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Sample records for premature infants fetus

  1. Nutrition of the fetus and the premature infant.

    PubMed

    Battaglia, F C; Thureen, P J

    1998-08-01

    Developments in fetal and placental nutrition have highlighted the interaction of the placenta and fetal liver for the exchange and metabolism of nutrients. Of particular importance is the exchange of serine and glycine and their interconversion within these two organs and the exchange of glutamine and glutamate. Placental metabolism of nutrients and the placenta's role in the production and utilization of certain amino acids alters significantly the delivery rate of nutrients into the fetal circulation. Postnatal nutrition has focused on the role of early nutritional intervention in the extremely low birth weight infants and the recognition of the category of semi-essential amino acids in these infants. The role of minimal enteral feedings in small babies and the changes in nutritional requirements induced by medical complications has also received increasing attention.

  2. Premature infant

    MedlinePlus

    ... infant is a baby born before 37 completed weeks of gestation (more than 3 weeks before the due date). ... one of the following: Premature (less than 37 weeks gestation) Full term (37 to 42 weeks gestation) ...

  3. Osteopenia - premature infants

    MedlinePlus

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

  4. Infant survival in prematurity.

    PubMed

    CARTWRIGHT, E W

    1954-05-01

    Reduction of neonatal mortality and the rate of stillbirth may be expected from improved management of spontaneous labor and delivery.Neither roentgenographic measurement nor the inception of fetal movement or heartbeat nor any other single test is an index of fetal maturity; all must be considered together. Prenatal care, particularly supplemented diet, will help to avoid premature delivery, or at least to prolong pregnancy; since the fetus undergoes accelerated growth during the last weeks of pregnancy, even slight extension of gestation increases the chances for survival. Analgesia in the first stage of premature labor is contraindicated. Only low spinal anesthesia and other types of conduction anesthesia should be employed for later stages. The fetal membranes should be preserved as long as possible, but premature rupture does not call for immediate termination of pregnancy. Deep episiotomy and prophylactic outlet forceps are routinely employed to hasten the second stage of premature delivery and to protect the immature fetus. Breech presentation is managed by unassisted expulsion or by forceps extraction of the head. The umbilical cord is not immediately severed on delivery; administration of oxytocic drugs after the second stage of labor, combined with gentle stripping of the cord, results in rapid transfer of increased amount of placental blood. The airways of the infant should be immediately cleared. Artificial respiration may be necessary and it must be gentle.All premature infants should receive supplementary oxygen to render breathing regular and more efficient. They should be insulated immediately in controlled temperature and humidity, and they should be handled little.

  5. 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

  6. 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

  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. Nutritional needs of premature infants.

    PubMed

    Civardi, Elisa; Tzialla, Chryssoula; Garofoli, Francesca; Mazzucchelli, Iolanda; Bollani, Lina; Stronati, Mauro

    2011-10-01

    Preterm birth is the leading cause of perinatal morbidity and mortality in developed countries. Many innovation in neonatology have raised survival rates in the two past decades, but despite progress in neonatal intensive care, nutrition and growth of preterm infants are still critical points for neonatologists around the world and extrauterine growth restriction remains a common problem. Since growth is recognized as a major problem, in 2010, the European Society of Pediatric Gastroenterology and Nutrition published recommendations on enteral nutrition for preterm infants. The aim of this review is to revise nutritional needs of premature infants, taking into consideration the recommendations of ESPGHAN and the recent international literature.

  9. 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.

  10. The premature infant home intervention program.

    PubMed

    Jones, S; Struk, C; Hack, M; Friedman, H

    1990-12-01

    The Premature Infant Home Intervention Program, a collaborative effort of the Visiting Nurse Association of Cleveland and Rainbow Babies and Children's Hospital of Cleveland, is designed to provide family support and medical surveillance for high-risk premature infants, to ensure post-discharge wellbeing, and improve survival outcome during the first years of life.

  11. 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

  12. Achalasia cardia in a premature infant.

    PubMed

    Shettihalli, Naveen; Venugopalan, Vikranth; Ives, Nicholas Kevin; Lakhoo, Kokila

    2010-11-05

    Achalasia cardia is defined as a neuromuscular disorder of the oesophagus with abnormal motility and failure of relaxation of the distal oesophagus. It is an uncommon but well-recognised entity in infants and children. However, achalasia in a preterm baby has not been previously described. We report the condition in a premature infant with unusual presentation, treated successfully with Heller's oesophagomyotomy and fundoplication.

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

    PubMed

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

    2016-01-01

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

  14. 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

  15. [Ophthalmologic prevention in premature infants].

    PubMed

    Mayer, U M; Baumer, P; Michel, U

    1987-11-01

    Forty-four of the 262 pupils at the school for blind and visually handicapped children in Nuremberg, i.e., 17%, suffer from sequelae of retinopathy of prematurity (ROP); this condition is currently top of the list of causes of blindness. The risk factors involved were identified by analyzing 294 histories of premature children born between 1981 und 1984. In the case of 16 children, ophthalmoscopic criteria were taken from the 1984 international classification. The data of the children with ROP, at birth and at the time when ROP developed, were recorded on a prognosis card, in each case between the child's absolute age (abscissa) and birthweight in g (ordinate). In this way it was possible to read off the critical phase of retinal development for each newly examined child. This card facilitates monitoring, the provision of forensic evidence, the timing of ophthalmoscopy during critical phases of retinal development, and may also enable further relationships to be detected. PMID:3430997

  16. Oral feeding readiness assessment in premature infants.

    PubMed

    Gennattasio, Annmarie; Perri, Elizabeth A; Baranek, Donna; Rohan, Annie

    2015-01-01

    Oral feeding readiness is a complex concept. More evidence is needed on how to approach beginning oral feedings in premature hospitalized infants. This article provides a review of literature related to oral feeding readiness in the premature infant and strategies for promoting safe and efficient progression to full oral intake. Oral feeding readiness assessment tools, clinical pathways, and feeding advancement protocols have been developed to assist with oral feeding initiation and progression. Recognition and support of oral feeding readiness may decrease length of hospital stay and have a positive impact on reducing healthcare costs. Supporting effective cue-based oral feeding through use of rigorous assessment or evidence-based care guidelines can also optimize the hospital experience for infants and caregivers, which, in turn, can promote attachment and parent satisfaction.

  17. Extensive hepatic necrosis in a premature infant.

    PubMed

    Bemmel, L A; Hack, W W; Seldenrijk, C A; Kneepkens, C M

    1992-02-01

    A fatal case of fulminant hepatic failure that occurred in the neonatal period is reported in a premature infant born after 27 4/7-weeks' gestation. Immediately after birth the infant had severe hypoxia and hypotension resulting from birth asphyxia, hypovolemic shock, and septicemia. At autopsy, histological appearance of the liver showed virtually total hepatocellular necrosis without features of fibrosis. Although the exact cause of hepatocellular injury cannot be fully ascertained, it is assumed that hypoxia and hypotension must have been the predominant factors leading to massive hepatic necrosis.

  18. Management of inguinal hernia in premature infants: 10-year experience

    PubMed Central

    Crankson, Stanley John; Al Tawil, Khalil; Al Namshan, Mohammad; Al Jadaan, Saud; Baylon, Beverly Jane; Gieballa, Mutaz; Ahmed, Ibrahim Hakim

    2015-01-01

    Aim: Debatable issues in the management of inguinal hernia in premature infants remain unresolved. This study reviews our experience in the management of inguinal hernia in premature infants. Materials and Methods: Retrospective chart review of premature infants with inguinal hernia from 1999 to 2009. Infants were grouped into 2: Group 1 had repair (HR) just before discharge from the neonatal intensive care unit (NICU) and Group 2 after discharge. Results: Eighty four premature infants were identified. None of 23 infants in Group 1 developed incarcerated hernia while waiting for repair. Of the 61 infants in Group 2, 47 (77%) underwent day surgery repair and 14 were admitted for repair. At repair mean postconceptional age (PCA) in Group1 was 39.5 ± 3.05 weeks. Mean PCA in Group 2 was 66.5 ± 42.73 weeks for day surgery infants and 47.03 ± 8.87 weeks for admitted infants. None of the 84 infants had an episode of postoperative apnea. Five (5.9%) infants presented subsequently with metachronous contralateral hernia and the same number of infants had hernia recurrence. Conclusions: Delaying HR in premature infants until ready for discharge from the NICU allows for repair closer to term without increasing the risk of incarceration. Because of low occurrence of metachronous hernia contralateral inguinal exploration is not justified. Day surgery HR can be performed in former premature infant if PCA is >47 weeks without increasing postoperative complications. PMID:25552826

  19. Necrotizing enterocolitis in premature infants and newborns.

    PubMed

    Mϋller, M J; Paul, T; Seeliger, S

    2016-09-16

    Necrotizing enterocolitis (NEC) is the most common acquired disease of the gastrointestinal tract (GIT) in premature infants and newborns. It is defined as an ulcerative inflammation of the intestinal wall. The clinical signs of incipient NEC are often very discrete, and range from localized intestinal symptoms to generalized signs of sepsis. NEC is classified depending on its severity into disease states according to the modified Bell's Classification. Treatment of NEC ranges, depending on its severity, from a conservative therapeutic approach to surgery with resection of the affected parts of the intestine. Mortality is considerably high in extremely small preterm infants reaching up to 42% of the affected children. Measures such as breastfeeding or alternatively nutrition with pasteurized human donor milk from a milk bank, administration of probiotics, avoidance of histamine type II receptor antagonists, and restrictive antibiotic treatment should be considered early on for prevention of NEC. PMID:27589549

  20. Brainstem evoked response audiometry in the premature infant population.

    PubMed

    Cox, L C; Hack, M; Metz, D A

    1981-09-01

    Auditory brainstem response (ABR) audiometry was performed on 76 non-selected premature infants from 32 to 40 weeks conceptional age. Follow-up ABR was completed on 45 infants at 4 months of age. The results were compared to data from selected, relatively low risk infants of comparable age. No significant differences were seen between the two groups, which indicates that normative data from non-selected premature infants can be obtained to identify ABR abnormality.

  1. 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…

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

    PubMed Central

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

    2013-01-01

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

  3. 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…

  4. New Perspectives on Premature Infants and Their Parents

    ERIC Educational Resources Information Center

    Browne, Joy V.

    2003-01-01

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

  5. Formulas for premature infants: fate of the calcium and phosphorus.

    PubMed

    Bhatia, J; Fomon, S J

    1983-07-01

    Formulas designed for feeding of premature infants contain minerals added by the manufacturer. Although it is known that these minerals may be poorly suspended in the formula, little is known about concentrations of minerals in formula delivered to the infant under conditions prevailing in premature infant nurseries. In partially empty bottles of Similac Special Care, concentrations of calcium and phosphorus of this residual formula were found to be substantially greater than concentrations in full bottles. Presumably, concentrations of calcium and phosphorus in formula delivered to the infants was relatively low. Enfamil Premature and SMA Preemie infant formulas contain lesser quantities of added calcium and demonstrated less tendency to sedimentation. Substantial decrease in concentration of calcium was observed with all three formulas during continuous infusion, but the decrease was greatest with Similac Special Care. Little or no change in concentrations of calcium and phosphorus were observed with simulated bolus feeding by gavage.

  6. Transitioning premature infants supine: state of the science.

    PubMed

    McMullen, Sherri L

    2013-01-01

    Safe infant sleep has been the focus of two decades of research. Improving supine sleep position in infants has coincided with a reduction in sudden infant death syndrome (SIDS). Premature infants spend time prone while hospitalized to promote appropriate growth and development; however, after hospitalization, infants should be positioned supine to reduce the risk of SIDS. Research has not been conducted on the optimal timing of transitioning the premature infant supine prior to hospital discharge. Infants transitioned too early are at risk for developmental delays, and infants not transitioned prior to discharge are at risk for being positioned in a nonsupine position, thereby increasing the risk of SIDS. Parents can observe appropriate role modeling of their infant while hospitalized and potentially improve the rate of supine sleep after discharge to reduce the risk of SIDS. This review explores the current literature on transitioning the premature infant to the supine position prior to hospital discharge to improve evidence-based practice and potentially further reducing the SIDS rate. PMID:23060326

  7. The epidemiology and diagnosis of invasive candidiasis among premature infants.

    PubMed

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

    2015-03-01

    Invasive candidiasis is a leading infectious cause of morbidity and mortality in premature infants. Improved recognition of modifiable risk factors and antifungal prophylaxis has contributed to the recent decline in the incidence of this infection among infants. Invasive candidiasis typically occurs in the first 6 weeks of life and presents with nonspecific signs of sepsis. Definitive diagnosis relies on the growth of Candida in blood culture or cultures from other normally sterile sites, but this may identify fewer than half of cases. Improved diagnostics are needed to guide the initiation of antifungal therapy in premature infants.

  8. Preventing respiratory syncytial virus in homebound premature infants.

    PubMed

    Austin, Jennifer

    2007-01-01

    This article explores the home health nurse's role in preventing respiratory syncytial virus (RSV) among premature infants. Thousands of children infected with RSV require hospitalization each year. Consistent contact with the infant alerts the nurse to subtle signs and symptoms of RSV infection, which may include nasal congestion, cough, low-grade fever, and malaise. By developing patient and caregiver trust, the home health nurse can implement an RSV prevention plan, leading to a decrease in hospitalization episodes of premature infants with RSV. Identification of patient risk factors contributing to RSV together with caregiver education is addressed in this article.

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

    PubMed Central

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

    2015-01-01

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

  10. [Prematurity risk according to prematurity risk score and postpartal morbidity of the newborn infants (author's transl)].

    PubMed

    Coradello, H; Lubec, G; Simbruner, G

    1981-02-01

    Risk of premature birth was evaluated retrospectively in 610 women in the first days after delivery using the prematurity risk score published by Thalhammer 1973. The calculated risk of premature birth was compared than prospectively to postpartal morbidity of the newborn infants as determined by duration of hospital stay, incidence of respiratory distress syndrome, need of artificial ventilation and mortality. A positive correlation could be found between risk of premature birth and postpartal morbidity of the newborn infants especially in small premature infants with birthweights of 2000 grams and less. The same correlation existed also in two groups of infants out of two different obstetric clinics which showed the same distribution of prenatal risks and the same prenatal care frequencies. It clearly becomes evident that infants with the same prenatal risks but good prenatal care during pregnancy had much lower hospital stays, lower respiratory distress frequencies and lower mortality rates than babies delivered from pregnancies badly cared for. These prenatal care related differences in postpartum morbidity again were much more evident in infants out of lower birth weight classes.

  11. Imaging findings of bronchial atresia in fetuses, neonates and infants.

    PubMed

    Alamo, Leonor; Vial, Yvan; Gengler, Carole; Meuli, Reto

    2016-03-01

    Congenital lung malformations are increasingly detected before birth. However, bronchial atresia is rarely identified in utero and not always recognized in neonates. There are two types of atresia: 1) proximal, located at the level of the mainstem or the proximal lobar bronchi, which is extremely rare and usually lethal during pregnancy, causing a tremendous volume increase of the distal involved lung with secondary hypoplasia of the normal lung, and 2) peripheral, located at the segmental/subsegmental bronchial level, which may present as an isolated lesion or as part of a complex congenital malformation. Prenatal findings are mostly nonspecific. Postnatal exams show overinflated lung areas and focal bronchial dilations. The typical fluid-filled bronchoceles are not always observed in neonates but develop progressively in the first months of life. This pictorial essay describes the spectrum of imaging findings of bronchial atresia in fetuses, neonates and infants. PMID:26646151

  12. Prognosis of Full-Thickness Skin Defects in Premature Infants

    PubMed Central

    Moon, Hyung Suk; Yang, Won Yong; Kang, Sang Yoon

    2012-01-01

    Background In the extremities of premature infants, the skin and subcutaneous tissue are very pliable due to immaturity and have a greater degree of skin laxity and mobility. Thus, we can expect wounds to heal rapidly by wound contraction. This study investigates wound healing of full-thickness defects in premature infant extremities. Methods The study consisted of 13 premature infants who had a total of 14 cases of full-thickness skin defects of the extremities due to extravasation after total parenteral nutrition. The wound was managed with intensive moist dressings with antibiotic and anti-inflammatory agents. After wound closure, moisturization and mild compression were performed. Results Most of the full-thickness defects in the premature infants were closed by wound contraction without granulation tissue formation on the wound bed. The defects resulted in 3 pinpoint scars, 9 linear scars, and 2 round hypertrophic scars. The wounds with less granulation tissue were healed by contraction and resulted in linear scars parallel to the relaxed skin tension line. The wounds with more granulation tissue resulted in round scars. There was mild contracture without functional abnormality in 3 cases with a defect over two thirds of the longitudinal length of the dorsum of the hand or foot. The patients' parents were satisfied with the outcomes in 12 of 14 cases. Conclusions Full-thickness skin defects in premature infants typically heal by wound contraction with minimal granulation tissue and scar formation probably due to excellent skin mobility. PMID:23094240

  13. Biomarkers of brain injury in the premature infant.

    PubMed

    Douglas-Escobar, Martha; Weiss, Michael D

    2012-01-01

    The term "encephalopathy of prematurity" encompasses not only the acute brain injury [such as intraventricular hemorrhage (IVH)] but also complex disturbance on the infant's subsequent brain development. In premature infants, the most frequent recognized source of brain injury is IVH and periventricular leukomalacia (PVL). Furthermore 20-25% infants with birth weigh less than 1,500 g will have IVH and that proportion increases to 45% if the birth weight is less than 500-750 g. In addition, nearly 60% of very low birth weight newborns will have hypoxic-ischemic injury. Therefore permanent lifetime neurodevelopmental disabilities are frequent in premature infants. Innovative approach to prevent or decrease brain injury in preterm infants requires discovery of biomarkers able to discriminate infants at risk for injury, monitor the progression of the injury, and assess efficacy of neuroprotective clinical trials. In this article, we will review biomarkers studied in premature infants with IVH, Post-hemorrhagic ventricular dilation (PHVD), and PVL including: S100b, Activin A, erythropoietin, chemokine CCL 18, GFAP, and NFL will also be examined. Some of the most promising biomarkers for IVH are S100β and Activin. The concentrations of TGF-β1, MMP-9, and PAI-1 in cerebrospinal fluid could be used to discriminate patients that will require shunt after PHVD. Neonatal brain injury is frequent in premature infants admitted to the neonatal intensive care and we hope to contribute to the awareness and interest in clinical validation of established as well as novel neonatal brain injury biomarkers.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-07-01

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

  16. 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…

  17. [Surgical therapy of interstitial pulmonary emphysema in a premature infant].

    PubMed

    Storm, W

    1986-07-01

    Pulmonary interstitial emphysema is a frequent complication in the use of respirators in newborn infants suffering from respiratory insufficiency. If it is diffuse and bilateral, treatment often is without success; occasionally, interstitial emphysema may be localized in a lobe, in which case it may persist and lead to therapeutic difficulties. We report a successful surgical approach to a unilateral pulmonary interstitial emphysema in a premature infant.

  18. Daily Enteral DHA Supplementation Alleviates Deficiency in Premature Infants.

    PubMed

    Baack, Michelle L; Puumala, Susan E; Messier, Stephen E; Pritchett, Deborah K; Harris, William S

    2016-04-01

    Docosahexaenoic acid (DHA) is an essential fatty acid (FA) important for health and neurodevelopment. Premature infants are at risk of DHA deficiency and circulating levels directly correlate with health outcomes. Most supplementation strategies have focused on increasing DHA content in mother's milk or infant formula. However, extremely premature infants may not reach full feedings for weeks and commercially available parenteral lipid emulsions do not contain preformed DHA, so blood levels decline rapidly after birth. Our objective was to develop a DHA supplementation strategy to overcome these barriers. This double-blind, randomized, controlled trial determined feasibility, tolerability and efficacy of daily enteral DHA supplementation (50 mg/day) in addition to standard nutrition for preterm infants (24-34 weeks gestational age) beginning in the first week of life. Blood FA levels were analyzed at baseline, full feedings and near discharge in DHA (n = 31) or placebo supplemented (n = 29) preterm infants. Term peers (n = 30) were analyzed for comparison. Preterm infants had lower baseline DHA levels (p < 0.0001). Those receiving DHA had a progressive increase in circulating DHA over time (from 3.33 to 4.09 wt% or 2.88 to 3.55 mol%, p < 0.0001) while placebo-supplemented infants (receiving standard neonatal nutrition) had no increase over time (from 3.35 to 3.32 wt% or 2.91 to 2.87 mol%). Although levels increased with additional DHA supplementation, preterm infants still had lower blood DHA levels than term peers (4.97 wt% or 4.31 mol%) at discharge (p = 0.0002). No differences in adverse events were observed between the groups. Overall, daily enteral DHA supplementation is feasible and alleviates deficiency in premature infants. PMID:26846324

  19. New Ballard Score, expanded to include extremely premature infants.

    PubMed

    Ballard, J L; Khoury, J C; Wedig, K; Wang, L; Eilers-Walsman, B L; Lipp, R

    1991-09-01

    The Ballard Maturational Score was refined and expanded to achieve greater accuracy and to include extremely premature neonates. To test validity, accuracy, interrater reliability, and optimal postnatal age at examination, the resulting New Ballard Score (NBS) was assessed for 578 newly born infants and the results were analyzed. Gestational ages ranged from 20 to 44 weeks and postnatal ages at examination ranged from birth to 96 hours. In 530 infants, gestational age by last menstrual period was confirmed by agreement within 2 weeks with gestational age by prenatal ultrasonography (C-GLMP). For these infants, correlation between gestational age by NBS and C-GLMP was 0.97. Mean differences between gestational age by NBS and C-GLMP were 0.32 +/- 1.58 weeks and 0.15 +/- 1.46 weeks among the extremely premature infants (less than 26 weeks) and among the total population, respectively. Correlations between the individual criteria and C-GLMP ranged from 0.72 to 0.82. Interrater reliability of NBS, as determined by correlation between raters who rated the same subgroup of infants, ws 0.95. For infants less than 26 weeks of gestational age, the greatest validity (97% within 2 weeks of C-GLMP) was seen when the examination was performed before 12 hours of postnatal age. For infants at least 26 weeks of gestational age, percentages of agreement with C-GLMP remained constant, averaging 92% for all postnatal age categories up to 96 hours. The NBS is a valid and accurate gestational assessment tool for extremely premature infants and remains valid for the entire newborn infant population. PMID:1880657

  20. A Program of Stimulation for Infants Born Prematurely.

    ERIC Educational Resources Information Center

    Barnard, Kathryn

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

  1. Stability and Change in the Behavioral Development of Premature Infants.

    ERIC Educational Resources Information Center

    Mitchell, Sandra K.; Telzrow, Robert W.

    The Brazelton Neonatal Behavioral Assessment Scale (BNBAS) was administered to a group of 73 premature infants at approximately 34, 36, and 40 weeks of gestational age. Six behavioral cluster scores and one reflex cluster score were computed for each examination. Repeated measures analyses of variance showed significant steady improvement on all…

  2. [Is Candida septicemia in premature infants a nosocomial infection?].

    PubMed

    Laskus, A; Mendling, W; Runge, K; Schmidt, A

    1998-01-01

    Yeast colonization of the vagina is found in about 30% of all pregnant women. Premature infants are severely endangered by generalized fungal infections due to their immature immune system. The objective of this study was to elucidate the relationship between vaginal yeast colonization of the mothers and Candida septicemia in their premature babies. In a prospective study, running from 12/1994 to 8/1996, 176 mothers, facing probable premature birth, were investigated, when hospitalized, for vaginal yeast colonization. 150 premature infants (birth weights ranging from 550 to 2390 g) of these mothers were culturally examined for yeasts in specimens from the mouth, ear, stool and urine immediately after birth as well as once weekly in the following weeks. The patients were divided into two groups. In group A, oral prophylaxis with nystatin was practiced only in infants with at least one positive yeast culture. In group B, all patients received nystatin prophylaxis. Candida septicemia developed one or two weeks after birth mainly in infants with birth weights below 1000 g. Primary oral prophylaxis with nystatin lowers considerably the risk of developing Candida infection.

  3. 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)

  4. 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.

  5. Nutritional balance studies: evaluation of a premature infant formula.

    PubMed

    Cordano, A; Bancalari, E; Hansen, J W; Feller, R

    1985-06-01

    A 24 kcal/oz (81 kcal/100 ml) premature infant formula (Enfamil Premature Formula) with moderately high mineral content (117 mg Ca/100 ml and 58 mg P/100 ml) and a protein content of 3 g/100 kcal was evaluated in sixteen 3-day balance studies at 10 and 21 days of age in nine premature infants with birth weights from 1,200 to 1,400 g. Growth rates were similar to in utero rates, and the formula was well accepted and tolerated. Calcium retention (62.5%) was similar to in utero accretion, and phosphorus retention was only slightly lower. Nitrogen retention was high without the development of metabolic acidosis or abnormal serum urea nitrogen levels.

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

    ERIC Educational Resources Information Center

    Macey, Terri J.; And Others

    1987-01-01

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

  7. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants.

    PubMed

    Janaillac, Marie; Labarinas, Sonia; Pfister, Riccardo E; Karam, Oliver

    2016-01-01

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

  8. Long Latency Auditory Evoked Potential in Term and Premature Infants

    PubMed Central

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

    2013-01-01

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

  9. Plasma carnitine alterations in premature infants receiving various nutritional regimes.

    PubMed

    Smith, R B; Sachan, D S; Plattsmier, J; Feld, N; Lorch, V

    1988-01-01

    Plasma carnitine, carnitine esters, and triglyceride concentrations were determined in 36 appropriate-forgestational-age (AGA) infants at various stages of prematurity throughout hospitalization to determine the effect of a carnitine-free and carnitine-containing diet on plasma carnitine and triglyceride concentrations. The infants were entered into one of three experimental groups based on birth weight: group I less than 1.0 kg; group II 1.0-1.51 kg; and group III 1.52-2.5 kg. Throughout the study subjects were placed on appropriate nutritional regimes which included hyperalimentation (HA), intravenous (iv) fat emulsion (Intralipid), Portagen, Enfamil-24 Premature Formula, Enfamil-20, and breastmilk. Blood samples were drawn from each infant at birth, days 1-5,7 then weekly, also before and after each nutritional intervention to determine carnitine and triglyceride concentrations. Results showed that plasma total carnitine and nonesterified carnitine decreased in all groups when the infants were maintained on a carnitine-free diet (HA, Intralipid, Portagen). In general, the carnitine levels continued to decrease until a carnitine-containing diet was initiated. Once a carnitine-containing diet was begun, plasma total carnitine (TC) and nonesterified carnitine (NEC) levels increased at fairly similar rates in all groups. However, an inverse relationship between carnitine and triglyceride (TG) concentrations were not seen in these infants. This would indicate that most premature infants require exogenous carnitine to maintain the plasma concentration of carnitine. However, a decreased concentration of plasma carnitine was not correlated with an elevated TG level under the conditions of this study.

  10. 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

  11. 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.

  12. 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…

  13. 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.

  14. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

    PubMed Central

    Janaillac, Marie; Labarinas, Sonia

    2016-01-01

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

  15. Cerebral tissue oxygenation index in very premature infants

    PubMed Central

    Naulaers, G; Morren, G; Van Huffel, S; Casaer, P; Devlieger, H

    2002-01-01

    Aim: To describe normal values of the cerebral tissue oxygenation index (TOI) in premature infants. Methods: TOI was measured by spatially resolved spectroscopy in preterm infants on the first 3 days of life. Infants with an abnormal cranial ultrasound were excluded. Other simultaneously measured variables were PaO2, PaCO2, pH, mean arterial blood pressure, heart rate, haemoglobin, glycaemia, and peripheral oxygen saturation. Results: Fifteen patients with a median postmenstrual age of 28 weeks were measured. There was a significant increase in median TOI over the first 3 days of life: 57% on day 1, 66.1% on day 2, and 76.1% on day 3. Multiple regression analysis showed no correlation between TOI and postmenstrual age, peripheral oxygen saturation, mean arterial blood pressure, PaO2, PaCO2, and haemoglobin concentration. Conclusion: Cerebral TOI increases significantly in the first 3 days of life in premature babies. This increase probably reflects the increase in cerebral blood flow at this time. PMID:12390989

  16. [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.

  17. Adrenal and thyroid function in the fetus and preterm infant

    PubMed Central

    2014-01-01

    Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant. PMID:25379042

  18. [Use of sterile petrolatum for extravasation injury in a premature infant].

    PubMed

    Grabois, Florencia S; Voievdca, Tomás; Aqcuavita, Adriana; Kizlansky, Viviana; Saint Genez, Daniel; Vidaurreta, Santiago

    2008-12-01

    The skin of premature infants is an ineffective barrier. The stratum corneum is thinner than that found in full-term infants. We report on a premature patient with extravasation injury from sodium bicarbonate. Daily treatment with sterile petrolatum resulted in restitutio ad integrum.

  19. International Survey of Transfusion Practices for Extremely Premature Infants

    PubMed Central

    Guillén, Úrsula; Cummings, James J.; Bell, Edward F.; Hosono, Shigerharu; Frantz, Axel R.; Maier, Rolf F.; Whyte, Robin K.; Boyle, Elaine; Vento, Max; Widness, John A.; Kirpalani, Haresh

    2013-01-01

    Our objective was to survey neonatologists regarding international practice of red cell transfusion thresholds for premature infants with <1000-g birth weight and/or <28-week gestation. An invitation to fill out an 11-question web-based survey was distributed to neonatologists through their professional societies in 22 countries. Physicians were asked about which specific factors, in addition to hemoglobin levels, influenced their decisions about transfusing premature infants. These factors included gestational age, postnatal age, oxygen need, respiratory support, reticulocyte count, and inotropic support. Physicians were presented with 5 scenarios and asked to identify hemoglobin cutoff values for transfusing infants with <1000-g birth weight and/or <28-week gestation. One thousand eighteen neonatologists responded: the majority were from the United States (67.5%), followed by Germany (10.7%), Japan (8.0%), the United Kingdom (4.9%), Spain (3.9%), Italy (2.6%), Colombia (0.6%), Argentina (0.4%), Canada (0.4%), Belgium (0.1%), and the Netherlands (0.1%). Half of the respondents (51.1%) reported having a written policy with specific red cell transfusion guidelines in their unit. Factors considered “very important” regarding the need to administer blood transfusions included degree of oxygen requirement (44.7%) and need for respiratory support (44.1%). Erythropoietin was routinely used to treat anemia by 26.0% of respondents. Delayed cord clamping or cord milking was practiced by 29.1% of respondents. The main finding was of a wide variation in the hemoglobin values used to transfuse infants, regardless of postnatal age. Step-wise increments in the median hemoglobin cutoffs directly paralleled an increase in the need for levels of respiratory support. In the first week of life, there was a wider range in the distribution of hemoglobin transfusion thresholds for infants requiring no respiratory support and full mechanical ventilation compared with the thresholds

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

    PubMed

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

    2016-07-01

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

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

    PubMed

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

    2016-07-01

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

  2. Detecting rickets in premature infants and treating them with calcitriol: experience from two cases.

    PubMed

    Chen, Hung-Yi; Chiu, Li-Chien; Yek, Yung-Lee; Chen, Yi-Ling

    2012-08-01

    A premature infant is a baby born before 37 weeks of gestation. Rickets is a bone disease characterized by growth retardation due to the expansion of the hypertrophic chondrocyte layer of the growth plate and a failure to mineralize bone. Consequently, the bone is soft and permits marked bending and distortion. Although the incidence of rickets in preterm infants is lower due to improvements in health care and nutrition, there are still infants at high risk for this disease. However, few reports are available regarding the treatment of rickets in premature infants. Furthermore, published case studies on experiences with using calcitriol as a potential therapeutic for rickets in premature infants are very rare. Herein, we describe the detection of rickets in premature infants and our experience with calcitriol treatment in two premature infants. We recommended the use of oral calcitriol at a dose of 0.03-0.125 μg/kg/day, in addition to an appropriate formula that provides an adequate amount of calcium and phosphate intake. One patient was prescribed calcitriol for 40 days and the other for 37 days. The two infants gradually recovered and were discharged without any obvious side effects. It is recommended that alkaline phosphatase levels be monitored within 1 month after birth in premature infants with a birth weight of <1000 g. Infants presenting with high alkaline phosphatase levels are candidates for a long bone survey.

  3. Body weight, static and dynamic skinfold thickness in small premature infants during the first month of life.

    PubMed

    Bustamante, S A; Jacobs, P; Gaines, J A

    1983-10-01

    The growth of prematurely born infants is different from the growth of fetuses of the same age remaining in utero. This is in part due to changes in body composition that occur after birth. In search for a practical and reliable method to assess the growth of small prematures, we analyzed data obtained in two anthropometric studies that included 180 premature infants of 750-1750 g weight at birth, and we studied the relationships between weight, static skinfold thickness (SSFT) and dynamic skinfold thickness (delta SFT, i.e. the percentage of change in skinfold thickness between 15 and 60 s after application of the Harpenden caliper). The results show that the SSFT increases steadily after birth in spite of a significant decrease in weight and delta SFT. Whether it contains fat or not, the fold of the skin is increasing in thickness at a time when by weight alone, one would have considered that there was no growth. The nutritional implication of this finding remains to be studied. Serial correlations of measures obtained at each period indicate that weight and SSFT have a good correlation to same measures in subsequent weeks (P less than 0.01). delta SFT, however, showed only a weak correlation (P = 0.05). The delta SFT follows the general pattern of known changes in total body water, but it is not accurate enough to determine changes in individual infants; further studies are thus needed to find a practical method to evaluate changes of body composition and its relevance in the measurement of growth of premature infants.

  4. [Developing early intervention and follow-up system for premature infants of brain injury ].

    PubMed

    Luo, Rong; De-Zhi, Mu

    2013-03-01

    As the increasing trend of survival rate for premature birth, especially in early preterm infants, it calls more and more attention to neurologic sequelae of premature birth. Besides cerebral palsy, there are high incidences of neuropsychological disorders in premature infants, such as learning and social communication problems, which sometimes remain a challenge for the quality of life even in their adulthood. In order to solve these difficult situation and problems, more and more medical research and clinical efforts have being focused on the mechanism of brain injury, neurological sequelae of premature birth, early intervention and follow-up for premature. Hereby we are discussing our works for brain injury in preterm the mechanism of neurological sequelae, assessment methods and early intervention, to provide rationale for the establishment of early intervention and follow-up system for premature infants with brain injury. PMID:23745269

  5. 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.

  6. Maternal Attention Directing Strategies and Infants' Response to Toys: Effects of Downs Syndrome and Prematurity.

    ERIC Educational Resources Information Center

    Landry, Susan H.; Chapieski, Lynn

    The project studied videotaped unstructured play sessions between 16 Downs Syndrome (DS) infants (aged 6 months and 12 months) and their mothers, to investigate the relationship between maternal attention-directing strategies and the infants' response to toys. A comparison group consisted of 16 high-risk premature infants matched by mental and…

  7. 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

  8. Retinol (vitamin A) and the neonate: special problems of the human premature infant.

    PubMed

    Zachman, R D

    1989-09-01

    Retinol stores accumulate in fetal tissue during gestation. Hence, the premature infant faces extrauterine adaptation with less total reserves of retinol than does the term infant. Retinol-binding protein in serum is also lower in the premature infant population. The parenteral retinol supplementation frequently required for these infants has only recently become adequate by the finding of methods to avoid large losses of retinol onto intravenous tubing. Retinol is an essential vitamin for epithelial cell function; nearly 40% of lung cells are of epithelial origin. The premature infant's lung often is the initial site of difficulties during extrauterine adaptation, and respiratory system epithelial-cell damage and chronic lung disease frequently develop. Because these infants have associated low retinol reserves, retinol supplementation to help repair pulmonary injury is being considered. Some of these relationships are beginning to be clarified by basic research on the metabolism and function of retinol in lung. PMID:2672772

  9. 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.

  10. 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

  11. A comparative study of a premature infant formula and preterm breast milk for low birthweight infants.

    PubMed

    Tudehope, D I; Mitchell, F; Cowley, D M

    1986-08-01

    Although the unique composition of preterm milk (PTM) has led to its increasing use in feeding of low birthweight (LBW) infants, controversy exists as to whether such milk adequately meets their requirements. This study compares the clinical tolerance and anthropometric, biochemical and haematological parameters of LBW infants fed exclusively with their own mother's PTM, a premature infant formula (Alprem; Nestlé Australia) and a mixture of PTM and Alprem. Of 90 enrolled LBW infants (1000-1750 g birthweight), 78 completed the feeding trial for a mean duration of 42 days. Twenty-eight babies were fed Alprem (Group A), 31 received a mixture of Alprem and PTM (Group B) and 18 received PTM (Group C). Babies in Groups A and B were smaller, less mature and more asphyxiated at birth than those in Group C. Weight gain from full enteral feeding was greater in Group A (18.1 g/kg per day) and Group B (17.6 g/kg per day) than in Group C (13.0 g/kg per day). Throughout the trial, weight gain in Groups A and B exceeded predicted intra-uterine growth rates, whereas that for Group C approximated the predicted intra-uterine growth rates. Growth rates of length and head circumference were also greatest in the Alprem-fed babies. Infants receiving PTM were supplemented with calcium, sodium, vitamins and energy, whereas the only three infants requiring mineral supplementation in the Alprem group were those receiving Frusemide therapy for chronic lung disease. lower serum concentrations of phosphorus, iron, albumin and urea, and higher zinc and alkaline phosphatase concentrations were found in infants receiving PTM (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

  12. 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.

  13. 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…

  14. Protective and defensive airway reflexes in premature infants.

    PubMed

    Javorka, K; Tomori, Z; Zavarská, L

    1980-01-01

    The incidence of respiratory reactions to stimulation of the nasal and propharyngeal mucose was studied in 44 newborn premature infants. The inhalation of menthol fumes or the administration of drops of Mukoseptonex to the nasal mucosa caused transient respiratory arrest or a drop in the respiration rate. The heart rate rose during chemical stimulation of the nasal mucosa, possibly in association with a general arousal reaction. Mechanical stimulation of the nasal mucosal with a nylon fibre elicited an expulsive reaction in 95% of the cases. As distinct from experimental animals, sneezing was not preceded by a deep initial inspiration. Stimulation of the oropharyngeal region produced transient apnoea in 24.5% of the cases, in 18% expiratory reactions reminiscent of the expiration reflex, in 33% independent, intensive inspiratory reactions and in 24.5% cough. Cough from both the oropharyngeal and the laryngeal region had a pronounced inspiratory component. Independent inspiratory reactions may to some extent be co-responsible for the high incidence of aspirations in the neonatal period. PMID:6444736

  15. 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

  16. [Pancreas structure in fetuses and newborn infants who died in the perinatal period].

    PubMed

    Uliyanovskaya, S A; Tiukhtina, T G; Stukov, N V; Ankudinov, V V

    2014-01-01

    In the pancreas of fetuses at weeks 22-40 of prenatal development (n = 111) and of newborn infants who died during the first week of postnatal life (n = 38) the changes were detected that were characterized by exocrine part hypoplasia, retardation of acinar pancreatocyte differentiation, connective tissue outgrowth, pancreatic (Langerhans) islet hyperplasia and hypertrophy. The results of the study have shown that with the increase of the total risk sum of the perinatal period pathology development (expressed in balls), the relative content of the insular part of the organ and the number of large pancreatic islets (larger than 100 microm in diameter) decreased. The morphological features detected in this study indirectly reflect endo-ecologically discomfortable conditions of fetus development within the fetoplacental unit which increase the risk of polyendocrinopathy development and fetal intrauterine growth retardation. These polyendocrinopathies increase further the risk of endocrine disturbance occurence in childhood.

  17. 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

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

    SciTech Connect

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

    1997-07-15

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

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

    PubMed

    Wildrick, D

    1997-10-01

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

  20. 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

  1. [Parenteral nutrition in premature infants: practical aspects to optimize postnatal growth and development].

    PubMed

    Senterre, T; Rigo, J

    2013-09-01

    Nutrition and growth are still a major challenge in neonatal intensive care. Many studies have demonstrated that premature infants frequently develop severe cumulative nutritional deficit during the first weeks of life. This malnutrition is the primary etiology of postnatal growth restriction, which is still universally described in very premature infants. Furthermore, both postnatal nutritional deficit and postnatal growth restriction have been associated with adverse long-term outcome in adulthood. Due to their immaturity, premature infants are frequently not fed by the enteral route. Therefore, parenteral nutrition remains an essential therapy in neonatology. Most recent recommendations suggest starting parenteral nutrition as soon as possible after birth with a minimum of 40 kcal/kg/day with around 2-3g/kg/day of amino acids and 1g/kg/day of lipids. Afterwards, intake should increase rapidly during the first week of life, up to 90-120 kcal/kg/day with around 3.5 g/kg/day amino acids and 3g/kg/day of lipids. There is great heterogeneity in parenteral nutrition practices among neonatal units, with frequent discrepancies. This article discusses the principal theoretical aspects of parenteral nutrition in premature infants, the guidelines, and the opportunity to optimize nutritional support routinely, especially in very premature infants. PMID:23845601

  2. 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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Sarnat, Harvey B; Flores-Sarnat, Laura

    2016-05-01

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

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

    PubMed

    Forsum, Elisabet; Olhager, Elisabeth; Törnqvist, Caroline

    2016-04-22

    (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.

  6. 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

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

    PubMed

    Eckert, E E

    1992-05-01

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

  8. 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.

  9. Use of the intramuscular relative-dose-response test to predict bronchopulmonary dysplasia in premature infants.

    PubMed

    Zachman, R D; Samuels, D P; Brand, J M; Winston, J F; Pi, J T

    1996-01-01

    We tested the hypothesis that an intramuscular relative dose response (IM-RDR) on day 1 of life would more accurately predict which premature infants would develop bronchopulmonary dysplasia (BPD) than single measurements of retinol, retinyl palmitate (RP), or retinol binding protein (RBP). Seventy-five premature infants < or = 32 wk gestation had the IM-RDR on day 1 of life. An RDR > or = 25% occurred in 6 of 37 infants who did not develop BPD compared with 15 of 38 infants who developed BPD (P = 0.025). Retinol, RP, and RBP on day 1 were not different between the groups. BPD infants who received postnatal dexamethasone during their hospital course had a higher day-28 baseline retinol concentration (1.19 +/- 0.15 mumol/L) than did the group with no BPD (0.82 +/- 0.06 mumol/L) (P = 0.03). However, the effect of postnatal dexamethasone on serum retinol was biphasic, rising initially, and then declining after 8-12 d. RP values at time 0 and 5 h on day 28 were higher than day 1 values in both infants without BPD and infants with BPD who did not receive dexamethasone. Retrospective analysis also revealed a significant correlation between a day-1 RDR > or = 25% and the incidence of intraventricular hemorrhage in these premature infants. Because the IM-RDR is more helpful in predicting the development of BPD than single serum retinol and RP analyses, this test could be useful in determining which premature infants might benefit from supplemental vitamin A for BPD. PMID:8604659

  10. [Recent advances in nutritional support and postnatal growth in premature infants].

    PubMed

    Senterre, T; Rigo, J

    2013-02-01

    Nutrition has always been described as challenging in premature infants, especially in very low birth weight (VLBW, < 1500 g) infants. Therefore, postnatal malnutrition is frequently observed in these infants and most develop a severe postnatal growth restriction with a very high incidence of hypotrophy at term corrected age. Otherwise, both insufficient nutritional intakes and postnatal growth restriction during the perinatal period have been associated with adverse developmental outcomes. In this article, an optimized nutritional policy characterized by a standardization of nutritional support is discussed. This policy implies the use of one standardized parenteral nutrition solution and a rapidly enriched feeding regimen. Recent studies in VLBW infants have demonstrated that this approach is associated with significant improvement of nutritional support, postnatal growth and biological homeostasis. Only 6% of appropriate for gestational age infants at birth were described small for gestational age at discharge. This policy has recently been reproduced by the industry that developed the first manufactured triple-chamber parenteral nutrition bags specifically designed for premature infants. It represents a great opportunity for premature infants to improve their development and long-term outcomes.

  11. 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

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

    PubMed

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

    2015-02-01

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

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

    PubMed

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

    2015-02-01

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

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

    PubMed

    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

  15. 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

  16. 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

  17. 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.

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

    PubMed Central

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

    2016-01-01

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

  19. Reduced incidental light exposure: effect on the development of retinopathy of prematurity in low birth weight infants.

    PubMed

    Ackerman, B; Sherwonit, E; Williams, J

    1989-06-01

    In a recent study, it was reported that incidental lighting within the newborn intensive care unit setting may play a role in the development of retinopathy of prematurity. Consequently, the routine clinical management in the intensive care nursery at Yale-New Haven Hospital was modified to include shielding each premature infant's isolette, thereby decreasing the intensity of the nursery lights on an infant's eyes from a median light level of 55 foot-candles to 15 foot-candles. The effect of this reduction of light level on the incidence of retinopathy of prematurity in 161 premature infants was prospectively investigated. This group was then compared with a historic control group of 129 premature infants with similar characteristics who had been exposed to standard nursery lighting. There was no difference in the incidence and severity of retinopathy of prematurity between the two groups. PMID:2726352

  20. 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.

  1. 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.

  2. [Pharmacokinetic and clinical evaluations on ceftriaxone in neonates and premature infants].

    PubMed

    Shiro, H; Kusumoto, Y; Satoh, Y; Oikawa, T; Osano, M

    1988-03-01

    Ceftriaxone (CTRX) was clinically evaluated and its pharmacokinetics studied in neonates and premature infants, and the results obtained are summarized as follows. 1. Average blood levels of CTRX after intravenous administration of 10 mg/kg in 3 neonates with birth weights of 2,500 g or more were 45.32 mcg/ml at 15 minutes, 28.91 mcg/ml at 1 hour, 15.76 mcg/ml at 6 hours, and 16.28 mcg/ml at 12 hours, and the half-life was 9.93 hours. The half-life in a newly born premature infant (less than 1 day) was 28.90 hours, and in a premature infant 6 days old it was 12.90 hours. 2. Average blood levels after intravenous administration of 20 mg/kg to 2 neonates aged 0 and 3 days with birth weights of 2,500 g or more, were 129.7 mcg/ml at 15 minutes, 60.94 mcg/ml at 1 hour, 32.04 mcg/ml at 6 hours, and 24.23 mcg/ml at 12 hours, and the half-life was 8.95 hours. The half-life in a newly born premature infant (less than 1 day) was 20.70 hours. 3. Urinary recovery rates of CTRX in 12 hours after intravenous administration of 10 or 20 mg/kg to 6 neonates aged 0 to 3 days (including premature infants) ranged from 13.8 to 50.6%. 4. Clinical efficacies of CTRX were excellent or good in 3 of 4 neonates including infants suspected of having infections (efficacy rate: 75%). 5. As a side effect, diarrhea was noted in 1 case. PMID:3404644

  3. 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

  4. Importance of Close Follow-Up in the Fetus with Premature Atrial Contractions Accompanied by Atrial Septal Aneurysm: A Case Report

    PubMed Central

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

    2013-01-01

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

  5. 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...

  6. 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…

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

    PubMed Central

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  9. Effects of low humidity on small premature infants in servocontrol incubators. II. Increased severity of apnea.

    PubMed

    Belgaumkar, T K; Scott, K E

    1975-01-01

    Apneic spells were recorded in 8 of 19 premature infants nursed in high and low humidity alternately in servocontrol incubators. A significantly greater proportion of severe apnea occurred in low than in high humidity. It is postulated that this frequency and severity was due to the increased (as well as widely fluctuating) ambient temperature during low humidity.

  10. 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…

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

    PubMed Central

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

    2011-01-01

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

  12. 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. PMID:24313853

  13. 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

  14. Effects of sponge bathing on vagal tone and behavioural responses in premature infants.

    PubMed

    Lee, Hae-Kyung

    2002-07-01

    The purpose of this study was to evaluate the effects of sponge bathing on physiological (vagal tone, heart rate, heart period, oxygen saturation) and behavioural responses in newly born premature infants in the intensive care unit of a university hospital in South Korea. A convenience sample was taken of 40 infants who were between 27 and 36 weeks gestational age at birth and free of congenital defects. The infants' physiological parameters were recorded 10 min before, during and after bathing. To determine behavioural status, tools were modified from the instruments used in a previous study by Scafidi et al. (1990). Analysis of the results showed that the premature infants reacted to sponge bathing with decreases in vagal tone and heart period and increases in heart rate. Oxygen saturation did not demonstrate any remarkable alteration during bathing. Also, there were no significant differences in behavioural signs, motor activity and behavioural distress. Results of this study indicated that nurses in a neonatal intensive care unit should decide according to a premature infant's physiological state whether or not to give a sponge bath. PMID:12100647

  15. 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.

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

    PubMed

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

    2009-12-01

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

  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. Parenting the Premature Infant: Balancing Vulnerability and Quality of Life

    ERIC Educational Resources Information Center

    Eiser, C.; Eiser, J. R.; Mayhew, A. G.; Gibson, A. T.

    2005-01-01

    Background: Relationships between child quality of life (QOL), maternal well-being and parenting were explored in a questionnaire study. Method: Mothers of 126 full-term (FT) and 91 pre-term (PT) infants during the child's second year of life completed measures of their own and the child's quality of life and behavioural difficulties. We developed…

  19. Fucosyltransferase 2 non-secretor and low secretor status predicts severe outcomes in premature infants

    PubMed Central

    Morrow, Ardythe L.; Meinzen-Derr, Jareen; Huang, Pengwei; Schibler, Kurt R.; Cahill, Tanya; Keddache, Mehdi; Kallapur, Suhas G.; Newburg, David S.; Tabangin, Meredith; Warner, Barbara B.; Jiang, Xi

    2010-01-01

    Objective To investigate secretor gene fucosyltransferase2 (FUT2) polymorphism and secretor phenotype in relation to outcomes of prematurity. Study design Study infants were ≤32 weeks gestational age. Secretor genotype was determined from salivary DNA. Secretor phenotype was measured by H antigen, the carbohydrate produced by secretor gene enzymes, in saliva samples collected on day 9±5. The optimal predictive cut-point in salivary H values was identified by Classification and Regression Tree analysis. Study outcomes were death, necrotizing enterocolitis (NEC, Bell’s stage II/III), and confirmed sepsis. Results There were 410 study infants, 26 deaths, 30 cases of NEC, and 96 cases of sepsis. Analyzed by genotype, 13% of 95 non-secretors, 5% of 203 heterozygotes, and 2% of 96 infants who were secretor dominant died (p=0.01). Analyzed by phenotype, 15% of 135 infants with low secretor phenotype died, compared with 2% of 248 infants with high secretor phenotype (predictive value=76%, p<0.001). Low secretor phenotype was associated (P<.05) with NEC, and non-secretor genotype was associated (P=.05) with gram negative sepsis. Secretor status remained significant after controlling for multiple clinical factors. Conclusions Secretor genotype and phenotype may provide strong predictive biomarkers of adverse outcomes in premature infants. PMID:21256510

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

    PubMed

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

    2016-09-01

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

  1. 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

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

    PubMed

    MacDonald, Noni E; McDonald, Jane C

    2014-12-01

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

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

    PubMed

    MacDonald, Noni E; McDonald, Jane C

    2014-11-01

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

  4. [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.

  5. Nutritional follow-up of the breastfeeding premature infant after hospital discharge.

    PubMed

    Hall, R T

    2001-04-01

    In summary, fortification of human milk may be beneficial in preterm infants, particularly those born at less than 34 weeks' gestation or less than 1800 g birth weight, during and after initial hospitalization. This fortification after hospital discharge is more crucial for infants who cannot consume ad libitum quantities of breast milk, have poor growth, or have abnormalities in the biochemical screen of nutritional status. Although data indicate that in-hospital, short-term gains in growth and mineral status are achieved, information is fragmentary regarding the influence on long-term growth and neurodevelopmental outcomes of feeding supplemented human milk. Also, no data are available on outcomes when providing these mixtures to premature infants after hospital discharge. It is recommended that a nutritional survey be accomplished before and approximately 1 month after discharge and that fortification or supplementation be initiated if an infant is failing to achieve normal growth and biochemical measures of nutrition.

  6. Transient hypothyroidism in premature infants after short-term topical iodine exposure: an avoidable risk?

    PubMed

    Pinsker, Jordan E; McBayne, Krista; Edwards, Mary; Jensen, Kirk; Crudo, David F; Bauer, Andrew J

    2013-04-01

    Studies in preterm infants have shown that prolonged treatment with topical iodine (multiple doses, often over multiple days) can transiently suppress thyroid function. However, it is uncertain if topical iodine exposure for very short periods of time can cause significant changes in thyroid function. We report two cases of transient hypothyroidism in preterm infants after short-term exposure to topical iodine during surgical preparation, and review their clinical and laboratory findings before and after iodine exposure. We conclude that premature infants are at risk of developing transient hypothyroidism in response to a single, short-term exposure to topical iodine, even in iodine-sufficient geographical areas. We advise monitoring of thyroid function in these infants after iodine exposure, as treatment with levothyroxine may be needed for a limited duration to prevent the sequelae of untreated hypothyroidism. Consideration of using alternative cleansing agents is also advised.

  7. 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

  8. Role of antioxidant nutrients and lipid peroxidation in premature infants with respiratory distress syndrome and bronchopulmonary dysplasia.

    PubMed

    Falciglia, Horacio S; Johnson, J Robert; Sullivan, JoAnn; Hall, Charles F; Miller, Jeffery D; Riechmann, George C; Falciglia, Grace A

    2003-02-01

    The objective of this study was to determine if newborn premature infants with severe respiratory distress syndrome (RDS) who developed bronchopulmonary dysplasia (BPD) demonstrate, within the first 3 days of life, lower blood levels of antioxidants and higher urine levels of lipid peroxidation products than premature infants who recovered from RDS. Perinatal variables (gestational age, birth weight, and Apgar scores) and antioxidant indices in cord and in third day of life plasma and red blood cell (RBC) samples from healthy premature infants (n = 35), infants with RDS (n = 23) and infants with BPD (n = 23) were examined. Antioxidant indices included selenium, alpha-tocopherol, total and oxidized glutathione, glutathione peroxidase, superoxide dismutase, and urinary malondialdehyde. By inferential statistics, only the perinatal variables and cord plasma selenium distinguished healthy premature infants from premature infants with RDS or BPD. From perinatal variables and antioxidant indices we calculated: (1) cord to third-day-of-life variable differences, (2) variable-to-variable ratios, and (3) ratios of a difference for one variable to a difference for any second variable. Subset regression analysis yielded an equation (adjusted R2 = 0.8839) that correctly predicted infants who developed BPD 100% of the time. Predictor variables for BPD were gestational age, Apgar at 1 min, cord and third-day-of-life RBC selenium, cord total glutathione, cord and third-day-of-life glutathione peroxidase and nine different ratios involving Apgar scores, RBC selenium, total and oxidized glutathione, alpha-tocopherol, glutathione peroxidase, and superoxide dismutase. In this study, there was no relationship between lipid peroxidation and BPD. There was a higher rate of patent ductus arteriosus, congestive heart failure, and retinopathy of prematurity in infants with BPD. This study confirms that low plasma selenium and alpha-tocopherol levels in premature infants (< or = 30 weeks

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  11. Iron absorption and red blood cell incorporation in premature infants fed an iron-fortified infant formula.

    PubMed

    McDonald, M C; Abrams, S A; Schanler, R J

    1998-10-01

    This study was designed to identify differences in red blood cell (RBC) incorporation and iron absorption in premature infants between iron provided in a premature infant formula compared with iron provided as a supplement between feedings. We used a triple stable isotope technique in which 13 infants received 57Fe mixed with Enfamil Premature Formula on d 1 of the study, and 54Fe with a multivitamin supplement between meals on d 2. Two weeks later, blood was drawn for isotope analysis and 58Fe was given i.v. The percentage RBC incorporation of the 54Fe and 57Fe was calculated, and the percent absorption of these tracers was estimated by dividing by the percentage of 58Fe identified in RBCs 14 d after its infusion. We found a small, but significantly greater, percentage of RBC incorporation of the 54Fe given as a supplement compared with the 57Fe given in the formula (9.7 +/- 3.8% versus 7.8 +/- 3.1%, p = 0.02). The RBC 57Fe incorporation was closely correlated with the reticulocyte count (r = 0.80, p = 0.001), but not the serum ferritin or the Hb concentration. Approximately 68% of an i.v. dose of 58Fe was incorporated into RBCs. These findings indicate 1) iron is incorporated well into RBCs from preterm infant formula, with only a small increase in incorporation when given as a supplement, and 2) the reticulocyte count, but not the Hb concentration, is a good measure of RBC iron-incorporating capacity.

  12. Special Premie Oxygen Targeting (SPOT): a program to decrease the incidence of blindness in infants with retinopathy of prematurity.

    PubMed

    Coe, Kristi; Butler, Mandy; Reavis, Nicole; Klinepeter, Mary Ellen; Purkey, Connie; Oliver, Tonya; Starbuck, Alisa; Griffin, Jennifer; Wilmoth, Cathy; Block, Steven

    2006-01-01

    Infants born prematurely have a plethora of medical problems. Some have cerebral palsy, resulting in limited mobility, while others require oxygen, hearing aids, and/or glasses for medical problems. Most of these could have been prevented if preterm birth was avoided, but efforts to curb this have been slow. This article discusses how blindness can be prevented in infants born prematurely by accepting lower oxygen saturations when on oxygen in the intensive care nursery. PMID:16816603

  13. Taurine supplementation of a premature formula improves fat absorption in preterm infants.

    PubMed

    Galeano, N F; Darling, P; Lepage, G; Leroy, C; Collet, S; Giguère, R; Roy, C C

    1987-07-01

    The predominance of taurine (Tau) conjugated over glycine conjugated bile acids in infants fed human milk as opposed to those on formulas without added Tau could account for a more complete absorption of fat. Fifteen low birth weight infants were randomized to either Enfamil Premature or to Enfamil Premature added with 40 mumol/dl of Tau and compared to a third group made up of nine low birth weight infants fed their own mother's preterm milk. Formulas and human milk were fed according to tolerance and constituted the sole nutrition for 3 months. A metabolic study was carried out at 3 wk of age and control of growth was done periodically. Urinary Tau excretion (mumol/dl) was very low (p less than 0.001) in the group fed Enfamil Premature (0.3 +/- 0.1) when compared to the values obtained in infants supplemented with Tau (51.6 +/- 12.5) and in those on human milk (36.3 +/- 7.9). Infants supplemented with Tau (92.5 +/- 1.2) had a coefficient of fat absorption which was higher (p less than 0.05) than the unsupplemented group (87.5 +/- 7.9) and comparable to the human milk-fed group (91.6 +/- 1.4). The effect was more pronounced on the saturated fatty acids and varied inversely with their individual water solubility. There was no effect of Tau on nitrogen retention and growth was identical in the three groups. These data show that the addition of Tau to formula had no effect on growth but improved the absorption of fat especially saturated fatty acids which require higher concentrations of bile acids to form mixed micelles.

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

    PubMed Central

    Badiee, Zohreh; Vakiliamini, Mazyar; Mohammadizadeh, Majid

    2013-01-01

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

  15. Gastric motility in premature infants fed two different formulas.

    PubMed

    Hancock, P J; Bancalari, E

    1984-11-01

    The effect of two different formulas on gastric contractions was investigated in 10 preterm infants, of mean birth weight 1,149 g and mean gestational age 30.5 weeks, who were being advanced from a 20 calorie per ounce formula (Enfamil) to a 24 calorie per ounce formula (Similac Special Care 24). The neonates were fed by gravity with a feeding tube on a 2-h schedule. The orogastric tube was connected between feedings to a pressure transducer and recorder system upon which pressure waves reflecting gastric contractions were recorded. In the 1st h after feeding there were significantly fewer gastric contractions with 24 calorie than 20 calorie formula. The mean intensity of the gastric contractions per minute of contraction time was significantly less in the 1st h after feeding with the 24 calorie compared with the 20 calorie formula. In the 2nd h after feeding these values were similar. Gastric contractions are decreased with 24 calorie formula compared with 20 calorie formula during the 1st h after feeding. This difference in contractions may influence tolerance to different formulas.

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

    PubMed

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

    2016-09-01

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

  17. Comparison of the Effect of Two Human Milk Fortifiers on Clinical Outcomes in Premature Infants

    PubMed Central

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

    2014-01-01

    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

  18. 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

    2014-01-01

    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

  19. 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…

  20. 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…

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

    PubMed

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

    2010-12-01

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

  2. [Impact of herpesvirus infections on the level of proinflammatory cytokines in premature neonatal infants].

    PubMed

    Klimova, R R; Malinovskaia, V V; Guseva, T S; Parshina, O V; Getiia, E G; Degtiareva, M V; Soldatova, I G; Volodin, N N; Gadzhieva, Z S; Tsibizov, A S; Kushch, A A

    2011-01-01

    The aim of this study was to estimate the frequency of HSV and/or CMV among the pathogens causing intrauterine infections (IUI) and to investigate their impact on the level of proinflammatory cytokines in premature neonatal infants. Examinations were performed in 3 neonatal groups: 1) premature neonates with clinical manifestations of IUI; 2) those without IUI; 3) full-term newborns. In group 1, viral (HSV and/or CMV) and bacterial infections were detectable with the same frequency. Quantitative analysis of plasma IL-6 and IL-8 levels and the induced production of these cytokines by blood cells in vitro showed that in Group 1 neonates, IL-6 and IL-8 concentrations were substantially higher and the induced production of these cytokines was lowerthan those in Group 3. The detection of HSV and/or CMV markers in premature newborn infants was attended by a statistically significant rise in plasma IL-6 levels; the identification of the opportunistic bacterial microflora correlated with the higher concentration of IL-8. In Group 1, wiferon produced an immunomodulatory effect, by lowering IL-8 concentrations to the level observed in Group 3. PMID:21899065

  3. Pharmacokinetics and clinical efficacy of indomethacin in premature infants with patent ductus arteriosus.

    PubMed

    Regazzi, M B; Rondanelli, R; Vidale, E; Chirico, G; Rondini, G; Chiara, A; Piccolo, A

    1984-01-01

    Despite a considerable amount of investigation, controversy continues concerning the use of indomethacin in inducing the closure of patent ductus arteriosus. This controversy may be attributable to differences in dosage, route of administration, postnatal age at treatment and the variable pharmacokinetics of the drug in premature infants. The pharmacokinetics and clinical efficacy of i.v. administered indomethacin in five premature infants with PDA were evaluated. There was considerable intersubject variability in the half life of elimination (63.1 +/- 38 h). This variability was mainly due to clearance (0.0086 +/- 0.0069 l/h/kg) rather than to distribution volume variability (0.54 +/- 0.27 l/kg). A reduction of half life was observed after the second dose, probably due to a maturation process. A permanent closure of the ductus was obtained in two patients after the first dose and in two patients after the second dose. The side-effects observed in our infants were transient and no long-term complication was attributable to this drug.

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

    PubMed

    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.

  5. 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.

  6. Tension pneumothorax at anaesthetic induction in an ex-premature infant with bronchopulmonary dysplasia

    PubMed Central

    Freed, Chayim; Guha, Ranjan

    2012-01-01

    ME, a 12-week-old premature infant with a history of complicated ventilatory support at birth, was referred to as a large tertiary centre for urgent retinal laser photocoagulation for retinopathy of prematurity. Following routine induction by a consultant paediatric anaesthetist, immediate ventilation difficulties were encountered, associated with a distended abdomen. Rapid assessment and escalation of the situation occurred, including assistance from several consultants. ME was diagnosed as having a pneumothorax. Rapid intervention, including needle decompression and insertion of a chest drain stabilised the patient. The procedure was cancelled, and the patient returned to intensive care. Over the next few days the patient gradually improved, and was gradually stepped down. The patient continued to improve, successfully overcoming the pneumothorax, pneumonia and insertion of a ventriculoperitoneal shunt, and eventually was discharged back to the referring hospital. PMID:22967679

  7. The relationship between attention deficit hyperactivity disorder and premature infants in Taiwanese: a case control study

    PubMed Central

    2012-01-01

    Background Preterm survivors from the neonatal intensive care unit (NICU) are considered to be at risk for some neurobehavioral disorders such as attention-deficit/hyperactivity disorder (ADHD). The current study aimed to explore the relationship between ADHD and premature infants in Taiwan. Methods A total of 195 children (157 males and 38 females) diagnosed with ADHD based on DSM-IV and aged between 6 to 12 years and a control group of 212 (164 males, 48 females) age- and sex-matched healthy children were enrolled. The ADHD-Rating scale and CGI severity were performed by child psychiatrists. Demographic data of the children, including birth history, perinatal neurological and respiratory problems were collected to facilitate the investigation of whether a correlation exists between ADHD and prematurity. Results The ADHD group had a significantly higher rate of prematurity and significantly higher rate of low birth body weight (defined as <2500 g) than the control group (both P = 0.003). Pearson correlation showed a significantly negative correlation between gestational age and ADHD-RS score, inattentive score, hyperactivity and CGI-S score (P = 0.004, 0.013, 0.015 and 0.002, respectively). However, only a CGI-S score (P = 0.018) showed a significantly correlation between low birth weight and ADHD. Conclusions Premature infants have significantly more severe symptoms of ADHD at school age and they were highly correlated. Further study is necessary to determine the main effect and pathogenesis of moderate as well as extreme preterm birth on the development of ADHD. PMID:22824325

  8. Effects of low humidity on small premature infants in servocontrol incubators. I. Decrease in rectal temperature.

    PubMed

    Belgaumkar, T K; Scott, K

    1975-01-01

    19 small premature infants in servocontrol incubators, whose abdominal skin temperature was 36.0 +/- 0.3 degrees C, were subjected to alternate high- and low-humidity environments. With low humidity, rectal temperature dropped significantly below abdominal skin temperature. Skin was the predominant site of evaporative heat loss. The temperature was lower on naked skin than on an area covered by adhesive tape. Thus, servocontrol with low humidity increases evaporative heat loss and engenders a cycle of events that results in paradoxical body temperature decrease as the incubator temperature increases.

  9. Development of the premature infant nose throat-model (PrINT-Model): an upper airway replica of a premature neonate for the study of aerosol delivery.

    PubMed

    Minocchieri, Stefan; Burren, Juerg Martin; Bachmann, Marc Aurel; Stern, Georgette; Wildhaber, Johannes; Buob, Stefan; Schindel, Ralf; Kraemer, Richard; Frey, Urs Peter; Nelle, Mathias

    2008-08-01

    Clinical efficacy of aerosol therapy in premature newborns depends on the efficiency of delivery of aerosolized drug to the bronchial tree. To study the influence of various anatomical, physical, and physiological factors on aerosol delivery in preterm newborns, it is crucial to have appropriate in vitro models, which are currently not available. We therefore constructed the premature infant nose throat-model (PrINT-Model), an upper airway model corresponding to a premature infant of 32-wk gestational age by three-dimensional (3D) reconstruction of a three-planar magnetic resonance imaging scan and subsequent 3D-printing. Validation was realized by visual comparison and comparison of total airway volume. To study the feasibility of measuring aerosol deposition, budesonide was aerosolized through the cast and lung dose was expressed as percentage of nominal dose. The airway volumes of the initial magnetic resonance imaging and validation computed tomography scan showed a relative deviation of 0.94%. Lung dose at low flow (1 L/min) was 61.84% and 9.00% at high flow (10 L/min), p < 0.0001. 3D-reconstruction provided an anatomically accurate surrogate of the upper airways of a 32-wk-old premature infant, making the model suitable for future in vitro testing.

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

    PubMed

    Howe, Edmund G

    2015-01-01

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

  11. Hybrid stenting of aortic coarctation in very low birth weight premature infant.

    PubMed

    Cools, Bjorn; Meyns, Bart; Gewillig, Marc

    2013-03-01

    A very low birth weight infant with severe aortic coarctation developed progressive left ventricular dysfunction and pulmonary overflow with hemorrhage, while receiving prostaglandins. To avoid morbidity from conventional surgery or percutaneous intervention, a two-step strategy was performed at a weight of 970 g. First vascular access was obtained through sternotomy: a 3/8 mm coronary stent was deployed through a 4 French sheath in the ascending aorta; the arterial duct was clipped. At the age of 5 months, the stent was removed and the aortic arch reconstructed with an end-to-end anastomosis through lateral thoracotomy. This strategy was not associated with morbidity typical for premature infants with congenital heart disease.

  12. Cisapride: a review of the evidence supporting its use in premature infants with feeding intolerance.

    PubMed

    Premji, S S; Wilson, J; Paes, B; Gray, S

    1997-10-01

    A systematic computerized search of all databases was performed to review the scientific evidence in support of the efficacy of cisapride in reducing feeding intolerance in premature infants. Reference lists from these articles were used to identify relevant scientific literature to address important aspects of the use of cisapride. Three open prospective, uncontrolled studies were found. All studies reported improved clinical outcomes as evidenced by decreased gastric residuals, decreased incidence of vomiting, increased feeding volume, decrease in all reflux parameters measured, and increased weight gain. These observational studies reflect the current state of knowledge and have important research and clinical implications because of the profound effects of feeding intolerance on infant growth and development and on length of stay within NICUs.

  13. Enhancing maternal interactive behavior and child social competence in low birth weight, premature infants.

    PubMed

    Spiker, D; Ferguson, J; Brooks-Gunn, J

    1993-06-01

    Effects of a comprehensive early intervention program for low birth weight, premature infants--the Infant Health and Development Program--on mother-child interaction were examined at 30 months (N = 683). Small significant positive effects were found: Intervention mothers had higher ratings on quality of assistance; intervention children had higher ratings on persistence and enthusiasm and on an overall child rating of competence and involvement and lower ratings on percentage of time off-task; intervention dyads were rated as more synchronous. Of a set of initial status variables indexing biological and environmental risk, only 2 treatment interactions were found. Intervention group black children had higher ratings on enthusiasm and lower percentage of time off-task. Independent of treatment, maternal ethnicity and education were significant predictors of maternal and dyadic ratings, while ethnicity and birth weight predicted child ratings. Implications for early intervention and center-based care are discussed.

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

    PubMed

    Meyer, J; Sive, A; Jacobs, P

    1992-07-01

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

  15. Resting oxygen consumption of premature infants covered with a plastic thermal blanket.

    PubMed

    Darnall, R A; Ariagno, R L

    1979-04-01

    Premature infants in single-wall incubators covered with "thermal blankets" made of plastic packing material have large reductions in insensible water loss (IWL) compared with naked infants. We postulated that such reductions inevaporative heat loss would not result in decreases in caloric expenditure if body temperature were maintained by a servocontrolled heat source. Using an open-circuit technique, we measured oxygen consumption (VO2), carbon dioxide production (VCO2), heart rate (HR), respiratory rate (RR), and abdominal skin (Tabd), cheek, thigh, rectal, incubator air, wall, and room air temperatures in ten infants less than 37 weeks gestational age and from 2 to 24 days of age both naked and covered with a plastic thermal blanket. Tabd temperature was maintained between 36.2 and 36.8 C and rectal temperature between 36.8 and 37.2 C in each environment by manual or automatic servocontrol. A "resting state" was defined by using a combination of subjective and objective criteria. The mean values of VO2 during the "resting state" were 7.31 and 7.59 cc/kg of body weight per minute for naked and covered infants, respectively. There were no significant differences between mean values of VCO2, respiratory quotient, HR, RR, abdominal, cheek, thigh, or rectal temperatures in the two environments. Operant temperatures averaged 0.5 C lower when the infants were covered. These data support the hypothesis that decreases in insensible water loss do not necessarily imply reductions in caloric requirements in infants where Tabd is maintained by servocontrol. PMID:440864

  16. Domperidone for Treatment of Low Milk Supply in Breast Pump-Dependent Mothers of Hospitalized Premature Infants: A Clinical Protocol.

    PubMed

    Haase, Barbara; Taylor, Sarah N; Mauldin, Jill; Johnson, Teresa S; Wagner, Carol L

    2016-05-01

    Mothers of hospitalized premature infants who choose to provide breast milk are at increased risk of an inadequate breast milk supply. When nonpharmacologic interventions to increase milk supply fail, clinicians are faced with limited options. There is no current evidence to support the use of herbal galactogogues in this population and a black box warning for metoclopramide for potential serious side effects. Thus, domperidone was the only known, effective option for treatment of low milk supply in this population. With a thorough review of the literature on domperidone and coordination with the obstetrical, neonatal, lactation, and pharmacology teams, a domperidone treatment protocol for mothers of hospitalized premature infants with insufficient milk supply was developed at our institution and is presented in this article. A comprehensive understanding of domperidone for use as a galactogogue with a standard treatment protocol will facilitate safer prescribing practices and minimize potential adverse reactions in mothers and their hospitalized premature infants. PMID:26905341

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

    PubMed

    Fujioka, Tao; Nii, Masaki; Tanaka, Yasuhiko

    2016-06-01

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

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

    PubMed Central

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

    2015-01-01

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

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. Measurement of true calcium absorption in premature infants using intravenous 46Ca and oral 44Ca.

    PubMed

    Hillman, L S; Tack, E; Covell, D G; Vieira, N E; Yergey, A L

    1988-06-01

    We have developed a method for measuring true fractional calcium absorption (alpha) in premature infants using two stable isotopes of calcium and tested it in seven studies in seven infants (birth weight 1543 +/- 65 g, gestation 32.8 +/- 7 wk). A total of 7.5 micrograms/kg 46Ca was given as a single intravenous bolus. Immediately thereafter 1.25 mg/kg of 44Ca was given in a single gavage feeding of standard infant formula (Enfamil). A metabolic isolette was used to obtain 4-h collections of urine for 24 h total. 46Ca and 44Ca were measured in urine by thermal ionization mass spectroscopy and expressed as the ratio to naturally occurring 48Ca. The differences in the 46Ca/48Ca and 44Ca/48Ca ratios from natural levels (delta % excess 46Ca and delta % excess 44Ca) were calculated. Percent absorption (alpha) equals a constant times cumulative delta % excess 44Ca/delta % excess 46Ca. The calculation of alpha is independent of urine volume or concentration. The delta % excess 46Ca, showed the expected multiexponential decline as a function of time, and delta % excess 44Ca usually peaked during a 4- to 8-h urine collection. Calculations of alpha using increasingly long sampling times showed that a plateau had been reached by 12 h. alpha values calculated after 16-24 h in the seven infants at 2 wk of age were 41, 48, 45, 46, 25, 55, and 51%. Repeat studies at 3 wk of age were 46, 60, and 54%. These values are somewhat higher than net percent calcium absorption values reported for standard formula and thus appear very appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. 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

  6. Changes in Oxygenation Levels Precede Changes in Amplitude of the EEG in Premature Infants.

    PubMed

    Caicedo, Alexander; Thewissen, Liesbeth; Smits, Anne; Naulaers, Gunnar; Allegaert, Karel; Van Huffel, Sabine

    2016-01-01

    Brain function is supported by an appropriate balance between the metabolic demand and the supply of nutrients and oxygen. However, the physiological principles behind the regulation of brain metabolism and demand in premature infants are unknown. Some studies found that changes in hemodynamic variables in this population precede changes in EEG activity; however, these studies only used descriptive statistics. This paper describes the relationship between changes in cerebral oxygenation, assessed by means of near-infrared spectroscopy (NIRS), and changes in EEG, using mathematical methods taken from information dynamics. In a cohort of 35 neonates subjected to sedation by propofol, we quantified the direction of information transfer between brain oxygenation and EEG. The results obtained indicate that, as reported in other studies, changes in NIRS are likely to precede changes in EEG activity. PMID:27526136

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  9. 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

  10. 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

  11. 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

  12. The relationship between consanguineous marriage and death in fetus and infants

    PubMed Central

    Mohammadi, Majid Mehr; Hooman, Heidar Ali; Afrooz, Gholam Ali; Daramadi, Parviz Sharifi

    2012-01-01

    Background: Given the high prevalence of consanguineous marriages in rural and urban areas of Iran, the aim of this study was to identify its role in increasing fetal and infant deaths. Materials ans Methods: This was a cross-sectional study in which 494 mothers with more than one exceptional child (mentally retarded and physically-dynamically disabled) or with normal children were selected based on multi-stage random sampling method. Data was gathered using the features of parents with more than one exceptional child questionnaire. The validity and reliability of this questionnaire was acceptable. Hierarchical log-linear method was used for statistical analysis. Results: Consanguineous marriage significantly increased the number of births of exceptional children. Moreover, there was a significant relation between the history of fetal/infant death and belonging to the group. There was a significant relation between consanguineous marriage and the history of fetal/infant death which means consanguineous marriage increased the prevalence of fetal/infant death in parents with exceptional children rather than in parents with normal children. Conclusions: The rate of fetal/infant death in exceptional births of consanguineous marriages was higher than that of non-consanguineous marriages. PMID:23626609

  13. Optimizing protein intake in premature infants: a neonatal quality improvement project.

    PubMed

    Strahm, Alyse; Mohsini, Khawar; Nwankwo, Martin; Turner, Barbara

    2013-12-01

    This article examines a quality-improvement project to reduce clinical practice variation and measure growth outcomes by standardizing the process for the provision of protein intake for premature infants weighing 1250 g or less. Eighteen infants with a birth weight of 1250 g or less and gestational age of 32 weeks or less born between June and October 2010 were compared with 15 historical controls of the same birth weight and gestation born between January and May 2010 using a prospective cohort design. The prospective group followed a newly implemented standardized protein nutritional guideline. Independent t-tests and repeated measures of analyses of variance (between- and within-subjects) were performed on the difference between the intended and actual protein intakes between the 2 groups. A multivariate analysis of variance computed the difference between the birth and discharge gains. The prospective group showed statistically significant differences between the amount of intended and actual protein intakes (P = .023) when compared with historical controls. Growth outcomes were not significantly different (P = .67) between the 2 groups. Length of stay was not statistically significantly shorter (P = .06) in the prospective group. Reduction in clinical practice variation was associated with the implementation of a protein nutritional guideline. There was no statistical support for an improvement in the growth outcomes or reduction in length of stay. PMID:24300966

  14. Is treatment futile for an extremely premature infant with giant omphalocele?

    PubMed

    Feltman, Dalia; Stokes, Theophil; Kett, Jennifer; Lantos, John D

    2014-01-01

    Doctors have no ethical obligation to provide futile treatment. This has been true since the time of Hippocrates who warned physicians not to treat patients who were "overmastered by their disease." This principle remains valid today but, as the Society for Critical Care Medicine notes, it is difficult to identify treatment as absolutely futile in all but a few clinical situations. Far more common, they note, are "treatments that are extremely unlikely to be beneficial, are extremely costly, or are of uncertain benefit." These, they say, "may be considered inappropriate and hence inadvisable, but should not be labeled futile." So what should doctors do when they have a case that seems close to the futility threshold but does not, perhaps, quite cross it? In such cases, is it appropriate to make unilateral decisions to withhold life-sustaining treatment even if the family objects? Or should treatment be provided knowing that it might cause pain and suffering to an infant with no likelihood of benefit? To address these questions, we present a case of an extremely premature infant with a giant omphalocele and ask 3 neonatologists, Dr Dalia Feltman of Evanston Hospital, Dr Theophil Stokes of the Walter Reed Medical Center, and Dr Jennifer Kett, a neonatologist and fellow in bioethics at Seattle Children's Hospital, to comment. PMID:24366996

  15. Impact of routine fluconazole prophylaxis for premature infants with birth weights of less than 1250 grams in a developing country.

    PubMed

    Rueda, Kathia; Moreno, Maria Teresa; Espinosa, Manuel; Sáez-Llorens, Xavier

    2010-11-01

    Systemic fungal infections are associated with substantial case-morbidity and fatality rates in premature infants. Considerable evidence indicates that prophylaxis with fluconazole given to premature infants reduces the risk of invasive fungal infection. There is scant information from developing countries. A comparative study of 2 years, one with fluconazole prophylaxis and the other without was conducted in all premature babies weighing less than 1250 g at birth. Fluconazole was administered in 3 mg/kg doses, given every 48 hours, starting on day 3 of life, for a period of 6 weeks. Documented systemic Candida infection was the primary outcome. A total of 271 and 252 patients, respectively, were evaluated during the year before (control group) and after (treatment group) routine fluconazole prophylaxis. The control group developed 21 Candida infections (7.7%) while the treatment group had only 3 Candida infections (1.1%). This difference was statistically significant (P = 0.007; odds ratio, 0.13; 95% confidence interval, 0.03-0.47). The number needed to treat to prevent one case was 7. Although case-fatality rates for documented Candida infection were similar in both periods (76% vs. 67%), fewer deaths attributed to the fungal infection were noted in the prophylaxis year (6% vs. 1%, P = 0.003). Routine fluconazole prophylaxis given to premature infants of less than 1250 g at birth is associated with a significant impact on frequency of documented systemic Candida infections. PMID:20571460

  16. L-carnitine-supplemented parenteral nutrition improves fat metabolism but fails to support compensatory growth in premature Korean infants.

    PubMed

    Seong, So-Hui; Cho, Soo-Chul; Park, Yongsoon; Cha, Youn-Soo

    2010-04-01

    We have previously shown that pregnant Korean mothers often have especially poor carnitine status, which may be responsible for the suboptimal carnitine levels of newborn Korean infants. This study tested the hypothesis that carnitine obtained from premature infant formula alone is adequate in sustaining optimal lipid metabolism and growth in premature infants. Accordingly, we investigated the effects of parenteral carnitine supplementation on carnitine status, growth parameters, and lipid metabolism in premature infants by measuring serum lipid profiles, carnitine and beta-hydroxybutyrate concentrations, and body weight, size, and length. Twenty-five low-birth weight Korean infants were randomly assigned to control (LCNS, n = 12) or L-carnitine-supplemented (10 mg/[kg d], LCS, n = 13) groups. On day 9, the triacylglycerol concentration was lower in the LCS group; but the high-density lipoprotein cholesterol concentration and free, acyl, and total carnitine and beta-hydroxybutyrate were significantly increased compared with the LCNS group. The ratio of acyl carnitine to free carnitine was significantly lower on day 5 in the LCS compared with the LCNS group. Body weight, height, Apgar score (1 and 5 minute), head circumference, and chest circumference were recorded on day 0; and body weight was measured again on days 5 and 9. Infant formula intake was recorded every day. There was no significant difference in body weight or growth parameters between the groups from days 0 to 9.Therefore, we concluded that, in low-birth weight infants, the addition of 10 mg/(kg d) supplemental carnitine significantly improves lipid profiles and serum carnitine level but does not enhance growth. PMID:20534325

  17. 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

  18. Pulmonary infantile hemangioma presenting as a mass in a premature male infant: a case report focusing on pathological features.

    PubMed

    Siaghani, Parwiz J; Chavez, Claire; Anselmo, Dean M; Shane, Lisa

    2015-01-01

    Infantile hemangiomas are the most common benign neoplasm of infancy, with most occurring in the head and neck region. Predisposing factors include prematurity, low birth weight, multiple gestations, advanced maternal age, and chorionic villous sampling. In addition, white women, particularly those with a family history, are also at a higher risk. However, pulmonary infantile hemangiomas are exceedingly rare, with only a few case reports in the literature. Infantile hemangiomas should be considered in the differential diagnosis of a pulmonary mass in the early pediatric population. We present a case of pulmonary infantile hemangioma in a premature male infant successfully managed by surgical excision, with an emphasis on the pathogenesis and histologic features.

  19. 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.

  20. The premature breech: caesarean section or trial of labour?

    PubMed Central

    Anderson, G; Strong, C

    1988-01-01

    Obstetricians face difficult decisions when the interests of fetus and mother conflict. An example is the problem of choosing the delivery method when labour begins prematurely and the fetus is breech. Vaginal delivery involves risks for the breech fetus of brain damage or death caused by umbilical cord compression and head entrapment. Caesarean section might avoid these dangers but involves risks for the mother, including infection, haemorrhage and even death in a small percentage of cases. If a caesarean section is performed the infant might die anyway, due to complications of prematurity. Thus, decisions about delivery method involve balancing the risks to mother and fetus. Uncertainty about the frequency of fetal injuries in vaginal breech deliveries adds to the difficulty of these decisions. PMID:3280800

  1. Lower respiratory tract illness and RSV prophylaxis in very premature infants

    PubMed Central

    Lacaze-Masmonteil, T; Truffert, P; Pinquier, D; Daoud, P; Goldfarb, G; Vicaut, E; Fauroux, B

    2004-01-01

    Aims: To determine the frequency of and the risk factors for readmissions for any lower respiratory tract illness (LRTI) and for respiratory syncytial virus (RSV) documented LRTI in children born very prematurely who had or had not received RSV prophylaxis. Methods: Multicentre prospective longitudinal cohort study of 2813 infants, born between April 2000 and December 2000 at less than 33 weeks of gestational age, and followed until the end of the epidemic season. Results: Among the 2256 children who had no bronchopulmonary dysplasia at 36 weeks of postmenstrual age and were not submitted to RSV prophylaxis, 27.4% were readmitted at least once for any reason during the epidemic season; 15.1% and 7.2% were readmitted at least once for any LRTI and RSV related LRTI, respectively. Children born at less than 31 weeks' gestation, having an intrauterine growth restriction, or living in a single mother family were at a significantly higher risk of readmission for LRTI in general as well as for RSV related LRTI. Of the 376 children submitted to prophylaxis, 28.2% were readmitted at least once for any LRTI and 6.1% for RSV related LRTI. Conclusion: One out of four children who had received no prophylaxis, was born very prematurely, and was without bronchopulmonary dysplasia at 36 weeks of postmenstrual age, was readmitted at least once for any reason. Roughly 50% and 20% of these readmissions were related to a LRTI and an RSV infection, respectively. Further epidemiological studies are warranted to assess the aetiology and impact of other respiratory pathogens on post-discharge readmission and respiratory morbidity in this population. PMID:15155404

  2. Skin-to-Skin contact (Kangaroo care) promotes self-regulation in premature infants: sleep-wake cyclicity, arousal modulation, and sustained exploration.

    PubMed

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

    2002-03-01

    The effect of mother-infant skin-to-skin contact (kangaroo care, or KC) on self-regulatory processes of premature infants was studied. Seventy-three infants who received KC were compared with 73 infants matched for birth weight, gestational age, medical risk, and family demographics. State organization was measured in 10-s epochs over 4 hr before KC and again at term. No differences between KC infants and controls were found before KC. At term, KC infants showed more mature state distribution and more organized sleep-wake cyclicity. At 3 months, KC infants had higher thresholds to negative emotionality and more efficient arousal modulation while attending to increasingly complex stimuli. At 6 months, longer duration of and shorter latencies to mother-infant shared attention and infant sustained exploration in a toy session were found for KC infants. The results underscore the importance of maternal body contact for infants' physiological, emotional, and cognitive regulatory capacities. PMID:11881756

  3. ["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…

  4. Normal EEG of premature infants born between 24 and 30 weeks gestational age: terminology, definitions and maturation aspects.

    PubMed

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

    2007-01-01

    This article presents normal EEG characteristics and their maturational pattern in premature infants of 24-30 weeks gestational age. Although the very premature infants with a normal outcome are not that numerous, their normal EEG pattern should be known, as EEG constitutes a basis for neurological prognosis. Background activity is first discontinuous but the discontinuity gradually decreases and the activity is completely continuous at 30 weeks of age, during active sleep. At the same time, interburst intervals become shorter so that the proportion of time without EEG activity decreases. Based on EEG activity and eyes movements, a rough sleep state differentiation appears as early as 25 weeks of gestational age and is complete at 30 weeks. The main EEG figures are high-voltage delta waves, whose frequency is slower and amplitude higher in younger infants. Temporal delta waves occur in sequences and are characteristic of the very premature infant; they progressively become smaller and less numerous and disappear around 27-28 weeks. In contrast, occipital delta waves remain numerous; they are of high voltage and usually bilaterally superimposed with fast rhythms. Both types of frontal delta waves that are seen in 24-27 weeks premature babies disappear with maturation. Bursts of synchronized delta waves, which are less numerous than localized delta waves, also disappear before 28 weeks of gestational age. Finally, diffuse theta bursts which are mainly recorded at 26-27 weeks, progressively focus on temporal areas with maturation. At 30 weeks, they are observed on temporal areas, mainly during slow-wave sleep.

  5. Premature Infant Swallowing: Patterns of Tongue-Soft Palate Coordination Based Upon Videofluoroscopy

    PubMed Central

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

    2009-01-01

    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. PMID:20181397

  6. The instrumented fetal sheep as a model of cerebral white matter injury in the premature infant.

    PubMed

    Back, Stephen A; Riddle, Art; Dean, Justin; Hohimer, A Roger

    2012-04-01

    Despite advances in neonatal intensive care, survivors of premature birth remain highly susceptible to unique patterns of developmental brain injury that manifest as cerebral palsy and cognitive-learning disabilities. The developing brain is particularly susceptible to cerebral white matter injury related to hypoxia-ischemia. Cerebral white matter development in fetal sheep shares many anatomical and physiological similarities with humans. Thus, the fetal sheep has provided unique experimental access to the complex pathophysiological processes that contribute to injury to the human brain during successive periods in development. Recent refinements have resulted in models that replicate major features of acute and chronic human cerebral injury and have provided access to complex clinically relevant studies of cerebral blood flow and neuroimaging that are not feasible in smaller laboratory animals. Here, we focus on emerging insights and methodologies from studies in fetal sheep that have begun to define cellular and vascular factors that contribute to white matter injury. Recent advances include spatially defined measurements of cerebral blood flow in utero, the definition of cellular maturational factors that define the topography of injury and the application of high-field magnetic resonance imaging to define novel neuroimaging signatures for specific types of chronic white matter injury. Despite the higher costs and technical challenges of instrumented preterm fetal sheep models, they provide powerful access to clinically relevant studies that provide a more integrated analysis of the spectrum of insults that appear to contribute to cerebral injury in human preterm infants.

  7. 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

  8. 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

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

    PubMed

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

    2016-01-01

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

  10. Inhaled Nitric Oxide Increases Urinary Nitric Oxide Metabolites and Cyclic Guanosine Monophosphate in Premature Infants: Relationship to Pulmonary Outcome

    PubMed Central

    Ballard, Philip L.; Keller, Roberta L.; Black, Dennis M.; Durand, David J.; Merrill, Jeffrey D.; Eichenwald, Eric C.; Truog, William E.; Mammel, Mark C.; Steinhorn, Robin; Ryan, Rita M.; Courtney, Sherry E.; Horneman, Hart; Ballard, Roberta A.

    2016-01-01

    Objective Inhaled nitric oxide (iNO) has been tested to prevent bronchopulmonary dysplasia (BPD) in premature infants, however, the role of cyclic guanosine monophosphate (cGMP) is not known. We hypothesized that levels of NO metabolites (NOx) and cGMP in urine, as a noninvasive source for biospecimen collection, would reflect the dose of iNO and relate to pulmonary outcome. Study Design Studies were performed on 125 infants who required mechanical ventilation at 7 to 14 days and received 24 days of iNO at 20–2 ppm. A control group of 19 infants did not receive iNO. Results In NO-treated infants there was a dose-dependent increase of both NOx and cGMP per creatinine (maximal 3.1- and 2-fold, respectively, at 10–20 ppm iNO) compared with off iNO. NOx and cGMP concentrations at both 2 ppm and off iNO were inversely related to severity of lung disease during the 1st month, and the NOx levels were lower in infants who died or developed BPD at term. NOx was higher in Caucasian compared with other infants at all iNO doses. Conclusion Urinary NOx and cGMP are biomarkers of endogenous NO production and lung uptake of iNO, and some levels reflect the severity of lung disease. These results support a role of the NO–cGMP pathway in lung development. PMID:24968129

  11. 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

  12. 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.

  13. Risk and clinical course of retinopathy of prematurity in 78 infants of gestational age 22–25 weeks

    PubMed Central

    Miller, Marijean M.; Revenis, Mary E.; Lai, Michael M.; Meleth, Annal D.; Jeffress, Elaine S.; Carrera, Ana; Cheng, Yao I.; Sill, Ann M.; McCarter, Robert

    2014-01-01

    Purpose To characterize the retinopathy of prematurity (ROP) and survival of infants born at gestational age (GA) of 22–25 weeks. Methods This study was a comparative case series for the total set of 78 infants ≤25 GA screened for ROP at a level IV NICU during a 21-month period. Data are presented on infants screened for ROP from 6 weeks after birth for 22 and 23 weeks’ GA infants and from 5 weeks after birth for 24 and 25 weeks’ GA. Accounting for the competing risk of mortality, we implemented Cox CR regression models to assess birth weight, GA, and admission diagnosis as potential risk factors for the following time to event outcomes: type 1 disease, aggressive posterior ROP (AP-ROP), plus disease, first presentation of ROP, and worst ROP observed. Results Risk of laser treatment (subhazard ratio [SHR] = 0.56, P = 0.007) and of plus disease (SHR = 0.49, P = 0.001) was increased among those born at lower GA. Twenty infants required laser for type 1 disease at median postmenstrual age (PMA) of 35.8 weeks (range, 33.0–42.7); infants with AP-ROP had laser at PMA of 34.5 weeks (range, 33.0–36.9), 2 weeks earlier than infants without AP-ROP at PMA 36.5 weeks (range, 33.9–42.7). The cumulative probability of receiving laser therapy approached 46% (22 or 23 weeks’ GA), 30% (24 weeks’ GA), and 18% (25 weeks’ GA). Conclusions This study confirms the 2013 screening guidelines appear to be appropriate for infants of 22 and 23 weeks’ GA when ROP screening begins at PMA 31 weeks. PMID:24924282

  14. 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.

  15. Longitudinal Analysis of the Premature Infant Intestinal Microbiome Prior to Necrotizing Enterocolitis: A Case-Control Study

    PubMed Central

    Zhou, Yanjiao; Shan, Gururaj; Sodergren, Erica; Weinstock, George; Walker, W. Allan; Gregory, Katherine E.

    2015-01-01

    Necrotizing enterocolitis (NEC) is an inflammatory disease of the newborn bowel, primarily affecting premature infants. Early intestinal colonization has been implicated in the pathogenesis of NEC. The objective of this prospective case-control study was to evaluate differences in the intestinal microbiota between infants who developed NEC and unaffected controls prior to disease onset. We conducted longitudinal analysis of the 16S rRNA genes of 312 samples obtained from 12 NEC cases and 26 age-matched controls with a median frequency of 7 samples per subject and median sampling interval of 3 days. We found that the microbiome undergoes dynamic development during the first two months of life with day of life being the major factor contributing to the colonization process. Depending on when the infant was diagnosed with NEC (i.e. early vs. late onset), the pattern of microbial progression was different for cases and controls. The difference in the microbiota was most overt in early onset NEC cases and controls. In proximity to NEC onset, the abundances of Clostridium sensu stricto from Clostridia class were significantly higher in early onset NEC subjects comparing to controls. In late onset NEC, Escherichia/Shigella among Gammaproteobacteria, showed an increasing pattern prior to disease onset, and was significantly higher in cases than controls six days before NEC onset. Cronobacter from Gammaproteobacteria was also significantly higher in late onset NEC cases than controls 1-3 days prior to NEC onset. Thus, the specific infectious agent associated with NEC may vary by the age of infant at disease onset. We found that intravenously administered antibiotics may have an impact on the microbial diversity present in fecal material. Longitudinal analysis at multiple time points was an important strategy utilized in this study, allowing us to appreciate the dynamics of the premature infant intestinal microbiome while approaching NEC at various points. PMID:25741698

  16. 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.

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

    PubMed

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

    2016-07-01

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

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

    PubMed

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

    2015-10-01

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

  19. 'They have to show that they can make it': vitality as a criterion for the prognosis of premature infants.

    PubMed

    Brinchmann, B S

    2000-03-01

    In this article, the vitality of premature infants will be described and discussed. Vitality was one of the main factors in a grounded theory study in which the aim was to generate knowledge concerning the ethical decision-making processes with which nurses and physicians are faced in a neonatal unit. Which assessments underlie decisions about whether to start, continue or stop medical treatment of very sick premature babies? A descriptive study design, including 120 hours of field observations and 22 qualitative in-depth interviews with doctors and nurses, was chosen. Strauss and Glaser's comparative method was used to analyse the field observations and interviews. The findings indicate that life-and-death decisions are somewhat ambivalent; experience does not always make them easier. In situations of ambiguity, decisions also seem to be based upon the vitality of the babies concerned.

  20. 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…

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

    PubMed

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

    2012-12-01

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

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

    PubMed

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

    2012-12-01

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

  3. 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

  4. 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

    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.

  5. 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

  6. The relationship between cardiac output, cerebral electrical activity, cerebral fractional oxygen extraction and peripheral blood flow in premature newborn infants.

    PubMed

    Victor, Suresh; Appleton, Richard E; Beirne, Margaret; Marson, Anthony G; Weindling, A Michael

    2006-10-01

    Cardiac output is a determinant of systemic blood flow and its measurement may therefore be a useful indicator of abnormal hemodynamics and tissue oxygen delivery. The purpose of this study was to investigate in very premature newborn infants the relationships between cardiac output (left and right ventricular outputs), systemic blood pressure, peripheral blood flow (PBF) and two indicators of cerebral oxygen delivery (cerebral electrical activity and cerebral fractional oxygen extraction (CFOE)). This was a prospective observational study performed on 40 infants of less than 30 wk gestation. Digital electroencephalograms (EEGs) were recorded for one hour every day during the first four days after birth and subjected to qualitative and quantitative analysis. Left and right ventricular outputs, mean blood pressure (MBP), CFOE, PBF and arterial blood gases were measured at the same time. Within the ranges studied, there was no apparent relationship between left or right ventricular output (RVO), PBF and indicators of cerebral perfusion (cerebral electrical activity and CFOE). The EEG was normal in infants with low left and right ventricular outputs (<150 mL/kg/min) and MBP > 30 mm Hg. Infants with low cardiac output and normal MBP seem able to maintain cerebral perfusion, possibly through vasodilatation of the cerebral microvasculature. PMID:16940235

  7. Effects of sleeping position and time after feeding on the organization of sleep/wake states in prematurely born infants.

    PubMed

    Myers, M M; Fifer, W P; Schaeffer, L; Sahni, R; Ohira-Kist, K; Stark, R I; Schulze, K F

    1998-06-15

    Epidemiologic studies provide strong evidence for the conclusion that sleeping in the prone position places infants at greater risk for sudden infant death syndrome (SIDS). Prior studies in newborn infants found that in the prone sleeping position there is less time awake and more quiet sleep, but little change in the amount of active sleep. To determine whether the effects of sleeping position on state distribution vary with time after feeding, we studied prematurely born infants in both the prone and supine sleeping positions. Sleep states were recorded each minute during interfeed intervals. Results demonstrate expected effects of sleep position on state distribution: prone sleeping is associated with a 79% increase in quiet sleep and a 71% decrease in time awake. While the decreases in time awake are seen throughout the interfeed interval, increases in quiet sleep in the prone position are found only within the first hour and again near the end of the interfeed interval. These results are consistent with the hypothesis that prone sleeping could increase risk for SIDS by altering the organization of sleep, and that time after feeding may play an important role in the expression of these effects. PMID:9646378

  8. Understanding the Biologic Therapies of Probiotics, Prebiotics, and Synbiotics: Exploring Current Evidence for Use in Premature Infants for the Prevention of Necrotizing Enterocolitis.

    PubMed

    Asmerom, Mussie; Crowe, Lindsay; Marin, Terri

    2015-01-01

    Necrotizing enterocolitis remains a significant cause of morbidity and mortality in very low-birth-weight infants (<1500 g), with current preventive strategies unclear. Scientific evidence has recently emerged, suggesting that probiotics, prebiotics, and synbiotics may effectively and safely alter the premature intestinal microbiota, enhancing a deficient innate immune response and maturing the intestinal barrier to prevent necrotizing enterocolitis development. Currently, formal recommendations do not support routine use of these dietary supplementations for premature infants. Here, we examine how probiotic, prebiotic, and synbiotic preparations physiologically alter the underdeveloped intestinal microbial environment to potentially reduce necrotizing enterocolitis incidence and discuss current evidence that has examined safety and efficacy factors potentially supporting routine use among the premature infant population.

  9. A Premature Infant with Fetal Myocardial and Abdominal Calcifications and Factor V Leiden Homozygosity

    PubMed Central

    Parker, Margaret G.K.; Webster, Gregory; Insoft, Robert M.

    2014-01-01

    We present a premature male neonate with confirmed Factor V Leiden deficiency diagnosed prenatally with cardiac and abdominal calcifications. Our patient’s findings suggest that clinicians consider thromboembolic conditions when multiple fetal calcifications are visualized. PMID:19861970

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

    PubMed

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

    2015-03-01

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

  11. Enhanced activity of the pituitary-gonadal axis in premature human infants.

    PubMed

    Tapanainen, J; Koivisto, M; Vihko, R; Huhtaniemi, I

    1981-02-01

    The postnatal pituitary-gonadal function of fullterm and premature boys and girls (mean gestational age, 40 and 32 weeks, respectively) was studied by measurements of serum FSH, LH, PRL, and testosterone (T) between 0-25 weeks of postnatal age. During the first 10 postnatal weeks, serum FSH in premature girls reached 10-20 times higher levels than in fullterm girls (mean at 1-5 weeks, 63 and 3.9 mIU/ml, respectively; P < 1.001). During the same time, serum LH levels were 3-4 times higher in premature (12-17 mIU/ml) than in fullterm girls (3.8-4.7 mIU/ml; P < 0.01). In contrast, no difference in serum gonadotropin levels were observed between premature and fullterm boys. Serum T in premature boys (mean, 2.95 ng/ml) reached a significantly higher level (P < 0.01) than in fullterm boys (1.45 ng/ml) from 11-15 weeks of age. The results emphasize the importance of the last weeks of gestation for the functional maturation of the fetal hypothalamic-pituitary-gonadal axis. Interruption of this maturational process by premature birth results in enhanced pituitary gonadotropin production in girls and increased testicular T production in boys.

  12. 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…

  13. Modification of the open circuit N2 washout technique for measurement of functional residual capacity in premature infants.

    PubMed

    Hentschel, R; Suska, A; Volbracht, A; Brune, T; Jorch, G

    1997-06-01

    We compared the standard nitrogen (N2) washout technique for measuring functional residual capacity (FRC) with a modified technique that uses a helium/oxygen mixture (heliox) at different ratio instead of pure oxygen. The tests were made with a standard lung function system equipped with an ultraviolet (UV) analyzer for measurement of N2 concentrations in the expired gas. We examined models of "spontaneous breathing" and "mechanical ventilation," each with volumes of FRC in the range of a premature and a newborn lung (20-80 ml), using both techniques at different baseline inspired oxygen concentrations (FIO2). Correlations between known and measured volumes were high and identical for the two techniques (r = 0.996), and the mean error was not significantly different from zero (P = 0.111). Measurements of FRC in 6 infants gave a correlation coefficient of r = 0.989 between the two techniques; reproducibility, as measured by the coefficient of variation, was high, showing no significant differences between both techniques (P = 0.792). However, values of individual infants were different (P = 0.011), and the slope of the regression line relating measurements by the 2 techniques was 1.04, with an intercept on the y-axis at 1.46. We conclude that FRC can be measured with the modified N2 washout technique, using heliox as a washout gas. Volumes can be measured with high precision and reproducibility, even in premature infants with low lung volumes and/or high baseline FIO2. A correction factor may be necessary to equate FRC measurements made by oxygen-N2 vs. heliox-N2 washouts. Hyperoxemia and hypoxemia can be avoided by admixing different flows of oxygen to a standard heliox mixture.

  14. Fatty acid patterns early after premature birth, simultaneously analysed in mothers' food, breast milk and serum phospholipids of mothers and infants

    PubMed Central

    Sabel, Karl-Göran; Lundqvist-Persson, Cristina; Bona, Elsa; Petzold, Max; Strandvik, Birgitta

    2009-01-01

    Background The supply of long-chain polyunsaturated fatty acids via the placenta is interrupted in premature infants, making them exclusively dependent on breast milk, which varies in fatty acid (FA) concentrations depending on the mother's diet. Objective To in a longitudinal study explore the relation between FA status in mothers and infants from an unselected cohort of prematures, not requiring intensive care. Design Breast milk and mothers' and infants' plasma phospholipid FA concentrations from birth to 44 weeks of gestational age were analysed and compared with mothers' food intake, assessed using a 3-day diary. Fatty acids were analysed by capillary gas-liquid chromatography. Results The energy intake was low in 75% of mothers, and 90% had low intake of essential FAs (EFAs). Dietary linoleic acid (LA, 18:2w6), but not w3 FAs, correlated to concentrations in breast milk. Infants' plasma and breast milk correlated for arachidonic (AA, 20:4w6), eicosapentaenoic (EPA, 20:5w3) and docosahexaenoic (DHA, 22:6w3) acids. A high concentration of mead acid (20:3w9) in the infants at birth correlated negatively to the concentrations of LA, AA and w3 FAs. Infants of mothers who stopped breastfeeding during the study period showed decreased DHA concentrations and increased w6/w3 ratios, with the opposite FA pattern seen in the mothers' plasma. Conclusion Although dietary w3 FAs were insufficient in an unselected cohort of mothers of premature infants, breastfeeding resulted in increased levels of DHA in the premature infants at the expense of the mothers, suggesting a general need to increase dietary w3 FAs during pregnancy and lactation. PMID:19515230

  15. 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. PMID:25571458

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

    PubMed Central

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

    2012-01-01

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

  17. Premature infant behavior: an ethological study in a special care nursery.

    PubMed

    Newman, L F

    1986-01-01

    The Social and Sensory Environment Studies of very low birthweight infants have quantified the amount and quality of social interaction with staff and parents and described the sound environment in an incubator. The present study concerns preterm infant behavior and reactions to these stimuli with particular reference to approach and withdrawal and vocalization. Among the findings are that while intermittent vocalization increases, infant cry decreases over the first three weeks in the incubator. Approach activities take place with some consistency whereas withdrawal differs from child to child. The ethnographic focus on interactive components of the intensive care experience documents the process of intersubjective development for the purpose of locating and isolating points of vulnerability in language and cognitive skills of infants born at very low birthweight.

  18. Growth hormone deficiency and premature thelarche in a female infant with kabuki makeup syndrome.

    PubMed

    Devriendt, K; Lemli, L; Craen, M; de Zegher, F

    1995-01-01

    We report on a girl with the kabuki makeup syndrome, including short stature, premature thelarche and partial growth hormone deficiency of hypothalamic origin, without stalk interruption. Treatment with recombinant human growth hormone resulted in an increase of annualized growth velocity from 3.6 to 11.2 cm. The kabuki makeup syndrome may be associated with hypothalamopituitary dysfunction.

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

    PubMed

    Vinogradova, I V

    2013-01-01

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

  20. 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...

  1. Motivating for Competence: Integrating Child- and Family-Focused Mastery Motivation Strategies into Early Intervention for the Extremely Premature Infant and Toddler.

    ERIC Educational Resources Information Center

    Keilty, Bonnie

    This paper discusses preliminary results of a project investigating the phenomenon of mastery motivation with three significant groups: provider, family, and extremely premature infant. Three focus groups to determine the state of early intervention's knowledge and utilization of mastery motivation were conducted in three states. A repeated…

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

    PubMed

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

    1993-01-01

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

  3. 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

  4. 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.

  5. Impaired cerebral autoregulation using near-infrared spectroscopy and its relation to clinical outcomes in premature infants.

    PubMed

    Caicedo, Alexander; De Smet, Dominique; Vanderhaegen, Joke; Naulaers, Gunnar; Wolf, Martin; Lemmers, Petra; Van Bel, Frank; Ameye, Lieveke; Van Huffel, Sabine

    2011-01-01

    The concordance between the change in the Mean Arterial Blood Pressure (MABP) and the Cerebral Blood Flow (CBF) is studied using the Correlation, Coherence and Partial Coherence methods in order to detect Impaired Cerebral Autoregulation in Neonates. The presence of impaired autoregulation is assessed by the use of the Critical Percentage of Recording Time (CPRT). The changes in CBF are reflected by the measurement of changes in cerebral intravascular oxygenation (HbD), regional cerebral oxygen saturation (rSO(2)), and cerebral tissue oxygenation (TOI), as measured by Near-Infrared Spectroscopy (NIRS) (INVOS4100 and NIRO300). The relation between impaired autoregulation and long term clinical outcomes in premature infants is studied. PMID:21445792

  6. 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.

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

    PubMed

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

    2016-09-01

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

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

    PubMed

    Gunay, Murat; Celik, Gokhan; Con, Rahim

    2015-01-01

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

  9. Transdermal delivery of theophylline to premature infants using a hydrogel disc system.

    PubMed Central

    Cartwright, R G; Cartlidge, P H; Rutter, N; Melia, C D; Davis, S S

    1990-01-01

    1. Preterm infants show incompletely developed skin with reduced barrier function. The possibility of transdermal delivery of theophylline from hydrogel discs swollen with choline theophyllinate has been investigated. 2. Drug loaded hydrogel discs 2 cm2 in area were applied to the abdomen and occluded. Serum theophylline concentrations were measured in twenty-one infants of less than 31 weeks gestation. 3. Therapeutic concentrations were achieved in 18 individuals, and maintained for up to 15 days after repeated application of discs. A correlation between maximum serum drug concentration and transepidermal water loss, gestation and birthweight was demonstrated. Images Figure 1 PMID:2350529

  10. 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.

  11. 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…

  12. 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…

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

    PubMed

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

    2001-06-01

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

  14. 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.

  15. Coupled oxygenation oscillation measured by NIRS and intermittent cerebral activation on EEG in premature infants.

    PubMed

    Roche-Labarbe, N; Wallois, F; Ponchel, E; Kongolo, G; Grebe, R

    2007-07-01

    Electroencephalography of premature neonates shows a physiological discontinuity of electrical activity during quiet sleep. Near infrared spectroscopy (NIRS) shows spontaneous oscillations of hemoglobin oxygenation and volume. Similar oscillations are visible in term neonates and adults, with NIRS and other functional imaging techniques (fMRI, Doppler, etc.), but are generally thought to result from vasomotion and to be a physiological artifact of limited interest. The origin and possible relationship to neuronal activity of the baseline changes in the NIRS signal have not been established. We carried out simultaneous EEG-NIRS recordings on six healthy premature neonates and four premature neonates presenting neurological distress, to determine whether changes in the concentration of cerebral oxy- and deoxy- and total hemoglobin were related to the occurrence of spontaneous bursts of cerebral electric activity. Bursts of electroencephalographic activity in neonates during quiet sleep were found to be coupled to a transient stereotyped hemodynamic response involving a decrease in oxy-hemoglobin concentration, sometimes beginning a few seconds before the onset of electroencephalographic activity, followed by an increase, and then a return to baseline. This pattern could be either part of the baseline oscillations or superimposed changes to this baseline, influencing its shape and phase. The temporal patterns of NIRS parameters present an unique configuration, and tend to be different between our healthy and pathological subjects. Studies of physiological activities and of the effects of intrinsic regulation on the NIRS signal should increase our understanding of these patterns and EEG-NIRS studies should facilitate the integration of NIRS into the set of clinical tools used in neurology.

  16. Heart-rate-corrected QT interval evolution in premature infants during the first week of life.

    PubMed

    Ulrich, Timothy J B; Ellsworth, Marc A; Carey, William A; Zubair, Adeel S; MacQueen, Brianna C; Colby, Christopher E; Ackerman, Michael J

    2014-12-01

    Automated monitoring of the QT interval is increasingly common in a variety of clinical settings. A better understanding of how the heart-rate-corrected QT interval (QTc) evolves in early postnatal life is needed before its clinical utility in neonates can be determined. This study aimed to use real-time bedside monitoring as a tool to describe the QTc evolution of premature neonates during the first week of life. All neonates born at a gestation age (GA) of 31 weeks or later and admitted to the level 2 intensive care nursery of the authors' institution between December 2012 and March 2013 were included in this study. The authors prospectively collected QTc values at 15-min intervals during the first week of life, then used two-way analysis of variance (ANOVA) to compare these data among three GA cohorts: 31 to <34 weeks (cohort A), 34 to <37 weeks (cohort B), and ≥37 weeks (cohort C). All the cohorts demonstrated a statistically significant decline in the 24-h average QTc during the first 3-4 days of life before reaching a stable baseline. No diurnal variation in the QTc was identified in any of the study patients. Marked variability and a progressive decline in the QTc of premature neonates occur during the first 3-4 days of life. Understanding this phenomenon is imperative when screening programs for the early detection of QT prolongation are considered.

  17. 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.

  18. [CA, P, AND MG POSTNATAL METABOLISM AND REQUIREMENTS IN PARENTERAL AND ENTERAL NUTRITION OF PREMATURE INFANTS].

    PubMed

    Pieltain, C; Senterre, Th; De Halleux, V; Rigo, J

    2015-12-01

    During the last trimester of gestation, transplacental mineral transfer and fetal mineral accretion is particularly high: 2.3-3.2 mmol/kg/day (90-130 mg/kg/d) of calcium, 2.4-2.7 mmol/kg/d (65-75 mg/kg/day) of phosphorus and 0.12-0.20 mmol/kg/d (2.9-4.8 mg/kg/day) of magnesium. After birth, there is a dramatic change in bone mineral metabolism from a maximal bone deposition during fetal life to a postnatal bone turnover stimulation improving bone structure and resistance. This physiological change could partly reduce the mineral requirements, as minerals available from the remodeling activities could be recycled for bone mineralization. In addition, recent studies in preterm infants, suggest that the use of early more "aggressive" nutritional support, providing high aminoacid intakes from the first day of life, may induce a "refeeding like syndrome" suggesting that early phosphorus and electrolytes supplies are also necessary. The aim of the present paper is to review the mineral metabolism of Very Low Birth Weight (VLBW) infants during the first weeks of life at the light of the more recent studies and to revise the nutritional recommendations for mineral parenteral and enteral intakes in VLBW infants. PMID:26867308

  19. Alternative pathway of complement activation in full term and premature infants.

    PubMed

    Strunk, R C; Fenton, L J; Gaines, J A

    1979-05-01

    Classical and alternative pathway complement levels were measured in the cord blood sera of 60 newly born infants, with weights ranging from 1200--4165 g. The impact of maternal illness and infant illness on the complement levels was also evaluated. The mean values for CH50, C3, C4, PH50, factor B, and properdin were all significantly less than normal adult levels (P less than 0.0001). All of the above determinations were significantly correlated with one another except for the relationship between properdin and factor B. CH50, PH50, C4, and properdin levels were significantly correlated with birth weight although there was much residual scatter. Neither maternal illness nor mild to moderate illness in the newborn altered the birth weight-complement relationships. Severe infant illness did significantly alter the relationship between birth weight and complement. However, the impact of this variable on the birth weight-complement relationships was not consistent among the various components. These inconsistencies and the small sample size preclude drawing any strong conclusions about severe illness and complement levels. PMID:471596

  20. Alternative pathway of complement activation in full term and premature infants.

    PubMed

    Strunk, R C; Fenton, L J; Gaines, J A

    1979-05-01

    Classical and alternative pathway complement levels were measured in the cord blood sera of 60 newly born infants, with weights ranging from 1200--4165 g. The impact of maternal illness and infant illness on the complement levels was also evaluated. The mean values for CH50, C3, C4, PH50, factor B, and properdin were all significantly less than normal adult levels (P less than 0.0001). All of the above determinations were significantly correlated with one another except for the relationship between properdin and factor B. CH50, PH50, C4, and properdin levels were significantly correlated with birth weight although there was much residual scatter. Neither maternal illness nor mild to moderate illness in the newborn altered the birth weight-complement relationships. Severe infant illness did significantly alter the relationship between birth weight and complement. However, the impact of this variable on the birth weight-complement relationships was not consistent among the various components. These inconsistencies and the small sample size preclude drawing any strong conclusions about severe illness and complement levels.

  1. Antibiotics Before Removal of Percutaneously Inserted Central Venous Catheters Reduces Clinical Sepsis in Premature Infants

    PubMed Central

    Reynolds, Gail E.; Tierney, Sarah B.

    2015-01-01

    OBJECTIVES: Evaluate the incidence of postcatheter removal clinical sepsis when antibiotics were infused prior to the removal of percutaneously inserted central venous catheters (PICCs). METHODS: A retrospective chart review of premature neonates (n = 196) weighing ≤1250 g at birth with 218 PICC line removals in the presence or absence of antibiotics at a tertiary level neonatal intensive care unit (NICU) between January 1, 2010, and May 31, 2012. Charts were reviewed looking for the presence of clinical sepsis defined as a sepsis workup including white blood cell count, differential, C-reactive protein, blood and/or cerebral spinal fluid (CSF), and urine cultures along with at least 48 hours of antibiotic therapy given within 72 hours after removal of a PICC line. Antibiotics were considered present at line removal if given within 12 hours before catheter removal either electively or at completion of a planned course. RESULTS: When antibiotics were given within 12 hours before PICC line removal, only 2% of the line removal episodes (1/48) resulted in a neonate developing clinical sepsis versus 13% (21/165) when no antibiotics were given prior to removal (p = 0.03, Fisher's exact test). Despite the increased use of elective antibiotics with line removal, there was no increase in total antibiotic usage due to the overall decrease in episodes of clinical sepsis or changes in antibiogram susceptibility patterns. CONCLUSIONS: There was an 11% absolute decrease and a 6-fold relative decrease in postcatheter removal clinical sepsis events in premature neonates who received antibiotics prior to PICC line removal. PMID:26170772

  2. 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…

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Garg, Shalabh; Sinha, Sunil

    2013-01-01

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

  5. 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

  6. 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.

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

    PubMed

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

    2016-06-01

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

  8. Determination of indomethacin in plasma by micellar electrokinetic chromatography with UV detection for premature infants with patent ducts arteriosus.

    PubMed

    Lin, Shun-Jin; Chen, Yi-Ru; Su, Yu-Hui; Tseng, Hsing-I; Chen, Su-Hwei

    2006-01-18

    A simple and selective micellar electrokinetic chromatography (MEKC) is described for determination of indomethacin in plasma. Plasma proteins are precipitated by acetonitrile. An aliquot of supernatant was evaporated and reconstituted with Tris buffer for MEKC analysis. The separation of indomethacin was performed at 25 degrees C using a background electrolyte consisting of Tris buffer (30 mM; pH 8.0) with 100 mM sodium octanesulfonate (SOS) as an anionic surfactant. Under this condition, a good separation with high efficiency and short analysis time is achieved. Several parameters affecting the separation of indomethacin were studied, including pH and concentrations of the Tris buffer and SOS. The linear range of the method for the determination of indomethacin was over 0.3-10.0 microg/mL; the detection limit (signal-to-noise ratio=3; injection 0.5 psi 5s) was 0.1 microg/mL. The proposed method for determination of indomethacin in premature infants with patent ducts arteriosus has been demonstrated. PMID:16321577

  9. 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

  10. 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

  11. [Effect of obstetric-perinatal measures on mortality and early morbidity of premature infants weighing 500 to 1,500 grams].

    PubMed

    Voigt, H J; Lang, N; Segerer, H; Stehr, K

    1989-08-01

    In a retrospective analysis of perinatal influencing factors in 186 premature newborns of the Department of Gynaecology of the University of Erlangen covering the period from 1982-1987 with birth weights between 500 and 1500 grams, the mortality and early morbidity were analysed, as characterised by cerebral haemorrhages, respiratory distress syndrome and infections insofar, as they had been connected with the obstetrical approach and paediatric intensive-care treatment, 45 infants born in 1982/83 were compared with 141 infants, who had been subjected to a different treatment approach during 1984 to 1987. During the second period, there was a marked drop both in mortality and in the incidence of asphyxia-induced severe cerebral haemorrhage and of the respiratory distress syndrome. A shortened latency period after premature rupture of the amnion, and a more pronounced presence of a neonatologically experienced team of paediatricians were found to be significant obstetric liberal influencing factors in determining the need to perform Caesarean section. The triplication of the frequency of Caesarean section observed resulted in a 50% reduction in perinatal mortality and morbidity. Infants with pelvic presentation benefited most from the more liberal performance of Caesarean section, as did infants with vertex presentation. Shortening of the latency phase in premature rupture resulted in a marked reduction in infection morbidity and mortality. Therefore we conclude, that the frequently practised procrastination with the aim to await an improvement in lung maturity should be replaced by a more active obstetric management, avoiding both infection and birth trauma. Obstetric decisions should be based rather on prenatal estimation of weight than on the calculated gestational age. At present, the lowest birth weight associated with the expectation of a healthy life is considered to be 750 grams.

  12. 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.

  13. Use of 2% 2-phenoxyethanol and 0.1% octenidine as antiseptic in premature newborn infants of 23-26 weeks gestation.

    PubMed

    Bührer, C; Bahr, S; Siebert, J; Wettstein, R; Geffers, C; Obladen, M

    2002-08-01

    In preterm newborn infants, topical iodine-containing antiseptics disturb thyroid hormone regulation while alcohol-based disinfectants may cause local burns. We therefore investigated the use of an aqueous solution containing 0.1% octenidine and 2% 2-phenoxyethanol for skin disinfection during the first seven days of life in premature newborns with a gestational age <27 weeks who were consecutively admitted to our level III neonatal intensive care unit between November 1, 2000 and December 31, 2001 (N=24). In boys. (N=13) the renal excretion of absorbed 2-phenoxyethanol and its metabolite 2-phenoxyacetic acid was quantitated by high-pressure liquid chromatography. In the most immature newborn (gestational age 23 6/7 weeks), a transient erythematous reaction was observed following application of the octenidine/phenoxyethanol solution prior to umbilical vessel catheterization. No other local reactions were observed. The urinary concentration of 2-phenoxyethanol was <2 ppm in all samples, while urinary 2-phenoxyacetic acid concentrations reached 5-95 ppm (median 24 ppm). One infant had a culture-proven septicaemia (Bacillus species) during the first seven days of life. We conclude that, in contrast to alcohol-based antiseptics, an aqueous solution of 0.1% octenidine and 2-phenoxyethanol does not cause major skin damage in premature newborn infants <27 weeks' gestation. 2-Phenoxyethanol is readily absorbed by the newborn's skin but apparently undergoes extensive oxidative metabolization to 2-phenoxyacetic acid.

  14. 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…

  15. Protein Needs of Preterm Infants: Why Are They So Difficult to Meet?

    PubMed

    Ziegler, Ekhard E

    2016-01-01

    Because of their exceedingly high rate of growth, premature infants have very high needs for all nutrients. Requirements have been estimated by the factorial method based on the body composition of the fetus. Failure to meet the high requirements for protein impairs growth and places the infant at risk of neurodevelopmental impairments. Human milk, the preferred feeding for premature infants because of its protective effects, does not provide adequate amounts of nutrients and must be fortified. On the basis of studies performed several decades ago using very high protein intakes, in the past it has been believed that protein intakes that met the high needs of premature babies are dangerous for premature babies. To prevent protein intakes from being too high, the protein content of fortifiers in the past has been kept low. Today, this fear of protein is still the reason why protein intakes tend to be kept low, with the result that protein intakes are often too low. PMID:27336165

  16. Amino acid metabolism in the human fetus at term: leucine, valine, and methionine kinetics.

    PubMed

    van den Akker, Chris H P; Schierbeek, Henk; Minderman, Gardi; Vermes, Andras; Schoonderwaldt, Ernst M; Duvekot, Johannes J; Steegers, Eric A P; van Goudoever, Johannes B

    2011-12-01

    Human fetal metabolism is largely unexplored. Understanding how a healthy fetus achieves its fast growth rates could eventually play a pivotal role in improving future nutritional strategies for premature infants. To quantify specific fetal amino acid kinetics, eight healthy pregnant women received before elective cesarean section at term, continuous stable isotope infusions of the essential amino acids [1-13C,15N]leucine, [U-13C5]valine, and [1-13C]methionine. Umbilical blood was collected after birth and analyzed for enrichments and concentrations using mass spectrometry techniques. Fetuses showed considerable leucine, valine, and methionine uptake and high turnover rates. α-Ketoisocaproate, but not α-ketoisovalerate (the leucine and valine ketoacids, respectively), was transported at net rate from the fetus to the placenta. Especially, leucine and valine data suggested high oxidation rates, up to half of net uptake. This was supported by relatively low α-ketoisocaproate reamination rates to leucine. Our data suggest high protein breakdown and synthesis rates, comparable with, or even slightly higher than in premature infants. The relatively large uptakes of total leucine and valine carbon also suggest high fetal oxidation rates of these essential branched chain amino acids.

  17. [ANALYSIS OF THE ASSOCIATIONS BETWEEN ANGIOTENSIN-CONVERTING ENZYME GENE POLYMORPHISM AND ARTERIAL HYPOTENSION IN PREMATURE INFANTS WITH EARLY ONSET BACTERIAL INFECTIONS].

    PubMed

    Kovaleva, E; Pokhylko, V; Chernyavskaya, Yu; Kalyuzka, E; Poltoropavlov, V

    2015-11-01

    The rate of neonatal sepsis is not reduced varying inversely proportional to the gestational age at birth, and may reach 60% in the most immature infants. The high mortality rate of this disease and adverse neurological effects are associated with the development of cardiovascular changes and shock. The main leadership role in the regulation of blood pressure and blood volume in the body plays a renin-angiotensin system. Synthesis of angiotensin-converting enzyme is regulated by the ACE gene. The aim of the study was to identify and analyze the associations between the development of arterial hypotension in premature infants and insertion-deletion (I/D) polymorphism of the ACE gene. We conducted a prospective cohort study, which included 118 prematurely born children with early onset bacterial infections (n=57 with clinical manifestations in the form of hypotension, n=61 without hypotension). Both groups were genotyped to determine the insertion-deletion polymorphism ACE gene. We compared the clinical, laboratory and instrumental parameters in premature infants with hypotension and II, ID, DD genotype of the ACE gene. Also an analysis of the associations between different genotypes of ACE gene and the development of arterial hypotension in prematurely born children was conducted. The distribution of neonates in relation to the three polymorphic variants of ACE gene with respect to I/D polymorphism was identical among the study groups. The study found that children with a variety of I/D polymorphic variants of ACE gene had no significant differences in hemodynamic parameters. The rate of hemodynamic support use did not differ in both groups. The study of the associations between the ACE gene polymorphism and major ultrasound, Doppler indices that characterized both systemic and organ hemodynamics, revealed no significant differences in mean values of all the criteria that have been studied. It can be concluded no effect of I/D polymorphism of ACE gene on the

  18. Calciuria and aminoaciduria in very low birth weight infants fed a high-mineral premature formula with varying levels of protein.

    PubMed

    Hillman, L S; Salmons, S S; Erickson, M M; Hansen, J W; Hillman, R E; Chesney, R

    1994-08-01

    To assess the influence of protein intake on renal excretion of calcium and amino acids and on bone mineralization in preterm infants, we randomly selected within weight group strata 27 infants who weighed < 1500 gm at birth (nine per group) to be fed a high-mineral (calcium, 940 mg/L; phosphorus, 470 mg/L) premature formula with one of the following protein contents: formula A, 3.0 gm/100 kcal; formula B, 2.7 gm/100 kcal; and formula C, 2.2 gm/100 kcal. Mean (+/- SD) daily weight gain was greater in infants receiving the higher protein intakes for the first 30 days (formula A, 24.8 +/- 5.1 gm; formula B, 20.5 +/- 3.8 gm; formula C, 16.2 +/- 5.9 gm (analysis of variance: p < 0.01; C < A, p < 0.05)). Bone mineral content did not differ at any time point, and all groups had a high prevalence of generalized aminoaciduria (4 weeks: formula A, 56%; formula B, 71%; formula C, 75%). Urinary calcium corrected for creatinine (in milligrams per milligram) increased as protein content decreased (2 weeks: formula A, 0.16 +/- 0.10; formula B, 0.20 +/- 013; formula C, 0.44 +/- 0.33 (C > A, C > B, p < 0.05); 4 weeks: formula A, 0.23 +/- 0.15; formula B,0.34 +/- 0.47; formula C, 0.49 +/- 0.22 (C > A, p < 0.01). We conclude that the high mineral content and other components of premature formulas result in a higher growth rate and may increase protein requirements. Failure to meet protein requirements may result in underutilization of absorbed calcium and increased renal excretion of calcium. In preterm infants, higher protein intake probably supports rather than jeopardizes bone mineral accretion, and reduces rather then increases calciuria.

  19. The experience of premature birth for fathers: the application of the Clinical Interview for Parents of High-Risk Infants (CLIP) to an Italian sample

    PubMed Central

    Candelori, Carla; Trumello, Carmen; Babore, Alessandra; Keren, Miri; Romanelli, Roberta

    2015-01-01

    Aim: The study explored fathers’ experience of premature birth during the hospitalization of their infants, analyzing levels of depressive and anxiety symptoms as compared with mothers. Moreover the Italian version of the Clinical Interview for Parents of High-Risk Infant (CLIP) was tested through confirmatory factor analysis. Methods: Couples of parents (N = 64) of preterm infants (gestational age < 37 weeks) were administered a socio-demographic questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory and the CLIP after the admission to the Neonatal Intensive Care Unit (NICU). Results: Significant levels of anxiety and depressive symptoms and high percentages of subjects above the corresponding risk thresholds were found among fathers and mothers with higher scores among the latters. Confirmatory factor analysis of the CLIP showed an adequate structure, with better fit for mothers than for fathers. Conclusion: Results highlighted the importance for nurses and clinicians working in the NICU to consider not only the maternal difficulties but also the paternal ones, even if these are often more hidden and silent. In addition the CLIP may be considered an useful interview for research and clinical purposes to be used with parents of high-risk infants. PMID:26483712

  20. Junctional Bradycardia as Early Sign of Digoxin Toxicity in a Premature Infant with Congestive Heart Failure due to a Left to Right Shunt.

    PubMed

    Dasgupta, Soham; Aly, Ashraf M; Jain, Sunil K

    2016-03-01

    Introduction Congestive heart failure due to left to right cardiac shunt is usually managed medically with diuretics, angiotensin converting enzyme inhibitors, and, in some cases, with the addition of digoxin. Case We report a 31-week gestation premature male infant who did not respond to such treatment and developed hyperaldosteronism and severe hypokalemia secondary to activation of the renin angiotensin aldosterone system. The hypokalemia was not responsive to intravenous KCL supplementation and induced digoxin toxicity despite a relatively normal digoxin level. The earliest signs of digoxin toxicity in the patient were junctional rhythm and bradycardia. The discontinuation of digoxin and the administration of digoxin specific immunoglobulin fragments (Fab) reversed those changes. The addition of spironolactone (an aldosterone antagonist) had a dramatic effect, resulting in clinical improvement of the patient coupled with normalization of Q4 serum and urine electrolytes. Conclusion Serum Digoxin level alone may fail as an independent guide in the diagnosis of digoxin toxicity when hypokalemia is present. In premature infants with congestive heart failure and hypokalemia, addition of an aldosterone antagonist should be considered.

  1. Adrenocortical function and dysfunction in the fetus and neonate.

    PubMed

    Watterberg, Kristi L

    2004-02-01

    Under normal circumstances, the fetus is exposed to very low concentrations of cortisol until late in gestation. Perturbations of the intra-uterine environment resulting in fetal exposure to increased cortisol may have consequences not only in infancy, but also into adult life. In the postnatal period, developmental immaturity and/or the effects of critical illness on adrenal function may result in insufficient cortisol production to maintain homeostasis in the face of acute stress or illness, a situation that has been labelled 'relative adrenal insufficiency' in other acutely ill populations. The definition of inadequate adrenal function in the newborn and its possible relationship to adverse outcomes in both premature and term infants are only beginning to be characterized.

  2. 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.

  3. Notes from the field: Fatal gastrointestinal mucormycosis in a premature infant associated with a contaminated dietary supplement--Connecticut, 2014.

    PubMed

    Vallabhaneni, Snigdha; Walker, Tiffany A; Lockhart, Shawn R; Ng, Dianna; Chiller, Tom; Melchreit, Richard; Brandt, Mary E; Smith, Rachel M

    2015-02-20

    In October 2014, a hospital in Connecticut notified CDC and the Connecticut Department of Public Health of a fatal case of gastrointestinal mucormycosis in a preterm infant. The infant, born at 29 weeks' gestation and weighing 1,400 grams (about 3 pounds), had developed signs and symptoms initially consistent with necrotizing enterocolitis approximately 1 week after birth. Exploratory laparotomy revealed complete ischemia of the gastrointestinal tract from the esophagus to the rectum; a portion of necrotic cecum was sent for microscopic examination. Following surgery, the infant developed multiple areas of vascular occlusion, including a large clot in the aorta, findings not usually associated with necrotizing enterocolitis. The infant died soon after. Histopathology results from the resected cecum revealed an angioinvasive fungal infection consistent with mucormycosis. Gastrointestinal mucormycosis is an extremely rare fungal infection caused by mold in the order Mucorales. It occurs predominantly in low birth weight infants, patients with diarrhea and malnutrition, and those receiving peritoneal dialysis; mortality is 85%. Local investigation revealed that the infant had received a dietary supplement, ABC Dophilus Powder, for 7 days, beginning on day 1 of life.

  4. Histologic evolution of the reactions to hemorrhage in the premature human infant's brain. A combined ultrasound and autopsy study and a comparison with the reaction in adults.

    PubMed Central

    Darrow, V. C.; Alvord, E. C.; Mack, L. A.; Hodson, W. A.

    1988-01-01

    With the development and routine use of real-time ultrasound scanning, it has been possible to collect 20 autopsy cases of infants in whom the ultrasound scan was first normal and then showed evidence of subependymal/intraventricular hemorrhage (SEH/IVH). Analysis of these cases with known postnatal origin of the hemorrhage permitted the development for the first time of a time scale to characterize the temporal evolution of the histopathologic reactions to hemorrhage in the premature human brain. This time scale was then used to define the histologic stage of the lesions in 27 other cases of infants who had a scan demonstrating SEH/IVH prior to death but who had not a previously normal scan. Only 2 cases were found to lie off the original scale, indicating a prenatal onset of the hemorrhage in about 5% of the total cases. Thus, postnatal events immediately preceding the onset of the hemorrhage are more likely to be implicated in the pathogenesis of SEH/IVH than prenatal or obstetric events. Comparison with similar reactions in the adult indicate that the early reactions by macrophages occur at about the same rate but the routine transfer of iron from macrophages to astrocytes and the much slower rate of absorption to form a cyst in the adult combine to form a complicated pattern that requires a different set of criteria for the intermediate and late stages in the adult. Images Figure 4 Figure 3 Figure 9 Figure 2 Figure 1 Figure 5 Figure 7 PMID:3276212

  5. Transient ileus associated with the use of mydriatics after screening for retinopathy of prematurity in a very low birth weight infant.

    PubMed

    Degirmencioglu, Halil; Oncel, Mehmet Yekta; Calisici, Erhan; Say, Birgul; Uras, Nurdan; Dilmen, Ugur

    2014-01-01

    Very low birth weight (VLBW) infants have ophthalmologic examinations for retinopathy of prematurity (ROP) prior to discharge, with appropriate follow-up and intervention where appropriate. Eye drops such as cylopentolate, tropicamide, and phenylephrine are used at different concentrations to provide proper pupil dilation for screening ROP. Topical instillation of eye drops may cause mild or severe ocular or systemic adverse effects. Early recognition of systemic toxicity after eye drop instillation is important. The authors present a case of a VLBW infant who developed significant abdominal symptoms (mimicking ileus) that were significant enough to discontinue oral feeding after ocular instillation of 0.5% tropicamide and 2.5% phenylephrine eye drops for routine examination of ROP. After structural and functional gastrointestinal disorders and sepsis were excluded, symptoms resolved completely after discontinuation of the drug. This report is thought to be the first in the medical literature to address 5% tropicamide and 2.5% phenylephrine eye drops, and the combination that may lead to serious complication after ROP examinations. PMID:25003832

  6. The Long Anticipated Day: Strategies for Success When a Premature Infant Comes Home from the Neonatal Intensive Care Unit.

    ERIC Educational Resources Information Center

    Hadden, D. Sarah

    2000-01-01

    This article offers guidance for preparing parents of infants in a neonatal intensive care unit to manage their child at home. Topics covered include effective, formal discharge teaching, providing information about child development, continuity of care from the hospital to home (including linkages with professionals, agencies, and other…

  7. 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

  8. 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

  9. Oral paracetamol vs. oral ibuprofen in the treatment of symptomatic patent ductus arteriosus in premature infants: A randomized controlled trial

    PubMed Central

    Yang, Bo; Gao, Xiangyu; Ren, Yi; Wang, Yun; Zhang, Qinglin

    2016-01-01

    The aim of the present study was to analyze the changes of plasma and urinary prostaglandin E2 (PGE2) levels in preterm infants with symptomatic patent ductus arteriosus (sPDA) treated with oral ibuprofen and acetaminophen. A total of 87 preterm infants with sPDA admitted to the Neonatal Ward of the Affiliated Xuzhou Hospital of Medical College of Southeast University from October, 2012 to June, 2015 were selected and randomly divided into the ibuprofen group (n=43, 10 mg/kg ibuprofen administered orally as initial dose, followed by 5 mg/kg during the first 24 and 48 h later) and acetaminophen group (n=44, 15 mg/kg acetaminophen administered orally once every 6 h for three days). The levels of plasma and urinary PGE2 in the two groups were estimated before and after treatment. The treatment of sPDA infants with ibuprofen (ibuprofen group) or acetaminophen (acetaminophen group) caused a significant decrease in the plasma and urinary PGE2 levels in comparison with plasma and urinary PGE2 levels before treatment (P<0.05). Furthermore, plasma and urinary PGE2 levels in the acetaminophen group (45.0±36.9 ng/l) were significantly lower than those in the ibuprofen group (73.5±44.8 ng/l, P=0.002). The arterial duct closure rate was similar between the acetaminophen [31 (70.5%)] and ibuprofen groups [33 (76.7%), P=0.506]. The incidence of oliguria was less among sPDA infants of the acetaminophen group [1 (2.3%)] than observed among the sPDA infants of the ibuprofen group [6 (14.0%)]; however, this difference was not statistically significant (P=0.108). Additionally, the incidences of fecal occult blood positive rate, intraventricular hemorrhage, neonatal necrotizing enterocolitis and bronchopulmonary dysplasia were distributed similarly in the ibuprofen and acetaminophen groups (P>0.05). The levels of platelet, serum creatinine and alanine transaminase showed no significant changes between the ibuprofen and acetaminophen groups (P>0.05). Following treatment with ibuprofen

  10. Oral paracetamol vs. oral ibuprofen in the treatment of symptomatic patent ductus arteriosus in premature infants: A randomized controlled trial

    PubMed Central

    Yang, Bo; Gao, Xiangyu; Ren, Yi; Wang, Yun; Zhang, Qinglin

    2016-01-01

    The aim of the present study was to analyze the changes of plasma and urinary prostaglandin E2 (PGE2) levels in preterm infants with symptomatic patent ductus arteriosus (sPDA) treated with oral ibuprofen and acetaminophen. A total of 87 preterm infants with sPDA admitted to the Neonatal Ward of the Affiliated Xuzhou Hospital of Medical College of Southeast University from October, 2012 to June, 2015 were selected and randomly divided into the ibuprofen group (n=43, 10 mg/kg ibuprofen administered orally as initial dose, followed by 5 mg/kg during the first 24 and 48 h later) and acetaminophen group (n=44, 15 mg/kg acetaminophen administered orally once every 6 h for three days). The levels of plasma and urinary PGE2 in the two groups were estimated before and after treatment. The treatment of sPDA infants with ibuprofen (ibuprofen group) or acetaminophen (acetaminophen group) caused a significant decrease in the plasma and urinary PGE2 levels in comparison with plasma and urinary PGE2 levels before treatment (P<0.05). Furthermore, plasma and urinary PGE2 levels in the acetaminophen group (45.0±36.9 ng/l) were significantly lower than those in the ibuprofen group (73.5±44.8 ng/l, P=0.002). The arterial duct closure rate was similar between the acetaminophen [31 (70.5%)] and ibuprofen groups [33 (76.7%), P=0.506]. The incidence of oliguria was less among sPDA infants of the acetaminophen group [1 (2.3%)] than observed among the sPDA infants of the ibuprofen group [6 (14.0%)]; however, this difference was not statistically significant (P=0.108). Additionally, the incidences of fecal occult blood positive rate, intraventricular hemorrhage, neonatal necrotizing enterocolitis and bronchopulmonary dysplasia were distributed similarly in the ibuprofen and acetaminophen groups (P>0.05). The levels of platelet, serum creatinine and alanine transaminase showed no significant changes between the ibuprofen and acetaminophen groups (P>0.05). Following treatment with ibuprofen

  11. Long Chain Polyunsaturated Fatty Acid Levels in U.S. Donor Human Milk: Meeting the Needs of Premature Infants?

    PubMed Central

    Baack, Michelle L.; Norris, Andrew W.; Yao, Jianrong; Colaizy, Tarah

    2011-01-01

    Objective To determine fatty acid levels in the US donor milk supply. Study Design Donor human milk samples from Iowa (n=62), Texas (n=5), North Carolina (n=5), and California (n=5) were analyzed by gas chromatography. Levels in Iowa donor milk were compared before and after pasteurization using Student’s t-test. Docosahexaenoic acid (DHA) and arachidonic acid (ARA) levels were compared among all milk banks using ANOVA. Results ARA (0.4 pre, 0.4 post, p=0.18) and DHA (0.073 pre, 0.073 post, p=0.84) were not affected by pasteurization. DHA varied between banks (p <0.0001), whereas ARA did not (p = 0.3). DHA levels from all banks were lower than published values for maternal milk and infant formula (p<0.0001). Conclusion Pasteurization of breastmilk does not affect DHA or ARA levels. However, DHA content in US donor milk varies with bank location and may not meet the recommended provision for preterm infants. PMID:22323096

  12. Effects of red cell transfusion on cardiac output and blood flow velocities in cerebral and gastrointestinal arteries in premature infants.

    PubMed Central

    Nelle, M; Höcker, C; Zilow, E P; Linderkamp, O

    1994-01-01

    Anaemia may increase the risk of tissue hypoxia in preterm infants. The effect of transfusion on circulation was studied in 33 preterm infants with a mean (SD) gestational age of 29 (5) weeks (range 26-34), birth weight 1153 (390) g (range 520-1840), and postnatal age of 48 (21) days (range 19-100). Packed cell volume, blood viscosity (capillary viscometer), cardiac output, and cerebral blood flow velocities in the internal carotid artery, anterior cerebral artery, and coeliac trunk (Doppler ultrasound) were determined before and after transfusion of 10 ml/kg of packed red blood cells. Transfusion increased packed cell volume from a mean (SD) 0.27 (0.45) to 0.37 (0.48). Mean arterial blood pressure did not change while heart rate decreased significantly from 161 (14) l/min to 149 (12). Cardiac output decreased from 367 (93) ml/kg/min to 311 (74) due to decrease in stroke volume from 2.28 (0.57) ml/kg to 2.14 (0.46) and in heart rate. There was a significant increase in systemic red cell transport (cardiac output times packed cell volume) by 17%, systemic flow resistance (blood pressure to cardiac output ratio) by 23%, and blood viscosity by 33%. Vascular hindrance (flow resistance to blood viscosity ratio) did not change significantly, thereby suggesting that neither vasoconstriction nor vasodilation occurred with transfusion. After transfusion blood flow velocities decreased significantly in the anterior cerebral artery by 23%, in the internal carotid artery by 8%, and in the coeliac trunk by 12%. Red cell transport estimated as products of blood flow velocities times packed cell volume increased significantly by 25% in the internal carotid artery and by 21% in the coeliac trunk. These results indicate that red cell transfusion improved systemic oxygen transport as well as oxygen transport in the internal carotid artery and coeliac trunk. PMID:8092871

  13. Intraventricular twin fetuses in fetu.

    PubMed

    Huddle, Lauren N; Fuller, Christine; Powell, Tiffany; Hiemenga, Judith A; Yan, Jia; Deuell, Brian; Lyders, Eric M; Bodurtha, Joann N; Papenhausen, Peter R; Jackson-Cook, Colleen K; Pandya, Arti; Jaworski, Margie; Tye, Gary W; Ritter, Ann M

    2012-01-01

    The authors report a rare case of multiple intracranial fetuses in fetu, fulfilling Willis' traditional criteria, which include an axial and appendicular skeleton with surrounding organized tissue. This case was ascertained from studies of a full-term female neonate who presented with ventriculomegaly. A CT scan showed intracranial calcifications that were suggestive of an axial skeleton. Her birth weight was 3.176 kg (50th-75th percentile), length was 52 cm (90th percentile), head circumference was 35 cm (50th-75th percentile), and Apgar scores were 7 and 8 at 1 and 5 minutes, respectively. Prenatal ultrasonography studies performed at 12 weeks and 5 days, and 19 weeks and 6 days revealed normal findings. A 37-week prenatal ultrasonography study showed ventriculomegaly and obstructive hydrocephalus, with a possible intracranial teratoma. Cranial imaging at birth with ultrasonography, CT and MR imaging, and MR angiography demonstrated 2 complex intraventricular masses with cystic, solid, and bony elements. A craniotomy with resection of the masses was performed at 3 months of age. The infant survived and is now 12 months old with some developmental progress. Two axial skeletons, with accompanying rib cage and extremities, including well-formed feet and toes, were noted. Both anencephalic structures had skin with hair, fat, skeletal and smooth muscle, and bony structures with bone marrow and focal areas of calcification. Multiple viscera were present and included thymus, bowel, stomach, salivary gland, kidney, adrenal gland, lung, and presumed adnexal structures. A diagnosis of fetuses in fetu was rendered. Chromosomal studies of the child and tissue from the 2 fetuses in fetu showed normal female karyotypes. A single nucleotide polymorphism array analysis from the proband infant and tissue from the 2 identified fetuses in fetu appeared to be genetically identical. These results are consistent with a monozygotic twin embryonic origin of the fetus in fetu tissue

  14. Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

    PubMed

    Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

    2009-01-01

    More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children. The costs associated with preterm birth are exorbitant. In 2005, it is estimated that preterm birth cost the United States $26.2 billion. The purpose of this study was to perform a cost analysis of the Creating Opportunities for Parent Empowerment (COPE) program for parents of premature infants, a manualized educational-behavioral intervention program comprising audiotaped information and an activity workbook that is administered to parents in 4 phases, the first phase commencing 2 to 4 days after admission to the NICU. Findings indicated that the COPE program resulted in cost savings of at least $4864 per infant. In addition to improving parent and child outcomes, routine implementation of COPE in NICUs across the United States could save the healthcare system more than $2 billion per year.

  15. Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

    PubMed

    Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

    2009-01-01

    More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children. The costs associated with preterm birth are exorbitant. In 2005, it is estimated that preterm birth cost the United States $26.2 billion. The purpose of this study was to perform a cost analysis of the Creating Opportunities for Parent Empowerment (COPE) program for parents of premature infants, a manualized educational-behavioral intervention program comprising audiotaped information and an activity workbook that is administered to parents in 4 phases, the first phase commencing 2 to 4 days after admission to the NICU. Findings indicated that the COPE program resulted in cost savings of at least $4864 per infant. In addition to improving parent and child outcomes, routine implementation of COPE in NICUs across the United States could save the healthcare system more than $2 billion per year. PMID:19092521

  16. Premature Menopause

    PubMed Central

    Okeke, TC; Anyaehie, UB; Ezenyeaku, CC

    2013-01-01

    Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk. PMID:23634337

  17. Determination of radial bone mineral content in low birth weight infants by photon absorptiometry

    SciTech Connect

    Greer, F.R.

    1988-07-01

    Studies at the University of Wisconsin have demonstrated that photon absorptiometry is a precise, accurate, and reproducible technique for measuring bone mineral content in premature infants and can be used to establish an intrauterine curve of bone mineralization in the fetus. Photon absorptiometry can also be used to measure bone width, thereby documenting appositional bone growth. The bone mineral content/bone width ratio may be helpful in identifying disorders of bone mineral metabolism in premature infants. The technique has been used to demonstrate that relatively poor bone mineralization (compared with the intrauterine curve) occurs in very low birth weight infants after birth, regardless of the type of feeding or the presence or absence of bronchopulmonary dysplasia. 31 references.

  18. Mid- and long-term outcome of 166 premature infants weighing less than 1,000 g at birth, all small for gestational age.

    PubMed

    Monset-Couchard, M; de Bethmann, O; Kastler, B

    2002-01-01

    This longitudinal study reported the mid- and long-term neurodevelopmental outcome of 166 premature infants born with an extremely low birth weight (<1,000 g), all small for gestational age (<10th percentile birth weight for gestational age). Nine girls were lost to follow-up before 3 years of age, and 6 children were excluded a posteriori because of specific conditions diagnosed in the 1st year of life (severe abnormalities in 5). Of the remaining 151 children, 2% had cerebral palsy, 15% had lesser motor disturbances (reduced to 2% after psychomotor training), 8% had early severe developmental delays, and added mild and moderate delays and increasing cognitive gaps amounted to 28% in the 14th year. Visual deficits increased with age up to 63% of the older children. Seven children had deafness and 13 had hearing losses after otitis media. Language delays were observed at some stage in 31% of cases, as well as behavioral disturbances in 42% (severe problems in 12%). At last evaluation, 34% of the children were normal (12% of the older ones), 51% had minor deficiencies, 18% had moderate and 3% had major disabilities. Children entered the first grade in the 7th year in only 84% of cases, which dropped to 63% at proper level in the second grade; 47% entered high school at the proper age, 7/15 obtained the 'baccalauréat' in the 19th/20th year. The school performance was heavily dependent on the socioeconomic and cultural level of the family. PMID:12011568

  19. Symptom index P-value and symptom sensitivity index P-value to determine symptom association between apnea and reflux in premature infants at term.

    PubMed

    Glen, D R; Murakami, P; Nunez, J S

    2013-08-01

    The current method to determine temporal association (TA) between reflux and symptoms is the symptom association probability (SAP), but this method has limitations due to the constraints of binning and the violation of statistical principles of the Fisher's exact test that lead to an invalid estimation of TA. The aim of this study is to develop improved methods of computing the TA between apneic and reflux events using simulation and permutation methods and to compare these to the SAP. TA was analyzed between polysomnographic obstructive apneas and multichannel intraluminal impedance (MII) reflux events. Three new numerical methods were compared to the SAP in four former premature infants with persistent apneas at term. The experimentally found association was compared to the association observed in simulated or permuted data consistent with the lack of association beyond what is expected by chance alone. Temporal association was computed based on symptom and symptom sensitivity indices, SI and SSI, with varying window of association (WA) times from 15 to 300 s. The three new methods estimated P-values at varying WA that generally followed the same pattern of the SAP which had a more erratic pattern. The WA that gave the lowest P-value was approximately 120 s. Each of the novel methods produced P-value results consistent with each other and the SAP yet not subject to its limitations. The variation of WA gave a temporal profile of TA providing clues to its etiology. These new metrics are called Symptom Index (SIP) and Symptom Sensitivity Index (SSIP) P-values.

  20. 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…

  1. Retinopathy of prematurity

    PubMed Central

    Hellström, Ann; Smith, Lois E H; Dammann, Olaf

    2015-01-01

    The immature retinas of preterm neonates are susceptible to insults that disrupt neurovascular growth, leading to retinopathy of prematurity. Suppression of growth factors due to hyperoxia and loss of the maternal–fetal interaction result in an arrest of retinal vascularisation (phase 1). Subsequently, the increasingly metabolically active, yet poorly vascularised, retina becomes hypoxic, stimulating growth factor-induced vasoproliferation (phase 2), which can cause retinal detachment. In very premature infants, controlled oxygen administration reduces but does not eliminate retinopathy of prematurity. Identification and control of factors that contribute to development of retinopathy of prematurity is essential to prevent progression to severe sight-threatening disease and to limit comorbidities with which the disease shares modifiable risk factors. Strategies to prevent retinopathy of prematurity will depend on optimisation of oxygen saturation, nutrition, and normalisation of concentrations of essential factors such as insulin-like growth factor 1 and ω-3 polyunsaturated fatty acids, as well as curbing of the effects of infection and inflammation to promote normal growth and limit suppression of neurovascular development. PMID:23782686

  2. [Twin pregnancy with intrauterine death of one fetus].

    PubMed

    Jaczewski, B; Krasomski, G; Wilczyński, J

    1993-02-01

    A case of twin pregnancy with congenital malformations and intrauterine death of one fetus in the 27th week of pregnancy has been discussed. The pregnancy was continued with special care of the mother and the alive fetus. During all stay of the pregnant in the clinic no coagulation disturbances were observed. In the 33rd week of pregnancy spontaneous labour occurred, which was conducted by vaginal delivery. Simultaneously a macerated dead fetus and an alive premature newborn were born. The alive one was charged home in good condition in the 38th day of staying in the Neonatal Ward. PMID:8359726

  3. 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

  4. Intravenous lipids for preterm infants: a review.

    PubMed

    Salama, Ghassan Sa; Kaabneh, Mahmmoud Af; Almasaeed, Mai N; Alquran, Mohammad Ia

    2015-01-01

    Extremely low birth weight infants (ELBW) are born at a time when the fetus is undergoing rapid intrauterine brain and body growth. Continuation of this growth in the first several weeks postnatally during the time these infants are on ventilator support and receiving critical care is often a challenge. These infants are usually highly stressed and at risk for catabolism. Parenteral nutrition is needed in these infants because most cannot meet the majority of their nutritional needs using the enteral route. Despite adoption of a more aggressive approach with amino acid infusions, there still appears to be a reluctance to use early intravenous lipids. This is based on several dogmas that suggest that lipid infusions may be associated with the development or exacerbation of lung disease, displace bilirubin from albumin, exacerbate sepsis, and cause CNS injury and thrombocytopena. Several recent reviews have focused on intravenous nutrition for premature neonate, but very little exists that provides a comprehensive review of intravenous lipid for very low birth and other critically ill neonates. Here, we would like to provide a brief basic overview, of lipid biochemistry and metabolism of lipids, especially as they pertain to the preterm infant, discuss the origin of some of the current clinical practices, and provide a review of the literature, that can be used as a basis for revising clinical care, and provide some clarity in this controversial area, where clinical care is often based more on tradition and dogma than science. PMID:25698888

  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. Premature adrenarche.

    PubMed

    Saenger, P; Dimartino-Nardi, J

    2001-10-01

    Adrenarche is the puberty of the adrenal gland. The descriptive term "pubarche" indicates the appearance of pubic hair, which may be accompanied by axillary hair. This process is considered premature if it occurs before age 8 yr in girls and 9 yr in boys. The chief hormonal products of adrenarche are DHEA and DHEAS. The well-documented evolution of adrenarche in primates and men is incompatible with either a neutral or harmful role for DHEA and implies most likely a positive role for some aspects of young adult pubertal maturation and developmental maturation. Premature adrenarche has no adverse effects on the onset and progression of gonadarche and/or final height. Mechanisms for initiation of adrenal androgen secretion at adrenarche are still not well understood. Maturational increases in 17-hydroxylase and 17,20-lyase are seen together with a lower activity of 3beta-hydroxysteroid dehydrogenase (3beta-HSD). There is good evidence that the zona reticularis is the source of adrenal androgens. Adrenarche and gonadarche are regulated differently. Although premature adrenarche has been thought to be a benign, normal variant of puberty, our findings indicate that, for certain girls, premature adrenarche represents an early clinical feature of syndrome X (obesity, hypertension, dyslipidemia, insulin resistance). Perhaps the early identification of these patients will permit early therapy, such as lifestyle changes, including dietary and activity level intervention. As insulin resistance is an underlying feature of premature adrenarche, it seems rational to assess the efficacy and safety of using insulin-sensitizing agents to treat these individuals. In the absence of controlled longitudinal studies, the cross-sectional data available from our studies suggest that premature pubarche driven by premature adrenarche and hyperinsulinemia may precede the development of ovarian hyperandrogenism, and this sequence may have an early origin with low birth weight serving as a

  7. Fathers and fetuses.

    PubMed

    Harris, George W

    1986-04-01

    Harris postulates that in certain instances it would be morally impermissible for a woman to have an abortion because it would be a wrongful harm to the father and a violation of his autonomy. He constructs and analyzes five cases chosen to elucidate the moral issues involved and concludes that, for a man to lay claim to the fetus being his in a sense that the mother is obligated to respect, the fetus must be the result of his having pursued a legitimate interest in procreation in a morally legitimate way. When a man has satisfied the requirements of autonomy both for himself and for his sexual partner in regard to the interest in procreation, the woman has a prima facie obligation to him not to harm the fetus. Therefore, unless there is some contravening moral consideration that overrides this obligation, the abortion of the fetus is morally impermissible.

  8. Epidemiology of spontaneous premature rupture of membranes: factors in pre-term births.

    PubMed Central

    Miller, H. C.; Jekel, J. F.

    1989-01-01

    The frequency of spontaneous premature rupture of membranes (PROM) was determined in the pregnancies of 1,848 white mothers and their singleton infants, born at the University of Kansas Medical Center between April 1975 and April 1978. The frequency of PROM increased significantly from a low of 34/707 (4.8 percent) among low-risk mothers, to 40/444 (9.0 percent) among mothers smoking one to 60 cigarettes a day, to 21/204 (10.3 percent) among mothers with multiple adverse maternal practices, and to 12/46 (26 percent) among mothers with selected complications of their pregnancies. The proportion of low birth weight (LBW) (less than 2,500 g) pre-term infants born to PROM mothers increased among the risk factor groups in a similar manner, from a low of 2/34 (6 percent) in low-risk pregnancies to 8/40 (20 percent) among mothers smoking one to 60 cigarettes a day, to 7/21 (33 percent) among mothers with multiple adverse practices, and to 7/12 (58 percent) among mothers with selected complications of pregnancy. The increased incidence of low birth weight pre-term infants born to mothers with PROM was associated with evidence of growth retardation among full-term infants in the high-risk groups. This finding was manifested by reductions in mean birth weights of full-term infants born to high-risk mothers but not observed in full-term infants born to low-risk mothers. The attained growth at birth of low birth weight pre-term infants could not be determined, because appropriate birth weight standards for pre-term infants born to mothers with low-risk pregnancies are not available. These results suggest that growth retardation in fetuses increased the probability of the mothers having PROM prior to the onset of labor, and, if PROM did occur, of having a premature delivery. We hypothesize that the tensile strength of the amnion and chorion is diminished by the same conditions that retard fetal growth, and that this reduction in strength of the fetal membranes contributes to

  9. The legal status of the fetus in New South Wales.

    PubMed

    Uppal, Talat; Pickering, A; Erasmus, K; Pardey, J; Beran, Roy G

    2012-09-01

    The issue of how to define the legal status of the fetus is complex. Three clinical cases with fetal losses following motor vehicle accidents raise important issues regarding the legal status of the unborn child. Legislation was submitted to the New South Wales Parliament in the form of the Crimes Amendment (Grievous Bodily Harm) Bill 2005 (NSW) but was subsequently repealed. Medical technological advances make the viability of a fetus a shifting standard and encourage the comparison between newborns and late-term fetuses, offer increased fetal health status information and provide greater capacity to maintain the life of babies born prematurely. In view of the sophisticated state of medical care available in New South Wales, the three cases reviewed highlight the discrepancy between the medical recognition of the fetus as a patient and its lack of legal recognition.

  10. 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.

  11. Early preventive attachment-oriented psychotherapeutic intervention program with parents of a very low birthweight premature infant: results of attachment and neurological development.

    PubMed

    Brisch, Karl Heinz; Bechinger, Doris; Betzler, Suzanne; Heinemann, Hilde

    2003-06-01

    The birth of a very small preterm infant (< or = 1500 grams) can be a traumatizing experience for many parents. A developmental risk model is presented that is the background to an early attachment-oriented preventive psychotherapeutic intervention. This comprehensive parent-centered intervention program is composed of supportive group psychotherapy, attachment-oriented focal individual psychotherapy, a home visit and video-based sensitivity training. The intervention aims at improving parental coping, the process of attachment and parent-infant interaction. In a prospective longitudinal design mothers were randomly assigned to a control (N = 44) and an intervention group (N = 43) after preterm delivery. Results show that the percentage of secure (control vs. intervention group: 77.8% vs. 59.4%) and insecure (control vs. intervention group: 8.3% vs. 31.3% avoidant, 13.9% vs. 9.4% ambivalent) attachment quality in high-risk preterm infants is comparable to results from studies with term infants. There was no significant statistical difference in terms of quality of attachment of the preterm infants between the control group and the intervention group. However, only in the control group, impaired neurological development corresponded significantly with an insecure quality of attachment, but not in the intervention group, although there were significantly more neurologically impaired infants in the intervention group. This result is discussed as an effect of the intervention program.

  12. Role of elevated plasma soluble ICAM-1 and bronchial lavage fluid IL-8 levels as markers of chronic lung disease in premature infants.

    PubMed Central

    Little, S.; Dean, T.; Bevin, S.; Hall, M.; Ashton, M.; Church, M.; Warner, J.; Shute, J.

    1995-01-01

    BACKGROUND--Pulmonary neutrophilia characterises both the relatively transient inflammation associated with infant respiratory distress syndrome (IRDS) and the persistent inflammation of chronic lung disease. The possibility that persistently raised markers of inflammation indicate the development of chronic lung disease in low birth weight (< 1730 g) preterm (< 31 weeks) infants was therefore investigated. METHODS--Soluble ICAM-1 (sICAM-1) levels in plasma, and interleukin (IL)-8 and myeloperoxidase (MPO) levels in bronchial lavage fluid (BLF) obtained from 17 infants on days 1, 5, and 14 following birth were measured and correlations with the number of neutrophils in BLF sought. Peripheral neutrophils were isolated on Polymorphoprep and chemotactic responsiveness to IL-8 was assessed using micro Boyden chambers. RESULTS--Sixteen infants developed IRDS and, of these, 10 infants subsequently developed chronic lung disease. Levels of IL-8 in BLF at 14 days of age correlated with the long term requirement for intermittent positive pressure ventilation (IPPV). Interleukin 8 levels in BLF correlated with neutrophil numbers and MPO concentration, suggesting both recruitment and activation in response to this cytokine. Antibody depletion studies showed that approximately 50% of total neutrophil chemotactic activity in BLF was due to IL-8. No difference in peripheral neutrophil chemotactic responsiveness at any age was observed for infants with IRDS or chronic lung disease. Plasma soluble intercellular adhesion molecule (sICAM-1) was higher at 14 days of age in infants who developed chronic lung disease than in those with resolving IRDS, and correlated with severity of disease, as indicated by duration of IPPV. CONCLUSIONS--The results indicate that high levels of plasma sICAM-1 and IL-8 in BLF at day 14 correlate with the development of chronic lung disease and indicate the severity of disease. PMID:7491556

  13. [Premature ejaculation].

    PubMed

    Sapetti, Adrián

    2013-01-01

    Premature ejaculation is the more frequent sexological consultation in men along with the Erectile Dysfunction. In this article a revision will become of its definitions, its clinical manifestations that allow to an effective diagnosis and its therapeutic boarding with Sexual Therapies and, in certain cases, with drugs like PDE-5 Inhibitors, tricyclic antidepressants, IRSS, or dapoxetine. PMID:24260751

  14. Effect of premature delivery on rat lung retinol (vitamin A) and retinyl ester stores.

    PubMed

    Zachman, R D; Valceschini, G

    1988-01-01

    Low plasma retinol (vitamin A) in premature infants has been associated with bronchopulmonary dysplasia. Also, retinol (vitamin A) deficiency is characterized by loss of cilia and squamous metaplasia of the respiratory tract, similar to the histological lesions of bronchopulmonary dysplasia of the premature infant. Recent work showed that the fetal rat lung retinyl palmitate stores were high preterm, but fell abruptly between 21 days of gestation and postpartum. This report extends this observation by showing that lung retinyl palmitate also decreases after cesarean section delivery preterm. Lung retinol and retinyl palmitate in the lungs of 21-day gestation fetuses delivered by cesarean section and stimulated to breath were compared to their in utero littermates. In utero lungs contained 2.2 +/- 0.14 micrograms/g dry weight retinol and 14.9 +/- 0.8 micrograms/g dry weight retinyl palmitate. Lungs from littermates that had been removed from the uterus and breathed on their own for 4 h had lower retinol (1.6 +/- 0.08 micrograms/g) and retinyl palmitate (11.3 +/- 0.4 micrograms/g; p less than 0.01). Fetal lung contains retinyl palmitate stores that are readily mobilized with delivery at term or preterm. PMID:3203123

  15. 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

  16. [Cerebral syndromes in premature children].

    PubMed

    Edel'shteĭn, E A; Bandarenko, E S

    1983-01-01

    Cerebral disturbances observed in premature infants are analyzed. These disturbances are a consequence of developmental slowdown and are associated with the pathological immaturity of the brain structures. On condition an active pathogenetic therapy is given these disturbances may gradually regress. On the basis of long-term observations of 600 prematurely born infants the authors describe the following clinical syndromes: muscular hypotonicity lasting up to 4-5 months and followed with a rise of the tone; the syndrome of "paretic hands" observed during the first two months of life; a hypertensive-hydrocephalic syndrome combined with a rise of the neuro-reflectory excitability; the syndrome of psychomotor development retardation followed at an age of over 1.5 to 2 years by complete recovery or minimal cerebral insufficiency with belated development of motor speech and neurosis-like reactions. PMID:6880498

  17. Vital and Vulnerable Functions of the Primate Placenta Critical for Infant Health and Brain Development

    PubMed Central

    Coe, Christopher L.; Lubach, Gabriele R.

    2014-01-01

    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. PMID:24699357

  18. 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.

  19. [Premature birth and cognitive functioning in adolescence].

    PubMed

    Lubetzky, O; Weitzman, A; Gilat, I; Tyano, S

    1999-11-01

    Premature infants are considered a high-risk population for developing cognitive dysfunction. Studies have indicated lower cognitive performance among elementary school children born prematurely. We focused on cognitive functioning of such adolescents. This age was chosen because of its critical importance in the development of the individual. 50 adolescents aged 14-16 years born prematurely were compared with 50 born at full-term and matched for gender, age and socioeconomic status. All subjects attended regular schools and did not suffer severe neurological disorders. Cognitive functioning was measured by the Bender-Visual Motor Gestalt Test and by 3 subtests from the Wechsler Intelligence Scale for Children (revised WISC-R test). Results revealed that prematurely born adolescents scored lower than those born at term on all measures of cognitive performance. The results are discussed in terms of their developmental meaning and of therapy for the prematurely born. PMID:11419040

  20. Adherence of medium-chain fatty acids to feeding tubes of premature infants fed formula fortified with medium-chain triglyceride.

    PubMed

    Mehta, N R; Hamosh, M; Bitman, J; Wood, D L

    1991-10-01

    Adherence of medium-chain triglyceride (MCT) oil to feeding tubes during gavage feeding of Enfamil formula was quantitated. Infants were fed similar volumes of either unfortified formula (n = 11) or MCT oil-fortified formula (0.5 ml/oz); either the MCT oil was mixed with the formula before feeding (n = 11) or the MCT oil was delivered into the feeding tube and then was followed by formula (n = 11). The fat residue in the feeding sets was quantitated by gravimetry, and individual fatty acids were characterized by gas-liquid chromatography. The data show that only trace amounts of lipid (0.23 +/- 0.04%) adhered to feeding sets during feeding of unfortified formula. Significantly more lipid (p less than 0.0005) adhered when formula was fortified with MCT oil, and the method of feeding greatly affected lipid adherence, i.e., 1.52 +/- 0.21% when the MCT oil was followed by formula versus 10.20 +/- 1.76% when the MCT oil was mixed with formula before feeding. Analysis of the fat residue of fortified formula showed that greater than 90% was composed of C8:0 and C10:0, the major fatty acid components of MCT oil. We suggest that care be exercised when fortifying infant formula with MCT oil.

  1. 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

  2. Development of an artificial placenta: survival of isolated goat fetuses for three weeks with umbilical arteriovenous extracorporeal membrane oxygenation.

    PubMed

    Unno, N; Kuwabara, Y; Okai, T; Kido, K; Nakayama, H; Kikuchi, A; Narumiya, Y; Kozuma, S; Taketani, Y; Tamura, M

    1993-12-01

    The purpose of our study was to examine the feasibility of long-term extrauterine incubation of an isolated premature fetus in artificial amniotic fluid with arteriovenous extracorporeal circulation. Two premature goat fetuses (age 120 and 128 days) were incubated in an isothermal artificial amniotic fluid incubator with arteriovenous extracorporeal membrane oxygenation via the umbilical vessels. We administered pancuronium bromide to suppress fetal movement and swallowing because movement and swallowing have been implicated in fetal deterioration during extrauterine fetal incubation. The fetuses maintained stable circulatory and respiratory parameters. The total incubation time was 494 and 543 h. The animals were then removed from the incubator and stimulated to initiate lung respiration. With ventilator support, both animals maintained stable blood-gas exchange and survived for more than 1 week. These results clearly indicate that umbilical arteriovenous extracorporeal membrane can effectively support extended extrauterine incubation of an isolated premature fetus.

  3. Quality improvement for neonatal nurses, part II: using a PDSA quality improvement cycle approach to implement an oral feeding progression guideline for premature infants.

    PubMed

    Marcellus, Lenora; Harrison, Adele; Mackinnon, Kathleen

    2012-01-01

    The development of clinical practice guidelines involving multiple health care providers presents a challenge in the neonatal intensive care unit (NICU). Implementation and evaluation of the guideline is as important as the development of the guideline itself. We explored the use of a quality improvement approach in the implementation of a feeding framework. A Plan-Do-Study-Act (PDSA) quality improvement cycle model was used to implement and evaluate a stepwise oral infant feeding guideline with emphasis on parent and care provider satisfaction. Three PDSA cycles were conducted, with each cycle resulting in modifications to use of the framework and development of knowledge translation and parent education techniques and tools. A PDSA cycle approach can be used effectively in guideline implementation and evaluation involving multidisciplinary health care professionals. This is Part II of a two-part series. Part I introduced the concept of quality improvement and tools for advancing practice changes.

  4. [The fetus and noise].

    PubMed

    Brezinka, C; Lechner, T; Stephan, K

    1997-01-01

    From 23 weeks of gestation some and from 28 weeks all healthy fetuses are capable of reacting to sound stimulation. The intrauterine acoustic environment is dominated by maternal sounds--heartbeat, breathing, the mother's voice, borborygmi and sounds caused by body movements. Background noise is never below 28 dB and can rise to 84 dB when the mother is singing. Noises that are meant to reach the fetus must be louder than the background noise and must be of low frequency as high frequency sounds are damped by maternal tissue. Vibroacoustic stimulation tests (VAST) have become popular in pregnancy surveillance over the last 20 years, mostly using an artificial larynx. Advantages and problems of the various VAST protocols in fetal monitoring are discussed in the light of animal experiments and clinical studies. Health legislation laws in most countries forbid pregnant women to work in surroundings with a high noise level (80 dB continuous noise and/or rapid impulse noise changes of 40 dB). Whereas regulations for pregnant women are easy to enforce in industry, pregnant women employed in discos or performing as musicians spend most of their working day exposed to noise impact higher than the recommended limit.

  5. 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

  6. Patent Ductus Arteriosus in Premature Neonates

    PubMed Central

    Mezu-Ndubuisi, Olachi J.; Agarwal, Ghanshyam; Raghavan, Aarti; Pham, Jennifer T.; Ohler, Kirsten H.; Maheshwari, Akhil

    2015-01-01

    Persistent patency of the ductus arteriosus is a major cause of morbidity and mortality in premature infants. In infants born prior to 28 weeks of gestation, a hemodynamically-significant patent ductus arteriosus (PDA) can cause cardiovascular instability, exacerbate respiratory distress syndrome, prolong the need for assisted ventilation, and increase the risk of bronchopulmonary dysplasia, intraventricular hemorrhage, renal dysfunction, intraventricular hemorrhage, cerebral palsy, and mortality. In this article, we review the pathophysiology, clinical features, and assessment of hemodynamic significance, and provide a rigorous appraisal of the quality of evidence to support current medical and surgical management of PDA of prematurity. Cyclo-oxygenase inhibitors such as indomethacin and ibuprofen remain the mainstay of medical therapy for PDA, and can be used both for prophylaxis as well as rescue therapy to achieve PDA closure. Surgical ligation is also effective and is used in infants who do not respond to medical management. Although both medical and surgical treatment have proven efficacy in closing the ductus, both modalities are associated with significant adverse effects. Because the ductus does undergo spontaneous closure in some premature infants, improved and early identification of infants most likely to develop a symptomatic PDA could help in directing treatment to the at-risk infants and allow others to receive expectant management. PMID:22564132

  7. Effects of Maternal Treatment with Corticosteroids on Tight Junction Protein Expression in the Cerebral Cortex of the Ovine Fetus with and without Exposure to In-Utero Brain Ischemia

    PubMed Central

    Malaeb, Shadi N; Sadowska, Grazyna B; Stonestreet, Barbara S

    2007-01-01

    Maternal treatment with corticosteroids reduces blood-brain barrier permeability in premature ovine fetuses and the incidence of intraventricular hemorrhage in premature infants. We tested the hypothesis that maternally administered corticosteroids increase the expression of tight junction (TJ) proteins in the cerebral cortex of ovine fetuses with and without exposure to in-utero brain ischemia. Fetuses at 80% of gestation were studied 18 h after the last of four 4−6 mg dexamethasone or placebo injections were given over 48 h to ewes. Groups were placebo/control, dexamethasone/control, placebo/ischemic, and dexamethasone/ischemic. Ischemia consisted of 30 min of fetal carotid artery occlusion and 72 h of reperfusion. Cerebral cortex was snap frozen. Western immunoblot was used to measure the protein expression of occludin, claudin-1, claudin-5, zonula occludens (ZO)-1, and ZO-2, and a TJ accessory protein annexin II. Occludin and annexin II protein expression were 48% and 58% higher (P<0.05) in the dexamethasone/ischemic than placebo/control group, respectively. Claudin-5 protein expression was 69% and 73% higher (P<0.05) in the placebo/ischemic and dexamethasone/ischemic than placebo/control group. Claudin-1 expression did not differ among groups. ZO-1 protein expression was 25%, 40%, and 55% lower in the dexamethasone/control, placebo/ischemic and dexamethasone/ischemic than placebo/control group, respectively. ZO-2 expression was 45% and 70% lower (P<0.01) in the placebo/ischemic and dexamethasone/ischemic than placebo/control group. We conclude that maternal corticosteroid treatment differentially regulates the expression of component proteins of TJs in the cerebral cortex of fetuses exposed to brain ischemia. The functional significance of this differential regulation warrants further investigation. PMID:17583681

  8. Premature ejaculation.

    PubMed

    McMahon, Chris G

    2007-04-01

    Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

  9. Premature ejaculation

    PubMed Central

    McMahon, Chris G.

    2007-01-01

    Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have “definite” PE, while men with IELTs between 1 and 1.5 minutes have “probable” PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects. PMID:19675782

  10. Premature ejaculation.

    PubMed

    McMahon, Chris G

    2007-04-01

    Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects. PMID:19675782

  11. 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.

  12. Early Menopause (Premature Menopause)

    MedlinePlus

    ... has been called “premature menopause” or “premature ovarian failure.” But a better term is “primary ovarian insufficiency,” ... and what procedures might cause it. Premature Ovarian Failure: Premature Menopause (Copyright © American Pregnancy Association) - This article ...

  13. 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.

  14. [Premature rupture of membranes and chorioamnionitis].

    PubMed

    Lopez Garcia, R

    1988-01-01

    , and congenital malformations. Neonatal sepsis occurs in about 5% of live births following premature rupture, but the rate triples after 24 hours, especially in premature infants. The rate of neonatal asphyxia also increases considerable after 24 hours. Congenital malformations, prolapse of the cord, and pelvic presentation are positively associated with premature rupture of membranes. If the decision is made to interrupt the pregnancy, it should be done between 12-24 hours after rupture because the risks of infection and respiratory difficulty are most balanced at that point. Vaginal deliveries should be preferred only if conditions are favorable for a prompt delivery. The gestational age, presence of infection, obstetric condition of the mother, and indication for hysterectomy are the most important points to consider i management of premature rupture.

  15. Even Partial Steroid Treatment Can Benefit Extremely Preterm Infants, NIH Study Suggests

    MedlinePlus

    ... Even partial steroid treatment can benefit extremely preterm infants, NIH study suggests Infants exposed to partial treatment in the womb healthier ... chances of certain birth defects for extremely premature infants, even if the treatment course is not finished ...

  16. Sleep deprivation, pain and prematurity: a review study.

    PubMed

    Bonan, Kelly Cristina Santos de Carvalho; Pimentel Filho, João da Costa; Tristão, Rosana Maria; Jesus, José Alfredo Lacerda de; Campos Junior, Dioclécio

    2015-02-01

    The aim was to describe current reports in the scientific literature on sleep in the intensive care environment and sleep deprivation associated with painful experiences in premature infant. A systematic search was conducted for studies on sleep, pain, premature birth and care of the newborn. Web of Knowledge, MEDLINE, LILACS, Cochrane Library, PubMed, EMBASE, Scopus, VHL and SciELO databases were consulted. The association between sleep deprivation and pain generates effects that are observed in the brain and the behavioral and physiological activity of preterm infants. Polysomnography in intensive care units and pain management in neonates allow comparison with the first year of life and term infants. We have found few references and evidence that neonatal care programs can influence sleep development and reduce the negative impact of the environment. This evidence is discussed from the perspective of how hospital intervention can improve the development of premature infants.

  17. Isolated Complete Heart Block in the Fetus.

    PubMed

    Ho, Andrew; Gordon, Patrick; Rosenthal, Eric; Simpson, John; Miller, Owen; Sharland, Gurleen

    2015-07-01

    Isolated congenital complete heart block (CCHB) is a rare disease with significant associated morbidity and mortality. A diagnosis is often made in fetal life, but data regarding long-term outcomes are limited, and fetal therapy to improve prognosis is controversial. In our institution, 85 fetuses were diagnosed with CCHB from 1981 to 2013 in 80 mothers. There were 37 anti-Ro-positive pregnancies, 36 both anti-Ro and anti-La positive, 10 antibody negative, and 2 of unknown antibody status. Antenatal treatments were given in 14 fetuses, with 8 given fluorinated steroids, 4 beta sympathomimetics, and both in 2. Of the original 85, 74 babies survived to delivery. Fetal hydrops was the only risk factor found to be significantly associated with intrauterine death (p <0.001). Four babies died before pacemaker implantation, 56 have had pacemakers implanted, and 14 are pacemaker free. The Kaplan-Meier estimate for median time to pacemaker implantation was 2.6 years, with 15 implanted in the neonatal period. There have been 14 postnatal deaths, with a Kaplan-Meier estimate of survival at 30 years of 76.8% (95% confidence interval 65% to 90%). Dilated cardiomyopathy was uncommon, occurring in 6 patients. Prematurity and hydrops were associated with increased postnatal mortality (p = 0.02 and 0.005, respectively). In conclusion, we present the largest single-unit experience of prenatally diagnosed CCHB in the published literature. Our cohort was conservatively managed, with survival similar to those previously published. These data offer insight into the long-term natural history of CCHB.

  18. Premature Ovarian Failure

    MedlinePlus

    Premature ovarian failure (POF) is when a woman's ovaries stop working before she is 40. POF is different from premature menopause. With premature menopause, ... be a disease, surgery, chemotherapy, or radiation. With POF, some women still have occasional periods. They may ...

  19. Anatomy of Inferior Mesenteric Artery in Fetuses.

    PubMed

    Nuzhat, Ayesha

    2016-01-01

    Aim. To analyze Inferior Mesenteric Artery in fetuses through its site of origin, length, diameter, and variation of its branches. Method. 100 fetuses were collected from various hospitals in Warangal at Kakatiya Medical College in Andhra Pradesh, India, and were divided into two groups, group I (second-trimester fetuses) and group II (third-trimester fetuses), followed by dissection. Result. (1) Site of Origin. In group I fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra in 33 out of 34 fetuses (97.2%). In one fetus it was at first lumbar vertebra, 2.8%. In all group II fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra. (2) Length. In group I fetuses it ranged between 18 and 30 mm, average being 24 mm except in one fetus where it was 48 mm. In group II fetuses the length ranged from 30 to 34 mm, average being 32 mm. (3) Diameter. In group I fetuses it ranged from 0.5 to 1 mm, and in group II fetuses it ranged from 1 to 2 mm, average being 1.5 mm. (4) Branches. Out of 34 fetuses of group I, 4 fetuses showed variation. In one fetus left colic artery was arising from abdominal aorta, 2.9%. In 3 fetuses, Inferior Mesenteric Artery was giving a branch to left kidney, 8.8%. Out of 66 fetuses in group II, 64 had normal branching. In one fetus left renal artery was arising from Inferior Mesenteric Artery, 1.5%, and in another fetus one accessory renal artery was arising from Inferior Mesenteric Artery and entering the lower pole of left kidney. Conclusion. Formation, course, and branching pattern of an artery depend on development and origin of organs to attain the actual adult position. PMID:27313956

  20. 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). PMID:26500242

  1. 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

  2. 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

  3. [Generalized candidiasis in a prematurely born infant].

    PubMed

    Morpurgo, F G; Hack, W W; Ree, E F; Weyers, T; van der Harten, J J; Taets van Amerongen, A

    1990-10-01

    A male neonate born after spontaneous labor during the 25 3/7 week of gestation, developed a fatal course of disseminated candidiasis. Disseminated candidiasis is seen in newborns undergoing intensive care and has a high mortality rate. Important etiologic factors are low immunologic response, invasive monitoring techniques, systemic antibiotics and parenteral nutrition. Early diagnosis and efficient antimycotic therapy with amphotericin B and if necessary combined with flucytosine contribute a great deal to the chance of survival.

  4. 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.

  5. Laser therapy for retinopathy of prematurity.

    PubMed

    Banach, M J; Berinstein, D M

    2001-06-01

    Retinopathy of prematurity (ROP) is a potentially blinding condition that afflicts preterm infants in the neonatal period. Although advances in scleral buckling and vitrectomy techniques offer hope for those infants suffering from stage 4 or 5 ROP, prevention of progression to these stages offers the most promise for favorable structural and visual outcomes. Proper screening for threshold ROP and treatment with peripheral retinal ablation are the keys to successfully managing ROP. Technological advances in screening tools and portable diode lasers enable ophthalmologists to provide prompt, effective, and safe treatment for patients with threshold ROP.

  6. 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)

  7. The fetus in maternal hyperthyroidism.

    PubMed

    Perelman, A H; Clemons, R D

    1992-01-01

    A recent article in the New England Journal of Medicine reported the successful diagnosis and treatment of fetal goitrous hypothyroidism in a mother with Graves' disease. The fetus is being recognized as an important patient in its own right in terms of thyroid disease. The fetal thyroid system develops independently of the normal maternal thyroid axis. Presence of feedback suppression of TSH by T4 has been demonstrated in a 35-week fetus. Information learned from congenital hypothyroidism suggests that lack of fetal thyroid hormones may have a negative impact on the developing fetal brain with lack of normal myelination. It is uncertain at what gestational age the fetus and the developing central nervous system become adversely affected by thyroid hormone deficiency. Since congenital hypothyroidism is sporadic and since there is no current method for easily screening all pregnancies for hypothyroidism, the thrust in fetal diagnosis and therapy has been in those pregnancies suspected of having a hypothyroid fetus when a fetal goiter is detected by ultrasonography or in a hyperthyroid mother who may be on antithyroid therapy. Intraamniotic injections of L-thyroxine have proven successful for fetal therapy. Amniotic fluid TSH may prove useful in the diagnosis and treatment of a hypothyroid fetus. Previous studies have suggested that the period of thyroxine dependency of the fetal central nervous system is limited predominantly to the last 4-8 weeks of gestation. Fetal hyperthyroidism due to transplacental transmission of thyroid-stimulating immunoglobulins may occur in a mother with a history of hyperthyroidism due to Graves' disease.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Touch during preterm infant resuscitation.

    PubMed

    Kitchin, L W; Hutchinson, S

    1996-10-01

    Preterm infants frequently require resuscitation in the delivery room. Under the intense circumstances of providing lifesaving interventions, caregivers may be unaware of the amount and kind of touch an infant receives. The purpose of this qualitative, ethologic study was to describe the kinds of touch that occur during resuscitation of premature infants immediately after delivery as viewed on videotape. The convenience sample consisted of ten videotapes of premature infant resuscitation performed at a tertiary care center. Using Spradley's Developmental Research Sequence, a description of kinds of touch--including mechanical and human touch--was developed. Descriptive research conceptualizing touch promotes awareness of current practice and may lead to alterations in clinical practice that best support the adaptive response in the depressed infant. PMID:9035643

  9. Anaemia of Prematurity: Pathophysiology & Treatment

    PubMed Central

    Strauss, Ronald G

    2010-01-01

    Most infants with birth weight <1.0 kg are given multiple red blood cell (RBC) transfusions within the first few weeks of life. The anaemia of prematurity is caused by untimely birth occuring before placental iron transport and fetal erythropoiesis are complete, by phlebotomy blood losses taken for laboratory testing, by low plasma levels of erythropoietin due to both diminished production and accelerated catabolism, by rapid body growth and need for commensurate increase in red cell volume/mass, and by disorders causing RBC losses due to bleeding and/or hemolysis. RBC transfusions are the mainstay of therapy with recombinant human erythropoietin largely unused because it fails to substantially diminish RBC transfusion needs — despite exerting substantial erythropoietic effects on neonatal marrow. PMID:20817366

  10. Retinopathy of Prematurity in Triplets

    PubMed Central

    Şekeroğlu, Mehmet Ali; Hekimoğlu, Emre; Çelik, Ülker; Kale, Yusuf; Baş, Ahmet Yağmur

    2016-01-01

    Objectives: To investigate the incidence, severity and risk factors of retinopathy of prematurity (ROP) in triplets. Materials and Methods: The medical records of consecutive premature triplets who had been screened for ROP in a single maternity hospital were analyzed and presence and severity of ROP; birth weight, gender, gestational age of the infant; route of delivery and the mode of conception were recorded. Results: A total of 54 triplets (40 males, 14 females) who were screened for ROP between March 2010 and February 2013 were recruited for the study. All triplets were delivered by Caesarean section and 36 (66.7%) were born following an assisted conception. During follow-up, seven (13%) of the infants developed ROP of any stage and two (3.7%) required laser photocoagulation. The mean gestational age of triplets with ROP was 27.6±1.5 (27-31) weeks whereas it was 32.0±1.5 (30-34) weeks in those without ROP (p=0.002). The mean birth weights of triplets with and without ROP were 1290.0±295.2 (970-1600) g and 1667.5±222.2 (1130-1960) g, respectively (p<0.001). The presence of ROP was not associated with gender (p=0.358) or mode of conception (p=0.674). Conclusion: ROP in triplets seems to be mainly related to low gestational age and low birth weight. Further prospective randomized studies are necessary to demonstrate risk factors of ROP in triplets and to determine if and how gemelarity plays a role in the development of ROP. PMID:27800273

  11. 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…

  12. [The skin of the premature newborn under the nurse's evaluation: orientating the manteinance of cutaneous integrity].

    PubMed

    Martins, Christiane Pereira; Tapia, Carmen Elisa Villalobos

    2009-01-01

    The prematurity expressed relevance to the health neonatal, demonstrating ascending compromising regarding morbi-mortality of this patients, whose larger incidence can be attributed to the inadequate practices with the skin of the premature. Revision of the literature about the beneficial interaction among the skin of premature infant newborn and the appropriate handling, orientated by the nurse, that through the standardization of the cares of direct interference and continuous evaluation of the cutaneous integrity and attending the premature. It publishes the importance of the care with the skin of the premature newborn, not just making possible the survival, but the opportunity to integrate and to enjoy of the life with quality.

  13. [Treatment of premature ejaculation].

    PubMed

    Targoński, Aleksander; Prajsner, Andrzej

    2012-01-01

    Premature ejaculation is the most common sexual dysfunction in men. Its prevalence rate in Europe and in United States is estimated to be between 20% and 30%. The diagnosis of premature ejaculation is based on three main criteria: increased intravaginal ejaculatory latency time (IELT), lack of control over ejaculation and interpersonal psychological disturbances. Premature ejaculation is classified as lifelong (primary) or acquired (secondary) and might be facilitated by chronic prostatitis, diabetes mellitus, hyperthyroidism, obesity. The exact etiology of the disease remains unclear, although 5-HT (5-hydroxytryptamine) receptors are known to have a significant role. The use of SSRIs (selective serotonine reuptake inhibitors) is old and efficient form of therapy for premature ejaculation. Other drugs like tramadol, clomipramine, local anaesthetics and PDE-5 (phosphodiesterase 5) inhibitors also have some efficacy in the treatment of premature ejaculation. To minimize adverse effects the "on demand" therapy is preferred to the daily treatment. Simple questionnaires for patients are used to assess treatment effects. PMID:22827115

  14. Retinopathy of prematurity: Recommendations for screening

    PubMed Central

    Jefferies, AL

    2010-01-01

    Retinopathy of prematurity (ROP) is a disorder of the developing retinal blood vessels of the preterm infant. New recommendations for screening and treatment of ROP have been published in the past few years. Current evidence suggests that screening infants with gestational ages of 30 6/7 weeks or less (regardless of birth weight) and birth weights of 1250 g or less is a strategy with a very small likelihood that an unscreened baby would have treatable ROP. Individual centres may choose to extend birth weight screening criteria to 1500 g. Initial screening should be performed at 31 weeks’ postmenstrual age in infants with gestational ages of 26 6/7 weeks or less at birth, and at four weeks’ chronological age in infants with gestational ages of 27 weeks or more at birth by an ophthalmologist skilled in the detection of ROP. Follow-up examinations are conducted according to the ophthalmologist’s recommendation. Infants with high-risk prethreshold ROP and threshold ROP are referred for retinal ablative therapy. Developing processes for ROP screening, documenting results and communicating results to parents as well as health professionals involved in the infant’s care are important responsibilities for all nurseries providing care for preterm infants. PMID:22131866

  15. Consequences in Infants That Were Intrauterine Growth Restricted

    PubMed Central

    Cosmi, Erich; Fanelli, Tiziana; Visentin, Silvia; Trevisanuto, Daniele; Zanardo, Vincenzo

    2011-01-01

    Intrauterine growth restriction is a condition fetus does not reach its growth potential and associated with perinatal mobility and mortality. Intrauterine growth restriction is caused by placental insufficiency, which determines cardiovascular abnormalities in the fetus. This condition, moreover, should prompt intensive antenatal surveillance of the fetus as well as follow-up of infants that had intrauterine growth restriction as short and long-term sequele should be considered. PMID:21547088

  16. Suspected Central Anticholinergic Syndrome Related to Cycloplegic Eye Drop in a Premature Baby

    PubMed Central

    Bedirli, Nurdan; Akgün, Fatma; Hondur, Ahmet; Işık, Berrin

    2012-01-01

    The therapeutic approach for the central anticholinergic syndrome after application of cycloplegic eye drops in a premature infant patient who was scheduled for laser photocoagulation under general anesthesia is reviewed in the light of the relevant literature. PMID:25207025

  17. 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

  18. Effects of Prematurity on the Development of Contrast Sensitivity: Testing the Visual Experience Hypothesis

    PubMed Central

    Bosworth, Rain G.; Dobkins, Karen R.

    2013-01-01

    In order to investigate the effects of visual experience on early visual development, the current study compared contrast sensitivity across infants born with different levels of moderate-to-late prematurity. Here the logic is that at any given postterm age, the most premature infants will have the oldest postnatal age. Given that postnatal age is a proxy for visual experience, the visual experience hypothesis predicts that infants who are more premature, yet healthy, should have higher sensitivity. Luminance (light/dark) and chromatic (red/green) contrast sensitivities (CS) were measured in 236 healthy infants (born −10 to +2 weeks relative to due date) between 5 and 32 weeks postterm age from due date and 8 to 38 weeks postnatal from birth date. For chromatic CS, we found clear evidence that infants who were most premature within our sample had the highest sensitivity. Specifically, 4 to 10 additional weeks of visual experience, by virtue of being born early, enhanced chromatic CS. For luminance CS, similar but weaker results were seen. Here, only infants with an additional 6 to 10 weeks of visual experience, and only at later age points in development, showed enhanced sensitivity. However, CS in preterm infants was still below that of fullterm infants with equivalent postnatal age. In sum, these results suggest that chromatic CS is influenced more by prematurity (and possibly visual experience) than is luminance CS, which has implications for differential development of Parvocellular and Magnocellular pathways. PMID:23485427

  19. Linking Assessment and Intervention for Developmental/Functional Outcomes of Premature, Low-Birth-Weight Children

    ERIC Educational Resources Information Center

    Xu, Yaoying; Filler, John W.

    2005-01-01

    Prematurity and low birth weight (LBW) are two major biological factors that put infants and young children at high risk for developmental delays or disabilities. While survival rates for premature and LBW children have improved, incidence figures have changed little over the past 20 years; in fact, the incidence of LBW has increased. Although the…

  20. 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

  1. 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.

  2. 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…

  3. Apnea of prematurity: from cause to treatment.

    PubMed

    Zhao, Jing; Gonzalez, Fernando; Mu, Dezhi

    2011-09-01

    Apnea of prematurity (AOP) is a common problem affecting premature infants, likely secondary to a "physiologic" immaturity of respiratory control that may be exacerbated by neonatal disease. These include altered ventilatory responses to hypoxia, hypercapnia, and altered sleep states, while the roles of gastroesophageal reflux and anemia remain controversial. Standard clinical management of the obstructive subtype of AOP includes prone positioning and continuous positive or nasal intermittent positive pressure ventilation to prevent pharyngeal collapse and alveolar atelectasis, while methylxanthine therapy is a mainstay of treatment of central apnea by stimulating the central nervous system and respiratory muscle function. Other therapies, including kangaroo care, red blood cell transfusions, and CO(2) inhalation, require further study. The physiology and pathophysiology behind AOP are discussed, including the laryngeal chemoreflex and sensitivity to inhibitory neurotransmitters, as are the mechanisms by which different therapies may work and the potential long-term neurodevelopmental consequences of AOP and its treatment. PMID:21301866

  4. 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…

  5. 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…

  6. Iatrogenic disorders of the fetus, infant, and child. Vol. 2

    SciTech Connect

    Kassner, E.G.

    1985-01-01

    The purpose of this book is to encompass all the undesired outcomes of diagnostic or therapy interventions of surgical procedures. The eight chapters cover surgery of the airway, thorax, and diaphragm; cardiac surgery; surgery of the upper gastrointestinal tract, abdominal wall, and liver-biliary tract; surgery of the colon; urologic diagnosis and surgery; urinary diversion and undiversion; orthopedic surgery and treatments of skeletal trauma; and neurologic surgery. The chosen format is to describe a procedure or condition and then discuss in great depth the short- and long-term complications. This book is a comprehensive summary of diagnostic and therapeutic complications relating to diseases requiring surgery.

  7. Pattern of pulmonary venous blood flow in the hypoplastic left heart syndrome in the fetus

    PubMed Central

    Better, D; Apfel, H; Zidere, V; Allan, L

    1999-01-01

    OBJECTIVE—To determine whether restriction at the atrial septum in the newborn with hypoplastic left heart syndrome can be predicted accurately by examining the pattern of pulmonary venous flow in the fetus. A restrictive atrial septum can contribute to haemodynamic instability before surgery for this lesion and has been associated with an increased mortality.
DESIGN—Pulmonary venous pulsed Doppler tracings were compared between fetuses with hypoplastic left heart syndrome and controls. The size of the atrial septal defect on the postnatal echocardiogram was graded according to the degree of restriction. Pulsed Doppler tracings of pulmonary venous blood flow were obtained in 18 fetuses with left atrial outflow atresia and compared with 77 controls, adjusted for gestational age. Postnatal echocardiograms were available for analysis in 13 of 18 neonates.
SETTING—A tertiary referral centre for fetal cardiology and paediatric cardiac surgery.
RESULTS—Fetuses with hypoplastic left heart syndrome were different from controls in all pulmonary vein indices measured. As assessed from the postnatal echocardiogram, there were seven fetuses with a restrictive atrial septum. In these fetuses, the systolic flow velocity (p < 0.01), S/D ratio (p < 0.01), and peak reversal wave (p < 0.001) in the pulmonary vein tracing showed a good correlation with the degree of restriction.
CONCLUSIONS—The Doppler pattern of pulmonary venous flow in the fetus with hypoplastic left heart syndrome appears to be a reliable predictor of restriction of the atrial septum in the neonate. This may help in the immediate post-delivery management of these infants before surgery.


Keywords: fetus; congenital heart defects; echocardiography; risk factors PMID:10336926

  8. Ultrasonographic Investigation of Human Fetus Responses to Maternal Communicative and Non-communicative Stimuli.

    PubMed

    Ferrari, Gabriella A; Nicolini, Ylenia; Demuru, Elisa; Tosato, Cecilia; Hussain, Merhi; Scesa, Elena; Romei, Luisa; Boerci, Maria; Iappini, Emanuela; Dalla Rosa Prati, Guido; Palagi, Elisabetta; Ferrari, Pier F

    2016-01-01

    During pregnancy fetuses are responsive to the external environment, specifically to maternal stimulation. During this period, brain circuits develop to prepare neonates to respond appropriately. The detailed behavioral analysis of fetus' mouth movements in response to mothers' speech may reveal important aspects of their sensorimotor and affective skills; however, to date, no studies have investigated this response. Given that newborns at birth are capable of responding with matched behaviors to the social signals emitted by the caregiver, we hypothesize that such precocious responses could emerge in the prenatal period by exploiting infants' sensitivity to their mother's voice. By means of a two-dimensional (2D) ultrasonography, we assessed whether fetuses at 25 weeks of gestation, showed a congruent mouthmotor response to maternal acoustic stimulation. Mothers were asked to provide different stimuli, each characterized by a different acoustic output (e.g., chewing, yawning, nursery rhymes, etc.) and we recorded the behavioral responses of 29 fetuses. We found that, when mothers sang the syllable LA in a nursery rhyme, fetuses significantly increased mouth openings. Other stimuli provided by the mother did not produce other significant changes in fetus' behavior. This finding suggests that fetuses are sensitive only to specific maternal vocalizations (LA) and that fetal matched responses are rudimentary signs of early mirroring behaviors that become functional in the postnatal period. In conclusion, fetuses seem to be predisposed to respond selectively to specific maternal stimuli. We propose that such responses may play a role in the development of behavioral and emotional attunement with their mothers long before birth.

  9. Ultrasonographic Investigation of Human Fetus Responses to Maternal Communicative and Non-communicative Stimuli.

    PubMed

    Ferrari, Gabriella A; Nicolini, Ylenia; Demuru, Elisa; Tosato, Cecilia; Hussain, Merhi; Scesa, Elena; Romei, Luisa; Boerci, Maria; Iappini, Emanuela; Dalla Rosa Prati, Guido; Palagi, Elisabetta; Ferrari, Pier F

    2016-01-01

    During pregnancy fetuses are responsive to the external environment, specifically to maternal stimulation. During this period, brain circuits develop to prepare neonates to respond appropriately. The detailed behavioral analysis of fetus' mouth movements in response to mothers' speech may reveal important aspects of their sensorimotor and affective skills; however, to date, no studies have investigated this response. Given that newborns at birth are capable of responding with matched behaviors to the social signals emitted by the caregiver, we hypothesize that such precocious responses could emerge in the prenatal period by exploiting infants' sensitivity to their mother's voice. By means of a two-dimensional (2D) ultrasonography, we assessed whether fetuses at 25 weeks of gestation, showed a congruent mouthmotor response to maternal acoustic stimulation. Mothers were asked to provide different stimuli, each characterized by a different acoustic output (e.g., chewing, yawning, nursery rhymes, etc.) and we recorded the behavioral responses of 29 fetuses. We found that, when mothers sang the syllable LA in a nursery rhyme, fetuses significantly increased mouth openings. Other stimuli provided by the mother did not produce other significant changes in fetus' behavior. This finding suggests that fetuses are sensitive only to specific maternal vocalizations (LA) and that fetal matched responses are rudimentary signs of early mirroring behaviors that become functional in the postnatal period. In conclusion, fetuses seem to be predisposed to respond selectively to specific maternal stimuli. We propose that such responses may play a role in the development of behavioral and emotional attunement with their mothers long before birth. PMID:27014160

  10. 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.

  11. CPR - infant

    MedlinePlus

    Rescue breathing and chest compressions - infant; Resuscitation - cardiopulmonary - infant; Cardiopulmonary resuscitation - infant ... those who take care of children should learn infant and child CPR. See www.americanheart.org for ...

  12. Infant Mortality

    MedlinePlus

    ... Infant Mortality Infant Mortality: What is CDC Doing? Sudden Infant Death Syndrome Teen Pregnancy Contraception CDC Contraceptive Guidance for ... and low birth weight Maternal complications of pregnancy Sudden Infant Death Syndrome (SIDS) Injuries (e.g., suffocation). The top ...

  13. 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.

  14. 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…

  15. The carotid body and arousal in the fetus and neonate.

    PubMed

    Darnall, Robert A

    2013-01-01

    Arousal from sleep is a major defense mechanism in infants against hypoxia and/or hypercapnia. Arousal failure may be an important contributor to SIDS. Areas of the brainstem that have been found to be abnormal in a majority of SIDS infants are involved in the arousal process. Arousal is sleep state dependent, being depressed during AS in most mammals, but depressed during QS in human infants. Repeated exposure to hypoxia causes a progressive blunting of arousal that may involve medullary raphe GABAergic mechanisms. Whereas CB chemoreceptors contribute heavily to arousal in response to hypoxia, serotonergic central chemoreceptors have been implicated in the arousal response to CO(2). Pulmonary or chest wall mechanoreceptors also contribute to arousal in proportion to the ventilatory response and decreases in their input may contribute to depressed arousal during AS. Little is known about specific arousal pathways beyond the NTS. Whether CB chemoreceptor stimulation directly stimulates arousal centers or whether this is done indirectly through respiratory networks remains unknown. This review will focus on arousal in response to hypoxia and CO(2) in the fetus and newborn and will outline what we know (and do not know) about the involvement of the carotid body in this process. PMID:22684039

  16. [The Outpatient Health Care Package for the very premature infant: application of the program to follow-up services for the Neonatal Intensive Care, Pediatrics Department, Università "La Sapienza" I Facoltà, Roma (June 2008-March 2010)].

    PubMed

    Colarizi, P; De Luca, T; Ruggeri, A; Cerasaro, C

    2010-06-01

    Fifty-nine children were enrolled in the Outpatient Health Care Package (OHCP) from 01/06/2008 to 31/03/2010. All children, except two, attended entirely the follow-up appointments; a satisfactory result, considering also that 30% of family were living outside the urban area and more than a third of the families was originated in a foreign country. At 3 months corrected age(CA) Haemoglobin mean values of 47 infants, all in iron treatment, were: 12.26 (10.1-14-1) g/dL; 25% had values between 10.1 and 12 g/dL. Mean values for Calcium were 10.75 (9.50-15.26) mg/dL Mean values for ALP were 393 (179-1075) UI/L, values >1000 UI/L were found in two infants who suspended Vitamin D treatment. At 3 months CA 50 infants performed ABR, 12 of these showing abnormalities. To date 9 infants repeated ABR at 6-9 months CA, 4 of these showed again abnormal results. Overall were found 4 ABR abnormalities among 47 children (8.5%). Outcome of 23 children at 12 months CA: no moderate or severe neurologic abnormalities were found, 4 children (17.4%) presented mild abnormalities, 2 were referred for rehabilitation. No QSM <80% was found (mean QSM 93.7%) in 10 children evaluated. One child presented growth retardation <5 degrees; 2 underwent laser treatment for ROP with normal vision, 7 (30.4%)had sistolic BP > or = 95 degrees; 6 (26%) were rehospitalized. This experience was positive: OHCP promoted a better compliance and standardization of follow-up. It would be desirable to prolong OHCP until school-age, including renal and cardiac functions monitoring.

  17. Protection of pregnant mice, fetuses and neonates from lethality of H5N1 influenza viruses by maternal vaccination.

    PubMed

    Hwang, Seon Do; Shin, Jin Soo; Ku, Keun Bon; Kim, Hyun Soo; Cho, Sung Whan; Seo, Sang Heui

    2010-04-01

    The highly pathogenic H5N1 influenza viruses are one of candidates for the next pandemic. Information on protective immunity for pregnant animals by vaccination against the H5N1 influenza virus is limited. Here, we show that the immunization of pregnant mice with inactivated H5N1 influenza vaccine protects them, their fetuses, and their infant mice from H5N1 influenza viruses. Pregnant mice immunized with two doses of H5N1 influenza vaccine were protected from homologous infections of H5N1 influenza viruses with no viruses detected in fetuses, and that they were protected upto 30% from heterologous infections of H5N1 influenza viruses with viruses detected in fetuses. The infant mice born to mothers immunized with H5N1 influenza vaccine were fully protected from infections of H5N1 influenza viruses for upto 4 weeks of age. The protection of infant mice was closely related to the presence of IgG2a antibody in lung, heart, and rectum tissues. Our results suggest that maternal vaccination may be critical for protecting pregnant animals, their fetuses, and their infant mice from lethal infections of H5N1 influenza viruses.

  18. Premature rupture of membranes

    MedlinePlus

    ... the 37th week of pregnancy, it is called preterm premature rupture of membranes (PPROM). The earlier your water breaks, the more ... babies born early). If there is not a preterm unit where you deliver, you and your baby will be moved to a hospital that has one.

  19. Percutaneous absorption in preterm infants.

    PubMed

    West, D P; Halket, J M; Harvey, D R; Hadgraft, J; Solomon, L M; Harper, J I

    1987-11-01

    The skin of preterm infants varies considerably in its level of maturity. To understand skin absorption in premature infants better, we report a technique for the assessment of percutaneous absorption at various gestational and postnatal ages using stable, isotope-labeled (13C6) benzoic acid. Our results indicate that in the preterm infant, this method detects enhanced skin absorption in the first postnatal days, which declines over three weeks to that expected of a full-term infant. This approach also indicates an inverse relationship between gestational age and skin absorption, as well as postnatal age and skin absorption. The reported technique is a safe and noninvasive method using a model skin penetrant for the study of percutaneous absorption in preterm infants from which basic data may be derived to add to our understanding of skin barrier function. PMID:3422856

  20. Babies at Double Hazard: Early Development of Infants at Biologic and Social Risk.

    ERIC Educational Resources Information Center

    Escalona, Sibylle K.

    1982-01-01

    The interaction of biological and social factors on the mental and psychological development of 114 low-bIrth-weight premature infants from primarily poor and non White urban families was studied. It is suggested that premature infants are more vulnerable to environmental insufficiencies than are full-term babies. Journal Availability: American…

  1. [Ontological and ethical status of anencephalic fetus].

    PubMed

    Besio R, Mauricio; Besio H, Francisca

    2008-06-01

    Due to advances in prenatal techniques, it is now possible to diagnose malformations in utero, such as anencephaly, which in the past was only known at birth. Having knowledge of a malformation before birth, the moment in which almost every individual obtains social and legal protection, puts the malformed fetus in a vulnerable situation toward possible actions that lead to the interruption of pregnancy. The aim of this article is to analyze different positions about the quality and reality of the anencephalic fetus, its human condition and the care that the fetus and mother deserve. PMID:18769837

  2. 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

  3. Abnormal TREC-Based Newborn Screening Test in a Premature Neonate with Massive Perivillous Fibrin Deposition of the Placenta.

    PubMed

    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

  4. Human Milk for Preterm Infants and Fortification.

    PubMed

    Bhatia, Jatinder

    2016-01-01

    Breastfeeding is universally accepted as the preferred feeding for all newborn infants, including premature infants. The World Health Organization, American Academy of Pediatrics, Canadian Pediatric Society and the European Society for Pediatric Gastroenterology, Hepatology and Nutrition, among others, recommend exclusive breastfeeding for the first 6 months in term infants, while complementary feeding is introduced over the next several months. However, for preterm infants, fortification is recommended to meet requirements. Human milk composition varies with the duration of lactation, within a day and even during one expression, and composition may be altered by method of storage and pasteurization. In this monograph, the use of human milk for premature infants, its limitations, strategies to overcome said limitations and follow-up studies will be reviewed. PMID:27347886

  5. Gaze Behaviors of Preterm and Full-Term Infants in Nonsocial and Social Contexts of Increasing Dynamics: Visual Recognition, Attention Regulation, and Gaze Synchrony

    ERIC Educational Resources Information Center

    Harel, Hagar; Gordon, Ilanit; Geva, Ronny; Feldman, Ruth

    2011-01-01

    Although research has demonstrated poor visual skills in premature infants, few studies assessed infants' gaze behaviors across several domains of functioning in a single study. Thirty premature and 30 full-term 3-month-old infants were tested in three social and nonsocial tasks of increasing complexity and their gaze behavior was micro-coded. In…

  6. 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.

  7. 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…

  8. 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.

  9. 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, ...

  10. 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.

  11. 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.

  12. Understanding the Short- and Long-Term Respiratory Outcomes of Prematurity and Bronchopulmonary Dysplasia.

    PubMed

    Islam, Jessica Y; Keller, Roberta L; Aschner, Judy L; Hartert, Tina V; Moore, Paul E

    2015-07-15

    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

  13. [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.

  14. Bacteremia due to Agrobacterium tumefaciens (radiobacter). Report of infection in a pregnant women and her stillborn fetus.

    PubMed

    Southern, P M

    1996-01-01

    Agrobacterium tumefaciens (radiobacter) is usually a plant pathogen, but is isolated occasionally from human clinical specimens, frequently along with other bacteria. Agrobacterium tumefaciens (radiobacter) has been isolated from blood, central intravenous catheters, peritoneal fluid, urine, and cellulitis aspirates, often in immunocompromised individuals. This report details the isolation of A. tumefaciens (radiobacter) from the blood of a pregnant woman, as well as from the blood of her stillborn, premature fetus. It is, to our knowledge, the first report of such an occurrence.

  15. The challenge of screening for retinopathy of prematurity.

    PubMed

    Wilson, Clare M; Ells, Anna L; Fielder, Alistair R

    2013-06-01

    Screening for retinopathy of prematurity (ROP) and the optimum treatment of sight-threatening disease requires detailed understanding of the infants at risk and timely identification. Despite a plethora of guidelines, not all populations and situations are adequately covered, so that what should be preventable visual disability still occurs. This article considers the design of screening guidelines and the possibility of a global guideline, although in certain parts of the world manpower for ROP screening is not available. Algorithms linked to the increase in weight of preterm infants over time may refine the number of babies needing to undergo treatment. PMID:23719308

  16. Non-invasive Respiratory Support and Severe Retinopathy of Prematurity.

    PubMed

    Raghu, Rahul; Fisher, Marilyn; Cerone, Jennifer; Barry, Gerard

    2016-01-01

    The authors describe two premature infants who developed stage 3, zone I retinopathy of prematurity (ROP) with plus disease in both eyes, despite limited exposure to supra-ambient oxygen. Both infants received noninvasive respiratory support for several weeks. Both cases are notable because the ROP was more posterior and aggressive than is typical for the gestational ages or birth weights. These cases are insufficient to make definitive conclusions regarding the factors that cause ROP. Further investigation is required to determine if there is an association between the use of non-invasive respiratory support, even in the absence of supra-ambient oxygen, and severe ROP development. [J Pediatr Ophthalmol Strabismus. 2016;53:e47-e50.]. PMID:27537495

  17. 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

  18. Hormonal response of the premature primate to operative stress.

    PubMed

    Taylor, A F; Lally, K P; Chwals, W J; McCurnin, D C; Gerstmann, D R; Shade, R A; deLemos, R A

    1993-06-01

    There are few data on the hormonal response to operation in the premature infant. Studies examining the response of newborn human infants have been performed on patients beyond the first few days of life, where some adaptation to postnatal life has occurred. This study evaluated the response of the newly born premature primate to surgical stress. Premature baboons (75% gestation) were intubated, mechanically ventilated and underwent thoracotomy at 2 hours of life with exposure of the ductus arteriosus (PDA). In group 1, formalin was infiltrated to keep the ductus patent. In group 2, the PDA was ligated. Controls had no operation. Blood was drawn at 0, 6, 24, 48, 72, and 96 hours of age. Echocardiograms were performed to confirm patency or closure of the ductus and to monitor cardiac function. Epinephrine, norepinephrine, renin, and cortisol levels were measured. Cortisol levels rose in all groups. Operation stimulated a marked increase in catecholamine and renin levels in both operative groups, which was more marked in the group with PDA ligation at 24 hours. These data reflect expected pathophysiology since early PDA ligation exerts additional hemodynamic demand on the heart. In conclusion, the premature primate is able to mount a significant and severity-dependent endocrine response to stress. PMID:8331518

  19. Development of an artificial placenta IV: 24 hour venovenous extracorporeal life support in premature lambs.

    PubMed

    Gray, Brian W; El-Sabbagh, Ahmed; Rojas-Pena, Alvaro; Kim, Anne C; Gadepali, Samir; Koch, Kely L; Capizzani, Tony R; Bartlet, Robert H; Mychaliska, George B

    2012-01-01

    An extracorporeal artificial placenta would change the paradigm of treating extremely premature infants. We hypothesized that a venovenous extracorporeal life support (VV-ECLS) artificial placenta would maintain fetal circulation, hemodynamic stability, and adequate gas exchange for 24 hours. A near-term neonatal lamb model (130 days; term = 145 days) was used (n = 9). The right jugular vein was cannulated for VV-ECLS outflow, and an umbilical vein was used for inflow. The circuit included a peristaltic roller pump and a 0.5 m(2) hollow fiber oxygenator. Lambs were maintained on VV-ECLS in an "amniotic bath" for up to 24 hours. Five of nine fetuses survived for 24 hours. In the survivors, average mean arterial pressure was 69 ± 10 mm Hg for the first 4 hours and 36 ± 8 mm Hg for the remaining 20 hours. The mean fetal heart rate was 202 ± 30. Mean VV-ECLS flow was 94 ± 20 ml/kg/min. Using a gas mixture of 50% O(2)/3% CO(2) and sweep flow of 1-2 L/min, the mean pH was 7.27 ± 0.09, with Po(2) of 35 ± 12 mm Hg and Pco(2) of 48 ± 12 mm Hg. Necropsy revealed a patent ductus arteriosus in all cases, and there was no gross or microscopic intracranial hemorrhage. Complications in failed attempts included technically difficult cannulation and multisystem organ failure. Future studies will enhance stability and address the factors necessary for long-term support.

  20. Conservative Management of Fetus Papyraceus: A Report of Two Cases

    PubMed Central

    Dahiya, Pushpa; Bains, Ranjita

    2014-01-01

    The term fetus papyraceus is used to describe a mummified fetus associated with multiple gestations where one fetus dies and is flattened between the membranes of living fetus and uterine wall. Though the maternal and fetal complications in affected cases can be severe, we report of two cases of fetus papyraceus managed conservatively without any complications. Successful outcome is related to careful monitoring during pregnancy. PMID:24715942

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

    PubMed

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

    2011-07-01

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

  3. The Wolf-Hirschhorn syndrome in fetuses.

    PubMed

    Tachdjian, G; Fondacci, C; Tapia, S; Huten, Y; Blot, P; Nessmann, C

    1992-12-01

    Wolf-Hirschhorn syndrome (WHS) with partial deletion of the short arm of chromosome 4 has been exceptionally diagnosed in fetuses. We report prenatal diagnosis of five cases of monosomy 4p. The fetuses were karyotyped for severe intrauterine growth retardation (IUGR) diagnosed on routine ultrasound (US). In addition, cleft-lip and palate and diaphragmatic hernia respectively were found in two cases. The quantity of amniotic fluid was normal in all cases. At autopsy, the fetuses showed the typical craniofacial dysmorphy but without microcephaly. Major renal hypoplasia was the only constant visceral anomaly. Midline fusion defects were observed in all the fetuses, ranging from minor abnormalities such as scalp defect, hypertelorism, pulmonary isomerism, common mesentery, hypospadias and sacral dimple, to cleft palate, corpus callosum agenesis, ventricular septal defect, and diaphragmatic hernia. On post-mortem X-rays, a delayed bone age was always observed. All the placentae were hypotrophic, and two exhibited vascular lesions, although there was no maternal hypertension. Chromosomal studies showed that the breakpoints were within the 4p16 band in three cases, the 4p15 band in one case, and the 4p14 band in one case. The deletion was de novo in four cases, and resulted from a paternal translocation in one case. This study emphasizes the importance of karyotyping all fetuses with IUGR, especially when the quantity of amniotic fluid is normal, and suggests the possibility of recognizing on US the particular phenotype of WHS in utero.

  4. Cortical overgrowth in fetuses with isolated ventriculomegaly.

    PubMed

    Kyriakopoulou, Vanessa; Vatansever, Deniz; Elkommos, Samia; Dawson, Sarah; McGuinness, Amy; Allsop, Joanna; Molnár, Zoltán; Hajnal, Joseph; Rutherford, Mary

    2014-08-01

    Mild cerebral ventricular enlargement is associated with schizophrenia, autism, epilepsy, and attention-deficit/hyperactivity disorder. Fetal ventriculomegaly is the most common central nervous system (CNS) abnormality affecting 1% of fetuses and is associated with cognitive, language, and behavioral impairments in childhood. Neurodevelopmental outcome is partially predictable by the 2-dimensional size of the ventricles in the absence of other abnormalities. We hypothesized that isolated fetal ventriculomegaly is a marker of altered brain development characterized by relative overgrowth and aimed to quantify brain growth using volumetric magnetic resonance imaging (MRI) in fetuses with isolated ventriculomegaly. Fetal brain MRI (1.5 T) was performed in 60 normal fetuses and 65 with isolated ventriculomegaly, across a gestational age range of 22-38 weeks. Volumetric analysis of the ventricles and supratentorial brain structures was performed on 3-dimensional reconstructed datasets. Fetuses with isolated ventriculomegaly had increased brain parenchyma volumes when compared with the control cohort (9.6%, P < 0.0001) with enlargement restricted to the cortical gray matter (17.2%, P = 0.002). The extracerebral cerebrospinal fluid and third and fourth ventricles were also enlarged. White matter, basal ganglia, and thalamic volumes were not significantly different between cohorts. The presence of relative cortical overgrowth in fetuses with ventriculomegaly may represent the neurobiological substrate for cognitive, language, and behavioral deficits in these children.

  5. 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…

  6. 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

  7. Preclinical Models of Encephalopathy of Prematurity.

    PubMed

    Jantzie, Lauren L; Robinson, Shenandoah

    2015-01-01

    Encephalopathy of prematurity (EoP) encompasses the central nervous system (CNS) abnormalities associated with injury from preterm birth. Although rapid progress is being made, limited understanding exists of how cellular and molecular CNS injury from early birth manifests as the myriad of neurological deficits in children who are born preterm. More importantly, this lack of direct insight into the pathogenesis of these deficits hinders both our ability to diagnose those infants who are at risk in real time and could potentially benefit from treatment and our ability to develop more effective interventions. Current barriers to clarifying the pathophysiology, developmental trajectory, injury timing, and evolution include preclinical animal models that only partially recapitulate the molecular, cellular, histological, and functional abnormalities observed in the mature CNS following EoP. Inflammation from hypoxic-ischemic and/or infectious injury induced in utero in lower mammals, or actual prenatal delivery of more phylogenetically advanced mammals, are likely to be the most clinically relevant EOP models, facilitating translation to benefit infants. Injury timing, type, severity, and pathophysiology need to be optimized to address the specific hypothesis being tested. Functional assays of the mature animal following perinatal injury to mimic EoP should ideally test for the array of neurological deficits commonly observed in preterm infants, including gait, seizure threshold and cognitive and behavioral abnormalities. Here, we review the merits of various preclinical models, identify gaps in knowledge that warrant further study and consider challenges that animal researchers may face in embarking on these studies. While no one model system is perfect, insights relevant to the clinical problem can be gained with interpretation of experimental results within the context of inherent limitations of the chosen model system. Collectively, optimal use of multiple models

  8. Total parenteral nutrition - infants

    MedlinePlus

    IV fluids - infants; TPN - infants; Intravenous fluids - infants; Hyperalimentation - infants ... vitamins, minerals, and often lipids (fats) into an infant's vein. TPN can be lifesaving for very small ...

  9. 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

  10. [Accessory renal arteries in human fetuses].

    PubMed

    Gościcka, D; Szpinda, M; Kochan, J

    1996-12-01

    Using conventional anatomical methods, renal arteries of 140 human fetuses were studied. It was found (21.1%) that the accessory renal arteries occurred in a three-fold manner: 1. as single arteries (19.2%), 2. as double arteries (2.1%) and 3. as triplex arteries (0.7%). More often they originated from the right part of the circumference of the abdominal aorta, mainly in the female fetuses. These arteries penetrated the following segments of the kidney: the inferior (12.9%), the superior (2.3%), the anterior inferior (2.8%), the posterior (2.1%) and the anterior superior (1.5%). They crossed the renal pelvis more often in front (12.2%) than from behind of it (5%). The frequency of the occurrence of the accessory arteries depends not from the age of the fetus. PMID:9082875

  11. [The unclear status of the fetus is an ethical dilemma. Neonatal care can save the fetus when abortion is still legally possible].

    PubMed

    Persson, I

    1990-05-01

    A striking situation occasionally occurs in Swedish hospitals: a fetus survives late abortion and then all available intensive care resources are employed to keep it alive. The law permits free abortion through the 18th week of pregnancy, but with permission from the social service authorities, the limit for abortion can be stretched to the end of the 22nd week. At the same time it is possible to save the life of a premature birth down to the 23rd or 24th week. The development of a neonatal advanced care is based upon the assumption that it is desirable to save the life of a human fetus no matter how young it may be. At the same time, legislation which legitimizes free abortion up to a certain period of time expresses the view that the life of the fetus up through that time possesses little or no real value. A recent report by a government commission on the individuality of the pregnant woman and the fetus should have dealt with this ambivalence but did not. One possible way out of this dilemma is for society to take an active role in offering the woman economic compensation for bearing the child to term with a view toward giving it up for adoption. The commission's report compromised in not presenting this alternative as an official suggestion because it is too unpopular politically. The result is that tens of thousands of humans in Sweden every year are denied a chance for normal life because the public allows itself to be represented by politicians who lack the courage or the insight to accept the moral consequences of this decision.

  12. Premature loss of primary teeth associated with congenital syphilis: a case report.

    PubMed

    Antonio, Andréa Gonçalves; Kelly, Alice; Maia, Lucianne Cople

    2005-01-01

    Congenital syphilis is an infectious disease transmitted by an infected mother to her fetus. Several reports in the literature have focused on oral manifestations of congenital syphilis, mainly about Hutchinson's teeth and dysplastic molars, which are more common. However, this paper describes an unusual feature of congenital syphilis in a four-year-old child. A case of premature loss of primary teeth associated with congenital syphilis is reported.

  13. 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.

  14. 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.

  15. Beyond Building Better Brains: Bridging the Docosahexaenoic acid (DHA) Gap of Prematurity

    PubMed Central

    Harris, William

    2014-01-01

    Long chain polyunsaturated fatty acids (LCPUFA) including docosahexaenoic acid (DHA), are essential for normal vision and neurodevelopment. DHA accretion in utero occurs primarily in the last trimester of pregnancy to support rapid growth and brain development. Premature infants, born before this process is complete, are relatively deficient in this essential fatty acid. Very low birth weight (VLBW) infants remain deficient for a long period of time due to ineffective conversion from precursor fatty acids, lower fat stores, and a limited nutritional provision of DHA after birth. In addition to long- term visual and neurodevelopmental risks, VLBW infants have significant morbidity and mortality from diseases specific to premature birth, including bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP). There is increasing evidence that DHA has protective benefits against these disease states. The aim of this article is to identify the unique needs of premature infants, review the current recommendations for LCPUFA provision in infants, and discuss the caveats and innovative new ways to overcome the DHA deficiency through postnatal supplementation, with the long term goal of improving morbidity and mortality in this at risk population. PMID:25357095

  16. [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.

  17. Beyond building better brains: bridging the docosahexaenoic acid (DHA) gap of prematurity.

    PubMed

    Harris, W S; Baack, M L

    2015-01-01

    Long-chain polyunsaturated fatty acids (LCPUFA) including docosahexaenoic acid (DHA) are essential for normal vision and neurodevelopment. DHA accretion in utero occurs primarily in the last trimester of pregnancy to support rapid growth and brain development. Premature infants, born before this process is complete, are relatively deficient in this essential fatty acid. Very low birth weight (VLBW) infants remain deficient for a long period of time due to ineffective conversion from precursor fatty acids, lower fat stores and a limited nutritional provision of DHA after birth. In addition to long-term visual and neurodevelopmental risks, VLBW infants have significant morbidity and mortality from diseases specific to premature birth, including bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity. There is increasing evidence that DHA has protective benefits against these disease states. The aim of this article is to identify the unique needs of premature infants, review the current recommendations for LCPUFA provision in infants and discuss the caveats and innovative new ways to overcome the DHA deficiency through postnatal supplementation, with the long-term goal of improving morbidity and mortality in this at-risk population.

  18. 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)

  19. 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…

  20. Cardiorespiratory events in preterm infants: etiology and monitoring technologies.

    PubMed

    Di Fiore, J M; Poets, C F; Gauda, E; Martin, R J; MacFarlane, P

    2016-03-01

    Every year, an estimated 15 million infants are born prematurely (<37 weeks gestation) with premature birth rates ranging from 5 to 18% across 184 countries. Although there are a multitude of reasons for this high rate of preterm birth, once birth occurs, a major challenge of infant care includes the stabilization of respiration and oxygenation. Clinical care of this vulnerable infant population continues to improve, yet there are major areas that have yet to be resolved including the identification of optimal respiratory support modalities and oxygen saturation targets, and reduction of associated short- and long-term morbidities. As intermittent hypoxemia is a consequence of immature respiratory control and resultant apnea superimposed upon an immature lung, improvements in clinical care must include a thorough knowledge of premature lung development and pathophysiology that is unique to premature birth. In Part 1 of a two-part review, we summarize early lung development and diagnostic methods for cardiorespiratory monitoring. PMID:26583939

  1. Airway compromise in the fetus and neonate: Prenatal assessment and perinatal management.

    PubMed

    Ryan, Greg; Somme, Stig; Crombleholme, Timothy M

    2016-08-01

    The fetus with a potentially obstructed airway can be identified on routine antenatal imaging. These cases should be referred to fetal care centers, which have the necessary expertise to fully evaluate and manage these fetuses and neonates appropriately. Complete airway obstruction may result in fetal hydrops and intrauterine demise. If a newborn infant has a compromised airway at delivery, the inability to secure its airway quickly may result in a hypoxic cerebral insult or death. In the most severely affected cases, prenatal, perinatal, or postnatal surgical intervention may be necessary. The timing of such an intervention will depend on the exact cause of the airway obstruction, other associated findings and the anticipated difficulty in establishing an airway at delivery. Fetal ultrasound and magnetic resonance imaging can differentiate between intrinsic and extrinsic airway obstruction, which allows for the optimal planning and management of the delivery and neonatal resuscitation. PMID:27084444

  2. Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity.

    PubMed

    Abdallah, Enas A A; Said, Reem N; Mosallam, Dalia S; Moawad, Eman M I; Kamal, Naglaa M; Fathallah, Mohammed G E-D

    2016-09-01

    Metabolic bone disease of prematurity is a condition characterized by reduction in bone mineral content (osteopenia). It is a problem faced by very low birth weight (VLBW) infants because of lack of fetal mineralization during the last trimester. Our aim was to assess serum alkaline phosphatase (ALP) level as an early biomarker for osteopenia in premature infants and to estimate an optimal cutoff value of serum ALP at which osteopenia is detected radiologically in premature newborns.This prospective study was conducted on a cohort of 120 newborn infants of both sex of ≤34 weeks' gestational age and <1500 g birth weight. Two blood samples, from each infant on at least 2 consecutive weeks, were reported for calcium, phosphorus, and ALP. Evidence of osteopenia was evaluated radiologically by performing wrist/knee x-ray.Sixteen infants (13.3%) had evidence of osteopenia in x-ray, whereas 104 infants (86.7%) were nonosteopenic and all the osteopenic infants were <1000-g birth weight. Birth weight and gestational age were significantly inversely related to serum ALP levels. Both samples showed statistically significantly higher mean ALP level in osteopenic than nonosteopenics (P < 0.001, and P < 0.001 respectively). There was no constant value of serum ALP related to radiologic evidence of osteopenia. However, the optimal cutoff value of serum ALP at which osteopenia is detected is 500 IU/L with 100% sensitivity and 80.77% specificity.High levels of ALP can be considered a reliable biomarker to predict the status of bone mineralization and the need for radiological evaluation in premature infants particularly those <1000-g birth weight and <32 weeks' gestation. PMID:27631238

  3. 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

  4. Prenatal Stress, Prematurity, and Asthma.

    PubMed

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C

    2015-12-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the United States 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 cause not only 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: interleukin 6 (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 comorbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (eg, 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

  5. Prenatal Stress, Prematurity, and Asthma.

    PubMed

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C

    2015-12-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the United States 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 cause not only 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: interleukin 6 (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 comorbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (eg, 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.

  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. Nutritional management of preterm infants postdischarge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The usual recommendation for feeding prematurely born infants is to provide sufficient nutrients to support rates of growth and nutrient accretion equal to intrauterine rates. The protein and energy intakes required to achieve this goal, provided the intakes of all other necessary nutrients are adeq...

  8. Can circumcision prevent recurrent urinary tract infections in hospitalized infants?

    PubMed

    Cason, D L; Carter, B S; Bhatia, J

    2000-12-01

    Urinary tract infection (UTI) is an uncommon but concerning condition for hospitalized premature infants. A retrospective chart review of all male infants admitted to the neonatal intensive care unit (NICU) from June 1996 through March 1999 was conducted at the Medical College of Georgia--a large academic medical center with a tertiary Level III NICU--to investigate the frequency and potential prevention of recurrent UTI in hospitalized infants. The effect of circumcision on recurrence of UTI was also investigated. There were 38 infants with 53 UTIs among 744 male infants admitted during the study period (5.1%). Infants were divided into two groups: A1 <37 weeks with a single UTI and A2 <37 weeks with more than one UTI. In groups A1 and A2, 57% of the first UTIs were due to Candida or E. coli, the remaining were due to other gram-negative organisms and Staphylococcus species. Mean gestational age (GA) in groups A1 and A2 were similar (29 +/- 2 weeks, and 29 +/- 4 weeks); however, mean GA of infants with Candida UTI was 27 +/- 2 weeks, and for bacterial UTI, 30 +/- 3 weeks (p<0.01). None of the premature infants in the study had a recurrent UTI once a circumcision was performed. Premature uncircumcised males had an increased risk for UTI (Odds Ratio=11.1, 95% CI, 3.3-28.9, p<0.001). Circumcision appears beneficial in reducing the risk for recurrent UTI in these infants.

  9. 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.

  10. 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. PMID:8259083

  11. 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.

  12. DRUGS IN PREGNANCY—Their Effects on the Fetus and Newborn

    PubMed Central

    Sandberg, Douglas H.

    1961-01-01

    In considering drug therapy for pregnant women, it must be borne in mind that almost all chemical compounds in use as therapeutic agents pass from the maternal to the fetal circulation through the placenta. These drugs can produce a wide range of harmful effects on the fetus and neonatal infant. The effects of some substances for which we have data reflecting a deleterious effect are listed. It is suggested that in the future more caution be exercised in using drugs during pregnancy and that in histories, both obstetrical and pediatric, any therapy given to the mother during gestation be recorded in detail. PMID:13746121

  13. [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.

  14. 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...

  15. Your Premature Baby: Low Birthweight

    MedlinePlus

    ... experts Calculating your due date Ovulation calendar 39 weeks is best Order bereavement materials News Moms Need ... birthweight: Premature birth . This is birth before 37 weeks of pregnancy. About 7 of 10 low-birthweight ...

  16. 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…

  17. Bio-social and environmental factors of premature births and stillbirths in Italy.

    PubMed

    Pinnelli, A; Zannella, F

    1981-01-01

    An examination of a number of biological and social aspects of infant survival in Italy is presented, with particular reference to regional differences in premature births and stillbirths. Factors examined include birth order, mother's age, mother's educational background, father's occupation, and the economic, hygienic, and health care conditions of the province of residence. Data are for 1974-1975. (summary in FRE, ITA)

  18. 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…

  19. 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.

  20. Aplasia Cutis Congenita Associated with Fetus Papyraceus.

    PubMed

    Pieretti, María Lía; Alcalá, Rebeca; Boggio, Paula; Noguera-Morel, Lucero; Porriño, María Librada; Luna, Paula C; Hernández-Martín, Angela; Schroh, Roberto; Larralde, Margarita; Torrelo, Antonio

    2015-01-01

    Aplasia cutis congenita (ACC), or congenital absence of skin, is a heterogeneous condition that may be due to varied mechanisms. ACC has rarely been reported in association with fetus papyraceus, representing a peculiar phenotype of ACC. We present six new cases of neonates born with symmetric ACC associated with intrauterine fetal demise of co-twins during the late first or early second trimester. PMID:26212801

  1. Premature ovarian failure.

    PubMed

    Vujović, Svetlana; Ivović, Miomira; Tancić-Gajić, Milina; Marina, Ljiljana; Barać, Marija; Arizanović, Zorana; Nenezić, Ana; Ivanisević, Maja; Micić, Jelena; Sajić, Silvija; Micić, Dragan

    2012-01-01

    Premature ovarian failure (POF) is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions) or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc.The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone), karyotype (<30 years of age), ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc. PMID:23350261

  2. [Premature ovarian failures].

    PubMed

    Bricaire, Léopoldine; Laroche, Emmanuelle; Bourcigaux, Nathalie; Donadille, Bruno; Christin-Maitre, Sophie

    2013-11-01

    Premature ovarian failure (POF) is clinically suspected by amenorrhea and confirmed by an elevated FSH serum level above 40 mUI/L (even 20 mUI/L) twice, in a woman before the age of 40. Prevalence of POF is between 1 to 2% in women. In 90% of cases, no aetiology is identified. Obvious causes are chemotherapy, pelvic radiotherapy, ovarian surgery and diethylstilbestrol exposure in utero. A karyotype should be performed as Turner Syndrome is the most frequent genetic cause of POF. Some X abnormalities such as X deletion or X autosome translocation can be found. FMR1 pre-mutation (fragile X syndrome) should be searched for, even though no cases of mental retardation are known, in the family. Other genetic abnormalities can be suggested by associated symptoms (i.e.: FOXL2, SF1 mutations). Auto-immune aetiology can be suspected if other auto-immune features are present, however, there are no reliable auto-antibodies to confirm auto-immunity in POF. Treatment of POF is based on hormonal replacement therapy in order to avoid estrogen deficiency, suppress vasomotor symptoms and avoid bone loss as well as cardiovascular risk. Estrogens should be associated with progesterone or a progestin, at least up to the age of 51. Patients with POF should be informed that spontaneous pregnancies may occur (in 5% of cases). In case of desire of pregnancy, the patient should be oriented to a specialized unit for in vitro fertilization with oocyte donation. Psychological support is essential and should be part of the treatment. POF is associated with an increased risk of emotional distress and depression. No preventive treatment of POF is available so far. PMID:24157186

  3. 78 FR 61383 - Certain Thermal Support Devices For Infants, Infant Incubators, Infant Warmers, and Components...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... COMMISSION Certain Thermal Support Devices For Infants, Infant Incubators, Infant Warmers, and Components... United States after importation of certain thermal support devices for infants, infant incubators, infant... certain thermal support devices for infants, infant incubators, infant warmers, and components thereof...

  4. 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) PMID:7666822

  5. 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)

  6. 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

  7. A Clinical Prediction Model to Stratify Retinopathy of Prematurity Risk Using Postnatal Weight Gain

    PubMed Central

    Ying, Gui-shuang; Quinn, Graham E.; Dreiseitl, Stephan; Karp, Karen; Roberts, Robin S.; Kirpalani, Haresh

    2011-01-01

    OBJECTIVE: To develop an efficient clinical prediction model that includes postnatal weight gain to identify infants at risk of developing severe retinopathy of prematurity (ROP). Under current birth weight (BW) and gestational age (GA) screening criteria, <5% of infants examined in countries with advanced neonatal care require treatment. PATIENTS AND METHODS: This study was a secondary analysis of prospective data from the Premature Infants in Need of Transfusion Study, which enrolled 451 infants with a BW < 1000 g at 10 centers. There were 367 infants who remained after excluding deaths (82) and missing weights (2). Multivariate logistic regression was used to predict severe ROP (stage 3 or treatment). RESULTS: Median BW was 800 g (445–995). There were 67 (18.3%) infants who had severe ROP. The model included GA, BW, and daily weight gain rate. Run weekly, an alarm that indicated need for eye examinations occurred when the predicted probability of severe ROP was >0.085. This identified 66 of 67 severe ROP infants (sensitivity of 99% [95% confidence interval: 94%–100%]), and all 33 infants requiring treatment. Median alarm-to-outcome time was 10.8 weeks (range: 1.9–17.6). There were 110 (30%) infants who had no alarm. Nomograms were developed to determine risk of severe ROP by BW, GA, and postnatal weight gain. CONCLUSION: In a high-risk cohort, a BW-GA-weight-gain model could have reduced the need for examinations by 30%, while still identifying all infants requiring laser surgery. Additional studies are required to determine whether including larger-BW, lower-risk infants would reduce examinations further and to validate the prediction model and nomograms before clinical use. PMID:21321036

  8. Refining Neurobehavioral Assessment of the High-Risk Infant Using the NICU Network Neurobehavioral Scale.

    PubMed

    Sullivan, Mary C; Miller, Robin J; Fontaine, Lynne Andreozzi; Lester, Barry

    2012-01-01

    Nurses caring for high-risk infants use advanced assessment skills to identify the nature of infant instability and to assure timely intervention. The NICU Network Neurobehavioral Scale (NNNS) is a comprehensive assessment of neurological integrity and behavioral function of infants at risk. Research evidence supports its validity and reliability for clinical and research use. The NNNS offers nurses a neurobehavioral assessment especially suited to high-risk and premature infants.

  9. Immunohistochemical identification of Campylobacter fetus in natural cases of bovine and ovine abortions.

    PubMed

    Campero, C M; Anderson, M L; Walker, R L; Blanchard, P C; Barbano, L; Chiu, P; Martínez, A; Combessies, G; Bardon, J C; Cordeviola, J

    2005-04-01

    An immunohistochemistry (IHC) procedure for the detection of Campylobacter fetus antigens using an avidin-biotin complex technique was performed on formalin fixed bovine and ovine fetal tissues from 26 natural cases of Campylobacter spp. abortion (four ovine and 22 bovine). The species of Campylobacter isolated included C. fetus ssp. venerealis from 13 bovine fetuses, C. fetus ssp. fetus from two ovine and one bovine fetus, Campylobacter jejuni from seven bovine fetuses, Campylobacter lari from two ovine fetuses and an unspeciated Campylobacter species in one bovine fetus. Histologic lesions identified in the aborted fetuses included placentitis, serositis, pneumonia, gastroenteritis, hepatitis and encephalitis. Campylobacter fetus antigens were identified by IHC in 13 of 13 bovine fetuses from which C. fetus ssp. venerealis was isolated and in two of two ovine fetuses from which C. fetus ssp. fetus was isolated. The IHC stains were negative in tissues from seven bovine fetuses from which C. jejuni was isolated, one bovine fetus infected with C. fetus ssp. fetus, one bovine fetus infected with the unspeciated Campylobacter and two ovine fetuses infected with C. lari. In positive cases, the IHC stain most frequently identified bacteria in the lung and gastrointestinal tract. The C. fetus IHC procedure performed on formalin fixed tissues is a practical tool for the diagnosis of natural cases of ovine and bovine abortion caused by C. fetus.

  10. [Haemolytic disease of the fetus and newborn/HDFN/timing in pregnant women and prophylaxis].

    PubMed

    Kulinska, R

    2014-01-01

    Haemolytic disease of the fetus and newborn/HDFN/is a condition in which the lifespan of the fetal or newborn infants red cells is shortened by the action of maternal antibodies against antigens present on the infants red cells. The most common routes of maternal sensitization are via blood transfusion or fetomaternal hemorrhage. With the institution of antenatal Rhesus (Rh) D immunoglobulin prophylaxis, the frequency of maternal alloimmunization in Rh D-negative women has decreased significantly. The prevention and treatment of Rh D alloimmunization is a true success story in obstetrics. This article present the reasons for the persistence of the anti-D alloimmunization, protocol for the prevention and diagnosis of HDFN, immunohematological management of all pregnant women, critical titre, protocol and timing in alloimmunized pregnant women. PMID:25098112

  11. [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.

  12. Systematic Review of Digital Imaging Screening Strategies for Retinopathy of Prematurity

    PubMed Central

    Kemper, Alex R.; Wallace, David K.; Quinn, Graham E.

    2008-01-01

    BACKGROUND Retinal imaging with remote interpretation could decrease the number of diagnostic eye examinations that premature infants need for the detection of retinopathy of prematurity and thus decrease the time demand on the relatively small pool of ophthalmologists who perform retinopathy of prematurity examinations. OBJECTIVE Our goal was to review systematically the evidence regarding the reliability, validity, safety, costs, and benefits of retinal imaging to screen infants who are at risk for retinopathy of prematurity. METHODS We searched Medline, the Cochrane library, CINAHL, and the bibliographies of all relevant articles. All English-language studies regardless of design with primary data about our study questions were included. We excluded (1) studies that only included subjects with retinopathy of prematurity, (2) hypothetical models other than cost-effectiveness studies, and (3) validity studies without sufficient data to determine prevalence, sensitivity, and specificity or that only evaluated subjects for 1 component of retinopathy of prematurity (eg, plus disease only). RESULTS Studies of only 1 retinal imaging device (RetCam [Clarity Medical Systems, Inc, Pleasanton, CA]) met the inclusion criteria. There was a wide range in reported sensitivity, but specificity was high. There were several important limitations noted, including the eye as the unit of analysis instead of the individual or variations in the criteria for determining a true-positive or true-negative screening result. The risk of retinal hemorrhage resulting from imaging is low, and systemic effects (eg, bradycardia, hypertension, decreased oxygen saturation) are mild. No generalizable cost-effectiveness data were found. CONCLUSIONS The evidence base is not sufficient to recommend that retinal imaging be routinely adopted by NICUs to identify infants who have serious retinopathy of prematurity. PMID:18829807

  13. 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...

  14. Preclinical Models of Encephalopathy of Prematurity

    PubMed Central

    Jantzie, Lauren L.; Robinson, Shenandoah

    2015-01-01

    Encephalopathy of prematurity (EoP) encompasses the central nervous system (CNS) abnormalities associated with injury from preterm birth. Although rapid progress is being made, limited understanding exists of how the cellular and molecular CNS injury from early birth manifests as the myriad of neurological deficits in children who are born preterm. More importantly, this lack of direct insight into the pathogenesis of these deficits hinders both our ability to diagnose those infants who are at risk in real-time and could potentially benefit from treatment, and our ability to develop more effective interventions. Current barriers to clarifying the pathophysiology, developmental trajectory, injury timing and evolution include preclinical animal models that only partially recapitulate the molecular, cellular, histological and functional abnormalities observed in the mature CNS following EoP. Inflammation from hypoxic-ischemic and/or infectious injury induced in utero in lower mammals, or actual prenatal delivery of more phylogenetically-advanced mammals, are likely to be the most clinically relevant EOP models, facilitating translation to benefit infants. Injury timing, type, severity and pathophysiology need to be optimized to address the specific hypothesis being tested. Functional assays of the mature animal following perinatal injury to mimic EoP should ideally test for the array of neurological deficits commonly observed in preterm infants including gait, seizure threshold, cognitive and behavioral abnormalities. Here, we review the merits of various preclinical models, identify gaps in knowledge that warrant further study and consider challenges that animal researchers may face in embarking on these studies. While no one model system is perfect, insights relevant to the clinical problem can be gained with interpretation of experimental results within the context of inherent limitations of the chosen model system. Collectively, optimal use of multiple models will

  15. Screening for retinopathy of prematurity: a report from upper Egypt

    PubMed Central

    Nassar, Mahmoud M.

    2016-01-01

    AIM To detect the incidence of retinopathy of prematurity (ROP) in a tertiary referral neonatal intensive care unit in upper Egypt and to describe the obstacles faced during implementing the screening protocol for the first time. METHODS Consecutive infants were enrolled at birth and screened for ROP. We used the UK ROP guideline (May 2008) for infant selection, follow up and treatment. Repeat examinations were performed until retinal vascularisation was complete. RESULTS Fifty-two infants were enrolled: 24 males and 28 females. Mean gestational age was 31.3wk (±2.8 SD) and mean birth weight was 1234.6 g (±221.1 SD). Incidence of ROP was 36.5% (stages 1, 2, 3 and 4a were 9.6%, 9.6%, 15.4% and 1.9% respectively), no stages 4b or 5 were found in this series. Six infants (11.5%) died during screening without ROP, 25 infants (48.1%) were discharged from screening with retinal vascularisation reaching zone III, 5 infants (9.6%) were treated with indirect diode with or without additional cryotherapy and 16 infants (30.8%) were lost to follow up. In this series gestational age rather than birth weight was found significantly correlated and predictive (P<0.05) with ROP stages. CONCLUSION ROP in a single site in Upper Egypt appears to have comparable incidence to other areas worldwide. The main screening obstacle was missing cases due to the absence of a national ROP screening protocol. PMID:26949647

  16. Major full thickness skin burn injuries in premature neonate twins.

    PubMed

    Rimdeika, R; Bagdonas, R

    2005-02-01

    Burns in neonates have been reported following the use of pulse oximeters, various electrodes, chemical disinfecting agents and phototherapy blankets. Burn injuries in premature neonates are very rare and there have been no reports on major full skin thickness injuries. This case reports on preterm neonate male twins delivered at a Community Hospital. After the delivery they were placed on water warmers for 15-20 min and then transported into incubators. Burn injuries were noticed 1h after the delivery. Infant One, weight 1500 g, had an injury of 20% TBSA on his dorsum, waist and buttocks. The other infant, weight 1835 g, had an injury of 14% TBSA on the same areas. The infants were transported to the University Hospital. At the seventh day after the injury they recovered from respiratory distress and surgical procedures started. The eschar was excised deep to fascia and wounds were grafted with 0.1mm thickness skin grafts harvested from the thigh and cut into islets. Autografts were protected by overlay with fresh allograft harvested from the twins' father. Surgery procedures were performed in two steps, each second day, not exceeding 10% of total body area during excision. Donor sites healed at the eighth day after the surgery. Burn wounds healed gradually by way of spontaneous replacement of allograft and wound closure by spontaneous epithelization from the autograft islets. Eighteen days after the surgery all the grafted wounds were found epithelized. We conclude that in premature neonates relatively low temperatures may cause deep burn injuries. We recommend the delivery of preterm childbirths at well equipped facilities with staff qualified in nursing of premature neonates. PMID:15639370

  17. 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…

  18. A Melodic Contour Repeatedly Experienced by Human Near-Term Fetuses Elicits a Profound Cardiac Reaction One Month after Birth

    PubMed Central

    Granier-Deferre, Carolyn; Bassereau, Sophie; Ribeiro, Aurélie; Jacquet, Anne-Yvonne; DeCasper, Anthony J.

    2011-01-01

    Background Human hearing develops progressively during the last trimester of gestation. Near-term fetuses can discriminate acoustic features, such as frequencies and spectra, and process complex auditory streams. Fetal and neonatal studies show that they can remember frequently recurring sounds. However, existing data can only show retention intervals up to several days after birth. Methodology/Principal Findings Here we show that auditory memories can last at least six weeks. Experimental fetuses were given precisely controlled exposure to a descending piano melody twice daily during the 35th, 36th, and 37th weeks of gestation. Six weeks later we assessed the cardiac responses of 25 exposed infants and 25 naive control infants, while in quiet sleep, to the descending melody and to an ascending control piano melody. The melodies had precisely inverse contours, but similar spectra, identical duration, tempo and rhythm, thus, almost identical amplitude envelopes. All infants displayed a significant heart rate change. In exposed infants, the descending melody evoked a cardiac deceleration that was twice larger than the decelerations elicited by the ascending melody and by both melodies in control infants. Conclusions/Significance Thus, 3-weeks of prenatal exposure to a specific melodic contour affects infants ‘auditory processing’ or perception, i.e., impacts the autonomic nervous system at least six weeks later, when infants are 1-month old. Our results extend the retention interval over which a prenatally acquired memory of a specific sound stream can be observed from 3–4 days to six weeks. The long-term memory for the descending melody is interpreted in terms of enduring neurophysiological tuning and its significance for the developmental psychobiology of attention and perception, including early speech perception, is discussed. PMID:21383836

  19. Functional outcomes of very premature infants into adulthood.

    PubMed

    Saigal, Saroj

    2014-04-01

    The outcomes of very low birth weight survivors born in the early post-neonatal intensive care era have now been reported to young adulthood in several longitudinal cohort studies, and more recently from large Scandinavian national databases. The latter reports corroborate the findings that despite disabilities, a significant majority of very low birth weight survivors are leading productive lives, and are functioning better than expected. This is reassuring, but there are still concerns about future psychopathology, cardiovascular and metabolic problems as they approach middle age. Although these findings may not be directly applicable to the current survivors of modern neonatal intensive care, they do provide a yardstick by which to project the outcomes of future survivors until more contemporaneous data are available. PMID:24289905

  20. Borderline viability: controversies in caring for the extremely premature infant.

    PubMed

    Leuthner, Steven R

    2014-12-01

    Controversy surrounding the decision to resuscitate at the limits or borderline of viability has been at the center of neonatal ethical debate for decades. This debate has led to numerous reports from individual institutions, councils, and advisory committees that all have remarkable consistency in the development of gestational age-based guidelines. This article reviews legal or regulatory concerns that may contradict ethical discussion and guidelines, discriminatory and scientific basis concerns with consensus guidelines, and personal controversy about how to determine best interest. Guidelines are a reasonable place to start in helping determine parental authority and autonomy. The article also addresses controversies raised in counseling and costs.

  1. Sleep State Periodicity in Prematures and Young Infants.

    ERIC Educational Resources Information Center

    Stern, Evelyn; And Others

    An autocorrelation technique was used to determine the periodicity underlying successive recurrences of specific sleep states (Quiet Sleep and Active Sleep). Groups of short (2-3 hour) polygraphic records and individual all night recordings were analyzed. Active Sleep and Quiet Sleep periodicities at 32 weeks conceptional age were 12 minutes. At…

  2. 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

  3. Dopamine use is an indicator for the development of threshold retinopathy of prematurity

    PubMed Central

    Mizoguchi, M.; Chu, T.; Murphy, F.; Willits, N.; Morse, L.

    1999-01-01

    AIM—To assess whether treatment of premature infants with dopamine is a risk factor for development of retinopathy of prematurity (ROP).
METHODS—A retrospective case series analysis of two groups was utilised with a minimum follow up of 6 months. Clinical profiles and patient risk factors were identified along with an evaluation of ROP progression and an analysis of clinical outcome. All infants were seen in a single community neonatal intensive care unit (NICU). 41 consecutive high risk infants were identified during a 36 month period whose birth weight was less than 1000 grams and who remained in the NICU without transfer until at least 28 days of age. Dilated indirect ophthalmoscopy fundus examinations were performed on all infants to identify the degree of and progression to threshold ROP.
RESULTS—18 of 41 infants were treated with dopamine for hypotension. The group of infants requiring dopamine differed statistically from the non-dopamine treated group by having a slightly higher birth weight, a greater incidence of hypotension and colloid treatment, and in manifesting more advanced respiratory disease. Within the dopamine treated group, 12 of 18 infants (67%) reached prethreshold ROP and seven infants (39%) reached threshold ROP requiring laser treatment. In contrast, only three of the infants (13%) who did not require dopamine for hypotension progressed to prethreshold (p=0.001) and only one of these infants (4%) progressed to threshold ROP (p = 0.02). Logistic regression analysis among other variables demonstrated that dopamine use and gestational age are important factors in this low birthweight population for predicting the development of threshold ROP (dopamine use: adjusted odds ratio = 119.88, p = 0.0061; gestational age: adjusted odds ratio = 0.061, p = 0.0043).
CONCLUSIONS—Dopamine use in low birthweight infants may therefore be a risk factor for the development of threshold ROP. More vigilant screening of high risk

  4. Outcomes of 83 fetuses exposed to angiotensin receptor blockers during the second or third trimesters: a literature review.

    PubMed

    Shimada, Chisa; Akaishi, Rina; Cho, Kazutoshi; Morikawa, Mamoru; Kaneshi, Yosuke; Yamda, Takahiro; Minakami, Hisanori

    2015-05-01

    This literature review was conducted to provide better counsel to pregnant women who erroneously took angiotensin receptor blockers (ARBs) during the second and/or third trimesters regarding infant outcomes. Information was available on 83 fetuses in 34 literature reports, including one that we encountered recently. Fourteen pregnancies were terminated, and six were unknown regarding status of amniotic fluid volume (AFV). Fifty-eight and five fetuses did and did not show oligohydramnios, respectively, after being exposed to ARBs. Of the 58 fetuses that presented with oligohydramnios, 57 were exposed to ARBs at gestational week (GW) ⩾ 20, and 19 exhibited resolution of oligohydramnios 1-6 weeks after cessation of ARBs. The 24 mothers without oligohydramnios at delivery ceased taking ARBs earlier (GW of 26.8 ± 5.1 vs. 31.8 ± 4.0, respectively, P = 0.000) and had longer duration of gestation after cessation of ARBs (8.4 ± 5.2 vs. 0.7 ± 2.3 weeks, respectively, P = 0.000). The mothers without oligohydramnios also had better outcomes in terms of favorable infant outcomes (63% (15/24) vs. 15% (6/39), respectively, P = 0.000) and infant mortality rates (13% (3/24) vs. 56% (22/39), respectively, P = 0.001) than the 39 with oligohydramnios. Thus, a favorable outcome may be feasible if the fetuses are not indicated for prompt delivery at presentation and exhibit normal AFV or resolution of oligohydramnios after cessation of ARBs. Although the prevalence rate of oligohydramnios was high in this study, it may have been due to publication bias. A prospective study suggested a lower prevalence rate than that reported in the present study. PMID:25693853

  5. Approach to Infants Born at 22 to 24 Weeks’ Gestation: Relationship to Outcomes of More-Mature Infants

    PubMed Central

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

    2012-01-01

    OBJECTIVE: We sought to determine if a center’s approach to care of premature infants at the youngest gestational ages (22–24 weeks’ gestation) is associated with clinical outcomes among infants of older gestational ages (25–27 weeks’ gestation). METHODS: Inborn infants of 401 to 1000 g birth weight and 22 0/7 to 27 6/7 weeks’ gestation at birth from 2002 to 2008 were enrolled into a prospectively collected database at 20 centers participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Markers of an aggressive approach to care for 22- to 24-week infants included use of antenatal corticosteroids, cesarean delivery, and resuscitation. The primary outcome was death before postnatal day 120 for infants of 25 to 27 weeks’ gestation. Secondary outcomes were the combined outcomes of death or a number of morbidities associated with prematurity. RESULTS: Our study included 3631 infants 22 to 24 weeks’ gestation and 5227 infants 25 to 27 weeks’ gestation. Among the 22- to 24-week infants, use of antenatal corticosteroids ranged from 28% to 100%, cesarean delivery from 13% to 65%, and resuscitation from 30% to 100% by center. Centers with higher rates of antenatal corticosteroid use in 22- to 24-week infants had reduced rates of death, death or retinopathy of prematurity, death or late-onset sepsis, death or necrotizing enterocolitis, and death or neurodevelopmental impairment in 25- to 27-week infants. CONCLUSIONS: This study suggests that physicians’ willingness to provide care to extremely low gestation infants as measured by frequency of use of antenatal corticosteroids is associated with improved outcomes for more-mature infants. PMID:22641761

  6. 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

  7. Anthropometric measurements in the second trimester fetus.

    PubMed

    Chambers, H M; Knowles, S; Staples, A; Tamblyn, M; Haan, E A

    1993-04-01

    Normal anthropometric measurements, of accepted value for clinicians and pathologists in the assessment of the dysmorphic neonate, have not in the past been available for the second trimester fetus, in which dysmorphic features are often more subtle and objective measurements most needed. In order to establish these values 19 anthropometric measurements, comparable to those published for the larger fetus and neonate, were recorded at autopsy on each of 260 overtly normal non-macerate singleton fetuses between 13 and 26 weeks gestation. Regression lines for each parameter, and growth ratios of potential value for description and assessment of dysmorphic features, were derived. The sex ratio was 1.27 and as there was no statistically significant sex difference for any of the 19 measurements chosen, the data was subsequently pooled. There were linear correlations between gestational age and each growth parameter, all but three exceeding 0.90. The linear correlations between pairs of growth parameter were higher than the correlations between gestational age and individual growth parameters. This suggests that growth parameter pairs, expressed as a ratio, are less affected by errors in gestational age estimation. Ratios enabling the dysmorphologist to more objectively assess common observations such as abnormalities of head shape, relationship between limb and trunk length and gross proportional relationships between major body segments were derived. Collected measurements were compared with established ultrasound reference ranges. While reference ranges for biparietal diameter and head circumference showed close concordance with those derived from ultrasound measurements, the abdominal circumference was consistently lower than that measured by ultrasound possibly because of differing trunk positions in utero compared with after death. The graphs and ratios derived in this study can be rapidly applied to confirm visual impressions at clinical examination and at autopsy

  8. 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

  9. Infants of azotemic mothers: a report of three live births.

    PubMed

    Brem, A S; Singer, D; Anderson, L; Lester, B; Abuelo, J G

    1988-10-01

    Women with severe renal failure rarely conceive, and when they do become pregnant these women often deliver prematurely. The clinical course of mothers with renal failure has been described, but little attention has been given to the offspring. In this report, we provide data on three infants born prematurely to mothers either on dialysis or with severe renal failure. The infants were the appropriate size for gestational age and demonstrated no obvious physical abnormalities. Laboratory data, including renal function, was also within normal limits. Renal size in the two infants studied by ultrasound was near or above the 95th percentile when corrected for gestational age. The premature birth appeared to be a function of maternal complications rather than a primary in utero growth disturbance.

  10. One-Stage Repair of an Interrupted Aortic Arch with an Aortopulmonary Window in a Premature Neonate.

    PubMed

    Bobos, Dimitrios; Kanakis, Meletios A; Koulouri, Sofia; Giannopoulos, Nicholas M

    2015-12-01

    Interrupted aortic arch with an aortopulmonary window is a rare congenital entity that is associated with high morbidity and mortality, especially in premature low-birth-weight infants, and the proper timing of surgical correction remains a matter of debate. We present the case of a premature infant weighing 1.6 kg who successfully underwent one stage surgical repair to treat interrupted aortic arch with an aortopulmonary window. The therapeutic management of this patient is described below, and a review of the literature is presented.

  11. One-Stage Repair of an Interrupted Aortic Arch with an Aortopulmonary Window in a Premature Neonate

    PubMed Central

    Bobos, Dimitrios; Kanakis, Meletios A.; Koulouri, Sofia; Giannopoulos, Nicholas M.

    2015-01-01

    Interrupted aortic arch with an aortopulmonary window is a rare congenital entity that is associated with high morbidity and mortality, especially in premature low-birth-weight infants, and the proper timing of surgical correction remains a matter of debate. We present the case of a premature infant weighing 1.6 kg who successfully underwent one stage surgical repair to treat interrupted aortic arch with an aortopulmonary window. The therapeutic management of this patient is described below, and a review of the literature is presented. PMID:26665109

  12. 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

  13. 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.

  14. 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. PMID:21675878

  15. Prenatal diagnosis and management in fetuses with cystic hygromata colli.

    PubMed

    Gembruch, U; Hansmann, M; Bald, R; Zerres, K; Schwanitz, G; Födisch, H J

    1988-12-01

    We report on 45 fetuses with prenatally diagnosed bilateral cystic hygromata colli by ultrasound. Two of the 45 cases involved a twin pregnancy with only one fetus showing hygromata colli. In 2 cases there was only isolated hygromata colli. The other 43 cases showed the signs of non-immune hydrops fetalis. The cytogenetic findings were: 9 fetuses with Turner syndrome, 1 fetus with Turner mosaicism, 1 fetus with trisomy 18, 6 fetuses with trisomy 21, 12 fetuses with normal karyotype, and 16 fetuses with a failed chromosome culture. In fetuses with Turner syndrome and normal karyotype the sonographic findings were similar: massive bilateral hygromata colli, substantial fluid accumulations in skin and body cavities, oligohydramnios and intra-uterine growth retardation. In the cases with trisomy 21, the relative size of the hygromata colli was smaller. Intra-uterine growth retardation and oligohydramnios were not observed. The sole survivor of our group (elective pregnancy interruption: 30 cases; intra-uterine death: 14 cases) (karyotype: 46,XY) presented sonographically with massive ascites, a moderate cystic hygroma, and appropriate fetal development, and a normal amniotic fluid quantity. These findings are analysed in order to provide recommendations for prenatal diagnosis, prenatal management and genetic counselling of the couples concerned.

  16. Automatic detection of apnoea of prematurity.

    PubMed

    Belal, Suliman Yousef; Emmerson, Anthony John; Beatty, Paul Charles William

    2011-05-01

    The detection of the incidents of apnoea of prematurity (AP) in preterm infants is important in the intensive care unit, but this detection is often based on simple threshold techniques, which suffer from poor specificity. Three methods for the automatic detection of AP were designed, tested and evaluated using approximately 2426 h of continuous recording from 54 neonates (μ = 44 h and σ = 7 h). The first method was based on the cumulative sum of the time series of heart rate (HR), respiratory rate (RR) and oxygen saturation (SpO(2)) along with the sum of their Shannon entropy. The performance of this method gave 94.53% sensitivity, 74.72% specificity and 77.84% accuracy. The second method was based on the correlation between the time series of HR, RR and SpO(2), which were used as inputs to an artificial neural network. This gave 81.85% sensitivity, 75.83% specificity and 76.78% accuracy. The third method utilized the derivative of the three time series and yielded a performance of 100% sensitivity, 96.19% specificity and 96.79% accuracy. Although not optimized to work in real time, the latter method has the potential for forming the basis of a real time system for the detection of incidents of AP.

  17. Retinopathy of prematurity: Past, present and future.

    PubMed

    Shah, Parag K; Prabhu, Vishma; Karandikar, Smita S; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

    2016-02-01

    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. 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

  19. Quantitation of baby wipes lotion transfer to premature and neonatal skin.

    PubMed

    Hossain, Md Monir; Jones, Jennifer M; Dey, Swatee; Carr, Gregory J; Visscher, Marty O

    2015-10-01

    Exposure to topically applied substances occurs routinely in premature and hospitalized infant care. Safety determinations are most accurate when exposures are based on appropriately designed studies to capture variations in practice patterns and population heterogeneity. Current safety assessments may not reflect actual practice resulting in overly conservative or understated default assumptions for toxicological determinations. We quantified the amount of baby wipes lotion transferred to premature and term neonatal skin as grams/kg body weight/day. We observed the soil type and number of wipes used for skin cleansing and measured lotion transfer from one wipe applied to freshly clean, dry skin. A Bayesian imputation approach was applied to compute lotion exposure and produce summary statistics. Model covariates were age and weight at evaluation, gender, soil type, soil amount, and number of diaper changes per day. Lotion transfer was measured for 66 premature and 55 term neonates with 449 and 254 evaluations, respectively. The wipes per day was 12.52 overall (all infants and soils), 12.78 for premature and 12.21 for term neonates. Lotion transfer was 0.20 g/kg/day (95th percentile) overall, 0.21 for premature and 0.19 for term neonates. The statistical and experimental methodology represents an effective strategy for determining exposure and assessing risk. PMID:26285167

  20. Quantitation of baby wipes lotion transfer to premature and neonatal skin.

    PubMed

    Hossain, Md Monir; Jones, Jennifer M; Dey, Swatee; Carr, Gregory J; Visscher, Marty O

    2015-10-01

    Exposure to topically applied substances occurs routinely in premature and hospitalized infant care. Safety determinations are most accurate when exposures are based on appropriately designed studies to capture variations in practice patterns and population heterogeneity. Current safety assessments may not reflect actual practice resulting in overly conservative or understated default assumptions for toxicological determinations. We quantified the amount of baby wipes lotion transferred to premature and term neonatal skin as grams/kg body weight/day. We observed the soil type and number of wipes used for skin cleansing and measured lotion transfer from one wipe applied to freshly clean, dry skin. A Bayesian imputation approach was applied to compute lotion exposure and produce summary statistics. Model covariates were age and weight at evaluation, gender, soil type, soil amount, and number of diaper changes per day. Lotion transfer was measured for 66 premature and 55 term neonates with 449 and 254 evaluations, respectively. The wipes per day was 12.52 overall (all infants and soils), 12.78 for premature and 12.21 for term neonates. Lotion transfer was 0.20 g/kg/day (95th percentile) overall, 0.21 for premature and 0.19 for term neonates. The statistical and experimental methodology represents an effective strategy for determining exposure and assessing risk.

  1. 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

  2. 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

  3. Neonatal circumcision revisited. Fetus and Newborn Committee, Canadian Paediatric Society.

    PubMed Central

    1996-01-01

    OBJECTIVE: To assist physicians in providing guidance to parents regarding neonatal circumcision. OPTIONS: Whether to recommend the routine circumcision of newborn male infants. OUTCOMES: Costs and complications of neonatal circumcision, the incidence of urinary tract infections, sexually transmitted diseases and cancer of the penis in circumcised and uncircumcised males, and of cervical cancer in their partners, and the costs of treating these diseases. EVIDENCE: The literature on circumcision was reviewed by the Fetus and Newborn Committee of the Canadian Paediatric Society. During extensive discussion at meetings of the committee over a 24-month period, the strength of the evidence was carefully weighed and the perspective of the committee developed. VALUES: The literature was assessed to determine whether neonatal circumcision improves the health of boys and men and is a cost-effective approach to preventing penile problems and associated urinary tract conditions. Religious and personal values were not included in the assessment. BENEFITS, HARMS AND COSTS: The effect of neonatal circumcision on the incidence of urinary tract infection, sexually transmitted diseases, cancer of the penis, cervical cancer and penile problems; the complications of circumcision; and estimates of the costs of neonatal circumcision and of the treatment of later penile conditions, urinary tract infections and complications of circumcision. RECOMMENDATION: Circumcision of newborns should not be routinely performed. VALIDATION: This recommendation is in keeping with previous statements on neonatal circumcision by the Canadian Paediatric Society and the American Academy of Pediatrics. The statement was reviewed by the Infectious Disease Committee of the Canadian Paediatric Society. The Board of Directors of the Canadian Paediatric Society has reviewed its content and approved it for publication. SPONSOR: This is an official statement of the Canadian Paediatric Society. No external

  4. Effect of bright light in the hospital nursery on the incidence of retinopathy of prematurity.

    PubMed

    Glass, P; Avery, G B; Subramanian, K N; Keys, M P; Sostek, A M; Friendly, D S

    1985-08-15

    The preterm infant is subjected to prolonged exposure to ambient nursery illumination at levels that have been found to produce retinal damage in animals. We prospectively investigated the effect of exposure to light in two intensive care nurseries by comparing the incidence of retinopathy of prematurity among 74 infants from the standard bright nursery environment (median light level, 60 foot-candles [ftc]) with the incidence among 154 infants of similar birth weight for whom the light levels were reduced (median, 25 ftc). There was a higher incidence of retinopathy of prematurity in the group of infants who had been exposed to the brighter nursery lights, particularly in those with birth weights below 1000 g (86 percent vs. 54 per cent, P less than 0.01 by chi-square test). We conclude that the high level of ambient illumination commonly found in the hospital nursery may be one factor contributing to retinopathy of prematurity and that safety standards with regard to current lighting practices should be reassessed. PMID:3839567

  5. Nutritional recommendations for the late-preterm infant and the preterm infant after hospital discharge.

    PubMed

    Lapillonne, Alexandre; O'Connor, Deborah L; Wang, Danhua; Rigo, Jacques

    2013-03-01

    Early nutritional support of preterm infants is critical to life-long health and well being. Numerous studies have demonstrated that preterm infants are at increased risk of mortality and morbidity, including disturbances in brain development. To date, much attention has focused on enhancing the nutritional support of very low and extremely low birth weight infants to improve survival and quality of life. In most countries, preterm infants are sent home before their expected date of term birth for economic or other reasons. It is debatable whether these newborns require special nutritional regimens or discharge formulas. Furthermore, guidelines that specify how to feed very preterm infants after hospital discharge are scarce and conflicting. On the other hand, the late-preterm infant presents a challenge to health care providers immediately after birth when decisions must be made about how and where to care for these newborns. Considering these infants as well babies may place them at a disadvantage. Late-preterm infants have unique and often-unrecognized medical vulnerabilities and nutritional needs that predispose them to greater rates of morbidity and hospital readmissions. Poor or inadequate feeding during hospitalization may be one of the main reasons why late-preterm infants have difficulty gaining weight right after birth. Providing optimal nutritional support to late premature infants may improve survival and quality of life as it does for very preterm infants. In this work, we present a review of the literature and provide separate recommendations for the care and feeding of late-preterm infants and very preterm infants after discharge. We identify gaps in current knowledge as well as priorities for future research. PMID:23445854

  6. Nutritional recommendations for the late-preterm infant and the preterm infant after hospital discharge.

    PubMed

    Lapillonne, Alexandre; O'Connor, Deborah L; Wang, Danhua; Rigo, Jacques

    2013-03-01

    Early nutritional support of preterm infants is critical to life-long health and well being. Numerous studies have demonstrated that preterm infants are at increased risk of mortality and morbidity, including disturbances in brain development. To date, much attention has focused on enhancing the nutritional support of very low and extremely low birth weight infants to improve survival and quality of life. In most countries, preterm infants are sent home before their expected date of term birth for economic or other reasons. It is debatable whether these newborns require special nutritional regimens or discharge formulas. Furthermore, guidelines that specify how to feed very preterm infants after hospital discharge are scarce and conflicting. On the other hand, the late-preterm infant presents a challenge to health care providers immediately after birth when decisions must be made about how and where to care for these newborns. Considering these infants as well babies may place them at a disadvantage. Late-preterm infants have unique and often-unrecognized medical vulnerabilities and nutritional needs that predispose them to greater rates of morbidity and hospital readmissions. Poor or inadequate feeding during hospitalization may be one of the main reasons why late-preterm infants have difficulty gaining weight right after birth. Providing optimal nutritional support to late premature infants may improve survival and quality of life as it does for very preterm infants. In this work, we present a review of the literature and provide separate recommendations for the care and feeding of late-preterm infants and very preterm infants after discharge. We identify gaps in current knowledge as well as priorities for future research.

  7. The fetus as a patient. Surgical considerations.

    PubMed Central

    Harrison, M R; Adzick, N S

    1991-01-01

    The diagnosis and treatment of human fetal defects has evolved rapidly over the past decade due to improved fetal imaging techniques and better understanding of fetal pathophysiology derived from animal models. The detection of a fetal anomaly may now lead to a change in the timing of delivery, a change in the mode of delivery, or prenatal treatment. Because most therapeutic maneuvers involve some risk to the fetus and mother, there must be a reasonable expectation that the procedure is feasible, safe, and effective before it can be attempted in humans. This requires reliable information about the pathophysiology and natural history of the disease process, the efficacy of fetal surgical intervention in ameliorating the disease, and the feasibility and safety of the proposed intervention. This paper focuses on the rationale and initial clinical experience with fetal surgery for a variety of life-threatening fetal anatomic defects. PMID:2009009

  8. The unique endocrine milieu of the fetus.

    PubMed Central

    Fisher, D A

    1986-01-01

    Table II summarizes in tabular form the major features of the fetal endocrine milieu discussed in the foregoing pages. The mammalian fetus develops in an environment where respiration, alimentation, and excretory functions are provided by the placenta. Fetal tissue metabolism is oriented largely to anabolism; body temperature is modulated by maternal metabolism, and fetal tissue thermogenesis is maintained at a basal level. Tissue and organ growth appear to be regulated by growth factors which probably function by autocrine or paracrine mechanisms during most of gestation (72, 146-148). In this milieu conventional endocrine control systems are largely redundant, and other transient systems more appropriate to the intrauterine environment have evolved. We have developed some insights into these systems, but much more information is necessary before we can truly understand this fascinating environment. PMID:3018041

  9. An evaluation of the system to control blood flow in maintaining goat fetuses on arterio-venous extracorporeal membrane oxygenation: a novel approach to the development of an artificial placenta.

    PubMed

    Unno, N; Baba, K; Kozuma, S; Nishina, H; Okai, T; Kuwabara, Y; Taketani, Y

    1997-12-01

    We compared various methods to control blood flow for extrauterine incubation of goat fetuses without lung respiration using arterio-venous extracorporeal membrane oxygenation via umbilical vessels to develop a suitable system for a long-term life support system for premature neonates. In twenty-seven consecutive preparations of goat fetuses, 4 designs (System 1, manual flow control without a reservoir; System 2, manual flow control with an arterial open-top reservoir; System 3, semiautomatic flow control with an arterial open top reservoir; and System 4, semiautomatic flow control with a tube occluder and an arterial open top reservoir) were tested in terms of the duration of incubation periods during which fetuses were kept under stable conditions. The incubation periods became prolonged with the advancement of the system (System 1, 5.4 h; System 2, 11.6 h; System 3, 64.8 h; and System 4, 159.8 h medians of the incubation periods). The incubation periods with System 4 were significantly longer compared to those with System 1 and System 2. These results suggest that, for extrauterine incubation of goat fetuses using arterio-venous extracorporeal membrane oxygenation via umbilical vessels, the method to control blood flow is of utmost importance for long-term maintenance, and thus a control system with the fixed vascular resistance of the extracorporeal circuit is applicable to long-term maintenance of premature goat fetuses.

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

    PubMed

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

    2015-01-01

    Infant skin is critical to the newborn child's transition from the womb environment to the journey to self-sufficiency. This review provides an integrative perspective on the skin development in full term and premature infants. There is a particular focus on the role of vernix caseosa and on the implications of skin development for epidermal penetration of exogenous compounds. Healthy full-term newborn skin is well-developed and functional at birth, with a thick epidermis and well-formed stratum corneum (SC) layers. Transepidermal water loss is very low at birth, equal to, or lower than adults, indicating a highly effective skin barrier. Vernix facilitates SC development in full-term infants through a variety of mechanisms including physical protection from amniotic fluid and enzymes, antimicrobial effects, skin surface pH lowering, provision of lipids, and hydration. Premature infants, particularly those of very low birth weight, have a poor skin barrier with few cornified layers and deficient dermal proteins. They are at increased risk for skin damage, increased permeability to exogenous agents and infection. The SC barrier develops rapidly after birth but complete maturation requires weeks to months. The best methods for caring for infant skin, particularly in the diaper region, are described and related to these developmental changes. PMID:25889127

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

    PubMed

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

    2015-01-01

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

  12. Possible homozygous Waardenburg syndrome in a fetus with exencephaly

    SciTech Connect

    1995-11-06

    This paper describes a pedigree with Waardenburg syndrome and an aborted fetus who had severe congenital malformations but no detected genetic mutations. The authors concluded that despite the fact that no homozygosity of the fetus was demonstrated, the phenotype pointed to homozygous mutations of the PAX3 gene. 17 refs., 4 figs.

  13. Genome-wide epigenetic alterations in cloned bovine fetuses.

    PubMed

    Cezar, Gabriela Gebrin; Bartolomei, Marisa S; Forsberg, Erik J; First, Neal L; Bishop, Michael D; Eilertsen, Kenneth J

    2003-03-01

    To gain a better understanding of global methylation differences associated with development of nuclear transfer (NT)-generated cattle, we analyzed the genome-wide methylation status of spontaneously aborted cloned fetuses, cloned fetuses, and adult clones that were derived from transgenic and nontransgenic cumulus, genital ridge, and body cell lines. Cloned fetuses were recovered from ongoing normal pregnancies and were morphologically normal. Fetuses generated by artificial insemination (AI) were used as controls. In vitro fertilization (IVF) fetuses were compared with AI controls to assess effects of in vitro culture on the 5-methylcytosine content of fetal genomes. All of the fetuses were female. Skin biopsies were obtained from cloned and AI-generated adult cows. All of the adult clones were phenotypically normal and lactating and had no history of health or reproductive disorders. Genome-wide cytosine methylation levels were monitored by reverse-phase HPLC, and results indicated reduced levels of methylated cytosine in NT-generated fetuses. In contrast, no differences were observed between adult, lactating clones and similarly aged lactating cows produced by AI. These data imply that survivability of cloned cattle may be closely related to the global DNA methylation status. This is the first report to indicate that global methylation losses may contribute to the developmental failure of cloned bovine fetuses. PMID:12604655

  14. Severe neonatal complication of transverse lie after preterm premature rupture of membranes.

    PubMed

    Van der Kaay, D C M; Horsch, S; Duvekot, J J

    2013-07-08

    Both transverse lie and preterm premature rupture of membranes (PPROM) are associated with neonatal morbidity and mortality. We present a neonate born at 29 weeks gestation with severe birth trauma after PPROM and transverse lie. The patient had extensive swelling and areas of desquamated and necrotic skin of the right lower limb. Neonatal compartment syndrome (NCS) was suspected. Perfusion of the limb improved after decompressing subcutaneous incisions. A fetus in transverse lie may be mechanically damaged in the case of PPROM, especially at an early gestational age. Early recognition is of great interest in the management and prognosis of NCS.

  15. The patient observer: does the hands-and-knees posture during labor help to rotate the occiput posterior fetus?

    PubMed

    Biancuzzo, M

    1991-03-01

    Retrospective chart review was conducted for four low-risk women with full-term, healthy fetuses in the occiput posterior position. The first woman pushed for over two hours and delivered a 6 lb, 8 3/4 oz baby by cesarean section. The second woman delivered a 5 lb, 2 3/4 oz baby posteriorly by vacuum extraction and had a third-degree laceration. The third and fourth women both assumed the hands-and-knees posture during labor; their infants weighted 7 lb, 7 3/4 oz and 7 lb, 11 3/4 oz, respectively. Both of these fetuses rotated to the anterior position and were born spontaneously without complications.

  16. Pulmonary beta-adrenergic receptors and response do not mature precociously in growth-retarded rabbit fetuses.

    PubMed

    Lee, J K; Goldfien, A; Lykins, D L; Roberts, J M

    1989-10-01

    Growth-retarded infants have a reduced risk of pulmonary morbidity. We used a naturally occurring model of growth retardation in rabbits to test the hypothesis that reduced risk might be related to precocious maturation of the alveolar beta-adrenergic response system in runted neonates. We confirmed that the weights of the fetuses were significantly different, depending on uterine position, as predicted by this model. However, we found no evidence of either increased beta-adrenergic receptor concentration or cyclic adenosine monophosphate generation in the smaller fetuses. These results indicate that reduced fetal size in this model of growth retardation does not result in accelerated maturation of alveolar beta-adrenergic responses in neonates.

  17. Human milk feeding supports adequate growth in infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite current nutritional strategies, premature infants remain at high risk for extrauterine growth restriction. The use of an exclusive human milk-based diet is associated with decreased incidence of necrotizing enterocolitis (NEC), but concerns exist about infants achieving adequate growth. The ...

  18. Using Infant Massage Following a Mother's Unfavorable Neonatal Intensive Care Unit Experiences: A Case Study

    ERIC Educational Resources Information Center

    Lappin, Grace

    2005-01-01

    The purpose of this case study was to explore the synchronous behaviors enacted by mother and infant with blindness. In the study, a mother's less than optimal experience with the neonatal intensive care unit (NICU) had a profound effect not only on her and her infant son, who was born 3 months prematurely and was visually impaired, but also on…

  19. Postpartal anxiety and depression in mothers of term and preterm infants.

    PubMed

    Gennaro, S

    1988-01-01

    This study examined differences in anxiety and depression in mothers of term and preterm infants in the first week postpartum and over the next 6 weeks. Mothers of 41 preterm infants were matched with 41 mothers of term infants on parity, type of delivery, age, and race. Sixteen mothers of preterm infants and 10 mothers of term infants completed all 7 weeks of data collection. Mothers of preterm infants were significantly more anxious and depressed than mothers of term infants in the first postpartal week but this difference did not persist over time. Maternal affect was unrelated to parity or type of delivery in the first postpartal week and over time. There were no differences among mothers of premature infants in initial anxiety or depression, based on the level of illness of the infant.

  20. Infants' sensitivity to vertical disparity for depth perception

    NASA Astrophysics Data System (ADS)

    Tsuruhara, Aki; Kaneko, Hirohiko; Kanazawa, So; Otsuka, Yumiko; Shirai, Nobu; Yamaguchi, Masami K.

    2013-05-01

    Both horizontal and vertical binocular disparities produce depth perception in adults. In developmental studies, infants aged around 4 to 6 months were shown to perceive depth from horizontal disparity. However, infants' sensitivity to vertical disparity has not been shown clearly. To examine the sensitivity in infants, this study measured preferential looking behavior of infants aged 20 to 27 weeks. Results showed a significant preference for the stimulus with vertical disparity, providing the first evidence of infants' sensitivity to vertical disparity. The infants in the same age group did not show preference for stimulus with horizontal disparity when the stimulus were comparable to the stimulus with vertical disparity, while their sensitivity to horizontal disparity was confirmed with the stimuli used in a previous study. Our results would suggest that properties in processing horizontal and vertical disparities are different in infancy, and that the sensitivity to horizontal disparity are still premature in 27 weeks after birth.

  1. Short- and Long-Term Outcomes for Extremely Preterm Infants.

    PubMed

    Patel, Ravi Mangal

    2016-02-01

    Prematurity is the leading cause of infant mortality worldwide. In developed countries, extremely preterm infants contribute disproportionately to both neonatal and infant mortality. Survival of this high-risk population has incrementally improved in recent years. Despite these improvements, approximately one in four extremely preterm infants dies during the birth hospitalization. Among those who survive, respiratory and other morbidities are common, although their effect on quality of life is variable. In addition, long-term neurodevelopmental impairment is a large concern for patients, clinicians, and families. However, the interplay of multiple factors contributes to neurodevelopmental impairment, with measures that change over time and outcomes that can be difficult to define and predict. Understanding outcomes of extremely preterm infants can help better counsel families regarding antenatal and postnatal care and guide strategies to improve survival without morbidity. This review summarizes recent evidence to provide an overview into the short- and long-term outcomes for extremely preterm infants.

  2. [Premature orgasm in the male].

    PubMed

    Köhn, F M

    2003-11-13

    To date, we have no uniform definition of ejaculatio praecox. In a qualitative approach, premature ejaculation is ascribed to a failure to control excitement. As causes, organic disorders and erectile dysfunction must be excluded. The majority of cases, however, are due to psychological or partnership problems. The history-taking should aim, in particular, to uncover possible anxiety in conjunction with premature orgasm, and also to establish the reactions of the partner. As therapy, medication (local anesthetics, antidepressive agents, PDE-5 inhibitors) and sexual-therapeutic measures are available. Since few sufferers take the initiative in seeking treatment, particular importance attaches to providing the public with information about the therapeutic options for treating this common disorder. PMID:14699829

  3. Biometry of face and brain in fetuses with trisomy 21.

    PubMed

    Guihard-Costa, Anne-Marie; Khung, Suonavy; Delbecque, Kathy; Ménez, Françoise; Delezoide, Anne-Lise

    2006-01-01

    The aim of this study was to specify the early setting of the particular craniofacial morphology in Down syndrome during the fetal period from data based on postmortem examinations. The study included 1277 fetuses at 15-38 gestational weeks (GW): 922 control fetuses and 355 fetuses with trisomy 21, selected from fetopathology units in Paris. Body weight (BW) and nine dimensions of the face, skull, and brain were recorded: the outer and inner canthal distances (OCD, ICD), biparietal diameter (BPD), head circumference (HC), brain weight (BrW), occipitofrontal diameters of left and right hemispheres (lOFD, rOFD), weight of the infratentorial part of the brain (IBW), and maximal transversal diameter of the cerebellum (CTD). Four ratios were computed: BPD/HC, OCD/BPD, BrW/BW, IBW/BrW. Differences between trisomic fetuses and control fetuses were tested by age interval. Results showed that BW, rOFD, and lOFD were lower in trisomic fetuses as early as 15 GW. Cerebellar hypoplasia included lower IBW and CTD in trisomic fetuses. The IBW/BrW ratio was higher in trisomic fetuses, showing that growth restriction affected the infratentorial part of the brain less than the supratentorial part. Early brachycephaly was found in trisomic fetuses, with higher values of BPD and BPD/HC from 15 GW. ICD and OCD were not significantly different in the two groups, but OCD/DBP ratio was lower in trisomic fetuses. These results confirm the early phenotypical expression of trisomy 21 on craniofacial morphology, associated with a marked restriction of brain growth, especially in the supratentorial part. PMID:16326987

  4. Ventricular ejection force in growth-retarded fetuses.

    PubMed

    Rizzo, G; Capponi, A; Rinaldo, D; Arduini, D; Romanini, C

    1995-04-01

    The objective of this study was to determine whether in growth-retarded fetuses secondary to uteroplacental insufficiency the cardiac ventricles exert a force different from that of appropriately grown fetuses. Doppler echocardiographic studies were performed in 156 appropriately grown fetuses (gestational age 18-38 weeks) and in 72 growth-retarded fetuses (gestational age 24-36 weeks) free from structural and chromosomal abnormalities and characterized by Doppler changes in the umbilical artery and middle cerebral artery suggesting uteroplacental insufficiency as the most likely etiology of the growth defect. Right and left ventricular ejection force values were calculated from velocity waveforms recorded at the level of aortic and pulmonary valves, according to Newton's second law of motion. In appropriately grown fetuses, left and right ventricular ejection force values significantly increased with advancing gestation and the two ventricles exerted similar force. In growth-retarded fetuses, the ventricular ejection force was significantly and symmetrically decreased in both ventricles. Among growth-retarded fetuses, a poorer perinatal outcome was observed in those fetuses in which the ejection force of both ventricles was below the 5th centile of the normal limits for gestation. In 12 growth-retarded fetuses followed longitudinally during the last week preceding intrauterine death or Cesarean section due to antepartum heart-rate late decelerations, a significant decrease of ejection force was found in both ventricles. Finally, a significant relationship was found between the severity of acidosis and right and left ventricular ejection force values in 22 fetuses in which Doppler recordings were performed immediately before cordocentesis.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Neutropenia - infants

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007230.htm Neutropenia - infants To use the sharing features on this page, please enable JavaScript. Neutropenia is an abnormally low number of white blood ...

  6. Infant botulism

    MedlinePlus

    ... found in soil and certain foods (such as honey and some corn syrups). Infant botulism occurs mostly ... late as 1 year. Risk factors include swallowing honey as a baby, being around contaminated soil, and ...

  7. Infant reflexes

    MedlinePlus

    ... neck reflex; Galant reflex; Truncal incurvation; Rooting reflex; Parachute reflex; Grasp reflex ... was stroked and begin to make sucking motions. PARACHUTE REFLEX This reflex occurs in slightly older infants ...

  8. Complete genome sequence of Campylobacter fetus subsp. testudinum type strain 03-427T

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Campylobacter fetus subsp. testudinum has been isolated from reptiles and humans. This Campylobacter subspecies is genetically distinct from other C. fetus subspecies. Here we present the first whole genome sequence for this C. fetus subspecies....

  9. Role of gender in morbidity and mortality of extremely premature neonates.

    PubMed

    Binet, Marie-Eve; Bujold, Emmanuel; Lefebvre, Francine; Tremblay, Yves; Piedboeuf, Bruno

    2012-03-01

    We investigated the effect of gender on survival and short-term outcomes of extremely premature infants (≤27 weeks) born in Canada. The records of infants admitted between 2000 and 2005 to a neonatal intensive care unit participating in the Canadian Neonatal Network were reviewed for infant gender, birth weight, gestational age, outborn status, Score for Neonatal Acute Physiology II, and antenatal corticosteroid exposure. The following outcomes were recorded: survival at final discharge, necrotizing enterocolitis, bronchopulmonary dysplasia (BPD), intraventricular hemorrhage grade ≥3, retinopathy grade ≥3, days on ventilation, and length of hospital stay. Among 2744 extremely premature infants, 1480 (54%) were male and 1264 (46%) were female. Mean birth weight of female neonates was significantly lower at each week of gestational age. Although no significant difference in survival at discharge was found between genders overall, the prevalence of BPD, combined adverse outcomes, and mortality for infants born between 24 and 26 weeks were significantly higher in males. This study suggests that, in the postsurfactant era, males remain at higher risk of respiratory complications and may have higher mortality when born between 24 and 26 weeks of gestation.

  10. Fetal programming of infant neuromotor development: the generation R study.

    PubMed

    van Batenburg-Eddes, Tamara; de Groot, Laila; Steegers, Eric A P; Hofman, Albert; Jaddoe, Vincent W V; Verhulst, Frank C; Tiemeier, Henning

    2010-02-01

    The objective of the study was to examine whether infant neuromotor development is determined by fetal size and body symmetry in the general population. This study was embedded within the Generation R Study, a population-based cohort in Rotterdam. In 2965 fetuses, growth parameters were measured in mid-pregnancy and late pregnancy. After birth, at age 9 to 15 wks, neuromotor development was assessed with an adapted version of Touwen's Neurodevelopmental Examination. Less optimal neuromotor development was defined as a score in the highest tertile. We found that higher fetal weight was beneficial to infant neurodevelopment. A fetus with a 1-SD score higher weight in mid-pregnancy had an 11% lower risk of less optimal neuromotor development (OR: 0.89; 95% CI: 0.82-0.97). Similarly, a fetus with a 1-SD score larger abdominal-to-head circumference (AC/HC) ratio had a 13% lower risk of less optimal neuromotor development (OR: 0.87; 95% CI: 0.79-0.96). These associations were also present in late pregnancy. Our findings show that fetal size and body symmetry in pregnancy are associated with infant neuromotor development. These results suggest that differences in infant neuromotor development, a marker of behavioral and cognitive problems, are at least partly caused by processes occurring early in fetal life. PMID:19809381

  11. Review of interventions to reduce stress among mothers of infants in the NICU.

    PubMed

    Chertok, Ilana R Azulay; McCrone, Susan; Parker, Dennelle; Leslie, Nan

    2014-02-01

    Nearly half a million preterm infants are born each year in the United States. Preterm delivery has significant psychosocial implications for mothers, particularly when their baby spends time in the neonatal intensive care unit (NICU). The decrease in length of gestation causes mothers to have to parent prematurely, without the less time for emotional preparation than mothers of full-term infants. Parents of NICU infants experience stress related to feelings of helplessness, exclusion and alienation, and lack sufficient knowledge regarding parenting and interacting with their infants in the NICU. There are a number of interventions that nurses can do that help reduce the stress of mothers of infants in the NICU.

  12. Eruption chronology of the first deciduous teeth in children born prematurely with birth weight less than 1500g

    PubMed Central

    F., Pedro Garcia; Falcão, Mário Cícero

    2014-01-01

    Objective: To describe the eruption chronology of the first deciduous teeth in premature infants with birth weight less than 1500g and to compare it according to gender and nutritional status at birth. Methods: Longitudinal study including 40 low birth weight premature infants of both genders. The tooth was considered erupted when the crown went through the gum and became part of the oral environment. The comparison of the eruption chronology in relation to gender and among children appropriate or small for gestational age was done by Student's t-test, being significant p<0.05. Results: The eruption of the first tooth (teeth) occurred, on average, with 11.0±2.1 months of chronological age and with 9.6±1.9 months corrected for prematurity. The first erupted teeth were the lower central incisors. The average eruption for males was 9.7±1.9 and, for females, 9.5±1.9 months, both corrected for prematurity (p=0.98). The average eruption in children with birth weight appropriate for gestational age was 10.1±1.4 months; for small for gestational age, it was 9.4±2.2, also corrected for prematurity (p=0.07). Conclusions: The average eruption age of the first teeth, corrected for prematurity, was 9.6 months. Sex and nutritional status at birth did not change the eruption chronology. PMID:24676185

  13. Anatomy of the infant head

    SciTech Connect

    Bosma, J.F.

    1986-01-01

    This text is mainly an atlas of illustration representing the dissection of the head and upper neck of the infant. It was prepared by the author over a 20-year period. The commentary compares the anatomy of the near-term infant with that of a younger fetus, child, and adult. As the author indicates, the dearth of anatomic information about postnatal anatomic changes represents a considerable handicap to those imaging infants. In part 1 of the book, anatomy is related to physiologic performance involving the pharynx, larynx, and mouth. Sequential topics involve the regional anatomy of the head (excluding the brain), the skeleton of the cranium, the nose, orbit, mouth, larynx, pharynx, and ear. To facilitate use of this text as a reference, the illustrations and text on individual organs are considered separately (i.e., the nose, the orbit, the eye, the mouth, the larynx, the pharynx, and the ear). Each part concerned with a separate organ includes materials from the regional illustrations contained in part 2 and from the skeleton, which is treated in part 3. Also included in a summary of the embryologic and fetal development of the organ.

  14. From Biological Rhythms to Social Rhythms: Physiological Precursors of Mother-Infant Synchrony

    ERIC Educational Resources Information Center

    Feldman, Ruth

    2006-01-01

    Links between neonatal biological rhythms and the emergence of interaction rhythms were examined in 3 groups (N=71): high-risk preterms (HR; birth weight less than 1,000 g), low-risk preterms (LR; birth weight=1,700-1,850 g), and full-term (FT) infants. Once a week for premature infants and on the 2nd day for FT infants, sleep-wake cyclicity was…

  15. Retinopathy of prematurity in port harcourt, Nigeria.

    PubMed

    Adio, Adedayo O; Ugwu, Rosemary O; Nwokocha, Chidi G; Eneh, Augusta U

    2014-01-01

    Purpose. With many preterm babies now surviving as a result of improvement in neonatal care in Nigeria, the incidence of visual impairment/blindness as a result of retinopathy of prematurity (ROP) may rise. We describe our findings after screening starts for the first time in a 15-year-old special care baby unit so as to establish the incidence and risk factors for developing ROP. Methods. A prospective study carried out at the Special Care Baby Unit (SCBU) and Pediatric Outpatient Clinics of the University of Port Harcourt Teaching Hospital between January 1 and October 31, 2012. Fifty-three preterm babies (of 550 neonates admitted within the study period) delivered before 32 completed weeks and weighing less than 1500 g were included in the study following informed consent and the main outcome measure was the development of any stage of ROP. Results. Mean gestational age at birth was 28.98 ± 1.38 weeks. Mean birth weight was 1411 ± 128 g. Out of 550 babies admitted at SCBU, 87 of 100 preterms survived with 53 included in study. Twenty-five (47.2%) had different degrees of ROP with prevalence found to be 47.2%. Prevalence was higher (75%) in babies weighing <1300 g and those delivered before 30-week gestation (58%). Twenty-one (84%) had stage 1 no plus disease and 3 (12%) had stage 2 no plus disease. Only 1 (4%) had threshold disease in Zone 1. None had disease at stage 4 or 5 or AP-ROP. Receiving supplemental oxygen (χ (2) = 6.17; P = 0.01), presence of sepsis (χ (2) = 7.47; P = 0.006), multiple blood transfusions (χ (2) = 5.11; P = 0.02), and delivery by caesarian section (χ (2) = 4.22; P = 0.04) were significantly associated with development of ROP. There were no significant differences with gender, apneic spells, jaundice, or phototherapy. Conclusions and Relevance. All live infants with ROP were noted to regress spontaneously in this study. Though it may not be cost effective to acquire treatment facilities at the moment (the only child with

  16. The low-birth-weight infant

    PubMed Central

    1989-01-01

    Low-birth-weight (LBW) infants have special nutritional requirements arising from their rapid growth rate and developmental immaturity. LBW infants are of many kinds; for example, the nutritional needs and functional capabilities of a small-for-gestational-age full-term infant are not the same as those of a very LBW premature infant. Ideal criteria for evaluating the nutritional management of these infants have not been established, and thus the recommended intakes given here do not represent proven physiological requirements. They nevertheless provide a basis from which more refined recommendations may be made. Although this chapter is not intended as such to be a discussion of applicable feeding techniques, it would be difficult and artificial to divorce two such closely intertwined aspects of the distinctive needs of this highly vulnerable group. Feeding techniques have to be carefully assessed in the light of specific environments and the expertise available, and none is entirely risk-free in any setting. Thus, it is essential to compensate for the immaturity of the infants and to avoid compromising the airway or risking aspiration of gastric contents. The choice between using breast milk or proprietary formulas in feeding LBW infants is complex on both nutritional and immunological grounds as well as for practical reasons. Given that the preponderance (>90%) of LBW infants are born in developing countries, the use of an infant's own mother's fresh milk may be the only realistic option. However, irrespective of the health care facilities, level of technology or alternative formulas that might be available, studies show that there is much to recommend feeding LBW infants their own mothers' milk in any environment. PMID:20604471

  17. Conflicting perceptions of the fetus: person, patient, 'nobody', commodity?

    PubMed

    Williams, C; Alderson, P; Farsides, B

    2001-01-01

    Different constructions of the fetus lie at the centre of reproductive, abortion and disability politics. Recent developments mean that, within the same hospital, a fetus may be perceived in contrasting and potentially conflicting ways. It is also argued that the status given to the fetus is directly relevant to the status given to pregnant women. During group discussions facilitated by an ethicist, health-care staff highlighted various perceptions of the fetus which included: person; patient; 'nobody'; commodity. Perhaps not surprisingly in view of the current legal situation, staff tended to claim that it is usually the pregnant women who decides how her fetus will be constructed, and the practitioner who responds to this. However, various ways in which practitioners might influence women's perceptions of their fetus are highlighted, as are some ways in which the perceptions of staff might be influenced. This paper illustrates how sensitive health-care staff will need to be if they are indeed to respond to, rather than shape, women's constructions of their fetus. PMID:15584143

  18. Framing the fetus in medical work: rituals and practices.

    PubMed

    Williams, Clare

    2005-05-01

    What does it mean to investigate the fetus, and what might be the potential consequences? Although a number of feminists have engaged with the debate around the status of the fetus in terms of the possible implications for women, discussion of fetuses has been avoided by many feminists, in response to the politics around the abortion debate. However, there has recently been a move to explore the ways in which the meanings and significance of the fetus can be socially constructed. Set within a United Kingdom context, this paper focuses on two areas which are arguably changing perceptions of the fetus: the recent 'discovery' of fetal 'pain'; and the growing recognition of the fetus as a patient. One of the key concerns of those who support the autonomy of women is that any increasing discourse around the concept of fetal patienthood may promote the notion of fetal personhood, which in turn may affect the status of pregnant women. In exploring perceptions of the fetus, this article firstly cites some of the key policy documents and medical articles which were published during the 1990s, looking at apparent shifts in the ways in which the fetus is discussed in terms of pain and patienthood. It then explores how practitioners from different disciplines talked about fetal pain and patienthood in relation to the clinical setting. Although this paper does not provide conclusive evidence of a wholesale shift in terms of how the fetus is perceived by practitioners, it does point to subtle shifts occurring, which may or may not be significant. It is important to track such shifts closely, primarily because of the potential impact on women, but also for others involved, including practitioners. Such tracking needs to be set within specific cultural and policy contexts. PMID:15743656

  19. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn.

    PubMed

    Burd, L; Blair, J; Dropps, K

    2012-09-01

    Fetal alcohol spectrum disorders (FASDs) are a common cause of intellectual impairment and birth defects. More recently, prenatal alcohol exposure (PAE) has been found to be a risk factor for fetal mortality, stillbirth and infant and child mortality. This has led to increased concern about detection and management of PAE. One to 2 h after maternal ingestion, fetal blood alcohol concentrations (BACs) reach levels nearly equivalent to maternal levels. Ethanol elimination by the fetus is impaired because of reduced metabolic capacity. Fetal exposure time is prolonged owing to the reuptake of amniotic-fluid containing ethanol by the fetus. Alcohol elimination from the fetus relies on the mother's metabolic capacity. Metabolic capacity among pregnant women varies eightfold (from 0.0025 to 0.02 g dl(-1)  h(-1)), which may help explain how similar amounts of ethanol consumption during pregnancy results in widely varying phenotypic presentations of FASD. At birth physiological changes alter the neonate's metabolic capacity and it rapidly rises to a mean value of 83.5% of the mother's capacity. FASDs are highly recurrent and younger siblings have increased risk. Detection of prenatal alcohol use offers an important opportunity for office-based interventions to decrease exposure for the remainder of pregnancy and identification of women who need substance abuse treatment. Mothers of children with FAS have been found to drink faster, get drunk quicker and to have higher BACs. A modest increase in the prevalence of a polymorphism of alcohol dehydrogenase, which increases susceptibility to adverse outcomes from PAE has been reported. Lastly, detection of alcohol use and appropriate management would decrease risk from PAE for subsequent pregnancies.

  20. Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms.

    PubMed

    Glover, Vivette

    2015-01-01

    Many prospective studies have shown that if a mother is depressed, anxious or stressed while pregnant, this increases the risk for her child having a wide range of adverse outcomes including emotional problems, symptoms of attention deficit hyperactivity disorder (ADHD) or impaired cognitive development. Although genetics and postnatal care clearly affect these outcomes, evidence for a prenatal causal component also is substantial. Prenatal anxiety/depression may contribute 10-15 % of the attributable load for emotional/behavioural outcomes.The mechanisms underlying these changes are just starting to be explored. One possible mediating factor is increased exposure of the fetus to cortisol, as has been shown in animal studies. However, the human hypothalamic-pituitary-adrenal (HPA) axis which makes cortisol functions differently in human pregnancy from in most animals. The maternal HPA axis becomes gradually less responsive to stress as pregnancy progresses. And there is only a weak, if any, association between a mother's prenatal mood and her cortisol level, especially later in pregnancy. Cytokines are alternative possible mediators. An additional explanation is that stress or anxiety causes increased transfer of maternal cortisol across the placenta to the fetus. The placenta plays a crucial role in moderating fetal exposure to maternal factors and presumably in preparing the fetus for the environment in which it is going to find itself. There is some evidence in both rat models and in humans that prenatal stress can reduce placental 11β-HSD2, the enzyme which metabolises cortisol to inactive cortisone. The level of cortisol in the amniotic fluid, surrounding the baby in the womb, has been shown to be inversely correlated with infant cognitive development. However, several other biological systems are likely to be involved. Serotonin is another possible mediator of prenatal stress induced programming effects on offspring neurocognitive and behavioural