were to assess body fat changes in newborns ≤32 weeks gestation by weekly skinfold thickness (SFT) measurements and to compare them with those of late preterm infants born at 34, 35, and 36 weeks once they reached 34, 35, and 36 weeks corrected age (CA). Preterm infants ≤32 weeks gestation had SFT measured from 4 body sites, including biceps, triceps, and subscapulary and suprailiac regions, by a Holtain caliper starting from 48 hours of age at weekly intervals until 34, 35, and 36 weeks CA. The measurements were compared with those of late preterm controls born at 34, 35, and 36 weeks gestation. There were 37 preterm infants in the patient group. When reaching 34, 35, and 36 weeks CA, preterm infants had higher SFT values compared with controls in all body sites. Median and range of total SFT were 14.6 mm (9.6-18.9 mm) in patients and 11 mm (7.8-16.4 mm) in controls at 34 weeks CA, 15.5 mm (10.7-21.8 mm) in patients and 12.3 mm (7-17 mm) in controls at 35 weeks CA, and 16.4 mm (11.8-23.7 mm) in patients and 12.9 mm (7-17.8 mm) in controls at 36 weeks CA (P = .001 in all). No sex difference was observed at 34 and 35 weeks. These results show that preterm infants start accumulating excess fat even from early weeks of life. Careful assessment of growth by tools other than simple anthropometric measurements is essential to avoid future complications. © 2015 American Society for Parenteral and Enteral Nutrition.

  4. Pregnancy at high altitude in the Andes leads to increased total vessel density in healthy newborns

    PubMed Central

    Gassmann, Norina N.; van Elteren, Hugo A.; Goos, Tom G.; Morales, Claudia R.; Rivera-Ch, Maria; Martin, Daniel S.; Cabala Peralta, Patricia; Passano del Carpio, Agustin; Aranibar Machaca, Saul; Huicho, Luis; Reiss, Irwin K. M.; de Jonge, Rogier C. J.

    2016-01-01

    The developing human fetus is able to cope with the physiological reduction in oxygen supply occurring in utero. However, it is not known if microvascularization of the fetus is augmented when pregnancy occurs at high altitude. Fifty-three healthy term newborns in Puno, Peru (3,840 m) were compared with sea-level controls. Pre- and postductal arterial oxygen saturation (SpO2) was determined. Cerebral and calf muscle regional tissue oxygenation was measured using near infrared spectroscopy (NIRS). Skin microcirculation was noninvasively measured using incident dark field imaging. Pre- and postductal SpO2 in Peruvian babies was 88.1 and 88.4%, respectively, which was 10.4 and 9.7% lower than in newborns at sea level (P < 0.001). Cerebral and regional oxygen saturation was significantly lower in the Peruvian newborns (cerebral: 71.0 vs. 74.9%; regional: 68.5 vs. 76.0%, P < 0.001). Transcutaneously measured total vessel density in the Peruvian newborns was 14% higher than that in the newborns born at sea level (29.7 vs. 26.0 mm/mm2; P ≤ 0.001). This study demonstrates that microvascular vessel density in neonates born to mothers living at high altitude is higher than that in neonates born at sea level. PMID:27445300

  5. Comparison of Cerebral Oximeter and Pulse Oximeter Values in the First 72 Hours in Premature, Asphyctic and Healthy Newborns

    PubMed Central

    Kaya, A; Okur, M; Sal, E; Peker, E; Köstü, M; Tuncer, O; Kirimi, E

    2014-01-01

    ABSTRACT Aim: The monitoring of oxygenation is essential for providing patient safety and optimal results. We aimed to determine brain oxygen saturation values in healthy, asphyctic and premature newborns and to compare cerebral oximeter and pulse oximeter values in the first 72 hours of life in neonatal intensive care units. Methods: This study was conducted at the neonatal intensive care unit (NICU) of Van Yüzüncü Yil University Research and Administration Hospital. Seventy-five neonatal infants were included in the study (28 asphyxia, 24 premature and 23 mature healthy infants for control group). All infants were studied within the first 72 hours of life. We used a Somanetics 5100C cerebral oximeter (INVOS cerebral/somatic oximeter, Troy, MI, USA). The oxygen saturation information was collected by a Nellcor N-560 pulse oximeter (Nellcor-Puriton Bennet Inc, Pleasanton, CA, USA). Results: In the asphyxia group, the cerebral oximeter average was 76.85 ± 14.1, the pulse oximeter average was 91.86 ± 5.9 and the heart rate average was 139.91 ± 22.3. Among the premature group, the cerebral oximeter average was 79.08 ± 9.04, the pulse oximeter average was 92.01 ± 5.3 and the heart rate average was 135.35 ± 17.03. In the control group, the cerebral oximeter average was 77.56 ± 7.6, the pulse oximeter average was 92.82 ± 3.8 and the heart rate average was 127.04 ± 19.7. Conclusion: Cerebral oximeter is a promising modality in bedside monitoring in neonatal intensive care units. It is complementary to pulse oximeter. It may be used routinely in neonatal intensive care units. PMID:25867556

  6. IgE screening in 1701 newborn infants and the development of atopic disease during infancy.

    PubMed Central

    Croner, S; Kjellman, N I; Eriksson, B; Roth, A

    1982-01-01

    IgE screening was done using the Phadebas IgE PRIST technique on the cord blood of 1701 newborn infants. Of these 8.3% developed obvious or probable atopic disease, predominantly atopic dermatitis and bronchial asthma, during the first 18 months of life. Of infants with a family history of atopic disease 10.5% developed such illness; the corresponding figure for infants with an initially high IgE concentration was 70%. Atopic disease developed in 73% of infants with a high IgE concentration in cord blood and a family history, but in only 3% of infants with a low IgE and no family history. A high IgE concentration in cord blood was associated with a high IgE and a positive radioallergosorbent test at between ages 18 and 24 months more often than was a low initial IgE level, indicating that in man as in animals there are high and low IgE responders already genetically coded at birth. IgE screening in cord blood is recommended if there is obvious atopy in both parents or if severe atopic disease if present in a sibling or in one parent. PMID:7092292

  7. 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

  8. Robust reference intervals for Liver function test (LFT) analytes in newborns and infants

    PubMed Central

    2012-01-01

    Background Reference intervals (RIs) are ranges of upper and lower limits of a given analyte which are used for a laboratory test to determine whether a disease is present or absent or to know if the patient is at risk for future disease states. In Ethiopia, a country with highly diversified population groups and geographical sites, there are no established RIs to metabolic analytes including the liver function test (LFT) analytes for the pediatric population though it has been known that liver function assessment in this population is vital as a result of varied vulnerability to both endogenous and xenobiotic substances. Methods A cross sectional study was conducted in Tikur Anbessa Specialized Hospital (TASH) and Teklehaymanot Health Center (THC) from November 2010 to April 2011. 117 cord blood (from newborns) and venous blood samples (from infants) were collected and analyzed using HumaStar 300. All pre-analytical, analytical and post-analytical aspects were thoroughly controlled. A robust, CLSI/ IFCC recommended, method was used for the determination of upper and lower end points covering 95% of the reference values of each analyte with respective 90% CIs using MedCalc® software. Results Combined RIs for newborns and infants were established for albumin, AST, ALP, direct bilirubin and total bilirubin to be 3.88-5.82 g/dl, 16.1-55.4U/l, 130-831U/l, <0.41 mg/dl and <1.37 mg/dl respectively. But, separated RIs were indicated for ALT and GGT as 1.2-23.1U/l and 6.94-24.8U/l ALT; and 30.6-160.7U/L and 10–28.2U/l GGT for newborns and infants respectively. Some maternal and infantile factors were identified to affect the values of analytes. Conclusion Almost all analytes were different from previously reported values for other target population of similar age group, kit insert values and adult values. So, interpretation of values of these analytes in newborns and infants of Ethiopian population sounds better to be performed by using such RIs taking the effect of

  9. [Anatomic approach to the sphenooccipital synchondrosis in newborns and infants with craniocerebral injury].

    PubMed

    Parilov, S L; Chikun, V I; Klevno, V A

    2008-01-01

    An anatomic approach is developed to sphenooccipital synchondrosis in newborn infants and nurslings. After removal of the squamous portion of the occipital bone by the method of Medvedev, opening of the cerebrospinal canal, removal of the spinal cord and hypophysis, two parallel cuts converging at an angle of approximately 90 degrees were made with a dissecting blade saw along both sides of sella turcica towards the anterior edge of the great occipital foramen to transect the sphenoid bone and main part of the occipital bone. The resulting osteochondrous fragment showed up defects in synchondrosis including consolidated ones.

  10. A Case Study of the Environmental Experience of a Hospitalized Newborn Infant With Complex Congenital Heart Disease.

    PubMed

    Daniels, Jacki M; Harrison, Tondi M

    2016-01-01

    Infants with complex congenital heart disease are at high risk for developmental delays. Although the etiology of these delays is multifactorial, the physical environment may be a contributory factor. Extensive studies have been conducted in neonatal intensive care units measuring environmental influences on development, resulting in policy and practice changes. Cardiothoracic intensive care units and cardiac step-down units are new environments in which newborns with heart disease receive care. No environmental studies have been conducted in units caring for newborn infants recovering from cardiac surgery. The aim of this study is to examine the environmental experience of a newborn infant with heart disease after surgical intervention within the first month of life. Measurements of illumination, sound levels, and sleep were recorded on 1 infant for 2 consecutive postoperative days in the cardiothoracic intensive care unit and 2 consecutive days in the step-down unit. Although average daily noise exposure remained below recommended guidelines on 3 of 4 days, the infant experienced intermittent periods of excessive noise (≥55 dBA) during 59 of 87 hours and 110 episodes of acute noise events greater than 70 dBA. Average daily light exposure was below the recommended guidelines. However, light levels were more than twice the recommended levels at multiple points daily. For each of the 4 observation days, the infant experienced 66 to 102 awakenings during sleep, and sleep durations were less than 30 minutes 90% of the time. This study provides the first report of potential environmental stressors in newborn infants cared for in cardiac specialty units. Excessive levels of light and noise as well as frequent interruptions for medical and nursing care may contribute to disorganized sleep and increased patient distress and may impact subsequent neurodevelopment. Studies are needed to identify potentially adverse aspects of the intensive caregiving environment for

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

    PubMed

    Baumgart, S

    1982-10-01

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

  12. Feasibility of quantitative ultrasound measurements on the humerus of newborn infants for the assessment of the skeletal status.

    PubMed

    Gonnelli, S; Montagnani, A; Gennari, L; Martini, S; Merlotti, D; Cepollaro, C; Perrone, S; Buonocore, G; Nuti, R

    2004-07-01

    Quantitative ultrasound (QUS), although widely used in adults has, so far, been scarcely employed in newborn infants and children. This study aimed to evaluate the feasibility of the use of QUS in newborn children and the factors influencing QUS parameters. In 140 consecutive healthy full-term newborn babies (76 male and 64 female; gestational age: 39.5 +/- 1.5 weeks) QUS parameters were assessed within 3 days of the child's birth at the distal diaphysis of the humerus by use of Bone Profiler, after an appropriate modification of caliper and software. In all subjects we evaluated the amplitude-dependent speed of sound (AD-SoS) (meters per second), the characterizing graphic trace parameters [signal dynamic (SDy), fast wave amplitude (FWA) and bone transmission time (BTT)], SoS (meters per second), that is, the speed of sound calculated on the first peak, and hBTT, that is, the interval time between the first peak of the ultrasound and when this reaches the speed of 1,570 m/s, which is the velocity of ultrasound in the soft tissue. This latter parameter allows one to measure bone tissue independently of soft tissue. QUS measurements were also performed at the phalanges on all mothers (age range 24-38 years), who also completed a self-report questionnaire on their obstetric history, smoking and dietary habits and family history of osteoporosis. In 73 mothers and their children QUS was repeated after 12 months. All QUS parameters were slightly higher in male than in female newborn infants but the difference was not significant. BTT and hBTT of neonates showed a significant relationship with birth weight (r = 0.20; P < 0.05 and r = 0.37; P < 0.01, respectively) and with cranial circumference (r = 0.22; P < 0.05 and r = 0.36; P < 0.01, respectively). In newborn infants none of the QUS parameters was significantly influenced by maternal QUS or by maternal smoking and calcium intake. In a model of multiple regression analysis the cranial circumference was the only

  13. The Parental Experience of Having an Infant in the Newborn Intensive Care Unit

    PubMed Central

    Obeidat, Hala M.; Bond, Elaine A.; Callister, Lynn Clark

    2009-01-01

    The purpose of this systematic review was to explore and describe the experience of parents with an infant in the newborn intensive care unit (NICU). A literature search covering the period 1998–2008 was conducted. Fourteen articles reporting qualitative studies describing parental experiences and meeting the inclusion criteria were evaluated and themes were identified. Findings revealed that parents with an infant in the NICU experience depression, anxiety, stress, and loss of control, and they vacillate between feelings of inclusion and exclusion related to the provision of health care to their neonate. Nursing interventions that promote positive psychosocial outcomes are needed to decrease parental feelings of stress, anxiety, and loss of control. Interventions need to focus on family-centered and developmentally supportive care. PMID:20514124

  14. Feasibility and safety of intact cord resuscitation in newborn infants with congenital diaphragmatic hernia (CDH).

    PubMed

    Lefebvre, Caroline; Rakza, Thameur; Weslinck, Nathalie; Vaast, Pascal; Houfflin-Debarge, Véronique; Mur, Sébastien; Storme, Laurent

    2017-08-30

    Starting resuscitation before clamping the umbilical cord at birth may progressively increase pulmonary blood flow while umbilical venous blood flow is still contributing to maintenance of oxygenation and left ventricle preload. To evaluate the feasibility, safety, and effects of intact cord resuscitation (ICR) on cardiorespiratory adaptation at birth in newborn infants with CDH. Prospective, observational, single-center pilot study. Physiologic variables and outcomes were collected prospectively in 40 consecutive newborn infants with an antenatal diagnosis of isolated CDH. Infants were managed with immediate cord clamping (ICC group) from 1/2012 to 5/2014 or the cord was clamped after initiation of resuscitation maneuvers (ICR group) from 6/2014 to 4/2016 (20 in each group). Ante- and postnatal markers of CDH severity were similar between groups. Resuscitation before cord clamping was possible for all infants in the ICR group. No increase in maternal or neonatal adverse events was observed during the period of ICR. The pH was higher and the plasma lactate concentration was significantly lower at one hour after birth in the ICR than in the ICC group (pH=7.17±0.1 vs 7.08±0.2; lactate=3.6±2.3 vs 6.6±4.3mmol/l, p<0.05). Mean blood pressure was significantly higher in the ICR than in the ICC group at H1 (52±7.7 vs 42±7.5mmHg), H6 (47±3.9 vs 40±5.6mmHg) and H12 (44±2.9 vs 39±3.3mmHg) (p<0.05). Commencing resuscitation and initiating ventilation while the infant is still attached to the placenta is feasible in infants with CDH. The procedure may support the cardiorespiratory transition at birth in infants with CDH. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. 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

  16. Anesthetic use in newborn infants: the urgent need for rigorous evaluation

    PubMed Central

    Nasr, Viviane G.; Davis, Jonathan M.

    2015-01-01

    Approximately 1.5 million neonates receive general anesthesia each year for a surgical procedure. Despite this being an essential practice, a number of recent studies now indicate that anesthetic exposure could cause toxicity and neuronal apoptosis in the developing brain. This could potentially influence long-term neurodevelopmental outcome, especially premature infants in need of multiple surgical procedures. Most anesthetic drugs routinely administered to neonates have not been adequately tested for safety or efficacy. Given the number of confounders, dosing is often extrapolated from adults. This is concerning since many different drugs can be administered concurrently, with few of these agents actually approved for use by the Food and Drug Administration. Since 1997, legislation has been passed in the United States and abroad encouraging more drug investigation in infants and children. This has resulted in over 500 labeling changes to products regarding safety and efficacy in various pediatric age groups. However, only three drugs routinely used as anesthetic agents in newborn infants have had any updated labeling (none in very premature infants). This “off-label” use without adequate testing must be addressed. Therefore, more clinical trials of common anesthetic agents used alone and in combination in neonates are urgently needed. PMID:25790274

  17. Risk factors associated with neonatal hypothermia during cleaning of newborn infants in labour rooms.

    PubMed

    Cheah, F C; Boo, N Y

    2000-02-01

    Cleaning newborn infants with coconut oil shortly after birth is a common practice in Malaysian labour rooms. This study aimed: (1) to determine whether this practice was associated with a significant decrease in the core temperature of infants; and (2) to identify significant risk factors associated with neonatal hypothermia. The core temperature of 227 randomly selected normal-term infants immediately before and after cleaning in labour rooms was measured with an infrared tympanic thermometer inserted into their left ears. Their mean post-cleaning body temperature (36.6 degrees C, SD = 1.0) was significantly lower than their mean pre-cleaning temperature (37.1 degrees C, SD = 1.0; p < 0.001). Logistic regression analysis showed that the risk factors significantly associated with pre-cleaning hypothermia (< 36.5 degrees C) were: (1) not being placed under radiant warmer before cleaning p = 0.03); and (2) lower labour room temperature (p < 0.001). Logistic regression analysis also showed that the risk factors significantly associated with post-cleaning hypothermia were: (1) lower labour room temperature (p < 0.001); (2) lower pre-cleaning body temperature (p < 0.001); and (3) longer duration of cleaning (p = 0.002). In conclusion, to prevent neonatal hypothermia, labour room temperature should be set at a higher level and cleaning infants in the labour room should be discouraged.

  18. Dietary intake and bio-activation of nitrite and nitrate in newborn infants

    PubMed Central

    Jones, Jesica A.; Hopper, Andrew O.; Power, Gordon G.; Blood, Arlin B.

    2015-01-01

    Nitrate and nitrite are commonly thought of as inert end products of nitric oxide (NO) oxidation, possibly carcinogenic food additives, or well-water contaminants. However, recent studies have shown that nitrate and nitrite play an important role in cardiovascular and gastrointestinal homeostasis through conversion back into NO via a physiological system involving enterosalivary recirculation, bacterial nitrate reductases, and enzyme-catalyzed or acidic reduction of nitrite to NO. The diet is a key source of nitrate in adults; however, infants ingest significantly less nitrate due to low concentrations in breast milk. In the mouth, bacteria convert nitrate to nitrite, which has gastro-protective effects. However, these nitrate-reducing bacteria are relatively inactive in infants. Swallowed nitrite is reduced to NO by acid in the stomach, affecting gastric blood flow, mucus production, and the gastric microbiota. These effects are likely attenuated in the less acidic neonatal stomach. Systemically, nitrite acts as a reservoir of NO bioactivity that can protect against ischemic injury, yet plasma nitrite concentrations are markedly lower in infants than in adults. The physiological importance of the diminished nitrate→nitrite→NO axis in infants and its implications in the etiology and treatment of newborn diseases such as necrotizing enterocolitis and hypoxic/ischemic injury are yet to be determined. PMID:25314582

  19. [Effect of very early kangaroo care on extrauterine temperature adaptation in newborn infants with hypothermia problems].

    PubMed

    Huang, Ya-Yi; Huang, Ching-Yi; Lin, Shiu-Mei; Wu, Shu-Chuan

    2006-08-01

    Increased morbidity and mortality has been associated with neonates admitted with body temperatures below 36 degrees C. We employed an experimental design in a randomized control trial to compare the effectiveness of using early kangaroo care (KC) for extrauterine temperature adaptation against that of using radiant warmers. Trial subjects included 78 consecutive cesarean newborn infants with hypothermia problems. The KC group received skin-to-skin contact with their mothers in the post-operative room, while infants in the control group received routine care under radiant warmers. The mean temperature of the KC group was slightly higher than that of the control group (36.29 degrees C vs. 36.22 degrees C, p = .044). After four hours, 97.43% of KC group infants had reached normal body temperatures, compared with 82.05% in the radiant warmer group. Results demonstrate the positive effects of KC for extrauterine temperature adaptation in hypothermia infants. In the course of evidence-based practice, KC could be incorporated into the standard care regimen in order to improve hypothermia care.

  20. Screening for seemingly healthy newborns with congenital cytomegalovirus infection by quantitative real-time polymerase chain reaction using newborn urine: an observational study

    PubMed Central

    Yamaguchi, Akira; Oh-ishi, Tsutomu; Arai, Takashi; Sakata, Hideaki; Adachi, Nodoka; Asanuma, Satoshi; Oguma, Eiji; Kimoto, Hirofumi; Matsumoto, Jiro; Fujita, Hidetoshi; Uesato, Tadashi; Fujita, Jutaro; Shirato, Ken; Ohno, Hideki; Kizaki, Takako

    2017-01-01

    Objective Approximately 8–10% of newborns with asymptomatic congenital cytomegalovirus (cCMV) infection develop sensorineural hearing loss (SNHL). However, the relationship between CMV load, SNHL and central nervous system (CNS) damage in cCMV infection remains unclear. This study aimed to examine the relationship between urinary CMV load, SNHL and CNS damage in newborns with cCMV infection. Study design The study included 23 368 newborns from two maternity hospitals in Saitama Prefecture, Japan. Urine screening for cCMV infection (quantitative real-time PCR) and newborn hearing screening (automated auditory brainstem response (AABR) testing) were conducted within 5 days of birth to examine the incidence of cCMV infection and SNHL, respectively. CNS damage was assessed by MRI of cCMV-infected newborns. Results The incidence of cCMV infection was 60/23 368 (0.257%; 95% CI 0.192% to 0.322%). The geometric mean urinary CMV DNA copy number in newborns with cCMV was 1.79×106 copies/mL (95% CI 7.97×105 to 4.02×106). AABR testing revealed abnormalities in 171 of the 22 229 (0.769%) newborns whose parents approved hearing screening. Of these 171 newborns, 22 had SNHL (12.9%), and 5 of these 22 were infected with cCMV (22.7%). Newborns with both cCMV and SNHL had a higher urinary CMV DNA copy number than newborns with cCMV without SNHL (p=0.036). MRI revealed CNS damage, including white matter abnormalities, in 83.0% of newborns with cCMV. Moreover, newborns with CNS damage had a significantly greater urinary CMV load than newborns without CNS damage (p=0.013). Conclusions We determined the incidence of cCMV infection and urinary CMV DNA copy number in seemingly healthy newborns from two hospitals in Saitama Prefecture. SNHL and CNS damage were associated with urinary CMV DNA copy number. Quantification of urinary CMV load may effectively predict the incidence of late-onset SNHL and neurodevelopmental disorders. PMID:28110288

  1. Cord Blood Irisin Levels are Positively Correlated with Birth Weight in Newborn Infants

    PubMed Central

    Joung, Kyoung Eun; Park, Kyung-Hee; Filippiaos, Andreas; Dincer, Fadime; Christou, Helen; Mantzoros, Christos S.

    2017-01-01

    Background Irisin is a novel myokine, secreted from skeletal muscle after exercise. Irisin mediates exercise-related energy expenditure by turning white adipose tissue (WAT) into brown adipose tissue (BAT). Thus, irisin is considered as a potential biomarker for obesity and metabolic syndrome. Infants born small for gestational age (SGA) have increased risk for metabolic syndrome. However, the physiologic role of irisin in neonates remains to be studied. Objective To evaluate the association of umbilical cord blood irisin levels with gestational age and birth weight categories in neonates. Methods A cross-sectional study of 341 newborns, from 26 to 41 weeks' gestation. We collected umbilical cord blood and analyzed plasma for irisin by ELISA. Results Plasma irisin levels were positively correlated with gestational age (r=0.21, p<0.001), and birth weight Z-score (r=0.18, p<0.001). SGA infants had significantly lower irisin (median [interquartile range] 55.38 [46.56 - 65.72] ng/mL) compared to appropriate for gestational age infants (64.41 [53.87 - 76.76] ng/mL) and large for gestational age infants (68.70 [54.78 - 79.09] ng/mL, p<0.01). The association between SGA and lower irisin remained significant in multivariate analysis independent of gestational age, maternal age, maternal BMI, and gestational diabetes (p=0.03). In singleton infants, irisin was also significantly negatively associated with maternal preeclampsia (p=0.01). Conclusions Our results support the notion that irisin may have a physiologic role in neonates. We speculate that decreased levels of irisin in SGA infants may contribute to the development of catch up growth and metabolic syndrome later in life. PMID:26303870

  2. [A clinical study on 106 infant cases who received detailed hearing tests after newborn hearing screening].

    PubMed

    Okano, Takayuki; Iwai, Noriko; Taniguchi, Mirei; Ito, Juichi

    2014-10-01

    Newborn hearing screening (NHS) has been conducted widely in Japan in the last decade, however, there seems to be some confusion regarding the significance of NHS or management of the results obtained from NHS among clinics and practitioners. The system of NHS in Japan should be improved and refined through continuous evaluation of NHS, in terms of cost effectiveness in particular, so that NHS can be conducted more efficiently and effectively. To achieve this goal, the authors thought it important to clarify the current status and roles of our department as a facility for infants with congenital hearing impairment. In the present study, we studied 106 infant cases who were referred to the Department of Otolaryngology in Kyoto University Hospital after NHS before the age of twelve months in a period of seven years from 2006 to 2012 via retrospective chart reviewing. 79.2% of 96 infants who were qualified as referred either unilaterally or bilaterally following NHS were diagnosed as having hearing impairment in any form, either unilateral or bilateral, or conductive and/or sensorineural. The positive agreement rate was 88.7% in 53 cases who were qualified as referred bilaterally in NHS, demonstrating a high reliability of the NHS system. Twenty-four cases were diagnosed as having the need for hearing aids and were assigned to treatment and education. All the infants who underwent cochlear implantation in our department had severe bilateral hearing impairment of more than 105 dBnHL in both ears at the first examination. Moreover, a number of infants who were qualified as having passed in both ears in NHS or who had failed to receive NHS at birth were revealed as having hearing impairment and needed treatment later in the first year of their life, suggesting that NHS should be conducted in combination with periodical health checkups by family practitioners in order to identify infants with hearing impairment earlier in their life with higher efficacy.

  3. Thyroid status of iodine deficient newborn infants living in central region of Turkey: a pilot study.

    PubMed

    Bastug, Osman; Korkmaz, Levent; Halis, Hulya; Memur, Seyma; Korkut, Sabriye; Ozdemir, Ahmet; Gunes, Tamer; Ozturk, Mehmet Adnan; Kurtoglu, Selim

    2017-10-01

    Iodine deficiency (ID) during the fetal and neonatal periods can lead to neonatal hypothyroidism. This study was conducted to evaluate the effect of ID on the thyroid hormone level of newborns living in Turkey. Between 1998 and 2013, 71 newborns with a urinary iodine concentration <100 μg/L were recruited into the study. Data on thyroid volume, free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroglobulin (Tg) were collected from all newborns, and on breast milk iodine from their mothers. Infants who were classified as having congenital hypothyroidism (TSH >40 mU/L and fT4 <8.5 pmol/L) were treated with levothyroxine (n=26, T group), while the remaining infants remained untreated (n=45, UT group). Thyroid hormones were subsequently measured 7-14 days later in a sub-sample of both treated and untreated infants. The average values at the time of admission were as follows [median (min-max)]. fT3: 5.0 (2.8-7.1) pmol/L, fT4: 7.7 (0.13-19.1) pmol/L, TSH: 75 (14-426) mU/L, Tg: 464 (226-1100) ng/mL, urinary iodine concentration (UIC): 30 (0-61) μg/L, breast milk iodine levels: 21 (10-150) μg/L, thyroid ultrasound (USG): 1.10 (0.24-1.95) mL for the T group; and fT3: 5.7 (1.7-12.7) pmol/L, fT4: 16.2 (9.9-33.5) pmol/L, TSH: 5.4 (0.63-41.8) mU/L, Tg: 171 (15-2124) ng/mL, UIC: 39 (0-90) μg/L, breast milk iodine levels: 47 (10-120) μg/L, thyroid USG: 0.75 (0.35-1.72) mL for the UT group. A significant difference was found between groups in respect to fT3, fT4, TSH and Tg levels. No significant difference in thyroid ultrasonography, UIC, and breast milk iodine levels was found between the two groups. The Tg levels of 50 out of 71 patients were measured, 40 (80%) of whom had Tg levels above the normal range (101 ng/mL). In our country, despite the use of iodized salt, congenital hypothyroidism due to ID remains a problem. The Tg level of newborns can be used as a good indicator of ID.

  4. Variables associated with peripherally inserted central catheter related infection in high risk newborn infants 1

    PubMed Central

    Rangel, Uesliz Vianna; Gomes, Saint Clair dos Santos; Costa, Ana Maria Aranha Magalhães; Moreira, Maria Elisabeth Lopes

    2014-01-01

    OBJECTIVE: to relate the variables from a surveillance form for intravenous devices in high risk newborn infants with peripherally inserted central catheter related infection. METHODOLOGY: approximately 15 variables were studied, being associated with peripherally inserted central catheter related infection, this being defined by blood culture results. The variables analyzed were obtained from the surveillance forms used with intravenous devices, attached to the medical records of newborn infants weighing between 500 and 1,499 g. The statistical association was defined using the Chi-squared and Student t tests. The study was approved by the Research Ethics Committee of the Instituto Fernandes Figueira under process N. 140.703/12. RESULTS: 63 medical records were analyzed. The infection rate observed was 25.4%. Of the variables analyzed, only three had a statistically-significant relationship with the blood culture - the use of drugs capable of inhibiting acid secretion, post-natal steroid use, and undertaking more than one invasive procedure (p-value of 0.0141, 0.0472 and 0.0277, respectively). CONCLUSION: the absence of significance of the variables of the form may be related to the quality of the records and to the absence of standardization. It is recommended that the teams be encouraged to adhere to the protocol and fill out the form. PMID:25493681

  5. Prospective cohort study of factors influencing the relative weights of the placenta and the newborn infant.

    PubMed Central

    Williams, L. A.; Evans, S. F.; Newnham, J. P.

    1997-01-01

    OBJECTIVES: To determine the demographic, environmental, and medical factors that influence the relative weights of the newborn infant and the placenta and compare this ratio with other factors known to predispose to adult ill health. DESIGN: Prospective cohort study. SETTING: The tertiary referral centre for perinatal care in Perth, Western Australia. SUBJECTS: 2507 pregnant women who delivered a single live infant at term. MAIN OUTCOME MEASURES: Placental weight, birth weight, and the ratio of placental weight to birth weight. RESULTS: By multiple regression analysis the placental weight to birthweight ratio was significantly and positively associated with gestational age, female sex, Asian parentage, increasing maternal body mass index, increased maternal weight at booking, lower socioeconomic status, maternal anaemia, and increasing number of cigarettes smoked daily. There were no consistent relations between the placental weight to birthweight ratio and measures of newborn size. CONCLUSIONS: The ratio of placental weight to birth weight is not an accurate marker of fetal growth. In its role as a predictor of adult disease the ratio may be acting as a surrogate for other factors which are already known to influence health and may act before or after birth. Determining the role that relative growth rates of the fetus and placenta have in predisposing to adult disease requires prospective study to account for the many confounding variables which complicate this hypothesis. PMID:9224128

  6. Neurobehaviors of Japanese newborns in relation to the characteristics of early mother-infant interaction.

    PubMed

    Loo, Kek Khee; Ohgi, Shohei; Howard, Judy; Tyler, Rachelle; Hirose, Taiko

    2005-09-01

    The authors examined the relationship between newborn neurobehavioral profiles and the characteristics of early mother-infant interaction in Nagasaki, Japan. The authors administered the Brazelton Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent, 1995) in the newborn period and the Nursing Child Assessment Teaching Scale at 1 month (NCATS; G. Sumner & A. Spietz, 1994). They administered the Perceived Stress Scale (S. Cohen, T. Kamarck, & R. Mermelstein, 1983) as an index of maternal stress experienced over the past month. Lower irritability, higher stability in skin coloration, and lower tremulousness in the neonatal period were correlated with higher levels of maternal nurturing behaviors at 1 month. Birth weight and 2 NBAS range-of-state items (peak of excitement, irritability) predicted 31% of the variance in NCATS caregiver subscale score. The NBAS autonomic stability items (tremulousness, startles, lability of skin color) predicted 31% of the variance in the NCATS child subscale score. Perceived stress and maternal sociodemographic variables (education, income, age, parity) were not associated with child, caregiver, and total scores on the NCATS. The results suggested that lack of autonomic stability in Japanese neonates might serve as an early indicator of infant frailty, negative behavioral cues, and decreased maternal responsiveness.

  7. Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants.

    PubMed

    Fernandez, Erika; Watterberg, Kristi L; Faix, Roger G; Yoder, Bradley A; Walsh, Michele C; Lacy, Conra Backstrom; Osborne, Karen A; Das, Abhik; Kendrick, Douglas E; Stoll, Barbara J; Poindexter, Brenda B; Laptook, Abbot R; Kennedy, Kathleen A; Schibler, Kurt; Bell, Edward F; Van Meurs, Krisa P; Frantz, Ivan D; Goldberg, Ronald N; Shankaran, Seetha; Carlo, Waldemar A; Ehrenkranz, Richard A; Sánchez, Pablo J; Higgins, Rosemary D

    2015-09-01

    We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Interleukin-8 (CXCL8) production is a signatory T cell effector function of human newborn infants.

    PubMed

    Gibbons, Deena; Fleming, Paul; Virasami, Alex; Michel, Marie-Laure; Sebire, Neil J; Costeloe, Kate; Carr, Robert; Klein, Nigel; Hayday, Adrian

    2014-10-01

    In spite of their precipitous encounter with the environment, newborn infants cannot readily mount T helper type 1 (TH1) cell antibacterial and antiviral responses. Instead, they show skewing toward TH2 responses, which, together with immunoregulatory functions, are thought to limit the potential for inflammatory damage, while simultaneously permitting intestinal colonization by commensals. However, these collective capabilities account for relatively few T cells. Here we demonstrate that a major T cell effector function in human newborns is interleukin-8 (CXCL8) production, which has the potential to activate antimicrobial neutrophils and γδ T cells. CXCL8 production was provoked by antigen receptor engagement of T cells that are distinct from those few cells producing TH1, TH2 and TH17 cytokines, was co-stimulated by Toll-like receptor signaling, and was readily apparent in preterm babies, particularly those experiencing neonatal infections and severe pathology. By contrast, CXCL8-producing T cells were rare in adults, and no equivalent function was evident in neonatal mice. CXCL8 production counters the widely held view that T lymphocytes in very early life are intrinsically anti-inflammatory, with implications for immune monitoring, immune interventions (including vaccination) and immunopathologies. It also emphasizes qualitative distinctions between infants' and adults' immune systems.

  9. Methadone-exposed newborn infants: outcome after alterations to a service for mothers and infants.

    PubMed

    Miles, J; Sugumar, K; Macrory, F; Sims, D G; D'Souza, S W

    2007-03-01

    To evaluate the impact of a shared care approach in clinical management with a drug liaison midwife (DLM) service for mothers and infants established in 1995-1996 in an inner city area and to address the problem of congenital abnormality and microcephaly with fetal drug exposure. Descriptive analysis of data in live births of women enrolled in a methadone maintenance programme in 1991-1994 (n = 78) and 1997-2001 (n = 98), including time spent in hospital, treatment for neonatal abstinence syndrome (NAS), admission to the neonatal medical unit (NMU) and follow-up for child health checks. In 1997-2001 compared with 1991-1994, the mothers used more methadone in the last week of pregnancy (median 40.0 mg/day vs. 21.5 mg/day, P = 0.0006) and there were more preterm deliveries (36% vs. 21%, P = 0.03). The infants spent less time in hospital (median 5 days vs. 28 days, P < 0.0001), a smaller proportion had treatment for NAS (14% vs. 79%, P < 0.0001), and NMU admission was reduced (median 14 days vs. 26 days, P < 0.0003). Neonatal convulsions (P = 0.0001) and jaundice (P < 0.001) occurred less frequently, and more infants were breastfed (P = 0.001). One infant in each study group had a cleft palate and none had microcephaly. Child health checks for 18-24 months showed a favourable outcome in 1997-2001. We altered antenatal care and modified neonatal management, subsequently infants spent less time in hospital and NMU admissions were reduced with less NAS treatment. Congenital abnormalities and microcephaly were not common and as regular child health checks were possible, the impact of the DLM service in shared management merits further investigation, for mother-infant bonding and developmental outcome.

  10. Weight-Gain Velocity in Newborn Infants Managed with the Kangaroo Method and Associated Variables.

    PubMed

    Nobre, Raquel Guimarães; de Azevedo, Daniela Vasconcelos; de Almeida, Paulo César; de Almeida, Nádia Maria Girão Saraiva; Feitosa, Francisco Edson de Lucena

    2017-01-01

    Objectives The Kangaroo method helps promote maternal breastfeeding and adequate growth of low birthweight preterm infants. The objective of this study was to analyze the association between weight-gain velocity during use of the Kangaroo method and maternal and infant variables. Methods A nested cross-sectional study in a cohort of newborn infants managed using the Kangaroo method was carried out at a reference center for the method in Brazil. Data on low birthweight and preterm infants managed using the Kangaroo Method (n = 78) and on their respective mothers (n = 70) was collected between January and July 2014. Maternal and infant variables were associated and correlated with weight-gain velocity (g/kg/day) at each phase of the method (p < 0.05). Results Mean weight-gain velocity increased from 0.12 ± 11.11 g/kg/day in the first phase to 13.47 ± 4.84 g/kg/day in the third phase (p < 0.001), and percentage of adequate weight increased at phase 3 (p < 0.001). Birthweight was inversely correlated with weight-gain velocity at phases 1 and 2 of the Kangaroo method. Birthweight of under 1500 g was associated with a lower likelihood of inadequate weight-gain velocity of the newborn at phase 1 (OR = 0.1; 95 % CI 0.01-0.78; p = 0.012). In phase 3, maternal age was directly correlated with weight-gain velocity. Conclusions Weight-gain velocity was associated with maternal (age) and infant (gestational age at birth, birthweight, weight for gestational age at birth, length of hospital stay and five-minute Apgar score) variables. Knowledge of the factors influencing weight-gain velocity and its behavior at each phase of the method can help guide conduct toward potentializing factors that promote adequate weight-gain.

  11. Continuous infusion of clonidine in ventilated newborns and infants: a randomized controlled trial.

    PubMed

    Hünseler, Christoph; Balling, Gunter; Röhlig, Christoph; Blickheuser, Rainer; Trieschmann, Uwe; Lieser, Ulla; Dohna-Schwake, Christian; Gebauer, Corinna; Möller, Oliver; Hering, Fritz; Hoehn, Thomas; Schubert, Stephan; Hentschel, Roland; Huth, Ralf G; Müller, Andreas; Müller, Carsten; Wassmer, Gernot; Hahn, Moritz; Harnischmacher, Urs; Behr, Julie; Roth, Bernhard

    2014-07-01

    To assess the influence of an infusion of clonidine 1 μg/kg/hr on fentanyl and midazolam requirement in ventilated newborns and infants. Prospective, double-blind, randomized controlled multicenter trial. Controlled trials.com/ISRCTN77772144. Twenty-eight level 3 German PICUs/neonatal ICUs. Ventilated newborns and infants: stratum I (1-28 d), stratum II, (29-120 d), and stratum III (121 d to 2 yr). Patients received clonidine 1 μg/kg/hr or placebo on day 4 after intubation. Fentanyl and midazolam were adjusted to achieve a defined level of analgesia and sedation according to Hartwig score. Two hundred nineteen infants were randomized; 212 received study medication, 69.7% were ventilated in the postoperative care and 30.3% for other reasons. Primary endpoint: consumption of fentanyl and midazolam in the 72 hours following the onset of study medication (main observation period) in the overall study population. The confirmatory analysis of the overall population showed no difference in the consumption of fentanyl and midazolam. Explorative age-stratified analysis demonstrated that in stratum I (n = 112) the clonidine group had a significantly lower consumption of fentanyl (clonidine: 2.1 ± 1.8 μg/kg/hr, placebo: 3.2 ± 3.1 μg/kg/hr; p = 0.032) and midazolam (clonidine: 113.0 ± 100.1 μg/kg/hr, placebo: 180.2 ± 204.0 μg/kg/hr; p = 0.030). Strata II (n = 43) and III (n = 46) showed no statistical difference. Sedation and withdrawal-scores were significantly lower in the clonidine group of stratum I (p < 0.001). Frequency of severe adverse events did not differ between groups. Clonidine 1 μg/kg/hr in ventilated newborns reduced fentanyl and midazolam demand with deeper levels of analgesia and sedation without substantial side effects. This was not demonstrated in older infants, possibly due to lower clonidine serum levels.

  12. 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

  13. The influence of maternal anthropometric characteristics on the birth size of term singleton South-East Nigerian newborn infants.

    PubMed

    Onubogu, C U; Egbuonu, I; Ugochukwu, E F; Nwabueze, A S; Ugochukwu, O

    2017-07-01

    This study examined the usefulness of maternal anthropometry in predicting the birth size of term singleton newborn infants at NAUTH, Nnewi, Nigeria. A cross-sectional study was conducted among 301 mother/newborn infant pairs. The mean birth weight was 3.27 ± 0.60 kg whereas the incidence of low birth weight and fetal macrosomia were 8.0% and 11.3%, respectively. The anthropometric indices varied in their ability to detect newborn babies who experienced abnormal intrauterine growth. The rate of subnormal intrauterine growth was 9.0%, 11.6%m and 18.6% using weight-for-gestational age (GA), ponderal index (PI), and mid-arm circumference (MAC)/occipito-frontal circumference (OFC) criteria, respectively. On the other hand, the rate of excessive intrauterine growth was 16.6% and 12.0% using weight-for-GA and PI criteria, respectively. Apart from maternal height, all the assessed maternal anthropometric parameters had a significant relationship with size at birth. Mothers of newborn infants who experienced subnormal intrauterine growth were more likely to have MAC < 25 cm, intrapartum weight < 65 kg, intrapartum BMI < 25 kg/m2, and rate of third trimester weight gain < 250 g/week. On the other hand, mothers of newborn infants who experienced excessive intrauterine growth were more likely to have MAC > 30 cm, intrapartum BMI ≥ 30 kg/m2, and rate of third trimester weight gain ≥ 500 g/week. Conclusion/Recommendation: Maternal anthropometry is a very useful tool in identifying mothers at risk of having newborn infants who experienced abnormal intrauterine growth. Therefore, its routine application is recommended to enable such mothers benefit from interventions targeted at ensuring optimal intrauterine growth and improved pregnancy outcomes.

  14. [Ultrasound echography (A-scan) of the cerebral ventricles in newborn infants: its relation to the degree of maturity and clinical significance].

    PubMed

    Laub, M C; Alberti, P

    1984-01-01

    Since during fetal development the intracerebral ventricular system shows characteristic changes wer tried to varify wether there is a relationship between the width of the ventricles of the newborn and the degree of maturity. In 304 neurologically healthy newborn infants (28. until 42. weeks of gestation) the ventricular diameters in the region of body of the lateral ventricles were measured by ultrasound (A-mode) once between the third and eight day of life. In addition the cella-media-indices were calculated. With increasing maturation we found wider ventricles. Also the cella-media-indices were higher in the more mature infants which we believe is the result from growth of cerebral substance in the last third of pregnancy. Small-for-date infants born at term showed significantly lower cella-media-indices than normal weight term babies (p less than 0,01). These results may help interprete sonographic and computertomographic measurements of the premature ventricles. The significance of ventricular diameters smaller or larger than our normal values is not yet exactly understood and further studies are needed.

  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

  17. Advantages of fentanyl over morphine in analgesia for ventilated newborn infants after birth: A randomized trial.

    PubMed

    Saarenmaa, E; Huttunen, P; Leppäluoto, J; Meretoja, O; Fellman, V

    1999-02-01

    To compare the efficacy and adverse effects of fentanyl or morphine analgesia during the first 2 days of life in newborn infants who underwent mechanical ventilation. In a randomized double-blind trial, 163 infants were allocated to receive a continuous infusion of fentanyl (10.5 microg/kg over a 1-hour period followed by 1.5 microg/kg/hr) or morphine (140 microg/kg over a 1-hour period followed by 20 microg/kg/hr) for at least 24 hours. The severity of pain was assessed with physiological parameters, a behavioral pain scale, and stress hormone concentrations before and 2 and 24 hours after the start of treatment. The analgesic effect was similar in both groups, as judged by the pain scale. Plasma adrenaline and noradrenaline concentrations decreased significantly from 0 to 24 hours in both groups. Median adrenaline decrease was 0.5 nmol/L (interquartile range [IQR] 1.1;0.0) in the fentanyl and 0.7 nmol/L (IQR 1.3;0.1) in the morphine group, noradrenaline 2.1 nmol/L (IQR 9.0;0.2), and 3.0 nmol/L (IQR 7. 5;0.3), respectively. beta-endorphin decreased significantly only in the fentanyl group ( 14 pmol/L (IQR 28; 7), P <.05). Decreased gastrointestinal motility was less frequent in the fentanyl group (23% vs 47%, P <.01). With at least as effective analgesia as with morphine, fentanyl had fewer side effects. Fentanyl may be superior to morphine for short-term postnatal analgesia in newborn infants.

  18. Prolactin, a potential mediator of reduced social interactive behavior in newborn infants following maternal perinatal depressive symptoms.

    PubMed

    Zhang, Huiping; Su, Qian; Yao, Dan; Wang, Shan; Dang, Shaokang; Ding, Ding; Zhu, Zhongliang; Shao, Shuya; Li, Hui

    2017-06-01

    The hormone prolactin (PRL) plays a crucial role for the initiation and maintenance of maternal behavior, and is also associated with the etiology of mood disorders in women, especially for depression. The present study aimed to determine whether maternal peripheral prolactin would be associated with newborn behavior disorders following maternal perinatal depressive symptoms, and further to explore the efficacy of the Newborn Behavioral Observations (NBO) in improving newborn social interactive behavior. Interview and the 24-item Hamilton Rating Scale for Depression (HAMD) were used to assess the hospitalized pregnant women waiting for delivery at 37-42weeks of gestation. A total of 255 subjects were recruited, diagnosed with depression (n=135), and control group (n=120). Within 2 weeks postpartum, mothers were asked to fill with Maternal Attachment Inventory (MAI) to measure maternal care. Neonatal Behavioral Assessment Scale (NBAS) were used to evaluate newborn behavior. The depressed mother-newborns dyad was randomly assigned to NBO intervention and control group. Serum prolaction in mothers and cortisol in mothers and newborns were measured. The newborns of mothers exposed to maternal perinatal depressive symptoms displayed the reduced newborn social interactive behavior accompanied by decreased maternal serum PRL as well as increased maternal and neonatal serum cortisol. The NBO could be an effective intervention tool. Our study could not be double-blind. The mothers knew which group their infant were in. Maternal peripheral PRL had the potential to be a mediator in reduced social interactive behavior in newborn infants following maternal perinatal depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. The Clinical Aspects of Newborn Screening: Importance of Newborn Screening Follow-Up

    ERIC Educational Resources Information Center

    James, Philip M.; Levy, Harvey L.

    2006-01-01

    The aim of newborn screening is to identify presymptomatic healthy infants that will develop significant metabolic or endocrine derangements if left undiagnosed and untreated. The goal of ultimately reducing or eliminating irreversible sequelae is reached by maximizing test sensitivity of the primary newborn screening that measures specific…

  20. The Clinical Aspects of Newborn Screening: Importance of Newborn Screening Follow-Up

    ERIC Educational Resources Information Center

    James, Philip M.; Levy, Harvey L.

    2006-01-01

    The aim of newborn screening is to identify presymptomatic healthy infants that will develop significant metabolic or endocrine derangements if left undiagnosed and untreated. The goal of ultimately reducing or eliminating irreversible sequelae is reached by maximizing test sensitivity of the primary newborn screening that measures specific…

  1. Accuracy of infrared thermometers in very low birth weight infants and impact on newborn behavioural states.

    PubMed

    Jarvis, Melanie; Guy, Katelyn J; König, Kai

    2013-06-01

    To study the impact on newborn behavioural states and accuracy of three infrared thermometers compared with digital axillary thermometer measurements in very low birth weight infants. Single-centre prospective observational study. Preterm infants born <1500-g birth weight were eligible. Infants were observed for pre-measurement behaviour state using a five-point neonatal behaviour observation tool. One infrared temperature was taken from each of the devices, followed by an axillary measurement. Further behaviour-state observations were recorded following infrared and axillary measurements. One hundred measurements were collected from each infrared device among a cohort of 42 very low birth weight infants. Only one infrared device showed satisfactory agreement with bias -0.071 (95% limits of agreement -0.68 to 0.54). The other two devices demonstrated poor agreement: bias -1.34; 95% limits of agreement -2.62 to -0.5 and bias -0.56; 95% limits of agreement -1.38 to 0.25. Neonatal behavioural scores showed only minimal changes when infrared measurements were performed but increased significantly following axillary measurements. The difference between the two modalities was statistically significant with a mean increase of 1.44 points following axillary measurements (95% confidence interval 1.21 to 1.67, P < 0.001). Temperature measurements taken with infrared thermometers demonstrated less disruption to preterm infants' behavioural state, however accuracy of devices varied. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. 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.

  3. 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…

  4. Total bilirubin level in relation to excipients in parenteral morphine sulfate administered to seriously ill newborn infants.

    PubMed

    Lesko, S M; Mitchell, A A

    1994-10-01

    We examined exposure to excipients in different morphine sulfate preparations in relation to maximum total bilirubin level during the first 5 days of life among 155 infants admitted to a newborn intensive care unit. Sixty-six (43%), 47 (30%), and 42 (27%) newborns were exposed to chlorobutanol, phenol and neither excipient, respectively. Mean maximum total bilirubin in the first 5 days of life among newborns not exposed to chlorobutanol or phenol was 10.8 mg/dL (184 mumol/L). After adjusting for birthweight, race, sex, and use of phototherapy, the maximum total bilirubin level among newborns exposed to phenol was 1.4 mg/dL (24 mumol/L) higher than the maximum level among newborns exposed to neither excipient (P < 0.05); the corresponding difference associated with chlorobutanol exposure was 1.6 mg/dL (27 mumol/L) (P < 0.02). Further adjustment for potential confounding by the major risk factors for hyperbilirubinaemia did not materially change the results. While unconfirmed, these findings support the growing concern that excipients added to parenteral medications may not be 'inactive' as is often assumed, and that the safety of such exposures in seriously ill newborn infants needs to be studied further.

  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. Morphology of chordae tendianeae of atrioventricular heart valves of newborns and infants in terms of laser polarimetry

    NASA Astrophysics Data System (ADS)

    Pentelejchuk, N. P.; Chala, K. M.; Yermolenko, S. B.

    2013-12-01

    The paper studied the morphological features of the structure and polarization properties of tendon tissue strings atrioventricular valvular of newborns and infants on histological sections. Analysis of the obtained results showed high diagnostic sensitivity of statistic moments of coordinate distributions of matrix elements of both types of chordae tendianeae of atrioventricular valves hearts tissue to the changes of optical-geometric structure.

  7. [Impact of cocooning and maternal voice on the autonomic nervous system activity in the premature newborn infant].

    PubMed

    Alexandre, C; De Jonckheere, J; Rakza, T; Mur, S; Carette, D; Logier, R; Jeanne, M; Storme, L

    2013-09-01

    Discomfort, pain, and stress have an adverse impact on the psychomotor development in the premature newborn infant. Recent studies indicate that pain and stress are associated with a reduction of parasympathetic outflow. We hypothesized that cocooning associated with the human voice has a favorable impact on parasympathetic activity in the premature newborn infant. We compared heart rate variability (HRV) before and after standardized cocooning phases associated with the human voice and carried out: 1) by the mother and 2) by a third person. HRV was assessed and expressed as an index reflecting the parasympathetic tone. Ten children were included (median gestational age, 33 weeks (30(+4)-33(+2))). We observed a higher HRV index after the period of cocooning associated with the human voice compared with the baseline measurement (P<0.05), whether the procedure was carried out by the mother or a third person. This study shows that cocooning associated with the human voice enhances HRV in the preterm newborn infant, indicating an increase in parasympathetic activity after cocooning associated with the human voice. However, the impact is similar whether the cocooning associated with the human voice is performed by the mother or a third person. This result suggests that cocooning associated with the human voice carried out either by the mother or a third person contributes to decreasing stress and discomfort in the premature newborn infant. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Holistic Face Processing in Newborns, 3-Month-Old Infants, and Adults: Evidence from the Composite Face Effect

    ERIC Educational Resources Information Center

    Turati, Chiara; Di Giorgio, Elisa; Bardi, Lara; Simion, Francesca

    2010-01-01

    Holistic face processing was investigated in newborns, 3-month-old infants, and adults through a modified version of the composite face paradigm and the recording of eye movements. After familiarization to the top portion of a face, participants (N = 70) were shown 2 aligned or misaligned faces, 1 of which comprised the familiar top part. In the…

  9. Holistic Face Processing in Newborns, 3-Month-Old Infants, and Adults: Evidence from the Composite Face Effect

    ERIC Educational Resources Information Center

    Turati, Chiara; Di Giorgio, Elisa; Bardi, Lara; Simion, Francesca

    2010-01-01

    Holistic face processing was investigated in newborns, 3-month-old infants, and adults through a modified version of the composite face paradigm and the recording of eye movements. After familiarization to the top portion of a face, participants (N = 70) were shown 2 aligned or misaligned faces, 1 of which comprised the familiar top part. In the…

  10. Overview of Longitudinal Survey of Newborns in the 21st Century: Factors Affecting Infant Growth.

    PubMed

    Sata, Fumihiro; Fukuoka, Hideoki; Ozaki, Takashi; Ito, Yoshiya; Yoshiike, Nobuo; Takimoto, Hidemi

    2017-01-01

    There are two major nationwide birth cohort studies in Japan, namely, the Longitudinal Survey of Newborns in the 21st Century conducted by the Ministry of Health, Labor and Welfare (MHLW) and the Japan Environment and Children's Study (JECS) conducted by the Ministry of Environment. The former was a longitudinal questionnaire survey focusing on environmental and socioeconomic factors for descriptive epidemiology conducted every year since 2001 by mail. The latter was based on 15 unit centers nationwide with environmental measurements and collection of biological samples for environmental risk evaluation. Both are prospective birth cohort studies whose findings will be expected as the basis for establishing health policies. The data obtained in the former study can be used for research with permission from MHLW. To date, there have been more than ten published studies using those data. We have reviewed these studies and introduced our preliminary findings on factors affecting infant growth. Employment before delivery, educational background of parents, household income, and smoking habit of both parents have been suggested to affect infant growth. We will analyze the associations between socioeconomic factors and infant growth trajectory to elucidate the most adequate intervention for children.

  11. Correlation between the cord vitamin D levels and regulatory T cells in newborn infants.

    PubMed

    Güven, Ayşegül; Ecevit, Ayşe; Sözer, Oktay; Tarcan, Aytül; Tarcan, Aylin; Ozbek, Namık

    2012-08-01

    Vitamin D is important for calcium homeostasis, muscle, and bone health. It has also immunomodulatory capacities in vivo and in vitro. Regulatory T cells (Treg) have been found to suppress a number of T cell-mediated immune disorders, including allergic responses and autoimmune diseases. This study aimed to investigate the correlation between 25-hydroxyvitamin D (25(OH)D) levels and the regulatory T cells in cord blood. The study group is comprised of 101 full-term newborn infants. Umbilical cord 25(OH)D levels and number and percentage of T lymphocyte, T helper, and Treg cells were measured. Infants were grouped according to 25-hydroxyvitamin D levels (25(OH)D <12 ng/ml and 25(OH)D >12 ng/ml) (converting factor of 25OHD level into SI unit, 2.6). Severe vitamin D deficiency (25(OH)D <12 ng/ml) was observed in 32% of the infants. There was no significant correlation between 25-hydroxyvitamin D levels and T cell number and percentages. There were also no significant differences in white blood cell, total lymphocyte count, T helper, and Treg cell percentage and number between groups. These results suggest that the serum level of 25-hydroxyvitamin D is not crucially involved in the correlation between vitamin D status and T cell regulation in cord blood.

  12. Newborn screening for cystic fibrosis: parents' preferences regarding counseling at the time of infants' sweat test.

    PubMed

    Tluczek, Audrey; Koscik, Rebecca L; Modaff, Peggy; Pfeil, Darci; Rock, Michael J; Farrell, Philip M; Lifchez, Caroline; Freeman, Mary Ellen; Gershan, William; Zaleski, Christina; Sullivan, Bradley

    2006-08-01

    Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents' preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents' preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents' distress while mismatched counseling tended to increase parents' worry about their infant.

  13. Neurophysiological measures of nociceptive brain activity in the newborn infant--the next steps.

    PubMed

    Hartley, Caroline; Slater, Rebeccah

    2014-03-01

    Infants within neonatal intensive care units can receive multiple medically essential painful procedures per day. How they respond to these events, how best to alleviate the negative effects, and the long-term consequences for the infant are all significant questions that have yet to be fully answered. In recent years, several studies have examined cortical responses to noxious stimuli in the neonate through the use of near-infrared spectroscopy (NIRS) and electroencephalography (EEG). These investigations dispel any notion that the newborn infant does not process noxious stimuli at a cortical level and open the way for future research. In this Viewpoint Article, we review these studies and discuss key clinical challenges which may be elucidated with the use of these techniques. Simultaneously measuring the changes that are evoked in behaviour, physiology and the cortex following noxious events will provide the best approach to understanding the neonate's experience of pain. © 2013 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  14. Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

    PubMed Central

    Costa, Ana Cristina de Oliveira; Schettino, Renata de Carvalho; Ferreira, Sandra Clecêncio

    2014-01-01

    Objective To identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes. Methods Prospective study conducted at a neonatal intensive care unit from May to November 2011. A total of 176 infants of both genders subjected to mechanical ventilation were assessed after extubation. Extubation failure was defined as the need to resume mechanical ventilation within less than 72 hours. Reintubation was defined as the need to reintubate the infants any time after the first 72 hours. Results Based on the univariate analysis, the variables gestational age <28 weeks, birth weight <1,000g and low Apgar scores were associated with extubation failure and reintubation. Based on the multivariate analysis, the variables length of mechanical ventilation (days), potential of hydrogen (pH) and partial pressure of oxygen (pO2) remained associated with extubation failure, and the five-minute Apgar score and age at extubation were associated with reintubation. Conclusion Low five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation. PMID:24770689

  15. Acute posterior fossa epidural hematoma in a newborn infant with Menkes disease.

    PubMed

    Takeuchi, Satoru; Horikawa, Masahiro; Wakamatsu, Hajime; Hashimoto, Jyunya; Nawashiro, Hiroshi

    2014-02-01

    Epidural hematoma (EDH) in newborn infants is rare compared with other types of intracranial hemorrhages. Furthermore, posterior fossa EDH is extremely rare. We present a case of posterior fossa EDH in an infant with Menkes disease with accessory bones in the occiput. A male infant with a condition diagnosed with Menkes disease by prenatal testing was born at 39 weeks via vacuum extraction. The patient presented with a mild tremor at 2 days after delivery. A brain computed tomography (CT) scan showed an acute EDH in the posterior fossa, extending into the occipitoparietal area. Three-dimensional CT and bone window CT scan revealed several accessory bones, diastasis of 1 accessory suture, a communicated fracture, and a linear fracture in the occipital bone. Furthermore, a bone fragment from a communicated fracture displaced toward the inside. The patient was treated conservatively for EDH because of his good general condition. The hematoma gradually resolved, and his tremor did not recur. We suggest the following mechanism of posterior fossa EDH development in our patient: (1) external force was applied to the occiput inside the birth canal during delivery, resulting in diastasis; (2) a communicated fracture occurred, and a bone fragment displaced toward the inside (linear fracture was caused indirectly by the force); (3) a transverse sinus was injured by the fragment; and (4) EDH developed in both the posterior fossa and supratentorial region. Copper deficiency can also cause fragility of connective tissues, vessels, and bones.

  16. Telemedicine for the support of parents of high-risk newborn infants.

    PubMed

    Tan, Kenneth; Lai, Nai Ming

    2012-06-13

    Telemedicine is the use of electronic communications technology to provide care for patients when distance separates the practitioner and the patient. As the parents and families of infants admitted to the NICU require major support from health professionals in terms of information and time, telemedicine has the potential to increase this support. To evaluate if the use of telemedicine technology to support families of newborn infants receiving intensive care affects the length of hospital stay and parental/family satisfaction. We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2011, Issue 8), MEDLINE (from 1966 to September 2011), EMBASE (1980 to September 2011). We also searched ClinicalTrials.gov (http://www.clinicaltrials.gov) and the EudraCT (http://eudract.emea.eu.int) web sites. We searched the proceedings of conferences of the Canadian Society of Telehealth, American Telemedicine Association, the International Society for Telemedicine, the Annual Conference of The International e-Health Association, American Medical Informatics Association and MedInfo. We attempted to identify randomised controlled trials that assessed the use of telemedicine designed to support parents of infants cared for in a Neonatal Intensive Care Unit (NICU) compared with standard support measures. Our primary outcome was the length of hospital stay, and secondary outcomes included parental and staff satisfaction, emergency hospital visits post-discharge and family utilisation of infant health-related resources. Two review authors independently screened the studies, extracted the data and assessed the risk of bias of the one included study using the standard methods of the Cochrane Neonatal Review Group. We planned to express treatment effects as risk ratio (RR), risk difference (RD), number needed to treat (NNT) and mean difference (MD) where appropriate, using a fixed-effect model. A single study was included for

  17. 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…

  18. 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

  19. 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.

  20. [Variations of the skin permeability in premature newborn infants. Value of the skin vasoconstriction test with neosynephrine].

    PubMed

    Plantin, P; Jouan, N; Karangwa, A; Gavanou, J; Cauvin, J M; Schollhammer, M; Sizun, J; Guillois, B; Sassolas, B; Collet, M

    1992-01-01

    The skin of preterm infants is defective as a barrier and does not function like that of mature until about 2 weeks of age. Percutaneous drug absorption was studied by observing the blanching response to aqueous solutions of 10% Neosynephrin applied to a small area of skin on the internal surface of the thigh. The subjects, 10 preterm infants born at gestational ages 29 to 32 weeks (mean: 31 weeks 2 days), were tested when they were aged from day 0 to 7. The controls were 8 normal newborns aged 2 days. All preterm infants were tested a second time at the age 7 to 17 days (mean: 10 days). The blanching response was measured after 5 minutes, and graded on a scale of 0 to 4. The first test was positive grade 2 to 4 in all the preterm babies, while it was negative in the normal newborns. The second test was negative in 7 of the 10 preterm infants; in other 3, the grade was at least 50% lower. Infants nursed under radiant heaters were not different from the other infants. Skin permeability is increased in immature infants, but falls steadily until about the age of 10 days. The results of the Neosynephrin test could be useful in predicting the response to topically administered drug.

  1. Resolution of opioid-induced postoperative ileus in a newborn infant after methylnaltrexone.

    PubMed

    Garten, Lars; Degenhardt, Petra; Bührer, Christoph

    2011-03-01

    Transient impairment of bowel function is a frequent and distressing problem in neonates on opioid-induced analgesia. Methylnaltrexone, a peripheral-acting μ-opioid receptor antagonist, has been studied in adults for the treatment of opioid-induced constipation in advanced illness and has been suggested as a promising therapeutic concept for reducing postoperative ileus. Here, we report on a newborn infant on fentanyl analgesia after major abdominal surgery with aggravated ileus. After 8 days of quiescent bowel, the patient's intestinal dysmotility resolved within 15 minutes after intravenous administration of methylnaltrexone (0.15 mg/kg body weight). Methylnatrexone was repeated daily until cessation of fentanyl administration. There were no signs of pain or opioid withdrawal. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Case of 46,XX/47,XY, +21 chimerism in a newborn infant with ambiguous genitalia

    SciTech Connect

    Sawai, Tomoko; Yoshimoto, Masaaki; Kinoshita, Ei-ichi; Baba, Tsuneyoshi; Matsumoto, Tadashi; Tsuji, Yoshiro, Niikawa, Norio; Fukuda, Shinpei; Harada, Naoki

    1994-02-15

    The authors describe the whole-body chimerism in a newborn infant with small phallus, pseudo-vaginal perineal hypospadias, and a bifid scrotum containing gonads. The human testis determining factor gene (SRY) was detected by PCR amplification. GTG-banding chromosome analysis in peripheral blood lymphocytes and cultured fibroblasts derived from right cubital skin showed a 46,XX/47,XY, +21 karyotype. Their ratios in each cell line were 294:5 and 178:7, respectively. QFQ-banding chromosome analysis documented 3 heteromorphic satellites on trisomic chromsomes 21 in the 47,XY,+21 cell line and a homozygous satellite pattern in the 46,XX cell line. Heteromorphic patterns of chromsomes 4, 13, 14, and 22 were also different between the two cell lines. To our knowledge, such disomy/trisomy chimeras have not been described previously. 10 refs., 3 figs.

  3. Case of 46,XX/47,XY, +21 chimerism in a newborn infant with ambiguous genitalia.

    PubMed

    Sawai, T; Yoshimoto, M; Kinoshita, E; Baba, T; Matsumoto, T; Tsuji, Y; Fukuda, S; Harada, N; Niikawa, N

    1994-02-15

    We describe whole-body chimerism in a newborn infant with small phallus, pseudo-vaginal perineal hypospadias, and a bifid scrotum containing gonads. The human testis determining factor gene (SRY) was detected by PCR amplification. GTG-banding chromosome analysis in peripheral blood lymphocytes and cultured fibroblasts derived from right cubital skin showed a 46,XX/47,XY, +21 karyotype. Their ratios in each cell line were 294:5 and 178:7, respectively. QFQ-banding chromosome analysis documented 3 heteromorphic satellites on trisomic chromosomes 21 in the 47,XY, +21 cell line and a homozygous satellite pattern in the 46,XX cell line. Heteromorphic patterns of chromosomes 4, 13, 14, and 22 were also different between the two cell lines. To our knowledge, such disomy/trisomy chimeras have not been described previously.

  4. Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes.

    PubMed

    Kolås, Toril; Saugstad, Ola D; Daltveit, Anne K; Nilsen, Stein T; Øian, Pål

    2006-12-01

    The purpose of this study was to examine neonatal outcomes among women with a planned cesarean and a planned vaginal delivery at term. This prospective survey was conducted on 18,653 singleton deliveries that represent 24 maternity units during a 6-month period. The data were retrieved from the Medical Birth Registry of Norway and analyzed according to intended mode of delivery. Compared with planned vaginal deliveries, planned cesarean delivery increased transfer rates to the neonatal intensive care unit from 5.2% to 9.8% (P < .001). The risk for pulmonary disorders (transient tachypnea of the newborn infant and respiratory distress syndrome) rose from 0.8% to 1.6% (P = .01). There were no significant differences in the risks for low Apgar score and neurologic symptoms. A planned cesarean delivery doubled both the rate of transfer to the neonatal intensive care unit and the risk for pulmonary disorders, compared with a planned vaginal delivery.

  5. Avicenna (AD 980 to 1037) and the care of the newborn infant and breastfeeding.

    PubMed

    Modanlou, H D

    2008-01-01

    A brief historical review of medicine during the fourth century Islamic civilization or eleventh century AD in Persia or Iran was undertaken with its focus on Avicenna. A physician-philosopher, named Ibn Sina or Avicenna (980 to 1037), followed and further expanded the tradition of western philosophy and medicine by Aristotle, Hippocrates and Galen. Avicenna, a physician, philosopher, astrologist, anatomist, pharmacologist, ethicist and poet wrote, the Canon of Medicine, the most comprehensive medical textbook of its time. This important textbook was extensively used in European medical schools for centuries after Avicenna's death. In the Canon of Medicine, a chapter is dedicated to the care of the newborn infant dealing with hygiene, breastfeeding and upbringing of the child.

  6. Novel CRLF1 gene mutation in a newborn infant diagnosed with Crisponi syndrome.

    PubMed

    Hakan, Nilay; Eminoglu, Fatma Tuba; Aydin, Mustafa; Zenciroglu, Aysegul; Karadag, Nazmiye Nilgun; Dursun, Arzu; Okumus, Nurullah; Ceylaner, Serdar

    2012-12-01

    Crisponi syndrome is an infrequently described disorder with autosomal recessive trait. It is characterized by extensive muscular contractions in the face after even minimal stimuli or crying, hypertonia, opisthotonus, camptodactyly, and typical facial features. Muscle contractions attenuate during rest or when the infant calms down. As a recently described new disease, Crisponi syndrome may be confused with epileptic manifestations. Most of the patients die in the first months of life due to hyperthermia and feeding problems. Recently, it has been demonstrated that mutations of the CRLF1 gene 'cytokine receptor-like factor 1' are associated with Crisponi syndrome. Here, we present a newborn diagnosed with Crisponi syndrome and report a novel homozygous CFRL1 gene mutation.

  7. Development of a finite element/multi-body model of a newborn infant for restraint analysis and design.

    PubMed

    Bondy, Matthew; Altenhof, William; Chen, Xilin; Snowdon, Anne; Vrkljan, Brenda

    2014-01-01

    A finite element/multi-body model of a newborn infant has been developed by researchers at the University of Windsor. The geometry of this model is derived from a Nita newborn hospital training mannequin. It consists of 17 parts: eight upper and lower limb segments, the torso, head, and a seven-segment neck with seven translational and eight rotational joints. Anthropometry is consistent with hospital growth charts, measurements requested from health professionals and data from the open literature. The biomechanical properties of the model (i.e. joint stiffnesses) are implementations of data identified in the open literature. The model has been validated with respect to studies of the biomechanics of shaken baby syndrome, infant falls and the Q0 anthropomorphic testing device. A significant conclusion of this study is that the kinetics of the Q0 neck is not biofidelic. This model is currently used in an analysis of airway patency for infants in modern automotive child restraints.

  8. Presentation of Aural Stimuli to Newborns and Premature Infants: An Audiological Perspective.

    PubMed

    Cassidy

    1999-01-01

    The purpose of this study was twofold: (a) to examine extant research in the field of music with premature and full term infants in order to identify protocols being used in the presentation of musical stimuli to neonates and (b) to use knowledge gleaned from audiology as a basis for suggesting a standardized protocol for use of musical stimuli with infants. Articles considered appropriate for inclusion in the analysis met the following criteria: (a) presented data for the effects of music on a dependent measure, (b) had subjects who were identified as either premature or term newborns receiving treatment after birth and prior to discharge from the hospital, and (c) used music for some or all of the aural stimuli. Articles (N = 20) were categorized by demographic information, types of aural stimuli, independent variables, dependent measures, and protocol used to present the musical stimuli. Of primary importance to this study was the protocol used in each study to present musical stimuli. Data regarding total duration of stimuli per day, longest duration of stimuli per day, method of stimuli presentation, placement of speakers, decibel level of stimuli, and where;he decibel level was measured reveal that there is no standard protocol being followed with regard to the presentation of aural stimuli. Recommendations include future research on (a) determining a minimum gestational age where music therapy may be appropriate, (b) determining the frequency spectrum perceived by a premature infant, (c) determining the decibel levels reaching the ear drum and assessing appropriate levels for minimum stimulation with maximum results, and (d) carefully considering the method of stimulus presentation as it will have an impact on the decibel level reaching the ear drum of these infants.

  9. Cochrane Review: Screening programmes for developmental dysplasia of the hip in newborn infants.

    PubMed

    Shorter, Damon; Hong, Timothy; Osborn, David A

    2013-01-01

    ultrasound resulted in no significant difference in late diagnosed DDH but a significant reduction in treatment. No infants in either group received surgery. There is insufficient evidence to give clear recommendations for practice. There is inconsistent evidence that universal ultrasound results in a significant increase in treatment compared to the use of targeted ultrasound or clinical examination alone. Neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. The studies are substantially underpowered to detect significant differences in the uncommon event of late detected DDH or surgery. For infants with unstable hips or mildly dysplastic hips, use of delayed ultrasound and targeted splinting reduces treatment without significantly increasing the rate of late diagnosed DDH or surgery. Screening methods for dislocated or improperly formed hips in newborn infants The hip joint is a ball and socket joint. Newborns may have hips that are not in their socket (dislocated) or hips that are improperly formed (dysplasia). Risk factors for hip dysplasia include a family history of a similar problem and female infants delivered in the breech position. The hips of most newborns will be examined clinically after birth and during infancy to determine whether they are stable, unstable or dislocated. Screening for hip dysplasia may prevent the need for late treatment, which is associated with long term hip deformity, gait disturbance and arthritis. However, early screening leads to increased treatment. Treatment may be complicated by damage to the hip due to impairment of the blood supply (avascular necrosis). This review found no studies that compared the benefits and costs of early screening versus not screening for hip problems. Studies that compared the addition of ultrasound to clinical examination reported that when ultrasound was performed on all infants, the rate of treatment increased with no significant

  10. Branched Chain Fatty Acids Are Constituents of the Normal Healthy Newborn Gastrointestinal Tract

    PubMed Central

    Ran-Ressler, Rinat R.; Devapatla, Srisatish; Lawrence, Peter; Brenna, J. Thomas

    2008-01-01

    Vernix suspended in amniotic fluid is normally swallowed by the late term fetus. We hypothesized that branched chain fatty acids (BCFA), long known to be major vernix components, would be found in meconium and that the profiles would differ systematically. Vernix and meconium were collected from term newborns and analyzed. BCFA-containing lipids constituted about 12% of vernix dry weight, and were predominantly saturated, and had 11 to 26 carbons per BCFA. In contrast, meconium BCFA had 16 to 26 carbons, and was about 1% of dry weight. Meconium BCFA were mostly in the iso configuration, whereas vernix BCFA contained dimethyl and middle chain branching, and five anteiso BCFA. The mass of BCFA entering the fetal gut as swallowed vernix particles is estimated to be 180 mg in the last month of gestation while the total mass of BCFA found in meconium is estimated to be 16 mg, thus most BCFA disappear from the fetal gut. The BCFA profiles of vernix and meconium show that BCFA are major components of normal healthy term newborn gastrointestinal tract. BCFA are candidates for agents that play a role in gut colonization and should be considered a nutritional component for the fetus/newborn. PMID:18614964

  11. Skin findings in newborns

    MedlinePlus

    Newborn skin characteristics; Infant skin characteristics; Neonatal care - skin ... the first few weeks of the baby's life. Newborn skin will vary, depending on the length of the pregnancy. Premature infants have thin, transparent skin. The skin of a ...

  12. Assisted reproductive technology alters deoxyribonucleic acid methylation profiles in bloodspots of newborn infants.

    PubMed

    Estill, Molly S; Bolnick, Jay M; Waterland, Robert A; Bolnick, Alan D; Diamond, Michael P; Krawetz, Stephen A

    2016-09-01

    To evaluate the effect of infertility and intracytoplasmic sperm injection (ICSI) on DNA methylation of offspring. Microarray analysis of DNA methylation in archived neonatal bloodspots of in vitro fertilization (IVF)/ICSI-conceived children compared with controls born to fertile and infertile parents. Academic research laboratory. Neonatal blood spots of 137 newborns conceived spontaneously, through intrauterine insemination (IUI), or through ICSI using fresh or cryopreserved (frozen) embryo transfer. None. The Illumina Infinium HumanMethylation450k BeadChip assay determined genome-wide DNA methylation. Methylation differences between conception groups were detected using a Bioconductor package, ChAMP, in conjunction with Adjacent Site Clustering (A-clustering). The methylation profiles of assisted reproductive technology and IUI newborns were dramatically different from those of naturally (in vivo) conceived newborns. Interestingly, the profiles of ICSI-frozen (FET) and IUI infants were strikingly similar, suggesting that cryopreservation may temper some of the epigenetic aberrations induced by IVF or ICSI. The DNA methylation changes associated with IVF/ICSI culture conditions and/or parental infertility were detected at metastable epialleles, suggesting a lasting impact on a child's epigenome. Both infertility and ICSI alter DNA methylation at specific genomic loci, an effect that is mitigated to some extent by FET. The impact of assisted reproductive technology and/or fertility status on metastable epialleles in humans was uncovered. This study provides an expanded set of loci for future investigations on IVF populations. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. [Prospective evaluation of umbilical catheters in newborn infants. The Castrillo Hospital Group].

    PubMed

    2000-11-01

    To evaluate the current use of umbilical catheters in newborn infants in spain by analyzing technical characteristics and infections, as well as mechanical and local complications. Umbilical catheters inserted in newborns in the neonatal units of the hospitals in the Castrillo hospital group from july 15, 1998 to december 31, 1998 were collected for prospective analysis. A total of 489 umbilical catheters (201 venous and 288 arterial) placed in 475 newborns were analysed. No difficulties were found in inserting the catheters and they had an average indwelling time of less than 5 days. Most were removed electively. A total of 461 (94.3%) catheter tips were sent for microbiological examination and cultures were positive in 98 (21.2%). Of these, catheter contamination was found in 85 (18.4%) and catheter related sepsis was confirmed in 11(2.4%). Staphylococcus epidermidis was the most commonly isolated organism (72.2% of contaminated catheters and 63.6% of catheter-related sepsis). The main risk factor for contamination was duration of catheterization >/= 3 days and that for cather related sepsis was duration of catheterization >/= 3 days and birth weight

  14. Sugaring the pill: ethics and uncertainties in the use of sucrose for newborn infants.

    PubMed

    Wilkinson, Dominic J C; Savulescu, Julian; Slater, Rebeccah

    2012-07-01

    Sucrose is widely used for the management of procedural pain in newborn infants, including capillary blood sampling, venepuncture, and vascular cannulation. Multiple randomized controlled trials have demonstrated that sweet-tasting solutions reduce behavioral responses to acute painful stimuli. It has been claimed that sucrose should be a standard of care in neonatal units and that further placebo-controlled trials of sucrose are unnecessary and unethical. However, recently published data cast doubt on the analgesic properties of sucrose. We review this new evidence and analyze the philosophical and ethical questions that it raises, including the "problem of other minds." Sugar may be better understood not as an analgesic, removing or relieving pain, but as a compensating pleasure. There is a need for further research on the mechanism of sucrose's effect on pain behavior and on the long-term effects of sucrose treatment. Such trials will require comparison with placebo or with other interventions. Given uncertainty about the benefit of sucrose, it may be wise to use alternative analgesics or nonpharmacological interventions where these are available and appropriate. Sucrose may not be the answer to procedural pain in newborns.

  15. Impact of a Central Line Infection Prevention Bundle in Newborn Infants.

    PubMed

    McMullan, Rowena; Gordon, Adrienne

    2016-09-01

    OBJECTIVE To compare central line use and central line-associated bloodstream infection in newborn infants before and after the introduction of a central line infection prevention bundle in order to determine the effectiveness of the bundle and to identify areas for further improvement. DESIGN Retrospective cohort analysis of prospectively collected data. SETTING Level 5 neonatal intensive care unit in Sydney, Australia. PATIENTS Newborn infants admitted to the Royal Prince Alfred Hospital Neonatal Intensive Care Unit who had a central venous catheter (CVC) inserted. METHODS Data regarding clinical characteristics, CVC use, and infection were collected before and after the introduction of a bundle of interventions. The bundles encompassed (1) insertion of CVC, (2) maintenance of CVC, (3) an education program, and (4) ongoing surveillance and feedback. RESULTS Baseline and intervention groups were comparable in clinical characteristics. The number of CVCs inserted was reduced in the intervention group (central line utilization rate, 0.16 vs 0.2, P<.0001). Overall CVC dwell time was reduced, resulting from significant reduction in peripherally inserted CVC dwell time (6 days [95% CI, 5.0-11.8 days] vs 7.3 days [4.0-10.4 days], P=.0004). Central line-associated bloodstream infections were significantly reduced, predominantly secondary to decreased peripherally inserted CVC-related bloodstream infections (1.2/1,000 central line-days vs 11.5/1,000 central line-days, P<.0001). CONCLUSION This central line infection bundle was effective in reducing CVC use, dwell time, and central line-associated bloodstream infections. Infect Control Hosp Epidemiol 2016;37:1029-1036.

  16. Urinary paraben concentrations among pregnant women and their matching newborn infants of Korea, and the association with oxidative stress biomarkers.

    PubMed

    Kang, Sungeun; Kim, Sunmi; Park, Jeongim; Kim, Hae-Joong; Lee, Jeongjae; Choi, Gyuyeon; Choi, Sooran; Kim, Sungjoo; Kim, Su Young; Moon, Hyo-Bang; Kim, Sungkyoon; Kho, Young Lim; Choi, Kyungho

    2013-09-01

    Parabens have been used in multiple products including personal care products, pharmaceuticals, and foods for more than 50 years but increasing numbers of studies have raised concerns on their safety. The present study was designed to determine urinary paraben levels among pregnant women and their matching newborn infants (<48 h after delivery), and the association between paraben levels and stress markers. Pregnant women (n=46) and their matching newborn infants were recruited from four university hospitals located in Seoul, Ansan and Jeju of Korea, 2011. Parabens including methyl paraben (MP), ethyl paraben (EP), n-propyl paraben (PP), and n-butyl paraben (BP) were measured in the urine using an automatic, high throughput online SPE-LC-MS/MS method. Urinary concentrations were normalized with specific gravity (SG). Free cortisol, malondealdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured in the urine as stress marker. Urinary MP was detected as the highest, and BP was detected as the lowest paraben in the urine samples of both pregnant women and their infants. Significant correlations between paraben concentrations of maternal and their newborn infant's urine were observed. The levels of urinary parabens among Korean pregnant women are comparable to those reported elsewhere, except for EP which were 4-9 folds higher than pregnant women of other countries. The ratios of infant to maternal urinary paraben concentrations varied between 0.5 and 0.6 for MP and PP, but approximately 10 fold lower for EP. Urinary MP or EP levels were associated with several oxidative stress related biomarkers such as urinary 8-OHdG and MDA, even after the adjustment of relevant covariates such as maternal age, mode of delivery, pre-pregnancy BMI, gestational age and parity. This is the first study that reported the levels of major parabens in the first urine of newborn infants. Further studies are warranted to understand the implications of paraben exposure among

  17. [Recommendations for the care of the healthy normal newborn at delivery and during the first postnatal hours].

    PubMed

    Luna, M Sánchez; Alonso, C R Pallás; Mussons, F Botet; Urcelay, I Echániz; Conde, J R Castro; Narbona, E

    2009-10-01

    Standardised normal newborn care at delivery and during the first hours of life is one of the objectives of the Spanish National Society of Neonatology. The object of this review is to apply the best evidence possible to the procedures of the care of the newborn from delivery and during the first moments after delivery; as well as standards and routines in care to improve quality and the safety of the newborn. A PubMed (MeSH) review using the key words: term newborn; prophylaxis of ophthalmia neonatorum; haemorrhagic disease of the newborn; neonatal jaundice; neonatal screening and hospital discharge. Concepts of regular care of the healthy newborn at delivery; normal practices in the delivery room; prophylaxis of ophthalmia neonatorum; prevention of vitamin K deficiency bleeding; care of the umbilical cord; newborn screening and hospital discharge are reviewed. The standard of care of the newborn at delivery and during the first hours of life have been updated; recommendations based on evidence and on experts of the standard committee of the spanish society of neonatology are done.

  18. 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

  19. [Features of the rheological properties of red blood cells in healthy newborns].

    PubMed

    Andreeva, A A; Evsiukova, I I; Katiukhin, L N

    2014-08-01

    Variability of deformation and aggregation properties of erythrocytes is a component part of nonspecific antihypoxic response of formation of adequate blood flow in the tissues and efficiency of the microcirculation in different sections of the vascular bed. Degree of change in these properties during neonatal adaptation to spontaneous breathing can be a marker of its abnormality. We examined 19 healthy full-term newborns in the first 1-2 and 13 children in the first 5-7 days of life. The control group consisted of 30 healthy people aged 25-35 years. It is shown that the aggregation properties of erythrocytes, reduced on the birthday, significantly increased to 5-7 day to values in adults. Erythrocyte deformability in neonates enhanced by an excess reserve of specific surface and reduced strength of the membranes to stretch. Adapting to the transition to spontaneous breathing accompanied by an emphasis on the hyperkinetic type of hemodynamics.

  20. [Measuring vibrations of transport stress in premature and newborn infants during incubator transport].

    PubMed

    Peters, C; Bauer, M; Speidel, U; Jung, E; Homberg, F; Schofer, O

    1997-01-01

    Despite increasing numbers of centers for perinatology, transportation of newborns and premature infants can not totally be avoided for several obvious reasons. The following investigations were carried out as part of our quality control measures of the established neonatal transportation system, and were aimed on the optimization of a new neonatal transportation equipment resulting in reduction of transportation stress caused by acceleration forces. The new system investigated consisted of a Volkswagen type T4 equipped with a Dräger incubator type 5400, which was mounted on a pneumatic patient lift. We measured acceleration forces in three axes (expressed as K-Wert) as well as over a spectrum of frequencies (1-80 Hz). Measurements were taken at different points of the transportation unit during simulated transports driving a predetermined route. After obtaining informed consent of the parents, one actual transport of a newborn was used for an additional point measurement at the newborn's head. The mean K-Wert was decreased by about 50% in the vertical axis between the chassis of the car and the incubator by activating the pneumatic patient lift. Without activating the lift the K-Wert increased by about 20% between the car's chassis and the incubator. The frequency analysis showed resonance effects between the different components of the system. However, by activating the patient lift, effective accelerations in the incubator were decreased to less than 0.1 m/s2 across the whole frequency spectrum evaluated. The single measurement at a newborn's head revealed similar acceleration forces at the head of the baby and under its head. Utilization of a pneumatic patient lift can reduce acceleration forces. However, our results show that each system (car, incubator, and its base) has to be investigated and optimized for this purpose as a unit. Optimization of the complete system is necessary not only before its primary use but also in regular intervals over the years

  1. Tackling Health Inequities in Chile: Maternal, Newborn, Infant, and Child Mortality Between 1990 and 2004

    PubMed Central

    Requejo, Jennifer Harris; Nien, Jyh Kae; Merialdi, Mario; Bustreo, Flavia; Betran, Ana Pilar

    2009-01-01

    Objectives. We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions. Methods. Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4 000 000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles. Results. During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100 000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile. Conclusions. During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions. PMID:19443831

  2. Reproducibility of cerebral tissue oxygen saturation measurements by near-infrared spectroscopy in newborn infants

    NASA Astrophysics Data System (ADS)

    Jenny, Carmen; Biallas, Martin; Trajkovic, Ivo; Fauchère, Jean-Claude; Bucher, Hans Ulrich; Wolf, Martin

    2011-09-01

    Early detection of cerebral hypoxemia is an important aim in neonatology. A relevant parameter to assess brain oxygenation may be the cerebral tissue oxygen saturation (StO2) measured by near-infrared spectroscopy (NIRS). So far the reproducibility of StO2 measurements was too low for clinical application, probably due to inhomogeneities. The aim of this study was to test a novel sensor geometry which reduces the influence of inhomogeneities. Thirty clinically stable newborn infants, with a gestational age of median 33.9 (range 26.9 to 41.9) weeks, birth weight of 2220 (820 to 4230) g, postnatal age of 5 (1 to 71) days were studied. At least four StO2 measurements of 1 min duration were carried out using NIRS on the lateral head. The sensor was repositioned between measurements. Reproducibility was calculated by a linear mixed effects model. The mean StO2 was 79.99 +/- 4.47% with a reproducibility of 2.76% and a between-infant variability of 4.20%. Thus, the error of measurement only accounts for 30.1% of the variability. The novel sensor geometry leads to considerably more precise measurements compared to previous studies with, e.g., ~5% reproducibility for the NIRO 300. The novel StO2 values hence have a higher clinical relevance.

  3. Cerebral blood flow in the newborn infant: comparison of Doppler ultrasound and /sup 133/xenon clearance

    SciTech Connect

    Greisen, G.; Johansen, K.; Ellison, P.H.; Fredriksen, P.S.; Mali, J.; Friis-Hansen, B.

    1984-03-01

    Two techniques of Doppler ultrasound examination, continuous-wave and range-gated, applied to the anterior cerebral artery and to the internal carotid artery, were compared with /sup 133/xenon clearance after intravenous injection. Thirty-two sets of measurements were obtained in 16 newborn infants. The pulsatility index, the mean flow velocity, and the end-diastolic flow velocity were read from the Doppler recordings. Mean cerebral blood flow was estimated from the /sup 133/Xe clearance curves. The correlation coefficients between the Doppler and the /sup 133/Xe measurements ranged from 0.41 to 0.82. In the subset of 16 first measurements in each infant, there were no statistically significant differences between the correlation coefficients of the various Doppler ultrasound variables, but the correlation coefficients were consistently lower for the pulsatility index than for mean flow velocity or end-diastolic flow velocity, and they were consistently higher for the range-gated than for the continuous-wave Doppler technique.

  4. Mothering a Preterm Infant Receiving NIDCAP Care in a Level III Newborn Intensive Care Unit.

    PubMed

    Nelson, Antonia M; Bedford, Pamela J

    2016-01-01

    The purpose of the study is to describe the unique meaning and significance of the essential elements of mothering a preterm infant receiving Newborn Individualized Developmental Care and Assessment Program (NIDCAP) care in a level III NICU. The overall aim was to promote an increased understanding among healthcare practitioners of the experience of this group of women. The authors utilized an existential-phenomenologic method to investigate the experience of 7 mothers of a preterm infant 30weeks gestation or less at birth. Analysis of interview transcripts revealed one overarching theme, parenting with permission, and three essential themes with nine underlying subthemes: choosing to participate (subthemes: managing, settling in, making friends), dealing with people (subthemes: meeting needs, facing judgment, and recognizing not everyone is 'on board,' and coming to feel like a mother (subthemes: overcoming fear, gaining understanding, and feeling empowered). Mothers universally praised NIDCAP for the education and support it provided them. However findings also suggest that great sensitivity and patience is required by professionals to assist mothers to overcome their fear, gain confidence, and participate in NIDCAP without feeling judged. In addition private rooms were found to hold great significance for mothers and should be maintained for the entire hospitalization whenever possible. Finally, ongoing NIDCAP education/support for staff and regular team meetings to discuss and problem-solve concerns are suggested. This might address inconsistent adherence to the NIDCAP care plan by some nurses, which is the greatest source of maternal conflict and frustration. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Combined treatment with chlorhexidine and 0·9% saline in a newborn infant with an infected surgical wound.

    PubMed

    Tekgündüz, Kadir Şerafettin; Kepenekli, Eda; Demirelli, Yaşar; Caner, İbrahim; Kara, Mustafa

    2016-10-01

    Newborns are more susceptible to infection; this makes proper wound care extremely important in them. Unfortunately, in spite of successful surgery, patients can die as a result of wound area infections. Herein, we report a case in which a combined therapy of chlorhexidine (a disinfectant) and saline (a cleansing agent used in wound care) was used effectively to treat the wound in a newborn infant with an antibiotic-resistant, Gram-negative, bacteria-related surgical site infection. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  6. White matter tract integrity and developmental outcome in newborn infants with hypoxic-ischemic encephalopathy treated with hypothermia.

    PubMed

    Massaro, An N; Evangelou, Iordanis; Fatemi, Ali; Vezina, Gilbert; Mccarter, Robert; Glass, Penny; Limperopoulos, Catherine

    2015-05-01

    To determine whether corpus callosum (CC) and corticospinal tract (CST) diffusion tensor imaging (DTI) measures relate to developmental outcome in encephalopathic newborn infants after therapeutic hypothermia. Encephalopathic newborn infants enrolled in a longitudinal study underwent DTI after hypothermia. Parametric maps were generated for fractional anisotropy, mean, radial, and axial diffusivity. CC and CST were segmented by DTI-based tractography. Multiple regression models were used to examine the association of DTI measures with Bayley-II Mental (MDI) and Psychomotor Developmental Index (PDI) at 15 months and 21 months of age. Fifty-two infants (males n=32, females n=20) underwent DTI at median age of 8 days. Two were excluded because of poor magnetic resonance imaging quality. Outcomes were assessed in 42/50 (84%) children at 15 months and 35/50 (70%) at 21 months. Lower CC and CST fractional anisotropy were associated with lower MDI and PDI respectively, even after controlling for gestational age, birth weight, sex, and socio-economic status. There was also a direct relationship between CC axial diffusivity and MDI, while CST radial diffusivity was inversely related to PDI. In encephalopathic newborn infants, impaired microstructural organization of the CC and CST predicts poorer cognitive and motor performance respectively. Tractography provides a reliable method for early assessment of perinatal brain injury. © 2014 Mac Keith Press.

  7. [The significance of fucosylated glycoconjugates of human milk in nutrition of newborns and infants].

    PubMed

    Lis-Kuberka, Jolanta; Orczyk-Pawiłowicz, Magdalena

    2015-07-22

    Human milk is extremely complex secretion rich in biologically active glycoconjugates including free oligosaccharides, glycoproteins, glycolipids, and glycosaminoglycans. Alpha1-2-fucosylated glycoconjugates of human milk are component of the innate immune system and provide an additional defense for infants. Participation of fucosylated glycotopes in the inhibition of infections caused by some bacteria and/or viruses rely on blocking of lectin-receptors of pathogen. Free fucosylated glycoconjugates present in milk are recognized and bound by the lectin-receptors of bacteria and/or viruses, and prevent pathogens adhesion to host epithelial cells and development of infection. So far, the efficacy of fucosylated glycoconjugates of human milk in the inhibition of adhesion has been confirmed for Escherichia coli, Campylobacter jejuni, Salmonella enterica, Rotaviruses, HIV, and Noroviruses. In this process the secretor/nonsecretor status of mother plays an important role. This is particularly important for the women who are nonsecretors and whose milk does not contain α1-2-fucosylated glycoconjugates and has reduced anti-microbial properties. Fucosylated glycoconjugates of milk are also one of the energy sources for physiological bacterial flora (Bifidobacterium), and have a positive impact on the intestinal peristalsis, and indirectly stimulate the central nervous system of infants. Furthermore, compared to human milk, the content of fucosylated glycoconjugates of cow’s milk is very low and does not provide adequate protection. This fact is particularly important in terms of nutrition and should be taken into consideration when artificial mixtures based on cows’ milk are used. The paper presents the current state of knowledge on human milk glycoconjugates, particularly on α1-2-fucosylated free oligosaccharides and glycoproteins, and discusses the significance of fucosylated glycoconjugates of human milk in the nutrition of newborns and infants.

  8. Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening.

    PubMed

    Sly, Peter D; Brennan, Siobhain; Gangell, Catherine; de Klerk, Nicholas; Murray, Conor; Mott, Lauren; Stick, Stephen M; Robinson, Philip J; Robertson, Colin F; Ranganathan, Sarath C

    2009-07-15

    The promise of newborn screening (NBS) for cystic fibrosis (CF) has not been fully realized, and the extent of improvement in respiratory outcomes is unclear. We hypothesized that significant lung disease was present at diagnosis. To determine the extent of lung disease in a geographically defined population of infants with CF diagnosed after detection by NBS. Fifty-seven infants (median age, 3.6 mo) with CF underwent bronchoalveolar lavage and chest computed tomography (CT) using a three-slice inspiratory and expiratory protocol. Despite the absence of respiratory symptoms in 48 (84.2%) of infants, a substantial proportion had lung disease with bacterial infection detected in 12 (21.1%), including Staphylococcus aureus (n = 4) and Pseudomonas aeruginosa (n = 3); neutrophilic inflammation (41. 4 x 10(3) cells/ml representing 18.7% of total cell count); proinflammatory cytokines, with 44 (77.2%) having detectable IL-8; and 17 (29.8%) having detectable free neutrophil elastase activity. Inflammation was increased in those with infection and respiratory symptoms; however, the majority of those infected were asymptomatic. Radiologic evidence of structural lung disease was common, with 46 (80.7%) having an abnormal CT; 11 (18.6%) had bronchial dilatation, 27 (45.0%) had bronchial wall thickening, and 40 (66.7%) had gas trapping. On multivariate analysis, free neutrophil elastase activity was associated with structural lung disease. Most children with structural lung disease had no clinically apparent lung disease. These data support the need for full evaluation in infancy and argue for new treatment strategies, especially those targeting neutrophilic inflammation, if the promise of NBS for CF is to be realized.

  9. Relationship Between Serum Albumin Levels and Infections in Newborn Late Preterm Infants

    PubMed Central

    Yang, Chunyan; Liu, Zhaoguo; Tian, Min; Xu, Ping; Li, Baoyun; Yang, Qiaozhi; Yang, Yujun

    2016-01-01

    Background We aimed to evaluate the clinical value of serum albumin levels for the evaluation and prognosis of late preterm infants with infections. Material/Methods This was a retrospective study performed in late preterm infants admitted at the neonatal intensive care unit (NICU) of the Liaocheng People’s Hospital between July 2012 and March 2013. Data, including laboratory test results, neonatal critical illness score (NCIS), perinatal complications and prognosis, were analyzed. The newborn infants were divided into 3 groups according to their serum albumin levels, (≥30 g/L, 25–30 g/L and ≤25 g/L for high, moderate, and low, respectively). Results Among 257 patients, birth weight was 2003±348 g, gestational age was 35.7±2.3 weeks, and 59.1% were male. In addition, 127 (49.4%) were in the low albumin group. There were 32 patients with sepsis, 190 with infections, and 35 without infection, and their rates of hypoalbuminemia were 86.0%, 50.5%, and 30.7%, respectively (P<0.05). Albumin levels of the patients who survived were higher than those of the patients who died. In the low albumin group, the number of individual-event-critical NCIS cases and the frequency of multiple organs injuries were 63.8% and 28.3%, respectively, and were higher than in the 2 other groups. Mortality was higher in patients with sepsis. Hypoalbuminemia was associated with severe adverse outcomes (odds ratio=6.3, 95% confidence interval: 3.7–10.9, P<0.001). Conclusions Hypoalbuminemia was frequent among neonates with sepsis. Lower albumin levels might be associated with a poorer prognosis. Albumin levels could be appropriate for the diagnosis and prognosis of late preterm neonates with infections. PMID:26747243

  10. 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

  11. Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-year Results of the Newborn Eye Screen Test (NEST) Study

    PubMed Central

    Callaway, Natalia F.; Ludwig, Cassie A.; Blumenkranz, Mark S.; Jones, Jennifer Michelle; Fredrick, Douglas R.; Moshfeghi, Darius M.

    2016-01-01

    Purpose To report the birth prevalence, risk factors, characteristics and location of fundus hemorrhages (FH) of the retina and optic nerve present in newborns at birth. Design Prospective cohort study at Stanford University School of Medicine. Participants All infants who were 37 weeks postmenstrual age or older and were deemed stable by their pediatrician were eligible for screening. Infants who were anophthalmic or had known or suspected infectious conjunctivitis were excluded. Methods Infants born at Lucile Packard Children's Hospital (LPCH) from July 25, 2013 through July 25, 2014 were offered universal newborn screening via wide-angle digital retinal photography in the Newborn Eye Screen Test (NEST) study. Maternal, obstetric, and neonatal factors were obtained by reviewing hospital records prior to discharge. The location, retinal layer, and laterality of FH were recorded by one pediatric vitreoretinal specialist. Main Outcome Measures Birth prevalence of FH. Secondary outcomes included rate of adverse events, risk factors for FH, hemorrhage characteristics and adverse events. Results The birth prevalence of FH in this study was 20.3% (41/202 infants). Ninety-five percent of FHs involved the periphery, 83% involved the macula, and 71% involved multiple layers of the retina. The fovea was involved in 15% of FH cases (birth prevalence, 3.0%). No cases of bilateral foveal hemorrhage were found. Fundus hemorrhages were more common in the left eye than the right. Fundus hemorrhages were most commonly optic nerve flame hemorrhages (48%) and white-centered retinal hemorrhages (30%). Retinal hemorrhages were found most frequently in all 4 quadrants (35%) and more often were multiple than solitary. Macular hemorrhages most often were intraretinal (40%). Among the risk factors examined in this study, vaginal delivery compared with cesarean section (odds ratio [OR], 9.34; 95% confidence interval [CI], 2.57-33.97) showed the greatest level of association with FH. Self

  12. Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study

    PubMed Central

    2014-01-01

    Background Few studies have focused on cerebral complications among newborn infants delivered by vacuum extraction (VE). The aim of this study was to determine the risk for intracranial haemorrhage and/or cerebral dysfunction in newborn infants delivered by VE and to compare this risk with that after cesarean section in labour (CS) and spontaneous vaginal delivery, respectively. Methods Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010 including all singleton newborn infants delivered at term after onset of labour by VE (n = 87,150), CS (75,216) or spontaneous vaginal delivery (n = 851,347), we compared the odds for neonatal intracranial haemorrhage, traumatic or non-traumatic, convulsions or encephalopathy. Logistic regressions were used to calculate adjusted (for major risk factors and indication) odds ratios (AOR), using spontaneous vaginal delivery as reference group. Results The rates of traumatic and non-traumatic intracranial hemorrhages were 0.8/10,000 and 3.8/1,000. VE deliveries provided 58% and 31.5% of the traumatic and non-traumatic cases, giving a ten-fold risk [AOR 10.05 (4.67-21.65)] and double risk [AOR 2.23 (1.57-3.16)], respectively. High birth weight and short mother were associated with the highest risks. Infants delivered by CS had no increased risk for intracranial hemorrhages. The risks for convulsions or encephalopathy were similar among infants delivered by VE and CS, exceeding the OR after non-assisted spontaneous vaginal delivery by two-to-three times. Conclusion Vacuum assisted delivery is associated with increased risk for neonatal intracranial hemorrhages. Although causality could not be established in this observational study, it is important to be aware of the increased risk of intracranial hemorrhages in VE deliveries, particularly in short women and large infants. The results warrant further studies in decision making and conduct of assisted vaginal delivery. PMID:24444326

  13. [Effects on the newborn infant of thiopental and propofol used in anesthetic induction in cesarean section].

    PubMed

    Zamora, E; Redondo, J A; Catalán, P A; Carrillo, F

    1994-01-01

    To compare the effects of an anesthetic induction dose of thiopental to that of propofol on the vitality of the neonate, as measured by Apgar score and the interval between extraction of the newborn and unassisted respiration. One hundred ASA I-II women undergoing cesarean section were randomly assigned to two groups of 50. Anesthesia was induced with thiopental 4 mg/kg in one group; in the other group, propofol 2 mg/kg was used. Time intervals recorded were induction-to-extraction, uterine incision-to-extraction and extraction-to-unassisted respiration. An Apgar score was recorded 1, 5 and 10 min after birth. For statistical analysis, each group was divided into three subgroups, in accordance with the reason for performing the cesarean section: subgroup 1, elective cesarean; subgroup 2, emergency cesarean due to dystocia or failure; subgroup 3, emergency cesarean section due to acute fetal distress. Means of intervals for induction-extraction and uterine incision-extraction showed no significant differences. All induction-extraction intervals were under 10 min (4.94 +/- 1.55 min) and all uterine incision-extraction intervals were under 180 sec, with most staying under 90 sec (43.13 +/- 25.76 sec). No statistically significant differences were found for vitality between the two groups of neonates. If the induction-extraction interval is 10 min or less, both thiopental (4 mg/kg) and propofol (2 mg/kg) given in a single dose for induction of general anesthesia in all types of cesarean section are equally safe for the newborn infant.

  14. Maternal assessment of recommendations on the newborn infant care upon hospital discharge.

    PubMed

    Herrero-Morín, José David; Huidobro Fernández, Belén; Amigo Bello, María Cristina; Quiroga González, Rocío; Fernández González, Nuria

    2015-01-01

    It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

  15. A reference set of SNOMED terms for the structured representation of respiratory disorders of the newborn infant.

    PubMed

    James, Andrew G; Ng, Eugene; Shah, Prakesh S

    2009-01-01

    The SNOMED CT(R) July 2006 release was systematically examined using the CliniClue(R) terminology browser to identify SNOMED terms that might be relevant for the structured representation of respiratory disorders of the newborn infant. Three neonatologists evaluated 348 candidate terms for inclusion in a reference set. Two hundred and eighty-eight (83%) terms were selected for inclusion. Most of the terms (73%) are SNOMED terms that are very relevant for the specific domain of care for the newborn infant. Nearly half the terms are fully defined and a third have one or more synonyms. The estimated use for the RefSet terms was more than once per month for 9% of the SNOMED terms and less than once a year for 66% of the terms.

  16. Bloodstream infection with Oligella ureolytica in a newborn infant: a case report and review of the literature.

    PubMed

    Demir, Tülin; Celenk, Nuran

    2014-06-11

    Oligella species are small, Gram-negative, nonsaccharolytic aerobic rods or coccobacilli that are catalase and oxidase-positive, mostly isolated from the urinary tract and rarely from wounds, bloodstream infections, septic arthritis, or peritonitis.In this article, we report a case of O.ureolytica-related bloodstream infection in a newborn infant and we review the literature for previously reported cases of Oligella infections.

  17. 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...

  18. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) with Kangaroo Mother Care (KMC): Comprehensive Care for Preterm Infants

    PubMed Central

    Als, Heidelise; McAnulty, Gloria B.

    2014-01-01

    State-of-the-art Newborn Intensive Care Units (NICUs), instrumental in the survival of high-risk and ever-earlier-born preterm infants, often have costly human repercussions. The developmental sequelae of newborn intensive care are largely misunderstood. Developed countries eager to export their technologies must also transfer the knowledge-base that encompasses all high-risk and preterm infants’ personhood as well as the neuro-essential importance of their parents. Without such understanding, the best medical care, while assuring survival jeopardizes infants’ long-term potential and deprives parents of their critical role. Exchanging the womb for the NICU environment at a time of rapid brain growth compromises preterm infants’ early development, which results in long-term physical and mental health problems and developmental disabilities. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) aims to prevent the iatrogenic sequelae of intensive care and to maintain the intimate connection between parent and infant, one expression of which is Kangaroo Mother Care. NIDCAP embeds the infant in the natural parent niche, avoids over-stimulation, stress, pain, and isolation while it supports self-regulation, competence, and goal orientation. Research demonstrates that NIDCAP improves brain development, functional competence, health, and life quality. It is cost effective, humane, and ethical, and promises to become the standard for all NICU care. PMID:25473384

  19. Regional cerebral oxygen saturation in newborn infants in the first 15 min of life after vaginal delivery.

    PubMed

    Kratky, Elisabeth; Pichler, Gerhard; Rehak, Thomas; Avian, Alexander; Pocivalnik, Mirjam; Müller, Wilhelm; Urlesberger, Berndt

    2012-01-01

    The objective of this study was to evaluate regional oxygen saturation of the brain during immediate transition after birth, and to correlate it with pre-ductal arterial oxygen saturation in newborn infants. The prospective observational study including newborn infants in the first 15 min after spontaneous vaginal delivery and uncomplicated transitional period was undertaken. Regional cerebral oxygen saturation (rSO(2)brain) was measured using near-infrared spectroscopy. Arterial oxygen saturation (SpO(2)) and heart rate (HR) were measured on the right wrist by pulse oximetry. rSO(2)brain, SpO(2) and HR measurements were started immediately after birth and were performed in the first 15 min of life. Cerebral fractional tissue oxygen extraction (FTOE) was calculated for each minute. Of 145 newborn infants, 16 were included and the gender allocation was 31 females (49.2%) and 32 males (50.8%). rSO(2)brain increased rapidly from 39% (2 min) to 69% (5 min), SpO(2) increased from 72% (2 min) to 96% (14 min) and FTOE showed a significant decrease from minute 2 (0.47) until minute 4 (0.30) and an increase between 8 to 13 min. rSO(2)brain increased rapidly after vaginal delivery. Although SpO(2) increased within the first 14 min after delivery, rSO(2)brain showed no further significant changes after 5 min. FTOE decreased in the first 4 min and reached standard values subsequently.

  20. Depressive symptoms and associated factors in caregivers of newborn infants hospitalized in a neonatal intensive care unit.

    PubMed

    Alvarado Socarrás, Jorge L; Gamboa-Delgado, Edna M; Trujillo Cáceres, Silvia; Rodríguez Forero, Sandra

    2017-04-01

    A high prevalence of depressive symptoms has been reported in family members of newborn infants hospitalized in neonatal intensive care units. This causes a high negative impact on the newborn infant-family bond. To establish the prevalence of depressive symptoms and their associated factors in caregivers of newborn infants hospitalized in a neonatal intensive care unit in Colombia. Cross-sectional, analytical study conducted at a tertiary care health facility specialized in cardiovascular disease. The Beck Depression Inventory-II was administered upon admission to the NICU and on Day 8. Depressive symptoms were considered present if caregivers had intermittent, moderate, severe, or extreme depression. Bivariate and multivariate analyses were done using binomial regression models. A total of 107 children and their caregivers were studied. The prevalence of depressive symptoms was 20.56% (95% confidence interval [CI]: 12.77-28.34) at baseline and 12.86% (95% CI: 4.1-20.89) on Day 8. Male caregivers and caregivers older than 30 years old had a lower risk of having depressive symptoms whereas being the head of the household, having completed primary education or no education at all, and having a baby with an Apgar score at birth of 1-6 were risk factors for developing depressive symptoms. The prevalence of depressive symptoms was high. Being the head of the household, having a low level of education, and an Apgar score at birth of 1-6 were associated with depressive symptoms among caregivers.

  1. Radiation absorbed dose estimates for oxygen-15 radiopharmaceuticals (H2( V)O, C VO, O VO) in newborn infants

    SciTech Connect

    Powers, W.J.; Stabin, M.; Howse, D.; Eichling, J.O.; Herscovitch, P.

    1988-12-01

    In preparation for measurement of regional cerebral oxygen metabolism by positron emission tomography, radiation absorbed dose estimates for 19 internal organs, blood, and total body were calculated for newborn infants following bolus intravenous administration of H2( V)O and brief inhalation of C VO and O VO. Cumulated activity for each radiopharmaceutical was calculated from a compartmental model based on the known biologic behavior of the compound. Values for mean absorbed dose/unit cumulated activity (S) for internal organs and total body were based on a newborn phantom. S was separately calculated for blood. Total radiopharmaceutical absorbed dose estimates necessary to measure cerebral oxygen metabolism in a 3.51-kg infant based on 0.7 mCi/kg H2( V)O and 1 mCi/kg C VO and O VO were determined to be 1.6 rad to the lung (maximum organ dose), 0.28 rad to the marrow, 0.46 rad to the gonads, and 0.22 rad to total body. These values are similar to those for current clinical nuclear medicine procedures employing /sup 99m/Tc in newborn infants.

  2. Protocolized versus non-protocolized weaning for reducing the duration of invasive mechanical ventilation in newborn infants.

    PubMed

    Wielenga, Joke M; van den Hoogen, Agnes; van Zanten, Henriette A; Helder, Onno; Bol, Bas; Blackwood, Bronagh

    2016-03-21

    Mechanical ventilation is a life-saving intervention for critically ill newborn infants with respiratory failure admitted to a neonatal intensive care unit (NICU). Ventilating newborn infants can be challenging due to small tidal volumes, high breathing frequencies, and the use of uncuffed endotracheal tubes. Mechanical ventilation has several short-term, as well as long-term complications. To prevent complications, weaning from the ventilator is started as soon as possible. Weaning aims to support the transfer from full mechanical ventilation support to spontaneous breathing activity. To assess the efficacy of protocolized versus non-protocolized ventilator weaning for newborn infants in reducing the duration of invasive mechanical ventilation, the duration of weaning, and shortening the NICU and hospital length of stay. To determine efficacy in predefined subgroups including: gestational age and birth weight; type of protocol; and type of protocol delivery. To establish whether protocolized weaning is safe and clinically effective in reducing the duration of mechanical ventilation without increasing the risk of adverse events. We searched the Cochrane Central Register of Controlled trials (CENTRAL; the Cochrane Library; 2015, Issue 7); MEDLINE In-Process and other Non-Indexed Citations and OVID MEDLINE (1950 to 31 July 2015); CINAHL (1982 to 31 July 2015); EMBASE (1988 to 31 July 2015); and Web of Science (1990 to 15 July 2015). We did not restrict language of publication. We contacted authors of studies with a subgroup of newborn infants in their study, and experts in the field regarding this subject. In addition, we searched abstracts from conference proceedings, theses, dissertations, and reference lists of all identified studies for further relevant studies. Randomized, quasi-randomized or cluster-randomized controlled trials that compared protocolized with non-protocolized ventilator weaning practices in newborn infants with a gestational age of 24 weeks or

  3. Assessment of gestational age in the Cameroonian newborn infant: a comparison of four scoring methods.

    PubMed

    Sunjoh, F; Njamnshi, A K; Tietche, F; Kago, I

    2004-10-01

    A clinical assessment of gestational age using four different methods was performed in the same population of 358 Cameroonian newborn infants with the aim of determining the most applicable in the local context. Method applicability was compared in terms of validity, accuracy, reliability, and ease of administration. The gestational age ranged from 25 to 44 weeks. The infants were evaluated within 72 h from birth, using the scoring methods of Farr (FSM), Dubowitz (DSM), Ballard (New Ballard Score--NBS) and Eregie (ESM). The DSM was the most valid with a 93 per cent agreement within +/-2 weeks of gestational age by dates followed by the ESM with 92.4 per cent. The NBS and the FSM showed lower validity of 85.6 per cent and 78.3 per cent respectively. The ESM was the most accurate with a mean difference (MD) in weeks (+/-1 SD) between gestational age by method and gestational age by dates of 0.259+/-1.376, followed by the NBS with 0.355+/-1.51. The DSM was fairly accurate with a MD of 0.500+/-1.31, and the FSM the least accurate with a MD of 1.228+/-1.495. The DSM was the most reliable with a high correlation coefficient (r) of 0.94. The NBS and the ESM had comparable reliability with correlation coefficient of 0.93 each. The easiest to administer was the ESM, completed in an average of 41 s, followed by the FSM in 1 min 22 s. The NBS was completed in 2 min 48 s and the DSM in 4 min 28 s. We concluded that the Eregie model has comparable validity and reliability to the Dubowitz score but is more accurate, simple, and very easy to administer. It is therefore recommended where the workload is heavy and health personnel limited, as is the case in developing countries.

  4. US assessment of estrogen-responsive organ growth among healthy term infants: piloting methods for assessing estrogenic activity

    PubMed Central

    Nguyen, Ruby H. N.; Parad, Richard B.; Stroehla, Berrit; Rogan, Walter J.; Estroff, Judy A.

    2011-01-01

    Background A mother’s circulating estrogen increases over the third trimester, producing physiological effects on her newborn that wane postnatally. Estrogenization might be prolonged in newborns exposed to exogenous estrogens, such as isoflavones in soy formula. Objective We evaluated ultrasonography for monitoring growth of multiple estrogen-responsive organs in healthy infants and developed organ-growth trajectories. Materials and methods We studied 38 boys (61 visits) from birth to age 6 months and 41 girls (96 visits) from birth to age 1 year using a partly cross-sectional, partly longitudinal design. We measured uterus and ovaries in girls, testes and prostate in boys, and kidneys, breasts, thymus, and thyroid in all children. We imaged all organs from the body surface in one session of < 1 h. Results Uterine volume decreased from birth (P<0.0001), whereas ovarian volume increased sharply until age 2 months and then decreased (P<0.001). Testicular volume increased with age (P<0.0001), but prostatic volume showed minimal age trend. Breast bud diameter showed no age trend in girls but declined from birth in boys (P=0.03). Conclusion US examination of multiple estrogen-responsive organs in infants in a single session is feasible and yields volume estimates useful for assessing potential endocrine disruptor effects on organ growth. PMID:21104239

  5. Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population.

    PubMed

    Berngard, Samuel Clark; Berngard, Jennifer Bishop; Krebs, Nancy F; Garcés, Ana; Miller, Leland V; Westcott, Jamie; Wright, Linda L; Kindem, Mark; Hambidge, K Michael

    2013-12-01

    Stunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala. The objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy. One hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 months. Maternal measurements were also obtained. Mean ± SD length-for-age Z-score (LAZ) declined from newborn -1.0 ± 1.01 to -2.20 ± 1.05 and -2.26 ± 1.01 at 3 and 6 months respectively. Stunting rates for newborn, 3 and 6 months were 47%, 53% and 56% respectively. A multiple regression model (R(2) = 0.64) demonstrated that the major predictor of LAZ at 3 months was newborn LAZ with the other predictors being newborn weight-for-age Z-score (WAZ), gender and maternal education∗maternal age interaction. Because WAZ remained essentially constant and LAZ declined during the same period, weight-for-length Z-score (WLZ) increased from -0.44 to +1.28 from birth to 3 months. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ. The primary conclusion is that impaired fetal linear growth is the major predictor of early infant linear growth failure indicating that prevention needs to start with maternal interventions. © 2013.

  6. [Drug withdrawal in newborns - clinical data of 49 infants with intrauterine drug exposure: what should be done?].

    PubMed

    Bläser, A; Pulzer, F; Knüpfer, M; Robel-Tillig, E; Vogtmann, C; Nickel, P; Kiess, W

    2008-01-01

    Infants of drug abusing mothers are at high risk to suffer from neonatal abstinence syndrome (NAS). Depending on the drug signs of neonatal withdrawal vary but mainly include central nervous system irritability. NAS causes long duration of hospital stay. Severe withdrawal signs are seen in infants exposed to methadone, infants exposed to other opioids like heroin or buprenorphine have been shown to be less symptomatic. Between the years 1997 and 2003 following the border opening there was a dramatic increase in drug exposed newborns seen in the area of Leipzig (East Germany). In a retrospective study maternal and infant characteristics, severity of symptoms, duration of withdrawal and hospital stay, duration and kind of treatment as well as modalities for release from hospital were analyzed. From 1997 to 2003 49 drug exposed newborns were admitted to our neonatal care unit. There was an increase of the number of affected infants within these years ( ). Maternal drug abuse (n=48) included mainly methadone (n=33), in second line heroine and benzodiazepines, in a few cases also cocaine and cannabinoides. 3 mothers received substitution therapy with buprenorphine. Additional drug use to substitution therapy was seen in 15 mothers. Drugs of abuse were detected in infant urine specimen (36/48). 35 of exposed newborns showed signs of NAS (incidence of NAS 71%). For evaluation of withdrawal signs and conduction of therapy the Finnegan score was used. As first line pharmacological treatment phenobarbitone was administered (n=42), secondary morphine was used (n=14, treatment failure 33%). Mean duration of hospital stay was 21 days. Mean duration of pharmacological treatment was 14 days with longer duration for methadone exposed infants vs. non-methadone exposed infants (16 vs. 10 days). Hospital stay was longer for non-methadone exposed infants. Maternal intake of more than 20 mg methadone per day vs. up to 20 mg per day caused longer duration of hospital stay (28 vs. 20

  7. Influence of prone positioning on premature newborn infant stress assessed by means of salivary cortisol measurement: pilot study.

    PubMed

    Cândia, Maria Fernanda; Osaku, Erica Fernanda; Leite, Marcela Aparecida; Toccolini, Beatriz; Costa, Nicolle Lamberti; Teixeira, Sandy Nogueira; Costa, Claudia Rejane Lima de Macedo; Piana, Pitágoras Augusto; Cristovam, Marcos Antonio da Silva; Osaku, Nelson Ossamu

    2014-01-01

    This study sought to assess the influence of prone positioning on the stress of newborn premature infants through the measurement of the salivary cortisol concentration and the evaluation of physiological and behavioral responses before and after changes in body positioning. Saliva samples were collected from newborn infants at two different times: the first (corresponding to the baseline) after a period of 40 minutes during which the infants were not subjected to any manipulation and were placed in the lateral or supine position, and the second 30 minutes after placement in the prone position. Variables including heart rate, respiratory rate, peripheral oxygen saturation, and the Brazelton sleep score were recorded before, during, and at the end of the period in the prone position. The sample comprised 16 newborn premature infants (56.3% male) with a gestational age between 26 and 36 weeks, postnatal age between 1 and 33 days, birth weight of 935 to 3,050g, and weight at the time of intervention of 870 to 2,890g. During the intervention, six participants breathed room air, while the remainder received oxygen therapy. The median salivary cortisol concentration was lower in the prone position compared to baseline (0.13 versus 0.20; p=0.003), as was the median Brazelton sleep score (p=0.02). The average respiratory rate was lower after the intervention (54.88±7.15 versus 60±7.59; p=0.0004). The remainder of the investigated variables did not exhibit significant variation. Prone positioning significantly reduced the salivary cortisol level, respiratory rate, and Brazelton sleep score, suggesting a correlation between prone positioning and reduction of stress in preterm infants.

  8. [Population genetics approach to the problem of the nonspecific biological resistance of the human body. I. Statement of the problem and basis for the approach. Distribution parameters of anthropometric markers of normal and ill newborn infants and nurslings].

    PubMed

    Altukhov, Iu P; Botvin'ev, O K; Kurbatova, O L

    1979-01-01

    Distributions of two metrical characters-the weight and the body length at birth are considered in several groups of healthy, diseased and dead newborns and infants. Significant differences in statistical parameters of these distributions (mean, standard deviation, skewness and kurtosis) are demonstrated for normal and malformated children. The increased number of children with minimal deviations from the mean values of characters (adaptive norm) is observed among healthy newborns, while in groups of diseased and dead children the frequency of individuals with extreme (especially low) values is increased. The principle of classification of individuals based simultaneously on two characteris is suggested and the problem of "average phenotype" classification by the number of characters is discussed.

  9. The window of opportunity: decision theory and the timing of prognostic tests for newborn infants.

    PubMed

    Wilkinson, Dominic

    2009-11-01

    In many forms of severe acute brain injury there is an early phase when prognosis is uncertain, followed later by physiological recovery and the possibility of more certain predictions of future impairment. There may be a window of opportunity for withdrawal of life support early, but if decisions are delayed there is the risk that the patient will survive with severe impairment. In this paper I focus on the example of neonatal encephalopathy and the question of the timing of prognostic tests and decisions to continue or to withdraw life-sustaining treatment. Should testing be performed early or later; and how should parents decide what to do given the conflicting values at stake? I apply decision theory to the problem, using sensitivity analysis to assess how different features of the tests or different values would affect a decision to perform early or late prognostic testing. I draw some general conclusions from this model for decisions about the timing of testing in neonatal encephalopathy. Finally I consider possible solutions to the problem posed by the window of opportunity. Decision theory highlights the costs of uncertainty. This may prompt further research into improving prognostic tests. But it may also prompt us to reconsider our current attitudes towards the palliative care of newborn infants predicted to be severely impaired.

  10. Regional development of glutamate-N-methyl-D-aspartate receptor sites in asphyxiated newborn infants.

    PubMed

    Andersen, D L; Tannenberg, A E; Burke, C J; Dodd, P R

    1998-04-01

    The N-methyl-D-aspartate (NMDA) subclass of glutamate receptors was examined in newborn infants dying between 25 weeks' gestation and term, either from acute cerebral hypoxia, or from other noncerebral conditions incompatible with life. Frontal, occipital, temporal, and motor cortex tissue samples were obtained at autopsy (post mortem delay: median, 45.9 hr; range, 24-96 hr) and frozen for subsequent [3H]MK801 homogenate binding assays. Whereas no significant variation was observed in ligand affinity (KD), in all cases receptor density (BMAX) increased with gestational age, in occipital cortex (27 weeks, BMAX = 222 +/- 44 fmol x mg protein(-1); 39 weeks, 439 +/- 42 fmol x mg protein[-1]), but not in motor or temporal cortex. The gestational-age increase also occurred in control frontal cortex (27 weeks, 284 +/- 80; 39 weeks, 567 +/- 40 fmol x mg protein[-1]), but was significantly less marked in frontal cortex in hypoxia cases (27 weeks, 226 +/- 90; 39 weeks, 326 +/- 47 fmol x mg protein[-1]). In all cortical areas except temporal, the maximal response to glutamate did not vary across case groups. Hypoxia cases showed an increased response to glutamate enhancement selectively in temporal cortex. Binding site density did not correlate with degree of hypoxia as assessed pathologically, suggesting that receptor differences preceded the hypoxic episode. Regional differences in glutamate-NMDA receptor sites may underlie increased vulnerability to hypoxia at birth.

  11. Utilizing temporal data abstraction for data validation and therapy planning for artificially ventilated newborn infants.

    PubMed

    Miksch, S; Horn, W; Popow, C; Paky, F

    1996-11-01

    Medical diagnosis and therapy planning at modern intensive care units (ICUs) have been refined by the technical improvement of their equipment. However, the bulk of continuous data arising from complex monitoring systems in combination with discontinuously assessed numerical and qualitative data creates a rising information management problem at neonatal ICUs (NICUs). We developed methods for data validation and therapy planning which incorporate knowledge about point and interval data, as well as expected qualitative trend descriptions to arrive at unified qualitative descriptions of parameters (temporal data abstraction). Our methods are based on schemata for data-point transformation and curve fitting which express the dynamics of and the reactions to different degrees of parameters' abnormalities as well as on smoothing and adjustment mechanisms to keep the qualitative descriptions stable. We show their applicability in detecting anomalous system behavior early, in recommending therapeutic actions, and in assessing the effectiveness of these actions within a certain period. We implemented our methods in VIE-VENT, an open-loop knowledge-based monitoring and therapy planning system for artificially ventilated newborn infants. The applicability and usefulness of our approach are illustrated by examples of VIE-VENT. Finally, we present our first experiences with using VIE-VENT in a real clinical setting.

  12. [Dermohypodermitis and gut translocation Escherichia coli septicemia in a newborn infant].

    PubMed

    Gouache, E; Chantier, E; Hubert, N; Rivière, M-F

    2013-01-01

    The burden of neonatal bacterial infections continues. They remain a significant cause of death and morbidity, despite recommendations for prevention. The epidemiology of these infections has changed. Currently the two most causative pathogens for early-onset neonatal sepsis and for late-onset sepsis in term infants are Group B streptococci (GBS) and Escherichia coli. E. coli's role is increasingly important since the widespread use of intrapartum antibiotic prophylaxis. In late-onset infections, one of the suggested pathophysiological mechanisms is microbial translocation in the gut secondary to digestive colonization, particularly when E. coli is isolated in blood cultures. This can occur either before or after birth. Bacterial sepsis can be associated with various non-specific peripheral manifestations involving skin and soft tissues. We report the case of a full-term, 26-day-old newborn admitted to the hospital for fever. She presented with dermohypodermitis of the left trunk and was diagnosed with E. coli septicemia. She was discharged in good condition after appropriate intravenous antibiotic therapy.

  13. Radiant warmers versus incubators for regulating body temperature in newborn infants.

    PubMed

    Flenady, V J; Woodgate, P G

    2003-01-01

    The provision of a thermoneutral environment is an essential component of the immediate and longer term care of newborn infants. A variety of methods are currently employed including incubators and open-care systems, with or without modifications such as heat shields and plastic wrap. The system used must allow ready access to the infant but should also minimise alterations in the immediate environment. To assess the effects of radiant warmers versus incubators on neonatal fluid and electrolyte balance, morbidity and mortality. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of electronic databases: Oxford Database of Perinatal Trials, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2003), MEDLINE (1966 -2003), and CINAHL (1982-2003), previous reviews including cross references, abstracts, conferences, symposia proceedings, expert informants and journal hand searching mainly in the English language. Randomised or quasi-randomised trials in which radiant warmers were compared to incubators in a neonatal population. Independent data extraction and quality assessment of included trials was conducted by the authors. Data were analysed using relative risk (RR) and weighted mean difference (WMD). Results are presented with 95% confidence intervals. Meta-analysis was undertaken using a fixed effect model. Eight studies are included in this review; six employed a crossover design. In the overall comparison of radiant warmers vs incubators, radiant warmers caused a statistically significant increase in insensible water loss (IWL) [WMD 0.94g/Kg/day (95% CI 0.47, 1.41)] and a trend towards increased oxygen consumption which was not statistically significant [WMD 0.27mL/kg/min (95% CI -0.09, 0.63)]. Due to small numbers, effects on important clinical outcomes could not be adequately assessed. A comparison of radiant warmers with heat shields vs incubators without heat shields showed a

  14. Radiant warmers versus incubators for regulating body temperature in newborn infants.

    PubMed

    Flenady, V J; Woodgate, P G

    2002-01-01

    The provision of a thermoneutral environment is an essential component of the immediate and longer term care of newborn infants. A variety of methods are currently employed including incubators and open-care systems, with or without modifications such as heat shields and plastic wrap. The system used must allow ready access to the infant but should also minimise alterations in the immediate environment. To assess the effects of radiant warmers versus incubators on neonatal fluid and electrolyte balance, morbidity and mortality. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of electronic databases: Oxford Database of Perinatal Trials, Cochrane Controlled Trials Register (Cochrane Library Issue 4 2001), MEDLINE (1966 -2001), and CINAHL (1982-2001). Randomised or quasi-randomised trials in which radiant warmers were compared to incubators in a neonatal population. Independent data extraction and quality assessment of included trials was conducted by the authors. Data were analysed using relative risk (RR) and weighted mean difference (WMD). Results are presented with 95% confidence intervals. Meta-analysis was undertaken using a fixed effect model. Eight studies are included in this review; six employed a crossover design. In the overall comparison of radiant warmers vs incubators, radiant warmers caused a statistically significant increase in insensible water loss (IWL) [WMD 0.94g/Kg/day (95% CI 0.47, 1.41)] and a trend towards increased oxygen consumption which was not statistically significant [WMD 0.27mL/kg/min (95% CI -0.09, 0.63)]. Due to small numbers, effects on important clinical outcomes could not be adequately assessed. A comparison of radiant warmers with heat shields vs incubators without heat shields showed a trend for increased IWL in the radiant warmer group, which was not statistically significant. No difference was shown in oxygen consumption. Radiant warmers result in increased IWL compared to

  15. Multiple-antigen slide test for detection of immunoglobulin M antibodies in newborn and infant sera by immunofluorescence.

    PubMed Central

    Gallo, D; Riggs, J L; Schachter, J; Emmons, R W

    1981-01-01

    A microimmunofluorescence test was evaluated for use in measuring immunoglobulin M (IgM) antibodies in infant sera to five of the agents implicated in congenital and neonatal disease. Pen point dots of Toxoplasma gondii, cytomegalovirus, rubella virus, herpes simplex virus, and chlamydial cell culture antigens were applied to each circle of eight-circle printed slides. These multiple-antigen slides greatly facilitated the screening of 607 sera from infants and 117 sera from mothers for the presence of IgM antibody to these agents. Forty sera could be examined microscopically in approximately 30 min. All sera reacting with one or more antigens were tested for rheumatoid factor by the latex method, absorbed with glutaraldehyde-cross-linked human IgG, and retested for the presence of IgM antibody. IgM antibody to cytomegalovirus was demonstrated in sera from four newborns, but IgM antibody to rubella virus could not be detected until 21 days after birth, although rubella virus was isolated from sera from five younger infants. This may indicate that rubella IgM levels in many congenitally infected newborns are too low to be measured by the immunofluorescence method. Five percent of the sera from infants in this study possessed demonstrable IgM antibody to one of the antigens. PMID:6262369

  16. Conservation of the fourth gene among rotaviruses recovered from asymptomatic newborn infants and its possible role in attenuation

    SciTech Connect

    Flores, J.; Midthun, K.; Hoshino, Y.; Green, K.; Gorziglia, M.; Kapikian, A.Z.; Chanock, R.M.

    1986-11-01

    RNA-RNA hybridization was performed to assess the extent of genetic relatedness among human rotaviruses isolated from children with gastroenteritis and from asymptomatic newborn infants. /sup 32/P-labeled single-stranded RNAs produced by in vitro transcription from viral cores of the different strains tested were used as probes in two different hybridization assays: (1) undenatured genomic RNAs were resolved by polyacrylamide gel electrophoresis, denatured in situ, electrophoretically transferred to diazobenzyloxymethyl-paper (Northern blots), and then hybridized to the probes under two different conditions of stringency; and (ii) denatured genomic double-stranded RNAs were hybridized to the probes in solution and the hybrids which formed were identified by polyacrylamide gel electrophoresis. When analyzed by Northern blot hybridization at a low level of stringency, all genes from the strains tested cross-hybridized, providing evidence for some sequence homology in each of the corresponding genes. However, when hybridization stringency was increased, a difference in gene 4 sequence was detected between strains recovered from asymptomatic newborn infants (nursery strains) and strains recovered from infants and young children with diarrhea. Although the nursery strains exhibited serotypic diversity, the fourth gene appeared to be highly conversed. These results were confirmed and extended during experiments in which the RNA-RNA hybridization was carried out in solution and the resulting hybrids were analyzed by polyacrylamide gel electrophoresis. Full-length hybrids did not form between the fourth genes from the nursery strains and the corresponding genes from the strains recovered from symptomatic infants and young children.

  17. Surfactant therapy in preterm infants with respiratory distress syndrome and in near-term or term newborns with acute RDS.

    PubMed

    Ramanathan, R

    2006-05-01

    Many different surfactant preparations derived from animal sources, as well as synthetic surfactants, are available for the treatment of preterm infants with respiratory distress syndrome (RDS). Natural, modified surfactants containing surfactant-associated proteins appear to be more effective than non-protein-containing synthetic surfactants. Comparative trials with poractant alfa at a higher initial dose of 200 mg/kg appear to be associated with rapid weaning of FiO2, less need for additional doses, and decreased mortality in infants <32 weeks gestation when compared with beractant. Early rescue (<30 min of age) surfactant therapy is an effective method to minimize over treatment of some preterm infants who may not develop RDS. Surfactant therapy followed by rapid extubation to nasal ventilation appears to be more beneficial than continued mechanical ventilation. In near-term or term newborns with acute RDS, surfactant therapy has been shown to be 70% effective in improving respiratory failure.

  18. Variation in Formula Supplementation of Breastfed Newborn Infants in New York Hospitals.

    PubMed

    Nguyen, Trang; Dennison, Barbara A; Fan, Wei; Xu, Changning; Birkhead, Guthrie S

    2017-07-01

    We examined the variation between 126 New York hospitals in formula supplementation among breastfed infants after adjusting for socioeconomic, maternal, and infant factors and stratifying by level of perinatal care. We used 2014 birth certificate data for 160 911 breastfed infants to calculate hospital-specific formula supplementation percentages by using multivariable hierarchical logistic regression models. Formula supplementation percentages varied widely among hospitals, from 2.3% to 98.3%, and was lower among level 1 hospitals (18.2%) than higher-level hospitals (50.6%-57.0%). Significant disparities in supplementation were noted for race and ethnicity (adjusted odds ratios [aORs] were 1.54-2.05 for African Americans, 1.85-2.74 for Asian Americans, and 1.25-2.16 for Hispanics, compared with whites), maternal education (aORs were 2.01-2.95 for ≤12th grade, 1.74-1.85 for high school or general education development, and 1.18-1.28 for some college or a college degree, compared with a Master's degree), and insurance coverage (aOR was 1.27-1.60 for Medicaid insurance versus other). Formula supplementation was higher among mothers who smoked, had a cesarean delivery, or diabetes. At all 4 levels of perinatal care, there were exemplar hospitals that met the HealthyPeople 2020 supplementation goal of ≤14.2%. After adjusting for individual risk factors, the hospital-specific, risk-adjusted supplemental formula percentages still revealed a wide variation. A better understanding of the exemplar hospitals could inform future efforts to improve maternity care practices and breastfeeding support to reduce unnecessary formula supplementation, reduce disparities, increase exclusive breastfeeding and breastfeeding duration, and improve maternal and child health outcomes. Copyright © 2017 by the American Academy of Pediatrics.

  19. 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

  20. Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.

    PubMed

    Bhutani, Vinod K

    2011-10-01

    To standardize the use of phototherapy consistent with the American Academy of Pediatrics clinical practice guideline for the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Relevant literature was reviewed. Phototherapy devices currently marketed in the United States that incorporate fluorescent, halogen, fiber-optic, or blue light-emitting diode light sources were assessed in the laboratory. The efficacy of phototherapy units varies widely because of differences in light source and configuration. The following characteristics of a device contribute to its effectiveness: (1) emission of light in the blue-to-green range that overlaps the in vivo plasma bilirubin absorption spectrum (~460-490 nm); (2) irradiance of at least 30 μW · cm(-2) · nm(-1) (confirmed with an appropriate irradiance meter calibrated over the appropriate wavelength range); (3) illumination of maximal body surface; and (4) demonstration of a decrease in total bilirubin concentrations during the first 4 to 6 hours of exposure. RECOMMENDATIONS (SEE APPENDIX FOR GRADING DEFINITION): The intensity and spectral output of phototherapy devices is useful in predicting potential effectiveness in treating hyperbilirubinemia (group B recommendation). Clinical effectiveness should be evaluated before and monitored during use (group B recommendation). Blocking the light source or reducing exposed body surface should be avoided (group B recommendation). Standardization of irradiance meters, improvements in device design, and lower-upper limits of light intensity for phototherapy units merit further study. Comparing the in vivo performance of devices is not practical, in general, and alternative procedures need to be explored.

  1. Is chest CT useful in newborn screened infants with cystic fibrosis at 1 year of age?

    PubMed Central

    Thia, Lena P; Calder, Alistair; Stocks, Janet; Bush, Andrew; Owens, Catherine M; Wallis, Colin; Young, Carolyn; Sullivan, Yvonne; Wade, Angie; McEwan, Angus; Brody, Alan S

    2014-01-01

    Rationale Sensitive outcome measures applicable in different centres to quantify and track early pulmonary abnormalities in infants with cystic fibrosis (CF) are needed both for clinical care and interventional trials. Chest CT has been advocated as such a measure yet there is no validated scoring system in infants. Objectives The objectives of this study were to standardise CT data collection across multiple sites; ascertain the incidence of bronchial dilatation and air trapping in newborn screened (NBS) infants with CF at 1 year; and assess the reproducibility of Brody-II, the most widely used scoring system in children with CF, during infancy. Methods A multicentre observational study of early pulmonary lung disease in NBS infants with CF at age 1 year using volume-controlled chest CT performed under general anaesthetic. Main results 65 infants with NBS-diagnosed CF had chest CT in three centres. Small insignificant variations in lung recruitment manoeuvres but significant centre differences in radiation exposures were found. Despite experienced scorers and prior training, with the exception of air trapping, inter- and intraobserver agreement on Brody-II score was poor to fair (eg, interobserver total score mean (95% CI) κ coefficient: 0.34 (0.20 to 0.49)). Only 7 (11%) infants had a total CT score ≥12 (ie, ≥5% maximum possible) by either scorer. Conclusions In NBS infants with CF, CT changes were very mild at 1 year, and assessment of air trapping was the only reproducible outcome. CT is thus of questionable value in infants of this age, unless an improved scoring system for use in mild CF disease can be developed. PMID:24132911

  2. Organization of the autoantibody repertoire in healthy newborns and adults revealed by system level informatics of antigen microarray data

    PubMed Central

    Madi, Asaf; Hecht, Inbal; Bransburg-Zabary, Sharron; Merbl, Yifat; Pick, Adi; Zucker-Toledano, Merav; Quintana, Francisco J.; Tauber, Alfred I.; Cohen, Irun R.; Ben-Jacob, Eshel

    2009-01-01

    The immune system is essential to body defense and maintenance. Specific antibodies to foreign invaders function in body defense, and it has been suggested that autoantibodies binding to self molecules are important in body maintenance. Recently, the autoantibody repertoires in the bloods of healthy mothers and their newborns were studied using an antigen microarray containing hundreds of self molecules. It was found that the mothers expressed diverse repertoires for both IgG and IgM autoantibodies. Each newborn shares with its mother a similar repertoire of IgG antibodies, which cross the placental but its IgM repertoire is more similar to those of other newborns. Here, we took a system-level approach and analyzed the correlations between autoantibody reactivities of the previous data and extended the study to new data from newborns at birth and a week later, and from healthy young women. For the young women, we found modular organization of both IgG and IgM isotypes into antigen cliques—subgroups of highly correlated antigen reactivities. In contrast, the newborns were found to share a universal congenital IgM profile with no modular organization. Moreover, the IgG autoantibodies of the newborns manifested buds of the mothers' antigen cliques, but they were noticeably less structured. These findings suggest that the natural autoantibody repertoire of humans shows relatively little organization at birth, but, by young adulthood, it becomes sorted out into a modular organization of subgroups (cliques) of correlated antigens. These features revealed by antigen microarrays can be used to define personal states of autoantibody organizational motifs. PMID:19667184

  3. Parental experiences of providing skin-to-skin care to their newborn infant--part 1: a qualitative systematic review.

    PubMed

    Anderzén-Carlsson, Agneta; Lamy, Zeni Carvalho; Eriksson, Mats

    2014-01-01

    To describe parental experiences of providing skin-to-skin care (SSC) to their newborn infants. SSC care for newborn infants has been reported to have positive physiological and psychological benefits to the infants and their parents. No systematic review regarding parental experiences has been identified. In this first part of a meta-study, the findings of a systematic literature review on parental experience of SSC care are presented. Four databases were searched, without year or language limitations, up until December 2013. Manual searches were performed in reference lists and in a bibliography of the topic. After a quality-appraisal process, data from the original articles were extracted and analysed using qualitative content analysis. The systematic and manual searches led to the inclusion of 29 original qualitative papers from nine countries, reporting experiences from 401 mothers and 94 fathers. Two themes that characterized the provision of SSC emerged: a restoring experience and an energy-draining experience. This review has added scientific and systematic knowledge about parental experiences of providing SSC. Further research about fathers' experiences is recommended.

  4. Klebsiella pneumonia: An unusual cause of ophthalmia neonatorum in a healthy newborn.

    PubMed

    Kumar, Jaya B; Silverstein, Evan; Wallace, David K

    2015-12-01

    Ophthalmia neonatorum is one of the most common infections during the neonatal period. Chlamydia trachomatis and Neisseria gonorrhoea must be ruled out, given their high virulence and systemic complications. We describe a case of ophthalmia neonatroum from Klebsiella pneumonia. Gram-negative organisms have been reported in hospital-acquired conjunctivitis (HAC), but we are unaware of any published reports of K. pneumonia conjunctivitis in an otherwise healthy full-term infant born in the United States who has received prophylaxis. It is important to promptly identify and treat Klebsiella conjunctivitis because it can lead to severe complications. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  5. Barriers to enrollment in a randomized controlled trial of hydrocortisone for cardiovascular insufficiency in term and late preterm newborn infants.

    PubMed

    Watterberg, K L; Fernandez, E; Walsh, M C; Truog, W E; Stoll, B J; Sokol, G M; Kennedy, K A; Fraga, M V; Beauman, S S; Carper, B; Das, A; Duncan, A F; Buss, W F; Gauldin, C; Lacy, C B; Sanchez, P J; Chawla, S; Lakshminrusimha, S; Cotten, C M; Van Meurs, K P; Poindexter, B B; Bell, E F; Carlo, W A; Devaskar, U; Wyckoff, M H; Higgins, R D

    2017-09-07

    To analyze reasons for low enrollment in a randomized controlled trial (RCT) of the effect of hydrocortisone for cardiovascular insufficiency on survival without neurodevelopmental impairment (NDI) in term/late preterm newborns. The original study was a multicenter RCT. Eligibility: ⩾34 weeks' gestation, <72 h old, mechanically ventilated, receiving inotrope. Primary outcome was NDI at 2 years; infants with diagnoses at high risk for NDI were excluded. This paper presents an analysis of reasons for low patient enrollment. Two hundred and fifty-seven of the 932 otherwise eligible infants received inotropes; however, 207 (81%) had exclusionary diagnoses. Only 12 infants were randomized over 10 months; therefore, the study was terminated. Contributing factors included few eligible infants after exclusions, open-label steroid therapy and a narrow enrollment window. Despite an observational study to estimate the population, very few infants were enrolled. Successful RCTs of emergent therapy may require fewer exclusions, a short-term primary outcome, waiver of consent and/or other alternatives.Journal of Perinatology advance online publication, 7 September 2017; doi:10.1038/jp.2017.131.

  6. Amikacin in Newborn Infants: Comparative Pharmacology with Kanamycin and Clinical Efficacy in 45 Neonates with Bacterial Diseases

    PubMed Central

    Howard, Jorge B.; McCracken, George H.; Trujillo, Hugo; Mohs, Edgar

    1976-01-01

    The pharmacokinetic properties of amikacin (BBK8) were similar to those of kanamycin in newborn infants. Peak serum concentrations of both drugs were in the range of 15 to 25 μg/ml with the exception of kanamycin in babies weighing greater than 2,000 g at birth where peak levels were 12.5 to 15 μg/ml. Volumes of distribution, plasma clearances, and serum half-life values were comparable for the two drugs. The clinical and bacteriological responses to amikacin therapy were assessed in 45 neonates with bacterial diseases. A case fatality rate of 26% was observed in infants with septicemia and/or meningitis, whereas no deaths occurred among 22 infants with urinary tract and mucocutaneous infections. Cultures from infected sites were sterile within 72 h of initiating amikacin therapy in 47% of the infants, continued positive for greater than 72 h in 31%, and were not reevaluated during therapy in 22%. The clinical response was judged to be satisfactory in 92% of the surviving infants. The efficacy of amikacin was comparable to that of kanamycin or gentamicin in neonatal bacterial diseases. PMID:984762

  7. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 1: The palate of the term newborn

    PubMed Central

    Hohoff, Ariane; Rabe, Heike; Ehmer, Ulrike; Harms, Erik

    2005-01-01

    Background The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinical studies are needed. The objective of this review is to provide a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development. One focus of this review is the analysis of studies on the palate of the term newborn, since knowing what is 'normal' is a precondition of being able to assess abnormalities. Methods A search profile based on Cochrane search strategies applied to 10 medical databases was used to identify existing studies. Articles, mainly those published before 1960, were identified from hand searches in textbooks, encyclopedias, reference lists and bibliographies. Sources in English, German, and French of more than a century were included. Data for term infants were recalculated if particular information about weight, length, or maturity was given. The extracted values, especially those from non-English paper sources, were provided unfiltered for comparison. Results The search strategy yielded 182 articles, of which 155 articles remained for final analysis. Morphology of the term newborn's palate was of great interest in the first half of the last century. Two general methodologies were used to assess palatal morphology: visual and metrical descriptions. Most of the studies on term infants suffer from lack of reliability tests. The groove system was recognized as the distinctive feature of the infant palate. The shape of the palate of the term infant may vary considerably, both visually and metrically. Gender, race, mode of delivery, and nasal deformities were identified as causes contributing to altered palatal morphology. Until today, anatomical features of the newborn's palate are subject to a non-uniform nomenclature. Conclusion Today's knowledge of a newborn's 'normal' palatal morphology is based on non

  8. [Immunological behavior (IgG, IgM, IgA) and total complement (CH50) of newborns infants with risk factors for early onset sepsis. Comparative analysis of newborns with and without infection].

    PubMed

    Ceccon, M E; Diníz, E M; Carneiro-Sampaio, M M; Arslanian, C; Diogo, C L; Ramos, J L; Vaz, F A

    1998-01-01

    Immunological behavior (IgG, IgM, IgA) and total Complement (CH50) of newborns infants with risk factors for early onset sepsis. Comparative analysis between newborns with and without infection. Rev. Hosp. Clín. Fac. Med. S. Paulo, 53(6): 303-310, 1998. The objective of this study was to verify the immunological behavior of the newborn infant in front of an infection. We studied 60 newborn infants that had risk factors for early onset sepsis (premature rupture membranes, clinic amnionitis or tract urinary infection) from de immunological and infection point of view. They were classified into three gestational age groups: < 34 weeks, between 34 and 36 6/7 weeks and > or = 37 weeks. Sepsis diagnosis was done through clinical and laboratorial data and we also included the followings exams: Immunological types (IgG, IgM, IgA) and total complement (CH50) obtained from the newborn at birth and on the fifth day of life. We could verify that 15 newborns (25%) presented early sepsis. There was a statistical association between perinatal asfixia and infection in the group with gestational age < 34 weeks and this same group presented statistical association between infection and death. The serical levels of IgG and CH50 were directly related to the gestational age and there were significant statistical differences between levels of IgG, IgM and total Complement between infected and not infected newborns within the same group os gestional age. We observed that the infection was associated to low levels of IgG and CH50, at birth and on the fifth day, mainly in the group of infected newborns with gestional age < 34 weeks, being this group, therefore, the one that would mostly benefit from an immunological support in front of and infection.

  9. 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.

  10. Stability and Instability in the Newborn Infant: The Quest for Elusive Threads.

    ERIC Educational Resources Information Center

    Horowitz, Frances Degen; And Others

    1978-01-01

    Reviews issues of reliability (especially test-retest reliability) in newborn assessment, discusses predictive models based on newborn assessment, and presents information on modifications of the Brazelton Neonatal Behavioral Assessment Scale which may help in pursuing fruitful questions involving prediction of development. (Author/BH)

  11. Size Constancy at Birth: Newborn Infants' Responses to Retinal and Real Size.

    ERIC Educational Resources Information Center

    Slater, Alan; And Others

    1990-01-01

    First, newborns' preferential looking between pairs of stimuli which varied in real size and viewing distance was solely determined by retinal size. Second, newborns desensitized to changes in distance and retinal size strongly preferred an object of a different size to the familiar one. (RH)

  12. The Foundations of Social Cognition: Studies on Face/Voice Integration in Newborn Infants

    ERIC Educational Resources Information Center

    Streri, Arlette; Coulon, Marion; Guellai, Bahia

    2013-01-01

    A series of studies on newborns' abilities for recognizing speaking faces has been performed in order to identify the fundamental cues of social cognition. We used audiovisual dynamic faces rather than photographs or patterns of faces. Direct eye gaze and speech addressed to newborns, in interactive situations, appear to be two good candidates for…

  13. The Foundations of Social Cognition: Studies on Face/Voice Integration in Newborn Infants

    ERIC Educational Resources Information Center

    Streri, Arlette; Coulon, Marion; Guellai, Bahia

    2013-01-01

    A series of studies on newborns' abilities for recognizing speaking faces has been performed in order to identify the fundamental cues of social cognition. We used audiovisual dynamic faces rather than photographs or patterns of faces. Direct eye gaze and speech addressed to newborns, in interactive situations, appear to be two good candidates for…

  14. 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

  15. 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.

  16. In Italy, healthy life expectancy drop dramatically: from 2004 to 2008 there was a 10 years drop among newborn girls.

    PubMed

    Gennaro, Valerio; Ghirga, Giovanni; Corradi, Laura

    2012-05-18

    In this short essay, we would like to address a severe divergence observed in Italy between Life Expectancy (LE) and Healthy Life Expectancy (Healthy LE) and a unique trend of worsening in Healthy LE, compared to the other European countries. Both issues emerge in recent data by EUROSTAT Report. The analysis used by the authors of the EUROSTAT report is based on Sullivan method which combines 2 type of variables: mortality and morbidity data. While several European countries started to deal with comparable data about LE since 1960, in Italy, analogous data were available for the first time in EUROSTAT Report only in 1985. In Italy, in the period 1985-2008, there was a good progressive increase in L.E., following the best European values. Nevertheless, while until 2004 Italy was among the European best countries in terms of both LE and Healthy LE at birth, four years later in 2008 there was a shocking loss of 10 years of Healthy LE at birth in newborn girls. In the process, they lost their 2-years previous advantage with respect to males (the latter lost only 6 years of Healthy LE, in the same time span). Looking at healthy LE at age 65 in respect to 2004, Italian women in 2008 could expect to live healthy only about 7 years (as much as men) versus the almost 15 years of the European best values (14 years for men). It is legitimate to wonder why no one official comment has been produced as a reaction after the first year of spectacular decline in Healthy Life Years in Italy: in counter-tendency with European values, from 2004 to 2008 there is a clear evidence of a 10 years drop in Healthy LE among newborn girls. The problem has not been taken into consideration even when the situation clearly appeared to worsen in the following years, dropping 4-6 more years for males and females in 2006 (for newborn babies); two more years of healthy life expectancy have been lost between 2006 and 2007 for each gender. One more year of Healthy Life Expectancy is lost in 2008. And

  17. Feasibility, diagnostic validity and limits of postmortem evaluation of a newborn infant following an extremely prolonged freezing interval: a thanatological case study.

    PubMed

    Krajčovič, Jozef; Janík, Martin; Novomeský, František; Straka, Lubomír; Hejna, Petr

    2014-11-01

    In forensic assessment, denial and concealment of pregnancy has wide-ranging implications including criminal abortions, extramural deliveries, concealment of birth, newborn infant abandonment or even neonaticide. Clarification of whether a newborn was born alive is the most important factor when evaluating an abandoned neonate or concealment of birth. Other points that need to be addressed are determination of viability and maturity of the newborn infant, and the identity of the mother. A prolonged postmortem interval following illegal disposal of a dead body often leads to advanced decomposition, making postmortem elucidation difficult. We report an exceptionally uncommon autopsy case of a well-preserved female newborn, which was accidentally found after eight years in a home freezer. Despite the prolonged postmortem interval, tissue preservation was sufficient for a meaningful autopsy including a comprehensive histopathological study. The purpose of the present investigations was to expand our understanding of thanatological processes, as well as detectability of particular histological findings on the remains of a newborn after extremely prolonged storage in an artificially frozen environment. In addition, this article discusses forensically important issues regarding concealment of newborn infant under specific conditions.

  18. Assessing effects of serotonin precursors on newborn behavior.

    PubMed

    Yogman, M W; Zeisel, S H; Roberts, C

    While traditional studies of newborn diet have focused on the effects of malnutrition on the central nervous system, there is now interest in how qualitative differences in the composition of early newborn feeding might influence behavior. This paper reviews the available techniques for assessing newborn perception and cognition, as well as behavioral organization. The paper then focuses intensively on measures of newborn state behaviour in view of evidence in adult humans, as well as in non-human species, suggesting a relationship between sleep behavior (sleep onset, night waking) and brain serotonin levels. A study designed to examine the relationship between dietary precursors of brain serotonin (within the range of concentrations found in human milk) and newborn state behavior after feeding is described to illustrate the application of these techniques. Healthy, fullterm newborns were fed a modified formula, containing tryptophan or valine, on one day, a routine formula on another day, and observed continuously for 3 h after each feeding for the observation and recording of newborn state. Data from individual infants in the tryptophan and valine groups are presented to illustrate the findings that infants fed tryptophan entered quiet sleep and active sleep sooner than infants fed valine and spent more time in active sleep and less time alert. These results illustrate the value of newborn behavior as a sensitive dependent variable in studies of behavioral effects of diet and suggests that variations in serotonin levels in the newborn brain may modulate the newborn's sleep/wake behaviour.

  19. 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.

  20. Noninvasive monitoring of gas in the lungs and intestines of newborn infants using diode lasers: feasibility study.

    PubMed

    Lundin, Patrik; Svanberg, Emilie Krite; Cocola, Lorenzo; Lewander Xu, Märta; Somesfalean, Gabriel; Andersson-Engels, Stefan; Jahr, John; Fellman, Vineta; Svanberg, Katarina; Svanberg, Sune

    2013-12-01

    Preterm newborn infants have a high morbidity rate. The most frequently affected organs where free gas is involved are the lungs and intestines. In respiratory distress syndrome, both hyperexpanded and atelectatic (collapsed) areas occur, and in necrotizing enterocolitis, intramural gas may appear in the intestine. Today, these conditions are diagnosed with x-ray radiography. A bed-side, rapid, nonintrusive, and gas-specific technique for in vivo gas sensing would improve diagnosis. We report the use of noninvasive laser spectroscopy, for the first time, to assess gas content in the lungs and intestines of three full-term infants. Water vapor and oxygen were studied with two low-power diode lasers, illuminating the skin and detecting light a few centimeters away. Water vapor was easily detected in the intestines and was also observed in the lungs. The relatively thick chest walls of the infants prevented detection of the weaker oxygen signal in this study. However, results from a previous phantom study, together with scaling of the results presented here to the typical chest-wall thickness of preterm infants, suggest that oxygen also should be detectable in their lungs.

  1. Do women tend while men fight or flee? Differential emotive reactions of stressed men and women while viewing newborn infants.

    PubMed

    Probst, Fabian; Meng-Hentschel, Juliane; Golle, Jessika; Stucki, Sylvia; Akyildiz-Kunz, Carola; Lobmaier, Janek S

    2017-01-01

    Infant care often is carried out under stressful circumstances. Little is known about differences in caretaking motivation between men and women under stress. In the present study, stress was induced in 40 participants (21 women, 19 men) by means of the cold pressor stress test, 40 (22 women, 18 men) serving as controls. Participants then rated their urge to care for newborn infants shown on 20 short video clips. The infants in the videos were either crying (N=10) or were showing typical neonatal facial movements (N=10). Skin conductance was obtained while participants viewed the videos and salivary cortisol was measured to capture stress responses. We found sex differences in caretaking motivation, such that stress led to decreased caretaking motivation in men but not in women. Furthermore, stressed men elicited a stronger skin conductance change while viewing infant videos than stressed women. These findings provide further evidence for differential stress reactions in men and women and may have crucial implications for parental care.

  2. Early Acquisition of Pneumocystis jirovecii Colonization and Potential Association With Respiratory Distress Syndrome in Preterm Newborn Infants.

    PubMed

    Rojas, Pilar; Friaza, Vicente; García, Elisa; de la Horra, Carmen; Vargas, Sergio L; Calderón, Enrique J; Pavón, Antonio

    2017-09-15

    Pneumocystis pneumonia is a well-recognized lung disease of premature and malnourished babies. Even though serologic studies have shown that children are exposed to Pneumocystis jirovecii early in life, the epidemiology of human P. jirovecii infection and the host-microorganism relationship in infancy remain poorly understood. The aim of the present study was to investigate the prevalence of P. jirovecii colonization in preterm infants and its possible association with medical complications. A prospective observational study of preterm infants (birth weight <1500 g and/or gestational age <32 weeks) was carried out. Identification of P. jirovecii colonization was performed by means of molecular techniques in nasal aspirated samples at birth. A total of 128 preterm infants were included during the study period. Pneumocystis DNA was identified in 25.7% (95% confidence interval [CI], 17.8%-33.7%) of newborns studied. A significant increase of respiratory distress syndrome in colonized group, even after adjusting for confounding factors (odds ratio, 2.7 [95% CI, 1.0-7.5]; P = .04), was observed. No differences were observed in other medical conditions between the 2 groups. Pneumocystis jirovecii colonization is frequent in preterm births and could be a risk factor to develop respiratory distress syndrome among preterm infants.

  3. Simultaneous EEG and diffuse optical imaging of seizure-related hemodynamic activity in the newborn infant brain

    NASA Astrophysics Data System (ADS)

    Hebden, Jeremy C.; Cooper, Robert J.; Gibson, Adam; Everdell, Nick; Austin, Topun

    2012-06-01

    An optical imaging system has been developed which uses measurements of diffusely reflected near-infrared light to produce maps of changes in blood flow and oxygenation occurring within the cerebral cortex. Optical sources and detectors are coupled to the head via an array of optical fibers, on a probe held in contact with the scalp, and data is collected at a rate of 10 Hz. A clinical electroencephalography (EEG) system has been integrated with the optical system to enable simultaneous observation of electrical and hemodynamic activity in the cortex of neurologically compromised newborn infants diagnosed with seizures. Studies have made a potentially critically important discovery of previously unknown transient hemodynamic events in infants treated with anticonvulsant medication. We observed repeated episodes of small increases in cortical oxyhemoglobin concentration followed by a profound decrease in 3 of 4 infants studied, each with cerebral injury who presented with neonatal seizures. This was not accompanied by clinical or EEG seizure activity and was not present in nineteen matched controls. The underlying cause of these changes is currently unknown. We tentatively suggest that our results may be associated with a phenomenon known as cortical spreading depolarization, not previously observed in the infant brain.

  4. Noninvasive monitoring of gas in the lungs and intestines of newborn infants using diode lasers: feasibility study

    NASA Astrophysics Data System (ADS)

    Lundin, Patrik; Svanberg, Emilie Krite; Cocola, Lorenzo; Xu, Märta Lewander; Somesfalean, Gabriel; Andersson-Engels, Stefan; Jahr, John; Fellman, Vineta; Svanberg, Katarina; Svanberg, Sune

    2013-12-01

    Preterm newborn infants have a high morbidity rate. The most frequently affected organs where free gas is involved are the lungs and intestines. In respiratory distress syndrome, both hyperexpanded and atelectatic (collapsed) areas occur, and in necrotizing enterocolitis, intramural gas may appear in the intestine. Today, these conditions are diagnosed with x-ray radiography. A bed-side, rapid, nonintrusive, and gas-specific technique for in vivo gas sensing would improve diagnosis. We report the use of noninvasive laser spectroscopy, for the first time, to assess gas content in the lungs and intestines of three full-term infants. Water vapor and oxygen were studied with two low-power diode lasers, illuminating the skin and detecting light a few centimeters away. Water vapor was easily detected in the intestines and was also observed in the lungs. The relatively thick chest walls of the infants prevented detection of the weaker oxygen signal in this study. However, results from a previous phantom study, together with scaling of the results presented here to the typical chest-wall thickness of preterm infants, suggest that oxygen also should be detectable in their lungs.

  5. A Sensory Basis for the Lateral Difference in the Newborn Infant's Response to Somesthetic Stimulation

    ERIC Educational Resources Information Center

    Hammer, Madeline; Turkewitz, Gerald

    1974-01-01

    Cardiac response to stimulation of the left and right perioral region in infants was examined. Cardiac acceleration and ipsilateral head turning occurred more reliably to stimulation of the infant's right side than to stimulation of the left side. Results reflect a difference in sensitivity at the infant's two sides. (SDH)

  6. Tc-99m-labeled red blood cells for the measurement of red cell mass in newborn infants: concise communication

    SciTech Connect

    Linderkamp, O.; Betke, K.; Fendel, H.; Klemm, J.; Lorenzen, K.; Riegel, K.P.

    1980-07-01

    In vitro and in vivo investigations were performed to examine the binding of Tc-99m to neonatal red blood cells (RBC). Labeling efficiency was about 90%, and unbound Tc-99m less than 3% after one washing, in premature and full-term newborns and in children. Thus presence of high percentages of fetal hemoglobin (Hb F) did not influence the labeling of RBCs with Tc-99m. RBCs of 11 newborns were hemolysed and the distribution of Tc-99m on RBC components was analyzed. Although Hb F percentage averaged (60.0 +- 8.10)% (s.d.), only (11.9 +- 3.7)% of Tc-99m was bound by Hb F, whereas (45.0 +- 6.1)% was associated with Hb A. RBC membranes bound (13.7 +- 4.3)% and (29.3 +- 4.0)% were found unbound in hemolysates. These results indicate that Tc-99m preferentially binds to beta chains. In vivo equilibration of Tc-99m RBCs and of albumin labeled with Evans blue was investigated in five newborn infants. Tc-99m RBCs were stable in each case during the first hour after injection. Elution of Tc-99m from RBCs was (3.4 +- 1.5)% per h. Body-to-venous hematocrit ratio averaged 0.86 +- 0.03.

  7. Bacterial Colonization and Antibiotic Resistance in a Prospective Cohort of Newborn Infants During the First Year of Life

    PubMed Central

    Stange, Kurt C.; Jacobs, Michael R.; Weiss, Judith K.; Bajaksouzian, Saralee; Bonomo, Robert A.

    2016-01-01

    Background. Infants are virtually sterile at birth and frequently use antibiotics; our objective was to (1) characterize the longitudinal colonization with bacterial pathogens and associated antibiotic resistance in a cohort of community-dwelling infants in Northeast Ohio and (2) describe longitudinal concurrent antibiotic and daycare exposures. Methods. For 35 newborns, nasopharyngeal swabs were cultured for Streptococcus pneumoniae, anterior nasal for Staphylococcus aureus, and perirectal for extended-spectrum beta-lactamase (ESBL)-producing Gram-negative enteric bacteria, at 3-month intervals for 12 months. Infant and household antibiotics and daycare exposure were assessed longitudinally. Results. Thirteen infants received perinatal or nursery antibiotics. By 3 months, at least 22 were colonized with Gram-negative bacteria; 2 with S pneumoniae (type 19A, resistant; 15C, susceptible), 5 with methicillin-susceptible S aureus. By 12 months, at least 22 of 35 infants received antibiotics, 20 had household members with antibiotics, and 12 attended daycare; 7 more had household members with daycare exposure. The ESBL-producing organisms were not identified. At least 10 infants were colonized at some time with an antibiotic-resistant organism, 3 more with pathogens displaying intermediate resistance. Pathogen colonization and resistance were intermittent and inconsistent. Conclusions. In a community-based cohort followed from birth, early antibiotic and daycare exposures are common, especially considering perinatal maternal exposures. Colonization patterns of Gram-negative bacteria, S pneumoniae, S aureus, and resistant pneumococci are strikingly dynamic. Further research can identify key areas for potential interventions to maximize clinical antibiotic outcomes while minimizing future resistance. PMID:27957505

  8. B-type natriuretic peptide in the recognition of critical congenital heart disease in the newborn infant.

    PubMed

    Das, Srikant; Chanani, Nikhil K; Deshpande, Shriprasad; Maher, Kevin O

    2012-08-01

    Infants with congenital heart disease having obstruction to the left ventricular outflow and ductal-dependent systemic circulation can present critically ill with shock. Prompt disease recognition and initiation of prostaglandins are necessary to prevent excess morbidity and mortality. We assessed a large cohort of newborn infants with ductal-dependent systemic circulation to determine if B-type natriuretic peptide (BNP) is consistently elevated at presentation, potentially aiding in diagnosis and treatment. The clinical records of infants with left-sided obstructive lesions admitted from January 2005 to June 2009 were reviewed. Infants were divided into 2 groups: group 1 was diagnosed with cardiogenic/circulatory shock at presentation, and group 2 consisted of infants with ductal-dependent systemic circulation without evidence of shock. B-type natriuretic peptide levels and other variables between the groups were compared. All patients with critical congenital heart disease presenting with shock had elevated BNP levels, ranging from 553 to greater than 5000 pg/mL. Infants in group 1 (shock, n = 36) had significantly higher median BNP levels of 4100 pg/mL at presentation compared with group 2 patients (no shock, n = 86), who had a median BNP of 656 pg/mL (range, 30-3930 pg/mL; P < 0.001). Every 100 U of increase in BNP at presentation increased the likelihood of shock (odds ratio, 100; P < 0.001). B-type natriuretic peptide is markedly elevated in neonates presenting in shock secondary to left-sided obstructive heart disease and is an important diagnostic tool to aid in the rapid identification and treatment of these patients.

  9. The effect of newborn vitamin A supplementation on infant immune functions: trial design, interventions, and baseline data.

    PubMed

    Ahmad, Shaikh Meshbahuddin; Raqib, Rubhana; Qadri, Firdausi; Stephensen, Charles B

    2014-11-01

    In recent years, neonatal vitamin A supplementation is considered as an essential infant-survival intervention but the evidence is not conclusive. This randomized controlled clinical trial was conducted to evaluate the effect of vitamin A on immune competence in early infancy. Results would provide a mechanistic basis for understanding the effect of this intervention on infant survival. Within 2 days of birth, infants born at one maternity clinic located in a poor slum area of Dhaka city were supplemented with either 50,000 IU vitamin A or placebo. Live attenuated oral polio vaccine (OPV) and BCG vaccine were provided after supplementation. Infants also receive diphtheria, pertussis, tetanus (TT), hepatitis B (HBV) and Haemophilus influenzae B vaccines (pentavalent combination) along with OPV at 6, 10 and 14 weeks of age. Infant thymus size, anthropometry, feeding practice and morbidity data were collected at regular interval. Infant blood samples were collected to determine T-cell-receptor excision circle (TREC), total, naïve and memory T cells and mucosal targeting lymphocytes including Treg cells. TT-, HBV-, BCG- and OPV-specific T cell blastogenic, cytokine and plasma cell antibody responses were also measured. In 16 mo enrollment period, 306 newborns, equal number of boys and girls, were enrolled. ~95% completed the 4-month follow-up period. Baseline characteristics are presented here. Anthropometry and immune assays with fresh blood samples were completed immediately while stored samples were analyzed in single batches at the end of the trial. Connecting different aspects of immunological data in early infancy will help elucidate immune competence for protecting infection. Trial registration ClinicalTrials.gov: NCT01583972.

  10. A proposed new international convention supporting the rights of pregnant women and girls and their newborn infants.

    PubMed

    Winrow, Benjamin; Bile, Khalif; Hafeez, Assad; Davies, Hugh; Brown, Nick; Zafar, Shamsa; Cham, Mamady; Phillips, Barbara; MacDonald, Rhona; Southall, David P

    2012-05-01

    For a multitude of eminently modifiable reasons, death rates for pregnant women and girls and their newborn infants in poorly resourced countries remain unacceptably high. The concomitant high morbidity rates compound the situation. The rights of these vulnerable individuals are incompletely protected by existing United Nations human rights conventions, which many countries have failed to implement. The authors propose a novel approach grounded on both human rights and robust evidence-based clinical guidelines to create a 'human rights convention specifically for pregnant women and girls and their newborn infants'. The approach targets the 'right to health' of these large, vulnerable and neglected populations. The proposed convention is designed so that it can be monitored, audited and evaluated objectively. It should also foster a sense of national ownership and accountability as it is designed to be relevant to local situations and to be incorporated into local clinical governance systems. It may be of particular value to those countries that are not yet on target to meet the Millennium Development Goals (MDGs), especially MDGs 4 and 5, which target child and maternal mortality, respectively. To foster a sense of international responsibility, two additional initiatives are integral to its philosophy: the promotion of twinning between well and poorly resourced regions and a raising of awareness of how some well-resourced countries can damage the health of mothers and babies, for example, through the recruitment of health workers trained by national governments and taken from the public health system.

  11. A synopsis of 2007 ACCM clinical practice parameters for hemodynamic support of term newborn and infant septic shock.

    PubMed

    Carcillo, Joseph A

    2014-03-01

    This is a synopsis of the term newborn and infant portion of the 2007 document (Brierley et al., Crit Care Med 2009;37(2):666-88) which examined and graded new studies performed to test the utility and efficacy of the 2002 recommendations. This 2007 document examined and graded relevant new treatment and outcome studies to determine to what degree, if any, the 2002 guidelines should be modified. More than 30 clinical investigators and clinicians affiliated with the Society of Critical Care Medicine who had special interest in hemodynamic support of pediatric patients with sepsis volunteered to be members of the "update" task force. Subcommittees were formed to review and grade the literature using the evidence-based scoring system of the American College of Critical Care Medicine. The literature was accrued in part by searching PUBMED/MEDLINE using the following keywords: sepsis, septicemia, septic shock, endotoxemia, persistent pulmonary hypertension, nitric oxide, and ECMO. The search was narrowed to identify studies specifically relevant to term newborns, infants, and children. "Best Practice Outcomes" were identified and described clinical practice in these centers was used as a model. The new taskforce is presently working on updating new guidelines evaluating the literature of the past 6 years. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Frequency of high-quality communication behaviors used by primary care providers of heterozygous infants after newborn screening.

    PubMed

    Farrell, Michael H; Christopher, Stephanie A

    2013-02-01

    To examine the quality of communication likely to be experienced by parents when being first informed about how newborn screening identified heterozygous "carrier" status for cystic fibrosis or sickle cell disease. Primary care providers (PCPs) of infants found to have carrier status were telephoned over a 48-month period, and asked to rehearse with a standardized patient how they would inform the infants' parent(s). 214 rehearsal transcripts were abstracted using explicit criteria methods to measure the frequency of five categories of high-quality communication behaviors. Overall, PCPs used large amounts of jargon and failed to use high quality communication behaviors. On average, PCPs used 18.6 total jargon words (8.7 unique words), but explained 2.4 jargon words. The most frequent assessment of understanding was the close-ended version, although it was only seen in 129 of 214 transcripts. The most common organizing behavior was importance emphasis (121/214). Precautionary empathy was rare; the most frequent behavior was "instruction about emotion" (33/214). The limited use of high-quality communication behaviors in rehearsals raises concern about parental understanding, decision-making, and psychosocial outcomes after newborn screening. Measurement of specific behaviors may help PCPs to improve communication, and thereby improve the patient experience. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. The effect of improved compliance with hygiene guidelines on transmission of Staphylococcus aureus to newborn infants: the Swedish Hygiene Intervention and Transmission of S aureus study.

    PubMed

    Mernelius, Sara; Löfgren, Sture; Lindgren, Per-Eric; Blomberg, Marie; Olhager, Elisabeth; Gunnervik, Christina; Lenrick, Raymond; Thrane, Malena Tiefenthal; Isaksson, Barbro; Matussek, Andreas

    2013-07-01

    Newborn infants are often colonized with Staphylococcus aureus originating from health care workers (HCWs). We therefore use colonization with S aureus of newborn infants to determine the effect of an improved compliance with hygiene guidelines on bacterial transmission. Compliance with hygiene guidelines was monitored prior to (baseline) and after (follow-up) a multimodal hygiene intervention in 4 departments of obstetrics and gynecology. spa typing was used to elucidate transmission routes of S aureus collected from newborn infants, mothers, fathers, staff members, and environment. The compliance with hygiene guidelines increased significantly from baseline to follow-up. The transmission of S aureus from HCWs to infants was however not affected. Fathers had the highest colonization rates. Persistent carriage was indicated in 18% of the HCWs. The most commonly isolated spa type was t084, which was not detected in a previous study from the same geographic area. It is possible to substantially improve the compliance with hygiene guidelines, by using multimodal hygiene intervention. The improved compliance did not decrease the transmission of S aureus from sources outside the own family to newborn infants. Furthermore, we show the establishment of a new spa type (t084), which now is very common in our region. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  14. Age-Related 1H NMR Characterization of Cerebrospinal Fluid in Newborn and Young Healthy Piglets

    PubMed Central

    Barone, Francesca; Elmi, Alberto; Romagnoli, Noemi; Bacci, Maria Laura

    2016-01-01

    When it comes to neuroscience, pigs represent an important animal model due to their resemblance with humans’ brains for several patterns including anatomy and developmental stages. Cerebrospinal fluid (CSF) is a relatively easy-to-collect specimen that can provide important information about neurological health and function, proving its importance as both a diagnostic and biomedical monitoring tool. Consequently, it would be of high scientific interest and value to obtain more standard physiological information regarding its composition and dynamics for both swine pathology and the refinement of experimental protocols. Recently, proton nuclear magnetic resonance (1H NMR) spectroscopy has been applied in order to analyze the metabolomic profile of this biological fluid, and results showed the technique to be highly reproducible and reliable. The aim of the present study was to investigate in both qualitative and quantitative manner the composition of Cerebrospinal Fluid harvested form healthy newborn (5 days old-P5) and young (30-P30 and 50-P50 days old) piglets using 1H NMR Spectroscopy, and to analyze any possible difference in metabolites concentration between age groups, related to age and Blood-Brain-Barrier maturation. On each of the analyzed samples, 30 molecules could be observed above their limit of quantification, accounting for 95–98% of the total area of the spectra. The concentrations of adenine, tyrosine, leucine, valine, 3-hydroxyvalerate, 3-methyl-2-oxovalerate were found to decrease between P05 and P50, while the concentrations of glutamine, creatinine, methanol, trimethylamine and myo-inositol were found to increase. The P05-P30 comparison was also significant for glutamine, creatinine, adenine, tyrosine, leucine, valine, 3-hydroxyisovalerate, 3-methyl-2-oxovalerate, while for the P30-P50 comparison we found significant differences for glutamine, myo-inositol, leucine and trimethylamine. None of these molecules showed at P30 concentrations

  15. [Parasitic and viral marker detection in pregnant adolescents and their newborn infants at risk].

    PubMed

    Contreras, M C; Escaff, V; Salinas, P; Saavedra, T; Suárez, M

    1995-01-01

    We have investigated the prevalence of antibodies against Toxoplasma gondii, Trypanosoma cruzzi, Hepatitis B virus, cytomegalovirus, rubella virus, and human immunodeficiency virus in 139 adolescent pregnant women and in their high risk newborn children. The methods employed were the Sabin and Feldman reaction, complement fixation reaction, ELISA, and xenodiagnostic 30.9% of the pregnant group were seropositive for T. gondii, both mothers and newborns were IgM-negative. Two mothers (1.4%) presented anti T. cruzii antibodies, and one newborn child had circulating parasites. Related to the virological studies, 93.5% of the population were anti CMV antibodies positive and all their newborns were IgM (-) 90.6% of the adolescents were rubella positive and one was seropositive to VIH. We conclude that the prevalence found in this group of adolescent pregnant women are not significantly different to the one reported for the general pregnant women population.

  16. [Hopeless and unbearable suffering and deliberate ending of life of newborn infants].

    PubMed

    Verhagen, A A E; van der Hoeven, M A H B M; van Goudoever, J B; de Vries, M C; Schoutenvan-van Meeteren, A Y N; Albers, M J I J

    2007-06-30

    Deliberate ending of life of newborns is an extreme measure that is usually based on hopeless and existing unbearable suffering. There are currently developments that may lead to clarification and refinement of the standards and rules surrounding deliberate ending of life of newborns. This pertains to the phase immediately following the decision to refrain from curative treatment. An important aspect here is that parents and doctors will have to reach agreement on the extent to which the suffering of the newborn can be classified as unbearable. Furthermore, in the case of deliberate ending of life of newborns, consideration must be given not only to current suffering but also the severe suffering that will develop in the near future. The points ofspecial importance that the medical profession had developed in relation to the assessment of future unbearable suffering may provide assistance here and should be implemented.

  17. [Anthropometric data on newborn infants: comparative study of two ethnic groups].

    PubMed

    Martínez Cortés, F; Martínez Guerrero, M V; Valdivielso Felices, P; Legros Carrenard, J R; Martín Sánchez, J

    1992-11-01

    We have studied the birth weights, obstetrics data and anthropometrical data from 1.157 full-term newborns who were delivered in the Hospital del Insalud-Cruz Roja in Ceuta (Spain). Of these newborns, 489 were of arabic origin and 668 of hispanic origin. Arabic newborns were heavier (3.248 +/- 473 g versus 3.280 +/- 431 g, p < 0.001) and longer (50.2 +/- 1.8 cm versus 49.6 +/- 1.8 cm, p < 0.001) than their hispanic counterparts. These differences were not due to a disproportion in sex or gestational age between the groups. Furthermore, the differences were still present after adjustments were made for maternal age, parity and the mother's smoking habit. Thus, this difference in size at birth between arabic and hispanic newborns could be, at least in part, ethnically related.

  18. 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.

  19. The drug epidemic: effects on newborn infants and health resource consumption at a tertiary perinatal centre.

    PubMed

    Kelly, J J; Davis, P G; Henschke, P N

    2000-06-01

    Illicit drug taking in Australia, with its attendant social and medical consequences, is increasing and the effects extend to maternity hospitals where infants born to addicted mothers have more health problems in the neonatal period. The aims of this study were to evaluate (1) the patterns of illness of such infants and (2) the burden imposed on the neonatal department of a large tertiary maternity centre. An audit was conducted of all Chemical Dependency Unit (CDU) mothers and babies delivered at the Royal Women's Hospital, Melbourne, Australia during 1997. Data were compared with those from a concurrent control group of mothers and babies randomly generated from the hospital's obstetric database. Ninety-six infants born to CDU mothers were compared with a control group of 200 infant/mother pairs. The majority of women in the CDU clinic were treated for narcotic addiction with methadone (90%) but most continued to use heroin during pregnancy (68%). Infants born to CDU mothers were significantly less mature and lighter than control infants. Fifty-three (55%) CDU infants required admission to the Special Care Nursery either because of neonatal abstinence syndrome (n = 29) or other medical reasons (n = 24). The median length of hospital stay was significantly longer in CDU compared with control infants (8 vs 3 days, P < 0.01). Infants born to drug dependent mothers have more neonatal problems requiring specialized medical and nursing expertise, compared with control infants. These infants are large consumers of scarce health resources.

  20. Peripartum maternal transmission of extended-spectrum β-lactamase organism to newborn infants.

    PubMed

    Peretz, Avi; Skuratovsky, Alina; Khabra, Efrat; Adler, Amos; Pastukh, Nina; Barak, Shay; Perlitz, Yuri; Ben-Ami, Moshe; Kushnir, Amir

    2017-02-01

    The aim of this study was to determine whether the route of extended-spectrum β-lactamase (ESBL) transmission to hospitalized newborns was from their mothers during delivery. Neonatal intensive care unit (NICU) hospitalized newborns were sampled for ESBL presence by stool cultures on the first and fourth days of life. Mothers of ESBL-positive newborns were sampled for possible correlation detection. Bacteria isolates were molecularly identified and susceptibility tests for antibiotic agents were performed. Of the 225 newborns, 14 (6.2%) were ESBL positive, 10 (4.4%) were Escherichia coli positive, and 4 (1.7%) were Klebsiella pneumoniae positive. Among the 14 mothers of positive newborns, 13 (92.8%) were found ESBL positive and one mother of a newborn with E. coli carriage was found ESBL negative. Genes encoding for ESBL resistance were identified. Antibiotic sensitivity and resistance were tested. This study demonstrated that ESBL bacteria carrier neonates hospitalized in NICU may be a result of transmission from mother to baby during delivery.

  1. In utero exposure to dioxins and dioxin-like compounds and anogenital distance in newborns and infants.

    PubMed

    Vafeiadi, Marina; Agramunt, Silvia; Papadopoulou, Eleni; Besselink, Harrie; Mathianaki, Kleopatra; Karakosta, Polyxeni; Spanaki, Ariana; Koutis, Antonis; Chatzi, Leda; Vrijheid, Martine; Kogevinas, Manolis

    2013-01-01

    Anogenital distance in animals is used as a measure of fetal androgen action. Prenatal exposure to dioxins and dioxin-like compounds in rodents causes reproductive changes in male offspring and decreases anogenital distance. We assessed whether in utero exposure to dioxins and dioxin-like compounds adversely influences anogenital distance in newborns and young children (median age, 16 months; range, 1-31 months). We measured anogenital distance among participants of the "Rhea" mother-child cohort study in Crete and the Hospital del Mar (HMAR) cohort in Barcelona. Anogenital distance (AGD; anus to upper penis), anoscrotal distance (ASD; anus to scrotum), and penis width (PW) were measured in 119 newborn and 239 young boys; anoclitoral (ACD; anus to clitoris) and anofourchetal distance (AFD; anus to fourchette) were measured in 118 newborn and 223 young girls. We estimated plasma dioxin-like activity in maternal blood samples collected at delivery with the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR CALUX®) bioassay. Anogenital distances were sexually dimorphic, being longer in males than females. Plasma dioxin-like activity was negatively associated with AGD in male newborns. The estimated change in AGD per 10 pg CALUX®-toxic equivalent/g lipid increase was -0.44 mm (95% CI: -0.80, -0.08) after adjusting for confounders. Negative but smaller and nonsignificant associations were observed for AGD in young boys. No associations were found in girls. Male infants may be susceptible to endocrine-disrupting effects of dioxins. Our findings are consistent with the experimental animal evidence used by the Food and Agriculture Organization/World Health Organization to set recommendations for human dioxin intake.

  2. In Utero Exposure to Dioxins and Dioxin-like Compounds and Anogenital Distance in Newborns and Infants

    PubMed Central

    Vafeiadi, Marina; Agramunt, Silvia; Papadopoulou, Eleni; Besselink, Harrie; Mathianaki, Kleopatra; Karakosta, Polyxeni; Spanaki, Ariana; Koutis, Antonis; Chatzi, Leda; Vrijheid, Martine

    2012-01-01

    Background: Anogenital distance in animals is used as a measure of fetal androgen action. Prenatal exposure to dioxins and dioxin-like compounds in rodents causes reproductive changes in male offspring and decreases anogenital distance. Objective: We assessed whether in utero exposure to dioxins and dioxin-like compounds adversely influences anogenital distance in newborns and young children (median age, 16 months; range, 1–31 months). Methods: We measured anogenital distance among participants of the “Rhea” mother–child cohort study in Crete and the Hospital del Mar (HMAR) cohort in Barcelona. Anogenital distance (AGD; anus to upper penis), anoscrotal distance (ASD; anus to scrotum), and penis width (PW) were measured in 119 newborn and 239 young boys; anoclitoral (ACD; anus to clitoris) and anofourchetal distance (AFD; anus to fourchette) were measured in 118 newborn and 223 young girls. We estimated plasma dioxin-like activity in maternal blood samples collected at delivery with the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR CALUX®) bioassay. Results: Anogenital distances were sexually dimorphic, being longer in males than females. Plasma dioxin-like activity was negatively associated with AGD in male newborns. The estimated change in AGD per 10 pg CALUX®–toxic equivalent/g lipid increase was –0.44 mm (95% CI: –0.80, –0.08) after adjusting for confounders. Negative but smaller and nonsignificant associations were observed for AGD in young boys. No associations were found in girls. Conclusions: Male infants may be susceptible to endocrine-disrupting effects of dioxins. Our findings are consistent with the experimental animal evidence used by the Food and Agriculture Organization/World Health Organization to set recommendations for human dioxin intake. PMID:23171674

  3. Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss.

    PubMed

    Ross, Shannon A; Ahmed, Amina; Palmer, April L; Michaels, Marian G; Sánchez, Pablo J; Stewart, Audra; Bernstein, David I; Feja, Kristina; Fowler, Karen B; Boppana, Suresh B

    2017-05-01

    To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. [Implications of nicotine detected in autopsy cases of newborn babies and infants from the perspective of social medicine].

    PubMed

    Nishimura, Hiroyuki; Furumiya, Junichi; Nakanishi, Akinori; Hashimoto, Yoshiaki

    2011-10-01

    Smoking by pregnant and parturient women is generally suspected to increase nicotine levels in fetal and infant blood. Supportive data of nicotine levels in infants is, however, inadequate. We investigated blood and muscle nicotine and cotinine levels in 14 autopsy cases of newborn babies and infants using gas chromatography. Among the 14 cases investigated, nicotine or cotinine was detected in six cases (42.9%). In each of these six cases, the mother was a smoker. Route of exposure to nicotine originating from smoking was transplacental in three cases, via breast milk in one case and secondhand smoke in two cases. Nicotine and cotinine levels in blood from the two cases with placental exposure were 10.6-84.4 ng/ml and 20.3-183 ng/ml, and levels in muscle from one case were 43.9 ng/g and 308 ng/g, respectively. Nicotine and cotinine levels in blood from exposure via breast milk were 19.1 ng/ml and 87.1 ng/ml, and from secondhand smoke were 0 ng/ml and 14.6-20.1 ng/ml. Mean concentrations of blood nicotine and cotinine in 68 autopsy cases of adult habitual smokers were 30.0 ng/ml and 247 ng/ml. Our data for nicotine and cotinine levels in infant blood seem to indicate that some infants who are born and develop under exposure to smoking by family members, particularly the mother, may show high nicotine levels in blood and experience possible health risks.

  5. Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System.

    PubMed

    Daniali, Lily N; Rezzadeh, Kameron; Shell, Cheryl; Trovato, Matthew; Ha, Richard; Byrd, H Steve

    2017-03-01

    A single practice's treatment protocol and outcomes following molding therapy on newborn ear deformations and malformations with the EarWell Infant Ear Correction System were reviewed. A classification system for grading the severity of constricted ear malformations was created on the basis of anatomical findings. A retrospective chart/photograph review of a consecutive series of infants treated with the EarWell System from 2011 to 2014 was undertaken. The infants were placed in either deformation or malformation groups. Three classes of malformation were identified. Data regarding treatment induction, duration of treatment, and quality of outcome were collected for all study patients. One hundred seventy-five infant ear malformations and 303 infant ear deformities were treated with the EarWell System. The average age at initiation of treatment was 12 days; the mean duration of treatment was 37 days. An average of six office visits was required. Treated malformations included constricted ears [172 ears (98 percent)] and cryptotia [three ears (2 percent)]. Cup ear (34 ears) was considered a constricted malformation, in contrast to the prominent ear deformity. Constricted ears were assigned to one of three classes, with each subsequent class indicating increasing severity: class I, 77 ears (45 percent); class II, 81 ears (47 percent); and class III, 14 ears (8 percent). Molding therapy with the EarWell System reduced the severity by an average of 1.2 points (p < 0.01). Complications included minor superficial excoriations and abrasions. The EarWell System was shown to be effective in eliminating or reducing the need for surgery in all but the most severe malformations. Therapeutic, IV.

  6. Use of 2% 2-phenoxyethanol and 0.1% octenidine as antiseptic in premature newborn infants of 23-26 weeks gestation.

    PubMed

    Bührer, C; Bahr, S; Siebert, J; Wettstein, R; Geffers, C; Obladen, M

    2002-08-01

    In preterm newborn infants, topical iodine-containing antiseptics disturb thyroid hormone regulation while alcohol-based disinfectants may cause local burns. We therefore investigated the use of an aqueous solution containing 0.1% octenidine and 2% 2-phenoxyethanol for skin disinfection during the first seven days of life in premature newborns with a gestational age <27 weeks who were consecutively admitted to our level III neonatal intensive care unit between November 1, 2000 and December 31, 2001 (N=24). In boys. (N=13) the renal excretion of absorbed 2-phenoxyethanol and its metabolite 2-phenoxyacetic acid was quantitated by high-pressure liquid chromatography. In the most immature newborn (gestational age 23 6/7 weeks), a transient erythematous reaction was observed following application of the octenidine/phenoxyethanol solution prior to umbilical vessel catheterization. No other local reactions were observed. The urinary concentration of 2-phenoxyethanol was <2 ppm in all samples, while urinary 2-phenoxyacetic acid concentrations reached 5-95 ppm (median 24 ppm). One infant had a culture-proven septicaemia (Bacillus species) during the first seven days of life. We conclude that, in contrast to alcohol-based antiseptics, an aqueous solution of 0.1% octenidine and 2-phenoxyethanol does not cause major skin damage in premature newborn infants <27 weeks' gestation. 2-Phenoxyethanol is readily absorbed by the newborn's skin but apparently undergoes extensive oxidative metabolization to 2-phenoxyacetic acid.

  7. Influence of maternal pregravid weight, height and body mass index on birth weight of male and female newborns.

    PubMed

    Miletić, Tomislav; Stoini, Eugenio

    2005-06-01

    The study included 2300 healthy couples and their healthy newborns delivered vaginally from singleton, normal term (37-42 weeks) pregnancies in Sibenik, Zadar and Split (Croatia). Both fathers and mothers of male newborns were older and had a higher weight than those of female newborns (p < 0.05). Gestational age and birth weight were higher in male than female newborns (p < 0.001). Increasing maternal pregravid weight led to increasing birth weight of both male and female newborns (p < 0.001). Furthermore, increasing maternal height and body mass index resulted in increasing birth weight of male and female newborns (p < 0.001). Thus, the fathers and mothers of male infants were older than those of female infants (p < 0.05), and increasing pre-gravid body weight, body height and body mass index were associated with a higher birth weight in both male and female newborns.

  8. Association between Several Persistent Organic Pollutants and Thyroid Hormone Levels in Cord Blood Serum and Bloodspot of the Newborn Infants of Korea.

    PubMed

    Kim, Sunmi; Park, Jeongim; Kim, Hai-Joong; Lee, Jeong Jae; Choi, Gyuyeon; Choi, Sooran; Kim, Sungjoo; Kim, Su Young; Moon, Hyo-Bang; Kim, Sungkyoon; Choi, Kyungho

    2015-01-01

    Current knowledge on adverse endocrine disruption effects of persistent organic pollutants (POPs) among newborn infants is limited and often controversial. To investigate the associations between prenatal exposure to major POPs and thyroid hormone levels among newborn infants, both cord serum or maternal serum concentrations of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and organochlorine pesticides (OCPs) were compared with five thyroid hormones in cord serum of newborn infants as well as TSH in bloodspot collected at 2 day after birth (n=104). Since cord serum thyroid hormones could be affected by those of mothers, thyroid hormone concentrations of the matching mothers at delivery were adjusted. In cord serum, BDE-47, -99, and Σchlordane (CHD) showed significant positive associations with cord or bloodspot TSH. At the same time, p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and hexachlorbenzene (HCB) showed negative associations with total T3 and total T4 in cord serum, respectively. Maternal exposure to β-hexachlorhexane (β-HCH), ΣCHD, ΣDDT, or p,p'-DDE were also associated with neonatal thyroid hormones. Although the sample size is small and the thyroid hormone levels of the subjects were within the reference range, our observation supports thyroid disrupting potential of several POPs among newborn infants, at the levels occurring in the general population. Considering the importance of thyroid hormones during gestation and early life stages, health implication of thyroid hormone effects by low level POPs exposure deserves further follow up investigations.

  9. Association between Several Persistent Organic Pollutants and Thyroid Hormone Levels in Cord Blood Serum and Bloodspot of the Newborn Infants of Korea

    PubMed Central

    Kim, Sunmi; Park, Jeongim; Kim, Hai-Joong; Lee, Jeong Jae; Choi, Gyuyeon; Choi, Sooran; Kim, Sungjoo; Kim, Su Young; Moon, Hyo-Bang; Kim, Sungkyoon; Choi, Kyungho

    2015-01-01

    Current knowledge on adverse endocrine disruption effects of persistent organic pollutants (POPs) among newborn infants is limited and often controversial. To investigate the associations between prenatal exposure to major POPs and thyroid hormone levels among newborn infants, both cord serum or maternal serum concentrations of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and organochlorine pesticides (OCPs) were compared with five thyroid hormones in cord serum of newborn infants as well as TSH in bloodspot collected at 2 day after birth (n=104). Since cord serum thyroid hormones could be affected by those of mothers, thyroid hormone concentrations of the matching mothers at delivery were adjusted. In cord serum, BDE-47, -99, and Σchlordane (CHD) showed significant positive associations with cord or bloodspot TSH. At the same time, p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and hexachlorbenzene (HCB) showed negative associations with total T3 and total T4 in cord serum, respectively. Maternal exposure to β-hexachlorhexane (β-HCH), ΣCHD, ΣDDT, or p,p'-DDE were also associated with neonatal thyroid hormones. Although the sample size is small and the thyroid hormone levels of the subjects were within the reference range, our observation supports thyroid disrupting potential of several POPs among newborn infants, at the levels occurring in the general population. Considering the importance of thyroid hormones during gestation and early life stages, health implication of thyroid hormone effects by low level POPs exposure deserves further follow up investigations. PMID:25965908

  10. Is the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) effective for preterm infants with intrauterine growth restriction?

    PubMed Central

    Als, H; Duffy, FH; McAnulty, GB; Fischer, CB; Kosta, S; Butler, SC; Parad, RB; Blickman, JG; Zurakowski, D; Ringer, SA

    2014-01-01

    Objective This study investigates the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on neurobehavioral and electrophysiological functioning of preterm infants with severe intrauterine growth restriction (IUGR). Study Design Thirty IUGR infants, 28 to 33 weeks gestational age, randomized to standard care (control/C = 18), or NIDCAP (experimental/E = 12), were assessed at 2 weeks corrected age (2wCA) and 9 months corrected age (9mCA) in regard to health, anthropometrics, and neurobehavior, and additionally at 2wCA in regard to electrophysiology (EEG). Result The two groups were comparable in health and anthropometrics at 2wCA and 9mCA. The E-group at 2wCA showed significantly better autonomic, motor, and self-regulation functioning, improved motility, intensity and response thresholds, and reduced EEG connectivity among several adjacent brain regions. At 9mCA, the E-group showed significantly better mental performance. Conclusion This is the first study to show NIDCAP effectiveness for IUGR preterm infants. PMID:20651694

  11. Effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants

    SciTech Connect

    Younkin, D.P.; Reivich, M.; Jaggi, J.L.; Obrist, W.D.; Delivoria-Papadopoulos, M.

    1987-06-01

    The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 (/sup 133/Xe) clearance technique, which uses an intravenous bolus of /sup 133/Xe, an external chest detector to estimate arterial /sup 133/Xe concentration, eight external cranial detectors to measure cephalic /sup 133/Xe clearance curves, and a two-compartmental analysis of the cephalic /sup 133/Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBF varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications.

  12. A Followup of Twenty Three Infants with Diarrhoea in the Newborn Period.

    ERIC Educational Resources Information Center

    MacArthur, Barton; Farmer, Keitha

    1979-01-01

    Factors such as gestational age and birthweight were compared in a follow-up study of 66 neonates with diarrhea and two groups of infants--one with low birthweight, one with optimal birthweight. Among findings was that low birthweight was found to correlate with low test scores on visual perception regardless of whether the infants had had…

  13. 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.

  14. Dopamine D2 receptor gene polymorphisms in newborn infants of drug-using women.

    PubMed

    Oei, Ju Lee; Xu, Hong Xiu; Abdel-Latif, Mohamed E; Vunnam, Krishna; Al-Amry, Adil; Clews, Sara; Falconer, Janet; Feller, John M; Lui, Kei

    2012-05-01

    To determine the characteristics of dopamine D2 receptor gene (DRD2) polymorphisms in drug-exposed and unexposed neonates and the relationship to neonatal abstinence syndrome (NAS). Retrospective case-control analysis between drug-exposed and unexposed infants between DRD2 polymorphisms, drug exposure and NAS treatment. Drug-exposed (n=48) and drug-free (n=49) infants born between March 1999 and December 2006. Analysis of DNA for the Taq1A, -141Ins/Del and Ser311Cys DRD2 polymorphisms. Drug exposure was determined by antenatal maternal drug and alcohol history. Frequency measures of DRD2 polymorphisms were compared between drug-exposed infants, treatment NAS medication and with control infants. Tertiary maternity hospital, Sydney, Australia. All infants were born in a good condition (25.7% <37 weeks gestation). Opiates (methadone and heroin) were used by 45 (93.8%) of drug-exposed mothers. The A2A2 allele was more common in drug-exposed infants (37 (77.0%) versus 23 (46.9%), p=0.003) but the A1A2 allele was more common in control infants (23 (46.9%) versus 4 (8.3%), p=0.00002). The-ins allele was more common in control (39 (79.6%) versus 20 (41.7%), p=<0.01) and unmedicated drug-exposed (14/25 (56%) versus 5/23 (21.7%), p=0.02) infants. The majority of infants (41 (83.7%) controls versus 41 (85.4%), p=1.000) expressed the least common, Ser polymorphism. DRD2 polymorphisms are detectable from DNA obtained from stored blood spots. The -ins allele is more common in control and unmedicated drug-exposed infants. Further study is recommended to explore postneonatal outcomes especially in relation to neuropsychiatric behaviours.

  15. 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