WorldWideScience

Sample records for extremely low-birthweight infants

  1. Outcomes of extremely low birthweight infants with acidosis at birth.

    Science.gov (United States)

    Randolph, David A; Nolen, Tracy L; Ambalavanan, Namasivayam; Carlo, Waldemar A; Peralta-Carcelen, Myriam; Das, Abhik; Bell, Edward F; Davis, Alexis S; Laptook, Abbot R; Stoll, Barbara J; Shankaran, Seetha; Higgins, Rosemary D

    2014-07-01

    To test the hypothesis that acidosis at birth is associated with the combined primary outcome of death or neurodevelopmental impairment (NDI) in extremely low birthweight (ELBW) infants, and to develop a predictive model of death/NDI exploring perinatal acidosis as a predictor variable. The study population consisted of ELBW infants born between 2002 and 2007 at National Institute of Child Health and Development (NICHD) Neonatal Research Network hospitals. Infants with cord blood gas data and documentation of either mortality prior to discharge or 18-22 month neurodevelopmental outcomes were included. Multiple logistic regression analysis was used to determine the contribution of perinatal acidosis, defined as a cord blood gas with a pHacidosis is significantly associated with death/NDI in ELBW infants. Perinatal acidosis is infrequent in ELBW infants, however, and other factors are more important in predicting death/NDI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Trace elements and antioxidant enzymes in extremely low birthweight infants.

    Science.gov (United States)

    Loui, Andrea; Raab, Andrea; Maier, Rolf F; Brätter, Peter; Obladen, Michael

    2010-04-01

    Oxygen radicals are believed to contribute to typical diseases of prematurity, such as bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH), retinopathy of prematurity (ROP) and necrotising enterocolitis (NEC). Our aim was to investigate whether these disorders are associated with disturbances in antioxidant enzyme activities and with low trace elements, which are co-factors of antioxidant enzymes. 209 infants with birthweight less than 1000g were enrolled into a European multicentre randomised erythropoietin (rhEPO) trial; 155 developed one or more of the above mentioned diseases. We analysed Zn, Cu, Fe, Se in plasma and red blood cells (RBCs), superoxide dismutase (CuZn-SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) in RBCs on the 3rd and 68th day of life. Zn, Fe, Se in plasma, and Se in RBCs decreased (p<0.01), and Zn in RBC (p<0.001), CuZn-SOD (p<0.01) and CAT increased (p<0.05), whereas GSH-Px remained unchanged. No differences were observed between the rhEPO and control groups. Antioxidant enzyme activities did not correlate with gestational age. In infants with BPD, IVH, ROP, or NEC, CuZn-SOD and CAT (p<0.05) were higher at day 68 than in infants without these diseases. CuZn-SOD and GSH-Px at 3 days and CuZn-SOD at 68 days correlated positively (p<0.05) with the duration of oxygen treatment. In conclusion, in ELBW infants, trace element concentrations decreased over the first 10 weeks of life. Lower trace element concentrations, did not affect the activities of CuZn-SOD, GSH-Px, and CAT. Typical diseases of prematurity were not associated with decreased antioxidant enzyme activities.

  3. Permissive hypotension in the extremely low birthweight infant with signs of good perfusion.

    LENUS (Irish Health Repository)

    Dempsey, E M

    2012-01-31

    INTRODUCTION: Many practitioners routinely treat infants whose mean arterial blood pressure in mm Hg is less than their gestational age in weeks (GA). OBJECTIVE: To assess the effectiveness of utilising a combined approach of clinical signs, metabolic acidosis and absolute blood pressure (BP) values when deciding to treat hypotension in the extremely low birthweight (ELBW) infant. METHODS: Retrospective cohort study of all live born ELBW infants admitted to our neonatal intensive care unit over a 4-year period. Patients were grouped as either normotensive (BP never less than GA), hypotensive and not treated (BPinfants during the first 24 h. Infants hypotensive on GA criteria but with clinical evidence of good perfusion had as good an outcome as normotensive patients. Treated low blood pressure was associated with adverse outcome.

  4. Ventriculomegaly in very-low-birthweight infants with Down syndrome.

    Science.gov (United States)

    Movsas, Tammy Z; Spitzer, Alan R; Gewolb, Ira H

    2016-11-01

    The prevalence of Down syndrome in infants with fetal ventriculomegaly is 5% to 10%; however, the converse, the prevalence of cerebral ventriculomegaly in live-born infants with Down syndrome, is not well established. Because cranial ultrasounds are performed on most very-low-birthweight (VLBW) infants (birthweight Down syndrome, and whether VLBW infants with Down syndrome are at higher risk for cranial ultrasound abnormalities, compared with the already elevated risk in other VLBW infants. This study comprised retrospective analysis of data from Pediatrix BabySteps Clinical Data Warehouse. The study population consisted of 121 736 VLBW infants (61 869 males, 59 867 females), born between 1996 and 2013, of whom 441 had Down syndrome (233 males, 208 females; mean gestational age 30wks, standard deviation [SD] 2.8wks). Logistic regression was used to calculate odds of ventriculomegaly and IVH for Down syndrome. Prevalence of ventriculomegaly in Down syndrome was 5.2% compared with 0.8% in other VLBW infants. Multivariate analysis indicated 5.8× odds (95% confidence interval [CI] 3.4-9.7) of ventriculomegaly in Down syndrome and 0.9× odds (95% CI 0.7-1.1) of IVH for Down syndrome. Very preterm infants with Down syndrome are at increased risk for ventriculomegaly (but not for IVH) compared with other infants born very preterm. © 2016 Mac Keith Press.

  5. Increased enamel hypoplasia and very low birthweight infants.

    Science.gov (United States)

    Nelson, S; Albert, J M; Geng, C; Curtan, S; Lang, K; Miadich, S; Heima, M; Malik, A; Ferretti, G; Eggertsson, H; Slayton, R L; Milgrom, P

    2013-09-01

    Birth cohort studies of developmental defects of enamel (DDE) and early childhood caries (ECC) in very low birthweight (VLBW) and normal birthweight (NBW) infants are rare. In this birth cohort of 234 VLBW and 234 NBW infants, we report the incidence of ECC and DDE at 8 and 18-20 mos of corrected age. Infant medical and maternal socio-demographic data were abstracted from medical records at birth. Dental assessments for ECC and DDE (enamel hypoplasia, demarcated and diffuse opacities) were completed at 8 and 18-20 mos. The incidence of hypoplasia was significantly higher in VLBW compared with NBW infants (8 mos, 19% vs. 2%; 18 mos, 31% vs. 8%). The incidence of ECC (International Caries Detection and Assessment System: ICDAS ≥ 2) was 1.4% (8 mos) and 12% (18-20 mos) and was similar between the VLBW and NBW groups. At both ages, using a beta-binomial regression model to control for potential confounders (maternal and infant characteristics), we found increased risk for enamel hypoplasia among the VLBW infants compared with the NBW infants. African Americans had a lower risk for enamel hypoplasia at 18-20 mos. The VLBW infants should be monitored for ECC due to the presence of enamel hypoplasia.

  6. Proteinuria and glomerular hypertrophy in extremely low-birthweight children.

    Science.gov (United States)

    Hayashi, Asako; Santo, Yoko; Satomura, Kenichi

    2014-12-01

    Of late, there is an increased awareness of the frequent occurrence of hypertension or proteinuria in adults born at low birthweight. We retrospectively studied five children born with extremely low birthweight (ELBW) who were first diagnosed with proteinuria in a school urinary screening program. These children were born at 23-25 weeks of gestation, and their birthweight was 532-732 g. Proteinuria was identified in all the subjects in a school urinary screening program when they were 6-15 years old. Renal biopsy showed diffuse increase in glomerular size, consistent with glomerular hypertrophy. There were no findings of mesangial proliferation or glomerular sclerosis. All the subjects had a marked decrease in proteinuria after angiotensin receptor blocker (ARB) treatment. Reduced number of glomeruli associated with prematurity was speculated to have caused compensatory glomerular hyperfiltration, hypertrophy, and hypertension in children born with ELBW when they developed proteinuria. ARB could have been effective for proteinuria by reducing glomerular hypertension. Physicians should be aware of proteinuria in children born with ELBW because there is an increasing number of ELBW survivors as a result of advances in medical technology. © 2014 Japan Pediatric Society.

  7. Factors related to transfusion in very low birthweight infants treated with erythropoietin.

    Science.gov (United States)

    Maier, R. F.; Obladen, M.; Messinger, D.; Wardrop, C. A.

    1996-01-01

    The need for red cell transfusions is reduced but not eliminated by recombinant human erythropoietin (rhEPO) in very low birthweight (VLBW) infants. To detect factors associated with the decision to transfuse VLBW infants during rhEPO treatment and to explain rhEPO 'non-responders', the subgroup of those 120 VLBW infants who were treated with rhEPO 750 IU/kg per week in the second European Multicentre rhEPO Trial was evaluated. Sixty (50%) infants received at least one transfusion during erythropoietin treatment. Transfusion was frequent in infants with extremely low birthweight (79% for 750-999 g), low gestational age (70% for or = 1 ml/kg per day). The prognostic variables birthweight, initial haematocrit, and gestational age were found to be most predictive for transfusion. To improve rhEPO response in VLBW infants, there is a need to minimise diagnostic blood loss, to prevent iron deficiency, and to develop rational criteria for transfusion in preterm infants. PMID:8777681

  8. Vineland Adaptive Behavior Scales as a summary of functional outcome of extremely low-birthweight children.

    Science.gov (United States)

    Rosenbaum, P; Saigal, S; Szatmari, P; Hoult, L

    1995-07-01

    This study reports moderate to high Pearson correlations between Vineland Adaptive Behavior Scale (VABS) subscale and total scores and a variety of cognitive, academic and motor performance tests on a population of extremely low-birthweight infants assessed at eight years of age. The subscales describe adaptive behaviour in daily living, communication, motor function and socialization, as well as an adaptive behaviour composite score. Because it can provide a norm-referenced description of functional outcomes and can be used to assess all children regardless of disability, the authors believe that the VABS should be applied uniformly by all groups reporting school-age outcome of neonatal intensive-care populations.

  9. Motor Coordination Difficulties and Physical Fitness of Extremely-Low-Birthweight Children

    Science.gov (United States)

    Burns, Yvonne R.; Danks, Marcella; O'Callaghan, Michael J.; Gray, Peter H.; Cooper, David; Poulsen, Leith; Watter, Pauline

    2009-01-01

    Motor coordination difficulties and poor fitness exist in the extremely low birthweight (ELBW) population. This study investigated the relative impact of motor coordination on the fitness of ELBW children aged 11 to 13 years. One hundred and nine children were recruited to the study: 54 ELBW participants (mean age at assessment 12y 6mo; 31 male,…

  10. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 2: The palate of the preterm/low birthweight infant

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-10-01

    Full Text Available Abstract Background Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1. The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. Methods An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. Results Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. Conclusion There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and

  11. Neural correlates of impaired vision in adolescents born extremely preterm and/or extremely low birthweight.

    Directory of Open Access Journals (Sweden)

    Claire E Kelly

    Full Text Available BACKGROUND: Adolescents born extremely preterm (EP; <28 weeks' gestation and/or extremely low birthweight (ELBW; <1000 g experience high rates of visual impairments, however the potential neural correlates of visual impairments in EP/ELBW adolescents require further investigation. This study aimed to: 1 compare optic radiation and primary visual cortical structure between EP/ELBW adolescents and normal birthweight controls; 2 investigate associations between perinatal factors and optic radiation and primary visual cortical structure in EP/ELBW adolescents; 3 investigate associations between optic radiation and primary visual cortical structure in EP/ELBW adolescents and the odds of impaired vision. METHODS: 196 EP/ELBW adolescents and 143 controls underwent magnetic resonance imaging at a mean age of 18 years. Optic radiations were delineated using constrained spherical deconvolution based probabilistic tractography. Primary visual cortices were segmented using FreeSurfer software. Diffusion tensor variables and tract volume of the optic radiations, as well as volume, surface area and thickness of the primary visual cortices, were estimated. RESULTS: Axial, radial and mean diffusivities within the optic radiations, and primary visual cortical thickness, were higher in the EP/ELBW adolescents than controls. Within EP/ELBW adolescents, postnatal corticosteroid exposure was associated with altered optic radiation diffusion values and lower tract volume, while decreasing gestational age at birth was associated with increased primary visual cortical volume, area and thickness. Furthermore, decreasing optic radiation fractional anisotropy and tract volume, and increasing optic radiation diffusivity in EP/ELBW adolescents were associated with increased odds of impaired vision, whereas primary visual cortical measures were not associated with the odds of impaired vision. CONCLUSIONS: Optic radiation and primary visual cortical structure are altered in

  12. Physical outcome and school performance of very-low-birthweight infants treated with minimal handling and early nasal CPAP

    DEFF Research Database (Denmark)

    Dahl, Marianne; Kamper, Jens

    2006-01-01

    AIM: To describe physical outcome and school performance in a cohort of very-low-birthweight infants treated with early nasal continuous positive airway pressure (NCPAP)/minimal handling regimen with permissive hypercapnia, in comparison to siblings of normal birthweight. MATERIAL AND METHODS......: Neonatal and follow-up data from 213 very-low-birthweight infants from 1983-1988 were registered and a questionnaire concerning school achievements was sent to the families of survivors and siblings attending school. RESULTS: Mortality was 22%. Of the survivors, 4% had moderate-severe and 9% mild sequelae...

  13. Comparison of mortality risk: a score for very low birthweight infants

    Science.gov (United States)

    Maier, R; Rey, M; Metze, B; Obladen;, M; TARNOW-MORDI, W.

    1997-01-01

    AIM—To develop and evaluate a score which quantifies mortality risk in very low birthweight (VLBW) infants (birthweight below 1500 g) at admission to the neonatal intensive care unit.
METHODS—Five hundred and seventy two VLBW infants admitted from 1978 to 1987 were randomly assigned to a cohort (n = 396) for score development and a cohort (n = 176) for score validation. Two hundred and ninety four VLBW infants admitted from 1988 to 1991 were used to compare risk adjusted mortality between the two eras.
RESULTS—Using multiple regression analysis, birthweight, Apgar score at 5 minutes, base excess at admission, severity of respiratory distress syndrome, and artificial ventilation were predictive of death in the development cohort. According to regression coefficients, a score ranging from 3 to 40 was developed. At a cutoff of 21, it predicted death in the validation cohort with a sensitivity of 0.85, a specificity of 0.73, and a correct classification rate of 0.76. The area under the receiver operating characteristic curve was 0.86. There was no significant difference in risk severity and in risk adjusted mortality between the eras 1978-87 and 1988-91.
CONCLUSION—The present score is robust, easily obtainable at admission, and permits early randomisation based on mortality risk.

 Keywords: mortality risk; scoring system; very low birthweight PMID:9175942

  14. Early cessation of breast milk feeding in very low birthweight infants.

    Science.gov (United States)

    Killersreiter, B; Grimmer, I; Bührer, C; Dudenhausen, J W; Obladen, M

    2001-01-01

    This investigation was carried out to comparatively assess the duration of breast milk feeding and to analyze risk factors for early cessation of breast milk feeding in term and very preterm infants. A cohort study was performed in 89 consecutive very low birthweight (VLBW) infants (2500 g born in the same hospital matched for gender and multiplicity. Median duration of breast milk feeding, as determined from charts and questionnaires mailed to the mothers at 6 and 12 months corrected age, was 36 days in VLBW infants, compared to 112 days in control infants (P35 years and spontaneous pregnancy (as opposed to pregnancy following infertility treatment) in term infants. Multivariate analysis revealed that VLBW, smoking and low parental school education were independent negative predictors of breast milk feeding. While these results emphasize the need for special support of VLBW infant mothers promoting lactation, the relationships between smoking, school education and breast milk feeding in both strata show that efforts to increase breast milk feeding require a public health perspective.

  15. Thyroid function in very low birthweight infants after intravenous administration of the iodinated contrast medium iopromide

    Science.gov (United States)

    Dembinski, J; Arpe, V; Kroll, M; Hieronimi, G; Bartmann, P

    2000-01-01

    BACKGROUND—Thyroid function disorders have often been observed in preterm infants after intravenous administration of iodinated contrast medium. The effect on thyroid function depends on the dosage, but the choice of the contrast medium may be equally important, as there are appreciable pharmacological differences between them.
METHOD—Thyroid function was analysed in 20 very low birthweight infants of gestational age less than 30 weeks after injection of iopromide, a monomeric non-ionic iodinated contrast medium. Levels of free thyroxine and thyroid stimulating hormone were compared with those in 26 control infants.
RESULTS—Free thyroxine levels in all study infants ranged from 9.0 to 25.7 pmol/l (days 14-21) and 9.0 to 23.2 pmol/l (days 35-49), and thyroid stimulating hormone levels ranged from 0.13 to 0.26mU/l (days 14-21) and 0.26 to 11.11 mU/l (days 35-49). These levels were not altered after injection of iopromide.
CONCLUSION—The risk of transient hypothyroidism or hyperthyrotropinaemia may be reduced with the use of iopromide compared with other contrast media.

 PMID:10794789

  16. Improved neurosensory outcome at 8 years of age of extremely low birthweight children born in Victoria over three distinct eras

    OpenAIRE

    Doyle, L; Anderson, P.; t and,

    2005-01-01

    Aim: To determine neurosensory outcome at 8 years of age of extremely low birthweight (ELBW) children born in the 1990s, how it varies with birth weight, and how it compares with ELBW children born in the 1980s and 1970s.

  17. Outcomes of very-low-birthweight infants after discharge with a discharge weight of 1500 grams.

    Science.gov (United States)

    Ahmadpour-Kacho, Mousa; Pasha, Yadollah Zahed; Aliabadi, Behdis Motevalli

    2012-04-01

    Discharge of very-low-birthweight (VLBW) neonates from hospital is an important issue and has a standard criterion worldwide. According to this criterion, VLBW infants will be discharged from hospital when weighing 1800-2100 g but in the newborn services at Amirkola Children's Hospital (ACH), VLBW neonates are discharged when reaching 1500 g. The aim of this study was to determine the safety of this policy. In this analytic-prospective study, 100 premature neonates with discharging weight (DW) of 1500 g and a control group of 150 neonates with DW of 1600-2500 g were included. Both groups showed similar socioeconomic, perinatal and postnatal conditions. They were admitted and treated in the newborn services at ACH. The outcome variables, including death after discharge, readmission and need for emergency visit for an acute problem up to 3 months after discharge, were studied. The information was analyzed by SPSS-16 software and a P-value discharge reached a significant difference between the two groups (31 in the case group vs 21 in the control group, P= 0.000), but there were no significant differences in the readmission rate and death after discharge (two deaths and 15 readmissions in the case group vs two deaths and 21 readmissions in the control group, P= 0.855) In order to decrease the need for emergency visits, we suggest a program of early hospital discharge with home nursing visits and neonatologist support. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  18. CRIB (clinical risk index for babies) in relation to nosocomial bacteraemia in very low birthweight or preterm infants.

    OpenAIRE

    Fowlie, P. W.; Gould, C. R.; Parry, G J; Phillips, G.; Tarnow-Mordi, W O

    1996-01-01

    Positive blood cultures in very low birthweight or preterm infants usually reflect bacteraemia, septicaemia, or failure of asepsis during sampling and lead to increased costs and length of stay. Rates of nosocomial, or hospital acquired, bacteraemia may therefore be important indicators of neonatal unit performance, if comparisons are adjusted for differences in initial risk. In a preliminary study the risk of nosocomial bacteraemia was related to initial clinical risk and illness severity me...

  19. The ProVIDe study: the impact of protein intravenous nutrition on development in extremely low birthweight babies

    OpenAIRE

    Bloomfield, Frank H.; Crowther, Caroline A; Harding, Jane E; Cathryn A. Conlon; Jiang, Yannan; Cormack, Barbara E.

    2015-01-01

    Background Preterm birth and very small size at birth have long-term effects on neurodevelopment and growth. A relatively small percentage of extremely low birthweight babies suffer from severe neurological disability; however, up to 50 % experience some neurodevelopmental or learning disability in childhood. Current international consensus is that increased protein intake in the neonatal period improves both neurodevelopment and growth, but the quantum of protein required is not known. This ...

  20. Japanese secular trends in birthweight and the prevalence of low birthweight infants during the last three decades: A population-based study

    OpenAIRE

    Yo Takemoto; Erika Ota; Daisuke Yoneoka; Rintaro Mori; Satoru Takeda

    2016-01-01

    Since low birthweight has been correlated with both neonatal and long-term health, we performed this epidemiological study to evaluate the Japanese secular trends in mean birthweight and the prevalence of preterm/term low birthweight infants during the last three decades. We used population-based birth certificate data from January 1979 to December 2010. Time trends were analysed using a linear regression model. During the study period, we observed a significant decrease in the mean birthweig...

  1. Parental factors in cognitive outcome of non-handicapped low birthweight infants.

    OpenAIRE

    Sommerfelt, K.; Ellertsen, B; Markestad, T.

    1995-01-01

    A population based cohort of 144 children weighing less than 2000 g who were without major handicap, and a random control sample of 163 children born at term and weighing over 3000 g were investigated. The aim was to assess the relative importance for cognitive development at 5 years of age, of birthweight, parental demographic factors, and factors related to the environment in which the child was reared. The mean non-verbal IQ was 6.1 points lower (95% CI, 2.3 to 10) for the low birthweight ...

  2. Housing conditions as a social determinant of low birthweight and preterm low birthweight

    OpenAIRE

    Mario Vianna Vettore; Silvana Granado Nogueira da Gama; Gabriela de Almeida Lamarca; Arthur Orlando Corrêa Schilithz; Maria do Carmo Leal

    2010-01-01

    OBJECTIVE: To assess the relationship between housing conditions and low birthweight and preterm low birthweight among low-income women. METHODS: A case-control study was conducted with post-partum women living in the city of Rio de Janeiro, Southeast Brazil, in 2003-2005. Two groups of cases, low birthweight (n=96) and preterm low birthweight infants (n=68), were compared against normal weight term controls (n=393). Housing conditions were categorized into three levels: adequate, inadequate,...

  3. Does supplementation of formula with evening primrose and fish oils augment long chain polyunsaturated fatty acid status of low birthweight infants to that of breast-fed counterparts?

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Schaafsma, A; Okken, A; Muskiet, FAJ

    1999-01-01

    We investigated whether formulae with evening primrose and fish oils raise long chain polyunsaturated fatty acids (LCPUFA) in plasma cholesterol esters (CE), erythrocytes (RSC) and platelets (PLT) to levels encountered in breast-fed infants. Low birthweight infants (less than or equal to 2500 g) rec

  4. Does supplementation of formula with evening primrose and fish oils augment long chain polyunsaturated fatty acid status of low birthweight infants to that of breast-fed counterparts?

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Schaafsma, A; Okken, A; Muskiet, FAJ

    We investigated whether formulae with evening primrose and fish oils raise long chain polyunsaturated fatty acids (LCPUFA) in plasma cholesterol esters (CE), erythrocytes (RSC) and platelets (PLT) to levels encountered in breast-fed infants. Low birthweight infants (less than or equal to 2500 g)

  5. Does supplementation of formula with evening primrose and fish oils augment long chain polyunsaturated fatty acid status of low birthweight infants to that of breast-fed counterparts?

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Schaafsma, A; Okken, A; Muskiet, FAJ

    1999-01-01

    We investigated whether formulae with evening primrose and fish oils raise long chain polyunsaturated fatty acids (LCPUFA) in plasma cholesterol esters (CE), erythrocytes (RSC) and platelets (PLT) to levels encountered in breast-fed infants. Low birthweight infants (less than or equal to 2500 g) rec

  6. The efficacy of facilitated tucking for relieving procedural pain of endotracheal suctioning in very low birthweight infants.

    Science.gov (United States)

    Ward-Larson, Charlotte; Horn, Robert A; Gosnell, Florence

    2004-01-01

    This study compared the efficacy of a behavioral pain reducing intervention (facilitated tucking) with standard neonatal intensive care unit (NICU) care for decreasing procedural pain (endotracheal suctioning) in very low birthweight (VLBW) infants. A prospective randomized crossover design with infants as their own controls were used. The sample consisted of 40 VLBW infants, 23-32 weeks gestation, and weighing 560-1498 g with tracheal intubation. The infants were observed twice during each endotracheal suctioning experience; one suctioning was done according to normal nursery routine; another was done using facilitated tucking (the caregiver "hand-swaddling" the infant by placing a hand on the infant's head and feet while providing flexion and containment). The Premature Infant Pain Profile (PIPP) measured the infant's pain response, and severity of illness of each infant was measured by the Score for Neonatal Acute Physiology (SNAP) and the NTISS (Neonatal Therapeutic Intervention Scoring System). Repeated measures analysis of variance (RMANOVA) determined the efficacy of facilitated tucking for reducing procedural pain (PIPP) and the effects of order of intervention vs. control. Regression analyses examined the relationship of gestational age, severity of illness, and number of painful procedures to the pain response. There was a significant difference between the PIPP scores for tucking and nontucking positions (p = 0.001) and a nonsignificant interaction with order (p = 0.64) as well as a nonsignificant main effect for order (p = 0.46). In the regression analyses, all predictors taken together did not significantly predict PIPP scores in the tucked position (p = 0.11) or nontucked position (p = 0.57). Facilitated tucking is a developmentally sensitive, nonpharmacological comfort measure that can relieve procedural pain in VLBW infants. Nurses need to be increasingly aware of infant pain during daily care taking, and to use validated pain assessment instruments

  7. Endothelial progenitor cells in mothers of low-birthweight infants: a link between defective placental vascularization and increased cardiovascular risk?

    Science.gov (United States)

    King, Thomas F J; Bergin, David A; Kent, Etaoin M; Manning, Fiona; Reeves, Emer P; Dicker, Patrick; McElvaney, Noel G; Sreenan, Seamus; Malone, Fergal D; McDermott, John H

    2013-01-01

    Offspring birthweight is inversely associated with future maternal cardiovascular mortality, a relationship that has yet to be fully elucidated. Endothelial progenitor cells (EPCs) are thought to play a key role in vasculogenesis, and EPC numbers reflect cardiovascular risk. Our objective was to ascertain whether EPC number or function was reduced in mothers of low-birthweight infants. This was a prospective cohort study in a general antenatal department of a university maternity hospital. Twenty-three mothers of small for gestational age (SGA) infants (birthweight mothers of appropriate for gestational age (AGA) infants (birthweight ≥ 10th centile) were recruited. Maternal EPC number and function, conventional cardiovascular risk markers, and cord blood adiponectin were measured. Median EPC count was lower (294 vs. 367, P = 0.005) and EPC migration was reduced (0.91 vs. 1.59, P < 0.001) in SGA compared with AGA infants, with no difference in EPC adhesion (0.221 vs. 0.284 fluorescence units, P = 0.257). Maternal triglyceride levels were higher in SGA than AGA infants (0.98 vs. 0.78 mmol/liter, P = 0.006), but there was no difference in cholesterol, glucose, insulin, glycosylated hemoglobin, adiponectin, or blood pressure. There was a moderate monotone (increasing) relationship between birthweight and umbilical cord blood adiponectin (r = 0.475, P = 0.005). Giving birth to an SGA infant was associated with lower maternal EPC number and reduced migratory function. Cord blood adiponectin was significantly correlated with birthweight.

  8. The Cues and Care Trial: A randomized controlled trial of an intervention to reduce maternal anxiety and improve developmental outcomes in very low birthweight infants

    Directory of Open Access Journals (Sweden)

    Dunkley David

    2008-09-01

    Full Text Available Abstract Background Very low birthweight infants are at risk for deficits in cognitive and language development, as well as attention and behaviour problems. Maternal sensitive behaviour (i.e. awareness of infant cues and appropriate responsiveness to those cues in interaction with her very low birthweight infant is associated with better outcomes in these domains; however, maternal anxiety interferes with the mother's ability to interact sensitively with her very low birthweight infant. There is a need for brief, cost-effective and timely interventions that address both maternal psychological distress and interactive behaviour. The Cues and Care trial is a randomized controlled trial of an intervention designed to reduce maternal anxiety and promote sensitive interaction in mothers of very low birthweight infants. Methods and design Mothers of singleton infants born at weights below 1500 g are recruited in the neonatal intensive care units of 2 tertiary care hospitals, and are randomly assigned to the experimental (Cues intervention or to an attention control (Care condition. The Cues intervention teaches mothers to attend to their own physiological, cognitive, and emotional cues that signal anxiety and worry, and to use cognitive-behavioural strategies to reduce distress. Mothers are also taught to understand infant cues and to respond sensitively to those cues. Mothers in the Care group receive general information about infant care. Both groups have 6 contacts with a trained intervener; 5 of the 6 sessions take place during the infant's hospitalization, and the sixth contact occurs after discharge, in the participant mother's home. The primary outcome is maternal symptoms of anxiety, assessed via self-report questionnaire immediately post-intervention. Secondary outcomes include maternal sensitive behaviour, maternal symptoms of posttraumatic stress, and infant development at 6 months corrected age. Discussion The Cues and Care trial will

  9. Evaluation of care for the preterm infant: Review of literature on follow-up of preterm and low birthweight infants : Report from the collaborative Project On Preterm and Small for gestational age infants (POPS) in The Netherlands

    NARCIS (Netherlands)

    Ens-Dokkum, M.H.; Schreuder, A.M.; Veen, S.; Verloove-Vanhorick, S.P.; Brand, R.; Ruys, J.H.

    1992-01-01

    Since the introduction of neonatal intensive care in the 1960s, mortality in very preterm and very low birthweight infants has been decreasing steadily. Consequently, interest in the outcome of surviving infants is growing. Restriction of health care resources has stressed the need for information

  10. Evaluation of care for the preterm infant: Review of literature on follow-up of preterm and low birthweight infants : Report from the collaborative Project On Preterm and Small for gestational age infants (POPS) in The Netherlands

    NARCIS (Netherlands)

    Ens-Dokkum, M.H.; Schreuder, A.M.; Veen, S.; Verloove-Vanhorick, S.P.; Brand, R.; Ruys, J.H.

    1992-01-01

    Since the introduction of neonatal intensive care in the 1960s, mortality in very preterm and very low birthweight infants has been decreasing steadily. Consequently, interest in the outcome of surviving infants is growing. Restriction of health care resources has stressed the need for information c

  11. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 3: Discussion and Conclusion

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-11-01

    Full Text Available Abstract Background It has been hypothesized that prematurity and adjunctive neonatal care is 'a priori' a risk for disturbances of palatal and orofacial development which increases the need for later orthodontic or orthognathic treatment. As results on late consequences of prematurity are consistently contradictory, the necessity exists for a fundamental analysis of existing methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. Method A search of the literature was conducted based on Cochrane search strategies including sources in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered in tables for comparison (Parts 1 and 2. Results Morphology assessment of the infant palate is subject to non-standardized visual and metrical measurements. Most methodologies are inadequate for measuring a three-dimensional shape. Several confounding factors were identified as causes contributing to disturbances of palatal and orofacial development. Conclusion Taking into account the abovementioned shortcomings, the following conclusions may be drawn for practitioners and prospective investigators of clinical studies. 1 The lack of uniformity in the anatomical nomenclature of the infant's palate underlines the need for a uniform definition. 2 Metrically, non-intubated preterm infants do not exhibit different palatal width or height compared to matched term infants up to the corrected age of three months. Beyond that age, no data on the subject are currently available. 3 Oral intubation does not invariably alter palatal morphology of preterm and low birthweight infants. 4 The findings on palatal grooving, height, and asymmetry as a consequence of orotracheal intubation up to the age of 11 years are inconsistent. 5 Metrically

  12. Delayed umbilical cord clamping for reducing anaemia in low birthweight infants : implications for developing countries

    NARCIS (Netherlands)

    van Rheenen, Patrick F.; Gruschke, Sebastian; Brabin, Bernard J.

    BACKGROUND: Cheap and effective interventions are needed to reduce the risk of infant anaemia in developing countries. Delayed cord clamping (DCC) has been shown to be a simple, safe and cost-free delivery procedure that augments red cell mass in appropriate-for-gestational-age term and preterm

  13. Microbiome assembly across multiple body sites in low-birthweight infants

    National Research Council Canada - National Science Library

    Costello, Elizabeth K; Carlisle, Erica M; Bik, Elisabeth M; Morowitz, Michael J; Relman, David A

    2013-01-01

    ...) infants in relation to host body site, individual, and age. Bacterial 16S rRNA genes from saliva samples, skin swabs, and stool samples collected on postnatal days 8, 10, 12, 15, 18, and 21 from six LBW (five premature...

  14. Live music reduces stress levels in very low-birthweight infants.

    Science.gov (United States)

    Schwilling, Diana; Vogeser, Michael; Kirchhoff, Fabian; Schwaiblmair, Frauke; Boulesteix, Anne-Laure; Schulze, Andreas; Flemmer, Andreas W

    2015-04-01

    Music might benefit preterm infants in stressful, intensive care environments. However, data on stress level indicators, determined by salivary cortisol levels, are scarce. We evaluated the effect of live harp music on the stress level indicators of preterm infants in a neonatal intensive care unit (NICU). We exposed 20 stable preterm infants to music for 15 min on three consecutive days. Saliva was collected before the music was played and 25 min and 4 h after it ended. Salivary cortisol levels were measured by liquid chromatography-tandem mass spectrometry and vital signs, oxygen saturation, bradycardia, apnoeas and oxygen desaturations were recorded. Pain levels were assessed by the Bernese Pain Scale for Neonates. Salivary cortisol was significantly lower 25 min (18.9 nmol/L [3.9-35.6] p = 0.001) and 4 h after music (17.4 nmol/L [3.9-35.3] p = 0.003) than at baseline 4 h before exposure (19.5 nmol/L [7.2-51.1]). After music, the number of apnoeas and oxygen desaturations was significantly reduced on all three, days and the number of bradycardia episodes on day one. Pain scores significantly improved after music on all 3 days. Exposure to live music reduced salivary cortisol and had beneficial effects on the physiologic parameters of stable preterm infants in a NICU. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Benchmarking care for very low birthweight infants in Ireland and Northern Ireland.

    LENUS (Irish Health Repository)

    Murphy, B P

    2012-01-31

    BACKGROUND: Benchmarking is that process through which best practice is identified and continuous quality improvement pursued through comparison and sharing. The Vermont Oxford Neonatal Network (VON) is the largest international external reference centre for very low birth weight (VLBW) infants. This report from 2004-7 compares survival and morbidity throughout Ireland and benchmarks these results against VON. METHODS: A standardised VON database for VLBW infants was created in 14 participating centres across Ireland and Northern Ireland. RESULTS: Data on 716 babies were submitted in 2004, increasing to 796 babies in 2007, with centres caring for from 10 to 120 VLBW infants per year. In 2007, mortality rates in VLBW infants varied from 4% to 19%. Standardised mortality ratios indicate that the number of deaths observed was not significantly different from the number expected, based on the characteristics of infants treated. There was no difference in the incidence of severe intraventricular haemorrhage between all-Ireland and VON groups (5% vs 6%, respectively). All-Ireland rates for chronic lung disease (CLD; 15-21%) remained lower than rates seen in the VON group (24-28%). The rates of late onset nosocomial infection in the all-Ireland group (25-26%) remained double those in the VON group (12-13%). DISCUSSION: This is the first all-Ireland international benchmarking report in any medical specialty. Survival, severe intraventricular haemorrhage and CLD compare favourably with international standards, but rates of nosocomial infection in neonatal units are concerning. Benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning neonatal intensive care service provision.

  16. Diffuse neonatal hemangiomatosis in a very low-birthweight infant treated with erythropoietin.

    Science.gov (United States)

    Okuno, Takashi; Tokuriki, Shuko; Yoshino, Tomomi; Tanaka, Nanae; Ohshima, Yusei

    2015-04-01

    Diffuse neonatal hemangiomatosis (DNH) is a rare condition characterized by the concomitant development of multiple cutaneous infantile hemangiomas (IH) and visceral hemangiomas. Recently, an association between erythropoietin treatment and an increased incidence of infantile hemangioma was noted. A Japanese male infant was born via cesarean section at 27 weeks of gestation. Following the commencement of erythropoietin treatment for anemia of prematurity, he developed multiple cutaneous hemangiomas, high cardiac output heart failure and hepatomegaly. Abdominal imaging indicated comorbidity of diffuse infantile hepatic hemannigomas, resulting in the final diagnosis of DNH. The discontinuation of erythropoietin treatment and long-term therapy with propranolol improved the hepatic lesions and cutaneous hemangiomas. The possibility of multiple organ involvement and the exacerbating effects of erythropoietin treatment should be considered in cases in which multiple cutaneous hemangiomas develop in preterm infants receiving erythropoietin treatment. © 2015 Japan Pediatric Society.

  17. A quality improvement initiative for delayed umbilical cord clamping in very low-birthweight infants.

    Science.gov (United States)

    Bolstridge, Jeff; Bell, Tracy; Dean, Barbara; Mackley, Amy; Moore, Gina; Swift, Cheryl; Viscount, Dina; Paul, David A; Pearlman, Stephen A

    2016-09-13

    Due to clinical benefits, delayed cord clamping (DCC) is recommended in infants born before 37 weeks gestational age. The objective was to institute a delayed cord clamping program and to evaluate clinical outcomes one year after initiation. This study occured at Christiana Care Health System, a tertiary care facility with a 52 bed level 3 Neonatal Intensive Care Unit (NICU). A multidisciplinary team created a departmental policy, a DCC protocol and educational programs to support the development of a DCC program. A year after initiation of DCC, we evaluated two cohorts of very low birth weight (VLBW) infants (cord clamping protocol and a decrease in the percentage of VLBW infants requiring red blood cell transfusion from 53.7 to 35.9 % (p = 0.003). We also found a decreased need for respiratory support in the second cohort with no increases in the balancing measures of admission hypothermia and jaundice requiring phototherapy. During the Control Phase ongoing monitoring and education has led to a 93.7 % compliance rate. A multidisciplinary team including key leadership from the obstetric and pediatric departments allowed for the rapid and safe implementation of DCC.

  18. Strict red blood cell transfusion guideline reduces the need for transfusions in very-low-birthweight infants in the first 4 weeks of life: a multicentre trial.

    Science.gov (United States)

    Miyashiro, A M; Santos, N dos; Guinsburg, R; Kopelman, B I; Peres, C de Araújo; Taga, M F de Lima; Shinzato, A R; Costa, H de Paula Fiod

    2005-02-01

    Very-low-birthweight infants are among the most heavily transfused patients. The objective of this study was to verify if the introduction of a strict guideline would reduce the need for red blood cell transfusions in the first 4 weeks of life in these neonates. This was a multicentre prospective study of two cohorts of very-low-birthweight infants transfused in accordance with the recommendations of a neonatologist (Phase 1) or according to previously published guidelines (Phase 2). In the first 28 days of life, 102 patients (68.5%) in Phase 1 and 117 (59.7%) in Phase 2 were transfused. The number of transfusions was 1.9 +/- 2.0 in Phase 1 and 1.4 +/- 1.6 in Phase 2 (P = 0.01). After adjusting for gestational age, blood loss and the presence of respiratory distress syndrome, the strict guideline reduced the number of transfusions in 17.6% (IC 95%-30.5% to -2.6%). The strict guideline was effective in reducing erythrocyte transfusions in very-low-birthweight infants.

  19. Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants: a systematic review.

    Science.gov (United States)

    Kamphorst, Kim; Sietsma, Ydelette; Brouwer, Annemieke J; Rood, Paul J T; van den Hoogen, Agnes

    2016-11-01

    Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies published between 2007 and 2014 and covered 495 infants. Suppositories were ineffective in shortening the time to reach full enteral feeding, and the evidence on enemas was contradictory. Enemas and rectal stimulation did not shorten the time until complete meconium evacuation was reached. Further research into safe, effective interventions to accelerate meconium excretion is needed. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  20. Intra-vesical knot of bladder catheter in an extremely low birthweight neonate: A case report

    Directory of Open Access Journals (Sweden)

    Paula M.Y. Tang

    2015-07-01

    Full Text Available Premature and extremely low birth weight (ELBW neonates are at high risk of developing multiple co-morbidities and often require urinary catheterization for various medical indications. Intra-vesical knotting of bladder catheter is a known but uncommon complication of this procedure. We report a case of an ELBW baby boy with a knotted bladder catheter requiring surgical retrieval. After an elective operation for the closure of patent ductus arteriosus, a 4 French urinary catheter was inserted into an ELBW baby boy for urine output monitoring and left in-situ. Resistance was encountered in attempt to remove the urinary catheter. Abdominal X Ray confirmed intra-vesical knotting of the tube. Knot unravelling by interventional radiology was attempted but was unsuccessful. Open extra-peritoneal bladder exploration was performed for the retrieval of the tightly knotted catheter. A 6 French transurethral Foley catheter was inserted for bladder drainage. Upon removal of the Foley's catheter on day 5 post op, the baby was able to void spontaneously. With literature review, we postulated the potential risk factors resulting in this potentially avoidable iatrogenic unusual complication. Recommendations were suggested to avoid further incidences.

  1. Housing conditions as a social determinant of low birthweight and preterm low birthweight

    Directory of Open Access Journals (Sweden)

    Mario Vianna Vettore

    2010-12-01

    Full Text Available OBJECTIVE: To assess the relationship between housing conditions and low birthweight and preterm low birthweight among low-income women. METHODS: A case-control study was conducted with post-partum women living in the city of Rio de Janeiro, Southeast Brazil, in 2003-2005. Two groups of cases, low birthweight (n=96 and preterm low birthweight infants (n=68, were compared against normal weight term controls (n=393. Housing conditions were categorized into three levels: adequate, inadequate, and highly inadequate. Covariates included sociodemographic and anthropometric characteristics, risk behaviors, violence, anxiety, satisfaction during pregnancy, obstetric history and prenatal care. RESULTS: Poor housing conditions was independently associated with low birthweight (inadequate - OR 2.3 [1.1;4.6]; highly inadequate - OR 7.6 [2.1;27.6] and preterm low birthweight (inadequate - OR 2.2 [1.1;4.3]; highly inadequate - OR 7.6 [2.4;23.9] and factors associated with outcomes were inadequate prenatal care and previous preterm birth. Low income and low maternal body mass index remained associated with low birthweight. CONCLUSIONS: Poor housing conditions were associated with low birthweight and preterm low birthweight.

  2. Review of mortality of very low birthweight infants at the University Hospital of the West Indies over the past four decades.

    Science.gov (United States)

    Trotman, H

    2012-07-01

    A review of two previously published studies done at the University Hospital of the West Indies, an unpublished study and annual perinatal statistics was conducted to detect trends in the mortality of very low birthweight infants at the institution over four decades. Mortality decreased from 54% to 38% over the time period, the decrease was greater for infants weighing 1001-1500 g (40%) than those weighing < or = 1000 g (28%). Despite increased access to mechanical ventilation over time, there was no appreciable decrease in mortality for infants weighing < or = 750 g. There was a statistically significant decrease in mortality with increasing birthweight for the time period 1987-2002, p < 0.001. The mean +/- SD weight of survivors 1.18 +/- 0.24 kg was significantly greater than that for non-survivors 0.89 +/- 0.21 kg for the same period. Further decrease in mortality of very low birthweight infants will involve measures aimed at decreasing mortality in infants weighing < or = 750 g and increasing the availability of parenteral nutrition and the accessibility of surfactant.

  3. Your Premature Baby: Low Birthweight

    Science.gov (United States)

    ... many low-birthweight babies are born prematurely, many risk factors for having a low-birthweight baby are the same for preterm labor and ... risk for having a low-birthweight baby. Medical risk factors for having a low-birthweight baby Preterm labor . This is labor that starts ...

  4. Prevention of low birthweight.

    Science.gov (United States)

    Alam, Dewan S

    2009-01-01

    Globally an estimated 20 million infants are born with low birthweight (LBW), of those over 18 million are born in developing countries. These LBW infants are at a disproportionately higher risk of mortality, morbidity, poor growth, impaired psychomotor and cognitive development as immediate outcomes, and are also disadvantaged as adults due to their greater susceptibility to type 2 diabetes, hypertension and coronary heart disease. Maternal malnutrition prior to and during pregnancy manifested by low bodyweight, short stature, inadequate energy intake during pregnancy and coexisting micronutrient deficiency are considered major determinants in developing countries where the burden is too high. LBW is a multifactorial outcome and its prevention requires a lifecycle approach and interventions must be continued for several generations. So far, most interventions are targeted during pregnancy primarily due to the increased nutritional demand and aggravations of already existing inadequacy in most women. Several individually successful interventions during pregnancy include balanced protein energy supplementation, several single micro-nutrients or more recently a mix of multiple micronutrients. Nutrition education has been successful in increasing the dietary intake of pregnant women but has had no effect on LBW. The challenge is to identify a community-specific intervention package. Current evidence supports intervention during pregnancy with increased dietary intakes including promotions of foods rich in micronutrients and micronutrient supplementation, preferably with a multiple micronutrient mix. Simultaneously a culturally appropriate educational component is required to address misconceptions about diet during pregnancy and childbirth including support for healthy pregnancy with promotion of antenatal and perinatal care services. While further research is needed to identify more efficacious interventions, an urgent public health priority would be to select and

  5. All-Cause Mortality of Low Birthweight Infants in Infancy, Childhood, and Adolescence: Population Study of England and Wales.

    Directory of Open Access Journals (Sweden)

    W John Watkins

    2016-05-01

    Full Text Available Low birthweight (LBW is associated with increased mortality in infancy, but its association with mortality in later childhood and adolescence is less clear. We investigated the association between birthweight and all-cause mortality and identified major causes of mortality for different birthweight groups.We conducted a population study of all live births occurring in England and Wales between 1 January 1993 and 31 December 2011. Following exclusions, the 12,355,251 live births were classified by birthweight: 500-1,499 g (very LBW [VLBW], n = 139,608, 1,500-2,499 g (LBW, n = 759,283, 2,500-3,499 g (n = 6,511,411, and ≥3,500 g (n = 4,944,949. The association of birthweight group with mortality in infancy (<1 y of age and childhood/adolescence (1-18 y of age was quantified, with and without covariates, through hazard ratios using Cox regression. International Classification of Diseases codes identified causes of death. In all, 74,890 (0.61% individuals died between birth and 18 y of age, with 23% of deaths occurring after infancy. Adjusted hazard ratios for infant deaths were 145 (95% CI 141, 149 and 9.8 (95% CI 9.5, 10.1 for the VLBW and LBW groups, respectively, compared to the ≥3,500 g group. The respective hazard ratios for death occurring at age 1-18 y were 6.6 (95% CI 6.1, 7.1 and 2.9 (95% CI 2.8, 3.1. Male gender, the youngest and oldest maternal age bands, multiple births, and deprivation (Index of Multiple Deprivation score also contributed to increased deaths in the VLBW and LBW groups in both age ranges. In infancy, perinatal factors, particularly respiratory issues and infections, explained 84% and 31% of deaths in the VLBW and LBW groups, respectively; congenital malformations explained 36% and 23% in the LBW group and ≥2,500 g groups (2,500-3,499 g and ≥3,500 g groups combined, respectively. Central nervous system conditions explained 20% of deaths in childhood/adolescence in the VLBW group, with deaths from neoplasms and

  6. Predicting outcome in very low birthweight infants using an objective measure of illness severity and cranial ultrasound scanning

    OpenAIRE

    Fowlie, P; Tarnow-Mordi, W; Gould, C.; Strang, D

    1998-01-01

    AIM—To investigate the feasibility of developing an objective tool for predicting death and severe disability using routinely available data, including an objective measure of illness severity, in very low birthweight babies.
METHOD—A cohort study of 297 premature babies surviving the first three days of life was made. Predictive variables considered included birthweight, gestation, 3 day cranial ultrasound appearances and 3 day CRIB (clinical risk index for babies) score. ...

  7. Trends in cerebral palsy among infants of very low birthweight (<1500 g) or born prematurely (<32 weeks) in 16 European centres: a database study

    DEFF Research Database (Denmark)

    Platt, Mary Jane; Cans, Christine; Johnson, Ann

    2007-01-01

    BACKGROUND: The risk of cerebral palsy, the commonest physical disability of children in western Europe, is higher in infants of very low birthweight (VLBW)--those born weighing less than 1500 g--and those from multiple pregnancies than in infants of normal birthweight. An increasing proportion...... of Cerebral Palsy in Europe, agreed a standard definition of cerebral palsy and inclusion and exclusion criteria. Data for children with cerebral palsy born in the years 1980-96 were pooled. The data were analysed to describe the distribution and prevalence of cerebral palsy in VLBW infants. Prevalence trends...... were expressed as both per 1000 livebirths and per 1000 neonatal survivors. FINDINGS: There were 1575 VLBW infants born with cerebral palsy; 414 (26%) were of birthweight less than 1000 g and 317 (20%) were from multiple pregnancies. 1426 (94%) had spastic cerebral palsy, which was unilateral...

  8. Kangaroo mother method: randomised controlled trial of an alternative method of care for stabilised low-birthweight infants. Maternidad Isidro Ayora Study Team.

    Science.gov (United States)

    Sloan, N L; Camacho, L W; Rojas, E P; Stern, C

    1994-09-17

    Because resources for care of low-birthweight (LBW) infants in developing countries are scarce, the Kangaroo mother method (KMM) was developed. The infant is kept upright in skin-to-skin contact with the mother's breast. Previous studies reported several benefits with the KMM but interpretation of their findings is limited by small size and design weaknesses. We have done a longitudinal, randomised, controlled trial at the Isidro Ayora Maternity Hospital in Quito, Ecuador. Infants with LBW (< 2000 g) who satisfied out-of-risk criteria of tolerance of food and weight stabilisation were randomly assigned to KMM and control (standard incubator care) groups (n = 128 and 147, respectively). During 6 months of follow-up the KMM group had a significantly lower rate than the control group of serious illness (lower-respiratory-tract disorders, apnoea, aspiration, pneumonia, septicaemia, general infections; 7 [5%] vs 27 [18%], p < 0.002), although differences between the groups in less severe morbidity were not significant. There was no significant difference in growth or in the proportion of women breastfeeding, perhaps because the proportion breastfeeding was high in both groups owing to strong promotion. Mortality was the same in both groups; most deaths occurred during the stabilisation period before randomisation. KMM mothers made more unscheduled clinic visits than control mothers but their infants had fewer re-admissions and so the cost of care was lower with the KMM. Since the eligibility criteria excluded nearly 50% of LBW infants from the study, the KMM is not universally applicable to these infants. The benefits might be greater in populations where breastfeeding is not so common.

  9. Plasma total homocysteine increases from day 20 to 40 in breastfed but not formula-fed low-birthweight infants

    NARCIS (Netherlands)

    Fokkema, M R; Woltil, H A; van Beusekom, C M; Schaafsma, A; Dijck-Brouwer, D A J; Muskiet, F A J

    2002-01-01

    Homocysteine is an intermediate in the folate cycle and methionine metabolism. This study investigated whether formula-fed infants have different plasma total homocysteine to their breastfed counterparts, and during what period any difference developed. Plasma total homocysteine was determined in 53

  10. Childhood diarrhoea in Danish day care centres could be associated with infant colic, low birthweight and antibiotics

    DEFF Research Database (Denmark)

    Jensen, Betina Hebbelstrup; Röser, Dennis; Andreassen, Bente Utoft

    2016-01-01

    information on gastrointestinal symptoms and exposure. A logistic regression was performed to identify the odds ratios of different risk factors for diarrhoea. RESULTS: The odds ratios for diarrhoea were 1.97 (0.93-4.20) for children with a history of infant colic, 1.91 (0.90-4.04) for low birth weight......AIM: Diarrhoea is very common in children attending day care centres. The aim of this study was to examine certain predisposing risk factors for an association with diarrhoea, including foreign travel, treatment with antibiotics, having household pets, infant colic, bottle feeding, using a pacifier...... and low birth weight. METHODS: A dynamic one-year follow-up cohort study comprising 179 children from 36 day care centres was conducted from September 2009 to July 2013 in Copenhagen, Denmark. Questionnaires were sent to the children's parents or legal guardians every two months for a year, requesting...

  11. Factors affecting prenatal sonographic estimation of weight in extremely low birthweight infants.

    Science.gov (United States)

    Townsend, R R; Filly, R A; Callen, P W; Laros, R K

    1988-04-01

    Because critical management decisions are based on sonographic estimation of fetal weight in fetuses less than 1000 g, we sought to evaluate the accuracy of birthweight prediction in this range and to identify factors affecting this accuracy. Fetal weight was estimated using several published methods in 53 fetuses with birthweights less than 1000 g. Standard deviations greater than 12.3% indicate more random error in the sonographic weight prediction than has been reported in higher weight groups. No statistically significant differences were found between patient groups with decreased, normal, or increased amniotic fluid volume or portable examination. There was a trend toward lower mean deviation (2.9 vs 6.0%) and standard deviation (8.9 vs. 15.0%) in studies with scan quality judged "good" compared with "poor" based on ability to visualize anatomic landmarks.

  12. Low birthweight and mortality

    DEFF Research Database (Denmark)

    Bakketeig, Leiv S.; Jacobsen, Geir; Skjærven, Rolv

    2006-01-01

    Previous studies have demonstrated the tendency to repeat gestational age and birthweight in successive pregnancies. Also, it has been shown that this tendency is associated with infant survival. Women tend to give birth to babies of a certain foetal age and size and if the outcome departs...... considerably from this age and weight, then the baby’s survival is reduced. This study focuses on which diseases or conditions that might lie behind this affected survival. Data were provided through linkages between three Danish health registries, namely the Danish Medical Birth Registry, the National...... Hospital Registry, and a Registry for Preventive Medicine. Such linkage is possible due to the use of unique ID-person numbers. The study was based on Danish births, 1981-1994. All 8 219 second order low birth weight (LBW) singleton births from that period were included, of whom 7 811 were live born...

  13. Severe events in the first 6 months of life in a cohort of HIV-unexposed infants from South Africa: effects of low birthweight and breastfeeding status.

    Science.gov (United States)

    Doherty, Tanya; Jackson, Debra; Swanevelder, Sonja; Lombard, Carl; Engebretsen, Ingunn M S; Tylleskär, Thorkild; Goga, Ameena; Ekström, Eva-Charlotte; Sanders, David

    2014-10-01

    To report on risk factors for severe events (hospitalisation or infant death) within the first half of infancy amongst HIV-unexposed infants in South Africa. South African data from the multisite community-based cluster-randomised trial PROMISE EBF promoting exclusive breastfeeding in three sub-Saharan countries from 2006 to 2008 were used. The South African sites were Paarl in the Western Cape Province, and Umlazi and Rietvlei in KwaZulu-Natal. This analysis included 964 HIV-negative mother-infant pairs. Data on severe events and infant feeding practices were collected at 3, 6, 12 and 24 weeks post-partum. We used a stratified extended Cox model to examine the association between the time to the severe event and covariates including birthweight, with breastfeeding status as a time-dependent covariate. Seventy infants (7%) experienced a severe event. The median age at first hospitalisation was 8 weeks, and the two main reasons for hospitalisation were cough and difficult breathing followed by diarrhoea. Stopping breastfeeding before 6 months (HR 2.4; 95% CI 1.2-5.1) and low birthweight (HR 2.4; 95% CI 1.3-4.3) were found to increase the risk of a severe event, whilst maternal completion of high school education was protective (HR 0.3; 95% CI 0.1-0.7). A strengthened primary healthcare system incorporating promotion of breastfeeding and appropriate caring practices for low birthweight infants (such as kangaroo mother care) are critical. Given the leading reasons for hospitalisation, early administration of oral rehydration therapy and treatment of suspected pneumonia are key interventions needed to prevent hospitalisation in young infants. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  14. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 1: The palate of the term newborn

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-10-01

    Full Text Available Abstract Background The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinical studies are needed. The objective of this review is to provide a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development. One focus of this review is the analysis of studies on the palate of the term newborn, since knowing what is 'normal' is a precondition of being able to assess abnormalities. Methods A search profile based on Cochrane search strategies applied to 10 medical databases was used to identify existing studies. Articles, mainly those published before 1960, were identified from hand searches in textbooks, encyclopedias, reference lists and bibliographies. Sources in English, German, and French of more than a century were included. Data for term infants were recalculated if particular information about weight, length, or maturity was given. The extracted values, especially those from non-English paper sources, were provided unfiltered for comparison. Results The search strategy yielded 182 articles, of which 155 articles remained for final analysis. Morphology of the term newborn's palate was of great interest in the first half of the last century. Two general methodologies were used to assess palatal morphology: visual and metrical descriptions. Most of the studies on term infants suffer from lack of reliability tests. The groove system was recognized as the distinctive feature of the infant palate. The shape of the palate of the term infant may vary considerably, both visually and metrically. Gender, race, mode of delivery, and nasal deformities were identified as causes contributing to altered palatal morphology. Until today, anatomical features of the newborn's palate are subject to a non-uniform nomenclature. Conclusion Today's knowledge of a newborn's 'normal' palatal

  15. Prevalência do aleitamento materno em recém-nascidos de baixo peso Prevalence of breast feeding of low birthweight infants

    Directory of Open Access Journals (Sweden)

    César C. Xavier

    1991-10-01

    Full Text Available Estudou-se de forma longitudinal e prospectiva a duração do aleitamento materno no primeira ano de vida de 222 crianças nascidas com peso menor ou igual a 2.500 gramas no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (Brasil, no período de outubro de 1985 a setembro de 1986. A incidência do aleitamento materno foi de 86,5%. A prevalência encontrada para as crianças que foram amamentadas foi de 62,5% aos 3 meses, 38,5% aos 6 meses, 28,7% aos 9 meses e 25,0% aos 12 meses de vida. A mediana da duração do aleitamento materno foi de 4 meses. O peso ao nascer mostrou associação positiva com a incidência e duração do aleitamento materno, O nível de escolaridade materno associou-se positivamente com sua duração. A idade materna, situação conjugal e o número de consultas pré-natais não apresentaram associação com o aleitamento materno. Estes dados mostram índices menores em relação aos de populações de países desenvolvidos, em especial os pré-termos finlandeses nascidos com peso menor do que 1.500 gramas. Programas de ações envolvendo a comunidade e/ou instituições devem resultar em melhoria de nossos índices, se bem implementados.The present situation regarding the breast feeding of children born with a weight of 2,500 grammes or less (LWB at the Hospital das Clínicas of the Medical School of the Universidade de S. Paulo in Ribeirão Preto (Brazil was studied. The study was descriptive and the data were obtained through a longitudinal follow-up carried over the period from October 1985 to September 1986 inclusive. Of the 222 children included in the study, 30 (13.5% infants were not breastfed. Thus the incidence of breast feeding among this population was of 86.5%. At 3 months 62.5% of these infants were still being breastfed. At 6 months this figure fell to 38.5% and only 25.0% were still being breast-fed at the end of 12 months. The average duration of breast feeding for the 192 children that

  16. Preterm low birthweight and the role of oral bacteria

    Directory of Open Access Journals (Sweden)

    Elizabeth Shira Davenport

    2010-12-01

    Full Text Available Preterm and low birthweight (PTLBW continues to be a major cause of mortality and morbidity across the world. In recent years, maternal periodontal disease has been implicated as a risk factor for adverse pregnancy outcomes. There is conflicting evidence to support such an outcome as illustrated by descriptive, case control and randomised controlled trials involving pregnant women from across the world, using different measurement tools to determine the level of periodontal disease. Whilst considering the literature, there is evidence for both arguments, based on the effect of periodontal inflammatory by products. Bacteria associated with periodontal disease are not dissimilar to those known to be associated with genito-urinary bacterial infections and adverse pregnancy outcomes. Several groups have demonstrated the apparent translocation of Fusobacterium nucleatum, Prevotella nigrescens, Prevotella intermedia, Porphyromonus gingivalis, Treponema denticola to the foetal placental unit whereby a maternal or foetal response has been detected resulting in premature birth or low birthweight. The normal process of parturition involves a cascade of events including a build-up of inflammatory mediators as linked to inflammation, whereby the maternal environment becomes hostile and threatens the well-being of the infant, and the foetus expelled. The question remains therefore, is there a greater risk of delivering a PTLBW infant when the mother has detectable periodontal disease, or is the release of inflammatory mediators and their translocation via the haematogenous route sufficient to induce a poor pregnancy outcome? The data investigated would suggest that there is a positive outcome when certain oral gram-negative bacteria create a cumulative effect sufficient to trigger early delivery, which represents the final straw to result in preterm or low birthweight delivery. There is equally sufficient epidemiological evidence that does not support this

  17. Cardiac surgery of premature and low birthweight newborns: is a change of fate possible?

    Science.gov (United States)

    Alkan-Bozkaya, Tijen; Türkoğlu, Halil; Akçevin, Atif; Paker, Tufan; Ozkan-Çerçi, Hilda; Dindar, Aygün; Ersoy, Cihangir; Bayer, Vedat; Aşkin, Demet; Undar, Akif

    2010-11-01

    Low birthweight (LBW) continues to be a high-risk factor in surgery for congenital heart disease. This risk is particularly very high in very low birthweight infants under 1500g and extremely LBW infants under 1000g. From January 2005 to December 2008, 33 consecutive LBW neonates underwent cardiac surgery in our clinic in keeping with the criteria for choice of surgery. Their weight range was between 800 and 1900g. Nine of them were under 1000g. Cardiopulmonary bypass (CPB) was used in 17 patients (39.5%) and pulsatile perfusion mode was applied to patients in the CPB group. The same surgical team operated to achieve palliation (8 patients, 24.2%) or full repair (25 patients, 75.8%). Median gestational age was 36 weeks with 12 (36.4%) premature babies (≤37 weeks). Median age at operation was 5 days. Pathologies were single ventricle (n=3), pulmonary atresia-ventricular septal defect (n=3), aortic coarctation (n=10), aorticopulmonary window and interrupted aortic arch combination (n=6), patent arterial duct (n=11), critical aortic stenosis (n=8), and tetralogy of Fallot with pulmonary atresia (n=2). One infant had VATER syndrome. Selective cerebral perfusion technique was used in complex arch pathologies for cerebral protection. Median follow-up was 14 months. There were four early postoperative deaths. None of the cases showed a need for early reoperation. The acceptable early- and midterm mortality rates in this group suggest that these operations can be successfully performed. There is a need for further multicenter studies to evaluate these high-risk groups.

  18. Ambient air pollution and low birthweight

    DEFF Research Database (Denmark)

    Pedersen, Marie; Giorgis-Allemand, Lise; Bernard, Claire

    2013-01-01

    BACKGROUND: Ambient air pollution has been associated with restricted fetal growth, which is linked with adverse respiratory health in childhood. We assessed the effect of maternal exposure to low concentrations of ambient air pollution on birthweight. METHODS: We pooled data from 14 population...... air pollutants and traffic during pregnancy is associated with restricted fetal growth. A substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution was reduced. FUNDING: The European Union....

  19. Effect of vitamin A supplementation on morbidity of low-birthweight ...

    African Journals Online (AJOL)

    Effect of vitamin A supplementation on morbidity of low-birthweight neonates. ... Low-birth-weight (LBW) infants « 2 500 g) are at increased risk of respiratory infection in ... After adjusting for risk factors this difference was no longer significant.

  20. Delayed cord clamping in South African neonates with expected low birthweight : a randomised controlled trial

    NARCIS (Netherlands)

    Tiemersma, Sybrich; Heistein, Julia; Ruijne, Roos; Lopez, Gustavo; van Lobenstein, Jeroen; van Rheenen, Patrick

    OBJECTIVE: To evaluate safety and haematological effects of delayed cord clamping (DCC) in infants with expected low birthweight born in a resource-poor setting. METHODS: Randomised controlled trial involving pregnant women in early labour ≥18 years with intrapartum symphysal-fundal height ≤32 cm.

  1. Headlights on tobacco road to low birthweight outcomes

    DEFF Research Database (Denmark)

    Bache, Stefan Holst; Dahl, Christian Møller; Kristensen, Johannes Tang

    2013-01-01

    Low birthweight outcomes are associated with considerable social and economic costs, and therefore the possible determinants of low birthweight are of great interest. One such determinant which has received considerable attention is maternal smoking. From an economic perspective this is in part d...

  2. Data linkage to explore the risk of low birthweight associated with maternal proximity to hazardous waste sites from the National Priorities List

    Energy Technology Data Exchange (ETDEWEB)

    Sosniak, W.A.; Kaye, W.E. (Agency for Toxic Substances and Disease Registry, Atlanta, GA (United States)); Gomez, T.M. (Centers for Disease Control and Prevention, Atlanta, GA (United States))

    Data from the 1988 National Maternal and Infant Health Survey files were linked with data from the 1990 Environmental Protection Agency National Priorities List of hazardous waste sites to determine whether any relationship existed between living in proximity to hazardous waste sites and low birthweight. The odds ratio for low birthweight versus normal birthweight was 1.03 (95% confidence internal [95% Cl] = 0.98-1.16), and remained at 0.99 (95% Cl = 0.86-1.16) when adjusted for maternal age, parity, infant sex, prenatal care, and behavioral and socioeconomic factors. Very low birthweight, infant and fetal death, prematurity, and congenital malformation were not found to be associated with living in the vicinity of a hazardous waste site during pregnancy. Merging a large population database with environmental data proved to be an innovative but not very efficient method of assessing the risks of low birthweight related to the environment. 20 refs., 4 tabs.

  3. Low birthweight in Mexico: a systematic review.

    Science.gov (United States)

    Buekens, Pierre; Canfield, Caitlin; Padilla, Nicolas; Lara Lona, Elia; Lozano, Rafael

    2013-01-01

    There is abundant literature on the birth outcomes of women of Mexican origin living in the United States, but in most cases it does not refer to data available in Mexico. We conducted a systematic review of available data regarding low birthweight (LBW) rates in Mexico. We searched official online Mexican administrative data bases and four literature databases: OVID (Global Health), EMBASE, PubMed, and Bireme. The following inclusion criteria were used: (1) study is in English, Spanish, or Portuguese; (2) study presents data regarding LBW or birthweight distribution in Mexico; (3) study defines LBW as either 7.9%). States at low altitudes (<50 m) had LBW rates lower than the median, with the exception of Yucatán state. The systematic literature review identified 22 hospital-based studies and three household interview surveys that met our inclusion criteria. The hospital-based LBW rates were relatively similar to the birth certificate data and slightly lower than survey data. Data on LBW rates are available in Mexico. They should be analyzed further and used for comparative studies.

  4. low birthweight babies: socio-demographic and obstetric ...

    African Journals Online (AJOL)

    2002-10-01

    Oct 1, 2002 ... mothers (aged below 20 years) and older mothers of low birthweight ( ... have unfavourable socio-demographic and obstetric factors like ... having less formal education, being unemployed and having obstetric risks for poor.

  5. Paternal Age as a Risk Factor for Low Birthweight

    National Research Council Canada - National Science Library

    Reichman, Nancy E; Teitler, Julien O

    2006-01-01

    ... birthweight were found. Conclusions. We identified paternal age as an independent risk factor for low birthweight in the US urban population, suggesting that more attention needs to be paid to ...

  6. Vitamin A supplementation and BCG vaccination at birth in low birthweight neonates

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Fisker, Ane Baerent; Napirna, Bitiguida Mutna

    2010-01-01

    OBJECTIVE: To investigate the effect of vitamin A supplementation and BCG vaccination at birth in low birthweight neonates. DESIGN: Randomised, placebo controlled, two by two factorial trial. SETTING: Bissau, Guinea-Bissau. PARTICIPANTS: 1717 low birthweight neonates born at the national hospital....... INTERVENTION: Neonates who weighed less than 2.5 kg were randomly assigned to 25 000 IU vitamin A or placebo, as well as to early BCG vaccine or the usual late BCG vaccine, and were followed until age 12 months. MAIN OUTCOME MEASURE: Mortality, calculated as mortality rate ratios (MRRs), after follow-up to 12...... months of age for infants who received vitamin A supplementation compared with those who received placebo. RESULTS: No interaction was observed between vitamin A supplementation and BCG vaccine allocation (P=0.73). Vitamin A supplementation at birth was not significantly associated with mortality...

  7. Preconceptional factors associated with very low birthweight delivery in East and West Berlin: a case control study

    Directory of Open Access Journals (Sweden)

    Reiher Horst

    2002-06-01

    Full Text Available Abstract Background Very low birthweight, i.e. a birthweight Methods In 1992, two years after the German unification, we started to recruit two cohorts of very low birthweight infants and controls in East and West Berlin for a long-term neurodevelopmental study. The present analysis was undertaken to compare potential preconceptional risk factors for very low birthweight delivery in a case-control design including 166 mothers (82 East vs. 84 West Berlin with very low birthweight delivery and 341 control mothers (166 East vs. 175 West. Results Multivariate logistic regression analysis was used to assess the effects of various dichotomous parental covariates and their interaction with living in East or West Berlin. After backward variable selection, short maternal school education, maternal unemployment, single-room apartment, smoking, previous preterm delivery, and fetal loss emerged as significant main effect variables, together with living in West Berlin as positive effect modificator for single-mother status. Conclusion Very low birthweight has been differentially associated with obstetrical history and indicators of maternal socioeconomic status in East and West Berlin. The ranking of these risk factors is under the influence of the political framework.

  8. Outcomes for extremely premature infants.

    Science.gov (United States)

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

    2015-06-01

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

  9. Outcomes for Extremely Premature Infants

    Science.gov (United States)

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

    2015-01-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages. The striking similarities in response to extreme prematurity in the lung and brain imply that agents and techniques that benefit one organ are likely to also benefit the other. Finally, since therapy and supportive care continue to change, the outcomes of ELBW infants are ever evolving. Efforts to minimize injury, preserve

  10. Desenvolvimento mental e motor aos 24 meses de crianças nascidas a termo com baixo peso Mental and motor development at 24 months of full-term low birthweight infants

    Directory of Open Access Journals (Sweden)

    Sophie Helena Eickmann

    2002-09-01

    Full Text Available Este estudo teve como objetivo comparar o desenvolvimento aos 24 meses de 152 crianças nascidas a termo, com baixo peso (The objective of this study was to compare the development at 24 months of 152 full-term infants, born with low (<2500g and appropriate birth weight (3000 to 3499g, paired in a proportion of 1:1 by sex and age. Mental and motor development were assessed through the Bayley scale. A variety of sociodemographic and environmental stimulation conditions were also assessed. The infants born with low weight had on average significantly lower mental and motor indexes than those born with appropriate weight (p<0.001, with a difference of 9.1 and 10.2 points, respectively. The multiple linear regression analysis showed that socioeconomic conditions and environmental stimulation explained 11% and 12% of the variation of mental index, and 12% and 9% of motor development, respectively. All together, they explained 23% and 21% of the variation of these indexes. Low birth weight influenced only 3% of the variation of mental index and 5% of motor index.

  11. Genome-wide association study of sepsis in extremely premature infants.

    Science.gov (United States)

    Srinivasan, Lakshmi; Page, Grier; Kirpalani, Haresh; Murray, Jeffrey C; Das, Abhik; Higgins, Rosemary D; Carlo, Waldemar A; Bell, Edward F; Goldberg, Ronald N; Schibler, Kurt; Sood, Beena G; Stevenson, David K; Stoll, Barbara J; Van Meurs, Krisa P; Johnson, Karen J; Levy, Joshua; McDonald, Scott A; Zaterka-Baxter, Kristin M; Kennedy, Kathleen A; Sánchez, Pablo J; Duara, Shahnaz; Walsh, Michele C; Shankaran, Seetha; Wynn, James L; Cotten, C Michael

    2017-09-01

    To identify genetic variants associated with sepsis (early-onset and late-onset) using a genome-wide association (GWA) analysis in a cohort of extremely premature infants. Previously generated GWA data from the Neonatal Research Network's anonymised genomic database biorepository of extremely premature infants were used for this study. Sepsis was defined as culture-positive early-onset or late-onset sepsis or culture-proven meningitis. Genomic and whole-genome-amplified DNA was genotyped for 1.2 million single-nucleotide polymorphisms (SNPs); 91% of SNPs were successfully genotyped. We imputed 7.2 million additional SNPs. p Values and false discovery rates (FDRs) were calculated from multivariate logistic regression analysis adjusting for gender, gestational age and ancestry. Target statistical value was p<10(-5). Secondary analyses assessed associations of SNPs with pathogen type. Pathway analyses were also run on primary and secondary end points. Data from 757 extremely premature infants were included: 351 infants with sepsis and 406 infants without sepsis. No SNPs reached genome-wide significance levels (5×10(-8)); two SNPs in proximity to FOXC2 and FOXL1 genes achieved target levels of significance. In secondary analyses, SNPs for ELMO1, IRAK2 (Gram-positive sepsis), RALA, IMMP2L (Gram-negative sepsis) and PIEZO2 (fungal sepsis) met target significance levels. Pathways associated with sepsis and Gram-negative sepsis included gap junctions, fibroblast growth factor receptors, regulators of cell division and interleukin-1-associated receptor kinase 2 (p values<0.001 and FDR<20%). No SNPs met genome-wide significance in this cohort of extremely low birthweight infants; however, areas of potential association and pathways meriting further study were identified. 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/.

  12. Gravidez na adolescência e baixo peso ao nascer: existe associação? Embarazo en la adolescencia y bajo peso al nacer: ¿existe asociación? Pregnancy in teenagers and low birthweight infant: is there an association?

    Directory of Open Access Journals (Sweden)

    Almir de Castro Neves Filho

    2011-12-01

    Full Text Available OBJETIVO: Verificar a associação entre gravidez na adolescência (dez a 19 anos e baixo peso ao nascer. MÉTODOS: Estudo transversal realizado em maternidade terciária entre junho de 2000 a junho de 2001. Por sorteio aleatório simples, foram selecionadas mães adolescentes e não adolescentes entrevistadas no primeiro dia após o parto. Aplicou-se a análise multivariada por meio de regressão logística das variáveis implicadas com o baixo peso ao nascer. RESULTADOS: Foram selecionadas 539 duplas (mães e seus respectivos recém-nascidos, sendo 331 (61,4% mulheres com 20 anos ou mais e 208 (38,5% abaixo de 20 anos. Entre as adolescentes, 50 bebês (24% tiveram idade gestacional OBJETIVO: Verificar la asociación entre embarazo en la adolescencia (10 a 19 años y bajo peso al nacer. MÉTODOS: Estudio transversal realizado en maternidad terciaria entre junio de 2000 a junio de 2001. Por sorteo aleatorio simple, se seleccionaron madres adolescentes y no adolescentes entrevistadas en el primer día después del parto. Se aplicó el análisis multivariado mediante regresión logística de las variables implicadas con el bajo peso al nacer. RESULTADOS: Se seleccionaron 539 parejas (madres y sus respectivos recién-nacidos, siendo 331 (61,4% mujeres con 20 años o más y 208 (38,5% abajo de los 20 años. Entre las adolescentes, 50 bebés (24% tuvieron edad gestacional OBJECTIVE: To study the association between teenage pregnancy (ten to 19 years old and low birthweight. METHODS: Cross-sectional study carried out at a tertiary center from June 2000 to June 2001. A simple random drawing selected teenagers and adult mothers who were interviewed during the first day after birth. Multivariate analysis using logistic regression of variables related to low birthweight was applied. RESULTS: 539 pairs (mothers and their newborns were studied - 331 (61.4% women with 20 years old or more and 208 (38.5% <20 years old. Among the adolescents, 50 (24% infants

  13. Early diphtheria-tetanus-pertussis vaccination associated with higher female mortality and no difference in male mortality in a cohort of low birthweight children

    DEFF Research Database (Denmark)

    Aaby, Peter; Ravn, Henrik; Roth, Adam Anders Edvin

    2012-01-01

    Studies from low-income countries have suggested that diphtheria-tetanus-pertussis (DTP) vaccine provided after Bacille Calmette-Guerin (BCG) vaccination may have a negative effect on female survival. The authors examined the effect of DTP in a cohort of low birthweight (LBW) infants....

  14. Low birthweight as an indicator of child health in Greenland--use, knowledge and implications

    OpenAIRE

    Niclasen, Birgit

    2007-01-01

    OBJECTIVES: The aim of this study was to analyse if low birthweight is a valuable indicator of child health in Greenland. STUDY DESIGN: A case study focusing on "low birthweight as an indicator in Greenland" with 3 units and 5 subunits of analyses. METHODS: Literature reviews, interviews with health care professionals and an analysis of the National Birth Register. RESULTS: Low birthweight was a well-known and yearly surveyed indicator, but not used by clinicians or by policymakers. Resear...

  15. InReach: Connecting NICU Infants and Their Parents with Community Early Intervention Services

    Science.gov (United States)

    Akers, Adrienne L.; Boyce, Glenna; Mabey, Vanya; Boyce, Lisa

    2007-01-01

    Infants who are born prematurely may experience developmental delays and impairments during infancy and beyond. Those who are born at extremely low birthweight face the greatest challenges. Many families could benefit from early intervention services through their local Part C of Individuals With Disabilities Education Act (IDEA) programs, but…

  16. Relative risks of low birthweight in Scotland 1980-2.

    OpenAIRE

    Pickering, R.M.

    1987-01-01

    Routinely collected data for 187,000 Scottish singleton livebirths in 1980-2 were used to relate the risk of birthweight below 2500 g, 2000 g, 1500 g, and 1000 g to sex of infant and nine maternal factors. Maternal height was a major predictor of birthweight below 2500g but was less important in predicting birthweight in the lower intervals. A history of prenatal death and spontaneous abortion was important for all four intervals and was associated with most extreme risks for birthweight belo...

  17. Growth and development in children born very low birthweight.

    Science.gov (United States)

    Scharf, Rebecca J; Stroustrup, Annemarie; Conaway, Mark R; DeBoer, Mark D

    2016-09-01

    To examine the relationships between growth (birth to age 2 years) and developmental outcomes in children born with very low birthweight (VLBW). Motor and mental development in children born with VLBW were regressed on anthropometric measurements at birth, 9 months and 2 years using multivariable regression. The Early Childhood Longitudinal Study-Birth Cohort, a longitudinal cohort, community sample, designed to be representative of children born across the USA. 950 children born with VLBW (children exhibited poor growth, with length-for-age z-scores children at 9 months (adjusted for prematurity) and 34.2% of children at 2 years. Compared with children having z-scores >-2, children with growth shortfalls in head circumference, length and weight had a higher adjusted OR (aOR) of low Bayley motor scores at 9 months and 2 years (aOR ranging from 1.8 to 3.3, all pchildren born with VLBW. While careful length measures may be a particularly useful marker, deficits in all anthropometric measures were risk factors for developmental delays. 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/

  18. Influence of a combination of probiotics on bacterial infections in very low birthweight newborns.

    Science.gov (United States)

    Kanic, Zlatka; Micetic Turk, Dusanka; Burja, Silva; Kanic, Vojko; Dinevski, Dejan

    2015-12-01

    Late-onset infections are an important cause of morbidity and mortality in preterm infants. The purpose of our prospective randomised study was to establish whether a combination of probiotics (Lactobacillus acidophilus, Enterococcus faecium and Bifidobacterium infantum) affects the incidence of late-onset sepsis and other infections in very low birthweight infants (birthweight under 1500 g, gestational age under 33 weeks). From 80 included infants, one half received probiotics (L. acidophilus, E. faecium and B. infantum) in the ratio 1.5:1:1.5, at a dose of 0.6 × 107 colony-forming units twice daily, given with the first portions of milk until discharge, whereas the other half did not. In the group receiving probiotics, 16 children had late-onset sepsis compared with 29 in the group without probiotics; p = 0.006. The number of late-onset septic events was lower (30) in the group receiving probiotics than in the group that did not receive probiotics (69); p = 0.003. Furthermore, fewer children had at least one late-onset infection (20 infants in the group receiving probiotics compared with 32 in the group without them; p = 0.009). There were less episodes of late-onset infections in the group receiving probiotics (35) than in the group without probiotics (79); p = 0.002. A combination of probiotics at a low dose (1.2 × 107 colony-forming units) decreased the frequency of late-onset sepsis and other infections, as described in previous studies. In addition, children were discharged at a lower postmenstrual age. There were no side effects of probiotics reported.

  19. Very-low-birthweight neonates: do outcomes differ in multiple compared with singleton gestations?

    Science.gov (United States)

    Hayes, Edward J; Paul, David; Ness, Amen; Mackley, Amy; Berghella, Vincenzo

    2007-06-01

    The purpose of this study is to determine if outcomes for very-low-birthweight (VLBW) neonates differ in multiple versus singleton gestations. This is a retrospective cohort study of neonates weighing less than 1500 g admitted to a neonatal intensive care unit from 1993 to 2004. Outcome variables were necrotizing enterocolitis, death, and/or severe intraventricular hemorrhage (IVH). Statistical analysis included univariate and multivariate analysis. During the study period, 1769 VLBW infants including 465 multiples and 1304 singletons were identified. Gestational age and birthweight were similar; conversely white race (68% multiples versus 43% singletons), maternal age (28.7 +/- 5.7 versus 26.1 +/- 6.5 years), born at facility (95% versus 86%), antenatal steroids (74% versus 58%), preeclampsia (14% versus 24%), and preterm labor (74% versus 62%) were significantly different. Correcting for these, VLBW multiples had a higher odds ratio (OR) of death and/or severe IVH, OR 1.4 (1.03-1.95). In our population, VLBW multiple gestations were at elevated odds for death and/or severe IVH compared with VLBW singletons.

  20. Intervention strategies for preventing low birthweight in developing countries: importance of considering multiple interactive factors.

    Science.gov (United States)

    Uauy, Ricardo; Corvalan, Camila; Casanello, Paola; Kuzanovic, Juan

    2013-01-01

    The need to prevent low birthweight (LBW) defined as a birthweight ≤2,500 g is presently well recognized, not only because of the immediate consequences increasing the risk of neonatal death and burden of disease but also in terms of the impact of being LBW on lifelong health and well-being. Children are born LBW (<2,500 g) either because they were born too early (true preterm LBW infants) or alternatively they failed to grow adequately despite a normal duration of gestation (intrauterine growth retardation IUGR). In this later case, the weight may be over 2,500 g, but the infant is lighter than expected for his/her gestational age. In fact, many preterm infants are to some degree growth retarded. Despite the differences in origin, all LBW categories are considered at increased risk of neonatal death and later morbidity. Preventive actions are more likely to succeed if we consider the nutritional interventions as part of a package that addresses in a holistic manner the full spectrum of needs of women from before conception as well as during pregnancy. We have gained sufficient experience with single nutrient and/or 'magic bullet' approaches to learn from this and avoid them in the future. New fetal growth standards (INTERGROWTH 2012) represent major progress in terms of evaluating the effect of early life events on later growth, health and well-being. Thus, for the first time, clinicians and researchers will have sequential longitudinal data that will serve to characterize whole body as well as brain, liver, and long bone growth, relating this indirectly to placental blood flow and transfer function, neonatal health, morbidity and mortality. Copyright © 2013 Nestec Ltd., Vevey/S. Karger AG, Basel.

  1. Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care

    Directory of Open Access Journals (Sweden)

    Sutherland Georgina A

    2011-03-01

    Full Text Available Abstract Background Investment in strategies to promote 'a healthy start to life' has been identified as having the greatest potential to reduce health inequalities across the life course. The aim of this study was to examine social determinants of low birthweight in an Australian population-based birth cohort and consider implications for health policy and health care systems. Methods Population-based survey distributed by hospitals and home birth practitioners to >8000 women six months after childbirth in two states of Australia. Participants were women who gave birth to a liveborn infant in Victoria and South Australia in September/October 2007. Main outcome measures included stressful life events and social health issues, perceived discrimination in health care settings, infant birthweight. Results 4,366/8468 (52% of eligible women returned completed surveys. Two-thirds (2912/4352 reported one or more stressful life events or social health issues during pregnancy. Women reporting three or more social health issues (18%, 768/4352 were significantly more likely to have a low birthweight infant ( Conclusions There is a window of opportunity in antenatal care to implement targeted preventive interventions addressing potentially modifiable risk factors for poor maternal and infant outcomes. Developing the evidence base and infrastructure necessary in order for antenatal services to respond effectively to the social circumstances of women's lives is long overdue.

  2. Neurological follow-up of very low birthweight premature infants and very preterm infants%极低出生体重儿和极早早产儿随访检测及预后影响因素分析

    Institute of Scientific and Technical Information of China (English)

    赵凯怡; 赵芸; 潘静子; 王丽; 梁莉丹; 陈尚勤; 林振浪; 陈翔

    2015-01-01

    Objective To investigate the neurodevelopment of very low birth weight (VLBWI) and very preterm infants (VPI) and the factors influencing that development,especially the effect of early intervention.Methods Early intervention and follow-up visits were performed on 114 VPIs and VLBWIs after their discharge from the neonatal NICU.The infants were classified into an intervention group and a non-intervention group,based on whether the parents had performed early family intervention or not.The infants received the infant Developmental test of Children's Center of China (CDCC) at 1 year old.According to the test results,they were divided into a normal mental development index (MDI) group,an abnormal MDI group,a normal psychomotor development index (PDI)group and an abnormal PDI group.A 20-item neurological movement scale was also used to assess the subjects.Potential high-risk factors were sought using Logistic regression.Results Significant differences between the normal and abnormal MDI groups were observed in terms of the male/female ratio,the incidence of asphyxia and hypothermia,antenatal training and the intensity of their early education (P < 0.05).There were also significant differences between the normal and abnormal PDI groups in terms of gestational age and the incidence of asphyxia,hypoxic-ischemic encephalopathy and intracranial hemorrhage (P < 0.05).The fathers' education level,antenatal training and the frequency of intervention also predicted PDI scores.The average PDI and MDI score of the intervention group was 97.40 ± 21.07 and 96.15 ± 18.10,and those of the non-intervention group were 81.70 ± 21.69 and 91.35 ± 19.24,both with significant difference between the two groups (P < 0.05).In the intervention group significantly fewer infants had abnormal PDI scores,with abnormal results of the 20-item scale or cerebral palsy (P < 0.05).The regression results suggest that asphyxia and hypoxic-ischemic encephalopathy are risk factors for poor mental

  3. Is paediatric assessment of motor development of very preterm and low-birthweight children appropriate?

    NARCIS (Netherlands)

    Kleine, M.J. de; Nijhuis-Van der Sanden, M.W.G.; Ouden, A.L. den

    2006-01-01

    AIM: To determine whether paediatricians that examine, in regular clinical practice, very preterm and very-low-birthweight children at 5 y of age detect neurological impairments and functional motor problems in these children. METHODS: We compared a paediatric judgement, a standardized neurological

  4. Is paediatric assessment of motor development of very preterm and low-birthweight children appropriate?

    NARCIS (Netherlands)

    Kleine, M.J. de; Nijhuis-Van der Sanden, M.W.G.; Ouden, A.L. den

    2006-01-01

    AIM: To determine whether paediatricians that examine, in regular clinical practice, very preterm and very-low-birthweight children at 5 y of age detect neurological impairments and functional motor problems in these children. METHODS: We compared a paediatric judgement, a standardized neurological

  5. Association between paternal schizophrenia and low birthweight:ADAM12 may matter

    Institute of Scientific and Technical Information of China (English)

    Hans-Gert Bernstein; Susan Müller; Johann Steiner; Nadine Farkas; Bernhard Bogerts; Uwe Lendeckel

    2010-01-01

    @@ Dear Editor, I am Dr Hans-Gert Bernstein from the Department of Psychiatry, University of Magdeburg, Germany.Although it is now a well-established fact that mothers with schizophrenia are at higher risk for obstetric complications (preterm births, preeclampsia, low birthweight [LBW] and small-for-gestational-age babies), a putative paternal impact was largely ignored until recently.

  6. Epigenetic programming of adipose-derived stem cells in low birthweight individuals

    DEFF Research Database (Denmark)

    Broholm, Christa; Olsson, Anders H; Perfilyev, Alexander

    2016-01-01

    AIMS/HYPOTHESIS: Low birthweight (LBW) is associated with dysfunctions of adipose tissue and metabolic disease in adult life. We hypothesised that altered epigenetic and transcriptional regulation of adipose-derived stem cells (ADSCs) could play a role in programming adipose tissue dysfunction...

  7. The dynamic relationship between low birthweight and induced abortion in New York City. An aggregate time-series analysis.

    Science.gov (United States)

    Joyce, T; Grossman, M

    1990-11-01

    We use a vector autoregression to examine the dynamic relationship between the race-specific percentage of pregnancies terminated by induced abortion and the race-specific percentage of low-birthweight births in New York City. With monthly data beginning in 1972, we find that induced abortion explains low birthweight for blacks, but not for whites. There is no evidence of feedback from low birthweight to induced abortion. The findings suggest that unanticipated decreases in the percentage of pregnancies terminated by induced abortion would worsen birth outcomes among blacks in New York City.

  8. Single motherhood and low birthweight in Spain: Narrowing social inequalities in health?

    Directory of Open Access Journals (Sweden)

    Teresa Castro-Martin

    2010-05-01

    Full Text Available Nonmarital childbearing is becoming an increasingly common path to family formation in Spain. The proportion of births to unmarried mothers has increased from 2Š in 1975 to 30.2Š in 2007. Along with this marked increase, there has been an important shift in the sociodemographic profile of unmarried mothers. This study focuses on the impact of mothers' marital status on the health status of their newborns, using low birthweight as an indicator. We are interested in examining how the impact of mothers' unmarried status on birth outcomes changes as nonmarital childbearing shifts from a marginal to a relatively common behaviour. The results of the analysis reveal that the health disadvantage gap between marital and nonmarital births has narrowed significantly over the past decade in Spain. We argue that diminishing selection processes and increasing social acceptance could explain the declining significance of marital status as a risk factor for low birthweight.

  9. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sorensen, Simon; Pellicer, Adelina; Alderliesten, Thomas

    2015-01-01

    OBJECTIVE: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. DESIGN: Phase II randomised, single blinded, parallel clinical trial. SETTING: Eight tertiary neonatal intensive care units...

  10. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sorensen, Simon; Pellicer, Adelina; Alderliesten, Thomas;

    2015-01-01

    OBJECTIVE: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. DESIGN: Phase II randomised, single blinded, parallel clinical trial. SETTING: Eight tertiary neonatal intensive care units...

  11. Risk factors for low birthweight based on birth registration and census information, England and Wales, 1981-2000

    National Research Council Canada - National Science Library

    Collingwood Bakeo, Aleks; Clarke, Lynda

    2006-01-01

    This study examines whether there are socio-demographic factors (collected at census) that are not routinely available at birth registration that help to explain low birthweight in England and Wales in the 1980s and 1990s...

  12. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

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

  13. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

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

  14. Clinical analysis of risk factors of parenteral nutrition-associated cholestasis in very low birthweight infants%极低出生体质量儿胃肠外营养相关性胆汁淤积危险因素临床分析

    Institute of Scientific and Technical Information of China (English)

    杨军; 李水霞; 陈莉娜

    2015-01-01

    Objective To investigate the risk factors of parenteral nutrition-associated cholestasis (PNAC)in very low birth weight infants (VLBWI).Methods VLBWI who were accorded with inclusion and exclusion criteria of this study:treatment for parenteral nutrition (PN)for over 14 days in West China Second University Hospital of Sichuan University from May 2008 to May 2014 were chosen as study subjects.By retrospectively analyzed method,they were divided into PNAC group and non PNAC group according to whether suflered from PNAC or not.First of all,according to the clinical experience,the influence factors of PNAC were identified and carried on the single factor analysis,then comprehensively considered with statistically significant variables and professional knowledge,multiple factors unconditional logistic regression analysis method was used to further analyze the independent and risk factors of PNAC. Results ① A total of 1 72 cases of VLBWI were chosen as study subjects finally.According to whether suffered from PNAC or not,they were divided into PNAC group (n=29)and non PNAC group (n=143), and the incidence of PNAC was 1 6.9%.There were no significant differences between two groups among gender ratio,gestational age at delivery and mode of delivery,etc.(P > 0.05 ).② According to clinical experience,the single factor analysis results about 27 clinical observation items and 1 9 nutritional factors which may lead to PNAC showed that 8 clinical observation items and 5 nutritional factors were influence factors of PNAC,such as VLBWI,less than appropriate for gestational age (SGA),long fasting time and longer duration of PN,higher amino acid and fat emulsion calories,milk lower calories,higher neonatal infections,such as infectious pneumonia,sepsis,neonatal necrotizing enterocolitis (NEC)and septic shock rate,lower breastfeeding and oral probiotics rate,and all the differences were statistically significant (t/χ2 =3.306,3.306,1.790,1.231,3.1 93,2.81 5,2.5 1 9,4.61 5,3

  15. Housing conditions as a social determinant of low birthweight and preterm low birthweight Condiciones de vivienda como determinante social de bajo peso al nacer y de prematuro de bajo peso al nacer Condições de moradia como determinante social de baixo peso ao nascer e prematuro de baixo peso

    Directory of Open Access Journals (Sweden)

    Mario Vianna Vettore

    2010-12-01

    Full Text Available OBJECTIVE: To assess the relationship between housing conditions and low birthweight and preterm low birthweight among low-income women. METHODS: A case-control study was conducted with post-partum women living in the city of Rio de Janeiro, Southeast Brazil, in 2003-2005. Two groups of cases, low birthweight (n=96 and preterm low birthweight infants (n=68, were compared against normal weight term controls (n=393. Housing conditions were categorized into three levels: adequate, inadequate, and highly inadequate. Covariates included sociodemographic and anthropometric characteristics, risk behaviors, violence, anxiety, satisfaction during pregnancy, obstetric history and prenatal care. RESULTS: Poor housing conditions was independently associated with low birthweight (inadequate - OR 2.3 [1.1;4.6]; highly inadequate - OR 7.6 [2.1;27.6] and preterm low birthweight (inadequate - OR 2.2 [1.1;4.3]; highly inadequate - OR 7.6 [2.4;23.9] and factors associated with outcomes were inadequate prenatal care and previous preterm birth. Low income and low maternal body mass index remained associated with low birthweight. CONCLUSIONS: Poor housing conditions were associated with low birthweight and preterm low birthweight.OBJETIVO: Evaluar la relación entre condiciones de vivienda y bajo peso al nacer y prematuridad asociada al bajo peso al nacer en los hijos de mujeres de baja renta. MÉTODOS: Se realizó estudio caso-control con mujeres en el postparto residentes en el municipio de Rio de Janeiro, Sureste de Brasil, en 2003-2005. Dos grupos de casos fueron comparados con controles a término y con peso normal (n=393: bajo peso al nacer (n=96 y prematuridad asociada al bajo peso al nacer (n=68. Las condiciones de vivienda fueron consideradas en los niveles: adecuadas, inadecuadas y muy inadecuadas. Las covariables investigadas fueron características sociodemográficas, antropométricas, hábitos de riesgo, violencia, ansiedad, satisfacción con el embarazo

  16. Effect of kangaroo mother care on growth and development of low birthweight babies up to 12 months of age: a controlled clinical trial.

    Science.gov (United States)

    Bera, Alpanamayi; Ghosh, Jagabandhu; Singh, Arun K; Hazra, Avijit; Mukherjee, Suchandra; Mukherjee, Ranajit

    2014-06-01

    Kangaroo mother care (KMC) is a nonconventional low-cost method of newborn care. Our aim was to assess the effect of sustained KMC on the growth and development of low birthweight Indian babies up to the age of 12 months. We enrolled 500 mother and baby pairs, in groups of five, in a parallel group controlled clinical trial. The three infants with the lowest birthweight in each group received KMC, while the other two received conventional care. All babies were exclusively breastfed for 6 months. Babies in the intervention group were provided KMC until the infant was 40 weeks of corrected gestation or weighed 2500 g. Weight, length and head, chest and arm circumferences were evaluated at birth and at the corrected ages of 0, 3, 6, 9 and 12 months. Development was assessed using the Developmental Assessment Scales for Indian Infants (DASII) at 12 months. The KMC babies rapidly achieved physical growth parameters similar to the control babies at 40 weeks of corrected age. But after that, they surpassed them, despite being smaller at birth. DASII motor and mental development quotients were also significantly better for KMC babies. The infants in the KMC group showed better physical growth and development than the conventional control group. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Adipose tissue transcriptomics and epigenomics in low birthweight men and controls

    DEFF Research Database (Denmark)

    Gillberg, Linn; Perfilyev, Alexander; Brøns, Charlotte

    2016-01-01

    Aims/hypothesis: Individuals who had a low birthweight (LBW) are at an increased risk of insulin resistance and type 2 diabetes when exposed to high-fat overfeeding (HFO). We studied genome-wide mRNA expression and DNA methylation in subcutaneous adipose tissue (SAT) after 5 days of HFO and after...... in CDK5, IGFBP5 and SLC2A4) was altered in SAT after overfeeding in this and in another cohort. Conclusions/interpretation: Young men who had a LBW exhibit epigenetic alterations in their adipose tissue that potentially influence insulin resistance and risk of type 2 diabetes. Short-term overfeeding...... influences gene transcription and, to some extent, DNA methylation in adipose tissue; there was no major difference in this response between LBW and control participants....

  18. Intelligence of very preterm or very low birthweight infants in young adulthood.

    NARCIS (Netherlands)

    Weisglas-Kuperus, N.; Hille, E.T.; Duivenvoorden, H.J.; Finken, M.J.; Wit, J.M.; Buuren, S. van; Goudoever, J.B. van; Verloove-Vanhorick, S.P.; Kollee, L.A.A.

    2009-01-01

    OBJECTIVE: To examine the effect of intrauterine and neonatal growth, prematurity and personal and environmental risk factors on intelligence in adulthood in survivors of the early neonatal intensive care era. METHODS: A large geographically based cohort comprised 94% of all babies born alive in the

  19. Intelligence of very preterm or very low birthweight infants in young adulthood

    NARCIS (Netherlands)

    Weisglas-Kuperus, N.; Hille, E.T.M.; Duivenvoorden, H.J.; Finken, M.J.J.; Wit, J.M.; Buuren, S. van; Goudoever, J.B. van; Verloove-Vanhorick, S.P.

    2009-01-01

    Objective: To examine the effect of intrauterine and neonatal growth, prematurity and personal and environmental risk factors on intelligence in adulthood in survivors of the early neonatal intensive care era. Methods: A large geographically based cohort comprised 94% of all babies born alive in the

  20. Survival of a very low-birthweight infant with Potter sequence on long-term hemodialysis.

    Science.gov (United States)

    Miyahara, Jun; Yamamoto, Masaki; Motoshige, Kyoko; Fujita, Naoya; Ohki, Shigeru

    2016-07-01

    Recent advances in neonatal cardiorespiratory management and neonatal renal replacement therapy have led to occasional reports of favorable short-term and long-term outcomes for Potter sequence, once thought to be fatal. The present patient was a girl born at a gestational age of 34 weeks 4 days with a birthweight of 1398 g. She was diagnosed with Potter sequence complicated by pulmonary hypoplasia due to left renal agenesis and small right kidney. Hemodialysis was started because anuria persisted even after persistent pulmonary hypertension receded and cardiorespiratory status improved. Peritoneal dialysis during the clinical course failed to achieve stability because of pericatheter leakage and frequent obstruction of the peritoneal dialysis catheter; in the meantime, hemodialysis was also performed. Once bodyweight passed 3.5 kg, peritoneal dialysis became more feasible with stability; the patient was discharged at 9 months and at the time of writing was on peritoneal dialysis at home, and renal transplantation was planned.

  1. Intelligence of very preterm or very low birthweight infants in young adulthood

    NARCIS (Netherlands)

    Weisglas-Kuperus, N.; Hille, E.T.M.; Duivenvoorden, H.J.; Finken, M.J.J.; Wit, J.M.; Buuren, S. van; Goudoever, J.B. van; Verloove-Vanhorick, S.P.

    2009-01-01

    Objective: To examine the effect of intrauterine and neonatal growth, prematurity and personal and environmental risk factors on intelligence in adulthood in survivors of the early neonatal intensive care era. Methods: A large geographically based cohort comprised 94% of all babies born alive in the

  2. Mental Health Outcomes in US Children and Adolescents Born Prematurely or with Low Birthweight

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh

    2013-01-01

    Full Text Available We examined the effects of prematurity (37 weeks of gestation and low birthweight (2500 g on mental health outcomes among US children aged 2–17 years. The 2011-2012 National Survey of Children’s Health ( = 95,677 was used to estimate prevalence of parent-reported mental health problems in children. Prevalence of mental disorders was 22.9% among children born prematurely, 28.7% among very-low-birth-weight (1500 g children, and 18.9% among moderately low-birth-weight (1500–2499 g children, compared with 15.5% in the general child population. Compared to those born full term, children born prematurely had 61% higher adjusted odds of serious emotional/behavioral problems, 33% higher odds of depression, and 58% higher odds of anxiety. Children born prematurely had 2.3 times higher odds of autism/ASD, 2.9 times higher odds of development delay, and 2.7 times higher odds of intellectual disability than term children. Very-low-birth-weight children had 3.2 times higher odds of autism/ASD, 1.7 times higher odds of ADD/ADHD, 5.4 times higher odds of development delay, and 4.4 times higher odds of intellectual disability than normal-birth-weight children. Social factors were significant predictors of mental disorders in both premature/low-birth-weight and term/normal-birth-weight children. Neurodevelopmental conditions accounted for the relationship between prematurity and depression/anxiety/conduct problems. Prematurity and low birthweight are significant risk factors for mental health problems among children.

  3. Secular trends of low birthweight and macrosomia and related maternal factors in Beijing, China: a longitudinal trend analysis

    Science.gov (United States)

    2014-01-01

    Background Information tracking changes of birthweight is scarce in China. To examine trends of low birthweight (birthweight birthweight ≥ 4000 g) and potential risk factors in Beijing, hospital records from two major obstetrics and gynecology hospitals in urban districts in Beijing were analyzed. Methods Hospital records from 1996 to 2010 were retrieved. Information of prenatal examination and birth outcomes was entered into a structured database. Live births were used for trend analysis. Information of live births in 2010 was used to identify potential risk factors. Results A total of 63 661 live births were delivered during 1996–2010 in the study hospitals. The average birthweight increased from 3271 g in 1996 to 3 359 g in 2000 and slightly declined to 3 331 in 2010. The percentage of low birthweight fluctuated around 4.0%. No significant increase or decrease was observed. Preterm birth was the main cause of low birthweight, accounting for more than 73% of low birthweight. The average percentage of macrosomia was 7.6%. The percentages of macrosomia increased from 6.6% in 1996 to 9.5% in 2000 and declined to 7.0% in 2010. Excessive gestational weight gain and gestational diabetes were significantly associated with macrosomia. Conclusions Continuously monitoring abnormal birthweight is needed and intervention should focus on appropriate gestational weight gain and reduction of preterm birth and gestational diabetes. PMID:24641671

  4. Visual Functions in Relation with Neonatal Cerebral Ultrasound, Neurology and Cognitive Development in Very-Low-Birthweight Children

    NARCIS (Netherlands)

    Weisglas-Kuperus, N.; Heersema, D. J.; Baerts, W.; Fetter, W. P. F.; Smrkovsky, M.; van Hof-van Duin, J.; Sauer, P. J. J.

    1993-01-01

    In order to determine the relationship between visual functions and neonatal cerebral ultrasound, neurological examinations and cognitive development, a prospective longitudinal study was conducted in 69 high-risk very-low-birthweight children. Visual development was studied at 1 and 2.6 years of co

  5. Secular trends of low birthweight and macrosomia and related maternal factors in Beijing, China: a longitudinal trend analysis.

    Science.gov (United States)

    Shan, Xiaoyi; Chen, Fangfang; Wang, Wenpeng; Zhao, Juan; Teng, Yue; Wu, Minghui; Teng, Honghong; Zhang, Xue; Qi, Hong; Liu, Xiaohong; Tan, Chunying; Mi, Jie

    2014-03-18

    Information tracking changes of birthweight is scarce in China. To examine trends of low birthweight (birthweight macrosomia (birthweight ≥ 4000 g) and potential risk factors in Beijing, hospital records from two major obstetrics and gynecology hospitals in urban districts in Beijing were analyzed. Hospital records from 1996 to 2010 were retrieved. Information of prenatal examination and birth outcomes was entered into a structured database. Live births were used for trend analysis. Information of live births in 2010 was used to identify potential risk factors. A total of 63 661 live births were delivered during 1996-2010 in the study hospitals. The average birthweight increased from 3271 g in 1996 to 3 359 g in 2000 and slightly declined to 3 331 in 2010. The percentage of low birthweight fluctuated around 4.0%. No significant increase or decrease was observed. Preterm birth was the main cause of low birthweight, accounting for more than 73% of low birthweight. The average percentage of macrosomia was 7.6%. The percentages of macrosomia increased from 6.6% in 1996 to 9.5% in 2000 and declined to 7.0% in 2010. Excessive gestational weight gain and gestational diabetes were significantly associated with macrosomia. Continuously monitoring abnormal birthweight is needed and intervention should focus on appropriate gestational weight gain and reduction of preterm birth and gestational diabetes.

  6. Brain Development of Very Preterm and Very Low-Birthweight Children in Childhood and Adolescence: A Meta-Analysis

    Science.gov (United States)

    de Kieviet, Jorrit F.; Zoetebier, Lydia; van Elburg, Ruurd M.; Vermeulen, R. Jeroen; Oosterlaan, Jaap

    2012-01-01

    Aim: The aim of this article was to clarify the impact and consequences of very preterm birth (born less than 32wks of gestation) and/or very low birthweight ([VLBW], weighing less than 1500g) on brain volume development throughout childhood and adolescence. Method: The computerized databases PubMed, Web of Knowledge, and EMBASE were searched for…

  7. Anxiety in Adolescents Born Preterm or with Very Low Birthweight: A Meta-Analysis of Case-Control Studies

    Science.gov (United States)

    Somhovd, Mikael J.; Hansen, Bo M.; Brok, Jesper; Esbjorn, Barbara H.; Greisen, Gorm

    2012-01-01

    Aim: To determine if adolescents who are born very preterm (less than 32wks; of gestation) and/or with very low birthweight (VLBW; less than 1500g) have a higher risk of experiencing clinically significant anxiety problems. Method: We used a systematic review and meta-analysis. We searched the databases ISI Web of Knowledge, PubMed, PsycNET,…

  8. Low birthweight and preterm birth in young people with special educational needs: a magnetic resonance imaging analysis

    Directory of Open Access Journals (Sweden)

    Owens David GC

    2008-01-01

    Full Text Available Abstract Background Although neuroanatomical and cognitive sequelae of low birthweight and preterm birth have been investigated, little is understood as to the likely prevalence of a history of low birthweight or preterm birth, or neuroanatomical correlates of such a history, within the special educational needs population. Our aim was to address these issues in a sample of young people receiving additional learning support. Methods One hundred and thirty-seven participants aged 13–22 years, receiving additional learning support, were recruited via their schools or colleges and underwent structural magnetic resonance imaging (MRI. Obstetric records, available in 98 cases, included birthweight and gestational data in 90 and 95 cases, respectively. Both qualitative and quantitative voxel-based analyses of MRI data were conducted. Results A history of low birthweight and preterm birth was present in 13.3% and 13.7% of cases, respectively. Low birthweight and preterm birth were associated with specific qualitative anomalies, including enlargement of subarachnoid cisterns and thinning of the corpus callosum. Low birthweight was associated with reduced grey matter density (GMD in the superior temporal gyrus (STG bilaterally, left inferior temporal gyrus and left insula. Prematurity of birth was associated with reduced GMD in the STG bilaterally, right inferior frontal gyrus and left cerebellar hemisphere. Comparison of subjects with no history of low birthweight or preterm birth with a previously defined control sample of cognitively unimpaired adolescents (n = 72 demonstrated significantly greater scores for several anomalies, including thinning of the corpus callosum, loss of white matter and abnormalities of shape of the lateral ventricles. Conclusion Although a two-fold increased prevalence of a history of low birthweight and preterm birth exists within the special educational needs population, other aetiological factors must be considered for

  9. Computerized working memory training has positive long-term effect in very low birthweight preschool children.

    Science.gov (United States)

    Grunewaldt, Kristine Hermansen; Skranes, Jon; Brubakk, Ann-Mari; Lähaugen, Gro C C

    2016-02-01

    Working memory deficits are frequently found in children born preterm and have been linked to learning disabilities, and cognitive and behavioural problems. Our aim was to evaluate if a computerized working memory training program has long-term positive effects on memory, learning, and behaviour in very-low-birthweight (VLBW) children at age 5 to 6 years. This prospective, intervention study included 20 VLBW preschool children in the intervention group and 17 age-matched, non-training VLBW children in the comparison group. The intervention group trained with the Cogmed JM working memory training program daily for 5 weeks (25 training sessions). Extensive neuropsychological assessment and parental questionnaires were performed 4 weeks after intervention and at follow-up 7 months later. For most of the statistical analyses, general linear models were applied. At follow-up, higher scores and increased or equal performance gain were found in the intervention group than the comparison group on memory for faces (p=0.012), narrative memory (p=0.002), and spatial span (p=0.003). No group differences in performance gain were found for attention and behaviour. Computerized working memory training seems to have positive and persisting effects on working memory, and visual and verbal learning, at 7-month follow-up in VLBW preschool children. We speculate that such training is beneficial by improving the ability to learn from the teaching at school and for further cognitive development. © 2015 Mac Keith Press.

  10. Secular trends of low birthweight and macrosomia and related maternal factors in Beijing, China: a longitudinal trend analysis

    OpenAIRE

    Shan, Xiaoyi; Chen, Fangfang; Wang, Wenpeng; Zhao, Juan; Teng, Yue; Wu, Minghui; Teng, Honghong; Zhang, Xue; Qi, Hong; Liu, Xiaohong; Tan, Chunying; Mi, Jie

    2014-01-01

    Background Information tracking changes of birthweight is scarce in China. To examine trends of low birthweight (birthweight < 2500 g) and macrosomia (birthweight ≥ 4000 g) and potential risk factors in Beijing, hospital records from two major obstetrics and gynecology hospitals in urban districts in Beijing were analyzed. Methods Hospital records from 1996 to 2010 were retrieved. Information of prenatal examination and birth outcomes was entered into a structured database. Live births were u...

  11. Systemic inflammation and cerebral palsy risk in extremely preterm infants.

    Science.gov (United States)

    Kuban, Karl C K; O'Shea, T Michael; Allred, Elizabeth N; Paneth, Nigel; Hirtz, Deborah; Fichorova, Raina N; Leviton, Alan

    2014-12-01

    The authors hypothesized that among extremely preterm infants, elevated concentrations of inflammation-related proteins in neonatal blood are associated with cerebral palsy at 24 months. In 939 infants born before 28 weeks gestation, the authors measured blood concentrations of 25 proteins on postnatal days 1, 7, and 14 and evaluated associations between elevated protein concentrations and cerebral palsy diagnosis. Protein elevations within 3 days of birth were not associated with cerebral palsy. Elevations of tumor necrosis factor-α, tumor necrosis factor-α-receptor-1, interleukin-8, and intercellular adhesion molecule-1 on at least 2 days were associated with diparesis. Recurrent-persistent elevations of interleukin-6, E-selectin, or insulin-like growth factor binding protein-1 were associated with hemiparesis. Diparesis and hemiparesis were more likely among infants who had at least 4 of 9 protein elevations that previously have been associated with cognitive impairment and microcephaly. Repeated elevations of inflammation-related proteins during the first 2 postnatal weeks are associated with increased risk of cerebral palsy.

  12. Risk factors for low birthweight in the public-hospitals at Peshawar, NWFP-Pakistan

    Directory of Open Access Journals (Sweden)

    Payne Roger

    2008-06-01

    Full Text Available Abstract Background Low birthweight is a widely used indicator of newborn health. This study investigates the association of birthweight Methods Data on geo-demographics, maternal health indicators, pregnancy history and outcome scores for newborn babies and their families (n = 1039 were collected prospectively between August and November 2003 in a cross-sectional survey of four public hospitals in Peshawar, NWFP-Pakistan. Crude and adjusted odds ratios were used to investigate the factors affecting incidence of LBW, by multivariate logistic regression. Gestational age was included as an explanatory variable therefore the additional covariates identified by model selection are expected to account for SGA. Results The main geo-demographic risk factors for SGA identified in this study, controlling for gestational age of less than 37 weeks, are maternal age, nationality and consanguinity. Presentation with anaemia and the history of previous abortion/miscarriage were also found to be significant independent factors. The adjusted odds ratio for gestational age showed the largest effect in explaining the incidence of LBW. The next highest odds ratio was for maternal age below 20 years. The explanatory model included two pairwise interactions, for which the predicted incidence figures for LBW show an increase among the Tribal area with presentation of anaemia, and among full term babies with their mothers having a previous history of abortion/miscarriage. Conclusion In addition to gestational age, specific factors related to geo-demographics (maternal age, consanguinity and nationality, maternal health (anaemia and pregnancy history (abortion/miscarriage were significantly associated with the incidence of LBW observed at the four hospitals surveyed in Peshawar. These results indicate that cultural factors can adversely affect the incidence of SGA in this area of Pakistan.

  13. Prognostic factors for low birthweight repetition in successive pregnancies: a cohort study

    Directory of Open Access Journals (Sweden)

    Sclowitz Iândora Krolow Timm

    2013-01-01

    Full Text Available Abstract Background To identify prognostic factors associated with recurrence of low birthweight (LBW in successive gestations, a study was carried out with a subsample of mothers enrolled in the 2004 Pelotas Birth Cohort. Methods Data were collected by hospital-based interviews. Newborns were weighed and measured. Gestational age was defined according to the date of last menstrual period, ultra-sound scan before the 20th week of pregnancy or the Dubowitz method. Mothers who reported at least one LBW newborn in the two previous gestations were included. Prevalence ratios (PR and 95% confidence intervals were estimated from Poisson Regression. All estimates were adjusted for parity. Results A total of 4558 births were identified in 2004, and 565 met inclusion criteria, out of which 86 (15.2% repeated LBW in 2004. Among mothers with two LBW babies before 2004, 47.9% presented LBW recurrence. Belonging to the highest socio-economic stratum (PR 0.89; 0.01-0.46 and gaining ≥ 10 kg during pregnancy (PR 0.09; 0.01-0.77 were protective against LBW recurrence. Higher risk of LBW recurrence was observed among mothers with higher parity (≥3 previous deliveries; PR=1.93; 95% CI 1.23-3.02; who had given birth to a previous preterm baby (PR=4.01; 2.27-7.10; who delivered a female newborn in current gestation (PR=2.61; 1.45-4.69; and that had not received adequate antenatal care (PR=2.57; 1-37-4.81. Conclusion Improved quality of antenatal care and adequate maternal weight gain during pregnancy may be feasible strategies to prevent LBW repetition in successive pregnancies.

  14. Not ready for prime time: transitional events in the extremely preterm infant.

    Science.gov (United States)

    Armentrout, Debra

    2014-01-01

    Successful transition from intrauterine to extrauterine life involves significant physiologic changes. The majority of these changes occur relatively quickly during those first moments following delivery; however, transition for the extremely preterm infant occurs over a longer period of time. Careful assessment and perceptive interventions on the part of neonatal care providers is essential as the extremely preterm infant adjusts to life outside the womb. This article will focus on respiratory, cardiovascular, gastrointestinal, and neurologic transitional events experienced by the extremely premature infant.

  15. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Pellicer, Adelina; Alderliesten, Thomas

    2015-01-01

    in eight European countries. PARTICIPANTS: 166 extremely preterm infants born before 28 weeks of gestation: 86 were randomised to cerebral NIRS monitoring and 80 to blinded NIRS monitoring. The only exclusion criterion was a decision not to provide life support. INTERVENTIONS: Monitoring of cerebral...... oxygenation using NIRS in combination with a dedicated treatment guideline during the first 72 hours of life (experimental) compared with blinded NIRS oxygenation monitoring with standard care (control). MAIN OUTCOME MEASURES: The primary outcome measure was the time spent outside the target range of 55......-85% for cerebral oxygenation multiplied by the mean absolute deviation, expressed in %hours (burden of hypoxia and hyperoxia). One hour with an oxygenation of 50% gives 5%hours of hypoxia. Secondary outcomes were all cause mortality at term equivalent age and a brain injury score assessed by cerebral...

  16. Greater mortality and mordidity in extremely preterm infants fed a diet containing cow milk protein products

    Science.gov (United States)

    Provision of human milk has important implications for the health and outcomes of extremely preterm (EP) infants. This study evaluated the effects of an exclusive human milk diet on the health of EP infants during their stay in the neonatal intensive care unit. EP infants <1,250 g birth weight recei...

  17. Young men with low birthweight exhibit decreased plasticity of genome-wide muscle DNA methylation by high-fat overfeeding

    DEFF Research Database (Denmark)

    Jacobsen, Stine C; Gillberg, Linn; Bork-Jensen, Jette

    2014-01-01

    individuals, and we recently showed multiple DNA methylation changes during short-term high-fat overfeeding in muscle of healthy people. In a randomised crossover study, we analysed genome-wide DNA promoter methylation in skeletal muscle of 17 young LBW men and 23 matched normal birthweight (NBW) men after......The association between low birthweight (LBW) and risk of developing type 2 diabetes may involve epigenetic mechanisms, with skeletal muscle being a prime target tissue. Differential DNA methylation patterns have been observed in single genes in muscle tissue from type 2 diabetic and LBW...

  18. Determinants of low birthweight, small-for-gestational-age and preterm birth in Lombok, Indonesia: analyses of the birthweight cohort of the SUMMIT trial.

    Science.gov (United States)

    Sebayang, Susy K; Dibley, Michael J; Kelly, Patrick J; Shankar, Anita V; Shankar, Anuraj H

    2012-08-01

    To examine the determinants of low birthweight (LBW), small-for-gestation (SGA) and preterm births in Lombok, Indonesia, an area of high infant mortality. Data from The Supplementation with Multiple Micronutrient Intervention Trial (SUMMIT), a double-blind cluster-randomised controlled trial, were analysed. The odds ratio of factors known to be associated with LBW, SGA and preterm birth was assessed and adjusted for the cluster design of the trial using hierarchical logistic regression. Determinants included constitutional, demographic and psychosocial factors, toxic exposure, maternal nutrition and obstetric history and maternal morbidity during and prior to pregnancy. Population attributable risks of modifiable determinants were calculated. A cohort of 14,040 singleton births was available for analysis of LBW, with 13,498 observations for preterm births and 13,461 for SGA births. Determinants of LBW and SGA were similar and included infant's sex, woman's education, season at birth, mothers' residence, household wealth, maternal mid-upper arm circumference (MUAC), height and a composite variable of birth order and pregnancy interval. Socioeconomic indicators were also related to preterm births and included mother's education, residence and household wealth, while nutritional-related factors including low MUAC and birth order and interval were associated with preterm birth but not maternal height. Nausea was protective of preterm birth, while diarrhoea was associated with higher odds of preterm birth. Oedema during pregnancy was protective of SGA but associated with higher odds of preterm delivery. Around 33%, 13% and 13% of the determinants of LBW, SGA and preterm births were preventable. Women's education, maternal nutrition and household wealth and family planning are key factors to improving birth outcomes. © 2012 Blackwell Publishing Ltd.

  19. First two months of pregnancy - critical time for preterm delivery and low birthweight caused by adverse effects of coal combustion toxics

    Energy Technology Data Exchange (ETDEWEB)

    Mohorovic, L. [Obstetric and Gynecologic Primary Care, Labin, Rabac (Croatia)

    2004-07-01

    The objective of this study was to define the most critical gestation period for adverse effects of environmental toxics in terms of preterm delivery ({lt}37 weeks) and low birthweight ({lt}2500 g) in humans. From January 1, 1987 to December 31, 1989, 704 women were included in a retrospective epidemiological study. All were from the district of Labin and lived in the vicinity of a coal power plant Plomin 1, Croatia. This plant is the single large source of air pollution in the area. The coal used for fuel is extremely rich with sulfur, 9-11%. Daily, weekly, and monthly consumption of coal and related SO{sub 2} emissions were calculated for each pregnant woman from the beginning to the end of pregnancy. The results show that a greater and longer exposure to SO{sub 2} emissions during the initial two months of pregnancy resulted in a significantly shorter gestation. The results of this study confirm the role of inhaled environmental toxics in the early development of human embryo and in adverse pregnancy course caused by permanent oxidative stress, misbalanced production of reactive oxygen species (ROS), reactive nitrogen species (RNS), reactive sulfur species (RSS), and other unfavorable metabolic processes on early embryogenesis, resulting in growth-arrested cells.

  20. Risk Factors for Low Birthweight in Zimbabwean Women: A Secondary Data Analysis

    National Research Council Canada - National Science Library

    Feresu, Shingairai A; Harlow, Siobán D; Woelk, Godfrey B

    2015-01-01

    .... The purpose of this study was to describe the socio-demographic, nutritional, reproductive, medical and obstetrical risk factors for delivering a live LBW infant at Harare Maternity Hospital, Zimbabwe...

  1. Risk Factors for Low Birthweight in Zimbabwean Women: A Secondary Data Analysis: e0129705

    National Research Council Canada - National Science Library

    Shingairai A Feresu; Siobán D Harlow; Godfrey B Woelk

    2015-01-01

    .... The purpose of this study was to describe the socio-demographic, nutritional, reproductive, medical and obstetrical risk factors for delivering a live LBW infant at Harare Maternity Hospital, Zimbabwe...

  2. Surveillance of extreme hyperbilirubinaemia in Denmark. A method to identify the newborn infants

    DEFF Research Database (Denmark)

    Bjerre, J.V.; Petersen, Jes Reinholdt; Ebbesen, F.

    2008-01-01

    AIM: To describe the incidence of infants born at term or near-term with extreme hyperbilirubinaemia. METHODS: The study period was between 1 January 2002 and 31 December 2005, and included all infants born alive at term or near-term in Denmark. Medical reports on all newborn infants with a total...... serum bilirubin concentration (TSB) > or = 450 micromol/L were obtained by linking laboratory data to the unique Danish personal identification number. RESULTS: In total, 113 infants were included, that is, an incidence of 45/100,000 live births. Thirty-seven infants presented in hospital, 2 after home...... birth and the others after having been discharged. The maximum TSB was 485 (450-734) micromol/L (median [range]) and appeared latest amongst those infants admitted from home, but was not different from the maximum TSB of the nondischarged infants. Forty-three infants had symptoms of early-phase acute...

  3. Invulnerable High Risk Preterm Infants.

    Science.gov (United States)

    Pederson, David R.; And Others

    In an effort to look at factors moderating the negative effects of preterm low birthweight and perinatal illness, the study followed up (at 7 and 12 months of age) 50 preterm infants whose cumulative morbidity score was greater than 100 and/or who had a life threatening complication. Home visits provided ratings of maternal sensitivity, the…

  4. Maternal homocysteine and related B vitamins as risk factors for low birthweight.

    NARCIS (Netherlands)

    Hogeveen, M.; Blom, H.J.; Heijden, E.H.M. van der; Semmekrot, B.A.; Sporken, J.M.J.; Ueland, P.M.; Heijer, M. den

    2010-01-01

    OBJECTIVE: We designed a large prospective study to explore the relationship between maternal homocysteine concentrations and related B vitamins and birthweight. STUDY DESIGN: Blood was sampled from pregnant women at 30-34 weeks of gestation and their newborn infants (n = 366). RESULTS:

  5. Maternal homocysteine and related B vitamins as risk factors for low birthweight.

    NARCIS (Netherlands)

    Hogeveen, M.; Blom, H.J.; Heijden, E.H.M. van der; Semmekrot, B.A.; Sporken, J.M.J.; Ueland, P.M.; Heijer, M. den

    2010-01-01

    OBJECTIVE: We designed a large prospective study to explore the relationship between maternal homocysteine concentrations and related B vitamins and birthweight. STUDY DESIGN: Blood was sampled from pregnant women at 30-34 weeks of gestation and their newborn infants (n = 366). RESULTS: Concentratio

  6. Influence of obstetric management on outcome of extremely preterm growth retarded infants

    NARCIS (Netherlands)

    Schaap, A.H.P.; Wolf, H.; Bruinse, H.W.; Ouden, A.L. den; Smolders-de Haas, H.; Ertbruggen, I. van; Treffers, P.E.

    1997-01-01

    Aim - To describe the long term outcome of extremely preterm growth retarded infants in relation to obstetric management and various perinatal events. Methods - A cohort study was undertaken in two tertiary care centres with different obstetric management. All infants with fetal growth retardation d

  7. General movements in the first fourteen days of life in extremely low birth weight (ELBW) infants

    NARCIS (Netherlands)

    de Vries, N. K. S.; Erwich, J. J. H. M.; Bos, A. F.

    2008-01-01

    Objective: To assess the quality of general movements (GMs) in the first fourteen days of life in relation to obstetric and postnatal risk factors and neurodevelopmental outcome in extremely low birth weight (ELBW) infants. Study design: The GMs of nineteen infants were assessed on days 2, 4, 6, 10

  8. Improvement in perinatal care for extremely premature infants in Denmark from 1994 to 2011

    DEFF Research Database (Denmark)

    Hasselager, Asbjørn Børch; Børch, Klaus; Pryds, Ole Axel

    2016-01-01

    gestational age and administration of surfactant. CONCLUSIONS: Centralisation of treatment of extremely premature infants has been implemented because more children are being born at highly specialised perinatal centres. Care improved as more infants received evidence-based treatment. IVH 3-4 rates declined...

  9. New evidence on the effects of international migration on the risk of low birthweight in Mexico.

    Science.gov (United States)

    Sunil, Thankam S; Flores, Miguel; Garcia, Ginny E

    2012-04-01

    The purpose of this article is to provide new empirical evidence linking migration of Mexican households to the USA with infant health outcomes. By using new data for Mexico, the Encuesta Nacional de la Dinamica Demografica 2006, this research focuses on the effect of migration on birth weight. Multivariate logistic regression methods are used to model low birth weight (LBW) as a function of a set of proximate, intermediate and socioeconomic determinants. In analyzing the channels through which migration affects birth outcomes, the findings provide no conclusive evidence for remittances as the only mechanism associated with lowering the odds of LBW. Given the limitations of the data, the study results showed new empirical evidence explaining the significance of both financial and social remittances associated with international migration and infant health outcomes in Mexico.

  10. First two months of pregnancy - critical time for preterm delivery and low birthweight caused by adverse effects of coal combustion toxics

    Energy Technology Data Exchange (ETDEWEB)

    Mohorovic, L. [Obstetrics & Gynecology Primary Care, Rabac (Croatia)

    2004-11-15

    The objective of this study was to define the most critical gestation period for adverse effects of environmental toxics in terms of preterm delivery ({lt}37 weeks) and low birthweight ({lt}2500 g) in humans. From January 1, 1987 to December 31, 1989, 704 women were included in a retrospective epidemiological study. All were from the district of Labin and lived in the vicinity of a coal power plant Plomin 1, Croatia. This plant is the single large source of air pollution in the area. The coal used for fuel is extremely rich with sulfur, 9-11%. Daily, weekly, and monthly consumption of coal and related SO{sub 2} emissions were calculated for each pregnant woman from the beginning to the end of pregnancy. We found that a greater and longer exposure to SO emissions during the initial two months of pregnancy resulted in a significantly shorter gestation (end of the first month: -0.0914, p=0.008, end of the second month: -0.0806, p=0.016) and in lower body mass of a newborn (end of the first month: -0.0807, p-0.016, end of the second month -0.0733, p=0.026). The results of this study confirm the role of inhaled environmental toxics in the early development of human embryo and in adverse pregnancy course caused by permanent oxidative stress, misbalanced production of reactive oxygen species (ROS), reactive nitrogen species (RNS), reactive sulfur species (RSS), and other unfavorable metabolic processes on early embryogenesis, resulting in growth-arrested cells.

  11. Improvement in perinatal care for extremely premature infants in Denmark from 1994 to 2011

    DEFF Research Database (Denmark)

    Hasselager, Asbjørn Børch; Børch, Klaus; Pryds, Ole Axel

    2016-01-01

    INTRODUCTION: Major advances in perinatal care over the latest decades have increased the survival rate of extremely premature infants. Centralisation of perinatal care was implemented in Denmark from 1995. This study evaluates the effect of organisational changes of perinatal care on survival...... gestational age and administration of surfactant. CONCLUSIONS: Centralisation of treatment of extremely premature infants has been implemented because more children are being born at highly specialised perinatal centres. Care improved as more infants received evidence-based treatment. IVH 3-4 rates declined...

  12. Differential Susceptibility to Effects of the Home Environment on Motor Developmental Outcomes of Preschool Children: Low Birthweight Status as a Susceptibility Factor

    Science.gov (United States)

    Wu, Jennifer Chun-Li; Chiang, Tung-liang

    2016-01-01

    Low birthweight (LBW) children tend to have higher risks of developmental problems. According to differential susceptibility hypothesis, these putatively vulnerable children may also disproportionately benefit from positive environmental exposure. This study aimed to examine whether LBW status moderates home environmental influences on…

  13. Differential Susceptibility to Effects of the Home Environment on Motor Developmental Outcomes of Preschool Children: Low Birthweight Status as a Susceptibility Factor

    Science.gov (United States)

    Wu, Jennifer Chun-Li; Chiang, Tung-liang

    2016-01-01

    Low birthweight (LBW) children tend to have higher risks of developmental problems. According to differential susceptibility hypothesis, these putatively vulnerable children may also disproportionately benefit from positive environmental exposure. This study aimed to examine whether LBW status moderates home environmental influences on…

  14. Early Vocalization of Preterm Infants with Extremely Low Birth Weight (ELBW), Part I: From Birth to Expansion Stage

    Science.gov (United States)

    Torola, Helena; Lehtihalmes, Matti; Heikkinen, Hanna; Olsen, Paivi; Yliherva, Anneli

    2012-01-01

    The vocalization of preterm infants with extremely low birth weight (ELBW) up to the expansion stage was systematically described and compared with those of healthy full-term infants. The sample consisted of 18 preterm ELBW infants and the control group of 11 full-term infants. The follow-up was performed intensively using video-recordings. The…

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

    Science.gov (United States)

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

    1990-02-01

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

  16. Green teeth are a late complication of prolonged conjugated hyperbilirubinemia in extremely low birth weight infants.

    Science.gov (United States)

    Battineni, Sireesha; Clarke, Paul

    2012-01-01

    Eruption of green, discolored teeth affecting the primary dentition has been described in association with congenital viral infection, sepsis, hemolytic jaundice, and cholestasis. The purpose of this paper was to present the cases of 3 extremely low birth weight preterm infants who were noted to have green teeth at the corrected ages of 10 to 12 months. All had a history of prolonged conjugated hyperbilirubinemia during their time in neonatal intensive care. For infants with prolonged conjugated hyperbilirubinemia, extreme preterm birth and/or extremely low birth weight may be additional risk factors predisposing to the eruption of green teeth in later infancy.

  17. Risk Factors for Low Birthweight in Zimbabwean Women: A Secondary Data Analysis.

    Directory of Open Access Journals (Sweden)

    Shingairai A Feresu

    Full Text Available Low birth weight (LBW remains the main cause of mortality and morbidity in infants, and a problem in the care of pregnant women world-wide particularly in developing countries. The purpose of this study was to describe the socio-demographic, nutritional, reproductive, medical and obstetrical risk factors for delivering a live LBW infant at Harare Maternity Hospital, Zimbabwe.A secondary data analysis from data obtained through a questionnaire and delivery records was conducted. Linear regression models with a complimentary log-log link function were used to estimate the relative risks for all LBW, term LBW and preterm LBW.The frequency of LBW was 16.7%. Lack of prenatal care (adjusted relative risk [ARR] 1.69, 95% CI 1.44, 1.98, mother's mid-arm circumference below 28.5 cm, (ARR 1.35, 95% CI 1.19, 1.54 and rural residence (ARR 1.22, 95% CI 1.04, 1.40 increased the risk of LBW. Eclampsia, anemia, and ante-partum hemorrhage, were associated with LBW (ARR 2.64, 95% CI 1.30, 5.35; ARR = 2.63, 95% CI 1.16, 5.97; and ARR = 2.39, 95% CI 1.55, 3.68, respectively. Malaria increased the risk of LBW (ARR = 1.89, 95% CI 1.21, 2.96. Prenatal care, infant sex, anemia, antepartum hemorrhage, premature rapture of membranes and preterm labor were associated with the three LBW categories. History of abortion or stillbirth, history of LBW, malaria, eclampsia, and placenta Previa, were associated with all LBW and preterm LBW, while pregnancy induced hypertension, and number of children alive were associated with all LBW and term LBW.LBW frequency remains high and is associated with nutritive, reproductive, medical and obstetrical factors. Preterm LBW and term LBW have similar and also different risk factors. Understanding the role of different risk factors in these different LBW categories is important if the goal is to reduce LBW frequency, and its complications, in Zimbabwe.

  18. Head circumference growth among extremely preterm infants in Denmark has improved during the past two decades

    DEFF Research Database (Denmark)

    Zachariassen, Gitte; Hansen, Bo Mølholm

    2015-01-01

    INTRODUCTION: Treatment of extremely preterm and low birth weight infants is still evolving and improving. In this study, we evaluated if growth has improved from birth to two years of corrected age (CA) among extremely low birth weight (BW) and preterm born infants in Denmark. METHODS......: This was an observational study with comparison of head circumference (HC), weight and length growth in two Danish cohorts of extremely preterm (gestational age (GA) low birth weight (ELBW with a BW ....03), while no significant difference was recorded for length or weight. CONCLUSION: Growth during hospitalisation seems to have improved among extremely preterm and low birth weight infants from 1994-1995 to 2004-2008. This may be a result of improved nutrition in combination with improved intensive care...

  19. Early communicative behaviors and their relationship to motor skills in extremely preterm infants.

    Science.gov (United States)

    Benassi, Erika; Savini, Silvia; Iverson, Jana M; Guarini, Annalisa; Caselli, Maria Cristina; Alessandroni, Rosina; Faldella, Giacomo; Sansavini, Alessandra

    2016-01-01

    Despite the predictive value of early spontaneous communication for identifying risk for later language concerns, very little research has focused on these behaviors in extremely low-gestational-age infants (ELGAmotor development. In this study, communicative behaviors (gestures, vocal utterances and their coordination) were evaluated during mother-infant play interactions in 20 ELGA infants and 20 full-term infants (FT) at 12 months (corrected age for ELGA infants). Relationships between gestures and motor skills, evaluated using the Bayley-III Scales were also examined. ELGA infants, compared with FT infants, showed less advanced communicative, motor, and cognitive skills. Giving and representational gestures were produced at a lower rate by ELGA infants. In addition, pointing gestures and words were produced by a lower percentage of ELGA infants. Significant positive correlations between gestures (pointing and representational gestures) and fine motor skills were found in the ELGA group. We discuss the relevance of examining spontaneous communicative behaviors and motor skills as potential indices of early development that may be useful for clinical assessment and intervention with ELGA infants.

  20. Endothelial progenitor cells in mothers of low-birthweight infants: a link between defective placental vascularization and increased cardiovascular risk?

    LENUS (Irish Health Repository)

    King, Thomas F J

    2013-01-01

    Offspring birthweight is inversely associated with future maternal cardiovascular mortality, a relationship that has yet to be fully elucidated. Endothelial progenitor cells (EPCs) are thought to play a key role in vasculogenesis, and EPC numbers reflect cardiovascular risk.

  1. Impaired Word Stress Pattern Discrimination in Very-Low-Birthweight Infants during the First 6 Months of Life

    Science.gov (United States)

    Herold, Birgit; Hohle, Barbara; Walch, Elisabeth; Weber, Tanja; Obladen, Michael

    2008-01-01

    Prosodic information, such as word stress and speech rhythm, is important in language acquisition, and sensitivity to stress patterns is present from birth onwards. Exposure to prosodic properties of the native language occurs prenatally. Preterm birth and an associated lack of exposure to prosodic information are suspected to affect language…

  2. Improvement in perinatal care for extremely premature infants in Denmark from 1994 to 2011

    DEFF Research Database (Denmark)

    Hasselager, Asbjørn Børch; Børch, Klaus; Pryds, Ole Axel

    2016-01-01

    PVL) and intraventricular haemorrhage grade 3-4 (IVH 3-4). RESULTS: A total of 184, 83 and 127 infants were included from the cohorts. Delivery rates at level 3 Neonatal Intensive Care Unit (NICU) hospitals increased from 69% to 87%. Transfer rates to level 3 NICU almost doubled during the period. Survival rates were......INTRODUCTION: Major advances in perinatal care over the latest decades have increased the survival rate of extremely premature infants. Centralisation of perinatal care was implemented in Denmark from 1995. This study evaluates the effect of organisational changes of perinatal care on survival...... gestational age and administration of surfactant. CONCLUSIONS: Centralisation of treatment of extremely premature infants has been implemented because more children are being born at highly specialised perinatal centres. Care improved as more infants received evidence-based treatment. IVH 3-4 rates declined...

  3. Adipose tissue transcriptomics and epigenomics in low birthweight men and controls: role of high-fat overfeeding.

    Science.gov (United States)

    Gillberg, Linn; Perfilyev, Alexander; Brøns, Charlotte; Thomasen, Martin; Grunnet, Louise G; Volkov, Petr; Rosqvist, Fredrik; Iggman, David; Dahlman, Ingrid; Risérus, Ulf; Rönn, Tina; Nilsson, Emma; Vaag, Allan; Ling, Charlotte

    2016-04-01

    Individuals who had a low birthweight (LBW) are at an increased risk of insulin resistance and type 2 diabetes when exposed to high-fat overfeeding (HFO). We studied genome-wide mRNA expression and DNA methylation in subcutaneous adipose tissue (SAT) after 5 days of HFO and after a control diet in 40 young men, of whom 16 had LBW. mRNA expression was analysed using Affymetrix Human Gene 1.0 ST arrays and DNA methylation using Illumina 450K BeadChip arrays. We found differential DNA methylation at 53 sites in SAT from LBW vs normal birthweight (NBW) men (false discovery rate obesity-related traits in a replication cohort of 142 individuals. DNA methylation at 652 CpG sites (including in CDK5, IGFBP5 and SLC2A4) was altered in SAT after overfeeding in this and in another cohort. Young men who had a LBW exhibit epigenetic alterations in their adipose tissue that potentially influence insulin resistance and risk of type 2 diabetes. Short-term overfeeding influences gene transcription and, to some extent, DNA methylation in adipose tissue; there was no major difference in this response between LBW and control participants.

  4. Young men with low birthweight exhibit decreased plasticity of genome-wide muscle DNA methylation by high-fat overfeeding.

    Science.gov (United States)

    Jacobsen, Stine C; Gillberg, Linn; Bork-Jensen, Jette; Ribel-Madsen, Rasmus; Lara, Ester; Calvanese, Vincenzo; Ling, Charlotte; Fernandez, Agustin F; Fraga, Mario F; Poulsen, Pernille; Brøns, Charlotte; Vaag, Allan

    2014-06-01

    The association between low birthweight (LBW) and risk of developing type 2 diabetes may involve epigenetic mechanisms, with skeletal muscle being a prime target tissue. Differential DNA methylation patterns have been observed in single genes in muscle tissue from type 2 diabetic and LBW individuals, and we recently showed multiple DNA methylation changes during short-term high-fat overfeeding in muscle of healthy people. In a randomised crossover study, we analysed genome-wide DNA promoter methylation in skeletal muscle of 17 young LBW men and 23 matched normal birthweight (NBW) men after a control and a 5 day high-fat overfeeding diet. DNA methylation was measured using Illumina's Infinium BeadArray covering 27,578 CpG sites representing 14,475 different genes. After correction for multiple comparisons, DNA methylation levels were found to be similar in the LBW and NBW groups during the control diet. Whereas widespread DNA methylation changes were observed in the NBW group in response to high-fat overfeeding, only a few methylation changes were seen in the LBW group (χ(2), p muscle from LBW vs NBW men, potentially contributing to understanding the link between LBW and increased risk of type 2 diabetes.

  5. Aquired Cytomegalovirus Infection of Extremely Low Birth Weight Infant

    Directory of Open Access Journals (Sweden)

    Serdar Alan

    2013-12-01

    Full Text Available Breast milk is a major source for acquired cytomegalovirus infection especially in premature infants and acquired CMV infection occurs in infants whose mothers were seropositive for CMV. Although most of mothers of premature infants are seropositive in Turkey, acquired life-threatening breast milk acquired CMV infection was reported occasionally. Treatment of preterm with symptomatic breast milk acquired CMV infection should be done according to the severity of clinical signs. In this report, a preterm case with a diagnosis of breast milk-acquired CMV meningitis and sepsis without multiorgan failure on the 111th day of life, who did not require antiviral therapy was presented and discussed in the context of the acquired CMV literature. In preterm babies, when there is sepsis with no apparent causes, unexplained thrombocytopenia, elevated liver transaminases and direct hyperbilirubinemia acquired CMV infection should be suspected. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2013; 11: 138-41

  6. 'Resuscitation' of extremely preterm and/or low-birth-weight infants - time to 'call it'?

    Science.gov (United States)

    O'Donnell, Colm P F

    2008-01-01

    Since ancient times, various methods have been used to revive apparently stillborn infants; many were of dubious efficacy and had the potential to cause harm. Based largely on studies of acutely asphyxiated term animal models, clinical assessment and positive pressure ventilation have become the cornerstones of neonatal resuscitation over the last 40 years. Over the last 25 years, care of extremely preterm infants in the delivery room has evolved from a policy of indifference to one of increasingly aggressive support. The survival of these infants has improved considerably in recent years; this has not, however, necessarily been due to more aggressive resuscitation. Urban myths have evolved that all extremely preterm infants died before they were intubated, and that all such infants need to immediately intubated or they will quickly die. This has never been true. Clinical assessment of infants at birth is subjective. Also, many techniques used to support preterm infants at birth have not been well studied and there is evidence that they may be harmful. It may thus be argued that many of our well-intentioned resuscitation interventions are of dubious efficacy and have the potential to cause harm. 'Resuscitation' is an emotive term which means 'restoration of life'. Death, thankfully, is a rare presentation in the delivery room. Therefore, concerning neonatal 'resuscitation', it is time to 'call it' something else. This will allow us to dispassionately distinguish preterm infants who are dead, or nearly dead, from those who are merely at high risk of parenchymal lung disease. We may then be able to refine our interventions and determine what methods of support benefit these infants most.

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

    Science.gov (United States)

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

    2016-05-01

    To compare cortical hemodynamic responses to known and unknown facial stimuli between infants born extremely preterm and term-born infants, and to correlate the responses of the extremely preterm-born infants to regional cortical volumes at term-equivalent age. We compared 27 infants born extremely preterm (infrared spectroscopy. In the preterm group, we also performed structural brain magnetic resonance imaging and correlated regional cortical volumes to hemodynamic responses. The preterm-born infants demonstrated different cortical face recognition processes than the term-born infants. They had a significantly smaller hemodynamic response in the right frontotemporal areas while watching their mother's face (0.13 μmol/L vs 0.63 μmol/L; P recognition process compared with term-born infants. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

  9. 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.

  10. 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.

  11. Low birthweight and mortality

    DEFF Research Database (Denmark)

    Bakketeig, Leiv S.; Jacobsen, Geir; Skjærven, Rolv

    2006-01-01

    Hospital Registry, and a Registry for Preventive Medicine. Such linkage is possible due to the use of unique ID-person numbers. The study was based on Danish births, 1981-1994. All 8 219 second order low birth weight (LBW) singleton births from that period were included, of whom 7 811 were live born...

  12. Neurodevelopmental Outcomes of Extremely Preterm Infants Randomized to Stress Dose Hydrocortisone.

    Directory of Open Access Journals (Sweden)

    Nehal A Parikh

    Full Text Available To compare the effects of stress dose hydrocortisone therapy with placebo on survival without neurodevelopmental impairments in high-risk preterm infants.We recruited 64 extremely low birth weight (birth weight ≤1000 g infants between the ages of 10 and 21 postnatal days who were ventilator-dependent and at high-risk for bronchopulmonary dysplasia. Infants were randomized to a tapering 7-day course of stress dose hydrocortisone or saline placebo. The primary outcome at follow-up was a composite of death, cognitive or language delay, cerebral palsy, severe hearing loss, or bilateral blindness at a corrected age of 18-22 months. Secondary outcomes included continued use of respiratory therapies and somatic growth.Fifty-seven infants had adequate data for the primary outcome. Of the 28 infants randomized to hydrocortisone, 19 (68% died or survived with impairment compared with 22 of the 29 infants (76% assigned to placebo (relative risk: 0.83; 95% CI, 0.61 to 1.14. The rates of death for those in the hydrocortisone and placebo groups were 31% and 41%, respectively (P = 0.42. Randomization to hydrocortisone also did not significantly affect the frequency of supplemental oxygen use, positive airway pressure support, or need for respiratory medications.In high-risk extremely low birth weight infants, stress dose hydrocortisone therapy after 10 days of age had no statistically significant effect on the incidence of death or neurodevelopmental impairment at 18-22 months. These results may inform the design and conduct of future clinical trials.ClinicalTrials.gov NCT00167544.

  13. Greater Mortality and Morbidity in Extremely Preterm Infants Fed a Diet Containing Cow Milk Protein Products

    Science.gov (United States)

    Schanler, Richard J.; Lee, Martin L.; Rechtman, David J.

    2014-01-01

    Abstract Background: Provision of human milk has important implications for the health and outcomes of extremely preterm (EP) infants. This study evaluated the effects of an exclusive human milk diet on the health of EP infants during their stay in the neonatal intensive care unit. Subjects and Methods: EP infants <1,250 g birth weight received a diet consisting of either human milk fortified with a human milk protein-based fortifier (HM) (n=167) or a diet containing variable amounts of milk containing cow milk-based protein (CM) (n=93). Principal outcomes were mortality, necrotizing enterocolitis (NEC), growth, and duration of parenteral nutrition (PN). Results: Mortality (2% versus 8%, p=0.004) and NEC (5% versus 17%, p=0.002) differed significantly between the HM and CM groups, respectively. For every 10% increase in the volume of milk containing CM, the risk of sepsis increased by 17.9% (p<0.001). Growth rates were similar between groups. The duration of PN was 8 days less in the subgroup of infants receiving a diet containing <10% CM versus ≥10% CM (p<0.02). Conclusions: An exclusive human milk diet, devoid of CM-containing products, was associated with lower mortality and morbidity in EP infants without compromising growth and should be considered as an approach to nutritional care of these infants. PMID:24867268

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Beyond bacteria: a study of the enteric microbial consortium in extremely low birth weight infants.

    Directory of Open Access Journals (Sweden)

    Mariam Susan LaTuga

    Full Text Available Extremely low birth weight (ELBW infants have high morbidity and mortality, frequently due to invasive infections from bacteria, fungi, and viruses. The microbial communities present in the gastrointestinal tracts of preterm infants may serve as a reservoir for invasive organisms and remain poorly characterized. We used deep pyrosequencing to examine the gut-associated microbiome of 11 ELBW infants in the first postnatal month, with a first time determination of the eukaryote microbiota such as fungi and nematodes, including bacteria and viruses that have not been previously described. Among the fungi observed, Candida sp. and Clavispora sp. dominated the sequences, but a range of environmental molds were also observed. Surprisingly, seventy-one percent of the infant fecal samples tested contained ribosomal sequences corresponding to the parasitic organism Trichinella. Ribosomal DNA sequences for the roundworm symbiont Xenorhabdus accompanied these sequences in the infant with the greatest proportion of Trichinella sequences. When examining ribosomal DNA sequences in aggregate, Enterobacteriales, Pseudomonas, Staphylococcus, and Enterococcus were the most abundant bacterial taxa in a low diversity bacterial community (mean Shannon-Weaver Index of 1.02 ± 0.69, with relatively little change within individual infants through time. To supplement the ribosomal sequence data, shotgun sequencing was performed on DNA from multiple displacement amplification (MDA of total fecal genomic DNA from two infants. In addition to the organisms mentioned previously, the metagenome also revealed sequences for gram positive and gram negative bacteriophages, as well as human adenovirus C. Together, these data reveal surprising eukaryotic and viral microbial diversity in ELBW enteric microbiota dominated bytypes of bacteria known to cause invasive disease in these infants.

  16. An extremely low body weight infant born to a mother with measles.

    Science.gov (United States)

    Go, H; Hashimoto, K; Imamura, T; Sato, M; Kawasaki, Y; Momoi, N; Hosoya, M

    2010-02-01

    The incidence of measles epidemics has decreased recently owing to the development and widespread use of measles vaccine in the United States of America and Europe. However, repeated measles epidemics have been reported in Japan. Here, the authors report a case of an extremely low body weight infant (ELBWI) whose mother had a measles virus infection. Real-time PCR was performed on the infant's blood and urine samples and skin, nasal secretion, and anal swabs, as well as on the mother's breast milk, blood samples and throat swabs. The infant was found to be positive for measles virus by PCR, but not immunoglobulin M positive. An earlier report showed that there were no such cases in which the patient was found to be positive for measles virus by real-time PCR but was not infected by the measles virus.

  17. [Nutritional dilemmas in extremely low birth weight infants and their effects on childhood, adolescence and adulthood].

    Science.gov (United States)

    Camelo, José Simon; Martinez, Francisco Eulógio

    2005-03-01

    To review the recent medical literature on nutrition of extremely low birth weight infants, focusing on nutritional disorders and their effects on childhood, adolescence and adulthood. An extensive review of the related literature was performed using MEDLINE, the Cochrane Database of Systematic Reviews and the Best Evidence database. There is a growing body of evidence that early nutritional practices may affect short-term growth and development outcome. In addition, these practices may play a role in determining adult health and disease. There is still much to be learned about safe and efficacious nutrient administration in preterm infants; about techniques to assess the effect of different nutritional strategies; and about the long-term effects of these regimens on development outcome, growth and disease. Despite recent progress in neonatal nutrition, there is a lack of basic and clinical research to better define the nutritional requirements of preterm infants and the best way to meet these requirements, avoiding long-term undesirable consequences.

  18. Crecimiento en recién nacidos prematuros de muy bajo peso natal Growth of very low birthweight pre-term neonates

    Directory of Open Access Journals (Sweden)

    Tania Mayvel Espinosa Reyes

    2013-04-01

    at 4 gynecobstetric hospitals from January 1st 2005 to December 31st, 2007 in Havana. Results: the sample was made up of 73 patients of whom 37 were females (50.7 %. Of this number, 60.2 % was born with 32-36 weeks of gestation; 50.6 % weighing 1 200-1 399 g and 36 % showed a size of 38 to 40.9 cm. After three months, 70 % was found to be less than 3 percentile of size/age and weight/age, but at one year, over 50 % reached normal percentile values. The smaller gestational age, the only pregnancy, the exclusive breastfeeding (68.5 %, longer duration of breastfeeding as well as lack of infections were all related to statistically significant higher weight gain. Conclusions: the preterm newborns with very low birthweight experience accelerated growth rate in their first year of life. This catch-up growth is linked to perinatal, postnatal and nutritional factors.

  19. Endoscopic Diagnosis and Management of Iatrogenic Cervical Esophageal Perforation in Extremely Premature Infants

    Directory of Open Access Journals (Sweden)

    Wen-Jue Soong

    2007-04-01

    Full Text Available Blind oro-(naso-pharyngeal suction and feeding catheter intubation are very common practices in pediatric critical care. However, these simple procedures may produce unexpected complications in friable tiny patients. We encountered 3 extremely premature infants in whom cervical esophageal perforation and further submucosal excavation were caused by traumatic catheter injury and subsequently led to catastrophes. These episodes of iatrogenic trauma were all successfully diagnosed early, documented and managed with the aid of ultrathin flexible endoscopy.

  20. Additional Protein Fortification Is Necessary in Extremely Low-Birth-Weight Infants Fed Human Milk.

    Science.gov (United States)

    Picaud, Jean-Charles; Houeto, Nellie; Buffin, Rachel; Loys, Claire-Marie; Godbert, Isabelle; Haÿs, Stephane

    2016-07-01

    In the present study, approximately one in three (49/152, 32.2%) extremely low-birth-weight infants were demonstrated to require additional protein intake to supplement the standard fortification to achieve satisfactory weight gain. This additional protein fortification also resulted in a rapid increase in length-for-age (P < 0.001) and head circumference-for-age (P = 0.02) z scores.

  1. Early nutrition mediates the influence of severity of illness on extremely LBW infants.

    Science.gov (United States)

    Ehrenkranz, Richard A; Das, Abhik; Wrage, Lisa A; Poindexter, Brenda B; Higgins, Rosemary D; Stoll, Barbara J; Oh, William

    2011-06-01

    To evaluate whether differences in early nutritional support provided to extremely premature infants mediate the effect of critical illness on later outcomes, we examined whether nutritional support provided to "more critically ill" infants differs from that provided to "less critically ill" infants during the initial weeks of life, and if, after controlling for critical illness, that difference is associated with growth and rates of adverse outcomes. One thousand three hundred sixty-six participants in the NICHD Neonatal Research Network parenteral glutamine supplementation randomized controlled trial who were alive on day of life 7 were stratified by whether they received mechanical ventilation for the first 7 d of life. Compared with more critically ill infants, less critically ill infants received significantly more total nutritional support during each of the first 3 wk of life, had significantly faster growth velocities, less moderate/severe bronchopulmonary dysplasia, less late-onset sepsis, less death, shorter hospital stays, and better neurodevelopmental outcomes at 18-22 mo corrected age. Rates of necrotizing enterocolitis were similar. Adjusted analyses using general linear and logistic regression modeling and a formal mediation framework demonstrated that the influence of critical illness on the risk of adverse outcomes was mediated by total daily energy intake during the first week of life.

  2. Gluconeogenesis is Not Regulated by Either Glucose or Insulin in Extremely Low Birth Weight Infants Receiving Total Parenteral Nutrition

    NARCIS (Netherlands)

    Chacko, Shaji K.; Ordonez, Jorge; Sauer, Pieter J. J.; Sunehag, Agneta L.

    2011-01-01

    Objective To determine potential factors regulating gluconeogenesis (GNG) in extremely low birth weight infants receiving total parenteral nutrition. Study design 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 1

  3. 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.

    2011-01-01

    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 fi

  4. Mortality, Neonatal Morbidity and Two Year Follow-Up of Extremely Preterm Infants Born in the Netherlands in 2007.

    NARCIS (Netherlands)

    Waal, C.G. de; Weisglas-Kuperus, N.; Goudoever, J.B. van; Walther, F.J.; Liem, K.D.

    2012-01-01

    BACKGROUND: Extremely preterm infants are at high risk of neonatal mortality and adverse outcome. Survival rates are slowly improving, but increased survival may come at the expense of more handicaps. METHODOLOGY/PRINCIPAL FINDINGS: Prospective population-based cohort study of all infants born at 23

  5. Mortality, neonatal morbidity and two year follow-up of extremely preterm infants born in the netherlands in 2007

    NARCIS (Netherlands)

    C.G. de Waal (Cornelia); N. Weisglas-Kuperus (Nynke); J.B. van Goudoever (Hans); F.J. Walther (Frans)

    2012-01-01

    textabstractBackground: Extremely preterm infants are at high risk of neonatal mortality and adverse outcome. Survival rates are slowly improving, but increased survival may come at the expense of more handicaps. Methodology/Principal Findings: Prospective population-based cohort study of all infant

  6. Premature birth and low birthweight are associated with a lower rate of reproduction in adulthood: a Swedish population-based registry study.

    Science.gov (United States)

    deKeyser, N; Josefsson, A; Bladh, M; Carstensen, J; Finnström, O; Sydsjö, G

    2012-04-01

    The aim of this study was to investigate if individuals born with sub-optimal birth characteristics have reduced probability of reproducing in adulthood. Using population-based registries, the authors included 522 216 males and 494 692 females born between 1973 and 1983 and examined their reproductive status as of 2006. Outcome measure was the hazard ratio (HR) of reproducing. Adjustments were made for socio-economic factors. Males and females born very premature displayed a reduced probability of reproducing [HR = 0.78, 95% confidence interval (CI): 0.70-0.86 for males; HR = 0.81, CI: 0.75-0.88 for females]. Likewise for very low birthweight (HR = 0.83, CI: 0.71-0.95 for males; HR = 0.80, 95% CI: 0.72-0.89 for females). Individuals born large for gestational age (LGA) displayed no significant changes. Males born small for gestational age (SGA) had a 9% lower reproductive rate (CI: 0.89-0.94) and that reduction increased as the individuals aged. Women born SGA tended to start reproducing at an earlier age. The results suggest that being born with low birthweight, premature or SGA (for males) is associated with a reduced probability of reproducing as an adult. LGA shows no statistically significant relationship with future reproduction.

  7. Prevalence of Cerebral Palsy among 8-Year-Old Children in 2010 and Preliminary Evidence of Trends in Its Relationship to Low Birthweight

    Science.gov (United States)

    Durkin, Maureen S.; Benedict, Ruth E.; Christensen, Deborah; Dubois, Lindsay A.; Fitzgerald, Robert T.; Kirby, Russell S.; Maenner, Matthew J.; Van Naarden Braun, Kim; Wingate, Martha S.; Yeargin-Allsopp, Marshalyn

    2017-01-01

    Background The public health objective for cerebral palsy (CP) in the United States is to reduce the percentage of children with CP who were born low birthweight (LBW, public health objective. Methods Data on children with CP at age 8 years were ascertained by the Autism and Developmental Disabilities Monitoring (ADDM) Network, a population-based surveillance system that monitored CP in four areas of the United States. Results CP prevalence in 2010 was 2.9 per 1000 [95% confidence interval (CI) 2.6, 3.2], down from 3.5 (95% CI 3.2, 3.9) in the same surveillance area in 2006. Among CP cases with no documented postneonatal aetiology, 49.1% (95% CI 42.9, 55.2) were born LBW in 2010 compared with 54.3% (95% CI 48.4, 60.1) in 2006. In 2010, 28.1% (95% CI 22.9, 30.4) were born very low birthweight (VLBW, relative risks for associations between CP and both LBW and VLBW also declined, though not significantly, during the study period. Conclusions Declines in the associations between CP and LBW categories may have contributed to declines during the study period in both the prevalence of CP and the percentage of children with CP who were born LBW or VLBW. Ongoing monitoring of these trends is warranted. PMID:27215680

  8. Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden.

    Science.gov (United States)

    Serenius, Fredrik; Ewald, Uwe; Farooqi, Aijaz; Fellman, Vineta; Hafström, Maria; Hellgren, Kerstin; Maršál, Karel; Ohlin, Andreas; Olhager, Elisabeth; Stjernqvist, Karin; Strömberg, Bo; Ådén, Ulrika; Källén, Karin

    2016-10-01

    Active perinatal care increases the rate of survival of extremely preterm infants, but there are concerns that improved survival might increase the rate of disabled survivors. To determine the neurodevelopmental outcomes of a national cohort of children 6.5 years of age who had been born extremely preterm (WISC-IV), and the mean (SD) scores of the children who had been born extremely preterm were compared with those of the controls. Clinical examinations and parental questionnaires were used for diagnosis of cerebral palsy, hearing and vision impairments, and cognition for the children who were not assessed with the WISC-IV. Of 486 eligible infants who were born extremely preterm, 441 (90.7%) were assessed at 6.5 years of age (59 by medical record review only) alongside 371 controls. The adjusted mean (SD) full-scale WISC-IV score was 14.2 (95% CI, 12.1-16.3) points lower for children who had been born extremely preterm than for controls. Cognitive disability was moderate for 18.8% of extremely preterm children and 2.2% of controls (P < .001), and it was severe for 11.1% of extremely preterm children and 0.3% of controls (P < .001). Cerebral palsy was observed in 9.5% of extremely preterm children and 0.0% of controls (P < .001), blindness was observed in 2.0% of extremely preterm children and 0.0% of controls (P < .001), and hearing impairment was observed in 2.1% of extremely preterm children and 0.5% of controls (P = .07). Overall, 36.1% (95% CI, 31.7%-40.6%) of extremely preterm children had no disability, 30.4% (95% CI 26.3%-34.8%) had mild disability, 20.2% (95% CI, 16.6%-24.2%) had moderate disability, and 13.4% (95% CI, 10.5%-16.9%) had severe disability. For extremely preterm children, moderate or severe overall disability decreased with gestational age at birth (adjusted odds ratio per week, 0.65 [95% CI, 0.54-0.79]; P < .001) and increased from 26.6% to 33.5% (P = .01) for children assessed both at 2.5 and 6.5 years. Of the

  9. 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.

  10. Residual blood volume in the umbilical cord of extremely premature infants.

    Science.gov (United States)

    Hosono, Shigeharu; Hine, Kotaro; Nagano, Nobuhiko; Taguchi, Yosuke; Yoshikawa, Kayo; Okada, Tomoo; Mugishima, Hideo; Takahashi, Shigeru; Takahashi, Shori

    2015-01-01

    The aim of this study was to investigate residual blood volume in the umbilical cord of extremely premature infants. Twenty extremely premature infants were held at or below the placenta while the umbilical cord was clamped and cut at approximately 2-3 cm from the umbilicus within 30 s after birth. The umbilical cord was then clamped near the placenta to obtain a length of approximately 30 cm and cut. The residual blood volume in the segment of cord was drained and measured in milliliters. Mean birthweight was 846 ± 172 g (range, 587-1180 g). The average length of the clamped segment of umbilical cord was 29.8 ± 1.5 cm (range, 27-32 cm). Total residual blood volume and residual blood volume per cm were 15.5 ± 6.7 mL (range, 6-25 mL) and 0.5 ± 0.2 mL/cm (range, 0.2-0.8 mL/cm), respectively. The residual cord blood volume per kilogram of infant weight per 30 cm was 17.7 ± 5.5 mL/kg/30 cm (range, 8.9-29.0 mL/kg/30 cm). Infants could receive approximately 18 mL/kg of whole blood by one-time milking of 30 cm umbilical cord. With an average hematocrit of 40%, this volume is equivalent to approximately 13 mL of packed red blood cells (hematocrit 55%). © 2014 Japan Pediatric Society.

  11. Generating Innovative Strategies for Healthy Infants and Children. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundred Second Congress, First Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

    In this report of a hearing on infants' and children's health, two factsheets present information on the lack of recent progress in reducing infant mortality rates; the accessibility of prenatal care; low birthweight; nutrition; inadequate child health care; health risks for low-income children; the lack of adequate health insurance; the health…

  12. An Ecological Analysis of Racial Difference in Low Birthweight: Implications for Maternal and Child Health Social Work.

    Science.gov (United States)

    Jaffee, Kim D.; Perloff, Janet D.

    2003-01-01

    Explores the effects of ecological and individual risk factors on infant health for black and white women. Examines the association among neighborhood economic indicators, neighborhood quality, access to prenatal care, and individual perinatal risk factors and subsequent birthweight. The findings emphasize the need for socially and ecologically…

  13. Sepsis as a risk factor for neonatal morbidity in extremely preterm infants.

    Science.gov (United States)

    Ohlin, Andreas; Björkman, Louise; Serenius, Fredrik; Schollin, Jens; Källén, Karin

    2015-11-01

    This study evaluated sepsis as a risk factor for neonatal morbidities and investigated the association between specific pathogens and neonatal morbidities. This was a nationwide Swedish prospective cohort study, consisting of the 497 extremely premature children, who were born before 27 weeks of gestation between 2004 and 2007 and survived their first year of life. Neonatal sepsis was evaluated as a risk factor for neonatal morbidity using multiple logistic linear regression analyses. We found that 326 (66%) of the infants had at least one sepsis episode and coagulase-negative staphylococci was the most common pathogen. Definite sepsis, with an odds ratio (OR) of 1.6, was associated with severe bronchopulmonary dysplasia, but not clinical sepsis (OR 1.1). Definite sepsis was also associated with a prolonged hospital stay (OR 1.6). Sepsis was not significantly associated with a higher risk of retinopathy of prematurity or intraventricular haemorrhage. Extremely preterm infants face a great risk of acquiring neonatal sepsis, with coagulase-negative staphylococci being the most common pathogen in this population. Definite sepsis seemed to be a risk factor for severe bronchopulmonary dysplasia and prolonged hospital stay, but the associations were weaker than in previous studies. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. The 5-minute Apgar score: survival and short-term outcomes in extremely low-birth-weight infants.

    Science.gov (United States)

    Phalen, Ann Gibbons; Kirkby, Sharon; Dysart, Kevin

    2012-01-01

    The Apgar score is a standardized tool for evaluating newborns in the delivery room. Despite its long history and widespread use, debate remains over its reliability of predicting neonatal outcomes, especially in extremely low-birth-weight premature infants. The aim of the study was to examine the relationship between the 5-minute Apgar score of extremely low-birth-weight infants, as it relates to survival and morbidities associated with prematurity and length of hospital stay. A retrospective query of the Alere neonatal database from 2001 to 2011 examined all infants less than 32 weeks' gestation and less than 1000-g birth weight. The 5-minute Apgar score was divided into 2 groups, score of 4 or greater or less than 4. The study compared results of the 5-minute Apgar score and associated morbidities in surviving infants. Statistical analyses included chi-square, Fisher exact test, t test, and multivariate regression. The sample consisted of 3898 infants with an 86.4% (n = 3366) survival rate. Controlling for gestational age and birth weight, surviving infants with a 5-minute Apgar score of less than 4 were more likely to demonstrate nonintact survival. Infants with a low 5-minute Apgar score have greater risk for mortality and morbidities associated with prematurity.

  15. [BRONCHOPULMONARY DYSPLASIA IN VERY LOW BIRTH WEIGHT INFANTS--THE OLD NEW PROBLEM].

    Science.gov (United States)

    Vakrilova, L; Hitrova, St; Dimitrova, V; Slancheva, B; Radulova, P; Neikova, K

    2015-01-01

    The advances in perinatal intensive care have increased the survival rate of extremely low birthweight (ELBW) and gestational age infants. Among them the risk of developing bronchopulmonary dysplasia (BPD) remains high. To evaluate the frequency of BPD by birthweight and gestational age, to identify the main postnatal risk factors and the associated comorbidities. 683 VLBW infants ( 30% and/or ventilator support). Infants with BPD were with significantly higher CRIB (9.9 ± 3.1) compared with those without BPD (4.0 ± 3.0), p birthweight 1200g. Logistic regression analysis showed that each gestational week decreased the odds of BPD by 60%; each CRIB point increased the odds by 62%. Each point increment in 1/5 min Apgar-scores reduced the risk by 40%/50% respectively The need for ventilator support increased from 1.4 ± 2.7 days (no-BPD group) to 52.8 ± 5.1 days (severe-BPD infants), p birthweight and CRIB. Additional risk factors are low A pgar scores, PDA and air leak syndrome. Associated comorbidities as severe brain injury and ROP further worsen the long term prognosis.

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

    Directory of Open Access Journals (Sweden)

    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

  17. 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 milk to ELBW infants may serve to expose the infant's oropharynx to protective (immune and trophic) biofactors (also present in amniotic fluid) and may protect the infant against NEC. Emerging evidence suggests that this intervention may have many benefits for extremely premature infants including protection against bacteremia, NEC, and ventilator-associated 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.

  18. Early Head Growth: Relation with IQ at 8 Years and Determinants in Term Infants of Low and Appropriate Birthweight

    Science.gov (United States)

    Lira, Pedro I. C.; Eickmann, Sophie H.; Lima, Marilia C.; Amorim, Rosemary J.; Emond, Alan M.; Ashworth, Ann

    2010-01-01

    Aim: To investigate the relation between head growth at different periods and IQ at 8 years, and to identify factors associated with more rapid head growth. Method: Two parallel cohorts of term low birthweight (LBW) and appropriate birthweight (ABW) infants were enrolled at birth in northeast Brazil. Anthropometric measurements were made at birth,…

  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...

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

    Science.gov (United States)

    Newman, L F

    1986-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  2. 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.

  3. Development of low birthweight infants at 19 months of age correlates with early intake and status of long-chain polyunsaturated fatty acids

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Okken-Beukens, M; Schaafsma, A; Muskiet, FAJ; Okken, A

    1999-01-01

    We investigated the influence of early nutrition with and without long-chain polyunsaturated fatty acids (LCP) on later development of less than or equal to 2500 g newborns receiving preterm formula without LCP (n=75), preterm formula with 18:3 omega 6 and LCP omega 3 (at two doses; n=26) or their m

  4. Development of low birthweight infants at 19 months of age correlates with early intake and status of long-chain polyunsaturated fatty acids

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Okken-Beukens, M; Schaafsma, A; Muskiet, FAJ; Okken, A

    1999-01-01

    We investigated the influence of early nutrition with and without long-chain polyunsaturated fatty acids (LCP) on later development of less than or equal to 2500 g newborns receiving preterm formula without LCP (n=75), preterm formula with 18:3 omega 6 and LCP omega 3 (at two doses; n=26) or their

  5. Development of low birthweight infants at 19 months of age correlates with early intake and status of long-chain polyunsaturated fatty acids

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Okken-Beukens, M; Schaafsma, A; Muskiet, FAJ; Okken, A

    1999-01-01

    We investigated the influence of early nutrition with and without long-chain polyunsaturated fatty acids (LCP) on later development of less than or equal to 2500 g newborns receiving preterm formula without LCP (n=75), preterm formula with 18:3 omega 6 and LCP omega 3 (at two doses; n=26) or their m

  6. Low birthweight (LBW and neonatal hyperbilirubinemia (NNH in an Indian cohort: association of homocysteine, its metabolic pathway genes and micronutrients as risk factors.

    Directory of Open Access Journals (Sweden)

    Krishna Kishore Sukla

    Full Text Available BACKGROUND & AIMS: Indian subcontinent has the highest child mortality rates along with a very high frequency of low birthweight (LBW. Folate and vitamin B12 (Vit-B12 are necessary during foetal development and their deficiency prevalence in Indians is very high. The objective of the present paper is to assess whether foetal homocysteine (Hcy/folate metabolic pathway genes, their cofactors and homocysteine level independently (or collectively predispose children to Low birth weight. METHODS: Cord blood was collected for the study. Frequency of 5 SNPs in 4-Hcy-pathway genes, and levels of Hcy, Vit-B12 and folate were evaluated. RESULTS: Of the 421 newborns recruited for the study, 38% showed low birth weight (<2.5 kg and 16% were preterm babies. 101 neonates developed neonatal hyperbilirubinemia (NNH. High prevalence of Vit-B12 (65% and folate (27% deficiency was observed in newborns along with hyperhomocystinemia (hypHcy-25%. Preterm delivery, micronutrient deficiency, hypHcy and MTHFR 677T SNP are associated as risk factor while G allele of TCN2 C776G is protective against LBW. MTHFR 677T allele and folate deficiency are also independent risk factors for NNH. CONCLUSION: We record the highest incidence of Vit-B12, folate deficiency and elevated Hcy levels, of all the studies so far reported on neonates. These together with MTHFR 677T are potential risk factors for LBW. Association of impaired folate/Hcy metabolism with NNH is reported for the first time and the possible way of interaction is discussed. It appears that proper nutritional management during pregnancy would reduce the risk of complex clinical outcomes.

  7. Low birthweight and premature birth are both associated with type 2 diabetes in a random sample of middle-aged Danes.

    Science.gov (United States)

    Pilgaard, K; Færch, K; Carstensen, B; Poulsen, P; Pisinger, C; Pedersen, O; Witte, D R; Hansen, T; Jørgensen, T; Vaag, A

    2010-12-01

    We studied the associations of size at birth and prematurity with type 2 diabetes, insulin sensitivity and beta cell function in the Danish population-based Inter99 study (ClinicalTrials.gov NCT00289237). Information about size at birth and prematurity was identified from original midwife records in 4,744 middle-aged Danes. Type 2 diabetes status, insulin sensitivity (Matsuda index) and beta cell function (disposition index) were assessed using a 75 g oral glucose tolerance test. Participants born prematurely were compared with a group of at-term participants born small for gestational age. An increase in birthweight of 1 kg was associated with a 51% (OR 0.49, 95% CI 0.35-0.69) reduced risk of type 2 diabetes. Ponderal index, reflecting thinness at birth, was associated with type 2 diabetes to the same extent as birthweight. The prevalence of type 2 diabetes was increased to a similar degree in participants born prematurely and participants born small for gestational age, although the former had a higher ponderal index at birth. In addition, birthweight z-scores, reflecting fetal growth rate, were unrelated to the risk of type 2 diabetes and to other measures of glucose regulation in participants born prematurely. While low birthweight was inversely associated with insulin sensitivity and beta cell function, prematurity was associated solely with decreased insulin sensitivity. While the association between birthweight and risk of type 2 diabetes is mediated via combined effects on beta cell function and insulin sensitivity, prematurity seems to influence risk of type 2 diabetes via attenuated insulin sensitivity only and independently of fetal growth rates.

  8. High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

    Science.gov (United States)

    Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-12-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

  9. 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

    2015-01-01

    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 developed

  10. Azithromycin in the extremely low birth weight infant for the prevention of Bronchopulmonary Dysplasia: a pilot study

    Directory of Open Access Journals (Sweden)

    Anstead Michael I

    2007-06-01

    Full Text Available Abstract Background Azithromycin reduces the severity of illness in patients with inflammatory lung disease such as cystic fibrosis and diffuse panbronchiolitis. Bronchopulmonary dysplasia (BPD is a pulmonary disorder which causes significant morbidity and mortality in premature infants. BPD is pathologically characterized by inflammation, fibrosis and impaired alveolar development. The purpose of this study was to obtain pilot data on the effectiveness and safety of prophylactic azithromycin in reducing the incidence and severity of BPD in an extremely low birth weight (≤ 1000 grams population. Methods Infants ≤ 1000 g birth weight admitted to the University of Kentucky Neonatal Intensive Care Unit (level III, regional referral center from 9/1/02-6/30/03 were eligible for this pilot study. The pilot study was double-blinded, randomized, and placebo-controlled. Infants were randomized to treatment or placebo within 12 hours of beginning mechanical ventilation (IMV and within 72 hours of birth. The treatment group received azithromycin 10 mg/kg/day for 7 days followed by 5 mg/kg/day for the duration of the study. Azithromycin or placebo was continued until the infant no longer required IMV or supplemental oxygen, to a maximum of 6 weeks. Primary endpoints were incidence of BPD as defined by oxygen requirement at 36 weeks gestation, post-natal steroid use, days of IMV, and mortality. Data was analyzed by intention to treat using Chi-square and ANOVA. Results A total of 43 extremely premature infants were enrolled in this pilot study. Mean gestational age and birth weight were similar between groups. Mortality, incidence of BPD, days of IMV, and other morbidities were not significantly different between groups. Post-natal steroid use was significantly less in the treatment group [31% (6/19] vs. placebo group [62% (10/16] (p = 0.05. Duration of mechanical ventilation was significantly less in treatment survivors, with a median of 13 days (1–47

  11. Clinical use of cerebral oximetry in extremely preterm infants is feasible

    DEFF Research Database (Denmark)

    Hyttel-Sørensen, Simon; Austin, Topun; van Bel, Frank

    2013-01-01

    The research programme Safeguarding the Brains of our smallest Children (SafeBoosC) aims to test the benefits and harms of cerebral near-infrared spectroscopy (NIRS) oximetry in infants born before 28 weeks of gestation. In a phase II trial, infants will be randomised to visible cerebral NIRS...

  12. Catch-up growth in Malawian babies, a longitudinal study of normal and low birthweight babies born in a malarious endemic area

    NARCIS (Netherlands)

    Kalanda, B.F.; Buuren, S. van; Verhoeff, F.H.; Brabin, B.J.

    2005-01-01

    Introduction: Infant growth has not been studied in developing countries in relation to maternal factors related to malaria in pregnancy and maternal illiteracy. Objective: To describe growth patterns in infants with low and normal birthweight and determine maternal risk factors for infant

  13. Growth and Development in Extremely Low Birth Weight Infants After the Introduction of Exclusive Human Milk Feedings.

    Science.gov (United States)

    Colacci, Michael; Murthy, Karna; DeRegnier, Raye-Ann O; Khan, Janine Y; Robinson, Daniel T

    2017-01-01

    Objective To estimate associations of exclusive human milk (EHM) feedings with growth and neurodevelopment through 18 months corrected age (CA) in extremely low birth weight (ELBW) infants. Study Design ELBW infants admitted from July 2011 to June 2013 who survived were reviewed. Infants managed from July 2011 to June 2012 were fed with bovine milk-based fortifiers and formula (BOV). Beginning in July 2012, initial feedings used a human milk-based fortifier to provide EHM feedings. Infants were grouped on the basis of feeding regimen. Primary outcomes were the Bayley-III cognitive scores at 6, 12, and 18 months and growth. Results Infants (n = 85; 46% received EHM) were born at 26 ± 1.9 weeks (p = 0.92 between groups) weighing 776 ± 139 g (p = 0.67 between groups). Cognitive domain scores were similar at 6 months (BOV: 96 ± 7; EHM: 95 ± 14; p = 0.70), 12 months (BOV: 97 ± 10; EHM: 98 ± 9; p = 0.86), and 18 months (BOV: 97 ± 16; EHM: 98 ± 14; p = 0.71) CA. Growth velocity prior to discharge (BOV: 12.1 ± 5.2 g/kg/day; EHM: 13.1 ± 4.0 g/kg/day; p = 0.33) and subsequent growth was similar between groups. Conclusion EHM feedings appear to support similar growth and neurodevelopment in ELBW infants as compared with feedings containing primarily bovine milk-based products.

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

    Science.gov (United States)

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

    2017-01-01

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

  15. Gait Transitions in Human Infants: Coping with Extremes of Treadmill Speed.

    Directory of Open Access Journals (Sweden)

    Erin V Vasudevan

    Full Text Available Spinal pattern generators in quadrupedal animals can coordinate different forms of locomotion, like trotting or galloping, by altering coordination between the limbs (interlimb coordination. In the human system, infants have been used to study the subcortical control of gait, since the cerebral cortex and corticospinal tract are immature early in life. Like other animals, human infants can modify interlimb coordination to jump or step. Do human infants possess functional neuronal circuitry necessary to modify coordination within a limb (intralimb coordination in order to generate distinct forms of alternating bipedal gait, such as walking and running? We monitored twenty-eight infants (7-12 months stepping on a treadmill at speeds ranging between 0.06-2.36 m/s, and seventeen adults (22-47 years walking or running at speeds spanning the walk-to-run transition. Six of the adults were tested with body weight support to mimic the conditions of infant stepping. We found that infants could accommodate a wide range of speeds by altering stride length and frequency, similar to adults. Moreover, as the treadmill speed increased, we observed periods of flight during which neither foot was in ground contact in infants and in adults. However, while adults modified other aspects of intralimb coordination and the mechanics of progression to transition to a running gait, infants did not make comparable changes. The lack of evidence for distinct walking and running patterns in infants suggests that the expression of different functional, alternating gait patterns in humans may require neuromuscular maturation and a period of learning post-independent walking.

  16. Incidencia de la retinopatía de la prematuridad en el bajo peso Incidence of the retinopathy of prematurity in the low birthweight

    Directory of Open Access Journals (Sweden)

    Rosa María Fernández Ragi

    2010-01-01

    Full Text Available OBJETIVO: Conocer el comportamiento de la retinopatía en los nacidos de menos de 1750 gramos o menos de 35 semanas en la provincia La Habana. MÉTODOS: Se realizó un estudio prospectivo longitudinal de todos los niños bajo peso nacidos en la provincia La Habana desde enero de 2004 a diciembre de 2008, se obtuvieron un total de 1847 niños bajo peso. El protocolo de investigación lo integraron los menores de 1750 gramos de peso al nacer o con edad gestacional inferior a 35 semanas, a quienes se les valoraron algunos factores de riesgo. Se excluyeron del estudio los fallecidos en ese período. RESULTADOS: La incidencia fue de 15,3 % mediante examen oftalmoscópico. Fue mayor en el grado III, en el peso comprendido de 1000-1499 gramos y edad gestacional de 28-32 semanas. En los niños investigados para ROP, el mayor porcentaje recibió oxígeno, solo dos casos no tuvieron dicho tratamiento. CONCLUSIÓN: La incidencia de retinopatía de la prematuridad, a pesar de resultar baja, generalmente ocurre de manera grave en el grado III, en el peso comprendido de 1000-1499 gramos y edad gestacional de 28-32 semanas, la oxigenoterapia es un factor de riesgo muy importante.OBJECTIVE: To find out the situation of the retinopathy in children with birthweight under 1750 grams or born with less than 35 weeks in Havana province. METHODS: A prospective longitudinal study of all the low birthweight children in Havana province, who were born from January from 2004 to December of 2008, was made. A total number of 1847 low weighted children was obtained. The study protocol included those children who were born weighing less than 1750 grams or whose gestational age was lower than 35 weeks; their risk factors were taken into consideration. The deceased children in this period were excluded. RESULTS: The incidence was 15.3 % based on the ophthalmologic exam. It was higher in the grade III, in the 1000-1499 gram range of weight and in the age 28-32 wk gestational age

  17. Significados atribuídos à vivência materna como acompanhante do recém-nascido pré-termo e de baixo peso Meaning attributed to the experience of mothers accompanying hospitalized premature and low birthweight newborns

    Directory of Open Access Journals (Sweden)

    Maria Gorete Lucena de Vasconcelos

    2006-03-01

    Full Text Available OBJETIVOS: identificar o significado de ser mãe acompanhante do recém-nascido pré-termo e de baixo peso, em participantes de um grupo de apoio multidisciplinar. MÉTODOS: pesquisa qualitativa, realizada por meio de estudo descritivo e exploratório. O contexto da investigação foi o Hospital das Clínicas da Universidade Federal de Pernambuco, sendo os dados coletados por meio da observação e entrevista gravada com 16 mães acompanhantes, no período de março a dezembro de 2003, seguindo critérios de inclusão até a saturação teórica, em resposta a duas questões norteadoras. Utilizou-se a análise de conteúdo, na modalidade análise temática transversal. RESULTADOS: a idade das mães variou entre 15 e 28 anos e 11 delas já tinham um filho. A partir da percepção materna acerca da experiência vivida, foram identificados quatro temas: o sofrimento pela separação da família e o apoio recebido; o alojamento materno como prisão; a não admissão da possibilidade de alta sem o filho e o alojamento materno enquanto espaço de novas amizades, aconselhamento e conflitos. CONCLUSÕES: o estudo aponta para a necessidade da ação humana de cuidar. O aprendizado coletivo se dá de forma concreta e positiva num contexto formal, podendo servir como subsídio para outras realidades.OBJECTIVES: to identify the meaning of being an accompanying mother to a hospitalized premature and low birthweight newborn and participant of a multidisciplinary support group. METHODS: qualitative research performed through a descriptive exploratory study at the Hospital das Clínicas da Universidade Federal de Pernambuco with data collected through observation and taped interviews with 16 accompanying mothers of hospitalized infants in the period of March to December, 2003. According to inclusion criteria to theoretical saturation in response to two guiding questions, content analysis through cross sectional thematic analysis was made. RESULTS: age of women

  18. Economic evaluation alongside the Premature Infants in Need of Transfusion randomised controlled trial.

    Science.gov (United States)

    Kamholz, Karen L; Dukhovny, Dmitry; Kirpalani, Haresh; Whyte, Robin K; Roberts, Robin S; Wang, Na; Mao, WenYang; Zupancic, John A F

    2012-03-01

    The Premature Infants in Need of Transfusion (PINT) Outcome Study showed no significant difference in the primary outcome of death or neurodevelopmental impairment (NDI) in extremely low birthweight (ELBW) infants. However, a post-hoc analysis expanding the definition of NDI to include borderline intellectual functioning (Mental Development Index (MDI) <85) found an improvement in outcomes in the group maintained at higher haemoglobin levels. To determine the cost effectiveness of more frequent red blood cell transfusions (high-Hb threshold) compared with less frequent transfusions (low-Hb threshold) in ELBW infants. The authors performed an economic evaluation using patient-level data collected during the PINT randomised trial. The authors measured comprehensive costs from a third-party payer's perspective over a time horizon from birth through 18-21 months corrected age. The average total cost in the high-Hb threshold group was CAN$149 767 compared with CAN$150 227 in the low-Hb threshold group (difference of CAN$460, p=0.96). Cost-effectiveness analysis estimated savings of CAN$6879 for every additional infant surviving without severe NDI. There was a 48% chance that the high-Hb threshold reduced costs while improving outcome and a 90% chance that it would be cost effective at a willingness-to-pay threshold of CAN$250 000 per additional survivor without severe NDI. Post-hoc analysis defining cognitive delay as MDI score <85, instead of <70, revealed savings in the high-Hb threshold group of CAN$4457 per additional survivor without NDI. Results were robust to deterministic sensitivity analyses. A high-Hb threshold for transfusion, as measured in ELBW PINT study infants through 18 months corrected gestational age, may be an economically appealing intervention. The estimates were associated with moderate statistical uncertainty that should be targeted in larger, future studies.

  19. Trends in Overall Mortality, and Timing and Cause of Death among Extremely Preterm Infants near the Limit of Viability

    Science.gov (United States)

    Sung, Sein; Ahn, So Yoon; Park, Won Soon

    2017-01-01

    Objective To investigate the trends in mortality, as well as in the timing and cause of death, among extremely preterm infants at the limit of viability, and thus to identify the clinical factors that contribute to decreased mortality. Methods We retrospectively reviewed the medical records of 382 infants born at 23–26 weeks’ gestation; 124 of the infants were born between 2001 and 2005 (period I) and 258 were born between 2006 and 2011 (period II). We stratified the infants into two subgroups–“23–24 weeks” and “25–26 weeks”–and retrospectively analyzed the clinical characteristics and mortality in each group, as well as the timing and cause of death. Univariate and multivariate logistic regression analyses were done to identify the clinical factors associated with mortality. Results The overall mortality rate in period II was 16.7% (43/258), which was significantly lower than that in period I (30.6%; 38/124). For overall cause of death, there were significantly fewer deaths due to sepsis (2.4% [6/258] vs. 8.1% [10/124], respectively) and air-leak syndrome (0.8% [2/258] vs. 4.8% (6/124), respectively) during period II than during period I. Among the clinical factors of time period, 1-and 5-min Apgar score, antenatal steroid identified significant by univariate analyses. 5-min Apgar score and antenatal steroid use were significantly associated with mortality in multivariate analyses. Conclusion Improved mortality rate attributable to fewer deaths due to sepsis and air leak syndrome in the infants with 23–26 weeks’ gestation was associated with higher 5-minute Apgar score and more antenatal steroid use. PMID:28114330

  20. 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

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

    Institute of Scientific and Technical Information of China (English)

    Hui-Jia Lin; Li-Zhong Du; Xiao-Lu Ma; Li-Ping Shi; Jia-Hua Pan; Xiao-Mei Tong; Qiu-Ping Li

    2015-01-01

    Background:With the progress ofperinatal 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) <1000 g were included between January 1,2011 and December 3 1,201 1.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 developed countries.

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

    Science.gov (United States)

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

    2015-08-01

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

  3. Coagulation abnormalities and severe intraventricular hemorrhage in extremely low birth weight infants.

    Science.gov (United States)

    Piotrowski, Andrzej; Dabrowska-Wojciak, Iwona; Mikinka, Marek; Fendler, Wojciech; Walas, Wojciech; Sobala, Wojciech; Kuczkowski, Krzysztof Marek

    2010-07-01

    The association between intraventricular hemorrhage (IVH) and coagulation in infants has been a subject of controversy. Only few publications assessing risk factors for development of IVH reported results of coagulation studies. To evaluate the levels of coagulation and fibrinolysis systems in ELBW infants and determine their influence on IVH. Following IRB approval coagulation status of 38 ELBW infants was evaluated on first and second day of life. Severity of IVH assessed by cerebral ultrasonography was graded according to Papile classification. Newborns were assigned to either Group A--Grade III or IV, or Group B--Grade I-II, or no IVH. Neonates with Grade III/IV IVH had significantly lower plasma Factor VII (FVII) level on first day of life and FVII differed significantly between Groups A and B with sensitivity of 100%, specificity 41% for a cut-off value of< 7%. In Group A there was no improvement of prothrombin and activated partial thromboplastin times on Day 2. A significant decline of platelet count was also observed. High-grade IVH coincides with severe derangement of coagulation in ELBW infants with FVII level being the most sensitive, it is not clear what the reason for such low FVII concentration is. Further studies are indicated.

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

    Science.gov (United States)

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

    2003-01-01

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

  5. Investigating skin-to-skin care patterns with extremely preterm infants in the NICU and their effect on early cognitive and communication performance: a retrospective cohort study

    Science.gov (United States)

    Gonya, Jenn; Ray, William C; Rumpf, R Wolfgang; Brock, Guy

    2017-01-01

    Objectives The primary objective of the study was to investigate how patterns of skin-to-skin care might impact infant early cognitive and communication performance. Design This was a retrospective cohort study. Setting This study took place in a level-IV all-referral neonatal intensive care unit in the Midwest USA specialising in the care of extremely preterm infants. Participants Data were collected from the electronic medical records of all extremely preterm infants (gestational age 0.05). Mothers provided the majority of skin-to-skin care with a sharp decline at 30 weeks corrected age, regardless of when extremely preterm infants were admitted. Additional exploratory network analysis suggests that medical and skin-to-skin factors play a parallel, non-synergistic role in contributing to early cognitive and communication performance as assessed through the Bayley-III. Conclusions This study suggests an association between early and frequent skin-to-skin care with extremely preterm infants and early cognitive and communication performance. PMID:28320787

  6. Initial clinical experience with the Medtronic Micro Vascular Plug™ in transcatheter occlusion of PDAs in extremely premature infants.

    Science.gov (United States)

    Sathanandam, Shyam; Justino, Henri; Waller, B Rush; Radtke, Wolfgang; Qureshi, Athar M

    2017-05-01

    To describe the early multicenter, clinical experience with the Medtronic Micro Vascular Plug™ (MVP) for the occlusion of patent ductus arteriosus (PDA) in premature infants. The MVP is a large diameter plug that can be delivered through a microcatheter for occlusion of abnormal blood vessels. A Retrospective review of PDA embolization procedures performed in two centers using the MVP was performed. Fifteen premature infants underwent attempted PDA occlusion using the MVP. The gestational age and birth weight were 25.6 ± 2.5 weeks and 735 ± 251 g, respectively. The median weight and age at the time of the procedure were 1,210 g (700-3,500 g) and 4.5 weeks (2-12 weeks), respectively. Median procedure and fluoroscopy times were 45 and 6.5 min, respectively. The median radiation and contrast doses were 19.7 mGy and 2.4 mL/kg, respectively. Antegrade occlusion was successfully achieved in 13 patients 2 kg had arterial access and attempted retrograde occlusion; one of which was unsuccessful due to the PDA being short and wide. Complete closure was observed in 13 of 14 successful procedures (93%), with one patient having a small residual shunt that was not seen on follow-up. There were no complications related to the procedure or noted during follow-up (Median 11 months). The MVP is a new, large-diameter vascular embolization device that may be useful for the occlusion of PDA in extremely small, premature infants. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. Is there any role for terlipressin in the extremely low birth weight infant with refractory septic shock?

    Directory of Open Access Journals (Sweden)

    Francesca Bissolo

    2012-10-01

    Full Text Available Terlipressin, a synthetic long-acting analogue of vasopressin, has been investigated as a second line vasopressor in adults and children with refractory septic shock, i.e. not responding to fluid resuscitation and high-dose catecholamine administration. Little experience is available about the safety and efficacy of terlipressin in term and preterm newborns. We report the case of an extremely low birth weight infant with severe septic shock, unresponsive to fluids, noradrenalin and hydrocortisone, in whom terlipressin was attempted as a rescue drug. Despite three doses of terlipressin, administered 6-hourly, the patient remained profoundly hypotensive and eventually died. Further studies are required before any recommendation on the use of terlipressin in term or preterm newborns with septic shock can be made.

  8. A phase II randomized clinical trial on cerebral near-infrared spectroscopy plus a treatment guideline versus treatment as usual for extremely preterm infants during the first three days of life (SafeBoosC)

    DEFF Research Database (Denmark)

    Hyttel-Sorensen, Simon; Austin, Topun; van Bel, Frank

    2013-01-01

    Every year in Europe about 25,000 infants are born extremely preterm. These infants have a 20% mortality rate, and 25% of survivors have severe long-term cerebral impairment. Preventative measures are key to reduce mortality and morbidity in an extremely preterm population. The primary objective ...

  9. Crescimento e desenvolvimento a longo prazo do prematuro extremo Growth and developmental outcomes of the extremely preterm infant

    Directory of Open Access Journals (Sweden)

    Ligia Maria Suppo de Souza Rugolo

    2005-03-01

    chronological age with respect of the degree of prematurity. There is special concern regarding the prognoses of small for gestational age preterm infants, and for those with bronchopulmonary dysplasia. Attention must be directed towards improving the nutrition of extremely low birth weight infants during their first years of life; these infants have high prevalence levels of failure to catch-up on growth, diseases and rehospitalizations during their first 2 years. They are frequently underweight and shorter than expected during early childhood, but delayed catch-up growth may occur between 8 and 14 years. Extremely low birth weight infants are at increased risk of neurological abnormalities and developmental delays during their first years of life. Educational, psychological, and behavioral problems are frequent during school years. Teenage and adult outcomes show that although some performance differences persist, social integration is not impaired. CONCLUSIONS: The growth and neurodevelopment of all ELBW infants must be carefully monitored after discharge, to ensure that children and their families receive adequate support and intervention to optimize prognoses.

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

    Science.gov (United States)

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

  11. Second serial transverse enteroplasty procedure in an infant with extreme short bowel syndrome.

    Science.gov (United States)

    Oh, Jung-Tak; Koh, Hong; Chang, Eun Young; Chang, Hye Kyung; Han, Seok Joo

    2012-06-01

    The serial transverse enteroplasty (STEP) procedure is a novel technique to lengthen and taper the bowel in patients with short bowel syndrome. The advantages of STEP include not only technical ease and simplicity, but also the ability to repeat the procedure. Herein, we report a case of extreme short bowel syndrome that was successfully treated by the second STEP procedure. A 3-day old newborn girl underwent STEP because of jejunal atresia with the small bowel length of 15 cm, but her bowel elongation was not enough to escape from short bowel syndrome. At the age of 6 months, she underwent a second STEP procedure. The bowel lengthening by the second STEP made her tolerable to enteral feeding with body weight gain and rescued her from short bowel syndrome. This case showed that second STEP is very helpful in treatment of extreme short bowel syndrome.

  12. Fatores associados à morte neonatal em recém-nascidos de muito baixo peso em quatro maternidades no Município do Rio de Janeiro, Brasil Factors associated with neonatal mortality among very low birthweight newborns in four maternity hospitals in the city of Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    José Luiz Muniz Bandeira Duarte

    2005-02-01

    Full Text Available Os recém-nascidos de muito baixo peso representam a grande maioria das mortes no período neonatal, constituindo o maior percentual da mortalidade infantil no Brasil. Este estudo, do tipo longitudinal, incluiu um total de 487 recém-nascidos e propôs uma análise dos fatores associados à mortalidade em recém-nascidos de muito baixo peso até completarem 27 dias de vida. Foram calculados os riscos relativos de óbito para cada uma das variáveis estudada, e as que se mostraram estatisticamente significativas foram selecionadas para o modelo multivariado, no qual se calcularam as razões de chances (OR com a regressão logística. Os fatores associados à diminuição do risco de morte foram: uso de corticosteróide antenatal (OR = 0,40; IC90%: 0,23-0,74 e uso de nutrição parenteral total (OR = 0,06; IC90%: 0,02-0,15. Os fatores associados ao risco de morte foram: recém-nascido do sexo masculino (OR = 2,19; IC90%: 1,27-4,00; hemorragia materna (OR = 4,28; IC90%: 1,27-14,46 e uso de ventilação mecânica (OR = 18,83; IC90%: 5,15-68,87; escore de CRIB (OR = 4,48; IC90%: 2,43-8,27 e peso ao nascimento. O uso de corticosteróide antenatal deve ser mais difundido, visando à diminuição da morbi-mortalidade neonatal.In Brazil, neonatal mortality is the most common cause of infant mortality. The majority of deaths occur in very low birthweight newborns. This longitudinal study assesses factors associated with mortality risk in very low birthweight newborns during the first 27 days of life. Relative risk of mortality was assessed for each variable, and the most statistically significant variables were selected for the multivariate model, in which odds ratios were calculated using logistic regression. Factors associated with decreased mortality risk were: prenatal corticosteroid (OR = 0.40; 90%CI: 0.23-0.74 and total parenteral nutrition (OR = 0.06; 90%CI: 0.02-0.15. Factors associated with increased mortality risk were: male gender (OR = 2

  13. Pulmonary sequestration causing severe cardiac failure requiring lobectomy in an extreme preterm infant

    Directory of Open Access Journals (Sweden)

    Rohit Nagar

    2015-10-01

    Full Text Available We report a case of a large, extralobar pulmonary sequestration in a preterm infant born at 25 weeks gestational age. A computed tomography (CT angiogram demonstrated that the arterial supply arose from the celiac trunk while an abnormally large, single left pulmonary vein drained the sequestration. This, along with the large patent ductus arteriosus (PDA, created a double left to right shunt, which resulted in severe, high output cardiac failure. Despite aggressive medical management for 3 weeks, he remained critically ill and developed renal failure. Therefore, after multiple, extensive multi-disciplinary discussions with the family, resection was offered as the only possibility for survival. He underwent a left thoracotomy and resection of the extra-lobar sequestration, which was occupying the lower two-thirds of his left hemithorax. To our knowledge, this is the youngest patient in the literature to undergo resection of an extra-lobar sequestration. Management challenges in terms of balancing the cardiac failure against the timing, approach and success of surgical intervention are also discussed along with a review of the literature.

  14. Trends in survival among extremely-low-birth-weight infants (less than 1000 g without significant bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Botet Francesc

    2012-06-01

    Full Text Available Abstract Objective The aim of this study was to analyze the evolution from 1997 to 2009 of survival without significant (moderate and severe bronchopulmonary dysplasia (SWsBPD in extremely-low-birth-weight (ELBW infants and to determine the influence of changes in resuscitation, nutrition and mechanical ventilation on the survival rate. Study design In this study, 415 premature infants with birth weights below 1000 g (ELBW were divided into three chronological subgroups: 1997 to 2000 (n = 65, 2001 to 2005 (n = 178 and 2006 to 2009 (n = 172. Between 1997 and 2000, respiratory resuscitation in the delivery room was performed via a bag and mask (Ambu®, Ballerup, Sweden with 40-50% oxygen. If this procedure was not effective, oral endotracheal intubation was always performed. Pulse oximetry was never used. Starting on January 1, 2001, a change in the delivery room respiratory policy was established for ELBW infants. Oxygenation and heart rate were monitored using a pulse oximeter (Nellcor® attached to the newborn’s right hand. If resuscitation was required, ventilation was performed using a face mask, and intermittent positive pressure was controlled via a ventilator (Babylog2, Drägger. In 2001, a policy of aggressive nutrition was also initiated with the early provision of parenteral amino acids. We used standardized parenteral nutrition to feed ELBW infants during the first 12–24 hours of life. Lipids were given on the first day. The glucose concentration administered was increased by 1 mg/kg/minute each day until levels reached 8 mg/kg/minute. Enteral nutrition was started with trophic feeding of milk. In 2006, volume guarantee treatment was instituted and administered together with synchronized intermittent mandatory ventilation (SIMV + VG. The complications of prematurity were treated similarly throughout the study period. Patent ductus arteriosus was only treated when hemodynamically significant. Surgical closure of the

  15. Linking Early Adversity, Emotion Dysregulation, and Psychopathology: The Case of Extremely Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Lauren A. Drvaric

    2013-01-01

    Full Text Available The ability to regulate emotion is a crucial process that humans utilize in order to adapt to the demands of environmental constraints. Individuals exposed to early adverse life events such as being born at an extremely low birth weight (ELBW, 501–1000 g are known to have problems regulating emotion which have been linked to the development of psychopathology in this population. Recent studies have used psychophysiological measures, such as electroencephalogram (EEG and cardiac vagal tone, to index emotion regulatory processes. The purpose of this paper was three-fold: (1 to investigate the relation between ELBW and emotion regulation issues (pathway 1, (2 to review studies investigating the relation between early emotion regulation and later internalizing problems (pathway 2; and (3 to provide a model in which two psychophysiological measures (i.e., frontal EEG asymmetry and cardiac vagal tone are suggested to understand the proposed conceptual pathways in the relation between ELBW and psychopathology.

  16. The effects of umbilical cord milking in extremely preterm infants: a randomized controlled trial

    Science.gov (United States)

    March, MI; Hacker, MR; Parson, AW; Modest, AM; de Veciana, M

    2014-01-01

    OBJECTIVE Delayed cord clamping has been shown to decrease the need for transfusion in preterm neonates, but may delay resuscitation. The aim of this study was to determine whether umbilical cord milking compared with immediate cord clamping in extremely preterm deliveries reduces the need for neonatal red blood cell transfusion. STUDY DESIGN Women admitted to a tertiary care center and expected to deliver between 24 to 28 completed weeks of gestation were randomized to cord milking before clamping or immediate cord clamping. The primary outcome was the risk of neonatal transfusion, reported as risk ratio (RR) and 95% confidence interval (CI). RESULT Of 113 women who were enrolled and randomized, 56 were assigned to cord milking with 36 remaining eligible and completing the study and 57 were assigned to the control group with 39 remaining eligible and completing the study. Albeit not statistically significant, neonates in the cord milking group were less likely to require transfusion compared with those in the control group (RR: 0.86; 95% CI: 0.73 to 1.0). Neonates whose cords were milked had higher hematocrits at birth (P = 0.004) and were less likely to develop an intraventricular hemorrhage (P = 0.0195). CONCLUSION Milking the umbilical cord of a preterm neonate is an easy intervention with the potential to improve perinatal outcomes. Our results suggest that milking of the cord increases the neonate’s initial hematocrit and may lessen the need for transfusion in the neonatal period. The observed reduction in the incidence of intraventricular hemorrhage may have important long-term implications that warrant further study. PMID:23867960

  17. Reduced Hospital Mortality With Surgical Ligation of Patent Ductus Arteriosus in Premature, Extremely Low Birth Weight Infants: A Propensity Score-matched Outcome Study.

    Science.gov (United States)

    Tashiro, Jun; Perez, Eduardo A; Sola, Juan E

    2016-03-01

    To evaluate outcomes after surgical ligation (SL) of patent ductus arteriosus (PDA) in premature, extremely low birth weight (ELBW) infants. Optimal management of PDA in this specialized population remains undefined. Currently, surgical therapy is largely reserved for infants failing medical management. To date, a large-scale, risk-matched population-based study has not been performed to evaluate differences in mortality and resource utilization. Data on identified premature (Propensity score-matched analysis of 1620 SL versus 1584 non-SL found reduced mortality (15% vs 26%) and more routine disposition (48% vs 41%) for SL (P Propensity score-matched analysis demonstrates reduced mortality in premature/ELBW infants with SL for PDA. NEC and sepsis are predictors of mortality and resource utilization.

  18. Introduction of percutaneous-tunneled transfontanellar external ventricular drainage in the management of hydrocephalus in extremely low-birth-weight infants.

    Science.gov (United States)

    Zucchelli, Mino; Lefosse, Mariella; Corvaglia, Luigi; Martini, Silvia; Sandri, Fabrizio; Soffritti, Silvia; Ancora, Gina; Mammoliti, Palma; Gargano, Giancarlo; Galassi, Ercole

    2016-07-01

    OBJECTIVE Hydrocephalus treatment in extremely low-birth-weight (ELBW) infants still represents a challenge for the pediatric neurosurgeon, particularly when the patient weighs far less than 1000 g. In such cases, the benefits in terms of neurological outcome following early treatment do not always outweigh the surgical risks, especially considering the great difference in the surgical risk before patient weight increases. To assess the efficacy and reliability of a percutaneous-tunneled, transfontanellar external ventricular drain (PTTEVD) in ELBW infants, the authors started a new protocol for the early surgical treatment of hydrocephalus. METHODS Ten cases of posthemorrhagic hydrocephalus (PHH) in ELBW infants (5 cases introduction of PTTEVD placement in our standard protocol for the management of PHH has proved to be a wise option for small patients.

  19. Imunização ativa e passiva no prematuro extremo Active and passive immunization in the extremely preterm infant

    Directory of Open Access Journals (Sweden)

    Eduardo C. Tavares

    2005-03-01

    Full Text Available OBJETIVO: Revisão sobre a indicação, contra-indicação, época ideal, eficácia imunogênica e reatogenicidade (eventos adversos das imunizações passiva e ativa nos RN pré-termo extremos. FONTE DOS DADOS: Pesquisa em livros-textos clássicos de infectologia pediátrica e nas bases de dados eletrônicas MEDLINE, Lilacs, PubMed e Akwanmed, utilizando os seguintes descritores de ciências da saúde: prematuro, recém-nascido de muito baixo peso, imunização, imunização ativa, imunização passiva, vacinas, imunoglobulina. SÍNTESE DOS DADOS: A imunização do recém-nascido pré-termo extremo ou de muito baixo peso ao nascer é um grande desafio para o pediatra, por não haver conhecimento suficiente da eficácia da resposta imunitária e das reações indesejáveis. Talvez, por isto, seja comum encontrar estas crianças com o seu esquema de imunizações incompleto ou atrasado. No entanto, apesar da escassez de publicações sobre o tema, em princípio, a idade gestacional e o baixo peso ao nascer não devem ser considerados fatores limitantes para que um recém-nascido prematuro clinicamente estável seja imunizado na mesma idade cronológica indicada para as crianças nascidas a termo. CONCLUSÃO: Não é possível, baseado em evidências, apresentar uma conduta inquestionável para a aplicação de vacinas e imunoglobulinas em recém-nascidos prematuros extremos ou de muito baixo peso. A tendência é - com raras exceções, como, por exemplo, a vacina BCG - manter o mesmo esquema de imunização ativa do recém-nascido a termo, independentemente do peso ao nascer ou da idade gestacional. A imunização passiva merece especial atenção, tendo indicações mais liberais neste grupo de recém-nascidos.OBJECTIVE: A review of the indications, contraindications, ideal timing, immunogenic efficacy and reactogenicity (adverse events of active and passive immunization for extremely preterm infants. SOURCES OF DATA: Research in classic

  20. The timing of surgical ligation for patent ductus arteriosus is associated with neonatal morbidity in extremely preterm infants born at 23-25 weeks of gestation.

    Science.gov (United States)

    Sung, Se In; Choi, Soo Young; Park, Jae Hyun; Lee, Myung Sook; Yoo, Hye Soo; Ahn, So Yoon; Chang, Yun Sil; Park, Won Soon

    2014-04-01

    The purpose of this study was to evaluate prognostic factors associated with surgical ligation for patent ductus arteriosus (PDA) in extremely preterm infants born at the limits of viability. Ninety infants who were born at 23-25 weeks of gestation and who received surgical ligation were included and their cases were retrospectively reviewed. Infants were classified into two different groups: survivors with no major morbidity (N), and non-survivors or survivors with any major morbidity (M). Clinical characteristics were compared between the groups. Possible prognostic factors were derived from this comparison and further tested by logistic regression analysis. The mean gestational age and the mean birth weight of M were significantly lower than those of N. Notably, the mean postnatal age at time of ligation in N was significantly later than that of the other group (17 ± 12 vs 11 ± 8 days in N and M, respectively). An adjusted analysis showed that delayed ligation (>2 weeks) was uniquely associated with a significantly decreased risk for mortality or composite morbidity after surgical ligation (OR, 0.105; 95% CI, 0.012-0.928). In conclusion, delayed surgical ligation for PDA (>2 weeks) is associated with decreased mortality or morbidities in extremely preterm infants born at 23-25 weeks of gestation.

  1. Hypersecretion of FSH in infant boys and girls born small for gestational age.

    Science.gov (United States)

    Ibáñez, Lourdes; Valls, Carme; Cols, Maria; Ferrer, Angela; Marcos, Maria Victoria; De Zegher, Francis

    2002-05-01

    Prenatal growth restraint, as reflected in a low birthweight for gestational age, is a risk factor for postpubertal FSH hypersecretion and for reduced gonadal size. The ontogeny of the low-birthweight effect on the FSH-inhibin B feedback loop is unknown. Infancy is an episode of choice to study the possibility of an early low-birthweight effect on the FSH-inhibin B loop because this phase is characterized by high activity within the gonadal axis. We assessed serum concentrations of FSH and inhibin B in 46 infants [26 girls and 20 boys; mean age, 4 months; range, 3-6 months; 17 appropriate for gestational age (AGA), 29 small for gestational age (SGA); mean birthweight, 3.2 kg for AGA vs. 2.3 kg for SGA], together with circulating levels of LH, E2, and free androgen index. In SGA girls and boys, serum FSH levels were 2- and 4-fold higher (P hypersecretion in infancy is a marker of subsequent subfertility.

  2. 103例超未成熟儿及超低出生体重儿转归及影响因素分析%Outcome and influencing factors of 103 cases of extremely premature infant and extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    王晓磊; 梅花; 刘春枝; 张亚昱; 刘春丽; 宋丹; 张钰恒

    2016-01-01

    目的 总结超未成熟儿及超低出生体重儿发生的原因、相关影响因素及转归情况.方法 分析内蒙古医科大学附属医院2009年1月至2015年12月NICU收治的符合条件的103例超低出生体重儿及超未成熟儿的临床资料,包括母孕期病史、新生儿出生时情况、诊治经过及预后.结果 103例患儿存活67例,死亡36例,存活率65.0% (67/103).妊娠高血压综合征、感染、胎膜早破等为发生超未成熟和超低出生体重儿的主要因素,影响两者的转归因素包括胎龄、性别、出生体重、肺出血、支气管肺发育不良、坏死性小肠结肠炎(P<0.05).长期住院的存活患儿后期易并发贫血.死亡直接原因前4位包括肺出血、呼吸窘迫综合征、新生儿肺炎及坏死性小肠结肠炎.结论 加强高危妊娠监测管理,预防早产,加强NICU超未成熟儿及超低出生体重儿的监护管理,及早发现、及早处理各种并发症,防止医院感染发生,是提高两者存活率,改善生活质量的根本措施.%Objective To summarize the causes,related factors and outcome of extremely premature infants and extremely low birth weight infants.Methods One hundred and three cases of extremely premature infants and extremely low birth weight infants were admired to First Affiliated Hospital of Inner Mongolia Medical University between January 2009 and December 2015.The study was performed to analyze the clinical data of the 103 cases,included history of pregnancy,birth situation,treatment and prognosis.Results In these 103 cases,67 infants survived,36 infants died.The survival rate was 65.0% (67/103).The extremely premature infants and extremely low birth weight infants were mainly associated with pregnancy-induced hypertension,infection,premature rupture of membranes.Factors that could affect the outcome of these cases included gestational age,sex,birth weight,pulmonary hemorrhage,bronchopulmonary dysplasia and necrotizing

  3. Perinatal and infant mortality in Wales: inter-district variations and associations with socio-environmental characteristics.

    Science.gov (United States)

    West, R R

    1988-06-01

    Stillbirth rates, perinatal death rates, early and late neonatal death rates and (post-neonatal) infant death rates are reported for Wales since local government and NHS reorganization in 1974. The time trends in these rates show declining mortality, in full weight and in low birthweight babies. Analysis of average rates for the period 1974-81 inclusive in the 37 local authority districts within Wales demonstrate wide variations, with PMRs ranging from 11.5 to 22.5 per 1000. Many highly statistically significant associations were evident between socioeconomic characteristics of the districts and stillbirth rates but few with neonatal death rates and none with infant death rates.

  4. Como minimizar a lesão pulmonar no prematuro extremo: propostas Strategies to minimize lung injury in extremely low birth weight infants

    Directory of Open Access Journals (Sweden)

    Cleide Suguihara

    2005-03-01

    Full Text Available OBJETIVO: Apresentar uma revisão das principais causas da nova displasia broncopulmonar e as estratégias utilizadas para diminuir sua incidência nos prematuros extremos. FONTES DOS DADOS: Para essa revisão, pesquisas foram feitas na MEDLINE (1996 a outubro de 2004, no Cochrane Database, em resumos da Society for Pediatric Research e recentes conferências sobre o tema. SÍNTESE DOS DADOS: A tecnologia e os novos conhecimentos científicos têm aumentado significantemente a sobrevida de prematuros extremos. Esse aumento da sobrevida resultou em aumento da incidência de displasia broncopulmonar. Atualmente, a displasia broncopulmonar é mais freqüentemente observada em recém-nascidos OBJECTIVE: To review the main causes of new bronchopulmonary dysplasia and the strategies utilized to decrease its incidence in extremely low birth weight infants. DATA SOURCES: For this review a MEDLINE search from 1966 to October 2004, the Cochrane Database, abstracts from the Society for Pediatric Research and recent meetings on the topic were used. SUMMARY OF FINDINGS: The survival of extremely low birth weight infants has increased significantly due to improvement in both scientific knowledge and technology. This improvement in survival has therefore resulted in an increased incidence of bronchopulmonary dysplasia. The characteristics of bronchopulmonary dysplasia in extremely low birth weight infants, the so called "new" bronchopulmonary dysplasia are quite different from the classic bronchopulmonary dysplasia described by Northway. This new bronchopulmonary dysplasia has a multifactorial etiology, which includes volutrauma, atelectrauma, oxygen toxicity and lung inflammation. Therapy such as prenatal corticosteroids, exogenous surfactant, nasal continuous positive airway pressure, new mechanical ventilation modalities and gentle ventilation have been used in attempts to decrease lung injury severity. CONCLUSIONS: In order to prevent lung injury in

  5. The factors affecting morbidity and mortality in low birth-weight infants

    Directory of Open Access Journals (Sweden)

    Mervan Bekdaş

    2013-01-01

    Full Text Available jective: To investigate the frequency of short term morbidity and mortality and the factors affecting them for the infants born with low birth-weight at our hospitalMethods: At our hospital, 195 infants born with low birthweight within a period of 18 months were identified and 150 infants born with normal birth-weights were selected as the control group. Results: Within the mentioned period of time, 4.4% (n=168 of the infants born in our hospital had low birthweight, 0.7% (n=27 had very low birth-weight (VLBW. Multiple pregnancies and asphyxiating birth rates were significantly high in these infants as compared to the control group. (p=0.029, p=0.011, respectively. For VLBW infants, the rates of asphyxiating birth (OR=14.2, 95% CI (6.6-30.7, p<0.001, hospitalization at the neonatal intensive care unit (OR=34.8, 95% CI (4.7-256.3, p<0,001 and diagnosis of respiratory distress syndrome (OR=11.5, 95% CI (4-33.5, p<0.001 were significantly high. In all infants, the transient metabolic disorders were identified at a significantly high rate (p=0.045. The birth-weight and gestational age of infants were inversely correlated with their fetal and neonatal mortalities (for all p<0.001. Conclusion: This study demonstrated that the most important factor affecting infants was multiple pregnancies. The birth-weight and gestational age of infants were inversely correlated with their morbidity and mortality rates.Key words: Low birth weight, perinatal risk factors, morbidity, mortality

  6. Energy balance, nitrogen balance, and growth in preterm infants fed expressed breast milk, a premature infant formula, and two low-solute adapted formulae.

    Science.gov (United States)

    Brooke, O G; Wood, C; Barley, J

    1982-12-01

    Energy balance, nitrogen balance, and growth studies were done in 37 preterm infants (20 of very low birthweight) who were fed on expressed breast milk or on one of 3 formulae each of different composition, including a special premature formula and a highly adapted 'humanised' formula. The variability of breast milk composition was such that it would have been difficult to predict the infants' protein and energy intakes under normal nursing conditions. All measured parameters of nutritional performance were best in infants fed on the 'premature' formula and were reflected in greater weight gain, linear growth, and head growth. The nitrogen balance data suggest that the highly adapted formula, which had a protein content comparable with that of mature human milk, contained too little protein for small preterm infants.

  7. The agreement between oscillometric and intra-arterial technique for blood pressure monitoring in the lower extremities for infants and toddlers undergoing aortic coarctation repair.

    Science.gov (United States)

    Peng, Zhe-Zhe; Zhang, Ma-Zhong; Sun, Ying; Bai, Jie; Gu, Hong-Bin; Liu, Pei-Pei; Li, Min; Cai, Mei-Hua

    2016-11-01

    Anesthetic management for patients undergoing surgical repair of aortic coarctation (CoA) should include constant blood pressure monitoring of the right upper extremity and a lower extremity. The delayed or absent pulse in the lower limbs often leads to unsuccessful arterial cannulation in infants and the oscillometric technique used for blood pressure measurement. The aim of this study was to evaluate the agreement between the oscillometric method and intra-arterial technique for blood pressure monitoring in the lower limbs of infants undergoing CoA. A total of 45 infants diagnosed with isolated CoA were initially enrolled in this study and five were excluded because of cannulation failure. Thus, 40 patients had their blood pressure measured simultaneously by both oscillometric technique on the thigh and femoral artery catheterization. After induction and intubation, five pairs of blood pressure readings from each patient were collected in an interval of 3 min. Statistical analysis was accomplished by revised Bland-Altman analysis. There was a strong correlation between oscillometric and invasive blood pressure measurements [systolic blood pressure (SBP) r = 0.771, diastolic blood pressure (DBP) r = 0.704 and mean artery pressure (MAP) r = 0.850]. The mean difference and 95% limits of agreement (95% LOA) between oscillometric and femoral artery blood pressure readings was 3.830 mmHg (-19.297, 26.957) for SBP, -8.725 mmHg (-26.236, 8.786) for DBP, and -3.235 mmHg (-18.842, 12.372) for MAP. There were only one pair of MAP (1/40) and two pairs of SBP readings (2/40) out of range (95% LOA), and all of paired DBP readings were within 95% LOA. There was a good agreement between oscillometric and invasive blood pressure measurements of lower extremities in infants with isolated CoA statistically. However, the oscillometry-measured SBP showed a tendency to overestimate the intra-arterial blood pressure reference, while oscillometry-measured DBP underestimated its

  8. Serum ibuprofen levels of extremely preterm infants treated prophylactically with oral ibuprofen to prevent patent ductus arteriosus

    NARCIS (Netherlands)

    Kanmaz, Gozde; Erdeve, Omer; Canpolat, Fuat Emre; Oguz, Serife Suna; Uras, Nurdan; Altug, Nahide; Greijdanus, Ben; Dilmen, Ugur

    2013-01-01

    The aim of this study was to explore the effects of early oral ibuprofen administration on the incidence of hemodynamically significant patent ductus arteriosus (hsPDA) and define the association between serum ibuprofen levels and ductal closure. Preterm infants with a gestational age of <28 weeks a

  9. 早期胃肠外营养方案对超低出生体重儿电解质的影响%The effect of early parenteral nutrition on preventing electrolyte imbalance within 72 hour after birth in extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    陈春; 崔银珠; 张谦慎

    2012-01-01

    目的 探讨早期胃肠外营养方案对超低出生体重儿(ELBWI)出生72 h内电解质的影响.方法 回顾性分析我院2010-2011年收治的 ELBWI的胃肠外营养方案,根据营养方案不同分为早期胃肠外营养组(EPN组)和延迟胃肠外营养组(LPN组),EPN组生后4 h内开始予以6.7%小儿氨基酸1.6 g/(kg·d),1 g/(kg·d)递增,10%葡萄糖酸钙1 mmol/100 ml,24 h内开始予以20%脂肪乳1 g/(kg·d),1 g/(kg·d)递增;LPN组出生8~24 h开始予以6.7%小儿氨基酸0.5 g/(kg·d),0.5 g/(kg·d)递增,20%脂肪乳0.5 g/(kg·d),0.5 g/(kg·d)递增,根据血钙水平决定是否补钙.分别于出生后24、48 h及72 h检测血清钾、钠、游离钙水平,记录每日液体摄入量、尿量及死亡例数等.结果 与EPN组相比,LPN组72 h内高钾血症、低钙血症发生率均增加(33.3%比3.6%,80.0%比10.7%,P均0.05).结论 对ELBWI早期予氨基酸、钙剂以及24 h内开始脂肪乳可减少早期电解质紊乱,尤其减少早期非少尿性高钾血症,可以预防致命性高血钾的发生.%Objective To study the effect of early parenteral nutrition ( PN ) on preventing life threatening electrolyte imbalance during the first 72 hours after birth in extremely low birthweight infants ( ELBWI ). Methods Retrospective comparative analysis was performed for all ELBWIs admitted to the NICU of a tertiary hospital in south China from January 2010 to December 2011. The infants in the early parenteral nutrition ( EPN ) group started PN within the first 4h after delivery, and the nutrition plan included 1. 6 g/( kg·d ) aminoacids at the beginning with an increment of 1. 0 g/( kg·d ) , lipid was given at 1 g/( kg·d ) within the first 24 hours, with an increment of 1. 0 g/( kg·d ). The infants in late parenteral nutrition ( LPN ) group received PN during 8 - 24 h after birth, including 0. 5 g/( kg·d ) aminoacids with an increment of 1.0 g/( kg·d ), and lipid was started on day 2 by 0. 5 g/( kg·d ) with an increment of 0

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

    Science.gov (United States)

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

    2014-04-01

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

  11. How many low birthweight babies in low- and middle-income countries are preterm? Cuantos de los recién nacidos de bajo peso de países emergentes son pre-término? Quantos dos recém-nascidos de baixo peso de países emergentes são pré-termo?

    Directory of Open Access Journals (Sweden)

    Fernando C Barros

    2011-06-01

    Full Text Available OBJECTIVE: To assess the prevalence of preterm birth among low birthweight babies in low and middle-income countries. METHODS: Major databases (PubMed, LILACS, Google Scholar were searched for studies on the prevalence of term and preterm LBW babies with field work carried out after 1990 in low- and middle-income countries. Regression methods were used to model this proportion according to LBW prevalence levels. RESULTS: According to 47 studies from 27 low- and middle-income countries, approximately half of all LBW babies are preterm rather than one in three as assumed in studies previous to the 1990s. CONCLUSIONS: The estimate of a substantially higher number of LBW preterm babies has important policy implications in view of special health care needs of these infants. As for earlier projections, our findings are limited by the relative lack of population-based studies.OBJETIVO: Estimar la prevalencia de recién nacidos pre-término entre los recién nacidos de bajo peso al nacer de países de renta media o baja. MÉTODOS: En consulta a bases de datos (PubMed, LILACS, Google Scholar fueron procurados estudios sobre la prevalencia de recién nacidos a término y pre-término entre aquellos de bajo peso al nacer conducidos posteriores a 1990 en países emergentes. Modelos de regresión fueron usados para evaluar la proporción de acuerdo con las prevalencias de bajo peso. RESULTADOS: Con base en 47 estudios de 27 países emergentes, aproximadamente la mitad de todos los recién nacidos con bajo peso serían prematuros, y no uno de cada tres, como se estimó en estudios anteriores a la década de 1990. CONCLUSIONES: La estimación de números sustancialmente más altos de prematuros con bajo peso tiene importantes consecuencias en la planificación de salud, ya que tales recién nacidos demandan cuidados especiales. Aún, los resultados son limitados por la falta de estudios poblacionales.OBJETIVO: Estimar a prevalência de recém-nascidos pr

  12. Hemorrhagic gianotti-crosti syndrome in a one and half month old infant: An extremely unusual presentation

    Directory of Open Access Journals (Sweden)

    Nilendu Sarma

    2013-01-01

    Full Text Available Gianotti-Crosti syndrome is parainfectious exanthematous disease having unique presentation of small papulovesicular eruptions symmetrically over extensor surface of limbs and face in children. Hemorrhagic lesions are very rare and are always localized. Here, a case of EBV-induced Gianotti-Crosti syndrome with extensive hemorrhagic vesicles in a one and half month old infant, possibly induced by Epstein Barr virus, is reported. Neither the involvement of the disease at this early age nor the extensive hemorrhagic vesicles as the predominant presentation is reported before.

  13. Use and Cutaneous Side Effects of Skin Antiseptics in Extremely Low Birth Weight Infants - A Retrospective Survey of the German NICUs.

    Science.gov (United States)

    Biermann, C D; Kribs, A; Roth, B; Tantcheva-Poor, I

    2016-07-01

    Background Nosocomial infections are a serious problem in the treatment of extremely low birth weight infants (ELBW, Octenidine without phenoxyethanol (OwPh) and Octenisept(®) were the predominantly used skin antiseptics for intensive-care procedures. At least one skin complication was reported by 27% (n=17) of the NICUs. In 9 cases Octenisept(®) was used, and in 6 cases octenidine was used. According to our knowledge, this is the first study surveying practices and safety of skin antisepsis in ELBWs in the German NICUs. Most German NICUs use octenidine, however, in different preparations. Skin complications including blistering, necrosis and scarring were seen with all octenidine products, a fact which has not been previously reported. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Frequent Use of Fresh Frozen Plasma Is a Risk Factor for Venous Thrombosis in Extremely Low Birth Weight Infants: A Matched Case-control Study

    Directory of Open Access Journals (Sweden)

    Maruyama,Hidehiko

    2012-02-01

    Full Text Available Percutaneously inserted central catheters (PICCs are often used in neonatal medicine. Venous thrombosis (VT is one of the complications associated with PICC use. According to some reports, fresh frozen plasma (FFP may be a risk factor for VT. The purpose of this study was to determine whether FFP use is associated with VT in extremely low birth weight infants (ELBWIs. We performed a matched case-control study on risk factors for VT in ELBWIs born over a period of 5 years in the neonatal intensive care unit of a tertiary hospital. Controls were infants from the unit matched for gestational age and birth weight. We performed univariate analyses and created receiver operating characteristic (ROC curves for the cut-off values of continuous parameters such as FFP. We also conducted multivariate conditional logistic regression analysis and calculated adjusted odds ratios and their 95% confidence intervals. Thirteen VT cases and 34 matched controls were examined. Using an ROC curve, FFP by day 5>50mL/kg was selected as the cut-off value. In multivariate conditional logistic regression analysis, FFP by day 5>50mL/kg exhibited an adjusted odds ratio of 5.88 (95% confidence interval:1.12-41.81, p=0.036. FFP by day 5>50mL/kg may be a risk factor for VT in ELBWIs.

  15. [The use of caspofungin in extremely low birth weight preterm infants based on clinical trials and reports considering the own experience (case report)].

    Science.gov (United States)

    Stempniewicz, Krzysztof; Walas, Wojciech; Gregorek-Pełka, Edyta; Kamińska, Ewa

    2014-01-01

    In recent years, despite of significant progress in the treatment of premature infants with extremely low body weight, still a significant problem remains severe, treatment-resistant generalized infections among which the percentage of fungal infections is increasing. The invasive candidiasis, especially caused by non-albicans species of Candida, are of particular importance. In the case of resistance on fluconazole and amphotericin B the use of echinocandin drug may be a useful choice. This paper reviews the pharmacokinetics of caspofungin in neonates and children, as well as the case reports and clinical trials on the use of caspofungin in neonates, including the premature infants. We describe also the premature neonate with low birth weight and a generalized infection caused by Candida glabrata, where, despite of the treatment based on the sensitivity of the fungus it did not achieve clinical improvement and sterilization of cultures. It was not until the lead-in of caspofungin in dose 2 mg/kg/day allowed to cure the patient. There was a transient increase in the activity of aminotransferases and level of bilirubin as a complication of treatment. At the end of application of caspofungin the liver functions have been slowly normalized. Caspofungin appeared to be effective in the treatment of systemic fungal C. glabrata in premature neonate with extremely low birth weight. Echinocandins, including caspofungin, appear to be a promising alternative to previously used agents in the treatment of invasive Candida infections in newborns. However, the further randomized trials on the use of caspofungin in preterm neonates, regarding long term follow-up, should be undertaken.

  16. Fluconazole prophylaxis in extremely low birth weight infants and neurodevelopmental outcomes and quality of life at 8 to 10 years of age.

    Science.gov (United States)

    Kaufman, David A; Cuff, Amy L; Wamstad, Julia B; Boyle, Robert; Gurka, Matthew J; Grossman, Leigh B; Patrick, Peter

    2011-05-01

    To examine the long-term effects of fluconazole prophylaxis in extremely low birth weight infants. Neurodevelopmental status and quality of life of survivors from a randomized, placebo-controlled trial of fluconazole prophylaxis were evaluated at 8 to 10 years of life using the Vineland Adaptive Behavior Scales-II (VABS-II) and the Child Health Questionnaire Parent-Completed Form 28 (CHQ-PF28), respectively. VABS-II Domain Scores for the fluconazole-treated (n = 21; 9.1 ± 0.7 years) compared with the placebo group (n = 17; 9.3 ± 0.8 years) were similar for communication [94.6 (±14.8) versus 92.6 (±12.6), P = .65], daily living skills [87.9 (±10.6) versus 87.4 (±9.3), P = .89], socialization [97.2 (±9.2) versus 94.4 (±7.9), P = .31], and motor skills [92.1 (±17.8) versus 95.1 (±14.6), P = .57]. Internalizing and externalizing behaviors and maladaptive behavior index were also similar. The CHQ-PF28 revealed no differences between the two groups regarding quality of life. Survivors were also happy or satisfied with school (90% versus 100%, P = .49), friendships (90% versus 88%, P = 1.00), and life (95% versus 100%, P = 1.00). Self esteem scores were 87.3 ± 15.7 versus 89.7 ± 10.4 (P = .59). There were also no differences between groups regarding emotional difficulties or behavior problems. Fluconazole prophylaxis for the prevention of invasive Candida infections is safe in extremely low birth weight infants and does not appear to be associated with any long-term adverse effects on neurodevelopment and quality of life at 8 to 10 years of life. Copyright © 2011 Mosby, Inc. All rights reserved.

  17. Administering different levels of parenteral phosphate and amino acids did not influence growth in extremely preterm infants

    DEFF Research Database (Denmark)

    Thomsen, Katrine Moe; Beck-Nielsen, Signe Sparre; Lando, Ane

    2015-01-01

    AIM: When a new high amino acid parenteral nutrition (PN) solution was introduced to our hospital, a design error led to decreased phosphate levels. This prompted us to examine the effect of three different PN solutions on plasma phosphate, plasma calcium and weight increases on extremely preterm...

  18. 极低及超低出生体重儿的预后因素分析%Prognostic factors in very low birth weight infants and extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    王恋; 李娟; 毛健; 张静; 陈丹

    2014-01-01

    Objective To analyze the clinical data of very low birth weight infants (VLBWIs) and extremely low birth weight infants (ELBWIs) (birth weight≤1 200 g) and to provide prewarning indicators for prognostic evaluation and clinical intervention. Methods A retrospective analysis was performed on the clinical data of 108 VLBWIs and ELBWIs to investigate the maternal history of diseases during pregnancy, neonatal birth status, the process of diagnosis and treatment, and prognosis. Unconditional logistic regression analysis was used to determine prognostic factors. Results Of the 108 preterm infants, 15 had a birth weight of<800 g, 29 had a birth weight of 800-999 g, and 64 had a birth weight of 1000-1200 g. The mortality was 33.3%(36/108). Placenta previa and Apgar score≤3 at 5 minutes were the main risk factors for death within 24 hours of birth;premature rupture of membrane, Apgar score≤3 at 5 minutes, and pulmonary hemorrhage were the main risk factors for death between 24 hours and 7 days after birth;late-onset sepsis caused by invasive fungal infection was an independent risk factor for death over 7 days after birth, while pregnancy-induced hypertension syndrome was a protective factor. Conclusions The mortality in VLBWIs and ELBWIs is relatively high, and the prognostic factors vary between preterm infants of different ages. Clinicians should discuss management options for the infants on the basis of these ifndings to increase the survival of preterm infants.%目的:分析极低及超低出生体重儿(出生体重≤1200 g)的临床资料,为其预后及临床干预提供预警指标。方法回顾性分析108例极低及超低出生体重儿的母孕期病史、新生儿出生时情况、诊治经过及预后,采用非条件logistic回归分析筛选预后的影响因素。结果108例极低及超低出生体重儿,出生体重范围在<800 g,800~999 g和1000~1200 g的早产儿分别为15例、29例和64例。存活72例,死亡36

  19. Temporary left ventricular assistance for extreme postoperative heart failure in two infants with Bland-White-Garland syndrome

    Science.gov (United States)

    Pawlak, Szymon; Grzybowski, Adam; Śliwka, Joanna; Rycaj, Jarosław; Obersztyn-Zawiślan, Anna; Wierzyk, Arkadiusz; Przybylski, Roman

    2016-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland syndrome – BWG) is a serious congenital cardiac anomaly leading to myocardial ischemia with severe heart failure. Immediate surgical correction is the treatment of choice, and the risk of postoperative complications depends on the degree of myocardial injury. The authors present two cases of infants with BWG, in whom long-term (175 and 26 days) left ventricular assistance with a Berlin Heart device was used, resulting in successful weaning from the support and subsequent hospital discharge. Because of serious hemorrhagic complications and their neurological consequences observed in the first patient, the anticoagulation protocol was modified in the second patient, providing more stable support and allowing the device to be removed after a shorter period of time. The Berlin Heart left ventricular assist device may be treated not only as a bridge for transplantation but also, considering the shortage of donors in this age group, as a bridge to recovery.

  20. Crescimento de prematuros de extremo baixo peso nos primeiros dois anos de vida Growth of extremely low birth weight infants during the first two years of life

    Directory of Open Access Journals (Sweden)

    Ligia Maria S. S. Rugolo

    2007-06-01

    Full Text Available OBJETIVO: Analisar o padrão de crescimento de prematuros de extremo baixo peso (EBP até 24 meses de idade corrigida, a influência da displasia broncopulmonar (DBP e os fatores de risco para falha de crescimento. MÉTODOS: Coorte de prematuros OBJECTIVE: To evaluate the growth pattern of extremely low birth weight infants(ELBW from birth to 24 months of adjusted gestational age (AA, the influence of bronchopulmonary dysplasia (BPD and risk factors associated to growth failure. METHODS: This cohort study included all singleton inborn infants with birthweight <1,000g, admitted in the follow-up clinic of a level III Perinatal Center. Weight, length and head circumference were measured at birth, 40 weeks, and 3, 6, 9, 12, 18, 24 months AA, and Z-scores were calculated. Out of the 82 survivors, 70 were studied and classified in two groups: BPD (n=41 and no-BPD (n=29. Statistical analysis included t-test or Mann-Withney, chi-square or Fisher Exact test, and multivariate logistic regression. RESULTS: In both groups, weight z-score decreased significantly between birth and 40 weeks AA. A peak incremental change in weight, length and head circumference z-scores occurred between 40 weeks and three months. Z-scores for the no-BPD group were close to the expected values by the age of six months and remained at these levels at 24 months AA. Children with BPD had lower z-scores for weight and head circumference in the first year of life, but no difference was found between BPD and no-BPD children in the second year of life. Regression analysis showed that catch-down in weight z-score at 40 weeks was a risk factor for failure to thrive. CONCLUSIONS: ELBW infants experienced early catch-up growth during the first two years of life. ELBW with BPD had poor weight gain. Post-natal growth restriction predicts failure to thrive in infancy.

  1. Importância dos minerais na alimentação do pré-termo extremo Minerals in the nutrition of extremely low birth weight infants

    Directory of Open Access Journals (Sweden)

    Cleide E. P. Trindade

    2005-03-01

    Full Text Available OBJETIVO: Revisão crítica da literatura sobre os minerais cálcio, fósforo e microelementos na nutrição do pré-termo extremo, considerando a importância no crescimento, mineralização óssea e como componente de dietas. FONTES DOS DADOS: Utilizamos o banco de dados MEDLINE e o Cochrane Database of Systematic Reviews, de 1994 a 2004. Selecionamos artigos com enfoques originais, artigos de revisão e livros específicos. SÍNTESE DOS DADOS: As dificuldades na nutrição de prematuros extremos aumentam a freqüência de prematuros com restrição de crescimento, cujas conseqüências futuras estão para serem determinadas. Todavia, há pouca literatura sobre minerais, especialmente sobre micronutrientes na nutrição do pré-termo extremo, considerando-se o deficiente armazenamento e a importância destes em nutrição. O principal enfoque desta revisão foi sobre o cálcio e o fósforo na mineralização óssea e na suplementação em nutrição parenteral e enteral, bem como a avaliação crítica da nutrição pós-alta sobre a mineralização óssea. São abordadas as necessidades de micronutrientes, principalmente selênio e zinco, e a função antioxidante do selênio na provável prevenção de doenças do prematuro com atuação de radicais livres. CONCLUSÃO: Considerando os baixos estoques de minerais em prematuros extremos, há necessidade de mais pesquisas sobre minerais na nutrição destes prematuros para definir suas reais necessidades, os aspectos metabólicos, bem como aplicar os conhecimentos na formulação de dietas que permitam prevenir quadros de deficiência e conseqüências a longo prazo. Ainda há controvérsias sobre a influência de fórmulas pós-alta sobre a evolução da doença óssea da prematuridade.OBJECTIVE: To review the literature on the role of calcium, phosphorus and trace elements in the nutrition of extremely low birth weight infants, considering their importance for metabolism, bone mineralization

  2. Early Vocalization of Preterm Infants with Extremely Low Birth Weight (ELBW), Part II: From Canonical Babbling up to the Appearance of the First Word

    Science.gov (United States)

    Torola, Helena; Lehtihalmes, Matti; Heikkinen, Hanna; Olsen, Paivi; Yliherva, Anneli

    2012-01-01

    The aim of this study was to systematically describe the preverbal development of preterm infants from canonical babbling up to the first word and to compare it with that of healthy full-term infants. In addition, the amount of vocalization between the preterm and full-term groups was compared. The sample consisted of 18 preterm infants with…

  3. 超低出生体重儿呼吸管理的研究进展%Advance in the respiratory management of extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    黄文娣

    2014-01-01

    随着辅助生育技术及新生儿重症监护室的发展,超低出生体重儿存活率逐渐增加.由于超低出生体重儿肺发育不成熟,一些产前干预、复苏策略及产后的呼吸管理对于该类患儿长期存活及远期预后具有重要意义.无创性呼吸支持策略可以减少机械通气产生的气压伤、容量伤及氧化应激损伤.吸入性NO、体外膜肺等呼吸支持策略还有待深入研究.%With the improvement of assisted reproductive technology and neonatal intensive care unit,the extremely low birth weight infants have increasingly survived.Since the immature pulmonary,antenatal interventions,resuscitation techniques and postnatal respiratory management attribute to their survival and long term outcomes.Non-invasive ventilation minimize barotrauma,volutrauma and oxygen toxicity induced by mechanical ventilation.Other new strategy such asinhaled NO,extracorporeal membrane oxygenation will be explored.

  4. 超低出生体重儿生存状况分析%Investigation of the extremely low birth weight infant living condition

    Institute of Scientific and Technical Information of China (English)

    陆丹芳; 童笑梅

    2013-01-01

    【Objective】 To investigate the extremely low birth weight infant's (ELBWI) quality of life and related intervention measures through review of ELBWI's living condition from a single centre NICU in recently years. 【Method】 It was retrospectively analyzed about the clinical data of 32 patients of ELBWI from February 2000 to January 2012. 【Results】 The ELBWI suvival rate, mortality rate, abandon rate were 34. 4%, 25. 0%,and 40. 6% respectively. The Assisted Reproductive Technologies (ART) ELBWI suvival rate was 75. 0%. Female suvival rate(72. 7%) was higer than male's in all suvival patients. The common direct causes of death were pulmonary haemorrhage (62. 5%), hyaline membrane disease (12. 5%),intracranial haemorrhage(12. 5%) and gastrointestinal bleeding(12. 5%). The data were divided into two stages (February 2000~January 2006 vs February 2006~January 2012). Compared with the former group,the abandon rate of the later was obviously lower(28. 0% vs 85. 7%) and suvival rate was significantly higher (44% vs 0%). There was significant diffrence of ART between survival group and mortality/abandon group(P<0. 05) with single factor analysis and logistic regression analysis.【Conclusion】 Positive treatment and timely processing of complications can improve ELBWI survival rate and reduce mortality. The treatment of survival limits.ELBWI should weigh up pros and cons,and should elevated the living quality of ELBWI.%[目的] 通过对12年来中心NICU中超低出生体重儿(extremely low birth weight infant,ELBWI)的生存状况分析,探讨ELBWI的生存质量及相关干预措施. [方法]对本院新生儿病房NICU自2000年2月-2012年1月的32例ELBWI进行回顾性分析. [结果]12年来ELBWI存活率34.4%,病死率25.0%,放弃率40.6%,辅助生育的ELBWI均积极治疗,存活率75.0%.所有存活者中女性占72.7%,明显高于男性.直接死亡原因最常见肺出血(62.5%),其次为早产儿肺透明膜病(12.5

  5. 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).

  6. Research Progress of Early Treatment Management of Extremely Low Birth Weight Infant%超低出生体质量儿的早期治疗管理进展

    Institute of Scientific and Technical Information of China (English)

    孔祎琳; 陈燕华; 李慧; 周晓玉; 薛梅

    2014-01-01

    The extremely low birth weight (ELBW)infant means that the premature infants′birth body weight is less than 1 000 g.At present,with the increase of neonatal intensive care technology,the survival rate of the ELBW infant is gradually improving,but the early treatment management of ELBW is still one of the most difficult problems in the world.The current studies showed many disputes in the early treatment management of the ELBW infant.This review summarized the early treatment management of the ELBW infant from the perspectives of breathing management, nutrition management, infection and complications.%超低出生体质量(ELBW)儿是指出生体质量<1000 g的早产儿。随着新生儿重症监护技术的提高,ELBW儿的存活率呈逐年上升趋势,但其早期治疗管理仍是国内外学者关注的重点及难题之一。目前,就 ELBW儿的早期治疗管理仍存争议。笔者拟就从呼吸管理、营养管理、感染及并发症处理方面对ELBW儿的早期治疗管理,进行综述如下。

  7. 极低和超低出生体重儿败血症临床分析%Analysis of clinical characteristics and antimicrobial susceptibilities in very low birth weight infants and extremely low birth weight infants with neonatal sepsis

    Institute of Scientific and Technical Information of China (English)

    林素; 吴百威; 王能里; 刘花兰; 胡淑英; 林振浪

    2010-01-01

    目的 了解极低和超低出生体重儿败血症临床特点、病原菌分布及药物敏感情况,以指导临床合理用药.方法 对1999年1月1日至2008年12月31日温州医学院附属育英儿童医院新生儿重症监护病房收治的56例极低和超低出生体重儿败血症(早发型败血症3例,晚发型败血症53例)临床特点、血培养结果及药物敏感情况进行回顾性分析.结果 极低和超低出生体重儿败血症临床表现无特征性.血培养结果阳性43例,以条件致病菌为主,其中新生儿早发型败血症血培养阳性1例.为脑膜炎败血黄杆菌;新生儿晚发型败血症血培养病原菌中,革兰阴性细菌主要是肺炎克雷伯菌(33.3%,14/42);革兰阳性细菌以凝固酶阴性葡萄球菌为首(26.2%,11/42),其次是肠球菌(11.9%,5/42);另有真菌感染2例,为白念珠菌败血症(4.8%,2/42).药物敏感试验方面,所有凝固酶阴性葡萄球菌均为耐苯唑西林凝同酶阴性葡萄球菌,对大部分β-内酰胺类抗生素耐药,对林可霉素、氨基糖苷类、大环内酯类及喹诺酮类抗生素亦不敏感,但对万古霉素未发现耐药,对利福平均敏感;所有肺炎克雷伯菌均产超广谱β-内酰胺酶,仅对碳青霉烯类、氨基糖苷类以及喹诺酮类等少数抗生素敏感.56例败血症患儿治愈43例,死亡13例(包括6例病情恶化放弃治疗),病死率为23.2%.结论极低和超低出生体重儿败血症临床表现缺乏特异性,病原菌主要为条件致病菌,并存在多重耐药,对可疑败血症患儿应及时行病原学检查及药物敏感试验,合理选择抗生素.为减少多重耐药菌感染的发生,应正确合理使用第三代头孢菌素.%Objective To review the basic clinical characteristics and the pathogens and their antimicrobial susceptibilities to neonatal sepsis in very low birth weight infants (VLBWI) and extremely low birth weight infants ( ELBWI) for selection of appropriate antibiotics. Methods A

  8. Early and intensive nutritional strategy combining parenteral and enteral feeding promotes neurodevelopment and growth at 18months of corrected age and 3years of age in extremely low birth weight infants.

    Science.gov (United States)

    Ohnishi, Satoshi; Ichiba, Hiroyuki; Tanaka, Yuko; Harada, Sayaka; Matsumura, Hisako; Kan, Ayako; Asada, Yuki; Shintaku, Haruo

    2016-09-01

    To evaluate whether aggressive nutrition can improve long-term neurodevelopmental outcomes and growth in extremely low birth weight (ELBW) infants born appropriate for gestational age (AGA). This single-center cohort study included 137 ELBW AGA infants born in two epochs. The first group received standard nutrition (SN; n=79) consisting of amino acids started at 0.5g/kg/day on Day 4 of life and increased to 1.0g/kg/day. The second aggressive nutrition (AN) group received amino acids started at 1.5-2.0g/kg/day within 24h of life and increased to 3.5g/kg/day. Parenteral and enteral feedings were combined in both groups. Neurodevelopmental outcomes by the Kyoto Scale of Psychological Development and growth were followed up to 18months of corrected age or 3years of age and compared by univariate and multivariate analyses. Baseline characteristics were similar between the two groups. At 3years of age, AN children had a significantly greater mean value of head circumference, but not length or weight, than SN children (49.1 vs 48.0cm, p=0.014). The cognitive-adaptive (C-A) score in the AN group was also significantly higher than that in the SN group (98.3 vs 91.9 at 18months, p=0.039 and 89.5 vs 83.1 at 3years, p=0.047). AN infants born ≥26weeks of gestation were less likely to develop borderline disability in C-A, language-social and overall developmental scores compared to gestational age-matched SN infants. Parenteral and enteral AN after birth improved the long-term cognitive neurodevelopment in ELBW AGA infants, especially in those born ≥26weeks of gestational age, however results need to be confirmed in a larger, multi-site randomized trial. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Estudo transversal sobre fatores associados ao baixo peso ao nascer a partir de informações obtidas em sala de vacinação Cross-sectional study of factors associated to low birthweight according to records obtained in vaccination service

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Costa Nascimento

    2003-03-01

    Full Text Available OBJETIVOS: estimar alguns fatores de risco para baixo peso ao nascer, em Guaratinguetá, cidade do Sudeste do Brasil, com dados primários obtidos junto a mães que procuraram o setor de vacinação do Sistema Único de Saúde em 1998. MÉTODOS: estudo transversal com amostra de conveniência e correspondente a 598 mães entrevistadas - 28,9% dos partos ocorridos no ano de 1998. As variáveis independentes foram ganho de peso materno, número de consultas realizadas no pré-natal, paridade, infecção no trato gênito-urinário, hipertensão arterial, outros filhos com baixo peso, tabagismo, idade materna e situações conjugal e trabalhista. Utilizou-se regressão logística e foram estimados os riscos relativos e o risco atribuível populacional; o nível de significância foi p OBJECTIVES: to estimate some of the risk factors for low birthweight in Guaratinguetá, a city located in Southeast Brazil, based on records from mothers seeking the vaccination service of the Universal Health Systemin 1998. METHODS: cross-sectional studies with convenience sampling corresponding to 598 mothers interviewed - 28, 9% of the deliveries in the year of 1998. Independent variables were maternal weight gain, number of medical visits, parity, infection of the genital and urinary tract, arterial hypertension, smoking, mother's age and marriage and job status. Logistic regression was used and relative and population attributable risk estimated; significance level was established at p < 0,05. RESULTS: variables with statistical significance present in the final model were maternal age under 20 years old (OR = 2,08 other underweight children (OR = 3,94, weight gain equal or under 10kg (OR = 1,69, arterial hypertension (OR = 2,16 and smoking (OR = 2,43. CONCLUSIONS: the control of these last three factors, that may occur during prenatal care, to the contrary of the other two, may reduce in almost 50% the prevalence of low birthweight.

  10. Neonatal cutaneous disseminated aspergillosis in a preterm extremely-low-birth-weight infant with favourable outcome at 3-year follow-up: a case report.

    Science.gov (United States)

    Manzoni, P; Rizzollo, S; Monetti, C; Carbonara, C; Priolo, C; Mastretta, E; Barberis, L; Galletto, P; Cigna, P; Leonessa, M L; Sala, U; Gomirato, G; Mostert, M; Stronati, M; Ruffinazzi, G; Tzialla, C; Jacqz-Aigrain, E; Kaguelidou, F; Farina, D

    2012-05-01

    Invasive disseminated neonatal aspergillosis is an uncommon disease, with only scattered reports in literature in the last few years. Here we report on a 25-week gestational age, 730 g at birth preterm female infant who developed on day-of-life 10 multiple cutaneous exhulcerative lesions in her right arm, trunk and abdomen. Early recognition and diagnosis of these lesions as a due to cutaneous initial symptom of cutaneous disseminated aspergillosis, as well as prompt treatment with Liposomal amphotericin B + Itraconazole, secured successful recovery from the systemic infection. Skin lesions healed without any surgical treatment. The infant was discharged in good health. Long-term follow-up at three years of age revealed normality of all neurodevelopmental and cognitive parameters. To our knowledge, this is one of the very few cases of survival, free from sequelae, for a preterm infant affected by neonatal cutaneous disseminated aspergillosis.

  11. CPR - infant

    Science.gov (United States)

    ... breathing and chest compressions - infant; Resuscitation - cardiopulmonary - infant; Cardiopulmonary resuscitation - infant ... CPR is best done by someone trained in an accredited CPR course. The newest techniques emphasize compression ...

  12. Factors influencing feeding practices of extreme poor infants and young children in families of working mothers in Dhaka slums: A qualitative study

    Science.gov (United States)

    Maitrot, Mathilde Rose Louise

    2017-01-01

    Background Nutritional status differs between infants and young children living in slum and non-slum conditions—infants and young children living in City Corporation slums are likely to have worse nutritional status compared to those from non-slums. Furthermore, families in slums tend to engage female labor in cash-earning activities as a survival strategy; hence, a higher percentage of mothers stay at work. However, little is known about feeding practices for infants and young children in families with working mothers in slums. This study aims to understand the factors that determine feeding practices for infants and young children living in families with working mothers in Dhaka slums. Methods This study adopted a qualitative approach. Sixteen In-depth Interviews, five Key Informant Interviews, and Focused Group Discussions were conducted with family members, community leaders, and program staff. Method triangulation and thematic analyses were conducted. Results Feeding practices for infants and young children in families with working mothers are broadly determined by mothers’ occupation, basis civic facilities, and limited family buying capacity. Although mothers have good nutritional knowledge, they negotiate between work and feeding their infants and young children. Household composition, access to cooking facilities, and poverty level were also found to be significant determining factors. Conclusion The results suggest a trade-off between mothers’ work and childcare. The absence of alternative care support in homes and/or work places along with societal factors outweighs full benefits of project interventions. Improving alternative childcare support could reduce the burden of feeding practice experienced by working mothers and may improve nutritional outcomes. PMID:28207894

  13. Analysis of early respiratory complications on extremely low and very low birth weight infants%超低和极低出生体重儿早期呼吸系统并发症分析

    Institute of Scientific and Technical Information of China (English)

    余华娟

    2013-01-01

    目的探讨超低和极低出生体重儿早期呼吸系统并发症的发生情况。方法对2010年3月~2012年12月本院出生的129例超低和极低出生体重儿早期呼吸系统并发症进行临床分析。结果新生儿呼吸窘迫综合征(NRDS),呼吸暂停,肺部感染,气漏,支气管肺发育不良(BPD)3组间比较,差异有统计学意义(P<0.05),其中<1000 g组发生率最高,1250~1499 g组发生率最低。3组痊愈率比较,差异有统计学意义(P<0.05)。结论对超低和极低出生体重儿早期呼吸系统并发症进行密切监护和针对治疗,可提高患儿的成活率,提高生存质量。%Objective To investigate the occurrence of early respiratory complications on extremely low and very low birth weight infants. Methods Early respiratory complications of 129 cases with extremely low and very low birth weight infants born in our hospital from March 2010 to December 2012 were analyzed. Results There were significant differences in NRDS,apnea,pulmonary infection,gas leakage and BPD among the three groups(P<0.05).The incidence of the group with birth weight less than 1000 g was the highest,while the incidence of the group with birth weight ranged from 1250 g to 1499 g was the lowest.There was significant difference in the cure rate among the three groups(P<0.05). Concluson Close monitoring and corresponding treatment of early respiratory complications on extremely low and very low birth weight infants can improve the survival rate and life quality of infants.

  14. Growth and bone mineralization in small-for-gestational-age preterm infants.

    Science.gov (United States)

    Kitazawa, Shigetaka; Itabashi, Kazuo; Umeda, You; Inoue, Makoto; Nishioka, Takashi

    2014-02-01

    Preterm infants are at risk for metabolic bone disease and suboptimal growth. This study examined the hypothesis that, apart from prematurity, intrauterine growth status (expressed as gestational age-specific birthweight standard deviation score) influences bone mineralization and body composition in early infancy. In this retrospective study, the groups consisted of preterm small-for-gestational-age (SGA) infants (n = 18; SGA group) and preterm appropriate-for-gestational-age (AGA) infants (n = 24; AGA group). Postnatal bone mineralization was measured at term-adjusted age (postmenstrual age, 37-42 weeks). Bone mineral content (BMC) and body composition were determined on dual-energy X-ray absorptiometry of the whole body. BMC and lean mass were significantly lower in the SGA group than in the AGA group at term-adjusted age (37-42 weeks postmenstrual age). Stepwise regression analysis identified weight at examination as the most significant factor, accounting for 51% of the variance in BMC. Bodyweight at term-adjusted age, rather than intrauterine growth, may affect postnatal bone mineralization in preterm low-birthweight infants. Therefore, promoting an increase in body size might increase postnatal bone mineralization in preterm SGA infants. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  15. A reanimação do prematuro extremo em sala de parto: controvérsias Controversies about the resuscitation of extremely preterm infants in the delivery room

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2005-03-01

    Full Text Available OBJETIVO: Relatar as principais controvérsias quanto aos procedimentos atualmente realizados na reanimação de recém-nascidos de extremo baixo peso na sala de parto. FONTES DOS DADOS: Revisão sistemática dos artigos incluídos em MEDLINE, SciELO e Cochrane Library e dos temas livres publicados em congressos internacionais e nacionais, utilizando-se as palavras-chave reanimação, asfixia e recém-nascido. SÍNTESE DOS DADOS: As principais controvérsias incluem aspectos relacionados à oxigenação e à ventilação do prematuro de extremo baixo peso ao nascimento. Os efeitos da administração de oxigênio em concentrações entre 21% e 100% precisam ser investigados. Os parâmetros adequados de pressão inspiratória, volume pulmonar e pressão expiratória final positiva necessitam ser estabelecidos com a finalidade de minimizar o barotrauma e o volutrauma. Os benefícios da aplicação da pressão positiva contínua de vias aéreas por via nasal também precisam ser bem determinados através de ensaios clínicos randomizados. Além disso, reanimadores manuais devem ser desenvolvidos para otimizar a administração desses parâmetros e minimizar a lesão pulmonar no início da vida extra-uterina. Estudos clínicos sobre a administração ao nascimento de adrenalina, expansores de volume e bicarbonato de sódio são inexistentes em prematuros de muito baixo peso. Adicionalmente, o principal dilema ético envolve a decisão conjunta entre os profissionais e os pais de não iniciar a reanimação na dependência da idade gestacional. CONCLUSÕES: A conduta atualmente vigente poderá ser modificada a partir dos resultados de ensaios clínicos randomizados e controlados, em conjunto com a avaliação do desenvolvimento, realizados em recém-nascidos de extremo baixo peso submetidos à reanimação na sala de parto.OBJECTIVE: To describe the main controversies about resuscitation procedures performed in extremely low birth weight infants in

  16. Clinical analysis of 165 extremely low birth weight infants%超低出生体重儿165例临床分析

    Institute of Scientific and Technical Information of China (English)

    庄严; 高喜容; 刘新晖; 熊月娥; 刘雨; 张琼

    2014-01-01

    Objective To analyze the clinical features and prognosis of extremely low birth weight infants (ELBWI).Method Data of totally 165 hospitalized ELBWI between August 1st,2008 and November 30th,2013 in Hunan Children's Hospital were analyzed.The information of general data and births,prenatal care,delivery room stabilization,transfer information,complications,treatment,outcome and follow up were summarized.Result (1) One hundred and sixty-five ELBWI were involved,their mean gestational age was(28.4 ± 2.4) weeks,mean birth weight (910.9 ± 93.1) g.(2) Rate of delivery in tertiary hospital was 46.7% (77/165)and prenatal steroids exposure was found in 52.1% (86/165).None of the cases were treated with continuous positive airway pressure (CPAP) in delivery room.(3) Rate of infants who were transfered to the class Ⅲ b neonatal ward within 12 hours after birth was 58.8% (97/165).(4) The main complications of them included neonatal respiratory distress syndrome (NRDS,77.0%,127/165),bronchopulmonary dysplasia (BPD,70.1%,75/107),patent ductus arteriosus (PDA,50.0%,40/80),preterm retinopathy (ROP,43.0%,46/107),sepsis 39.4% (65/165),intraventricular hemorrhage (IVH,34.8%,49/141),necrotizing enterocolitis(NEC,8.0%,7/88).(5) Treatment:97.6%(161/165) received oxygen therapy and 66.1% (109/165) received mechanical ventilation,55.2% (91/165) used CPAP.89.8% (114/127) of the NRDS used PS; 44.0% (33/75) of the BPD used low dose dexamethasone,32.0% (24/75) used low dose nitric oxide; 60.0% (24/40)of the PDA used medication.32.6% (15/46) of the ROP received laser photocoagulation.The average time of beginning enteral feeding was 2.0 d,the mean time to achieve full gastrointestinal feeding was 43.4 d.(6) Outcome:rate of survival in 165 cases with ELBWI was 51.5% (85/165),treatment was abandoned in 37.6% (62/165),total mortality was 48.5% (80/165).There were significant difference in survival rate between different birth weight group

  17. Motion-defined form processing in extremely premature children.

    Science.gov (United States)

    Jakobson, L S; Frisk, V; Downie, A L S

    2006-01-01

    Children born extremely prematurely are at risk for a variety of problems with motion analysis, including problems with motion-defined (MD) form recognition [Downie, A. L. S., Jakobson, L. S., Frisk, V., & Ushycky, I. (2003). Periventricular brain injury, visual motion processing, and reading and spelling abilities in children who were extremely-low-birthweight. Journal of the International Neuropsychological Society, 9, 440-449]. The aims of the present study were (1) to examine the impact of retinopathy of prematurity (ROP) and mild periventricular brain injury (PVBI) on MD form processing in this population; (2) to assess relationships between MD form recognition in these children and their performance in several other areas of visual competence. To this end, a battery of visual and visuomotor tests was administered to 43, 5- and 6-year old, extremely premature children, all of whom had escaped severe PVBI. A group of full-term controls was also studied. Relative to controls, premature children displayed clear deficits in MD form recognition and these deficits were related to the presence of ROP and/or mild PVBI, rather than to a history of prematurity per se. Regression analyses revealed significant associations in premature children between MD form processing deficits and problems with visual search, stereopsis, visuoconstructive and graphomotor skills, motor development, and Performance IQ. The results suggest that assessment of sensitivity to MD forms may be useful in the early identification of preterm children at greatest risk for visual problems associated with dorsal stream dysfunction.

  18. Magnetic resonance imaging at term and neuromotor outcome in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Valkama, A.M.; Paeaekkoe, E.L.E.; Vainionpaeae, L.K.; Lanning, F.P.; Ilkko, E.A.; Koivisto, M.E

    2000-07-01

    In order to evaluate the value of neonatal brain magnetic resonance imaging (MRI) for prediction neuro motor outcome in very low birthweight (VLBW) preterm infants, 51 such infants with gestational age less than 34 wk underwent brain MRI at term age. Myelination, parenchymal lesions (haemorrhage, leukomalacia, infarction, reduction of white matter), parenchymal lesions without subependymal haemorrhage, ventricular/brain ratios and widths of the extra cerebral spaces were assessed. The MRI findings were compared with cranial ultrasound (US) performed at term. Infants' neuro motor development was followed up until 18 mo corrected age. Parenchymal lesions seen in MRI at term predicted cerebral palsy (CP) with 100 % sensitivity and 79 % specificity, the corresponding figures for US being 67 % and 85 %, respectively. Parenchymal lesions in MRI, excluding subependymal haemorrhages, predicted CP with a sensitivity of 82 % and specificity of 97 %, the corresponding figures for US being 58 % and 100 % respectively. Delayed myelination, ventricular/brain ratios and widths of the extra cerebral spaces failed to predict CP. Term age is a good time for neuroradiological examinations in prematurely born high-risk infants. Parenchymal lesions seen in MRI are reliable predictors for CP.

  19. Early intracardiac thrombosis in preterm infants and thrombolysis with recombinant tissue type plasminogen activator

    Science.gov (United States)

    Ferrari, F; Vagnarelli, F; Gargano, G; Roversi, M; Biagioni, O; Ranzi, A; Cavazzuti, G

    2001-01-01

    OBJECTIVES—To determine the incidence of catheter related thrombosis and to test the efficacy of recombinant tissue type plasminogen activator (rt-PA) in preterm infants.
STUDY DESIGN—From January 1995 to December 1998, echocardiography was performed in the first few days of life in 76 very low birthweight (⩽ 1500 g) infants out of a total of 147 having an umbilical catheter placed. When intracardiac thrombosis was diagnosed, rt-PA infusion was performed.
RESULTS—Four infants (5%) developed an intracardiac thrombosis during the first few days of life. In three of them, rt-PA at a dose of 0.4-0.5 mg/kg in a 20-30 minute bolus led to dissolution of the clot. One patient received a three hour infusion after the bolus, at a dose of 0.1 mg/kg/h, with resolution of the thrombus. No systemic effects were observed after rt-PA infusion.
CONCLUSIONS—Early thrombosis may occur as a complication of umbilical catheterisation in preterm infants; early echocardiographic detection of this disorder allows complete, safe, and rapid lysis with rt-PA.

 PMID:11420328

  20. Perinatal and Infant Health Among Rural and Urban American Indians/Alaska Natives

    Science.gov (United States)

    Baldwin, Laura-Mae; Grossman, David C.; Casey, Susan; Hollow, Walter; Sugarman, Jonathan R.; Freeman, William L.; Hart, L. Gary

    2002-01-01

    Objectives. We sought to provide a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health. Methods. In this cross-sectional study of all 1989–1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (< 2500 g), infant mortality, and cause of death for US rural and urban AI/AN and non-AI/AN populations. Results. Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs 14.4%, P ≤ .001); rates for both groups were over twice that for Whites (6.8%). AI/AN postneonatal death rates (rural = 6.7 per 1000; urban = 5.4 per 1000) were more than twice that of Whites (2.6 per 1000). Conclusions. Preventable disparities between AI/ANs and Whites in maternal and infant health status persist. PMID:12197982

  1. Effect of intrapartum nursing of NICU nurse specialist to rescue extremely low birth weight infants%NICU专科护士产时护理对超低出生体重儿抢救效果的影响

    Institute of Scientific and Technical Information of China (English)

    于新颖; 刘丹妮; 王玲

    2012-01-01

    目的 探讨产时NICU专科护士配合抢救对超低出生体重儿抢救效果的影响.方法 将2008年11月至2012年1月出生的超低出生体重儿按出生单双日分组,单日为观察组30例,产时为NICU专科护士配合抢救和护理;双日为对照组30例,产时是产科接产医生配合抢救,观察配合人员改变后对抢救效果的影响.结果 观察组5 min Apgar评分明显高于对照组[(8.13±0.68)分比(6.73±0.83)分],差异有统计学意义(t=7.152,P<0.01).观察组体温、pH值、BE值明显高于对照组,差异均有统计学意义(t值分别为13.274,6.152,2.691;P均<0.05);抢救时间较对照组缩短[(12.67±2.86) min比(14.33±2.86)min],差异亦有统计学意义(t=-2.260,P<0.05).结论 产时NICU专科护士配合抢救和护理可明显提高超低出生体重儿的抢救效果,缩短抢救时间,为后续治疗奠定基础.%Objective To investigate the rescuing effect of extremely low birth weight infants under the assistance of intrapanrtum NICU nurse specialist.Methods Sixty extremely low birth weight infants born from November 2008 to January 2012 were divided into two groups according to the odd-even date of their birth.30 infants who were born on odd days were the observation group and rescued and nursed by intrapanrtum NICU nurse specialist,while 30 infants who were born on even days were the control group and rescued by obstetric doctors.The effect of personnel change on rescuing was observed and compared.Results In the observation group,5 minute Apgar scorewas significantly higher than that in the control group [(8.13 ±0.68) vs (6.73 ±0.83) (t = 7.152,P < 0.01) ; the body temperature,pH value and BE value were all significantly higher than those in the control group (t = 13.274,6.152,2.691,respectively;P <0.05) ; rescue time was shorter than that of the control group [(12.67 ± 2.86) min vs (14.33 ± 2.86) min] (t =-2.260,P < 0.05).Conclusions The assistance and nursing by

  2. Effect of maternal multiple micronutrient supplementation on fetal loss and infant death in Indonesia: a double-blind cluster-randomised trial.

    Science.gov (United States)

    Shankar, A H; Jahari, A B; Sebayang, S K; Aditiawarman; Apriatni, M; Harefa, B; Muadz, H; Soesbandoro, S D A; Tjiong, R; Fachry, A; Shankar, A V; Atmarita; Prihatini, S; Sofia, G

    2008-01-19

    Maternal nutrient supplementation in developing countries is generally restricted to provision of iron and folic acid (IFA). Change in practice toward supplementation with multiple micronutrients (MMN) has been hindered by little evidence of the effects of MMN on fetal loss and infant death. We assessed the effect of maternal supplementation with MMN, compared with IFA, on fetal loss and infant death in the setting of routine prenatal care services. In a double-blind cluster-randomised trial in Lombok, Indonesia, we randomly assigned 262 midwives to distribute IFA (n=15 ,86) or MMN (n=15,804) supplements to 31 290 pregnant women through government prenatal care services that were strengthened by training and community-based advocacy. Women obtained supplements, to be taken daily, every month from enrolment to 90 days post partum. The primary outcome was early infant mortality (deaths until 90 days post partum). Secondary outcomes were neonatal mortality, fetal loss (abortions and stillbirths), and low birthweight. Analysis was by intention to treat. The study is registered as an International Standard Randomised Controlled Trial, number ISRCTN34151616. Infants of women consuming MMN supplements had an 18% reduction in early infant mortality compared with those of women given IFA (35.5 deaths per 1000 livebirths vs 43 per 1000; relative risk [RR] 0.82, 95% CI 0.70-0.95, p=0.010). Infants whose mothers were undernourished (mid upper arm circumference <23.5 cm) or anaemic (haemoglobin <110 g/L) at enrolment had a reduction in early infant mortality of 25% (RR 0.75, 0.62-0.90, p=0.0021) and 38% (RR 0.62, 0.49-0.78, p<0.0001), respectively. Combined fetal loss and neonatal deaths were reduced by 11% (RR 0.89, 0.81-1.00, p=0.045), with significant effects in undernourished (RR 0.85, 0.73-0.98, p=0.022) or anaemic (RR 0.71, 0.58-0.87, p=0.0010) women. A cohort of 11 101 infants weighed within 1 h of birth showed a 14% (RR 0.86, 0.73-1.01, p=0.060) decreased risk of low

  3. An analysis of the socio-demographic characteristics of sole registered births and infant deaths.

    Science.gov (United States)

    Messer, Julie

    2011-01-01

    Differences in birth characteristics and infant mortality rates by marital status and birth registration type reflect complex underlying factors. In particular, births registered solely by the mother are seen as a disadvantaged group. This article analyses the socio-demographic characteristics of births by registration type and parents' marital status and explores these differences for health outcomes. Birth notifications data from the NHS Numbers for Babies system was linked to birth registration data held by the Office for National Statistics (ONS) for births occurring in 2007 and 2008 in England and Wales. This dataset was further linked to death registration data to identify infants who died before their first birthday.Regression analysis was used to compare factors and health outcomes across marital and registration status groups. Regression models were calculated to determine the main risk factors for poor outcomes. The registration groups differed in the age of the mother at birth, the proportion of young mothers, ethnic group distribution and measures of deprived circumstances. The joint registered-different address and sole registered groups were similar in the proportion of young mothers and the deprivation indices. The groups also differed in the proportion of low birthweight and premature babies. The joint registered-different address and sole registered groups both had higher percentages of 'small for gestational age' babies compared with the within-marriage and joint registered-same address groups. The stillbirth rate was highest in the sole registered group. Both the joint registered-different address and sole registered groups had higher infant mortality rates compared with the within-marriage and joint registered-same address groups. Multivariate analysis indicated that low birthweight was a key factor in infant mortality. Births registered solely by the mother were found to be a disadvantaged group but were also similar to the joint

  4. 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

  5. Low birthweight and prematurity in relation to paternal factors

    DEFF Research Database (Denmark)

    Basso, Olga; Olsen, Jørn; Christensen, Kaare

    1999-01-01

    was associated with changes in the recurrence risk. Fathers who changed partner had offspring with similar birthweight and gestational length between the three sub-cohorts, while a difference was evident in offspring to fathers whose female partner was unchanged. CONCLUSIONS: We did not identify any paternal...

  6. Anxiety in adolescents born preterm or with very low birthweight

    DEFF Research Database (Denmark)

    Sømhovd, Mikael Julius; Hansen, Bo Mølholm; Brok, Jesper Sune

    2012-01-01

    Aim To determine if adolescents who are born very preterm (anxiety problems. Method We used a systematic review and meta-analysis. We searched the databases ISI Web...... of identified articles. We selected casecontrol studies of adolescents 11 to 20 years old who were very preterm/VLBW and had a matched reference group born at term with normal birthweight that reported a validated anxiety outcome measure. For data extraction, two authors independently reviewed titles, abstracts......, and full articles identified through the searches. Subsequently two authors independently extracted data. Results We included six studies with 1519 adolescents (787 very preterm/VLBW, 732 comparisons). The general risk of developing clinically significant anxiety problems was nearly doubled (p

  7. Adult glucose metabolism in extremely birthweight-discordant monozygotic twins

    DEFF Research Database (Denmark)

    Frost, M; Petersen, I; Brixen, K

    2012-01-01

    Low birthweight (BW) is associated with increased risk of type 2 diabetes. We compared glucose metabolism in adult BW-discordant monozygotic (MZ) twins, thereby controlling for genetic factors and rearing environment.......Low birthweight (BW) is associated with increased risk of type 2 diabetes. We compared glucose metabolism in adult BW-discordant monozygotic (MZ) twins, thereby controlling for genetic factors and rearing environment....

  8. 极低和超低出生体重儿神经发育预后及其影响因素%Neurodevelopmental outcomes and its risk factors of very low and extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    翟倩; 曹云; 王艺; 张澜; 杨红; 邵肖梅; 徐秀; 陆春梅

    2013-01-01

    Objective To investigate the neurodevelopmental outcomes and its risk factors of very low birth weight infant (VLBWI) and extremely low birth weight infants (ELBWI).Methods Data of 85 VLBWI and ELBWI hospitalized in Children's Hospital of Fudan University from October 2005 to November 2009 who had finished infant development test of Baley Scales of Infant Development Ⅱ (Bayley Ⅱ) for neurological development at corrected gestational age between 18 to 42 months were retrospectively reviewed.Twelve infants who accepted treatment in other hospital over 10 days were excluded; the rest 73 infants were divided into normal (neurodevelopment) group or abnormal group according to the definition of neurodevelopmental impairment reported by National Institute of Child Health and Human Development (NICHD) Neonatal Network.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression.Results The mean gestational age of 73 infants was (30.4±2.3) weeks; among which 13 were smaller than 28 weeks,42 between 28 and 32 weeks,and 18 older than 32 weeks.The mean birth weight was (1208.0±208.5) g; among which 15 (20.6%) <1000 g,and 58 (79.4%) were between 1000 g and 1500 g.Four babies (5.5%) were diagnosed as movement retardation,and neurodevelopmental impairment occurred in 16 cases (21.9 %),psychomotor developmental index <70 occurred in 6 cases (8.2%,one case complicating with cerebral palsy); mental developmental index <70 occurred in 2 cases (2.7%); both psychomotor developmental index and mental developmental index <70 occurred in 7 cases (9.6 %,two cases complicating with cerebral palsy),and one case (1.4 %) was cerebral palsy only.Blind in either eyes and hearing impairment requiring deaf-aid were not found in any of the 73 babies.Logistic stepwise regression showed that use of mechanical ventilation was related to neurodevelopmental impairment (OR =6.183,95% CI:1.664-22.983,P =0.003).Psychomotor

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

    Science.gov (United States)

    de Róiste, Aine

    2004-12-01

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

  10. How extreme are extremes?

    Science.gov (United States)

    Cucchi, Marco; Petitta, Marcello; Calmanti, Sandro

    2016-04-01

    High temperatures have an impact on the energy balance of any living organism and on the operational capabilities of critical infrastructures. Heat-wave indicators have been mainly developed with the aim of capturing the potential impacts on specific sectors (agriculture, health, wildfires, transport, power generation and distribution). However, the ability to capture the occurrence of extreme temperature events is an essential property of a multi-hazard extreme climate indicator. Aim of this study is to develop a standardized heat-wave indicator, that can be combined with other indices in order to describe multiple hazards in a single indicator. The proposed approach can be used in order to have a quantified indicator of the strenght of a certain extreme. As a matter of fact, extremes are usually distributed in exponential or exponential-exponential functions and it is difficult to quickly asses how strong was an extreme events considering only its magnitude. The proposed approach simplify the quantitative and qualitative communication of extreme magnitude

  11. Post-neonatal infant mortality in Malawi: the importance of maternal health.

    Science.gov (United States)

    Verhoeff, Francine H; Le Cessie, Saskia; Kalanda, Boniface F; Kazembe, Peter N; Broadhead, Robin L; Brabin, Bernard J

    2004-06-01

    In a cohort study of mothers and their infants, information was collected from women attending the antenatal services of two hospitals in a rural area of Malawi and 561 of their babies were enrolled in a follow-up study. There were 128 with a low birthweight (LBW, <2500 g), 138 with fetal anaemia (FA, cord haemoglobin <12.5 g/dl), 42 with both and 228 with a normal birthweight and no FA. Infants were seen monthly for 1 year. Risk factors for post-neonatal infant mortality (PNIM) were calculated using Cox regression analysis adjusting for LBW and FA. PNIM was 9.3%. Respiratory infections and diarrhoeal disease were the principal attributable causes of death. PNIM increased with LBW (RR 3.08, 95% CI 1.51-6.23) but not significantly so with FA (RR 1.60, 95% CI 0.78-3.27). An additional effect on PNIM was observed with maternal HIV (RR 3.44, 95% CI 1.63-7.26) and malaria at the first antenatal visit (RR 2.26, 95% CI 1.09-4.73). Illiteracy was not associated with mortality. Placental malaria in HIV-seronegative mothers was significantly associated with increased PNIM. Improving birthweight through effective antimalarial control in pregnancy will lead to a reduction in PNIM. Reduction of HIV prevalence and prevention of mother-to-child transmission of HIV must be a main target for government health policy.

  12. 体位固定法在婴幼儿上肢静脉穿刺中的应用效果评价%Effect evaluation of position fixed method on application of infant's upper extremity venous puneture

    Institute of Scientific and Technical Information of China (English)

    杨明珊; 陈环; 梁芳娟; 黄五星; 蔡小梅

    2013-01-01

    Objective To explore the clinical effect of immobilization applications in upper extremity venous puncture in infants.Methods Six hundreds infants who accepted infusion therapy in hospital outpatient were chosen and randomly divided into the experimental group with odd outpatient number and the control group with even outpatient number,each with 300 cases.The experimental group used immobilization in upper extremity venous puncture while the control group used a random postural,and two groups'success rate of the first puncture,nurses'confidence in vein puncture as well as the satisfaction of the patients'family were compared.Results Success rate of the first puncture,nurses'confidence in vein puncture and satisfaction of the patients'family were 92%,96%,95% respectively in experimental group and 75%,72%,76% in control group,the differences were statistically significant (x2 =31.5,43.6,45.6;P <0.01).Conclusions Immobilization applications in upper extremity venous puncture in infants could increase success rate of the first puncture,nurses'confidence in vein puncture,and satisfaction of the patients'family.It is a simple and practical method.%目的 探讨体位固定在婴幼儿上肢静脉穿刺中的应用效果.方法 选取门诊输液治疗的600例婴幼儿,按门诊号的单双分为观察组及对照组各300例,观察组应用体位固定法进行上肢静脉穿刺,对照组进行上肢静脉穿刺时不固定体位,比较两组一针穿刺的成功率、护士对静脉穿刺的信心及家属对护士的满意度.结果 观察组一针穿刺成功率为92%,护士对静脉穿刺的信心为96%,家属对护士的满意度为95%,均明显高于对照组(75%,72%,76%),两组比较差异有统计学意义(x2值分别为31.5,43.6,45.6;P<0.01).结论 婴幼儿静脉输液选择体位固定法进行上肢静脉穿刺,能提高静脉一针穿刺成功率、护士静脉穿刺的信心及家属的满意度.

  13. Maternal smoking in successive pregnancies and recurrence of low birthweight: the 2004 Pelotas birth cohort study, Brazil Tabaquismo materno en sucesivas gestaciones y recurrencia de bajo peso al nacer: cohorte de nacimientos de Pelotas, Río Grande do Sul, Brasil, 2004 Tabagismo materno em sucessivas gestações e recorrência de baixo peso ao nascer: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 2004

    Directory of Open Access Journals (Sweden)

    Iândora Krolow Timm Sclowitz

    2013-01-01

    Full Text Available To evaluate the frequency of maternal smoking in successive pregnancies and its association with repetition of low birthweight, a study was conducted of a subsample of mothers from the 2004 Pelotas Birth Cohort in Brazil. Only women with previous histories of low birthweight newborns were included. Women with ≥ 2 previous births were eligible only if at least one of the two births immediately preceding the 2004 birth had low birthweight. From 4,458 births, 565 were included in this study. Frequency of smoking was 32.4%. Considering past pregnancies, 67.1% of mothers never smoked, 21.4% smoked during all pregnancies, 6.5% were ex-smokers, and 5% smoked only during the current pregnancy. In the adjusted analyses, when compared to mothers who never smoked, those who smoked during all pregnancies had 2.5 times greater probability of low birthweight recurrence in 2004 (PR = 2.5; 95%CI: 1.32-4.80. Smoking persistence is an important factor for the recurrence of low birthweight in successive pregnancies.Este estudio fue realizado en una submuestra de madres de la cohorte de nacimientos de Pelotas, Río Grande do Sul, Brasil, de 2004 para evaluar la frecuencia y asociación del tabaquismo en sucesivas gestaciones con el fenómeno de repetición del bajo peso al nacer. Se incluyeron solamente mujeres con antecedentes en el historial médico de recién nacidos con bajo peso al nacer. Se elegían a mujeres con ≥ 2 partos anteriores, solamente, si por lo menos uno de los dos partos inmediatamente anteriores al de 2004 hubiera sido de bajo peso al nacer. De los 4.458 nacimientos, 565 fueron incluidos en la muestra. La frecuencia de tabaquismo fue de un 32,4% y, teniendo en consideración las gestaciones anteriores, un 67,1% nunca fumaron; un 21,4% siempre fumaron; un 6,5% eran ex-fumadoras; y un 5,0% fumaron solamente en la gestación actual. En el análisis multivariable, las madres que fumaron en todas las gestaciones tuvieron una probabilidad 2

  14. Late-onset sepsis in very and extremely low birth weight infants%62例极低/超低出生体重儿晚发型败血症的临床分析

    Institute of Scientific and Technical Information of China (English)

    莫文辉; 杨杰; 李奕; 罗耀明

    2014-01-01

    Objective To investigate the features of late-onset sepsis (LOS) in the very low birth weight(VLBW) infants and extremely low birth weight(ELBW) infants,and to explore the laboratory examination for the early detection of LOS in premature infants.Methods Data were collected from 62 VLBW/ELBW infants diagnosed with LOS and admitted into the neonatal intensive care units of our hospital and Gnangdong Women and Children' s Hospital from January,2010 to June,2013.60 VLBW/ELBW infants without sepsis admitted into these two hospitals' departments of neonate pediatrics in the same period were randomly selected as a control group.The risk factors,main infection and laboratory examination indexes were retrospectively analyzed in VLBW/ ELBW infants with LOS.Results The gestational age,mechanical ventilation,central venipuncturation,and the time of parenteral nutrition were the major risks leading to LOS in VLBW/ELBW infants.The main approaches of infection were respiratory tract infection,intestinal infection,and skin infection.The clinical symptoms of LOS were different.The first symptoms were mainly abdominal distension or stomach retention,apnea or blood oxygen fluctuations,anhelation,poor response,fever,and tachycardia.And the analysis showed that CRP and PCT significantly increased in the early stage of LOS,but the WBC and platelet didn' t significantly change.Blood culture indicated that the main bacteria was Gram negative bacteria.Conclusions VLBW/ELBW infants were susceptibility to the LOS.Clinical features don' t show in the early stage of LOS.Infection can be found out detecting CRP and PCT.%目的 分析早产极低/超低出生体重儿晚发型败血症的临床特点,探讨早期发现早产儿晚发型败血症的方法.方法 选择2010年1月至2013年6月于我院及广东省妇幼保健院新生儿ICU住院,按晚发型败血症诊断标准诊断的62例早产极低/超低出生体重儿,并随机选择同期我院及广东省妇幼保健

  15. Within prisons, is there an association between the quantity of prenatal care and infant birthweight?

    Science.gov (United States)

    Howard, David L; Strobino, Donna; Sherman, Susan; Crum, Rosa

    2008-07-01

    There is still controversy surrounding the effectiveness of prenatal care in reducing low birthweight. In addition, very few studies have assessed the relationship between prenatal care and infant birthweight among pregnant women within the prison system. We sought to ascertain whether there is an association between the quantity of prenatal care and infant birthweight among pregnant women within such a setting. We examined the prison medical records of 147 infants born to women delivering at term (37-41 weeks of gestation) between 1 January 2002 and 31 December 2004 who were incarcerated during pregnancy in Texas state prisons. Linear regression was used to evaluate the association between the number of prison prenatal care visits and infant birthweight while adjusting for potential confounders (age, gravidity, maternal education, maternal race, history of substance use, history of alcohol use, history of tobacco use and the presence of any chronic disease). We also adjusted for the interaction between the gestational age at admission to prison and the number of prison prenatal care visits. There was a statistically significant 120.5 g increase in adjusted mean birthweight with each additional prison prenatal care visit (P = 0.001) among study infants whose mothers entered prison during the first trimester. This trend was not observed among women who came in after the first trimester. There appears to be a positive association between the amount of prison prenatal care and infant birthweight among incarcerated pregnant women delivering at term, but this association appears to be limited to women entering prison during the first trimester of pregnancy.

  16. Pharmacoeconomic impact of use of the probiotic Lactobacillus reuteri DSM 17938 for prevention of necrotizing enterocolitis in extremely low-birth-weight infants

    Directory of Open Access Journals (Sweden)

    Dimaguila MAVT

    2013-04-01

    Full Text Available Mary Ann VT Dimaguila,1,2 Peter Gal,1,3,4 Tiffany Wilson,1 John E Wimmer Jr,1,2 McCrae Smith,1,2 Rita Q Carlos,1,2 Christie C Davanzo,1,2 J Laurence Ransom1,2 1Women's Hospital of Greensboro, Cone Health, Greensboro, NC, USA; 2Piedmont Neonatology, Greensboro, NC, USA; 3Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 4Greensboro Area Health Education Center, Greensboro, NC, USA Background: A recent study showed that use of Lactobacillus reuteri as probiotic prophylaxis decreased the necrotizing enterocolitis (NEC rate from 15.1% to 2.5% in neonates with birth weight below 1000 g. Given the controversies surrounding use of probiotics in neonatal intensive care units, we address one additional aspect of routine implementation of probiotics for NEC prophylaxis – the pharmacoeconomic impact. Methods: Using data from our initial published experience, and continuing data collection after instituting a higher dose of L. reuteri, we measured the reduction in NEC in neonates with birth weight below 1000 g. Cost savings from prior studies examining the cost and outcomes of medical and surgical NEC were used to calculate the financial impact of routine L. reuteri DSM 17938 prophylaxis. Results: Medical records for 354 neonates were reviewed, 232 in the years before introduction of L. reuteri prophylaxis and 79 who received L. reuteri prophylaxis dosed at 0.1 mL daily and 43 neonates given a total daily dose of 0.2 mL as one or two doses. The incidence of NEC was significantly lower in the neonates who received L. reuteri (two of 122 neonates [1.6%] versus 35 of 232 neonates [15.1%]. The expected benefits for our neonatal intensive care unit per 100 extremely low-birth-weight neonates treated were four fewer deaths, five fewer cases of medical NEC, eight fewer cases of surgical NEC, one less patient with short-bowel syndrome, and a cost saving of approximately $2.2 million. Conclusion: Prophylactic

  17. Catch–up growth in the first two years of life in Extremely Low Birth Weight (ELBW) infants is associated with lower body fat in young adolescence

    Science.gov (United States)

    Jacobs, Lotte; Rayyan, Maissa; van Tienoven, Theun Pieter; Ortibus, Els; Levtchenko, Elena

    2017-01-01

    Aim To investigate growth patterns and anthropometrics in former extremely low birth weight (ELBW, 0.67 SDS. At 11 years, anthropometrics, neurocognitive performance, body composition, grip strength and puberty scores were assessed. Results ELBW neonates displayed extra–uterine growth restriction with mean Z–scores for height, weight and head circumference of –0.77, –0.93 and –0.46 at birth, –1.61, –1.67 and –0.72 at 9 months, –1.22, –1.61 and –0.84 at 24 months, and –0.42, –0.49 and –1.09 at 11 years. ELBW children performed consistently worse on neurocognitive testing with an average intelligence quotient equivalent at 11 years of 92.5 (SD 13.1). Catch–up growth was not associated with neurocognitive performance. Compared to controls, ELBW cases had lower grip strength (13.6 vs. 15.9 kg) and percentage lean body weight (75.1 vs. 80.5%), but higher body fat (24.6 vs. 19.2%) and advanced puberty scores at 11 years (all P≤0.025). Catch–up growth for weight and height in the first two years of life in cases was associated with a lower percentage body fat compared to cases without catch–up growth (16.8% catch-up growth for weight vs. 25.7%, P<0.001; 20.9% catch-up for height vs. 25.8%, P = 0.049). Conclusions In young adolescence, former ELBW children still have difficulties to reach their target height. Compared to normal birth weight controls, ELBW adolescents show lower neurocognitive performance and grip strength and a higher percentage body fat, a potential risk factor for adverse health outcomes in adulthood. Our key finding is that catch–up growth in ELBW children in the first two years of life is associated with a lower percentage body fat and is therefore likely to be beneficial. PMID:28278233

  18. Risk Factors for Neutropenia in Extremely Low Birth Weight Infants%极低出生体重儿中性粒细胞减少症的危险因素

    Institute of Scientific and Technical Information of China (English)

    王晨; 王丹华

    2014-01-01

    目的:研究极低出生体重儿中性粒细胞减少症的危险因素。方法回顾性纳入2011年1月至2013年12月在北京协和医院新生儿重症监护室住院治疗的极低出生体重儿。根据生后第一周内有无中性粒细胞减少症,分为早发中性粒细胞减少症和无早发中性粒细胞减少症病例;同时根据第一周后有无中性粒细胞减少症,分为晚发中性粒细胞减少症和无晚发中性粒细胞减少症病例。分别对其临床情况进行比较,对中性粒细胞减少症的危险因素进行分析。结果共108例患儿纳入本研究,平均胎龄(30.1±2.2)周,平均出生体重(1188±216) g。其中32例发生早发中性粒细胞减少症,53例发生晚发中性粒细胞减少症。早发中性粒细胞减少症患儿孕母妊娠期患高血压疾病发生率高于未发生早发中性粒细胞减少症患儿(59.4%比31.6%, P=0.007)。晚发中性粒细胞减少症患儿胎龄小于未发生晚发中性粒细胞减少症患儿[(29.5±2.3)周比(30.6±2.0)周, P=0.009];出生体重低于未发生晚发中性粒细胞减少症患儿[(1123±212) g比(1251±201) g, P=0.002];早发感染、晚发感染的发生率均高于未发生晚发中性粒细胞减少症患儿(50.9%比30.9%, P=0.034;100%比43.6%, P<0.001)。早发感染患儿中血小板减少症发生率高于中性粒细胞减少症发生率(45.5%比25.0%, P=0.045)。结论早发中性粒细胞减少症与晚发中性粒细胞减少症的危险因素不同。孕母妊娠期高血压疾病可能是早发中性粒细胞减少症的危险因素;小胎龄、低出生体重、早发感染和晚发感染可能是晚发中性粒细胞减少症的危险因素。%Objective To investigate the risk factors for neutropenia in extremely low birth weight ( EL-BW) infants.Methods We retrospectively studied the clinical data of ELBW infants treated in Neonatal

  19. [Infant botulism].

    Science.gov (United States)

    Falk, Absalom; Afriat, Amichay; Hubary, Yechiel; Herzog, Lior; Eisenkraft, Arik

    2014-01-01

    Infant botulism is a paralytic syndrome which manifests as a result of ingesting spores of the toxin secreting bacterium Clostridium botulinum by infants. As opposed to botulism in adults, treating infant botulism with horse antiserum was not approved due to several safety issues. This restriction has led to the development of Human Botulism Immune Globulin Intravenous (BIG-IV; sells under BabyBIG). In this article we review infant botulism and the advantages of treating it with BIG-IV.

  20. Change of Nosocomial Infection of Very Low or Extremely Low Birth Weight Infants in the Last 10 Years%极低和超低出生体质量儿医院感染的十年变迁

    Institute of Scientific and Technical Information of China (English)

    吴俊; 吴本清; 黄进洁; 罗亮; 陈霆

    2012-01-01

    目的 探讨新生儿重症监护病房(NICU)极低和超低出生体质量儿医院感染的流行病学情况及病原菌的变化趋势.方法 回顾性分析2001年1月-2010年12月在我院NICU住院的654例极低和超低出生体质量儿的医院感染发生情况,将发生医院感染的162例极低和超低出生体质量儿分为2001年1月-2005年12月和2006年1月-2010年12月两组,对比分析两组医院感染的发病率、感染疾病和病原菌的变迁.结果 第一组和第二组医院感染发生率分别为22.55%和26.01%,两者间差异无统计学意义(P>0.05).两组医院感染疾病均以肺炎为主,前后五年比较所占比例有所下降,但两者间差异无统计学意义(P>0.05);败血症的构成比由22.6%增加至38.5%,两者间差异有统计学意义(P<0.05).两组病原菌均以革兰阴性菌为主,前后五年构成比显示革兰阳性菌和真菌呈上升趋势,肺炎克雷伯杆菌成为第一位的医院感染致病菌,凝固酶阴性葡萄球菌明显上升,差异有统计学意义(P<0.05).结论 极低和超低出生体质量儿医院感染发生率有上升趋势,败血症构成比增加,应根据病原菌谱的变化合理应用抗生素.%To investigate the change trends of pathogens and epidemiological condition of nosocomial infection ( NI ) of very low or extremely low birth weight infants in neonate intensive care unit ( NICU ) . Methods The data of 654 very low or extremely low birth weight infants in NICU of our hospital from January 2001 to December 2010 were investigated retrospectively. The 162 infants diagnosed with nosocomial infection were divided into 2 groups according to their hospitalization periods ; from 2001 to 2005 ( group I ) and from 2006 to 2010 ( group H )The NI rate, infected site and pathogens were comparatively analyzed between the two groups. Results The NI rate was 22. 55% in group I and 26. 01% in group H , with no statistical difference (P>0.05). The most common infection

  1. 住院极低和超低出生体质量儿506例救治体会%Treatment Experience of 506 Cases of Very Low and Extremely Low Birth Weight Infants in NICU

    Institute of Scientific and Technical Information of China (English)

    杨素娥; 董玉红; 翟炳辉

    2012-01-01

    Objective To analysethe remedy circumtance of 506 cases of very low birth weight infant ( VLBWI )and extremely 1 ow birth weight infant( ELBWI )in neonatal intensive care unit( NICU )of Sanme-nxia central hospital. Methods 506 cases of VLBWI and ELBWI from April 2004 toMarch 2011 were divided into the first 4-year group and the second 4-year group. Then the major complications and turnovers between the two groups were compared. Results The complications in the second group such as asphyxia, scle-first group. The decreased rates on infectious diease was non-significant. Compared to the first 4-year group, the suvival rates went up remarkablly and the mortality fallde dratically( P < 0. 05 ). Conclusion In order to reduce neonatal mortality rate, improvement in the technical level of NICU staff, co-operation between obstetrics and pediatrics, stress on the training of primary hospital should be the priorities.%目的 分析三门峡市中心医院新生儿重症监护室(NICU)住院极低出生体质量儿(VLBWI)和超低出生体质量儿(ELBWI)的救治情况.方法 将我院NICU自2004年4月至2011年3月收治的506例VLBWI和ELBWI分成前后4年2组,比较主要并发症发生率和转归情况.结果 后4年组和前4年组相比,主要并发症如窒息、硬肿症、肺透明膜病、颅内出血的发生率下降有统计学意义,感染性疾病的发生率下降,无统计学意义.但治愈率增高,病死率下降,差异有显著统计学意义(P<0.05).结论 不断提高NICU医护人员技术水平,进行产儿科合作,开展宫内转运,加强基层网络医院医护人员的培训,重视细节化管理,可明显降低本地区此类患儿病死率,提高治愈率.

  2. 78 FR 61383 - Certain Thermal Support Devices For Infants, Infant Incubators, Infant Warmers, and Components...

    Science.gov (United States)

    2013-10-03

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

  3. Dilemas nutricionais no pré-termo extremo e repercussões na infância, adolescência e vida adulta Nutritional dilemmas in extremely low birth weight infants and their effects on childhood, adolescence and adulthood

    Directory of Open Access Journals (Sweden)

    José Simon Camelo Jr.

    2005-03-01

    Full Text Available OBJETIVO: Rever a literatura atual sobre a alimentação do recém-nascido pré-termo extremo, enfocando os principais dilemas nutricionais e repercussões na infância, adolescência e vida adulta. FONTE DOS DADOS: Foi realizada revisão bibliográfica utilizando os bancos de dados MEDLINE, Cochrane Database of Systematic Reviews e Best Evidence. SÍNTESE DOS DADOS: Cada vez mais fica evidente que as práticas alimentares estabelecidas com os pré-termo podem afetar não só o desenvolvimento imediato, mas também sua evolução a longo prazo. A nutrição neste período pode determinar se o adulto será mais ou menos saudável. Existe um longo caminho de aprendizado sobre a segurança e eficácia dos nutrientes administrados para os pré-termo; sobre as técnicas para avaliar as diferentes estratégias alimentares; e sobre os efeitos a longo prazo destes regimes no desenvolvimento, crescimento e aparecimento de doenças. CONCLUSÃO: Apesar dos grandes avanços na área, ainda são necessários estudos básicos e clínicos para aprofundar a compreensão das necessidades nutricionais do recém-nascido pré-termo e a forma mais adequada de supri-las, evitando-se conseqüências indesejáveis a longo prazo.OBJECTIVE: To review the recent medical literature on nutrition of extremely low birth weight infants, focusing on nutritional disorders and their effects on childhood, adolescence and adulthood. SOURCES OF DATA: An extensive review of the related literature was performed using MEDLINE, the Cochrane Database of Systematic Reviews and the Best Evidence database. SUMMARY OF THE FINDINGS: There is a growing body of evidence that early nutritional practices may affect short-term growth and development outcome. In addition, these practices may play a role in determining adult health and disease. There is still much to be learned about safe and efficacious nutrient administration in preterm infants; about techniques to assess the effect of different

  4. Symptomatic Dengue infection during pregnancy and infant outcomes: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Eleanor E Friedman

    2014-10-01

    Full Text Available Dengue is a mosquito-borne disease that is common in many tropical and subtropical areas. Dengue infections can occur at any age and time in the lifespan, including during pregnancy. Few large scale studies have been conducted to determine the risk of preterm birth (PTB and low birthweight (LBW for infants born to women who had symptomatic dengue infection during pregnancy.This study is a retrospective cohort study using medical records from 1992-2010 from pregnant women who attended a public regional referral hospital in western French Guiana. Exposed pregnancies were those with laboratory confirmed cases of dengue fever during pregnancy. Each of the 86 exposed infants was matched to the three unexposed births that immediately followed them to form a stratum. Conditional logistic regression was used to analyze these matched strata. Three groups were examined: all infants regardless of gestational age, only infants> = 17 weeks of gestational age and their strata, and only infants> = 22 weeks of age and their strata. Odds ratios were adjusted (aOR for maternal age, maternal ethnicity, maternal gravidity, interpregnancy interval and maternal anemia. There was an increased risk of PTB among women with symptomatic dengue; (aOR all infants: 3.34 (1.13, 9.89, aOR 17 weeks: 1.89 (0.61, 5.87, aOR 22 weeks: 1.41 (0.39, 5.20 but this risk was only statistically significant when all infants were examined (p value = 0.03. Adjusted results for LBW were similar, with an increased risk in the exposed group (aOR All infants: 2.23 (1.01, 4.90, aOR 17 weeks: 1.67 (0.71, 3.93, aOR 22 weeks: 1.43 (0.56, 3.70 which was only statistically significant when all infants were examined (p value = 0.05.Symptomatic dengue infection during pregnancy may increase the risk of PTB and LBW for infants. More research is needed to confirm these results and to examine the role of dengue fever in miscarriage.

  5. Symptomatic Dengue Infection during Pregnancy and Infant Outcomes: A Retrospective Cohort Study

    Science.gov (United States)

    Friedman, Eleanor E.; Dallah, Fadi; Harville, Emily W.; Myers, Leann; Buekens, Pierre; Breart, Gerard; Carles, Gabriel

    2014-01-01

    Background Dengue is a mosquito-borne disease that is common in many tropical and subtropical areas. Dengue infections can occur at any age and time in the lifespan, including during pregnancy. Few large scale studies have been conducted to determine the risk of preterm birth (PTB) and low birthweight (LBW) for infants born to women who had symptomatic dengue infection during pregnancy. Methodology/Principal Findings This study is a retrospective cohort study using medical records from 1992–2010 from pregnant women who attended a public regional referral hospital in western French Guiana. Exposed pregnancies were those with laboratory confirmed cases of dengue fever during pregnancy. Each of the 86 exposed infants was matched to the three unexposed births that immediately followed them to form a stratum. Conditional logistic regression was used to analyze these matched strata. Three groups were examined: all infants regardless of gestational age, only infants> = 17 weeks of gestational age and their strata, and only infants> = 22 weeks of age and their strata. Odds ratios were adjusted (aOR) for maternal age, maternal ethnicity, maternal gravidity, interpregnancy interval and maternal anemia. There was an increased risk of PTB among women with symptomatic dengue; (aOR all infants: 3.34 (1.13, 9.89), aOR 17 weeks: 1.89 (0.61, 5.87), aOR 22 weeks: 1.41 (0.39, 5.20)) but this risk was only statistically significant when all infants were examined (p value = 0.03). Adjusted results for LBW were similar, with an increased risk in the exposed group (aOR All infants: 2.23 (1.01, 4.90), aOR 17 weeks: 1.67 (0.71, 3.93), aOR 22 weeks: 1.43 (0.56, 3.70)) which was only statistically significant when all infants were examined (p value = 0.05). Conclusions/Significance Symptomatic dengue infection during pregnancy may increase the risk of PTB and LBW for infants. More research is needed to confirm these results and to examine the role of dengue fever in

  6. Infant botulism.

    Science.gov (United States)

    Polin, R A; Brown, L W

    1979-05-01

    Infant botulism is a unique neuromuscular disease affecting infants less than six months old. It is the result of intraintestinal toxin production by C. botulinum (toxi-infection). Characteristic symptoms include constipation, lethargy, and decreased feeding. Physical examination often reveals generalized hypotonia with cranial nerve impairment. Recovery is dependent on supportive care in an intensive care setting. The relationship of this disease to the sudden infant death syndrome requires further study.

  7. Extreme Heat

    Science.gov (United States)

    ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ...

  8. Ultrasonically detectable cerebellar haemorrhage in preterm infants.

    LENUS (Irish Health Repository)

    McCarthy, Lisa Kenyon

    2011-07-01

    To determine the frequency and pattern of cerebellar haemorrhage (CBH) on routine cranial ultrasound (cUS) imaging in infants of ≤32 weeks gestation, and to investigate how extremely preterm infants with CBH differ from those with severe intraventricular haemorrhage (IVH).

  9. The impact of early age at first childbirth on maternal and infant health.

    Science.gov (United States)

    Gibbs, Cassandra M; Wendt, Amanda; Peters, Stacey; Hogue, Carol J

    2012-07-01

    The objective of this review was to assess whether early age at first childbirth is associated with increased risk of poor pregnancy outcomes. Early age at childbirth is variously defined in studies of its effect on maternal and infant health. In this systematic review, we limit analysis to studies of at least moderate quality that examine first births among young mothers, where young maternal age is defined as low gynaecological age (≤ 2 years since menarche) or as a chronological age ≤ 16 years at conception or delivery. We conduct meta-analyses for specific maternal or infant health outcomes when there are at least three moderate quality studies that define the exposure and outcome in a similar manner and provide odds ratios or risk ratios as their effect estimates. We conclude that the overall evidence of effect for very young maternal age (effect or precision but not to change the conclusion. Evidence points to an impact of young maternal age on low birthweight and preterm birth, which may mediate other infant outcomes such as neonatal mortality. The evidence that young maternal age increases risk for maternal anaemia is also fairly strong, although information on other nutritional outcomes and maternal morbidity/mortality is less clear. Many of the differences observed among older teenagers with respect to infant outcomes may be because of socio-economic or behavioural differences, although these may vary by country/setting. Future, high quality observational studies in low income settings are recommended in order to address the question of generalisability of evidence. In particular, studies in low income countries need to consider low gynaecological age, rather than simply chronological age, as an exposure. As well, country-specific studies should measure the minimum age at which childbearing for teens has similar associations with health as childbearing for adults. This 'tipping point' may vary by the underlying physical and nutritional health of girls

  10. Mandelbrot's Extremism

    NARCIS (Netherlands)

    Beirlant, J.; Schoutens, W.; Segers, J.J.J.

    2004-01-01

    In the sixties Mandelbrot already showed that extreme price swings are more likely than some of us think or incorporate in our models.A modern toolbox for analyzing such rare events can be found in the field of extreme value theory.At the core of extreme value theory lies the modelling of maxima

  11. Premature infant

    Science.gov (United States)

    There are many support groups for parents of premature babies. Ask the social worker in the neonatal intensive care unit. ... Prematurity used to be a major cause of infant deaths. Improved ... Prematurity can have long-term effects. Many premature infants ...

  12. Nutrition management strategy of very low and extremely low birth weight infants%极低和超低出生体质量儿营养管理策略

    Institute of Scientific and Technical Information of China (English)

    韩树萍

    2014-01-01

    Extrauterine growth restriction is a major clinical problem for very low and extremely low birth weight infants.They need the rapid accumulation of protein and energy after born;otherwise it will lead to an increase in nutritional deficiencies,malnutrition and neurological problems.The ideal nutritional strategies is to provide parenteral nutrition after birth,amino acids and lipids are initially provided at a minimum of 2.0 g/(kg · d) and 1.0 g/(kg — d),which advance to 3.5-4.0 g/(kg · d) and 3.0 g/(kg · d),keep the appropriate protein/energy ratio.The appropriate vitamin,minerals and elements should be provided.Enteral feeding should be initiated immediately about 24 h after birth,minimal feeding [10-20 mL/(kg · d)] should last 3-5 days.Human milk should gradually increase to 75-120 mL/(kg · d) and add human milk fortifier.Parenteral nutrition is stopped when human milk fed to 120 mL/(kg · d).%极低和超低出生体质量儿出生早期如无快速积累蛋白和能量,将发生营养不足,导致神经发育不良和疾病的增加.理想的营养策略为出生就开始肠外营养,氨基酸、脂肪乳剂分别从2.0 g/(kg·d)和1.0g/(kg·d)开始,并快速达到3.5 ~4.0g/(kg·d)、3.0 g/(kg·d),保持适当的蛋白/能量比,合理添加维生素、矿物质和微量元素.肠内营养于出生后24 h左右开始喂养,微量喂养10~20 mL/(kg·d),持续3~5d后逐渐增加奶量.母乳喂养者奶量增至75~ 120 mL/(kg·d)可添加母乳强化剂.奶量至120 mL/(kg·d)停肠外营养.

  13. Use of laryngeal mask airway in an extremely low birth weight premature infant undergoing laser photocoagulation treatment of retinopathy of prematurity with general anesthesia%喉罩通气道全麻用于超低出生体重儿视网膜病变激光光凝术的麻醉处理

    Institute of Scientific and Technical Information of China (English)

    马兰; 张建文; 左云霞

    2013-01-01

    报道1例胎龄27+4周,现月龄1月27 d,体重1.67 kg的超低出生体重伴双眼早产儿视网膜病变(retinopathy of prematurity,ROP)的早产儿在喉罩通气道全麻下行双眼激光光凝术治疗.%This case report describes the successful use of laryngeal mask airway in an extremely low birth weight premature infant undergoing laser photocoagulation treatment.The premature infant with gestational age of 27 ~ weeks is retinopathy in both eyes,57 d old,and 1.67 kg weight.

  14. Management of the woman with threatened birth of an infant of extremely low gestational age. Fetus and Newborn Committee, Canadian Paediatric Society, Maternal-Fetal Medicine Committee, Society of Obstetricians and Gynaecologists of Canada.

    OpenAIRE

    1994-01-01

    OBJECTIVE: To offer guidelines for parents, physicians and other members of the health-care team for management of the probable birth of an infant with a gestational age of 26 completed weeks or less. OPTIONS: Vaginal birth or birth by cesarean section for fetal indications and active treatment or palliative care of the infant at birth. OUTCOMES: Increased risk of complications for the mother from cesarean section at this stage of pregnancy and the difficulty in making a prognosis before or a...

  15. Maternal Drug Use during Pregnancy: Are Preterm and Full-Term Infants Affected Differently?

    Science.gov (United States)

    Brown, Josephine V.; Bakeman, Roger; Coles, Claire D.; Sexson, William R.; Demi, Alice S.

    1998-01-01

    Examined effects of prenatal drug exposure on infants born preterm and full-term to African American mothers. Found more extreme fetal growth deficits in later-born infants, and more extreme irritability increases in earlier-born infants. Gestation length did not moderate cardiorespiratory reactivity effects. Exposure effects occurred for…

  16. Multiple nutritional deficiencies in infants from a strict vegetarian community.

    Science.gov (United States)

    Zmora, E; Gorodischer, R; Bar-Ziv, J

    1979-02-01

    Severe nutritional deficiencies developed in four infants from a new vegan religious community. They had received breast milk until the age of 3 months; thereafter, breast milk was supplemented with or replaced by extremely low caloric-density preparations. All of the infants had profound protein-caloric malnutrition, severe rickets, osteoporosis, and vitamin B12 and other deficiencies. One infant died, while the three others had an uneventful recovery. After discharge of the infants from the hospital, the community responded well to a modification of the infants' diet, which did not violate their vegetarian philosophy. However, they refused to give their infants vitamin B12 on a regular basis.

  17. CPR: Infant

    Medline Plus

    Full Text Available Refresher Center Home FIRST AID, CPR and AED LIFEGUARDING Refresher Putting It All Together: CPR—Infant (1:52) Refresher videos only utilize this player QUICK LINKS Home ...

  18. CPR: Infant

    Medline Plus

    Full Text Available ... AID, CPR and AED LIFEGUARDING Refresher Putting It All Together: CPR—Infant (1:52) Refresher videos only ... Store Contact Us Privacy Policy Terms and Conditions All rights reserved. 2011 American National Red Cross.

  19. Infant Curiosity

    OpenAIRE

    2013-01-01

    This publication is one in a series that reviews tips parents can use to improve the relationships with their children and the learning that happens within the family. This publication deals in particular with infant development.

  20. Infant Constipation

    Science.gov (United States)

    ... Prenatal Baby Bathing & Skin Care Breastfeeding Crying & Colic Diapers & Clothing Feeding & Nutrition Preemie Sleep Teething & Tooth Care ... Teen Young Adult Healthy Children > Ages & Stages > Baby > Diapers & Clothing > Infant Constipation Ages & Stages Listen Español Text ...

  1. Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7 year period: coagulase-negative Staphylococcus as the predominant pathogen.

    Science.gov (United States)

    Ozkan, Hilal; Cetinkaya, Merih; Koksal, Nilgün; Celebi, Solmaz; Hacımustafaoglu, Mustafa

    2014-02-01

    The aim of this study was to determine the causative agents in early, late- and very late-onset sepsis in preterm infants. The demographic features, risk factors, clinical and laboratory findings in sepsis types were also defined. A total of 151 preterm infants with culture-proven neonatal sepsis were enrolled in this prospective study. The infants were classified into three groups with regard to the onset of sepsis: early onset sepsis (EOS), late-onset sepsis (LOS) and very late-onset sepsis (VLOS). A sepsis screen including whole blood count, blood smear, infection markers and cultures was performed before initiating antibiotic therapy. EOS, LOS and VLOS groups consisted of 23, 86 and 42 infants, respectively. Coagulase-negative staphylococci (CONS) was the most common organism in all sepsis groups. The main factors associated with EOS included presence of premature rupture of membranes, antibiotic use in pregnancy and choriamnionitis. Previous antibiotic use was the main factor associated with LOS, while low birthweight was the main factor in infants with VLOS. Although mortality rate due to Gram-negative bacteria and fungi was higher, CONS was an important cause of mortality in infants with LOS and VLOS. CONS was found to be the most common causative organism in three sepsis types in preterm neonates. Although the mortality rate due to CONS was lower in EOS, it was an important cause of mortality in LOS and VLOS. CONS seems to be the main pathogen in neonatal sepsis in developing countries, as in developed countries. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  2. Extreme cosmos

    CERN Document Server

    Gaensler, Bryan

    2011-01-01

    The universe is all about extremes. Space has a temperature 270°C below freezing. Stars die in catastrophic supernova explosions a billion times brighter than the Sun. A black hole can generate 10 million trillion volts of electricity. And hypergiants are stars 2 billion kilometres across, larger than the orbit of Jupiter. Extreme Cosmos provides a stunning new view of the way the Universe works, seen through the lens of extremes: the fastest, hottest, heaviest, brightest, oldest, densest and even the loudest. This is an astronomy book that not only offers amazing facts and figures but also re

  3. Parents’ lived experience of providing kangaroo care to their preterm infants

    Directory of Open Access Journals (Sweden)

    Angela Leonard

    2008-12-01

    Full Text Available Premature and low birthweight infants pose particular challenges to health services in South Africa. While there is good evidence to demonstrate the benefits of kangaroo care in low birthweight infants, limited research has been conducted locally on the experiences of parents who provide kangaroo care to their preterm infants. This phenomenological study explores the lived experience of parents who provided their preterm infants with kangaroo care at a tertiary-level maternity centre in the Western Cape. In-depth interviews were conducted with six parents: four mothers and two fathers. Data was analysed using an adaptation of the approaches described by Colaizzi (1978:48-71 and Hycner (1985:280-294. To ensure trustworthiness, the trustworthiness criteria described by Guba and Lincoln (1989:242-243 were applied. Kangaroo care is a phased process, each phase bringing a unique set of experiences. The eight themes that emerged are described: unforeseen, unprepared and uncertain - the experience of birth; anxiety and barriers; an intimate connection; adjustments, roles and responsibilities; measuring success; a network of encouragement and support; living-in challenges; and living with the infant outside of hospital. Challenges facing health care providers are described and recommendations for information about kangaroo care and support for parents are made. Opsomming Vroeggebore babas en babas met ’n lae geboortegewig stel besondere uitdagings vir Suid-Afrikaanse gesondhiedsdienste. Daar bestaan goeie bewyse dat die kangaroesorgmetode voordelig is vir babas met ’n laegeboortegewig, dog is minimale plaaslike navorsing gedoen oor die ondervindinge van ouers wat hierdie metode gebruik om vir hul vroeggebore babas te sorg. Hierdie fenomenologiese studie verken die geleefde ervaringe van ouers wat vir hulle vroeggebore babas deur middel van die kangaroesorgmetode in ’n tersiêre kraamsentrum in die Weskaap gesorg het. Data is ingesamel deur in

  4. Comparação de ibuprofeno via oral e indometacina intravenosa no tratamento da persistência do canal arterial em neonatos com extremo baixo peso ao nascer Comparison of oral ibuprofen and intravenous indomethacin for the treatment of patent ductus arteriosus in extremely low birth weight infants

    Directory of Open Access Journals (Sweden)

    Eun Mi Yang

    2013-02-01

    (PDA in extremely low birth weight (ELBW infants. Oral ibuprofen was compared to intravenous indomethacin regarding efficacy and safety in the treatment of PDA in infants weighting less than 1,000 g at birth. METHOD: This was a retrospective study in a single center. Data on ELBW infants who had an echocardiographically confirmed PDA were collected. The infants were treated with either intravenous indomethacin or oral ibuprofen. Rate of ductal closure, need for additional treatment, drug-related side effects or complications, and mortality were compared between the two treatment groups. RESULT: 26 infants who received indomethacin and 22 infants who received ibuprofen were studied. The overall rate of ductal closure was similar between the two treatments: it occurred in 23 of 26 infants (88.5% treated with indomethacin, and in 18 of 22 infants (81.8% treated with ibuprofen (p = 0.40. The rate of surgical ligation (11.5% versus 18.2%; p = 0.40 did not differ significantly between the two treatment groups. No significant difference was found in post-treatment serum creatinine concentrations between the two groups. There were no significant differences regarding additional side effects or complications. CONCLUSION: In ELBW infants, oral ibuprofen is as efficacious as intravenous indomethacin for the treatment of PDA. There were no differences between the two drugs with respect to safety. Oral ibuprofen could be used as an alternative agent for the treatment of PDA in ELBW infants.

  5. Impact of blood sampling in very preterm infants

    DEFF Research Database (Denmark)

    Madsen, L P; Rasmussen, M K; Bjerregaard, L L;

    2000-01-01

    In a prospective investigation, 99 very preterm infants (gestational age (GA) 24 32 weeks, birthweight 560-2,255 g) were studied during the first 4 weeks of life. The infants were divided into two groups: infants born extremely early (GA <28 weeks, n = 20) and infants of GA 28 - 32 weeks; the gro......In a prospective investigation, 99 very preterm infants (gestational age (GA) 24 32 weeks, birthweight 560-2,255 g) were studied during the first 4 weeks of life. The infants were divided into two groups: infants born extremely early (GA ... low GA received 28 blood transfusions, corresponding to 27.0 ml/kg of blood on average during the study period. Four developed late anaemia; thus, in total, 14 (70%) of the infants born extremely early received 35 transfusions during the first 3 months of life, corresponding to a total mean of 34.8 ml....../kg. For the extremely preterm infants a significant correlation between sampled and transfused blood volume was found (mean 37.1 and 33.3 ml/kg, respectively, r = + 0.71, p = 0.0003). The most frequently requested analyses were glucose, sodium and potassium. Few blood gas analyses were requested (1.9/ infant). No blood...

  6. Impact of blood sampling in very preterm infants

    DEFF Research Database (Denmark)

    Madsen, L P; Rasmussen, M K; Bjerregaard, L L

    2000-01-01

    In a prospective investigation, 99 very preterm infants (gestational age (GA) 24 32 weeks, birthweight 560-2,255 g) were studied during the first 4 weeks of life. The infants were divided into two groups: infants born extremely early (GA <28 weeks, n = 20) and infants of GA 28 - 32 weeks; the gro......In a prospective investigation, 99 very preterm infants (gestational age (GA) 24 32 weeks, birthweight 560-2,255 g) were studied during the first 4 weeks of life. The infants were divided into two groups: infants born extremely early (GA .../kg. For the extremely preterm infants a significant correlation between sampled and transfused blood volume was found (mean 37.1 and 33.3 ml/kg, respectively, r = + 0.71, p = 0.0003). The most frequently requested analyses were glucose, sodium and potassium. Few blood gas analyses were requested (1.9/ infant). No blood...... in extremely preterm, critically ill infants. Udgivelsesdato: 2000-Apr...

  7. Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: A systematic review and meta-analysis

    Science.gov (United States)

    Thorne-Lyman, Andrew L.; Fawzi, Wafaie W.

    2013-01-01

    Summary Vitamin A (VA) deficiency during pregnancy is common in low income countries and a growing number of intervention trials have examined the effects of supplementation during pregnancy on maternal, perinatal, and infant health outcomes. We systematically reviewed the literature to identify trials isolating the effects of VA or carotenoid supplementation during pregnancy on maternal, fetal, neonatal and early infant health outcomes. Meta-analysis was used to pool effect estimates for outcomes with more than one comparable study. We used GRADE criteria to assess the quality of individual studies and the level of evidence available for each outcome. We identified 23 eligible trials of which 17 had suitable quality for inclusion in meta-analyses. VA or beta-carotene (βC) supplementation during pregnancy did not have a significant overall effect on birthweight indicators, preterm birth, stillbirth, miscarriage, or fetal loss. Among HIV-positive women, supplementation was protective against low birthweight (neonatal/infant mortality, or pregnancy-related maternal mortality, random effects RR=0.86, [0.60, 1.24] although high heterogeneity was observed in the maternal mortality estimate[I2=74%, p=0.02]. VA supplementation during pregnancy was found to improve hemoglobin levels and reduce anemia risk (<11.0 g/dL) during pregnancy random effects RR=0.81 [0.69, 0.94], also with high heterogeneity (I2=52%, p=0.04). We found no effect of VA/βC supplementation on mother-to-child HIV transmission in pooled analysis, although some evidence suggests that it may increase transmission. There is little consistent evidence of benefit of maternal supplementation with VA or βC during pregnancy on maternal or infant mortality. While there may be beneficial effects for certain outcomes, there may also be potential for harm through increased HIV transmission in some populations. PMID:22742601

  8. Administration of Bifidobacterium breve PS12929 and Lactobacillus salivarius PS12934, Two Strains Isolated from Human Milk, to Very Low and Extremely Low Birth Weight Preterm Infants: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Laura Moles

    2015-01-01

    Full Text Available The preterm infant gut has been described as immature and colonized by an aberrant microbiota. Therefore, the use of probiotics is an attractive practice in hospitals to try to reduce morbidity and mortality in this population. The objective of this pilot study was to elucidate if administration of two probiotic strains isolated from human milk to preterm infants led to their presence in feces. In addition, the evolution of a wide spectrum of immunological compounds, including the inflammatory biomarker calprotectin, in both blood and fecal samples was also assessed. For this purpose, five preterm infants received two daily doses (~109 CFU of a 1 : 1 mixture of Bifidobacterium breve PS12929 and Lactobacillus salivarius PS12934. Bacterial growth was detected by culture-dependent techniques in all the fecal samples. The phylum Firmicutes dominated in nearly all fecal samples while L. salivarius PS12934 was detected in all the infants at numerous sample collection points and B. breve PS12929 appeared in five fecal samples. Finally, a noticeable decrease in the fecal calprotectin levels was observed along time.

  9. CPR: Infant

    Medline Plus

    Full Text Available Refresher Center Home FIRST AID, CPR and AED LIFEGUARDING Refresher Putting It All Together: CPR—Infant (1:52) Refresher videos only utilize this player QUICK LINKS Home RedCross.org Purchase Course Materials Shop Our Store ...

  10. 78 FR 54911 - Certain Thermal Support Devices for Infants, Infant Incubators, Infant Warmers and Components...

    Science.gov (United States)

    2013-09-06

    ... COMMISSION Certain Thermal Support Devices for Infants, Infant Incubators, Infant Warmers and Components.... International Trade Commission has received a complaint entitled Certain Thermal Support Devices for Infants, Infant Incubators, Infant Warmers and Components Thereof, DN 2976; the Commission is soliciting...

  11. Neonatal status: an objective scoring method for identifying infants at risk for poor outcome.

    Science.gov (United States)

    Salamy, A; Davis, S; Eldredge, L; Wakeley, A; Tooley, W H

    1988-01-01

    The likelihood of sustaining neurological, sensory or cognitive deficits is considerably greater for very low birthweight (VLBW) infants who require intensive care in early postnatal life than those without major neonatal illness. Identifying which, if any, medical events are responsible for an adverse outcome is most difficult in the face of multiple concurrent complications. In this research, a principal components analysis was performed in order to arrive at a set of orthogonal variables which succinctly described clinical involvement in the nursery. With this procedure, a single hypothetical factor depicting neonatal status (NS) was computed. Principal component scores were then generated for NS and assigned to 252 VLBW (less than 1500 g) infants. These subjects were followed prospectively from birth to 4 years of age. Standardized measures of neurological, sensory and intellectual function were regularly administered. Neonatal status was shown to be significantly correlated with the various test results and predictive of long-term development. When subjects were divided into quartiles with respect to NS, a specific subgroup was identified as "at high risk" for poor outcome. Those subjects falling into the lower quartile incurred more neurological abnormalities persisting beyond the first year. They also suffered a higher incidence of intracranial hemorrhage and sensori-neural hearing loss. In addition, the lower 25%, as a group, scored well below all others on traditional tests of mental ability. These differences were sustained throughout infancy and early childhood and could not be attributed to a number of demographic variables including sex, gestational age, birthweight, Apgar scores or parental educational level.

  12. A Review of the Impact of Dietary Intakes in Human Pregnancy on Infant Birthweight

    Directory of Open Access Journals (Sweden)

    Jessica A. Grieger

    2014-12-01

    Full Text Available Studies assessing maternal dietary intakes and the relationship with birthweight are inconsistent, thus attempting to draw inferences on the role of maternal nutrition in determining the fetal growth trajectory is difficult. The aim of this review is to provide updated evidence from epidemiological and randomized controlled trials on the impact of dietary and supplemental intakes of omega-3 long-chain polyunsaturated fatty acids, zinc, folate, iron, calcium, and vitamin D, as well as dietary patterns, on infant birthweight. A comprehensive review of the literature was undertaken via the electronic databases Pubmed, Cochrane Library, and Medline. Included articles were those published in English, in scholarly journals, and which provided information about diet and nutrition during pregnancy and infant birthweight. There is insufficient evidence for omega-3 fatty acid supplements’ ability to reduce risk of low birthweight (LBW, and more robust evidence from studies supplementing with zinc, calcium, and/or vitamin D needs to be established. Iron supplementation appears to increase birthweight, particularly when there are increases in maternal hemoglobin concentrations in the third trimester. There is limited evidence supporting the use of folic acid supplements to reduce the risk for LBW; however, supplementation may increase birthweight by ~130 g. Consumption of whole foods such as fruit, vegetables, low-fat dairy, and lean meats throughout pregnancy appears beneficial for appropriate birthweight. Intervention studies with an understanding of optimal dietary patterns may provide promising results for both maternal and perinatal health. Outcomes from these studies will help determine what sort of dietary advice could be promoted to women during pregnancy in order to promote the best health for themselves and their baby.

  13. Zinc deficiency in infants and children: a review of its complex and synergistic interactions.

    Science.gov (United States)

    Krebs, Nancy F; Miller, Leland V; Hambidge, K Michael

    2014-11-01

    Zinc deficiency is estimated to contribute to over half a million deaths per year in infants and children under 5 years of age. This paper reviews the features of mild-to-moderate zinc deficiency, which include growth faltering, deficits in immune function and altered integrity and function of the gastro-intestinal tract. Sub-clinical features include oxidative stress and a pro-inflammatory state. The homeostatic response to low dietary zinc intake by increasing absorption is limited, especially if the source of zinc is of poor bioavailability, and conservation of endogenous intestinal losses is a critical component of adaptation. Owing to low zinc intakes, older breastfed infants, especially those of low birthweight, are predictably at risk of zinc deficiency if complementary food choices are unfortified and/or low in zinc. Host factors such as young age, poor intra-uterine zinc accretion owing to poor maternal status and/or prematurity, and gastro-intestinal dysfunction also potently predispose to zinc deficiency. Environmental enteropathy, which is prevalent in low-resource settings, may substantially impair zinc absorption and/or increase endogenous losses, and thus lead to relatively high zinc requirements. Emerging evidence highlights common features between chronic inflammation and zinc deficiency, and each may exacerbate the other. More investigations of zinc homeostasis in populations in low-resource settings are needed to better quantify absorption capacity and losses. Effective preventive strategies must address potentially higher zinc requirements as well as the underlying context that perpetuates a vicious cycle of zinc deficiency and multiple adverse outcomes.

  14. Preterm birth and behaviour problems in infants and preschool-age children: a review of the recent literature.

    Science.gov (United States)

    Arpi, Elena; Ferrari, Fabrizio

    2013-09-01

    The behaviour problems of children born preterm at school age are well known, but there have been few studies on the behaviour problems of preterm-born infants during infancy and at preschool age. Fourteen cohort studies published in PubMed and PsycINFO between 2000 and 2012 were reviewed with a focus on the type, occurrence, comorbidity, stability, prediction, perinatal, social, and relational risk factors for behaviour problems of preterm-born children in infancy (0-2y) and at preschool age (3-5y). The relational risk factor was considered in an additional four papers. Very-preterm, very-low-birthweight, and moderately-preterm children, in both age groups, show more behaviour problems than term-born comparison children even after perinatal and social risk factors and cognitive performance have been controlled for. Poor social/interactive skills, poor behavioural and emotional self-regulation, emotional difficulties, and reduced attention are the most common behaviour problems. Behaviour problems in infancy are predictive of later behaviour problems and they should be included in follow-up programmes.

  15. Postmortem blood ferritin concentrations in sudden infant death syndrome.

    OpenAIRE

    Worwood, M; Raha-Chowdhury, R; Fagan, D G; Moore, C A

    1995-01-01

    AIMS--To confirm the observation of extremely high concentrations of ferritin in postmortem serum samples in sudden infant death syndrome (SIDS); to examine the factors influencing blood ferritin concentrations postmortem; to determine whether or not these high blood ferritin concentrations are characteristic of SIDS. METHODS--Postmortem samples of cardiac blood were obtained from 58 full term infants who died of SIDS and 14 full-term infants who died of a variety of other causes. Whole blood...

  16. Neonatal anemia.

    Science.gov (United States)

    Aher, Sanjay; Malwatkar, Kedar; Kadam, Sandeep

    2008-08-01

    Neonatal anemia and the need for red blood cell (RBC) transfusions are very common in neonatal intensive care units. Neonatal anemia can be due to blood loss, decreased RBC production, or increased destruction of erythrocytes. Physiologic anemia of the newborn and anemia of prematurity are the two most common causes of anemia in neonates. Phlebotomy losses result in much of the anemia seen in extremely low birthweight infants (ELBW). Accepting a lower threshold level for transfusion in ELBW infants can prevent these infants being exposed to multiple donors.

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

    Science.gov (United States)

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

    2013-03-01

    Early nutritional support of preterm infants is critical to life-long health and well being. Numerous studies have demonstrated that preterm infants are at increased risk of mortality and morbidity, including disturbances in brain development. To date, much attention has focused on enhancing the nutritional support of very low and extremely low birth weight infants to improve survival and quality of life. In most countries, preterm infants are sent home before their expected date of term birth for economic or other reasons. It is debatable whether these newborns require special nutritional regimens or discharge formulas. Furthermore, guidelines that specify how to feed very preterm infants after hospital discharge are scarce and conflicting. On the other hand, the late-preterm infant presents a challenge to health care providers immediately after birth when decisions must be made about how and where to care for these newborns. Considering these infants as well babies may place them at a disadvantage. Late-preterm infants have unique and often-unrecognized medical vulnerabilities and nutritional needs that predispose them to greater rates of morbidity and hospital readmissions. Poor or inadequate feeding during hospitalization may be one of the main reasons why late-preterm infants have difficulty gaining weight right after birth. Providing optimal nutritional support to late premature infants may improve survival and quality of life as it does for very preterm infants. In this work, we present a review of the literature and provide separate recommendations for the care and feeding of late-preterm infants and very preterm infants after discharge. We identify gaps in current knowledge as well as priorities for future research. Copyright © 2013 Mosby, Inc. All rights reserved.

  18. Relationship between gestational weight gain and birthweight among clients enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Hawaii, 2003-2005.

    Science.gov (United States)

    Chihara, Izumi; Hayes, Donald K; Chock, Linda R; Fuddy, Loretta J; Rosenberg, Deborah L; Handler, Arden S

    2014-07-01

    To investigate the relationship between gestational weight gain (GWG) and birthweight outcomes among a low-income population in Hawaii using GWG recommendations from the 2009 Institute of Medicine (IOM) guidelines. Data were analyzed for 19,130 mother-infant pairs who participated in Hawaii's Special Supplemental Nutrition Program for Women, Infants, and Children from 2003 through 2005. GWG was categorized as inadequate, adequate, or excessive on the basis of GWG charts in the guidelines. Generalized logit models assessed the relationship between mothers' GWG and their child's birthweight category (low birthweight [LBW: < 2,500 g], normal birthweight [2,500 g ≤ BW < 4,000 g], or high birthweight [HBW: ≥ 4,000 g]). Final models were stratified by prepregnancy body mass index (underweight, normal weight, overweight, or obese) and adjusted for maternal age, education, race/ethnicity, smoking status, parity, and marital status. Overall, 62% of the sample had excessive weight gain and 15% had inadequate weight gain. Women with excessive weight gain were more likely to deliver a HBW infant; this relationship was observed for women in all prepregnancy weight categories. Among women with underweight or normal weight prior to pregnancy, those with inadequate weight gain during pregnancy were more likely to deliver a LBW infant. Among the low-income population of Hawaii, women with GWG within the range recommended in the 2009 IOM guidelines had better birthweight outcomes than those with GWG outside the recommended range. Further study is needed to identify optimal GWG goals for women with an obese BMI prior to pregnancy.

  19. Osteopenia - premature infants

    Science.gov (United States)

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

  20. Infant Formula and Fluorosis

    Science.gov (United States)

    ... child. Does using infant formula increase risk for dental fluorosis? Because most infant formulas contain low levels of ... I use affect my child’s chance of getting dental fluorosis? Three types of infant formula are available in ...

  1. Maternal Characteristics of a Cohort of Preterm Infants with a Birth Weight

    NARCIS (Netherlands)

    Claas, Marieke J.; de Vries, Linda S.; Bruinse, Hein W.

    2011-01-01

    Our objectives were to describe the obstetric complications of women who delivered an extremely low-birth-weight infant by comparing two consecutive 5-year periods and infants appropriate for gestational age (AGA) versus infants small for gestational age (SGA). This descriptive study included women

  2. Unilateral galactocele in a male infant

    Directory of Open Access Journals (Sweden)

    Vlahović Aleksandar

    2015-01-01

    Full Text Available Introduction. Galactocele, generally occuring in young women during or after lactation, is an extremely rare cause of breast enlargement in infants and children of exclusively male gender. Only 26 cases have been published so far, including two our cases. Case report. We described unilateral, cystic, breast enlargement, without any endocrinologic and other abnormalities in a 29-month-old boy. A typical clinical and histopathologic presentation of galactocele was followed with a complete excision. Conclusion. This was a 27th well documented case of galactocele in a male infant with typical clinical and histopathologic presentation. There are several hypotheses regarding etiology of the lesion, but it is likely to be multifactorial. Because of its extreme rarity, there are some difficulties in differential diagnosis and treatment options of galactocele in male infants.

  3. Advances in nutrition of the newborn infant.

    Science.gov (United States)

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

    2017-04-22

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

  4. Minor neurological dysfunction, cognitive development, and somatic development at the age of 3 to 7 years after dexamethasone treatment in very-low birth-weight infants.

    Science.gov (United States)

    Kutschera, J; Tomaselli, J; Maurer, U; Mueller, W; Urlesberger, B

    2005-03-01

    The objective of this study was to assess minor neurological dysfunction, cognitive development, and somatic development after dexamethasone therapy in very-low-birthweight infants. Thirty-three children after dexamethasone treatment were matched to 33 children without dexamethasone treatment. Data were assessed at the age of 3-7 years. Dexamethasone was started between the 7th and the 28th day of life over 7 days with a total dose of 2.35 mg/kg/day. Exclusion criteria were asphyxia, malformations, major surgical interventions, small for gestational age, intraventricular haemorrhage grades III and IV, periventricular leukomalacia, and severe psychomotor retardation. Each child was examined by a neuropediatrician for minor neurological dysfunctions and tested by a psychologist for cognitive development with a Kaufman Assessment Battery for Children and a Draw-a-Man Test. There were no differences in demographic data, growth, and socio-economic status between the two groups. Fine motor skills and gross motor function were significantly better in the control group (pdevelopment of speech, social development, and the Kaufman Assessment Battery for Children. After dexamethasone treatment, children showed a higher rate of minor neurological dysfunctions. Neurological development was affected even without neurological diagnosis. Further long-term follow-up studies will be necessary to fully evaluate the impact of dexamethasone on neurological and cognitive development.

  5. post partum emotional distress in mothers of preterm infants

    African Journals Online (AJOL)

    depressed than mothers of full term normal infants(3.7%). These differences were found ... disturbances at one extreme to florid psychosis at the other end. There is abundant ... 0-9 indicate no significant symptoms, 10-18 mild/moderate,. 19-29 moderate/severe, and 30-63 extremely severe depression. The items of the ...

  6. Congenital Heart Disease in Premature Infants 25-32 Weeks' Gestational Age.

    Science.gov (United States)

    Chu, Patricia Y; Li, Jennifer S; Kosinski, Andrzej S; Hornik, Christoph P; Hill, Kevin D

    2017-02-01

    To determine the birth prevalence of congenital heart defects (CHDs) across the spectrum of common defects in very/extremely premature infants and to compare mortality rates between premature infants with and without CHDs. The Kids' Inpatient Databases (2003-2012) were used to estimate the birth prevalence of CHDs (excluding patent ductus arteriosus) in very/extremely premature infants born between 25 and 32 weeks' gestational age. Birth prevalence was compared with term infants for a subset of "severe" defects expected to be near universally diagnosed in the neonatal period. Weighted multivariable logistic regression was used to calculate aORs of mortality comparing very and extremely premature infants with vs without CHDs. We identified 249 011 very/extremely premature infants, including 28 806 with CHDs. The overall birth prevalence of CHDs was 116 per 1000 very/extremely premature births. Severe CHDs had significantly higher birth prevalence in very/extremely premature infants when compared with term infants (7.4 per 1000 very/premature births vs 1.5 per 1000 term births; P premature infants with severe CHDs had an overall 26.3% in-hospital mortality and a 7.5-fold increased adjusted odds of death compared with those without CHDs. Mortality varied widely by defect in very/extremely premature infants, ranging from 12% for interrupted aortic arch to 67% for truncus arteriosus. Given the increased birth prevalence of severe CHDs in very/extremely premature infants, and significantly higher mortality, there is justification for intensive interventions aimed at decreasing the likelihood of premature delivery for patients where CHD is diagnosed in utero. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Surfactant therapy in late preterm infants

    Directory of Open Access Journals (Sweden)

    Murat Yurdakök

    2013-06-01

    Full Text Available Late preterm (LPT neonates are at a high risk for respiratory distress soon after birth due to respiratory distress syndrome (RDS, transient tachypnea of the newborn, persistent pulmonary hypertension, and pneumonia along with an increased need for surfactant replacement therapy, continuous positive airway pressure, and ventilator support when compared with the term neonates. In the past, studies on outcomes of infants with respiratory distress have primarily focused on extremely premature infants, leading to a gap in knowledge and understanding of the developmental biology and mechanism of pulmonary diseases in LPT neonates. Surfactant deficiency is the most frequent etiology of RDS in very preterm and moderately preterm infants, while cesarean section and lung infection play major roles in RDS development in LPT infants. The clinical presentation and the response to surfactant therapy in LPT infants may be different than that seen in very preterm infants. Incidence of pneumonia and occurrence of pneumothorax are significantly higher in LPT and term infants. High rates of pneumonia in these infants may result in direct injury to the type II alveolar cells of the lung with decreasing synthesis, release, and processing of surfactant. Increased permeability of the alveolar capillary membrane to both fluid and solutes is known to result in entry of plasma proteins into the alveolar hypophase, further inhibiting the surface properties of surfactant. However, the oxygenation index value do not change dramatically after ventilation or surfactant administration in LPT infants with RDS compared to very preterm infants. These finding may indicate a different pathogenesis of RDS in late preterm and term infants. In conclusion, surfactant therapy may be of significant benefit in LPT infants with serious respiratory failure secondary to a number of insults. However, optimal timing and dose of administration are not so clear in this group. Additional

  8. Excessive crying in infants

    Directory of Open Access Journals (Sweden)

    Ricardo Halpern

    2016-06-01

    Full Text Available ABSTRACT Objective: Review the literature on excessive crying in young infants, also known as infantile colic, and its effects on family dynamics, its pathophysiology, and new treatment interventions. Data source: The literature review was carried out in the Medline, PsycINFO, LILACS, SciELO, and Cochrane Library databases, using the terms “excessive crying,” and “infantile colic,” as well technical books and technical reports on child development, selecting the most relevant articles on the subject, with emphasis on recent literature published in the last five years. Summary of the findings: Excessive crying is a common symptom in the first 3 months of life and leads to approximately 20% of pediatric consultations. Different prevalence rates of excessive crying have been reported, ranging from 14% to approximately 30% in infants up to 3 months of age. There is evidence linking excessive crying early in life with adaptive problems in the preschool period, as well as with early weaning, maternal anxiety and depression, attention deficit hyperactivity disorder, and other behavioral problems. Several pathophysiological mechanisms can explain these symptoms, such as circadian rhythm alterations, central nervous system immaturity, and alterations in the intestinal microbiota. Several treatment alternatives have been described, including behavioral measures, manipulation techniques, use of medication, and acupuncture, with controversial results and effectiveness. Conclusion: Excessive crying in the early months is a prevalent symptom; the pediatrician's attention is necessary to understand and adequately manage the problem and offer support to exhausted parents. The prescription of drugs of questionable action and with potential side effects is not a recommended treatment, except in extreme situations. The effectiveness of dietary treatments and use of probiotics still require confirmation. There is incomplete evidence regarding alternative

  9. Patterns of infant mortality in Kuwait from 2003 to 2006.

    Science.gov (United States)

    Al-Waheeb, Salah; Al-Kandary, Nadia

    2013-11-01

    Infant death is often tragic, particularly in the Arab World, where infants, especially males, are supposed to carry their family's names due to ancient cultural traditions. The conditions and events that may be associated with infant death are extremely varied. Infants may die from either congenital disorders or natural diseases, or may pass away as a consequence of a complicated delivery. Infants are also victims of accidents and violence such as homicides. The main aim of this study was to investigate the reported medico legal cases of infant mortality in Kuwait due to natural and un-natural causes between 2003 and 2006. The average IMR rate in Kuwait during the study period was better than the IMR average for developing countries and the IMR average for the world during the same study period. In general, these figures for Kuwait are even better than the average for Middle East and North Africa. More medico- legal cases were reported for deaths among Kuwaiti infants in 2004, 2005 and 2006 compared to non Kuwaiti infants. More Kuwaiti infants died due to RTA and domestic accidents. In contrast, only non Kuwaiti infant died from infanticide.

  10. Premature infants' health at multiple induced pregnancy.

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2015-09-01

    Full Text Available Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART; to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies, from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

  11. Infant - newborn development

    Science.gov (United States)

    ... feeding are good. This is due to immature abdominal muscles used for pushing and does not need to ... holding, rocking, or cuddling. The infant's growth or development does not appear normal. Your infant seems to ...

  12. Auditory Responses of Infants

    Science.gov (United States)

    Watrous, Betty Springer; And Others

    1975-01-01

    Forty infants, 3- to 12-months-old, participated in a study designed to differentiate the auditory response characteristics of normally developing infants in the age ranges 3 - 5 months, 6 - 8 months, and 9 - 12 months. (Author)

  13. Infant and Newborn Nutrition

    Science.gov (United States)

    ... It has all the necessary vitamins and minerals. Infant formulas are available for babies whose mothers are not able or decide not to breastfeed. Infants usually start eating solid foods between 4 and ...

  14. Prebiotics in infant formula

    OpenAIRE

    Vandenplas,Yvan; DE GREEF, Elisabeth; Veereman, Gigi

    2014-01-01

    The gastrointestinal microbiota of breast-fed babies differ from classic standard formula fed infants. While mother's milk is rich in prebiotic oligosaccharides and contains small amounts of probiotics, standard infant formula doesn’t. Different prebiotic oligosaccharides are added to infant formula: galacto-oligosaccharides, fructo-oligosaccharide, polydextrose, and mixtures of these. There is evidence that addition of prebiotics in infant formula alters the gastrointestinal (GI) microbiota ...

  15. Growth and body composition changes in late preterm infants in the first months of life

    Directory of Open Access Journals (Sweden)

    N. Liotto

    2013-08-01

    Full Text Available Objectives: The aim of this study was to compare growth and body composition of late preterm infants to that of extremely preterm and full-term infants. Methods: Observational longitudinal study. Forty-nine late preterm infants and 63 extremely preterm infants were included in the study. Forty healthy, full-term, breast-fed infants were enrolled as a reference group. Anthropometric parameters and body composition by an air displacement plethysmography system were assessed at 36th week, at term, at 1 and 3 months of corrected age in all groups. Late preterm infants were also assessed on the fifth day of life. Results: Late preterm infants showed higher weight, length and head circumference values than those of very low birth weight infants but lower fat mass values on the fifth day of life and at 36th week of corrected age. However, at 3 months of corrected age, percentage of fat mass in late preterm infants reached values comparable with those of very low birth weight infants, probably because of the fast catch-up fat recorded between the fifth day of life and term corrected age. Moreover, percentage of fat mass in the first month of corrected age in preterm infants was higher as compared with full-term infants. This difference was no longer found at 3 months of corrected age. Conclusions: Further studies are needed to investigate whether this rapid increase in fat mass may modulate the risk of chronic diseases.

  16. Biological and social factors in the development of very low birthweight child

    NARCIS (Netherlands)

    N. Weisglas-Kuperus (Nynke)

    1992-01-01

    textabstract!n this thesis a prospective longitudinal follow-up study will be described from birth to 3.6 years of age in 79 high-risk VLBW children. The aim of the study was to find answers to the following questions: 1. What is the predictive value of standardized assessments in the neonatal

  17. Women with minor menstrual irregularities have increased risk of preeclampsia and low birthweight in spontaneous pregnancies

    DEFF Research Database (Denmark)

    Bonnesen, Barbara; Oddgeirsdóttir, Hanna L; Naver, Klara Vinsand

    2016-01-01

    examination-based gestational age. Outcome measures were gestational diabetes, hypertension, preeclampsia, preterm premature rupture of membranes, preterm birth, prolonged pregnancy, birthweight, umbilical artery pH ... with more than 7 days' deviation between self-reported and ultrasound examination-based gestational age were compared with women with a deviation of 7 days or less. RESULTS: Irregular menstrual cycle before conception increases the risk of preeclampsia (7.9% vs. 5.2%, p

  18. Low Birthweight, Rapid Weight Gain and Metabolic Syndrome in Adolescence: An Illustrative Case Report

    Directory of Open Access Journals (Sweden)

    Onyiriuka Alphonsus N.

    2015-12-01

    Full Text Available A 16-year-old boy whose diabetes mellitus was diagnosed 3 months previously in a private hospital but was not placed on medication. The presenting complaints were fast breathing for 24 hours, weakness for 2 hours, and unresponsiveness to calls for 0.5 hours. His father was obese with type 2 diabetes mellitus and died 8 months earlier from cardiac arrest. His birthweight was low, 2.2kg. At first presentation, his weight, BMI and blood pressure were 60kg (25th-50th percentile, 19.4kg/m2 (25thpercentile and 110/70mmHg (systolic BP 50th percentile, diastolic BP 50th-90th percentile, respectively. He was managed for diabetic ketoacidosis and was discharged on subcutaneous premixed insulin, 1 Unit/kg/day. At point of discharge, weight and BP were 60.5 kg and 120/70 mmHg, respectively. The patient defaulted but presented again 6 months later at the age of 17 years. At second presentation, his weight, BMI and BP were 89 kg (95th percentile, 27.5 kg/m2 (90th-95th percentile and 180/80 mmHg (systolic 99th percentile; diastolic 90th percentile, respectively. His waist circumference was 98.7cm (> 90th percentile. We had no record of previous waist circumference. His lipid profile showed low HDL-cholesterol 0.7252 mmol/L [(28mg/dl; <5thpercentile]. His fasting blood glucose and HbA1C were 6.5 mmol/L (117mg/dl and 34 mol/mol (5.3%, respectively. A diagnosis of metabolic syndrome in a patient with ketosis-prone type 2 diabetes was made. He was referred to the pediatric cardiologist for management of his hypertension. He defaulted again and was lost to follow up. Conclusion: This report illustrates the association of low birth weight and rapid weight gain with metabolic syndrome in adolescence.

  19. Biological and social factors in the development of very low birthweight child

    NARCIS (Netherlands)

    N. Weisglas-Kuperus (Nynke)

    1992-01-01

    textabstract!n this thesis a prospective longitudinal follow-up study will be described from birth to 3.6 years of age in 79 high-risk VLBW children. The aim of the study was to find answers to the following questions: 1. What is the predictive value of standardized assessments in the neonatal perio

  20. Early versus Late Parenteral Nutrition in Very Low Birthweight Neonates; A retrospective study from Oman

    Directory of Open Access Journals (Sweden)

    Amitha R Aroor

    2012-02-01

    Full Text Available Objectives: The aim of this study was to compare the biochemical parameters, weight gain, osteopenia and phosphate supplementation in very low birth weight (VLBW neonates receiving early versus late parenteral nutrition (EPN versus LPN. Methods: A retrospective study was undertaken in the level III Neonatal Intensive Care Unit at Sultan Qaboos University Hospital, Oman: from January 2007 to October 2008 (LPN group, n = 47 and from January 2009 to June 2010 (EPN group, n = 44. Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. Results: The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia (12.7% versus 6.8% and non-oliguric hyperkalemia (12.7% versus 6.8% in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age (CGA of 34 weeks (40 in LPN and 41 in EPN, revealed a reduction in metabolic bone disease (osteopenia of prematurity [OOP], 17.5% versus 7.3% and the need for phosphate supplementation (22.5% versus 7.3% in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. Conclusion: EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation.

  1. Infant crying and abuse

    NARCIS (Netherlands)

    Reijneveld, S.A.; van der Wal, M.F.; Brugman, E.; Hira Sing, R.A.; Verloove-Vanhorick, S.P.

    2004-01-01

    Child abuse and neglect are important causes of child morbidity and death. We assessed potentially detrimental parental actions induced by infant crying in 3259 infants aged 1-6 months, in the Netherlands. In infants aged 6 months, 5.6% (95% CI 4.2-7.0) of parents reported having smothered, slapped,

  2. Hip Problems in Infants

    Science.gov (United States)

    ... hip problems later in life? ResourcesScreening for Developmental Dysplasia of the Hip by LM French, M.D., and FR Dietz, ... 2014 Categories: Family Health, Infants and ToddlersTags: dislocation, dysplasia, external, femoral, hip, infants, internal, problems, socket, torsion Family Health, Infants ...

  3. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  4. Brain ultrasonography in the premature infant.

    Science.gov (United States)

    Veyrac, Corinne; Couture, Alain; Saguintaah, Magali; Baud, Catherine

    2006-07-01

    Brain ultrasonography plays a central role in the detection and management of neonatal disease in the preterm infant. Although morphological study, using high-frequency transducers, remains the cornerstone of imaging, pulsed and colour Doppler scans provide additional information and improve the diagnostic and prognostic accuracy of ultrasonography. Particular features of normal brain US in the extremely preterm infant are reported. Cerebral haemorrhage and its different patterns (intraventricular haemorrhage and periventricular hemorrhagic infarction) are described. The value of Doppler techniques is emphasized, e.g. demonstration of coloured signal within the aqueduct of Sylvius, visualization of patency of the terminal veins, demonstration of Doppler spectrum fluctuations, recognition of low blood flow, and the detection of vasodilatation. The sonographic diagnosis of periventricular leucomalacia and its difficulties are documented. Some uncommon brain lesions of the premature infant are illustrated, e.g. gangliothalamic ischaemic damage, cortical necrosis, focal infarcts, etc. The importance of repeating the US examinations until near term is highlighted.

  5. Extreme Temperatures May Increase Risk for Low Birth Weight at Term

    Science.gov (United States)

    ... at term, NIH study suggests Skip sharing on social media links Share this: Page Content Monday, February 27, 201 7 -Stock photo Extreme hot or cold temperatures during pregnancy may increase the risk that infants born at ...

  6. COME PLAY WITH ME! Handmade Toys for Infants. First Years Together. Project Enlightenment.

    Science.gov (United States)

    Campbell, Shirley

    This book describes 21 toys that were designed to stimulate development in low birthweight babies, ages 0-3, and can be made from basic materials found in the home. Step-by-step instructions are given for each toy along with a list of necessary supplies. Illustrations and/or patterns are provided as needed. Each entry includes suggestions for…

  7. Adequacy of prenatal care and neonatal mortality in infants born to mothers with and without antenatal high-risk conditions.

    Science.gov (United States)

    Chen, Xi-Kuan; Wen, Shi Wu; Yang, Qiuying; Walker, Mark C

    2007-04-01

    Previous studies have found that inadequate prenatal care was associated with increased neonatal mortality in the general pregnant women. To examine the association between adequacy of prenatal care and neonatal mortality in the presence and absence of antenatal high-risk conditions. We conducted a retrospective cohort study of infants based on 1995-2000 vital statistics data in the USA. The relative risk for neonatal death associated with adequacy of prenatal care was estimated by multivariate logistic regressions with adjustment of confounding factors. Inadequate prenatal care was associated with increased neonatal mortality when pregnancies were complicated by anaemia, cardiac disease, lung disease, chronic hypertension, diabetes, renal disease, pregnancy-induced hypertension, and previous preterm/small-for-gestational-age birth. The observed association also existed in the absence of these antenatal high-risk conditions. Overutilisation of prenatal care was associated with increased risk of neonatal deaths in both the presence and the absence of antenatal high-risk conditions. When gestational age at delivery and birthweight were further adjusted, the observed association between inadequate prenatal care and neonatal mortality was not significant in pregnancies with various high-risk conditions. Inadequate prenatal care is associated with increased neonatal death in both the presence and the absence of antenatal high-risk conditions. The observed association between inadequate prenatal care and neonatal mortality may be mediated by increased risk of preterm delivery and low birthweight in these pregnancies. Overutilisation of prenatal care is associated with potential risks for fetal and neonatal development, leading to increased neonatal mortality.

  8. Effect of breastfeeding quality improvement on breastfeeding rate in very low birth weight and extremely low birth weight infants%母乳喂养质量改进对极低和超低出生体重儿亲母母乳喂养率的影响

    Institute of Scientific and Technical Information of China (English)

    刘凤; 韩树萍; 余章斌; 张俊; 陈小慧; 吴薇敏; 楚雪; 刘蓓蓓

    2016-01-01

    ObjectiveTo study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU). MethodsA retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group). The parameters including condition of breastfeeding (breastfeeding rate, breastfeeding amount, and breastfeeding time), duration of parenteral nutrition, time to enteral feeding, and incidence of feeding intolerance were compared between the two groups. ResultsThe implementation of breastfeeding quality improvement measures signiifcantly increased breastfeeding rate and amount, signiifcantly shortened time to addition of human milk fortiifer, duration of parenteral nutrition, and time to enteral feeding, and signiifcantly decreased the incidence of feeding intolerance.ConclusionsBreastfeeding quality improvement measures can increase breastfeeding rate in the NICU and decrease gastrointestinal complications in preterm infants.%目的:探讨NICU中母乳喂养质量改进措施对极低和超低出生体重儿亲母母乳喂养率的影响。方法回顾性调查收集2014年7月至2015年7月收治的极低和超低出生体重儿(质量改进前组)以及实施母乳质量改进措施后的2015年8月至2016年6月的极低和超低出生体重儿(质量改进后组)资料。对两组患儿住院期间亲母母乳喂养情况(喂养率、喂养量、喂养时间)、静脉营养持续时间、达到全肠道喂养的时间,喂养不耐受发生率等指标进行比较。结果实施质量改进后,亲母母乳喂养率和喂养量均明显增高,母乳强化剂添加时间、静脉营养时间、达全肠道喂养时间

  9. Multidimensional extremal dependence coefficients

    OpenAIRE

    2017-01-01

    Extreme values modeling has attracting the attention of researchers in diverse areas such as the environment, engineering, or finance. Multivariate extreme value distributions are particularly suitable to model the tails of multidimensional phenomena. The analysis of the dependence among multivariate maxima is useful to evaluate risk. Here we present new multivariate extreme value models, as well as, coefficients to assess multivariate extremal dependence.

  10. The European Extreme Right and Religious Extremism

    Directory of Open Access Journals (Sweden)

    Jean-Yves Camus

    2007-12-01

    Full Text Available The ideology of the Extreme Right in Western Europe is rooted in Catholic fundamentalism and Counter-Revolutionary ideas. However, the Extreme Right, like all other political families, has had to adjust to an increasingly secular society. The old link between religion and the Extreme Right has thus been broken and in fact already was when Fascism overtook Europe: Fascism was secular, sometimes even anti-religious, in its essence. Although Catholic fundamentalists still retain strong positions within the apparatus of several Extreme Right parties (Front National, the vote for the Extreme Right is generally weak among regular churchgoers and strong among non-believers. In several countries, the vote for the Extreme Right is stronger among Protestant voters than among Catholics, since while Catholics may support Christian-Democratic parties, there are very few political parties linked to Protestant churches. Presently, it also seems that Paganism is becoming the dominant religious creed within the Extreme Right. In a multicultural Europe, non-Christian forms of religious fundamentalism such as Islamism also exist with ideological similarities to the Extreme Right, but this is not sufficient to categorize Islamism as a form of Fascism. Some Islamist groups seek alliances with the Extreme Right on the basis of their common dislike for Israel and the West, globalization and individual freedom of thought.

  11. Intravenous Lipids for Preterm Infants: A Review

    Directory of Open Access Journals (Sweden)

    Ghassan S. A. Salama

    2015-01-01

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

  12. Acquired methemoglobinemia in infants

    Directory of Open Access Journals (Sweden)

    Mehmet Mutlu

    2011-06-01

    Full Text Available Objective: This study aimed to determine the etiologic factors of acquired methemoglobinemia in infants younger than three months in our region. Material and Methods: This study was carried out retrospectively in infants with methemoglobinemia admitted to Karadeniz Technical University, Pediatric Clinic, during the period 2000-2009. Infants with methemoglobinemia were identified according to the medical records or ICD-10 code. Results: Nine infants with acquired methemoglobinemia (8 male, 1 female were included in the study. Seven cases were associated with the use of prilocaine for circumcision, one case with the use of prilocaine-lidocaine for local pain therapy, and one case with neonatal sepsis caused by Staphylococcus aureus.Conclusion: Prilocaine should not be used in infants less than three months of age because of the risk of methemoglobinemia. Ascorbic acid is an effective therapy if methylene blue is not obtained. It should not be forgotten that sepsis caused by S. aureus may cause methemoglobinemia in infants.

  13. Giant lipoblastoma of the thigh: A rare soft tissue tumor in an infant

    Directory of Open Access Journals (Sweden)

    Tanveer Akhtar

    2012-01-01

    Full Text Available Lipoblastoma is a rare lipomatous tumor encountered almost exclusively in infants and young children. It arises from embryonic white fat. The common site of involvement is the extremities. In spite of their potential for local invasion, they are benign tumors. We report a case of a lipoblastoma in an infant and review the literature pertaining to clinical management of these tumors.

  14. Early Development of the Low SES Infant Weighing Less Than 1001 Grams at Birth.

    Science.gov (United States)

    Finello, Karen M.; And Others

    To evaluate outcomes in infants of very low birth weight born in 1982-83 to families of extremely low socioeconomic status (SES), 33 infants who weighed less than 1001 grams at birth and survived the nursery period were followed for 1 year. The sample was 79 percent Hispanic and 58 percent female. Mean birth weight was 868 grams and mean…

  15. Prebiotics in infant formula.

    Science.gov (United States)

    Vandenplas, Yvan; De Greef, Elisabeth; Veereman, Gigi

    2014-01-01

    The gastrointestinal microbiota of breast-fed babies differ from classic standard formula fed infants. While mother's milk is rich in prebiotic oligosaccharides and contains small amounts of probiotics, standard infant formula doesn't. Different prebiotic oligosaccharides are added to infant formula: galacto-oligosaccharides, fructo-oligosaccharide, polydextrose, and mixtures of these. There is evidence that addition of prebiotics in infant formula alters the gastrointestinal (GI) microbiota resembling that of breastfed infants. They are added to infant formula because of their presence in breast milk. Infants on these supplemented formula have a lower stool pH, a better stool consistency and frequency and a higher concentration of bifidobacteria in their intestine compared to infants on a non-supplemented standard formula. Since most studies suggest a trend for beneficial clinical effects, and since these ingredients are very safe, prebiotics bring infant formula one step closer to breastmilk, the golden standard. However, despite the fact that adverse events are rare, the evidence on prebiotics of a significant health benefit throughout the alteration of the gut microbiota is limited.

  16. Prebiotics in infant formula

    Science.gov (United States)

    Vandenplas, Yvan; Greef, Elisabeth De; Veereman, Gigi

    2014-01-01

    The gastrointestinal microbiota of breast-fed babies differ from classic standard formula fed infants. While mother's milk is rich in prebiotic oligosaccharides and contains small amounts of probiotics, standard infant formula doesn’t. Different prebiotic oligosaccharides are added to infant formula: galacto-oligosaccharides, fructo-oligosaccharide, polydextrose, and mixtures of these. There is evidence that addition of prebiotics in infant formula alters the gastrointestinal (GI) microbiota resembling that of breastfed infants. They are added to infant formula because of their presence in breast milk. Infants on these supplemented formula have a lower stool pH, a better stool consistency and frequency and a higher concentration of bifidobacteria in their intestine compared to infants on a non-supplemented standard formula. Since most studies suggest a trend for beneficial clinical effects, and since these ingredients are very safe, prebiotics bring infant formula one step closer to breastmilk, the golden standard. However, despite the fact that adverse events are rare, the evidence on prebiotics of a significant health benefit throughout the alteration of the gut microbiota is limited. PMID:25535999

  17. Epididymo-orchitis in an extremely preterm infant

    Directory of Open Access Journals (Sweden)

    Scott Morris

    2016-04-01

    Full Text Available Epididymo-orchitis (EO is a rare condition in the neonatal period. An underlying uropathy is variably associated with EO in published cases and more frequently seen in older children. In this case report, a male baby born at 26 weeks gestation had confirmed congenital Escherichia coli septicemia. The E. coli was sensitive to gentamicin, and he was treated with 10 days of intravenous gentamicin and cefotaxime, with normalization of markers of infection. He did not have a urinary catheter at any stage. He developed recurrent E. coli septicemia 19 days after ceasing antibiotics, in association with a tender scrotal swelling. A urine culture could not be obtained prior to commencing intravenous antibiotics. Surgical exploration revealed a right pyocele and a viable right testis. He was treated with 2 weeks of intravenous piperacillin and tazobactam and a further 2 weeks of oral amoxycillin and clavulanic acid. Urological investigations were normal. No further episodes of EO occurred, and follow-up showed normal testicular growth. This case adds weight to existing literature which suggests hematogenous spread as the most frequent cause of neonatal EO, without urinary tract abnormality. EO as cause of recurrent sepsis in the neonate after apparently adequate treatment of antecedent blood born infection is highlighted. Surgical exploration confirmed diagnosis, and evacuation of the pyocele assisted resolution of systemic sepsis and decompressed the testis.

  18. Change in social status and risk of low birth weight in Denmark: population based cohort study.

    OpenAIRE

    Basso, O; Olsen, J.; Johansen, A. M.; Christensen, K

    1997-01-01

    OBJECTIVE: To estimate the risk of having a low birthweight infant associated with changes in social, environmental, and genetic factors. DESIGN: Population based, historical cohort study using the Danish medical birth registry and Statistic Denmark's fertility database. SUBJECTS: All women who had a low birthweight infant (< 2500 g) (index birth) and a subsequent liveborn infant (outcome birth) in Denmark between 1980 and 1992 (exposed cohort, n = 11,069) and a random sample of the populatio...

  19. Bilateral mesenchymal hamartoma of the chest wall in an infant boy.

    Science.gov (United States)

    Li, Rong; Kelly, David; Siegal, Gene P

    2012-12-01

    Mesenchymal chest wall hamartoma is an extremely rare tumor striking neonates and infants. Histologically, the tumor is composed of islands of hyaline cartilage intermixed with mesenchymal-like stroma and hemorrhagic cysts. We present a case of a congenital bilateral mesenchymal chest wall hamartoma (MCWH) in an infant boy. This extremely rare benign entity may be misdiagnosed as malignant tumor and shares features with another tumor of childhood-fibrocartilagenous mesenchymoma of bone.

  20. High prevalence of cranial asymmetry exists in infants with neonatal brachial plexus palsy.

    Science.gov (United States)

    Tang, Megan; Gorbutt, Kimberly A; Peethambaran, Ammanath; Yang, Lynda; Nelson, Virginia S; Chang, Kate Wan-Chu

    2016-11-30

    This study aimed to: 1) evaluate the prevalence of cranial asymmetry (positional plagiocephaly) in infants with neonatal brachial plexus palsy (NBPP); 2) examine the association of patient demographics, arm function, and NBPP-related factors to positional plagiocephaly; and 3) determine percentage of spontaneous recovery from positional plagiocephaly and its association with arm function. Infants plagio group), including infants with resolved positional plagiocephaly (plagio-resolved subgroup); and 2) those who never had positional plagiocephaly (non-plagio group). Standard statistics were applied. Eighteen of 28 infants (64%) had positional plagiocephaly. Delivery type might be predictive for plagiocephaly. Infants in the non-plagio group exhibited more active range of motion than infants in the plagio group. All other factors had no significant correlations. A high prevalence of positional plagiocephaly exists among the NBPP population examined. Parents and physicians should encourage infants to use their upper extremities to change position and reduce chance of cranial asymmetry.

  1. Legacy to the extreme

    NARCIS (Netherlands)

    A. van Deursen (Arie); T. Kuipers (Tobias); L.M.F. Moonen (Leon)

    2000-01-01

    textabstractWe explore the differences between developing a system using extreme programming techniques, and maintaining a legacy system. We investigate whether applying extreme programming techniques to legacy maintenance is useful and feasible.

  2. Legacy to the extreme

    NARCIS (Netherlands)

    Deursen, A. van; Kuipers, T.; Moonen, L.M.F.

    2000-01-01

    We explore the differences between developing a system using extreme programming techniques, and maintaining a legacy system. We investigate whether applying extreme programming techniques to legacy maintenance is useful and feasible.

  3. Infant discrimination of humanoid robots

    Directory of Open Access Journals (Sweden)

    Goh eMatsuda

    2015-09-01

    Full Text Available Recently, extremely humanlike robots called androids have been developed, some of which are already being used in the field of entertainment. In the context of psychological studies, androids are expected to be used in the future as fully controllable human stimuli to investigate human nature. In this study, we used an android to examine infant discrimination ability between human beings and non-human agents. Participants (N = 42 infants were assigned to three groups based on their age, i.e., 6- to 8-month-olds, 9- to 11-month-olds, and 12- to 14-month-olds, and took part in a preferential looking paradigm. Of three types of agents involved in the paradigm—a human, an android modeled on the human, and a mechanical-looking robot made from the android—two at a time were presented side-by-side as they performed a grasping action. Infants’ looking behavior was measured using an eye tracking system, and the amount of time spent focusing on each of three areas of interest (face, goal, and body was analyzed. Results showed that all age groups predominantly looked at the robot and at the face area, and that infants aged over 9 months watched the goal area for longer than the body area. There was no difference in looking times and areas focused on between the human and the android. These findings suggest that 6- to 14-month-olds are unable to discriminate between the human and the android, although they can distinguish the mechanical robot from the human.

  4. Infant discrimination of humanoid robots

    Science.gov (United States)

    Matsuda, Goh; Ishiguro, Hiroshi; Hiraki, Kazuo

    2015-01-01

    Recently, extremely humanlike robots called “androids” have been developed, some of which are already being used in the field of entertainment. In the context of psychological studies, androids are expected to be used in the future as fully controllable human stimuli to investigate human nature. In this study, we used an android to examine infant discrimination ability between human beings and non-human agents. Participants (N = 42 infants) were assigned to three groups based on their age, i.e., 6- to 8-month-olds, 9- to 11-month-olds, and 12- to 14-month-olds, and took part in a preferential looking paradigm. Of three types of agents involved in the paradigm—a human, an android modeled on the human, and a mechanical-looking robot made from the android—two at a time were presented side-by-side as they performed a grasping action. Infants’ looking behavior was measured using an eye tracking system, and the amount of time spent focusing on each of three areas of interest (face, goal, and body) was analyzed. Results showed that all age groups predominantly looked at the robot and at the face area, and that infants aged over 9 months watched the goal area for longer than the body area. There was no difference in looking times and areas focused on between the human and the android. These findings suggest that 6- to 14-month-olds are unable to discriminate between the human and the android, although they can distinguish the mechanical robot from the human. PMID:26441772

  5. Extreme environment electronics

    CERN Document Server

    Cressler, John D

    2012-01-01

    Unfriendly to conventional electronic devices, circuits, and systems, extreme environments represent a serious challenge to designers and mission architects. The first truly comprehensive guide to this specialized field, Extreme Environment Electronics explains the essential aspects of designing and using devices, circuits, and electronic systems intended to operate in extreme environments, including across wide temperature ranges and in radiation-intense scenarios such as space. The Definitive Guide to Extreme Environment Electronics Featuring contributions by some of the world's foremost exp

  6. Deficiently Extremal Gorenstein Algebras

    Indian Academy of Sciences (India)

    Pavinder Singh

    2011-08-01

    The aim of this article is to study the homological properties of deficiently extremal Gorenstein algebras. We prove that if / is an odd deficiently extremal Gorenstein algebra with pure minimal free resolution, then the codimension of / must be odd. As an application, the structure of pure minimal free resolution of a nearly extremal Gorenstein algebra is obtained.

  7. Caudal ropivacaine in infants

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Ilett, K F; Reid, C;

    2001-01-01

    Ropivacaine is a new long-acting amino-amide local anesthetic. However, there are no data on its use in infants. In the current study, the authors investigated the pharmacokinetics of caudal ropivacaine in 30 infants younger than 12 months....

  8. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Ultrasound: Infant Hip KidsHealth > For Parents > Ultrasound: Infant Hip A A A What's in this ... en los lactantes What It Is A hip ultrasound is a safe and painless test that uses ...

  9. Sudden Infant Death Syndrome.

    Science.gov (United States)

    Barnett, Henry L.; And Others

    There is a growing body of evidence that Sudden Infant Death Syndrome (SIDS) victims are not completely normal and healthy, as was once believed. A variety of new information from several disciplines strongly suggests that the infant who dies suddenly and unexpectedly may do so because of subtle developmental, neurologic, cardiorespiratory, and…

  10. Caudal ropivacaine in infants

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Ilett, K F; Reid, C

    2001-01-01

    Ropivacaine is a new long-acting amino-amide local anesthetic. However, there are no data on its use in infants. In the current study, the authors investigated the pharmacokinetics of caudal ropivacaine in 30 infants younger than 12 months....

  11. Cerebral Asymmetry in Infants.

    Science.gov (United States)

    Vargha-Khadem, Faraneh; Corballis, Michael C.

    This paper describes two experiments conducted to replicate the reported findings (Entus, 1975) that infants demonstrate a right ear advantage in the perception of dichotically presented syllables. Using the non-nutritive sucking paradigm, 48 infants 1-3 months of age were presented with verbal stimuli contingent upon criterion level sucking.…

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

    Directory of Open Access Journals (Sweden)

    Hyung Suk Moon

    2012-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Hyung Suk Moon

    2012-09-01

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

  14. Extreme value distributions

    CERN Document Server

    Ahsanullah, Mohammad

    2016-01-01

    The aim of the book is to give a through account of the basic theory of extreme value distributions. The book cover a wide range of materials available to date. The central ideas and results of extreme value distributions are presented. The book rwill be useful o applied statisticians as well statisticians interrested to work in the area of extreme value distributions.vmonograph presents the central ideas and results of extreme value distributions.The monograph gives self-contained of theory and applications of extreme value distributions.

  15. Characterizing the burden of invasive Pseudomonas infection on neonatal units in the UK between 2005 and 2011.

    Science.gov (United States)

    Kadambari, S; Botgros, A; Clarke, P; Vergnano, S; Anthony, M; Chang, J; Collinson, A; Embleton, N; Kennea, N; Settle, P; Heath, P T; Menson, E N

    2014-10-01

    Concern about Pseudomonas infection in neonatal units has focused on outbreaks. This study analysed cases of invasive Pseudomonas infection in 18 UK neonatal units participating in the NeonIN Neonatal Infection Surveillance Network from January 2005 to December 2011. Forty-two cases were reported. The majority (35/42, 93%) of cases were late-onset (median 14 days, range 2-262 days), the highest incidence was seen in extremely-low-birthweight infants and all cases were sporadic. One-third of cases were known to be colonized prior to invasive disease. Attributable mortality was 18%. Opportunities for preventing invasive disease due to this important pathogen should be prioritized.

  16. Impaired oligodendrocyte maturation in preterm infants : Potential therapeutic targets

    NARCIS (Netherlands)

    van Tilborg, Erik; Heijnen, Cobi J.; Benders, Manon J.; van Bel, Frank; Fleiss, Bobbi; Gressens, Pierre; Nijboer, Cora H.

    2016-01-01

    Preterm birth is an evolving challenge in neonatal health care. Despite declining mortality rates among extremely premature neonates, morbidity rates remain very high. Currently, perinatal diffuse white matter injury (WMI) is the most commonly observed type of brain injury in preterm infants and has

  17. When Infants Talk, Infants Listen: Pre-Babbling Infants Prefer Listening to Speech with Infant Vocal Properties

    Science.gov (United States)

    Masapollo, Matthew; Polka, Linda; Ménard, Lucie

    2016-01-01

    To learn to produce speech, infants must effectively monitor and assess their own speech output. Yet very little is known about how infants perceive speech produced by an infant, which has higher voice pitch and formant frequencies compared to adult or child speech. Here, we tested whether pre-babbling infants (at 4-6 months) prefer listening to…

  18. Effect of provision of an integrated neonatal survival kit and early cognitive stimulation package by community health workers on developmental outcomes of infants in Kwale County, Kenya: study protocol for a cluster randomized trial.

    Science.gov (United States)

    Pell, Lisa G; Bassani, Diego G; Nyaga, Lucy; Njagi, Isaac; Wanjiku, Catherine; Thiruchselvam, Thulasi; Macharia, William; Minhas, Ripudaman S; Kitsao-Wekulo, Patricia; Lakhani, Amyn; Bhutta, Zulfiqar A; Armstrong, Robert; Morris, Shaun K

    2016-09-08

    Each year, more than 200 million children under the age of 5 years, almost all in low- and middle-income countries (LMICs), fail to achieve their developmental potential. Risk factors for compromised development often coexist and include inadequate cognitive stimulation, poverty, nutritional deficiencies, infection and complications of being born low birthweight and/or premature. Moreover, many of these risk factors are closely associated with newborn morbidity and mortality. As compromised development has significant implications on human capital, inexpensive and scalable interventions are urgently needed to promote neurodevelopment and reduce risk factors for impaired development. This cluster randomized trial aims at evaluating the impact of volunteer community health workers delivering either an integrated neonatal survival kit, an early stimulation package, or a combination of both interventions, to pregnant women during their third trimester of pregnancy, compared to the current standard of care in Kwale County, Kenya. The neonatal survival kit comprises a clean delivery kit (sterile blade, cord clamp, clean plastic sheet, surgical gloves and hand soap), sunflower oil emollient, chlorhexidine, ThermoSpot(TM), Mylar infant sleeve, and a reusable instant heater. Community health workers are also equipped with a portable hand-held electric scale. The early cognitive stimulation package focuses on enhancing caregiver practices by teaching caregivers three key messages that comprise combining a gentle touch with making eye contact and talking to children, responsive feeding and caregiving, and singing. The primary outcome measure is child development at 12 months of age assessed with the Protocol for Child Monitoring (Infant and Toddler version). The main secondary outcome is newborn mortality. This study will provide evidence on effectiveness of delivering an innovative neonatal survival kit and/or early stimulation package to pregnant women in Kwale County

  19. Oligosaccharides in infant formula: more evidence to validate the role of prebiotics.

    Science.gov (United States)

    Vandenplas, Yvan; Zakharova, Irina; Dmitrieva, Yulia

    2015-05-14

    The gastrointestinal (GI) microbiota differs between breast-fed and classic infant formula-fed infants. Breast milk is rich in prebiotic oligosaccharides (OS) and may also contain some probiotics, but scientific societies do not recommend the addition of prebiotic OS or probiotics to standard infant formula. Nevertheless, many infant formula companies often add one or the other or both. Different types of prebiotic OS are used in infant formula, including galacto-oligosaccharide, fructo-oligosaccharide, polydextrose and mixtures of these OS, but none adds human milk OS. There is evidence that the addition of prebiotics to infant formula brings the GI microbiota of formula-fed infants closer to that of breast-fed infants. Prebiotics change gut metabolic activity (by decreasing stool pH and increasing SCFA), have a bifidogenic effect and bring stool consistency and defecation frequency closer to those of breast-fed infants. Although there is only limited evidence that these changes in GI microbiota induce a significant clinical benefit for the immune system, interesting positive trends have been observed in some markers. Additionally, adverse effects are extremely seldom. Prebiotics are added to infant formula because breast milk contains human milk OS. Because most studies suggest a trend of beneficial effects and because these ingredients are very safe, prebiotics bring infant formula one step closer to the golden standard of breast milk.

  20. Stillbirth and Infant Mortality

    DEFF Research Database (Denmark)

    Nøhr, Ellen Aagaard

    2012-01-01

    mechanisms behind these associations remain largely unknown. Although maternal obesity is associated with a wide range of complications in the mother and neonate that may impair fetal and infant survival, the increased risk of stillbirth and infant mortality is virtually unchanged when accounting...... indicating that some of the excess risk may have a placental origin. To further understand the associations between maternal obesity and late fetal and infant death, we need better and more detailed clinical data, which is difficult to obtain on a population level given the rarity of the outcomes. The best...

  1. The impact of smoke-free legislation on fetal, infant and child health: a systematic review and meta-analysis protocol.

    Science.gov (United States)

    Been, Jasper V; Nurmatov, Ulugbek; van Schayck, Constant P; Sheikh, Aziz

    2013-01-01

    Second-hand smoke (SHS) exposure is estimated to kill 600 000 people worldwide annually. The WHO recommends that smoke-free indoor public environments are enforced through national legislation. Such regulations have been shown to reduce SHS exposure and, consequently, respiratory and cardiovascular morbidity. Evidence of particular health benefit in children is now emerging, including reductions in low birthweight deliveries, preterm birth and asthma exacerbations. We aim to comprehensively assess the impact of smoke-free legislation on fetal, infant and childhood outcomes. This can inform further development and implementation of global policy and strategies to reduce early life SHS exposure. Two authors will search online databases (1975-present; no language restrictions) of published and unpublished/in-progress studies, and references and citations to articles of interest. We will consult experts in the field to identify additional studies. Studies should describe associations between comprehensive or partial smoking bans in public places and health outcomes among children (0-12 years): stillbirth, preterm birth, low birth weight, small for gestational age, perinatal mortality, congenital anomalies, bronchopulmonary dysplasia, upper and lower respiratory infections and wheezing disorders including asthma. The Cochrane Effectiveness Practice and Organisational Care (EPOC)-defined study designs are eligible. Study quality will be assessed using the Cochrane 7-domain-based evaluation for randomised and clinical trials, and EPOC criteria for quasiexperimental studies. Data will be extracted by two reviewers and presented in tabular and narrative form. Meta-analysis will be undertaken using random-effects models, and generic inverse variance analysis for adjusted effect estimates. We will report sensitivity analyses according to study quality and design characteristics, and subgroup analyses according to coverage of ban, age group and parental/maternal smoking status

  2. Extreme Velocity Wind Sensor

    Science.gov (United States)

    Perotti, Jose; Voska, Ned (Technical Monitor)

    2002-01-01

    This presentation provides an overview of the development of new hurricane wind sensor (Extreme Velocity Wind Sensor) for the Kennedy Space Center (KSC) which is designed to withstand winds of up to three hundred miles an hour. The proposed Extreme Velocity Wind Sensor contains no moveable components that would be exposed to extreme wind conditions. Topics covered include: need for new hurricane wind sensor, conceptual design, software applications, computational fluid dynamic simulations of design concept, preliminary performance tests, and project status.

  3. How extreme is extreme hourly precipitation?

    Science.gov (United States)

    Papalexiou, Simon Michael; Dialynas, Yannis G.; Pappas, Christoforos

    2016-04-01

    The importance of accurate representation of precipitation at fine time scales (e.g., hourly), directly associated with flash flood events, is crucial in hydrological design and prediction. The upper part of a probability distribution, known as the distribution tail, determines the behavior of extreme events. In general, and loosely speaking, tails can be categorized in two families: the subexponential and the hyperexponential family, with the first generating more intense and more frequent extremes compared to the latter. In past studies, the focus has been mainly on daily precipitation, with the Gamma distribution being the most popular model. Here, we investigate the behaviour of tails of hourly precipitation by comparing the upper part of empirical distributions of thousands of records with three general types of tails corresponding to the Pareto, Lognormal, and Weibull distributions. Specifically, we use thousands of hourly rainfall records from all over the USA. The analysis indicates that heavier-tailed distributions describe better the observed hourly rainfall extremes in comparison to lighter tails. Traditional representations of the marginal distribution of hourly rainfall may significantly deviate from observed behaviours of extremes, with direct implications on hydroclimatic variables modelling and engineering design.

  4. Infant Botulism (For Parents)

    Science.gov (United States)

    ... for it until their first birthdays. Spores of Clostridium botulinum bacteria, found in dirt and dust, can contaminate ... from the illness. Prevention Like many germs, the Clostridium botulinum spores that cause botulism in infants are everywhere ...

  5. Cow's milk - infants

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002448.htm Cow's milk - infants To use the sharing features on this ... old, you should not feed your baby cow's milk, according to the American Academy of Pediatrics (AAP). ...

  6. CPR - infant - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100216.htm CPR - infant - series—Check for responsiveness To use the ... yourself to call 911 until you have performed CPR for about 2 minutes. 3. Carefully place the ...

  7. Abbott Infant Formula Recall

    Data.gov (United States)

    U.S. Department of Health & Human Services — This list includes products subject to recall since September 2010 related to infant formula distributed by Abbott. This list will be updated with publicly...

  8. Infant formulas - overview

    Science.gov (United States)

    ... based formulas. These formulas are made with cow's milk protein that has been changed to be more like ... be helpful for infants who have allergies to milk protein and for those with skin rashes or wheezing ...

  9. Abbott Infant Formula Recall

    Data.gov (United States)

    U.S. Department of Health & Human Services — This list includes products subject to recall since September 2010 related to infant formula distributed by Abbott. This list will be updated with publicly available...

  10. Feeding tube - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007235.htm Feeding tube - infants To use the sharing features on this page, please enable JavaScript. A feeding tube is a small, soft, plastic tube placed ...

  11. Reflux in Infants

    Science.gov (United States)

    ... to 14 months. What causes reflux and GERD in infants? There is a muscle (the lower esophageal ... contents don't flow back into the esophagus. In babies who have reflux, the lower esophageal sphincter ...

  12. CHEST PHYSIOTHERAPY FOR INFANTS

    Directory of Open Access Journals (Sweden)

    Preeti S. Christian (M.P.T Cardiopulmonary Conditions

    2014-10-01

    Full Text Available In the normal lung, secretions are removed by Mucociliary activity, normal breathing cycles, and cough. In disease, increased secretion viscosity and volume, dyskinesia of the cilia, and ineffective cough combine to reduce the ability to clear secretions, and may increase exacerbations and infections. Many chest physiotherapy techniques like postural drainage, percussion and vibration are used since many years. These techniques are derived from adult studies but these techniques are quite stressful for the infants as the infant respiratory system is different from the adult respiratory system. Advance chest physiotherapy techniques were developed specifically for infants; in accordance with their physiological characteristics. So this review is to introduce some new chest physiotherapy helpful for newborn infants.

  13. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  14. Extremely Preterm Birth

    Science.gov (United States)

    ... infants. Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there is high blood pressure and other signs of organ injury, such as an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, ...

  15. [Prebiotics in infant health].

    Science.gov (United States)

    Chirdo, Fernando G; Menéndez, Ana M; Pita Martín de Portela, María L; Sosa, Patricia; Toca, María del C; Trifone, Liliana; Vecchiarelli, Carmen

    2011-02-01

    The composition of human milk is the main base for the development of infant formulas concerning its macronutrients and micronutrients contents and bioactive compounds. Technological advances in the composition of human milk have identified a great number of bioactive compounds such as prebiotics which are responsible for immunological protection and the prevention of different pathologies. In order to achieve similar benefits, they are part of the contents of infant formulas.

  16. Integrating neurocritical care approaches into neonatology: should all infants be treated equitably?

    Science.gov (United States)

    Mann, P C; Gospe, S M; Steinman, K J; Wilfond, B S

    2015-12-01

    To improve the neurologic outcomes for infants with brain injury, neonatal providers are increasingly implementing neurocritical care approaches into clinical practice. Term infants with brain injury have been principal beneficiaries of neurologically-integrated care models to date, as evidenced by the widespread adoption of therapeutic hypothermia protocols for hypoxic-ischemic encephalopathy. Innovative therapeutic and diagnostic support for very low birth weight infants with brain injury has lagged behind. Given that concern for significant future neurodevelopmental impairment can lead to decisions to withdraw life supportive care at any gestational age, providing families with accurate prognostic information is essential for all infants. Current variable application of multidisciplinary neurocritical care approaches to infants at different gestational ages may be ethically problematic and reflect distinct perceptions of brain injury for infants born extremely premature.

  17. Avaliação longitudinal do desenvolvimento motor e da habilidade de sentar em crianças nascidas prematuras Longitudinal assessment of motor development and sitting skill in preterm infants

    Directory of Open Access Journals (Sweden)

    Cibelle Kayenne Martins Roberto Formiga

    2010-06-01

    Full Text Available Os bebês prematuros apresentam maior risco para atrasos na aquisição das habilidades neuromotoras. O objetivo do estudo foi detectar atrasos no desenvolvimento motor de crianças prematuras com baixo peso, analisar a evolução da habilidade do sentar e verificar a associação entre essa habilidade com outras aquisições motoras até os 8 meses de idade corrigida (IC. Foram avaliadas 10 crianças nascidas pré-termo, de ambos os sexos, dos 4 aos 8 meses de IC, pela escala motora infantil de Alberta AIMS (Alberta Infant Motor Scale. Cada criança foi avaliada três vezes, aos 4 para 5 meses, 5 para 6 meses, e 7 para 8 meses; os escores foram comparados para verificar alterações ao longo do tempo e identificação de possíveis atrasos no desenvolvimento motor. Os resultados mostram que, aos 7 para 8 meses, 30% das crianças apresentaram desenvolvimento motor atrasado e foram encaminhadas para tratamento fisioterapêutico. A habilidade de sentar foi melhorando progressiva e significativamente com a idade, tendo se mostrado fortemente correlacionada com outras posturas do desenvolvimento motor e com o escore total na AIMS.Preterm-born infants present higher risks of delayed neuromotor development. This study aimed at detecting delayed motor development in preterm, low-birthweight infants, by analysing development of the sitting skill in association to other motor development acquisitions until corrected age (CA of 8 months. Ten preterm infants of both sexes were assessed by the AIMS - Alberta Infant Motor Scale from ages 4 to 8 months. Each child was evaluated three times, at 4-to-5 months, 5-to-6 months, and at 7-to-8 months CA; their scores were compared to verify changes over time and identify possible delays in motor development. Results show that at the age of 7-to-8 months, 30% of the children had delayed motor development and were referred for physical therapy treatment. The pace of sitting skill development increased gradually and

  18. Fetal Alcohol Syndrome & Effects: A Continuing Education Offering

    Science.gov (United States)

    1988-01-01

    risk of 50, inclIuding: a) spontaneous abort tcns 30?6 b) neonatal depression 20 c) low birthweight 250, d) intrauterine CTrowth retardation 2011 e... factors may cause specific mothers and/or fetuses to be at either high or low risk for FAS or effects (Diaz & Samson, 1980). An Interesting...durIng pregnancy was connected with low birthweight . of 20,000 infants bor,n to his patients, infants of abstainers averaged the highest birthweights

  19. Health, United States, 1998, with Socioeconomic Status and Health Chartbook

    Science.gov (United States)

    1998-01-01

    Occupation. Children’s Health. Health Status Infant Mortality. Low BirthweighL Activity Limitation. Risk Factors Teenage Childbearing_ Smoking in...in 1987-96 (table 4). ■ Low birthweight is associated with elevated risk of death and disability in infants. In 1996 the incidence of low ...is considered to be a good measure of overall community health (10). Low birthweight is associated with an increased risk of health and

  20. Classifying Returns as Extreme

    DEFF Research Database (Denmark)

    Christiansen, Charlotte

    2014-01-01

    I consider extreme returns for the stock and bond markets of 14 EU countries using two classification schemes: One, the univariate classification scheme from the previous literature that classifies extreme returns for each market separately, and two, a novel multivariate classification scheme tha...

  1. 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 s

  2. Recurrent Wheezing in Infants

    Science.gov (United States)

    Belhassen, Manon; De Blic, Jacques; Laforest, Laurent; Laigle, Valérie; Chanut-Vogel, Céline; Lamezec, Liliane; Brouard, Jacques; Fauroux, Brigitte; de Pouvourville, Gérard; Ginoux, Marine; Van Ganse, Eric

    2016-01-01

    Abstract Recurrent wheezing (RW) has a significant impact on infants, caregivers, and society, but morbidity and related medical resource utilization (MRU) have not been thoroughly explored. The burden of RW needs to be documented with population-based data. The objective was to assess the characteristics, medical management, and MRU of RW infants identified from national claims data. Infants aged from 6 to 24 months, receiving ≥2 dispensations of respiratory drugs within 3 months, and presenting a marker of poor control (index date), were selected. During the 6 months after index date, MRU was described in the cohort and among 3 subgroups with more severe RW, defined as ≥4 dispensations of respiratory drugs, ≥3 dispensations of oral corticosteroids (OCS), or ≥1 hospitalization for respiratory symptoms. A total of 115,489 infants had RW, corresponding to 8.2% of subjects in this age group. During follow-up, 68.7% of infants received inhaled corticosteroids, but only 1.8 U (unit) were dispensed over 6 months, suggesting discontinuous use. Control was mostly inadequate: 61.7% of subjects received OCS, 80.2% antibiotics, and 71.2% short-acting beta-agonists, and medical/paramedical visits were numerous, particularly for physiotherapy. Severe RW concerned 39.0% of the cohort; 32.8% and 11.7% of infants had repeated use of respiratory drugs and OCS, respectively, and 5.5% were hospitalized for respiratory symptoms. In this real-life nation-wide study, RW was common and infants had poor control and high MRU. Interventions are needed to support adequate use of controller therapy, and to improve medical care. PMID:27082618

  3. Moving in extreme environments

    DEFF Research Database (Denmark)

    Lucas, Samuel J E; Helge, Jørn W; Schütz, Uwe H W;

    2016-01-01

    This review addresses human capacity for movement in the context of extreme loading and with it the combined effects of metabolic, biomechanical and gravitational stress on the human body. This topic encompasses extreme duration, as occurs in ultra-endurance competitions (e.g. adventure racing...... and transcontinental races) and expeditions (e.g. polar crossings), to the more gravitationally limited load carriage (e.g. in the military context). Juxtaposed to these circumstances is the extreme metabolic and mechanical unloading associated with space travel, prolonged bedrest and sedentary lifestyle, which may...

  4. Extremal surface barriers

    Energy Technology Data Exchange (ETDEWEB)

    Engelhardt, Netta; Wall, Aron C. [Department of Physics, University of California,Santa Barbara, CA 93106 (United States)

    2014-03-13

    We present a generic condition for Lorentzian manifolds to have a barrier that limits the reach of boundary-anchored extremal surfaces of arbitrary dimension. We show that any surface with nonpositive extrinsic curvature is a barrier, in the sense that extremal surfaces cannot be continuously deformed past it. Furthermore, the outermost barrier surface has nonnegative extrinsic curvature. Under certain conditions, we show that the existence of trapped surfaces implies a barrier, and conversely. In the context of AdS/CFT, these barriers imply that it is impossible to reconstruct the entire bulk using extremal surfaces. We comment on the implications for the firewall controversy.

  5. Analysis of extreme events

    CSIR Research Space (South Africa)

    Khuluse, S

    2009-04-01

    Full Text Available ) determination of the distribution of the damage and (iii) preparation of products that enable prediction of future risk events. The methodology provided by extreme value theory can also be a powerful tool in risk analysis...

  6. Extreme environments and exobiology.

    Science.gov (United States)

    Friedmann, E I

    1993-01-01

    Ecological research on extreme environments can be applied to exobiological problems such as the question of life on Mars. If life forms (fossil or extant) are found on Mars, their study will help to solve fundamental questions about the nature of life on Earth. Extreme environments that are beyond the range of adaptability of their inhabitants are defined as "absolute extreme". Such environments can serve as terrestrial models for the last stages of life in the history of Mars, when the surface cooled down and atmosphere and water disappeared. The cryptoendolithic microbial community in porous rocks of the Ross Desert in Antarctica and the microbial mats at the bottom of frozen Antarctic lakes are such examples. The microbial communities of Siberian permafrost show that, in frozen but stable communities, long-term survival is possible. In the context of terraforming Mars, selected microorganisms isolated from absolute extreme environments are considered for use in creation of a biological carbon cycle.

  7. Venous Ultrasound (Extremities)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Venous (Extremities) Venous ultrasound uses sound waves to ... limitations of Venous Ultrasound Imaging? What is Venous Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  8. Statistics of extremes

    CERN Document Server

    Gumbel, E J

    2012-01-01

    This classic text covers order statistics and their exceedances; exact distribution of extremes; the 1st asymptotic distribution; uses of the 1st, 2nd, and 3rd asymptotes; more. 1958 edition. Includes 44 tables and 97 graphs.

  9. 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...

  10. Association between feeding difficulties and language delay in preterm infants using Bayley Scales of Infant Development-Third Edition.

    Science.gov (United States)

    Adams-Chapman, Ira; Bann, Carla M; Vaucher, Yvonne E; Stoll, Barbara J

    2013-09-01

    To evaluate the relationship between abnormal feeding patterns and language performance on the Bayley Scales of Infant Development-Third Edition at 18-22 months adjusted age among a cohort of extremely premature infants. This is a descriptive analysis of 1477 preterm infants born ≤ 26 weeks gestation or enrolled in a clinical trial between January 1, 2006 and March 18, 2008 at a National Institute of Child Health and Human Development Neonatal Research Network center who completed the 18-month neurodevelopmental follow-up assessment. At 18-22 months adjusted age, a comprehensive neurodevelopmental evaluation was performed by certified examiners including the Receptive and Expressive Language Subscales of the Bayley Scales of Infant Development-Third Edition and a standardized adjusted age feeding behaviors and nutritional intake. Data were analyzed using bivariate and multilevel linear and logistic regression modeling. Abnormal feeding behaviors were reported in 193 (13%) of these infants at 18-22 months adjusted age. Abnormal feeding patterns, days of mechanical ventilation, hearing impairment, and Gross Motor Functional Classification System level ≥ 2 each independently predicted lower composite language scores. At 18 months adjusted age, premature infants with a history of feeding difficulties are more likely to have language delay. Neuromotor impairment and days of mechanical ventilation are both important risk factors associated with these outcomes. Copyright © 2013 Mosby, Inc. All rights reserved.

  11. Infants' Hearing Loss

    Directory of Open Access Journals (Sweden)

    Homa Zarin koob

    1993-03-01

    Full Text Available This is a study performed following the study between the years 1980 to 1982 to investigate risk factors and diagnostic and rehabilitative patterns in a group of newborns suffered hearing loss in a city centre. The current findings which have been attained from 1983 to 1988 manifested that just one third of the deaf newborns can be tracked by means of common auditory evaluation tests in the Neonatal Intense Care Unit (NICU. Although these newborns have been followed sooner than the infants in the Well Baby Nursery (WBN. The age for enrolling in the Parent-Infant Program for both groups is approximately 20 month. During these 8 years it has been detected that the common age for taking part in the rehabilitative programs for newborns is 1 year or more greater than that recommended by Joint Committee on infant hearing

  12. Infant death scene investigation.

    Science.gov (United States)

    Tabor, Pamela D; Ragan, Krista

    2015-01-01

    The sudden unexpected death of an infant is a tragedy to the family, a concern to the community, and an indicator of national health. To accurately determine the cause and manner of the infant's death, a thorough and accurate death scene investigation by properly trained personnel is key. Funding and resources are directed based on autopsy reports, which are only as accurate as the scene investigation. The investigation should include a standardized format, body diagrams, and a photographed or videotaped scene recreation utilizing doll reenactment. Forensic nurses, with their basic nursing knowledge and additional forensic skills and abilities, are optimally suited to conduct infant death scene investigations as well as train others to properly conduct death scene investigations. Currently, 49 states have child death review teams, which is an idea avenue for a forensic nurse to become involved in death scene investigations.

  13. Totally vegetarian diets and infant nutrition.

    Science.gov (United States)

    Shinwell, E D; Gorodischer, R

    1982-10-01

    Observations on the deleterious effects of a totally vegetarian diet in infancy are reported and the difficulties encountered in the prevention of nutritional deficiencies in a vegan religious community are discussed. Twenty-five infants of this community who were seen at the hospital showed evidence of protein-calorie malnutrition, iron- and vitamin B12-deficient anemia, rickets, zinc deficiency, and multiple recurrent infections. Evidence of growth retardation was also found in 47 infants seen at the local mother-child health (well-baby) clinic. Samples of breast milk showed low levels of carbohydrate (1.6 to 3.5 gm/100 ml), protein (0.8 to 1.4 gm/100 ml), and fat (2.4 to 4.1 gm/100 ml). The main constituent of the infants' diet after the age of 3 months (a "soya milk" prepared at the community's central kitchen) was extremely dilute with a very low calorific value (13.7 kcal/100 ml). Persistent attempts to find dietary modifications that would satisfy both the vegan philosophy and also the recommended dietary allowances failed. This problem represents a scientific and medicosocial challenge to pediatricians and nutritionists.

  14. Lipid profile of different infant formulas for infants.

    Science.gov (United States)

    Mendonça, Marcio Antonio; Araújo, Wilma Maria Coelho; Borgo, Luiz Antonio; Alencar, Ernandes de Rodrigues

    2017-01-01

    Situations including premature infants, or those in which there is a rejection to breastfeeding, require the use infant formulas for total or partial replacement of human milk. The objective of this study was to determine the lipid content and to identify the lipid profile of infant formulas. Samples were collected from ten different infant formulas, used as a substitute for breast milk at the Maternal and Child Hospital of Brasilia. The human milk sample consisted of a pool of samples from 10 mature milk donors at the milk bank of the University Hospital of Brasilia. The lipid content and lipid profile of the different infant formulas and human milk were analyzed. The experiment was conducted in a randomized block design, with eleven treatments and three replicates, in triplicate. The data obtained in this study indicated significant differences between infant formulas and human milk, and among the infant formulas analyzed in relation to the percentage of total lipids and the fatty acid profile, except for the fractions of linoleic acid and linolenic acid. Regarding the percentage of polyunsaturated fatty acids in relation to the total unsaturated fatty acids, only the Soy Protein Isolate-based Infant Formula (SPIIF) and Whey Protein Extensively Hydrolyzed Infant Formula (WPEHIF) resembled human milk. It was concluded that despite the observed differences, the use of infant formulas is a viable strategy for the development of infants subjected or not to specific physiological conditions.

  15. Extreme Programming: Maestro Style

    Science.gov (United States)

    Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang; Powell, Mark

    2009-01-01

    "Extreme Programming: Maestro Style" is the name of a computer programming methodology that has evolved as a custom version of a methodology, called extreme programming that has been practiced in the software industry since the late 1990s. The name of this version reflects its origin in the work of the Maestro team at NASA's Jet Propulsion Laboratory that develops software for Mars exploration missions. Extreme programming is oriented toward agile development of software resting on values of simplicity, communication, testing, and aggressiveness. Extreme programming involves use of methods of rapidly building and disseminating institutional knowledge among members of a computer-programming team to give all the members a shared view that matches the view of the customers for whom the software system is to be developed. Extreme programming includes frequent planning by programmers in collaboration with customers, continually examining and rewriting code in striving for the simplest workable software designs, a system metaphor (basically, an abstraction of the system that provides easy-to-remember software-naming conventions and insight into the architecture of the system), programmers working in pairs, adherence to a set of coding standards, collaboration of customers and programmers, frequent verbal communication, frequent releases of software in small increments of development, repeated testing of the developmental software by both programmers and customers, and continuous interaction between the team and the customers. The environment in which the Maestro team works requires the team to quickly adapt to changing needs of its customers. In addition, the team cannot afford to accept unnecessary development risk. Extreme programming enables the Maestro team to remain agile and provide high-quality software and service to its customers. However, several factors in the Maestro environment have made it necessary to modify some of the conventional extreme

  16. Occult intracranial injury in infants.

    Science.gov (United States)

    Greenes, D S; Schutzman, S A

    1998-12-01

    The objectives of this study were as follows: (1) to determine whether clinical symptoms and signs of brain injury are sensitive indicators of intracranial injury (ICI) in infants admitted with head trauma, (2) to describe the clinical characteristics of infants who have ICI in the absence of symptoms and signs of brain injury, and (3) to determine the clinical significance of those ICIs diagnosed in asymptomatic infants. We conducted a retrospective analysis of all infants younger than 2 years of age admitted to a tertiary care pediatric hospital with acute ICI during a 6(1/2)-year period. Infants were considered symptomatic if they had loss of consciousness, history of behavior change, seizures, vomiting, bulging fontanel, retinal hemorrhages, abnormal neurologic examination, depressed mental status, or irritability. All others were considered to have occult ICI. Of 101 infants studied, 19 (19%; 95% confidence interval [CI] 12%, 28%) had occult ICI. Fourteen of 52 (27%) infants younger than 6 months of age had occult ICI, compared with 5 of 34 (15%) infants 6 months to 1 year, and none of 15 (0%) infants older than 1 year. Eighteen (95%) infants with occult ICI had scalp contusion or hematoma, and 18 (95%) had skull fracture. Nine (47%) infants with occult ICI received therapy for the ICI. No infants with occult ICI (0%) (95% CI 0, 14%) required surgery or medical management for increased intracranial pressure. Only 1 subject (5%) with occult ICI had any late symptoms or complications: a brief, self-limited convulsion. We found that 19 of 101 ICIs in infants admitted with head trauma were clinically occult. All 19 occult ICIs occurred in infants younger than 12 months of age, and 18 of 19 had skull fractures. None experienced serious neurologic deterioration or required surgical intervention. Physicians cannot depend on the absence of clinical signs of brain injury to exclude ICI in infants younger than 1 year of age.

  17. Oxygen supplementation to stabilize preterm infants in the fetal to neonatal transition: no satisfactory answer.

    Directory of Open Access Journals (Sweden)

    Isabel eTorres-Cuevas

    2016-04-01

    Full Text Available Fetal life elapses in a relatively low oxygen environment. Immediately after birth with the initiation of breathing the lung expands and oxygen availability to tissue rises by twofold generating a physiologic oxidative stress. However, both lung anatomy and function and the antioxidant defense system do not mature until late in gestation and therefore very preterm infants often need respiratory support and oxygen supplementation in the delivery room to achieve postnatal stabilization. Notably, interventions in the first minutes of life can have long-lasting consequences. Recent trials have aimed to assess what initial inspiratory fraction of oxygen and what oxygen targets during this transitional period are best for extremely preterm infants based on the available nomogram. However, oxygen saturation nomogram informs only of term and late preterm infants but not on extremely preterm infants. Therefore, the solution to this conundrum may still have to wait before a satisfactory answer is available.

  18. Mortalidade infantil em duas coortes de base populacional no Sul do Brasil: tendências e diferenciais Infant mortality in two population-based cohorts in southern Brazil: trends and differentials

    Directory of Open Access Journals (Sweden)

    Ana M. B. Menezes

    1996-01-01

    Full Text Available Estudou-se a tendência temporal da mortalidade infantil através de dois estudos de coorte realizados em Pelotas, Rio Grande do Sul, em 1982 e 1993. Ambas coortes incluíram todos os nascimentos hospitalares e óbitos verificados através de visitas regulares aos hospitais, cartórios e cemitérios. As informações sobre a causa de morte foram obtidas através de entrevistas com pediatras, revisão do prontuário, necrópsias e entrevista com os pais das crianças. O coeficiente de mortalidade infantil caiu de 36,4 por mil nascidos vivos para 21,1 na década. As principais causas de mortalidade infantil em 1993 foram as perinatais, malformações congênitas, diarréia e infecções respiratórias. Crianças com baixo peso ao nascer apresentaram mortalidade 12 vezes maior do que crianças com peso adequado, e crianças pré-termo, duas vezes mais do que crianças com retardo de crescimento intra-uterino. Crianças de famílias com renda baixa (um salário mínimo apresentaram mortalidade sete vezes superior àquelas com renda alta (10 salários mínimos. A mortalidade de crianças de baixo peso ao nascer e alta renda familiar decresceu em 67%, contra apenas 36% para as de baixa renda. Conclui-se que, mesmo com uma queda expressiva da mortalidade infantil na década, persistem importantes desigualdades sociais.Time trends in infant mortality were assessed through two cohort studies carried out in Pelotas, Southern Brazil, in 1982 and 1993. Both cohorts included all hospital deliveries, and deaths were monitored through regular visits to hospitals, cemeteries, and notary publics. Information on cause of death was obtained from pediatricians, case notes, autopsies, and home visits to parents. The infant mortality rate fell from 36.4 in 1982 to 21.1 per thousand live births in 1993. The main causes of death in 1993 were perinatal, congenital malformations, diarrhea, and respiratory infections. Low birthweight babies were twelve times more likely

  19. Colic in infants.

    Science.gov (United States)

    Lucassen, Peter

    2010-02-05

    Colic in infants causes one in six families (17%) with children to consult a health professional. One systematic review of 15 community-based studies found a wide variation in prevalence, which depended on study design and method of recording. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for colic in infants? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: advice to increase carrying, advice to reduce stimulation, casein hydrolysate milk, cranial osteopathy, crib vibrator device, focused counselling, gripe water, infant massage, low-lactose milk, simethicone, soya-based infant feeds, spinal manipulation, and whey hydrolysate milk.

  20. Milk Allergy in Infants

    Science.gov (United States)

    ... Habits for TV, Video Games, and the Internet Milk Allergy in Infants KidsHealth > For Parents > Milk Allergy ... español Alergia a la leche en bebés About Milk Allergy People of any age can have a ...

  1. Ptosis - infants and children

    Science.gov (United States)

    Blepharoptosis-children; Congenital ptosis; Eyelid drooping-children; Eyelid drooping-amblyopia; Eyelid drooping-astigmatism ... Ptosis in infants and children is often due to a problem with the muscle that raises the eyelid. A nerve problem in the eyelid can ...

  2. Chikungunya infection in infants

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Menezes Bezerra Duarte

    Full Text Available Abstract Introduction: the infection of chikungunya virus presents clinical manifestations variables, particularly in infants in which may present multiple cutaneous manifestations. Description: a case series study was carried out in an analytical character of 14 infants (>28 days to < 2 years old admitted in a hospital between November 2015 and January 2016 with suspected case of chikungunya, by a specific IgM reactive serology. Patients positive for dengue fever, Zika virus, bacterial infections and other exanthematic diseases were excluded. Fever and cutaneous alterations were the most frequent clinical manifestations in 100% of the cases, followed by irritability (64.3%, vomits and arthralgia/arthritis in 35.7% each. Three children presented alterations in the cerebrospinal fluid compatible to meningitis. Anemia frequency was 85.7%. The median white blood cells count was 7.700/mm3 (2.600 to 20.300/mm3. High levels of aminotransferases were observed in three cases (230 to 450 U/L. Antibiotic therapy was indicated in 64.3% of the cases. Two infants needed opioid derivatives for analgesia while others took acetaminophen and/or dipyrone. Discussion: the study shows evident multi-systemic involvement of chikungunya infection in infants. The treatment is supportive, giving special attention to hydration, analgesia, skin care, and rational use of antibiotic therapy.

  3. Lactose intolerance in infants.

    Science.gov (United States)

    Taylor, Cathy

    Cathy Taylor describes the pathophysiology and aetiology of lactose intolerance and how to diagnose and treat it. Management of the infant by the primary health care team is discussed, with emphasis on advice and nutritional support that can be recommended to parents.

  4. Bromoderma in an infant*

    Science.gov (United States)

    Hoefel, Isadora da Rosa; Camozzato, Fernanda Oliveira; Hagemann, Laura Netto; Rhoden, Deise Louise Bohn; Kiszewski, Ana Elisa

    2016-01-01

    Bromoderma is a cutaneous eruption caused by the absorption of bromide. Clinical manifestations include acneiform and vegetative lesions. We report the case of an infant with bromoderma caused by the use of syrup for abdominal colic containing calcium bromide. The lesions regressed after discontinuation of the drug.

  5. Neuroprotection in Preterm Infants

    Directory of Open Access Journals (Sweden)

    R. Berger

    2015-01-01

    Full Text Available Preterm infants born before the 30th week of pregnancy are especially at risk of perinatal brain damage which is usually a result of cerebral ischemia or an ascending intrauterine infection. Prevention of preterm birth and early intervention given signs of imminent intrauterine infection can reduce the incidence of perinatal cerebral injury. It has been shown that administering magnesium intravenously to women at imminent risk of a preterm birth leads to a significant reduction in the likelihood of the infant developing cerebral palsy and motor skill dysfunction. It has also been demonstrated that delayed clamping of the umbilical cord after birth reduces the rate of brain hemorrhage among preterm infants by up to 50%. In addition, mesenchymal stem cells seem to have significant neuroprotective potential in animal experiments, as they increase the rate of regeneration of the damaged cerebral area. Clinical tests of these types of therapeutic intervention measures appear to be imminent. In the last trimester of pregnancy, the serum concentrations of estradiol and progesterone increase significantly. Preterm infants are removed abruptly from this estradiol and progesterone rich environment. It has been demonstrated in animal experiments that estradiol and progesterone protect the immature brain from hypoxic-ischemic lesions. However, this neuroprotective strategy has unfortunately not yet been subject to sufficient clinical investigation.

  6. Colic in infants

    NARCIS (Netherlands)

    Lucassen, P.L.

    2015-01-01

    INTRODUCTION: Colic in infants leads one in six families (17%) with children to consult a health professional. One systematic review of 15 community-based studies found a wide variation in prevalence, which depended on study design and method of recording. METHODS AND OUTCOMES: We conducted a system

  7. Streptococcus oralis cerebral abscess following monkey bite in a 2-month-old infant.

    Science.gov (United States)

    Thiagarajan, Srinivasan; Krishnamurthy, Sriram; Raghavan, Renitha; Mahadevan, Subramanian; Madhugiri, Venkatesh S; Sistla, Sujatha

    2016-05-01

    Although cerebral abscesses caused by animal bites have been reported, they are extremely rare in infants and have not been described following monkey bite. A 55-day-old male infant presented with a multi-loculated Streptococcus oralis cerebral abscess following a monkey bite on the scalp. There was a clinical response to antibiotic therapy and repeated surgical aspiration followed by a ventriculoperitoneal shunt. This is the first report of a patient with a brain abscess following a monkey bite.

  8. Maternal and infant sleep postpartum.

    Science.gov (United States)

    McGuire, Elizabeth

    2013-07-01

    New parents should be aware that infants' sleep is unlike that of adults and that meeting their infant's needs is likely to disrupt their own sleep. They will need to adjust their routine to manage their own sleep needs. Parental sleep patterns in the postpartum period are tied to the infant's development of a circadian sleep-wake rhythm, and the infant's feeds. Close contact with the mother and exposure to light/dark cues appear to assist in the development of the infant's circadian rhythm. The composition of breastmilk varies over the course of 24 hours and some components produced at night are likely to contribute to the infant's day/night entrainment. There is no clear evidence that using artificial feeds improves maternal sleep. Most infants need night feeds but requirements for nighttime feeds vary with the individual.

  9. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.

    2015-04-10

    Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event of interest may be very limited, efficient methods of inference play an important role. This article reviews this domain, emphasizing current research topics. We first sketch the classical theory of extremes for maxima and threshold exceedances of stationary series. We then review multivariate theory, distinguishing asymptotic independence and dependence models, followed by a description of models for spatial and spatiotemporal extreme events. Finally, we discuss inference and describe two applications. Animations illustrate some of the main ideas. © 2015 by Annual Reviews. All rights reserved.

  10. Extremely deformable structures

    CERN Document Server

    2015-01-01

    Recently, a new research stimulus has derived from the observation that soft structures, such as biological systems, but also rubber and gel, may work in a post critical regime, where elastic elements are subject to extreme deformations, though still exhibiting excellent mechanical performances. This is the realm of ‘extreme mechanics’, to which this book is addressed. The possibility of exploiting highly deformable structures opens new and unexpected technological possibilities. In particular, the challenge is the design of deformable and bi-stable mechanisms which can reach superior mechanical performances and can have a strong impact on several high-tech applications, including stretchable electronics, nanotube serpentines, deployable structures for aerospace engineering, cable deployment in the ocean, but also sensors and flexible actuators and vibration absorbers. Readers are introduced to a variety of interrelated topics involving the mechanics of extremely deformable structures, with emphasis on ...

  11. Precursors of extreme increments

    CERN Document Server

    Hallerberg, S; Holstein, D; Kantz, H; Hallerberg, Sarah; Altmann, Eduardo G.; Holstein, Detlef; Kantz, Holger

    2006-01-01

    We investigate precursors and predictability of extreme events in time series, which consist in large increments within successive time steps. In order to understand the predictability of this class of extreme events, we study analytically the prediction of extreme increments in AR(1)-processes. The resulting strategies are then applied to predict sudden increases in wind speed recordings. In both cases we evaluate the success of predictions via creating receiver operator characteristics (ROC-plots). Surprisingly, we obtain better ROC-plots for completely uncorrelated Gaussian random numbers than for AR(1)-correlated data. Furthermore, we observe an increase of predictability with increasing event size. Both effects can be understood by using the likelihood ratio as a summary index for smooth ROC-curves.

  12. Eosinophilic colitis in infants

    Directory of Open Access Journals (Sweden)

    Adriana Chebar Lozinsky

    2014-01-01

    Full Text Available OBJECTIVE: To review the literature for clinical data on infants with allergic or eosinophilic colitis. DATA SOURCE: MEDLINE search of all indexes was performed using the words ''colitis or procto-colitis and eosinophilic'' or ''colitis or proctocolitis and allergic'' between 1966 and February of 2013. All articles that described patients' characteristics were selected. DATA SYNTHESIS: A total of 770 articles were identified, of which 32 met the inclusion criteria. The 32 articles included a total of 314 infants. According to the available information, 61.6% of infants were male and 78.6% were younger than 6 months. Of the 314 patients, 49.0% were fed exclusively breast milk, 44.2% received cow's milk protein, and 6.8% received soy protein. Diarrheal stools were described in 28.3% of patients. Eosinophilia was found in 43.8% (115/263 of infants. Colonic or rectal biopsy showed infiltration by eosinophils (between 5 and 25 perhigh-power field in 89.3% (236/264 of patients. Most patients showed improvement with theremoval of the protein in cow's milk from their diet or the mother's diet. Allergy challenge tests with cow's milk protein were cited by 12 of the 32 articles (66 patients. CONCLUSIONS: Eosinophilic colitis occurs predominantly in the first six months of life and in males. Allergy to cow's milk was considered the main cause of eosinophilic colitis. Exclusion of cow'smilk from the diet of the lactating mother or from the infant's diet is generally an effective therapeutic measure.

  13. Weather and Climate Extremes.

    Science.gov (United States)

    1997-09-01

    Antarctica’s highest (New Zealand Antarctic Society, 1974). This extreme exceeded the record of 58°F (14.4°C) that occurred on 20 October 1956 at Esperanza ... Esperanza (also known as Bahia Esperanza , Hope Bay) was in operation from 1945 through the early 1960s. Meteorological/Climatological Factors: This extreme...cm) Location: Grand Ilet, La R’eunion Island [21°00’S, 55°30’E] Date: 26 January 1980 WORLD’S GREATEST 24-HOUR RAINFALL 72 in (182.5 cm

  14. Adventure and Extreme Sports.

    Science.gov (United States)

    Gomez, Andrew Thomas; Rao, Ashwin

    2016-03-01

    Adventure and extreme sports often involve unpredictable and inhospitable environments, high velocities, and stunts. These activities vary widely and include sports like BASE jumping, snowboarding, kayaking, and surfing. Increasing interest and participation in adventure and extreme sports warrants understanding by clinicians to facilitate prevention, identification, and treatment of injuries unique to each sport. This article covers alpine skiing and snowboarding, skateboarding, surfing, bungee jumping, BASE jumping, and whitewater sports with emphasis on epidemiology, demographics, general injury mechanisms, specific injuries, chronic injuries, fatality data, and prevention. Overall, most injuries are related to overuse, trauma, and environmental or microbial exposure.

  15. Extremal graph theory

    CERN Document Server

    Bollobas, Bela

    2004-01-01

    The ever-expanding field of extremal graph theory encompasses a diverse array of problem-solving methods, including applications to economics, computer science, and optimization theory. This volume, based on a series of lectures delivered to graduate students at the University of Cambridge, presents a concise yet comprehensive treatment of extremal graph theory.Unlike most graph theory treatises, this text features complete proofs for almost all of its results. Further insights into theory are provided by the numerous exercises of varying degrees of difficulty that accompany each chapter. A

  16. 早产儿经下肢浅静脉置入中心静脉导管成功率的影响因素分析%The Retrospective Analysis on Success Rate of Lower Extremity Superficial Vein in Premature Infants with Central Venous Catheter

    Institute of Scientific and Technical Information of China (English)

    文锦香

    2015-01-01

    Objective To study the factors that influenced the success rate of premature by superficial vein in central ve‐nous catheter ,And do preliminary research for building the future premature usm clinical operating standards .Methods A retrospective analysis in February 2012‐February 2014 during the records of 108 patients with lower limb in our new pediat‐ric superficial vein in central venous catheter in the treatment of the critically ill premature infants ,and success rate of cathe‐ter multi‐factor ,statistical analysis of gestational age ,weight ,puncture and catheter after phlebitis ,blocking pipe ,inci‐dence of complications such as infection ,pipe ,and so on and so forth the impact on the success rate of catheter ,double‐blind recorded 108 cases of clinical treatment and the result of catheter .Results 108 cases of children with 99 cases of placement success ,the success rate was 91 .67% ;With Multinomial Logistic regression analysis ,the main effect model of premature gestational age ,weight and phlebitis after catheter ,blocking pipe ,complications such as infection ,take off the tube were the key factors influencing the success .Conclusion Critically ill premature by central venous catheter as superficial vein of lower limb in peripheral vein in the alternative way to central venous catheter ,can effectively solve the poor upper limb vein condition of central venous catheter placement problem ,critically ill premature premature gestational age、weight and phlebi‐tis after catheter ,blocking pipe ,incidence of complications such as infection ,take off the tube of the lower extremity super‐ficial vein in central venous catheter plays a role of influence the success of the operation .%目的对影响早产儿经下肢浅静脉置入中心静脉导管成功率的因素进行分析,为建立早产儿PICC的临床操作标准提供依据。方法分析2012年2月~2014年2月我科收治的108例行下肢浅静脉置入中心静脉导管治

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

    Science.gov (United States)

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

    2014-01-01

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

  18. Sudden twin infant death on the same day: a case report and review of the literature.

    Science.gov (United States)

    Huang, Ping; Yu, Rongjun; Li, Shiying; Qin, Zhiqiang; Liu, Ningguo; Zhang, Jianhua; Zou, Donghua; Chen, Yijiu

    2013-06-01

    Sudden infant death syndrome (SIDS) is a major contributor to infant mortality. The cause of death is unknown: suggested possibilities include cardiovascular disease, anaphylactic shock, and suffocation. The occurrence of simultaneous sudden infant death syndrome is uncommon, such cases being extremely rare in forensic pathologic practice. We report two 10-week-old male twins who appeared well at the time of their evening feeding, yet died while sleeping on their backs. Both infants had petechial hemorrhages on the visceral pleura, epicardial surface of the heart, and thymus gland. Microscopic examination revealed pulmonary edema, intra-alveolar hemorrhage, and minor lymphocytic infiltration, again in both infants. In this report, we discuss the risk factors for SIDS, which should be considered individually or in combination as possible causes of death.

  19. Micafungin in Premature and Non-premature Infants

    Science.gov (United States)

    Wu, Chunzhang; Tweddle, Lorraine; Roilides, Emmanuel

    2014-01-01

    Background: Invasive fungal infections cause excessive morbidity and mortality in premature neonates and severely ill infants. Methods: Safety and efficacy outcomes of micafungin were compared between prematurely and non-prematurely born infants premature [birth weight (BW) premature, received ≥1 dose of micafungin. Among premature patients, 14.5% were low BW (1500–2499 g), 36.4% very low BW (1000–1499 g) and 49.1% extremely low BW (premature)] died. Significantly more non-premature than premature patients discontinued treatment (P = 0.003). Treatment-related adverse events were recorded in 23% of patients with no difference between groups. More extremely low BW (n = 4, 15%) and very low BW (n = 8, 40%) infants experienced treatment-related adverse events than low BW (n = 0) and there was no relation to micafungin dose or duration. For a subgroup of 30 patients with invasive candidiasis, treatment success was achieved in 73% in both premature and non-premature groups. Prophylaxis was successful in 4/5 non-premature hematopoietic stem cell transplant patients. Conclusion: Micafungin has a safe profile in premature and non-premature infants with substantial efficacy. PMID:24892849

  20. Paradox found (again): infant mortality among the Mexican-origin population in the United States.

    Science.gov (United States)

    Hummer, Robert A; Powers, Daniel A; Pullum, Starling G; Gossman, Ginger L; Frisbie, W Parker

    2007-08-01

    Recent research suggests that the favorable mortality outcomes for the Mexican immigrant population in the United States may largely be attributable to selective out-migration among Mexican immigrants, resulting in artificially low recorded death rates for the Mexican-origin population. In this paper we calculate detailed age-specific infant mortality rates by maternal race/ethnicity and nativity for two important reasons: (1) it is extremely unlikely that women of Mexican origin would migrate to Mexico with newborn babies, especially if the infants were only afew hours or afew days old; and (2) more than 50% of all infant deaths in the United States occur during the first week of life, when the chances of out-migration are very small. We use concatenated data from the U.S. linked birth and infant death cohort files from 1995 to 2000, which provides us with over 20 million births and more than 150,000 infant deaths to analyze. Our results clearly show that first-hour, first-day, and first-week mortality rates among infants born in the United States to Mexican immigrant women are about 10% lower than those experienced by infants of non-Hispanic, white U.S.-born women. It is extremely unlikely that such favorable rates are artificially caused by the out-migration of Mexican-origin women and infants, as we demonstrate with a simulation exercise. Further, infants born to U.S.-born Mexican American women exhibit rates of mortality that are statistically equal to those of non-Hispanic white women during the first weeks of life and fare considerably better than infants born to non-Hispanic black women, with whom they share similar socioeconomic profiles. These patterns are all consistent with the definition of the epidemiologic paradox as originally proposed by Markides and Coreil (1986).

  1. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable ext

  2. Hydrological extremes and security

    Science.gov (United States)

    Kundzewicz, Z. W.; Matczak, P.

    2015-04-01

    Economic losses caused by hydrological extremes - floods and droughts - have been on the rise. Hydrological extremes jeopardize human security and impact on societal livelihood and welfare. Security can be generally understood as freedom from threat and the ability of societies to maintain their independent identity and their functional integrity against forces of change. Several dimensions of security are reviewed in the context of hydrological extremes. The traditional interpretation of security, focused on the state military capabilities, has been replaced by a wider understanding, including economic, societal and environmental aspects that get increasing attention. Floods and droughts pose a burden and serious challenges to the state that is responsible for sustaining economic development, and societal and environmental security. The latter can be regarded as the maintenance of ecosystem services, on which a society depends. An important part of it is water security, which can be defined as the availability of an adequate quantity and quality of water for health, livelihoods, ecosystems and production, coupled with an acceptable level of water-related risks to people, environments and economies. Security concerns arise because, over large areas, hydrological extremes - floods and droughts - are becoming more frequent and more severe. In terms of dealing with water-related risks, climate change can increase uncertainties, which makes the state's task to deliver security more difficult and more expensive. However, changes in population size and development, and level of protection, drive exposure to hydrological hazards.

  3. Acute lower extremity ischaemia

    African Journals Online (AJOL)

    tend to impact at arterial bifurcations, the commonest site being the ... Other ominous signs of advanced ischaemia include bluish ... Recommended standards for lower extremity ischaemia*. Doppler signals ... of the embolectomy procedure. An ... in a cath-lab or angio-suite under local ... We serially measure the aPTT and.

  4. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable

  5. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    . A theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

  6. de Sitter Extremal Surfaces

    CERN Document Server

    Narayan, K

    2015-01-01

    We study extremal surfaces in de Sitter space in the Poincare slicing in the upper patch, anchored on spatial subregions at the future boundary ${\\cal I}^+$, restricted to constant boundary Euclidean time slices (focussing on strip subregions). We find real extremal surfaces of minimal area as the boundaries of past lightcone wedges of the subregions in question: these are null surfaces with vanishing area. We find also complex extremal surfaces as complex extrema of the area functional, and the area is not always real-valued. In $dS_4$ the area is real and has some structural resemblance with entanglement entropy in a dual $CFT_3$. There are parallels with analytic continuation from the Ryu-Takayanagi expressions for holographic entanglement entropy in $AdS$. We also discuss extremal surfaces in the $dS$ black brane and the de Sitter "bluewall" studied previously. The $dS_4$ black brane complex surfaces exhibit a real finite cutoff-independent extensive piece. In the bluewall geometry, there are real surface...

  7. Moving in extreme environments

    DEFF Research Database (Denmark)

    Lucas, Samuel J E; Helge, Jørn W; Schütz, Uwe H W

    2016-01-01

    and transcontinental races) and expeditions (e.g. polar crossings), to the more gravitationally limited load carriage (e.g. in the military context). Juxtaposed to these circumstances is the extreme metabolic and mechanical unloading associated with space travel, prolonged bedrest and sedentary lifestyle, which may...

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

    Directory of Open Access Journals (Sweden)

    Tooten Anneke

    2012-06-01

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

  9. Services for Families of Infants and Toddlers Experiencing Trauma. A Research-to-Practice Brief. OPRE Report 2015-14

    Science.gov (United States)

    Harden, Branda Jones

    2015-01-01

    Infancy is a time of extreme opportunity, but it is also a time of extreme vulnerability, particularly for those reared in high-risk environments. Although infant exposure to any risk is important to understand, this brief focuses on the experience and impact of "trauma," defined as witnessing or experiencing an event that poses a real…

  10. Newborn predictors of infant irritability.

    Science.gov (United States)

    Keefe, M R; Froese-Fretz, A; Kotzer, A M

    1998-01-01

    To identify newborn infant behaviors that may predict infant irritability, commonly referred to as colic. A prospective, correlational design, with data collection occurring the first 4 days of life and again at 1 month of age. This study was conducted in a private hospital in a large metropolitan city in the Midwest. Sixty infants who were at low risk and full term and whose weight was appropriate for gestational age were recruited during their postpartum hospital stay. Infants with congenital anomalies, signs of illness, or high-risk factors were excluded from the study. During infants' 1-4-day hospital stays, their crying was assessed and reported by the nurses, and a Neonatal Behavioral Assessment Scale was completed on each infant. At 1 month of age, irritability was measured using the Fussiness Rating Scale. Only two components of the Neonatal Behavioral Assessment Scale were related to development of colic or infant irritability at 1 month of age. These were the cluster of variables representing motor activity and the Neonatal Behavioral Assessment Scale supplemental item measuring the persistence necessary on the part of the examiner to get the infant to attend to stimuli presented. The infants who were classified by parents as irritable at 1 month of age were more active and more attentive to stimuli in the first few days of life. Of interest was that the newborn nursery nurses cry ratings were not related to the later development of colic in these infants. Active infants who are sensitive to stimuli may be predisposed to infant irritability; however, further work is needed to understand the relationships of these infant characteristics to the human interactions and physical environments they encounter

  11. Dissociation between small and large numerosities in newborn infants.

    Science.gov (United States)

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

    2014-01-01

    In the first year of life, infants possess two cognitive systems encoding numerical information: one for processing the numerosity of sets of 4 or more items, and the second for tracking up to 3 objects in parallel. While a previous study showed the former system to be already present a few hours after birth, it is unknown whether the latter system is functional at this age. Here, we adapt the auditory-visual matching paradigm that previously revealed sensitivity to large numerosities to test sensitivity to numerosities spanning the range from 2 to 12. Across studies, newborns discriminated pairs of large numerosities in a 3:1 ratio, even when the smaller numerosity was 3 (3 vs. 9). In contrast, newborn infants failed to discriminate pairs including the numerosity 2, even at the same ratio (2 vs. 6). These findings mirror the dissociation that has been reported with older infants, albeit with a discontinuity situated between numerosities 2 and 3. Two alternative explanations are compatible with our results: either newborn infants have a separate system for processing small sets, and the capacity of this system is limited to 2 objects; or newborn infants possess only one system to represent numerosities, and this system either is not functional or is extremely imprecise when it is applied to small numerosities.

  12. The Institution of a Standardized Investigation Protocol for Sudden Infant Death in the Eastern Metropole, Cape Town, South Africa(,)().

    Science.gov (United States)

    Dempers, Johan J; Coldrey, Jean; Burger, Elsie H; Thompson, Vonita; Wadee, Shabbir A; Odendaal, Hein J; Sens, Mary Ann; Randall, Brad B; Folkerth, Rebecca D; Kinney, Hannah C

    2016-11-01

    The rate for the sudden infant death syndrome (SIDS) in Cape Town, South Africa, is estimated to be among the highest in the world (3.41/1000 live births). In several of these areas, including those of extreme poverty, only sporadic, nonstandardized infant autopsy, and death scene investigation (DSI) occurred. In this report, we detail a feasibility project comprising 18 autopsied infants with sudden and unexpected death whose causes of death were adjudicated according to the 1991 NICHD definitions (SIDS, n = 7; known cause of death, n = 7; and unclassified, n = 4). We instituted a standardized autopsy and infant DSI through a collaborative effort of local forensic pathology officers and clinical providers. The high standard of forensic investigation met international standards, identified preventable disease, and allowed for incorporation of research. We conclude that an effective infant autopsy and DSI protocol can be established in areas with both high sudden unexpected infant death, and elsewhere. (SUID)/SIDS risk and infrastructure challenges.

  13. Brain tumors in infants

    Directory of Open Access Journals (Sweden)

    Seyyed Mohammad Ghodsi

    2015-01-01

    Full Text Available Background: Brain tumors in infants have different clinical presentations, anatomical distribution, histopathological diagnosis, and clinical prognosis compared with older children. Materials and Methods: A retrospective analysis was done in patients <12 months old who were operated on for primary brain tumor in Children's Hospital Medical Center since 2008 to 2014. Results: Thirty-one infants, 20 males and 11 females, with the mean age of 7.13 months (0.5–12 were enrolled. There were 16 supratentorial and 15 infratentorial tumors. The presenting symptoms included increased head circumference (16; bulge fontanel (15; vomiting (15; developmental regression (11; sunset eye (7; seizure (4; loss of consciousness (4; irritability (3; nystagmus (2; visual loss (2; hemiparesis (2; torticollis (2; VI palsy (3; VII, IX, X nerve palsy (each 2; and ptosis (1. Gross total and subtotal resection were performed in 19 and 11 cases, respectively. Fourteen patients needed external ventricular drainage in the perioperative period, from whom four infants required a ventriculoperitoneal shunt. One patient underwent ventriculoperitoneal shunting without tumor resection. The most common histological diagnoses were primitive neuroectodermal tumor (7, followed by anaplastic ependymoma (6 and grade II ependymoma. The rate of 30-day mortality was 19.3%. Eighteen patients are now well-controlled with or without adjuvant therapy (overall survival; 58%, from whom 13 cases are tumor free (disease free survival; 41.9%, 3 cases have residual masses with fixed or decreased size (progression-free survival; 9.6%, and 2 cases are still on chemotherapy. Conclusion: Brain tumors in infants should be treated with surgical resection, followed by chemotherapy when necessary.

  14. Energy conservation in infants.

    Science.gov (United States)

    Blass, Elliott

    2015-08-01

    Energy acquisition through suckling has been widely studied in rat and human infants. Processes mediating energy conservation, however, have not received the attention that they deserve. This essay, in honor of Professor Jerry Hogan, discusses parallel behaviors used by rat and human mothers to minimize energy loss in their offspring. Parallel mechanisms underlying energy preservation have been identified in rats and humans, suggesting phylogenetic conservation and possibly continuity. This article is part of a Special Issue entitled: In Honor of Jerry Hogan.

  15. Infant-Directed Speech Drives Social Preferences in 5-Month-Old Infants

    Science.gov (United States)

    Schachner, Adena; Hannon, Erin E.

    2011-01-01

    Adults across cultures speak to infants in a specific infant-directed manner. We asked whether infants use this manner of speech (infant- or adult-directed) to guide their subsequent visual preferences for social partners. We found that 5-month-old infants encode an individuals' use of infant-directed speech and adult-directed speech, and use this…

  16. Racial discrepancies in the association between paternal vs. maternal educational level and risk of low birthweight in Washington State

    Directory of Open Access Journals (Sweden)

    Ko Cynthia W

    2004-06-01

    Full Text Available Abstract Background The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW across different racial groups. Methods We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789. We assessed the associations between maternal or paternal education and LBW, adjusting for demographic variables, health services factors, and maternal behavioral and obstetrical factors. Results Paternal educational level was independently associated with LBW after adjustment for race, maternal education, demographic characteristics, health services factors; and other maternal factors. We found an interaction between the race and maternal education on risk of LBW. In whites, maternal education was independently associated with LBW. However, in the remainder of the sample, maternal education had a minimal effect on LBW. Conclusions The degree of association between maternal education and LBW delivery was different in whites than in members of other racial groups. Paternal education was associated with LBW in both whites and non-whites. Further studies are needed to understand why maternal education may impact pregnancy outcomes differently depending on race and why paternal education may play a more important role than maternal education in some racial categories.

  17. Social Perception in Children Born at Very Low Birthweight and Its Relationship with Social/Behavioral Outcomes

    Science.gov (United States)

    Williamson, Kathryn E.; Jakobson, Lorna S.

    2014-01-01

    Background: Research has shown that children born very prematurely are at substantially elevated risk for social and behavioral difficulties similar to those seen in full-term children with autism spectrum disorders (ASDs). Methods: To gain insight into core deficits that may underlie these difficulties, in this study, we assessed the social…

  18. Social Perception in Children Born at Very Low Birthweight and Its Relationship with Social/Behavioral Outcomes

    Science.gov (United States)

    Williamson, Kathryn E.; Jakobson, Lorna S.

    2014-01-01

    Background: Research has shown that children born very prematurely are at substantially elevated risk for social and behavioral difficulties similar to those seen in full-term children with autism spectrum disorders (ASDs). Methods: To gain insight into core deficits that may underlie these difficulties, in this study, we assessed the social…

  19. Non-extremal branes

    Directory of Open Access Journals (Sweden)

    Pablo Bueno

    2015-04-01

    Full Text Available We prove that for arbitrary black brane solutions of generic Supergravities there is an adapted system of variables in which the equations of motion are exactly invariant under electric–magnetic duality, i.e. the interchange of a given extended object by its electromagnetic dual. We obtain thus a procedure to automatically construct the electromagnetic dual of a given brane without needing to solve any further equation. We apply this procedure to construct the non-extremal (p,q-string of Type-IIB String Theory (new in the literature, explicitly showing how the dual (p,q-five-brane automatically arises in this construction. In addition, we prove that the system of variables used is suitable for a generic characterization of every double-extremal Supergravity brane solution, which we perform in full generality.

  20. Tibetans at extreme altitude.

    Science.gov (United States)

    Wu, Tianyi; Li, Shupin; Ward, Michal P

    2005-01-01

    Between 1960 and 2003, 13 Chinese expeditions successfully reached the summit of Chomolungma (Mt Everest or Sagarmatha). Forty-five of the 80 summiteers were Tibetan highlanders. During these and other high-altitude expeditions in Tibet, a series of medical and physiological investigations were carried out on the Tibetan mountaineers. The results suggest that these individuals are better adapted to high altitude and that, at altitude, they have a greater physical capacity than Han (ethnic Chinese) lowland newcomers. They have higher maximal oxygen uptake, greater ventilation, more brisk hypoxic ventilatory responses, larger lung volumes, greater diffusing capacities, and a better quality of sleep. Tibetans also have a lower incidence of acute mountain sickness and less body weight loss. These differences appear to represent genetic adaptations and are obviously significant for humans at extreme altitude. This paper reviews what is known about the physiologic responses of Tibetans at extreme altitudes.

  1. Extremal periodic wave profiles

    Directory of Open Access Journals (Sweden)

    E. van Groesen

    2007-01-01

    Full Text Available As a contribution to deterministic investigations into extreme fluid surface waves, in this paper wave profiles of prescribed period that have maximal crest height will be investigated. As constraints the values of the momentum and energy integrals are used in a simplified description with the KdV model. The result is that at the boundary of the feasible region in the momentum-energy plane, the only possible profiles are the well known cnoidal wave profiles. Inside the feasible region the extremal profiles of maximal crest height are "cornered" cnoidal profiles: cnoidal profiles of larger period, cut-off and periodically continued with the prescribed period so that at the maximal crest height a corner results.

  2. Extreme Photonics & Applications

    CERN Document Server

    Hall, Trevor J; Paredes, Sofia A

    2010-01-01

    "Extreme Photonics & Applications" arises from the 2008 NATO Advanced Study Institute in Laser Control & Monitoring in New Materials, Biomedicine, Environment, Security and Defense. Leading experts in the manipulation of light offered by recent advances in laser physics and nanoscience were invited to give lectures in their fields of expertise and participate in discussions on current research, applications and new directions. The sum of their contributions to this book is a primer for the state of scientific knowledge and the issues within the subject of photonics taken to the extreme frontiers: molding light at the ultra-finest scales, which represents the beginning of the end to limitations in optical science for the benefit of 21st Century technological societies. Laser light is an exquisite tool for physical and chemical research. Physicists have recently developed pulsed lasers with such short durations that one laser shot takes the time of one molecular vibration or one electron rotation in an ...

  3. Extremal Hairy Black Holes

    CERN Document Server

    Gonzalez, P A; Saavedra, Joel; Vasquez, Yerko

    2014-01-01

    We consider a gravitating system consisting of a scalar field minimally coupled to gravity with a self-interacting potential and an U(1) electromagnetic field. Solving the coupled Einstein-Maxwell-scalar system we find exact hairy charged black hole solutions with the scalar field regular everywhere. We go to the zero temperature limit and we study the effect of the scalar field on the near horizon geometry of an extremal black hole. We find that except a critical value of the charge of the black hole there is also a critical value of the charge of the scalar field beyond of which the extremal black hole is destabilized. We study the thermodynamics of these solutions and we find that if the space is flat then at low temperature the Reissner-Nordstr\\"om black hole is thermodynamically preferred, while if the space is AdS the hairy charged black hole is thermodynamically preferred at low temperature.

  4. Wearable Sensor Systems for Infants

    OpenAIRE

    Zhihua Zhu; Tao Liu; Guangyi Li; Tong Li; Yoshio Inoue

    2015-01-01

    Continuous health status monitoring of infants is achieved with the development and fusion of wearable sensing technologies, wireless communication techniques and a low energy-consumption microprocessor with high performance data processing algorithms. As a clinical tool applied in the constant monitoring of physiological parameters of infants, wearable sensor systems for infants are able to transmit the information obtained inside an infant’s body to clinicians or parents. Moreover, such sys...

  5. Religious Extremism in Pakistan

    Science.gov (United States)

    2014-12-01

    Face (July 2008): 32. 21 Ahmed Rashid , Pakistan on the Brink: The Future of America, Pakistan, and Afghanistan (New York: Viking, 2012). 22 Brian J...promoting extremism. Commentators such as Jessica Stern, Alan Richards, Hussain Haqqani, Ahmed Rashid , and Ali Riaz are a few of the scholars who...www.jstor.org/stable/3183558; See also Ahmed Rashid , Descent Into Chaos: The United States and the Failure of Nation Building in Pakistan, Afghanistan, and

  6. USACE Extreme Sea levels

    Science.gov (United States)

    2014-03-14

    report summarising the results of the research, together with a set of recommendations arising from the research. This report describes progress to...Southampton University at HR Wallingford and subsequent teleconference with Heidi Moritz and Kate White. The notes summarising the findings of the...suggestion was made that we may want to begin talking about extreme water levels separate from storms. Ivan mentioned an analysis of storminess which

  7. Extreme geomagnetically induced currents

    Science.gov (United States)

    Kataoka, Ryuho; Ngwira, Chigomezyo

    2016-12-01

    We propose an emergency alert framework for geomagnetically induced currents (GICs), based on the empirically extreme values and theoretical upper limits of the solar wind parameters and of d B/d t, the time derivative of magnetic field variations at ground. We expect this framework to be useful for preparing against extreme events. Our analysis is based on a review of various papers, including those presented during Extreme Space Weather Workshops held in Japan in 2011, 2012, 2013, and 2014. Large-amplitude d B/d t values are the major cause of hazards associated with three different types of GICs: (1) slow d B/d t with ring current evolution (RC-type), (2) fast d B/d t associated with auroral electrojet activity (AE-type), and (3) transient d B/d t of sudden commencements (SC-type). We set "caution," "warning," and "emergency" alert levels during the main phase of superstorms with the peak Dst index of less than -300 nT (once per 10 years), -600 nT (once per 60 years), or -900 nT (once per 100 years), respectively. The extreme d B/d t values of the AE-type GICs are 2000, 4000, and 6000 nT/min at caution, warning, and emergency levels, respectively. For the SC-type GICs, a "transient alert" is also proposed for d B/d t values of 40 nT/s at low latitudes and 110 nT/s at high latitudes, especially when the solar energetic particle flux is unusually high.

  8. Extremes in nature

    CERN Document Server

    Salvadori, Gianfausto; Kottegoda, Nathabandu T

    2007-01-01

    This book is about the theoretical and practical aspects of the statistics of Extreme Events in Nature. Most importantly, this is the first text in which Copulas are introduced and used in Geophysics. Several topics are fully original, and show how standard models and calculations can be improved by exploiting the opportunities offered by Copulas. In addition, new quantities useful for design and risk assessment are introduced.

  9. Resistive indices of cerebral arteries in very preterm infants: values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

    NARCIS (Netherlands)

    G.M. Ecury-Goossen (Ginette); M.M.A. Raets (Marlou); F.A. Camfferman (Fleur); Vos, R.H.J. (Rik H. J.); J.M. van Rosmalen (Joost); I.K.M. Reiss (Irwin); P. Govaert (Paul); J. Dudink (Jeroen)

    2016-01-01

    textabstractBackground: Little is known about cerebral artery resistive index values in infants born extremely preterm. Objective: To report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks’ gestation, and to compare resistive index in

  10. Resistive indices of cerebral arteries in very preterm infants : values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

    NARCIS (Netherlands)

    Ecury-Goossen, Ginette M; Raets, Marlou M A; Camfferman, Fleur A; Vos, Rik H J; van Rosmalen, Joost; Reiss, Irwin K M; Govaert, Paul; Dudink, Jeroen

    2016-01-01

    BACKGROUND: Little is known about cerebral artery resistive index values in infants born extremely preterm. OBJECTIVE: To report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks' gestation, and to compare resistive index in these arteri

  11. What Should We Do about Low Blood Pressure in Preterm Infants.

    Science.gov (United States)

    Dempsey, Eugene M

    2017-01-01

    The management of preterm infants with low blood pressure soon after birth remains unresolved. The definition of what constitutes low blood pressure is uncertain. At birth, mean blood pressure appears to be gestation specific and increases in the first few days of life. Antenatal steroids, delayed cord clamping, and the avoidance of mechanical ventilation are all associated with higher mean blood pressure and less hypotension after birth. Rates of hypotension of 15-50% have been reported in various studies of extremely preterm infants. However, only about 10% of all extremely preterm infants receive inotropes, suggesting that clinicians take into account other factors such as clinical, biochemical, and echocardiographic findings before deciding to intervene. The exact role of functional echocardiography in assessing the need for treatment of low blood pressure in extremely preterm infants remains to be determined. Near- infrared spectroscopy to assess cerebral perfusion may also have a role to play. Volume expansion (usually 10 mL/kg of saline) remains the most commonly used intervention for low blood pressure but evidence of benefit is lacking and there may be safety concerns. Whilst dopamine is the most commonly used inotropic drug, dobutamine, epinephrine, corticosteroids, milrinone, and vasopressin have also been utilised in preterm infants with low blood pressure. Clinical trials with long-term outcomes are needed to determine the most suitable inotrope and when to use it. Early hypotension differs from late hypotension with regard to cause, treatment, and outcome. A number of recent studies aimed at improving the evidence base for the treatment of early hypotension in extremely preterm infants have been terminated early because of poor recruitment. Currently, the answer to the question of what to do about low blood pressure in preterm infants remains unclear. © 2017 S. Karger AG, Basel.

  12. Serum Phosphorus Levels in Premature Infants Receiving a Donor Human Milk Derived Fortifier

    Directory of Open Access Journals (Sweden)

    Katherine E. Chetta

    2015-04-01

    Full Text Available An elevated serum phosphorus (P has been anecdotally described in premature infants receiving human milk fortified with donor human milk-derived fortifier (HMDF. No studies have prospectively investigated serum P in premature infants receiving this fortification strategy. In this single center prospective observational cohort study, extremely premature infants ≤1250 grams (g birth weight (BW were fed an exclusive human milk-based diet receiving HMDF and serum P levels were obtained. We evaluated 93 infants with a mean gestational age of 27.5 ± 2.0 weeks (Mean ± SD and BW of 904 ± 178 g. Seventeen infants (18.3% had at least one high serum P level with a mean serum P of 9.2 ± 1.1 mg/dL occurring at 19 ± 11 days of life. For all infants, the highest serum P was inversely correlated to the day of life of the infant (p < 0.001, R2 = 0.175 and positively correlated with energy density of HMDF (p = 0.035. Serum P was not significantly related to gender, BW, gestational age, or days to full feeds. We conclude that the incidence of hyperphosphatemia was mild and transient in this population. The risk decreased with infant age and was unrelated to gender, BW, or ethnicity.

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

    Directory of Open Access Journals (Sweden)

    Firas S. Azzeh

    Full Text Available Introduction: 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. Objective: 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. Methods: 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 (15012500 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 < 0.05 than that at birth for ELBW and VLBW groups; while sodium level decreased in ELBW group to be within normal ranges. Albumin level was improved (p < 0.05 in ELBW group. Conclusion: Health care management for low birth weight infants in Al-Noor Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups.

  14. Feeding patterns and diet -- babies and infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000712.htm Feeding patterns and diet - babies and infants To use ... prevent childhood obesity Alternative names Babies and infants - feeding; Diet - age appropriate - babies and infants; Breastfeeding - babies ...

  15. Sudden Infant Death Syndrome: Facts for Caregivers.

    Science.gov (United States)

    Texas Child Care, 2000

    2000-01-01

    Presents risk factors and prevention measures related to Sudden Infant Death Syndrome. Offers infant sleep recommendations and five discussion questions to test knowledge of Sudden Infant Death Syndrome. (DLH)

  16. Know Concentration Before Giving Acetaminophen to Infants

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Know Concentration Before Giving Acetaminophen to Infants Share Tweet Linkedin ... infants has only been available in a stronger concentration that doesn’t require giving the infants as ...

  17. Infant Sleep Positioners Pose Suffocation Risk

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Infant Sleep Positioners Pose Suffocation Risk Share Tweet Linkedin Pin ... sharing options Linkedin Pin it Email Print Infant Sleep Positioner Example See more images of Infant Sleep ...

  18. Infant Massage: Understand This Soothing Therapy

    Science.gov (United States)

    ... Understand when and how to give an infant massage. By Mayo Clinic Staff Infant massage is a way for you to gently nurture ... Find out about the possible benefits of infant massage and know how to get started. Research suggests ...

  19. Infant Development: Birth to 3 Months

    Science.gov (United States)

    Healthy Lifestyle Infant and toddler health Infant development begins at birth. Consider major infant development milestones from birth to 3 months — and know what to do when something's not right. By ...

  20. Evaluation of non-verbal cognitive function in infants with severe hearing impairment

    Institute of Scientific and Technical Information of China (English)

    Shuyu Wang; Xiaoming Li; Li Zhao; Jianhong Li; Yuxia Pan

    2008-01-01

    BACKGROUND: The relationship between hearing impairment and verbal developmental deficits in infants has become a hotspot in research, focusing on improving hearing and promoting verbal development. However, language is only one element of cognition. There are other elements of non-verbal cognitive deficits in infants with hearing impairment.OBJECTIVE: This study was designed to compare the differences in gross motor, fine motor, adaptability, and behavioral development between infants with severe hearing impairment and ordinary children of the same age. DESIGN: Case-control observation.SETTING: Department of Otolaryngology-Head Surgery, Bethune International Peace Hospital.PARTICIPANTS: Fifty-two infants with hearing impairment, who received treatment in the Department of Otolaryngology-Head Surgery, Bethune International Peace Hospital from February to December 2007, were confirmed to suffer from severe (or extremely severe) sensorineural deafness by auditory brain-stem response (ABR) and were recruited for this study. The infants comprised 30 males and 22 females. Among them, 18 were aged 0-1 year, 18 were aged 1-2 years, and 16 were aged 2-3 years. An additional 60 individuals, aged 0-3 years, who received developmental monitoring simultaneously, and were confirmed to have normal hearing and verbal ability, were included as controls. Among the control subjects, there were 31 males and 29 females: 20 were 0.05). The behavioral developmental quotient was significantly less in hearing-impaired infants compared to control infants, who were between 1 and 2 years of age (P < 0.05). The development quotients of fine motor and behavioral development were significantly less in hearing-impaired infants than in control infants, who were 2-3 years of age (P < 0.05).CONCLUSION: Compared to control infants, severe hearing-impaired infants have a lower behavioral developmental quotient after 1 year and a lower fine motor developmental quotient after 2 years of age.

  1. Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012

    DEFF Research Database (Denmark)

    Bonet, Mercedes; Cuttini, M; Piedvache, A

    2017-01-01

    OBJECTIVE: to investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTI) between 2003 and 2012 and concurrent trends in their mortality and morbidity in ten European regions. DESIGN: population-based cohort studies in 2003 (MOSAIC study) and 2011/12 (EPIC...

  2. Delivery of the extremely low-birth- weight vertex-presenting baby ...

    African Journals Online (AJOL)

    2010-12-02

    Dec 2, 2010 ... both mother and baby when delivery of an extremely low- birth-weight infant is inevitable. Over the past few decades there has been a sharp rise in the .... there was any advantage for very-low-birth-weight babies delivered by ...

  3. Infant Neurosensory Development: Considerations for Infant Child Care

    Science.gov (United States)

    Marshall, Jennifer

    2011-01-01

    Infant brain development is a dynamic process dependent upon endogenous and exogenous stimulation and a supportive environment. A critical period of brain and neurosensory development occurs during the third trimester and into the "fourth" trimester (first three months of life). Disruption, damage, or deprivation in the infant's social and…

  4. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993–2012

    Science.gov (United States)

    Stoll, Barbara J.; Hansen, Nellie I.; Bell, Edward F.; Walsh, Michele C.; Carlo, Waldemar A.; Shankaran, Seetha; Laptook, Abbot R.; Sánchez, Pablo J.; Van Meurs, Krisa P.; Wyckoff, Myra; Das, Abhik; Hale, Ellen C.; Ball, M. Bethany; Newman, Nancy S.; Schibler, Kurt; Poindexter, Brenda B.; Kennedy, Kathleen A.; Cotten, C. Michael; Watterberg, Kristi L.; D’Angio, Carl T.; DeMauro, Sara B.; Truog, William E.; Devaskar, Uday; Higgins, Rosemary D.

    2016-01-01

    Importance Extremely preterm infants contribute disproportionately to neonatal morbidity and mortality. Objective To review 20-year trends in maternal/neonatal care, complications, and mortality among extremely preterm infants born at Neonatal Research Network centers. Design, Setting, Participants Prospective registry of 34,636 infants 22–28 weeks’ gestational age (GA) and 401–1500 gram birthweight born at 26 Network centers, 1993–2012. Exposure Extremely preterm birth. Main Outcomes Maternal/neonatal care, morbidities, and survival. Major morbidities, reported for infants who survived more than 12 hours, were: severe necrotizing enterocolitis, infection, bronchopulmonary dysplasia, severe intracranial hemorrhage, cystic periventricular leukomalacia, and/or severe retinopathy of prematurity. Regression models assessed yearly changes, adjusting for study center, race/ethnicity, GA, birthweight for GA, and sex. Results Use of antenatal corticosteroids increased from 1993 to 2012 (348/1431 [24%] to 1674/1919 [87%], p<0.001), as did cesarean delivery (625/1431 [44%] to 1227/1921 [64%], p<0.001). Delivery room intubation decreased from 1144/1433 (80%) in 1993 to 1253/1922 (65%) in 2012 (p<0.001). After increasing in the 1990s, postnatal steroid use declined to 141/1757 (8%) in 2004 (p<0.001), with no significant change thereafter. Although most infants were ventilated, continuous positive airway pressure without ventilation increased from 120/1666 (7%) in 2002 to 190/1756 (11%) in 2012 (p<0.001). Despite no improvement from 1993 to 2004, rates of late-onset sepsis declined between 2005 and 2012 for infants of each GA (median GA 26 weeks, 109/296 [37%] to 85/320 [27%], adjusted relative risk [aRR]: 0.93 [95% CI, 0.92–0.94]). Rates of other morbidities declined, but bronchopulmonary dysplasia increased between 2009 and 2012 for infants 26–27 weeks (26 weeks, 130/258 [50%] to 164/297 [55%], p<0.001). Survival increased between 2009 and 2012 for infants 23

  5. Ischial apophyseal fracture in an abused infant

    Energy Technology Data Exchange (ETDEWEB)

    Bixby, Sarah D.; Kleinman, Paul K. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Wilson, Celeste R. [Boston Children' s Hospital, Child Protection Program, Department of Pediatrics, Boston, MA (United States); Barber, Ignasi [Hospital Vall d' Hebron, Department of Pediatric Radiology, Barcelona (Spain)

    2014-09-15

    We report a previously healthy 4-month-old who presented to the hospital with leg pain and swelling and no history of trauma. Radiographs demonstrated a comminuted left femur fracture. Given the concern for child abuse, skeletal survey was performed and revealed four vertebral compression deformities. Although abuse was suspected, the possibility of a lytic lesion associated with the femur fracture and multiple spinal abnormalities raised the possibility of an underlying process such as Langerhans cell histiocytosis. Subsequently 18F-NaF positron emission tomographic (PET) scintigraphy revealed increased tracer activity in the ischium, and MRI confirmed an ischial apophyseal fracture. Pelvic fractures, particularly ischial fractures, are extremely rare in the setting of child abuse. This case report describes the multimodality imaging findings of an ischial fracture in an abused infant. (orig.)

  6. Deciphering infant mortality

    Science.gov (United States)

    Berrut, Sylvie; Pouillard, Violette; Richmond, Peter; Roehner, Bertrand M.

    2016-12-01

    This paper is about infant mortality. In line with reliability theory, "infant" refers to the time interval following birth during which the mortality (or failure) rate decreases. This definition provides a systems science perspective in which birth constitutes a sudden transition falling within the field of application of the Transient Shock (TS) conjecture put forward in Richmond and Roehner (2016c). This conjecture provides predictions about the timing and shape of the death rate peak. It says that there will be a death rate spike whenever external conditions change abruptly and drastically and also predicts that after a steep rise there will be a much longer hyperbolic relaxation process. These predictions can be tested by considering living organisms for which the transient shock occurs several days after birth. Thus, for fish there are three stages: egg, yolk-sac and young adult phases. The TS conjecture predicts a mortality spike at the end of the yolk-sac phase and this timing is indeed confirmed by observation. Secondly, the hyperbolic nature of the relaxation process can be tested using very accurate Swiss statistics for postnatal death rates spanning the period from one hour immediately after birth through to age 10 years. It turns out that since the 19th century despite a significant and large reduction in infant mortality, the shape of the age-specific death rate has remained basically unchanged. Moreover the hyperbolic pattern observed for humans is also found for small primates as recorded in the archives of zoological gardens. Our overall objective is to identify a series of cases which start from simple systems and move step by step to more complex organisms. The cases discussed here we believe represent initial landmarks in this quest.

  7. Cervical necrotizing fasciitis in infant: case report

    Directory of Open Access Journals (Sweden)

    Schiavetto, Renata Rennó

    2008-12-01

    Full Text Available Introduction: Necrotizing fasciitis is a bacterial infection characterized by extensive necrosis of tissues, and may include skin and muscles. It's more frequent in adults than in children and generally involves the trunk and extremities. Head and neck area is less commonly affected. The most frequently isolated pathogens are the Streptococcus pyogenes (group A and Staphylococcus aureus. The anatomopathological exam is the best diagnostic method, which early identifies the disease. The clinical support, surgical debridement, and the intravenous antibiotic therapy, are fundamental for the treatment. Objective: To report a case of an infant who suffered from Cervical Necrotizing Fasciitis. Case Report: Infant, male sex, white, 2 months old, previously healthy, with Necrotizing Fasciitis involving the frontal and right lateral cervical regions. After adequate treatment the patient obtained excellent recovery without presenting important aesthetic or functional alterations. Conclusion: The Cervical Necrotizing Fasciitis is uncommon in children. The early surgical debridement is necessary to control the infection, even if it may result in great and deep injuries. The wide spectrum antibiotic therapy and hemodynamic support are also basic for the therapeutic success.

  8. Extreme Programming Pocket Guide

    CERN Document Server

    Chromatic

    2003-01-01

    Extreme Programming (XP) is a radical new approach to software development that has been accepted quickly because its core practices--the need for constant testing, programming in pairs, inviting customer input, and the communal ownership of code--resonate with developers everywhere. Although many developers feel that XP is rooted in commonsense, its vastly different approach can bring challenges, frustrations, and constant demands on your patience. Unless you've got unlimited time (and who does these days?), you can't always stop to thumb through hundreds of pages to find the piece of info

  9. Mycetoma of lower extremity

    Directory of Open Access Journals (Sweden)

    Sahariah S

    1978-01-01

    Full Text Available Ten cases of mycetoma of the lower extremity were seen and treated at the Postgraduate Institute of Medical Education & Research, Chandigarh, India, during the years 1973 to 1975. Six were treated by conservative method e.g. antibiotics, sulfonamides and immobilization of the part while remaining four were submitted t o surgery. Four out o f six from the first group had recurrence and has been put on second line of therapy. Recurrence occurred in only one case from the second group and he required an above knee amputation while the remaining three are free of disease and are well rehabilitated.

  10. Metagenomics of extreme environments.

    Science.gov (United States)

    Cowan, D A; Ramond, J-B; Makhalanyane, T P; De Maayer, P

    2015-06-01

    Whether they are exposed to extremes of heat or cold, or buried deep beneath the Earth's surface, microorganisms have an uncanny ability to survive under these conditions. This ability to survive has fascinated scientists for nearly a century, but the recent development of metagenomics and 'omics' tools has allowed us to make huge leaps in understanding the remarkable complexity and versatility of extremophile communities. Here, in the context of the recently developed metagenomic tools, we discuss recent research on the community composition, adaptive strategies and biological functions of extremophiles.

  11. Characterizing Extreme Ionospheric Storms

    Science.gov (United States)

    Sparks, L.; Komjathy, A.; Altshuler, E.

    2011-12-01

    Ionospheric storms consist of disturbances of the upper atmosphere that generate regions of enhanced electron density typically lasting several hours. Depending upon the storm magnitude, gradients in electron density can sometimes become large and highly localized. The existence of such localized, dense irregularities is a major source of positioning error for users of the Global Positioning System (GPS). Consequently, satellite-based augmentation systems have been implemented to improve the accuracy and to ensure the integrity of user position estimates derived from GPS measurements. Large-scale irregularities generally do not pose a serious threat to estimate integrity as they can be readily detected by such systems. Of greater concern, however, are highly localized irregularities that interfere with the propagation of a signal detected by a user measurement but are poorly sampled by the receivers in the system network. The most challenging conditions have been found to arise following disturbances of large magnitude that occur only rarely over the course of a solar cycle. These extremely disturbed conditions exhibit behavior distinct from moderately disturbed conditions and, hence, have been designated "extreme storms". In this paper we examine and compare the behavior of the extreme ionospheric storms of solar cycle 23 (or, more precisely, extreme storms occurring between January 1, 2000, and December 31, 2008), as represented in maps of vertical total electron content. To identify these storms, we present a robust means of quantifying the regional magnitude of an ionospheric storm. Ionospheric storms are observed frequently to occur in conjunction with magnetic storms, i.e., periods of geophysical activity as measured by magnetometers. While various geomagnetic indices, such as the disturbance storm time (Dst) and the planetary Kp index, have long been used to rank the magnitudes of distinct magnetic storms, no comparable, generally recognized index exists for

  12. Neonatal sepsis in a rapidly growing, tertiary neonatal intensive care unit: Trends over 18 years.

    Science.gov (United States)

    Heo, Ju Sun; Shin, Seung Han; Jung, Young Hwa; Kim, Ee-Kyung; Choi, Eun Hwa; Kim, Han-Suk; Lee, Hoan Jong; Choi, Jung-Hwan

    2015-10-01

    We investigated changes in the admission patterns of neonatal intensive care units and the epidemiology of neonatal sepsis following the rapid expansion and improvements in neonatal intensive care. Data on the admission of neonates with culture-proven sepsis between 1996 and 2013 (period I, 1996-2005; period II, 2006-2013) were collected retrospectively. The admission of extremely low-birthweight (ELBW) infants increased between periods I and II (11.1 vs 28.7 infants per 1000 live births, P sepsis among all infants and ELBW infants increased (all infants, 5.9 vs 12.7 cases per 1000 live births; ELBW infants, 189.5 vs 290.1 cases per 1000 live births). In ELBW infants, the incidence of sepsis caused by coagulase-negative Staphylococcus (CONS), significantly increased during period II (8.8 vs 25.4%, P = 0.039). On multivariate analysis, central vascular catheters and prolonged hospitalization were independently associated with increased sepsis rate, particularly CONS in ELBW infants. The inborn admission rate for ELBW infants has increased significantly and is accompanied by improved survival and longer hospital stay. The incidence of neonatal sepsis, particularly in ELBW infants, has also increased, and CONS has emerged as a major pathogen. Central vascular catheters and prolonged hospitalization could be independent risk factors for the increased sepsis rate, particularly sepsis due to CONS. © 2015 Japan Pediatric Society.

  13. Winter Storms and Extreme Cold

    Science.gov (United States)

    ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ...

  14. What Is Infant Mental Health?

    Science.gov (United States)

    Osofsky, Joy D.; Thomas, Kandace

    2012-01-01

    Unfortunately, the term "infant mental health" can be confusing for some people because it may be understood as translating into "mental illness." Others may not appreciate that babies and toddlers have the capacity to experience complex emotions. The Guest Editors of this issue of the Journal explore the meaning of infant mental health.

  15. Prenatal meditation influences infant behaviors.

    Science.gov (United States)

    Chan, Ka Po

    2014-11-01

    Meditation is important in facilitating health. Pregnancy health has been shown to have significant consequences for infant behaviors. In view of limited studies on meditation and infant temperament, this study aims to explore the effects of prenatal meditation on these aspects. The conceptual framework was based on the postulation of positive relationships between prenatal meditation and infant health. A randomized control quantitative study was carried out at Obstetric Unit, Queen Elizabeth Hospital in Hong Kong. 64 pregnant Chinese women were recruited for intervention and 59 were for control. Outcome measures were cord blood cortisol, infant salivary cortisol, and Carey Infant Temperament Questionnaire. Cord blood cortisol level of babies was higher in the intervention group (pmeditation can influence fetal health. Carey Infant Temperament Questionnaire showed that the infants of intervention group have better temperament (pmeditation in relation to child health. Present study concludes the positive effects of prenatal meditation on infant behaviors and recommends that pregnancy care providers should provide prenatal meditation to pregnant women.

  16. Averaged Electroencephalic Audiometry in Infants

    Science.gov (United States)

    Lentz, William E.; McCandless, Geary A.

    1971-01-01

    Normal, preterm, and high-risk infants were tested at 1, 3, 6, and 12 months of age using averaged electroencephalic audiometry (AEA) to determine the usefulness of AEA as a measurement technique for assessing auditory acuity in infants, and to delineate some of the procedural and technical problems often encountered. (KW)

  17. Selectivity in Infant Social Referencing

    Science.gov (United States)

    Stenberg, Gunilla

    2009-01-01

    In laboratory studies of social referencing, infants as young as 12 months have been reported to prefer looking at the experimenter over the caregiver for clarifying information. From an expertise perspective, such behavior could be interpreted as if the infant seeks information from others and can discriminate between persons who have or do not…

  18. Learning and Memory in Infants.

    Science.gov (United States)

    Lipsitt, Lewis P.

    1990-01-01

    Discusses important recent strides in the documentation and understanding of the infant's learning and memory capacity. Focuses on the psychobiology of learning, hedonic mediation of approach-avoidance and learned behavior, infant memory, and critical conditions of infancy and behavioral misadventures. (RJC)

  19. Recovery of Habituation in Infants

    Science.gov (United States)

    Pancratz, Charity N.; Cohen, Leslie B.

    1970-01-01

    Male infants habituated their fixation time over trials and differentiated between the novel and familiar stimuli when the posthabituation interval was 15 seconds, but neither male nor female infants did so when the interval was 5 minutes. This paper is based upon a thesis submitted by the first author in partial fulfillment of the requirements…

  20. Determinants of Infant Behaviour IV.

    Science.gov (United States)

    Foss, B. M., Ed.

    This volume consists of reports of individual studies and surveys of research work on mother-infant interactions. It is divided into two parts. The first section presents a wide range of studies on mother-infant relations as exhibited in the behavior of animals. The second part, concerning human behavior, includes studies on the natural history of…