WorldWideScience

Sample records for newly born infants

  1. Delivery room management of term and preterm newly born infants.

    Science.gov (United States)

    Saugstad, Ola Didrik

    2015-01-01

    Delivery room management, especially in the first 'golden' minute, is of the utmost importance. An exact and universal definition of when a baby is born is needed to obtain agreement on what is meant by the first minute of life. Education of young girls is a basic requirement to optimize the health of the mother and baby. Interventions in pregnancy should as far as possible be evidence based. Antenatal care, the selection of birth mode and antenatal steroid therapy when indicated also contribute to obtaining the best outcome. Delayed cord clamping is recommended for both preterm and term infants. However, more data are needed regarding the most immature infants. Routine suctioning of the mouth and airways is not required. Thermal control is important - keep the temperature in the delivery room at 26°C and wrap infants start with CPAP from the first breath. A T-piece device seems to have some advantages compared to self-inflating bags. Surfactant instillation is often not needed prophylactically provided the mother has received antenatal steroids. Less invasive methods for administering surfactant may be useful. If ventilatory support is needed, start with air in term and near-term infants. For babies of 29-33 weeks of gestation start with 21-30% oxygen and for infants start with 30% oxygen and adjust according to the response obtained. © 2015 S. Karger AG, Basel.

  2. Long-term cognitive outcomes of infants born moderately and late preterm.

    Science.gov (United States)

    Odd, David Edward; Emond, Alan; Whitelaw, Andrew

    2012-08-01

    To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. A cohort study based on the Avon Longitudinal Study of Parents and Children. Cognitive measures were assessed between the ages of 8 and 11 years. Exposure groups were defined as moderate/late preterm (32-36 weeks' gestation) or term (37-42 wk). Regression models were used to investigate the association between gestational age and IQ. Seven hundred and forty-one infants (5.4% of total eligible population; 422 males, 319 females; mean (SD) birthweight 2495 g [489]) were born between 32 and 36 weeks' gestation. The analysis was based on 6957 infants with IQ data at age 11 (50% of eligible infants). In the adjusted model, children born moderately and late preterm had similar IQ scores to peers born at term (mean difference [95% confidence interval] -0.18 [-1.88 to 1.52]). However, the preterm infants had a higher risk of having special educational needs at school (odds ratio 1.56 [1.18-2.07]). Despite an increased risk of special educational needs, there is little evidence of a reduction in IQ, memory, or attention measures at school age in children born between 32 and 36 weeks' gestation. Although interpretation is limited by the amount of missing data, further work is needed to identify why these infants have increased educational needs. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  3. Premature infants display increased noxious-evoked neuronal activity in the brain compared to healthy age-matched term-born infants.

    Science.gov (United States)

    Slater, Rebeccah; Fabrizi, Lorenzo; Worley, Alan; Meek, Judith; Boyd, Stewart; Fitzgerald, Maria

    2010-08-15

    This study demonstrates that infants who are born prematurely and who have experienced at least 40days of intensive or special care have increased brain neuronal responses to noxious stimuli compared to healthy newborns at the same postmenstrual age. We have measured evoked potentials generated by noxious clinically-essential heel lances in infants born at term (8 infants; born 37-40weeks) and in infants born prematurely (7 infants; born 24-32weeks) who had reached the same postmenstrual age (mean age at time of heel lance 39.2+/-1.2weeks). These noxious-evoked potentials are clearly distinguishable from shorter latency potentials evoked by non-noxious tactile sensory stimulation. While the shorter latency touch potentials are not dependent on the age of the infant at birth, the noxious-evoked potentials are significantly larger in prematurely-born infants. This enhancement is not associated with specific brain lesions but reflects a functional change in pain processing in the brain that is likely to underlie previously reported changes in pain sensitivity in older ex-preterm children. Our ability to quantify and measure experience-dependent changes in infant cortical pain processing will allow us to develop a more rational approach to pain management in neonatal intensive care. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  4. Motor Development of Premature Infants Born between 32 and 34 Weeks

    Directory of Open Access Journals (Sweden)

    S. A. Prins

    2010-01-01

    Full Text Available Little is known about motor development in late preterm born infants. Our objective was to determine long-term outcome of motor skills of infants born between 32 and 34 weeks. All infants were assessed at corrected ages of 3 and 9 months, using the Alberta Infant Motor Scale. At corrected ages of 4 years, the Movement Assessment Battery for Children was done. Seventy infants were seen at 4 years of age (median of 3 assessments per infant. Abnormal assessment at 3 or 9 months of age resulted in normal outcome in almost 80% at 4 years. On the other hand, a normal outcome in the first year of life resulted in an abnormal outcome at 4 years in 10% of the infants. Our results suggest that long-term followup of these late preterm born infants is necessary, as the assessments in the first year do not predict the long-term outcome.

  5. The Chinese-born immigrant infant feeding and growth hypothesis

    Directory of Open Access Journals (Sweden)

    Kristy A. Bolton

    2016-10-01

    Full Text Available Abstract Background Rapid growth in the first six months of life is a well-established risk factor for childhood obesity, and child feeding practices (supplementation or substitution of breast milk with formula and early introduction of solids have been reported to predict this. The third largest immigrant group in Australia originate from China. Case-studies reported from Victorian Maternal and Child Health nurses suggest that rapid growth trajectories in the infants of Chinese parents is common place. Furthermore, these nurses report that high value is placed by this client group on rapid growth and a fatter child; that rates of breastfeeding are low and overfeeding of infant formula is high. There are currently no studies which describe infant growth or its correlates among this immigrant group. Presentation of hypothesis We postulate that in Australia, Chinese-born immigrant mothers will have different infant feeding practices compared to non-immigrant mothers and this will result in different growth trajectories and risk of overweight. We present the Chinese-born immigrant infant feeding and growth hypothesis - that less breastfeeding, high formula feeding and early introduction of solids in infants of Chinese-born immigrant mothers living in Australia will result in a high protein intake and subsequent rapid growth trajectory and increased risk of overweight and obesity. Testing the hypothesis Three related studies will be conducted to investigate the hypothesis. These will include two quantitative studies (one cross-sectional, one longitudinal and a qualitative study. The quantitative studies will investigate differences in feeding practices in Chinese-born immigrant compared to non-immigrant mothers and infants; and the growth trajectories over the first 3.5 years of life. The qualitative study will provide more in-depth understanding of the influencing factors on feeding practices in Chinese-born immigrant mothers. Implications of the

  6. Predicting healthcare outcomes in prematurely born infants using cluster analysis.

    Science.gov (United States)

    MacBean, Victoria; Lunt, Alan; Drysdale, Simon B; Yarzi, Muska N; Rafferty, Gerrard F; Greenough, Anne

    2018-05-23

    Prematurely born infants are at high risk of respiratory morbidity following neonatal unit discharge, though prediction of outcomes is challenging. We have tested the hypothesis that cluster analysis would identify discrete groups of prematurely born infants with differing respiratory outcomes during infancy. A total of 168 infants (median (IQR) gestational age 33 (31-34) weeks) were recruited in the neonatal period from consecutive births in a tertiary neonatal unit. The baseline characteristics of the infants were used to classify them into hierarchical agglomerative clusters. Rates of viral lower respiratory tract infections (LRTIs) were recorded for 151 infants in the first year after birth. Infants could be classified according to birth weight and duration of neonatal invasive mechanical ventilation (MV) into three clusters. Cluster one (MV ≤5 days) had few LRTIs. Clusters two and three (both MV ≥6 days, but BW ≥or <882 g respectively), had significantly higher LRTI rates. Cluster two had a higher proportion of infants experiencing respiratory syncytial virus LRTIs (P = 0.01) and cluster three a higher proportion of rhinovirus LRTIs (P < 0.001) CONCLUSIONS: Readily available clinical data allowed classification of prematurely born infants into one of three distinct groups with differing subsequent respiratory morbidity in infancy. © 2018 Wiley Periodicals, Inc.

  7. Increased risk of peanut allergy in infants of Asian-born parents compared to those of Australian-born parents.

    Science.gov (United States)

    Koplin, J J; Peters, R L; Ponsonby, A-L; Gurrin, L C; Hill, D; Tang, M L K; Dharmage, S C; Allen, K J

    2014-12-01

    Asian infants appear to be over-represented among patients with clinical food allergy in Australia, but this has not been formally examined at the population level. Any difference in prevalence according to parental country of birth may be secondary to modifiable lifestyle factors. We aimed to quantify (i) differences in the prevalence of peanut allergy by parental country of birth and (ii) contribution of measured environmental exposures to these differences. The population-based HealthNuts study in Melbourne, Australia, screened 5276 infants (74% participation) with skin prick tests and sensitized infants underwent food challenge. Of these, 535 had a parent born in East Asia and 574 in UK/Europe. Associations between parents' country of birth and offspring peanut allergy were examined using multiple logistic regression. Compared to infants with two Australian-born parents, peanut allergy was more common among infants with parent/s born in East Asia (OR 3.4, 95% CI 2.2-5.1) but not those with parent/s born in the UK/Europe (OR 0.8, 95% CI 0.4-1.5). Paradoxically rates of allergic disease were lower among Asian parents. A higher prevalence of eczema among infants of Asian parents explained around 30% of the increase in peanut allergy, while differences in dog ownership explained around 18%. The high peanut allergy prevalence among infants of Asian-born parents appears to have occurred in a single generation and was not present among infants with parents migrating from other countries, suggesting gene-environment interactions are important. The role of eczema and microbial exposure in food allergy prevention warrants exploration. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. 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.

  9. 90Sr in the skeleton of new-born children and infants

    International Nuclear Information System (INIS)

    Borisov, B.K.

    1980-01-01

    The correlation between 90 Sr content in the skeleton of new-born children and infants and 90 Sr content in the vertebrae spongy tissue of mother, is studied in different countries from 1965 to 1973. The highest indexes of 90 Sr concentration in the bone tissue of new-born children are found to be characteristic of Canada and Norway. The minimum 90 Sr content is observed in Japan. The dynamics of indexes which characterize 90 Sr content in the bone tissue of infants is presented. The peculiarities are conditioned by particular nutrition of an infant nursing and cow milk used as additional food

  10. Human parechovirus type 3 infection: Cause of apnea in infants born prematurely.

    Science.gov (United States)

    Nirei, Jun; Aizawa, Yuta; Okazaki, Minoru; Kobayashi, Akira; Onozuka, Junya; Numata, Osamu; Oishi, Tomohiro; Saitoh, Akihiko

    2016-05-01

    Four infants born prematurely presented with multiple apnea episodes caused by human parechovirus type 3 (HPeV3) infection. All patients required oxygen supplementation, and one patient required mechanical ventilation. HPeV3 infection might be included in the differential diagnosis of apnea in neonates and young infants, especially those born prematurely. © 2016 Japan Pediatric Society.

  11. Distinguishing Newly Born Strange Stars from Neutron Stars with g-Mode Oscillations

    International Nuclear Information System (INIS)

    Fu Weijie; Wei Haiqing; Liu Yuxin

    2008-01-01

    The gravity-mode (g-mode) eigenfrequencies of newly born strange quark stars (SQSs) and neutron stars (NSs) are studied. It is found that the eigenfrequencies in SQSs are much lower than those in NSs by almost 1 order of magnitude, since the components of a SQS are all extremely relativistic particles while nucleons in a NS are nonrelativistic. We therefore propose that newly born SQSs can be distinguished from the NSs by detecting the eigenfrequencies of the g-mode pulsations of supernovae cores through gravitational radiation by LIGO-class detectors

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Age correction in cognitive, linguistic, and motor domains for infants born preterm: an analysis of the Bayley Scales of Infant and Toddler Development, Third Edition developmental patterns.

    Science.gov (United States)

    Morsan, Valentina; Fantoni, Carlo; Tallandini, Maria Anna

    2018-03-15

    To verify whether it is appropriate to use age correction for infants born preterm in all the developmental domains (cognitive, linguistic, and motor) considered by the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Seventy-three infants born preterm (26-35wks) without major neurological sequelae and 67 infants born at term were assessed at 12 months (corrected age for infants born preterm). The performance of the infants born preterm was assessed with two different evaluations: scores based on uncorrected age and scores based on corrected age. The developmental trends of infants born at term and infants born preterm differ across domains. Statistical analysis shows that age correction produces an overrated estimate of motor performance (12.5 points [95% confidence interval 9.05-16.01]) but not of cognitive performance. Given the broad use of the Bayley-III by psychologists and paediatricians, these results are important in the early diagnosis of developmental difficulties for children born preterm. Correction for gestational age should be applied for the cognitive domain only; whereas for the motor domain, chronological age should be used. No clear data emerged for language. Age correction with Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) for infants born preterm should be applied differently in cognitive, language, and motor domains. Using corrected age with Bayley-III, the motor skills are overrated. Correction for preterm births adequately measures cognitive skills. No clear indication emerged about language skills. © 2018 Mac Keith Press.

  14. Feasibility of pulse oximetry for assessment of infants born in community based midwifery care

    NARCIS (Netherlands)

    Smit, M.; Ganzeboom, A.; Dawson, J.A.; Walther, F.J.; Bustraan, J.; van Roosmalen, Jos; te Pas, A.B.

    2014-01-01

    To evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care. Design: a prospective, observational study of infants born after midwifery supervised (home) births. Setting: 27 midwives from seven practices providing primary care in (home)

  15. The Control of Posture in Newly Standing Infants is Task Dependent

    Science.gov (United States)

    Claxton, Laura J.; Melzer, Dawn K.; Ryu, Joong Hyun; Haddad, Jeffrey M.

    2012-01-01

    The postural sway patterns of newly standing infants were compared under two conditions: standing while holding a toy and standing while not holding a toy. Infants exhibited a lower magnitude of postural sway and more complex sway patterns when holding the toy. These changes suggest that infants adapt postural sway in a manner that facilitates…

  16. Growth of infants born to HIV-infected women when fed a ...

    African Journals Online (AJOL)

    Growth of infants born to HIV-infected women when fed a ... breast-feeding.1 This must be balanced against the many benefits of ... milk formulas for their newborn infants. Outcome ... Inclusion criteria were normally grown (birth weight 2500–.

  17. Congenital malformations in infants born after in vitro fertilization in Sweden.

    Science.gov (United States)

    Källén, Bengt; Finnström, Orvar; Lindam, Anna; Nilsson, Emma; Nygren, Karl-Gösta; Otterblad, Petra Olausson

    2010-03-01

    The risk for congenital malformations is increased in infants born after in vitro fertilization (IVF). Some specific malformations appear to be more affected than others. The presence of congenital malformations in 15,570 infants born after IVF with an embryo transfer between April 1, 2001, and the end of 2006 were compared with all infants born in Sweden during 2001 to 2007 (n = 689,157). Risk estimates were made after adjusting for year of birth, maternal age, parity, smoking, and body mass index. The risks of specific malformations were compared with data from a previous study (1982 to March 31, 2001) of 16,280 infants born after IVF. Different IVF methods were compared to respect to malformation risk. Increased risks of a similar magnitude were found for most cardiovascular malformations and limb reduction defects for both study periods. For neural tube defects, cardiac septal defects, and esophageal atresia, there was still an increased risk, but it was lower during the second than during the first period. For small bowel atresia, anal atresia, and hypospadias, the risk increase observed during the first study period had disappeared during the second period. An increased risk was seen for some syndromes that have been associated with imprinting errors. No difference in malformation risk according to IVF method was apparent. A slightly increased risk for congenital malformations after IVF persists. A decreasing risk is seen for some specific malformations, either true or the result of multiple testing. Copyright 2010 Wiley-Liss, Inc.

  18. Improved survival and neurodevelopmental outcomes among extremely premature infants born near the limit of viability.

    Science.gov (United States)

    Younge, Noelle; Smith, P Brian; Gustafson, Kathryn E; Malcolm, William; Ashley, Patricia; Cotten, C Michael; Goldberg, Ronald N; Goldstein, Ricki F

    2016-04-01

    Infants born near the limit of viability are at high risk for death or adverse neurodevelopmental outcomes. It is unclear whether these outcomes have improved over the past 15 years. To determine if death and neurodevelopmental impairment have declined over the past 15 years in infants born at 22 to 24 weeks' gestation. Retrospective cohort study. We identified infants born at 22 to 24 weeks' gestation in our center in two epochs: 1998-2004 (Epoch 1) and 2005-2011 (Epoch 2). The primary outcome, death or neurodevelopmental impairment, was evaluated at 17-25 months' corrected gestational age with neurologic exams and Bayley Scales of Infant Development. Perinatal characteristics, major morbidities, and outcomes were compared between epochs. Birth weight and gestational age were similar between 170 infants in Epoch 1 and 187 infants in Epoch 2. Mortality was significantly lower in Epoch 2, 55% vs. 42% (p=0.02). Among surviving infants, late-onset sepsis (pNeurodevelopmental impairment among surviving infants declined from 68% in Epoch 1 to 47% in Epoch 2, p=0.02. Odds of death or NDI were significantly lower in Epoch 2 vs. Epoch 1, OR=0.31 (95% confidence interval; 0.16, 0.58). Risk of death or neurodevelopmental impairment decreased over time in infants born at 22 to 24 weeks' gestation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. [Neonatal hyperthyroidism in a premature infant born to a mother with Grave's disease].

    Science.gov (United States)

    Nicaise, C; Gire, C; Brémond, V; Minodier, P; Soula, F; d'Ercole, C; Palix, C

    2000-05-01

    Neonatal thyrotoxicosis is most commonly due to transplacental transfer of maternal thyroid-stimulating hormone receptor antibodies (TRAb). Bioassay of thyrotropin receptor antibodies may help to determine the risk for neonatal hyperthyroidism. Thyrotoxicosis developed in a premature infant born to a mother with Graves' disease, with a low level of TRAb by bioassay. The infant was treated with carbimazole for two months, until TRAb had disappeared. Bioassay TRAb is not always reliable for predicting the development of neonatal hyperthyroidism in infants born to mothers with Graves' disease. Thyroid function should be measured in all these neonates.

  20. Thymic size in uninfected infants born to HIV-positive mothers and fed with pasteurized human milk

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth; Hasselbalch, H; Ersbøll, A K

    2003-01-01

    AIM: To examine the size of the thymus in uninfected infants born to HIV-positive mothers and to study the effects of feeding by human donor milk on the size of the thymus in these infants. METHODS: The absolute and relative thymic size was assessed by sonography as thymic index (Ti), and the Ti....../weight-ratio (Ti/w) at birth and at 4 mo of age in 12 healthy uninfected infants born to HlV-infected mothers. All infants were exclusively fed pasteurized donor milk. The results were compared with those obtained from a previous cohort of exclusively breastfed, partially breastfed and exclusively formula......-fed infants. RESULTS: At birth the Ti was reduced in infants born to HIV-infected mothers in comparison with that in control infants but this difference disappeared when their birthweights were taken into consideration (Ti/w-ratio). At 4 mo of age the geometric mean Ti of infants fed donor milk was 23...

  1. Computed tomography of the head of new born premature infants

    International Nuclear Information System (INIS)

    Ohno, Tsutomu; Mizobe, Naoki; Takehiro, Hideo

    1983-01-01

    Evaluation of the extracerebral space on CT resulted as follows: The existence of the etracerebral space in the parieto-occipital region (PO-ECS) was physiological findings characteristic to premature infants. Its incidence was higher and the width of the space was greater, in those of premature infants. Generally PO-ECS disappeared around 40 weeks of gestation, while it tended to remaine beyond 40 weeks in premature infants born after less than 30 weeks of pregnancy. The appearance and disappearance of the PO-ECS may present some approach to learning the development of the brain in premature infants. (Ueda, J.)

  2. Estimating the impact of newly arrived foreign-born persons on tuberculosis in the United States.

    Directory of Open Access Journals (Sweden)

    Yecai Liu

    Full Text Available Among approximately 163.5 million foreign-born persons admitted to the United States annually, only 500,000 immigrants and refugees are required to undergo overseas tuberculosis (TB screening. It is unclear what extent of the unscreened nonimmigrant visitors contributes to the burden of foreign-born TB in the United States.We defined foreign-born persons within 1 year after arrival in the United States as "newly arrived", and utilized data from U.S. Department of Homeland Security, U.S. Centers for Disease Control and Prevention, and World Health Organization to estimate the incidence of TB among newly arrived foreign-born persons in the United States. During 2001 through 2008, 11,500 TB incident cases, including 291 multidrug-resistant TB incident cases, were estimated to occur among 20,989,738 person-years for the 1,479,542,654 newly arrived foreign-born persons in the United States. Of the 11,500 estimated TB incident cases, 41.6% (4,783 occurred among immigrants and refugees, 36.6% (4,211 among students/exchange visitors and temporary workers, 13.8% (1,589 among tourists and business travelers, and 7.3% (834 among Canadian and Mexican nonimmigrant visitors without an I-94 form (e.g., arrival-departure record. The top 3 newly arrived foreign-born populations with the largest estimated TB incident cases per 100,000 admissions were immigrants and refugees from high-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of ≥100 cases/100,000 population/year; 235.8 cases/100,000 admissions, 95% confidence interval [CI], 228.3 to 243.3, students/exchange visitors and temporary workers from high-incidence countries (60.9 cases/100,000 admissions, 95% CI, 58.5 to 63.3, and immigrants and refugees from medium-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of 15-99 cases/100,000 population/year; 55.2 cases/100,000 admissions, 95% CI, 51.6 to 58.8.Newly arrived nonimmigrant visitors contribute substantially to the burden of

  3. Estimating the impact of newly arrived foreign-born persons on tuberculosis in the United States.

    Science.gov (United States)

    Liu, Yecai; Painter, John A; Posey, Drew L; Cain, Kevin P; Weinberg, Michelle S; Maloney, Susan A; Ortega, Luis S; Cetron, Martin S

    2012-01-01

    Among approximately 163.5 million foreign-born persons admitted to the United States annually, only 500,000 immigrants and refugees are required to undergo overseas tuberculosis (TB) screening. It is unclear what extent of the unscreened nonimmigrant visitors contributes to the burden of foreign-born TB in the United States. We defined foreign-born persons within 1 year after arrival in the United States as "newly arrived", and utilized data from U.S. Department of Homeland Security, U.S. Centers for Disease Control and Prevention, and World Health Organization to estimate the incidence of TB among newly arrived foreign-born persons in the United States. During 2001 through 2008, 11,500 TB incident cases, including 291 multidrug-resistant TB incident cases, were estimated to occur among 20,989,738 person-years for the 1,479,542,654 newly arrived foreign-born persons in the United States. Of the 11,500 estimated TB incident cases, 41.6% (4,783) occurred among immigrants and refugees, 36.6% (4,211) among students/exchange visitors and temporary workers, 13.8% (1,589) among tourists and business travelers, and 7.3% (834) among Canadian and Mexican nonimmigrant visitors without an I-94 form (e.g., arrival-departure record). The top 3 newly arrived foreign-born populations with the largest estimated TB incident cases per 100,000 admissions were immigrants and refugees from high-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of ≥100 cases/100,000 population/year; 235.8 cases/100,000 admissions, 95% confidence interval [CI], 228.3 to 243.3), students/exchange visitors and temporary workers from high-incidence countries (60.9 cases/100,000 admissions, 95% CI, 58.5 to 63.3), and immigrants and refugees from medium-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of 15-99 cases/100,000 population/year; 55.2 cases/100,000 admissions, 95% CI, 51.6 to 58.8). Newly arrived nonimmigrant visitors contribute substantially to the burden of foreign-born

  4. Brain metabolite alterations in infants born preterm with intrauterine growth restriction: association with structural changes and neurodevelopmental outcome.

    Science.gov (United States)

    Simões, Rui V; Muñoz-Moreno, Emma; Cruz-Lemini, Mónica; Eixarch, Elisenda; Bargalló, Núria; Sanz-Cortés, Magdalena; Gratacós, Eduard

    2017-01-01

    Intrauterine growth restriction and premature birth represent 2 independent problems that may occur simultaneously and contribute to impaired neurodevelopment. The objective of the study was to assess changes in the frontal lobe metabolic profiles of 1 year old intrauterine growth restriction infants born prematurely and adequate-for-gestational-age controls, both premature and term adequate for gestational age and their association with brain structural and biophysical parameters and neurodevelopmental outcome at 2 years. A total of 26 prematurely born intrauterine growth restriction infants (birthweight intrauterine growth restriction infants had slightly smaller brain volumes and increased frontal lobe white matter mean diffusivity compared with both prematurely born but adequate for gestational age and term adequate for gestational age controls. Frontal lobe N-acetylaspartate levels were significantly lower in prematurely born intrauterine growth restriction than in prematurely born but adequate for gestational age infants but increased in prematurely born but adequate for gestational age compared with term adequate-for-gestational-age infants. The prematurely born intrauterine growth restriction group also showed slightly lower choline compounds, borderline decrements of estimated glutathione levels, and increased myoinositol to choline ratios, compared with prematurely born but adequate for gestational age controls. These specific metabolite changes were locally correlated to lower gray matter content and increased mean diffusivity and reduced white matter fraction and fractional anisotropy. Prematurely born intrauterine growth restriction infants also showed a tendency for poorer neurodevelopmental outcome at 2 years, associated with lower levels of frontal lobe N-acetylaspartate at 1 year within the preterm subset. Preterm intrauterine growth restriction infants showed altered brain metabolite profiles during a critical stage of brain maturation, which

  5. Changing Survival Rate of Infants Born Before 26 Gestational Weeks

    Science.gov (United States)

    Rahman, Asad; Abdellatif, Mohamed; Sharef, Sharef W.; Fazalullah, Muhammad; Al-Senaidi, Khalfan; Khan, Ashfaq A.; Ahmad, Masood; Kripail, Mathew; Abuanza, Mazen; Bataclan, Flordeliza

    2015-01-01

    Objectives: This study aimed to evaluate the changing survival rate and morbidities among infants born before 26 gestational weeks at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective study assessed the mortality and morbidities of all premature infants born alive at 23–26 gestational weeks at SQUH between June 2006 and May 2013. Infants referred to SQUH within 72 hours of birth during this period were also included. Electronic records were reviewed for gestational age, gender, birth weight, maternal age, mode and place of delivery, antenatal steroid administration, morbidity and outcome. The survival rate was calculated and findings were then compared with those of a previous study conducted in the same hospital from 1991 to 1998. Rates of major morbidities were also calculated. Results: A total of 81 infants between 23–26 gestational weeks were admitted to the neonatal unit during the study period. Of these, 58.0% were male and 42.0% were female. Median gestational age was 25 weeks and mean birth weight was 770 ± 150 g. Of the 81 infants, 49 survived. The overall survival rate was 60.5% compared to 41% reported in the previous study. Respiratory distress syndrome (100.0%), retinopathy of prematurity (51.9%), bronchopulmonary dysplasia (34.6%), intraventricular haemorrhage (30.9%) and patent ductus arteriosus (28.4%) were the most common morbidities. Conclusion: The overall survival rate of infants between 23–26 gestational weeks during the study period had significantly improved in comparison to that found at the same hospital from 1991 to 1998. There is a need for the long-term neurodevelopmental follow-up of premature infants. PMID:26357555

  6. Mortality, neonatal morbidity and two year follow-up of extremely preterm infants born in The Netherlands in 2007.

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    Cornelia G de Waal

    Full Text Available Extremely preterm infants are at high risk of neonatal mortality and adverse outcome. Survival rates are slowly improving, but increased survival may come at the expense of more handicaps.Prospective population-based cohort study of all infants born at 23 to 27 weeks of gestation in The Netherlands in 2007. 276 of 345 (80% infants were born alive. Early neonatal death occurred in 96 (34.8% live born infants, including 61 cases of delivery room death. 29 (10.5% infants died during the late neonatal period. Survival rates for live born infants at 23, 24, 25 and 26 weeks of gestation were 0%, 6.7%, 57.9% and 71% respectively. 43.1% of 144 surviving infants developed severe neonatal morbidity (retinopathy of prematurity grade ≥3, bronchopulmonary dysplasia and/or severe brain injury. At two years of age 70.6% of the children had no disability, 17.6% was mild disabled and 11.8% had a moderate-to-severe disability. Severe brain injury (p = 0.028, retinopathy of prematurity grade ≥3 (p = 0.024, low gestational age (p = 0.019 and non-Dutch nationality of the mother (p = 0.004 increased the risk of disability.52% of extremely preterm infants born in The Netherlands in 2007 survived. Surviving infants had less severe neonatal morbidity compared to previous studies. At two years of age less than 30% of the infants were disabled. Disability was associated with gestational age and neonatal morbidity.

  7. Change-point analysis data of neonatal diffusion tensor MRI in preterm and term-born infants

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    Dan Wu

    2017-06-01

    Full Text Available The data presented in this article are related to the research article entitled “Mapping the Critical Gestational Age at Birth that Alters Brain Development in Preterm-born Infants using Multi-Modal MRI” (Wu et al., 2017 [1]. Brain immaturity at birth poses critical neurological risks in the preterm-born infants. We used a novel change-point model to analyze the critical gestational age at birth (GAB that could affect postnatal development, based on diffusion tensor MRI (DTI acquired from 43 preterm and 43 term-born infants in 126 brain regions. In the corresponding research article, we presented change-point analysis of fractional anisotropy (FA and mean diffusivities (MD measurements in these infants. In this article, we offered the relative changes of axonal and radial diffusivities (AD and RD in relation to the change of FA and FA-based change-points, and we also provided the AD- and RD-based change-point results.

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

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    Afsaneh Arzani

    2015-03-01

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

  9. Brain metabolite differences in one-year-old infants born small at term and association with neurodevelopmental outcome.

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    Simões, Rui V; Cruz-Lemini, Mónica; Bargalló, Núria; Gratacós, Eduard; Sanz-Cortés, Magdalena

    2015-08-01

    We assessed brain metabolite levels by magnetic resonance spectroscopy (MRS) in 1-year-old infants born small at term, as compared with infants born appropriate for gestational age (AGA), and their association with neurodevelopment at 2 years of age. A total of 40 infants born small (birthweight growth restriction or as small for gestational age, based on the presence or absence of prenatal Doppler and birthweight predictors of an adverse perinatal outcome, respectively. Single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) data were acquired from the frontal lobe at short echo time. Neurodevelopment was evaluated at 2 years of age using the Bayley Scales of Infant and Toddler Development, Third Edition, assessing cognitive, language, motor, social-emotional, and adaptive behavior scales. As compared with AGA controls, infants born small showed significantly higher levels of glutamate and total N-acetylaspartate (NAAt) to creatine (Cr) ratio at age 1 year, and lower Bayley Scales of Infant and Toddler Development, Third Edition scores at 2 years. The subgroup with late intrauterine growth restriction further showed lower estimated glutathione levels at age 1 year. Significant correlations were observed for estimated glutathione levels with adaptive scores, and for myo-inositol with language scores. Significant associations were also noticed for NAA/Cr with cognitive scores, and for glutamate/Cr with motor scores. Infants born small show brain metabolite differences at 1 year of age, which are correlated with later neurodevelopment. These results support further research on MRS to develop imaging biomarkers of abnormal neurodevelopment. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Thymic size in uninfected infants born to HIV-positive mothers and fed with pasteurized human milk.

    Science.gov (United States)

    Jeppesen, D; Hasselbalch, H; Ersbøll, A K; Heilmann, C; Valerius, N H

    2003-06-01

    To examine the size of the thymus in uninfected infants born to HIV-positive mothers and to study the effects of feeding by human donor milk on the size of the thymus in these infants. The absolute and relative thymic size was assessed by sonography as thymic index (Ti), and the Ti/weight-ratio (Ti/w) at birth and at 4 mo of age in 12 healthy uninfected infants born to HlV-infected mothers. All infants were exclusively fed pasteurized donor milk. The results were compared with those obtained from a previous cohort of exclusively breastfed, partially breastfed and exclusively formula-fed infants. At birth the Ti was reduced in infants born to HIV-infected mothers in comparison with that in control infants but this difference disappeared when their birthweights were taken into consideration (Ti/w-ratio). At 4 mo of age the geometric mean Ti of infants fed donor milk was 23.8 and the mean Ti/w-ratio was 4.2. Compared with those of exclusively breastfed infants, the Ti and Ti/w-ratio of infants fed donor milk were significantly reduced (p milk-fed infants compared with that in the formula-fed infants (p = 0.02). At birth the size of the thymus was smaller in uninfected infants of HIV-positive mothers compared with infants of HIV-negative mothers but when birthweight was taken into account this difference disappeared. Feeding by human donor milk seemed to result in an increased size of the thymus at 4 mo of age compared with thymic size in infants that were exclusively formula fed.

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

    Science.gov (United States)

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

    2016-01-01

    Gestational genitourinary infections, which have been associated with neurodevelopmental impairments among infants born near term, have not been studied among very preterm infants. The mothers of 989 infants born before 28 weeks of gestation were interviewed about urine, bladder, or kidney infections (UTIs) and cervical or vaginal infections (CVIs) during pregnancy, as well as other exposures and characteristics, and their charts were reviewed for the Extremely Low Gestational Age Newborns (ELGAN) Study (2002-2004). At 2 years of age, these infants underwent a neurodevelopmental assessment. Generalized estimating equation logistic regression models of developmental adversities were used to adjust for potential confounders. Infants born to women who reported a UTI were less likely than were others to have a very low Mental Development Index (adjusted odds ratio = 0.5; 95% confidence interval: 0.3, 0.8), whereas infants born to women who reported a CVI were more likely than others to have a low Psychomotor Development Index (adjusted odds ratio = 1.7; 95% confidence interval: 1.04, 2.7). In this high-risk sample, maternal gestational CVI, but not UTI, was associated with a higher risk of impaired motor development at 2 years of age. The apparent protective effect of UTI might be spurious, reflect confounding due to untreated asymptomatic bacteriuria among women who were not given a diagnosis of UTI, or reflect preconditioning. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. [Influencing factors on the death of infants born to HIV infected mothers].

    Science.gov (United States)

    Fang, Li-wen; Xing, Zai-ling; Wang, Lin-hong; Wang, Qian; Zhang, Wei; Sun, Ding-yong; Huang, Yue-hua; Zhang, Yan

    2009-11-01

    To understand the influencing factors on the death of infants born to HIV infected mothers in areas with high prevalence of HIV/AIDS in China. Based on the follow-up cohort study targeting at HIV/AIDS infected pregnant women and their babies initiated in 2004, a survey on the death status and influencing factors on the infants born to HIV/AIDS infected mothers enrolled in this cohort from Jan.2004 to Nov.2007 was carried out during Aug.to Nov.2008 in seven counties of four provinces in China. A total of 498 pairs of HIV-infected mothers and their infants were enrolled and their related information was collected. Single factor and multiple factors Cox model methods were adopted for data analysis. The total observed person-years of 498 infants was 406.22, among which, 45 infants died, and the mortality density was 110.78 per 1000 child-year. A single factor Cox model showed, the pregnancy in pre-period of HIV/AIDS and HIV/AIDS period (RR = 1.971, 95%CI: 1.143 - 3.396), living status of the pregnancy (RR = 3.062, 95%CI: 1.097 - 8.550), multipara women (RR = 0.517, 95%CI: 0.278 - 0.961), natural childbirth (RR = 0.561, 95%CI: 0.345 - 0.910), premature labor (RR = 5.302, 95%CI: 2.944 - 9.547), low birth weight (RR = 4.920, 95%CI: 2.691 - 8.994), mother-child pairs taking antiretroviral drugs (RR = 0.227, 95%CI: 0.121 - 0.428) and infants infected HIV (RR = 5.870, 95%CI: 3.232 - 10.660) could affect the infants death. The death of HIV-exposed infants was influenced by various factors. The death risk of infants born to HIV infected mothers who were in the danger of pre-period of HIV/AIDS and HIV/AIDS period was greater than the infants delivered by HIV infected mothers who were in preclinical period of HIV/AIDS (RR = 6.99, 95%CI: 1.92 - 25.64). The death risks were greater in the group that the women whose CD4(+)TLC count number lower than 200 cells/microl (RR = 2.05, 95%CI: 1.01 - 4.15). The infants whose mothers had no ARV treatment had higher possibility to die than

  13. The status of newborn infants born to women with hypertensive disorders

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    N. A. Shakhbazova

    2014-01-01

    Full Text Available The status of 239 newborn infants born to mothers with hypertensive syndrome (a study group and that of 51 neonates from healthy mothers (a control group were analyzed. Neonatal mortality and morbidity rates were studied in relation to gestational age and the type and severity of hypertensive disorders. Hypertensive disorders in pregnancy were found to lead to still birth in 2,1% of cases, late miscarriage in 12,1%, prematurity in 47,7%, and intrauterine growth retardation in 27,6%. The incidence of diseases in the infants born to hypertensive mothers was 6,6 times higher than that in those from healthy mothers. The most common nosological entities among the newborn infants were intracranial hemorrhage (29,3%, respiratory distress syndrome (20,1%, hypoxic-ischemic brain damage (22,6%, polycythemia (8,4%, and hyperbihrubinemia (8,8%. Reproductive losses in hypertensive disorders accounted for 17,2% and occurred in 70,7% of cases in the early postnatal period. Severe pathology and prematurity are responsible for high neonatal morbidity and mortality rates.

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

    Science.gov (United States)

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

    2014-04-24

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

  15. 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.

  16. Validity of the language development survey in infants born preterm.

    Science.gov (United States)

    Beaulieu-Poulin, Camille; Simard, Marie-Noëlle; Babakissa, Hélène; Lefebvre, Francine; Luu, Thuy Mai

    2016-07-01

    Preterm infants are at greater risk of language delay. Early identification of language delay is essential to improve functional outcome in these children. To examine the concurrent validity of Rescorla's Language Development Survey and the Bayley Scales of Infant and Toddler Development (Bayley-III) at 18months corrected age in preterm infants. Test accuracy study. 189 preterm infants born Language Development Survey, a parent-reported screening instrument, was administered in French concurrently with the Language Scales of the Bayley-III. Receiver-Operating-Characteristics curves were used to determine optimal cut-off score on the Language Development Survey to identify Bayley-III score language delay as per the Bayley-III. The optimal threshold was ≤10 words for both boys and girls. In girls, lowering the cut-off score decreased sensitivity (79%), but improved specificity (82%), thus lowering the number of false-positives. Our findings support using the Language Development Survey as an expressive language screener in preterm infants. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Study on the effect of hypoxia on apoptosis of cultured newly born rat cardiac myocytes

    International Nuclear Information System (INIS)

    Su Weidong; Li Huiqiang; Yao Zhi

    2005-01-01

    Objective: To investigate the possible hypoxia-mediated cellular apoptosis after ischemic cardiac injury via a model of cultured newly born rat cardiac myocytes. Methods: Cardiac myocytes cultures from newly born rats (1-3d) were examined for apoptosis with HE stain and flow cytometry after cultured 96h and again examined after exposure to hypoxic environment for 16h. Results: Apoptotic changes were evident in the hypoxic culture cells. The HE stain revealed cellular shrinkage, nuclear chromosomal condensation with cytoplasmic eosinophilia. Also, distinct apoptosis peak was observed in the flow cytometry. Conclusion: This experiment proved that hypoxic model of cardiac myocyte culture showed definite apoptosis of the cells. (authors)

  18. The relative kicking frequency of infants born full-term and preterm during learning and short-term and long-term memory periods of the mobile paradigm.

    Science.gov (United States)

    Heathcock, Jill C; Bhat, Anjana N; Lobo, Michele A; Galloway, James C

    2005-01-01

    Infants born preterm differ in their spontaneous kicking, as well as their learning and memory abilities in the mobile paradigm, compared with infants born full-term. In the mobile paradigm, a supine infant's ankle is tethered to a mobile so that leg kicks cause a proportional amount of mobile movement. The purpose of this study was to investigate the relative kicking frequency of the tethered (right) and nontethered (left) legs in these 2 groups of infants. Ten infants born full-term and 10 infants born preterm (infants participated in the study. The relative kicking frequencies of the tethered and nontethered legs were analyzed during learning and short-term and long-term memory periods of the mobile paradigm. Infants born full-term showed an increase in the relative kicking frequency of the tethered leg during the learning period and the short-term memory period but not for the long-term memory period. Infants born preterm did not show a change in kicking pattern for learning or memory periods, and consistently kicked both legs in relatively equal amounts. Infants born full-term adapted their baseline kicking frequencies in a task-specific manner to move the mobile and then retained this adaptation for the short-term memory period. In contrast, infants born preterm showed no adaptation, suggesting a lack of purposeful leg control. This lack of control may reflect a general decrease in the ability of infants born preterm to use their limb movements to interact with their environment. As such, the mobile paradigm may be clinically useful in the early assessment and intervention of infants born preterm and at risk for future impairment.

  19. VISUAL OUTCOME IN PRETERM INFANTS ANALYSIS OF PRETERM INFANTS BORN IN LJUBLJANA 1990–1999

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    Branka Stirn-Kranjc

    2002-12-01

    Full Text Available Background. Improved perinatal care has increased the survival rate of prematurely born infants. An epidemiological fact that 6–18% and more visually impaired children were prematurely born, emphasises the effect of premature birth on both visual function and development. Despite better knowledge on retinopathy of prematurity (ROP it is stressed not to underestimate refractive errors, strabismus and visual impairment after brain lesions, being more common in preterm babies.Methods. Over 1300 preterm infants with a birth weight of 1500 g or less and gestational age of 30 weeks or less, born in Maternity Hospital of Ljubljana, Slovenia in the period 1990– 1999 were examined according to contemporary paediatricophthalmologic recommendations. At least one year ophthalmologic follow-up (average 3.5 years of 594 prematurely born infants with high neonatal risk factors for ROP and with general health problems, was performed. Sex, gestational age, birth weight, artificial ventilation, exchange blood transfusion, bronchopulmonary dysplasia, respiratory distress syndrome, apnoea, septicaemia, intraventricular haemorrhage, hyperbilirubinemia were analysed for correlation with ROP and visual impairment.Results. The survival rate of the studied preterm infants was 65–87% (mean 77.3%. ROP stage 1, 2 has developed in 33 children with a birth weight under 900 g and in 10 with a birth weight 900–1200 g (altogether in 8%. ROP stage 3–5 has been registered (with or without plus disease in 7 children (below 6%. In 6 children cryo or argon laser photocoagulation has been performed and vitreoretinal surgery in 1 child (without functional results. In the studied group altogether 4 children (below 1% became blind (visual acuity < 0.05, all of them have had septicaemia. Squint has been registered in 6.9% of children, and has correlated with higher refractive error, mostly myopia. Severe optic nerve atrophy has been noticed already in the first year of follow

  20. Serological follow-up of infants born to mothers with positive syphilis serology - real-world experiences.

    Science.gov (United States)

    Wallace, Harriet E; Broomhall, Harriet M; Isitt, Catherine E; Miall, Lawrence S; Wilson, Janet D

    2016-11-01

    The 2008 UK syphilis guideline recommends infants born to women with any positive syphilis serology be followed up until both treponemal and nontreponemal tests are negative to exclude congenital syphilis, whereas Centers for Disease Control and Prevention guidelines recommend using only nontreponemal tests. Historically, we had low infant follow-up rates with no coherent pathways. We initiated a change in multidisciplinary team practice of infant testing for syphilis in 2011 and evaluated the results before and after by retrospective review of testing of infants born to women with positive syphilis serology between 2005 and 2012. A total of 28 infants' mothers were treated in pregnancy (termed 'high risk'); 26 had adequate treatment prior to pregnancy (termed 'low risk'). There was a significant increase in serological testing after 2011 compared with before (83% versus 48%; OR 5.07 [95% CI 1.22-22.77] p = 0.01) but mainly in low risk infants with no significant improvement in high risk infants who are the priority group. Using nontreponemal tests only in the infants would have reduced the tests required by at least 50%, allowing health resources to be concentrated on achieving adequate follow-up for those infants most at risk. © The Author(s) 2015.

  1. Probabilistic maps of the white matter tracts with known associated functions on the neonatal brain atlas: Application to evaluate longitudinal developmental trajectories in term-born and preterm-born infants.

    Science.gov (United States)

    Akazawa, Kentaro; Chang, Linda; Yamakawa, Robyn; Hayama, Sara; Buchthal, Steven; Alicata, Daniel; Andres, Tamara; Castillo, Deborrah; Oishi, Kumiko; Skranes, Jon; Ernst, Thomas; Oishi, Kenichi

    2016-03-01

    Diffusion tensor imaging (DTI) has been widely used to investigate the development of the neonatal and infant brain, and deviations related to various diseases or medical conditions like preterm birth. In this study, we created a probabilistic map of fiber pathways with known associated functions, on a published neonatal multimodal atlas. The pathways-of-interest include the superficial white matter (SWM) fibers just beneath the specific cytoarchitectonically defined cortical areas, which were difficult to evaluate with existing DTI analysis methods. The Jülich cytoarchitectonic atlas was applied to define cortical areas related to specific brain functions, and the Dynamic Programming (DP) method was applied to delineate the white matter pathways traversing through the SWM. Probabilistic maps were created for pathways related to motor, somatosensory, auditory, visual, and limbic functions, as well as major white matter tracts, such as the corpus callosum, the inferior fronto-occipital fasciculus, and the middle cerebellar peduncle, by delineating these structures in eleven healthy term-born neonates. In order to characterize maturation-related changes in diffusivity measures of these pathways, the probabilistic maps were then applied to DTIs of 49 healthy infants who were longitudinally scanned at three time-points, approximately five weeks apart. First, we investigated the normal developmental pattern based on 19 term-born infants. Next, we analyzed 30 preterm-born infants to identify developmental patterns related to preterm birth. Last, we investigated the difference in diffusion measures between these groups to evaluate the effects of preterm birth on the development of these functional pathways. Term-born and preterm-born infants both demonstrated a time-dependent decrease in diffusivity, indicating postnatal maturation in these pathways, with laterality seen in the corticospinal tract and the optic radiation. The comparison between term- and preterm-born

  2. Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil

    OpenAIRE

    Fausto, Maria Arlene; Carneiro, Mariângela; Antunes, Carlos Maurício F; Colosimo, Enrico Antonio; Pinto, Jorge Andrade

    2011-01-01

    OBJECTIVE: To evaluate the growth parameters in infants who were born to HIV-1-infected mothers. METHODS: The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected ch...

  3. Neonatal outcomes following extensive cardiopulmonary resuscitation in the delivery room for infants born at less than 33 weeks gestational age.

    Science.gov (United States)

    Soraisham, Amuchou Singh; Lodha, Abhay Kumar; Singhal, Nalini; Aziz, Khalid; Yang, Junmin; Lee, Shoo K; Shah, Prakesh S

    2014-02-01

    To examine the neonatal mortality and morbidity of infants born at CPR) immediately after birth. In this retrospective cohort study, we performed secondary analyses of data from infants born at Neonatal Network between January 2010 and December 2011. Infants were divided into two groups based on birth weight (neonatal morbidity and mortality compared using bivariate and multivariate analyses. Of the 8033 eligible infants, 419 (5.2%) received DR-CPR. For infants weighing CPR, whereas 3.4% (outborn: 9.6%, inborn: 2.2%) of those weighing ≥1000 g received DR-CPR. If infants received DR-CPR there was increased risk of mortality, bronchopulmonary dysplasia (BPD) and severe brain injury. Logistic regression analysis showed DR-CPR was associated with increased mortality (adjusted odds ratio [aOR]: 2.09, 95% CI [1.39, 3.14]) in infants born weighing CPR was associated with increased mortality (aOR: 7.16, 95% CI [3.88, 13.2]), severe brain injury (aOR: 3.08, 95% CI [1.82, 5.22]), BPD (aOR: 2.14, 95% CI [1.25, 3.65]), pneumothorax (aOR: 3.11, 95% CI [1.53, 6.31]) and intestinal perforation (aOR: 3.47, 95% CI [1.46, 8.24]). DR-CPR is associated with increased risk of mortality and morbidity especially in preterm infants born weighing ≥1000 g. Long-term neurodevelopmental follow up is warranted for these infants.

  4. Fixel-based analysis reveals alterations is brain microstructure and macrostructure of preterm-born infants at term equivalent age

    Directory of Open Access Journals (Sweden)

    Kerstin Pannek

    Full Text Available Preterm birth causes significant disruption in ongoing brain development, frequently resulting in adverse neurodevelopmental outcomes. Brain imaging using diffusion MRI may provide valuable insight into microstructural properties of the developing brain. The aim of this study was to establish whether the recently introduced fixel-based analysis method, with its associated measures of fibre density (FD, fibre bundle cross-section (FC, and fibre density and bundle cross-section (FDC, is suitable for the investigation of the preterm infant brain at term equivalent age. High-angular resolution diffusion weighted images (HARDI of 55 preterm-born infants and 20 term-born infants, scanned around term-equivalent age, were included in this study (3 T, 64 directions, b = 2000 s/mm2. Postmenstrual age at the time of MRI, and intracranial volume (FC and FDC only, were identified as confounding variables. Gestational age at birth was correlated with all fixel measures in the splenium of the corpus callosum. Compared to term-born infants, preterm infants showed reduced FD, FC, and FDC in a number of regions, including the corpus callosum, anterior commissure, cortico-spinal tract, optic radiations, and cingulum. Preterm infants with minimal macroscopic brain abnormality showed more extensive reductions than preterm infants without any macroscopic brain abnormality; however, little differences were observed between preterm infants with no and with minimal brain abnormality. FC showed significant reductions in preterm versus term infants outside regions identified with FD and FDC, highlighting the complementary role of these measures. Fixel-based analysis identified both microstructural and macrostructural abnormalities in preterm born infants, providing a more complete picture of early brain development than previous diffusion tensor imaging (DTI based approaches. Keywords: Fixel-based analysis, Diffusion, Prematurity, Neonate

  5. Timing of umbilical cord clamping among infants born at 22 through 27 weeks' gestation.

    Science.gov (United States)

    Backes, C H; Huang, H; Iams, J D; Bauer, J A; Giannone, P J

    2016-01-01

    To investigate the safety, feasibility and efficacy of delayed cord clamping (DCC) compared with immediate cord clamping (ICC) at delivery among infants born at 22 to 27 weeks' gestation. This was a pilot, randomized, controlled trial in which women in labor with singleton pregnancies at 22 to 27 weeks' gestation were randomly assigned to ICC (cord clamped at 5 to 10 s) or DCC (30 to 45 s). Forty mother-infant pairs were randomized. Infants in the ICC and DCC groups had mean gestational ages (GA) of 24.6 and 24.4 weeks, respectively. No differences were observed between the groups across all available safety measures, although infants in the DCC group had higher admission temperatures than infants in the ICC group (97.4 vs. 96.2 °F, P=0.04). During the first 24 h of life, blood pressures were lower in the ICC group than in the DCC group (P<0.05), despite a threefold greater incidence of treatment for hypotension (45% vs. 12%, P<0.01). Infants in the ICC group had increased numbers of red blood transfusions (in first 28 days of life) than infants in DCC group (4.1±3.9 vs. 2.8±2.2, P=0.04). Among infants born at an average GA of 24 weeks', DCC appears safe, logistically feasible, and offers hematological and circulatory advantages compared with ICC. A more comprehensive appraisal of this practice is needed.

  6. Do preterm infants with a birth weight ≤1250 g born to single-parent families have poorer neurodevelopmental outcomes at age 3 than those born to two-parent families?

    Science.gov (United States)

    Lodha, Abhay; Lakhani, Jahan; Ediger, Krystyna; Tang, Selphee; Lodha, Arijit; Gandhi, Vardhil; Creighton, Dianne

    2018-05-08

    Investigate neurodevelopmental outcomes at 3 years corrected age in infants with a birth weight ≤1250 g born to single parents. Infants born between 1995 and 2010 with a birth weight ≤1250 g were considered eligible. Primary outcome was neurodevelopmental impairment; considered present if a child had any of the following: cerebral palsy, cognitive delay, visual impairment, or deafness/neurosensory hearing impairment. Univariate and multivariate analyses were performed. A total of 1900 infants were eligible for inclusion. Follow-up data were available for 1395; 88 were born to a single parent. Infants in the single-parent group had higher mortality (18% vs. 11%, p = 0.009), IQ ≥1 SD below the mean (40% vs. 21%, p = 0.001) and any neurodevelopmental impairment (47% vs. 29%, p = 0.003). Single-parent family status, maternal education, bronchopulmonary dysplasia and severe neurological injury were significant predictors of intellectual impairment at 3 years corrected age. Preterm infants with a birth weight ≤1250 g born to single parents at birth have poorer intellectual functioning at 3 years corrected age.

  7. Hypothyroidism among military infants born in countries of varied iodine nutrition status

    Directory of Open Access Journals (Sweden)

    Smith Tyler C

    2010-02-01

    Full Text Available Abstract Background Iodine deficiency is a global problem representing the most common preventable cause of mental retardation. Recently, the impact of subtle deficiencies in iodine intake on children and pregnant women has been questioned. This study was designed to compare hypothyroidism among infants born to US military families in countries of varied iodine nutrition status. Methods A cohort design was used to analyze data from the Department of Defense Birth and Infant Health Registry for infants born in 2000-04 (n = 447,691. Hypothyroidism was defined using ICD-9-CM codes from the first year of life (n = 698. The impact of birth location on hypothyroidism was assessed by comparing rates in Germany, Japan, and US territories with the United States, while controlling for infant gender, plurality, gestational age, maternal age, maternal military status, and military parent's race/ethnicity. Results Hypothyroidism did not vary by birth location with adjusted odds ratios (OR as follows: Germany (OR 0.82, [95% CI 0.50, 1.35], Japan (OR 0.67, [95% CI 0.37, 1.22], and US territories (OR 1.29, [95% CI 0.57, 2.89]. Hypothyroidism was strongly associated with preterm birth (OR 5.44, [95% CI 4.60, 6.42]. Hypothyroidism was also increased among infants with civilian mothers (OR 1.24, [95% CI 1.00, 1.54], and older mothers, especially ages 40 years and older (OR 2.09, [95% CI 1.33, 3.30]. Conclusions In this study, hypothyroidism in military-dependent infants did not vary by birth location, but was associated with other risk factors, including preterm birth, civilian maternal status, and advanced maternal age.

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

    Science.gov (United States)

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

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

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    Asad Rahman

    2015-08-01

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

  10. Changing Survival Rate of Infants Born Before 26 Gestational Weeks: Single-centre study.

    Science.gov (United States)

    Rahman, Asad; Abdellatif, Mohamed; Sharef, Sharef W; Fazalullah, Muhammad; Al-Senaidi, Khalfan; Khan, Ashfaq A; Ahmad, Masood; Kripail, Mathew; Abuanza, Mazen; Bataclan, Flordeliza

    2015-08-01

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

  11. Depressive symptoms in mothers of prematurely born infants.

    Science.gov (United States)

    Miles, Margaret Shandor; Holditch-Davis, Diane; Schwartz, Todd A; Scher, Mark

    2007-02-01

    This longitudinal, descriptive study described the level of depressive symptoms in mothers of preterm infants from birth through 27 months corrected age and examined factors associated with depressive symptoms. The framework for the study was guided by an ecological developmental systems perspective and an adaptation of the Preterm Parental Distress Model. In this model, we hypothesize that a mother's emotional distress to the birth and parenting of a prematurely born child is influenced by personal and family factors, severity of the infant's health status, and illness-related stress and worry. Participants were 102 mothers of preterm infants who were off the ventilator and not otherwise dependent on major technology at enrollment. Mean depressive symptoms scores on the Center for Epidemiologic Studies Depression Scale (CES-D) during hospitalization were high and more than half the mothers (63%) had scores of > or =16 indicating risk of depression. Depressive scores declined over time until 6 months and then were fairly stable. Unmarried mothers, mothers of infants who were rehospitalized, and mothers who reported more maternal role alteration stress during hospitalization and worry about the child's health had more depressive symptoms through the first year. Mothers who reported more parental role alteration stress during hospitalization (odds ratio [OR] = 1.570, 95% confidence interval [CI]: 1.171-2.104) and more worry about the child's health (OR = 2.350, 95% CI: 1.842-2.998) were more likely to experience elevated CES-D scores that put them at risk of depression. Also, mothers of rehospitalized infants had decreasing odds of elevated CES-D scores over time (OR = 0.982 per week, 95% CI: 0.968-0.996). Findings have implications for the support of mothers during hospitalization and in the early years of parenting a preterm infant.

  12. The Test of Infant Motor Performance at 3 months predicts language, cognitive, and motor outcomes in infants born preterm at 2 years of age.

    Science.gov (United States)

    Peyton, Colleen; Schreiber, Michael D; Msall, Michael E

    2018-03-13

    To determine the relationship between the Test of Infant Motor Performance (TIMP) at 3 months and cognitive, language, and motor outcomes on the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 2 years of age in high-risk infants born preterm. One hundred and six infants (47 females, 59 males) born at earlier than 31 weeks gestational age were prospectively tested with the TIMP at 10 to 15 weeks after term age and were assessed again with the Bayley-III at 2 years corrected age. Sensitivity and specificity were calculated for various cut points of the TIMP z-score and Bayley-III composite scores of no more than 85. The TIMP z-scores at 10 to 15 weeks of age were significantly associated with all three subscales on the Bayley-III at 2 years of age (pcognitive (87%), language (88%), and motor (89%) outcomes, but sensitivity was low (cognitive 41%, language 49%, motor 57%). This study demonstrates that the TIMP is related to cognitive, language, and motor outcomes on the Bayley-III at 2 years of age in high-risk infants born preterm. The Test of Infant Motor Performance (TIMP) predicts Bayley Scales of Infant and Toddler Development, Third Edition outcomes at 2 years of age. The TIMP is relatively good at discriminating between children who will and will not have typical development. © 2018 Mac Keith Press.

  13. Outcome of Premature Infants Born Prior to 32 Weeks' Gestation with Intraventricular Hemorrhage

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    Yao-Chia Chuang

    2004-12-01

    Conclusion: In VLBW infants born prior to 32 weeks' gestation, IVH is a risk factor for impaired development. Its effects on psychomotor development, but not mental development, are still apparent at 2 years of age.

  14. Emergency laparotomy in infants born at <26 weeks gestation: a neonatal network based cohort study of frequency, surgical pathology and outcomes

    OpenAIRE

    Hall, Nigel; Durell, Jonathan; Drewett, Melanie; Paramanantham, Kujan; Burge, David

    2017-01-01

    Objective: identify the proportion of infants born at <26 completed weeks gestation that require emergency laparotomy and review the surgical pathology, incidence of subsequent surgical procedures, and outcomeDesign: retrospective cohort review Setting: tertiary neonatal surgical unitPatients: all infants born at < 26 weeks gestation in a neonatal network over an 8 year periodResults: Of 381 infants, laparotomy was indicated in 61 (16%) and performed in 57. Surgical pathology encounter...

  15. Thymic size in uninfected infants born to HIV-positive mothers and fed with pasteurized human milk

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth; Hasselbalch, H; Ersbøll, A K

    2003-01-01

    /weight-ratio (Ti/w) at birth and at 4 mo of age in 12 healthy uninfected infants born to HlV-infected mothers. All infants were exclusively fed pasteurized donor milk. The results were compared with those obtained from a previous cohort of exclusively breastfed, partially breastfed and exclusively formula.......8 and the mean Ti/w-ratio was 4.2. Compared with those of exclusively breastfed infants, the Ti and Ti/w-ratio of infants fed donor milk were significantly reduced (p infants compared with that in the formula-fed infants (p = 0.02). CONCLUSION: At birth...... with thymic size in infants that were exclusively formula fed....

  16. Survival of infants born to HIV-positive mothers, by feeding modality, in Rakai, Uganda.

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    Joseph Kagaayi

    Full Text Available BACKGROUND: Data comparing survival of formula-fed to breast-fed infants in programmatic settings are limited. We compared mortality and HIV-free of breast and formula-fed infants born to HIV-positive mothers in a program in rural, Rakai District Uganda. METHODOLOGY/PRINCIPAL FINDINGS: One hundred eighty two infants born to HIV-positive mothers were followed at one, six and twelve months postpartum. Mothers were given infant-feeding counseling and allowed to make informed choices as to whether to formula-feed or breast-feed. Eligible mothers and infants received antiretroviral therapy (ART if indicated. Mothers and their newborns received prophylaxis for prevention of mother-to-child HIV transmission (pMTCT if they were not receiving ART. Infant HIV infection was detected by PCR (Roche Amplicor 1.5 during the follow-up visits. Kaplan Meier time-to-event methods were used to compare mortality and HIV-free survival. The adjusted hazard ratio (Adjusted HR of infant HIV-free survival was estimated by Cox regression. Seventy-five infants (41% were formula-fed while 107 (59% were breast-fed. Exclusive breast-feeding was practiced by only 25% of breast-feeding women at one month postpartum. The cumulative 12-month probability of infant mortality was 18% (95% CI = 11%-29% among the formula-fed compared to 3% (95% CI = 1%-9% among the breast-fed infants (unadjusted hazard ratio (HR = 6.1(95% CI = 1.7-21.4, P-value < 0.01. There were no statistically significant differentials in HIV-free survival by feeding choice (86% in the formula-fed compared to 96% in breast-fed group (Adjusted RH = 2.8[95%CI = 0.67-11.7, P-value = 0.16] CONCLUSIONS/SIGNIFICANCE: Formula-feeding was associated with a higher risk of infant mortality than breastfeeding in this rural population. Our findings suggest that formula-feeding should be discouraged in similar African settings.

  17. Thymic size in uninfected infants born to HIV-positive mothers and fed with pasteurized human milk

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth; Hasselbalch, H; Ersbøll, A K

    2003-01-01

    /weight-ratio (Ti/w) at birth and at 4 mo of age in 12 healthy uninfected infants born to HlV-infected mothers. All infants were exclusively fed pasteurized donor milk. The results were compared with those obtained from a previous cohort of exclusively breastfed, partially breastfed and exclusively formula...

  18. Sensitive quantitative analysis of the meconium bacterial microbiota in healthy term infants born vaginally or by cesarean section.

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    Ravinder Nagpal

    2016-12-01

    Full Text Available For decades, babies were thought to be born germ-free, but recent evidences suggest that they are already exposed to various bacteria in-utero. However, the data on population levels of such pioneer gut bacteria, particularly in context to birth mode, is sparse. We herein aimed to quantify such bacteria from the meconium of 151 healthy term Japanese infants born vaginally or by C-section. Neonatal first meconium was obtained within 24-48 hours of delivery; RNA was extracted and subjected to reverse-transcription-quantitative PCR using specific primers for Clostridium coccoides group, Clostridium leptum subgroup, Bacteroides fragilis group, Atopobium cluster, Prevotella, Bifidobacterium, Lactobacillus, Enterococcus, Enterobacteriaceae, Staphylococcus, Enterococcus, Streptococcus, Clostridium perfringens, and C. difficile. We detected several bacterial groups in both vaginally- and cesarean-born infants. B. fragilis group, Enterobacteriaceae, Enterococcus, Streptococcus and Staphylococcus were detected in more than 50% of infants, with counts ranging from 105-108 cells/g sample. About 30-35% samples harbored Bifidobacterium and Lactobacillus (104-105 cells/g; whereas C. coccoides group, C. leptum subgroup and C. perfringens were detected in 10-20% infants (103-105 cells/g. Compared to vaginally-born babies, cesarean-born babies were significantly less often colonized with Lactobacillus genus (6% vs. 37%; P=0.01 and L. gasseri subgroup (6% vs. 31%; P=0.04. Overall, seven Lactobacillus subgroups/ species i.e. L. gasseri subgroup, L. ruminis subgroup, L. casei subgroup, L. reuteri subgroup, L. sakei subgroup, L. plantarum subgroup and L. brevis were detected in the samples from vaginally-born group, whereas only two members i.e. L. gasseri subgroup and L. brevis were detected in the cesarean group. These data corroborate that several bacterial clades may already be present before birth in term infants’ gut. Further, Remarkably lower detection rate

  19. UK-born ethnic minority women and their experiences of feeding their newborn infant.

    Science.gov (United States)

    Twamley, Katherine; Puthussery, Shuby; Harding, Seeromanie; Baron, Maurina; Macfarlane, Alison

    2011-10-01

    to explore the factors that impact on UK-born ethnic minority women's experiences of and decisions around feeding their infant. in-depth semi-structured interviews. 34 UK-born women of Black African, Black Caribbean, Pakistani, Bangladeshi, Indian and Irish parentage and 30 health-care professionals. women and health-care professionals were recruited primarily from hospitals serving large numbers of ethnic minority women in London and Birmingham. despite being aware of the benefits of exclusive breast feeding, many women chose to feed their infant with formula. The main barriers to breast feeding were the perceived difficulties of breast feeding, a family preference for formula feed, and embarrassment about breast feeding in front of others. Reports from women of South Asian parentage, particularly those who lived with an extended family, suggested that their intentions to breast feed were compromised by the context of their family life. The lack of privacy in these households and grandparental pressure appeared to be key issues. Unlike other participants, Irish women reported an intention to feed their infant with formula before giving birth. The key facilitators to breast feeding were the self-confidence and determination of women and the supportive role of health-care professionals. these findings point to common but also culturally specific mechanisms that may hinder both the initiation and maintenance of breast feeding in UK-born ethnic minority women. They signal potential benefits from the inclusion of family members in breast-feeding support programmes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Body composition is normal in term infants born to mothers with well-controlled gestational diabetes mellitus.

    Science.gov (United States)

    Au, Cheryl P; Raynes-Greenow, Camille H; Turner, Robin M; Carberry, Angela E; Jeffery, Heather E

    2013-03-01

    This study aims to describe body composition in term infants of mothers with gestational diabetes mellitus (GDM) compared with infants of mothers with normal glucose tolerance (NGT). This cross-sectional study included 599 term babies born at Royal Prince Alfred Hospital, Sydney, Australia. Neonatal body fat percentage (BF%) was measured within 48 h of birth using air-displacement plethysmography. Glycemic control data were based on third-trimester HbA(1c) levels and self-monitoring blood glucose levels. Associations between GDM status and BF% were investigated using linear regression adjusted for relevant maternal and neonatal variables. Of 599 babies, 67 (11%) were born to mothers with GDM. Mean ± SD neonatal BF% was 7.9 ± 4.5% in infants with GDM and 9.3 ± 4.3% in infants with NGT, and this difference was not statistically significant after adjustment. Good glycemic control was achieved in 90% of mothers with GDM. In this study, neonatal BF% did not differ by maternal GDM status, and this may be attributed to good maternal glycemic control.

  1. Cognitive development in 7- to 24-month-old extremely/very-to-moderately/late preterm and full-term born infants: The mediating role of focused attention.

    Science.gov (United States)

    Reuner, Gitta; Weinschenk, Andrea; Pauen, Sabina; Pietz, Joachim

    2015-01-01

    The present study analyzed the links between prematurity, attention, and global cognitive performance in infancy and early childhood. At 7 months, focused attention (FA) was examined with an object examination task in 93 preterm infants (39 of them born extremely/very preterm, 54 born moderately/late preterm, and 38 infants born full-term). Global cognition was assessed at 7 and 24 months with the Bayley-II cognitive scale. Groups did not differ with respect to global cognitive performance but FA of infants born extremely/very preterm was significantly lower than in infants born moderately/late preterm. FA correlated significantly with both prematurity and cognitive performance at 7 months of age but not with global cognition in childhood. Findings point to a subtle adverse effect of prematurity on early attention and reveal evidence for the mediating role of FA on the effect of prematurity on cognition.

  2. Electroencephalographic activity in response to procedural pain in preterm infants born at 28 and 33 weeks gestational age.

    Science.gov (United States)

    Maimon, Neta; Grunau, Ruth E; Cepeda, Ivan L; Friger, Michael; Selnovik, Leonel; Gilat, Shlomo; Shany, Eilon

    2013-12-01

    Preterm infants undergo frequent painful procedures in the neonatal intensive care unit. Electroencephalography (EEG) changes in reaction to invasive procedures have been reported in preterm and full-term neonates. Frontal EEG asymmetry as an index of emotion during tactile stimulation shows inconsistent findings in full-term infants, and has not been examined in the context of pain in preterm infants. Our aim was to examine whether heel lance for blood collection induces changes in right-left frontal asymmetry, suggesting negative emotional response, in preterm neonates at different gestational age (GA) at birth and different duration of stay in the neonatal intensive care unit. Three groups of preterm infants were compared: set 1: group 1 (n=24), born and tested at 28 weeks GA; group 2 (n=22), born at 28 weeks GA and tested at 33 weeks; set 2: group 3 (n=25), born and tested at 33 weeks GA. EEG power was calculated for 30-second artifact-free periods, in standard frequency bandwidths, in 3 phases (baseline, up to 5 min after heel lance, 10 min after heel lance). No significant differences were found in right-left frontal asymmetry, or in ipsilateral or contralateral somatosensory response, across phases. In contrast, the Behavioral Indicators of Infant Pain scores changed across phase (P<0.0001). Infants in group 1 showed lower Behavioral Indicators of Infant Pain scores (P=0.039). There are technical challenges in recording EEG during procedures, as pain induces motor movements. More research is needed to determine the most sensitive approach to measure EEG signals within the context of pain in infancy.

  3. Brain imaging and neurodevelopmental outcome at school age in preterm-born infants: Effects of neonatal hydrocortisone treatment

    NARCIS (Netherlands)

    Rademaker, K.J.

    2006-01-01

    A 2-year cohort of 236 preterm-born infants (gestational age < 32 weeks and/or birth weight < 1500 grams), born between March 1, 1991 and March 1, 1993 and admitted to the NICU of the Wilhelmina Children's Hospital, was evaluated at school age. This cohort represented 83.4% of the surviving

  4. Disposition and Health Outcomes among Infants Born to Mothers with No Prenatal Care

    Science.gov (United States)

    Friedman, Susan Hatters; Heneghan, Amy; Rosenthal, Miriam

    2009-01-01

    Objective: This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity). Methods: A retrospective record…

  5. Depressive symptoms among immigrant and Canadian born mothers of preterm infants at neonatal intensive care discharge: a cross sectional study

    Science.gov (United States)

    2013-01-01

    Background Mothers of preterm infants are considered at higher risk for depressive symptoms, higher than for mothers of healthy term infants. Predictors of depressive symptoms in mothers of preterm infants are not yet well established. Immigrant mothers of term infants have higher prevalence of depressive symptoms than Canadian born mothers but the relative prevalence for immigrant mothers of preterm infants is unknown. This study had two aims: (i) to investigate the prevalence of depressive symptoms in immigrant as compared to Canadian born mothers of preterm infants, and (ii) to determine what factors are associated with depressive symptoms in mothers of preterm infants. Methods This is a multi-site, cross sectional study of mothers whose preterm infants required hospitalization in neonatal intensive care unit (NICU). Consecutive eligible mothers (N = 291) were recruited during the week prior to their infant’s NICU discharge. Mothers completed a self-administered questionnaire booklet of validated psychosocial/cultural measures including the Center for Epidemiological Studies Depression Scale (CES-D), Parental Stressor Scale:NICU, General Functioning Subscale of the McMaster Family Assessment Device, Social Support Index, and Vancouver Index of Acculturation; and demographic characteristics questions. Infant characteristics included gestational age, birth weight, sex, singleton/multiple birth, and Score for Neonatal Acute Physiology-II. Results Immigrant mothers (N = 107), when compared to Canadian born mothers (N = 184), reported more depressive symptoms, poorer family functioning, less social support, and less mainstream acculturation. Hierarchical regression for a subsample of 271 mothers indicated that single parent status, high stress, poorer family functioning, and less social support were associated with increased depressive symptoms and accounted for 39% of the variance on the CES-D. Immigrant status did not contribute significantly to the final

  6. Depressive symptoms among immigrant and Canadian born mothers of preterm infants at neonatal intensive care discharge: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ballantyne Marilyn

    2013-01-01

    Full Text Available Abstract Background Mothers of preterm infants are considered at higher risk for depressive symptoms, higher than for mothers of healthy term infants. Predictors of depressive symptoms in mothers of preterm infants are not yet well established. Immigrant mothers of term infants have higher prevalence of depressive symptoms than Canadian born mothers but the relative prevalence for immigrant mothers of preterm infants is unknown. This study had two aims: (i to investigate the prevalence of depressive symptoms in immigrant as compared to Canadian born mothers of preterm infants, and (ii to determine what factors are associated with depressive symptoms in mothers of preterm infants. Methods This is a multi-site, cross sectional study of mothers whose preterm infants required hospitalization in neonatal intensive care unit (NICU. Consecutive eligible mothers (N = 291 were recruited during the week prior to their infant’s NICU discharge. Mothers completed a self-administered questionnaire booklet of validated psychosocial/cultural measures including the Center for Epidemiological Studies Depression Scale (CES-D, Parental Stressor Scale:NICU, General Functioning Subscale of the McMaster Family Assessment Device, Social Support Index, and Vancouver Index of Acculturation; and demographic characteristics questions. Infant characteristics included gestational age, birth weight, sex, singleton/multiple birth, and Score for Neonatal Acute Physiology-II. Results Immigrant mothers (N = 107, when compared to Canadian born mothers (N = 184, reported more depressive symptoms, poorer family functioning, less social support, and less mainstream acculturation. Hierarchical regression for a subsample of 271 mothers indicated that single parent status, high stress, poorer family functioning, and less social support were associated with increased depressive symptoms and accounted for 39% of the variance on the CES-D. Immigrant status did not contribute

  7. Hypothyroidism Among Military Infants Born in Countries of Varied Iodine Nutrition Status

    Science.gov (United States)

    2010-02-01

    while permanent congenital hypothyroidism causes include thyroid dysgenesis, dys- hormonogenesis, and central hypothyroidism and is relatively rare, with... causes have found a gender influence only among permanent cases of congenital hypothyroidism [15,20]. Given our use of ICD-9-CM codes to define cases...Naval Health Research Center Hypothyroidism among Military Infants Born in Countries of Varied Iodine Nutrition Status . M. M. Cranston

  8. Outcomes and related factors in a cohort of infants born in Taiwan over a period of five years (2007–2011 with borderline viability

    Directory of Open Access Journals (Sweden)

    Jui-Hsing Chang

    2018-05-01

    Full Text Available Background: Advances in perinatal and neonatal care have increased the survival of extremely preterm infants, but the viability limit is still debated. Here we assess the survival, neonatal morbidity, and neurodevelopmental outcomes at 2 years of age of infants born at 22–26 weeks of gestation in Taiwan between 2007 and 2011. Methods: This is a prospective longitudinal multicenter cohort study on extremely preterm infants registered in the Taiwan Premature Infant Developmental Collaborative Study Group from 2007 to 2011, including 22 neonatal care centers. We extracted demographic and clinical data of infants born at 22–26 weeks, and obtained growth and developmental outcome data from the follow-up clinic at 24 months of corrected age. Multivariate analyses using a logistic regression model identified factors significantly impacting survival. Results: 647 of the 1098 infants included in the study (58.9% survived to discharge. Survival rates were 8% (4/50, 25% (27/108, 46.8% (117/250, 67.0% (211/315, and 76.8% (288/375 for infants born at 22, 23, 24, 25, and 26 weeks, respectively. Most survivors (567/647, 87.6% had major morbidities during hospitalization, and we identified factors that positively and negatively affected survival. 514 (79.4% patients received follow-up evaluation at 2 years, and 204 (39.7% of them had neurodevelopmental impairment (NDI with an incidence of 75%, 65.2%, 49.5%, 39.5%, and 32.8% for infants born at 22, 23, 24, 25, and 26 weeks, respectively. Conclusion: Infants born at 22 and 23 weeks have a very low likelihood of surviving with little or no impairment. These findings are valuable for parental counseling and perinatal care decisions. Keywords: Extremely preterm, Morbidity, Mortality, Outcomes

  9. Risk Factors for Intraventricular Hemorrhage in Preterm Infants Born at 34 Weeks of Gestation or Less Following Preterm Premature Rupture of Membranes.

    Science.gov (United States)

    Lu, Hongyan; Wang, Qiuxia; Lu, Junyin; Zhang, Qiang; Kumar, Pravesh

    2016-04-01

    The objective of this study is to identify possible perinatal risk factors related to intraventricular hemorrhage (IVH) in preterm infants born at 34 weeks of gestation or less following preterm premature rupture of membranes (pPROM). A total of 292 preterm infants born at 34 weeks of gestation or less following pPROM were enrolled in the study, while 155 newborns with incomplete data, especially those that lack histological examination of the placenta, maternal details, and neonatal characteristics, have been further excluded. Finally, data of 137 preterm infants were included in the analysis. All infants underwent ultrasonographic screening for IVH. Thirty-three infants with IVH were considered as cases and 104 infants without IVH were considered as controls. The association between risk factors and IVH was evaluated by univariate and multivariate logistic regression analyses. The incidence of IVH in preterm infants born at 34 weeks of gestation or less following pPROM was 24.1%, while the incidence of maternal chorioamnionitis was 43.8%. By univariate analysis, gestational age, birth weight, asphyxia resuscitation, maternal chorioamnionitis, fetal distress, amniotic fluid index, and latency of the rupture of membranes to birth were found to be significantly different between the 2 groups. By logistic regression analysis, lower gestational age, low birth weight, asphyxia resuscitation, and maternal chorioamnionitis were found to be independent risk factors for IVH. Lower gestational age, low birth weight, asphyxia resuscitation, and maternal chorioamnionitis are independent risk factors for IVH in preterm infants born at 34 weeks of gestation or less following pPROM. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. The course of pregnancy and the condition of infants born to patients treated for Hodgkin's disease

    International Nuclear Information System (INIS)

    Bajsogolov, G.D.; Shishkin, I.P.

    1985-01-01

    The paper is concerned with some data on the pregnancy and delivery of 78 patients with Hodgkin's disease as well as on the condition of 89 infants born to them following radiation and combined treatment. It was established that pregnancy and delivery in most of the women were normal, the infants' psychomotor development (at the age of 1 to 14) was in accordance with age

  11. Developmental trajectories of attention and executive functioning in infants born preterm: The influence of perinatal risk factors and maternal interactive styles

    NARCIS (Netherlands)

    van de Weijer-Bergsma, E.

    2009-01-01

    Infants born preterm (born before 37 weeks of gestation) are at a heightened risk for developmental delay and learning disabilities. Even children born preterm who have intellectual abilities within the normal range at school age often require special educational services. The preterm population is

  12. Effect of Early Physical Activity Programs on Motor Performance and Neuromuscular Development in Infants Born Preterm: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh

    2017-03-01

    Full Text Available Introduction: Although the survival rate of infants born preterm has increased, the prevalence of developmental problems and motor disorders among this population of infants remains the same. This study investigated the effect of physical activity programs in and out of water on motor performance and neuromuscular development of infants born preterm and had induced immobility by mechanical ventilation.Methods: This study was carried out in Al-Zahra hospital, Tabriz. 76 premature infants were randomly assigned into four groups. One group received daily passive range of motion to all extremities based on the Moyer-Mileur protocol. Hydrotherapy group received exercises for shoulders and pelvic area in water every other day. A combination group received physical activity programs in and out of water on alternating days. Infants in a containment group were held in a fetal position. Duration of study was two weeks ‘from 32 through 33 weeks post menstrual age (PMA. Motor outcomes were measured by the Test of Infant Motor Performance. Neuromuscular developmental was assessed by New Ballard scale and leg recoil and Ankle dorsiflexion items from Dubowitz scale. Data were analyzed using SPSS version 13.Results: TIMP and neuromuscular scores improved in all groups. Motor performance did not differ between groups at 34 weeks PMA. Postural tone of leg recoil was significantly higher in physical activity groups post intervention.Conclusion: Physical activities and containment didn’t have different effects on motor performance in infants born preterm. Leg recoil of neuromuscular development items was affected by physical activity programs.

  13. Disproportionate cardiac hypertrophy during early postnatal development in infants born preterm.

    Science.gov (United States)

    Aye, Christina Y L; Lewandowski, Adam J; Lamata, Pablo; Upton, Ross; Davis, Esther; Ohuma, Eric O; Kenworthy, Yvonne; Boardman, Henry; Wopperer, Samuel; Packham, Alice; Adwani, Satish; McCormick, Kenny; Papageorghiou, Aris T; Leeson, Paul

    2017-07-01

    BackgroundAdults born very preterm have increased cardiac mass and reduced function. We investigated whether a hypertrophic phenomenon occurs in later preterm infants and when this occurs during early development.MethodsCardiac ultrasound was performed on 392 infants (33% preterm at mean gestation 34±2 weeks). Scans were performed during fetal development in 137, at birth and 3 months of postnatal age in 200, and during both fetal and postnatal development in 55. Cardiac morphology and function was quantified and computational models created to identify geometric changes.ResultsAt birth, preterm offspring had reduced cardiac mass and volume relative to body size with a more globular heart. By 3 months, ventricular shape had normalized but both left and right ventricular mass relative to body size were significantly higher than expected for postmenstrual age (left 57.8±41.9 vs. 27.3±29.4%, P<0.001; right 39.3±38.1 vs. 16.6±40.8, P=0.002). Greater changes were associated with lower gestational age at birth (left P<0.001; right P=0.001).ConclusionPreterm offspring, including those born in late gestation, have a disproportionate increase in ventricular mass from birth up to 3 months of postnatal age. These differences were not present before birth. Early postnatal development may provide a window for interventions relevant to long-term cardiovascular health.

  14. The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts

    Directory of Open Access Journals (Sweden)

    Wehby George L

    2011-12-01

    Full Text Available Abstract Background Cleft lip and/or palate (CL/P increase mortality and morbidity risks for affected infants especially in less developed countries. This study aimed at assessing the effects of systematic pediatric care on neonatal mortality and hospitalizations of infants with cleft lip and/or palate (CL/P in South America. Methods The intervention group included live-born infants with isolated or associated CL/P in 47 hospitals between 2003 and 2005. The control group included live-born infants with CL/P between 2001 and 2002 in the same hospitals. The intervention group received systematic pediatric care between the 7th and 28th day of life. The primary outcomes were mortality between the 7th and 28th day of life and hospitalization days in this period among survivors adjusted for relevant baseline covariates. Results There were no significant mortality differences between the intervention and control groups. However, surviving infants with associated CL/P in the intervention group had fewer hospitalization days by about six days compared to the associated control group. Conclusions Early systematic pediatric care may significantly reduce neonatal hospitalizations of infants with CL/P and additional birth defects in South America. Given the large healthcare and financial burden of CL/P on affected families and the relatively low cost of systematic pediatric care, improving access to such care may be a cost-effective public policy intervention. Trial Registration ClinicalTrials.gov: NCT00097149

  15. Ultrasound Measurements of Thyroid Gland Volume at 36 Weeks' Corrected Gestational Age in Extremely Preterm Infants Born before 28 Weeks' Gestation.

    Science.gov (United States)

    Ng, Sze May; Turner, Mark A; Avula, Shivaram

    2018-01-01

    Thyroid ultrasound is a non-invasive imaging tool and provides good evaluation of thyroid anatomy, location, vascularisation, and echogenicity. The aim of this study was to assess thyroid function and thyroid volume in extremely preterm infants born before 28 weeks' gestation evaluated at 36 weeks' corrected gestational age (CGA) compared to term infants' normative data in the literature. In this largest prospective UK study of extremely premature infants born at less than 28 weeks' gestation, thyroid volume measurement was assessed at 36 weeks' CGA. Fifty-five extremely preterm infants (28 males) who were born before 28 weeks' gestation were recruited to the study. All infants had ultrasound assessment of the thyroid gland at 36 weeks' CGA. We also prospectively measured thyroid stimulating hormone (TSH) and free thyroxine (FT 4 ) in all infants at the time of recruitment (within 5 days of birth), at days 14, 21, and 28, and at 36 weeks' CGA. The mean thyroid volume was measured at 0.57 mL (SD ±0.18). There was no association between mean thyroid volume and thyroid function (TSH or FT 4 ). No associations were found between mean thyroid volume and gestation or birth weight in these infants. Our findings provide a reference range with a mean thyroid volume of 0.57 mL (SD ±0.18) in this extremely preterm age group if less than 28 weeks' gestation. Thyroid volume at birth can vary from country to country due to variations in iodine intake as well as gestational age.

  16. Neonatal and infant outcome in boys and girls born very prematurely.

    Science.gov (United States)

    Peacock, Janet L; Marston, Louise; Marlow, Neil; Calvert, Sandra A; Greenough, Anne

    2012-03-01

    Although important new strategies have improved outcomes for very preterm infants, males have greater mortality/morbidity than females. We investigated whether the excess of adverse later effects in males operated through poorer neonatal profile or if there was an intrinsic male effect. Male sex was significantly associated with higher birth weight, death or oxygen dependency (72% vs. 61%, boys vs. girls), hospital stay (97 vs. 86 days), pulmonary hemorrhage (15% vs. 10%), postnatal steroids (37% vs. 21%), and major cranial ultrasound abnormality (20% vs. 12%). Differences remained significant after adjusting for birth weight and gestation. At follow-up, disability, cognitive delay, and use of inhalers remained significant after further adjustment. We conclude that in very preterm infants, male sex is an important risk factor for poor neonatal outcome and poor neurological and respiratory outcome at follow-up. The increased risks at follow-up are not explained by neonatal factors and lend support to the concept of male vulnerability following preterm birth. Data came from the United Kingdom Oscillation Study, with 797 infants (428 boys) born at 23-28 wk gestational age. Thirteen maternal factors, 8 infant factors, 11 acute outcomes, and neurological and respiratory outcomes at follow-up were analyzed. Follow-up outcomes were adjusted for birth and neonatal factors sequentially to explore mechanisms for differences by sex.

  17. Cognitive impairment at age 5 years in very preterm infants born following premature rupture of membranes.

    Science.gov (United States)

    Mura, Thibault; Picaud, Jean-Charles; Larroque, Béatrice; Galtier, Florence; Marret, Stephane; Roze, Jean-Christophe; Truffert, Patrick; Kuhn, Pierre; Fresson, Jeanne; Thiriez, Gérard; Arnaud, Catherine; Mercier, Gregoire; Picot, Marie-Christine; Ancel, Pierre-Yves; Ledesert, Bernard

    2013-08-01

    To evaluate the relationship between preterm premature rupture of membranes (PPROM) and cognitive impairment in 5-year-old children born very preterm. The Etude Epidémiologique sur les Petits Ages Gestationnels Study is a population-based cohort of children followed up from birth to age 5 years recruited in 9 French regions in 1997. We analyzed data from singletons born between 24 and 32 weeks gestation categorized into 4 groups according to etiology of prematurity: infants born after PPROM, after idiopathic preterm labor, in a vascular context (Vasc), and to women with other complications (Other). Cognitive development at age 5 years was assessed using the Mental Processing Composite score of the Kaufman-Assessment Battery for Children. Among the 1051 children followed up to age 5 years, the mean Mental Processing Composite score was 93.6 ± 19.7, and 13.3% of the children (140 of 1051) had cognitive impairment. After adjustment for potential confounders, the risk of cognitive impairment among infants in the PPROM group was not significantly different than that in the idiopathic preterm labor group (OR, 1.09; 95% CI, 0.62-1.92) and the Other group (OR, 1.36; 95% CI, 0.75-2.47), but was lower than that in the Vasc group (OR, 1.86; 95% CI, 1.16-2.97). In the PPROM group, the risk of cognitive impairment was greater when the latency period (ie, time from rupture to delivery) was <3 days (OR, 2.32; 95% CI, 1.07-5.02). Preterm infants born after PPROM are not at increased risk for cognitive impairment in childhood, but the time between PPROM and birth may influence that risk. Copyright © 2013 Mosby, Inc. All rights reserved.

  18. Postural complexity influences development in infants born preterm with brain injury: relating perception-action theory to 3 cases.

    Science.gov (United States)

    Dusing, Stacey C; Izzo, Theresa; Thacker, Leroy R; Galloway, James Cole

    2014-10-01

    Perception-action theory suggests a cyclical relationship between movement and perceptual information. In this case series, changes in postural complexity were used to quantify an infant's action and perception during the development of early motor behaviors. Three infants born preterm with periventricular white matter injury were included. Longitudinal changes in postural complexity (approximate entropy of the center of pressure), head control, reaching, and global development, measured with the Test of Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, were assessed every 0.5 to 3 months during the first year of life. All 3 infants demonstrated altered postural complexity and developmental delays. However, the timing of the altered postural complexity and the type of delays varied among the infants. For infant 1, reduced postural complexity or limited action while learning to control her head in the midline position may have contributed to her motor delay. However, her ability to adapt her postural complexity eventually may have supported her ability to learn from her environment, as reflected in her relative cognitive strength. For infant 2, limited early postural complexity may have negatively affected his learning through action, resulting in cognitive delay. For infant 3, an increase in postural complexity above typical levels was associated with declining neurological status. Postural complexity is proposed as a measure of perception and action in the postural control system during the development of early behaviors. An optimal, intermediate level of postural complexity supports the use of a variety of postural control strategies and enhances the perception-action cycle. Either excessive or reduced postural complexity may contribute to developmental delays in infants born preterm with white matter injury. © 2014 American Physical Therapy Association.

  19. [Two-year follow-up of infants born at 24 weeks gestation; first outcomes following implementation of the new 'Guideline for perinatal policy in cases of extreme prematurity'

    NARCIS (Netherlands)

    Aarnoudse-Moens, C.S.H.; Rijken, M.; Swarte, R.M.; Andriessen, P.; Horst, H.J. van der; Tollenaer, S.M. Mulder-de; Koopman-Esseboom, C.; Laarman, A.R.C.; Steiner, K.; Hoeven, A. van der; Kornelisse, R.F.; Duvekot, J.J.; Weisglas-Kuperus, N.

    2017-01-01

    OBJECTIVE: Since 2010 the guideline 'Guideline for perinatal policy in cases of extreme prematurity' has advised an active policy in infants born at 24 weeks gestation. We investigated how infants born at 24 and 25 weeks gestation in the first year following the implementation of the guideline had

  20. [Effects of deformational plagiocephaly during the first 12 months on the psychomotor development of prematurely born infants].

    Science.gov (United States)

    Fabre-Grenet, M; Garcia-Méric, P; Bernard-Niel, V; Guagliardo, V; Cortaredona, S; Aymeric-Ponsonnet, M

    2017-09-01

    The link between deformational plagiocephaly and psychomotor development is a recurrent question in medical publications. Main publications concentrate on term infants, but there is a lack of data on the impact of deformational plagiocephaly on the long-term neurodevelopment of premature infants. We attempted to establish a possible relation between deformational plagiocephaly during the 1st year of life and the psychomotor score at 4 years in prematurely born infants. Other risk factors potentially impacting the psychomotor score were also studied. A retrospective study of the files of the children followed by the "Naître et Devenir Région PACA Ouest Corse Sud" healthcare network and included in the database allowed us to select a cohort of 594 infants born prematurely at under 33 weeks of gestational age. These children were developmentally evaluated during the 1st year of life and at 4 years or age using the "EVAL Mater" test. The "Naître et Devenir" network is following up infants born prematurely at under 33 weeks of gestation in the West Provence Alpes Côte d'Azur and South Corsica region, from discharge to 7 years. A group of 170 specially trained pediatricians follow these infants developmentally at term, 3, 6, 9, 12, 18, and 24 months of corrected age and 3, 4 5, 6, and 7 years. Data are collected in a specially designed database. There was no significant link between deformational plagiocephaly during the 1st year of life and a pathological psychomotor score at age 4, but some risk factors were demonstrated: male gender, birth at under 28 weeks of gestational age, weight at birth under 1000g, having a Latal and Ferriero neuromotor score equal to or greater than 2 at 3 months of corrected age, and to a lesser extent having a prescription for physiotherapy during the 1st year. The research on deformational plagiocephaly in the full-term infant suggests a relation between deformational plagiocephaly and developmental delay predominantly

  1. Infant weight gain and adolescent body mass index: comparison across two British cohorts born in 1946 and 2001.

    Science.gov (United States)

    Johnson, William; Bann, David; Hardy, Rebecca

    2018-04-19

    To investigate how the relationship of infant weight gain with adolescent body mass index (BMI) differs for individuals born during and before the obesity epidemic era. Data from two British birth cohorts, the 1946 National Survey of Health and Development (NSHD, n=4199) and the 2001 Millennium Cohort Study (MCS, n=9417), were used to estimate and compare associations of infant weight gain between ages 0 and 3 years with adolescent outcomes. BMI Z-scores and overweight/obesity at ages 11 and 14 years. Infant weight gain, in Z-scores, was positively associated with adolescent BMI Z-scores in both cohorts. Non-linearity in the MCS meant that associations were only stronger than in the NSHD when infant weight gain was above -1 Z-score. Using decomposition analysis, between-cohort differences in association accounted for 20%-30% of the differences (secular increases) in BMI Z-scores, although the underlying estimates were not precise with 95% CIs crossing 0. Conversely, between-cohort differences in the distribution of infant weight gain accounted for approximately 9% of the differences (secular increases) in BMI Z-scores, and the underlying estimates were precise with 95% CI not crossing 0. Relative to normal weight gain (change of -0.67 to +0.67 Z-scores between ages 0 and 3 years), very rapid infant weight gain (>1.34), but not rapid weight gain (+0.67 to +1.34), was associated with higher BMI Z-scores more strongly in the MCS (β=0.790; 95% CI 0.717 to 0.862 at age 11 years) than in the NSHD (0.573; 0.466 to 0.681) (pgain (gain was not, however, more strongly associated with increased risk of adolescent overweight/obesity or thinness, respectively, in the more recently born cohort. Greater infant weight gain, at the middle/upper end of the distribution, was more strongly associated with higher adolescent BMI among individuals born during (compared with before) the obesity epidemic. Combined with a secular change towards greater infant weight gain, these

  2. Infants born preterm, stress, and neurodevelopment in the neonatal intensive care unit: might music have an impact?

    Science.gov (United States)

    Anderson, Dane E; Patel, Aniruddh D

    2018-03-01

    The neonatal intensive care unit (NICU) provides life-saving medical care for an increasing number of newborn infants each year. NICU care, while lifesaving, does have attendant consequences which can include repeated activation of the stress response and reduced maternal interaction, with possible negative long-term impacts on brain development. Here we present a neuroscientific framework for considering the impact of music on neurodevelopment in the NICU of infants born preterm and evaluate current literature on the use of music with this population to determine what is most reliably known of the physiological effects of music interventions. Using online academic databases we collected relevant, experimental studies aimed at determining effects of music listening in infants in the NICU. These articles were evaluated for methodological rigor, ranking the 10 most experimentally stringent as a representative sample. The selected literature seems to indicate that effects are present on the cardio-pulmonary system and behavior of neonates, although the relative effect size remains unclear. These findings indicate a need for more standardized longitudinal studies aimed at determining not only whether NICU music exposure has beneficial effects on the cardio-pulmonary system, but also on the hypothalamic-pituitary-adrenal axis, brain structures, and cognitive behavioral status of these children as well. Provides a neuroscience framework for considering how music might attenuate stress in neonatal intensive care unit (NICU) infants. Considers how repeated stress may cause negative neurodevelopmental impacts in infants born preterm. Posits epigenetics can serve as a mechanistic pathway for music moderating the stress response. © 2018 Mac Keith Press.

  3. Birth defects in infants born in 1998-2004 to men and women serving in the U.S. military during the 1990-1991 Gulf War era.

    Science.gov (United States)

    Bukowinski, Anna T; DeScisciolo, Connie; Conlin, Ava Marie S; K Ryan, Margaret A; Sevick, Carter J; Smith, Tyler C

    2012-09-01

    Concerns about reproductive health persist among U.S. military members who served in the 1990-1991 Gulf War. This study explores the long-term impact of 1990-1991 Gulf War deployment on the prevalence of birth defects among infants of Gulf War veterans. Health care data from the Department of Defense Birth and Infant Health Registry and demographic and deployment information from the Defense Manpower Data Center were used to identify infants born between 1998 and 2004 to both male and female 1990-1991 Gulf War veterans. Multivariable logistic regression models estimated the adjusted odds of any birth defect and eight specific birth defects among infants of deployers versus non-deployers. In addition, birth defects were evaluated among infants born to 1990-1991 Gulf War veterans with deployment-specific exposures. Among 178,766 infants identified for these analyses, 3.4% were diagnosed with a birth defect in the first year of life. Compared to infants of non-deployers, infants of deployers were not at increased odds of being diagnosed with a birth defect, or any of eight specific birth defects, in the first year of life. A slightly increased prevalence of birth defects was observed among infants born to men who deployed to the 1990-1991 Gulf War for 153 to 200 days compared to those who deployed for 1 to 92 days. No other deployment-specific exposures were associated with birth defects in these infants. The 1990-1991 Gulf War deployers, including those with specific exposures of concern, were not found to be at increased risk for having infants with birth defects 7 to 14 years after deployment. Published 2012 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2012-12-01

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

  5. Some studies of maternal and infant lead exposure in Glasgow

    Energy Technology Data Exchange (ETDEWEB)

    Moore, M.R.; Goldberg, A.; Pocock, S.J.; Meredith, A.; Stewart, I.M.; MacAnespie, H.; Lees, R.; Low, A.

    1982-04-01

    In two studies in the city of Glasgow, 236 mothers and their newly born infants and 117 mothers and their 6-weeks old children's environmental lead exposure were examined. In both studies blood lead concentrations were found to correlate significantly with the cube root of the domestic water lead concentrations. In the first study, multiple regression analyses of maternal blood lead and cord blood lead concentrations on other variables showed a significant negative correlation with gestational age. It was also noted that there was an annual fluctuation in maternal blood lead concentration with highest values in the autumn. In the second study, similar relationships were found. Although there was no association between blood lead and sex, age, place of birth or feeding method, as in the previous study, a significant association between social class and blood lead was found. This could be explained on the basis of the significant correlation between water lead and social class. In those mothers who breast fed, breast milk lead concentrations were found to correlate significantly with blood lead concentrations where breast milk lead was around one tenth of blood lead concentration. These studies emphasise the importance of water lead in the economy of environmental lead exposure to mothers and their unborn and newly born infants.

  6. 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.

  7. Heart size in new born infants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Won; Yu, Yun Jeong; Chung, Hye Kyung [Eul-ji General Hospital, Seoul (Korea, Republic of)

    1985-10-15

    Cardiac size of 291 new-bone infants was measured using the method illustrated on Fig 1. Among the 291 infants, 53 were asphyxiated, and asphyxia was only regarded from Apgar score below 6 on 1 min. and 5 min. Remaining 238 infants were normal, and classified to group with lung abnormalities and without lung abnormalities on chest A-P film. The results are as follows; 1. The average CTR. of normal group was 52.37. (C/T1; 54.89, C/T2; 49.43, C/T3; 49.15, C/T4;55.97) 2. The average CTR. of asphyxiated group was 54.91 (C/T1; 57.13, C/T2; 51.69, C/T3; 51.94, C/T4;58.25) 3. Consequently, asphyxiated infants revealed larger cardiac size than normal infant group.

  8. Advanced megaesophagus (Group III secondary to vector-borne Chagas disease in a 20-month-old infant

    Directory of Open Access Journals (Sweden)

    Anis Rassi

    2012-04-01

    Full Text Available The authors report the case of a female infant with Group III (or Grade III megaesophagus secondary to vector-borne Chagas disease, resulting in severe malnutrition that reversed after surgery (Heller technique. The infant was then treated with the antiparasitic drug benznidazole, and the infection was cured, as demonstrated serologically and parasitologically. After follow-up of several years without evidence of disease, with satisfactory weight and height development, the patient had her first child at age 23, in whom serological tests for Chagas disease yielded negative results. Thirty years after the initial examination, the patient's electrocardiogram, echocardiogram, and chest radiography remained normal.

  9. Normal Growth of Healthy Infants Born from HIV+ Mothers Fed a Reduced Protein Infant Formula Containing the Prebiotics Galacto-Oligosaccharides and Fructo-Oligosaccharides: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Hugo Da Costa Ribeiro Júnior

    2015-01-01

    Full Text Available Objective The aim of the current study was to evaluate the safety of a new reduced protein (2.1 g/100 kcal infant formula containing 4 g/L of 90% galacto-oligosaccharides (GOS and 10% fructo-oligosaccharides (FOS. Methods Healthy term infants from Brazil were enrolled. Those born to human immunodeficiency virus (HIV-positive mothers were randomized to a test ( n = 65 or control ( n = 63 formula group. Infants born to HIV-negative mothers were either exclusively breast-fed ( n = 79 or received a mixed diet (breast milk and test formula, n = 65. Between 2 weeks and 4 months of age, infants were exclusively fed according to their assigned group. Anthropometric measurements were taken at baseline, 1, 2, 3, 4, 6, 8, 10, and 12 months. Digestive tolerance was evaluated during the first 4 months. The primary outcome was mean daily weight gain between 2 weeks and 4 months in the test formula and breast-fed groups. Results Data from all infants ( N = 272 were used in the intention-to-treat (ITT analysis and data from 230 infants were used in the per-protocol (PP analysis. The difference in mean daily weight gain between 2 weeks and 4 months in the test formula and breast-fed groups was 1.257 g/day (onesided 95% confidence interval [CI]: -0.705 to inf, P < 0.001 in the PP analysis, showing that the lower bound of the 95% CI was above the -3.0 g/day non-inferiority margin. Results were similar in the ITT analysis. Symptoms of digestive tolerance and frequency of adverse events were similar in the two groups. Conclusions The formula containing 2.1 g/100 kcal protein and GOS and FOS was safe and tolerated well.

  10. Term infants born at home in Peru are less likely to be hospitalised in the neonatal period than those born in hospital.

    Science.gov (United States)

    Lavin, Tina; Preen, David B

    2017-08-01

    More than 50% of women worldwide give birth at home, but little is known about home birth and subsequent neonatal hospitalisation. The objective of the study was to investigate home birth and neonatal hospitalisation of term neonates in Peru. The relationship between birth setting [home - with or without skilled birth attendant (SBA), health centre, hospital] and neonatal hospitalisation (n = 1656) and incubator care (n = 1651) was investigated using data from the 2002 Young Lives Study. Infants were sampled from 20 sentinel sites across Peru. At each sentinel site 100 households with children aged 6-18 months were randomly sampled (therefore the sample only captured children surviving to 6 months of age). Multivariate regression modelling was used with models adjusted for a range of demographic and clinical factors. After adjustment, the odds of hospitalisation were lower in neonates born at home (with SBA OR 0.20, 95% CI 0.0-0.8, p = 0.021; without SBA OR = 0.4, 95% CI 0.2-0.7, p = 0.002) than in those born in hospital. Socio-demographic factors such as ethnicity, rural living, education, socio-economic status and access to transport did not influence neonatal hospitalisation, time in hospital, incubator care or time under incubator care. Neonates born at home were less likely to be hospitalised after birth owing to neonatal morbidity than neonates born in hospital. It is unclear whether this finding reflects poorer accessibility to hospital care for neonates born at home, or if neonates born at home required hospitalisation less frequently than neonates born in hospital owing to lower neonatal morbidity or other factors such as lower rates of medical intervention for home births. Further research is needed to explore the underlying mechanisms of these findings.

  11. Intensity of delivery room resuscitation and neonatal outcomes in infants born at 33 to 36 weeks' gestation.

    Science.gov (United States)

    Jiang, S; Lyu, Y; Ye, X Y; Monterrosa, L; Shah, P S; Lee, S K

    2016-02-01

    Examine the relationship between delivery room resuscitation intensity and mortality, morbidities and resource use in late preterm infants. Retrospective cohort study of inborn infants born at 33 to 36 weeks' gestation and admitted to Canadian neonatal intensive care units during 2010 to 2013. The 13 619 infants were grouped according to delivery room resuscitation intensity: no or minimal resuscitation (64.5%); continuous positive airway pressure (10.2%); bag-mask ventilation (21.7%); endotracheal intubation (3.1%); and cardiopulmonary resuscitation (CPR) (0.6%). Overall mortality, early mortality, respiratory distress, pneumothorax, late-onset sepsis and resource use increased with higher intensity resuscitation. Compared with no or minimal resuscitation, intubation and CPR were associated with increased odds of mortality (adjusted odds ratio (95% confidence interval): 50 (20 to 125) and 180 (63 to 518), respectively). Intubation or higher intensity delivery room resuscitation is associated with increased mortality, morbidities and resource use in late preterm infants. Extra intensive care is required for such infants, especially during the first week of life.

  12. Does acute maternal stress in pregnancy affect infant health outcomes? Examination of a large cohort of infants born after the terrorist attacks of September 11, 2001

    Directory of Open Access Journals (Sweden)

    Conlin Ava Marie S

    2009-07-01

    Full Text Available Abstract Background Infants in utero during the terrorist attacks of September 11, 2001 may have been negatively affected by maternal stress. Studies to date have produced contradictory results. Methods Data for this retrospective cohort study were obtained from the Department of Defense Birth and Infant Health Registry and included up to 164,743 infants born to active-duty military families. Infants were considered exposed if they were in utero on September 11, 2001, while the referent group included infants gestating in the same period in the preceding and following year (2000 and 2002. We investigated the association of this acute stress during pregnancy with the infant health outcomes of male:female sex ratio, birth defects, preterm birth, and growth deficiencies in utero and in infancy. Results No difference in sex ratio was observed between infants in utero in the first trimester of pregnancy on September 11, 2001 and infants in the referent population. Examination of the relationship between first-trimester exposure and birth defects also revealed no significant associations. In adjusted multivariable models, neither preterm birth nor growth deficiencies were significantly associated with the maternal exposure to the stress of September 11 during pregnancy. Conclusion The findings from this large population-based study suggest that women who were pregnant during the terrorist attacks of September 11, 2001 had no increased risk of adverse infant health outcomes.

  13. High Prevalence of HIV Drug Resistance Among Newly Diagnosed Infants Aged <18 Months: Results From a Nationwide Surveillance in Nigeria.

    Science.gov (United States)

    Inzaule, Seth C; Osi, Samuels J; Akinbiyi, Gbenga; Emeka, Asadu; Khamofu, Hadiza; Mpazanje, Rex; Ilesanmi, Oluwafunke; Ndembi, Nicaise; Odafe, Solomon; Sigaloff, Kim C E; Rinke de Wit, Tobias F; Akanmu, Sulaimon

    2018-01-01

    WHO recommends protease-inhibitor-based first-line regimen in infants because of risk of drug resistance from failed prophylaxis used in prevention of mother-to-child transmission (PMTCT). However, cost and logistics impede implementation in sub-Saharan Africa, and >75% of children still receive nonnucleoside reverse transcriptase inhibitor-based regimen (NNRTI) used in PMTCT. We assessed the national pretreatment drug resistance prevalence of HIV-infected children aged resistance surveillance protocol. We used remnant dried blood spots collected between June 2014 and July 2015 from 15 early infant diagnosis facilities spread across all the 6 geopolitical regions of Nigeria. Sampling was through a probability proportional-to-size approach. HIV drug resistance was determined by population-based sequencing. Overall, in 48% of infants (205 of 430) drug resistance mutations (DRM) were detected, conferring resistance to predominantly NNRTIs (45%). NRTI and multiclass NRTI/NNRTI resistance were present at 22% and 20%, respectively, while resistance to protease inhibitors was at 2%. Among 204 infants with exposure to drugs for PMTCT, 57% had DRMs, conferring NNRTI resistance in 54% and multiclass NRTI/NNRTI resistance in 29%. DRMs were also detected in 34% of 132 PMTCT unexposed infants. A high frequency of PDR, mainly NNRTI-associated, was observed in a nationwide surveillance among newly diagnosed HIV-infected children in Nigeria. PDR prevalence was equally high in PMTCT-unexposed infants. Our results support the use of protease inhibitor-based first-line regimens in HIV-infected young children regardless of PMTCT history and underscore the need to accelerate implementation of the newly disseminated guideline in Nigeria.

  14. Effect of semen quality on human sex ratio in in vitro fertilization and intracytoplasmic sperm injection: an analysis of 27,158 singleton infants born after fresh single-embryo transfer.

    Science.gov (United States)

    Arikawa, Mikiko; Jwa, Seung Chik; Kuwahara, Akira; Irahara, Minoru; Saito, Hidekazu

    2016-04-01

    To evaluate the effect of semen quality on human sex ratio in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Retrospective cohort study. Not applicable. A total of 27,158 singleton infants born between 2007 and 2012 after fresh single-embryo transfer. None. Proportion of male infants among liveborn infants. There were 14,996 infants born after IVF, 12,164 infants born after ICSI with ejaculated sperm, and 646 infants born after ICSI with nonejaculated sperm. The sex ratio of IVF was 53.1% (95% confidence interval [CI], 52.3-53.9); the sex ratio of ICSI with ejaculated and nonejaculated sperm demonstrated as statistically significant reduction (48.2%; 95% CI, 47.3-49.1 and 47.7%; 95% CI, 43.8-51.6, respectively). In IVF, lower sperm motility, including asthenozoospermia (sperm motility ratio compared with normal sperm (51.0%; 95% CI, 48.6-53.3 vs. 53.4%; 95% CI, 52.5-54.3). In ICSI with ejaculated sperm, there was no association between sperm motility and sex ratio. Sperm concentration was not associated with sex ratio in both IVF and ICSI. In IVF, lower sperm motility was associated with a statistically significant reduction in sex ratio; ICSI with either ejaculated or nonejaculated sperm was associated with a statistically significant reduction in sex ratio regardless of semen quality. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Infant feeding and mental and motor development at 18 months of age in first born singletons.

    Science.gov (United States)

    Florey, C D; Leech, A M; Blackhall, A

    1995-01-01

    To determine the relationship between type of infant feeding and mental and psychomotor development at age 18 months. A follow-up study of children born to primigravidae living in Dundee and booked into antenatal clinics in the City of Dundee (Local Authority District) from 1 May 1985 to 30 April 1986. The study population was 846 first born singletons, of whom 592 attended for developmental assessment at age 18 months. The main outcome measures were the Bayley Scales of Infant Mental and Motor Development. Higher mental development was significantly related to breast feeding on discharge from hospital and according to the health visitors' notes at about 2 weeks after discharge after allowing for partner's social class, mother's education, height, alcohol and cigarette consumption; placental weight and the child's sex, birth weight and gestational age at birth. After adjustment for statistically significant variables, the difference in Bayley mental development index between breast and bottle fed infants was between 3.7 and 5.7 units depending on the source of feeding data. No differences were found for psychomotor development or behaviour. The study provides further evidence of a robust statistical association between type of feeding and child intelligence. However, the literature is replete with suggestions for potential confounding variables which offer alternative causal explanations. To unravel what is an important clinical and public health question, further research should concentrate on randomized trials of supplemented formula feeds for children of mothers opting for bottle feeding and on epidemiological studies designed to disentangle the relation between method of feeding, parental intelligence and social environment.

  16. Does a parent-administrated early motor intervention influence general movements and movement character at 3months of age in infants born preterm?

    Science.gov (United States)

    Fjørtoft, Toril; Ustad, Tordis; Follestad, Turid; Kaaresen, Per Ivar; Øberg, Gunn Kristin

    2017-09-01

    Studies of preterm and term-born infants have shown absent fidgety movements and an abnormal movement character to be related to brain lesions and unfavourable neurological outcomes. The present study examines what effect a parent-administered early intervention program applied to preterm infants in a randomised control trial (RCT) between 34 and 36weeks gestational age has on their fidgety movements and overall movement character at three months of age. The study was part of the RCT in an early intervention programme including preterm infants born between 2010 and 2014 at three Norwegian university hospitals. 130 preterm infants participated in the study, with 59 of them in the control group and 71 in the intervention group. Fidgety movements and overall movement character at three months corrected age. No difference was found between the intervention group and the control group in terms of fidgety movements or movement character. Approximately half of the infants in both groups showed an abnormal movement character. No evidence was found in this RCT to suggest that an intervention at 34 to 37weeks gestational age has a significant effect on the fidgety movements or overall movement character of preterm infants. This is in line with the assumption that absent fidgety movements and an abnormal movement character are due to permanent brain injury and are therefore good predictors for later neurological impairments. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Nutritional and Hormonal Status of Premature Infants Born with Intrauterine Growth Restriction at the Term Corrected Age.

    Science.gov (United States)

    Belyaeva, I A; Namazova-Baranova, L S; Bombardirova, E P; Okuneva, M V

    Inadequate nutrition supply during the period of intrauterine growth and the first year of life leads to persistent metabolic changes and provokes development of various diseases. Тo compare physical development, body composition, and hormonal status (insulin, insulin-like growth factor-1 (IGF-1), somatotropic hormone (STH), C-Peptide, cortisol) indices in premature infants born with intrauterine growth restriction (IUGR) at the term corrected age with the same indices in mature infants with IUGR and premature infants with weight appropriate for their gestational age (GA). А crossover study of anthropometric measures, body composition and growth hormones changes assessment was carried out. It included 140 premature infants with weight appropriate for their GA, 58 premature infants with IUGR and 64 mature infants with IUGR. Anthropometric measures were assessed with Fenton and Anthro growth charts (WHO, 2009); body composition was studied with the air plethysmography method (РЕA POD, LMi, USA). Level of hormones in blood serum was assessed with biochemical methods. It is found that anthropometric measures in premature infants with weight appropriate for their GA and premature infants with IUGR at the term corrected age did not have any significant differences while premature infants with IUGR tended to have lower weight. Studying body composition we found that both groups of premature infants had slightly higher level of fat mass in comparison with mature infants. High concentration of insulin, cortisol, IGF-1, and C-peptide was found in premature and mature infants with IUGR. Instead, lower levels of STH was found in infants with IUGR. Formula fed premature infants (comparing to breastfed ones) had higher levels of fat mass, insulin, IGF-1, and C-peptide. Mature infants with IUGR did not tend to have the correlation between levels of fat mass, insulin, IGF-1, C-peptide, and type of feeding. Not only insufficient intrauterine growth but also nutrition pattern

  18. Carbon Dioxide Fluctuations Are Associated with Changes in Cerebral Oxygenation and Electrical Activity in Infants Born Preterm.

    Science.gov (United States)

    Dix, Laura Marie Louise; Weeke, Lauren Carleen; de Vries, Linda Simone; Groenendaal, Floris; Baerts, Willem; van Bel, Frank; Lemmers, Petra Maria Anna

    2017-08-01

    To evaluate the effects of acute arterial carbon dioxide partial pressure changes on cerebral oxygenation and electrical activity in infants born preterm. This retrospective observational study included ventilated infants born preterm with acute fluctuations of continuous end-tidal CO 2 (etCO 2 ) as a surrogate marker for arterial carbon dioxide partial pressure, during the first 72 hours of life. Regional cerebral oxygen saturation and fractional tissue oxygen extraction were monitored with near-infrared spectroscopy. Brain activity was monitored with 2-channel electroencephalography. Spontaneous activity transients (SATs) rate (SATs/minute) and interval between SATs (in seconds) were calculated. Ten-minute periods were selected for analysis: before, during, and after etCO 2 fluctuations of ≥5  mm Hg. Thirty-eight patients (mean ± SD gestational age of 29 ± 1.8 weeks) were included, with 60 episodes of etCO 2 increase and 70 episodes of etCO 2 decrease. During etCO 2 increases, brain oxygenation increased (regional cerebral oxygen saturation increased, fractional tissue oxygen extraction decreased; P carbon dioxide partial pressure that may be harmful to the neonatal brain. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Macrosomia Predictors in Infants Born to Cuban Mothers with Gestational Diabetes.

    Science.gov (United States)

    Cruz, Jeddú; Grandía, Raiden; Padilla, Liset; Rodríguez, Suilbert; Hernández García, Pilar; Lang Prieto, Jacinto; Márquez-Guillén, Antonio

    2015-07-01

    INTRODUCTION Fetal macrosomia is the most important complication in infants of women with diabetes, whether preconceptional or gestational. Its occurrence is related to certain maternal and fetal conditions and negatively affects maternal and perinatal outcomes. The definitive diagnosis is made at birth if a newborn weighs >4000 g. OBJECTIVE Identify which maternal and fetal conditions could be macrosomia predictors in infants born to Cuban mothers with gestational diabetes. METHODS A case-control study comprising 236 women with gestational diabetes who bore live infants (118 with macrosomia and 118 without) was conducted in the América Arias University Maternity Hospital, Havana, Cuba, during 2002-2012. The dependent variable was macrosomia (birth weight >4000 g). Independent maternal variables included body mass index at pregnancy onset, overweight or obesity at pregnancy onset, gestational age at diabetes diagnosis, pregnancy weight gain, glycemic control, triglycerides and cholesterol. Fetal variables examined included third-semester fetal abdominal circumference, estimated fetal weight at ≥28 weeks (absolute and percentilized by Campbell and Wilkin, and Usher and McLean curves). Chi square was used to compare continuous variables (proportions) and the student t test (X ± SD) for categorical variables, with significance threshold set at p gestational diabetes diagnosis, total fasting cholesterol and hypercholesterolemia. The highest OR for macrosomia were for maternal hypertriglyceridemia (OR 4.80, CI 2.34-9.84), third-trimester fetal abdominal circumference >75th percentile (OR 7.54, CI 4.04-14.06), and estimated fetal weight >90th percentile by Campbell and Wilkin curves (OR 4.75, CI 1.42-15.84) and by Usher and McLean curves (OR 8.81, CI 4.25-18.26). CONCLUSIONS Most variables assessed were predictors of macrosomia in infants of mothers with gestational diabetes. They should therefore be taken into account for future studies and for patient management

  20. Perinatal mortality among infants born during health user-fees (Cash & Carry) and the national health insurance scheme (NHIS) eras in Ghana: a cross-sectional study.

    Science.gov (United States)

    Ibrahim, Abdallah; Maya, Ernest T; Donkor, Ernestina; Agyepong, Irene A; Adanu, Richard M

    2016-12-08

    This research determined the rates of perinatal mortality among infants delivered under Ghana's national health insurance scheme (NHIS) compared to infants delivered under the previous "Cash and Carry" system in Northern Region, especially as the country takes stock of its progress toward meeting the Millennium Development Goals (MDG) 4 and 5. The labor and maternity wards delivery records of infants delivered before and after the implementation of the NHIS in Northern Region were examined. Records of available daily deliveries during the two health systems were extracted. Fisher's exact tests of non-random association were used to examine the bivariate association between categorical independent variables and perinatal mortality. On average, 8% of infants delivered during the health user-fee (Cash & Carry) died compared to about 4% infant deaths during the NHIS delivery fee exemption period in Northern Region, Ghana. There were no remarkable difference in the rate of infant deaths among mothers in almost all age categories in both the Cash and Carry and the NHIS periods except in mothers age 35 years and older. Infants born to multiparous mothers were significantly more likely to die than those born to first time mothers. There were more twin deaths during the Cash and Carry system (p = 0.001) compared to the NHIS system. Deliveries by caesarean section increased from an average of 14% in the "Cash and Carry" era to an average of 20% in the NHIS era. The overall rate of perinatal mortality declined by half (50%) in infants born during the NHIS era compared to the Cash and Carry era. However, caesarean deliveries increased during the NHIS era. These findings suggest that pregnant women in the Northern Region of Ghana were able to access the opportunity to utilize the NHIS for antenatal visits and possibly utilized skilled care at delivery at no cost or very minimal cost to them, which therefore improved Ghana's progress towards meeting the MDG 4, (reducing

  1. Immunophenotypic profile and increased risk of hospital admission for infection in infants born to female kidney transplant recipients.

    Science.gov (United States)

    Ono, E; Dos Santos, A M; Viana, P O; Dinelli, M I S; Sass, N; De Oliveira, L; Goulart, A L; de Moraes-Pinto, M I

    2015-06-01

    Children born to female kidney recipients are exposed to immunosuppressive drugs during gestation. Little is known about their immune system at birth or in the long term. Twenty-eight children born to female kidney recipients and 40 full-term children born to healthy mothers were evaluated. T, B, NK, NKT, γδT cells were assessed by flow cytometry and functional evaluation of T and dendritic cells after in vitro activation was performed at birth and at 8 months of age. At birth, infants born to female kidney recipients showed lower numbers of CD4+ T, NKT and intense reduction of B cells (median cells/mm(3) , transplant: 153.7 X control: 512.4; p memory and exhausted memory B cells showed higher percentages among children exposed to immunosuppressors when compared to control group. At 8 months, most immune alterations were no longer observed, but four children still had low numbers of some lymphocyte subsets at this age. Children born to female kidney recipients had 4.351 (95% CI: 1.026-15.225; p = 0.046) higher risk of hospital admission in the first months of life-some, with severe clinical manifestations-than those born to healthy women. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. Moderate and late preterm infants exhibit widespread brain white matter microstructure alterations at term-equivalent age relative to term-born controls

    NARCIS (Netherlands)

    Kelly, Claire E.; Cheong, Jeanie L Y; Gabra Fam, Lillian; Leemans, Alexander; Seal, Marc L.; Doyle, Lex W.; Anderson, Peter J.; Spittle, Alicia J.; Thompson, Deanne K.

    2016-01-01

    Despite the many studies documenting cerebral white matter microstructural alterations associated with very preterm birth (<32 weeks’ gestation), there is a dearth of similar research in moderate and late preterm infants (born 32–36 weeks’ gestation), who experience higher rates of

  3. Mother-infant interaction assessment at discharge and at 6 months in a French cohort of infants born very preterm: The OLIMPE study.

    Directory of Open Access Journals (Sweden)

    Gilles Cambonie

    Full Text Available The principal aim was to investigate the feasibility of assessing mother-infant interactions at discharge and at 6 months infant corrected age in singletons born before 32 weeks of gestation. The secondary aims were to describe these interactions and their disorders, explore the association between maternal emotional state and the interactions, and assess the relationship between disordered interactions and infant social withdrawal behaviour.OLIMPE is an ancillary study of the population-based study EPIPAGE 2, which recruited preterm neonates in France in 2011. 163 dyads participated at discharge and 148 at 6 months. Interactions were observed with the Attachment During Stress (ADS scale, which includes two behavioural subscales, for the mother (m-ADS and her infant (i-ADS. Two professionals independently completed the ADS scales for one third of the observations. Maternal emotional state was assessed using self-administered questionnaires of depression, anxiety, and stress. Infant's social withdrawal behaviour at 6 months was measured by the Alarm Distress Baby scale.At discharge, 15.3% of the m-ADS scales and 43.3% of the i-ADS scales had at least one unobserved component. At 6 months, all items on both scales were noticeable in >90% of the dyads. Reliability, estimated by the kappa coefficient, ranged between 0.39 and 0.76 at discharge, and between 0.21 and 0.69 at 6 months. Disordered interactions were indicated on 48.6% of the m-ADS scales and 36.5% of the i-ADS scales at discharge. At 6 months, these rates were 32.6% and 26.0%. Disordered interactions at 6 months were associated with identified disorder at discharge. Insecure infant attachment was not influenced by maternal mental health but was strongly associated with infant social withdrawal behaviour.The ADS scale can be used to screen for early interaction disorders after premature birth and may help to target dyads that would most benefit from early intervention.

  4. Neurodevelopmental Outcomes of Infants Born at <29 Weeks of Gestation Admitted to Canadian Neonatal Intensive Care Units Based on Location of Birth.

    Science.gov (United States)

    Amer, Reem; Moddemann, Diane; Seshia, Mary; Alvaro, Ruben; Synnes, Anne; Lee, Kyong-Soon; Lee, Shoo K; Shah, Prakesh S

    2018-05-01

    To compare mortality and neurodevelopmental outcomes of outborn and inborn preterm infants born at neurodevelopmental impairment (NDI), and overall NDI were compared between outborn and inborn infants at 18-21 months of age, corrected for prematurity. Of 2951 eligible infants, 473 (16%) were outborn. Mean birth weight (940 ± 278 g vs 897 + 237 g), rates of treatment with antenatal steroids (53.9% vs 92.9%), birth weight small for gestational age (5.3% vs 9.4%), and maternal college education (43.7% vs 53.9%) differed between outborn and inborn infants, respectively (all P values neurodevelopmental impairment were significantly higher in outborn compared with inborn infants admitted to Canadian NICUs. Adverse outcomes were mainly attributed to increased mortality and cerebral palsy in outborn neonates. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. The role of social risk in an early preventative care programme for infants born very preterm: a randomized controlled trial.

    Science.gov (United States)

    Spittle, Alicia J; Treyvaud, Karli; Lee, Katherine J; Anderson, Peter J; Doyle, Lex W

    2018-01-01

    To examine the differential effects of an early intervention programme for infants born preterm on neurodevelopment and parental mental health according to family social risk. One hundred and twenty infants born earlier than 30 weeks' gestation were randomized to early intervention (n=61) or control groups (n=59). Cognitive, language, and motor outcomes were assessed by blinded assessors at 2 years, 4 years, and 8 years, and primary caregivers completed questionnaires on their anxiety and depression. Outcomes at each time point were compared between groups using linear regression with an interaction term for social risk (higher/lower). There was evidence of interactions between intervention group and social risk for cognition at 2 years and 4 years, motor function at 4 years, and language at 8 years, with a greater intervention effect in children from higher social risk environments. In contrast, the impact of early intervention on parental depressive symptoms was greater for parents of lower social risk than for those of higher social risk. Effects of early intervention on outcomes for children born preterm and their caregivers varied according to family social risk. Family social risk should be considered when implementing early intervention programmes for children born preterm and their families. Intervention is associated with better early cognitive functioning for children in higher social risk families. Positive effects of intervention for the high risk group were not sustained at school-age. Intervention has a greater effect on primary caregiver mental health in the lower social risk group compared with higher social risk. © 2017 Mac Keith Press.

  6. The functional significance of newly born neurons integrated into olfactory bulb circuits.

    Science.gov (United States)

    Sakamoto, Masayuki; Kageyama, Ryoichiro; Imayoshi, Itaru

    2014-01-01

    The olfactory bulb (OB) is the first central processing center for olfactory information connecting with higher areas in the brain, and this neuronal circuitry mediates a variety of odor-evoked behavioral responses. In the adult mammalian brain, continuous neurogenesis occurs in two restricted regions, the subventricular zone (SVZ) of the lateral ventricle and the hippocampal dentate gyrus. New neurons born in the SVZ migrate through the rostral migratory stream and are integrated into the neuronal circuits of the OB throughout life. The significance of this continuous supply of new neurons in the OB has been implicated in plasticity and memory regulation. Two decades of huge investigation in adult neurogenesis revealed the biological importance of integration of new neurons into the olfactory circuits. In this review, we highlight the recent findings about the physiological functions of newly generated neurons in rodent OB circuits and then discuss the contribution of neurogenesis in the brain function. Finally, we introduce cutting edge technologies to monitor and manipulate the activity of new neurons.

  7. The functional significance of newly born neurons integrated into olfactory bulb circuits

    Directory of Open Access Journals (Sweden)

    Masayuki eSakamoto

    2014-05-01

    Full Text Available The olfactory bulb (OB is the first central processing center for olfactory information connecting with higher areas in the brain, and this neuronal circuitry mediates a variety of odor-evoked behavioral responses. In the adult mammalian brain, continuous neurogenesis occurs in two restricted regions, the subventricular zone (SVZ of the lateral ventricle and the hippocampal dentate gyrus. New neurons born in the SVZ migrate through the rostral migratory stream and are integrated into the neuronal circuits of the OB throughout life. The significance of this continuous supply of new neurons in the OB has been implicated in plasticity and memory regulation. Two decades of huge investigation in adult neurogenesis revealed the biological importance of integration of new neurons into the olfactory circuits. In this review, we highlight the recent findings about the physiological functions of newly generated neurons in rodent OB circuits and then discuss the contribution of neurogenesis in the brain function. Finally, we introduce cutting edge technologies to monitor and manipulate the activity of new neurons.

  8. Hearing loss - infants

    Science.gov (United States)

    ... can allow many infants to develop normal language skills without delay. In infants born with hearing loss, ... therapy allow many children to develop normal language skills at the same age as their peers with ...

  9. Mortality, Morbidity, and Developmental Outcomes in Infants Born to Women Who Received Either Mefloquine or Sulfadoxine-Pyrimethamine as Intermittent Preventive Treatment of Malaria in Pregnancy: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    María Rupérez

    2016-02-01

    Full Text Available Little is known about the effects of intermittent preventive treatment of malaria in pregnancy (IPTp on the health of sub-Saharan African infants. We have evaluated the safety of IPTp with mefloquine (MQ compared to sulfadoxine-pyrimethamine (SP for important infant health and developmental outcomes.In the context of a multicenter randomized controlled trial evaluating the safety and efficacy of IPTp with MQ compared to SP in pregnancy carried out in four sub-Saharan countries (Mozambique, Benin, Gabon, and Tanzania, 4,247 newborns, 2,815 born to women who received MQ and 1,432 born to women who received SP for IPTp, were followed up until 12 mo of age. Anthropometric parameters and psychomotor development were assessed at 1, 9, and 12 mo of age, and the incidence of malaria, anemia, hospital admissions, outpatient visits, and mortality were determined until 12 mo of age. No significant differences were found in the proportion of infants with stunting, underweight, wasting, and severe acute malnutrition at 1, 9, and 12 mo of age between infants born to women who were on IPTp with MQ versus SP. Except for three items evaluated at 9 mo of age, no significant differences were observed in the psychomotor development milestones assessed. Incidence of malaria, anemia, hospital admissions, outpatient visits, and mortality were similar between the two groups. Information on the outcomes at 12 mo of age was unavailable in 26% of the infants, 761 (27% from the MQ group and 377 (26% from the SP group. Reasons for not completing the study were death (4% of total study population, study withdrawal (6%, migration (8%, and loss to follow-up (9%.No significant differences were found between IPTp with MQ and SP administered in pregnancy on infant mortality, morbidity, and nutritional outcomes. The poorer performance on certain psychomotor development milestones at 9 mo of age in children born to women in the MQ group compared to those in the SP group may deserve

  10. Comparison in outcomes at two-years of age of very preterm infants born in 2000, 2005 and 2010.

    Directory of Open Access Journals (Sweden)

    Lénaïg Abily-Donval

    Full Text Available To investigate alteration in 2-year neurological/behavioral outcomes of very preterm infants born in a French level three neonatal intensive care unit.We conducted a prospective, comparative study of very preterm infants born before 33 weeks' gestation at 5-year intervals in 2000, 2005 and 2010 at Rouen University Hospital. Neonatal mortality/morbidities, ante- and neonatal treatments, and at age 2 years motor, cognitive and behavioral data were collected by standardized questionnaires.We included 536 very preterm infants. Follow-up rates at two years old were 78% in 2000, 93% in 2005 and 92% in 2010 respectively. No difference in gestational age, birthweight, neonatal mortality/morbidities was observed except a decrease in low grade subependymal/intraventricular hemorrhages. Care modifications concerned use of antenatal magnesium sulfate, breast-feeding and post-natal corticosteroid therapy. Significant improvement in motor outcome and dramatic decrease in cerebral palsy rates (12% in 2000, 6% in 2005, 1% in 2010, p<0.001 were observed, as were improvements in feeding behavior. Although a non significant difference to better psychosocial behavior was reported, there was no difference in cognitive outcome.Improvement in neuromotor outcome and behavior was reported. This could be due to multiple modifications in care: including administration of magnesium sulfate to women at risk of preterm birth, increase in breast-feeding, decrease in low grade subependymal/intraventricular hemorrhages, and decrease in post-natal corticosteroid therapy, all of which require further investigation in other studies. Extended follow-up until school age is mandatory for better detection of cognitive, learning and behavioral disorders.

  11. Current insights in brain protection for the sick newborn infant

    OpenAIRE

    KOOI E.M.W.

    2015-01-01

    This paper presents an overview of the modern antenatal and postnatal strategies in brain protection for both preterm and term born infants. It is known, that the two most common causes of neonatal brain injury are prematurity and hypoxic-ischemic encephalopathy (HIE) in the term born infant. Approximately one in nine babies is born before term. Nowadays these preterm born infants more often survive the neonatal period due to developments in treatment options in the last decades. They are how...

  12. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age.

    Directory of Open Access Journals (Sweden)

    Henrica M A de Bie

    Full Text Available Intrauterine growth restriction (IUGR can lead to infants being born small for gestational age (SGA. SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI.18 children born appropriate for gestational age (AGA and 34 SGA born children (18 with and 16 without postnatal catch-up growth participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning. A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes.Neuropsychological testing demonstrated that SGA children had IQ's within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA.This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on.

  13. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age.

    Science.gov (United States)

    de Bie, Henrica M A; de Ruiter, Michiel B; Ouwendijk, Mieke; Oostrom, Kim J; Wilke, Marko; Boersma, Maria; Veltman, Dick J; Delemarre-van de Waal, Henriette A

    2015-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI). 18 children born appropriate for gestational age (AGA) and 34 SGA born children (18 with and 16 without postnatal catch-up growth) participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning). A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes. Neuropsychological testing demonstrated that SGA children had IQ's within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA. This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on.

  14. 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.

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

    Science.gov (United States)

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

    2017-10-01

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

  16. Achieved versus intended pulse oximeter saturation in infants born less than 28 weeks' gestation: the AVIOx study.

    Science.gov (United States)

    Hagadorn, James I; Furey, Anne M; Nghiem, Tuyet-Hang; Schmid, Christopher H; Phelps, Dale L; Pillers, De-Ann M; Cole, Cynthia H

    2006-10-01

    The objective of this study was to document pulse oximeter saturation levels achieved in the first 4 weeks of life in infants who were born at signal-extraction oximeters for a 72-hour period in each of the first 4 weeks of life. Data were compared with the pulse oximeter saturation target range prescribed by local institutional policy. Factors that were associated with intended range compliance were identified with hierarchical modeling. Fourteen centers from 3 countries enrolled 84 infants with mean +/- SD birth weight of 863 +/- 208 g and gestational age of 26 +/- 1.4 weeks. Oxygen saturation policy limits ranged between 83% and 92% for lower limits and 92% and 98% for upper limits. For infants who received respiratory support, median pulse oximeter saturation level achieved was 95%. Center-specific medial levels were within the intended range at 12 centers. Centers maintained infants within their intended range 16% to 64% of the time but were above range 20% to 73% of the time. In hierarchical modeling, wider target ranges, higher target range upper limits, presence of a policy of setting oximeter alarms close to the target range limits, and lower gestational age were associated with improved target range compliance. Success with maintaining the intended pulse oximeter saturation range varied substantially among centers, among patients within centers, and for individual patients over time. Most noncompliance was above the intended range. Methods for improving compliance and the effect of improved compliance on neonatal outcomes require additional research.

  17. Early Benefits of a Starter Formula Enriched in Prebiotics and Probiotics on the Gut Microbiota of Healthy Infants Born to HIV+ Mothers: A Randomized Double-Blind Controlled Trial

    Directory of Open Access Journals (Sweden)

    Peter Cooper

    2016-01-01

    Full Text Available The gut microbiota of infants is shaped by both the mode of delivery and the type of feeding. The gut of vaginally and cesarean-delivered infants is colonized at different rates and with different bacterial species, leading to differences in the gut microbial composition, which may persist up to 6 months. In a multicenter, randomized, controlled, double-blind trial conducted in South Africa, we tested the effect of a formula supplemented with a prebiotic (a mixture of bovine milk-derived oligosaccharides [BMOS] generated from whey permeate and containing galactooligosaccharides and milk oligosaccharides such as 3′- and 6′-sialyllactose and the probiotic Bifidobacterium animalis subsp. lactis (B. lactis strain CNCM I-3446 on the bifidobacteria levels in the gut of infants born vaginally or via cesarean section in early life. Additionally, the safety of the new formulation was evaluated. A total of 430 healthy, full-term infants born to HIV-positive mothers who had elected to feed their child beginning from birth (≤3 days old exclusively with formula were randomized into this multicenter trial of four parallel groups. A total of 421 infants who had any study formula intake were included in the full analysis set (FAS. The first two groups consisted of cesarean-delivered infants assigned to the Test formula (n = 92 (a starter infant formula [IF] containing BMOS at a total oligosaccharide concentration of 5.8 ± 1.0 g/100 g of powder formula [8 g/L in the reconstituted formula] + B. lactis [1 × 10 7 colony-forming units {cfu}/g] or a Control IF (n = 101; the second two groups consisted of vaginally delivered infants randomized to the same Test (n = 115 or Control (n = 113 formulas from the time of enrollment to 6 months. The primary efficacy outcome was fecal bifidobacteria count at 10 days, and the primary safety outcome was daily weight gain (g/d between 10 days and 4 months. At 10 days, fecal bifidobacteria counts were significantly higher

  18. Building Relationships: Integrating Infant Mental Health Services in a Newborn and Infant Critical Care Unit

    Science.gov (United States)

    Lakatos, Patricia P.; Matic, Tamara; Carson, Melissa C.; Williams, Marian E.

    2017-01-01

    Infants are born primed to develop attachment relationships. However, when infants are hospitalized in the neonatal intensive care unit at birth, the stress and trauma associated with the highly specialized medical environment can threaten the development of a nurturing and secure caregiving relationship. Infant mental health is an evidence-based…

  19. Description of 13 Infants Born During October 2015-January 2016 With Congenital Zika Virus Infection Without Microcephaly at Birth - Brazil.

    Science.gov (United States)

    van der Linden, Vanessa; Pessoa, André; Dobyns, William; Barkovich, A James; Júnior, Hélio van der Linden; Filho, Epitacio Leite Rolim; Ribeiro, Erlane Marques; Leal, Mariana de Carvalho; Coimbra, Pablo Picasso de Araújo; Aragão, Maria de Fátima Viana Vasco; Verçosa, Islane; Ventura, Camila; Ramos, Regina Coeli; Cruz, Danielle Di Cavalcanti Sousa; Cordeiro, Marli Tenório; Mota, Vivian Maria Ribeiro; Dott, Mary; Hillard, Christina; Moore, Cynthia A

    2016-12-02

    Congenital Zika virus infection can cause microcephaly and severe brain abnormalities (1). Congenital Zika syndrome comprises a spectrum of clinical features (2); however, as is the case with most newly recognized teratogens, the earliest documented clinical presentation is expected to be the most severe. Initial descriptions of the effects of in utero Zika virus infection centered prominently on the finding of congenital microcephaly (3). To assess the possibility of clinical presentations that do not include congenital microcephaly, a retrospective assessment of 13 infants from the Brazilian states of Pernambuco and Ceará with normal head size at birth and laboratory evidence of congenital Zika virus infection was conducted. All infants had brain abnormalities on neuroimaging consistent with congenital Zika syndrome, including decreased brain volume, ventriculomegaly, subcortical calcifications, and cortical malformations. The earliest evaluation occurred on the second day of life. Among all infants, head growth was documented to have decelerated as early as 5 months of age, and 11 infants had microcephaly. These findings provide evidence that among infants with prenatal exposure to Zika virus, the absence of microcephaly at birth does not exclude congenital Zika virus infection or the presence of Zika-related brain and other abnormalities. These findings support the recommendation for comprehensive medical and developmental follow-up of infants exposed to Zika virus prenatally. Early neuroimaging might identify brain abnormalities related to congenital Zika infection even among infants with a normal head circumference (4).

  20. Focused attention, heart rate deceleration, and cognitive development in preterm and full-term infants.

    Science.gov (United States)

    Petrie Thomas, Julianne H; Whitfield, Michael F; Oberlander, Tim F; Synnes, Anne R; Grunau, Ruth E

    2012-05-01

    The majority of children who are born very preterm escape major impairment, yet more subtle cognitive and attention problems are very common in this population. Previous research has linked infant focused attention during exploratory play to later cognition in children born full-term and preterm. Infant focused attention can be indexed by sustained decreases in heart rate (HR). However there are no preterm studies that have jointly examined infant behavioral attention and concurrent HR response during exploratory play in relation to developing cognition. We recruited preterm infants free from neonatal conditions associated with major adverse outcomes, and further excluded infants with developmental delay (Bayley Mental Development Index [MDI attention and concurrent HR response were compared in 83 preterm infants (born 23-32 weeks gestational age [GA]) who escaped major impairment to 46 full-term infants. Focused attention and HR response were then examined in relation to Bayley MDI, after adjusting for neonatal risk. MDI did not differ by group, yet full-term infants displayed higher global focused attention ratings. Among the extremely preterm infants born attention episodes, accounted for 49% of adjusted variance in predicting concurrent MDI. There were no significant associations for later-born gestational age (29-32 weeks) or full-term infants. Among extremely preterm infants who escape major impairment, our findings suggest unique relationships between focused attention, HR deceleration, and developing cognition. Copyright © 2011 Wiley Periodicals, Inc.

  1. Comparison outcomes of sick babies born to teenage mothers with those born to adult mothers.

    Science.gov (United States)

    Chotigeat, Uraiwan; Sawasdiworn, Siraporn

    2011-08-01

    Adolescent period is the transitional stage of physical and mental development from childhood to adulthood. Pregnancy in teenage girls is generally classified to have a higher risk than those in adults. In many previous studies reported only the outcome of teenage mothers but no comparative outcome between sick babies born to teen mothers and adult mothers, so the authors conducted the present study. To compare the outcomes of sick infants born to teenage mothers with those born to adult mothers (age > or = 20 years). This prospective study was carried out from October 1st, 2006 to September 30th, 2009. The study group consisted of sick babies born to teenage mothers and admitted at Queen Sirikit National Institute of Child Health (QSNICH). These babies were compared to sick babies (control group) born to adult mothers during the same period. The demographic data of mothers and sick babies in both groups were recorded in the designed case record forms. Developmental assessment was done until two years of age. A total of 6,342 deliveries took place in Rajavithi Hospital during the study period of which 697 babies were born to teenage mothers. The incidence of teenage pregnancy was 10.99%. The number of sick babies from teenage mothers and adult mothers were 78 and 147 cases, respectively. There was a significantly higher mortality in the study group (7 cases, 9%) than the control group (4 cases, 2.7%). There was statistically significant difference in most of the demographic characteristics between the teenage and adult mothers except anemia, PROM and MSAF (meconium stain amniotic fluid). Although there was a trend of more cases of anemia and MSAF in teenage mothers than in adult mothers, there was no statistically significant difference. There was a shorter interval time from marriage to pregnancy in teen mothers than in adult mothers and a lower number of antenatal care visits with late antenatal care among the teenage mothers too. On comparing the data in infants

  2. THE NEWLY BORN MAGNETARS POWERING GAMMA-RAY BURST INTERNAL-PLATEAU EMISSION: ARE THERE STRANGE STARS?

    International Nuclear Information System (INIS)

    Yu Yunwei; Cao Xiaofeng; Zheng Xiaoping

    2009-01-01

    The internal-plateau X-ray emission of gamma-ray bursts (GRBs) indicates that a newly born magnetar could be the central object of some GRBs. The observed luminosity and duration of the plateaus suggest that, for such a magnetar, a rapid spin with a sub- or millisecond period is sometimes able to last thousands of seconds. In this case, the conventional neutron star (NS) model for the magnetar may be challenged, since the rapid spin of nascent NSs would be remarkably decelerated within hundreds of seconds due to r-mode instability. In contrast, the r-modes can be effectively suppressed in nascent strange stars (SSs). In other words, to a certain extent, only SSs can keep nearly constant extremely rapid spin for a long period of time during the early ages of the stars. We thus propose that the sample of the GRB rapidly spinning magnetars can be used to test the SS hypothesis based on the distinct spin limits of NSs and SSs.

  3. Outcome of singleton preterm small for gestational age infants born to mothers with pregnancy-induced hypertension. A population-based study.

    Science.gov (United States)

    Regev, Rivka H; Arnon, Shmuel; Litmanovitz, Ita; Bauer-Rusek, Sofia; Boyko, Valentina; Lerner-Geva, Liat; Reichman, Brian

    2015-04-01

    Pregnancy-induced hypertension (PIH) has been associated with a decreased risk of infant mortality in small for gestational age (SGA) preterm infants. To evaluate the influence of PIH on mortality and major neonatal morbidities in singleton preterm SGA infants, in the presence and absence of acute pregnancy complications. Population-based observational study of singleton SGA infants, born at 24 to 32 weeks gestation in the period 1995-2010 (n = 2139). Multivariable logistic regression analyses were used to assess the independent effect of PIH on mortality and neonatal morbidities. Acute pregnancy complications comprised premature labor, premature rupture of membranes >6 h, antepartum hemorrhage and clinical chorioamnionitis. In the absence of pregnancy complications, the odds ratio (95% confidence interval) for mortality (0.77; 0.50-1.16), survival without severe neurological morbidity (1.14; 0.79-1.65) and survival without bronchopulmonary dysplasia (BPD) (0.85; 0.59-1.21) were similar in the PIH versus no-PIH groups. In the presence of pregnancy complications, mortality (0.76; 0.40-1.44), survival without severe neurological morbidity (1.16; 0.64-2.12) and survival without BPD (1.04; 0.58-1.86) were also similar in the PIH versus no-PIH groups. PIH was not associated with improved outcome in preterm SGA infants, both in the presence and absence of acute pregnancy complications.

  4. Improving the outcome of infants born at <30 weeks' gestation - a randomized controlled trial of preventative care at home

    Directory of Open Access Journals (Sweden)

    Orton Jane

    2009-12-01

    Full Text Available Abstract Background Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems. Methods/Design We have designed a randomized controlled trial to assess the effectiveness of a preventative care program delivered at home over the first 12 months of life for infants born very preterm ( Discussion This paper presents the background, study design and protocol for a randomized controlled trial in very preterm infants utilizing a preventative care program in the first year after discharge home designed to improve cognitive, motor and behavioral outcomes of very preterm children and caregiver mental health at two-years' corrected age. Clinical Trial Registration Number ACTRN12605000492651

  5. Disparities in Infant Mortality by Race Among Hispanic and Non-Hispanic Infants.

    Science.gov (United States)

    Rice, Whitney S; Goldfarb, Samantha S; Brisendine, Anne E; Burrows, Stevie; Wingate, Martha S

    2017-07-01

    U.S.-born Hispanic infants have a well-documented health advantage relative to other minority groups. However, little published research has examined racial heterogeneity within the Hispanic population, in relation to health outcomes. The current study aims to explore possible implications of racial identification for the health of U.S. born Hispanic compared to non-Hispanic infants. Methods Data were drawn from 2007 to 2008 NCHS Cohort Linked Live Birth-Infant Death Files, restricted to deliveries of Hispanic black, Hispanic white, non-Hispanic black (NHB) and non-Hispanic white mothers (NHW) (n = 7,901,858). Adjusted odds ratios for first week mortality, neonatal, postneonatal, and overall infant mortality were calculated for each group, using NHW as the reference group. A distinct health gradient was observed in which NHB infants (n = 1,250,222) had the highest risk of first week (aOR 2.29, CI 2.21-2.37), neonatal (aOR 2.23, CI 2.17-2.30), postneonatal (aOR 1.74, CI 1.68-1.81), and infant mortality (aOR 2.05, CI 2.00-2.10) compared to NHW infants (n = 4,578,150). Hispanic black infants (n = 84,377) also experienced higher risk of first-week (aOR 1.28 (1.12-1.47), neonatal (aOR .27, CI 1.13-1.44), postneonatal (aOR 1.34, CI 1.15-1.56), and infant mortality (aOR 1.30, CI 1.18-1.43) compared to both NHW and Hispanic white infants (n = 1,989,109). Conclusions for Practice: Risk of infant mortality varies among Hispanic infants by race, with poorer outcomes experienced by Hispanic black infants. Compared to non-Hispanic infants of the same race, Hispanic black infants experience a smaller health disadvantage and Hispanic white infants have better or similar infant health outcomes. Our findings suggest implications of racial heterogeneity on infant health outcomes, and provide insight into the role of race as a social construct.

  6. Survival and Neurodevelopmental Outcomes among Periviable Infants.

    Science.gov (United States)

    Younge, Noelle; Goldstein, Ricki F; Bann, Carla M; Hintz, Susan R; Patel, Ravi M; Smith, P Brian; Bell, Edward F; Rysavy, Matthew A; Duncan, Andrea F; Vohr, Betty R; Das, Abhik; Goldberg, Ronald N; Higgins, Rosemary D; Cotten, C Michael

    2017-02-16

    Data reported during the past 5 years indicate that rates of survival have increased among infants born at the borderline of viability, but less is known about how increased rates of survival among these infants relate to early childhood neurodevelopmental outcomes. We compared survival and neurodevelopmental outcomes among infants born at 22 to 24 weeks of gestation, as assessed at 18 to 22 months of corrected age, across three consecutive birth-year epochs (2000-2003 [epoch 1], 2004-2007 [epoch 2], and 2008-2011 [epoch 3]). The infants were born at 11 centers that participated in the National Institute of Child Health and Human Development Neonatal Research Network. The primary outcome measure was a three-level outcome - survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, or death. After accounting for differences in infant characteristics, including birth center, we used multinomial generalized logit models to compare the relative risk of survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, and death. Data on the primary outcome were available for 4274 of 4458 infants (96%) born at the 11 centers. The percentage of infants who survived increased from 30% (424 of 1391 infants) in epoch 1 to 36% (487 of 1348 infants) in epoch 3 (Pneurodevelopmental impairment increased from 16% (217 of 1391) in epoch 1 to 20% (276 of 1348) in epoch 3 (P=0.001), whereas the percentage of infants who survived with neurodevelopmental impairment did not change significantly (15% [207 of 1391] in epoch 1 and 16% [211 of 1348] in epoch 3, P=0.29). After adjustment for changes in the baseline characteristics of the infants over time, both the rate of survival with neurodevelopmental impairment (as compared with death) and the rate of survival without neurodevelopmental impairment (as compared with death) increased over time (adjusted relative risks, 1.27 [95% confidence interval {CI}, 1.01 to 1.59] and 1

  7. Outcomes of intraventricular hemorrhage and posthemorrhagic hydrocephalus in a population-based cohort of very preterm infants born to residents of Nova Scotia from 1993 to 2010.

    Science.gov (United States)

    Radic, Julia A E; Vincer, Michael; McNeely, P Daniel

    2015-06-01

    OBJECT Intraventicular hemorrhage (IVH) is a common complication of preterm birth, and the prognosis of IVH is incompletely characterized. The objective of this study was to describe the outcomes of IVH in a population-based cohort with minimal selection bias. METHODS All very preterm (≥ 30 completed weeks) patients born in the province of Nova Scotia were included in a comprehensive database. This database was screened for infants born to residents of Nova Scotia from January 1, 1993, to December 31, 2010. Among very preterm infants successfully resuscitated at birth, the numbers of infants who died, were disabled, developed cerebral palsy, developed hydrocephalus, were blind, were deaf, or had cognitive/language scores assessed were analyzed by IVH grade. The relative risk of each outcome was calculated (relative to the risk for infants without IVH). RESULTS Grades 2, 3, and 4 IVH were significantly associated with an increased overall mortality, primarily in the neonatal period, and the risk increased with increasing grade of IVH. Grade 4 IVH was significantly associated with an increased risk of disability (RR 2.00, p < 0.001), and the disability appeared to be primarily due to cerebral palsy (RR 6.07, p < 0.001) and cognitive impairment (difference in mean MDI scores between Grade 4 IVH and no IVH: -19.7, p < 0.001). No infants with Grade 1 or 2 IVH developed hydrocephalus, and hydrocephalus and CSF shunting were not associated with poorer outcomes when controlling for IVH grade. CONCLUSIONS Grades 1 and 2 IVH have much better outcomes than Grades 3 or 4, including a 0% risk of hydrocephalus in the Grade 1 and 2 IVH cohort. Given the low risk of selection bias, the results of this study may be helpful in discussing prognosis with families of very preterm infants diagnosed with IVH.

  8. Humoral immune response to measles and varicella vaccination in former very low birth weight preterm infants

    OpenAIRE

    Carolina Schlindwein Mariano Ferreira; Maria Cristina Abrão Aued Perin; Maria Isabel de Moraes-Pinto; Raquel Maria Simão-Gurge; Ana Lucia Goulart; Lily Yin Weckx; Amélia Miyashiro Nunes dos Santos

    2018-01-01

    Introduction: Immune response to vaccination in infants born prematurely may be lower than in infants born at full-term. Some clinical factors might be associated with humoral immune response. Objectives: The objectives of this study were to compare the immune response to measles and varicella vaccination in infants born prematurely with those born at full-term and to analyze factors associated with measles and varicella antibody levels. Methods: Prospective study including two groups o...

  9. Wellbeing of gay fathers with children born through surrogacy: a comparison with lesbian mother families and heterosexual IVF parent families

    OpenAIRE

    Van Rijn-van Gelderen, L; Bos, HWM; Joregnsen, TD; Ellis-Davies, K; Winstanley, A; Golombok, S; Rubio, B; Gross, M; Vecho, O; Lamb, ME

    2018-01-01

    Study question:\\ud Are there differences in levels of parental wellbeing (parental stress, psychological adjustment, and partner relationship satisfaction) between gay-father families with infants born through surrogacy, lesbian-mother families with infants born through donor insemination, and heterosexual-parent families with infants born through IVF?\\ud \\ud Summary answer:\\ud There were no differences in parental wellbeing.\\ud \\ud What is known already: \\ud The only other study of parental ...

  10. Self-reported maternal parenting style and confidence and infant temperament in a multi-ethnic community: results from the Born in Bradford cohort.

    Science.gov (United States)

    Prady, Stephanie L; Kiernan, Kathleen; Fairley, Lesley; Wilson, Sarah; Wright, John

    2014-03-01

    Ethnic minority children in the United Kingdom often experience health disadvantage. Parenting influences children's current and future health, but little is known about whether parenting behaviours and mother's perception of her infant vary by ethnicity. Using the Born in Bradford (BiB) birth cohort, which is located in an ethnically diverse and economically deprived UK city, we conducted a cross-sectional analysis of mother's self-reported parenting confidence, self-efficacy, hostility and warmth, and infant temperament at six months of age. We examined responses from women of Pakistani (N = 554) and White British (N = 439) origin. Pakistani mothers reported feeling more confident about their abilities as a parent. Significantly fewer Pakistani women adopted a hostile approach to parenting, an effect that was attenuated after adjustment for socioeconomic status and mental health. Overall, women with more self-efficacious, warm and less hostile parenting styles reported significantly fewer problems with their infant's temperaments. Of women with higher self-efficacy parenting styles, Pakistani mothers were significantly more likely than White British mothers to report more problematic infant temperaments, although absolute differences were small. It is unlikely that the ethnic variation seen in children's cognitive and behavioural outcomes in childhood is attributable to differences in parenting or infant characteristics reported at six months.

  11. Use of plastic bags to prevent hypothermia at birth in preterm infants--do they work at lower gestations?

    Science.gov (United States)

    Ibrahim, C P H; Yoxall, C W

    2009-02-01

    Hypothermia at birth is strongly associated with mortality and morbidity in preterm infants. Occlusive wrapping of preterm infants during resuscitation, including polythene bags have been shown to prevent hypothermia. To evaluate the effectiveness of the introduction of polythene bags at resuscitation of infants born below 30 weeks gestation in a large tertiary neonatal centre. Retrospective audit of admission temperatures of all infants born below 30 weeks gestation for two years before and two years after the introduction of polythene bags. Hypothermia was defined as admission axillary temperature bags. The main reduction in hypothermia was seen in infants born above 28 weeks gestation (19.4% vs. 3.9%, p = 0.017). There was no significant effect in infants born between 28 weeks and 30 weeks (29.3% vs. 24.8%, p = 0.58). Polythene bags are effective in reducing the incidence of hypothermia at admission in infants born below 30 weeks gestation. The benefit in infants born below 28 weeks gestation was only marginal. This is in contrast to previously published studies. This may be related to the comparatively low incidence of hypothermia at the study centre even prior to introduction of polythene bags.

  12. Cardiovascular malformations in infants of diabetic mothers

    OpenAIRE

    Wren, C; Birrell, G; Hawthorne, G

    2003-01-01

    Objective: To compare the prevalence at live birth and the spectrum of cardiovascular malformations in infants born to diabetic mothers with pre-existing diabetes with that in infants of non-diabetic mothers.

  13. Pacemaker therapy in low-birth-weight infants.

    Science.gov (United States)

    Fuchigami, Tai; Nishioka, Masahiko; Akashige, Toru; Shimabukuro, Atsuya; Nagata, Nobuhiro

    2018-02-01

    Infants born with complete atrioventricular block (CAVB) and fetal bradycardia are frequently born with low birth weight. Three low-birth-weight CAVB infants underwent temporary pacemaker implantation, followed by permanent single-chamber pacemaker implantation at median body weights of 1.7 and 3.2 kg, respectively. All infants caught up with their growth curves and had >3 years of estimated residual battery life. This two-stage strategy was successful in facilitating permanent pacemaker implantation in low-birth-weight babies. Placement of single-chamber pacemaker on the apex of the left ventricle appears to be associated with longer battery lifespan. © 2018 Wiley Periodicals, Inc.

  14. Pulmonary Morbidity in Infancy after Exposure to Chorioamnionitis in Late Preterm Infants.

    Science.gov (United States)

    McDowell, Karen M; Jobe, Alan H; Fenchel, Matthew; Hardie, William D; Gisslen, Tate; Young, Lisa R; Chougnet, Claire A; Davis, Stephanie D; Kallapur, Suhas G

    2016-06-01

    Chorioamnionitis is an important cause of preterm birth, but its impact on postnatal outcomes is understudied. To evaluate whether fetal exposure to inflammation is associated with adverse pulmonary outcomes at 6 to 12 months' chronological age in infants born moderate to late preterm. Infants born between 32 and 36 weeks' gestational age were prospectively recruited (N = 184). Chorioamnionitis was diagnosed by placenta and umbilical cord histology. Select cytokines were measured in samples of cord blood. Validated pulmonary questionnaires were administered (n = 184), and infant pulmonary function testing was performed (n = 69) between 6 and 12 months' chronological age by the raised volume rapid thoracoabdominal compression technique. A total of 25% of participants had chorioamnionitis. Although infant pulmonary function testing variables were lower in infants born preterm compared with historical normative data for term infants, there were no differences between infants with chorioamnionitis (n = 20) and those without (n = 49). Boys and black infants had lower infant pulmonary function testing measurements than girls and white infants, respectively. Chorioamnionitis exposure was associated independently with wheeze (odds ratio [OR], 2.08) and respiratory-related physician visits (OR, 3.18) in the first year of life. Infants exposed to severe chorioamnionitis had increased levels of cord blood IL-6 and greater pulmonary morbidity at age 6 to 12 months than those exposed to mild chorioamnionitis. Elevated IL-6 was associated with significantly more respiratory problems (OR, 3.23). In infants born moderate or late preterm, elevated cord blood IL-6 and exposure to histologically identified chorioamnionitis was associated with respiratory morbidity during infancy without significant changes in infant pulmonary function testing measurements. Black compared with white and boy compared with girl infants had lower infant pulmonary function testing

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    BACKGROUND: The risk of cerebral palsy, the commonest physical disability of children in western Europe, is higher in infants of very low birthweight (VLBW)--those born weighing less than 1500 g--and those from multiple pregnancies than in infants of normal birthweight. An increasing proportion....... The frequency of cerebral palsy was higher in male than female babies in the group of birthweight 1000-1499 g (61.0 [53.8-68..2] vs 49.5 [42.8-56.2] per 1000 livebirths; p=0.0025) but not in the group of birthweight below 1000 g. INTERPRETATION: These data from a large population base provide evidence...

  16. The development of regional functional connectivity in preterm infants into early childhood.

    Science.gov (United States)

    Lee, Wayne; Morgan, Benjamin R; Shroff, Manohar M; Sled, John G; Taylor, Margot J

    2013-09-01

    Resting state networks are proposed to reflect the neuronal connectivity that underlies cognitive processes. Consequently, abnormal behaviour of these networks due to disease or altered development may predict poor cognitive outcome. To understand how very preterm birth may affect the development of resting state connectivity, we followed a cohort of very preterm-born infants from birth through to 4 years of age using resting state functional MRI. From a larger longitudinal cohort of infants born very preterm (regions and left and right temporal lobes, we investigated local and inter-region connectivity as a function of group and age. We found strong local connectivity during the preterm period, which matured into inter-hemispheric and preliminary default-mode network correlations by 4 years of age. This development is comparable to the resting state networks found in term-born infants of equivalent age. The results of this study suggest that differences in developmental trajectory between preterm-born and term-born infants are small and, if present, would require a large sample from both populations to be detected.

  17. Sex of the first-born and risk of preterm birth in the subsequent pregnancy

    DEFF Research Database (Denmark)

    Mortensen, Laust H; Nielsen, Henriette Svarre; Cnattingius, Sven

    2011-01-01

    BACKGROUND: Recent data suggest that the chance of successfully maintaining a pregnancy may be influenced by the sex of previously born children. We explored a possible relation between sex of the first-born infant and the risk of preterm birth in the second pregnancy. METHODS: Using data from...... the National Medical Birth Registries in Denmark 1980-2004 and Sweden 1980-2001, we selected all women whose first and second births were singleton and who had information on sex of first-born infant and gestational age for the second (Denmark, n = 393,686; Sweden, n = 603,282). Cox proportional hazards...... regression analysis was used to estimate the hazard ratio of preterm birth in the second pregnancy according to the sex of the first-born infant. RESULTS: Compared with women whose first baby was a girl, women with boys had an increased risk of preterm birth in a second pregnancy (hazard ratio = 1.10 [95...

  18. Mother, Father, and Infant as an Interactive System.

    Science.gov (United States)

    Pedersen, Frank A.

    This study investigates three types of reciprocal interactions among members of the family unit (father, mother and infant): father-infant interaction affecting child's development, father-infant interaction affecting mother's behavior, and husband-wife interaction affecting mother's behavior. Data from a sample of 39 healthy first-born infants…

  19. Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG-administered infants born to HBsAg positive mothers.

    Science.gov (United States)

    Zhou, Shan; Li, Tingting; Allain, Jean-Pierre; Zhou, Bin; Zhang, Yuming; Zhong, Mei; Fu, Yongshui; Li, Chengyao

    2017-12-01

    The status of chronic and occult HBV infection (OBI) in neonatal hepatitis B vaccine and immunoglobulin (HBIG) vaccinated infants born to HBsAg+ mothers was investigated at a major hospital in China. Seventy-seven and 15 blood samples were collected in first or second follow-up detection from the vaccinated babies aged 3-36 months born to 43 HBsAg+ or plus 25 HBeAg+ mothers. HBV infection was analyzed between the paired baby and mother by serology and DNA analysis. Among 77 children born to 68 HBsAg+ mothers, 3.9% (3/77) were HBsAg+, and 36.4% (28/77) were HBV DNA+/HBsAg- (OBIs) by a single PCR, respectively. Thirteen of 28 HBV DNA+/HBsAg- samples were conformed by two PCRs or S sequence, which accounted for 16.9% (13/77) of children. Three HBsAg+ and six OBIs were genotyped in consistent with their mother's HBV strains. Of 77 babies' blood samples, anti-HBs reactivity varied slightly according to age groups, while passively transmitted anti-HBc reactivity declined from 100% high reactivity at age 3-5 months to mostly negative at age ≥12 months. Babies with apparent OBI had higher levels of anti-HBc and lower levels of anti-HBs than those without OBI but all eight OBI babies with second follow-up samples became HBV DNA negative beyond 1 year of age. The vaccinated infants born to HBsAg+ mothers presented the low rate of HBsAg occurrence as vaccination failure and high frequency of viral persistence in the form of transient OBIs since no evidence of active HBV infection occurred beyond 1 year of age. © 2017 Wiley Periodicals, Inc.

  20. Neurodevelopment of preterm infants born at 28 to 36 weeks of gestational age: the role of hypothyroxinemia and long-term outcome at 4 years.

    Science.gov (United States)

    Ares, Susana; Quero, José; Diez, Jesus; Morreale de Escobar, Gabriella

    2011-01-01

    Hypothyroxinemia in premature neonates may affect long-term neurodevelopment. This study aimed to examine the effects of hypothyroxinemia of the newborn preterm infants born at 28-36 weeks of gestational age (GA) on the neurodevelopment at 4 years of age. Prospective observational cohort study conducted in Madrid, Spain. Forty-six preterm infants were included in the study. The effects of the exposure to neonatal hypothyroxinemia on mental development were examined. Using regression analyses we found that neonatal T4 had a positive association with general cognitive index and Verbal index, and neonatal FT4 with general cognitive and Memory indexes at 4 years of age. The exposure to hypothyroxinemia during the neonatal period of late preterm infants may play role in neurodevelopmental delays. Higher T4 level means a trend to higher indexes and low T4 level means a lower neurodevelopmental indexes at 4 years of age.

  1. Rethinking Stress in Parents of Preterm Infants: A Meta-Analysis

    Science.gov (United States)

    Schappin, Renske; Wijnroks, Lex; Uniken Venema, Monica M. A. T.; Jongmans, Marian J.

    2013-01-01

    Background With improved medical outcome in preterm infants, the psychosocial situation of their families is receiving increasing attention. For parents, the birth of a preterm infant is generally regarded as a stressful experience, and therefore many interventions are based on reducing parental stress. Nevertheless, it remains unclear whether parents of children born preterm experience more stress than parents of term-born children, which would justify these interventions. This meta-analysis provides a comprehensive account of parental stress in parents of preterm infants, from birth of the infant through to their adolescence. Mean levels of stress in specific domains of family functioning were investigated, and stress levels in parents of preterm and term infants, and fathers and mothers of preterm infants, were compared. Furthermore, we investigated moderators of parental stress. Methods and Findings A random-effects meta-analysis was conducted including 38 studies describing 3025 parents of preterm (stress was measured with two parent-reported questionnaires, the Parenting Stress Index and the Parental Stressor Scale: Neonatal Intensive Care Unit. The results indicate that parents of preterm-born children experience only slightly more stress than parents of term-born children, with small effect sizes. Furthermore, mothers have slightly more stress than fathers, but these effect sizes are also small. Parents report more stress for infants with lower gestational ages and lower birth weights. There is a strong effect for infant birth year, with decreasing parental stress from the 1980s onward, probably due to increased quality of care for preterm infants. Conclusions Based on our findings we argue that prematurity can best be regarded as one of the possible complications of birth, and not as a source of stress in itself. PMID:23405105

  2. Influence of post discharge nutrition on body composition at 6 years of age among children born very preterm

    DEFF Research Database (Denmark)

    Toftlund, Line Hedegaard; Zachariassen, Gitte; Agertoft, Lone

    Background Very preterm born infants receive nutrition that ensures optimal growth during the neonatal period. New research has shown that the type of nutrition in early life may affect not only growth but also later body composition and risk of developing metabolic syndrome. Aim • To evaluate...... if type of nutrition in early life effects the body composition in later life among very preterm born children Method In 2004-08 a birth cohort of very preterm born infants with a gestational age ≤32+0 weeks. At time of hospital discharge, the infants were randomised into 3 different feeding groups...

  3. Baby doe redux? The Department of Health and Human Services and the Born-Alive Infants Protection Act of 2002: a cautionary note on normative neonatal practice.

    Science.gov (United States)

    Sayeed, Sadath A

    2005-10-01

    screening examination under circumstances in which a "prudent layperson observer" could conclude from the infant's "appearance or behavior" that it was "suffering from an emergency medical condition." The memorandum fails to clarify which observers qualify as prudent, what infant appearance or behavior is relevant, or what defines an emergency medical condition. Because these evaluative criteria are not constrained by reference to relevant standards of medical care, the agency arguably substitutes a nonprofessional's presumed sagacious assessment of survivability for reasonable medical judgment. Indeed, under a straightforward reading of the instruction, a family member could conceivably trigger an investigation after observing a relative deliver a 20-week fetus who maintains a heartbeat for an hour before its death. Most physicians would not consider this an emergency medical condition and, rather than perform a screening examination, would provide comfort for the newborn and support for the family. The guideline, however, does not state that professional acumen trumps the layperson's observations in these instances; thus, physicians are left unclear about whether screening examinations are required for all newborns regardless of a priori, reasoned considerations of survivability. In this context, the NRP Steering Committee opinion states that "at the time of delivery... the medical condition and prognosis of the newly born infant should be assessed. At that point decisions about withholding or discontinuing medical treatment that is considered futile may be considered by... providers in conjunction with the parents acting in the best interest of their child." However, most pediatricians skilled in screening and resuscitation are not currently called on to perform this function when the gestational age of a nonviable fetus is reasonably certain before delivery. If under the law screening is now required at any gestational age, professional procedure immediately after

  4. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su Mi; Chai, Jee Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The aim of this study was to characterize the brain ultrasonographic findings of late-onset circulatory dysfunction (LCD) due to adrenal insufficiency (AI) in preterm infants. Among the 257 preterm infants born at <33 weeks of gestation between December 2009 and February 2014 at our institution, 35 preterm infants were diagnosed with AI. Brain ultrasonographic findings were retrospectively analyzed before and after LCD in 14 preterm infants, after exclusion of the other 21 infants with AI due to the following causes: death (n=2), early AI (n=5), sepsis (n=1), and patent ductus arteriosus (n=13). Fourteen of 257 infants (5.4%) were diagnosed with LCD due to AI. The age at LCD was a median of 18.5 days (range, 9 to 32 days). The last ultrasonographic findings before LCD occurred showed grade 1 periventricular echogenicity (PVE) in all 14 patients and germinal matrix hemorrhage (GMH) with focal cystic change in one patient. Ultrasonographic findings after LCD demonstrated no significant change in grade 1 PVE and no new lesions in eight (57%), grade 1 PVE with newly appearing GMH in three (21%), and increased PVE in three (21%) infants. Five infants (36%) showed new development (n=4) or increased size (n=1) of GMH. Two of three infants (14%) with increased PVE developed cystic periventricular leukomalacia (PVL) and rapid progression to macrocystic encephalomalacia. LCD due to AI may be associated with the late development of GMH, increased PVE after LCD, and cystic PVL with rapid progression to macrocystic encephalomalacia.

  5. Infant, maternal, and geographic factors influencing gastroschisis related mortality in Zimbabwe.

    Science.gov (United States)

    Apfeld, Jordan C; Wren, Sherry M; Macheka, Nyasha; Mbuwayesango, Bothwell A; Bruzoni, Matias; Sylvester, Karl G; Kastenberg, Zachary J

    2015-12-01

    Survival for infants with gastroschisis in developed countries has improved dramatically in recent decades with reported mortality rates of 4-7%. Conversely, mortality rates for gastroschisis in sub-Saharan Africa remain as great as 60% in contemporary series. This study describes the burden of gastroschisis at the major pediatric hospital in Zimbabwe with the goal of identifying modifiable factors influencing gastroschisis-related infant mortality. We performed a retrospective cohort study of all cases of gastroschisis admitted to Harare Children's Hospital in 2013. Univariate and multivariate analyses were performed to describe infant, maternal, and geographic factors influencing survival. A total of 5,585 neonatal unit admissions were identified including 95 (1.7%) infants born with gastroschisis. Gastroschisis-related mortality was 84% (n = 80). Of infants with gastroschisis, 96% (n = 91) were born outside Harare Hospital, 82% (n = 78) were born outside Harare Province, and 23% (n = 25) were home births. The unadjusted odds of survival for these neonates with gastroschisis were decreased for low birth weight infants (age; OR, 0.06; 95% CI, 0.01-0.50), and for those born to teenage mothers (age; OR, 0.05; 95% CI, 0.01-0.46). There was also a trend toward decreased odds of survival for home births (OR, 0.16; 95% CI, 0.02-1.34) and for those born outside Harare Province (OR, 0.35; 95% CI, 0.10-1.22). Gastroschisis-related infant mortality in Zimbabwe is associated with well-known risk factors, including low birth weight, prematurity, and teenage mothers. However, modifiable factors identified in this study signify potential opportunities for developing innovative approaches to perinatal care in such a resource-constrained environment. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The newborn period problems of the infants born to diabetic mothers

    Directory of Open Access Journals (Sweden)

    Deniz Anuk ince

    2014-09-01

    Results: A total of 31 infants were included. The incidence of insulin dependent diabetes mellitus was %22,6 and the incidence of gestational diabetes was %77,4. Mothers' mean age was 32,6+/-7,9 years and HbA1c level was 5,4+/-1 (4,2-10,2. The mean gestational age of infants was 37,5+/-1,5 weeks and the mean birth weight of infants was 3322,5+/- 695,8 g. Macrosomia was present in 32.2% of infants. Hypoglycemia was present in 9,7% of infants, hypocalcemia was seen 3.2%, polycytemia was seen 6.5%, anemia was seen 6.5%, thrombocytopenia was seen 9.2%, hyperbilirubinemia was seen 41.9%, respiratory distress syndrome was seen 12.9%, congenital anomaly was seen 3.7% of all infants. There was no correlation between HbA1c levels of mothers and hypoglycemia, hypocalcemia, anemia and respiratory distress syndrome. Conclusion: Many complications may be prevented with appropriate management, obstetric care and neonatal management. It is possible to reduce morbidities with the identification of gestational diabetes and metabolic control of hyperglycemia, the determination of risk factors, the close contact between the diabetic mother and her infant in the first hours of delivery and the close follow-up of infants of diabetic mothers with rooming-in who do not need neonatal intensive care unit care. [J Contemp Med 2014; 4(3.000: 115-120

  7. For Debate: Growth Hormone Treatment of Infants Born Small for Gestational Age should be Started at or before the First Year of Age.

    Science.gov (United States)

    Laron, Zvi; Laron-Kenet, Tamar; Klinger, Gil

    2016-12-01

    Children born small for gestational age without early catch-up of somatic growth and head circumference subsequently remain short and suffer from various degrees of neurocognitive and psychological impairment. Based upon the role of growth hormone (GH) and insulin-like growth factor-I on early brain growth and maturation, we propose that GH treatment of these infants be instituted prior to their 2nd birthday. Copyright© of YS Medical Media ltd.

  8. The relationship between planned and reported home infant sleep locations among mothers of late preterm and term infants.

    Science.gov (United States)

    Tully, Kristin P; Holditch-Davis, Diane; Brandon, Debra

    2015-07-01

    To compare maternal report of planned and practiced home sleep locations of infants born late preterm (34 0/7 to 36 6/7 gestational weeks) with those infants born term (≥37 0/7 gestational weeks) over the first postpartum month. Open-ended semi-structured maternal interviews were conducted in a US hospital following birth and by phone at 1 month postpartum during 2010-2012. Participants were 56 mother-infant dyads: 26 late preterm and 30 term. Most women planned to room share at home with their infants and reported doing so for some or all of the first postpartum month. More women reported bed sharing during the first postpartum month than had planned to do so in both the late preterm and term groups. The primary reason for unplanned bed sharing was to soothe nighttime infant fussiness. Those participants who avoided bed sharing at home commonly discussed their fear for infant safety. A few parents reported their infants were sleeping propped on pillows and co-sleeping on a recliner. Some women in both the late preterm and term groups reported lack of opportunity to obtain a bassinet prior to childbirth. The discrepancy between plans for infant sleep location at home and maternally reported practices were similar in late preterm and term groups. Close maternal proximity to their infants at night was derived from the need to assess infant well-being, caring for infants, and women's preferences. Bed sharing concerns related to infant safety and the establishment of an undesirable habit, and alternative arrangements included shared recliner sleep.

  9. Mapping the critical gestational age at birth that alters brain development in preterm-born infants using multi-modal MRI.

    Science.gov (United States)

    Wu, Dan; Chang, Linda; Akazawa, Kentaro; Oishi, Kumiko; Skranes, Jon; Ernst, Thomas; Oishi, Kenichi

    2017-04-01

    Preterm birth adversely affects postnatal brain development. In order to investigate the critical gestational age at birth (GAB) that alters the developmental trajectory of gray and white matter structures in the brain, we investigated diffusion tensor and quantitative T2 mapping data in 43 term-born and 43 preterm-born infants. A novel multivariate linear model-the change point model, was applied to detect change points in fractional anisotropy, mean diffusivity, and T2 relaxation time. Change points captured the "critical" GAB value associated with a change in the linear relation between GAB and MRI measures. The analysis was performed in 126 regions across the whole brain using an atlas-based image quantification approach to investigate the spatial pattern of the critical GAB. Our results demonstrate that the critical GABs are region- and modality-specific, generally following a central-to-peripheral and bottom-to-top order of structural development. This study may offer unique insights into the postnatal neurological development associated with differential degrees of preterm birth. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Modification of stool's water content in constipated infants: management with an adapted infant formula

    Directory of Open Access Journals (Sweden)

    Alvarez Marina M

    2011-05-01

    Full Text Available Abstract Background Constipation is a common occurrence in formula-fed infants. The aim of this preliminary study was to evaluate the impact of a formula with high levels of lactose and magnesium, in compliance with the official regulations, on stool water content, as well as a parental assessment of constipation. Materials and methods Thirty healthy term-born, formula-fed infants, aged 4-10 weeks, with functional constipation were included. All infants were full-term and fed standard formula. Exclusion criteria were preterm and/or low birth weight, organic constipation, being breast fed or fed a formula specially designed to treat constipation. Stool composition was measured by near-infrared reflectance analysis (NIRA and parents answered questions about crying associated with defecation and stool consistency at baseline and after two weeks of the adapted formula. Results After 2 weeks of the adapted formula, stool water content increased from 71 +/- 8.1% to 84 +/- 5.9%, (p Conclusions This preliminary study suggests that an adapted formula with high levels of lactose and magnesium increases stool water content and improves symptoms of constipation in term-born, formula-fed infants. A larger randomized placebo-controlled trial is indicated.

  11. Tick-borne pathogen – Reversed and conventional discovery of disease

    Directory of Open Access Journals (Sweden)

    Ellen eTijsse Klasen

    2014-07-01

    Full Text Available Molecular methods have increased the number of known microorganisms associated with ticks significantly. Some of these newly identified microorganisms are readily linked to human disease while others are yet unknown to cause human disease. The face of tick-borne disease discovery has changed with more diseases now being discovered in a ‘reversed way’, detecting disease cases only years after the tick-borne microorganism was first discovered. Compared to the conventional discovery of infectious diseases, this order of discoveries presents researchers with new challenges. Especially estimating public health risks of such agents is challenging, as case definitions and diagnostic procedures may initially be missing. We discuss the advantages and shortcomings of molecular methods, serology, epidemiological studies that might be used to study some fundamental questions regarding newly identified tick-borne diseases. With increased tick-exposure and improved detection methods, more tick-borne microorganisms will be added to the list of pathogens causing disease in humans in future.

  12. Risk factors for wheezing in infants born in Cuba.

    Science.gov (United States)

    Venero-Fernández, S J; Suárez-Medina, R; Mora-Faife, E C; García-García, G; Valle-Infante, I; Gómez-Marrero, L; Abreu-Suárez, G; González-Valdez, J; Fabró-Ortiz, D Dania; Fundora-Hernández, H; Venn, A; Britton, J; Fogarty, A W

    2013-11-01

    Cuba is a unique country, and despite limited economic development, has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high. As early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheezing in Cuban infants. Cross-sectional study. A random sample of 2032 children aged 12-15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers. Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of emergency services was 30% and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema [odds ratio (OR) 2.09; 95% confidence interval (CI) 1.48-2.94], family history of asthma (OR 2.05; 95% CI 1.60-2.62), poor ventilation in the house (OR 1.99; 95% CI 1.48-2.67), attendance at nursery (OR 1.78; 95% CI 1.24-2.57), male sex (OR1.52; 95% CI 1.19-1.96) and the number of smokers in the house (P Cuba. As the prevalence of smoking in the house is high (51%), intervention studies are required to determine effective strategies to improve infant health.

  13. A predictive model for respiratory syncytial virus (RSV hospitalisation of premature infants born at 33–35 weeks of gestational age, based on data from the Spanish FLIP study

    Directory of Open Access Journals (Sweden)

    Figueras-Aloy Jose

    2008-12-01

    Full Text Available Abstract Background The aim of this study, conducted in Europe, was to develop a validated risk factor based model to predict RSV-related hospitalisation in premature infants born 33–35 weeks' gestational age (GA. Methods The predictive model was developed using risk factors captured in the Spanish FLIP dataset, a case-control study of 183 premature infants born between 33–35 weeks' GA who were hospitalised with RSV, and 371 age-matched controls. The model was validated internally by 100-fold bootstrapping. Discriminant function analysis was used to analyse combinations of risk factors to predict RSV hospitalisation. Successive models were chosen that had the highest probability for discriminating between hospitalised and non-hospitalised infants. Receiver operating characteristic (ROC curves were plotted. Results An initial 15 variable model was produced with a discriminant function of 72% and an area under the ROC curve of 0.795. A step-wise reduction exercise, alongside recalculations of some variables, produced a final model consisting of 7 variables: birth ± 10 weeks of start of season, birth weight, breast feeding for ≤ 2 months, siblings ≥ 2 years, family members with atopy, family members with wheeze, and gender. The discrimination of this model was 71% and the area under the ROC curve was 0.791. At the 0.75 sensitivity intercept, the false positive fraction was 0.33. The 100-fold bootstrapping resulted in a mean discriminant function of 72% (standard deviation: 2.18 and a median area under the ROC curve of 0.785 (range: 0.768–0.790, indicating a good internal validation. The calculated NNT for intervention to treat all at risk patients with a 75% level of protection was 11.7 (95% confidence interval: 9.5–13.6. Conclusion A robust model based on seven risk factors was developed, which is able to predict which premature infants born between 33–35 weeks' GA are at highest risk of hospitalisation from RSV. The model could be

  14. Altered Intracellular ATP Production by Activated CD4+ T-Cells in Very Preterm Infants

    Directory of Open Access Journals (Sweden)

    Giulia Aquilano

    2016-01-01

    Full Text Available Background. The neonatal immune system is not fully developed at birth; newborns have adequate lymphocytes counts but these cells lack function. Objective. To assess the activity of T-cells and the influence of the main perinatal factors in very preterm infants (birth weight < 1500 g. Design. Blood samples from 59 preterm infants (21/59 were dizygotic twins were collected at birth and at 30 days of life to measure CD4+ T-cell activity using the ImmuKnow™ assay. Fifteen healthy adults were included as a control group. Results. CD4+ T-cell activity was lower in VLBW infants compared with adults (p<0.001. Twins showed lower immune activity compared to singletons (p=0.005. Infants born vaginally showed higher CD4+ T-cell activity compared to those born by C-section (p=0.031; infants born after prolonged Premature Rupture of Membranes (pPROM showed higher CD4+ T-cell activity at birth (p=0.002 compared to infants born without pPROM. Low CD4+ T-cell activity at birth is associated with necrotizing enterocolitis (NEC in the first week of life (p=0.049. Conclusions. Preterm infants show a lack in CD4+ T-cell activity at birth. Perinatal factors such as intrauterine inflammation, mode of delivery, and zygosity can influence the adaptive immune activation capacity at birth and can contribute to exposing these infants to serious complications such as NEC.

  15. Infant mortality and causes of infant deaths in rural Ethiopia: a population-based cohort of 3684 births.

    Science.gov (United States)

    Weldearegawi, Berhe; Melaku, Yohannes Adama; Abera, Semaw Ferede; Ashebir, Yemane; Haile, Fisaha; Mulugeta, Afework; Eshetu, Frehiwot; Spigt, Mark

    2015-08-11

    Ethiopia has made large-scale healthcare investments to improve child health and survival. However, there is insufficient population level data on the current estimates of infant mortality rate (IMR) in the country. The aim of this study was to measure infant mortality rate, investigate risk factors for infant deaths and identify causes of death in a rural population of northern Ethiopia. Live births to a cohort of mothers under the Kilite Awlaelo Health and Demographic Surveillance System were followed up to their first birthday or death, between September 11, 2009 and September 10, 2013. Maternal and infant characteristics were collected at baseline and during the regular follow-up visit. Multiple-Cox regression was used to investigate risk factors for infant death. Causes of infant death were identified using physician review verbal autopsy method. Of the total 3684 infants followed, 174 of them died before their first birthday, yielding an IMR of 47 per 1000 live births (95 % CI: 41, 54) over the four years of follow-up. About 96 % of infants survived up to their first birthday, and 56 % of infant deaths occurred during the neonatal period. Infants born to mothers aged 15-19 years old had higher risk of death (HR = 2.68, 95 % CI: 1. 74, 4.87) than those born to 25-29 years old. Infants of mothers who attained a secondary school and above had 56 % lower risk of death (HR = 0.44, 95 % CI: 0.24, 0.81) compared to those whose mothers did not attend formal education. Sepsis, prematurity and asphyxia and acute lower respiratory tract infections were the commonest causes of death. The IMR for the four-year period was lower than the national and regional estimates. Our findings suggest the need to improve the newborn care, and empower teenagers to delay teenage pregnancy and attain higher levels of education.

  16. Infants of Narcotic Addicted Mothers: Developmental Status, Maternal Care, Home Environments and Interventive Efforts During the First Three Months of Life.

    Science.gov (United States)

    Derrick, Sara M.; Hock, Ellen

    This study compared infants born to narcotic addicted mothers with infants born to nonaddicted mothers and described the potential of an intervention program. Infants of five addicted women were matched with infants of five nonaddicted women on the basis of age and socioeconomic class of the mothers and on the basis of gestational ages, birth…

  17. High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants.

    Science.gov (United States)

    Fjørtoft, Toril; Evensen, Kari Anne I; Øberg, Gunn Kristin; Songstad, Nils Thomas; Labori, Cathrine; Silberg, Inger Elisabeth; Loennecken, Marianne; Møinichen, Unn Inger; Vågen, Randi; Støen, Ragnhild; Adde, Lars

    2016-03-01

    To compare early motor repertoire between extremely preterm and term-born infants. An association between the motor repertoire and gestational age and birth weight was explored in extremely preterm infants without severe ultrasound abnormalities. In a multicentre study, the early motor repertoire of 82 infants born extremely preterm (ELGAN:<28 weeks) and/or with extremely low birth weight (ELBW:<1000 g) and 87 term-born infants were assessed by the "Assessment of Motor Repertoire - 2 to 5 Months" (AMR) which is part of Prechtl's "General Movement Assessment", at 12 weeks post-term age. Fidgety movements were classified as normal if present and abnormal if absent, sporadic or exaggerated. Concurrent motor repertoire was classified as normal if smooth and fluent and abnormal if monotonous, stiff, jerky and/or predominantly fast or slow. Eight-teen ELBW/ELGAN infants had abnormal fidgety movements (8 absent, 7 sporadic and 3 exaggerated fidgety movements) compared with 2 control infants (OR:12.0; 95%CI:2.7-53.4) and 46 ELBW/ELGAN infants had abnormal concurrent motor repertoire compared with 17 control infants (OR:5.3; 95%CI:2.6-10.5). Almost all detailed aspects of the AMR differed between the groups. Results were the same when three infants with severe ultrasound abnormalities were excluded. In the remaining ELBW/ELGAN infants, there was no association between motor repertoire and gestational age or birth weight. ELBW/ELGAN infants had poorer quality of early motor repertoire than term-born infants.The findings were not explained by severe abnormalities on neonatal ultrasound scans and were not correlated to the degree of prematurity. The consequences of these abnormal movement patterns remain to be seen in future follow-up studies. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  18. Congenital and nosocomial sepsis in infants born in a regional perinatal unit: cause, outcome, and white blood cell response.

    Science.gov (United States)

    Ohlsson, A; Vearncombe, M

    1987-02-01

    The incidence, cause, and outcome of sepsis and the white blood cell response were studied in 6315 infants born in a regional perinatal unit. The incidence of neonatal sepsis was 6.5 per 1000 live births. Congenital sepsis (12 cases) was overwhelming, with associated maternal infection (92%), neutropenia (75%), and high rate of mortality (50%). The most common organism was Escherichia coli (58%). Gestational age and birth weight were similar in survivors and nonsurvivors. There was a strong correlation between total white blood cell count and both mature and immature neutrophil counts in survivors but this correlation decreased substantially in neonates that died. Analysis of variance indicated that the means for polymorphonuclear leukocyte and immature neutrophil counts were significantly higher in survivors. Nosocomial sepsis (38 cases) occurred in premature low birth weight infants receiving invasive, intensive care. The most common organism was Staphylococcus epidermidis (76%). Total white blood cell, polymorphonuclear leukocyte, and immature neutrophil counts rose significantly in response to sepsis. None died. Prevention of congenital sepsis requires methods to detect early maternal-fetal infection. Providing granulocytes to neutropenic neonates with congenital sepsis might improve outcome.

  19. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age

    NARCIS (Netherlands)

    de Bie, Henrica M. A.; de Ruiter, Michiel B.; Ouwendijk, Mieke; Oostrom, Kim J.; Wilke, Marko; Boersma, Maria; Veltman, Dick J.; Delemarre-van de Waal, Henriette A.

    2015-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic

  20. Cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers.

    Science.gov (United States)

    Vela-Huerta, M; Aguilera-López, A; Alarcón-Santos, S; Amador, N; Aldana-Valenzuela, C; Heredia, A

    2007-09-01

    To compare cardiopulmonary adaptation in large for gestational age infants of diabetic and nondiabetic mothers. Color Doppler echocardiography was performed in 113 (22 large for gestational age infants of diabetic mothers, 21 of nondiabetic mothers and 70 adequate for gestational age newborns) full-term infants. Pulmonary arterial pressure was significantly higher in infants of diabetic mothers than in those of nondiabetic mothers and normal infants at 24 h (38.5 vs. 32.5, and 35.5 mmHg, respectively). However, slow fall in this parameter was shown in all large for gestational age infants. Open ductus arteriosus was frequent in all large for gestational age infants, but its closure was significantly delayed in infants of diabetic mothers. Septal hypertrophy was higher in infants of diabetic mothers than in large for gestational age infants of nondiabetic mothers. Large for gestational age infants born from nondiabetic mothers showed delayed fall in pulmonary arterial pressure similar to those born from diabetic mothers but showed lower proportion of septal hypertrophy. Patent ductus arteriosus persisted for longer period of time in all large for gestational age infants than in normal infants, but its closure was significantly delayed in infants of diabetic mothers.

  1. Gene expression in placentas from nondiabetic women giving birth to large for gestational age infants

    NARCIS (Netherlands)

    Ahlsson, F.; Åkerud, H.; Schijven, D.; Olivier, J.; Sundstrom-Poromaa, I.

    2015-01-01

    Gestational diabetes, obesity, and excessive weight gain are known independent risk factors for the birth of a large for gestational age (LGA) infant. However, only 1 of the 10 infants born LGA is born by mothers with diabetes or obesity. Thus, the aim of the present study was to compare placental

  2. A study of neonatal body weight and colonization of Ureaplasma Urealiticum on the new borns

    Directory of Open Access Journals (Sweden)

    Ghazi Saidi K

    1997-04-01

    Full Text Available Ureaplasma urealyticum is an important cause in habital abortion, perinatal, death chorioamnionitis and low birth weight. In this study, 163 specimens obtained from neonates who have borned in the two university hospital of Tehran. 240 new born infant had the weight less than or equal 2500 g (low birth weight and others had more than 2500 g (from the total in 37 cases, ureaplasma urealyticum colonized and 126 cases were responded negative. From these positive cases 9 were L.B.W (two birth weight and 28 were normal weight and from the negative cases. 15 had L.B.W and 111 had normal weight. Finally with the 5% probability of error byK square (K² test. Two factors, colonization and weight of new born infant show the correlation. Sampling location, the age of mothers, and the position of chorioamnions are three factors that were studied. Two factors of the above do not display correlation about normal infant and L.B.W.

  3. Babies at Double Jeopardy: Medically Fragile Infants and Child Neglect

    Science.gov (United States)

    Fullar, Suzanne A.

    2008-01-01

    Medically fragile infants, those born prematurely or with other complex medical or genetic problems, are at risk of long-term health and developmental problems. When a medically fragile infant comes home to a family with significant social problems such as domestic violence, mental illness, or substance abuse, the infant is at double jeopardy--at…

  4. Tracing Trajectories of Audio-Visual Learning in the Infant Brain

    Science.gov (United States)

    Kersey, Alyssa J.; Emberson, Lauren L.

    2017-01-01

    Although infants begin learning about their environment before they are born, little is known about how the infant brain changes during learning. Here, we take the initial steps in documenting how the neural responses in the brain change as infants learn to associate audio and visual stimuli. Using functional near-infrared spectroscopy (fNRIS) to…

  5. Retrospective cohort study of all deaths among infants born between 22 and 27 completed weeks of gestation in Switzerland over a 3-year period.

    Science.gov (United States)

    Berger, T M; Steurer, M A; Bucher, H U; Fauchère, J C; Adams, M; Pfister, R E; Baumann-Hölzle, R; Bassler, D

    2017-06-15

    The aim of this research is to assess causes and circumstances of deaths in extremely low gestational age neonates (ELGANs) born in Switzerland over a 3-year period. Population-based, retrospective cohort study. All nine level III perinatal centres (neonatal intensive care units (NICUs) and affiliated obstetrical services) in Switzerland. ELGANs with a gestational age (GA) Switzerland, most deaths among infants born at less than 24 weeks of gestation occurred in the delivery room. In contrast, most deaths of ELGANs with a GA ≥24 weeks were observed following unrestricted provisional intensive care, end-of-life decision-making and redirection of care in the NICU regardless of the degree of immaturity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Early psychomotor development of low-risk preterm infants: Influence of gestational age and gender.

    Science.gov (United States)

    Romeo, Domenico M; Brogna, Claudia; Sini, Francesca; Romeo, Mario G; Cota, Francesco; Ricci, Daniela

    2016-07-01

    The influence of gestational age and gender in the neurodevelopment of infants during the first year of age is not yet fully elucidated. The purpose of this study was to identify the early occurrence of neurodevelopmental differences, between very preterm, late preterm and term born infants and the possible influence of the gender on the neurodevelopment in early infancy. A total of 188 low-risk infants, 69 very preterms, 71 late-preterms, and 48 term infants were assessed at 3, 6, 9, 12 months corrected age using the Hammersmith Infant Neurological Examination (HINE). At two years of age infants performed the Mental Developmental Index (MDI) of the Bayley Scales of Infant Development. The main results indicate that both very preterms and late-preterms showed significant lower global scores than term born infants at each evaluation (p development of infants assessed during the first 2 years of life. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  7. 24-month HIV-free survival among infants born to HIV-positive women enrolled in Option B+ program in Kigali, Rwanda: The Kabeho Study.

    Science.gov (United States)

    Gill, Michelle M; Hoffman, Heather J; Ndatimana, Dieudonne; Mugwaneza, Placidie; Guay, Laura; Ndayisaba, Gilles F; Bobrow, Emily A; Asiimwe, Anita; Mofenson, Lynne M

    2017-12-01

    Lifelong antiretroviral therapy (ART) provision to all pregnant HIV-positive women ("Option B+") has been recommended by the World Health Organization since 2013, but there remain limited data on the effects of Option B+ on long-term HIV-free survival in breastfeeding HIV-exposed infants. The Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) study enrolled HIV-positive women from the third trimester of pregnancy to 2 weeks postpartum in 14 heath facilities implementing Option B+ in Kigali, Rwanda. Mother-child pairs in the longitudinal observational cohort were followed until 24 months postpartum, with HIV diagnostic testing at 6 weeks, and 9, 18 and 24 months. The Kaplan-Meier method was used to estimate HIV transmission, survival, and HIV-free survival through 24 months. We enrolled 608 HIV-positive women in 2013-2014; birth outcome data were available for 600 women and 597 live-born infants. By 6 weeks, 11 infants had died and 3 infants had confirmed HIV infection (0.5% transmission; 95% confidence interval [CI] 0.2-1.6). At 9 months, there were 9 additional deaths and 2 new infections (cumulative transmission 0.9%, 95% CI 0.4-2.2). At 18 months, there were 6 additional deaths and no new infant infections. At 24 months, there were no additional child deaths and 1 new infection (cumulative 2.2%, 95% CI 0.7-7.0), for an overall 24-month HIV-free survival of 93.2% (95% CI 89.5-95.6). Low transmission rates and high HIV-free survival at 24 months were achieved in breastfeeding infants of HIV-positive mothers receiving universal ART in urban health facilities in Rwanda, though vigilance on maintaining viral suppression for ART-experienced women is needed. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  8. Premature infants' health at multiple induced pregnancy.

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2015-09-01

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

  9. 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

  10. Gas Velocities Reveal Newly Born Planets in a Disk

    Science.gov (United States)

    Kohler, Susanna

    2018-06-01

    , which can be reproduced by the presence of a 2-Jupiter-mass planet at 260 AU. [Pinte et al. 2018]Watching Gas MoveIn two papers published today in ApJL one led by Richard Teague (University of Michigan) and the other led by Christophe Pinte (Monash University in Australia and Grenoble Alpes University in France) astronomers have announced the detection of distinctive signs of planets in the gas motion of the disk surrounding HD 163296. This young star, located about 330 light-years away, is only 4 million years old.Unlike studies that hinge on observations of a disks dust which only makes up 1% of the disks mass! both studies here took a new approach: they used detailed ALMA observations revealing the dynamics of the disks carbon monoxide gas. By studying the gass motion, the teams found deviations from the Keplerian velocity that would be expected if there were no planets present. The authors then ran simulations to demonstrate that the deviations are consistent with local pressure perturbations caused by the passage of giant planets.Rotational velocity deviations due to changes in the local pressure, caused in this simulation by the presence of planets. [Teague et al. 2018]Giants FoundWhat did they find? Teague and collaborators, whose technique to identify velocity variations is best suited to explore the inner regions of the disk, discovered evidence for two separate Jupiter-mass planets orbiting at distances of 83 AU and 137 AU in the disk. Pinte and collaborators, whose velocity-measurement technique better explores the outer regions of the disk, found evidence for a two-Jupiter-mass planet orbiting at 260 AU.These results will rely on additional imaging in the coming years to confirm the presence of these newly born planets and a detection of point sources at these radii remains a hopeful goal for the future. Nonetheless, the new techniques explored here by Teague, Pinte, and collaborators are a promising route for young exoplanet discovery and characterization

  11. Survival of infants and children born to women who died from ...

    African Journals Online (AJOL)

    Factors favouring infant survival include nursing, up-bringing and breast-feeding by a surrogate mother (who is usually either the deceased's sister or mother), infant feeding with goat's or cow's milk, Immunization, hospital treatment of aliments, hospital delivery or maternal death in the hospital and finally when the caretaker ...

  12. Delivery room management of extremely preterm infants: the EPIPAGE-2 study.

    Science.gov (United States)

    Perlbarg, J; Ancel, P Y; Khoshnood, B; Durox, M; Boileau, P; Garel, M; Kaminski, M; Goffinet, F; Foix-L'Hélias, L

    2016-09-01

    To analyse the delivery room management of babies born between 22 and 26 weeks of completed gestational age and to identify the factors associated with the withholding or withdrawal of intensive care. Population-based cohort study. Our study population comprised 2145 births between 22 and 26 completed weeks enrolled in the EPIPAGE-2 study, a French cohort of very preterm infants born in 2011. The primary outcome measure was withholding or withdrawal of intensive care in the delivery room. Among infants born alive at 22-23 weeks, intensive care was withheld or withdrawn for >90%. At 24 weeks, resuscitative measures were withheld or withdrawn for 38%, at 25 weeks for 8% and at 26 weeks for 3%. Other factors besides gestational age at birth associated with this withholding or withdrawal for infants born at 24-26 weeks were birth weight rates of withholding or withdrawal of intensive care varied substantially between maternity units (from 0% to 100%), the variability was primarily explained by differences in distributions of gestational age at birth. Although gestational age is only one factor predicting survival of preterm infants, practices in France appear to be based primarily on this factor, which thus has direct effects on the survival of extremely preterm infants. The ethical implications of basing life and death decisions only on gestational age before 25 weeks require further examination. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Mortality among infants with congenital malformations, New York State, 1983 to 1988.

    Science.gov (United States)

    Druschel, C; Hughes, J P; Olsen, C

    1996-01-01

    OBJECTIVE. The authors examined first-year mortality and risk factors for mortality among infants with major congenital malformations. METHODS. Infants with major congenital malformations born from 1983 to 1988 were identified from a statewide population-based congenital malformations registry. Variables analyzed included year of birth, birth weight, gestational age, infant sex, number of malformations, number of organ systems involved, level of care of the birth hospital, maternal age, maternal education, and maternal ethnicity. RESULTS. Infants with major malformations had a risk of death 6.3 times higher than the general population of live births. The risk declined from 6.5 in 1983 to 5.9 in 1988. Birth weight and number of malformations were the strongest risk factors. The likelihood of survival was similar for white and black infants. CONCLUSIONS. Being born with a malformation outweighs most of the other risks for infant mortality. Children with congenital malformations had higher cause-specific mortality for all causes except injury. PMID:8711105

  14. Postural control of small for gestational age infants born at term Controle postural de lactentes nascidos a termo pequenos para a idade gestacional

    Directory of Open Access Journals (Sweden)

    D Campos

    2007-02-01

    Full Text Available OBJECTIVE: This study compared the postural control of small (SGA and appropriate (AGA for gestational age infants born at term, at the ages of 3, 6, 9 and 12 months. METHOD: This was a cohort study of infants born at term, with birth weight less than the 10th percentile for the SGA group and between the 10th and 90th percentiles for the AGA group. Infants with genetic syndromes, malformations, congenital infections and internment in neonatal intensive care unit were excluded. The evaluation instrument was the Alberta Infant Motor Scale. RESULTS: Comparison of the SGA and AGA groups did not show any significant differences (p>0.05 at the assessment times. However, the postural control of the SGA group was influenced by the gestational age (r=-0.83; p= 0.006 and 5th minute Apgar (r= 0.79; p= 0.01 in the 3rd month, and by maternal occupation (r= 0.67; p= 0.01 in the 6th month. CONCLUSION: It was concluded that the postural control was similar in the groups. However, the postural control of the SGA group was influenced by biological and environmental factors.OBJETIVO: Este estudo teve por objetivo comparar o controle postural de lactentes nascidos a termo, pequenos (PIG e adequados para a idade gestacional (AIG nos 3º, 6º, 9º e 12º meses. MÉTODO: Estudo longitudinal de lactentes nascidos a termo, com peso de nascimento menor que o percentil 10 para o grupo PIG e entre o percentil 10 e 90 para o grupo AIG. Síndromes genéticas, más-formações, infecções congênitas e internados em unidade de terapia intensiva neonatal foram excluídos. O instrumento de avaliação foi Alberta Infant Motor Scale. RESULTADOS: A comparação do grupo PIG e AIG não mostrou diferença significativa (p> 0,05 nos meses avaliados. Entretanto, o controle postural do grupo PIG foi influenciado pela idade gestacional (r= -0,83/p= 0,006 e Apgar de 5' (r= 0,79/p= 0,01 no 3º mês; e pela ocupação materna (r= 0,67/p= 0,01 no 6º mês. CONCLUSÃO: Concluiu-se que o

  15. Risk factors for bronchopulmonary dysplasia in neonates born at ≤ 1500 g (1999-2009).

    Science.gov (United States)

    Zhang, Hongshan; Fang, Jianpei; Su, Haobin; Chen, Miao

    2011-12-01

    Advances in perinatal care have improved the survival rate for very low-birthweight (VLBW) infants in China. The incidence of bronchopulmonary dysplasia (BPD), however, has not been reduced. The objective of the present study was to identify the perinatal risk factors for BPD in neonates born at ≤ 1500 g. A retrospective analysis of data for neonates born at ≤ 1500 g between 1999 and 2009 in the neonatal intensive care unit (NICU) of Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou city, China, was carried out. Out of a total of 11,506 live births, 3538 infants were admitted to level II nursery and NICU (level III nursery). Among 149 preterm infants born at ≤ 1500 g, 77.8% survived until day 28, and the incidence of BPD was 48.3%. Logistic regression analysis showed that gestational age (GA) ≤ 30 weeks (odds ratio [OR], 9.507; 95% confidence intervals [95%CI]: 2.604-34.707), maternal chorioamnionitis (OR, 41.987; 95%CI: 6.048-291.492), ventilation-associated pneumonia (OR, 11.600; 95%CI: 2.847-47.268), and more than three blood transfusions (OR, 10.214; 95%CI: 2.191-47.623) were associated with the development of BPD. Clinical evidence has been provided for possibly significant risk factors associated with BPD in neonates born at ≤ 1500 g, which can provide useful information for further research to improve survival of VLBW infants and decrease the incidence of BPD. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  16. Test-retest reliability of computer-based video analysis of general movements in healthy term-born infants.

    Science.gov (United States)

    Valle, Susanne Collier; Støen, Ragnhild; Sæther, Rannei; Jensenius, Alexander Refsum; Adde, Lars

    2015-10-01

    A computer-based video analysis has recently been presented for quantitative assessment of general movements (GMs). This method's test-retest reliability, however, has not yet been evaluated. The aim of the current study was to evaluate the test-retest reliability of computer-based video analysis of GMs, and to explore the association between computer-based video analysis and the temporal organization of fidgety movements (FMs). Test-retest reliability study. 75 healthy, term-born infants were recorded twice the same day during the FMs period using a standardized video set-up. The computer-based movement variables "quantity of motion mean" (Qmean), "quantity of motion standard deviation" (QSD) and "centroid of motion standard deviation" (CSD) were analyzed, reflecting the amount of motion and the variability of the spatial center of motion of the infant, respectively. In addition, the association between the variable CSD and the temporal organization of FMs was explored. Intraclass correlation coefficients (ICC 1.1 and ICC 3.1) were calculated to assess test-retest reliability. The ICC values for the variables CSD, Qmean and QSD were 0.80, 0.80 and 0.86 for ICC (1.1), respectively; and 0.80, 0.86 and 0.90 for ICC (3.1), respectively. There were significantly lower CSD values in the recordings with continual FMs compared to the recordings with intermittent FMs (ptest-retest reliability of computer-based video analysis of GMs, and a significant association between our computer-based video analysis and the temporal organization of FMs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Ventricular configuration and cerebral growth in infants born to drug-dependent mothers

    International Nuclear Information System (INIS)

    Pasto, M.E.; Deiling, J.M.; Kurtz, A.B.; Goldberg, B.; Graziani, L.J.; Tunis, S.L.; Finnegan, L.P.

    1985-01-01

    Cranial ultrasound examinations were performed during the first 3 days of life and at age 1 month on 22 infants with the neonatal abstinence syndrome. The results were compared to those obtained in 15 control infants who were not exposed to narcotic drugs in utero. The ultrasound images were examined for ventricular configuration, intracranial hemidiameters, area of thalami, and width of temporal lobes. At 24 to 72 h and at 1 month of age, significantly more drug-exposed than control infants had a slit-like ventricular configuration. The intracranial hemidiameter was significantly smaller in the drug-exposed than in the control infants. All cerebral measurements except the right temporal lobe demonstrated significant growth over the first month of life in both groups of infants. By means of ancillary examinations (computerized tomography and transfontanel pressure measurements) the pathogenesis of the slit-like ventricles was found not to be related to edema or to increased intracranial pressure. Whether or not the ventricles remain small and brain growth remains parallel after the period of abstinence awaits further investigation. (orig.)

  18. Improved Cognitive Development in Preterm Infants with Shared Book Reading.

    Science.gov (United States)

    Braid, Susan; Bernstein, Jenny

    2015-01-01

    To examine the effect of shared book reading on the cognitive development of children born preterm and to determine what factors influence shared book reading in this population. Secondary analysis using the Early Childhood Longitudinal Study-Birth Cohort, a large, nationally representative survey of children born in the United States in 2001. One thousand four hundred singleton preterm infants (22-36 weeks gestation). Cognitive development measured using the Bayley Mental Scale score from the Bayley Scales of Infant Development Research Edition. Adjusting for neonatal, maternal, and socioeconomic characteristics, reading aloud more than two times a week is associated with higher cognitive development scores in two-year-old children born preterm (p book reading holds potential as an early developmental intervention for this population.

  19. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard

    DEFF Research Database (Denmark)

    Lee, Anne Cc; Kozuki, Naoko; Cousens, Simon

    2017-01-01

    Objectives  To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard. Design  Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14...... birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age......  CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small...

  20. Economic outcome for intensive care of infants of birthweight 500-999 g born in Victoria in the post surfactant era. The Victorian Infant Collaborative Study Group.

    Science.gov (United States)

    1997-06-01

    To determine the incremental cost of improving the outcome for extremely low birthweight (ELBW, birthweight 500-999 g) infants born in Victoria after the introduction of exogenous surfactant (the post surfactant era). This was a geographically determined cohort study of ELBW children in Victoria, Australia of consecutive livebirths born in three distinct eras: (i) 1979-80 (n = 351); (ii) 1985-87 (n = 560); and (iii) 1991-92 (n = 429). Exogenous surfactant was first used in Victoria in March, 1991. The consumption of nursery resources per livebirth, and the survival and sensorineural disability rates at 2 years of age for each era were investigated. Utilities were assigned as follows: 0 for dead, 0.4 for severe disability, 0.6 for moderate disability, 0.8 for mild disability, and 1 for no disability. Utilities were multiplied for more than one disability. Dollar costs were assumed to be $1470 ($A 1992) per day of assisted ventilation, and one dose of exogenous surfactant was assumed to be equivalent to one third of a day of assisted ventilation. Cost-effectiveness (additional costs per additional survivor or life-year gained) and cost-utility (additional costs per additional quality-adjusted survivor or life-year gained) ratios were calculated for the pre-surfactant era (1985-87 vs 1979-80), and for the post surfactant era (1991-92 vs 1985-87). Considering only the costs incurred during the primary hospitalization, cost-effectiveness and cost-utility ratios were lower (i.e. economically better) in the post surfactant era than in the pre-surfactant era (pre-surfactant vs post surfactant; $7040 vs $4040 per life year gained; $6700 vs $5360 per quality-adjusted life year gained). Both ratios fell with increasing birthweight. In contrast with the pre-surfactant era, cost-utility ratios were less favourable than cost-effectiveness ratios in the post surfactant era. With costs for long-term care of severely disabled children added, both cost ratios were higher in the post

  1. Physiological Reactivity to Infant Crying and Observed Maternal Sensitivity

    Science.gov (United States)

    Joosen, Katharina J.; Mesman, Judi; Bakermans-Kranenburg, Marian J.; Pieper, Suzanne; Zeskind, Philip S.; van IJzendoorn, Marinus H.

    2013-01-01

    Relations between maternal sensitivity and physiological reactivity to infant crying were examined using measures of heart rate (HR) and respiratory sinus arrhythmia (RSA) in 49 mothers of second-born infants. Using the Ainsworth Sensitivity Scale, an independent assessment of maternal sensitivity was made during maternal free play and bathing of…

  2. Socioeconomic factors affecting infant sleep-related deaths in St. Louis.

    Science.gov (United States)

    Hogan, Cathy

    2014-01-01

    Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. Though researchers have analyzed and described various sociodemographic characteristics of SIDS and infant deaths by unintentional suffocation in St. Louis, they have not simultaneously controlled for contributory risk factors to racial disparity such as race, poverty, maternal education, and number of children born to each mother (parity). To determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death. This quantitative case-control study used secondary data collected by the Missouri Department of Health and Senior Services between 2005 and 2009. The sample includes matched birth/death certificates and living birth certificates of infants who were born/died within time frame. Descriptive analysis, Chi-square, and logistic regression. The controls were birth records of infants who lived more than 1 year. Chi-square and logistic regression analyses confirmed that race and poverty have significant relationships with infant sleep-related deaths. The social significance of this study is that the results may lead to population-specific modifications of prevention messages that will reduce infant sleep-related deaths. © 2013 Wiley Periodicals, Inc.

  3. Impact of maternal obesity on very preterm infants.

    Science.gov (United States)

    Khalak, Rubia; Rijhsinghani, Asha; McCallum, Sarah E

    2017-05-01

    Infants born at less than  34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation. Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed. BMI categorization followed the National Institutes of Health BMI classification that subdivides obesity into three ascending BMI groups. Records were obtained on 1,224 women, of whom 31.6% were classified with obesity. Despite similar mean gestational age (31 to 31.6 weeks, P = 0.57) and birth weight (1,488 to 1,569 g, P = 0.51) of the infants in the BMI categories, delivery room (DR) resuscitation was more common for infants of women with level III obesity (63.2%, P = 0.04) with a trend toward the continued need for assisted ventilation (54.7%, P = 0.06). Preterm infants of women with level III obesity were more likely to require DR resuscitation with a trend to continued need for ventilatory support beyond 6 hours of age. This could impact utilization of DR resources at delivering hospitals. © 2017 The Obesity Society.

  4. Effects of Vitamin E in Neonates and Young Infants

    Directory of Open Access Journals (Sweden)

    Gian Maria Pacifici

    2016-05-01

    Full Text Available Vitamin E (alpha-tocopherol is a potent and natural antioxidant. Vitamin E is concentrated from soybean oil. The Committee on Fetus and Newborn of the Academy of the American of Pediatrics endorsed 1 to 2 mg/dl as the normal range of serum tocopherol level. Human infants are born with low stores of vitamin E, thus they require an adequate intake of vitamin E soon after birth. The optimum intravenous dose of vitamin E is 2.8 mg/kg per day (maximum 7 mg/kg per day. Treating very-low-birth-weight infants with 100 mg/kg vitamin E for >1 week results in levels >3.5 mg/dl and significantly reduces the risks of severe retinopathy, intracranial hemorrhage, hemolytic anemia, chronic lung disease, retrolental fibroplasia and incidence and severity of intraventricular hemorrhage, but increases the risks of sepsis, necrotizing enterocolitis and can cause retinal hemorrhage in very-low-birth-weight infants. Vitamin E supplementation prevents the isolated vitamin E deficiency that causes spinocerebellar symptoms. The major benefits arising from elevated dosages of vitamin E have been the relief of symptoms of vitamin E deficiency in infants with abetalipoproteinamia and chronic cholestasis. Excessive doses of vitamin E may result in side effects and careful monitoring of vitamin E is thus essential. Neonates born to mothers treated with high doses of vitamin E have significantly lower birth weight compared to neonates born to untreated mothers. Vitamin E is not teratogenic. The aim of this study was to review the effects of vitamin E in neonates and young infants.

  5. [Neurodevelopmental outcome at 3 years of age of infants born at less than 26 weeks].

    Science.gov (United States)

    Delmas, O; Garcia, P; Bernard, V; Fabre, M; Vialet, R; Boubred, F; Fayol, L

    2016-09-01

    To describe the neurodevelopmental outcome and perinatal factors associated with favorable outcome among extremely preterm children at 3 years of age. All infants born before 26 weeks of gestation between 2007 and 2011, admitted to intensive care units participating in a French regional network (western PACA-southern Corsica) were included. Perinatal data were collected to assess the main neonatal morbidities. At 3 years of age, the children's neurodevelopment was assessed by trained physicians participating in the follow-up network. Children were classified according to their disability: none, moderate, or severe. Using logistic regression, we determined the perinatal factors associated with the absence of disability at 3 years of age. One hundred and sixty-two very preterm newborns were admitted to neonatal intensive care units. At discharge the survival rate was 62% (101). Rates of survival increased with gestational age (33% at 23 weeks, 57% at 24 weeks and 68% at 25 weeks). Among the 101 surviving extremely preterm children, 66 were evaluated at 3 years. The perinatal characteristics were not significantly different from those of the children lost to follow-up. Overall, 56% of extremely preterm children had no disability and 6% had severe disability. Cerebral palsy was diagnosed in 13% of children. At 3 years of age, the main perinatal factors associated with no disability were short duration of mechanical ventilation (OR=0.96 [0.93-0.99]; P=0.03) and complete course of prenatal corticosteroids (OR=4.7 [1.2-17.7]; P=0.02). As mortality rates continue to decrease for very preterm infants, concerns are rising about their long-term outcome. In this high-risk population, improving perinatal care remains a challenge to improve long-term outcome. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Do immigrants from Turkey, Pakistan and Ex-Yugoslavia with newly diagnosed type 2 diabetes initiate recommended statin therapy to the same extent as Danish-born residents? A nationwide register study

    DEFF Research Database (Denmark)

    Sanchez-Ramirez, Diana; Krasnik, Allan; Kildemoes, Helle Wallach

    2012-01-01

    PURPOSE: To explore whether newly diagnosed type 2 diabetes patients without previous cardiovascular disease (CVD) initiate preventive statin therapy regardless of ethnic background. METHODS: Using nationwide individual-level registers, we followed a cohort of Danish-born residents and immigrants...... the odds ratios (ORs) of early statin therapy initiation (within 180 days after first GLM dispensing) are the same regardless of ethnic background. While age and gender were included as confounders in the basic model, income was included in the second model as a potential mediating variable. RESULTS....... CONCLUSIONS: Immigrants from Turkey, Pakistan and Ex-Yugoslavia with type 2 diabetes were less likely to initiate statin therapy than Danish-born residents-despite a similar or even higher risk of CVD. The treatment inequities associated with ethnicity were more pronounced in women than men...

  7. Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.

    Science.gov (United States)

    Matthews, T J; MacDorman, Marian F; Thoma, Marie E

    2015-08-06

    This report presents 2013 period infant mortality statistics from the linked birth/infant death data set (linked file) by maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. Descriptive tabulations of data are presented and interpreted. The U.S. infant mortality rate was 5.96 infant deaths per 1,000 live births in 2013, similar to the rate of 5.98 in 2012. The number of infant deaths was 23,446 in 2013, a decline of 208 infant deaths from 2012. From 2012 to 2013, infant mortality rates were stable for most race and Hispanic origin groups; declines were reported for two Hispanic subgroups: Cuban and Puerto Rican. Since 2005, the most recent high, the U.S. infant mortality rate has declined 13% (from 6.86), with declines in both neonatal and postneonatal mortality overall and for most groups. In 2013, infants born at 37–38 weeks of gestation (early term) had mortality rates that were 63% higher than for full-term (39–40 week) infants. For multiple births, the infant mortality rate was 25.84, 5 times the rate of 5.25 for singleton births. In 2013, 36% of infant deaths were due to preterm-related causes of death, and an additional 15% were due to causes grouped into the sudden unexpected infant death category. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  8. Clinical features of infants treated for severe retinopathy of prematurity: 8-yearstudy from a large tertiary neonatal intensive care unit in Turkey.

    Science.gov (United States)

    Özen Tunay, Zühal; Özdemir, Özdemir; Ergintürk Acar, Damla; Petriçli, İkbal Seza; Oğuz, Şerife Suna

    2016-01-05

    The aim of this study was to report the gestational age (GA) and birth weight (BW) distribution of premature babies who needed treatment for retinopathy of prematurity (ROP) and to assess the timing of the treatment. The records of 9008 infants who were screened for ROP were examined and 556 infants who underwent laser therapy for ROP were reviewed. Sex, GA, BW, postnatal age, and postmenstrual (PM) age at the time of laser therapy were recorded. The babies were classified as in-born (Group 1) and out-born infants (Group 2). The mean GA was 27.3 weeks (range: 22-33 weeks) and the mean BW was 991.1 g (range: 520-2160 g). Of the treated infants, 7.0% were born later than 32 weeks and 8.3% were born over 1500 g. The mean postnatal age was 9.48 weeks (range: 5-22 weeks) and the mean PM age was 36.72 weeks (range: 29-48 weeks) at the time of treatment. Mean BWs and GAs were significantly higher and the mean postnatal age at the time of laser therapy was significantly earlier in Group 2. Infants with severe ROP had a wider range of BWs and GAs compared to those from developed countries and earlier treatment was needed for out-born infants.

  9. Impact of enhanced sensory input on treadmill step frequency: infants born with myelomeningocele.

    Science.gov (United States)

    Pantall, Annette; Teulier, Caroline; Smith, Beth A; Moerchen, Victoria; Ulrich, Beverly D

    2011-01-01

    To determine the effect of enhanced sensory input on the step frequency of infants with myelomeningocele (MMC) when supported on a motorized treadmill. Twenty-seven infants aged 2 to 10 months with MMC lesions at, or caudal to, L1 participated. We supported infants upright on the treadmill for 2 sets of 6 trials, each 30 seconds long. Enhanced sensory inputs within each set were presented in random order and included baseline, visual flow, unloading, weights, Velcro, and friction. Overall friction and visual flow significantly increased step rate, particularly for the older subjects. Friction and Velcro increased stance-phase duration. Enhanced sensory input had minimal effect on leg activity when infants were not stepping. : Increased friction via Dycem and enhancing visual flow via a checkerboard pattern on the treadmill belt appear to be more effective than the traditional smooth black belt surface for eliciting stepping patterns in infants with MMC.

  10. A Methodology for Assessing Parental Perception of Infant Temperament.

    Science.gov (United States)

    Pedersen, Frank A.; And Others

    The Perception of Baby Temperament Scales (PBT) were used to elicit parental perceptions of infant temperament, with the results rated for internal consistency and congruence between parents. Data was obtained from 26 families, with both father and mother describing their first-born infants at five months of age. The PBT Scales deal with a range…

  11. Prenatal Characteristics of Infants with a Neuronal Migration Disorder: A National-Based Study

    Directory of Open Access Journals (Sweden)

    Estelle Naumburg

    2012-01-01

    Full Text Available The development of the central nervous system is complex and includes dorsal and ventral induction, neuronal proliferation, and neuronal migration, organization, and myelination. Migration occurs in humans in early fetal life. Pathogenesis of malformations of the central nervous system includes both genetic and environmental factors. Few epidemiological studies have addressed the impact of prenatal exposures. All infants born alive and included in the Swedish Medical Birth Register 1980–1999 were included in the study. By linkage to the Patient Register, 820 children with a diagnosis related to a neuronal migration abnormality were identified. Through copies of referrals for computer tomography or magnetic resonance imaging of the brain, the diagnosis was confirmed in 17 children. Median age of the mothers was 29 years. At the start of pregnancy, four out of 17 women smoked. Almost half of the women had a body mass index that is low or in the lower range of average. All infants were born at term with normal birth weights. Thirteen infants had one or more concomitant diseases or malformations. Two infants were born with rubella syndrome. The impact of low maternal body mass index and congenital infections on neuronal migration disorders in infants should be addressed in future studies.

  12. Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil Evaluación antropométrica longitudinal de lactantes nacidos de madres infectadas por VIH-1 Avaliação antropométrica longitudinal de lactentes nascidos de mães infectadas pelo HIV-1

    OpenAIRE

    Maria Arlene Fausto; Mariângela Carneiro; Carlos Maurício F Antunes; Enrico Antonio Colosimo; Jorge Andrade Pinto

    2011-01-01

    OBJECTIVE: To evaluate the growth parameters in infants who were born to HIV-1-infected mothers. METHODS: The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected ch...

  13. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer.

    Science.gov (United States)

    Dominguez-Bello, Maria G; De Jesus-Laboy, Kassandra M; Shen, Nan; Cox, Laura M; Amir, Amnon; Gonzalez, Antonio; Bokulich, Nicholas A; Song, Se Jin; Hoashi, Marina; Rivera-Vinas, Juana I; Mendez, Keimari; Knight, Rob; Clemente, Jose C

    2016-03-01

    Exposure of newborns to the maternal vaginal microbiota is interrupted with cesarean birthing. Babies delivered by cesarean section (C-section) acquire a microbiota that differs from that of vaginally delivered infants, and C-section delivery has been associated with increased risk for immune and metabolic disorders. Here we conducted a pilot study in which infants delivered by C-section were exposed to maternal vaginal fluids at birth. Similarly to vaginally delivered babies, the gut, oral and skin bacterial communities of these newborns during the first 30 d of life was enriched in vaginal bacteria--which were underrepresented in unexposed C-section-delivered infants--and the microbiome similarity to those of vaginally delivered infants was greater in oral and skin samples than in anal samples. Although the long-term health consequences of restoring the microbiota of C-section-delivered infants remain unclear, our results demonstrate that vaginal microbes can be partially restored at birth in C-section-delivered babies.

  14. Are babies conceived during Ramadan born smaller and sooner than babies conceived at other times of the year? A Born in Bradford Cohort Study.

    Science.gov (United States)

    Daley, Amanda; Pallan, Miranda; Clifford, Sue; Jolly, Kate; Bryant, Maria; Adab, Peymane; Cheng, K K; Roalfe, Andrea

    2017-07-01

    It is not known whether infants exposed to intermittent maternal fasting at conception are born smaller or have a higher risk of premature birth than those who are not. Doctors are therefore unsure about what advice to give women about the safety of Ramadan fasting. This cohort study aimed to investigate these questions in Muslim mother-infant pairs to inform prenatal care. Routinely collected data accessed from maternity records were the source for information. Mothers were considered exposed if they were Muslim and Ramadan overlapped with their infant conception date, estimated to be 14 days after the last menstrual period. Infants were included as exposed if their estimated conception date was in the first 21 days of Ramadan or 7 days prior to Ramadan. After adjusting for gestational age, maternal age, infant gender, maternal body mass index at booking, smoking status, gestational diabetes, parity and year of birth, there was no significant difference in birth weight between infants born to Muslim mothers who were conceived during Ramadan (n=479) and those who were not (n=4677) (adjusted mean difference =24.3 g, 95% CI -16.4 to 64.9). There was no difference in rates of premature births in exposed and unexposed women (5.2% vs 4.9%; OR=1.08, 95% CI 0.71 to 1.65). Healthy Muslim women considering becoming pregnant prior to, or during Ramadan, can be advised that fasting does not seem to have a detrimental effect on the size (weight) of their baby and it appears not to increase the likelihood of giving birth prematurely. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Retinopathy of Prematurity Is Associated with Increased Systolic Blood Pressure in Adults Who Were Born Preterm.

    Science.gov (United States)

    Kistner, Anna; Jacobson, Lena; Östergren, Jan; Hellström, Ann

    2017-01-01

    Adults born preterm are at risk of developing cardiovascular morbidities. The aim of this study was to evaluate the relationship between retinopathy of prematurity (ROP) and blood pressure (BP) and salivary cortisol levels during adulthood. Sixty-nine subjects (mean age 22.6 years) were included. Subjects were adults who were: (a) ex-preterm infants with severe ROP (n = 22), born at gestational age (GA) <30 weeks with a birth weight (BW) <1,000 g, (b) ex-preterm infants with no/mild ROP (n = 21), born at GA <28 weeks with a BW <1,000 g, or (c) full-term controls (n = 26). Anthropometric data, office BP, ambulatory BP, and morning and evening salivary cortisol were analyzed. As adults, ex-preterm infants with severe ROP had on average 7.4 mm Hg higher systolic office BP than those with no/mild ROP (p = 0.019) and controls (p = 0.007). A high cortisol level, tall height, and severe ROP were independent predictors of higher ambulatory systolic BP during adulthood in forward stepwise regression analysis, independent of GA. Our results indicate that preterm infants with severe abnormal retinal vascular development during the neonatal period may be at an increased risk for increased BP during adulthood. We found no differences between those with no/mild ROP as infants and controls with regard to BP data. © 2017 The Author(s) Published by S. Karger AG, Basel.

  16. [Extremely Low Birthweight Infants in Iceland. Health and development.].

    Science.gov (United States)

    Georgsdóttir, Ingibjœrg; Sæmundsen, Evald; Símonardóttir, Ingibjœrg; Halldórsson, Jónas G; Egilson, Snæfríður Thorn; Leósdóttir, Thornóra; Ingvarsdóttir, Brynhildur; Sindrason, Einar; Dagbjartsson, Atli

    2003-01-01

    Survival of extremely low birthweight infants (BWastma (p=0.001), convulsions (p=0.001), difficulties in swallowing (p=0.001) and weight gaining (p=0.005). At five years of age significantly more ELBW children born in 1991-95 compared to control children had abnormal general physical examination (pinfants born in 1982-90 and 1991-95 are similar regarding problems during pregnancy, birth and newborn period. The proportion of children with disabilities is similar in both periods although survival was significantly increased. When compared to matched control children, ELBW children born in 1991-95 suffer significantly more longterm health and developmental problems.

  17. ''Intraventricular'' hemorrhage and cystic periventricular leukomalacia in preterm infants: how are they related?

    NARCIS (Netherlands)

    Kusters, C.D.J.; Chen, M.L.; Follett, P.L.; Dammann, O.

    2009-01-01

    Intraventricular hemorrhage and cystic periventricular leukomalacia are often co-occurring characteristics of brain damage in preterm infants. Using data from 1016 infants born before 30 completed weeks' gestational age, we sought to clarify the relationship between severe intraventricular

  18. An advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation.

    Science.gov (United States)

    Kattwinkel, J; Niermeyer, S; Nadkarni, V; Tibballs, J; Phillips, B; Zideman, D; Van Reempts, P; Osmond, M

    1999-04-01

    The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours after birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles: Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.

  19. The present challenges of parenteral nutrition in preterm infants and children

    NARCIS (Netherlands)

    van Goudoever, Johannes B.; Vlaardingerbroek, Hester

    2013-01-01

    The goal of pediatricians involved in the nutritional management of preterm infants is to mimic intrauterine growth and to obtain a functional outcome comparable to that for infants born at term. Appropriate administration of nutrients in the first few days to weeks of life will reduce the growth

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  2. Tiny Dramas: Vocal Communication Between Mother and Infant in Japanese and American Families.

    Science.gov (United States)

    Caudill, William

    Why do American infants have a greater amount of vocalization, and particularly of happy vocalization, than do Japanese infants? To answer this question, 30 Japanese and 30 American first-born, 3- to 4-month old infants equally divided by sex, and living in intact middle class urban families were observed in their homes on two consecutive days…

  3. Low-grade intraventricular hemorrhage disrupts cerebellar white matter in preterm infants: evidence from diffusion tensor imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morita, Takashi; Morimoto, Masafumi; Hasegawa, Tatsuji; Morioka, Shigemi; Kidowaki, Satoshi; Moroto, Masaharu; Yamashita, Satoshi; Maeda, Hiroshi; Chiyonobu, Tomohiro; Tokuda, Sachiko; Hosoi, Hajime [Kyoto Prefectural University of Medicine, Department of Pediatrics, Graduate School of Medical Science, Kyoto (Japan); Yamada, Kei [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2015-05-01

    Recent diffusion tensor imaging (DTI) studies have demonstrated that leakage of hemosiderin into cerebrospinal fluid (CSF), which is caused by high-grade intraventricular hemorrhage (IVH), can affect cerebellar development in preterm born infants. However, a direct effect of low-grade IVH on cerebellar development is unknown. Thus, we evaluated the cerebellar and cerebral white matter (WM) of preterm infants with low-grade IVH. Using DTI tractography performed at term-equivalent age, we analyzed 42 infants who were born less than 30 weeks gestational age (GA) at birth (22 with low-grade IVH, 20 without). These infants were divided into two birth groups depending on GA, and we then compared the presence and absence of IVH which was diagnosed by cerebral ultrasound (CUS) within 10 days after birth or conventional magnetic resonance imaging (MRI) at term-equivalent age in each group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) at the superior cerebellar peduncle (SCP), middle cerebellar peduncle (MCP), motor tract, and sensory tract were measured. In the SCP, preterm born infants with IVH had lower FA values compared with infants without IVH. In particular, younger preterm birth with IVH had lower FA values in the SCP and motor tract and higher ADC values in the MCP. Low-grade IVH impaired cerebellar and cerebral WM, especially in the SCP. Moreover, younger preterm infants exhibited greater disruptions to cerebellar WM and the motor tract than infants of older preterm birth. (orig.)

  4. Functioning of very preterm born children at preschool age: Follow-up of an early intervention programme

    NARCIS (Netherlands)

    Verkerk, G.J.Q.

    2014-01-01

    The thesis presents the effects of the multicentre RCT on the Infant Behavioral Assessment and Intervention Program (IBAIP) in children born preterm, with a gestation of less than 32 weeks and/or a birth weight below 1500 grams (VLBW), at the age of school entry. Eighty-six infants were enrolled in

  5. Nutritional requirements and feeding recommendations for small for gestational age infants.

    Science.gov (United States)

    Tudehope, David; Vento, Maximo; Bhutta, Zulfiqar; Pachi, Paulo

    2013-03-01

    We define the small for gestational age (SGA) infant as an infant born ≥ 35 weeks' gestation and milk for SGA infants because it meets most of their nutritional requirements and provides short- and long-term benefits. Several distinct patterns of intrauterine growth restriction are identified among the heterogeneous grouping of SGA infants; each varies with regard to neonatal morbidities, requirements for neonatal management, postnatal growth velocities, neurodevelopmental progress, and adult health outcomes. There is much we do not know about nutritional management of the SGA infant. We need to identify and define: infants who have "true" growth restriction and are at high risk for adverse metabolic outcomes in later life; optimal growth velocity and "catch-up" growth rates that are conducive with life-long health and well being; global approaches to management of hypoglycemia; and an optimal model for postdischarge care. Large, rigorously conducted trials are required to determine whether aggressive feeding of SGA infants results in improved nutritional rehabilitation, growth, and neurodevelopmental outcomes. Before birth, maternal supplementation with specific nutrients reduces the rate and severity of growth restriction and may prevent nutrient deficiency states if infants are born SGA. After birth, the generally accepted goal is to provide enough nutrients to achieve postnatal growth similar to that of a normal fetus. In addition, we recommend SGA infants be allowed to "room in" with their mothers to promote breastfeeding, mother-infant attachment, and skin-to-skin contact to assist with thermoregulation. Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.

  6. Influence of Infant Feeding Type on Gut Microbiome Development in Hospitalized Preterm Infants

    Science.gov (United States)

    Cong, Xiaomei; Judge, Michelle; Xu, Wanli; Diallo, Ana; Janton, Susan; Brownell, Elizabeth A.; Maas, Kendra; Graf, Joerg

    2016-01-01

    Background Premature infants have a high risk for dysbiosis of the gut microbiome. Mother’s own breastmilk (MOM) has been found to favorably alter gut microbiome composition in infants born at term. Evidence about the influence of feeding type on gut microbial colonization of preterm infants is limited. Objective The purpose of this study was to explore the effect of feeding types on gut microbial colonization of preterm infants in the neonatal intensive care unit (NICU). Methods Thirty-three stable preterm infants were recruited at birth and followed-up for the first 30 days of life. Daily feeding information was used to classify infants into six groups (mother’s own milk [MOM], human donated milk [HDM], formula, MOM+HDM, MOM+Formula, and HDM+forumla) during postnatal days 0–10, 11–20, and 21–30 after birth. Stool samples were collected daily. DNA extracted from stool was used to sequence the 16S rRNA gene. Exploratory data analysis was conducted with a focus on temporal changes of microbial patterns and diversities among infants from different feeding cohorts. Prediction of gut microbial diversity from feeding type was estimated using linear mixed models. Results Preterm infants fed MOM (at least 70% of the total diet) had highest abundance of Clostridiales, Lactobacillales, and Bacillales compared to infants in other feeding groups, whereas infants fed primarily human donor milk or formula had a high abundance of Enterobacteriales compared to infants fed MOM. After controlling for gender, postnatal age, weight and birth gestational age, the diversity of gut microbiome increased over time and was constantly higher in infants fed MOM relative to infants with other feeding types (p breast milk benefits gut microbiome development of preterm infants, including balanced microbial community pattern and increased microbial diversity in early life. PMID:28252573

  7. 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.

  8. Neurobehavioural and cognitive development in infants born to mothers with eating disorders.

    Science.gov (United States)

    Barona, Manuela; Taborelli, Emma; Corfield, Freya; Pawlby, Susan; Easter, Abigail; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

    2017-08-01

    Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with EDs. Women with an active and past ED and healthy controls were recruited to a prospective longitudinal study during their first trimester or second trimester of pregnancy. Newborns and infants of mothers with ED were compared with newborns and infants of healthy controls on (a) neurobehavioural dysregulation using the Brazelton Neonatal Behavioural Assessment Scale at 8 days postpartum (active ED, n = 15; past ED, n = 20; healthy controls, n = 28); and (b) cognitive development using the Bayley Scales of Infant and Toddler Development at 1-year postpartum (active ED, n = 18; past ED, n = 19; healthy controls, n = 28). In order to maintain the largest possible sample at each time point, sample size varied across time points. Newborns of mothers with an active ED had worse autonomic stability when compared with newborns of healthy controls [B = -0.34 (-1.81, -0.26)]. Infants of mothers with a past ED had poorer language [B = -0.33 (-13.6, -1.9)] and motor development [B = -0.32 (-18.4, -1.3)] compared with healthy controls. Children of mothers with ED display neurobehavioural dysregulation early after birth and poorer language and motor development at 1 year. These characteristics suggest evidence of early neurobiological markers in children at risk. Differential outcomes in children of women with active versus past ED suggest that active symptomatology during pregnancy might have an effect on physiological reactivity while cognitive characteristics might be more stable markers of risk for ED. © 2017 Association for Child and Adolescent Mental Health.

  9. [Parents have accepted the advice on how to prevent sudden infant death].

    Science.gov (United States)

    Alm, Bernt; Wennergren, Göran; Erdes, Laslo; Möllborg, Per; Pettersson, Rolf; Aberg, Nils; Norvenius, S Gunnar

    2004-04-01

    We have compared 430 healthy Swedish infants born between 1991 and 1995 with 599 healthy, six months old infants born in 2002, regarding the prevalence of risk factors for SIDS. Following the introduction of the campaign to reduce the risk of SIDS in Sweden in 1992, we could see a decrease in prone sleeping from 32% to 7% together with an increase in supine sleeping from 35% to 44%. Maternal smoking during pregnancy has gone down from 24% to 10%. The prevalence of breast feeding, already high in Sweden in the 90s, was largely unchanged, 69% at six months of age in 2002. This comparison shows that parents of small infants have accepted the advice on ways to reduce the risk of SIDS, and that information given at infant welfare clinics is still effective ten years later. Further improvements are possible by changing the side sleeping position to supine, and by decreasing tobacco smoking among pregnant mothers.

  10. Maternal HIV infection alters the immune balance in the mother and fetus; implications for pregnancy outcome and infant health.

    Science.gov (United States)

    Pfeifer, Caroline; Bunders, Madeleine J

    2016-03-01

    With the rapid roll-out of combination antiretroviral therapy to prevent mother-to-child transmission of HIV, there is an annual increase in the number of uninfected infants born to HIV-infected women. Although the introduction of combination antiretroviral therapy has vastly improved pregnancy outcome and the health of infants born to HIV-infected women, concerns remain regarding the impact the maternal HIV infection on the pregnancy outcome and the health of HIV-exposed uninfected infants. Maternal HIV infection is associated with negative pregnancy outcomes such as low birth weight. In addition, an increased susceptibility to infections is reported in HIV-exposed uninfected infants compared with infants born to uninfected women. Studies have shown that HIV-exposure affects the maternal/fetal unit, with increase of proinflammatory cytokine produced by placental cells, as well as altered infant immune responses. These changes could provide the underlying conditions for negative pregnancy outcomes and facilitate mother-to-child transmission of HIV in the infant. Further studies are required to understand the underlying mechanisms and investigate whether these altered infant immune responses persist and have clinical consequences beyond childhood. HIV infection in pregnant women is associated with altered immune responses in HIV-infected women and their offspring with clinical consequences for pregnancy outcome and the HIV-exposed uninfected infant. Further studies are required to address the origin and long-term consequences of prenatal HIV-exposure and subsequent immune activation for infant health.

  11. Breast-feeding and complementary feeding practices in the first 6 months of life among Norwegian-Somali and Norwegian-Iraqi infants: the InnBaKost survey.

    Science.gov (United States)

    Grewal, Navnit Kaur; Andersen, Lene Frost; Sellen, Daniel; Mosdøl, Annhild; Torheim, Liv Elin

    2016-03-01

    To examine breast-feeding and complementary feeding practices during the first 6 months of life among Norwegian infants of Somali and Iraqi family origin. A cross-sectional survey was performed during March 2013-February 2014. Data were collected using a semi-quantitative FFQ adapted from the second Norwegian national dietary survey among infants in 2006-2007. Somali-born and Iraqi-born mothers living in eastern Norway were invited to participate. One hundred and seven mothers/infants of Somali origin and eighty mothers/infants of Iraqi origin participated. Breast-feeding was almost universally initiated after birth. Only 7 % of Norwegian-Somali and 10 % of Norwegian-Iraqi infants were exclusively breast-fed at 4 months of age. By 1 month of age, water had been introduced to 30 % of Norwegian-Somali and 26 % of Norwegian-Iraqi infants, and infant formula to 44 % and 34 %, respectively. Fifty-four per cent of Norwegian-Somali and 68 % of Norwegian-Iraqi infants had been introduced to solid or semi-solid foods at 4 months of age. Breast-feeding at 6 months of age was more common among Norwegian-Somali infants (79 %) compared with Norwegian-Iraqi infants (58 %; P=0·001). Multivariate analyses indicated no significant factors associated with exclusive breast-feeding at 3·5 months of age. Factors positively associated with breast-feeding at 6 months were country of origin (Somalia) and parity (>2). Breast-feeding initiation was common among Iraqi-born and Somali-born mothers, but the exclusive breast-feeding period was shorter than recommended in both groups. The study suggests that there is a need for new culture-specific approaches to support exclusive breast-feeding and complementary feeding practices among foreign-born mothers living in Norway.

  12. Trends in infant bedding use: National Infant Sleep Position study, 1993-2010.

    Science.gov (United States)

    Shapiro-Mendoza, Carrie K; Colson, Eve R; Willinger, Marian; Rybin, Denis V; Camperlengo, Lena; Corwin, Michael J

    2015-01-01

    Use of potentially hazardous bedding, as defined by the American Academy of Pediatrics (eg, pillows, quilts, comforters, loose bedding), is a modifiable risk factor for sudden infant death syndrome and unintentional sleep-related suffocation. The proportion of US infants sleeping with these types of bedding is unknown. To investigate the US prevalence of and trends in bedding use, we analyzed 1993-2010 data from the National Infant Sleep Position study. Infants reported as being usually placed to sleep with blankets, quilts, pillows, and other similar materials under or covering them in the last 2 weeks were classified as bedding users. Logistic regression was used to describe characteristics associated with bedding use. From 1993 to 2010, bedding use declined but remained a widespread practice (moving average of 85.9% in 1993-1995 to 54.7% in 2008-2010). Prevalence was highest for infants of teen-aged mothers (83.5%) and lowest for infants born at term (55.6%). Bedding use was also frequently reported among infants sleeping in adult beds, on their sides, and on a shared surface. The rate of decline in bedding use was markedly less from 2001-2010 compared with 1993-2000. For 2007 to 2010, the strongest predictors (adjusted odds ratio: ≥1.5) of bedding use were young maternal age, non-white race and ethnicity, and not being college educated. Bedding use for infant sleep remains common despite recommendations against this practice. Understanding trends in bedding use is important for tailoring safe sleep interventions. Copyright © 2015 by the American Academy of Pediatrics.

  13. Parenting stress and development of late preterm infants at 4 months corrected age.

    Science.gov (United States)

    Mughal, Muhammad K; Ginn, Carla S; Magill-Evans, Joyce; Benzies, Karen M

    2017-10-01

    Parenting stress has been linked to child development issues in early preterm infants, but less is known about its effects on development in infants born late preterm. We examined relationships between parenting stress of 108 mothers and 108 fathers and development of late preterm infants born at 34 0/7 to 36 6/7 weeks gestation. At 4 months corrected age, mothers and fathers completed the Parenting Stress Index (PSI-3); mothers were primary caregivers in almost all families and completed the Ages and Stages Questionnaire (ASQ-2) on child development. Mothers reported significantly more stress than fathers on the PSI-3 Parent Domain. PSI-3 subscale scores from the Child Domain were significant predictors of mother-reported infant development as measured by the ASQ-2 in regression models: Reinforces Parent predicted Gross Motor, Mood predicted Communication, and Acceptability predicted Communication, Fine Motor, Problem Solving, and Personal -Social development scale scores. Experiences of parenting stress differed for mothers and fathers. Further research is required on specific dimensions of parenting stress related to development of late preterm infants. © 2017 Wiley Periodicals, Inc.

  14. Resistive indices of cerebral arteries in very preterm infants : values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

    NARCIS (Netherlands)

    Ecury-Goossen, Ginette M; Raets, Marlou M A; Camfferman, Fleur A; Vos, Rik H J; van Rosmalen, Joost; Reiss, Irwin K M; Govaert, Paul; Dudink, Jeroen

    BACKGROUND: Little is known about cerebral artery resistive index values in infants born extremely preterm. OBJECTIVE: To report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks' gestation, and to compare resistive index in these

  15. Decline in Tuberculosis among Mexico-Born Persons in the United States, 2000–2010

    Science.gov (United States)

    Baker, Brian J.; Jeffries, Carla D.; Moonan, Patrick K.

    2016-01-01

    Background In 2010, Mexico was the most common (22.9%) country of origin for foreign-born persons with tuberculosis in the United States, and overall trends in tuberculosis morbidity are substantially influenced by the Mexico-born population. Objectives To determine the risk of tuberculosis disease among Mexico-born persons living in the United States. Methods Using data from the U.S. National Tuberculosis Surveillance System and the American Community Survey, we examined tuberculosis case counts and case rates stratified by years since entry into the United States and geographic proximity to the United States–Mexico border. We calculated trends in case rates over time measured by average annual percent change. Results The total tuberculosis case count (−14.5%) and annual tuberculosis case rate (average annual percent change −5.1%) declined among Mexico-born persons. Among those diagnosed with tuberculosis less than 1 year since entry into the United States (newly arrived persons), there was a decrease in tuberculosis cases (−60.4%), no change in tuberculosis case rate (average annual percent change of 0.0%), and a decrease in population (−60.7%). Among those living in the United States for more than 5 years (non-recently arrived persons), there was an increase in tuberculosis cases (+3.4%), a decrease in tuberculosis case rate (average annual percent change of −4.9%), and an increase in population (+62.7%). In 2010, 66.7% of Mexico-born cases were among non–recently arrived persons, compared with 51.1% in 2000. Although border states reported the highest proportions (>15%) of tuberculosis cases that were Mexico-born, the highest Mexico-born–specific tuberculosis case rates (>20/100,000 population) were in states in the eastern and southeastern regions of the United States. Conclusions The decline in tuberculosis morbidity among Mexico-born persons may be attributed to fewer newly arrived persons from Mexico and lower tuberculosis case rates among

  16. Worth the Wait? The Effect of Early Term Birth on Maternal and Infant Health

    OpenAIRE

    Buckles, Kasey; Guldi, Melanie

    2016-01-01

    Early term birth is defined as birth at 37 or 38 weeks gestation. While infants born early term are not considered premature, the medical literature suggests that they have an increased risk of serious adverse health outcomes compared to infants born at term (39 or 40 weeks). Despite these known harms, we document a rise in early term births in the United States from 1989 to the mid-2000's, followed by a decline in recent years. We posit that the recent decline in early term births has been d...

  17. The protective effects of father involvement for infants of teen mothers with depressive symptoms.

    Science.gov (United States)

    Lewin, Amy; Mitchell, Stephanie J; Waters, Damian; Hodgkinson, Stacy; Southammakosane, Cathy; Gilmore, Jasmine

    2015-05-01

    The purpose of this study is to examine the role of father involvement on infant distress among children born to teen mothers, particularly those who are depressed. 119 teen mothers (questionnaires administered at baseline, before participation in the intervention or comparison conditions. 29 % of teen mothers screened positive for depression. Mothers reported that 78 % of fathers were engaged with their children, typically seeing them a few times per month, and 71 % took financial responsibility for their children. In a multiple linear regression, father responsibility predicted lower infant distress, maternal depression predicted higher infant distress, and there was a significant interaction in which father engagement buffered the effect of maternal depression on infant distress. Fathers may be a protective resource for children born to teen mothers, even as early as the first 6 months of life, potentially mitigating the heightened risk associated with maternal depression in the postpartum period.

  18. Bilingualism as a potential strategy to improve executive function in preterm infants: a review.

    Science.gov (United States)

    Head, Lauren M; Baralt, Melissa; Darcy Mahoney, Ashley E

    2015-01-01

    Preterm birth is associated with long-term deficits in executive functioning and cognitive performance. Using the model of brain plasticity as a theoretical framework, it is possible that preterm infants' neurodevelopmental sequelae can be altered. Evidence suggests that bilingualism confers cognitive advantages on executive functioning, so it is possible that bilingualism may improve preterm infants' neurodevelopment. However, bilingualism has only been studied in term children. This review examined literature that compared the performance of preterm-born children to term children and bilingual children to monolingual children on executive function tasks. To address cognitive disparities in preterm-born children, studies investigating the effect of bilingualism on preterm infants' executive functioning is warranted. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  19. Risk for late-onset blood-culture proven sepsis in very-low-birth weight infants born small for gestational age: a large multicenter study from the German Neonatal Network.

    Science.gov (United States)

    Tröger, Birte; Göpel, Wolfgang; Faust, Kirstin; Müller, Thilo; Jorch, Gerhard; Felderhoff-Müser, Ursula; Gortner, Ludwig; Heitmann, Friedhelm; Hoehn, Thomas; Kribs, Angela; Laux, Reinhard; Roll, Claudia; Emeis, Michael; Mögel, Michael; Siegel, Jens; Vochem, Matthias; von der Wense, Axel; Wieg, Christian; Herting, Egbert; Härtel, Christoph

    2014-03-01

    It was the aim of this study to assess whether very-low-birth-weight (VLBW) infants born small for gestational age (SGA; birth weight less than 10th percentile) are at increased risk for late-onset sepsis. This was a prospective, multicenter study of the German Neonatal Network including VLBW infants from 23 to risk with coagulase-negative staphylococci in our SGA cohort. In a multivariate logistic regression analysis, higher gestational age [per week; odds ratio (OR): 0.75, 95% confidence interval (CI): 0.72-0.78, PGerman descendance (OR: 0.76, 95% CI: 0.63-0.91, P = 0.003) and prophylaxis with glycopeptide antibiotics (OR: 0.64, 95% CI: 0.47-0.87, P = 0.005) were shown to be protective against late-onset sepsis. In contrast, longer duration of parenteral nutrition (per day; OR: 1.016, 95% CI: 1.011-1.021, P risk factors (OR: 1.31, 95% CI: 1.02-1.68, P= 0.03). SGA contributes to the risk of late-onset sepsis in VLBW infants. Future studies are needed to investigate the underlying pathophysiology to guide individualized preventive measures in this vulnerable subgroup.

  20. Measles Antibodies in Mother-Infant Dyads in Tianjin, China.

    Science.gov (United States)

    Boulton, Matthew L; Wang, Xiexiu; Wagner, Abram L; Zhang, Ying; Carlson, Bradley F; Gillespie, Brenda W; Ding, Yaxing

    2017-11-27

    Many measles cases in Tianjin, China, occur in infants whose mothers were born after widespread vaccination programs. We assessed age-specific decreases in maternal measles antibodies in infants and examined maternal and infant characteristics in relation to infant antibody titers. Infant and mother dyads were enrolled from a sample of immunization clinics in all Tianjin districts. Participants' antibody titers were measured from dried blood spots. A multivariable log-linear model regressed infant antibody titers onto infant and mother characteristics. Among 551 infants aged ≤8 months, protective levels of measles antibodies were observed in infants whose mothers had measles titers ≥800 IU/mL (mean antibody titer, 542.5 IU/mL) or 400 to measles and an accordingly low efficiency of transplacental transmission to a fetus. Current vaccination programs, which target children aged 8 months through adolescence may be ineffective in controlling transmission of measles to infants. © 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.

  1. Study on the correlation between mercury contents in hair of lying-in women and their new-born babies by INAA

    International Nuclear Information System (INIS)

    Feng Weiyue; Qian Qinfang; Chai Zhifang

    1994-01-01

    The instrumental neutron activation analysis (INAA) has been performed on 27 pairs of scalp hair samples for mothers and their new-born babies living in Haidian District, Beijing. The transfer of mercury in pregnant women and its accumulation in new-born babies were studied. The results showed that a significant positive correlation exists between the mercury contents in maternal and infant hair (γ = + 0.856, P < 0.001), and the infant level exceeded the maternal level by 12%. It was found that the concentration of mercury in maternal hair was gradually decreased during pregnancy

  2. The Development of the circadian heart rate rhytm (CDR) in Asian infants

    OpenAIRE

    Stanislaus Sandarupa, Drs., M.A., Ph.D.

    2011-01-01

    Although the human fetus can follow the maternal circadian thythm, the enterained expression of the circadian clock, based in the suprachiasmatic nucleus (SCN) of the hypothalamus awaits postnatal maturation of the retinal hypothalamic tract, and melatonin neurotransmission. Objective: To test the hypothesis that term-born Asian Infants, at reduced risk to die of Sudden Infant Death Syndrome (SIDS) exhibit a circadian heat rate thythm (CHR) at a later age than non-Asian term infants.

  3. [Eugenic abortion could explain the lower infant mortality in Cuba compared to that in Chile].

    Science.gov (United States)

    Donoso S, Enrique; Carvajal C, Jorge A

    2012-08-01

    Cuba and Chile have the lower infant mortality rates of Latin America. Infant mortality rate in Cuba is similar to that of developed countries. Chilean infant mortality rate is slightly higher than that of Cuba. To investigate if the lower infant mortality rate in Cuba, compared to Chile, could be explained by eugenic abortion, considering that abortion is legal in Cuba but not in Chile. We compared total and congenital abnormalities related infant mortality in Cuba and Chile during 2008, based on vital statistics of both countries. In 2008, infant mortality rates in Chile were significantly higher than those of Cuba (7.8 vs. 4.7 per 1,000 live born respectively, odds ratio (OR) 1.67; 95% confidence intervals (Cl) 1.52-1.83). Congenital abnormalities accounted for 33.8 and 19.2% of infant deaths in Chile and Cuba, respectively. Discarding infant deaths related to congenital abnormalities, infant mortality rate continued to be higher in Chile than in Cuba (5.19 vs. 3.82 per 1000 live born respectively, OR 1.36; 95%CI 1.221.52). Considering that antenatal diagnosis is widely available in both countries, but abortion is legal in Cuba but not in Chile, we conclude that eugenic abortion may partially explain the lower infant mortality rate observed in Cuba compared to that observed in Chile.

  4. Parents of Children with Autism Spectrum Disorders Have Merited Concerns about Their Later-Born Infants

    Science.gov (United States)

    McMahon, Caitlin R.; Malesa, Elizabeth E.; Yoder, Paul J.; Stone, Wendy L.

    2007-01-01

    Infant siblings of children with autism spectrum disorders (ASD) are at elevated risk for social, cognitive, and language delays which may cause parents to become hypervigilant (i.e., excessively worried) about their infant's development. The extent to which parental concern is related to actual cognitive or language impairment in these infants is…

  5. Trends in Infant Bedding Use: National Infant Sleep Position Study, 1993–2010

    Science.gov (United States)

    Colson, Eve R.; Willinger, Marian; Rybin, Denis V.; Camperlengo, Lena; Corwin, Michael J.

    2015-01-01

    BACKGROUND: Use of potentially hazardous bedding, as defined by the American Academy of Pediatrics (eg, pillows, quilts, comforters, loose bedding), is a modifiable risk factor for sudden infant death syndrome and unintentional sleep-related suffocation. The proportion of US infants sleeping with these types of bedding is unknown. METHODS: To investigate the US prevalence of and trends in bedding use, we analyzed 1993–2010 data from the National Infant Sleep Position study. Infants reported as being usually placed to sleep with blankets, quilts, pillows, and other similar materials under or covering them in the last 2 weeks were classified as bedding users. Logistic regression was used to describe characteristics associated with bedding use. RESULTS: From 1993 to 2010, bedding use declined but remained a widespread practice (moving average of 85.9% in 1993–1995 to 54.7% in 2008–2010). Prevalence was highest for infants of teen-aged mothers (83.5%) and lowest for infants born at term (55.6%). Bedding use was also frequently reported among infants sleeping in adult beds, on their sides, and on a shared surface. The rate of decline in bedding use was markedly less from 2001–2010 compared with 1993–2000. For 2007 to 2010, the strongest predictors (adjusted odds ratio: ≥1.5) of bedding use were young maternal age, non-white race and ethnicity, and not being college educated. CONCLUSIONS: Bedding use for infant sleep remains common despite recommendations against this practice. Understanding trends in bedding use is important for tailoring safe sleep interventions. PMID:25452654

  6. Born at 27 weeks of gestation with classical PKU: challenges of dietetic management in a very preterm infant

    Directory of Open Access Journals (Sweden)

    Diana Ballhausen

    2011-11-01

    Full Text Available Few cases of premature infants with classical phenylketonuria (PKU have been reported. Treatment of these patients is challenging due to the lack of a phenylalanine (Phe-free amino acid (AA solution for parenteral nutrition. A boy born at 27 weeks of gestation with a weight of 1000 g was diagnosed with classical PKU on day 7 because of highly elevated Phe level at newborn screening (2800 μmol/L. Phe intake was suspended for 5 days and during this time intravenous glucose and lipids as well as small amounts of Phe-free formula through nasogastric tube were given. Because of insufficient weight gain attributable to deficiency of essential AA, a Phe-reduced, BCAA-enriched parenteral nutrition was added to satisfy AA requirements without overloading in Phe. Under this regimen, the boy started to gain weight, Phe plasma levels progressively reduced and normalized on day 19. At the age of 40 months, the patient shows normal growth parameters (height 25th percentile, weight 25-50th percentile, head circumference 50th percentile with a normal result for formally tested psychomotor development (WPPSI-III. The good outcome of the patient in spite of over 2 weeks of extremely high Phe concentrations suggests that the premature brain may still have enough plasticity to recover. Lacking a Phe-free intravenous AA solution, successful management of premature infants with PKU depends on the child’s tolerance of enteral nutrition. Although the coincidence of PKU and prematurity is rare, there is strong need for the development of an appropriate Phe-free amino acid solution for parenteral nutrition especially in case of gastro-intestinal complications of prematurity.

  7. Unusual case of congenital/infantile fibrosarcoma in a new born ...

    African Journals Online (AJOL)

    We report an unusual case of CIFS occurring in new–born mimicking an hemangioma and causing hemorrhage in the neonatal period. The tumor is located in the left arm and axilla and associated with a hand malformation. A shoulder amputation is performed after chemotherapy failure. The infant is now two-years old with ...

  8. On a new approach for constructing wormholes in Einstein-Born-Infeld gravity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Young [Kunsan National University, Department of Physics, Kunsan (Korea, Republic of); Park, Mu-In [Sogang University, Research Institute for Basic Science, Seoul (Korea, Republic of)

    2016-11-15

    We study a new approach for the wormhole construction in Einstein-Born-Infeld gravity, which does not require exotic matters in the Einstein equation. The Born-Infeld field equation is not modified by coordinate independent conditions of continuous metric tensor and its derivatives, even though the Born-Infeld fields have discontinuities in their derivatives at the throat in general. We study the relation of the newly introduced conditions with the usual continuity equation for the energy-momentum tensor and the gravitational Bianchi identity. We find that there is no violation of energy conditions for the Born-Infeld fields contrary to the usual approaches. The exoticity of the energy-momentum tensor is not essential for sustaining wormholes. Some open problems are discussed. (orig.)

  9. Risk of congenital cytomegalovirus infection among HIV-exposed uninfected infants is not decreased by maternal nelfinavir use during pregnancy.

    Science.gov (United States)

    Gantt, Soren; Leister, Erin; Jacobsen, Denise L; Boucoiran, Isabelle; Huang, Meei-Li; Jerome, Keith R; Jourdain, Gonzague; Ngo-Giang-Huong, Nicole; Burchett, Sandra; Frenkel, Lisa

    2016-06-01

    Congenital cytomegalovirus (cCMV) infection is common among infants born to HIV-infected women. Nelfinavir (NFV), an antiretroviral drug that is safe during pregnancy, inhibits CMV replication in vitro at concentrations that standard doses achieve in plasma. We hypothesized that infants born to women receiving NFV for prevention of mother-to-child transmission of HIV (PMTCT) would have a reduced prevalence of cCMV infection. The prevalence of cCMV infection was compared among HIV-uninfected infants whose HIV-infected mothers either received NFV for >4 weeks during pregnancy (NFV-exposed) or did not receive any NFV in pregnancy (NFV-unexposed). CMV PCR was performed on infant blood samples collected at 4 weeks during pregnancy and 941 did not receive any NFV during pregnancy. The overall prevalence of cCMV infection in the infants was 2.2%, which did not differ by maternal NFV use. Maternal CD4 T cell counts were inversely correlated with risk of cCMV infection, independent of the time NFV was initiated during gestation. Infants with cCMV infection were born 0.7 weeks earlier (P = 0.010) and weighed 170 g less (P = 0.009) than uninfected infants. Among HIV-exposed uninfected infants, cCMV infection was associated with adverse perinatal outcomes. NFV use in pregnancy was not associated with protection against cCMV. Safe and effective strategies to prevent cCMV infection are needed. © 2015 Wiley Periodicals, Inc.

  10. The Infant Born to a Woman with Gestational Diabetes.

    Science.gov (United States)

    Povinelli, Theresa; Lim, Caitlin; Raines, Deborah A

    2017-07-01

    Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. During pregnancy, women with GDM develop insulin resistance, which results in altered glucose tolerance. As a result, there are frequent episodes of hyperglycemia and high levels of circulating amino acids, increasing the transfer of nutrients to the fetus. This article discusses the role of the mother-baby nursing in the care of neonates born to women with gestational diabetes.

  11. The effects of parental sensitivity and involvement in caregiving on mother-infant and father-infant attachment in a Portuguese sample.

    Science.gov (United States)

    Fuertes, Marina; Faria, Anabela; Beeghly, Marjorie; Lopes-dos-Santos, Pedro

    2016-02-01

    In the present longitudinal study, we investigated attachment quality in Portuguese mother-infant and in father-infant dyads, and evaluated whether attachment quality was related to parental sensitivity during parent-infant social interaction or to the amount of time each parent spent with the infant during play and in routine caregiving activities (e.g., feeding, bathing, play). The sample consisted of 82 healthy full-term infants (30 girls, 53 boys, 48 first born), and their mothers and fathers from mostly middle-class households. To assess parental sensitivity, mothers and fathers were independently observed during free play interactions with their infants when infants were 9 and 15 months old. The videotaped interactions were scored by masked coders using the Crittenden's CARE-Index. When infants were 12 and 18 months old, mother-infant and father-infant dyads were videotaped during an adaptation of Ainsworth's Strange Situation. Parents also described their level of involvement in infant caregiving activities using a Portuguese version of the McBride and Mills Parent Responsibility Scale. Mothers were rated as being more sensitive than fathers during parent-infant free play at both 9 and 15 months. There also was a higher prevalence of secure attachment in mother-infant versus father-infant dyads at both 12 and 18 months. Attachment security was predicted by the amount of time mothers and fathers were involved in caregiving and play with the infant, and with parents' behavior during parent-infant free play. (c) 2016 APA, all rights reserved).

  12. Natural evolution of patent ductus arteriosus in the extremely preterm infant.

    Science.gov (United States)

    Rolland, Audrey; Shankar-Aguilera, Shivani; Diomandé, Douty; Zupan-Simunek, Véronique; Boileau, Pascal

    2015-01-01

    The persistence of the patent ductus arteriosus (PDA) is frequently encountered in very preterm infants. Neither preventive nor curative treatments of PDA have been shown to improve the outcome of these infants. Since no consensus on optimal treatment of PDA is established, we evaluated the rate of spontaneous PDA closure in infants born before 28 weeks of gestation. We studied a retrospective cohort of 103 infants (gestational age 24-27 weeks) admitted to our neonatal intensive care unit from 1 June 2008 to 31 July 2010. Maternal and neonatal characteristics were collected. The PDA was defined by the persistence of ductal patency after 72 h and was followed up by regular echocardiography. Twelve infants died within the first 72 h and were excluded from the analysis. Among 91 infants analysed, 8 (9%) closed their ductus arteriosus before 72 h and the ductus could not be determined patent in 13. Of the 70 infants with a PDA still persistent, one underwent surgical ligation and echocardiography showed spontaneous closure in 51 (73%) of them. In the remaining 18 infants, the date of PDA closure could not be determined either because of their death (n=11) or due to discharge (n=7). Overall, a spontaneous closure of the ductus arteriosus was observed in 59 of the 91 infants. We have to question whether exposure to the risks of therapeutic interventions targeted for ductal closure is warranted since a PDA closes spontaneously in at least 73% of infants born before 28 weeks. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    DEFF Research Database (Denmark)

    Zachariassen, Gitte; Hansen, Bo Mølholm

    2015-01-01

    INTRODUCTION: Treatment of extremely preterm and low birth weight infants is still evolving and improving. In this study, we evaluated if growth has improved from birth to two years of corrected age (CA) among extremely low birth weight (BW) and preterm born infants in Denmark. METHODS: This was ......INTRODUCTION: Treatment of extremely preterm and low birth weight infants is still evolving and improving. In this study, we evaluated if growth has improved from birth to two years of corrected age (CA) among extremely low birth weight (BW) and preterm born infants in Denmark. METHODS...... during hospitalisation. FUNDING: Collection of data in the 2004-2008 cohort was supported by the Institute of Regional Health Services Research, the Egmont Foundation and the University of Southern Denmark. Collection of data from birth to two years of age in the 1994-1995 cohort was without financial...

  14. Associations Among Perinatal Factors and Age of Achievement of Full Oral Feeding in Very Preterm Infants

    Directory of Open Access Journals (Sweden)

    Yea-Shwu Hwang

    2013-10-01

    Conclusion: A regression model incorporating significant predictors to estimate the PMA of full oral feeding in very preterm infants was suggested. It could enhance communication between health professionals and parents about the feeding progress of infants born very prematurely.

  15. School-age outcomes of children born at the limit of viability : a Swedish national prospective follow-up study at 10 to 12 years

    OpenAIRE

    Farooqi, Aijaz

    2007-01-01

    Background/Aim: During the past two decades, major advances in maternal-fetal medicine, neonatology, and the development of regionalized perinatal care have resulted in dramatic increases in survival rates, by more than 60%, of extremely immature (EI) infants born at less than 26 completed weeks of gestation, creating a new infant population. Studies of school-age outcomes in children with an extremely low birth weight of < 1000 g, born in the1980s, indicated that these children had a subs...

  16. Maternal Vaccination With a Monocomponent Pertussis Toxoid Vaccine Is Sufficient to Protect Infants in a Baboon Model of Whooping Cough.

    Science.gov (United States)

    Kapil, Parul; Papin, James F; Wolf, Roman F; Zimmerman, Lindsey I; Wagner, Leslie D; Merkel, Tod J

    2018-03-28

    Bordetella pertussis is a human pathogen responsible for serious respiratory illness. The disease is most severe in infants too young to be vaccinated with most hospitalizations and deaths occurring within this age group. The Advisory Committee on Immunization Practices recommended immunization of pregnant women to protect infants from birth until their first vaccination at 6-8 weeks of age. We previously demonstrated that maternal vaccination with licensed acellular pertussis vaccines protected newborn baboons from disease. We hypothesized that protection was due to toxin-neutralizing, maternal anti-pertussis toxin antibodies and predicted that maternal vaccination with a pertussis toxoid (PTx)-only vaccine would protect newborns from disease. Infant baboons born to unvaccinated mothers or mothers vaccinated with a PTx-only vaccine were challenged with B. pertussis at 5 weeks of age and followed for infection and signs of disease. Although all challenged infants were heavily colonized, the infant baboons born to mothers vaccinated with PTx-only vaccine were free from clinical disease following exposure to B. pertussis. In contrast, disease was observed in infants born to unvaccinated mothers. Our results demonstrated that maternal vaccination with a PTx-only vaccine is sufficient to protect newborn baboons from disease following exposure to pertussis.

  17. Painful procedures can affect post-natal growth and neurodevelopment in preterm infants.

    Science.gov (United States)

    Coviello, Caterina; Popple Martinez, Marina; Drovandi, Livia; Corsini, Iuri; Leonardi, Valentina; Lunardi, Clara; Antonelli, Carla; Pratesi, Simone; Dani, Carlo

    2018-05-01

    This Italian study evaluated whether painful procedures during the first four weeks of life were related to subsequent weight gain, head circumference (HC) and neurodevelopmental outcomes in preterm infants, METHODS: We evaluated the number of invasive procedures that infants born at less than 32 weeks of gestational age (GA) underwent in the Neonatal Intensive Care Unit of Careggi Hospital, Florence, from January to December 2015. Weight and HC were recorded at birth, 36 weeks of PMA and six and 12 months of CA. Neurological outcomes were assessed at six and 12 months of CA using the Bayley Scales of Infant and Toddler Development - Third Edition. We studied 83 preterm infants with a GA of 28 ± 2 weeks and birth weight of 1098 ± 340 g. A higher number of invasive painful procedures were related to a lower HC standard deviation score at 36 weeks of PMA and six and 12 months of CA and with lower cognitive scores at six months. At 12 months, the relationship only remained significant for infants born at less than 28 weeks (p growth and short-term cognitive scores in preterm infants in the first year of life. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  18. Brain Development, Intelligence and Cognitive Outcome in Children Born Small for Gestational Age

    NARCIS (Netherlands)

    de Bie, H.M.A.; Oostrom, K.J.; Delemarre-van d Waal, H.A.

    2010-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with increased neonatal morbidity and mortality as well as short stature, cardiovascular disease, insulin resistance, diabetes mellitus type 2, dyslipidemia and end-stage renal

  19. Perioperative considerations in a newly described subtype of congenital long QT syndrome.

    Science.gov (United States)

    Joseph-Reynolds, Ann; Auden, Steve; Sobczyzk, Walter

    1997-05-01

    An infant with a newly-described subtype of congenital long QT syndrome is presented, along with her perioperative management on three separate occasions. During each anaesthetic characteristic arrhythmias occurred. The available literature and rational approaches to these high risk patients are reviewed. 1997 Blackwell Science Ltd.

  20. Neonatal antecedents of hearing loss in very preterm infants

    OpenAIRE

    Chant, K. C.

    2017-01-01

    BACKGROUND: The prevalence of hearing impairment in infants born prematurely or with low birth weight is around 1-2%, up to 10 times higher than babies born at term. The aetiology of which is poorly understood; risk factors are likely to be interrelated. Susceptibility to the audiological toxicity of gentamicin, frequently given to newborn babies, is increased in the presence of m.1555A>G, a mitochondrial mutation. OBJECTIVES: This study aims to investigate the aetiology of hear...

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

    African Journals Online (AJOL)

    Very low birth weight (VLBW) infants are those born weighing less ... an association between retinopathy of prematurity and poor weight gain. .... LGA = large for gestational age; SGA = small for gestational age; NEC = necrotising enterocolitis;.

  2. Effects of antiretroviral agents during pregnancy on liver enzymes and amylase in HIV-exposed, uninfected newborn infants

    Directory of Open Access Journals (Sweden)

    Patrícia El Beitune

    Full Text Available This study assessed the effect of antiretroviral drugs administered to pregnant women on amylase and liver enzymes of the neonate. A prospective study was conducted on 52 neonates divided into three groups: infants born to HIV-infected mothers taking zidovudine (ZDV group, n = 18, infants born to mothers taking zidovudine + lamivudine + nelfinavir (TT group, n = 22 and infants born to normal women (control group, n = 12. Umbilical cord blood from the newborn infant was used to determine liver transaminases and amylase. Data were analyzed statistically by nonparametric tests, with the level of significance set at p<0.05. The median levels for TT group newborns were 33.3 U/L for oxaloacetic transaminase, 21.5 U/L for pyruvic transaminase, 1.9 mg/dL for total bilirubin, 153 mg/dL for alkaline phosphatase, and 9.6 U/L for amylase. These results did not differ from those obtained for Control newborns or newborns exposed to ZDV alone. No association was observed between the use of antiretroviral drugs during pregnancy and adverse effects on neonatal amylase and hepatic parameters at birth.

  3. Associated malformations among infants with anophthalmia and microphthalmia.

    Science.gov (United States)

    Stoll, Claude; Dott, Beatrice; Alembik, Yves; Roth, Marie-Paule

    2012-03-01

    Infants with anophthalmia and microphthalmia frequently have other associated congenital anomalies. The reported frequency and types of associated malformations vary among different studies. The purpose of this investigation was to assess the frequency and types of associated malformations among infants with anophthalmia and microphthalmia in a geographically well defined population from 1979 to 2004 of 346,831 consecutive births. Of the 87 infants with anophthalmia and microphthalmia born during this period (prevalence at birth, 2.5 per 10,000), 90% had associated malformations. Infants with associated malformation were divided into recognizable conditions (22 infants [25%] with chromosomal and 15 infants [17%] with nonchromosomal conditions), and nonrecognizable conditions (41 infants [47%] with multiple malformations). Trisomies 13 and 18 were the most frequent chromosomal abnormalities. Amniotic bands sequence, CHARGE syndrome, Meckel-Gruber syndrome, and VACTERL association were most often present in recognizable nonchromosomal conditions. Malformations in the musculoskeletal, cardiovascular, and central nervous systems were the most common other anomalies in infants with multiple malformations and nonrecognizable conditions. The frequency of associated malformations in infants with anophthalmia or microphthalmia emphasizes the need for a thorough investigation of these infants. Routine screening for other malformations-especially musculoskeletal, cardiac, and central nervous system anomalies-may need to be considered in infants with anophthalmia or microphthalmia, and referral of these infants for genetics evaluation and counseling seems warranted. Copyright © 2012 Wiley Periodicals, Inc.

  4. Explaining Racial Disparities in Infant Health in Brazil

    Science.gov (United States)

    Nyarko, Kwame A.; Lopez-Camelo, Jorge; Castilla, Eduardo E.

    2015-01-01

    Objectives. We sought to quantify how socioeconomic, health care, demographic, and geographic effects explain racial disparities in low birth weight (LBW) and preterm birth (PTB) rates in Brazil. Methods. We employed a sample of 8949 infants born between 1995 and 2009 in 15 cities and 7 provinces in Brazil. We focused on disparities in LBW (Public policies to improve children’s health should target prenatal care and geographic location differences to reduce health disparities between infants of African and European ancestries in Brazil. PMID:26313046

  5. Racial and Ethnic Infant Mortality Gaps and the Role of Socio-Economic Status

    OpenAIRE

    Elder, Todd E.; Goddeeris, John H.; Haider, Steven J.

    2016-01-01

    We assess the extent to which differences in socio-economic status are associated with racial and ethnic gaps in a fundamental measure of population health: the rate at which infants die. Using micro-level Vital Statistics data from 2000 to 2004, we examine mortality gaps of infants born to white, black, Mexican, Puerto Rican, Asian, and Native American mothers. We find that between-group mortality gaps are strongly and consistently (except for Mexican infants) associated with maternal marita...

  6. Another Mexican birthweight paradox? The role of residential enclaves and neighborhood poverty in the birthweight of Mexican-origin infants.

    Science.gov (United States)

    Osypuk, Theresa L; Bates, Lisa M; Acevedo-Garcia, Dolores

    2010-02-01

    Examining whether contextual factors influence the birth outcomes of Mexican-origin infants in the US may contribute to assessing rival explanations for the so-called Mexican health paradox. We examined whether birthweight among infants born to Mexican-origin women in the US was associated with Mexican residential enclaves and exposure to neighborhood poverty, and whether these associations were modified by nativity (i.e. mother's place of birth). We calculated metropolitan indices of neighborhood exposure to Mexican-origin population and poverty for the Mexican-origin population, and merged with individual-level, year 2000 natality data (n=490,332). We distinguished between neighborhood exposure to US-born Mexican-origin population (i.e. ethnic enclaves) and neighborhood exposure to foreign-born (i.e. Mexico-born) Mexican-origin population (i.e. immigrant enclaves). We used 2-level hierarchical linear regression models adjusting for individual, metropolitan, and regional covariates and stratified by nativity. We found that living in metropolitan areas with high residential segregation of US-born Mexican-origin residents (i.e. high prevalence of ethnic enclaves) was associated with lower birthweight for infants of US-born Mexican-origin mothers before and after covariate adjustment. When simultaneously adjusting for exposure to ethnic and immigrant enclaves, the latter became positively associated with birthweight and the negative effect of the former increased, among US-born mothers. We found no contextual birthweight associations for mothers born in Mexico in adjusted models. Our findings highlight a differential effect of context by nativity, and the potential health effects of ethnic enclaves, which are possibly a marker of downward assimilation, among US-born Mexican-origin women. Copyright 2009 Elsevier Ltd. All rights reserved.

  7. Postnatal Growth in a Cohort of Sardinian Intrauterine Growth-Restricted Infants

    Directory of Open Access Journals (Sweden)

    Maria Grazia Clemente

    2017-01-01

    Full Text Available Recent studies have shown that infants with intrauterine growth restriction (IUGR undergo catch-up growth during infancy. The aim of our study was to evaluate the postnatal growth in a cohort of IUGR infants born in a tertiary-level Obstetric University Hospital of Northern Sardinia. An observational retrospective study was conducted on 12 IUGR (group A and 12 control infants (group B by measuring the anthropometric parameters of weight (W, length (L and head circumference (HC from birth to the 3rd postnatal year. At birth, significant differences were found between group A and group B with regard to all the auxological parameters (W, mean 1846.6 versus 3170.8 g, p < 0.0001; HC, 30.1 versus 34.4 cm, p < 0.0001; L, mean 43.4 versus 49.4 cm, p < 0.0001. During the 1st year, 8 of 12 (70% IUGR infants exhibited a significant catch-up growth in the 3 anthropometric parameters and a regular growth until the 3rd year of follow-up. The majority but not all infants born with IUGR in our series showed significant postnatal catch-up growth essentially during the first 12 months of life. An improved knowledge of the causes of IUGR will help to develop measures for its prevention and individualized treatment.

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

    Directory of Open Access Journals (Sweden)

    Uthman Mubashir B

    2008-09-01

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

  9. Review of Randomized Controlled Trials of Massage in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Anna-Kaisa Niemi

    2017-04-01

    Full Text Available Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants.

  10. Stunting and wasting are associated with poorer psychomotor and mental development in HIV-exposed Tanzanian infants.

    Science.gov (United States)

    McDonald, Christine M; Manji, Karim P; Kupka, Roland; Bellinger, David C; Spiegelman, Donna; Kisenge, Rodrick; Msamanga, Gernard; Fawzi, Wafaie W; Duggan, Christopher P

    2013-02-01

    Infants born to HIV-infected women are at increased risk of impaired neurodevelopment, but little research has attempted to identify modifiable risk factors. The objective of this prospective cohort analysis was to identify maternal, socioeconomic, and child correlates of psychomotor and mental development in the first 18 mo of life among Tanzanian infants born to HIV-infected women. We hypothesized that child HIV infection, morbidity, and undernutrition would be associated with lower developmental status when taking into consideration maternal health and socioeconomic factors. Baseline maternal characteristics were recorded during pregnancy, birth characteristics were collected immediately after delivery, infant micronutrient status was measured at 6 wk and 6 mo, and anthropometric measurements and morbidity histories were performed at monthly follow-up visits. The Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Development, 2nd edition (BSID-II) were used to assess developmental functioning at 6, 12, and 18 mo of age. Multivariate repeated regression models with time-varying covariates were used to estimate adjusted mean MDI and PDI scores for each level of the variables. A total of 311 infants contributed ≥1 BSID-II assessments for 657 PDI and 655 MDI measurements. Of infants, 51% were male, 23% were born preterm, 7% were low birth weight, and 10% were HIV-positive at 6 wk. Preterm birth, child HIV infection, stunting, and wasting were independently associated with lower PDI and MDI scores. Strategies to lower mother-to-child transmission of HIV, prevent preterm birth, and enhance child growth could contribute to improved child psychomotor and mental development.

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

    Science.gov (United States)

    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.

  12. Fine Motor Skill Predicts Expressive Language in Infant Siblings of Children with Autism

    Science.gov (United States)

    LeBarton, Eve Sauer; Iverson, Jana M.

    2013-01-01

    We investigated whether fine motor and expressive language skills are related in the later-born siblings of children with autism (heightened-risk, HR infants) who are at increased risk for language delays. We observed 34 HR infants longitudinally from 12 to 36 months. We used parent report and standardized observation measures to assess fine motor…

  13. Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study

    NARCIS (Netherlands)

    de Haan, Timo R.; Bijleveld, Yuma A.; van der Lee, Johanna H.; Groenendaal, Floris; van den Broek, Marcel P. H.; Rademaker, Carin M. A.; van Straaten, Henrica L. M.; van Weissenbruch, Mirjam M.; Vermeulen, Jeroen R.; Dijk, Peter H.; Dudink, Jeroen; Rijken, Monique; van Heijst, Arno; Dijkman, Koen P.; Gavilanes, Danilo; van Kaam, Anton H.; Offringa, Martin; Mathôt, Ron A. A.

    2012-01-01

    Background: In the Netherlands, perinatal asphyxia (severe perinatal oxygen shortage) necessitating newborn resuscitation occurs in at least 200 of the 180-185.000 newly born infants per year. International randomized controlled trials have demonstrated an improved neurological outcome with

  14. Infants with prenatally diagnosed kidney anomalies have an increased risk of urinary tract infections

    DEFF Research Database (Denmark)

    Rasmussen, Maria; Sunde, Lone; Andersen, René F

    2017-01-01

    AIM: This study estimated the urinary tract infection (UTI) risk in a nationwide cohort of infants prenatally diagnosed with parenchymal kidney anomalies compared with a comparison cohort. METHODS: A Danish population-based nationwide cohort of foetuses diagnosed with parenchymal kidney anomalies...... between 2007 and 2012 had previously been identified. These were compared with foetuses without kidney anomalies who were prenatally scanned the same year. Live born infants were followed from birth until the diagnosis of UTI, emigration, death or two years of age. Cumulative incidences of UTIs were...... computed. Mortality was estimated using the Kaplan-Meier method. RESULTS: We identified 412 foetuses with parenchymal kidney anomalies out of 362 069 who underwent ultrasound scans and 277 were born alive. The overall risk of a UTI before the age of two years was 19%, and it was 14% among infants without...

  15. Neonatal cerebral oxygenation is not linked to foetal vasculitis and predicts intraventricular haemorrhage in preterm infants

    DEFF Research Database (Denmark)

    Sorensen, Line C; Maroun, Lisa L; Borch, Klaus

    2008-01-01

    Aim: The aim of the study was to compare the cerebral tissue oxygenation index (c-TOI) measured by near infrared spectroscopy (NIRS) in infants with and without foetal vasculitis. Methods: Twenty-four infants with placental signs of a foetal inflammatory response (FIR), foetal vasculitis, were.......002). Conclusion: Cerebral oxygenation was not affected in the first day of life in preterm infants born with foetal vasculitis, while cerebral oxygenation in infants that later developed intraventricular haemorrhage was impaired....

  16. Early Childhood Neurodevelopmental Outcomes in Infants Exposed to Infectious Syphilis In Utero.

    Science.gov (United States)

    Verghese, Valsan P; Hendson, Leonora; Singh, Ameeta; Guenette, Tamara; Gratrix, Jennifer; Robinson, Joan L

    2018-06-01

    There are minimal neurodevelopmental follow-up data for infants exposed to syphilis in utero. This is an inception cohort study of infants exposed to syphilis in utero. We reviewed women with reactive syphilis serology in pregnancy or at delivery in Edmonton (Canada), 2002 through 2010 and describe the neurodevelopmental outcomes of children with and without congenital syphilis. There were 39 births to women with reactive syphilis serology, 9 of whom had late latent syphilis (n = 4), stillbirths (n = 2) or early neonatal deaths (n = 3), leaving 30 survivors of which 11 with and 7 without congenital syphilis had neurodevelopmental assessment. Those with congenital syphilis were all born to women with inadequate syphilis treatment before delivery. Neurodevelopmental impairment was documented in 3 of 11 (27%) infants with congenital syphilis and one of 7 (14%) without congenital syphilis with speech language delays in 4 of 11 (36%) with congenital syphilis and 3 of 7 (42%) without congenital syphilis. Infants born to mothers with reactive syphilis serology during pregnancy are at high risk for neurodevelopmental impairment, whether or not they have congenital syphilis, so should all be offered neurodevelopmental assessments and early referral for services as required.

  17. Respiratory Rate During the First 24 Hours of Life in Healthy Term Infants.

    Science.gov (United States)

    Tveiten, Lars; Diep, Lien My; Halvorsen, Thomas; Markestad, Trond

    2016-04-01

    Abnormal respiratory rate (RR) is a key symptom of disease in the newborn. The aim of this study was to establish the reference range for RR during the first 24 hours of life in healthy infants born at term. Infants were included at the hospital postnatal ward when time permitted. During sleep or a defined quiet state, RR was counted at 2, 4, 8, 16, and 24 hours by placing the bell of a stethoscope in front of the nostrils and mouth for 60 seconds. Data on maternal health, pregnancies, and births were obtained from medical records and the Medical Birth Registry of Norway. The study included 953 infants. Median RRs were 46 breaths/minute at 2 hours, thereafter 42 to 44 breaths/minute. The 95th percentile was 65 breaths/minute at 2 hours, thereafter 58 to 60 breaths/minute. The fifth percentile was 30 to 32 breaths/minute. Within these limits, the intraindividual variation was wide. The overall mean RR was 5.2 (95% confidence interval [CI], 4.7 to 5.7, P < .001) breaths/minute higher while awake than during sleep, 3.1 (95% CI, 1.5 to 4.8, P < .001) breaths/minute higher after heavy meconium staining of the amniotic fluid, and 1.6 (95% CI, 0.8 to 2.4, P < .001) breaths/minute higher in boys than girls. RR did not differ for infants born after vaginal versus cesarean deliveries. The RR percentiles established from this study allow for a scientifically based use of RR when assessing newborn infants born at term. Copyright © 2016 by the American Academy of Pediatrics.

  18. Developmental outcomes of Japanese children born through Assisted Reproductive Technology (ART) in toddlerhood.

    Science.gov (United States)

    Aoki, Sayaka; Hashimoto, Keiji; Ogawa, Kohei; Horikawa, Reiko; Sago, Haruhiko

    2018-05-01

    This study aimed to investigate developmental outcomes of Japanese babies born through Assisted Reproductive Technology (ART) at ages 2 and 3. The data were gathered from 1085 children in a hospital-based cohort study conducted in Japan. The children's level of development was assessed through a parent-rated questionnaire, the Kinder Infant Development Scale, which consists of nine developmental domains. We compared the development of children born through ART and those born naturally by conducting analyses of covariance. For the analyses, the effect of maternal age, family income, parental education and multiple birth were controlled for. At 24 months, no significant difference was found between children born through ART and those born naturally in development in any domain. At 36 months, a significant difference was found in development of Receptive language (F (1, 845) = 6.148, P = 0.013), Expressive language (F (1, 845) = 4.060, P = 0.044) and Language concept (F (1, 845) = 6.968, P = 0.008). For these domains, children born through ART had a significantly higher developmental age compared to children born naturally. At age 2, no significant difference was found between the children born through ART and those born naturally in nine developmental domains, although at age 3, the children born through ART showed significantly better language development than the children born naturally. © 2018 Japan Society of Obstetrics and Gynecology.

  19. The use of car-borne gamma-ray spectrometric survey in a basin

    International Nuclear Information System (INIS)

    Liu Tengyao; Lu Shili; Luo Zongquan.

    1985-01-01

    This paper describes the geological results in a basin in the Inner Mongolia which were obtained by using our newly-developed and assembled car-borne gamma-ray spectrometric system. Combined with the work of regional geology and remote sensing, five relatively favourable uranium zones were located within the working area. The field procedures of car-borne gamma-ray spectrometry for less rigid regions is discussed. The gamma-ray spectrometric profiling is mainly used for regional reconnaissance. In the case of enhanced anomalious radioactivity the profiling with varying directions is adopted and the data are plotted on scale 1:50000 topographic map. It is suggested that the car-borne gamma-ray spectrometric system can be calibrated both by the pads specified for portable spectrometers and by testing site when the calibration facility for the car-borne gamma-ray spectrometric system is not available. The effect of rainfall on car-borne gamma-ray spectrometric survey and the simplified field qualitative determination of U-Ra disequilibrium are also briefly discussed

  20. Development and adaptation to resection of infant rat gut

    NARCIS (Netherlands)

    J.E. de Vries

    1982-01-01

    textabstractInfants with malrotation of the gut easily develop midgut volvuluse If this volvulus is not treated immediately, ischemic necrosis of the small bowel may develop rapidly. The treatment of these children requires extensive small bowel resection. Infrequently, children are born with

  1. Echocardiographic Evaluation of Patent Ductus Arteriosus in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Romaine Arlettaz

    2017-06-01

    Full Text Available Patent ductus arteriosus (PDA is part of the typical morbidity profile of the preterm infant, with a high incidence of 80–90% in extremely low birth weight infants born before 26 weeks of gestation. Whereas spontaneous closure of the ductus arteriosus (DA is likely in term infants, it is less so in preterm ones. PDA is associated with increased mortality and various comorbidities including cardiac failure, need for respiratory support, bronchopulmonary dysplasia, pulmonary or intracranial hemorrhage, and necrotizing enterocolitis; however, there is no proven causality between these morbidities and the presence of DA. Thus, the indication to close PDA remains highly controversial. This paper focuses on echocardiographic evaluation of PDA in the preterm infant and particularly on the echocardiographic signs of hemodynamic significance.

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

    Directory of Open Access Journals (Sweden)

    Alice M. Kiy

    2015-05-01

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

  3. Spiritual needs of mothers with sick new born or premature infants

    DEFF Research Database (Denmark)

    Büssing, Arndt; Waßermann, Undine; Christian Hvidt, Niels

    2018-01-01

    Peace Needs correlated with their stress perception (r=.34), impairments of life concerns (r=.25) and grief (r=.23). DISCUSSION: Mothers of sick born/premature children felt supported by the hospital team and their partner, but nevertheless experienced stress and daily life impairments, and particularly...

  4. Early identification of cerebral visual impairments in infants born extremely preterm

    NARCIS (Netherlands)

    Pel, Johan J M; Dudink, Jeroen; Vonk, Mark; Plaisier, Annemarie; Reiss, Irwin K M; van der Steen, Johannes

    2016-01-01

    AIM: Children born extremely preterm are at risk of visual processing problems related to brain damage. Damage in visual pathways can remain undetected by conventional magnetic resonance imaging (MRI) and functional consequences cannot always be predicted. The aim of this study was to assess the

  5. Changes in plasma thyroid hormone levels after a single dose of triiodothyronine in premature infants of less than 30 weeks gestational age

    NARCIS (Netherlands)

    Cools, F.; van Wassenaer, A. G.; Kok, J. H.; de Vijlder, J. J.

    2000-01-01

    OBJECTIVE: Evaluation of thyroid hormone response to a single administration of triiodothyronine (T3) early postnatally to premature infants of <30 weeks gestational age. DESIGN: A prospective clinical trial with historical control. METHODS: Ten infants born <28 weeks gestational age and ten infants

  6. Rhythmic EEG patterns in extremely preterm infants : Classification and association with brain injury and outcome

    NARCIS (Netherlands)

    Weeke, Lauren C; van Ooijen, Inge M; Groenendaal, Floris; van Huffelen, Alexander C.; van Haastert, Ingrid C; van Stam, Carolien; Benders, Manon J; Toet, Mona C; Hellström-Westas, Lena; de Vries, Linda S

    2017-01-01

    OBJECTIVE: Classify rhythmic EEG patterns in extremely preterm infants and relate these to brain injury and outcome. METHODS: Retrospective analysis of 77 infants born <28 weeks gestational age (GA) who had a 2-channel EEG during the first 72 h after birth. Patterns detected by the BrainZ seizure

  7. Trends in All-Cause Mortality across Gestational Age in Days for Children Born at Term

    DEFF Research Database (Denmark)

    Wu, Chunsen; Sun, Yuelian; Nohr, Ellen Aagaard

    2015-01-01

    pattern was observed when analyses were restricted to children born to by mothers without pregnancy complications. CONCLUSIONS: This study demonstrates heterogeneity in mortality rates even among singletons born at term. The highest mortality was observed among children born 37 weeks of gestation, which......BACKGROUND: Term birth is a gestational age from 259 days to 293 days. However trends in mortality according to gestational ages in days have not yet been described in this time period. METHODS AND FINDINGS: Based on nation-wide registries, we conducted a population-based cohort study among all...... children born at term in Denmark from 1997 to 2004 to estimate differences in mortality across gestational ages in days among singletons born at term. We studied early-neonatal mortality, neonatal mortality, infant mortality, and five-year mortality. Children were followed from birth up to the last day...

  8. Integrating neurocritical care approaches into neonatology: should all infants be treated equitably?

    Science.gov (United States)

    Mann, P C; Gospe, S M; Steinman, K J; Wilfond, B S

    2015-12-01

    To improve the neurologic outcomes for infants with brain injury, neonatal providers are increasingly implementing neurocritical care approaches into clinical practice. Term infants with brain injury have been principal beneficiaries of neurologically-integrated care models to date, as evidenced by the widespread adoption of therapeutic hypothermia protocols for hypoxic-ischemic encephalopathy. Innovative therapeutic and diagnostic support for very low birth weight infants with brain injury has lagged behind. Given that concern for significant future neurodevelopmental impairment can lead to decisions to withdraw life supportive care at any gestational age, providing families with accurate prognostic information is essential for all infants. Current variable application of multidisciplinary neurocritical care approaches to infants at different gestational ages may be ethically problematic and reflect distinct perceptions of brain injury for infants born extremely premature.

  9. Nosocomial acquisition of Escherichia coli by infants delivered in hospitals.

    Science.gov (United States)

    Fujita, K; Murono, K

    1996-04-01

    The delivery of infants in hospitals is desirable for obstetric reasons, but exposes the neonates to the microbiological hazards of a maternity unit. When neonates are born and cared for in hospital, the Escherichia coli strains that colonize the intestine tend to be acquired from the environment or from other babies, and are potentially pathogenic. The colonization of the infant with maternal flora should be promoted by strict rooming-in of mother and baby, or by delivery at home.

  10. Continuities and changes in infant attachment patterns across two generations.

    Science.gov (United States)

    Raby, K Lee; Steele, Ryan D; Carlson, Elizabeth A; Sroufe, L Alan

    2015-01-01

    This study examined the intergenerational continuities and changes in infant attachment patterns within a higher-risk longitudinal sample of 55 female participants born into poverty. Infant attachment was assessed using the Strange Situation when participants were 12 and 18 months as well as several decades later with participants' children. Paralleling earlier findings from this sample on the stability of attachment patterns from infancy to young adulthood, results provided evidence for intergenerational continuities in attachment disorganization but not security. Children of adults with histories of infant attachment disorganization were at an increased risk of forming disorganized attachments. Although changes in infant attachment patterns across the two generations were not correlated with individuals' caregiving experiences or interpersonal stresses and supports during childhood and adolescence, higher quality social support during adulthood was associated with intergenerational changes from insecure to secure infant-caregiver attachment relationships.

  11. Genome-wide DNA methylation profiling in infants born to gestational diabetes mellitus.

    Science.gov (United States)

    Weng, Xiaoling; Liu, Fatao; Zhang, Hong; Kan, Mengyuan; Wang, Ting; Dong, Mingyue; Liu, Yun

    2018-03-26

    Offspring exposed to gestational diabetes mellitus (GDM) are at a high risk for metabolic diseases. The mechanisms behind the association between offspring exposed to GDM in utero and an increased risk of health consequences later in life remain unclear. The aim of this study was to clarify the changes in methylation levels in the foetuses of women with GDM and to explore the possible mechanisms linking maternal GDM with a high risk of metabolic diseases in offspring later in life. A genome-wide comparative methylome analysis on the umbilical cord blood of infants born to 30 women with GDM and 33 women with normal pregnancy was performed using Infinium HumanMethylation 450 BeadChip assays. A quantitative methylation analysis of 18 CpG dinucleotides was verified in the validation umbilical cord blood samples from 102 newborns exposed to GDM and 103 newborns who experienced normal pregnancy by MassARRAY EpiTYPER. A total of 4485 differentially methylated sites (DMSs), including 2150 hypermethylated sites and 2335 hypomethylated sites, with a mean β-value difference of >0.05, were identified by the 450k array. Good agreement was observed between the massarray validation data and the 450k array data (R 2 > 0.99; P 0.15 between the GDM and healthy groups were identified and showed potential as clinical biomarkers for GDM. "hsa04940: Type I diabetes mellitus" was the most significant Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, with a P-value = 3.20E-07 and 1.36E-02 in the hypermethylated and hypomethylated genepathway enrichment analyses, respectively. In the Gene Ontology (GO) pathway analyses, immune MHC-related pathways and neuron development-related pathways were significantly enriched. Our results suggest that GDM has epigenetic effects on genes that are preferentially involved in the Type I diabetes mellitus pathway, immune MHC (major histocompatibility complex)-related pathways and neuron development-related pathways, with consequences on fetal growth

  12. Joint Laxity in Preschool Children Born Preterm.

    Science.gov (United States)

    Romeo, Domenico M; Velli, Chiara; Lucibello, Simona; Ferrantini, Gloria; Leo, Giuseppina; Brogna, Claudia; Cota, Francesco; Ricci, Daniela; Gallini, Francesca; Romagnoli, Costantino; Vento, Giovanni; Mercuri, Eugenio

    2018-06-01

    To evaluate the prevalence of joint laxity in children born preterm assessed in the first 2 years, the relationship between joint laxity and motor performance at preschool age, and possible changes over time in a subgroup of children followed longitudinally. The revised scale of Beighton Score was used to evaluate joint laxity in a population of 132 preschool children born preterm between 24 and 32 weeks of gestational age. All were assessed for joint laxity between 12 and 24 months of age. Children also performed the Movement Assessment Battery for Children-Second Edition between the age of 3 years and 6 months and 4 years; the age at onset of independent walking also was recorded. The total Beighton Score ranged between 0 and 8. Twenty percent of the cohort showed joint laxity. No differences related to sex or gestational age were observed. Children born preterm with joint laxity achieved later independent walking and achieved lower scores on Movement Assessment Battery for Children-Second Edition than those without joint laxity. In 76 children born preterm, an assessment for joint laxity was repeated once between 25 and 36 months and again after >36 months. No statistically significant difference was observed between the 3 assessments. The Beighton Score can be used to assess generalized joint laxity in children born preterm. As the presence of joint laxity influenced motor competences, the possibility to early identify these infants in the first 2 years is of interest to benefit from early intervention and potentially improve gross motor skills and coordination. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Mother-to-infant transmission of intestinal bifidobacterial strains has an impact on the early development of vaginally delivered infant's microbiota.

    Directory of Open Access Journals (Sweden)

    Hiroshi Makino

    Full Text Available OBJECTIVES: Bifidobacterium species are one of the major components of the infant's intestine microbiota. Colonization with bifidobacteria in early infancy is suggested to be important for health in later life. However, information remains limited regarding the source of these microbes. Here, we investigated whether specific strains of bifidobacteria in the maternal intestinal flora are transmitted to their infant's intestine. MATERIALS AND METHODS: Fecal samples were collected from healthy 17 mother and infant pairs (Vaginal delivery: 12; Cesarean section delivery: 5. Mother's feces were collected twice before delivery. Infant's feces were collected at 0 (meconium, 3, 7, 30, 90 days after birth. Bifidobacteria isolated from feces were genotyped by multilocus sequencing typing, and the transitions of bifidobacteria counts in infant's feces were analyzed by quantitative real-time PCR. RESULTS: Stains belonging to Bifidobacterium adolescentis, Bifidobacterium bifidum, Bifidobacterium catenulatum, Bifidobacterium longum subsp. longum, and Bifidobacterium pseudocatenulatum, were identified to be monophyletic between mother's and infant's intestine. Eleven out of 12 vaginal delivered infants carried at least one monophyletic strain. The bifidobacterial counts of the species to which the monophyletic strains belong, increased predominantly in the infant's intestine within 3 days after birth. Among infants delivered by C-section, monophyletic strains were not observed. Moreover, the bifidobacterial counts were significantly lower than the vaginal delivered infants until 7 days of age. CONCLUSIONS: Among infants born vaginally, several Bifidobacterium strains transmit from the mother and colonize the infant's intestine shortly after birth. Our data suggest that the mother's intestine is an important source for the vaginal delivered infant's intestinal microbiota.

  14. Born in Bradford, a cohort study of babies born in Bradford, and their parents: Protocol for the recruitment phase

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    Raynor Pauline

    2008-09-01

    Full Text Available Abstract Background Bradford, one of the most deprived cities in the United Kingdom, has a wide range of public health problems associated with socioeconomic deprivation, including an infant mortality rate almost double that for England and Wales. Infant mortality is highest for babies of Pakistani origin, who comprise almost half the babies born in Bradford. The Born in Bradford cohort study aims to examine environmental, psychological and genetic factors that impact on health and development perinatally, during childhood and subsequent adult life, and those that influence their parents' health and wellbeing. This protocol outlines methods for the recruitment phase of the study. Methods Most Bradford women attend for antenatal care and give birth at the Bradford Royal Infirmary, which has approximately 5,800 births per year. Women are eligible for recruitment if they plan to give birth here. Babies born from March 2007 are eligible to participate, recruitment is planned to continue until 2010. Fathers of babies recruited are invited to participate. Women are usually recruited when they attend for a routine oral glucose tolerance test at 26–28 weeks gestation. Recruitment of babies is at birth. Fathers are recruited whenever possible during the antenatal period, or soon after the birth. The aim is to recruit 10,000 women, their babies, and the babies' fathers. At recruitment women have blood samples taken, are interviewed to complete a semi-structured questionnaire, weighed, and have height, arm circumference and triceps skinfold measured. Umbilical cord blood is collected at birth. Within two weeks of birth babies have their head, arm and abdominal circumference measured, along with subscapular and triceps skinfold thickness. Fathers self-complete a questionnaire at recruitment, have height and weight measured, and provide a saliva sample. Participants are allocated a unique study number. NHS numbers will be used to facilitate record linkage

  15. Maternal Education Level Predicts Cognitive, Language, and Motor Outcome in Preterm Infants in the Second Year of Life.

    Science.gov (United States)

    Patra, Kousiki; Greene, Michelle M; Patel, Aloka L; Meier, Paula

    2016-07-01

    Objective To evaluate the relative impact of maternal education level (MEL) on cognitive, language, and motor outcomes at 20 months' corrected age (CA) in preterm infants. Study Design A total of 177 preterm infants born between 2008 and 2010 were tested at 20 months' CA using the Bayley Scales of Infant and Toddler Development-III. Multiple regression analyses were done to determine the relative impact of MEL on cognitive, language, and motor scores. Results Infants born to mothers with high school MEL were 3.74 times more likely to have a subnormal motor index, while those born to mothers with some college and graduate school MEL had reduced odds (0.36 and 0.12, respectively) of having subnormal language index at 20 months. In linear regression, MEL was the strongest predictor of cognitive, language, and motor scores, and graduate school MEL was associated with increases in cognitive, motor, and language scores of 8.49, 8.23, and 15.74 points, respectively. Conclusions MEL is the most significant predictor of cognitive, language, and motor outcome at 20 months' CA in preterm infants. Further research is needed to evaluate if targeted interventions that focus on early childhood learning and parenting practices can ameliorate the impact of low MEL. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Maternal Caffeine Consumption and Infant Nighttime Waking: Prospective Cohort Study

    Science.gov (United States)

    Santos, Iná S.; Matijasevich, Alicia

    2012-01-01

    OBJECTIVE: Coffee and other caffeinated beverages are commonly consumed in pregnancy. In adults, caffeine may interfere with sleep onset and have a dose-response effect similar to those seen during insomnia. In infancy, nighttime waking is a common event. With this study, we aimed to investigate if maternal caffeine consumption during pregnancy and lactation leads to frequent nocturnal awakening among infants at 3 months of age. METHODS: All children born in the city of Pelotas, Brazil, during 2004 were enrolled on a cohort study. Mothers were interviewed at delivery and after 3 months to obtain information on caffeine drinking consumption, sociodemographic, reproductive, and behavioral characteristics. Infant sleeping pattern in the previous 15 days was obtained from a subsample. Night waking was defined as an episode of infant arousal that woke the parents during nighttime. Multivariable analysis was performed by using Poisson regression. RESULTS: The subsample included 885 of the 4231 infants born in 2004. All but 1 mother consumed caffeine in pregnancy. Nearly 20% were heavy consumers (≥300 mg/day) during pregnancy and 14.3% at 3 months postpartum. Prevalence of frequent nighttime awakeners (>3 episodes per night) was 13.8% (95% confidence interval: 11.5%–16.0%). The highest prevalence ratio was observed among breastfed infants from mothers consuming ≥300 mg/day during the whole pregnancy and in the postpartum period (1.65; 95% confidence interval: 0.86–3.17) but at a nonsignificant level. CONCLUSIONS: Caffeine consumption during pregnancy and by nursing mothers seems not to have consequences on sleep of infants at the age of 3 months. PMID:22473365

  17. The Immune System of HIV-Exposed Uninfected Infants.

    Science.gov (United States)

    Abu-Raya, Bahaa; Kollmann, Tobias R; Marchant, Arnaud; MacGillivray, Duncan M

    2016-01-01

    Infants born to human immunodeficiency virus (HIV) infected women are HIV-exposed but the majority remains uninfected [i.e., HIV-exposed uninfected (HEU)]. HEU infants suffer greater morbidity and mortality from infections compared to HIV-unexposed (HU) peers. The reason(s) for these worse outcomes are uncertain, but could be related to an altered immune system state. This review comprehensively summarizes the current literature investigating the adaptive and innate immune system of HEU infants. HEU infants have altered cell-mediated immunity, including impaired T-cell maturation with documented hypo- as well as hyper-responsiveness to T-cell activation. And although prevaccination vaccine-specific antibody levels are often lower in HEU than HU, most HEU infants mount adequate humoral immune response following primary vaccination with diphtheria toxoid, haemophilus influenzae type b, whole cell pertussis, measles, hepatitis B, tetanus toxoid, and pneumococcal conjugate vaccines. However, HEU infants are often found to have lower absolute neutrophil counts as compared to HU infants. On the other hand, an increase of innate immune cytokine production and expression of co-stimulatory markers has been noted in HEU infants, but this increase appears to be restricted to the first few weeks of life. The immune system of HEU children beyond infancy remains largely unexplored.

  18. Neonatal cerebral oxygenation is not linked to foetal vasculitis and predicts intraventricular haemorrhage in preterm infants

    DEFF Research Database (Denmark)

    Sørensen, Line Carøe; Maroun, Lisa Leth; Borch, K.

    2008-01-01

    AIM: The aim of the study was to compare the cerebral tissue oxygenation index (c-TOI) measured by near infrared spectroscopy (NIRS) in infants with and without foetal vasculitis. METHODS: Twenty-four infants with placental signs of a foetal inflammatory response (FIR), foetal vasculitis, were.......002). CONCLUSION: Cerebral oxygenation was not affected in the first day of life in preterm infants born with foetal vasculitis, while cerebral oxygenation in infants that later developed intraventricular haemorrhage was impaired Udgivelsesdato: 2008/11...

  19. Intracranial hemorrhage associated with medulla oblongata dysplasia in a premature infant: A case report.

    Science.gov (United States)

    Jiang, Li-Na; Wei, Mei-Chen; Cui, Hong

    2018-04-01

    Medulla oblongata dysplasia is an extremely rare form of neurodevelopmental immaturity in premature infants. Intracranial hemorrhage in premature infants may be closely related to neurodevelopmental immaturity. We report a female premature infant who succumbed to intracranial hemorrhage caused by medulla oblongata dysplasia. The infant was born at 31 weeks gestation. The onset manifestation was symptomatic epilepsy associated with subependymal hemorrhage. Levetiracetam and sodium valproate were administered. During the hospitalization, hydrocephalus developed and the intracranial hemorrhage aggravated. The infant died on day 171 after birth. Early identification and prompt treatment should be emphasized. Clinicians should be aware of this condition, as it can potentially cause neonatal intracranial hemorrhage.

  20. Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data.

    Science.gov (United States)

    Garcia, Rebecca; Ali, Nasreen; Guppy, Andy; Griffiths, Malcolm; Randhawa, Gurch

    2017-08-11

    To compare mean birth weights and gestational age at delivery of infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK. Retrospective analysis using routinely recorded secondary data in Ciconia Maternity information System, between 2008 and 2013. Luton, UK. Mothers whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian and living in Luton, aged over 16, who had a live singleton birth over 24 weeks of gestation were included in the analysis (n=14 871). Primary outcome measures were mean birth weight and gestational age at delivery. After controlling for maternal age, smoking, diabetes, gestation age, parity and maternal height and body mass index at booking, a significant difference in infants' mean birth weight was found between white British and Indian, Pakistani and Bangladeshi infants, F(3, 12 287)=300.32, pmothers, compared with Indian mothers (Wald=8.192, df 1, pmothers and preterm delivery, when compared with Pakistani, Bangladeshi and white British women. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Early feeding and neonatal hypoglycemia in infants of diabetic mothers

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    Leandro Cordero

    2013-12-01

    Full Text Available Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30% had hypoglycemia, corrected by early feeding in 75 (86%, while 12 (14% required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%, prematurity (33% or prevention of hypoglycemia (27%. Although all newborn intensive care unit patients received intravenous dextrose, 22 (22% had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82% were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding.

  2. Early feeding and neonatal hypoglycemia in infants of diabetic mothers

    Science.gov (United States)

    Ramesh, Shilpa; Hillier, Kirsty; Giannone, Peter J; Nankervis, Craig A

    2013-01-01

    Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL) were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30%) had hypoglycemia, corrected by early feeding in 75 (86%), while 12 (14%) required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%), prematurity (33%) or prevention of hypoglycemia (27%). Although all newborn intensive care unit patients received intravenous dextrose, 22 (22%) had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82%) were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding. PMID:26770697

  3. A novel six consecutive monthly doses of palivizumab prophylaxis protocol for the prevention of respiratory syncytial virus infection in high-risk preterm infants in Taiwan.

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    Hsin Chi

    Full Text Available Respiratory syncytial virus (RSV circulates year round in Taiwan. A novel six consecutive monthly doses of palivizumab for RSV prevention protocol has been approved for high risk preterm infants since December 2010. This study aimed to determine the clinical effectiveness and safety of this novel protocol for the prevention of RSV infection.From April 2011 to March 2013, we enrolled infants born at ≤28 weeks gestation and infants born at ≤35 weeks gestation with chronic lung disease (CLD who received palivizumab prophylaxis as study group and followed up for 12 months. Historic control, those who were born and followed up between July 2000 and June 2008, were retrieved for propensity score matching. Primary endpoint was RSV-related hospitalization, and secondary endpoints included the length of hospital stay and intensive care unit (ICU care.We enrolled 127 infants (108 infants born at ≤28 weeks and 19 infants born at 29-35 weeks with CLD. They completed 6-dose palivizumab as scheduled. Among the study group, the RSV-related hospitalizations were 2 (1.6% within 6 months and 5 (3.9% within 12 months after discharge. We matched 127 infants in the control group with 127 infants in the study group by propensity score matching. The reduction of RSV-related hospitalization rates were 86% (10.2% vs 1.6%, p = 0.002 within 6 months after discharge and 78% (15.7% vs 3.9%, p = 0.004 within 12 months after discharge. Compared to the control group, the rate of ICU care significantly decreased from 7.1% to 0.8% (p = 0.024 within 6 months after discharge and from 7.9% to 0.8% (p = 0.014 within 12 months after discharge. Adverse events were recorded in 6.4% injections.Six monthly intramuscular administration of palivizumab is effective for prevention of RSV hospitalization in regions with no single seasonal peak of RSV infection such as Taiwan.

  4. Can very early music interventions promote at-risk infants' development?

    Science.gov (United States)

    Virtala, Paula; Partanen, Eino

    2018-04-30

    Music and musical activities are often a natural part of parenting. As accumulating evidence shows, music can promote auditory and language development in infancy and early childhood. It may even help to support auditory and language skills in infants whose development is compromised by heritable conditions, like the reading deficit dyslexia, or by environmental factors, such as premature birth. For example, infants born to dyslexic parents can have atypical brain responses to speech sounds and subsequent challenges in language development. Children born very preterm, in turn, have an increased likelihood of sensory, cognitive, and motor deficits. To ameliorate these deficits, we have developed early interventions focusing on music. Preliminary results of our ongoing longitudinal studies suggest that music making and parental singing promote infants' early language development and auditory neural processing. Together with previous findings in the field, the present studies highlight the role of active, social music making in supporting auditory and language development in at-risk children and infants. Once completed, the studies will illuminate both risk and protective factors in development and offer a comprehensive model of understanding the promises of music activities in promoting positive developmental outcomes during the first years of life. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

  5. Congenital Hyperterophic Pyloric Stenosis of Infants | Mbanaso ...

    African Journals Online (AJOL)

    We present a 7-week-old male infant with congenital hyperterophic pyloric stenosis. The essence of this case report is to show that this condition could be mistaken for failure to thrive, protein caloric malnutrition, or ignorance on the part of the mother on how to feed the first born child. All these were suggested in our patient, ...

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

    Science.gov (United States)

    Jensen, Erik A; Lorch, Scott A

    2015-08-01

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

  7. Complementary feeding at 4 versus 6 months of age for preterm infants born at less than 34 weeks of gestation: a randomised, open-label, multicentre trial

    Directory of Open Access Journals (Sweden)

    Shuchita Gupta, MD

    2017-05-01

    Full Text Available Summary: Background: Evidence on the optimal time to initiation of complementary feeding in preterm infants is scarce. We examined the effect of initiation of complementary feeding at 4 months versus 6 months of corrected age on weight for age at 12 months corrected age in preterm infants less than 34 weeks of gestation. Methods: In this open-label, randomised trial, we enrolled infants born at less than 34 weeks of gestation with no major malformation from three public health facilities in India. Eligible infants were tracked from birth and randomly assigned (1:1 at 4 months corrected age to receive complementary feeding at 4 months corrected age (4 month group, or continuation of milk feeding and initiation of complementary feeding at 6 months corrected age (6 month group, using computer generated randomisation schedule of variable block size, stratified by gestation (30 weeks or less, and 31–33 weeks. Iron supplementation was provided as standard. Participants and the implementation team could not be masked to group assignment, but outcome assessors were masked. Primary outcome was weight for age Z-score at 12 months corrected age (WAZ12 based on WHO Multicentre Growth Reference Study growth standards. Analyses were by intention to treat. The trial is registered with Clinical Trials Registry of India, number CTRI/2012/11/003149. Findings: Between March 20, 2013, and April 24, 2015, 403 infants were randomly assigned: 206 to receive complementary feeding from 4 months and 197 to receive complementary feeding from 6 months. 22 infants in the 4 month group (four deaths, two withdrawals, 16 lost to follow-up and eight infants in the 6 month group (two deaths, six lost to follow-up were excluded from analysis of primary outcome. There was no difference in WAZ12 between two groups: −1·6 (SD 1·2 in the 4 month group versus −1·6 (SD 1·3 in the 6 month group (mean difference 0·005, 95% CI −0·24 to 0·25; p=0·965. There were more

  8. Infant mortality in Pelotas, Brazil: a comparison of risk factors in two birth cohorts.

    Science.gov (United States)

    Menezes, Ana Maria Baptista; Hallal, Pedro Curi; Santos, Iná Silva dos; Victora, Cesar Gomes; Barros, Fernando Celso

    2005-12-01

    To compare two population-based birth cohorts to assess trends in infant mortality rates and the distribution of relevant risk factors, and how these changed after an 11-year period. Data from two population-based prospective birth cohorts (1982 and 1993) were analyzed. Both studies included all children born in a hospital (> 99% of all births) in the city of Pelotas, Southern Brazil. Infant mortality was monitored through surveillance of all maternity hospitals, mortality registries and cemeteries. There were 5,914 live-born children in 1982 and 5,249 in 1993. The infant mortality rate decreased by 41%, from 36.0 per 1,000 live births in 1982 to 21.1 per 1,000 in 1993. Socioeconomic and maternal factors tended to become more favorable during the study period, but there were unfavorable changes in birthweight and gestational age. Poverty, high parity, low birthweight, preterm delivery, and intrauterine growth restriction were the main risk factors for infant mortality in both cohorts. The 41% reduction in infant mortality between 1982 and 1993 would have been even greater had the prevalence of risk factors remained constant during the period studied here. There were impressive declines in infant mortality which were not due to changes in the risk factors we studied. Because no reduction was seen in the large social inequalities documented in the 1982 cohort, it is likely that the reduction in infant mortality resulted largely from improvements in health care.

  9. 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.

  10. High rate of symptomatic cytomegalovirus infection in extremely low gestational age preterm infants of 22-24 weeks' gestation after transmission via breast milk.

    Science.gov (United States)

    Mehler, Katrin; Oberthuer, André; Lang-Roth, Ruth; Kribs, Angela

    2014-01-01

    Very immature preterm infants are at risk of developing symptomatic or severe infection if cytomegalovirus is transmitted via breast milk. It is still a matter of debate whether human cytomegalovirus (HCMV) infection may lead to long-term sequelae. We hypothesized that symptomatic and severe HCMV infection transmitted via breast milk affects extremely immature infants at a very high rate. In 2012, untreated breast milk was fed to extremely low birth weight infants after parental informed consent was obtained. We retrospectively analyzed data on HCMV infection of infants born in 2012 between 22 and 24 weeks of gestation. 17 infants were born to HCMV IgG-seropositive mothers. 11 (65%) of these were diagnosed with symptomatic infection. In all cases, thrombocytopenia was the reason to analyze the infant's urine. HCMV infection was diagnosed at a median time of 12 weeks after birth. In 5 (45%) infants, thrombocytopenia was the only symptom and resolved without antiviral therapy or platelet transfusion. 6 (55%) infants developed sepsis-like disease with mildly elevated CRP values and showed signs of respiratory failure. 3 (27%) were able to be stabilized on CPAP, 3 (27%) had to be intubated and mechanically ventilated. 4 children were treated with ganciclovir and/or valganciclovir. 55% failed otoacoustic emissions and/or automated auditory brainstem response testing at discharge. In very immature infants born at the border of viability and suffering from multiple preexisting problems, HCMV infection may trigger a severe deterioration of the clinical course. © 2013 S. Karger AG, Basel.

  11. Fabricating feeding plate in CLP infants with two different material: A series of case report

    Directory of Open Access Journals (Sweden)

    R Gupta

    2012-01-01

    Full Text Available Feeding is a family′s biggest concerns when a child is born with cleft lip and/or palate. The goal for that child is to have as near normal feeding as possible. This report presents fabrication of feeding plates in two infants born with cleft lip and palate using two different materials.

  12. Early neuromotor development of high risk infants - Gross motor function in preterm and full-term born infants

    NARCIS (Netherlands)

    van Haastert, I.C.

    2011-01-01

    This thesis is the result of 20 years follow-up of preterm and full-term born ‘graduates’ of the neonatal intensive care unit of the Wilhelmina Children’s Hospital, Utrecht. The aim was to answer questions that arose during admission and follow-up assessments. Typical gross motor development of

  13. Sensorized toys for measuring manipulation capabilities of infants at home.

    Science.gov (United States)

    Passetti, Giovanni; Cecchi, Francesca; Baldoli, Ilaria; Sgandurra, Giuseppina; Beani, Elena; Cioni, Giovanni; Laschi, Cecilia; Dario, Paolo

    2015-01-01

    Preterm infants, i.e. babies born after a gestation period shorter than 37 weeks, spend less time exploring objects. The quantitative measurement of grasping actions and forces in infants can give insights on their typical or atypical motor development. The aim of this work was to test a new tool, a kit of sensorized toys, to longitudinally measure, monitor and promote preterm infants manipulation capabilities with a purposive training in an ecological environment. This study presents preliminary analysis of grasping activity. Three preterm infants performed 4 weeks of daily training at home. Sensorized toys with embedded pressure sensors were used as part of the training to allow quantitative analysis of grasping (pressure and acceleration applied to toys while playing). Each toy was placed on the midline, while the infant was in supine position. Preliminary data show differences in the grasping parameters in relation to infants age and the performed daily training. Ongoing clinical trial will allow a full validation of this new tool for promoting object exploration in preterm infants.

  14. Profile of tuberculosis among the foreign-born population in Japan, 2007-2014.

    Science.gov (United States)

    Kawatsu, Lisa; Uchimura, Kazuhiro; Izumi, Kiyohiko; Ohkado, Akihiro; Ishikawa, Nobukatsu

    2016-01-01

    The proportion of foreign-born people among the newly notified tuberculosis (TB) patients has been increasing in recent years and potentially poses a new challenge to TB control in Japan. In this report, we analysed the data from the Japan TB surveillance system between 2007 and 2014 to gain an overview of the trends and characteristics of foreign-born TB patients in Japan. We found that the proportion of foreign-born TB patients was especially high among the younger age groups - 44.1% among the 20-29 years age group in 2014. The largest groups of foreign-born patients were from China and the Philippines; however, the number of those from Nepal and Viet Nam was on the rise. Students comprised the second largest professional category group for TB after regular workers, and its proportion increased over the study period. Compared to Japan-born TB patients, foreign-born patients were more likely to be diagnosed through routine medical check-ups. Treatment successes and patients still on treatment were significantly lower among foreign-born patients than their Japan-born counterparts; and transferred-out and unknown outcomes were higher. Our results indicated that distinctive subgroups within the foreign-born population in Japan, especially students and regular workers, might have a higher risk of developing TB. Measures to ensure early diagnosis and treatment adherence should be adapted to such populations.

  15. Distribution of haematological and chemical pathology values among infants in Malawi and Uganda

    Science.gov (United States)

    Kumwenda, Newton I.; Khonje, Tiwonge; Mipando, Linda; Nkanaunena, Kondwani; Katundu, Pauline; Lubega, Irene; Elbireer, Ali; Bolton, Steve; Bagenda, Danstan; Mubiru, Michael; Fowler, Mary Glenn; Taha, Taha E.

    2013-01-01

    Background Data on paediatric reference laboratory values are limited for sub-Saharan Africa. Objective To describe the distribution of haematological and chemical pathology values among healthy infants from Malawi and Uganda. Methods A cross-sectional study was conducted among healthy infants, 0–6 months old, born to HIV-uninfected mothers recruited from two settings in Blantyre, Malawi and Kampala, Uganda. Chemical pathology and haematology parameters were determined using standard methods on blood samples. Descriptive analyses by age-group were performed based on 2004 Division of AIDS Toxicity Table age categories. Mean values and interquartile ranges were compared by site and age-group. Results A total of 541 infants were included altogether, 294 from Malawi and 247 from Uganda. Overall, the mean laboratory values were comparable between the two sites. Mean alkaline phosphatase levels were lower among infants aged ≤21 days while aspartate aminotransferase, creatinine, total bilirubin and gamma-glutamyl transferase were higher in those aged 0–7 days than in older infants. Mean haematocrit, haemoglobin and neutrophil counts were higher in the younger age-groups (<35 days) and overall were lower than US norms. Red and white blood cell counts tended to decrease after birth but increased after ~2 months of age. Mean basophil counts were higher in Malawi than in Uganda in infants aged 0–1 and 2–7 days; mean counts for eosinophils (for age groups 8–21 or older) and platelets (for all age groups) were higher in Ugandan than in Malawian infants. Absolute lymphocyte counts increased with infant age. Conclusion The chemical pathology and haematological values in healthy infants born to HIV-uninfected mothers were comparable in Malawi and Uganda and can serve as useful reference values in these settings. PMID:23164296

  16. PREMM: preterm early massage by the mother: protocol of a randomised controlled trial of massage therapy in very preterm infants.

    Science.gov (United States)

    Lai, Melissa M; D'Acunto, Giulia; Guzzetta, Andrea; Boyd, Roslyn N; Rose, Stephen E; Fripp, Jurgen; Finnigan, Simon; Ngenda, Naoni; Love, Penny; Whittingham, Koa; Pannek, Kerstin; Ware, Robert S; Colditz, Paul B

    2016-08-27

    Preterm infants follow an altered neurodevelopmental trajectory compared to their term born peers as a result of the influence of early birth, and the altered environment. Infant massage in the preterm infant has shown positive effects on weight gain and reduced length of hospital stay. There is however, limited current evidence of improved neurodevelopment or improved attachment, maternal mood or anxiety. The aim of this study is to investigate the effects of infant massage performed by the mother in very preterm (VPT) infants. Effects on the infant will be assessed at the electrophysiological, neuroradiological and clinical levels.  Effects on maternal mood, anxiety and mother-infant attachment will also be measured. A randomised controlled trial to investigate the effect of massage therapy in VPT infants. Sixty VPT infants, born at 28 to 32 weeks and 6 days gestational age, who are stable, off supplemental oxygen therapy and have normal cranial ultrasounds will be recruited and randomised to an intervention (infant massage) group or a control (standard care) group. Ten healthy term born infants will be recruited as a reference comparison group. The intervention group will receive standardised massage therapy administered by the mother from recruitment, until term equivalent age (TEA). The control group will receive care as usual (CAU). Infants and their mothers will be assessed at baseline, TEA, 12 months and 24 months corrected age (CA), with a battery of clinical, neuroimaging and electrophysiological measures, as well as structured questionnaires, psychoanalytic observations and neurodevelopmental assessments. Optimising preterm infant neurodevelopment is a key aim of neonatal research, which could substantially improve long-term outcomes and reduce the socio-economic impact of VPT birth. This study has the potential to give insights into the mother-baby relationship and any positive effects of infant massage on neurodevelopment. An early intervention

  17. Brain Volumes at Term-Equivalent Age in Preterm Infants : Imaging Biomarkers for Neurodevelopmental Outcome through Early School Age

    NARCIS (Netherlands)

    Keunen, Kristin; Išgum, Ivana; van Kooij, Britt J M; Anbeek, Petronella; van Haastert, Ingrid C; Koopman-Esseboom, Corine; van Stam, Petronella C; Nievelstein, Rutger A J; Viergever, Max A; de Vries, Linda S; Groenendaal, Floris; Benders, Manon J N L

    OBJECTIVE: To evaluate the relationship between brain volumes at term and neurodevelopmental outcome through early school age in preterm infants. STUDY DESIGN: One hundred twelve preterm infants (born mean gestational age 28.6 ± 1.7 weeks) were studied prospectively with magnetic resonance imaging

  18. The Dual Nature of Early-Life Experience on Somatosensory Processing in the Human Infant Brain.

    OpenAIRE

    Maitre, N.L.; Key, A.P.; Chorna, O.D.; Slaughter, J.C.; Matusz, P.J.; Wallace, M.T.; Murray, M.M.

    2017-01-01

    Every year, 15 million preterm infants are born, and most spend their first weeks in neonatal intensive care units (NICUs) [1]. Although essential for the support and survival of these infants, NICU sensory environments are dramatically different from those in which full-term infants mature and thus likely impact the development of functional brain organization [2]. Yet the integrity of sensory systems determines effective perception and behavior [3, 4]. In neonates, touch is a cornerstone of...

  19. NAA, GC(EC) and SRXRF study of Hg species in head hair of mothers and their newborn infants

    International Nuclear Information System (INIS)

    Feng Weiyue; Qian Qinfang; Zhang Peiqun; Chai Zhifang

    1997-01-01

    Twenty-seven pairs of head from mothers and their new-born infants were collected at the time of delivery in a hospital in Beijing. The total mercury content in the hair samples was determined by INAA. The correlation between mercury content in hair of mothers and their new-born infants has been investigated. In addition, the change of Hg content in pregnant women's hair during their pregnancy was also studied by INAA and SRXRF. The results indicate a significant positive correlation between the mercury content in maternal and infant head hairs (r = +0.862, p < 0.001). The average content of Hg in infant and maternal hairs was (0.66 +- 0.31) μg/g and (0.59 +- 0.25) μg/g, respectively. The infant level exceeded the maternal by 12%. The Hg content in maternal head hair gradually reduced during pregnancy. Further, the methylmercury (Me-Hg) content in 3 maternal hair samples was analyzed by GC(EC). The Me-Hg was in accordance with the total mercury content. Thus a conclusion can be drawn that damage to the infant from Hg occurred in the early stages of pregnancy

  20. Longitudinal body composition of children born to mothers with normal weight, overweight, and obesity.

    Science.gov (United States)

    Andres, Aline; Hull, Holly R; Shankar, Kartik; Casey, Patrick H; Cleves, Mario A; Badger, Thomas M

    2015-06-01

    The longitudinal trajectories of body composition of children born to mothers with normal weight, overweight, and obesity have not been evaluated using precise body composition methods. This study investigated the relationship between maternal prepregnancy BMI and offspring body composition trajectories during the first 6 years of life. Healthy infants (N = 325) were assessed longitudinally (at ages 0.25, 0.5, 0.75, 1, 2, 3, 4, 5, and 6 years) using dual-energy X-ray absorptiometry. Mixed-effects regression for repeated measures was used to model each continuous outcome as a function of maternal BMI and covariates (race, gestational age, birth weight, and mode of infant feeding). Maternal obesity differentially impacted body fat, but not bone mineral content or density, of girls and boys. Boys born to mothers with obesity have higher body fat from ages 2-6 years compared to boys born to normal-weight and overweight mothers (P obesity was not different across groups during the first 6 years of life (P > 0.05). This clinical observational study demonstrates a sexual dimorphism in offspring body composition until age 6 years based on maternal BMI, with a greater effect of maternal adiposity seen in boys than in girls. © 2015 The Obesity Society.

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

    Directory of Open Access Journals (Sweden)

    Eleanor E Friedman

    2014-10-01

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

  2. Alterations in human milk leptin and insulin are associated with early changes in the infant intestinal microbiome.

    Science.gov (United States)

    Lemas, Dominick J; Young, Bridget E; Baker, Peter R; Tomczik, Angela C; Soderborg, Taylor K; Hernandez, Teri L; de la Houssaye, Becky A; Robertson, Charles E; Rudolph, Michael C; Ir, Diana; Patinkin, Zachary W; Krebs, Nancy F; Santorico, Stephanie A; Weir, Tiffany; Barbour, Linda A; Frank, Daniel N; Friedman, Jacob E

    2016-05-01

    Increased maternal body mass index (BMI) is a robust risk factor for later pediatric obesity. Accumulating evidence suggests that human milk (HM) may attenuate the transfer of obesity from mother to offspring, potentially through its effects on early development of the infant microbiome. Our objective was to identify early differences in intestinal microbiota in a cohort of breastfeeding infants born to obese compared with normal-weight (NW) mothers. We also investigated relations between HM hormones (leptin and insulin) and both the taxonomic and functional potentials of the infant microbiome. Clinical data and infant stool and fasting HM samples were collected from 18 NW [prepregnancy BMI (in kg/m(2)) obese (prepregnancy BMI >30.0) mothers and their exclusively breastfed infants at 2 wk postpartum. Infant body composition at 2 wk was determined by air-displacement plethysmography. Infant gastrointestinal microbes were estimated by using 16S amplicon and whole-genome sequencing. HM insulin and leptin were determined by ELISA; short-chain fatty acids (SCFAs) were measured in stool samples by using gas chromatography. Power was set at 80%. Infants born to obese mothers were exposed to 2-fold higher HM insulin and leptin concentrations (P obesity may adversely affect the early infant intestinal microbiome, HM insulin and leptin are independently associated with beneficial microbial metabolic pathways predicted to increase intestinal barrier function and reduce intestinal inflammation. This trial was registered at clinicaltrials.gov as NCT01693406. © 2016 American Society for Nutrition.

  3. 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 ...

  4. New insights in factors influencing growth in children born small for gestational age

    NARCIS (Netherlands)

    J.S. Renes (Judith)

    2013-01-01

    markdownabstract__Abstract__ Small for gestational age (SGA) refers to the size of an infant at birth. It is defined as a birth weight and/ or birth length of at least two standard deviation scores (SDS) below the mean for gestational age (1, 2). SGA children can be born full-term or premature.

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

    Science.gov (United States)

    Maxwell, Joan

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

  6. Standard of hygiene and immune adaptation in newborn infants

    NARCIS (Netherlands)

    Kallionpaa, Henna; Laajala, Essi; Oling, Viveka; Harkonen, Taina; Tillmann, Vallo; Dorshakova, Natalya V.; Ilonen, Jorma; Landesmaki, Harri; Knip, Mikael; Lahesmaa, Riitta; Koski, Katriina; Koski, Matti; Ryhanen, Samppa; Siljander, Heli; Hamalainen, Anu-Maaria; Ormisson, Anne; Peet, Aleksandr; Ulich, Valentina; Kuzmicheva, Elena; Mokurov, Sergei; Markova, Svettana; Pylova, Svetlana; Isakova, Marina; Shakurova, Elena; Petrov, Vladimir; Karapetyan, Tatyana; Varlamova, Tatyana; Ilonen, Jorma; Kiviniemi, Minna; Alnek, Kristi; Janson, Helis; Uibo, Raivo; Salum, Tiit; von Mutius, Erika; Weber, Juliane; Ahlfors, Helena; Moulder, Robert; Nieminen, Janne; Ruohtula, Terhi; Vaarala, Outi; Honkanen, Hanna; Hyoty, Heikki; Kondrashova, Anita; Oikarinen, Sami; Harmsen, Hermie J. M.; De Goffau, Marcus C.; Welling, Gjalt; Alahuhta, Kirsi; Korhonen, Tuuli; Virtanen, Suvi M.

    2014-01-01

    The prevalence of immune-mediated diseases, such as allergies and type 1 diabetes, is on the rise in the developed world. In order to explore differences in the gene expression patterns induced in utero in infants born in contrasting standards of living and hygiene, we collected umbilical cord blood

  7. Prospective study on antibiotics misuse among infants with upper respiratory infections.

    Science.gov (United States)

    El Sayed, Manal F; Tamim, Hala; Jamal, Diana; Mumtaz, Ghina; Melki, Imad; Yunis, Khalid

    2009-06-01

    The judicious prescription of antibiotics has become a central focus of professional and public health measures to combat the spread of resistant organisms. A one-year multi-center prospective follow-up study of 1,320 healthy infants was conducted. The study aim was to determine the prevalence and identify the predictors of antibiotics misuse in viral respiratory illnesses among healthy infants in the first year of life. Infants born between August 2001 and February 2002 were recruited through the clinics and dispensaries of 117 pediatricians located in the Greater Beirut area of Lebanon. On each routine visit from birth until one year of life, pediatricians reported any episodes of upper respiratory tract infection (URTI; common cold) and bronchiolitis, as well as the treatment type, duration, and dose. Predictors that were considered included infant, maternal, and pediatrician characteristics. Of the 1,320 recruited infants, 770 (58.3%) had common cold or acute bronchiolitis on at least one occasion during the study period. Pediatricians prescribed antibiotics at least once in 21.4% of cases diagnosed as the common cold and 45.5% of cases of acute bronchiolitis. Logistic regression analysis revealed that antibiotics misuse was more common among infants born to mothers with lower educational levels (odds ratio [OR] = 1.6; 95% confidence interval [CI]: 1.1-2.3). Furthermore, pediatricians tend to prescribe antibiotics in dispensaries more often than in private clinics (OR = 1.4; 95% CI: 1.0-2.3). This study shows a substantial quantity of antibiotics prescriptions for common cold and acute bronchiolitis in our population. Our findings suggest that lower maternal education and pediatricians working in dispensaries (versus private clinics) are associated with increased antibiotics misuse.

  8. Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study.

    Science.gov (United States)

    Nyqvist, Kerstin H; Rosenblad, Andreas; Volgsten, Helena; Funkquist, Eva-Lotta; Mattsson, Elisabet

    2017-01-01

    Skin-to-skin contact (SSC) is an important factor to consider in the care of late preterm infants (born between 34 0/7 and 36 6/7 completed weeks of gestation). The literature suggests that SSC between preterm infants and their mothers facilitates breastfeeding. However, more studies are needed to explore potential dose-response effects between SSC and breastfeeding as well as studies that explicitly investigate SSC by fathers among late preterm infants. The aim was to investigate the duration of healthy late preterm infants' SSC with the mother and father, respectively, during the first 48 h after birth and the associations with breastfeeding (exclusive/partial at discharged), clinical and demographic variables. This was an observational cohort study in which parents to healthy late preterm infants, born between 34 5/7 and 36 6/7 completed weeks of gestation, recorded duration of SSC provided by mother and father, respectively. Demographic and clinical variables were retrieved from the medical records and were used as predictors. Multiple linear regression analysis was used to assess the association between the predictors and the outcome, SSC (hours), separately for mothers and fathers. The mean (standard deviation [SD]) time per day spent with SSC with mothers ( n  = 64) and fathers ( n  = 64), was 14.7 (5.6) and 4.4 (3.3) hours during the first day (24 h) after birth and 9.2 (7.1) and 3.1 (3.3) hours during the second day (24 h), respectively. Regarding SSC with mothers, no variable was significantly associated with SSC during the first day, while the mean (95% confidence interval [CI]) time of SSC during the second day was 6.9 (1.4-12.4) hours shorter for each additional kg of birthweight ( p  = 0.014). Concerning SSC with fathers, the mean (95% CI) time of SSC during the first day was 2.1 (0.4-3.7) hours longer for infants born at night ( p  = 0.015), 1.7 (0.1-3.2) hours longer for boys ( p  = 0.033), 3.2 (1.2-5.2) hours longer for infants born by

  9. Patched Skin Bilirubin Assay to Monitor Neonates Born Extremely Preterm Undergoing Phototherapy.

    Science.gov (United States)

    De Luca, Daniele; Dell'Orto, Valentina

    2017-09-01

    To verify the reliability and safety of transcutaneous bilirubin (TcB) measurements in patched skin areas in neonates born extremely preterm under phototherapy. Sixty neonates (bilirubin (TSB), lactate, pH, hemoglobin, and skin temperature were measured within 10 minutes of the TcB assay. Clinicians were blinded to TcB values, and clinical decisions about phototherapy were made with the TSB measurement only. TcB and TSB significantly were correlated (r = 0.84; P bilirubin passage. TcB overestimated TSB, and this may expose infants born preterm to unnecessary phototherapy, although it could spare approximately 65% of TSB assays. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Evolving Understanding of Hypoxic-Ischemic Encephalopathy in the Term Infant

    NARCIS (Netherlands)

    de Vries, Linda S.; Cowan, Frances M.

    2009-01-01

    Our aim was to document changes in the evaluation and prognosis of term-born infants with neonatal encephalopathy of hypoxic-ischemic origin, with particular reference to our own experiences and influences, and to summarize the debate on causation and the relative importance of antenatal and

  11. Perinatal transmission in infants of mothers with chronic hepatitis B in California

    OpenAIRE

    Burgis, Jennifer C; Kong, Darryl; Salibay, Catheryn; Zipprich, Jennifer; Harriman, Kathleen; So, Samuel

    2017-01-01

    AIM To evaluate maternal hepatitis B virus (HBV) DNA as risk for perinatal HBV infection among infants of HBV-infected women in California. METHODS Retrospective analysis among infants born to hepatitis B surface antigen (HBsAg)-positive mothers who received post vaccination serologic testing (PVST) between 2005 and 2011 in California. Demographic information was collected from the California Department of Public Health Perinatal Hepatitis B Program databaseand matched to birth certificate re...

  12. The analysis of Sudden Infant Death Syndrome in Poland

    Directory of Open Access Journals (Sweden)

    Anna Lewandowska

    2017-05-01

    Full Text Available Introduction: Sudden Infant Death Syndrome is defined in literature similarly as a sudden and unexpected death of an infant occurring during sleep and, at the same time, causes of which cannot be explained based on anamnesis, circumstances of death or comprehensive post-mortem examinations. Sudden Infant Death Syndrome is considered to be the most frequent cause of death among infants in the developed countries. Incidence of SIDS in the whole world ranges from about 0.1 to 6.0/1,000 live births. As much as 90% concerns deaths in the first year of life of a child, whereas 70% stands for deaths for which the cause remains unknown. In SIDS, about 90% of cases concern children under 1 year old and, in particular, at the age of between 2 and 4 months. The aim: The aim of the study was to present the most significant aspects of SIDS as well as description and analysis of risk factors for occurrence of sudden infant death syndrome based on statistical data. Materials and methods: For the purpose of the study, the secondary data analysis and desk research technique have been applied. The analysis is based on statistical data from the time period 2009-2014 released by the Central Statistical Office of Poland. Results: In 2009-2014, the highest number of deaths of infants and new-borns was reported in 2009 with the number being as high as 2,327. In the following years, the number of deaths of new-borns and infants systematically decreased. In 2010 it was 2,057 and in 2011 – 1,836, in 2012 – 1,791, in 2013 – 1,684, and in 2014 – 1,583. The highest number of deaths of boys was reported in 2009 – 1,298, while the number of deaths of girls in that year, although it was the highest in the analysed period, was lower – 1,029. Conclusions: cases of death were more frequent among boys rather than girls. The highest number of deaths was reported among infants under the age of one month and the number decreased with an increasing infants’ age. More

  13. Neuroprotection in Preterm Infants

    Directory of Open Access Journals (Sweden)

    R. Berger

    2015-01-01

    Full Text Available Preterm infants born before the 30th week of pregnancy are especially at risk of perinatal brain damage which is usually a result of cerebral ischemia or an ascending intrauterine infection. Prevention of preterm birth and early intervention given signs of imminent intrauterine infection can reduce the incidence of perinatal cerebral injury. It has been shown that administering magnesium intravenously to women at imminent risk of a preterm birth leads to a significant reduction in the likelihood of the infant developing cerebral palsy and motor skill dysfunction. It has also been demonstrated that delayed clamping of the umbilical cord after birth reduces the rate of brain hemorrhage among preterm infants by up to 50%. In addition, mesenchymal stem cells seem to have significant neuroprotective potential in animal experiments, as they increase the rate of regeneration of the damaged cerebral area. Clinical tests of these types of therapeutic intervention measures appear to be imminent. In the last trimester of pregnancy, the serum concentrations of estradiol and progesterone increase significantly. Preterm infants are removed abruptly from this estradiol and progesterone rich environment. It has been demonstrated in animal experiments that estradiol and progesterone protect the immature brain from hypoxic-ischemic lesions. However, this neuroprotective strategy has unfortunately not yet been subject to sufficient clinical investigation.

  14. Motion Tracking of Infants in Risk of Cerebral Palsy

    DEFF Research Database (Denmark)

    Olsen, Mikkel Damgaard

    Every year 2-3 out of 1000 infants are born with cerebral cerebral palsy. Among others, the disorder often affects motor, cognitive and perceptual skills. The disorder is usually detected when the infants are old enough the crawl and walk, i.e. when the infant is 1-2 years old. However, studies...... show that the infant’s movements are affected already in the first year of life and methods exist for assessing the movements. The methods often require observation of the movements and qualitative evaluation of these. A more objective measure is desired in order to be able to diagnose cerebral palsy...... for automatic assessment of infant movement. This includes a preliminary study on automatic classification of movements related to cerebral palsy. The contributions included in this thesis can be divided into two groups. The first two contributions consider the analysis in order to estimate and track the body...

  15. The Profile Of Congenital Malformation Among Newborn Infants In ...

    African Journals Online (AJOL)

    Objective: The study pattern of congenital malformations (CM) among newborn infants in Calabar, South-south Nigeria. Patients and Methods: Medical records of all inborn and out-born neonates who were admitted and treated for CM in University of Calabar teaching Hospital (UCTH) from 1997 to 2006 (10 years) were ...

  16. Macro-economic conditions and infant health: a changing relationship for black and white infants in the United States.

    Science.gov (United States)

    Orsini, Chiara; Avendano, Mauricio

    2015-01-01

    We study whether the relationship between the state unemployment rate at the time of conception and infant health, infant mortality and maternal characteristics in the United States has changed over the years 1980-2004. We use microdata on births and deaths for years 1980-2004 and find that the relationship between the state unemployment rate at the time of conception and infant mortality and birthweight changes over time and is stronger for blacks than whites. For years 1980-1989 increases in the state unemployment rate are associated with a decline in infant mortality among blacks, an effect driven by mortality from gestational development and birth weight, and complications of placenta while in utero. In contrast, state economic conditions are unrelated to black infant mortality in years 1990-2004 and white infant mortality in any period, although effects vary by cause of death. We explore potential mechanisms for our findings and, including mothers younger than 18 in the analysis, uncover evidence of age-related maternal selection in response to the business cycle. In particular, in years 1980-1989 an increase in the unemployment rate at the time of conception is associated with fewer babies born to young mothers. The magnitude and direction of the relationship between business cycles and infant mortality differs by race and period. Age-related selection into motherhood in response to the business cycle is a possible explanation for this changing relationship.

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

    Science.gov (United States)

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

    2014-01-01

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

  18. Does perinatal asphyxia contribute to neurological dysfunction in preterm infants?

    NARCIS (Netherlands)

    van Iersel, Patricia A. M.; Bakker, Saskia C. M.; Jonker, Arnold J. H.; Hadders-Algra, Mijna

    Background: Children born preterm are known to be at risk for neurodevelopmental disorders. The role of perinatal asphyxia in this increased risk is still a matter of debate. Aim: To analyze the contribution of perinatal asphyxia in a population of preterm infants admitted to a secondary paediatric

  19. Convergence and Accommodation Development Is Preprogrammed in Premature Infants.

    Science.gov (United States)

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

    2015-08-01

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

  20. Infant Temperament in Russia, United States of America, and Israel: Differences and Similarities between Russian-Speaking Families

    Science.gov (United States)

    Gartstein, Maria A.; Peleg, Yana; Young, Brandi N.; Slobodskaya, Helena R.

    2009-01-01

    The present study addresses cross-cultural differences between infants born to families of Russian immigrants in USA and Israel, as well as Russian families residing in Russia, with the emphasis on evaluating the impact of immigration and acculturation. Community samples of primary caregivers of infants between 3 and 12 months of age were…

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

    Science.gov (United States)

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

    2017-08-15

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

  2. Profile of tuberculosis among the foreign-born population in Japan, 2007–2014

    Science.gov (United States)

    Uchimura, Kazuhiro; Izumi, Kiyohiko; Ohkado, Akihiro; Ishikawa, Nobukatsu

    2016-01-01

    The proportion of foreign-born people among the newly notified tuberculosis (TB) patients has been increasing in recent years and potentially poses a new challenge to TB control in Japan. In this report, we analysed the data from the Japan TB surveillance system between 2007 and 2014 to gain an overview of the trends and characteristics of foreign-born TB patients in Japan. We found that the proportion of foreign-born TB patients was especially high among the younger age groups – 44.1% among the 20–29 years age group in 2014. The largest groups of foreign-born patients were from China and the Philippines; however, the number of those from Nepal and Viet Nam was on the rise. Students comprised the second largest professional category group for TB after regular workers, and its proportion increased over the study period. Compared to Japan-born TB patients, foreign-born patients were more likely to be diagnosed through routine medical check-ups. Treatment successes and patients still on treatment were significantly lower among foreign-born patients than their Japan-born counterparts; and transferred-out and unknown outcomes were higher. Our results indicated that distinctive subgroups within the foreign-born population in Japan, especially students and regular workers, might have a higher risk of developing TB. Measures to ensure early diagnosis and treatment adherence should be adapted to such populations. PMID:27508086

  3. 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.

  4. Natality and infant mortality in Roma children in the Prešov region

    Directory of Open Access Journals (Sweden)

    Ján Koval

    2012-06-01

    Full Text Available Background: Due to the lack of exact data on natality and infant mortality rates of the Roma living in Slovakia we aim to look closer into these parameters, analyze them and in this respect compare two ethnic groups: Roma and non-Roma Slovak children. Material and methods: In the time period from 1997 to 2011, we collected data in selected parameters (birth rate, infant mortality rate, the number of newborns with low birth weight, the number of children abandoned by their mothers after birth in the Prešov region, and we evaluated them. Findings: A declining natality rate was observed in non-Roma children, as opposed to an upward trend in Roma children. In 1997, every fourth child was born to a Roma woman; in 2011, it was every third child. A declining infant mortality rate was observed in all groups studied. In the Roma children, the decline in the infant mortality rate was the biggest, yet the mere infant mortality rate, in this group of children, was the highest – in 1997 and in 2011 approximately 3-times higher than in the children born to non-Roma mothers. Conclusion: In our study, the infant mortality rate of Roma children is on decline, yet still it is high when compared to the non-Roma population. This may be caused by low interest of the Roma in providing health care to their children and their low responsibility or their inability to take responsibility for health and health care education of their children.

  5. Perinatal Factors Associated with Infant Maltreatment

    Directory of Open Access Journals (Sweden)

    Takeo Fujiwara M.D., Ph.D., MPH

    2008-01-01

    Full Text Available Background The association between birth outcomes and child maltreatment remains controversial. The purpose of this study is to test whether infants without congenital or chronic disease who are low birth weight (LBW, preterm, or small for gestational age (SGA are at an increased risk of being maltreated. Methods A hospital-based case-control study of infants without congenital or chronic diseases who visited the National Center for Child Health and Development, Tokyo, between April 1, 2002 and March 31, 2005 was conducted. Cases (N = 35 and controls (N = 29 were compared on mean birth weight, gestational age, and z-score of birth weight. Results SGA was significantly associated with infant maltreatment after adjusting for other risk factors (adjusted odds ratio: 4.45, 95% CI: 1.29–15.3. LBW and preterm births were not associated with infant maltreatment. Conclusion Infants born as SGA are 4.5 times more at risk of maltreatment, even if they do not have a congenital or chronic disease. This may be because SGA infants tend to have poorer neurological development which leads them to be hard-to-soothe and places them at risk for maltreatment. Abbreviations SCAN, Suspected Child Abuse and Neglect; LBW, low birth weight; ZBW, z-score of birth weight adjusted for gestational age, sex, and parity; SGA, small for gestational age; SD, standard deviation; OR, odds ratio; aOR, adjusted odds ratio; CI, confidence interval; IPV, intimate partner violence.

  6. Cranial ultrasound findings in preterm infants predict the development of cerebral palsy

    DEFF Research Database (Denmark)

    Skovgaard, Ann Lawaetz; Zachariassen, Gitte

    2017-01-01

    record review. The cohort consisted of very preterm born children (gestational age ≤ 32 + 0) born from 2004 to 2008. For each infant, we obtained results from all cranial ultrasounds performed during hospitalisation. In 2014, patient records were evaluated for cerebral palsy, Gross Motor Function...... haemorrhagic infarction (PVHI), of whom two developed cerebral palsy. Nine children were diagnosed with periventricular leukomalacia (PVL), of whom six developed cerebral palsy. Cerebral palsy was detected in 14 children (6.4%), and one (0.5%) child was in need of a hearing assistive device. Severe brain...... injury (GMH-IVH3, PVHI or PVL) (p = 0.000) and being of male gender (p = 0.03) were associated with cerebral palsy in childhood. Conclusion: Severe brain injuries detected by neonatal cranial ultrasound in very preterm infants is associated with development of cerebral palsy in childhood....

  7. Clinical associations of immature breathing in preterm infants: part 1-central apnea.

    Science.gov (United States)

    Fairchild, Karen; Mohr, Mary; Paget-Brown, Alix; Tabacaru, Christa; Lake, Douglas; Delos, John; Moorman, Joseph Randall; Kattwinkel, John

    2016-07-01

    Apnea of prematurity (AOP) is nearly universal among very preterm infants, but neither the apnea burden nor its clinical associations have been systematically studied in a large consecutive cohort. We analyzed continuous bedside monitor chest impedance and electrocardiographic waveforms and oxygen saturation data collected on all neonatal intensive care unit (NICU) patients 50 infant-years of data). Apneas, with bradycardia and desaturation (ABDs), defined as central apnea ≥10 s associated with both bradycardia hemorrhage (IVH) after accounting for GA. In the day before diagnosis of late-onset septicemia and necrotizing enterocolitis, ABD events were increased in some infants. Many infants continued to experience short ABD events in the week prior to discharge home. Frequency of apnea events is a function of GA and PMA in infants born preterm, and increased apnea is associated with acute but not with chronic pathologic conditions.

  8. Simplified feeding appliance for an infant with cleft palate

    Directory of Open Access Journals (Sweden)

    Shaila Masih

    2014-01-01

    Full Text Available A child born with cleft palate may experience difficulties while feeding. Early surgical treatment may need to be postponed until certain age and weight gain of the infant. The case presented here is of a 1-month-old neonate born with cleft palate, assisted with a new feeding appliance made with ethylene vinyl acetate using pressure molding technique to aid in proper feeding. The patient′s weight and health significantly improved after the insertion of obturator. The advantages of this material included being lightweight, moldability, good palatal fit and decreased soft tissue injury.

  9. Severe G6PD Deficiency Due to a New Missense Mutation in an Infant of Northern European Descent

    DEFF Research Database (Denmark)

    Warny, Marie; Lausen, Birgitte; Birgens, Henrik

    2015-01-01

    We report a term male infant born to parents of Danish descent, who on the second day of life developed jaundice peaking at 67 hours and decreasing on applied double-sided phototherapy. In the weeks following, the infant showed signs of ongoing hemolysis. Laboratory tests showed very low glucose-6...

  10. Late preterm infants – impact of perinatal factors on neonatal results. A clinical study

    Directory of Open Access Journals (Sweden)

    Grzegorz Jakiel

    2015-09-01

    Full Text Available Introduction. Infants born between the 34[sup]th[/sup] – 36[sup]th[/sup] week of pregnancy account for 75% of all preterm infants. Their seemingly slight immaturity is related to serious health problems. Objective. The aim of the study was to analyse perinatal factors that influence the occurrence in infants of such problems as respiratory failure, metabolic problems and early onset sepsis (EOS. Materials and method. The material for the study included all mothers and their late preterm infants: 34+0 – 36+6 born in our hospital (a tertiary referral academic centre in 2010 and 2011. The course of pregnancy and delivery, the type of delivery, applied preventive measures and treatment, as well as demographic data and the clinical state of infants were all analysed. Data from individual documentation of each mother and infant were collected by 5 designated people and data reliability was independently monitored by a random control of the documentation conducted by the supervising person. Results. A statistically significant relationship between the occurrence of respiratory distress syndrome and infant immaturity, bad state after birth and sepsis in infants were confirmed. Sepsis was more common in the case of vaginal delivery, and coexisted with respiratory distress syndrome. The mother’s diseases during pregnancy, a perinatal preventive antibiotic therapy, and possible delivery complications did not influence the infection. Perinatal asphyxia in an infant positively correlated with a Caesarean section and respiratory distress syndrome after birth. Conclusions. It is necessary to thoroughly establish the type of delivery of a late preterm infant in order to prevent an infection in the newborn child. The improvement of diagnosis of intrauterine hypoxia may reduce the number of Caesarean sections. The decision about late preterm delivery should be based on indices of the mother’s state of health. Premature delivery is related to the

  11. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010

    DEFF Research Database (Denmark)

    Lee, Anne C C; Katz, Joanne; Blencowe, Hannah

    2013-01-01

    million low-birthweight babies, 59% were term-SGA and 41% were preterm-SGA. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were......BACKGROUND: National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low...... birthweight (age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from...

  12. Intrauterine growth restriction affects the preterm infant's hippocampus.

    Science.gov (United States)

    Lodygensky, Gregory A; Seghier, Mohammed L; Warfield, Simon K; Tolsa, Cristina Borradori; Sizonenko, Stephane; Lazeyras, François; Hüppi, Petra S

    2008-04-01

    The hippocampus is known to be vulnerable to hypoxia, stress, and undernutrition, all likely to be present in fetal intrauterine growth restriction (IUGR). The effect of IUGR in preterm infants on the hippocampus was studied using 3D magnetic resonance imaging at term-equivalent age Thirteen preterm infants born with IUGR after placental insufficiency were compared with 13 infants with normal intrauterine growth age matched for gestational age. The hippocampal structural differences were defined using voxel-based morphometry and manual segmentation. The specific neurobehavioral function was evaluated by the Assessment of Preterm Infants' Behavior at term and at 24 mo of corrected age by a Bayley Scales of Infant and Toddler Development. Voxel-based morphometry detected significant gray matter volume differences in the hippocampus between the two groups. This finding was confirmed by manual segmentation of the hippocampus with a reduction of hippocampal volume after IUGR. The hippocampal volume reduction was further associated with functional behavioral differences at term-equivalent age in all six subdomains of the Assessment of Preterm Infants' Behavior but not at 24 mo of corrected age. We conclude that hippocampal development in IUGR is altered and might result from a combination of maternal corticosteroid hormone exposure, hypoxemia, and micronutrient deficiency.

  13. Determination of HIV status of infants born to HIV-infected mothers: A review of the diagnostic methods with special focus on the applicability of p24 antigen testing in developing countries

    DEFF Research Database (Denmark)

    Wessman, Maria J; Theilgaard, Zahra Persson; Katzenstein, Terese L

    2012-01-01

    Abstract In 2009, 2.5 million children under the age of 15 y were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS); 370,000 were diagnosed with HIV and 260,000 died due to AIDS. More than 90% of the children infected with HIV live in sub-Saharan Africa. Most...... children infected with HIV contract the infection in utero, during delivery, or via breast milk. This review outlines the current diagnostic methods to determine the HIV status of infants born to HIV-infected mothers. The HIV DNA and RNA polymerase chain reaction (PCR) tests are highly accurate...

  14. Neonatal morbidity and early outcome of very preterm infants

    Directory of Open Access Journals (Sweden)

    Heljić Suada

    2013-03-01

    Full Text Available Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions. The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s grade 3 IVH or PVL 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3% of infants who survived to 36 weeks postmenstrual age. In 38 (37.2% infants, episodes of infections were noticed (one or more episodes in 25 infants, half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the most frequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9% early onset of sepsis was documented. Conclusion: Very preterm infants remain very vulnerable group of population, and interventions to reduce the morbidity and mortality of preterm babies include tertiary interventions such as regionalized care, transportation in uterus, and treatment with antenatal steroids.

  15. Unusual case of congenital/infantile fibrosarcoma in a new born

    Directory of Open Access Journals (Sweden)

    Eddiba Tarik

    2013-01-01

    Full Text Available Congenital infantile fibrosarcoma (CIFS is a rare mesenchymal tumor that is primarily developed in the soft tissue of distal extremities and occasionally in unusual locations such as the lung and retroperitoneum. It occurs mainly in children below the age of 5 years. About 200 cases have been reported in the literature so far, very few of them in new-borns. The prognosis of this tumor is relatively good compared to adult forms. We report an unusual case of CIFS occurring in new-born mimicking an hemangioma and causing hemorrhage in the neonatal period. The tumor is located in the left arm and axilla and associated with a hand malformation. A shoulder amputation is performed after chemotherapy failure. The infant is now two-years old with no recurrence.

  16. Gestational weight gain and body mass indexes have an impact on the outcomes of diabetic mothers and infants.

    Science.gov (United States)

    Maayan-Metzger, Ayala; Schushan-Eisen, Irit; Strauss, Tzipora; Globus, Omer; Leibovitch, Leah

    2015-11-01

    This study evaluated mothers with diabetes to determine whether prepregnancy body mass index (BMI), BMI on delivery or gestational weight gain (GWG) had the greatest impact on maternal and neonatal outcomes. We retrospectively examined the medical charts of 634 full-term infants born to mothers with gestational diabetes mellitus not requiring insulin (n = 476), gestational diabetes mellitus requiring insulin (n = 140) and insulin-dependent diabetes mellitus (n = 18). Data regarding maternal BMI before pregnancy and on delivery were recorded, as well as maternal and neonatal complications. Infants born to women who gained more than the recommended weight during pregnancy had higher birthweights, higher rates of meconium-stained amniotic fluid and neonatal hypoglycaemia. Using logistic regression, Caesarean section delivery was predicted by gestational diabetes requiring insulin, with an odds ratio (OR) of 1.76, maternal hypertension (OR 2.4), infants born large for gestational age (OR 2.78) and maternal BMI ≥ 30 on delivery (OR 1.06). Neonatal complications were predicted by maternal insulin-dependent diabetes (OR 5.21), lower gestational age (OR 0.8) and GWG above the recommended amount (OR 1.56). Women with diabetes should be made aware that higher GWG can lead to Caesarean section delivery, infant macrosomia and other neonatal complications. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. NAA, GC(EC) and SRXRF study of Hg species in head hair of mothers and their newborn infants

    International Nuclear Information System (INIS)

    Feng, W.Y.; Qian, Q.F.; Zhang, P.Q.; Chai, C.F.

    1995-01-01

    Twenty-seven pairs of head hair from mothers and their new-born infants were collected at the time of delivery in a hospital in Beijing. The total mercury content in the hair samples was determined by INAA. The correlation between mercury content in hair of mothers and their new-born infants has been investigated. In addition, the change of Hg content in pregnant women's hair during their pregnancy was also studied by INAA and SRXRF. The results indicate a significant positive correlation between the mercury content in maternal and infant head hairs (r = +0.862, p< 0.001). The average content of Hg in infant and maternal hairs was 0.66 ± 0.31 μg/g and 0.59 ± 0.25 μg/g, respectively. The infant level exceeded the maternal by 12%. The Hg content in maternal head hair gradually reduced during pregnancy. Further, the methylmercury (Me-Hg) content in 3 maternal hair samples was analyzed by GC(EC). The Me-Hg was in accordance with the total mercury content. Thus a conclusion can be drawn that damage to the infant from Hg occurred in the early stages of pregnancy. (author). 9 refs., 5 figs., 2 tabs

  18. Infant mortality rates and structure in a town near a nuclear power enterprise

    International Nuclear Information System (INIS)

    Tret'yakov, F.D.; Voronina, Z.I.; Voronin, P.F.; Demin, S.N.

    1991-01-01

    The paper is devoted to analysis of the rates and structure of mortality of infants aged under 1 in a town, situated near a nuclear power enterprise (NPE). Altogether 38124 infants born in 1950-1978, were investigated. The dead infants (1160) were divided into 3 groups with relation to their parents' place of work: 1 - infants whose parents worked in the NPE; 2 - infants whose parents worked in town factories and offices; 3 - all infants in the town. The total doses of γ-irradiation for mothers were 10-400 cSv, those for fathers - 30-520 cSv, intrauterine irradiation of a fetus was 0.5-0.55 cSv. The individual effective equivalent dose of irradiation of the residents of the town was 17.3 cSv over 40 years. Occupational γ-irradiation of the parents at doses exceeding the maximum permissible ones in the first 10 years of work at the NPE made no effect on the mortality rates in infants of the first generation

  19. Spontaneous Closure of Patent Ductus Arteriosus in Infants ≤1500 g.

    Science.gov (United States)

    Semberova, Jana; Sirc, Jan; Miletin, Jan; Kucera, Jachym; Berka, Ivan; Sebkova, Sylva; O'Sullivan, Sinead; Franklin, Orla; Stranak, Zbynek

    2017-08-01

    Patent ductus arteriosus (PDA) remains a challenging issue in very low birth weight (VLBW) infants, and its management varies widely. Our aim in this study was to document the natural course of ductus arteriosus in a cohort of VLBW infants who underwent conservative PDA management with no medical or surgical intervention. A retrospective cohort study conducted in 2 European level-3 neonatal units. A total of 368 VLBW infants were born within the study period. Two hundred and ninety-seven infants were free of congenital malformations or heart defects and survived to hospital discharge. Out of those, 280 infants received truly conservative PDA management. In 237 (85%) of nontreated infants, the PDA closed before hospital discharge. The Kaplan-Meier model was used to document the incidence proportion of PDA closure over time for different gestational age groups. The median time to ductal closure was 71, 13, 8, and 6 days in closure before hospital discharge and neonatal morbidities. The likelihood of PDA spontaneous closure in VLBW infants is extremely high. We provide in our findings a platform for future placebo-controlled trials focused on the smallest and youngest infants. Copyright © 2017 by the American Academy of Pediatrics.

  20. [Standardization of the Kent Infant Development Scale: implications for primary care pediatricians].

    Science.gov (United States)

    García-Tornel Florensa, S; Ruiz España, A; Reuter, J; Clow, C; Reuter, L

    1997-02-01

    The purpose of this study was the standardization of an infant assessment protocol based on behavioral observations of Spanish parents. The Kent Infant Development (KIDS) scale was translated into Spanish and named "Escala de Desarrollo Infantil de Kent" (EDIK). The EDIK normative data were collected from the parents of 662 healthy infants (ages 1 to 15 months) in pediatric clinics. Infants born more than 2 weeks premature or who had serious physical or neurological illness were not included. EDIK raw scores of Spanish infants were converted to developmental ages by comparing them with the number of behaviors for each age group in the normative sample. We obtained the mean score and standard deviation for the full scale and different domains (cognitive, motor, social, language, and self-help). This study shows that EDIK is sensitive to differences in ages and a good instrument that allows one to make a classification between normal infants or those at risk. It should prove useful in developmental pediatric practice.

  1. Multidisciplinary surgical approach to a surviving infant with sirenomelia.

    Science.gov (United States)

    Messineo, Antonio; Innocenti, Marco; Gelli, Riccardo; Pancani, Simone; Lo Piccolo, Roberto; Martin, Alessandra

    2006-07-01

    Sirenomelia is an extremely complex and rare malformation with different degrees of lower-extremities fusion associated with gastrointestinal, musculoskeletal, vascular, cardiopulmonary, and central nervous system malformations. In the English literature, there are only 5 reports of infants surviving with this condition. In our case, a 2540-g female infant was born with normal vital signs, no facial dysmorphism, and a complete soft tissue fusion of the lower limbs, from perineum to ankles. Radiologic examinations revealed an intestinal atresia and a single pelvic kidney, with a unique ureter, 2 femurs, 2 tibias, 2 fibulas, and 2 feet (simpus dipus). At 7 months of age, a multidisciplinary surgical team achieved complete separation of the lower limbs, with independent vascular and nerve supplies. At the time of this writing, the infant was 28 months old and had a regular growth curve. Many future reconstructive surgeries have been planned to achieve an acceptable quality of life for this infant.

  2. Coordinated Care Organizations: Neonatal and Infant Outcomes in Oregon.

    Science.gov (United States)

    Harvey, S Marie; Oakley, Lisa P; Yoon, Jangho; Luck, Jeff

    2017-11-01

    In 2012, Oregon's Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. Estimating difference-in-differences models, we compared prepost CCO changes in outcomes (e.g., low birth weight, abnormal conditions, 5-minute Apgar score, congenital anomalies, and infant mortality) between Medicaid and non-Medicaid births among 99,924 infants born in Oregon during 2011 and 2013. We further examined differences in the impact of CCOs by ethnicity and rurality. Following CCO implementation the likelihood of low birth weight and abnormal conditions decreased by 0.95% and 1.08%, a reduction of 13.4% and 10.4% compared with the pre-CCO level for Medicaid enrollees, respectively. These reductions could be predictive of lifelong health benefits for infants and lower costs for acute care and are, therefore, important markers of success for the CCO model.

  3. LTR real-time PCR for HIV-1 DNA quantitation in blood cells for early diagnosis in infants born to seropositive mothers treated in HAART area (ANRS CO 01).

    Science.gov (United States)

    Avettand-Fènoël, Véronique; Chaix, Marie-Laure; Blanche, Stéphane; Burgard, Marianne; Floch, Corinne; Toure, Kadidia; Allemon, Marie-Christine; Warszawski, Josiane; Rouzioux, Christine

    2009-02-01

    HIV-1 diagnosis in babies born to seropositive mothers is one of the challenges of HIV epidemics in children. A simple, rapid protocol was developed for quantifying HIV-1 DNA in whole blood samples and was used in the ANRS French pediatric cohort in conditions of prevention of mother-to-child transmission. A quantitative HIV-1 DNA protocol (LTR real-time PCR) requiring small blood volumes was developed. First, analytical reproducibility was evaluated on 172 samples. Results obtained on blood cell pellets and Ficoll-Hypaque separated mononuclear cells were compared in 48 adult HIV-1 samples. Second, the protocol was applied to HIV-1 diagnosis in infants in parallel with plasma HIV-RNA quantitation. This prospective study was performed in children born between May 2005 and April 2007 included in the ANRS cohort. The assay showed good reproducibility. The 95% detection cut-off value was 6 copies/PCR, that is, 40 copies/10(6) leukocytes. HIV-DNA levels in whole blood were highly correlated with those obtained after Ficoll-Hypaque separation (r = 0.900, P mothers have received HAART. (c) 2008 Wiley-Liss, Inc.

  4. Update: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection - United States, October 2017.

    Science.gov (United States)

    Adebanjo, Tolulope; Godfred-Cato, Shana; Viens, Laura; Fischer, Marc; Staples, J Erin; Kuhnert-Tallman, Wendi; Walke, Henry; Oduyebo, Titilope; Polen, Kara; Peacock, Georgina; Meaney-Delman, Dana; Honein, Margaret A; Rasmussen, Sonja A; Moore, Cynthia A

    2017-10-20

    CDC has updated its interim guidance for U.S. health care providers caring for infants with possible congenital Zika virus infection (1) in response to recently published updated guidance for health care providers caring for pregnant women with possible Zika virus exposure (2), unknown sensitivity and specificity of currently available diagnostic tests for congenital Zika virus infection, and recognition of additional clinical findings associated with congenital Zika virus infection. All infants born to mothers with possible Zika virus exposure* during pregnancy should receive a standard evaluation at birth and at each subsequent well-child visit including a comprehensive physical examination, age-appropriate vision screening and developmental monitoring and screening using validated tools (3-5), and newborn hearing screen at birth, preferably using auditory brainstem response (ABR) methodology (6). Specific guidance for laboratory testing and clinical evaluation are provided for three clinical scenarios in the setting of possible maternal Zika virus exposure: 1) infants with clinical findings consistent with congenital Zika syndrome regardless of maternal testing results, 2) infants without clinical findings consistent with congenital Zika syndrome who were born to mothers with laboratory evidence of possible Zika virus infection, † and 3) infants without clinical findings consistent with congenital Zika syndrome who were born to mothers without laboratory evidence of possible Zika virus infection. Infants in the first two scenarios should receive further testing and evaluation for Zika virus, whereas for the third group, further testing and clinical evaluation for Zika virus are not recommended. Health care providers should remain alert for abnormal findings (e.g., postnatal-onset microcephaly and eye abnormalities without microcephaly) in infants with possible congenital Zika virus exposure without apparent abnormalities at birth.

  5. Neurologic Outcomes in Very Preterm Infants Undergoing Surgery.

    LENUS (Irish Health Repository)

    2012-01-31

    OBJECTIVE: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome. STUDY DESIGN: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30). Nineteen infants were excluded because of incomplete or unsuitable data. The surgical and nonsurgical groups were compared in terms of clinical demographic data, white matter injury, and brain volume at term. Neurodevelopmental outcome was assessed at age 2 years. RESULTS: Compared with the nonsurgical group, the infants in the surgical group were smaller and more growth-restricted at birth, received more respiratory support and oxygen therapy, and had longer hospital stays. They also had smaller brain volumes, particularly smaller deep nuclear gray matter volumes. Infants who underwent bowel surgery had greater white matter injury. Mental Developmental Index scores were lower in the surgical group, whereas Psychomotor Developmental Index scores did not differ between the groups. The Mental Developmental Index difference became nonsignificant after adjustment for confounding variables. CONCLUSION: Preterm infants exposed to surgery and anesthesia had greater white matter injury and smaller total brain volumes, particularly smaller deep nuclear gray matter volumes. Surgical exposure in the preterm infant should alert the clinician to an increased risk for adverse cognitive outcome.

  6. Ion cyclotron emission due to the newly-born fusion products induced fast Alfven wave radiative instabilities in tokamaks

    International Nuclear Information System (INIS)

    Arunasalam, V.

    1995-08-01

    The velocity distribution functions of the newly born (t = 0) charged fusion products of tokamak discharges can be approximated by a monoenergetic ring distribution with a finite v parallel such that v perpendicular ∼ v parallel ∼ v j where (M j V j 2 /2) = E j , the directed birth energy of the charged fusion product species j of mass M j . As the time t progresses these distribution functions will evolve into a Gaussian in velocity with thermal spreadings given by the perpendicular and parallel temperatures T perpendicularj (t) = T parallelj (t) with T j (t) increasing as t increases and finally reaches an isotropic saturation value of T perpendicularj (t ∼ τ j ) = T parallelj (t ∼ τ j ) = T j (t ∼ τ j ) ∼ [M j T d E j /(M j + M)] 1/2 , where T d is the temperature of the background deuterium plasma ions, M is the mass of a triton or a neutron for j = protons and alpha particles, respectively, and τ j ∼ τ sj /4 is the thermalization time of the fusion product species j in the background deuterium plasma and τ sj is the slowing-down time. For times t of the order of τ j their distributions can be approximated by a Gaussian in their total energy. Then for times t ≥ τ sj the velocity distributions of these fusion products will relax towards their appropriate slowing-down distributions. Here the authors will examine the radiative stability of all these distributions. The ion cyclotron emission from energetic ion produced by fusion reactions or neutral beam injection promises to be a useful diagnostic tool

  7. Prevalence and characteristics of rib fractures in ex-preterm infants.

    Science.gov (United States)

    Lucas-Herald, Angela; Butler, Sandra; Mactier, Helen; McDevitt, Helen; Young, David; Ahmed, Syed Faisal

    2012-12-01

    This study aimed to identify the prevalence and characteristics of rib fractures in ex-preterm infants. Infants born at rib fractures, and the case notes of all affected individuals were scrutinized. Of the 3318 eligible preterm infants, 1446 had a total of 9386 chest radiographs. Of these infants, 26 (1.8%) were identified as having a total of 62 rib fractures. Their median (range) gestation at birth was 26 weeks (23-34). The median chronological age of these infants at the time of the radiograph was 14 weeks (5 weeks to 8 months). The median corrected gestational age at the time of the radiograph was 39 weeks (34 weeks to 4 months). Of the 62 fractures, 27 (36%) were sited posteriorly, and 15 (53%) of the infants with posterior rib fractures were diagnosed with osteopathy of prematurity. Classic risk including conjugated hyperbilirubinemia and diuretics, were present in 23 of 26 (88%) infants. A full skeletal survey was performed in 8 of 26 (31%). Investigations for nonaccidental injury occurred in 4 of 26 (15%) cases. Evidence of rib fractures is present in ~2% of ex-preterm infants. The evaluation of these fractures in infancy requires a detailed neonatal history irrespective of the site of rib fracture.

  8. Dendritic cells in uninfected infants born to hepatitis B virus-positive mothers.

    Science.gov (United States)

    Koumbi, Lemonica J; Papadopoulos, Nikolaos G; Anastassiadou, Vassiliki; Machaira, Maria; Kafetzis, Dimitris A; Papaevangelou, Vassiliki

    2010-07-01

    Plasmacytoid dendritic cells (pDCs) play a central role in antiviral immunity, detecting viruses via Toll-like receptors (TLR) and producing in response vast amounts of type I interferons (IFNs). Hepatitis B virus (HBV) causes chronic infection after vertical transmission. This study investigated whether an HBV-infected maternal environment might influence DC numbers and pDC function in uninfected infants. Blood was collected from inactive HBsAg carrier and control mothers and their infants at birth and 1 and 6 months of age. HBV DNA was measured in maternal and neonatal perinatal sera using real-time PCR. The circulating frequencies of myeloid DCs (mDCs) and pDCs were determined in the babies by flow cytometry. Peripheral blood mononuclear cells (PBMCs) and cord blood pDCs were stimulated with resiquimod, and alpha interferon (IFN-alpha) production and the pDC phenotype were assessed. The effect of the common-cold virus, rhinovirus (RV), on resiquimod stimulation was also determined. HBV DNA was detected in 62.3% of the mothers and 41% of their infants. DC numbers and pDC functions were similar between subjects and controls and were not correlated with maternal or neonatal viremia. RV infection did not induce pDC maturation until the age of 6 months, and it reduced TLR7-dependent resiquimod-induced IFN-alpha production similarly in both groups. Although the DC system is immature at birth, DCs of uninfected neonates of HBV-positive mothers are competent to initiate and maintain T-cell responses. RV is a weak inducer of IFN-alpha production until the age of 6 months and inhibits IFN-alpha responses triggered by the TLR7 pathway.

  9. Maternal rigidity in infancy and level of intelligence at school age in children born preterm

    NARCIS (Netherlands)

    Butcher, P.R.; Wijnberg-Williams, B.J; Hegemann, N; Stremmelaar, E.F; Schoemaker, M.M.; Van der Meere, J.J.; Bambang Oetomo, S

    2004-01-01

    Forty-four children who had been born preterm and their mothers participated in the follow-up study. At 3 and 14 months (corrected age) cognitive development was assessed using the BOS 2-30, the Dutch version of the Bayley Scales of Infant Development. The BOS yields measures of mental and motor

  10. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2012-09-01

    Full Text Available Abstract Background Infant mortality rates (IMR remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. Methods A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150 in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Results Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143. Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88. Infections (35% and preterm births complications (23% were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. Conclusions We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  11. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study.

    Science.gov (United States)

    Hama Diallo, Abdoulaye; Meda, Nicolas; Sommerfelt, Halvor; Traore, Germain S; Cousens, Simon; Tylleskar, Thorkild

    2012-09-05

    Infant mortality rates (IMR) remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150) in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89-143). Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51-88). Infections (35%) and preterm births complications (23%) were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  12. Tritium releases, birth defects and infant deaths

    International Nuclear Information System (INIS)

    1991-01-01

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

  13. Electrocortical Activity at 7 Days of Life is Affected in Extremely Premature Infants with Patent Ductus Arteriosus.

    Science.gov (United States)

    Bruns, N; Metze, B; Bührer, C; Felderhoff-Müser, U; Hüseman, D

    2015-09-01

    The aim of this study was to determine whether the aEEG at 7 days of life is influenced by the presence of a PDA in non-sedated extremely low gestational age preterm infants. We prospectively recruited infants born at less than 28 weeks of gestation between 11/2007 and 12/2009. aEEGs were recorded at seven days of life and assessed by using the Burdjalov score and the electronically assessed lower border (eLBA). Kruskal-Wallis-Test and linear regression analysis were performed to determine how GA and a PDA affect the aEEG score and the eLBA. Using linear regression analysis we tested which components of the score are affected by a PDA. We recruited 44 infants with a GA of 26.5/7 (23.4/7-27.6/7) weeks and a birth weight of 837 (461-1230) g. The total sum of score points increased from 4 (1-6) to 8 (5-9) points in infants born at 23/24 weeks and 27 weeks of gestation, respectively. In infants with relevant PDA the aEEG scored lower with 8 (3-10) points compared to those with PDA: 5 (1-8) points. Linear regression analysis showed a positive influence of GA and a negative influence of a PDA on the total score. GA had a positive influence on SWC and the visually assessed LBA. A PDA had a negative influence on continuity. The eLBA increased from 4.61 (3.18-5.53) µV to 5.27 (3.38-6.51) µV in infants of 23/24 vs. 27 gestational weeks, but was not significantly influenced by a PDA. A PDA has a negative influence on the total Burdjalov score and continuity at 7 days of age in infants born at less than 28 weeks of gestation. The electrocortical disturbances may be the consequence of a diminished cerebral perfusion in the presence of a PDA. © Georg Thieme Verlag KG Stuttgart · New York.

  14. 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 ...

  15. Infant outcomes among women with Zika virus infection during pregnancy: results of a large prenatal Zika screening program.

    Science.gov (United States)

    Adhikari, Emily H; Nelson, David B; Johnson, Kathryn A; Jacobs, Sara; Rogers, Vanessa L; Roberts, Scott W; Sexton, Taylor; McIntire, Donald D; Casey, Brian M

    2017-03-01

    Zika virus infection during pregnancy is a known cause of congenital microcephaly and other neurologic morbidities. We present the results of a large-scale prenatal screening program in place at a single-center health care system since March 14, 2016. Our aims were to report the baseline prevalence of travel-associated Zika infection in our pregnant population, determine travel characteristics of women with evidence of Zika infection, and evaluate maternal and neonatal outcomes compared to women without evidence of Zika infection. This is a prospective, observational study of prenatal Zika virus screening in our health care system. We screened all pregnant women for recent travel to a Zika-affected area, and the serum was tested for those considered at risk for infection. We compared maternal demographic and travel characteristics and perinatal outcomes among women with positive and negative Zika virus tests during pregnancy. Comprehensive neurologic evaluation was performed on all infants delivered of women with evidence of possible Zika virus infection during pregnancy. Head circumference percentiles by gestational age were compared for infants delivered of women with positive and negative Zika virus test results. From March 14 through Oct. 1, 2016, a total of 14,161 pregnant women were screened for travel to a Zika-affected country. A total of 610 (4.3%) women reported travel, and test results were available in 547. Of these, evidence of possible Zika virus infection was found in 29 (5.3%). In our population, the prevalence of asymptomatic or symptomatic Zika virus infection among pregnant women was 2/1000. Women with evidence of Zika virus infection were more likely to have traveled from Central or South America (97% vs 12%, P Zika virus infection. Additionally, there was no difference in mean head circumference of infants born to women with positive vs negative Zika virus testing. No microcephalic infants born to women with Zika infection were identified

  16. Comparison of INTERGROWTH-21 and Fenton growth standards to assess size at birth and extrauterine growth in very preterm infants.

    Science.gov (United States)

    Tuzun, Funda; Yucesoy, Ebru; Baysal, Bora; Kumral, Abdullah; Duman, Nuray; Ozkan, Hasan

    2018-09-01

    This study aimed to compare the recently published prescriptive INTERGROWTH-21st standards with commonly used intrauterine based Fenton growth standards in terms of birth size classification and extrauterine growth restriction (EUGR) incidence in a sample of very preterm infants. The anthropometric measures of preterm infants born before 32 weeks of gestation at the Dokuz Eylul University Hospital during the period from January 2012 to February 2016 were obtained at birth, at the 36th gestational weeks or at the time of discharge. Birth and growth data were presented as percentiles according to the two reference standards. A total of 248 infants with mean gestational age of 29.1 ± 2.1 weeks were included. The small for gestational age (SGA) rate was significantly higher (12 versus 15%, p = .004) and the EUGR rate was significantly lower (40.2 versus 31.5%, p Fentons'. Twenty-four per cent of the infants who were accepted as SGA according to the INTERGROWTH-21st standards were appropriate for gestational age (AGA) according to the Fenton preterm growth charts. However, these newly identified SGA infants according to the Intergrowth-21st standards did not have increased risks of early morbidities. Furthermore, 77% of the cases who had EUGR due to the Fenton standards were categorized as EUGR when evaluated using the INTERGROWTH-21st standards. Results indicated that almost one out of every five cases assessed as EUGR according to Fenton standards was within the normal interval according to Intergrowth standards. On the contrary, one out of every four cases assessed as SGA according to the INTERGROWTH-21st standards was within the normal interval according to Fentons'. These differences observed with INTERGROWTH-21st standards may affect in-hospital and postdischarge nutrition plan of these vulnerable infants. However, new standards are needed to be evaluated against currently used ones before they are implemented and further studies should be conducted

  17. Tick-borne pathogens in ticks collected from birds in Taiwan

    Directory of Open Access Journals (Sweden)

    Chi-Chien Kuo

    2017-11-01

    Full Text Available Abstract Background A variety of human diseases transmitted by arthropod vectors, including ticks, are emerging around the globe. Birds are known to be hosts of ticks and can disperse exotic ticks and tick-borne pathogens. In Taiwan, previous studies have focused predominantly on mammals, leaving the role of birds in the maintenance of ticks and dissemination of tick-borne pathogens undetermined. Methods Ticks were collected opportunistically when birds were studied from 1995 to 2013. Furthermore, to improve knowledge on the prevalence and mean load of tick infestation on birds in Taiwan, ticks were thoroughly searched for when birds were mist-netted at seven sites between September 2014 and April 2016 in eastern Taiwan. Ticks were identified based on both morphological and molecular information and were screened for potential tick-borne pathogens, including the genera Anaplasma, Babesia, Borrelia, Ehrlichia and Rickettsia. Finally, a list of hard tick species collected from birds in Taiwan was compiled based on past work and the current study. Results Nineteen ticks (all larvae were recovered from four of the 3096 unique mist-netted bird individuals, yielding a mean load of 0.006 ticks/individual and an overall prevalence of 0.13%. A total of 139 ticks from birds, comprising 48 larvae, 35 nymphs, 55 adults and one individual of unknown life stage, were collected from 1995 to 2016, and 11 species of four genera were identified, including three newly recorded species (Haemaphysalis wellingtoni, Ixodes columnae and Ixodes turdus. A total of eight tick-borne pathogens were detected, with five species (Borrelia turdi, Anaplasma sp. clone BJ01, Ehrlichia sp. BL157-9, Rickettsia helvetica and Rickettsia monacensis not previously isolated in Taiwan. Overall, 16 tick species of five genera have been recorded feeding on birds, including nine species first discovered in this study. Conclusion Our study demonstrates the paucity of information on ticks of

  18. Assessing whether early attention of very preterm infants can be improved by an omega-3 long-chain polyunsaturated fatty acid intervention: a follow-up of a randomised controlled trial

    Science.gov (United States)

    Gould, Jacqueline F; Colombo, John; Collins, Carmel T; Makrides, Maria; Hewawasam, Erandi; Smithers, Lisa G

    2018-01-01

    Introduction Docosahexaenoic acid (DHA) accumulates in the frontal lobes (responsible for higher-order cognitive skills) of the fetal brain during the last trimester of pregnancy. Infants born preterm miss some of this in utero provision of DHA, and have an increased risk of suboptimal neurodevelopment. It is thought that supplementing infants born preterm with DHA may improve developmental outcomes. The aim of this follow-up is to determine whether DHA supplementation in infants born preterm can improve areas of the brain associated with frontal lobe function, namely attention and distractibility. Methods and analysis We will assess a subset of children from the N-3 (omega-3) Fatty Acids for Improvement in Respiratory Outcomes (N3RO) multicentre double-blind randomised controlled trial of DHA supplementation. Infants born cognition, language and motor development with the Bayley Scales of Infant and Toddler Development, Third Edition. A minimum of 72 children will be assessed to ensure 85% power to detect an effect on the primary outcome. Families, and research personnel are blinded to group assignment. All analyses will be conducted according to the intention-to-treat principal. Ethics and dissemination All procedures were approved by the relevant institutional ethics committees prior to commencement of the study. Results will be disseminated in peer-reviewed journal publications and academic presentations. Trial registration number ACTRN12612000503820; Pre-results. PMID:29804059

  19. Maternal stress and infant mortality: The importance of the preconception period

    Science.gov (United States)

    Class, Quetzal A.; Khashan, Ali S.; Lichtenstein, Paul; Långström, Niklas; D’Onofrio, Brian M.

    2013-01-01

    Although preconception and prenatal maternal stress are associated with adverse birth and childhood outcomes, the relation to infant mortality remains uncertain. We used logistic regression to study infant mortality risk following maternal stress within a population-based sample of offspring born in Sweden from 1973 to 2008 (N= 3,055,361). Preconception (6-0 months before conception) and prenatal (conception to birth) stress was defined as death of a first-degree relative of the mother. A total of 20,651 offspring were exposed to preconception stress, 26,731 to prenatal stress, and 8,398 cases of infant mortality were identified. Preconception stress increased the risk of infant mortality independent of measured covariates (adjusted OR=1.53; 95% CI=1.25–1.88) and the association was timing-specific and robust across low-risk groups. Prenatal stress did not increase risk of infant mortality (adjusted OR=1.05; 95% CI=0.84–1.30). The period immediately before conception may be a sensitive developmental period influencing risk for infant mortality. PMID:23653129

  20. Paternal and maternal birthweights and the risk of infant preterm birth.

    Science.gov (United States)

    Klebanoff, Mark A

    2008-01-01

    Increasing paternal birthweight has been associated with increased risk of fathering a preterm infant, causing speculation that a fetus programmed to grow rapidly can trigger preterm labor. Pregnancies occurring from 1974-1989 among women themselves born in the Danish Perinatal Study (1959-1961) were identified through the Population Register; obstetric records were abstracted. Paternal birthweight was obtained by linking Personal Identification Numbers of the fathers to archived midwifery records. Paternal birthweight was not associated with preterm infants overall. However, there was a significant interaction between paternal and maternal birthweights (P = .003). When the mother weighed less than 3 kg at birth, increasing paternal birthweight was associated with increased occurrence of preterm birth (P for trend = .02); paternal birthweight was unassociated with preterm birth for mothers weighing 3 kg or more at birth (P = .34). When the mother was born small, increasing paternal birthweight was associated with increased risk of preterm birth, suggesting that a fetus growing faster than its mother can accommodate might trigger preterm birth.

  1. Warming preterm infants in the delivery room: polyethylene bags, exothermic mattresses or both?

    Science.gov (United States)

    McCarthy, Lisa K; O'Donnell, Colm P F

    2011-12-01

    To compare the admission temperature of infants treated with polyethylene bags alone to infants treated with exothermic mattresses in addition to bags in the delivery room. We prospectively studied infants born at bags at birth. Some infants were also placed on mattresses. Admission axillary temperatures were measured in all infants on admission to the neonatal intensive care. We compared the temperatures of infants treated with bags alone to those treated with mattresses and bags. We studied 43 infants: 15 were treated with bags while 28 were treated with a bag and mattress. Mean admission temperature was similar between the groups. Hypothermia and hyperthermia occurred more frequently in infants treated with a bag and mattress, and more infants treated with a bag had admission temperatures 36.5-37.5°C. The use of exothermic mattresses in addition to polyethylene bags, particularly in younger, smaller newborns, may result in more hypothermia and hyperthermia on admission. A randomised controlled trial is necessary to determine which strategy results in more infants having admission temperatures in the normal range. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

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

    NARCIS (Netherlands)

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

    2016-01-01

    Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies

  3. Seroprevalence of Bordetella pertussis among vaccinated and unvaccinated pregnant women and newborn infants in a university hospital of Buenos Aires.

    Science.gov (United States)

    Bosch, Juan J; Fernández, Hilaria; Polak, Fernando P; Musante, Gabriel; Libster, Romina; Rocca Rivarola, Manuel

    2017-08-01

    Pertussis is a highly contagious disease caused by Bordetella pertussis. It poses a high morbidity and mortality rate, especially among infants younger than 6 months old. In Argentina, pertussis incidence and mortality have increased over the past three decades. To establish Bordetella pertussisantibody titers among pregnant women in their third trimester and among newborn infants, as measured in cord blood. This was an observational, cross-sectional study. The study started in 2011; at that time, pertussis vaccination was not mandatory for pregnant women as per the national immunization schedule, only optional. Maternal antibodies were measured in the last trimester of pregnancy for women and in cord blood for newborn infants. Antibody titers were determined using Abcam's anti-Bordetella pertussis toxin (PT) IgG in vitro ELISA kit. The χ² test was used to compare prevalence rates. The study included 111 mother-newborn infant dyads; 35 infants from unvaccinated mothers (before the introduction of the vaccine) and 76 from vaccinated mothers. Positive IgG antibodies were found in 92% (70/76) of infants born from vaccinated mothers whereas 100% (35/35) of infants born from unvaccinated mothers had negative results for antibodies; p < 0.001. In the vaccinated population of this study, 92% of infants had positive IgG antibodies. This study supports the need for maternal immunization against Bordetella pertussis to provide protection to newborn infants. Sociedad Argentina de Pediatría

  4. EFEK SUPLEMENTASI LAKTOFERIN PADA SUSU FORMULA TERHADAP AVAILABILITAS ZAT BESI, OKSIDASI LEMAK DAN PERTUMBUHAN Escherichia coli PADA SALURAN PENCERNAAN TIKUS [The Effects of Lactoferrin Supplementation to Infant Formula on Iron Availability, Lipid Oxidation and Escherichia coli Growth in RatsIntestine

    Directory of Open Access Journals (Sweden)

    Enny Purwati Nurlaili 1

    2002-12-01

    Full Text Available A research on lactoferrin supplementation to infant formula has been conducted. The objectives of this research were to study the effects of consumption of the supplemented formula on iron availability, lipid oxidation and growth of Escherichia coli in the intestine. Fifthly newly born rats and their mother (10 rats were used.They were divided into 5 groups of 10 newly born and 2 mother rats, and were given five different infant formula respectivelly i.e. FEAN (inorganic Fe supplementation, FEOR ( lactoferrin supplementation, FECAMP (inorganic and lactoferrin supplementation, Control (no Fe supplementation and Placebo. FeSO4. 7 H2O and lactoferrin were used as the source of inorganic and organic Fe respectively. During the experiment the rat baby also got regular milk from their mothers which were fed by AIN 93 diet. After 30 days of intervention, blood were withdrawn from the retro orbital plexus for Hb, Fe and TBARS determination. The rats were executed and liver was taken for Fe and TBARS analysis and large intestine were withdrawn for Escherichia coli determination. It was found that Fe supplementation of the formula have no effects on the serum total Fe, increase the total hemoglobin of the baby but was not significantly different between the sources of the Fe. Total Fe of the liver was highest in FECAMP and FEOR rats (101.3 ppm and 83.38 ppm, respectively and lowest in the Placebo groups (58.1 ppm. Inorganic Fe supplementation increase TBARS of the serum and liver of the rats. Number of total Escherichia coli was lowest in FEOR groups (1.7 10 7 cfu and was highest in FEAN rats (7.5 10 7 cfu.

  5. Differential effects of intrauterine growth restriction on brain structure and development in preterm infants: a magnetic resonance imaging study.

    Science.gov (United States)

    Padilla, Nelly; Falcón, Carles; Sanz-Cortés, Magdalena; Figueras, Francesc; Bargallo, Núria; Crispi, Fátima; Eixarch, Elisenda; Arranz, Angela; Botet, Francesc; Gratacós, Eduard

    2011-03-25

    Previous evidence suggests that preterm newborns with intrauterine growth restriction (IUGR) have specific neurostructural and neurodevelopmental anomalies, but it is unknown whether these effects persist in early childhood. We studied a sample of 18 preterm IUGR, 15 preterm AGA - born between 26 and 34 weeks of gestational age (GA) - and 15 healthy born-term infants. Infants were scanned at 12 months corrected age (CA), in a 3T scanner, without sedation. Analyses were made by automated lobar volumetry and voxel-based morphometry (VBM). The neurodevelopmental outcome was assessed in all subjects at 18 months CA with the Bayley Scale for Infant and Toddler Development, third edition. IUGR infants had reduced relative volumes for the insular and temporal lobes. According to VBM, IUGR infants had bilateral reduced gray matter (GM) in the temporal, parietal, frontal, and insular regions compared with the other groups. IUGR infants had increased white matter (WM) in temporal regions compared to the AGA group and in frontal, parietal, occipital, and insular regions compared to the term group. They also showed decreased WM in the cerebellum and a non-significant trend in the hippocampus compared to term infants. IUGR infants had reduced neurodevelopmental scores, which were positively correlated with GM in various regions. These data suggest that the IUGR induces a distinct brain pattern of structural changes that persist at 1 year of life and are associated with specific developmental difficulties. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Organ harvesting from anencephalic infants: health management over a sinkhole.

    Science.gov (United States)

    Alatis, A J

    As technology increases in the field of organ transplantation for newborns, a problematic limitation persists: too few organ donors are available to match the number of needy organ donees. Anencephalic newborns have been suggested (and recently used) as organ sources. Anencephalic infants are born without the upper part of their brain and usually die within a week after birth. This article will address the ethical considerations of using these infants as organ sources, particularly from the view of a physician and an attorney. This piece will further analyze the medico-legal ramifications of the various legislative proposals addressing this subject.

  7. Productive, physiological and biochemical changes in imported and locally born Friesian and holstein lactating cow under hot summer conditions of egypt

    International Nuclear Information System (INIS)

    Habeeb, A.A.M.; Marai, I.F.M.; Gabr, H.; Farghaly, H.M.

    1999-01-01

    A number of 20 of each of healthy lactating friesian and holstein cows similar age and body weight, non-pregnant at the 3 rd lactation season, 80-100 days postpartum, were used in the present study. The investigation was carried out in two farms at the same time during the hot summer season of egypt and lasted 8 weeks. The first farm was in damietta (North east of the nile delta, 31 degree 40 N) including 20 friesian cows and the second one was in Fakous (East of the Nile delta 30 degree 40 N) including 20 holstein cows. In each of the two farms, 10 cows were newly imported and other 10 ones were born in egypt. The results showed that the newly imported cows were significantly (P <0.01) higher than the locally born cows in average daily milk yield, as well as, milk production in both friesian and holstein strains at the same time, the newly imported cows were significantly (P < 0.01 or 0.05) lower than the locally born in T4, T3, urea-N, blood picture values and GPT enzyme activity in the two strains of cattle, while the locally born cows showed significantly (P < 0.01 or 0.05) lower values in rectal temperature and respiration rate, as well as, Got and ALK-P enzymes activities than in the newly imported cows either in friesian or holstein cattle. Holstein cows surpassed friesian ones (P < 0.01 or 0.05) in milk production, thyroid hormones content, cholesterol, haemoglobin, packed cell volume and erythrocyte count values. The opposite was true in serum total protein, urea-N, creatinine concentrations, leucocyte counts, Got, GPT and ALK-P enzymes activities

  8. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis

    NARCIS (Netherlands)

    Katz, Joanne; Lee, Anne C. C.; Kozuki, Naoko; Lawn, Joy E.; Cousens, Simon; Blencowe, Hannah; Ezzati, Majid; Bhutta, Zulfiqar A.; Marchant, Tanya; Willey, Barbara A.; Adair, Linda; Barros, Fernando; Baqui, Abdullah H.; Christian, Parul; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kolsteren, Patrick; Mongkolchati, Aroonsri; Mullany, Luke C.; Ndyomugyenyi, Richard; Nien, Jyh Kae; Osrin, David; Roberfroid, Dominique; Sania, Ayesha; Schmiegelow, Christentze; Silveira, Mariangela F.; Tielsch, James; Vaidya, Anjana; Velaphi, Sithembiso C.; Victora, Cesar G.; Watson-Jones, Deborah; Black, Robert E.; Clarke, Siân; Kariuki, Simon; Lusingu, John; Ndirangu, James; Newell, Marie-Louise; Ntozini, Robert; Rosen, Heather; ter Kuile, Feiko O.

    2013-01-01

    Babies with low birthweight ( <2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associated with

  9. Docosahexaenoic Acid and Neurodevelopmental Outcomes of Term Infants.

    Science.gov (United States)

    Meldrum, Suzanne; Simmer, Karen

    2016-01-01

    Docosahexaenoic acid (DHA), a long-chain polyunsaturated fatty acid, is essential for normal brain development. DHA is found predominantly in seafood, fish oil, breastmilk and supplemented formula. DHA intake in Western countries is often below recommendations. Observational studies have demonstrated an association between DHA intake in pregnancy and neurodevelopment of offspring but cannot fully adjust for confounding factors that influence child development. Randomised clinical trials of DHA supplementation during pregnancy and/or lactation, and of term infants, have not shown a consistent benefit nor harm on neurodevelopment of healthy children born at term. The evidence does not support DHA supplementation of healthy pregnant and lactating women, nor healthy infants. © 2016 S. Karger AG, Basel.

  10. Fathers' experience of starting family life with an infant born prematurely due to mothers' severe illness.

    Science.gov (United States)

    Værland, Inger Emilie; Vevatne, Kari; Brinchmann, Berit Støre

    2017-10-01

    To describe fathers' experiences of starting family life with an infant delivered prematurely out of necessity of saving the mother's and infant's lives due to the mother's severe preeclampsia. A descriptive, qualitative design was used. Six fathers were interviewed twice: from 6 to 24 days and from 4 to 22 weeks after delivery. Data were transcribed verbatim and analyzed using a reflective lifeworld research approach. The essence of the fathers' experiences of establishing a family with a seriously ill mother and a premature infant can be described as a process of becoming a family through reflection on life and death in a context of separation. The essence specifically comprised the following constituents: (1) starting fatherhood facing existential issues, (2) connecting the family, (3) becoming familiar with your infant, and (4) becoming a father in a public area. The fathers were able to develop their relationship to their infants; this emphasizes the importance of the fathers being able to spend their time in the NICU. The privacy of the fathers were more or less challenged, health professionals should be aware of individualize their approach to the fathers. The study reveals that family life started with separation. Health professionals should try to ensure that the family should be together. Mutual guidelines between the wards that treats mother and child should be implemented. When new mother and child-centers are planned a family friendly environment should be prioritized. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Sudden infant death syndrome, childhood thrombosis, and presence of genetic risk factors for thrombosis

    DEFF Research Database (Denmark)

    Larsen, T B; Nørgaard-Pedersen, B; Banner, Jytte

    2000-01-01

    in the child. This prompted us to investigate these genetic markers of thromboembolic disease in 121 cases of sudden infant death syndrome and in relevant controls, in the expectation of a more frequent occurrence of these markers if thrombosis is an etiological factor in sudden infant death syndrome......Sudden infant death syndrome or "cot death" has until the late eighties been a significant cause of death in children between the ages of 1 month and 1 year. Approximately two per 1000 children born alive dies of sudden infant death syndrome each year in Western Europe, North America, and Australia....... The vulnerability of the infant brain stem to ischemia has been suggested to be a conceivable cause of sudden infant death syndrome. This is compatible with a hypothesis that genetic risk factors for cerebral thrombosis could cause microinfarction in the brain stem during the first month of life, affecting vital...

  12. Risk factors for wheezing during infancy. A study of 5,953 infants

    DEFF Research Database (Denmark)

    Bisgaard, H; Dalgaard, P; Nyboe, J

    1987-01-01

    --particularly environmental. Poor social environment increases the risk of wheezing, as does the mother's smoking, and placement of the baby in day-care. Boys experienced wheezing more often than girls. Premature infants are more liable to develop wheezing than mature children. Remarkably, children born in the period April......Risk factors for the development of wheezing during infancy were studied in 5,953 children. The data for the study were collected from a large prospective investigation of children born in 1959-61, who had attended a one-year follow-up examination. Wheezing was diagnosed when the symptom had been...... through September develop wheezing, but not bronchitis, more often than children born in October through March....

  13. mortality in a cohort of children born to hiv-1 infected women from ...

    African Journals Online (AJOL)

    Nsuami M. Nsa W. Kamenga M. Badi N. Utshudi M Mortality in HJV-1 seropositive women,. their spouses, and their newly born dtildren during 36 months of follow-up in Kinshasha, Zaire. AIDS 1994; S, 667-fiTL. 10. Division of Oilld Health and Deve1opment.lntegrated Management ofCh£ldhooillU1U!SS. Information Pack.

  14. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study.

    Science.gov (United States)

    Paul, Ian M; Williams, Jennifer S; Anzman-Frasca, Stephanie; Beiler, Jessica S; Makova, Kateryna D; Marini, Michele E; Hess, Lindsey B; Rzucidlo, Susan E; Verdiglione, Nicole; Mindell, Jodi A; Birch, Leann L

    2014-07-18

    Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This "parenting" intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT's central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent-child responsibility for feeding, reducing subsequent risk for overeating and overweight. 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the "parenting" or "safety" groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3-4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic predictors of weight status. Finally, second-born

  15. The Baby Moves prospective cohort study protocol: using a smartphone application with the General Movements Assessment to predict neurodevelopmental outcomes at age 2 years for extremely preterm or extremely low birthweight infants.

    Science.gov (United States)

    Spittle, A J; Olsen, J; Kwong, A; Doyle, L W; Marschik, P B; Einspieler, C; Cheong, Jly

    2016-10-03

    Infants born extremely preterm (EP; smartphone application (app) developed for caregivers to video and upload their infant's general movements to be scored remotely by a certified GMA assessor. The aim of this study is to determine the predictive ability of using the GMA via the Baby Moves app for neurodevelopmental impairment in infants born EP/ELBW. This prospective cohort study will recruit infants born EP/ELBW across the state of Victoria, Australia in 2016 and 2017. A control group of normal birth weight (>2500 g birth weight), term-born (≥37 weeks' gestation) infants will also be recruited as a local reference group. Parents will video their infant's general movements at two time points between 3 and 4 months' corrected age using the Baby Moves app. Videos will be scored by certified GMA assessors and classified as normal or abnormal. Parental satisfaction using the Baby Moves app will be assessed via survey. Neurodevelopmental outcome at 2 years' corrected age includes developmental delay according to the Bayley Scales of Infant and Toddler Development-III and cerebral palsy diagnosis. This study was approved by the Human Research and Ethics Committees at the Royal Children's Hospital, The Royal Women's Hospital, Monash Health and Mercy Health in Melbourne, Australia. Study findings will be disseminated via peer-reviewed publications and conference presentations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Learning from picture books: Infants' use of naming information.

    Science.gov (United States)

    Khu, Melanie; Graham, Susan A; Ganea, Patricia A

    2014-01-01

    The present study investigated whether naming would facilitate infants' transfer of information from picture books to the real world. Eighteen- and 21-month-olds learned a novel label for a novel object depicted in a picture book. Infants then saw a second picture book in which an adult demonstrated how to elicit the object's non-obvious property. Accompanying narration described the pictures using the object's newly learnt label. Infants were subsequently tested with the real-world object depicted in the book, as well as a different-color exemplar. Infants' performance on the test trials was compared with that of infants in a no label condition. When presented with the exact object depicted in the picture book, 21-month-olds were significantly more likely to attempt to elicit the object's non-obvious property than were 18-month-olds. Learning the object's label before learning about the object's hidden property did not improve 18-month-olds' performance. At 21-months, the number of infants in the label condition who attempted to elicit the real-world object's non-obvious property was greater than would be predicted by chance, but the number of infants in the no label condition was not. Neither age group nor label condition predicted test performance for the different-color exemplar. The findings are discussed in relation to infants' learning and transfer from picture books.

  17. Low birthweight among US Hispanic/Latino subgroups: the effect of maternal foreign-born status and education.

    Science.gov (United States)

    Acevedo-Garcia, Dolores; Soobader, Mah-J; Berkman, Lisa F

    2007-12-01

    We investigated whether maternal foreign-born status confers a protective effect against low birthweight (LBW) across US Hispanic/Latino subgroups (i.e., Mexicans, Puerto Ricans, Cubans and Central/South Americans) in the USA, and whether the association between maternal education and LBW varies by Hispanic/Latino subgroup and by foreign-born status. We conducted logistic regression analyses of the 2002 US Natality Detail Data (n=634,797). Overall, foreign-born Latino women are less likely to have LBW infants than US-born Latino women. The protective effect of foreign-born status is stronger among Latino women with less than high school education. The maternal education gradient is significantly flatter among foreign-born Latino women than among their US-born counterparts (peducation (i.e., 0-11 and 12 years) than among women with more education (i.e., 13-15 and 16+ years). The educational gradient in LBW is less pronounced among foreign-born Mexicans and Central/South Americans than among their US-born counterparts. As such, maternal foreign-born status and education are associated with LBW, though the direction and strength of these associations vary across Latino subgroups. A "health paradox" is apparent for foreign-born Mexican and Central/South American women among whom there is a weak maternal educational gradient in LBW. Future research may test hypotheses regarding the mechanisms underlying these variations in LBW among Latino subgroups, i.e., different gradients in sending countries, health selection of immigrants, cultural factors, and social support.

  18. Percutaneous Patent Ductus Arteriosus (PDA) Closure in Very Preterm Infants: Feasibility and Complications.

    Science.gov (United States)

    Backes, Carl H; Cheatham, Sharon L; Deyo, Grace M; Leopold, Scott; Ball, Molly K; Smith, Charles V; Garg, Vidu; Holzer, Ralf J; Cheatham, John P; Berman, Darren P

    2016-02-12

    Percutaneous closure of patent ductus arteriosus (PDA) in term neonates is established, but data regarding outcomes in infants born very preterm (closure at weights closure. Twenty-five percent (13/52) of infants were closure. Compared to precatheterization trends, percutaneous PDA closure resulted in improved respiratory status, including less exposure to mechanical ventilation (mixed effects logistic model, Pclosure at weights closure versus alternative (surgical ligation) management strategies. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  19. Neonatal hyperthyroidism: neonatal clinical course of two brothers born to a mother with Graves-Basedow disease, before and after total thyroidectomy.

    Science.gov (United States)

    Zuppa, A A; Sindico, P; Savarese, I; D'Andrea, V; Fracchiolla, A; Cota, F; Romagnoli, C

    2007-04-01

    About 1-2% of infants born to mothers with Graves' disease or Hashimoto's thyroiditis develop neonatal hyperthyroidism because of transplacental passage of IgG stimulating TSH receptors (TRAb). To evaluate the effect of maternal total thyroidectomy on neonatal clinical course. We describe two brothers born to a mother with Graves' disease, before and after total thyroidectomy. The first child showed persistent tachycardia, the presence of TRAb and a laboratory pattern of hyperthyroidism. Lugol's solution was started and then propylthiouracil was added. Digitalis, furosemide and diazepam were necessary for treatment of heart failure, hypertension and irritability. On the 70th day of life, hormone serum levels normalized and treatment was interrupted. TRAb normalized by the third month of life. The second infant was born 2 years after the mother underwent total thyroidectomy. In spite of a laboratory pattern of hyperthyroidism and positivity to TRAb, he showed only considerable weight loss, and no therapy was required. TRAb may persist after total thyroidectomy: clinical and instrumental follow-up of the newborn is recommended.

  20. Maternal vitamin D status and infant outcomes in rural Vietnam: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah Hanieh

    Full Text Available Vitamin D deficiency affects 1 billion people globally. It has an important role in bone homeostasis, brain development and modulation of the immune system and yet the impact of antenatal vitamin D deficiency on infant outcomes is poorly understood. We assessed the association of 25- hydroxyvitamin D levels (25-OHD in late pregnancy and early infant growth and developmental outcomes in rural Vietnam.A prospective cohort study of 960 women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation in rural Vietnam was undertaken. Maternal 25-OHD concentration was measured at 32 weeks gestation, and infants were followed until 6 months of age. Main outcome measures were cognitive, motor, socio-emotional and language scores using the Bayley Scales of Infant Development, 3rd edition, and infant length-for-age z scores at 6 months of age.60% (582/960 of women had 25-OHD levels <75 nmol/L at 32 weeks gestation. Infants born to women with 25-OHD deficiency (<37.5 nmol/L had reduced developmental language scores compared to those born to women who were vitamin D replete (≥75 nmol/L (Mean Difference (MD -3.48, 95% Confidence Interval (CI -5.67 to -1.28. For every 25 nmol increase in 25-OHD concentration in late pregnancy, infant length-for-age z scores at 6 months of age decreased by 0.08 (95% CI -0.15 to -0.02.Low maternal 25- hydroxyvitamin D levels during late pregnancy are of concern in rural Vietnam, and are associated with reduced language developmental outcomes at 6 months of age. Our findings strengthen the evidence for giving vitamin D supplementation during pregnancy.

  1. Ethnic disparity in stillbirth and infant mortality in Denmark 1981-2003

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Mortensen, Laust Hvas; Andersen, Anne-Marie Nybo

    2009-01-01

    .60-2.77) for Somali women. The relative risks of infant mortality were 1.41 (1.22-1.63), 1.88 (1.53-2.30), 1.39 (1.03-1.89) for children born of Turkish, Pakistani, and Somali mothers, respectively. The fetal and infant mortality in offspring of Lebanese and Former Yugoslavian women was not different from...... the mortality in the Danish group. The differences found were, in general, not attributable to ethnic differences in socioeconomic position. Turkish, Pakistani, and Somali children had an excess relative risk of infant death due to congenital malformations and the risk of death of perinatal causes was increased...... among the Pakistani offspring. CONCLUSION: Among the five largest ethnic minorities, the Turkish. Pakistani, and Somali population had substantially higher fetal and infant mortality compared to the Danish majority population, while the Lebanese and Former Yugoslavian minorities were at the same level...

  2. Precursors of social emotional functioning among full-term and preterm infants at 12 months: Early infant withdrawal behavior and symptoms of maternal depression.

    Science.gov (United States)

    Moe, Vibeke; Braarud, Hanne Cecilie; Wentzel-Larsen, Tore; Slinning, Kari; Vannebo, Unni Tranaas; Guedeney, Antoine; Heimann, Mikael; Rostad, Anne Margrethe; Smith, Lars

    2016-08-01

    This study forms part of a longitudinal investigation of early infant social withdrawal, maternal symptoms of depression and later child social emotional functioning. The sample consisted of a group of full-term infants (N=238) and their mothers, and a group of moderately premature infants (N=64) and their mothers. At 3 months, the infants were observed with the Alarm Distress Baby Scale (ADBB) and the mothers completed the Edinburgh Postnatal Depression Scale (EPDS). At 12 months, the mothers filled out questionnaires about the infants' social emotional functioning (Infant Toddler Social Emotional Assessment and the Ages and Stages Questionnaire-Social Emotional). At 3 months, as we have previously shown, the premature infants had exhibited more withdrawal behavior and their mothers reported elevated maternal depressive symptoms as compared with the full-born group. At 12 months the mothers of the premature infants reported more child internalizing behavior. These data suggest that infant withdrawal behavior as well as maternal depressive mood may serve as sensitive indices of early risk status. Further, the results suggest that early maternal depressive symptoms are a salient predictor of later child social emotional functioning. However, neither early infant withdrawal behavior, nor gestational age, did significantly predict social emotional outcome at 12 months. It should be noted that the differences in strength of the relations between ADBB and EPDS, respectively, to the outcome at 12 months was modest. An implication of the study is that clinicians should be aware of the complex interplay between early infant withdrawal and signs of maternal postpartum depression in planning ports of entry for early intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants

    DEFF Research Database (Denmark)

    Dahl, Marianne; Holmskov, Uffe; Husby, Steffen

    2006-01-01

    of SP-D in capillary blood day 1 was 1,466 ng/mL (range 410-5,051 ng/mL), with lowest values in infants born with ROM and delivered vaginally. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be more likely in infants in need for respiratory support or surfactant...... treatment and susceptibility to infections. We conclude that SP-D concentrations in umbilical cord blood and capillary blood in premature infants are twice as high as in mature infants and depend on several perinatal conditions. High SP-D levels in umbilical cord blood and capillary blood on day 1 were...... found to be related to increased risk of RDS and infections....

  4. Caffeine Intake During Pregnancy in Different Intrauterine Environments and its Association with Infant Anthropometric Measurements at 3 and 6 Months of Age.

    Science.gov (United States)

    de Medeiros, Thamíris Santos; Bernardi, Juliana Rombaldi; de Brito, Mariana Lopes; Bosa, Vera Lucia; Goldani, Marcelo Zubaran; da Silva, Clécio Homrich

    2017-06-01

    Objective To investigate the association between maternal caffeine intake during pregnancy and infant anthropometric measurements at age 3 and 6 months. Methods Longitudinal observational study of mother-child pairs stratified into five groups: diabetic women (DM), hypertensive women (HYP), smoking mothers (SMO), mothers of infants small for gestational age (SGA), and controls (CTL). Pairs were recruited from three public hospitals in Porto Alegre, Brazil, from 2011 to 2015, using a convenience sampling strategy. The Food Frequency Questionnaire (FFQ) was administered on postpartum day 7 to evaluate maternal caffeine intake during pregnancy. The anthropometric measurements of interest (weight, length, and skinfold thickness) were assessed at birth and at age 3 and 6 months. Linear regression was used to analyze the interaction between caffeine intake and skinfold thickness. Results Overall, 272 mother-child pairs were investigated (41 DM, 26 HYP, 68 SMO, 25 SGA, and 112 CTL). There were no differences in anthropometric measurements between infants born to mothers who had and had not consumed caffeine during pregnancy (P > 0.05). Children of mothers in the DM group had the highest adjusted average skinfold thicknesses at 3 months. An interaction between maternal caffeine intake during pregnancy and the sum of skinfolds at age 3 months was found in the DM and CTL groups (P caffeine intake influenced infants skinfold thickness measurements at 3 months of age. This parameter was reduced in infants born to mothers with DM and increased in those born to healthy control mothers.

  5. Hydraulic fracturing and infant health: New evidence from Pennsylvania.

    Science.gov (United States)

    Currie, Janet; Greenstone, Michael; Meckel, Katherine

    2017-12-01

    The development of hydraulic fracturing ("fracking") is considered the biggest change to the global energy production system in the last half-century. However, several communities have banned fracking because of unresolved concerns about the impact of this process on human health. To evaluate the potential health impacts of fracking, we analyzed records of more than 1.1 million births in Pennsylvania from 2004 to 2013, comparing infants born to mothers living at different distances from active fracking sites and those born both before and after fracking was initiated at each site. We adjusted for fixed maternal determinants of infant health by comparing siblings who were and were not exposed to fracking sites in utero. We found evidence for negative health effects of in utero exposure to fracking sites within 3 km of a mother's residence, with the largest health impacts seen for in utero exposure within 1 km of fracking sites. Negative health impacts include a greater incidence of low-birth weight babies as well as significant declines in average birth weight and in several other measures of infant health. There is little evidence for health effects at distances beyond 3 km, suggesting that health impacts of fracking are highly local. Informal estimates suggest that about 29,000 of the nearly 4 million annual U.S. births occur within 1 km of an active fracking site and that these births therefore may be at higher risk of poor birth outcomes.

  6. Assessment and Stability of Early Learning Abilities in Preterm and Full-Term Infants across the First Two Years of Life

    Science.gov (United States)

    Lobo, Michele A.; Galloway, James C.

    2013-01-01

    Infants born preterm have increased risk for learning disabilities yet we lack assessments to successfully detect these disabilities in early life. We followed 23 full-term and 29 preterm infants from birth through 24 months to assess for differences in and stability of learning abilities across time. Measures included the Bayley-III cognitive…

  7. Effect of miscarriage history on maternal-infant bonding during the first year postpartum in the first baby study: a longitudinal cohort study.

    Science.gov (United States)

    Bicking Kinsey, Cara; Baptiste-Roberts, Kesha; Zhu, Junjia; Kjerulff, Kristen H

    2014-07-15

    Miscarriage, the unexpected loss of pregnancy before 20 weeks gestation, may have a negative effect on a mother's perception of herself as a capable woman and on her emotional health when she is pregnant again subsequent to the miscarriage. As such, a mother with a history of miscarriage may be at greater risk for difficulties navigating the process of becoming a mother and achieving positive maternal-infant bonding with an infant born subsequent to the loss. The aim of this study was to examine the effect of miscarriage history on maternal-infant bonding after the birth of a healthy infant to test the hypothesis that women with a history of miscarriage have decreased maternal-infant bonding compared to women without a history of miscarriage. We completed secondary analysis of the First Baby Study, a longitudinal cohort study, to examine the effect of a history of miscarriage on maternal-infant bonding at 1 month, 6 months, and 12 months after women experienced the birth of their first live-born baby. In a sample of 2798 women living in Pennsylvania, USA, we tested our hypothesis using linear regression analysis of Shortened Postpartum Bonding Questionnaire (S-PBQ) scores, followed by longitudinal analysis using a generalized estimating equations model with repeated measures. We found that women with a history of miscarriage had similar S-PBQ scores as women without a history of miscarriage at each of the three postpartum time points. Likewise, longitudinal analysis revealed no difference in the pattern of maternal-infant bonding scores between women with and without a history of miscarriage. Women in the First Baby Study with a history of miscarriage did not differ from women without a history of miscarriage in their reported level of bonding with their subsequently born infants. It is important for clinicians to recognize that even though some women may experience impaired bonding related to a history of miscarriage, the majority of women form a healthy bond

  8. Outcomes for Extremely Premature Infants

    Science.gov (United States)

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

    2015-01-01

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

  9. Infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Muluye Dagnachew

    2012-03-01

    Full Text Available Abstract Background It has been estimated that 430,000 children under 15 years of age were newly infected with HIV in 2008, and more than 71% are living in sub-Saharan Africa. In the absence of intervention to prevent mother-to-child transmission, 30-45% of infants born to HIV-positive mothers in developing countries become infected during pregnancy, delivery and breastfeeding. The aim of this study was to assess infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics of Northwest Ethiopia. Methods Institution based cross sectional study was conducted from January to May 2011 among all HIV positive mothers with less than two years old child attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions. A structured pre-tested questionnaire using interview technique was used for data collection. The data was entered and analyzed using SPSS version 16 statistical package. Results A total of 209 HIV positive mothers were included in the study. Of these, 187 (89.5% had followed the recommended way of infant feeding practice while significant percentage (10.5% had practiced mixed breast feeding. In multivariate analysis, disclosure of HIV status with their spouse, insufficient breast milk and occupational status were found to be independently associated (p-value of Conclusions Higher proportion of respondents used the recommended way of infant feeding practice by WHO as well as by Ethiopian Ministry of Health. However, mixed feeding in the first 6 months of age, an undesirable practice in infant feeding, were reported in this study. Infant feeding education that is aligned to national policy should be strengthened in primary health care, particularly in situations where prevention of mother to child transmission of HIV is prioritized.

  10. Readmission of Preterm Infants Less Than 32 Weeks Gestation Into Early Childhood

    Directory of Open Access Journals (Sweden)

    Ralser Elisabeth MD

    2014-09-01

    Full Text Available The aim of the study was to investigate the frequency of and the predictors for rehospitalization in preterm infants into early childhood, focusing on gender differences. All preterm infants born at <32 weeks of gestation in North Tyrol between January 2003 and December 2005 were enrolled in this survey. About one fifth of all children were readmitted, showing an inverse downward trend with increasing age. The most common reason for readmission in the third (36.5% and fourth (42.9% years of life was respiratory infection, but changed to miscellaneous surgeries in the fifth (52.1%. Male sex showed significantly higher readmission rates and more miscellaneous surgeries. Additionally, male sex and chronic lung disease were risk conditions for rehospitalization in the multivariate analysis. Readmission rates and respiratory infections in preterm-born children showed an inverse downward trend with increasing age. In early childhood, gender difference still plays a role with regard to rehospitalization.

  11. Rhythmic EEG patterns in extremely preterm infants: Classification and association with brain injury and outcome.

    Science.gov (United States)

    Weeke, Lauren C; van Ooijen, Inge M; Groenendaal, Floris; van Huffelen, Alexander C; van Haastert, Ingrid C; van Stam, Carolien; Benders, Manon J; Toet, Mona C; Hellström-Westas, Lena; de Vries, Linda S

    2017-12-01

    Classify rhythmic EEG patterns in extremely preterm infants and relate these to brain injury and outcome. Retrospective analysis of 77 infants born Rhythmic patterns were observed in 62.3% (ictal 1.3%, PEDs 44%, other waveforms 86.3%) with multiple patterns in 36.4%. Ictal discharges were only observed in one and excluded from further analyses. The EEG location of the other waveforms (pRhythmic waveforms related to head position are likely artefacts. Rhythmic EEG patterns may have a different significance in extremely preterm infants. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  12. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort.

    NARCIS (Netherlands)

    Papiernik, E.; Zeitlin, J.; Delmas, D.; Blondel, B.; Kunzel, W.; Cuttini, M.; Weber, T.; Petrou, S.; Gortner, L.; Kollee, L.A.A.; Draper, E.S.

    2010-01-01

    BACKGROUND: About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine

  13. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort

    DEFF Research Database (Denmark)

    Papiernik, Emile; Zeitlin, Jennifer; Delmas, Dominique

    2010-01-01

    About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine whether outcom...

  14. Macrophage phenotype is associated with disease severity in preterm infants with chronic lung disease.

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    Lynne R Prince

    Full Text Available The etiology of persistent lung inflammation in preterm infants with chronic lung disease of prematurity (CLD is poorly characterized, hampering efforts to stratify prognosis and treatment. Airway macrophages are important innate immune cells with roles in both the induction and resolution of tissue inflammation.To investigate airway innate immune cellular phenotypes in preterm infants with respiratory distress syndrome (RDS or CLD.Bronchoalveolar lavage (BAL fluid was obtained from term and preterm infants requiring mechanical ventilation. BAL cells were phenotyped by flow cytometry.Preterm birth was associated with an increase in the proportion of non-classical CD14(+/CD16(+ monocytes on the day of delivery (58.9 ± 5.8% of total mononuclear cells in preterm vs 33.0 ± 6.1% in term infants, p = 0.02. Infants with RDS were born with significantly more CD36(+ macrophages compared with the CLD group (70.3 ± 5.3% in RDS vs 37.6 ± 8.9% in control, p = 0.02. At day 3, infants born at a low gestational age are more likely to have greater numbers of CD14(+ mononuclear phagocytes in the airway (p = 0.03, but fewer of these cells are functionally polarized as assessed by HLA-DR (p = 0.05 or CD36 (p = 0.05 positivity, suggesting increased recruitment of monocytes or a failure to mature these cells in the lung.These findings suggest that macrophage polarization may be affected by gestational maturity, that more immature macrophage phenotypes may be associated with the progression of RDS to CLD and that phenotyping mononuclear cells in BAL could predict disease outcome.

  15. Macrophage phenotype is associated with disease severity in preterm infants with chronic lung disease.

    Science.gov (United States)

    Prince, Lynne R; Maxwell, Nicola C; Gill, Sharonjit K; Dockrell, David H; Sabroe, Ian; McGreal, Eamon P; Kotecha, Sailesh; Whyte, Moira K

    2014-01-01

    The etiology of persistent lung inflammation in preterm infants with chronic lung disease of prematurity (CLD) is poorly characterized, hampering efforts to stratify prognosis and treatment. Airway macrophages are important innate immune cells with roles in both the induction and resolution of tissue inflammation. To investigate airway innate immune cellular phenotypes in preterm infants with respiratory distress syndrome (RDS) or CLD. Bronchoalveolar lavage (BAL) fluid was obtained from term and preterm infants requiring mechanical ventilation. BAL cells were phenotyped by flow cytometry. Preterm birth was associated with an increase in the proportion of non-classical CD14(+)/CD16(+) monocytes on the day of delivery (58.9 ± 5.8% of total mononuclear cells in preterm vs 33.0 ± 6.1% in term infants, p = 0.02). Infants with RDS were born with significantly more CD36(+) macrophages compared with the CLD group (70.3 ± 5.3% in RDS vs 37.6 ± 8.9% in control, p = 0.02). At day 3, infants born at a low gestational age are more likely to have greater numbers of CD14(+) mononuclear phagocytes in the airway (p = 0.03), but fewer of these cells are functionally polarized as assessed by HLA-DR (p = 0.05) or CD36 (p = 0.05) positivity, suggesting increased recruitment of monocytes or a failure to mature these cells in the lung. These findings suggest that macrophage polarization may be affected by gestational maturity, that more immature macrophage phenotypes may be associated with the progression of RDS to CLD and that phenotyping mononuclear cells in BAL could predict disease outcome.

  16. A Test of Kangaroo Care on Preterm Infant Breastfeeding

    Science.gov (United States)

    Tully, Kristin P.; Holditch-Davis, Diane; White-Traut, Rosemary C.; David, Richard; O’Shea, T. Michael; Geraldo, Victoria

    2015-01-01

    Objective To test the effects of kangaroo care (KC) on breastfeeding outcomes in preterm infants compared to two control groups and to explore whether maternal-infant characteristics and the mother’s choice to use KC were related to breastfeeding measures. Design Secondary analysis of a multisite, stratified, and randomized 3-arm trial. The treatment groups used KC, auditory-tactile-visual-vestibular (ATVV) intervention, or preterm infant care information. Setting Neonatal intensive care units from 4 hospitals in the United States from 2006–2011. Participants Racially diverse mothers (N=231) and their preterm infants born weighing breastfeeding, and breastfeeding exclusivity after hospital discharge did not differ statistically among the treatment groups. Regardless of group assignment, married, older, and more educated women were more likely to feed at the breast during hospitalization. Mothers who practiced KC, regardless of randomly allocated group, were more likely to provide their milk than those who did not practice KC. Breastfeeding duration was greatest among more educated women. Conclusion As implemented in this study, assignment to KC did not appear to influence the measured breastfeeding outcomes. PMID:26815798

  17. Population-based study shows improved postnatal growth in preterm very-low-birthweight infants between 1995 and 2010.

    Science.gov (United States)

    Ofek Shlomai, Noa; Reichman, Brian; Lerner-Geva, Liat; Boyko, Valentina; Bar-Oz, Benjamin

    2014-05-01

    To assess whether the postnatal growth of preterm very-low-birthweight (VLBW) infants, as determined by measures of postnatal growth failure (PNGF), improved during the period 1995-2010 and to evaluate postnatal growth by gestational age (GA) and intrauterine growth groups. The study was based on the Israel national VLBW infant database and comprised 13 531 VLBW infants of 24-32 weeks' GA, discharged at a postmenstrual age of ≤40 weeks. Z-scores were determined for weight at birth and discharge. Severe and mild PNGF was defined as a decrease >2 and 1-2 z-scores, respectively. Three time periods were considered: 1995-2000, 2001-2005 and 2006-2010. Multinomial logistic regression was used to assess the independent effect of time period on PNGF. Severe PNGF decreased from 11.7% in 1995-2000 to 7.2% in 2001-2005 and 5.2% in 2006-2010. Infants born in 2006-2010 had sixfold lower odds for severe PNGF than babies born in 1995-2000 (adjusted odds ratio 0.17, 95% confidence interval 0.14-0.21) and infants from 1995-2000 to 2006-2010. This decline was even present in extremely premature infants. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  18. What follows newborn screening? An evaluation of a residential education program for parents of infants with newly diagnosed cystic fibrosis.

    Science.gov (United States)

    Sawyer, Susan M; Glazner, Judith A

    2004-08-01

    The diagnosis of a severe life-limiting condition, such as cystic fibrosis (CF), is generally followed by assessment and treatment of the child and education and counseling for parents. The introduction of newborn screening for CF provides an opportunity for standardized assessment and education. The aim of this study was to evaluate a 5-day residential assessment and education program for parents of infants who receive a diagnosis of CF after newborn screening. Eligible parents had a 6- to 30-month-old infant with CF diagnosed by newborn screening. Parents were interviewed by telephone using a structured questionnaire that addressed 3 main themes: 1) initial communication of the diagnosis of CF, 2) the perceived value of the 5-day assessment and education program, and 3) the perceived advantages and disadvantages of the residential component (Care-By-Parent unit) of the program. Fifteen of 17 eligible families took part in the 5-day assessment and education program, 12 of whom used the residential Care-By-Parent unit. At the end of the program, parents believed that they had the knowledge and skills required to manage their child's CF at home. One hundred percent endorsed the timing of the assessment and education program immediately after the child's diagnosis and would recommend it to other families in the same situation. Perceived advantages of the residential program were not having to travel (89%), being able to concentrate on CF (50%), and the benefit of a "home base" at the hospital (39%). Twenty-two percent reported that financial costs related to participation (paternal time off work) were a disadvantage, 17% reported additional strain on family members caring for siblings, and 17% mentioned lack of comfort within the unit. This time-intensive residential program was evaluated positively by parents of children with newly diagnosed CF. It provides a model for education programs after the diagnosis of CF by newborn screening, as well as for other pediatric

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

    Science.gov (United States)

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

    2017-01-01

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

  20. A comparison of the socio-economic determinants of growth retardation in South African and Filipino infants.

    Science.gov (United States)

    Jones, Laura L; Griffiths, Paula L; Adair, Linda S; Norris, Shane A; Richter, Linda M; Cameron, Noël

    2008-12-01

    To examine the association between household socio-economic status (SES) at birth and poor infant growth such as small for gestational age (SGA) and stunting across two different socio-cultural settings: South Africa and the Philippines. Data were from two longitudinal birth cohorts, the Birth to Twenty (Bt20) study in South Africa and the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines. Bt20 infants (n 2293 total; reduced to 758 (SGA), 450 (stunting 1 year) and 401 (stunting 2 years)) and CLHNS infants (n 2513 total; reduced to 2161 (SGA), 1820 (stunting 1 year) and 1710 (stunting 2 years)). CLHNS infants were significantly more likely to be born SGA (20.9 v. 11.7 %) and be stunted at 1 year (32.6 v. 8.7 %) and 2 years (48.9 v. 21.1 %) compared with Bt20 infants. Logistic regression analyses showed that SES (index) was a significant predictor of stunting at 1 and 2 years of age in the CLHNS cohort. SES (index or individual variables) was not a significant predictor of SGA in either cohort, or of stunting in the Bt20 cohort. Maternal education, ownership of a television and toilet facilities were all independent predictors of stunting in the CLHNS cohort. The social and economic milieu within the Philippines appears to place CLHNS infants at greater risk of being born SGA and being stunted compared with Bt20 infants. The present research highlights the importance of investigating the individual SES variables that predict infantile growth faltering, to identify the key areas for context-specific policy development and intervention.

  1. Sex difference in disability and handicap at five years of age in children born at very short gestation

    NARCIS (Netherlands)

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

    1994-01-01

    Objective. The objective of this study was to examine the relationship between sex and disabilities or handicaps at 5 years of age in infants born at less than 32 weeks gestation. Design. From the nationwide collaborative survey starting in 1983, including perinatal data obtained during routine

  2. Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study

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    Kerstin H. Nyqvist

    2017-10-01

    Full Text Available Background Skin-to-skin contact (SSC is an important factor to consider in the care of late preterm infants (born between 34 0/7 and 36 6/7 completed weeks of gestation. The literature suggests that SSC between preterm infants and their mothers facilitates breastfeeding. However, more studies are needed to explore potential dose-response effects between SSC and breastfeeding as well as studies that explicitly investigate SSC by fathers among late preterm infants. The aim was to investigate the duration of healthy late preterm infants’ SSC with the mother and father, respectively, during the first 48 h after birth and the associations with breastfeeding (exclusive/partial at discharged, clinical and demographic variables. Methods This was an observational cohort study in which parents to healthy late preterm infants, born between 34 5/7 and 36 6/7 completed weeks of gestation, recorded duration of SSC provided by mother and father, respectively. Demographic and clinical variables were retrieved from the medical records and were used as predictors. Multiple linear regression analysis was used to assess the association between the predictors and the outcome, SSC (hours, separately for mothers and fathers. Results The mean (standard deviation [SD] time per day spent with SSC with mothers (n = 64 and fathers (n = 64, was 14.7 (5.6 and 4.4 (3.3 hours during the first day (24 h after birth and 9.2 (7.1 and 3.1 (3.3 hours during the second day (24 h, respectively. Regarding SSC with mothers, no variable was significantly associated with SSC during the first day, while the mean (95% confidence interval [CI] time of SSC during the second day was 6.9 (1.4–12.4 hours shorter for each additional kg of birthweight (p = 0.014. Concerning SSC with fathers, the mean (95% CI time of SSC during the first day was 2.1 (0.4–3.7 hours longer for infants born at night (p = 0.015, 1.7 (0.1–3.2 hours longer for boys (p = 0.033, 3.2 (1.2–5.2 hours

  3. Caring for the infant of a diabetic mother.

    Science.gov (United States)

    Hatfield, Linda; Schwoebel, Ann; Lynyak, Corinne

    2011-01-01

    In the United States, approximately 100,000 infants are born to diabetic mothers each year. If diabetes in pregnancy is uncontrolled, the diversity of resulting health problems can have a profound effect on the embryo, the fetus, and the neonate. These infants are at risk for a multitude of physiologic, metabolic, and congenital complications such as macrosomia, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia and hyperviscosity, cardiomegaly, and central nervous system disruption. Preconception control of glucose metabolism throughout the trajectory of a woman's pregnancy is a significant factor in decreasing the adverse impact of diabetes on the fetus and newborn. Meticulous attention to neonatal glucose levels, thorough physical examination, and precise diagnosis are prerequisites to appropriate care for the neonate.

  4. Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission

    Science.gov (United States)

    Xu, Jiahong; Yeganeh, Nava; Camarca, Margaret; Morgado, Mariza G.; Watts, D. Heather; Mofenson, Lynne M.; Veloso, Valdilea G.; Pilotto, Jose Henrique; Joao, Esau; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa M.; Ceriotto, Mariana; Machado, Daisy Maria; Bryson, Yvonne J.; Grinsztejn, Beatriz; Moye, Jack; Klausner, Jeffrey D.; Bristow, Claire C.; Dickover, Ruth; Mirochnick, Mark; Nielsen-Saines, Karin

    2018-01-01

    Background Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. Methodology Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV. Infant HIV infection was determined by serial HIV DNA PCR testing. Maternal syphilis was tested by VDRL and confirmatory treponemal antibodies. Results A total of 899 mother-infant pairs were evaluated. Over 30% had at least one of the following infections (TP, CT, NG, and/or CMV) detected at the time of delivery. High rates of TP (8.7%), CT (17.8%), NG (4%), and CMV (6.3%) were observed. HIV MTCT was 9.1% (n = 82 infants). HIV MTCT was 12.5%, 10.3%, 11.1%, and 26.3% among infants born to women with CT, TP, NG or CMV respectively. Forty-two percent of HIV-infected infants were born to women with at least one of these 4 infections. Women with these infections were nearly twice as likely to have an HIV-infected infant (aOR 1.9, 95% CI 1.1–3.0), particularly those with 2 STIs (aOR 3.4, 95% CI 1.5–7.7). Individually, maternal CMV (aOR 4.4 1.5–13.0) and infant congenital CMV (OR 4.1, 95% CI 2.2–7.8) but not other STIs (TP, CT, or NG) were associated with an increased risk of HIV MTCT. Conclusion HIV-infected pregnant women identified during labor are at high risk for STIs. Co-infection with STIs including CMV nearly doubles HIV MTCT risk. CMV infection appears to confer the largest risk of HIV MTCT. Trial registration NCT00099359. PMID:29304083

  5. Term-equivalent functional brain maturational measures predict neurodevelopmental outcomes in premature infants.

    Science.gov (United States)

    El Ters, Nathalie M; Vesoulis, Zachary A; Liao, Steve M; Smyser, Christopher D; Mathur, Amit M

    2018-04-01

    Term equivalent age (TEA) brain MRI identifies preterm infants at risk for adverse neurodevelopmental outcomes. But some infants may experience neurodevelopmental impairments even in the absence of neuroimaging abnormalities. Evaluate the association of TEA amplitude-integrated EEG (aEEG) measures with neurodevelopmental outcomes at 24-36 months corrected age. We performed aEEG recordings and brain MRI at TEA (mean post-menstrual age of 39 (±2) weeks in a cohort of 60 preterm infants born at a mean gestational age of 26 (±2) weeks. Forty-four infants underwent Bayley Scales of Infant Development, 3rd Edition (BSID-III) testing at 24-36 months corrected age. Developmental delay was defined by a score greater than one standard deviation below the mean (neurodevelopmental outcomes was assessed using odds ratio, then adjusted for confounding variables using logistic regression. Infants with developmental delay in any domain had significantly lower values of SEF 90 . Absent cyclicity was more prevalent in infants with cognitive and motor delay. Both left and right SEF 90  neurodevelopmental outcomes. Therefore, a larger study is needed to validate these results in premature infants at low and high risk of brain injury. Copyright © 2018. Published by Elsevier B.V.

  6. Fatores de risco para mortalidade infantil em município do Nordeste do Brasil: linkage entre bancos de dados de nascidos vivos e óbitos infantis - 2000 a 2002 Risk factors for infant mortality in a city of northeastern Brazil: linkage between live birth and infant death databases - 2000 to 2002

    Directory of Open Access Journals (Sweden)

    Cristiana Ferreira da Silva

    2006-03-01

    of born-alive, with certificate of death or investigation instrument of infant death filled out and occurred between 01/01/2000 and 31/01/2003. The risk factors for the infant death were estimated utilizing the bi-varied and multi-varied analysis through the logistic regression. RESULTS: significant Odds Ratio (OR were found among born-alive with low weight when coming to life (OR=3.16; IC95% 1.58-6.35, premature born-alive (OR=2.70; IC95% 1.25-5.86, born-alive from mothers with pre-natal appointment the same as or lower than 6 (OR=2.05; IC95% 1.15-3.64 and born-alive whose Apgar score in the first (OR=4.40; IC95% 2.48-7.81 and the fifth (OR=5.5; IC95% 2.75-11.20 minutes of life were lower than seven. CONCLUSIONS: this study made it possible the use of data bases of birth and death, suggesting the continuous vigilance and offer of adequate assistance to the subgroup of newly-born with a higher risk of death and the guarantee of pre-natal assistance of quality.

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

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    Alan H. Jobe

    2010-02-01

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

  8. Mortality in infants discharged from neonatal intensive care units in Georgia.

    Science.gov (United States)

    Allen, D M; Buehler, J W; Samuels, B N; Brann, A W

    Although neonatal intensive care units (NICUs) have contributed to advances in neonatal survival, little is known about the epidemiology of deaths that occur after NICU discharge. To determine mortality rates following NICU discharge, we used linked birth, death, and NICU records for infants born to Georgia residents from 1980 through 1982 and who were admitted to NICUs participating in the state's perinatal care network. Infants who died after discharge (n = 120) had a median duration of NICU hospitalization of 20 days (range, 1 to 148 days) and a median birth weight of 1983 g (range, 793 to 5159 g). The postdischarge mortality rate was 22.7 per 1000 NICU discharges. This rate is more than five times the overall postneonatal mortality rate for Georgia from 1980 to 1982. The most common causes of death were congenital heart disease (23%), sudden infant death syndrome (21%), and infection (13%). Demographic characteristics commonly associated with infant mortality were not strongly associated with the mortality following NICU discharge.

  9. Ventilatory control and supplemental oxygen in premature infants with apparent chronic lung disease.

    Science.gov (United States)

    Coste, Ferdinand; Ferkol, Thomas; Hamvas, Aaron; Cleveland, Claudia; Linneman, Laura; Hoffman, Julie; Kemp, James

    2015-05-01

    Our goal was to evaluate changes in respiratory pattern among premature infants born at newborn intensive care unit. 37 of 49 infants (75.5%) failed the challenge, with severe or sustained falls in SpO2%. Also, 16 of 37 infants (43.2%) who failed had marked increases in the amount of periodic breathing at the time of challenge failure. An unstable respiratory pattern is unmasked with a decrease in inspired oxygen or airflow support in many premature infants. Although infants with significant chronic lung disease may also be predisposed to more periodic breathing, these data suggest that the classification of chronic lung disease of prematurity based solely on clinical requirements for supplemental oxygen or airflow do not account for multiple mechanisms that are likely contributing to the need for respiratory support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Lethal Consequences in an Infant with Myelomeningocele Following an Inadvertent Treatment

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    Xuemei Wu

    2016-01-01

    Full Text Available Myelomeningocele (MMC is a protrusion of spinal cord contents and meninges through a vertebral defect. Iatrogenic deaths of patients with MMC are rarely encountered in forensic practice. In our case, a 3-month-old female was born with a lumbosacral cyst, the size of which had been increasing gradually over age. There was no neurological, orthopedic, or urologic dysfunction. On the day of her death, she received a repetitive and rapid lumbosacral cyst puncture drainage procedure, performed by an illegal medical practitioner. Postmortem autopsy findings confirmed a diagnosis of MMC and the cause of death to be cerebellar tonsillar herniation. This is a pathetic case of preventable infant death. This report suggests that the possibility of MMC should be considered in infants born with a lumbosacral cyst, and aspiration is inadvisable. Besides, forensic autopsy has a valuable role in determining the exact cause of death, identifying, or excluding iatrogenic factors that may be relevant to death following a medical procedure. A final point is that prevention programs should be developed, especially by the health care sectors to reduce such tragedy.

  11. Born Pupils? Natural Pedagogy and Cultural Pedagogy.

    Science.gov (United States)

    Heyes, Cecilia

    2016-03-01

    The theory of natural pedagogy is an important focus of research on the evolution and development of cultural learning. It proposes that we are born pupils; that human children genetically inherit a package of psychological adaptations that make them receptive to teaching. In this article, I first examine the components of the package-eye contact, contingencies, infant-directed speech, gaze cuing, and rational imitation-asking in each case whether current evidence indicates that the component is a reliable feature of infant behavior and a genetic adaptation for teaching. I then discuss three fundamental insights embodied in the theory: Imitation is not enough for cumulative cultural inheritance, the extra comes from blind trust, and tweaking is a powerful source of cognitive change. Combining the results of the empirical review with these insights, I argue that human receptivity to teaching is founded on nonspecific genetic adaptations for social bonding and social learning and acquires its species- and functionally specific features through the operation of domain-general processes of learning in sociocultural contexts. We engage, not in natural pedagogy, but in cultural pedagogy. © The Author(s) 2016.

  12. The importance of hygiene in the domestic kitchen: implications for preparation and storage of food and infant formula.

    Science.gov (United States)

    Redmond, Elizabeth C; Griffith, Christopher J

    2009-03-01

    Public concerns relating to food safety remain high with most attention focused on manufactured foods and those served in catering operations. However, previous data have suggested that the home may be the main location for cases of food-borne disease. The aim of this paper is to review the microbiological risks associated with hygiene in the domestic kitchen related to food and infant formula safety. Compared to other food sectors, research on consumer food hygiene, domestic food-handling and preparation of infant formula is relatively understudied. Behavioural and microbiological studies of consumer hygiene and the domestic kitchen have been reviewed to incorporate research relating to the safety of infant formula. Incidence data identify the home as an important location for acquiring food-borne disease. The domestic kitchen can be used for a variety of purposes and is often contaminated with potentially harmful micro-organisms such as Campylobacter and Salmonella. Consumer hygiene habits have frequently been found to be inadequate and relate both to microbial growth, survival and cross-contamination. Due to the reduced immune response of infants, the activities associated with the preparation of infant formula and associated bottles and equipment are of particular concern. Cumulatively, the data suggest that more effort should be made to educate the consumer in food hygiene, especially when the kitchen is used to reconstitute infant formula. This information needs to be provided in a form appropriate for use by consumers.

  13. [Serological and nutritional outcome of infants born to HIV positive mothers undergoing option B + therapy in Guédiawaye].

    Science.gov (United States)

    Baptiste, Diouf Jean; Djibril, Diallo; Assane, Sylla; Ngagne, Mbaye; Baly, Ouattara; Ousmane, Ndiaye

    2016-01-01

    As part of its Plan to eliminate mother-to-child transmission of HIV, Senegal has adopted, since 2012, WHO's B + option, which consists of systematic triple therapy for HIV-positive pregnant women associated with breastfeeding and antiretroviral (ARV) prophylaxis for their infants. Our study aims to analyze the risks of mother-to-child transmission of HIV and the nutritional outcome of infants undergoing B + option. We conducted a descriptive, retrospective study at the King Baudouin health center in Guédiaway from 1 September 2012 to 30 April 2015. All infants whose mothers were on triple therapy, undergoing protected breastfeeding, ARV prophylaxis and serological test at 14th months were included in the study. The parameters studied were mother's age and serological profile, father's serological status, the sharing of the status within the couple, infant nourishing, infant ARV prophylaxis, nutritional status at 6 and 12 months and serological status of the infant at 14 months. Out of the 126 infants undergoing PMTCT program, 42 or 33.33% of infants following the B + guidelines were included in the study. The age of mothers ranged from 15 to 42 years, with an average age of 31 years. The majority of mothers (88.1%) carried type 1 virus and 11.9% carried type 2 virus; 20 couples (47.62%) were sero-concordant, 14 were serodifferent, while the serological status was unknown or not investigated in 8 fathers (19.05%). A significant difference between fathers' serological profile and the sharing status (p option is an effective strategy to reduce the MTCT rate. However, early malnutrition in children requires nutritional support for breastfeeding mothers as well as a good psychosocial support.

  14. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy

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    Guez Sophie

    2012-06-01

    Full Text Available Abstract Background In infants, vitamin B12 deficiency may be due to an inborn error of absorption and metabolism, or nutritional problems. Case presentation An exclusively breastfed 5-month-old Italian male infant, who was born after a normal full-term pregnancy to a vegan mother who was apparently daily treated with a multivitamin oral preparation during the second and third trimester, was hospitalised because of poor weight gain, feeding difficulties, severe pallor, muscle hypotonia and somnolence. Upon admission, his weight, length and head circumference were below the third percentile, he had an enlarged liver and spleen, and showed a significant delay in developmental milestones and communicative reactions. He had a hemoglobin level of 4.7 g/dL with an MCV of 84.2 fL, a white blood cell count of 4,680/mm3, and a platelet count of 45,000/mm3. His serum vitamin B12 level was 57 pg/mL (normal value 180–500 pg/mL and serum folate level 12.8 ng/mL (normal value >3 ng/mL. The results of metabolic examinations excluded a cobalamin C disorder, whereas nutritional screening showed a serum iron concentration of 9 μg/dL and serum ferritin of 4 ng/mL. Magnetic resonance imaging of the brain showed mild dilatation of the lateral ventricles with diffuse delayed myelination. The child was diagnosed as having vitamin B12 and iron deficiency due to nutritional inadequacy and was immediately treated with packed red blood cells, intramuscular vitamin B12 injections, and iron supplementation. A few days after the start of therapy, his hemoglobin levels and other hematological parameters rapidly improved, and a clinical improvement was observed within few weeks. There was an increase in his achievement of developmental milestones, but his development was still retarded seven months after the start of therapy. Conclusion This case underlines the importance of adequately controlling maternal vitamin B12 intake during pregnancy by means of

  15. Breast-Feeding Analgesia in Infants: An Update on the Current State of Evidence.

    Science.gov (United States)

    Benoit, Britney; Martin-Misener, Ruth; Latimer, Margot; Campbell-Yeo, Marsha

    To provide an updated synthesis of the current state of the evidence for the effectiveness of breast-feeding and expressed breast milk feeding in reducing procedural pain in preterm and full-term born infants. A systematic search of key electronic databases (PubMed, CINAHL, EMBASE) was completed. Of the 1032 abstracts screened, 21 were found eligible for inclusion. Fifteen studies reported on the use of breast-feeding or expressed breast milk in full-term infants and 6 reported on preterm infants. Direct breast-feeding was more effective than maternal holding, maternal skin-to-skin contact, topical anesthetics, and music therapy, and was as or more effective than sweet tasting solutions in full-term infants. Expressed breast milk was not consistently found to reduce pain response in full-term or preterm infants. Studies generally had moderate to high risk of bias. There is sufficient evidence to recommend direct breast-feeding for procedural pain management in full-term infants. Based on current evidence, expressed breast milk alone should not be considered an adequate intervention.

  16. Retinopathy of prematurity: the high cost of screening regional and remote infants.

    Science.gov (United States)

    Yu, Tzu-Ying; Donovan, Tim; Armfield, Nigel; Gole, Glen A

    2018-01-25

    Demand for retinopathy of prematurity (ROP) screening is increasing for infants born at rural and regional hospitals where the service is not generally available. The health system cost for screening regional/remote infants has not been reported. The objective of this study is to evaluate the cost of ROP screening at a large centralized tertiary neonatal service for infants from regional/rural hospitals. This is a retrospective study to establish the cost of transferring regional/rural infants to the Royal Brisbane and Women's Hospital for ROP screening over a 28-month period. A total of 131 infants were included in this study. Individual infant costs were calculated from analysis of clinical and administrative records. Economic cost of ROP screening for all transfers from regional/rural hospitals to Royal Brisbane and Women's Hospital. The average economic cost of ROP screening for this cohort was AUD$5110 per infant screened and the total cost was AUD$669 413. The average cost per infant screened was highest for infants from a regional centre with a population of 75 000 (AUD$14 856 per child), which was also geographically furthest from Brisbane. No infant in this cohort transferred from a regional nursery reached criteria for intervention for ROP by standard guidelines. Health system costs for ROP screening of remote infants at a centralized hospital are high. Alternative strategies using telemedicine can now be compared with centralized screening. © 2018 Royal Australian and New Zealand College of Ophthalmologists.

  17. Vaccine Education During Pregnancy and Timeliness of Infant Immunization.

    Science.gov (United States)

    Veerasingam, Priya; Grant, Cameron C; Chelimo, Carol; Philipson, Kathryn; Gilchrist, Catherine A; Berry, Sarah; Carr, Polly Atatoa; Camargo, Carlos A; Morton, Susan

    2017-09-01

    Pregnant women routinely receive information in support of or opposing infant immunization. We aimed to describe immunization information sources of future mothers' and determine if receiving immunization information is associated with infant immunization timeliness. We analyzed data from a child cohort born 2009-2010 in New Zealand. Pregnant women ( N = 6822) at a median gestation of 39 weeks described sources of information encouraging or discouraging infant immunization. Immunizations received by cohort infants were determined through linkage with the National Immunization Register ( n = 6682 of 6853 [98%]). Independent associations of immunization information received with immunization timeliness were described by using adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Immunization information sources were described by 6182 of 6822 (91%) women. Of these, 2416 (39%) received information encouraging immunization, 846 (14%) received discouraging information, and 565 (9%) received both encouraging and discouraging information. Compared with infants of women who received no immunization information (71% immunized on-time), infants of women who received discouraging information only (57% immunized on time, OR = 0.49, 95% CI 0.38-0.64) or encouraging and discouraging information (61% immunized on time, OR = 0.51, 95% CI 0.42-0.63) were at decreased odds of receiving all immunizations on time. Receipt of encouraging information only was not associated with infant immunization timeliness (73% immunized on time, OR = 1.00, 95% CI 0.87-1.15). Receipt, during pregnancy, of information against immunization was associated with delayed infant immunization regardless of receipt of information supporting immunization. In contrast, receipt of encouraging information is not associated with infant immunization timeliness. Copyright © 2017 by the American Academy of Pediatrics.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Early diagnosis and care is achieved but should be improved in infants with Prader-Willi syndrome.

    Science.gov (United States)

    Bar, Céline; Diene, Gwenaelle; Molinas, Catherine; Bieth, Eric; Casper, Charlotte; Tauber, Maithé

    2017-06-28

    PWS is a severe neurodevelopmental genetic disorder now usually diagnosed in the neonatal period from hypotonia and feeding difficulties. Our study analyzed the birth incidence and care of infants with early diagnosis. Data were collected on 61 infants with a molecular diagnosis of PWS born in 2012 and 2013 in France. Thirty-eight infants with PWS were born in 2013. The median age at diagnosis was 18 days. Birth incidence calculated for 2013 was 1/21,000 births. No case was diagnosed prenatally, despite 9 amniocenteses, including 4 for polyhydramnios. Five infants had delayed diagnosis, after 3 months of life. For 2 of them, the diagnosis was not suspected at birth and for 3, FISH analysis in the neonatal period was normal, with no further molecular studies. Ninety-three percent of the neonates were hospitalized, and 84% needed nasogastric tube feeding for a median of 38 days. Swallowing assessment was performed for 45%, at a median age of 10 days. Physiotherapy was started for 76% during hospitalization. Eighty percent of those diagnosed within the first 3 months were seen by a pediatric endocrinologist within the first week of life. Our study is the first to assess the birth incidence of PWS in France, at 1/21,000 births. Some prenatal or neonatal cases remain undiagnosed because of unrecognized clinical signs and the inappropriate choice of the initial molecular test. We also underscore the need to optimize neonatal care of infants with PWS.

  1. Prevalence of behaviour disorders in low birthweight infants.

    OpenAIRE

    Pharoah, P O; Stevenson, C J; Cooke, R W; Stevenson, R C

    1994-01-01

    OBJECTIVE--To determine the prevalence of behaviour disorders in low birthweight infants. DESIGN--Children of birth weight < or = 2000 g born to mothers resident in Merseyside in 1980-1 assessed using the Rutter parent and teacher behaviour questionnaires and the Conner modification of the Rutter teacher questionnaire. Children attending normal schools were assessed with controls matched for age, sex, and class in school. Children attending special schools were assessed unmatched. SUBJECTS--2...

  2. Parenting paradox: parenting after infant loss.

    Science.gov (United States)

    Warland, Jane; O'Leary, Joann; McCutcheon, Helen; Williamson, Victoria

    2011-10-01

    to gain an in-depth understanding of the parenting experiences of bereaved parents in the years following an infant death. an exploratory qualitative study. semi-structured interview in the participants' homes. Data were collected over a five-month period in 2008 and analysed using thematic analysis. a purposive sample of 13 bereaved parents (10 mothers and three fathers) was used. Parents who had accessed the support services offered by two bereavement support agencies were recruited. Participants were asked to describe their experiences of raising their subsequent child. Interviews were conducted when the next born child was at least three years of age. the parents described a 'paradoxical' parenting style where they were trying to parent using two diametrically opposed unsustainable options. For example, they described trying to hold their subsequent child emotionally close but aloof at the same time. the results from this study indicate that the impact of a loss of an infant has far-reaching consequences on subsequent parenting. Support and early intervention at the time of the stillbirth and subsequent pregnancy are likely to be useful. However, further research is required to determine the extent to which early intervention can alter the tendency towards bereaved parents adopting a paradoxical parenting style. The impact of this style on mental health and the emotional health and well-being of the next born child/ren after perinatal loss should also be further examined. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Intravenous Lipids for Preterm Infants: A Review

    Directory of Open Access Journals (Sweden)

    Ghassan S. A. Salama

    2015-01-01

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

  4. MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants.

    Science.gov (United States)

    Bruno, Christie J; Bengani, Shreyans; Gomes, William A; Brewer, Mariana; Vega, Melissa; Xie, Xianhong; Kim, Mimi; Fuloria, Mamta

    2017-01-01

    Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis. To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age. This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants. Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI. Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships. © 2017 S. Karger AG, Basel.

  5. Hierarchical organization in the temporal structure of infant-direct speech and song.

    Science.gov (United States)

    Falk, Simone; Kello, Christopher T

    2017-06-01

    Caregivers alter the temporal structure of their utterances when talking and singing to infants compared with adult communication. The present study tested whether temporal variability in infant-directed registers serves to emphasize the hierarchical temporal structure of speech. Fifteen German-speaking mothers sang a play song and told a story to their 6-months-old infants, or to an adult. Recordings were analyzed using a recently developed method that determines the degree of nested clustering of temporal events in speech. Events were defined as peaks in the amplitude envelope, and clusters of various sizes related to periods of acoustic speech energy at varying timescales. Infant-directed speech and song clearly showed greater event clustering compared with adult-directed registers, at multiple timescales of hundreds of milliseconds to tens of seconds. We discuss the relation of this newly discovered acoustic property to temporal variability in linguistic units and its potential implications for parent-infant communication and infants learning the hierarchical structures of speech and language. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Sensory processing and cognitive development of preterm and full term infants

    Directory of Open Access Journals (Sweden)

    Flávia Regina Ribeiro Cavalcanti Buffone

    2016-10-01

    Full Text Available Introduction: Current studies show the repercussion of sensory processing disorder in infant neurodevelopment. Little is known about the influence of these disorders in the infant’s cognitive development, however, it is known that they negatively interfere on daily life activities and remain during life course. Objective:To evaluate the relationship between sensory processing and cognitive development in infants and the association between prematurity and sensory processing in this population. Method: This is a cross-sectional study conducted in the Childcare Outpatient Department of the Hospital das Clínicas, Federal Universidade de Pernambuco, from December 2009 to August 2010. The sample consisted of 182 infants from 8 to 15 months, of which 54 (29.7% were born preterm with the prematurity age correction made to 40 weeks of gestational age. We used the Test of Sensory Functions in Infants (TSFI to evaluate the sensory processing and the Bayley Scales of Infant and Toddler Development III to assess cognitive development. Results: There was a significantly higher frequency of at risk and deficient sensory processing among preterm infants (37% when compared to term infants (21.9%. Cognitive delay was significantly higher (8.3% in infants with at risk and deficient sensory processing when compared to those with normal sensory processing (1.5%. Conclusion: Prematurity was a risk factor for sensory processing disorder, and infants diagnosed with this disorder showed cognitive delay more frequently. Prematurity alone was not associated with cognitive delay.

  7. Fine motor skill predicts expressive language in infant siblings of children with autism.

    Science.gov (United States)

    LeBarton, Eve Sauer; Iverson, Jana M

    2013-11-01

    We investigated whether fine motor and expressive language skills are related in the later-born siblings of children with autism (heightened-risk, HR infants) who are at increased risk for language delays. We observed 34 HR infants longitudinally from 12 to 36 months. We used parent report and standardized observation measures to assess fine motor skill from 12 to 24 months in HR infants (Study 1) and its relation to later expressive vocabulary at 36 months in HR infants (Study 2). In Study 1, we also included 25 infants without a family history of autism to serve as a normative comparison group for a parent-report fine motor measure. We found that HR infants exhibited fine motor delays between 12 and 24 months and expressive vocabulary delays at 36 months. Further, fine motor skill significantly predicted expressive language at 36 months. Fine motor and expressive language skills are related early in development in HR infants, who, as a group, exhibit risk for delays in both. Our findings highlight the importance of considering fine motor skill in children at risk for language impairments and may have implications for early identification of expressive language difficulties. © 2013 John Wiley & Sons Ltd.

  8. Neurological development of children born to liver transplant recipients.

    Science.gov (United States)

    Schreiber-Zamora, J; Kociszewska-Najman, B; Borek-Dzięcioł, B; Drozdowska-Szymczak, A; Czaplińska, N; Pawlik, O; Cyganek, A; Pietrzak, B; Wielgoś, M

    2014-10-01

    Immunosuppressive treatment used in pregnant liver recipients may have a negative impact on fetal development and successively a child. The aim of the study was to make a neurological assessment of infants and children born to liver transplant recipients (LTRs) born between December 4, 2001, and February 11, 2013, in the 1(st) Department of Obstetrics and Gynecology, Medical University of Warsaw. The study involved 88 children, of whom 44 children were born to LTR mothers, and 44 children born to women who were not organ recipients and delivered at a similar gestational age. The gestational age of neonates ranged from 33 to 41 weeks, and the birth weight ranged from 1420 g to 4100 g. The neurological examination was performed in children from 7 weeks to 10 years of age. The neurological development was assessed by a specialist in pediatric neurology. The results of the examination were divided according to the following criteria: 1) normal development, 2) slight disorders, 3) moderate disorders, and 4) severe disorders. The Fisher's exact test was used for statistical analysis. Normal development was found in 35 of 44 (79.54%) children in the LTR group and 39 of 44 (88.63%) children in the control group (P = .3827). Slight disorders were observed in 6 of 44 (13.63%) children in LTR group and 5 of 44 (11.36%) children in the control group. Moderate disorders were found only in 3 of 44 (6.81%) children in the LTR group. No severe disorders were observed in both groups. Neurological development of children born to the liver recipients who were exposed to chronic immunosuppressive treatment in their fetal lives is the same as that of children whose mothers have not undergone organ transplantation.

  9. Changes in muscle activation patterns in response to enhanced sensory input during treadmill stepping in infants born with myelomeningocele.

    Science.gov (United States)

    Pantall, Annette; Teulier, Caroline; Ulrich, Beverly D

    2012-12-01

    Infants with myelomeningocele (MMC) increase step frequency in response to modifications to the treadmill surface. The aim was to investigate how these modifications impacted the electromyographic (EMG) patterns. We analyzed EMG from 19 infants aged 2-10 months, with MMC at the lumbosacral level. We supported infants upright on the treadmill for 12 trials, each 30 seconds long. Modifications included visual flow, unloading, weights, Velcro and lcriction. Surface electrodes recorded EMG from tibialis anterior, lateral gastrocnemius, rectus femoris and biceps femoris. We determined muscle bursts for each stride cycle and from these calculated various parameters. Results indicated that each of the five sensory conditions generated different motor patterns. Visual flow and friction which we previously reported increased step frequency impacted lateral gastrocnemius most. Weights, which significantly decreased step frequency increased burst duration and co-activity of the proximal muscles. We also observed an age effect, with all conditions increasing muscle activity in younger infants whereas in older infants visual flow and unloading stimulated most activity. In conclusion, we have demonstrated that infants with myelomeningocele at levels which impact the myotomes of major locomotor muscles find ways to respond and adapt their motor output to changes in sensory input. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Birth weight and postnatal growth in preterm born children are associated with cortisol in early infancy, but not at age 8 years.

    Science.gov (United States)

    Ruys, Charlotte A; van der Voorn, Bibian; Lafeber, Harrie N; van de Lagemaat, Monique; Rotteveel, Joost; Finken, Martijn J J

    2017-08-01

    Preterm birth has been associated with altered hypothalamic-pituitary-adrenal (HPA-) axis activity as well as cardiometabolic diseases and neurodevelopmental impairments later in life. We assessed cortisol from term age to age 8 y in children born preterm, to explore the development of HPA-axis activity in association with intrauterine and early-postnatal growth until 6 mo. corrected age. In 152 children born at a gestational age ≤32 wks. and/or with a birth weight ≤1,500g, random serum cortisol was assessed at term age (n=150), 3 mo. (n=145) and 6 mo. corrected age (n=144), and age 8 y (n=59). Salivary cortisol was assessed at age 8 y (n=75): prior to bedtime, at awakening, 15min after awakening, and before lunch. Cortisol was analyzed in association with birth weight-standard deviation score (SDS), being born small for gestational age (SGA), and combinations of intrauterine and postnatal growth: appropriate for gestational age (AGA) with or without growth restriction (AGA GR+ or AGA GR-) at 6 mo. corrected age, and SGA with or without catch-up growth (SGA CUG+ or SGA CUG-) at 6 mo. corrected age. Cross-sectional associations at all time points were analyzed using linear regression, and longitudinal associations were analyzed using generalized estimating equations. Longitudinally, birth weight-SDS was associated with cortisol (β [95%CI]): lower cortisol over time was seen in infants with a birth weight ≤-2 SDS (-50.69 [-94.27; -7.11], p=0.02), infants born SGA (-29.70 [-60.58; 1.19], p=0.06), AGA GR+ infants (-55.10 [-106.02; -4.17], p=0.03) and SGA CUG- infants (-61.91 [-104.73; -19.10], p=0.01). In cross-sectional analyses at age 8 y, no associations were found between either serum or salivary cortisol and birth weight-SDS, SGA-status, or growth from birth to 6 mo. corrected age. In children born preterm, poor intrauterine and postnatal growth were associated with lower cortisol in early infancy, but not at age 8 y. Even though HPA-axis activity no longer

  11. Changes in muscle activation patterns in response to enhanced sensory input during treadmill stepping in infants born with myelomeningocele

    OpenAIRE

    Pantall, Annette; Teulier, Caroline; Ulrich, Beverly D.

    2012-01-01

    Infants with myelomeningocele (MMC) increase step frequency in response to modifications to the treadmill surface. The aim was to investigate how these modifications impacted the electromyographic (EMG) patterns. We analyzed EMG from 19 infants aged 2–10 months, with MMC at the lumbosacral level. We supported infants upright on the treadmill for 12 trials, each 30 seconds long. Modifications included visual flow, unloading, weights, Velcro and lcriction. Surface electrodes recorded EMG from t...

  12. Failure to Thrive in the Term and Preterm Infants of Mothers Depressed in the Postnatal Period: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Drewett, Robert; Blair, Peter; Emmett, Pauline; Emond, Alan

    2004-01-01

    Aims: To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. Method: In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional…

  13. Transient cultural influences on infant mortality: Fire-Horse daughters in Japan.

    Science.gov (United States)

    Bruckner, Tim A; Subbaraman, Meenakshi; Catalano, Ralph A

    2011-01-01

    Parental investment theory suggests that the quality and quantity of parental care depends, in part, on assessments of whether offspring will survive and yield grandchildren. Consistent with this theory, we hypothesize that parental perception that a birth cohort will have low reproductive success coincides with higher than expected infant mortality in the cohort. We test this hypothesis in industrialized Japan in 1966 when cultural aversion to females born in the astrological year of the Fire-Horse may have jeopardized the life of female infants. We applied time-series methods to cohort infant mortality data for Japan, from 1947 to 1976, to test whether female infant mortality in 1966 rose above levels expected from history, male infant mortality, and fertility. Methods control for the secular decline in infant mortality as well as other temporal patterns that could induce spurious associations. Findings support the hypothesis in that female infant mortality rises by 1.1 deaths per 1,000 live births above expected levels (coefficient = 0.0011; standard error = 0.0005; P = 0.03). The result indicates an excess of 721 female infant deaths statistically attributable to the Fire-Horse year. Findings remain robust to control for male infant mortality and the secular decline in mortality over the test period. The discovery of a predictable, acute increase in female infant mortality during the Fire-Horse year supports the relevance of parental investment theory to developed countries. Results should encourage further research on the health sequelae of abrupt, population-level shifts in culture. Copyright © 2011 Wiley-Liss, Inc.

  14. Determinants of body composition in preterm infants at the time of hospital discharge.

    Science.gov (United States)

    Simon, Laure; Frondas-Chauty, Anne; Senterre, Thibault; Flamant, Cyril; Darmaun, Dominique; Rozé, Jean-Christophe

    2014-07-01

    Preterm infants have a higher fat mass (FM) percentage and a lower fat-free mass (FFM) than do term infants at the time of hospital discharge. We determined perinatal and nutritional factors that affect the body composition of preterm infants at discharge. A total of 141 preterm infants born at FFM was compared with reference data in term infants according to sex and gestational age. Linear regression produced an excellent model to predict absolute FFM from perinatal characteristics and nutrition (R(2) = 0.82) but not the FM percentage (R(2) = 0.24). Gestational and postnatal ages played an equal role in absolute FFM accretion, as did the initial growth (between birth and day 5) and growth between day 5 and discharge. Antenatal corticosteroid treatment slightly reduced FFM accretion. As concerns nutritional intake, a higher protein:energy ratio at days 10 and 21 was significantly associated with decreased risk of an FFM deficit when preterm infants were compared with reference values for term infants. Boys had higher risk of an FFM deficit than did girls. The initial growth and quality of nutrition were significantly associated with absolute FFM accretion during a hospital stay in preterm infants. This trial was registered at clinicaltrials.gov as NCT01450436. © 2014 American Society for Nutrition.

  15. Early CPAP versus surfactant in extremely preterm infants.

    Science.gov (United States)

    Finer, Neil N; Carlo, Waldemar A; Walsh, Michele C; Rich, Wade; Gantz, Marie G; Laptook, Abbot R; Yoder, Bradley A; Faix, Roger G; Das, Abhik; Poole, W Kenneth; Donovan, Edward F; Newman, Nancy S; Ambalavanan, Namasivayam; Frantz, Ivan D; Buchter, Susie; Sánchez, Pablo J; Kennedy, Kathleen A; Laroia, Nirupama; Poindexter, Brenda B; Cotten, C Michael; Van Meurs, Krisa P; Duara, Shahnaz; Narendran, Vivek; Sood, Beena G; O'Shea, T Michael; Bell, Edward F; Bhandari, Vineet; Watterberg, Kristi L; Higgins, Rosemary D

    2010-05-27

    There are limited data to inform the choice between early treatment with continuous positive airway pressure (CPAP) and early surfactant treatment as the initial support for extremely-low-birth-weight infants. We performed a randomized, multicenter trial, with a 2-by-2 factorial design, involving infants who were born between 24 weeks 0 days and 27 weeks 6 days of gestation. Infants were randomly assigned to intubation and surfactant treatment (within 1 hour after birth) or to CPAP treatment initiated in the delivery room, with subsequent use of a protocol-driven limited ventilation strategy. Infants were also randomly assigned to one of two target ranges of oxygen saturation. The primary outcome was death or bronchopulmonary dysplasia as defined by the requirement for supplemental oxygen at 36 weeks (with an attempt at withdrawal of supplemental oxygen in neonates who were receiving less than 30% oxygen). A total of 1316 infants were enrolled in the study. The rates of the primary outcome did not differ significantly between the CPAP group and the surfactant group (47.8% and 51.0%, respectively; relative risk with CPAP, 0.95; 95% confidence interval [CI], 0.85 to 1.05) after adjustment for gestational age, center, and familial clustering. The results were similar when bronchopulmonary dysplasia was defined according to the need for any supplemental oxygen at 36 weeks (rates of primary outcome, 48.7% and 54.1%, respectively; relative risk with CPAP, 0.91; 95% CI, 0.83 to 1.01). Infants who received CPAP treatment, as compared with infants who received surfactant treatment, less frequently required intubation or postnatal corticosteroids for bronchopulmonary dysplasia (Pneonatal outcomes did not differ significantly between the two groups. The results of this study support consideration of CPAP as an alternative to intubation and surfactant in preterm infants. (ClinicalTrials.gov number, NCT00233324.) 2010 Massachusetts Medical Society

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

    Directory of Open Access Journals (Sweden)

    Adriana C. Vidal

    2013-01-01

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

  17. Interactions between sleeping position and feeding on cardiorespiratory activity in preterm infants.

    Science.gov (United States)

    Fifer, William P; Myers, Michael M; Sahni, Rakesh; Ohira-Kist, Kiyoko; Kashyap, Sudha; Stark, Raymond I; Schulze, Karl F

    2005-11-01

    Infants sleeping in the prone position are at greater risk for sudden infant death syndrome (SIDS). Sleep position-dependent changes in cardiorespiratory activity may contribute to this increased risk. Cardiorespiratory activity is also affected by feeding. Twenty prematurely-born infants were studied at 31-36 weeks postconceptional age while sleeping in the prone and supine positions. Heart rate, respiratory rate, and patterns of variability were recorded during interfeed intervals, and effects of position and time after feeding were analyzed by repeated measures analyses of variance. There were significant effects of both sleeping position and time after feeding. Heart rate is higher and heart period variability is lower in the prone position, and the effects of sleeping position on cardiac functioning are more pronounced during the middle of the intrafeed interval. In preterm infants, autonomic responses to nutrient processing modulate the cardiorespiratory effects of sleeping position. Prone sleeping risk may vary with time after feeding. Copyright 2005 Wiley Periodicals, Inc.

  18. Elevations of inflammatory proteins in neonatal blood are associated with obesity and overweight among 2-year-old children born extremely premature

    NARCIS (Netherlands)

    Perrin, Eliana M; O'Shea, T Michael; Skinner, Asheley Cockrell; Bose, Carl; Allred, Elizabeth N; Fichorova, Raina N; van der Burg, Jelske W; Leviton, Alan

    2018-01-01

    BACKGROUND: Childhood obesity is associated with elevated blood concentrations of inflammation markers. It is not known to what extent inflammation precedes the development of obesity. METHODS: In a cohort of 882 infants born before 28 weeks of gestation, we examined relationships between

  19. Ecological context of infant mortality in high-focus states of India

    Directory of Open Access Journals (Sweden)

    Laishram Ladusingh

    2016-03-01

    Full Text Available OBJECTIVES: This goal of this study was to shed light on the ecological context as a potential determinant of the infant mortality rate in nine high-focus states in India. METHODS: Data from the Annual Health Survey (2010-2011, the Census of India (2011, and the District Level Household and Facility Survey 3 (2007-08 were used in this study. In multiple regression analysis explanatory variable such as underdevelopment is measured by the non-working population, and income inequality, quantified as the proportion of households in the bottom wealth quintile. While, the trickle-down effect of education is measured by female literacy, and investment in health, as reflected by neonatal care facilities in primary health centres. RESULTS: A high spatial autocorrelation of district infant mortality rates was observed, and ecological factors were found to have a significant impact on district infant mortality rates. The result also revealed that non-working population and income inequality were found to have a negative effect on the district infant mortality rate. Additionally, female literacy and new-born care facilities were found to have an inverse association with the infant mortality rate. CONCLUSIONS: Interventions at the community level can reduce district infant mortality rates.

  20. New cardiopulmonary resuscitation guidelines 2010: managing the newly born in delivery room.

    Science.gov (United States)

    Biban, Paolo; Filipovic-Grcic, Boris; Biarent, Dominique; Manzoni, Paolo

    2011-03-01

    Most newborns are born vigorous and do not require neonatal resuscitation. However, about 10% of newborns require some type of resuscitative assistance at birth. Although the vast majority will require just assisted lung aeration, about 1% requires major interventions such as intubation, chest compressions, or medications. Recently, new evidence has prompted modifications in the international cardiopulmonary resuscitation (CPR) guidelines for both neonatal, paediatric and adult patients. Perinatal and neonatal health care providers must be aware of these changes in order to provide the most appropriate and evidence-based emergency interventions for newborns in the delivery room. The aim of this article is to provide an overview of the main recommended changes in neonatal resuscitation at birth, according to the publication of the international Liaison Committee on Resuscitation (ILCOR) in the CoSTR document (based on evidence of sciences) and the new 2010 guidelines released by the European Resuscitation Council (ERC), the American Heart Association (AHA), and the American Academy of Pediatrics (AAP). Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. [School performance of former premature infants in the first four years of school].

    Science.gov (United States)

    Frenzel, J; Paalhorn, U

    1992-12-01

    School achievement during the first four grades was analysed by means of subject marks in 203 prematurely born and in 140 maturely born children. In subjects referring to behaviour in the classroom, no statistically significant differences in average marks could be found between prematurely born children and the control group. The average marks in performance subjects were slightly higher in the subgroup of very prematurely born children. However, statistically significant lower marks were observed in the subject of sports only, and for formerly immature children also in the subject of manual training. The higher the educational level of the mothers, the better the average marks without sports. No relationships between school performance and manifestation of postnatal risk factor like Apgar score, blood gas values and duration of oxygen dependency could be seen. These results demonstrate that school performance of former premature infants lies within the normal variance of their grade.

  2. Auditory maturation in premature infants: a potential pitfall for early cochlear implantation.

    Science.gov (United States)

    Hof, Janny R; Stokroos, Robert J; Wix, Eduard; Chenault, Mickey; Gelders, Els; Brokx, Jan

    2013-08-01

    To describe spontaneous hearing improvement in the first years of life of a number of preterm neonates relative to cochlear implant candidacy. Retrospective case study. Hearing levels of 14 preterm neonates (mean gestational age at birth = 29 weeks) referred after newborn hearing screening were evaluated. Initial hearing thresholds ranged from 40 to 105 dBHL (mean = 85 dBHL). Hearing level improved to normal levels for four neonates and to moderate levels for five, whereas for five neonates, no improvement in hearing thresholds was observed and cochlear implantation was recommended. Three of the four neonates in whom the hearing improved to normal levels were born prior to 28 weeks gestational age. Hearing improvement was mainly observed prior to a gestational age of 80 weeks. Delayed maturation of an immature auditory pathway might be an important reason for referral after newborn hearing screening in premature infants. Caution is advised regarding early cochlear implantation in preterm born infants. Audiological follow-ups until at least 80 weeks gestational age are therefore recommended. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Human milk adiponectin is associated with infant growth in two independent cohorts.

    Science.gov (United States)

    Woo, Jessica G; Guerrero, M Lourdes; Altaye, Mekibib; Ruiz-Palacios, Guillermo M; Martin, Lisa J; Dubert-Ferrandon, Alix; Newburg, David S; Morrow, Ardythe L

    2009-06-01

    Adiponectin, a circulating adipocyte protein, is associated with lower obesity. We have previously shown that adiponectin is present in human milk. This study determined whether higher milk adiponectin is associated with infant growth and investigated milk adiponectin's oligomeric form. This is a study of two parallel longitudinal cohorts of breastfed infants born between 1998 and 2005. Forty-five mother-infant pairs from Cincinnati, OH and 277 mother-infant pairs from Mexico City, Mexico were analyzed. All participants were healthy, term infants breastfed at least 1 month who completed 6 months of follow-up. Monthly milk samples (n = 1,379) up to 6 months were assayed for adiponectin by radioimmunoassay. Infant weight-for-age, length-for-age, and weight-for-length Z-scores up to 6 months of age were calculated using World Health Organization standards. Repeated-measures analysis was conducted. The structural form of human milk adiponectin was assessed by western blot. In the population studies, initial milk adiponectin was 24.0 +/- 8.6 microg/L and did not differ by cohort. Over the first 6 months, higher milk adiponectin was associated with lower infant weight-for-age Z-score (-0.20 +/- 0.04, p milk adiponectin was predominantly in the biologically active high-molecular-weight form. Our data suggest milk adiponectin may play a role in the early growth and development of breastfed infants.

  4. Maternal resolution of grief after preterm birth: implications for infant attachment security.

    Science.gov (United States)

    Shah, Prachi E; Clements, Melissa; Poehlmann, Julie

    2011-02-01

    This study explored the association between mothers' unresolved grief regarding their infant's preterm birth and infant-mother attachment security. We hypothesized that mothers with unresolved grief would be more likely to have insecurely attached infants at 16 months and that this association would be partially mediated by maternal interaction quality. This longitudinal study focused on 74 preterm infants (age of infants. The present analysis included assessment of neonatal and socioeconomic risks at NICU discharge; maternal depression, Reaction to Preterm Birth Interview findings, and quality of parenting at a postterm age of 9 months; and infant-mother attachment at postterm age of 16 months. Associations among findings of grief resolution with the Reaction to Preterm Birth Interview, quality of parenting interactions, and attachment security were explored by using relative risk ratios and logistic and multivariate regression models. The relative risk of developing insecure attachment when mothers had unresolved grief was 1.59 (95% confidence interval: 1.03-2.44). Controlling for covariates (adjusted odds ratio: 2.94), maternal feelings of resolved grief regarding the preterm birth experience were associated with secure infant-mother attachment at 16 months. Maternal grief resolution and interaction quality were independent predictors of attachment security. Maternal grief resolution regarding the experience of preterm birth and the quality of maternal interactions have important implications for emerging attachment security for infants born prematurely.

  5. The effect of maternal presence on premature infant response to recorded music.

    Science.gov (United States)

    Dearn, Trish; Shoemark, Helen

    2014-01-01

    To determine the effect of maternal presence on the physiological and behavioral status of the preterm infant when exposed to recorded music versus ambient sound. Repeated-measures randomized controlled trial. Special care nursery (SCN) in a tertiary perinatal center. Clinically stable preterm infants (22) born at > 28 weeks gestation and enrolled at > 32 weeks gestation and their mothers. Infants were exposed to lullaby music (6 minutes of ambient sound alternating with 2x 6 minutes recorded lullaby music) at a volume within the recommended sound level for the SCN. The mothers in the experimental group were present for the first 12 minutes (baseline and first music period) whereas the mothers in the control group were absent overall. There was no discernible infant response to music and therefore no significant impact of maternal presence on infant's response to music over time. However during the mothers' presence (first 12 minutes), the infants exhibited significantly higher oxygen saturation than during their absence p = .024) and less time spent in quiet sleep after their departure, though this was not significant. Infants may have been unable to detect the music against the ambient soundscape. Regardless of exposure to music, the infants' physiological and behavioral regulation were affected by the presence and departure of the mothers. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  6. Low infant mortality among Palestine refugees despite the odds

    Science.gov (United States)

    Khader, Ali; Sabatinelli, Guido

    2011-01-01

    Abstract Objective To present data from a 2008 infant mortality survey conducted in Jordan, Lebanon, the Syrian Arab Republic, the Gaza Strip and the West Bank and analyse infant mortality trends among Palestine refugees in 1995–2005. Methods Following the preceding birth technique, mothers who were registering a new birth were asked if the preceding child was alive or dead, the day the child was born and the date of birth of the neonate whose birth was being registered. From this information, neonatal, infant and early child mortality rates were estimated. The age at death for early child mortality was determined by the mean interval between successive births and the mean age of neonates at registration. Findings In 2005–2006, infant mortality among Palestine refugees ranged from 28 deaths per 100 000 live births in the Syrian Arab Republic to 19 in Lebanon. Thus, infant mortality in Palestine refugees is among the lowest in the Near East. However, infant mortality has stopped decreasing in recent years, although it remains at a level compatible with the attainment of Millennium Development Goal 4. Conclusion Largely owing to the primary health care provided by the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East and other entities, infant mortality among Palestine refugees had consistently decreased. However, it is no longer dropping. Measures to address the most likely reasons – early marriage and childbearing, poor socioeconomic conditions and limited access to good perinatal care – are needed. PMID:21479095

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

    Science.gov (United States)

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

    2015-01-01

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

  8. A first step towards a consensus static in vitro model for simulating full-term infant digestion.

    Science.gov (United States)

    Ménard, O; Bourlieu, C; De Oliveira, S C; Dellarosa, N; Laghi, L; Carrière, F; Capozzi, F; Dupont, D; Deglaire, A

    2018-02-01

    In vitro alternatives to clinical trials are used for studying human food digestion. For simulating infant digestion, only a few models, lacking physiological relevance, are available. Thanks to an extensive literature review of the in vivo infant digestive conditions, a gastrointestinal static in vitro model was developed for infants born at term and aged 28days. The model was applied to the digestion of a commercial infant formula. Kinetics of digestion, as well as the structural evolution, were compared with those obtained while submitting the same formula to the adult international consensus protocol of in vitro static digestion. The kinetics of proteolysis and lipolysis differed according to the physiological stage resulting mainly from the reduced level of enzymes and bile salts, as well as the higher gastric pH in the infant model. This in vitro static model of infant digestion is of interest for scientists, food or pharmaceutical manufacturers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. [Quality analyses of the development of preterm infants: results of the Lower-Saxonian preterm infant follow-up project and a comparison group of term infants].

    Science.gov (United States)

    Damm, Gabriele; Macha, Thorsten; Petermann, Franz; Voss, Wolfgang; Sens, Brigitte

    2015-01-01

    Based on perinatal and neonatal quality assurance programmes, a follow-up project for the high-risk group of extremely preterm infants, unparalleled in Germany, was initiated in the federal state of Lower Saxony in 2004. Here we describe the new approach of examining a comparison group of term infants, which, for the first time, allows a valid interpretation of the collection of area-wide long-term outcome data on preterm children. The prospective long-term outcome project investigates the medical care situation for children born at less than 28 weeks of gestation up to school age. Based on the information obtained about the children's development the quality of health care will be optimised. A standardised examining concept with established development tests at defined follow-up intervals (at the age of 6 months, 2, 5 and 10 years) is used. At the age of five years 75 % of the examined premature children exhibited impairments. In order to better assess remarkable results, a comparison group of term infants (n=305) selected by a matched-pairs method was examined at the age of five using an analogous concept in kindergartens in Lower Saxony. The results were compared with the first two age cohorts of the follow-up-project (n=226) and quality analyses performed. As expected, significant differences have been found in the children's motor, cognitive and linguistic development between the preterm and term infants examined. This fact draws attention to the importance of early support for the majority of extremely premature infants. Feedback on the results given to the medical staff involved allows for the implementation of best practices and quality improvements. Identifying potential for improvement in everyday health care will help to develop specific optimisation measures. Copyright © 2015. Published by Elsevier GmbH.

  10. Related risk factors of cleft lip and palate in a group of infants born in Tehran (2012-2015

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    R.Hamedi

    2017-10-01

    Full Text Available Background: Cleft lip and palate is one of the most common congenital anomalies. The etiology of non syndromic orofacial clefts is multifactorial. Objective: The aim of this study was to evaluate the related risk factors of cleft lip and palate in a group of infants born in Tehran during the years between 2012-2015. Methods: In this case-control study the files of 105 newborns with oral clefts, and 218 normal newborns as control group with their mothers were evaluated in Mofid Hospital in Tehran. Data were analyzed by Chi-square test. Findings: Among 105 cases, 40 cases (38% were females and 65 cases (62% were males. The frequency of cleft lip and palate, cleft palate and cleft lip were 58%, 27.6% and 14.2% respectively. A significant relationship was found between parents with familial marriage (P=0.001. The highest number of clefts belonged to 25-35 year-old mothers (51.4%, 41% of mothers reported smoking during pregnancy thus maternal smoking would be an effective predisposing factor to have a child with oral clefts (P=0.001. Conclusion: The results of this study indicate that history of familial matrimony, mother’s age above 35 years and maternal smoking during pregnancy can enhance the risk of orofacial clefts 18, 17 and 14 times respectively. These findings emphasize the importance of preconception counseling of mothers-to-be on amendable lifestyle factors in order to reduce the birth prevalence of cleft lip/palate in future generations.

  11. Obstetric Antecedents to Body Cooling Treatment of the Newborn Infant

    Science.gov (United States)

    Nelson, David B.; Lucke, Ashley M.; McIntire, Donald D.; Sánchez, Pablo J.; Leveno, Kenneth J.; Chalak, Lina F.

    2014-01-01

    Objective Obstetric antecedents were analyzed in births where the infant received whole-body cooling for neonatal encephalopathy. Methods This retrospective cohort study included all live-born singleton infants delivered at or beyond 36 weeks gestation from October 2005 through December 2011. Infants who had received whole-body cooling identified by review of a prospective neonatal registry were compared to a control group comprising the remaining obstetric population delivered at greater than 36 weeks but not cooled. Univariable analysis was followed by a staged, stepwise selection of variables with the intent to rank significant risk factors for cooling. Results A total of 86,371 women delivered during the study period and 98 infants received whole-body cooling (1.1/1,000 livebirths). Of these 98 infants, 80 (88%) newborns had moderate encephalopathy and 10 (12%) had severe encephalopathy prior to cooling. Maternal age less than or equal to 15 years, low parity, maternal body habitus (BMI ≥ 40 kg/m2), diabetes, preeclampsia, induction, epidural analgesia, chorioamnionitis, length of labor, and mode of delivery were associated with significantly increased risk of infant cooling during univariable analysis. Catastrophic events to include umbilical cord prolapse (OR 14; 95%CI, 3–72), placental abruption (OR 17; 95%CI, 7–44), uterine rupture (OR 130; 95%CI, 11–1477) were the strongest factors associated with infant cooling after staged-stepwise logistic analysis. Conclusion A variety of intrapartum characteristics were associated with infant cooling for neonatal encephalopathy with the most powerful antecedents being umbilical cord prolapse, placental abruption, and uterine rupture. PMID:24530976

  12. Clinical sonography in premature infant: Sonographic analysis of incidence and grade of germinal metrixhemorrhage according to gestational age,risk

    International Nuclear Information System (INIS)

    Kim, Jae Hyoung; Kim, I. W.; Yeon, K. M.

    1989-01-01

    The authors reviewed 63 premature infants who was born from January 1986 to August 1988 at College of Medicine Seoul National University, to analyze grade of germinal metrixhemorrhage to gestational age, risk.

  13. Observations on the health of infants at a time of rapid societal change: a longitudinal study from birth to fifteen months in Abu Dhabi.

    Science.gov (United States)

    Gardner, Hazel; Green, Katherine; Gardner, Andrew S; Geddes, Donna

    2018-02-07

    Rapid economic and cultural transition in the United Arab Emirates has been accompanied by a rise in chronic disease. Early childhood is known to affect health outcomes in adulthood. This prospective longitudinal study examined the general health of Emirati infants born in a government maternity hospital in the Emirate of Abu Dhabi in October 2002. One hundred twenty-five women, who had recently given birth, were interviewed as part of a larger study encompassing a wide range of cultural, social, and behavioural aspects of health. They were then re-interviewed at three (n = 94), six (n = 59) and 15 months postpartum (n = 52). Data are presented using univariate statistics. In this study seven infants (6%) were born prematurely and four infants (3%) were classified as small for gestational age, while 11 (9%) of the infants weighed less than 2500 g. Low birth weight infants (LBW) were significantly more likely to require treatment in the neonatal intensive care unit (OR = 30.83, p = 0.00). Iron supplementation during pregnancy was associated with fewer underweight infants (OR = 3.92, p = 0.042). No associations were found between infant birth weight and maternal age, age at marriage, consanguinity, education level, current maternal employment, parity, pre-existing anaemia or anaemia in pregnancy, diabetes, folic acid intake, multivitamin intake or infant gender. Maternally-reported infant health issues, vaccination, medication, breast-feeding and infant nutrition, and use of secure car seats are also reported. The health of infants at birth in this UAE sample showed improvements compared to previous studies. The proportion of LBW infants is decreasing and continuing improvements in health care in the UAE are having a positive impact on infant health.

  14. A High Ductal Flow Velocity Is Associated with Successful Pharmacological Closure of Patent Ductus Arteriosus in Infants 22–27 Weeks Gestational Age

    Science.gov (United States)

    Olsson, Karl Wilhelm; Jonzon, Anders; Sindelar, Richard

    2012-01-01

    Objective. To identify factors affecting closure of patent ductus arteriosus (PDA) in newborn infants born at 22–27 weeks gestational age (GA) during pharmacological treatment with cyclooxygenase inhibitors. Method. Infants born at 22–27 weeks of GA between January 2006 and December 2009 who had been treated pharmacologically for PDA were identified retrospectively. Medical records were assessed for clinical, ventilatory, and outcome parameters. Echocardiographic examinations during treatment were reviewed. Results. Fifty-six infants were included in the study. Overall success rate of ductal closure with pharmacological treatment was 52%. Infants whose PDA was successfully closed had a higher GA (25 + 4 weeks versus 24 + 3 weeks; P = 0.047), and a higher pretreatment left to right maximal ductal flow velocity (1.6 m/s versus 1.1 m/s; P = 0.023). Correcting for GA, preeclampsia, antenatal steroids, and age at start of treatment, a higher maximal ductal flow velocity was still associated with successful ductal closure (OR 3.04; P = 0.049). Conclusion. Maximal ductal flow velocity was independently associated with success of PDA treatment. PMID:23316351

  15. A High Ductal Flow Velocity Is Associated with Successful Pharmacological Closure of Patent Ductus Arteriosus in Infants 22–27 Weeks Gestational Age

    Directory of Open Access Journals (Sweden)

    Karl Wilhelm Olsson

    2012-01-01

    Full Text Available Objective. To identify factors affecting closure of patent ductus arteriosus (PDA in newborn infants born at 22–27 weeks gestational age (GA during pharmacological treatment with cyclooxygenase inhibitors. Method. Infants born at 22–27 weeks of GA between January 2006 and December 2009 who had been treated pharmacologically for PDA were identified retrospectively. Medical records were assessed for clinical, ventilatory, and outcome parameters. Echocardiographic examinations during treatment were reviewed. Results. Fifty-six infants were included in the study. Overall success rate of ductal closure with pharmacological treatment was 52%. Infants whose PDA was successfully closed had a higher GA (25+4 weeks versus 24+3 weeks; P=0.047, and a higher pretreatment left to right maximal ductal flow velocity (1.6 m/s versus 1.1 m/s; P=0.023. Correcting for GA, preeclampsia, antenatal steroids, and age at start of treatment, a higher maximal ductal flow velocity was still associated with successful ductal closure (OR 3.04; P=0.049. Conclusion. Maximal ductal flow velocity was independently associated with success of PDA treatment.

  16. Maternal obesity and gestational weight gain are risk factors for infant death.

    Science.gov (United States)

    Bodnar, Lisa M; Siminerio, Lara L; Himes, Katherine P; Hutcheon, Jennifer A; Lash, Timothy L; Parisi, Sara M; Abrams, Barbara

    2016-02-01

    Assessment of the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality was performed. This study used Pennsylvania linked birth-infant death records (2003-2011) from infants without anomalies born to mothers with prepregnancy BMI categorized as underweight (n = 58,973), normal weight (n = 610,118), overweight (n = 296,630), grade 1 obesity (n = 147,608), grade 2 obesity (n = 71,740), and grade 3 obesity (n = 47,277). Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z scores of gestational weight gain and infant death after confounder adjustment. Infant mortality risk was lowest among normal-weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grades 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal-weight women. Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. © 2015 The Obesity Society.

  17. Causes of Infant Mortality in Kalaleh City During 2004-2012

    Directory of Open Access Journals (Sweden)

    Abed Nouri

    2013-10-01

    Full Text Available Background and objectives: Almost 130 million infants are born each year, more than 8 million of whomdie before their first year of life. In the developing countries, two thirds of these deaths occur in the first monthof their life. Reduced infant mortality is among the Millennium Development indicators, and this rate is highin Kalaleh city. This study aimed to identify the most common causes of infant death, so that the avoidabledeaths be prevented by offering intervention plans.Methods: information was collected with the designed form. The data were, then, coded and entered into the SPSS 17software, and analyzed using independent statistical chi-square test.In this study, all causes of infant death in Kalaleh city during 2003-2013 were investigated. TheResults: prematurity (47.42%, congenital abnormalities (22.42%, and disasters and accidents (9.79%. 82.73%of the infants weighed below 2500 g. 60% of the prematurity deaths occurred to primigravid women. There388 infant deaths accounted for 83% of under-5 mortality. The most common causes of death includewas a statistically significant relationship between primigravity and prematurity infant death with a 95% confidence(P=0.003. 74.74% of the infant deaths occurred in the first week, and 58.96% in the first 24 hours.Conclusion: As 38.4% of the infant deaths occurred in the first pregnancy, and 60% of prematurity deathshappened to primigravid women, and there was a relationship between primigravity and prematurity infantdeaths, the importance of the particular care of these mothers comes into sight. Planning for teaching the imof caring the primigravid mothers and making their families more sensitive about the significance ofportancecaring these mothers can be effective in reducing premature infant mortality.

  18. Determining the prevalence of cytomegalovirus infection in a cohort of preterm infants.

    Science.gov (United States)

    Pitlick, Mitchell M; Orr, Kristin; Momany, Allison M; McDonald, Erin L; Murray, Jeffrey C; Ryckman, Kelli K

    2015-01-01

    Preterm birth is a global public health problem that is a significant cause of infant morbidity and mortality. Congenital cytomegalovirus (CMV) infection has been proposed as a risk factor for preterm birth, but the rate of CMV in infants born preterm is unclear. CMV is the leading infectious cause of sensorineural hearing loss, which will affect 15% - 20% of congenitally infected infants later in their childhood. 90% of infected infants are asymptomatic at birth and are not recognized as at risk for CMV-associated deficits. To determine the prevalence of CMV infection in a large cohort of preterm infants. DNA was extracted from cord blood, peripheral blood, saliva, and buccal swab samples collected from preterm infants. A total of 1200 unique DNA samples were tested for CMV using a nested PCR protocol. The proportions of preterm infants with CMV was compared by sample collection type, race, gender, and gestational age. A total of 37 infants tested positive for CMV (3.08%). After excluding twins, siblings, and infants older than two weeks at the time of sample collection, two out of 589 infants were CMV positive (0.3%), which was lower than the proportion of CMV observed in the general population. All positive samples came from buccal swabs. Our work suggests that while CMV infection may not be greater in preterm infants than in the general population, given the neurologic consequences of CMV in preterm infants, screening of this population may still be warranted. If so, our results suggest buccal swabs, collected at pregnancy or at birth, may be an ideal method for such a program.

  19. Gentamicin Exposure and Sensorineural Hearing Loss in Preterm Infants.

    Directory of Open Access Journals (Sweden)

    Aline Fuchs

    Full Text Available To evaluate the impact of gentamicin exposure on sensorineural hearing loss (SNHL in very low birth weight (VLBW infants.Exposure to gentamicin was determined in infants born between 1993 and 2010 at a gestational age < 32 weeks and/or with a birthweight < 1500 g, who presented with SNHL during the first 5 years of life. For each case, we selected two controls matched for gender, gestational age, birthweight, and year of birth.We identified 25 infants affected by SNHL, leading to an incidence of SNHL of 1.58% in our population of VLBW infants. The proportion of infants treated with gentamicin was 76% in the study group and 70% in controls (p = 0.78. The total cumulated dose of gentamicin administered did not differ between the study group (median 10.2 mg/kg, Q1-Q3 1.6-13.2 and the control group (median 7.9 mg/kg, Q1-Q3 0-12.8, p = 0.47. The median duration of gentamicin treatment was 3 days both in the study group and the control group (p = 0.58. Maximum predicted trough serum levels of gentamicin, cumulative area under the curve and gentamicin clearance were not different between cases and controls.The impact of gentamicin on SNHL can be minimized with treatments of short duration, monitoring of blood levels and dose adjustment.

  20. Aggressive Posterior Retinopathy of Prematurity in a Premature Male Infant

    Directory of Open Access Journals (Sweden)

    Jun Zhou

    2017-07-01

    Full Text Available A premature male infant was born at 30 weeks’ gestation with a birth weight of 1,700 g in a rural hospital. He was diagnosed with respiratory distress syndrome and received continuous positive airway pressure treatment for 26 days. At 26 days after birth, the patient was transferred to our hospital for further evaluation and management. A comprehensive eye examination revealed a stage 3 retinopathy of prematurity (ROP involving zone 2 in both eyes. The patient was recommended to a provincial-level eye hospital for emergency laser therapy. Five months after birth, the feedback from the eye hospital showed that the patient had a high risk of blindness in both eyes. Our case report shows that delaying first screening examination increases the possibility of developing aggressive posterior ROP in infants with ROP. Doctors in rural hospitals should be aware of this possibility and trained for early screening and treatment in high-risk infants.

  1. Validity of the ages and stages questionnaires in Korean compared to Bayley Scales of infant development-II for screening preterm infants at corrected age of 18-24 months for neurodevelopmental delay.

    Science.gov (United States)

    Kwun, Yoojin; Park, Hye Won; Kim, Min-Ju; Lee, Byong Sop; Kim, Ellen Ai-Rhan

    2015-04-01

    This study aimed to evaluate the validity of the ages and stages questionnaire in Korean (ASQ 1st edition, Korean Questionnaires, Seoul Community Rehabilitation Center, 2000) for premature infants. The study population consisted of 90 premature infants born between January 1, 2005, and December 31, 2011, who were tested using the ASQ (Korean) and Bayley Scales of Infant Development (BSID) (II) at a corrected age of 18-24 months. The validity of the ASQ (Korean) using cut-off values set at < -2 SD was examined by comparing it to the BSID (II) components, namely, the mental developmental index (MDI) or psychomotor developmental index (PDI), which were both set at < 85. The calculation of the sensitivities, specificities, positive predictive values, and negative predictive values of the ASQ (Korean) components revealed that they detected infants with neurodevelopmental delay with low sensitivity and positive predictive values, however, the communication domain showed moderate correlations with MDI. The failure in more than one domain of the ASQ (Korean) was significantly correlated with the failure in MDI. The ASQ (Korean) showed low validity for screening neurodevelopmentally delayed premature infants.

  2. A Comparison of Nutritional Antioxidant Content in Breast Milk, Donor Milk, and Infant Formulas.

    Science.gov (United States)

    Hanson, Corrine; Lyden, Elizabeth; Furtado, Jeremy; Van Ormer, Matthew; Anderson-Berry, Ann

    2016-10-28

    Human milk is the optimal food for human infants, including infants born prematurely. In the event that a mother of a hospitalized infant cannot provide breast milk, donor milk is considered an acceptable alternative. It is known that the macronutrient composition of donor milk is different than human milk, with variable fat content and protein content. However, much less is known about the micronutrient content of donor milk, including nutritional antioxidants. Samples of breast milk from 12 mothers of infants hospitalized in the Newborn Intensive Care Unit until were collected and analyzed for concentrations of nutritional antioxidants, including α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin, retinol, and α-tocopherol. Additionally, a homogenized sample of donor milk available from a commercial milk bank and samples of infant formulas were also analyzed. Concentrations of nutritional antioxidants were measured using high-performance liquid chromatography. Compared to breast milk collected from mothers of hospitalized infants, commercially available donor milk had 18%-53% of the nutritional antioxidant content of maternal breast milk. As donor milk is becoming a common nutritional intervention for the high risk preterm infant, the nutritional antioxidant status of donor milk-fed premature infants and outcomes related to oxidative stress may merit further investigation.

  3. A Comparison of Nutritional Antioxidant Content in Breast Milk, Donor Milk, and Infant Formulas

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    Corrine Hanson

    2016-10-01

    Full Text Available Human milk is the optimal food for human infants, including infants born prematurely. In the event that a mother of a hospitalized infant cannot provide breast milk, donor milk is considered an acceptable alternative. It is known that the macronutrient composition of donor milk is different than human milk, with variable fat content and protein content. However, much less is known about the micronutrient content of donor milk, including nutritional antioxidants. Samples of breast milk from 12 mothers of infants hospitalized in the Newborn Intensive Care Unit until were collected and analyzed for concentrations of nutritional antioxidants, including α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin, retinol, and α-tocopherol. Additionally, a homogenized sample of donor milk available from a commercial milk bank and samples of infant formulas were also analyzed. Concentrations of nutritional antioxidants were measured using high-performance liquid chromatography. Compared to breast milk collected from mothers of hospitalized infants, commercially available donor milk had 18%–53% of the nutritional antioxidant content of maternal breast milk. As donor milk is becoming a common nutritional intervention for the high risk preterm infant, the nutritional antioxidant status of donor milk–fed premature infants and outcomes related to oxidative stress may merit further investigation.

  4. Use of a pacifier and behavioural features in 2-4-month-old infants.

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    Kelmanson, I A

    1999-11-01

    This study aimed to analyse a possible association between the use of a pacifier and particular behavioural features in 2-4-month-old infants as estimated by the means of the Early Infancy Temperament Questionnaire (EITQ). It comprised 192 randomly selected clinically healthy infants born in St Petersburg in 1997-1998. The mothers were asked to complete the questionnaires addressing infant, maternal and major demographic characteristics, and childcare practices, with particular emphasis on the use of a pacifier, as well as to fill in the EITQ. The EITQ scores nine different aspects of infant temperament: activity, rhythmicity, approach, adaptability, intensity, mood, persistence, distractibility and threshold. A total of 117 of 192 infants (60.9%) used pacifiers, and they appeared to have more rhythmic behaviour than non-users. This effect remained after adjustment was made for major potential confounding and/or modifying factors, including gender, parity, details from perinatal history and familial social background, feeding pattern, bed sharing and room sharing. With the exception of rhythmicity, no significant association was found between the use of a pacifier and any other particular feature of infant temperament. Use of a pacifier may be associated with higher rhythmicity in 2-4-month-old infants.

  5. The general movement assessment helps us to identify preterm infants at risk for cognitive dysfunction

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    Christa eEinspieler

    2016-03-01

    Full Text Available Apart from motor and behavioral dysfunctions, deficits in cognitive skills are among the well-documented sequelae of preterm birth. However, early identification of infants at risk for poor cognition is still a challenge, as no clear association between pathological findings based on neuroimaging scans and cognitive functions have been detected as yet. The Prechtl General Movement Assessment (GMA has shown its merits for the evaluation of the integrity of the young nervous system. It is a reliable tool for identifying infants at risk for neuromotor deficits. Recent studies on preterm infants demonstrate that abnormal general movements also reflect impairments of brain areas involved in cognitive development. The aim of this systematic review was to discuss studies that included (i the Prechtl GMA applied in preterm infants, and (ii cognitive outcome measures in six data bases. Seven studies met the inclusion criteria and yielded the following results: (a children born preterm with consistently abnormal general movements up to 8 weeks after term had lower intelligence quotients at school age than children with an early normalization of general movements; (b from 3 to 5 months after term, several qualitative and quantitative aspects of the concurrent motor repertoire, including postural patterns, were predictive of intelligence at 7 to 10 years of age. These findings in 428 individuals born preterm suggest that normal general movements along with a normal motor repertoire during the first months after term are markers for normal cognitive development until at least age 10.

  6. Crawling and walking infants encounter objects differently in a multi-target environment.

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    Dosso, Jill A; Boudreau, J Paul

    2014-10-01

    From birth, infants move their bodies in order to obtain information and stimulation from their environment. Exploratory movements are important for the development of an infant's understanding of the world and are well established as being key to cognitive advances. Newly acquired motor skills increase the potential actions available to the infant. However, the way that infants employ potential actions in environments with multiple potential targets is undescribed. The current work investigated the target object selections of infants across a range of self-produced locomotor experience (11- to 14-month-old crawlers and walkers). Infants repeatedly accessed objects among pairs of objects differing in both distance and preference status, some requiring locomotion. Overall, their object actions were found to be sensitive to object preference status; however, the role of object distance in shaping object encounters was moderated by movement status. Crawlers' actions appeared opportunistic and were biased towards nearby objects while walkers' actions appeared intentional and were independent of object position. Moreover, walkers' movements favoured preferred objects more strongly for children with higher levels of self-produced locomotion experience. The multi-target experimental situation used in this work parallels conditions faced by foraging organisms, and infants' behaviours were discussed with respect to optimal foraging theory. There is a complex interplay between infants' agency, locomotor experience, and environment in shaping their motor actions. Infants' movements, in turn, determine the information and experiences offered to infants by their micro-environment.

  7. Infant Development and Pre- and Post-partum Depression in Rural South African HIV-Infected Women.

    Science.gov (United States)

    Rodriguez, Violeta J; Matseke, Gladys; Cook, Ryan; Bellinger, Seanna; Weiss, Stephen M; Alcaide, Maria L; Peltzer, Karl; Patton, Doyle; Lopez, Maria; Jones, Deborah L

    2017-10-06

    HIV-exposed infants born to depressed women may be at risk for adverse developmental outcomes. Half of HIV-infected women in rural South Africa (SA) may suffer from pregnancy-related depression. This pilot study examined the impact of depression in HIV-infected women in rural SA on infant development. Mother-infant dyads (N = 69) were recruited in rural SA. Demographics, HIV disclosure, depression, male involvement, and alcohol use at baseline (18.35 ± 5.47 weeks gestation) were assessed. Male involvement, depression, infant HIV serostatus and development were assessed 12 months postnatally. Half of the women (age = 29 ± 5) reported depression prenatally and one-third reported depression postnatally. In multivariable logistic regression, not cohabiting with their male partner, nondisclosure of HIV status, and postnatal depression predicted cognitive delay; decreased prenatal male involvement predicted delayed gross motor development (ps depression among HIV-infected women and infant development and increasing male involvement may reduce negative developmental outcomes among HIV-exposed or infected infants.

  8. A Study of Maternal Attachment among Mothers of Infants with Congenital Anomalies in Turkey

    Science.gov (United States)

    Ylmaz, Hatice Bal; Kavlak, Oya; Isler, Aysegul; Liman, Tulin; Van Sell, Sharon L.

    2011-01-01

    The purpose of this study was to investigate the factors that affect maternal attachment among mothers whose infants were born with congenital anomalies. A questionnaire was used to collect individual sociodemographic data, and the Maternal Attachment Inventory was used to collect information about the emotional attachment of mothers to infants…

  9. Neonatal Morphine Exposure in Very Preterm Infants – Cerebral Development and Outcomes

    Science.gov (United States)

    Steinhorn, Rachel; McPherson, Chris; Anderson, Peter J; Neil, Jeffrey; Doyle, Lex W; Inder, Terrie

    2015-01-01

    Objective To investigate the association of morphine exposure in very preterm infants with cerebral volumes and neurodevelopmental outcome from birth through middle childhood. Study design Observational study of very preterm infants in the Victorian Infant Brain Study cohort. 230 infants born neonatal intensive care unit (NICU) of the Royal Women’s Hospital. 57 (25%) infants received morphine analgesia during their NICU stay at the attending physician’s discretion. Primary outcomes were regional brain volumes at term and 7 years; neurobehavioral performance at term; and cognitive, motor, emotional, behavioral, communication, and executive function scores at age 2 and 7 years. Linear regressions were used to compare outcomes between participants who did and did not receive morphine. Results At term, preterm infants who received morphine had similar rates of grey matter injury to no-morphine infants, but a trend towards smaller cortical volumes in the orbitofrontal (pleft=0.002, pright=0.01) and subgenual (pleft=0.01) regions. At seven years, cortical volumes did not differ between groups. At 2 years, morphine-exposed children were more likely to show behavioral dysregulation (p=0.007) than no-morphine children, but at seven years no detrimental impacts of morphine on neurobehavioral outcome were observed. Conclusions Low-dose morphine analgesia received during neonatal intensive care was associated with early alterations in cerebral structure and short-term neurobehavioral problems that did not persist into childhood. PMID:25919729

  10. 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