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Sample records for birth rates infant

  1. [Trendency analysis of infant mortality rate due to premature birth or low birth weight in China from 1996 to 2013].

    Science.gov (United States)

    Cui, Hao; He, Chunhua; Miao, Lei; Zhu, Jun; Wang, Yanping; Li, Qi; Li, Xiaohong; Shen, Liqin

    2015-02-01

    To study the secular trend and characteristics of infant mortality rate due to premature birth or low birth weight (IMRPL) in China from 1996 to 2013. Data used in this study was collected from the population-based Child's Health Surveillance Network of China. The Cochran-Armitage Trend test and Poisson regression were used to test the trend of IMRPL and explore the differences of the trend among different regions or areas. The nationwide IMRPL was 629.9 per 100 000 live births in 1996 and it decreased to 214.6 per 100 000 live births in 2013. The average annual decline rate was 6.14%, while the proportion of infant mortality due to premature birth or low birth weight in all infant deaths was on the rise with the average annual growth rate of 1.52%. And the proportion increased to 22.6% in 2013. IMRPLin rural and urban areas fell 28.1% and 66.6% respectively during 1996 and 2013. But the differences between urban and rural areas was obvious. During the same period, the average IMRPLin the central region was 1.40 times (95%CI:1.31-1.49) of that in the eastern region. And the average IMRPL in the western region was 2.25 times (95%CI:2.12-2.40) of that in the eastern region. The differences among different regions was obvious. Male infant mortality rate due to premature birth or low birth weight was 1.09 times (95%CI:1.05-1.14) of that in female infant from 1996 to 2013. The risk of IMRPL decreased substantially in China from 1996 to 2013. And the risk of IMRPL decreased more in rural areas than that in urban areas. The differences among different regions and areas were obvious. Premature birth or low birth weight as one of main factors has become a serious threat for health of Chinese children.

  2. Sex Ratio at Birth and Infant Mortality Rate in China: An Empirical Study

    Science.gov (United States)

    Lai, Denjian

    2005-01-01

    In this article, we used the data from the last three population censuses of China in 1982, 1990 and 2000, to study the dynamics of the sex ratio at birth and the infant mortality rate in China. In the late 1970s, China started its economic reform and implemented many family planning programs. Since then there has been great economic development…

  3. Investigating the variations in survival rates for very preterm infants in ten European regions: the MOSAIC birth cohort

    DEFF Research Database (Denmark)

    Draper, Elizabeth S; Zeitlin, Jennifer; Fenton, Alan C

    2008-01-01

    OBJECTIVE: To investigate the variation in the survival rate and the mortality rates for very preterm infants across Europe. DESIGN: A prospective birth cohort of very preterm infants for ten geographically defined European regions during 2003 followed to discharge home from hospital. PARTICIPANTS...... for NIC. For babies order...

  4. Investigating the variations in survival rates for very preterm infants in ten European regions: the MOSAIC birth cohort

    DEFF Research Database (Denmark)

    Draper, Elizabeth S; Zeitlin, Jennifer; Fenton, Alan C

    2008-01-01

    OBJECTIVE: To investigate the variation in the survival rate and the mortality rates for very preterm infants across Europe. DESIGN: A prospective birth cohort of very preterm infants for ten geographically defined European regions during 2003 followed to discharge home from hospital. PARTICIPANTS...... of the infants from 24 to 27 weeks gestation survived to discharge home from NIC. However large variations were seen in the timing of the deaths by region. Among all fetuses alive at onset of labour of 24-27 weeks gestation, between 84.0% and 98.9% were born alive and between 64.6% and 97.8% were admitted...

  5. Investigating the variations in survival rates for very preterm infants in ten European regions: the MOSAIC birth cohort

    DEFF Research Database (Denmark)

    Draper, Elizabeth S; Zeitlin, Jennifer; Fenton, Alan C

    2008-01-01

    OBJECTIVE: To investigate the variation in the survival rate and the mortality rates for very preterm infants across Europe. DESIGN: A prospective birth cohort of very preterm infants for ten geographically defined European regions during 2003 followed to discharge home from hospital. PARTICIPANTS...... for NIC. For babies babies alive at onset of labour were admitted to neonatal intensive care. CONCLUSIONS: There are wide variations in the survival rates to discharge from NIC for very preterm deliveries and in the timing of death across the MOSAIC regions. In order...

  6. Trends in Infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight

    OpenAIRE

    Barría-Pailaquilén, René Mauricio; Mendoza-Maldonado, Yessy; Urrutia-Toro, Yohana; Castro-Mora, Cristian; Santander-Manríquez, Gema

    2011-01-01

    The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at

  7. Randomized trial of very low birth weight infants receiving higher rates of infusion of intravenous fat emulsions during the first week of life.

    Science.gov (United States)

    Drenckpohl, Douglas; McConnell, Connie; Gaffney, Shirley; Niehaus, Matt; Macwan, Kamlesh S

    2008-10-01

    The goal was to determine whether very low birth weight infants could tolerate higher rates of infusion of intravenous fat emulsion during the first week of life and maintain their serum triglyceride levels at controlled trial of 110 infants who were classified as appropriate for gestational age and had birth weights between 750 g and 1500 g. The primary clinical outcome was serum triglyceride levels; secondary outcomes also were monitored. One hundred infants completed the study (experimental group: N = 48; control group: N = 52). Infants in the experimental group had significantly higher energy intake for the entire 7-day study period and achieved 90 kcal/kg per day (1 kcal = 4.184 kJ) significantly sooner (7.38 +/- 3.381 days vs 9.44 +/- 3.578 days). Triglyceride levels for infants in the experimental group remained significantly higher for the first 5 days of life. Fifteen percent of infants in the experimental group but only 4% of infants in the control group developed hypertriglyceridemia. Ten percent of infants in the control group but no infants in the experimental group required insulin therapy. Forty-two percent of infants in the experimental group and 17% of infants in the control group remained at >or=10th percentile for weight for age. Fourteen percent of infants in the control group but no infants in the experimental group developed necrotizing enterocolitis. Twenty-three percent of infants in the control group but only 6% of infants in the experimental group developed retinopathy of prematurity. There were no significant differences in other outcomes. Very low birth weight infants can tolerate higher rates of infusion of intravenous fat emulsion solutions during the first week of life without significant adverse events.

  8. Factors associated with inter-institutional variations in sepsis rates of very-low-birth-weight infants in 34 Malaysian neonatal intensive care units.

    Science.gov (United States)

    Boo, Nem-Yun; Cheah, Irene Guat-Sim

    2016-03-01

    This study aimed to determine whether patient loads, infant status on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis rates in very-low-birth-weight (VLBW) infants in the Malaysian National Neonatal Registry (MNNR). This was a retrospective study of 3,880 VLBW (≤ 1,500 g) infants admitted to 34 neonatal intensive care units (NICUs) in the MNNR. Sepsis was diagnosed in symptomatic infants with positive blood culture. Sepsis developed in 623 (16.1%) infants; 61 (9.8%) had early-onset sepsis (EOS) and 562 (90.2%) had late-onset sepsis (LOS). The median EOS rate of all NICUs was 1.0% (interquartile range [IQR] 0%, 2.0%). Compared with NICUs reporting no EOS (n = 14), NICUs reporting EOS (n = 20) had significantly higher patient loads (total live births, admissions, VLBW infants, outborns); more mothers with a history of abortions, and antenatal steroids and intrapartum antibiotic use; more infants requiring resuscitation procedures at birth; higher rates of surfactant therapy, pneumonia and insertion of central venous catheters. The median LOS rate of all NICUs was 14.5% (IQR 7.8%, 19.2%). Compared with NICUs with LOS rates below the first quartile (n = 8), those above the third quartile (n = 8) used less intrapartum antibiotics, and had significantly bigger and more mature infants, more outborns, as well as a higher number of sick infants requiring ventilator support and total parenteral nutrition. Patient loads, resuscitation at birth, status of infants on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis. Copyright: © Singapore Medical Association.

  9. birth-weight infants

    African Journals Online (AJOL)

    hours of life was more strongly associated with death than four traditional risk factors (birth weight, short gestation, male sex and the diagnosis of respiratory distress syndrome). Furthermore, mean pH in the first 12 hours was as strongly associated with death as was birth weight. Previous research in our neonatal population ...

  10. Tritium releases, birth defects and infant deaths

    International Nuclear Information System (INIS)

    1991-01-01

    The AECB has published a report 'Tritium releases from the Pickering Nuclear Generating Station and Birth Defects and Infant Mortality in Nearby Communities 1971-1988' (report number INFO-0401). This presents the results of a detailed analysis of deaths and birth defects occurring in infants born to mothers living in the area (25 Km radius) of the Pickering nuclear power plant, over an 18-year period. The analysis looked at the frequency of these defects and deaths in comparison to the general rate for Ontario, and also in relation to airborne and waterborne releases of tritium from the power plant. The overall conclusion was that the rates of infant death and birth defects were generally not higher in the study population than in all of Ontario. There was no prevalent relationship between these deaths and defects and tritium releases measured either at the power plant or by ground monitoring stations t some distance from the facility

  11. Using text messaging to obtain weekly data on infant feeding in a Danish birth cohort resulted in high participation rates

    DEFF Research Database (Denmark)

    Bruun, Signe; Wedderkopp, Niels; Mølgaard, Christian

    2016-01-01

    .1% exclusively. Complementary food was introduced at an average age of 20 weeks. Breastfeeding cessation was associated with maternal smoking, lower maternal age and supplementation with infant formula in the first days after birth (all pbreastfeeding, but only 1......AIM: Our aim was to use text message questions to obtain prospective, real-time data on exclusive and partial breastfeeding and introduction to complementary foods in a Danish birth cohort. We also wanted to identify factors influencing breastfeeding initiation and cessation. METHODS: This study...... formed part of the Odense Child Cohort and focused on mothers who gave birth to full-term singletons between April and October 2012. They received the same three to five questions, about breastfeeding, infant formula and introduction to complementary foods, three days after birth and then at weekly...

  12. Birth weight recovery among very low birth weight infants surviving ...

    African Journals Online (AJOL)

    of enteral feeds in the first days of their life in order to prevent NEC. Uhing reported that preterm infants ... where: SS = required sample size; Z = 95% confidence interval. (standard value of 1.96); P ... The recommended growth velocity (GV) of very low birth weight (VLBW) infants is 15 g/kg/day. Several factors have been.

  13. Infant mortality rates declining, but still high.

    Science.gov (United States)

    Hoffman, M

    1992-10-01

    Family planning can improve infant survival. Specifically, use of family planning methods can minimize family size, increase birth spacing, and reduce the likelihood of pregnancy for teenagers and women aged 40 or older. Immunizations and oral rehydration are responsible for the falling infant mortality rats since 1977 in developing countries, especially among 1-12 month old infants. Yet, neonatal mortality in developing countries had not changed. WHO intends to step up efforts to improve newborn survival. Accurate data are needed, however. Even in developed countries which keep good statistics, infant mortality bias exists. For example, in Japan, some infant deaths are called fetal deaths. In developing countries, much of the data come from hospitals, yet most birth do not occur in hospitals. Even in surveys, bias exists, such as problems with recall. Many researchers use traditional birth attendants (TBAs) to follow up on all births in an area which may eliminate some biases. Such a prospective and longitudinal study in Trairi county in northeastern Brazil shows the infant mortality rate to be less than half of the official rate (65 vs. 142). The major causes of infant death in developed countries, which tends to occur in the neonatal period, are low birth weight, prematurity, birth complications, and congenital defects; developing countries; they are vaccine preventable infectious diseases, diarrhea and dehydration, and respiratory illnesses, all complicated by malnutrition. To make further strides in reducing infant mortality, public health workers must concentrate on the neonatal period. Training TBAs in sterile techniques, appropriate technology, resuscitation of infants, and identification of potential problems is a positive step. Yet, unpredictable conditions (e.g., AIDS) exist and/or will arise which erode improvements. For example, in Nicaragua, within 1 year after the new government introduced health budget cuts which resulted in the poor paying for

  14. Changes in outcome and complication rates of very-low-birth-weight infants in one tertiary center in southern Taiwan between 2003 and 2010.

    Science.gov (United States)

    Chen, Shen-Dar; Lin, Yung-Chieh; Lu, Chin-Li; Chen, Solomon Chih-Cheng

    2014-08-01

    Neonatal intensive care has changed dramatically over the past few decades and the survival of infants has generally improved in many countries. The purpose of this study was to explore the recent evolution of mortality and morbidities among very-low-birth-weight (VLBW) infants in southern Taiwan. We retrospectively reviewed the medical records of VLBW (birth weight BBW), gestational age (GA), Apgar score, patent ductus arteriosus (PDA), necrotizing enterocolitis, retinopathy, chronic lung disease (CLD), inguinal hernia, and sepsis. The length of stay (LOS) in hospital was compared between the two cohorts. A total of 420 (212 male) VLBW infants were enrolled with 52 (12.4%) deaths. Compared to surviving infants, deceased infants had significantly lower GA, Apgar scores, and BBW. The mortality of VLBW infants remained static between the two birth cohorts, but the incidence of major morbidities generally decreased. The LOS for overall surviving infants and the proportion of LOS > 60 days were both reduced in the period of 2007-2010. With further stratification by BBW, the major reduction of long LOS was only found in the group of BBW ≥ 1000 g. The multivariate logistic regression model found PDA, CLD, and BBW < 1000 g were major complications to be associated with long LOS among surviving infants. Periodic evaluation of the mortality and morbidity of preterm infants can help to understand the changes and trends of our neonatal care. Further study using the national dataset to provide more representative information is warranted. Copyright © 2013. Published by Elsevier B.V.

  15. Resettlement and Birth Rates

    African Journals Online (AJOL)

    GB

    effect on mothers' age at first birth (p < 0.001), the number of children born within the five years of the survey (p<0.001), and the total number of ... approach that compares reported numbers of births for settlers and non-settlers in ... 1Department of Geography, Sonoma State University, USA. 2. Department of Epidemiology ...

  16. Immobility reaction at birth in newborn infant.

    Science.gov (United States)

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

    2014-08-01

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

  17. NEONATAL SEPTICAEMIA IN LOW BIRTH WEIGHT INFANTS AT ...

    African Journals Online (AJOL)

    2005-03-03

    Mar 3, 2005 ... Conclusion: Case fatality rate for low birth weight infants with sepsis is high. Gram negative organisms are the predominant pathogens. No maternal risk factors were identified. Antibiotic sensitivity shows adequate sensitivity to aminoglycosides and third generation cephalosporins. INTRODUCTION.

  18. Hypoglycaemia in fasting low birth weight infants in Jos, Nigeria ...

    African Journals Online (AJOL)

    Background/Objective: Low birth weight (LBW) infants are commonly at risk of hypoglycaemia. The prevalence of hypoglycaemia and its neurological features in fasting LBW infants below 24 hours of age was assessed. Methods: Low birth weight (LBW) infants seen within 24 hours of birth who had not fed or received ...

  19. Does maternal birth outcome differentially influence the occurrence of infant death among African Americans and European Americans?

    Science.gov (United States)

    Masho, Saba W; Archer, Phillip W

    2011-11-01

    The United States continues to have one of the highest infant mortality rates (IMR). Although studies have examined the association between maternal and infant birth outcomes, few studies have examined the impact of maternal birth outcome on infant mortality. This study was designed to examine the influence of maternal low birth weight and preterm birth on infant mortality. The 1997-2007 Virginia birth and infant death registry was analyzed. The infant birth and death data was linked to maternal birth registry data using the mother's maiden name and date of birth. From the mother's birth registry data, the grandmother's demographic and pregnancy history was obtained. Logistic regression modeling was used to estimate adjusted odds ratios and their 95% confidence intervals. There was a statistically significant association between maternal birth outcome and subsequent infant mortality. Infants born from a mother who was low birth weight were 2.3 times more likely to have an infant die within the first year of life. Similarly, infants born from a mother born preterm were 2.2 times more likely to have an infant die. Stratification by race showed that there was no statistical association between maternal birth weight and infant death among Whites. However, a strong association was observed among Blacks. Maternal birth outcomes may be an important indicator for infant mortality. Future longitudinal studies are needed to understand the underlying cause of these associations.

  20. Birth statistics of high birth weight infants (macrosomia in Korea

    Directory of Open Access Journals (Sweden)

    Byung-Ho Kang

    2012-08-01

    Full Text Available &lt;B&gt;Purpose:&lt;/B&gt; The authors analyzed the trend from the birth-related statistics of high birth weight infants (HBWIs over 50 years in Korea from 1960 to 2010. &lt;B&gt;Methods:&lt;/B&gt; We used 2 data sources, namely, the hospital units (1960’s to 1990’s and Statistics Korea (1993 to 2010. The analyses include the incidence of HBWIs, birth weight distribution, sex ratio, and the relationship of HBWI to maternal age. &lt;B&gt;Results:&lt;/B&gt; The hospital unit data indicated the incidence of HBWI as 3 to 7% in the 1960’s and 1970’s and 4 to 7% in the 1980’s and 1990’s. Data from Statistics Korea indicated the percentages of HBWIs among total live births decreased over the years: 6.7% (1993, 6.3% (1995, 5.1 % (2000, 4.5% (2000, and 3.5% (2010. In HBWIs, the birth weight rages and percentage of incidence in infants’ were 4.0 to 4.4 kg (90.3%, 4.5 to 4.9 kg (8.8%, 5.0 to 5.4 kg (0.8%, 5.5 to 5.9 kg (0.1%, and &gt;6.0 kg (0.0% in 2000 but were 92.2%, 7.2%, 0.6%, 0.0%, and 0.0% in 2009. The male to female ratio of HBWIs was 1.89 in 1993 and 1.84 in 2010. In 2010, the mother's age distribution correlated with low (4.9%, normal (91.0%, and high birth weights (3.6%: an increase in mother's age resulted in an increase in the frequency of low birth weight infants (LBWIs and HBWIs. &lt;B&gt;Conclusion:&lt;/B&gt; The incidence of HBWIs for the past 50 years has been dropping in Korea. The older the mother, the higher was the risk of a HBWI and LBWI. We hope that these findings would be utilized as basic data that will aid those managing HBWIs.

  1. Neurodevelopmental outcomes at 3 years old for infants with birth weights under 500 g.

    Science.gov (United States)

    Nagara, Syunsuke; Kouwaki, Masanori; Togawa, Takao; Sugiura, Tokio; Okada, Mayumi; Koyama, Norihisa

    2017-09-21

    Marked improvements have been achieved in the survival of extremely low birth weight infants, but survival rates and prognoses of extremely small infants with birth weights ≤500 g remain poor. The aim of this study was to clarify long-term outcomes for surviving infants with birth weights ≤500 g. The study population comprised fetuses of gestational age ≥22 weeks, expected live- or stillbirth weight ≤500 g, and birth date between 2003 and 2012. Developmental assessments were performed prospectively at 3 years old. Data were obtained for 21 fetuses, including 10 live births and 11 stillbirths. Of the 10 live births, median gestational age was 25.2 weeks (range, 22.4-27.1 weeks), median birth weight was 426 g (range, 370-483 g), and two neonates died before discharge. One infant with severe asphyxia died within 12 h and another infant with Down syndrome died at 34 days. The survival rate was thus 80%. All surviving infants were small for gestational age. Seven of the 8 surviving infants (88%) weighed less than 2500 g at a corrected age of 40 weeks. Seven infants were available for developmental assessments at 3 years old. One infant could not be followed. Two of those seven infants (29%) showed normal development, three infants (42%) showed mild neurodevelopmental disability, and two infants (29%) showed severe neurodevelopmental disability. One infant had periventricular leukomalacia and cerebral palsy. Two of the seven infants (29%) had short stature (g. Further large studies are needed to assess long-term outcomes for extremely small infants. Copyright © 2017. Published by Elsevier B.V.

  2. Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants.

    Science.gov (United States)

    Azzeh, Firas S; Alazzeh, Awfa Y; Dabbour, Ibrahim R; Jazar, Abdelelah S; Obeidat, Ahmed A

    2014-10-01

    Infants with low birth weights are provided with hospital nutrition support to enhance their survivability and body weights. However, different hospitals have different nutrition support formulas. Therefore, the effectiveness of these nutrition support formulas should be investigated. To assess the effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants at Al-Noor hospital, Saudi Arabia. A cross-sectional study was conducted between October, 2010 and December, 2012. Three hundred newborns were recruited from Al-Noor Hospital in Makkah city, Saudi Arabia. Infants were selected according to their birth weights and were divided equally into three groups; (i) Low Birth Weight (LBW) infants (1501- 2500 g birth weight), (ii) Very Low Birth Weight (VLBW) infants (1001-1500 g birth weight) and (iii) Extremely Low Birth Weight (ELBW) infants ( 0.05) were observed among groups. Serum calcium, phosphorus and potassium levels at discharge were higher (p Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  3. Economic influences on birth rates.

    Science.gov (United States)

    Ermisch, J

    1988-11-01

    A researcher uses an econometric analysis to test his theory that economic developments influence birth rates in post World War II in Great Britain. The base of the analysis consists of a group of equilibrium relationships examining the levels of conditional birth rates (at each birth order and each mother's age) and the levels of economic variables, e.g., ratio of women's hourly wage after taxes. The leading cause of a decrease in births, especially after 1974, was an increase in women's net wages in comparison to men's net wages. Additional evidence suggested that higher women's wages increase the cost of an additional child by raising missed earnings, and this higher opportunity cost reduces the chance of another birth. On the other hand, if men's earnings are higher, couples have more children and at a young age. Further, the higher the real house prices the more likely women are to postpone starting a family and, in the case of 20-24 year old women, these high prices also deter them from having a 2nd child. Higher house prices do not affect higher order births, however. When all other things are equal, women from larger families have a tendency to begin having children in their 30s and produce smaller families than those women from smaller families. Large child allowances encourage 3rd-4th births and early motherhood. To increase fertility to replacement level over the long term, the current level of child allowances would have to double costing about 5 billion British pounds or 1.5% of the gross domestic product.

  4. Increasing Incidence of Infants with Low Birth Weight in Oman

    Directory of Open Access Journals (Sweden)

    M. Mazharul Islam

    2015-05-01

    Full Text Available This review article provides an overview of the levels, trends and some possible explanations for the increasing rate of low birth weight (LBW infants in Oman. LBW data from national health surveys in Oman, and published reports from Oman’s Ministry of Health and the World Health Organization were collected and assessed between January and August 2014. Oman’s LBW rate has been increasing since the 1980s. It was approximately 4% in 1980 and had nearly doubled (8.1% by 2000. Since then, it has shown a slow but steady rise, reaching 10% in recent times. High rates of consanguinity, premature births, number of increased pregnancies at an older maternal age and changing lifestyles are some important factors related to the increasing rate of LBW in Oman. The underlying causes of this increase need to be understood and addressed in obstetric policies and practices in order to reduce the rate of LBW in Oman.

  5. Nephrocalcinosis in very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Nasseri Fatemeh

    2010-01-01

    Full Text Available To determine the incidence and risk factors of nephrocalcinosis in preterm infants, we studied in a prospectively 64 preterm infants of birth weight :5 1500 g from February 2006 to November 2007. Data were collected on gestation, birth weight, gender and family history of renal calculi, respiratory support, and use of nephrotoxic drugs. The parameters of mineral meta-bolism were assessed in blood and spot urine samples at the end of 2 nd and 4 th weeks of age. Forty-nine babies completed the study, and nephrocalcinosis was observed in 13 (26.5% babies and was bilateral in 7 (14.3% infants. The mean age of diagnosis of nephrocalcinosis was 52.58 days (range 30-123 days. Gestational age, birth weight, and sex were not significantly associated with increased risk of nephrocalcinosis. The mean duration of ventilation was significantly less in babies with than without nephrocalcinosis (P= 0.020, and the mean levels of urine calcium and phosphate at 4 weeks of age, respectively (P= 0.013, P= 0.048. There were also significant diffe-rences in urine calcium/creatinine ratio (P= 0.001, mean plasma levels of calcium at 2 weeks of age (P= 0.047 and plasma levels of phosphate at 4 weeks of age (P= 0.016 between babies with and without nephrocalcinosis. Using logistic regression analysis, family history of renal stone (P= 0.002 and urine calcium/creatinine ratio (P= 0.011 were significant predictors of nephrocalci-nosis. However, there were no significant differences in the length of stay in the intensive care unit, duration of total parenteral nutrition, and duration and cumulative doses of nephrotoxic drugs between these two groups. We conclude that the incidence of nephrocalcinosis was similar in our population to the previous studies. Family history of renal stone and urine calcium/ creatinine ratio are the major risk factors of nephrocalcinosis in very low birth weight neonates.

  6. Hyponatraemia in very low birth weight infants | Ndwiga | East ...

    African Journals Online (AJOL)

    Objective: To evaluate the influence of infant early neonatal morbidity on serum sodium levels and justify regular monitoring and supplementation. Design: Comparative cohort study. Setting: Newborn Unit, Kenyatta National Hospital, Nairobi. Subjects: Fifty six very low birth weight (1000-1500 grams at birth) infants during ...

  7. A population-based study of effect of multiple birth on infant mortality in Nigeria

    Directory of Open Access Journals (Sweden)

    Uthman Mubashir B

    2008-09-01

    Full Text Available Abstract Background Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life. Methods We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. Results Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19 holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality. Conclusion Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

  8. Trends in Infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight Tendencia de la mortalidad infantil y de neonatos menores de 32 semanas y de muy bajo peso Tendência da mortalidade infantil e dos neonatos menores de 32 semanas e de muito baixo peso

    OpenAIRE

    René Mauricio Barría-Pailaquilén; Yessy Mendoza-Maldonado; Yohana Urrutia-Toro; Cristian Castro-Mora; Gema Santander-Manríquez

    2011-01-01

    The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at

  9. Enteral iron supplementation in preterm and low birth weight infants.

    Science.gov (United States)

    Mills, Ryan John; Davies, Mark W

    2012-03-14

    analysis. The heterogeneity of participants, methods and results precluded an extensive quantitative synthesis. Of the 21 studies comparing iron supplementation with controls, none evaluated neurodevelopmental status as an outcome. Of thirteen studies reporting at least one growth parameter as an outcome, only one study of poor quality found a significant benefit of iron supplementation. Regarding haematological outcomes, no benefit for iron supplementation was demonstrated within the first 8.5 weeks of postnatal life (16 trials), except by two poor quality studies. After this age, most studies reported a higher mean haemoglobin in iron-supplemented infants. We were only able to include a limited number of studies in a quantitative meta-analysis, which suggested the haemoglobin concentration in iron-supplemented infants was higher by about 6 g/L at six to nine months. One study comparing high dose and low dose iron supplementation monitored neurodevelopmental outcome for one year, without finding any significant difference between the groups. One study comparing early versus late commencement of iron supplementation found no difference in cognitive outcome, but an increased rate of abnormal neurological examination in the late iron group at five years of age. The studies comparing high and low doses of iron indicated that there was no discernible haematological benefit in exceeding 'standard' doses of iron (i.e. 2 mg/kg/day to 3 mg/kg/day). The available data suggest that infants who receive iron supplementation have a slightly higher haemoglobin level, improved iron stores and a lower risk of developing iron deficiency anaemia when compared with those who are unsupplemented. However, it is unclear whether iron supplementation in preterm and low birth weight infants has long term benefits in terms of neurodevelopmental outcome and growth. The optimum timing and duration of iron supplementation remains unclear.

  10. The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight.

    Science.gov (United States)

    Komro, Kelli A; Livingston, Melvin D; Markowitz, Sara; Wagenaar, Alexander C

    2016-08-01

    To investigate the effects of state minimum wage laws on low birth weight and infant mortality in the United States. We estimated the effects of state-level minimum wage laws using a difference-in-differences approach on rates of low birth weight (minimum wage above the federal level was associated with a 1% to 2% decrease in low birth weight births and a 4% decrease in postneonatal mortality. If all states in 2014 had increased their minimum wages by 1 dollar, there would likely have been 2790 fewer low birth weight births and 518 fewer postneonatal deaths for the year.

  11. Preterm birth, infant weight gain, and childhood asthma risk

    DEFF Research Database (Denmark)

    Sonnenschein-van der Voort, Agnes M M; Arends, Lidia R; de Jongste, Johan C

    2014-01-01

    birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). METHODS: First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations...... of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age childhood asthma outcomes. RESULTS: Younger gestational...... age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P childhood asthma were explained by gestational age at birth. Compared with term-born children with normal...

  12. Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity.

    Science.gov (United States)

    Arifeen, S E; Black, R E; Caulfield, L E; Antelman, G; Baqui, A H; Nahar, Q; Alamgir, S; Mahmud, H

    2000-10-01

    Relations between size and maturity at birth and infant growth have been studied inadequately in Bangladesh, where the incidence of low birth weight is high and most infants are breast-fed. This study was conducted to describe infant growth patterns and their relations to birth weight, intrauterine growth retardation, and prematurity. A total of 1654 infants born in selected low-socioeconomic areas of Dhaka, Bangladesh, were enrolled at birth. Weight and length were measured at birth and at 1, 3, 6, 9, and 12 mo of age. The infants' mean birth weight was 2516 g, with 46.4% weighing birth weight, SGA, or preterm categories were retained throughout infancy. Mean z scores based on the pooled breast-fed sample were -2.38, -1. 72, and -2.34 at birth, 3 mo, and 12 mo. Correlation analysis showed greater plasticity of growth in the first 3 mo of life than later in the first year. Infant growth rates were similar to those observed among breast-fed infants in developed countries. Most study infants experienced chronic intrauterine undernourishment. Catch-up growth was limited and weight at 12 mo was largely a function of weight at birth. Improvement of birth weight is likely to lead to significant gains in infant nutritional status in this population, although interventions in the first 3 mo are also likely to be beneficial.

  13. Vaccine schedule compliance among very low birth weight infants in Lima, Peru.

    Science.gov (United States)

    Ochoa, Theresa J; Zea-Vera, Alonso; Bautista, Rossana; Davila, Carmen; Salazar, José Antonio; Bazán, Carlos; López, Luis; Ecker, Lucie

    2015-01-03

    There is little information about vaccine schedule compliance in very-low-birth-weight infants in developing countries. The aim of the study was to describe the compliance with the vaccine schedule among this population in Lima, Peru. We conducted a prospective cohort study in four hospitals in Lima in infants with a birth-weight of less than 1500 g, followed from birth up to 12 months of age every 2 weeks. The date and age at administration of each vaccine was recorded 222 infants were enrolled. The median birth-weight was 1250 g (range 550-1499 g) and the median gestational age was 30.0 weeks (range 23-37 weeks). The mean age for the first pentavalent (DPT, Hib, HepB) and oral polio vaccine administration was 4.3 ± 1.4 months in infants with a birth-weight of vaccine. Only 35% had received the three doses of oral polio and pentavalent vaccine by seven months, although by nine months 81% had received these vaccines. Vaccination of very-low-birth-weight infants in Peru is significantly delayed, especially in infants with a birth-weight of vaccination rates and timing in these high risk populations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Assessment of Mesenteric Tissue Saturation, Oxygen Saturation, and Heart Rate Pre- and Post-Blood Transfusion in Very Low-Birth-Weight Infants Using Abdominal Site Near-Infrared Spectroscopy.

    Science.gov (United States)

    Miller, Harriet D; Penoyer, Daleen A; Baumann, Kari; Diaz, Ann; Sole, Mary Lou; Bowles, Susan M

    2017-10-01

    Preterm infants often receive blood transfusions during hospitalization. Although transfusions are intended to enhance oxygen delivery, previous studies found decreases in tissue and mesenteric oxygen saturation during and after blood transfusions without changes in vital signs and hemoglobin oxygen saturation. To study the effect of blood transfusions on regional mesenteric tissue oxygen saturation (rSO2), hemoglobin saturation of oxygen (SpO2), and heart rate (HR) in premature infants. A prospective, observational, nonrandomized study using a repeated-measures design was done to evaluate changes in physiologic variables (HR, SpO2, rSO2) before, during, and after a blood transfusion in premature infants. A convenience sample of 30 infants with a mean gestational age of 25.5 (2.1) weeks was recruited. Repeated-measures analysis of variance found no significant differences in HR (P = .06) and SpO2 (P = .55) over time. However, significant differences occurred in rSO2 over the 3 time periods (P < .001). The rSO2 increased during the transfusion from 40.3% to 41.5%, but decreased to 34.9% in the posttransfusion period. Pairwise comparisons revealed statistically significant mean rSO2 differences between pretransfusion and posttransfusion (P < .001), and during transfusion to posttransfusion (P < .001) periods. This study supports previous findings of perfusion changes during blood transfusions in preterm infants. Measuring mesenteric tissue oxygenation during blood transfusion in very low-birth-weight infants can potentially add another physiologic parameter to guide further clinical assessment and interventions during transfusions.

  15. Low birth weight infants and Calmette-Guérin bacillus vaccination at birth

    DEFF Research Database (Denmark)

    Roth, Adam Anders Edvin; Jensen, Henrik; Garly, May-Lill

    2004-01-01

    In developing countries, low birth weight (LBW) children are often not vaccinated with Calmette-Guérin bacillus (BCG) at birth. Recent studies have suggested that BCG may have a nonspecific beneficial effect on infant mortality. We evaluated the consequences of not vaccinating LBW children at birth...

  16. Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial

    OpenAIRE

    I G. A. P. Eka Pratiwi; Soetjiningsih Soetjiningsih; I Made Kardana

    2009-01-01

    Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn. Objective To evaluate the differences of...

  17. Survival of Premature and Low Birth Weight Infants: A Multicenter, Prospective, Cohort Study in Iran

    Directory of Open Access Journals (Sweden)

    Fatemeh Ghorbani

    2017-03-01

    Full Text Available ABSTRACTBackground: The survival rate of preterm and low-birth-weight (LBW infants depends on various factors such as birth weight, gestational age, and quality of care. The present study aimed at evaluating the survival rate of preterm and LBW infants, predictive factors, and the risk of mortality in three training hospitals of Mashhad and Tabriz cities.Methods: This prospective, cohort study was conducted during six months from 2013 to 2014. Infants with birth weight ≤1500 g or gestational age ≤32 weeks were enrolled. Their information was gathered by using data collection forms and clinical risk index for infants (CRIB II was calculated for each participant. Infants were followed up until discharge from the hospital and their outcomes were determined. Kaplan-Meier and Log rock tests were used for survival analysis. Cox regression was also applied in order to find out the factors associated with infants’ survival.Results: Among the 338 followed up infants, 97 (28.7% died and 241 (71.3% remained alive. The median of preterm and LBW infants’ overall survival rate was 76 days (CI: 60.4-91.5. Multivariate Cox regression analysis indicated that three factors of birth weight, base excess, and fifth minute Apgar score had a significant relationship with the survival rate of infants (P

  18. Oral Ibuprofen versus Intravenous Indomethacin for Closure of Patent Ductus Arteriosus in Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Cheng Han Lee

    2012-12-01

    Conclusion: In infants with VLBW, oral ibuprofen is as effective as intravenous indomethacin for closure of PDA and is associated with significantly fewer cases of necrotizing enterocolitis among infants with birth body weights <1250 g and significantly lower rates of elevated creatinine levels among neonates with birth body weights ranging from 1000 to 1500 g.

  19. Infant Development: Birth to 3 Months

    Science.gov (United States)

    ... the foundation of his or her healthy development. Trust your ability to meet your baby's needs. You ... infant-and-toddler-health/in-depth/infant-development/art-20048012 . Mayo Clinic Footer Legal Conditions and Terms ...

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

    Science.gov (United States)

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

    2016-02-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian mothers' perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 American Indian mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of American Indian culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that health care providers deliver culturally appropriate care that fully supports American Indian mothers and their premature infants. © The Author(s) 2015.

  1. Renal Calcification in Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Hung-Yang Chang

    2011-06-01

    Conclusion: The incidence of renal calcification in very low birth weight infants in this study was relatively low, and the calcification was transient in one-half of the infants. Extremely premature, sick infants requiring long-term ventilation, and those receiving furosemide or dexamethasone were more likely to have renal calcification. Clinicians should be aware that renal calcification may develop beyond the neonatal stage.

  2. Iron Supplements Reduce Behavior Problems in Low Birth Weight Infants

    Science.gov (United States)

    ... a a a print email share Facebook Twitter Iron Supplements Reduce Behavior Problems in Low Birth Weight ... Article Body ​​​​​​​​A study in Pediatrics found giving iron supplements to low birth weight infants reduces the ...

  3. Nosocomial infections in very low birth weight infants

    Directory of Open Access Journals (Sweden)

    V Vamsi Sivarama Raju, Jayashree Purkayastha, Leslie Lewis, Ramesh Bhat Y

    2017-03-01

    Full Text Available Objective: We aimed to find out the incidence and risk factors of nosocomial infections in VLBW neonates and to explore the microbiologic flora, sensitivity pattern and outcome. Methods: A prospective, observational study was performed in a neonatal intensive care unit of a teaching hospital. VLBW infants excluding those diagnosed with early onset sepsis, admitted to the unit between August 2012 and March 2013 were followed up for evidence of nosocomial sepsis. Results: Of 92 VLBW infants, 23 developed nosocomial sepsis, incidence rate being 25%. Decreasing birth weight (1251-1500 g, 10.9%; 1001-1250 g, 28%; 751-1000 g, 50%; P33wks, 0%; 29-32wks, 21.3%; 26-28 wks, 66.7%; p<.001 were found to be associated with statistically significant increase in nosocomial sepsis rate. On multivariate logistic regression, only peripherally inserted central catheter (PICC line was independently associated with increased risk of nosocomial sepsis (aOR 13.33, 95% CI 3.58-49.5 in VLBW. A predominance of Gram negative over Gram positive nosocomial sepsis (75% vs. 25% with higher mortality in the Gram negative group (55% vs. 0% was observed. Klebsiella pneumoniae was the predominant microbe (33.4%. All microbes were sensitive to first line antibiotics except Elizabeth kingia meningoseptica and one episode of K. pneumoniae. Seven (30.4% VLBW neonates with nosocomial sepsis died. Conclusions: Among VLBW infants, the incidence of nosocomial sepsis was 25%. Lower birth weight, lesser gestational age and PICC line were important risk factors. Gram negative nosocomial sepsis was associated with higher mortality compared to Gram positive sepsis. J Microbiol Infect Dis 2017; 7(1: 7-12

  4. Early term birth: understanding the health risks to infants.

    Science.gov (United States)

    Craighead, Debra Vela

    2012-01-01

    Early term birth, which occurs at 37 to 38 weeks gestation, is often elective and can carry significant health risks to infants, including short-term and long-term health outcomes. Nurses and other health care providers involved in the care of pregnant women and infants need to be aware of these infants' physiologic vulnerability and potential short- term and long-term care requirements. Nurses can educate patients and raise awareness of the risks associated with early term birth. © 2012 AWHONN.

  5. Cyst(e)ine requirements in enterally fed very low birth weight preterm infants.

    Science.gov (United States)

    Riedijk, Maaike A; Voortman, Gardi; van Beek, Ron H T; Baartmans, Martin G A; Wafelman, Leontien S; van Goudoever, Johannes B

    2008-03-01

    Optimal nutrition is of utmost importance for the preterm infant's later health and developmental outcome. Amino acid requirements for preterm infants differ from those for term and older infants, because growth rates differ. Some nonessential amino acids, however, cannot be sufficiently synthesized endogenously. Cyst(e)ine is supposed to be such a conditionally essential amino acid in preterm infants. The objective of this study was to determine, at 32 and 35 weeks' postmenstrual age, cyst(e)ine requirements in fully enterally fed very low birth weight preterm infants with gestational ages of ine requirement was determined with the indicator amino acid oxidation technique ([1-(13)C]phenylalanine) after 24-hour adaptation. Fractional [1-(13)C]phenylalanine oxidation was established in 47 very low birth weight preterm infants (mean gestational age: 28 weeks +/- 1 week SD; birth weight: 1.07 kg +/- 0.21 kg SD). Increase in dietary cyst(e)ine intake did not result in a decrease in fractional [1-(13)C]phenylalanine oxidation. These data do not support the hypothesis that endogenous cyst(e)ine synthesis is limited in very low birth weight preterm infants with gestational ages of ine requirement is ine is probably not a conditionally essential amino acid in these infants.

  6. Effects of parenting role and parent-child interaction on infant motor development in Taiwan Birth Cohort Study.

    Science.gov (United States)

    Chiang, Yi-Chen; Lin, Dai-Chan; Lee, Chun-Yang; Lee, Meng-Chih

    2015-04-01

    Previous studies have rarely focused on healthy infants' motor development, and nationwide birth cohort studies in Taiwan are limited. It has been shown that parent-child interactions significantly influence infant motor development and the effect of mother-infant attachment on infant development is stronger than father-infant attachment. However, it is not well understood that whether the mother-infant or father-infant interaction has the confounding effect on infant motor development. To understand healthy infant motor development in Taiwan; and to investigate the effects of parenting roles and parent-child interactions on infant motor development. Data were derived from the 1st through the 2nd waves of the Taiwan Birth Cohort Study-Pilot Database. Infants were classified into two categories (complete or incomplete development) according to their developmental milestones. Generalized estimating equations (GEE) and random effects models were used to clarify the possible long-term effects. The rate of infants who completed development in 6 months was 30.50%; however the rate was increased in 18 month-old children (80.01%). A mother's perceived infant care competence was the most important factor for infant motor development. "Whether or not the infant was the only baby in the family" and "parent-child interaction" had slightly significant effect on infant motor development. In conclusion, the mother's perceived competence must be strengthened and parent-infant interactions should be emphasized on a daily basis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Improvement of outcome for infants of birth weight under 1000 g. The Victorian Infant Collaborative Study Group.

    Science.gov (United States)

    1991-07-01

    The two year outcome of extremely low birth-weight (ELBW) infants (birth weight 500 to 999 g), born in the state of Victoria over two distinct eras, 1979-80 and 1985-7, were compared. In the 1979-80 era, 25.4% of the ELBW infants survived to 2 years of age; only 12.5% of liveborn ELBW infants survived to 2 years with no neurological disabilities. In the 1979-80 era, ELBW infants born outside the level III centres in the state were significantly disadvantaged in both mortality and neurological morbidity. By 1985-7, the two year survival rate of ELBW infants rose significantly from 25.4% to 37.9%. By 1985-7, the proportion of ELBW infants who survived to 2 years free of neurological disabilities increased from 12.5% to 26.2%. Despite the improved survival, the absolute number of 2 year old children survivors with severe neurological disabilities remained constant at 8/year in both eras. By 1985-7, fewer ELBW infants were born outside the level III centres, their survival rate remained lower, but the severe neurological disability rate in survivors was no longer significantly higher. There has been a concomitant improvement in both survival and reduction in neurological morbidity.

  8. Neurodevelopmental outcomes of triplets or higher-order extremely low birth weight infants.

    Science.gov (United States)

    Wadhawan, Rajan; Oh, William; Vohr, Betty R; Wrage, Lisa; Das, Abhik; Bell, Edward F; Laptook, Abbot R; Shankaran, Seetha; Stoll, Barbara J; Walsh, Michele C; Higgins, Rosemary D

    2011-03-01

    Extremely low birth weight twins have a higher rate of death or neurodevelopmental impairment than singletons. Higher-order extremely low birth weight multiple births may have an even higher rate of death or neurodevelopmental impairment. Extremely low birth weight (birth weight 401-1000 g) multiple births born in participating centers of the Neonatal Research Network between 1996 and 2005 were assessed for death or neurodevelopmental impairment at 18 to 22 months' corrected age. Neurodevelopmental impairment was defined by the presence of 1 or more of the following: moderate to severe cerebral palsy; mental developmental index score or psychomotor developmental index score less than 70; severe bilateral deafness; or blindness. Infants who died within 12 hours of birth were excluded. Maternal and infant demographic and clinical variables were compared among singleton, twin, and triplet or higher-order infants. Logistic regression analysis was performed to establish the association between singletons, twins, and triplet or higher-order multiples and death or neurodevelopmental impairment, controlling for confounding variables that may affect death or neurodevelopmental impairment. Our cohort consisted of 8296 singleton, 2164 twin, and 521 triplet or higher-order infants. The risk of death or neurodevelopmental impairment was increased in triplets or higher-order multiples when compared with singletons (adjusted odds ratio: 1.7 [95% confidence interval: 1.29-2.24]), and there was a trend toward an increased risk when compared with twins (adjusted odds ratio: 1.27 [95% confidence: 0.95-1.71]). Triplet or higher-order births are associated with an increased risk of death or neurodevelopmental impairment at 18 to 22 months' corrected age when compared with extremely low birth weight singleton infants, and there was a trend toward an increased risk when compared with twins.

  9. Changes in Outcome and Complication Rates of Very-low-birth-weight Infants in One Tertiary Center in Southern Taiwan Between 2003 and 2010

    Directory of Open Access Journals (Sweden)

    Shen-Dar Chen

    2014-08-01

    Conclusion: Periodic evaluation of the mortality and morbidity of preterm infants can help to understand the changes and trends of our neonatal care. Further study using the national dataset to provide more representative information is warranted.

  10. Birth weight recovery among very low birth weight infants surviving ...

    African Journals Online (AJOL)

    A multiple linear regression showed a negative association between ZSW at discharge and number of days nil per os without parenteral nutrition (PN). Antenatal steroids were associated with poor GV. There were no factors associated with regaining birth weight after 21 days on multiple logistic regression. Conclusion.

  11. Maternal Depression During Pregnancy is Associated with Increased Birth Weight in Term Infants

    Science.gov (United States)

    Ecklund-Flores, L; Myers, MM; Monk, C; Perez, A; Odendaal, HA; Fifer, WP

    2017-01-01

    Previous research of maternal depression during pregnancy suggests an association with low birth weight in newborns. Review of these studies reveals predominant comorbidity with premature birth. This current study examines antenatal depression and birth weight in term, medically low-risk pregnancies. Maternal physiological and demographic measures were collected as well. In total, 227 pregnant women were recruited to participate in four experimental protocols at Columbia University Medical Center. Results indicate that depressed pregnant women who carry to term had significantly higher heart rates, lower heart rate variability, and gave birth to heavier babies than those of pregnant women who were not depressed. Low income participants had significantly higher levels of depression, as well as significantly higher heart rates and lower heart rate variability, than those in higher income groups. In full-term infants, maternal prenatal depression appears to promote higher birth weight, with elevated maternal heart rate as a likely mediating mechanism. PMID:28323349

  12. Zinc supplementation, mental development and behaviour in low birth weight term infants in northeast Brazil.

    Science.gov (United States)

    Ashworth, A; Morris, S S; Lira, P I; Grantham-McGregor, S M

    1998-03-01

    To test whether zinc supplementation reduces the deficits in mental development and behaviour that are found in term infants of low birth weight in the study population. A prospective double-blind, part-randomised efficacy trial. A low-income population in Pernambuco, northeast Brazil, where the economy is largely dependent on sugar-cane production, and where over 90% of deliveries occur in health facilities. During a 20-month period, all singleton, term infants weighing 1500-2499 g born to families of low income ( tested were 163 and 138 respectively. Infants born from January 1993-January 1994 were randomly assigned to receive daily, except Sundays, a placebo (n = 66) or 1 mg zinc (n = 68). Those born February-August 1994 were given 5 mg zinc (n = 71). Supplementation was for eight weeks, starting at birth. Field workers visited each infant at home to administer the supplement. At 6 and 12-months, mental and psychomotor development was assessed with the Bayley Scales of Infant Development and no significant differences in the scores of the three groups were found. At 12-months, behaviour was also assessed on 5 ratings. Ratings were highest in infants given 5 mg zinc (P = 0.042). Zinc supplementation (5 mg/d) for eight weeks may reverse some of the poor behaviours, particularly responsiveness, exhibited by low birth weight infants. No amelioration of their mental and psychomotor deficits was found.

  13. Indomethacin prophylaxis or expectant treatment of patent ductus arteriosus in extremely low birth weight infants?

    Science.gov (United States)

    Cordero, L; Nankervis, C A; Delooze, D; Giannone, P J

    2007-03-01

    Indomethacin prophylaxis or expectant treatment are common strategies for the prevention or management of symptomatic patent ductus arteriosus (sPDA). To compare the clinical responses of extremely low birth weight (ELBW) infants to indomethacin prophylaxis with that of other infants who were managed expectantly by being treated with indomethacin or surgically only after an sPDA was detected. Retrospective cohort investigation of 167 ELBW infants who received indomethacin prophylaxis (study) and 167 ELBW infants (control) treated expectantly who were matched by year of birth (1999 to 2006), birth weight, gestational age (GA) and gender. Mothers of the two groups of infants were comparable demographically and on the history of preterm labor, pre-eclampsia, antepartum steroids and cesarean delivery. Study and control infants were similar in birth weight, GA, low 5 min Apgar scores, surfactant administration, the need for arterial blood pressure control, bronchopulmonary dysplasia and neonatal mortality. Necrotizing enterocolitis, spontaneous intestinal perforations, intraventricular hemorrhage grade III to IV, periventricular leukomalacia and stage 3 to 5 retinopathy of prematurity occurred also with similar frequency in both groups of infants. In the indomethacin prophylaxis group, 29% of the infants developed sPDA, and of them 38% responded to indomethacin treatment. In the expectantly treated group, 37% developed sPDA, and of them 59% responded to indomethacin treatment. Overall, surgical ligation rate for sPDA was similar between both groups of patients. In our experience, indomethacin prophylaxis does not show any advantages over expectant early treatment on the management of sPDA in ELBW infants. Although no deleterious effects were observed, prophylaxis exposed a significant number of infants who may have never developed sPDA, to potential indomethacin-related complications.

  14. Very Low Birth Weight Infants as Young Adults : Focus on aspects of cognition, behavior and sleep

    OpenAIRE

    Strang-Karlsson, Sonja

    2011-01-01

    Major advances in the treatment of preterm infants have occurred during the last three decades. Survival rates have increased, and the first generations of preterm infants born at very low birth weight (VLBW; less than 1500 g) who profited from modern neonatal intensive care are now in young adulthood. The literature shows that VLBW children achieve on average lower scores on cognitive tests, even after exclusion of individuals with obvious neurosensory deficits. Evidence also exists for an i...

  15. Prenatal Secondhand Smoke Exposure and Infant Birth Weight in China

    Directory of Open Access Journals (Sweden)

    Adolfo Correa

    2012-09-01

    Full Text Available Epidemiologic evidence provides some support for a causal association between maternal secondhand smoke (SHS exposure during pregnancy and reduction in infant birth weight. The purpose of this cross-sectional study is to examine the magnitude of this association in China, where both prevalence and dose of SHS exposure are thought to be higher than in U.S. populations. Women who gave birth in Beijing and Changchun September 2000–November 2001 were interviewed to quantify self-reported prenatal SHS exposure. Their medical records were reviewed for data on pregnancy complications and birth outcomes. Non-smoking women who delivered term babies (≥37 weeks gestation were included in the study (N = 2,770. Nearly a quarter of the women (24% reported daily SHS exposure, 47% reported no prenatal exposure, and 75% denied any SHS exposure from the husband smoking at home. Overall, no deficit in mean birth weight was observed with exposure from all sources of SHS combined (+11 grams, 95% CI: +2, +21. Infants had higher mean birth weights among the exposed than the unexposed for all measures of SHS exposure. Future studies on SHS exposure and infant birth weight in China should emphasize more objective measures of exposure to quantify and account for any exposure misclassification.

  16. Very Preterm Infants Failing CPAP Show Signs of Fatigue Immediately after Birth.

    Directory of Open Access Journals (Sweden)

    Melissa L Siew

    Full Text Available To investigate the differences in breathing pattern and effort in infants at birth who failed or succeeded on continuous positive airway pressure (CPAP during the first 48 hours after birth.Respiratory function recordings of 32 preterm infants were reviewed of which 15 infants with a gestational age of 28.6 (0.7 weeks failed CPAP and 17 infants with a GA of 30.1 (0.4 weeks did not fail CPAP. Frequency, duration and tidal volumes (VT of expiratory holds (EHs, peak inspiratory flows, CPAP-level and FiO2-levels were analysed.EH incidence increased 9 ml/kg with higher peak inspiratory flows than CPAP-fail infants (71.8 ± 15.8 vs. 15.5 ± 5.2 ml/kg.s, p <0.05. CPAP-fail infants required higher FiO2 (0.31 ± 0.03 vs. 0.21 ± 0.01, higher CPAP pressures (6.62 ± 0.3 vs. 5.67 ± 0.26 cmH2O and more positive pressure-delivered breaths (45 ± 12 vs. 19 ± 9% (p <0.05.At 9-12 minutes after birth, CPAP-fail infants more commonly used lower VTs and required higher peak inspiratory flow rates while receiving greater respiratory support. VT was less variable and larger VT was infrequently used reflecting early signs of fatigue.

  17. Monitoring lung aeration during respiratory support in preterm infants at birth.

    Directory of Open Access Journals (Sweden)

    Liane J Kang

    Full Text Available If infants fail to initiate spontaneous breathing, resuscitation guidelines recommend respiratory support with positive pressure ventilation (PPV. The purpose of PPV is to establish functional residual capacity and deliver an adequate tidal volume (VT to achieve gas exchange.The aim of our pilot study was to measure changes in exhaled carbon dioxide (ECO2, VT, and rate of carbon dioxide elimination (VCO2 to assess lung aeration in preterm infants requiring respiratory support immediately after birth.A prospective observational study was performed between March and July 2013. Infants born at <37 weeks gestational age who received continuous positive airway pressure (CPAP or PPV immediately after birth had VT delivery and ECO2 continuously recorded using a sensor attached to the facemask.Fifty-one preterm infants (mean (SD gestational age 29 (3 weeks and birth weight 1425 (592 g receiving respiratory support in the delivery room were included. Infants in the CPAP group (n = 31 had higher ECO2 values during the first 10 min after birth compared to infants receiving PPV (n = 20 (ranging between 18-30 vs. 13-18 mmHg, p<0.05, respectively. At 10 min no significant difference in ECO2 values was observed. VT was lower in the CPAP group compared to the PPV group over the first 10 min ranging between 5.2-6.6 vs. and 7.2-11.3 mL/kg (p<0.05, respectively.Immediately after birth, spontaneously breathing preterm infants supported via CPAP achieved better lung aeration compared to infants requiring PPV. PPV guided by VT and ECO2 potentially optimize lung aeration without excessive VT administered.

  18. Retinopathy of prematurity in infants with birth weight above 1500 ...

    African Journals Online (AJOL)

    hypotension at birth and the non-use of surfactant were the only risk factors to be associated with disease. However, with logistic regression analysis, none of these were independently associated with ROP. Conclusion: ROP may occur in newborn infants of larger birthweight but with good prognosis, and oxygen therapy ...

  19. Pulmonary diseases of the infants weighing under 1500 grams at birth: clinical and radiographic findings

    International Nuclear Information System (INIS)

    Kim, Ok Hwa; Park, Jeong Mi; Bahk, Yong Whee

    1990-01-01

    Since the introduction of the intensive perinatal care, the survival rate of the infants weighing less than 1500 gm at birth has improved substantially. However, pulmonary diseases remain to be the major causes of the high mortality of these low birthweight infants. In order to systematically assess an epidemiologic distribution of the pulmonary diseases in these very low weight prematures, we have analyzed the chest x-rays of 102 infants weighing less than 1500 gm. These consisted of 30 with extreme low birth weight (ELBW) weighing less than 1000 gm and 72 with very low birth weight (VLBW) weighing 1001 - 1500 gm. The survival rate of ELBW and VLBW was 10% and 49%, respectively. Seventy of 102 infants had abnormal findings in the chest x-ray. Forty-eight had idiopathic respiratory distress syndrome (IRDS), 8 immature lung, 6 Wilson-Mikity syndrome, 4 pneumonia, 2 pulmonary hemorrhage, 1 congenital heart disease, and 1 suspicious Pierre-Robin syndrome. Seven out of 48 infants with IRDS had persistent ductus arteriosus, and in only 2(30%) of 7 cases were alive. Endotracheal intubation and assisted ventilation application for the treatment of IRDS resulted in pulmonary interstitial emphysema in 4 infants and pneumothorax and / or pneumomediastinum in 4 infants. Displacement of endotracheal intubation showed lobar and / or unilateral lung atelectasis in 8 infants and a case of accidental dislodgement of intubation tube into the esophagus resulted in air esophagogram and worsened lung aeration. In spite of the development of many sophisticated methods of diagnostic radiology, the chest x-ray was still the most valuable yet simple way of evaluating the pulmonary problems in these extreme and very low birth weight prematures

  20. Association of type of birth attendant and place of delivery on infant ...

    African Journals Online (AJOL)

    Objective: To examine the association between type of birth attendant and place of delivery, and infant mortality (IM). Methods: This cross-sectional study ... made little progress towards this goal, reducing child mortality at an annual rate of 1%3. ...... FR229/FR229.pdf. 22. Kenya National Bureau of Statistics and ICF Mac- ro.

  1. Morbidity and mortality of low birth weight infants in the New Born ...

    African Journals Online (AJOL)

    Background: Morbidity and mortality of low birth weight (LBW) infants at Kenyatta National Hospital (KNH) has previously been found to be high. Other centres have shown that even with lack of neonatal intensive care facilities, selective interventions can be implemented that improve neonatal survival rates. It is important to ...

  2. Impact of Birth HIV-PCR Testing on the Uptake of Follow-up Early Infant Diagnosis Services in Cape Town, South Africa.

    Science.gov (United States)

    Dunning, Lorna; Kroon, Max; Fourie, Lezanne; Ciaranello, Andrea; Myer, Landon

    2017-12-01

    Polymerase chain reaction testing at birth ("birth-testing") is suggested by new World Health Organization guidelines for rapid diagnosis of infants infected with HIV in utero. However, there are few data on the implementation of this approach in sub-Saharan Africa, and whether birth testing affects uptake of subsequent routine early infant diagnosis (EID) testing at 6-10 weeks of age is unknown. We reviewed 575 consecutive infants undergoing targeted high-risk birth testing in Cape Town, South Africa, and matched those testing HIV negative at birth (n = 551) to HIV-exposed infants who did not receive birth testing (n = 551). Maternal and infant clinical and demographic data, including EID testing uptake, were abstracted from routine records. Overall, 3.8% of all birth tests conducted were positive while later EID testing positivity rates were 0.5% for those infants testing HIV negative at birth and 0.4% for those without birth testing. Infants who underwent birth testing were less likely to present for later EID compared with those without a birth test (73% vs. 85%; P testing also presented for later EID at a significantly older age (mean age, 60 vs. 50 days; P testing in this setting appears high, neonates testing HIV negative at birth may be less likely to present for subsequent EID testing. For birth testing implementation to contribute to overall EID program goals, structured interventions are required to support follow-up EID services after negative birth test results.

  3. Variations in multiple birth rates and impact on perinatal outcomes in Europe

    NARCIS (Netherlands)

    Heino, A.; Gissler, M.; Hindori-Mohangoo, A.D.; Blondel, B.; Klungsøyr, K.; Verdenik, I.; Mierzejewska, E.; Velebil, P.; Sól Ólafsdóttir, H.; Macfarlane, A.; Zeitlin, J.; et al.

    2016-01-01

    Objective. Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse

  4. Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus among Very-Low-Birth-Weight Infants in Korea.

    Science.gov (United States)

    Ahn, So Yoon; Shim, So-Yeon; Sung, In Kyung

    2015-10-01

    Here, we aimed to evaluate the incidence and mortality of intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus (PHH) among very-low-birth-weight (VLBW) infants in Korea and assess the associated factors of PHH. This cohort study used prospectively collected data from the Korean Neonatal Network (KNN). Among 2,386 VLBW infants in the KNN database born between January 2013 and June 2014, 63 infants who died without brain ultrasonography results were excluded. Maternal demographics and neonatal clinical characteristics were assessed. The overall incidence of IVH in all the VLBW infants was 42.2% (987 of 2,323), while those of IVH grade 1, 2, 3, and 4 were 25.1%, 7.0%, 4.8%, and 5.5%, respectively. The incidence and severity of IVH showed a negatively correlating trend with gestational age and birth weight. PHH developed in 0%, 3.5%, 36.1%, and 63.8% of the surviving infants with IVH grades 1, 2, 3, and 4, respectively. Overall, in the VLBW infants, the IVH-associated mortality rate was 1.0% (24/2,323). Only IVH grade severity was proven to be an associated with PHH development in infants with IVH grades 3-4. This is the first Korean national report of IVH and PHH incidences in VLBW infants. Further risk factor analyses or quality improvement studies to reduce IVH are warranted.

  5. Reduced Disparities in Birth Rates Among Teens

    Science.gov (United States)

    ... at CDC Reduced Disparities in Birth Rates among Teens Aged 15–19 Years in the United States ... Do To Address Disparities Community-wide Initiatives Preventing teen pregnancy: Remarkable progress for many teens, but challenges ...

  6. Infant mortality among Arab-Americans: findings from the Arab-American birth outcomes study.

    Science.gov (United States)

    Finkton, Darryl W; El-Sayed, Abdulrahman M; Galea, Sandro

    2013-05-01

    Arab-Americans (AAs) have lower risk of preterm birth relative to Non-Arab Whites. This has been attributed to lower likelihood of birth out of wedlock, maternal tobacco use during pregnancy, and foreign maternal birthplace among AAs. We were interested in understanding the roles of these and other demographic factors in the etiology of infant mortality among this group. Using data about all live, singleton births between 1989 and 2005 in the state with the highest proportion of AAs in the US, we calculated infant mortality (death prior to 1 year of life) for AAs and Non-Arab Whites. To clarify the etiology of potential differences in infant mortality, we also assessed infant mortality sub-categories, including neonatal mortality (death prior to 28 days of life) and post-neonatal mortality (death between 28 and 365 days of life). We fit trivariable and multivariable logistic regression models adjusted for explanatory covariates to assess each covariate's contributions to the relation between ethnicity and infant mortality. AAs had a lower infant mortality rate (4.7 per 1,000 live births) than non-Arab Whites (5.6 per 1,000 live births), overall (odds ratio = 0.84, 95% confidence interval: 0.74-0.96). In trivariable models, adjusting for marital status, maternal tobacco consumption during pregnancy, and maternal birthplace each separately attenuated the bivariate ethnicity-mortality relation to non-significance. Our findings suggest that lower risk of infant mortality among AAs relative to non-Arab Whites may be explained by differences in demographic characteristics and parental behavioral practices between them.

  7. Trends in mortality and morbidity for very low birth weight infants, 1991-1999.

    Science.gov (United States)

    Horbar, Jeffrey D; Badger, Gary J; Carpenter, Joseph H; Fanaroff, Avroy A; Kilpatrick, Sarah; LaCorte, Meena; Phibbs, Roderic; Soll, Roger F

    2002-07-01

    Medical care for very low birth weight (VLBW) infants and their mothers has changed dramatically during the 1990s, yet it is unclear how these changes have affected mortality and morbidity. We used the Vermont Oxford Network Database to identify trends in clinical practice and patient outcomes for VLBW infants born from 1991 to 1999. Logistic regression was used to evaluate temporal trends in practices and outcomes while adjusting for patient characteristics and accounting for clustering of cases within hospitals. There were 118 448 infants 501 to 1500 g from 362 neonatal intensive care units enrolled in the Network Database from 1991 to 1999. Prenatal care, cesarean section, multiple births, antenatal steroids, and 1-minute Apgar scores increased during this period, as did the use of nasal continuous positive airway pressure, high-frequency ventilation, surfactant, and postnatal steroids. The proportion of white infants decreased; the proportions of Hispanic infants and those of other races increased. The crude and adjusted rates of mortality, pneumothorax, intraventricular hemorrhage (IVH), and severe IVH declined from 1991 to 1995, whereas from 1995 to 1999, the rates of mortality, IVH, and severe IVH did not change significantly, and pneumothorax increased. There have been major changes in both obstetric and neonatal care during the 1990s. These changes were associated with decreases in mortality and morbidity for VLBW infants during the first half of the decade. However, since 1995, no additional improvements in mortality or morbidity have been seen, ending a decades-long trend of improving outcomes for these infants.

  8. [Role of donor human milk feeding in preventing nosocomial infection in very low birth weight infants].

    Science.gov (United States)

    Bi, Hong-Juan; Xu, Jing; Wei, Qiu-Fen

    2018-02-01

    To investigate the role of donor human milk in the prevention of nosocomial infection in very low birth weight infants. MeETHODS: A total of 105 hospitalized preterm infants with a very low birth weight were enrolled. They were classified into mother's own milk feeding group, donor human milk feeding group, and preterm formula feeding group, with 35 infants in each group. The three groups were compared in terms of incidence rates of nosocomial infection, necrotizing enterocolitis, and feeding intolerance, time to full enteral feeding, and early growth indices. Compared with the preterm formula feeding group, the donor human milk feeding group and the mother's own milk feeding group had significantly lower incidence rates of nosocomial infection and necrotizing enterocolitis and shorter time to full enteral feeding (Pgroups. Donor human milk can be used in case of a lack of mother's own milk and may help to reduce nosocomial infection.

  9. Ethical issues related to caring for low birth weight infants.

    Science.gov (United States)

    Webb, Mary S; Passmore, Denise; Cline, Genieveve; Maguire, Denise

    2014-09-01

    Currently preterm births are the leading causes of newborn deaths and newborn mortality in developed countries. Infants born prematurely remain vulnerable to many acute complications and long-term disabilities. There is a growing concern surrounding the moral and ethical implications of the complex and technological care being provided to extremely low birth weight infants in neonatal intensive care units in the developed nations. The purpose of this study was to describe the ethical and moral issues that neonatal intensive care nurses experience when caring for low birth weight preterm infants and their families. A phenomenological method design was used to describe the lived experiences of nurses with ethical and moral issues encountered in the neonatal intensive care unit. One-on-one, semi-structured interviews using open-ended questions were used to gather data from the participants. The setting for this study was a 97-bed neonatal intensive care. A total of 16 female nurses were interviewed. Approval to conduct the research study was obtained from the institutional review board of the hospital where the study was conducted. Formal signed consent was obtained from each participant. To ensure confidentiality, each participant was asked to choose a confederate name to be used in the interview and the transcriptions. The thematic analysis identified five recurring themes: (a) at the edge of viability, (b) infant pain and discomfort, (c) crucial decisions, (d) communicating with parents, and (e) letting go. Neonatal intensive care unit nurses indicated that they often had challenges to their own sense of morality as they struggled to protect the infant from pain and unnecessary discomfort, provide care to an infant and their family whom they thought was faced with a lifetime of challenges and poor health, accepting decisions made by parents, and feeling as if parents were not adequately informed about outcomes. © The Author(s) 2014.

  10. Glycerin Suppositories Use in Very Low Birth Weight Infants.

    Science.gov (United States)

    Patel, Shalinkumar; Dereddy, Narendra; Talati, Ajay J; Gaston, Kan; Dhanireddy, Ramasubbareddy

    2017-01-01

    Objective  To study the characteristics of very low birth weight (VLBW) infants receiving glycerin suppositories (GS) and evaluate the association of GS use with outcomes. Study Design  This is a retrospective study of VLBW infants admitted to a level III neonatal intensive care unit. Infants with birth weight between 500 and 1,499 g were evaluated. We evaluated the frequency of GS use and compared the characteristics and outcomes of the GS group with the no-GS group. Multivariate analyses controlling for gestational age and small for gestational age status were performed to study the effect of GS on outcomes. Results  A total of 1,073 infants were included in the study. Out of those, 527 (49.1%) infants received GS. Incidence of necrotizing enterocolitis was not significantly different between the two groups, while days to reach full enteral feeds and length of hospital stay were significantly longer in the GS group. Conclusion  Frequent use of GS warrants further prospective studies to evaluate its safety and efficacy in view of our study showing association with longer time to reach full enteral feeds. We speculate that GS use could be a marker for gastrointestinal dysmotility and hence the association with unfavorable clinical outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Contribution of low Birth –Weight and Very Low Birth Weight Infants ...

    African Journals Online (AJOL)

    Objective: To determine the association between low and very low birth weight infants and perinatal mortality at the University of Nigeria Teaching Hospital, Enugu. Methods: A retrospective study of the hospital records in the labour ward and the Newborn Special Care Unit (N.B.S.C.U), of the UNTH was carried out for the ...

  12. Saving Lives at Birth : The Impact of Home Births on Infant Outcomes

    NARCIS (Netherlands)

    Meltem Daysal, N.; Trandafir, M.; van Ewijk, R.

    2012-01-01

    Abstract: Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for

  13. The Development of Nursing Care Services Model for Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Dessie Wanda

    2017-01-01

    Full Text Available Introduction: Low birth weight (LBW infants deal with various problems during transitional period from intra-uterine and extra-uterine because of immature organs’ functions. This leads to LBW as the second death cause in Indonesia, particularly in the fi rst seventh days of infants’ lifes. The problem continues to occur at home when the infants have discharged. This research was aimed to develop the nursing care services model for LBW infants and to test the model. Method: The research design was an action research using quantitative and qualitative approach. This design was chosen as it facilitated improvement in health care system, which was involving nurses and other health providers. Results: Nursing care services provided by the nursing team are hindered by several factors, such as various level of nurses’ knowledge, not optimal health education activities, incomplete standard operational procedure, ethical dilemma, paramedic functions, and documentation system. This model was developed based on conservation and becoming a mother/maternal role attainment theory, family-centered care principles, and input from the experts through focus group discussion. Discussion: The result of this research is going to increase the quality of nursing care for LBW infants by achieving nurses’ and parents’ satisfaction in giving care for their infants which can lead to lower infant death rate.Key words: Model, Low birth weight infant, Nursing services, Action research

  14. Intermittent detection of fetal heart rate abnormalities identify infants at greatest risk for fresh stillbirths, birth asphyxia, neonatal resuscitation, and early neonatal deaths in a limited-resource setting: a prospective descriptive observational study at Haydom Lutheran Hospital.

    Science.gov (United States)

    Langli Ersdal, Hege; Mduma, Estomih; Svensen, Erling; Sundby, Johanne; Perlman, Jeffrey

    2012-01-01

    Intermittent fetal heart rate (FHR) monitoring during labor using an acoustic stethoscope is the most frequent method for fetal assessment of well-being in low- and middle-income countries. Evidence concerning reliability and efficacy of this technique is almost nonexistent. To determine the value of routine intermittent FHR monitoring during labor in the detection of FHR abnormalities, and the relationship of abnormalities to the subsequent fresh stillbirths (FSB), birth asphyxia (BA), need for neonatal face mask ventilation (FMV), and neonatal deaths within 24 h. This is a descriptive observational study in a delivery room from November 2009 through December 2011. Research assistants/observers (n = 14) prospectively observed every delivery and recorded labor information including FHR and interventions, neonatal information including responses in the delivery room, and fetal/neonatal outcomes (FSB, death within 24 h, admission neonatal area, or normal). 10,271 infants were born. FHR was abnormal (i.e. 160 beats/min) in 279 fetuses (2.7%) and absent in 200 (1.9%). Postnatal outcomes included FSB in 159 (1.5%), need for FMV in 695 (6.8%), BA (i.e. 5-min Apgar score neonatal resuscitation, BA, and neonatal death in a limited-resource setting. The likelihood of an abnormal FHR is magnified with labor complications. Copyright © 2012 S. Karger AG, Basel.

  15. Disparities in Perinatal Quality Outcomes for Very Low Birth Weight Infants in Neonatal Intensive Care

    Science.gov (United States)

    Lake, Eileen T; Staiger, Douglas; Horbar, Jeffrey; Kenny, Michael J; Patrick, Thelma; Rogowski, Jeannette A

    2015-01-01

    Objective To determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics. Data Sources Nurse survey and VLBW infant registry data. Study Design Retrospective study of 8,252 VLBW infants in 98 Vermont Oxford Network hospital neonatal intensive care units (NICUs) nationally. NICUs were classified into three groups based on their percent of infants of black race. Two nurse-sensitive perinatal quality standards were studied: nosocomial infection and breast milk. Data Collection Primary nurse survey (N = 5,773, 77 percent response rate). Principal Findings VLBW infants born in high-black concentration hospitals had higher rates of infection and discharge without breast milk than VLBW infants born in low-black concentration hospitals. Nurse understaffing was higher and practice environments were worse in high-black as compared to low-black hospitals. NICU nursing features accounted for one-third to one-half of the hospital-level health disparities. Conclusions Poorer nursing characteristics contribute to disparities in VLBW infant outcomes in two nurse-sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black VLBW infants who are born in high-black hospitals in this country. PMID:25250882

  16. Definition and outpatient management of the very low-birth-weight infant with bronchopulmonary dysplasia.

    Science.gov (United States)

    Groothuis, Jessie R; Makari, Doris

    2012-04-01

    Bronchopulmonary dysplasia (BPD), also known as chronic lung disease of prematurity, is the major cause of pulmonary disease in infants. The pathophysiology and management of BPD have evolved over the past four decades as improved neonatal intensive care unit (NICU) modalities have increased survival rates. The likelihood for developing BPD increases with the degree of prematurity and reaches 25-35% in very low-birth-weight and extremely low-birth-weight infants. BPD affects many organ systems, and infants with BPD are at increased risk for rehospitalization and numerous complications following NICU discharge. The management of BPD and medically related problems, particularly during the first 2 years of life, remains a continuing challenge for parents and healthcare providers. It is important that a multidisciplinary team consisting of the neonatologist/attending physician, primary care physician, and other specialized support staff work in concert and meet regularly to provide continuity of care and accurate patient assessments.

  17. Guidelines for Feeding Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Sourabh Dutta

    2015-01-01

    Full Text Available Despite the fact that feeding a very low birth weight (VLBW neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas.

  18. Guidelines for feeding very low birth weight infants.

    Science.gov (United States)

    Dutta, Sourabh; Singh, Balpreet; Chessell, Lorraine; Wilson, Jennifer; Janes, Marianne; McDonald, Kimberley; Shahid, Shaneela; Gardner, Victoria A; Hjartarson, Aune; Purcha, Margaret; Watson, Jennifer; de Boer, Chris; Gaal, Barbara; Fusch, Christoph

    2015-01-08

    Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas.

  19. Prevalence and pathogen distribution of neonatal sepsis among very-low-birth-weight infants.

    Science.gov (United States)

    Lim, Wai Ho; Lien, Reyin; Huang, Yhu-Chering; Chiang, Ming-Chou; Fu, Ren-Huei; Chu, Shih-Ming; Hsu, Jen-Fu; Yang, Peng-Hong

    2012-08-01

    Neonatal sepsis contributes to great mortality and morbidity among very-low-birth-weight (VLBW) infants. Prevalence and pathogen distribution of sepsis in the neonatal intensive care units (NICUs) vary with time and geographic location. Such information serves as a guide for selection of empirical antibiotics coverage. This is a case series study performed by retrospective chart review of VLBW infants (birth body weight, BBW, <1500 g) in a medical center during a 5-year period from January 2005 to December 2009. Episodes of positive blood cultures, pathogen distribution and related clinical manifestations were described. A total of 158 episodes of sepsis were identified from 1042 VLBW infants. Sepsis rate was 152 per 1000 live births. The vast majority of infections (60.7%) were caused by Gram-positive organisms [G(+)], and overall Coagulase-negative staphylococci (CoNS) (52.5%) were the most common pathogen identified. Prevalence for early-onset sepsis (EOS) was 1% and for late-onset sepsis (LOS) was 14.2%. Infants with EOS had a much higher case fatality rate than LOS (40% vs. 4.7%). Escherichia coli (40%) were the leading pathogen of EOS while CoNS (54.7%) was the leading pathogens of LOS. Overall, apnea and/or bradycardia and/or cyanosis (65.8%), poor activity (48.7%), and increased respiratory effort (43.0%) were the most common presenting features of sepsis. Unlike term infants, Gram-negative organism and E coli were the leading pathogen of EOS among VLBW infants. Judicious and timely use of antibiotic therapy is crucial in the care of VLBW infants. Copyright © 2012. Published by Elsevier B.V.

  20. [A follow-up on first-year growth and development of 61 very low birth weight preterm infants].

    Science.gov (United States)

    Deng, Ying; Xiong, Fei; Wu, Meng-Meng; Yang, Fan

    2016-06-01

    To investigate the physical growth and psychomotor development of very low birth weight (VLBW) preterm infants in the first year after birth and related influencing factors. A total of 61 VLBW preterm infants received growth and development monitoring for 12 months. Z score was used to evaluate parameters for physical growth, and Denver Development Screen Test (DDST) was used for development screening. Among the 61 VLBW preterm infants, 27 (44.3%) were small-for-gestational-age (SGA) infants, and 34 (55.7%) were appropriate-for-gestational-age (AGA) infants. During the 1-year follow-up, the median weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), head circumference-for-age Z-score (HCZ), and weight-for-height Z score (WHZ) were >-1 SD in all age groups. The peaks of body mass index-for-age Z-score (BAZ) and WHZ appeared at 1 month of corrected age. At a corrected age of 40 weeks, the incidence rates of underweight, growth retardation, emaciation, microcephalus, overweight, and obesity were 15%, 16%, 11%, 13%, 20%, and 10%, respectively. Compared with those with a corrected age of 40 weeks, the infants with a corrected age of 6 months or 9-12 months had a significantly reduced incidence rate of overweight (3%) (P<0.05). Up to 1 year after birth, 15 infants (25%) had abnormal developmental quotient (DQ). The SGA group had a significantly higher incidence rate of abnormal DQ than the AGA group (P<0.05). SGA was the independent risk factor for retarded growth in the first year after birth in VLBW preterm infants. VLBW preterm infants experience an obvious growth deviation within 3 months of corrected age. Within the first year after birth, the proportion of infants with abnormal DQ screened by DDST is high.

  1. NCHS - Infant and neonatal mortality rates: United States, 1915-2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rates are infants (under 1 year) and neonatal (under 28 days) deaths per 1,000 live births. https://www.cdc.gov/nchs/data-visualization/mortality-trends/

  2. Changing outcome for infants of birth-weight 500-999 g born outside level 3 centres in Victoria. The Victorian Infant Collaborative Study Group.

    Science.gov (United States)

    1997-08-01

    The aim of this study of extremely low birth-weight (ELBW, birth weight 500-999 g) infants born in Victoria was to determine the changes between 3 distinct eras; 1979-80, 1985-87, and 1991-2, in the proportions who were born outside level 3 perinatal centres (outborn), the proportions of outborn infants who were transferred after birth to a level 3 neonatal unit, the survival rate for outborn infants, and sensorineural impairment and disability rates in outborn survivors. The proportion of ELBW livebirths who were outborn fell significantly over successive eras, from 30.2% (106 of 351) in 1979-80, to 23.0% (129 of 560) in 1985-87, and to 15.6% (67 of 429) in 1991-92. Between 1979-80 and 1985-87, the proportions who were outborn fell predominantly in those of birth-weight from 800-999 g, whereas between 1985-87 and 1991-92 the proportions who were outborn fell predominantly in those of birth weight 500-799 g. The proportions of outborn infants who were transferred after birth to a level 3 neonatal unit were similar in the 3 eras, at 49.1%, 38.0% and 41.2%, respectively. The survival rates for outborn infants were lower in each era than for infants born in a level 3 perinatal centre. Only 1 outborn infant not transferred after birth to a level-3 unit survived in any era. The survival rates for infants transferred after birth were similar in the first 2 eras, but rose significantly in 1991-92 (34.6%, 36.7% and 60.7%, respectively). The rates of sensorineural impairments and disabilities in survivors fell significantly between the first 2 eras, and remained low in the last era. It is pleasing that the proportion of tiny babies who were outborn fell significantly over time, reflecting increased referral of high-risk mothers to level 3 perinatal centres before birth. For ELBW outborn infants, survival prospects free of substantial disability are reasonable, but not as good as for those born in level 3 perinatal centres.

  3. Early and late Iron supplementation for low birth weight infants: a meta-analysis.

    Science.gov (United States)

    Jin, Hong-Xing; Wang, Rong-Shan; Chen, Shu-Jun; Wang, Ai-Ping; Liu, Xi-Yong

    2015-03-14

    Iron deficiency in infancy is associated with a range of clinical and developmentally important issues. Currently, it is unclear what is the optimal timing to administer prophylactic enteral iron supplementation in preterm and very low birth weight infants. The objective of this meta-analysis was to evaluate early compared with late iron supplementation in low birth weight infants. PubMed and Cochrane Library databases were searched up to May 10, 2014 for studies that compared the benefit of early and late iron supplementation in infants of low birth weight. Sensitivity analysis was carried out using the leave one-out approach and the quality of the included data was assessed. The data base search and detailed review identified four studies that were included in the meta-analysis. The number of included patients was 246 (n=121 for early supplementation and n=125 for late supplementation) and the majority were premature infants. Across studies, early supplementation ranged from as early as enteral feeding was tolerated to 3 weeks, and late supplementation ranged from 4 weeks to about 60 days. Early treatment was associated with significantly smaller decreases in serum ferritin and hemoglobin levels (Psupplementation (P=0.022). There was no difference between early and late supplementation in the number of patients with nectorizing enteroclitis (>bell stage 2) (P=0.646). Sensitivity analysis indicated no one study overly influenced the findings and that the data was reliable. In conclusion, early iron supplementation resulted in less a decrease in serum ferritin and hemoglobin levels in infants with low birth rate. However, caution should be used when treating infants with iron so as not to result in iron overload and possibly negative long-term effects on neurodevelopment.

  4. Medida da freqüência respiratória e do volume corrente para prever a falha na extubação de recém-nascidos de muito baixo peso em ventilação mecânica Evaluation of respiratory rate and tidal volume to predict extubation failure in mechanically ventilated very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Josy Davidson

    2008-03-01

    Full Text Available OBJETIVO: Verificar se a freqüência respiratória (FR, o volume corrente (VC e a relação FR/VC poderiam prever a falha na extubação em recém-nascidos de muito baixo peso submetidos à ventilação mecânica. MÉTODOS: Estudo prospectivo, observacional, de recém-nascidos com idade gestacional OBJECTIVE: To verify if respiratory rate (RR, tidal volume (TV and respiratory rate and tidal volume ratio (RR/TV could predict extubation failure in very low birth weight infants submitted to mechanical ventilation. METHODS: This prospective observational study enrolled newborn infants with gestational age <37 weeks and birth weight <1,500g, mechanically ventilated from birth during 48 hours to 30 days and thought to be ready for extubation. As soon as the physicians decided for extubation, the neonates received endotracheal continuous positive airway pressure (CPAP for 10 minutes while spontaneous RR, TV and RR/TV were measured using a fixed-orifice pneumotachograph positioned between the endotracheal tube and the ventilator circuit. Thereafter, the neonates were extubated to nasal CPAP. Extubation failure was defined as the need for reintubation within 48 hours. RESULTS: Of the 35 studied infants, 20 (57% were successfully extubated and 15 (43% required reintubation. RR and RR/TV before extubation had a trend to be higher in unsuccessfully extubated infants. TV was similar in both groups. Sensitivity and specificity of these parameters as predictors of extubation failure were 50 and 67% respectively for RR, 40 and 67% for TV and 40 and 73% for RR/TV. CONCLUSIONS: RR, TV and RR/TV showed low sensitivity and specificity to predict extubation failure in mechanically ventilated very low birth weight infants.

  5. BIRTH ORDER, STAGE OF INFANCY AND INFANT MORTALITY IN INDIA.

    Science.gov (United States)

    Mishra, S K; Ram, Bali; Singh, Abhishek; Yadav, Awdhesh

    2017-10-02

    Using data from India's National Family Health Survey, 2005-06 (NFHS-3), this article examines the patterns of relationship between birth order and infant mortality. The analysis controls for a number of variables, including mother's characteristics such as age at the time of survey, current place of residence (urban/rural), years of schooling, religion, caste, and child's sex and birth weight. A modest J-shaped relationship between birth order of children and their risk of dying in the neonatal period is found, suggesting that although both first- and last-born children are at a significantly greater risk of dying compared with those in the middle, last-borns (i.e. fourth and higher order births) are at the worst risk. However, in the post-neonatal period first-borns are not as vulnerable, but the risk increases steadily with the addition of successive births and last-borns are at much greater risk, even worse than those in the neonatal period. Although the strength of relationship between birth order and mortality is attenuated after the potential confounders are taken into account, the relationship between the two variables remains curvilinear in the neonatal period and direct in the post-neonatal period. There are marked differences in these patterns by the child's sex. While female children are less prone to the risk of dying in the neonatal period in comparison with male children, the converse is true in the post-neonatal period. Female children not only run higher risks of dying in the post-neonatal period, but also become progressively more vulnerable with an increase in birth order.

  6. Black-White Differences in Maternal Age, Maternal Birth Cohort, and Period Effects on Infant Mortality in the U.S. (1983-2002)1

    OpenAIRE

    Powers, Daniel A.

    2013-01-01

    We investigate three interrelated sources of change in infant mortality rates over a 20 year period using the National Center for Health Statistics (NCHS) linked birth and infant death cohort files. The effects of maternal age, maternal birth cohort, and time period of childbirth on infant mortality are estimated using a modified age/period/cohort (APC) model that identifies age, period, cohort effects. We document black-white differences in the patterning of these effects and find that mater...

  7. Motor Acquisition Rate in Brazilian Infants

    Science.gov (United States)

    Lopes, Virlaine Bardella; de Lima, Carolina Daniel; Tudella, Eloisa

    2009-01-01

    This study used the Alberta Infant Motor Scale (AIMS) with the aim of characterizing motor acquisition rate in 70 healthy 0-6-month-old Brazilian infants, as well as comparing both emergence (initial age) and establishment (final age) of each skill between the study sample and the AIMS normative data. New motor skills were continuously acquired…

  8. Kluyvera ascorbata sepsis in an extremely low birth weight infant

    Directory of Open Access Journals (Sweden)

    D Sharma

    2015-01-01

    Full Text Available Kluyvera ascorbata belongs to Enterobacteriaceae family and is a gram negative micro-organism. This bacteria is usually considered a commensal, however it can cause significant infections rarely. This organism is usually resistant to most commonly used antibiotics used as first line in neonatal units. Antimicrobial agents active against Kluyvera strains include third-generation cephalosporins, fluoroquinolones, and aminoglycosides. We report a case of an extremely low birth weight male infant who presented on day 4 of life with clinical features of sepsis, multi-organ dysfunction, shock and pulmonary haemorrhage. Neonatal sepsis was associated with marked elevation of C-reactive protein and a falling platelet count. Infant expired on day 5 of life in spite of aggressive supportive care and treatment with meropenem. with growth of Kluyvera ascorbataon blood culture.

  9. Infant behavioral assessment and intervention program in very low birth weight infants improves independency in mobility at preschool age

    NARCIS (Netherlands)

    Verkerk, Gijs; Jeukens-Visser, Martine; Koldewijn, Karen; van Wassenaer, Aleid; Houtzager, Bregje; Kok, Joke; Nollet, Frans

    2011-01-01

    To evaluate the effects of the Infant Behavioral Assessment and Intervention Program(©) (IBAIP) in very low birth weight infants on sensory processing and daily activities at preschool age. Follow-up of children included in a randomized controlled trial. Eighty-six infants were enrolled in

  10. The Effect of Gestational Age at Birth on Post-Term Maturation of Heart Rate Variability

    Science.gov (United States)

    Fyfe, Karinna L.; Yiallourou, Stephanie R.; Wong, Flora Y.; Odoi, Alexsandria; Walker, Adrian M.; Horne, Rosemary S.C.

    2015-01-01

    Study Objective: Preterm birth delays maturation of autonomic cardiovascular control, reflected in reduced heart rate variability (HRV) in preterm compared to term infants at term-equivalent age. It has been suggested that immature cardiovascular control contributes to the increased risk for the sudden infant death syndrome (SIDS) in preterm infants. However, the effects of prone sleeping, the major SIDS risk factor, and of gestational age (GA) at birth on HRV have not been assessed in preterm infants beyond term-equivalent age. Subjects and Methods: Very preterm (n = 21; mean GA 29.4 ± 0.3 weeks), preterm (n = 14; mean GA 33.5 ± 0.3 weeks), and term (n = 17; mean GA 40.1 ± 0.3 weeks) infants were recruited and underwent daytime polysomnography at 2–4 weeks, 2–3 months, and 5–6 months post-term corrected age (CA). Infants slept both supine and prone. HRV was assessed in the low frequency (LF) and high frequency (HF) ranges. Results: There was no effect of prone sleeping on HRV parameters in either preterm group. In term infants LF/HF was significantly elevated in the prone position in AS at 2–4 weeks (P preterm compared to both preterm and term infants at 2–3 months CA. Conclusion: Prone sleeping did not significantly impact on heart rate variability (HRV) in preterm infants. However, reduced maturation of high frequency HRV in very preterm infants resulted in significantly altered sympathovagal balance at 2–3 months corrected age, the age of peak sudden infant death syndrome (SIDS) risk. This may contribute to the increased risk of SIDS in infants born at earlier gestational age. Citation: Fyfe KL, Yiallourou SR, Wong FY, Odoi A, Walker AM, Horne RS. The effect of gestational age at birth on post-term maturation of heart rate variability. SLEEP 2015;38(10):1635–1644. PMID:25902805

  11. Perinatal and infant mortality and low birth weight among residents near cokeworks in Great Britain

    Energy Technology Data Exchange (ETDEWEB)

    Dolk, H.; Pattenden, S.; Vrijheid, M.; Thakrar, B.; Armstrong, B.

    2000-02-01

    With growing evidence of the adverse health effects of air pollution--especially fine particulates--investigators must concentrate on the fetus, neonate, and infant as potentially vulnerable groups. Cokeworks are a major source of smoke and sulfur dioxide. In the current study, the authors investigated whether populations residing near cokeworks had a higher risk of adverse perinatal and infant outcomes. Zones of 7.5-km radius around 22 cokeworks in Great Britain were studied, within which the authors assumed that exposure declined from highest levels within 2 km to background levels. Routinely recorded birth and death data for Great Britain during the period 1981--1992 were analyzed. Each individual record had a postcode that referred to a small geographical area of typically 15--17 addresses. The authors calculated expected numbers on the basis of regional rates, stratified by year, sex, and a small-area socio-economic deprivation score. For all cokeworks combined, the observed/expected ratio within 2 km of cokeworks was 1.00 for low-birth-weight infants; 0.94 for still births; 0.95 for infant mortality; 0.86 for neonatal mortality; 1.10 for postneonatal mortality; 0.79 for respiratory postneonatal mortality; and 1.07 for postneonatal Sudden Infant Death Syndrome. Respiratory postneonatal mortality was low throughout the entire 0--7.5-km study area. There was no statistically significant decline in risk with distance from cokeworks for any of the outcomes studied. The authors concluded that there was no evidence of an increased risk of low birth weight, stillbirths, and/or neonatal mortality near cokeworks, and there was no strong evidence for any association between residence near cokeworks and postneonatal mortality. One must remember, however, the limited statistical power of the study to detect small risks.

  12. Poverty Mapping Project: Global Subnational Infant Mortality Rates

    Data.gov (United States)

    National Aeronautics and Space Administration — The Global Subnational Infant Mortality Rates consists of estimates of infant mortality rates for the year 2000. The infant mortality rate for a region or country is...

  13. Neurodevelopmental Outcomes in Very Low Birth Weight Infants Using Aminophylline for the Treatment of Apnea.

    Science.gov (United States)

    Tey, Shu-Leei; Lee, Wei-Te; Lee, Pei-Lun; Lu, Chu-Chong; Chen, Hsiu-Lin

    2016-02-01

    Aminophylline has been widely used in the treatment of apneic episodes in premature infants. Animal models suggest caution in the use of aminophylline as it may increase the cerebral metabolic rate and decrease the rate of anoxic survival in neonates. This study aimed to evaluate the neurological outcomes in very low birth weight (VLBW) infants treated with aminophylline for apnea in our neonatal intensive care unit. All VLBW infants (body birth weight prematurity, and necrotizing enterocolitis were not significantly different between the two groups. Only bronchopulmonary dysplasia remained significantly higher in the aminophylline group after adjusting for risk factors (48.08% vs. 21.15%; adjusted odds ratio: 12.50; p apnea of prematurity had no apparent and additional risk on the neurodevelopmental outcomes of VLBW infants at a corrected age of 18 months. Further studies with a larger sample size are needed to confirm the adverse neurological effects of aminophylline treatment. Copyright © 2016. Published by Elsevier B.V.

  14. [Neonatal polysomnography in newborn infants with severe birth asphyxia].

    Science.gov (United States)

    Hernández-Duarte, A M; Domínguez-Dieppa, F; Roca-Molina, M C

    Neonatal polysomnography studies (electroencephalogram, electrooculography, body movements, cardiorespiratory frequencies) were performed in 101 newborn full-term infants diagnosed with severe birth asphyxia. To analyse results, the sample was divided into two groups, depending on whether hypoxic-ischaemic encephalopathy (HIE) had occurred or not. The results of the polysomnography studies were correlated with those from the full-term neurological examination and the sequelae from the neurological development during the first two years of life. Significant correlations were obtained among the variables that were studied. The normality observed in the electrophysiological study in the group of patients with severe asphyxia without HIE was associated with a full-term neurological examination and with a neurological development that has progressed in a satisfactory manner. In the group of patients with grade II HIE there was a predominance of severe alterations in the full-term neonatal polysomnography study, which were significantly correlated with the pathological full-term neurological examinations and serious sequelae from neurological development. It has been proved that neonatal polysomnography studies are a valuable aid in evaluating the neurological status of newborn infants in a critical condition and in predicting the sequelae of neurological development in the first two years of life. Further research should be aimed at determining the effects exerted by the daily administration of medication (sedatives, anaesthetics and antiepileptic agents) in critical newborn infants on electrical activity in the brain and the cyclic structuring of the different phases of sleep.

  15. Survival of extremely low-birth-weight infants | Kalimba | South ...

    African Journals Online (AJOL)

    pressure (NCPAP) with or without surfactant, and Apgar scores. Results. A total of 382 neonates were included in the study. Overall survival was ... Overall the rate of NCPAP use was 15.5%, and NCPAP was not associated with improved survival. Conclusion. Survival of ELBW infants is low. BW and GA were the strongest ...

  16. Effect of vitamin A supplementation on the urinary retinol excretion in very low birth weight infants.

    Science.gov (United States)

    Schmiedchen, Bettina; Longardt, Ann Carolin; Loui, Andrea; Bührer, Christoph; Raila, Jens; Schweigert, Florian J

    2016-03-01

    Despite high-dose vitamin A supplementation of very low birth weight infants (VLBW, supplementation on the urinary vitamin A excretion in VLBW infants was investigated. Sixty-three VLBW infants were treated with vitamin A (5000 IU intramuscular, 3 times/week for 4 weeks); 38 untreated infants were classified as control group. On days 3 and 28 of life, retinol, retinol-binding protein 4 (RBP4), glomerular filtration rate, proteinuria, and Tamm-Horsfall protein were quantified in urine. On day 3 of life, substantial retinol and RBP4 losses were found in both groups, which significantly decreased until day 28. Notwithstanding, the retinol excretion was higher (P supplementation as compared to infants of the control group. On day 28 of life, the urinary retinol concentrations were predictive for serum retinol concentrations in the vitamin A treated (P supplementation efficacy in VLBW infants. Advanced age and thus postnatal kidney maturation seems to be an important contributor in the prevention of urinary retinol losses.

  17. Birth defects in perinatal infants in areas contiguous to Hongyanhe Nuclear Power Plant before its normal operation

    International Nuclear Information System (INIS)

    Zhou Ling; Yin Zhihua; Han Zhonghui

    2011-01-01

    Objective: To understand the status of birth defects among the perinatal infants in the areas contiguous to Hongyanhe nuclear power plant before its normal operation, so as to provide background information for the evaluation of the impact of nuclear power plant on birth defects. Methods: From 1 October 1995 to 30 September 2009 the midwifery units at second class and above of Wafangdian City were asked to be in charge of recording the birth defects among the perinatal infants born during this period within the range of 50 km around the Hongyanhe nuclear power plant. Results: The total number of birth defects was 697, and the maternal number Was 83779. The average defect rate Was 83.20/10 4 . There were significant differences in the birth defect rate among different years (χ 2 =39.54, P<0.05), however, without linear trend therein,and among the survey areas (χ 2 =15.36, P<0.05) as well. The top five birth defects were congenital heart disease (148 cases), cleft lip with cleft palate (67 cases), congenital hydrocephalus (63 cases), and spina bifida (37 cases) and cleft lip (36 cases). Conclusions: The birth defect rate within the range of 50 km around the Hongyanhe nuclear power plant is lower than that of the region of Liaoning Province and the national rate of birth defects. (authors)

  18. Early-Onset Invasive Candidiasis in Extremely Low Birth Weight Infants: Perinatal Acquisition Predicts Poor Outcome.

    Science.gov (United States)

    Barton, Michelle; Shen, Alex; O'Brien, Karel; Robinson, Joan L; Davies, H Dele; Simpson, Kim; Asztalos, Elizabeth; Langley, Joanne; Le Saux, Nicole; Sauve, Reginald; Synnes, Anne; Tan, Ben; de Repentigny, Louis; Rubin, Earl; Hui, Chuck; Kovacs, Lajos; Yau, Yvonne C W; Richardson, Susan E

    2017-04-01

    Neonatal invasive candidiasis (IC) presenting in the first week of life is less common and less well described than later-onset IC. Risk factors, clinical features, and disease outcomes have not been studied in early-onset disease (EOD, ≤7 days) or compared to late-onset disease (LOD, >7 days). All extremely low birth weight (ELBW, candidiasis enrolled from 2001 to 2003 were included in this study. Factors associated with occurrence and outcome of EOD in ELBW infants were determined. Forty-five ELBW infants and their 84 matched controls were included. Fourteen (31%) ELBW infants had EOD. Birth weight <750 g, gestation <25 weeks, chorioamnionitis, and vaginal delivery were all strongly associated with EOD. Infection with Candida albicans, disseminated disease, pneumonia, and cardiovascular disease were significantly more common in EOD than in LOD. The EOD case fatality rate (71%) was higher than in LOD (32%) or controls (15%) (P = .0001). The rate of neurodevelopmental impairment and mortality combined was similar in EOD (86%) and LOD (72%), but higher than in controls (32%; P = .007). ELBW infants with EOD have a very poor prognosis compared to those with LOD. The role of perinatal transmission in EOD is supported by its association with chorioamnionitis, vaginal delivery, and pneumonia. Dissemination and cardiovascular involvement are common, and affected infants often die. Empiric treatment should be considered for ELBW infants delivered vaginally who have pneumonia and whose mothers have chorioamnionitis or an intrauterine foreign body. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2009-01-01

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

  20. [Changes in the outcome for infants, with birth weight under 500 grams, at our department (First Department of Obstetrics and Gynecology, Semmelweis University, Budapest)].

    Science.gov (United States)

    Varga, Péter; Jeager, Judit; Harmath, Ágnes; Berecz, Botond; Kollár, Tímea; Pete, Barbara; Magyar, Zsófia; Rigó, János; Romicsné Görbe, Éva

    2015-03-08

    The mortality and morbidity of extremely low birth weight infants (birth weight below 1000 grams) are different from low birth weight and term infants. The Centers for Disease Control statistics from the year 2009 shows that the mortality of preterm infants with a birth weight less than 500 grams is 83.4% in the United States. In many cases, serious complications can be expected in survivals. The aim of this retrospective study was to find prognostic factors which may improve the survival of the group of extremely low birth weight infants (grams). Data of extremely low birth weight infants with less than 500 grams born at the 1st Department of Obstetrics and Gynecology, Semmelweis University between January 1, 2006 and June 1, 2012 were analysed, and mortality and morbidity of infants between January 1, 2006 and December 31, 2008 (period I) were compared those found between January 1, 2009 and June 1, 2012 (period II). Statistical analysis was performed with probe-t, -F and -Chi-square. Survival rate of extremely low birth weight infants less than 500 grams in period 1 and II was 26.31% and 55.17%, respectively (p = 0.048), whereas the prevalence of complications were not significantly different between the period examined. The mean gestational age of survived infants (25.57 weeks) was higher than the gestational age of infants who did not survive (24.18 weeks) and the difference was statistically significant (p = 0.0045). Education of the team of the Neonatal Intensive Care Unit, professional routine and technical conditions may improve the survival chance of preterm infants. The use of treatment protocols, conditions of the Neonatal Intensive Care Unit and steroid prophylaxis may improve the survival rate of extremely low birth weight infants.

  1. Mother-preterm infant interactions at three months of corrected age: influence of maternal depression, anxiety and neonatal birth weight

    Directory of Open Access Journals (Sweden)

    Erica eNeri

    2015-09-01

    Full Text Available Maternal depression and anxiety represent risk factors for the quality of early mother-preterm infant interactions, especially in the case of preterm birth. Despite the presence of many studies on this topic, the comorbidity of depressive and anxious symptoms has not been sufficiently investigated, as well as their relationship with the severity of prematurity and the quality of early interactions. The Aim of this study was to evaluate the quality of early mother-infant interactions and the prevalence of maternal depression and anxiety comparing dyads of Extremely Low Birth Weight-ELBW and Very Low Birth Weight-VLBW preterm infants with full-term ones. 77 preterm infants (32 ELBW; 45 VLBW and 120 full term (FT infants and their mothers were recruited. At 3 months of corrected age, 5 minutes of mother-infant interactions were recorded and later coded through the Global Ratings Scales. Mothers completed the Edinburgh Postnatal Depression Scale and Penn State Worry Questionnaire. Infant levels of development were assessed through the Griffiths Mental Development Scales. A relation emerged among the severity of prematurity, depression, anxiety, and the quality of interactions. When compared with the FT group, the ELBW interactions were characterized by high maternal intrusiveness and low remoteness, while the VLBW dyads showed high levels of maternal sensitivity and infant communication. Depression was related to maternal remoteness and negative affective state, anxiety to low sensitivity, while infant interactive behaviours were impaired only in case of comorbidity. ELBW’s mothers showed the highest prevalence of depressive and anxious symptoms; moreover, only in FT dyads, low maternal sensitivity, negative affective state and minor infant communication were associated to the presence of anxious symptoms. The results confirmed the impact of prematurity on mother–infant interactions and on maternal affective state. Early diagnosis help to plan

  2. Factors affecting successful closure of hemodynamically significant patent ductus arteriosus with indomethacin in extremely low birth weight infants.

    Science.gov (United States)

    Yang, Chuan-Zhong; Lee, Jiun

    2008-05-01

    The incidence of patent ductus arteriosus (PDA) is high in extremely low birth weight (ELBW) infants. Indomethacin has been widely used in the prophylaxis and treatment of hemodynamically significant PDA. This retrospective study was undertaken to identify factors such as birth weight, gestational age, gender, fetal growth retardation, ductal size, timing of the first dose of indomethacin and side effects of indomethacin, which may affect the successful closure of the PDA with indomethacin in ELBW infants. A cohort of 139 ELBW infants who had received indomethacin treatment for PDA during a consecutive period of more than three years (September 2000 to December 2003) was retrospectively analyzed. Administration of indomethacin was associated with closure of PDA in 108 (77.7%) of 139 ELBW infants, and only 19.4% of infants required surgical ligation of the ductus eventually. There was no significant relationship between closure of PDA with gestational age, gender, fetal growth retardation, and ductal size. A higher birth weight and early use of indomethacin after birth could significantly increase the closure rate of PDA (P<0.05). Side effects of indomethacin such as transient oliguria and hyponatremia during indomethacin therapy did not affect PDA closure. Indomethacin is effective for the treatment of PDA in ELBW infants. A higher rate of ductal closure is related to the increase of birth weight. PDA closure with indomethacin is age-related, and early administration of indomethacin could increase PDA closure and reduce the incidence of hyponatremia. There is no significant difference in major morbidities such as bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP) after early treatment. Early screening for hemodynamically significant PDA in ELBW infants and early treatment with indomethacin are recommended.

  3. Early nCPAP versus intubation in very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Pedro Neves Tavares

    2013-06-01

    Full Text Available For many years endotracheal intubation and mechanical ventilation have been the standard of care for very low birth weight infants but, in the last decade, nasal continuous positive airway pressure (nCPAP has been described in many studies as an option for the treatment of preterm infants with respiratory distress syndrome. In fact, recent studies have shown that early nCPAP is not associated with higher rates of morbidity and mortality and does not imply more days of ventilation support when compared to traditional ventilation techniques. The authors conducted a study to compare the outcomes (in terms of mortality, morbidity and need for medical support of very low birth weight infants treated with nCPAP or endotracheal intubation and mechanical ventilation. One hundred and four newborns were enrolled in this study, 44 (42.3% were treated with nCPAP and 60 (57.7% with endotracheal intubation followed by mechanical ventilation. A subgroup analysis of newborns with gestational age between 28 and 31 weeks was also performed. It included 57 newborns with similar demographic characteristics, 29 (50.9% treated with nCPAP and 28 (49.1% with endotracheal intubation followed by mechanical ventilation. No statistically significant differences were found in the frequency of death or bronchopulmonary dysplasia. Statistically significant differences were found in the prevalence of hyaline membrane disease (p = 0.033 and surfactant administration (p = 0.021 with lower rates in the nCPAP group. No other differences were found in the prevalence of other morbidities or in the need for medical support after birth. These results suggests that nCPAP might be chosen as primary ventilatory support choice in very low birth weight preterm, when there are no contraindications to its use.

  4. Time trends and risk factor associated with premature birth and infants deaths due to prematurity in Hubei Province, China from 2001 to 2012.

    Science.gov (United States)

    Xu, Haiqing; Dai, Qiong; Xu, Yusong; Gong, Zhengtao; Dai, Guohong; Ding, Ming; Duggan, Christopher; Hu, Zubin; Hu, Frank B

    2015-12-10

    The nutrition and epidemiologic transition has been associated with an increasing incidence of preterm birth in developing countries, but data from large observational studies in China have been limited. Our study was to describe the trends and factors associated with the incidence of preterm birth and infant mortality due to prematurity in Hubei Province, China. We conducted a population-based survey through the Maternal and Child Health Care Network in Hubei Province from January 2001 to December 2012. We used data from 16 monitoring sites to examine the trend and risk factors for premature birth as well as infant mortality associated with prematurity. A total of 818,481 live births were documented, including 76,923 preterm infants (94 preterm infants per 1,000 live births) and 2,248 deaths due to prematurity (2.75 preterm deaths per 1,000 live births). From 2001 to 2012, the incidence of preterm birth increased from 56.7 to 105.2 per 1,000 live births (P for trend infant mortality rate due to prematurity declined from 95.0 to 13.4 per 1,000 live births (P for trend infant male sex were independently associated with a higher incidence of preterm birth (all p values mortality rate, while use of newborn emergency transport services (NETS) was associated with a lower preterm mortality rate (all p values infant mortality due to prematurity were observed in Hubei Province from 2001 to 2012. Our results provide important information for areas of improvements in reducing incidence and mortality of premature birth.

  5. Blood Culture Proven Early Onset Sepsis and Late Onset Sepsis in Very-Low-Birth-Weight Infants in Korea.

    Science.gov (United States)

    Lee, Soon Min; Chang, Meayoung; Kim, Ki-Soo

    2015-10-01

    Neonatal sepsis remains one of the most important causes of death and co-morbidity in very-low-birth-weight (VLBW) infants. The aim of this study was to determine the current incidences of early-onset sepsis (EOS) and late-onset sepsis (LOS), the distribution of pathogens, and the impact of infection on co-morbidities in VLBW infants. We analyzed the data including sepsis episode from 2,386 VLBW infants enrolled in Korean Neonatal Network from January 2013 to June 2014. We defined EOS as a positive blood culture occurring between birth and 7 days of life and LOS after 7 days of life. Sepsis was found in 21.1% of VLBW infants. The risk of sepsis was inversely related to birth weight and gestational age. EOS was found in only 3.6% of VLBW infants, however the mortality rate was as high as 34.1%. EOS was associated with the increased odds for bronchopulmonary dysplasia and intraventricular hemorrhage. The vast majority of EOS was caused by Gram-positive organisms, particularly coagulase-negative staphylococci (30.6%). LOS developed in 19.4% of VLBW infants with a 16.1% mortality rate. Pathogens in LOS were dominated by coagulase-negative staphylococci (38.3%). Twenty-five percent and fifty percent of first LOS episode occurred after 12 days and 20 days from birth, respectively. Younger and smaller VLBW infants showed the earlier occurrence day for the 25% of first LOS episode. This study provides a recent nationwide epidemiology of sepsis in VLBW infants in Korea. Based on this study, successful strategies to reduce infections would improve survival and reduce morbidity.

  6. The administration of 100% oxygen and respiratory drive in very preterm infants at birth.

    Directory of Open Access Journals (Sweden)

    Jeroen J van Vonderen

    Full Text Available To retrospectively investigate the changes of SpO2 and respiratory drive in preterm infants at birth after administration of 100% oxygen.Respiratory parameters, FiO2 and oximetry of infants 95% occurred more often in PPV group (53% vs. 69% and lasted longer (70(40-95 vs. 120(50-202 s. In CPAP group, minute volume increased from 134 (76-265 mL/kg/min 1 minute before to 240 (157-370 mL/kg/min (p<0.01 1 minute after start FiO2 1.0 and remained stable at 2 minutes (252 (135-376 mL/kg/min; ns. The rate of rise to maximum tidal volume increased (from 13.8 (8.0-22.4 mL/kg/s to 18.2 (11.0-27.5 mL/kg/s; p<0.0001 to 18.8 (11.8-27.8 mL/kg/s; ns. In the PPV group respiratory rate increased from 0(0-4 to 9(0-20 at 1 minute (p<0.001 to 23 (0-34 breaths per minute at 2 minutes (p<0.01.In preterm infants at birth, a rapid increase in oxygenation, resulting from a transient increase to 100% oxygen might improve respiratory drive, but increases the risk for hyperoxia.

  7. Early neonatal deaths with perinatal asphyxia in very low birth weight Brazilian infants.

    Science.gov (United States)

    de Almeida, M F B; Moreira, L M O; Vaz dos Santos, R M; Kawakami, M D; Anchieta, L M; Guinsburg, R

    2015-11-01

    The objective of this study was to assess the frequency of early deaths associated with birth asphyxia of very low birth weight infants between 2005 and 2010, in Brazil. This population study enrolled all live births with birth weight from 400 to 1499 g, gestational age ⩾ 22 weeks, without malformations that died up to 6 days after birth with perinatal asphyxia. Asphyxia was defined if intrauterine hypoxia, asphyxia at birth or meconium aspiration syndrome were written in any line of the death certificate. Active search was carried out in 27 Brazilian federative units. For every 1000 live births of very low birth weight infants without congenital malformations, 40.25 and 32.38 died with birth asphyxia in the first week after birth, respectively, in 2005 and 2010 (Pasphyxia to early neonatal death of these infants was approximately 10 to 12% all study years. Reduction of birth asphyxia in very low birth weight infants is essential to reducing neonatal mortality in Brazil.

  8. Birth weight ratio as an alternative to birth weight percentile to express infant weight in research and clinical practice: a nationwide cohort study

    NARCIS (Netherlands)

    Voskamp, Bart Jan; Kazemier, Brenda M.; Schuit, Ewoud; Mol, Ben Willem J.; Buimer, Maarten; Pajkrt, Eva; Ganzevoort, Wessel

    2014-01-01

    Objective. To compare birth weight ratio and birth weight percentile to express infant weight when assessing pregnancy outcome. Study Design. We performed a national cohort study. Birth weight ratio was calculated as the observed birth weight divided by the median birth weight for gestational age.

  9. Surgical closure of patent ductus arteriosus in extremely low birth weight infants less than 750 grams.

    Science.gov (United States)

    Stankowski, Tomasz; Aboulhassan, Sleiman Sebastian; Fritzsche, Dirk; Misterski, Marcin; Marczak, Jakub; Szymańska, Anna; Szarpak, Lukasz; Augustyn, Cyprian; Cichoń, Romuald; Perek, Bartłomiej

    2018-01-09

    Patent ductus arteriosus (PDA) occurs more frequently in premature infants. Depending on the degree of prematurity, these children often have other serious comorbidities that could significantly impact on surgical outcome. This study aimed to evaluate clinical results of the surgical ligation of PDA in extremely low body weight preterm infants with birth weight below 750 grams and to identify risk factors of mortality. A total of 31 preterm infants with birth weight below 750 grams and significant PDA were operated between 2006 and 2016 through posterolateral thoracotomy (n=16) or with the use of video-assisted thoracoscopic (VATS) method (n = 15). Mean weight at the time of surgery was 750.8 ± 104.7 g. The gestational age ranged from 22 to 32 weeks. Data were retrospectivel1y analyzed and prospective 100% follow-up was performed. In-hospital mortality was 25.8% (n = 8). Type of surgery had no influence on the results. During the follow-up period lasting 5.2 ± 2.5 years two other patients died. One-year and 5-year probability of survival was 77.4% and 74.2%, respectively. The predominant cause of death was acute heart failure. All patients with preoperative renal dysfunction died in the postoperative period. Moreover, Cox regression analysis revealed renal dysfunction as an independent risk factor of early death. Preterm infants with birth weight less than 750 grams and significant PDA are highly challenging patients. Despite the recent advances in perioperative management with neonates, surgery is still associated with high early mortality rate irrespective of applied method.

  10. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study.

    Science.gov (United States)

    Lin, Hui-Jia; Du, Li-Zhong; Ma, Xiao-Lu; Shi, Li-Ping; Pan, Jia-Hua; Tong, Xiao-Mei; Li, Qiu-Ping; Zhou, Jian-Guo; Yi, Bing; Liu, Ling; Chen, Yun-Bing; Wei, Qiu-Fen; Wu, Hui-Qing; Li, Mei; Liu, Cui-Qing; Gao, Xi-Rong; Xia, Shi-Wen; Li, Wen-Bin; Yan, Chao-Ying; He, Ling; Liang, Kun; Zhou, Xiao-Yu; Han, Shu-Ping; Lyu, Qin; Qiu, Yin-Ping; Li, Wen; Chen, Dong-Mei; Lu, Hong-Ru; Liu, Xiao-Hong; Liu, Hong; Lin, Zhen-Lang; Liu, Li; Zhu, Jia-Jun; Xiong, Hong; Yue, Shao-Jie; Zhuang, Si-Qi

    2015-10-20

    With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China. All infants admitted to 26 NICUs with a birth weight (BW) infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.

  11. Poor birth weight recovery among low birth weight/preterm infants following hospital discharge in Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Namiiro Flavia B

    2012-01-01

    Full Text Available Abstract Background Healthy infants typically regain their birth weight by 21 days of age; however, failure to do so may be due to medical, nutritional or environmental factors. Globally, the incidence of low birth weight deliveries is high, but few studies have assessed the postnatal weight changes in this category of infants, especially in Africa. The aim was to determine what proportion of LBW infants had not regained their birth weight by 21 days of age after discharge from the Special Care Unit of Mulago hospital, Kampala. Methods A cross sectional study was conducted assessing weight recovery of 235 LBW infants attending the Kangaroo Clinic in the Special Care Unit of Mulago Hospital between January and April 2010. Infants aged 21 days with a documented birth weight and whose mothers gave consent to participate were included in the study. Baseline information was collected on demographic characteristics, history on pregnancy, delivery and postnatal outcome through interviews. Pertinent infant information like gestation age, diagnosis and management was obtained from the medical records and summarized in the case report forms. Results Of the 235 LBW infants, 113 (48.1% had not regained their birth weight by 21 days. Duration of hospitalization for more than 7 days (AOR: 4.2; 95% CI: 2.3 - 7.6; p value Conclusion Failure to regain birth weight among LBW infants by 21 days of age is a common problem in Mulago Hospital occurring in almost half of the neonates attending the Kangaroo clinic. Currently, the burden of morbidity in this group of high-risk infants is undetected and unaddressed in many developing countries. Measures for consideration to improve care of these infants would include; discharge after regaining birth weight and use of total parenteral nutrition. However, due to the pressure of space, keeping the baby and mother is not feasible at the moment hence the need for a strong community system to boost care of the infant. Close

  12. Breastfeeding practices and determinants in infants from birth to six ...

    African Journals Online (AJOL)

    2016-04-26

    Apr 26, 2016 ... tion of breastfeeding after birth need to be improved. ... rates in order to approach and hopefully surpass the esti- mated percentage of 39% 9 ..... Confidence. Interval 95%. Age of mother. 25-40 years. 2.19. 0.64. 2.68. 0.007*. (1.23-3.89). Maternal education. (>Secondary). 1.13. 0.30. 0.44. 0.662. (0.66-1.91).

  13. Effect of polyethylene occlusive skin wrapping on heat loss in very low birth weight infants at delivery: a randomized trial.

    Science.gov (United States)

    Vohra, S; Frent, G; Campbell, V; Abbott, M; Whyte, R

    1999-05-01

    Significant evaporative heat loss in the very low birth weight infant can occur in the delivery room. We investigated the effect of polyethylene wrap applied immediately at birth (without drying) on rectal temperature measured at nursery admission. Sixty-two consecutive infants delivered at radiant warmers. Wraps were removed on nursery admission. Rectal temperature was taken by digital electronic thermometer. Fifty-nine of 62 recruited infants completed the study. Maternal temperature, delivery room temperature, transfer-incubator temperature, and time to admission were recorded. Use of occlusive wrapping resulted in a significantly higher admission rectal temperature in infants means = 1.9 C, P temperature in infants of 28 to 31 weeks' gestation (difference in means = 0.17 C, P =.47). All 5 deaths were in the nonwrap group (vs wrap, P =.04); their mean temperature was 35.1 C versus 36.5 C in survivors (P =.001). Occlusive wrapping of very low birth weight infants at delivery reduces postnatal temperature fall. This may result in a decreased mortality rate.

  14. Influence of birth weight on differences in infant mortality by social class and legitimacy.

    Science.gov (United States)

    Leon, D A

    1991-01-01

    OBJECTIVE--To investigate the influence of birth weight on the pronounced social class differences in infant mortality in Britain. DESIGN--Analysis of routine data on births and infant deaths. SETTING--England and Wales. SUBJECTS--All live births and infant deaths, 1983-5. MAIN OUTCOME MEASURE--Mortality in infants by social class, birth weight, and legitimacy according to birth and death certificates. RESULTS--Neonatal and postneonatal mortality (deaths/1000 births) increased with social class. Neonatal and postneonatal mortality was 4.2/1000 and 2.3/1000 respectively for social class I and 6.8/1000 and 5.6/1000 respectively for social class V. Mortality was lower among births registered within marriage (postneonatal 3.5/1000; neonatal 5.2/1000) than among those jointly registered outside marriage (5.1/1000; 6.4/1000); mortality was highest in those solely registered outside marriage (7.2/1000; 7.0/1000). For neonatal mortality the effect of social class varied with birth weight. Social class had little effect on neonatal mortality in low birthweight babies and increasing effect in heavier babies. For postneonatal mortality the effect of social class was similar for all birth weights and was almost as steep as for all birth weights combined. CONCLUSION--Birth weight mediates little of the effect of social class on postneonatal mortality. PMID:1954421

  15. The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants : A randomized controlled trial

    NARCIS (Netherlands)

    van den Berg, Anemone; Fetter, Willem P. F.; Westerbeek, Elisabeth A. M.; van der Vegt, Ina M.; van der Molen, Hilda R. A.; van Elburg, Ruurd M.

    2006-01-01

    Background: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as

  16. The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants: A randomized controlled trial

    NARCIS (Netherlands)

    van den Berg, Anemone; Fetter, Willem P. F.; Westerbeek, Elisabeth A. M.; van der Vegt, Ina M.; van der Molen, Hilda R. A.; van Elburg, Ruurd M.

    2006-01-01

    Background: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as

  17. Drug Improves Birth Rates for Women with Ovary Disorder

    Science.gov (United States)

    ... NIH Research Matters July 21, 2014 Drug Improves Birth Rates for Women with Ovary Disorder At a ... more effective than standard therapy in increasing live births for women with polycystic ovary syndrome. Letrozole could ...

  18. The paternal component of the "healthy migrant" effect: fathers' natality and infants' low birth weight.

    Science.gov (United States)

    Krishnakumar, Ambika; Lane, Sandra D; Hall, Meghan; Tso, Evaline; Pinto, Natasha; Oberoi, Navpriya; Suk, William; Badawy, Zaki; Wojtowycz, Martha A; Aubry, Richard

    2011-11-01

    This study examines the predictors of birth outcomes among women of European and African ancestry and considers the birthplace of the babies' fathers (foreign born vs. native born) as a protective factor. This is a secondary data analysis of 146,431 singleton births among women of European and African ancestry, both native-born and foreign-born, in a 21 birth hospital region of Central New York State from 1996 to 2003. Foreign born fathers were found to have 15% fewer low birth weight infants than US-born fathers, after controlling for the race and birthplace of the mother, tobacco use and Medicaid. Although this secondary data analysis does not allow us to determine the social determinants of the better birth outcomes among infants of foreign born fathers, it does demonstrate that fathers matter and that foreign born fathers are associated with reduced low birth weight in their infants.

  19. Disseminated candidemia refractory to caspofungin therapy in an infant with extremely low birth weight

    Directory of Open Access Journals (Sweden)

    Meng-Ju Li

    2012-01-01

    Full Text Available Systemic fungal infections have high morbidity and mortality rates in neonates, especially neonates with an extremely low birth weight (ELBW. Here, we describe a 21-day-old ELBW female infant with an amphotericin B-unresponsive congenital Candida albicans infection that was treated with caspofungin. Blood sterilization was performed during the first episode, but a second episode of candidemia occurred after the discontinuation of caspofungin. Blood sterilization was again performed during the second round of caspofungin treatment, but fungal endocarditis and renal fungal balls still developed during the second episode. Caspofungin can be considered for invasive candidiasis in premature infants, especially in life-threatening situations. As for the focal lesions, more aggressive treatments other than just parenteral antibiotics should be considered. The literature regarding caspofungin therapy for neonatal candidiasis is also reviewed.

  20. Hepatitis B vaccine birth dose coverage correlates worldwide with rates of institutional deliveries and skilled attendance at birth.

    Science.gov (United States)

    Allison, Robert D; Patel, Minal K; Tohme, Rania A

    2017-07-24

    Chronic hepatitis B virus (HBV) infection occurs in 90% of infants infected perinatally but is prevented when a hepatitis B vaccine is given within 24h of birth (HepB-BD), followed by 2-3 additional doses. Using Spearman's rho correlation coefficients (rho), we analyzed global and regional data to assess correlations between HepB-BD coverage, institutional delivery rates (IDR), skilled birth attendance (SBA) rates, and other potential co-variates. Significant correlations were observed worldwide between HepB-BD and SBA rates (rho=0.44, pAsia and Western Pacific Regions. Increasing IDR and SBA rates, training and supervising staff, increasing community awareness, and using HepB-BD outside the cold chain where needed would increase HepB-BD coverage and prevent chronic infections. Published by Elsevier Ltd.

  1. Time course study of blood pressure in term and preterm infants immediately after birth.

    Directory of Open Access Journals (Sweden)

    Gerhard Pichler

    Full Text Available To describe temporal changes in systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively in term and preterm infants immediately after birth.Prospective observational two-center study. In term infants SBP, DBP, and MBP were assessed non-invasively every minute for the first 15 minutes, and in preterm infants every minute for the first 15 minutes, as well as at 20, 25, 30, 45, and 60 minutes after birth. Regression analyses were performed by gender and respiratory support in all neonates; and by mode of delivery, cord clamping time, and development of ultrasound-detected brain injury in preterm neonates.Term infants (n = 54 had a mean (SD birth weight of 3298 (442 g and gestational age of 38 (1 weeks, and preterm infants (n = 94 weighed 1340 (672 g and were 30 (3 weeks gestation. Term infants' SBP, DBP and MBP within the first 15 minutes after birth were independent of gender or respiratory support. Linear mixed regression analysis showed that preterm infants, who were female, born vaginally, had delayed cord clamping and did not require positive pressure ventilation nor develop periventricular injury or ventriculomegaly, had significantly higher SBP, DBP, and MBP at some measurement points within the first hour after birth.We present novel reference ranges of BP immediately after birth in a cohort of term and preterm neonates. They may aid in optimization of cardiovascular support during early transition at all gestations.

  2. Increasing illness severity in very low birth weight infants over a 9-year period

    Directory of Open Access Journals (Sweden)

    Locke Robert G

    2006-02-01

    Full Text Available Abstract Background Recent reports have documented a leveling-off of survival rates in preterm infants through the 1990's. The objective of this study was to determine temporal changes in illness severity in very low birth weight (VLBW infants in relationship to the outcomes of death and/or severe IVH. Methods Cohort study of 1414 VLBW infants cared for in a single level III neonatal intensive care unit in Delaware from 1993–2002. Infants were divided into consecutive 3-year cohorts. Illness severity was measured by two objective methods: the Score for Neonatal Acute Physiology (SNAP, based on data from the 1st day of life, and total thyroxine (T4, measured on the 5th day of life. Death before hospital discharge and severe intraventricular hemorrhage (IVH were investigated in the study sample in relation to illness severity. The fetal death rate was also investigated. Statistical analyses included both univariate and multivariate analysis. Results Illness severity, as measured by SNAP and T4, increased steadily over the 9-year study period with an associated increase in severe IVH and the combined outcome of death and/or severe IVH. During the final 3 years of the study, the observed increase in illness severity accounted for 86% (95% CI 57–116% of the variability in the increase in death and/or severe IVH. The fetal death rate dropped from 7.8/1000 (1993–1996 to 5.3/1000 (1999–2002, p = .01 over the course of the study. Conclusion These data demonstrate a progressive increase in illness in VLBW infants over time, associated with an increase in death and/or severe IVH. We speculate that the observed decrease in fetal death, and the increase in neonatal illness, mortality and/or severe IVH over time represent a shift of severely compromised patients that now survive the fetal time period and are presented for care in the neonatal unit.

  3. Birth intervention and non-maternal infant-handling during parturition in a nonhuman primate.

    Science.gov (United States)

    Pan, Wenshi; Gu, Tieliu; Pan, Yue; Feng, Chunguang; Long, Yu; Zhao, Yi; Meng, Hao; Liang, Zuhong; Yao, Meng

    2014-10-01

    Direct intervention in infant delivery by non-parturient individuals is a rare phenomenon in nonhuman primates. In contrast, birth assistance by other individuals, or the practice of midwifery, is universal among human societies and generally believed to be a behavior unique to our species. It has been proposed that the enlarged head of the human fetus and the relatively narrow birth canal constrained by bipedalism has made human parturition more difficult than in nonhuman primates, and these anatomic challenges have led to the rotation of the fetus in the birth canal and an occiput anterior (i.e., backward-facing) orientation of emergence. These characteristics have hindered the mother's ability to self-assist the delivery of the infant, therefore necessitating assistance by other individuals or midwives for successful birth. Here we report the first high-definition video recordings of birth intervention behavior in a wild nonhuman primate, the white-headed langur (Trachypithecus leucocephalus). We observed that while a primiparous female gave birth to an infant in an occiput posterior (i.e., forward-facing) orientation, a multiparous female intervened in the delivery by manually pulling the infant out of the birth canal and cared for it in the following hours. Our finding shows extensive social interactions throughout parturition, and presents an unequivocal case of non-maternal intervention with infant birth in a nonhuman primate.

  4. The indeterminate rate problem for birth-death processes

    NARCIS (Netherlands)

    van Doorn, Erik A.

    1987-01-01

    A birth-death process is completely determined by its set of rates if and only if this set satisfies a certain condition C, say. If for a set of rates R the condition C is not fulfilled, then the problem arises of characterizing all birth-death processes which have rate set R (the indeterminate rate

  5. Improved fluid management utilizing humidified incubators in extremely low birth weight infants.

    Science.gov (United States)

    Gaylord, M S; Wright, K; Lorch, K; Lorch, V; Walker, E

    2001-01-01

    To compare fluid and electrolyte management in extremely low birth weight (ELBW) infants nursed in humidified versus nonhumidified incubators. Setting--tertiary intensive care nursery. Subjects--all infants with birth weight incubators and survived for > 96 hours (N = 155). Intervention--retrospective comparison of daily weights, fluid intakes, urine outputs, and serum electrolytes between group 1 (n = 70, nonhumidified incubators, born 1/95 to 1/97) and group 2 (n = 85, humidified incubators, born 1/97 to 1/99) over the first 4 days after birth. Despite similar daily weight losses between groups, group 1 infants received higher fluid intakes, had lower urine outputs, and had a higher incidence of hypernatremia, hyperkalemia, and azotemia (p incubators. ELBW weight infants nursed in humidified incubators have lower fluid requirements, improved electrolyte balance, and higher urine outputs during the first 4 days after birth compared to those nursed in nonhumidified incubators.

  6. Maternal BMI, IGF-I Levels, and Birth Weight in African American and White Infants

    Directory of Open Access Journals (Sweden)

    Adriana C. Vidal

    2013-01-01

    Full Text Available At birth, elevated IGF-I levels have been linked to birth weight extremes; high birth weight and low birth weight are risk factors for adult-onset chronic diseases including obesity, cardiovascular disease, and type 2 diabetes. We examined associations between plasma IGF-I levels and birth weight among infants born to African American and White obese and nonobese women. Prepregnancy weight and height were assessed among 251 pregnant women and anthropometric measurements of full term infants (≥37 weeks of gestation were taken at birth. Circulating IGF-I was measured by ELISA in umbilical cord blood plasma. Linear regression models were utilized to examine associations between birth weight and high IGF-I, using the bottom two tertiles as referents. Compared with infants with lower IGF-I levels (≤3rd tertile, those with higher IGF-I levels (>3rd tertile were 130 g heavier at birth, (β-coefficient=230, se=58.0, P=0.0001, after adjusting for gender, race/ethnicity, gestational age, delivery route, maternal BMI and smoking. Stratified analyses suggested that these associations are more pronounced in infants born to African American women and women with BMI ≥30 kg/m2; the cross product term for IGF-I and maternal BMI was statistically significant (P≤0.0004. Our findings suggest that the association between IGF-I levels and birth weight depends more on maternal obesity than African American race/ethnicity.

  7. Oral Health in Women During Preconception and Pregnancy: Implications for Birth Outcomes and Infant Oral Health

    OpenAIRE

    Boggess, Kim A.; Edelstein, Burton L.

    2006-01-01

    The mouth is an obvious portal of entry to the body, and oral health reflects and influences general health and well being. Maternal oral health has significant implications for birth outcomes and infant oral health. Maternal periodontal disease, that is, a chronic infection of the gingiva and supporting tooth structures, has been associated with preterm birth, development of preeclampsia, and delivery of a small-for-gestational age infant. Maternal oral flora is transmitted to the newborn in...

  8. The contribution of very low birth weight death to infant mortality ...

    African Journals Online (AJOL)

    Background: Infant mortality remains high in many developing countries in which the contribution of deaths among infants born very low birth weight (VLBW) may be considerable. This contribution has however not been quantified in most such countries. This paper explores a model that can be used in this respect.

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

    Science.gov (United States)

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

  10. Race/Ethnic Differences in Birth Size, Infant Growth, and Body Mass Index at Age Five Years in Children in Hawaii.

    Science.gov (United States)

    Oshiro, Caryn E S; Novotny, Rachel; Grove, John S; Hurwitz, Eric L

    2015-12-01

    Factors at birth and infancy may increase risk of being overweight in childhood. The aim of this study was to examine the relationship of birth size and infant growth (2-24 months) with BMI at age 5 years in a multiethnic population. This was a retrospective study (using electronic medical records of a health maintenance organization in Hawaii) of singleton children born in 2004-2005, with linked maternal and birth information, infant weights (n = 597) and lengths (n = 473) in the first 2 years, and BMI measures at age 5 years (n = 894). Multiple regression models were used to estimate the association of BMI at age 5 years with birth size and infant growth. Birth weight was positively associated with BMI at age 5 years, adjusting for gestational age, sex, race/ethnicity, and maternal prepregnancy weight, age, education, and smoking. A greater change in infant weight was associated with a higher BMI at age 5 years, though the effect of birth weight on BMI was neither mediated nor modified by infant growth rate. Birth weight, change in infant weight, and BMI at age 5 years varied by race/ethnicity. Change in infant BMI in the first 2 years was higher in other Pacific Islanders and whites (Δ = 0.966; confidence interval [CI] = 0.249-1.684; p = 0.02) than in Asian, other, and part Native Hawaiian race/ethnic groups. Early biological measures of birth weight and infant weight gain varied by race/ethnicity and positively predicted BMI at age 5 years.

  11. Rickets in very-Iow-birth-weight infants born at Baragwanath Hospital

    African Journals Online (AJOL)

    Abstract Disturbed mineral and bone metabolism has been reported to occur frequently in very-10w-birth- weight infants fed breast-milk during the first 3 months of life. This study was designed to assess the prevalence of disturbed mineral homeostasis in a breast-milk-fed very-Iow-birth-weight popu- lation at Baragwanath ...

  12. Birth Order and Injury-Related Infant Mortality in the U.S.

    Science.gov (United States)

    Ahrens, Katherine A; Rossen, Lauren M; Thoma, Marie E; Warner, Margaret; Simon, Alan E

    2017-10-01

    The purpose of this study was to evaluate the risk of death during the first year of life due to injury, such as unintentional injury and homicide, by birth order in the U.S. Using national birth cohort-linked birth-infant death data (births, 2000-2010; deaths, 2000-2011), risks of infant mortality due to injury in second-, third-, fourth-, and fifth or later-born singleton infants were compared with first-born singleton infants. Risk ratios were estimated using log-binomial models adjusted for maternal age, marital status, race/ethnicity, and education. The statistical analyses were conducted in 2016. Approximately 40%, 32%, 16%, 7%, and 4% of singleton live births were first, second, third, fourth, and fifth or later born, respectively. From 2000 to 2011, a total of 15,866 infants died as a result of injury (approximately 1,442 deaths per year). Compared with first-born infants (2.9 deaths per 10,000 live births), second or later-born infants were at increased risk of infant mortality due to injury (second, 3.6 deaths; third, 4.2 deaths; fourth, 4.8 deaths; fifth or later, 6.4 deaths). The corresponding adjusted risk ratios were as follows: second, 1.84 (95% CI=1.76, 1.91); third, 2.42 (95% CI=2.30, 2.54); fourth, 2.96 (95% CI=2.77, 3.16); and fifth or later, 4.26 (95% CI=3.96, 4.57). Singleton infants born second or later were at increased risk of mortality due to injury during their first year of life in the U.S. This study's findings highlight the importance of investigating underlying mechanisms behind this increased risk. Published by Elsevier Inc.

  13. Fine Motor Development of Low Birth Weight Infants Corrected Aged 8 to 12 Months

    Directory of Open Access Journals (Sweden)

    Sepideh Nazi

    2012-10-01

    Full Text Available Objectives: The aim of this study was to compare the fine motor development between Low Birth Weight (LBW infants and Normal Birth Weight infants (NBW at the age of 8-12 months by using the Peabody Developmental Motor Scale-2 (PDMS-2 . Methods: This was a non experimental and cross sectional study which was conducted on the 18 LBW infants and 14 normal infants. By referring to the profile of infants in NICU of Aliasghar Hospital, those with defined inclusion criteria was recognized (case group. The normal weight infants, randomly selected from Health Center of that hospital, matched with case group for date of birth. After completing the questionnaire about demographic variables, their gross motor development was assessed with PDMS-2. Finally the scores of the motor quotient were analyzed by independent t-test statistical method. Results: There was a significant difference between Fine motor quotient of groups (P=0.007. Discussion: This study showed that LBW infants are significantly lower than normal weight infants in attaining Fine motor skills. It means that the LBW infants are more prone to developmental difficulties.

  14. Device-associated pneumonia of very low birth weight infants in Polish Neonatal Intensive Care Units.

    Science.gov (United States)

    Wójkowska-Mach, Jadwiga; Merritt, T Allen; Borszewska-Kornacka, Maria; Domańska, Joanna; Gulczyńska, Ewa; Nowiczewski, Marek; Helwich, Ewa; Kordek, Agnieszka; Pawlik, Dorota; Adamski, Paweł

    2016-03-01

    Late-Onset Pneumonia (LO-PNEU) is still the most important complication associated with the hospitalization of infants with very low birth weight (PNEU as associated or not associated with respiratory support in the NICU and distribution of causative pathogens from the Polish Neonatology Surveillance Network (PNSN). Surveillance of infections was conducted in the years 2009-2011 at six Polish NICUs. The incidence was 3.1/1000 NICU patient days (pds). The mean gestational age and birth weight among infants with LO-PNEU were significantly lower. The VAP incidence was of 18.2/1000 NICU pds for mechanically ventilated (MV) infants, while the rates for those receiving only CPAP were as low as 7.7/1000 NICU pds. MV significantly increased the risk of PNEU, but MV or CPAP for PNEU. Significantly associated with LO-PNEU was the use of central or peripheral venous catheters and total parenteral nutrition for longer periods. Microorganisms isolated in cases of LO-PNEU were Gram-positive cocci (53.5%) and Gram-negative rods, with predominating E. coli. Non fermentative bacilli were significantly more frequent in cases of VAP than in other cases. Observed incidence rates associated with VAP and CPAP-PNEU, were higher than in other national surveillance systems and expressing the feasibility of lowering the risk of LO-PNEU and increasing patient safety. The incidence of pneumonia was found to be lower when using CPAP as compared to using MV. Copyright © 2015 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  15. Birth Weight of Infants of Mothers With Aggressive Periodontitis

    Science.gov (United States)

    Schenkein, Harvey A.; Koertge, Thomas E.; Sabatini, Robert; Brooks, Carol N.; Gunsolley, John C.

    2014-01-01

    Background It was hypothesized that if periodontal infections predispose low birth weights and premature birth, then such outcomes should be apparent when the mother has aggressive periodontitis (AgP). Methods Birth weight data were collected by questionnaire from females with AgP, their periodontally healthy siblings, and unrelated periodontally healthy women. Both prospective and retrospective birth outcome data were used. Because many of the periodontal evaluations were performed after the births, there were incomplete data regarding most of the risk factors for low birth weight. We determined associations between mothers’ periodontal diagnoses and clinical variables and the reported birth weights. Results There were no significant differences in mean birth weights of babies born to control subjects or AgP patients. This was true whether all the births were considered or only those reported pregnancy outcomes, we used a compromised approach using prospective data as well as weaker retrospective data assuming that disease onset was likely before the births. Our results, within the limitations of this approach, indicate no evidence that AgP in the mother predisposes low birth weights. AgP has many unique biologic characteristics that differentiate it from chronic forms of periodontal disease, and the possible lack of its association with birth weight may be another such characteristic. PMID:21819247

  16. Secular trends in the rate of low birth weight in Brazilian State Capitals in the period 1996 to 2010.

    Science.gov (United States)

    Veloso, Helma Jane Ferreira; Silva, Antônio Augusto Moura da; Barbieri, Marco Antônio; Goldani, Marcelo Zubarán; Lamy Filho, Fernando; Simões, Vanda Maria Ferreira; Batista, Rosângela Fernandes Lucena; Alves, Maria Teresa S S Britto e; Bettiol, Heloísa

    2013-01-01

    Secular trends in rates of low birth weight in Brazilian state capital cities were evaluated for the period 1996 to 2010 using joinpoint regression models. The rates were calculated using data from the Live Births Information System. Newborns weighing less than 500 g were excluded. Only data for capital cities was included since under-registration of births in these cities is lower and new trends can be detected earlier. There was a significant increase in the rate of low birth weight in the Brazilian capitals of the North Region, Northeast Region, South Region and Southeast Region up to 2003/2004, stabilizing thereafter. In the capitals of the Center-west Region the rate increased throughout the whole study period. The rate of low birth weight was higher in the capitals of the more developed regions. The rate of multiple births increased significantly in all Brazilian capitals, while the stillbirth rate decreased and showed a negative correlation with the rate of low birth weight. The increase in the rate of low birth weight may be partially explained by the increase in multiple births, an increase in the birth of infants weighing 500 to 999 g and by the reduction in the stillbirth rate.

  17. The birth rate decline in developing countries.

    Science.gov (United States)

    Robey, B

    1993-01-01

    in countries with few cultural, social or economic barriers. Developing world birth rates have fallen since the 1960s from an average of six children to four in the 1990s, but a replacement level of 2.1 is needed to reach balanced growth.

  18. The role of immunonutrients in the prevention of necrotizing enterocolitis in preterm very low birth weight infants

    DEFF Research Database (Denmark)

    Zhou, Ping; Li, Yanqi; Ma, Li-Ya

    2015-01-01

    Necrotizing enterocolitis (NEC) is a critical intestinal emergency condition, which mainly occurs in preterm very low birth weight (PVLBW) infants. Despite remarkable advances in the care of PVLBW infants, with considerable improvement of the survival rate in recent decades, the incidence of NEC...... and NEC-related mortality have not declined accordingly. The fast progression from nonspecific signs to extensive necrosis also makes primary prevention the first priority. Recently, increasing evidence has indicated the important role of several nutrients in primary prevention of NEC. Therefore, the aim...

  19. Skin blood flow as a predictor of intraventricular hemorrhage in very-low-birth-weight infants.

    Science.gov (United States)

    Ishiguro, Akio; Suzuki, Keiji; Sekine, Takashi; Sudo, Yousuke; Kawasaki, Hidenori; Itoh, Kanako; Kanai, Masayo; Kato, Ineko; Sobajima, Hisanori; Tamura, Masanori

    2014-02-01

    Cardiovascular instability immediately after birth is associated with intraventricular hemorrhage (IVH) in very-low-birth-weight (VLBW) infants. For circulatory management, evaluation of organ blood flow is important. In this study, the relationship between peripheral perfusion within 48 h after birth and IVH was evaluated in VLBW infants. In this prospective observational study involving 83 VLBW infants, forehead blood flow (FBF) and lower-limb blood flow (LBF) were measured for 48 h after birth using a laser Doppler flowmeter. Blood flow was compared between infants with and without IVH. Multivariate logistic regression analysis was performed to identify the risk factors for IVH. IVH developed in nine infants. In eight of these patients, IVH occurred after 24 h. LBF was lower in infants with IVH at 18 and 24 h and increased to the same level as that of infants without IVH at 48 h. Multivariate logistic regression analysis identified a correlation only between LBF and IVH at 18 h. These findings were consistent with the hypoperfusion-reperfusion theory, which states that IVH develops after reperfusion subsequent to hypoperfusion. We speculate that measurement of skin blood flow in addition to systemic and cerebral circulation may be helpful in predicting IVH.

  20. A lower limit for the birth rate of pulsars

    International Nuclear Information System (INIS)

    Narayan, R.; Vivekanand, M.

    1981-01-01

    Using experimental data on observed pulsars, a lower limit for the birth rate of pulsars in our galaxy was estimated, taking into account the beam factor which allows for the possibility that only a fraction of all pulsars is beamed towards the earth. The calculation reduces the discrepancy between pulsar and supernova birth rates. (U.K.)

  1. Catch up growth in low birth weight infants: striking a healthy balance.

    Science.gov (United States)

    Jain, Vandana; Singhal, Atul

    2012-06-01

    Catch-up growth in the first few months of life is seen almost ubiquitously in infants born small for their gestational age and conventionally considered highly desirable as it erases the growth deficit. However, recently such growth has been linked to an increased risk of later adiposity, insulin resistance and cardiovascular disease in both low income and high-income countries. In India, a third of all babies are born with a low birth weight, but the optimal growth pattern for such infants is uncertain. As a response to the high rates of infectious morbidities, undernutrition and stunting in children, the current policy is to promote rapid growth in infancy. However, with socio-economic transition and urbanization making the Indian environment more obesogenic, and the increasing prevalence of type 2 diabetes and cardiovascular disease, affecting progressively younger population, the long term adverse programming effect of fast/excessive weight gain in infancy on later body composition and metabolism may outweigh short-term benefits. This review discusses the above issues focusing on the need to strike a healthy balance between the risks and benefits of catch-up growth in Indian infants.

  2. Using the Alberta Infant Motor Scale to early identify very low-birth-weight infants with cystic periventricular leukomalacia.

    Science.gov (United States)

    Wang, Lin-Yu; Wang, Yu-Lin; Wang, Shan-Tair; Huang, Chao-Ching

    2013-01-01

    We examined whether the Alberta Infant Motor Scale (AIMS) is able to identify very low-birth-weight (VLBW) preterm infants with cystic periventricular leukomalacia (PVL) as early as 6 months of corrected age. Longitudinal follow-up AIMS assessments were done at 6, 12, and 18 months old for 35 VLBW infants with cystic PVL (cPVL(+)), 70 VLBW infants without cystic PVL (cPVL(-)), and 76 term infants (healthy controls: HC). Corrected age was used for the preterm infants. The cPVL(+) group had significantly lower prone, supine and sitting subscales at age 6, 12, and 18 months than the cPVL(-) group (all p<0.05). The cPVL(-) group showed significantly lower supine, prone, sitting, and standing subscales than the HC group only at age 6 months. At age 6 months, the areas under the receiver operator curve used to discriminate the cPVL(+) infants from cPVL(-) infants were 0.82±0.04 for prone, 0.93±0.02 for supine, 0.83±0.05 for sitting, and 0.62±0.07 for standing. The AIMS may help early identify VLBW infants with cystic PVL at age 6 months old. Copyright © 2011 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  3. Vitamin A supplementation in extremely low-birth-weight infants: subgroup analysis in small-for-gestational-age infants.

    Science.gov (United States)

    Londhe, Vedang A; Nolen, Tracy L; Das, Abhik; Higgins, Rosemary D; Tyson, Jon E; Oh, William; Devaskar, Sherin U

    2013-10-01

    Preterm infants with intrauterine growth restriction are at increased risk of respiratory distress syndrome and bronchopulmonary dysplasia (BPD). A randomized clinical trial by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network demonstrated that vitamin A supplementation in extremely low-birth-weight (ELBW) preterm infants requiring early respiratory support decreased the risk of developing BPD. A subgroup analysis of small-for-gestational-age (SGA) infants from the original NICHD trial was performed to test the hypothesis that in infants requiring early respiratory support, vitamin A supplementation decreases the relative risk of BPD or death in premature SGA infants to a greater extent than in gestational age-equivalent vitamin A-treated appropriate-for-gestational-age (AGA) infants. Although vitamin A supplementation significantly increased serum retinol concentrations in AGA ELBW infants (median [5th percentile, 95th percentile]: 16.3 [-7.0, 68.8] versus 2.4 [-13.9, 55.1]; p supplementation in preterm SGA infants requiring early respiratory support decreases the relative risk of BPD or death as compared with preterm AGA infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Neonatal outcomes of preterm infants in breech presentation according to mode of birth in Canadian NICUs.

    Science.gov (United States)

    Lodha, Abhay; Zhu, Qiaohao; Lee, Shoo K; Shah, Prakesh S

    2011-03-01

    Many medical practitioners have adopted the practice of caesarean section for preterm infants in breech presentation based on term infant data. Some studies have highlighted deleterious effects on survival, such as intraventricular haemorrhage and periventricular leucomalacia, while others have reported no difference from the outcomes after vaginal delivery. To compare outcomes of preterm infants of ≤32 weeks' gestational age who were in breech position at the time of birth according to mode of birth in Canadian neonatal intensive care units (NICUs). 29 Canadian NICUs. Neonates admitted to participating NICUs in the Canadian Neonatal Network between 2003 and 2007 were included in this retrospective study. Infants who were in breech position at the time of birth were divided into two groups: vaginal birth (VB) and caesarean section (CS). Data on common neonatal outcomes were compared using univariate and multivariate logistic regression. Neonatal mortality and other neonatal morbidities. Of 3552 preterm infants in breech position at birth, 2937 (83%) were delivered by CS and 615 (17%) by VB. Multivariate regression analysis with adjustment for perinatal risk factors indicated that VB was associated with an increased risk of death (OR 1.7; 95% CI 1.3 to 2.3), chronic lung disease (OR 1.5; 95% CI 1.1 to 1.9) and severe retinopathy of prematurity (OR 1.6; 95% CI 1.1 to 2.3). Vaginal birth for preterm infants in breech presentation is possibly associated with a higher risk of adverse neonatal outcomes compared with caesarean birth in Canadian NICUs. It is not clear whether adverse outcomes are due to the mode of delivery or whether breech birth is associated with other risk factors, an issue that can only be resolved by a randomised controlled trial.

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

    Science.gov (United States)

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

    2014-04-24

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

  6. Birth weight of infants of mothers with aggressive periodontitis.

    Science.gov (United States)

    Schenkein, Harvey A; Koertge, Thomas E; Sabatini, Robert; Brooks, Carol N; Gunsolley, John C

    2012-03-01

    It was hypothesized that if periodontal infections predispose low birth weights and premature birth, then such outcomes should be apparent when the mother has aggressive periodontitis (AgP). Birth weight data were collected by questionnaire from females with AgP, their periodontally healthy siblings, and unrelated periodontally healthy women. Both prospective and retrospective birth outcome data were used. Because many of the periodontal evaluations were performed after the births, there were incomplete data regarding most of the risk factors for low birth weight. We determined associations between mothers' periodontal diagnoses and clinical variables and the reported birth weights. There were no significant differences in mean birth weights of babies born to control subjects or AgP patients. This was true whether all the births were considered or only those reported periodontal examination. For periodontally healthy controls, 13.2% of babies born to siblings of AgP patients and 12.8% of babies born to unrelated mothers weighed characteristics that differentiate it from chronic forms of periodontal disease, and the possible lack of its association with birth weight may be another such characteristic.

  7. Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocolitis in Very Low-Birth-Weight Infants.

    Science.gov (United States)

    Patel, Ravi M; Knezevic, Andrea; Shenvi, Neeta; Hinkes, Michael; Keene, Sarah; Roback, John D; Easley, Kirk A; Josephson, Cassandra D

    2016-03-01

    Data regarding the contribution of red blood cell (RBC) transfusion and anemia to necrotizing enterocolitis (NEC) are conflicting. These associations have not been prospectively evaluated, accounting for repeated, time-varying exposures. To determine the relationship between RBC transfusion, severe anemia, and NEC. In a secondary, prospective, multicenter observational cohort study from January 2010 to February 2014, very low-birth-weight (VLBW, ≤1500 g) infants, within 5 days of birth, were enrolled at 3 level III neonatal intensive care units in Atlanta, Georgia. Two hospitals were academically affiliated and 1 was a community hospital. Infants received follow-up until 90 days, hospital discharge, transfer to a non-study-affiliated hospital, or death (whichever came first). Multivariable competing-risks Cox regression was used, including adjustment for birth weight, center, breastfeeding, illness severity, and duration of initial antibiotic treatment, to evaluate the association between RBC transfusion, severe anemia, and NEC. The primary exposure was RBC transfusion. The secondary exposure was severe anemia, defined a priori as a hemoglobin level of 8 g/dL or less. Both exposures were evaluated as time-varying covariates at weekly intervals. Necrotizing enterocolitis, defined as Bell stage 2 or greater by preplanned adjudication. Mortality was evaluated as a competing risk. Of 600 VLBW infants enrolled, 598 were evaluated. Forty-four (7.4%) infants developed NEC. Thirty-two (5.4%) infants died (all cause). Fifty-three percent of infants (319) received a total of 1430 RBC transfusion exposures. The unadjusted cumulative incidence of NEC at week 8 among RBC transfusion-exposed infants was 9.9% (95% CI, 6.9%-14.2%) vs 4.6% (95% CI, 2.6%-8.0%) among those who were unexposed. In multivariable analysis, RBC transfusion in a given week was not significantly related to the rate of NEC (adjusted cause-specific hazard ratio, 0.44 [95% CI, 0.17-1.12]; P = .09). Based

  8. NCHS - Births and General Fertility Rates: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes crude birth rates and general fertility rates in the United States since 1909. The number of states in the reporting area differ historically....

  9. Vertical and horizontal transmission of Candida albicans in very low birth weight infants using DNA fingerprinting techniques.

    Science.gov (United States)

    Bliss, Joseph M; Basavegowda, Kumar P; Watson, Wendy J; Sheikh, Asad U; Ryan, Rita M

    2008-03-01

    Very low birth weight infants (VLBW, point, only 41% (11/27) became colonized by vertical transmission. Both vertical and horizontal transmission contribute to Candida colonization of VLBW infants in the neonatal intensive care unit.

  10. Timing of Prenatal Smoking Cessation or Reduction and Infant Birth Weight: Evidence from the United Kingdom Millennium Cohort Study

    OpenAIRE

    Ji Yan; Peter A. Groothuis

    2013-01-01

    Objectives: Smoking during pregnancy is a key preventable risk contributor to poor infant health. Our study presents a full dynamic relationship between the timing of prenatal smoking cessation or reduction and infant birth weight. Methods: Using a large representative dataset of birth cohort in the United Kingdom, we apply multiple linear regressions to examine how smoking cessation or reduction at different stages especially different months of pregnancy affects infant birth weight. For rob...

  11. Association between early postnatal weight loss and death or BPD in small and appropriate for gestational age extremely low-birth-weight infants.

    Science.gov (United States)

    Wadhawan, R; Oh, W; Perritt, R; Laptook, A R; Poole, K; Wright, L L; Fanaroff, A A; Duara, S; Stoll, B J; Goldberg, R

    2007-06-01

    To examine the association between weight loss during the first 10 days of life and the incidence of death or bronchopulmonary dysplasia (BPD) in small for gestational age (SGA) and appropriate for gestational age (AGA) extremely low-birth-weight infants. This is a retrospective analysis of a cohort of ELBW (birth weight BPD, within each birth weight/gestation category (SGA or AGA). BPD and death were also analyzed separately in relation to EPWL. Logistic regression analysis was done to evaluate the risk of death or BPD in SGA and AGA groups, controlling for maternal and neonatal demographic and clinical factors found to be significant by univariate analysis. SGA ELBW infants had a lower prevalence of EPWL as compared with AGA ELBW infants (81.2 vs 93.7%, respectively, PBPD rate was lower in the group of infants with EPWL compared with infants without EPWL (53.4 vs 74.3%, respectively, PBPD (47.2 vs 64%, PBPD (OR 0.47, 95% CI: 0.37-0.60). In SGA infants, on univariate analysis, a similar association between EPWL and outcomes was seen as shown in AGA infants: death or BPD (55.9 vs 75.2%, PBPD rate (48.3 vs 62.1%, P=0.002) and rate death (19 vs 40.8%, PBPD (OR 0.60, 95% CI: 0.41-0.89) among SGA infants. SGA infants experienced less EPWL when compared with their AGA counterparts. EPWL was associated with a lower risk of death or BPD in both ELBW AGA and SGA infants. These data suggest that clinicians who consider the association between EPWL and risk of death or BPD should do so independent of gestation/birth weight status.

  12. Thymic size at birth in preterm infants with severe respiratory ...

    African Journals Online (AJOL)

    decreases radiological thymic size in infants,3 there has been some debate about whether low-dose antenatal exogenous steroids given to the mother has a thymolytic effect on thymic size.5,9,11,12 We undertook to investigate whether thymic size in infants diagnosed with RDS is related to survival. In addition,.

  13. The association between parity, infant gender, higher level of paternal education and preterm birth in Pakistan: a cohort study

    Directory of Open Access Journals (Sweden)

    Shaikh Kiran

    2011-11-01

    Full Text Available Abstract Background High rates of antenatal depression and preterm birth have been reported in Pakistan. Self reported maternal stress and depression have been associated with preterm birth; however findings are inconsistent. Cortisol is a biological marker of stress and depression, and its measurement may assist in understanding the influence of self reported maternal stress and depression on preterm birth. Methods In a prospective cohort study pregnant women between 28 to 30 weeks of gestation from the Aga Khan Hospital for Women and Children completed the A-Z Stress Scale and the Centre for Epidemiology Studies Depression Scale to assess stress and depression respectively, and had a blood cortisol level drawn. Women were followed up after delivery to determine birth outcomes. Correlation coefficients and Wilcoxon rank sum test was used to assess relationship between preterm birth, stress, depression and cortisol. Logistic regression analysis was used to determine the key factors predictive of preterm birth. Results 132 pregnant women participated of whom 125 pregnant women had both questionnaire and cortisol level data and an additional seven had questionnaire data only. Almost 20% of pregnant women (19·7%, 95% CI 13·3-27·5 experienced a high level of stress and nearly twice as many (40·9%, 95% CI 32·4-49·8% experienced depressive symptoms. The median of cortisol level was 27·40 ug/dl (IQR 22·5-34·2. The preterm birth rate was 11·4% (95% CI 6·5-18. There was no relationship between cortisol values and stress scale or depression. There was a significant positive relationship between maternal depression and stress. Preterm birth was associated with higher parity, past delivery of a male infant, and higher levels of paternal education. Insufficient numbers of preterm births were available to warrant the development of a multivariable logistic regression model. Conclusions Preterm birth was associated with higher parity, past delivery

  14. Teamwork in the NICU setting and its association with healthcare-associated infections in very low birth weight infants

    Science.gov (United States)

    Profit, Jochen; Sharek, Paul J.; Kan, Peiyi; Rigdon, Joseph; Desai, Manisha; Nisbet, Courtney C.; Tawfik, Daniel S.; Thomas, Eric J.; Lee, Henry C.; Sexton, J. Bryan

    2018-01-01

    Background and Objective Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale level and item level associations with healthcare-associated infection (HAI) rates in very low birth weight (VLBW) infants. Methods Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2073 of 3294 eligible (response rate 63%) NICU health professionals. The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (OR [95% CI] 0.82 [0.73-0.92], p = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion Improving teamwork may be an important element in infection control efforts. PMID:28395366

  15. Fosfluconazole for Antifungal Prophylaxis in Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Daijiro Takahashi

    2009-01-01

    Full Text Available We conducted a retrospective case series study to evaluate the safety of fosfluconazole prophylaxis for preventing invasive fungal infection in VLBW infants with a central vascular access. Fosfluconazole was administered intravenously at a dose of 6 mg/kg everyday during which time a central venous catheter was placed. A total of 23 infants met the criteria for enrollment in our study. No cases of fungal infection were detected during the central venous catheter placement in the group. None of the infants had an elevated β-D-glucan, and all of them were still alive at discharge. Regarding the liver and renal function, no statistically significant differences were observed before and at the end of fosfluconazole prophylaxis. The results of this study demonstrate that fosfluconazole prophylaxis in preventing invasive fungal infection was well tolerated by VLBW infants. This is a first report to describe antifungal prophylaxis using fosfluconazole for VLBW infants.

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

    Science.gov (United States)

    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.

  17. Impact of Prolonged Mechanical Ventilation in Very Low Birth Weight Infants: Results From a National Cohort Study.

    Science.gov (United States)

    Choi, Young-Bin; Lee, Juyoung; Park, Jisun; Jun, Yong Hoon

    2018-03-01

    To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less. The individual mortality rate increased after 8 weeks, reaching 50% and 60% at 14 and 16 weeks of cumulative mechanical ventilation, respectively. After adjusting for potential confounders, the cumulative duration of mechanical ventilation was associated with a clinically significant increase in the odds of bronchopulmonary dysplasia and pulmonary hypertension. Mechanical ventilation exposure for longer than 2 weeks, compared with 7 days or less, was associated with retinopathy of prematurity requiring laser coagulation and periventricular leukomalacia. The odds of abnormal auditory screening test results were significantly increased in infants who needed mechanical ventilation for more than 4 weeks. A longer cumulative duration of mechanical ventilation was associated with increased lengths of hospitalization and parenteral nutrition and a higher probability of discharge with poor achievement of physical growth. Although mechanical ventilation is a life-saving intervention for premature infants, these results indicate that it is associated with negative consequences when applied for prolonged periods. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Postpartum anxiety and adjustment disorders in parents of infants with very low birth weight: Cross-sectional results from a controlled multicentre cohort study.

    Science.gov (United States)

    Helle, Nadine; Barkmann, Claus; Ehrhardt, Stephan; von der Wense, Axel; Nestoriuc, Yvonne; Bindt, Carola

    2016-04-01

    Both preterm delivery and survival rates of very low birth weight (VLBW: anxiety in parents after VLBW birth. Parents with VLBW infants and parents with term infants were recruited into the longitudinal HaFEn-study at the three largest centers of perinatal care in Hamburg, Germany. State anxiety was assessed with the State-Trait-Anxiety Inventory and anxiety and adjustment disorders with a clinical interview one month postpartum. Psychiatric lifetime diagnoses, social support, trait anxiety, stress during birth, socioeconomic status, risks during pregnancy, and mode of delivery were also evaluated. To examine predictors of postpartum state anxiety in both parents simultaneously a multiple random coefficient model was used. 230 mothers and 173 fathers were included. The risk for minor/major anxiety symptoms and adjustment disorders was higher in parents with VLBW infants compared to the term group. The risk for anxiety disorders was not higher in parents with VLBW infants. The most important predictors for postpartum state anxiety were high trait anxiety, the birth of a VLBW infant, high stress during birth, and low social support. Data reported here are cross-sectional. Thus, temporal relationships cannot be established. Our results emphasize the importance of early screening for postpartum anxiety in both parents with VLBW infants. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Survival of very-low-birth-weight infants according to birth weight ...

    African Journals Online (AJOL)

    Conclusion. Survival among infants weighing less than 1 000 g is poor. In addition to severe prematurity, the poor survival among these infants(< 1 000 g) is most likely related to the fact that they were not offered mechanical ventilation. Mechanical ventilation should be offered to infants weighing < 1 000 g as it may improve ...

  20. Maternal Anemia during pregnancy and infant low birth weight: A systematic review and Meta-analysis.

    Science.gov (United States)

    Rahmati, Shoboo; Delpishe, Ali; Azami, Milad; Hafezi Ahmadi, Mohammed Reza; Sayehmiri, Kurosh

    2017-03-01

    Infant low birth weight is one of the major problems in different societies. Different reports have provided different results regarding the relationship between maternal anemia and infant low birth weight in different months of pregnancy. The aim of this study was to determine the relationship between maternal anemia during pregnancy and infant low birth weight. This systematic review was conducted using related keywords in national (Sid, Iran.doc, Iran medex and Magiran) and international (PubMed, Science Direct, Cochrane, Medline, Web of Science, Scopus, Springer, Embase, Google scholar) databases. Relative risks and confidence intervals were extracted from each study. The results were combined using random-effects model for meta-analysis. The I 2 index was also used to measure heterogeneity between the studies. Overall, 17 studies with a total sample size of 245407 entered the final meta-analysis and demonstrated that the relative risk for maternal anemia in the first, second and third trimester of pregnancy were 1.26 (95% CI: 1.03-1.55), 0.97 (95% CI: 0.57-1.65), and 1.21 (95% CI: 0.84-1.76), respectively. The relationship between maternal anemia and infant low birth weight in the first trimester of pregnancy was significant. Maternal anemia, especially during the first trimester of pregnancy, can be considered as a risk factor for pregnancy outcomes. Therefore, one needs to take the necessary steps to cure this disease in order to reduce the incidence of infant low birth weight.

  1. Initial Resuscitation at Delivery and Short Term Neonatal Outcomes in Very-Low-Birth-Weight Infants.

    Science.gov (United States)

    Cho, Su Jin; Shin, Jeonghee; Namgung, Ran

    2015-10-01

    Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birth, chest compression was performed on only 104 infants (5.4%) and epinephrine was administered to 80 infants (4.1%). Infants who received cardiac compression and/or epinephrine administration at birth (DR-CPR) were significantly more acidotic (P CPR resulted in greater early mortality of less than 7 days (OR, 5.64; 95% CI 3.25-9.77) increased intraventricular hemorrhage ≥ grade 3 (OR, 2.71; 95% CI 1.57-4.68), periventricular leukomalacia (OR, 2.94; 95% CI 1.72-5.01), and necrotizing enterocolitis (OR, 2.12; 95% CI 1.15-3.91) compared with those infants who needed only PPV. Meticulous and aggressive management of infants who needed DR-CPR at birth and quality improvement of the delivery room management will result in reduced morbidities and early death for the vulnerable VLBWI.

  2. Clinical Outcome of Cytomegalovirus Infection on Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Ali Usman

    2014-09-01

    Full Text Available Abstract Cytomegalovirus (CMV is a DNA virus and a marker of the herpes virus groups. This virus was found only in human and the infection occurs for a long time. The transmission of CMV infection to fetus/neonates is via congenital infections or perinatal infections. Clinical manifestation of symptomatic CMV infection of the fetus has two presentations, early and second early manifestations. Diagnosis of neonatal CMV infection may be done by serologic test based on detection of IgM of CMV infection. The objective of this study is to asses clinical outcome of CMV infection of low birth weight infants delivery with long term sequelae. An observational study was conducted since March 2010 until December 2011 in Advent and Hermina Pasteur Hospital, all subjects were low birth weight infants (LBWI. The inclusion criterias are all LBWI who were delivered in those hospital or were a referred neonates. The exclusion criterias are major congenital defect, which is not related to congenital CMV infection and neonates’ death before one week of life. Every neonate was examine both their physical and peripher blood count, glucose, Ca. Liver function test done for neonates with acute hepatitis and titre IgG and IgM CMV serial, head ultrasound serial and head CT scan/MRI used for babies with intracranial bleeding and hydrocephaly.  During the period of this study there were 50 cases of LBWI, consisted of 41 preterm babies, and 30 small for gestational age babies. Clinical manifestation of acute hepatitis were found in 20% subjects, all of them with the  elevation of liver function test. Microcephaly which occured in the first untill three weeks of life were 8%. Ventricular dilatation were 10% in the first week of life and increased up to 48% after three weeks. Cases with intracranial haemorrhage were found in 6% and 10% with cerebral calcification on head while sensorineural hearing loss were 8%. All of LBWI have 100% serorespon immune IgG. IgM CMV

  3. Efficacy of Six-Week Extended-Dose Nevirapine Varies by Infant Birth Weight with Greatest Relative Efficacy in Low Birth Weight Infants.

    Directory of Open Access Journals (Sweden)

    Nikhil Gupte

    Full Text Available Latest World Health Organization guidelines recommend weight-based nevirapine prophylaxis for all HIV-exposed infants in resource-limited settings, yet low birth weight (LBW infants (2000 g and ≤ 2500 g, and normal birth weight (NBW > 2500 g. Outcomes were HIV-1 infection, HIV-1 infection or death by 12 months, and severe adverse events (SAEs. The Kaplan-Meier method was used to estimate probability of efficacy outcomes in birth weight groups, and differential effects of SWEN by birth weight group were examined using Cox proportional hazards models adjusting for independent risk factors for HIV maternal-to-child transmission and significant covariates. Among 50 VLBW, 249 MLBW, and 433 NBW infants, 50% were randomized to SWEN; median gestational age was 36, 38 and 38 weeks, respectively; and there was no difference in breastfeeding duration (p = 0.99. Compared to SD: SWEN-treated VLBW had lower estimates of HIV-1 infection (13% vs. 38%, p = 0.004 and HIV-1 infection or death (13% vs. 41%, p = 0.002; SWEN-treated MLBW had lower estimated HIV-1 infection (13% vs. 17%, p = 0.042; and efficacy endpoints were similar by treatment arm in NBW. In multivariate analysis, SWEN was associated with reduced risk of HIV-1 infection or death by 83% (p = 0.03 in VLBW versus 45% (p = 0.05 in MLBW. SAE frequency was similar by treatment arm in VLBW (68% vs. 76%, p = 0.53 and MLBW (37% vs. 36%, p = 0.93. SWEN may safely increase HIV-free survival among HIV-exposed LBW infants with greatest protective advantage among infants ≤ 2000 g.

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

    Science.gov (United States)

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

    2016-04-01

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

  5. High infant mortality rate, high total fertility rate and very low female literacy in selected African countries.

    Science.gov (United States)

    Susuman, A Sathiya; Chialepeh, Wilson N; Bado, Aristide; Lailulo, Yishak

    2016-02-01

    This study focused on the top 10 selected African countries with key interventions such as high infant mortality rate, high total fertility rate and female literacy rate. The World Bank's 2013 data were used. Descriptive analyses were performed. Findings show that Sierra Leone (107.2), Angola (102) and Central Africa Republic (96.1) reported the highest infant mortality rate per 1000 live births. The total fertility rates in Niger (7.6), Mali (6.8) and Somalia (6.6) were higher than other comparable countries. Health care service providers need to pay more attention during pregnancy periods, improve number of field visits, identify pregnant women and promote 100% antenatal care if this is done practically, these countries will reduce and ultimately eliminate infant mortality. © 2015 the Nordic Societies of Public Health.

  6. Reduction of preterm birth rates starts at preconception

    NARCIS (Netherlands)

    Oudijk, M. A.

    2017-01-01

    Obesity, in the absence of other chronic disease, is associated with preterm birth (PTB) according to the article by Kim et al. Perhaps their most interesting finding is that obesity is positively associated in nulliparous women with extremely PTB rates (birth at < 28 weeks of gestation), both

  7. Second-birth rates in Denmark from 1980 to 1994

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Katrine; Knudsen, Lisbeth B.; Thygesen, Lau Caspar

    2010-01-01

    A statistical age-period-cohort model was used to depict second-time birth rates and the spacing between the first and second child in Denmark, including 524,316 one-child mothers who gave birth to 296,923 second children 1980-1994. The spacing between the first and second child varies according...

  8. Mortality and Length of Stay of Very Low Birth Weight and Very Preterm Infants: A EuroHOPE Study.

    Directory of Open Access Journals (Sweden)

    Dino Numerato

    Full Text Available The objective of this paper was to compare health outcomes and hospital care use of very low birth weight (VLBW, and very preterm (VLGA infants in seven European countries. Analysis was performed on linkable patient-level registry data from seven European countries between 2006 and 2008 (Finland, Hungary, Italy (the Province of Rome, the Netherlands, Norway, Scotland, and Sweden. Mortality and length of stay (LoS were adjusted for differences in gestational age (GA, sex, intrauterine growth, Apgar score at five minutes, parity and multiple births. The analysis included 16,087 infants. Both the 30-day and one-year adjusted mortality rates were lowest in the Nordic countries (Finland, Sweden and Norway and Scotland and highest in Hungary and the Netherlands. For survivors, the adjusted average LoS during the first year of life ranged from 56 days in the Netherlands and Scotland to 81 days in Hungary. There were large differences between European countries in mortality rates and LoS in VLBW and VLGA infants. Substantial data linkage problems were observed in most countries due to inadequate identification procedures at birth, which limit data validity and should be addressed by policy makers across Europe.

  9. Changing Survival Rate of Infants Born Before 26 Gestational Weeks; Single-centre study

    Directory of Open Access Journals (Sweden)

    Asad Rahman

    2015-08-01

    Full Text Available Objectives: This study aimed to evaluate the changing survival rate and morbidities among infants born before 26 gestational weeks at the Sultan Qaboos University Hospital (SQUH in Muscat, Oman. Methods: This retrospective study assessed the mortality and morbidities of all premature infants born alive at 23–26 gestational weeks at SQUH between June 2006 and May 2013. Infants referred to SQUH within 72 hours of birth during this period were also included. Electronic records were reviewed for gestational age, gender, birth weight, maternal age, mode and place of delivery, antenatal steroid administration, morbidity and outcome. The survival rate was calculated and findings were then compared with those of a previous study conducted in the same hospital from 1991 to 1998. Rates of major morbidities were also calculated. Results: A total of 81 infants between 23–26 gestational weeks were admitted to the neonatal unit during the study period. Of these, 58.0% were male and 42.0% were female. Median gestational age was 25 weeks and mean birth weight was 770 ± 150 g. Of the 81 infants, 49 survived. The overall survival rate was 60.5% compared to 41% reported in the previous study. Respiratory distress syndrome (100.0%, retinopathy of prematurity (51.9%, bronchopulmonary dysplasia (34.6%, intraventricular haemorrhage (30.9% and patent ductus arteriosus (28.4% were the most common morbidities. Conclusion: The overall survival rate of infants between 23–26 gestational weeks during the study period had significantly improved in comparison to that found at the same hospital from 1991 to 1998. There is a need for the long-term neurodevelopmental follow-up of premature infants.

  10. Benefits of iron supplementation for low birth weight infants: a systematic review.

    Science.gov (United States)

    Long, Hui; Yi, Jing-Mei; Hu, Pei-Li; Li, Zhi-Bin; Qiu, Wei-Ya; Wang, Fang; Zhu, Sing

    2012-07-16

    A number of studies have reported on the effects of iron supplementation in low birth weight infants; however, no systematic review of the available evidence has been conducted to date. Hence, we performed a systematic review of the literature to examine the effects of iron supplementation on hematologic iron status, growth, neurodevelopment, and adverse effects in low birth weight/premature infants. We searched the Cochrane Library, Medline, and PubMed for articles reporting on the effects of iron supplementation in low weight infants. The following search terms were used: "preterm born infant(s)/children"; "preterm infants"; "prematurely born children" "weight less than 1500 g at birth"; "born prematurely"; "low birth weight infant(s)"; "infants born preterm"; "prematurity"; "small-for-gestational age"; "very small gestational age infants"; "iron supplementation"; "iron intake"; "iron supplements"; "ferric and/or ferrous compounds"; and "ferrous sulphate/fumarate/sulfate". A total of 15 studies were identified and included in the systematic review. Supplemental iron was given orally or as an iron-fortified formula in 14/15 studies. The duration of treatment ranged from 1 week to 18 months. Iron supplementation significantly increased hematologic measures of iron status (including hemoglobin, hematocrit, serum ferritin) relative to placebo or over time in most studies. All controlled studies that examined iron-deficiency anemia (IDA)/ID reported a decreased prevalence of IDA/ID with iron supplementation. Dose dependent decreases in the prevalence of IDA/ID were reported in several studies. Of the 5 studies reporting on growth, none found any significant effect on growth-related parameters (length, height, weight, and head circumference). Only 2 studies reported on neurodevelopment; no marked effects were reported. There were no consistently reported adverse effects, including oxidative stress, inhibited nutrient absorption, morbidity, or the requirement for blood

  11. Exchange-Driven Growth with Birth Rate Less Than Death

    International Nuclear Information System (INIS)

    Lin Zhenquan; Ye Gaoxiang; Ke Jianhong

    2005-01-01

    We further study the kinetic behavior of the exchange-driven growth with birth and death for the case of birth rate kernel being less than that of death based on the mean-field theory. The symmetric exchange rate kernel is K(k,j) = K'(k,j) = Ikj υ , and the birth and death rates are proportional to the aggregate's size. The long time asymptotic behavior of the aggregate size distribution a k (t) is found to obey a much unusual scaling law with an exponentially growing scaling function Φ(x) = exp (x).

  12. Mask versus Nasal Tube for Stabilization of Preterm Infants at Birth: Respiratory Function Measurements.

    Science.gov (United States)

    van Vonderen, Jeroen J; Kamlin, C Omar; Dawson, Jennifer A; Walther, Frans J; Davis, Peter G; te Pas, Arjan B

    2015-07-01

    To compare the nasal tube with face mask as interfaces for stabilization of very preterm infants at birth by using physiological measurements of leak, obstruction, and expired tidal volumes during positive pressure ventilation (PPV). In the delivery room, 43 infants mask. Respiratory function, heart rate, and oxygen saturation were measured. Occurrence of obstruction, amount of leak, and tidal volumes were compared using a Mann-Whitney U test or a Fisher exact test. The first 5 minutes after initiation of PPV were analyzed (1566 inflations in the nasal tube group and 1896 inflations in the face mask group). Spontaneous breathing coincided with PPV in 32% of nasal tube and 34% of face mask inflations. During inflations, higher leak was observed using nasal tube compared with face mask (98% [33%-100%] vs 14 [0%-39%]; P mask (0.0 [0.0-3.1] vs 9.9 [5.5-12.8] mL/kg; P 0.05). Heart rate was not significantly different between groups, but oxygen saturation was significantly lower in the nasal tube group the first 2 minutes after start of respiratory support. The use of a nasal tube led to large leak, more obstruction, and inadequate tidal volumes compared with face mask. Trial registration Registered with the Dutch Trial Registry (NTR 2061) and the Australia and New Zealand Clinical Trials Register (ACTRN 12610000230055). Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Effect of Concomitant Birth Defects and Genetic Anomalies on Infant Mortality in Tetralogy of Fallot.

    Science.gov (United States)

    Jernigan, Eric G; Strassle, Paula D; Stebbins, Rebecca C; Meyer, Robert E; Nelson, Jennifer S

    2017-08-15

    A substantial proportion of infants born with tetralogy of Fallot (TOF) die in infancy. A better understanding of the heterogeneity associated with TOF, including extracardiac malformations and chromosomal anomalies is vital to stratifying risk and optimizing outcomes during infancy. Using the North Carolina Birth Defects Monitoring Program, infants diagnosed with TOF and born between 2003 and 2012 were included. Kaplan-Meier survival curves were used to estimate cumulative 1-year mortality, stratified by the presence of concomitant birth defects (BDs) and chromosomal anomalies. Multivariable logistic regression was used to estimate the direct effect of each concomitant BD, after adjusting for all others. A total of 496 infants with TOF were included, and 15% (n = 76) died. The number of concomitant BD systems was significantly associated with the risk of death at 1-year, p < 0.0001. Specifically, the risk of mortality was 8% among infants with TOF with or without additional cardiac defects, 16% among infants with TOF and 1 extracardiac BD system, 19% among infants with 2 extracardiac BD systems, and 39% among infants with ≥ 3 extracardiac BD systems. After adjustment, concomitant eye and gastrointestinal defects were significantly associated increased with 1-year mortality, odds ratio 2.83 (95% confidence interval, 1.08-7.32) and odds ratio 4.43 (95% confidence interval, 1.57, 12.45), respectively. Infants with trisomy 13 or trisomy 18 were also significantly more likely to die, p < 0.0001. Both concomitant BDs and genetic anomalies increase the risk of mortality among infants with TOF. Future studies are needed to identify the underlying genetic and socioeconomic risk factors for high-risk TOF infants. Birth Defects Research 109:1154-1165, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Miller, Michael D.; Ottinger, Donald R.

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

  15. Human-Based Human Milk Fortifier as Rescue Therapy in Very Low Birth Weight Infants Demonstrating Intolerance to Bovine-Based Human Milk Fortifier.

    Science.gov (United States)

    Sandhu, Amanjot; Fast, Sharla; Bonnar, Kari; Baier, Ronald John; Narvey, Michael

    2017-11-01

    To describe the results of utilizing a human milk-based human milk fortifier (HMHMF) as rescue therapy to meet nutritional requirements in very low birth weight and preterm infants demonstrating feeding intolerance to bovine-based human milk fortifier (BHMF) in the Canadian Neonatal Intensive Care Unit (NICU) setting. At two Level III NICUs in Winnipeg, MB, Canada, a rescue protocol was implemented to provide HMHMF for infants demonstrating intolerance to BHMF. To qualify for rescue, infants were required to experience two episodes of significant gastrointestinal (GI) symptoms associated with fortification with BHMF. A case series report was conducted retrospectively examining the success of rescue therapy, growth rates, protein, and calorie intakes before and after initiation of HMHMF in seven infants. Seven infants (birth weight 723 ± 247 g, gestation 25.3 ± 3.4 weeks) were treated with rescue fortification with HMHMF. All infants were transitioned off parenteral nutrition (PN) without relapse of GI symptoms. Growth rate, protein, and calorie intakes improved with the use of HMHMF. Very low birth weight and preterm infants with GI intolerance to BHMF were successfully rescued with use of HMHMF. Improvements in growth were achieved without need for supplementation with PN through achievement of sufficient enteral calorie and protein intakes.

  16. Sustained developmental effects of the infant behavioral assessment and intervention program in very low birth weight infants at 5.5 years corrected age

    NARCIS (Netherlands)

    van Hus, Janeline W. P.; Jeukens-Visser, Martine; Koldewijn, Karen; Geldof, Christiaan J. A.; Kok, Joke H.; Nollet, Frans; van Wassenaer-Leemhuis, Aleid G.

    2013-01-01

    To evaluate the effect of the Infant Behavioral Assessment and Intervention Program (IBAIP) in very low birth weight (VLBW) infants on cognitive, neuromotor, and behavioral development at 5.5 years corrected age (CA). In a randomized controlled trial, 86 VLBW infants received post discharge IBAIP

  17. Cyst(e)ine requirements in enterally fed very low birth weight preterm infants

    NARCIS (Netherlands)

    Riedijk, Maaike A.; Voortman, Gardi; van Beek, Ron H. T.; Baartmans, Martin G. A.; Wafelman, Leontien S.; van Goudoever, Johannes B.

    2008-01-01

    Optimal nutrition is of utmost importance for the preterm infant's later health and developmental outcome. Amino acid requirements for preterm infants differ from those for term and older infants, because growth rates differ. Some nonessential amino acids, however, cannot be sufficiently synthesized

  18. Cyst(e)ine requirements in enterally fed very low birth weight preterm infants

    NARCIS (Netherlands)

    M.A. Riedijk (Maaike); G.J. Voortman (Gardi); R.H.Th. van Beek (Ron); M.G.A. Baartmans (Martin); L.S. Wafelman (Leontien); J.B. van Goudoever (Hans); R.H.Th. van Beek (Ron)

    2008-01-01

    textabstractOBJECTIVE. Optimal nutrition is of utmost importance for the preterm infant's later health and developmental outcome. Amino acid requirements for preterm infants differ from those for term and older Infants, because growth rates differ. Some nonessential amino acids, however, cannot be

  19. Pulse oximetry measures a lower heart rate at birth compared with electrocardiography.

    Science.gov (United States)

    van Vonderen, Jeroen J; Hooper, Stuart B; Kroese, Jacco K; Roest, Arno A W; Narayen, Ilona C; van Zwet, Erik W; te Pas, Arjan B

    2015-01-01

    To examine the effect of time after birth on heart rate (HR) measured by pulse oximetry (PO) (HRPO) and electrocardiography (ECG) (HRECG). HRECG and HRPO (collected at maximum sensitivity) were assessed in 53 term and preterm infants at birth. ECG electrodes and a PO sensor were attached as soon as possible and HRECG and HRPO were compared every 30 seconds from 1-10 minutes after birth. Data were compared using a Wilkinson signed-rank test. Clinical relevance (eg, HR <100 beats per minute [bpm] was tested using a McNemar test). Seven hundred fifty-five data pairs were analyzed. Median (IQR) gestational age was 37 (31-39) weeks. Mean (SD) starting time of PO and ECG data collection was 99 (33) vs 82 (26) seconds after birth (P = .001). In the first 2 minutes after birth, HRPO was significantly lower compared with HRECG (94 (67-144) vs 150 (91-153) bpm at 60 seconds (P < .05), 81 (60-109) vs 148 (83-170) bpm at 90 seconds (P < .001) and 83 (67-145) vs 158 (119-176) at 120 seconds (P < .001). A HR <100 bpm was more frequently observed with a PO than ECG in the first 2 minutes (64% vs 27% at 60 seconds (P = .05), 56% vs 26% at 90 seconds (P < .05) and 53% vs 21% at 120 seconds (P < .05). HR by ECG was verified by ultrasound for outflow from a subset of infants. In infants at birth, HRPO is significantly lower compared with ECG with clinically important differences in the first minutes. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Risk Factors for Invasive Candidiasis in Infants >1500 g Birth Weight

    Science.gov (United States)

    Lee, Jan Hau; Hornik, Christoph P.; Benjamin, Daniel K.; Herring, Amy H.; Clark, Reese H.; Cohen-Wolkowiez, Michael; Smith, P. Brian

    2012-01-01

    Background We describe the incidence, risk factors, and outcomes of invasive candidiasis in infants >1500 g birth weight. Methods We conducted a retrospective cohort study of infants >1500 g birth weight discharged from 305 NICUs in the Pediatrix Medical Group from 2001–2010. Using multivariable logistic regression, we identified risk factors for invasive candidiasis. Results Invasive candidiasis occurred in 330/530,162 (0.06%) infants. These were documented from positive cultures from ≥1 of these sources: blood (n=323), cerebrospinal fluid (n=6), or urine from catheterization (n=19). Risk factors included day of life >7 (OR 25.2; 95% CI 14.6–43.3), vaginal birth (OR 1.6 [1.2–2.3]), exposure to broad-spectrum antibiotics (OR 1.6 [1.1–2.4]), central venous line (OR 1.8 [1.3–2.6]), and platelet count candidiasis had increased mortality (OR 2.2 [1.3–3.6]). Conclusions Invasive candidiasis is uncommon in infants >1500 g birth weight. Infants at greatest risk are those exposed to broad-spectrum antibiotics and with platelet counts of <50,000/mm3. PMID:23042050

  1. Gestational age-specific perinatal mortality rates for assisted reproductive technology (ART) and other births.

    Science.gov (United States)

    Chughtai, Abrar A; Wang, Alex Y; Hilder, Lisa; Li, Zhuoyang; Lui, Kei; Farquhar, Cindy; Sullivan, Elizabeth A

    2018-02-01

    Is perinatal mortality rate higher among births born following assisted reproductive technology (ART) compared to non-ART births? Overall perinatal mortality rates in ART births was higher compared to non-ART births, but gestational age-specific perinatal mortality rate of ART births was lower for very preterm and moderate to late preterm births. Births born following ART are reported to have higher risk of adverse perinatal outcomes compared to non-ART births. This population-based retrospective cohort study included 407 368 babies (391 952 non-ART and 15 416 ART)-393 491 singletons and 10 877 twins or high order multiples. All births (≥20 weeks of gestation and/or ≥400 g of birthweight) in five states and territories in Australia during the period 2007-2009 were included in the study, using National Perinatal Data Collection (NPDC). Primary outcome measures were rates of stillbirth, neonatal and perinatal deaths. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to estimate the likelihood of perinatal death. Rates of multiple birth and low birthweight were significantly higher in ART group compared to the non-ART group (P ART births (16.5 per 1000 births, 95% CI 14.5-18.6), compared to non-ART births (11.3 per 1000 births, 95% CI 11.0-11.6) (AOR 1.45, 95% CI 1.26-1.68). However, gestational age-specific perinatal mortality rate of ART births (including both singletons and multiples) was lower for very preterm (ART births. Congenital abnormality and spontaneous preterm were the most common causes of neonatal deaths in both ART and non-ART group. Due to different cut-off limit for perinatal period in Australia, the results of this study should be interpreted with cautions for other countries. Australian definition of perinatal period commences at 20 completed weeks (140 days) of gestation and ends 27 completed days after birth which is different from the definition by World Health Organisation (commences at 22 completed weeks (154 days) of

  2. Factors Affecting the Neonatal Intensive Care Unit Stay Duration in Very Low Birth Weight Premature Infants

    OpenAIRE

    Niknajad, Akram; Ghojazadeh, Morteza; Sattarzadeh, Niloufar; Bashar Hashemi, Fazileh; Dezham Khoy Shahgholi, Farid

    2012-01-01

    Introduction: Improved survival of very low birth weight (VLBW) premature infants requires urgent intensive care, professional nursing and medical care. On the other hand, long hospital stay period imposes emotional and economic burdens on the family and society. Therefore, it is necessary to clarify the most important factors affecting their hospitalization duration to lessen unwanted outcomes of premature birth and to eliminate or relieve the problems. Methods: In a descri...

  3. Early weight changes after birth and serum high-molecular-weight adiponectin level in preterm infants.

    Science.gov (United States)

    Yoshida, Tomohide; Nagasaki, Hiraku; Asato, Yoshihide; Ohta, Takao

    2011-12-01

    Extra-uterine growth retardation (EUGR) is associated with an increased risk for cardiometabolic diseases later in life. The aim of the present study was to examine the relationship between early weight change after birth in preterm infants and adiponectin (adn) multimeric complexes. Subjects included 28 preterm infants born between weeks 24 and 33 of gestation. Serum adn multimeric complexes and the anthropometric parameters were measured in preterm infants at birth and at corrected term. Bodyweight (BW) decreased during the first week of life, with birthweight restored at approximately 19 days after birth. Nineteen of the subjects had EUGR at corrected term. Total (T)-adn, high-molecular-weight (H)-adn, and the ratio of H-adn to T-adn (H/T-adn) were significantly elevated at corrected term than at birth. Postmenstrual age, birthweight, birth length and lowest BW after birth were positively correlated with H-adn and H/T-adn. Weight reduction after birth was negatively correlated with H-adn. Age to restore birthweight was negatively correlated with T-adn, H-adn and H/T-adn. Stepwise multiple regression analysis indicated age to restore birthweight as the major predictor of T-adn and H-adn. Early weight changes after birth may alter serum adn level in preterm infants at corrected term. The appropriate nutritional support in the early postnatal period could reduce the prevalence of EUGR and the future risk for cardiometabolic diseases. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  4. Prospective Analysis of Pulmonary Hypertension in Extremely Low Birth Weight Infants

    Science.gov (United States)

    Bhat, Ramachandra; Salas, Ariel A.; Foster, Chris; Carlo, Waldemar A.

    2012-01-01

    OBJECTIVES: Pulmonary hypertension is associated with bronchopulmonary dysplasia in extremely low birth weight (ELBW) infants and contributes to morbidity and mortality. The objective was to determine the prevalence of pulmonary hypertension among ELBW infants by screening echocardiography and evaluate subsequent outcomes. METHODS: All ELBW infants admitted to a regional perinatal center were evaluated for pulmonary hypertension with echocardiography at 4 weeks of age and subsequently if clinical signs suggestive of right-sided heart failure or severe lung disease were evident. Management was at discretion of the clinician, and infants were evaluated until discharge from the hospital or pre-discharge death occurred. RESULTS: One hundred forty-five ELBW infants (birth weight: 755 ± 144 g; median gestational age: 26 weeks [interquartile range: 24–27]) were screened from December 2008 to February 2011. Overall, 26 (17.9%) were diagnosed with pulmonary hypertension at any time during hospitalization (birth weight: 665 ± 140 g; median gestational age: 26 weeks [interquartile range: 24–27]): 9 (6.2%) by initial screening (early pulmonary hypertension) and 17 (11.7%) who were identified later (late pulmonary hypertension). Infants with pulmonary hypertension were more likely to receive oxygen treatment on day 28 compared with those without pulmonary hypertension (96% vs 75%, P Pulmonary hypertension is relatively common, affecting at least 1 in 6 ELBW infants, and persists to discharge in most survivors. Routine screening of ELBW infants with echocardiography at 4 weeks of age identifies only one-third of the infants diagnosed with pulmonary hypertension. Further research is required to determine optimal detection and intervention strategies. PMID:22311993

  5. International migration to Canada: the post-birth health of mothers and infants by immigration class.

    Science.gov (United States)

    Gagnon, Anita J; Dougherty, Geoffrey; Wahoush, Olive; Saucier, Jean-François; Dennis, Cindy-Lee; Stanger, Elizabeth; Palmer, Becky; Merry, Lisa; Stewart, Donna E

    2013-01-01

    There are over 214 million international migrants worldwide, half of whom are women, and all of them assigned by the receiving country to an immigration class. Immigration classes are associated with certain health risks and regulatory restrictions related to eligibility for health care. Prior to this study, reports of international migrant post-birth health had not been compared between immigration classes, with the exception of our earlier, smaller study in which we found asylum-seekers to be at greatest risk for health concerns. In order to determine whether refugee or asylum-seeking women or their infants experience a greater number or a different distribution of professionally-identified health concerns after birth than immigrant or Canadian-born women, we recruited 1127 migrant (and in Canada immigration class (refugee, asylum-seeker, immigrant, or Canadian-born). Between February 2006 and May 2009, we followed them from childbirth (in one of eleven birthing centres in Montreal or Toronto) to four months and found that at one week postpartum, asylum-seeking and immigrant women had greater rates of professionally-identified health concerns than Canadian-born women; and at four months, all three migrant groups had greater rates of professionally-identified concerns. Further, international migrants were at greater risk of not having these concerns addressed by the Canadian health care system. The current study supports our earlier findings and highlights the need for case-finding and services for international migrant women, particularly for psychosocial difficulties. Policy and program mechanisms to address migrants' needs would best be developed within the various immigration classes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Silver-based dressing in an extremely low-birth-weight infant: a case study.

    Science.gov (United States)

    August, Deanne L; Ireland, Susan; Benton, Judy

    2015-01-01

    Dressings containing silver have been considered dangerous for neonatal patients. Many practitioners are hesitant to place wound applications (with or without silver) on premature infants based on the potential risk of absorption and toxicity. Few studies have been conducted looking at long-term effects of current dressing products in the neonate. We used a flexible polyurethane foam containing ionic silver to treat the skin breakdown in a 23-week-old infant. The silver foam dressing was safely and successfully used in the treatment of this extremely low-birth-weight infant with skin breakdown.

  7. Gluconeogenesis is not regulated by either glucose or insulin in extremely low birth weight infants receiving total parenteral nutrition

    Science.gov (United States)

    The objective was to determine potential factors regulating gluconeogenesis (GNG) in extremely low birth weight infants receiving total parenteral nutrition. Seven infants (birth weight, 0.824 +/- 0.068 kg; gestational age, 25.4 +/- 0.5 weeks; postnatal age, 3.3 +/- 0.2 days) were studied for 11 hou...

  8. A Birth Cohort Study of Maternal and Infant Serum PCB-153 and DDE Concentrations and Responses to Infant Tuberculosis Vaccination

    Science.gov (United States)

    Jusko, Todd A.; De Roos, Anneclaire J.; Lee, Sue Y.; Thevenet-Morrison, Kelly; Schwartz, Stephen M.; Verner, Marc-André; Murinova, Lubica Palkovicova; Drobná, Beata; Kočan, Anton; Fabišiková, Anna; Čonka, Kamil; Trnovec, Tomas; Hertz-Picciotto, Irva; Lawrence, B. Paige

    2015-01-01

    Background: Reasons for the highly variable and often poor protection conferred by the Mycobacterium bovis bacille Calmette–Guérin (BCG) vaccine are multifaceted and poorly understood. Objectives: We aimed to determine whether early-life exposure to PCBs (polychlorinated biphenyls) and DDE [1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene] reduces 6-month infant BCG vaccine response. Methods: Data came from families participating in a prospective birth cohort in eastern Slovakia. At birth, maternal and cord blood were collected for chemical analyses, and infants were immunized with BCG. Blood was collected from infants for chemical analyses and to determine 6-month BCG-specific immunoglobulin (Ig) G and IgA levels. Multivariable linear regression models were fit to examine chemical–BCG associations among approximately 500 mother–infant pairs, with adjustment for confounders. Results: The median 6-month infant concentration of the prevalent congener PCB-153 was 113 ng/g lipid [interquartile range (IQR): 37–248], and 388 ng/g lipid (IQR: 115–847) for DDE. Higher 6-month infant concentrations of PCB-153 and DDE were strongly associated with lower 6-month BCG-specific antibody levels. For instance, BCG-specific IgG levels were 37% lower for infants with PCB-153 concentrations at the 75th percentile compared to the 25th percentile (95% CI: –42, –32; p PCB–DDE additivity, where exposure to both compounds reduced anti-BCG levels more than exposure to either compound alone. Conclusions: The associations observed in this study indicate that environmental exposures may be overlooked contributors to poorer responses to BCG vaccine. The overall association between these exposures and tuberculosis incidence is unknown. Citation: Jusko TA, De Roos AJ, Lee SY, Thevenet-Morrison K, Schwartz SM, Verner MA, Palkovicova Murinova L, Drobná B, Kočan A, Fabišiková A, Čonka K, Trnovec T, Hertz-Picciotto I, Lawrence BP. 2016. A birth cohort study of maternal and infant

  9. Enteral zinc supplementation and growth in extremely-low-birth-weight infants with chronic lung disease.

    Science.gov (United States)

    Shaikhkhalil, Ala K; Curtiss, Jennifer; Puthoff, Teresa D; Valentine, Christina J

    2014-02-01

    Zinc deficiency causes growth deficits. Extremely-low-birth-weight (ELBW) infants with chronic lung disease (CLD), also known as bronchopulmonary dysplasia, experience growth failure and are at risk for zinc deficiency. We hypothesized that enteral zinc supplementation would increase weight gain and linear growth. A cohort of infants was examined retrospectively at a single center between January 2008 and December 2011. CLD was defined as the need for oxygen at 36 weeks postmenstrual age. Zinc supplementation was started in infants who had poor weight gain. Infants' weight gain and linear growth were compared before and after zinc supplementation using the paired t test. A total of 52 ELBW infants with CLD met entry criteria. Mean birth weight was 682 ± 183 g, and gestational age was 25.3 ± 2 weeks. Zinc supplementation started at postmenstrual age 33 ± 2 weeks. Most infants received fortified human milk. Weight gain increased from 10.9 before supplementation to 19.9 g · kg(-1) · day(-1) after supplementation (P supplementation improved growth in ELBW infants with CLD receiving human milk. Further investigation is warranted to reevaluate zinc requirements, markers, and balance.

  10. The effect of sociodemographic factors on infant mortality according to cause of death: a birth cohort in Seoul, Korea, 1999-2003.

    Science.gov (United States)

    Son, Ji-Young; Lee, Jong-Tae

    2011-02-01

    The aim of this study was to examine the effect of socioeconomic status and demographic factors on infant mortality, classified by cause of death, in a group of children born in Seoul, Korea during 1999-2003. Linked infant birth and death data were collected from the Korea National Statistical Office. Logistic regression models were used to investigate the effect of socioeconomic and demographic factors on infant mortality. The results were adjusted to take into account the infants' length of gestation and birth weight. Infant death rates from all causes tended to decrease as the parents' educational level increased. We observed a similar pattern for deaths from other specific causes. We also found higher mortality rates for mothers less than 20 years of age and over 35. Our analysis shows that socioeconomic and demographic factors affect infant mortality. In the case of postneonatal infant death, we confirmed that adequate follow-up care can reduce the risks of death from these acquired factors. This suggests that these are important factors to consider in reducing infant mortality.

  11. Development of lung function in very low birth weight infants with or without bronchopulmonary dysplasia: Longitudinal assessment during the first 15 months of corrected age

    Directory of Open Access Journals (Sweden)

    Schmalisch Gerd

    2012-03-01

    Full Text Available Abstract Background Very low birth weight (VLBW infants ( Methods Comprehensive lung function assessment was performed at about 50, 70, and 100 weeks of postmenstrual age in 55 sedated VLBW infants (29 with former BPD [O2 supplementation was given at 36 weeks of gestational age] and 26 VLBW infants without BPD [controls]. Mean gestational age (26 vs. 29 weeks, birth weight (815 g vs. 1,125 g, and the proportion of infants requiring mechanical ventilation for ≥7 d (55% vs. 8%, differed significantly between BPD infants and controls. Results Both body weight and length, determined over time, were persistently lower in former BPD infants compared to controls, but no significant between-group differences were noted in respiratory rate, respiratory or airway resistance, functional residual capacity as determined by body plethysmography (FRCpleth, maximal expiratory flow at the FRC (V'max FRC, or blood gas (pO2, pCO2 levels. Tidal volume, minute ventilation, respiratory compliance, and FRC determined by SF6 multiple breath washout (representing the lung volume in actual communication with the airways were significantly lower in former BPD infants compared to controls. However, these differences became non-significant after normalization to body weight. Conclusions Although somatic growth and the development of some lung functional parameters lag in former BPD infants, the lung function of such infants appears to develop in line with that of non-BPD infants when a body weight correction is applied. Longitudinal lung function testing of preterm infants after discharge from hospital may help to identify former BPD infants at risk of incomplete recovery of respiratory function; such infants are at risk of later respiratory problems.

  12. Protein use and weight-gain quality in very-low-birth-weight preterm infants fed human milk or formula.

    Science.gov (United States)

    Morlacchi, Laura; Roggero, Paola; Giannì, Maria Lorella; Bracco, Beatrice; Porri, Debora; Battiato, Enrico; Menis, Camilla; Liotto, Nadia; Mallardi, Domenica; Mosca, Fabio

    2018-02-01

    Nutritional management of preterm infants aims to approximate the tissue growth and body composition of a fetus of the same postmenstrual age. The adequacy of the quality of protein supply can influence the rate and the relative quality of weight gain. We investigated the protein balance according to feeding regimen and the association between human milk feeding and fat-free mass content at the term-corrected age in very-low-birth-weight preterm infants. A prospective observational study was conducted. Inclusion criteria were as follows: healthy infants, gestational age ≤32 wk, birth weight milk or formula at discharge. Infants were enrolled at hospital discharge. At enrollment, macronutrient intakes and protein balance were determined. Anthropometric measurements and body composition were also assessed. The nutritional composition of human milk was calculated by infrared spectroscopy. The protein balance was determined according to the nitrogen balance standard method. Body composition was assessed by an air-displacement plethysmography system. At the term-corrected age, anthropometry and body composition assessments were repeated. Seventeen preterm infants fed fortified human milk and 15 preterm infants fed formula were enrolled. At discharge, despite similar macronutrient intakes, infants fed fortified human milk showed a higher nitrogen balance (expressed as mg · kg-1 · d-1) compared with preterm formula-fed infants (mean ± SD: 488.3 ± 75 compared with 409.8 ± 85 mg · kg-1 · d-1, P = 0.009). At term-corrected age, growth was similar in the 2 groups, whereas fortified human milk-fed infants showed a higher percentage of fat-free mass (85.1% ± 2.8% compared with 80.8% ± 3.2%, P = 0.002). Moreover, at multiple linear regression, fat-free mass content was independently associated with being fed human milk (R2 = 0.93, P milk feeding is associated with early fat-free mass deposition in healthy and stable preterm infants. This trial was

  13. Oral immunoglobulin for the prevention of rotavirus infection in low birth weight infants.

    Science.gov (United States)

    Pammi, Mohan; Haque, Khalid N

    2011-11-09

    Rotavirus is a common neonatal nosocomial viral infection and epidemics with the newer P(6)G9 strains have been reported. Local mucosal immunity in the intestine to rotavirus is important in the resolution of infection and protection against subsequent infections. Oral administration of anti-rotaviral immunoglobulin preparations might be a useful strategy in preventing rotaviral infections, especially in low birth weight babies. To determine the effectiveness and safety of oral immunoglobulin preparations for the prevention of rotavirus infection in hospitalized low birthweight infants (birthweight rotavirus infection compared to placebo OR no intervention; 4) at least one of the following outcomes were reported: all cause mortality during hospital stay, mortality due to rotavirus infection during hospital stay, rotavirus infection , duration of diarrhea, need for rehydration, duration of viral excretion, duration of infection control measures, length of hospital stay in days, recurrent diarrhea or chronic diarrhea. The two review authors independently abstracted data from the included trials. One published study (Barnes 1982) was eligible for inclusion in this review. Barnes 1982 found no significant difference in the rates of rotavirus infection after oral gammaglobulin versus placebo in hospitalized low birthweight babies [RR 1.27 (95% CI 0.65 to 2.37)]. In the subset of infants who became infected with rotavirus after receiving gammaglobulin or placebo for prevention of rotavirus infection, there was no significant difference in the duration of rotavirus excretion between the group who had gammaglobulin (mean 2 days, range 1 to 4 days) and the group who had placebo (mean 3 days, range 1 to 6 days). Barnes 1982 reported no adverse effects after administration of oral immunoglobulin preparations. Current evidence does not support the use of oral immunoglobulin preparations to prevent rotavirus infection in low birthweight infants. Researchers are encouraged to

  14. Intraocular pressure in very low birth weight preterm infants and its association with postconceptional age

    Directory of Open Access Journals (Sweden)

    Rodrigo L. Lindenmeyer

    2012-11-01

    Full Text Available OBJECTIVE: To evaluate intraocular pressure in very low birth weight preterm infants and correlate it with postconceptional age. METHODS: The intraocular pressure in a prospective cohort of very low birth weight premature infants (defined as a birth weight <1,500 g and gestational age <32 weeks admitted to Hospital de Clínicas de Porto Alegre , Brazil was evaluated weekly. The evaluated outcome was the variation in the intraocular pressure following changes in the postconceptional age (defined as the gestational age at birth plus the age in weeks at the time of examination in the weeks following preterm birth. Mixed-effects models were used for the statistical analysis to determine the intraocular pressure variation according to postconceptional age, and means and 10th and 90th percentiles were calculated for the intraocular pressure values. RESULTS: Fifty preterm infants with a mean gestational age of 29.7 ± 1.6 weeks and a mean birth weight of 1,127.7 ± 222.7 g were evaluated. The mean intraocular pressure for the entire cohort considering both eyes was 14.9 ± 4.5 mmHg, and 13.5% of all recorded intraocular pressure values were greater than 20 mmHg. The analysis revealed a mean reduction in the intraocular pressure of 0.29 mmHg for each increase in postconceptional age (p = 0.047; 95% CI: -0.58 to -0.0035. The mean intraocular pressure (P10-P90 decreased from 16.3 mmHg (10.5222.16 at 26.3 weeks to 13.1 mmHg (7.28-18.92 at 37.6 weeks of postconceptional age. CONCLUSIONS: The mean intraocular pressure in very low birth weight preterm infants was 14.9 ± 4.5 mmHg. This value decreased 0.29 mmHg per week as the postconceptional age increased.

  15. Sex-differential effect on infant mortality of oral polio vaccine administered with BCG at birth in Guinea-Bissau. A natural experiment.

    Directory of Open Access Journals (Sweden)

    Christine Stabell Benn

    Full Text Available The policy to provide oral polio vaccine (OPV at birth was introduced in low-income countries to increase coverage. The effect of OPV at birth on overall child mortality was never studied. During a trial of vitamin A supplementation (VAS at birth in Guinea-Bissau, OPV was not available during several periods. We took advantage of this "natural experiment" to test the effect on mortality of receiving OPV at birth.Between 2002 and 2004, the VAS trial randomised normal-birth-weight infants to 50,000 IU VAS or placebo administered with BCG. Provision of OPV at birth was not part of the trial, but we noted whether the infants received OPV or not. OPV was missing during several periods in 2004. We used Cox proportional hazards models to compute mortality rate ratios (MRR of children who had received or not received OPV at birth.A total of 962 (22.1% of the 4345 enrolled children did not receive OPV at birth; 179 children died within the first year of life. Missing OPV at birth was associated with a tendency for decreased mortality (adjusted MRR = 0.69 (95% CI = 0.46-1.03, the effect being similar among recipients of VAS and placebo. There was a highly significant interaction between OPV at birth and sex (p = 0.006. Not receiving OPV at birth was associated with a weak tendency for increased mortality in girls (1.14 (0.70-1.89 but significantly decreased mortality in boys (0.35 (0.18-0.71.In our study OPV at birth had a sex-differential effect on mortality. Poliovirus is almost eradicated and OPV at birth contributes little to herd immunity. A randomised study of the effect of OPV at birth on overall mortality in both sexes is warranted.

  16. The relationship between air pollution and low birth weight: effects by mother's age, infant sex, co-pollutants, and pre-term births

    International Nuclear Information System (INIS)

    Bell, Michelle L; Ebisu, Keita; Belanger, Kathleen

    2008-01-01

    Previously we identified associations between the mother's air pollution exposure and birth weight for births in Connecticut and Massachusetts from 1999-2002. Other studies also found effects, though results are inconsistent. We explored potential uncertainties in earlier work and further explored associations between air pollution and birth weight for PM 10 , PM 2.5 , CO, NO 2 , and SO 2 . Specifically we investigated: (1) whether infants of younger (≤24 years) and older (≥40 years) mothers are particularly susceptible to air pollution's effects on birth weight; (2) whether the relationship between air pollution and birth weight differed by infant sex; (3) confounding by co-pollutants and differences in pollutants' measurement frequencies; and (4) whether observed associations were influenced by inclusion of pre-term births. Findings did not indicate higher susceptibility to the relationship between air pollution and birth weight based on the mother's age or the infant's sex. Results were robust to exclusion of pre-term infants and co-pollutant adjustment, although sample size decreased for some pollutant pairs. These findings provide additional evidence for the relationship between air pollution and birth weight, and do not identify susceptible sub-populations based on infant sex or mother's age. We conclude with discussion of key challenges in research on air pollution and pregnancy outcomes.

  17. Thymic size at birth in preterm infants with severe respiratory ...

    African Journals Online (AJOL)

    The only maternal and postnatal factors influencing CT/T ratio were the presence of pre-eclamptic toxaemia (PET) and birth by caesarean section (CS), but these factors did not influence likelihood of survival. Factors found to be not associated with thymic size were antenatal steroid administration, maternal HIV status, ...

  18. Two year neurological outcomes of very low birth weight infants ...

    African Journals Online (AJOL)

    Background: High risk newborns such as the Very Low Birth Weight (VLBW) require long term follow up to ascertain their subsequent survival and quality of life (based on neurological intactness). Though such data is now standard in the developed world, little is known in published literature about the situation in resource ...

  19. Pregnancy, Birth, Infant and Child Care: Midwifery Skill and Knowledge.

    Science.gov (United States)

    Negussie, Birgit

    This presentation, which is based in part on a cross-cultural survey of East Africans and also on research conducted in Ethiopia, highlights the importance of traditional knowledge of midwifery. Examples of traditional skills in pregancy and birth care, and of child care and child rearing in several East African countries, are offered. It is…

  20. Cytomegalovirus infections among low birth weight infants in a ...

    African Journals Online (AJOL)

    Human Cytomegalovirus (HCMV) is one of the leading causes of congenital infections, which can lead to severe foetal anomalies or even foetal loss. In order to determine the incidence of congenital HCMV infection in low birth weight neonates and the most prevalent genotype, cord blood samples were collected from a ...

  1. Association of type of birth attendant and place of delivery on infant ...

    African Journals Online (AJOL)

    Association of type of birth attendant and place of delivery on infant mortality in sub-Saharan Africa. ... Methods: This cross-sectional study used self-reported data from the Demographic Health Surveys for women in Ghana, Kenya, and Sierra Leone. Logistic regression estimated odds ratios (ORs) and95% confidence ...

  2. Growth of preterm low birth weight infants until 24 months corrected age: effect of maternal hypertension

    Directory of Open Access Journals (Sweden)

    Alice M. Kiy

    2015-05-01

    Conclusion: Preterm low birth weight born infants to hypertensive mothers have an increased risk of overweight at 24 months CA. Being born small for gestational age and inadequate growth in the 1st year of life are risk factors for growth disorders at 24 months CA.

  3. Chlorhexidine-Induced Chemical Burns in Very Low Birth Weight Infants.

    Science.gov (United States)

    Neri, Iria; Ravaioli, Giulia Maria; Faldella, Giacomo; Capretti, Maria Grazia; Arcuri, Santo; Patrizi, Annalisa

    2017-12-01

    Skin disinfection with chlorhexidine gluconate has not been standardized in preterm infants. We present 5 cases of chemical burns that occurred within the first 2 days of life in very low birth weight neonates after skin disinfection with aqueous and alcohol-based chlorhexidine solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Serum magnesium in the first week of life in extremely low birth weight infants.

    LENUS (Irish Health Repository)

    Noone, D

    2012-01-01

    Evidence that antenatal administration of magnesium sulfate (MgSO(4)) to women in preterm labor may confer fetal neuroprotection is growing. MgSO(4) crosses the placenta and can affect the neonate. Magnesium homeostasis in extremely low birth weight (ELBW) infants remains to be clarified.

  5. Low birth weight and fetal anaemia as risk factors for infant morbidity ...

    African Journals Online (AJOL)

    Low birth weight (LBW) and fetal anaemia (FA) are common in malaria endemic areas. To investigate the .... with 95% confidence and 80% power, with a 6 to 1 ratio of infants in the NBW to LBW group, a sample of 162 NBW ..... community and in order to improve prevention strategies. Fetal anaemia and morbidity incidence.

  6. Very low birth weight infants who are fed human milk have decreased body fat as assessed by air displacement plethysmography

    Science.gov (United States)

    Methods to evaluate body composition in infants have recently been enhanced. There are few data regarding body composition in very low birth weight (VLBW) infants. Our objective was to evaluate body composition in VLBW infants consuming human milk or formula using novel techniques. Using air-displac...

  7. Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study.

    Science.gov (United States)

    Grandi, Carlos; Tapia, Jose L; Cardoso, Viviane C

    2015-01-01

    To compare mortality and morbidity in very low birth weight infants (VLBWI) born to women with and without diabetes mellitus (DM). This was a cohort study with retrospective data collection (2001-2010, n=11.991) from the NEOCOSUR network. Adjusted odds ratios and 95% confidence intervals were calculated for the outcome of neonatal mortality and morbidity as a function of maternal DM. Women with no DM served as the reference group. The rate of maternal DM was 2.8% (95% CI: 2.5-3.1), but a significant (p=0.019) increase was observed between 2001-2005 (2.4%, 2.1-2.8) and 2006-2010 (3.2%, 2.8-3.6). Mothers with DM were more likely to have received a complete course of prenatal steroids than those without DM. Infants of diabetic mothers had a slightly higher gestational age and birth weight than infants of born to non-DM mothers. Distribution of mean birth weight Z-scores, small for gestational age status, and Apgar scores were similar. There were no significant differences between the two groups regarding respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, and patent ductus arteriosus. Delivery room mortality, total mortality, need for mechanical ventilation, and early-onset sepsis rates were significantly lower in the diabetic group, whereas necrotizing enterocolitis (NEC) was significantly higher in infants born to DM mothers. In the logistic regression analysis, NEC grades 2-3 was the only condition independently associated with DM (adjusted OR: 1.65 [95% CI: 1.2 -2.27]). VLBWI born to DM mothers do not appear to be at an excess risk of mortality or early morbidity, except for NEC. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  8. Continuity of nursing care and its link to cesarean birth rate.

    Science.gov (United States)

    Gagnon, Anita J; Meier, Katharine M; Waghorn, Kathy

    2007-03-01

    High cesarean birth rates are an international concern. The role of patterns of nursing care responsibility in preventing or contributing to cesarean births has been understudied. Our study sought to identify and describe indicators of continuity of nursing care responsibility during labor and to explore whether any association between these indicators and risk of cesarean birth could be identified empirically using an existing data set. We obtained a representative sample of low-risk women giving birth in an intrapartum unit at a university hospital in Quebec, Canada, with approximately 3,700 births per year. To be considered for inclusion, women needed to have been primiparous, carrying singletons in vertex position, and at 37 weeks' gestation or more. All women giving birth over a 13-month period were assessed for eligibility using the hospital's birth log. Data were extracted from the medical records of every second eligible birth, including information related to patterns of nursing care responsibility, maternal and infant characteristics, obstetric procedures, non-health-related risk factors, and type of birth. Data on all variables of interest were available for 467 women. These women were cared for by 1-17 nurses, care responsibility changed hands for them from 1 to 28 times, and the mean length of labor for which the same nurse was responsible for a woman ranged from 10 to 1,045 minutes. After controlling for length of labor, maternal age, maternal height, infant weight, gestational age, induction, type of rupture, and epidural analgesia, the odds ratio for cesarean birth due to number of nurses was 1.17 (95% CI 1.04, 1.32); 1 or more nurses switch per 2 hours (i.e., number of times care responsibilities changed hands), 1.04 (95% CI 0.62, 1.74); and 33 percent or more of the labor attended by the same nurse, 0.74 (95% CI 0.42, 1.30). An association was observed between number of nurses caring for a laboring woman and risk of cesarean delivery. Estimates of

  9. Investigation on some maternal factors affecting the birth of preterm infants: a case – control study

    Directory of Open Access Journals (Sweden)

    Sakineh Dadipoor

    2017-02-01

    Full Text Available Background: Infant mortality is considered as the key healthcare index in every country. The outcomes of a preterm birth are among the main and direct causes of neonate mortality. Therefore, the present research aims to investigate some maternal factors influencing the immature birth. Materials and Methods: This observational case study was conducted on 100 term babies as the control group. The questionnaires were completed through interviewed mothers or perused hospital files. Results: The results of this study showed the high chances of premature birth in women with multiple pregnancies, smoking, placenta previa, uterine problems and placental abruption compared to most of the mothers with no history of such problems. In mothers with cervical incompetence, the chances of delivering a preterm baby are 11 times as high as mothers with no such problems. Similarly, the chances are 9.33 times as high among the mothers who had a history of placenta previa. Conclusion: Identifying maternal factors influencing the preterm infant birth as well as attentive care taken during pregnancy can significantly reduce the preterm infant birth.

  10. The effect of glutamine-enriched enteral nutrition on intestinal microflora in very low birth weight infants: A randomized controlled trial.

    NARCIS (Netherlands)

    van den Berg, A.; van Elburg, R.M.; Westerbeek, E.A.; van der Linde, E.G.; Knol, J.; Twisk, J.W.R.; Fetter, W.P.F.

    2007-01-01

    Background & aims: In a previous study, we have found that glutamine supplementation decreased the infection rate in very low birth weight (VLBW) infants. In this study, we investigated whether this beneficial effect originated from increased number of bifidobacteria and lactobacilli in the

  11. The effect of glutamine-enriched enteral nutrition on intestinal microflora in very low birth weight infants: a randomized controlled trial

    NARCIS (Netherlands)

    van den Berg, Anemone; van Elburg, Ruurd M.; Westerbeek, Elisabeth A. M.; van der Linde, Esmeralda G. M.; Knol, J.; Twisk, Jos W. R.; Fetter, Willem P. F.

    2007-01-01

    In a previous study, we have found that glutamine supplementation decreased the infection rate in very low birth weight (VLBW) infants. In this study, we investigated whether this beneficial effect originated from increased number of bifidobacteria and lactobacilli in the intestinal microflora of

  12. Outcome following spinal accessory to suprascapular (spinoscapular) nerve transfer in infants with brachial plexus birth injuries.

    Science.gov (United States)

    Ruchelsman, David E; Ramos, Lorna E; Alfonso, Israel; Price, Andrew E; Grossman, Agatha; Grossman, John A I

    2010-06-01

    The purpose of this study is to evaluate the value of distal spinal accessory nerve (SAN) transfer to the suprascapular nerve (SSN) in children with brachial plexus birth injuries in order to better define the application and outcome of this transfer in these infants. Over a 3-year period, 34 infants with brachial plexus injuries underwent transfer of the SAN to the SSN as part of the primary surgical reconstruction. Twenty-five patients (direct repair, n = 20; interposition graft, n = 5) achieved a minimum follow-up of 24 months. Fourteen children underwent plexus reconstruction with SAN-to-SSN transfer at less than 9 months of age, and 11 underwent surgical reconstruction at the age of 9 months or older. Mean age at the time of nerve transfer was 11.6 months (range, 5-30 months). At latest follow-up, active shoulder external rotation was measured in the arm abducted position and confirmed by review of videos. The Gilbert and Miami shoulder classification scores were utilized to report shoulder-specific functional outcomes. The effects of patient age at the time of nerve transfer and the use of interpositional nerve graft were analyzed. Overall mean active external rotation measured 69.6°; mean Gilbert score was 4.1 and the mean Miami score was 7.1, corresponding to overall good shoulder functional outcomes. Similar clinical and shoulder-specific functional outcomes were obtained in patients undergoing early (9 months of age, n = 11) SAN-to-SSN transfer and primary plexus reconstruction. Nine patients (27%) were lost to follow-up and are not included in the analysis. Optimum results were achieved following direct transfer (n = 20). Results following the use of an interpositional graft (n = 5) were rated satisfactory. No patient required a secondary shoulder procedure during the study period. There were no postoperative complications. Distal SAN-to-SSN (spinoscapular) nerve transfer is a reliable option for shoulder reinnervation in

  13. Maternal Anemia during pregnancy and infant low birth weight: A systematic review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Shoboo Rahmati

    2017-08-01

    Full Text Available Background: Infant low birth weight is one of the major problems in different societies. Different reports have provided different results regarding the relationship between maternal anemia and infant low birth weight in different months of pregnancy. Objective: The aim of this study was to determine the relationship between maternal anemia during pregnancy and infant low birth weight. Materials and Methods: This systematic review was conducted using related keywords in national (Sid, Iran.doc, Iran medex and Magiran and international (PubMed, Science Direct, Cochrane, Medline, Web of Science, Scopus, Springer, Embase, Google scholar databases. Relative risks and confidence intervals were extracted from each study. The results were combined using random-effects model for meta-analysis. The I2 index was also used to measure heterogeneity between the studies. Results: Overall, 17 studies with a total sample size of 245407 entered the final meta-analysis and demonstrated that the relative risk for maternal anemia in the first, second and third trimester of pregnancy were 1.26 (95% CI: 1.03-1.55, 0.97 (95% CI: 0.57-1.65, and 1.21 (95% CI: 0.84-1.76, respectively. The relationship between maternal anemia and infant low birth weight in the first trimester of pregnancy was significant. Conclusion: Maternal anemia, especially during the first trimester of pregnancy, can be considered as a risk factor for pregnancy outcomes. Therefore, one needs to take the necessary steps to cure this disease in order to reduce the incidence of infant low birth weight.

  14. Teen Birth Rate. Facts at a Glance, 2002.

    Science.gov (United States)

    Papillo, Angela Romano, Comp.; Franzetta, Kerry, Comp.; Manlove, Jennifer, Comp.; Moore, Kristin Anderson, Comp.; Terry-Humen, Elizabeth, Comp.; Ryan, Suzanne, Comp.

    This publication reports trends in teen childbearing in the nation, in each state, and in large cities using data from the 2001 National Center for Health Statistics (NCHS). Rates of teenage childbearing continue to steadily decline, and the 2001 rates are historic lows for each age group. NCHS data showed that almost 80% of teen births nationwide…

  15. Teen Birth Rate. CTS Facts at a Glance.

    Science.gov (United States)

    Moore, Kristin Anderson, Comp.; Papillo, Angela Romano, Comp.; Williams, Stephanie, Comp.; Jager, Justin, Comp.; Jones, Fanette, Comp.

    This fact sheet presents several data tables related to teen pregnancy, birth rates, abortion, contraceptive use, and sexually transmitted diseases. The data reveal that during the 1990s, rates of teen childbearing have declined, returning to the levels reached in the mid-1980s. Declines come from a lower proportion of teens having sex and a…

  16. Milk consumption during pregnancy is associated with increased infant size at birth: prospective cohort study

    DEFF Research Database (Denmark)

    Olsen, Sjurdur F; Halldorsson, Thorhallur I; Willett, Walter C

    2007-01-01

    BACKGROUND: Cow milk contains many potentially growth-promoting factors. OBJECTIVE: The objective was to examine whether milk consumption during pregnancy is associated with greater infant size at birth. DESIGN: During 1996-2002, the Danish National Birth Cohort collected data on midpregnancy diet......'s socioeconomic status The analyses included data from 50,117 mother-infant pairs. RESULTS: Mean (+/-SD) consumption of milk was 3.1 +/- 2.0 glasses/d. Milk consumption was inversely associated with the risk of small-for gestational age (SGA) birth and directly with both large-for-gestational age (LGA) birth...... and mean birth weight (P for trend drinking >or=6 glasses/d with those drinking 0 glasses/d, the odds ratio for SGA was 0.51 (95% CI: 0.39, 0.65) and for LGA was 1.59 (1.16, 2.16); the increment in mean birth weight was 108 g (74, 143 g). We also found graded relations (P...

  17. Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Alan H. Jobe

    2010-02-01

    Full Text Available The increased survival of very preterm infants is generally attributed to improved care strategies. This review develops the thesis that the features of abnormal pregnancies responsible for very preterm deliveries also provide an explanation of why very preterm infants often survive. A normal fetus born at 24 weeks is very unlikely to survive. However, pregnancies that result in deliveries at 24 weeks are generally highly abnormal, and may have been so for prolonged periods prior to the preterm deliveries. Inflammatory or vascular developmental abnormalities resulting in very preterm birth can alter fetal development in such a way that organ system maturation is induced. This is supported clinically by the relative lack of very preterm infants with respiratory distress syndrome. Interventions such as antenatal corticosteroid treatment and postnatal surfactant treatment for infants with respiratory distress syndrome and gentle ventilation strategies maximize fetal adaptations to the abnormal fetal environment and improve outcomes.

  18. An energy-saving development initiative increases birth rate and childhood malnutrition in rural Ethiopia.

    Directory of Open Access Journals (Sweden)

    Mhairi A Gibson

    2006-04-01

    Full Text Available Evolutionary life history theory predicts that, in the absence of contraception, any enhancement of maternal condition can increase human fertility. Energetic trade-offs are likely to be resolved in favour of maximizing reproductive success rather than health or longevity. Here we find support for the hypothesis that development initiatives designed to improve maternal and child welfare may also incur costs associated with increased family sizes if they do not include a family planning component.Demographic and anthropometric data were collected in a rural Ethiopian community benefiting from a recent labour-saving development technology that reduces women's energetic expenditure (n = 1,976 households. Using logistic hazards models and general linear modelling techniques, we found that whilst infant mortality has declined, the birth rate has increased, causing greater scarcity of resources within households.This study is, to our knowledge, the first to demonstrate a link between a technological development intervention and an increase in both birth rate and childhood malnutrition. Women's nutritional status was not improved by the energy-saving technology, because energy was diverted into higher birth rates. We argue that the contribution of biological processes to increased birth rates in areas of the developing world without access to modern contraception has been overlooked. This highlights the continued need for development programmes to be multisectoral, including access to and promotion of contraception.

  19. Tritium releases from the Pickering Nuclear Generating Station and birth defects and infant mortality in nearby communities 1971-1988

    International Nuclear Information System (INIS)

    Johnson, K.C.; Rouleau, J.

    1991-10-01

    This study was commissioned to examine whether there were elevated rates of stillbirth, birth defects, or death in the first year of life between 1971 and 1988 among offspring of residents of communities within a 25-kilometre radius of the Pickering Nuclear Generating Station. The study was also to investigate whether there were any statistical associations between the monthly airborne or waterborne tritium emissions from the Pickering Nuclear Generating Station and the rates of these reproductive outcomes. Overall analysis did not support a hypothesis of increased rates of stillbirths, neonatal mortality or infant mortality near the Pickering Nuclear Generating Station, or a hypothesis of increased birth prevalence of birth defects for 21 of 22 diagnostic categories. The prevalence of Down Syndrome was elevated in both Pickering and Ajax; however, there was no consistent pattern between tritium release levels and Down Syndrome prevalence, chance could not be ruled out for the associations between Down Syndrome and tritium releases or ground-monitored concentrations, the association was detected in an analysis where multiple testing was done which may turn up significant associations by change, and maternal residence at birth and early in pregnancy needs to be verified. The association between Down Syndrome and low-level radiation remains indeterminate when existing evidence from epidemiological studies is summed. The estimated radiation exposure from the nuclear plant for residents of Pickering and Ajax is lower by a factor of 100 than the normal natural background radiation. Further study is recommended. (21 tabs., 29 figs., 5 maps, 37 refs.)

  20. The infant behavioral assessment and intervention program in very low birth weight infants; outcome on executive functioning, behaviour and cognition at preschool age.

    Science.gov (United States)

    Verkerk, Gijs; Jeukens-Visser, Martine; Houtzager, Bregje; Koldewijn, Karen; van Wassenaer, Aleid; Nollet, Frans; Kok, Joke

    2012-08-01

    The Infant Behavioral Assessment and Intervention Program (IBAIP©) improved motor function at 24 months, and mental and behavioural development in high risk subgroups of very low birth weight (VLBW) infants. To determine IBAIP's effects on executive functioning, behaviour and cognition at preschool age. Follow-up of a randomised controlled trial (RCT). At 44 months corrected age, all 176 VLBW infants were invited for follow-up. Forty-one term born children were assessed for comparison. Visual Attention Task (VAT), Gift delay, Peabody Picture Vocabulary Test III-NL (PPVT), Visual motor integration tests and Miller assessment for preschoolers. Parents completed Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P) and Child Behavior Checklist (CBCL). At preschool age, 76 (88%) children of the intervention group and 75 (83%) children of the control group participated. There were no significant differences between the intervention and the control group. However, positive interaction effects between intervention and infants with bronchopulmonary dysplasia, infants born at gestational agechildren. The 151 VLBW children performed significantly worse than the term born children on the VAT, BRIEF-P and CBCL. IBAIP effects in VLBW children did not sustain until preschool age on executive functioning, behaviour and cognition. However, the most vulnerable children had a clinical relevant profit from IBAIP. VLBW children performed worse than the term born children. This study is a follow-up at preschool age of the multi-centre RCT of IBAIP versus usual care in VLBW infants. The RCT was performed in Amsterdam, The Netherlands (IBAIP). Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Integrated approaches to improve birth outcomes: perinatal periods of risk, infant mortality review, and the Los Angeles Mommy and Baby Project.

    Science.gov (United States)

    Chao, Shin Margaret; Donatoni, Giannina; Bemis, Cathleen; Donovan, Kevin; Harding, Cynthia; Davenport, Deborah; Gilbert, Carol; Kasehagen, Laurin; Peck, Magda G

    2010-11-01

    This article provides an example of how Perinatal Periods of Risk (PPOR) can provide a framework and offer analytic methods that move communities to productive action to address infant mortality. Between 1999 and 2002, the infant mortality rate in the Antelope Valley region of Los Angeles County increased from 5.0 to 10.6 per 1,000 live births. Of particular concern, infant mortality among African Americans in the Antelope Valley rose from 11.0 per 1,000 live births (7 cases) in 1999 to 32.7 per 1,000 live births (27 cases) in 2002. In response, the Los Angeles County Department of Public Health, Maternal, Child, and Adolescent Health Programs partnered with a community task force to develop an action plan to address the issue. Three stages of the PPOR approach were used: (1) Assuring Readiness; (2) Data and Assessment, which included: (a) Using 2002 vital records to identify areas with the highest excess rates of feto-infant mortality (Phase 1 PPOR), and (b) Implementing Infant Mortality Review (IMR) and the Los Angeles Mommy and Baby (LAMB) Project, a population-based study to identify potential factors associated with adverse birth outcomes. (Phase 2 PPOR); and (3) Strategy and Planning, to develop strategic actions for targeted prevention. A description of stakeholders' commitments to improve birth outcomes and monitor infant mortality is also given. The Antelope Valley community was engaged and ready to investigate the local rise in infant mortality. Phase 1 PPOR analysis identified Maternal Health/Prematurity and Infant Health as the most important periods of risk for further investigation and potential intervention. During the Phase 2 PPOR analyses, IMR found a significant proportion of mothers with previous fetal loss (45%) or low birth weight/preterm (LBW/PT) birth, late prenatal care (39%), maternal infections (47%), and infant safety issues (21%). After adjusting for potential confounders (maternal age, race, education level, and marital status), the

  2. Hope in Parents of Very-Low Birth Weight Infants and its Association with Parenting Stress and Quality of Life.

    Science.gov (United States)

    Nordheim, Trond; Rustøen, Tone; Solevåg, Anne Lee; Småstuen, Milada Cvancarova; Nakstad, Britt

    Being a parent of a very-low-birth-weight (VLBW) infant can be stressful. We aimed to describe parental hope 42months after the birth of a VLBW infant and determine whether there is an association between hope and parenting stress with quality of life (QoL), respectively. Fifty-nine parents of VLBW infants completed questionnaires about hope, parenting stress and QoL. Pearson correlation coefficients (r) and linear regression models were used to examine the relationship between the selected variables. To compare groups, t-test was used and Cohen's d for effect size was calculated. Parents of VLBW infants were more hopeful than the general population (phope were both independently associated with QoL (phope (p=0.041) and higher parenting stress (p=0.041) than parents of infants with birth weight 1000-1500g. Hope and parenting stress were both independent determinants of QoL. Parents of the presumably sickest infants had less hope and higher parenting stress than parents of VLBW infants with a birth weight over 1000g. Hope should be further explored as a coping mechanism in parents of VLBW infants. The clinical implications of the strong association between hope, parenting stress and QoL remain to be determined, but reducing stress and strengthening hope seem to be important. This should be taken into account both at hospital discharge and at follow-up, especially for lower-birth-weight infants. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Birth prevalence of congenital cytomegalovirus among infants of HIV-infected women on prenatal antiretroviral prophylaxis in South Africa.

    Science.gov (United States)

    Manicklal, S; van Niekerk, A M; Kroon, S M; Hutto, C; Novak, Z; Pati, S K; Chowdhury, N; Hsiao, N Y; Boppana, S B

    2014-05-01

    A high rate of congenital cytomegalovirus (CMV) has been documented in human immunodeficiency virus (HIV)-exposed infants in industrialized settings, both in the pre- and post-highly active antiretroviral therapy (HAART) era. Only limited data on the birth prevalence of congenital CMV among infants of HIV-infected women on prenatal antiretroviral (ARV) prophylaxis are available from sub-Saharan Africa, despite a high prevalence of both infections. We evaluated the prevalence of congenital CMV in HIV-exposed infants in the Western Cape, South Africa. HIV-infected mothers were recruited in the immediate postnatal period at a referral maternity hospital between April and October 2012. Maternal and infant clinical data and newborn saliva swabs were collected. Saliva swabs were assayed by real-time polymerase chain reaction for CMV. Data were analyzed using univariate and multivariate logistic regression analyses to determine specific demographic, maternal, and newborn characteristics associated with congenital CMV. CMV was detected in 22 of 748 newborn saliva swabs (2.9%; 95% confidence interval [CI], 1.9%-4.4%). Overall, 96% of mothers used prenatal ARV prophylaxis (prenatal zidovudine, 43.9%; HAART, 52.1%). Maternal age, gestational age, prematurity (CMV-infected and -uninfected infants. Maternal CD4 count CMV (adjusted odds ratio, 2.9; 95% CI, 1.2-7.3). A negative correlation between CMV load in saliva and maternal CD4 count was observed (r = -0.495, n = 22, P = .019). The birth prevalence of congenital CMV was high despite prenatal ARV prophylaxis, and was associated with advanced maternal immunosuppression.

  4. High birth rates despite easy access to contraception and abortion

    DEFF Research Database (Denmark)

    Hognert, Helena; Skjeldestad, Finn E; Gemzell-Danielsson, Kristina

    2017-01-01

    INTRODUCTION: The aim of this study was to describe and compare contraceptive use, fertility, birth, and abortion rates in the Nordic countries. MATERIAL AND METHODS: National data on births, abortions, fertility rate (1975-2013), redeemed prescriptions of hormonal contraceptives and sales figures...... contraception followed by the levonorgestrel-releasing intrauterine system were the most common methods. During 1975-2013 abortion rates decreased in Denmark (from 27/1000 women to 15/1000 women aged 15-44/1000 women) and Finland (from 20 to 10/1000 women), remained stable in Norway (≈16) and Sweden (≈20......) and increased in Iceland (from 6 to 15/1000 women). Birth rates remained stable around 60/1000 women aged 15-44 in all countries except for Iceland where the birth rate decreased from 95 to 65/1000 women. Abortion rates were highest in the age group 20-24 years. In the same age group, Sweden had a lower...

  5. Intraventricular hemorrhage in a very low birth weight infants: Associated risk factors in Isfahan, Iran

    International Nuclear Information System (INIS)

    Badiee, Z.

    2007-01-01

    Prematurely born infants with intraventricular hemorrhage (IVH) suffer significant morbidity and mortality, particularly with those infants with high-grade hemorrhage. Previous studies have proposed a number of risk factors for IVH; however, lack of adequate matching for gestational age and birth weight may have confounded the results. The purpose of this study was to identify variables that affect the risk of IVH. We identified 31 preterm infants with gestational age < 32 weeks and birth weight < 1500 g, with IVH, from November 2003 to January 2005 at Alzahra University Hospital, Isfahan, Iran. A control group of 90 infants, matched for gestational age and birth weight was selected. Maternal factors, labor and delivery characteristics and neonatal parameters were collected in both groups. Results of cranial ultrasound examinations were also collected. The significant risk factors for IVH were found to be: patent ductus artreiosus arteriosus (PDA) [4 (13.3%) versus 3(3.3%) (p=0.01)], longer duration of assisted ventilation [4 (2.8+-5.8 days versus 0.5+-2.1 days (p=0.002)], a higher number of endotracheal suctioning [9.7+-18.4 versus 3.06+-13.7 (p=0.004)], surfactant use, [7(22.6%) versus 3(3.4%) (p=0.003)], positive pressure ventilation at birth [12 (38.7%) versus 12(13.3%), (p=0.004)] and low Apgar score at 1 and 5 minutes. Whereas antenatal steroid treatments and cesarean sections have protective effect on the occurrence of IVH. Our data emphasize the importance of obstetric and prenatal care to improve outcomes of premature infants. (author)

  6. Enhanced nutrition improves growth and increases blood adiponectin concentrations in very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Elin W. Blakstad

    2016-12-01

    Full Text Available Background: Adequate nutrient supply is essential for optimal postnatal growth in very low birth weight (VLBW, birth weight<1,500 g infants. Early growth may influence the risk of metabolic syndrome later in life. Objective: To evaluate growth and blood metabolic markers (adiponectin, leptin, and insulin-like growth factor-1 (IGF-1 in VLBW infants participating in a randomized nutritional intervention study. Design: Fifty VLBW infants were randomized to an enhanced nutrient supply or a standard nutrient supply. Thirty-seven infants were evaluated with growth measurements until 2 years corrected age (CA. Metabolic markers were measured at birth and 5 months CA. Results: Weight gain and head growth were different in the two groups from birth to 2 years CA (weight gain: pinteraction=0.006; head growth: pinteraction=0.002. The intervention group improved their growth z-scores after birth, whereas the control group had a pronounced decline, followed by an increase and caught up with the intervention group after discharge. At 5 months CA, adiponectin concentrations were higher in the intervention group and correlated with weight gain before term (r=0.35 and nutrient supply (0.35≤r≤0.45. Leptin concentrations correlated with weight gain after term and IGF-1 concentrations with length growth before and after term and head growth after term (0.36≤r≤0.53. Conclusion: Enhanced nutrient supply improved early postnatal growth and may have prevented rapid catch-up growth later in infancy. Adiponectin concentration at 5 months CA was higher in the intervention group and correlated positively with early weight gain and nutrient supply. Early nutrition and growth may affect metabolic markers in infancy.Clinical Trial Registration (ClinicalTrials.gov no.: NCT01103219

  7. Serum 25 Hydroxy Vitamin D Levels in Very Low Birth Weight Infants Receiving Oral Vitamin D Supplementation.

    Science.gov (United States)

    Munshi, Upender K; Graziano, Pauline D; Meunier, Kara; Ludke, Jennifer; Rios, Angel

    2017-11-03

    Vitamin D supplementation in preterm infants has been recommended by American Academy of Pediatrics (AAP) however its efficacy and safety has not been well studied. To study 25 hydroxy vitamin D (25OHD) levels as a marker of vitamin D status of very low birth weight infants while on vitamin D supplementation during NICU hospitalization. Retrospective study of preterm infants with birth weight supplementation. Serum 25OHD level were checked at 4, 8 and 12 weeks of age or before discharge and the levels were stratified as deficient 100 ng/ml. 301 infants were enrolled, 186 very low birth weight VLBW (1000 -1499 g) infants and 115 extremely low birth weight ELBW (supplementation VLBW infants increased their 25OHD levels significantly by 8 and 12 weeks of age while ELBW infants lagged behind at 8 weeks and increased their 25OHD levels by 12 weeks of age. Eighty percent of ELBW and VLBW infants have either deficient or insufficient vitamin D status at 4 weeks of age. Vitamin D supplementation helps in improving the vitamin D levels, VLBW infants significantly more than ELBW infants. AAP recommendation appears to be safe, however if using higher supplement dosing, 25OHD level should be monitored to avoid high and very high vitamin D levels.

  8. Fractional anisotropy in white matter tracts of very-low-birth-weight infants

    International Nuclear Information System (INIS)

    Dudink, Jeroen; Conneman, Nikk; Goudoever, Johannes van; Govaert, Paul; Lequin, Maarten; Pul, Carola van; Buijs, Jan

    2007-01-01

    Advances in neonatal intensive care have not yet reduced the high incidence of neurodevelopmental disability among very-low-birth-weight (VLBW) infants. As neurological deficits are related to white-matter injury, early detection is important. Diffusion tensor imaging (DTI) could be an excellent tool for assessment of white-matter injury. To provide DTI fractional anisotropy (FA) reference values for white-matter tracts of VLBW infants for clinical use. We retrospectively analysed DTI images of 28 VLBW infants (26-32 weeks gestational age) without evidence of white-matter abnormalities on conventional MRI sequences, and normal developmental outcome (assessed at age 1-3 years). For DTI an echoplanar sequence with diffusion gradient (b = 1,000 s/mm 2 ) applied in 25 non-collinear directions was used. We measured FA and apparent diffusion coefficient (ADC) of different white-matter tracts in the first 4 days of life. A statistically significant correlation was found between gestational age and FA of the posterior limb of the internal capsule in VLBW infants (r = 0.495, P<0.01). Values of FA and ADC were measured in white-matter tracts of VLBW infants. FA of the pyramidal tracts measured in the first few days after birth is related to gestational age. (orig.)

  9. Fractional anisotropy in white matter tracts of very-low-birth-weight infants

    Energy Technology Data Exchange (ETDEWEB)

    Dudink, Jeroen; Conneman, Nikk; Goudoever, Johannes van; Govaert, Paul [Erasmus MC-Sophia Children' s Hospital, Division of Neonatology, Department of Paediatrics, P.O. Box 2060, Rotterdam (Netherlands); Lequin, Maarten [Erasmus MC-Sophia Children' s Hospital, Division of Paediatrics, Department of Radiology, Rotterdam (Netherlands); Pul, Carola van [Maxima Medical Center, Department of Clinical Physics, Veldhoven (Netherlands); Buijs, Jan [Maxima Medical Center, Division of Neonatology, Department of Paediatrics, Veldhoven (Netherlands)

    2007-12-15

    Advances in neonatal intensive care have not yet reduced the high incidence of neurodevelopmental disability among very-low-birth-weight (VLBW) infants. As neurological deficits are related to white-matter injury, early detection is important. Diffusion tensor imaging (DTI) could be an excellent tool for assessment of white-matter injury. To provide DTI fractional anisotropy (FA) reference values for white-matter tracts of VLBW infants for clinical use. We retrospectively analysed DTI images of 28 VLBW infants (26-32 weeks gestational age) without evidence of white-matter abnormalities on conventional MRI sequences, and normal developmental outcome (assessed at age 1-3 years). For DTI an echoplanar sequence with diffusion gradient (b = 1,000 s/mm{sup 2}) applied in 25 non-collinear directions was used. We measured FA and apparent diffusion coefficient (ADC) of different white-matter tracts in the first 4 days of life. A statistically significant correlation was found between gestational age and FA of the posterior limb of the internal capsule in VLBW infants (r = 0.495, P<0.01). Values of FA and ADC were measured in white-matter tracts of VLBW infants. FA of the pyramidal tracts measured in the first few days after birth is related to gestational age. (orig.)

  10. Feeding pratices and HIV positivity rates of exposed infants: results ...

    African Journals Online (AJOL)

    Background: Breast milk despite its benefit is a known route of HIV transmission in developing countries this cannot be easily replaced and as such the feeding of the HIV exposed infant becomes a great challenge. We evaluated the impact of infant feeding practices on HIV positivity rates. Methods: HIV DNA PCR was ...

  11. Assessment of different folic acid supplementation doses for low-birth-weight infants.

    Science.gov (United States)

    Çelik, Fatma Çakmak; Aygün, Canan; Gülten, Sedat; Bedir, Abdulkerim; Çetinoğlu, Erhan; Küçüködük, Şükrü; Bek, Yüksel

    2016-12-01

    The adequacy of 50 mcg folic acid supplementation given to low-birth-weight babies was investigated. The folate levels of the mothers and infants, and breastmilk, and the optimum dose for folic acid supplementation were also investigated. After obtaining blood from 141 low-birth-weight infants on the 1st day of life for serum and red cell folate levels, the infants were randomly allocated into three groups according to the folic acid supplement dose. Forty-six infants were given 25 μg/d folic acid, 39 were given 50 μg/d folic acid, and 44 were given 75 μg/d folic acid. Folic acid could not be given to 12 infants. Follow-up blood samples were obtained at the end of folic acid supplementation. Maternal samples for red cell and serum folate levels and breast milk folate levels were obtained within the first 48 hours and the samples for measuring breastmilk folate level were obtained on the 3rd day postnatally. The feeding modes of the infants, maternal folic acid intake, and details of neonate intensive care unit course were recorded. The mean birth weight and gestational age of the infants were found as 1788.2±478.4 g and 33.5±2.9 weeks, respectively. The mean serum and red cell folate levels on admission were found as 21.2±12.2 ng/mL and 922.7±460.7 ng/mL, respectively. The mean maternal serum and red cell folate levels and the mean breast milk folate levels were found as 12.3±7.5 ng/mL, 845.5±301.4 ng/mL, and 30.6±33.0 ng/m, respectively. The breast milk folate levels of mothers who were supplemented with folic acid during pregnancy were significantly higher compared with mothers who were not supplemented with folic acid (psupplemented with folic acid had higher follow-up serum folate levels compared with the basal level in all groups, but there was no statistically significant difference between the groups. This study showed that the folic acid doses of 25, 50, and 75 μcg/d affected serum folate levels similarly. We can conclude that the dose of 25

  12. Intraurethral knot in a very-low-birth-weight infant: radiological recognition, surgical management and prevention

    International Nuclear Information System (INIS)

    Lodha, Abhay; Ly, Linh; McNamara, Patrick J.; Brindle, Mary; Daneman, Alan

    2005-01-01

    We report a case where a knot developed in a urinary catheter and became lodged within the urethra of a very-low-birth-weight (VLBW) preterm infant. The catheter was removed with the assistance of a urologist. We recommend using caution when placing urinary catheters in VLBW infants and question the appropriateness of feeding tubes as catheters. Recognition on radiographs of malpositioned bladder catheters is vital to the care of these patients. All staff involved in the insertion, maintenance or removal of these catheters should be suitably trained to minimize the risk of knots and related complications. (orig.)

  13. Intraurethral knot in a very-low-birth-weight infant: radiological recognition, surgical management and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Lodha, Abhay; Ly, Linh; McNamara, Patrick J. [Hospital for Sick Children, Division of Neonatology, Toronto (Canada); Brindle, Mary [Hospital for Sick Children, Department of Surgery, Toronto (Canada); Daneman, Alan [Hospital for Sick Children, Department of Radiology, Toronto (Canada)

    2005-07-01

    We report a case where a knot developed in a urinary catheter and became lodged within the urethra of a very-low-birth-weight (VLBW) preterm infant. The catheter was removed with the assistance of a urologist. We recommend using caution when placing urinary catheters in VLBW infants and question the appropriateness of feeding tubes as catheters. Recognition on radiographs of malpositioned bladder catheters is vital to the care of these patients. All staff involved in the insertion, maintenance or removal of these catheters should be suitably trained to minimize the risk of knots and related complications. (orig.)

  14. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    Directory of Open Access Journals (Sweden)

    Hui-Jia Lin

    2015-01-01

    Full Text Available Background: With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU stay in the mainland of China. Methods: All infants admitted to 26 NICUs with a birth weight (BW < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results: A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3% died and another 69 infants (26.7% died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019. BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions: Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other

  15. Idiopathic severe hypermagnesemia in an extremely low birth weight infant on the first day of life

    Directory of Open Access Journals (Sweden)

    Hye Sun Hyun

    2011-07-01

    Full Text Available A preterm female infant born at 27 weeks of gestation with a birth weight of 990 g developed acute hypotonia, apnea, hypotension and bradycardia mimicking septic shock syndrome at 14h after birth. Laboratory tests indicated a severe hypermagnesemia of 45 mg/dL. The renal function, complete blood count and maternal blood concentrations of magnesium were normal, and the blood cultures were negative. The patient recovered with treatment including exchange transfusion. However, the etiology of the severe hypermagnesemia remains unknown.

  16. Factors associated with thymic size at birth among low and normal birth-weight infants

    DEFF Research Database (Denmark)

    Eriksen, Helle Brander; Biering-Sørensen, Sofie; Lund, Najaaraq

    2014-01-01

    treatment at the time of labor (0.84 [0.70-1.00]), number of pregnancy consultations (1.03 [1.00-1.05]), maternal age (0.91 [0.84-0.98]), Apgar score (1.06 [1.03-1.10]), and infant convulsions (0.44 [0.29-0.65]) were all independent determinants of thymic index but not all were determinants of thymus...

  17. The relationship between resettlement and birth rates: The case of ...

    African Journals Online (AJOL)

    Background: This study aims to examine the possible impacts of resettlement on birth rates by using the length of stay variable in the 2000 Demographic and Health Survey (DHS). Methods: Data in all three rounds of Gambella Administrative Region's Demographic and Health Surveys (DHS) are analyzed. The neighboring ...

  18. Reading difficulty in school-aged very low birth weight infants in Japan.

    Science.gov (United States)

    Takeuchi, Akihito; Koeda, Tatsuya; Takayanagi, Toshimitsu; Sato, Kazuo; Sugino, Noriko; Bonno, Motoki; Kada, Akiko; Nakamura, Makoto; Kageyama, Misao

    2016-10-01

    To investigate the prevalence of and the perinatal risk factors related to reading difficulty in school-aged very low birth weight infants (VLBWI) with normal intelligence. Subjects were 79 Japanese children in the second to fourth grade of elementary school who had been born at very low birth weight and who regularly visited a follow-up clinic at one of four hospitals. All members had a full-scale IQ score of 80 or higher. Perinatal information was obtained retrospectively from medical records. Each subject underwent four reading tasks, testing monomoratic syllable reading, word reading, non-word reading and short sentence reading. Subjects with an SD reading time score greater than 2.0 in two or more tasks were considered to have reading difficulty (RD). Furthermore we investigated the relations between RD and perinatal factors using logistic regression analysis adjusted for potential confounding factors. Twenty-five (31.6%) out of 79 subjects had RD. We discovered that treated retinopathy of prematurity (tRoP) was a significant risk factor (adjusted OR=5.80, 95% confidence interval=1.51-22.33). The rate of RD in school-aged VLBWI was higher than the estimated prevalence of dyslexia in Japan. Even in children with normal intelligence, long-term developmental follow-up including support for reading skills is necessary for VLBWI. Further investigation is desired to elucidate the relations between visual problems and RD in school-aged children. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  19. Nutrition for healthy term infants: recommendations from birth to six months.

    Science.gov (United States)

    2012-01-01

    This joint statement provides health professionals in Canada with evidence-informed principles and recommendations to promote communication of accurate, consistent advice to parents and caregivers on infant nutrition in the first six months. Participating organizations in the Infant Feeding Joint Work Group collaborated to revise guidance from 1998 and 2005. Development of this statement involved an extensive review of scientific evidence in peer-reviewed literature, with content guidance from the Infant Feeding Expert Advisory Group and broad stakeholder consultation. Updated guidance on nutrition from six months to two years will be available in early 2014. Each section of this joint statement includes recommendations, rationale and references, organized under seven principles. The first five principles and recommendations are: Breastfeeding is the normal and unequalled method of feeding infants. · Recommend exclusive breastfeeding for the first six months. Breastfeeding initiation and duration rates increase with active protection, support, and promotion. · Implement the policies and practices of the Baby-Friendly Initiative (BFI) for hospitals and community health services. Supplemental vitamin D is recommended for breastfed infants. · Recommend a daily vitamin D supplement of 10 µg (400 IU) for breastfed infants. First complementary foods should be iron-rich. · Recommend meat, meat alternatives, and iron-fortified cereal as an infant's first complementary foods. Routine growth monitoring is important to assess infant health and nutrition. · Use the World Health Organization (WHO) Growth Charts for Canada for optimal monitoring of infant growth. Additional recommendations are provided under the last two principles regarding unnecessary feeding changes (e.g., responding to infant gastrointestinal issues) and rare contraindications for breastfeeding (e.g., advising mothers with infections, using medications or illicit drugs). A separate section addresses

  20. Breastfeeding Progression in Preterm Infants Is Influenced by Factors in Infants, Mothers and Clinical Practice: The Results of a National Cohort Study with High Breastfeeding Initiation Rates

    Science.gov (United States)

    Maastrup, Ragnhild; Hansen, Bo Moelholm; Kronborg, Hanne; Bojesen, Susanne Norby; Hallum, Karin; Frandsen, Annemi; Kyhnaeb, Anne; Svarer, Inge; Hallström, Inger

    2014-01-01

    Background and Aim Many preterm infants are not capable of exclusive breastfeeding from birth. To guide mothers in breastfeeding, it is important to know when preterm infants can initiate breastfeeding and progress. The aim was to analyse postmenstrual age (PMA) at breastfeeding milestones in different preterm gestational age (GA) groups, to describe rates of breastfeeding duration at pre-defined times, as well as analyse factors associated with PMA at the establishment of exclusive breastfeeding. Methods The study was part of a prospective survey of a national Danish cohort of preterm infants based on questionnaires and structured telephone interviews, including 1,221 mothers and their 1,488 preterm infants with GA of 24–36 weeks. Results Of the preterm infants, 99% initiated breastfeeding and 68% were discharged exclusively breastfed. Breastfeeding milestones were generally reached at different PMAs for different GA groups, but preterm infants were able to initiate breastfeeding at early times, with some delay in infants less than GA 32 weeks. Very preterm infants had lowest mean PMA (35.5 weeks) at first complete breastfeed, and moderate preterm infants had lowest mean PMA at the establishment of exclusive breastfeeding (36.4 weeks). Admitting mothers to the NICU together with the infant and minimising the use of a pacifier during breastfeeding transition were associated with 1.6 (95% CI 0.4–2.8) and 1.2 days (95% CI 0.1–2.3) earlier establishment of exclusive breastfeeding respectively. Infants that were small for gestational age were associated with 5.6 days (95% CI 4.1–7.0) later establishment of exclusive breastfeeding. Conclusion Breastfeeding competence is not developed at a fixed PMA, but is influenced by multiple factors in infants, mothers and clinical practice. Admitting mothers together with their infants to the NICU and minimising the use of pacifiers may contribute to earlier establishment of exclusive breastfeeding. PMID:25251690

  1. Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy.

    Science.gov (United States)

    Honein, Margaret A; Dawson, April L; Petersen, Emily E; Jones, Abbey M; Lee, Ellen H; Yazdy, Mahsa M; Ahmad, Nina; Macdonald, Jennifer; Evert, Nicole; Bingham, Andrea; Ellington, Sascha R; Shapiro-Mendoza, Carrie K; Oduyebo, Titilope; Fine, Anne D; Brown, Catherine M; Sommer, Jamie N; Gupta, Jyoti; Cavicchia, Philip; Slavinski, Sally; White, Jennifer L; Owen, S Michele; Petersen, Lyle R; Boyle, Coleen; Meaney-Delman, Dana; Jamieson, Denise J

    2017-01-03

    Understanding the risk of birth defects associated with Zika virus infection during pregnancy may help guide communication, prevention, and planning efforts. In the absence of Zika virus, microcephaly occurs in approximately 7 per 10 000 live births. To estimate the preliminary proportion of fetuses or infants with birth defects after maternal Zika virus infection by trimester of infection and maternal symptoms. Completed pregnancies with maternal, fetal, or infant laboratory evidence of possible recent Zika virus infection and outcomes reported in the continental United States and Hawaii from January 15 to September 22, 2016, in the US Zika Pregnancy Registry, a collaboration between the CDC and state and local health departments. Laboratory evidence of possible recent Zika virus infection in a maternal, placental, fetal, or infant sample. Birth defects potentially Zika associated: brain abnormalities with or without microcephaly, neural tube defects and other early brain malformations, eye abnormalities, and other central nervous system consequences. Among 442 completed pregnancies in women (median age, 28 years; range, 15-50 years) with laboratory evidence of possible recent Zika virus infection, birth defects potentially related to Zika virus were identified in 26 (6%; 95% CI, 4%-8%) fetuses or infants. There were 21 infants with birth defects among 395 live births and 5 fetuses with birth defects among 47 pregnancy losses. Birth defects were reported for 16 of 271 (6%; 95% CI, 4%-9%) pregnant asymptomatic women and 10 of 167 (6%; 95% CI, 3%-11%) symptomatic pregnant women. Of the 26 affected fetuses or infants, 4 had microcephaly and no reported neuroimaging, 14 had microcephaly and brain abnormalities, and 4 had brain abnormalities without microcephaly; reported brain abnormalities included intracranial calcifications, corpus callosum abnormalities, abnormal cortical formation, cerebral atrophy, ventriculomegaly, hydrocephaly, and cerebellar abnormalities

  2. Cognitive function and MRI findings in very low birth weight infants

    International Nuclear Information System (INIS)

    Imamura, Atsuko; Takagishi, Yuka; Takada, Satoru; Uetani, Yoshiyuki; Nakamura, Toru; Nakamura, Hajime; Inagaki, Yuko.

    1996-01-01

    Twenty-two very low birth weight infants at preschool ages of 5-6 years were studied to clarify the correlation between cognitive function and MRI findings. Cognitive function was evaluated by the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Frostig developmental test of visual perception. Ventricular enlargement, assessed by the bioccipital index (B.I.) measured on MRI, was correlated to cognitive disorders. Children with periventricular high intensity areas (T 2 -weighted images) extending from the posterior periventricular region to the parietal lobe tend to highly suffer from cerebral palsy and visuoperceptual impairment. These results indicate that the disorders of cognitive function in very low birth weight infants were caused by a damage of association fibers in periventricular areas which was detectable by MRI. (author)

  3. Cognitive function and MRI findings in very low birth weight infants

    Energy Technology Data Exchange (ETDEWEB)

    Imamura, Atsuko; Takagishi, Yuka; Takada, Satoru; Uetani, Yoshiyuki; Nakamura, Toru; Nakamura, Hajime [Kobe Univ. (Japan). School of Medicine; Inagaki, Yuko

    1996-07-01

    Twenty-two very low birth weight infants at preschool ages of 5-6 years were studied to clarify the correlation between cognitive function and MRI findings. Cognitive function was evaluated by the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Frostig developmental test of visual perception. Ventricular enlargement, assessed by the bioccipital index (B.I.) measured on MRI, was correlated to cognitive disorders. Children with periventricular high intensity areas (T{sub 2}-weighted images) extending from the posterior periventricular region to the parietal lobe tend to highly suffer from cerebral palsy and visuoperceptual impairment. These results indicate that the disorders of cognitive function in very low birth weight infants were caused by a damage of association fibers in periventricular areas which was detectable by MRI. (author)

  4. Mineral balance studies in very low birth weight infants fed human milk

    International Nuclear Information System (INIS)

    Schanler, R.J.; Abrams, S.A.; Garza, C.

    1988-01-01

    Mineral homeostasis often is disrupted in the very low birth weight (VLBW) infant fed either human milk or commercial formula that contains insufficient quantities of available calcium (Ca) and phosphorus (P). Alterations in mineral homeostasis include abnormal patterns of serum (Ca and P concentrations and alkaline phosphatase activity) and urine (Ca and P) biochemical markers, low net Ca and P retentions in comparison with intrauterine estimates of mineral accretion, and decreased bone mineral content. A two-phase study was conducted in our laboratory to test for these alterations in mineral homeostasis. In phase 1, VLBW infants fed a preparation of fortified human milk (either human milk-derived fortifier I or II or cow milk-derived fortifier) or cow milk-based formula specially designed for VLBW infants were evaluated during their hospitalization. In phase 2, after hospitalization, these infants were evaluated during the first 6 months of life when fed either their mother's milk or routine formula exclusively. The bioavailability of Ca and P from the tested preparations varied widely. Although the fortification of human milk resulted in both an improved biochemical pattern and net retention of Ca and P, optimal intrauterine mineral accretion was not achieved in any group tested. Longitudinal assessments of bone mineralization, by single photon absorptiometry, demonstrated that human milk-fed former VLBW infants had reduced bone mineral content. These investigations suggest that former VLBW infants fed human milk exclusively may be at risk for Ca and P deficiencies

  5. Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study

    Science.gov (United States)

    2014-01-01

    Background Few studies have focused on cerebral complications among newborn infants delivered by vacuum extraction (VE). The aim of this study was to determine the risk for intracranial haemorrhage and/or cerebral dysfunction in newborn infants delivered by VE and to compare this risk with that after cesarean section in labour (CS) and spontaneous vaginal delivery, respectively. Methods Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010 including all singleton newborn infants delivered at term after onset of labour by VE (n = 87,150), CS (75,216) or spontaneous vaginal delivery (n = 851,347), we compared the odds for neonatal intracranial haemorrhage, traumatic or non-traumatic, convulsions or encephalopathy. Logistic regressions were used to calculate adjusted (for major risk factors and indication) odds ratios (AOR), using spontaneous vaginal delivery as reference group. Results The rates of traumatic and non-traumatic intracranial hemorrhages were 0.8/10,000 and 3.8/1,000. VE deliveries provided 58% and 31.5% of the traumatic and non-traumatic cases, giving a ten-fold risk [AOR 10.05 (4.67-21.65)] and double risk [AOR 2.23 (1.57-3.16)], respectively. High birth weight and short mother were associated with the highest risks. Infants delivered by CS had no increased risk for intracranial hemorrhages. The risks for convulsions or encephalopathy were similar among infants delivered by VE and CS, exceeding the OR after non-assisted spontaneous vaginal delivery by two-to-three times. Conclusion Vacuum assisted delivery is associated with increased risk for neonatal intracranial hemorrhages. Although causality could not be established in this observational study, it is important to be aware of the increased risk of intracranial hemorrhages in VE deliveries, particularly in short women and large infants. The results warrant further studies in decision making and conduct of assisted vaginal delivery. PMID:24444326

  6. Breastfeeding practices and determinants in infants from birth to six ...

    African Journals Online (AJOL)

    Introduction: Exclusive breastfeeding (EBF) has the benefits of reduced rates of infectious morbidity and mortality. However, the EBF rate remains low worldwide including in Côte d'Ivoire despite efforts by health authorities. Objective: The study was carried out to describe the knowledge and practices of mothers concerning ...

  7. Initial Resuscitation at Delivery and Short Term Neonatal Outcomes in Very-Low-Birth-Weight Infants

    OpenAIRE

    Cho, Su Jin; Shin, Jeonghee; Namgung, Ran

    2015-01-01

    Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birt...

  8. VSRR - Provisional monthly and 12-month ending number of live births, deaths and infant deaths: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — https://www.cdc.gov/nchs/products/vsrr/provisional-tables.htm Monthly and 12 month-ending provisional counts of births, deaths and infant deaths are provided for the...

  9. Association of Using Oxytocin during Labor and Breastfeeding Behaviors of Infants within Two Hours after Birth

    Directory of Open Access Journals (Sweden)

    Mehri Abdoulahi

    2017-09-01

    Full Text Available Background: Opioids are used to relieve pain during labor and may affect the neurobehavioral conditions of infants. However, effects of using drugs, such as oxytocin, as a routine component of pre- and post-delivery care on the breastfeeding behaviors of newborns remain unclear. The present study aimed to investigate the association between the maternal use of oxytocin during labor and breastfeeding behaviors of neonates within two hours after birth.Methods: This descriptive-analytical study was conducted on 160 women selected via convenience sampling. The participants were assigned to two groups of oxytocin administration (n=70 and physiologic delivery (n=90. Data were collected using demographic questionnaires and infant breastfeeding assessment tool (IBFAT. IBFAT was completed by the researcher through observing the behaviors of infants during breastfeeding after birth. Data analysis was performed in SPSS version 20, using descriptive and analytical statistics, including independent t-test, correlation-coefficients, and analysis of variance.Results: Mean age of the mothers in the oxytocin administration and physiologic delivery groups was 26.9±5.9 and 27.8±5.5 years, respectively. Breastfeeding was significantly stronger in the infants whose mothers had physiologic delivery compared to the group administered with oxytocin during labor.Conclusion: According to the results, use of oxytocin during labor directly weakens the breastfeeding of neonates. Therefore, it seems necessary to inform and prepare women for physiologic delivery during pregnancy

  10. Exhaled Carbon Dioxide and Neonatal Breathing Patterns in Preterm Infants after Birth.

    Science.gov (United States)

    Nicoll, Jessica; Cheung, Po-Yin; Aziz, Khalid; Rajani, Vishaal; O'Reilly, Megan; Pichler, Gerhard; Schmölzer, Georg M

    2015-10-01

    To examine the amount of exhaled carbon dioxide (ECO2) with different breathing patterns in spontaneously breathing preterm infants after birth. Preterm infants had a facemask attached to a combined carbon dioxide/flow sensor placed over their mouth and nose to record ECO2 and gas flow. A breath-by-breath analysis of the first 5 minutes of the recording was performed. Thirty spontaneously breathing preterm infants, gestational age (mean ± SD) 30 ± 2 weeks and birth weight 1635 ± 499 g were studied. ECO2 from normal breaths and slow expirations was significantly larger than with other breathing patterns (P breath also increased with gestational age P breathing pattern both during the first minute of recording and overall. Breathing pattern proportions also varied by gestational age. Finally, ECO2 from the fifth minute of recording was significantly greater than that produced during the first 4 minutes of recording (P ≤ .029). ECO2 varies with different breathing patterns and increases with gestational age and over time. ECO2 may be an indicator of lung aeration and that postnatal ECO2 monitoring may be useful in preterm infants in the delivery room. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Gaurav Sanghi

    2014-01-01

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

  12. The comparative study of the impact of antenatal training care infants to fathers and couple on the fathers' participations after birth.

    Directory of Open Access Journals (Sweden)

    mahin Tafzoli

    2013-12-01

    Full Text Available The comparative study of the impact of antenatal training care infants to fathers and couple on the fathers' participations. Objectives: Increasing number of working mothers and changes in viewpoints on fathers’ roles in families has increased fathers’ participations. Fathers’ participation is his broad, positive and active participation in different stages of children’s life. Wives possess the main role in enhancing and limiting father’s participation. Fathers and couples require training to define father’s role in infant care and the significance of his role in infant’s health and foundation of family. Therefore, the present study is done to determine the impact of training couples and fathers how to take care of infants on the rate of father’s participation to take care of infants after birth. Method: the study was done as a clinical trial in three groups, on 150 people in hygienic- clinical centers of Medical University of Mashhad. Fathers of training group and couples of training group took part in two training sessions of infant care in weeks 35 to 37 of pregnancy. The questionnaires of role of father’s training in infant care were filled by mothers in three groups and were analyzed by SPSS software (version 18 and ANOVA with repeated measure, Bonferroni tests. Findings: role of fathers’ participation in infants care in father’s training group and couple training group than control group increased significantly. (p=0/0003 Results: training fathers and couples before birth will enhance rate of their participation in infant care. Key words: fathers’ participation, care of infant, training.

  13. Early Caffeine Use in Very Low Birth Weight Infants and Neonatal Outcomes: A Systematic Review and Meta-Analysis

    OpenAIRE

    Park, Hye Won; Lim, Gina; Chung, Sung-Hoon; Chung, Sochung; Kim, Kyo Sun; Kim, Soo-Nyung

    2015-01-01

    The use of caffeine citrate for treatment of apnea in very low birth weight infants showed short-term and long-term benefits. A systematic review and meta-analysis of the literature was undertaken to document the effect providing caffeine early (0-2 days of life) compared to providing caffeine late (?3 days of life) in very low birth weight infants on several neonatal outcomes, including bronchopulmonary dysplasia (BPD). We searched MEDLINE, the EMBASE database, the Cochrane Library, and Kore...

  14. Literacy Rates and its Impact on Birth Rates in Nadia District, West Bengal, India

    OpenAIRE

    Mahadeb Ghosh; Biswaranjan Mistri

    2016-01-01

    Equality in socio-economic component is essential for human development and social change. Educational inequality reduces economic growth and women's empowerment on the one hand and increases birth rate on the other. In population studies, it has been established that educational level is collinearly related with demographic behaviour. This study aims to investigate inequalities in literacy rates and its impact on birth rates in Nowpara-I Gram Panchayat (GP) located in the Krishnagar II C.D. ...

  15. Hypernatremia and grade III/IV intraventricular hemorrhage among extremely low birth weight infants.

    Science.gov (United States)

    Lim, W-H; Lien, R; Chiang, M-C; Fu, R-H; Lin, J-J; Chu, S-M; Hsu, J-F; Yang, P-H

    2011-03-01

    To identify the risk factors contributing to intraventricular hemorrhage (IVH) in extremely low birth weight infants during early postnatal life, after appropriate matching for gestational age (GA) and birth body weight (BBW). A case-control retrospective study was designed to evaluate preterm infants with a GA ≤ 26 weeks and a BBW ≤ 1000 g admitted to our hospital during a 7.5-year period. From a cohort of 347 preterm infants, 36 infants (10.7%) had severe IVH (grades III and/or IV). We selected a control group of 36 preterm infants without IVH who were closely matched for GA (± 1 week) and body weight (± 100 g). Univariate and multivariate logistic regression analyses were performed to identify risk factors for severe IVH. The GA and BBW of the IVH and control groups were 24.6 ± 1 weeks and 764.4 ± 118.5 g, and 24.8 ± 0.9 weeks and 771.5 ± 125.9 g, respectively. Vaginal delivery, male sex, resuscitation in the delivery room, high sodium serum levels (meq l(-1)) (162.6 vs 148.8), fluctuation of serum sodium (meq l(-1)) (17.3 vs 6.2), pH, PaCO(2), hemoglobin and platelet counts were associated with an increased risk of severe IVH. Multivariate logistic regression indicated that sodium fluctuations >13 meq l(-1), vaginal delivery, male sex and hemoglobin fluctuations are strongly associated with the development of severe IVH. Hypernatremia and fluctuations of sodium seem to be related to early severe IVH among preterm infants; however, further studies are required to clarify the causal relationship.

  16. [Description and evaluation of creative thinking in preterm low birth weight infants].

    Science.gov (United States)

    Parisi, L; Di Filippo, T; Firrigno, L; La Grutta, S; Testa, D; Roccella, M

    2007-04-01

    Since the 1950s, the problem of how to evaluate creativity has been addressed in studies on the definition of measurement criteria and on the relationship between intelligence and creative thinking. Many revealed cognitive and relational disorders in preterm infants, particularly in preterm very low birth weight infants (birth weight 2500 g. The test battery included: Torrance Test of Creative Thinking (TCTT); WISC-R intelligence test; Goodenough Human Figure Drawing Test. Statistical analysis (Mann-Whitney U test) showed a statistically significant difference (P>0.05) between the 2 groups; scores for figure originality, figure fluidity and figure elaboration were consistently higher in the control group. Within the low birth weight group, there was a significant correlation (Spearman r) between verbal IQ and verbal fluidity and verbal flexibility subscale scores and between IQ performance and figure elaboration. Scores on the figure drawing tests showed higher creative ability in the control group. In children born preterm with low birth weight, emotive dynamics and flow of affection may influence the channels of communication between child and family. The low figure originality subscale scores support the hypothesis that psychodynamic and relational factors (worry about the preterm condition, overprotective behaviour by parents and others) could lead to diminished autonomy, flexibility and manipulatory interest in the child.

  17. Teen birth rates in sexually abused and neglected females.

    Science.gov (United States)

    Noll, Jennie G; Shenk, Chad E

    2013-04-01

    Prospectively track teen childbirths in maltreated and nonmaltreated females and test the hypothesis that child maltreatment is an independent predictor of subsequent teen childbirth over and above demographic characteristics and other risk factors. Nulliparous adolescent females (N = 435) aged 14 to 17 years were assessed annually through age 19 years. Maltreated females were referred by Child Protective Services agencies for having experienced substantiated sexual abuse, physical abuse, or neglect within the preceding 12 months. Comparison females were matched on race, family income, age and family constellation. Teen childbirth was assessed via self-report during annual interviews. Births were confirmed using hospital delivery records. Seventy participants gave birth during the study, 54 in the maltreated group and 16 in the comparison group. Maltreated females were twice as likely to experience teen childbirth after controlling for demographic confounds and known risk factors (odds ratio = 2.17, P = 0.01). Birth rates were highest for sexually abused and neglected females. Sexual abuse and neglect were both independent predictors of teen childbirth after controlling for demographic confounds, other risk factors and alternative forms of maltreatment occurring earlier in development. Results provide evidence that sexual abuse and neglect are unique predictors of subsequent teen childbirth. Partnerships between protective service providers and teen childbirth prevention strategists hold the best promise for further reducing the US teen birth rate. Additional research illuminating the pathways to teen childbirth for differing forms of maltreatment is needed so that tailored interventions can be realized.

  18. Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight

    Directory of Open Access Journals (Sweden)

    Claudia Regina Hentges

    2014-01-01

    Full Text Available OBJECTIVE: To establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW, according to the etiologic agent METHOD: This was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU with up to 48 hours of life, and followed-up at the outpatient follow-up clinic for preterm infants with VLBW until 2 years of corrected age. Exclusion criteria: death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV, congenital infection (STORCH, presence of early-onset spesis and cases with more than one pathogen growth in blood cultures. Septic and non-septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI-II at 18 to 24 months of corrected age. RESULTS: 411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281grams. Late-onset sepsis occurred in 94 preterm infants with VLBW (22.8%. VLBW infants with Gram-positive infection showed motor deficit when compared to the non-septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6-21.8, p = 0.006; the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase-negative Staphylococcus, 21.8% for Gram-positive bacteria, and 50% for Gram-negative bacteria and fungi. CONCLUSION: Neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram-positive infections are associated with motor deficit.

  19. Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight.

    Science.gov (United States)

    Hentges, Cláudia Regina; Silveira, Rita C; Procianoy, Renato Soibelmann; Carvalho, Clarissa Gutierrez; Filipouski, Gabriela Ribeiro; Fuentefria, Rubia Nascimento; Marquezotti, Fernanda; Terrazan, Ana Carolina

    2014-01-01

    To establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW), according to the etiologic agent. This was a cohort of newborns with birth weight<1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU) with up to 48 hours of life, and followed-up at the outpatient follow-up clinic for preterm infants with VLBW until 2 years of corrected age. death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV), congenital infection (STORCH), presence of early-onset sepsis and cases with more than one pathogen growth in blood cultures. Septic and non-septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI-II) at 18 to 24 months of corrected age. 411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281 grams. Late-onset sepsis occurred in 94 preterm infants with VLBW (22.8%). VLBW infants with Gram-positive infection showed motor deficit when compared to the non-septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6-21.8, p=0.006); the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase-negative Staphylococcus, 21.8% for Gram-positive bacteria, and 50% for Gram-negative bacteria and fungi. Neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram-positive infections are associated with motor deficit. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  20. Changes in Survival and Neonatal Morbidity in Infants with a Birth Weight of 750 g or Less

    NARCIS (Netherlands)

    Claas, M. J.; Bruinse, H. W.; van der Heide-Jalving, M.; Termote, J. U. M.; de Vries, L. S.

    2010-01-01

    Background: Improvement in perinatal and neonatal care has resulted in increased survival of extremely low birth weight (ELBW) infants. Objectives: To describe survival and neonatal morbidity in a cohort of ELBW infants, to compare two consecutive 5-year periods, and compare appropriate (AGA) with

  1. Early corticosteroid treatment does not affect severity of unconjugated hyperbilirubinemia in extreme low birth weight preterm infants

    NARCIS (Netherlands)

    Hulzebos, Christian V.; Bos, Arend F.; Anttila, Eija; Hallman, Mikko; Verkade, Henkjan J.

    Aim: To determine the relationship between early postnatal dexamethasone (DXM) treatment and the severity of hyperbilirubinemia in extreme low birth weight (ELBW) preterm infants. Methods: In 54 ELBW preterm infants, total serum bilirubin concentrations (TSB) and phototherapy (PT) data during the

  2. Impact of delivery room resuscitation on outcomes up to 18 months in very low birth weight infants

    NARCIS (Netherlands)

    DeMauro, Sara B.; Roberts, Robin S.; Davis, Peter; Alvaro, Ruben; Bairam, Aida; Schmidt, Barbara; Schmidt, B.; D'Ilario, J.; Cairnie, J.; Dix, J.; Adams, B.; Davis, P.; Doyle, L.; Faber, B.; Callanan, K.; Davis, N.; Duff, J.; Ford, G.; Asztalos, E.; Golec, L.; Lacy, M.; Hohn, D.; Haslam, R.; Barnett, C.; Goodchild, L.; Lontis, R.; Fraser, S.; Keng, J.; Saunders, K.; Opie, G.; Kelly, E.; Bairam, A.; Ferland, S.; Laperriere, L.; Bélanger, S.; St-Amand, P.; Blayney, M.; Davis, D.; Frank, J.; Lemyre, B.; Solimano, A.; Singh, A.; Chalmers, M.; Ramsay, K.; Synnes, A.; Whitfield, M.; Rogers, M.; Tomlinson, J.; Offringa, M.; Nuytemans, D.; Vermeulen, E.; Kok, J.; van Wassenaer, A.; Arnon, S.; Chalaf, A.; Regev, R.; Netter, I.; Ohlsson, A.; Nesbitt, K.; O'Brien, K.; Hamilton, A. M.; Sankaran, K.; Morgan, S.; Proctor, P.; LaCorte, M.; LeBlanc, P.; Braithwaite, A.; Golan, A.; Barabi, T.; Goldstein, E.; Reynolds, G.; Dromgool, B.; Meskell, S.; McMillan, D.; Schaab, D.; Spellen, L.; Sauve, R.; Christianson, H.; Anseeuw-Deeks, D.; Alvaro, R.; Chiu, A.; Porter, C.; Turner, G.; Moddemann, D.; Granke, N.; Penner, K.; Mulder, T.; Ghys, A.; van der Hoeven, M.; Clarke, M.; Parfitt, J.; MacLean, H.; Nwaesei, C.; Kuhn, L.; Ryan, H.; Saunders, C.; Schulze, A.; Pudenz, P.; Muller, M.; Lagercrantz, H.; Bhiladvala, M.; Legnevall, L.; Herlenius, E.; Matthew, D.; Amos, W.; Tulsiani, S.; Tan-Dy, C.; Turner, M.; Shinwell, E.; Levine, R.; Juster-Reicher, A.; Barrington, K.; Kokkotis, T.; Khairy, M.; Grier, P.; Vachon, J.; Sinha, S.; Tin, W.; Fritz, S.; Walti, H.; Royer, D.; Halliday, H.; Millar, D.; Berry, A.; Mayes, C.; Cummings, C.; Fahnenstich, H.; Philipp, K.; Tillmann, B.; Weber, P.; Canning, R.; Wariyar, U.; Embleton, N.; Bucher, H.-U.; Fauchere, J.-C.; Pfister, R.; Launoy, V.; Huppi, P.; Poets, C.; Urschitz-Duprat, P.; Doyle, L. W.; Roberts, R. S.; Gent, M.; Fraser, W.; Hey, E.; Perlman, M.; Thorpe, K.; Gray, S.; Chambers, C.; Costantini, L.; McGean, E.; Scapinello, L.

    2011-01-01

    To examine the relationships between intensity of delivery room resuscitation and short- and long-term outcomes of very low birth weight infants enrolled in the Caffeine for Apnea of Prematurity (CAP) Trial. The CAP Trial enrolled 2006 infants with birthweights between 500 and 1250 g who were

  3. Motor, Sleep/Wake and Physiological Organization in Very Low Birth Weight Infants Given Developmental Care. Conference Draft.

    Science.gov (United States)

    Becker, Patricia T.; And Others

    This study examined the effect of a modification of nursing care on stressors associated with care procedures for low birth weight infants in a neonatal intensive care unit (NICU); and on infants' physiological, motor, and behavioral development. The nursing staff of an NICU received training to reduce environmental and procedural stress, support…

  4. Association of Maternal Preeclampsia With Infant Risk of Premature Birth and Retinopathy of Prematurity.

    Science.gov (United States)

    Shulman, Julia P; Weng, Cindy; Wilkes, Jacob; Greene, Tom; Hartnett, M Elizabeth

    2017-09-01

    Studies report conflicting associations between preeclampsia and retinopathy of prematurity (ROP). This study provides explanations for the discrepancies to clarify the relationship between preeclampsia and ROP. To evaluate the association of maternal preeclampsia and risk of ROP among infants in an unrestricted birth cohort and a restricted subcohort of preterm, very low birth weight (P-VLBW) infants. A retrospective review of 290 992 live births within the Intermountain Healthcare System in Utah from January 1, 2001, through December 31, 2010, was performed. Generalized estimating equations for logistic regressions with covariate adjustment were applied to relate ROP to preeclampsia among the full cohort and in a subcohort of P-VLBW infants born at younger than 31 weeks' gestation and weighing less than 1500 g. The occurrence of ROP was related to maternal preeclampsia in the full cohort and in a subcohort of P-VLBW infants. In the full cohort, 51% of the infants were male and the mean (SD) gestational age was 38.38 (1.87) weeks. In the P-VLBW cohort, 55% were male and the mean (SD) gestational age was 26.87 (2.40) weeks. In the full cohort, preeclampsia was associated with an increased risk of all ROP (adjusted odds ratio [aOR], 2.46; 95% CI, 2.17-2.79; P preeclampsia was inversely associated with the development of all ROP (aOR, 0.79; 95% CI, 0.68-0.92; P = .003), severe ROP (aOR, 0.62; 95% CI, 0.36-1.06; P = .08), and infant death (aOR, 0.19; 95% CI, 0.11-0.32; P Preeclampsia was associated with an increased risk of developing ROP among an unrestricted cohort but with a reduced risk of ROP among a restricted subcohort of P-VLBW infants. Although the conflicting associations in the full and P-VLBW cohorts may reflect true differences, the association of a reduced risk of ROP among the P-VLBW subcohort also may reflect biases from restricting the cohort to prematurity, because prematurity is an outcome of preeclampsia.

  5. Impact of delivery room resuscitation on outcomes up to 18 months in very low birth weight infants.

    Science.gov (United States)

    DeMauro, Sara B; Roberts, Robin S; Davis, Peter; Alvaro, Ruben; Bairam, Aida; Schmidt, Barbara

    2011-10-01

    To examine the relationships between intensity of delivery room resuscitation and short- and long-term outcomes of very low birth weight infants enrolled in the Caffeine for Apnea of Prematurity (CAP) Trial. The CAP Trial enrolled 2006 infants with birthweights between 500 and 1250 g who were eligible for caffeine therapy. All levels of delivery room resuscitation were recorded in study participants. We divided infants in 4 groups of increasing intensity of resuscitation: minimal, n = 343; bag-mask ventilation, n = 372; endotracheal intubation, n = 1205; and cardiopulmonary resuscitation (chest compressions/epinephrine), n = 86. We used multivariable logistic regression models to compare outcomes across the 4 groups. The observed rates of death or disability, death, cerebral palsy, cognitive deficit, and hearing loss at 18 months increased with higher levels of resuscitation. Risk of bronchopulmonary dysplasia, severe retinopathy of prematurity, and brain injury also increased with higher levels of resuscitation. Adjustment for prognostic variables reduced the differences between the groups for most outcomes. Only the adjusted rates of bronchopulmonary dysplasia and severe retinopathy remained significantly higher after more intense resuscitation. In CAP Trial participants, the risk of death or neurodevelopmental disability at 18 months did not increase substantially with increasing intensity of delivery room resuscitation. Copyright © 2011 Mosby, Inc. All rights reserved.

  6. Variations in Multiple Birth Rates and Impact on Perinatal Outcomes in Europe.

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    Anna Heino

    Full Text Available Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level.We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA, stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births. We also used European Society of Human Reproduction and Embryology (ESHRE data on assisted conception and single embryo transfer (SET. The impact of MBR on outcomes was studied using meta-analysis techniques with random-effects models to derive pooled risk ratios (pRR overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR for these groups.In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania to 26.5 (Cyprus. Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1-9.8 of preterm birth (<37 weeks GA, an almost 12-fold increased risk (pRR 11.7, 95% CI 11.0-12.4 of very preterm birth (<32 weeks GA. Pooled RR were 2.4 (95% Cl 1.5-3.6 for fetal mortality at or after 28 weeks GA and 7.0 (95% Cl 6.1-8.0 for neonatal mortality. PAR of neonatal death and very preterm birth were higher in countries with high MBR compared to low MBR (17.1% (95% CI 13.8-20.2 versus 9.8% (95% Cl 9.6-11.0 for neonatal death and 29.6% (96% CI 28.5-30.6 versus 17.5% (95% CI 15.7-18.3 for very preterm births, respectively.Wide variations in MBR and their impact on population outcomes imply that efforts by countries to reduce MBR could improve perinatal outcomes, enabling better long-term child health.

  7. Integrated Pest Management with Stochastic Birth Rate for Prey Species

    Directory of Open Access Journals (Sweden)

    Olcay eAkman

    2013-08-01

    Full Text Available X. Song and Z. Xiang [5] developed an impulsive differential equations model for a two-prey one-predator model with stage structure for the predator. They demonstrate the conditions on the impulsiveperiod for which a globally asymptotically stable pest-eradication periodic solution exists, as well asconditions on the impulsive period for which the prey species is permanently maintained under aneconomically acceptable threshold. We extend their model by including stage structure for both predatorand prey as well as by adding stochastic elements in the birth rate of the prey. As in [5], we find theconditions under which a globally asymptotically stable pest eradication periodic solution exists. Inaddition, we numerically show the relationship between the stochastically varying birth rate of the preyand the necessary efficacy of the pesticide for which the probability of eradication of the prey speciesis above 90%. This is significant because the model recognizes varying environmental and climaticconditions which affect the resources needed for pest eradication.

  8. Depressive Symptoms Prior to Pregnancy and Infant Low Birth Weight in South Africa.

    Science.gov (United States)

    Tomita, Andrew; Labys, Charlotte A; Burns, Jonathan K

    2015-10-01

    Despite improvements in service delivery and patient management, low birth weight among infants has been a persistent challenge in South Africa. The study aimed to explore the relationship between depression before pregnancy and the low birth weight (LBW) of infants in post-apartheid South Africa. This study utilized data from Waves 1 and 2 of the South African National Income Dynamics Study, the main outcome being a dichotomous measure of child LBW (<2500 g) drawn from the Wave 2 child questionnaire. Depressive symptoms of non-pregnant women was the main predictor drawn from the Wave 1 adult questionnaire. Depressive symptoms were screened using the 10-item four-point Likert version of the Center for Epidemiologic Studies Depression Scale (CES-D) instrument. A total score of 10 or greater on the CES-D indicates a positive screen for depressive symptoms. An adjusted logistic regression model was used to examine the relationship between women's depression before pregnancy and infant LBW. A sample size of 651 women in Wave 1 was linked to 672 newborns in Wave 2. The results of the adjusted logistic regression model indicated depressive symptoms (CES-D ≥ 10) prior to pregnancy were associated with infant LBW (adjusted OR 2.84, 95 % CI 1.08-7.46). Another significant covariate in the model was multiple childbirths. Our finding indicates that women's depressive symptoms prior to pregnancy are associated with the low birth weight of newborns and suggests that this association may not be limited to depression present during the ante-natal phase.

  9. Timing of First Respiratory Virus Detections in Infants: A Community-Based Birth Cohort Study.

    Science.gov (United States)

    Sarna, Mohinder; Ware, Robert S; Lambert, Stephen B; Sloots, Theo P; Nissen, Michael D; Grimwood, Keith

    2018-01-17

    Determining timing of first virus detection episodes (fVDEs) for different respiratory viruses in infants identifies risk periods and informs preventive interventions, including vaccination. We describe the ages and nature of fVDEs in an infant birth cohort and explore factors associated with increased odds of symptomatic fVDEs. The Observational Research in Childhood Infectious Diseases (ORChID) study is a community-based birth cohort describing acute respiratory infections in infants until their second birthday. Parents recorded daily symptoms and collected nose swabs weekly, which were batch-tested using polymerase chain reaction assays for 17 respiratory viruses. One hundred fifty-eight infants participated in ORChID. The median age for fVDEs was 2.9 months for human rhinovirus (HRV) but was ≥13.9 months for other respiratory viruses. Overall, 52% of HRV fVDEs were symptomatic, compared with 57%-83% of other fVDEs. Respiratory syncytial virus and human metapneumovirus fVDEs were more severe than HRV fVDEs. Older age and the winter season were associated with symptomatic episodes. Infants do not always experience respiratory symptoms with their fVDE. Predominance of early HRV detections highlights the need for timing any intervention early in life. fVDEs from other respiratory viruses most commonly occur when maternal vaccines may no longer provide protection. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  10. Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth.

    Science.gov (United States)

    Bell, Edward F; Hansen, Nellie I; Brion, Luc P; Ehrenkranz, Richard A; Kennedy, Kathleen A; Walsh, Michele C; Shankaran, Seetha; Acarregui, Michael J; Johnson, Karen J; Hale, Ellen C; Messina, Lynn A; Crawford, Margaret M; Laptook, Abbot R; Goldberg, Ronald N; Van Meurs, Krisa P; Carlo, Waldemar A; Poindexter, Brenda B; Faix, Roger G; Carlton, David P; Watterberg, Kristi L; Ellsbury, Dan L; Das, Abhik; Higgins, Rosemary D

    2013-12-01

    Our aim was to examine the impact of a single enteral dose of vitamin E on serum tocopherol levels. The study was undertaken to see whether a single dose of vitamin E soon after birth can rapidly increase the low α-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage. Ninety-three infants vitamin E or placebo by gastric tube within 4 hours of birth. The vitamin E group received 50 IU/kg of vitamin E as dl-α-tocopheryl acetate (Aquasol E). The placebo group received sterile water. Blood samples were taken for measurement of serum tocopherol levels by high-performance liquid chromatography before dosing and 24 hours and 7 days after dosing. Eighty-eight infants received the study drug and were included in the analyses. The α-tocopherol levels were similar between the groups at baseline but higher in the vitamin E group at 24 hours (median 0.63 mg/dL vs. 0.42 mg/dL, P = .003) and 7 days (2.21 mg/dL vs 1.86 mg/dL, P = .04). There were no differences between groups in γ-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had α-tocopherol levels vitamin E raised serum α-tocopherol levels, but to consistently achieve α-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.

  11. Optimality of the birth population reduces learning and behaviour disorders and sudden infant death after the first month.

    Science.gov (United States)

    Saugstad, L F

    1999-05-01

    CNS signs and learning and behaviour problems. The male predominance accords with males more than 500 g higher optimal birthweight than females and susceptibility to a depressed weight at birth. In order to prevent postneonatal dying, SIDS and reduce learning/behaviour disorders it is necessary to raise the proportion of heavy newborns by promoting foetal growth rate equal to the maternal intrinsic rate by eating to one's appetite a balanced diet, favouring a diet high in marine fat, especially in third trimester, in order to ensure maturation of the CNS and prolong gestation, thereby increasing birthweight. Although the increased survival of some very low birthweight neonates confounds the issue, a division between SIDS in neonatal and postneonatal death is recommended in order to assess the proportion of "avoidable infant death" as opposed to persistent classical neonatal SIDS.

  12. Oral immunoglobulin for the treatment of rotavirus diarrhea in low birth weight infants.

    Science.gov (United States)

    Pammi, Mohan; Haque, Khalid N

    2011-10-05

    Rotavirus infection is the most common neonatal nosocomial viral infection. It is a major health problem worldwide. Epidemics with the newer P(6)G9 strains have been reported in neonatal units globally. These strains can cause severe symptoms in most infected infants. Infection control measures become necessary and the utilization of hospital resources increase. Local mucosal immunity in the intestine to rotavirus is important in the resolution of infection and protection against subsequent infections. Boosting local immunity by oral administration of anti-rotaviral immunoglobulin preparations might be a useful strategy in treating rotaviral infections, especially in low birth weight babies. To determine the effectiveness and safety of oral immunoglobulin preparations for the treatment of rotavirus diarrhea in hospitalized low birth weight infants (birth weight less than 2500 g) Electronic databases including The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2004), MEDLINE, EMBASE and CINAHL, Biological Abstracts (BIOSIS) were searched by the strategy outlined in the protocol. Science Citation Index search for all articles that referenced Barnes 1982 were searched. The proceedings of the Pediatric Academic Societies published online at 'Abstracts Online' were searched. Ongoing registered trials at www.clinicaltrials.gov and www.controlled-trials.com were searched. Authors prominent in the field were contacted for any unpublished articles and more information on published articles was sought. Reference lists of identified clinical trials and personal files were also reviewed. The above search was updated in July 2011. The criteria used to select studies for inclusion were: 1) DESIGN: randomized or quasi-randomized controlled trials 2) Hospitalized low birth weight infants with rotavirus diarrhea 3) INTERVENTION: Oral immunoglobulin preparations compared to placebo or no intervention 4) At least one of the following outcomes

  13. Homologous human milk supplement for very low birth weight preterm infant feeding

    Science.gov (United States)

    Grance, Thayana Regina de Souza; Serafin, Paula de Oliveira; Thomaz, Débora Marchetti Chaves; Palhares, Durval Batista

    2015-01-01

    OBJECTIVE: To develop a homologous human milk supplement for very low-birth weight infant feeding, using an original and simplified methodology, to know the nutritional composition of human milk fortified with this supplement and to evaluate its suitability for feeding these infants. METHODS: For the production and analysis of human milk with the homologous additive, 25 human milk samples of 45mL underwent a lactose removal process, lyophilization and then were diluted in 50mL of human milk. Measurements of lactose, proteins, lipids, energy, sodium, potassium, calcium, phosphorus and osmolality were performed. RESULTS: The composition of the supplemented milk was: lactose 9.22±1.00g/dL; proteins 2.20±0.36g/dL; lipids 2.91±0.57g/dL; calories 71.93±8.69kcal/dL; osmolality 389.6±32.4mOsmol/kgH2O; sodium 2.04±0.45mEq/dL; potassium 1.42±0.15mEq/dL; calcium 43.44±2.98mg/dL; and phosphorus 23.69±1.24mg/dL. CONCLUSIONS: According to the nutritional contents analyzed, except for calcium and phosphorus, human milk with the proposed supplement can meet the nutritional needs of the very low-birth weight preterm infant. PMID:25662564

  14. Homologous human milk supplement for very low birth weight preterm infant feeding

    Directory of Open Access Journals (Sweden)

    Thayana Regina de Souza Grance

    2015-03-01

    Full Text Available OBJECTIVE: To develop a homologous human milk supplement for very low-birth weight infant feeding, using an original and simplified methodology, to know the nutritional composition of human milk fortified with this supplement and to evaluate its suitability for feeding these infants. METHODS: For the production and analysis of human milk with the homologous additive, 25 human milk samples of 45mL underwent a lactose removal process, lyophilization and then were diluted in 50mL of human milk. Measurements of lactose, proteins, lipids, energy, sodium, potassium, calcium, phosphorus and osmolality were performed. RESULTS: The composition of the supplemented milk was: lactose 9.22±1.00g/dL; proteins 2.20±0.36g/dL; lipids 2.91±0.57g/dL; calories 71.93±8.69kcal/dL; osmolality 389.6±32.4mOsmol/kgH2O; sodium 2.04±0.45mEq/dL; potassium 1.42±0.15mEq/dL; calcium 43.44±2.98mg/dL; and phosphorus 23.69±1.24mg/dL. CONCLUSIONS: According to the nutritional contents analyzed, except for calcium and phosphorus, human milk with the proposed supplement can meet the nutritional needs of the very low-birth weight preterm infant.

  15. Association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants.

    Science.gov (United States)

    Lee, Jan Hau; Greenberg, Rachel G; Quek, Bin H; Clark, Reese H; Laughon, Matthew M; Smith, P Brian; Hornik, Christoph P

    2017-11-01

    In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical outcomes may depend on the accuracy of diagnosis and the timing of administration. The objective of the present study was to characterise the association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants. This retrospective cohort study used electronic health record data on inborn infants of gestational age ⩽28 weeks and birth weight patent ductus arteriosus was diagnosed in 31,712/48,551 (65%). The diagnosis was more common in infants who had undergone early echocardiography (14,549/15,971 [91%] versus 17,163/32,580 [53%], ppatent ductus arteriosus (odds ratio 1.01, 95% CI 0.90-1.15). Early echocardiography was associated with an increased diagnosis of patent ductus arteriosus, but not with decreased mortality.

  16. Infant mortality in a very low birth weight cohort from a public hospital in Rio de Janeiro, RJ, Brazil

    Directory of Open Access Journals (Sweden)

    Regina Coeli Azeredo Cardoso

    2013-09-01

    Full Text Available OBJECTIVES: to evaluate infant mortality in very low birth weight newborns from a public hospital in Rio de Janeiro, Brazil (2002-2006. METHODS: a retrospective cohort study was performed using the probabilistic linkage method to identify infant mortality. Mortality proportions were calculated according to birth weight intervals and period of death. The Kaplan-Meier method was used to estimate overall cumulative survival probability. The association between maternal schooling and survival of very low birth weight infants was evaluated by means of Cox proportional hazard models adjusted for: prenatal care, birth weight, and gestational age. RESULTS: the study included 782 very low birth weight newborns. Of these, (28.6% died before one year of age. Neonatal mortality was 19.5%, and earlyneonatal mortality was 14.9%. Mortality was highest in the lowest weight group (71.6%. Newborns whose mothers had less than four years of schooling had 2.5 times higher risk of death than those whose mothers had eight years of schooling or more, even after adjusting for intermediate factors. CONCLUSIONS: the results showed higher mortality among very low birth weight infants. Low schooling was an independent predictor of infant death in this low-income population sample.

  17. CDC WONDER: Mortality - Infant Deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mortality - Infant Deaths (from Linked Birth / Infant Death Records) online databases on CDC WONDER provide counts and rates for deaths of children under 1 year...

  18. Validity of Infant Race/Ethnicity from Birth Certificates in the Context of U.S. Demographic Change

    Science.gov (United States)

    Mason, Lisa Reyes; Nam, Yunju; Kim, Youngmi

    2014-01-01

    ObjectiveTo compare infant race/ethnicity based on birth certificates with parent report of infant race/ethnicity in a survey. Data SourcesThe 2007 Oklahoma birth certificates and SEED for Oklahoma Kids baseline survey. Study DesignUsing sensitivity scores and positive predictive values, we examined consistency of infant race/ethnicity across two data sources (N = 2,663). Data Collection/Extraction MethodsWe compared conventional measures of infant race/ethnicity from birth certificate and survey data. We also tested alternative measures that allow biracial classification, determined from parental information on the infant’s birth certificate or parental survey report. Principal FindingsSensitivity of conventional measures is highest for whites and African Americans and lowest for Hispanics; positive predictive value is highest for Hispanics and African Americans and lowest for American Indians. Alternative measures improve values among whites but yield mostly low values among minority and biracial groups. ConclusionsHealth disparities research should consider the source and validity of infant race/ethnicity data when creating sampling frames or designing studies that target infants by race/ethnicity. The common practice of assigning the maternal race/ethnicity as infant race/ethnicity should continue to be challenged. PMID:23829226

  19. DNA Methylation of Regulatory Regions of Imprinted Genes at Birth and Its Relation to Infant Temperament

    Directory of Open Access Journals (Sweden)

    Bernard F. Fuemmeler

    2016-01-01

    Full Text Available BACKGROUND DNA methylation of the differentially methylated regions (DMRs of imprinted genes is relevant to neurodevelopment. METHODS DNA methylation status of the DMRs of nine imprinted genes in umbilical cord blood leukocytes was analyzed in relation to infant behaviors and temperament (n = 158. RESULTS MEG3 DMR levels were positively associated with internalizing ( β = 0.15, P = 0.044 and surgency ( β = 0.19, P = 0.018 behaviors, after adjusting for birth weight, gender, gestational age at birth, maternal age at delivery, race/ethnicity, education level, smoking status, parity, and a history of anxiety or depression. Higher methylation levels at the intergenic MEG3-IG methylation regions were associated with surgency ( β = 0.28, P = 0.0003 and PEG3 was positively related to externalizing ( β = 0.20, P = 0.01 and negative affectivity ( β = 0.18, P = 0.02. CONCLUSION While the small sample size limits inference, these pilot data support gene-specific associations between epigenetic differences in regulatory regions of imprinted domains at birth and later infant temperament.

  20. Infant Growth after Preterm Birth and Mental Health in Young Adulthood

    Science.gov (United States)

    Sammallahti, Sara; Lahti, Marius; Pyhälä, Riikka; Lahti, Jari; Pesonen, Anu-Katriina; Heinonen, Kati; Hovi, Petteri; Eriksson, Johan G.; Strang-Karlsson, Sonja; Järvenpää, Anna-Liisa; Andersson, Sture; Kajantie, Eero; Räikkönen, Katri

    2015-01-01

    Objectives Faster growth after preterm birth benefits long-term cognitive functioning. Whether these benefits extend to mental health remains largely unknown. We examined if faster growth in infancy is associated with better self-reported mental health in young adults born preterm at very low birth weight (VLBW) (term, and 12 months of corrected age, and growth between these time points. Growth data were collected from records and measures at term and at 12 months of corrected age were interpolated. Additionally, we examined the moderating effects of intrauterine growth restriction. Results Size at birth, term, or 12 months of corrected age, or growth between these time points were not associated with mental health outcomes (p-values >0.05). Intrauterine growth restriction did not systematically moderate any associations. Conclusions Despite the high variability in early growth of VLBW infants, the previously described association between slow growth in infancy and poorer cognitive functioning in later life is not reflected in symptoms of depression, ADHD, and other psychiatric problems. This suggests that the development of cognitive and psychiatric problems may have dissimilar critical periods in VLBW infants. PMID:26327229

  1. Effect of Women's Decision-Making Autonomy on Infant's Birth Weight in Rural Bangladesh.

    Science.gov (United States)

    Sharma, Arpana; Kader, Manzur

    2013-01-01

    Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14-45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting.

  2. [Analysis of the cardiac arrhythmias in premature infants throughout the 24 hours following birth using Holter method].

    Science.gov (United States)

    Kohut, Joanna; Durmała, Jacek; Rokicki, Władysław; Gołba, Ewa; Goc, Barbara; Petelenz, Jolanta

    2002-01-01

    The aim of the study was to determine the heart rhythm (the frequency and disturbances) in premature infants in satisfactory clinical condition throughout the 24 hours following birth using Holter method. The influence of some maternal parameters (number of previous pregnancies, delivery mode, usage of pregnancy maintaining drugs) on newborn's heart rhythm and the influence of child's parameters (sex, birthweight, gestational week, clinical state according to Apgar score) were studied. Digital Holter registration system with two channels real-time recording Silicon Beat 2000 version 3.2 by Medea (Poland) was used. Sixty two premature infants were studied. Cardiac arrhythmias were found in 38 cases. They were mainly benign disturbances. The most frequent ones were supraventricular extrasystolic beats. The analysis of the influence of definitive features of mothers and children on arrhythmias and the values of heart rate revealed, that in naturally born infants naturally born and in these ones with low Apgar score the supraventricular extrasystolic beats were significantly more common as compared with those born by Caesarean section and with higher Apgar score. In younger subjects (< 30 gestation weeks) and with lower birthweight (< 2000 g) the sinus tachycardia was significantly more frequent as compared with older and heavier ones.

  3. Early BCG vaccine to low-birth-weight infants and the effects on growth in the first year of life

    DEFF Research Database (Denmark)

    Biering-Sørensen, Sofie; Andersen, Andreas; Ravn, Henrik

    2015-01-01

    BACKGROUND: Randomised trials have shown that early Bacille Calmette-Guérin (BCG) vaccine reduces overall neonatal and infant mortality. However, no study has examined how BCG affects growth. We investigated the effect on infant growth of early BCG vaccine given to low-birth-weight (LBW) infants...... A supplementation (VAS) or placebo. Anthropometric measurements were obtained 2, 6, and 12 months after enrolment. RESULTS: Overall there was no effect of early BCG on growth in the first year of life. The effect of early BCG on weight and mid-upper-arm circumference at 2 months tended to be beneficial among girls...... but not among boys (interaction between "early BCG" and sex: weight p = 0.03 and MUAC p = 0.04). This beneficial effect among girls was particularly seen among the largest infants weighing 2.0 kg or more at inclusion. CONCLUSION: Though BCG vaccination is not recommended to be given to LBW infants at birth...

  4. Mutual touch during mother-infant face-to-face still-face interactions: influences of interaction period and infant birth status.

    Science.gov (United States)

    Mantis, Irene; Stack, Dale M; Ng, Laura; Serbin, Lisa A; Schwartzman, Alex E

    2014-08-01

    Contact behaviours such as touch, have been shown to be influential channels of nonverbal communication between mothers and infants. While existing research has examined the communicative roles of maternal or infant touch in isolation, mutual touch, whereby touching behaviours occur simultaneously between mothers and their infants, has yet to be examined. The present study was designed to investigate mutual touch during face-to-face interactions between mothers and their 5½-month-old fullterm (n=40), very low birth weight/preterm (VLBW/preterm; n=40) infants, and infants at psychosocial risk (n=41). Objectives were to examine: (1) how the quantitative and qualitative aspects of touch employed by mothers and their infants varied across the normal periods of the still-face (SF) procedure, and (2) how these were associated with risk status. Mutual touch was systematically coded using the mother-infant touch scale. Interactions were found to largely consist of mutual touch and one-sided touch plus movement, highlighting that active touching is pervasive during mother-infant interactions. Consistent with the literature, while the SF period did not negatively affect the amount of mutual touch engaged in for mothers and their fullterm infants and mothers and their infants at psychosocial risk, it did for mothers and their VLBW/preterm infants. Together, results illuminate how both mothers and infants participate in shaping and co-regulating their interactions through the use of touch and underscore the contribution of examining the influence of birth status on mutual touch. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. The influence of maternal socioeconomic and emotional factors on infant weight gain and weight faltering (failure to thrive): data from a prospective birth cohort

    Science.gov (United States)

    Wright, C M; Parkinson, K N; Drewett, R F

    2006-01-01

    Aims To study the influence of maternal socioeconomic and emotional factors on infant weight gain and weight faltering (failure to thrive) in the first year of life. Methods The Gateshead Millennium Baby Study is a population birth cohort in northeast England studied prospectively from birth, via parental questionnaires and a health check aged 13 months. Data were collected on maternal education, deprivation, eating attitudes, and depression, using the Edinburgh Post Natal Depression Scale (EPDS) at 3 months. Weight gain was assessed using change in weight SD score, conditional on birth weight (Thrive Index); weight faltering was defined as conditional weight gain below the 5th centile. Results Of 923 eligible infants born at term, 774 (84%) had both weight and questionnaire data. Replicating a previous finding, both the highest and the lowest levels of deprivation were associated with weight faltering; this was independent of the type of milk feeding. No relation was found with maternal educational status. Maternal eating restraint was unrelated to weight gain. Infants of mothers with high depression symptom scores (EPDS >12) had significantly slower weight gain and increased rates of weight faltering up to 4 months (relative risk 2.5), especially if they came from deprived families, but by 12 months they were no different from the remainder of the cohort. Conclusions In this setting, social and maternal characteristics had little influence on infants' weight gain, apart from a strong, but transient effect of postnatal depression. PMID:16397011

  6. A mortalidade do prematuro extremo em nosso meio: realidade e desafios Mortality of very low birth weight preterm infants in Brazil: reality and challenges

    Directory of Open Access Journals (Sweden)

    Manoel de Carvalho

    2005-03-01

    Full Text Available OBJETIVO: Este trabalho apresenta uma revisão da literatura sobre os indicadores epidemiológicos e a estrutura organizacional da assistência perinatal no sistema de saúde brasileiro, enfatizando os aspectos ligados aos neonatos com peso ao nascer OBJECTIVE: The objective of this article is to review and discuss the medical literature on epidemiological indicators and organizational structure of the Brazilian perinatal health system concerning the care of very low birth weight premature infants (< 1,500 g. DATA SOURCES: Electronic search of the MEDLINE, Lilacs and SciELO databases from 1990 to 2004, with a selection made of the most relevant articles. Documents and reports from the Ministry of Health (Mortality Information System - SIM and Live Births Information System - SINASC. SUMMARY OF FINDINGS: The decrease in infant mortality rates and the high incidence of maternal deaths, observed since 1990, prompted de Brazilian government to focus its strategies on the organization and delivery of care to pregnant women and their newborn infants. However, a critical analysis of the actions aimed at the care of premature infants reveals that the coverage and utilization of these services are not uniform and that the records on birth and death rates are not reliable. The availability of neonatal beds is very limited and does not meet the demand, especially for those requiring high levels of complexity. Important challenges must be overcome to adequately deal with the incorporation of inappropriate technology, the limited number of qualified health professionals and utilization of evidence-based best practices to improve perinatal care. CONCLUSIONS: A reduction in the rates of morbidity and mortality of premature infants requires more effective planning and intervention in the prenatal care system. To meet the demand, increases in the number of neonatal intensive care beds should be implemented through specialized perinatal centers rather than

  7. Diffusion tensor imaging of the cortical plate and subplate in very-low-birth-weight infants

    International Nuclear Information System (INIS)

    Dudink, Jeroen; Govaert, Paul; Zwol, Arjen L. van; Conneman, Nikk; Goudoever, Johannes B. van; Buijs, Jan; Lequin, Maarten

    2010-01-01

    Many intervention studies in preterm infants aim to improve neurodevelopmental outcome, but short-term proxy outcome measurements are lacking. Cortical plate and subplate development could be such a marker. Our aim was to provide normal DTI reference values for the cortical plate and subplate of preterm infants. As part of an ongoing study we analysed diffusion tensor imaging (DTI) images of 19 preterm infants without evidence of injury on conventional MRI, with normal outcome (Bayley-II assessed at age 2), and scanned in the first 4 days of life. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the frontal and temporal subplate and cortical plate were measured in single and multiple voxel regions of interest (ROI) placed on predefined regions. Using single-voxel ROIs, statistically significant inverse correlation was found between gestational age (GA) and FA of the frontal (r = -0.5938, P = 0.0058) and temporal (r = -0.4912, P = 0.0327) cortical plate. ADC values had a significant positive correlation with GA in the frontal (r = 0.5427, P = 0.0164) and temporal (r = 0.5540, P = 0.0138) subplate. Diffusion tensor imaging allows in vivo exploration of the evolving cortical plate and subplate. We provide FA and ADC values of the subplate and cortical plate in very-low-birth-weight (VLBW) infants with normal developmental outcome that can be used as reference values. (orig.)

  8. Arrhythmia associated with tetracaine in an extremely low birth weight premature infant.

    Science.gov (United States)

    Maulidi, Halima; McNair, Carol; Seller, Neil; Kirsh, Joel; Bradley, Timothy J; Greenway, Steven C; Tomlinson, Chris

    2012-12-01

    Infants in NICUs undergo a variety of painful procedures. The management of pain has become an integral part of newborn infant care with the use of both systemic and topical agents to provide analgesia and anesthesia for procedural pain. Tetracaine and prilocaine-lidocaine are the 2 topical anesthetics most frequently used. Tetracaine belongs to an ester group of local anesthetics available as a topical 4% gel (Ametop, Smith and Nephew, Canada). The major side effects reported when using topical anesthetics are cutaneous reactions. There are no definite reports of systemic toxicity in the published literature. We present a recent case of an extremely low birth weight premature infant who developed a clinically significant arrhythmia after topical tetracaine was applied before the insertion of a peripherally inserted central catheter. The infant had no other identifiable cause for the resulting bradycardia that occurred only after Ametop was applied. The cardiac symptoms resolved with treatment. This case highlights a significant potential adverse event when using topical tetracaine.

  9. Diffusion tensor imaging of the cortical plate and subplate in very-low-birth-weight infants

    Energy Technology Data Exchange (ETDEWEB)

    Dudink, Jeroen; Govaert, Paul; Zwol, Arjen L. van; Conneman, Nikk; Goudoever, Johannes B. van [Erasmus MC-Sophia Children' s Hospital, Division of Neonatology, Department of Paediatrics, Rotterdam (Netherlands); Buijs, Jan [Maxima Medical Center, Division of Neonatology, Department of Paediatrics, Veldhoven (Netherlands); Lequin, Maarten [Erasmus MC-Sophia Children' s Hospital, Division of Paediatrics, Department of Radiology, Rotterdam, Zuid-holland (Netherlands)

    2010-08-15

    Many intervention studies in preterm infants aim to improve neurodevelopmental outcome, but short-term proxy outcome measurements are lacking. Cortical plate and subplate development could be such a marker. Our aim was to provide normal DTI reference values for the cortical plate and subplate of preterm infants. As part of an ongoing study we analysed diffusion tensor imaging (DTI) images of 19 preterm infants without evidence of injury on conventional MRI, with normal outcome (Bayley-II assessed at age 2), and scanned in the first 4 days of life. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the frontal and temporal subplate and cortical plate were measured in single and multiple voxel regions of interest (ROI) placed on predefined regions. Using single-voxel ROIs, statistically significant inverse correlation was found between gestational age (GA) and FA of the frontal (r = -0.5938, P = 0.0058) and temporal (r = -0.4912, P = 0.0327) cortical plate. ADC values had a significant positive correlation with GA in the frontal (r = 0.5427, P = 0.0164) and temporal (r = 0.5540, P = 0.0138) subplate. Diffusion tensor imaging allows in vivo exploration of the evolving cortical plate and subplate. We provide FA and ADC values of the subplate and cortical plate in very-low-birth-weight (VLBW) infants with normal developmental outcome that can be used as reference values. (orig.)

  10. Medication error in an extremely low birth weight infant: paracetamol overdose.

    Science.gov (United States)

    Brener, Pablo; Ballardo, Mónica; Mariani, Gonzalo; Ceriani Cernadas, José M

    2013-01-01

    Errors are part of human nature and are usually present in our actions. Medical errors occur quite often and can be serious. Medication errors are among the most frequent, especially in newborn infants because of the multiple steps that occur during the process of prescribing and administering drugs and because most drugs are not licensed for being used in newborn infants (off-label). The aim of this report is to describe a medication error in prescribing paracetamol for closing a patent ductus arteriosus in a preterm infant and to analyze its causes. A preterm female infant born at 27 weeks of gestational age with a birth weight of 750 g received paracetamol at 9 days old at a dose 20 times greater than required. The initial plasma level was 480 µg/mL. N-acetylcysteine was administered and her clinical outcome was satisfactory. Parents were notified of the event, which was recorded in the medical record and in the electronic error reporting system of the Hospital Italiano de Buenos Aires. We consider this report as an example that we are exposed to making mistakes and should maximize precautions to improve patient safety in neonatal units.

  11. Effects of a Birth Hospital's Neonatal Intensive Care Unit Level and Annual Volume of Very Low-Birth-Weight Infant Deliveries on Morbidity and Mortality.

    Science.gov (United States)

    Jensen, Erik A; Lorch, Scott A

    2015-08-01

    The annual volume of deliveries of very low-birth-weight (VLBW) infants has a greater effect on mortality risk than does neonatal intensive care unit (NICU) level. The differential effect of these hospital factors on morbidity among VLBW infants is uncertain. To assess the independent effects of a birth hospital's annual volume of VLBW infant deliveries and NICU level on the risk of several neonatal morbidities and morbidity-mortality composite outcomes that are predictive of future neurocognitive development. Retrospective, population-based cohort study (performed in 2014) of all VLBW infants without severe congenital anomalies delivered in all hospitals in California, Missouri, and Pennsylvania between January 1, 1999, and December 31, 2009 (N = 72,431). Risk-adjusted odds ratios and risk-adjusted probabilities were determined by logistic regression. The primary study outcomes were the individual composites of death or bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, and severe intraventricular hemorrhage. Among the 72,431 VLBW infants in the present study, birth at a hospital with 10 or less deliveries of VLBW infants per year was associated with the highest risk-adjusted probability of death (15.3% [95% CI, 14.4%-16.3%]), death or severe intraventricular hemorrhage (17.5% [95% CI, 16.5%-18.6%]), and death or necrotizing enterocolitis (19.3% [95% CI, 18.1%-20.4%]). These complications were also more common among infants born at hospitals with a level I or II NICU compared with infants delivered at hospitals with a level IIIB/C NICU. The risk-adjusted probability of death or retinopathy of prematurity was highest among infants born at hospitals with a level IIIB/C NICU and lowest among infants born at hospitals with a level IIIA NICU. When the effects of NICU level and annual volume of VLBW infant deliveries were evaluated simultaneously, the annual volume of deliveries was the stronger contributor to the risk of death, death or

  12. Burden of early-term birth on adverse infant outcomes: a population-based cohort study in Brazil.

    Science.gov (United States)

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elisabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2017-12-27

    To estimate the national rate of early-term live births in Brazil and to evaluate the effect of birth at 37 and 38 weeks' gestation, as compared with 39 and 40 weeks' gestation on infant outcomes according to precursors of birth and the existence of maternal/fetal medical conditions. National perinatal population-based cohort study. 266 maternity services located in the five Brazilian macroregions. 18 652 singleton live newborns from 37 0/7 to 40 6/7 weeks of gestation. Resuscitation in delivery room, oxygen therapy, transient tachypnoea, admission to neonatal intensive care unit (NICU), hypoglycaemia, use of antibiotics, phototherapy, phototherapy after hospital discharge, neonatal death and breastfeeding. Early terms accounted for 35% (95% CI 33.4% to 36.7%) of all live births. Among provider-initiated births in women without medical conditions, infants of 37 and 38 weeks' gestation had higher odds of oxygen therapy (adjusted OR (AOR) 2.93, 95% CI 1.72 to 4.98 and AOR 1.92 95% CI 1.18 to 3.13), along with admission to NICU (AOR 2.01, 95% CI 1.18 to 3.41 and AOR 1.56, 95% CI 1.02 to 2.60), neonatal death (AOR 14.40, 95% CI 1.94 to 106.69 and AOR 13.76,95% CI 2.84 to 66.75), hypoglycaemia in the first 48 hours of life (AOR 7.86, 95% CI 1.95 to 31.71 and AOR 5.76, 95% CI 1.63 to 20.32), transient tachypnoea (AOR 2.98, 95% CI 1.57 to 5.65 and AOR 2.12, 95% CI 1.00 to 4.48) and the need for phototherapy within the first 72 hours of life (AOR 3.59, 95% CI 1.95 to 6.60 and AOR 2.29, 95% CI 1.49 to 3.53), yet lower odds of breastfeeding up to 1 hour after birth (AOR 0.67, 95% CI 0.53 to 0.86 and AOR 0.87, 95% CI 0.76 to 0.99) and exclusive breastfeeding during hospital stay (AOR 0.68, 95% CI 0.51 to 0.89 and AOR 0.84, 95% CI 0.71 to 0.99). Birth at 37 and 38 weeks' gestation increased the risk of most adverse infant outcomes analysed, especially among provider-initiated births and should be avoided before 39 weeks' gestation in healthy pregnancies. © Article

  13. Multivalent rotavirus vaccine and wild-type rotavirus strain shedding in Australian infants: a birth cohort study.

    Science.gov (United States)

    Ye, Suifang; Whiley, David M; Ware, Robert S; Kirkwood, Carl D; Lambert, Stephen B; Grimwood, Keith

    2017-11-15

    Rotavirus vaccines have reduced moderate-to-severe gastroenteritis episodes in infants and young children. Nevertheless, knowledge gaps exist concerning rotavirus vaccine shedding and vaccine impact upon mild and asymptomatic wild-type infections. Our primary objective was to investigate vaccine shedding in Australian infants where the multivalent human-bovine reassortant rotavirus vaccine, RotaTeq®, was part of the routine vaccination schedule. The Observational Research in Childhood Infectious Diseases (ORChID) birth cohort study was conducted in Brisbane, Australia, from September 2010 to October 2014. Newborn infants were enrolled progressively and followed until their second birthday. Parents recorded daily symptoms and mailed weekly stool swab samples from their infants to the laboratory where reverse transcription-polymerase chain reaction (RT-PCR) testing was performed, and rotavirus-positive samples underwent genotyping to distinguish between vaccine and wild-type strains. Rotavirus was detected in 1,068/11,139 (9.6%) stool swabs from 158 infants, and 994 (93.1%) were genotyped. RotaTeq® vaccine strains accounted for 951/994 (95.7%) of typed rotavirus-positive swabs. Proportions of infants shedding RotaTeq® after the first, second and third vaccine doses were 87.0%, 57.4% and 47.3% respectively and median (interquartile range) shedding duration after vaccine doses 1-3 was 3 (1-8), 1.5 (1-3) and 1 (1-2) weeks respectively. In contrast, the incidence rate of wild-type rotavirus episodes was 10.3 (95% confidence interval 6.8-15.6) per 100 child-years of observation. RotaTeq® vaccine virus was detected in stool samples from 47-87% of infants after each vaccine dose. Genotyping is an essential tool for differentiating between rotavirus vaccine and wild-type strains and monitoring vaccine impact in children. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e

  14. An Investigation of the Mortality Rate and Risk Factors in Newborn Infants With Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Sabzehei

    2016-08-01

    Full Text Available Background One of the serious challenges facing neonatal medicine is meconium aspiration syndrome, delays in the treatment of which can lead to high mortality. Objectives This study was designed and conducted with the aim of determining the mortality rate and risk factors affecting this rate in newborn infants with meconium aspiration syndrome. Methods This study was conducted as a retrospective descriptive research on newborn infants with meconium aspiration syndrome hospitalized at the neonatal intensive care unit (NICU of Fatemieh and Be’sat hospitals in Hamadan city during a 10-year period from 2004 to 2014. Demographic information of the mother and the newborn, hospitalization course, the need for mechanical ventilation, and complications and outcomes of disease were extracted and were analyzed using the SPSS software version 22. Results Sixty-three newborn infants, diagnosed with meconium aspiration syndrome, were entered in this study, 40% of them were male, 85.7% wighed more than 2500 g, and 17.5% were post term, 25.3% had a five-minute Apgar Score (AS5min of less than seven, 39.6% were nonvigorous at birth, 31.8% needed to be placed on mechanical ventilation, and 14.3% died during the hospitalization course. There was a significant relationship between the need for mechanical ventilation, nonvigorous state at the birth, complications of disease and mortality rate. Conclusions Despite the progress made in medicine, meconium aspiration syndrome is still one of the causes of newborn infants’ mortality. The mortality and morbidity rates can be reduced by improvement in perinatal care, prevention of post term delivery, timely caesarean and effective neonatal resuscitation at birth.

  15. Infant Feeding and Risk of Type 1 Diabetes in Two Large Scandinavian Birth Cohorts

    DEFF Research Database (Denmark)

    Lund-Blix, Nicolai A.; Sander, Stine Dydensborg; Størdal, Ketil

    2017-01-01

    breastfeeding (HR per month 0.99 [95% CI 0.97–1.01]) and any breastfeeding (0.97 [0.92–1.03]). CONCLUSIONS: Suggestive evidence supports the contention that breastfeeding reduces the risk of type 1 diabetes. Among those who were breastfed, however, no evidence indicated that prolonging full or any breastfeeding......OBJECTIVE: Our aim was to study the relation between the duration of full and any breastfeeding and risk of type 1 diabetes. RESEARCH DESIGN AND METHODS: We included two population-based cohorts of children followed from birth (1996–2009) to 2014 (Denmark) or 2015 (Norway). We analyzed data from...... a total of 155,392 children participating in the Norwegian Mother and Child Cohort Study (MoBa) and the Danish National Birth Cohort (DNBC). Parents reported infant dietary practices when their child was 6 and 18 months old. The outcome was clinical type 1 diabetes, ascertained from nationwide childhood...

  16. Recombinant Erythropoietin And Blood Transfusion In Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Keramat Nouri

    2005-05-01

    Full Text Available Backgroundp: Very low birth weight infants ( <1500 g frequently require blood transfusions because of repeated blood sampling accompanied by anemia of prematurity. Methods: In an attempt to identify the effect of human recombinant erythropoietin to decrease the requirement for blood transfusions, erythropoietin was administered to 24 pre term infants less than 1500 g prospectively from September 1999 till December2000. Data about the characteristics of the population, the severity of diseases, and treatment with erythropoietin, clinical diagnosis, initial and subsequent hemoglobin, volume of blood loss, and the number of blood transfusions were recorded. These results were compared with data from the recorded information of 49 infants who did not receive erythropoietin during those past 2 years. There were no differences between the 2 groups with regard to the gestational age, birth weight, clinical diagnosis, severity of the illness, primary causes of admission, and initial hematologic parameters such as hemoglobin, hematocrit and reticulocytes. Erythropoietin was administered in a dose of 200 ill/kg three times weekly for 6-8 weeks accompanied with iron supplement 6 mg/ kg/day. Transfusions were administered according to protocol. Results: There was no significant difference between the number of blood transfusion among these 2 groups (p= 0.07. However, transfusions in the erythropoietin treated group were fewer in comparison to the other group (1.9 +1-1.6 to 3.2 +/-1.1. No difference was observed between final hemoglobin and hematocrit levels among the two groups (10.3 +1- 0.9 vs. 10.4 +1- 0.7 and 33.7 +1- 2.3 vs. 32.2 +1- 2.2. Conclusion: Very low birth weight infants receive frequent blood transfusions but a reduction in transfusion requirements was not apparent after administration of erythropoietin and iron in preterm infants in this study. However, the lack of impact on transfusion requirements fails to support routine use of

  17. Respiratory severity score and extubation readiness in very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Maroun J. Mhanna

    2017-12-01

    Full Text Available Background: The respiratory severity score (RSS is a byproduct of mean airway pressure (MAP and fraction of inspired oxygen (FiO2. We sought to determine whether RSS could be used as a screening tool to predict extubation readiness in very low birth weight (VLBW infants. Methods: In a retrospective cohort study, medical records of all VLBW infants admitted to our unit (6/1/09–2/28/12 were reviewed for infants' demographics, prenatal characteristics, and medication use. Also, records were reviewed for unplanned vs. planned extubation, blood gas, ventilator parameters and signs of severe respiratory failure [RF, defined as partial pressure of carbon dioxide (pCO2 > 65, pH  50%, and MAP > 10 cm] on the day of extubation. Results: During the study period 31% (45/147 failed extubation. Overall, infants who failed extubation had a lower birth weight (BW and gestational age (GA, and on the day of extubation had a higher RSS and percentage of having one or more signs of severe RF. In a logistic regression model, adjusting for BW, GA, RSS and RF, RSS remained the only risk factor associated with extubation failure [adjusted OR 1.63 (95% CI: 1.10–2.40; p = 0.01]. RSS had a sensitivity of 0.86 (95% CI: 0.72–0.94 at a cutoff of 1.26 and a specificity of 0.88 (95% CI: 0.80–0.94 at a cutoff of 2.5. There was no difference in extubation failure between unplanned vs. planned extubation [41% (9/22 vs. 29% (36/125; p = 0.25]. Conclusion: An elevated RSS is associated with extubation failure. Successful unplanned extubation is common in VLBW infants. Key Words: very low birth weight, extubation, mechanical ventilation, respiratory severity score

  18. Teamwork in the NICU Setting and Its Association with Health Care-Associated Infections in Very Low-Birth-Weight Infants.

    Science.gov (United States)

    Profit, Jochen; Sharek, Paul J; Kan, Peiyi; Rigdon, Joseph; Desai, Manisha; Nisbet, Courtney C; Tawfik, Daniel S; Thomas, Eric J; Lee, Henry C; Sexton, J Bryan

    2017-08-01

    Background and Objective  Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale-level and item-level associations with health care-associated infection (HAI) rates in very low-birth-weight (VLBW) infants. Methods  Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6,663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2,073 of 3,294 eligible NICU health professionals (response rate 63%). The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results  Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (odds ratio, 0.82; 95% confidence interval, 0.73-0.92, p  = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion  Improving teamwork may be an important element in infection control efforts. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Validity of anthropometric equations to estimate infant fat mass at birth and in early infancy.

    Science.gov (United States)

    Cauble, Jennifer S; Dewi, Mira; Hull, Holly R

    2017-03-27

    In newborns and children, body fat estimation equations are often used at different ages than the age used to develop the equations. Limited validation studies exist for newborn body fat estimation equations at birth or later in infancy. The study purpose was to validate 4 newborn fat mass (FM) estimation equations in comparison to FM measured by air displacement plethysmography (ADP; the Pea Pod) at birth and 3 months. Ninety-five newborns (1-3 days) had their body composition measured by ADP and anthropometrics assessed by skinfolds. Sixty-three infants had repeat measures taken (3 months). FM measured by ADP was compared to FM from the skinfold estimation equations (Deierlein, Catalano, Lingwood, and Aris). Paired t-tests assessed mean differences, linear regression assessed accuracy, precision was assessed by R 2 and standard error of the estimate (SEE), and bias was assessed by Bland-Altman plots. At birth, FM measured by ADP differed from FM estimated by Deierlein, Lingwood and Aris equations, but did not differ from the Catalano equation. At 3 months, FM measured by ADP was different from all equations. At both time points, poor precision and accuracy was detected. Bias was detected in most all equations. Poor agreement, precision, and accuracy were found between prediction equations and the criterion at birth and 3 months.

  20. [Disorders of the mother-child relationship in newborn infants with low birth weight].

    Science.gov (United States)

    Heimann, J P; Calame, A; Marchand, C; Plancherel, B; Prod'hom, L S

    1981-02-01

    The influence of premature birth or intrauterine growth retardation (IUGR) on the mother-child relationship has been studied in 80 children with birth-weight below 2000 g, treated in the Neonatology Unit of the Pediatric Department of Lausanne University. 40 children with birth-weight over 2500 g and without perinatal complications born in the Obstetrical Department of the same hospital were used as controls. The 80 infants with low birth-weight presented only minor neonatal disturbances and showed later on a normal psychomotor development. The mother-child relationship was evaluated by free and structured interviews accompanied by a questionnaire and by regular contacts throughout the first 12 months. With the exception of the professional work of the mother during and after pregnancy, all the family and social factors were not significantly different in the 3 groups. The mothers of premature children showed significantly more disturbances of their family relationship than the mothers in the control group. On the other hand, a significantly higher number of attachment problems is the only difference observed in the group of mothers of IUGR-babies. There was no mathematical correlation between these problems and the characteristics of the family and social-economic environment of the mothers. The importance of subjective, i.e. psychological, factors as cause of difficulties in the mother-child relationship is stressed.

  1. Nutritional intake and weight z-scores in very low birth weight infants in Peru.

    Science.gov (United States)

    Proaño, Alvaro; Aragón, Romina Elena; Rivera, Fabiola; Zegarra, Jaime

    2016-03-29

    To determine the actual nutritional intake of very low birth weight infants and their growth outcome during the first month of life. Additionally, we identified factors that account for a negative neonatal outcome in this population. A case-series study was conducted in a tertiary hospital in Lima, Peru between 2011 and 2012 and the data was obtained from medical records. No feeding protocol was used during this study. Daily fluids, energy and protein intakes were documented and weekly weight z-scores were calculated. A logistic regression analysis was used to identify factors for an adverse outcome, defined as neonatal mortality or extra-uterine growth restriction, during the first 28 days of life. After applying selection criteria, 76 participants were included. The nutritional intakes were similar to standard values seen in the literature, but protein intakes were suboptimal in all of the four weeks. Birth weight z-score was associated with an adverse outcome (p=0.035). It was determined that having a birth weight z-score under -1.09 predicted a negative outcome with an area under the curve of 96.8% [93.5%, 100%] with a 95% confidence interval. Protein intakes are widely deficient in the population of this study. Nevertheless, an adverse outcome during the neonatal period is more associated with a poor birth weight z-score than nutrition-related factors.

  2. The burden of malaria infection on pregnant women and birth weight of infants in south western Nigeria.

    Science.gov (United States)

    Akanbi, O M; Odaibo, A B; Ademowo, O G

    2009-04-01

    To determine the effect of malaria infection on pregnant women and the birth weight of the infants in the south western Nigeria. 262 pregnant women who came for antenatal clinic at Ade-Oyo maternity hospital. 128 were primigravidae while 134 were multigravidae. 2ml of blood was withdrawn from 262 pregnant women who came for antenatal clinic at Ade Oyo maternity hospital. Thick blood smears were prepared for parasite identification and quantification. Anaemia was detected by measuring Hb levels using Drabkin's solution. Age, gravidity and history of treatment with antimalaria drugs were obtained from the subjects using questionnaire. The overall prevalence of infection was 41.8%. Primigravidae were more infected (35%) than multigravidae (22%). The prevalence was significantly higher (p<0.05) in wet season than dry season. Teenagers and primigravidae were more infected than the adults and multigravidae. The severity of the anaemia was significantly higher (p<0.05) among malaria positive teenagers and primigravidae than adults and multigravidae. The mean birth weight of infants born to malaria positive was significantly lower (p<0.05) than those born to malaria negative mothers. Malaria positive teenagers and primigravidae had infants with lowest birth weight as compared with adult and multigravidae. The birth weights of the infants were positively correlated with the Hb levels. This study suggests that malaria infection, anaemia, and gravidity affect the birth weight of infants born in Ibadan, southwestern Nigeria.

  3. Malaria model with periodic mosquito birth and death rates.

    Science.gov (United States)

    Dembele, Bassidy; Friedman, Avner; Yakubu, Abdul-Aziz

    2009-07-01

    In this paper, we introduce a model of malaria, a disease that involves a complex life cycle of parasites, requiring both human and mosquito hosts. The novelty of the model is the introduction of periodic coefficients into the system of one-dimensional equations, which account for the seasonal variations (wet and dry seasons) in the mosquito birth and death rates. We define a basic reproduction number R(0) that depends on the periodic coefficients and prove that if R(0)1 then the disease is endemic and may even be periodic.

  4. Development of left ventricular longitudinal speckle tracking echocardiography in very low birth weight infants with and without bronchopulmonary dysplasia during the neonatal period.

    Directory of Open Access Journals (Sweden)

    Christoph Czernik

    Full Text Available OBJECTIVES: In preterm infants, postnatal myocardial adaptation may be complicated by bronchopulmonary dysplasia (BPD. We aimed to describe the development of left ventricular function by serial 2D, Doppler, and speckle tracking echocardiography (2D-STE in infants with and without BPD during the neonatal period and compare these to anthropometric and conventional hemodynamic parameters. STUDY DESIGN: Prospective echocardiography on day of life (DOL 1, 7, 14, and 28 in 119 preterm infants 10% were seen for the apical segment. While anthropometric parameters show rapid development during the first 4 weeks of life, the speckle tracking parameters did not differ statistically significantly during the neonatal period. Infants with and without BPD differed significantly (p<0.001 in the development of anthropometric parameters, conventional hemodynamic parameters except for heart rate, and 2D-STE parameters: global longitudinal systolic strain rate (GLSSR and longitudinal systolic strain for the mid left wall (LSSR. The largest differences were seen at DOL 1 and 7 in GLSSR (p<0.001 and in LSSR (p<0.01. CONCLUSIONS: Reproducible 2D-STE measurements are possible in preterm infants <1500 g. Cardiac deformation reveals early (DOL 1 and 7 ventricular changes (GLSSR and LSSR in very low birth weight infants who develop BPD.

  5. Structural growth trajectories and rates of change in the first 3 months of infant brain development.

    Science.gov (United States)

    Holland, Dominic; Chang, Linda; Ernst, Thomas M; Curran, Megan; Buchthal, Steven D; Alicata, Daniel; Skranes, Jon; Johansen, Heather; Hernandez, Antonette; Yamakawa, Robyn; Kuperman, Joshua M; Dale, Anders M

    2014-10-01

    The very early postnatal period witnesses extraordinary rates of growth, but structural brain development in this period has largely not been explored longitudinally. Such assessment may be key in detecting and treating the earliest signs of neurodevelopmental disorders. To assess structural growth trajectories and rates of change in the whole brain and regions of interest in infants during the first 3 months after birth. Serial structural T1-weighted and/or T2-weighted magnetic resonance images were obtained for 211 time points from 87 healthy term-born or term-equivalent preterm-born infants, aged 2 to 90 days, between October 5, 2007, and June 12, 2013. We segmented whole-brain and multiple subcortical regions of interest using a novel application of Bayesian-based methods. We modeled growth and rate of growth trajectories nonparametrically and assessed left-right asymmetries and sexual dimorphisms. Whole-brain volume at birth was approximately one-third of healthy elderly brain volume, and did not differ significantly between male and female infants (347 388 mm3 and 335 509 mm3, respectively, P = .12). The growth rate was approximately 1%/d, slowing to 0.4%/d by the end of the first 3 months, when the brain reached just more than half of elderly adult brain volume. Overall growth in the first 90 days was 64%. There was a significant age-by-sex effect leading to widening separation in brain sizes with age between male and female infants (with male infants growing faster than females by 200.4 mm3/d, SE = 67.2, P = .003). Longer gestation was associated with larger brain size (2215 mm3/d, SE = 284, P = 4×10-13). The expected brain size of an infant born one week earlier than average was 5% smaller than average; at 90 days it will not have caught up, being 2% smaller than average. The cerebellum grew at the highest rate, more than doubling in 90 days, and the hippocampus grew at the slowest rate, increasing by 47% in 90 days. There was left

  6. High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support.

    Science.gov (United States)

    Mitchell, Shannon M; Rogers, Stefanie P; Hicks, Penni D; Hawthorne, Keli M; Parker, Bruce R; Abrams, Steven A

    2009-07-29

    Osteopenia and rickets are common among extremely low birth weight infants (ELBW, alkaline phosphatase activity (P-APA) in ELBW infants and evaluate our experience with the diagnosis of rickets in these infants. We evaluated all ELBW infants admitted to Texas Children's Hospital NICU in 2006 and 2007. Of 211 admissions, we excluded 98 patients who were admitted at >30 days of age or did not survive/stay for >6 weeks. Bone radiographs obtained in 32 infants were reviewed by a radiologist masked to laboratory values. In this cohort of 113 infants, P-APA was found to have a significant inverse relationship with BW, gestational age and serum phosphorus. In paired comparisons, P-APA of infants nutrition greater than 3 to 4 weeks, or clinical suspicion. Of these, 18 showed radiologic rickets and 14 showed osteopenia without rickets. Infants with BW 600 IU/L was very common in ELBW infants. BW was significantly inversely related to both P-APA and radiologic rickets. No single value of P-APA was related to radiological findings of rickets. Given the very high risk of osteopenia and rickets among ELBW infants, we recommend consideration of early screening and early mineral supplementation, especially among infants <600 g BW.

  7. Integrated pest management with stochastic birth rate for prey species

    Science.gov (United States)

    Akman, Olcay; Comar, Timothy D.; Hrozencik, Daniel

    2013-01-01

    Song and Xiang (2006) developed an impulsive differential equations model for a two-prey one-predator model with stage structure for the predator. They demonstrate the conditions on the impulsive period for which a globally asymptotically stable pest-eradication periodic solution exists, as well as conditions on the impulsive period for which the prey species is permanently maintained under an economically acceptable threshold. We extend their model by including stage structure for both predator and prey as well as by adding stochastic elements in the birth rate of the prey. As in Song and Xiang (2006), we find the conditions under which a globally asymptotically stable pest eradication periodic solution exists. In addition, we numerically show the relationship between the stochastically varying birth rate of the prey and the necessary efficacy of the pesticide for which the probability of eradication of the prey species is above 90%. This is significant because the model recognizes varying environmental and climatic conditions which affect the resources needed for pest eradication. PMID:23964194

  8. Early neurodevelopment in very low birth weight infants with mild intraventricular hemorrhage or those without intraventricular hemorrhage

    Directory of Open Access Journals (Sweden)

    Il Rak Choi

    2012-11-01

    Full Text Available &lt;B&gt;Purpose:&lt;/B&gt; This study aimed to assess early development in very low birth weight (VLBW infants with mild intraventricular hemorrhage (IVH or those without IVH and to identify the perinatal morbidities affecting early neurodevelopmental outcome. &lt;B&gt;Methods:&lt;/B&gt; Bayley Scales of Infant Development-II was used for assessing neurological development in 49 infants with a birth weight &lt;1,500 g and with low grade IVH (?#167;rade II or those without IVH at a corrected age of 12 months. &lt;B&gt;Results:&lt;/B&gt; Among the 49 infants, 19 infants (38.8% showed normal development and 14 (28.6% showed abnormal mental and psychomotor development. Infants with abnormal mental development (n=14 were mostly male and had a longer hospitalization, a higher prevalence of patent ductus arteriosus (PDA and bronchopulmonary dysplasia (BPD, and were under more frequent postnatal systemic steroid treatment compared with infants with normal mental development (n=35, P&lt;0.05. Infants with abnormal psychomotor development (n=29 had a longer hospitalization and more associated PDA compared to infants with normal psychomotor development (n=20, P&lt;0.05. Infants with abnormal mental and psychomotor development were mostly male and had a longer hospitalization and a higher prevalence of PDA and BPD compared to infants with normal mental and psychomotor development (n=19, P&lt;0.05. Using multiple logistic regression analysis, a longer duration of hospitalization and male gender were found to be significant risk factors. &lt;B&gt;Conclusion:&lt;/B&gt; Approximately 62% of VLBW infants with low grade IVH or those without IVH had impaired early development.

  9. Postnatal Unit Bassinet Types When Rooming-In After Cesarean Birth: Implications for Breastfeeding and Infant Safety

    Science.gov (United States)

    Tully, Kristin P.; Ball, Helen L.

    2013-01-01

    Background Postnatal unit rooming-in promotes breastfeeding. Previous research indicates that side-cars (three-sided bassinets that lock onto the maternal bed-frame) faciliate breastfeeding after vaginal birth more than stand-alone bassinets (standard rooming-in). No study has previously investigated side-car bassinet use after cesarean, despite the constraints on maternal-infant interactions that are inherent in recovery from this birth mode. Objective To test the effect of the side-car bassinet on postnatal unit breastfeeding frequency and other maternal-infant behaviors compared to a stand-alone bassinet following cesarean birth. Methods Participants were recruited and prenatally randomized to receive the side-car or stand-alone bassinet for their postnatal unit stay between January 2007 and March 2009 in Northeast England. Mother-infant interactions were filmed over the second postpartum night. Participants completed face-to-face interviews before and after filming. The main outcome measures were infant location, bassinet acceptability, and breastfeeding frequency. Other outcomes assessed were breastfeeding effort, maternal-infant contact, sleep states, midwife presence, and infant risk. Results Differences in breastfeeding frequency, maternal-infant sleep overlap, and midwife presence were not statistically significant. The 20 dyads allocated to side-car bassinets breastfed a median of 0.6 bouts/ hour compared to 0.4 bouts/hour for the 15 stand-alone bassinet dyads. Participants expressed overwhelming preference for the side-car bassinets. Bedsharing was equivalent between the groups, although the motivation for this practice may have differed. Infant handling was compromised with stand-alone bassinet use, including infants positioned on pillows while bedsharing with their sleeping mothers. Conclusions Women preferred the side-car but differences in breastfeeding frequency were not significant. More infant risks were observed with stand-alone bassinet use

  10. Exploring the use of mothers' own milk as oral care for mechanically ventilated very low-birth-weight preterm infants.

    Science.gov (United States)

    Thibeau, Shelley; Boudreaux, Cynthia

    2013-06-01

    The purpose of this study was to explore the use of mothers' own milk (colostrums, transitional milk, and mature milk) as oral care in the ventilator-associated pneumonia (VAP)-prevention bundle of mechanically ventilated preterm infants weighing 1500 g or less. Mechanically ventilated preterm infants weighing 1500 g or less admitted to a regional level III NICU in the Gulf South between January 1, 2006, and December 31, 2009. Retrospective descriptive. Oral care with mothers' own milk was implemented as part of the VAP-prevention bundle in the neonatal intensive care unit in the fourth quarter of 2007. Using retrospective deidentified data retrieved from the electronic medical record, the primary and secondary outcome variables were collected among eligible infants (≤1500 g) admitted January 1, 2006, to December 31, 2007 (before implementation) and January 1, 2008, to December 31, 2009 (after implementation). Sample characteristics, including infant gestational age, birth weight, and gender, as well as maternal age, type of delivery, and incidence of maternal chorioamnionitis, were also collected. Data analysis included frequencies and distributions to summarize sample characteristics and variables of interest. Appropriate tests for differences were conducted on outcome variables between the before and after groups of the human milk oral care intervention. The feasibility outcome variable included nursing compliance with the oral care procedure. The safety outcome variable included record of any adverse events associated with the oral care procedure. The efficacy health outcomes included the rate of positive tracheal aspirates, positive blood cultures, the number of ventilator days, and length of stay. Infant age (26.1-26.6 weeks) and weight (840-863 g) were similar in the before (n = 70) and after (n = 68) sample subjects. There were no statistically significant differences in ventilator days, χ² (46, n = 115) = 46.22, P = .46, and length of stay, χ (75, n

  11. The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families.

    Science.gov (United States)

    Shah, Prakesh S; McDonald, Sarah D; Barrett, Jon; Synnes, Anne; Robson, Kate; Foster, Jonathan; Pasquier, Jean-Charles; Joseph, K S; Piedboeuf, Bruno; Lacaze-Masmonteil, Thierry; O'Brien, Karel; Shivananda, Sandesh; Chaillet, Nils; Pechlivanoglou, Petros

    2018-01-18

    Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems. Three broad clusters of projects will be undertaken. Cluster 1 will focus on quality-improvement efforts that use the Evidence-based Practice for Improving Quality method to evaluate information from the CPTBN database and review the current literature, then identify potentially better health care practices and implement identified strategies. Cluster 2 will assess the impact of current practices and practice changes in maternal, perinatal and neonatal care on maternal, neonatal and neurodevelopmental outcomes. Cluster 3 will evaluate the effect of preterm birth on babies, their families and the health care system by integrating CPTBN data, parent feedback, and national and provincial database information in order to identify areas where more parental support is needed, and also generate robust estimates of resource use, cost and cost-effectiveness around preterm neonatal care. These collaborative efforts will create a flexible, transdisciplinary, evaluable and informative research and quality-improvement platform that supports programs, projects and partnerships focused on improving outcomes of preterm neonates. Copyright 2018, Joule Inc. or its licensors.

  12. Infants born with critical CHD in Arizona and capacities of birth centres for screening and management.

    Science.gov (United States)

    Villa, Lydia; Bjornsen, Brent; Giacone, Heather; Weidler, Erica M; Bajaj, Ekta; Muth, Andrew; Kennedy, Melanie; Flood, Timothy; Contreras, Dianna; Spadafino, Joseph; Shah, Ashish

    2018-02-01

    The aims of this study were to identify locations of births in Arizona with critical CHD, as well as to assess the current use of pulse-oximetry screening and capacities of birth centres to manage a positive screen. Study design Infants (n=487) with a potentially critical CHD were identified from the Arizona Department of Health Services from 2012 and 2013; charts were retrospectively reviewed. Diagnosis was confirmed using echocardiographies. ArcGIS was used to generate maps to visualise the location of treating facility and mother's residence. Birth centres were surveyed to assess screening practices and capacities to manage critical CHD in 2015. Of the 272 patients identified with critical CHD, 52% had been diagnosed prenatally. Patients travelled an average distance of 55.1 miles to their treating facility. Mortality was not related to prenatal diagnosis (p=0.30), living at a high elevation (p=0.82), or to distance travelled to the treating facility (p=0.68). Of 50 birth centres, 33 responded to the survey and all centres practiced critical CHD screening. A total of 25 centres could perform paediatric echocardiographies; 64% of these centres could digitally transmit echocardiograms. In all, 24 birth centres maintained access to prostaglandins. Pulse-oximetry screening in newborns is currently implemented in the majority of Arizona hospitals. Although most centres could perform initial management steps following a positive screen, access to paediatric cardiology services was limited. Patients with critical CHD sometimes travelled a great distance to treating facilities. Digital transmission of echocardiograms or tele-echocardiography would reduce the distance travelled for the management of a positive screen, decrease the financial burden of transportation, and expedite care for critically ill neonates.

  13. Association between thyroxine levels at birth and choanal atresia or stenosis among infants in Texas, 2004-2007.

    Science.gov (United States)

    Lee, Laura J; Canfield, Mark A; Hashmi, S Shahrukh; Moffitt, Karen B; Marengo, Lisa; Agopian, A J; Belmont, John W; Freedenberg, Debra; Tanksley, Susan M; Mitchell, Laura E; Lupo, Philip J

    2012-11-01

    The causes of choanal atresia or stenosis (CA) are largely unknown. Infant thyroxine (T(4) ) levels collected during newborn screening may be proxy measures for a risk factor present during the critical period of development. Therefore, we conducted a case-control study to examine the association between newborn T(4) levels and CA. Data for cases with CA and controls were obtained from the Texas Birth Defects Registry for the period of 2004 to 2007. Information on infant T(4) levels at birth was obtained from the Texas Newborn Screening Program. Controls (n = 3570) were drawn from unaffected births in Texas for the same period and frequency matched to cases (n = 69) on year of birth, then linked to the newborn screening database. Logistic regression was used to evaluate the association between continuous and categorical infant T(4) levels and nonsyndromic CA. After adjustment for gestational age and year of birth, infant T(4) levels were inversely associated with CA (adjusted odds ratio [AOR], 0.85; 95% confidence interval [CI], 0.80-0.90). We observed a linear trend (p < 0.001) across quartiles of T(4) ; compared to infants with low levels, AORs for CA were 0.50 (95% CI, 0.28-0.91), 0.39 (95% CI, 0.20-0.75), and 0.15 (95% CI, 0.06-0.40) for infants with medium-to-low, medium, and high levels, respectively. Our findings suggest a role of low thyroid hormone levels in the development of CA, or that low newborn T(4) levels are potential proxy measures of a risk factor present during the critical period. Birth Defects Research (Part A), 2012. Copyright © 2012 Wiley Periodicals, Inc.

  14. Plurality of Birth and Infant Mortality Due to External Causes in the United States, 2000-2010.

    Science.gov (United States)

    Ahrens, Katherine A; Thoma, Marie E; Rossen, Lauren M; Warner, Margaret; Simon, Alan E

    2017-03-01

    Risk of death during the first year of life due to external causes, such as unintentional injury and homicide, may be higher among twins and higher-order multiples than among singletons in the United States. We used national birth cohort linked birth-infant death data (2000-2010) to evaluate the risk of infant mortality due to external causes in multiples versus singletons in the United States. Risk of death from external causes during the study period was 3.6 per 10,000 live births in singletons and 5.1 per 10,000 live births in multiples. Using log-binomial regression, the corresponding unadjusted risk ratio was 1.40 (95% confidence interval (CI): 1.30, 1.50). After adjustment for maternal age, marital status, race/ethnicity, and education, the risk ratio was 1.68 (95% CI: 1.56, 1.81). Infant deaths due to external causes were most likely to occur between 2 and 7 months of age. Applying inverse probability weighting and assuming a hypothetical intervention where no infants were low birth weight, the adjusted controlled direct effect of plurality on infant mortality due to external causes was 1.64 (95% CI: 1.39, 1.97). Twins and higher-order multiples were at greater risk of infant mortality due to external causes, particularly between 2 and 7 months of age, and this risk appeared to be mediated largely by factors other than low-birth-weight status. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  15. The Impact of Gestational Age and Birth Weight on the Risk of Strabismus among Premature Infants

    Science.gov (United States)

    Gulati, Shilpa; Andrews, Chris A.; Apkarian, Alexandra O.; Musch, David C.; Lee, Paul P.; Stein, Joshua D.

    2014-01-01

    IMPORTANCE Strabismus causes irreversible vision loss if not detected and treated early. It is unclear whether birth weight (BW) and gestational age (GA) are risk factors for strabismus. OBJECTIVE To estimate the impact of BW and GA on the likelihood of developing strabismus among premature infants. DESIGN In this longitudinal cohort analysis, we followed a group of premature children from birth to determine the proportion which developed strabismus and the timing of first strabismus diagnosis. Multivariable Cox regression analyses assessed the relationships of BW and GA and the development of strabismus. Regression models were adjusted for other known risk factors for strabismus, sociodemographic factors, and ocular comorbidities. SETTING Communities throughout the United States PARTICIPANTS 38055 otherwise healthy children born prematurely who were enrolled for >6 months in a nationwide US managed care network between 2001–2011. EXPOSURE BW strabismus with 95% confidence intervals (CIs) RESULTS Of 38055 otherwise healthy children who were born prematurely, 587 were diagnosed with strabismus later in life. Cumulative incidence of strabismus was 3.0% at 5 years. Controlling for GA and other factors, infants born with BW strabismus. Controlling for BW and other covariates, there was no significant association between strabismus and GA (HR=0.98, [CI, 0.69–1.38]). Among premature infants with BW strabismus relative to those born after 32 weeks (HR=1.27, [CI, 0.86–1.88]). In contrast, among those with GA ≤32 weeks, BW strabismus relative to BW >2000g (HR=14.4, [CI 1.99–104]). CONCLUSIONS AND RELEVANCE Independent of GA, very low BW conferred a large increase in strabismus risk among premature infants. In contrast, independent of BW, GA did not significantly impact the risk of strabismus. Updates to existing guidelines in the pediatric and ophthalmic literature should be considered, highlighting the importance of BW rather than GA and alerting clinicians about

  16. Effect of Kangaroo Mother Care on Growth and Morbidity Pattern in Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Keerti Swarnkar

    2016-01-01

    Full Text Available Background: Kangaroo Mother Care (KMC is dened as skin-to-skin contact between a mother and her newborn baby derived from practical similarities to marsupial care giving, proximately exclusive breastfeeding and early discharge from hospital. This concept was proposed as an alternative to conventional methods of care for low birth weight (LBW infants, and in replication to quandaries of earnest overcrowding in Neonatal Intensive Care Units (NICUs. KMC essentially utilizes the mother as a natural incubator Aim and Objectives: The aim was to assess the feasibility, acceptability and the effectiveness of KMC in LBW infants. It avoids agitation routinely experienced in busy ward. Material and Methods: A pilot open-labeled quasi-randomised clinical trial was conducted in Level III NICU of a teaching institution. 60 newborn infants <2500 g, meeting inclusion criteria were alternatively randomised into two groups: Kangaroo Mother Care (KMC and Conventional Methods of Care (CMC. Kangaroo mother care was practiced with minimum total period of eight hours a day intermittently for the intervention group while the controls remained in incubators or cots. Weight, head circumference, length, morbidity episodes, hospital stay, feeding patterns were monitored for all infants till postmenstrual age of 42 weeks in preterm babies or till a weight of 2500 g is achieved in term SGA babies. Results: The pilot study conrmed that trial processes were efcient, the intervention was acceptable (to mothers and nurses and that the outcome measures were appropriate; KMC babies achieved signicantly better growth at the end of the study (For preterm babies, weight, length and head circumference gain were signicantly higher in the KMC group (weight 19.28±2.9g/day, length 0.99±0.56cm/week and head circumference 0.72±0.07 cm/week than in the CMC group (P <0.001. A signicantly higher number of babies in the CMC group suffered from hypothermia, hypoglycemia, and

  17. Exclusive Breastfeeding among Preterm Low Birth Weight Infants at One Month Follow-up after Hospital Discharge

    Directory of Open Access Journals (Sweden)

    Ishrat Jahan

    2011-01-01

    Full Text Available Background: Establishment and maintenance of breastfeeding in preterm low birth weight (PT LBW neonates after discharge from hospital is challenging and may be affected by multiple factors. We designed this study to find out the association of these factors with breastfeeding in our population. Objectives: To observe the rate of exclusive breasrfeeding (EBF among the PT LBW neonates at one month follow up and to identify the factors that are related with the maintenance of EBF. Materials and Methods: This observational study was conducted during the period from July 2009 to October 2011 in Enam Medical College Hospital (EMCH. Preterm infants ≤ 34 wks gestation, stayed in the NICU for >3 days and discharged home were eligible. Mothers were interviewed at one month follow-up after discharge. Infants who were given only breast milk up to 4 weeks were termed as “Exclusively breastfed (EBF” and who were given formula milk in addition were labeled as “Nonexclusively breastfed (NEBF”. Baseline information regarding maternal demography, delivery of the baby, feeding during discharge was taken from database of neonatal ward. Results: Among 89 infants, 37 (42% were female and 52 (58% were male, including 5 twins. Gestational age ranged from 29 to 34 weeks (mean 32±2, and birth weight ranged from 1100 to 2200 grams (mean 1763±20 g. At one month follow up visit 19% (17/89 were found to be NEBF and 81% were EBF. Factors significantly associated with EBF were shorter duration of hospital stay (p=0.001, method of feeding at discharge (p=0.001, mode of delivery (p=0.004, below average socio-economic status (p=0.03, maternal education (p=0.02, number of antenatal visits (p=0.02 and larger birth weight (p=0.038. Conclusion: A variety of factors may affect EBF in PT LBW babies. Extensive counseling of the mothers during antenatal visits, counseling of the family members regarding the advantages of exclusive breastfeeding is necessary. Support should be

  18. The outcome at 12 months of very-Iow-birth-weight infants ventilated ...

    African Journals Online (AJOL)

    Main outcome measures. Attrition rates for rural and urban babies, BPD, ROP, IVH and abnormal motor development. Study population and setting. All ventilated VLBW infants discharged from the neonatal intensive care unit at Tygerberg Hospital over a 1-year period were followed up at 3-monthly intervals for 12 months.

  19. The 'Effects of Transfusion Thresholds on Neurocognitive Outcome of Extremely Low Birth-Weight Infants (ETTNO)' Study

    DEFF Research Database (Denmark)

    Reinholdt, Jes; Veiergang, Gitte

    2012-01-01

    Background: Infants with extremely low birth weight uniformly develop anemia of prematurity and frequently require red blood cell transfusions (RBCTs). Although RBCT is widely practiced, the indications remain controversial in the absence of conclusive data on the long-term effects of RBCT....... Objectives: To summarize the current equipoise and to outline the study protocol of the 'Effects of Transfusion Thresholds on Neurocognitive Outcome of extremely low birth-weight infants (ETTNO)' study. Methods: Review of the literature and design of a large pragmatic randomized controlled trial...

  20. Analysis of the parameters of postnatal growth in infants with very low body weight at birth in neonatal intensive care and special care units

    Directory of Open Access Journals (Sweden)

    Shunko Ye.Ye.

    2016-03-01

    Full Text Available Objective: to study the rates of increase in body weight (BW, body length (BL and head circumference (HC in infants with VLBW; define significant factors affecting the rates of postnatal growth (PG for each parameter; identify correlations between the factors and PG parameters. Patients and methods. The assessment of PG of infants with VLBW (n=92 and ELBW (n=34 was carried out during three time intervals: in the neonatal intensive-care unit (NICU, in the special care nursery and from birth until the hospital discharge. Results. Average PG rates in infants with VLBW and ELBW (the growth of BW, BL and HC in NICU amounted to 8.63 g/day, 0.89 cm/week and 0.4 cm/week respectively; in the special care nursery: 24.2 g/day, 0.94 cm/week, 0.7 cm/week respectively; during the entire treatment period: 18.23 g/day, 0.92 cm/week and 0.6 cm/week respectively. The growth of BW and HC in infants with VLBW and ELBW during the entire treatment period was directly proportional to the growth of BW, BL and HC in NICU; the growth of BW, BL and HC in the special care nursery, as well as the BL growth during the entire treatment period. The growth of PG parameters was inversely proportional to the BW, BL and HC at birth. Conclusion. The PG rates are directly proportional to the growth of all PG parameters and inversely proportional to the PG parameters at birth.

  1. Literacy Rates and its Impact on Birth Rates in Nadia District, West Bengal, India

    Directory of Open Access Journals (Sweden)

    Mahadeb Ghosh

    2016-11-01

    Full Text Available Equality in socio-economic component is essential for human development and social change. Educational inequality reduces economic growth and women's empowerment on the one hand and increases birth rate on the other. In population studies, it has been established that educational level is collinearly related with demographic behaviour. This study aims to investigate inequalities in literacy rates and its impact on birth rates in Nowpara-I Gram Panchayat (GP located in the Krishnagar II C.D. Block, Nadia District of West Bengal using a household survey conducted in 356 households among women aged 49 and above in triangulation with secondary data. The aim of this study is to explore the causes of the spatial inequalities in education and its effect on spatial variations in birth rates. The key finding suggest that in Nowpara-I, negative relationships exist between female education and birth rate because education has a positive impact on empowerment, late marriage, use of contraceptives and family size.

  2. Blood glucose levels within 7 days after birth in preterm infants according to gestational age

    Directory of Open Access Journals (Sweden)

    Ju Young Yoon

    2015-12-01

    Full Text Available PurposeThis study investigated blood glucose levels in preterm babies according to gestational age (GA.MethodsSubjects were 141 preterm infants with a GA180 mg/dL.ResultsDuring the 7 days after birth, hypo- and hyperglycemia occurred in 29 (29 of 141, 20.6% and 42 (42 of 141, 29.8% neonates, respectively. During the first 2 hours, 18 neonates (12.8% exhibited hypoglycemia, and only 2 (2 of 141, 1.4% developed hyperglycemia. From 6 to 24 hours, hypo- and hyperglycemia were observed in 0 and 9 (9 of 141, 6.4% neonates, respectively. Infants small for their GA (SGA were at risk for hypoglycemia both within 24 hours (odds ratio [OR], 2.718; P=0.045 and during days 2 to 7 (OR, 4.454; P=0.006, and hyperglycemia during days 2 to 7 (OR, 3.200; P=0.005. Low 1-minite Apgar score was risk factor for both hypo- and hyperglycemia during days 2 to 7 (OR, 0.756; P=0.035 for hypoglycemia and OR, 0.789; P=0.016 for hyperglycemia. Both hypo- and hyperglycemia within 24 hours were less common in those who started feeding (OR, 0.294; P=0.013 for hypoglycemia and OR, 0.162; P=0.011 for hyperglycemia.ConclusionCareful blood glucose level monitoring is required in preterm infants, especially SGA infants or those with low Apgar score. Early feeding could be beneficial for maintaining euglycemia.

  3. Associations of consumption of fruits and vegetables during pregnancy with infant birth weight or small for gestational age births: a systematic review of the literature

    Science.gov (United States)

    Murphy, Mary M; Stettler, Nicolas; Smith, Kimberly M; Reiss, Richard

    2014-01-01

    Maternal nutrition is recognized as one of the determinants of fetal growth. Consumption of fruits and vegetables is promoted as part of a healthful diet; however, intakes are typically lower than recommended levels. The purpose of this study was to systematically review results from studies examining the relationship between maternal consumption of fruits and vegetables during pregnancy with infant birth weight or risk for delivering a small for gestational age baby. A comprehensive search of PubMed and EMBASE was conducted and abstracts were screened using predefined criteria. Eleven relevant studies were identified and systematically reviewed, including six prospective cohort studies, three retrospective cohort studies, and two case–control studies. Seven studies were conducted in cohorts from highly developed countries. One prospective study from a highly developed area reported increased risk for small for gestational age birth by women with low vegetable intakes (odds ratio 3.1; 95% confidence interval 1.4–6.9; P=0.01); another large prospective study reported a 10.4 g increase in birth weight per quintile increase in fruit intake (95% confidence interval 6.9–3.9; Pfruits and vegetables (combined) or fruits, vegetables, and juice (combined), respectively. One retrospective study reported an association between low fruit intake and birth weight. In less developed countries, increased vegetable or fruit intake was associated with increased birth weight in two prospective studies. Overall, limited inconclusive evidence of a protective effect of increased consumption of vegetables and risk for small for gestational age birth, and increased consumption of fruits and vegetables and increased birth weight among women from highly developed countries was identified. Among women in less developed countries, limited inconclusive evidence suggests that increased consumption of vegetables or fruits may be associated with higher infant birth weight. The available

  4. Rate of vertical transmission of human papillomavirus from mothers to infants: Relationship between infection rate and mode of delivery

    Directory of Open Access Journals (Sweden)

    Park Hyun

    2012-04-01

    Full Text Available Abstract Background In contrast to consistent epidemiologic evidence of the role of sexual transmission of human papillomavirus (HPV in adults, various routes may be related to HPV infection in infants. We have assessed the extent of HPV infection during the perinatal period, and the relationship between mode of delivery and vertical transmission. Results A total of 291 pregnant women over 36 weeks of gestation were enrolled with informed consent. Exfoliative cells were collected from maternal cervix and neonatal buccal mucosa. HPV infection and genotypes were determined with an HPV DNA chip, which can recognise 24 types. The HPV-positive neonates were re-evaluated 6 months after birth to identify the presence of persistent infection. HPV DNA was detected in 18.9 % (55/291 of pregnant women and 3.4 % (10/291 of neonates. Maternal infection was associated with abnormal cytology (p = 0.007 and primiparity (p = 0.015. The infected neonates were all born to HPV-positive mothers. The rate of vertical transmission was estimated at 18.2 % (10/55 which was positively correlated with maternal multiple HPV infection (p = 0.003 and vaginal delivery (p = 0.050, but not with labour duration and premature rupture of membranes. The rate of concordance of genotype was 100 % in mother-neonate pairs with vertical transmission. The neonatal HPV DNAs found at birth were all cleared at 6 months after delivery. Conclusions Vertical transmission of HPV DNA from HPV infected mother to the neonate increased when the infant was delivered through an infected cervix. However, the absence of persistent infection in infants at 6 months after delivery may suggest temporary inoculation rather than true vertical infection.

  5. Effect of Natural-Feeding Education on Successful Exclusive Breast-Feeding and Breast-Feeding Self-Efficacy of Low-Birth-Weight Infants

    Science.gov (United States)

    Küçükoğlu, Sibel; Çelebioğlu, Ayda

    2014-01-01

    Objective: The ideal nourishment for newborns with low birth-weight is breast milk. The purpose of the study was to determine the effect of natural-feeding education given to mothers of low-birth-weight infants, on the mothers’ breast-feeding self-efficacy level, breast-feeding success, and the growth of the infants. Methods: The study was conducted in a quasi-experimental way. The study group consisted of a total of 85 low-birth-weight infants and their mothers who had been treated in the neonatal clinics of two hospitals. The mothers included in the test group were given breast-feeding education for half an hour per day, during the first 5 days of their hospitalization. Home visits were carried out at the homes of the participants from both the test and control groups, until the infants reached 6 months of age. For collecting data, the following forms were used: Personal Information Form, Breast-feeding Self-Efficacy Form, LATCH Breast-feeding Assessment Tool, and Anthropometric Measurements Form. For analyzing the collected data, percentage, arithmetic mean, standard deviation, and chi-square we used, and, in independent groups, t-tests were employed. Findings : It was determined that natural-feeding education given to the mothers increases their breast-feeding self-efficacy levels and success in breast-feeding (P<0.05). It was found that in the test group, the rate of feeding the infants exclusively with breast milk is higher in comparison with the control group (P<0.001). Conclusion: Results of the study indicate that natural-feeding education increases breast-feeding self-efficacy levels, breast-feeding success, and the breast-feeding duration. PMID:25793045

  6. The association of birth weight and infant growth with physical fitness at 8-9 years of age--the ABCD study

    NARCIS (Netherlands)

    van Deutekom, A. W.; Chinapaw, M. J. M.; Vrijkotte, T. G. M.; Gemke, R. J. B. J.

    2015-01-01

    Low birth weight and accelerated infant growth are independently associated with childhood obesity. We hypothesized that birth weight and infant growth are associated with physical fitness in childhood, and thereby could act as a link in the developmental origins of obesity. In addition, we assessed

  7. The association of birth weight and infant growth with physical fitness at 8-9 years of age-the ABCD study

    NARCIS (Netherlands)

    van Deutekom, A.W.; Chin A Paw, M.J.M.; Vrijkotte, T.G.M.; Gemke, R.J.B.J.

    2015-01-01

    Background:Low birth weight and accelerated infant growth are independently associated with childhood obesity. We hypothesized that birth weight and infant growth are associated with physical fitness in childhood, and thereby could act as a link in the developmental origins of obesity. In addition,

  8. Description of 13 Infants Born During October 2015-January 2016 With Congenital Zika Virus Infection Without Microcephaly at Birth - Brazil.

    Science.gov (United States)

    van der Linden, Vanessa; Pessoa, André; Dobyns, William; Barkovich, A James; Júnior, Hélio van der Linden; Filho, Epitacio Leite Rolim; Ribeiro, Erlane Marques; Leal, Mariana de Carvalho; Coimbra, Pablo Picasso de Araújo; Aragão, Maria de Fátima Viana Vasco; Verçosa, Islane; Ventura, Camila; Ramos, Regina Coeli; Cruz, Danielle Di Cavalcanti Sousa; Cordeiro, Marli Tenório; Mota, Vivian Maria Ribeiro; Dott, Mary; Hillard, Christina; Moore, Cynthia A

    2016-12-02

    Congenital Zika virus infection can cause microcephaly and severe brain abnormalities (1). Congenital Zika syndrome comprises a spectrum of clinical features (2); however, as is the case with most newly recognized teratogens, the earliest documented clinical presentation is expected to be the most severe. Initial descriptions of the effects of in utero Zika virus infection centered prominently on the finding of congenital microcephaly (3). To assess the possibility of clinical presentations that do not include congenital microcephaly, a retrospective assessment of 13 infants from the Brazilian states of Pernambuco and Ceará with normal head size at birth and laboratory evidence of congenital Zika virus infection was conducted. All infants had brain abnormalities on neuroimaging consistent with congenital Zika syndrome, including decreased brain volume, ventriculomegaly, subcortical calcifications, and cortical malformations. The earliest evaluation occurred on the second day of life. Among all infants, head growth was documented to have decelerated as early as 5 months of age, and 11 infants had microcephaly. These findings provide evidence that among infants with prenatal exposure to Zika virus, the absence of microcephaly at birth does not exclude congenital Zika virus infection or the presence of Zika-related brain and other abnormalities. These findings support the recommendation for comprehensive medical and developmental follow-up of infants exposed to Zika virus prenatally. Early neuroimaging might identify brain abnormalities related to congenital Zika infection even among infants with a normal head circumference (4).

  9. NCHS - Teen Birth Rates for Females by Age Group, Race, and Hispanic Origin: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes teen birth rates for females by age group, race, and Hispanic origin in the United States since 1960. National data on births by Hispanic...

  10. NCHS - Birth Rates for Unmarried Women by Age, Race, and Hispanic Origin: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes birth rates for unmarried women by age group, race, and Hispanic origin in the United States since 1970. National data on births by Hispanics...

  11. Oral immunoglobulin for the treatment of rotavirus infection in low birth weight infants.

    Science.gov (United States)

    Mohan, P; Haque, K

    2003-01-01

    Rotavirus infection is the most common neonatal nosocomial viral infection. Epidemics with the newer P(6)G9 strains have been reported in neonatal units worldwide. These strains can cause severe symptoms in most infected infants. Infection control measures become necessary and the utilisation of hospital resources increase. Local mucosal immunity in the intestine to rotavirus is important in the resolution of infection and protection against subsequent infections. Boosting local immunity by oral administration of anti-rotaviral immunoglobulin preparations might be a useful strategy in treating rotaviral infections, especially in low birth weight babies. To determine the effectiveness and safety of oral immunoglobulin preparations for the treatment of rotavirus infection in hospitalised low birthweight infants (birth weight less than 2500 gms) Electronic databases including The Cochrane Controlled Trials Register (The Cochrane Llibrary, Issue 2, 2002), MEDLINE (1966 - June 2002), EMBASE (1980 - June 2002) and CINAHL (1982 - June 2002) were searched by the strategy outlined in the protocol. Science Citation Index search for all articles which referenced Barnes 1982 were searched. The proceedings of the Pediatric Academic Societies which were published in the journal, Pediatric Research, from 1991 were searched as well as abstracts of the doctoral dissertations and theses from 1960. All of the above search strategies were completed in June 2002. Authors prominent in the field were contacted for any unpublished articles and more information on published articles was sought. Reference lists of identified clinical trials and personal files were also reviewed. The criteria used to select studies for inclusion were: 1) DESIGN: randomised or quasi-randomised controlled trials 2) Hospitalised low birthweight infants with rotavirus infection 3) INTERVENTION: Oral immunoglobulin preparations compared to placebo OR no intervention 4) At least one of the following outcomes were

  12. Comparing two motor assessment tools to evaluate neurobehavioral intervention effects in infants with very low birth weight at 1 year

    NARCIS (Netherlands)

    van Hus, Janeline W. P.; Jeukens-Visser, Martine; Koldewijn, Karen; van Sonderen, Loekie; Kok, Joke H.; Nollet, Frans; van Wassenaer-Leemhuis, Aleid G.

    2013-01-01

    Infants with very low birth weight (VLBW) are at increased risk for motor deficits, which may be reduced by early intervention programs. For detection of motor deficits and to monitor intervention, different assessment tools are available. It is important to choose tools that are sensitive to

  13. A Randomized controlled trial of enteral glutamine supplementation in very low birth weight infants: Plasma amino acid concentrations

    NARCIS (Netherlands)

    van den Berg, Anemone; van Elburg, Ruurd M.; Teerlink, T.; Lafeber, Harrie N.; Twisk, Jos W. R.; Fetter, Willem P. F.

    2005-01-01

    Objective: Glutamine depletion has negative effects on the functional integrity of the gut and leads to immunosuppression. Very low birth weight (VLBW) infants are susceptible to glutamine depletion, as enteral nutrition is limited in the first weeks of life. Enteral glutamine supplementation may

  14. Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children

    Czech Academy of Sciences Publication Activity Database

    Sonnenschein-van der Voort, A. M. M.; Arends, L. R.; de Jongste, J. C.; Annesi-Maesano, I.; Arshad, S. H.; Barros, H.; Basterrechea, M.; Bisgaard, H.; Chatzi, L.; Corpeleijn, E.; Correia, S.; Craig, L. C.; Devereux, G.; Dogaru, C.; Dostál, Miroslav; Duchen, K.; Eggesbø, M.; van der Ent, C. K.; Fantini, M. P.; Forastiere, F.; Frey, U.; Gehring, U.; Gori, D.; van der Gugten, A. C.; Hanke, W.; Henderson, A. J.; Heude, B.; Iniguez, C.; Inskip, H. M.; Keil, T.; Kelleher, C.; Kogevinas, M.; Kreiner-Moller, E.; Kuehni, C. E.; Kuepers, L. K.; Lancz, K.; Larsen, P. S.; Lau, S.; Ludvigsson, J.; Mommers, M.; Andersen, A. M. N.; Palkovicova, L.; Pike, K. C.; Pizzi, C.; Polanska, K.; Porta, D.; Richiardi, L.; Roberts, G.; Schmidt, A.; Šrám, Radim; Sunyer, J.; Thijs, C.; Torrent, M.; Viljoen, K.; Wijga, A. H.; Vrijheid, M.; Jaddoe, V. W. V.; Duijts, L.

    2014-01-01

    Roč. 133, č. 5 (2014), s. 1317-1329 ISSN 0091-6749 Institutional support: RVO:68378041 Keywords : gestational age * low birth weight * infant growth Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 11.476, year: 2014

  15. Long-term effects of neonatal glutamine-enriched nutrition in very-low-birth-weight infants

    NARCIS (Netherlands)

    van Zwol, Annelies; Neu, Josef; van Elburg, Ruurd M.

    2011-01-01

    Several studies in very-low-birth-weight (VLBW) infants have investigated the effect of parenteral or enteral glutamine supplementation on morbidity, mortality, and outcome in the neonatal period. No evidence of toxicity of glutamine supplementation was found in these clinical trials, but the

  16. A randomized controlled trial of enteral glutamine supplementation in very low birth weight infants: plasma amino acid concentrations

    NARCIS (Netherlands)

    van den Berg, A.; van Elburg, R.M.; Teerlink, T.; Lafeber, H.N.; Twisk, J.W.R.; Fetter, W.P.F.

    2005-01-01

    Objective: Glutamine depletion has negative effects on the functional integrity of the gut and leads to immunosuppression. Very low birth weight (VLBW) infants are susceptible to glutamine depletion, as enteral nutrition is limited in the first weeks of life. Enteral glutamine supplementation may

  17. Intestinal microbiota in allergic and nonallergic 1-year-old very low birth weight infants after neonatal glutamine supplementation

    NARCIS (Netherlands)

    van Zwol, A.; van den Berg, A.; Knol, J.; Twisk, J. W. R.; Fetter, W. P. F.; van Elburg, R. M.

    2010-01-01

    Aim: Previously, glutamine-enriched enteral nutrition in very low birth weight infants (VLBW) decreased the incidence of atopic dermatitis at age 1 year. The aim of this study was to determine whether this effect is related to changes in intestinal bacterial species that are associated with allergy,

  18. Reduced mortality and increased BPD with histological chorioamnionitis and leukocytosis in very-low-birth-weight infants.

    Science.gov (United States)

    Paul, D A; Zook, K; Mackley, A; Locke, R G

    2010-01-01

    To investigate the association between leukocytosis, mortality and bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants (VLBW) born to mothers with histological chorioamnionitis. A retrospective cohort study from a single level 3 neonatal intensive care unit. The study sample included infants born to mothers with histological chorioamnionitis (n=252). Total white blood cells (WBCs) after birth were measured. Leukocytosis was defined as a total WBC count >30 000 per mm(3) in the first 2 days of life. Outcomes investigated included BPD and death. Both unadjusted and multivariable analyses were carried out. After controlling for potential confounding variables, infants who developed a leukocytosis after birth had increased odds of BPD (4.6, 95% confidence interval (95% CI): 2.0 to 10.3), but decreased odds of death (0.3, 95% CI: 0.1 to 0.90). In our population of VLBW infants born to mothers with histological chorioamnionitis, leukocytosis after birth is associated with a decrease in mortality but an increase in BPD.

  19. Predicting Infant Maltreatment in Low-Income Families: The Interactive Effects of Maternal Attributions and Child Status at Birth

    Science.gov (United States)

    Bugental, Daphne Blunt; Happaney, Keith

    2004-01-01

    Maternal attributions and child neonatal status at birth were assessed as predictors of infant maltreatment (harsh parenting and safety neglect). The population included low-income, low-education families who were primarily Hispanic. Child maltreatment during the 1st year of life (N = 73) was predicted by neonatal status (low Apgar scores, preterm…

  20. Impact of birth weight and early infant weight gain on insulin resistance and associated cardiovascular risk factors in adolescence

    DEFF Research Database (Denmark)

    Fabricius-Bjerre, Signe; Jensen, Rikke Beck; Færch, Kristine

    2011-01-01

    Low birth weight followed by accelerated weight gain during early childhood has been associated with adverse metabolic and cardiovascular outcomes later in life. The aim of this study was to examine the impact of early infant weight gain on glucose metabolism and cardiovascular risk factors...

  1. Bedside upper gastrointestinal series in critically ill low birth weight infants.

    Science.gov (United States)

    Nayak, Gopi K; Levin, Terry L; Kurian, Jessica; Kohli, Anirudh; Borenstein, Steven H; Goldman, Harold S

    2014-10-01

    The upper gastrointestinal (UGI) series is the preferred method for the diagnosis of malrotation. A bedside UGI technique was developed at our institution for use in low birth weight, critically ill neonates to minimize the risks of transportation from the neonatal intensive care unit (NICU) such as hypothermia and dislodgement of support lines and tubes. To determine the ability of a bedside UGI technique to identify the position of the duodenojejunal junction (DJJ) in low birth weight, critically ill infants in the NICU. We retrospectively reviewed bedside UGI examinations performed in premature infants weighing less than 1,500 g from 2008 to 2013 and correlated the findings with clinical data, imaging studies and surgical findings. Of 27 patients identified (weight range: 633-1,495 g), 21 (78%) bedside UGI series were diagnostic. Twenty of 27 cases (74%) demonstrated normal intestinal rotation. One case demonstrated malrotation with midgut volvulus, which was confirmed at surgery. In six cases (22%), the position of the DJJ could not be accurately determined. No cases of malrotation with midgut volvulus were missed. None of the patients with normal bedside UGI studies was found to have malrotation based on clinical follow-up (mean: 20 months), surgical findings or further imaging. The bedside UGI is a useful technique to exclude malrotation in critically ill neonates and minimizes potential risks of transportation to the radiology suite. Pitfalls that may preclude a diagnostic examination include incorrect timing of radiographs, patient rotation, suboptimal enteric tube position and bowel distention. In cases of diagnostic uncertainty, a follow-up study should be performed.

  2. [Gaussian distribution of intelligence in VLBW preterm infants at age 5: very low correlation with very low birth weight].

    Science.gov (United States)

    van Baalen, A; Ross, C; Kewitz, G; Mildenberger, E; Berns, M; Bartsch, M; Kössel, H; Kruppa, E; Bohn, R; Versmold, H

    2008-04-01

    Preterm infants with very low birth weight intelligence values, we studied the distribution of intelligence at preschool age in VLBW infants and the risk factors influencing this distribution. A prospective cohort study of 277 VLBW infants intelligence (Kaufman-Assessment Battery for Children) at age 5. Statistical methods employed were: explorative data analysis, correlation, chi (2)- and t-tests; the tested variables were: small for gestational age ( 0.21 > or = 36 weeks), intraventricular hemorrhage, ventricular dilation, periventricular leukomalacia, seizures, abnormal acoustic evoked potentials, and hyperexcitability at discharge. The distribution of intelligence in 137 VLBW infants intelligence increased very slightly with birth weight (Pearson correlation: 0.172; p = 0.045) and was significantly lower in children with hypoglycemia after the first day of life (- 13.35; 95 % confidence interval: - 20.08 to - 6.63; p = 0.002), hyperexcitability at discharge (- 16.28; 95 % confidence interval: - 25.26 to - 7.31; p = 0.005), and bronchopulmonary dysplasia (- 7.00; 95 % confidence interval - 11.71 to - 2.29; p = 0.039). At preschool age, the intelligence of VLBW infants is normally distributed and correlates only slightly with the very low birth weight. Hypoglycemia after the first day of life and bronchopulmonary dysplasia are risk factors for lower intelligence. Hyperexcitability at discharge seemed to represent a promising prognostic factor for a later intelligence reduction.

  3. Neonatal sepsis as a risk factor for neurodevelopmental changes in preterm infants with very low birth weight.

    Science.gov (United States)

    Ferreira, Rachel C; Mello, Rosane R; Silva, Kátia S

    2014-01-01

    to evaluate neonatal sepsis as a risk factor for abnormal neuromotor and cognitive development in very low birth weight preterm infants at 12 months of corrected age. this was a prospective cohort study that followed the neuromotor and cognitive development of 194 very low birth weight preterm infants discharged from a public neonatal intensive care unit. The Bayley Scale of Infant Development (second edition) at 12 months of corrected age was used. The outcomes were the results of the clinical/neurological evaluation and the scores of the psychomotor development index (PDI) and mental development index (MDI) of the Bayley Scale of Infant Development II. The association between neonatal sepsis and neuromotor development and between neonatal sepsis and cognitive development was verified by logistic regression analysis. mean birth weight was 1,119g (SD: 247) and mean gestational age was 29 weeks and 6 days (SD: 2). Approximately 44.3%(n=86) of the infants had neonatal sepsis and 40.7% (n=79) had abnormal neuromotor development and/or abnormal psychomotor development index (PDI de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. Care around birth, infant and mother health and maternal health investments – Evidence from a nurse strike

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Sievertsen, Hans Henrik; Wüst, Miriam

    2016-01-01

    ' prenatal midwife consultations, their length of hospital stay at birth, and the number of home visits by trained nurses after hospital discharge. We find that this reduction in care around birth increased the number of child and mother general practitioner (GP) contacts in the first month. As we do...... investments indicate that strike-exposed mothers—especially those who lacked postnatal early home visits—are less likely to exclusively breastfeed their child at four months. Thus reduced care around birth may have persistent effects on treated children through its impact on parental investments.......Care around birth may impact child and mother health and parental health investments. We exploit the 2008 national strike among Danish nurses to identify the effects of care around birth on infant and mother health (proxied by health care usage) and maternal investments in the health...

  5. Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates

    Science.gov (United States)

    ... mortality rates for sudden infant death syndrome (SIDS), congenital malformations, and unintentional injuries were also substantially higher for ... infant mortality rate. SIDS accounted for 6 percent, congenital malformations 5 percent, and unintentional injuries 4 percent of ...

  6. Early Conventional MRI for Prediction of Neurodevelopmental Impairment in Extremely-Low-Birth-Weight Infants.

    Science.gov (United States)

    Slaughter, Laurel A; Bonfante-Mejia, Eliana; Hintz, Susan R; Dvorchik, Igor; Parikh, Nehal A

    2016-01-01

    Extremely-low-birth-weight (ELBW; ≤1,000 g) infants are at high risk for neurodevelopmental impairments. Conventional brain MRI at term-equivalent age is increasingly used for prediction of outcomes. However, optimal prediction models remain to be determined, especially for cognitive outcomes. The aim was to evaluate the accuracy of a data-driven MRI scoring system to predict neurodevelopmental impairments. 122 ELBW infants had a brain MRI performed at term-equivalent age. Conventional MRI findings were scored with a standardized algorithm and tested using a multivariable regression model to predict neurodevelopmental impairment, defined as one or more of the following at 18-24 months' corrected age: cerebral palsy, bilateral blindness, bilateral deafness requiring amplification, and/or cognitive/language delay. Results were compared with a commonly cited scoring system. In multivariable analyses, only moderate-to-severe gyral maturational delay was a significant predictor of overall neurodevelopmental impairment (OR: 12.6, 95% CI: 2.6, 62.0; p cognitive delay, cognitive delay/death, and neurodevelopmental impairment/death. Diffuse cystic abnormality was a significant predictor of cerebral palsy (OR: 33.6, 95% CI: 4.9, 229.7; p impairment. In our cohort, conventional MRI at term-equivalent age exhibited high specificity in predicting neurodevelopmental outcomes. However, sensitivity was suboptimal, suggesting additional clinical factors and biomarkers are needed to enable accurate prognostication. © 2016 S. Karger AG, Basel.

  7. Correlation between developmental disorders and MRI findings in very low birth weight infants

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, Kuniaki; Endo, Shoichi; Goda, Tomoko; Ota, Akira; Akita, Yuji; Furukawa, Seikyo (Kagawa Children' s National Sanatorium, Zentsuji (Japan))

    1994-08-01

    We investigated the prevalence of developmental disorders in very low birth weight infants, their risk factors during the neonatal period, and the correlation between their neurological symptoms and their MRI findings. Seventy-three infants, who were followed up for more than 5 years in the developmental clinic, were enrolled. The developmental disorders included 6 patients with cerebral palsy (CP) and 6 patients with mental retardation (MR). The types of CP were as follows: spastic diplegia (3), spastic quadriplegia (2), athetotic quadriplegia (1). Intraventricular hemorrhage (IVH) and mechanical ventilation (MV) were significant risk factors for CP and MR and retinopathy was also a significant risk factor for MR. Periventricular areas of bright signal intensity on T2 (TR 2000 msec/TE 120 mse) weighted images, compatible with old, small white matter infarcts, gliosis or demyelination, were observed in only three of the seven patients. We measured the width of anterior horns, the maximum diameter of cerebrum, and the minimum thickness of white matter in occipital lobe on T1 (TR 500 msec/TE 20 msec) weighted transaxial images in eight patients (five patients with CP, three patients with MR). The maximum diameters of cerebrums and the minimum thickness of white matters were significantly smaller in patients with CP or MR than those in controls, respectively. The DQ of patients significantly correlated with the maximum diameters of cerebrums and the minimum thickness of white matters in left occipital lobe significantly correlated with DQ. (author).

  8. Survival and morbidity of very low birth weight infant in a South American neonatal network.

    Science.gov (United States)

    Fernández, Rocío; D'Apremont, Ivonne; Domínguez, Angélica; Tapia, José L

    2014-10-01

    To analyze survival and relevant morbidity by gestational age (GA) in very low birth weight (VLBW) infants (Neonatal Network (Red Neonatal Neocosur) between January 2001 and December 2011. Data on 8234 VLBW with a GA between 24+0 and 31+6 weeks were analyzed. Overall mortality was 26% (95% CI: 25.0-26.9), including 2.6% of deaths in the delivery room. Fact sheets for survival and morbidity for each week of gestation were developed based on collected data. Survival at discharge increased from 29% at 24 weeks of GA to 91% at 31 weeks of GA (p neonatal morbidity was inversely related to GA (p hemorrhage, and 4.6% periventricular leukomalacia. Among survivors, 47.3% had none of these five conditions. A tool for use in a clinical setting was developed based on updated regional data for establishing week-to-week survival and morbidity of newborn infants born between 24+0 and 31+6 weeks of GA. This information could be used to make decisions related to perinatal care and for counseling parents.

  9. Perinatal factors and regional brain volume abnormalities at term in a cohort of extremely low birth weight infants.

    Directory of Open Access Journals (Sweden)

    Nehal A Parikh

    Full Text Available Our objective was to investigate diverse clinical antecedents of total and regional brain volume abnormalities and white matter hyperintensity volume on term MRI in extremely low birth weight (birth weight ≤1000 g survivors. A consecutive cohort of extremely low birth weight infants who survived to 38 weeks postmenstrual age (n = 122 and a control group of 16 healthy term newborns underwent brain MRI at term-equivalent age. Brain volumes were measured using semi-automated and manual segmentation methods. Using multivariable linear regression, clinical antecedents were correlated with volumes of total brain tissue, white matter hyperintensities, and regional tissues/structures, adjusted for age at MRI, total cranial volume, and total tissue volume. Regional brain volumes were markedly reduced in extremely low birth weight infants as compared to term newborns (relative difference range: -11.0%, -35.9%. Significant adverse clinical associations for total brain tissue volume included: small for gestational age, seizures, caffeine therapy/apnea of prematurity, duration of parenteral nutrition, pulmonary hemorrhage, and white matter injury (p<0.01 for each; relative difference range: -1.4% to -15.0%. Surgery for retinopathy of prematurity and surgery for necrotizing enterocolitis or spontaneous intestinal perforation were significantly associated with increasing volume of white matter hyperintensities. Regional brain volumes are sensitive to multiple perinatal factors and neonatal morbidities or interventions. Brain growth measurements in extremely low birth weight infants can advance our understanding of perinatal brain injury and development.

  10. Small volume transfusion of irradiated red blood cells using satellite bags in very low birth weight infants

    Energy Technology Data Exchange (ETDEWEB)

    Yamagiwa, Kazuhiro; Honda, Yoshinobu; Sakuma, Kimiko; Igarashi, Etsuo; Watanabe, Masahiko; Ujiie, Niro; Suzuki, Hitoshi; Ohto, Hitoshi (Fukushima Medical Coll. (Japan))

    1993-09-01

    We have treated anemia of prematurity with concentrated red cells divided into 3 packs by using the Sterile Connection Device (SCD, USA). This study was performed to reveal the influence for very low birth weight infants of transfusion of red cells stored after irradiation. The following facts were observed in infants after transfusion: (1) no change in sodium and potassium level and leucocyte count, (2) increased amount of total bilirubin but no change in unbound bilirubin level, (3) decrease in platelet count less than 50,000/mm[sup 3]. According to these results we conclude that the transfusion of concentrated red blood cells stored within 2 weeks after irradiation was safe even for very low birth weight infants. (author).

  11. Small volume transfusion of irradiated red blood cells using satellite bags in very low birth weight infants

    International Nuclear Information System (INIS)

    Yamagiwa, Kazuhiro; Honda, Yoshinobu; Sakuma, Kimiko; Igarashi, Etsuo; Watanabe, Masahiko; Ujiie, Niro; Suzuki, Hitoshi; Ohto, Hitoshi

    1993-01-01

    We have treated anemia of prematurity with concentrated red cells divided into 3 packs by using the Sterile Connection Device (SCD, USA). This study was performed to reveal the influence for very low birth weight infants of transfusion of red cells stored after irradiation. The following facts were observed in infants after transfusion: (1) no change in sodium and potassium level and leucocyte count, (2) increased amount of total bilirubin but no change in unbound bilirubin level, (3) decrease in platelet count less than 50,000/mm 3 . According to these results we conclude that the transfusion of concentrated red blood cells stored within 2 weeks after irradiation was safe even for very low birth weight infants. (author)

  12. Optimal thermal management for low birth weight infants nursed under high-powered radiant warmers.

    Science.gov (United States)

    Malin, S W; Baumgart, S

    1987-01-01

    Servocontrol of skin temperature for the critically ill premature neonate nursed on a radiant warmer bed has been assumed to be analogous to skin temperature control for infants nursed in convection-warmed incubators. There are significant differences between these two warming techniques, and no definitive data exist to aid the clinical specialist in governing radiant warmer control. Eighteen low birth weight premature infants less than 2 weeks of age were studied under powerful overhead radiant warmers to determine the optimal skin temperature for servocontrol of radiant heater output. Anterior abdominal wall temperature was servocontrolled at 35.5 degrees, 36.5 degrees, and 37.5 degrees C in a randomized fashion for three periods of 90 minutes each after thermal equilibrium was established. Oxygen consumption was measured during the entire 90-min sample period at each temperature by a computerized metabolic apparatus to determine the optimal thermal neutral control temperature defined as minimal oxygen consumption with normal body temperature. Skin, deep rectal, and environmental temperature measurements, as well as behavior assessments, were made concurrently. Oxygen consumption was significantly elevated at 35.5 degrees C (8.62 +/- 0.73 mL/kg/min, mean +/- SEM) compared with 36.5 degrees C (7.30 +/- 0.55 mL/kg/min). Changing servocontrol temperature to 37.5 degrees C produced no further significant decrease in oxygen consumption (7.41 +/- 0.70 mL/kg/min), and nine infants manifested supranormal deep rectal temperatures (greater than 37.5 degrees C). Optimal abdominal skin temperature control at 36.5 degrees C (slightly warmer than previously reported but less than 37.5 degrees C) is recommended for premature neonates nursed on radiant warmer beds.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. [Homologous human milk supplement for very low birth weight preterm infant feeding].

    Science.gov (United States)

    Grance, Thayana Regina de Souza; Serafin, Paula de Oliveira; Thomaz, Débora Marchetti Chaves; Palhares, Durval Batista

    2015-01-01

    To develop a homologous additive of human milk for feeding the very low weight infants with an original and simplified methodology, to know the nutritional composition of fortified human milk with this additive and to evaluate its suitability for feeding these infants. For the production and analysis of human milk with the homologous additive, 25 human milk samples of 45 mL have undergone a lactose removal process, lyophilization and they were diluted in 50 mL of human milk. Doses of lactose, proteins, lipids, energy, sodium, potassium, calcium, phosphorus and osmolality were measured. The composition of the additive milk was lactose 9.22 ± 1.00 g/dL; proteins 2.20 ± 0.36 g/dL; lipids 2.91 ± 0.57 g/dL; calories 71.93 ± 8.69 kcal/dL; osmolality 389.6 ± 32.4 mOsmol/kg H2O; sodium 2.04 ± 0.45 mEq/dL; potassium 1.42 ± 0.15 mEq/dL; calcium 43.44 ± 2.98 mg/dL; and phosphorus 23.69 ± 1.24 mg/dL. According to the nutritional contents analyzed, except for calcium and phosphorus, the human milk with the proposed additive can achieve the nutritional needs of the very low birth weight preterm infant. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. What is the infant mortality rate in South Africa? The need for ...

    African Journals Online (AJOL)

    The number of births recorded in the health services was analysed by province in order to assess and explore alternatives within health authorities that could complement the existing system. Results. 1. Published estimates of infant mortality for the period from 1990 range from 40 to 71 / 1 000 births and estimates based on ...

  15. Association between maternal periodontitis and preterm and/or low birth weight infants in normal pregnancies.

    Science.gov (United States)

    Usin, María Matilde; Menso, Julieta; Rodríguez, Verónica Inés; González, Analía; Tabares, Sandra; Parodi, Ricardo; Sembaj, Adela

    2016-01-01

    To relate the periodontal condition with the presence of periodontal bacteria in pregnant that had babies with preterm delivery or/and low weight at birth (PTLBW). We recruited 134 pregnant women without systemic diseases attending at the Gynaecology and Obstetrics Room, from Maternal Provincial Hospital, Córdoba, Argentine. Pregnant were grouped according to the International Classification for a System of Periodontal Disease. A sample from periodontal pocket was extracted to identify Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf) Prevotella intermedia (Pi) and Agreggatibacter actinomycemcomitans (Aa). We identified 7 (5%) cases of children born underweight or preterm of mothers diagnosed with Gingivitis, 6 (4%) in Mild Periodontitis and 4 (3%) in Moderate Periodontitis. We estimated that when Pi and/or Aa were not detected in the periodontal pockets of mothers, the infants had more than 129% chance of having normal birth weights (OR 3.47 for Pi and OR and 2.29 for Aa). The average age of the mothers who has PTLBW was 21 ± 3.5. The age showed an association with PTLBW (p periodonto bacteria like Pi and Aa.

  16. Where are the Sunday babies? II. Declining weekend birth rates in Switzerland

    Science.gov (United States)

    Lerchl, Alexander; Reinhard, Sarah C.

    2008-02-01

    Birth dates from almost 3 million babies born between 1969 and 2005 in Switzerland were analyzed for the weekday of birth. As in other countries but with unprecedented amplitude, a very marked non-random distribution was discovered with decreasing numbers of births on weekends, reaching -17.9% in 2005. While most of this weekend births avoidance rate is due to fewer births on Sundays (up to -21.7%), the downward trend is primarily a consequence of decreasing births on Saturdays (up to -14.5%). For 2005, these percentages mean that 3,728 fewer babies are born during weekends than could be expected from equal distribution. Most interestingly and surprisingly, weekend birth-avoiding rates are significantly correlated with birth numbers ( r = 0.86), i.e. the lower the birth number per year, the lower the number of weekend births. The increasing avoidance of births during weekends is discussed as being a consequence of increasing numbers of caesarean sections and elective labor induction, which in Switzerland reach 29.2 and 20.5%, respectively, in 2004. This hypothesis is supported by the observation that both primary and secondary caesarean sections are significantly correlated with weekend birth avoidance rates. It is therefore likely that financial aspects of hospitals are a factor determining the avoidance of weekend births by increasing the numbers of caesarean sections.

  17. Vasopressin versus dopamine for treatment of hypotension in extremely low birth weight infants: a randomized, blinded pilot study.

    Science.gov (United States)

    Rios, Danielle R; Kaiser, Jeffrey R

    2015-04-01

    To evaluate vasopressin vs dopamine as initial therapy in extremely low birth weight (ELBW) infants with hypotension during the first 24 hours of life. ELBW infants with hypertension ≤ 30 weeks' gestation and ≤ 24 hours old randomly received treatment with vasopressin or dopamine in a blinded fashion. Normotensive infants not receiving vasopressor support served as a comparison group. Twenty ELBW infants with hypertension received vasopressin (n = 10) or dopamine (n = 10), and 50 were enrolled for comparison. Mean gestational age was 25.6 ± 1.4 weeks and birth weight 705 ± 154 g. Response to vasopressin paralleled that of dopamine in time to adequate mean blood pressure (Kaplan-Meier curve, P = .986); 90% of infants in each treatment group responded with adequate blood pressure. The vasopressin group received fewer doses of surfactant (P hypotension appeared safe. This pilot study supports a larger randomized controlled trial of vasopressin vs dopamine therapy in ELBW infants with hypotension. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Hormones in infant rhesus monkeys' (Macaca mulatta) hair at birth provide a window into the fetal environment.

    Science.gov (United States)

    Kapoor, Amita; Lubach, Gabriele; Hedman, Curtis; Ziegler, Toni E; Coe, Christopher L

    2014-04-01

    It is established that maternal parity can affect infant growth and risk for several disorders, but the prenatal endocrine milieu that contributes to these outcomes is still largely unknown. Recently, it has been shown that hormones deposited in hair can provide a retrospective reflection of hormone levels while the hair was growing. Taking advantage of this finding, our study utilized hair at birth to investigate if maternal parity affected fetal hormone exposure during late gestation. Hair was collected from primiparous and multiparous mother and infant monkeys at birth and used to determine steroid hormones embedded in hair while the infant was in utero. A high-pressure liquid chromatography-triple quadrupole mass spectrometry technique was refined, which enabled the simultaneous measurement of eight hormones. Hormone concentrations were dramatically higher in neonatal compared to maternal hair, reflecting extended fetal exposure as the first hair was growing. Further, hair cortisone was higher in primiparous mothers and infants when compared to the multiparous dyads. This research demonstrates that infant hair can be used to track fetal hormone exposure and a panel of steroid hormones can be quantified from hair specimens. Given the utility in nonhuman primates, this approach can be translated to a clinical setting with human infants.

  19. High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support

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    Parker Bruce R

    2009-07-01

    Full Text Available Abstract Background Osteopenia and rickets are common among extremely low birth weight infants (ELBW, Methods We evaluated all ELBW infants admitted to Texas Children's Hospital NICU in 2006 and 2007. Of 211 admissions, we excluded 98 patients who were admitted at >30 days of age or did not survive/stay for >6 weeks. Bone radiographs obtained in 32 infants were reviewed by a radiologist masked to laboratory values. Results In this cohort of 113 infants, P-APA was found to have a significant inverse relationship with BW, gestational age and serum phosphorus. In paired comparisons, P-APA of infants Conclusion Elevation of P-APA >600 IU/L was very common in ELBW infants. BW was significantly inversely related to both P-APA and radiologic rickets. No single value of P-APA was related to radiological findings of rickets. Given the very high risk of osteopenia and rickets among ELBW infants, we recommend consideration of early screening and early mineral supplementation, especially among infants

  20. The development of parents-infant relationship in high-risk pregnancies and preterm birth

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    Camilla Pisoni

    2014-06-01

    Full Text Available The theory of human attachment, developed in 1951 by John Bowlby, has been widely applied across psychological, medical and social disciplines, especially in the context of developmental psychology; more recently it has been studied in the obstetric and neonatal fields. Numerous studies suggest that attachment patterns have an impact on the social, cognitive and emotional development of the off-spring, and are also believed to influence the individual’s psychosocial trajectories across the lifespan. Starting from empirical study of attachment, the psychological analysis of the experience of pregnancy allowed to introduce the concept of prenatal attachment, considered as the earlier internalized representation of the fetus that both parents acquire and elaborate during pregnancy. Recent studies have attempted to investigate how prenatal attachment develops in conditions of hazard, as for example in women hospitalized for a high-risk pregnancy or preterm birth. Literature showed that these clinical conditions may represent risk factors that, along with psychological distress and lack of familiar and social support, may adversely affect the mother-child relationship, with consequences on the psycosocial development of the off-spring. During pregnancy, medical team should assess mothers’ distress and attachment, perform procedures to positively develop attachment, and direct parents with low attachment scores to receive a professional, specific counseling. In the premature birth context, it is important to closely support mother-infant contact and to decrease maternal stress in every possible way during hospitalization and after discharge. Promotion of psychological wellbeing and attachment during pregnancy and after birth may serve as a crucial opportunity of improving maternal health practices, perinatal health and neonatal outcomes. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014

  1. Perinatal outcomes in a South Asian setting with high rates of low birth weight

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    Joseph K S

    2009-02-01

    Full Text Available Abstract Background It is unclear whether the high rates of low birth weight in South Asia are due to poor fetal growth or short pregnancy duration. Also, it is not known whether the traditional focus on preventing low birth weight has been successful. We addressed these and related issues by studying births in Kaniyambadi, South India, with births from Nova Scotia, Canada serving as a reference. Methods Population-based data for 1986 to 2005 were obtained from the birth database of the Community Health and Development program in Kaniyambadi and from the Nova Scotia Atlee Perinatal Database. Menstrual dates were used to obtain comparable information on gestational age. Small-for-gestational age (SGA live births were identified using both a recent Canadian and an older Indian fetal growth standard. Results The low birth weight and preterm birth rates were 17.0% versus 5.5% and 12.3% versus 6.9% in Kaniyambadi and Nova Scotia, respectively. SGA rates were 46.9% in Kaniyambadi and 7.5% in Nova Scotia when the Canadian fetal growth standard was used to define SGA and 6.7% in Kaniyambadi and Conclusion High rates of fetal growth restriction and relatively high rates of preterm birth are responsible for the high rates of low birth weight in South Asia. Increased emphasis is required on health services that address the morbidity and mortality in all birth weight categories.

  2. Focused group discussion with health care staff improves breastfeeding rates in hospitalized infants

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    Agnes Yunie Purwita Sari

    2017-08-01

    Full Text Available Background Improving breastfeeding in sick infants is essential. During the neonatal care, health care staff play an important role in promoting breastfeeding. Therefore, it is important to study in depth how healthcare staff can improve breastfeeding practice in sick neonates. Objective To compare breastfeeding rates in sick infants before and after a focused group discussion (FGD of health care staff on how to improve breastfeeding. Methods This study was an operational study using FGD and in-depth interviews as an intervention. A fish bone diagram was used to assess problems that may prevent mothers from breastfeeding their sick infants. Breastfeeding achievement was compared before and after the FGD. Results Of 257 sick infants, 177 subjects were in the before FGD group and 80 subjects were in the after FGD group. Significantly more after FGD subjects were breastfed during hospitalization than before FGD subjects [97.5% vs. 82.9%, respectively; (x2 =9.43; P=0.002]. Breastfeeding initiation within 0-4 hours of birth was also significantly higher in the after FGD group [10 (12.5% vs. 6 (3.5%, respectively; (x2 = 52.5; P<0.001]. The solutions for breastfeeding problems were: 1 support of hospital management, 2 support of healthcare workers for breastfeeding mothers, 3 support of husbands and families for breastfeeding mothers, 4 financial support, 5 other factors such as level of care and consistent FGD events, and 6 a prospective cohort study. Conclusion The FGD with health care staff significantly increases breastfeeding achievement during infant hospitalization, and accelerated breastfeeding initiation. A fish bone diagram is used to effectively assess the problems with breastfeeding programs for sick babies.

  3. Diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury

    Energy Technology Data Exchange (ETDEWEB)

    Medina, L.S. [Miami Children' s Hospital, Division of Neuroradiology, Department of Radiology, Brain Institute, Health Outcomes, Policy, and Economics (HOPE) Center, Miami, FL (United States); Miami Children' s Hospital, Department of Radiology, Miami, FL (United States); Yaylali, Ilker [Miami Children' s Hospital, Brachial Plexus and Peripheral Nerve Surgery Program, Miami, FL (United States); Zurakowski, David [Harvard Medical School, Boston Children' s Hospital, Boston, MA (United States); Ruiz, Jennifer; Altman, Nolan R. [Miami Children' s Hospital, Division of Neuroradiology, Department of Radiology, Brain Institute, Health Outcomes, Policy, and Economics (HOPE) Center, Miami, FL (United States); Grossman, John A.I. [Miami Children' s Hospital, Brachial Plexus and Peripheral Nerve Surgery Program, Miami, FL (United States); New York University, Hospital for Joint Disease, New York, NY (United States)

    2006-12-15

    Detailed evaluation of a brachial plexus birth injury is important for treatment planning. To determine the diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury. Included in the study were 31 children with perinatal brachial plexus injury who underwent surgical intervention. All patients had cervical and brachial plexus MRI. The standard of reference was the combination of intraoperative (1) surgical evaluation and (2) electrophysiological studies (motor evoked potentials, MEP, and somatosensory evoked potentials, SSEP), and (3) the evaluation of histopathological neuronal loss. MRI findings of cord lesion, pseudomeningocele, and post-traumatic neuroma were correlated with the standard of reference. Diagnostic performance characteristics including sensitivity and specificity were determined. From June 2001 to March 2004, 31 children (mean age 7.3 months, standard deviation 1.6 months, range 4.8-12.1 months; 19 male, 12 female) with a brachial plexus birth injury who underwent surgical intervention were enrolled. Sensitivity and specificity of an MRI finding of post-traumatic neuroma were 97% (30/31) and 100% (31/31), respectively, using the contralateral normal brachial plexus as the control. However, MRI could not determine the exact anatomic area (i.e. trunk or division) of the post-traumatic brachial plexus neuroma injury. Sensitivity and specificity for an MRI finding of pseudomeningocele in determining exiting nerve injury were 50% and 100%, respectively, using MEP, and 44% and 80%, respectively, using SSEP as the standard of reference. MRI in infants could not image well the exiting nerve roots to determine consistently the presence or absence of definite avulsion. In children younger than 18 months with brachial plexus injury, the MRI finding of pseudomeningocele has a low sensitivity and a high specificity for nerve root avulsion. MRI and MR myelography cannot image well the exiting nerve roots to determine

  4. Temperature and its variations in birth rates and sex ratio in Greater ...

    African Journals Online (AJOL)

    The relationship between birth rates, sex ratio and temperature in Yola has been investigated. Data on temperature and births, for 12 years (1990-2001), were collected from Federal Meteorological Department, Yola and Federal medical Centre, Yola respectively. Average mean monthly births and temperature data for the ...

  5. Effect of parenteral glutamine supplementation on plasma amino acid concentrations in extremely low-birth-weight infants.

    Science.gov (United States)

    Poindexter, Brenda B; Ehrenkranz, Richard A; Stoll, Barbara J; Koch, Matthew A; Wright, Linda L; Oh, William; Papile, Lu-Ann; Bauer, Charles R; Carlo, Waldemar A; Donovan, Edward F; Fanaroff, Avroy A; Korones, Sheldon B; Laptook, Abbot R; Shankaran, Seetha; Stevenson, David K; Tyson, Jon E; Lemons, James A

    2003-03-01

    Glutamine is one of the most abundant amino acids in both plasma and human milk and may be conditionally essential in premature infants. However, glutamine is not provided by standard intravenous amino acid solutions. We assessed the effect of parenteral glutamine supplementation on plasma amino acid concentrations in extremely low-birth-weight infants receiving parenteral nutrition (PN). A total of 141 infants with birth weights of 401-1000 g were randomly assigned to receive a standard intravenous amino acid solution that did not contain glutamine or an isonitrogenous amino acid solution with 20% of the total amino acids as glutamine. Blood samples were obtained just before initiation of study PN and again after the infants had received study PN (mean intake: 2.3 +/- 1.0 g amino acids x kg(-1) x d(-1)) for approximately 10 d. Infants randomly assigned to receive glutamine had mean plasma glutamine concentrations that increased significantly and were approximately 30% higher than those in the control group in response to PN (425 +/- 182 and 332 +/- 148 micromol/L for the glutamine and control groups, respectively). There was no significant difference between the 2 groups in the relative change in plasma glutamate concentration between the baseline and PN samples. In both groups, there were significant decreases in plasma phenylalanine and tyrosine between the baseline and PN samples; the decrease in tyrosine was greater in the group that received glutamine. In extremely low-birth-weight infants, parenteral glutamine supplementation can increase plasma glutamine concentrations without apparent biochemical risk. Currently available amino acid solutions are likely to be suboptimal in their supply of phenylalanine, tyrosine, or both for these infants.

  6. Early nutrition, growth and cognitive development of infants from birth to 2 years in Malaysia: a study protocol.

    Science.gov (United States)

    Nurliyana, Abdul Razak; Mohd Shariff, Zalilah; Mohd Taib, Mohd Nasir; Gan, Wan Ying; Tan, Kit-Aun

    2016-09-29

    The first 2 years of life is a critical period of rapid growth and brain development. During this period, nutrition and environmental factors play important roles in growth and cognitive development of a child. This report describes the study protocol of early nutrition, growth and cognitive development of infants from birth to 2 years of age. This is a prospective cohort study of mothers and infants recruited from government health clinics in Seremban district in Negeri Sembilan, Malaysia. Infants are followed-up at 6, 12, 18 and 24 months of age. Pre-natal factors that include mother's pre-pregnancy body mass index, gestational weight gain, blood glucose and blood pressure during pregnancy, infant's gestational age, birth weight and head circumference at birth are obtained from patient card. Post-natal factors assessed at each follow-up are feeding practices, dietary intake, anthropometric measurements and cognitive development of infants. Iron status is assessed at 6 months, while infant temperament and home environment are assessed at 12 months. Maternal intelligence is assessed at 18 months. Early life nutritional programming is of current interest as many longitudinal studies are actively being conducted in developed countries to investigate this concept. The concept however is relatively new in developing countries such as Malaysia. This study will provide useful information on early nutrition and infant development in the first two years of life which can be further followed up to identify factors that track into childhood and contribute to growth and cognitive deviations.

  7. THE CHERNOBYL ACCIDENT, THE MALE TO FEMALE RATIO AT BIRTH AND BIRTH RATES

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    Victor Grech

    2014-01-01

    Full Text Available Introduction: The male:female ratio at birth (male births divided by total live births – M/T has been shown to increase in response to ionizing radiation due to gender-biased fetal loss, with excess female loss. M/T rose sharply in 1987 in central-eastern European countries following the Chernobyl accident in 1986. This study analyses M/T and births for the former Soviet Republics and for the countries most contaminated by the event. Methods: Annual birth data was obtained from the World Health Organisation. The countries with the highest exposure levels (by 137Cs were identified from an official publication of the International Atomic Energy Agency. All of the former Soviet states were also analysed and the periods before and after 1986 were compared. Results: Except for the Baltic States, all regions in the former USSR showed a significant rise in M/T from 1986. There were significant rises in M/T in the three most exposed (Belarus, Ukraine and the Russian Federation. The birth deficit in the post-Soviet states for the ten years following Chernobyl was estimated at 2,072,666, of which 1,087,924 are accounted by Belarus and Ukraine alone. Discussion: Chernobyl has resulted in the loss of millions of births, a process that has involved female even more than male fetuses. This is another and oft neglected consequence of widespread population radiation contamination.

  8. The Chernobyl accident, the male to female ratio at birth and birth rates.

    Science.gov (United States)

    Grech, Victor

    2014-01-01

    The male:female ratio at birth (male births divided by total live births - M/T) has been shown to increase in response to ionizing radiation due to gender-biased fetal loss, with excess female loss. M/T rose sharply in 1987 in central-eastern European countries following the Chernobyl accident in 1986. This study analyses M/T and births for the former Soviet Republics and for the countries most contaminated by the event. Annual birth data was obtained from the World Health Organisation. The countries with the highest exposure levels (by ¹³⁷Cs) were identified from an official publication of the International Atomic Energy Agency. All of the former Soviet states were also analysed and the periods before and after 1986 were compared. Except for the Baltic States, all regions in the former USSR showed a significant rise in M/T from 1986. There were significant rises in M/T in the three most exposed (Belarus, Ukraine and the Russian Federation). The birth deficit in the post-Soviet states for the ten years following Chernobyl was estimated at 2,072,666, of which 1,087,924 are accounted by Belarus and Ukraine alone. Chernobyl has resulted in the loss of millions of births, a process that has involved female even more than male fetuses. This is another and oft neglected consequence of widespread population radiation contamination.

  9. Canonical correlation analysis of infant's size at birth and maternal factors: a study in rural northwest Bangladesh.

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    Alamgir Kabir

    Full Text Available This analysis was conducted to explore the association between 5 birth size measurements (weight, length and head, chest and mid-upper arm [MUAC] circumferences as dependent variables and 10 maternal factors as independent variables using canonical correlation analysis (CCA. CCA considers simultaneously sets of dependent and independent variables and, thus, generates a substantially reduced type 1 error. Data were from women delivering a singleton live birth (n = 14,506 while participating in a double-masked, cluster-randomized, placebo-controlled maternal vitamin A or β-carotene supplementation trial in rural Bangladesh. The first canonical correlation was 0.42 (P<0.001, demonstrating a moderate positive correlation mainly between the 5 birth size measurements and 5 maternal factors (preterm delivery, early pregnancy MUAC, infant sex, age and parity. A significant interaction between infant sex and preterm delivery on birth size was also revealed from the score plot. Thirteen percent of birth size variability was explained by the composite score of the maternal factors (Redundancy, RY/X = 0.131. Given an ability to accommodate numerous relationships and reduce complexities of multiple comparisons, CCA identified the 5 maternal variables able to predict birth size in this rural Bangladesh setting. CCA may offer an efficient, practical and inclusive approach to assessing the association between two sets of variables, addressing the innate complexity of interactions.

  10. Prediction of Late Death or Disability at Age 5 Years Using a Count of 3 Neonatal Morbidities in Very Low Birth Weight Infants.

    Science.gov (United States)

    Schmidt, Barbara; Roberts, Robin S; Davis, Peter G; Doyle, Lex W; Asztalos, Elizabeth V; Opie, Gillian; Bairam, Aida; Solimano, Alfonso; Arnon, Shmuel; Sauve, Reginald S

    2015-11-01

    To evaluate bronchopulmonary dysplasia (BPD), serious brain injury, and severe retinopathy of prematurity (ROP) as predictors of poor long-term outcome in very low birth weight infants. We examined the associations between counts of the 3 morbidities and long-term outcomes in 1514 of 1791 (85%) infants with birth weights of 500-1250 g who were enrolled in the Caffeine for Apnea of Prematurity trial from October 1999, to October 2004, had complete morbidity data, and were alive at 36 weeks postmenstrual age (PMA). BPD was defined as use of supplemental oxygen at 36 weeks PMA. Serious brain injury on cranial ultrasound included grade 3 and 4 hemorrhage, cystic periventricular leucomalacia, porencephalic cysts, or ventriculomegaly of any cause. Poor long-term outcome was death after 36 weeks PMA or survival to 5 years with 1 or more of the following disabilities: motor impairment, cognitive impairment, behavior problems, poor general health, deafness, and blindness. BPD, serious brain injury, and severe ROP occurred in 43%, 13%, and 6% of the infants, respectively. Each of the 3 morbidities was similarly and independently correlated with poor 5-year outcome. Rates of death or disability (95% CI) in children with none, any 1, any 2, and all 3 morbidities were 11.2% (9.0%-13.7%), 22.9% (19.6%-26.5%), 43.9% (35.5%-52.6%), and 61.5% (40.6%-79.8%), respectively. In very low birth weight infants who survive to 36 weeks PMA, a count of BPD, serious brain injury, and severe ROP predicts the risk of a late death or survival with disability at 5 years. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Predicting live birth, preterm delivery, and low birth weight in infants born from in vitro fertilisation: a prospective study of 144,018 treatment cycles.

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    Scott M Nelson

    2011-01-01

    Full Text Available The extent to which baseline couple characteristics affect the probability of live birth and adverse perinatal outcomes after assisted conception is unknown.We utilised the Human Fertilisation and Embryology Authority database to examine the predictors of live birth in all in vitro fertilisation (IVF cycles undertaken in the UK between 2003 and 2007 (n = 144,018. We examined the potential clinical utility of a validated model that pre-dated the introduction of intracytoplasmic sperm injection (ICSI as compared to a novel model. For those treatment cycles that resulted in a live singleton birth (n = 24,226, we determined the associates of potential risk factors with preterm birth, low birth weight, and macrosomia. The overall rate of at least one live birth was 23.4 per 100 cycles (95% confidence interval [CI] 23.2-23.7. In multivariable models the odds of at least one live birth decreased with increasing maternal age, increasing duration of infertility, a greater number of previously unsuccessful IVF treatments, use of own oocytes, necessity for a second or third treatment cycle, or if it was not unexplained infertility. The association of own versus donor oocyte with reduced odds of live birth strengthened with increasing age of the mother. A previous IVF live birth increased the odds of future success (OR 1.58, 95% CI 1.46-1.71 more than that of a previous spontaneous live birth (OR 1.19, 95% CI 0.99-1.24; p-value for difference in estimate <0.001. Use of ICSI increased the odds of live birth, and male causes of infertility were associated with reduced odds of live birth only in couples who had not received ICSI. Prediction of live birth was feasible with moderate discrimination and excellent calibration; calibration was markedly improved in the novel compared to the established model. Preterm birth and low birth weight were increased if oocyte donation was required and ICSI was not used. Risk of macrosomia increased with advancing

  12. Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants

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    Wai Ho Lim

    2012-08-01

    Conclusion: Unlike term infants, Gram-negative organism and E coli were the leading pathogen of EOS among VLBW infants. Judicious and timely use of antibiotic therapy is crucial in the care of VLBW infants.

  13. Associations of consumption of fruits and vegetables during pregnancy with infant birth weight or small for gestational age births: a systematic review of the literature

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    Murphy MM

    2014-10-01

    Full Text Available Mary M Murphy,1 Nicolas Stettler,1,2 Kimberly M Smith,1 Richard Reiss3 1Exponent, Inc., Center for Chemical Regulation and Food Safety, Washington, DC, USA; 2The Lewin Group, Falls Church, VA, USA; 3Exponent, Inc., Center for Chemical Regulation and Food Safety, Alexandria, VA, USA Abstract: Maternal nutrition is recognized as one of the determinants of fetal growth. Consumption of fruits and vegetables is promoted as part of a healthful diet; however, intakes are typically lower than recommended levels. The purpose of this study was to systematically review results from studies examining the relationship between maternal consumption of fruits and vegetables during pregnancy with infant birth weight or risk for delivering a small for gestational age baby. A comprehensive search of PubMed and EMBASE was conducted and abstracts were screened using predefined criteria. Eleven relevant studies were identified and systematically reviewed, including six prospective cohort studies, three retrospective cohort studies, and two case–control studies. Seven studies were conducted in cohorts from highly developed countries. One prospective study from a highly developed area reported increased risk for small for gestational age birth by women with low vegetable intakes (odds ratio 3.1; 95% confidence interval 1.4–6.9; P=0.01; another large prospective study reported a 10.4 g increase in birth weight per quintile increase in fruit intake (95% confidence interval 6.9–3.9; P<0.0001 and increases of 8.4 or 7.7 g per quintile intake of fruits and vegetables (combined or fruits, vegetables, and juice (combined, respectively. One retrospective study reported an association between low fruit intake and birth weight. In less developed countries, increased vegetable or fruit intake was associated with increased birth weight in two prospective studies. Overall, limited inconclusive evidence of a protective effect of increased consumption of vegetables and risk for

  14. Effects of therapeutic hypothermia on the gut microbiota and metabolome of infants suffering hypoxic-ischemic encephalopathy at birth.

    Science.gov (United States)

    Watkins, C; Murphy, K; Yen, S; Carafa, I; Dempsey, E M; O'Shea, C A; Vercoe, E A; Ross, R P; Stanton, C; Ryan, C A

    2017-12-01

    Neonatal hypoxic ischemic encephalopathy (HIE) in the perinatal period can lead to significant neurological deficits in later life. Total body cooling (TBC) is a neuroprotective strategy used in the treatment of HIE and has been shown to reduce seizures and improve neurodevelopmental outcomes in treated infants. Little is known, however, about the effects of HIE/TBC on the developing gut microbiota composition and subsequent metabolic profile. Ten term infants with HIE who received TBC at 33.5°C for 72h were recruited. A control group consisted of nine healthy full term infants. Faecal samples were collected from both groups at 2 years of age and stored at -20°C. 16S rRNA amplicon Illumina sequencing was carried out to determine gut microbiota composition and 1H NMR analysis was performed to determine the metabolic profile of faecal water. The gut microbiota composition of the HIE/TBC infants were found to have significantly lower proportions of Bacteroides compared to the non-cooled healthy control group. Alpha diversity measures detected significantly lower diversity in microbial richness in the HIE/TBC infant group compared to the control infants (Shannon index, gut microbiota composition and metabolic profile of both groups. Initial principal coordinate analysis and hierarchal clustering of compounds on MetaboAnalyst 3.0 indicated no clear separation in the metabolic profile of these two infant groups. These results suggest that there is no significant impact on the gut microbial development of HIE/TBC infants compared to healthy infants at 2years of life. To our knowledge this is the first study to report the gut microbiota composition and metabolic profile of infants who have experienced HIE/TBC at birth. Copyright © 2017. Published by Elsevier Ltd.

  15. Early corticosteroid treatment does not affect severity of unconjugated hyperbilirubinemia in extreme low birth weight preterm infants.

    Science.gov (United States)

    Hulzebos, Christian V; Bos, Arend F; Anttila, Eija; Hallman, Mikko; Verkade, Henkjan J

    2011-02-01

    To determine the relationship between early postnatal dexamethasone (DXM) treatment and the severity of hyperbilirubinemia in extreme low birth weight (ELBW) preterm infants. In 54 ELBW preterm infants, total serum bilirubin concentrations (TSB) and phototherapy (PT) data during the first 10 days were evaluated retrospectively. ELBW infants had participated in a randomized controlled trial of early DXM treatment which aimed to assess effects on chronic lung disease. Infants had been treated with DXM (0.25 mg/kg twice daily at postnatal day 1 and 2) or with placebo (normal saline). Analysis was performed on an intention to treat basis. Twenty-five Infants had been randomized into the DXM group; 29 into the placebo group. Mean (±SD) TSB [120 (±19) μmol/L vs. 123 (±28) μmol/L, DXM versus placebo, respectively] and maximum TSB [178 (±23) μmol/L vs. 176 (±48), DXM versus placebo, respectively] concentrations were similar. TSB concentrations peaked 30 h earlier in the DXM group (p ≤ 0.05). The need for PT as well as the duration of PT was similar in both groups. Early DXM treatment does not affect the severity of neonatal hyperbilirubinemia in ELBW preterm infants. Our results seem compatible with the concept that factors other than bilirubin conjugation capacity are important for the pathophysiology of neonatal jaundice in ELBW preterm infants. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

  16. The human milk project: a quality improvement initiative to increase human milk consumption in very low birth weight infants.

    Science.gov (United States)

    Ward, Laura; Auer, Christine; Smith, Carrie; Schoettker, Pamela J; Pruett, Raymond; Shah, Nilesh Y; Kotagal, Uma R

    2012-08-01

    Human milk has well-established health benefits for preterm infants. We conducted a multidisciplinary quality improvement effort aimed at providing at least 500 mL of human milk/kg in the first 14 days of life to very low birth weight (VLBW) (milk program, and twice-daily physician evaluation of infants' ability to tolerate feedings. The number of infants receiving at least 500 mL of human milk/kg in their first 14 days of life increased from 50% to 80% within 11 months of implementation, and this increase has been sustained for 4 years. Infants who met the feeding goal because they received donor milk increased each year. Since September 2007, infants have received, on average, 1,111 mL of human milk/kg. Approximately 4% of infants did not receive any human milk. Respiratory instability was the most frequent physiological reason given by clinicians for not initiating or advancing feedings in the first 14 days of life. Our quality improvement initiative resulted in a higher consumption of human milk in VLBW infants in the first 14 days of life. Other clinicians can use these described quality improvement methods and techniques to improve their VLBW babies' consumption of human milk.

  17. High Flow Nasal Cannula Use Is Associated with Increased Morbidity and Length of Hospitalization in Extremely Low Birth Weight Infants

    Science.gov (United States)

    Taha, Dalal K.; Kornhauser, Michael; Greenspan, Jay S.; Dysart, Kevin C.; Aghai, Zubair H.

    2017-01-01

    Objective To determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in extremely low birth weight infants managed on high flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP). Study design This is aretrospective data analysis from the Alere Neonatal Database for infants born between January 2008 and July 2013, weighing ≤ 1000 g at birth, and received HFNC or CPAP. Baseline demographics, clinical characteristics, and neonatal outcomes were compared between the infants who received CPAP and HFNC, or HFNC ± CPAP. Multivariable regression analysis was performed to control for the variables that differ in bivariate analysis. Results A total of 2487 infants met the inclusion criteria (941 CPAP group, 333 HFNC group, and 1546 HFNC ± CPAP group). The primary outcome of BPD or death was significantly higher in the HFNC group (56.8%) compared with the CPAP group (50.4%, P < .05). Similarly, adjusted odds of developing BPD or death was greater in the HFNC ± CPAP group compared with the CPAP group (OR 1.085, 95% CI 1.035–1.137, P = .001). The number of ventilator days, postnatal steroid use, days to room air, days to initiate or reach full oral feeds, and length of hospitalization were significantly higher in the HFNC and HFNC ± CPAP groups compared with the CPAP group. Conclusions In this retrospective study, use of HFNC in extremely low birth weight infants is associated with a higher risk of death or BPD, increased respiratory morbidities, delayed oral feeding, and prolonged hospitalization. A large clinical trial is needed to evaluate long-term safety and efficacy of HFNC in preterm infants. PMID:27004673

  18. Preterm birth enhances the contribution of mothers' mind-mindedness to infants' expressive language development: A longitudinal investigation.

    Science.gov (United States)

    Costantini, Alessandro; Coppola, Gabrielle; Fasolo, Mirco; Cassibba, Rosalinda

    2017-11-01

    Maternal mind-mindedness has been shown to be a powerful predictor of many developmental outcomes and to buffer the impact of psychosocial risk conditions, but no study has investigated whether this parental feature might support child development in the presence of biological risk, such as preterm birth. The present study addresses this gap, by investigating whether early maternal mind-mindedness contributes to the growth of a child's linguistic abilities in the following two years of life, and if the contribution of this maternal feature might be stronger in the presence of preterm birth. Forty mother-child dyads (twenty with a preterm infant) were followed longitudinally, with maternal mind-mindedness assessed at 14 months of age and child's expressive linguistic abilities at 24 and 36 months through observational measures. Multilevel models showed that linguistic abilities increased from 24 to 36 months of age, but that this increase was stronger in full-term infants. Maternal mind-mindedness also contributed to this growth, playing a stronger role in preterm infants than in full-term infants. Altogether, these findings contribute more deeply to the understanding of language development in preterm infants and of the joint contribution made by biological risk and environmental factors; from a practical standpoint, they suggest the importance of addressing mother's mind-mindedness in order to support child's language development. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Prevalence of Birth Defects Among Infants of Gulf War Veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993

    Science.gov (United States)

    2003-01-01

    unilateral absence/agenesis/dysplasia/hypoplasia of kidneys (right), polycystic kidneys (left, infantile type), congenital hydronephrosis (left...categories, and expected 1.2 of 24 birth defects cat - Araneta MRG, Destiche DA, Schlangen KM, et al. 2000. Birth defects prev- alence among infants of Persian ...San Diego, California ’Birth Defects and Pediatric Genetics Branch, Centers for Disease Control and Prevention, Atlanta, Georgia ’Hawaii Birth

  20. Effects of prenatal micronutrient and early food supplementation on maternal hemoglobin, birth weight, and infant mortality among children in Bangladesh: the MINIMat randomized trial.

    Science.gov (United States)

    Persson, Lars Åke; Arifeen, Shams; Ekström, Eva-Charlotte; Rasmussen, Kathleen M; Frongillo, Edward A; Yunus, Md

    2012-05-16

    Nutritional insult in fetal life and small size at birth are common in low-income countries and are associated with serious health consequences. To test the hypothesis that prenatal multiple micronutrient supplementation (MMS) and an early invitation to food supplementation would increase maternal hemoglobin level and birth weight and decrease infant mortality, and to assess whether a combination of these interventions would further enhance these outcomes. A randomized trial with a factorial design in Matlab, Bangladesh, of 4436 pregnant women, recruited between November 11, 2001, and October 30, 2003, with follow-up until June 23, 2009. Participants were randomized into 6 groups; a double-masked supplementation with capsules of 30 mg of iron and 400 μg of folic acid, 60 mg of iron and 400 μg of folic acid, or MMS containing a daily allowance of 15 micronutrients, including 30 mg of iron and 400 μg of folic acid, was combined with food supplementation (608 kcal 6 days per week) randomized to either early invitation (9 weeks' gestation) or usual invitation (20 weeks' gestation). Maternal hemoglobin level at 30 weeks' gestation, birth weight, and infant mortality. Under 5-year mortality was also assessed. Adjusted maternal hemoglobin level at 30 weeks' gestation was 115.0 g/L (95% CI, 114.4-115.5 g/L), with no significant differences among micronutrient groups. Mean maternal hemoglobin level was lower in the early vs usual invitation groups (114.5 vs 115.4 g/L; difference, -0.9 g/L; 95% CI, -1.7 to -0.1; P = .04). There were 3625 live births out of 4436 pregnancies. Mean birth weight among 3267 singletons was 2694 g (95% CI, 2680-2708 g), with no significant differences among groups. The early invitation with MMS group had an infant mortality rate of 16.8 per 1000 live births vs 44.1 per 1000 live births for usual invitation with 60 mg of iron and 400 μg of folic acid (hazard ratio [HR], 0.38; 95% CI, 0.18-0.78). Early invitation with MMS group had an under 5

  1. Effects of a swimming program on infants' heart rate response.

    Science.gov (United States)

    Costa, Mario J; Barbosa, Tiago M; Ramos, Alberto; Marinho, Daniel A

    2016-04-01

    The physiological response has been used to characterize or estimate physical demands while exercising. The aim of this study was to analyze the infant's physiological adaptations over an intervention water program. Fourteen infants (36±5.08 months old) were tested before (M1) and 4 months after (M2) a well-designed swimming program aiming to develop aquatic readiness, cognitive behavior and social interaction. The physiological response was assessed based on heart rate measurements (HR, bpm) at a sampling rate of 1 Hz during several basic aquatic motor skills: 1) individual displacement in ventral position (HR@InD); 2) Individual displacement in vertical position (HR@VD); 3) immersion (HR@Im); 4) voluntary underwater displacement (HR@UnD); 5) jump from the deck (HR@JD); 6) jump from the swimming mat (HR@JM); 7) from a swimming slider (HR@Sli). The HR@Im showed the lowest values (~119 bpm) at the end of the program. Main trend was for a HR decreased over time (HR@Im: -14.17±17.76%; HR@InD: -8.16±9.16%; HR@JD: -10.36±12.70%; HR@Sli: -3.48±6.40%. In all other skills, HR remained unchanged. Our findings suggest that infants experience significant hear rate adaptations while participating on a swimming program. The HR decreases suggests a higher capability to perform the basic aquatic motor skills and a less stressful behavior through the lessons.

  2. The effect of massage on heart rate variability in preterm infants

    Science.gov (United States)

    Smith, SL.; Lux, R.; Haley, S.; Slater, H.; Beechy, J.; Moyer-Mileur, LJ.

    2012-01-01

    Objective To test the hypothesis that massage would improve autonomic nervous system (ANS) function as measured by heart rate variability (HRV) in preterm infants. Study Design Medically stable, 29- to 32-week preterm infants (17 massage, 20 control) were enrolled in a masked, randomized longitudinal study. Licensed massage therapists provided the massage or control condition twice a day for 4 weeks. Weekly HRV, a measure of ANS development and function, was analyzed using SPSS generalized estimating equations. Results Infant characteristics were similar between groups. HRV improved in massaged infants but not in the control infants (PMassaged males had a greater improvement in HRV than females (Pmassaged infants was on a trajectory comparable to term-born infants by study completion. Conclusion Massage-improved HRV in a homogeneous sample of hospitalized, medically stable, preterm male infants and may improve infant response to exogenous stressors. We speculate that massage improves ANS function in these infants. PMID:22538325

  3. Rehospitalization Through Childhood and Adolescence: Association with Neonatal Morbidities in Infants of Very Low Birth Weight.

    Science.gov (United States)

    Kuint, Jacob; Lerner-Geva, Liat; Chodick, Gabriel; Boyko, Valentina; Shalev, Varda; Reichman, Brian

    2017-09-01

    To evaluate the impact of major neonatal morbidities on the risks for rehospitalization in children and adolescents born of very low birth weight. An observational study was performed on data of the Israel Neonatal Network linked together with the Maccabi Healthcare Services medical records. After discharge from the neonatal intensive care unit, 6385 infants of very low birth weight born from 1995 to 2012 were registered with Maccabi Healthcare Services and formed the study cohort. Multivariable negative binomial regression models were calculated to estimate the adjusted relative risk (aRR) and 95% CI for hospitalization. Up to 18 years following discharge, 3956 infants were hospitalized at least once. The median age of follow-up was 10.7 years with total of follow-up of 67 454 patient years and 10 895 hospitalizations. The risks for rehospitalization were increased significantly for each of the neonatal morbidities: surgical necrotizing enterocolitis (NEC), aRR 2.71 (95% CI 2.08-3.53), intraventricular hemorrhage grades 3-4, 2.13 (1.85-2.46), periventricular leukomalacia (PVL), 1.83 (1.58-2.13), bronchopulmonary dysplasia, 1.94 (1.72-2.17), and retinopathy of prematurity stages 3-4, 1.59 (1.36-1.85). During the first 4 years, children with surgically treated NEC, intraventricular hemorrhage, PVL, or bronchopulmonary dysplasia had 1.5- to 2.5-fold greater risks for hospitalization compared with those without the specific morbidity. In the 11th-14th and 15th-18th years, respectively, surgically treated NEC was associated with a 3.05 (1.32-7.04) and 3.26 (0.99-10.7) aRR for hospitalization, and PVL was associated with a 2.67 (1.79-3.97) and 3.47 (2.03-5.92) aRR for hospitalization. Specific major neonatal morbidities as well as the number of morbidities were associated with excess risks of rehospitalization through childhood and adolescence. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Extremely Low Birth Weight Preterm Infants Lack Vasomotor Response in Relationship to Cold Body Temperatures at Birth

    OpenAIRE

    Knobel, Robin B.; Holditch-Davis, Diane; Schwartz, Todd A.; Wimmer, John E.

    2009-01-01

    Objective This study evaluated peripheral vasoconstriction in ELBW infants when body temperature decreased during the first 12-hours of life. Design An exploratory, within-subjects design with 10 ELBW infants. Abdominal and foot temperatures were measured every minute. Peripheral vasoconstriction (abdominal > peripheral temperature by 2? C) and abdominal-peripheral temperature difference were also evaluated. Results Abdominal and peripheral temperatures were significantly correlated within ea...

  5. [Age, period and birth-cohort effects on marriage rates in Japanese women between 1985 and 2005, and comparison of trends of effects between marriage and birth rates].

    Science.gov (United States)

    Uchida, Hiroyuki; Odagiri, Youichi; Ohtake, Kazuo; Kobayashi, Jun

    2008-07-01

    An age-period-cohort (APC) analysis was performed to provide information about age-, period-, and cohort-specific effects on marriage trends in Japanese women. In addition, the relationships of the trends of age-, period-, and cohort-specific effects between marriage and birth were analyzed. We obtained data regarding marriages of Japanese women aged between 19 and 38 years for the period of 1985 to 2005 from the National Vital Statistics. Population data used were for an estimated population, obtained from the Population Estimates Annual Reports. Standard cohort tables comprising marriage and population data were analyzed using a Bayesian APC model to identify age-, period-, and cohort-specific effects on marriage rate trends. Previously obtained data for a similar APC-analysis of birth trends were used to compare the trends in the effects of age, period, and cohort on marriage and birth patterns. For this purpose, the estimated values for each effect were normalized. With regard to the marriage trends in Japanese women, the effect of age was the greatest, peaking at the age of 25 years. The period effect increased after 1997; however, its effect was relatively limited as compared to the other effects. The cohort effect, which was greater than the period effect and less than the age effect, on marriage trends showed a decreasing slope for birth cohorts born after 1966 and subsequent increase after 1982. Comparison of age, period and cohort effects between the trends in marriage and birth rates showed that the age effect distinctly peaked at 25 and 28 years for marriage and births, respectively. The period effect on marriage and birth showed a decreasing trend until 1991 and subsequent increased in 1992 and 1997 for births and marriage, respectively. With regard to the cohort effect on birth rates, a decreasing trend was observed for the birth cohorts after 1961, with increase after 1977. However, with regard to the cohort effect on marriage rates, the decreasing

  6. Adverse pregnancy, birth, and infant outcomes in twins: effects of maternal fertility status and infant gender combinations; the Massachusetts Outcomes Study of Assisted Reproductive Technology.

    Science.gov (United States)

    Luke, Barbara; Gopal, Daksha; Cabral, Howard; Stern, Judy E; Diop, Hafsatou

    2017-09-01

    It is unknown whether the risk of adverse outcomes in twin pregnancies among subfertile women, conceived with and without in vitro fertilization, differs from those conceived spontaneously. We sought to evaluate the effects of fertility status on adverse perinatal outcomes in twin pregnancies on a population basis. All twin live births of ≥22 weeks' gestation and ≥350 g birthweight to Massachusetts resident women in 2004 through 2010 were linked to hospital discharge records, vital records, and in vitro fertilization cycles. Women were categorized by their fertility status as in vitro fertilization, subfertile, or fertile, and by twin pair genders (all, like, unlike). Women whose births linked to in vitro fertilization cycles were classified as in vitro fertilization; those with indicators of subfertility but without in vitro fertilization treatment were classified as subfertile; all others were classified as fertile. Risks of 6 adverse pregnancy outcomes (gestational diabetes, pregnancy hypertension, uterine bleeding, placental complications [placenta abruptio, placenta previa, and vasa previa], prenatal hospitalizations, and primary cesarean) and 9 adverse infant outcomes (very low birthweight, low birthweight, small-for-gestation birthweight, large-for-gestation birthweight, very preterm [women with twin pregnancies (6090 fertile, 724 subfertile, and 3538 in vitro fertilization). Among all twins, the risks for all 6 adverse pregnancy outcomes were significantly increased for the subfertile and in vitro fertilization groups, with highest risks for uterine bleeding (adjusted relative risk ratios, 1.92 and 2.58, respectively) and placental complications (adjusted relative risk ratios, 2.07 and 1.83, respectively). Among all twins, the risks for those born to subfertile women were significantly increased for very preterm birth and neonatal and infant death (adjusted relative risk ratios, 1.36, 1.89, and 1.87, respectively). Risks were significantly

  7. Delivery mode and intraventricular hemorrhage risk in very-low-birth-weight infants: Observational data of the German Neonatal Network.

    Science.gov (United States)

    Humberg, Alexander; Härtel, Christoph; Paul, Pia; Hanke, Kathrin; Bossung, Verena; Hartz, Annika; Fasel, Laura; Rausch, Tanja K; Rody, Achim; Herting, Egbert; Göpel, Wolfgang

    2017-05-01

    Very-low-birth-weight infants (VLBWI) are frequently delivered by cesarean section (CS). However, it is unclear at what gestational age the benefits of spontaneous delivery outweigh the perinatal risks, i.e. intraventricular hemorrhage (IVH) or death. To assess the short-term outcome of VLBWI on IVH according to mode of delivery in a population-based cohort of the German Neonatal Network (GNN). A total cohort of 2203 singleton VLBWI with a birth weight 30 weeks of gestation prevalence for IVH was not significantly different in VD and planned CS (5.3% vs. 4.4%). Our observational data demonstrate that elective cesarean section is associated with a reduced risk of IVH in preterm infants <30 weeks gestational age when presenting with preterm labor. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Oropharyngeal administration of mother's milk to prevent necrotizing enterocolitis in extremely low-birth-weight infants: theoretical perspectives.

    Science.gov (United States)

    Rodriguez, Nancy A; Caplan, Michael S

    2015-01-01

    The oropharyngeal administration of mother's milk-placing drops of milk onto the infant's oral mucosa-may serve as a preventative strategy against necrotizing enterocolitis (NEC) for extremely low-birth-weight (ELBW: birth weight pneumonia, an earlier attainment of full enteral feeds, enhanced maturation of oral feeding skills, improved growth, and enhanced breast-feeding outcomes. While more research is needed to definitively establish safety and efficacy of this intervention, this article will examine biological plausibility and will describe the theoretical mechanisms of protection against NEC for ELBW infants who receive this intervention. Nurses play a key role in advancing the science and practice of this intervention. Future directions for research and implications for nursing practice will also be presented.

  9. Human Milk Provision Experiences, Goals, and Outcomes for Teen Mothers with Low-Birth-Weight Infants in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Rossman, Beverly; Meier, Paula P; Janes, Judy E; Lawrence, Christie; Patel, Aloka L

    Breastfeeding rates are virtually unknown for teen mothers whose low-birth-weight (LBW; goals, and outcomes of teen mothers of LBW infants. We conducted a multimethod study using a qualitative research design, survey, and infant medical records. The primary data source was individual interviews conducted with teen mothers of LBW infants hospitalized in a tertiary NICU. Content analysis and descriptive statistics were used for data analysis. All 15 teen mothers (12 black, 3 Hispanic) wanted what was best for their infants and initiated lactation by breast pump. However, maintaining lactation was challenging and the following barriers were identified: fear of being judged; body image issues; influence of the maternal grandmother; and disorganized thought processes about combining pumping with returning to school or work. Despite these barriers, 50% of the teen mothers met their goals for human milk provision at NICU discharge. Most of the teen mothers' lactation barriers reflected their adolescent developmental stage. Potential interventions are identified and include focus groups with teen mothers and maternal grandmothers and lactation support by NICU-based teen breastfeeding peer counselors.

  10. Salivary Cortisol as a Biomarker of Stress in Mothers and their Low Birth Weight Infants and Sample Collecting Challenges

    Directory of Open Access Journals (Sweden)

    Janevski Milica Ranković

    2016-04-01

    Full Text Available Background: Salivary cortisol measurement is a non-invasive method suitable for use in neonatal research. Mother-infant separation after birth represents stress and skin-to-skin contact (SSC has numerous benefits. The aim of the study was to measure salivary cortisol in mothers and newborns before and after SSC in order to assess the effect of SSC on mothers’ and infants’ stress and to estimate the efficacy of collecting small saliva samples in newborns.

  11. Effect of Nutrition Education by Paraprofessionals on Dietary Intake, Maternal Weight Gain, and Infant Birth Weight in Pregnant Native American and Caucasian Adolescents.

    Science.gov (United States)

    Hermann, Janice; Williams, Glenna; Hunt, Donna

    2001-01-01

    Evaluation of nutrition instruction provided to 366 pregnant Native American and Caucasian teens by paraprofessionals determined that it effectively improved their dietary intake, maternal weight gain, and infant birth weight. Further modifications for Native Americans were suggested. (SK)

  12. Rourke Baby Record 2014: Evidence-based tool for the health of infants and children from birth to age 5.

    Science.gov (United States)

    Riverin, Bruno; Li, Patricia; Rourke, Leslie; Leduc, Denis; Rourke, James

    2015-11-01

    To update the 2011 edition of the Rourke Baby Record (RBR) by reviewing current best evidence on health supervision of infants and children from birth to 5 years of age. The quality of evidence was rated with the former (until 2006) Canadian Task Force on Preventive Health Care classification system and GRADE (grading of recommendations, assessment, development, and evaluation) approach. New evidence has been incorporated into the 2014 RBR recommendations related to growth monitoring, nutrition, education and advice, development, physical examination, and immunization. Growth is monitored with the World Health Organization growth charts that were revised in 2014. Infants' introduction to solid foods should be based on infant readiness and include iron-containing food products. Delaying introduction to common food allergens is not currently recommended to prevent food allergies. At 12 months of age, use of an open cup instead of a sippy cup should be promoted. The education and advice section counsels on injuries from unstable furniture and on the use of rear-facing car seats until age 2, and also includes information on healthy sleep habits, prevention of child maltreatment, family healthy active living and sedentary behaviour, and oral health. The education and advice section has also added a new environmental health category to account for the effects of environmental hazards on child health. The RBR uses broad developmental surveillance to recognize children who might be at risk of developmental delays. Verifying tongue mobility and patency of the anus is included in the physical examination during the first well-baby visit. The 2014 RBR also provides updates regarding the measles-mumps-rubella, live attenuated influenza, and human papillomavirus vaccines. The 2014 RBR is the most recent update of a longstanding evidence-based, practical knowledge translation tool with related Web-based resources to be used by both health care professionals and parents for

  13. Preterm birth has sex-specific effects on autonomic modulation of heart rate variability in adult sheep.

    Directory of Open Access Journals (Sweden)

    Mary Berry

    Full Text Available INTRODUCTION: Globally, 11% of infants are born preterm. In adulthood, individuals born preterm are at increased risk of cardiovascular morbidity and mortality, but the mechanistic basis of this remains unknown. Clinically overt cardiovascular disease may be preceded by altered cardiac autonomic activity characterised by increased sympathetic activity and/or reduced parasympathetic activity. Thus, altered cardiac autonomic activity in survivors of preterm birth may underlie later cardiovascular risk. OBJECTIVE: To investigate the impact of gestational age on cardiac autonomic activity in juvenile and adult sheep. METHODS AND RESULTS: Singleton-bearing ewes were randomised antenatally to spontaneous term birth (TC; n=73 or corticosteroid induced preterm birth (PT; n=60. Cardiac autonomic modulation was assessed using heart rate variability analysis in juvenile and adult offspring. Preterm birth in adult males was associated with altered sympatho-vagal modulation (LFnu: PT 64 ± 4 vs. TC 49 ± 4, p<0.05; LogLF/HF: PT 1.8 ± 0.1 vs. TC 1.5 ± 0.1, p<0.05 and reduced parasympathetic modulation (LogRMSSD: PT 2.9 ± 0.2 vs. TC 3.4 ± 0.1, p<0.05; LogNN50: PT 0.3 ± 0.4 vs. TC 1.6 ± 0.4, p<0.05. Within the range of term birth, each one-day increment in gestational age was associated with a decrement in LFnu in juvenile females and with a decrement in LFnu and LF/HF ratio, but an increment in RMSSD and NN50 in adult females. CONCLUSIONS: Cardiac autonomic function in adult sheep is affected in a sex-specific manner by gestational age at birth, even within the term range. Altered cardiac autonomic function may contribute to increased later cardiovascular morbidity in those born preterm.

  14. Parenteral nutrition in very low birth weight infants in the United Kingdom and Ireland.

    LENUS (Irish Health Repository)

    Hopewell, J

    2012-02-01

    Parenteral nutrition (PN) plays an important role in providing nutrients for infants unable to tolerate enteral feeds study was to look at PN prescribing in neonatal units in the United Kingdom (U.K.) and Ireland, in particular in infants < 1.5 kg. A postal questionnaire was administered to the 235 neonatal units. The response rate was 179 (76%), of which 136 (76%) used PN. The initial amount of protein prescribed was 0.1-2 g\\/kg\\/day in 102 units (91%), >2 g\\/kg\\/day in 4 (4%) and 5 (5%) used no protein. 88 (80%) started lipids with the first PN prescription. Only 5 units (5%) started with >1 g\\/kg\\/day. The maximum dose of lipids and protein both varied from 2 - >4 g\\/kg\\/day. The initial glucose infusion rate was 4-8 mg\\/kg\\/min. Interestingly only 44% of units started PN in the first 24 hours of age. Hence results show great variation in PN prescribing.

  15. Observations on the health of infants at a time of rapid societal change: a longitudinal study from birth to fifteen months in Abu Dhabi.

    Science.gov (United States)

    Gardner, Hazel; Green, Katherine; Gardner, Andrew S; Geddes, Donna

    2018-02-07

    Rapid economic and cultural transition in the United Arab Emirates has been accompanied by a rise in chronic disease. Early childhood is known to affect health outcomes in adulthood. This prospective longitudinal study examined the general health of Emirati infants born in a government maternity hospital in the Emirate of Abu Dhabi in October 2002. One hundred twenty-five women, who had recently given birth, were interviewed as part of a larger study encompassing a wide range of cultural, social, and behavioural aspects of health. They were then re-interviewed at three (n = 94), six (n = 59) and 15 months postpartum (n = 52). Data are presented using univariate statistics. In this study seven infants (6%) were born prematurely and four infants (3%) were classified as small for gestational age, while 11 (9%) of the infants weighed less than 2500 g. Low birth weight infants (LBW) were significantly more likely to require treatment in the neonatal intensive care unit (OR = 30.83, p = 0.00). Iron supplementation during pregnancy was associated with fewer underweight infants (OR = 3.92, p = 0.042). No associations were found between infant birth weight and maternal age, age at marriage, consanguinity, education level, current maternal employment, parity, pre-existing anaemia or anaemia in pregnancy, diabetes, folic acid intake, multivitamin intake or infant gender. Maternally-reported infant health issues, vaccination, medication, breast-feeding and infant nutrition, and use of secure car seats are also reported. The health of infants at birth in this UAE sample showed improvements compared to previous studies. The proportion of LBW infants is decreasing and continuing improvements in health care in the UAE are having a positive impact on infant health.

  16. Preterm birth rates in Japan from 1979 to 2014: Analysis of national vital statistics.

    Science.gov (United States)

    Sakata, Soyoko; Konishi, Shoko; Ng, Chris Fook Sheng; Watanabe, Chiho

    2018-03-01

    Secular trends of preterm birth in Japan between 1979 and 2014 were examined to determine whether changes could be explained by a shift in the distribution of maternal age at delivery and parity and/or by changes in age-specific preterm birth rates. Live birth data for 1979 to 2014 were obtained from the Japanese Ministry of Health, Labour and Welfare. Analyses were limited to singleton children born in Japan (n = 43 632 786). Preterm birth was defined using two cut-offs at < 37 or < 34 weeks of gestation. Crude and standardized rates of preterm birth were calculated for firstborn and later-born singletons by maternal age at delivery for specific time periods. Throughout the study period, the rates of preterm birth (both at < 37 and < 34 weeks of gestation) were higher among mothers aged 20 and younger, and mid-30s and older, compared to mothers in their 20s or early 30s. The rates of preterm birth at < 37 (but not at < 34) weeks decreased for mothers aged in their late 30s and 40s, and increased for mothers in their 20s and early 30s. Standardized rates of preterm birth showed a secular increase for preterm births at < 37 but not < 34 weeks of gestation. The rates of preterm birth among mothers aged in their 20s and early 30s increased between 1979 and 2014, which contributed to the secular increase in rates of preterm birth at < 37 weeks. © 2017 Japan Society of Obstetrics and Gynecology.

  17. Pneumococcal vaccination and otitis media in Australian Aboriginal infants: comparison of two birth cohorts before and after introduction of vaccination

    Directory of Open Access Journals (Sweden)

    Mackenzie Grant

    2009-02-01

    Full Text Available Abstract Background Aboriginal children in remote Australia have high rates of complicated middle ear disease associated with Streptococcus pneumoniae and other pathogens. We assessed the effectiveness of pneumococcal vaccination for prevention of otitis media in this setting. Methods We compared two birth cohorts, one enrolled before (1996–2001, and the second enrolled after introduction of 7-valent pneumococcal conjugate and booster 23-valent polysaccharide vaccine (2001–2004. Source populations were the same for both cohorts. Detailed examinations including tympanometry, video-recorded pneumatic otoscopy and collection of discharge from tympanic membrane perforations, were performed as soon as possible after birth and then at regular intervals until 24 months of life. Analyses (survival, point prevalence and incidence were adjusted for confounding factors and repeated measures with sensitivity analyses of differential follow-up. Results Ninety-seven vaccinees and 51 comparison participants were enrolled. By age 6 months, 96% (81/84 of vaccinees and 100% (41/41 of comparison subjects experienced otitis media with effusion (OME, and by 12 months 89% and 88% experienced acute otitis media (AOM, 34% and 35% experienced tympanic membrane perforation (TMP and 14% and 23% experienced chronic suppurative otitis media (CSOM. Age at the first episode of OME, AOM, TMP and CSOM was not significantly different between the two groups. Adjusted incidence of AOM (incidence rate ratio: 0.88 [95% confidence interval (CI: 0.69–1.13] and TMP (incidence rate ratio: 0.63 [0.36–1.11] was not significantly reduced in vaccinees. Vaccinees experienced less recurrent TMP, 9% (8/95 versus 22% (11/51, (odds ratio: 0.33 [0.11–1.00]. Conclusion Results of this study should be interpreted with caution due to potential bias and confounding. It appears that introduction of pneumococcal vaccination among Aboriginal infants was not associated with significant changes

  18. Healing patterns of clavicular birth injuries as a guide to fracture dating in cases of possible infant abuse

    International Nuclear Information System (INIS)

    Walters, Michele M.; Forbes, Peter W.; Buonomo, Carlo; Kleinman, Paul K.

    2014-01-01

    Dating fractures is critical in cases of suspected infant abuse. There are little scientific data to guide radiologists, and dating is generally based on personal experience and conventional wisdom. Since birth-related clavicular fractures are not immobilized and their age is known, we propose that an assessment of these injuries may serve as a guide for dating inflicted fractures in young infants, acknowledging that patterns observed in the clavicle may not be entirely generalizable to other bones injured in the setting of abuse. One hundred thirty-one radiographs of presumed birth-related clavicular fractures in infants between 0 and 3 months of age were reviewed by two pediatric radiologists with 30 and 15 years' experience. Readers were asked to evaluate images based on several parameters of fracture healing, with a focus on subperiosteal new bone formation (SPNBF) and callus formation. SPNBF and callus were each evaluated with regard to presence, thickness and character. Responses were correlated with known fracture ages. SPNBF was rarely seen in fractures less than 7 days old and was most often present by 10 days. Callus formation was rarely seen in fractures less than 9 days old and was most often present by 15 days. SPNBF thickness increased with fracture age and the character of SPNBF evolved from single-layered to solid/multilayered. Callus thickness decreased with fracture age and callus matrix evolved from soft to intermediate to hard in character. There is an evolution in clavicular fracture healing in young infants that follows a predictable pattern. These findings afford the prospect that predictable patterns of infant clavicular fracture healing can provide an evidence base that may be applicable in cases of suspected infant abuse. (orig.)

  19. Comparing two motor assessment tools to evaluate neurobehavioral intervention effects in infants with very low birth weight at 1 year.

    Science.gov (United States)

    Van Hus, Janeline W P; Jeukens-Visser, Martine; Koldewijn, Karen; Van Sonderen, Loekie; Kok, Joke H; Nollet, Frans; Van Wassenaer-Leemhuis, Aleid G

    2013-11-01

    Infants with very low birth weight (VLBW) are at increased risk for motor deficits, which may be reduced by early intervention programs. For detection of motor deficits and to monitor intervention, different assessment tools are available. It is important to choose tools that are sensitive to evaluate the efficacy of intervention on motor outcome. The purpose of this study was to compare the Alberta Infant Motor Scale (AIMS) and the Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development-Dutch Second Edition (BSID-II-NL) in their ability to evaluate effects of an early intervention, provided by pediatric physical therapists, on motor development in infants with VLBW at 12 months corrected age (CA). This was a secondary study in which data collected from a randomized controlled trial (RCT) were used. At 12 months CA, 116 of 176 infants with VLBW participating in an RCT on the effect of the Infant Behavioral Assessment and Intervention Program were assessed with both the AIMS and the PDI. Intervention effects on the AIMS and PDI were compared. Corrected for baseline differences, significant intervention effects were found for AIMS and PDI scores. The highest effect size was for the AIMS subscale sit. A significant reduction of abnormal motor development in the intervention group was found only with the AIMS. No Dutch norms are available for the AIMS. The responsiveness of the AIMS to detect intervention effects was better than that of the PDI. Therefore, caution is recommended in monitoring infants with VLBW only with the PDI, and the use of both the AIMS and the Bayley Scales of Infant Development is advised when evaluating intervention effects on motor development at 12 months CA.

  20. A newborn infant chimpanzee snatched and cannibalized immediately after birth: Implications for "maternity leave" in wild chimpanzee.

    Science.gov (United States)

    Nishie, Hitonaru; Nakamura, Michio

    2018-01-01

    This study reports on the first observed case of a wild chimpanzee infant being snatched immediately after delivery and consequently cannibalized by an adult male in the Mahale Mountains, Tanzania. We demonstrate "maternity leave" from long-term data from the Mahale M group and suggest that it functions as a possible counterstrategy of mother chimpanzees against the risk of infanticide soon after delivery. The subjects of this study were the M group chimpanzees at Mahale Mountains, Tanzania. The case of cannibalism was observed on December 2, 2014. We used the long-term daily attendance record of the M group chimpanzees between 1990 and 2010 to calculate the lengths of "maternity leave," a perinatal period during which a mother chimpanzee tends to hide herself and gives birth alone. We observed a very rare case of delivery in a wild chimpanzee group. A female chimpanzee gave birth in front of other members, and an adult male snatched and cannibalized the newborn infant immediately after birth. Using the long-term data, we demonstrate that the length of "maternity leave" is longer than that of nonmaternity leave among adult and adolescent female chimpanzees. We argue that this cannibalism event immediately after birth occurred due to the complete lack of "maternity leave" of the mother chimpanzee of the victim, who might lack enough experience of delivery. We suggest that "maternity leave" taken by expecting mothers may function as a possible counterstrategy against infanticide soon after delivery. © 2017 Wiley Periodicals, Inc.

  1. Efficacy and safety of early supplementation with 800 IU of vitamin D in very preterm infants followed by underlying levels of vitamin D at birth.

    Science.gov (United States)

    Cho, Sang Yeun; Park, Hyun-Kyung; Lee, Hyun Ju

    2017-05-04

    To determine the efficacy and safety of early supplementation with 800 IU of vitamin D in very low birth weight (VLBW) infants. Sixty-six infants with a birth weight less than 1500 g admitted to the Neonatal Intensive Care Unit. Of these, 52 infants were eligible and received 800 IU/day vitamin D from 2 weeks of age. We examined 25-hydroxyvitamin-D (25[OH]D) levels from cord blood at birth and serum at 32 and 36 weeks of postmenstrual age. The study infants were divided by cord-blood levels of 25(OH)D at birth into 25(OH)D concentrations birth. Considering the efficacy and safety of vitamin D supplementation in this study, vitamin D intake of 800 IU/day may enhance vitamin D status during early hospitalization in VLBW infants with 25 OHD concentrations birth. The clinical significance of optimal vitamin D intake in VLBW infants needs to be studied in larger controlled studies.

  2. Humoral immune response to measles and varicella vaccination in former very low birth weight preterm infants

    Directory of Open Access Journals (Sweden)

    Carolina Schlindwein Mariano Ferreira

    2018-01-01

    Conclusions: Humoral responses to measles and varicella were similar between infants born prematurely and full-term infants. Measles antibody levels were negatively associated with antenatal corticosteroid use; varicella antibodies were positively associated with prolonged breastfeeding.

  3. Sildenafil and retinopathy of prematurity risk in very low birth weight infants

    NARCIS (Netherlands)

    S. Samiee-Zafarghandy; J.N. van den Anker (John); M. Laughon (Matthew); R.H. Clark; P.B. Smith; C.P. Hornik

    2016-01-01

    textabstractObjective: 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

  4. [Early parenteral nutrition with very low and extremely low birth weight infants--practical approach].

    Science.gov (United States)

    Vakrilova, L; Sluncheva, B; Emilova, Z; Pramatarova, T; Jarukova, N; Radulova, P; Chitrova, S; Petrova, G

    2010-01-01

    Newborn infants with birth weight 1500 g and less (VLBW/ELBW) have higher nutritional needs, but enteral feeding is often insufficient or impossible. Parenteral nutrition (PN) as an important component of intensive care with them minimizes the risk of nutritional deficiency. To evaluate the safety and efficacy of early PN administration in VLBW/ELBW infants. The prospective study includes 23 newborn babies with birthweight below 1500 g who were admitted to the NICU from 01.03. to 20.04. 2009. With all babies a PN was started from the first day of life with dextrose and amino acid solutions, adding lipid solutions in gradually increasing quantity on the second day. During the first 20 days of life for each baby were calculated on a daily basis the exact quantities of energy and the essential nutritional substances as well as the balance among them. All babies were followed up for weight gain, presence or absence of complications, related with parenteral nutrition as well as for: blood sugar, acid-base status, total serum protein, electrolytes, urea, triglycerides, billirubin, alkaline phosphatase, ASAT ALAT RESULTS: We found that due to the small infusion volumes during the first days, the minimal daily needed nutrition levels are reached at day 4-5. Nutritional intake at day 7-10 in most children is enough for growth. A positive mean weight gain for the whole group 6.6 g/kg/d (SD 6.2) is observed. Negative weight gain during the first 20 days is observed only with two critically ill babies with substantial reduction of infusion volume. In 9 babies a transient increase in urea levels was observed during the first week, 5 babies had an increase in triglycerides as a symptom of bad lipid tolerance. In 7 babies on prolonged total PN an increase in alkaline phosphatase is observed. Conclusions. Early and sufficient PN in newborn babies below 1500 g guarantees the daily intake of energy and essential nutritive substances for adequate growth and is a basic component of

  5. A cohort study of haemoglobin and zinc protoporphyrin levels in term Zambian infants : effects of iron stores at birth, complementary food and placental malaria

    NARCIS (Netherlands)

    Van Rheenen, P. F.; de Moor, L. T. T.; Eschbach, S.; Brabin, B. J.

    2008-01-01

    Objective: To examine zinc-protoporphyrin (ZPP) and haemoglobin levels, and to determine predictors of iron deficiency anaemia (IDA) in Zambian infants. Subjects and methods: Ninety-one women and their normal birth weight (NBW) infants were followed bi-monthly during the first 6 months of life, and

  6. Oxygenation with T-piece versus self-inflating bag for ventilation of extremely preterm infants at birth: a randomized controlled trial.

    LENUS (Irish Health Repository)

    Dawson, Jennifer A

    2011-06-01

    To investigate whether infants < 29 weeks gestation who receive positive pressure ventilation (PPV) immediately after birth with a T-piece have higher oxygen saturation (SpO₂) measurements at 5 minutes than infants ventilated with a self inflating bag (SIB).

  7. Failure to Thrive in the Term and Preterm Infants of Mothers Depressed in the Postnatal Period: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Drewett, Robert; Blair, Peter; Emmett, Pauline; Emond, Alan

    2004-01-01

    Aims: To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. Method: In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional…

  8. Rotavirus vaccination in a Medicaid infant population from four US states: compliance, vaccination completion rate, and predictors of compliance.

    Science.gov (United States)

    Calnan, Michaela; Krishnarajah, Girishanthy; Duh, Mei Sheng; Haider, Batool A; Yermakov, Sander; Davis, Matthew; Yan, Songkai

    2016-05-03

    A retrospective observational cohort study was conducted using Medicaid administrative claims data from four states in the United States (US) to analyze overall and state-specific compliance and completion rates for rotavirus (RV) vaccines. Compliance was based on an infant receiving the recommended number of doses each within the appropriate time frame, and completion was based on an infant receiving the recommended number of doses over a recommended time period. Compliance and completion were defined separately for RV vaccines by package insert (PI) and Advisory Committee on Immunization Practices (ACIP) guidelines. Infants born between 1 May 2008 and 31 October 2011 in Florida, 31 July 2012 in Iowa and Kansas, and 30 April 2013 in Mississippi, and continuously enrolled in Medicaid with medical and pharmacy benefits for ≥8 months from birth were included. Study participants were assigned to cohorts based on type of RV vaccinations received within recommended vaccination windows. Using the PI guidelines, there were 658,219 eligible infants; 40% received no RV vaccines. The RV1 cohort had a significantly higher proportion of compliant infants compared to the RV5 cohort (54% vs. 25%; p vaccination were use of RV1 vaccine and DTaP vaccination completion. Increased awareness to the importance and timeliness of vaccination is needed.

  9. Growth and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants: A Single Center’s Experience

    Directory of Open Access Journals (Sweden)

    Yung-Chieh Lin

    2011-12-01

    Conclusion: ELBW infants have a high incidence of growth and developmental delay at corrected age of 2 years, particularly in male infants or those with BW less than 750 g. This study reveals that ELBW infants require well predischarge planning and postdischarge follow-up.

  10. Maternal Cytomegalovirus-Specific Immune Responses and Symptomatic Postnatal Cytomegalovirus Transmission in Very Low-Birth-Weight Preterm Infants

    Science.gov (United States)

    Ehlinger, Elizabeth P.; Webster, Emily M.; Kang, Helen H.; Cangialose, Aislyn; Simmons, Adam C.; Barbas, Kimberly H.; Burchett, Sandra K.; Gregory, Mary L.; Puopolo, Karen P.

    2011-01-01

    Introduction. Transmission of cytomegalovirus (CMV) via breast milk can lead to severe acute illness in very low-birth-weight (VLBW) preterm infants. Although the majority of CMV-seropositive women shed CMV in milk, symptomatic postnatal infection of VLBW infants occurs infrequently, suggesting that virologic or immunologic factors in milk may be associated with the risk and severity of postnatal CMV infection. Methods. We investigated the magnitude of CMV-specific cellular and humoral immune responses in milk of 30 seropositive mothers of VLWB preterm infants and assessed their relationship to milk CMV load and symptomatic CMV transmission. Results. Milk immunoglobulin G (IgG) avidity was inversely correlated to milk CMV load (r = −0.47; P = .009). However, milk CMV load and CMV-specific cellular and humoral immune responses were similar in mothers of VLBW infants with and those without symptomatic postnatal CMV infection. Conclusions. Similar immunologic parameters in milk of CMV-seropositive mothers of VLBW infants with and without symptomatic postnatal CMV infection indicate that screening milk by these parameters may not predict disease risk. However, the inverse correlation between milk CMV IgG avidity and CMV load may suggest that enhancement of maternal CMV-specific IgG responses could aid in reduction of CMV shedding into breast milk. PMID:21984738

  11. Do State-Based Policies Have an Impact on Teen Birth Rates and Teen Abortion Rates in the United States?

    Science.gov (United States)

    Chevrette, Marianne; Abenhaim, Haim Arie

    2015-10-01

    The United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely, as do policies on abortion and sex education. The objective of our study is to assess whether US state-level policies regarding abortion and sexual education are associated with different teen birth and teen abortion rates. We carried out a state-level (N = 51 [50 states plus the District of Columbia]) retrospective observational cross-sectional study, using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to study the association of different state policies with teen birth and teen abortion rates. The state-level mean birth rates, when stratifying between policies protective and nonprotective of teen births, were not statistically different-for sex education policies, 39.8 of 1000 vs 45.1 of 1000 (P = .2187); for mandatory parents' consent to abortion 45 of 1000, vs 38 of 1000 when the minor could consent (P = .0721); and for deterrents to abortion, 45.4 of 1000 vs 37.4 of 1000 (P = .0448). Political affiliation (35.1 of 1000 vs 49.6 of 1000, P teen births. Lower teen abortion rates were, however, associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent. While teen birth rates do not appear to be influenced by state-level sex education policies, state-level policies that restrict abortion appear to be associated with lower state teen abortion rates. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  12. Banked preterm versus banked term human milk to promote growth and development in very low birth weight infants.

    LENUS (Irish Health Repository)

    Dempsey, Eugene

    2012-01-31

    BACKGROUND: Human milk banking has been available in many countries for the last three decades. The milk provided from milk banking is predominantly term breast milk, but some milk banks provide preterm breast milk. There are a number of differences between donor term and donor preterm human milk. OBJECTIVES: To determine the effect of banked preterm milk compared with banked term milk regarding growth and developmental outcome in very low birth weight infants (infants weighing less than 1500 g). SEARCH STRATEGY: We used the standard methods of the Cochrane Neonatal Review Group, including a search of the Cochrane Neonatal Group specialized register and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, January 2010). We searched the computerised bibliographic databases MEDLINE (1966 to February 2010), EMBASE (1988 to February 2010) and Web of Science (1975 to February 2010). We searched reference lists of all selected articles, review articles and the Oxford Database of Perinatal Trials. We also searched abstracts from neonatal and pediatric meetings (PAS electronic version from 2000 to 2009, ESPR hand search from 2000 to 2009). We applied no language restrictions. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing banked donor preterm milk with banked donor term milk regarding growth and developmental outcomes in very low birth weight infants DATA COLLECTION AND ANALYSIS: We planned to perform assessment of methodology regarding blinding of randomisation, intervention and outcome measurements as well as completeness of follow-up. We planned to evaluate treatment effect using a fixed-effect model using relative risk (RR), relative risk reduction, risk difference (RD) and number needed to treat (NNT) for categorical data and using mean, standard deviation and weighted mean difference (WMD) for continuous data. We planned an evaluation of heterogeneity. MAIN RESULTS: No studies met the inclusion criteria. AUTHORS

  13. School performance at nine years of age in very premature and very low birth weight infants : Perinatal risk factors and predictors at five years of age

    NARCIS (Netherlands)

    Hille, E.T.M.; Ouden, A.L. den; Bauer, L.; Oudenrijn, C. van den; Brand, R.; Verloove-Vanhorick, S.P.

    1994-01-01

    To assess the impact of both perinatal disorders and developmental problems identified at preschool age on school performance, we followed a virtually complete birth cohort of very premature (<32 completed weeks of gestation) and very low birth weight infants until they were 9 years of age. In 84%

  14. Both very low- and very high in vitro cytokine responses were associated with infant death in low-birth-weight children from Guinea bissau

    DEFF Research Database (Denmark)

    Andersen, Andreas; Jensen, Kristoffer J; Erikstrup, Christian

    2014-01-01

    BACKGROUND: The mechanisms behind heterologous immunity and non-specific effects of vaccines on mortality are not well understood. We examined associations between cytokine responses and subsequent mortality in low-birth-weight infants in Guinea-Bissau. METHODS: A low-birth-weight trial randomize...

  15. Variation in home-birth rates between midwifery practices in the Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Kerssens, J.J.; Keirse, M.J.N.C.

    2000-01-01

    Objective: to examine the reasons for the variation in home-birth rates between midwifery practices. method: multi-level analysis of client and midwife associated, case-specific and structural factors in relation to 4420 planned and actual home or hospital births in 42 midwifery practices. Findings:

  16. Influence of vitamin D on key bacterial taxa in infant microbiota in the KOALA Birth Cohort Study.

    Directory of Open Access Journals (Sweden)

    Chris E Talsness

    Full Text Available Vitamin D has immunomodulatory properties giving it the potential to affect microbial colonization of the intestinal tract. We investigated whether maternal vitamin D supplemention, maternal plasma 25-hydroxyvitamin D concentration, or direct supplementation of the infant influences key bacterial taxa within microbiota of one month old infants. Infant and maternal vitamin D supplement use was ascertained via questionnaires. Maternal plasma 25-hydroxyvitamin D was determined at approximately the 36th week of pregnancy. In 913 one month old infants in the prospective KOALA Birth Cohort Study, fecal Bifidobacterium spp., Escherichia coli, Clostridium difficile, Bacteroides fragilis group, Lactobacillus spp. and total bacteria were quantified with real-time polymerase chain reaction assays targeting 16S rRNA gene sequences. The association between vitamin D exposure and prevalence or abundance of a specific bacterial group or species was analyzed using logistic or linear regression, respectively. There was a statistically significant negative linear trend between counts of Bifidobacterium spp. and levels of maternal vitamin D supplementation and maternal 25-hydroxyvitamin D quintiles, respectively. In addition, a positive linear trend between quintile groups and B. fragilis group counts was observed. Lower counts of C. difficile were associated with vitamin D supplementation of breast fed infants whose mothers were more likely to adhere to an alternative lifestyle in terms of, e.g., dietary habits. These data suggest that vitamin D influences the abundance of several key bacterial taxa within the infant microbiota. Given that intestinal microbiotic homeostasis may be an important factor in the prevention of immune mediated diseases and that vitamin D status is a modifiable factor, further investigation of the impact of postnatal vitamin D supplementation should be conducted in older infants.

  17. [Declining birth rates as a cause of unemployment? Some remarks on the Gunther paradox].

    Science.gov (United States)

    Wagner, A

    1980-01-01

    Gunther (1931) regarded the fact that a diminishing future labor force due to lack of demand leads to increasing unemployment at the present time as a paradox. The presumed connection between declining birth rates and rising unemployment in contrast to a rising birth rate and declining unemployment in a transition period of about 15-20 years is called a Guenther paradox. The author tries to explain the Guenther paradox by means of a macrodemoeconomic model with disequilibrium on the labor market. Clearly there is a relationship between birth rate and unemployment. (author's)

  18. Left Ventricular Rotational Mechanics in Preterm Infants Less Than 29 Weeks' Gestation over the First Week after Birth.

    Science.gov (United States)

    James, Adam; Corcoran, John David; Mertens, Luc; Franklin, Orla; El-Khuffash, Afif

    2015-07-01

    There is a paucity of data on left ventricular (LV) rotational physiology, twist, and torsional mechanics in preterm infants. The principal aims of the present study were to assess the feasibility and reproducibility of measuring LV rotation, twist, and torsion in preterm infants (changes in those parameters over the first week after birth. This was a prospective observational study involving preterm infants time points. Intra- and interobserver reproducibility were assessed using Bland-Altman analysis and the intraclass correlation coefficient. Fifty-one infants with a mean ± SD gestational age of 26.8 ± 1.5 weeks and a mean birth weight of 945 ± 233 g were included. There was high intra- and interobserver reproducibility for basal and apical rotation, LV twist, and LV torsion, with intraclass correlation coefficients ranging from 0.78 to 0.96 (P fashion (11.8 ± 5.0° vs 12.1 ± 6.1° vs 11.7 ± 8.3°, P = .92). Basal rotation changed from counterclockwise on day 1 to clockwise on day 7 (median, 5.5° [interquartile range, -0.3° to 8.3°] vs 4.0 [interquartile range, -4.7° to 7.2°] vs -4.5° [interquartile range, -5.8° to -2.3°], P change in LVTR (P = .60), but LVUTR increased across the same time period (P = .01). Assessment of twist, LVTR, and LVUTR is feasible in preterm infants, with acceptable reproducibility. There are increases in LV twist and torsion in addition to LVUTR, suggesting changes in LV mechanics during the first week of age. Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  19. Birth Defects in Infants Born in 1998-2004 to Men and Women Serving in the US Military During the 1990-1991 Gulf War Era

    Science.gov (United States)

    2012-08-18

    pregnancy during the Persian Gulf War: the risk to women veterans. Ann Epide- miol 14:109–116. Araneta MR, Moore CA, Olney RS, et al. 1997. Goldenhar...Reefhuis J, Honein MA. 2004. Maternal age and non-chromosomal birth defects, Atlanta–1968–2000: teenager or thirty-something, who is at risk ? Birth...Team. 2008. Pregnancy , birth, and infant health outcomes from the National Smallpox Vaccine in Pregnancy Registry, 2003–2006. Clin Infect Dis 46 Suppl

  20. Growth pattern and final height of very preterm vs. very low birth weight infants

    NARCIS (Netherlands)

    Hollanders, J.J.; Pal, S.M. van der; Dommelen, P. van; Rotteveel, J.; Finken, M.J.J.

    2017-01-01

    BackgroundBoth very preterm (VP; i.e., gestational age <32 weeks) and very low birth weight (VLBW; i.e., birth weight <1,500 g) are used as inclusion criteria by studies on preterm birth. We aimed to quantify the impact of these entities on postnatal growth until final height.MethodsSubjects born VP

  1. Living in stressful neighbourhoods during pregnancy: an observational study of crime rates and birth outcomes.

    Science.gov (United States)

    Clemens, Tom; Dibben, Chris

    2017-04-01

    Patterns of adverse birth outcomes vary spatially and there is evidence that this may relate to features of the physical environment such as air pollution. However, other social characteristics of the environment such as levels of crime are relatively understudied. This study examines the association between crime rates and birth weight and prematurity. Maternity inpatient data recorded at birth, including residential postcode, was linked to a representative 5% sample of Scottish Census data and small area crime rates from Scottish Police forces. Coefficients associated with crime were reported from crude and confounder adjusted models predicting low birth weight (crime rates were associated with strong and significant reductions in mean birth weight and increases in the risks of both a small for gestational age baby and premature birth. These effects, with the exception of prematurity, were robust to adjustment for individual characteristics including smoking, ethnicity and other socio-economic variables as well as area based confounders including air pollution. Mean birth weight was robust to additional adjustment for neighbourhood income deprivation. The level of crime in a mother's area of residence, which may be a proxy for the degree of threat felt and therefore stress experienced, appears to be an important determinant of the risk of adverse birth outcomes. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

  2. Physical Activity Pattern and Personal-Social Factors of Mothers During Pregnancy And Infant Birth Weight Based On MET Scale: A Case-Control Study.

    Science.gov (United States)

    Mahmoodi, Zohreh; Karimlou, Masoud; Sajjadi, Homeira; Dejman, Masoumeh; Vameghi, Meroe; Dolatian, Mahrokh; Baradarn Eftekhari, Monir

    2013-07-01

    Low birth weight is one of the most important public health issues in developing and developed countries and identifying its etiology is important for prevention. Considering the unknown impact of physical activity on low birth weight, this research was conducted to investigate the relationship between physical activity and low birth weight. This research was conducted using a case-control design. The control group was made of 500 women with normal birth weight infants and the case group included 250 women with low birth weight infants from the selected hospitals in city of Tehran. The information was gathered using a researcher-made questionnaire which was prepared for determining the relationship between mothers' lifestyle during pregnancy and infants' low birth weight using social determinants of health approach. In this questionnaire, scope of physical activity was investigated in three groups of athletic activities, activities at home and leisure activities. Activity intensity was determined using MET scale and the data were analyzed in SPSS software using independent t-test, Chi-square and logistic regression. In the present research, based on the results of multiple logistic regression test, an increase in the time spent on sport activities (OR = 2.20) and home activities (OR =1.44) (P = 0.003) was accompanied by increased chance of giving birth to low birth weight infants; in contrast, one hour increase of leisure activities decreased the probability of low birth weight infants by 0.32 (P = 0.008). An increase in the time spent on sport and home activities, even after considering other influential factors, was related to low birth weight.

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

    Directory of Open Access Journals (Sweden)

    Hsin-Chung Huang

    Full Text Available 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.

  4. A clinical comparison of radiant warmer and incubator care for preterm infants from birth to 1800 grams.

    Science.gov (United States)

    Meyer, M P; Payton, M J; Salmon, A; Hutchinson, C; de Klerk, A

    2001-08-01

    The objective of this study was to compare radiant warmer and incubator care for preterm infants from birth with respect to temperature control and weight gain. Sixty preterm infants radiant warmer or incubator care. The initial goal was to maintain abdominal temperature at 36.8 degrees C in both groups and axillary temperature at 36.8 to 37.3 degrees C; air servocontrol was used for incubator infants. Infants in both groups received added humidity for 5 days if their weight was temperatures were obtained. The percentage of the recording time during which the abdominal temperature was in the target range of between 36 degrees C and 37.5 degrees C was determined as an indicator of temperature control. Weight gain from birth to 1800 g was compared. Secondary outcomes included fluid balance and clinical events. There were 30 infants in each group; 48 were temperature control were noted on day 1. Although admission temperatures were similar, lower abdominal temperatures were noted in the first 2 hours of life in the incubator group (medians were 36.6 degrees C and 35.9 degrees C in the radiant warmer and incubator groups, respectively). Similarly, mean abdominal temperatures during the 3-hour recording on day 1 were lower in the incubator group, and infants in this group spent a significantly greater percentage of the recording time with temperatures outside the target range (17.3% compared with 0.88%). Other temperature recordings from the forehead and foot were not significantly different in the groups. Fluid intakes were higher for infants under radiant warmer on days 2, 3, and 4, and the difference amounted to a mean of 12.8 mL/kg/d. Maximum sodium levels in the first week were similar in the 2 groups. Mean weight gain was 17.4 g/kg/d for the radiant warmer group and 17.1 g/kg/d for the incubator group; days to regain birth weight and length of hospital stay were not significantly different. Greater numbers of infants in the radiant warmer group required

  5. Early Caffeine Prophylaxis and Risk of Failure of Initial Continuous Positive Airway Pressure in Very Low Birth Weight Infants.

    Science.gov (United States)

    Patel, Ravi M; Zimmerman, Kanecia; Carlton, David P; Clark, Reese; Benjamin, Daniel K; Smith, P Brian

    2017-11-01

    To test the hypothesis that early caffeine treatment on the day of birth, compared with later treatment in very low birth weight (VLBW, caffeine in the first week of life. We used multivariable conditional logistic regression to compare the risk of CPAP failure, defined as invasive mechanical ventilation or surfactant therapy on DOL 1-6, by timing of caffeine treatment as either early (initiation on DOL 0) or routine (initiation on DOL 1-6). We identified 11 133 infants; 4528 (41%) received early caffeine and 6605 (59%) received routine caffeine. Median gestational age was lower in the early caffeine group, 29 weeks (25th, 75th percentiles; 28, 30) vs the routine caffeine group, 30 weeks (29, 31); P caffeine groups: 22% vs 21%; adjusted OR = 1.05 (95% CI: 0.93, 1.18). Early caffeine treatment on the day of birth was not associated with a decreased risk of CPAP failure in the first week of life for VLBW infants initially treated with CPAP. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Early postnatal additional high-dose oral vitamin A supplementation versus placebo for 28 days for preventing bronchopulmonary dysplasia or death in extremely low birth weight infants.

    Science.gov (United States)

    Meyer, Sascha; Gortner, Ludwig

    2014-01-01

    Prematurity and the associated risk for bronchopulmonary dysplasia (BPD) remain a significant threat to extremely low birth weight (ELBW) infants. Vitamin A has been considered a therapeutic alternative in reducing the rate of BPD and mortality. To investigate whether early postnatal, additional high-dose oral vitamin A supplementation for 28 days is more efficient in reducing BPD or death in ELBW infants than placebo treatment. This is a multicenter, double-blind RCT comparing postnatal high-dose oral vitamin A supplementation (5,000 IU vitamin A/kg/day vs. placebo) for 28 days in ELBW neonates requiring mechanical ventilation, noninvasive ventilatory support or supplemental oxygen at 24 h of age. The primary end point is the proportion of children who died before 36 weeks' gestational age or developed moderate or severe BPD. BPD is defined as the need for supplemental oxygen to maintain SaO2 of ≥92% at rest at 36 weeks' postmenstrual age (PMA). Clinical secondary end points include the following: BPD (including mild form), intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis, total number of days of mechanical ventilation and oxygen supplementation, and safety and tolerability of high-dose vitamin A supplementation. The results of the NeoVitaA trial will provide robust data with regard to the efficacy of high-dose oral vitamin A supplementation in reducing the incidence of BPD or death at 36 weeks' PMA in ELBW infants. © 2014 S. Karger AG, Basel.

  7. Live birth rates after MESA or TESE in men with obstructive azoospermia: is there a difference?

    NARCIS (Netherlands)

    van Wely, Madelon; Barbey, Natalie; Meissner, Andreas; Repping, Sjoerd; Silber, Sherman J.

    2015-01-01

    How do live birth rates compare after intracytoplasmic sperm injection (ICSI) for men with obstructive azoospermia when using sperm derived from testicular sperm extraction (TESE) versus microsurgical epididymal sperm aspiration (MESA)? Our study suggests that proximal epididymal sperm (from MESA)

  8. Teen Birth Rates for Age Group 15-19 in the United States by County

    Data.gov (United States)

    U.S. Department of Health & Human Services — This data set contains mean teen birth rates by year for each county and state in the United States. Hierarchical Bayesian space-time models were used to generate...

  9. [Breast feeding rates and factors influencing breast feeding practice in late preterm infants: comparison with preterm born at less than 34 weeks of gestational age].

    Science.gov (United States)

    Jang, Gun Ja; Lee, Sang Lak; Kim, Hyeon Mi

    2012-04-01

    This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm (34 ≤ GA neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.

  10. The effect of kangaroo ward care in comparison with "intermediate intensive care" on the growth velocity in preterm infant with birth weight control trial.

    Science.gov (United States)

    Sharma, Deepak; Murki, Srinivas; Pratap, Oleti Tejo

    2016-10-01

    Kangaroo mother care (KMC) reduces neonatal mortality, neonatal sepsis and improves growth outcome in preterm infants. In this study, we compared the efficacy of "baby care in kangaroo ward (KWC)" with "baby care in intermediate intensive care (IIC)" in stable preterm infants (birth weight birth weight <1100 g) infants at term gestational age. Clinical trial registry of India CTRI/2014/05/004625 WHAT IS KNOWN: • Kangaroo mother care (KMC) reduces neonatal mortality, neonatal sepsis and improves growth outcome in VLBW infants. What is new: • Baby care by mother can be given safely in kangaroo ward from a weight of 1150 g in stable preterm infants without any adverse effects.

  11. Asymmetry of cerebral glucose metabolism in very low-birth-weight infants without structural abnormalities.

    Directory of Open Access Journals (Sweden)

    Jae Hyun Park

    Full Text Available Thirty-six VLBW infants who underwent F-18 fluorodeoxyglucose (F-18 FDG brain PET and MRI were prospectively enrolled, while infants with evidence of parenchymal brain injury on MRI were excluded. The regional glucose metabolic ratio and asymmetry index were calculated. The asymmetry index more than 10% (right > left asymmetry or less than -10% (left > right asymmetry were defined as abnormal. Regional cerebral glucose metabolism were compared between right and left cerebral hemispheres, and between the following subgroups: multiple gestations, premature rupture of membrane, bronchopulmonary dysplasia, and low-grade intraventricular hemorrhage.In the individual analysis, 21 (58.3% of 36 VLBW infants exhibited asymmetric cerebral glucose metabolism. Fifteen infants (41.7% exhibited right > left asymmetry, while six (16.7% exhibited left > right asymmetry. In the regional analysis, right > left asymmetry was more extensive than left > right asymmetry. The metabolic ratio in the right frontal, temporal, and occipital cortices and right thalamus were significantly higher than those in the corresponding left regions. In the subgroup analyses, the cerebral glucose metabolism in infants with multiple gestations, premature rupture of membrane, bronchopulmonary dysplasia, or low-grade intraventricular hemorrhage were significantly lower than those in infants without these.VLBW infants without structural abnormalities have asymmetry of cerebral glucose metabolism. Decreased cerebral glucose metabolism are noted in infants with neurodevelopmental risk factors. F-18 FDG PET could show microstructural abnormalities not detected by MRI in VLBW infants.

  12. Low-Salt Intake during Mating or Gestation in Rats Is Associated with Low Birth and Survival Rates of Babies

    Directory of Open Access Journals (Sweden)

    Ranna Chou

    2014-01-01

    Full Text Available We investigated the influence of maternal salt restriction during mating or gestation on birth rate and offspring growth in Dahl salt-sensitive rats (DS. DS were divided into 5 groups: DS fed a low-salt (0.3% NaCl, w/w (DS-low or high-salt (4% NaCl, w/w diet (DS-high during mating and DS-high or DS-low during gestation, and DS fed regular chow (0.75% NaCl, w/w (DS-regular throughout mating and gestation. During the unspecified periods, the rats were given regular chow. DS-low during mating delivered fewer infants than high-salt mothers (P<0.05. The birth rate on regular chow was 87%. Six out of 11 DS-low rats during pregnancy produced pups while the rats fed a high-salt diet all delivered pups (P<0.025. The pup survival rate was 67% for high-salt mothers during mating and 54% for mothers on a low-salt diet. The pup survival rate was 95% for mothers on a high-salt diet during pregnancy and 64% for mothers on a low-salt diet (P<0.0001. Seven out of 8 DS-regular rats during mating delivered 59 neonates. However, 66% of the neonates survived. A low-salt diet during mating or pregnancy lowers birth rate and the neonates from low-salt mothers during pregnancy were more likely to die than those from high-salt mothers.

  13. Maybe Next Month? Temperature Shocks, Climate Change, and Dynamic Adjustments in Birth Rates

    OpenAIRE

    Barreca, Alan I.; Deschenes, Olivier; Guldi, Melanie

    2015-01-01

    Dynamic adjustments could be a useful strategy for mitigating the costs of acute environmental shocks when timing is not a strictly binding constraint. To investigate whether such adjustments could apply to fertility, we estimate the effects of temperature shocks on birth rates in the United States between 1931 and 2010. Our innovative approach allows for presumably random variation in the distribution of daily temperatures to affect birth rates up to 24 months into the future. We find that a...

  14. Teen Birth Rates for Urban and Rural Areas in the United States, 2007-2015.

    Science.gov (United States)

    Hamilton, Brady E; Rossen, Lauren M; Branum, Amy M

    2016-11-01

    Data from the National Vital Statistics System •Birth rates for teenagers aged 15-19 declined in urban and rural counties from 2007 through 2015, with the largest declines in large urban counties and the smallest declines in rural counties. •From 2007 through 2015, the teen birth rate was lowest in large urban counties and highest in rural counties. •Declines in teen birth rates in all urban counties between 2007 and 2015 were largest in Arizona, Massachusetts, Connecticut, Minnesota, and Colorado, with 17 states experiencing a decline of 50% or more. •Declines in teen birth rates in all rural counties between 2007 and 2015 were largest (50% or more) in Colorado and Connecticut. •In 2015, teen birth rates were highest in rural counties and lowest in large urban counties for non-Hispanic white, non-Hispanic black, and Hispanic females. Teen birth rates have demonstrated an unprecedented decline in the United States since 2007 (1). Declines occurred in all states and among all major racial and Hispanic-origin groups, yet disparities by both geography and demographic characteristics persist (2,3). Although teen birth rates and related declines have been described by state, patterns by urban-rural location have not yet been examined. This report describes trends in teen birth rates in urban (metropolitan) and rural (nonmetropolitan) areas in the United States overall and by state from 2007 through 2015 and by race and Hispanic origin for 2015. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  15. Links between environmental geochemistry and rate of birth defects: Shanxi Province, China

    International Nuclear Information System (INIS)

    Yu Haiying; Zhang Keli

    2011-01-01

    The rate of birth defects in Shanxi Province is among the highest worldwide. In order to identify the impacts of geochemical and environmental factors on birth defect risk, samples of soil, water and food were collected from an area with an unusually high rate of birth defects (study area) and an area with a low rate of birth defects (control area) in Shanxi Province, China. Element contents were determined by ICP-OES, and the results were analyzed using a non-parametric test and stepwise regression. Differences in the level and distribution of 14 geochemical elements, namely arsenic (As), selenium (Se), molybdenum (Mo), zinc (Zn), strontium (Sr), iron (Fe), tin (Sn), magnesium (Mg), vanadium (V), calcium (Ca), copper (Cu), aluminum (Al), potassium (K) and sulfur (S) were thus compared between the study and control areas. The results reveal that the geochemical element contents in soil, water and food show a significant difference between the study area and control area, and suggest that the study area was characterized by higher S and lower Sr and Al contents. These findings, based on statistical analysis, may be useful in directing further epidemiological investigations identifying the leading causes of birth defects. - Research Highlights: → Environmental geochemistry has an significant impact on birth defects in the regions with an unusually high rate of birth defects. → An excess of S and deficiency of Sr and Al are the distinctive environmental features associated with the high rate of birth defects in the Shanxi Province of China. → Geochemical anomalies is a non-medical basis for effective prevention and cure of birth defects.

  16. Links between environmental geochemistry and rate of birth defects: Shanxi Province, China

    Energy Technology Data Exchange (ETDEWEB)

    Yu Haiying [State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Geography, Beijing Normal University, Beijing 100875 (China); College of Resources and Environmental Sciences, Sichuan Agricultural University, Ya' an, Sichuan 625014 (China); Zhang Keli, E-mail: keli@bnu.edu.cn [State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Geography, Beijing Normal University, Beijing 100875 (China)

    2011-01-01

    The rate of birth defects in Shanxi Province is among the highest worldwide. In order to identify the impacts of geochemical and environmental factors on birth defect risk, samples of soil, water and food were collected from an area with an unusually high rate of birth defects (study area) and an area with a low rate of birth defects (control area) in Shanxi Province, China. Element contents were determined by ICP-OES, and the results were analyzed using a non-parametric test and stepwise regression. Differences in the level and distribution of 14 geochemical elements, namely arsenic (As), selenium (Se), molybdenum (Mo), zinc (Zn), strontium (Sr), iron (Fe), tin (Sn), magnesium (Mg), vanadium (V), calcium (Ca), copper (Cu), aluminum (Al), potassium (K) and sulfur (S) were thus compared between the study and control areas. The results reveal that the geochemical element contents in soil, water and food show a significant difference between the study area and control area, and suggest that the study area was characterized by higher S and lower Sr and Al contents. These findings, based on statistical analysis, may be useful in directing further epidemiological investigations identifying the leading causes of birth defects. - Research Highlights: {yields} Environmental geochemistry has an significant impact on birth defects in the regions with an unusually high rate of birth defects. {yields} An excess of S and deficiency of Sr and Al are the distinctive environmental features associated with the high rate of birth defects in the Shanxi Province of China. {yields} Geochemical anomalies is a non-medical basis for effective prevention and cure of birth defects.

  17. Focused attention, heart rate deceleration, and cognitive development in preterm and full-term infants.

    Science.gov (United States)

    Petrie Thomas, Julianne H; Whitfield, Michael F; Oberlander, Tim F; Synnes, Anne R; Grunau, Ruth E

    2012-05-01

    The majority of children who are born very preterm escape major impairment, yet more subtle cognitive and attention problems are very common in this population. Previous research has linked infant focused attention during exploratory play to later cognition in children born full-term and preterm. Infant focused attention can be indexed by sustained decreases in heart rate (HR). However there are no preterm studies that have jointly examined infant behavioral attention and concurrent HR response during exploratory play in relation to developing cognition. We recruited preterm infants free from neonatal conditions associated with major adverse outcomes, and further excluded infants with developmental delay (Bayley Mental Development Index [MDI attention and concurrent HR response were compared in 83 preterm infants (born 23-32 weeks gestational age [GA]) who escaped major impairment to 46 full-term infants. Focused attention and HR response were then examined in relation to Bayley MDI, after adjusting for neonatal risk. MDI did not differ by group, yet full-term infants displayed higher global focused attention ratings. Among the extremely preterm infants born attention episodes, accounted for 49% of adjusted variance in predicting concurrent MDI. There were no significant associations for later-born gestational age (29-32 weeks) or full-term infants. Among extremely preterm infants who escape major impairment, our findings suggest unique relationships between focused attention, HR deceleration, and developing cognition. Copyright © 2011 Wiley Periodicals, Inc.

  18. Recombinant human erythropoietin and blood transfusion in low-birth weight preterm infants under restrictive transfusion guidelines

    International Nuclear Information System (INIS)

    Badiee, Z.; Pourmirzaiee, Mohmmad A.; Naseri, F.; Kelishadi, R.

    2006-01-01

    To compare the number and volume of red blood cell transfusions (RBCTs) in very low birth weight infants under restrictive red blood cell transfusion guidelines with and without erythropoietin administration. In a controlled clinical trial conducted at the neonatal intensive care unit of Alzahra Hospital, Isfahan, Iran, between April 2002 to April 2004, 60 premature infants with gestational age up to 34 weeks, birth weight up to 1500 g, and postnatal age between 8 and 14 days were included. The newborns were randomized into 2 groups: Group 1 received 3 doses of 400 IU/kg erythropoietin per week for 6 weeks, and Group 2 received no treatment aside from their conventional medications. The 2 groups did not differ significantly with respect to their mean gestational age, birth weight and hematocrit at the study entry. Fewer transfusions were administered to those receiving erythropoietin (26.7% versus 50%, p=0.03), but there was no statistically significant difference between groups with respect to volume of transfusion. Compared with the placebo group, the infants receiving erythropoietin had a higher mean hematocrit (34% +/- 4.3 versus 29% +/- 5.9, p<0.001) and absolute reticulocyte count (57 +/- 19 versus 10 +/- 4.8 x 106, p<0.001) at the end of the study. We found no significant difference in the incidence of thrombocytopenia and leukopenia between the 2 groups. We conclude that when the restrictive RBCT guidelines were followed, treatment with erythropoietin can be useful in reduction of the number of RBCTs. (author)

  19. [Short, medium and long-term benefits of human milk intake in very-low-birth-weight infants].

    Science.gov (United States)

    Chinea Jiménez, Bibiana; Awad Parada, Yumana; Villarino Marín, Antonio; Sáenz de Pipaón Marcos, Miguel

    2017-10-24

    The aim of the present study is to evaluate the effect of human milk feeding during the first weeks of life in very low birth weight infants on weight gain at discharge, length of hospitalization, postmenstrual age at discharge and nutritional assessment, growth and neurodevelopment at two and five years. Longitudinal study of very-low-birth-weight infants (Care Unit of La Paz University Hospital, from January 1st 2009 to December 31st 2009, followed in the follow-up clinic. Their parents agreed to perform a more exhaustive anthropometric study at five years, classified according to the type of feeding at the time of discharge (exclusive human milk, formula milk or mixed). Initial hospital duration and anthropometry at discharge were evaluated. At two years of age, anthropometric data (weight, height and head circumference) were collected and neurodevelopment was assessed according to the Bayley scale of child development. Data at five years were collected prospectively. Measurements of weight, height and head circumference, waist circumference, hip, relaxed and contracted arm, thigh and middle leg, bicipital, triceps, subscapular, suprailiac and leg skin folds were performed. For patients older than five years, the Kaufman test battery for children was used. The effect of human milk on the variables of interest was investigated using a multivariate analysis correcting for gestational age and weight at birth. One hundred and fifty-two infants born in 2009 were discharged from our unit: exclusive breast milk (59), formula (55) or mixed milk (38). More detailed follow-up was carried out for 61 of them. Human milk during the first admission decreases the initial hospital stay, and is associated with a higher head circumference at two and five years, and a better score in the global and verbal cognitive area at five years. Our results suggest that maternal milk feeding during initial admission should be encouraged because it can improve neurodevelopment at five years

  20. Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.

    LENUS (Irish Health Repository)

    Miletin, J

    2012-02-01

    OBJECTIVE: Recent evidence suggests that high cortisol concentrations are associated with increased morbidity and mortality in very low birth weight (VLBW) infants. Neonatal illness severity and mortality risk scores are reliable in predicting morbidity and mortality. The objectives were (i) to assess the correlation between serum cortisol levels and clinical assessment of multi-organ dysfunction\\/illness severity scores (CRIB II, SNAPPE-II and neonatal multiple organ dysfunction score (NEOMOD)) in first 24 h in VLBW infants and (ii) to assess the relationship between surrogates of end organ blood flow and serum cortisol levels. STUDY DESIGN: A prospective observational cohort study. Neonates with birth weight <1500 g were eligible for enrollment. Echocardiography evaluation of superior vena cava (SVC) flow was carried out in the first 24 h life. Cortisol levels were measured simultaneously and appropriate clinical scores were calculated. RESULT: A total of 54 VLBW neonates were enrolled following parental consent. Two patients were excluded because of congenital malformations. In 14 babies the cortisol value was not simultaneously obtained. The mean birth weight was 1.08 kg, mean gestational age was 27.8 weeks. There was a significant correlation between cortisol and NEOMOD score (P=0.006). There was no correlation between cortisol and CRIB II score (P=0.34), SVC flow (P=0.49) and mean arterial blood pressure respectively (P=0.35). CONCLUSION: There was no correlation between SVC flow and cortisol values or between cortisol and mean blood pressure values. There was a significant correlation between cortisol levels and neonatal organ dysfunction score evaluated suggesting that stressed VLBW infants do mount a cortisol response.

  1. Both very low- and very high in vitro cytokine responses were associated with infant death in low-birth-weight children from Guinea Bissau.

    Directory of Open Access Journals (Sweden)

    Andreas Andersen

    Full Text Available The mechanisms behind heterologous immunity and non-specific effects of vaccines on mortality are not well understood. We examined associations between cytokine responses and subsequent mortality in low-birth-weight infants in Guinea-Bissau.A low-birth-weight trial randomized children to Bacille Calmette-Guérin (BCG at birth or later according to local policy. Blood samples were obtained from a sub-group at age 6 weeks. Interleukin (IL-5, IL-10, IL-13, interferon (IFN-γ, and tumor necrosis factor (TNF-α were measured in whole-blood cell cultures stimulated with lipopolysaccharide (LPS, phytohaemagglutinin (PHA, or purified protein derivative (PPD. The outcome was mortality between bleeding and 1 year of age. Non-linear associations between cytokine responses and mortality were examined.Cytokine measurements were available from 390 children. The mortality rate (MR was high (6.8/100 person-years-observation (PYO. Both low and high cytokine responses to LPS and PHA were associated with high mortality (MR up to 25/100 PYO in the lowest 10% and 9.2/100 PYO in the highest 10%. In BCG-vaccinated children, higher IFN-γ responses to PPD were associated with better survival (MR ratio = 0.43 (0.24-0.77.Data presented a rare opportunity to explore associations between cytokine responses and mortality. Both low and high cytokine responses were associated with high mortality; a balanced response to invading pathogens seems preferable.

  2. Both very low- and very high in vitro cytokine responses were associated with infant death in low-birth-weight children from Guinea Bissau.

    Science.gov (United States)

    Andersen, Andreas; Jensen, Kristoffer J; Erikstrup, Christian; Ravn, Henrik; Fisker, Ane B; Lisse, Ida M; Sartono, Erliyani; Aaby, Peter; Yazdanbakhsh, Maria; Benn, Christine S

    2014-01-01

    The mechanisms behind heterologous immunity and non-specific effects of vaccines on mortality are not well understood. We examined associations between cytokine responses and subsequent mortality in low-birth-weight infants in Guinea-Bissau. A low-birth-weight trial randomized children to Bacille Calmette-Guérin (BCG) at birth or later according to local policy. Blood samples were obtained from a sub-group at age 6 weeks. Interleukin (IL)-5, IL-10, IL-13, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were measured in whole-blood cell cultures stimulated with lipopolysaccharide (LPS), phytohaemagglutinin (PHA), or purified protein derivative (PPD). The outcome was mortality between bleeding and 1 year of age. Non-linear associations between cytokine responses and mortality were examined. Cytokine measurements were available from 390 children. The mortality rate (MR) was high (6.8/100 person-years-observation (PYO)). Both low and high cytokine responses to LPS and PHA were associated with high mortality (MR up to 25/100 PYO in the lowest 10% and 9.2/100 PYO in the highest 10%). In BCG-vaccinated children, higher IFN-γ responses to PPD were associated with better survival (MR ratio = 0.43 (0.24-0.77)). Data presented a rare opportunity to explore associations between cytokine responses and mortality. Both low and high cytokine responses were associated with high mortality; a balanced response to invading pathogens seems preferable.

  3. [Blood lactate measurments as a diagnostic and prognostic tool after birth asphyxia in newborn infants with gestational age > or = 34 gestational weeks].

    Science.gov (United States)

    Varkilova, L; Slancheva, B; Emilova, Z; Nikolov, A; Metodieva, V; Hitrova, S; Doicheva, E

    2013-01-01

    Blood lactate at birth as result of activated anaerobic glycolysis is a marker of perinatal asphyxia. To evaluate the dynamics of blood lactate, pH and base excess (BE) as a tool for assessing the severity of fetal hypoxia and predicting neonatal outcome. 79 neonates (> or = 34 gestational weeks) were included and followed up until discharge: 43 with pathologic fetal hearth rate patterns and/or 1-minute Apgar score asphyxia group"); 36 without obstetric or clinical signs of asphyxia (control group). Samples from umbilical artery (u.a.), capillary blood at 2h and 12-24 h after birth were analyzed for blood lactate, pH and BE. Lactate value (u.a.) was significantly higher (5.3 +/- 3.4 mmol/l), pH and BE were lower (7.29 +/- 0.05 and -14.1 +/- 5.9 mmol/l) in the "asphyxia group" compared to the control group (2.7 +/- 1.2 mmol/l, 7.29 +/- 0.05 and -5.9 +/- 3.3 respectively). The 2 h lactate-values increased significantly in infants with asphyxia (6,.7 +/- 4.7) compared to the controls (3.2 +/- 1.1), the 12-24 h values were reduced in the main group (4.6 +/- 1.5) and without changes in the controls (3.2 +/- 0.88). Values of pH and BE at 2 h and 12-24 h increased progressively in both groups without significant differences between them. Hypoxic-ischemic encephalopathy (HIE) stage II-III was observed in infants with u.a. pH asphyxia. Increasing lactate concentration after birth is better predictor of severe HIE.

  4. Child mortality estimation: consistency of under-five mortality rate estimates using full birth histories and summary birth histories.

    Directory of Open Access Journals (Sweden)

    Romesh Silva

    Full Text Available Given the lack of complete vital registration data in most developing countries, for many countries it is not possible to accurately estimate under-five mortality rates from vital registration systems. Heavy reliance is often placed on direct and indirect methods for analyzing data collected from birth histories to estimate under-five mortality rates. Yet few systematic comparisons of these methods have been undertaken. This paper investigates whether analysts should use both direct and indirect estimates from full birth histories, and under what circumstances indirect estimates derived from summary birth histories should be used.Usings Demographic and Health Surveys data from West Africa, East Africa, Latin America, and South/Southeast Asia, I quantify the differences between direct and indirect estimates of under-five mortality rates, analyze data quality issues, note the relative effects of these issues, and test whether these issues explain the observed differences. I find that indirect estimates are generally consistent with direct estimates, after adjustment for fertility change and birth transference, but don't add substantial additional insight beyond direct estimates. However, choice of direct or indirect method was found to be important in terms of both the adjustment for data errors and the assumptions made about fertility.Although adjusted indirect estimates are generally consistent with adjusted direct estimates, some notable inconsistencies were observed for countries that had experienced either a political or economic crisis or stalled health transition in their recent past. This result suggests that when a population has experienced a smooth mortality decline or only short periods of excess mortality, both adjusted methods perform equally well. However, the observed inconsistencies identified suggest that the indirect method is particularly prone to bias resulting from violations of its strong assumptions about recent mortality

  5. An 8-month history of meningitis in an extremely low birth weight infant? - Long-lasting Infection with Ureaplasma parvum.

    Science.gov (United States)

    Glaser, K; Wohlleben, M; Speer, C P

    2015-02-01

    Ureaplasma spp. have been implicated in the pathogenesis of both preterm labor and neonatal morbidity including pneumonia and sepsis and the development of chronic lung disease of prematurity. Data on Ureaplasma meningitis are limited and partly controversially discussed. We report the unique case of a 9-month-old infant with progressive internal hydrocephalus of unknown origin and developmental delay due to a history of>200 days of inflammation of the central nervous system. The female extremely low birth weight infant had been referred to our hospital for ventriculoperitoneal shunt implantation. She had been born at 26+3 weeks of gestation with a birth weight of 940 g. With the exception of a moderate respiratory distress syndrome, postnatal period had been reported uneventful. However, internal hydrocephalus had become manifest at 4 weeks of postnatal age. Intraventricular hemorrhage had not been documented by cranial ultrasound and magnetic resonance imaging. Cerebrospinal fluid (CSF) analysis had repetitively revealed pronounced inflammation reflected by pleocytosis (50-86 leukocytes/μL, 60% lymphocytes), CSF protein levels of 578-1,026 mg/dL and undetectable CSF glucose. Although suggesting bacterial meningitis, microbial diagnostics had not been indicative, and empirical antibiotics had not affected the CSF findings. On admission to our hospital, CSF analysis still documented significant inflammation (125 leukocytes/μL, CSF protein 565 mg/dL, CSF glucosetreatment with chloramphenicol, CSF profile continuously normalized, and cultures and PCR became negative. Treatment was continued for 3 weeks, and the infant was discharged after uncomplicated ventriculoperitoneal shunt placement. During a 12-month observation period she has shown encouraging recovery. In preterm infants, in particular, internal hydrocephalus of unknown origin and sustained CSF inflammation are highly suggestive of Ureaplasma meningitis. Our case highlights that infection may escape

  6. Increased urinary neutrophil gelatinase-associated lipocalin in very-low-birth-weight infants with oliguria and normal serum creatinine.

    Science.gov (United States)

    Shin, So Young; Ha, Ji Yong; Lee, Sang Lak; Lee, Won Mok; Park, Jae Hyun

    2017-06-01

    In infants, oliguria is defined as a urine output of serum cystatin C (CysC) levels in very-low-birth-weight infants (VLBWIs) with a normal serum creatinine (Cr) level. Fifty-seven VLBWIs were enrolled in the study. Urinary NGAL, serum CysC and Cr levels and urinary NGAL/Cr ratios were measured. Infants with Apgar scores of >5 at 5 min and/or a serum Cr level of >1.5 mg/dL or those treated for patent ductus arteriosus were excluded. In case of antibiotic treatment, blood and urine samples were collected at ≥48 h after discontinuation of antibiotic treatment. There was a significant difference in gestational age between infants with oliguric episodes during hospitalization and those without, but not in birth weight, perinatal or postnatal factors. Gestational age was negatively correlated with urinary NGAL and serum CysC levels and urinary NGAL/Cr ratio (p serum Cr level and urinary NGAL/Cr ratio (p serum CysC or serum Cr levels. The urinary NGAL level [area under the curve (AUC) 0.886, 95% confidence interval (CI) 0.814-0.937] and urinary NGAL/Cr ratio (AUC 0.853, 95% CI 0.775-0.911) showed significantly greater discrimination for oliguria than serum CysC (AUC 0.610, 95% CI: 0.515-0.699) or serum Cr (AUC 0.747, 95%CI 0.659-0.823) levels. Urinary NGAL level and urinary NGAL/Cr ratio were more sensitive markers for the presence of oliguria in VLBWIs with normal serum Cr levels than serum CysC level.

  7. Neonatal Acute Kidney Injury and the Risk of Intraventricular Hemorrhage in the Very Low Birth Weight Infant.

    Science.gov (United States)

    Stoops, Christine; Sims, Brian; Griffin, Russell; Askenazi, D J

    2016-01-01

    Despite improvements in survival of premature infants, many have comorbid conditions. The role of the kidney in multiorgan dysfunction is unclear, particularly in regard to intraventricular hemorrhage (IVH). We hypothesized that infants diagnosed with acute kidney injury (AKI) have an increased risk of IVH independent of gestational age (GA) and other variables associated with both comorbidities. This prospective cohort study consisted of 125 infants with a birth weight ≤1,200 g and/or GA ≤31 weeks. A definition of AKI was used from KDIGO, not including urine output as nonoliguria is common in this population. IVH was based on serial head ultrasounds. Neonates with AKI had a higher trend towards having IVH compared to those without [14/35 (40%) vs. 22/83 (26.5%), p = 0.1]. Infants with AKI were more likely to have stage 2 IVH or higher than those without AKI [12/36 (33.3%) vs. 6/82 (7.3%); p < 0.01]. AKI was associated with a 3.6-fold increased risk of a grade 2 or higher IVH [hazard ratio (HR) 3.55, 95% confidence interval (CI) 1.39-9.07] and over 4-fold increase in risk of a grade 3 or higher IVH (HR 4.34, 95% CI 1.43-13.21). While there was no association between AKI and IVH overall, those with AKI had a higher hazard ratio to develop a grade 2 or higher IVH even when controlling for birth weight, antenatal steroid use, and 5-min Apgar score. Future studies are indicated to expand sample size and to control for other clinical variables that could be associated with both AKI and IVH. © 2016 S. Karger AG, Basel.

  8. The birth rate of hypospadias in the Turku area in Finland

    DEFF Research Database (Denmark)

    Virtanen, H E; Kaleva, M; Haavisto, A M

    2001-01-01

    Reports based on national registers of congenital malformations have suggested that the birth rate of hypospadias has increased during the last few decades. Register-based information may, however, have pitfalls because of changes in diagnostics, reporting accuracy and registration system. The aim...... of this study was to determine the current birth rate of hypospadias in Turku University Central Hospital (TUCH) in Finland. This was a prospective study on live-born boys born in TUCH from 1997 to 1999. In the total birth cohort (n=5,798) as well as in a special subcohort group (n=1,505) 0.3% of boys had...... hypospadias. Only one scrotal hypospadias was found in a boy who had a chromosomal anomaly. Other hypospadias were glandular or coronal. No increase was found in the birth rate of hypospadias when comparing our result with register-based data of boys born in Finland during the years 1970 to 1986...

  9. Variations in breastfeeding rates for very preterm infants between regions and neonatal units in Europe

    DEFF Research Database (Denmark)

    Bonet, Mercedes; Blondel, Béatrice; Agostino, Rocco

    2011-01-01

    To compare breastfeeding rates at discharge for very preterm infants between European regions and neonatal units, and to identify characteristics associated with breast feeding using multilevel models.......To compare breastfeeding rates at discharge for very preterm infants between European regions and neonatal units, and to identify characteristics associated with breast feeding using multilevel models....

  10. Body composition from birth to 6 mo of age in Ethiopian infants

    DEFF Research Database (Denmark)

    Andersen, Gregers Stig; Girma, Tsinuel; Wells, Jonathan C

    2013-01-01

    Data on body composition in infancy may improve the understanding of the relation between variability in fetal and infant growth and disease risk through the life course. Although new assessment techniques have recently become available, body composition is rarely described in infants from low-in...

  11. Iron overload in very low birth weight infants: Serum Ferritin and adverse outcomes

    LENUS (Irish Health Repository)

    Barrett, M

    2011-11-01

    Adequate iron isessential for growth and haematpoiesis. Oral iron supplementation is the standard of care in VLBW infants. Post mortem evidence has confirmed significant iron overload. Excessive free iron has been associated with free radical formation and brain injury in term infants.

  12. Human milk feeding supports adequate growth in infants birth weight

    Science.gov (United States)

    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 ...

  13. Developmental Changes in Mother-Infant Face-to-Face Communication: Birth to 3 Months.

    Science.gov (United States)

    Lavelli, Manuela; Fogel, Alan

    2002-01-01

    Investigated development of face-to-face communication in infants between 1 and 14 weeks old and their mothers. Found a curvilinear development of early face-to-face communication, with increases occurring between weeks 4 and 9. When placed on a sofa, infants' face-to-face communication was longer than when they were held. Girls spent a longer…

  14. The Growth of Very-low-birth-weight Infants at 5 Years Old in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Wei Wang

    2014-04-01

    Conclusion: The growth of VLBW infants was lower than that of healthy full-term infants through 5 years of age. The cognitive performance for VLBW children was also decreased compared to that of the control group, and there was an association between slower growth and decreased cognitive ability.

  15. An increasing proportion of infants weight more than 4000 grams at birth

    DEFF Research Database (Denmark)

    Ørskou, J.; Kesmodel, Ulrik; Henriksen, Tine Brink

    2001-01-01

    Background. To investigate how mean birthweight has changed in the past decade, and to describe changes in the proportion of infants with a birthweight above 4000 grams (g). Methods. We analyzed data on 43,561 singleton infants born between 1990 and 1999 at Aarhus University Hospital, Denmark...

  16. Infant's sex, birth control policy and postpartum well-being: a prospective cohort study in Shanghai, China.

    Science.gov (United States)

    Hua, Jing; Zhu, Liping; Du, Wenchong; Du, Li; Luo, Ting; Wu, Zhuochun

    2016-10-06

    The majority of Chinese families were under either one-child or two-child birth control policy status from 2001 to 2015. We explore the association between an infant's sex and the mother's postpartum well-being, which may be moderated by birth control policy status in China. We conducted a prospective cohort study in Shanghai City, one of the largest cities in China. A total number of 1730 childbearing women from eight obstetric hospitals across Shanghai were included in the study at baseline, with 1503 women completing the survey 7 days postpartum in 2013. The General Well-Being Schedule (GWBS) was used to assess maternal well-being at baseline and follow-up investigation in the study. The women's demographic, clinical characteristics, and well-being were measured at baseline. Maternal satisfaction and postpartum well-being were assessed in the follow-up survey. Multivariable linear regression analyses showed that women who gave birth to male infants were positively associated with the total score of maternal well-being, when the participating hospitals, maternal well-being at baseline, sociodemographic characteristics, and maternal and infant health outcomes were added to the adjustments (β=1.462, pchild policy status was added to the adjustments (p>0.05). The results of a multiple logistic regression model showed that having a male infant was a risk factor of 'severe distress' (OR=1.607, pchild policy status (p>0.05). Our results emphasise the importance of conducting interventions to increase maternal general well-being, especially for those with a female infant in a society such as China where preference is for a son, and enhance the necessity of sustainability of a newly relaxed two-child policy which allows more couples to have a second child in China. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Vitamin A supplementation to prevent mortality and short- and long-term morbidity in very low birth weight infants.

    Science.gov (United States)

    Darlow, Brian A; Graham, P J; Rojas-Reyes, Maria Ximena

    2016-08-22

    Vitamin A is necessary for normal lung growth and the integrity of respiratory tract epithelial cells. Preterm infants have low vitamin A status at birth and this has been associated with an increased risk of developing chronic lung disease. To evaluate supplementation with vitamin A on the incidence of death or neonatal chronic lung disease and long-term neurodevelopmental disability in very low birth weight (VLBW) infants compared with a control (placebo or no supplementation), and to consider the effect of the supplementation route, dose, and timing. For the original review and subsequent updates, we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, Science Citation Index, and the Oxford Database of Perinatal Trials. The reference lists of relevant trials, paediatric and nutrition journals, and conference abstracts and proceedings were handsearched up to 2010.For the 2016 update, we used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 4), MEDLINE via PubMed (1 May 2016), EMBASE (1 May 2016), and CINAHL (1 May 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised controlled trials comparing vitamin A supplementation with a control (placebo or no supplementation) or other dosage regimens in VLBW infants (birth weight ≤ 1500 grams or less than 32 weeks' gestation). Two review authors screened the search results, extracted data, and assessed the trials for risk of bias. Results were reported as risk ratios (RR), risk differences (RD), and number needed to treat to benefit (NNTB), all with 95% confidence intervals (CI). Trialists were contacted for additional data. Eleven trials met the inclusion criteria. Ten trials (1460 infants) compared vitamin A supplementation with a

  18. Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant.

    LENUS (Irish Health Repository)

    Moran, M

    2012-02-01

    BACKGROUND: Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation. AIM: To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life. METHODS: A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL\\/kg\\/min. cTOI was measured using NIRO 200 Hamamatsu. RESULTS: Twenty-seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29\\/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57-1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs\\/kg\\/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p-value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra- and extracardiac shunts. CONCLUSION: There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.

  19. Blood Cytokine Profiles Associated with Distinct Patterns of Bronchopulmonary Dysplasia among Extremely Low Birth Weight Infants.

    Science.gov (United States)

    D'Angio, Carl T; Ambalavanan, Namasivayam; Carlo, Waldemar A; McDonald, Scott A; Skogstrand, Kristin; Hougaard, David M; Shankaran, Seetha; Goldberg, Ronald N; Ehrenkranz, Richard A; Tyson, Jon E; Stoll, Barbara J; Das, Abhik; Higgins, Rosemary D

    2016-07-01

    To explore differences in blood cytokine profiles among distinct bronchopulmonary dysplasia (BPD) patterns. We evaluated blood spots collected from 943 infants born at ≤1000 g and surviving to 28 days on postnatal days 1, 3, 7, 14, and 21 for 25 cytokines. Infants were assigned to the following lung disease patterns: (1) no lung disease (NLD); (2) respiratory distress syndrome without BPD; (3) classic BPD (persistent exposure to supplemental oxygen until 28 days of age); or (4) atypical BPD (period without supplemental oxygen before 28 days). Median cytokine levels for infants with BPD were compared with the IQR of results among infants with NLD. The distribution of enrolled infants by group was as follows: 69 (NLD), 73 (respiratory distress syndrome), 381 (classic BPD), and 160 (atypical BPD). The remaining 260 infants could not be classified because of missing data (104) or not fitting a predefined pattern (156). Median levels of 3 cytokines (elevated interleukin [IL]-8, matrix metalloproteinase-9; decreased granulocyte macrophage colony-stimulating factor) fell outside the IQR for at least 2 time points in both infants with atypical and classic BPD. Profiles of 7 cytokines (IL-6, IL-10, IL-18, macrophage inflammatory protein-1α, C-reactive protein, brain-derived neurotrophic factor, regulated on activation, normal T cell expressed and secreted) differed between infants with classic and atypical BPD. Blood cytokine profiles may differ between infants developing classic and atypical BPD. These dissimilarities suggest the possibility that differing mechanisms could explain the varied patterns of pathophysiology of lung disease in extremely premature infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Do Infant Birth Outcomes Vary Among Mothers With and Without Health Insurance Coverage in Sub-Saharan Africa? Findings from the National Health Insurance and Cash and Carry Eras in Ghana, West Africa

    Directory of Open Access Journals (Sweden)

    Abdallah Ibrahim, DrPH

    2014-06-01

    Full Text Available Background: Beginning in the late 1960’s, and accelerating after 1985, a system known as “Cash and Carry” required the people of Ghana to pay for health services out-of-pocket before receiving them. In 2003, Ghana enacted a National Health Insurance Scheme (NHIS (fully implemented by 2005 that allowed pregnant women to access antenatal care and hospital delivery services for low annual premiums tied to income. The objective of this study was to compare trends in low birth weight (LBW among infants born under the NHIS with infants born during the Cash and Carry system when patients paid out-of-pocket for maternal and child health services. Methods: Sampled birth records abstracted from birth folders at the Tamale Teaching Hospital (TTH were examined. Chi-squared tests were performed to determine differences in the prevalence of LBW. A p-value of ≤ 0.05 was considered statistically significant. Analyses were conducted for selected variables in each year from 2000 to 2003 (Cash and Carry and 2008 to 2011(NHIS. Results: Higher birth weights were not observed for deliveries under NHIS compared to those under Cash and Carry. More than one-third of infants in both eras were born to first-time mothers, and they had a significantly higher prevalence of LBW compared to infants born to multiparous mothers. Conclusion and Global Health Implications: Understanding the factors that affect the prevalence of LBW is crucial to public health policy makers in Ghana. LBW is a powerful predictor of infant survival, and therefore, an important factor in determining the country’s progress toward meeting the United Nations Millennium Development Goal of reducing under-five child mortality rates (MDG4 by the end of 2015.

  1. Contribution of maternal age to preterm birth rates in Denmark and Quebec, 1981-2008

    DEFF Research Database (Denmark)

    Auger, Nathalie; Hansen, Anne V; Mortensen, Laust Hvas

    2013-01-01

    to 29 years, whereas rates decreased or remained stable in women aged 35 years and older. The overall increase over time was driven by age-specific PTB rates, although the contribution of younger women was countered by fewer births at this age in both Denmark and Quebec. CONCLUSIONS: PTB rates increased...

  2. Effects of Multiple Ventilation Courses and Duration of Mechanical Ventilation on Respiratory Outcomes in Extremely Low-Birth-Weight Infants.

    Science.gov (United States)

    Jensen, Erik A; DeMauro, Sara B; Kornhauser, Michael; Aghai, Zubair H; Greenspan, Jay S; Dysart, Kevin C

    2015-11-01

    Extubation failure is common in extremely preterm infants. The current paucity of data on the adverse long-term respiratory outcomes associated with reinitiation of mechanical ventilation prevents assessment of the risks and benefits of a trial of extubation in this population. To evaluate whether exposure to multiple courses of mechanical ventilation increases the risk of adverse respiratory outcomes before and after adjustment for the cumulative duration of mechanical ventilation. We performed a retrospective cohort study of extremely low-birth-weight (ELBW; birth weight mechanical ventilation. Analysis was conducted between November 2014 and February 2015. Data were obtained from the Alere Neonatal Database. The primary study exposures were the cumulative duration of mechanical ventilation and the number of ventilation courses. The primary outcome was bronchopulmonary dysplasia (BPD) among survivors. Secondary outcomes were death, use of supplemental oxygen at discharge, and tracheostomy. We identified 3343 ELBW infants, of whom 2867 (85.8%) survived to discharge. Among the survivors, 1695 (59.1%) were diagnosed as having BPD, 856 (29.9%) received supplemental oxygen at discharge, and 31 (1.1%) underwent tracheostomy. Exposure to a greater number of mechanical ventilation courses was associated with a progressive increase in the risk of BPD and use of supplemental oxygen at discharge. Compared with a single ventilation course, the adjusted odds ratios for BPD ranged from 1.88 (95% CI, 1.54-2.31) among infants with 2 ventilation courses to 3.81 (95% CI, 2.88-5.04) among those with 4 or more courses. After adjustment for the cumulative duration of mechanical ventilation, the odds of BPD were only increased among infants exposed to 4 or more ventilation courses (adjusted odds ratio, 1.44; 95% CI, 1.04-2.01). The number of ventilation courses was not associated with increased risk of supplemental oxygen use at discharge after adjustment for the length of ventilation

  3. Vitamin A supplementation for prevention of bronchopulmonary dysplasia in very-low-birth-weight premature Thai infants: a randomized trial.

    Science.gov (United States)

    Kiatchoosakun, Pakaphan; Jirapradittha, Junya; Panthongviriyakul, M Charnchai; Khampitak, Tueanjit; Yongvanit, Puangrat; Boonsiri, Patcharee

    2014-10-01

    Bronchopulmonary dysplasia (BPD) is one ofthe most significant complications among very-low-birth-weight (VLBW) premature infants. Vitamin A deficiency increases the risk of BPD in VLBWinfants. To assess the effect of vitamin A supplementation for prevention of bronchopulmonary dysplasia in VLBW premature Thai infants. Randomized control trial. Eighty premature infants weighing supplementation at 24 hours ofage-admitted to Neonatal units ofSrinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand-were assigned to receive either intramuscular vitaminA 5, 000 IU3 times/week (treatment group) or sham procedure (control group) for four weeks. Serum vitamin A levels were measured before and after administration of the vitamin A. The baseline of mean serum vitamin A levels were similar in both groups. The mean serum level of vitamin A was significantly higher in the vitamin A supplemented infants than in the control infants on day 7 (1.41 +/- 0.48 vs. 0.92+0.38 pmol/ L, psupplementation. None of the infants in the vitamin A supplemented group, compared to 5% of the infants in the control group, had vitamin A level supplemented group required oxygen supplementation at 36 weeks postmenstrual age than in the control group albeit not statistically significant (22.5 vs. 35% relative risk 0.71; 95% CI 0.40 +/- 1.26; p = 0.21). Supplementation with vitamin A was also associated with a significant reduction in the duration ofintubation (10.8 +/- 3.1 days vitamin A supplemented group vs. 26.1 +/- 6.4 days control group, p = 0.03), days on oxygen therapy (29.8 +/- 5.1 days vitamin A supplemented group vs. 58.2 +/- 9.1 days control group, p = 0.01) and length of hospital stay (61.9 +/- 4.2 days vitamin A supplemented group vs. 88.3 +/- 7.2 days control group, p = 0.002). The dose of vitamin A used in this study reduced biochemical evidence of vitamin A deficiency and, without complications, resulted in reducing duration of intubation, days of oxygen therapy, and length of

  4. Birth rates among male cancer survivors and mortality rates among their offspring : a population-based study from Sweden

    NARCIS (Netherlands)

    Tang, Siau-Wei; Liu, Jenny; Juay, Lester; Czene, Kamila; Miao, Hui; Salim, Agus; Verkooijen, Helena M|info:eu-repo/dai/nl/213707705; Hartman, Mikael

    2016-01-01

    BACKGROUND: With improvements in treatment of cancer, more men of fertile age are survivors of cancer. This study evaluates trends in birth rates among male cancer survivors and mortality rates of their offspring. METHODS: From the Swedish Multi-generation Register and Cancer Register, we identified

  5. Milk protein quantity and quality in low-birth-weight infants. IV. Effects on tyrosine and phenylalanine in plasma and urine.

    Science.gov (United States)

    Rassin, D K; Gaull, G E; Räihä, N C; Heinonen, K

    1977-03-01

    Well, appropriate-for-gestational age, low-birth-weight infants were divided into three gestational age groups and assigned randomly within each age group to one of five feeding regimens: pooled human milk (BM); formula 1 (F1) = 1.5 gm/dl protein, 60 parts bovine whey proteins: 40 parts bovine caseins; F2 = 3.0 gm/dl, 60:40; F3 = 1.5 gm/dl, 18:82; F4 = 3.0 gm/dl, 18:82. Plasma and urine concentrations of tyrosine and phenylalanine were far higher in the infants fed F1 to F4, especially F2 and F4, than in the infants fed BM. These findings offer further evidence for the limited capacity of the low-birth-weight infant to catabolize tyrosine. Infants fed F3 had significantly higher plasma tyrosine concentrations than infants fed F1, and those fed F4 had higher concentrations than those fed F2. Thus, increased plasma tyrosine concentrations in low-birth-weight infants are related directly both to the quantity and to the quality of the protein in their diets.

  6. Hyperglycaemia Among Nigerian Infants Weighing Less Than 1,500 Grammes at Birth: A Retrospective Assessment of the Clinical Data

    Directory of Open Access Journals (Sweden)

    Onyiriuka Alphonsus N.

    2014-06-01

    Full Text Available Background and Aims: In very low birthweight (VLBW infants, birthweight < 1,500g, hyperglycaemia is associated with increased rates of mortality and morbidity. Our study aimed at determining the prevalence of hyperglycaemia among VLBW infants and describing their clinical characteristics. Methods: A retrospective chart review of all inborn VLBW infants was performed. Information obtained included birthweight, gestational age (best obstetric record, gender, and history of chorioamnionitis/maternal medical disorders, type and rates of intravenous fluid administration. Blood glucose level ≥ 7 mmol/L on at least two occasions defined hyperglycaemia. Results: Of the 279 blood glucose values, obtained from 93 infants, 91 (32.6%; 95% CI = 27.1% -38.1% were in the hyperglycaemic range, with the majority (61.5% occurring in the first 48 hours of life. The frequency of hyperglycaemia was significantly associated with a rate of infusion greater than 0.4g/kg/hour (Odds Ratio, OR = 3.76; 95% CI=1.58-8.94 and a positive history of maternal chorioamnionitis (OR = 3.04; 95%CI= 1.15-8.01. Conclusion: In the first 48 hours of life, hyperglycaemia co-existing with or complicating primary illnesses was common in VLBW infants who had dextrose infusion and a positive history of maternal chorioamnionitis

  7. Changes in haemoglobin levels in infants in Malawi: effect of low birth weight and fetal anaemia

    NARCIS (Netherlands)

    le Cessie, S.; Verhoeff, F. H.; Mengistie, G.; Kazembe, P.; Broadhead, R.; Brabin, B. J.

    2002-01-01

    Objectives: To examine the effect of low birth weight (LBW) and fetal anaemia (FA) on haemoglobin (Hb) patterns in infancy. To study the additional contribution of other risk factors known at birth. To examine the effect of iron supplementation during infancy on Hb levels. Methods: A stratified

  8. Investigating recent trends in the U.S. teen birth rate.

    Science.gov (United States)

    Kearney, Melissa S; Levine, Phillip B

    2015-05-01

    We investigate trends in the U.S. rate of teen childbearing between 1981 and 2010, focusing specifically on the sizable decline since 1991. We focus on establishing the role of state-level demographic changes, economic conditions, and targeted policies in driving recent aggregate trends. We offer three main observations. First, the recent decline cannot be explained by the changing racial and ethnic composition of teens. Second, the only targeted policies that have had a statistically discernible impact on aggregate teen birth rates are declining welfare benefits and expanded access to family planning services through Medicaid, but these policies can account for only 12.6 percent of the observed decline since 1991. Third, higher unemployment rates lead to lower teen birth rates and can account for 16 percent of the decline in teen birth rates since the Great Recession began. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Comparison of Obstetric Outcome in Terms of the Risk of Low Birth Weight, Preterm Delivery, Cesarean Section Rate and Anemia in Primigravid Adolescents and Older Primigravida

    International Nuclear Information System (INIS)

    Naz, U.

    2014-01-01

    Objective: To compare the obstetric outcome in terms of risk of low birth weight, preterm delivery, cesarean section rate and anemia in primigravid adolescents and older primigravida. Study Design: Cohort study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore, from July to December 2012. Methodology: Three hundred primigravid women presenting to department of obstetrics and gynecology of Sir Ganga Ram Hospital, Lahore, having live singleton pregnancy, including 150 adolescents (A/sup 2/ 19 years) and 150 adults (A/sup 3/ 20 years) were studied. Obstetric outcome in terms of gestational age at delivery, infant's birth weight, presence of anemia and cesarean section rate was compared between two groups. Results were analyzed using Statistical Package for Social Sciences (SPSS) version 16. Chi-square test was applied with 0.05 as level of significance. Results: The mean age of adolescent subjects was 17.3 + 1.5 years and of adults 25.6 + 3.4 years. Mean gestational age at delivery was similar in two groups (39.2 weeks and 39.4 weeks, p = 0.37). Adolescents were more likely to have a preterm delivery (11.2% vs. 4.9%, p = 0.04) and low birth weight infants (19.3% vs. 8.2%, p = 0.005) than adults. Adolescents were more likely to be anemic (46% vs. 32%, p = 0.01) than adults. However, cesarean section rate was not statistically different between two groups. Conclusion: This study showed that primiparous adolescents have significantly higher risk of adverse pregnancy outcomes such as preterm delivery, low birth weight infants and anemia as compared to adult primiparas. (author)

  10. Chorioamnionitis and lung damage in the extremely low birth weight infant

    Directory of Open Access Journals (Sweden)

    Gustavo Rocha

    2007-09-01

    Full Text Available Some experimental work suggests that exposure to intrauterine infection is associated, not only, with lung maturation and a reduced risk of respiratory distress syndrome, but also, with delayed alveolarization and increased risk of bronchopulmonary dysplasia. Aim: To evaluate the association between histological chorioamnionitis and lung disease in extremely low birth weight preterm infants. Methods: A retrospective chart review of 63 less than 1000 g birthweight, appropriated for gestational age neonates, delivered at three tertiary medical centers in the north of Portugal, between 2001 and 2002. The association between histological chorioamnionitis and lung damage (respiratory distress syndrome and bronchopulmonary dysplasia was evaluated through the calculation of crude and adjusted odds ratio. Results: There were 32 newborns from mothers with histological chorioamnionitis and 31 without the condition. The association between histological chorioamnionitis and respiratory distress syndrome was OR 0.23 (95% CI 0.01 – 2.51. The association between chorioamnionitis and bronchopulmonary dysplasia was OR 1.61 (95% CI 0.38 – 6.97. The association between histological chorioamnionitis and bronchopulmonary dysplasia when adjusted for gestational age, multiple birth and C-section revealed no statistical significance: OR 2.66 (95% CI 0.36 – 19.60 for chorioamnionitis without funisitis or vasculitis and OR 1.68 (95% CI 0.25 – 11.18 for funisitis and/or vasculitis. Conclusion: In this study we could not confirm a decreased risk of respiratory distress syndrome nor an increased risk of bronchopulmonary dysplasia in extremely low birth weight preterm neonates with histological chorioamnionitis. Resumo: Alguns estudos experimentais sugerem que a exposição a infecção intra-uterina associa-se, não só, a maturação pulmonar e menor risco de doença das membranas hialinas, mas também a atraso na forma

  11. Early motor repertoire in very low birth weight infants in India is associated with motor development at one year.

    Science.gov (United States)

    Adde, Lars; Thomas, Niranjan; John, Hima B; Oommen, Samuel; Vågen, Randi Tynes; Fjørtoft, Toril; Jensenius, Alexander Refsum; Støen, Ragnhild

    2016-11-01

    Most studies on Prechtl's method of assessing General Movements (GMA) in young infants originate in Europe. To determine if motor behavior at an age of 3 months post term is associated with motor development at 12 months post age in VLBW infants in India. 243 VLBW infants (135 boys, 108 girls; median gestational age 31wks, range 26-39wks) were video-recorded at a median age of 11wks post term (range 9-16wks). Certified and experienced observers assessed the videos by the "Assessment of Motor Repertoire - 2-5 Months". Fidgety movements (FMs) were classified as abnormal if absent, sporadic or exaggerated, and as normal if intermittently or continually present. The motor behaviour was evaluated by repertoire of co-existent other movements (age-adequacy) and concurrent motor repertoire. In addition, videos of 215 infants were analyzed by computer and the variability of the spatial center of motion (C SD ) was calculated. The Peabody Developmental Motor Scales was used to assess motor development at 12 months. Abnormal FMs, reduced age adequacy, and an abnormal concurrent motor repertoire were significantly associated with lower Gross Motor and Total Motor Quotient (GMQ, TMQ) scores (p < 0.05). The C SD was higher in children with TMQ scores <90 (-1SD) than in children with higher TMQ scores (p = 0.002). Normal FMs (assessed by Gestalt perception) and a low variability of the spatial center of motion (assessed by computer-based video analysis) predicted higher Peabody scores in 12-month-old infants born in India with a very low birth weight. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  12. Microbial succession in the gut: directional trends of taxonomic and functional change in a birth cohort of Spanish infants.

    Science.gov (United States)

    Vallès, Yvonne; Artacho, Alejandro; Pascual-García, Alberto; Ferrús, Maria Loreto; Gosalbes, María José; Abellán, Juan José; Francino, M Pilar

    2014-06-01

    In spite of its major impact on life-long health, the process of microbial succession in the gut of infants remains poorly understood. Here, we analyze the patterns of taxonomic and functional change in the gut microbiota during the first year of life for a birth cohort of 13 infants. We detect that individual instances of gut colonization vary in the temporal dynamics of microbiota richness, diversity, and composition at both functional and taxonomic levels. Nevertheless, trends discernible in a majority of infants indicate that gut colonization occurs in two distinct phases of succession, separated by the introduction of solid foods to the diet. This change in resource availability causes a sharp decrease in the taxonomic richness of the microbiota due to the loss of rare taxa (p = 2.06e-9), although the number of core genera shared by all infants increases substantially. Moreover, although the gut microbial succession is not strictly deterministic, we detect an overarching directionality of change through time towards the taxonomic and functional composition of the maternal microbiota. Succession is however not complete by the one year mark, as significant differences remain between one-year-olds and their mothers in terms of taxonomic (p = 0.009) and functional (p = 0.004) microbiota composition, and in taxonomic richness (p = 2.76e-37) and diversity (p = 0.016). Our results also indicate that the taxonomic composition of the microbiota shapes its functional capacities. Therefore, the observed inter-individual variability in taxonomic composition during succession is not fully compensated by functional equivalence among bacterial genera and may have important physiological consequences. Finally, network analyses suggest that positive interactions among core genera during community assembly contribute to ensure their permanence within the gut, and highlight an expansion of complexity in the interactions network as the core of taxa shared by all infants grows

  13. Planned birth at or near term for improving health outcomes for pregnant women with pre-existing diabetes and their infants.

    Science.gov (United States)

    Biesty, Linda M; Egan, Aoife M; Dunne, Fidelma; Smith, Valerie; Meskell, Pauline; Dempsey, Eugene; Ni Bhuinneain, G Meabh; Devane, Declan

    2018-02-09

    Pregnant women with pre-existing diabetes (Type 1 or Type 2) have increased rates of adverse maternal and neonatal outcomes. Current clinical guidelines support elective birth, at or near term, because of increased perinatal mortality during the third trimester of pregnancy.This review replaces a review previously published in 2001 that included "diabetic pregnant women", which has now been split into two reviews. This current review focuses on pregnant women with pre-existing diabetes (Type 1 or Type 2) and a sister review focuses on women with gestational diabetes. To assess the effect of planned birth (either by induction of labour or caesarean birth) at or near term gestation (37 to 40 weeks' gestation) compared with an expectant approach, for improving health outcomes for pregnant women with pre-existing diabetes and their infants. The primary outcomes relate to maternal and perinatal mortality and morbidity. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (15 August 2017), and reference lists of retrieved studies. We planned to include randomised trials (including those using a cluster-randomised design) and non-randomised trials (e.g. quasi-randomised trials using alternate allocation) which compared planned birth, at or near term, with an expectant approach for pregnant women with pre-existing diabetes. Two of the review authors independently assessed study eligibility. In future updates of this review, at least two of the review authors will extract data and assess the risk of bias in included studies. We will also assess the quality of the evidence using the GRADE approach. We identified no eligible published trials for inclusion in this review.We did identify one randomised trial which examined whether expectant management reduced the incidence of caesarean birth in uncomplicated pregnancies of women with gestational diabetes (requiring insulin) and with

  14. Trends in Birth Weight and Gestational Age for Infants Born to HIV-infected, Antiretroviral Treatment-Naïve Women in Malawi

    Science.gov (United States)

    Taha, Taha E.; Dadabhai, Sufia S.; Rahman, M. Hafizur; Sun, Jin; Kumwenda, Johnstone; Kumwenda, Newton I.

    2012-01-01

    Background We analyzed birth outcomes among infants of treatment-naïve, HIV-infected women from a series of mother-to-child transmission of HIV studies in Blantyre, Malawi. Methods Data from six prospective studies at one research site were analyzed. Mean birth weight (BW) and gestational age (GA), and frequency of low birth weight (LBW; <2500 g) and preterm (PT) birth (GA<37 weeks) were estimated. We assessed risk factors for LBW and PT birth using mixed-effects logistic regression. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) from earlier studies (1989-94) and later studies (2000-07) are presented separately. Results The analysis included 8874 HIV-exposed infants. Mean BW and GA ranged from 2793 to 3079 g, and 37.8 to 39.0 weeks. Greater maternal age was consistently (during both the early and late periods) associated with lower odds of LBW and PT birth; AOR (95% CI) for both outcomes in the early and late periods, respectively, were 0.98 (0.96-1.00) and 0.97 (0.95-0.99). Female infant gender was consistently associated with higher odds of PT birth during both periods and with higher odds of LBW during the later period. During the early period, higher maternal education was associated with lower odds of LBW (AOR 0.67 (0.48-0.95)) and PT birth (AOR 0.70 (0.51-0.95)) and later birth year was associated with lower odds of PT birth (AOR 0.35 (0.19-0.70)). Conclusions BW and GA remained stable within each time period. This analysis provides important baseline information for monitoring HIV treatment effects on birth outcomes. Modifiable factors affecting BW and GA should continue to be explored. PMID:22327871

  15. Parity Specific Birth Rates for West Germany: An Attempt to Combine Survey Data and Vital Statistics

    OpenAIRE

    Kreyenfeld, Michaela

    2014-01-01

    In this paper, we combine vital statistics and survey data to obtain parity specific birth rates for West Germany. Since vital statistics do not provide birth parity information, one is confined to using estimates. The robustness of these estimates is an issue, which is unfortunately only rarely addressed when fertility indicators for (West) Germany are reported. In order to check how reliable our results are, we estimate confidence intervals and compare them to results from survey data and e...

  16. Prenatal and neonatal variables associated with enamel hypoplasia in deciduous teeth in low birth weight preterm infants

    Directory of Open Access Journals (Sweden)

    Kátia Maria Dmytraczenko Franco

    2007-12-01

    Full Text Available This study investigated possible prenatal and neonatal variables that may influence the prevalence of tooth enamel hypoplasia in preterm and low birth weight children (LBW and a matched control group of term children with normal birth weight (NBW. The study sample consisted of 61 children born preterm and with LBW examined at 18-34 months of age. The control group was formed by 61 infants born full term and with NBW examined at 31-35 months of age. All children were born at the Center of Integrated Attention of Women's Health (CAISM-UNICAMP. FDI criteria were followed for dental examination. Medical data was collected retrospectively from hospital records. Among preterms, 57.4% had some type of developmental defects of enamel (DDE, 52.5 % had opacities and 21.3 % presented hypoplasia. Among full-term children, 24.6% presented DDE, 24.6% had opacities and 3.3% had hypoplasia. LBW preterm infants presented a higher prevalence of hypoplasia than NBW controls. The deciduous teeth most affected by hypoplasia were maxillary incisors. There was no significant association with prenatal variables; among neonatal variables there was a significant association with respiratory distress syndrome and neurological examination at discharge with an altered result.

  17. Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants.

    Science.gov (United States)

    Biesty, Linda M; Egan, Aoife M; Dunne, Fidelma; Dempsey, Eugene; Meskell, Pauline; Smith, Valerie; Ni Bhuinneain, G Meabh; Devane, Declan

    2018-01-05

    Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestational diabetes to minimise perinatal complications, especially those related to macrosomia.This review replaces a review previously published in 2001 that included "diabetic pregnant women", which has now been split into two reviews. This current review focuses on pregnant women with gestational diabetes and a sister review focuses on women with pre-existing diabetes (Type 1 or Type 2). To assess the effect of planned birth (either by induction of labour or caesarean birth), at or near term (37 to 40 weeks' gestation) compared with an expectant approach for improving health outcomes for women with gestational diabetes and their infants. The primary outcomes relate to maternal and perinatal mortality and morbidity. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (15 Augus