Social causes of low birth weight.

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Kogan, M D

1995-01-01

The manifest importance of reducing the incidence of low birth weight is most obvious for the first year of life: low birth weight is the single most important factor affecting infant morbidity and mortality. However, there is growing evidence that the adverse consequences of low birth weight continue throughout the life cycle. This review deals primarily with social causes of low birth weight.

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

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

2017-03-01

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

Correlates of Low Birth Weight

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Ankur Barua MD, PhD

2014-12-01

Full Text Available Background. Low birth weight is the single most important factor that determines the chances of child survival. A recent annual estimation indicated that nearly 8 million infants are born with low birth weight in India. The infant mortality rate is about 20 times greater for all low birth weight babies. Methods. A matched case–control study was conducted on 130 low birth weight babies and 130 controls for 12 months (from August 1, 2007, to July 31, 2008 at the Central Referral Hospital, Tadong, East District of Sikkim, India. Data were analyzed using the Statistical Package for Social Sciences, version 10.0 for Windows. Chi-square test and multiple logistic regression were applied. A P value less than .05 was considered as significant. Results. In the first phase of this study, 711 newborn babies, borne by 680 mothers, were screened at the Central Referral Hospital of Sikkim during the 1-year study period, and the proportion of low birth weight babies was determined to be 130 (18.3%. Conclusion. Multiple logistic regression analysis, conducted in the second phase, revealed that low or middle socioeconomic status, maternal underweight, twin pregnancy, previous history of delivery of low birth weight babies, smoking and consumption of alcohol during pregnancy, and congenital anomalies had independent significant association with low birth weight in this study population.

Risk Factors for the Development of Refeeding Syndrome-Like Hypophosphatemia in Very Low Birth Weight Infants.

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Igarashi, Aiko; Okuno, Takashi; Ohta, Genrei; Tokuriki, Shuko; Ohshima, Yusei

2017-01-01

Refeeding syndrome is characterized by metabolic disturbance including hypophosphatemia and hypokalemia upon reinstitution of nutrition in severely malnourished patients. The present study sought to identify the risk factors for the development of refeeding syndrome-like metabolic disturbance in very low birth weight infants. The correlations of severe hypophosphatemia with the serum levels of potassium and ionized calcium, daily calorie and phosphate intake, and umbilical cord blood flow on ultrasonography were analyzed in 49 very low birth weight infants. Fifteen infants (36%) presented with hypophosphatemia during the first postnatal week. Hypophosphatemia was significantly associated with birth weight z score (odds ratio, 1.60; 95% confidence interval, 1.04-2.47; p = 0.034) and umbilical artery resistance index (odds ratio, 7.72 E -04; 95% confidence interval, 1.14 E -06-0.523; p = 0.031). Multiple regression analysis revealed that umbilical artery resistance index was independently associated with hypophosphatemia. Umbilical artery resistance index may serve as a useful marker for future development of refeeding syndrome-like hypophosphatemia in very low birth weight infants. Close monitoring of serum phosphorus and potassium levels and early intervention are important for the management of very low birth weight infants with intrauterine growth restriction due to placental dysfunction.

Risk Factors for the Development of Refeeding Syndrome-Like Hypophosphatemia in Very Low Birth Weight Infants

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Aiko Igarashi

2017-01-01

Full Text Available Background. Refeeding syndrome is characterized by metabolic disturbance including hypophosphatemia and hypokalemia upon reinstitution of nutrition in severely malnourished patients. Objective. The present study sought to identify the risk factors for the development of refeeding syndrome-like metabolic disturbance in very low birth weight infants. Methods. The correlations of severe hypophosphatemia with the serum levels of potassium and ionized calcium, daily calorie and phosphate intake, and umbilical cord blood flow on ultrasonography were analyzed in 49 very low birth weight infants. Results. Fifteen infants (36% presented with hypophosphatemia during the first postnatal week. Hypophosphatemia was significantly associated with birth weight z score (odds ratio, 1.60; 95% confidence interval, 1.04–2.47; p=0.034 and umbilical artery resistance index (odds ratio, 7.72E−04; 95% confidence interval, 1.14E−06–0.523; p=0.031. Multiple regression analysis revealed that umbilical artery resistance index was independently associated with hypophosphatemia. Conclusions. Umbilical artery resistance index may serve as a useful marker for future development of refeeding syndrome-like hypophosphatemia in very low birth weight infants. Close monitoring of serum phosphorus and potassium levels and early intervention are important for the management of very low birth weight infants with intrauterine growth restriction due to placental dysfunction.

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

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

2007-04-01

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

Prospective Analysis of Pulmonary Hypertension in Extremely Low Birth Weight Infants

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

2012-01-01

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

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

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Shoboo Rahmati

2017-08-01

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

Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation.

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Wyckoff, Myra H; Salhab, Walid A; Heyne, Roy J; Kendrick, Douglas E; Stoll, Barbara J; Laptook, Abbot R

2012-02-01

To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants. We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index blindness, or deafness). Data are adjusted ORs with 95% CIs. Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708±141 g versus 764±146g, PCPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population. Copyright © 2012 Mosby, Inc. All rights reserved.

Glycerin Suppositories Use in Very Low Birth Weight Infants.

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

2017-01-01

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

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

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Sepideh Nazi

2012-10-01

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

The temperament of pre-term, low birth weight infants and its potential biological substrates.

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Weiss, Sandra J; Jonn-Seed, Mary St; Wilson, Peggy

2004-12-01

Temperament profiles of pre-term, low birth weight (LBW) infants were assessed at 6 months of age using standardized norms from the Revised Infant Temperament Questionnaire (RITQ). The contributions of perinatal risk, ethnicity, and gender to various temperament dimensions were examined. The sample included 152 infants with a mean birth weight of 1687 g and a mean gestational age of 31 weeks. Eighty percent of the infants were classified as having temperaments that were difficult to manage. Irregularity of the infants' biorhythms, slowness in their ability to adapt to changes, and distractibility were the most problematic. Birth weight, gestational age, and gender were not associated with temperament. Perinatal morbidity was related to the temperament dimension of infant persistence, with implications for the infant's attention span and task performance. Euro American infants were rated as more persistent and less intense in emotional expression than were infants of other ethnic groups. Results suggest the need for a more direct assessment of the effects of neurobiological processes on development of temperament phenotypes and for measurement of temperament that is socioculturally appropriate.

Failure of erythromycin to eliminate airway colonization with ureaplasma urealyticum in very low birth weight infants

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Kruger Thomas E

2003-09-01

Full Text Available Abstract Background Airway colonization of mechanically ventilated very low birth weight infants (birth weight Ureaplasma urealyticum (Uu is associated with an increased risk of bronchopulmonary dysplasia (BPD. While Uu is sensitive to erythromycin in vitro, the efficacy of intravenous (IV erythromycin to eliminate Uu from the airways has not been studied. Methods 17 very low birth weight infants with Uu positive tracheal aspirate (TA cultures were randomized to either 5 (8 infants or 10 days (9 infants of IV erythromycin lactobionate (40 mg/kg/day in 3 divided doses. Tracheal aspirate cultures for Uu were performed on days 0, 5, 10 and 15. Results Intravenous erythromycin failed to eliminate airway colonization in a large proportion of infants regardless of whether they received 5 or 10 days of treatment. Ureaplasma urealyticum was isolated from 4/15 (27% of TAs obtained at 5 days, 5/12 TAs (42% obtained at 10 days and 6/11(55% TAs obtained at 15 days (combined group data. Conclusions Erythromycin administered IV does not eliminate Uu from the airways in a large proportion of infants. Failure of erythromycin to eliminate Uu from the airways may contribute to the lack of efficacy of this drug in reducing the incidence of BPD in very low birth weight infants.

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

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Regina Coeli Azeredo Cardoso

2013-09-01

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

Ethical issues related to caring for low birth weight infants.

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

2014-09-01

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

Does gender affect neonatal hyperbilirubinemia in low-birth-weight infants?

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Tioseco, Jennifer A; Aly, Hany; Milner, Josh; Patel, Kantilal; El-Mohandes, Ayman A E

2005-03-01

Neonatal mortality and morbidity are gender-biased in low-birth-weight (LBW) infants. The male disadvantage theory has been suggested to be responsible for these maturational differences. To examine the impact of gender on neonatal hyperbilirubinemia. A retrospective observational study. Data on all LBW infants admitted to George Washington University neonatal intensive care unit and surviving for >48 hrs from January 1992 to March 2003 were analyzed. Males and females were compared for gestational age, birth weight, race, Apgar scores at 1 and 5 mins, peak bilirubin levels, sepsis, and intraventricular hemorrhage (IVH). Significant differences were entered in a regression model to detect the influence of gender on bilirubin (Bili). Analysis was repeated after stratification of infants into: group A, <1000 g; group B, 1000-1499 g; and group C, 1500-2499 g. A total of 840 infants were included in this study. When comparing males (n = 407) with females (n = 433), significant differences were detected in birth weight (1,539 +/- 541 vs. 1,428 +/- 549 g; p = .003), IVH (14.2% vs. 9%; p = .025), and Bili (10.1 +/- 3.0 vs. 9.2 +/- 2.8 mg%; p < .001). No differences were detected in gestational age, sepsis, or Apgar 1 and 5. Difference in Bili for the entire group remained significant in the regression model (regression coefficient [RC] = 0.79 +/- 0.22; p < .001). In subgroup analyses: group A Bili (8.4 +/- 2.3 vs. 8.0 +/- 2.0; p = .14) and group B Bili (9.0 +/- 2.1 vs. 9.2 +/- 2.2; p = .51) did not differ in bivariate or multivariate analyses. In group C, Bili was (11.3 +/- 3.1 vs. 10.1 +/- 3.3; p < .001) and remained the only significant difference in the regression model (RC = 1.19 +/- 0.37; p = .001). Bili in LBW infants is significantly higher in males when compared with females. After stratification to birth weight subgroups, significance is retained in the 1500- to 2499-g group after logistic regression analysis. Bili levels in infants <1500 g are influenced more

Incidence and severity of stage IV bronchopulmonary dysplasia in infants of very low birth weight

International Nuclear Information System (INIS)

Parker, B.R.; Stevens, S.K.; Northway, W.H.

1989-01-01

To evaluate the incidence and severity of stage IV bronchopulmonary dysplasia (BPD) in infants of very low birth weight, the authors reviewed the clinical course and chest radiographs of 138 such infants. In the lowest weight group ( 1500 g, 10%). However, the severity of BPD (graded by the Toce-Edwards Scale) was highest (6.3) in the < 1500-g group (< 900 g, 5.4; 1200-1500 g, 5.9). These data showed that, although the incidence of stage IV BVD significantly decreased as birth weight increased, the severity of chronic changes was independent of birth weight

Joint Attention Development in Low-risk Very Low Birth Weight Infants at Around 18 Months of Age.

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Yamaoka, Noriko; Takada, Satoshi

2016-10-18

The purpose of this study was to clarify the developmental characteristics of joint attention in very low birth weight (VLBW) infants with a low risk of complications. Section B of the Checklist for Autism in Toddlers (CHAT) was administered to 31 VLBW and 45 normal birth weight (NBW) infants aged 18-22 months, while the sessions were recorded with a video camera. A semi-structured observation scale was developed to assess infants' joint attention from the video footage, and was shown to be reliable. VLBW, compared to NBW, infants showed significantly poorer skills in 2 of 4 items on responding to joint attention, and in 6 of 10 items on initiating joint attention. VLBW infants need more clues in order to produce joint attention. The difficulty was attributed to insufficient verbal and fine motor function skills. Continuous follow-up evaluation is essential for both high-risk and low-risk VLBW infants and their parents.

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

African Journals Online (AJOL)

Low birth weight (LBW) and fetal anaemia (FA) are common in malaria endemic areas. To investigate the ... In sub-Saharan Africa, infant morbidity and mortality are excessively high and reductions in mortality rates .... lower respiratory infection for children under two months of age, for older infants, a cut-off value of 50 per ...

Developmental outcome of very low birth weight infants in a developing country

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Ballot Daynia E

2012-02-01

Full Text Available Abstract Background Advances in neonatal care allow survival of extremely premature infants, who are at risk of handicap. Neurodevelopmental follow up of these infants is an essential part of ongoing evaluation of neonatal care. The neonatal care in resource limited developing countries is very different to that in first world settings. Follow up data from developing countries is essential; it is not appropriate to extrapolate data from units in developed countries. This study provides follow up data on a population of very low birth weight (VLBW infants in Johannesburg, South Africa. Methods The study sample included all VLBW infants born between 01/06/2006 and 28/02/2007 and discharged from the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH. Bayley Scales of Infant and Toddler Development Version 111 (BSID 111 were done to assess development. Regression analysis was done to determine factors associated with poor outcome. Results 178 infants were discharged, 26 were not available for follow up, 9 of the remaining 152 (5.9% died before an assessment was done; 106 of the remaining 143 (74.1% had a BSID 111 assessment. These 106 patients form the study sample; mean birth weight and mean gestational age was 1182 grams (SD: 197.78 and 30.81 weeks (SD: 2.67 respectively. The BSID (111 was done at a median age of 16.48 months. The mean cognitive subscale was 88.6 (95% CI: 85.69 - 91.59, 9 (8.5% were Conclusion Although the neurodevelopmental outcome of this group of VLBW infants was within the normal range, with a low incidence of cerebral palsy, these results may reflect the low survival of babies with a birth weight below 900 grams. In addition, mean subscale scores were low and one third of the babies were identified as "at risk", indicating that this group of babies warrants long-term follow up into school going age.

Early nCPAP versus intubation in very low birth weight infants

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Pedro Neves Tavares

2013-06-01

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

Birth weight trends among interracial black and white infants.

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Parker, J D

2000-05-01

I examined time trends in low birth weight (LBW) and very low birth weight (VLBW) among interracial compared with single-race infants. Using natality data from 1978 through 1997 for singleton births to black and white parents, I calculated relative risks (RRs) of LBW and VLBW for interracial compared with single-race births, stratified by maternal race and adjusted for maternal characteristics. Among black mothers, interracial births had lower risks of LBW and VLBW than single-race births, and RRs were similar throughout the time period [for example, adjusted RR = 0.76 and 95% confidence interval (CI) = 0.73-0.80 for LBW in 1994-1997]. Among white mothers, interracial infants had higher risks of LBW than single-race infants; however, the adjusted RRs declined over the time period, from 1.22 (95% CI = 1.19-1.27) in 1978-1981 to 1.05 (95% CI = 1.03-1.08) in 1994-1997. Since 1978, there has been some relative improvement in birth outcomes for infants of white mothers and black fathers compared with single-race white births. There was, however, no relative improvement for black mother/black father infants relative to black mother/white father births.

Sharing the science on human milk feedings with mothers of very-low-birth-weight infants.

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Rodriguez, Nancy A; Miracle, Donna J; Meier, Paula P

2005-01-01

Mother's milk provides protection from serious and costly morbidity for very-low-birth-weight infants (nosocomial infection, and necrotizing enterocolitis. However, NICU and maternity nurses may be hesitant to encourage mothers to initiate lactation because of a reluctance to make mothers feel guilty or coerced. This article reviews the evidence for the health outcomes of mothers' milk feeding in very-low-birth-weight infants and provides examples of ways to share this science with mothers so that they can make an informed feeding decision.

Increasing low birth weight rates: deliveries in a tertiary hospital in istanbul.

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Akin, Yasemin; Cömert, Serdar; Turan, Cem; Unal, Orhan; Piçak, Abdülkadir; Ger, Lale; Telatar, Berrin

2010-09-01

Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth weight and stillbirth deliveries were determined. Among 19,533 total births, there were 450 (23.04 per 1000) stillbirths. Low birth weight rate was 10.61%. A significant increase in yearly distribution of low birth weight deliveries was observed (Pbirth weight and extremely low birth weight delivery rates were 3.14% and 1.58% respectively. Among 2073 low birth weight infants, 333 (16.06%) were stillbirths. The stillbirth delivery rate and the birth of a female infant among low birth weight deliveries were significantly higher than infants with birth weight ≥2500g (Pbirth weight and maternal age. The rate of cesarean section among low birth weight infants was 49.4%. High low birth weight and stillbirth rates, as well as the increase in low birth weight deliveries over the past five years in this study are striking. For reduction of increased low birth weight rates, appropriate intervention methods should be initiated.

Non-nutritive sucking for gastro-oesophageal reflux disease in preterm and low birth weight infants.

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Psaila, Kim; Foster, Jann P; Richards, Robyn; Jeffery, Heather E

2014-10-15

Gastro-oesophageal reflux (GOR) is commonly diagnosed in the neonatal population (DiPietro 1994), and generally causes few or no symptoms (Vandenplas 2009). Conversely, gastro-oesophageal reflux disease (GORD) refers to GOR that causes troublesome symptoms with or without complications such as damage to the oesophagus (Vandenplas 2009). Currently there is no evidence to support the range of measures recommended to help alleviate acid reflux experienced by infants. Non-nutritive sucking (NNS) has been used as an intervention to modulate neonatal state behaviours through its pacifying effects such as decrease infant fussiness and crying during feeds (Boiron 2007; Pickler 2004). To determine if NNS reduces GORD in preterm infants (less than 37 weeks' gestation) and low birth weight (less than 2500 g) infants, three months of age and less, with signs or symptoms suggestive of GORD, or infants with a diagnosis of GORD. We performed computerised searches of the electronic databases of the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 9, 2013), MEDLINE (1966 to September 2013), CINAHL (1982 to September 2013), and EMBASE (1988 to September 2013). We applied no language restrictions. Controlled trials using random or quasi-random allocation of preterm infants (less than 37 weeks' gestation) and low birth weight (less than 2500 g) infants three months of age and less with signs or symptoms suggestive of GORD, or infants with a diagnosis of GORD. We included studies reported only by abstracts, and cluster and cross-over randomised trials. Two review authors independently reviewed and selected trials from searches, assessed and rated study quality and extracted relevant data. We identified two studies from the initial search. After further review, we excluded both studies. We identified no studies examining the effects of NNS for GORD in preterm and low birth weight infants There was insufficient evidence to determine the effectiveness of NNS for GORD

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

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Rodrigo L. Lindenmeyer

2012-11-01

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

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

DEFF Research Database (Denmark)

Reinholdt, Jes; Veiergang, Gitte

2012-01-01

Background: Infants with extremely low birth weight uniformly develop anemia of prematurity and frequently require red blood cell transfusions (RBCTs). Although RBCT is widely practiced, the indications remain controversial in the absence of conclusive data on the long-term effects of RBCT....... Objectives: To summarize the current equipoise and to outline the study protocol of the 'Effects of Transfusion Thresholds on Neurocognitive Outcome of extremely low birth-weight infants (ETTNO)' study. Methods: Review of the literature and design of a large pragmatic randomized controlled trial...... of restrictive versus liberal RBCT guidelines enrolling 920 infants with birth weights of 400-999 g with long-term neurodevelopmental follow-up. Results and Conclusions: The results of ETTNO will provide definite data about the efficacy and safety of restrictive versus liberal RBCT guidelines in very preterm...

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

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Dessie Wanda

2017-01-01

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

Guidelines for Feeding Very Low Birth Weight Infants

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Sourabh Dutta

2015-01-01

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

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

NARCIS (Netherlands)

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

2011-01-01

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

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.

Recombinant Erythropoietin And Blood Transfusion In Very Low Birth Weight Infants

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Keramat Nouri

2005-05-01

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

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

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

2015-10-01

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

Maternal socioeconomic status and infant mortality with low birth weight as a mediator: an inter-country comparison between Scotland and Denmark using administrative data

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Yongfu Yu

2017-04-01

Our result suggests that SES has similar effects on infant mortality in Denmark and Scotland but more of the effect of SES on infant mortality is mediated through low birth weight in Denmark. Public health preventive strategies for infant mortality in both countries need to address prenatal risk factors for low birth weight. The substantial direct effects of SES on infant mortality seen in Scotland, which were not mediated through low birth weight, may be explained by other birth characteristics or could reflect persisting SES disparities in the care of infants after birth.

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

OpenAIRE

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

2009-01-01

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

Low birth weight in relation to maternal age and multiple ...

African Journals Online (AJOL)

Vihar

Objectives: To determine the relationship between Low Birth Weight (LBW), maternal age and multiple ... mothers. Low socio-economic status is the underlying ... rate of low birth weight infants. ... Table 3: Distribution of Age against Birth weight.

Neonatal sepsis as a risk factor for neurodevelopmental changes in preterm infants with very low birth weight.

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Ferreira, Rachel C; Mello, Rosane R; Silva, Kátia S

2014-01-01

to evaluate neonatal sepsis as a risk factor for abnormal neuromotor and cognitive development in very low birth weight preterm infants at 12 months of corrected age. this was a prospective cohort study that followed the neuromotor and cognitive development of 194 very low birth weight preterm infants discharged from a public neonatal intensive care unit. The Bayley Scale of Infant Development (second edition) at 12 months of corrected age was used. The outcomes were the results of the clinical/neurological evaluation and the scores of the psychomotor development index (PDI) and mental development index (MDI) of the Bayley Scale of Infant Development II. The association between neonatal sepsis and neuromotor development and between neonatal sepsis and cognitive development was verified by logistic regression analysis. mean birth weight was 1,119g (SD: 247) and mean gestational age was 29 weeks and 6 days (SD: 2). Approximately 44.3%(n=86) of the infants had neonatal sepsis and 40.7% (n=79) had abnormal neuromotor development and/or abnormal psychomotor development index (PDI de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

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

African Journals Online (AJOL)

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

Servo-control for maintaining abdominal skin temperature at 36C in low birth weight infants.

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Sinclair, J C

2002-01-01

Randomized trials have shown that the neonatal mortality rate of low birth-weight babies can be reduced by keeping them warm. For low birth-weight babies nursed in incubators, warm conditions may be achieved either by heating the air to a desired temperature, or by servo-controlling the baby's body temperature at a desired set-point. In low birth weight infants, to determine the effect on death and other important clinical outcomes of targeting body temperature rather than air temperature as the end-point of control of incubator heating. Standard search strategy of the Cochrane Neonatal Review Group. Searches were made of the Cochrane Controlled Trials Register (CCTR) (Cochrane Library, Issue 4, 2001) and MEDLINE, 1966 to November 2001. Randomized or quasi-randomized trials which test the effects of having the heat output of the incubator servo-controlled from body temperature compared with setting a constant incubator air temperature. Trial methodologic quality was systematically assessed. Outcome measures included death, timing of death, cause of death, and other clinical outcomes. Categorical outcomes were analyzed using relative risk and risk difference. Meta-analysis assumed a fixed effect model. Two eligible trials were found. In total, they included 283 babies and 112 deaths. Compared to setting a constant incubator air temperature of 31.8C, servo-control of abdominal skin temperature at 36C reduces the neonatal death rate among low birth weight infants: relative risk 0.72 (95% CI 0.54, 0.97); risk difference -12.7% (95% CI -1.6, -23.9). This effect is even greater among VLBW infants. During at least the first week after birth, low birth weight babies should be provided with a carefully regulated thermal environment that is near the thermoneutral point. For LBW babies in incubators, this can be achieved by adjusting incubator temperature to maintain an anterior abdominal skin temperature of at least 36C, using either servo-control or frequent manual

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

Science.gov (United States)

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

Trends in Patent Ductus Arteriosus Diagnosis and Management for Very Low Birth Weight Infants.

Science.gov (United States)

Ngo, Samantha; Profit, Jochen; Gould, Jeffrey B; Lee, Henry C

2017-04-01

To examine yearly trends of patent ductus arteriosus (PDA) diagnosis and treatment in very low birth weight infants. In this retrospective cohort study of very low birth weight infants (<1500 g) between 2008 and 2014 across 134 California hospitals, we evaluated PDA diagnosis and treatment by year of birth. Infants were either inborn or transferred in within 2 days after delivery and had no congenital abnormalities. Intervention levels for treatment administered to achieve ductal closure were categorized as none, pharmacologic (indomethacin or ibuprofen), both pharmacologic intervention and surgical ligation, or ligation only. Multivariable logistic regression was used to assess risk factors for PDA diagnosis and treatment. PDA was diagnosed in 42.8% (12 002/28 025) of infants, with a decrease in incidence from 49.2% of 4205 infants born in 2008 to 38.5% of 4001 infants born in 2014. Pharmacologic and/or surgical treatment was given to 30.5% of patients. Between 2008 and 2014, the annual rate of infants who received pharmacologic intervention (30.5% vs 15.7%) or both pharmacologic intervention and surgical ligation (6.9% vs 2.9%) decreased whereas infants who were not treated (60.5% vs 78.3%) or received primary ligation (2.2% vs 3.0%) increased. There is an increasing trend toward not treating patients diagnosed with PDA compared with more intensive treatments: pharmacologic intervention or both pharmacologic intervention and surgical ligation. Possible directions for future study include the impact of these trends on hospital-based and long-term outcomes. Copyright © 2017 by the American Academy of Pediatrics.

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

Science.gov (United States)

Groothuis, Jessie R; Makari, Doris

2012-04-01

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

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

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Maroun J. Mhanna

2017-12-01

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

Low birth weight in the United States.

Science.gov (United States)

Goldenberg, Robert L; Culhane, Jennifer F

2007-02-01

Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.

Small volume transfusion of irradiated red blood cells using satellite bags in very low birth weight infants

International Nuclear Information System (INIS)

Yamagiwa, Kazuhiro; Honda, Yoshinobu; Sakuma, Kimiko; Igarashi, Etsuo; Watanabe, Masahiko; Ujiie, Niro; Suzuki, Hitoshi; Ohto, Hitoshi

1993-01-01

We have treated anemia of prematurity with concentrated red cells divided into 3 packs by using the Sterile Connection Device (SCD, USA). This study was performed to reveal the influence for very low birth weight infants of transfusion of red cells stored after irradiation. The following facts were observed in infants after transfusion: (1) no change in sodium and potassium level and leucocyte count, (2) increased amount of total bilirubin but no change in unbound bilirubin level, (3) decrease in platelet count less than 50,000/mm 3 . According to these results we conclude that the transfusion of concentrated red blood cells stored within 2 weeks after irradiation was safe even for very low birth weight infants. (author)

Surgical Ligation of Patent Ductus Arteriosus in Very-low-birth-weight Premature Infants in the Neonatal Intensive Care Unit

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Yu-Chen Ko

2009-01-01

Full Text Available This study reported our experience of bedside patent ductus arteriosus (PDA ligation for prematurity in the neonatal intensive care unit (NICU. Between April 1992 and March 2006, 41 very-low-birth-weight premature infants underwent PDA ligation in the NICU. There were 18 male and 23 female infants. The mean gestational age and birth weight were 26.9 weeks and 900.9 g, respectively. Preoperatively, 25 infants were ventilator-dependent. After operation, there were five deaths caused by complications of prematurity. Surgical complications occurred in four and all recovered well after treatment. Twenty preoperatively intubated babies survived and were extubated at 21.6 ± 12.7 days postoperatively. In conclusion, bedside PDA ligation in the NICU is safe and effective. It can avoid transportation of critically ill, very small infants. We suggest surgical closure as the primary treatment in very-low-birth-weight infants who are ventilator-dependent to avoid the possible complications of indomethacin and prolonged intubation.

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

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Elin W. Blakstad

2016-12-01

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

Continuous versus bolus intragastric tube feeding for preterm and low birth weight infants with gastro-oesophageal reflux disease.

Science.gov (United States)

Richards, Robyn; Foster, Jann P; Psaila, Kim

2014-07-17

Gastro-oesophageal reflux disease is a particularly common condition in preterm and low birth weight infants. These infants are also more likely to have excessive regurgitation, as they do not have a fully developed antireflux mechanism. Preterm and low birth weight infants who are unable to suck oral feeds are required to be fed via an intragastric tube for varying lengths of time. Intragastric tube feeding can be delivered by the intermittent bolus or continuous feeding method. Use of continuous or intermittent bolus intragastric feeding may have a positive or negative effect on the incidence or severity of gastro-oesophageal reflux disease. To determine whether continuous or intermittent bolus intragastric tube feeding reduces the number of episodes and the duration of gastro-oesophageal reflux disease (GORD) in preterm and low birth weight infants.We intended to perform subgroup analyses for gestational age; birth weight; age in days from birth at full enteral feeding via intragastric tube (breast vs bottle); frequency of intermittent bolus feed; and type of medication for treatment of GORD (only if medication prescribed and given similarly to both intervention groups). We used the standard search strategy of the Cochrane Neonatal Group as described in The Cochrane Library (www.thecochranelibrary.com) to search for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE (1966 to September 2013), EMBASE (1980 to September 2013) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to September 2013). We also searched previous reviews, including cross-references, abstracts and conference and symposia proceedings of the Perinatal Society of Australia and New Zealand and the Pediatric Academic Societies (American Pediatric Society/Society for Pediatric Research and European Society for Paediatric Research) from 1990 to 2012. Published and unpublished RCTs and quasi

Influence of aggressive nutritional support on growth and development of very low birth weight infants.

Science.gov (United States)

Xu, Y M; Zhu, X P; Xiao, Z; Yu, L; Zhao, X

2014-01-01

To investigate the influence of the early postnatal aggressive nutritional support on the very low birth weight infants (VLBWI) during hospitalization. Surviving premature infants without obvious deformity, with gestational age more than 28 weeks and less than 32 weeks, birth weight 1,000 g to 1,500 g, admitted in NICU in Affiliated Children's Hospital of Suzhou University during 12 hours after birth and stay for two weeks or more from January 2008 to December 2011 were selected, including 44 cases (admitted from September 2010 to December 2011) in the observation group and 36 cases in the control group (admitted from January 2008 and September 2010). The infants in the observation group were treated by aggressive nutritional management, while traditional nutritional management for infants in the control group. The variations of nutritional intake, weight gain, jaundice index, blood biochemistry, serum electrolytes indexes, and complications were compared between the two groups. Compared to the control group, the average growth rate and the albumin (ALB) and prealbumin (PA) levels two week after birth and before leaving hospital of the infants in the observation group was significantly higher (p nutrition, liver function, blood lipid levels, blood glucose, blood PH, serum creatinine, urea nitrogen, and electrolytes of the first day and the seventh day after birth and the in- cidence of parenteral nutrition-associated cholestasis (PNAC) and necrotizing enterocolitis (NEC) between the two group had no difference (p > 0.05). The implementation of aggressive nutritional management on the with VLBWI was safe and effective.

[Effect of extensively hydrolyzed formula on growth and development of infants with very/extremely low birth weight].

Science.gov (United States)

Gu, Chun-Yan; Jiang, Hui-Fen; Wang, Jin-Xiu

2017-08-01

To study the effect of extensively hydrolyzed formula on the growth and development in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. A total of 375 VLBW or ELBW infants were enrolled and divided into an observation group (187 infants) and a control group (188 infants) using a random number table. The infants in the observation group were given extensively hydrolyzed formula, and when the amount of extensively hydrolyzed formula reached 10 mL/time, it was changed to the standard formula for preterm infants. The infants in the control group were given standard formula for preterm infants. Both groups were fed for 4 consecutive weeks and were compared in terms of incidence rate of feeding intolerance, time to establish full enteral feeding, time to complete meconium excretion, number of spontaneous bowel movements, growth and development, motilin level at 4 and 10 days after feeding, and incidence rate of infection. Compared with the control group, the observation group had a lower rate of feeding intolerance (Pdevelopment, and reduce the incidence of infection in VLBW and ELBW infants.

Black/white differences in very low birth weight neonatal mortality rates among New York City hospitals.

Science.gov (United States)

Howell, Elizabeth A; Hebert, Paul; Chatterjee, Samprit; Kleinman, Lawrence C; Chassin, Mark R

2008-03-01

We sought to determine whether differences in the hospitals at which black and white infants are born contribute to black/white disparities in very low birth weight neonatal mortality rates in New York City. We performed a population-based cohort study using New York City vital statistics records on all live births and deaths of infants weighing 500 to 1499 g who were born in 45 hospitals between January 1, 1996, and December 31, 2001 (N = 11 781). We measured very low birth weight risk-adjusted neonatal mortality rates for each New York City hospital and assessed differences in the distributions of non-Hispanic black and non-Hispanic white very low birth weight births among these hospitals. Risk-adjusted neonatal mortality rates for very low birth weight infants in New York City hospitals ranged from 9.6 to 27.2 deaths per 1000 births. White very low birth weight infants were more likely to be born in the lowest mortality tertile of hospitals (49%), compared with black very low birth weight infants (29%). We estimated that, if black women delivered in the same hospitals as white women, then black very low birth weight mortality rates would be reduced by 6.7 deaths per 1000 very low birth weight births, removing 34.5% of the black/white disparity in very low birth weight neonatal mortality rates in New York City. Volume of very low birth weight deliveries was modestly associated with very low birth weight mortality rates but explained little of the racial disparity. Black very low birth weight infants more likely to be born in New York City hospitals with higher risk-adjusted neonatal mortality rates than were very low birth weight infants, contributing substantially to black-white disparities.

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

Science.gov (United States)

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

2015-01-01

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

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

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Thayana Regina de Souza Grance

2015-03-01

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

Management and outcome of extremely low birth weight infants

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Apostolos Papageorgiou

2014-06-01

Full Text Available Survival of extremely low birth weight (ELBW and extremely premature (EP infants has shown consistent improvement thanks to advances and innovations in perinatal and neonatal care. Regionalization, with high-risk deliveries in a tertiary perinatal center, offers the coordinated, collaborative, expert and specialized care needed by these mothers and their infants. Despite decreasing rates of the major neonatal morbidities observed in recent years, these continue still to be significant for ELBW/EP infants, impacting their overall prognosis. After NICU discharge and in the first years of life, issues with health, growth and development are common. In school age and adolescence, problems with behavior, socialization and cognition are prevalent. Adult outcomes of ELBW/EP need further clarity, emphasizing the importance for consistent long-term follow-up for this special cohort. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

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

Science.gov (United States)

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

2016-03-29

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

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Effects of infants' birth order, maternal age, and socio-economic status on birth weight.

Science.gov (United States)

Ghaemmaghami, Seyed J; Nikniaz, Leila; Mahdavi, Reza; Nikniaz, Zeinab; Razmifard, Farzad; Afsharnia, Farzaneh

2013-09-01

To determine the effects of infants' birth order, maternal age, and socioeconomic status (SES) on birth weight. This cross-sectional study included a sample of 858 mothers recruited over a 6-month period in 2010, in a defined population of 9 urban health centers, and who were admitted for their infants' first vaccination. Maternal clinical data, demographic data, and infants' birth weight were obtained from the interview and maternal hospital files. Multiple regression and analysis of variance were used for data analysis. First and fourth births had lower birth weights compared with second and third births in all maternal ages in controlling parity, birth weight increases with maternal age up to the early 24, and then tends to level off. Male gender, maternal age 20-24 years, second and third births had a significant positive effect on birth weight. Lower family economic status and higher educational attainment were significantly associated with lower birth weight. For women in the 15-19 and 40-44 years age groups, the second birth order was associated with the most undesirable effect on birth weight. Accessibility of health care services, parity, maternal age, and socioeconomic factors are strongly associated with infants' birth weight.

Preterm birth, infant weight gain, and childhood asthma risk

DEFF Research Database (Denmark)

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

2014-01-01

BACKGROUND: Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. OBJECTIVES: We performed an individual participant data meta-analysis for 147,252 children of 31...

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.

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

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

NARCIS (Netherlands)

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

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

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

International Nuclear Information System (INIS)

Badiee, Z.

2007-01-01

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

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

Science.gov (United States)

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

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

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

DEFF Research Database (Denmark)

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

2015-01-01

Necrotizing enterocolitis (NEC) is a critical intestinal emergency condition, which mainly occurs in preterm very low birth weight (PVLBW) infants. Despite remarkable advances in the care of PVLBW infants, with considerable improvement of the survival rate in recent decades, the incidence of NEC...

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

Science.gov (United States)

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

2018-02-01

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

Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia.

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Hung-Yang Chang

Full Text Available Neonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants.This retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5-37.5°C, mild hypothermia (36.0-36.4°C, moderate hypothermia (32.0-35.9°C, and severe hypothermia (< 32°C. We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.We studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02 and smaller birth weight (1004 g vs. 1187 g, P < .001 compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001, respiratory distress syndrome (RDS (58.0% vs. 39.2%, P = .006, and mortality (18.5% vs. 5.1%, P = .005. Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years' corrected age. Mild hypothermia had no effect on short-term or long-term outcomes.Admission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment.

Pneumoretroperitoneum and Perirenal Air Associated With Pneumothorax in an Extremely Low-Birth-Weight Infant

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Belma Saygili Karagol

2011-02-01

Full Text Available Pneumothorax-associated pneumoretroperitoneum and perirenal air have rarely been reported in infants. We report a case of an extremely low-birth-weight infant who developed pneumoretroperitoneum and perirenal air associated with tension pneumothorax and deteriorated acutely despite prompt pleural water-seal vacuum drainage system insertion. Our aim in presenting this case report is to emphasize keeping in mind that there could be extrapleural air leaks, such as pneumoretroperitoneum in patients with pneumothorax.

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

Science.gov (United States)

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

2015-10-01

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

Developmental outcome of low birth-weight and preterm newborns: a re-view of current evidence

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Farin Soleimani

2013-12-01

Full Text Available Low birth weight (LBW and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems. Global statistics demonstrates an increase in the prevalence of low birth weight in the developing countries. Low birth weight infants are exposed to complications such as major neurosensory impairements, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances. The majority of infant's death and developmental disorders were due to disorders relating to prematurity and unspecified low birth weight. Infants weighing less than 2500 g, is a major determinant of both neonatal and infant mortality rates and, together with congenital anomalies (e.g., cardiac, central nervous system, and respiratory, contributes significantly to childhood morbidity. Various studies indicate that low birth weight infants are suffering from physiological and psychosocial disabilities, two to three times more than the other children. At school age, preterm and low birth weight infants have poorer physical growth, cognitive function, and school performance. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Although the survival rates have increased dramatically and the incidence of morbidities has decreased, the complications are still considered to be associated with economical and social burdens. Most children with Low birth weight suffer from multiple disabilities. Therefore, they need special and consistent care. On demand of reducing the infant mortality rate, the need to decrease the complications in low birth weight and preterm infants should be considered by the policy makers in health care system. In this review article, we assessed current evidences on developmental outcomes of low birth weight and

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

Science.gov (United States)

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

2016-08-01

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

Associations between maternal hormonal biomarkers and maternal mental and physical health of very low birth weight infants

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June Cho

2016-12-01

Full Text Available The purpose of this study was to determine whether maternal mental and physical health is associated with maternal testosterone and cortisol levels, parenting of very low birth weight infants, physical exercise, and White vs non-White race. A total of 40 mothers of very low birth weight infants were recruited from a neonatal intensive care unit at a University Hospital in the Southeast United States. Data were collected through a review of medical records, standardized questionnaires, and biochemical measurement. Maternal mental and physical health status using questionnaires as well as maternal testosterone and cortisol levels using an enzyme immunoassay were measured four times (birth, 40 weeks postmenstrual age [PMA], and 6 and 12 months [age of infant, corrected age]. General linear models showed that higher testosterone levels were associated with greater depressive symptoms, stress, and poorer physical health at 40 weeks PMA, and at 6 and 12 months. High cortisol levels were associated with greater anxiety at 40 weeks PMA; however, with better mental and physical health at 40 weeks PMA, and 6 and 12 months. Physical activity was associated with lower maternal perceived stress at 12 months. Maternal health did not differ by race, except anxiety, which was higher in White than non-White mothers after birth. As very low birth weight infants grew up, maternal physical health improved but mental health deteriorated. Testosterone and cortisol levels were found to be positively correlated in women but testosterone was more predictive of maternal mental and physical health than cortisol. Indeed testosterone consistently showed its associations with maternal health. Maternal stress might be improved through regular physical exercise.

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

Science.gov (United States)

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

2016-06-01

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

Medical, nutritional, and dental considerations in children with low birth weight.

LENUS (Irish Health Repository)

O'Connell, Susan

2009-11-01

It is estimated that 8 to 26 percent of infants are born with low birth weight (LBW) worldwide. These children are at risk for medical problems in childhood and adulthood and often have poor oral health. The influence of fetal growth on birth weight and its relevance to childhood growth and future adult health is controversial. Evidence now indicates that the postnatal period is a critical time when nutrition may predispose the child to lifelong metabolic disturbance and obesity. Given the lack of consensus on optimum infant nutrition for LBW, premature, and small-for-gestational-age infants, many such infants may be suboptimally managed. This may result in rapid postnatal weight gain and ongoing health problems. The purpose of this review was to summarize medical terminology and issues related to fetal growth, morbidity associated with being born low birth weight, premature, or small for gestational age, and the importance of appropriate nutrition in such infants. Pediatric dentists can play an important role in supporting healthy feeding practices and improving long-term health in these children. Early integrated medical and dental care should be encouraged for all children with low birth weight.

Medical, nutritional, and dental considerations in children with low birth weight.

Science.gov (United States)

O'Connell, Susan; O'Connell, Anne; O'Mullane, Elaine; Hoey, Hilary

2009-01-01

It is estimated that 8 to 26 percent of infants are born with low birth weight (LBW) worldwide. These children are at risk for medical problems in childhood and adulthood and often have poor oral health. The influence of fetal growth on birth weight and its relevance to childhood growth and future adult health is controversial. Evidence now indicates that the postnatal period is a critical time when nutrition may predispose the child to lifelong metabolic disturbance and obesity. Given the lack of consensus on optimum infant nutrition for LBW, premature, and small-for-gestational-age infants, many such infants may be suboptimally managed. This may result in rapid postnatal weight gain and ongoing health problems. The purpose of this review was to summarize medical terminology and issues related to fetal growth, morbidity associated with being born low birth weight, premature, or small for gestational age, and the importance of appropriate nutrition in such infants. Pediatric dentists can play an important role in supporting healthy feeding practices and improving long-term health in these children. Early integrated medical and dental care should be encouraged for all children with low birth weight.

Association of Timing of Weight Gain in Pregnancy With Infant Birth Weight.

Science.gov (United States)

Retnakaran, Ravi; Wen, Shi Wu; Tan, Hongzhuan; Zhou, Shujin; Ye, Chang; Shen, Minxue; Smith, Graeme N; Walker, Mark C

2018-02-01

Gestational weight gain is a determinant of infant birth weight, but it is unclear whether its timing in pregnancy may hold implications in this regard. Previous studies have yielded conflicting findings on the association of maternal weight gain in early pregnancy with birth weight. However, as these studies have typically recruited women during the first trimester, they are inherently limited by a reliance on self-reported pregravid weight. To evaluate the associations of directly measured maternal pregravid weight and the timing of subsequent weight gain across pregnancy with infant birth weight. In this prospective, preconception, observational cohort study, 1164 newly married women in Liuyang, China, underwent pregravid evaluation at a median of 19.9 weeks before a singleton pregnancy during which they underwent serial weight measurements. The study was conducted from February 1, 2009, to November 4, 2015. Data analysis was performed between September 1, 2016, and May 6, 2017. Maternal weight gain was calculated for the following 10 gestational intervals: from pregravid to less than 14, 14 to 18, 19 to 23, 24 to 28, 29 to 30, 31 to 32, 33 to 34, 35 to 36, 37 to 38, and 39 to 40 weeks. Associations of pregravid weight and weight gain within each of the 10 gestational intervals with the outcome of infant birth weight. The mean (SD) age of the 1164 women included in the study was 25.3 (3.1) years. Pregravid weight was consistently associated with infant birth weight. However, among the 10 gestational intervals, only weight gain from pregravid to 14 weeks and from 14 to 18 weeks was associated with birth weight. Birth weight increased by 13.6 g/kg (95% CI, 3.2-24.1 g/kg) of maternal weight gain from pregravid to 14 weeks and by 26.1 g/kg (95% CI, 3.8-48.4 g/kg) of maternal weight gain from 14 to 18 weeks. Maternal weight only in the first half of gestation is a determinant of infant birth weight. Before pregnancy and early gestation may be a critical window for

Periventricular-intraventricular haemorrhage in low-birth-weight ...

African Journals Online (AJOL)

The prevalence of periventricular-intraventricular haemorrhage (PV-IVH) aInong very-low-birthweight infants at Baragwanath Hospital has not been well docwnented. In this prospective study, a total of 282 live-born infants with birth weights of 1 000 - 1 749 g were studied over a 41/2-month period. Every infant had at least ...

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

Energy Technology Data Exchange (ETDEWEB)

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

2007-12-15

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

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

International Nuclear Information System (INIS)

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

2007-01-01

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

Early docosahexaenoic and arachidonic acid supplementation in extremely-low-birth-weight infants.

Science.gov (United States)

Robinson, Daniel T; Caplan, Michael; Carlson, Susan E; Yoder, Rachel; Murthy, Karna; Frost, Brandy

2016-10-01

Extremely-low-birth-weight (ELBW) infants accrue large deficits in docosahexaenoic acid (DHA) and arachidonic acid (ARA) and require improved supplementation strategies. We hypothesized that once daily DHA+ARA drops applied to buccal mucosa will increase blood levels. Thirty ELBW infants were randomized to receive DHA 20 mg/kg/d + ARA 40 or 60 mg/kg/d + ARA 120 mg/kg/d or placebo within 72 h of age for 8 wk duration. Red blood cell phospholipid levels of DHA (primary) and ARA (secondary) were measured at 2 and 8 wk of age. Twenty-eight survivors with a median birth weight of 806 g completed dosing and sampling. Red blood cell levels were similar between the three groups at 2 wk (DHA: 4.62 wt% (interquartile range (IQR) 4.1-5.5) for all, P = 0.29 between groups; ARA: 21.1 wt% (IQR 18.78-22.6) for all, P = 0.41 between groups) and 8 wk (DHA: 6.0 wt% (IQR 5.1-7.1) for all, P = 0.57 between groups; ARA: 20.1 wt% (IQR 18.3-23.1) for all, P = 0.63 between groups). DHA in all infants showed a median increase of 31% from 2 to 8 wk (P 0.6). Daily buccal DHA and ARA supplements did not affect fatty acid levels in ELBW infants.

Outcome of Very Low Birth Weight Infants Over 3 Years Report From an Iranian Center

Science.gov (United States)

Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Fallahi, Minoo; Esmaili, Fatemeh

2013-01-01

Objective Very low birth weight (VLBW) infants are at high risk for morbidity and mortality. This article determines the frequency of disease, rate od survival, complications and risk factors for morbidity and mortality in VLBW neonates admitted to a level III neonatal intensive care unit (NICU) at Mahdieh Hospital in Tehran. Methods This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates. Relevant pre- and peri-natal data up to the time of discharge from the hospital or death, including complications during the course of hospitalization, were collected from the case notes, documented on a pre-designed questionnaire and analyzed. Findings Out of 13197 neonates, 564 (4.3%) were VLBW with 51.4% males. Mean gestational age was 29.6±2.5 weeks; mean birth weight 1179±257 grams. Mean birth weight, gestational age and Apgar scores were significantly higher in babies who survived than in those who died, (1275±189 vs. 944±253 grams; 30.5±2.2 vs. 27.5±2 weeks and 6.9±1.7 vs. 5±2.1 respectively, P<0.001 in all instances). Overall survival was 70.9%; in extremely low birth weight (ELBW) newborns this figure was 33.3% rising to 84.1% in infants weighing between 1001-1500 grams. Respiratory failure resulting from RDS in ELBW babies was the major factor leading to death. Need for mechanical ventilation, pulmonary hemorrhage and gastro-intestinal bleeding were also significant predictive factors for mortality. Conclusion Birth weight and mechanical ventilation are the major factors predicting VLBW survival. PMID:24800021

Maternal and infant characteristics associated with human milk feeding in very low birth weight infants.

Science.gov (United States)

Sisk, Paula M; Lovelady, Cheryl A; Dillard, Robert G; Gruber, Kenneth J; O'Shea, T Michael

2009-11-01

This study identified maternal and infant characteristics predicting human milk (HM) feeding in very low birth weight (VLBW) infants whose mothers (n = 184) participated in a study of lactation counseling and initiated milk expression. Data were collected prospectively, by maternal interview and medical record review. During hospitalization, 159 (86%) infants received at least 50% HM proportion of feedings in the first 2 weeks of life, and 114 (62%) received some HM until the day of hospital discharge. Analysis showed plan to breastfeed was the strongest predictor of initiation and duration of HM feeding. Greater than 12 years of education, respiratory distress syndrome, Apgar score >6, and female gender were significant predictors, and no perinatal hypertensive disorder, white race, and mechanical ventilation were marginal predictors of HM feeding. Women with a high-risk pregnancy should be provided education about the benefits of breastfeeding for infants who are likely to be born prematurely.

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

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

2015-10-01

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

Comparative Effect of Massage Therapy versus Kangaroo Mother Care on Body Weight and Length of Hospital Stay in Low Birth Weight Preterm Infants

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Priya Singh Rangey

2014-01-01

Full Text Available Background. Massage therapy (MT and kangaroo mother care (KMC are both effective in increasing the weight and reducing length of hospital stay in low birth weight preterm infants but they have not been compared. Aim. Comparison of effectiveness of MT and KMC on body weight and length of hospital stay in low birth weight preterm (LBWPT infants. Method. 30 LBWPT infants using convenience sampling from Neonatal Intensive Care Unit, V.S. hospital, were randomly divided into 2 equal groups. Group 1 received MT and Group 2 received KMC for 15 minutes, thrice daily for 5 days. Medically stable babies with gestational age < 37 weeks and birth weight < 2500 g were included. Those on ventilators and with congenital, orthopedic, or genetic abnormality were excluded. Outcome measures, body weight and length of hospital stay, were taken before intervention day 1 and after intervention day 5. Level of significance was 5%. Result. Data was analyzed using SPSS16. Both MT and KMC were found to be effective in improving body weight (P = 0.001, P = 0.001. Both were found to be equally effective for improving body weight (P = 0.328 and reducing length of hospital stay (P = 0.868. Conclusion. MT and KMC were found to be equally effective in improving body weight and reducing length of hospital stay. Limitation. Long term follow-up was not taken.

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

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Yang, Chuan-Zhong; Lee, Jiun

2008-05-01

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

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

Science.gov (United States)

Osteopenia and rickets are common among extremely low birth weight infants (ELBW, <1000 g birth weight) despite current practices of vitamin and mineral supplementation. Few data are available evaluating the usual course of markers of mineral status in this population. Our objectives in this study w...

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) 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. PMID:26481740

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

Energy Technology Data Exchange (ETDEWEB)

Bell, Michelle L; Ebisu, Keita [School of Forestry and Environmental Studies, Yale University, 205 Prospect Street, New Haven, CT 06511 (United States); Belanger, Kathleen [Department of Epidemiology and Public Health, School of Medicine, Yale University, One Church Street, 6th Floor, New Haven, CT 06510 (United States)], E-mail: michelle.bell@yale.edu

2008-10-15

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

Physical activity during pregnancy and infant's birth weight: results from the 3D Birth Cohort.

Science.gov (United States)

Bisson, Michèle; Croteau, Jordie; Guinhouya, Benjamin C; Bujold, Emmanuel; Audibert, François; Fraser, William D; Marc, Isabelle

2017-01-01

To evaluate the association between maternal physical activity and infant's birth weight or risk of inappropriate weight for gestational age (GA), and whether this association differs by infant's sex, maternal body mass index (BMI) or pregnancy complications in a prospective cohort study. 1913 pregnant women from the 3D Birth Cohort (Québec, Canada) completed the Pregnancy Physical Activity Questionnaire at each trimester. Energy expenditure (metabolic equivalent of task (MET)*hours/week) for total activity, sports and exercise and vigorous intensity activities was calculated. The associations with birth weight and risk of inappropriate weight for GA were evaluated by regression modelling. Interactions were tested with infant's sex, maternal prepregnancy BMI, gestational diabetes, hypertensive disorders and prematurity. Each 1 MET/hours/week increase in sports and exercise in the first trimester was associated with a 2.5 g reduction in infant's birth weight (95% CI -4.8 to -0.3) but was not associated with the risk of small weight for GA. In contrast, although not significant, a 17% reduction in the risk of large weight for GA was observed with increasing sports and exercise. Furthermore, in women with subsequent pre-eclampsia (but not normotensive or hypertensive women), each 1 MET/hours/week increment spent in any vigorous exercise in the first trimester reduced the infant's birth weight by 19.8 g (95% CI -35.2 to -4.3). Pregnant women with higher sports and exercise levels in the first trimester delivered infants with a lower birth weight. The risk of reducing infant's birth weight with vigorous exercise in women who develop pre-eclampsia later in pregnancy requires evaluation.

Outcome of very-low-birth-weight babies managed with nasal ...

African Journals Online (AJOL)

very-low-birth-weight (VLBW) infants is often due to respiratory distress syndrome (RDS) ... to be associated with CPAP failure have included lower gestational age (GA) and birth weight ... was intubated and put on MV. In developing countries ...

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

Science.gov (United States)

Leon, D A

1991-01-01

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

Increasing Incidence of Infants with Low Birth Weight in Oman

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M. Mazharul Islam

2015-05-01

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

Increasing Incidence of Infants with Low Birth Weight in Oman

Science.gov (United States)

Islam, M. Mazharul

2015-01-01

This review article provides an overview of the levels, trends and some possible explanations for the increasing rate of low birth weight (LBW) infants in Oman. LBW data from national health surveys in Oman, and published reports from Oman’s Ministry of Health and the World Health Organization were collected and assessed between January and August 2014. Oman’s LBW rate has been increasing since the 1980s. It was approximately 4% in 1980 and had nearly doubled (8.1%) by 2000. Since then, it has shown a slow but steady rise, reaching 10% in recent times. High rates of consanguinity, premature births, number of increased pregnancies at an older maternal age and changing lifestyles are some important factors related to the increasing rate of LBW in Oman. The underlying causes of this increase need to be understood and addressed in obstetric policies and practices in order to reduce the rate of LBW in Oman. PMID:26052449

Peritoneal drainage does not stabilize extremely low birth weight infants with perforated bowel: data from the NET Trial.

Science.gov (United States)

Rees, Clare M; Eaton, Simon; Khoo, A Kate; Kiely, Edward M; Pierro, Agostino

2010-02-01

Proponents of peritoneal drainage (PD) hypothesize that it allows stabilization before laparotomy. We examined this hypothesis by comparing clinical status before and after either PD or primary laparotomy (LAP). In an ethically approved, international, prospective randomized controlled trial (2002-2006), extremely low birth weight (drainage does not immediately improve clinical status in extremely low birth weight infants with bowel perforation. The use of PD as a stabilizing or temporizing measure is not supported by these results. Copyright 2010 Elsevier Inc. All rights reserved.

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

NARCIS (Netherlands)

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

2014-01-01

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

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

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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

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

OpenAIRE

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

2012-01-01

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

Preterm birth, infant weight gain, and childhood asthma risk: a meta-analysis of 147,000 European children.

Science.gov (United States)

Sonnenschein-van der Voort, Agnes M M; Arends, Lidia R; de Jongste, Johan C; Annesi-Maesano, Isabella; Arshad, S Hasan; Barros, Henrique; Basterrechea, Mikel; Bisgaard, Hans; Chatzi, Leda; Corpeleijn, Eva; Correia, Sofia; Craig, Leone C; Devereux, Graham; Dogaru, Cristian; Dostal, Miroslav; Duchen, Karel; Eggesbø, Merete; van der Ent, C Kors; Fantini, Maria P; Forastiere, Francesco; Frey, Urs; Gehring, Ulrike; Gori, Davide; van der Gugten, Anne C; Hanke, Wojciech; Henderson, A John; Heude, Barbara; Iñiguez, Carmen; Inskip, Hazel M; Keil, Thomas; Kelleher, Cecily C; Kogevinas, Manolis; Kreiner-Møller, Eskil; Kuehni, Claudia E; Küpers, Leanne K; Lancz, Kinga; Larsen, Pernille S; Lau, Susanne; Ludvigsson, Johnny; Mommers, Monique; Nybo Andersen, Anne-Marie; Palkovicova, Lubica; Pike, Katharine C; Pizzi, Costanza; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Roberts, Graham; Schmidt, Anne; Sram, Radim J; Sunyer, Jordi; Thijs, Carel; Torrent, Maties; Viljoen, Karien; Wijga, Alet H; Vrijheid, Martine; Jaddoe, Vincent W V; Duijts, Liesbeth

2014-05-01

Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age childhood asthma outcomes. Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27). Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights

Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children

Science.gov (United States)

Sonnenschein-van der Voort, Agnes M.M.; Arends, Lidia R.; de Jongste, Johan C.; Annesi-Maesano, Isabella; Arshad, S. Hasan; Barros, Henrique; Basterrechea, Mikel; Bisgaard, Hans; Chatzi, Leda; Corpeleijn, Eva; Correia, Sofia; Craig, Leone C.; Devereux, Graham; Dogaru, Cristian; Dostal, Miroslav; Duchen, Karel; Eggesbø, Merete; van der Ent, C. Kors; Fantini, Maria P.; Forastiere, Francesco; Frey, Urs; Gehring, Ulrike; Gori, Davide; van der Gugten, Anne C.; Hanke, Wojciech; Henderson, A. John; Heude, Barbara; Iñiguez, Carmen; Inskip, Hazel M.; Keil, Thomas; Kelleher, Cecily C.; Kogevinas, Manolis; Kreiner-Møller, Eskil; Kuehni, Claudia E.; Küpers, Leanne K.; Lancz, Kinga; Larsen, Pernille S.; Lau, Susanne; Ludvigsson, Johnny; Mommers, Monique; Nybo Andersen, Anne-Marie; Palkovicova, Lubica; Pike, Katharine C.; Pizzi, Costanza; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Roberts, Graham; Schmidt, Anne; Sram, Radim J.; Sunyer, Jordi; Thijs, Carel; Torrent, Maties; Viljoen, Karien; Wijga, Alet H.; Vrijheid, Martine; Jaddoe, Vincent W.V.; Duijts, Liesbeth

2014-01-01

Background Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. Objectives We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). Methods First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age childhood asthma outcomes. Results Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P childhood asthma were explained by gestational age at birth. Compared with term-born children with normal infant weight gain, we observed the highest risks of school-age asthma in children born preterm with high infant weight gain (odds ratio [OR], 4.47; 95% CI, 2.58-7.76). Preterm birth was positively associated with an increased risk of preschool wheezing (pooled odds ratio [pOR], 1.34; 95% CI, 1.25-1.43) and school-age asthma (pOR, 1.40; 95% CI, 1.18-1.67) independent of birth weight. Weaker effect estimates were observed for the associations of low birth weight adjusted for gestational age at birth with preschool wheezing (pOR, 1.10; 95% CI, 1.00-1.21) and school-age asthma (pOR, 1.13; 95% CI, 1.01-1.27). Conclusion Younger gestational age at birth and higher infant weight gain were associated with childhood asthma outcomes. The associations of lower birth weight with childhood asthma were largely explained by gestational age at birth. PMID:24529685

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

Directory of Open Access Journals (Sweden)

Alice M. Kiy

2015-05-01

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

Outcomes of very low birth weight infants in a newborn tertiary center in Turkey, 1997-2000.

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Atasay, Begüm; Günlemez, Ayla; Unal, Sevim; Arsan, Saadet

2003-01-01

Our purpose was to determine mortality and morbidity rates and selected outcome variables for infants weighing less than 1500 g, who were admitted to the neonatal intensive care unit of our hospital from 1997 to 2000. The ultimate goal of the study was to define a model for developing a regional database. Information on all very low birth weight (VLBW) admissions to a tertiary level neonatal intensive care unit (NICU) in Ankara between January 1997 and December 2000 was prospectively collected by three neonatologists using a standard manual of operation and definitions. The data consisted of patient information including sociodemographic characteristics; antenatal history; mode of delivery; APGAR scores; need for resuscitation; admission illness severity (Clinical Risk Index for Babies-CRIB) and therapeutic intensity (Neonatal Therapeutic Intensity Scoring System-NTISS); selected NICU parameters and procedures such as respiratory support, surfactant therapy, and postnatal corticosteroid therapy; and selected patient outcomes such as intraventricular hemorrhage, septicemia, necrotizing enterecolitis, retinopathy of prematurity, and chronic lung disease. The number of VLBW admissions to the NICU was 133, with 51 (28.6%) referrals from other maternity centers. The mean birth weight and gestational age of the infants were 1175 +/- 252 g and 30.3 +/- 2.9 weeks, respectively. One hundred and seventeen of 133 cases (88.7%) received at least one antenatal care visit. The median CRIB and NTISS scores were 4.5 and 31, respectively. Antenatal steroids had been given to 74 (55.6%) infants. Surfactant treatment and respiratory support were given to 33 (24.8%) and 73 (54.8%) infants, respectively. Among selected outcomes, chronic lung disease (CLD), threshold retinopathy of prematurity (ROP), severe intraventricular hemorrhage (IVH > or = grade III), nosocomial infection and necrotizing enterocolitis (NEC) were encountered in 14 (12.6%), 9 (8.1%), 3 (2.2%), 34 (25.5%) and 35 (26

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

NARCIS (Netherlands)

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

2006-01-01

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

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

NARCIS (Netherlands)

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

2006-01-01

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

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

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Adriana C. Vidal

2013-01-01

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

[Factors influencing the prognosis of patent ductus arteriosus in very low birth weight infants].

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Wang, Chen-Hong; Shi, Li-Ping; Ma, Xiao-Lu; Luo, Fang; Chen, Zheng; Lin, Hui-Jia; DU, Li-Zhong

2016-08-01

To investigate the factors influencing the prognosis of patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants. A total of 194 VLBW infants who were admitted from January 2012 to December 2014 were enrolled as study subjects. According to cardiac ultrasound findings and treatment outcome, these infants were divided into non-PDA group, spontaneous closure group, pharmaceutical closure group, and surgical closure group. Their clinical and echocardiographic characteristics were analyzed. The spontaneous closure rate of PDA was 58.7%. The spontaneous closure group showed significantly higher gestational age, birth weight, and proportion of small-for-gestational-age infants than the pharmaceutical and surgical closure groups (Pclosure groups had a significantly higher incidence rate of neonatal respiratory distress syndrome and a significantly higher proportion of infants who were given pulmonary surfactant (PS) than the spontaneous closure group (Pclosure group had a significantly smaller ductus arteriosus diameter than the pharmaceutical and surgical closure groups (Pductus arteriosus diameter at 48 hours were significantly associated with the prognosis of PDA. The major transductal flow pattern in the spontaneous closure group was closing pattern, while in the pharmaceutical and surgical closure groups, the main flow patterns were pulmonary hypertension and growing patterns within 48 hours and growing pattern on days 4 and 7. The VLBW infants have a high spontaneous closure rate of PDA. A decreased closure rate of PDA is associated with the lower gestational age and the application of PS. PDA with a large ductus arteriosus diameter and a growing or pulsatile flow pattern cannot easily achieve spontaneous closure.

Impact of antenatal steroids on intraventricular hemorrhage in very-low-birth weight infants.

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Wei, J C; Catalano, R; Profit, J; Gould, J B; Lee, H C

2016-05-01

To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. We used cross-sectional data from the California Perinatal Quality Care Collaborative during 2007 to 2013 for infants ⩽32 weeks gestational age. Using multivariable logistic regression, we evaluated the effect of antenatal steroids on intraventricular hemorrhage, stratified by gestational age. In 25 979 very-low-birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio=0.68, 95% confidence interval: 0.62, 0.75) and a reduction in incidence of severe intraventricular hemorrhage (odds ratio=0.51, 95% confidence interval: 0.45, 0.58). This association was seen across gestational ages ranging from 22 to 29 weeks. Although current guidelines recommend coverage for preterm birth at 24 to 34 weeks gestation, our results suggest that treatment with antenatal steroids may be beneficial even before 24 weeks of gestational age.

Impact of Antenatal Steroids on Intraventricular Hemorrhage in Very Low Birth Weight Infants

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Wei, Julia C.; Catalano, Ralph; Profit, Jochen; Gould, Jeffrey B.; Lee, Henry C.

2016-01-01

Objective To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. Methods We used cross-sectional data from the California Perinatal Quality Care Collaborative during 2007-2013 for infants ≤ 32 weeks gestational age. Using multivariable logistic regression, we evaluated the effect of antenatal steroids on intraventricular hemorrhage, stratified by gestational age. Results In 25,979 very low birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio = 0.51, 95% confidence interval: 0.45, 0.58) and a reduction in incidence of severe intraventricular hemorrhage (odds ratio = 0.62, 95% confidence interval: 0.57, 0.67). This association was seen across gestational ages ranging from 22 to 29 weeks. Conclusions While current guidelines recommend coverage for preterm birth at 24 to 34 weeks gestation, our results suggest that treatment with antenatal steroids may be beneficial even before 24 weeks of gestational age. PMID:27010109

The Effect of Activity Restriction on Infant's Birth Weight and Gestational Age at Birth: PRAMS Data Analysis.

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Omar, Abeer

2018-01-01

Activity restriction is extensively prescribed for pregnant women with major comorbidities despite the lack of evidence to support its effectiveness in preventing preterm birth or low birth weight. To determine the moderation effect of home activity restriction for more than a week on infant's birth weight and gestational age at birth for high-risk women with obstetrical and medical comorbidities. A secondary analysis of 2004-2008 New York Pregnancy Risk Assessment Monitoring System was conducted with 1426 high-risk women. High-risk group included 41% of women treated with activity restriction and 59% of those not treated with activity restriction. Women with preterm premature rupture of membrane (PPROM) who were treated with activity restriction had a lower infant birth weight ( b = -202.85, p = ≤.001) and gestational age at birth ( b = -.91, p = ≤.001) than those without activity restriction. However, women with preterm labor and hypertensive disorders of pregnancy who were not treated with activity restriction had lower infant gestational age at birth ( b = -96, p = ≤.01) and ( b = -92, p = ≤.001), respectively, compared to those who were treated with activity restriction. Findings suggest a contrary effect of activity restriction on infants born to women with PPROM, which is a major reason for prescribing activity restriction. The current study results may trigger the need to conduct randomized control trials to determine the effect of severity of activity restriction on maternal and infant outcomes.

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

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Il Rak Choi

2012-11-01

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

Anatomy-driven design of a prototype video laryngoscope for extremely low birth weight infants

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Baker, Katherine; Tremblay, Eric; Karp, Jason; Ford, Joseph; Finer, Neil; Rich, Wade

2010-11-01

Extremely low birth weight (ELBW) infants frequently require endotracheal intubation for assisted ventilation or as a route for administration of drugs or exogenous surfactant. In adults and less premature infants, the risks of this intubation can be greatly reduced using video laryngoscopy, but current products are too large and incorrectly shaped to visualize an ELBW infant's airway anatomy. We design and prototype a video laryngoscope using a miniature camera set in a curved acrylic blade with a 3×6-mm cross section at the tip. The blade provides a mechanical structure for stabilizing the tongue and acts as a light guide for an LED light source, located remotely to avoid excessive local heating at the tip. The prototype is tested on an infant manikin and found to provide sufficient image quality and mechanical properties to facilitate intubation. Finally, we show a design for a neonate laryngoscope incorporating a wafer-level microcamera that further reduces the tip cross section and offers the potential for low cost manufacture.

Effects of low birth weight on time to BCG vaccination in an urban poor settlement in Nairobi, Kenya: an observational cohort study.

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Mutua, Martin Kavao; Ochako, Rhoune; Ettarh, Remare; Ravn, Henrik; Echoka, Elizabeth; Mwaniki, Peter

2015-04-18

The World Health Organization recommends Bacillus Calmette-Guérin (BCG) vaccination against tuberculosis be given at birth. However, in many developing countries, pre-term and low birth weight infants get vaccinated only after they gain the desired weight. In Kenya, the ministry of health recommends pre-term and low birth weight infants to be immunized at the time of discharge from hospital irrespective of their weight. This paper seeks to understand the effects of birth weight on timing of BCG vaccine. The study was conducted in two Nairobi urban informal settlements, Korogocho and Viwandani which hosts the Nairobi Urban Health and Demographic Surveillance system. All infants born in the study area since September 2006 were included in the study. Data on immunization history and birth weight of the infant were recorded from child's clinic card. Follow up visits were done every four months to update immunization status of the child. A total of 3,602 infants were included in this analysis. Log normal accelerated failure time parametric model was used to assess the association between low birth weight infants and time to BCG immunization. In total, 229 (6.4%) infants were low birth weight. About 16.6% of the low birth weight infants weighed less than 2000 grams and 83.4% weighed between 2000 and 2490 grams. Results showed that, 60% of the low birth weight infants received BCG vaccine after more than five weeks of life. Private health facilities were less likely to administer a BCG vaccine on time compared to public health facilities. The effects of low birth weight on females was 0.60 and 0.97-times that of males for infants weighing 2000-2499 grams and for infants weighing <2000 grams respectively. The effect of low birth weight among infants born in public health facilities was 1.52 and 3.94-times that of infants delivered in private health facilities for infants weighing 2000-2499 grams and those weighing < 2000 grams respectively. Low birth weight infants

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

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Cheng Han Lee

2012-12-01

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

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

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

2017-11-01

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

Survey of the Relationship Between Mother’s Chronic Diseases and Low Birth Weight in Infants, Ahvaz, South of Iran, 2014

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Marzieh Monjezi

2016-11-01

Full Text Available Background Birth weight is the most important indicator of infant’s health, and this critical index is directly related to mother’s health. Hence, knowledge of the maternal chronic disease before and during the pregnancy can be considered as an effective factor in maintaining the infant’s ideal weight. Babies with low birth weight are more susceptible to risks such as disabilities of neurological, respiratory diseases and sudden infant death syndrome. Therefore, identifying and modifying the risk factors can control and prevent low birth weight. Objectives This study was performed to determine the association between mothers’ chronic diseases and low birth weight in infants. Methods In this descriptive study, 1500 infants from 12 health centers in east and west areas of Ahvaz were selected using the random cluster sampling method. The developed researcher checklist was used for data gathering. The data was analyzed with SPSS version 20, using descriptive indexes and Chi-square, t-test and ANOVA while P ≤ 0.05 was considered as significant. Results The prevalence of LBW in Ahvaz from the beginning to the end of the year 2015 has been 9.5%. There is a significant relationship between the cardiovascular disease before pregnancy (P ≤ 0.003, anemia before pregnancy (P ≤ 0.001, hypertensive pregnancy (P ≤ 0.001, urinary tract infection during pregnancy (P ≤ 0.001, gestational diabetic in the mother (P ≤ 0.003 and LBW. Conclusions Our study showed that many mothers' schronic disease such as cardiovascular disease, anemia, hypertensive, gestational diabetic and UTI have relationship with LBW. Therefore it seems essential to design and implement a detailed antenatal care program for mothers with chronic disease to reduce LBW, infant mortality and defects.

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

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Keerti Swarnkar

2016-01-01

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

Transgenerational effect of neighborhood poverty on low birth weight among African Americans in Cook County, Illinois.

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Collins, James W; David, Richard J; Rankin, Kristin M; Desireddi, Jennifer R

2009-03-15

In perinatal epidemiology, transgenerational risk factors are defined as conditions experienced by one generation that affect the pregnancy outcomes of the next generation. The authors investigated the transgenerational effect of neighborhood poverty on infant birth weight among African Americans. Stratified and multilevel logistic regression analyses were performed on an Illinois transgenerational data set with appended US Census income information. Singleton African-American infants (n = 40,648) born in 1989-1991 were considered index births. The mothers of index infants had been born in 1956-1976. The maternal grandmothers of index infants were identified. Rates of infant low birth weight (birth weight for maternal grandmother's residence in a poor neighborhood (compared with an affluent neighborhood) equaled 1.3 (95% confidence interval: 1.1, 1.4). This study suggests that maternal grandmother's exposure to neighborhood poverty during her pregnancy is a risk factor for infant low birth weight among African Americans.

Long-term cognitive outcome of very low birth-weight Saudi preterm infants at the corrected age of 24-36 months.

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Sobaih, Badr H

2018-04-01

To assess infants' cognitive function at the corrected age of 24-36 months, and to identify factors associated with adverse outcome and examine the correlation between Bayley Infants Neurodevelopmental Screener (BINS) score and Gesell Schedule of Child Development (GSCD). Methods: This retrospective study was performed on Saudi very low birth-weight (VLBW)  infants born   in King Khalid University Hospital, Riyadh, Saudi Arabia between 1997 and 2014 by the use of BINS as screening test and GSCD as definitive test. Results: Of 561 enrolled infants, 367 (65.4%) continued to follow-up. Three-hundred and fifteen infants (85.6%) had a normal cognitive function. In addition to lower birth weight (beta = -0.003) (p less than 0.001), male gender (OR =3.9) (p=0.001)and cerebral palsy (OR =33.9) (p less than 0.001) were the strongest factors associated with poor cognitive outcome. Approximately 75.4% of infants with normal BINS score had normal cognitive function and 7.6% of total infants had sever cognitive impairment. Conclusion: The majority of VLBW infants in our center have  normal cognitive function at the corrected age of 24-36 months. Male gender, lower birth weight, and cerebral palsy are major predictors of poor outcome. The BINS scores were correlated with GSCD as a valid predictor for future developmental outcome.

Maternal dental radiography during pregnancy is not associated with term low birth weight

International Nuclear Information System (INIS)

Mortazavi, S.M.J.; Center for Radiation Research, Shiraz University, Shiraz; Aminzadeh, F.; Manshouri, A.; Kamali, M.; Rezaiean, M.; Vazirinejad, R.

2007-01-01

Complete text of publication follows. Objective: In a report published in JAMA in 2004, Hujoel and colleagues indicated that maternal dental radiography during pregnancy may be associated with term low birth weight. Interestingly, they concluded that dental radiographies cause measurable radiation doses to the hypothalamus-pituitary-thyroid axis and the radiation effects on this axis is the reason for term low birth weight. On the other hand, low birth weight is the second leading cause of infant death. In this paper the results obtained in a 2 year study conducted at a midwifery hospital in Rafsanjan, IR Iran are reported. Methods: Four hundred seventy-five singleton infants with gestational periods of 37-44 wk born between 2006 and 2007 at the Niknafs Teaching Hospital affiliated with Rafsanjan University of Medical Sciences and met the inclusion criteria were enrolled in the study. Demographic data and clinical findings at birth including gestation age, sex of infant, birth order, season of birth, maternal age, and maternal education were collected from maternal and newborn hospital records and by interviews with parents. Maternal history of exposure to common sources of man-made ionizing and non-ionizing (exposure to radiations emitted by mobile phones, CRTs, cordless phones) radiation before and during pregnancy were carefully recorded. Results: Among the 475 infants who were studied, there were only 15 cases with a history of maternal dental radiography during pregnancy. The average newborn infants' birth weight in non-exposed and exposed (maternal dental radiography during pregnancy) groups were 3166.69±481.31 g and 3118.67±341.42 g respectively. This difference was not statistically significant. Conclusions: In this study, low birth weight was not associated with maternal dental radiography during pregnancy. These results are generally inconsistent with those reported by Hujoel and colleagues.

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

International Nuclear Information System (INIS)

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

1988-01-01

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

[Short, medium and long-term benefits of human milk intake in very-low-birth-weight infants].

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Chinea Jiménez, Bibiana; Awad Parada, Yumana; Villarino Marín, Antonio; Sáenz de Pipaón Marcos, Miguel

2017-10-24

The aim of the present study is to evaluate the effect of human milk feeding during the first weeks of life in very low birth weight infants on weight gain at discharge, length of hospitalization, postmenstrual age at discharge and nutritional assessment, growth and neurodevelopment at two and five years. Longitudinal study of very-low-birth-weight infants (Care Unit of La Paz University Hospital, from January 1st 2009 to December 31st 2009, followed in the follow-up clinic. Their parents agreed to perform a more exhaustive anthropometric study at five years, classified according to the type of feeding at the time of discharge (exclusive human milk, formula milk or mixed). Initial hospital duration and anthropometry at discharge were evaluated. At two years of age, anthropometric data (weight, height and head circumference) were collected and neurodevelopment was assessed according to the Bayley scale of child development. Data at five years were collected prospectively. Measurements of weight, height and head circumference, waist circumference, hip, relaxed and contracted arm, thigh and middle leg, bicipital, triceps, subscapular, suprailiac and leg skin folds were performed. For patients older than five years, the Kaufman test battery for children was used. The effect of human milk on the variables of interest was investigated using a multivariate analysis correcting for gestational age and weight at birth. One hundred and fifty-two infants born in 2009 were discharged from our unit: exclusive breast milk (59), formula (55) or mixed milk (38). More detailed follow-up was carried out for 61 of them. Human milk during the first admission decreases the initial hospital stay, and is associated with a higher head circumference at two and five years, and a better score in the global and verbal cognitive area at five years. Our results suggest that maternal milk feeding during initial admission should be encouraged because it can improve neurodevelopment at five years

Epidemiological factors involved in the development of bronchopulmonary dysplasia in very low birth-weight preterm infants.

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Lardón-Fernández, Marita; Uberos, José; Molina-Oya, Manuel; Narbona-López, Eduardo

2017-02-01

In spite of the advances made in perinatal medicine, the incidence of bronchopulmonary dysplasia (BPD) has not decreased and the aetiopathogenesis of the "new" BPD is still a matter for debate. The objectives of the present study were to analyse the epidemiological factors and morbidity associated with the development of BPD in a cohort of very low birth-weight (VLBW) preterm infants. This retrospective observational study included all the preterm infants with birth weight ≤1500 g who were admitted to a tertiary-level hospital NICU from 2008 to 2011. A neurological follow-up was also carried out during the first two years of life. A total of 140 VLBW infants were analyzed: 28.4% presented oxygen dependence at 28 days, and 17.2% at 36 weeks adjusted gestational age. Predictive factors for the development of BPD were gestational age, birth weight, number of days of parenteral nutrition, number of days to achieve full enteral feeding, number of transfusions, duration of respiratory support and insulin administration, vasoactive drugs, diuretics, sedoanalgesia and postnatal corticosteroids. The neonatal morbidity associated with the development of BPD was late neonatal sepsis, patent ductus arteriosus, retinopathy of prematurity (ROP) and intraventricular hemorrhage. Non-significant associations with neurodevelopmental impairment were observed. Predictive factors for the development of BPD were respiratory support, feeding and different types of medication. Moreover, patients with BPD had a higher associated morbidity than those who did not develop BPD.

Development skills of children born premature with low and very low birth weight.

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Ribeiro, Camila da Costa; Pachelli, Mariane Regina de Oliveira; Amaral, Natalie Camillo de Oliveira; Lamônica, Dionísia Aparecida Cusin

2017-01-30

To compare the performance of children born premature with low birth weight (LBW) and very low birth-weight (VLBW) with that of children born at term, within the age range of one to three years, regarding child development in the gross motor, fine motor-adaptive, personal-social and language domains. This is a cross-sectional study in a cohort of 150 infants born premature (experimental group) and at term (control group) divided into eight groups with respect to weight (low birth weight: motor, fine motor-adaptive, personal-social and language domains. In this study, the preterm groups presented different performances, i.e., normative, average, and below average performances were observed within the same group.

The role of lifestyle in preventing low birth weight.

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Chomitz, V R; Cheung, L W; Lieberman, E

1995-01-01

Lifestyle behaviors such as cigarette smoking, weight gain during pregnancy, and use of other drugs play an important role in determining fetal growth. The relationship between lifestyle risk factors and low birth weight is complex and is affected by psychosocial, economic, and biological factors. Cigarette smoking is the largest known risk factor for low birth weight. Approximately 20% of all low birth weight could be avoided if women did not smoke during pregnancy. Reducing heavy use of alcohol and other drugs during pregnancy could also reduce the rate of low birth weight births. Pregnancy and the prospect of pregnancy provide an important window of opportunity to improve women's health and the health of children. The adoption before or during pregnancy of more healthful lifestyle behaviors, such as ceasing to smoke, eating an adequate diet and gaining enough weight during pregnancy, and ceasing heavy drug use, can positively affect the long-term health of women and the health of their infants. Detrimental lifestyles can be modified, but successful modification will require large-scale societal changes. In the United States, these societal changes should include a focus on preventive health, family-centered workplace policies, and changes in social norms.

A quality improvement project to improve admission temperatures in very low birth weight infants.

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Lee, H C; Ho, Q T; Rhine, W D

2008-11-01

To review the results of a quality improvement (QI) project to improve admission temperatures of very low birth weight inborn infants. The neonatal intensive care unit at Lucile Packard Children's Hospital underwent a QI project to address hypothermic preterm newborns by staff education and implementing processes such as polyethylene wraps and chemical warming mattresses. We performed retrospective chart review of all inborn infants with birth weight project. The improvement was consistent and persisted over a 15-month period. After risk adjustment, the strongest predictor of hypothermia was being born in the period before implementation of the QI project (odds ratio 8.12, 95% confidence interval 4.63, 14.22). Although cesarean delivery was a strong risk factor for hypothermia prior to the project, it was no longer significant after the project. There was no significant difference in death or intraventricular hemorrhage detected between periods. There was a significant improvement in admission temperatures after a QI project, which persisted beyond the initial implementation period. Although there was no difference in mortality or intraventricular hemorrhage rates, we did not have sufficient power to detect small differences in these outcomes.

Trends in incidence of low birth weight deliveries in a tertiary hospital, in Northern Nigeria

OpenAIRE

O Hassan; Z Muhammad

2011-01-01

Background: Low birth weight is an important determinant of both infant and neonatal mortality rates and is also an indicator of social and economic development. The World Health Organization described any baby with birth weight of less than 2.5kg as low birth weight baby. Objective: To determine the incidence of low birth weight deliveries in Aminu Kano Teaching Hospital, Kano. Study design: A retrospective descriptive study. Results: The overall incidence of low birth weight delive...

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

International Nuclear Information System (INIS)

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

2005-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

The Relationship between Folic Acid Intake and Infant Birth Weight

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Fariba Esmailzadeh

2016-12-01

Full Text Available Background and Objectives: Folic acid is a B vitamin which 5mg daily intake before gestation and until the tenth week of pregnancy is recommended. Since no study has been conducted in some regions of East Azerbaijan including Bostanabad, Khosroshahr and Sarab and no prevalence was spotted in country specific studies, therefore, the aim of this study was to determine the relationship between folic acid intake and infant birth weight. Material and Methods: This study was a retrospective cohort. In this study, 1939 of pregnant women who were referred to health care centers before pregnancy were selected randomly. They were divided into two groups: first group of pregnant women who regularly took folic acid before pregnancy and second group included the women who did not take folic acid supplements. Data were analyzed by SPSS 16 using T-Test and ANOVA. Results: This study was conducted on 1939 mothers who had an average age of 25.98 years and average infants birth weight was 3.209 kg. Totally, 92.9% of the mothers had regular consumption of folic acid during pregnancy. Analysis of the results showed that with increasing maternal BMI, birth weight also increased. It showed a significant relationship between regular folic acid intake and increase in infant birth weight. Conclusion : Our results showed that both high maternal pre-pregnancy weight and folic acid intake lead to higher birth weight infants.

Reducing the Incidence of Low Birth Weight in Low-Income Countries Has Substantial Economic Benefits

OpenAIRE

Alderman, Harold; Behrman, Jere R.

2006-01-01

Reducing the incidence of low birth weight not only lowers infant mortality rates but also has multiple benefits over the life cycle. This study estimates the economic benefits of reducing the incidence of low birth weight in low-income countries, both through lower mortality rates and medical costs and through increased learning and productivity. The estimated economic benefits, under pla...

Effect of prophylactic CPAP in very low birth weight infants in South America.

Science.gov (United States)

Zubizarreta, J R; Lorch, S A; Marshall, G; D'Apremont, I; Tapia, J L

2016-08-01

The objective of this study was to examine the effect of prophylactic continuous positive airway pressure (CPAP) on infants born in 25 South American neonatal intensive care units affiliated with the Neocosur Neonatal Network using novel multivariate matching methods. A prospective cohort was constructed of infants with a birth weight 500 to 1500 g born between 2005 and 2011 who clinically were eligible for prophylactic CPAP. Patients who received prophylactic CPAP were matched to those who did not on 23 clinical and sociodemographic variables (N=1268). Outcomes were analyzed using the McNemar's test. Infants not receiving prophylactic CPAP had higher mortality rates (odds ratio (OR)=1.69, 95% confidence interval (CI) 1.17, 2.46), need for any mechanical ventilation (OR=1.68, 95% CI 1.33, 2.14) and death or bronchopulmonary dysplasia (BPD) (OR=1.47, 95% CI 1.09, 1.98). The benefit of prophylactic CPAP varied by birth weight and gender. The implementation of this process was associated with a significant improvement in survival and survival free of BPD.

Changes in Parenteral Nutrition During the First Week of Life Influence Early but Not Late Postnatal Growth in Very Low-Birth-Weight Infants.

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Izquierdo, Montserrat; Martínez-Monseny, Antonio Federico; Pociello, Neus; Gonzalez, Paloma; Del Rio, Ruth; Iriondo, Martin; Iglesias-Platas, Isabel

2016-10-01

Postnatal growth restriction remains a serious problem in very low-birth-weight infants. Enhanced parenteral supply of nutrients as soon as possible after birth is one of the strategies addressed to avoid extrauterine growth restriction. We aimed to analyze changes in growth patterns and in clinical outcomes in our unit after a change in our parenteral nutrition (PN) protocol. We collected data from 2 time periods, comprising the 2 years before (period I) and the 2 years after (period II) the change of protocol. We included 142 very low-birth-weight infants ≤32 weeks of gestation with a birth weight ≤1500 g. Data regarding nutrition intakes (parenteral and enteral) in the first week of life, growth during admission, and clinical outcomes were retrieved from clinical charts. Babies in period II received a higher nutrition supply during the first week of life, but no further differences were found after this period. Weight at 14 days of life was significantly higher in period II but not at day 28 of life or discharge. In our population, an enhanced PN regimen for very low-birth-weight infants led to a better growth at 14 days of life. However, this positive effect had disappeared at day 28 of life. Strategies to improve nutrient supply once the preterm baby is stable and on full enteral feeds should be implemented and analyzed. © 2016 American Society for Parenteral and Enteral Nutrition.

Impact of a standardized hand hygiene program on the incidence of nosocomial infection in very low birth weight infants.

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Capretti, Maria Grazia; Sandri, Fabrizio; Tridapalli, Elisabetta; Galletti, Silvia; Petracci, Elisabetta; Faldella, Giacomo

2008-08-01

This study examined the effects of a standardized hand hygiene program on the rate of nosocomial infection (NI) in very low birth weight (VLBW) infants (birth weight hand hygiene program was implemented using antimicrobial soap (4% chlorhexidine gluconate) and alcohol-based hand rubs. NI after 72 hours of life was detected in 16 of the 85 VLBW infants in the first period and in 5 of the 80 VLBW infants in the second period. The rate of central venous catheter colonization was significantly lower in the second period (5.8%) than in the first period (16.6%). In our NICU, the incidence of NI in VLBW infants was significantly reduced after the introduction of a standardized handwashing protocol. In our experience, a proper hand hygiene program can save approximately 10 NI episodes/year, at a cost of $10,000 per episode. Therefore, improving hand hygiene practice is a cost-effective program in the NICU.

Continuous Positive Airway Pressure versus Mechanical Ventilation on the Fist Day of Life in Very Low-Birth-Weight Infants

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Flannery, Dustin D.; O’Donnell, Elizabeth; Kornhauser, Mike; Dysart, Kevin; Greenspan, Jay; Aghai, Zubair H.

2017-01-01

Objective The objective of this study was to determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in very low-birth-weight (VLBW) infants managed successfully on continuous positive airway pressure (CPAP) versus mechanical ventilation on the first day of life (DOL). Study Design This is a retrospective analysis of the Alere neonatal database for infants born between January 2009 and December 2014, weighing ≤ 1,500 g. Baseline demographics, clinical characteristics, and outcomes were compared between the two groups. Multivariate regression analysis was performed to control the variables that differ in bivariate analysis. Results In this study, 4,629 infants (birth weight 1,034 ± 290 g, gestational age 28.1 ± 2.5 weeks) met the inclusion criteria. The successful use of early CPAP was associated with a significant reduction in BPD or death (p CPAP on the first DOL in VLBW infants is associated with a reduced risk of BPD or death. PMID:27057767

Risk factors of extubation failure in extremely low birth weight infants: a five year retrospective analysis.

Science.gov (United States)

Lee, Chao-Yi; Su, Bai-Horng; Lin, Tsung-Wen; Lin, Hung-Chih; Li, Tsai-Chung; Wang, Nai-Phon

2002-01-01

Extubation failure is one of the most serious complications in extremely low birth weight infants (ELBWI) on mechanical ventilation therapy. We performed a 5-year retrospective analysis to realize the status of extubation failure in ELBWI. Extubation failure was defined as requirements of re-intubation within 72 hours after extubation. The extubation failure rate was 21% (29/138). The mean birth body weight was 808.3 +/- 140.4 gm. The mean gestational age was 25.8 +/- 1.2 wks. The incidence of chronic lung disease (CLD) in infants with extubation failure was 100% (29/29). Apnea of prematurity 49% (14/29) and post-extubation atelectasis 39% (11/29) were the most common reasons for reintubation. The major microbiology findings which correlated with nosocomial pneumonia in infants with extubation failure were Acinetobacter baumanni (21%), Klebsiella pneumonia (21%), Pseudomonas aeroginosa (14%), and Methicillin resistant staphylococcus aureus (14%). In conclusion, post-extubation atelectasis and apnea were the most common reasons for reintubation. ELBWI with extubation failure had higher incidences of post-extubation atelectasis, CLD, and nosocomial pneumonia. Further prospective studies are needed in order to clarify the appropriate extubation program for ELBWI and to prevent post-extubation atelectasis and nosocomial pneumonia.

Pattern of growth of very low birth weight preterm infants, assessed using the WHO Growth Standards, is associated with neurodevelopment.

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Nash, Andrea; Dunn, Michael; Asztalos, Elizabeth; Corey, Mary; Mulvihill-Jory, Bridget; O'Connor, Deborah L

2011-08-01

Several Canadian professional organizations recently recommended that the growth of preterm infants be monitored using the World Health Organization Growth Standards (WHO-GS) after hospital discharge. The WHO-GS are a prescriptive set of growth charts that describe how term infants should grow under ideal environmental conditions. Whether preterm infants following this pattern of growth have better outcomes than infants that do not has yet to be evaluated. Our aim was to determine whether the pattern of growth of very low birth weight (VLBW) infants during the first 2 years, assessed using the WHO-GS or the traditional Centers for Disease Control and Prevention reference growth charts (CDC-RGC), is associated with neurodevelopment. Pattern of weight, length, and head circumference gain of appropriate-for-gestation VLBW preterm infants (n = 289) from birth to 18-24 months corrected age was classified, using the WHO-GS and CDC-RGC, as sustained (change in Z-score ≤1 SD), decelerated (decline >1 SD), or accelerated (incline >1 SD). Development was assessed using the Bayley Scales of Infant and Toddler Development (BSID)-III at 18-24 months corrected age. Using the WHO-GS, children with a decelerated pattern of weight gain had lower cognitive (10 points), language (6 points), and motor (4 points) scores than infants with sustained weight gain (p growth.

Gender-related clinical and immunological features of extremely low birth weight infants

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G. N. Chistyakova

2016-01-01

Full Text Available Examinations were made in 35 boys and 39 girls with extremely low birth weight in order to identify gender-related clinical and immunological features. A comparison group consisted of 31 full-term newborns with early uncomplicated adaptation. The investigators determined the number of lymphocyte subpopulations and cytokine-producing cells (CD3+INF-γ+, CD3+IL-4+ by flow cytometry and the serum levels of cytokines (IL-4, IFN-γ and neopterin by enzyme immunoassay. A study of immunological parameters revealed that the boys had a smaller number of CD3+, CD4+, and CD8+ subpopulations, a reduced content of CD3+IL-4+ cells at birth, and low IL-4 production on the first day of life compared to the full-term neonates. The girls were recorded to have higher levels of neopterin and B cells on the first day of life, the quantitative characteristics of T lymphocytes were consistent with those in the full-term infants. The findings are indicative of the greater functional immaturity of the immune system in the preterm boys. 

Recombinant human erythropoietin and blood transfusion in low-birth weight preterm infants under restrictive transfusion guidelines

International Nuclear Information System (INIS)

Badiee, Z.; Pourmirzaiee, Mohmmad A.; Naseri, F.; Kelishadi, R.

2006-01-01

To compare the number and volume of red blood cell transfusions (RBCTs) in very low birth weight infants under restrictive red blood cell transfusion guidelines with and without erythropoietin administration. In a controlled clinical trial conducted at the neonatal intensive care unit of Alzahra Hospital, Isfahan, Iran, between April 2002 to April 2004, 60 premature infants with gestational age up to 34 weeks, birth weight up to 1500 g, and postnatal age between 8 and 14 days were included. The newborns were randomized into 2 groups: Group 1 received 3 doses of 400 IU/kg erythropoietin per week for 6 weeks, and Group 2 received no treatment aside from their conventional medications. The 2 groups did not differ significantly with respect to their mean gestational age, birth weight and hematocrit at the study entry. Fewer transfusions were administered to those receiving erythropoietin (26.7% versus 50%, p=0.03), but there was no statistically significant difference between groups with respect to volume of transfusion. Compared with the placebo group, the infants receiving erythropoietin had a higher mean hematocrit (34% +/- 4.3 versus 29% +/- 5.9, p<0.001) and absolute reticulocyte count (57 +/- 19 versus 10 +/- 4.8 x 106, p<0.001) at the end of the study. We found no significant difference in the incidence of thrombocytopenia and leukopenia between the 2 groups. We conclude that when the restrictive RBCT guidelines were followed, treatment with erythropoietin can be useful in reduction of the number of RBCTs. (author)

Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant.

LENUS (Irish Health Repository)

Moran, M

2012-02-01

BACKGROUND: Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation. AIM: To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life. METHODS: A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL\\/kg\\/min. cTOI was measured using NIRO 200 Hamamatsu. RESULTS: Twenty-seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29\\/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57-1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs\\/kg\\/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p-value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra- and extracardiac shunts. CONCLUSION: There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.

Prenatal Secondhand Smoke Exposure and Infant Birth Weight in China

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Adolfo Correa

2012-09-01

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

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

Science.gov (United States)

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

2017-04-01

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

Banked preterm versus banked term human milk to promote growth and development in very low birth weight infants.

LENUS (Irish Health Repository)

Dempsey, Eugene

2012-01-31

BACKGROUND: Human milk banking has been available in many countries for the last three decades. The milk provided from milk banking is predominantly term breast milk, but some milk banks provide preterm breast milk. There are a number of differences between donor term and donor preterm human milk. OBJECTIVES: To determine the effect of banked preterm milk compared with banked term milk regarding growth and developmental outcome in very low birth weight infants (infants weighing less than 1500 g). SEARCH STRATEGY: We used the standard methods of the Cochrane Neonatal Review Group, including a search of the Cochrane Neonatal Group specialized register and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, January 2010). We searched the computerised bibliographic databases MEDLINE (1966 to February 2010), EMBASE (1988 to February 2010) and Web of Science (1975 to February 2010). We searched reference lists of all selected articles, review articles and the Oxford Database of Perinatal Trials. We also searched abstracts from neonatal and pediatric meetings (PAS electronic version from 2000 to 2009, ESPR hand search from 2000 to 2009). We applied no language restrictions. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing banked donor preterm milk with banked donor term milk regarding growth and developmental outcomes in very low birth weight infants DATA COLLECTION AND ANALYSIS: We planned to perform assessment of methodology regarding blinding of randomisation, intervention and outcome measurements as well as completeness of follow-up. We planned to evaluate treatment effect using a fixed-effect model using relative risk (RR), relative risk reduction, risk difference (RD) and number needed to treat (NNT) for categorical data and using mean, standard deviation and weighted mean difference (WMD) for continuous data. We planned an evaluation of heterogeneity. MAIN RESULTS: No studies met the inclusion criteria. AUTHORS

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

Science.gov (United States)

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

2015-03-08

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

Correlation of periodontitis during pregnancy and incidence of low birth weight babies

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Prashanthi Reddy

2012-01-01

After delivery, gestational age (in weeks and birth weight of baby (in kg were collected from hospital records. Infants were placed into following categories by gestational age (WHO and by birth weight preterm-3,900 gm. Results: Based on the findings of the study, a significant correlation was observed between periodontitis and low birth weight and preterm low birth weight (p<_0.001 and a significant relation was observed between periodontitis and gestational age (p < 0.001. Conclusion: Periodontitis was considered a risk indicator for reduced gestational age and birth weight. Multicentric trials will greatly help to establish the independent role of periodontal disease and their relationship in terms of pregnancy outcomes.

Implementation of an Automatic Stop Order and Initial Antibiotic Exposure in Very Low Birth Weight Infants.

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Tolia, Veeral N; Desai, Sujata; Qin, Huanying; Rayburn, Polli D; Poon, Grace; Murthy, Karna; Ellsbury, Dan L; Chiruvolu, Arpitha

2017-01-01

Objective  To evaluate if an antibiotic automatic stop order (ASO) changed early antibiotic exposure (use in the first 7 days of life) or clinical outcomes in very low birth weight (VLBW) infants. Study Design  We compared birth characteristics, early antibiotic exposure, morbidity, and mortality data in VLBW infants (with birth weight  48 hours. Secondary outcomes included mortality, early mortality, early onset sepsis (EOS), and necrotizing enterocolitis. Results  Birth characteristics were similar between the two groups. We observed reduced median antibiotic exposure (pre-ASO: 6.5 DOT vs. Post-ASO: 4 DOT; p   48 hours (63.4 vs. 41.3%; p  < 0.001). There were no differences in mortality (12.1 vs 10.2%; p  = 0.44), early mortality, or other reported morbidities. EOS accounted for less than 10% of early antibiotic use. Conclusion  Early antibiotic exposure was reduced after the implementation of an ASO without changes in observed outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Low-birth-weight, but not catch-up growth, correlates with insulin resistance and resistin level in SGA infants at 12 months.

Science.gov (United States)

Giapros, Vasileios; Vavva, Efthymia; Siomou, Ekaterini; Kolios, Georgios; Tsabouri, Sofia; Cholevas, Vasileios; Bairaktari, Eleni; Tzoufi, Meropi; Challa, Anna

2017-08-01

To investigate the insulin resistance status in SGA infants at 12 months and its relationship with auxological and metabolic parameters. One group of 45 SGA and one of 50 appropriate for gestational age infants were followed from birth to the end of the first year of life. At 12 months, skinfold thickness, waist circumference, and blood levels of glucose, insulin, adiponectin, leptin, resistin, visfatin, retinol-binding protein 4, IGFs, lipids profile were determined, and the HOMA-IR index was calculated. The SGAs had increased insulin (5.2 ± 2.7 versus 2.9 ± 2.4 μIU/ml, p = 0.012) and HOMA-IR (1.09 ± 0.9 versus 0.59 ± 0.55, p = 0.016). In multiple regression, insulin resistance indices were independently correlated with low-birth-weight (β = -2.92, p = 0.015 for insulin, β = -2.98, p = 0.011 for HOMA-IR) but not with catch-up growth in either height or weight or any other metabolic parameter. Resistin was higher in the SGAs (5.1 ± 2.1 versus 3.9 ± 2.1 ng/ml, p = 0.03) and independently correlated with low-birth-weight but not insulin resistance. Resistin was negatively correlated with total cholesterol (R = -0.33, p = 0.007) and positively with lipoprotein(a) (R = 0.49, p = 0.001). Low-birth-weight, but not catch-up growth or adiposity tissue hormones, was correlated with insulin resistance at 12 months in non-obese SGA infants. The higher resistin in SGA infants and its correlation with total cholesterol and lipoprotein(a) need further clarification.

Survival of the very-low-birth-weight infants after cardiopulmonary resuscitation in neonatal intensive care unit.

Science.gov (United States)

Kostelanetz, Anna S; Dhanireddy, Ramasubbareddy

2004-05-01

To assess whether advances in neonatal care in the last decade have altered the outcome of very-low-birth-weight (VLBW) infants after cardiopulmonary resuscitation (CPR) in the neonatal intensive care unit (NICU). Medical records of all VLBW infants (n=283, body weight (BW)=1066+/-281 g, gestational age (GA)=28.3+/-2.9 weeks) admitted to the NICU between 1999 and 2002 were reviewed. In all, 29 (10.25%) infants received CPR in the NICU. Only one of these infants survived. After adjusting for GA, the clinical variables significantly associated with the need for CPR in the NICU were (adjusted odds ratio; 95% CI): pulmonary hemorrhage (7.89; 3.06 to 20.28), pulmonary air leak syndrome (23.90; 7.58 to 75.4), and delivery by Cesarian section (0.26; 0.1 to 0.66). The results were similar when the data were reanalyzed matching the 28 infants in the CPR group with 28 infants of identical GA in the non-CPR group. Survival rate for the infants who require CPR in the NICU remains extremely poor. This poor outcome needs to be discussed with parents and the option of the "do not resuscitate" (DNR) order may be appropriate for these infants, especially for those infants with multiple organ failure unresponsive to therapy.

Different Risk Factors for Very Low Birth Weight, Term-Small-for-Gestational-Age, or Preterm Birth in Japan

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Naomi Tamura

2018-02-01

Full Text Available From 1985 to 2013, the mean birth weight of infants in Japan decreased from 3120 g to 3000 g, and the low-birth-weight rate among live births increased from 6.3% to 9.6%. No prospective study has elucidated the risk factors for poor fetal growth and preterm birth in recent Japanese parents, such as increased parental age, maternal body figure, assisted reproductive technology (ART, and socioeconomic status. Participants were mother–infant pairs (n = 18,059 enrolled in a prospective birth cohort in Hokkaido, Japan from 2002 to 2013. Parental characteristics were obtained via self-reported questionnaires during pregnancy. Medical records helped identify very-low-birth-weight (VLBW; <1500g, term-small-for-gestational-age (term-SGA, and preterm-birth (PTB; <37 weeks infants. We calculated relative risks (RRs for PTB, VLBW, and term-SGA birth based on parental characteristics. The prevalence of PTB, VLBW, and term-SGA was 4.5%, 0.4%, and 6.5%, respectively. Aged parents and ART were risk factors for PTB and VLBW. Maternal alcohol drinking during pregnancy increased the risk; a parental educational level of ≥16 years reduced risk of term-SGA. Maternal pre-pregnancy BMI of <18.5 kg/m2 increased the risk of PTB and term-SGA. The RR for low BMI was highest among mothers who have low educational level. Among various factors, appropriate nutritional education to maintain normal BMI is important to prevent PTB and term-SGA in Japan.

The neglected sociobehavioral risk factors of low birth weight

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Mohsen Momeni

2016-08-01

Full Text Available Background: Low Birth Weight (LBW is one of the most important health indicators in the world. It has certain known and unknown causes. The present study was designed to evaluate the role of socio-behavioral factors on neonatal birth weight.Methods: The current case-control study was conducted on 300 eligible neonates (150 LBW infants as cases and 150 normal body weight infants as controls in 2015. The national pregnancy care forms of the neonates kept in heath care centers in Kerman were used. The data was analyzed running Independent samples t-test, Chi square test, and Fisher’s Exact test in SPSS. The significance level was set as 0.05.Results: Preterm birth (P<0.001, number of primary care during pregnancy (P=0.001, mother’s age (P=0.049, consumption of supplements during pregnancy (P=0.03, and history of substance abuse in mothers (P=0.03 were found to have significant roles in having LBW neonate.Conclusion: Identifying the sociobehavioral risk factors of Preterm labor and modifying them to prevent preterm birth are essential approaches to prevent LBW. Governments should pay special attention to nutritional status of teenage and young girls to have healthy mothers and babies in the future. Women of childbearing age should be screened and educated about risky behaviors. Pregnancy care and support should be delivered to all pregnant women according to the standard methods.Keywords: Low Birth Weight; Risk Factors; Behavior; Preterm Labor

Outcome of Very Low Birth Weight Infants Over 3 Years Report From an Iranian Center

OpenAIRE

Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Fallahi, Minoo; Esmaili, Fatemeh

2013-01-01

Objective Very low birth weight (VLBW) infants are at high risk for morbidity and mortality. This article determines the frequency of disease, rate od survival, complications and risk factors for morbidity and mortality in VLBW neonates admitted to a level III neonatal intensive care unit (NICU) at Mahdieh Hospital in Tehran. Methods This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates. Relevant pre- and peri-natal data up to t...

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

OpenAIRE

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

2015-01-01

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

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

Science.gov (United States)

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

2018-03-01

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

Variations and Determinants of Mortality and Length of Stay of Very Low Birth Weight and Very Low for Gestational Age Infants in Seven European Countries.

Science.gov (United States)

Fatttore, Giovanni; Numerato, Dino; Peltola, Mikko; Banks, Helen; Graziani, Rebecca; Heijink, Richard; Over, Eelco; Klitkou, Søren Toksvig; Fletcher, Eilidh; Mihalicza, Péter; Sveréus, Sofia

2015-12-01

The EuroHOPE very low birth weight and very low for gestational age infants study aimed to measure and explain variation in mortality and length of stay (LoS) in the populations of seven European nations (Finland, Hungary, Italy (only the province of Rome), the Netherlands, Norway, Scotland and Sweden). Data were linked from birth, hospital discharge and mortality registries. For each infant basic clinical and demographic information, infant mortality and LoS at 1 year were retrieved. In addition, socio-economic variables at the regional level were used. Results based on 16,087 infants confirm that gestational age and Apgar score at 5 min are important determinants of both mortality and LoS. In most countries, infants admitted or transferred to third-level hospitals showed lower probability of death and longer LoS. In the meta-analyses, the combined estimates show that being male, multiple births, presence of malformations, per capita income and low population density are significant risk factors for death. It is essential that national policies improve the quality of administrative datasets and address systemic problems in assigning identification numbers at birth. European policy should aim at improving the comparability of data across jurisdictions. Copyright © 2015 John Wiley & Sons, Ltd.

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

Science.gov (United States)

1997-08-01

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

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

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

2011-12-01

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

Permissive hypotension in extremely low birth weight infants (≤1000 gm).

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Ahn, So Yoon; Kim, Eun Sun; Kim, Jin Kyu; Shin, Jeong Hee; Sung, Se In; Jung, Ji Mi; Chang, Yun Sil; Park, Won Soon

2012-07-01

We performed this study to evaluate the safety of permissive hypotension management in extremely low birth weight infants (ELBWIs). Medical records of all inborn ELBWIs admitted to Samsung Medical Center from January 2004 to December 2008 were reviewed retrospectively. Of a total of 261 ELBWIs, 47 (18%) required treatment for hypotension (group T), 110 (42%) remained normotensive (group N), and 104 (40%) experienced more than one episode of hypotension without treatment (group P) during the first 72 hours of life. Treatment of hypotension included inotropic support and/or fluid loading. Birth weight and Apgar scores were significantly lower in the T group than the other two groups. In the N group, the rate of pathologically confirmed maternal chorioamnionitis was significantly higher than other two groups, and the rate was higher in the P group than the T group. After adjusting for covariate factors, no significant differences in mortality and major morbidities were found between the N and P groups. However, the mortality rate and the incidence of intraventricular hemorrhage (≥stage 3) and bronchopulmonary dysplasia (≥moderate) were significantly higher in the T group than the other two groups. Long term neurodevelopmental outcomes were not significantly different between the N and P groups. Close observation of hypotensive ELBWIs who showed good clinical perfusion signs without intervention allowed to avoid unnecessary medications and resulted in good neurological outcomes.

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

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

2012-01-01

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

Delivery mode and intraventricular hemorrhage risk in very-low-birth-weight infants: Observational data of the German Neonatal Network.

Science.gov (United States)

Humberg, Alexander; Härtel, Christoph; Paul, Pia; Hanke, Kathrin; Bossung, Verena; Hartz, Annika; Fasel, Laura; Rausch, Tanja K; Rody, Achim; Herting, Egbert; Göpel, Wolfgang

2017-05-01

Very-low-birth-weight infants (VLBWI) are frequently delivered by cesarean section (CS). However, it is unclear at what gestational age the benefits of spontaneous delivery outweigh the perinatal risks, i.e. intraventricular hemorrhage (IVH) or death. To assess the short-term outcome of VLBWI on IVH according to mode of delivery in a population-based cohort of the German Neonatal Network (GNN). A total cohort of 2203 singleton VLBWI with a birth weight 30 weeks of gestation prevalence for IVH was not significantly different in VD and planned CS (5.3% vs. 4.4%). Our observational data demonstrate that elective cesarean section is associated with a reduced risk of IVH in preterm infants <30 weeks gestational age when presenting with preterm labor. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

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

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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.

Risk status for dropping out of developmental followup for very low birth weight infants.

Science.gov (United States)

Catlett, A T; Thompson, R J; Johndrow, D A; Boshkoff, M R

1993-01-01

Not keeping scheduled visits for medical care is a major health care issue. Little research has addressed how the interaction of demographic and biomedical parameters with psychosocial processes has an impact on appointment keeping. Typical factors are stress of daily living, methods of coping, social support, and instrumental support (that is, tangible assistance). In this study, the authors examine the role of these parameters and processes in the risk status for dropping out of a developmental followup program for very low birth weight infants. The findings suggest that the stress of daily living is a significant predictor for the mother's return when the infant is 6 months of age (corrected for prematurity). The predictors for return at 24 months corrected age include marital status, race, gestational age of the infant, maternal intelligence, and efficacy expectations. Providing transportation was found to be a successful intervention strategy for a subgroup at very high risk for dropping out due to a constellation of biomedical, demographic, and psychosocial factors.

Impact of birth weight and early infant weight gain on insulin resistance and associated cardiovascular risk factors in adolescence

DEFF Research Database (Denmark)

Fabricius-Bjerre, Signe; Jensen, Rikke Beck; Færch, Kristine

2011-01-01

Low birth weight followed by accelerated weight gain during early childhood has been associated with adverse metabolic and cardiovascular outcomes later in life. The aim of this study was to examine the impact of early infant weight gain on glucose metabolism and cardiovascular risk factors...

Prevalence of and risk factors for cranial ultrasound abnormalities in very-low-birth-weight infants at Charlotte Maxeke Johannesburg Academic Hospital

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Azra Ghoor

2017-07-01

Full Text Available Background. Periventricular-intraventricular haemorrhage (IVH and cystic periventricular leukomalacia (cPVL contribute to neonatal mortality and morbidity. Low birth weight and gestational age are among the risk factors for IVH and cPVL. Objectives. To assess how many very low birth weight (VLBW infants had cranial ultrasound screening at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH and to determine the prevalence of cranial ultrasound abnormalities. To compare the characteristics and risk factors of those VLBW infants with cranial ultrasound abnormalities to those with normal cranial ultrasound findings. Methods. This was a retrospective case-controlled study of infants <1 500 g admitted to CMJAH from 1 January 2013 to 31 December 2015. Cases were identified as infants with IVH or cPVL. Controls were matched 1:2 based on birth weight and gender. Results. Only 55% (856/1 562 of VLBW infants had undergone cranial ultrasound screening. The final sample included 803 VLBW infants. IVH was identified in 26.7% of cases (n=215; 95% confidence interval (CI 23.8 - 29.9 and 0.9% had cPVL (n=8; 95% CI 0.5 - 1.9. A total of 197 cases were identified and matched with 394 controls. Antenatal care attendance was lower in the cases (71% v. 79%; p=0.039. Sepsis, ventilation, metabolic acidosis and patent ductus arteriosus were all significantly higher in the cases. The use of antenatal steroids was significantly higher in the grades I - II IVH/no-IVH group v. grades III - IV IVH group (44% v. 25%; p=0.017. Conclusion. The prevalence of IVH in our setting was consistent with that of developed countries. Improving antenatal care, infection control, and adequate early resuscitation could decrease the incidence of IVH and cPVL. All VLBW infants should undergo cranial ultrasound screening

The association of birth weight and infant growth with physical fitness at 8-9 years of age-the ABCD study

NARCIS (Netherlands)

van Deutekom, A.W.; Chin A Paw, M.J.M.; Vrijkotte, T.G.M.; Gemke, R.J.B.J.

2015-01-01

Background:Low birth weight and accelerated infant growth are independently associated with childhood obesity. We hypothesized that birth weight and infant growth are associated with physical fitness in childhood, and thereby could act as a link in the developmental origins of obesity. In addition,

The association of birth weight and infant growth with physical fitness at 8-9 years of age--the ABCD study

NARCIS (Netherlands)

van Deutekom, A. W.; Chinapaw, M. J. M.; Vrijkotte, T. G. M.; Gemke, R. J. B. J.

2015-01-01

Low birth weight and accelerated infant growth are independently associated with childhood obesity. We hypothesized that birth weight and infant growth are associated with physical fitness in childhood, and thereby could act as a link in the developmental origins of obesity. In addition, we assessed

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

Science.gov (United States)

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

2015-01-01

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

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

Directory of Open Access Journals (Sweden)

Hsin-Chung Huang

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

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

African Journals Online (AJOL)

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

Hospital outcomes of extremely low birth weight infants after introduction of donor milk to supplement mother's milk.

Science.gov (United States)

Verd, Sergio; Porta, Roser; Botet, Francesc; Gutiérrez, Antonio; Ginovart, Gemma; Barbero, Ana Herranz; Ciurana, Anna; Plata, Isabel Iglesias

2015-04-01

This study evaluated the impact of an exclusive human milk diet to nourish extremely low birth weight infants in the neonatal intensive care unit. This multicenter pre-post retrospective study included all inborn infants milk policy. The feeding protocol was unchanged in both periods. Collected data included maternal/infant demographics, infant clinical data, and enteral intake as mother's own milk, donor milk, and formula. Two hundred one infants were enrolled. Infant growth and other clinical outcomes were similar in both groups. Exposure to mother's own milk at discharge was not different. Median time in oxygen and duration of mechanical ventilation were significantly higher among formula-fed infants (63 versus 192 hours [p=0.046] and 24 versus 60 hours [p=0.016], respectively). Our results add evidence supporting the safety of donor milk. This study also found an association between exposure to formula in preterm infants and the requirement for respiratory support, a finding that warrants further investigation.

High Flow Nasal Cannula Use Is Associated with Increased Morbidity and Length of Hospitalization in Extremely Low Birth Weight Infants

Science.gov (United States)

Taha, Dalal K.; Kornhauser, Michael; Greenspan, Jay S.; Dysart, Kevin C.; Aghai, Zubair H.

2017-01-01

Objective To determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in extremely low birth weight infants managed on high flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP). Study design This is aretrospective data analysis from the Alere Neonatal Database for infants born between January 2008 and July 2013, weighing ≤ 1000 g at birth, and received HFNC or CPAP. Baseline demographics, clinical characteristics, and neonatal outcomes were compared between the infants who received CPAP and HFNC, or HFNC ± CPAP. Multivariable regression analysis was performed to control for the variables that differ in bivariate analysis. Results A total of 2487 infants met the inclusion criteria (941 CPAP group, 333 HFNC group, and 1546 HFNC ± CPAP group). The primary outcome of BPD or death was significantly higher in the HFNC group (56.8%) compared with the CPAP group (50.4%, P < .05). Similarly, adjusted odds of developing BPD or death was greater in the HFNC ± CPAP group compared with the CPAP group (OR 1.085, 95% CI 1.035–1.137, P = .001). The number of ventilator days, postnatal steroid use, days to room air, days to initiate or reach full oral feeds, and length of hospitalization were significantly higher in the HFNC and HFNC ± CPAP groups compared with the CPAP group. Conclusions In this retrospective study, use of HFNC in extremely low birth weight infants is associated with a higher risk of death or BPD, increased respiratory morbidities, delayed oral feeding, and prolonged hospitalization. A large clinical trial is needed to evaluate long-term safety and efficacy of HFNC in preterm infants. PMID:27004673

High Flow Nasal Cannula Use Is Associated with Increased Morbidity and Length of Hospitalization in Extremely Low Birth Weight Infants.

Science.gov (United States)

Taha, Dalal K; Kornhauser, Michael; Greenspan, Jay S; Dysart, Kevin C; Aghai, Zubair H

2016-06-01

To determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in extremely low birth weight infants managed on high flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP). This is a retrospective data analysis from the Alere Neonatal Database for infants born between January 2008 and July 2013, weighing ≤1000 g at birth, and received HFNC or CPAP. Baseline demographics, clinical characteristics, and neonatal outcomes were compared between the infants who received CPAP and HFNC, or HFNC ± CPAP. Multivariable regression analysis was performed to control for the variables that differ in bivariate analysis. A total of 2487 infants met the inclusion criteria (941 CPAP group, 333 HFNC group, and 1546 HFNC ± CPAP group). The primary outcome of BPD or death was significantly higher in the HFNC group (56.8%) compared with the CPAP group (50.4%, P CPAP group compared with the CPAP group (OR 1.085, 95% CI 1.035-1.137, P = .001). The number of ventilator days, postnatal steroid use, days to room air, days to initiate or reach full oral feeds, and length of hospitalization were significantly higher in the HFNC and HFNC ± CPAP groups compared with the CPAP group. In this retrospective study, use of HFNC in extremely low birth weight infants is associated with a higher risk of death or BPD, increased respiratory morbidities, delayed oral feeding, and prolonged hospitalization. A large clinical trial is needed to evaluate long-term safety and efficacy of HFNC in preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.

The influence of fish-oil lipid emulsions on retinopathy of prematurity in very low birth weight infants: a randomized controlled trial.

Science.gov (United States)

Beken, Serdar; Dilli, Dilek; Fettah, Nurdan Dinlen; Kabataş, Emrah Utku; Zenciroğlu, Ayşegül; Okumuş, Nurullah

2014-01-01

To compare the effect of two lipid emulsions on the development of retinopathy of prematurity in very low birth weight infants. Randomized controlled study. Eighty very low birth weight infants receiving parenteral nutrition from the first day of life were evaluated. One of the two lipid emulsions were used in the study infants: Group 1 (n=40) received fish-oil based lipid emulsion (SmofLipid®) and Group 2 (n=40) soybean oil based lipid emulsion (Intralipid®). The development of retinopathy of prematurity and the need for laser photocoagulation were assessed. The maternal and perinatal characteristics were similar in both groups. The median (range) duration of parenteral nutrition [14days (10-28) vs 14 (10-21)] and hospitalization [34days (20-64) vs 34 (21-53)] did not differ between the groups. Laboratory data including complete blood count, triglyceride level, liver and kidney function tests recorded before and after parenteral nutrition also did not differ between the two groups. In Group 1, two patients (5.0%) and in Group 2, 13 patients (32.5%) were diagnosed with retinopathy of prematurity (OR: 9.1, 95% CI 1.9-43.8, p=0.004). One patient in each group needed laser photocoagulation, without significant difference. Multivariate analysis showed that only receiving fish-oil emulsion in parenteral nutrition decreased the risk of development of retinopathy of prematurity [OR: 0.76, 95% CI (0.06-0.911), p=0.04]. Premature infants with very low birth weight receiving an intravenous fat emulsion containing fish oil developed less retinopathy of prematurity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Trends and racial differences in birth weight and related survival.

Science.gov (United States)

Alexander, G R; Tompkins, M E; Allen, M C; Hulsey, T C

1999-06-01

In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates. Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life. Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans. The ongoing decline in neonatal mortality is mainly due to reductions in birth weight specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.

Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.

LENUS (Irish Health Repository)

Miletin, J

2012-02-01

OBJECTIVE: Recent evidence suggests that high cortisol concentrations are associated with increased morbidity and mortality in very low birth weight (VLBW) infants. Neonatal illness severity and mortality risk scores are reliable in predicting morbidity and mortality. The objectives were (i) to assess the correlation between serum cortisol levels and clinical assessment of multi-organ dysfunction\\/illness severity scores (CRIB II, SNAPPE-II and neonatal multiple organ dysfunction score (NEOMOD)) in first 24 h in VLBW infants and (ii) to assess the relationship between surrogates of end organ blood flow and serum cortisol levels. STUDY DESIGN: A prospective observational cohort study. Neonates with birth weight <1500 g were eligible for enrollment. Echocardiography evaluation of superior vena cava (SVC) flow was carried out in the first 24 h life. Cortisol levels were measured simultaneously and appropriate clinical scores were calculated. RESULT: A total of 54 VLBW neonates were enrolled following parental consent. Two patients were excluded because of congenital malformations. In 14 babies the cortisol value was not simultaneously obtained. The mean birth weight was 1.08 kg, mean gestational age was 27.8 weeks. There was a significant correlation between cortisol and NEOMOD score (P=0.006). There was no correlation between cortisol and CRIB II score (P=0.34), SVC flow (P=0.49) and mean arterial blood pressure respectively (P=0.35). CONCLUSION: There was no correlation between SVC flow and cortisol values or between cortisol and mean blood pressure values. There was a significant correlation between cortisol levels and neonatal organ dysfunction score evaluated suggesting that stressed VLBW infants do mount a cortisol response.

Postdischarge growth and development in a predominantly Hispanic, very low birth weight population.

Science.gov (United States)

Powers, George C; Ramamurthy, Rajam; Schoolfield, John; Matula, Kathleen

2008-12-01

The goals were to assess postdischarge growth and developmental progress of very low birth weight (birth weight: population and to identify predictors for neurodevelopmental impairment at 3 years of age. A cohort of 135 very low birth weight infants (gestational age: 23 to 35 weeks) were monitored to 3 years of age. Maternal and neonatal characteristics, anthropometric z scores, and developmental performance (using corrected age until 24 months) were analyzed collectively and according to gestational age groups. Specific criteria for failure to thrive and microcephaly were used. A characteristic pattern of poor weight gain in the first 12 months was followed by accelerated weight gain starting at 18 months, whereas head growth decreased at 18 months, with recovery beginning at 30 months of age. Infants born at gestational age of growth-impaired at 3 years of age, whereas infants born at gestational age of >or=27 weeks achieved catch-up growth by 30 months of age. Mean developmental scores also decreased in infancy, with improvements in motor development emerging at 18 months and cognitive skills at 30 months. Growth z scores, particularly for head growth, correlated with developmental scores. Infants born at gestational age of growth patterns that coincided with developmental progress in the first 3 years of life. Birth at gestational age of

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

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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

Birth weight and fetal growth in infants born to female hairdressers and their sisters.

Science.gov (United States)

Axmon, A; Rylander, L

2009-03-01

To investigate birth weight and fetal growth in female hairdressers, while controlling for intergenerational effects and effects related to childhood exposures. A cohort of women who had attended vocational schools for hairdressers were compared to their sisters with respect to birth weight and fetal growth (measured as small for gestational age (SGA) or large for gestational age (LGA), respectively) in their infants. In total, 6223 infants born to 3137 hairdressers and 8388 infants born to 3952 hairdressers' sisters were studied. Among the infants born to the hairdressers' sisters, the distribution of birth weights were wider than that among the infants born to the hairdressers. This was also reflected in that hairdresser cohort affiliation tended to be protective against both SGA (odds ratio 0.80; 95% confidence interval 0.49 to 1.31) and LGA (0.77; 0.54 to 1.09). For LGA, this effect was even more pronounced among women who had actually worked as hairdressers during at least one pregnancy (0.60; 0.39 to 0.92). The infants born to these women also had a significantly lower mean birth weight (3387 g vs 3419 g; p = 0.033). The results from the present study suggest that infants born to hairdressers have a decreased risk of being LGA. This is most likely not caused by a shift in birth weight distribution or abnormal glucose metabolism.

Refeeding syndrome in very-low-birth-weight intrauterine growth-restricted neonates.

Science.gov (United States)

Ross, J R; Finch, C; Ebeling, M; Taylor, S N

2013-09-01

Determine the incidence of refeeding syndrome, defined by the presence of hypophosphatemia in very-low-birth-weight (VLBW) infants with intrauterine growth restriction (IUGR) compared with those without IUGR. In this retrospective cohort study, VLBW infants admitted over a 10-year period (271 IUGR and 1982 non-IUGR) were evaluated for specific electrolyte abnormalities in the first postnatal week. IUGR infants were significantly more likely to have hypophosphatemia (41% vs 8.9%, relative risk (95% confidence interval: 7.25 (5.45, 9.65)) and severe hypophosphatemia (11.4% vs 1%, 12.06 (6.82, 21.33)) in the first postnatal week. The incidence of hypophosphatemia was significantly associated with the presence of maternal preeclampsia in all VLBW infants (odds ratio (OR): 2.58 (1.96, 3.40)) when controlling for birth weight and gestational age. Refeeding syndrome occurs in VLBW infants with IUGR and born to mothers with preeclampsia. Close monitoring of electrolytes, especially phosphorus, is warranted in this population.

Factors associated with low birth weight in Nepal using multiple imputation

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Usha Singh

2017-02-01

Full Text Available Abstract Background Survey data from low income countries on birth weight usually pose a persistent problem. The studies conducted on birth weight have acknowledged missing data on birth weight, but they are not included in the analysis. Furthermore, other missing data presented on determinants of birth weight are not addressed. Thus, this study tries to identify determinants that are associated with low birth weight (LBW using multiple imputation to handle missing data on birth weight and its determinants. Methods The child dataset from Nepal Demographic and Health Survey (NDHS, 2011 was utilized in this study. A total of 5,240 children were born between 2006 and 2011, out of which 87% had at least one measured variable missing and 21% had no recorded birth weight. All the analyses were carried out in R version 3.1.3. Transform-then impute method was applied to check for interaction between explanatory variables and imputed missing data. Survey package was applied to each imputed dataset to account for survey design and sampling method. Survey logistic regression was applied to identify the determinants associated with LBW. Results The prevalence of LBW was 15.4% after imputation. Women with the highest autonomy on their own health compared to those with health decisions involving husband or others (adjusted odds ratio (OR 1.87, 95% confidence interval (95% CI = 1.31, 2.67, and husband and women together (adjusted OR 1.57, 95% CI = 1.05, 2.35 were less likely to give birth to LBW infants. Mothers using highly polluting cooking fuels (adjusted OR 1.49, 95% CI = 1.03, 2.22 were more likely to give birth to LBW infants than mothers using non-polluting cooking fuels. Conclusion The findings of this study suggested that obtaining the prevalence of LBW from only the sample of measured birth weight and ignoring missing data results in underestimation.

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

Science.gov (United States)

1991-07-01

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

Economic Crises, Maternal and Infant Mortality, Low Birth Weight and Enrollment Rates: Evidence from Argentina’s Downturns

OpenAIRE

Guillermo Cruces; Pablo Glüzman; Luis Felipe López Calva

2011-01-01

This study investigates the impact of recent crises in Argentina (including the severe downturn of 2001-2002) on health and education outcomes. The identification strategy relies on both the inter-temporal and the cross-provincial co-variation between changes in regional GDP and outcomes by province. These results indicate significant and substantial effects of aggregate fluctuations on maternal and infant mortality and low birth weight, with countercyclical though not significant patterns fo...

Delivery of the extremely low-birth- weight vertex-presenting baby ...

African Journals Online (AJOL)

2010-12-02

Dec 2, 2010 ... rise in the caesarean section rate.1 This rise has been disproportionate to ... a possible extremely low-birth-weight infant the risks of mortality and short- and .... the US Health Statistics data from 1999 to 2000 using multivariate ...

Experience in application of enriched breast milk in feeding children with very low birth weight

Directory of Open Access Journals (Sweden)

Panina O.S.

2014-12-01

Full Text Available Nursing of very low and extremely low birth weight infants is one of the most difficult problems of modern perinatol-ogy. It is impossible to carry out this task without organization of fee-ding of this group of children. The aim of our research was to study clinical efficiency of breast milk fortifiers administration (human milk fortifier when preterm infants feeding. Materials and methods. In consequence of this clinical research (with included 60 premature infants born at less than 33 weeks of gestational age with less than 1500g birth weight the following advantages before other types of feeding were revealed. Results. Mother and child solidarity in the course of breast feeding make deep favorable mutual emotional pressure. It was succeeded to keep all breast feeding advantages and to provide preterm infants special needs in feedstuffs. Human milk fortifiers administration provides higher body weight gain intensity; reduces length of stay in a hospital. It should not go unnoticed high tolerability and lack of complications at its medication usability was noted. Human milk fortifier divorce with small quantity of breast milk and that is especially important for very low and extremely low birth weight infants feeding. Conclusion. All above-mentioned allows recommending human milk fortifiers «PRE NAN FM 85» administration for breast milk in neonatal practice

THE EFFECTIVENESS OF COMBINATION OF KANGAROO MOTHER CARE METHOD AND LULLABY MUSIC THERAPY ON VITAL SIGN CHANGE IN INFANTS WITH LOW BIRTH WEIGHT

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Nuuva Yusuf

2017-08-01

Full Text Available Background: Kangaroo mother care (KMC and lullaby music methods have been considered as the alternative treatment for vital sign changes in low birth weight infants. However, little is known about the combination of the two methods. Objective: To identify effectiveness of combinations of Kangaroo mother care and Lullaby music methods on changes in vital signs in low birth weight infants. Methods: A quasi experiment with non-equivalent control group design. This study was conducted on October– December 2016 at the General Hospital of Ambarawa and General Hospital of Ungaran, Semarang. There were 36 samples selected using consecutive sampling divided into three groups, namely: 1 a group of LBW infants with the combination of KMC and lullaby music, 2 a LBW infant group with the lullaby music intervention, and 3 a control group given standard care in LBW infants by KMC method. Paired t-test and MANOVA test were used to analyzed the data. Results: Findings revealed that there were significant differences between the combination group, lullaby music group, and control group in temperature (p=0.003, pulse (p=0.001, respiration (p=0.001, and oxygen saturation (p=0.014 with significant value of <0.05, which indicated that there was a statistically significant difference in vital sign changes among the three groups. Conclusion: The combination of KMC method and Lullaby music intervention was effective on vital sign changes (temperature, pulse, respiration, and oxygen saturation compared with the lullaby music group alone and control group with KMC method in low birth weight infants. It is suggested that the combination of KMC and Lullaby music methods can be used as an alternative to improve LBW care for mothers in the NICU and at home and to reach the stability of the baby's vital signs.

Relationship between periodontal disease and preterm low birth weight: systematic review.

Science.gov (United States)

Teshome, Amare; Yitayeh, Asmare

2016-01-01

Periodontal disease is a neglected bacterial infection that causes destruction of the periodontium in pregnant women. Yet its impact on the occurrence of adverse pregnancy outcomes has not systematically evaluated and there is no clear statement on the relationship between periodontal disease and preterm low birth weight. The objective of this study was to summarize the evidence on the impact of periodontal disease on preterm low birth weight. We searched the following data bases from January 2005 to December 2015: CINAHL (cumulative index to nursing and allied health literature), MEDLINE, AMED, EMBASE (excerpta medica database), Cochrane library and Google scholar. Only case-control studies with full text in English were eligible. Critical appraisal of the identified articles was done by two authors independently to provide the possible relevance of the papers for inclusion in the review process. The selected Case control studies were critically appraised with 12 items structured checklist adapted from national institute of health (NIH). Odds ratio (OR) or risk ratios (RR) were extracted from the selected studies. The two reviewers who selected the appropriate studies also extracted the data and evaluated the risk of bias. Of 229 articles, ten studies with a total of 2423 participants with a mean age ranged from 13 to 49 years were met the inclusion criteria. The studies focused on preterm birth, low birth weight and /or preterm low birth weight and periodontitis. Of the selected studies, 9 implied an association between periodontal disease and increased risk of preterm birth, low birth weight and /or preterm low birth weight outcome (ORs ranging from 2.04 to 4.19) and only one study found no evidence of association. Periodontal disease may be one of the possible risk factor for preterm low birth weight infant. However, more precise studies with randomized clinical trial with sufficient follow-up period must be done to confirm the association.

Mortality and major morbidity of very low birth weight infants in Germany 2008-2012: A report based on administrative data

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Elke eJeschke

2016-03-01

Full Text Available Background: Expectant parents of very preterm infants, physicians and policy makers require estimates for chances of survival and survival without morbidity. Such estimates should derive from a large, reliable and contemporary data base of easily available items known at birth.Objective: To determine short-term outcome and risk factors in very low birth weight preterm infants based on administrative dataMethods: Anonymized routine data sets transmitted from hospital administrations to statutory health insurance companies were used to assess survival and survival free of major morbidities in a large cohort of preterm infants in Germany.Results: After exclusion of infants with lethal malformations, there were 13,147 infants with a birth weight below 1,500 g admitted to neonatal care 2008-2012, of whom 1,432 infants (10.9% died within 180 d. Estimated 180 d survival probabilities were 0.632 [95% confidence interval 0.583-0.677] for infants with 250-499 g birth weight, 0.817 [0.799-0.834] for 500-749 g, 0.931 [0.920-0.940] for 750-999 g, 0.973 [0.967-0.979] for 1,000-1,249 g and 0.985 [0.981-0.988] for 1,250-1,499 g. Estimated probabilities for survival without major morbidity (surgically treated intraventricular hemorrhage, necrotizing enterocolitis, intestinal perforation, or retinopathy were 0.433 [0.384-0.481] (250-499 g, 0.622 [0.600-0.643] (500-749 g, 0.836 [0.821-0.849] (750-999 g, 0.938 [0.928-0.946] (1,000-1,249 g, and 0.969 [0.964-0.974] (1,250-1,499 g, respectively. Prediction of survival and survival without major morbidities was moderately improved by adding sex, small-for-gestational-age, and severe or moderate congenital malformation, increasing ROC areas under the curve from 0.839 [0.827-0.850] to 0.862 [0.852-0.874] (survival and from 0.827 [0.822-0.842] to 0.852 [0.846-0.863] (survival without major morbidities, respectively. Conclusion: The present analysis encourages attempts to use administrative data to investigate the

Endothelial dysfunction and functional status of intestinal mucosal barrier in asphyxiated low birth weight infants

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Huseynova S.A.

2016-03-01

Full Text Available Aim of study. The main prpose of present study was to determine the effect of endothelial dysfunction to the levels of markers of functional state of digestive system in infants with perinatal hypoxia. Materials and methods. The neuronal dysfunction was detected basing on the levels of NSE and NR2 antibodies. The functional state of gastrointestinal tract was estimated by IFABP, sLFABP, MUC-2, ITF, LBP. As the markers of endothelial dysfunction it was detected endotelin-1 and NO. The concentrations of markers were determined in peripheral blood of 66 preterm newborns exposure intrauterine hypoxia with 32–36 weeks of gestational age, which were classified as asphyxiated (1st group, n=30, non asphyxiated (2nd group, n=36 infants. Control group consisted of 22 healthy preterm babies. Results. It was not detected significant difference of NSE and NR2 antibodies levels between 1st and 2nd groups. The endothelin-1 concentrations significantly decreased in asphyxiated group in the background of high NO levels. The elevated level of IFABP in asphyxiated infants associated with compensative increasing of ITF and low anti endotoxine immunity. Conclusion. Endothelial dysfunction is one of the main factor resulting in hypoxic-ischemic injury of gastrointestinal tract in asphyxiated low birth weight infants.

Regional Brain Biometrics at Term-Equivalent Age and Developmental Outcome in Extremely Low-Birth-Weight Infants.

Science.gov (United States)

Melbourne, Launice; Murnick, Jonathan; Chang, Taeun; Glass, Penny; Massaro, An N

2015-10-01

This study aims to evaluate individual regional brain biometrics and their association with developmental outcome in extremely low-birth-weight (ELBW) infants. This is a retrospective study evaluating term-equivalent magnetic resonance imaging (TE-MRI) from 27 ELBW infants with known developmental outcomes beyond 12 months corrected age. Regional biometric measurements were performed by a pediatric neuroradiologist blinded to outcome data. Measures included biparietal width, transcerebellar diameter (TCD), deep gray matter area (DGMA), ventricular dilatation, corpus callosum, and interhemispheric distance. The relationship between regional biometrics and Bayley-II developmental scores were evaluated with linear regression models. The study cohort had an average±standard deviation birth weight of 684±150 g, gestational age of 24.6±2 weeks and 48% males. DGMA was significantly associated with both cognitive and motor outcomes. Significant associations were also observed between TCD and corpus callosum splenium with cognitive and motor outcomes, respectively. Other biometric measures were not associated with outcome (p>0.05). DGMAbiometrics reflecting impaired deep gray matter, callosal, and cerebellar size is associated with worse early childhood cognitive and motor outcomes. DGMA may be the most robust single biometric measure to predict adverse developmental outcome in preterm survivors. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Low-birth-weight babies among hospital deliveries in Nepal: a hospital-based study

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Koirala AK

2015-06-01

Full Text Available Arun K Koirala,1 Dharma N Bhatta2,3 1Administrative Department, Helping Hands Community Hospital, Chabahil, Kathmandu, 2Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 3Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Background: Birth weight is an important indicator of a population’s health and is associated with numerous interrelated factors in the infant, mother, and physical environment. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a liveborn infant among the women in Morang, Nepal.Methods: A cross-sectional survey was carried out from December 2010 to March 2011 among 255 mothers who gave birth during the study period at the Koshi Zonal Hospital, Nepal. Data were collected using a structured questionnaire with face-to-face interviews. Data were analyzed through logistic regression and presented with crude and adjusted odds ratios (AORs with 95% confidence intervals (CIs.Results: The study showed that the prevalence of low-birth-weight babies was 23.1% (95% CI: 17.9–28.1. The mean (standard deviation age of mothers was 23.23 (4.18 years. The proportion of low birth weight of previous baby was 3.9% (95% CI: 0.1–7.9, and 15.7% (95% CI: 11.5–20.5 of the respondents had preterm delivery. Nearly one-third (36.1%; 95% CI: 26.4–45.6 of the respondents had >2 years’ gap after the previous delivery. Nonformal employment (AOR: 2.14; 95% CI: 0.523–8.74, vegetarian diet (AOR: 1.47; 95% CI: 0.23–9.36, and no rest during pregnancy (AOR: 1.38; 95% CI: 0.41–4.39 were factors more likely to determine low birth weight. However, none of the variables showed a significant association between low birth weight and other dependent variables.Conclusion: Low birth weight is an important factor for perinatal morbidity and mortality and is a common problem in the developing world. The

Association of Antegrade Pulmonary Artery Diastolic Velocity with Spontaneous Closure of the Patent Ductus Arteriosus in Extremely Low-Birth-Weight Infants.

Science.gov (United States)

Weiss, Dawn M; Kaiser, Jeffrey R; Swearingen, Christopher; Malik, Sadia; Sachdeva, Ritu

2015-11-01

This study aims to determine echocardiographic parameters associated with spontaneous patent ductus arteriosus (PDA) closure in extremely low-birth-weight (ELBW) infants. Retrospective demographic review and analysis of echocardiograms from 189 ELBW infants with suspected and confirmed hemodynamically significant PDA identified on an initial echocardiogram was performed. Comparison of echocardiographic parameters was made between infants with spontaneous closure versus those who received treatment. The mean birth weight (787 ± 142 vs. 724 ± 141 g, p = 0.04) and gestational age (27.4 ± 2.8 vs. 26.2 ± 1.6 weeks, p = 0.03) were higher in the spontaneous closure versus the treatment group. Antegrade pulmonary artery (PA) diastolic velocity was lower in infants with spontaneous PDA closure versus those who received treatment (0.15 ± 0.06 vs. 0.22 ± 0.12 m/s, p = 0.009). Heavier and more mature ELBW infants with a lower antegrade PA diastolic velocity were likely to have spontaneous closure of the PDA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Parenteral lipid administration to very-low-birth-weight infants-early introduction of lipids and use of new lipid emulsions: a systematic review and meta-analysis

NARCIS (Netherlands)

Vlaardingerbroek, Hester; Veldhorst, Margriet A. B.; Spronk, Sandra; van den Akker, Chris H. P.; van Goudoever, Johannes B.

2012-01-01

Background: The use of intravenous lipid emulsions in preterm infants has been limited by concerns regarding impaired lipid tolerance. As a result, the time of initiation of parenteral lipid infusion to very-low-birth-weight (VLBW) infants varies widely among different neonatal intensive care units.

Relationship between maternal periodontal disease and low birth weight babies

Directory of Open Access Journals (Sweden)

Ahmad Haerian-Ardakani

2013-01-01

Full Text Available Background: Periodontal infections, which serve as a reservoir of inflammatory mediators, may pose a threat to the fetal-placental unit and cause adverse pregnancy outcomes. Objective: The aim of this study was assessing the periodontal status of women during puerperium and determining the possible relationship between their periodontal disease and low birth weight delivery. Materials and Methods: This was a case-control study. The sample included 88 ex-pregnant women were seen at maternity hospitals of Yazd, Iran. Half of the mothers had low birth babies (LBW (birth weight below 2500g- case group and the others had normal weight babies (>2500g- control group. The mothers’ data were obtained from medical files, interview and periodontal clinical examination carried out up to 3 days after delivery. Bleeding on probing, presence of supra-gingival calculus and CPITN (Community Periodontal Index for Treatment Needs were used for periodontal assessment Results: Among the known risk factors of LBW babies, history of previous LBW infant among case mothers reached statistical significance (p=0.0081, Student t-test. Mothers of LBW infants had less healthy areas of gingiva (p=0.042, and more deep pockets (p=0.0006, Mann-Whitney test. Conclusion: The maternal periodontal disease can be a potential independent risk factor for LBW.

Correlation between developmental disorders and MRI findings in very low birth weight infants

Energy Technology Data Exchange (ETDEWEB)

Fukuda, Kuniaki; Endo, Shoichi; Goda, Tomoko; Ota, Akira; Akita, Yuji; Furukawa, Seikyo (Kagawa Children' s National Sanatorium, Zentsuji (Japan))

1994-08-01

We investigated the prevalence of developmental disorders in very low birth weight infants, their risk factors during the neonatal period, and the correlation between their neurological symptoms and their MRI findings. Seventy-three infants, who were followed up for more than 5 years in the developmental clinic, were enrolled. The developmental disorders included 6 patients with cerebral palsy (CP) and 6 patients with mental retardation (MR). The types of CP were as follows: spastic diplegia (3), spastic quadriplegia (2), athetotic quadriplegia (1). Intraventricular hemorrhage (IVH) and mechanical ventilation (MV) were significant risk factors for CP and MR and retinopathy was also a significant risk factor for MR. Periventricular areas of bright signal intensity on T2 (TR 2000 msec/TE 120 mse) weighted images, compatible with old, small white matter infarcts, gliosis or demyelination, were observed in only three of the seven patients. We measured the width of anterior horns, the maximum diameter of cerebrum, and the minimum thickness of white matter in occipital lobe on T1 (TR 500 msec/TE 20 msec) weighted transaxial images in eight patients (five patients with CP, three patients with MR). The maximum diameters of cerebrums and the minimum thickness of white matters were significantly smaller in patients with CP or MR than those in controls, respectively. The DQ of patients significantly correlated with the maximum diameters of cerebrums and the minimum thickness of white matters in left occipital lobe significantly correlated with DQ. (author).

Correlation between developmental disorders and MRI findings in very low birth weight infants

International Nuclear Information System (INIS)

Fukuda, Kuniaki; Endo, Shoichi; Goda, Tomoko; Ota, Akira; Akita, Yuji; Furukawa, Seikyo

1994-01-01

We investigated the prevalence of developmental disorders in very low birth weight infants, their risk factors during the neonatal period, and the correlation between their neurological symptoms and their MRI findings. Seventy-three infants, who were followed up for more than 5 years in the developmental clinic, were enrolled. The developmental disorders included 6 patients with cerebral palsy (CP) and 6 patients with mental retardation (MR). The types of CP were as follows: spastic diplegia (3), spastic quadriplegia (2), athetotic quadriplegia (1). Intraventricular hemorrhage (IVH) and mechanical ventilation (MV) were significant risk factors for CP and MR and retinopathy was also a significant risk factor for MR. Periventricular areas of bright signal intensity on T2 (TR 2000 msec/TE 120 mse) weighted images, compatible with old, small white matter infarcts, gliosis or demyelination, were observed in only three of the seven patients. We measured the width of anterior horns, the maximum diameter of cerebrum, and the minimum thickness of white matter in occipital lobe on T1 (TR 500 msec/TE 20 msec) weighted transaxial images in eight patients (five patients with CP, three patients with MR). The maximum diameters of cerebrums and the minimum thickness of white matters were significantly smaller in patients with CP or MR than those in controls, respectively. The DQ of patients significantly correlated with the maximum diameters of cerebrums and the minimum thickness of white matters in left occipital lobe significantly correlated with DQ. (author)

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

Science.gov (United States)

Sharma, Arpana

2013-01-01

Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14–45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting. PMID:24575305

A risk prediction model for severe intraventricular hemorrhage in very low birth weight infants and the effect of prophylactic indomethacin.

Science.gov (United States)

Luque, M J; Tapia, J L; Villarroel, L; Marshall, G; Musante, G; Carlo, W; Kattan, J

2014-01-01

Develop a risk prediction model for severe intraventricular hemorrhage (IVH) in very low birth weight infants (VLBWI). Prospectively collected data of infants with birth weight 500 to 1249 g born between 2001 and 2010 in centers from the Neocosur Network were used. Forward stepwise logistic regression model was employed. The model was tested in the 2011 cohort and then applied to the population of VLBWI that received prophylactic indomethacin to analyze its effect in the risk of severe IVH. Data from 6538 VLBWI were analyzed. The area under ROC curve for the model was 0.79 and 0.76 when tested in the 2011 cohort. The prophylactic indomethacin group had lower incidence of severe IVH, especially in the highest-risk groups. A model for early severe IVH prediction was developed and tested in our population. Prophylactic indomethacin was associated with a lower risk-adjusted incidence of severe IVH.

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

African Journals Online (AJOL)

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

Efficacy of Saccharomyces boulardii on necrotizing enterocolitis or sepsis in very low birth weight infants: a randomised controlled trial.

Science.gov (United States)

Serce, Ozge; Benzer, Derya; Gursoy, Tugba; Karatekin, Guner; Ovali, Fahri

2013-12-01

Probiotics have strain specific effects and the effects of fungi in preventing diseases in preterm infants have been investigated poorly. Saccharomyces boulardii is a yeast which acts both as a probiotic and a polyamine producer. The objective of this study was to investigate the efficacy of S. boulardii in preventing necrotizing enterocolitis (NEC) or sepsis in very low birth weight infants. A prospective, double blind, placebo controlled trial was conducted in preterm infants (≤ 32 GWs, ≤ 1500 g birth weight). They were randomized either to receive feeding supplementation with S. boulardii 50 mg/kg every 12 h or placebo, starting with the first feed until discharged. Necrotizing enterocolitis (NEC) or sepsis and NEC or death. Birth weight and gestational age of the study (n = 104) and the control (n = 104) groups were 1126 ± 232 vs 1162 ± 216 g and 28.8 ± 2.2 vs 28.7 ± 2.1 weeks, respectively. Neither the incidence of stage ≥ 2 NEC or death nor stage ≥ 2 NEC or late onset culture proven sepsis was significantly lower in the study group when compared with the control group (9.6% vs 7.7%, p = 0.62; 28.8% vs 23%, p = 0.34). Time to reach 100 mL/kg/day of enteral feeding (11.9 ± 7 vs 12.6 ± 7 days, p = 0.37) was not different between the groups. Saccharomyces boulardii did not decrease the incidence of NEC or sepsis. © 2013 Elsevier Ireland Ltd. All rights reserved.

OBSERVATION ON INCREASE IN WEIGHT OF LOW BIRTH WEIGHT (LBW) BABIES BY IMPLEMENTING KANGAROO MOTHER CARE (KMC) TECHNIQUE

OpenAIRE

Purnendu Kumar Singh; Kumar Amritanshu; Bijoy Mukherjee

2014-01-01

Kangaroo Mother Care (KMC) is a practical technique for nursing of low birth weight babies by direct skin to contact with the mother. This study was undertaken to observe and record the effect of KMC with focus on increase in weight of at term low birth weight (LBW) babies weighing less than 2000 grams. The study was conducted over thirty six month’s period from July 2011 to June 2014. The method of care consisted of skin to skin contact between the mother and the infant along ...

Motor development in very preterm and very low-birth-weight children from birth to adolescence: A meta-analysis

NARCIS (Netherlands)

de Kieviet, J.F.; Piek, J.P.; Aarnoudse-Moens, C.S.H.; Oosterlaan, J.

2009-01-01

Context: Infants who are very preterm (born ≤32 weeks of gestation) and very low birth weight (VLBW) (weighing ≤1500 g) are at risk for poor developmental outcomes. There is increasing evidence that very preterm birth and VLBW have a considerable effect on motor development, although findings are

Post-discharge body weight and neurodevelopmental outcomes among very low birth weight infants in Taiwan: A nationwide cohort study.

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Chung-Ting Hsu

Full Text Available Premature infants are at high risk for developmental delay and cognitive dysfunction. Besides medical conditions, growth restriction is regarded as an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence and even into adulthood. In this study, we analyzed the relationship between post-discharge body weight and psychomotor development using a nationwide dataset.This was a nationwide cohort study conducted in Taiwan. Total of 1791 premature infants born between 2007 and 2011 with a birth weight of less than 1500 g were enrolled into this multi-center study. The data were obtained from the Taiwan Premature Infant Developmental Collaborative Study Group. The growth and neurodevelopmental evaluations were performed at corrected ages of 6, 12 and 24 months. Post-discharge failure to thrive was defined as a body weight below the 3rd percentile of the standard growth curve for Taiwanese children by the corrected age.The prevalence of failure to thrive was 15.8%, 16.9%, and 12.0% at corrected ages of 6, 12, and 24 months, respectively. At corrected ages of 24 months, 12.9% had low Mental Developmental Index (MDI scores (MDI<70, 17.8% had low Psychomotor Developmental Index (PDI scores (PDI<70, 12.7% had cerebral palsy, and 29.5% had neurodevelopmental impairment. Post-discharge failure to thrive was significantly associated with poor neurodevelopmental outcomes. After controlling for potential confounding factors (small for gestational age, extra-uterine growth retardation at discharge, cerebral palsy, gender, mild intraventricular hemorrhage, persistent pulmonary hypertension of newborn, respiratory distress syndrome, chronic lung disease, hemodynamic significant patent ductus arteriosus, necrotizing enterocolitis, surfactant use and indomethacin use, post-discharge failure to thrive remained a risk factor.This observational study observed the association between lower body weight at corrected age

Metabolomic profiling in blood from umbilical cords of low birth weight newborns

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Ivorra Carmen

2012-07-01

Full Text Available Abstract Background Low birth weight has been linked to an increased risk to develop obesity, type 2 diabetes, and hypertension in adult life, although the mechanisms underlying the association are not well understood. The objective was to determine whether the metabolomic profile of plasma from umbilical cord differs between low and normal birth weight newborns. Methods Fifty healthy pregnant women and their infants were selected. The eligibility criteria were being born at term and having a normal pregnancy. Pairs were grouped according to their birth weight: low birth weight (LBW, birth weight th percentile, n = 20 and control (control, birth weight between the 75th-90th percentiles, n = 30. Nuclear Magnetic Resonance (NMR was used to generate metabolic fingerprints of umbilical cord plasma samples. Simultaneously, the metabolomic profiles of the mothers were analysed. The resulting data were subjected to chemometric, principal component and partial least squares discriminant analyses. Results Umbilical cord plasma from LBW and control newborns displayed a clearly differentiated metabolic profile. Seven metabolites were identified that discriminate the LBW from the control group. LBW newborns had lower levels of choline, proline, glutamine, alanine and glucose than did the control newborns, while plasma levels of phenylalanine and citrulline were higher in LBW newborns (p Conclusions Low birth weight newborns display a differential metabolomic profile than those of normal birth weight, a finding not present in the mothers. The meaning and the potential utility of the findings as biomarkers of risk need to be addressed in future studies.

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

Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary

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R. Kishore Kumar

2017-05-01

Full Text Available Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW infants. The following were the primary recommendations of the panel: (1 enteral feeding is safe and may be preferred to parenteral nutrition due to the complications associated with the latter; however, parenteral nutrition may be a useful adjunct to enteral feeding in some critical cases; (2 early, fast, or continuous enteral feeding yields better outcomes compared to late, slow, or intermittent feeding, respectively; (3 routine use of nasogastric tubes is not advisable; (4 preterm infants can be fed while on ventilator or continuous positive airway pressure; (5 routine evaluation of gastric residuals and abdominal girth should be avoided; (6 expressed breast milk (EBM is the first choice for feeding preterm infants due to its beneficial effects on cardiovascular, neurological, bone health, and growth outcomes; the second choice is donor pasteurized human milk; (7 EBM or donor milk may be fortified with human milk fortifiers, without increasing the osmolality of the milk, to meet the high protein requirements of preterm infants; (8 standard fortification is effective and safe but does not fulfill the high protein needs; (9 use of targeted and adjustable fortification, where possible, helps provide optimal nutrition; (10 optimizing weight gain in preterm infants prevents long-term cardiovascular complications

Growth pattern and final height of very preterm vs. very low birth weight infants

NARCIS (Netherlands)

Hollanders, J.J.; Pal, S.M. van der; Dommelen, P. van; Rotteveel, J.; Finken, M.J.J.

2017-01-01

BackgroundBoth very preterm (VP; i.e., gestational age <32 weeks) and very low birth weight (VLBW; i.e., birth weight <1,500 g) are used as inclusion criteria by studies on preterm birth. We aimed to quantify the impact of these entities on postnatal growth until final height.MethodsSubjects born VP

Prenatal and neonatal variables associated with enamel hypoplasia in deciduous teeth in low birth weight preterm infants

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Kátia Maria Dmytraczenko Franco

2007-12-01

Full Text Available This study investigated possible prenatal and neonatal variables that may influence the prevalence of tooth enamel hypoplasia in preterm and low birth weight children (LBW and a matched control group of term children with normal birth weight (NBW. The study sample consisted of 61 children born preterm and with LBW examined at 18-34 months of age. The control group was formed by 61 infants born full term and with NBW examined at 31-35 months of age. All children were born at the Center of Integrated Attention of Women's Health (CAISM-UNICAMP. FDI criteria were followed for dental examination. Medical data was collected retrospectively from hospital records. Among preterms, 57.4% had some type of developmental defects of enamel (DDE, 52.5 % had opacities and 21.3 % presented hypoplasia. Among full-term children, 24.6% presented DDE, 24.6% had opacities and 3.3% had hypoplasia. LBW preterm infants presented a higher prevalence of hypoplasia than NBW controls. The deciduous teeth most affected by hypoplasia were maxillary incisors. There was no significant association with prenatal variables; among neonatal variables there was a significant association with respiratory distress syndrome and neurological examination at discharge with an altered result.

Distributions of heavy metals in maternal and cord blood and the association with infant birth weight in China.

Science.gov (United States)

Hu, Xiaobin; Zheng, Tongzhang; Cheng, Yibin; Holford, Theodore; Lin, Shaobin; Leaderer, Brian; Qiu, Jie; Bassig, Bryan A; Shi, Kunchong; Zhang, Yawei; Niu, Jianjun; Zhu, Yong; Li, Yonghong; Guo, Huan; Chen, Qiong; Zhang, Jianqing; Xu, Shunqing; Jin, Yinlong

2015-01-01

To measure serum levels of heavy metals in Chinese pregnant women and their newborns, and to evaluate the association of these metals with infant birth weight. We measured serum concentrations of lead (Pb), thallium (Tl), cadmium (Cd), selenium (Se), arsenic (As), nickle (Ni), vanadium (V), cobalt (Co), and mercury (Hg) in 81 mother-infant pairs using an inductively coupled plasma mass spectrometry method. Multiple linear regression analyses were used to evaluate the associations of these heavy metals with infant birth weight. Se, Pb, As, and Cd showed the highest detection rates (98.8%) in both the maternal and cord blood, followed by Tl, which was detected in 79.0% and 71.6% of the maternal and cord blood samples, respectively. Pb had the highest concentrations in both the maternal and cord blood samples of all toxic metals detected, with concentrations of 23.1 ng/g and 22.0 ng/g, respectively. No significant associations were observed between any heavy metals and birth weight. However, Tl in the maternal and cord blood was most notably inversely associated with birth weight. Se intake was low in Chinese women and their newborns, whereas Pb had the highest concentrations in both the maternal and cord blood samples of all toxic metals detected. Tl was a unique pollution source in this population, and Tl levels were shown to have the largest effect on decreasing infant birth weight in this pilot study. Further research incorporating larger sample sizes is needed to investigate the effects of prenatal exposure to heavy metals--especially Tl and Pb--on birth outcome in Chinese infants.

Incidence and outcomes of acute kidney injury in extremely-low-birth-weight infants.

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Chien-Chung Lee

Full Text Available Acute kidney injury (AKI is a common event in the neonatal intensive care unit (NICU, especially in extremely-low-birth-weight (ELBW infants. This cohort study investigated the incidence of and risk factors for AKI in ELBW infants and their overall survival at the postmenstrual age (PMA of 36 weeks.All ELBW infants admitted to our NICU between January 2010 and December 2013 were enrolled. Those who died prior to 72 hours of life, had congenital renal abnormality, or had only one datum of the serum creatinine (SCr level after the first 24 hours of life were excluded. The criteria used for the diagnosis of AKI was set according to the modified neonatal KDIGO AKI definition.AKI occurred in 56% of 276 infants. Specifically, stage 1, stage 2, and stage 3 AKI occurred in 30%, 17%, and 9% of ELBW infants, respectively. High-frequency ventilation support (adjusted odds ratio [OR]: 3.4, 95% confidence interval [CI]: 1.78-6.67, p< 0.001, the presence of patent ductus arteriosus (adjusted OR: 4.3, 95% CI: 2.25-8.07, p < 0.001, lower gestational age (adjusted OR for gestational age: 0.7, 95% CI: 0.58-0.83, < 0.001, and inotropic agent use (adjusted OR: 2.6, 95% CI: 1.31-5.21, p = 0.006 were independently associated with AKI. Maternal pre-eclampsia was a protective factor (adjusted OR: 0.4, 95% CI: 0.14-0.97, p = 0.044. Infants with AKI had higher mortality before the PMA of 36 weeks with an adjusted hazard ratio (HR of 5.34 (95% CI: 1.21-23.53, p = 0.027. Additionally, infants with stage 3 AKI had a highest HR of 10.60, 95% CI: 2.09-53.67, p = 0.004.AKI was a very common event (56% in ELBW infants and was associated with a lower GA, high-frequency ventilation support, the presence of PDA, and inotropic agent use. AKI reduced survival of ELBW infants before the PMA of 36 weeks.

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

Science.gov (United States)

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

2016-03-01

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

School performance at nine years of age in very premature and very low birth weight infants : Perinatal risk factors and predictors at five years of age

NARCIS (Netherlands)

Hille, E.T.M.; Ouden, A.L. den; Bauer, L.; Oudenrijn, C. van den; Brand, R.; Verloove-Vanhorick, S.P.

1994-01-01

To assess the impact of both perinatal disorders and developmental problems identified at preschool age on school performance, we followed a virtually complete birth cohort of very premature (<32 completed weeks of gestation) and very low birth weight infants until they were 9 years of age. In 84%

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

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Ishrat Jahan

2011-01-01

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

Relationship of periodontal disease to pre-term low birth weight infants in a selected population--a prospective study.

Science.gov (United States)

Ali, T B Taiyeb; Abidin, K Zainal

2012-03-01

To assess effect of periodontal status of antenatal mothers on pregnancy outcomes in a selected population in Malaysia. Prospective cohort study on a multi-ethnic convenient sample. 73 healthy pregnant women between 28 to 36 gestation weeks attending 5 ante-natal centres were recruited. Both Interviewer-administered Questionnaire and Periodontal examination, which included Plaque index, Gingival index, Papillary Bleeding index, probing pocket depth and attachment loss were conducted. Pregnancy outcome data which included gestational age at delivery, birth weight of newborn and delivery complications were collected after delivery. Study sample of 73 mothers was approximately in 1:3 case:control ratio (21.9% & 78.1% respectively). Case was defined as those with preterm (PT) deliveries and low birth weight (LBW) infants whereas control was otherwise. 37 pregnant women were diagnosed with periodontal disease (minimum 2 teeth with > or = 5 mm periodontal pockets and > or = 3 mm attachment loss) and 36 without periodontal disease (PD). Of those with PD, 4 (10.8%) had PT delivery and 3 (8.1%) had LBW infants. None of the PD variable means or PD status associated significantly with either of the two groups (P>0.05). Logistic regression analysis to test the possible predictor (demographic and clinical) for PT or LBW status indicated only Plaque Index mean as a significant predictor (P < 0.03). In this study population, PD was not shown to be a risk factor for PT delivery or LBW infant. Only mean Plaque Index was associated with PT deliveries and LBW infants.

A Systematic Review againts Risk Factors on The Low-weight Birth Incidence in Indonesia

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Estri Kusumawati

2017-04-01

Full Text Available The number of maternal and infant mortality in Indonesia is still high. Most of Indonesian neonatal mortality occurs in the first week of life with low-weight birth (LwB / premature as the main cause. Birth weight is an important and reliable indicator for the survival of neonates and infants, both in terms of physical growth and development of the mental status. LwB caused by many complicated factors that related each others as if maternal factors that also affect the baby's weight at their birth. The purpose of this study was to identified the determinant factors that affect the incidence of LwB based on the related research topic. The data source obtained from the scientific journals with LwB studies during the years of 2009 untill 2016 with the total of 14 studies consisting of scientific papers and thesis. In this study, researchers divided into five risk factors associated with LwB. From those factors then it divided again into 20 aspects. The result show that the maternal nutritional aspec and anemia status have become significant risk factors againts the low-weight birth incidence.

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

Science.gov (United States)

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

2015-01-01

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

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

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Carlos Grandi

2015-06-01

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

Inattention and development of toddlers born in preterm and with low birth weight.

Science.gov (United States)

Huang, June-Hui; Huang, Huei-Lin; Chen, Hsiu-Lin; Lin, Lung-Chang; Tseng, Hsing-I; Kao, Tsung-Jen

2012-07-01

The objective of this study was to examine the impact of low birth weight and preterm birth on a toddler's inattention and development, including cognitive, language, motor, social-emotional and adaptive behaviors. A total of 105 toddlers enrolled for the study; they were divided into four groups: 40 full-term and normal birth weight (NBW, birth weight greater than 2500 g) toddlers, 24 moderate birth weight (MLBW, birth weight between 2499 and 1500 g) toddlers, 20 very to extremely low birth weight (V-ELBW, 12 between 1000 and 1499 g and 8 lower than 1000 g) toddlers, and 21 term toddlers who were recruited from a clinic of developmental delay as the developmental delay at risk (DDR) group. The Bayley Scales of Infant and Toddler Development-Third Edition (BSID-III) and Disruptive Behavior Rating Scale-Toddler were used. The findings were as follows: (1) DDR group performed worst in BSID-III; (2) although there were no statistical differences among the NBW, MLBW, and V-ELBW groups in BSID-III, the lower the birth weight, the lower the average performance, especially in language, adaptive social behavior, and adaptive practical behavior; and (3) comparing the inattention score, the DDR group was the poorest, normal and V-ELBW groups were the best, and MLBW group was in the middle. In conclusion, low birth weight and preterm delivery affected children's inattention and development of language, adaptive social behavior, and adaptive practical behavior. Copyright © 2012. Published by Elsevier B.V.

Inattention and development of toddlers born in preterm and with low birth weight

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June-Hui Huang

2012-07-01

Full Text Available The objective of this study was to examine the impact of low birth weight and preterm birth on a toddler's inattention and development, including cognitive, language, motor, social–emotional and adaptive behaviors. A total of 105 toddlers enrolled for the study; they were divided into four groups: 40 full-term and normal birth weight (NBW, birth weight greater than 2500 g toddlers, 24 moderate birth weight (MLBW, birth weight between 2499 and 1500 g toddlers, 20 very to extremely low birth weight (V-ELBW, 12 between 1000 and 1499 g and 8 lower than 1000 g toddlers, and 21 term toddlers who were recruited from a clinic of developmental delay as the developmental delay at risk (DDR group. The Bayley Scales of Infant and Toddler Development—Third Edition (BSID-III and Disruptive Behavior Rating Scale—Toddler were used. The findings were as follows: (1 DDR group performed worst in BSID-III; (2 although there were no statistical differences among the NBW, MLBW, and V-ELBW groups in BSID-III, the lower the birth weight, the lower the average performance, especially in language, adaptive social behavior, and adaptive practical behavior; and (3 comparing the inattention score, the DDR group was the poorest, normal and V-ELBW groups were the best, and MLBW group was in the middle. In conclusion, low birth weight and preterm delivery affected children's inattention and development of language, adaptive social behavior, and adaptive practical behavior.

Growth and Neurodevelopmental Outcomes of Early, High-Dose Parenteral Amino Acid Intake in Very Low Birth Weight Infants: A Randomized Controlled Trial.

Science.gov (United States)

Balakrishnan, Maya; Jennings, Alishia; Przystac, Lynn; Phornphutkul, Chanika; Tucker, Richard; Vohr, Betty; Stephens, Bonnie E; Bliss, Joseph M

2017-03-01

Administration of high-dose parenteral amino acids (AAs) to premature infants within hours of delivery is currently recommended. This study compared the effect of lower and higher AA administration starting close to birth on short-term growth and neurodevelopmental outcomes at 18-24 months corrected gestational age (CGA). Infants Toddler Development, Third Edition at 18-24 months CGA. Secondary outcomes were growth parameters at 36 weeks CGA among infants surviving to hospital discharge, serum bicarbonate, serum urea nitrogen, creatinine, AA profiles in the first week of life, and incidence of major morbidities and mortality. No differences in neurodevelopmental outcome were detected between the high and low AA groups. Infants in the high AA group had significantly lower mean weight, length, and head circumference percentiles than those in the standard AA group at 36 weeks CGA and at hospital discharge. These differences did not persist after controlling for birth growth parameters, except for head circumference. Infants in the high AA group had higher mean serum urea nitrogen than the standard group on each day throughout the first week. Current recommendations for high-dose AA starting at birth are not associated with improved growth or neurodevelopmental outcomes.

Ophthalmic, Hearing, Speaking and School Readiness Outcomes in Low Birth Weight and Normal Birth Weight Primary School Children in Mashhad-Iran

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Ashraf Mohammadzadeh

2011-01-01

Full Text Available Low Birth weight infants are at risk of many problems. Therefore their outcome must evaluate in different ages especially in school age. In this study we determined prevalence of ophthalmic, hearing, speaking and school readiness problems in children who were born low birth weight and compared them with normal birth weight children. In a cross-sectional and retrospective study, all Primary School children referred to special educational organization center for screening before entrance to school were elected in Mashhad, Iran. In this study 2400 children enrolled to study and were checked for ophthalmic, hearing, speaking and school readiness problems by valid instrument. Data were analyzed by SPSS 11.5. This study showed that 8.3% of our population had birth weight less than 2500 gram. Visual impairment in LBW (Low Birth Weight and NBW (Normal Birth Weight was 8.29% vs. 5.74% and there was statistically significant difference between them (P=0.015. Hearing problem in LBW and NBW was 2.1% vs. 1.3 and it was not statistically significant. Speaking problem in LBW and NBW was 2.6% vs. 2.2% and it was not statistically significant. School readiness problem in LBW and NBW was 12.4% vs. 5.8% and it was statistically significant (P<0.001. According to the results, neurological problems in our society is more than other society and pay attention to this problem is critical. We believe that in our country, it is necessary to provide a program to routinely evaluate LBW children.

Disease Human - MDC_LowBirthWeight

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NSGIC Local Govt | GIS Inventory — Polygon feature class based on Zip Code boundaries showing the percentage of babies born in Miami-Dade County in 2006 with low birth weights. Low birth weight is...

Advancing maternal age and infant birth weight among urban African Americans: the effect of neighborhood poverty.

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Collins, James W; Simon, Dyan M; Jackson, Tara A; Drolet, Aimee

2006-01-01

This study sought to determine whether neighborhood poverty modifies the relationship between maternal age and infant birth weight among urban African Americans. Stratified analyses were performed on the vital records of African Americans born in Chicago by means of 1992-1995 computerized birth file with appended 1990 US Census income and 1995 Chicago Department of Public Health data. Four neighborhood-level variables (low median family income, high rates of unemployment, homicide, and lead poisoning) were analyzed. This is a population-based study. Twenty-one percent (n=21,811) of women resided in nonimpoverished neighborhoods (zero ecologic risk factors); 23% (n=24,914) of women lived in extremely impoverished neighborhoods (four ecologic risk factors). In nonimpoverished neighborhoods, 30-34 year old women had a moderately low birth weight (1500-2499 g) rate of 13.9% compared to 10.3% for women aged 20-24 years; risk difference (95% confidence interval [CI])=3.5 (2.2-4.6). In contrast, extremely impoverished women aged 30-34 years had a moderately low birth weight rate of 19.8% compared to 11.8% for women aged 20-24 years; risk difference (95% CI)=7.7 (6.1-9.3). This trend persisted among women who received early prenatal care and were primagravids or of low parity. Neighborhood poverty did not modify the association of advancing maternal age and the risk of very low birth weight (poverty accelerates the rise in moderately low birth weight but not very low birth weight; rates were associated with advancing maternal age among urban African Americans.

Early Caffeine Prophylaxis and Risk of Failure of Initial Continuous Positive Airway Pressure in Very Low Birth Weight Infants.

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Patel, Ravi M; Zimmerman, Kanecia; Carlton, David P; Clark, Reese; Benjamin, Daniel K; Smith, P Brian

2017-11-01

To test the hypothesis that early caffeine treatment on the day of birth, compared with later treatment in very low birth weight (VLBW, caffeine in the first week of life. We used multivariable conditional logistic regression to compare the risk of CPAP failure, defined as invasive mechanical ventilation or surfactant therapy on DOL 1-6, by timing of caffeine treatment as either early (initiation on DOL 0) or routine (initiation on DOL 1-6). We identified 11 133 infants; 4528 (41%) received early caffeine and 6605 (59%) received routine caffeine. Median gestational age was lower in the early caffeine group, 29 weeks (25th, 75th percentiles; 28, 30) vs the routine caffeine group, 30 weeks (29, 31); P caffeine groups: 22% vs 21%; adjusted OR = 1.05 (95% CI: 0.93, 1.18). Early caffeine treatment on the day of birth was not associated with a decreased risk of CPAP failure in the first week of life for VLBW infants initially treated with CPAP. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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Parker Bruce R

2009-07-01

Full Text Available Abstract Background Osteopenia and rickets are common among extremely low birth weight infants (ELBW, Methods We evaluated all ELBW infants admitted to Texas Children's Hospital NICU in 2006 and 2007. Of 211 admissions, we excluded 98 patients who were admitted at >30 days of age or did not survive/stay for >6 weeks. Bone radiographs obtained in 32 infants were reviewed by a radiologist masked to laboratory values. Results In this cohort of 113 infants, P-APA was found to have a significant inverse relationship with BW, gestational age and serum phosphorus. In paired comparisons, P-APA of infants Conclusion Elevation of P-APA >600 IU/L was very common in ELBW infants. BW was significantly inversely related to both P-APA and radiologic rickets. No single value of P-APA was related to radiological findings of rickets. Given the very high risk of osteopenia and rickets among ELBW infants, we recommend consideration of early screening and early mineral supplementation, especially among infants

Magnitude and Correlates of Low Birth Weight at Term in Rural Wardha, Central India

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Kumar V

2016-05-01

Full Text Available Introduction: Birth weight is one of the most important determinant of the neonatal and infant survival. The goal of reducing low birth weight incidence by at least one third between 2000 and 2010 was one of the major goals in ‘A World Fit for Children’. The prevention of low birth weight is a public health priority, particularly in developing countries with high magnitude. Knowledge regarding magnitude and correlates help prevent the condition. Hence, the present study was carried out to study the magnitude and the correlates of low birth weight. Methodology: Two hundred and six newborn babies were recruited on a birth cohort from two Primary Health Centres (PHC of Wardha district to study growth in first year of life. Here, we present the baseline analysis of 172 children who were born full term to study the correlates of low birth weight babies born full term. The children were recruited within first week of their birth. Data was collected on socio-demographic profile, birth history, and maternal characteristics. Proportion of low birth weight was expressed in percentage along with 95% confidence interval. Univariate and multivariate logistic regression was used to study the correlates. Findings are expressed in odds ratios with their 95% confidence intervals. Results: The magnitude of low birth weight at term was found to be 33.1% (95% CI: 26.4%-40.4%. On univariate analysis, significant correlates of low birth weight were consumption of less than 50 iron-folic acid tables and being born to than mother. On multivariate analysis, the significant correlates were female sex of child (OR=2.856, being born to thin mother (OR=5.320, consumption of less than 50 tablets (OR=4.648, and complications of pregnancy (OR=2.917. Conclusions: The magnitude of low birth weight is very high and modifiable correlates of low birth weight are nutritional status of mother, lower consumption of IFA tablets and complications of pregnancy.

Neurodevelopmental outcomes of infants with very low birth weights are associated with the severity of their extra-uterine growth retardation

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Han-Chun Chien

2018-04-01

Full Text Available Background: For infants with very low birth weights (VLBW, their neurodevelopmental outcomes are thought to be associated with extra-uterine growth retardation (EUGR. In this study, based on a single institute, we analyzed the association between different levels or severity of EUGR of VLBW infants and their neurodevelopmental outcomes later at a corrected age of 24 months. Methods: This is a hospital-based retrospective cohort study. The severity of EUGR was classified into three categories according to the z-score of discharge weight: z < −2.0, <−2.5, and <−3.0. The outcomes were assessed using the Bayley Scales of Infant Development-II (BSID-II at a corrected age of 24 months. We then estimated the association of EUGR with low mental developmental index (MDI or low psychomotor developmental index (PDI. Multiple logistic regression and stratified analyses were used to adjust for the possible confounding factors. Results: In total, 224 VLBW infants were enrolled in this study from 1997 to 2006. In the univariate analysis, EUGR for weight at discharge from hospital was associated with MDI <85 at the corrected age of 24 months, and this association was related to the severity of EUGR (z < −2.5, OR: 1.92 (1.04–3.53; z < −3.0, OR: 2.83 (1.26–6.36. In addition, the relationship was not confounded by gender nor small for gestational age. The stratified analysis against hemodynamic significant patent ductus arteriosus also revealed that EUGR was an independent predictor for neurodevelopmental outcomes. Conclusion: In VLBW preterm infants, EUGR was significantly associated with low MDI scores assessed at a corrected age of 24 months. Early evaluation and recognition of EUGR should be emphasized when caring for preterm infants. Key Words: EUGR, VLBW, neurodevelopment

Changes in mortality for extremely low birth weight infants in the 1990s: implications for treatment decisions and resource use.

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Meadow, William; Lee, Grace; Lin, Kathy; Lantos, John

2004-05-01

Much has changed in neonatal intensive care unit (NICU) care over the past decade. High-frequency oscillation, inhaled nitric oxide, and antenatal corticosteroids are now widely available. We wondered how these medical advances had affected both the epidemiology and ethics of life and death for extremely low birth weight (ELBW) infants in the NICU. We identified 1142 ELBW infants (birth weight [BW] NICU between 1991 and 2001. We abstracted BW, gestational age, survival or death, and length of stay in the NICU. Statistical analyses were performed by using linear regression and 2-way analysis of variance. Both increasing BW and later year were significantly associated with improved survival. However, for larger ELBW infants, survival was approximately 90% for the entire decade, and large-scale improvement was hardly possible. For smaller infants, greater improvements were both possible and observed, at least early in the decade. From 1991 to 1997, overall ELBW survival increased steadily (approximately 4% per year). However, from 1997 to 2001, there was no significant improvement in survival for ELBW infants. There was no change in the distribution of deaths accounted for by BW subgroups within the ELBW population from 1991 to 2001. Median length of stay for infants who eventually expired before discharge rose from 2 days in 1991 to 10 days in 2001. As a consequence, during the past decade, the percentage of infants whose outcome was "undeclared" by day of life 4 rose from 10% to 20% for ELBW infants overall and to 33% for infants with BWs of 450 to 700 g. The percentage of ELBW NICU bed-days occupied by nonsurvivors remained very low (approximately 7%) from 1991 to 2001. 1) Fewer infants in all ELBW subgroups are dying, compared with a decade ago, and the improvement has been most prominent for BWs of 450 to 700 g, at which mortality was and remains to be greatest. 2) This progress seems to have slowed, or even stopped, by the end of the decade. 3) Although most

The effect of long chain polyunsaturated fatty acid supplementation on intelligence in low birth weight infant during lactation: A meta-analysis

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Song, Yuan; Liu, Ya; Pan, Yun; Yuan, Xiaofeng; Chang, Pengyu; Tian, Yuan; Cui, Weiwei

2018-01-01

Background Low birth weight infant (LBWIs) are prone to mental and behavioural problems. As an important constituent of the brain and retina, long chain polyunsaturated fatty acids are essential for foetal infant mental and visual development. The effect of lactation supplemented with long chain polyunsaturated fatty acids (LCPUFA) on the improvement of intelligence in low birth weight children requires further validation. Methods In this study, a comprehensive search of multiple databases was performed to identify studies focused the association between intelligence and long chain polyunsaturated fatty acid supplementation in LBWIs. Studies that compared the Bayley Scales of Infant Development (BSID) or the Wechsler Abbreviated Scale of Intelligence for Children (WISC) scores between LBWIs who were supplemented and controls that were not supplemented with LCPUFA during lactation were selected for inclusion in the meta-analysis. Results The main outcome was the mean difference in the mental development index (MDI) and psychomotor development index (PDI) of the BSID and the full scale intelligence quotient (FSIQ), verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) of the WISC between LBWIs and controls. Our findings indicated that the mean BSID or WISC scores in LBWIs did not differ between the supplemented groups and controls. Conclusion This meta-analysis does not reveal that LCPUFA supplementation has a significant impact on the level of intelligence in LBWIs. PMID:29634752

Ethnicity, maternal risk, and birth weight among Hispanics in Massachusetts, 1987-89.

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Cohen, B B; Friedman, D J; Mahan, C M; Lederman, R; Munoz, D

1993-01-01

National data reveal that low birth weight and infant mortality rates among Hispanics are, in general, between the rates for whites and those for blacks. The question remains, do differences in low birth weight reflect distributions of known risk factors, or do ethnic differences persist after simultaneously adjusting for intervening variables? In this study, Massachusetts birth certificate data for 206,973 white non-Hispanic infants and 19,571 Hispanic infants are used to examine differences...

Post-discharge body weight and neurodevelopmental outcomes among very low birth weight infants in Taiwan: A nationwide cohort study

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Hsu, Chung-Ting; Chen, Chao-Huei; Wang, Teh-Ming; Hsu, Ya-Chi

2018-01-01

Background Premature infants are at high risk for developmental delay and cognitive dysfunction. Besides medical conditions, growth restriction is regarded as an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence and even into adulthood. In this study, we analyzed the relationship between post-discharge body weight and psychomotor development using a nationwide dataset. Materials and methods This was a nationwide cohort study conducted in Taiwan. Total of 1791 premature infants born between 2007 and 2011 with a birth weight of less than 1500 g were enrolled into this multi-center study. The data were obtained from the Taiwan Premature Infant Developmental Collaborative Study Group. The growth and neurodevelopmental evaluations were performed at corrected ages of 6, 12 and 24 months. Post-discharge failure to thrive was defined as a body weight below the 3rd percentile of the standard growth curve for Taiwanese children by the corrected age. Results The prevalence of failure to thrive was 15.8%, 16.9%, and 12.0% at corrected ages of 6, 12, and 24 months, respectively. At corrected ages of 24 months, 12.9% had low Mental Developmental Index (MDI) scores (MDIneurodevelopmental impairment. Post-discharge failure to thrive was significantly associated with poor neurodevelopmental outcomes. After controlling for potential confounding factors (small for gestational age, extra-uterine growth retardation at discharge, cerebral palsy, gender, mild intraventricular hemorrhage, persistent pulmonary hypertension of newborn, respiratory distress syndrome, chronic lung disease, hemodynamic significant patent ductus arteriosus, necrotizing enterocolitis, surfactant use and indomethacin use), post-discharge failure to thrive remained a risk factor. Conclusion This observational study observed the association between lower body weight at corrected age of 6, 12, and 24 months and poor neurodevelopmental outcomes among VLBW

Factors associated with low birth weight in Goiás State

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Ruth Minamisava

2006-12-01

Full Text Available ABSTRACT: Low birth weight (LBW is public health problem, because they are associated with increased risk of morbidity and mortality. No previous studies on factors associated with LBW carried out in central Brazil were found in the literature. The main aims of this study were to determine the prevalence and the factors associated with LBW in children born alive in the State of Goiás, Brazil. A cross-sectional analysis was performed using data from the Live Births Information System from the Brazilian Health Ministry. All 92.745 singleton births in the State of Goiás during the year of 2000 were examined. Logistic regression analysis was used to examine the factors associated with LBW (< 2500 g. In Goiás, the prevalence of LBW was 5.96% and the most important factors associated with LBW were: prematurity, young and older mothers, unmarried women, mother illiteracy, mothers who had less than seven prenatal care visits, non-hospital delivery, and female infants. Local public health actions are necessary to reduce inequalities in infant and maternal care. KEYWORDS: newborn, birth weight, prenatal care.

Growth, lung function, and physical activity in schoolchildren who were very-low-birth-weight preterm infants.

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Winck, Aline Dill; Heinzmann-Filho, João Paulo; Schumann, Deise; Zatti, Helen; Mattiello, Rita; Jones, Marcus Herbert; Stein, Renato Tetelbom

2016-01-01

To compare somatic growth, lung function, and level of physical activity in schoolchildren who had been very-low-birth-weight preterm infants (VLBWPIs) or normal-birth-weight full-term infants. We recruited two groups of schoolchildren between 8 and 11 years of age residing in the study catchment area: those who had been VLBWPIs (birth weight prematuros com muito baixo peso e escolares nascidos a termo e com peso adequado. Foram recrutados escolares com idade de 8 a 11 anos residentes na mesma área de abrangência do estudo: prematuros e com peso < 1.500 g e controles (nascidos a termo e com peso ≥ 2.500 g). Foram obtidas medidas antropométricas e espirométricas e aplicado um questionário sobre a atividade física. Além disso, foram coletadas informações do período perinatal/neonatal dos recém-nascidos com muito baixo peso (RNMBP) de seus prontuários médicos. Dos 93 escolares avaliados, 48 crianças no grupo RNMBP e 45 no grupo controle. Não houve diferenças significativas entre os grupos em relação às características antropométricas e nutricionais ou aos parâmetros de função pulmonar. Não foram encontradas associações entre as variáveis perinatais/neonatais e parâmetros da função pulmonar dos escolares no grupo RNMBP. Embora sem diferença significativa em relação aos níveis de atividade física, o grupo RNMBP apresentou uma tendência de ser mais ativo que o grupo controle. Nos escolares aqui estudados o crescimento e a função pulmonar parecem não ser afetados por prematuridade, peso ao nascimento ou nível de atividade física.

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

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Erica eNeri

2015-09-01

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

Stress in parents of very low birth weight preterm infants hospitalized in neonatal intensive care units. A multicenter study.

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Wormald, Francisca; Tapia, José L; Torres, Gabriela; Cánepa, Paula; González, María Aurelia; Rodríguez, Diana; Escobar, Marisol; Reyes, Bernardita; Capelli, Carola; Menéndez, Laura; Delgado, Patricia; Treuer, Sergio; Ramírez, Rodrigo; Borja, Norma; Domínguez, Angélica

2015-08-01

The birth of a premature baby is a stressful event for parents. The objective of this study was to determine early stress in parents of very low birth weight infants (VLBWIs) hospitalized in 12 neonatal intensive care units from a South American Neonatal Network, to identify associated factors, and to compare the level of parental stress in public versus private healthcare facilities. Cross-sectional study in mothers/fathers of VLBWIs (500 to 1500 g). Early parental stress was measured using the Parental Stressor Scale, with a score from 1 (low stress) to 5 (high stress). The sociodemographic characteristics of parents and newborn infants were collected and associated with levels of parental stress. The study included 273 fathers/mothers of a total of 218 VLBW preterm infants. The survey was administered at 5.9 ± 2.0 days of life. The average total parental stress was 3.1 ± 0.8, and the highest score was obtained for the parental role subscale (3.6). A lower education level, unemployment, not having held the newborn infant, and respiratory support requirement were associated with higher parental stress levels. Stress was higher among mothers than fathers, and at public facilities versus private ones. Among parents of VLBWIs, a moderate early parental stress was observed. Parental role alteration was the most relevant factor. Parental stress was higher among mothers and at public healthcare facilities. A greater sensitization, further research and interventions in this area are required.

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

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Jensen, Erik A; Lorch, Scott A

2015-08-01

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

Protocol of the Low Birth Weight South Asia Trial (LBWSAT), a cluster-randomised controlled trial testing impact on birth weight and infant nutrition of Participatory Learning and Action through women's groups, with and without unconditional transfers of fortified food or cash during pregnancy in Nepal.

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Saville, Naomi M; Shrestha, Bhim P; Style, Sarah; Harris-Fry, Helen; Beard, B James; Sengupta, Aman; Jha, Sonali; Rai, Anjana; Paudel, Vikas; Pulkki-Brannstrom, Anni-Maria; Copas, Andrew; Skordis-Worrall, Jolene; Bhandari, Bishnu; Neupane, Rishi; Morrison, Joanna; Gram, Lu; Sah, Raghbendra; Basnet, Machhindra; Harthan, Jayne; Manandhar, Dharma S; Osrin, David; Costello, Anthony

2016-10-21

Low birth weight (LBW, nutrition Participatory Learning and Action behaviour change strategy (PLA) for pregnant women through women's groups, with or without unconditional transfers of food or cash to pregnant women in two districts of southern Nepal. The study is a cluster randomised controlled trial (non-blinded). PLA comprises women's groups that discuss, and form strategies about, nutrition in pregnancy, low birth weight and hygiene. Women receive up to 7 monthly transfers per pregnancy: cash is NPR 750 (~US$7) and food is 10 kg of fortified sweetened wheat-soya Super Cereal per month. The unit of randomisation is a rural village development committee (VDC) cluster (population 4000-9200, mean 6150) in southern Dhanusha or Mahottari districts. 80 VDCs are randomised to four arms using a participatory 'tombola' method. Twenty clusters each receive: PLA; PLA plus food; PLA plus cash; and standard care (control). Participants are (mostly Maithili-speaking) pregnant women identified from 8 weeks' gestation onwards, and their infants (target sample size 8880 birth weights). After pregnancy verification, mothers may be followed up in early and late pregnancy, within 72 h, after 42 days and within 22 months of birth. Outcomes pertain to the individual level. Primary outcomes include birth weight within 72 h of birth and infant weight-for-age Z-score measured cross-sectionally on children born of the study. Secondary outcomes include prevalence of LBW, eating behaviour and weight during pregnancy, maternal and newborn illness, preterm delivery, miscarriage, stillbirth or neonatal mortality, infant Z-scores for length-for-age and weight-for-length, head circumference, and postnatal maternal BMI and mid-upper arm circumference. Exposure to women's groups, food or cash transfers, home visits, and group interventions are measured. Determining the relative importance to birth weight and early childhood nutrition of adding food or cash transfers to PLA women's groups

Relationship between Maternal Serum Copper Level and Birth Weight Neonate

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Mirzarahimi M

2012-01-01

Full Text Available Background and Objectives: Low birth weight (LBW is a major public health problem. LBW is associated with increased neonatal morbidity and mortality. There is no consensus in the literature as to whether maternal copper nutrition is associated with pregnancy outcome or fetal growth. Methods: This case-control study was carried out at Alavi Hospital in Ardabil between August 2008 and August 2009. 56 women who had delivered low-birth- weight infants (<2500gr were taken as the case group, and from the mothers who had delivered normal birth weight infants (≥2500gr, 56 were selected at random as the control group. Venous blood samples were obtained from the mothers. Serum zinc level was determined by the Atomic Absorption Spectrophotometer method.Results: Mean of birth weight in infants, maternal age, body mass index in mothers and socioeconomic or demographic factors did not differ between cases and control groups. Maternal copper concentration (μg/dl differed between Cases and Controls; 231.75±38.12μg/dl vs. 204.42±31.30μg/dl respectively. There is a significant difference (p<0.001 in the serum copper concentration between the two groups.Conclusion: There is a negative relation between low infant birth weight and maternal copper concentration.

Growth and development of very low birth weight infants aged 18-24 months at Queen Sirikit National Institute of Child Health.

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Sangtawesin, Varaporn; Singarj, Yupayao; Kanjanapattanakul, Wiboon

2011-08-01

The number of very low birth weight (VLBW) births is increasing worldwide. Despite better care in recent years, they have a high incidence of delayed growth and development. There are no previous studies regarding the growth and development of these infants at Queen Sirikit National Institute of Child Health (QSNICH). To study growth and developmental outcome of VLBW infants, aged 18-24 months who were discharged from QSNICH. VLBW infants who were discharged from QSNICH during the year 2007 were recruited in the study. Patients with chromosomal abnormalities, major congenital anomalies, definite congenital infections and positive maternal anti-HIV tests were excluded. At the corrected age of 18-24 months, the parents were called upon to bring their infants for complete physical examination and developmental evaluation on 2 occasions, two months apart. There were 111 cases of VLBW infants who were discharged from QSNICH during the year 2007. Fifty-four patients were eligible for the present study. Thirty cases (55.56%) were contacted for the first examination. During this examination, there were 3 cases (10%) with low head circumference, 1 case (3.33%) with poor weight gain, 5 cases (16.67%) with visual defect, 1 case (3.33%) with moderately severe hearing loss, 1 case (3.33%) with cerebral palsy and 7 cases (23.33%) with delayed development. Twenty-one cases could be recalled for a second evaluation. Two of the 5 cases had delayed language development. There were no cases with hydrocephalous, blindness or profound hearing loss. VLBW infants at QSNICH had much better survival during recent years. Most of these survivors had normal growth and development. Those with delayed growth and development need aggressive intervention and long-term follow-up for enhancement of quality of their lives.

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

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

2010-08-15

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Targeting 2.5 versus 4 g/kg/day of amino acids for extremely low birth weight infants: a randomized clinical trial.

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Burattini, Ilaria; Bellagamba, Maria Paola; Spagnoli, Cristina; D'Ascenzo, Rita; Mazzoni, Nadia; Peretti, Anna; Cogo, Paola E; Carnielli, Virgilio P

2013-11-01

To compare the effect of 2.5 vs 4 g/kg/d of amino acid (AA) in parenteral nutrition of extremely low birth weight infants on metabolic tolerance, short-term growth, and neurodevelopment. One hundred thirty-one infants with birth weight between 500 and 1249 g were randomized to 2.5 (standard AA [SAA] group) or 4 (high AA [HAA] group) g/kg/d AA intake, with equal nonprotein energy. The primary outcome was body size at 36 weeks. One hundred thirty-one patients were randomized and 114 analyzed (58 SAA group and 56 HAA group). Study groups had similar demographics and clinical characteristics. Elevated blood urea (BU >70 mg/dL = BU nitrogen >32.6 mg/dL) occurred in 24% vs 59% (P = .000) and hyperglycemia (>175 mg/dL) in 34% vs 11% (P = .003) of the SAA and HAA patients, respectively. Body weight, length, and head circumference at 36 weeks and 2 years were similar between groups. Bayley Scales of Infant and Toddler Development, Third Edition score was 94 ± 13 in the SAA group and 97 ± 15 in the HAA group (P = .35). The HAA group had higher BU levels and better glucose control. An extra 8 g/kg of AA over the first 10 days of life did not improve growth and neurodevelopment. Copyright © 2013 Mosby, Inc. All rights reserved.

Pathways of job style and preterm low birth weight.

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Salehi, Katayoun; Mahmoodi, Zohreh; Kabir, Kourosh; Dolatian, Mahrokh

2016-09-01

Preterm and low birth weight tend to occur as a direct result of prenatal risky behaviors, diseases, as well as fetal exposure to harmful social and environmental factors. The present study aimed to investigate the relationship between job style and preterm low birth weight. The present case-control study was conducted in the Kamali hospital, Teheran, Iran in 2014. Participants included 156 mothers having a gestational age of less than 37 weeks and infants weighing less than 2500 gm. Additionally, the control group consisted of 433 mothers with a gestational age of over 37 weeks and having infants weighing between 2500-4000 gm. The data were collected using the Mother's Lifestyle Scale (MLS) during pregnancy based on recognized social determinants of health and those developed by the researchers. The domain of the mother's job style was assessed using a questionnaire consisting of 18 items on topics such as working conditions, job satisfaction, and perceived employer empathy. Higher overall scores in this instrument indicate the mother's poorer job style. The data were analyzed using SPSS version 16 and Lisrel version 8.8 through a statistical path analysis. The model fit indices indicated that there was found to be high favorability, demonstrated that the model fit and that there were rational relationships (CFI=1, RMSEA=0.00), and showed that on the direct path that the mother's job style had the most adverse effect (B=-0.3) with weight gain during pregnancy showing the most positive effect (B=0.16) on PLBW. The mother's level of education was found to be the only variable that affected PLBW negatively in both the direct and indirect paths through the mother's job style and household income (B=-0.17). According the path analysis model, job style has a direct influence on preterm low birth weight. Thus, special consideration should be placed on aspects surrounding a mother's job situation in order to prevent any adverse effects.

Neurodevelopmental outcome at 5 years of age of a national cohort of extremely low birth weight infants who were born in 1996-1997.

Science.gov (United States)

Mikkola, Kaija; Ritari, Niina; Tommiska, Viena; Salokorpi, Teija; Lehtonen, Liisa; Tammela, Outi; Pääkkönen, Leena; Olsen, Päivi; Korkman, Marit; Fellman, Vineta

2005-12-01

Increasing survival of extremely low birth weight (ELBW; birth weight infants raises a concern regarding the risks of adverse long-term outcome such as cognitive dysfunction. Few studies have reported long-term follow-up of representative regional cohorts. The objective of this study was to assess the 5-year outcome of a prospectively followed national ELBW infant cohort. Of all live-born ELBW infants (n = 351) who were delivered in the 2-year period 1996-1997 in Finland, 206 (59%) survived until the age of 5 years. Of these, 103 were born at infants who were born at memory values of NEPSY assessment were significantly poorer compared with normal population means. Four percent needed a hearing aid, and 30% had ophthalmic findings. Of 21 children who had been treated with laser/cryo for retinopathy of prematurity, 17 (81%) had abnormal ophthalmic findings. Of the whole cohort, 41 (20%) exhibited major disabilities, 38 (19%) exhibited minor disabilities, and 124 (61%) showed development with no functional abnormalities but subtle departures from the norm. Only 53 (26%) of the total ELBW infant cohort were classified to have normal outcome excluding any abnormal ophthalmic, auditory, neurologic, or developmental findings. Being small for gestational age at birth was associated with suboptimal growth at least until age 5. Only one fourth of the ELBW infants were classified as normally developed at age 5. The high rate of cognitive dysfunction suggests an increased risk for learning difficulties that needs to be evaluated at a later age. Extended follow-up should be the rule in outcome studies of ELBW infant cohorts to elucidate the impact of immaturity on school achievement and social behavior later in life.

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

Science.gov (United States)

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

2018-01-01

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

Survival and morbidity of very low birth weight infant in a South American neonatal network.

Science.gov (United States)

Fernández, Rocío; D'Apremont, Ivonne; Domínguez, Angélica; Tapia, José L

2014-10-01

To analyze survival and relevant morbidity by gestational age (GA) in very low birth weight (VLBW) infants (Neonatal Network (Red Neonatal Neocosur) between January 2001 and December 2011. Data on 8234 VLBW with a GA between 24+0 and 31+6 weeks were analyzed. Overall mortality was 26% (95% CI: 25.0-26.9), including 2.6% of deaths in the delivery room. Fact sheets for survival and morbidity for each week of gestation were developed based on collected data. Survival at discharge increased from 29% at 24 weeks of GA to 91% at 31 weeks of GA (p neonatal morbidity was inversely related to GA (p hemorrhage, and 4.6% periventricular leukomalacia. Among survivors, 47.3% had none of these five conditions. A tool for use in a clinical setting was developed based on updated regional data for establishing week-to-week survival and morbidity of newborn infants born between 24+0 and 31+6 weeks of GA. This information could be used to make decisions related to perinatal care and for counseling parents.

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

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Claudia Regina Hentges

2014-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

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Gaurav Sanghi

2014-01-01

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

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

Science.gov (United States)

Sanghi, Gaurav; Dogra, Mangat R; Katoch, Deeksha; Gupta, Amod

2014-02-01

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

Post discharge formula fortification of maternal human milk of very low birth weight preterm infants: an introduction of a feeding protocol in a University Hospital

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Abeer El Sakka

2016-10-01

Full Text Available The objective of this study is to determine the growth parameters and nutritional biochemical markers and complications of fortification of human milk by post discharge formula of preterm very low birth weight newborns (VLBW. Fifty preterm infants less than 37 weeks with weight less than 1500 g were enrolled in the study. They received parental nutrition and feeding according to our protocol. When enteral feeding reached 100 cc/kg/day, infants were randomized into two groups: group I, Cases, n=25, where post discharge formula (PDF was used for fortification, group II, Controls, n=25 with no fortification. Infants of both groups were given 50% of required enteral feeding as premature formula. This protocol was used until infants’ weight reached 1800 g. Daily weight, weekly length and head circumference were recorded. Hemoglobin, albumin (Alb, electrolytes, blood urea nitrogen (BUN and clinical complications were documented. Human milk fortification with PDF resulted in better growth with increase in weight 16.8 and 13.78 g/kg/day (P=0.0430, length 0.76 and 0.58 cm/week (P=0.0027, and head circumference of 0.59 and 0.5 cm/week (P=0.0217 in cases and controls respectively. Duration of hospital stay was less in cases (22.76 versus 28.52 days in Controls, P=0.02. No significant changes were found in serum electrolytes, BUN, or Alb between both groups. Hemoglobin was significantly higher in Cases, P=0.04. There were no significant clinical complications. Our feeding protocol of fortification of human milk with PDF in preterm very low birth weight newborns resulted in better growth and decrease in length of hospital stay. The use of PDF could be an alternative option for fortification of mothers’ milk for preterm VLBW infants in developing countries with low resources.

A Study Of Risk Factors For Low Birth Weight

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Deswal B S

1999-01-01

Full Text Available Research question: What is the extent of low weight babies born in hospitals and its association with some maternal factors? Objectives: 1. To find an overall prevalence of low birth weight babies amongst hospital births in Meerut city. 2. To identify and quantify the effects of some risk factors for low birth weight. Setting: District women Hospital of Meerut city of western U.P. Study Design: Hospital based matched case-control study. Sample size: 491 low birth weight babies as ‘cases’ and an equal number of babies of normal birth weight in ‘control’ group matched for maternal age, sex of baby, birth order and institution of delivery. Study variables: Socio-economic Status: maternal biological factors including obstetric history: antenatal factors: nutritional factors: history of abortion: toxaemia of pregnancy etc. Results: Overall proportion of low birth weight babies was found to be 21.8% amongst hospital live births and 30.9% born to mothers aged below 30 years of age. Low maternal weight, under nutrition, lack of antenatal care, short inter-pregnancy interval, toxacmia of pregnancy were independent factors increasing the risk of low birth weight significantly. Conclusions: The study suggested that a substantial proportion of low birth weight babies can be averted by improving maternal nutritional status including anemic condition, birth spacing and proper antenatal care.

Maternal Cytomegalovirus-Specific Immune Responses and Symptomatic Postnatal Cytomegalovirus Transmission in Very Low-Birth-Weight Preterm Infants

Science.gov (United States)

Ehlinger, Elizabeth P.; Webster, Emily M.; Kang, Helen H.; Cangialose, Aislyn; Simmons, Adam C.; Barbas, Kimberly H.; Burchett, Sandra K.; Gregory, Mary L.; Puopolo, Karen P.

2011-01-01

Introduction. Transmission of cytomegalovirus (CMV) via breast milk can lead to severe acute illness in very low-birth-weight (VLBW) preterm infants. Although the majority of CMV-seropositive women shed CMV in milk, symptomatic postnatal infection of VLBW infants occurs infrequently, suggesting that virologic or immunologic factors in milk may be associated with the risk and severity of postnatal CMV infection. Methods. We investigated the magnitude of CMV-specific cellular and humoral immune responses in milk of 30 seropositive mothers of VLWB preterm infants and assessed their relationship to milk CMV load and symptomatic CMV transmission. Results. Milk immunoglobulin G (IgG) avidity was inversely correlated to milk CMV load (r = −0.47; P = .009). However, milk CMV load and CMV-specific cellular and humoral immune responses were similar in mothers of VLBW infants with and those without symptomatic postnatal CMV infection. Conclusions. Similar immunologic parameters in milk of CMV-seropositive mothers of VLBW infants with and without symptomatic postnatal CMV infection indicate that screening milk by these parameters may not predict disease risk. However, the inverse correlation between milk CMV IgG avidity and CMV load may suggest that enhancement of maternal CMV-specific IgG responses could aid in reduction of CMV shedding into breast milk. PMID:21984738

Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children

Czech Academy of Sciences Publication Activity Database

Sonnenschein-van der Voort, A. M. M.; Arends, L. R.; de Jongste, J. C.; Annesi-Maesano, I.; Arshad, S. H.; Barros, H.; Basterrechea, M.; Bisgaard, H.; Chatzi, L.; Corpeleijn, E.; Correia, S.; Craig, L. C.; Devereux, G.; Dogaru, C.; Dostál, Miroslav; Duchen, K.; Eggesbø, M.; van der Ent, C. K.; Fantini, M. P.; Forastiere, F.; Frey, U.; Gehring, U.; Gori, D.; van der Gugten, A. C.; Hanke, W.; Henderson, A. J.; Heude, B.; Iniguez, C.; Inskip, H. M.; Keil, T.; Kelleher, C.; Kogevinas, M.; Kreiner-Moller, E.; Kuehni, C. E.; Kuepers, L. K.; Lancz, K.; Larsen, P. S.; Lau, S.; Ludvigsson, J.; Mommers, M.; Andersen, A. M. N.; Palkovicova, L.; Pike, K. C.; Pizzi, C.; Polanska, K.; Porta, D.; Richiardi, L.; Roberts, G.; Schmidt, A.; Šrám, Radim; Sunyer, J.; Thijs, C.; Torrent, M.; Viljoen, K.; Wijga, A. H.; Vrijheid, M.; Jaddoe, V. W. V.; Duijts, L.

2014-01-01

Roč. 133, č. 5 (2014), s. 1317-1329 ISSN 0091-6749 Institutional support: RVO:68378041 Keywords : gestational age * low birth weight * infant growth Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 11.476, year: 2014

BIRTH WEIGHT : A COMMUNITY PERSPECTIVE

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J P SRIVASTAVA

2003-06-01

Full Text Available India has a dubious distinction of belonging to the top bracket of countries with a very high under-5 Mortality Rate (U5MR of above 96/1000 live births. The U5MR considered the single most significant basic indicator of health status of a community, is proportional to the Infant Mortality Rate (IMR which in turn is contributed to directly and indirectly by the incidence of low Birth Weight (LB W.About 25 million LB W are born each year consisting 17% of all live births,nearly 95% of them in developing countries. About 26% of newborns are LBW in India, and indeed over 16% in those countries with very high U5MR.Both preterm and small-for-dates almost equally make up this category of vulnerable infants predisposed to asphyxia, feeding problems, anemia and growth failure. Considering the close relationship of birth weight with perinatal and infant morbidity as well as mortality, it is crucial to identify the liigh risk groups of low birth weight babies as early as possible.Unfortunately, in a community where 80% of newborns never get to have their weight measured, this itself is a tall order. In our society, the cry of the newborn is greeted with anxious queries about the sex of the baby and not his well­being and potential for healthy survival. The basic concept of the importance of birth weight is missing even among educated families. Indeed, it is as if the weighing machine has no place in the requirements at childbirth. In the absence of this basic facility, field workers and TBAs must report to other means to identify babies at risk. Mid-arm circumference, thigh circumference, foot length, and skin-fold thickness etc. are measurements that have been correlated satisfactorily with the baby’s weight. Simple tools like coloured strips have been developed and these show promise of applicability in field situation for identification of LB W by TBAs for early referral.

BIRTH WEIGHT : A COMMUNITY PERSPECTIVE

Directory of Open Access Journals (Sweden)

J P SRIVASTAVA

2003-06-01

Full Text Available India has a dubious distinction of belonging to the top bracket of countries with a very high under-5 Mortality Rate (U5MR of above 96/1000 live births. The U5MR considered the single most significant basic indicator of health status of a community, is proportional to the Infant Mortality Rate (IMR which in turn is contributed to directly and indirectly by the incidence of low Birth Weight (LB W.About 25 million LB W are born each year consisting 17% of all live births,nearly 95% of them in developing countries. About 26% of newborns are LBW in India, and indeed over 16% in those countries with very high U5MR.Both preterm and small-for-dates almost equally make up this category of vulnerable infants predisposed to asphyxia, feeding problems, anemia and growth failure.Considering the close relationship of birth weight with perinatal and infant morbidity as well as mortality, it is crucial to identify the liigh risk groups of low birth weight babies as early as possible.Unfortunately, in a community where 80% of newborns never get to have their weight measured, this itself is a tall order. In our society, the cry of the newborn is greeted with anxious queries about the sex of the baby and not his well­being and potential for healthy survival. The basic concept of the importance of birth weight is missing even among educated families. Indeed, it is as if the weighing machine has no place in the requirements at childbirth. In the absence of this basic facility, field workers and TBAs must report to other means to identify babies at risk. Mid-arm circumference, thigh circumference, foot length, and skin-fold thickness etc. are measurements that have been correlated satisfactorily with the baby’s weight. Simple tools like coloured strips have been developed and these show promise of applicability in field situation for identification of LB W by TBAs for early referral.

Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011.

Science.gov (United States)

Liang, Fu-Wen; Chou, Hung-Chieh; Chiou, Shu-Ti; Chen, Li-Hua; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Lu, Tsung-Hsueh

2018-06-01

A yearly increase in the proportion of very low birth weight (VLBW) live births has resulted in the slowdown of decreasing trends in crude infant mortality rates (IMRs). In this study, we examined the trends in birth weight-specific as well as birth weight-adjusted IMRs in Taiwan. We linked three nationwide datasets, namely the National Birth Reporting Database, National Birth Certification Registry, and National Death Certification Registry databases, to calculate the IMRs according to the birth weight category. Trend tests and mortality rate ratios in the periods 2010-2011 and 2004-2005 were used to examine the extent of reduction in birth weight-specific and birth weight-adjusted IMRs. The proportion of VLBW (births increased from 0.78% in 2004-2005 to 0.89% in 2010-2011, thus exhibiting a 15% increase. The extents of the decreases in birth weight-specific IMRs in the 500-999, 1000-1499, 1500-1999, 2000-2499, and 2500-2999 g birth weight categories were 15%, 33%, 43%, 30%, and 28%, respectively, from 2004-2005 to 2010-2011. The reduction in IMR in each birth weight category was larger than the reduction in the crude IMR (13%). By contrast, the IMR in the birth weight category exhibited a 56% increase during the study period. The IMRs were calculated by excluding all live births with a birth weight of birth weight-adjusted IMRs, which were calculated using a standard birth weight distribution structure for adjustment, exhibited similar extent reductions. In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs. Copyright © 2017. Published by Elsevier B.V.

morbidity and mortality of low birth weight infants in the new born

African Journals Online (AJOL)

hi-tech

2004-07-01

Jul 1, 2004 ... developing countries, it has been suggested that a substantial number of ... adequate to improve our low birth weight survival rates. In the mid eighties, ..... could be a reflection of poor transfer facilities between hospitals or ...

Neonatal and Infant Mortality in Korea, Japan, and the U.S.: Effect of Birth Weight Distribution and Birth Weight-Specific Mortality Rates

OpenAIRE

Kim, Do-Hyun; Jeon, Jihyun; Park, Chang Gi; Sriram, Sudhir; Lee, Kwang-sun

2016-01-01

Difference in crude neonatal and infant mortality rates (NMR and IMR) among different countries is due to the differences in its two determinants: birth weight distribution (BWD) and birth weight-specific mortality rates (BW-SMRs). We aimed to determine impact of BWD and BW-SMRs on differences in crude NMR and IMR among Korea, Japan, and the U.S. Our study used the live birth data of the period 2009 through 2010. Crude NMR/IMR are the lowest in Japan, 1.1/2.1, compared to 1.8/3.2, in Korea, a...

The relationship between maternal periodontitis and preterm low birth weight: A case-control study

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Satheesh Mannem

2011-01-01

Full Text Available Background: The relationship between periodontal diseases in pregnancy and children born prematurely or with low birth weight has been increasingly investigated, showing positive and negative results, respectively. Objective: To evaluate the association between Maternal Periodontitis and Preterm delivery or Low Birth Weight. Materials and Methods: In this case-control study, 104 pregnant women without systemic disease or other risk factors for preterm labor were chosen. The control group (n = 52 had term labor (infants ≥37 weeks and the case group (n = 52 had preterm labor (infants <37 weeks. Plaque index, bleeding index, and birth weight were measured. Results: The data of plaque index (cases 1.21±0.56; controls 0.63±0.31, bleeding index (cases, 2.08±0.62; controls, 1.52±0.61, birth weight (cases, 2.01±0.36; controls 2.87±0.32, and Probing Pocket Depth (PPD ≥4mm and Clinical Attachment Level (CAL ≥3mm in at least 4 teeth (odds ratio 137.50, P value < 0.0001 revealed a statistically significant difference between the two groups P< 0.05. Conclusions: A noticeable relationship between periodontal health and duration of pregnancy; periodontal disease could be a risk factor for preterm labor. Oral hygiene maintenance should be a part of prenatal care protocol.

Relation between birth weight and blood pressure: longitudinal study of infants and children

NARCIS (Netherlands)

L.J. Launer (Lenore); D.E. Grobbee (Diederick); A. Hofman (Albert)

1993-01-01

textabstractOBJECTIVE--To study the relation between birth weight and systolic blood pressure in infancy and early childhood. DESIGN--Longitudinal study of infants from birth to 4 years of age. SETTING--A middle class community in the Netherlands. PARTICIPANTS--476

Scrotal enteric fistula in an extremely low birth weight premature neonate

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Caitlin A. Smith

2018-03-01

Full Text Available Congenital inguinal hernia is a common condition in the pediatric population. Incarceration of inguinal hernias is known to result in significant morbidity such as necrotic bowel, and if not recognized promptly, has the potential to present as a scrotal fecal fistula. We present an extremely low birth weight premature male infant who developed spontaneous fecal drainage from his right scrotum.

Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil

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Barbieri Marco A

2000-01-01

Full Text Available OBJECTIVE: To identify risk factors for low birth weight (LBW among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.

Parenting very low birth weight children at school age: maternal stress and coping.

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Singer, Lynn T; Fulton, Sarah; Kirchner, H Lester; Eisengart, Sheri; Lewis, Barbara; Short, Elizabeth; Min, Meeyoung O; Kercsmar, Carolyn; Baley, Jill E

2007-11-01

To compare severity and determinants of stress and coping in mothers of 8-year-old very low birth weight (VLBW) and term children varying in medical and developmental risk. Three groups of mothers/infants were prospectively compared in a longitudinal study from birth to 8 years (110 high-risk VLBW, 80 low-risk VLBW, and 112 term). Maternal psychological distress, coping, parenting/marital stress, child health, and family impact were measured in the children at age 8 years. Mothers of VLBW children differed from term mothers, reporting less consensus with partners, more concern for their children's health, less parent-child conflict, and fewer years of education attained. Mothers of high-risk VLBW children experienced the greatest family and personal strains and used less denial and disengagement coping. The groups exhibited no differences in the sense of parenting competence, divorce rate, parenting/marital satisfaction, family cohesion, and psychological distress symptoms. Multiple birth, low socioeconomic status, and lower child IQ added to maternal stress. VLBW birth has long-term negative and positive impacts on maternal/family outcomes related to the infant's medical risk.

Trends in low birth weight: a comparison of two birth cohorts separated by a 15-year interval in Ribeirão Preto, Brazil.

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Silva, A. A.; Barbieri, M. A.; Gomes, U. A.; Bettiol, H.

1998-01-01

The incidence and some determinants of low birth weight (LBW) were studied in two population-based cohorts of singletons born live to families in Ribeirão Preto, São Paulo State, Brazil. The first cohort comprised infants born between June 1978 and May 1979 (6750 births--population survey) and the second, infants born between May and August 1994 (2990 births--sample survey). The incidence of LBW was 7.2% in 1978-79 and 10.6% in 1994. After adjustment for confounding factors, the following det...

[Perinatal health: low birth weight and social class].

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da Silva, A A; Barbieri, M A; Bettiol, H; Dal Bó, C M; Mucillo, G; Gomes, U A

1991-04-01

A survey was carried out in Ribeirão Preto, S. Paulo State, Brazil, between June 1978 and May 1979 with a view to studying the prevalence of low birth weight and its occurrence among different social classes. Data were collected from 8,878 singleton live births in eight maternity hospitals, accounting for 98% of all births in the area. Social classes were determinated by the use of a model proposed by Singer and modified for epidemiological purposes by Barros. Out of the 8,878 births, 660 (7.5%) were of low birth weight. The prevalence of deficient weight at birth (between 2,500 and 2,999 grams) was of 21.1%. Analysis indicated that 50.6% of children with low birth weight were at term and the majority of them suffered form intrauterine growth retardation. The prevalence of low birth weight according to social class was seen to be lower in the bourgeoisie classes (ranging from 2.8% to 3.9%) and higher in working classes (from 7% up to 9.5%). Low birth weight (defined as less than or equal to 2,500 grams) was used for purposes of comparison with other previous surveys. The percentage was lower in this study (8.3%) than that found in the Interamerican Investigation of Mortality in Childhood (8.7%), carried out in 1968-70. No statistically significant differences in the percentage of low birth weight were found in the case of Ribeirão Preto when these two surveys were compared.

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

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

2011-02-01

To determine the relationship between early postnatal dexamethasone (DXM) treatment and the severity of hyperbilirubinemia in extreme low birth weight (ELBW) preterm infants. In 54 ELBW preterm infants, total serum bilirubin concentrations (TSB) and phototherapy (PT) data during the first 10 days were evaluated retrospectively. ELBW infants had participated in a randomized controlled trial of early DXM treatment which aimed to assess effects on chronic lung disease. Infants had been treated with DXM (0.25 mg/kg twice daily at postnatal day 1 and 2) or with placebo (normal saline). Analysis was performed on an intention to treat basis. Twenty-five Infants had been randomized into the DXM group; 29 into the placebo group. Mean (±SD) TSB [120 (±19) μmol/L vs. 123 (±28) μmol/L, DXM versus placebo, respectively] and maximum TSB [178 (±23) μmol/L vs. 176 (±48), DXM versus placebo, respectively] concentrations were similar. TSB concentrations peaked 30 h earlier in the DXM group (p ≤ 0.05). The need for PT as well as the duration of PT was similar in both groups. Early DXM treatment does not affect the severity of neonatal hyperbilirubinemia in ELBW preterm infants. Our results seem compatible with the concept that factors other than bilirubin conjugation capacity are important for the pathophysiology of neonatal jaundice in ELBW preterm infants. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

Bedside detection of low systemic flow in the very low birth weight infant on day 1 of life.

LENUS (Irish Health Repository)

Miletin, J

2012-02-01

We aimed to assess the relationship between the clinical and biochemical parameters of perfusion and superior vena cava (SVC) flow in a prospective observational cohort study of very low birth weight (VLBW) infants. Newborns with congenital heart disease were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Capillary refill time (forehead, sternum and toe), mean blood pressure, urine output and serum lactate concentration were also measured simultaneously. Thirty-eight VLBW infants were examined. Eight patients (21%) had SVC flow less than 40 ml\\/kg\\/min. There was a poor correlation between the capillary refill time (in all sites), mean blood pressure, urine output and SVC flow. The correlation coefficient for the serum lactate concentration was r = -0.28, p = 0.15. The median serum lactate concentration was 3.5 (range 2.8-8.5) vs. 2.7 (range 1.2-6.9) mmol\\/l (p = 0.01) in low flow versus normal flow states. A serum lactate concentration of >2.8 was 100% sensitive and 60% specific for detecting a low flow state. Combining a capillary refill time of >4 s with a serum lactate concentration of >4 mmol\\/l had a specificity of 97% for detecting a low SVC flow state. Serum lactate concentrations are higher in low SVC flow states. A capillary refill time of >4 s combined with serum lactate concentrations >4 mmol\\/l increased the specificity and positive and negative predictive values of detecting a low SVC flow state.

Trends in low birth weight infants and changes in Baltimore's childbearing population, 1972–77

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Strobino, Donna M.

1982-01-01

Linked birth and death records provided the population for a study of trends in low birth weight (LBW) rates in Baltimore between 1972 and 1977 and of the effect of changes in the characteristics of the childbearing population on these trends. The impact of shifts in the birth weight distribution on neonatal mortality rates was also investigated. Trends were analyzed for unstandardized LBW rates as well as for rates standardized on the distributions of maternal age, education, gravidity, prio...

The Role of Immunonutrients in the Prevention of Necrotizing Enterocolitis in Preterm Very Low Birth Weight Infants

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Ping Zhou

2015-08-01

Full Text Available Necrotizing enterocolitis (NEC is a critical intestinal emergency condition, which mainly occurs in preterm very low birth weight (PVLBW infants. Despite remarkable advances in the care of PVLBW infants, with considerable improvement of the survival rate in recent decades, the incidence of NEC and NEC-related mortality have not declined accordingly. The fast progression from nonspecific signs to extensive necrosis also makes primary prevention the first priority. Recently, increasing evidence has indicated the important role of several nutrients in primary prevention of NEC. Therefore, the aim of this review is to summarize some potential immunomodulatory nutrients in the prevention of NEC, including bovine colostrum, probiotics, prebiotics (e.g., human milk oligosaccharides, long chain polyunsaturated fatty acids, and amino acids (glutamine, cysteine and N-acetylcysteine, l-arginine and l-citrulline. Based on current research evidence, probiotics are the most documented effective method to prevent NEC, while others still require further investigation in animal studies and clinical randomized controlled trials.

Gestational weight gain among minority adolescents predicts term birth weight.

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Ekambaram, Maheswari; Irigoyen, Matilde; DeFreitas, Johelin; Rajbhandari, Sharina; Geaney, Jessica Lynn; Braitman, Leonard Edward

2018-03-07

In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers. This was a retrospective cohort study of 411 singleton live term infants born to mothers ≤ 18 years. Data were abstracted from electronic medical records. Gestational weight gain was related to infant birth weight (ρ = 0.36, P gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval (CI) 1.07-1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6-19.5). Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.

Both very low- and very high in vitro cytokine responses were associated with infant death in low-birth-weight children from Guinea Bissau.

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Andreas Andersen

Full Text Available The mechanisms behind heterologous immunity and non-specific effects of vaccines on mortality are not well understood. We examined associations between cytokine responses and subsequent mortality in low-birth-weight infants in Guinea-Bissau.A low-birth-weight trial randomized children to Bacille Calmette-Guérin (BCG at birth or later according to local policy. Blood samples were obtained from a sub-group at age 6 weeks. Interleukin (IL-5, IL-10, IL-13, interferon (IFN-γ, and tumor necrosis factor (TNF-α were measured in whole-blood cell cultures stimulated with lipopolysaccharide (LPS, phytohaemagglutinin (PHA, or purified protein derivative (PPD. The outcome was mortality between bleeding and 1 year of age. Non-linear associations between cytokine responses and mortality were examined.Cytokine measurements were available from 390 children. The mortality rate (MR was high (6.8/100 person-years-observation (PYO. Both low and high cytokine responses to LPS and PHA were associated with high mortality (MR up to 25/100 PYO in the lowest 10% and 9.2/100 PYO in the highest 10%. In BCG-vaccinated children, higher IFN-γ responses to PPD were associated with better survival (MR ratio = 0.43 (0.24-0.77.Data presented a rare opportunity to explore associations between cytokine responses and mortality. Both low and high cytokine responses were associated with high mortality; a balanced response to invading pathogens seems preferable.

Both very low- and very high in vitro cytokine responses were associated with infant death in low-birth-weight children from Guinea Bissau.

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Andersen, Andreas; Jensen, Kristoffer J; Erikstrup, Christian; Ravn, Henrik; Fisker, Ane B; Lisse, Ida M; Sartono, Erliyani; Aaby, Peter; Yazdanbakhsh, Maria; Benn, Christine S

2014-01-01

The mechanisms behind heterologous immunity and non-specific effects of vaccines on mortality are not well understood. We examined associations between cytokine responses and subsequent mortality in low-birth-weight infants in Guinea-Bissau. A low-birth-weight trial randomized children to Bacille Calmette-Guérin (BCG) at birth or later according to local policy. Blood samples were obtained from a sub-group at age 6 weeks. Interleukin (IL)-5, IL-10, IL-13, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were measured in whole-blood cell cultures stimulated with lipopolysaccharide (LPS), phytohaemagglutinin (PHA), or purified protein derivative (PPD). The outcome was mortality between bleeding and 1 year of age. Non-linear associations between cytokine responses and mortality were examined. Cytokine measurements were available from 390 children. The mortality rate (MR) was high (6.8/100 person-years-observation (PYO)). Both low and high cytokine responses to LPS and PHA were associated with high mortality (MR up to 25/100 PYO in the lowest 10% and 9.2/100 PYO in the highest 10%). In BCG-vaccinated children, higher IFN-γ responses to PPD were associated with better survival (MR ratio = 0.43 (0.24-0.77)). Data presented a rare opportunity to explore associations between cytokine responses and mortality. Both low and high cytokine responses were associated with high mortality; a balanced response to invading pathogens seems preferable.

Randomized trial of BCG vaccination at birth to low-birth-weight children: beneficial nonspecific effects in the neonatal period?

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Aaby, Peter; Roth, Adam; Ravn, Henrik; Napirna, Bitiguida Mutna; Rodrigues, Amabelia; Lisse, Ida Maria; Stensballe, Lone; Diness, Birgitte Rode; Lausch, Karen Rokkedal; Lund, Najaaraq; Biering-Sørensen, Sofie; Whittle, Hilton; Benn, Christine Stabell

2011-07-15

Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG. In the period 2004-2008 we recruited 2320 LBW children in Bissau. The children were visited at home at 2, 6, and 12 months of age. With a pretrial infant mortality of 250 per 1000, we hypothesized a 25% reduction in infant mortality for LBW children. Infant mortality was only 101 per 1000 during the trial. In the primary analysis, infant mortality was reduced insignificantly by 17% (mortality rate ratio [MRR] = .83 [.63-1.08]). In secondary analyses, early BCG vaccine was safe with an MRR of .49 (.21-1.15) after 3 days and .55 (.34-.89) after 4 weeks. The reduction in neonatal mortality was mainly due to fewer cases of neonatal sepsis, respiratory infection, and fever. The impact of early BCG on infant mortality was marked for children weighing <1.5 kg (MRR = .43 [.21-.85]) who had lower coverage for diphtheria-tetanus-pertussis vaccinations. Though early BCG did not reduce infant mortality significantly, it may have a beneficial effect in the neonatal period. This could be important for public health because BCG is often delayed in low-income countries.

Preterm Birth and Low Birth Weight Following Icsi- Pregnancies

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Aygül Demirol; Süleyman Güven; Timur Gürgan

2006-01-01

OBJECTIVE: To report preterm birth and low birth weight rate of intracytoplasmic sperm injection (ICSI) related pregnancies and to compare our data with literature findings. STUDY DESIGN: Three-hundred and eighty-nine pregnancies following controlled ovarian hyperstimulation and intracytoplasmic sperm injection were retrospectively evaluated. Patients’ characteristics including age, gestational age at delivery and birth weight were noted from special clinic files. Women with early pregnanc...

The human milk project: a quality improvement initiative to increase human milk consumption in very low birth weight infants.

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Ward, Laura; Auer, Christine; Smith, Carrie; Schoettker, Pamela J; Pruett, Raymond; Shah, Nilesh Y; Kotagal, Uma R

2012-08-01

Human milk has well-established health benefits for preterm infants. We conducted a multidisciplinary quality improvement effort aimed at providing at least 500 mL of human milk/kg in the first 14 days of life to very low birth weight (VLBW) (milk program, and twice-daily physician evaluation of infants' ability to tolerate feedings. The number of infants receiving at least 500 mL of human milk/kg in their first 14 days of life increased from 50% to 80% within 11 months of implementation, and this increase has been sustained for 4 years. Infants who met the feeding goal because they received donor milk increased each year. Since September 2007, infants have received, on average, 1,111 mL of human milk/kg. Approximately 4% of infants did not receive any human milk. Respiratory instability was the most frequent physiological reason given by clinicians for not initiating or advancing feedings in the first 14 days of life. Our quality improvement initiative resulted in a higher consumption of human milk in VLBW infants in the first 14 days of life. Other clinicians can use these described quality improvement methods and techniques to improve their VLBW babies' consumption of human milk.

Neonatal bartter syndrome in an extremely low birth weight baby

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Deeparaj Hegde

2017-01-01

Full Text Available Early diagnosis of Bartter syndrome (BS in the neonatal period is a clinical challenge, more so in an extremely low birth weight (ELBW baby because of the inherent renal immaturity and the associated difficulty in fluid management. However, once a diagnosis is made, the disorder is known to respond well to fluid and electrolyte management, prostaglandin inhibitors, and potassium-sparing diuretics. Herein, we report a case of neonatal BS in a very premature ELBW infant.

Efficacy and safety of rectal ibuprofen for patent ductus arteriosus closure in very low birth weight preterm infants.

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Demir, Nihat; Peker, Erdal; Ece, İbrahim; Balahoroğlu, Ragıp; Tuncer, Oğuz

2017-09-01

To compare rectal ibuprofen with oral ibuprofen for the closure of hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) preterm infants. In a prospective, randomized study, 72 VLBW infants who had hsPDA received either rectal or oral ibuprofen. The plasma concentration of ibuprofen and renal functions were determined in both groups by the high-performance liquid chromatography (HPLC) method and cystatin-C (cys-C), respectively. The hsPDA closure rate of the group that received rectal ibuprofen was similar to oral ibuprofen (86.1% versus 83.3%) after the first course of the treatment (p = 0.745). A statistically significant difference was identified between the mean plasma cys-C levels before and after treatment in both the rectal and oral ibuprofen groups (p = 0.004 and p 0.05 for all values). Rectal ibuprofen is as effective as oral ibuprofen for hsPDA closure in VLBW infants. The rise in the cys-C level with rectal and oral treatment shows that patients with borderline renal function should be evaluated and followed closely.

Rehospitalization Through Childhood and Adolescence: Association with Neonatal Morbidities in Infants of Very Low Birth Weight.

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Kuint, Jacob; Lerner-Geva, Liat; Chodick, Gabriel; Boyko, Valentina; Shalev, Varda; Reichman, Brian

2017-09-01

To evaluate the impact of major neonatal morbidities on the risks for rehospitalization in children and adolescents born of very low birth weight. An observational study was performed on data of the Israel Neonatal Network linked together with the Maccabi Healthcare Services medical records. After discharge from the neonatal intensive care unit, 6385 infants of very low birth weight born from 1995 to 2012 were registered with Maccabi Healthcare Services and formed the study cohort. Multivariable negative binomial regression models were calculated to estimate the adjusted relative risk (aRR) and 95% CI for hospitalization. Up to 18 years following discharge, 3956 infants were hospitalized at least once. The median age of follow-up was 10.7 years with total of follow-up of 67 454 patient years and 10 895 hospitalizations. The risks for rehospitalization were increased significantly for each of the neonatal morbidities: surgical necrotizing enterocolitis (NEC), aRR 2.71 (95% CI 2.08-3.53), intraventricular hemorrhage grades 3-4, 2.13 (1.85-2.46), periventricular leukomalacia (PVL), 1.83 (1.58-2.13), bronchopulmonary dysplasia, 1.94 (1.72-2.17), and retinopathy of prematurity stages 3-4, 1.59 (1.36-1.85). During the first 4 years, children with surgically treated NEC, intraventricular hemorrhage, PVL, or bronchopulmonary dysplasia had 1.5- to 2.5-fold greater risks for hospitalization compared with those without the specific morbidity. In the 11th-14th and 15th-18th years, respectively, surgically treated NEC was associated with a 3.05 (1.32-7.04) and 3.26 (0.99-10.7) aRR for hospitalization, and PVL was associated with a 2.67 (1.79-3.97) and 3.47 (2.03-5.92) aRR for hospitalization. Specific major neonatal morbidities as well as the number of morbidities were associated with excess risks of rehospitalization through childhood and adolescence. Copyright © 2017 Elsevier Inc. All rights reserved.

The relationship of birth weight, gestational age, and postmenstrual age with ocular biometry parameters in premature infants

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Ozdemir Ozdemir

2015-06-01

Full Text Available ABSTRACT Purpose: To analyze ocular biometry parameters and evaluate their relationship with gestational age, birth weight, and postmenstrual age in prematurely born infants. Methods: The right eyes of 361 premature infants born before the 36th gestational week were evaluated. Birth weight, gestational week, and gender were recorded. An A-scan Biometer was used for obtaining axial measurements, including anterior chamber depth, lens thickness, vitreous length, and total axial length. Results: Gestational age and birth weight values ranged from 23 to 36 weeks and from 560 to 2,670 g, respectively. The mean gestational age and birth weight were 30.8 ± 2.8 weeks and 1,497.9 ± 483.6 g, respectively. During the first examination (4-5 weeks of postnatal age, birth weight and gestational age of the infants correlated significantly and positively with lens thickness, vitreous length, and axial length (r>0.5, p<0.001, but not with anterior chamber depth (r<0.5. Increased vitreous and axial lengths correlated significantly with increasing postmenstrual age of the infants (r=0.669, p<0.001; r=0.845, p<0.001, respectively. Conclusions: Lens thickness, vitreous length, and axial length, but not anterior chamber depth, were significantly correlated with birth weight and gestational age. All four parameters increased with increasing postmenstrual age, with higher correlations for vitreous and axial lengths than for anterior chamber depth and lens thickness. It was concluded that axial elongation resulted primarily from increasing posterior chamber length.