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Sample records for premature infants fetus

  1. Osteopenia - premature infants

    MedlinePlus

    Neonatal rickets; Brittle bones - premature infants; Weak bones - premature infants; Osteopenia of prematurity ... of calcium and phosphorus needed to form strong bones. While in the womb, fetal activity increases during ...

  2. Premature infant

    MedlinePlus

    ... the mother, such as diabetes, heart disease, and kidney disease, may contribute to preterm labor. Often, the cause of preterm labor is unknown. 15% of all premature births are multiple pregnancies, such as twins or triplets. Different pregnancy-related ...

  3. Pain assessment in human fetus and infants.

    PubMed

    Bellieni, Carlo Valerio

    2012-09-01

    In humans, painful stimuli can arrive to the brain at 20-22 weeks of gestation. Therefore several researchers have devoted their efforts to study fetal analgesia during prenatal surgery, and during painful procedures in premature babies. Aim of this paper is to gather from scientific literature the available data on the signals that the human fetus and newborns produce, and that can be interpreted as signals of pain. Several signs can be interpreted as signals of pain. We will describe them in the text. In infants, these signs can be combined to create specific and sensible pain assessment tools, called pain scales, used to rate the level of pain.

  4. [Premature rupture of membranes one fetus from a multiple pregnancy].

    PubMed

    Malinowski, Witold

    2011-10-01

    In multiple gestation, premature rupture of fetal membranes (PROM) is an important risk factor for premature delivery and intrauterine infection. The incidence of PROM in twin gestations is threefold of that in singleton pregnancies. The incidence in triplets occurs even more frequently underlining the role of PROM as a leading cause of infant mortality and morbidity. Besides prematurity the complications of PROM include umbilical cord compression due to oligohydramnios, cord prolapse, placental abruption, and chorioamnionitis. Together with PROM, chorioamnionitis is held responsible for significant maternal and neonatal morbidity including endometritis and sepsis in the mother and early-onset sepsis, respiratory distress syndrome, inborn pneumonia, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular white matter injury in the neonate. Furthermore, in twin gestations, PROM remains an independent risk factor for long-term neonatal care. An uncommon situation develops when in multiple gestation PROM affects only one of the fetuses. In such cases, the co-existence in the uterine cavity of the properly developing fetus(es) can be a challenge for the process of medical decision-making. In the present work, limited world literature on the topic was critically reviewed in search of the best possible recommendations for clinical management.

  5. Outcomes for extremely premature infants.

    PubMed

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

    2015-06-01

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

  6. Outcomes for Extremely Premature Infants

    PubMed Central

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

    2015-01-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (< 1000 grams) remain at high risk for death and disability with 30–50% mortality and, in survivors, at least 20–50% risk of morbidity. The introduction of CPAP, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for

  7. Music Therapy with Premature Infants

    ERIC Educational Resources Information Center

    Standley, Jayne

    2003-01-01

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

  8. Human milk for the premature infant.

    PubMed

    Underwood, Mark A

    2013-02-01

    Premature infants are at risk for growth failure, developmental delays, necrotizing enterocolitis, and late-onset sepsis. Human milk from women delivering prematurely has more protein and higher levels of bioactive molecules. Human milk must be fortified for premature infants to achieve adequate growth. Mother's own milk improves growth and neurodevelopment, decreases the risk of necrotizing enterocolitis and late-onset sepsis, and should be the primary enteral diet for premature infants. Donor milk is a resource for premature infants whose mothers are unable to provide an adequate supply of milk. Challenges include the need for pasteurization, nutritional and biochemical deficiencies, and limited supply.

  9. Transitioning premature infants from gavage to breast.

    PubMed

    Nye, Carla

    2008-01-01

    Breast milk provides physiologic and neurodevelopmental protection for premature infants. Most hospitals are breast-milk friendly, but the number of premature infants breastfeeding successfully at discharge is relatively small. There are evidence-based techniques to improve the odds of premature infants breastfeeding at discharge and into the first year of life. Measures that help the infant make the transition to the breast include kangaroo care, nonnutritive sucking, avoidance of bottles, and consistent and supportive staff. A guide to management of the transition process is provided in this article.

  10. Human milk for the premature infant

    PubMed Central

    Underwood, Mark A.

    2012-01-01

    Synopsis Premature infants are a heterogeneous group with widely differing needs for nutrition and immune protection with risk of growth failure, developmental delays, necrotizing enterocolitis, and late-onset sepsis increasing with decreasing gestational age and birth weight. Human milk from women delivering prematurely has more protein and higher levels of many bioactive molecules compared to milk from women delivering at term. Human milk must be fortified for small premature infants to achieve adequate growth. Mother’s own milk improves growth and neurodevelopment and decreases the risk of necrotizing enterocolitis and late-onset sepsis and should therefore be the primary enteral diet of premature infants. Donor milk is a valuable resource for premature infants whose mothers are unable to provide an adequate supply of milk, but presents significant challenges including the need for pasteurization, nutritional and biochemical deficiencies and a limited supply. PMID:23178065

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-02-01

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

  13. Human milk for the premature infant.

    PubMed

    Cunningham, M D; Desai, N S; Charlet, S S

    1979-05-01

    Closer study of premature infants has led to the establishment of human milk as the recommended nutritional standard for them. Infants fed with human milk are found to gain protection against necrotizing enterocolitis, and have fewer upper respiratory tract infections and systemic infections. Antibacterial components of human milk include leukocytes (macrophages, granulocytes, and T and B cell lymphocytes), the B cell secreted immunoglobulins, and complement factors. Lactoperoxidase and lactoferrin in breast milk are particularly active against group B beta hemolytic streptococcus and staphylococcus, respectively. Fresh human milk helps in the colonization of the infant's gut by Lactobacillus bifidus, a bacteria that suppresses other possibly pathogenic organisms. Nutritional values of human milk offer certain advantages and disadvantages over cow's milk. The quality of human milk protein is superior to that of cow's milk, and human milk's higher levels of cystine are especially required in the premature infant, where the liver is deficient in the enzyme required to convert methionine to cystine. Human milk is low in certain essential electrolytes and trace elements, such as sodium. It can also harbor drugs, pollutants, and harmful viruses that can be dangerous to the infant. Freezing of human milk for banking can destroy many of the immunological advantages of its use. Given that the advantages seem to outweigh the disadvantages, the authors favor the use of human milk for premature infants.

  14. Impact of Rotavirus Vaccine on Premature Infants

    PubMed Central

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

    2014-01-01

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

  15. Impact of rotavirus vaccine on premature infants.

    PubMed

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

    2014-10-01

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

  16. [Skin antisepsis in premature infants].

    PubMed

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

    2011-01-01

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

  17. Age determination from central incisors of fetuses and infants.

    PubMed

    Aka, P Sema; Canturk, Nergis; Dagalp, Rukiye; Yagan, Murat

    2009-01-30

    Age at time of death for a fetus or infant is an important issue in the field of forensic science. Dental development can give an accurate measure of infant and fetal age and current literature does not include any studies of dental age from central incisor development. The objective of this study is to determine the age of deceased fetuses and infants by examining metric tooth development of central incisors in deceased fetuses and infants. Five dimensions of 76 maxillary and mandibular central incisors were measured: mesio-distal (MD), bucco-lingual (BL), crown height (CH), crown thickness (CT), and root height (RH). The results showed that 44.45+/-0-2 weeks is a sectional time for age calculations, which corresponds to 40 weeks from conception plus 4 to 5 weeks after birth. Four ATA entitled age formulas are derived to give the relation of age with tooth dimensions before and after 44.45 weeks [ATA is the special name given to the honor of the great Turkish leader Mustafa Kemal Atatürk (1881-1938)]. Age estimation can be calculated from these formulas with an accuracy of the age +/-0-2 weeks. Also, calcification time can be determined from ATA formulas. In conclusion, the age of fetuses and infants can be assessed by the measurements of a single central incisor. According to this research, when estimating age during identification studies, forensic researchers must take into consideration the period of embryonic human growth and development.

  18. Neurodevelopmental outcomes of infants born prematurely.

    PubMed

    Aylward, Glen P

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Neal, Mary V.

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

  20. A Control System for Oxygen Therapy of Premature Infants

    DTIC Science & Technology

    2007-11-02

    prevented to avoid retinopathy of prematurity , edema of the lungs, and other untoward effects of hyperoxia and oxygen toxicity. Several control systems have... effects of shunt in the lungs, a varying dead space, and prematurity of arterial receptors in infants are included. Lungs, brain, cerebrospinal fluid, and...A CONTROL SYSTEM FOR OXYGEN THERAPY OF PREMATURE INFANTS F. T. Tehrani Department of Electrical Engineering, California State University, Fullerton

  1. Periventricular leukomalacia in premature infants in mainland China.

    PubMed

    Liu, Jing; Li, Jian; Qin, Gui-Lian; Chen, Yan-Hua; Wang, Qi

    2008-10-01

    Periventricular leukomalacia (PVL) in premature infants is a major cause of mortality and disability. However, while China is the largest developing country, there is an absence of data concerning PVL. This study was carried out in order to explore the incidence rate and analyze the high-risk factors of PVL in premature infants, and to suggest a working protocol for the prevention of PVL in newborns at risk. The cohort prospective study included 921 premature infants < 37 weeks' gestation from January 2004 to July 2007. The study group was comprised of 271 premature infants with an ultrasound diagnosis of PVL and the control group was comprised of 650 premature infants who were submitted to the same evaluation protocol but did not show any echographic signs of PVL. The results showed that the incidence rate of PVL was 29.4% in China. High-degree PVL accounted for < 12% and > 88% of PVL was low-degree. The incidence rate was much higher when premature infants were accompanied by the following complications: low gestational age, low birth weight, prolonged rupture of membranes, chorionitis, mechanical ventilation, periventricular-ventricular hemorrhage, hypocapnia, and hyperlactacidemia. Severe complications that occur in premature infants also significantly increase the incidence of PVL. Antenatal corticosteroids can significantly decrease the incidence rate of PVL. This investigation provided a theoretical reference for the prevention of premature PVL.

  2. Palliative care for extremely premature infants and their families.

    PubMed

    Boss, Renee D

    2010-01-01

    Extremely premature infants face multiple acute and chronic life-threatening conditions. In addition, the treatments to ameliorate or cure these conditions often entail pain and discomfort. Integrating palliative care from the moment that extremely premature labor is diagnosed offers families and clinicians support through the process of defining goals of care and making decisions about life support. For both the extremely premature infant who dies soon after birth and the extremely premature infant who experiences multiple complications over weeks and months in the neonatal intensive care unit, palliative care can maintain a focus on infant comfort and family support. This article highlights the ways in which palliative care can be incorporated into intensive care for all critically ill infants.

  3. [Supraventricular tachycardia and premature atrial contractions in fetus].

    PubMed

    Vlagsma, R; Hallensleben, E; Meijboom, E J

    2001-02-17

    Foetal arrhythmias are encountered in 1-2% of pregnancies and 10% of these are associated with some form of foetal mortality or morbidity, including structural heart disease, foetal death and neurological complications. The most frequent types of arrhythmia are supraventricular arrhythmias of which the innocent premature atrial depolarisations make up 85%; 10% are tachycardias with a foetal heart rate of over 180/min. Echocardiographic evaluation is required to exclude associated structural abnormalities and to decide whether therapy is required. The prognosis of a foetus with tachycardia depends on the presence of associated pathology, the type of arrhythmia, the presence of foetal hydrops, the heart rate and the adequacy of treatment. The treatment of foetal tachycardia depends on the type of the tachycardia and since most tachycardias are of supraventricular origin the therapeutic armamentarium includes digoxin, sotalol and flecainide, each with its specific side effects. Foetal tachycardia patients require immediate diagnosis and if necessary therapy in a specialized center.

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

    PubMed

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

    1993-12-01

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

  5. Palliative Care for Extremely Premature Infants and Their Families

    ERIC Educational Resources Information Center

    Boss, Renee D.

    2010-01-01

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

  6. Digestion of Protein in Premature and Term Infants

    PubMed Central

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

    2014-01-01

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

  7. Hyperleukocytosis in a premature infant with intrauterine herpes simplex encephalitis.

    PubMed

    Underwood, M A; Wartell, A E; Borghese, R A

    2012-06-01

    Herpes encephalitis is a rare but devastating infection in premature infants. We report a 29 week gestation infant with severe intrauterine cutaneous and central nervous system herpes accompanied by hyperleukocytosis. Leukemoid reactions are not uncommon in this population, but the association of herpes encephalitis and a leukemoid reaction or hyperleukocytosis has not been reported previously.

  8. Evaluation and Treatment of Anemia in Premature Infants

    PubMed Central

    Hasanbegovic, Edo; Cengic, Nermana; Hasanbegovic, Snijezana; Heljic, Jasmina; Lutolli, Ismail; Begic, Edin

    2016-01-01

    Introduction: Anemia in preterm infants is the pathophysiological process with greater and more rapid decline in hemoglobin compared to the physiological anemia in infants. There is a need for transfusions and administration of human recombinant erythropoietin. Aim: To determine the frequency of anemia in premature infants at the Pediatric Clinic, University Clinical Center Sarajevo, as well as parameter values in the blood count of premature infants and to explore a relationship between blood transfusions with the advent of intraventricular hemorrhage (determine treatment outcome in preterm infants). Patients and methods: Research is retrospective study and it included the period of six months in year 2014. Research included 100 patients, gestational age < 37 weeks (premature infants). Data were collected by examining the medical records of patients at the Pediatric Clinic, UCCS. Results: The first group of patients were premature infants of gestational age ≤ 32 weeks (62/100) and the second group were premature infants of gestational age 33-37 weeks (38/100). Among the patients, 5% were boys and 46% girls. There was significant difference in birth weight and APGAR score among the groups. In the first group, there were 27.42% of deaths, while in the second group, there were only 10.53% of deaths. There was a significant difference in the length of treatment. There was a statistically significant difference in the need for transfusion among the groups. 18 patients in the first group required a transfusion, while in the second group only 3 patients. Conclusions: Preterm infants of gestational age ≤ 32 weeks are likely candidates for blood transfusion during treatment. Preterm infants of gestational age ≤ 32 weeks have the risk of intracranial bleeding associated with the application of blood transfusion in the first week of life. PMID:28210010

  9. [Improving recovery of body temperature after ablution in premature infants].

    PubMed

    Chiu, Shu-Yen; Huang, Hisu-Min; Tseng, Chi-Ying

    2007-06-01

    The purpose of this project was to improve the problem of decreased body temperature after ablution in premature infants, and increase the rate of recovery of body temperature. Before administration of this program, the rate of body temperature recovery was slow. The body temperatures of only 35% of premature infants' reached 36.5 degrees C at 30 minutes after bath, those of 43% did so at 60 minutes after bath, and those of 70 % did so at 120 minutes after bath. After a warmth maintenance nursing standard had been set, the bathing nursing standard corrected, standard interventions promoted and the system inspected, the percentage of body temperature recovery to 36.5 degrees C was raised from 35% to 74% at 30 minutes after bath and the body temperature became normal in all premature infants at 60 minutes after bath. This program not only solves the problem of low body temperature after ablution in premature infants, but also consolidates nursing staffs' knowledge and skills in maintaining body temperature in prematurity to promote the quality of premature care.

  10. Outcomes of human milk-fed premature infants.

    PubMed

    Schanler, Richard J

    2011-02-01

    Significant benefits to infant host defense, sensory-neural development, gastrointestinal maturation, and some aspects of nutritional status are observed when premature infants are fed their mothers' own milk. A reduction in infection-related morbidity in human milk-fed premature infants has been reported in nearly a dozen descriptive, and a few quasi-randomized, studies in the past 25 years. Human milk-fed infants also have decreased rates of rehospitalization for illness after discharge. Studies on neurodevelopmental outcomes have reported significantly positive effects for human milk intake in the neonatal period and long-term mental and motor development, intelligence quotient, and visual acuity through adolescence. Body composition in adolescence also is associated with human milk intake in the neonatal intensive care unit. Finally, human milk intake is less associated with the development of the metabolic syndrome than infant formula feeding.

  11. Transition of Premature Infants From Hospital to Home Life

    PubMed Central

    Lopez, Greta L.; Anderson, Kathryn Hoehn; Feutchinger, Johanna

    2013-01-01

    Purpose To conduct an integrative literature review to studies that focus on the transition of premature infants from neonatal intensive care unit (NICU) to home. Method A literature search was performed in Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE to identify studies consisting on the transition of premature infants from hospital to home life. Results The search yielded seven articles that emphasized the need for home visits, child and family assessment methods, methods of keeping contact with health care providers, educational and support groups, and described the nurse’s role in the transition program. The strategy to ease the transition differed in each article. Conclusion Home visits by a nurse were a key component by providing education, support, and nursing care. A program therefore should consist of providing parents of premature infants with home visits implemented by a nurse or staying in contact with a nurse (e.g., via video-conference). PMID:22763247

  12. Nutritional care of premature infants: microminerals.

    PubMed

    Domellöf, Magnus

    2014-01-01

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

  13. Parents' Responses to Normal and Premature Infants.

    ERIC Educational Resources Information Center

    Frodi, Ann; Willie, Diana

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

  14. Quantification of periodic breathing in premature infants

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    King, Janet C.; Charlet, Sara

    1978-01-01

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

  16. Metabolic studies of transient tyrosinemia in premature infants

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

  17. Human milk and the premature infant.

    PubMed

    Bhatia, Jatinder

    2013-01-01

    Human milk is the preferred feeding for both term and preterm infants. While being considered optimal for term infants, human milk, even from mothers delivering preterm infants, is lacking in protein, energy, sodium, calcium, and phosphorus, resulting in poorer growth and nutrient deficiencies when compared to formulas designed for these high-risk infants. Further, the lack of growth is associated with long-term adverse consequences. Since human milk has unique properties in promoting gastrointestinal maturation and immunological benefits, it is prudent to implement strategies to fortify it appropriately to realize its benefits which include reduced rates of necrotizing enterocolitis, fewer episodes of sepsis and urinary tract infections, and improved visual and neurocognitive development. Donor human milk is being widely used when mothers' own milk is not available or is in short supply. While it retains some of the biological properties and clinical benefits of mothers' own milk, it requires additional care in fortification, especially if the donor milk is from a pool of term human milk. As nutritional strategies improve, the ultimate goal is to minimize extrauterine growth restriction and promote appropriate growth after regaining birth weight.

  18. 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

  19. Maternal panic disorder: Infant prematurity and low birth weight.

    PubMed

    Warren, Susan L; Racu, Camellia; Gregg, Vanessa; Simmens, Samuel J

    2006-01-01

    The aim of this pilot research was to investigate whether infants of mothers with panic disorder (PD) would be at higher risk for prematurity and low birth weight (corrected for gestational age) than controls. Medical records were reviewed for 25 mothers with PD and 33 mothers without a lifetime history of anxiety disorders or other major psychopathology as determined by diagnostic interview. Mothers also completed questionnaires concerning demographic information and life stresses. Compared to controls, infants with PD mothers were not significantly more likely to be born prematurely or earlier than controls but did show smaller birth weight corrected for gestational age, even after accounting for possible confounding influences. Additional research is needed to confirm these preliminary findings. Studying PD mothers during pregnancy could provide insight concerning mechanisms for the development of low birth weight and psychopathology.

  20. 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.

  1. Kangaroo mother care may help oral growth and development in premature infants.

    PubMed

    Zhang, Feng; Liu, Shoutao

    2012-08-01

    Premature infants have a shorter prenatal development period and are prone to many serious medical problems during neonatal period. This may impact the development of oral tissues, as manifested by enamel hypoplasia, palatal distortion, malocclusion, or delay in tooth eruption and maturation. Kangaroo mother care (KMC) is a standardized and protocol-based care system for premature infants, based on skin-to-skin contact between the infant and their mother. Kangaroo mother care has been demonstrated to greatly improve the nurturing of premature infants and comparatively reduce the risk factors of oral defects. We hypothesize that KMC also facilitates oral growth and development in premature infants.

  2. Surgical salvage of acquired lung lesions in extremely premature infants.

    PubMed

    Sacks, Greg D; Chung, Katherine; Jamil, Kevin; Garg, Meena; Dunn, James C Y; DeUgarte, Daniel A

    2014-05-01

    Acquired neonatal lung lesions including pneumatoceles, cystic bronchopulmonary dysplasia, and pulmonary interstitial emphysema can cause extrinsic mediastinal compression, which may impair pulmonary and cardiac function. Acquired lung lesions are typically managed medically. Here we report a case series of three extremely premature infants with acquired lung lesions. All three patients underwent aggressive medical management and ultimately required tube thoracostomies. These interventions were unsuccessful and emergency thoracotomies were performed in each case. Two infants with acquired pneumatoceles underwent unroofing of the cystic structure and primary repair of a bronchial defect. The third infant with pulmonary interstitial emphysema, arising from cystic bronchopulmonary dysplasia, required a middle lobectomy for severe and diffuse cystic disease. When medical management fails, tube thoracostomy can be attempted, leaving surgical intervention for refractory cases. Surgical options include oversewing a bronchial defect in the setting of a bronchopleural fistula or lung resection in cases of an isolated expanding lobe.

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

    NASA Astrophysics Data System (ADS)

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

    2002-12-01

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

  4. 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…

  5. Maternal behavior and infant physiology during feeding in premature and term infants over the first year of life.

    PubMed

    Weber, Ashley M; Harrison, Tondi M

    2014-12-01

    Little is known about the relationship between maternal behavior and the stability of premature infants' physiologic responses during feeding. In a secondary data analysis, we examined relationships between quality of maternal behavior and cardiorespiratory physiology during feeding in 61 premature and 53 term infants at four times over the first year of life. Measures included heart rate (HR), respiratory rate (RR), and oxygen saturation; Child Feeding Skills Checklist; and Parent-Child Early Relational Assessment. Birthweight, gestational age, and neurodevelopmental risk were covariates. Quality of maternal behavior did not predict infants' physiologic response to feeding. However, birthweight was related to infant feeding physiology among all infants over the first year of life. Stress during fetal life, which may lead to impaired intrauterine growth and low birthweight, may have longitudinal effects on cardiorespiratory functioning of premature infants. Research is needed to further investigate the biological pathways by which maternal-infant interaction supports behavioral and physiologic feeding outcomes of premature infants.

  6. Intestinal perforations in a premature infant caused by Bacillus cereus.

    PubMed

    Girisch, M; Ries, M; Zenker, M; Carbon, R; Rauch, R; Hofbeck, M

    2003-06-01

    Although Bacillus cereus is a ubiquitous bacterium, the incidence of neonatal infections is very low with only a few cases of B. cereus infections in neonates reported in the literature. We report the case of a premature infant with multiple intestinal perforations and an abdominal B. cereus infection. The initial course was characterized by severe cardiovascular shock, anemia, thrombocytopenia and disseminated intravascular coagulation, leading to periventricular leukomalacia, alopecia capitis and toxic epidermal necrolysis. The possible role of B. cereus-associated enterotoxins for the clinical manifestations are discussed. Our case confirms previous reports of severe clinical symptoms in B. cereus infection in premature neonates. We speculate that the systemic complications of B. cereus infection are at least partly related to the effect of B. cereus-associated enterotoxins.

  7. [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.

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

    PubMed Central

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

    2015-01-01

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

  9. Cardiovascular anatomy and physiology of the fetus, neonate, infant, child, and adolescent.

    PubMed

    Alyn, I B; Baker, L K

    1992-04-01

    Practicing cardiovascular nurses are aware that significant differences exist in the cardiac anatomy and physiology of children and adults. Generally, the younger the child the greater these differences are. The cellular anatomy and physiology are markedly different in the fetus, neonate, and infant. As development progresses, cardiac function begins to more closely approximate that of an adult. This article describes the anatomical and physiologic development of the fetus, neonate, infant, child, and adolescent. The developmental differences in preload, afterload, contractility, and heart rate are summarized.

  10. The association between systemic vascular endothelial growth factor and retinopathy of prematurity in premature infants: a systematic review.

    PubMed

    Kandasamy, Yogavijayan; Hartley, Leo; Rudd, Donna; Smith, Roger

    2017-01-01

    Retinopathy of prematurity (ROP), a vasoproliferative disorder exclusive to premature infants is an important cause of childhood blindness. The number of premature infants surviving with this condition is expected to increase globally. Animal models of oxygen-induced retinopathy studies have shown vascular endothelial growth factor (VEGF) to be a key player in the pathogenesis of ROP. This has led to increased use of VEGF antagonist as an alternative treatment for ROP. The purpose of this systematic review is to determine the association between VEGF and ROP in human newborn. The literature review identified 12 studies to date which fulfilled the search criteria. Investigators used cord blood, serum, plasma and tissue samples to investigate the association between ROP and VEGF. Studies that measured VEGF in cord blood found mixed results, with low VEGF (at birth) associated with ROP in one study and no difference noted in two others. Mixed results were also seen in studies determining VEGF in postnatal venous samples. Four studies showed no difference in VEGF level between premature infants with and without ROP, one study showed an increased VEGF level in premature infants with ROP and another study found serum VEGF to be low in premature infants with ROP. The most recent study demonstrated an initial increase in serum VEGF followed by a decline at the time of treatment. These contradictory results indicate that we are yet to fully understand the role of VEGF in human premature infants and question the rationale of treating ROP with anti-VEGF. Anti-VEGF therapy results in systemic effect on serum VEGF levels for up to 2 months and this could have an effect on neurodevelopmental outcome. The effect of this on other developing organs is currently unknown. More studies are required to determine the mechanistic relationships between systemic VEGF and ROP in premature infants.

  11. Decreased cysteine and proline synthesis in parenterally fed, premature infants.

    PubMed

    Miller, R G; Jahoor, F; Jaksic, T

    1995-07-01

    Little is known about the amino acid (AA) biosynthetic capacity and requirements of premature infants. This study assessed the synthesis of seven biochemically nonessential AA from a universal precursor, glucose, in stable, parenterally fed, premature neonates. Seven infants (six boys, one girl) were studied at a mean age of 6.3 +/- 0.6 (SEM) days; mean gestational age was 29.7 +/- 1.3 (SEM) weeks, and mean birth weight was 1,222.8 +/- 176.5 (SEM) grams. All infants were parenterally fed a mixture of 7.5% to 12.5% dextrose and 2.2% Trophamine, with or without lipid. Mean caloric intake was 93 +/- 8.4 (SEM) kcal/kg/d, and total AA intake was standardized at 2.86 g/kg/d AA, plus supplemental cysteine (30 mg/g AA/d). Each infant received a 4-hour continuous, unprimed intravenous infusion of a stable isotope tracer of D(-)[U13C] glucose (200 mg/kg). Blood samples were obtained before and at the end of the infusion. Conversion of the glucose tracer into seven biochemically nonessential AA (cysteine [Cys], proline [Pro], aspartate [Asp], serine [Ser], glutamate [Glu], alanine [Ala], and glycine [Gly]) was assessed by measuring their isotopic enrichment in plasma, using gas chromatography/mass spectrometry (GC/MS), and expressed as mole percent excess (MPE) (mean +/- SEM). The isotopic enrichment of plasma glucose was also measured using GC/MS. Free plasma AA concentrations (mean +/- SD) were measured using an automated amino acid analyzer. Mean MPE for M + 1, M + 2 and M + 3 Cys, and for M + 1 and M + 3 Pro were not significantly different from 0; M + 2 Pro barely achieved statistical significance (P = .048).(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Safety of ROP Examination and imaging in Premature Infants

    PubMed Central

    Wade, Kelly C.; Pistilli, Maxwell; Baumritter, Agnieshka; Karp, Karen; Gong, Alice; Kemper, Alex R.; Ying, Gui-Shuang; Quinn, Graham

    2015-01-01

    Objectives To describe adverse events (AEs) and noteworthy clinical or ocular findings associated with retinopathy of prematurity (ROP) evaluation procedures. Study design Descriptive analysis of pre-defined AEs and noteworthy findings reported in a prospective observational cohort study of infants <1251 g birth weight (BW) who had ROP study visits consisting of both binocular indirect ophthalmoscopy (BIO) and digital retinal imaging. We compared infant characteristics during ROP visits with and without AEs. We compared respiratory support, nutrition, and number of apnea, bradycardia, or hypoxia events 12 hours before and after ROP visits. Results 1,257 infants, mean BW 802 g, had 4,263 BIO and 4,048 imaging sessions (total 8,311 procedures). No serious AEs were related to ROP visits. Sixty-five AEs were reported among 61 infants for an AE rate of 4.9% infants (61/1257) or 0.8% total procedures (65/8311 BIO + imaging). Most AEs were due to apnea, bradycardia, and/or hypoxia (68%), tachycardia (16%), or emesis (8%). At ROP visit, infants with AEs, compared with those without, were more likely to be on mechanical ventilation (26% versus 12%, p=0.04) even after adjustment for weight and PMA. Noteworthy clinical findings were reported during 8% BIO and 15% imaging exams. Respiratory and nutrition support were not significantly different before and after ROP evaluations. Conclusions Retinal imaging by non-physicians combined with BIO was safe. Noteworthy clinical findings occurred during both procedures. Ventilator support was a risk factor for AEs. Monitoring rates of AEs and noteworthy findings are important to the safe implementation of ROP imaging protocols. Trial registration Clinicaltrials.gov: NCT01264276 PMID:26299381

  13. Dysfunction of pulmonary surfactant in chronically ventilated premature infants.

    PubMed

    Merrill, Jeffrey D; Ballard, Roberta A; Cnaan, Avital; Hibbs, Anna Maria; Godinez, Rodolfo I; Godinez, Marye H; Truog, William E; Ballard, Philip L

    2004-12-01

    Infants of <30 wk gestation often require respiratory support for several weeks and may develop bronchopulmonary dysplasia (BPD), which is associated with long-term pulmonary disability or death in severe cases. To examine the status of surfactant in infants at high risk for BPD, this prospective study analyzed 247 tracheal aspirate samples from 68 infants of 23-30 wk gestation who remained intubated for 7-84 d. Seventy-five percent of the infants had one or more surfactant samples with abnormal function (minimum surface tension 5.1-21.7 mN/m by pulsating bubble surfactometer), which were temporally associated with episodes of infection (p = 0.01) and respiratory deterioration (p = 0.005). Comparing normal and abnormal surfactant samples, there were no differences in amount of surfactant phospholipid, normalized to total protein that was recovered from tracheal aspirate, or in relative content of phosphatidylcholine and phosphatidylglycerol. Contents of surfactant proteins (SP) A, B, and C, measured in the surfactant pellet by immunoassay, were reduced by 50%, 80%, and 72%, respectively, in samples with abnormal surface tension (p < or = 0.001). On multivariable analysis of all samples, SP-B content (r = -0.58, p < 0.0001) and SP-C content (r = -0.32, p < 0.001) were correlated with surfactant function. We conclude that most premature infants requiring continued respiratory support after 7 d of age experience transient episodes of dysfunctional surfactant that are associated with a deficiency of SP-B and SP-C.

  14. An ROP screening dilemma: hereditary cataracts developing in a premature infant after birth.

    PubMed

    Marcus, Inna; Salchow, Daniel J; Stoessel, Kathleen M; Levada, Andrew J

    2012-02-14

    A female infant born prematurely at 23 weeks' gestational age developed bilateral hereditary cataracts at post-menstrual age 33 weeks, which precluded retinopathy of prematurity screening. The infant underwent right cataract extraction 1 week later, and retinopathy of prematurity was monitored by examining the right eye. In the seventeenth week of life (post-menstrual age 40 weeks), the cataract was removed from the left eye. Visual outcome at 19 months of age was good in both eyes. Very early cataract extraction may be necessary in premature infants to allow ROP evaluations.

  15. Radiation Dose Assessments for the Embryo, Fetus, and Nursing Infant during Operation Tomodachi

    DTIC Science & Technology

    2013-08-01

    from the Fukushima Daiichi nuclear power station units’ radiological releases that followed the earthquake and tsunami on March 11, 2011. The...Tomodachi, Radiation Dose, Department of Defense, Japan, Fukushima , Earthquake, Tsunami, Embryo, Fetus, Nursing Infant 16. SECURITY CLASSIFICATION OF...two months following the accident at the Fukushima Daiichi Nuclear Power Station (FDNPS). As discussed in Cassata et al. (2012), this population was

  16. Late-onset blueberry muffin lesions following recombinant erythropoietin administration in a premature infant.

    PubMed

    Pandey, Vishal; Dummula, Krishna; Fraga, Garth; Parimi, Prabhu

    2012-10-01

    Recombinant erythropoietin is being used in premature population for anemia of prematurity. It is considered very safe in this population, although risks are still being evaluated. We report the first case of dermal erythropoiesis as a side effect of recombinant erythropoietin in an extremely prematurely born infant presenting with late-onset blueberry muffin lesions.

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

    PubMed

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

    2013-10-01

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

  18. The hematology of bacterial infections in premature infants.

    PubMed

    Zipursky, A; Palko, J; Milner, R; Akenzua, G I

    1976-06-01

    A series of premature infants was studied for the presence of bacterial infection. On the basis of clinical evidence and bacteriological studies, they were divided into three groups in which sepsis was considered to be proven, possible, or unlikely. Band neutrophil counts were elevated most frequently in the "sepsis-proven" group and the elevation occurred usually within 24 hours of onset of signs of disease. Qualitative changes in neutrophils (Döhle bodies, toxic granulation, and vacuolization) were more frequent in the sepsis-proven group and, together with the band count, provided valuable techniques for the diagnosis of bacterial infections. Thrombocytopenia occurred frequently in the sepsis-proven group and seemed to result from increased utilization or destruction of platelets rather than failure of production. In such cases, evidence of intravascular coagulation was minimal and it was concluded that thrombocytopenia had resulted from a direct effect of the bacteria or its products on platelets and/or endothelium.

  19. The sizes of renal glomeruli in fetuses and infants.

    PubMed Central

    Souster, L P; Emery, J L

    1980-01-01

    An attempt was made to obtain normal values of the sizes of glomeruli in the fetus and child. The kidneys of 117 children from 12 weeks gestation to 5 years of age were measured and the difference in size between the juxta-arcuate, mid-cortical and superficial glomeruli was examined. Juxta-arcuate and mid-cortical glomeruli showed an initial decrease in size from 12 to 20 weeks gestation. This was not seen in the most superficial glomeruli. After the initial decrease, the juxta-arcuate and superficial glomeruli remained at the same size until birth. The superficial glomeruli remained the same size from 12 weeks gestation to term. There was an immediate increase in size after birth in all three groups which slowed down after 2 years, when all three groups became the same size. The changes in size of the juxta-arcuate and mid-cortical glomeruli may be explained by functional demand. PMID:7410201

  20. Nutrient needs and feeding of premature infants. Nutrition Committee, Canadian Paediatric Society.

    PubMed Central

    1995-01-01

    OBJECTIVE: To recommend appropriate intake of nutrients, food sources and feeding practices for premature infants. OPTIONS: Unfortified milk from the premature infant's own mother, fortified milk from the premature infant's own mother, formula designed for preterm infants and parenteral nutrition. OUTCOMES: From birth to 7 days, the minimum achievable goal is the provision of sufficient nutrients to prevent deficiencies and catabolism of nutrient substrate in premature infants; from 7 days to discharge from the neonatal intensive care unit, growth and nutrient retention at a rate similar to that which would have been achieved had the infant remained in utero; and for 1 year following discharge, nutrient intake to achieve catch-up growth. EVIDENCE: Few randomized clinical trials of feeding infants specific nutrients or of feeding choices have been conducted. On the basis of a MEDLINE search of the literature, committee members prepared reviews of the available information on each nutrient and feeding choice. The reviews were critically appraised by the committee. Recommendations were based on the consensus of the committee. VALUES: Whenever possible, the evidence was weighed in favour of randomized controlled trials. If such trials were unavailable, cohort studies were considered. If trials of either kind were unavailable, published data were reviewed and recommendations were based on consensus opinion. BENEFITS, HARMS AND COSTS: The advantages of feeding premature infants unfortified milk from their own mothers are psychologic benefits for the mother as well as anti-infective benefits and possibly improved intellectual development for the infant. However, unfortified milk from the infant's own mother is inadequate as a sole source of nutrients. The use of fortified milk from the mother results in faster growth as well as having the other benefits of mother's milk. When formulas designed for premature infants are given in adequate volumes, they provide an intake of

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

    PubMed

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

    2015-03-03

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

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

    SciTech Connect

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

    1996-06-14

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

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

    PubMed Central

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

    2015-01-01

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

  4. Nurses' expectations of using music for premature infants in neonatal intensive care unit.

    PubMed

    Pölkki, Tarja; Korhonen, Anne; Laukkala, Helena

    2012-08-01

    This study aimed to describe nurses' expectations of using music for premature infants in the neonatal intensive care unit (NICU) and to find out about the related background factors. The subjects consisted of 210 Finnish nurses who were recruited from the country's five university hospitals providing premature infant care in NICU. The data were collected by validated questionnaire, and the response rate was 82%. Most nurses preferred recorded music to live music in the NICU. They expected that music would have positive effects on premature infants, parents, and staff. Few demographic and many background factors of the respondents' music-related experiences correlated significantly with the expectations concerning their preference. In conclusion, the nurses' expectations were positive regarding the use of music in the NICU, which supports evidence regarding the efficacy of music therapy for premature infants.

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

    ERIC Educational Resources Information Center

    Stone, Kathy Kees; And Others

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

  6. Achondroplasia in the Premature Infant: An Elusive Diagnosis in the Neonatal Intensive Care Unit

    PubMed Central

    Fagen, Kimberly E.; Blask, Anna R.; Rubio, Eva I.; Bulas, Dorothy I.

    2017-01-01

    Achondroplasia is a difficult prenatal diagnosis to make before the late second and third trimester. We describe two cases where an infant was born prematurely with no overt signs of achondroplasia. Despite multiple chest and abdominal radiographs during the neonatal course, the diagnosis was not made until term equivalent age was reached. We retrospectively reviewed these two cases to highlight the elusive findings of achondroplasia in the premature infant. PMID:28210519

  7. Comparative absorption of [13C]glucose and [13C]lactose by premature infants.

    PubMed

    Murray, R D; Boutton, T W; Klein, P D; Gilbert, M; Paule, C L; MacLean, W C

    1990-01-01

    Oxidation of orally administered [13C]glucose and [13C]lactose and fecal recovery of malabsorbed substrates were determined in two groups of premature infants. Eighteen studies were performed with six infants at Johns Hopkins Hospital (JHH); 24 studies were performed with nine infants at Columbus Children's Hospital (CCH). The two groups differed in that JHH infants had shorter gestations but were older when studied. Fecal 13C loss after [13C]glucose administration did not differ between the two groups. Compared with glucose, the metabolism of lactose appeared to involve more malabsorption and colonic fermentation in JHH infants than in CCH infants and resulted in higher fecal losses of substrate carbon. Maturation appeared to involve increased proximal intestinal absorption and greater retention of absorbed carbohydrate. Simultaneous absorption of substrate from the small and large intestine may limit the usefulness of breath tests for 13C in the premature infant.

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

    PubMed Central

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

    2014-01-01

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

  9. Early Intervention for Low Birthweight, Premature Infants: Participation and Intellectual Development.

    ERIC Educational Resources Information Center

    Blair, Clancy; And Others

    1995-01-01

    The Infant Health and Development Program was an eight-site randomized controlled trial of comprehensive early intervention for low birthweight, premature infants from birth to age three. Higher mental development and IQ were associated with high levels of intervention participation at 24 and 36 (but not 12) months. A dose-response relation…

  10. Effect of White Noise in Relieving Vaccination Pain in Premature Infants.

    PubMed

    Kucukoglu, Sibel; Aytekin, Aynur; Celebioglu, Ayda; Celebi, Arzu; Caner, Ibrahim; Maden, Rukiye

    2016-12-01

    The purpose of this study was to evaluate the effect of white noise as a distraction method in relieving procedural pain caused by vaccination for premature infants. This experimental study was performed at a neonatal intensive care unit (NICU) of a university hospital in Turkey between July and September 2013. The study population was composed of 75 premature infants (35 in the study group and 40 in the control group) who met the inclusion criteria. Premature infants in the study group were exposed to white noise using MP3 players placed at the head of the infants' open crib for 1 minute before vaccination. The white noise continued until 1 minute after vaccination. Premature infants in the control group were not exposed to white noise. The Premature Infant Information Form, Intervention Follow-up Form, and Premature Infant Pain Profile (PIPP) were used to collect study data. Descriptive statistics, chi-square test, and independent sample t-tests were used to evaluate the data. The pain level of the control group (PIPP = 14.35 ± 2.59) was significantly higher than the pain level of the study group (PIPP = 8.14 ± 3.14) (p < .05). The authors found that 67.6% of the infants in the study group had moderate pain during vaccination and only 2.9% had severe pain. Most of the infants in the control group (82.5%) had severe pain, whereas 17.5% had moderate pain (p < .05). White noise was found to be effective for this sample; however, there is a dire need for extensive research on white noise and its use with this vulnerable population.

  11. Unplanned ultrasound-guided puncture of a tracheal balloon in a premature infant with congenital diaphragmatic hernia.

    PubMed

    Rugolotto, S; Giacomello, L; El-Dalati, G; Sacchetto, L; Antonello, L; De Luca, G; Raffaelli, R

    2014-01-01

    Temporary tracheal balloons have been shown to improve lung growth in fetuses with severe congenital diaphragmatic hernia. Fetoscopic Endoluminal Tracheal Occlusion (FETO) is performed at 26-28 weeks gestation, and then is removed in utero at 34 weeks gestation at highly specialized centers. In case of preterm labor at a hospital without a specialized team, a number of techniques have been used to remove the balloon, sometimes with death of the newborn. We have successfully performed an ultrasound-guided approach to puncture and remove the tracheal balloon in a premature infant in an emergency setting at birth. After that she was treated for congenital diaphragmatic hernia at our Newborn Intensive Care Unit.

  12. [Jacksonian fits and threatened premature labour (the effect of valium, prepar and antiepileptic drugs on the fetus and uterine contractility ante and intra partum) (author's transl)].

    PubMed

    Tempfer, H

    1975-12-12

    The case is reported of a 30-year-old patient whose fifth pregnancy (para 2, no living children) was complicated by the necessity of surgical removal of a stage II astrocytoma. Threatened premature labour was averted by the continuous administration of Prepar as from the 25th week of pregnancy and spontaneous vaginal delivery of a live-born infant was achieved in the 35th week. The development of repeated Jacksonian fits necessitated the administration of high doses of Valium (215 mg i.v. over a 50-nour period) both pre and intra partum, over and above the long-term antiepileptic maintenance therapy which the patient had received throughout the entire pregnancy. The fetal heart rate was not affected by Valium even at such high dosage. This case serves to illustrate that if the indication arises, high doses of Valium may be given before and during labour in conjunction with long-term antiepileptic drugs and Prepar apparently without adverse effects on the fetus or on uterine activity.

  13. A meta-analysis of the efficacy of music therapy for premature infants.

    PubMed

    Standley, Jayne M

    2002-04-01

    This meta-analysis on music research with premature infants in neonatal intensive care units (NICU) showed an overall large, significant, consistent effect size of almost a standard deviation (d =.83) (Cohen, 1998). Effects were not mediated by infants' gestational age at the time of study, birthweight, or type of music delivery nor by physiologic, behavioral, or developmental measures of benefit. The homogeneity of findings suggests that music has statistically significant and clinically important benefits for premature infants in the NICU. The unique acoustic properties that differentiate music from all other sounds are discussed and clinical implications for research-based music therapy procedures cited.

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

    PubMed

    Stalnaker, Kelsey A; Poskey, Gail A

    2016-01-01

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

  15. Frequency and cytokine phenotype of blood T cells from premature infants responding to staphylococcal enterotoxin B.

    PubMed

    Hayward, A R; Cosyns, M; Zhang, Y

    1995-04-01

    The responder cell frequency (RCF) of premature (< 1900 g birth weight) infants' blood lymphocytes, which proliferate in cultures stimulated by staphylococcal enterotoxin B, falls from 1:3400 to about 1:8000 during the first 2 wk of life. Term infants, in contrast, show no fall in RCF. The reduced RCF in the premature infants affected cells that make interferon-gamma more than cells making IL-4. The reduced RCF was accompanied by a fall in the fraction of V beta 3+ T cells that entered cell cycle in stimulated cultures. The RCF of premature infants' T cells was increased in cultures supplemented with irradiated monocytes from adults. Addition of IL-4 (but not IL-2, IL-6, or indomethacin) increased the RCF and fraction of cells entering cell cycle of the premature infants. The data suggest that postnatal environmental factors limit the ability of premature infants' monocytes to support a T-cell response to staphylococcal enterotoxin B in vitro and that this limitation is overcome by adding IL-4.

  16. Parental self-support: A study of parents' confront strategy when giving birth to premature infants

    PubMed Central

    Aliabadi, Faranak; Kamali, Mohammad; Borimnejad, Leili; Rassafiani, Mehdi; Rasti, Mehdi; Shafaroodi, Narges; Rafii, Foroogh; Askari Kachoosangi, Reihaneh

    2014-01-01

    Background: This study aimed to understand the confront strategies of parents of premature infants hospitalized in NICU. Methods: This study was performed using qualitative content analysis approach. Twelve participants including nine parents whose infants were hospitalized in NICU, two nurses and one physician, all selected by purposive sampling method were interviewed by a female expert occupational therapist. Data were gathered by semistructured interviews. Data were analyzed by inductive content analysis approach. Results: One category, six subcategories and twenty one themes emerged from data analysis expressed confront strategies of parents of premature infants admitted in NICU. These categories were: taking assurance, stop thinking to bad things, diverting mind, taking supports, emotional expression, complaining from staff. Conclusion: Premature infant's parents announced that they do not receive adequate formal support to manage their feelings and needs. So, they seek for other informal resources of support and apply some special strategies including self-support. PMID:25664283

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

    PubMed Central

    2012-01-01

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

  18. Sensitivity to Auditory Spectral Width in the Fetus and Infant – An fMEG Study

    PubMed Central

    Muenssinger, Jana; Matuz, Tamara; Schleger, Franziska; Draganova, Rossitza; Weiss, Magdalene; Kiefer-Schmidt, Isabelle; Wacker-Gussmann, Annette; Govindan, Rathinaswamy B.; Lowery, Curtis L.; Eswaran, Hari; Preissl, Hubert

    2013-01-01

    Auditory change detection is crucial for the development of the auditory system and a prerequisite for language development. In neonates, stimuli with broad spectral width like white noise (WN) elicit the highest response compared to pure tone and combined tone stimuli. In the current study we addressed for the first time the question how fetuses react to “WN” stimulation. Twenty-five fetuses (Mage = 34.59 weeks GA, SD ± 2.35) and 28 healthy neonates and infants (Mage = 37.18 days, SD ± 15.52) were tested with the first paradigm, wherein 500 Hz tones, 750 Hz tones, and WN segments were randomly presented and auditory evoked responses (AERs) were measured using fetal magnetoencephalography (fMEG). In the second paradigm, 12 fetuses (Mage = 25.7 weeks GA, SD ± 2.4) and 6 healthy neonates (Mage = 23 days and SD ± 6.2) were presented with two auditory oddball conditions: condition 1 consisted of attenuated WN as standard and 500 Hz tones and WN as deviants. In condition 2, standard 500 Hz tones were intermixed with WN and attenuated WN. AERs to volume change and change in spectral width were evaluated. In both paradigms, significantly higher AER amplitudes to WN than to pure tones replicated prior findings in neonates and infants. In fetuses, no significant differences were found between the auditory evoked response amplitudes of WN segments and pure tones (both paradigms). A trend toward significance was reached when comparing the auditory evoked response amplitudes elicited by attenuated WN with those elicited by WN (loudness change, second paradigm). As expected, we observed high sensibility to spectral width in newborns and infants. However, in the group of fetuses, no sensibility to spectral width was observed. This negative finding may be caused by different attenuation levels of the maternal tissue for different frequency components. PMID:24427130

  19. Sensitivity to Auditory Spectral Width in the Fetus and Infant - An fMEG Study.

    PubMed

    Muenssinger, Jana; Matuz, Tamara; Schleger, Franziska; Draganova, Rossitza; Weiss, Magdalene; Kiefer-Schmidt, Isabelle; Wacker-Gussmann, Annette; Govindan, Rathinaswamy B; Lowery, Curtis L; Eswaran, Hari; Preissl, Hubert

    2013-01-01

    Auditory change detection is crucial for the development of the auditory system and a prerequisite for language development. In neonates, stimuli with broad spectral width like white noise (WN) elicit the highest response compared to pure tone and combined tone stimuli. In the current study we addressed for the first time the question how fetuses react to "WN" stimulation. Twenty-five fetuses (M age = 34.59 weeks GA, SD ± 2.35) and 28 healthy neonates and infants (M age = 37.18 days, SD ± 15.52) were tested with the first paradigm, wherein 500 Hz tones, 750 Hz tones, and WN segments were randomly presented and auditory evoked responses (AERs) were measured using fetal magnetoencephalography (fMEG). In the second paradigm, 12 fetuses (M age = 25.7 weeks GA, SD ± 2.4) and 6 healthy neonates (M age = 23 days and SD ± 6.2) were presented with two auditory oddball conditions: condition 1 consisted of attenuated WN as standard and 500 Hz tones and WN as deviants. In condition 2, standard 500 Hz tones were intermixed with WN and attenuated WN. AERs to volume change and change in spectral width were evaluated. In both paradigms, significantly higher AER amplitudes to WN than to pure tones replicated prior findings in neonates and infants. In fetuses, no significant differences were found between the auditory evoked response amplitudes of WN segments and pure tones (both paradigms). A trend toward significance was reached when comparing the auditory evoked response amplitudes elicited by attenuated WN with those elicited by WN (loudness change, second paradigm). As expected, we observed high sensibility to spectral width in newborns and infants. However, in the group of fetuses, no sensibility to spectral width was observed. This negative finding may be caused by different attenuation levels of the maternal tissue for different frequency components.

  20. Gluconeogenesis continues in premature infants receiving total parenteral nutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed Central

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

    2012-01-01

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

  2. A comparison of two probiotic strains of bifidobacteria in premature infants

    PubMed Central

    Underwood, Mark A; Kalanetra, Karen M; Bokulich, Nicholas A; Lewis, Zachery T; Mirmiran, Majid; Tancredi, Daniel J; Mills, David A

    2013-01-01

    Objective To determine the impact of two probiotic bifidobacteria on the fecal microbiota of premature infants fed either human milk or formula. Study design In the first of two phase 1 clinical trials, twelve premature infants receiving formula feedings were randomly assigned to receive either Bifidobacterium longum ssp infantis or Bifidobacterium animalis ssp lactis in increasing doses over a five week period. In the second, nine premature infants receiving their mother’s milk received each of the two bifidobacteria for two weeks separated by a one week wash out period. Serial stool specimens from each infant were analyzed by terminal restriction fragment length polymorphism and quantitative polymerase chain reaction for bacterial composition. Results Among the formula-fed infants, there was a greater increase in fecal bifidobacteria among infants receiving B. infantis than those receiving B. lactis. This difference was most marked at a dose of 1.4 × 109 cfu twice daily (p < 0.05). Bacterial diversity improved over dose/time in those infants receiving B. infantis. Among the human milk-fed infants, greater increases in fecal bifidobacteria and decreases in γ-Proteobacteria followed administration of B. infantis than B. lactis. The B. longum group (which includes B. infantis but not B. lactis) was the dominant bifidobacteria among the human milk-fed infants, regardless of the probiotic administered. Conclusions B. infantis was more effective at colonizing the fecal microbiota than B. lactis in both formula-fed and human milk-fed premature infants. The combination of human milk plus B. infantis resulted in the highest fecal levels of bifidobacteria. PMID:23993139

  3. Intestinal Fatty-Acid Binding Protein and Metronidazole Response in Premature Infants

    PubMed Central

    Sampson, Mario R.; Bloom, Barry T.; Arrieta, Antonio; Capparelli, Edmund; Benjamin, Daniel K.; Smith, P. Brian; Kearns, Gregory L.; van den Anker, John; Cohen-Wolkowiez, Michael

    2014-01-01

    Objectives In premature infants with suspected intra-abdominal infection, biomarkers for treatment response to antimicrobial therapy are lacking. Intestinal fatty acid-binding protein (I-FABP) is specific to the enterocyte and is released in response to intestinal mucosal injury. I-FABP has not been evaluated as a surrogate marker of disease response to antimicrobial therapy. We examined the relationship between metronidazole exposure and urinary I-FABP concentrations in premature infants with suspected intra-abdominal infection. Study design We conducted an intravenous metronidazole pharmacokinetic study, collecting ≤3 urine samples per infant for I-FABP concentration measurements. We analyzed the relationship between I-FABP concentrations and measures of metronidazole exposure and pharmacokinetics, maturational factors, and other covariates. Results Twenty-six samples from 19 premature infants were obtained during metronidazole treatment. When analyzed without regard to presence of necrotic gastrointestinal disease, there were no significant associations between predictor variables and I-FABP concentrations. However, when the sample was limited to premature infants with necrotic gastrointestinal disease, an association was found between average predicted metronidazole concentration and I-FABP concentration (p=0.006). Conclusion While a predictive association between urinary I-FABP and metronidazole systemic exposure was not observed, the data suggest the potential of this endogenous biomarker to serve as a pharmacodynamic surrogate for antimicrobial treatment of serious abdominal infections in neonates and infants. PMID:25318626

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

    PubMed Central

    Forsum, Elisabet; Olhager, Elisabeth; Törnqvist, Caroline

    2016-01-01

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

  5. Frontal brain activation in premature infants' response to auditory stimuli in neonatal intensive care unit.

    PubMed

    Saito, Yuri; Fukuhara, Rie; Aoyama, Shiori; Toshima, Tamotsu

    2009-07-01

    The present study was focusing on the very few contacts with the mother's voice that NICU infants have in the womb as well as after birth, we examined whether they can discriminate between their mothers' utterances and those of female nurses in terms of the emotional bonding that is facilitated by prosodic utterances. Twenty-six premature infants were included in this study, and their cerebral blood flows were measured by near-infrared spectroscopy. They were exposed to auditory stimuli in the form of utterances made by their mothers and female nurses. A two (stimulus: mother and nurse) x two (recording site: right frontal area and left frontal area) analysis of variance (ANOVA) for these relative oxy-Hb values was conducted. The ANOVA showed a significant interaction between stimulus and recording site. The mother's and the nurse's voices were activated in the same way in the left frontal area, but showed different reactions in the right frontal area. We presume that the nurse's voice might become associated with pain and stress for premature infants. Our results showed that the premature infants reacted differently to the different voice stimuli. Therefore, we presume that both mothers' and nurses' voices represent positive stimuli for premature infants because both activate the frontal brain. Accordingly, we cannot explain our results only in terms of the state-dependent marker for infantile individual differences, but must also address the stressful trigger of nurses' voices for NICU infants.

  6. Perspectives on Promoting Breastmilk Feedings for Premature Infants During a Quality Improvement Project

    PubMed Central

    Martin-Anderson, Sarah; Lyndon, Audrey; Dudley, R. Adams

    2013-01-01

    Abstract Objective This study investigated clinicians' perspectives during a quality improvement project to promote breastmilk feedings in premature infants. Study Design From 2009 to 2010, 11 hospitals in the California Perinatal Quality Care Collaborative participated in a project to promote breastmilk feedings in premature infants. Audio recordings of monthly meetings held to encourage sharing of ideas were analyzed using qualitative methods to identify common themes related to barriers and solutions to breastmilk feeding promotion. Results Two broad categories were noted: communication and team composition. Communication subthemes included (1) communication among hospital staff, including consistent documentation, (2) communication with family, and (3) communication between transfer hospitals. Team composition subthemes included (4) importance of physician buy-in and (5) integrated teams designed to empower leaders. Conclusions Optimizing communication among health professionals and parents and improving team composition may be key components of facilitating breastmilk feeding promotion in premature infants. PMID:23186387

  7. Gestational therapy with an angiotensin II receptor antagonist and transient renal failure in a premature infant.

    PubMed

    Bass, J Kirk; Faix, Roger G

    2006-07-01

    The fetotoxic effects of angiotensin converting enzyme inhibitors when used during the second half of pregnancy are well known. The more recently developed angiotensin II receptor antagonists appear to yield similar fetal abnormalities. We report a premature infant born to a 41-year-old mother with a long history of infertility who had received losartan therapy for hypertension throughout an undetected pregnancy. Ultrasound examination 2 days prior to delivery identified a single fetus at 29 weeks gestation, anhydramnios, and an empty fetal bladder. The neonatal course was complicated by oliguria, hyperkalemia, marked renal dysfunction, respiratory failure, joint contractures, and a large anterior fontanelle with widely separated sutures. Hypotension (mean arterial pressure<25 torr) on day 1 responded to volume expansion, dopamine, and hydrocortisone. Serum creatinine reached a maximum of 2.7 mg/dL on day 6 and decreased to 0.4 by day 56. No formal urinalysis was performed, but the urine was reported to be visually clear throughout the course. Although a renal ultrasound on day 2 was normal, a follow-up study at 7 months revealed bilateral generalized parenchymal echogenicity, consistent with medical renal disease. Since then, weight and length have been at the 5th percentile or less, with apparent renal tubular acidosis necessitating the addition of sodium citrate supplements. This case emphasizes the importance of maintaining a high index of suspicion for potential pregnancy when contemplating the use of a drug of this class, and considering serial testing for pregnancy when using such drugs, even in patients with a longstanding history of infertility.

  8. Development of Emotional Face Processing in Premature and Full-Term Infants.

    PubMed

    Carbajal-Valenzuela, Cintli Carolina; Santiago-Rodríguez, Efraín; Quirarte, Gina L; Harmony, Thalía

    2017-03-01

    The rate of premature births has increased in the past 2 decades. Ten percent of premature birth survivors develop motor impairment, but almost half exhibit later sensorial, cognitive, and emotional disabilities attributed to white matter injury and decreased volume of neuronal structures. The aim of this study was to test the hypothesis that premature and full-term infants differ in their development of emotional face processing. A comparative longitudinal study was conducted in premature and full-term infants at 4 and 8 months of age. The absolute power of the electroencephalogram was analyzed in both groups during 5 conditions of an emotional face processing task: positive, negative, neutral faces, non-face, and rest. Differences between the conditions of the task at 4 months were limited to rest versus non-rest comparisons in both groups. Eight-month-old term infants had increases ( P ≤ .05) in absolute power in the left occipital region at the frequency of 10.1 Hz and in the right occipital region at 3.5, 12.8, and 16.0 Hz when shown a positive face in comparison with a neutral face. They also showed increases in absolute power in the left occipital region at 1.9 Hz and in the right occipital region at 2.3 and 3.5 Hz with positive compared to non-face stimuli. In contrast, positive, negative, and neutral faces elicited the same responses in premature infants. In conclusion, our study provides electrophysiological evidence that emotional face processing develops differently in premature than in full-term infants, suggesting that premature birth alters mechanisms of brain development, such as the myelination process, and consequently affects complex cognitive functions.

  9. Gestational age, sex and maternal parity correlate with bone turnover in premature infants.

    PubMed

    Aly, Hany; Moustafa, Mohamed F; Amer, Hanna A; Hassanein, Sahar; Keeves, Christine; Patel, Kantilal

    2005-05-01

    Factors affecting bone turnover in premature infants are not entirely clear but certainly are different from those influencing bones of adults and children. To identify fetal and maternal factors that might influence bone turnover, we prospectively studied 50 infants (30 preterm and 20 full-term) born at Ain Shams University Obstetric Hospital in Cairo, Egypt. Maternal parity and medical history and infant's weight, gestational age, gender and anthropometrical measurements were recorded. Cord blood samples were collected and serum type I collagen C-terminal propeptide (PICP) was assessed as a marker for fetal bone formation. First morning urine samples were collected and pyridinoline cross-links of collagen (Pyd) were measured as an index for bone resorption. Serum PICP was higher in premature infants when compared with full-term infants (73.30 +/- 15.1 versus 64.3 +/- 14.7, p = 0.022) and was higher in male premature infants when compared with females (81.64 +/- 9.06 versus 66.0 +/- 15.7, p = 0.018). In a multiple regression model using PICP as the dependent variable and controlling for different infant and maternal conditions, PICP significantly correlated with infant gender (r = 8.26 +/- 4.1, p = 0.05) maternal parity (r = -2.106 +/- 0.99, p = 0.041) and diabetes (r = 22.488 +/- 8.73, p = 0.041). Urine Pyd tended to increase in premature infants (612 +/- 308 versus 434 +/- 146, p = 0.057) and correlated significantly with gestational age (r = -63.93 +/- 19.55, p = 0.002). Therefore, bone formation (PICP) is influenced by fetal age and gender, as well as maternal parity and diabetes. Bone resorption (Pyd) is mostly dependent on gestational age only. Further in-depth studies are needed to enrich management of this vulnerable population.

  10. Anatomical configurations associated with posthemorrhagic hydrocephalus among premature infants with intraventricular hemorrhage.

    PubMed

    Tully, Hannah M; Wenger, Tara L; Kukull, Walter A; Doherty, Dan; Dobyns, William B

    2016-11-01

    OBJECTIVE Intraventricular hemorrhage (IVH) is a complication of prematurity often associated with ventricular dilation, which may resolve over time or progress to posthemorrhagic hydrocephalus (PHH). This study investigated anatomical factors that could predispose infants with IVH to PHH. METHODS The authors analyzed a cohort of premature infants diagnosed with Grade III or IV IVH between 2004 and 2014. Using existing ultrasound and MR images, the CSF obstruction pattern, skull shape, and brain/skull ratios were determined, comparing children with PHH to those with resolved ventricular dilation (RVD), and comparing both groups to a set of healthy controls. RESULTS Among 110 premature infants with Grade III or IV IVH, 65 (59%) developed PHH. Infants with PHH had more severe ventricular dilation compared with those with RVD, although ranges overlapped. Intraventricular CSF obstruction was observed in 36 (86%) of 42 infants with PHH and 0 (0%) of 18 with RVD (p < 0.001). The distribution of skull shapes in infants with PHH was similar to those with RVD, although markedly different from controls. No significant differences in supratentorial brain/skull ratio were observed; however, the mean infratentorial brain/skull ratio of infants with PHH was 5% greater (more crowded) than controls (p = 0.006), whereas the mean infratentorial brain/skull ratio of infants with RVD was 8% smaller (less crowded) than controls (p = 0.004). CONCLUSIONS Among premature infants with IVH, intraventricular obstruction and infratentorial crowding are strongly associated with PHH, further underscoring the need for brain MRI in surgical planning. Prospective studies are required to determine which factors are cause and which are consequence, and which can be used to predict the need for surgical intervention.

  11. The effects of music listening on inconsolable crying in premature infants.

    PubMed

    Keith, Douglas R; Russell, Kendra; Weaver, Barbara S

    2009-01-01

    Over the decades, medical staff have developed strategies to manage crying episodes of the critically ill and convalescing premature infant. These episodes of crying occur frequently after infants are removed from ventilation, but before they are able to receive nutrition orally. Not only are these episodes stressful to infants and upsetting to parents, but they are also stressful and time consuming for the staff that take care of these patients. Although the literature supports the benefits of music therapy in regard to physiological and certain behavioral measures with premature infants, no research exists that explores the use of music therapy with inconsolability related to the "nothing by mouth" status. This study explored the effects of music therapy on the crying behaviors of critically ill infants classified as inconsolable. Twenty-four premature infants with gestational age 32-40 weeks received a developmentally appropriate music listening intervention, alternating with days on which no intervention was provided. The results revealed a significant reduction in the frequency and duration of episodes of inconsolable crying as a result of the music intervention, as well as improved physiological measures including heart rate, respiration rate, oxygen saturation, and mean arterial pressure. Findings suggest the viability of using recorded music in the absence of a music therapist or the maternal voice to console infants when standard nursing interventions are not effective.

  12. Ultrasound measurement of the corpus callosum and neural development of premature infants.

    PubMed

    Liu, Fang; Cao, Shikao; Liu, Jiaoran; Du, Zhifang; Guo, Zhimei; Ren, Changjun

    2013-09-15

    Length and thickness of 152 corpus callosa were measured in neonates within 24 hours of birth. Using ultrasonic diagnostic equipment with a neonatal brain-specific probe, corpus callosum length and thickness of the genu, body, and splenium were measured on the standard mid-sagittal plane, and the anteroposterior diameter of the genu was measured in the coronal plane. Results showed that corpus callosum length as well as thickness of the genu and splenium increased with tional age and birth weight, while other measures did not. These three factors on the standard mid-sagittal plane are therefore likely to be suitable for real-time evaluation of corpus callosum velopment in premature infants using cranial ultrasound. Further analysis revealed that thickness of the body and splenium and the anteroposterior diameter of the genu were greater in male infants than in female infants, suggesting that there are sex differences in corpus callosum size during the neonatal period. A second set of measurements were taken from 40 premature infants whose gestational age was 34 weeks or less. Corpus callosum measurements were corrected to a gestational age of 40 weeks, and infants were grouped for analysis depending on the outcome of a neonatal behavioral neurological assessment. Compared with infants with a normal neurological assessment, corpus callosum length and genu and splenium thicknesses were less in those with abnormalities, indicating that corpus callosum growth in premature infants is associated with neurobehavioral development during the early extrauterine stage.

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

    PubMed Central

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

    2010-01-01

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

  14. Kangaroo care on premature infant growth and maternal attachment and post-partum depression in South Korea.

    PubMed

    Ahn, Hye Young; Lee, Joohyun; Shin, Hwa-Jin

    2010-10-01

    After births, premature infants need a high level of medical treatments for their survivals in the neonatal intensive care unit (NICU). This separation deprives mothers of the chance to initiate an attachment process. Kangaroo care (KC) can be one of the ways to reunite mothers and their infants in the NICU and improve health outcomes. This study was conducted to investigate the effects of KC on both premature infants and their mothers. Ten sessions of 60-min KC for 3 weeks were practiced at a level III NICU at E university hospital. Infants' body weight, height and head circumference (HC), maternal attachment and depression were measured. As a result, premature infants in KC showed higher in their height and bigger in their HC than infants in control. Maternal attachment scores were higher among the KC mothers. The results supported the beneficial effects of KC on Korean premature infants and their mothers.

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

    PubMed Central

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

    2015-01-01

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

  16. Effects of music therapy on oxygen saturation in premature infants receiving endotracheal suctioning.

    PubMed

    Chou, Lih-Lih; Wang, Ru-Hwa; Chen, Shu-Jen; Pai, Lu

    2003-09-01

    The purpose of this study was to investigate how premature infants' oxygen saturation changed in response to music therapy while they were receiving endotracheal suctioning. A convenience sample of 30 premature infants was selected from three neonatal intensive care units. A one-group repeated measures design was adopted for this study. The oxygen saturation of all subjects was first measured while they were receiving endotracheal suctioning during a four-hour control period with regular care. Then, four hours after the control period was completed, an experimental period began in which the music " Transitions " was played. One minute before suctioning, the level of oxygen saturation was measured to provide the baseline data. During a period of 30 minutes after suctioning, the oxygen saturation was recorded every minute to analyze the clinical effects of music therapy. The results showed that premature infants receiving music therapy with endotracheal suctioning had a significantly higher SPO(2); than that when not receiving music therapy (p <.01), and the level of oxygen saturation returned to the baseline level faster than when they did not receive music therapy (p <.01). Accordingly, it is hoped that giving appropriate music therapy as developmental care to premature infants when performing any nursing intervention may enhance not only the quality of nursing care but also quality of the infant's life.

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

    PubMed Central

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

    2016-01-01

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

  18. Language acquisition in premature and full-term infants.

    PubMed

    Peña, Marcela; Pittaluga, Enrica; Mehler, Jacques

    2010-02-23

    We tested healthy preterm (born near 28 +/- 2 weeks of gestational age) and full-term infants at various different ages. We compared the two populations on the development of a language acquisition landmark, namely, the ability to distinguish the native language from a rhythmically similar one. This ability is attained 4 months after birth in healthy full-term infants. We measured the induced gamma-band power associated with passive listening to (i) the infants' native language (Spanish), (ii) a rhythmically close language (Italian), and (iii) a rhythmically distant language (Japanese) as a marker of gains in language discrimination. Preterm and full-term infants were matched for neural maturation and duration of exposure to broadcast speech. We found that both full-term and preterm infants only display a response to native speech near 6 months after their term age. Neural maturation seems to constrain advances in speech discrimination at early stages of language acquisition.

  19. Heparinization of alimentation solutions administered through peripheral veins in premature infants: a controlled study.

    PubMed

    Alpan, G; Eyal, F; Springer, C; Glick, B; Goder, K; Armon, J

    1984-09-01

    A randomized controlled study was done to determine whether the addition of heparin (1 U/mL) to peripheral intravenous alimentation solutions would affect the incidence of phlebitis and duration of patency of intravenous catheters in premature infants. Twenty-two-gauge Teflon catheters were uniformly used. One hundred five catheters infused with heparin were placed in 13 infants, and 122 catheters were placed in the control group of 13 infants. The time, nature, and incidence of complications were noted for each infusion site. Infusion of heparin was found to double the duration of patency of intravenous catheters and to reduce significantly the incidence of phlebitis. No complications related to the administration of heparin were noted. Heparinization of intravenous alimentation solutions should therefore be considered in premature infants as a means of reducing the work load and incidence of complications associated with peripheral lines.

  20. Unaltered development of the archi- and neocortex in prematurely born infants: genetic control dominates in proliferation, differentiation and maturation of cortical neurons.

    PubMed

    Abrahám, Hajnalka; Veszprémi, Béla; Gömöri, Eva; Kovács, Krisztina; Kravják, András; Seress, László

    2007-01-01

    The development of cerebral cortex includes highly organized, elaborate and long-lasting series of events, which do not come to an end by the time of birth. Indeed, many developmental events continue after the 40th postconceptual week resulting in a long morphological, behavioral and cognitive development of children. Premature birth causes an untimely dramatic change in the environment of the human fetus and often results in serious threats for life. Cognitive abilities of prematurely born children vary, but a correlation between cognitive impairment and the time of birth is evident. In this study we review the morphological evidence of cortical maturation in preterm and full-term infants. Various aspects of postnatal cortical development including cell proliferation and maturation of neurons in the temporal archi- and neocortex are discussed and compared in preterm infants and age-matched full-term controls. Our results suggest that cell proliferation and maturation are not influenced by the preterm delivery. In contrast, the perinatal decrease of the number of Cajal-Retzius cells might be regulated by a mechanism that is affected by preterm birth. We demonstrate that cognitive deficiencies of the prematurely born infants cannot be explained with light microscopically observed alteration of proliferation and maturation of neurons.

  1. Delayed Early Primary Visual Pathway Development in Premature Infants: High Density Electrophysiological Evidence

    PubMed Central

    Tremblay, Emmanuel; Vannasing, Phetsamone; Roy, Marie-Sylvie; Lefebvre, Francine; Kombate, Damelan; Lassonde, Maryse; Lepore, Franco; McKerral, Michelle; Gallagher, Anne

    2014-01-01

    In the past decades, multiple studies have been interested in developmental patterns of the visual system in healthy infants. During the first year of life, differential maturational changes have been observed between the Magnocellular (P) and the Parvocellular (P) visual pathways. However, few studies investigated P and M system development in infants born prematurely. The aim of the present study was to characterize P and M system maturational differences between healthy preterm and fullterm infants through a critical period of visual maturation: the first year of life. Using a cross-sectional design, high-density electroencephalogram (EEG) was recorded in 31 healthy preterms and 41 fullterm infants of 3, 6, or 12 months (corrected age for premature babies). Three visual stimulations varying in contrast and spatial frequency were presented to stimulate preferentially the M pathway, the P pathway, or both systems simultaneously during EEG recordings. Results from early visual evoked potentials in response to the stimulation that activates simultaneously both systems revealed longer N1 latencies and smaller P1 amplitudes in preterm infants compared to fullterms. Moreover, preterms showed longer N1 and P1 latencies in response to stimuli assessing the M pathway at 3 months. No differences between preterms and fullterms were found when using the preferential P system stimulation. In order to identify the cerebral generator of each visual response, distributed source analyses were computed in 12-month-old infants using LORETA. Source analysis demonstrated an activation of the parietal dorsal region in fullterm infants, in response to the preferential M pathway, which was not seen in the preterms. Overall, these findings suggest that the Magnocellular pathway development is affected in premature infants. Although our VEP results suggest that premature children overcome, at least partially, the visual developmental delay with time, source analyses reveal abnormal brain

  2. 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.

  3. Effects of the pacifier activated lullaby on weight gain of premature infants.

    PubMed

    Cevasco, Andrea M; Grant, Roy E

    2005-01-01

    Within the past 5 years there has been an increase of premature infants surviving in the neonatal intensive care unit as well as an increasing cost for each day the infant is kept there. It is important for the premature infant to acquire the feeding skills necessary for weight gain, which lead to discharge from the hospital, and recent advancements have indicated the effectiveness in using contingent music to teach sucking skills to premature infants. The purpose of the first analysis in this study was to determine the effects of Pacifier Activated Lullaby (PAL) trials on weight gain of premature infants. During a 2-year time period, 62 infants from a sample of 188 met criteria for analysis. A one-way analysis of variance showed no significance in daily weight gain for the number of PAL trials completed. The mean weight gains for infants with 1 PAL trial = 13.85 grams, 2 trials = 26.67, 3 trials = 29.64, and 4 or more = 22.89. The Pearson product-moment correlation between the mean percent of music earned via nonnutritive sucking (NNS) and mean weight gain of all trials approached significance (p = .077, r = 0.18). In a second analysis, weight gained prior to use of PAL, during use of PAL, and post use of PAL was analyzed. Results indicated no significant difference between weight gain 1 day prior to use of PAL, the day of PAL trial, and 1 day post use of PAL. Mean weight gain for those infants who participated in 1 PAL trial was 8.49 grams for 1 day prior to use of PAL, 18.73 the day of PAL trial, and 24.81 for 1 day post use of PAL. Mean weight gain for 3 days prior to using the PAL was 10.78, 11.30 on the day of PAL trial, and 24.78 grams for 3 days post PAL use. The analyses show definite trends of greater weight gain with PAL use; however, individual variability within groups was greater than group differences leading to no significance in statistical analysis. In the third analysis the effect of proximity between premature infants' feeding schedule and PAL

  4. Carnitine deficiency in premature infants receiving total parenteral nutrition: effect of L-carnitine supplementation.

    PubMed

    Schmidt-Sommerfeld, E; Penn, D; Wolf, H

    1983-06-01

    To investigate whether L-carnitine supplementation may correct nutritional carnitine deficiency and associated metabolic disturbances in premature infants receiving total parenteral nutrition, an intravenous fat tolerance test (1 gm/kg Intralipid over four hours) was performed in 29 premature infants 6 to 10 days of age (15 receiving carnitine supplement 10 mg/kg . day L-carnitine IV, and 14 receiving no supplement). Total carnitine plasma values were normal or slightly elevated in supplemented but decreased in nonsupplemented infants. In both groups, fat infusion resulted in an increase in plasma concentrations of triglycerides, free fatty acids, D-beta-hydroxybutyrate, and short-chain and long-chain acylcarnitine, but total carnitine values did not change. After fat infusion, the free fatty acids/D-beta-hydroxybutyrate ratios were lower and the increase of acylcarnitine greater in supplemented infants of 29 to 33 weeks' gestation than in nonsupplemented infants of the same gestational age. This study provides evidence that premature infants of less than 34 weeks' gestation requiring total parenteral nutrition develop nutritional carnitine deficiency with impaired fatty acid oxidation and ketogenesis. Carnitine supplementation improves this metabolic disturbance.

  5. Type 1 Retinopathy of Prematurity and Its Laser Treatment of Large Preterm Infants in East China

    PubMed Central

    Shan, Haidong; Ni, Yinqing; Xue, Kang; Yu, Jia; Huang, Xin

    2015-01-01

    Purpose To describe Type 1 retinopathy of prematurity (ROP) and its laser treatment outcomes in premature infants with birth weight > 1250 g in Eastern China. Methods A retrospective review of 3175 ROP records was conducted at Shanghai Eye & ENT Hospital of Fudan University. The records were collected at the ROP clinic from 2006 to 2014, including their demographic and medical information such as gestational age, birth weight, supplemental oxygen therapy, systemic complications, ROP stage, location, presence of plus disease. All infants were examined by RetCam fundus camera. Those with Type 1 ROP were also examined by indirect ophthalmoscope before undergoing transpupillary laser treatment. Results A total of 12 infants (24 eyes) with Type 1 ROP and birth weight > 1250 g were enrolled. All infants enrolled had plus disease and ROP in zone II retina. Specifically, 16 eyes (67%) had stage 2 ROP. 8 eyes (33%) had stage 3 ROP. ROP regressed in 23 eyes (96%) following laser treatment. Partial retinal detachment developed in one eye (4%). No severe involution sequelaes or laser-related complications were recorded. Mean follow-up was 30±6 weeks. Conclusion Type 1 ROP may occur in large premature infants who have undergone supplemental oxygen therapy. This Type 1 ROP is mainly located in zone II retina. Laser treatment is a safe and effective intervention for these infants. PMID:26674190

  6. Pyramidal tract abnormalities in the human fetus and infant with trisomy 18 syndrome.

    PubMed

    Miyata, Hajime; Miyata, Mio; Ohama, Eisaku

    2014-06-01

    Trisomy 18 or Edwards syndrome is known to exhibit various developmental abnormalities in the central nervous system. We report dominant uncrossed pyramidal tract in trisomy 18 syndrome, based on the postmortem neuropathologic study of eight consecutive autopsied fetuses and infants with trisomy 18 ranging in age from 16 to 39 weeks of gestation, including six males and two females, along with autopsy cases of a stillborn triploid infant with 69XXX and two stillborn infants without chromosomal or neurodevelopmental abnormalities. Five out of eight cases with trisomy 18 showed a larger proportion of uncrossed than crossed pyramidal tract. All of these cases were male, and the anterior corticospinal tract on one side was constantly larger than the contralateral lateral corticospinal tract in the spinal cord on both sides, while the pyramidal tract was hypoplastic in female cases with trisomy 18 and a case with 69XXX. Abnormal pyramidal decussation has been found in cases with posterior fossa malformations such as occipital encephaloceles, Dandy-Walker malformation, Joubert syndrome and Möbius syndrome, but has not been described in cases with trisomy 18. Our data, together with the previous reports describing uncrossed aberrant ipsilateral pyramidal tract in patients with congenital mirror movements caused by DCC gene mutation in chromosome 18, and hypolasia and hyperplasia of the pyramidal tract in X-linked recessive disorders caused by L1CAM and Kal1 gene mutations, respectively, suggest a role of trisomy 18 in association with X-chromosome in the abnormal development of the pyramidal tract.

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

    PubMed Central

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

    2015-01-01

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

  8. Behavioral and dermatologic changes and low serum zinc and copper concentrations in two premature infants after parenteral alimentation.

    PubMed

    Sivasubramanian, K N; Henkin, R I

    1978-11-01

    Two premature infants were observed to develop behavioral and dermatologic changes and low serum zinc and copper concentrations following cessation of prolonged parenteral alimentation, while being fed exclusively with human milk. Following treatment with exogenous oral zinc supplementation, prompt relief of symptoms and increases of serum zinc and copper concentrations were observed in both infants. These patients comprise about 5% of our premature infants who are treated with parenteral alimentation for more than two weeks. We recommend that premature infants on prolonged parenteral alimentation should be monitored for changes in serum zinc and copper concentrations and, if a marked fall is observed, supplementation should be considered.

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

    PubMed Central

    Ghorbani, Fatemeh; Asadollahi, Maliheh; Valizadeh, Sousan

    2013-01-01

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

  10. Evidence for the safety of ascorbic acid administration to the premature infant.

    PubMed

    Bass, W T; Malati, N; Castle, M C; White, L E

    1998-02-01

    Ascorbic acid (AA), a plasma antioxidant, is maintained at high levels in premature fetal blood and declines rapidly postpartum. The sudden reduction in blood AA levels secondary to premature delivery may increase the risk of oxidant injury, that is, bronchopulmonary dysplasia and intraventricular hemorrhage. There is concern that administration of AA to premature infants, in an effort to increase antioxidant capacity, may cause hemolysis. We felt that the benefits of early AA administration and prevention of the immediate postnatal drop in blood AA levels, might outweigh the risks of erthrocyte damage. Fifty one high-risk premature infants were randomized to receive either normal saline or 100 mg/kg of AA, daily for the first week of life. Double-blind comparisons were made of hemoglobin, hematocrit, erythrocyte morphology, bilirubin, number of blood transfusions and days of phototherapy, renal function tests, the incidence of infection, bronchopulmonary dysplasia, and intraventricular hemorrhage during the first month of life. The administration of AA prevented the immediate postnatal drop in AA and was not associated with evidence of increased hemolysis. No significant differences in renal function, rate of infection, bronchopulmonary dysplasia, or intraventricular hemorrhage were seen between the two groups. This study suggests that AA administration to the premature infant is safe and supports the designing and performance of larger clinical studies of the antioxidant properties of AA.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  12. Design of an Incubator for Premature Infant Based on LabVIEW.

    PubMed

    Zhang, Lina; Zhou, Runjing

    2005-01-01

    This paper introduces the system structure, hardware circuits, control algorithms, and software program of the incubator for premature infant based on LabVIEW. The main advantages of this device are that preheating is less time than others, the capability of meeting of emergency is provided, control track of temperature and humidity are visible, operation is easy to clinical practice, and maintainability is possessed.

  13. Cardiac and Behavioral Responsivity to Tactile Stimulation in Premature and Full-Term Infants

    ERIC Educational Resources Information Center

    Rose, Susan A.; And Others

    1976-01-01

    In this study, an attempt was made to determine whether psychophysiological differences existed between 20 prematurely born and 20 full-term infants in their responsiveness to tactile stimulation and in their ability to discriminate among different intensities of such stimulation. (Author/SB)

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  16. Therapeutic effects of music and mother's voice on premature infants.

    PubMed

    Standley, J M; Moore, R S

    1995-01-01

    Aversive environment auditory stimuli is a common concern in neonatal intensive care. Recently, interest has developed regarding the use of music applications to mask such stimuli and to reduce the high risk for complications or failure to thrive. In this study of 20 oxygenated, low birth weight infants in a Newborn Intensive Care Unit of a regional medical center in the Southeastern United States, 10 infants listened to lullabies and 10 infants to recordings of their mother's voice through earphones for 20 minutes across three consecutive days. Oxygen saturation levels and frequency of oximeter alarms were recorded. Results indicated a differential response to the two auditory stimuli as listening time progressed. On Day 1, the infants listening to music had significantly higher oxygen saturation levels, but these effects disappeared by Days 2 and 3. On Days 2 and 3, however, the babies hearing music had significantly depressed oxygen saturation levels during the posttest intervals after the music was terminated. Infants hearing music had significantly fewer occurrences of Oximeter alarms during auditory stimuli than did those listening to the mothers' voice. Implications for the therapeutic use of auditory stimuli in the Newborn Intensive Care Unit are discussed.

  17. [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.

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

    PubMed Central

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

    2014-01-01

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

  19. Factors Associated with Retinopathy of Prematurity in Hospitalized Preterm Infants in Sanandaj, Iran

    PubMed Central

    Mansouri, Majid; Hemmatpour, Sirous; Sedighiani, Fouzieh; Ghamari, Mojgan; Chavoshi, Delnia

    2016-01-01

    Introduction In the near future, retinopathy of prematurity (ROP) will be the most significant cause of blindness in upper and middle-income countries. Due to the increasing survival chances for premature and low birth weight infants and the importance of the diagnosis and treatment of ROP, this study was aimed at determining the prevalence of ROP and its related factors in Sanandaj, Iran, in 2014. Methods This cross-sectional study was performed on 47 preterm infants, weighing less than 2000 g or with a gestational age of less than of 34 weeks. The sampling method was census. From the first examination to 1 to 4 weeks later, until retinal vascularization completion, examinations were performed by the same ophthalmologist. Data were analyzed using SPSS version 20 and frequency, mean, SD and Chi-square tests. Results The prevalence of ROP in the infants was 10.6%. Prevalence among girls was 16% and among boys it was 4.5%. The results showed that 23.5% of infants with ROP needed mechanical ventilation. The difference between the two groups was statistically significant (p = 0.031). Conclusion In this study, the prevalence of ROP in the NICU and neonatal ward of Besat Hospital in Sanandaj was low. However, due to serious consequences of the disease in premature infants, timely screening, determination, and control of risk factors provided necessary support to manage the disease. PMID:27790346

  20. Schore's regulation theory: maternal-infant interaction in the NICU as a mechanism for reducing the effects of allostatic load on neurodevelopment in premature infants.

    PubMed

    Weber, Ashley M; Harrison, Tondi M; Steward, Deborah K

    2012-10-01

    Premature infants confront numerous physiologic and environmental stressors in the neonatal intensive care unit (NICU) that have the potential to permanently alter their neurodevelopment. Schore's regulation theory postulates that positive maternal-infant interactions can shape the infant's developmental outcomes through inducing mechanistic changes in brain structure and function. The purposes of this article are to explain the regulation of infant neurobiological processes during interactions between mothers and healthy infants in the context of Schore's theory, to identify threats to these processes for premature infants, and to propose principles of clinical practice and areas of research necessary to establish a supportive environment and prevent or reduce maladaptive consequences for these vulnerable infants. A premature birth results in the disruption of neurodevelopment at a critical time. Chronic exposure to stressors related to the NICU environment overwhelms immature physiologic and stress systems, resulting in significant allostatic load, as measured by long-term neurodevelopmental impairments in the premature infant. Positive maternal-infant interactions during NICU hospitalization and beyond have the potential to reduce neurologic deficits and maximize positive neurodevelopmental outcomes in premature infants. The quality of the maternal-infant interaction is affected not only by the infant's developing neurobiology but also by the mother's responses to the stressors surrounding a premature birth and mothering an infant in the NICU environment. Nurses can empower mothers to overcome these stressors, promote sensitive interactions with their infants, and facilitate neurodevelopment. Research is critically needed to develop and test nursing interventions directed at assisting mothers in supporting optimal neurodevelopment for their infants.

  1. The role of parenteral lipids in supporting gluconeogenesis in very premature infants.

    PubMed

    Sunehag, Agneta L

    2003-10-01

    We have previously demonstrated that very premature infants receiving glucose at 17 micromol/kg min plus appropriate supply of parenteral lipids (Intralipid) and amino acids (TrophAmine) maintained normoglycemia by glucose produced primarily via gluconeogenesis. The present study addressed the individual roles of parenteral lipids and amino acids in supporting gluconeogenesis. Fourteen premature infants (993 +/- 36 g 27 +/- 1 wk) (mean +/- SE) were studied for 8 h on d 5 +/- 1 of life. All infants were receiving standard TPN prior to the study. At start of study, the glucose infusion rate was decreased to approximately 17 micromol/kg min and either Intralipid (g + AA; n = 8) or TrophAmine (g + IL; n = 6) was discontinued. Data from 14 previously studied infants receiving glucose (approximately 17 micromol/kg min) + TrophAmine + Intralipid (g + AA + IL) are included for comparison. Gluconeogenesis was measured by [U-13 C]glucose, (g + AA) and (8 infants of the g + AA + IL group) or [2-13C]glycerol, (g + IL) and (6 infants of the g + AA + IL group). Infants studied by the same method were compared. Withdrawal of Intralipid resulted in decreased gluconeogenesis, 6.3 +/- 0.9 (g +AA) vs. 8.4 +/- 0.7 micromol/kg min (g + AA + IL) (p = 0.03). Withdrawal of TrophAmine affected neither total gluconeogenesis, 7.5 +/- 0.8 vs. 7.9 +/- 0.9 micromol/kg min nor gluconeogenesis from glycerol, 4.4 +/- 0.6 vs. 4.9 +/- 0.7 micromol/kg min (g+ IL and g + AA + IL groups, respectively). In conclusion, in parenterally fed very premature infants, lipids play a primary role in supporting gluconeogenesis.

  2. Premature singleton versus a twin or triplet infant death: parental adjustment studied through a personal interview.

    PubMed

    Netzer, D; Arad, I

    1999-12-01

    Parental adjustment following the death of a premature singleton or multiple birth infant has hitherto been studied by mailed questionnaires or telephone survey. In the present study, using an in-depth personal interview, grief reactions and adjustment patterns of nine families who lost a singleton premature infant ('Single Group') were compared with those of nine families who lost one of a premature multiple birth cohort ('Multiple Group'). The interview was conducted 1-4 years after the death of the infant and evaluated specific areas or 'scales' of life adjustment, including individual feelings, relationship between husband and wife, and functioning at home and at work. There was no significant difference between the paternal and maternal level of adjustment of the two groups in any of the studied scales. A positive correlation was found between maternal and paternal grief reaction of the same family in the scales of individual feelings (r = 0.65), relationships between husband and wife (r = 0.70), and functioning at home (r = 0.57). Comparing the father's scale with the mother's scale revealed a significant difference only in the area of 'individual feelings'. The gestational age, maternal bonding during hospitalisation of the infant and the parental attendance at the event of death were significantly associated with the process of parental adjustment. The results of this study support previous reports of similar parental reactions following the demise of a premature singleton or multiple birth infant. Since societal environment may not recognise the need for consolation of these families, care, compassion, and sensitivity should be encouraged in dealing with these parents at the time of their infant' death, and for a long time thereafter.

  3. Music modulates behaviour of premature infants following heel lance.

    PubMed

    Butt, M L; Kisilevsky, B S

    2000-03-01

    The physiological and behavioural effects of music during recovery from heel lance were examined in 14 preterm infants at 29 to 36 weeks post-conceptual age (PCA). Infants were tested on 2 occasions: during a music condition and during a no-music control condition. Each condition was videotaped during 3 periods: baseline, heel lance, and recovery. Infants were divided into 2 age groups for data analyses: less than and greater than 31 weeks PCA. Mixed model ANOVAs showed that heel lance elicited a stress response (i.e., increased heart rate, decreased oxygen saturation, increased state-of-arousal, and increased facial actions indicative of pain) in both age groups. The stress response was greater in the older group. During recovery, the older group had a more rapid return of heart rate, behavioural state, and facial expressions of pain to baseline levels in the presence of compared to the absence of music. It was concluded that music is an effective NICU intervention following a stress-provoking stimulus in infants older than 31 weeks PCA.

  4. Reevaluation of the DHA requirement for the premature infant

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed

    Bernick, Steven J; Kane, Sunanda

    2012-07-01

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

  6. Supporting parents' decision making surrounding the anticipated birth of an extremely premature infant.

    PubMed

    Kavanaugh, Karen; Moro, Teresa T; Savage, Teresa A; Reyes, Maria; Wydra, Marguerite

    2009-01-01

    Parents who are at risk for giving birth to an extremely premature infant, defined as 22 to 25 weeks' gestation, can find themselves faced with urgent treatment decisions for their unborn infant that have life-altering consequences. Despite the recommendation for involving parents in decision making for these infants, there is limited evidence regarding guidelines for involving parents. In this article, we describe a case from a larger collective case study that examines the decision making and the decision support needs of parents regarding life support decisions made over time (prenatally and postnatally) for extremely premature infants from the perceptions of parents, physicians, and nurses. For this case study, we describe decisions that were made during the antenatal hospitalization of the mother whose infant was stillborn, the support the parents received, and advice for healthcare professionals for improving care to families. For this case, the mother and father, a physician, and 2 nurses were interviewed before the birth of the infant. The findings in this case study demonstrate the importance of the nurse being present when information is given to parents, of informing with compassion, and helping parents to understand treatment options and decisions.

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

    PubMed Central

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

    2016-01-01

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

  8. 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

  9. Low-dose mercury exposure in early life: relevance of thimerosal to fetuses, newborns and infants.

    PubMed

    Dórea, José G

    2013-01-01

    This review explores the different aspects of constitutional factors in early life that modulate toxicokinetics and toxicodynamics of low-dose mercury resulting from acute ethylmercury (etHg) exposure in Thimerosal-containing vaccines (TCV). Major databases were searched for human and experimental studies that addressed issues related to early life exposure to TCV. It can be concluded that: a) mercury load in fetuses, neonates, and infants resulting from TCVs remains in blood of neonates and infants at sufficient concentration and for enough time to penetrate the brain and to exert a neurologic impact and a probable influence on neurodevelopment of susceptible infants; b) etHg metabolism related to neurodevelopmental delays has been demonstrated experimentally and observed in population studies; c) unlike chronic Hg exposure during pregnancy, neurodevelopmental effects caused by acute (repeated/cumulative) early life exposure to TCV-etHg remain unrecognized; and d) the uncertainty surrounding low-dose toxicity of etHg is challenging but recent evidence indicates that avoiding cumulative insults by alkyl-mercury forms (which include Thimerosal) is warranted. It is important to a) maintain trust in vaccines while reinforcing current public health policies to abate mercury exposure in infancy; b) generally support WHO policies that recommend vaccination to prevent and control existing and impending infectious diseases; and c) not confuse the 'need' to use a specific 'product' (TCV) by accepting as 'innocuous' (or without consequences) the presence of a proven 'toxic alkyl-mercury' (etHg) at levels that have not been proven to be toxicologically safe.

  10. Factors influencing plasma renin and renin substrate in premature infants.

    PubMed Central

    Stephenson, T J; Broughton Pipkin, F; Elias-Jones, A C

    1991-01-01

    Concentrations of plasma renin (PRC) and plasma renin substrate (PRS) were measured during the first week of life in 52 infants born at less than 37 weeks' gestation (mean (SEM) gestation 30 (0.4) weeks, mean (SEM) birth weight 1.35 (0.08) kg). Both PRC (median 35, interquartiles 16.3, 94.5 ng/ml/hour) and PRS (median 2.3, interquartiles 1.3, 5.0 micrograms/ml) were raised compared with adults. The proportional rise in PRC was much greater than that in PRS, suggesting that PRS may be rate limiting in the generation of angiotensin I. Log10 PRC was inversely proportional to gestational age and a high urinary sodium loss was associated with a significantly raised log10 PRC. In hypoxaemic infants, there was a strong correlation between log10 PRS and haemoglobin concentration; this is a new observation in human infants but consistent with data available from other species. PMID:1750766

  11. Changes in heart rate variability in a premature infant with hydrocephalus.

    PubMed

    Uhrikova, Zuzana; Kolarovszki, Branislav; Javorka, Kamil; Javorka, Michal; Matasova, Katarina; Kolarovszka, Hana; Zibolen, Mirko

    2012-11-01

    Objective To define changes of heart rate variability in premature infant with hydrocephalus before and after drainage procedure. Study Design The authors report a case of a premature infant with hydrocephalus with analysis of heart rate variability before and after drainage procedure. Three subsequent recordings of the electrocardiography and heart rate variability were done: the first at the age of 22 days before insertion of ventriculoperitoneal shunt, the second at the age of 36 days with functional shunt, the third at the age of 71 days (before discharge). Results Before drainage operation, there was reduced heart rate variability in time and spectral domains, and sympathetic activity was dominant. After surgery, an increase in heart rate variability parameters was found, particularly with spectral analysis. The ratio of low-frequency/high-frequency band and relative power of the low-frequency band decreased, reflecting enhanced parasympathetic activity. Conclusion Results of the heart rate variability analysis in a preterm infant with hydrocephalus before and after drainage procedure showed marked improvement in chronotropic cardiac regulation. Evaluation of heart rate variability in premature infants with hydrocephalus with increased intracranial pressure can be an additional method for monitoring of cardiac dysregulation and improvement of the cardiovascular control after successful drainage procedure.

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

    PubMed

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

    2012-11-01

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

  13. Baseline values of candidate urine acute kidney injury biomarkers vary by gestational age in premature infants.

    PubMed

    Askenazi, David J; Koralkar, Rajesh; Levitan, Emily B; Goldstein, Stuart L; Devarajan, Prasad; Khandrika, Srikrishna; Mehta, Ravindra L; Ambalavanan, Namasivayam

    2011-09-01

    Acute kidney injury (AKI) is common in premature infants and is associated with poor outcomes. Novel biomarkers can detect AKI promptly. Because premature infants are born with underdeveloped kidneys, baseline biomarker values may differ. We describe baseline values of urinary neutrophil gelatinase-associated lipocalin (NGAL), IL-18, kidney injury molecule-1 (KIM-1), osteopontin (OPN), beta-2 microglobulin (B2mG), and Cystatin-C (Cys-C). Next, we test the hypothesis that these biomarkers are inversely related to GA. Candidate markers were compared according to GA categories in 123 infants. Mixed linear regression models were performed to determine the independent association between demographics/interventions and baseline biomarker values. We found that urine NGAL, KIM-1, Cys-C, and B2mG decreased with increasing GA. With correction for urine creatinine (cr), these markers and OPN/cr decreased with increasing GA. IL-18 (with or without correction for urine creatinine) did not differ across GA categories. Controlling for other potential clinical and demographic confounders with regression analysis shows that NGAL/cr, OPN/cr, and B2mG/cr are independently associated with GA. We conclude that urine values of candidate AKI biomarkers are higher in the most premature infants. These findings should be considered when designing and analyzing biomarker studies in newborn with AKI.

  14. Changes in Heart Rate Variability in a Premature Infant with Hydrocephalus

    PubMed Central

    Uhrikova, Zuzana; Kolarovszki, Branislav; Javorka, Kamil; Javorka, Michal; Matasova, Katarina; Kolarovszka, Hana; Zibolen, Mirko

    2012-01-01

    Objective To define changes of heart rate variability in premature infant with hydrocephalus before and after drainage procedure. Study Design The authors report a case of a premature infant with hydrocephalus with analysis of heart rate variability before and after drainage procedure. Three subsequent recordings of the electrocardiography and heart rate variability were done: the first at the age of 22 days before insertion of ventriculoperitoneal shunt, the second at the age of 36 days with functional shunt, the third at the age of 71 days (before discharge). Results Before drainage operation, there was reduced heart rate variability in time and spectral domains, and sympathetic activity was dominant. After surgery, an increase in heart rate variability parameters was found, particularly with spectral analysis. The ratio of low-frequency/high-frequency band and relative power of the low-frequency band decreased, reflecting enhanced parasympathetic activity. Conclusion Results of the heart rate variability analysis in a preterm infant with hydrocephalus before and after drainage procedure showed marked improvement in chronotropic cardiac regulation. Evaluation of heart rate variability in premature infants with hydrocephalus with increased intracranial pressure can be an additional method for monitoring of cardiac dysregulation and improvement of the cardiovascular control after successful drainage procedure. PMID:23946905

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

    PubMed Central

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

    2014-01-01

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

  16. [Effect of gentle nursing care of premature infants on bonding and emotional development of the child. Follow-up of premature infants in Dr. Marina Marcovich's study].

    PubMed

    Huter, Beate Marina

    2003-06-01

    The study was set out to investigate whether the Marcovich model of a "soft treatment" of premature infants encourages the parent-infant-relationship to such an extent that, at school age, the Marcovich-children would be found to differ significantly from children treated with standard care with regard to the quality of their attachment and the prevalence of emotional and behavioural disorders. The Marcovich-children of the present sample had been discharged from hospital much earlier than the standard group, they were less frequently treated with artificial respiration, infant-parent body contact was encouraged significantly earlier, and, although they were less frequently breast-fed, those who were breast-fed were allowed to do so at a much earlier stage. The Marcovich-children were found to display higher social competence, more emotional openness, more emotional coherence, less dismissal of attachment and less preoccupied anger. The two samples did not differ with regard to their total attachment quality as well as their emotional and behavioural problems. The fact that no significant differences could be established with regard to the quality of the attachment suggests that the complex life-saving attachment system is not irreversibly affected by the early separation and distress and that the months and years after the hospital stay have the power to make up with any experienced trauma. It seems, however, that special aspects of the attachment system, such as the communication and interaction, are positively encouraged and enhanced by the soft treatment of the premature infant, which leads to greater emotional openness and social competence, as well as less preoccupied anger against the attachment figures.

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

    SciTech Connect

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

    2014-10-15

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

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

    PubMed Central

    Hao, Haiping; Rivkees, Scott A.

    1999-01-01

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

  19. [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.

  20. Deficits in Top-Down Sensory Prediction in Infants At Risk due to Premature Birth.

    PubMed

    Emberson, Lauren L; Boldin, Alex M; Riccio, Julie E; Guillet, Ronnie; Aslin, Richard N

    2017-02-06

    A prominent theoretical view is that the brain is inherently predictive [1, 2] and that prediction helps drive the engine of development [3, 4]. Although infants exhibit neural signatures of top-down sensory prediction [5, 6], in order to establish that prediction supports development, it must be established that deficits in early prediction abilities alter trajectories. We investigated prediction in infants born prematurely, a leading cause of neuro-cognitive impairment worldwide [7]. Prematurity, independent of medical complications, leads to developmental disturbances [8-12] and a broad range of developmental delays [13-17]. Is an alteration in early prediction abilities the common cause? Using functional near-infrared spectroscopy (fNIRS), we measured top-down sensory prediction in preterm infants (born <33 weeks gestation) before infants exhibited clinically identifiable developmental delays (6 months corrected age). Whereas preterm infants had typical neural responses to presented visual stimuli, they exhibited altered neural responses to predicted visual stimuli. Importantly, a separate behavioral control confirmed that preterm infants detect pattern violations at the same rate as full-terms, establishing selectivity of this response to top-down predictions (e.g., not in learning an audiovisual association). These findings suggest that top-down sensory prediction plays a crucial role in development and that deficits in this ability may be the reason why preterm infants experience altered developmental trajectories and are at risk for poor developmental outcomes. Moreover, this work presents an opportunity for establishing a neuro-biomarker for early identification of infants at risk and could guide early intervention regimens.

  1. Increased serum levels of interleukin 6 are associated with severe intraventricular haemorrhage in extremely premature infants

    PubMed Central

    Heep, A; Behrendt, D; Nitsch, P; Fimmers, R; Bartmann, P; Dembinski, J

    2003-01-01

    Background: Intraventricular haemorrhage (IVH) and periventricular leucomalacia (PVL) in premature infants presumably have many causes. It has been proposed that inflammatory processes in the fetomaternal unit play an important role in the pathogenesis of these lesions. Objective: To study the correlation of postpartum serum interleukin 6 (IL6) concentration as a marker of inflammation and neonatal cerebral morbidity in preterm infants < 28 weeks of gestational age. Methods: A total of 88 infants were grouped according to maximum serum IL6 levels within 12 hours post partum: group A (n = 50), ⩽ 100 pg/ml; group B (n = 38), > 100 pg/ml. Ultrasound studies and clinical assessment were performed routinely. Results: IVH was noted significantly more often in group B (24/38; 63%) than in group A (19/50; 38%) (p = 0.02). In a multiple logistic regression model, raised serum IL6 independently predicted development of severe IVH (odds ratio 8.4; 95% confidence interval 2.85 to 24.9; p = 0.0001). Conclusions: Raised serum IL6 may serve as a marker for severe IVH in infants < 28 weeks of gestational age. Although cerebral morbidity in premature infants is determined by different variables, the identification of systemic inflammation can help to define the need for anti-inflammatory strategies to prevent cerebral morbidity. PMID:14602698

  2. Challenges in delivering peritoneal dialysis to a premature infant.

    PubMed

    Hebert, A M

    1997-02-01

    The proposed outcomes for C.Q. were achieved. Communication between dietician, neonatal intensive care and pediatric nursing staff, pediatric nephrology nurses and physicians played a critical role in providing optimal care for C.Q. Due to her multiple problems, it was imperative that all disciplines collaborate and coordinate their care. The meticulous supervision by the staff nurses allowed this tiny patient to overcome her multiple problems. Careful follow-up included monitoring nutritional markers, laboratory results, and adequacy of dialysis. It is also important to note that open communication by the nephrology nurses allows small patients like C.Q. to have enhanced quality of life at home with their families. C.Q. is now a thriving infant, cared for by her mother at home.

  3. [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.

  4. [Parents' grief at the loss of a premature infant and approaches to their care].

    PubMed

    Liu, Hsiu-Mei

    2007-10-01

    The more than 3,000 deaths of premature infants due to low weight in Taiwan cause deep personal grief in their parents, for whom there is no pain greater than losing a child. This loss, nearly always sudden and unexpected, is an issue often ignored by clinic nursing staff. The purpose of this paper was to consider various grief counseling theories in order to help nurses attend to the grief counseling needs of parents who lose a premature infant. Better understanding of parents' grief responses by nursing staffs will help nurses to accept and address such. Grief processes identified include: shock and numbness, searching and yearning, disorientation and reorganization. Grief responses include: feel, physiology and sense organs, cognition and behavior. The four tasks essential to grief recovery include: to accept the reality of the loss, to work through the pain of grief, to adjust to an environment in which the deceased is missing, and to emotionally relocate the deceased and move on with life. Coaching through grief counseling theory puts forward and looks after concrete measures, and provides three suggestions for the parents who lose a premature infant. These can be used as reference by clinical staffs, help promote nursing staff understanding of this topic, help improve care for grieving parents and improve care quality.

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

    PubMed Central

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

    2014-01-01

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

  6. Higher limb asymmetry in deceased human fetuses and infants with aneuploidy.

    PubMed

    Bots, Jessica; ten Broek, Clara M A; Belien, Jeroen A M; Bugiani, Marianna; Galis, Frietson; Van Dongen, Stefan

    2014-01-15

    Aneuploidies cause gene-dosage imbalances that presumably result in a generalized decreased developmental homeostasis, which is expected to be detectable through an increase in fluctuating asymmetry (FA) of bilateral symmetric traits. However, support for the link between aneuploidy and FA is currently limited and no comparisons among different aneuploidies have been made. Here, we study FA in deceased human fetuses and infants from a 20-year hospital collection. Mean FA of limb bones was compared among groups of aneuploidies with different prenatal and postnatal survival chances and two reference groups (normal karyogram or no congenital anomalies). Limb asymmetry was 1.5 times higher for aneuploid cases with generally very short life expectancies (trisomy 13, trisomy 18, monosomy X, triploidy) than for trisomy 21 patients and both reference groups with higher life expectancies. Thus, FA levels are highest in groups for which developmental disturbances have been highest. Our results show a significant relationship between fluctuating asymmetry, human genetic disorders and severity of the associated abnormalities.

  7. TAC-TIC therapy with premature infants: a series of investigative studies.

    PubMed

    de Róiste, Aine

    2004-12-01

    This article provides a synopsis of a series of studies exploring the effects of TAC-TIC (Touching And Caressing-Tender In Caring) therapy with premature infants. Study 1 looked at the short and long-term effects and found enhanced mental development in the stroked infants at 15 months. In study 2 the physiological effects of an abbreviated version of TAC-TIC with high-risk ventilated infants were examined and it was concluded that TAC-TIC exerted no harm to these vulnerable infants. The behavioural reactions of a sample of premature and low birthweight infants to TAC-TIC and parental responses to administering it were explored in study 3. The infants were found to respond predominantly with arm and leg movements to TAC-TIC while fathers and mothers reported enjoying performing TAC-TIC and elicited a similar pattern and frequency of behavioural reactions. In study 4 the question of whether TAC-TIC benefits preterm infant learning and/or sucking behaviour was investigated. The conclusion reached was that TAC-TIC may potentially benefit cognitive performance within the neonatal period and that this may be an early indicator of long-term cognitive gains reported by previous studies. Using a matched subjects design, study 5 explored the impact of TAC-TIC upon the digestive system by analysing gastric aspirates before and after TAC-TIC and a control period of time. It was concluded that TAC-TIC appeared to induce a more suitable stomach environment for digestion.

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

    PubMed

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

    2002-03-01

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

  9. Intravitreal Injection of Bevacizumab for Retinopathy of Prematurity in an Infant with Peters Anomaly

    PubMed Central

    Minami, Tsuyoshi; Kuniyoshi, Kazuki; Kusaka, Shunji; Sugioka, Koji; Sakuramoto, Hiroyuki; Sakamoto, Masuo; Izu, Akane; Wada, Norihisa; Shimomura, Yoshikazu

    2014-01-01

    Purpose To report our findings in an infant with Peters anomaly type II whose retinopathy of prematurity (ROP) was treated with an anti-VEGF agent and surgeries. Case Report A male infant weighing 548 g was born prematurely at 23 weeks and 1 day with corneal opacity and shallow anterior chambers in both eyes. At the postmenstrual age of 35 weeks and 3 days, the infant was tentatively diagnosed with stage 3 ROP because of a dilated tunica vasculosa lentis and ultrasonographic findings. The boy was treated with bilateral intravitreal injections of bevacizumab (IVB) because laser photocoagulation of the retina could not be performed due to the corneal opacity. The retina in the right eye detached 3 times, namely 5 days, 16 days, and 7 months after the IVB; encircling the scleral buckle and a vitrectomy with endolaser photocoagulation were therefore required. In his left eye, the retina was reattached after the initial IVB, and no additional treatment was required. ROP was not reactivated in both eyes until the last examination at the age of 2 years and 6 months. Conclusions Our results showed that IVB is a useful treatment for ROP in patients with Peters anomaly. However, a retinal detachment can be a complication after IVB. The optimal timing of IVB for ROP in infants with hazy media needs to be determined. PMID:25408672

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

    PubMed Central

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

    2014-01-01

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

  11. The effect of music reinforcement for non-nutritive sucking on nipple feeding of premature infants.

    PubMed

    Standley, Jayne M; Cassidy, Jane; Grant, Roy; Cevasco, Andrea; Szuch, Catherine; Nguyen, Judy; Walworth, Darcy; Procelli, Danielle; Jarred, Jennifer; Adams, Kristen

    2010-01-01

    In this randomized, controlled multi-site study, the pacifier-activated-lullaby system (PAL) was used with 68 premature infants. Dependent variables were (a) total number of days prior to nipple feeding, (b) days of nipple feeding, (c) discharge weight, and (d) overall weight gain. Independent variables included contingent music reinforcement for non-nutritive sucking for PAL intervention at 32 vs. 34 vs. 36 weeks adjusted gestational age (AGA), with each age group subdivided into three trial conditions: control consisting of no PAL used vs. one 15-minute PAL trial vs. three 15-minute PAL trials. At 34 weeks, PAL trials significantly shortened gavage feeding length, and three trials were significantly better than one trial. At 32 weeks, PAL trials lengthened gavage feeding. Female infants learned to nipple feed significantly faster than male infants. It was noted that PAL babies went home sooner after beginning to nipple feed, a trend that was not statistically significant.

  12. The effect of music-reinforced nonnutritive sucking on feeding rate of premature infants.

    PubMed

    Standley, Jayne M

    2003-06-01

    Premature infants are fed by gavage tube before 34 weeks adjusted gestational age and when nipple feeding results in detrimental changes in respiration and heart rate. Nipple feeding skill must be developed and correlates with length of hospitalization and neurobehavioral development. This study provided music reinforcement for nonnutritive sucking and assessed nipple feeding rates pre- and posttreatment for 32 infants referred as poor feeders. A pacifier fitted with a pressure transducer activated 10 seconds of recorded music in a one-trial, 15-minute intervention given to experimental infants (n = 16) 30 to 60 minutes before the late afternoon bottle feeding. Feeding rates were collected for bottle feedings pre- and postintervention and for a similar interval for a no-contact control group (n = 16). Results showed that the intervention significantly increased feeding rates. Music functioned as reinforcement and the sucking behavior transferred from a nonnutritive to a nutritive event.

  13. The contribution of salivary amylase to glucose polymer hydrolysis in premature infants.

    PubMed

    Murray, R D; Kerzner, B; Sloan, H R; McClung, H J; Gilbert, M; Ailabouni, A

    1986-02-01

    To determine whether salivary amylase of premature infants can function as a surrogate for pancreatic amylase, we evaluated its production in the infant, acid resistance, and hydrolytic potency in a simulated oropharyngeal, gastric, and intestinal environment. The activity of salivary amylase in 11 prematures varied between 1 and 33 U/ml; the isozymic profile and acid resistance of the premature salivary amylase were identical to those of the enzyme of adults. A "modular" formula containing 7 g/dl of a 14C labeled long chain glucose polymer with degrees of polymerization ranging between 18 and 29 glucose units was prepared. Salivary amylase, 1.1 U/ml, was added to this formula. The progressive breakdown of the 14C polymers as the milk was subjected to oropharyngeal, gastric, and intestinal phase environments was evaluated by quantifying the liberation of short-chain oligomers from the 14C labeled substrates. The gastric pH was varied between 2 and 5 and the gastric incubation time was either 5 or 180 min. Substantial gastric phase breakdown only occurred after 3 h of exposure at the higher pHs of 4 (12%) and 5 (32%). During the intestinal phase, salivary amylase activity resumed. Prior gastric phase pH affected ultimate intestinal phase breakdown, p less than 0.001; after 5-min gastric phases at pHs ranging from 2 to 5, the intestinal phase breakdown ranged from 17 to 55%. We conclude that the limited salivary amylase in the saliva of premature infants can produce significant glucose polymer digestion in both the stomach and small intestine but the digestion falls substantially short of that accomplished by usual concentrations of pancreatic amylase.

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

    PubMed Central

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

    2013-01-01

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

  15. Comparison of the effect of two human milk fortifiers on clinical outcomes in premature infants.

    PubMed

    Thoene, Melissa; Hanson, Corrine; Lyden, Elizabeth; Dugick, Laura; Ruybal, Leslie; Anderson-Berry, Ann

    2014-01-03

    The use of human milk fortifiers (HMF) helps to meet the high nutritional requirements of the human milk-fed premature infant. Previously available powdered products have not met the protein requirements of the preterm infant population and many neonatologists add powder protein modulars to help meet protein needs. The use of powdered products is discouraged in neonatal intensive care units (NICU) due to concern for invasive infection. The use of a commercially available acidified liquid product with higher protein content was implemented to address these two concerns. During the course of this implementation, poor growth and clinically significant acidosis of infants on Acidified Liquid HMF (ALHMF) was observed. The purpose of this study was to quantify those observations by comparing infant outcomes between groups receiving the ALHMF vs. infants receiving powdered HMF (PHMF). A retrospective chart review compared outcomes of human milk-fed premature infants<2000 g receiving the ALHMF (n=23) and the PHMF (n=46). Infant growth, enteral feeding tolerance and provision, and incidence of necrotizing enterocolitis (NEC), metabolic acidosis, and diaper dermatitis were compared between the two groups. No infants were excluded from this study based on acuity. Use of ALHMF resulted in a higher incidence of metabolic acidosis (p=0.002). Growth while on HMF as measured in both g/kg/day (10.59 vs. 15.37, p<0.0001) and in g/day (23.66 vs. 31.27, p=0.0001) was slower in the ALHMF group, on increased mean cal/kg/day (128.7 vs. 117.3, p=0.13) with nearly twice as many infants on the ALHMF requiring increased fortification of enteral feedings beyond 24 cal/ounce to promote adequate growth (48% vs. 26%, p=0.10). Although we were not powered to study NEC as a primary outcome, NEC was significantly increased in the ALHMF group. (13% vs. 0%, p=0.03). Use of a LHMF in an unrestricted NICU population resulted in an increase in clinical complications within a high-acuity NICU, including

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  17. 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.

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

    ERIC Educational Resources Information Center

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

    2002-01-01

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

  19. The effects of earmuff on physiologic and motor responses in premature infants admitted in neonatal intensive care unit

    PubMed Central

    Abdeyazdan, Zahra; Ghassemi, Sara; Marofi, Maryam

    2014-01-01

    Background: Continuous high-intensity noise in the Neonatal Intensive Care Unit (NICU) is stressful for premature infants and its reduction is considered as a nursing care. This study aimed to evaluate the effects of earmuffs’ use on the physiologic and motor responses of premature infants. Materials and Methods: This is a clinical trial conducted on 64 premature infants admitted to the NICU, who met the inclusion criteria, and were randomly assigned to study and control groups. Earmuffs were used for premature infants for 2 h in the morning and 2 h in the afternoon for two consecutive days to reduce the noise intensity in the busiest time of the NICU. The group with earmuff (study group) was compared with the control group receiving only routine care. Infants’ physiologic and motor responses were observed before, during, immediately, and 1 h after the intervention. Analysis of covariance and repeated measure analysis of variance (ANOVA) were used to analyze the data. Results: When infants wore the earmuffs, they had significantly higher mean arterial oxygen saturation, the less frequent motor response, and a decrease in their pulse and respiratory rate. Conclusion: Paying attention to environmental noise can help the patients, especially the neonates in the NICU, and can be considered as a nursing care. Wearing earmuffs can protect premature infants against noise in the NICU and improve their physiological and motor state. PMID:24834077

  20. Telemedicine based screening of infants at risk for retinopathy of prematurity.

    PubMed

    Lorenz, B; Bock, M; Müller, H M; Massie, N A

    1999-01-01

    Retinopathy of Prematurity (ROP) is a major risk for permanent visual loss in extreme prematures. In stage 3+ (zone I and II), defined as threshold disease, the risk for retinal detachment with subsequent blindness is about 50% without treatment, compared to only a few percent with laser photoablation. Visualisation and interpretation of the critical retinal changes requires a high degree of expertise. Therefore, screening by general ophthalmologists will not identify all cases at threshold necessary to prevent blindness in as many infants as possible. The development of a new digital wide-field camera system (RetCam 120) allows documentation of nearly the entire retina within minutes. Recently, sensitivity, specificity, positive predictive power and negative predictive power have been evaluated to be high. Data collection is also possible by trained staff of the neonatal care units. Data can be transferred electronically, even though it could be transferred through physical transport. Analyzing the data in a central reading center specialized in the treatment of ROP will allow optimal timing of treatment and thus salvage vision in more infants. In addition, unnecessary referrals that are not only expensive but put also stress on the very vulnerable prematures can be avoided. At present, efforts are made to realize a pilot project in Eastern Bavaria that will test the potentials of telemedicine based screening for ROP. In addition, the potential of the system will be evaluated in other neuroophthalmological diseases.

  1. Pathogenesis and therapy of non-oliguric hyperkalaemia of the premature infant.

    PubMed

    Mildenberger, Eva; Versmold, Hans T

    2002-08-01

    Non-oliguric hyperkalaemia is a common and serious complication of extreme prematurity, resulting from a potassium loss from the intra- into the extracellular space during a specific post-natal period. Treatment of this disorder has been adapted from the treatment of hyperkalaemia in renal failure, an entity of completely different pathophysiology. A few years ago, the administration of salbutamol, which induces cellular potassium uptake, was proposed as a new therapeutic option. In this review article we discuss the pathogenesis and current therapy of non-oliguric hyperkalaemia of the premature infant, with special emphasis on the presently available knowledge and concerns with regard to the use of salbutamol. Being aware of the paucity of studies on non-oliguric hyperkalaemia, we propose treatment recommendations which are based on best available evidence. These comprise the administration of calcium, infusion of insulin plus glucose, correction of acidosis, and exchange transfusion or peritoneal dialysis as a last resort therapy. Before controlled trials on efficacy of salbutamol treatment of non-oliguric hyperkalaemia of the premature infant can be initiated, more data on safety are needed.

  2. [Pharmacokinetic and clinical studies of latamoxef (moxalactam) in neonates and premature infants].

    PubMed

    Fujii, R; Hashira, S; Takimoto, M; Oka, T; Yoshioka, H; Tsuchida, A; Sanae, N; Maruyama, S; Tojo, M; Sunakawa, K

    1984-06-01

    Studies were carried out on the in vivo kinetics and clinical efficacy of latamoxef (LMOX) in neonates and premature infants. The results are summarized below. Serum concentration and T1/2 following intravenous injection of LMOX to neonates LMOX was intravenously administered to neonates as one shot doses of 10 mg/kg and 20 mg/kg. The serum concentration of LMOX showed a dose-response to the 10 and 20 mg/kg doses in each of the 0--3 day-old group, 4--7 day-old group and 8--28 day-old group. The T 1/2 values were as follows; for the 10 mg/kg dose, 5.17 hours in the 0--3 day-old group, 3.28 hours in the 4--7 day-old group and 2.79 hours in the 8--28 day-old group; for the 20 mg/kg dose, 5.58 hours in the 0--3 day-old group, 3.46 hours in the 4--7 day-old group and 3.14 hours in the 8--28 day-old group. Thus, it is seen that the half-life of both dosages decreased as the infants became older. Serum concentration and T 1/2 following intravenous injection of LMOX to premature infants Similar to the case of neonates described above, the concentration of LMOX in the serum of the premature infants showed a dose-response to the 10 mg/kg and 20 mg/kg dosages. The T 1/2 values for the 0--3, 4--7 day-old and 8--28 day-old groups were 7.54, 3.93 hours and 6.25 hours, respectively, for the 10 mg/kg dose, and 10.8, 4.05 hours and 3.23 hours, respectively, for the 20 mg/kg dose. Again, it is seen that the half-life of both dosages decreased as the age of the prematurely-born infants increased. Serum concentration and T1/2 following 1-hour intravenous drip infusion of LMOX to neonates LMOX was administered to neonates in doses of 10 mg/kg and 20 mg/kg, by i.v. drip infusion over a 1-hour period. With both dosages, the peak serum concentration of LMOX occurred at the time of completion of the infusion. The T1/2 values for the 0--3, 4--7 day-old and 8--28 day-old groups were 5.41, 3.68 hours and 1.92 hours, respectively, for the 10 mg/kg dose, and 5.31, 2.67 hours and 4.86 hours

  3. Determinants of Indices of Cerebral Volume in Former Very Premature Infants at Term Equivalent Age

    PubMed Central

    Wirth, Maelle

    2017-01-01

    Conventional magnetic resonance imaging (MRI) at term equivalent age (TEA) is suggested to be a reliable tool to predict the outcome of very premature infants. The objective of this study was to determine simple reproducible MRI indices, in premature infants and to analyze their neonatal determinants at TEA. A cohort of infants born before 32 weeks gestational age (GA) underwent a MRI at TEA in our center. Two axial images (T2 weighted), were chosen to realize nine measures. We defined 4 linear indices (MAfhlv: thickness of lateral ventricle; CSI: cortex-skull index; VCI: ventricular-cortex index; BOI: bi occipital index) and 1 surface index (VS.A: volume slice area). Perinatal data were recorded. Sixty-nine infants had a GA (median (interquartile range)) of 30.0 weeks GA (27.0; 30.0) and a birth weight of 1240 grams (986; 1477). MRI was done at 41.0 (40.0; 42.0) weeks post menstrual age (PMA). The inter-investigator reproducibility was good. Twenty one MRI (30.5%) were quoted abnormal. We observed an association with retinopathy of prematurity (OR [95CI] = 4.205 [1.231–14.368]; p = 0.017), surgery for patent ductus arteriosus (OR = 4.688 [1.01–21.89]; p = 0.036), early onset infection (OR = 4.688 [1.004–21.889]; p = 0.036) and neonatal treatment by cefotaxime (OR = 3.222 [1.093–9.497]; p = 0.03). There was a difference for VCI between normal and abnormal MRI (0.412 (0.388; 0.429) vs. 0.432 (0.418; 0.449); p = 0,019); BOI was higher when fossa posterior lesions were observed; VS.A seems to be the best surrogate for cerebral volume, 80% of VS.As’ variance being explained by a multiple linear regression model including 7 variables (head circumference at birth and at TEA, PMA, dopamine, ibuprofen treatment, blood and platelets transfusions). These indices, easily and rapidly achievable, seem to be useful but need to be validated in a large population to allow generalization for diagnosis and follow-up of former premature infants. PMID:28125676

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

    PubMed Central

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

    2015-01-01

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

  5. Variation in the diagnosis and management of patent ductus arteriosus in premature infants

    PubMed Central

    Lai, Lillian SW; McCrindle, Brian W

    1998-01-01

    OBJECTIVES: To determine variations in neonatology practice regarding the diagnosis and management of patent ductus arteriosus (PDA) in premature infants. DESIGN: Standardized telephone interview of preferences and practices. SUBJECTS: Canadian neonatologists in active clinical practice. RESULTS: Of 136 eligible Canadian neonatologists, 100 respondents (74%) estimated the proportion of infants with suspected PDA who have echocardiography to be a median of 80% (range 0% to 100%), with considerable variation both within and between centres. Only two centres had written guidelines. More recent medical school graduates were significantly more likely to use echocardiography. Increased use of echocardiography was also significantly related to increased availability. Fluid restriction and indomethacin was used as initial therapy by 89% of respondents, with the indomethacin dose standardized for 83%; surgical ligation was used when indomethacin therapy was contraindicated or had failed. Personal guidelines directed decisions regarding therapy for the majority of neonatologists. CONCLUSIONS: Among Canadian neonatologists, there is considerable variation regarding practices related to the diagnosis and management of PDA in premature infants. This variation may potentially affect the cost effectiveness of care for these patients. PMID:20401223

  6. Inhaled nitric oxide in premature infants: effect on tracheal aspirate and plasma nitric oxide metabolites

    PubMed Central

    Posencheg, M A; Gow, A J; Truog, W E; Ballard, R A; Cnaan, A; Golombek, S G; Ballard, P L

    2010-01-01

    Objective: Inhaled nitric oxide (iNO) is a potential new therapy for prevention of bronchopulmonary dysplasia and brain injury in premature infants. This study examined dose-related effects of iNO on NO metabolites as evidence of NO delivery. Study Design: A subset of 102 premature infants in the NO CLD trial, receiving 24 days of iNO (20 p.p.m. decreasing to 2 p.p.m.) or placebo, were analyzed. Tracheal aspirate (TA) and plasma samples collected at enrollment and at intervals during study gas were analyzed for NO metabolites. Result: iNO treatment increased NO metabolites in TA at 20 and 10 p.p.m. (1.7- to 2.3-fold vs control) and in plasma at 20, 10, and 5 p.p.m. (1.6- to 2.3-fold). In post hoc analysis, treated infants with lower metabolite levels at entry had an improved clinical outcome. Conclusion: iNO causes dose-related increases in NO metabolites in the circulation as well as lung fluid, as evidenced by TA analysis, showing NO delivery to these compartments. PMID:19812581

  7. The effect of contingent music to increase non-nutritive sucking of premature infants.

    PubMed

    Standley, J M

    2000-01-01

    This study assessed music as reinforcement for non-nutritive sucking of 12 premature infants born at an average gestation of 29.3 weeks and an average birthweight of 1111.9 g. At the time of the study, the infants' average post conception age was 35.5 weeks, and their average weight was 1747.3 g. A pacifier was fitted with a pressure transducer so that a sufficient suck activated frequency and duration signals as well as 10 seconds of recorded music consisting of lullabies sung by female vocalists. A 14-minute ABAB study design included a silence baseline for 2 minutes, 5 minutes of contingent music, 2 minutes of silence, and 5 minutes of contingent music. Frequency data were recorded for each 5-second interval in which the duration light was activated for at least 3 seconds. Results demonstrated that sucking rates during the periods of contingent music were 2.43 times greater than baseline (silence) sucking rates. In this study, music contributed significantly to the development of non-nutritive sucking of premature infants.

  8. The developing oligodendrocyte: key cellular target in brain injury in the premature infant.

    PubMed

    Volpe, Joseph J; Kinney, Hannah C; Jensen, Frances E; Rosenberg, Paul A

    2011-06-01

    Brain injury in the premature infant, a problem of enormous importance, is associated with a high risk of neurodevelopmental disability. The major type of injury involves cerebral white matter and the principal cellular target is the developing oligodendrocyte. The specific phase of the oligodendroglial lineage affected has been defined from study of both human brain and experimental models. This premyelinating cell (pre-OL) is vulnerable because of a series of maturation-dependent events. The pathogenesis of pre-OL injury relates to operation of two upstream mechanisms, hypoxia-ischemia and systemic infection/inflammation, both of which are common occurrences in premature infants. The focus of this review and of our research over the past 15-20 years has been the cellular and molecular bases for the maturation-dependent vulnerability of the pre-OL to the action of the two upstream mechanisms. Three downstream mechanisms have been identified, i.e., microglial activation, excitotoxicity and free radical attack. The work in both experimental models and human brain has identified a remarkable confluence of maturation-dependent factors that render the pre-OL so exquisitely vulnerable to these downstream mechanisms. Most importantly, elucidation of these factors has led to delineation of a series of potential therapeutic interventions, which in experimental models show marked protective properties. The critical next step, i.e., clinical trials in the living infant, is now on the horizon.

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

    PubMed Central

    Zimmerman, Emily; Maki, Monika; Maron, Jill

    2016-01-01

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

  10. Pain-associated stressor exposure and neuroendocrine values for premature infants in neonatal intensive care.

    PubMed

    Rohan, Annie J

    2016-01-01

    Recurrent stress during neonatal intensive care taxes the adaptive capacity of the premature infant and may be a risk factor for suboptimal developmental outcomes. This research used a descriptive, cross-sectional design and a life course perspective to examine the relationship between resting adrenocorticoid values at 37 postmenstrual weeks of age and cumulative pain-associated stressor exposure in prematurely born infants. Subjects were 59 infants born at under 35 completed weeks of gestation, who were at least 2 weeks of age, and who had been cared for in the NICU since birth. No significant relationships were identified between cortisol values and any of the study variables (number of skin breaking procedures, hours of assisted ventilation, gestational age at birth, exposure to antenatal steroids, history of severe academia, birthweight, days of age to attain birthweight, weight at testing, days of age at testing, recent pain-associated procedures, and 17-OHP value). A significant negative correlation (Spearman rank, one-tailed) between the number of skin-breaking procedures and 17-OHP values was identified (r = -.232, p = .039). Recurrent pain-associated stressor exposure may be a more important factor in explaining the variance of 17-OHP values at 37 postmenstrual weeks of age than birthweight, gestational age, or chronological age.

  11. The effect of music and multimodal stimulation on responses of premature infants in neonatal intensive care.

    PubMed

    Standley, J M

    1998-01-01

    To assess the benefits of lullaby singing and multimodal stimulation on premature infants in neonatal intensive care, 40 infants in a Level III Newborn Intermediate Care Unit were divided into control (n = 20) and experimental (n = 20) groups by pair matching on the basis of gender, birthweight, gestational age at birth and severity of medical complications. Participants met these project criteria: (a) corrected gestational age > 32 weeks; (b) age since birth > 10 days; and (c) weight > 1700 g. All participants had been referred for developmental stimulation by the medical staff. Experimental infants received reciprocal, multimodal (ATVV) stimulation paired with line singing of Brahms' Lullaby. Stimulation was provided for 15-30 minutes, one or two times per week from referral to discharge. Dependent variables were (a) days to discharge, (b) weight gain/day, and (c) experimental infants' tolerance for stimulation. Results showed that music and multimodal stimulation significantly benefited females' days to discharge and increased weight gain/day for both males and females. Both male and female infants' tolerance for stimulation showed marked and steady increase across the stimulation intervals with females' tolerance increasing more rapidly than males.

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

    PubMed

    Greenfield, Jennifer C; Klawetter, Susanne

    2016-02-01

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

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

    PubMed

    Walworth, Darcy D

    2009-01-01

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

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

    SciTech Connect

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

    1989-05-01

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

  15. Different ventilation modes combined with ambroxol in the treatment of respiratory distress syndrome in premature infants

    PubMed Central

    Zhou, Bin; Zhai, Jing-Fang; Wu, Jie-Bin; Jin, Bao; Zhang, Yan-Yan

    2017-01-01

    The aim of the present study was to compare the effectiveness of different modes of mechanical ventilation in combination with secretolytic therapy with ambroxol in premature infants with respiratory distress syndrome. Seventy-three premature infants with hyaline membrane disease (HMD) (stage III–IV), also known as respiratory distress syndrome, who were supported by mechanical ventilation in the neonatal intensive care unit (NICU) of Xuzhou Central Hospital, were involved in the present study, between January 2013 and February 2015. Forty cases were randomly selected and treated with high frequency oscillatory ventilation (HFOV), forming the HFOV group, whereas 33 cases were selected and treated with conventional mechanical ventilation (CMV), forming the CMV group. Patients in the two groups were administered ambroxol intravenously at a dosage rate of 30 mg/kg body weight at the beginning of the study. The present study involved monitoring the blood gas index as well as changes in the respiratory function index in the two groups. Additionally, the incidence of complications in the premature infants in the two groups was observed prior to and following the ventilation. Pulmonary arterial oxygen tension (PaO2), the PaO2/fraction of inspired oxygen (FiO2) ratio, the oxygenation index [OI = 100 × mean airway pressure (MAP) × FiO2/PaO2], as well as the arterial/alveolar oxygen partial pressure ratio (a/APO2) = PaO2/(713 × FiO2 partial pressure of carbon dioxide (PaCO2)/0.8) of the patients in the HFOV group after 1, 12 and 24 h of treatment were significantly improved as compared to the patients of the CMV group. However, there was no significant difference between patients in the two groups with regard to the number of mortalities, complications such as pneumothorax, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and the time of ventilation. In conclusion, combining HFOV

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

    PubMed Central

    Meyer, J; Sive, A; Jacobs, P

    1992-01-01

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

  17. Erythrocyte incorporation and absorption of 58Fe in premature infants treated with erythropoietin.

    PubMed

    Widness, J A; Lombard, K A; Ziegler, E E; Serfass, R E; Carlson, S J; Johnson, K J; Miller, J E

    1997-03-01

    We hypothesized that treatment of very low birth weight premature infants with r-HuEPO would increase erythrocyte incorporation and gastrointestinal absorption of iron. Infants with birth weights < or = 1.25 kg and gestational ages < 31 wk were randomized to receive 6 wk of 500 U of r-HuEPO/kg/wk (epo group, n = 7) or placebo (placebo group, n = 7). All infants received daily enteral supplementation with 6 mg of elemental iron per kg. An enteral test dose of a stable iron isotope, 58Fe, was administered after the 1st ("early dosing") and 4th ("late dosing") wk of treatment. Mean (+/-SD) erythrocyte incorporation of the dose of 58Fe administered determined 2 wk after early dosing was significantly greater in the epo group compared with the placebo group (4.4% +/- 1.6 versus 2.0 +/- 1.4%, p = 0.013). In contrast, after late 58Fe dosing, there was no difference between groups in incorporation (3.8 +/- 1.6% versus 5.5 +/- 2.7%). Within the epo group, percentage erythrocyte incorporation of 58Fe did not differ between early and late dosing, whereas in the placebo group it increased 3-fold (p < 0.01). Percentage absorption of 58Fe was not different between the epo and placebo groups after both early dosing (30 +/- 22% versus 34 +/- 8%) and late dosing (32 +/- 9% versus 31 +/- 6%). Absorption of nonlabeled elemental iron and 58Fe were significantly correlated with one another. The percentage of the absorbed 58Fe dose incorporated into Hb was not different between groups. We conclude that, although erythropoietin treatment stimulates erythrocyte iron incorporation in premature infants, it has no effect on iron absorption at the r-HuEPO dose studied.

  18. How Nurses Assist Parents Regarding Life Support Decisions for Extremely Premature Infants

    PubMed Central

    Kavanaugh, Karen; Moro, Teresa T.; Savage, Teresa A.

    2010-01-01

    Objective To describe nurse behaviors that assisted parents to make life support decisions for an extremely premature infant before and after the infant’s birth. Design Qualitative, longitudinal, collective case study where interviews were done pre- and postnatally and medical chart data were collected. Setting Interviews were conducted face-to-face in a private room in the hospital, in the mother’s home, or over the telephone. Participants A sample of 40 cases (40 mothers, 14 fathers, 42 physicians, 17 obstetric nurses, 6 neonatal nurses, and 6 neonatal nurse practitioners) was recruited from three hospitals that provided high risk perinatal care. Parents were at least 18 years of age, English speaking, and had participated in a prenatal discussion with a physician regarding treatment decisions for their infant due to threatened preterm delivery. Physicians and nurses were those identified by parents who had spoken to them about life support treatment decisions for the infant. Methods Using a semi-structured interview guide, a total of 203 interviews were conducted (137 prenatal, 51 postnatal, and 15 end-of-life). For this analysis, all coded data related to the nurse’s role were analyzed and summarized. Results Parents and nurses both described several nurse behaviors: providing emotional support; giving information, and meeting the physical care needs of mothers, infants, and fathers. Physicians’ description of the nurse behaviors focused on the way nurses provided emotional support and gave information. Conclusions Nurses play a critical role in assisting parents surrounding life support decisions. PMID:20409115

  19. Screening Retinopathy of Prematurity in Extremely Low Birth Weight Infants in China and the Need for Earlier Screening Times

    PubMed Central

    Wang, Jianxun; Chen, Feng; He, Shiping

    2016-01-01

    Purpose. To convey the need for a revised screening strategy for retinopathy of prematurity (ROP) for extremely low birth weight (ELBW) infants in China. Design. A retrospective longitudinal study. Methods. The medical charts of infants with a birth weight (BW) of less than 1 kg were reviewed. The infants were divided into three groups: group A, without ROP; group B, with ROP but not up to type 1 prethreshold or threshold ROP; group C, with type 1 prethreshold or threshold ROP. Data collected included gender, gestational age (GA), BW, postmenstrual age (PMA), age of onset of ROP, and age at which treatment was carried out, if required. Results. A total of 77 infants were involved. Fifty-six infants developed ROP at any stage and 38 infants developed type 1 prethreshold or threshold ROP. The mean BW and GA of infants in group A were significantly different compared with groups B and C. The mean PMA of onset of ROP in infants who developed mild ROP was 37 weeks compared with 34 weeks for infants who developed severe ROP. Conclusion. ELBW infants have a higher incidence of ROP in China which highlights the need for optimizing neonatal care for these infants. In ELBW infants, ROP tends to develop more severely when it occurs earlier. It is necessary for ELBW infants, especially for those with a BW less than 800 g or a GA less than 25 weeks, to be initially screened at an earlier time. PMID:28116141

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

    PubMed Central

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

    2015-01-01

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

  1. The relationship between maternal self-esteem and maternal attachment in mothers of hospitalized premature infants.

    PubMed

    Chen, C W; Conrad, B

    2001-09-01

    The purpose of this study was to examine the relationship between maternal self-esteem and maternal attachment in mothers of hospitalized premature infants. The research instruments administered included: a demographic sheet, the Maternal Self-Report Inventory (MSRI), Rosenberg Self-Esteem Scale, and Leifer's How I Feel About My Baby Now Scale. Thirty-two mothers whose premature infants were medically stable and hospitalized in the NICU were studied. Two hypotheses on the positive relationships between maternal self-esteem and maternal attachment, and global self-esteem and maternal attachment could not be tested by correlational analyses due to the inadequate internal consistency of the How I Feel About My Baby Now Scale. A significant correlation was found between maternal self-esteem and global self-esteem. Thus, maternal role influenced general self-concept in mothers. In addition, it was found that there were no significant correlations between the MSRI and demographic variables, such as: maternal age, marital status, income, and educational level. Another result indicated that increased global self-esteem was correlated (p < .05) with maternal age, income, and educational level. The results of this study provide clinical nurses to pay attention not only to caregiving skills but also to the mother's appraisal of herself as a mother and attachment behaviors.

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

    PubMed

    Fujioka, Tao; Nii, Masaki; Tanaka, Yasuhiko

    2016-06-01

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

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

    PubMed

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

    2015-12-01

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

  4. Ethical decision making in the resuscitation of extremely premature infants: the health care professional's perspective.

    PubMed

    Weir, Mark; Evans, Marilyn; Coughlin, Kevin

    2011-01-01

    Across Canada, the rate of preterm birth (i.e., at < 37 weeks' gestation) has been steadily increasing. Advances in perinatal medicine and neonatal intensive care have resulted in an increased capacity to intervene at the extremes of prematurity, leading to an increase in the overall survival of infants born at early gestations. There has been little corresponding decrease in long-term complications. As a result, additional stresses are placed on neonatal intensive care units across the country, impacting families, health care professionals, and society as a whole. Moral distress and moral residue are often cited in the neonatal-perinatal literature as stressors experienced by those who participate in the resuscitation decision-making process. They are directly related to the challenge of making a concrete decision about life and death at extremely early gestations in the context of long-term uncertainty. In this review, we performed a systematic search of medical and ethics literature pertaining to resuscitation at the extremes of prematurity. The perspective of health care professionals is explored, including how definitions of viability and parental perspectives contribute to the decision-making process. We argue for the necessity of further research exploring the inter-professional context of ethical decision making at the extremes of prematurity.

  5. Do Hospitalized Premature Infants Benefit from Music Interventions? A Systematic Review of Randomized Controlled Trials

    PubMed Central

    Oliai Araghi, Sadaf; Jeekel, Johannes; Reiss, Irwin K. M; Hunink, M. G. Myriam; van Dijk, Monique

    2016-01-01

    Objective Neonatal intensive care units (NICU) around the world increasingly use music interventions. The most recent systematic review of randomized controlled trials (RCT) dates from 2009. Since then, 15 new RCTs have been published. We provide an updated systematic review on the possible benefits of music interventions on premature infants’ well-being. Methods We searched 13 electronic databases and 12 journals from their first available date until August 2016. Included were all RCTs published in English with at least 10 participants per group, including infants born prematurely and admitted to the NICU. Interventions were either recorded music interventions or live music therapy interventions. All control conditions were accepted as long as the effects of the music intervention could be analysed separately. A meta-analysis was not possible due to incompleteness and heterogeneity of the data. Results After removal of duplicates the searches retrieved 4893 citations, 20 of which fulfilled the inclusion/exclusion criteria. The 20 included studies encompassed 1128 participants receiving recorded or live music interventions in the NICU between 24 and 40 weeks gestational age. Twenty-six different outcomes were reported which we classified into three categories: physiological parameters; growth and feeding; behavioural state, relaxation outcomes and pain. Live music interventions were shown to improve sleep in three out of the four studies and heart rate in two out of the four studies. Recorded music improved heart rate in two out of six studies. Better feeding and sucking outcomes were reported in one study using live music and in two studies using recorded music. Conclusions Although music interventions show promising results in some studies, the variation in quality of the studies, age groups, outcome measures and timing of the interventions across the studies makes it difficult to draw strong conclusions on the effects of music in premature infants. PMID

  6. Continuous and multiple waves of emotional responses: Mother's experience with a premature infant

    PubMed Central

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

    2014-01-01

    Background: In recent years, there has been a rise in the number of premature births. Mothers of these newborns experience a high degree of stress over time. Since a more comprehensive understanding of this phenomenon can help the healthcare teams in detecting the deficiencies and needs of such newborns’ mothers for a better and more effective intervention, the present study was carried out to describe the mothers’ experiences in the area of premature birth. Materials and Methods: The present study is a qualitative study with a content analysis approach. The data collection process included 15 semi-structured and in-depth interviews with the mothers delivering premature babies during 2012-2013 in the medical educational centers of north and northwest of Iran. A purposive sampling method was used. All the interviews were recorded, typed, and finally analyzed using a qualitative content analysis with a conventional method. Results: Data analysis led to the extraction of continuous and multiple waves of emotional responses in mothers with premature birth. This has been revealed in mothers by the different categories of affective reactions, symptoms of anxiety, and mood disturbances including decline in performance, individual shortcomings, and mental irritation. Conclusions: Mothers’ unpreparedness and unexpected childbirth make them encounter the multiple and continuous waves of emotional responses, which will consequently lead to decline in performance, individual shortcomings, and mental irritation among them. Therefore, in order to prevent the negative and long-term consequences of such reactions, it is recommended that more attention should be given to support these mothers as the main caregivers of such infants. PMID:25183972

  7. Oxygen consumption and temperature control of premature infants in a double-wall incubator.

    PubMed

    Marks, K H; Lee, C A; Bolan, C D; Maisels, M J

    1981-07-01

    The effects of a double wall in a forced convection-heated incubator were studied on ten naked, nondistressed, premature infants by measuring their mean skin temperature, esophageal temperature, and oxygen consumption when they were in thermal steady state, with, and without, the double wall in place. The incubator air temperature was maintained within the recommended thermoneutral zone during the consecutive paired experiments. Ambient room temperature and relative humidity were constant and the infant's activity (quiet sleep) and postprandial state were the same in both conditions. Together with a significant rise in operative temperature (P less than .05) induced by the double wall (accounted for by a 0.9 C mean increased in incubator wall temperature nearest the baby), their mean skin temperature and esophageal temperatures increased (P less than .025), while a decrease in oxygen consumption occurred in nine of the ten infants (P less than .05). These findings suggest that the double wall reduced radiant and total heat loss from the baby by diminishing the temperature gradient between the skin and incubator surfaces and that metabolic heat production (oxygen consumption) was reduced when the double wall was in place.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Douret, L.; And Others

    1994-01-01

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

  11. Treatment trends for retinopathy of prematurity in the UK: active surveillance study of infants at risk

    PubMed Central

    Adams, Gillian G W; Xing, Wen; Butler, Lucilla; Long, Vernon; Reddy, Aravind

    2017-01-01

    Objectives To estimate the incidence of severe retinopathy of prematurity (ROP) requiring treatment and describe current treatment patterns in the UK. Design Nationwide population-based case ascertainment study via the British Ophthalmic Surveillance Unit and a national collaborative ROP special interest group. Practitioners completed a standardised case report form (CRF). Setting All paediatric ophthalmologists providing screening and/or treatment for retinopathy in the UK were invited to take part. Participants Any baby with ROP treated or referred for treatment between 1 December 2013 and 30 November 2014, treated with laser, cryotherapy, vascular endothelial growth factor (VEGF) inhibitor or vitrectomy/scleral buckling, or a combination. Main outcome measure Incidence of ROP requiring treatment. Results We received 370 CRFs; 327 were included. Denominator from epidemiological data: 8112 infants with birth weight of <1500 g. The incidence of ROP requiring treatment was 4% (327/8112, 95% CI 3.6% to 4.5%). Median gestational age was 25 weeks (IQR 24.3–26.1), and median birth weight 706 g (IQR 620–821). Median age at first treatment was 80 days (IQR 71–96). 204 right eyes (62.39%) had type 1 ROP, and 27 (8.26%) had aggressive posterior ROP. Infants were also treated for milder disease: 9 (2.75%) right eyes were treated for type 2 ROP, and 74 (22.63%) for disease milder than type 1 with plus or preplus, which we defined here as ‘type 2 plus’ disease. First-line treatment was diode laser photoablation of the avascular retina in 90.5% and injection of VEGF inhibitor in 8%. Conclusions ROP treatment incidence in the UK is 2.5 times higher than previously estimated. 8% of treated infants receive intravitreal VEGF inhibitor, currently unlicensed. Research is needed urgently to establish safety and efficacy of this approach. Earlier treatment and increasing numbers of surviving premature infants require an increase in appropriate eye care facilities and

  12. Enteropathogenic Esch. coli gastroenteritis in premature infants and children treated with fosfomycin.

    PubMed Central

    Baquero, F; Canedo, E; RODRIGUEZ, A; Jaso, E

    1975-01-01

    Forty-two infants, some premature, with enteropathogenic Esch. coli (EPEC) gastroenteritis were treated with an oral suspension of fosfomycin in a dose of 100 and 200 mg/kg per day. After the treatment there were 11 secondary clinical infections (6 reinfections and 5 relapses) which received a second treatment with fosfomycin. In total, 53 treatments were made with fosfomycin and in 92% of the cases there was both clinical and bacteriological cure. 93% of the EPEC strains were sensitive to fosfomycin in vitro, their minimum inhibitory concentrations being less than 64 mug/ml. The concentration of fosfomycin in blood and faeces was assayed by a diffusion plate microbiological method in a group of these children, showing that this antibiotic is partly absorbed and the rest eliminated in the faeces, where its concentration was found to be very high. Tolerance of the product was good, and there were neither toxic nor side effects. PMID:1103749

  13. Case Report: Congenital Erythroleukemia in a Premature Infant with Dysmorphic Features.

    PubMed

    Helin, Heidi; van der Walt, Jon; Holder, Muriel; George, Simi

    2016-01-01

    We present a case of pure erythroleukemia, diagnosed at autopsy, in a dysmorphic premature infant who died of multiorgan failure within 24 hours of birth. Dysmorphic features included facial and limb abnormalities with long philtrum, microagnathia, downturned mouth, short neck as well as abnormal and missing nails, missing distal phalanx from the second toe, and overlapping toes. Internal findings included gross hepatomegaly and patchy hemorrhages in the liver, splenomegaly, and cardiomegaly; and subdural, intracerebral, and intraventricular hemorrhages. Histology revealed infiltration of bone marrow, kidney, heart, liver, adrenal, lung, spleen, pancreas, thyroid, testis, thymus, and placenta by pure erythroleukemia. Only 6 cases of congenital erythroleukemia have been previously reported with autopsy findings similar to those of this case. The dysmorphic features, although not fitting any specific syndrome, make this case unique. Congenital erythroleukemia and possible syndromes suggested by the dysmorphic features are discussed.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-07-26

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

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  19. Effects of Gentle Human Touch and Field Massage on Urine Cortisol Level in Premature Infants: A Randomized, Controlled Clinical Trial

    PubMed Central

    Asadollahi, Malihe; Jabraeili, Mahnaz; Mahallei, Majid; Asgari Jafarabadi, Mohammad; Ebrahimi, Sakine

    2016-01-01

    Introduction: Hospitalization in neonatal intensive care unit may leads to many stresses for premature infants. Since premature infants cannot properly process stressors, identifying interventions that reduce the stress level for them is seems necessary. The aim of present study was to compare the effects of Field massage and Gentle Human Touch (GHT) techniques on the urine level of cortisol, as an indicator of stress in preterm infants. Methods: This randomized, controlled clinical trial was carried out in Al-Zahra hospital, Tabriz. A total of 84 premature infants were randomly assigned into three groups. First groups were touched by their mothers three times a day (15 minutes in each session) for 5 days by GHT technique. The second group was received 15 minutes Field massage with sunflower oil three times a day by their mothers for 5 days. The third group received routine care. In all groups, 24-hours urine samples were collected in the first and sixth day after the intervention and analyzed for cortisol level. Data were analyzed by SPSS software. Results: There were significant differences between mean of changes in cortisol level between GHT and control groups and Field massage and control groups (0.026). Conclusion: Although the massage with Field technique resulted in a significant reduction in blood cortisol level, but the GHT technique have also a similar effect. So, both methods are recommended for decreasing of stress in preterm infants. PMID:27752484

  20. Long-chain saturated and monounsaturated fatty acids associate with development of premature infants up to 18 months of age.

    PubMed

    Strandvik, Birgitta; Ntoumani, Eleni; Lundqvist-Persson, Cristina; Sabel, Karl-Göran

    2016-04-01

    Myelination is important perinatally and highly dependent on long-chain saturated and monounsaturated fatty acids. Long-chain polyunsaturated fatty acids, nowadays often supplemented, inhibit oleic acid synthesis. Using data from a premature cohort, we studied if nervonic, lignoceric and oleic acids correlated to growth and early development up to 18 months corrected age. Small for gestational age infants had lower concentrations than infants appropriate for gestational age. Only oleic acid was negatively correlated to long-chain polyunsaturated fatty acids. Oleic and lignoceric acids correlated to social interaction at one month, and nervonic acid to mental, psychomotor and behavioral development at 6, 10 and 18 months, also when adjusted for several confounders. Negative association between oleic acid and long-chain polyunsaturated fatty acids suggests inhibition of delta-9 desaturase, and nervonic acid´s divergent correlation to lignoceric and oleic acids suggests different metabolism in neonatal period. Our results may have implications for the supplementation of premature infants.

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

    SciTech Connect

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

    2005-09-01

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

  2. Critical issues with clinical research in children: the example of premature infants.

    PubMed

    Welty, Stephen E

    2005-09-01

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

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

    PubMed

    Quick, J D

    1978-10-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Packed red blood cell transfusions as a risk factor for parenteral nutrition associated liver disease in premature infants

    PubMed Central

    D’Souza, Antoni; Algotar, Anushree; Pan, Ling; Schwarz, Steven M; Treem, William R; Valencia, Gloria; Rabinowitz, Simon S

    2016-01-01

    AIM To determine if packed red blood cell transfusions contribute to the development of parenteral nutrition associated liver disease. METHODS A retrospective chart review of 49 premature infants on parenteral nutrition for > 30 d who received packed red blood cell (PRBC) transfusions was performed. Parenteral nutrition associated liver disease was primarily defined by direct bilirubin (db) > 2.0 mg/dL. A high transfusion cohort was defined as receiving > 75 mL packed red blood cells (the median value). Kaplan-Meier plots estimated the median volume of packed red blood cells received in order to develop parenteral nutrition associated liver disease. RESULTS Parenteral nutritional associated liver disease (PNALD) was noted in 21 (43%) infants based on db. Among the 27 high transfusion infants, PNALD was present in 17 (64%) based on elevated direct bilirubin which was significantly greater than the low transfusion recipients. About 50% of the infants, who were transfused 101-125 mL packed red blood cells, developed PNALD based on elevation of direct bilirubin. All infants who were transfused more than 200 mL of packed red blood cells developed PNALD. Similar results were seen when using elevation of aspartate transaminase or alanine transaminase to define PNALD. CONCLUSION In this retrospective, pilot study there was a statistically significant correlation between the volume of PRBC transfusions received by premature infants and the development of PNALD. PMID:27872824

  6. Identical bacterial populations colonize premature infant gut, skin, and oral microbiomes and exhibit different in situ growth rates

    PubMed Central

    Olm, Matthew R.; Brown, Christopher T.; Brooks, Brandon; Firek, Brian; Baker, Robyn; Burstein, David; Soenjoyo, Karina; Thomas, Brian C.; Morowitz, Michael; Banfield, Jillian F.

    2017-01-01

    The initial microbiome impacts the health and future development of premature infants. Methodological limitations have led to gaps in our understanding of the habitat range and subpopulation complexity of founding strains, as well as how different body sites support microbial growth. Here, we used metagenomics to reconstruct genomes of strains that colonized the skin, mouth, and gut of two hospitalized premature infants during the first month of life. Seven bacterial populations, considered to be identical given whole-genome average nucleotide identity of >99.9%, colonized multiple body sites, yet none were shared between infants. Gut-associated Citrobacter koseri genomes harbored 47 polymorphic sites that we used to define 10 subpopulations, one of which appeared in the gut after 1 wk but did not spread to other body sites. Differential genome coverage was used to measure bacterial population replication rates in situ. In all cases where the same bacterial population was detected in multiple body sites, replication rates were faster in mouth and skin compared to the gut. The ability of identical strains to colonize multiple body sites underscores the habit flexibility of initial colonists, whereas differences in microbial replication rates between body sites suggest differences in host control and/or resource availability. Population genomic analyses revealed microdiversity within bacterial populations, implying initial inoculation by multiple individual cells with distinct genotypes. Overall, however, the overlap of strains across body sites implies that the premature infant microbiome can exhibit very low microbial diversity. PMID:28073918

  7. Parent decision making for life support for extremely premature infants: from the prenatal through end-of-life period.

    PubMed

    Moro, Teresa T; Kavanaugh, Karen; Savage, Teresa A; Reyes, Maria R; Kimura, Robert E; Bhat, Rama

    2011-01-01

    Most deaths of extremely premature infants occur in the perinatal period. Yet, little is known about how parents make life support decisions in such a short period of time. In the paper, how parents make life support decisions for extremely premature infants from the prenatal period through death from the perspectives of parents, nurses, and physicians is described. Five cases, comprised of five mothers, four neonatologists, three nurses, and one neonatal nurse practitioner, are drawn from a larger collective case study. Prenatal, postnatal and end-of-life interviews were conducted, and medical record data were obtained. In an analysis by two research team members, mothers were found to exhibit these characteristics: desire for and actual involvement in life support decisions, weighing pain, suffering and hope in decision making, and wanting everything done for their infants. All mothers received decision making help and support from partners and family, but relationships with providers were also important. Finally, external resources impacted parental decision making in several of the cases. By understanding what factors contribute to parents' decision making, providers may be better equipped to prepare and assist parents when making life support decisions for their extremely premature infants.

  8. Parental post-traumatic reactions after premature birth: implications for sleeping and eating problems in the infant

    PubMed Central

    Pierrehumbert, B; Nicole, A; Muller-Nix, C; Forcada-Guex, M; Ansermet, F

    2003-01-01

    Background: Progress in perinatal medicine has made it possible to increase the survival of very or extremely low birthweight infants. Developmental outcomes of surviving preterm infants have been analysed at the paediatric, neurological, cognitive, and behavioural levels, and a series of perinatal and environmental risk factors have been identified. The threat to the child's survival and invasive medical procedures can be very traumatic for the parents. Few empirical reports have considered post-traumatic stress reactions of the parents as a possible variable affecting a child's outcome. Some studies have described sleeping and eating problems as related to prematurity; these problems are especially critical for the parents. Objective: To examine the effects of post-traumatic reactions of the parents on sleeping and eating problems of the children. Design: Fifty families with a premature infant (25–33 gestation weeks) and a control group of 25 families with a full term infant participated in the study. Perinatal risks were evaluated during the hospital stay. Mothers and fathers were interviewed when their children were 18 months old about the child's problems and filled in a perinatal post-traumatic stress disorder questionnaire (PPQ). Results: The severity of the perinatal risks only partly predicts a child's problems. Independently of the perinatal risks, the intensity of the post-traumatic reactions of the parents is an important predictor of these problems. Conclusions: These findings suggest that the parental response to premature birth mediates the risks of later adverse outcomes. Preventive intervention should be promoted. PMID:12937044

  9. Ultrasonographic demonstration of the superior ophthalmic vein in the orbit of premature infants with and without retinopathy of prematurity.

    PubMed

    Ron, Yonina; Barash, David; Erhenberg, Miriam; Friling, Ronit; Osovsky, Micky; Sirota, Lea; Snir, Moshe; Ehrlich, Rita

    2015-11-01

    Retinopathy of prematurity (ROP), which develops due to abnormal retinal vascularization in premature babies, can lead to irreversible vision loss. B-scan ocular ultrasonography is a noninvasive examination which makes it possible to image the eye and orbit. Our purpose was to echographically assess the orbit of premature babies with and without retinopathy of prematurity (ROP), with a focus on the superior ophthalmic vein (SOV) which is normally not detected by orbital ultrasound. A prospective study design was used after approved by the local institutional review board. ROP was diagnosed by routine ophthalmoscopic exam. Orbital ultrasound was performed by a single experienced ophthalmologist and ultra-sonographer who was masked to the routine ROP screening results. The results of the ophthalmoscopic exam were compared to the orbital ultrasound findings. The study group was divided into those diagnosed with ROP and those not diagnosed with ROP and were found to be comparable by age and weight at the time of the US examination. The SOV was dilated in 21 of 22 eyes (95.4%) with ROP and in only 5 of 32 eyes (15.6%) without ROP. The present study suggests an association between ROP and dilatation of the SOV.

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

    ERIC Educational Resources Information Center

    Illinois Public Health Association, Springfield.

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

  11. The Role of Follow-up in Monitoring the Outcomes of Prematurity in a Cohort of Romanian Infants

    PubMed Central

    Bivoleanu, Anca; Avasiloaiei, Andreea; Moscalu, Mihaela; Stamatin, Maria

    2017-01-01

    Background: The rate of preterm births in Romania is one of the highest among European countries. However, there is little information regarding the ways in which premature birth affects the outcome in Romanian preterm infants. Aims: To investigate the effects of early developmental intervention after discharge from the hospital on motor and cognitive development in preterm infants. Study Design: Longitudinal observational study. Methods: We performed the Amiel-Tison neurologic evaluation at discharge and the Bayley Scales of Infant Development from 3 to 24 months. Based on these evaluations, an outcome score was formulated. Results: Between 2007 and 2010, 1157 of 2793 premature infants were included into the study. There was a negative correlation between the number of evaluations and the risk of developing neurologic sequelae (p<0.001). The correlation analysis demonstrated a significant association between the final category of risk at the end of the follow up program and the degree of compliance (p<0.01). At 24 months evaluation, there was a correlation between the low gestational age and the risk of developing severe neurologic sequelae (p<0.001). Conclusion: This study shows the importance of follow up program in decreasing the risk of developing neurologic sequelae in preterm infants. PMID:28251019

  12. Strain-resolved community genomic analysis of gut microbial colonization in a premature infant

    PubMed Central

    Morowitz, Michael J.; Denef, Vincent J.; Costello, Elizabeth K.; Thomas, Brian C.; Poroyko, Valeriy; Relman, David A.; Banfield, Jillian F.

    2011-01-01

    The intestinal microbiome is a critical determinant of human health. Alterations in its composition have been correlated with chronic disorders, such as obesity and inflammatory bowel disease in adults, and may be associated with neonatal necrotizing enterocolitis in premature infants. Increasing evidence suggests that strain-level genomic variation may underpin distinct ecological trajectories within mixed populations, yet there have been few strain-resolved analyses of genotype–phenotype connections in the context of the human ecosystem. Here, we document strain-level genomic divergence during the first 3 wk of life within the fecal microbiota of an infant born at 28-wk gestation. We observed three compositional phases during colonization, and reconstructed and intensively curated population genomic datasets from the third phase. The relative abundance of two Citrobacter strains sharing ~99% nucleotide identity changed significantly over time within a community dominated by a nearly clonal Serratia population and harboring a lower abundance Enterococcus population and multiple plasmids and bacteriophage. Modeling of Citrobacter strain abundance suggests differences in growth rates and host colonization patterns. We identified genotypic variation potentially responsible for divergent strain ecologies, including hotspots of sequence variation in regulatory genes and intergenic regions, and in genes involved in transport, flagellar biosynthesis, substrate metabolism, and host colonization, as well as differences in the complements of these genes. Our results demonstrate that a community genomic approach can elucidate gut microbial colonization at the resolution required to discern medically relevant strain and species population dynamics, and hence improve our ability to diagnose and treat microbial community-mediated disorders. PMID:21191099

  13. Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

    PubMed Central

    Revello, Maria Grazia; Gerna, Giuseppe

    2002-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  15. [EEG of the very premature infant born at 24 to 30 weeks gestational age. Definitions and normal area].

    PubMed

    Vecchierini, M-F; André, M; d'Allest, A-M

    2007-01-01

    This article aims at summarizing normal EEG criteria and their maturational pattern in premature infants of 24 to 30 weeks gestational age. Although very premature infants with a normal outcome are not numerous, their normal EEG patterns must be known, as EEG constitutes a basis for neurological prognosis. Background activity is first discontinuous. Discontinuity decreases thereafter with increasing age, so that some long periods of continuous activity may be observed in active sleep, around 30 weeks of age. Conversely, interburst intervals become shorter and the proportion of time without EEG activity is decreasing. Based on EEG activity and eye movements, a rough sleep-state differentiation was described as soon as 25 weeks of gestational age and is completely achieved at 30 weeks. The main EEG figures are high-voltage delta waves of higher amplitude and slower frequency in younger infants. Temporal delta waves occur in sequences, these are very characteristic of the very premature infant; thereafter, they become smaller, less numerous and eventually disappear around 27-28 weeks. In contrast, occipital delta waves remain numerous and of high voltage, are usually bilateral and superimposed with fast rhythms. The two types of frontal delta waves that are observed in 24-27 weeks prematures disappear with maturation. Bursts of synchronized delta waves are less numerous than localized delta waves and also disappear before 28 weeks of age. Finally, diffuse theta bursts are mainly recorded at 26-27 weeks GA and become more localized in temporal areas with maturation. At 30 weeks, they are observed on temporal areas, mainly during slow-wave sleep.

  16. Effects of formula temperature on postprandial thermogenesis and body temperature of premature infants.

    PubMed

    Eckburg, J J; Bell, E F; Rios, G R; Wilmoth, P K

    1987-10-01

    To study the effect of formula temperature on the thermogenic response to gavage feeding, we fed formula at room temperature (mean 24.0 degrees C, SD 1.1) and at body temperature (mean 36.9 degrees C, SD 1.7) to premature infants in a crossover design while monitoring their metabolic heat production and gastric, rectal, and skin temperatures. After feeding with room temperature formula, stomach temperature fell by 6.9 degrees C, rectal temperature by 0.2 degree C, and mean skin temperature by 0.6 degree C, and metabolic rate increased by 16% in the first postprandial hour. After body temperature feedings, mean skin temperature fell by 0.2 degree C, but stomach and rectal temperatures did not change appreciably. The metabolic rate rose by 12% in the first hour, which was not significantly less than the rise after room temperature feeding. The heat required to warm the formula to body temperature did not result in a detectably greater rise in metabolic rate after cool feeding than after warm feeding. The effects of feed temperatures below room temperature were not studied, but it remains possible that cooler feedings might produce even greater body cooling and a greater thermogenic response.

  17. Premature infant swallowing: patterns of tongue-soft palate coordination based upon videofluoroscopy.

    PubMed

    Goldfield, Eugene C; Buonomo, Carlo; Fletcher, Kara; Perez, Jennifer; Margetts, Stacey; Hansen, Anne; Smith, Vincent; Ringer, Steven; Richardson, Michael J; Wolff, Peter H

    2010-04-01

    Coordination between movements of individual tongue points, and between soft palate elevation and tongue movements, were examined in 12 prematurely born infants referred from hospital NICUs for videofluoroscopic swallow study (VFSS) due to poor oral feeding and suspicion of aspiration. Detailed post-evaluation kinematic analysis was conducted by digitizing images of a lateral view of digitally superimposed points on the tongue and soft palate. The primary measure of coordination was continuous relative phase of the time series created by movements of points on the tongue and soft palate over successive frames. Three points on the tongue (anterior, medial, and posterior) were organized around a stable in-phase pattern, with a phase lag that implied an anterior to posterior direction of motion. Coordination between a tongue point and a point on the soft palate during lowering and elevation was close to anti-phase at initiation of the pharyngeal swallow. These findings suggest that anti-phase coordination between tongue and soft palate may reflect the process by which the tongue is timed to pump liquid by moving it into an enclosed space, compressing it, and allowing it to leave by a specific route through the pharynx.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. Scalp congenital hemangioma with associated high-output cardiac failure in a premature infant: Case report and review of literature.

    PubMed

    Shah, Sumedh S; Snelling, Brian M; Sur, Samir; Ramnath, Alexandra R; Bandstra, Emmalee S; Yavagal, Dileep R

    2017-02-01

    Introduction Scalp congenital hemangiomas (CHs) are rare vascular malformations among infants; they can be associated with an array of complications, including cardiac and cosmetic issues. Here, we report the endovascular treatment of a premature infant with a suspected large right parietal scalp hemangioma and associated high-output cardiac failure. Case description A two-day-old female premature infant (29 weeks gestational age; 1330 g birth weight) was referred by the neonatologists to our department for consultation and potential treatment of a large right parietal CH causing abrupt hypotension and high-output cardiac failure. Doppler ultrasound imaging at bedside revealed areas of arterial-venous shunting from the scalp and the presence of a superior sagittal sinus waveform, consistent with intracranial venous drainage. To alleviate cardiac dysfunction secondary to this lesion, trans-arterial embolization via n-butyl cyanoacrylate (nBCA) glue and deployment of detachable coils was performed via umbilical artery to occlude the right superficial temporal and occipital artery branches supplying the CH. Following treatment, the infant continued to require ventilator management, vasopressor support, and correction of coagulopathy, but by post-operative day two, her condition improved remarkably and the mass size began decreasing. The patient was discharged after a relatively uncomplicated subsequent 2½-month course in the neonatal intensive care unit. Conclusion Endovascular therapy proved effective and safe in treating cardiac failure associated with scalp CH, despite potential complications associated with neuro-interventional surgery in premature infants. Appropriate consideration in this patient population should be given to factors including blood loss, contrast use, radiation exposure, operative time, and possible intra-/post-operative complications.

  1. How I transfuse red blood cells and platelets to infants with the anemia and thrombocytopenia of prematurity

    PubMed Central

    Strauss, Ronald G.

    2010-01-01

    Many aspects of hematopoiesis are either incompletely developed in preterm infants or still functioning to serve the fetus (i.e., the intrauterine counterpart to a liveborn preterm neonate). This delayed development and/or slow adaptation to extrauterine life diminishes the capacity of the neonate to produce red blood cells (RBCs), platelets (PLTs), and neutrophils—particularly during the stress of life-threatening illnesses encountered after preterm birth such as sepsis, severe pulmonary dysfunction, necrotizing enterocolitis, and immune cytopenias. The serious medical and/or surgical problems of preterm birth can be further complicated by phlebotomy blood losses, bleeding, hemolysis, and consumptive coagulopathy. To illustrate, some preterm infants, especially those with birth weight less than 1.0 kg and respiratory distress, are given numerous RBC transfusions early in life owing to several interacting factors. Neonates delivered before 28 weeks of gestation (birth weight, <1.0 kg) are born before the bulk of iron transport has occurred from mother to fetus via the placenta and before the onset of marked erythropoietic activity of fetal marrow during the third trimester. Soon after preterm birth, severe respiratory disease can lead to repeated blood sampling for laboratory studies and, consequently, to replacement RBC transfusions. Additionally, preterm infants are unable to mount an effective erythropoietin (EPO) response to decreasing numbers of RBCs, and this factor contributes to the diminished ability to compensate for anemia—thus enhancing need for RBC transfusions. PMID:18194380

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2009-01-01

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

  4. Caffeine citrate treatment for extremely premature infants with apnea: population pharmacokinetics, absolute bioavailability, and implications for therapeutic drug monitoring.

    PubMed

    Charles, Bruce G; Townsend, Sarah R; Steer, Peter A; Flenady, Vicki J; Gray, Peter H; Shearman, Andrew

    2008-12-01

    The objective of this study was to develop a population model of the pharmacokinetics (PK) of caffeine after orogastric or intravenous administration to extremely premature neonates with apnea of prematurity who were to undergo extubation from ventilation. Infants of gestational age <30 weeks were randomly allocated to receive maintenance caffeine citrate dosing of either 5 or 20 mg/kg/d. Four blood samples were drawn at prerandomized times from each infant during caffeine treatment. Serum caffeine was assayed by enzyme-multiplied immunoassay technique. Concentration data (431 samples, median: 4 per subject) were obtained from 110 (52 male) infants of mean birth weight of 1009 g, current mean weight (WT) of 992 g, mean gestational age of 27.6 weeks, and mean postnatal age (PNA) of 12 days. Of 1022 doses given, 145 were orogastric, permitting estimation of absolute bioavailability. A 1-compartment model with first-order absorption was fitted to the data in NONMEM. Patient characteristics were screened (P < 0.01) in nested models for pharmacokinetic influence. Model stability was assessed by nonparametric bootstrapping. Clearance (CL) increased nonlinearly with increasing PNA, whereas volume of distribution (Vd) increased linearly with WT, according to the following allometric models: CL (L/h) = 0.167 (WT/70) (PNA/12); Vd (L) = 58.7 (WT/70). The mean elimination half-life was 101. Interindividual variability (IIV) of CL and Vd was 18.8 % and 22.3 %, respectively. Interoccasion variability (IOV) of CL and Vd was 35.1% and 11.1%, respectively. This study established that the elimination of caffeine was severely depressed in extremely premature infants but increased nonlinearly after birth up to age 6 weeks. Caffeine was completely absorbed, which has favorable implications for switching between intravenous and orogastric routes. The interoccasion variability about CL was twice the interindividual variability, which, among other factors, indicates that routine serum

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2015-08-01

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

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

    SciTech Connect

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

    1994-02-15

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

  8. The basics of prematurity.

    PubMed

    Kelly, Michelle M

    2006-01-01

    Prematurity is the greatest single risk factor for death within the first year of life. The March of Dimes and Centers for Disease Control and Prevention define prematurity as birth before the completion of 37 weeks' gestation. In 2002, one in eight babies were delivered prematurely. This manuscript is Part I of a three-part series on premature infants. The overall goal of this series is to educate pediatric primary care providers regarding topics specific to delivering care to premature infants after discharge. Part I addresses the incidence of prematurity and the terminology used in neonatal literature and provides an overview of common comorbidities associated with prematurity. Part II will focus on the primary care management of uncomplicated premature infants. Part III will highlight issues of primary care for medically complex premature infants.

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

    PubMed

    Huang, Hsin-Chung; Yang, Hwai-I; Chou, Hung-Chieh; Chen, Chien-Yi; Hsieh, Wu-Shiun; Tsou, Kuo-Inn; Tsao, Po-Nien

    2015-01-01

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

  10. Retinopathy of Prematurity

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  11. Association of Neurodevelopmental Outcomes and Neonatal Morbidities of Extremely Premature Infants With Differential Exposure to Antenatal Steroids

    PubMed Central

    Chawla, Sanjay; Natarajan, Girija; Shankaran, Seetha; Pappas, Athina; Stoll, Barbara J.; Carlo, Waldemar A.; Saha, Shampa; Das, Abhik; Laptook, Abbot R.; Higgins, Rosemary D.

    2017-01-01

    IMPORTANCE Many premature infants are born without exposure to antenatal steroids (ANS) or with incomplete courses. This study evaluates the dose-dependent effect of ANS on rates of neonatal morbidities and early childhood neurodevelopmental outcomes of extremely premature infants. OBJECTIVE To compare rates of neonatal morbidities and 18- to 22-month neurodevelopmental outcomes of extremely premature infants exposed to no ANS or partial or complete courses of ANS. DESIGN, SETTING, AND PARTICIPANTS In this observational cohort study, participants were extremely premature infants (birth weight range, 401–1000 g; gestational age, 22–27 weeks) who were born at participating centers of the National Institute of Child Health and Human Development Neonatal Research Network between January 2006 and December 2011. Data were analyzed between October 2013 and May 2016. MAIN OUTCOMES AND MEASURES Rates of death or neurodevelopmental impairment at 18 to 22 months’ corrected age. Neurodevelopmental impairment was defined as the presence of any of the following: moderate to severe cerebral palsy, a cognitive score less than 85 on the Bayley Scales of Infant and Toddler Development III, blindness, or deafness. RESULTS There were 848 infants in the no ANS group, 1581 in the partial ANS group, and 3692 in the complete ANS group; the mean (SD) birth weights were 725 (169), 760 (173), and 753 (170) g, respectively, and the mean (SD) gestational ages were 24.5 (1.4), 24.9 (2), and 25.1 (1.1) weeks. Of 6121 eligible infants, 4284 (70.0%) survived to 18- to 22-month follow-up, and data were available for 3892 of 4284 infants (90.8%). Among the no, partial, and complete ANS groups, there were significant differences in the rates of mortality (43.1%, 29.6%, and 25.2%, respectively), severe intracranial hemorrhage among survivors (23.3%, 19.1%, and 11.7%), death or necrotizing enterocolitis (48.1%, 37.1%, and 32.5%), and death or bronchopulmonary dysplasia (74.9%, 68.9%, and 65

  12. The effects of flexed (fetal tucking) and extended (free body) postures on the daily sleep quantity of hospitalized premature infants: A randomized clinical trial

    PubMed Central

    Valizadeh, Leila; Ghahremani, Golnar; Gharehbaghi, Manizheh Mostafa; Jafarabadi, Mohammad Asghari

    2016-01-01

    Background: Proper sleep is essential for the development of premature infants. Infants, during hospitalization, might suffer from inappropriate postures and insufficient sleep hours. To compare the daily sleep quantities of premature infants in flexed (facilitated fetal tucking) posture and extended (free body) posture. This study is a randomized clinical trial which was conducted in neonatal ward of Al-Zahra Teaching Hospital of Tabriz, Iran, 2015. Thirty-two premature infants with the age range of 33–36 weeks were selected for the study. Materials and Methods: Every infant was studied for 4 days in a sequential format. Every infant was studied for 4 days and in a 12-h period every day (8 a.m–8 p.m). Each day, an infant was randomly put in one of the four statuses, namely, free body posture in the supine position, free body posture in the lateral position, facilitated fetal tucking in the supine position and facilitated fetal tucking in the lateral position. Films were recorded in the 12-h period (8 a.m–8 p.m). SPSS Software (version 13) was used for data analysis. Results: The results showed that about the main effect of posture on sleep variable, there was a statistically significant difference (P = 0.003). In addition, about the main effect of position on sleep variable; there was a statistically significant difference (P = 0.002). Meanwhile, there was no significant interaction effect between the posture and position for the daily sleep duration (P = 0.746). Daily sleep duration of the infants in flexed (facilitated fetal tucking) posture and lateral position is longer than that of the infants in extended (free body) posture and supine position. Conclusion: Daily sleep duration in the infants experiencing flexed posture and lateral position at rest is longer. Moreover, it decreases wakefulness time of the premature infants. PMID:28331510

  13. Selective fiberoptic left main-stem intubation for severe unilateral barotrauma in a 24-week premature infant.

    PubMed

    Meyer, Michael T; Rice, Tom B; Glaspey, John C

    2002-03-01

    A 24-week premature infant developed severe right-sided pulmonary barotrauma secondary to mechanical ventilation for respiratory distress syndrome (RDS). High-frequency oscillatory ventilation and permissive hypercapnia were initiated. A chest tube was placed to relieve a pneumothorax, and a catheter was inserted into an air-filled cyst for drainage. These maneuvers failed to improve the child's respiratory status. The child's left main-stem bronchus was then successfully fiberoptically intubated for single-lung ventilation in order to reduce the unilateral barotrauma. Single-lung ventilation was effectively and safely continued for 5 days, with complete resolution of the pulmonary barotrauma.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    SciTech Connect

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

    1981-12-01

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

  17. A comparative study of respiratory syncytial virus (RSV) prophylaxis in premature infants within the Canadian Registry of Palivizumab (CARESS).

    PubMed

    Paes, B; Mitchell, I; Li, A; Lanctôt, K L

    2012-10-01

    We examined the dosing regimens, compliance, and outcomes of premature infants who received palivizumab within the Canadian Registry of Palivizumab (CARESS). Infants receiving ≥1 dose of palivizumab during the 2006-2011 respiratory syncytial virus (RSV) seasons were recruited across 30 sites. Respiratory illness events were captured monthly. Infants ≤32 completed weeks gestational age (GA) (Group 1) were compared to 33-35 completed weeks GA infants (Group 2) following prophylaxis. In total, 6,654 patients were analyzed (Group 1, n = 5,183; Group 2, n = 1,471). The mean GA was 29.9 ± 2.9 versus 34.2 ± 2.2 weeks for Groups 1 and 2, respectively. Group differences were significant (all p-values <0.05) for the following: proportion of males, Caucasians, siblings, multiple births, maternal smoking, smoking during pregnancy, household smokers, >5 household individuals, birth weight, and enrolment age. Overall, infants received 92.6 % of expected injections. Group 1 received significantly more injections, but a greater proportion of Group 2 received injections within recommended intervals. The hospitalization rates were similar for Groups 1 and 2 for respiratory illness (4.7 % vs. 3.7 %, p = 0.1) and RSV (1.5 % vs. 1.4 %, p = 0.3). Neither the time to first respiratory illness [hazard ratio = 0.9, 95 % confidence interval (CI) 0.7-1.2, p = 0.5] nor to first RSV hospitalization (hazard ratio = 1.3, 95 % CI 0.8-2.2, p = 0.3) were different. Compliance with RSV prophylaxis is high. Despite the higher number of palivizumab doses in infants ≤32 completed weeks GA, the two groups' respiratory illness and RSV-positive hospitalization rates were similar.

  18. Key Brainstem Structures Activated during Hypoxic Exposure in One-day-old Mice Highlight Characteristics for Modeling Breathing Network in Premature Infants

    PubMed Central

    Joubert, Fanny; Loiseau, Camille; Perrin-Terrin, Anne-Sophie; Cayetanot, Florence; Frugière, Alain; Voituron, Nicolas; Bodineau, Laurence

    2016-01-01

    We mapped and characterized changes in the activity of brainstem cell groups under hypoxia in one-day-old newborn mice, an animal model in which the central nervous system at birth is particularly immature. The classical biphasic respiratory response characterized by transient hyperventilation, followed by severe ventilation decline, was associated with increased c-FOS immunoreactivity in brainstem cell groups: the nucleus of the solitary tract, ventral reticular nucleus of the medulla, retrotrapezoid/parafacial region, parapyramidal group, raphe magnus nucleus, lateral, and medial parabrachial nucleus, and dorsal subcoeruleus nucleus. In contrast, the hypoglossal nucleus displayed decreased c-FOS immunoreactivity. There were fewer or no activated catecholaminergic cells activated in the medulla oblongata, whereas ~45% of the c-FOS-positive cells in the dorsal subcoeruleus were co-labeled. Approximately 30% of the c-FOS-positive cells in the parapyramidal group were serotoninergic, whereas only a small portion were labeled for serotonin in the raphe magnus nucleus. None of the c-FOS-positive cells in the retrotrapezoid/parafacial region were co-labeled for PHOX2B. Thus, the hypoxia-activated brainstem neuronal network of one-day-old mice is characterized by (i) the activation of catecholaminergic cells of the dorsal subcoeruleus nucleus, a structure implicated in the strong depressive pontine influence previously reported in the fetus but not in newborns, (ii) the weak activation of catecholaminergic cells of the ventral reticular nucleus of the medulla, an area involved in hypoxic hyperventilation, and (iii) the absence of PHOX2B-positive cells activated in the retrotrapezoid/parafacial region. Based on these results, one-day-old mice could highlight characteristics for modeling the breathing network of premature infants. PMID:28018238

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

    PubMed

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

    2015-03-01

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

  20. Effects of nesting and swaddling on the sleep duration of premature infants hospitalized in neonatal intensive care units

    PubMed Central

    Abdeyazdan, Zahra; Mohammadian-Ghahfarokhi, Maryam; Ghazavi, Zohreh; Mohammadizadeh, Majid

    2016-01-01

    Background: In neonatal intensive care unit (NICU), neonatal sleep is disrupted due to different factors. Due to the critical role of sleep in premature infants’ brain development, this study aimed to investigate the effect of nesting and swaddling on the sleep duration of premature infants hospitalized in NICUs. Materials and Methods: In a crossover clinical trial, 42 preterm infants who met the inclusion criteria were enrolled. They were randomly assigned to two groups of nest-swaddle and swaddle-nest. Sleep status was evaluated by observation and use of Prechtl's criteria. Then, durations of total sleep time (TST) and quiet sleep time (QST) were recorded. Data were analyzed using repeated measure analysis of variance (ANOVA). Results: Mean values of TST and QST during nesting and also swaddling periods were significantly higher than in the control period in both groups (P < 0.001). Mean values of TST and QST in the swaddling period were higher than in the nesting period in both groups, However, these differences were not significant (P = 0.245). Conclusions: Both swaddling and nesting could significantly increase the duration of TST and QST, compared to the control. There were no significant differences between the effects of these interventions on TST and QST. Therefore, using any of these methods is suggested to improve infants’ quality of sleep in NICU, with respect to the ward policies. PMID:27904643

  1. A histopathological study of premature and mature infants with pontosubicular neuron necrosis: neuronal cell death in perinatal brain damage.

    PubMed

    Takizawa, Yuji; Takashima, Sachio; Itoh, Masayuki

    2006-06-20

    Perinatal hypoxic-ischemic brain damage is a major cause of neuronal and behavior deficits, in which the onset of injury can be before, at or after birth, and the effects may be delayed. Pontosubicular neuron necrosis (PSN) is one of perinatal hypoxic-ischemic brain injury and its pathological peculiarity is neuronal apoptosis. In this study, we investigated whether apoptotic cascade of PSN used a caspase-pathway or not, and whether hypoglycemia activated apoptosis or not. Sections of the pons of PSN with and without hypoglycemia were stained using terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and immunohistochemistry for glial fibrillary acidic protein (GFAP), Bcl-2, Bcl-x and activated caspase 3. Additionally, we performed immunoblot analysis of Bcl-2, Bcl-x and activated caspase 3. TUNEL-positive cell was closely associated with the presence of karyorrhexis. Under combination of karyorrhectic and TUNEL-positive cells, number of apoptotic cells in premature brains was significantly more than in mature brains. Hypoxic-ischemic brain injury was considered to easily lead to apoptosis in premature infants. Moreover, as this pathophysiology, caspase-pathway activation contributed to neuronal death from caspase-immunoexpression analyses. PSN with hypoglycemia showed large number of apoptotic cells and higher expression of activated caspase 3. The result may be more severe with the background of hypoglycemia and prematurity complicated by hypoxia and/or ischemia.

  2. Oxygen as a cause of blindness in premature infants: "autopsy" of a decade of errors in clinical epidemiologic research.

    PubMed

    Jacobson, R M; Feinstein, A R

    1992-11-01

    Several intellectual "autopsies" have recently reviewed errors in clinical epidemiologic studies of causation, such as the original claim that amyl nitrite "poppers" caused AIDS. The current autopsy was done to determine why it took more than a decade--1942 to 1954--to end an iatrogenic epidemic in which high-dose oxygen therapy led to retrolental fibroplasia (RLF) in premature infants, blinding about 10,000 of them. The autopsy revealed a museum of diverse intellectual pathology. When first noted, RLF was regarded as neither a new disease nor a postnatal effect. In early investigations, the ophthalmologists did not establish explicit criteria for diagnosis and confused RLF with malformations previously seen in full-term infants. Because the patients were not referred until months after birth, the ophthalmologists assumed that the lesion, which resembled an embryologic structure, must have occurred prenatally. Other events suggesting a prenatal cause for RLF were its strong statistical associations with fetal anomalies, multiple gestations, and maternal infections. Although these events were also associated with prematurity, it was ignored when the RLF cases were compared with controls who were mainly full-term infants. The postnatal timing of RLF was eventually recognized when investigators did cohort studies in premature infants and found that RLF could develop in eyes that were normal at birth. As the search for a cause turned to events occurring after birth, statistical associations were produced for agents such as light, vitamins, iron, vitamin E deficiency, and hypoadrenalism. Each study had its own methodologic flaws: controls were missing for light; co-maneuvers were ignored for vitamins and iron; objective diagnosis was not used for vitamin E deficiency; and the research on hypoadrenalism contained biases in susceptibility and detection as well as problems of a competing outcome event. When the role of oxygen administration was first considered, the

  3. The Prevention of Prematurity: A Strategy to Reduce Infant Mortality in the District of Columbia.

    ERIC Educational Resources Information Center

    Maxwell, Joan

    The infant mortality rate in the District of Columbia is higher than that for any other state. This high rate stems from the great number of infants born seriously underweight and reflects the area's high percentage of births to impoverished black women. Efforts to reduce the mortality rate have centered around the medical treatment approach,…

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

    ERIC Educational Resources Information Center

    Smith, Barbara A.; Blass, Elliott M.

    1996-01-01

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

  5. Multi-parametric heart rate analysis in premature babies exposed to sudden infant death syndrome.

    PubMed

    Lucchini, Maristella; Signorini, Maria G; Fifer, William P; Sahni, Rakhesh

    2014-01-01

    Severe premature babies present a risk profile higher than the normal population. Reasons are related to the incomplete development of physiological systems that support baby's life. Heart Rate Variability (HRV) analysis can help the identification of distress conditions as it is sensitive to Autonomic Nervous System (ANS) behavior. This paper presents results obtained in 35 babies with severe prematurity, in quiet and active sleep and in prone and supine position. HRV was analyzed in time and frequency domain and with nonlinear parameters. The novelty of this approach lies in the combined use of parameters generally adopted in fetal monitoring and "adult" indices. Results show that most parameters succeed in classifying different experimental conditions. This is very promising as our final objective is to identify a set of parameters that could be the basis for a risk classifier to improve the care path of premature population.

  6. Plasma fatty acids in premature infants with hyperbilirubinemia: before-and-after nutrition support with fish oil emulsion.

    PubMed

    Klein, Catherine J; Havranek, Thomas G; Revenis, Mary E; Hassanali, Zahra; Scavo, Louis M

    2013-02-01

    Infants who are dependent on parenteral nutrition (PN) sometimes develop PN-associated cholestasis (PNAC). A compassionate use protocol, approved by the U.S. Food and Drug Administration and the institutional review board, guided enrollment of hospitalized infants with PNAC (<1 year of age, PN dependence for >3 weeks). Plasma concentrations of essential fatty acids were monitored before and after a soybean-based PN lipid, infused at 3 g/kg body weight/d, was replaced by an experimental fish oil-based intravenous fat emulsion (FO-IVFE) at 1.0 g/kg/d. All participants were born premature (n = 10; 20% male). At enrollment, infants were (mean ± SD) 86.5 ± 53.5 days of life and weighed 2.24 ± 0.87 kg; direct bilirubin was 5.5 ± 1.3 mg/dL. After treatment, blood concentrations significantly increased from baseline (P < .017) for circulating eicosapentaenoic acid (6.3 ± 3.0 to 147.8 ± 53.1 µg/mL), docosahexaenoic acid (20.7 ± 6.5 to 163.7 ± 43.4 µg/mL), pristanic acid (0.01 ± 0.01 to 0.17 ± 0.03 µg/mL), and phytanic acid (0.06 ± 0.03 to 0.64 ± 0.15 µg/mL). In contrast, total plasma ω-6 fatty acids (including linoleic acid) decreased (P < .017). The triene/tetraene ratio remained below the threshold value of 0.2 that defines ω-6 deficiency. No adverse effects were observed attributable to FO-IVFE. Discontinuation of FO-IVFE was typically due to infants (body weight 3.76 ± 1.68 kg) transitioning to enteral feeding rather than for resolution of hyperbilirubinemia (direct bilirubin 7.9 ± 4.8 mg/dL). These exploratory results suggest that FO-IVFE raises circulating ω-3 fatty acids in premature infants without development of ω-6 deficiency in the 8.3 ± 5.8-week time frame of this study.

  7. Effect of heparin dose and infusion rate on lipid clearance and bilirubin binding in premature infants receiving intravenous fat emulsions.

    PubMed

    Spear, M L; Stahl, G E; Hamosh, M; McNelis, W G; Richardson, L L; Spence, V; Polin, R A; Pereira, G R; Hamosh, P

    1988-01-01

    The effect of heparin dose and infusion rate on plasma lipids, lipases, and unbound bilirubin was investigated in 22 premature infants with physiologic jaundice. Infants were randomly assigned to receive low or high intravenous doses (24 vs 137.3 U/day) of heparin. Each patient then received 2 g/kg/day of 10% Intralipid on 2 successive days: one day during a 15-hour period and the other day over 24 hours, with the order assigned randomly. The results demonstrate a significantly greater change in serum-free fatty acids in infants receiving the high heparin dose during the 15-hour lipid infusion period. Lipoprotein lipase activity rose more with the high heparin dose and equally at either infusion rate. We conclude that lipid infusions of 2 g/kg/day with low heparin dosage infused over 24 hours resulted in less elevation in serum-free fatty acids. There were no adverse effects on unbound bilirubin at either infusion rate or heparin dosage.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed Central

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

    2015-01-01

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

  10. [Neurotoxicity of general anesthetics in childhood: does anesthesia leave its mark on premature babies, newborns and infants?].

    PubMed

    Sinner, B; Becke, K; Engelhard, K

    2013-02-01

    Many animal experiments have shown that anesthetics can have a neurotoxic effect on immature brains because they induce apoptosis and influence neurogenesis and synaptogenesis. In animal experiments this has substantial implications for the neurocognitive functions of animals in later life. Whether these results of animal experiments can be transferred to humans is currently the subject of intensive research. In several retrospective studies no clear association between anesthesia in premature babies, newborns or infants and the occurrence of learning disorders or behavioral problems could be found. The prospective studies GAS and PANDA are designed to obtain a deeper insight and if possible to clarify this problem. Because of the high relevance of this topic and in order to achieve more clarity for this problem when dealing with parents, the scientific working group for neuroanesthesia and pediatric anesthesia of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) has formulated a position document on the basis of currently available data.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2016-09-01

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

  13. Treatment for Retinopathy of Prematurity in an Infant with Adenoviral Conjunctivitis

    PubMed Central

    Gunay, Murat; Celik, Gokhan; Con, Rahim

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Feldman, Ruth

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Mathur, Amit; Inder, Terrie

    2009-01-01

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

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

    PubMed

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

    2015-08-19

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

  17. What we have learned regarding antibiotic therapy for the reduction of infant morbidity after preterm premature rupture of the membranes.

    PubMed

    Mercer, Brian M; Goldenberg, Robert L; Das, Anita F; Thurnau, Gary R; Bendon, Robert W; Miodovnik, Menachem; Ramsey, Risa D; Rabello, Yolanda A

    2003-06-01

    Preterm premature rupture of the membranes (pPROM) is responsible for approximately one third of the over 450,000 preterm births occurring in the United States annually. In this manuscript, we summarize the outcomes and analyses related to the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network (NICHD-MFMU) network multicenter trial of antibiotics to reduce infant morbidity after pPROM. Based on evident reduction in gestational age dependent and infectious infant morbidity, we provide the rationale for aggressive intravenous and oral, broad spectrum Ampicillin/Amoxicillin, and Erythromycin therapy during conservative management of pPROM before 32 weeks' gestation. We further review the histopathologic correlates to pPROM, to antibiotic treatment, and to perinatal outcome, and discuss the relationships between maternal and neonatal cytokine levels intercellular adhesion molecule, and other clinical and plasma markers regarding perinatal morbidity. The use and limitations of ultrasound and vaginally collected amniotic fluid pulmonary maturity assessment are discussed.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2008-01-01

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

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

    PubMed

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

    2001-06-01

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

  1. [Premature rupture of fetal membranes, risk of infection and infant prognosis--a comparison of 2 regions].

    PubMed

    Riegel, K; Söhne, B; Fischer, P; Ort, B; Wolke, D; Osterlund, K

    1999-01-01

    The question to be answered was: Does premature rupture of membranes (PROM) and duration of PROM lead to increased mortality, neonatal and late morbidity and adverse cognitive developmental outcome? We present data of a bi-national cohort observation study in South Bavaria (SBy) and South Finland (SF). The sample included all children, who were admitted to a children's hospital (SBy N: 7505/70,600 live births; SF N: 1536/15,618), and some not transferred control infants (916 and 658, respectively). Obstetric details like PROM were obtained from perinatal records. Mortality and neonatal morbidity were recorded prospectively. Somatic, neurological and cognitive development was assessed at five and 20 months (corrected age), and final diagnosis of cerebral palsy (CP) and severe mental retardation was made at 56 months of age. Data were analysed separately for three gestational groups (< 32 (I), 32-36 (II), and > 36 weeks PMA (III)). PROM occurred more frequent in SBy than in SF and in both areas with preterm delivery. PROM irrespective of its duration had no adverse effect on mortality, morbidity, CP-rate or cognitive outcome of groups I and III in either SBy or SF. There was even a slightly lower mortality rate in extremely preterm infants after PROM. In SBy only, group II with PROM > 24 hours had a slightly increased incidence of CP. Unfavorable outcome was closely related to perinatal infections, which increased with duration of PROM. PROM and/or preterm labor occurred more often without than with inflammations of amnion and placenta. We conclude: PROM per se has no adverse effects on longterm outcome of special care infants, but it is closely associated with the developmental risk factors perinatal infections and, in particular, preterm birth. The prevention of ascending infections deserves further investigation, although such action may be beneficial lately to only a minority of individuals.

  2. Necrotizing fasciitis: a case report of a premature infant with necrotizing enterocolitis.

    PubMed

    Casey, Denise M; Stebbins, Karen; Howland, Victoria

    2013-01-01

    Necrotizing fasciitis (NF) is a severe infection involving the superficial fascia, subcutaneous tissue, and, occasionally, deeper tissue layers. Usual treatment is with surgical debridement in combination with antibiotics. In review of the literature there is one neonatal report of NF associated with necrotizing enterocolitis. We present a case report of a 25 week gestation infant with necrotizing fasciitis and the complexity of wound and pain management presented for the nursing staff in the neonatal intensive care unit.

  3. Comparison of Oral Acetaminophen Versus Ibuprofen in Premature Infants With Patent Ductus Arteriosus

    PubMed Central

    Bagheri, Mohammad Mehdi; Niknafs, Pedram; Sabsevari, Fatemeh; Torabi, Mohammad Hosein; Bahman Bijari, Bahareh; Noroozi, Elahe; Mossavi, Hamid

    2016-01-01

    Background Patent ductus arteriosus (PDA) is a common cause of morbidity. The aim of this study was to compare the efficacy of oral Acetaminophen and oral Ibuprofen for the closure of patent ductus arteriosus (PDA) in preterm infants. Objectives This study demonstrated that, there was no significant difference between treatment of PDA with either oral Acetaminophen or oral Ibuprofen in preterm neonates. Patients and Methods This clinical trial, randomized study, enrolled 120 infants, with a gestational age of < 37 weeks, who were admitted in neonatal intensive care unit of Afzalipour hospital, Kerman, Iran, in 2014. PDA was confirmed echocardiographically. The trial was registered in Iranian registry of clinical trials (Reg. No. 25542). Sixty-seven infants received oral Acetaminophen (15mg/kg every six hours for three days) and 62 infants received Ibuprofen (an initial dose of 20 mg/kg, followed by 10 mg/kg at 24 and 48 hours). To evaluate the efficacy of the treatment, a second echocardiography was done after completing the treatment. Results After the first course of the treatment, PDA closed in 55 (82.1 %) patients who received oral Acetaminophen vs. 47 (75.8 %) of those given oral Ibuprofen (P = 0.38). After the second course of treatment, PDA closed in 50 % of oral Acetaminophen group and 73.3% of oral Ibuprofen group (P = 0.21). Conclusions This study demonstrated that, there was no significant difference between treatment of PDA with either oral Acetaminophen or oral Ibuprofen in preterm neonates. Oral Ibuprofen can effectively close PDA but is unfortunately associated with some adverse effects limiting its utility thus we studied an alternative drug with similar efficacy and less adverse effects. This study has recommends Acetaminophen with minimal complications for the treatment of PDA in preterm neonates instead of Ibuprofen. PMID:27713809

  4. The Role of Interleukin-6 and C-Reactive Protein in Non-Thyroidal Illness in Premature Infants Followed in Neonatal Intensive Care Unit

    PubMed Central

    Dilmen, Uğur

    2012-01-01

    Objective: To investigate the role of interleukin-6 (IL-6) and C-reactive protein (CRP) in non-thyroidal illness (NTI) in premature infants. Methods: Serum levels of IL-6 and CRP, thyroid-stimulating hormone (TSH), total thyroxine (T4), free T4 (fT4), total triiodothyronine (T3), and free T3 (fT3) were determined at the 1st, 2nd and 4th weeks of postnatal life in 148 premature infants born before 33 weeks of gestation. Results: At the 1st week, serum T3 was negatively correlated with IL-6(r= -0.33, p= 0.001) and CRP (r= -0.17, p= 0.03). Serum T3 was negatively and more strongly correlated with IL-6 (r= -0.49, p= 0.001) and CRP (r=- 0.33,p= 0.03) at the 2nd week, at which time sepsis frequency and low T3 rates were the highest. At the 4th week, mortality rate was higher among infants with lower T3 levels. Conclusions: High IL-6 and CRP values related to neonatal sepsis might have a significant role in the pathogenesis of NTI in premature infants. Conflict of interest:None declared. PMID:22672862

  5. Peptidome analysis of human milk from women delivering macrosomic fetuses reveals multiple means of protection for infants

    PubMed Central

    Cui, Xianwei; Li, Yun; Yang, Lei; You, Lianghui; Wang, Xing; Shi, Chunmei; Ji, Chenbo; Guo, Xirong

    2016-01-01

    Breastfeeding is associated with a lower incidence of obesity, diabetes, and cardiovascular disease later in life. While macrosomic infants have a higher risk of developing obesity and other metabolic disorders. Breast milk may contain special nutrients to meet the different growth needs of different infants. Whether mothers make breast milk different to meet the requirement of macrosomic infants is still unknown. Here, we conducted a comparison between mothers delivering macrosomic and non-macrosomic infants in colostrum endogenous peptides. More than 400 peptides, originating from at least 34 protein precursors, were identified by Liquid Chromatography/Mass Spectrometry (LC/MS). Out of these, 29 peptides found to be significant differently expressed (|fold change| ≥ 3, P < 0.01). Blastp analysis revealed 41 peptides may have established biological activities, which exhibit immunomodulating, antibacterial action, antioxidation, opioid agonist and antihypertensive activity. Furthermore, we found that peptide located at β-Casein 24-38 AA has antimicrobial effect against E. coli, Y. enterocolitica and S. aureus. While, κ-Casein 89-109 AA-derived peptide plays as a regulator of preadipocyte proliferation. The profile of endogenous peptides from macrosomic term infants is different from non-macrosomic terms. This different peptide expression potentially has specific physiological function to benefit macrosomic infants. Finally, we believe that our research is a meaningfull finding which may add to the understanding of milk peptide physiological action. PMID:27566575

  6. [Comparative evaluation of the effectiveness of various schedules of phototherapy in premature newborn infants with hyperbilirubinemia].

    PubMed

    Rudenko, E B; Kalinicheva, V I

    1990-01-01

    As many as 118 premature neonates weighing from 900 to 2500 g at birth, afflicted with hyperbilirubinemia were examined. In 80 children, the use of phototherapy (PT) appeared an indispensable condition of the treatment of jaundice. The regimen of radiation varied: 28 children received intermittent treatment lasting 24 hours; 52 children were given continuous treatment, with the period of radiation amounting to 48 or 72 hours. Part of the children were on PT combined with alpha-tocopherol acetate. Bilirubin concentration in the blood serum, lipid peroxidation, the lipid and phospholipid spectra of red blood cell membranes were used as criteria for the treatment efficacy. The highest therapeutic effect was attained in the children who received continuous radiation lasting 48 hours. The efficacy of PT turned out enhanced on its combination with alpha-tocopherol acetate.

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

    PubMed Central

    George, Lovya; Jain, Sunil K.

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Mitchell, Timothy J.

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

  9. Effects of oral L-carnitine supplementation in low-birth-weight premature infants maintained on human milk.

    PubMed

    Melegh, B; Kerner, J; Sándor, A; Vincellér, M; Kispál, G

    1987-01-01

    Effects of oral L-carnitine supplementation on fat and protein metabolism have been studied in 20 low-birth-weight premature infants (mean weight at birth 1.519 g, range 1,200-1,880 g) fed with pooled pasteurized human milk. Throughout 7 consecutive days, started at various postnatal ages (range 10-33 days) infants were fed exclusively with milk containing 300 nmol/ml L-carnitine as added supplement. The amount of extra carnitine intake ranged from 42.6 to 72.0 mumol/kg/day. Until day 5 of supplementation there was a continuous increase in the daily urinary excretion of total carnitine, which levelled off thereafter, corresponding approximately to 50% of the extra L-carnitine intake, indicating that a part of the supplement was retained by the body. Total, free and esterified carnitine levels were significantly elevated in the plasma at the end of the study period. The increased levels of acylcarnitines in plasma and urine indicate that the carnitine supplement was taken up by tissues and entered the intermediary metabolism. Plasma triglyceride level was decreased, whereas 3-hydroxybutyrate level was increased at the end of supplementation, indicating an enhanced fat utilization. Plasma and urine analysis also revealed an altered nitrogen handling. There was a marked decrease in plasma urea level as well as a significant fall in the urea and total N excretion, with a trend of decrease in excretion of 3-methylhistidine, suggesting a reduced amino acid and protein catabolism during L-carnitine supplementation.

  10. Automatic vessel segmentation in wide-field retina images of infants with retinopathy of prematurity.

    PubMed

    Poletti, Enea; Fiorin, Diego; Grisan, Enrico; Ruggeri, Alfredo

    2011-01-01

    The earliest signs of Retinopathy of Prematurity (ROP) are tortuosity and dilation of retinal vessels. Such vascular changes are considered of primary importance for the diagnosis and the follow-up of the disease. However, a widely accepted computerized system for their quantitative measurement is still missing. Images taken from a preterm baby's eye are often low-contrast, noisy, and blurred. Algorithms that have been successfully applied to analyze adult retinal images do not work well in ROP images. We propose here a novel method for the automatic extraction of vessel centerline in wide-field ROP retinal images, based on a sparse tracking scheme. After a set of seed points is identified all over the image, vessels are traced by connecting those seeds by means of minimum cost paths, whose weights depend on similarity features and alignment evaluated by a custom line operator. The performance of the method was assessed on a dataset of 20 images acquired with the RetCam fundus camera. A sensitivity of 0.78 and a false detection rate of 0.15 were obtained with respect to manual ground truth reference.

  11. Intraperitoneal administration of shiga toxin type 2 in rats in the late stage of pregnancy produces premature delivery of dead fetuses.

    PubMed

    Burdet, J; Zotta, E; Franchi, A M; Ibarra, C

    2009-06-01

    Infection associated with Shiga toxin-producing Escherichia coli (STEC) and subsequent Hemolytic-Uremic Syndrome (HUS) have become relevant in public health since STEC is considered as one of the most important emergent pathogens. STEC infection may either be asymptomatic or begin with watery diarrhea associated with hemorrhagic colitis and HUS. The major virulence factor of STEC is Shiga toxin type 1 or 2 (Stx1, Stx2) although strains that express only Stx2 are highly prevalent. Up to now, it has not been established whether STEC infection affect pregnant women. In this study, we evaluated the effect of Stx2 on maternal lethality, fetal status and delivery time by injecting Stx2 in rats in the late stage of pregnancy. Stx2 induced fetal resorption, placental abruption, intrauterine hemorrhage and fetal death at 1-2 days post-injection in a dose-dependent manner. With 2ng Stx2/g body weight, placentas and fetuses presented extensive necrotic areas, while uteri and kidneys showed normal histology. Immunolocalization of Stx2 was observed in placentas and fetuses. With 4 and 6ng Stx2/g body weight maternal death was also observed. Those rats that survived after Stx2-treatment were able to become pregnant and deliver normal pups at term. Our results show, for the first time, that the preterm labor with fetal death observed in treated rats may be a consequence of the action of Stx2 on the feto-maternal unit. Although there are no reports of Stx2 effects in human pregnancy, we speculate that STEC infections could be one of the causes not yet determined of fetal morbimortality.

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  14. Cervical ribs are more prevalent in stillborn fetuses than in live-born infants and are strongly associated with fetal aneuploidy.

    PubMed

    Furtado, Larissa V; Thaker, Harshwardhan M; Erickson, Lance K; Shirts, Brian H; Opitz, John M

    2011-01-01

    This study was undertaken to determine the prevalence of cervical ribs in stillborn fetuses undergoing autopsy at our institution and to search for significant associations with cervical ribs. European studies have reported an increased prevalence of cervical ribs in patients with childhood cancer and in stillborn fetuses. We reviewed data from autopsies performed at Primary Children's Medical Center, Utah, between 2006 and 2009 on 225 stillborns (≥20 weeks) and 93 deceased live-born infants (<1 year). Digital fetal radiographs in anterior-posterior and lateral views had been taken of each subject. Chi-square analysis and general linear models were used for statistical analysis of the data. The overall prevalence of cervical ribs was higher in stillborns than in live-borns who died in the first year (43.1% vs 11.8%). Karyotypes were available for 93 (41.3%) of the stillborns. Of those, cervical ribs were present in 33 of 76 (43.4%) stillborns with normal karyotype and in 13 of 17 (76.4%) stillborns with aneuploidy. Females with unavailable karyotypes were more likely to have cervical ribs than those with normal karyotypes (P  =  0.0002). This greater likelihood was not observed in males. Among the stillborns with normal karyotypes, we found no statistically significant association with gender or gestational age at fetal death. There was also no statistically significant association between congenital anomalies and the presence of cervical ribs. Our findings support the hypothesis that cervical ribs are markers for disadvantageous developmental events occurring during blastogenesis and have been subject to strong negative selection during evolution.

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

    PubMed Central

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

    2012-01-01

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

  16. Campylobacter fetus subspecies fetus spondylodiscitis.

    PubMed

    Chaillon, Antoine; Baty, Gaelle; Lauvin, Marie Agnès; Besnier, Jean Marc; Goudeau, Alain; Lanotte, Philippe

    2010-12-01

    Campylobacter spp. are common causes of gastrointestinal infections. Campylobacter fetus is a much rarer pathogen in humans, and usually causes bacteraemia and systemic complications in patients with predisposing conditions. We report a case of spondylodiscitis caused by C. fetus subsp. fetus as revealed by vertebral biopsy culture. This identification was confirmed by sequencing the 16S rRNA gene and by phylogenetic analysis. Treatment consisted of 6 weeks antimicrobial therapy combined with a strict initial immobilization, followed by a re-education program. The patient's recovery was uneventful.

  17. Retinopathy of Prematurity.

    ERIC Educational Resources Information Center

    Trief, E.; And Others

    1989-01-01

    Retinopathy of prematurity (ROP) has increased due to a high incidence of premature, low birthweight infants. Stages of severity range from no visual damage to total blindness, and educational problems of ROP children parallel those of other visually impaired children, early intervention being crucial. Treatments are either pharmacological or…

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

    PubMed

    Ozturk, Mehmet Adnan; Kardas, Zehra; Kardas, Fatih; Gunes, Tamer; Kurtoglu, Selim

    2016-03-01

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

  19. Severe zone III retinopathy of prematurity in an infant with a birth weight of more than 1,500 grams.

    PubMed

    Rutar, Tina; Schwartz, Daniel; Good, William

    2010-05-21

    The authors report zone III stage 3 retinopathy of prematurity requiring treatment in a former 1,692-g 30 6/7-week twin cared for in a modern intensive care nursery. This case highlights the need for identifying biomarkers that increase the risk of severe retinopathy of prematurity so that screening guidelines can be optimized.

  20. The early development of brain white matter: a review of imaging studies in fetuses, newborns and infants.

    PubMed

    Dubois, J; Dehaene-Lambertz, G; Kulikova, S; Poupon, C; Hüppi, P S; Hertz-Pannier, L

    2014-09-12

    Studying how the healthy human brain develops is important to understand early pathological mechanisms and to assess the influence of fetal or perinatal events on later life. Brain development relies on complex and intermingled mechanisms especially during gestation and first post-natal months, with intense interactions between genetic, epigenetic and environmental factors. Although the baby's brain is organized early on, it is not a miniature adult brain: regional brain changes are asynchronous and protracted, i.e. sensory-motor regions develop early and quickly, whereas associative regions develop later and slowly over decades. Concurrently, the infant/child gradually achieves new performances, but how brain maturation relates to changes in behavior is poorly understood, requiring non-invasive in vivo imaging studies such as magnetic resonance imaging (MRI). Two main processes of early white matter development are reviewed: (1) establishment of connections between brain regions within functional networks, leading to adult-like organization during the last trimester of gestation, (2) maturation (myelination) of these connections during infancy to provide efficient transfers of information. Current knowledge from post-mortem descriptions and in vivo MRI studies is summed up, focusing on T1- and T2-weighted imaging, diffusion tensor imaging, and quantitative mapping of T1/T2 relaxation times, myelin water fraction and magnetization transfer ratio.

  1. Apnea of Prematurity (For Parents)

    MedlinePlus

    ... other babies. The apnea of prematurity does not cause brain damage. A healthy baby who is apnea free for a week will probably never have AOP again. Although sudden infant death syndrome (SIDS) does happen more often in premature infants, no relationship between AOP and SIDS has ...

  2. Initiation and maintenance of a hospital-based parent group for parents of premature infants: key factors for success.

    PubMed

    Bracht, M; Ardal, F; Bot, A; Cheng, C M

    1998-04-01

    The impact of a premature birth can be very traumatic for parents. They are usually not prepared for this event, and their sense of grief and loss is so intense that they often have difficulty coping with the situation. A parent group can help parents adapt to the crisis of prematurity by providing information and family support. This article describes the development of a parent group at a regional perinatal center in Ontario and identifies key factors for its successful initiation and maintenance.

  3. Prescient Human Fetuses Thrive

    PubMed Central

    Sandman, Curt A.; Davis, Elysia Poggi; Glynn, Laura M.

    2012-01-01

    Fetal detection of adversity is a conserved trait that allows many species to adapt their early developmental trajectories to ensure survival. According to the fetal-programming model, exposure to stressful or hostile conditions in utero is associated with compromised development and a lifelong risk of adverse health outcomes. In a longitudinal study, we examined the consequences of prenatal and postnatal exposure to adversity for infant development. We found increased motor and mental development during the 1st year of life among infants whose mothers experienced congruent levels of depressive symptoms during and after pregnancy, even when the levels of symptoms were relatively high and the prenatal and postnatal environments were unfavorable. Congruence between prenatal and postnatal environments prepares the fetus for postnatal life and confers an adaptive advantage for critical survival functions during early development. PMID:22173740

  4. Prescient human fetuses thrive.

    PubMed

    Sandman, Curt A; Davis, Elysia Poggi; Glynn, Laura M

    2012-01-01

    Fetal detection of adversity is a conserved trait that allows many species to adapt their early developmental trajectories to ensure survival. According to the fetal-programming model, exposure to stressful or hostile conditions in utero is associated with compromised development and a lifelong risk of adverse health outcomes. In a longitudinal study, we examined the consequences of prenatal and postnatal exposure to adversity for infant development. We found increased motor and mental development during the 1st year of life among infants whose mothers experienced congruent levels of depressive symptoms during and after pregnancy, even when the levels of symptoms were relatively high and the prenatal and postnatal environments were unfavorable. Congruence between prenatal and postnatal environments prepares the fetus for postnatal life and confers an adaptive advantage for critical survival functions during early development.

  5. What matters to the parents? A qualitative study of parents' experiences with life-and-death decisions concerning their premature infants.

    PubMed

    Brinchmann, Berit Støre; Førde, Reidun; Nortvedt, Per

    2002-07-01

    The aim of this article is to generate knowledge about parents' participation in life-and-death decisions concerning their very premature and/or critically ill infants in hospital neonatal units. The question is: what are parents' attitudes towards their involvement in such decision making? A descriptive study design using in-depth interviews was chosen. During the period 1997-2000, 20 qualitative interviews with 35 parents of 26 children were carried out. Ten of the infants died; 16 were alive at the time of the interview. The comparative method (grounded theory) was used to analyse the data. The analysis was carried out continuously and in parallel with data collection. Six categories were revealed by the analysis: indecision and uncertainty (ambivalence); information and communication; participate, but do not decide; seeming to be included; the parents' child; and individual consideration. The findings appear to indicate that parents agree that they should not have the final word in decisions concerning their infants' future life or death. Such a responsibility would put too heavy a burden on parents who lack the medical knowledge and the professional experience needed to make such a decision, and would be likely to lead to them experiencing strong feelings of guilt. The findings show that parents should be well informed and listened to during the whole decision-making process. Their primary concern was how nurses and physicians communicate with parents who are experiencing a crisis, and how this serious information is presented.

  6. Evaluation of a School for Young Mothers: The Frequency of Prematurity Among Infants Born to Mothers Under 17 Years of Age, According to the Mother's Attendance of a Special School During Pregnancy

    ERIC Educational Resources Information Center

    Stine, Oscar C.; Kelley, Elizabeth B.

    1970-01-01

    Registration with a social agency, required attendance of prenatal care, school lunch, milk, and health an nutritional education are elements of a public school program for teenage mothers which is described in this article. Significantly fewer premature births and infant deaths are reported as a result of the program. (DM)

  7. [Noninvasive, continuous monitoring of artificial respiration in premature and newborn infants by the constant measurement of respiratory minute volume, oxygen consumption and carbon dioxide release].

    PubMed

    Leidig, E; Noller, F; Mentzel, H

    1986-01-01

    A system of instrumentation for the continuous measurement of the respiratory gases during assisted ventilation of neonates and premature infants based upon "breath-by-breath-method" is described. The four respiratory parameters flow (V), ventilation pressure (p), oxygen-concentration and carbon dioxide-concentration are measured. These datas are processed by a computer to generate a continuous display of the respiratory minute volume, the tidal volume, the breath rate, the oxygen consumption and the carbon dioxide production. All parameters are stored and can be displayed or plotted as trends. The flow-measurement is performed using hot-wire-anemometry. The very small flow sensor is adapted directly to the tube. Next to this sensor, the respiratory gas for the analysis of the O2- and CO2- concentration is suctioned off continuously. First clinical experience in mechanically ventilated newborns is characterized.

  8. Urinary neutrophil gelatinase-associated lipocalin is an early predictor of acute kidney injury in premature infants

    PubMed Central

    Kuribayashi, Ryota; Suzumura, Hiroshi; Sairenchi, Toshimi; Watabe, Yoshiyuki; Tsuboi, Yayoi; Imataka, George; Kurosawa, Hidemitsu; Arisaka, Osamu

    2016-01-01

    Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is produced in response to tubular epithelial injury and is a biomarker of tubulointerstitial injury. The aim of the present study was to examine whether acute kidney injury (AKI) could be predicted by measuring uNGAL in very low-birth weight (VLBW) infants. Forty VLBW infants with birthweight below 1,500 g were enrolled in the present study. uNGAL and serum creatinine (sCre) were measured daily from postnatal days 0 to 8. Infants with sCre ≥1.2 mg/dl were diagnosed with AKI. The relationship of uNGAL with sCre was measured on the day after uNGAL measurement (next-day sCre) was examined. The results showed that 16 infants had sCre ≥1.2 mg/dl in this period. Logistic regression analysis revealed that uNGAL on postnatal days 2, 3, 4, 5 and 6 was correlated with next-day sCre (P<0.05). uNGAL corrected by urinary Cre (uCre) (uNGAL/uCre) was only correlated with an increase in next-day sCre on postnatal days 5 and 6 (P<0.05). For the logistic analysis, subjects with high and low uNGAL levels based on the median value for each day, uNGAL on postnatal days 2, 3 and 6 in the high uNGAL group was correlated with an increase in next-day sCre. Thus, AKI may be predicted by measuring uNGAL in VLBW infants. This measurement was non-invasive, and is potentially useful for the evaluation of renal function in VLBW infants. PMID:28105101

  9. Growth is similar in premature infants fed human milk fortified with a human milk or bovine milk-based fortifier

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Preterm infants require fortification of human milk (HM) to provide adequate nutrients for growth. A human milk fortifier (HMF) made from donor human milk has recently been introduced. However, limited data are available comparing the growth outcomes of this product with current fortifiers. We evalu...

  10. Prenatal administration of the cytochrome P4501A inducer, {Beta}-naphthoflavone (BNF), attenuates hyperoxic lung injury in newborn mice: Implications for bronchopulmonary dysplasia (BPD) in premature infants

    SciTech Connect

    Couroucli, Xanthi I.; Liang Yanhong Wei; Jiang Weiwu; Wang Lihua; Barrios, Roberto; Yang Peiying; Moorthy, Bhagavatula

    2011-10-15

    Supplemental oxygen contributes to the development of bronchopulmonary dysplasia (BPD) in premature infants. In this investigation, we tested the hypothesis that prenatal treatment of pregnant mice (C57BL/6J) with the cytochrome P450 (CYP)1A1 inducer, ss-napthoflavone (BNF), will lead to attenuation of lung injury in newborns (delivered from these dams) exposed to hyperoxia by mechanisms entailing transplacental induction of hepatic and pulmonary CYP1A enzymes. Pregnant mice were administered the vehicle corn oil (CO) or BNF (40 mg/kg), i.p., once daily for 3 days on gestational days (17-19), and newborns delivered from the mothers were either maintained in room air or exposed to hyperoxia (> 95% O{sub 2}) for 1-5 days. After 3-5 days of hyperoxia, the lungs of CO-treated mice showed neutrophil infiltration, pulmonary edema, and perivascular inflammation. On the other hand, BNF-pretreated neonatal mice showed decreased susceptibility to hyperoxic lung injury. These mice displayed marked induction of ethoxyresorufin O-deethylase (EROD) (CYP1A1) and methoxyresorufin O-demethylase (MROD) (CYP1A2) activities, and levels of the corresponding apoproteins and mRNA levels until PND 3 in liver, while CYP1A1 expression alone was augmented in the lung. Prenatal BNF did not significantly alter gene expression of pulmonary NAD(P)H quinone reductase (NQO1). Hyperoxia for 24-72 h resulted in increased pulmonary levels of the F{sub 2}-isoprostane 8-iso-PGF{sub 2{alpha}}, whose levels were decreased in mice prenatally exposed to BNF. In conclusion, our results suggest that prenatal BNF protects newborns against hyperoxic lung injury, presumably by detoxification of lipid hydroperoxides by CYP1A enzymes, a phenomenon that has implications for prevention of BPD in infants. - Highlights: > Supplemental oxygen is routinely administered to premature infants. > Hyperoxia causes lung injury in experimental animals. > Prenatal treatment of mice with beta-naphthoflavone attenuates oxygen

  11. Correlation between risk factors during the neonatal period and appearance of retinopathy of prematurity in preterm infants in neonatal intensive care units in Alexandria, Egypt

    PubMed Central

    Hadi, Ahmed Mahmoud Abdel; Hamdy, Islam Shereen

    2013-01-01

    Background This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP) in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012. Methods A prospective cohort study was undertaken in infants weighing < 1250 g and maternal postmenstrual age < 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP. Perinatal variables considered were: birth weight, gestational age, gender, method of ventilation (nasal continuous airway pressure or intermittent mechanical ventilation), packed red blood cell and/or plasma transfusion, occurrence of sepsis, neonatal indirect hyperbilirubinemia, intraventricular hemorrhage, and patent ductus arteriosus. After obtaining informed consent from the parents, infants at risk were examined for ROP using indirect ophthalmoscopy, ie, RetCam II fundus photography. Results The study included 152 infants of mean gestational age 31.02 weeks and mean birth weight 1.229 kg. Seventy-two cases (47.5%) were male and 80 cases (52.5%) were female. Of the cases screened, 100 (65.6%) had no ROP, 52 had ROP of any stage (34.4%), and 27 (18%) had stage 1, five (3.3%) had stage 2, 17 (11.5%) had stage 3, and three (1.6%) had stage 4 disease. No infants had stage 5 ROP. Of all our cases with ROP, 15 (28.6%) had prethreshold disease type 1 that required treatment, comprising 9.8% of all cases screened for ROP. Using stepwise logistic regression analysis, all risk factors studied were found to be significantly associated with the development of ROP, except for neonatal indirect hyperbilirubinemia. Severity of ROP was inversely proportional to birth weight and gestational age. Conclusion ROP occurred in 34.4% of all infants screened in the neonatal intensive care units at three obstetric hospitals in Alexandria. The main risk factors for development of threshold ROP by regression analysis

  12. A multicenter, randomized, double-blind trial of a new porcine surfactant in premature infants with respiratory distress syndrome

    PubMed Central

    Rebello, Celso Moura; Precioso, Alexander Roberto; Mascaretti, Renata Suman

    2014-01-01

    Objective To compare the efficacy and safety of a new porcine-derived pulmonary surfactant developed by Instituto Butantan with those of animal-derived surfactants commercially available in Brazil, regarding neonatal mortality and the major complications of prematurity in preterm newborns with birth weight up to 1500g and diagnosed with respiratory distress syndrome. Methods Neonates diagnosed with respiratory distress syndrome were randomized to receive either Butantan surfactant (Butantan group) or one of the following surfactants: Survanta® or Curosurf®. Newborns receiving Survanta® or Curosurf® comprised the control group. The main outcome measures were mortality rates at 72 hours and at 28 days of life; the typical complications of prematurity as evaluated on the 28th day of life were defined as secundary outcomes. Results No differences were observed between the Butantan (n=154) and control (n=173) groups in relation to birth weight, gestational age, sex, and prenatal use of corticosteroids, or in mortality rates both at 72 hours (14.19% versus 14.12%; p=0.98) and at 28 days (39.86% versus 33.33%; p=0.24) of life. Higher 1- and 5-minute Apgar scores were observed among control group newborns. No differences were observed as regards the secondary outcomes, except for greater need for supplemental oxygen and a higher incidence of interstitial pulmonary emphysema in the Butantan group. Conclusion The mortality rates at 72 hours and 28 days of life and the incidence of major complications of prematurity were comparable to those found with the animal-derived surfactants commercially available in Brazil, showing the efficacy and safety of the new surfactant in the treatment of respiratory distress syndrome in newborns. PMID:25628188

  13. The effect of decibel level of music stimuli and gender on head circumference and physiological responses of premature infants in the NICU.

    PubMed

    Cassidy, Jane W

    2009-01-01

    The purpose of this study was to examine different protocols with regard to the presentation of music stimuli and compare gender differential reactions to those stimuli. Subjects for this study (N = 63) were premature infants in the Neonatal Intensive Care Unit (NICU) between the gestational ages of 28 and 33 weeks. Half of the experimental infants listened to 20 mins of lullaby music (female voice with orchestral background) on 2 days followed by 20 mins of classical music (Mozart string music) on 2 days. The other half listened to the same music in the reverse order. One quarter of the males and one quarter of the females listened to music presented at an average of 65 dB, one quarter at an average of 70 dB, one quarter at an average of 75 dB, and one quarter did not listen to any music and served as control subjects. Head circumference data were collected four times by the researcher: (a) upon receipt of parental consent, (b) on the first day of music presentation (1 week after consent), (c) on the last day of music presentation, and (d) 1 week after music presentation. Physiological data (heart rate, respiratory rate, oxygen saturation) were recorded by the researcher at 2-minute intervals starting 4 minutes prior to and ending 4 minutes after music presentation. There was a significant difference (p < .0001) in average daily head growth across time, but this seems unrelated to the music condition as the same curvilinear trend (larger gain during days of treatment, smaller gain during baseline before and after treatment) was noted for control infants who did not listen to music. Results indicate a significant (p = .002), but biologically unimportant, decrease in heart rate over the course of data collection. No differences due to gender were noted.

  14. Image-level tortuosity estimation in wide-field retinal images from infants with Retinopathy of Prematurity.

    PubMed

    Poletti, Enea; Grisan, Enrico; Ruggeri, Alfredo

    2012-01-01

    Tortuosity and dilation of retinal vessels are considered of primary importance for the diagnosis and follow-up of the Retinopathy of Prematurity (ROP) disease. We developed an algorithm to estimate vessel tortuosity in images acquired with a wide-field fundus camera in ROP subjects, offering clinicians a quantitative, objective, and reproducible diagnostic parameter. Vessels were manually traced in 20 images to provide error-free input data for the tortuosity estimation. At first we investigated different vessel-level measures, some including also caliber information. Then we used them to obtain different imagelevel tortuosity measures, which were eventually combined in a supervised approach to provide a tortuosity index capable to reproduce the clinical experts assessment.To provide manual assessment, the 20 images were independently ordered by increasing tortuosity by three clinical graders and three retinal imaging experts. The proposed tortuosity index obtains a Spearman’s correlation coefficient of 0.95 with ground truth, a performance comparable to the clinical graders’ one and better than the retinal imaging experts’ one.

  15. Serial evaluation of retinal vascular changes in infants treated with intravitreal bevacizumab for aggressive posterior retinopathy of prematurity in zone I

    PubMed Central

    Padhi, T R; Das, T; Rath, S; Pradhan, L; Sutar, S; Panda, K G; Modi, R; Jalali, S

    2016-01-01

    Purpose To evaluate the serial changes in retinal vasculature in infants treated with intravitreal bevacizumab (IVB) for aggressive posterior retinopathy of prematurity (APROP) in zone I. Methods Retrospective analysis of serial changes in retinal vasculature after IVB in the seven eyes of four babies with APROP in zone I. Results The initial regression, following IVB, was dramatic with reduction in vessel caliber and marked thinning and invisibility of the bridging shunts. Resurgent vascular development was very slow radially though there was continued abnormal vascular growth circumferentially. Common findings in all eyes were tangled vasculature and fine saw-toothed shunts. The variable findings were (1) new closely packed multilayered bridging shunts, long arching mature looking vessels, and finally a ridge at the periphery (n=3 eyes) at 52 weeks of postmenstrual age (PMA); (2) status quo at the stage of saw-toothed shunt and ridge in both eyes for a long time (n=2 eyes); and (3) multiple retinal hemorrhages within the vascularized retina and thick preretinal hemorrhage overlying the saw-toothed shunts and ridge that persisted for another 3 weeks and regressed 2 weeks after laser (n=1). The eyes that received bevacizumab alone (3) did not show any abnormal vascularization at 56 weeks of PMA or beyond. Conclusions The retinal vascularization following IVB was different than normal in terms of its time, speed, and morphology; few of these changes are first to be reported in the literature (Medline search) and warrants further studies. PMID:26584796

  16. Attitude and beliefs of traditional birth attendants to prematurely erupted teeth of infants in urban local government areas in Ibadan, Nigeria.

    PubMed

    Bankole, Olubunmi; Taiwo, Juliana; Nasiru, Olukemi

    Traditional birth attendants (TBAs) can be invaluable in assisting to dispel myths commonly associated with natal/neonatal teeth. To ensure correct delivery of the message, baseline data of their beliefs is important. To assess the attitude and beliefs of some Nigerian TBAs to prematurely erupted teeth in infants, a total enumeration of the TBAs in the five urban Local Government Areas in Ibadan was conducted and 163 consenting TBAs were recruited using an interviewer-administered questionnaire. The attitude of the TBAs was that of fear and shock (35.6%) while 30 (18.4%) will consider the child weird. Perceived causes of the variation include evil spirits (31.9%), contravening cultural taboos (9.2%), and prolonged gestation (4.9%). Beliefs on the effect of natal/neonatal teeth on the child include strange behavior (31.3%), child developing evil spiritual powers (41.1%), and mental retardation (3.1%). Practices included advising parents to get rid of/or hide the child (4.9%) and immediate extraction of the teeth with/without sacrifices (35.6%). There is an urgent need to address knowledge gaps by giving health education to TBAs.

  17. Prematurity Affects Age of Presentation of Pyloric Stenosis.

    PubMed

    Costanzo, Caitlyn M; Vinocur, Charles; Berman, Loren

    2017-02-01

    Term infants with hypertrophic pyloric stenosis (HPS) typically present between 4 and 6 weeks. There is limited consensus, however, regarding age of presentation of premature infants. We aim to determine if there is an association between the degree of prematurity and chronological age of presentation of HPS. A total of 2988 infants who had undergone a pyloromyotomy for HPS were identified from the 2012 and 2013 NSQIP-P Participant Use Files. Two hundred seventeen infants (7.3%) were born prematurely. A greater degree of prematurity was associated with an older chronological age of presentation ( P < .0001). Prematurity was significantly associated with an increase in overall postoperative morbidity, reintubation, readmission, and postoperative length of stay. When clinicians evaluate an infant with nonbilious emesis with a history of prematurity, they should consider pyloric stenosis if the calculated postconceptional age is between 44 and 50 weeks. When counseling families of premature infants, surgeons should discuss the increased incidence of postpyloromyotomy morbidity.

  18. The role of CO2 and central chemoreception in the control of breathing in the fetus and the neonate

    PubMed Central

    Darnall, Robert A.

    2010-01-01

    Central chemoreception is active early in development and likely drives fetal breathing movements, which are influenced by a combination of behavioral state and powerful inhibition. In the premature human infant and newborn rat ventilation increases in response to CO2; in the rat the sensitivity of the response increases steadily after ~P12. The premature human infant is more vulnerable to instability than the newborn rat and exhibits periodic breathing that is augmented by hypoxia and eliminated by breathing oxygen or CO2 or the administration of respiratory stimulants. The sites of central chemoreception active in the fetus are not known, but may involve the parafacial respiratory group which may be a precursor to the adult RTN. The fetal and neonatal rat brainstem spinal-cord preparations promise to provide important information about central chemoreception in the developing rodent and will increase our understanding of important clinical problems, including The Sudden Infant Death Syndrome, Congenital Central Hypoventilation Syndrome, and periodic breathing and apnea of prematurity. PMID:20399912

  19. Tactile/kinesthetic stimulation (TKS) increases tibial speed of sound and urinary osteocalcin (U-MidOC and unOC) in premature infants (29-32 wks PMA)

    PubMed Central

    Haley, S; Beachy, J; Ivaska, KK; Slater, H; Smith, S; Moyer-Mileur, LJ

    2012-01-01

    Preterm delivery (<37 wks post-menstrual age) is associated with suboptimal bone mass. We hypothesized that tactile/kinesthetic stimulation (TKS), a form of infant massage that incorporates kinesthetic movement, would increase bone strength and markers of bone accretion in preterm infants. Preterm, AGA infants (29-32 wks) were randomly assigned to TKS (N=20) or Control (N=20). Twice daily TKS was provided six days per week for two weeks. Control infants received the same care without TKS treatment. Treatment was masked to parents, health care providers, and study personnel. Baseline and week two measures were collected for tibial speed of sound (tSOS, m/sec), a surrogate for bone strength, by quantitative ultrasound (Sunlight8000) and urine markers of bone metabolism, pyridinium crosslinks and osteocalcin (U-MidOC and unOC). Infant characteristics at birth and study entry as well as energy/nutrient intake were similar between TKS and Control. TKS intervention attenuated the decrease in tSOS observed in Control infants (p<0.05). Urinary pyridinium crosslinks decreased over time in both TKS and CTL (p<0.005). TKS infants experienced greater increases in urinary osteocalcin (U-MidOC, p<0.001 and unOC, p<0.05). We conclude that TKS improves bone strength in premature infants by attenuating the decrease that normally follows preterm birth. Further, biomarkers of bone metabolism suggest a modification in bone turnover in TKS infants in favor of bone accretion. Taken together, we speculate that TKS improves bone mineralization. PMID:22846674

  20. Plasticity of neonatal neuronal networks in very premature infants: Source localization of temporal theta activity, the first endogenous neural biomarker, in temporoparietal areas.

    PubMed

    Routier, L; Mahmoudzadeh, M; Panzani, M; Azizollahi, H; Goudjil, S; Kongolo, G; Wallois, F

    2017-01-23

    Temporal theta slow-wave activity (TTA-SW) in premature infants is a specific signature of the early development of temporal networks, as it is observed at the turning point between non-sensory driven spontaneous local processing and cortical network functioning. The role in development and the precise location of TTA-SW remain unknown. Previous studies have demonstrated that preterms from 28 weeks of gestational age (wGA) are able to discriminate phonemes and voice, supporting the idea of a prior genetic structural or activity-dependent fingerprint that would prepare the auditory network to compute auditory information at the onset of thalamocortical connectivity. They recorded TTA-SW in 26-32 wGA preterms. The rate of TTA-SW in response to click stimuli was evaluated using low-density EEG in 30 preterms. The sources of TTA-SW were localized by high-density EEG using different tissues conductivities, head models and mathematical models. They observed that TTA-SW is not sensory driven. Regardless of age, conductivities, head models and mathematical models, sources of TTA-SW were located adjacent to auditory and temporal junction areas. These sources become situated closer to the surface during development. TTA-SW corresponds to spontaneous transient endogenous activities independent of sensory information at this period which might participate in the implementation of auditory, language, memory, attention and or social cognition convergent and does not simply represent a general interaction between the subplate and the cortical plate. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

  1. Post mortem magnetic resonance imaging in the fetus, infant and child: A comparative study with conventional autopsy (MaRIAS Protocol)

    PubMed Central

    2011-01-01

    Background Minimally invasive autopsy by post mortem magnetic resonance (MR) imaging has been suggested as an alternative for conventional autopsy in view of the declining consented autopsy rates. However, large prospective studies rigorously evaluating the accuracy of such an approach are lacking. We intend to compare the accuracy of a minimally invasive autopsy approach using post mortem MR imaging with that of conventional autopsy in fetuses, newborns and children for detection of the major pathological abnormalities and/or determination of the cause of death. Methods/Design We recruited 400 consecutive fetuses, newborns and children referred for conventional autopsy to one of the two participating hospitals over a three-year period. We acquired whole body post mortem MR imaging using a 1.5 T MR scanner (Avanto, Siemens Medical Solutions, Enlargen, Germany) prior to autopsy. The total scan time varied between 90 to 120 minutes. Each MR image was reported by a team of four specialist radiologists (paediatric neuroradiology, paediatric cardiology, paediatric chest & abdominal imaging and musculoskeletal imaging), blinded to the autopsy data. Conventional autopsy was performed according to the guidelines set down by the Royal College of Pathologists (UK) by experienced paediatric or perinatal pathologists, blinded to the MR data. The MR and autopsy data were recorded using predefined categorical variables by an independent person. Discussion Using conventional post mortem as the gold standard comparator, the MR images will be assessed for accuracy of the anatomical morphology, associated lesions, clinical usefulness of information and determination of the cause of death. The sensitivities, specificities and predictive values of post mortem MR alone and MR imaging along with other minimally invasive post mortem investigations will be presented for the final diagnosis, broad diagnostic categories and for specific diagnosis of each system. Clinical Trial Registration

  2. Prematures with and without Regressed Retinopathy of Prematurity: Comparison of Long-Term (6-10 Years) Ophthalmological Morbidity.

    ERIC Educational Resources Information Center

    Cats, Bernard P.; Tan, Karel E. W. P.

    Reporting long-term ophthalmologic sequelae among ex-prematures at 6 to 10 years of age, this study compares 42 ex-premature infants who had had regressed forms of retinopathy of prematurity (ROP) during the neonatal period with 42 matched non-ROP ex-premature controls at 6 to 10 years of age. Subjects were subdivided into four groups: (1) ROP…

  3. Gestational changes in the germinal matrix of the normal rhesus monkey fetus.

    PubMed

    Lenn, N J; Whitmore, L

    1985-01-01

    To explain the reported predisposition to germinal matrix hemorrhage in premature infants, pathogenetically important morphological features of the germinal matrix should be present in the 3rd trimester and rapidly change near term. Such features were sought in this study of the germinal matrix and its vasculature in normal rhesus monkey fetuses. The matrix cells, glia, ependyma, and capillaries showed no important structural changes during the 3rd trimester. The terminal vein tributaries were greatly enlarged by 148 days, but cellular and collagen support in their walls was minimal at this time. The latter features developed by the final days of gestation. These findings do not support a structural immaturity or specialization of the germinal matrix predisposing to germinal matrix hemorrhage. Our results, therefore, support the recent emphasis on physiological parameters in the pathogenesis and prevention of germinal matrix hemorrhage.

  4. Serotonin Receptors in the Medulla Oblongata of the Human Fetus and Infant: The Analytic Approach of the International Safe Passage Study

    PubMed Central

    Folkerth, Rebecca D.; Paterson, David S.; Broadbelt, Kevin G.; Dan Zaharie, S.; Hewlett, Richard H.; Dempers, Johan J.; Burger, Elsie; Wadee, Shabbir; Schubert, Pawel; Wright, Colleen; Sens, Mary Ann; Nelsen, Laura; Randall, Bradley B.; Tran, Hoa; Geldenhuys, Elaine; Elliott, Amy J.; Odendaal, Hein J.; Kinney, Hannah C.

    2016-01-01

    The Safe Passage Study is an international, prospective study of approximately 12 000 pregnancies to determine the effects of prenatal alcohol exposure (PAE) upon stillbirth and the sudden infant death syndrome (SIDS). A key objective of the study is to elucidate adverse effects of PAE upon binding to serotonin (5-HT) 1A receptors in brainstem homeostatic networks postulated to be abnormal in unexplained stillbirth and/or SIDS. We undertook a feasibility assessment of 5-HT1A receptor binding using autoradiography in the medulla oblongata (6 nuclei in 27 cases). 5-HT1A binding was compared to a reference dataset from the San Diego medical examiner’s system. There was no adverse effect of postmortem interval ≤100 h. The distribution and quantitated values of 5-HT1A binding in Safe Passage Study cases were essentially identical to those in the reference dataset, and virtually identical between stillbirths and live born fetal cases in grossly non-macerated tissues. The pattern of binding was present at mid-gestation with dramatic changes in binding levels in the medullary 5-HT nuclei over the second half of gestation; there was a plateau at lower levels in the neonatal period and into infancy. This study demonstrates feasibility of 5-HT1A binding analysis in the medulla in the Safe Passage Study. PMID:27634962

  5. Genome resolved analysis of a premature infant gut microbial community reveals a Varibaculum cambriense genome and a shift towards fermentation-based metabolism during the third week of life

    PubMed Central

    2013-01-01

    Background The premature infant gut has low individual but high inter-individual microbial diversity compared with adults. Based on prior 16S rRNA gene surveys, many species from this environment are expected to be similar to those previously detected in the human microbiota. However, the level of genomic novelty and metabolic variation of strains found in the infant gut remains relatively unexplored. Results To study the stability and function of early microbial colonizers of the premature infant gut, nine stool samples were taken during the third week of life of a premature male infant delivered via Caesarean section. Metagenomic sequences were assembled and binned into near-complete and partial genomes, enabling strain-level genomic analysis of the microbial community. We reconstructed eleven near-complete and six partial bacterial genomes representative of the key members of the microbial community. Twelve of these genomes share >90% putative ortholog amino acid identity with reference genomes. Manual curation of the assembly of one particularly novel genome resulted in the first essentially complete genome sequence (in three pieces, the order of which could not be determined due to a repeat) for Varibaculum cambriense (strain Dora), a medically relevant species that has been implicated in abscess formation. During the period studied, the microbial community undergoes a compositional shift, in which obligate anaerobes (fermenters) overtake Escherichia coli as the most abundant species. Other species remain stable, probably due to their ability to either respire anaerobically or grow by fermentation, and their capacity to tolerate fluctuating levels of oxygen. Metabolic predictions for V. cambriense suggest that, like other members of the microbial community, this organism is able to process various sugar substrates and make use of multiple different electron acceptors during anaerobic respiration. Genome comparisons within the family Actinomycetaceae reveal

  6. Osteopenia (metabolic bone disease) of prematurity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Osteopenia is defined as postnatal bone mineralization that is inadequate to fully mineralize bones. Osteopenia occurs commonly in very low birth weight (VLBW) infants. Prior to the use of high-mineral containing diets for premature infants, which is the current practice, significant radiographic ch...

  7. Operating on the fetus.

    PubMed

    Ruddick, W; Wilcox, W

    1982-10-01

    The advent of fetal surgery is analyzed in terms of its implications for the moral status of the fetus, its bearing on the abortion debate, and its effect on the nature of the physician patient relationship. Three types of therapeutic contracts are posited: the "gynecological," in which the pregnant woman is considered the primary patient; the "pediatric," in which the focus is on the fetus; and the "obstetrical," in which the woman and fetus have a shared interest in treatment. It is concluded that the possibility of fetal therapy does not preclude the "gynecological" and "obstetrical" contracts as moral options.

  8. Case series of infants presenting with end stage retinopathy of prematurity to two tertiary eye care facilities in Mexico: underlying reasons for late presentation.

    PubMed

    Zepeda-Romero, Luz C; Meza-Anguiano, Alonso; Barrera-de León, Juan C; Angulo-Castellanos, Eusebio; Ramirez-Ortiz, Marco A; Gutiérrez-Padilla, José A; Gilbert, Clare E

    2015-06-01

    To describe the characteristics of infants with bilateral Stage 4b or 5 ROP (i.e. with subtotal or total retinal detachment) who presented to eye departments in two major cities in Mexico, to identify reasons why they may have become blind in order to recommend how programs could be improved. A large case-series of infants with Stage 4b or 5 ROP in both eyes confirmed by ultrasound who attended the ROP Clinic, Hospital Civil de Guadalajara from September 2010 to November 2012, and the Department of Ophthalmology, Hospital Infantil de Mexico Federico Gomez from December 2011 to December 2012 were identified from the diagnostic databases of each hospital. Mothers of infants in Guadalajara had a telephone interview. 89/94 eligible infants were included in the study, 48 in Guadalajara and 41 in Mexico City. Cases came from 22 of the 32 states in Mexico. Half of the infants attending Guadalajara 24/48 (50 %) had been cared for in NICUs without ROP screening programs and were not examined. Among the 24 infants cared for in NICUs with ROP programs, 7/24 (29.1 %) mothers reported that their infant had not been examined while in the NICU, and a further 9/24 (37.5 %) were either not referred for screening after discharge or they did not attend. Two infants had failed laser treatment. Strategies and resources to prevent end stage ROP have not been firmly established in Mexico. There is an urgent need to expand the coverage and quality of ROP programs, to ensure that existing screening guidelines are better adhered to, and to improve communication with parents.

  9. Premature ejaculation

    MedlinePlus

    ... is no way to prevent this disorder. Images Male reproductive system References Cooper K, Martyn-St James M, Kaltenthaler E, et al. Behavioral therapies for management of premature ejaculation: a systematic ... CG. Disorders of male orgasm and ejaculation. In: Wein AJ, ed. Campbell- ...

  10. A possible role of the Infant/Toddler Sensory Profile in screening for autism: a proof-of-concept study in the specific sample of prematurely born children with birth weights <1,500 g

    PubMed Central

    Beranova, Stepanka; Stoklasa, Jan; Dudova, Iva; Markova, Daniela; Kasparova, Martina; Zemankova, Jana; Urbanek, Tomas; Talasek, Tomas; Luukka, Pasi; Hrdlicka, Michal

    2017-01-01

    Objective The objective of this study was to explore the potential of the Infant/Toddler Sensory Profile (ITSP) as a screening tool for autism spectrum disorders (ASD) in prematurely born children. Methods Parents of 157 children with birth weights <1,500 g (aged 2 years, corrected for prematurity; 88 boys, 69 girls) completed a screening battery that included the ITSP, Modified Checklist for Autism in Toddlers (M-CHAT), and the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC). Children with known disabilities were excluded. All the children who were screened positive on any of the screening tools subsequently underwent clinical examination including the Autism Diagnostic Observation Schedule. Results We used classification trees to answer the question whether ITSP (or some of its subscales) could be combined with the M-CHAT and/or the CSBS-DP-ITC or its subscales into an effective ASD screening tool. Using the CSBS-DP-ITC, overall score, and the Sensation Seeking subscale of the ITSP, we obtained a screening tool that was able to identify all of the ASD children in our sample (confirmed by cross-validation). The proposed screening tool is scored as follows: 1) if the overall CSBS-DP-ITC value is <45.5, then the screening is positive; 2) if the overall CSBS-DP-ITC value is ≥45.5 and the z-score of the Sensation Seeking subscale of ITSP is ≥1.54, then the screening is positive; 3) otherwise, the screening is negative. Conclusion The use of CSBS-DP-ITC in combination with the Sensation Seeking subscale of the ITSP improved the accuracy of autism screening in preterm children. PMID:28182143

  11. Premature Infants 750–1,250 g Birth Weight Supplemented with a Novel Human Milk-Derived Cream Are Discharged Sooner

    PubMed Central

    Bergner, Erynn M.; Lee, Martin L.; Moreira, Alvaro G.; Hawthorne, Keli M.; Rechtman, David J.; Abrams, Steven A.; Blanco, Cynthia L.

    2016-01-01

    Abstract Objective: Infants may benefit from early nutritional intervention to decrease hospital stay. To evaluate the effects of adding a human milk (HM)-derived cream (Cream) product to a standard feeding regimen in preterm infants. Materials and Methods: In a prospective multicenter randomized study, infants with birth weights 750–1,250 g were assigned to a Control or Cream group. The Control group received a standard feeding regimen consisting of mother's own milk or donor HM with donor HM-derived fortifier. The Cream group received the standard feeding regimen along with an additional HM-derived cream supplement when the HM they received was <20 kcal/oz. Primary outcomes of this secondary analysis included comorbidities, length of stay (LOS), and postmenstrual age (PMA) at discharge. Results: We enrolled 75 infants (Control n = 37, Cream n = 38) with gestational age 27.7 ± 1.8 weeks and birth weight 973 ± 145 g (mean ± SD). After adjusting for gestational age, birth weight, and presence of bronchopulmonary dysplasia (BPD), the Cream group had a decreased PMA at discharge (39.9 ± 4.8 versus 38.2 ± 2.7 weeks, p = 0.03) and LOS (86 ± 39 versus 74 ± 22 days, p = 0.05). For 21 infants with BPD, these values trended toward significance for PMA at discharge (44.2 ± 6.1 versus 41.3 ± 2.7 weeks, p = 0.08) and LOS (121 ± 49 versus 104 ± 23 days, p = 0.08). Conclusions: Very preterm infants who received an HM-derived cream supplement were discharged earlier. Infants with BPD may have benefited the most. PMID:26982282

  12. Nutrition of the Fetus and Newborn

    PubMed Central

    Kennaugh, Jan M.; Hay, William W.

    1987-01-01

    Both the successful development of healthy, long-term animal models to study fetal nutrition and metabolism and the improved survival of low-birth-weight, preterm infants have focused interest and research on fetal and neonatal nutrition and metabolism. Such a focus is important, given the recent emphasis on promoting neonatal growth in preterm infants at “normal” in utero growth rates. Estimates of nutrient requirements for growth in a human fetus remain ill defined, however. Body composition data appear biased toward thin infants. Animal data suggest that fetal nutrition proceeds according to species-specific growth rates, with variations in fat content largely dependent on placental fat permeability and on maternal nutrient supply as regulated by the placenta. After birth, neonatal nutrition is affected primarily by food intake and the functional integrity and capacity of the gastrointestinal tract. Additionally, muscle activity, thermoregulation and stresses of various kinds and degrees modify a neonate's nutritional requirements. Functional deficits of the gastrointestinal tract have been circumvented by a more aggressive use of intravenous nutrition. Both intravenous and enteral nutrient mixtures have been substantially improved in the quantity of all nutrients and have been modified qualitatively toward compositions that are closer to those of human milk. These nutrient mixtures now produce plasma nutrient concentrations that approximate those of a healthy, breast-fed infant. Although such efforts to improve the nutritional balance and growth of preterm infants have been successful, much remains to be learned about the nutritional requirements of sick infants. PMID:3318138

  13. Mummified fetus in a mare.

    PubMed

    Barber, J A; Troedsson, M H

    1996-05-01

    A 12-year-old Arabian mare with a history of repeated early embryonic losses gave birth to a mummified fetus. The fetus was not the result of a pregnancy with twins. The mare had been given a progestogen throughout gestation and expelled the mummified fetus at about 325 days of gestation, 2 weeks after progestogen treatment was discontinued. We estimate that the size of the fetus was consistent with a fetal age of 5 months. The mare and mummified fetus illustrated that progestogen administration after 100 days of gestation can promote retention of a nonviable fetus. When the fetoplacental unit is incapable of producing progestogens in adequate amounts for pregnancy maintenance at that stage of gestation, then it is also unlikely to provide sufficient oxygen and nutrients to meet the needs of the growing fetus. Monitoring fetal viability would enable practitioners to prevent prolonged retention of a nonviable fetus.

  14. Vital and vulnerable functions of the primate placenta critical for infant health and brain development.

    PubMed

    Coe, Christopher L; Lubach, Gabriele R

    2014-10-01

    The placenta is essential to mammalian pregnancy with many roles beyond just nutrient supply, including both endocrine and immune functions. During the course of evolution, the placenta of higher primates has acquired some unique features, including the capacity to secrete corticotropin-releasing hormone (CRH). In addition, a placental receptor for IgG enables particularly high levels of protective maternal antibody to reach the fetus before birth. This paper reviews the placental biology of primates, and discusses its involvement in adrenocortical hormone activity during pregnancy, the transfer of maternal antibody, and finally the delivery of maternal iron to the fetus, which is needed for normal brain development. An understanding of these vital functions during a full-term, healthy pregnancy provides insights into the consequences of gestational disturbances, such as maternal stress, illness, and undernutrition, which have even larger ramifications if the infant is born premature.

  15. Premature rupture of membranes.

    PubMed Central

    Poma, P. A.

    1996-01-01

    The management of patients with premature rupture of membranes has changed markedly in the past several years. The basis for this is a combination of a better understanding of newborn physiology, improved neonatal care, refinements in antibiotic therapy, and the widespread use of maternal and fetal monitoring. The best outcome for both mother and infant undoubtedly reflects data based on a combination of factors, among which are gestational age survival, evidence of fetal distress, presence or absence of labor and sepsis, and of course, the cervical condition as it is related to labor-readiness. An important recent advance is the recognition that an active observation management program is associated with less morbidity and mortality than the classic management course of delivery within 12 hours of membrane rupture. The fact that preterm premature rupture of membranes tends to recur in subsequent pregnancies offers an opportunity for prevention. Moreover, advances in perinatal and neonatal care will continue to improve the outcomes of these women and their children. PMID:8583489

  16. Cerebral ischemia or intrauterine inflammation promotes differentiation of oligodendroglial precursors in preterm ovine fetuses: possible cellular basis for white matter injury.

    PubMed

    Kitanishi, Ryuta; Matsuda, Tadashi; Watanabe, Shinpei; Saito, Masatoshi; Hanita, Takushi; Watanabe, Tatsuya; Kobayashi, Yoshiyasu

    2014-01-01

    White matter injury in premature infants is known to be major cause of long-term neurocognitive disability, but the pathogenic mechanism remains unclear, hampering our ability to develop preventions. Periventricular leukomalacia is a severe form of white matter injury. In the present study, we explored the effects of cerebral ischemia and/or intrauterine inflammation on the development of oligodendroglia in the cerebral white matter using chronically instrumented fetal sheep. Each fetus received one of three insults: hemorrhage, inflammation and their combination. In the hemorrhage group, 40% of the fetoplacental blood volume was acutely withdrawn, and 24 hours after removal, the blood was returned to the fetus. The inflammation group received intravenous granulocyte-colony stimulating factor and intra-amniotic endotoxin and thus suffered from necrotizing funisitis and chorioamnionitis. The inflammatory hemorrhage group underwent acute hemorrhage under the inflammatory state. The sham group received no insults. Importantly, periventricular leukomalacia was not detected in the sham and the inflammation groups. Differentiating oligodendroglia at various developmental stages were identified by immunohistochemical analysis with specific antibodies. No difference in the density of oligodendroglial progenitors was detected among the four groups, whereas oligodendroglial precursors were significantly reduced in the three insult groups, compared to sham control. Moreover, the density of immature oligodendroglia was higher in the inflammation group and the inflammatory hemorrhage group, while the density of mature oligodendroglia was highest in the hemorrhage group. We propose that cerebral ischemia or intrauterine inflammation induces the differentiation of oligodendroglial precursors in preterm fetuses, eventually resulting in their exhaustion.

  17. Retinopathy of prematurity: An update on screening and management

    PubMed Central

    Jefferies, Ann L

    2016-01-01

    Retinopathy of prematurity is a proliferative disorder of the developing retinal blood vessels in preterm infants. The present practice point reviews new information regarding screening and management for retinopathy of prematurity, including the role of risk factors in screening, optimal scheduling for screening examinations, pain management, digital retinal photography and antivascular endothelial growth factor therapy. PMID:27095887

  18. Neurodevelopmental outcome of fetuses referred for ventriculomegaly

    PubMed Central

    Beeghly, M.; Ware, J.; Soul, J.; Plessis, A. Du; Khwaja, O.; Senapati, G. M.; Robson, C. D.; Robertson, R. L.; Poussaint, T. Y.; Barnewolt, C. E.; Feldman, H. A.; Estroff, J. A.; Levine, D.

    2010-01-01

    Objective To characterize the delivery and postnatal neurodevelopmental outcomes of fetuses referred for ventriculomegaly (VM). Methods Under an internal review board-approved protocol, pregnant women were referred for magnetic resonance imaging (MRI) after sonographic diagnosis of VM and classified into one of four diagnostic groups: Group 1, normal central nervous system (CNS); Group 2, isolated mild VM (10–12 mm); Group 3, isolated VM > 12 mm; and Group 4, other CNS findings. Pregnancy outcome was obtained. Follow-up visits were offered with assessment of neurodevelopmental, adaptive and neurological functioning at 6 months and 1 year and/or 2 years of age. Atrial diameter and VM group differences in developmental outcomes were evaluated using repeated measures logistic regression and Fishers exact test, respectively. Results Of 314 fetuses, 253 (81%) were liveborn and survived the neonatal period. Fetuses in Groups 4 and 3 were less likely to progress to live delivery and to survive the neonatal period (60% and 84%, respectively) than were those in Groups 2 or 1 (93% and 100%, respectively, P < 0.001). Of the 143 fetuses followed postnatally, between 41% and 61% had a Bayley Scales of Infant Development (BSID-II) psychomotor developmental index score in the delayed range (< 85) at the follow-up visits, whereas the BSID-II mental developmental index and Vineland Adaptive Behavior composite scores were generally in line with normative expectations. Among those that were liveborn, neither VM group nor prenatal atrial diameter was related to postnatal developmental outcome. Conclusions Diagnostic category and degree of fetal VM based on ultrasound and MRI measurements are associated with the incidence of live births and thus abnormal outcome. Among those undergoing formal postnatal testing, VM grade is not associated with postnatal developmental outcome, but motor functioning is more delayed than is cognitive or adaptive functioning. PMID:20069560

  19. Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn.

    PubMed

    Delaney, Meghan; Matthews, Dana C

    2015-01-01

    Hemolytic disease of the fetus and newborn (HDFN) affects 3/100 000 to 80/100 000 patients per year. It is due to maternal blood group antibodies that cause fetal red cell destruction and in some cases, marrow suppression. This process leads to fetal anemia, and in severe cases can progress to edema, ascites, heart failure, and death. Infants affected with HDFN can have hyperbilirubinemia in the acute phase and hyporegenerative anemia for weeks to months after birth. The diagnosis and management of pregnant women with HDFN is based on laboratory and radiographic monitoring. Fetuses with marked anemia may require intervention with intrauterine transfusion. HDFN due to RhD can be prevented by RhIg administration. Prevention for other causal blood group specificities is less studied.

  20. Doppler velocimetry of ductus venous in preterm fetuses with brain sparing effect: neonatal outcome

    PubMed Central

    Cosmo, Ynesmara Coelho; Júnior, Edward Araujo; de Sá, Renato Augusto Moreira; de Carvalho, Paulo Roberto Nassar; Mattar, Rosiane; Lopes, Laudelino Marques; Nardozza, Luciano Marcondes Machado; de Souza, Eduardo; Moron, Antonio Fernandes

    2012-01-01

    Summary Objective to evaluate the relationship between ductus venous (DV) and Doppler velocimetry in neonatal outcome in severe compromised preterm fetuses. Methods the study was designed as an observational and cross-sectional study with 52 premature neonates with brain sparing effect. The criteria of neonatal severe morbidity were: severe intraventricular hemorrhage (grades 3 or 4), retinopathy of prematurity (grade 3 or 4), cystic periventricular leukomalatia, bronchopneumo dysplasia and neonatal mortality. The fetuses were divided in two groups: group 0 - all the fetuses with ventricular systole/atrial contraction (S/A) in DV ratio values less them 3.4; group 1 - fetuses with values of S/A ratio greater than 3.4. Results 42% of fetuses showed abnormal S/A ratio in DV and 48% showed birth weight below percentile 3 for gestational age. There was no statistical significance comparing the 02 groups according to bronchopneumo dysplasia, retinopathy of prematurity (grade 3 or 4) and intraventricular hemorrhage (grade 3 or 4). Only one fetus presented cystic periventricular leukomalatia. We found statistically significant association between abnormal DV S/A ratio and neonatal mortality (CI 95%, 1.28 –38.22, p< 0.002). Conclusions our results suggest that abnormal DV blood flow detected by Doppler examination isn’t associated with severe neonatal morbidity but with neonatal mortality. PMID:23181172

  1. Complete Genome Sequence of Type Strain Campylobacter fetus subsp. fetus ATCC 27374

    PubMed Central

    Oliveira, Luciana M.; Resende, Daniela M.; Dorneles, Elaine M. S.; Horácio, Elvira C. A.; Alves, Fernanda L.; Gonçalves, Leilane O.; Tavares, Grace S.; Stynen, Ana Paula R.; Lage, Andrey P.

    2016-01-01

    Campylobacter fetus subsp. fetus is a zoonotic bacterium important for animal and public health. The complete sequencing and annotation of the genome of the type strain C. fetus subsp. fetus ATCC 27374 are reported here. PMID:27979934

  2. Complete Genome Sequence of Type Strain Campylobacter fetus subsp. fetus ATCC 27374.

    PubMed

    Oliveira, Luciana M; Resende, Daniela M; Dorneles, Elaine M S; Horácio, Elvira C A; Alves, Fernanda L; Gonçalves, Leilane O; Tavares, Grace S; Stynen, Ana Paula R; Lage, Andrey P; Ruiz, Jeronimo C

    2016-12-15

    Campylobacter fetus subsp. fetus is a zoonotic bacterium important for animal and public health. The complete sequencing and annotation of the genome of the type strain C. fetus subsp. fetus ATCC 27374 are reported here.

  3. Prenatal substance abuse: short- and long-term effects on the exposed fetus.

    PubMed

    Behnke, Marylou; Smith, Vincent C

    2013-03-01

    Prenatal substance abuse continues to be a significant problem in this country and poses important health risks for the developing fetus. The primary care pediatrician's role in addressing prenatal substance exposure includes prevention, identification of exposure, recognition of medical issues for the exposed newborn infant, protection of the infant, and follow-up of the exposed infant. This report will provide information for the most common drugs involved in prenatal exposure: nicotine, alcohol, marijuana, opiates, cocaine, and methamphetamine.

  4. Caring for Your Premature Baby

    MedlinePlus

    ... hearing problems, immunization, immunizations, low birth weight, neonatal intensive care unit, newborn, NICU, patient education, patient information, pediatric, preemie, premature, premature babies, prematurity, premie, respiratory syncytial ...

  5. Your Premature Baby

    MedlinePlus

    ... Search Our mission Fighting premature birth About us Annual report Our work Community impact Global programs Research Need ... Cause Our mission Fighting premature birth About us Annual report Our work Community impact Global programs Research Need ...

  6. [Gastroesophageal reflux in premature: a case report].

    PubMed

    Ndour, Daouda

    2016-01-01

    Gastroesophageal reflux disease (GERD) is a common problem in neonatology. Various physiological protective reflex responses provide a plausible biological link between gastro-esophageal reflux and apnea and bradycardia in premature. It is uncertain whether or not there is a causal relationship between the two diseases. However there is no consensus about the clinical and paraclinical diagnosis. Further explorations and treatment offered to premature infants with symptoms are discussed. We report the case of a preterm infants admitted to neonatal intensive care and with apnea and bradycardia. Clinical examination and exploration results were normal. We retained the gastrointestinal reflux diagnosis complicated of apnea and bradycardia. Pharmacological therapy for gastro-esophageal reflux disease has not definitively been shown to be effective in improving symptoms and should be reserved especially for infants with treatment refractory apnea and bradycardia episodes suspected as being gastro-esophageal reflux in premature infants. From a case report we made a literature review to discuss at length the different aspects of the problem.

  7. Prenatal diagnosis and fetopathological findings in five fetuses with trisomy 9

    SciTech Connect

    Chitayat, D.; Hodgkinson, K.; Luke, A.

    1995-04-10

    Five male fetuses with trisomy 9 are discussed. Three were detected prenatally and terminated, 1 aborted spontaneously, and the fifth delivered prematurely and died soon after. Multiple congenital abnormalities characteristic of trisomy 9 were detected in all 5 cases and are compared to those of previous reports. 16 refs., 5 figs., 1 tab.

  8. Prematurity and potential predictors.

    PubMed

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2008-02-01

    Prematurity continues to be the leading cause of neonatal death and developmental disability, highlighting the importance of identifying potential predictors of prematurity as well as interventions that can be linked to the predictors. This review covers recent research on potential psychological, physiological, and biochemical predictors. Among the psychological stressors are depression, anxiety, difficult relationships, and lack of social support. Biochemical predictors include corticotropin-releasing hormone, cortisol, and fetal fibronectin. A program of research that links an intervention for prematurity with a predictor for prematurity, that is, massage therapy to reduce cortisol and, in turn, reduce prematurity, is then presented.

  9. The Role of Prematurity in Patients With Hemiplegic Cerebral Palsy.

    PubMed

    Zelnik, Nathanel; Lahat, Eli; Heyman, Eli; Livne, Amir; Schertz, Mitchell; Sagie, Liora; Fattal-Valevski, Aviva

    2016-05-01

    A multicenter retrospective study was conducted to investigate the perinatal factors, imaging findings and clinical characteristics of hemiplegic cerebral palsy with a particular focus on children born prematurely. Our cohort included 135 patients of whom 42% were born prematurely; 16% were extreme premature infants who were born at 30 weeks or earlier. Nineteen (14%) were twins. Right hemiplegia was slightly more common and accounted for 59% of the patients. Imaging findings of intraventricular hemorrhage and periventricular leukomalacia were more prevalent in premature children whereas stroke, porencephaly, cerebral hemorrhage and cerebral atrophy were more evenly distributed in both term-born and prematurely-born children (p< 0.01). The overall prevalence of epilepsy in the cohort was 26% with no differences in full-term compared to prematurely-born children. Regardless of the gestational birth age, intellectual deficits were more common in the presence of comorbidity of both hemiplegia and epilepsy (p< 0.05).

  10. Campylobacter Fetus Meningitis in Adults

    PubMed Central

    van Samkar, Anusha; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2016-01-01

    Abstract The zoonotic pathogen Campylobacter fetus is a rare cause of bacterial meningitis. Little is known about the clinical characteristics, predisposing factors and outcome of C fetus meningitis in adults. We report cases of C fetus meningitis in a nationwide cohort study of adult bacterial meningitis patients in the Netherlands and performed a review of the literature. Two patients with C fetus meningitis were identified from January 2006 through May 2015. The calculated annual incidence was 0.02 per million adults. Combined with the literature, we identified 22 patients with a median age of 48 years. An immunocompromised state was present in 16 patients (73%), mostly due to alcoholism (41%) and diabetes mellitus (27%). The source of infection was identified in 13 out of 19 patients (68%), consisting of regular contact with domestic animals in 5 and working on a farm in 4. Recurrent fever and illness was reported in 4 patients (18%), requiring prolonged antibiotic treatment. Two patients died (9%) and 3 survivors (15%) had neurological sequelae. C fetus is a rare cause of bacterial meningitis and is associated with an immunocompromised state. Based on the apparent slow clinical response seen in this limited number of cases, the authors of this study recommend a prolonged course of antimicrobial therapy when C fetus is identified as a causative agent of bacterial meningitis. Cases appeared to do best with carbapenem therapy. PMID:26937916

  11. The impact of premature childbirth on parental bonding.

    PubMed

    Hoffenkamp, Hannah N; Tooten, Anneke; Hall, Ruby A S; Croon, Marcel A; Braeken, Johan; Winkel, Frans Willem; Vingerhoets, Ad J J M; van Bakel, Hedwig J A

    2012-08-17

    The development of an affectionate parent-infant bond is essential for a newborn infant's survival and development. However, from evolutionary theory it can be derived that parental bonding is not an automatic process, but dependent on infants' cues to reproductive potential and parents' access to resources. The purpose of the present study was to examine the process of bonding in a sample of Dutch mothers (n = 200) and fathers (n = 193) of full-term (n = 69), moderately premature (n = 68), and very premature infants (n = 63). During the first month postpartum parents completed the Pictorial Representation of Attachment Measure (PRAM) and Postpartum Bonding Questionnaire (PBQ). Longitudinal analyses revealed that mothers' PRAM scores decreased after moderately preterm delivery, whereas decreases in PRAM scores occurred in both parents after very preterm delivery. As lower PRAM scores represent stronger feelings of parent-infant connectedness, our findings suggest a higher degree of bonding after premature childbirth. Results of the PBQ analysis were in line with PRAM outcomes, as parents of preterm infants reported less bonding problems compared to parents of full-terms. These findings support the hypothesis that in affluent countries with adequate resources, bonding in parents of preterm infants on average may be higher than in parents of full-term infants.

  12. Antepartum evaluation of the fetus and fetal well being.

    PubMed

    O'Neill, Erica; Thorp, John

    2012-09-01

    Despite widespread use of many methods of antenatal testing, limited evidence exists to demonstrate effectiveness at improving perinatal outcomes. An exception is the use of Doppler ultrasound in monitoring high-risk pregnancies thought to be at risk of placental insufficiency. Otherwise, obstetricians should proceed with caution and approach the initiation of a testing protocol by obtaining an informed consent. When confronted with an abnormal test, clinicians should evaluate with a second antenatal test and consider administering betamethasone, performing amniocentesis to assess lung maturity, and/or repeating testing to minimize the chance of iatrogenic prematurity in case of a healthy fetus.

  13. Neonatal outcome of fetuses with urinary tract abnormalities diagnosed by prenatal ultrasonography.

    PubMed Central

    Steele, B T; De Maria, J; Toi, A; Stafford, A; Hunter, D; Caco, C

    1987-01-01

    Between 1979 and 1986 an abnormality of the urinary tract was diagnosed by prenatal ultrasound examination in 93 fetuses. Postnatal investigation at a large teaching hospital showed a definite abnormality in 85 infants, 66 of whom were boys. An obstructed urinary tract, usually requiring surgery, was present in 46 infants. Other abnormalities included a multicystic kidney (in 15 infants), vesicoureteric reflux (in 9), prune-belly syndrome (in 5) and polycystic kidneys (in 5). Early recognition and treatment of urinary tract disorders in infants should be accompanied by informed prenatal counselling to minimize parents' anxiety. PMID:3297273

  14. [A neonate with anaemia of prematurity: zinc protoporphyrin identifies iron deficiency anaemia without iron deficiency].

    PubMed

    van der Feen, Diederik E; van Hillegersberg, Jacqueline L A M; Schippers, Johannes A

    2015-01-01

    Anaemia is a common problem in premature infants and is generally easy to treat with iron supplementation. If the anaemia persists despite appropriate correction of deficiencies, more extensive evaluation is required. We describe a case of a premature male infant with a production-deficient anaemia without metabolic deficiencies, eventually identified as anaemia of prematurity. This type of anaemia is commonly diagnosed but its highly variable and complex aetiology and phenotype are often poorly understood. A probable explanation for the anaemia of prematurity in this case was a transient iron incorporation defect, identifiable by high levels of zinc protoporphyrin.

  15. The Relationship between Gentle Tactile Stimulation on the Fetus and Its Temperament 3 Months after Birth

    PubMed Central

    Wang, Zhe-Wei; Hua, Jing; Xu, Yu-Hong

    2015-01-01

    Objective. The aim of this study was to evaluate the effect of gentle tactile stimulation on the fetus in its temperament 3 months after birth. Method. A total of 302 mother-3-month-infant dyads enrolled the retrospective cohort study. 76 mothers had regular gentle tactile stimulation on the fetus in their pregnancy; 62 mothers had irregular tactile stimulation on the fetus, and the rest of 164 mothers who had no tactile stimulation served as nonexposure group. Temperament was assessed using the EITS (a nine-dimensional scale of temperament). Results. Significant difference in temperament type was found among infants in 3 groups at 3 months of age. In the regular practice group, the babies with easy type temperament accounted for 73.7%, which was higher than that in irregular practice group (53.2%, P = 0.012) and that in the control group (42.1%, P < 0.001). Compared to infants in no practice group, the infants who had received regular gentle tactile stimulation before birth were lower in negative mood (P = 0.047) while higher in adaptability (P < 0.001), approach (P = 0.001), and persistence (P = 0.001), respectively. Conclusion. Regular gentle tactile stimulation on fetus may promote the formation of easy type infant temperament. PMID:26180374

  16. Acute kidney injury in the fetus and neonate.

    PubMed

    Nada, Arwa; Bonachea, Elizabeth M; Askenazi, David J

    2017-04-01

    Acute kidney injury (AKI) is an under-recognized morbidity of neonates; the incidence remains unclear due to the absence of a unified definition of AKI in this population and because previous studies have varied greatly in screening for AKI with serum creatinine and urine output assessments. Premature infants may be born with less than half of the nephrons compared with term neonates, predisposing them to chronic kidney disease (CKD) early on in life and as they age. AKI can also lead to CKD, and premature infants with AKI may be at very high risk for long-term kidney problems. AKI in neonates is often multifactorial and may result from prenatal, perinatal, or postnatal insults as well as any combination thereof. This review focuses on the causes of AKI, the importance of early detection, the management of AKI in neonates, and long-term sequela of AKI in neonates.

  17. Prematures and feeding therapy: new lullaby-powered research.

    PubMed

    Discenza, Deborah

    2013-01-01

    Premature babies are at risk for feeding issues that can result in longer NICU stays, challenging feeding sessions at home, and potential concerns for long-term issues with weight gain, developmental milestones, and more. Interviewed is Jayne M. Standley, PhD, MT -BC, NICU-MT , who talks about how lullaby music combined with a specialized device that includes a pacifier can help premature infants learn to pace themselves during feeding sessions.

  18. Characteristic clinical features associated with aggressive posterior retinopathy of prematurity.

    PubMed

    Ahn, Y J; Hong, K E; Yum, H R; Lee, J H; Kim, K S; Youn, Y A; Park, S H

    2017-02-24

    PurposeTo identify the risk factors for, and clinical features and treatment outcomes of aggressive posterior retinopathy of prematurity (APROP) in Korean infants.MethodsAmong 770 premature infants who underwent screening, 105 infants (198 eyes, 13.63%) received treatment for ROP. A total of 24 infants (48 eyes, 3.12%) developed APROP while 81 infants (150 eyes, 10.52%) developed non-APROP treatment-requiring type. The medical records of ROP-treated infants were reviewed retrospectively. The associated systemic and maternal risk factors were analyzed and anatomical outcomes were compared according to the severity of ROP and treatment modalities.ResultsThe mean gestational age and birth weight at birth in the APROP group were significantly lower than those in the non-APROP group (P=0.019, P<0.001, respectively). Infants who were born small for their GA developed APROP more frequently than non-APROP patients (P<0.001). Chorioamnionitis-positive infants also showed higher incidence rate of APROP (APROP vs non-APROP; P<0.001 and zone I APROP vs posterior zone II APROP; P=0.036, respectively). Infants with APROP required heavier laser treatment with a higher retreatment rate compared to infants with non-APROP. Favorable anatomical outcomes were achieved in 95.3% from treatment-requiring non-APROP group, 85.7% from zone I APROP and 84.6% from posterior zone II APROP group.ConclusionIntrauterine growth restriction and chorioamnionitis were associated with development of APROP. These findings suggest that perinatal maternal environment inhibiting normal retinal vascular growth in utero may contribute to increasing the risk of APROP in premature infants.Eye advance online publication, 24 February 2017; doi:10.1038/eye.2017.18.

  19. Retinal microvascular plasticity in a premature neonate.

    PubMed

    Kandasamy, Y; Hartley, L; Smith, R

    2017-01-31

    Dilation and abnormal tortuosity of retinal vessels are the hallmarks of severe retinopathy of prematurity (ROP) in premature infants. The stages of ROP are defined by vessel appearance at the interface between the vascular and avascular retinal areas. Deregulated signaling pathways involving hypoxia-inducible factors such as vascular endothelial growth factor (VEGF) are involved in the pathogenesis of ROP. VEGF-antagonists are increasingly being used as 'off-label medication' to treat this condition, with some success. We present Baby SM (female), who was born prematurely at 24 weeks gestation in a tertiary neonatal intensive care unit, and with a birth weight of 640 g. On screening at 35 weeks postmenstrual age (PMA), she was noted to have ROP, which became severe by 37 weeks PMA. She received one dose of intravitreal VEGF antagonist (Bevacizumab), resulting in a decrease in vessel tortuosity and dilation. However, repeat imaging at 4 weeks showed a re-emergence of vessel tortuosity. We believe the observed changes demonstrate an inherent retinal microvascular plasticity in premature neonates. With improved survival of extremely premature neonates and the availability of retinal imaging technology, we are now able to observe this plasticity.

  20. Caregiver-Infant Interaction and Early Cognitive Development in Preterm Infants

    ERIC Educational Resources Information Center

    Beckwith, Leila; And Others

    1976-01-01

    Caregiver-infant transactions with 51 premature infants were studied in naturalistic observations in the home when the infants were aged 1, 3, and 8 months. Gesell developmental schedules and a sensorimotor scale were administered at 9 months. (Author/JH)

  1. Family Perspectives on Prematurity

    ERIC Educational Resources Information Center

    Zero to Three (J), 2003

    2003-01-01

    In this article, seven families describe their experiences giving birth to and raising a premature baby. Their perspectives vary, one from another, and shift over time, depending on each family's circumstances and the baby's developmental course. Experiences discussed include premature labor, medical interventions and the NICU, bringing the baby…

  2. Antenatal glucocorticoid treatment of the growth-restricted fetus: benefit or cost?

    PubMed

    Morrison, Janna L; Orgeig, Sandra

    2009-06-01

    Women at risk of preterm labor are commonly treated with antenatal glucocorticoids to reduce neonatal complications, including respiratory distress syndrome. Despite the benefits of antenatal glucocorticoid for neonatal lung function, they are associated with negative cardiovascular outcomes. Among this population, there is a group of intrauterine growth-restricted fetuses in which substrate supply is reduced and these fetuses must undergo a range of cardiovascular adaptations to survive. Interestingly, the cardiovascular changes caused by antenatal glucocorticoid in normally grown fetuses are contrary to the cardiovascular adaptations that the intrauterine growth-restricted fetus must make to survive. Hence, the possibility exists that antenatal glucocorticoid in intrauterine growth-restricted infants may compromise cardiovascular development. This review first provides an overview of general antenatal glucocorticoid effects, before outlining the effects on cardiorespiratory development in normally grown fetuses, the cardiovascular adaptations that occur in the intrauterine growth-restricted fetus and finally integrating this with the very limited evidence for the effect of antenatal glucocorticoid in intrauterine growth-restricted infants.

  3. [Premature rupture of membranes: pathophysiology of neurological impact].

    PubMed

    Baud, O; Fontaine, R H; Olivier, P; Maury, L; El Moussawi, F; Bauvin, I; Arsac, M; Hovhannisyan, S; Farnoux, C; Aujard, Y

    2007-09-01

    The premature rupture of membranes (PROM) is responsible for 30 % of the premature births because of a high risk of associated chorioamnionitis. PROM and the perinatal infection are recognized as 2 of the main risk factors of periventricular leukomalacia and white matter disease in very preterm neonates. Inflammation associated with PROM is likely to induce neuronal or glial cell death at a developmental stage of great vulnerability for the developing brain. Several mechanisms (release of cytokines, accumulation of free radicals, excitotoxicity, apoptosis...) account for this deleterious effect. The decision to actively extract a fetus subjected to a fetal inflammatory response syndrome should take account of the risks of a proved intrauterine infection for both the mother and the fetus and the risks for the neonate related to a very preterm birth per se. A reasonable attitude seems not to maintain a fetus in an undoubtful septic context in utero if a preterm birth in the very short term appears unevitable. Practically, no consensus gives a recommendation between aggressive or conservative management in case of PROM within 30 and 34 weeks'gestation. Expectant management seems to be indicated before 28 weeks'gestation and intentional delivery could be recommended beyond 34 weeks'gestation due to increased maternal risks compared to relatively low incidence of the complications of prematurity at this term.

  4. Fetal lung maturity. I. Mode of onset of premature labor. Influence of premature rupture of the membranes.

    PubMed

    Worthington, D; Maloney, A H; Smith, B T

    1977-03-01

    In a prospective study of 133 spontaneous premature deliveries the relation between premature rupture of the membranes (PRM) and development of respiratory distress syndrome (RDS) in newborn infants is examined. PRM is associated with a significantly decreased incidence of RDS in newborn infants (P less than 0.002). This relation is valid at a gestational age of 28 weeks or more and a birthweight greater than 1000 g. Total respiratory morbidity in newborn infants (transient tachypnea + RDS) is also significantly decreased when labor is associated with PRM (P less than 0.005). Assessment of the influences of sex of the infant, fetal asphyxia, and delivery by cesarian section shows that PRM bears a stronger relation than each of these individual factors to a decreased incidence of RDS. Duration of the latent period has no influence on protection from RDS, and it is suggested that fetal lung maturity occurs before the membranes rupture.

  5. Premature ovarian failure.

    PubMed

    Kalantaridou, S N; Davis, S R; Nelson, L M

    1998-12-01

    In 1% of women, premature ovarian failure develops by 40 years of age, a condition causing amenorrhea, infertility, sex steroid deficiency, and elevated gonadotropins. Early loss of ovarian function has significant psychosocial sequelae and major health implications. These young women have a nearly two-fold age-specific increase in mortality rate. Among women with spontaneous premature ovarian failure who have a normal karyotype, half have ovarian follicles remaining in the ovary that function intermittently. Indeed, pregnancies have occurred after the diagnosis of premature ovarian failure. Thus, premature ovarian failure should not be considered as a premature menopause. Young women with this disorder have a 5% to 10% chance for spontaneous pregnancy. Attempts at ovulation induction using various regimens fail to induce ovulation rates greater than those seen in untreated patients; however, oocyte donation for women desiring fertility is an option. Young women with premature ovarian failure need a thorough assessment, sex steroid replacement, and long-term surveillance to monitor therapy. Estrogen-progestin replacement therapy should be instituted as soon as the diagnosis is made. Androgen replacement should also be considered for women with low libido, persistent fatigue, and poor well-being despite taking adequate estrogen replacement. Women with premature ovarian failure should be followed up for the presence of associated autoimmune endocrine disorders such as hypothyroidism, adrenal insufficiency, and diabetes mellitus.

  6. Dr Mary Crosse, OBE, MD (1900–1972) and the premature baby

    PubMed Central

    Dunn, P M

    2007-01-01

    On behalf of Birmingham's Department of Public Health, Dr Crosse developed the Sorrento Premature Baby Unit in 1931 and pioneered the modern care of these small newborn infants in Britain. PMID:17337665

  7. Apnea of prematurity

    MedlinePlus

    Apnea - newborns; AOP; As and Bs; A/B/D; Blue spell - newborns; Dusky spell - newborns; Spell - newborns; Apnea - neonatal ... the airway open are weak Other stresses in a sick or premature baby may worsen apnea, including: ...

  8. Premature Ventricular Contractions (PVCs)

    MedlinePlus

    ... in the body that may be caused by caffeine, tobacco, exercise or anxiety Injury to the heart ... may increase your risk of premature ventricular contractions: Caffeine, tobacco and alcohol Exercise High blood pressure (hypertension) ...

  9. Prevention of premature birth.

    PubMed

    Fuchs, F

    1980-03-01

    With six different groups of pharmacologic agents that potentially can inhibit undesirable uterine contractions, prevention of premature births should be increasingly successful. The rationale for the use of each of these agents and their advantages and disadvantages are discussed.

  10. Complications associated with the macrosomic fetus.

    PubMed

    Lazer, S; Biale, Y; Mazor, M; Lewenthal, H; Insler, V

    1986-06-01

    A retrospective study was done on 525 infants who weighed more than 4,500 g. The rates of grand multiparity, diabetes mellitus, pregnancy-induced hypertension, deliveries in women over 35 years of age, placenta previa and weight gain of more than 15 kg were higher than in a control group weighing 2,500-4,000 g. The rates of delivery with instruments and cesarean section were also significantly higher. The main indication for cesarean section in the study group was cephalopelvic disproportion, while in the control group it was repeat cesarean section. Rates of postpartum hemorrhage, shoulder dystocia, oxytocin augmentation of labor and tears in the birth canal far exceeded those in the control group. Maternal and fetal morbidity and perinatal mortality were significantly higher than in the control group. The complications were due to a difficult second stage of labor. Delivery of the macrosomic fetus by cesarean section is highly recommended except for the subgroup of women who already delivered a macrosomic child.

  11. Inflammatory and oxidative stress airway markers in premature newborns of hypertensive mothers.

    PubMed

    Madoglio, R J; Rugolo, L M S S; Kurokawa, C S; Sá, M P A; Lyra, J C; Antunes, L C O

    2016-08-01

    Although oxidative stress and inflammation are important mechanisms in the pathophysiology of preeclampsia and preterm diseases, their contribution to the respiratory prognosis of premature infants of hypertensive mothers is not known. Our objective was to determine the levels of oxidative stress and inflammation markers in the airways of premature infants born to hypertensive and normotensive mothers, in the first 72 h of life, and to investigate whether they are predictors of bronchopulmonary dysplasia (BPD)/death. This was a prospective study with premature infants less than 34 weeks' gestation on respiratory support who were stratified into 2 groups: 32 premature infants of hypertensive mothers and 41 of normotensive women, with a mean gestational age of 29 weeks. Exclusion criteria were as follows: diabetes mellitus, chorioamnionitis, malformation, congenital infection, and death within 24 h after birth. The outcome of interest was BPD/death. Malondialdehyde (MDA), nitric oxide (NO), and interleukin 8 (IL-8) were measured in airway aspirates from the first and third days of life and did not differ between the groups. Univariate and multivariate statistical analyses were performed. The concentrations of MDA, NO, and IL-8 were not predictors of BPD/death. Premature infants who developed BPD/death had higher levels of IL-8 in the first days of life. The gestational age, mechanical ventilation, and a small size for gestational age were risk factors for BPD/death. In conclusion, the biomarkers evaluated were not increased in premature infants of hypertensive mothers and were not predictors of BPD/death.

  12. Prematurity as a public health problem: US policy from the 1920s to the 1960s.

    PubMed Central

    Oppenheimer, G M

    1996-01-01

    During the 1920s and 1930s, a number of physicians created model premature infant stations in select hospitals, arguing that medicine could successfully treat premature infants, most of whom could be expected to live normal lives. Most hospitals and doctors, however, remained indifferent to the special medical needs of premature infants. Subsequently, public health officials, beginning in Chicago, took up the cause of the medical management of newborn premature infants, defining the problem and finding the resources for a community-wide solution. The latter included multiple, high-quality premature nurseries, infant transport, regionalization, and public financing. The "Chicago model" was adapted by many state and municipal departments of health, particularly after World War II, to create community-based programs, the largest of which was in New York City. As premature infant care became of greater interest to pediatricians and hospitals, in part because of the success achieved by public health officials, the earlier, prominent role of the latter was increasingly diminished and historically forgotten. Images p872-a p873-a p874-a PMID:8659665

  13. To Correct or Not to Correct: Age Adjustment for Prematurity.

    ERIC Educational Resources Information Center

    Aylward, Glen P.; And Others

    To evaluate whether conceptional or chronologic age should be used to determine scores in developmental follow-up studies, a study was made of 236 normal and 66 neurologically abnormal infants who were similar with respect to conceptional age but different with respect to degree of prematurity. Assessments of possible differences in cognitive and…

  14. Long Term Study of Prematures: Summary of Published Findings.

    ERIC Educational Resources Information Center

    Wiener, Gerald

    Are children intellectually impaired as a result of low birth weight and does relative impairment change as children grow older? Premature infants from a range of socioeconomic groups were studied in five rounds over 13 years to provide neurological, psychological, achievement, and sociological data on 582 children in three birth weight groups. A…

  15. Prematurity: A Major Health Problem. Matrix No. 1.

    ERIC Educational Resources Information Center

    Avery, Gordon B.

    Premature birth (defined as delivery before 37 weeks gestation) and low birthweight (below 2,500 grams) are major health problems in the United States. Infants in these categories account for 75 per cent of neonatal deaths and 50 per cent of deaths in the first year of life. Survivors contribute disproportionately to the pool of handicapped…

  16. Hepatic Insulin Resistance and Altered Gluconeogenic Pathway in Premature Baboons.

    PubMed

    McGill-Vargas, Lisa; Gastaldelli, Amalia; Liang, Hanyu; Anzueto Guerra, Diana; Johnson-Pais, Teresa; Seidner, Steven; McCurnin, Donald; Muscogiuri, Giovanna; DeFronzo, Ralph; Musi, Nicolas; Blanco, Cynthia

    2017-01-17

    Premature infants have altered glucose regulation early in life and increased risk for diabetes in adulthood. Although prematurity leads to an increased risk of diabetes and metabolic syndrome in adult life, the role of hepatic glucose regulation and adaptation to an early extra-uterine environment in preterm infants remain unknown. The purpose of this study was to investigate developmental differences in glucose metabolism, hepatic protein content and gene expression of key insulin signaling/gluconeogenic molecules. Fetal baboons were delivered at 67%, 75%, and term gestational age and sacrificed at birth. Neonatal baboons were delivered prematurely (67% gestation) and survived for 2 weeks, and compared to similar postnatal term animals and underwent serial hyperinsulinemic-euglycemic clamp studies. Premature baboons had decreased endogenous glucose production compared to term animals. Consistent with these results, the gluconeogenic molecule, PEPCK mRNA, was decreased in preterm baboons compared to terms. Hepatic insulin signaling was altered by preterm birth as evidenced by decreased insulin receptor (IR)-β, p85 subunit of PI3K, phosphorylated IRS-1, and Akt-1 under insulin stimulated conditions. Furthermore, preterm baboons failed to have the normal increase in GSK-3 from fetal to postnatal life. The blunted responses in hepatic insulin signaling may contribute to the hyperglycemia of prematurity, while impaired endogenous glucose production leads to hypoglycemia of prematurity.

  17. [Precocious neonatal mortality in premature newborns with low weight at birth and death].

    PubMed

    Garrido-calderon, J; Perez-lachapelle, A; Brito, A; Alvarez, P

    1996-01-01

    A retrospective study was conducted of all live births occurring in 1992 at a Dominican Institute of Social Security hospital in Santo Domingo to analyze the association between prematurity, low birth weight, and early neonatal mortality. Stillbirths, infants weighing less than 1000 g or born before 28 weeks of gestation, and those with lethal malformations were excluded. 5142 newborns met the inclusion criteria. 1701 deliveries (33%) were cesarean. 550 of the newborns (10.7%) were low birth weight, and 338 (6.6%) were premature. The early neonatal mortality rate was 17/1000. Low birth weight infants accounted for 66.2% of early neonatal mortality. 10.7% of low birth weight infants died within the first week of life, and their relative risk of early neonatal death was 16.42. 64% of all infants dying in their first week of life were also premature. The specific mortality rate for premature infants was 168.6/1000 live births. The relative risk was 25.32 for premature infants. Low birth weight infants born at term had an early neonatal mortality rate of 24.6/1000 live births, compared to 5.5/1000 for term births of adequate weight.

  18. Immunization of preterm infants

    PubMed Central

    Gagneur, Arnaud; Pinquier, Didier; Quach, Caroline

    2015-01-01

    Vaccinations of premature infants are often delayed despite being at an increased risk of contracting vaccine preventable diseases. This article reviews the current knowledge on the immune response to widely used vaccines, on the protection derived from routine immunization and on vaccine safety and tolerability in a population of preterm infants. Available data evaluating the immune response of preterm infants support early immunization without correction for gestational age. For a number of antigens, the antibody response to initial doses of vaccines may be lower than that of term infants, but protective concentrations are often achieved and memory successfully induced. Vaccines are immunogenic, safe and well tolerated in preterm infants. Preterm infants should be vaccinated using the same schedules as those usually recommended for full-term infants, with the exception of the hepatitis B vaccine, where additional doses should be administered in infants receiving the first dose during the first days of life if they weighed less than 2000 g because of a documented reduced immune response. PMID:26291883

  19. Prematurity: present and future

    PubMed Central

    Tsimis, M. E.; Al-Hamayel, N. Abu; Germaine, H.; Burd, I.

    2014-01-01

    The study of preterm labor and prematurity, as with any medical science, has undergone a major transformation in its approach from an inevitable part of obstetrics with few answers to one in which science has led to knowledge and clinical intervention. Despite these advancements, understanding of preterm labor and prevention of prematurity is still limited. In the current review, we begin the discussion with fetal viability, first from a historical perspective and then from the understanding of this issue from a prospective of various professional organizations. We then present the scope of the problem of preterm birth from various countries including the discrepancy between the US and Europe. We continue with updates on extreme prematurity and outcomes with two longitudinal studies from the past 2 years. We further review available interventions for prematurity and discuss the use of antenatal corticosteroids. First, we examine their use in the context of professional recommendations and then examine the trajectory of their continued use in the late preterm period. We focus on a European-based trial with preliminary results and an ongoing American counterpart. The current knowledge of molecular mechanisms behind preterm labor is presented with a focus on the multiple etiologies of preterm labor, both known and presumed, with updates in the basic science realm. Furthermore, up-to-date studies on prediction of preterm birth and prematurity-related morbidity are presented. PMID:25300768

  20. Dapoxetine: in premature ejaculation.

    PubMed

    Hoy, Sheridan M; Scott, Lesley J

    2010-07-30

    Dapoxetine, a selective serotonin reuptake inhibitor, is the first oral pharmacological agent indicated for the treatment of men aged 18-64 years with premature ejaculation. In four randomized, double-blind, placebo-controlled, multicentre studies of 12-24 weeks' duration, oral dapoxetine 30 or 60 mg (administered as needed) was effective in the treatment of men with premature ejaculation, inducing significantly (p < 0.001) greater improvements from baseline than placebo in the primary efficacy endpoint (mean intravaginal ejaculatory latency time [IELT] or mean average IELT [defined as the average of IELT values over the previous 4 weeks], as measured by the female partner utilizing a stopwatch). For the most part, dapoxetine recipients achieved significantly better outcomes than placebo recipients with regard to the secondary endpoints, including the Premature Ejaculation Profile (PEP) domains and the Clinical Global Impression or Patient Global Impression ratings of change in premature ejaculation, across these clinical studies. The beneficial effects of dapoxetine therapy on the perceived control over ejaculation and satisfaction with sexual intercourse PEP domains were sustained in a 9-month noncomparative extension phase of two identical 12-week, double-blind studies. Oral dapoxetine therapy for up to 12 months was generally well tolerated in men with premature ejaculation, with the nature of treatment-emergent adverse events generally similar across the clinical studies and between dapoxetine and placebo.

  1. Optical coherence tomography in retinopathy of prematurity: looking beyond the vessels.

    PubMed

    Maldonado, Ramiro S; Toth, Cynthia A

    2013-06-01

    Retinopathy of Prematurity (ROP) is a leading cause of childhood blindness in the United States. Optical Coherence Tomography (OCT) is a relatively new imaging technology capable of imaging ocular structures in cross section at high resolution. We present an age-customized approach to perform Spectral Domain OCT in neonates and infants, and from SDOCT, the in-vivo development of the human fovea during the premature period up through term birth along with retinal changes unique to premature infants with ROP. Finally, we explore how this novel information may affect our understanding of ROP and the possible implications in vision and retinal development.

  2. Infant Massage: Understand This Soothing Therapy

    MedlinePlus

    ... and your baby Help your baby relax and sleep Positively affect infant hormones that control stress Reduce crying Although further research is needed, some studies also suggest that infant massage involving moderate pressure might promote growth for premature babies. Massaging your baby too soon ...

  3. Autoimmune premature ovarian failure

    PubMed Central

    2017-01-01

    Premature ovarian failure (POF), also termed as primary ovarian insufficiency (POI), is a highly heterogenous condition affecting 0.5-3.0% of women in childbearing age. These young women comprise quite a formidable group with unique physical and psychological needs that require special attention. Premature ovarian senescence (POS) in all of its forms evolves insidiously as a basically asymptomatic process, leading to complete loss of ovarian function, and POI/POF diagnoses are currently made at relatively late stages. Well-known and well-documented risk factors exist, and the presence or suspicion of autoimmune disorder should be regarded as an important one. Premature ovarian failure is to some degree predictable in its occurrence and should be considered while encountering young women with loss of menstrual regularity, especially when there is a concomitant dysfunction in the immune system. PMID:28250725

  4. [Pain perception of the fetus].

    PubMed

    Jakobovits, Akos

    2010-11-07

    Author presents a comprehensive overview of the currently available information about fetal pain perception. In this context the article discusses the concept of pain sensation, its evolution during intrauterine life and its physical and biochemical signs. Only the last mentioned phenomena allow deduction with regard to the severity of pain related stress reaction, in the absence of objective yardstick for measuring the intensity of pain felt by the fetus. The discussion also involves pain associated with birthing process and extends to its possible alleviation.

  5. Babies at Double Jeopardy: Medically Fragile Infants and Child Neglect

    ERIC Educational Resources Information Center

    Fullar, Suzanne A.

    2008-01-01

    Medically fragile infants, those born prematurely or with other complex medical or genetic problems, are at risk of long-term health and developmental problems. When a medically fragile infant comes home to a family with significant social problems such as domestic violence, mental illness, or substance abuse, the infant is at double jeopardy--at…

  6. Prenatal Diagnosis and Outcome of Fetuses with Double-Inlet Left Ventricle

    PubMed Central

    Gidvani, Monisha; Ramin, Kirk; Gessford, Ellen; Aguilera, Marijo; Giacobbe, Lauren; Sivanandam, Shanthi

    2011-01-01

    The aim of this study is to characterize the in utero presentation of the subtype of double-inlet left ventricle (DILV), a rare congenital heart disease, and assess the postnatal outcome. We retrospectively studied fetuses diagnosed prenatally with DILV between 2007 and 2011. We reviewed the prenatal and postnatal echocardiograms, clinical presentations, karyotypes, and the postnatal outcomes. There were eight fetuses diagnosed with DILV with L-transposition of the great vessels (S, L, L). Mean gestational age at diagnosis was 24.7 weeks. Of these, four fetuses (50%) had pulmonary atresia. One fetus (12.5%) also had tricuspid atresia and coarctation of the aorta and died at 17 months of age. Complete heart block and long QT syndrome was present in one fetus (12.5%), who died shortly after birth. There were no extracardiac or karyotypic abnormalities. Six (75%) infants are alive and doing well. Double-inlet left ventricle with varied presentation can be accurately diagnosed prenatally. The outcome of fetuses is good in the absence of associated rhythm abnormalities with surgically staged procedures leading to a Fontan circulation. PMID:23705101

  7. The Effect of the Infant Behavioral Assessment and Intervention Program on Mother-Infant Interaction after Very Preterm Birth

    ERIC Educational Resources Information Center

    Meijssen, Dominique; Wolf, Marie-Jeanne; Koldewijn, Karen; Houtzager, Bregje A.; Van Wassenaer, Aleid; Tronick, Ed; Kok, Joke; Van Baar, Anneloes

    2010-01-01

    Background: Prematurity and perinatal insults lead to increased developmental vulnerability. The home-based Infant Behavioral Assessment and Intervention Program (IBAIP) was designed to improve development of preterm infants. In a multicenter randomized controlled trial the effect of IBAIP on mother-infant interaction was studied as a secondary…

  8. Pain and stress in the human fetus.

    PubMed

    Smith, R P; Gitau, R; Glover, V; Fisk, N M

    2000-09-01

    Invasive diagnostic and therapeutic techniques are increasingly applied to the fetus. It is not known if the fetus feels pain during such procedures, but the fetus does mount significant stress hormonal and circulatory changes in response to these from 18-20 weeks. Perinatal stress may have long-term neurodevelopmental implications. During open fetal surgery, maternal general anaesthesia provides fetal anaesthesia. However, in closed procedures, fetal analgesia presents difficulties. The optimal drug, dose, and route of administration remain to be determined.

  9. Fetal akinesia deformation sequence in previable fetuses.

    PubMed

    Davis, J E; Kalousek, D K

    1988-01-01

    We reviewed the morphologic findings of 948 previable fetuses and identified the fetal akinesia deformation sequence (FADS) in 16 cases. In eight fetuses who had joint contractures, micrognathia, and pulmonary hypoplasia, the cause of fetal akinesia could be attributed to an abnormal intrauterine environment restricting fetal movement. The other eight fetuses had pterygia across the immobilized joints, in addition to main manifestations of FADS. Since most of the fetuses with pterygia were of only 8-9 weeks developmental age, we suggest that embryonic onset of immobility interferes with limb development and results in joint fixation and pterygium formation, in contrast to fetal-onset immobility, which causes joint contractures alone.

  10. Feeding premature neonates: Kinship and species in translational neonatology.

    PubMed

    Dam, Mie S; Juhl, Sandra M; Sangild, Per T; Svendsen, Mette N

    2017-04-01

    Kinship, understood as biogenetic proximity, between a chosen animal model and a human patient counterpart, is considered essential to the process of 'translating' research from the experimental animal laboratory to the human clinic. In the Danish research centre, NEOMUNE, premature piglets are fed a novel milk diet (bovine colostrum) to model the effects of this new diet in premature infants. Our ethnographic fieldwork in an experimental pig laboratory and a neonatal intensive care unit (NICU) in 2013-2014 shows that regardless of biogenetics, daily practices of feeding, housing, and clinical care hold the potential for stimulating and eroding kinship relations between human and nonhuman actors. In the laboratory, piglets and researchers form 'interspecies-milk-kinships' that entail the intimate care crucial to keeping the compromised piglets alive during the experiments, thereby enhancing what the researchers refer to as the 'translatability' of the results. In the NICU, parents of premature infants likewise imagine a kind of interspecies kinship when presented with the option to supplement mother's own milk with bovine colostrum for the first weeks after birth. However, in this setting the NICU parents may perceive the animality of bovine colostrum, and the background information obtained in piglets, as a threat to the infants' connection to their biological parents as well as the larger human collective. Our study argues that the 'species flexibility' of premature beings profoundly shapes the translational processes in the field of neonatology research.

  11. Mothers' Working Models of Caregiving in the Context of Infant Feeding: Change through the First Year.

    ERIC Educational Resources Information Center

    Pridham, Karen; And Others

    This study examined the change in mothers' working models of infant feeding through the first post-term year of full-term infants and of prematurely born infants with a history of lung disease. It also examined the contribution of maternal resources such as education and mental well-being and infant attributes (maturity at birth and lung disease…

  12. [Autism and prematurity: state of the art].

    PubMed

    Ouss-Ryngaert, L; Alvarez, L; Boissel, A

    2012-09-01

    Research has shown a high rate of autism spectrum disorders among very low birth weight children over the past decade. This paper proposes a literature review on this topic. Two generations of research have followed one another. The first retrospective studies found a high rate of ASD among premature babies. The second generation of prospective studies underlined and relativized this risk. Prospective research using screening tools (M-CHAT) have found around 20 % ASD, whereas 2 studies assessing the actual diagnosis found 5 % and 8 % ASD, 10 to 12 times more than in the general population. A number of hypotheses have been put forward to explain these high rates of ASD: sensory impairment associated with prematurity, white matter abnormalities, and cerebellar impairment. The authors propose complex models that take into account neurological deficits and the effects of perinatal events on interactive dynamics between infants and their caregivers. These models aim to allow suitable prevention and care for premature children with autism, a heavy additional handicap.

  13. Postnatal Infections and Immunology Affecting Chronic Lung Disease of Prematurity

    PubMed Central

    Pryhuber, Gloria S.

    2015-01-01

    Synopsis Premature infants suffer significant respiratory morbidity during infancy with long-term negative consequences on health, quality of life, and health care costs. Enhanced susceptibility to a variety of infections and inflammation play a large role in early and prolonged lung disease following premature birth, though the mechanisms of susceptibility and immune dysregulation are active areas of research. This chapter will review aspects of host-pathogen interactions and immune responses that are altered by preterm birth and that impact chronic respiratory morbidity in these children. PMID:26593074

  14. Facial anatomy of the fetus.

    PubMed

    Jeanty, P; Romero, R; Staudach, A; Hobbins, J C

    1986-11-01

    Real-time ultrasonography was used in this study to demonstrate details of the anatomy of the face and neck of the fetus. Details such as the ocular globe, vitreous body, lens, anterior chamber, rectus muscles, optic nerve and disc, and the ophthalmic artery are visible at the level of the eye. The helix, scaphoid fossa, triangular fossa, concha, antihelix, antitragus, intertragic incisure, and lobule can be seen at the level of the ear. The tip of the nose, the alae nasi, and the columna are also seen. The epiglottis is visible in the vestibulum of the larynx. The fetal face is an important structure that can provide invaluable information in the search for congenital malformations, and possibly also in fetal behavior.

  15. Butyrate Infusions in the Ovine Fetus Delay the Biologic Clock for Globin Gene Switching

    NASA Astrophysics Data System (ADS)

    Perrine, Susan P.; Rudolph, Abraham; Faller, Douglas V.; Roman, Christine; Cohen, Ruth A.; Chen, Shao-Jing; Kan, Yuet Wai

    1988-11-01

    The switch from fetal to adult hemoglobin expression is regulated in many mammalian species by a developmental clock-like mechanism and determined by the gestational age of the fetus. Prolonging fetal globin gene expression is of considerable interest for therapeutic potential in diseases caused by abnormal β -globin genes. Butyric acid, which is found in increased plasma concentrations in infants of diabetic mothers who have delayed globin gene switching, was infused into catheterized fetal lambs in utero during the time of the normal globin gene switch period. The globin gene switch was significantly delayed in three of four butyrate-treated fetuses compared with controls and was entirely prevented in one fetus in whom the infusion was begun before the globin switch was under way. These data provide a model for investigating and arresting the biologic clock of hemoglobin switching.

  16. [Campylobacter fetus endocarditis: a case report].

    PubMed

    Désidéri-Vaillant, Catherine; Guichon, Jean-Michel; Noyer, Vincent; Nedelec, Yolande; Galinat, Hubert; Sapin-Lory, Jeanne; Di Costanzo, Laurence; Le Guen, Patrick; Nicolas, Xavier

    2013-01-01

    Campylobacter are known to be a cause of enteritidic infections but Campylobacter fetus is more often a cause of systemic infections, mainly in fragilized patients. We report a C. fetus endocarditis. The prognosis seemstobe improved by a prolonged betalactam antibiotic treatment.

  17. Doctor-Patient Relationships in Fetal/Infant Death Encounters.

    ERIC Educational Resources Information Center

    Knapp, Ronald J.; Peppers, Larry G.

    1979-01-01

    A Study of concerns of l00 middle class parents who had lost infants revealed that the death of an infant or fetus was viewed as devastating because of inadequate community recognition of the loss. Many parents turn for support to physicians who are often unable to meet their needs. Causes and solutions for this situation are discussed.…

  18. Are Armed Forces infants more at risk than civilian infants?

    PubMed

    Yoong, S Y; Miles, D; McKinney, P A; Feltbower, R G; Spencer, N

    2000-09-01

    The aim of the present study is to compare the health status of Armed Forces and civilian infants, accounting for social class. In a prospective cohort study, demographic data were obtained from mothers of liveborn infants from 436 civilian and 162 Armed Forces families. Birth details were taken from hospital maternity and child health systems. A six month follow-up was completed by health visitors. Standard social class classification, based on occupation, was used for civilian families and a new equivalent scheme for military personnel. No significant differences were found between civilian and military infants for birthweight, prematurity and failure to thrive. Military infants had significantly more hospital admissions (P=0.015) and accident and emergency attendances (P=0.002) mainly accounted for by the 'manual' social classes of the Armed Forces. Infant health status of civilian and military babies did not differ overall. Increased uptake of hospital services by military families can be explained by local circumstances.

  19. Premature Aging in Fibromyalgia.

    PubMed

    Hassett, Afton L; Clauw, Daniel J; Williams, David A

    2015-01-01

    Chronic pain is highly prevalent in older adults, and until recently, was considered to be common but relatively "benign." Mounting evidence, however, suggests that some of the 116 million US adults who suffer from chronic pain are also at an increased risk for developing age-related diseases prematurely, suffering earlier cognitive and physical decline, and experiencing earlier mortality. Given the aging US population and the prevalence of chronic pain along with related healthcare consequences, there is a critical need to better understand the relationship between aging and chronic pain. Herein, we focus on one chronic pain state, fibromyalgia, and provide an overview of the evidence suggesting that individuals with this chronic pain condition show signs of premature aging.

  20. Lifestyle influences on prematurity.

    PubMed

    Creasy, R K

    1991-01-01

    It is apparent from this review that the lifestyle of an individual gravida can potentially lead to a premature delivery. Some of these adverse behavioral characteristics may be dealt with by education and motivation, and some with actual medical treatment. However, there also appears to be significant need for public policy reorientation if we are to make a significant impact on the problem of preterm delivery.

  1. Abnormal TREC-Based Newborn Screening Test in a Premature Neonate with Massive Perivillous Fibrin Deposition of the Placenta

    PubMed Central

    Kostadinov, Stefan; Robbins, Karen A.; Hayward, Anthony

    2016-01-01

    Severe combined immunodeficiency (SCID), a primary immunodeficiency arising from variable defects in lymphocyte development and survival, is characterized by significant deficiency of thymus derived (T-) lymphocytes and variable defects in the B-lymphocyte population. Newborn screening for SCID is based on detection of low numbers of T-cell receptor excision circles (TRECs) by real time quantitative PCR (RT-qPCR). This screening allows for early identification of individuals with SCID and other disorders characterized by T-lymphopenia. Higher rates of abnormal screens are commonly seen in premature and critically ill neonates, often representing false positives. It is possible that many abnormal screens seen in these populations are result of conditions that are characterized by systemic inflammation or stress, possibly in the context of stress-induced thymic involution. We present a case of a male infant delivered at 27 weeks, 6 days of gestation, with severe intrauterine growth restriction who had an abnormal TREC screen and a massive perivillous fibrin deposition (MPFD) of the placenta. This association has not been reported previously. We are raising the awareness to the fact that conditions, such as MPFD, that can create adverse intrauterine environment are capable of causing severe stress-induced thymic involution of the fetus which can present with abnormal TREC results on newborn screening. PMID:27403355

  2. Prematurely terminated slug tests

    SciTech Connect

    Karasaki, K. )

    1990-07-01

    A solution of the well response to a prematurely terminated slug test (PTST) is presented. The advantages of a PTST over conventional slug tests are discussed. A systematized procedure of a PTST is proposed, where a slug test is terminated in the midpoint of the flow point, and the subsequent shut-in data is recorded and analyzed. This method requires a downhole shut-in device and a pressure transducer, which is no more than the conventional deep-well slug testing. As opposed to slug tests, which are ineffective when a skin is present, more accurate estimate of formation permeability can be made using a PTST. Premature termination also shortens the test duration considerably. Because in most cases no more information is gained by completing a slug test to the end, the author recommends that conventional slug tests be replaced by the premature termination technique. This study is part of an investigation of the feasibility of geologic isolation of nuclear wastes being carried out by the US Department of Energy and the National Cooperative for the Storage of Radioactive Waste of Switzerland.

  3. Metabolic maturation of white matter is altered in preterm infants.

    PubMed

    Blüml, Stefan; Wisnowski, Jessica L; Nelson, Marvin D; Paquette, Lisa; Panigrahy, Ashok

    2014-01-01

    Significant physiological switches occur at birth such as the transition from fetal parallel blood flow to a two-circuit serial system with increased arterial oxygenation of blood delivered to all organs including the brain. In addition, the extra-uterine environment exposes premature infants to a host of stimuli. These events could conceivably alter the trajectory of brain development in premature infants. We used in vivo magnetic resonance spectroscopy to measure absolute brain metabolite concentrations in term and premature-born infants without evidence of brain injury at equivalent post-conceptional age. Prematurity altered the developmental time courses of N-acetyl-aspartate, a marker for axonal and neuronal development, creatine, an energy metabolite, and choline, a membrane metabolite, in parietal white matter. Specifically, at term-equivalency, metabolic maturation in preterm infants preceded development in term infants, but then progressed at a slower pace and trajectories merged at ≈340-370 post-conceptional days. In parieto/occipital grey matter similar trends were noticed but statistical significance was not reached. The timing of white matter development and synchronization of white matter and grey matter maturation in premature-born infants is disturbed. This may contribute to the greater risk of long-term neurological problems of premature infants and to their higher risk for white matter injury.

  4. Retinopathy of prematurity: New developments bring concern and hope.

    PubMed

    Darlow, Brian A

    2015-08-01

    Blindness from retinopathy of prematurity (ROP) in Australian and New Zealand is an uncommon event although 3% of <31 weeks gestation infants receive treatment for the disease. New world-wide estimates of the incidence of blindness from ROP are much higher than previously at 20 000 children annually. The impact of severe ROP can be reduced through good evidence-based care of very preterm infants and careful organisation of eye examinations and follow-up services. Recent oxygen saturation targeting trial results might mean the adoption of higher targets than formerly in very preterm infants and will require vigilance to ensure all eligible infants are examined appropriately. A true screening examination for acute ROP might involve non-opthalmologists obtaining photographic retinal images and remote reading of these. Although treatment with laser gives good outcomes, there is interest in intravitreal anti-vascular endothelial factor agents, but issues concerning the systemic safety and retinal results of such treatment are unresolved.

  5. Inhaled nitric oxide in preterm infants with prolonged preterm rupture of the membranes: a case series.

    PubMed

    Semberova, J; O'Donnell, S M; Franta, J; Miletin, J

    2015-04-01

    The available evidence does not support the routine use of inhaled nitric oxide (iNO) in the care of premature infants. We present a case series of 22 preterm infants born after prolonged preterm premature rupture of membranes and oligohydramnios with respiratory failure. Oxygenation index decreased significantly after commencement of iNO.

  6. The Perceived Needs of Maine Parents of Premature Children for Services and Supports: A Retrospective Longitudinal Study

    ERIC Educational Resources Information Center

    McPhee, Karen Boulos

    2010-01-01

    The purpose of the study was to examine the perceived needs and correlates of Maine parents of premature infants related to the chronological distance from the NICU. The study focused on identifying the perceived service needs of parents of premature children and how these needs changed over time, revealed the relationships between perceived…

  7. Dramatic regression of persistent tunica vasculosa lentis associated with retinopathy of prematurity following treatment with intravitreal bevacizumab.

    PubMed

    Goldman, Darin R; Baumal, Caroline R

    2013-06-04

    The authors describe a preterm infant who developed advanced retinopathy of prematurity bilaterally with a prominent tunica vasculosa lentis. Treatment with intravitreal bevacizumab resulted in regression of the tunica vasculosa lentis and posterior manifestations of the retinopathy of prematurity. RetCam imaging (Clarity Medical Systems, Pleasanton, CA) of the anterior segment was used to document the dramatic tunica vasculosa lentis resolution.

  8. Understanding the Short- and Long-Term Respiratory Outcomes of Prematurity and Bronchopulmonary Dysplasia

    PubMed Central

    Islam, Jessica Y.; Keller, Roberta L.; Aschner, Judy L.; Hartert, Tina V.

    2015-01-01

    Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease associated with premature birth that primarily affects infants born at less than 28 weeks’ gestational age. BPD is the most common serious complication experienced by premature infants, with more than 8,000 newly diagnosed infants annually in the United States alone. In light of the increasing numbers of preterm survivors with BPD, improving the current state of knowledge of long-term respiratory morbidity for infants with BPD is a priority. We undertook a comprehensive review of the published literature to analyze and consolidate current knowledge of the effects of BPD that are recognized at specific stages of life, including infancy, childhood, and adulthood. In this review, we discuss both the short-term and long-term respiratory outcomes of individuals diagnosed as infants with the disease and highlight the gaps in knowledge needed to improve early and lifelong management of these patients. PMID:26038806

  9. Prenatal management, pregnancy and pediatric outcomes in fetuses with septated cystic hygroma

    PubMed Central

    Sanhal, C.Y.; Mendilcioglu, I.; Ozekinci, M.; Yakut, S.; Merdun, Z.; Simsek, M.; Luleci, G.

    2014-01-01

    It has been reported that, compared with simple increased nuchal translucency, fetal cases with septated cystic hygroma (CH) are more likely to face perinatal handicaps. However, pediatric outcomes and proper prenatal counseling for this anomaly have not yet been truly defined. We performed this study to determine pregnancy and pediatric outcomes of fetuses with septated CH. We searched records for cases with septated CH and collected data for structural abnormalities, karyotype analysis, and pregnancy outcomes. Fetuses born with septated CH were also evaluated for their pediatric outcomes. Sixty-nine fetuses with septated CH were enrolled in the study. Results showed that chromosomal abnormalities were present in 28 fetuses (40.6%), and the most common aneuploidy was Turner syndrome (n=14, 20.3%); 16 (23.2%) of the remaining cases, in which aneuploidy was not found, had coexistent structural malformations; 25 (36.2%) cases had normal karyotype and morphology. The total number of live births and infants with unfavorable neurologic follow-up were 13 (18.8%) and 2 (2.9%), respectively. Septated CH is associated with poor perinatal outcomes; therefore, karyotype analysis and ultrasonographic anomaly screening should be performed as initial steps, and expectant management should be offered to couples with euploid fetuses that have normal morphology. PMID:25075572

  10. [Is fetus able to feel pain?].

    PubMed

    Kosińska-Kaczyńska, Katarzyna; Wielgoś, Mirosław

    2011-02-01

    On the basis of fetal hormonal and hemodynamic responses to pain related stimuli, neuroanatomy and observations of preterm babies, it was concluded that human fetus is able to feel pain after 24 weeks gestation. However it is possible that the fetus may feel pain even before that time. With the development of intrauterine diagnostic and therapeutic procedures, it is crucial to provide fetuses undergoing painful procedures not only with anesthesia but also analgesia. The article presents fetal pain research history and its implications for medicine.

  11. Premature ovarian failure

    PubMed Central

    Beck-Peccoz, Paolo; Persani, Luca

    2006-01-01

    Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea). It is a heterogeneous disorder affecting approximately 1% of women <40 years, 1:10,000 women by age 20 and 1:1,000 women by age 30. The most severe forms present with absent pubertal development and primary amenorrhea (50% of these cases due to ovarian dysgenesis), whereas forms with post-pubertal onset are characterized by disappearance of menstrual cycles (secondary amenorrhea) associated with premature follicular depletion. As in the case of physiological menopause, POF presents by typical manifestations of climacterium: infertility associated with palpitations, heat intolerance, flushes, anxiety, depression, fatigue. POF is biochemically characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Beyond infertility, hormone defects may cause severe neurological, metabolic or cardiovascular consequences and lead to the early onset of osteoporosis. Heterogeneity of POF is also reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. POF has a strong genetic component. X chromosome abnormalities (e.g. Turner syndrome) represent the major cause of primary amenorrhea associated with ovarian dysgenesis. Despite the description of several candidate genes, the cause of POF remains undetermined in the vast majority of the cases. Management includes substitution of the hormone defect by estrogen/progestin preparations. The only solution presently available for the fertility defect in women with absent follicular reserve is ovum donation. PMID:16722528

  12. Abruption-associated prematurity

    PubMed Central

    Han, Christina S.; Schatz, Frederick; Lockwood, Charles J.

    2011-01-01

    SYNOPSIS Chronic, subacute decidual hemorrhage (i.e., abruptio placenta and retrochorionic hematoma formation) is an important contributor to preterm parturition. Such hemorrhage induces thrombin from decidual tissue factor, which play a pivotal role in the development of preterm premature rupture of membranes and preterm delivery by acting through protease-activated receptors to promote the production of pro-inflammatory cytokines, and matrix-degrading metalloproteinases. Severe, acute abruption can lead to maternal and fetal mortality. Current management of abruption is individualized based on severity of disease, underlying etiology, and gestational age. PMID:21890016

  13. The effect of mothers’ empowerment program on premature infants’ weight gain and duration of hospitalization

    PubMed Central

    Mohammaddoost, Fatemeh; Mosayebi, Ziba; Peyrovi, Hamid; Chehrzad, Minoo-Mitra; Mehran, Abbas

    2016-01-01

    Background: The readiness of mothers to take care for infants at discharge is a critical issue. Poor readiness of mothers in taking care of premature infants at the time of discharge is associated with potential adverse consequences. This study examined the effect of implementing mothers’ empowerment program on the weight gain and duration of hospitalization in premature infants. Materials and Methods: This study was a quasi-experimental before-after study with a control group, in which 80 mothers with premature infants who were hospitalized in NICU Level II of two hospitals were recruited in the study. Mothers’ empowerment program was implemented as a three-stage training program for the intervention group. Mothers’ readiness questionnaire was completed by the mothers before the intervention and at the discharge time. The changes in mean of mothers’ readiness scores were compared in both the groups. Results: The mean of daily weight gain in infants of the intervention group (3.95 g) was significantly higher than that of the infants in the control group (−0.9 g) (P = 0.003). The average duration of hospitalization for infants in the intervention and control groups was 15.45 days and 20.95 days, respectively, showing a statistically significant difference (P = 0.003). Conclusions: Providing training to the mothers regarding how to care for premature infants can be a useful and effective method in the process of weight gain of premature and low-birth newborns, and may shorten the duration of infants’ hospitalization. PMID:27563317

  14. Ultrasound, normal fetus - head measurements (image)

    MedlinePlus

    ... Many health care providers like to have fetal measurements to verify the size of the fetus and ... any abnormalities. This ultrasound is of a head measurement, indicated by the cross hairs and dotted lines.

  15. Ultrasound, normal fetus - abdomen measurements (image)

    MedlinePlus

    ... Many health care providers like to have fetal measurements to verify the size of the fetus and ... any abnormalities. This ultrasound is of an abdominal measurement. It shows a cross-section of the abdomen, ...

  16. Effects of Alcohol on a Fetus

    MedlinePlus

    ... oxygen to the fetus. 5 • Toxic byproducts of alcohol metabolism may become concentrated in the brain and contribute to the development of an FASD. 6 Alcohol Placenta Uterine Lining Umbilical Cord Figure 1: Transmission ...

  17. Premature physeal arrest of the distal tibia associated with temporary arterial insufficiency.

    PubMed

    Peterson, H A

    1993-01-01

    Premature physeal arrest may occur after various insults to the physis. Its association with diaphyseal fracture without obvious physeal damage is well known, but the cause is obscure. The case reported documents premature closure of the distal tibial physis of an infant after a temporary but significant episode of vascular insufficiency. Direct arterial occlusion or arterial spasm may account for some cases of physeal arrest associated with nonphyseal-related trauma.

  18. [Pharmacology for the fetus and the newborn].

    PubMed

    Juárez-Olguín, Hugo; Buendía-Soto, Erick; Lares-Asseff, Ismael

    2015-01-01

    During intrauterine life, the fetus can be exposed to a series of substances ingested by the mother, some of which are necessary for her health but detrimental to fetus. The noxious effects of such exposure could present immediately after exposure in the fetus or be manifested at the time of delivery and sometimes weeks after birth. The passage of drugs or nutrients across the placenta depends on some physicochemicals that have the ability to cross the placenta barrier, and thus get in contact with the fetus and produce harmful effects. Considering the physicochemical properties of the substances, the possibility of such compounds to cross the placenta barrier and thence to the fetus can be predicted. Equally, it is important to consider the characteristics of the newborn as an immature being, different from adults, when carrying out pharmacokinetic and pharmacodynamic processes. Based on the latter, it is important to know the behavior or characteristics of the fetus and the newborn in the face of drug management and above all consider the advantages and disadvantages of the use of such drugs for the care of a being yet in development, as is described in this work.

  19. Prevalence of Feeding Related Issues/Difficulties in Taiwanese Children with History of Prematurity, 2003-2006

    ERIC Educational Resources Information Center

    Howe, Tsu-Hsin; Hsu, Chyong-Hsin; Tsai, Mei-Wun

    2010-01-01

    Feeding problems are common problems seen in premature infants following their discharge from the NICU. However, the prevalence of feeding issues and failure to thrive among preterm infants in Taiwan is uncertain. All former studies of prevalence and identifications of feeding issues were from western countries. Those findings are therefore not…

  20. Inflammatory and oxidative stress airway markers in premature newborns of hypertensive mothers

    PubMed Central

    Madoglio, R.J.; Rugolo, L.M.S.S.; Kurokawa, C.S.; Sá, M.P.A.; Lyra, J.C.; Antunes, L.C.O.

    2016-01-01

    Although oxidative stress and inflammation are important mechanisms in the pathophysiology of preeclampsia and preterm diseases, their contribution to the respiratory prognosis of premature infants of hypertensive mothers is not known. Our objective was to determine the levels of oxidative stress and inflammation markers in the airways of premature infants born to hypertensive and normotensive mothers, in the first 72 h of life, and to investigate whether they are predictors of bronchopulmonary dysplasia (BPD)/death. This was a prospective study with premature infants less than 34 weeks’ gestation on respiratory support who were stratified into 2 groups: 32 premature infants of hypertensive mothers and 41 of normotensive women, with a mean gestational age of 29 weeks. Exclusion criteria were as follows: diabetes mellitus, chorioamnionitis, malformation, congenital infection, and death within 24 h after birth. The outcome of interest was BPD/death. Malondialdehyde (MDA), nitric oxide (NO), and interleukin 8 (IL-8) were measured in airway aspirates from the first and third days of life and did not differ between the groups. Univariate and multivariate statistical analyses were performed. The concentrations of MDA, NO, and IL-8 were not predictors of BPD/death. Premature infants who developed BPD/death had higher levels of IL-8 in the first days of life. The gestational age, mechanical ventilation, and a small size for gestational age were risk factors for BPD/death. In conclusion, the biomarkers evaluated were not increased in premature infants of hypertensive mothers and were not predictors of BPD/death. PMID:27533763

  1. 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)

  2. Nutritional support in the premature newborn

    PubMed Central

    Puntis, J W L

    2006-01-01

    The theory and practice of nutritional support in the premature newborn has assumed increasing importance with survival of greater numbers of very immature infants. After birth, many do not tolerate full enteral feeding until gastrointestinal motor function has matured. During this process some will develop necrotising enterocolitis (NEC), a devastating failure of adaptation to postnatal life that may result in death, or severe complications. The feeding strategy that minimises the risk of NEC remains to be defined. In addition, promoting growth rates and nutrient accretion equivalent to those achieved during fetal development while optimising neurodevelopmental and long term health outcomes represents an important challenge for neonatologists. This review will focus on the problems associated with enteral nutrition, the requirement for parenteral nutrition, and the long term consequences of early nutritional interventions, underlining the need for prolonged follow up in assessing the potential benefits of different approaches to feeding. PMID:16517801

  3. Hepatic subcapsular haematoma in a premature newborn.

    PubMed

    Gonçalves, Cristina; Aguilar, Sara; Prior, Ana Rita; Oliveira, Graça

    2013-06-03

    Subcapsular haematoma of the liver rarely occurs in neonates and the diagnosis is often missed or delayed. It is a catastrophic condition that can be caused by maternal, placentar or fetal factors. A high index of suspicion is essential for early identification and stabilisation of babies with such a pathology. In a newborn with hypovolemic shock and abdominal distension, haemoperitoneum should be suspected and, along with exclusion of other aetiologies, supportive therapy should be instituted. The hepatic subcapsular haematoma has a non-specific presentation, and should be considered in very low birth weight infants with hypovolemic shock. Abdominal ultrasonography is the investigation of choice. It can delineate the lesion well, differentiate it from neoplasms, rule out rupture and aid in serial follow-up. We report a premature newborn who had this uncommon condition in the early neonatal period and survived without sequelae.

  4. Cost estimate of hospital stays for premature newborns in a public tertiary hospital in Brazil

    PubMed Central

    Desgualdo, Claudia Maria; Riera, Rachel; Zucchi, Paola

    2011-01-01

    OBJECTIVES: To estimate the direct costs of hospital stays for premature newborns in the Interlagos Hospital and Maternity Center in São Paulo, Brazil and to assess the difference between the amount reimbursed to the hospital by the Unified Health System and the real cost of care for each premature newborn. METHODS: A cost-estimate study in which hospital and professional costs were estimated for premature infants born at 22 to 36 weeks gestation during the calendar year of 2004 and surviving beyond one hour of age. Direct costs included hospital services, professional care, diagnoses and therapy, orthotics, prosthetics, special materials, and blood products. Costs were estimated using tables published by the Unified Health System and the Brasíndice as well as the list of medical procedures provided by the Brazilian Classification of Medical Procedures. RESULTS: The average direct cost of care for initial hospitalization of a premature newborn in 2004 was $2,386 USD. Total hospital expenses and professional services for all premature infants in this hospital were $227,000 and $69,500 USD, respectively. The costs for diagnostic testing and blood products for all premature infants totaled $22,440 and $1,833 USD. The daily average cost of a premature newborn weighing less than 1,000 g was $115 USD, and the daily average cost of a premature newborn weighing more than 2,500 g was $89 USD. Amounts reimbursed to the hospital by the Unified Health System corresponded to only 27.42% of the real cost of care. CONCLUSIONS: The cost of hospital stays for premature newborns was much greater than the amount reimbursed to the hospital by the Unified Health System. The highest costs corresponded to newborns with lower birth weight. Hospital costs progressively and discretely decreased as the newborns' weight increased. PMID:22012050

  5. Premature ejaculation: A review

    PubMed Central

    Gajjala, Sukumar Reddy; Khalidi, Azheel

    2014-01-01

    Premature ejaculation (PE) is a common male sexual disorder. It is defined by the Diagnostic and statistical manual of mental disorders as “ejaculation occurring, without control, on or shortly after penetration and before the person wishes it, causing marked distress or interpersonal difficulty.[1] Although the timing of intravaginal ejaculatory latency time (IELT) (i.e., time from penetration to ejaculation) is not included in this definition, an IELT of <2 min, or ejaculation occurring before penetration, has been considered consistent with PE.[2] Management involves both the patient and his partner. Therapeutic options should suit both partners and be appropriate to their habit in planning and frequency of intercourse. Follow-up at appropriate intervals to judge efficacy, titrate dosage of pharmacological treatments and ascertain side effects is mandatory. PMID:26396440

  6. The neural retina in retinopathy of prematurity.

    PubMed

    Hansen, Ronald M; Moskowitz, Anne; Akula, James D; Fulton, Anne B

    2017-01-01

    Retinopathy of prematurity (ROP) is a neurovascular disease that affects prematurely born infants and is known to have significant long term effects on vision. We conducted the studies described herein not only to learn more about vision but also about the pathogenesis of ROP. The coincidence of ROP onset and rapid developmental elongation of the rod photoreceptor outer segments motivated us to consider the role of the rods in this disease. We used noninvasive electroretinographic (ERG), psychophysical, and retinal imaging procedures to study the function and structure of the neurosensory retina. Rod photoreceptor and post-receptor responses are significantly altered years after the preterm days during which ROP is an active disease. The alterations include persistent rod dysfunction, and evidence of compensatory remodeling of the post-receptor retina is found in ERG responses to full-field stimuli and in psychophysical thresholds that probe small retinal regions. In the central retina, both Mild and Severe ROP delay maturation of parafoveal scotopic thresholds and are associated with attenuation of cone mediated multifocal ERG responses, significant thickening of post-receptor retinal laminae, and dysmorphic cone photoreceptors. These results have implications for vision and control of eye growth and refractive development and suggest future research directions. These results also lead to a proposal for noninvasive management using light that may add to the currently invasive therapeutic armamentarium against ROP.

  7. Development of carbohydrate absorption in the fetus and neonate.

    PubMed

    Mobassaleh, M; Montgomery, R K; Biller, J A; Grand, R J

    1985-01-01

    Maturation of mechanisms for carbohydrate absorption occurs in a defined sequence during human fetal development. The intestinal enzymes, lactase, sucrase, maltase, isomaltase, and glucoamylase, are at mature levels in the term fetus. Mature levels of pancreatic amylase activity and glucose transport occur postnatally, and levels are low in both the term and preterm neonate. In the preterm infant, sucrase, maltase, and isomaltase are usually fully active, but lactase activity, which increases markedly from 24 to 40 weeks, may be low depending upon fetal age. Despite these developmental patterns, clinical lactose intolerance is uncommon. Postnatal adaptive responses to ingested carbohydrates lead to competent carbohydrate absorption. Inadequately absorbed carbohydrates are salvaged by colonic flora through fermentation of carbohydrates to hydrogen gas and short-chain fatty acids; the latter are readily absorbed by the colon. In this setting, carbohydrate tends to be absent from the stool. Noninvasive reflection of the status of carbohydrate absorption may be obtained from breath hydrogen testing, a technique of particular value in young infants.

  8. Premature birth and its repercussions on growth and development in guadalajara, jalisco, Mexico

    PubMed

    Ramos; Ramirez; Fern&aacuet;dez; Lopez

    1998-04-01

    This study focuses on the repercussions of prematurity for the growth and development of newborns from hospitals in Guadalajara, Jalisco, Mexico, typical of the health care system in Mexico. Infants were assessed every six months as to nutritional status and the Denver Selective Test. In analyzing the results, social groups were considered determinant categories for studying prematurity as the dependent variable. The results shows that both prematurity and social group are risk factors to be considered by the public health field when designing health care programs.

  9. [Role of nursing in the development of breastfeeding in the premature newborn].

    PubMed

    Borrero-Pachón, María del Pilar; Olombrada-Valverde, Ana Esther; Martínez de Alegría, María Inés

    2010-01-01

    The birth of a premature infant creates anxiety and uncertainty for the parents, who may go through the same grieving process as parents who have lost a baby. Breastfeeding is considered a natural act, although it is not always an easy one for mother and premature infant to establish. Providing breast milk is one of the most important psychological benefits a mother can give her premature infant. Breast milk can be considered the ideal nutrition for preterm infants. Involving the parent in the child's care helps increase parental feelings of control. Neonatal nurses are in a unique position to help minimize parental stress by providing information. It is the responsibility of health professionals who care for premature infants to provide accurate information regarding the benefits and methods of breastfeeding, so that the mother can make an informed choice. The existence of a standardized care plan could assist in establishing breastfeeding in the pre-term newborn, to unify and guide practitioners in making decisions. The aim of this article is to describe the actions needed to be made by nursing staff to achieve successful breastfeeding. We present a standardized care plan that follows the NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification), and NIC (Nursing Interventions Classification) and show how these needs could be managed by nursing professionals.

  10. Macular Findings Obtained by Spectral Domain Optical Coherence Tomography in Retinopathy of Prematurity

    PubMed Central

    Erol, Muhammet Kazim; Ozdemir, Ozdemir; Turgut Coban, Deniz; Bilgin, Ahmet Burak; Dogan, Berna; Sogutlu Sari, Esin; Toslak, Devrim

    2014-01-01

    Purpose. To examine the macular findings obtained with spectral domain optical coherence tomography (SD OCT) in infants with retinopathy of prematurity (ROP). Materials and Methods. The macular SD OCT images of 190 premature infants were analyzed. Data regarding central foveal thickness (CFT), cystoid macular edema (CME), and cyst grading were compared. The relationships of CFT with gestational age and birth weight were investigated. Results. The results were obtained from 358 eyes of 179 infants (81 females and 98 males) of a mean gestational age of 30.9 ± 2.7 weeks and a mean birth weight of 1609 ± 477 g. ROP was diagnosed in 126 eyes and CME in 139 eyes. A significantly greater percentage of eyes with ROP were found to have CME (54%) compared to eyes without ROP (31%; P = 0.001). The incidence of CME was 46.3% for stage 1 ROP, 57.1% for stage 2, and 87.5% for stage 3. There was a weakly inverse correlation between CFT, gestational age, and birth weight (P = 0.025, r = −0.227; P = 0.002, r = −0.182, resp., Spearman correlation test). Conclusions. High-quality SD OCT images can be obtained from premature infants using the iVue system. Severity and frequency of CME in premature infants increase as stage of ROP increases. PMID:25544895

  11. The long-term renal and cardiovascular consequences of prematurity.

    PubMed

    Abitbol, Carolyn L; Rodriguez, Maria M

    2012-02-28

    Infants born prematurely at <37 weeks' gestation account for over 80% of infants weighing <2,500 g at birth-low birth weight (LBW) infants. This designation remains the surrogate marker for developmental origins of adult disease. Landmark studies spanning four decades have shown that individuals born with a LBW are more likely to develop cardiovascular and renal disease in later life, which is believed to be related to 'developmental programming' of such adult disease during vulnerable periods of growth in utero and in the early postnatal period. There has long been ambiguity regarding the distinction between infants with intrauterine growth restriction and preterm infants since both show a low nephron endowment that is associated with subsequent hypertension and chronic kidney disease. Knowledge is growing specific to the preterm infant and the developmental associations of being born preterm with the interruption of normal organogenesis relative to the vascular tree and kidney. Both systems develop by branching morphogenesis and interruptions lead to considerable deficits in their structure and function. These developmental aberrations can lead to endothelial dysfunction, hypertension, proteinuria and metabolic abnormalities that persist throughout life. This Review will examine the effect of preterm birth on the development of cardiovascular and kidney disease in later life and will also discuss potential early interventions to alter the progression of disease.

  12. Fungal endocarditis in an extremely low birth weight infant: case report.

    PubMed

    Ozdemir, Abdurrahman A; Oral, Tugce K; Varol, Aydin

    2016-04-01

    Survival rates of premature infants have increased with developing technology and evolving knowledge but late-onset sepsis is more frequent due to prolonged hospitalization periods of these infants. We report the case of an extremely low birth weight premature infant who was admitted with respiratory distress syndrome, developed necrotizing enterocolitis and fungal sepsis with endocarditis by Candida albicans. He was treated with antifungal therapy until fungal vegetation resolved. Fungal sepsis and endocarditis may be an important morbidity in preterm infants; we review the recent literature about the risk factors, diagnosis, treatment and prevention of fungal sepsis in these high risk infants.

  13. Mother-infant interaction improves with a developmental intervention for mother-preterm infant dyads.

    PubMed

    White-Traut, Rosemary; Norr, Kathleen F; Fabiyi, Camille; Rankin, Kristin M; Li, Zhyouing; Liu, Li

    2013-12-01

    While premature infants have a high need for positive interactions, both infants and their mothers are challenged by the infant's biological immaturity. This randomized clinical trial of 198 premature infants born at 29-34 weeks gestation and their mothers examined the impact of the H-HOPE (Hospital to Home: Optimizing the Infant's Environment) intervention on mother-premature infant interaction patterns at 6-weeks corrected age (CA). Mothers had at least 2 social environmental risk factors such as minority status or less than high school education. Mother-infant dyads were randomly assigned to the H-HOPE intervention group or an attention control group. H-HOPE is an integrated intervention that included (1) twice-daily infant stimulation using the ATVV (auditory, tactile, visual, and vestibular-rocking stimulation) and (2) four maternal participatory guidance sessions plus two telephone calls by a nurse-community advocate team. Mother-infant interaction was assessed at 6-weeks CA using the Nursing Child Assessment Satellite Training-Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, 6-item contingency scale during a 5-min play session). NCAST and DMC scores for the Control and H-HOPE groups were compared using t-tests, chi-square tests and multivariable analysis. Compared with the Control group (n = 76), the H-HOPE group (n = 66) had higher overall NCAST scores and higher maternal Social-Emotional Growth Fostering Subscale scores. The H-HOPE group also had significantly higher scores for the overall infant subscale and the Infant Clarity of Cues Subscale (p < 0.05). H-HOPE dyads were also more likely to have high responsiveness during play as measured by the DMC (67.6% versus 58.1% of controls). After adjustment for significant maternal and infant characteristics, H-HOPE dyads had marginally higher scores during feeding on overall mother-infant interaction (β = 2.03, p = 0.06) and significantly higher scores on the infant subscale (β = 0.75, p

  14. Infant botulism.

    PubMed

    Fenicia, Lucia; Anniballi, Fabrizio

    2009-01-01

    Infant botulism is a rare disease that affects infant less than 12 months of age. The illness results from absorption of botulinum toxin produced in situ by neurotoxigenic clostridia that can temporarily colonize the intestinal tract of infants. To date, all inhabited continents except Africa have reported cases of infant botulism. Recognition of cases seem directly related to physician awareness and clinical suspicion. This review summarizes microbiological, clinical and epidemiological features of infant botulism.

  15. Making the World Work with Microcomputers: A Learning Prosthesis for Handicapped Infants.

    ERIC Educational Resources Information Center

    Brinker, Richard P.; Lewis, Michael

    1982-01-01

    The contingency intervention system based upon an Apple II microcomputer is described and its application to three Down's syndrome infants and one premature infant is discussed. The use of the microcomputer as a behavioral microscope in infant intervention is examined. (Author/CL)

  16. The Relationship between Neonatal Characteristics and Three-Month Mother-Infant Interaction in High-Risk Infants.

    ERIC Educational Resources Information Center

    Greene, Jamie G.; And Others

    1983-01-01

    Addresses three questions: (1) To what extent do risk factors of prematurity and illness affect neonatal characteristics? (2) Do these risk factors continue to account for differences in mother and infant social interactive behavior at three months? and (three) To what degree are neonatal characteristics predictive of mother and infant behavior at…

  17. Fetus-in-fetu: a pediatric rarity.

    PubMed

    Narayanasamy, Jeyanthi N; Nallusamy, Mohan Arunasalam; Baharuddin, Nur Daliza

    2014-02-01

    Fetus-in-fetu (FIF) is a rare entity resulting from abnormal embryogenesis in diamniotic monochorionic twins, being first described by Johann Friedrich Meckel (1800s). This occurs when a vertebrate fetus is enclosed in a normally growing fetus. Clinical manifestations vary. Detection is most often in infancy, the oldest reported age being 47. We report the case of a 4-day-old girl who was referred postnatally following a prenatal fetal scan which had revealed the presence of a multi-loculated retroperitoneal mass lesion with calcifications within. A provisional radiological diagnosis of FIF was made. Elective laparotomy revealed a well encapsulated retroperitoneal mass containing among other structures a skull vault and rudimentary limb buds. Recovery was uneventful. Here we discuss the difference between FIF and teratomas, risks of non-operative therapy and the role of serology in surveillance and detection of malignant change.

  18. Advances in treating premature ejaculation

    PubMed Central

    Şerefoğlu, Ege Can

    2014-01-01

    In spite of its high prevalence and long history, the ambiguity regarding the definition, epidemiology and management of premature ejaculation continues. Topical anesthetic creams and daily or on-demand selective serotonin reuptake inhibitor (SSRI) treatment forms the basis of pharmacotherapy for premature ejaculation today, in spite of low adherence by patients. Psychotherapy may improve the outcomes when combined with these treatment modalities. Tramadol and phosphodiesterase type 5 inhibitors have a limited role in the management of premature ejaculation. Further research is required to develop better options for the treatment of this common sexual disorder. PMID:25184045

  19. Outcome of retinopathy of prematurity.

    PubMed

    Holmström, Gerd; Larsson, Eva

    2013-06-01

    In prematurely born children, various visual and ophthalmologic sequelae occur because of both retinopathy of prematurity (ROP) and preterm birth per se. Several long-term follow-up studies have described the outcome of ROP. Visual impairment and blindness are well-known consequences, but the prevalence varies globally because of differing neonatal and ophthalmologic care. Improving treatment options and criteria for the treatment of ROP are continuously changing the ophthalmologic outcome. The anatomic outcome has improved with treatment, but good anatomic outcome in treated severe ROP does not always reflect the functional outcome. There is no consensus regarding long-term follow-up of prematurely born children.

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

    PubMed

    Desquiotz-Sunnen, N

    2008-01-01

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

  1. Antibiotic Treatment and Length of Hospital Stay in Relation to Delivery Mode and Prematurity

    PubMed Central

    Ahlén, Katia M.; Örtqvist, Anne K.; Gong, Tong; Wallas, Alva; Ye, Weimin; Lundholm, Cecilia; Almqvist, Catarina

    2016-01-01

    Aim To investigate how 1) maternal delivery mode and 2) prematurity in infants are associated to antibiotic treatment and length of hospital stay. Methods Women having given birth and infants 0–12 months discharged from hospital between July 2005 and November 2011 were identified from the Swedish National Patient Register. Medical records were reviewed for 203 women and 527 infants. The risk ratio (RR) between antibiotic treatment and 1) delivery mode in women; 2) prematurity in infants was calculated. Length of stay and days of antibiotic therapy were compared by Wilcoxon rank-sum test. Results Women: There was an association between emergency caesarean section (CS) and antibiotic treatment (RR 5.0 95% confidence interval (CI) 2.2–11.5), but not for elective CS. Length of stay was longer for CS (emergency and elective) compared to vaginal delivery (p<0.01). Infants: RR for antibiotic treatment in preterm compared to term infants was 1.4 (95% CI 1.0–1.9). Length of stay (p<0.01), but not days of therapy (p = 0.17), was higher in preterm compared to term infants. Conclusion We found that emergency CS increased the probability of maternal antibiotic treatment during hospitalisation, but no difference was found between term and preterm infants. The results are well aligned with current guidelines and may be considered in future studies on the effects of antibiotics. PMID:27716779

  2. Infant Colic

    PubMed Central

    Gelfand, Amy A.

    2015-01-01

    This article reviews the evidence for an association between infant colic and migraine. Infant colic, or excessive crying in an otherwise healthy and well-fed infant, affects approximately 5–19% of infants. Multiple case-control studies, a cross-sectional study, and a prospective cohort study have all found an association between infant colic and migraine. While infant colic is often assumed to have a gastrointestinal cause, several treatment trials aimed at gastrointestinal etiologies have been negative. Teaching parents how best to respond to inconsolable crying may be helpful and important for preventing shaken baby syndrome. Given accumulating evidence for a connection between infant colic and pediatric migraine, future studies should examine migraine-oriented treatments for infant colic. Infant colic should be moved into the main body of International Classification of Headache Disorders (ICHD-III beta) as one of the “Episodic syndromes that may be associated with migraine”. PMID:27017027

  3. The gubernaculum during testicular descent in the human fetus.

    PubMed Central

    Heyns, C F

    1987-01-01

    This study of 178 male human fetuses and infants demonstrates that descent of the testis through the inguinal canal is a rapid process, with 75% of testes descending between 24 and 28 weeks of gestation. The gubernaculum is a cylindrical, gelatinous structure attached cranially to the testis and epididymis. While the testis is in the abdomen, the caudal tip of the gubernaculum is firmly attached to the region of the inguinal canal. In a few fetuses prior to descent the globular tip of the gubernaculum can be seen bulging through the external inguinal ring, covered by superficial fascia, with no macroscopically discernible extensions to the scrotum or any other area. Once the testis has passed through the inguinal canal, the bulbous lower tip of the gubernaculum is no longer firmly attached to any structure, nor does it extend to the bottom of the scrotum. Histologically the gubernaculum consists of undifferentiated mesenchymatous tissue. Prior to descent of the testis, there is an increase in the length of the intra-abdominal gubernaculum. The wet mass of the gubernaculum relative to the fetal mass increases rapidly prior to descent, while the relative wet mass of the testis remains constant during this period. There is also an increase in the wet/dry mass ratio of the gubernaculum, denoting an increase in its water content prior to descent. This indicates that a combination of growth processes is responsible for testicular descent, with the increase in the size of the gubernaculum playing the most important role in passage of the testis through the inguinal canal. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 PMID:2892824

  4. [Premature ovarian failure: present aspects].

    PubMed

    Vilodre, Luiz Cesar; Moretto, Marcelo; Kohek, Maria Beatriz da Fonte; Spritzer, Poli Mara

    2007-08-01

    Premature ovarian failure occurs in approximately 1:1000 women before 30 years, 1:250 by 35 years and 1:100 by the age of 40. It is characterized by primary or secondary amenorrhea and cannot be considered as definitive because spontaneous conception may occur in 5 to 10% of cases. In 95% of cases, premature ovarian failure is sporadic. The known causes of premature ovarian failure include chromosomal defects, autoimmune diseases, exposure to radiation or chemotherapy, surgical procedures, and certain drugs. Frequently, however, the etiology is not clear and these cases are considered to be idiopathic. Premature ovarian failure is defined by gonadal failure and high serum follicle-stimulating hormone (FSH) levels. Clinical approach includes emotional support, hormonal therapy with estrogens and progesterone or progestogens, infertility treatment, and prevention of osteoporosis and potential cardiovascular risk.

  5. Renal function in the fetus and neonate - the creatinine enigma.

    PubMed

    Kastl, Justin T

    2017-04-01

    The use of serum creatinine levels to estimate glomerular function in infants is admittedly fraught with inherent inaccuracies which are both physiological and methodological in nature. This characteristic can understandably reduce the neonatal clinician's confidence in the ability of serum creatinine levels to provide useful information relevant to their patients' medical care. The aim of this review is to provide further insight into the peculiarities of serum creatinine trends in both premature and term infants with special focus on the maturational and developmental changes occurring in the kidney during this crucial time-period. Though newer markers of glomerular function are gaining increasing traction in the clinical realm, the most prominent of which is currently cystatin C, creatinine nonetheless remains an important player in the scientific evolution of glomerular filtration rate (GFR) estimation. Not only do its limitations provide a level of distinction for newer markers of GFR, but its advantages persist in refining the precision of newer GFR formulae which incorporate multiple patient characteristics.

  6. Feeding At-Risk Infants and Toddlers.

    ERIC Educational Resources Information Center

    Jaffe, Mata B.

    1989-01-01

    Speech-language pathologists working with infants or toddlers with feeding problems should obtain a feeding history, conduct an assessment of feeding practices, set appropriate preliminary and long-range goals, and investigate treatment options and appropriate feeding techniques. Feeding techniques for premature, neurologically impaired, Down…

  7. Methods of enteral feeding in preterm infants.

    PubMed

    Maggio, L; Costa, S; Zecca, C; Giordano, L

    2012-05-01

    Whenever possible, oral feeding is the preferred method in neonatal feeding. However, many premature infants are unable to suck and swallow effectively; in these cases alternative methods of nutrient delivery must be used. We briefly review the different feeding methods used in neonatal units, with particular attention to their theoretical advantages, disadvantages and to the current best evidence available.

  8. Cremation of body parts and fetuses.

    PubMed

    Dunlop, J M

    2004-06-01

    Crematoria are occasionally asked to cremate non-viable fetuses. Many doctors, especially those associated with crematoria, believe that there will be no cremated residue. However, if the cremation technique is modified, cremated remains are produced. These remains can form a focal point for the parent's grief. Crematoria are urged to ensure their technique yields a residue.

  9. Intracardiac pressures in the human fetus

    PubMed Central

    Johnson, P; Maxwell, D; Tynan, M; Allan, L

    2000-01-01

    OBJECTIVE—To obtain normal values for intracardiac pressures in the human
 fetus.
DESIGN—Intracardiac pressures were measured directly in the four chambers of the human fetal heart during clinically indicated invasive obstetric procedures.
SETTING—Department of fetal medicine in a tertiary referral centre.
PATIENTS—39 fetuses between 16 and 29 weeks of gestation.
RESULTS—The ventricular waveforms obtained were similar to those found in postnatal life. There was an increase in ventricular systolic and end diastolic pressures with advancing gestation. There was no difference between left and right ventricular pressures. Atrial pressures were equal and remained constant in the gestational age range studied.
CONCLUSIONS—Fetal cardiovascular pressure measurements in the normal fetus assist in understanding the fetal circulation, and provide a basis for the assessment of cases of congenital heart disease that may be amenable to intrauterine treatment.


Keywords: fetus; ventricular pressure; congenital heart disease PMID:10862590

  10. Intussusception in Premature Baby: Unusual Cause of Bowel Obstruction and Perforation

    PubMed Central

    Tepmalai, Kanokkan; Naowapan, Thanyaluck; Singhavejsakul, Jesda; Laohapensang, Mongkol; Khorana, Jiraporn

    2017-01-01

    Intussusception in a premature baby is a rare condition. We report a male preterm infant, who developed abdominal distension and abdominal wall erythema. He was operated with suspicion of NEC but an ileo-ileal intussusception and intestinal perforation were encountered at operation. PMID:28083499

  11. Determinants and Predictors of School Adaptation and Academic Achievement in Prematurely Born Children.

    ERIC Educational Resources Information Center

    Kalmar, Magda; Varga, Magdolna Estefan

    The study followed up 30 premature Hungarian infants of low birthweight (less than 2500 grams) but no other major perinatal complications. Subjects were tested at age 6 on the Budapest-Binet IQ test, the Goodenough's "Draw a Person" test, the Bender Gestalt test, and a school entry test battery. Test performances at age 6 found that the…

  12. The biology of retinopathy of prematurity: how knowledge of pathogenesis guides treatment.

    PubMed

    Smith, Lois E; Hard, Anna-Lena; Hellström, Ann

    2013-06-01

    Retinopathy of prematurity occurs because the retina of a preterm infant at birth is incompletely vascularized, and if the postnatal environment does not match the in utero environment that supported retinal development, the vessels and neural retina will not grow normally. Risk factors determined from many clinical studies and animal studies fall into 2 categories: prenatal factors and postnatal factors.

  13. Helping Moms, Saving Babies: Faith-Based Partnerships to Reduce Prematurity in the African American Community

    ERIC Educational Resources Information Center

    Lewis, LaToya L.

    2008-01-01

    The March of Dimes, Texas Chapter, partnered with the faith community to pilot Honey Child[SM], a prenatal education program for African American women. The program is designed to combat prematurity, which is the leading cause of death for African American infants. Honey Child uses a spiritual approach to promote prenatal health through…

  14. Menstrual Bleeding as a Manifestation of Mini-Puberty of Infancy in Severe Prematurity

    PubMed Central

    Vogiatzi, Maria G.; Pitt, Michelle; Oberfield, Sharon; Alter, Craig A.

    2017-01-01

    We report 2 infants with severe prematurity who presented with uterine bleeding at age 6 months (approximately 2.5 months corrected for gestational age). Mini-puberty of infancy should be considered in the differential diagnosis of girls who present with uterine bleeding during the first 6 months of life. PMID:27593439

  15. Special Start: A Collaborative Project Designed to Support Premature Babies and Their Families

    ERIC Educational Resources Information Center

    Greenwald, Susan

    2003-01-01

    This article describes how in Alameda County, California, the Children's Hospital Oakland (CHAO) Neonatal Follow-up Program and the County Public Health Department have collaboratively addressed gaps in services for premature infants and their families through the Special Start initiative. Mental health specialists, health specialists, and…

  16. Dopamine-resistant hypotension and severe retinopathy of prematurity

    PubMed Central

    Catenacci, Melissa; Miyagi, Shogo; Wickremasinghe, Andrea C.; Lucas, Sarah Scarpace; de Alba Campomanes, Alejandra G.; Good, William V.; Clyman, Ronald I.

    2013-01-01

    Objective To examine the relationship between the cause or severity of hypotension and the development of severe retinopathy of prematurity (sROP) (≥ stage 3 or stage 2 with plus disease in Zone I or II).. Study design Infants (<28 weeks’ gestation, n=242) were observed for hypotension and treated with a standardized hypotension-treatment protocol. Hypotension was classified as resulting from one of the following causes: (a) culture-positive infection and/or necrotizing enterocolitis, (b) PDA ligation, or (c) “idiopathic” (no cause identified other than prematurity), and as being either dopamine-responsive or dopamine-resistant. Cortisol levels were measured for infants with dopamine-resistant hypotension. Eye examinations were performed until the ROP resolved or the vasculature matured. Multivariable logistic regression analysis was performed to determine the relationship between the cause/severity of hypotension and sROP. Results Overall, 66% of infants developed hypotension (41% were dopamine-responsive and 25% were dopamine-resistant). sROP developed in 19% of infants. “Idiopathic” dopamine-resistant hypotension was the only cause significantly related to sROP. 66% of infants with dopamine-resistant hypotension had low serum cortisol (≤10 μg/dL). Low cortisol, in the presence of dopamine-resistant hypotension, was significantly associated with sROP and accounted for the relationship between “idiopathic” hypotension and sROP. When low cortisol was included in statistical models, other known risk factors, such as immature gestation, were no longer significantly related to sROP. Conclusion Low cortisol, in the presence of dopamine-resistant hypotension, has the greatest magnitude of association with sROP. PMID:23465406

  17. The role of serum apelin in retinopathy of prematurity

    PubMed Central

    Ali, Yasser F; El-Morshedy, Salah; Imam, Abdulbasit Abdulhalim; Abdelrahman, Nasser Ismai A; Elsayed, Riad M; Alkholy, Usama M; Abdalmonem, Nermin; Shehab, Mohammed M

    2017-01-01

    Objective To evaluate the role of serum apelin as a diagnostic tool in retinopathy of prematurity (ROP) disease. Patients and methods Thirty-eight preterm infants (60% male) with gestational age ranging from 30 to 36 weeks admitted to the neonatal intensive care unit, KJO Hospital, Saudi Arabia with proven diagnosis of ROP were included in the study. In addition, 27 preterm infants without ROP served as controls. All newborn infants in the study were subjected to adequate history taking, full clinical examination, and fundus examination by indirect ophthalmoscope (at 4–6 weeks) as well as determination of serum apelin at birth and at 4–6 weeks of age. Results The study revealed that oxygen therapy longer than 7 days’ duration, cesarean section (as a mode of delivery), sepsis, mechanical ventilation, blood transfusion, premature rupture of membranes, pneumothorax, perinatal asphyxia, cardiac problems, and neonatal jaundice were considered as risk factors related to development of ROP. Serum apelin levels were significantly lower in patients than controls (P<0.001) at time of diagnosis of the disease (4–6 weeks) while no significant differences were observed in levels at birth. Conclusion Serum apelin was found to be of significant diagnostic value in the occurrence of ROP. PMID:28260850

  18. Perinatal Systemic Inflammatory Response Syndrome and Retinopathy of Prematurity

    PubMed Central

    Sood, Beena G.; Madan, Ashima; Saha, Shampa; Schendel, Diana; Thorsen, Poul; Skogstrand, Kristin; Hougaard, David; Shankaran, Seetha; Carlo, Wally

    2010-01-01

    Fetal and neonatal inflammation is associated with several morbidities of prematurity. Its relationship to retinopathy of prematurity (ROP) has not been investigated. Our objective was to determine the relationship between cytokine levels and ROP in the first three postnatal weeks. Data for this study were derived from the NICHD Cytokine Study. Dried blood spots were obtained from infants <1000g on days 0-1, 3±1, 7±2, 14±3, and 21±3. Infants were classified into three groups – No, Mild, and Severe ROP. Multiplex Luminex assay was used to quantify 20 cytokines. Temporal profiles of cytokines were evaluated using mixed effects models after controlling for covariates. Of 1074 infants enrolled, 890 were examined for ROP and 877 included in the analysis. ROP was associated with several clinical characteristics on unadjusted analyses. Eight cytokines remained significantly different across ROP groups in adjusted analyses. IL-6 and IL-17 showed significant effects in early time periods (D0-3); TGF-β, brain derived neurotrophic factor (BDNF), and regulated upon activation, normal T cell expressed and secreted (RANTES) in later time periods (D7-21) and IL-18, C-reactive protein (CRP) and neurotrophin-4 (NT-4) in both early and later time periods. We conclude that perinatal inflammation may be involved in the pathogenesis of ROP. PMID:20032809

  19. Resting-State Functional Connectivity Differences in Premature Children

    PubMed Central

    Damaraju, Eswar; Phillips, John R.; Lowe, Jean R.; Ohls, Robin; Calhoun, Vince D.; Caprihan, Arvind

    2010-01-01

    We examine the coherence in the spontaneous brain activity of sleeping children as measured by the blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) signals. The results are described in terms of resting-state networks (RSN) and their properties. More specifically, in this study we examine the effect of severe prematurity on the spatial location of the visual, temporal, motor, basal ganglia, and the default mode networks, the temporal response properties of each of these networks, and the functional connectivity between them. Our results suggest that the anatomical locations of the RSNs are well developed by 18 months of age and their spatial locations are not distinguishable between premature and term born infants at 18 months or at 36 months, with the exception of small spatial differences noted in the basal ganglia area and the visual cortex. The two major differences between term and pre-term children were present at 36 but not 18 months and include: (1) increased spectral energy in the low frequency range (0.01–0.06 Hz) for pre-term children in the basal ganglia component, and (2) stronger connectivity between RSNs in term children. We speculate that children born very prematurely are vulnerable to injury resulting in weaker connectivity between resting-state networks by 36 months of age. Further work is required to determine whether this could be a clinically useful tool to identify children at risk of developmental delay related to premature birth. PMID:20725534

  20. Plasma aminotransferase concentrations in preterm infants.

    PubMed

    Victor, S; Dickinson, H; Turner, M A

    2011-03-01

    The aim of this study was to generate reference ranges for aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in preterm infants by describing the observed plasma concentration of these enzymes in babies born between 22 and 36 weeks' gestation. A service evaluation was conducted in babies admitted to two large neonatal intensive care units in the UK. 7006 blood samples from 1860 infants admitted to the two units between 2004 and 2008 were included. Extremely premature infants had high plasma enzyme activities when compared to babies at a later corrected gestational age. This may be due to more severe illness immediately after birth.

  1. [Visuospatial functions and prematurity].

    PubMed

    Miranda-Herrero, M C; Pascual-Pascual, S I; Barredo-Valderrama, E; Vazquez-Lopez, M; de Castro-De Castro, P

    2014-11-01

    Visuospatial functions are very important in learning process and development of abstract thought during childhood. Several studies show that preterm and low birth weight infants obtain lower scores in test that assess cognitive functions, specially in the first year of life. These differences are attenuated over time, but a developmental delay that affects working memory and visuospatial process still persists. It is unclear what factors are involved in development of these functions, and pre- or perinatal factors may interfere with the proper conduct of the same, but have been described anatomical and physiological differences between the preterm and term brain that could explain somewhere in these alterations. The different selective vulnerability to hypoxia between immature brain in which preoligodendrocytes and subplate neurons predominate, and mature brain, determine differences in the pattern of injury from hypoxia with greater involvement of the periventricular white matter in preterm children. This lesional pattern leaves to a dysfunction in attentional and visuospatial process, due to the increased vulnerability of the regions involved in the dorsal pathway of visual processing.

  2. Biochemical characterization of Campylobacter fetus lipopolysaccharides.

    PubMed Central

    Moran, A P; O'Malley, D T; Kosunen, T U; Helander, I M

    1994-01-01

    Lipopolysaccharides (LPS) of five strains of the human and animal pathogen Campylobacter fetus were electrophoretically and chemically characterized. Analysis with sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that all the strains produced smooth-form LPS with O side chains of relatively constant chain length. Upon extraction, LPS partitioned into both the water and phenol phases of phenol-water extracts, which showed that two chemical species of LPS were present in each C. fetus strain. Constituents common to all the LPS, though differing in molar ratios, were L-rhamnose, L-fucose, D-mannose, D-glucose, D-galactose, L-glycero-D-manno-heptose, and D-glycero-D-manno-heptose. L-Acofriose (3-O-methyl-L-rhamnose) was present in only two of the C. fetus strains. On the basis of these differences, it was possible to distinguish between LPS from strains of different serotypes and biotypes. Furthermore, chemical analysis indicated that the phenol phase LPS had a lower level of substitution by certain neutral sugars than did water phase LPS. N-Acetylneuraminic (sialic) acid and D-galactosamine were present in all the C. fetus LPS. Constituents normally found in the core and lipid A regions of LPS, 3-deoxy-D-manno-2-octulosonic acid, D-glucosamine, ethanolamine and its phosphorylated derivatives, and fatty acids [14:0, 16:0 14:0(3-OH), and 16:0(3-OH)] were detected. Unlike Campylobacter jejuni, in which 2,3-diamino-2,3-dideoxy-D-glucose occurs as a constituent of the lipid A backbone, this amino sugar was absent from C. fetus LPS, indicating major structural differences in the lipid A's of these species. Images PMID:8063409

  3. More than maternal sensitivity shapes attachment: infant coping and temperament.

    PubMed

    Fuertes, Marina; Santos, Pedro Lopes Dos; Beeghly, Marjorie; Tronick, Edward

    2006-12-01

    The aim of this longitudinal study was to investigate the effect of a set of factors from multiple levels of influence: infant temperament, infant regulatory behavior, and maternal sensitivity on infant's attachment. Our sample consisted of 48 infants born prematurely and their mothers. At 1 and 3 months of age, mothers described their infants' behavior using the Escala de Temperamento do Bebé. At 3 months of age, infants' capacity to regulate stress was evaluated during Tronick's Face-to-Face Still-Face (FFSF) paradigm. At 9 months of age, mothers' sensitivity was evaluated during free play using the CARE-Index. At 12 months of age, infants' attachment security was assessed during Ainsworth's Strange Situation. A total of 16 infants were classified as securely attached, 17 as insecure-avoidant, and 15 as insecure-resistant. Mothers of securely attached infants were more likely than mothers of insecure infants to describe their infants as less difficult and to be more sensitive to their infants in free play. In turn, secure infants exhibited more positive responses during the Still-Face. Infants classified as insecure-avoidant were more likely to self-comfort during the Still-Face and had mothers who were more controlling during free play. Insecure-resistant exhibited higher levels of negative arousal during the Still-Face and had mothers who were more unresponsive in free play. These findings show that attachment quality is influenced by multiple factors, including infant temperament, coping behavior, and maternal sensitivity.

  4. The neuroanatomy of prematurity: normal brain development and the impact of preterm birth.

    PubMed

    Ortinau, Cynthia; Neil, Jeffrey

    2015-03-01

    Brain development is a complex process of micro- and macrostructural events that include neuronal and glial proliferation and migration, myelination, and organizational development of cortical layers and circuitry. Recent progress in understanding these processes has provided insight into the pathophysiology of brain injury and alterations of cerebral development in preterm infants. A key factor of abnormalities in the preterm infant is the maturational stage of the brain at the time of birth. This review summarizes current data on normal brain development, patterns of brain injury in the preterm infant, and the associated axonal/neuronal disturbances that occur in the setting of this injury, often termed encephalopathy of prematurity.

  5. Infant botulism

    MedlinePlus

    ... and certain foods (such as honey and some corn syrups). Infant botulism occurs mostly in young infants ... spores. Clostridium spores are found in honey and corn syrup. These foods should not should not be ...

  6. Hyperglycemia - infants

    MedlinePlus

    High blood sugar - infants; High blood glucose level - infants ... have a low insulin level that results in high blood sugar. ... hyperglycemia often have no symptoms. Sometimes, babies with high blood sugar will produce large amounts of urine ...

  7. [Infant botulism].

    PubMed

    Falk, Absalom; Afriat, Amichay; Hubary, Yechiel; Herzog, Lior; Eisenkraft, Arik

    2014-01-01

    Infant botulism is a paralytic syndrome which manifests as a result of ingesting spores of the toxin secreting bacterium Clostridium botulinum by infants. As opposed to botulism in adults, treating infant botulism with horse antiserum was not approved due to several safety issues. This restriction has led to the development of Human Botulism Immune Globulin Intravenous (BIG-IV; sells under BabyBIG). In this article we review infant botulism and the advantages of treating it with BIG-IV.

  8. A possible explanation of sudden infant death syndrome (SIDS).

    PubMed

    Christos, G A; Christos, J A

    1993-09-01

    Research into (lucid) dreaming has shown that the images of a dream are supported by the corresponding body actions, utilizing those muscles which remain active during dreaming. We suggest that Sudden Infant Death Syndrome (SIDS) or Cot Death may be a result of an infant dreaming about its life as a fetus. In the course of that dream, since a fetus does not breathe in the usual sense, the infant may cease to breathe and die. Our hypothesis is consistent with the known facts about SIDS, including social factors such as sleeping position and climatic variation. We suggest that the risk of SIDS can be reduced by making the environment of the infant, as much as possible, unlike that of the womb.

  9. Aplasia cutis congenita in a setting of fetus papyraceus associated with small fetal abdominal circumference and high alpha-fetoprotein and amniotic acetylcholinesterase.

    PubMed

    Mazza, Joni M; Klein, Janice F; Christopher, Kurt; Silverberg, Nanette B

    2015-01-01

    Fetus papyraceus is the fetal death of one or more fetuses in a multiparous pregnancy. The surviving infants can experience extensive aplasia cutis in an H-shaped distribution over the flanks and abdomen as a consequence of the loss of their fetal sibling. We report the case of a monochorionic, diamniotic pregnancy complicated by a single fetal death at 13 weeks of gestational age. Aplasia cutis of the surviving twin was suggested in utero by three criteria: high amniotic and maternal alpha-fetoprotein, detectable acetylcholinesterase, and small abdominal circumference on prenatal ultrasound. This constellation of findings in the setting of fetus papyraceus can be an indicator of aplasia cutis in the surviving fetus.

  10. Prenatal stress, prematurity and asthma

    PubMed Central

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C.

    2016-01-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the U.S. and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic Blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced “premature asthma”. Prenatal stress may not only cause abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring Th2 (allergic) immune responses characteristic of atopic asthma: IL-6, which has been associated with premature labor, can promote Th2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing “premature asthma”. If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common co-morbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (e.g. from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health. PMID:26676148

  11. Chromosomal abnormalities in fetuses with ultrasonographically detected neural tube defects.

    PubMed

    Kanit, Hakan; Özkan, Azra Arici; Öner, Soner Recai; Ispahi, Ciğdem; Endrikat, Jan Siegfried; Ertan, Kubilay

    2011-10-01

    We analyzed the karyotype of fetuses with ultrasonographically detected neural tube defects (NTDs). In our study, we included a total of 194 fetuses with NTDs. We analyzed the type of NTD, the karyotype, maternal age, fetal gestational age at diagnosis, and fetal sex. Of the 194 fetuses with NTDs, 87 were anencephalic and 107 had other, nonanencephalic, NTDs. A total of 12 fetuses were shown to have chromosomal abnormalities. Three of 87 anencephalic fetuses (3.45%) had chromosomal abnormalities. The sex ratio for anencephalic fetuses was 65.5% : 34.5% for female and male fetuses. Nine of 107 fetuses with other NTDs (8.41%) had chromosomal abnormalities. Seven fetuses had isolated NTDs and a further seven fetuses had additional ultrasonographic anomalies. Two of the latter had abnormal karyotypes. The sex ratio of all other NTD cases was 67.3% : 32.7% for female and male fetuses. The high number of chromosomal abnormalities justifies prenatal karyotyping in all fetuses with ultrasonographically diagnosed NTDs.

  12. Risk Factors for Retinopathy of Prematurity in Premature Born Children

    PubMed Central

    Alajbegovic-Halimic, Jasmina; Zvizdic, Denisa; Alimanovic-Halilovic, Emina; Dodik, Irena; Duvnjak, Sanela

    2015-01-01

    Introduction: Retinopathy of Prematurity (ROP) represent disease of the eye in premature born children which affects immature blood vessels of the retina during their development. The emergence of retinopathy of prematurity depends on the interaction of multiple factors, such as: gestational age, low birth weight, hypoxia, duration of oxygen supplementation, respiratory distress syndrome, twin pregnancy, anemia, blood transfusions, sepsis, intraventricular hemorrhage, hypotension, hypothermia, etc. If remain unrecognized and untreated it can cause severe visual impairment and blindness in children, but can also be prevented with timely screening. Goals: To establish the number of patients with development of retinopathy of prematurity active forms in the observed time period and examine which risk factors have most significant impact on its origin. Material and methods: In a clinical, retrospective study we observed a total of 80 premature born children in the period from January to May 2015 with regard to listed risk factors identified for eye examination. Results: From a total of 80 premature newborns sample included 48.8% male and 51.2% female children. The active form of ROP developed in 6.2% of cases, while in 93.8% of cases there was a spontaneous resolution. Patients who developed active form of ROP have significantly younger gestational age (26.4±1.5 weeks) and lower birth weight (874±181 grams), lower Apgar score in the first and fifth minute and were longer on oxygen therapy (20±3.4 days). Conclusion: Of the potential risk factors that could affect the development of ROP active form following factors have a statistically significant influence: early gestational age, low birth weight, lower Apgar score and prolonged oxygen therapy (p <0.05). PMID:26843736

  13. [Inhibition of premature uterine contractions].

    PubMed

    Troszyński, M; Leibschang, J; Chazan, B; Adamowicz, R; Brankowska, J

    1979-01-01

    Various drugs used to stop premature uterine contractions are discussed in the paper. Particular attention is paid to beta-mimetic drugs. The results of ming Partusisten, one of beta-mimetic drugs, is presented on the material of 104 patients with threatening immature and premature labour. Partusisten was administered in the form of intravenous drip infusion or tablets. During treatment monitoring of the uterine contractility and of foetal heart rate took place. Inhibition of the uterine contraction activity was successful in 100 per cent of cases. In 60,9 per cent in the group of threatening immature labour and in 38,1 per cent in the group threatening premature labour, the delay of delivery was more then 28 days. The delay of delivery by 48 hours was 87 per cent and 84 per cent in both groups respectively. Tachycardia was one of the first side effects observed in 15,2 per cent of cases. There is also presented an example of pregnancy when delivery was delayed by 21 days in spite of premature outflow of amniotic fluid (at a high rupture of membrane). The authors are of the opinion that Partusisten is very effective and gives little side effects, preventing premature uterine contractions. Dosage should be individualized according to the case and labour advancement, and should be based on topographic evaluation of uterine contraction. Negative influence of the drug on foetuses was not observed.

  14. [Factors family background of mothers involved in having a premature baby].

    PubMed

    Kamburova, M; Hristova, I

    2014-01-01

    Level of prematurity is an objective criterion for determining the health welfare of the population. Several family background factors of the mother increases the risk of preterm birth child - family status, unwanted pregnancy, etc. Pregnancy among unmarried women and unwanted pregnancy are associated with a higher risk of giving premature baby. Aim of this study is a survey and analysis of factors of family background of the mother (family status and unplanned pregnancy) and their influence on the birth of a premature baby. The survey found nearly three times higher risk OR = 2,83 95 % CI (1,7-4,7) for the birth of a premature baby among unmarried mothers compared to married women, and twice as high proportion of unplanned pregnancy mothers of preterm infants - 20.7% compared to terminfants-10.4%.

  15. The omega-3 and retinopathy of prematurity relationship.

    PubMed

    Malamas, Angelakis; Chranioti, Angeliki; Tsakalidis, Christos; Dimitrakos, Stavros A; Mataftsi, Asimina

    2017-01-01

    The aim of this article is to examine the effect of omega-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) intake on retinopathy of prematurity (ROP) by reviewing the experimental and clinical trials conducted on animal models and infants. LCPUFAs demonstrate cytoprotective and cytotherapeutic actions contributing to a number of anti-angiogenic and neuroprotective mechanisms within the retina. Their intake appears to have a beneficial effect on ischemia, oxidative stress, inflammation and cellular signaling mechanisms, influencing retinal cell gene expression and cellular differentiation. ω-3 LCPUFAs may modulate metabolic processes that activate molecules implicated in the pathogenesis of vasoproliferative and neurodegenerative retinal diseases such as ROP.

  16. The omega-3 and retinopathy of prematurity relationship

    PubMed Central

    Malamas, Angelakis; Chranioti, Angeliki; Tsakalidis, Christos; Dimitrakos, Stavros A; Mataftsi, Asimina

    2017-01-01

    The aim of this article is to examine the effect of omega-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) intake on retinopathy of prematurity (ROP) by reviewing the experimental and clinical trials conducted on animal models and infants. LCPUFAs demonstrate cytoprotective and cytotherapeutic actions contributing to a number of anti-angiogenic and neuroprotective mechanisms within the retina. Their intake appears to have a beneficial effect on ischemia, oxidative stress, inflammation and cellular signaling mechanisms, influencing retinal cell gene expression and cellular differentiation. ω-3 LCPUFAs may modulate metabolic processes that activate molecules implicated in the pathogenesis of vasoproliferative and neurodegenerative retinal diseases such as ROP. PMID:28251092

  17. Infant dreaming and fetal memory: a possible explanation of sudden infant death syndrome.

    PubMed

    Christos, G A

    1995-04-01

    During rapid-eye-movement sleep, when we dream, the brain is thought to be processing stored memory. The memory of a newborn infant is dominated by its fetal experience, and the infant is likely to dream about its life in the womb. Research with lucid (or conscious) dreaming has shown that dream images are supported by the corresponding body actions, using those muscles which remain active during rapid-eye-movement sleep. We suggest that sudden infant death syndrome or cot death may be a result of an infant dreaming about its life (or memory) as a fetus. In the course of that dream, since a fetus does not breathe (in the usual sense) the infant may cease to breathe and may die. This simple hypothesis is consistent with all of the known facts about sudden infant death syndrome (pathological and epidemiological), such as the age at death curve (the observed exponential decay and possibly the peak at 2-3 months), the higher risk with the prone sleeping position (but not excluding the supine position), and the observed climatic variation (seasonal and regional) in the incidence of sudden infant death syndrome. Many of these well-established facts have no other known explanation and other theories can generally only account for a few of the known facts about sudden infant death syndrome. Our hypothesis is also supported by recent findings that, as a group, sudden infant death syndrome infants have a higher proportion of rapid-eye-movement sleep, and also that they have an average higher heart rate (corresponding to possible fetal dreams) but only during rapid-eye-movement sleep.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Multi-sensory intervention for preterm infants improves sucking organization

    PubMed Central

    Medoff-Cooper, Barbara; Rankin, Kristin; Li, Zhuoying; Liu, Li; White-Traut, Rosemary

    2015-01-01

    Objective The aim of this RCT was to evaluate sucking organization in premature infants following a preterm infant multi-sensory intervention, the Auditory, Tactile, Visual, and Vestibular (ATVV). Study Design A convenience sample of 183 healthy premature infants born 29 - 34 weeks post-menstrual age (PMA) enrolled. Sucking organization was measured at baseline, then weekly assessments, during the infant's hospital stay. Results A quadratic trend was observed for number of sucks, sucks per burst, and maturity index, with the intervention group increasing significantly faster by day 7 (Model estimates for group*day: β = 13.69, p < 0.01; β = 1.16, p < 0.01; and β = 0.12, p < 0.05, respectively). Sucking pressure increased linearly over time, with significant between-group differences at day 14 (β = 45.66, p < 0.01). Conclusion ATVV infants exhibited improved sucking organization during hospitalization, suggestive that ATVV intervention improves oral feeding. PMID:25822519

  19. The first closed genome sequence of Campylobacter fetus subsp. venerealis biovar intermedius

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Campylobacter fetus venerealis biovar intermedius is a variant of Campylobacter fetus subsp. venerealis, the causative agent of Bovine Genital Campylobacteriosis. In contrast to Campylobacter fetus subsp. venerealis which is restricted to the genital tract of cattle, Campylobacter fetus subsp. vener...

  20. Visual and visuocognitive development in children born very prematurely.

    PubMed

    Atkinson, Janette; Braddick, Oliver

    2007-01-01

    Preterm birth is a risk factor for deficits of neurological and cognitive development. Four cohort studies are reported investigating the effects of very premature birth (<32 weeks gestation) on visual, visuocognitive and visuomotor function between birth and 6-7 years of age. The first study used two measures of early visual cortical function, orientation reversal visual event-related potentials (OR-VERP) and fixation shifts under competition. Both these functional measures of visual development correlated with the severity of brain abnormality observed on structural MRI at and before term, and were sensitive predictors of neurodevelopmental outcome at 2 years. The second study compared VERP measures for orientation-reversal and direction-reversal (DR) stimuli, from 2 to 5 months post-term age, in healthy very premature infants compared to infants born at term. The groups did not differ on the development of OR-VERP responses, but the development of the DR-VERP motion responses was delayed in the premature group despite the absence of any brain damage visible on ultrasound, consistent with the developmental vulnerability we have identified in the dorsal cortical stream. The third study used the Atkinson Battery of Child Development for Examining Functional Vision (ABCDEFV) to assess sensory, perceptual, cognitive and spatial visual functions, together with preschool tests of attention and executive function. The premature group showed delays on these tests in line with severity of observed perinatal brain damage on structural MRI at term age. Deficits on certain spatial tasks (e.g. block-construction copying) and executive function tests (e.g. the detour box task) were apparent even in children with minimal damage apparent on MRI. The fourth study tested a large cohort of 6- to 7-year old children born before 32 weeks gestation, across a wide range of cognitive domains, including new tests of spatial cognition and memory. The premature group as a whole showed

  1. Pain and stress in the human fetus.

    PubMed

    White, Michelle C; Wolf, Andrew R

    2004-06-01

    It is not known if the fetus can actually feel pain, but noxious stimulation during fetal life does cause detectable stress responses. These responses cause both short and long-term changes in the central nervous system, which can affect subsequent pain behaviour. Reducing the stress response is known to be beneficial in children and adults and recent evidence suggests this is also true for the fetus. However, the optimal amount of suppression required and the best method of achieving this (opioid or regional anaesthesia techniques) remain unknown. Prevention and treatment of pain is a basic human right, regardless of age, and if the technique of fetal surgery is to progress then a greater understanding of nociception and the stress response is required.

  2. Precursors to glycogen in ovine fetuses

    SciTech Connect

    Levitsky, L.L.; Paton, J.B.; Fisher, D.E. )

    1988-11-01

    Postprandial hepatic glycogenesis in the adult animal is now felt to proceed largely through gluconeogenic pathways rather than directly from glucose. The ovine fetus, like the mature sheep, lacks specific hepatic glucokinase. Therefore, the authors examined the role of lactate as a fetal glycogenic precursor in seven chronically catheterized 125-day sheep fetuses. Fetuses were infused with L-(U-{sup 14}C)lactate and D-(3-{sup 3}H)glucose, while maternal glucose was maintained at 50 mg/dl. Mean fetal hepatic glycogen specific activity ({mu}Ci/mg {times} 10{sup 3}) was 0.82 {plus minus} 0.08 for {sup 14}C and 2.6 {plus minus} 0.4 for {sup 3}H, whereas fetal renal glycogen specific activity was 0.46 {plus minus} 0.22 for {sup 14}C and 0.78 {plus minus} 0.16 for {sup 3}H. In contrast, ({sup 14}C)glucose specific activity was undetectable in blood and mean ({sup 3}H)glucose specific activity was 8.9 {plus minus} 1.3 {mu}Ci/mg {times} 10{sup 3}. The least detectable specific activity of ({sup 14}C)glucose did not differ significantly from the ({sup 14}C)glycogen enrichment in liver, whereas ({sup 3}H)glucose specific activity was significantly greater than ({sup 3}H)glycogen enrichment. The authors conclude that glycogenesis from glucose is partly through the indirect gluconeogenic route and that lactate may be a glycogenic precursor in the ovine fetus.

  3. Automatic Tortuosity-Based Retinopathy of Prematurity Screening System

    NASA Astrophysics Data System (ADS)

    Sukkaew, Lassada; Uyyanonvara, Bunyarit; Makhanov, Stanislav S.; Barman, Sarah; Pangputhipong, Pannet

    Retinopathy of Prematurity (ROP) is an infant disease characterized by increased dilation and tortuosity of the retinal blood vessels. Automatic tortuosity evaluation from retinal digital images is very useful to facilitate an ophthalmologist in the ROP screening and to prevent childhood blindness. This paper proposes a method to automatically classify the image into tortuous and non-tortuous. The process imitates expert ophthalmologists' screening by searching for clearly tortuous vessel segments. First, a skeleton of the retinal blood vessels is extracted from the original infant retinal image using a series of morphological operators. Next, we propose to partition the blood vessels recursively using an adaptive linear interpolation scheme. Finally, the tortuosity is calculated based on the curvature of the resulting vessel segments. The retinal images are then classified into two classes using segments characterized by the highest tortuosity. For an optimal set of training parameters the prediction is as high as 100%.

  4. Multi-risk Infants: Predicting attachment security from sociodemographic, psychosocial, and health risk among African-American preterm infants

    PubMed Central

    Candelaria, Margo; Teti, Douglas M.; Black, Maureen M

    2010-01-01

    Background Ecological and transactional theories link child outcomes to accumulated risk. This study hypothesized that cumulative risk was negatively related to attachment, and that maternal sensitivity mediated linkages between risk and attachment. Methods 112 high-risk African-American premature infant-mother dyads participated. Psychosocial (maternal depression, stress and self-efficacy) and sociodemographic risk (poverty, maternal education, marital status) were maternal self-report (0–4 months). Infant health risk was obtained from hospital charts. Infant-mother attachment (12 months) and maternal sensitivity (4 months) were assessed with Q-sort measures. Findings Psychosocial and sociodemographic, but not infant health risk, negatively related to attachment. Both were mediated by maternal sensitivity. Conclusions The impact of risk domains on attachment security was mediated by maternal sensitivity. Results emphasize the need for early intervention programs targeting premature infants to identify and address environmental and personal factors that place parenting at risk. PMID:21434913

  5. Teratogenic effects of silymarin on mouse fetuses

    PubMed Central

    Gholami, Mahbobe; Moallem, Seyed Adel; Afshar, Mohammad; Amoueian, Sakineh; Etemad, Leila; Karimi, Gholamreza

    2016-01-01

    Objective: Silybum marianum has been used for centuries in herbal medicine for treatment of liver diseases. Currently, there is no data available on the possible effects of silymarin on fetal development. This study aimed to investigate the teratogenic effect of silymarin on BALB/c mice fetuses. Materials and Methods: A total of 40 pregnant mice were divided into 4 groups of 10 mice each. Three groups received silymarin at three different doses of 50, 100 and 200 mg/kg/day during gestational days (GDs). The control group received normal saline and tween (solvent). Dams were sacrificed on GD 18 and all fetuses were examined for gross malformations, size and body weight. Malformed fetuses were double stained with alizarin red and alcian blue. Results: Silymarin administration at all doses resulted in reduction of the mean fetal body weights. The abnormalities included limb, vertebral column and craniofacial malformations. Craniofacial malformations were the most common abnormalities, but they were not observed in a dose-dependent manner. The percentage of fetal resorption significantly increased (up to 15%) in all treatment groups. Conclusion: Based on our results, silymarin, especially at high doses can lead to fetal resorption, intrauterine growth retardation and limb, vertebral column and craniofacial abnormalities. More precise studies should be conducted about the teratogenic effects of herbal medicine investigating the underlying mechanisms. Thus, caution should be taken when administering S. marianum to pregnant woman. PMID:27761424

  6. Morphometric Study of Pancreas in Human Fetuses

    PubMed Central

    Dhende, Abhijeet S.; Joshi, Deepak S.

    2016-01-01

    Introduction The pancreas arises from the endoderm as a dorsal and a ventral bud which fuse together to form the single organ. It extends transversely across the posterior abdominal wall from the duodenum to the spleen. Functionally, it is endocrine and exocrine. Aim This study was undertaken to study the morphometry of human pancreas at different gestational age groups of normal, still born fetuses. Materials and Methods Forty aborted human fetuses (25 male and 15 female) of 12-40 weeks gestational age with no obvious congenital abnormality were obtained. The fetuses were dissected and pancreas was removed. The length and weight of the pancreas as well as height of its head were noted. Results It was observed that there was increase in body weight and crown rump length with increasing gestational age. The average length of pancreas was 1.80 cm in 12th week and 4.70 cm in 40th week of gestation. The average height of pancreas head was 0.80 cm in the 12th and 2.70 cm in 40th week of gestation. Conclusion The knowledge of development of pancreas helps in planning new therapeutic interventions in the treatment of various congenital and functional pancreatic anomalies. PMID:28050352

  7. Exome Sequencing in Fetuses with Structural Malformations

    PubMed Central

    Mackie, Fiona L.; Carss, Keren J.; Hillman, Sarah C.; Hurles, Matthew E.; Kilby, Mark D.

    2014-01-01

    Prenatal diagnostic testing is a rapidly advancing field. An accurate diagnosis of structural anomalies and additional abnormalities in fetuses with structural anomalies is important to allow “triage” and designation of prognosis. This will allow parents to make an informed decision relating to the pregnancy. This review outlines the current tests used in prenatal diagnosis, focusing particularly on “new technologies” such as exome sequencing. We demonstrate the utility of exome sequencing above that of conventional karyotyping and Chromosomal Microarray (CMA) alone by outlining a recent proof of concept study investigating 30 parent-fetus trios where the fetus is known to have a structural anomaly. This may allow the identification of pathological gene anomalies and consequently improved prognostic profiling, as well as excluding anomalies and distinguishing between de novo and inherited mutations, in order to estimate the recurrence risk in future pregnancies. The potential ethical dilemmas surrounding exome sequencing are also considered, and the future of prenatal genetic diagnosis is discussed. PMID:26237476

  8. Long-Term Maternal Effects of Early Childhood Intervention: Findings from the Infant Health and Development Program (IHDP)

    ERIC Educational Resources Information Center

    Martin, Anne; Brooks-Gunn, Jeanne; Klebanov, Pamela; Buka, Stephen L.; McCormick, Marie C.

    2008-01-01

    The Infant Health and Development Program (IHDP) was a randomized clinical trial of early intervention services for low birth weight, premature infants. Mothers and infants received services for 3 years beginning at neonatal discharge. At the intervention's conclusion, mothers in the intervention group who had lighter (less than 2001 g) birth…

  9. Infant Stimulation/Mother Training Program: Outreach Training Summary. (7/1/81-6/30/82). Overview of Project.

    ERIC Educational Resources Information Center

    Cincinnati Univ., OH. Coll. of Medicine.

    Objectives and outcome data of a University of Cincinnati College of Medicine program, which serves infants at risk for developmental disorders and their mothers, are presented. The Infant Stimulation/Mother Training Program for premature, low birthweight infants is designed to meet the following service objectives: 1) identify and recruit…

  10. Impact of fetal programming, birth weight, and infant feeding on later hypertension.

    PubMed

    Ingelfinger, Julie R; Nuyt, Anne-Monique

    2012-06-01

    The concept of developmental origins of adult disease derives from both epidemiologic and basic sciences. This brief review considers the impact of the intrauterine milieu, intrauterine growth retardation, premature birth, and infant feeding on later hypertension and kidney disease.

  11. Age-Related Effect of Viral-Induced Wheezing in Severe Prematurity

    PubMed Central

    Perez, Geovanny F.; Jain, Amisha; Kurdi, Bassem; Megalaa, Rosemary; Pancham, Krishna; Huseni, Shehlanoor; Isaza, Natalia; Rodriguez-Martinez, Carlos E.; Rose, Mary C.; Pillai, Dinesh; Nino, Gustavo

    2016-01-01

    Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to viral infections in children born severely premature is more specific for RV and RSV and persists during the first three years of age. Further studies are needed to elucidate the age-dependent molecular mechanisms that underlie why premature infants develop RV- and RSV-induced wheezing in early life. PMID:27775602

  12. Age-Related Effect of Viral-Induced Wheezing in Severe Prematurity.

    PubMed

    Perez, Geovanny F; Jain, Amisha; Kurdi, Bassem; Megalaa, Rosemary; Pancham, Krishna; Huseni, Shehlanoor; Isaza, Natalia; Rodriguez-Martinez, Carlos E; Rose, Mary C; Pillai, Dinesh; Nino, Gustavo

    2016-10-20

    Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32-37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to viral infections in children born severely premature is more specific for RV and RSV and persists during the first three years of age. Further studies are needed to elucidate the age-dependent molecular mechanisms that underlie why premature infants develop RV- and RSV-induced wheezing in early life.

  13. Optimizing nutrition of the preterm infant.

    PubMed

    Hay, William W Jr

    2017-01-01

    The goal of nutrition of the preterm infant is to meet the growth rate of the healthy fetus of the same gestational age and to produce the same body composition of the healthy fetus in terms of organ growth, tissue components, and cell number and structure. Nutritional quantity and quality are fundamental for normal growth and development of preterm infants, including neurodevelopmental outcomes. Failure to provide the necessary amounts of all of the essential nutrients has produced not only growth failure, but also increased morbidity and less than optimal neurodevelopment. Growth velocities during the NICU hospitalization period for preterm infants exert a significant effect on neurodevelopmental and anthropometric outcomes. Despite the obvious need for optimal nutrition, growth failure is almost universal among preterm infants. There is every reason, therefore, to optimize nutrition of the preterm infant, in terms of total energy and protein, but also in terms of individual components such as amino acids, specific carbohydrates and lipids, and even oxygen. This review presents scientific rationale for nutrient requirements and practical guidelines and approaches to intravenous and enteral feeding for preterm infants. Intravenous feeding, including amino acids, should be started right after birth at rates that are appropriate for the gestational age of the infant. Enteral feeding should be started as soon as possible after birth, using mother's colostrum and milk as first choices. Enteral feeding should begin with trophic amounts and advanced as rapidly as tolerated, decreasing IV nutrition accordingly, while maintaining nutrient intakes at recommended rates. Feeding protocols are valuable for improving nutrition and related outcomes. Further research is needed to determine the optimal nutrition and rate of growth in preterm infants that will achieve optimal neurocognitive benefits while minimizing the longer-term risk of chronic diseases.

  14. Infant Mortality

    MedlinePlus

    ... Control and Prevention. (2013). CDC health disparities and inequalities report—United States, 2013. Morbidity and Mortality Weekly ... M. (2008). The fall and rise of U.S. inequalities in premature mortality: 1960–2002. PLOS Medicine, 5 ( ...

  15. Comparative genomics of Campylobacter fetus from reptiles and mammals reveals divergent evolution in host-associated lineages

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Campylobacter fetus currently comprises three recognized subspecies: C. fetus subsp. fetus, C. fetus subsp. venerealis, and C. fetus subsp. testudinum, which display a distinct host association. Both C. fetus subsp. fetus and C. fetus subsp. venerealis are associated with endothermic mammals, primar...

  16. Comparison of functional status of 8- to 12-year-old children born prematurely: an integrative review of literature.

    PubMed

    Kelly, Michelle M

    2012-08-01

    Prematurity affects one in eight infants in the United States, a rate that reflects an overall increase of 20% between 1990 and 2005 (March of Dimes, 2008). This integrative review presents a synthesis of the current research addressing the functional status of 8- to 12-year-old children born prematurely. Findings from this review support the belief that children born prematurely function differently than their term peers. These children have academic and social delays that may necessitate special service support through middle childhood.

  17. Retinopathy of prematurity: Past, present and future

    PubMed Central

    Shah, Parag K; Prabhu, Vishma; Karandikar, Smita S; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

    2016-01-01

    Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940s and 1950s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP. PMID:26862500

  18. Apnea of Prematurity (For Parents)

    MedlinePlus

    ... with AOP are given oral or intravenous (IV) caffeine medication to stimulate their breathing. Like the caffeine in coffee or soft drinks, a low dose of caffeine helps keep infants alert and breathing regularly. Most ...

  19. Mothers' Retrospections of Premature Childbirth.

    ERIC Educational Resources Information Center

    Kalmar, Magda; And Others

    This study examined Hungarian mothers' recollections, 8 years after the birth of their premature baby, of their stress at the time of the baby's birth. Interviews were conducted with 30 mothers whose babies had been born between 30 and 37 weeks gestational age. At the time of the follow-up, all children had normal IQs and were attending normal…

  20. Application of a multiplex PCR assay for Campylobacter fetus detection and subspecies differentiation in uncultured samples of aborted bovine fetuses

    PubMed Central

    Iraola, Gregorio; Hernández, Martín; Calleros, Lucía; Paolicchi, Fernando; Silveyra, Silvia; Velilla, Alejandra; Carretto, Luis; Rodríguez, Eliana

    2012-01-01

    Campylobacter (C.) fetus (epsilonproteobacteria) is an important veterinary pathogen. This species is currently divided into C. fetus subspecies (subsp.) fetus (Cff) and C. fetus subsp. venerealis (Cfv). Cfv is the causative agent of bovine genital Campylobacteriosis, an infectious disease that leads to severe reproductive problems in cattle worldwide. Cff is a more general pathogen that causes reproductive problems mainly in sheep although cattle can also be affected. Here we describe a multiplex PCR method to detect C. fetus and differentiate between subspecies in a single step. The assay was standardized using cultured strains and successfully used to analyze the abomasal liquid of aborted bovine fetuses without any pre-enrichment step. Results of our assay were completely consistent with those of traditional bacteriological diagnostic methods. Furthermore, the multiplex PCR technique we developed may be easily adopted by any molecular diagnostic laboratory as a complementary tool for detecting C. fetus subspecies and obtaining epidemiological information about abortion events in cattle. PMID:23271178

  1. Application of a multiplex PCR assay for Campylobacter fetus detection and subspecies differentiation in uncultured samples of aborted bovine fetuses.

    PubMed

    Iraola, Gregorio; Hernández, Martín; Calleros, Lucía; Paolicchi, Fernando; Silveyra, Silvia; Velilla, Alejandra; Carretto, Luis; Rodríguez, Eliana; Pérez, Ruben

    2012-12-01

    Campylobacter (C.) fetus (epsilonproteobacteria) is an important veterinary pathogen. This species is currently divided into C. fetus subspecies (subsp.) fetus (Cff) and C. fetus subsp. venerealis (Cfv). Cfv is the causative agent of bovine genital Campylobacteriosis, an infectious disease that leads to severe reproductive problems in cattle worldwide. Cff is a more general pathogen that causes reproductive problems mainly in sheep although cattle can also be affected. Here we describe a multiplex PCR method to detect C. fetus and differentiate between subspecies in a single step. The assay was standardized using cultured strains and successfully used to analyze the abomasal liquid of aborted bovine fetuses without any pre-enrichment step. Results of our assay were completely consistent with those of traditional bacteriological diagnostic methods. Furthermore, the multiplex PCR technique we developed may be easily adopted by any molecular diagnostic laboratory as a complementary tool for detecting C. fetus subspecies and obtaining epidemiological information about abortion events in cattle.

  2. Sequential observation of infant regulated and dysregulated behavior following soothing and stimulating maternal behavior during feeding

    PubMed Central

    Brown, Lisa F.; Pridham, Karen A.; Brown, Roger

    2014-01-01

    Purpose To describe maternal behaviors occurring before infant regulated or dysregulated behavior at three times in early infancy and examine behavioral patterns over time with their prematurely born infants. Method & Design Video-recordings of 37 dyads were coded on infant regulated and dysregulated behaviors following maternal soothing and stimulating behaviors. Results At each time, infants showed more regulation after maternal soothing than after maternal stimulating. Further study is merited. Practice Implications Knowing infant regulation and dysregulation following categories of maternal behavior could help mothers anticipate infant regulatory or dysregulatory behavior in response to their own behavior and identify supportive caregiving strategies. PMID:24417766

  3. A Comparison of Strategies for Retinopathy of Prematurity Detection

    PubMed Central

    Prosser, Lisa A.; Wade, Kelly C.; Repka, Michael X.; Ying, Gui-shuang; Baumritter, Agnieshka; Quinn, Graham E.

    2016-01-01

    BACKGROUND AND OBJECTIVES: Delayed detection of type 1 retinopathy of prematurity (ROP) can lead to permanent visual impairment. Providing ROP examinations is challenging because of the limited ophthalmology workforce. This study compares digital imaging–based ROP detection strategies versus serial ROP examinations. METHODS: We conducted an individual-level microsimulation studyof a hypothetical cohort of 650 infants with gestational age from 23 to 30 weeks. Infants were evaluated by using strategies based on indirect ophthalmoscopy or digital imaging beginning at 32 weeks’ postmenstrual age (PMA) and continuing to discharge, transfer, or 40 weeks’ PMA. ROP status and the accuracy of digital imaging were based on the e-ROP (Telemedicine Approaches to Evaluating Acute-Phase ROP) study, which enrolled high-risk infants. RESULTS: Within the hypothetical NICU, the strategy of ROP examinations identified an average of 45.8 cases of type 1 ROP by discharge, transfer, or 40 weeks’ PMA, and another 1.9 cases were included in the group of infants recommended to have later follow-up. Digital imaging with an ROP examination at discharge identified all 47.7 cases of type 1 ROP. On average, the ROP examination–only strategy required 1745.7 ROP examinations, whereas digital imaging with a discharge examination required 1065.5 ROP examinations and 1786.2 digital imaging sessions. CONCLUSIONS: Although digital imaging decreased the number of ROP examinations per infant, there was an increase in the total number of interventions (ie, ROP examinations and imaging sessions). Providing an ROP examination at the time of NICU discharge can significantly reduce the number of infants who require follow-up. PMID:26672022

  4. Resuscitation of extremely preterm infants - controversies and current evidence

    PubMed Central

    Patel, Pooja N; Banerjee, Jayanta; Godambe, Sunit V

    2016-01-01

    Despite significant advances in perinatal medicine, the management of extremely preterm infants in the delivery room remains a challenge. There is an increasing evidence for improved outcomes regarding the resuscitation and stabilisation of extremely preterm infants but there is a lack of evidence in the periviable (gestational age 23-25 wk) preterm subgroup. Presence of an experienced team during the delivery of extremely preterm infant to improve outcome is reviewed. Adaptation from foetal to neonatal cardiorespiratory haemodynamics is dependent on establishing an optimal functional residual capacity in the extremely preterm infants, thus enabling adequate gas exchange. There is sufficient evidence for a gentle approach to stabilisation of these fragile infants in the delivery room. Evidence for antenatal steroids especially in the periviable infants, delayed cord clamping, strategies to establish optimal functional residual capacity, importance of temperature control and oxygenation in delivery room in extremely premature infants is reviewed in this article. PMID:27170925

  5. Review of Randomized Controlled Trials of Massage in Preterm Infants.

    PubMed

    Niemi, Anna-Kaisa

    2017-04-03

    Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants.

  6. Fetoscopic and ultrasound-guided decompression of the fetal trachea in a human fetus with Fraser syndrome and congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia.

    PubMed

    Kohl, T; Hering, R; Bauriedel, G; Van de Vondel, P; Heep, A; Keiner, S; Müller, A; Franz, A; Bartmann, P; Gembruch, U

    2006-01-01

    Congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia bears a poor prognosis for hydropic fetuses owing to cardiac failure. We attempted percutaneous fetoscopic and ultrasound-guided tracheal decompression in a hydropic human fetus with CHAOS associated with Fraser syndrome. Percutaneous fetoscopic and ultrasound-guided tracheal decompression was performed using three trocars under general materno-fetal anesthesia at 19 + 5 weeks of gestation. Abnormal fetoplacental blood flow normalized within hours as a result of the intervention. Furthermore, a normalization of lung : heart size and lung echogenicity was observed within days. Resolution of hydrops was complete within 3 weeks. Premature rupture of membranes and premature contractions prompted emergency delivery of the fetus by ex-utero intrapartum treatment (EXIT) at 28 + 2 weeks of gestation. Following delivery, the lungs could be ventilated at low pressures and ambient oxygen concentration. Weaning from ventilation was achieved at 18 days of postnatal life. Our experience indicated that percutaneous fetoscopic and ultrasound-guided decompression of the fetal trachea is feasible and may permit normalization of hemodynamics in hydropic human fetuses with CHAOS from laryngeal atresia. The procedure may also result in normalization of heart : lung size and provide the time needed to regain the function of the overstretched diaphragm in this grave fetal condition.

  7. Oral glucose for pain relief during examination for retinopathy of prematurity: a masked randomized clinical trial

    PubMed Central

    da Costa, Marlene Coelho; Eckert, Gabriela Unchalo; Fortes, Bárbara Gastal Borges; Filho, João Borges Fortes; Silveira, Rita C.; Procianoy, Renato S

    2013-01-01

    OBJECTIVE: Ophthalmologic examination for retinopathy of prematurity is a painful procedure. Pharmacological and non-pharmacological interventions have been proposed to reduce pain during eye examinations. This study aims to evaluate the analgesic effect of 25% glucose using a validated pain scale during the first eye examination for retinopathy of prematurity in preterm infants with birth weight ≤1,500 g and/or gestational age ≤32 weeks. METHODS: A masked, randomized clinical trial for one dose of 1 ml of oral 25% glucose solution 2 minutes before the first ophthalmologic examination for retinopathy of prematurity was conducted between March 2008 and April 2010. The results were compared to those of a control group that did not receive oral glucose solution. Pain was evaluated using a Neonatal Infant Pain Scale immediately before and immediately after the ophthalmologic examination in both groups. Clinicaltrials.gov: NCT00648687 RESULTS: One hundred and twenty-four patients who were examined for the first time for retinopathy of prematurity were included. Seventy were included in the intervention group and 54 in the control group. The number of patients with pain immediately before the procedure was similar in both groups. The number of patients with pain after ophthalmologic examination was 15.7% in the intervention group and 68.5% in the control group (p<0.001). CONCLUSIONS: One ml of oral 25% glucose solution given 2 minutes before an ophthalmologic examination for retinopathy of prematurity was an effective measure for pain relief. PMID:23525316

  8. Thinking about Pregnancy After Premature Birth

    MedlinePlus

    ... Search Our mission Fighting premature birth About us Annual report Our work Community impact Global programs Research Need ... Cause Our mission Fighting premature birth About us Annual report Our work Community impact Global programs Research Need ...

  9. Molecular epidemiologic research on the effects of environmental pollutants on the fetus.

    PubMed Central

    Perera, F P; Jedrychowski, W; Rauh, V; Whyatt, R M

    1999-01-01

    Evidence shows that fetuses and infants are more affected than adults by a variety of environmental toxicants because of differential exposure, physiologic immaturity, and a longer lifetime over which disease initiated in early life can develop. In this article we review data on the effects of in utero exposure to common environmental contaminants, including polycyclic aromatic hydrocarbons (PAH), particulate matter and environmental tobacco smoke (ETS). We then summarize results from our molecular epidemiologic study to assess risks from in utero exposures to ambient air pollution and ETS. This research study, conducted in Poland, used biomarkers to measure the internal and bioeffective dose of toxicants and individual susceptibility factors. The study included 160 mothers and 160 newborns. Ambient air pollution was significantly associated (p= 0.05) with the amount of PAH bound to DNA (PAH-DNA adducts) in both maternal and infant cord white blood cells (WBC). Newborns with elevated PAH-DNA adducts (greater than the median) had significantly decreased birth weight (p= 0.05), birth length (p= 0.02), and head circumference (p= 0.0005) compared to the newborns with lower adducts (n= 135). Maternal and infant cotinine levels were increased by active and passive cigarette smoke exposure of the mother (p= 0.01). An inverse correlation was seen between newborn plasma cotinine (nanograms per milliliter) and birth weight (p= 0.0001) and length (p= 0.003). Adducts were elevated in placental tissue and WBC of newborns who were heterozygous or homozygous for the cytochrome P4501A1 MspI restriction fragment length polymorphism (RFLP) compared to newborns without the RFLP. Levels of PAH-DNA and cotinine were higher in newborns than mothers. These results document that there is significant transplacental transfer of PAH and ETS constituents from mother to fetus; that PAH-DNA adduct levels in maternal and newborn WBC were increased with environmental exposure to PAH from ambient

  10. Neuromodulation of Limb Proprioceptive Afferents Decreases Apnea of Prematurity and Accompanying Intermittent Hypoxia and Bradycardia

    PubMed Central

    Kesavan, Kalpashri; Frank, Paul; Cordero, Daniella M.; Benharash, Peyman; Harper, Ronald M.

    2016-01-01

    Background Apnea of Prematurity (AOP) is common, affecting the majority of infants born at <34 weeks gestational age. Apnea and periodic breathing are accompanied by intermittent hypoxia (IH). Animal and human studies demonstrate that IH exposure contributes to multiple pathologies, including retinopathy of prematurity (ROP), injury to sympathetic ganglia regulating cardiovascular action, impaired pancreatic islet cell and bone development, cerebellar injury, and neurodevelopmental disabilities. Current standard of care for AOP/IH includes prone positioning, positive pressure ventilation, and methylxanthine therapy; these interventions are inadequate, and not optimal for early development. Objective The objective is to support breathing in premature infants by using a simple, non-invasive vibratory device placed over limb proprioceptor fibers, an intervention using the principle that limb movements trigger reflexive facilitation of breathing. Methods Premature infants (23–34 wks gestational age), with clinical evidence of AOP/IH episodes were enrolled 1 week after birth. Caffeine treatment was not a reason for exclusion. Small vibration devices were placed on one hand and one foot and activated in 6 hour ON/OFF sequences for a total of 24 hours. Heart rate, respiratory rate, oxygen saturation (SpO2), and breathing pauses were continuously collected. Results Fewer respiratory pauses occurred during vibration periods, relative to baseline (p<0.005). Significantly fewer SpO2 declines occurred with vibration (p<0.05), relative to control periods. Significantly fewer bradycardic events occurred during vibration periods, relative to no vibration periods (p<0.05). Conclusions In premature neonates, limb proprioceptive stimulation, simulating limb movement, reduces breathing pauses and IH episodes, and lowers the number of bradycardic events that accompany aberrant breathing episodes. This low-cost neuromodulatory procedure has the potential to provide a non

  11. Selenium deficiency and the effects of supplementation on preterm infants

    PubMed Central

    Freitas, Renata Germano B. O. N.; Nogueira, Roberto José N.; Antonio, Maria Ângela R. G. M.; Barros-Filho, Antonio de Azevedo; Hessel, Gabriel

    2014-01-01

    Objective: This study aimed to review the literature about blood concentrations of selenium associated with gestational age, feeding, supplementation and related clinical features in preterm infants. Data sources: Systematic review in the following databases: MEDLINE, PubMed, Google academics, SciELO. org, ScienceDirect (Elsevier) and CINAHL-Plus with Full Text (EBSCO). Articles published up to January 2013 with the keywords "selenium deficiency", "selenium supplementation", "neonates", "infants", "newborn" and "preterm infants" were selected. Data synthesis: The studies reported that low blood selenium levels are associated with increased risk of respiratory diseases. Preterm infants, especially with low birth weight, presented lower selenium levels. Selenium deficiency has also been associated with the use of oral infant formula, enteral and parenteral nutrition (with or without selenium addition). The optimal dose and length of selenium supplementation is not well-established, since they are based only on age group and selenium ingestion by breastfed children. Furthermore, the clinical status of the infant affected by conditions that may increase oxidative stress, and consequently, selenium requirements is not taken into account. Conclusions: Prematurity and low birth weight can contribute to low blood selenium in premature infants. Selenium supplementation seems to minimize or prevent clinical complications caused by prematurity. PMID:24676200

  12. Toward a fuzzy logic control of the infant incubator.

    PubMed

    Reddy, Narender P; Mathur, Garima; Hariharan, S I

    2009-10-01

    Premature birth is a world wide problem. Thermo regulation is a major problem in premature infants. Premature infants are often kept in infant incubators providing convective heating. Currently either the incubator air temperature is sensed and used to control the heat flow, or infant's skin temperature is sensed and used in the close loop control. Skin control often leads to large fluctuations in the incubator air temperature. Air control also leads to skin temperature fluctuations. The question remains if both the infant's skin temperature and the incubator air temperature can be simultaneously used in the control. The purpose of the present study was to address this question by developing a fuzzy logic control which incorporates both incubator air temperature and infant's skin temperature to control the heating. The control was evaluated using a lumped parameter mathematical model of infant-incubator system (Simon, B. N., N. P. Reddy, and A. Kantak, J. Biomech. Eng. 116:263-266, 1994). Simulation results confirmed previous experimental results that the on-off skin control could lead to fluctuations in the incubator air temperature, and the air control could lead to too slow rise time in the core temperature. The fuzzy logic provides a smooth control with the desired rise time.

  13. Topical iodine-containing antiseptics and subclinical hypothyroidism in preterm infants.

    PubMed

    Linder, N; Davidovitch, N; Reichman, B; Kuint, J; Lubin, D; Meyerovitch, J; Sela, B A; Dolfin, Z; Sack, J

    1997-09-01

    The influence of topical iodine-containing antiseptics on thyroid function test results of premature infants was determined in two separate studies. Thyroxine and thyrotropin levels were measured on blood-spotted filter paper. Samples were obtained from 128 premature infants on their tenth day of life; the infants were treated in two neonatal intensive care units. Both units used similar treatment protocols; however, one routinely used topical iodinated antiseptic agents (n = 73), whereas the other used chlorhexidine-containing antiseptics (n = 55). There was no difference in the mean T4 levels between the two groups. The mean thyrotropin levels were elevated in preterm babies exposed to iodine (15.4 vs 7.8 mIU/L, p < 0.01). Among the iodine-exposed infants, elevated thyrotropin levels (> 30 mIU/L) were found in 13.7% of infants, compared with none in the chlorhexidine-treated group (p < 0.01). We then studied an additional 46 premature infants who were treated in one neonatal intensive care unit. Iodine-containing solutions were used in 24 infants and chlorhexidine was used in 22 infants. T4 and thyrotropin levels were measured weekly during the first 28 days, one every 2 weeks until the age of 60 days, and at the age of 90 days. Among iodine-exposed infants, 20.8% had thyrotropin values > 30 mIU/L, whereas none of the infants in the chlorhexidine group had elevated thyrotropin values (p < 0.05). The elevated thyrotropin levels correlated positively with the area of disinfection. Elevated urine iodine levels were present reflecting an abnormally high iodine absorption. This study suggests that iodine absorption from topical iodine-containing antiseptics may cause disturbances in thyroid function test results in premature infants. We recommend that caution be exercised in the use of iodine-containing antiseptics in premature infants.

  14. Morphology of lacrimal gland in pig fetuses.

    PubMed

    Klećkowska-Nawrot, J; Dziegiel, P

    2008-02-01

    The morphological and histological examinations of the lacrimal gland were conducted on pig fetuses coming from the 20th, 24th, 27th, 30th, 35th, 50th, 63rd, 94th and 112th day of gestation. The morphological examinations were carried out using the method of macroscopic preparation with a forehead magnifying glass and binocular (magnification 1.5-5.0x). In order to better visualize the anatomical elements, 60-80% absolute alcohol and 0.5-4% acetic acid solution were used for the examinations. On the 20th, 24th, 27th, and 30th day of gestation the whole fetuses were collected for the histological examinations. The whole eyeball with developing accessory organs was collected from the pig fetuses on the 35th day of gestation. On the 50th, 63rd, 94th and 112th day of gestation only the lacrimal gland was collected. Staining with H-E and Azan method was performed. On the 20th, 24th, 27th, 30th and 35th day of gestation ectodermal cells were not found in the collected material. On the 50th and 63rd day of gestation the connective tissue divides the gland parenchyma into indistinct lobes composed of gland cells. On the 94th day of gestation the number of lobes is substantially higher than on the 50th and 63rd day of gestation, while the number of lobules forming lobes decreases. On the 112th day of gestation each lobe is composed of 8-22 excretory ducts made up of the simple cuboid epithelium with a round nucleus arranged less or more peripherally.

  15. Linezolid treatment of glycopeptide-resistant Enterococcus faecium in very low birth weight premature neonates.

    PubMed

    Hoehn, Rene; Groll, Andreas H; Schaefer, Volker; Bauer, Karl; Schloesser, Rolf L

    2006-03-01

    Glycopeptide-resistant Enterococcus faecium has emerged as an important nosocomial pathogen with limited therapeutic options. Here we report the successful treatment of glycopeptide-resistant E. faecium infection in two very low birth weight premature infants with the new oxazolidinone linezolid. Treatment with linezolid at a dosage of 10 mg/kg every 8 h intravenously for a duration of 16 days and 14 days, respectively, was well tolerated and led to complete clinical recovery and clearance of the organism from all body sites. The two cases support the clinical efficacy and safety of linezolid in very low birth weight premature neonates with glycopeptide-resistant E. faecium infections.

  16. Infant survival after cesarean section for trauma.

    PubMed Central

    Morris, J A; Rosenbower, T J; Jurkovich, G J; Hoyt, D B; Harviel, J D; Knudson, M M; Miller, R S; Burch, J M; Meredith, J W; Ross, S E; Jenkins, J M; Bass, J G

    1996-01-01

    HYPOTHESIS: Emergency cesarean sections in trauma patients are not justified and should be abandoned. SETTING AND DESIGN: A multi-institutional, retrospective cohort study was conducted of level 1 trauma centers. METHODS: Trauma admissions from nine level 1 trauma centers from January 1986 through December 1994 were reviewed. Pregnant women who underwent emergency cesarean sections were identified. Demographic and clinical data were obtained on all patients undergoing a cesarean section. Fetal distress was defined by bradycardia, deceleration, or lack of fetal heart tones (FHTs). Maternal distress was defined by shock (systolic blood pressure < 90) or acute decompensation. Statistical analyses were performed. RESULTS: Of the 114,952 consecutive trauma admissions, more than 441 pregnant women required 32 emergency cesarean sections. All were performed for fetal distress, maternal distress, or both. Overall, 15 (45%) of the fetuses and 23 (72%) of the mothers survived. Of 33 fetuses delivered, 13 had no FHTs and none survived. Twenty infants (potential survivors) had FHTs and an estimated gestational age (EGA) of greater than or equal to 26 weeks, and 75% survived. Infant survival was independent of maternal distress or maternal Injury Severity Score. The five infant deaths in the group of potential survivors resulted from delayed recognition of fetal distress, and 60% of these deaths were in mothers with mild to moderate injuries (Injury Severity Score < 16). CONCLUSIONS: In pregnant trauma patients, infant viability is defined by the presence of FHTs, estimated gestational age greater than or equal to 26 weeks. In viable infants, survival after emergency cesarean section is acceptable (75%). Infant survival is independent of maternal distress or Injury Severity Score. Sixty percent of infant deaths resulted from delay in recognition of fetal distress and cesarean section. These were potentially preventable. Given the definition of fetal viability, our initial

  17. Fryns anophthalmia-plus syndrome in an 18-week-old fetus.

    PubMed

    Jayasinghe, Caren; Gembruch, Ulrich; Kuchelmeister, Klaus; Körber, Friederike; Müller, Annette M

    2012-01-01

    Fryns anophthalmia-plus syndrome is a very rare condition initially described by Fryns and colleagues in 1995 in a pair of siblings of nonconsanguineous parents. Since that time, only a few cases have been reported, most of them in newborns and young children. Clinical presentation is variable and includes anophthalmia/microphthalmia, cleft lip/palate, and other facial deformities. Furthermore, skeletal, central nervous system, and endocrine anomalies have been described. We report the case of a male fetus of 18 weeks of gestation with normal karyotype and findings matching Fryns anophthalmia-plus syndrome. Pregnancy was terminated because of sonographically proven facial midline defects and a marked cerebral ventriculomegaly. Macroscopic and histological findings obtained at autopsy showed extreme bilateral microphthalmia, unilateral cleft palate, unilateral nasal deformity, and low-set ears. Skeletal anomalies included 13 pairs of ribs, premature ossification of the calcaneus, and talipes.

  18. [Forensic importance of premature craniosynostosis].

    PubMed

    Fehlow, P

    1991-01-01

    In agreement with Canabis craniosynostosis as a little known organic partial factor of sociopathy is demonstrated. A psychic syndrome of the frontal lobe with increased susceptibility in environmental damages is assumed to be basic disorder. In the criminals of the material sexual offenders were preponderating. Associated craniofacial dysplasias are a risk for psychic maldevelopment. The importance of premature craniosynostocis as a biological risk factor, incidence, diagnostic, indication for an operation, also in the meaning of a neurosurgical "Konflikttherapie" (cosmetical indication) are discussed.

  19. [New perspectives for an old problem: premature labor].

    PubMed

    Barrón Vallejo, J; Kably Ambe, A; Limón Luque, L; Barroso Villa, G; Jurado Jurado, M; Blank Goldenberg, C

    1997-08-01

    Preterm birth has been and continues to be one of the most serious problems in Obstetrics. It is the most common cause of neonatal death, and morbidity in surviving infants. The presence of bacterial vaginosis, and other genital infections is associated with increased risk of preterm labor. Cytokines promote the release of prostaglandin, and have been implicated as cause of uterina activity. Recently, new methods of detection as transvaginal ultrasonography, and measures of cervical fetal fibronectin have been acclaimed as useful to detect the problem. Atosiban, cytokines, glyceril trinitrate, and many others agents have been proposed as treatments and are under investigation. Such drugs, will allow an effective management of preterm labor with lower side effects. Antenatal TRH administration cannot be recommended for widespread clinical use. However, the antenatal administration of corticosteroids to fetuses at risk of preterm delivery include not only a reduction in the risk of respiratory distress syndrome but also a significative reduction in intraventricular hemorrhage mortality.

  20. Magnetoencephalographic signatures of numerosity discrimination in fetuses and neonates.

    PubMed

    Schleger, Franziska; Landerl, Karin; Muenssinger, Jana; Draganova, Rossitza; Reinl, Maren; Kiefer-Schmidt, Isabelle; Weiss, Magdalene; Wacker-Gußmann, Annette; Huotilainen, Minna; Preissl, Hubert

    2014-01-01

    Numerosity discrimination has been demonstrated in newborns, but not in fetuses. Fetal magnetoencephalography allows non-invasive investigation of neural responses in neonates and fetuses. During an oddball paradigm with auditory sequences differing in numerosity, evoked responses were recorded and mismatch responses were quantified as an indicator for auditory discrimination. Thirty pregnant women with healthy fetuses (last trimester) and 30 healthy term neonates participated. Fourteen adults were included as a control group. Based on measurements eligible for analysis, all adults, all neonates, and 74% of fetuses showed numerical mismatch responses. Numerosity discrimination appears to exist in the last trimester of pregnancy.