WorldWideScience

Sample records for premature infants late-preterm

  1. Association Between Apnea of Prematurity and Respiratory Distress Syndrome in Late Preterm Infants: An Observational Study

    Directory of Open Access Journals (Sweden)

    François Olivier

    2016-09-01

    Full Text Available AbstractLate preterm infants (34 to 36 weeks’ gestation remain a population at risk for apnea of prematurity (AOP. As infants affected by respiratory distress syndrome (RDS have immature lungs, they might also have immature control of breathing. Our hypothesis is that an association exists between RDS and AOP in late preterm infants.ObjectiveThe primary objective of this study was to assess the association between RDS and AOP in late preterm infants. The secondary objective was to evaluate if an association exists between apparent RDS severity and AOP.MethodsThis retrospective observational study was realized in a tertiary care center between January 2009 and December 2011. Data from late preterm infants who presented an uncomplicated perinatal evolution, excepted for RDS, were reviewed. Information related to AOP and RDS were collected using the medical record. Odds ratios were calculated using a binary logistic regression adjusted for GA and sex.ResultsAmong the 982 included infants 85 (8,6% had an RDS diagnosis, 281 (28,6% had AOP diagnosis and 107 (10,9% were treated with caffeine for AOP. There was a significant association between AOP treated with caffeine and RDS for all infants (OR = 3.3, 95% CI : 2.0 – 5.7. There was no association between AOP and RDS in 34 weeks infants [AOR : 1.6 (95% CI: 0.7 – 3.8] but an association remains for 35 [AOR : 5.7 (95% CI: 2.5 – 13.4] and 36 [OR: 7.8 (95% CI: 3.2 – 19.4] weeks infants. No association was found between apparent RDS severity and AOP regarding mean oxygen administration duration or complications associated with RDS.ConclusionThe association between RDS and AOP in late preterm infants reflects that patients affected by RDS are not only presenting lung immaturity, but also respiratory control immaturity. Special consideration should be given before discontinuing monitoring after RDS resolution in those patients.

  2. Surfactant therapy in late preterm infants

    Directory of Open Access Journals (Sweden)

    Murat Yurdakök

    2013-06-01

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

  3. [Antenatal corticosteroid therapy and late preterm infant morbidity and mortality].

    Science.gov (United States)

    Gázquez Serrano, I M; Arroyos Plana, A; Díaz Morales, O; Herráiz Perea, C; Holgueras Bragado, A

    2014-12-01

    Late preterm infants (34-36 weeks gestation) have a morbidity rate significantly higher than those born at term. However, few interventions have been undertaken to reduce this increased morbidity and mortality. Antenatal corticosteroid administration could be an effective preventive measure. The aim of this study was to describe the morbidity associated with late prematurity in our institution, and determine if there are differences between those who received antenatal corticosteroids. A prospective observational study was conducted on late preterm infants born in a tertiary hospital from October 2011 until September 2012. Two groups were formed according to whether or not they had received antenatal steroids. The rates of morbidity and mortality for each of the groups were analysed and compared. There was a total of 4127 live newborns during the study period, of whom 3795 were term and 332 were preterm (the overall prematurity rate was 8.04%). There were 247 late preterm deliveries, representing 6% of live born infants, and 74.4% of all premature infants. Of late preterm infants, 63.2% were admitted to the Neonatal Unit and 29.6% had received antenatal steroids. The incidence of admission to the Neonatal Unit and Neonatal Intensive Care, transient tachypnea, need for respiratory support in the form of continuous positive pressure airway and oxygen therapy, incidence of hypoglycemia, feeding difficulty, and jaundice requiring phototherapy were significantly higher (P<.05) in the late preterm group that did not receive antenatal steroids. Our finding suggests that the administration of antenatal corticosteroids to patients at risk of 34-36 weeks delivery could significantly reduce the cost and acute morbidity associated with late preterm birth. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  4. The Impact of Surgery on the Developmental Status of Late Preterm Infants – A Cohort Study

    Science.gov (United States)

    Trivedi, Amit; Walker, Karen; Loughran-Fowlds, Alison; Halliday, Robert; J. A. Holland, Andrew; Badawi, Nadia

    2015-01-01

    Aims: Despite increasing evidence in the literature regarding the impact of late prematurity on subsequent developmental impairment, the developmental outcome of late preterm infants who undergo major surgery remains unclear. The aim of this study therefore was to determine the developmental outcome for a cohort of late preterm surgical population. Methods: Late preterm infants with a gestational age from 34-36 weeks inclusive who were enrolled in the state-wide prospective Development After Infant Surgery (DAISy) study and who had undergone non-cardiac major surgery within the first ninety days of life were eligible for inclusion. Infants were assessed at one and three years of ages. Results: Forty-six infants were enrolled in the study, of which 38 infants had a complete developmental assessment at one year of age. Of these infants, late preterm infants scored significantly lower than the standardized norms of the assessment on the expressive language and gross motor subscales. At three years of age 26 infants were reassessed: late preterm infants who underwent major surgery only scored significantly lower than the standardized norms on the cognitive subscale (p less than 0.001). Conclusions: These data provide the evidence that late preterm infants who undergo major non-cardiac surgery are at risk of developmental impairment and consideration should be given to enrolling this cohort in multi-disciplinary developmental follow-up clinics. PMID:26023526

  5. The Impact of Surgery on the Developmental Status of Late Preterm Infants – A Cohort Study

    Directory of Open Access Journals (Sweden)

    Amit Trivedi

    2015-01-01

    Full Text Available Aims: Despite increasing evidence in the literature regarding the impact of late prematurity on subsequent developmental impairment, the developmental outcome of late preterm infants who undergo major surgery remains unclear. The aim of this study therefore was to determine the developmental outcome for a cohort of late preterm surgical population.Methods: Late preterm infants with a gestational age from 34-36 weeks inclusive who were enrolled in the state-wide prospective Development After Infant Surgery (DAISy study and who had undergone non-cardiac major surgery within the first ninety days of life were eligible for inclusion. Infants were assessed at one and three years of ages.Results: Forty-six infants were enrolled in the study, of which 38 infants had a complete developmental assessment at one year of age. Of these infants, late preterm infants scored significantly lower than the standardized norms of the assessment on the expressive language and gross motor subscales. At three years of age 26 infants were reassessed: late preterm infants who underwent major surgery only scored significantly lower than the standardized norms on the cognitive subscale (p<0.001.Conclusions: These data provide the evidence that late preterm infants who undergo major non-cardiac surgery are at risk of developmental impairment and consideration should be given to enrolling this cohort in multi-disciplinary developmental follow-up clinics.

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

    Science.gov (United States)

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

    2013-03-01

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

  7. Prevalence and Morbidity of Late Preterm Infants: Current Status in a Medical Center of Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Ming-Luen Tsai

    2012-06-01

    Conclusion: Late-preterm infants have increased risk of neonatal morbidities associated with organ immaturity. The results of this study emphasize the importance of judicious obstetrical decision-making when considering late preterm delivery, and the need to set up anticipatory clinical guidelines for the care of late preterm infants.

  8. Late preterm birth has direct and indirect effects on infant gut microbiota development during the first six months of life.

    Science.gov (United States)

    Forsgren, M; Isolauri, E; Salminen, S; Rautava, S

    2017-07-01

    Preterm infants display aberrant gut microbial colonisation. We investigated whether the differences in gut microbiota between late preterm and full-term infants results from prematurity or external exposures. This study comprised 43 late preterm infants (34(0/7) -36(6/7) ) and 75 full-term infants based on faecal samples collected following birth and at two to four weeks and six months of age. We assessed clinically relevant bacteria using quantitative polymerase chain reaction. Logistic regression analyses were performed to determine whether the observed differences in gut microbiota were attributable to prematurity or perinatal exposure. The prevalence of bifidobacteria differed in the intestinal microbiota of the full-term and late preterm neonates. Differences in the presence of specific species were detected at the age of six months, although the microbiota alterations were most prominent following delivery. As well as prematurity, the mode of birth, intrapartum and neonatal antibiotic exposure, and the duration of breastfeeding had an additional impact on gut microbiota development. The gut microbiota composition was significantly different between late preterm and full-term infants at least six months after birth. Antibiotic exposure was common in late preterm infants and modulated gut colonisation, but preterm birth also affected gut microbiota development independently. ©2017 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  9. 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

  10. A CLINICAL STUDY OF MORBIDITY AND MORTALITY PATTERN OF LATE PRETERM INFANTS AT SNCU, WARANGAL

    Directory of Open Access Journals (Sweden)

    Sudhakar

    2016-03-01

    Full Text Available OBJECTIVE A clinical study of morbidity and mortality pattern of late preterm infants in comparison with term infants. STUDY DESIGN Prospective observational study. SETTING SNCU, Mahatma Gandhi Memorial Hospital, Warangal. SUBJECTS Consecutive sample of late preterm infants and term infants referred to our hospital on or before fourth day of life. RESULTS 76 late preterm infants and 76 term infants with any of the pre-defined neonatal condition were included in the study. Late preterm infants were significantly at a higher risk for overall morbidity including hypothermia, sepsis, respiratory morbidity, jaundice, hypoglycemia, birth asphyxia. A trend towards higher mortality was also seen. CONCLUSION In an out born referral center, late preterm infants are more prone to suffer from morbidities than term infants. Hypothermia is the leading cause of morbidity in both term (61% and late pre-term (85% infants.

  11. Prediction of Participation and Sensory Modulation of Late Preterm Infants at 12 Months: A Prospective Study

    Science.gov (United States)

    Bart, O.; Shayevits, S.; Gabis, L. V.; Morag, I.

    2011-01-01

    The aim of the study was to prospectively assess the differences in participation and sensory modulation between late preterm infants (LPI) and term babies, and to predict it by LPI characteristics. The study population includes 124 late preterm infants at gestational age between 34 and 35 6/7 weeks who were born at the same medical center. The…

  12. Long-Term Cognitive Outcomes of Infants Born Moderately and Late Preterm

    Science.gov (United States)

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

    2012-01-01

    Aim: To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. Method: 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…

  13. Long-Term Cognitive Outcomes of Infants Born Moderately and Late Preterm

    Science.gov (United States)

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

    2012-01-01

    Aim: To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. Method: 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…

  14. Short-term respiratory outcomes in late preterm infants

    Science.gov (United States)

    2014-01-01

    Objective To evaluate short-term respiratory outcomes in late preterm infants (LPI) compared with those of term infants (TI). Methods A retrospective study conducted in a single third level Italian centre (2005–2009) to analyse the incidence and risk factors of composite respiratory morbidity (CRM), the need for adjunctive therapies (surfactant therapy, inhaled nitric oxide, pleural drainage), the highest level of respiratory support (mechanical ventilation – MV, nasal continuous positive airway pressure – N-CPAP, nasal oxygen) and the duration of pressure support (hours in N-CPAP and/or MV). Results During the study period 14,515 infants were delivered. There were 856 (5.9%) LPI and 12,948 (89.2%) TI. CRM affected 105 LPI (12.4%), and 121 TI (0.9%), with an overall rate of 1.6%. Eighty-four LPI (9.8%) and 73 TI (0.56%) received respiratory support, of which 13 LPI (1.5%) and 16 TI (0.12%) were ventilated. The adjusted OR for developing CRM significantly increased from 3.3 (95% CI 2.0-5.5) at 37 weeks to 40.8 (95% CI 19.7-84.9%) at 34 weeks. The adjusted OR for the need of MV significantly increased from 3.4 (95% CI 1.2-10) at 37 weeks to 34.4 (95% CI 6.7-180.6%) at 34 weeks. Median duration of pressure support was significantly higher at 37 weeks (66.6 h vs 40.5 h). Twin pregnancies were related to a higher risk of CRM (OR 4.3, 95% CI 2.6-7.3), but not independent of gestational age (GA). Cesarean section (CS) was associated with higher risk of CRM independently of GA, but the OR was lower in CS with labour (2.2, 95% CI 1.4-3.4 vs 3.0, 95% CI 2.1-4.2). Conclusions In this single third level care study late preterm births, pulmonary diseases and supportive respiratory interventions were lower than previously documented. LPI are at a higher risk of developing pulmonary disease than TI. Infants born from elective cesarean sections, late preterm twins in particular and 37 weekers too might benefit from preventive intervention. PMID:24893787

  15. Short-term respiratory outcomes in late preterm infants.

    Science.gov (United States)

    Natile, Miria; Ventura, Maria Luisa; Colombo, Marco; Bernasconi, Davide; Locatelli, Anna; Plevani, Cristina; Valsecchi, Maria Grazia; Tagliabue, Paolo

    2014-06-03

    To evaluate short-term respiratory outcomes in late preterm infants (LPI) compared with those of term infants (TI). A retrospective study conducted in a single third level Italian centre (2005-2009) to analyse the incidence and risk factors of composite respiratory morbidity (CRM), the need for adjunctive therapies (surfactant therapy, inhaled nitric oxide, pleural drainage), the highest level of respiratory support (mechanical ventilation - MV, nasal continuous positive airway pressure--N-CPAP, nasal oxygen) and the duration of pressure support (hours in N-CPAP and/or MV). During the study period 14,515 infants were delivered. There were 856 (5.9%) LPI and 12,948 (89.2%) TI. CRM affected 105 LPI (12.4%), and 121 TI (0.9%), with an overall rate of 1.6%. Eighty-four LPI (9.8%) and 73 TI (0.56%) received respiratory support, of which 13 LPI (1.5%) and 16 TI (0.12%) were ventilated. The adjusted OR for developing CRM significantly increased from 3.3 (95% CI 2.0-5.5) at 37 weeks to 40.8 (95% CI 19.7-84.9%) at 34 weeks. The adjusted OR for the need of MV significantly increased from 3.4 (95% CI 1.2-10) at 37 weeks to 34.4 (95% CI 6.7-180.6%) at 34 weeks. Median duration of pressure support was significantly higher at 37 weeks (66.6 h vs 40.5 h). Twin pregnancies were related to a higher risk of CRM (OR 4.3, 95% CI 2.6-7.3), but not independent of gestational age (GA). Cesarean section (CS) was associated with higher risk of CRM independently of GA, but the OR was lower in CS with labour (2.2, 95% CI 1.4-3.4 vs 3.0, 95% CI 2.1-4.2). In this single third level care study late preterm births, pulmonary diseases and supportive respiratory interventions were lower than previously documented. LPI are at a higher risk of developing pulmonary disease than TI. Infants born from elective cesarean sections, late preterm twins in particular and 37 weekers too might benefit from preventive intervention.

  16. Urinary Hypoxanthine as a Measure of Increased ATP Utilization in Late Preterm Infants

    Science.gov (United States)

    Holden, Megan S.; Hopper, Andrew; Slater, Laurel; Asmerom, Yayesh; Esiaba, Ijeoma; Boskovic, Danilo S.; Angeles, Danilyn M.

    2015-01-01

    Objective To examine the effect of neonatal morbidity on ATP breakdown in late preterm infants. Study Design Urinary hypoxanthine concentration, a marker of ATP breakdown, was measured from 82 late preterm infants on days of life (DOL) 3 to 6 using high-performance liquid chromatography. Infants were grouped according to the following diagnoses: poor nippling alone (n = 8), poor nippling plus hyperbilirubinemia (n = 21), poor nippling plus early respiratory disease (n = 26), and respiratory disease alone (n = 27). Results Neonates with respiratory disease alone had significantly higher urinary hypoxanthine over DOL 3 to 6 when compared with neonates with poor nippling (P = .020), poor nippling plus hyperbilirubinemia (P < .001), and poor nippling plus early respiratory disease (P = .017). Neonates with poor nippling who received respiratory support for 2 to 3 days had significantly higher hypoxanthine compared with infants who received respiratory support for 1 day (P = .017) or no days (P = .007). Conclusions These findings suggest that respiratory disorders significantly increase ATP degradation in late premature infants. PMID:26413195

  17. Risk of Asthma in Late Preterm Infants: A Propensity Score Approach

    Science.gov (United States)

    Voge, Gretchen A; Katusic, Slavica K; Qin, Rui; Juhn, Young J

    2015-01-01

    Background The risk of asthma, specifically in former late preterm infants, has not been well defined. Covariate imbalance and lack of controlling for this has led to inconsistent results in prior studies. Objective Determine the risk of asthma in former late preterm infants using a propensity score approach. Methods The study was a population-based birth cohort study. Study subjects were all children born in Rochester, Minnesota, between 1976 and 1982. Asthma status during the first seven years of life was assessed by applying predetermined criteria. The propensity score was formulated using 15 covariates by fitting a logistic regression model for late preterm birth versus term birth. We applied the propensity score method to match late preterm infants (34 0/7 to 36 6/7 weeks gestation) to term infants (37 0/7 to 40 6/7 weeks gestation) within a caliper of 0.2 standard deviation of logit of propensity score. Results Of the eligible 7,040 infants, 5,915 children had complete data. Before propensity score matching, late preterm infants had a higher risk of asthma (20 of 262, 7.6%) compared to full-term infants (272 of 5,653, 4.8%)(p=0.039). There was significant covariate imbalance between comparison groups. After matching with propensity scores, we found that former late preterm infants had a similar risk of asthma to the matched full-term infants (6.6% vs. 7.7%, respectively, p=0.61), and the result were consistent with covariate-adjustment, Cox regression models controlling for significant covariates (p=0.57). Conclusion A late preterm birth history is not independently associated with childhood asthma, as the reported risk of asthma among former late preterm infants appears to be due to covariate imbalance. PMID:25944734

  18. A qualitative study: Mothers of late preterm infants relate their experiences of community-based care

    Science.gov (United States)

    Dosani, Aliyah; Oliver, Lynnette May; Lodha, Abhay K; Young, Marilyn

    2017-01-01

    Purpose In Alberta, the high occurrence of late preterm infants and early hospital discharge of mother-infant dyads has implications for postpartum care in the community. Shortened hospital stay and complexities surrounding the care of biologically and developmentally immature late preterm infants heighten anxiety and fears. Our descriptive phenomenological study explores mothers’ experience of caring for their late preterm infants in the community. Methods Eleven mothers were interviewed using a semi-structured interview guide. Interview transcripts were analysed using an interpretive thematic approach. Findings The mothers’ hospital experience informed their perspective that being a late preterm infant was not a “big deal,” and they tended to treat their infant as normal. “Feeding was really problem,” especially the variability in feeding effectiveness, which was not anticipated. Failing to recognize late preterm infants’ feeding distress exemplified lack of knowledge of feeding cues and tendencies to either rationalize or minimize feeding concerns. Public health nurses represent a source of informational support for managing neonatal morbidities associated with being late preterm; however, maternal experiences with public health nurses varied. Some nurses used a directive style that overwhelmed certain mothers. Seeing multiple public health nurses and care providers was not always effective, given inconsistent and contradictory guidance to care. These new and changing situations increased maternal anxiety and stress and influenced maternal confidence in care. Fathers, family, and friends were important sources of emotional support. Conclusion After discharge, mothers report their lack of preparation to meet the special needs of their late preterm infants. Current approaches to community-based care can threaten maternal confidence in care. New models and pathways of care for late preterm infants and their families need to be responsive to the

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

    Directory of Open Access Journals (Sweden)

    N. Liotto

    2013-08-01

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

  20. Nonoliguric hyperkalemia in a late preterm infant with severe birth asphyxia.

    Science.gov (United States)

    Xiong, Xiaoyu; Chen, Dan; Zhang, Jing; Mao, Jian; Li, Juan

    2013-01-01

    Nonoliguric hyperkalemia (NOHK) is common during the first days after birth in premature infants with gestational age term or late preterm infants. We present a case of a 3 hours baby at 34 weeks and 3 days' gestational age who was delivered of severe birth asphyxia by cesarean section for failing to vaginal delivery. Serum potassium reached to 8.3 mmol/L at 12 hours age, with normal urinary output and serum urea and creatinine. Abnormal ECG of tall peaked T waves was developed. Marked fall in serum Ca(2+) of 0.6 mmol/L and total calcium of 1.13 mmol/L was also noted. Cerebral lesions in the head MRI demonstrated extensive periventricular white matter injury.

  1. Disparities in Mortality Rates Among US Infants Born Late Preterm or Early Term, 2003–2005

    Science.gov (United States)

    Gazmararian, Julie A.; Shapiro-Mendoza, Carrie K.

    2015-01-01

    The purpose of this study was to identify disparities in neonatal, post-neonatal, and overall infant mortality rates among infants born late preterm (34–36 weeks gestation) and early term (37–38 weeks gestation) by race/ethnicity, maternal age, and plurality. In analyses of 2003–2005 data from US period linked birth/infant death datasets, we compared infant mortality rates by race/ethnicity, maternal age, and plurality among infants born late preterm or early term and also determined the leading causes of death among these infants. Among infants born late preterm, infants born to American Indian/Alaskan Native, non-Hispanic black, or teenage mothers had the highest infant mortality rates per 1,000 live births (14.85,9.90, and 11.88 respectively). Among infants born early term, corresponding mortality rates were 5.69, 4.49, and 4.82, respectively. Among infants born late preterm, singletons had a higher infant mortality rate than twins (8.59 vs. 5.62), whereas among infants born early term, the rate was higher among twins (3.67 vs. 3.15). Congenital malformations and sudden infant death syndrome were the leading causes of death among both late preterm and early term infants. Infant mortality rates among infants born late preterm or early term varied substantially by maternal race/ ethnicity, maternal age, and plurality. Information about these disparities may help in the development of clinical practice and prevention strategies targeting infants at highest risk. PMID:23519825

  2. Stress in Fathers of Moderately and Late Preterm Infants: A Randomised Controlled Trial

    Science.gov (United States)

    Ravn, Ingrid Helen; Lindemann, Rolf; Smeby, Nina Aarhus; Bunch, Eli Haugen; Sandvik, Leiv; Smith, Lars

    2012-01-01

    The atypical behaviour of preterm infants can elicit stress in fathers and influence their ability to perceive and interpret infants' cues. This study investigated whether fathers of moderately and late preterm infants were more stressed than fathers of term infants. In a randomised controlled trial, we also studied the effect of the Mother-Infant…

  3. Factors associated with initiation and exclusive breastfeeding at hospital discharge: late preterm compared to 37 week gestation mother and infant cohort

    Directory of Open Access Journals (Sweden)

    Ayton Jennifer

    2012-11-01

    Full Text Available Abstract Background To investigate and examine the factors associated with initiation of, and exclusive breastfeeding at hospital discharge of, late preterm (34 0/7 - 36 6/7 weeks compared to 37 week gestation (37 0/7 - 37 6/7 week mother and baby pairs. Methods A retrospective population-based cohort study using a Perinatal National Minimum Data Set and clinical medical records review, at the Royal Hobart Hospital, Tasmania, Australia in 2006. Results Late preterm and 37 week gestation infants had low rates of initiation of breastfeeding within one hour of birth, 31 (21.1% and 61 (41.5% respectively. After multiple regression analysis, late preterm infants were less likely to initiate breastfeeding within one hour of birth (OR 0.3 95% CI 0.1, 0.7 p = 0.009 and were less likely to be discharged exclusively breastfeeding from hospital (OR 0.4 95% CI 0.1, 1.0 p = 0.04 compared to 37 week gestation infants. Conclusion A late preterm birth is predictive of breastfeeding failure, with late preterm infants at greater risk of not initiating breastfeeding and/or exclusively breastfeeding at hospital discharge, compared with those infants born at 37 weeks gestation. Stratifying breastfeeding outcomes by gestational age groups may help to identify those sub-populations at greatest risk of premature cessation of breastfeeding.

  4. Does Human Milk Modulate Body Composition in Late Preterm Infants at Term-Corrected Age?

    Science.gov (United States)

    Giannì, Maria Lorella; Consonni, Dario; Liotto, Nadia; Roggero, Paola; Morlacchi, Laura; Piemontese, Pasqua; Menis, Camilla; Mosca, Fabio

    2016-10-23

    (1) Background: Late preterm infants account for the majority of preterm births and are at risk of altered body composition. Because body composition modulates later health outcomes and human milk is recommended as the normal method for infant feeding, we sought to investigate whether human milk feeding in early life can modulate body composition development in late preterm infants; (2) Methods: Neonatal, anthropometric and feeding data of 284 late preterm infants were collected. Body composition was evaluated at term-corrected age by air displacement plethysmography. The effect of human milk feeding on fat-free mass and fat mass content was evaluated using multiple linear regression analysis; (3) Results: Human milk was fed to 68% of the infants. According to multiple regression analysis, being fed any human milk at discharge and at  term-corrected and being fed exclusively human milk at term-corrected age were positively associated with fat-free mass content(β = -47.9, 95% confidence interval (CI) = -95.7; -0.18; p = 0.049; β = -89.6, 95% CI = -131.5; -47.7; p milk feeding appears to be associated with fat-free mass deposition in late preterm infants. Healthcare professionals should direct efforts toward promoting and supporting breastfeeding in these vulnerable infants.

  5. Does Human Milk Modulate Body Composition in Late Preterm Infants at Term-Corrected Age?

    Directory of Open Access Journals (Sweden)

    Maria Lorella Giannì

    2016-10-01

    Full Text Available (1 Background: Late preterm infants account for the majority of preterm births and are at risk of altered body composition. Because body composition modulates later health outcomes and human milk is recommended as the normal method for infant feeding, we sought to investigate whether human milk feeding in early life can modulate body composition development in late preterm infants; (2 Methods: Neonatal, anthropometric and feeding data of 284 late preterm infants were collected. Body composition was evaluated at term-corrected age by air displacement plethysmography. The effect of human milk feeding on fat-free mass and fat mass content was evaluated using multiple linear regression analysis; (3 Results: Human milk was fed to 68% of the infants. According to multiple regression analysis, being fed any human milk at discharge and at  term-corrected and being fed exclusively human milk at term-corrected age were positively associated with fat-free mass content(β = −47.9, 95% confidence interval (CI = −95.7; −0.18; p = 0.049; β = −89.6, 95% CI = −131.5; −47.7; p < 0.0001; β = −104.1, 95% CI = −151.4; −56.7, p < 0.0001; (4 Conclusion: Human milk feeding appears to be associated with fat-free mass deposition in late preterm infants. Healthcare professionals should direct efforts toward promoting and supporting breastfeeding in these vulnerable infants.

  6. Association between breastfeeding support and breastfeeding rates in the UK: a comparison of late preterm and term infants

    Science.gov (United States)

    Rayfield, Sarah; Oakley, Laura; Quigley, Maria A

    2015-01-01

    Objective To explore the association between breastfeeding support and breastfeeding among late preterm (gestation 34–36 weeks) and term (gestation ≥37 weeks) infants. Methods Secondary analysis of the UK 2010 Infant Feeding Survey. Logistic regression was used to determine the association of breastfeeding support with breastfeeding at 10 days and 6 weeks in late preterm and term infants. Results The study included 14 525 term and 579 late preterm infants. A total of 11 729 infants initiated breastfeeding (11 292 (81.1%) term, 437 (79.4%) late preterm infants, p=0.425). Of these, 9230 (84.3%) term and 365 (85.6%) late preterm infants were breastfeeding at 10 days (p=0.586); of these 7547 (82.0%) term and 281 (75.4%) late preterm infants were still breastfeeding at 6 weeks (p=0.012). Mothers who reported receiving contact details for breastfeeding support groups had a higher likelihood of breastfeeding late preterm (adjusted ORs, aOR 3.14, 95% CI 1.40 to 7.04) and term infants (aOR 2.24, 95% CI 1.86 to 2.68) at 10 days and term infants at 6 weeks (aOR 1.83, 95% CI 1.51 to 2.22). Those who reported that they did not receive enough help with breastfeeding in hospital had a lower likelihood of breastfeeding late preterm at 10 days and term infants at 10 days and 6 weeks, compared to those who reported having enough help. Conclusions Receiving sufficient help with breastfeeding in hospital and the contact details for breastfeeding support groups is associated with breastfeeding term infants up to 6 weeks and late preterm infants at 10 days. PMID:26567257

  7. Premature infant

    Science.gov (United States)

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

  8. A national survey of admission practices for late preterm infants in England

    Science.gov (United States)

    2014-01-01

    Background Infants born at 34+0 to 36+6 weeks gestation are defined as ‘late preterm’ infants. It is not clear whether these babies can be managed on the postnatal ward (PNW) or routinely need to be admitted to the neonatal unit after birth. Aim To conduct a national survey of admission practice for late preterm and low birth weight infants directly to the PNW after birth in England. Methods All neonatal units were identified from the Standardised Electronic Neonatal Database (SEND). Individual units were contacted and data collected on their admission practice. Results All 180 neonatal units in England responded. 49, 84 and 47 Units were Special Care Units (SCUs), Local Neonatal Units (LNUs) and Neonatal Intensive Care Units (NICUs) respectively. 161 units (89%) had written guidelines in relation to direct PNW admission for late preterm infants. The mean gestational age of infants admitted directly to the PNW was significantly lower in LNUs compared to SCUs and NICUs compared to LNUs. Mean birth weight limit for direct PNW admission was significantly lower in NICUs compared to SCUs. 72 units had PNW nursery nurses. There was no significant difference in gestational age or birth weight limit for direct PNW admission in the presence of PNW nursery nurses. Conclusions Admission practices of late preterm infants directly to the PNW varies according to designation of neonatal unit in England. Further studies are needed to establish the factors influencing these differences. PMID:24939510

  9. Weighing worth against uncertain work: the interplay of exhaustion, ambiguity, hope and disappointment in mothers breastfeeding late preterm infants.

    Science.gov (United States)

    Radtke Demirci, Jill; Happ, Mary Beth; Bogen, Debra L; Albrecht, Susan A; Cohen, Susan M

    2015-01-01

    Poor breastfeeding outcomes among late preterm infants (LPIs) have been attributed to inadequate breast milk transfer stemming from physiological immaturities. However, breastfeeding is more than a biological phenomenon, and it is unclear how mothers of LPIs manage other factors that may also impact the breastfeeding course. Using grounded theory methods and incorporating serial post-partum interviews with several novel data collection techniques, we examined breastfeeding establishment over a 6-8-week-period among 10 late preterm mother-infant dyads recruited from a maternity hospital in Pittsburgh, Pennsylvania, USA. We found that breastfeeding in the LPI population was a fluctuating, cascade-like progression of trial and error, influenced by a host of contextual factors and events and culminating with breastfeeding continuation (with or without future caveats for duration or exclusivity of breastfeeding) or cessation. The trajectory was explained by the basic psychosocial process Weighing Worth against Uncertain Work, which encompassed the tension among breastfeeding motivation, the intensity of breastfeeding work and the ambiguity surrounding infant behaviour and feeding cues. Several sub-processes were also identified: Playing the Game, Letting Him Be the Judge vs. Accommodating Both of Us and Questioning Worth vs. Holding out Hope. If valid, our theoretical model indicates a need for earlier, more extensive and more qualified breastfeeding support for mothers of LPIs that emphasizes the connection between prematurity and observed feeding behaviours.

  10. 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

    2015-01-01

    Objective 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. Methods Open-ended semi-structured maternal interviews were conducted in a U.S. hospital following birth and by phone at one month postpartum during 2010–2012. Participants were 56 mother-infant dyads: 26 late preterm and 30 term. Results 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. Conclusions 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. PMID:25626714

  11. Risk factors for preterm birth and complications in 287 late preterm infants%287例晚期早产儿早产危险因素及并发症研究

    Institute of Scientific and Technical Information of China (English)

    张晓蕊; 曾超美; 刘捷

    2011-01-01

    Objective To investigate the risk factors for preterm birth and complications in late preterm infants.Methods The clinical data of 287 late preterm infants were retrospectively studied. Two hundred and eighty-eight term infants served as the control group. Logistic regression analysis was used to identify risk factors associated with late preterm birth. The common complications in late preterm infants were investigated. Results Several significant risk factors for late preterm birth were identified by logistic regression analysis: twin pregnancy, gestational diabetes mellitus, eclampsia or preeclampsia, placenta previa, placental abruption and premature rupture of membranes. The duration of hospitalization in late preterm infants was longer than that in term infants. The complications were common in late preterm infants, with a high prevalence of anemia, aspiration pneumonia, hypoglycemia and intracranial hemorrhage. Conclusions The late preterm infants are much more likely to suffer various complications. It is important to reduce the incidence of late preterm births by decreasing perinatal risk factors above mentioned.%目的:探讨晚期早产儿(late preterm infant,LPI)早产相关危险因素及临床常见并发症.方法:对287例LPI临床资料进行回顾性分析,同时随机抽取288例同期住院的足月新生儿作对照,应用logistic回归分析的方法筛选LPI早产的危险因素,并分析其常见临床并发症的发生等情况.结果:Logistic回归显示双胎、妊娠期糖尿病、先兆子癎及子癎、前置胎盘、胎盘早剥及胎膜早破为LPI早产发生的危险因素.LPI住院时间明显长于足月儿,其各系统并发症发生率均较高,其中以贫血、吸人性肺炎、低血糖症、颅内出血等为主.结论:LPI生后易发生多种并发症,应注意密切观察,及时救治.避免围产期异常分娩因素的发生是降低LPI出生的关键.

  12. Morbidity and Mortality Pattern in Late Preterm Infants at a Tertiary Care Hospital in Jammu & Kashmir, Northern India

    Science.gov (United States)

    Rather, Ghulam Nabi; Jan, Muzafar; Rafiq, Wasim; Hussain, Sheikh Quyoom; Latief, Mohmad

    2015-01-01

    Introduction The morbidity and mortality pattern in late preterm infants is higher than term infants (gestational age ≥ 37weeks). The main reason behind that is the relative physiologic and metabolic immaturity, though there is no significant difference in the weight or the size of the two groups. Aim The present study was undertaken to study the incidence, early neonatal morbidity and mortality (within first 7 days of life) in late preterm infants (34 – 36 6/7 weeks). Materials and Methods It was a hospital based prospective study conducted from April 2012 to March 2013. The study was conducted in the Department of Paediatrics and Neonatology at G.B. Pant General Hospital and Department of Gynaecology and Obstetrics L.D hospital and G.B. pant general hospital, (associated hospitals of Government Medical College, Srinagar). Results A total of 4100 neonates were included in the study. Incidence of late preterm neonates was 11.58 %. Three hundred sixty five (76.8%) of late preterm and 965 (28.3%) of term infants had at least one of the predefined neonatal conditions. Late preterm infants were at significantly higher risk for overall morbidity due to any cause (p<0.0001), respiratory morbidity (p<0.0001), mechanical ventilation (p=0.0002), jaundice (p<0.0001), hypoglycaemia (p<0.0001), and sepsis (p<0.0001) Perinatal asphyxia (p= 0.186). Early neonatal mortality in late preterm neonates was 2.5% or 25/1000 live births. Conclusion Compared with term infants, late preterm infants are at high risk for overall morbidity, respiratory morbidity, and need of mechanical ventilation, jaundice, hypoglycaemia & sepsis. They also have a higher mortality as compared to term neonates. PMID:26816959

  13. 晚期早产儿研究进展%Research Progress in Late Preterm Infants

    Institute of Scientific and Technical Information of China (English)

    鲁利群; 屈艺; 母得志

    2011-01-01

    晚期早产儿以往称为近足月儿,指胎龄34~36+6周的早产儿,约占早产儿的70%,近年来晚期早产儿出生人数逐年增加,其病死率、患病率、神经发育及再入院率等均明显高于足月儿.因此,有必要加强产前保健,减少早产儿出生,并针对此类人群制定相应的监护措施,以提高整体人口素质.%Late pretenn infants, born from 34 to 36 +6 weeks of gestation, account for about 70% of preterm infants. Although late preterm infants are near term,they are at higher risk of mortality,morbidity,readmissions,and neurodevelopmental problems compared with term infants. With the increase in late preterm births during the last decade,it is necessary to enhance antenatal care to decrease preterm birth and propose guidelines for the evaluation and management of these infants after birth.

  14. Effects of Video-Modeling on the Interaction Skills of First-Time Fathers of Late Preterm Infants

    Science.gov (United States)

    Benzies, Karen Marie; Magill-Evans, Joyce; Kurilova, Jana; Nettel-Aguirre, Alberto; Blahitka, Laurie; Lacaze-Masmonteil, Thierry

    2013-01-01

    This study evaluated the effects of an innovative educational--behavioral intervention for first-time fathers of late preterm (34-36 weeks' gestation) infants, with the aim of enhancing the infant's environment through strengthening fathers' skills in interaction with their young infant. Using a randomized controlled trial, fathers of 111 late…

  15. Progress on nursing care of late preterm infants%晚期早产儿的护理进展

    Institute of Scientific and Technical Information of China (English)

    任向芳

    2012-01-01

    Through the clinical observation and nursing practice for late preterm infants,it reviewed the epidemic characteristics and related clinical nursing progress of late preterm infants and so as to provide the references for clinical nursing practice and research.%通过对晚期早产儿的临床观察与护理实践,综述了晚期早产儿的流行病学特点及相关临床护理进展,为护理人员的临床护理实践和科研提供参考.

  16. Long-chain polyunsaturated fatty acids in breast-milk and erythrocytes and neurodevelopmental outcomes in Danish late-preterm infants

    DEFF Research Database (Denmark)

    Andersen, Stine Brøndum; Hellgren, Lars I; Larsen, Mette Krogh;

    2015-01-01

    acid composition of late-preterm human milk and identify possible associations between infant LC-PUFA status and perinatal as well as 1-year neurobehavioral outcomes. Methods: Mother’s milk and erythrocytes (RBC) were sampled from 53 Danish late-preterm infants (33-36 weeks of gestation) 1 week and 1...

  17. Skinfold thickness of preterm newborns when they become late preterm infants.

    Science.gov (United States)

    Simsek, Meral; Ergenekon, Ebru; Beken, Serdar; Kulalı, Ferit; Unal, Sezin; Kazancı, Ebru; Aktas, Selma; Altuntas, Nilgun; Hirfanoglu, Ibrahim; Turkyılmaz, Canan; Koç, Esin; Atalay, Yıldız

    2015-04-01

    Nutrition of very low-birth-weight newborns is important for a good physical and neurologic outcome. Body composition assessment, together with anthropometric measurements, is considered necessary to monitor adequate nutrition and growth. Objectives of this study were to assess body fat changes in newborns ≤32 weeks gestation by weekly skinfold thickness (SFT) measurements and to compare them with those of late preterm infants born at 34, 35, and 36 weeks once they reached 34, 35, and 36 weeks corrected age (CA). Preterm infants ≤32 weeks gestation had SFT measured from 4 body sites, including biceps, triceps, and subscapulary and suprailiac regions, by a Holtain caliper starting from 48 hours of age at weekly intervals until 34, 35, and 36 weeks CA. The measurements were compared with those of late preterm controls born at 34, 35, and 36 weeks gestation. There were 37 preterm infants in the patient group. When reaching 34, 35, and 36 weeks CA, preterm infants had higher SFT values compared with controls in all body sites. Median and range of total SFT were 14.6 mm (9.6-18.9 mm) in patients and 11 mm (7.8-16.4 mm) in controls at 34 weeks CA, 15.5 mm (10.7-21.8 mm) in patients and 12.3 mm (7-17 mm) in controls at 35 weeks CA, and 16.4 mm (11.8-23.7 mm) in patients and 12.9 mm (7-17.8 mm) in controls at 36 weeks CA (P = .001 in all). No sex difference was observed at 34 and 35 weeks. These results show that preterm infants start accumulating excess fat even from early weeks of life. Careful assessment of growth by tools other than simple anthropometric measurements is essential to avoid future complications. © 2015 American Society for Parenteral and Enteral Nutrition.

  18. Cup versus bottle feeding for hospitalized late preterm infants in Egypt: A quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Dabash Soheir A

    2008-11-01

    Full Text Available Abstract Background Although previous studies have demonstrated beneficial breastfeeding outcomes when cup feeding rather than bottle feeding was used for feeding preterm infants, cup feeding has not been implemented in Egypt. The aim of the current study was to examine the effect of using cup feeding as an exclusive method of feeding preterm infants during hospitalization on breastfeeding outcomes after discharge. Methods A quasi-experimental design, with the control group studied first, was used to examine the effect of cup feeding for preterm infants on breastfeeding outcomes after discharge. Sixty preterm infants (mean gestational age was 35.13 weeks and mean birth weight was 2150 grams were recruited during Neonatal Intensive Care Unit (NICU stay. Control group infants (n = 30 received only bottle feedings during hospitalization and the experimental group (n = 30 received only cup feedings during hospitalization. Both groups were followed up after discharge for six weeks to evaluate infant's breastfeeding behavior and mother's breastfeeding practices. Data were analyzed using descriptive statistics and repeated measures ANOVA for testing the differences between the cup feeding and bottle feeding groups over six weeks after discharge. Results Cup fed infants demonstrated significantly more mature breastfeeding behaviors when compared to bottle fed infants (p Conclusion Cup fed infants were more exclusively breast fed one week after discharge, supporting the Baby Friendly Hospital Initiative recommendations for using cup feeding and avoiding bottle feeding when providing supplementation for preterm infants. The current study provides initial evidence for the implementation of cup feeding as a method of supplementation for late preterm infants during hospitalization. Trial Registration Clinical Trial NCT00756587.

  19. Influence of Additional Ankle Weights on Kinematic Variables of Late Preterm Infants Aged 3-4 Months.

    Science.gov (United States)

    Dionisio, Jadiane; Santos, Gabriela Lopes Dos; Tudella, Eloisa

    2017-01-01

    The authors analyzed and compared the effect of additional weight on the spatiotemporal parameters of the kicking movement of late preterm and full-term infants. The experiment was divided into 4 conditions: training, baseline, weight, and postweight. In the W condition, a weight of one third the lower limb mass was added to the infant's ankle. During the baseline and postweight conditions, the ankle weight was removed. Late preterm infants do not differ from full-term infants in relation to spatiotemporal variables at 3 and 4 months. However, during the weight condition, the straightness index and the hip-ankle and knee-ankle correlations decreased in the preterm infants at both ages. In contrast, the straightness index increased in the postweight condition compared to the baseline values at both ages.

  20. Bibliographic analysis on epidemiology of late preterm infants%晚期早产儿流行病学特点的文献分析

    Institute of Scientific and Technical Information of China (English)

    孔丽萍; 余章斌; 韩树萍; 崔焱

    2012-01-01

    Objective To analyze the worldwide birth rate and clinical characteristics of late preterm infants. Methods Literatures related to epidemiology of late preterm infants were searched electronically from the databases of CNKI,WanFang,Chinese VIP,SinoMed,Medline and Embase,and were selected according to the inclusion criteria. Results A total of 29 literatures met the inclusion criteria. The results showed that the birth rate was higher,the number of births was increasing year by year and premature rupture of membranes, various pregnancy complications and multiple pregnancy were the most common causes of late preterm infants. Clinical problems of late preterm infants included complications of nervous system,respiratory system and digestive system,as well as hyperbilirubinemia,infections , hypoglycemia, anemia and temperature instability. The highest rate of complications was occuring in the respiratory system. Compared to term newboms, late preterm infants had longer hospital stay,more treatment cost,poorer clinical outcomes and higher risk for developmental delay. Conclusion Late preterm infants, who are physiologically immature and have more clinical problems than term infants,is in a large proportion of premature infants and should get highly attention.%目的 了解世界范围内晚期早产儿的出生情况和流行病学特点.方法 计算机检索中国知网全文数据库、万方数据库、维普中文数据库、中国生物医学文献数据库、Medline、Embase英文数据库关于晚期早产儿的研究报道,按照纳入标准筛选出符合要求的文献进行文献分析.结果 共有29篇文献纳入研究,现有研究表明,晚期早产儿出生率较高,出生人数逐年增长,主要早产原因有孕妇胎膜早破、各种妊娠并发症、多胎妊娠等.晚期早产儿易发生神经系统、呼吸系统、消化系统并发症和高胆红素血症、感染、低血糖、贫血、体温不稳定等并发症,其中呼吸系统并发症

  1. Can neonatal sepsis be predicted in late preterm premature rupture of membranes? Development of a prediction model.

    Science.gov (United States)

    van der Ham, David P; van Kuijk, Sander; Opmeer, Brent C; Willekes, Christine; van Beek, Johannes J; Mulder, Antonius L M; van Loon, Aren J; Groenewout, Martiët; Mantel, Gerald D; Bloemenkamp, Kitty W M; Porath, Martina; Kwee, Anneke; Akerboom, Bettina M C; Papatsonis, Dimitri N M; Metz, Godfried C H; Nijhuis, Jan G; Mol, Ben W J

    2014-05-01

    Women with late preterm premature rupture of membranes (PROM) have an increased risk that their child will develop neonatal sepsis. We evaluated whether neonatal sepsis can be predicted from antepartum parameters in these women. We used multivariable logistic regression to develop a prediction model. Data were obtained from two recent randomized controlled trials on induction of labor versus expectant management in late preterm PROM (PPROMEXIL trials, (ISRCTN29313500 and ISRCTN05689407). Data from randomized as well as non-randomized women, who consented to the use of their medical data, were used. We evaluated 13 potential antepartum predictors for neonatal sepsis. Missing data were imputed. Discriminative ability of the model was expressed as the area under the receiver operating characteristic (ROC) curve and a calibration with both a calibration plot and the Hosmer and Lemeshow goodness-of-fit test. Overall performance of the prediction model was quantified as the scaled Brier score. We studied 970 women. Thirty-three (3.4%) neonates suffered neonatal sepsis. Maternal age (OR 1.09 per year), maternal CRP level (OR 1.01 per mmol/l), maternal temperature (OR 1.80 per °C) and positive GBS culture (OR 2.20) were associated with an increased risk of neonatal sepsis. The model had an area under the ROC-curve of 0.71. The model had both a good calibration and accuracy. Antepartum parameters aid in the more precise prediction of the risk of neonatal sepsis in women with late preterm PPROM. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Long-term neurodevelopmental outcomes of infants born late preterm: a systematic review

    Directory of Open Access Journals (Sweden)

    Tripathi T

    2015-11-01

    Full Text Available Tanya Tripathi,1 Stacey C Dusing2,3 1Rehabilitation and Movement Science Program, Department of Physical Therapy, 2Department of Physical Therapy, 3Department of Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA, USA Purpose: Late preterm (LPT births constitute a large proportion of the preterm births in the USA. Over the last few decades, there has been an increase in research focusing on the neurodevelopment of infants born LPT. The purpose of this research was to systematically review the long-term neurodevelopmental outcomes in LPT infants. Materials and methods: We identified studies by using PubMed, ERIC, CINAHL, and PsycINFO databases. The references of included papers were reviewed for additional papers that met the inclusion criteria. Included papers compared motor, cognitive, language development, or academic performance outcomes between individuals born LPT and a term control group assessed between 12 months and 18 years of age. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards for systematic reviews were utilized including a two-step, two-investigator review process. Results: Of the 4,720 studies found in the initial search, 20 studies met the inclusion criteria. Approximately 75% of the 16 studies that assessed cognitive outcomes reported cognitive delay in the LPT group when compared to their full-term counterparts. More than 50% of the seven studies that assessed motor outcomes suggested a delay in motor development in the LPT group in comparison to full-term. Fewer papers assessed academic performance and language in children born LPT; however, the majority identified borderline differences when LPT infants were compared to those born full-term. Conclusion: Evidence suggests that infants born LPT are at an increased risk of neurodevelopmental delay between 1 and 18 years of life when compared to those born at term. The delay is most evident in the cognitive

  3. Oral Feeding Assessment Predicts Length of Hospital Stay in Late Preterm Infants

    Science.gov (United States)

    Lau, Chantal; Bhat, Kiran; Potak, Debra; Schanler, Richard J.

    2015-01-01

    Background When compared with term infants, late preterm (LP) infants have greater morbidity and mortality, longer hospital stay, and greater rate of hospital readmission. Oral feeding difficulty is one of the prominent reasons for delayed discharge in LP infants. Objective To identify the maturity levels of LP infants’ oral feeding skills (OFS) at the time of their first oral feeding and to determine the relationship between OFS maturity levels and length of hospital stay. Methods OFS was assessed in 48 LP infants born between 340/7 and 356/7 weeks gestational age at the time of their first oral feeding within 24 h of birth. The intake at 5 minutes, at completion of the feeding, and the duration of feeding a 15 mL prescribed volume of milk were tabulated. Proficiency expressed as percent mL consumed in the first 5 min/15 mL prescribed and rate of milk transfer over the entire feeding (mL/min) were recorded. OFS were assessed using a novel 4-level scale defined by the combined proficiency and rate of milk transfer. Results When compared with their 35-week counterparts, infants born at 34 weeks gestation had poorer OFS profiles (p = 0.035) and longer hospital stay (p < 0.001). Additionally, further analyses demonstrated that, independently, LOS was associated negatively with both GA and OFS. Conclusion Assessment of OFS levels in LP infants at their first oral feeding can help identify infants at risk of oral feeding issues that may delay hospital discharge. For those infants, we speculate that provision of evidence-based efficacious interventions that improve OFS may shorten hospital stay and decrease hospital re-admissions. PMID:27042698

  4. Osteopenia - premature infants

    Science.gov (United States)

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

  5. 晚期早产儿的研究进展%Research on late-preterm infant

    Institute of Scientific and Technical Information of China (English)

    周琳

    2012-01-01

    晚期早产儿是指在340/7~ 366/7孕周出生的婴儿.近年来,晚期早产儿的数量有不断上升的趋势,其在早产儿中的比例也逐年上升.晚期早产儿的发病率及病死率较足月儿显著增高,加之其所占比例的增加,相对消耗较多的医疗资源,因此得到了很多关注.该文对晚期早产儿各系统的患病情况及其影响因素进行综述,为医务人员进一步完善诊疗及研究提供依据.%The late-preterm infant refers to the infant who is born at 340/7 through 366/7 week's gestation.In recent years,the number of the late-preterm continually ascends and the proportion of them in the preterm group increase as well.Recent studies find that the rates of morbidity and mortality of late-preterm infants are much higher than those of term infants.The rise of the proportion of the former and the more medical resources consumed attract the considerable attention thereby.In this article,we will review late-preterm infants' morbidity of several systems and its influential factors in order to provide more information for perinatal medical staff to improve diagnosis,treatment and further research.

  6. 晚期早产儿发生率及围生期临床问题分析%Incidence of late preterm infants and clinical problem analysis during perinatal period

    Institute of Scientific and Technical Information of China (English)

    柳锡永; 徐兰飞; 金志彪; 吴燕; 季留青

    2014-01-01

    Objective To understand the incidence rate of late preterm infants and clinical problems during perinatal period. Methods By epidemiological investigation,the incidence rate of late preterm infants from January 2012 to De-cember 2013 was analyzed.The late preterm infants and full-term infants were selected as the observation subjects in order to analyze their clinical problems during perinatal period. Results The incidence rate of late preterm infants was 8.15% accounting for 82.34% in all premature infants.Percentage of boy,proportion of newborns with body weight less than 2500 g,incidence rate of neonatal asphyxia, and hospitalization rate in neonatology department after birth in late preterm infant group were all much higher than those in term infant group (P<0.01).Incidence rate of hyperbilirubine-mia,hypothermia,hypoglycemia,anemia,feeding intolerance,infection,transient tachypnea,respiratory distress,and apnea and utilization rate of assisted ventilation in late preterm infant group transferring to neonatology department were all higher than those in the term infant group (P<0.01). Conclusion A high incidence of late preterm infant has been found by the study.Late preterm infant has a higher hospitalization rate in neonatology department and more clinical problems during perinatal period in comparison with those in the term infant group.Clinical management of late preterm infant should be paid attention.%目的:了解晚期早产儿发生率及其围生期临床问题。方法采用流行病学调查方法,分析2012年1月~2013年12月的晚期早产儿的发生率;并将晚期早产儿与足月儿作为观察对象,分析其围生期临床问题。结果晚期早产儿的发生率为8.15%,占全部早产儿的82.34%。晚期早产儿组男孩比例、出生体质量<2500 g的新生儿比例、出生时窒息发生率、出生后新生儿科住院率均明显高于足月儿组(P<0.01)。转入新生儿科的晚期早产儿组高胆红素血症、

  7. Health status and affecting factors of late-preterm infants%晚期早产儿健康状况及其影响因素探讨

    Institute of Scientific and Technical Information of China (English)

    徐萍; 张雪峰; 李瑛; 刘向梅; 钱素云

    2009-01-01

    Objective To study the birth rate,mortality,complications,related factots of preterm infants at Beijing Haidian Maternity and Children's Hospital in 2007,80 as to establish the foundations for a more systematic and effective program for clinical treatments.Methods Data of all the neonates born at Beijing Haidian Maternity and Children's Hospital during the periodfrom January 1,2007 to December 31,2007 were recorded for statistical analysis.All near-term infants of 35-37 weeks of gestational age were taken into observation group.Within 24 hours after birth,blood routine examination,urine and stool routine examination,blood gas analysis and electrolytes,blood glucose monitoring(at 1st,3rd,6th,12th,and 24th hours),chest radiography examination,skull and heart color Doppler ultrasonographic examination were conducted.Full-term infants who were born on the first day of every month were randomly selected as a comparison group(totally 350 cases)for statistical analysis.Complications of the two groups were recorded in detail. Factors such as the ages of parturients,maternal infections,pregnancy-induced hypertension,diabetes,anaemia,premature rupture of membranes,abnormal aminotic fluid,abnormal umbilical cord,abnormal placenta,and twin were analyzed and compared.Results Of the 12 286 infants born during the study period.333 were late-preterm infants;the birth rate of late-preterm infants was 2.71%.Among the complications in late-preterm infants,the hyperbilirubinemia topped at 33.6%.followed by respiratory distress(16.8%),hypoglycemia(9.0%),intracranial hemorrhage(8.1%),anemia or erythrocytosis (5.7%),and digestive system disease(5.4%).Late-preterm infants have higher rate of the hyperbilirubinemia,respiratory distress,hypoglycemia,anemia or erythrocytosis and digestive system disease (P<0.05).The length of hospital stay of late-preterm infants,which is 5.1 d±3.90 d,was significantly longer than those of full-term infants which was 3.2 d±1.61 d(P<0.05).Conclusion The

  8. Neurobehavioral Profile of Moderate to Late Preterm Infants Admitted in a Tertiary Care Centre in South India

    Directory of Open Access Journals (Sweden)

    Sonia Khurana

    2016-07-01

    Full Text Available Background and objectives: Neonatal neurobehavioral organization is a multidimensional holistic phenomenon which involves synchronous working of autonomic, sensory and motor systems to influence the developmental maturation of neonates. Homeostasis of all these systems is well developed in term infants but preterm infants due to their physiological instability, incomplete cortical development are at higher risk of impaired neurobehavioral organisation. Neurobehavioral maturity of term infants has been documented in many studies but there is dearth of literature in preterm infants especially moderate to late preterm (MLP category (32 weeks – 36 weeks of gestation. Thus the present study was aimed to assess the neurobehavioral profile of MLP infants and to compare it with standard reference scores provided in the NAPI manual. Methods: A cross sectional study was planned in which sixty moderate to late preterm infants were included during their stay in neonatal intensive care unit (NICU. Neurobehavioral assessment of preterm infants (NAPI scale was used to document the neurobehavioral profile of preterm infants. Descriptive statistics was used to describe the baseline maternal and infant’s characteristics. One sample t test was used for comparing the study sample and standard values provided in NAPI Manual for parametric analysis. Wilcoxon signed rank test was used for comparing variables values between two groups which were not following normal distribution. Results: Scarf sign at 34 and 36 weeks of gestation, motor development and vigor and alertness and orientation components of NAPI showed statistically significant difference between our study sample and standard reference values taken from NAPI manual. However statistically insignificant difference was found in popliteal angle, irritability, cry quality and percent sleep ratings domains of NAPI. Conclusion: present study reported the neurobehavioral profile of our population. We found

  9. Analysis of risk factors of late preterm infants with hyperbilirubinemia%晚期早产儿高胆红素血症危险因素分析

    Institute of Scientific and Technical Information of China (English)

    杨树杰; 易海英; 汪珍珍; 黄杰; 何源; 魏贤; 王艳华

    2014-01-01

    Objective To explore the risk factors of hyperbilirubinemia in late preterm infants. Methods Clinical data of 211 cases of late preterm infants with hyperbilirubinemia and 246 cases of late preterm infants without hyperbilirubinemia were retro-spectively analyzed between 2011 and 2012. The risk factors of hyperbilirubinemia were filtered. Results Twenty-seven cases of late premature infants with hyperbilirubinemia were severe. Hospital stay less than 3 days, birth asphyxia history, small for gestatio-nal age, head hematoma, delivery injury, hypoalbuminemia, polycythemia, infection, hemolytic disease, feeding intolerance, and fe-tal excretion delay were associated with hyperbilirubinemia (P<0.05). Rural origin, pregnancy-induced hypertension syndrome and premature rupture of membrane were also associated with hyperbilirubinemia (P<0.05). Multivariate logistic regression analysis showed the history of birth asphyxia , fetal excretion delay, hypoalbuminemia, pregnancy-induced hypertension syndrome were risk factors of hyperbilirubinemia in late preterm infants (OR=2.35-4.05). Pregnancy-induced hypertension syndrome and hemolytic dis-ease were risk factors of severe hyperbilirubinemia in late preterm infants (OR=5.74, 73.64). Conclusions Neonatal asphyxia, fetal excretion delay, hypoalbuminemia and pregnancy-induced hypertension syndrome are risk factors of hyperbilirubinemia in late pre-term infants. Strengthening the management of pregnancy-induced hypertension syndrome and the treatment of newborn hemolytic disease can reduce the occurrence of severe hyperbilirubinemia in late preterm infants.%目的:探讨晚期早产儿高胆红素血症的危险因素。方法回顾性分析2011年至2012年收治的211例高胆红素血症晚期早产儿和246例非高胆红素血症晚期早产儿的临床资料,分析可能造成晚期早产儿高胆红素血症的危险因素。结果211例高胆红素晚期早产儿中27例为重症,晚期早产儿高胆红素血症

  10. 晚期早产儿近期呼吸系统并发症高危因素分析%Analysis on risk factors of early respiratory complications in late preterm infants

    Institute of Scientific and Technical Information of China (English)

    周宏; 陶珂; 李星云

    2016-01-01

    Objective To explore the risk factors of early respiratory complications in late preterm infants. Methods A total of 112 late preterm infants diagnosed with early respiratory complications were collected as the re-search group. At the same time, 112 late preterm infants without early respiratory complications were selected as the con-trol group. The clinical data was analyzed between the two groups in order to identify the risk factors of early respiratory complications in late preterm infants. Results Single factor analysis showed that the related factors of early respiratory complications in late preterm infants included the pregnancy-induced hypertension syndrome, placenta previa, placental abruption, maternal fever during the late pregnancy, premature rupture of membranes, contamination of amniotic fluid, fetal intrauterine distress, asphyxia, small for gestational age infant, cesarean delivery, incidence of multiple pregnancy and neonatal sepsis (P<0.05). Multivariate logistic regression analysis of the above indexes revealed that maternal fever during the late pregnancy, premature rupture of membranes, fetal intrauterine distress, cesarean delivery, incidence of multiple pregnancy, asphysia, and neonatal sepsis were the risk factors for early respiratory complications in late preterm infants (P<0.05), which have early warning function. Conclusion It is important to focus the risk factors for effective monitoring and follow-up, which could provide timely reasonable intervention for neonates and reduce the incidence of early respiratory complications in late preterm infants and the neonatal mortality.%目的 探讨晚期早产儿发生近期呼吸系统并发症的危险因素.方法 选取2011年1月至2014年12月我院收治的112例发生了近期呼吸系统疾病的晚期早产儿为观察组,随机选取同期收治的112例未发生此类疾病的晚期早产儿为对照组,分别对两组患儿的临床资料进行分析,筛选出晚期早产儿发生

  11. Intracranial haemorrhage: an incidental finding at magnetic resonance imaging in a cohort of late preterm and term infants

    Energy Technology Data Exchange (ETDEWEB)

    Sirgiovanni, Ida; Groppo, Michela; Bassi, Laura; Passera, Sofia; Schiavolin, Paola; Fumagalli, Monica; Mosca, Fabio [Universita degli Studi di Milano, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy); Avignone, Sabrina; Cinnante, Claudia; Triulzi, Fabio [Universita degli Studi di Milano, Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy); Lista, Gianluca [V. Buzzi Children' s Hospital, ICP, Neonatal Intensive Care Unit, Milan (Italy)

    2014-03-15

    Intracranial haemorrhage (ICH) in term newborns has been increasingly recognised but the occurrence in late preterm infants and the clinical presentation are still unclear. To investigate the appearance of intracranial haemorrhage at MRI in a cohort of infants born at 34 weeks' gestation or more and to correlate MRI findings with neonatal symptoms. We retrospectively reviewed neonatal brain MRI scans performed during a 3-year period. We included neonates ≥34 weeks' gestation with intracranial haemorrhage and compared findings with those in babies without intracranial haemorrhage. Babies were classified into three groups according to haemorrhage location: (1) infratentorial, (2) infra- and supratentorial, (3) infra- and supratentorial + parenchymal involvement. Intracranial haemorrhage was observed in 36/240 babies (15%). All of these 36 had subdural haemorrhage. Sixteen babies were included in group 1; 16 in group 2; 4 in group 3. All infants in groups 1 and 2 were asymptomatic except one who was affected by intraventricular haemorrhage grade 3. Among the infants in group 3, who had intracranial haemorrhage with parenchymal involvement, three of the four (75%) presented with acute neurological symptoms. Uncomplicated spontaneous vaginal delivery was reported in 20/36 neonates (56%), vacuum extraction in 4 (11%) and caesarean section in 12 (33%). Babies with intracranial haemorrhage had significantly higher gestational age (38 ± 2 weeks vs. 37 ± 2 weeks) and birth weight (3,097 ± 485 g vs. 2,803 ± 741 g) compared to babies without intracranial haemorrhage and were more likely to be delivered vaginally than by caesarian section. Mild intracranial haemorrhage (groups 1 and 2) is relatively common in late preterm and term infants, although it mostly represents an incidental finding in clinically asymptomatic babies; early neurological symptoms appear to be related to parenchymal involvement. (orig.)

  12. Development of Localized Pulmonary Interstitial Emphysema in a Late Preterm Infant without Mechanical Ventilation

    Directory of Open Access Journals (Sweden)

    Pritish Bawa

    2014-01-01

    Full Text Available Pulmonary interstitial emphysema (PIE is not an uncommon finding in premature infants with respiratory distress who need respiratory support by mechanical ventilation. PIE has been reported in a few cases of neonates in whom either no treatment other than room air was given or they were given continuous positive end-expiratory pressure (CPAP support. We present a case of a premature neonate who presented with respiratory distress, in whom PIE and spontaneous pneumothorax (PTX developed while on CPAP therapy only. The patient was treated conservatively with subsequent resolution of the radiological findings and clinical improvement. No surgical intervention was required. It is important to know that PIE may develop independently of mechanical ventilation. We would like to add this case to the literature and describe the pertinent plain film and computed tomography (CT findings of this entity, the possible mechanism of development, and the differential diagnosis. A review of the literature is also provided.

  13. Development of Localized Pulmonary Interstitial Emphysema in a Late Preterm Infant without Mechanical Ventilation

    Science.gov (United States)

    Soontarapornchai, Kultida; Perenyi, Agnes; Amodio, John

    2014-01-01

    Pulmonary interstitial emphysema (PIE) is not an uncommon finding in premature infants with respiratory distress who need respiratory support by mechanical ventilation. PIE has been reported in a few cases of neonates in whom either no treatment other than room air was given or they were given continuous positive end-expiratory pressure (CPAP) support. We present a case of a premature neonate who presented with respiratory distress, in whom PIE and spontaneous pneumothorax (PTX) developed while on CPAP therapy only. The patient was treated conservatively with subsequent resolution of the radiological findings and clinical improvement. No surgical intervention was required. It is important to know that PIE may develop independently of mechanical ventilation. We would like to add this case to the literature and describe the pertinent plain film and computed tomography (CT) findings of this entity, the possible mechanism of development, and the differential diagnosis. A review of the literature is also provided. PMID:24744939

  14. A pilot study of growth and development of late preterm infants and small for gestational age infants%晚期早产儿与足月小于胎龄儿生长发育状况比较

    Institute of Scientific and Technical Information of China (English)

    张彬彬; 朱敏蓉; 邵志英; 胡雯; 王留娣

    2012-01-01

    Objective To evaluate the growth and development of late preterm infants and full-term small for gestational age (SGA) infants with low birth weight. Methods One hundred 3-year old children with birth weight < 2 500 g were enrolled randomly, 50 of them were late preterm infants and the other 50 children were full-term SGA infants. The anthropometry and Gesell development schedules were performed. Results The birth weight and length of late premature infants were similar as full-term SGA infants but the height, weight and head circumference of late premature children were significantly better than those of full-term SGA children at 3 years old (P < 0.05). The DQs of motor, language, personal-social behavior, and adaptive behavior of late premature children were all significantly higher than those of full-term SGA children (P < 0.05). Conclusions With similar low birth weight, the late preterm children seem to have a better childhood growth and development than full-te,rm SGA children.%目的 比较均为低出生体质量的晚期早产与足月小于胎龄(SGA)儿童的生长和发育状况.方法 随机选取100例出生体质量<2 500 g的3岁儿童,其中50例为晚期早产儿童,50例为足月SGA儿童,对其进行体格测量及盖赛尔(Gesell)发育量表评估.结果 晚期早产和足月SGA儿童的出生体质量、出生身长相近,但3岁时晚期早产儿童的身高、体质量、头围明显优于足月SGA儿童,差异有统计学意义(P<0.05);Gesell发育评估显示,晚期早产儿童的动作能、应物能、语言能、应人能均高于足月SGA儿童,差异有统计学意义(P<0.05).结论 同为低出生体质量,晚期早产儿童的长期生长和发育状况优于足月SGA儿童.

  15. Mother-related factors of late-preterm infants and their short and long term risks%晚期早产儿的母源性影响因素及其近远期风险

    Institute of Scientific and Technical Information of China (English)

    殷张华

    2012-01-01

    晚期早产儿,为胎龄介于34+ (0-7)至36 +(6-7)孕周出生的新生儿.虽然晚期早产儿的外观发育特点与足月儿相近,但因其各系统尚未完全发育成熟,导致其并发症发生率与病死率均高于足月儿.人们逐渐认识到,要降低晚期早产率必须研究其发生原因并进行本质干预.目前发现母亲孕期某些高危因素与晚期早产的发生有着密切联系,如妊娠期高血压、妊娠期贫血、胎膜早破等,并且这些母源性因素将对晚期早产儿出生后的生长发育有重要影响.%Late-preterm infants are the neonates whose gestational ages are from 34+(0-7) to 36+(67)weeks.Although they look like term infants,their organs are immature.So the incidence of complication and mortality in late-preterm infants are higher than those of term infants.Now people have gradually realized that we could reduce the incidence of late-premature birth by exploring the pathogenesis of late-premature birth and trying to intervene it.People also have found that some maternal risk factors during pregnancy lead to latepreterm birth easily,such as pregnancy hypertension,pregnancy anemia,premature rupture of membranes,etc.These factors have significant impacts on the growth and development of late-preterm infants after birth.This paper is to review the progress of some maternal factors of late-preterm infants and their short and long term risks.

  16. 晚期早产儿高胆红素血症危险因素分析%Analysis of Risk Factors of Late Preterm Infants with Hyperbilirubinemia

    Institute of Scientific and Technical Information of China (English)

    刘增芳; 梅玲华; 贺兆平; 彭晓华

    2015-01-01

    目的:总结晚期早产儿高胆红素血症的临床特征并分析其危险因素,为疾病诊断与治疗提供依据。方法:选取收治的184例高胆红素血症晚期早产儿为研究对象(研究组),并随机选取同期收治的184例非高胆红素血症晚期早产儿作为对照(对照组),分别对两组患儿的临床资料进行分析,筛选出晚期早产儿高胆红素血症的危险因素。结果:对两组患儿中对单因素分析有统计学意义的指标进行Logistic回归分析,结果显示,妊高症、胎膜早破、母子血型不合、体重偏低、新生儿有窒息史与感染史、头颅血肿等7个变量检验有统计学意义(P<0.05),是晚期早产儿高胆红素血症的危险因素,具有早期预警功能。结论:早期对晚期早产儿高胆红素血症各危险因素进行有效监测与随访,可及时对患儿进行合理的干预,从而有效降低新生儿高胆红素血症的发生率与死亡率。%Objective: To summarize the risk factors of late preterm infants with hyperbilirubinemia . Method:The clinical data of 184 children diagnosed with hyperbilirubinemia were collected as the research group.At the same time, 184 cases of late preterm infants with normal hyperbilirubinemia were collected as control group .The clinical data was analyzed between the two groups in order to select the risk factor of late preterm infants with hyperbilirubinemia .Result:According to the single factor analysis ,logistic regression a-nalysis of index was analyzed .The result revealed seven index had statistically significant that included gesta-tional hypertension , premature rupture of membranes , different blood type between mother and child , low weight, asphyxia,infection history and head haematoma (P <0.05).The risk factor for late preterm high bili-rubin concentration has early warning function .Conclusion:It's important to focus the risk factors for effec-tive monitoring and

  17. 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 neurodevelopmenta

  18. 晚期早产儿的研究进展%Progress of research on late preterm infants

    Institute of Scientific and Technical Information of China (English)

    谢露; 尹晓娟

    2011-01-01

    @@ 当前国外把34周≤胎龄(gestational age,GA)<37周的早产儿视为早产儿亚群,定义为接近足月儿/晚期早产儿(Late Preterm Infants, LPIs)[1].因为"晚期早产儿"能更好地反映出接近足月儿人群有着较高风险的并发症,所以推荐使用"晚期早产儿"取代"接近足月儿"[2].虽然与出生体重600 g的微型儿相比,晚期早产儿的发病率很轻微,但其人数众多,却成了巨大的医疗负担[3].

  19. 晚期早产儿发生率及其母源性因素分析%Incidence and analysis of mother-related factors of late preterm infants

    Institute of Scientific and Technical Information of China (English)

    殷张华; 钱继红; 赵冬莹; 朱天闻; 张永红; 王蓓; 朱建幸

    2013-01-01

    目的 观察晚期早产儿的发生率和变化趋势,并分析其母源性影响因素.方法 采用流行病学调查方法,分析2001-2011年上海交通大学医学院附属新华医院产科所有早产儿和晚期早产儿的发生率.同时,收集该院2011年出生的新生儿,将晚期早产儿(n=183)和足月儿(n =2 144)作为观察对象,分析两组新生儿的出生情况及预后指标,并对母源性指标进行单因素和多因素分析.结果 流行病学资料显示,2001-2011年该院产科晚期早产儿总发生率为5.47%,占早产儿总数的67.39%;每年的早产儿、晚期早产儿发生率基本呈逐年上升趋势.晚期早产儿组与足月儿组的出生体质量、出生方式、住院时间及出生后因并发症转入新生儿科的比例差异均有统计学意义(P<0.05或P<0.01);对于两组中转入新生儿病区的患儿,足月儿组的预后明显优于晚期早产儿组(P<0.01).单因素和多因素分析显示:母亲有妊娠期高血压疾病、贫血、心功能异常、胎膜早破、前置胎盘、多胎妊娠及吸烟为晚期早产的独立危险因素.结论 晚期早产儿发生率呈上升趋势,产科医师应对母源性危险因素进行针对性干预.%Objective To observe the trend of birth rate of late preterm infants,and explore the mother-related factors.Methods The annual birth rates of premature and late preterm infants born at Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine between 2001 and 2011 were analyzed with the method of epidemiological survey.Meanwhile,the data of infants who were born at this hospital in 2011 were collected,and all the late preterm infants (n =183) and term infants (n =2 144) were observed.The data of birth and prognosis in two groups were analyzed,and their mother-related factors were recorded for univariate and multivariate analysis.Results The epidemiological data revealed that the overall birth rate of late preterm infants

  20. 晚期早产儿相关病因及并发症的研究进展%Research Progress of Related Diseases and Complications of Late Preterm Infants

    Institute of Scientific and Technical Information of China (English)

    樊珏(综述); 顾琴(审校)

    2015-01-01

    孕34~36+6周出生的新生儿称晚期早产儿,占早产儿的70%,临床上又称为近足月儿。近年来,我国晚期早产儿在早产儿中的比例不断上升,晚期早产儿人数逐年增加。多数研究发现,晚期早产儿的健康状况不太理想,与足月儿相比存在较多的健康问题,晚期早产儿的病死率、患病率均较高,神经发育与足月儿相比较为迟缓,晚期早产儿出生后出现并发症的风险较大,如新生儿湿肺、呼吸窘迫综合征、体温不稳定、黄疸、持续肺动脉高压、呼吸困难和喂养困难等。%Neonatals who are born after 34-36 +6 weeks′gestation are called late preterm infants,clini-cally also known as near-term infants.They account for 70%of premature infants.In recent years,the propor-tion as well as the number of late preterm infants has been increasing .According to most researches, the health situation of late preterm infants is not ideal,for compared with full-term infants,late preterm infants have more health problems such as higher fatality rate and illness rate ,slower neural development.Besides, they tend to suffer from higher risk of complications like neonatal wet lung ,respiratory distress syndrome, unstable body temperature,jaundice,continued high pulmonary pressure,dyspnea and feeding difficulties.

  1. Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: a prospective population-based study

    Science.gov (United States)

    Boyle, Elaine M; Johnson, Samantha; Manktelow, Bradley; Seaton, Sarah E; Draper, Elizabeth S; Smith, Lucy K; Dorling, Jon; Marlow, Neil; Petrou, Stavros; Field, David J

    2015-01-01

    Objective To describe neonatal outcomes and explore variation in delivery of care for infants born late (34–36  weeks) and moderately (32–33 weeks) preterm (LMPT). Design/setting Prospective population-based study comprising births in four major maternity centres, one midwifery-led unit and at home between September 2009 and December 2010. Data were obtained from maternal and neonatal records. Participants All LMPT infants were eligible. A random sample of term-born infants (≥37 weeks) acted as controls. Outcome measures Neonatal unit (NNU) admission, respiratory and nutritional support, neonatal morbidities, investigations, length of stay and postnatal ward care were measured. Differences between centres were explored. Results 1146 (83%) LMPT and 1258 (79% of eligible) term-born infants were recruited. LMPT infants were significantly more likely to receive resuscitation at birth (17.5% vs 7.4%), respiratory (11.8% vs 0.9%) and nutritional support (3.5% vs 0.3%) and were less likely to be fed breast milk (64.2% vs 72.2%) than term infants. For all interventions and morbidities, a gradient of increasing risk with decreasing gestation was evident. Although 60% of late preterm infants were never admitted to a NNU, 83% required medical input on postnatal wards. Clinical management differed significantly between services. Conclusions LMPT infants place high demands on specialist neonatal services. A substantial amount of previously unreported specialist input is provided in postnatal wards, beyond normal newborn care. Appropriate expertise and planning of early care are essential if such infants are managed away from specialised neonatal settings. Further research is required to clarify optimal and cost-effective postnatal management for LMPT babies. PMID:25834169

  2. Epidemiology of respiratory distress and the illness severity in late preterm or term infants: a prospective multi-center study

    Institute of Scientific and Technical Information of China (English)

    MA Xiao-lu; YI Bin; SHI Jing-yun; DU Li-zhong; XU Xue-feng; CHEN Chao; YAN Chao-ying; LIU Ya-ming; LIU Ling; XIONG Hong; SUN Hui-qing; LAI Jian-pu

    2010-01-01

    Background The severity of respiratory distress was associated with neonatal prognosis. This study aimed to explore the clinical characteristics, therapeutic interventions and short-term outcomes of late preterm or term infants who required respiratory support, and compare the usage of different illness severity assessment tools.Methods Seven neonatal intensive care units in tertiary hospitals were recruited. From November 2008 to October 2009, neonates born at ≥34 weeks' gestational age, admitted at <72 hours of age, requiring continuous positive airway pressure (CPAP) or mechanical ventilation for respiratory support were enrolled. Clinical data including demographic variables, underlying disease, complications, therapeutic interventions and short-term outcomes were collected. All infants were divided into three groups by Acute care of at-risk newborns (ACoRN) Respiratory Score <5, 5-8, and >8.Results During the study period, 503 newborn late preterm or term infants required respiratory support. The mean gestational age was (36.8±2.2) weeks, mean birth weight was (2734.5±603.5) g. The majority of the neonates were male (69.4%), late preterm (63.3%), delivered by cesarean section (74.8%), admitted in the first day of life (89.3%) and outborn (born at other hospitals, 76.9%). Of the cesarean section, 51.1% were performed electively. Infants in the severe group were more mature, had the highest rate of elective cesarean section, Apgar score <7 at 5 minutes and resuscitated with intubation, the in-hospital mortality increased significantly. In total, 58.1% of the patients were supported with mechanical ventilation and 17.3% received high frequency oscillation. Adjunctive therapies were commonly needed.Higher rate of infants in severe group needed mechanical ventilation or high frequency oscillation, volume expansion,bicarbonate infusion or vasopressors therapy (P <0.05). The incidence of complications was also increased significantly in severe group (P

  3. 晚期早产儿颅内出血的相关因素分析%Correlative Factors of Intraccranial Hemorrhage in Late Preterm Infants

    Institute of Scientific and Technical Information of China (English)

    于茂敏; 崔凯洁; 姜红

    2013-01-01

    目的:探讨晚期早产儿颅内出血的相关因素,指导晚期早产儿颅内出血的防治.方法:2011年9月至2012年8月我院收治晚期早产儿253例,其中有210例行头颅MRI检查,以经头颅MRI检查确诊颅内出血30例为ICH组,同时随机抽取同期住院的经头颅MRI证实无颅内出血晚期早产儿60例作为对照组.应用SPSS 17.0进行统计学分析.结果:1.ICH组产前激素应用率显著低于对照组(P<0.05).2.ICH组经阴分娩、胎膜早破、代谢性酸中毒发生率显著高于对照组(P<0.05).3.Logistic回归分析显示产前激素是颅内出血的保护因素(P<0.05),而经阴分娩、胎膜早破(P<0.01)、代谢性酸中毒(P<0.05)是颅内出血的危险因素.结论:产前应用激素是晚期早产儿颅内出血的保护因素,经阴分娩、胎膜早破、代谢性酸中毒是晚期早产儿颅内出血高危因素.%Objective:To investigate the corrective factors of intracranial hemorrhage (ICH) in late preterm infants and to guild how to prevent ICH.Methods:The study was conducted between Sep.2011 and Aug.2012.210 cases with 253 late preterm infants were performed by cranial magnetic resonance imaging examinations.30 cases diagnosed as ICH by MRI were the ICH group,60 cases selected randomly from infants excluded ICH by MRI were the control group.SPSS 17.0 software was used to analyze the data.Results:1.The antenatal dexamethasone treatment in ICH group was significantly higher than that of premature newborns in control group (P<0.05).2.The vaginal delivery,premature rupture of membrances and metabolic acidosis in ICH group was significantly lower than that in the control group (P<0.05).3.Logistic regression analysis showed that antenatal dexamethasone was the protective factores for ICH(P<0.05),and vaginal delivery,premature rupture of membrances (P<0.01) and metabolic acidosis (P<0.05)were risk factors for ICH.Conclusion:Antenatal dexamethasone is the protective factors for ICH

  4. Acute histologic chorioamnionitis is a risk factor for adverse neonatal outcome in late preterm birth after preterm premature rupture of membranes.

    Science.gov (United States)

    Lee, Seung Mi; Park, Jeong Woo; Kim, Byoung Jae; Park, Chan-Wook; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun

    2013-01-01

    The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005) than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM.

  5. Acute histologic chorioamnionitis is a risk factor for adverse neonatal outcome in late preterm birth after preterm premature rupture of membranes.

    Directory of Open Access Journals (Sweden)

    Seung Mi Lee

    Full Text Available BACKGROUND: The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. METHODOLOGY/PRINCIPAL FINDINGS: The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005 than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. CONCLUSIONS/SIGNIFICANCE: The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM.

  6. Acute Histologic Chorioamnionitis Is a Risk Factor for Adverse Neonatal Outcome in Late Preterm Birth after Preterm Premature Rupture of Membranes

    Science.gov (United States)

    Lee, Seung Mi; Park, Jeong Woo; Kim, Byoung Jae; Park, Chan-Wook; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun

    2013-01-01

    Background The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. Methodology/Principal Findings The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005) than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. Conclusions/Significance The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM. PMID:24324586

  7. 晚期早产儿脑损伤的常见发病因素%Risk factors of brain injury in late preterm infants

    Institute of Scientific and Technical Information of China (English)

    李丽华; 孔祥永; 孔令凯

    2011-01-01

    晚期早产儿又称近足月儿.该胎龄的早产儿外表接近成熟,由于器官发育不成熟,比足月儿存在更大发病风险,脑损伤与足月儿相比发病风险明显增加,脑性瘫痪的发病率增加3倍,生长发育/心理发育迟缓也有明显增多,这主要与晚期早产儿脑发育不成熟有关.晚期早产儿其他系统的常见病发生率也比较高,如窒息、低血糖、高胆红素血症、呼吸窘迫综合征、喂养困难等,这些疾病也可不同程度地影响脑发育,造成脑损伤.%Late preterm is labeled near term. As developmental immaturity, there was higher morbidity in late preterm infants compared with term infants. Especially brain injury, a 3-fold increased risk of cerebralpalsy and significantly higher rates of developmental delay and mental retardation for late preterm infants compared with term infants. In addition, a higher rates of neonatal complications had been documented on late preterm infants. These problems included apnea, hypoglycemia, hyperbilirubinemia, respiratory distress syndome, and poor feeding. It was known that long-term impact of these diseases will result in brain injury.

  8. Risk factors of late preterm birth and perinatal complications among late preterm infant%晚期早产的危险因素及围产期并发症分析

    Institute of Scientific and Technical Information of China (English)

    张莹; 赫英东; 陈倩

    2014-01-01

    To analyze maternal and neonatal complications among late preterm birth cases and to investigate risk factors of late preterm birth. Methods This was a retrospective analysis of 258 late preterm cases (late preterm group) born in Peking University First Hospital from January 1, 2009 to December 31, 2010. Maternal comorbidity and complications, delivery modes, and neonatal complications of these 258 late preterm infants were compared with 308 term cases (term group) during the same period. Statistical analysis was performed usingχ2 test, Fisher's exact probability test, t test and logistic regression. Results In Peking University First Hospital, late preterm births accounted for 3.9%(258/6 695) of live births and 60.1%(258/429) of preterm births. The incidence of the following maternal complications among the late preterm group was higher than that among term group(all P<0.05): severe pre-eclampsia [7.4%(19/258) vs 1.0%(3/308), χ2=15.35]; preterm rupture of membrane [42.6%(110/258) vs 15.3%(47/308), χ2=52.49];cervical insufficiency [1.9%(5/258) vs 0.0%(0/308), Fisher's exact test];placenta previa[3.5%(9/258) vs 0.6%(2/308), Fisher's exact test] and placental abruption [2.7%(7/258) vs 0.3%(1/308), Fisher's exact test]. Severe pre-eclampsia was the major risk factor leading to late preterm birth. The incidence of the following neonatal complications among the late preterm group was higher than that among term group (all P<0.05):respiratory distress syndrome (NRDS) [11.6%(30/258) vs 1.6%(5/308), χ2=24.22]; hyperbilirubinemia [64.3%(166/258) vs 39.6%(122/308),χ2=34.36];electrolyte disturbance [12.8%(33/258) vs 1.6(95/308),χ2=27.96];hypothermia [7.0%(18/258) vs 2.9%(9/308),χ2=5.08];infectious pneumonia[13.6%(35/258) vs 3.2%(10/308), χ2=20.43]; leukoencephalopathy [3.1%(8/258) vs 0.3%(1/308), χ2=5.25]; low body temperature [18.6%(48/258) vs 3.6%(11/308),χ2=33.98] and neonatal asphyxia [6.2%(16/258) vs 1.0%(3/308),χ2=11.86]. The incidence of the following

  9. Prospective validation of a prognostic model for respiratory syncytial virus bronchiolitis in late preterm infants: a multicenter birth cohort study.

    Directory of Open Access Journals (Sweden)

    Maarten O Blanken

    Full Text Available OBJECTIVES: This study aimed to update and validate a prediction rule for respiratory syncytial virus (RSV hospitalization in preterm infants 33-35 weeks gestational age (WGA. STUDY DESIGN: The RISK study consisted of 2 multicenter prospective birth cohorts in 41 hospitals. Risk factors were assessed at birth among healthy preterm infants 33-35 WGA. All hospitalizations for respiratory tract infection were screened for proven RSV infection by immunofluorescence or polymerase chain reaction. Multivariate logistic regression analysis was used to update an existing prediction model in the derivation cohort (n = 1,227. In the validation cohort (n = 1,194, predicted versus actual RSV hospitalization rates were compared to determine validity of the model. RESULTS: RSV hospitalization risk in both cohorts was comparable (5.7% versus 4.9%. In the derivation cohort, a prediction rule to determine probability of RSV hospitalization was developed using 4 predictors: family atopy (OR 1.9; 95%CI, 1.1-3.2, birth period (OR 2.6; 1.6-4.2, breastfeeding (OR 1.7; 1.0-2.7 and siblings or daycare attendance (OR 4.7; 1.7-13.1. The model showed good discrimination (c-statistic 0.703; 0.64-0.76, 0.702 after bootstrapping. External validation showed good discrimination and calibration (c-statistic 0.678; 0.61-0.74. CONCLUSIONS: Our prospectively validated prediction rule identifies infants at increased RSV hospitalization risk, who may benefit from targeted preventive interventions. This prediction rule can facilitate country-specific, cost-effective use of RSV prophylaxis in late preterm infants.

  10. Late preterms: A vulnerable group needing due attention

    Directory of Open Access Journals (Sweden)

    Milind M Jambagi

    2012-01-01

    Full Text Available "Late preterms may be apparently normal but a vulnerable group of preterm infants needing due attention both by the Obstetricians and Pediatricians. Late preterms like any other preterms are vulnerable to complications such as Respiratory Distress Syndrome (RDS and other complications seen in a preterm infant. The American Congress of Obstetricians and Gynecologists guidelines recommend administration of antenatal corticosteroids in a mother in premature labor only up to the gestational age of 34 weeks. This is a case report of a preterm baby with a gestational age of 35 weeks which presented with RDS. We are hereby reporting this case to draw attention of the Obstetricians and Pediatricians toward this entity of ′Late Preterm′ to provide better care to them and obtain better outcomes."

  11. Validation of transcutaneous bilirubin nomogram for identifying neonatal hyperbilirubinemia in healthy Chinese term and late-preterm infants: a multicenter study

    Directory of Open Access Journals (Sweden)

    Zhangbin Yu

    2014-06-01

    Full Text Available OBJECTIVE: to prospectively validate a previously constructed transcutaneous bilirubin (TcB nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. METHODS: this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia. RESULTS: in the present study, 972 neonates (10.6% developed significant hyperbilirubinemia. The 40th percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV (18.9%. Of the 453 neonates above the 95th percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%, but with low sensitivity (28.3%. The 75th percentile was highly specific (81.9% and moderately sensitive (79.8%. The area under the curve (AUC for the TcB nomogram was 0.875. CONCLUSIONS: this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination.

  12. 晚期早产儿和足月儿 RDS 的临床分析%Clinical analysis of RDS in late preterm infants and full-term infants

    Institute of Scientific and Technical Information of China (English)

    杨峻

    2015-01-01

    目的:探讨晚期早产儿和足月儿呼吸窘迫综合征(RDS)的高危因素和临床特点。方法收集新生儿科住院的 RDS 患儿共106例,按胎龄分为早产儿组(34周)44例,回顾分析其特点。结果选择性剖宫产、绒毛膜羊膜炎、妊娠期糖尿病是晚期早产儿/足月儿组 RDS 的高危因素(P0.05),需要机械通气比例高(P34 weeks) with 44 cases. Their characteristics were retrospectively analyzed. Results Selective cesarean section, chorioamnionitis, and gestational diabetes mellitus were the high risk factors for RDS in the late preterm infants/full-term infants group (P0.05) and higher proportion of mechanical ventilation (P<0.05). The late preterm infants/full-term infants group had high occurrence of RDS complicated with pneumothorax (P<0.05). Conclusion ①Selective cesarean section, chorioamnionitis, and gestational diabetes mellitus are the high risk factors for RDS in the late preterm infants/full-term infants group. ②The late preterm infants/full-term infants contain worse RDS symptoms and higher incidence of pneumothorax.

  13. Neurodevelopmental outcome at 18 months of late preterm infants%晚期早产儿出生18月龄神经发育情况

    Institute of Scientific and Technical Information of China (English)

    鲁利群; 屈艺; 母得志

    2015-01-01

    目的 前瞻性研究出生18月龄晚期早产儿的神经发育情况.方法 2009年1月至12月四川省成都市北部地区三家医院出生的7 584例活产新生儿,纳入标准的晚期早产儿89例,以健康足月儿170例为对照,随访18个月,矫正胎龄至40周时应用20项新生儿行为神经测查法,矫正年龄3、6、9、12和18月龄时应用贝利婴儿发展量表,进行神经行为发育评估,比较晚期早产儿和足月儿的神经行为发育情况.结果 成功随访的晚期早产儿63例,足月儿115例,矫正胎龄至40周时新生儿行为神经测查结果显示,晚期早产儿评分处于正常范围(≥37分)的比例明显低于足月儿(82.5%比94.8%),评分异常(<35分)者明显高于足月儿(4.8%比0),评分处于临界值(35 ~ 36分)者明显高于足月儿(12.7%比5.2%),2组比较差异有统计学意义(Z=-2.707,P<0.05);贝利婴儿发展量表测查结果显示,晚期早产儿运动发育指数(PDI)得分中位数在矫正年龄3、6、9、12月龄时低于足月儿,差异均有统计学意义(t=-4.266、-4.594、-5.663、-2.584,P均<0.05);晚期早产儿智力发育指数(MDI)得分中位数在矫正年龄3、6、9、12月龄时低于足月儿,差异均有统计学意义(t=-7.121、-7.829、-7.038、-6.002,P均<0.05);矫正年龄18月龄时MDI得分低于足月儿,差异有统计学意义(t=-4.115,P<0.05),PDI得分虽低于足月儿,但差异无统计学意义(t=-0.957,P>0.05).结论 晚期早产儿神经行为发育在出生第1年明显延迟,18月龄时其智能发育仍落后于足月儿.应制定适宜的早教措施,促进晚期早产儿早期的神经行为发育.%Objective To study the neurodevelopmental outcome prospectively at 18 months of the late preterm infants.Methods Data from 7 584 live born neonates were collected between January and December.2009 in 3 hospitals located in the north of Chengdu City,Sichuan Province were collected,89 late preterm infants were brought into

  14. Incidence, management and outcomes of cardiovascular insufficiency in critically ill term and late preterm newborn infants

    Science.gov (United States)

    Fernandez, Erika; Watterberg, Kristi L.; Faix, Roger G.; Yoder, Bradley A.; Walsh, Michele C.; Lacy, Conra Backstrom; Osborne, Karen A.; Das, Abhik; Kendrick, Douglas E.; Stoll, Barbara J.; Poindexter, Brenda B.; Laptook, Abbot R.; Kennedy, Kathleen A.; Schibler, Kurt; Bell, Edward F.; Van Meurs, Krisa P.; Frantz, Ivan D.; Goldberg, Ronald N.; Shankaran, Seetha; Carlo, Waldemar A.; Ehrenkranz, Richard A.; Sánchez, Pablo J.; Higgins, Rosemary D.

    2014-01-01

    Objective To characterize the incidence, management and short term outcomes of cardiovascular insufficiency (CVI) in mechanically ventilated newborns, evaluating 4 separate pre-specified definitions. Study Design Multicenter, prospective cohort study of infants ≥34 weeks gestational age (GA) and on mechanical ventilation during the first 72 hours. CVI was prospectively defined as either (1) mean arterial pressure (MAP) infants, 46% did not have CVI as defined by a MAP < GA ± signs of inadequate perfusion. Inotrope therapy was associated with increased mortality (11.1% vs. 1.3%; P < 0.05). Conclusion More than half of the infants met at least one definition of CVI. However, almost half of the treated infants met none of the definitions. Inotropic therapy was associated with increased mortality. These findings can help guide the design of future studies of CVI in newborns. PMID:24515617

  15. Nursing care exploration for clinical complications of the late-preterm infant%晚期早产儿并发症及护理的研究

    Institute of Scientific and Technical Information of China (English)

    姜桂荣

    2012-01-01

    Objective To analyse clinical complications of the late-preterm infants so as to explore the care strategies for them.Methods Totals of 312 late-preterm infants were experiment group in newborn department of Heze Municipal Hospital from January 2005 to December 2010 and full term infants horned in same time were control group.The clinical manifestations such as blood glucose,jaundice,the conditions of blood,urine,excrement and so on,and clinical complications of all infant were observed and compared.Results Among 260 cases (83.3%) of 312 late-preterm infants had complications,87 cases had more than two kinds of complications.The occurrence rate of pathological jaundice of late-preterm infants was 65.7%significantly higher than 33.5% that of full term infants ( x2 =35.772,P <0.05),and there was significantly different in other 9 kinds of complications ( P < 0.05 ).Conclusions Late-preterm infants have more complications than full term infants,so it is important to attention the treatment and nursing for late-preterm infants.%目的 分析晚期早产儿临床并发症发生情况,探讨晚期早产儿护理管理策略.方法 选择2005-2010年菏泽市立医院新生儿科收治的胎龄满34周而不足37周的312例晚期早产儿作为实验组,同时期本院产科出生的足月新生儿作为对照组,比较两组新生儿临床征象变化,实验室相关检查,分析其临床并发症发生情况.结果 312例晚期早产儿中并发症发生率为83.3%,其中有87例发生了两种或以上并发症,占27.9%.晚期早产儿病理性黄疸发生率为65.7%,足月新生儿为33.5%,两组比较差异有统计学意义(x2=35.772,P<0.05),其余9项并发症差异均有统计学意义(P<0.05).晚期早产儿组较足月新生儿更易发生呼吸系统并发症,两组新生儿呼吸窘迫综合征( NRDS)、新生儿肺炎发生率比较差异有统计学意义(x2分别为24.762,9.720;P <0.05).结论 晚期早产儿较足月新生儿易

  16. Long-chain polyunsaturated fatty acids in breast-milk and erythrocytes and neurodevelopmental outcomes in Danish late-preterm infants

    DEFF Research Database (Denmark)

    Andersen, Stine Brøndum; Hellgren, Lars I; Larsen, Mette Krogh

    2015-01-01

    on regulation (p=0.03). Infant RBC-AA at 1 month was also associated with a lower 1-year corrected age BSID-III score of receptive language (p=0.05) and fine motor development (p=0.03). Infant RBC-DHA did not ecrease significantly after delivery and was not associated with any of the developmental outcomes......Background: The supply of long-chain polyunsaturated fatty acids (LC-PUFA) during pregnancy and early lactation has been shown to affect cognitive development in preterm infants, but the effect on early neurodevelopment of late-preterm infants has not yet been examined. Aim: To examine the fatty....... Conclusion: Breast-milk LC-PUFA content was reflected in the RBC LC-PUFA status of the infant. Early RBC-AA status was associated with both early and long-term neurobehavioral development, but not in a consistent way....

  17. Validation of transcutaneous bilirubin nomogram for identifying neonatal hyperbilirubinemia in healthy Chinese term and late-preterm infants: a multicenter study.

    Science.gov (United States)

    Yu, Zhangbin; Han, Shuping; Wu, Jinxia; Li, Mingxia; Wang, Huaiyan; Wang, Jimei; Liu, Jiebo; Pan, Xinnian; Yang, Jie; Chen, Chao

    2014-01-01

    to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia. in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40(th) percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95(th) percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75(th) percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875. this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. 晚期早产儿的临床回顾分析%Retrospective survey on health issues of late preterm infants

    Institute of Scientific and Technical Information of China (English)

    陈冬梅; 何颖; 王瑞泉

    2009-01-01

    目的 研究晚期早产儿存在的临床问题.方法 回顾性总结我院新生儿病房及新生儿监护病房2007年9月至2008年9月收治的晚期早产儿508例、足月儿1 514例的临床资料.记录低体温、呼吸窘迫、暂时性呼吸增快、低血糖、黄疸、颅内出血的发生率及临床转归.结果 与足月儿相比.晚期早产儿低体温(13.4%vs 0)、低血糖(19.9%vs 3.0%)、呼吸窘迫(38.6%vs 10.8%)、暂时性呼吸增快(31.0%vs 13.1%)、颅内出血(5.1%vs 2.3%)、黄疽(55.0%vs 33.0%)及喂养不耐受(52.4%vs 14.2%)的发生率高,差异有非常显著性(P<0.01).晚期早产儿接受机械通气、应用肺表面活性物质和经鼻持续气道正压通气呼吸支持的比例高于足月儿(P<0.05,P<0.01).晚期早产儿未完成治疗的比例高于足月儿(P<0.01).结论 晚期早产儿比足月儿存在更多的临床问题,是不应被忽视的高危人群.%Objective To analyze if late preterm infants have more postnatal health issues than full term infants.Methods Two thousands four hundreds and ten neonatal records were reviewed from August 31st 2007 to September 1st 2008.There were totally 508 late preterm and 1 514 full term infants were admitted during that time.The incidence of hypothermia,jaundice,hypoglycemia,transient tachypnea of newborn,feeding difficulties,respiratory distress and intracranial hemorrhage was collected.Clinical prognosis was analyzed.Results The incidence of hypothermia was significantly higher in late preterm infants group as compared to full term infants group(13.4% vs 0),same as hypoglycemia(19.9% vs 3.0%,P <0.01),respiratory distress(38.6% vs 10.8%,P < 0.01),jaundice(55.0% vs 33.0%,P < 0.01),feeding difficulties (52.4% vs 14.2%,P <0.01),transient tachypnea of newborn(31.0% vs 13.1%,P <0.01)and intracranial hemorrhage(5.1% vs 2.3%,P <0.01).The proportion of ventilation,the usage of surfactant and nasal continuous positive airway pressure were higher in late

  19. Late-preterm birth in a level III hospital: incidence and associated morbidity

    Directory of Open Access Journals (Sweden)

    Carla Garcez

    2016-03-01

    Full Text Available Introduction: Late-preterm infants are physiologically and metabolically immature and have important risk of morbidity and mortality.Aim: To analyze the incidence of late prematurity and its associated morbidity and mortality at a level III hospital between 2011 and 2013.Methods: This was a descriptive and retrospective study of infants born between 34 + 0/7 and 36 + 6/7 weeks’ gestation and its associated morbidity and mortality. Medical records were reviewed.Results: In a 3-year period there were 8,458 births of witch 513 (6.1% were late-preterm infants. Of these, 99/513 (19.3% had 34 weeks’ gestation, 145/513 (28.3% had 35 weeks’ gestation and 269/513 (52.4% had 36 weeks’ gestation. Late-preterm birth rate was 5.7% in 2011, 6.9% in 2012 and 5.6% in 2013 (p = 0.08. In relation to birth weight, 269 (52.4% of late-preterm infants had low birth weight. There was an association between gestational age and birth weight (p = 0.002.Of the 513 late-preterm infants, 177 (34.5% were admitted to the Neonatal Intensive Care Unit (NICU and more often at 34 weeks’ gestation (69/99, 69.7% than at 35 (57/145, 39.3% and 36 (51/269, 19.0% weeks’ gestation (p < 0.001. Most frequent clinical diagnoses were hyperbilirubinemia (112/177, 63.3%, feeding difficulties (111/177, 62.7%, transient tachypnea of the newborn (71/177, 40.1%, hypoglycemia (38/177, 21.5%, intrauterine growth restriction (33/177, 18.6%. Average length of hospitalization was 12 days. Newborns of 34 weeks’ gestation were longer admitted than newborns of 35 and 36 weeks’ gestation (15.3 vs 9.8 vs 10.8 days; p = 0.002. There was one death due to sepsis after surgical correction of gastroschisis.Conclusion: The incidence of late-preterm birth remained stable between 2011 and 2013. Late-preterm hospitalization rate in the NICU was 34.5%. Hyperbilirubinemia, feeding difficulties and respiratory disease were the main diagnosis. Late-preterm of 34 weeks’ gestation were admitted more

  20. Clinical Analysis of 32 Late Preterm and Mature Infants with Respiratory Distress Syndrome%32例晚期早产儿和足月儿呼吸窘迫综合征临床分析

    Institute of Scientific and Technical Information of China (English)

    高明

    2012-01-01

    Objective To investigate the clinical characteristics of respiratory distress syndrome (RDS) in mature and late-preterm infants. Methods The RDS neonates from January 2004 to September 2011 in our hospital were collected. 32 mature and late- preterm infants with the gestational age more than 34 weeks were included in the experimental group, while 36 premature infants with the gestational age less than 34 weeks were attributed to the control group. The cause of disease, clinical manifestation , therapeutic measures and complications were analyzed and compared between the two groups. Results (DThe main causes of disease were the premature delivery in the control group,but were the selective caesarean section,perinatal asphyxia and meco-nium aspiration in the experimental group. ㏕he application of mechanical ventilation ( MV ) was later in the experimental group, and the 01 was higher 24 h after using the convention dosage of exogenous pulmonary surfactant (P < 0.05 ). Conclusion The main cause of RDS in mature and late- preterm infants were the selective caesarean section and perinatal asphyxia,the need for the mechanical ventilation is later,and the curative effect of exogenous pulmonary surfactant is not as good as the premature infants. The persistent pulmonary hypertension of the newbora(PPHN) , pneumothorax and multiple organ dysfunction syndrome are the common complications.%目的 了解晚期早产儿和足月儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的临床特征,提高对该病的认识.方法 将皖北煤电集团总医院新生儿病房2004年1月-2011年9月收治的32例胎龄≥34周的晚期早产儿或足月儿RDS为研究对象,即晚期早产儿-足月儿组;同期收治的胎龄<34周早产儿RDS 36例为对照组,即早产儿组.对两组患儿的病因、临床表现、治疗措施和并发症等资料进行对比分析.结果 ①两组发生RDS的病因不同:早产儿以早产为主要病因,晚期早产儿或足月

  1. Center Variation in the Delivery of Indicated Late Preterm Births.

    Science.gov (United States)

    Aliaga, Sofia; Zhang, Jun; Long, D Leann; Herring, Amy H; Laughon, Matthew; Boggess, Kim; Reddy, Uma M; Grantz, Katherine Laughon

    2016-08-01

    Objective Evidence for optimal timing of delivery for some pregnancy complications at late preterm gestation is limited. The purpose of this study was to identify center variation of indicated late preterm births. Study design We performed an analysis of singleton late preterm and term births from a large U.S. retrospective obstetrical cohort. Births associated with spontaneous preterm labor, major congenital anomalies, chorioamnionitis, and emergency cesarean were excluded. We used modified Poisson fixed effects logistic regression with interaction terms to assess center variation of indicated late preterm births associated with four medical/obstetric comorbidities after adjusting for socio-demographics, comorbidities, and hospital/provider characteristics. Results We identified 150,055 births from 16 hospitals; 9,218 were indicated late preterm births. We found wide variation of indicated late preterm births across hospitals. The extent of center variation was greater for births associated with preterm premature rupture of membranes (risk ratio [RR] across sites: 0.45-3.05), hypertensive disorders of pregnancy (RR across sites: 0.36-1.27), and placenta previa/abruption (RR across sites: 0.48-1.82). We found less center variation for births associated with diabetes (RR across sites: 0.65-1.39). Conclusion Practice variation in the management of indicated late preterm deliveries might be a source of preventable late preterm birth.

  2. A comparative research of clinical data during the last 10 years concerning complications of late preterm infants%晚期早产儿并发症10年临床资料对比分析

    Institute of Scientific and Technical Information of China (English)

    周晓丽; 何金根; 潘家华

    2011-01-01

    Objective To investigate the change of complications of late preterm infants during last 10 years and to guide the clinicai treatment. Methods Medical records of 693 hospitalized late preterm infants were reviewed. Results The complications of late preterm infant mainly included hypothermia, glycometabolism disorder, disease of respiratory system, digestive system disease and bleeding of encephalic. The incidence rate of respiratory system disease and bleeding of encephalic among them has increased while the rate of hypothermia and hyperbilirubinemia has reduced now compared with the past. The two groups of difference between now and the past were notable. Conclusion The late preterm infants are a group of high - risk children and are easy to get complications, so they should be accepted routinely into New- born Department to get observation treatment.%目的 探讨10年间晚期早产儿并发症的变化,以指导临床治疗.方法 对693例晚期早产儿的临床资料进行回顾性分析.结果 晚期早产儿的并发症主要有低体温、糖代谢紊乱、呼吸系统疾病、消化系统疾病,以及颅内出血.其中呼吸系统疾病和颅内出血发生率前后5年比较有增加,低体温和高胆红素血症前后5年比较有显著下降.结论 晚期早产儿是一群高危儿,易发生并发症,应常规收入新生儿科观察治疗.

  3. Bilirubin nomograms for identification of neonatal hyperbilirubinemia in healthy term and late-preterm infants:a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Zhang-Bin Yu; Shu-Ping Han; Chao Chen

    2014-01-01

    Background: Hyperbilirubinemia occurs in most healthy term and late-preterm infants, and must be monitored to identify those who might develop severe hyperbilirubinemia. Total serum bilirubin (TSB) or transcutaneous bilirubin (TcB) nomograms have been developed and validated to identify neonatal hyperbilirubinemia. This study aimed to review previously published studies and compare the TcB nomograms with the TSB nomogram, and to determine if the former has the same predictive value for signifi cant hyperbilirubinemia as TSB nomogram does. Methods: A predefined search strategy and inclusion criteria were set up. We selected studies assessing the predictive ability of TSB/TcB nomograms to identify significant hyperbilirubinemia in healthy term and latepreterm infants. Two independent reviewers assessed the quality and extracted the data from the included studies. Meta-Disc 1.4 analysis software was used to calculate the pooled sensitivity, specificity, and positive likelihood ratio of TcB/TSB nomograms. A pooled summary of the receiver operating characteristic of the TcB/TSB nomograms was created. Results: After screening 187 publications from electronic database searches and reference lists of eligible articles, we included 14 studies in the systematic review and meta-analysis. Eleven studies were of medium methodological quality. The remaining three studies were of low methodological quality. Seven studies evaluated the TcB nomograms, and seven studies assessed TSB nomograms. There were no differences between the predictive abilities of the TSB and TcB nomograms (the pooled area under curve was 0.819 vs. 0.817). Conclusions: This study showed that TcB nomograms had the same predictive value as TSB nomograms, both of which could be used to identify subsequent signifi cant hyperbilirubinemia. But this result should be interpreted cautiously because some methodological limitations of these included studies were identifi ed in this review.

  4. Características da sucção não-nutritiva em RN a termo e pré-termo tardio Characteristics of non-nutritive sucking in full-term and late preterm infants

    Directory of Open Access Journals (Sweden)

    Ana Paula d'Oliveira Gheti Kao

    2011-09-01

    Full Text Available OBJETIVO: Comparar os parâmetros de sucção não nutritiva de recém-nascidos a termo e pré-termo tardio. MÉTODOS: Os recém-nascidos foram divididos em dois grupos, pré-termo tardio (RNPT tardio e a termo (RN a termo e, submetidos à avaliação da sucção não-nutritiva utilizando-se um protocolo adaptado da Escala de Avaliação Motora Oral. Foi realizada análise estatística para comparação dos grupos. RESULTADOS: Os reflexos de procura e de sucção foram menos frequentes nos RNPT tardio, comparados aos RN a termo, assim como a preensão palmar e mãos em linha média. A maioria dos RNPT tardio apresentou sono leve ou estava sonolento antes da avaliação. Os RNPT tardio apresentaram predominantemente sucção esporádica ou grupos de sucção com pausas longas e travamento e/ou tremores de mandíbula. A retração de língua e a protrusão de língua foram mais presentes nos RNPT tardio e o canolamento de língua nos RN a termo. CONCLUSÃO: Prontidão para a mamada, estado comportamental, postura corporal, padrão e força de sucção e movimentos de língua foram os parâmetros menos frequentes nos RNPT tardio em relação aos RN a termo.PURPOSE: To compare non-nutritive sucking parameters between late preterm and full-term infants. METHODS: Infants were divided into two groups, full-term and late preterm, and were submitted to non-nutritive sucking assessment using a protocol adapted from the Oral Motor Assessment Scale. Statistical analysis was conducted for comparison between the groups. RESULTS: The seeking and sucking reflexes were less frequent in late preterm than in full-term newborns, as well as palmar grip and hands in the midline. Most late preterm infants presented light sleep or drowsiness before the assessment. Late preterm subjects predominantly presented sporadic sucking or blocks of sucking with long pauses and mandibular locking and/or tremors. Tongue retraction and protrusion were mostly present in late preterm

  5. Effection of lung fluid clearance disturbance in late preterm infants with respiratory distress syndrome%肺液吸收障碍在晚期早产儿呼吸窘迫综合征中的作用

    Institute of Scientific and Technical Information of China (English)

    汪丽

    2013-01-01

    部分患有呼吸窘迫综合征的晚期早产儿,给予外源性肺表面活性物质疗效不佳,且此类患儿无感染或其他可能导致呼吸窘迫综合征的危险因素,可能存在不同于早产儿呼吸窘迫综合征的发病机制.研究表明,作为肺液经由上皮转运过程中核心部分的α-钠离子通道,可通过抑制肺液吸收和肺表面活性物质活性而在晚期早产儿呼吸窘迫综合征发病机制中起着重要作用.该文就肺液吸收障碍在晚期早产儿呼吸窘迫综合征中的作用作一综述.%In recent studies,it has been demonstrated that the clinical efficacy of surfactant is poor for late protein infants.Besides,this kind of infants have not infection or other risk factors that may lead to respiratory distress syndrome(RDS).Thus,it is speculated that the pathogenesis of RDS of late preterm infants is different from preterm infants.New researches show that,as the key point of Lung fluid transport via Epithelium,α-ENaC plays an important role in the pathogenesis of RDS of late preterm infants through the inhibition of lung fluid clearance and activity of surfactant.This review highlights the most important mechanisms of Lung fluid absorption barrier in RDS of late preterm infants.

  6. Clinical analysis of primary diseases in 263 late preterm infants%晚期早产儿263例患病情况临床分析

    Institute of Scientific and Technical Information of China (English)

    翁景文; 刘红; 董世霄; 靳绯; 刘靖媛

    2013-01-01

    目的 分析晚期早产儿(late preterm infant,LPI)生后患病及并发症情况,分析需要呼吸支持治疗的围产期高危因素,为防治提供依据.方法 分析263例晚期早产儿临床资料,用Logistic回归分析的方法 筛选需要呼吸支持的晚期早产儿(LPI)的围产期高危因素,并分析常见临床并发症的发生情况.结果 呼吸困难是LPI生后住院治疗的首要病因,原发病以湿肺(24.33%)和败血症(18.63%)为首,其各系统并发症的发病率均较高,以高胆红素血症(17.87%)、低血糖(13.68%)等为主.logistic回归显示双胎、妊高症、剖宫产及生后窒息是LPI需要呼吸支持的危险因素(均P<0.05).结论 LPI生后易发生多种并发症,应注意观察,及时救治.重视围产期异常分娩因素,是降低LPI生后需要呼吸支持的关键.

  7. Outcomes for Extremely Premature Infants

    Science.gov (United States)

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

    2015-01-01

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

  8. Outcomes for extremely premature infants.

    Science.gov (United States)

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

    2015-06-01

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

  9. Music Therapy with Premature Infants

    Science.gov (United States)

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  10. Music Therapy with Premature Infants

    Science.gov (United States)

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  11. The case of late preterm birth: sliding forwards the critical window for cognitive outcome risk

    Science.gov (United States)

    Nosarti, Chiara

    2015-01-01

    Many survivors of preterm birth experience neurodevelopmental disabilities, such as cerebral palsy, visual and hearing problems. However, even in the absence of major neurological complications, premature babies show significant neuropsychological and behavioural deficits during childhood and beyond. While the clinical tools routinely used to assess neurocognitive development in those infants have been useful in detecting major clinical complications in early infancy, they have not been equally sensitive in identifying subtle cognitive impairments emerging during childhood. These methodological concerns become even more relevant when considering the case of late preterm children (born between 34 and 36 gestational weeks). Although these children have been traditionally considered as having similar risks for developmental problems as neonates born at term, a recent line of research has provided growing evidence that even late preterm children display altered structural and functional brain maturation, with potential life-long implications for neurocognitive functioning. A recent study by Heinonen put forward the hypothesis that environmental factors, in this case educational attainment, could moderate the association between late preterm birth (LPT) and neuropsychological impairments commonly associated with aging. In this paper we bring together clinical literature and recent neuroimaging evidence in order to provide two different but complementary approaches for a better understanding of the “nature-nurture” interplay underlying the lifespan neurocognitive development of preterm babies. PMID:26835378

  12. Micafungin in Premature and Non-premature Infants

    Science.gov (United States)

    Wu, Chunzhang; Tweddle, Lorraine; Roilides, Emmanuel

    2014-01-01

    Background: Invasive fungal infections cause excessive morbidity and mortality in premature neonates and severely ill infants. Methods: Safety and efficacy outcomes of micafungin were compared between prematurely and non-prematurely born infants premature [birth weight (BW) premature, received ≥1 dose of micafungin. Among premature patients, 14.5% were low BW (1500–2499 g), 36.4% very low BW (1000–1499 g) and 49.1% extremely low BW (premature)] died. Significantly more non-premature than premature patients discontinued treatment (P = 0.003). Treatment-related adverse events were recorded in 23% of patients with no difference between groups. More extremely low BW (n = 4, 15%) and very low BW (n = 8, 40%) infants experienced treatment-related adverse events than low BW (n = 0) and there was no relation to micafungin dose or duration. For a subgroup of 30 patients with invasive candidiasis, treatment success was achieved in 73% in both premature and non-premature groups. Prophylaxis was successful in 4/5 non-premature hematopoietic stem cell transplant patients. Conclusion: Micafungin has a safe profile in premature and non-premature infants with substantial efficacy. PMID:24892849

  13. Maternal and fetal factors observed with late preterm births

    Directory of Open Access Journals (Sweden)

    Madhusudan Dey

    2015-08-01

    Conclusion: Higher incidences of hypertensive disorders of pregnancy, anaemia and preterm premature rupture of membrane were found with late preterm birth and 10% of newborns required NICU care. [Int J Res Med Sci 2015; 3(8.000: 1969-1973

  14. Clinical study of complications and hospitalization in 389 late preterm infants%389例晚期早产儿并发症及住院情况的临床研究

    Institute of Scientific and Technical Information of China (English)

    伍剑; 张智睿; 胡敏; 黎媛; 李彦莉; 罗娟

    2015-01-01

    目的:分析晚期早产儿生后并发症的发生率、病死率及住院情况,为临床防治提供依据。方法对389例晚期早产儿生后并发症发生情况进行回顾分析。比较不同分娩方式对呼吸系统并发症发生率的影响;比较合并呼吸系统并发症与未合并呼吸系统并发症的晚期早产儿的住院时间、住院费用及病死率。结果本组晚期早产儿生后呼吸系统并发症的发生率较其他系统并发症高,为23.65%,单个并发症的发生率由高到低为低血糖(20.57%)、喂养不耐受(17.48%)、高胆红素血症(14.91%)、脑室内出血(8.23%);经剖宫产比阴道分娩发生呼吸系统并发症多(32.34% vs .10.39%,P <0.05);与未合并呼吸系统并发症的晚期早产儿相比,合并呼吸系统并发症的晚期早产儿的住院时间,住院费用及病死率均有增加(P <0.05)。结论晚期早产儿生后易发生多种并发症,严格执行剖宫产指针,可减少呼吸系统并发症的发生率。重视发生呼吸系统并发症的患儿,以缩短住院时间、减少住院费用、降低病死率。%Objective To analyze the morbidity,mortality,and hospitalization of complications in late preterm infants.Meth-ods A total of 389 late preterm infants were retrospectively analyzed.The influence of delivery mode on respiratory complications was compared.And the influence of respiratory complications on length of hospital stay,hospital expenses and mortality were ana-lyzed and compared.Results Our data showed that main complications were diagnosed as respiratory complications(23.65%).Oth-er complications were diagnosed as hypoglycemia (20.57%),feeding intolerance (1 7.48%),hyperbilirubinemia (14.91%),and in-tracranial hemorrhage (8.23%).Respiratory morbidity was significantly higher in preterm infants by caesarean section than by va-ginal delivery (32.34% vs .10.39%,P <0.05).The time and cost of hospitalization and the mortality were higher in late preterm infants

  15. Late preterm infants’ motor development until term age

    Science.gov (United States)

    Santos, Viviane Martins; Formiga, Cibelle Kayenne Martins Roberto; de Mello, Paulo Roberto Bezerra; Leone, Cléa Rodrigues

    2017-01-01

    OBJECTIVES: To analyze the motor development of late preterm newborn infants (LPI) from birth to term-corrected age using the Test of Infant Motor Performance (TIMP) and to compare the obtained results with those of term infants at birth. METHODS: Prospective cohort study, 29 late preterm newborn infants were evaluated by the TIMP at birth and every two weeks until term-corrected age. The TIMP was administered to 88 term infants at birth. RESULTS: The mean TIMP score of late preterm newborn infants was 51.9±5.8 at 34–35 weeks and 62.6±5.2 at 40 weeks. There was a significant increase at 38–39 weeks in the LPI group (p<0.05). There were no significant differences in the motor evaluations between term infants at birth and LPI at the equivalent age. CONCLUSION: The LPI presented a gradual progression of motor development until the term-corrected age, but differences with term infants at birth were not detected.

  16. A prospective study of late preterm infants' physical growth%晚期早产儿体格生长的前瞻性研究

    Institute of Scientific and Technical Information of China (English)

    张站站; 程茜

    2012-01-01

    Objective To evaluate birth weights (BW) in late pretenti infants (LPI) with different gestational ages ( GA ) and their physical growths at correct ages ( CA) 1 , 3 and 6 months. Methods A total of 287 LPls were recruited for a cohort study between May 2010 and September 2011. Birth weights ( BW) in infants with different gestational ages and their physical growths at CA 1, 3 and 6 months were evaluated. Results Of the 287 LPIs, mean BW in LPIs with gestational ages of 34-34 6+ and 35-35 +6 weeks was significantly lower than the reference value from a physical growth investigation on newboms of 15 cities of China in 1986 (P<0.05). However, mean BW in singleton LPIs (n = 128) with gestational ages of 36-36 +6'weeks was significantly higher than the reference value (P<0.05) . At CA 1, 3 and 6 months, more than 90% LPIs reached P3 level in weights for age, length for age and head circumference for age. At CA 1 and 3 months, weight for age and head circumference for age in the LPIs were statistically higher than the reference values of physical growth in children under 7 years from nine cities of china in 2005 ( P < 0.05). Mean length for age at CA 1, 3 and 6 months was not significantly different from threference value . Conclusions There are obvious differences in BW in the LPIs compared with the reference value from a physical growth investigation on newboms of 15 cities of China in 1986, suggesting that the reference value of BW at different gestational ages needs to be updated in a certain interval. Before CA 6 months, there is a risk of overweight in LPIs and long-term monitoring is necessary. Growth of length should be followed-up for a long time.%目的 评价不同胎龄晚期早产儿(late preterm infants,LPI)的出生体重(birth weight,BW)和矫正胎龄(correct age,CA)1、3、6月龄时的体格生长情况,为早产儿长期体格生长随访提供监测重点.方法 收集2010年5月至2011年9月就诊的287例LPI相

  17. 晚期早产儿围生期危险因素及并发症临床分析%Clinical analysis on the risk factors and complications of late preterm infants

    Institute of Scientific and Technical Information of China (English)

    吴怡玲

    2011-01-01

    Objective; To analyze the risk factors and complications of late preterm infants, provide a basis for prevention and treatment. Methods; The clinical data and perinatal complications of 137 late preterm infants and 329 term infants were analyzed and compared. Results; There was significant difference in Apgar score, birth weight, hospitalization time and maternal high risk factors during perinatal period between the two groups ( P < 0. 05) . The incidences of neonatal jaundice (92.0% ), low blood glucose and low temperature (31. 3% ) , respiratory system diseases ( 17. 5% ) and feeding intolerance (8. 8% ) in study group were significantly higher than those in control group (83.59% , 6. 99% , 2. 43% ,0) ( P <0.05) . The incidence of multiple neonatal complications in study group was 85.40% , which was significantly higher than that in control group (19. 45% ) (P <0. 05) . The incidences of complications among late preterm infants from high to low were listed as follows; jaundice (92. 0% ), cardiovascular system diseases (33. 6% ), low blood glucose and low temperature (31. 3% ), respiratory system diseases (17. 5% ) , intracranial hemorrhage and hypoxic - ischemic encephalopathy (16. 8% ), infectious diseases (14. 6% ) and feeding intolerance (8. 8% ) . Conclusion; Low Apgar score and maternal high risk factors during perinatal period may become risk factors of complications among late preterm infants, the monitoring of high bilirubin, electrocardiogram and blood glucose should be enhanced in clinic for early detection and timely treatment%目的:分析晚期早产儿围生期危险因素及并发症发生情况,为防治提供依据.方法:分析和比较137例晚期早产儿与329例足月儿临床资料和围生期并发症的发病情况.结果:Apgar评分、出生体重、住院天数、母体围产期高危因素方面两组新生儿均存在统计学差异(P<0.05);研究组新生儿黄疸(92.0%)、低血糖低体温(31.3%)、呼吸系统疾病(17.5

  18. Effect of chorioamnionitis on regulatory T cells in moderate/late preterm neonates☆

    Science.gov (United States)

    Rueda, Cesar M.; Wells, Casey B.; Gisslen, Tate; Jobe, Alan H.; Kallapur, Suhas G.; Chougnet, Claire A.

    2014-01-01

    Regulatory T-cells (Treg) have a protective role for the control of immune activation and tissue damage. The effects of chorioamnionitis (chorio) on Treg in moderate/late preterm newborns are not known. We hypothesized that infants exposed to chorio would have decreased Treg frequency and/or function. We isolated mononuclear cells from adult peripheral blood and cord blood from term and moderate/late preterm infants who were classified for severity of chorio exposure. Mononuclear cells were analyzed by flow cytometry for Treg frequency and phenotype. Treg suppression of activation of conventional T-cells (Tcon) was also quantified. Treg frequencies were similar in all groups of neonates, but lower than that found in adults. Newborn Treg had a naïve phenotype, with decreased levels of CD45RO, HLA-DR, CD39 and TIGIT compared to adult Treg and chorio did not affect the phenotype. Treg from preterm newborns exposed to severe chorio had higher expression of Ki67 compared to the other groups. Treg from preterm newborns were less suppressive than Treg from adults or term, and the level of suppression was reduced with severe chorio. Relative to term, Treg frequency and phenotype were not affected by prematurity and chorio but their functionality was decreased. Lower Treg activity may contribute to inflammation in newborns that is often associated with chorioamnionitis. PMID:25451985

  19. Human milk for the premature infant

    Science.gov (United States)

    Underwood, Mark A.

    2012-01-01

    Synopsis Premature infants are a heterogeneous group with widely differing needs for nutrition and immune protection with risk of growth failure, developmental delays, necrotizing enterocolitis, and late-onset sepsis increasing with decreasing gestational age and birth weight. Human milk from women delivering prematurely has more protein and higher levels of many bioactive molecules compared to milk from women delivering at term. Human milk must be fortified for small premature infants to achieve adequate growth. Mother’s own milk improves growth and neurodevelopment and decreases the risk of necrotizing enterocolitis and late-onset sepsis and should therefore be the primary enteral diet of premature infants. Donor milk is a valuable resource for premature infants whose mothers are unable to provide an adequate supply of milk, but presents significant challenges including the need for pasteurization, nutritional and biochemical deficiencies and a limited supply. PMID:23178065

  20. 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.

  1. Effect of combined music and touch intervention on pain response and β-endorphin and cortisol concentrations in late preterm infants.

    Science.gov (United States)

    Qiu, Jie; Jiang, Yun-Fei; Li, Fang; Tong, Qian-Hong; Rong, Hui; Cheng, Rui

    2017-01-26

    Preterm neonates undergo many painful procedures as part of their standard care in the neonatal intensive care unit. However, pain treatment is inadequate in many of these routine procedures. In the present study, we investigated the impact and mechanism of combined music and touch intervention (CMT) on the pain response in premature infants. Sixty-two preterm neonates (gestational age of painful procedures with CMT, and those in the control group underwent painful procedures without CMT. Blood samples were collected from all infants at the beginning of hospitalization and 2 weeks later to assess the cortisol and β-endorphin concentrations. Differences in the levels of cortisol and β-endorphin between two groups were examined using analysis of covariance (ANCOVA). In total, 3707 painful procedures were performed on 62 neonates during their hospitalization. The average number of painful procedures in the control group (n = 35.5) was higher than that in the experimental group (n = 29.0) during hospitalization, although no significant difference was reached (P > 0.05). After 2 weeks, the Premature Infant Pain Profile scores were significantly higher in the control group than experimental group (13.000 ± 0.461 vs 10.500 ± 0.850, respectively; P  0.05) or 2 weeks later (162.400 ± 23.580 vs 184.600 ± 21.170, respectively; P > 0.05). However, the serum β-endorphin concentration was higher in the experimental group than in the control group both at the beginning of hospitalization (1.640 ± 0.390 vs 1.179 ± 0.090, respectively; P pain response of preterm neonates by significantly improving the β-endorphin concentration, but not the blood cortisol concentration. Current Controlled Trials ISRCTN14131492 . Registered on 01 Aug 2016.

  2. Future Applications of Antioxidants in Premature Infants

    Science.gov (United States)

    Lee, Jennifer W.; Davis, Jonathan M.

    2012-01-01

    Purpose of Review This review will examine the unique susceptibility of premature infants to oxidative stress, the role of reactive oxygen species (ROS) in the pathogenesis of common disorders of the preterm infant, and potential for therapeutic interventions using enzymatic and/or non-enzymatic antioxidants. Recent Findings Oxidative stress is caused by an imbalance between the production of ROS and the ability to detoxify them with the help of antioxidants. The premature infant is especially susceptible to ROS-induced damage because of inadequate antioxidant stores at birth, as well as impaired upregulation in response to oxidant stress. Thus, the premature infant is at increased risk for the development of ROS-induced diseases of the newborn, such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and periventricular leukomalacia. Summary Potential therapies for ROS-induced disease include both enzymatic and non-enzymatic antioxidant preparations. More research is required to determine the beneficial effects of supplemental antioxidant therapy. PMID:21150443

  3. Effect of pulmonary surfactant on late preterm infants with respiratory distress syndrome%肺表面活性物质治疗晚期早产儿呼吸窘迫综合征疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘超; 张桂欣

    2012-01-01

    Objective To explore the curative effect of pulmonary surfactant in treatment of late preterm infants with respiratory distress syndrome (RDS). Methods Seventy-four late preterm infants with RDS were divided into two groups. Thirty-six patients in control group were treated with mechanical ventilation, infection prevention, prevention of brain injury, en-teral and parenteral nutrition; based on this, thirty-eight patients in observation group were treated with pulmonary surfactant through intratracheal instillation. The blood gas analysis was performed before treatment and six, twenty-four, forty-eight hours after treatment in two groups;and the curative effect was evaluated. Results There was no significant difference in the clinical effect between two groups (P >0. 05) . Before treatment, there was no significant difference in the indexes of arterial blood gas analysis between two groups(P >0.05). After treatment, the index of arterial blood gas analysis improved significantly in two groups(P < 0. 05,P < 0. 01) ,but the improvement was more in observation group( P <0.05). Conclusion Pulmonary surfactant can effectively improve hyoxemia in late preterm infants with RDS.%目的 探讨肺表面活性物质治疗晚期早产儿呼吸窘迫综合征(RDS)的疗效.方法 74例晚期早产儿RDS分为2组,对照组36例给予机械通气、预防感染和脑损伤、肠内和肠外营养支持等治疗,观察组38例在此基础上给予肺表面活性物质气管内滴入治疗;2组患者分别于治疗前及治疗6、24、48 h进行血气分析,并判定疗效.结果 2组临床疗效比较差异无统计学意义(P>0.05);2组患儿治疗前动脉血气分析指标比较差异均无统计学意义(P>0.05),2组患儿治疗后动脉血气分析指标均有显著改善(P <0.05,P<0.01),观察组改善更显著(P<0.05).结论 肺表面活性物质治疗晚期早产儿RDS可以有效改善低氧血症.

  4. Mortality and the related factors of hypoxemic respiratory failure in late preterm infants%晚期早产儿低氧性呼吸衰竭的病死率及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    周继勇; 段翌; 孙莹; 单若冰; 刘建红; 牛世平; 初清; 朱明哲; 董崇娟

    2014-01-01

    Objective To discuss the case distribution and the influencing factors of mortality of late preterm infants with hypoxemic respiratory failure in middle and east of Shandong province.And to provide a theoretical basis for the improvement of the level of clinical diagnosis and treatment in late preterm infants with respiratory failure and provide reference evidence for the related researches in Shandong province and even the whole country.Methods Two hundred and sixteen late preterm infants with respiratory failure were selected as the study objects to carry out prospective trial by cluster sampling from 7 hospitals of the middle and east of Shandong province from Jan 1,2010 to Dec 31,2012.The basic information,primary disease,clinical diagnosis and treatment methods,clinical outcome,mortality and influencing factors were analyzed.Results (l) All 216 investigation questionnaires were received.The ratio of male to female was 1.3∶ 1.The pathogenesis that leaded to the incidence of respiratory diseases were not identical in various places.(2) Mean birth weight was (2 660 ± 686) g,the minimum birth weight was 1 900 g and the maximum birth weight was 3 600 g.There were 38 cases with congenital anomalies,including 6 cases with 2 or more kinds of malformation,and congenital heart disease (including patent ductus arteriosus) was 16 cases.Mean age of mothers with respiratory failure infants was 32 years,the minimum one was 18 years and the maximum one was 42 years.The overall cesarean section rate was same to the one of spontaneous labor(106 cases vs 110 cases).One hundred and thirty-seven cases with acute respiratory failure received antenatal steroids.(3) The main primary diseases of infants with respiratory failure were respiratory distress syndrome(112 cases),pulmonary infection and sepsis (52 cases).The complications were,in turn,pulmonary infection and sepsis (23 cases),patent ductus arteriosus (89 cases) and vital organs hemorrhage (7 cases).(4) The case fatality

  5. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

    Science.gov (United States)

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

    2016-01-01

    Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

  6. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Science.gov (United States)

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

    2016-01-01

    A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  7. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Leal

    Full Text Available A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk.This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services.Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8% when compared to the ones receiving public services (rate of 2.4%, regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6 for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3 for women of high obstetric risk.The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  8. Risk factors and neonatal morbidity of small for gestational age infants in late-preterm birth%晚期早产儿中小于胎龄儿的临床特点

    Institute of Scientific and Technical Information of China (English)

    孔祥永; 董建英; 池婧涵; 李丽华; 周伟勤; 商明霞; 封志纯

    2012-01-01

    目的 探讨晚期早产儿中发生小于胎龄儿(SGA)的围产期因素及新生儿期患病特点.方法 对2009年10月至2010年9月在我院新生儿重症监护病房住院、胎龄34 ~ 36周的晚期早产儿临床资料进行回顾性分析,比较晚期早产儿中SGA和适于胎龄儿(AGA)的围产期因素及新生儿期患病情况.结果 SGA组(179例)住院天数明显长于AGA组(851例)[(16.4±6.2)天比(11.3±4.1)天,P<0.05].SGA组母亲妊娠期高血压疾病(HDCP)、多胎妊娠、羊水过少和宫内窘迫的比例均高于AGA组(34.1%比17.9%,29.1%比13.7%,21.2%比12.6%,19.6%11.0%,P均<0.01).SGA组患儿新生儿窒息、喂养不耐受、颅内出血、低血糖和红细胞增多症的发生率亦明显高于AGA组(12.8%比7.9%,7.8%比3.1%,6.1%比2.6%,27.4%比21.4%,3.4%比0.2%,P均<0.05).结论 母亲HDCP和多胎妊娠是造成晚期早产儿SGA的主要原因,SGA患儿相对于AGA患儿具有更高的患病风险,应针对造成SGA的围产期因素以及新生期疾病特点进行相应预防和干预.%Objective To compare perinatal risk factors and neonatal morbidity between late-preterm small-for-gestational-age (SGA) infants and appropriate-for-gestational-age (AGA) infants of the comparable gestational age ( GA) . Methods We retrospectively analyzed neonatal morbidity and perinatal factors of 179 infants with IUGR delivered between 34 and 36 weeks of GA due to maternal indication. The control group consisted of 851 infants with spontaneous preterm delivery at the same gestation, in which the infant was AGA. Results The birth weight in SGA group was significantly lower than that in AGA group ( P 0. 05). Conclusions Our study showed thatlate-preterm SGA infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants. The perinatal factors of HDCP and multiple pregnancy had a higher incidence complicated with SGA.

  9. 晚期早产儿与足月儿神经行为发育在不同时期的比较%Comparison of neurobehavioral development between late-preterm infants and full-term infants at different periods

    Institute of Scientific and Technical Information of China (English)

    陈林英; 李荣萍

    2014-01-01

    Objective To investigate the neurobehavioral developmental differences between late-preterm infants and full-term infants at 12 months and 18 months of age, and to compare the neurobehavioral developmental changes at these two periods.Methods In the study 75 late-preterm infants and 80 full-term infants were selected as samples to test and compare their neurobehavioral development at 12 months and 18 months of age.Results At the age of 12 months, late-preterm infants had significantly lower quotient scores in the aspects of big movement, fine motor, adaptibility, language and personal social intercourse than the full-term infants ( t value was -3.837, -5.801,-3.532, -5.258 and -4.582, respectively, all P<0.05).At the age of 18 months, late-preterm infants still had significantly lower quotient scores in the above five aspects (t value was -2.786, -3.967, -4.946, -4.155 and -3.449, respectively, all P<0.05). Late-preterm infants’ score of big movement was obviously higher and that of personal social intercourse was remarkably lower at the age of 18 months than at the age of 12 months (t value was 1.982 and -4.214, respectively, both P<0.05).For the full-term infants the scores of big movement and adaptability were significantly higher and the score of personal social intercourse was lower at the age of 18 months (t value was 2.188, 2.683 and -3.880, respectively, all P <0.05).Conclusion Late-preterm infants’ neurobehavioral developmental level is lower than the full-term infants’ both at the age of 12 months and 18 months.Both late-preterm infants and full-term infants have lower scores of personal social intercourse at 18 months of age than at 12 months of age, but the reason for it needs to be further explored.Late-preterm infant’ s neurobehavioral development is not mature enough, so it is very important to concern and promote early development of late-preterm infants.%目的:了解晚期早产儿和足月儿在生后第12个月和第18个月两个年

  10. Cord blood lipoprotein profile in term, preterm, and late preterm newborns

    Science.gov (United States)

    Ghaemi, Sedigheh; Najafi, Raziyeh; Kelishadi, Roya

    2014-01-01

    Background: High concentrations of triglyceride-rich lipoproteins, and apolipoprotein B in newborns with low gestational age may increase the risk of cardiovascular diseases in the future. We investigated the lipid profile in term, late preterm and preterm Iranian infants. Materials and Methods: A total number of 99 term (gestational age ≥37 weeks), preterm (gestational age 0.05). Conclusion: In this study, the cord blood concentrations of cholesterol, triglycerides, and LDL-C were lower in term than in preterm and late preterm infants. This finding should be considered in infant nutrition and preventive measures. PMID:25657747

  11. Cord blood lipoprotein profile in term, preterm, and late preterm newborns

    Directory of Open Access Journals (Sweden)

    Sedigheh Ghaemi

    2014-01-01

    Full Text Available Background: High concentrations of triglyceride-rich lipoproteins, and apolipoprotein B in newborns with low gestational age may increase the risk of cardiovascular diseases in the future. We investigated the lipid profile in term, late preterm and preterm Iranian infants. Materials and Methods: A total number of 99 term (gestational age ≥37 weeks, preterm (gestational age 0.05. Conclusion: In this study, the cord blood concentrations of cholesterol, triglycerides, and LDL-C were lower in term than in preterm and late preterm infants. This finding should be considered in infant nutrition and preventive measures.

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

    Science.gov (United States)

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

    2015-01-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian (AI) mothers’ perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 AI mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of AI culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that healthcare providers deliver culturally appropriate care that fully supports AI mothers and their premature infants. PMID:25721716

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

    Science.gov (United States)

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

    2016-02-01

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

  14. Impact of rotavirus vaccine on premature infants.

    Science.gov (United States)

    Roué, Jean-Michel; Nowak, Emmanuel; Le Gal, Grégoire; Lemaitre, Thomas; Oger, Emmanuel; Poulhazan, Elise; Giroux, Jean-Dominique; Garenne, Armelle; Gagneur, Arnaud

    2014-10-01

    Infants born preterm are at a higher risk of complications and hospitalization in cases of rotavirus diarrhea than children born at term. We evaluated the impact of a rotavirus vaccination campaign (May 2007 to May 2010) on hospitalizations for rotavirus gastroenteritis in a population of children under 3 years old born prematurely (before 37 weeks of gestation) in the Brest University Hospital birth zone. Active surveillance from 2002 to 2006 and a prospective collection of hospitalizations for rotavirus diarrhea were initiated in the pediatric units of Brest University Hospital until May 2010. Numbers of hospitalizations for rotavirus diarrhea among the population of children born prematurely, before and after the start of the vaccination program, were compared using a Poisson regression model controlling for epidemic-to-epidemic variation. A total of 217 premature infants were vaccinated from 2007 to 2010. Vaccine coverage for a complete course of three doses was 41.9%. The vaccine safety in premature infants was similar to that in term infants. The vaccination program led to a division by a factor of 2.6 (95% confidence interval [CI], 1.3 to 5.2) in the number of hospitalizations for rotavirus diarrhea during the first two epidemic seasons following vaccine introduction and by a factor of 11 (95% CI, 3.5 to 34.8) during the third season. We observed significant effectiveness of the pentavalent rotavirus vaccine on the number of hospitalizations in a population of prematurely born infants younger than 3 years of age. A multicenter national study would provide better assessment of this impact. (This study [Impact of Systematic Infants Vaccination Against Rotavirus on Gastroenteritis Hospitalization: a Prospective Study in Brest District, France (IVANHOE)] has been registered at ClinicalTrials.gov under registration no. NCT00740935.).

  15. 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.

  16. 晚期早产儿及足月儿与胎龄 <35周早产儿呼吸窘迫综合征临床分析%Comparison of clinical characteristics of respiratory distress syndrome between gestational age <35w premature neonates and term and late-preterm neonates

    Institute of Scientific and Technical Information of China (English)

    王美卿; 宋旸

    2015-01-01

    Objective To compare the clinical characteristics of respiratory distress syndrome ( RDS ) between gestational age <35w premature neonates and term and late-preterm neonates and the differences among them.Methods Eighty-nine cases of RDS admitted in People's Hospital of Lanxi City during the period of December 2011 to December 2013 were divided into two groups:term and late-preterm neonate group (gestational age≥35w, n=32) and gestational age<35w premature neonate group (gestational age<35w, n=57).The risk factors, onset time, treatment and complications of them were analyzed.Results Premature was the main etiology of RDS in gestational age<35w premature neonates, while cesarean section was the major high risk factor in term and late-preterm neonates (59.4%), followed by asphyxia, meconium aspiration and gestational diabetes mellitus (χ2 value was 6.52, 6.47, 9.24 and 4.15, respectively, all P<0.05).The occurrence of RDS was later (t=3.92,P<0.01) and the start time to use CPAP or ventilator was also later (t=4.20, P<0.01) in term and late-preterm neonate group than in gestational age<35w premature neonate group.But the continuous application of ventilator was longer (t=2.27,P<0.05) in term and late-preterm neonates, and they were more likely to suffer pneumothorax (χ2 =5.82,P<0.05) and persistent pulmonary hypertension (PPHN) (χ2 =9.49,P <0.01).Conclusion Cesarean section, meconium aspiration, asphyxia and gestational diabetes mellitus are the risk factors of term and late-preterm neonates with RDS.The onset time for RDS is late and mechanical ventilation is long in term and late-preterm neonates, who are likely to suffer pneumothorax and PPHN. Therefore, active preventing neonates asphyxia and meconium aspiration, and reducing cesarean section rate can significantly reduce the occurrence of RDS among term and late-preterm neonates.Meanwhile, it is important to improve clinician' s awareness on RDS to achieve early diagnosis and early treatment as well as

  17. Retrospective study of influence of different delivery modes on respiratory system diseases in late preterm infants%不同分娩方式对晚期早产儿呼吸系统疾病影响的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    黄雨茅; 郑戈; 涂芳芳

    2016-01-01

    Objective To study the influence of different delivery modes on the occurrence and prognosis of late preterm infant ’ s respiratory system disease.Methods Late preterm infants born in People’ s Hospital of Rui’ an from January 2010 to December 2014 were enrolled in study.Cases of elective cesarean section ( ECS) were included in study group, and the control group included cases of vaginal delivery and emergency cesarean section.Results The incidence of respiratory disease was 41.7% in the study group and 45.2% in the cases of emergency caesarean section.There was no significant difference between them (χ2 =0.415, P>0.05).The incidence was 19.8%in the cases of vaginal delivery, which was significantly different from the study group (χ2 =34.38,P<0.05).In terms of incidence of respiratory distress syndrome ( RDS) and transient tachypnea of newborn ( TTN) in late premature born at 34, 35 and 36 weeks, it was higher in ECS cases than in cases of vaginal delivery with significant differences (χ2 value was 6.018, 6.716, 6.455, 6.437, 9.815 and 13.36, respectively, all P<0.05).Compared to the cases of vaginal delivery, the study group was higher in prolonged hospital stays, admissions to neonatal intensive care unit ( NICU ) and continuous positive airway pressure ( CPAP ) usage, and the differences were significant (t value was 2.627, 2.139 and 2.191, respectively,χ2 value was 14.38, 14.65, 23.65, 6.254, 20.04 and 9.010, respectively, all P<0.05).Conclusion The risk of respiratory disease is equivalent between the late preterm infants delivered via ECS and emergency cesarean delivery.Compared to vaginal delivery, ECS may increase the incidence of respiratory disease and poor prognosis on late preterm infants.%目的:探讨不同分娩方式对晚期早产儿呼吸系统疾病发生及预后的影响。方法以2010年1月至2014年12月,在瑞安市人民医院产科出生的晚期早产儿为研究对象,将选择性剖宫产( ECS)的病例作为研

  18. Human cytomegalovirus infections in premature infants by ...

    African Journals Online (AJOL)

    Owner

    clinical importance of CMV infection in premature infants by breast-feeding is still unclear. This mini- ... Transmission of CMV by natural routes relates ... infection from the fresh breast milk containing the virus. ... As a result of transmission during the course of delivery ... hepatitis was speculated to be caused by primary.

  19. 珂立苏治疗晚期早产儿 RDS的最佳剂量研究%Optimal dosage of Calsurf for treatment of late preterm infants with respiratory distress syndrome

    Institute of Scientific and Technical Information of China (English)

    左君

    2016-01-01

    Objective To analyze the optimal dosage of Calsurf ( PS) for treatment of late preterm infants with respiratory distress syndrome ( RDS) .Methods Altogether 60 late preterm infants with RDS who were treated in Dongxing District People ’ s Hospital in Neijiang City from January 2006 to September 2014 were selected and randomly divided into control group (30 cases) and observation group (30 cases). The infants in the observation group were given 70mg/kg of PS, and the infants in control group were given 40mg/kg of PS.Blood gas indicators , oxygenation index ( OI) and incidence of complications were compared between two groups to analyze the treatment effect of two groups.Results After 24 hours of the first administration , OI and partial pressure of carbon dioxide ( PCO2 ) were significantly reduced , and partial pressure of oxygen (PO2) level increased significantly.After treatment, the levels of OI and PCO2 of the observation group were significantly better than those of the control group , and the differences were statistically significant ( t value was -6.505 and -3.093, respectively, both P 0.05).Mechanical ventilation time [ nasal continuous positive airway pressure ( nCPAP ) and synchronized intermittent mandatory ventilation ( SIMV ) ] ( t value was -5.188 and -4.132, respectively), the number of PS application (t=-4.038), incidence of pneumonia (χ2 =9.320), oxygen therapy time (t=-7.006) and hospitalization time (t=-3.027) of the observation group were lower than those of the control group, and the differences were statistically significant (all P 0.05).Conclusion Optimal dosage of PS for treatment of late preterm infants with RDS is 70mg/kg.%目的:探讨珂立苏( PS)治疗晚期早产儿呼吸窘迫综合征( RDS)的最佳剂量。方法选择于2006年1月至2014年9月在内江市东兴区人民医院就诊的晚期早产儿RDS患儿60例,将60名患儿随机分为观察组( n=30)和对照组( n=30);观察组应用PS 70mg

  20. Premature birth and diseases in premature infants: common genetic background?

    Science.gov (United States)

    Hallman, Mikko

    2012-04-01

    It has been proposed that during human evolution, development of obligate bipedalism, narrow birth canal cross-sectional area and the large brain have forced an adjustment in duration of pregnancy (scaling of gestational age; Plunkett 2011). Children compared to other mammals are born with proportionally small brains (compared to adult brains), suggesting shortening of pregnancy duration during recent evolution. Prevalence of both obstructed delivery and premature birth is still exceptionally high. In near term infants, functional maturity and viability is high, and gene variants predisposing to respiratory distress syndrome (RDS) are rare. Advanced antenatal and neonatal treatment practices during the new era of medicine allowed survival of also very preterm infants (gestation premature birth. Specific genes associating with diseases in preterm infants may also contribute to the susceptibility to preterm birth. Understanding and applying the knowledge of genetic interactions in normal and abnormal perinatal-neonatal development requires large, well-structured population cohorts, studies involving the whole genome and international interdisciplinary collaboration.

  1. Enteral nutrition of the premature infant

    Directory of Open Access Journals (Sweden)

    Su Jin Cho

    2010-01-01

    Full Text Available Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

  2. 应用DWI结合常规MRI动态评价晚期早产儿脑白质损伤%To evaluate cerebral white matter damage in the late preterm infants by DWI combined with conventional MRI

    Institute of Scientific and Technical Information of China (English)

    冯子鉴; 陈丹; 张静; 王晓明; 李娟; 毛健

    2014-01-01

    Objective According to the conventional magnetic resonance imaging (T1WI, T2WI) and diffusion weighted imaging (DWI), we can make sure the best time to do MRI and evaluate the prognosis for the late preterm infants. Method A total of 649 late preterm infants were enrolled and received the MRI scans with the sequences of conventional MRI and DWI. 271 cases were diagnosed CWMD. To investigate the early MRI signal characteristics of different types CWMD. And the 76 cases were followed up, to study the dynamic change rule. Result In the 271 late preterm infants with CWMD, 170 cases showed focal CWMD, 77 cases showed wide spread CWMD and 24 cases diffuse CWMD. The first time that they received magnetic resonance imaging was (8.3±6.4)(1.7-14.7)d, and the second time was (19.9±5.2)(14.7-25.1) d. There were 36 cases of lesions range reduced, and 23 cases disappeared. But 17 cases (6.3%) showed different degrees of leukomalacia. There were statistically significant differences between the different types of CWMD (P<0.05). (2) Within the first two weeks of white matter damage, DWI had high sensitivity. There were 98% characterized by high signal. T1WI also showed normal or slightly high signals, with or without low signals on T2WI. High signal on DWI of focal CWMD can last for more than 3 weeks, but diffuse CWMD had short duration (within 2 weeks). (3) Focal CWMD often only involved one site of damage (65.3%), mainly concentrated in the lateral ventricle hind feet (53.5%). Widespread CWMD often involved corpus callosum and internal capsule (79.2%), and diffuse CWMD often combined gray matter injury, accounting for 50.0%. (4) There were well correlations in damage type and the infants neurological development result. 1-3 weeks to review after damage, there were 97.1% of focal CWMD characterized by disappearing or decreasing of the lesion range. They often had normal or slightly high signal on DWI, high T1WI signal, with or without high T2WI signal. But the diffuse CWMD all

  3. Optimal oxygen saturation in premature infants

    Directory of Open Access Journals (Sweden)

    Meayoung Chang

    2011-09-01

    Full Text Available There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation (SpO2 is 90 to 93% with an intermittent review of the correlation between SpO2 and the partial pressure of arterial oxygen tension (PaO2. Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.

  4. [Developmental change in facial recognition by premature infants during infancy].

    Science.gov (United States)

    Konishi, Yukihiko; Kusaka, Takashi; Nishida, Tomoko; Isobe, Kenichi; Itoh, Susumu

    2014-09-01

    Premature infants are thought to be at increased risk for developmental disorders. We evaluated facial recognition by premature infants during early infancy, as this ability has been reported to be impaired commonly in developmentally disabled children. In premature infants and full-term infants at the age of 4 months (4 corrected months for premature infants), visual behaviors while performing facial recognition tasks were determined and analyzed using an eye-tracking system (Tobii T60 manufactured by Tobii Technologics, Sweden). Both types of infants had a preference towards normal facial expressions; however, no preference towards the upper face was observed in premature infants. Our study suggests that facial recognition ability in premature infants may develop differently from that in full-term infants.

  5. The Effect of Optimally Timed Osteopathic Manipulative Treatment on Length of Hospital Stay in Moderate and Late Preterm Infants: Results from a RCT

    Science.gov (United States)

    Pizzolorusso, Gianfranco; Cerritelli, Francesco; Accorsi, Alessandro; Lucci, Chiara; Tubaldi, Lucia; Lancellotti, Jenny; Barlafante, Gina; Renzetti, Cinzia; D'Incecco, Carmine; Perri, Francesco Paolo

    2014-01-01

    Introduction. Little research has been conducted looking at the effects of osteopathic manipulative treatment (OMT) on preterm infants. Aim of the Study. This study hypothesized that osteopathic care is effective in reducing length of hospital stay and that early OMT produces the most pronounced benefit, compared to moderately early and late OMT. A secondary outcome was to estimate hospital cost savings by the use of OMT. Methods. 110 newborns ranging from 32- to 37-week gestation were randomized to receive either OMT or usual pediatric care. Early, moderately early, and late OMT were defined as <4, <9, and <14 days from birth, respectively. Result. Hospital stay was shorter in infants receiving late OMT (−2.03; 95% CI −3.15, −0.91; P < 0.01) than controls. Subgroup analysis of infants receiving early and moderately early OMT resulted in shorter LOS (early OMT: −4.16; −6.05, −2.27; P < 0.001; moderately early OMT: −3.12; −4.36, −1.89; P < 0.001). Costs analysis showed that OMT significantly produced a net saving of €740 (−1309.54, −170.33; P = 0.01) per newborn per LOS. Conclusions. This study shows evidence that the sooner OMT is provided, the shorter their hospital stay is. There is also a positive association of OMT with overall reduction in cost of care. PMID:25506381

  6. The Effect of Optimally Timed Osteopathic Manipulative Treatment on Length of Hospital Stay in Moderate and Late Preterm Infants: Results from a RCT

    Directory of Open Access Journals (Sweden)

    Gianfranco Pizzolorusso

    2014-01-01

    Full Text Available Introduction. Little research has been conducted looking at the effects of osteopathic manipulative treatment (OMT on preterm infants. Aim of the Study. This study hypothesized that osteopathic care is effective in reducing length of hospital stay and that early OMT produces the most pronounced benefit, compared to moderately early and late OMT. A secondary outcome was to estimate hospital cost savings by the use of OMT. Methods. 110 newborns ranging from 32- to 37-week gestation were randomized to receive either OMT or usual pediatric care. Early, moderately early, and late OMT were defined as <4, <9, and <14 days from birth, respectively. Result. Hospital stay was shorter in infants receiving late OMT (−2.03; 95% CI −3.15, −0.91; P<0.01 than controls. Subgroup analysis of infants receiving early and moderately early OMT resulted in shorter LOS (early OMT: −4.16; −6.05, −2.27; P<0.001; moderately early OMT: −3.12; −4.36, −1.89; P<0.001. Costs analysis showed that OMT significantly produced a net saving of €740 (−1309.54, −170.33; P=0.01 per newborn per LOS. Conclusions. This study shows evidence that the sooner OMT is provided, the shorter their hospital stay is. There is also a positive association of OMT with overall reduction in cost of care.

  7. Effect of early intervention on mental and motor development in late preterm infants%晚期早产儿精神运动发育早期干预效果研究

    Institute of Scientific and Technical Information of China (English)

    王婷雪; 李蓓; 徐兵; 胡雯; 蒋齐安; 徐秀

    2015-01-01

    Objective To investigate the effect of early intervention on mental and motor development in late preterm infants (LPIs). Methods Two hundred and seven LPIs were divided into LPIs intervention group (122 cases) and LPIs control group (85 cases) based on the time of follow-up and voluntariness of parents, and another 54 full-term infants ( FTIs) were served as FTIs group. Follow-up was carried out in three groups, and early intervention was conducted in LPIs intervention group. Assessments were performed in three groups at corrected ages of (3 ± 0.7), (6 ± 0.7) and (12 ± 0.7) months using the Bayley Scales of Infant Development, Second Edition, and mental development index (MDI) and psychomotor development index (PDI) were calculated. Questionnaire survey on compliance was done among mothers in LPIs intervention group, and the results were analyzed. Results A complete follow-up was done in 83 cases in LPIs intervention group, 42 cases in LPIs control group and 43 cases in FTIs group. The PDI and MDI values gradually increased with ages in LPIs intervention group. There was no significant difference in PDI and MDI values between LPIs intervention group and LPIs control group at the age of 3 months ( P > 0.05) , while the PDI and MDI values in LPIs intervention group were significantly higher than those in LPIs control group at the age of 6 and 12 months ( P 0.05), 6、 12月龄时LPIs干预组PDI、 MDI显著大于LPIs对照组(P<0.05); 各月龄LPIs干预组和LPIs对照组PDI、 MDI均显著小于FTIs组(P<0.05). LPIs干预组母亲依从性调查问卷结果显示, 医师注重疏导家长的焦虑情绪等因素有助家长定期随访. 结论 LPIs认知、 运动水平低于FTIs, 对LPIs早期干预可有效提高其精神运动发育水平, 对LPIs的早期干预方案有待进一步完善.

  8. The Effect of Optimally Timed Osteopathic Manipulative Treatment on Length of Hospital Stay in Moderate and Late Preterm Infants: Results from a RCT.

    Science.gov (United States)

    Pizzolorusso, Gianfranco; Cerritelli, Francesco; Accorsi, Alessandro; Lucci, Chiara; Tubaldi, Lucia; Lancellotti, Jenny; Barlafante, Gina; Renzetti, Cinzia; D'Incecco, Carmine; Perri, Francesco Paolo

    2014-01-01

    Introduction. Little research has been conducted looking at the effects of osteopathic manipulative treatment (OMT) on preterm infants. Aim of the Study. This study hypothesized that osteopathic care is effective in reducing length of hospital stay and that early OMT produces the most pronounced benefit, compared to moderately early and late OMT. A secondary outcome was to estimate hospital cost savings by the use of OMT. Methods. 110 newborns ranging from 32- to 37-week gestation were randomized to receive either OMT or usual pediatric care. Early, moderately early, and late OMT were defined as OMT (-2.03; 95% CI -3.15, -0.91; P OMT resulted in shorter LOS (early OMT: -4.16; -6.05, -2.27; P OMT: -3.12; -4.36, -1.89; P OMT significantly produced a net saving of €740 (-1309.54, -170.33; P = 0.01) per newborn per LOS. Conclusions. This study shows evidence that the sooner OMT is provided, the shorter their hospital stay is. There is also a positive association of OMT with overall reduction in cost of care.

  9. [Application of massage therapy in premature infant nursing care].

    Science.gov (United States)

    Chang, Shu-Min; Sung, Huei-Chuan

    2007-02-01

    Massage therapy has been used in the care of premature infants for many years in western countries, and a significant body of research has already shown the effectiveness of massage therapy in significantly increasing body weight, decreasing infant hospital durations, enhancing bone formation, and improving behavior. Key considerations when applying massage therapy on premature infants include gestational age, bodyweight, and physical condition. Nurses can teach parents to administer massage therapy on their premature infants to enhance parent-child attachment and interaction. This article introduces massage therapy principles and methods, the effectiveness of massage therapy in premature infant care, and an approach to teaching parents how to apply massage therapy on their premature infants. Massage therapy can be included in premature infant care programs in the future.

  10. Brain ultrasonography in the premature infant.

    Science.gov (United States)

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

    2006-07-01

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

  11. Hematological and iron content evolution in exclusively breastfed late-preterm newborns

    Science.gov (United States)

    Yamada, Renato Takeshi; Leone, Cléa Rodrigues

    2014-01-01

    OBJECTIVES: To analyze and compare the evolution of hematological parameters and body iron content between exclusively breastfed late-preterm and term newborns during the first two months of life. METHODS: Cohort study. Weight, length, head circumference, body mass index, hemoglobin, hematocrit, reticulocytes, total iron-binding capacity, transferrin saturation, serum iron and ferritin were measured in 25 late-preterm and 21 term newborns (at birth and at one and two months of age) who were exclusively breastfed. Statistical analysis: Kolmogorov-Smirnov test, one-way ANOVA or Kruskal-Wallis test; and Student's t-test or Mann-Whitney test. Significance: p<0.05. RESULTS: The corrected gestational ages of the late-preterm infants were 39.98 weeks at one month of life and 44.53 weeks at two months. Anthropometric measures and the body mass index increased over time (p<0.001) and hemoglobin, hematocrit, reticulocytes and body iron content decreased (p<0.001). Late-preterm infants at term corrected gestational age had reduced hemoglobin, hematocrit and reticulocyte concentrations, and reduced total iron-binding capacity (p<0.001) and serum iron (p = 0.0034) compared with values observed in term newborns at birth. Late-preterm newborns at a corrected gestational age of one month post-term had hemoglobin (p = 0.0002), hematocrit (p = 0.0008), iron (p<0.0001) and transferrin saturation (p<0.001) levels lower than those of term newborns at one month of age and a higher total iron-binding capacity (p = 0.0018). Ferritin did not differ between the groups. CONCLUSION: Exclusively breastfed late-preterm newborns presented greater reductions in hemoglobin/hematocrit and lower iron stores at a corrected gestational age of one month post-term than did term newborns, suggesting specific iron supplementation needs. PMID:25627989

  12. Hematological and iron content evolution in exclusively breastfed late-preterm newborns

    Directory of Open Access Journals (Sweden)

    Renato Takeshi Yamada

    2014-01-01

    Full Text Available OBJECTIVES: To analyze and compare the evolution of hematological parameters and body iron content between exclusively breastfed late-preterm and term newborns during the first two months of life. METHODS: Cohort study. Weight, length, head circumference, body mass index, hemoglobin, hematocrit, reticulocytes, total iron-binding capacity, transferrin saturation, serum iron and ferritin were measured in 25 late-preterm and 21 term newborns (at birth and at one and two months of age who were exclusively breastfed. Statistical analysis: Kolmogorov-Smirnov test, one-way ANOVA or Kruskal-Wallis test; and Student's t-test or Mann-Whitney test. Significance: p<0.05. RESULTS: The corrected gestational ages of the late-preterm infants were 39.98 weeks at one month of life and 44.53 weeks at two months. Anthropometric measures and the body mass index increased over time (p<0.001 and hemoglobin, hematocrit, reticulocytes and body iron content decreased (p<0.001. Late-preterm infants at term corrected gestational age had reduced hemoglobin, hematocrit and reticulocyte concentrations, and reduced total iron-binding capacity (p<0.001 and serum iron (p = 0.0034 compared with values observed in term newborns at birth. Late-preterm newborns at a corrected gestational age of one month post-term had hemoglobin (p = 0.0002, hematocrit (p = 0.0008, iron (p<0.0001 and transferrin saturation (p<0.001 levels lower than those of term newborns at one month of age and a higher total iron-binding capacity (p = 0.0018. Ferritin did not differ between the groups. CONCLUSION: Exclusively breastfed late-preterm newborns presented greater reductions in hemoglobin/hematocrit and lower iron stores at a corrected gestational age of one month post-term than did term newborns, suggesting specific iron supplementation needs.

  13. The value of serum albumin level for the prognosis of late-preterm infants infection%血清白蛋白水平对晚期早产儿感染预后的预测价值

    Institute of Scientific and Technical Information of China (English)

    杨春燕; 李宝云; 许平; 杨玉军; 杨巧芝

    2015-01-01

    目的 探讨血清白蛋白(ALB)水平对晚期早产儿感染预后的预测价值.方法 回顾性分析2012年7月至2013年7月我院儿科新生儿监护室收治的晚期早产儿(胎龄34~36周)完整临床资料,包括相关实验室检查指标、新生儿危重病例评分(NCIS)、围产期合并症、转归等;根据血清 ALB 水平,将所有纳入新生儿分为>30 g/L、25 ~30 g/L、<25 g/L 3 组.结果 共纳入257例晚期早产儿, ALB 水平<25 g/L 组122 例,占47.4%.新生儿脓毒症32 例,新生儿感染190例,非新生儿感染35例,3组低白蛋白血症发生率分别为84.4%、50.0%、28.6%,病死率分别为15.6%、0.5%、0 ,脓毒症组低白蛋白血症发生率和病死率高于感染组和非感染组(P<0.05) ,感染组和非感染组差异无统计学意义(P>0.05).存活组ALB水平高于死亡组[ (29.6 ± 7.5)比(20.4 ± 6.9)g/L],差异有统计学意义(P<0.05).ALB<25 g/L组NCIS单项危重病例比例和脏器损伤≥4个的比例分别为65.5%和26.2%,单项危重病例比例高于其余两组,脏器损伤≥4个的比例高于>30 g/L组,差异有统计学意义(P<0.05).结论 新生儿脓毒症患儿低白蛋白血症发生率高,患儿血清ALB水平与预后关系密切.ALB水平测定对新生儿早期感染预后有良好的评估价值.%Objective To study the value of serum albumin ( ALB ) level for the prognosis of late-preterm infants infection. Methods Late-preterm infants admitted to the neonatal intensive care unit ( NICU) from July 2012 to July 2013 were recruited and their clinical data retrospectively reviewed, including the laboratory examination results, neonatal critical illness scores ( NCIS ) , perinatal complications and prognosis. The infants were assigned into three groups based on ALB levels (>30 g/L, 25-30 g/L, <25 g/L). Results A total of 257 cases were recruited and 122 cases (47. 4%) had ALB levels <25 g/L. 32 had neonatal sepsis ( sepsis group) , 190

  14. 乳铁蛋白对晚期早产儿贫血及神经行为发育的影响%Effect of Lactoferrin on anemia and neurobehavioral development of late preterm infant

    Institute of Scientific and Technical Information of China (English)

    刘瑛; 王馨; 林少勇; 吴婕翎; 柯海劲

    2014-01-01

    Objective To study the effect of Lactoferrin on anemia and neurobehavioral development of late preterm infant(LPI).Methods 120 LPI babies who followed-up in child care department of Guangdong Provincial Maternal and Children Hospital between March 2012 to March 2013 were chosen, and divided randomly into lactoferrin group and iron group. Compared the hemoglobin, red blood cells deposited, reticulocyte, serum ferritin and neurobehavioral development after 6 months.Results After 6 months, the value of hemoglobin, red blood cells deposited, reticulocyte, serum ferritin and development quotient from the two groups were no statistically significant difference(P>0.05).Conclusion Lactoferrin could prevent LPI from anemia as iron, and could promote the development of the nervous system.%目的:探讨乳铁蛋白对晚期早产儿贫血及其神经行为发育的影响。方法将2012年3月~2013年3月广东省妇女儿童医院儿童保健科门诊随访跟踪的晚期早产儿120例,随机分为乳铁蛋白组和铁剂组,观察两组患儿干预前后的血红蛋白、红细胞压积、网织红细胞、血清铁蛋白,并使用盖塞尔发展诊断量表评估其智能发育情况。结果矫正胎龄6月龄时,乳铁蛋白组及铁剂组婴儿的血红蛋白、红细胞压积、网织红细胞、血清铁蛋白差异无统计学意义(P>0.05)。乳铁蛋白组及铁剂组婴儿盖泽尔5大能区差异无统计学意义。结论乳铁蛋白对预防晚期早产儿贫血与铁剂补充有类似效果。

  15. A late-preterm, early-term stratified analysis of neonatal outcomes by gestational age in placenta previa: defining the optimal timing for delivery.

    Science.gov (United States)

    Balayla, Jacques; Wo, Bi Lan; Bédard, Marie-Josée

    2015-01-01

    Though no official guidelines address the issue of the optimal timing of delivery in placenta previa, common practice is to conduct delivery between 36 and 37 weeks gestation. Given the rising concerns regarding unnecessary premature deliveries, the objective of this study was to compare neonatal outcomes among pregnancies complicated by placenta previa delivered at the late-preterm period (35, 36 weeks) relative to the early-term period (37 and 38 weeks). We conducted a retrospective, population-based, cohort study using the CDC’s Linked Birth-Infant Death data files from the U.S. for the year 2004. We stratified the cohort according to gestational age and placenta previa status. Using 38 weeks gestation as reference controls, the effect of delivery in a pregnancy with placenta previa at 35, 36 and 37 weeks gestation on the risk of several neonatal outcomes was estimated using logistic regression analysis, adjusting for relevant confounders. We analyzed a total of 4 118 956 births, of which 5675 (0.1%) met inclusion criteria. Late-preterm delivery was associated with lower birthweight and increased adequacy of care. Relative to neonates born at 38 weeks, birth at 35, 36 and 37 weeks was associated with no greater odds of meconium passage, fetal distress, fetal anemia, neonatal seizures, increased ventilator needs, or infant death at 1 year. However, odds of 5-min APGAR scores placenta previa is associated with fewer complications and no greater risk than late-preterm delivery. This information may be helpful in the development of future guidelines, which are currently needed to guide the management of these pregnancies.

  16. Late preterm birth is a risk factor for growth faltering in early childhood: a cohort study

    Directory of Open Access Journals (Sweden)

    Victora Cesar G

    2009-11-01

    Full Text Available Abstract Background Rates of preterm birth are increasing worldwide and this increase is mostly due to infants born between 34 and 36 weeks of gestational age, the so-called "late preterm" births. The aim of this study was to assess the effect of late preterm birth over growth outcomes, assessed when children were 12 and 24 months old. Methods In 2004, all births taking place in Pelotas (Southern Brazil were recruited for a cohort study. Late preterm (34/0-36/6 weeks of gestational age and term children (37/0-42/6 weeks were compared in terms of weight-for-age, length-for-age and weight-for-length z-scores. Weight-for-age, length-for-age and weight-for-length z-scores below -2 were considered, respectively, underweight, stunting and wasting. Singleton newborns with adequate weight for gestational age at birth, successfully followed-up either at 12 or 24 months of age were analyzed and adjusted odds ratios with 95% confidence intervals calculated through logistic regression. Results 3285 births were included, 371 of whom were late preterm births (11.3%. At 12 months, prevalence of underweight, stunting and wasting were, respectively, 3.4, 8.7 and 1.1% among late preterm children, against 1.0, 3.4 and 0.3% among term children. At 24 months, correspondent values were 3.0, 7.2 and 0.8% against 0.8, 2.9 and 0.4%. Comparing with the term children, adjusted odds of being underweighted among late preterm children was 2.57 times higher (1.27; 5.23 at 12 months and 3.36 times higher (1.56; 7.23 at 24; of being stunted, 2.35 (1.49; 3.70 and 2.30 (1.40; 3.77; and of being wasted, 3.98 (1.07; 14.85 and 1.87 (0.50; 7.01. Weight gain from birth to 12 and 24 months was similar in late preterm and term children, whereas length gain was higher in the former group in both periods. Conclusion Late preterm children grow faster than children born at term, but they are at increased risk of underweight and stunting in the first two years of life. Failure to thrive in

  17. Clinical features of early preterm infants, late preterm infants and full term infants with respiratory distress syndrome.%早期晚期早产儿与足月新生儿呼吸窘迫综合征临床比较分析

    Institute of Scientific and Technical Information of China (English)

    徐发林; 白琼丹; 庄方莉; 段佳佳

    2012-01-01

    preterm group (34 ~< 37 weeks, 204 cases), and full-term group (≥37 weeks, 80 cases) according to gestational age respectively,and the general situation,risk factors,clinical condition,prognosis and complications in each group were analyzed. Results There was an increasing tendency for the incidence of RDS, which predominantly happened in the early preterm infants. What's more, the prevalence of RDS in late preterm infants and term infants was increased. The proportion of RDS in the male was higher than the female (P < 0.05), especially when the gestational ages and weight'were greater. The antenatal use of glucocorticoid in full-term RDS infants was significantly lower than the preterm infants. The risk factors of preterm RDS were closely relevant to the rupture of membranes, placental abnormalities, women with pregnancy-induced hypertension, while those of the full-term newboms with RDS were frequently related to selective cesarean section. The time window of the diagnosis of the full-term RDS was later than that of the preterm RDS. The application of mechanical ventilation to full-term RDS infants was significantly more than to the preterm infants while the clinical cure rate was significantly higher( P < 0.05), but the mortality rate was not different, and more pulmonary infection and pneumothorax oceured in full-term group consequently. Conclusion The incidence of neonatal RDS is increasing yearly and the prevalence of RDS in late preterm infants and term infants increase. The different clinical characteristics between the preterm RDS and full-term RDS lie in the morbidity, sex ratio, risk factors,clinical characteristics, treatment response and complications etc. The gestational age factor should be considered to diagnose and treat RDS. The full-term RDS which are characterized by relatively late onset and complication of pneumothorax, has a close relation to elective cesarean section and infection, should be paid more attention to in the future.

  18. Periodic heart rate decelerations in premature infants.

    Science.gov (United States)

    Flower, Abigail A; Moorman, J Randall; Lake, Douglas E; Delos, John B

    2010-04-01

    The pacemaking system of the heart is complex; a healthy heart constantly integrates and responds to extracardiac signals, resulting in highly complex heart rate patterns with a great deal of variability. In the laboratory and in some pathological or age-related states, however, dynamics can show reduced complexity that is more readily described and modeled. Reduced heart rate complexity has both clinical and dynamical significance - it may provide warning of impending illness or clues about the dynamics of the heart's pacemaking system. In this paper, we describe simple and interesting heart rate dynamics that we have observed in premature human infants - reversible transitions to large-amplitude periodic oscillations - and we show that the appearance and disappearance of these periodic oscillations can be described by a simple mathematical model, a Hopf bifurcation.

  19. Association between maternal pre-pregnancy body mass index and adverse outcomes of late preterm infants%妇女孕前体重指数对晚期早产儿不良结局的影响

    Institute of Scientific and Technical Information of China (English)

    袁志轩; 温晓红; 黄金华; 刘荃; 黄会芝; 于梅; 马力

    2016-01-01

    Objective To study the association between maternal pre-pregnancy body mass index (BMI) and adverse outcomes of late preterm infants (LPI). Methods A total of 367 LPI who were born from January 2011 to December 2015 and admitted to the neonatal ward were enrolled. The BMI criteria for Chinese population were used to analyze the factors for maternal pre-pregnancy BMI and its association with adverse outcomes of LPI (1 minute Apgar score≤7, delivery room resuscitation, hospitalization days after birth>7 days, and ventilation duration≥6 hours). Results Of all LPIs, there were 64 LPI (17.4%) in the low maternal pre-pregnancy BMI group, 243 LPI (66.2%) in the normal maternal pre-pregnancy BMI group, and 60 LPI (16.4%) in the high maternal pre-pregnancy BMI group. Low pre-pregnancy BMI was the risk factor for 1 minute Apgar score≤7 (OR=3.243, 95%CI:1.102-9.546) and need for delivery room resuscitation (OR=3.492, 95%CI: 1.090-11.190), and high pre-pregnancy BMI was the risk factor for hospitalization days after birth>7 days (OR=1.992, 95%CI:1.024-3.874). Conclusions Abnormal maternal pre-pregnancy BMI has adverse effects on the outcomes of LPI. In order to reduce these adverse outcomes BMI should be controlled within the normal range in pregnant women.%目的:探讨妇女孕前体重指数(BMI)与晚期早产儿(LPI)不良结局的关系。方法选择2011年1月至2015年12月的367例住院LPI为研究对象。分析母亲孕前BMI水平的相关因素,以及与LPI不良结局(1 min Apgar评分≤7分、产房复苏、住院天数>7 d以及呼吸机通气时间≥6 h)的关系。结果母亲孕前BMI降低、正常、增高的分别有64例(17.4%)、243例(66.2%)以及60例(16.4%)。母亲孕前BMI降低是LPI 1 min Apgar评分≤7分(OR=3.243,95%CI:1.102~9.546)和需要产房复苏(OR=3.492,95%CI:1.090~11.190)的危险因素,孕前高BMI是LPI住院时间>7 d(OR=1.992,95%CI:1.024~3.874)的危险因素。结论

  20. 晚期早产儿与足月新生儿呼吸衰竭发生及预后的影响因素%Risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants

    Institute of Scientific and Technical Information of China (English)

    朱天闻; 张永红; 陈妍; 夏红萍; 赵冬莹; 杨凌云; 朱建幸

    2013-01-01

    Objective To investigate the risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants.Methods Sixty-eight neonates with respiratory failure hospitalized in neonatal intensive care unit (NICU) were divided into late preterm infants group (n =34) and full-term infants group (n =34),the general clinical characteristics,perinatal parameters,treatment process of respiratory failure,main disease diagnosis and prognosis evaluation were compared between these two groups.Besides,the clinical parameters and respiratory parameters were compared between favorable prognosis group and unfavorable prognosis group.Results The average birth weight in late preterm infants group was significantly lower than that in full-term infants group (P < 0.01),and the proportion of infants with low body weight in late preterm infants group was significantly higher than that in full-term infants group (P <0.05).However,there was no significant difference in the gender constituent ratio,age at NICU admission and proportion of infants small for gestational age between two groups (P > 0.05).There was no significant difference in the healthy status and other perinatal parameters between late preterm infants group and full-term infants group (P > 0.05).Apnea was only found in late preterm infants group,and NO inhalation treatment and high frequency ventilation were only adopted in full-term infants group,while there was no significant difference in the main disease diagnosis,respiratory treatment modality and prognosis between two groups (P > 0.05).The proportion of infants small for gestational age in favorable prognosis group was significantly lower than that in unfavorable prognosis group (P < 0.05),while the Caesarean section rate in favorable prognosis group was significantly higher than that in unfavorable prognosis group (P < 0.05).Conclusion Relationship between gestational age and body weight of neonates with respiratory failure and way of

  1. Neonatal Outcomes of Late-Preterm Birth Associated or Not with Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Cristiane Ortigosa Rocha

    2010-01-01

    Full Text Available Objective. To compare neonatal morbidity and mortality between late-preterm intrauterine growth-restricted (IUGR and appropriate-for-gestational-age (AGA infants of the comparable gestational ages (GAs. Methods. We retrospectively analyzed neonatal morbidity and mortality of 50 singleton pregnancies involving fetuses with IUGR delivered between 34 and 36 6/7 weeks of GA due to maternal and/or fetal indication. The control group consisted of 36 singleton pregnancies with spontaneous preterm delivery at the same GA, in which the infant was AGA. Categorical data were compared between IUGR and AGA pregnancies by 2 analysis and Fisher's exact test. Ordinal measures were compared using the Kruskal-Wallis test. Results. The length of stay of newborns in the nursery, as well as the need for and duration of hospitalization in the neonatal intensive care unit, was longer in the group with IUGR. Transient tachypnea of the newborn or apnea rates did not differ significantly between the IUGR and AGA groups. IUGR infants were found to be at a higher risk of intraventricular hemorrhage. No respiratory distress syndrome, pulmonary hemorrhage or bronchopulmonary dysplasia was observed in either group. The frequency of sepsis, thrombocytopenia and hyperbilirubinemia was similar in the two groups. Hypoglycemia was more frequent in the IUGR group. No neonatal death was observed. Conclusion. Our study showed that late-preterm IUGR infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants.

  2. Mode of delivery and neurosonographic findings in premature infants

    Directory of Open Access Journals (Sweden)

    Velisavljev-Filipović Gordana

    2007-01-01

    Full Text Available Introduction Fetal and preterm infant brain is especially vulnerable to hemorrhagic and ischemic damage at the end of the second and at the beginning of the third trimester. This is due to vascular, cellular and anatomic characteristics of the brain during development. In premature babies, there is a physiological instability and limited autoregulation of cerebral circulation. Hemorrhagic and ischemic damages often occur together, though pathophysiological processes leading to lesions are different. Material and methods The paper deals with a detailed analysis of 860 ultrasound brain scans of prematurely born children. The examinations were performed at the Ultrasound Department of the Institute of Child and Youth Health Care in Novi Sad. 707 vaginally born premature infants and 153 premature infants born by Cesarean section were examined. The bleeding was graded according to the Papile classification. Results and Discussion Out of 384 children with diagnosed grade I hemorrhage, 75 premature infants (19.5% were born by Cesarean section. In the group of children with grade II hemorrhage, operative deliveries account for 14.7%. From the total of 85 children with grade III hemorrhage, (intraventricular bleeding with chamber dilatation, only 6 premature infants were born by Cesarean section (7%. Intra-parenchymal bleeding was diagnosed in a very small number of premature infants; 0.32% of all diagnosed hemorrhages were grade IV hemorrhages. In this group there were no children born by Cesarean section. The increase of hemorrhage grade is accompanied by a greater rate of pelvic presentation and manual assistance by Bracht. There were 240 prematurely born children with no echosonographically diagnosed hemorrhage, 38% of all examined premature infants. From this number, 13.3% of neonates were born by Cesarean section. Conclusion In the etiology of neonatal intracranial hemorrhage, especially prematurely born ones, apart from the trauma, which plays a

  3. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

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

  4. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

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

  5. Feeding premature infants banked human milk homogenized by ultrasonic treatment.

    Science.gov (United States)

    Rayol, M R; Martinez, F E; Jorge, S M; Gonçalves, A L; Desai, I D

    1993-12-01

    Premature neonates fed ultrasonically homogenized human milk had better weight gain and triceps skin-fold thickness than did a control group given untreated human milk (p homogenization of human milk appears to minimize loss of fat and thus allows better growth of premature infants.

  6. Intrauterine skull depression and intracranial hemorrhage in a premature infant

    Energy Technology Data Exchange (ETDEWEB)

    Batton, G.D.; DiCarmine, F.; Boal, D.K.

    1988-04-01

    The authors describe a case of a premature infant born with a parietal skull depression who suffered an intraventricular hemorrhage and an ipsilateral intracerebral injury. At 21 months of life the infant's gross motor milestones were delayed and he had moderate spastic hemiplegia. Although skull depressions at birth are usually benign, they may be associated with long-term neurologic sequelae.

  7. Congenital staphylococcal scalded skin syndrome in a premature infant

    NARCIS (Netherlands)

    Haveman, LM; Fleer, A; de Vries, LS; Gerards, LJ

    2004-01-01

    A case of congenital staphylococcal scalded skin syndrome (SSSS) with fatal outcome in a premature infant is reported. An intrauterine infection with Staphylococcus aureus was probably the cause for the fulminant course of the disease. Despite adequate antibiotic treatment, the infant died within 24

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

    Science.gov (United States)

    Coradello, H; Lubec, G; Simbruner, G

    1981-02-01

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

  9. Preventing respiratory syncytial virus in homebound premature infants.

    Science.gov (United States)

    Austin, Jennifer

    2007-01-01

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

  10. Evaluation and Treatment of Anemia in Premature Infants

    Science.gov (United States)

    Hasanbegovic, Edo; Cengic, Nermana; Hasanbegovic, Snijezana; Heljic, Jasmina; Lutolli, Ismail; Begic, Edin

    2016-01-01

    Introduction: Anemia in preterm infants is the pathophysiological process with greater and more rapid decline in hemoglobin compared to the physiological anemia in infants. There is a need for transfusions and administration of human recombinant erythropoietin. Aim: To determine the frequency of anemia in premature infants at the Pediatric Clinic, University Clinical Center Sarajevo, as well as parameter values in the blood count of premature infants and to explore a relationship between blood transfusions with the advent of intraventricular hemorrhage (determine treatment outcome in preterm infants). Patients and methods: Research is retrospective study and it included the period of six months in year 2014. Research included 100 patients, gestational age < 37 weeks (premature infants). Data were collected by examining the medical records of patients at the Pediatric Clinic, UCCS. Results: The first group of patients were premature infants of gestational age ≤ 32 weeks (62/100) and the second group were premature infants of gestational age 33-37 weeks (38/100). Among the patients, 5% were boys and 46% girls. There was significant difference in birth weight and APGAR score among the groups. In the first group, there were 27.42% of deaths, while in the second group, there were only 10.53% of deaths. There was a significant difference in the length of treatment. There was a statistically significant difference in the need for transfusion among the groups. 18 patients in the first group required a transfusion, while in the second group only 3 patients. Conclusions: Preterm infants of gestational age ≤ 32 weeks are likely candidates for blood transfusion during treatment. Preterm infants of gestational age ≤ 32 weeks have the risk of intracranial bleeding associated with the application of blood transfusion in the first week of life. PMID:28210010

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

    Directory of Open Access Journals (Sweden)

    Hyung Suk Moon

    2012-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Hyung Suk Moon

    2012-09-01

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

  13. Effect of vocal stimulation on responses of premature infants

    Directory of Open Access Journals (Sweden)

    Zahra Alipour

    2014-03-01

    Full Text Available Background and Objectives: There are studies that support music and singing as appropriate developmental care for premature infants, thus, we conducted this study to investigate the physiological and behavioral responses of premature infants to Quran recitation, lullaby music and silence. Methods: In a randomized controlled trial (2011-2012,120 premature infants in the Neonatal Unit (NNU at Izadi Hospital, were randomly assigned to experimental (holy Quran recitation, lullaby music and silence and control groups. The four groups were surveyed for physiological responses including, oxygen saturation, respiratory rate and heart rate and behavioral states. The data were analyzed using SPSS-PC software and quantitative tests. Results: 66females and 54 male infants with gestational age 28- 36 weeks entered into the study. The fourgroupswere not significantly different in terms of demographic variables (P>0.05. The comparisonofchangesinthe infant’s responsesintheendof the intervention comparedtothebase lines, showedno statistically significant differencesbetweengroups(P>0.05. Repeated measures ANOVA and Friedman test did notindicate any significant differences in the mean ofresponseswithinanyof the four groups during the courseof study (P>0.05. Conclusion: Although fluctuations were observed in the mean of physiological responses and behavioral states in premature infants who listened to the recitation of the holy Quran and lullaby music, but these fluctuations were not significant. Findings of this study demonstrated that the preterm infants did not display any adverse reactions to the carefully designed acoustic intervention.

  14. Maternal assessment of pain in premature infants

    Directory of Open Access Journals (Sweden)

    Maria Carolina Correia dos Santos

    2015-12-01

    Full Text Available Objective: to identify mothers' perceptions about the pain in their premature babies in the Neonatal Intensive Care Unit. Methods: evaluative, quantitative study with investigative nature conducted with 19 mothers of hospitalized premature newborns. Data were obtained from closed questions, answered by mothers. Results: from the participants, two (10.5% reported that newborns are unable to feel pain. From the 17 mothers who said that premature babies can feel pain, the majority (94.1% identified crying as a characteristic of pain sensation. Eleven (64.7% stated that uneasiness is a sign of pain in newborns. Conclusion: for the proper management of neonatal pain it is essential that mothers know the signs of pain in premature newborns, and that health professionals instruct this recognition, through the enhancement of the maternal presence and practice of effective communication between professionals and newborns’ families.

  15. Prematurity stereotyping and mothers' interactions with their premature and full-term infants during the first year.

    Science.gov (United States)

    Stern, Marilyn; Karraker, Katherine; McIntosh, Bonnie; Moritzen, Sara; Olexa, Michelle

    2006-07-01

    To longitudinally assess stability and correlates of prematurity stereotyping and perceptions of infant vulnerability in mothers of premature (N = 56) and full-term (N = 59) infants. At 5, 9, and 12 months, mothers rated videotapes of unfamiliar infants with a full-term label (FTL) or a preterm label (PL), interacted with their own infant, and completed other questionnaires. A subgroup of infants were administered a developmental assessment at 32 months. Mothers rated PL infants more negatively than FTL infants at each age. Individual differences in stereotyping were not stable. Mothers who negatively rated infants labeled with the same birth status of their own infants exhibited more negative interactive behaviors with their infants. Mothers who viewed their own infant as more vulnerable and who showed more prematurity stereotyping at 5 months had infants with lower 32-month mental scores. The results suggest an association between early maternal cognitions and both contemporaneous maternal behavior and later child developmental outcomes.

  16. Biomarkers of brain injury in the premature infant.

    Science.gov (United States)

    Douglas-Escobar, Martha; Weiss, Michael D

    2012-01-01

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

  17. Necrotizing enterocolitis and cytomegalovirus infection in a premature infant.

    Science.gov (United States)

    Tran, Lynn; Ferris, Michael; Norori, Johana; Stark, Matthew; Craver, Randall; Dowd, Scot; Penn, Duna

    2013-01-01

    Necrotizing enterocolitis is the most common gastrointestinal emergency in neonates. The etiology is considered multifactorial. Risk factors include prematurity, enteral feeding, hypoxia, and bacterial colonization. The etiologic role of viruses is unclear. We present a case of necrotizing enterocolitis associated with cytomegalovirus and Proteobacteria in a 48-day-old, ex-premature infant and discuss the effects of potential viral-bacterial interactions on host susceptibility to this disease.

  18. Biomarkers of brain injury in the premature infant

    Directory of Open Access Journals (Sweden)

    Martha V. Douglas-Escobar

    2013-01-01

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

  19. 不同胎龄早产儿1岁时体格和神经发育差异分析%Comparison of differences of physique and neurodevelopment in early preterm infants and late preterm infants at 1 year of age

    Institute of Scientific and Technical Information of China (English)

    陈飒英; 孙京惠; 王云峰; 王琳; 曲松梅

    2011-01-01

    目的:探讨不同胎龄早产儿l岁时体格发育和神经发育的差异.方法:随访年龄达到1岁的早产儿,分为早期早产儿(EPI)组(胎龄0.05),EPI组身长低于LPI组[(74.1±2.2)cm比(75.9±2.9)cm,P0.05),EPI组PDI低于LPI组[(77.7±9.4)分比(86.6±11.4)分,(81.0±12.1)分比(88.2±ll.5)分,P均<0.05)].脑性瘫痪EPI组2例,LPI组3例.结论:1岁时EPI身长和运动发育较LPI明显延迟,应重视不同胎龄早产儿的出院后干预.%Objective The study aims to compare physical development and neurodevelopment between early preterm infants ( EPI) and late preterm infants ( LPI) at 1 year of age. Methods Preterm infants are grouped into EPI and LPI with following up for one year. Differences in their body weight,body length, rate of growth retardation (≤P10) , psychomotor development index ( PDI), mental development index ( MDI) and neurophysical development are compared. Results Totally 68 cases of EPI and 106 cases of LPI were studied. The body length of EPI are shorter than the LPI (P < 0. 05) in body length and The incidence of developmental retardation in body length were higher in the EPI group than that in LPI group (P <0. 05) at l year of age, but no significant difference for weight (P >0. 05) There was no difFerence in MDI between the two groups at 6 months and 1 year of age ( P > 0. 05) , but PDI of EPI are lower than that of LPI (P <0. 05 ). We found 2 cases cerebral palsy in EPI group and 3 cases in EPI group. Conclusions Our data suggest that the length and physical development of EPI are significantly delayed compared with LPI at 1 year age, therefore priorities should be given to the early intervention of various preterm infants upon discharge.

  20. Nutritional care of premature infants: microminerals.

    Science.gov (United States)

    Domellöf, Magnus

    2014-01-01

    Microminerals, including iron, zinc, copper, selenium, manganese, iodine, chromium and molybdenum, are essential for a remarkable array of critical functions and need to be supplied in adequate amounts to preterm infants. Very low birth weight (VLBW) infants carry a very high risk of developing iron deficiency which can adversely affect neurodevelopment. However, a too high iron supply in iron-replete VLBW infants may induce adverse effects such as increased infection risks and impaired growth. Iron needs are influenced by birth weight, growth rates, blood losses (phlebotomy) and blood transfusions. An enteral iron intake of 2 mg/kg/day for infants with a birth weight of 1,500-2,500 g and 2-3 mg/kg/day for VLBW infants is recommended. Higher doses up to 6 mg/kg/day are needed in infants receiving erythropoietin treatment. Regular monitoring of serum ferritin during the hospital stay is advisable. Routine provision of iron with parenteral nutrition for VLBW infants is not recommended. Less certainty exists for the advisable intakes of other microminerals. It appears prudent to provide enterally fed VLBW infants with daily amounts per kilogram body weight of 1.4-2.5 mg zinc, 100-230 μg copper, 5-10 μg selenium, 1-15 μg manganese, 10-55 μg iodine, 0.03-2.25 μg chromium, and 0.3-5 μg molybdenum. Future scientific findings may justify deviations from these suggested ranges.

  1. Breastfeeding the premature infant and nursing implications.

    Science.gov (United States)

    Black, Amanda

    2012-02-01

    Research indicates that feeding preterm infants at the breast is physiologically less stressful than bottle-feeding. Poor sucking reflexes make it difficult to initiate breastfeeding for these high-risk infants. Mothers need to understand the difficulties of breastfeeding, as well as the advantages for herself and her baby. It is important for nurses to be well educated on how preterm infants are breastfed and how to best support the mother through her experience. The nurse must focus on caring for the infant as well as fostering the mother-infant connection to promote breastfeeding. A mother will need continual support, encouragement, and advice from the nurse, while teaching her baby how to breastfeed.

  2. Premature Infants: Perspectives on NICU-MT Practice

    OpenAIRE

    Jayne M Standley

    2014-01-01

    Music research began in the Neonatal Intensive Care Unit (NICU) over 25 years ago. Initially, medical staff resisted the idea that music therapy could impact premature infant medical outcomes. Today NICU-MT is well known in the U.S. with over 300 specially trained Board Certified Music Therapists (MT-BCs), and it is evolving in international settings. Over 50 research studies in refereed journals provide evidence-based methodology for NICU-MT and document important and unique infant benefit...

  3. [Recommendations for the perinatal management and follow up of late preterm newborns].

    Science.gov (United States)

    Hurtado Suazo, J A; García Reymundo, M; Calvo Aguilar, M J; Ginovart Galiana, G; Jiménez Moya, A; Trincado Aguinagalde, M J; Demestre Guasch, X

    2014-11-01

    Prematurity is the main reason for neonatal morbidity and mortality, and has become one of the greatest problems in public health, especially in developed countries. Prematurity rate has increased during the last 2 decades. This increase may be attributed to late preterm babies, that is, those with a gestational age between 34(+0) and 36(+6) weeks. Perinatal morbidities, as well as long term complications, are more frequent in this population than in term babies. The incidence is more similar to the one observed in earlier premature babies. The SEN34-36 group of the Spanish Society of Neonatology suggests these recommendations for the management of late preterm babies. Strategies are offered not only for the early detection of possible complications, but also for the correction of these morbidities, and from the point of view of a family and development centered care. Follow up is strongly recommended due to the high rate of late morbidities. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  4. Music and 25% glucose pain relief for the premature infant: a randomized clinical trial 1

    OpenAIRE

    Maria Vera Lúcia Moreira Leitão Cardoso; Leiliane Martins Farias; Gleicia Martins de Melo

    2014-01-01

    OBJECTIVE: to analyze the total Premature Infant Pain Profile scores of premature infants undergoing arterial puncture during music and 25% glucose interventions, and to assess their association with neonatal and therapeutic variables. METHOD: a randomized clinical trial with 80 premature infants; 24 in the Experimental Group 1 (music), 33 in the Experimental Group 2 (music and 25% glucose), 23 in the Positive Control Group (25% glucose). All premature infants were videotaped and a lullaby wa...

  5. A Program of Stimulation for Infants Born Prematurely.

    Science.gov (United States)

    Barnard, Kathryn

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

  6. ‘The influence of gestational age and socioeconomic status on neonatal outcomes in late preterm and early term gestation: a population based study’

    Directory of Open Access Journals (Sweden)

    Ruth Chelsea A

    2012-06-01

    Full Text Available Abstract Background Infants born late preterm (34 + 0 to 36 + 6 weeks GA (gestational age are known to have higher neonatal morbidity than term (37 + 0 to 41 + 6 weeks GA infants. There is emerging evidence that these risks may not be homogenous within the term cohort and may be higher in early term (37 + 0 to 38 + 6 weeks GA. These risks may also be affected by socioeconomic status, a risk factor for preterm birth. Methods A retrospective population based cohort of infants born at 34 to 41 weeks of GA was assembled; individual and area-level income was used to develop three socioeconomic (SES groups. Neonatal morbidity was grouped into respiratory distress syndrome (RDS, other respiratory disorders, other complications of prematurity, admission to a Level II/III nursery and receipt of phototherapy. Regression models were constructed to examine the relationship of GA and SES to neonatal morbidity while controlling for other perinatal variables. Results The cohort contained 25 312 infants of whom 6.1% (n = 1524 were born preterm and 32.4% (n = 8203 were of low SES. Using 39/40 weeks GA as the reference group there was a decrease in neonatal morbidity at each week of gestation. The odds ratios remained significantly higher at 37 weeks for RDS or other respiratory disorders, and at 38 weeks for all other outcomes. SES had an independent effect, increasing morbidity with odds ratios ranging from 1.2–1.5 for all outcomes except for the RDS group, where it was not significant. Conclusions The risks of morbidity fell throughout late preterm and early term gestation for both respiratory and non-respiratory morbidity. Low SES was associated with an independent increased risk. Recognition that the morbidities associated with prematurity continue into early term gestation and are further compounded by SES is important to develop strategies for improving care of early term infants, avoiding iatrogenic

  7. Timing of indicated late-preterm and early-term birth.

    Science.gov (United States)

    Spong, Catherine Y; Mercer, Brian M; D'alton, Mary; Kilpatrick, Sarah; Blackwell, Sean; Saade, George

    2011-08-01

    The growing public health awareness of prematurity and its complications has prompted careful evaluation of the timing of deliveries by clinicians and hospitals. Preterm birth is associated with significant morbidity and mortality, and affects more than half a million births in the United States each year. In some situations, however, a late-preterm or early-term birth is the optimal outcome for the mother, child, or both owing to conditions that can result in worse outcomes if pregnancy is allowed to continue. These conditions may be categorized as placental, maternal, or fetal, including conditions such as placenta previa, preeclampsia, and multiple gestations. Some risks associated with early delivery are common to all conditions, including prematurity-related morbidities (eg, respiratory distress syndrome and intraventricular hemorrhage) as well as maternal intrapartum morbidities such as failed induction and cesarean delivery. However, when continuation of the pregnancy is associated with more risks such as hemorrhage, uterine rupture, and stillbirth, preterm delivery maybe indicated. In February 2011, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Society for Maternal-Fetal Medicine held a workshop titled "Timing of Indicated Late Preterm and Early Term Births." The goal of the workshop was to synthesize the available information regarding conditions that may result in medically indicated late-preterm and early-term births to determine the potential risks and benefits of delivery compared with continued pregnancy, determine the optimal gestational age for delivery of affected pregnancies when possible, and inform future research regarding these issues. Based on available data and expert opinion, optimal timing for delivery for specific conditions was determined by consensus.

  8. Metabolic studies of transient tyrosinemia in premature infants

    Science.gov (United States)

    Fernbach, S. A.; Summons, R. E.; Pereira, W. E.; Duffield, A. M.

    1975-01-01

    The recently developed technique of gas chromatography-mass spectrometry supported by computer has considerably improved the analysis of physiologic fluids. This study attempted to demonstrate the value of this system in the investigation of metabolite patterns in urine in two metabolic problems of prematurity, transient tyrosinemia and late metabolic acidosis. Serial 24-hr urine specimens were analyzed in 9 infants. Transient tyrosinemia, characterized by 5- 10-fold increases over basal excretion of tyrosine, p-hydroxyphenyllactate, and p-hydroxyphenylpyruvate in urine, was noted in five of the infants. Late metabolic acidosis was seen in four infants, but bore no relation to transient tyrosinemia.

  9. Carnitine deficiency in premature infants receiving total parenteral nutrition.

    Science.gov (United States)

    Penn, D; Schmidt-Sommerfeld, E; Wolf, H

    1980-03-01

    Carnitine plays a significant role in fatty acid utilization and ketone body production. Its availability is especially important during the immediate postnatal period. To determine whether low birth weight infants who cannot be orally fed are at risk of developing carnitine deficiency, we compared the carnitine blood levels and urinary excretion of 12 premature infants (Group A) receiving total parenteral nutrition (TPN) with those of 8 infants of similar gestational age and birth weight (Group B) who received carnitine-containing milk formulas. In Group A, serum levels of total and free carnitine fell after 5 days of carnitine-deficient parenteral nutrition, and urinary excretion was significantly reduced. Serum levels and urinary excretion increased after the onset of oral feedings. The control Group B exhibited no significant changes in carnitine blood levels between the first and fifth days of life, but did show a later increase. Children in Group A had lower carnitine blood levels compared to those in Group B on the fifth day of life. These findings suggest that premature infants are not able to synthesize enough carnitine to maintain blood levels, and that carnitine deficiency can occur following TPN. Further investigation of metabolic consequences secondary to deficient carnitine intake in premature infants is necessary before carnitine supplementation should be considered.

  10. Effect of parenteral glutamine supplementation in premature infants

    Institute of Scientific and Technical Information of China (English)

    LI Zheng-hong; WANG Dan-hua; DONG Mei

    2007-01-01

    Background Glutamine, proposed to be conditionally essential for critically ill patients, is not added routinely to parenteral amino acid formulations for premature infants and is provided in only small quantities by the enteral route when enteral feeding is Iow. Parenteral feeding is the basic way of nutrition in the first days of life of premature infants. In this study, we evaluated the effects of glutamine supplemented parenteral nutrition for premature infants on growth and development, feeding toleration, and infective episodes.Methods From December 2002 to July 2006, 53 premature infants were given either standard or glutamine supplemented parenteral nutrition for more than 2 weeks. Twenty-eight infants were in glutamine supplemented group, whose gestational age (31.4±2.0) weeks, birth weight range (1386±251) g; twenty-five infants were in control group, gestational age (31.1 ± 1.7) weeks, with birth weight range (1346± 199) g. There were no differences between the two groups. Various growth and biochemical indices were monitored throughout the duration of hospital stay. Data between groups were analyzed with Student's t test. Nonparametric data were analyzed using a Chi-square test. A two-tailed P value < 0.05 was considered statistically significant.Results The level of serum albumin was lower in the glutamine groups on the second week (3.0 vs 3.2 g/dl, P=0.028), and blood urea nitrogen was higher in glutamine groups on the fourth week (8.1 vs 4.9 mg/dl, P=0.014), but normal. Glutamine group infants took fewer days to regain birth weight (8.1 vs 10.4 days, P=0.017), required fewer days on parenteral nutrition (24.8 vs 30.8 days, P=0.035), with shorter stays in hospital (32.1 vs 38.6 days, P=0.047). Episodes of hospital acquired infection in glutamine supplemented infants were lower than that in control group (0.96 vs 1.84 times, P=0.000).Conclusion Parenteral glutamine supplementation in premature infants can shorten days on parenteral nutrition and

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

    Science.gov (United States)

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

    2016-01-01

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

  12. BREAST FEEDING SUPPORT IN PREMATURE INFANTS: PROBLEMS AND SOLUTIONS

    Directory of Open Access Journals (Sweden)

    I. A. Belyaeva

    2014-01-01

    Full Text Available Support of long-term breast feeding is a pressing issue of neonatology. It is known that the unique composition of breast milk ensures proper physical and neuropsychic development of infants, as it contains all the necessary nutrients in the sufficient amount and optimal proportion. The authors gave specific attention to provision of premature infants, especially with very low and extremely low birth weight, with breast milk. However, it is very difficult to launch and maintain breast feeding in this very category of patients. There are many reasons impeding adequate provision of premature infants with breast milk. The main problem on the part of the mother is hypogalactia, which may be caused by preterm labor stress, lack of confidence in successful lactation, temporary medical contraindications and, therefore, deviant formation of the lactation dominant, motivation towards prolonged breast feeding etc. On the part of the child: severe condition, no or weak sucking reflex, often — prolonged parenteral and tube feeding, need in supplementary feeding. The article presents published data on various methods of maintaining breast feeding at the stage of hospital developmental care of premature infants and experience of breast feeding support accumulated at the Scientific Center of Children’s Health, which proves that simultaneous support and follow-up of the child’s mother and her family in whole by several specialists (neonatologist/pediatrician, psychologist, breast physician, dietician and recreation therapist not only at the stages of labor and development care, but also after discharge from hospital are required to ensure rational and prolonged breast feeding of premature infants and normal growth and development thereof. 

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

    Directory of Open Access Journals (Sweden)

    Didoné, Dayane Domeneghini

    2014-01-01

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

  14. Thermoregulation in premature infants: A mathematical model.

    Science.gov (United States)

    Pereira, Carina Barbosa; Heimann, Konrad; Czaplik, Michael; Blazek, Vladimir; Venema, Boudewijn; Leonhardt, Steffen

    2016-12-01

    In 2010, approximately 14.9 million babies (11.1%) were born preterm. Because preterm infants suffer from an immature thermoregulatory system they have difficulty maintaining their core body temperature at a constant level. Therefore, it is essential to maintain their temperature at, ideally, around 37°C. For this, mathematical models can provide detailed insight into heat transfer processes and body-environment interactions for clinical applications. A new multi-node mathematical model of the thermoregulatory system of newborn infants is presented. It comprises seven compartments, one spherical and six cylindrical, which represent the head, thorax, abdomen, arms and legs, respectively. The model is customizable, i.e. it meets individual characteristics of the neonate (e.g. gestational age, postnatal age, weight and length) which play an important role in heat transfer mechanisms. The model was validated during thermal neutrality and in a transient thermal environment. During thermal neutrality the model accurately predicted skin and core temperatures. The difference in mean core temperature between measurements and simulations averaged 0.25±0.21°C and that of skin temperature averaged 0.36±0.36°C. During transient thermal conditions, our approach simulated the thermoregulatory dynamics/responses. Here, for all infants, the mean absolute error between core temperatures averaged 0.12±0.11°C and that of skin temperatures hovered around 0.30°C. The mathematical model appears able to predict core and skin temperatures during thermal neutrality and in case of a transient thermal conditions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. NURSING AND CARING OF THE PREMATURE INFANTS

    DEFF Research Database (Denmark)

    Aagaard, Hanne; Jørgensen, Eva; Hall, Elisabeth

    2006-01-01

    of attention-related behaviours, and the infant’s competences to have self-control, growth, breath function and time for discharge. Variables and the mothers: maternal self-esteem; staffs support to the parents; parents support from different networks and a demographic data. The study includes 60 children...... quantitatively. The data collecting will take place from the 19. Of October 2005 and one year forward. The expectations of the results are to find a significant advantage in the intervention group showing that the infants will be more mature; more stable in their self control; the mothers will be more competent...

  16. [Developmental amnesia in the premature infant].

    Science.gov (United States)

    Mouron, V; Hays, S; Gonzalez-Monge, S

    2010-02-01

    All types of memory disorders have been observed in children, although these reports are rare. Developmental amnesia selectively involves episodic daily life memory while semantic learning is respected and general intelligence is not affected. Daily life is severely disturbed by this cognitive disorder usually occurring after hypoxic ischemic injury with bilateral hippocampal atrophy on MRI. Memory disorders are underdiagnosed in at-risk patients and rarely reported. We report on a former small-for-gestational-age preterm infant with no obvious hypoxic event during perinatal life. The follow-up was normal until elementary school. He had to spend 2 years in 1st grade and exhibited some behavioral troubles. At the age of 9, he was suspected of suffering from dyspraxia and was referred to a pediatrics rehabilitation center. IQ and neuropsychological tests were administered and showed selective autobiographical memory impairment defining developmental amnesia. Despite a typical clinical presentation, brain MRI was normal, including the hippocampal area. This observation underlines the need for a prolonged follow-up until school age to assess the outcome of preterm infants. Otherwise, the evaluation will be limited to motor impairment. Particular attention should be paid to memory during the follow-up to avoid misdiagnoses and to plan and adapt these children's educational strategies. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  17. [Maintenance of lactation: a challenge for hospitalized premature infant's mothers].

    Science.gov (United States)

    de Azevedo, Melissa; Mendes, Eliane Norma Wagner

    2008-03-01

    Preterm birth is a difficult situation for all family members, interfering with the establishment of parental bonding and attachment with the baby. This paper is a qualitative and collective case study, carried out with the purpose of identifying the perception of mothers concerning the maintenance of lactation during the hospital stay of premature infants at Hospital de Clínicas de Porto Alegre (Clinic Hospital of Porto Alegre), Rio Grande do Sul, Brazil. The data were collected from March to April/2006 through interviews and observations and resulted in four categories. This article focuses only on the categories that refer to the mechanisms used by mothers to maintain lactation during hospitalization: beliefs and attitudes related to maintenance of lactation and breast milk expression at the human milk bank. The maintenance of lactation constitutes a complex process to be learnt by mothers involved with their infant's prematurity and hospitalization.

  18. Maternal panic disorder: Infant prematurity and low birth weight.

    Science.gov (United States)

    Warren, Susan L; Racu, Camellia; Gregg, Vanessa; Simmens, Samuel J

    2006-01-01

    The aim of this pilot research was to investigate whether infants of mothers with panic disorder (PD) would be at higher risk for prematurity and low birth weight (corrected for gestational age) than controls. Medical records were reviewed for 25 mothers with PD and 33 mothers without a lifetime history of anxiety disorders or other major psychopathology as determined by diagnostic interview. Mothers also completed questionnaires concerning demographic information and life stresses. Compared to controls, infants with PD mothers were not significantly more likely to be born prematurely or earlier than controls but did show smaller birth weight corrected for gestational age, even after accounting for possible confounding influences. Additional research is needed to confirm these preliminary findings. Studying PD mothers during pregnancy could provide insight concerning mechanisms for the development of low birth weight and psychopathology.

  19. FEATURES OF INTENSIVE NUTRITIONAL SUPPORT OF PREMATURE INFANTS IN INTENSIVE CARE UNIT (PART 1

    Directory of Open Access Journals (Sweden)

    K.V. Romanenko

    2011-01-01

    Full Text Available The article presents the modern approaches to preterm infants feeding, principles of parenteral and enteral nutrition. The importance of adequate control of deficit status in preterm infants at different periods of developmental care is marked. Arguments for using the enriched milk or specialized formulas for prematurity during the in-clinic and out-clinic periods of care are provided.Key words: premature infants, enteral nutrition, formulas for premature infants, breast milk, breast milk enriches.

  20. Prostaglandin E2 and patent ductus arteriosus in premature infants

    Directory of Open Access Journals (Sweden)

    Mochammading,

    2016-01-01

    Full Text Available Background Patent ductus arteriosus (PDA is a congenital heart disease most commonly occurring in premature infants. Spontaneous ductus arteriosus (DA closure in premature infants has been suggested to be associated with duct lumen maturity and the DA sensitivity to prostaglandin E2 (PGE2. Objective To assess for a possible correlation between serum PGE2 levels and PDA size in premature infants. Methods This observational study using repeated measurements on premature infants with PDA detected at days 2-3 of life was undertaken in Cipto Mangunkusumo Hospital and Fatmawati Hospital, Jakarta, from April to May 2014. The PDA was diagnosed using 2-D echocardiography and PGE2 levels were measured by immunoassay. Pearson’s correlation test was used to evaluate a possible correlation between PGE2 level and DA diameter. Results Thirty-three premature infants of median gestational age 31 (range 28-32 weeks and median birth weight 1,360 (range 1,000-1,500 grams were enrolled. Almost two-thirds of the subjects were male. Almost all (30/33 subjects had spontaneous DA closure before the age of 10 days. Subjects’ mean DA diameter was 2.9 (SD 0.5 mm with maximum flow velocity of 0.2 (SD 0.06 cm/sec, and left atrial-to-aortic root ratio (LA/Ao of 1.5 (SD 0.2. Their mean PGE2 levels at the ages of 2-3, 5-7, and after 10 days were 5,238.6 (SD 1,225.2, 4,178.2 (SD 1,534.5, and 915.2 (SD 151.6 pg/mL, respectively. The PGE2 level at days 2-3 was significantly correlated with DA diameter (r = 0.667; P < 0.001, but not at days 5-7 (r = 0.292; P = 0.105 or at day 10 (r = 0.041; P = 0.941. Conclusion There is a strong, positive correlation between the PGE2 level and DA diameter in preterm infants at 2-3 days of age. However, there is no significant correlation between PGE2 level and persistence of PDA.

  1. Retinopathy of Prematurity in Infants with Late Retinal Examination

    Directory of Open Access Journals (Sweden)

    S. Zeinab Mousavi

    2009-01-01

    Full Text Available

    PURPOSE: To report the incidence, severity and risk factors of retinopathy of prematurity (ROP in premature infants with late ROP examination in Farabi Eye Hospital. METHODS: In a retrospective study from January 2001 to July 2007, hospital records of premature infants who were examined later than 9 weeks after birth were reviewed to determine the incidence, severity and possible risk factors of ROP including gender, singleton or multiple gestations, gestational age (GA, birth weight (BW, oxygen therapy, blood transfusion, phototherapy, respiratory distress syndrome (RDS, mechanical ventilation, intraventricular hemorrhage and sepsis as well as age at initial examination. RESULTS: Out of a total of 797 infants referred for ROP screening during the study period, 216 (27.1% had late examinations at a mean age of 141.7±150.4 (range 64-1,460 days. Of these, 87 (40.3% had different stages of ROP, 65 (30.1% had stage 4 or 5 disease including 34 (16.2% infants with stage 5 ROP in both eyes which was untreatable. Lower GA (P < 0.001, RDS (P=0.041 and blood transfusion (P=0.009 were associated with the development of ROP. CONCLUSION: The overall prevalence of ROP and the incidence

  2. 75 FR 43535 - NIH Consensus Development Conference on Inhaled Nitric Oxide Therapy for Premature Infants

    Science.gov (United States)

    2010-07-26

    ... Oxide Therapy for Premature Infants Notice Notice is hereby given of the National Institutes of Health (NIH) ``NIH Consensus Development Conference on Inhaled Nitric Oxide Therapy for Premature Infants'' to... ``premature'' or ``preterm'' and face increased risk for a variety of complications. Babies born before the...

  3. Apnea after Routine Eye Examinations in Premature Infants.

    Science.gov (United States)

    Reid, Brittany; Wang, Hongyue; Guillet, Ronnie

    2017-01-01

    Objective To determine the frequency of cardiorespiratory events following routine exams for retinopathy of prematurity (ROP). Study Design This is a retrospective review of 79 premature infants in the neonatal intensive care unit at the University of Rochester Medical Center. The baseline for each infant (mean cardiorespiratory events in the 72 hours before the exam) was compared with the number of cardiorespiratory events during the subsequent 24 hours using generalized estimating equation and the Mantel-Haenszel chi-square test to determine if there was an association between cardiorespiratory events and potential risk factors. Results Approximately 19 to 25% of infants experienced an increase in cardiorespiratory events in the 24 hours following their eye exams. These newborns were generally of a younger gestational age and lower birthweight. Conclusion The frequency of cardiorespiratory events following routine ROP exams is similar to that following routine immunizations in this population. Thus, in infants being continuously monitored during the 24 hours after the exam, alterations in medical care in the absence of other clinical signs suggestive of sepsis or clinical deterioration may not be required, limiting unnecessary antibiotic exposure, prolonged caffeine administration, unwarranted gastroesophageal reflux treatment, and undue family stress.

  4. [Development and fate of premature infants--then and now].

    Science.gov (United States)

    Haas, G

    1983-10-01

    New scientific results and progress in technology allow even premature infants with very low birth weight to survive today. A vehement discussion arouse about effectiveness and efficiency of intensive care programs for these infants. However, an appreciation of the results at present should not be made without taking note of those achieved in former decades. A. Ylppö was the first pediatrician in Germany at the beginning of the 20th century, who was working systematically for the survival of low birth weight infants. He achieved remarkable results even at that time. After World War II the chances for survival of low birth weight infants became worse because of dangerous therapeutic innovations. In the 60's the frequency of serious sequelae could be reduced by improved therapeutic approaches. Since then the mortality rate is decreasing, whereas the frequency of serious sequelae remains nearly stable during the last 15 years. We hope that clinical research and new technologies may also reduce the morbidity of surviving premature babies in the future.

  5. Premature Infants: Perspectives on NICU-MT Practice

    Directory of Open Access Journals (Sweden)

    Jayne M Standley

    2014-07-01

    Full Text Available Music research began in the Neonatal Intensive Care Unit (NICU over 25 years ago. Initially, medical staff resisted the idea that music therapy could impact premature infant medical outcomes. Today NICU-MT is well known in the U.S. with over 300 specially trained Board Certified Music Therapists (MT-BCs, and it is evolving in international settings. Over 50 research studies in refereed journals provide evidence-based methodology for NICU-MT and document important and unique infant benefits from music Quality of medical services is evaluated by benchmarks of benefit that are also economical and efficient. NICU-MT is underutilized and improves both medical and developmental outcomes for infants while reducing medical costs. For these reasons, it is an important new benchmark of quality NICU care. It behooves the profession to describe and promulgate specialized NICU-MT treatment techniques. Because of the extreme fragility and unique needs of premature infants still undergoing fetal development, it is also timely that the music therapy profession begins to develop specialized training for clinical treatment in this area. This article offers a perspective on NICU-MT by integrating music research with developmental theory, medical treatment, and MT clinical practice. It also provides suggestions for development of the specialization of NICU-MT.

  6. Three-dimensional optical tomography of the premature infant brain

    Energy Technology Data Exchange (ETDEWEB)

    Hebden, Jeremy C [Department of Medical Physics and Bioengineering, University College London, 11-20 Capper Street, London (United Kingdom); Gibson, Adam [Department of Medical Physics and Bioengineering, University College London, 11-20 Capper Street, London (United Kingdom); Yusof, Rozarina Md [Department of Medical Physics and Bioengineering, University College London, 11-20 Capper Street, London (United Kingdom); Everdell, Nick [Department of Medical Physics and Bioengineering, University College London, 11-20 Capper Street, London (United Kingdom); Hillman, Elizabeth M C [Department of Medical Physics and Bioengineering, University College London, 11-20 Capper Street, London (United Kingdom); Delpy, David T [Department of Medical Physics and Bioengineering, University College London, 11-20 Capper Street, London (United Kingdom); Arridge, Simon R [Department of Computer Science, University College London, Gower Street, London (United Kingdom); Austin, Topun [Department of Paediatrics and Child Health, University College London, 5 University Street, London (United Kingdom); Meek, Judith H [Department of Paediatrics and Child Health, University College London, 5 University Street, London (United Kingdom); Wyatt, John S [Department of Paediatrics and Child Health, University College London, 5 University Street, London (United Kingdom)

    2002-12-07

    For the first time, three-dimensional images of the newborn infant brain have been generated using measurements of transmitted light. A 32-channel time-resolved imaging system was employed, and data were acquired using custom-made helmets which couple source fibres and detector bundles to the infant head. Images have been reconstructed using measurements of mean flight time relative to those acquired on a homogeneous reference phantom, and using a head-shaped 3D finite-element-based forward model with an external boundary constrained to match the measured positions of the sources and detectors. Results are presented for a premature infant with a cerebral haemorrhage predominantly located within the left ventricle. Images representing the distribution of absorption at 780 nm and 815 nm reveal an asymmetry consistent with the haemorrhage, and corresponding maps of blood volume and fractional oxygen saturation are generally within expected physiological values.

  7. Results of Thyroid Function Tests in Premature Infants

    Directory of Open Access Journals (Sweden)

    Pelin Doğan

    2016-04-01

    Full Text Available Introduction: To determine the rate, etiology and morbidity association of disorders of thyroid function tests (TFTs in premature babies. Materials and Methods: A total of 139 premature babies who were admitted to Uludag University Faculty of Medicine Hospital Neonatal Intensive Care Unit between January 2009 and January 2012 were included in this study. Prenatal, natal and postnatal characteristics along with TFTs results were recorded. TFTs were performed for all patients in the first and third weeks of life. Thyroid stimulation hormone (TSH values of >10 IU/L was considered elevated. Free T3 and T4 levels were evaluated according to laboratory cut-off values. Weight, height and head circumference values of all individuals with and without the diagnosis of hypothyroidism on the 6th, 12th, and 18th months of their polyclinic follow-ups.Results: Abnormal TFTs were detected in 41 (24% patients. Twenty two patients (53% had transient TSH elevation, 9 (22% had primary hypothyroidism, 9 (22% had non-thyroidal disease and 1 (2.4% had transient hypothyroxinemia. Among morbidities, respiratory distress syndrome rate was found to be significantly higher in patients with thyroid function disorders (p=0.007. The rate of thyroid function disorders in patients with mothers with hypothyroidism was significantly more frequent compared to patients without maternal hypothyroidism (p=0.049. The mean head circumference in 18 month was significantly lower in patients with abnormal TFTs (p=0.047. Conclusions: Thyroid function disorders are common morbidities in premature babies and are important for neuromotor development. Maternal thyroid function disorder can lead to impairment of TFTs in infants. Thyroid function tests should be performed in all premature babies and hypotyhroidism should be treated. Avoidance of iodine exposure in premature infants can reduce the rate of abnormal TFTs and transient hypothyroidism.

  8. Management of patent ductus arteriosus in premature infants.

    Science.gov (United States)

    Bhat, Rama; Das, Utpala G

    2015-01-01

    Patency of the ductus arteriosus is required for fetal survival in utero. In infants born prematurely, ductus fails to close and shunt reverses from left to right. Incidence of patent ductus arteriosus (PDA) is inversely proportional to the gestational age. A large PDA (>1.5 mm diameter) with left to right shunt in very low birth weight infants can cause pulmonary edema, congestive heart failure, pulmonary hemorrhage and increase the risk for bronchopulmonary dysplasia. Attempts to prevent or close the duct by pharmacological or surgical methods have not changed the morbidity or the long term outcome. Pharmacological treatment with indomethacin or ibuprofen is successful in 75 to 80 % of infants but its use also exposes these infants to undesirable side effects like gastrointestinal bleeding, perforation and necrotizing enterocolitis. Prophylactic therapy with indomethacin or ibuprofen to prevent PDA has not altered the morbidity or long term outcome. Currently, there is a dilemma as to how to treat, when to treat and whom to treat. Recent literature suggests a trial of conservative management during the first week followed by selective use of anti-inflammatory drugs. Surgical ligation is reserved for infants who fail medical therapy and still remain symptomatic. Spontaneous closure of the PDA has been reported in up to 40-67 % of very low birth weight (VLBW) infants by 7 d. In this review authors discuss these controversies and propose a more rational approach.

  9. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

    Directory of Open Access Journals (Sweden)

    Marie Janaillac

    2016-01-01

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

  10. Retinopathies in premature infants, incidence, risk factors, prevention and treatment

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2014-12-01

    Full Text Available Research Objective: Analysis of incidence and accompanying states, detection of risk factors of retinopathies in premature infants (RN, dynamic monitoring and improvement of medical actions. Material and Methods: 134 children have been surveyed in the group of risk on development of RN for the last 2 years. Results: From 134 surveyed infants with gestation from 22 to 37 weeks and body weight at birth from 750 to 2500 kg. At 56 children (41,8% the retinopathy of various degree of expressiveness has been revealed. 38 children with RN of 1-2 stages (67,8% from which at 22 (39,3% —the disease ended with the induced regress after a course of «retinalamin», at 16 (28,6% of RN — spontaneous regress. 4 children (7,1% had RN 2-3 of the Art., 3-4 Art. at 12 (21,4%, and 5 Art. a cicatricial phase with retinal detachment — 2 (3,5%. In 12 cases the laser photocoagulation in the eye centers is carried out. Conclusion: The revealed relationship of cause and effect of risk factors of formation of RN with features of a current ofthe neonatal period at patients with RN, promoted development of the system of monitoring, implementation of the program of treatment and rehabilitation of prematurely born children suffering RN. Ophthalmologic screening of premature infants with the use of the ophthalmologic digital pediatric camera "Ret Cam 3" allows to diagnose a retinopathy at early stages, in due time to hold preventive an3 medical measures that allows to lower the invalidization of this group of children.

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

    Science.gov (United States)

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

    2017-02-01

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

  12. Neonatal morbidity associated with late preterm and early term birth: the roles of gestational age and biological determinants of preterm birth

    Science.gov (United States)

    Brown, Hilary K; Speechley, Kathy Nixon; Macnab, Jennifer; Natale, Renato; Campbell, M Karen

    2014-01-01

    Background The aim of this study was to elucidate the role of gestational age in determining the risk of neonatal morbidity among infants born late preterm (34–36 weeks) and early term (37–38 weeks) compared with those born full term (39–41 weeks) by examining the contribution of gestational age within the context of biological determinants of preterm birth. Methods This was a retrospective cohort study. The sample included singleton live births with no major congenital anomalies, delivered at 34–41 weeks of gestation to London-Middlesex (Canada) mothers in 2002–11. Data from a city-wide perinatal database were linked with discharge abstract data. Multivariable models used modified Poisson regression to directly estimate adjusted relative risks (aRRs). The roles of gestational age and biological determinants of preterm birth were further examined using mediation and moderation analyses. Results Compared with infants born full term, infants born late preterm and early term were at increased risk for neonatal intensive care unit triage/admission [late preterm aRR = 6.14, 95% confidence interval (CI) 5.63, 6.71; early term aRR = 1.54, 95% CI 1.41, 1.68] and neonatal respiratory morbidity (late preterm aRR = 6.16, 95% CI 5.39, 7.03; early term aRR = 1.46, 95% CI 1.29, 1.65). The effect of gestational age was partially explained by biological determinants of preterm birth acting through gestational age. Moreover, placental ischaemia and other hypoxia exacerbated the effect of gestational age on poor outcomes. Conclusions Poor outcomes among infants born late preterm and early term are not only due to physiological immaturity but also to biological determinants of preterm birth acting through and with gestational age to produce poor outcomes. PMID:24374829

  13. Retinopathy of prematurity outcome in infants with Prethreshold Retinopathy of Prematurity and oxygen saturation > 94% in room air : The High Oxygen Percentage in Retinopathy of Prematurity study

    NARCIS (Netherlands)

    McGregor, ML; Bremer, DL; Cole, C; McClead, RE; Phelps, DL; Fellows, RR; Oden, N

    2002-01-01

    Objectives. To determine the rate of progression from prethreshold to threshold retinopathy of prematurity (ROP) in infants excluded from Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP) because their median arterial oxygen saturation by pulse oximetry (Spo(2))

  14. Surfactant Protein A and B Gene Polymorphisms and Risk of Respiratory Distress Syndrome in Late-Preterm Neonates

    Science.gov (United States)

    Tsitoura, Maria-Eleni I.; Stavrou, Eleana F.; Maraziotis, Ioannis A.; Sarafidis, Kosmas; Athanassiadou, Aglaia; Dimitriou, Gabriel

    2016-01-01

    Background and Objectives Newborns delivered late-preterm (between 340/7 and 366/7 weeks of gestation) are at increased risk of respiratory distress syndrome (RDS). Polymorphisms within the surfactant protein (SP) A and B gene have been shown to predispose to RDS in preterm neonates. The aim of this study was to investigate whether specific SP-A and/or SP-B genetic variants are also associated with RDS in infants born late-preterm. Methods This prospective cross-sectional study included 56 late-preterm infants with and 60 without RDS. Specific SP-A1/SP-A2 haplotypes and SP-B Ile131Thr polymorphic alleles were determined in blood specimens using polymerase-chain-reaction and DNA sequencing. Results The SP-A1 6A4 and the SP-A2 1A5 haplotypes were significantly overrepresented in newborns with RDS compared to controls (OR 2.86, 95%CI 1.20–6.83 and OR 4.68, 95%CI 1.28–17.1, respectively). The distribution of the SP-B Ile131Thr genotypes was similar between the two late-preterm groups. Overall, the SP-A1 6A4 or/and SP-A2 1A5 haplotype was present in 20 newborns with RDS (35.7%), resulting in a 4.2-fold (1.60–11.0) higher probability of RDS in carriers. Multivariable regression analysis revealed that the effect of SP-A1 6A4 and SP-A2 1A5 haplotypes was preserved when adjusting for known risk or protective factors, such as male gender, smaller gestational age, smaller weight, complications of pregnancy, and administration of antenatal corticosteroids. Conclusions Specific SP-A genetic variants may influence the susceptibility to RDS in late-preterm infants, independently of the effect of other perinatal factors. PMID:27835691

  15. Rib enlargement in premature infants with bronchopulmonary dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung; Han, Kim Bokyung; Chang, Yun Sil; Choo, In Wook [Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of); Kim, Kyeong Ah [Anyang General Hospital, Anyang (Korea, Republic of)

    2000-04-01

    The purpose of this study is to describe the rib changes seen in patients with brochopulmonary dysplasia (BPD). Serial chest radiographs of nine premature infants with BPD who showed diffuse rib enlargement were reviewed for hyperinflation, which was compared with the observed degree of rib enlargement. Vibrator chest physiotherapy was performed in all cases, and five infants underwent conventional ventilation plus high frequency oscillatory ventilation therapy. Their calcium level was normal whereas alkaline phosphatase and phosphate levels were high. In all infants except one, liver enzyme levels were normal. For the treatment of patent ductus arteriosus, infection, and BPD, medications including indomethacin, antibiotics, and dexamethasone were administered. Vitamin D was given to all patients with total parenteral nutrition. Rib enlargement was found to be severe (n=3D4), moderate (n=3D3), or mild (n=3D2) with undulating margins or posterior tapering (n=3D2). Hyperinflation was noted in eight patients, in seven of whom it was moderate to severe. Among these seven, rib enlargement was severe (n=3D2), moderate (n=3D3), or mild (n=3D2). In one infant with mild hyperinflation, rib enlargement was severe. Bilateral irregular infiltrates and atelectases were noted in all patients. In BPD patients, rib enlargement may be seen. In order to differentiate this process from systemic bone disease or bony dysplasia, an awareness of the rib changes occurring in patients with BPD may be important. (author)

  16. Developmental Outcomes of Premature and Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Reza Saeidi

    2016-03-01

    Full Text Available Background: Prematurity is the most common cause of death and disability And Preterm infants, are prone to developmental complications. For this reason this study was designed for follow up of these babies until 2 years by modified DDST-2. Methods: This study was a prospective longitudinal descriptive study from March 2009 to March 2011 in clinic of sheikh and Imam Reza Hospitals, mashhad, Iran. Sample size with Confidence coefficient of 95% and power 80%, was determined 100 hundred babies. Infants were seen by a pediatrician at a follow up clinic at 1, 3, 6, 9,12,15,18, 24, months.The developmental assessment was done using Denver-2 Developmental Screening Test. Results: mean age for smiling was 4/6 ± 2/1  months which significantly differed with appropriate age (p = 0.000, mean age for telling two syllables words 11/7±  1/9 months, without significant difference of appropriate age.(p = 0.139. Average age for understanding NO was 10/4±  2/0 months that significantly differed with appropriate age(p = 0.000. The average age for telling 6 word was 17/8±  3/0, without significant difference with appropriate age (p = 0.510. Conclusion: Children with history of prematurity and low birth weight have more disability and developmental delay so they need to developmental screening tests.

  17. Correspondence: Probiotic (Lactobacillus reuteri Protectis in premature infants

    Directory of Open Access Journals (Sweden)

    Anirban Mandal

    2017-02-01

    Full Text Available Dear Editor,We read with great interest the article by Jerković Raguž et al. published in the latest issue of your journal. First, we would like to commend the authors for their endeavor. We have comments regarding the methodological issues which require further clarification by the authors for the benefit of the readers of JPNIM. This corrispondence refers to the following article:Jerković Raguž M, Brzica J, Rozić S, Šumanović Glamuzina D, Mustapić A, Novaković Bošnjak M, Božić T. The impact of probiotics (Lactobacillus reuteri Protectis on the treatment, course and outcome of premature infants in the Intensive Care Unit in Mostar. J Pediatr Neonat Individual Med. 2016;5(2:e050228. doi: 10.7363/050228.Authors’ reply can be found in the following article:Jerković Raguž M, Brzica J, Rozić S, Šumanović Glamuzina D, Mustapić A, Novaković Bošnjak M, Božić T. Correspondence: Probiotic (Lactobacillus reuteri Protectis in premature infants – Authors’ reply. J Pediatr Neonat Individual Med. 2017;6(1:e060130. doi: 10.7363/060130.

  18. 晚期早产儿和足月儿早期运动发育对照研究%Comparative study on early motor development of late preterm and term infants

    Institute of Scientific and Technical Information of China (English)

    张雪梅; 张丽娟

    2015-01-01

    目的 研究晚期早产儿(在校正月龄后)和同龄足月儿早期运动发育水平的差异,为早期实施针对性的运动干预方案提供依据.方法 选取2013年6月-2014年5月在本院出生并在门诊随访的晚期早产儿46例作为观察组,随机选择同时期在本院出生的健康足月儿50例为对照组.在两组婴儿(14.0±1.0)周龄运用Alberta婴儿运动量表(Alberta Infant Motor Scale,AIMS)进行运动发育评估,比较两组原始得分、百分位≥50%的比例和运动发育异常率.结果 晚期早产儿AIMS原始得分低于足月儿组,但两组差异无统计学意义(P>0.05);两组AIMS得分相对应的百分位≥50%的比例,晚期早产儿显著低于足月儿(P<0.01).晚期早产儿和足月儿运动发育异常的比例两组比较差异有统计学意义(P<0.05).结论 晚期早产儿的早期运动发育趋势在校正胎龄后还常落后于正常足月出生同龄婴儿,应尽早实施早期干预,促进早产儿的良好发育.

  19. EVALUATING THE EFFECTIVENESS OF ELKAR (L-CARNITINE IN PREMATURE INFANTS

    Directory of Open Access Journals (Sweden)

    Svetlana V. Garina

    2016-06-01

    Full Text Available Introduction. Recently in Russia there is a tendency to increase the proportion of premature infants, prolonged postnatal adaptation which may be associated with carnitine deficiency Early diagnosis and correction of carnitine deficiency in premature infants is possible to reserve the prevention of pathological conditions of the prenatal period in these patients. Materials and Methods. 98 newborn infants have been examined with the help of clinical laboratory methods. Results. It has been stated that the overwhelming majority of newborn infants irrespective of their gestational age and body mass at the moment of birth had reference ranges of crude carnitine and higher degree of floating carnitine in their peripheral blood within the first days of their lives. These changes are particularly characteristic for small pre-mature infants. Statistically significant differences between the levels of crude carnitine and floating carnitine depended on the gender of newborn infants have been revealed. Directly correlated dependence of the level of crude carnitine on the body mass at the moment of birth of small premature infants has been stated. Discussion and Conclusions. It has been proved that implementing L-carnitine into the development care plan for premature infants facilitates quick body weight gain, significantly cuts down the period of tube feeding, lowers frequency of anemia development of premature infants and duration of neonatal jaundice. The ability of Elkar to correct functional diseases of cardio vascular system of premature infants has been shown.

  20. The perception of partnership between parents of premature infants and nurses in neonatal intensive care units

    DEFF Research Database (Denmark)

    Brødsgaard, Anne; Larsen, Palle; Weis, Janne

    2016-01-01

    REVIEW QUESTION/OBJECTIVE: The objective of this review is to identify how parents of premature infants in neonatal intensive care units (NICUs) and nurses perceive their partnership.The review questions are: how do parents of premature infants and nurses perceive their partnership during hospita...

  1. Effects of midazolam and morphine on cerebral oxygenation and hemodynamics in ventilated premature infants.

    NARCIS (Netherlands)

    Velden, A.A.E.M. van der; Hopman, J.C.W.; Klaessens, J.H.G.M.; Feuth, A.B.; Sengers, R.C.A.; Liem, K.D.

    2006-01-01

    BACKGROUND: Midazolam sedation and morphine analgesia are commonly used in ventilated premature infants. OBJECTIVES: To evaluate the effects of midazolam versus morphine infusion on cerebral oxygenation and hemodynamics in ventilated premature infants. METHODS: 11 patients (GA 26.6-33.0 weeks, BW 78

  2. Cholesterol synthesis and de novo lipogenesis in premature infants determined by mass isotopomer distribution analysis

    NARCIS (Netherlands)

    Renfurm, LN; Bandsma, RHJ; Verkade, HJ; Hulzebos, CV; Van Dijk, T; Boer, T; Stellaard, F; Kuipers, F; Sauer, PJJ

    2004-01-01

    Premature infants change from placental supply of mainly carbohydrates to an enteral supply of mainly lipids earlier in their development than term infants. The metabolic consequences hereof are not known but might have long-lasting health effects. In fact, knowledge of lipid metabolism in premature

  3. Late-onset blueberry muffin lesions following recombinant erythropoietin administration in a premature infant.

    Science.gov (United States)

    Pandey, Vishal; Dummula, Krishna; Fraga, Garth; Parimi, Prabhu

    2012-10-01

    Recombinant erythropoietin is being used in premature population for anemia of prematurity. It is considered very safe in this population, although risks are still being evaluated. We report the first case of dermal erythropoiesis as a side effect of recombinant erythropoietin in an extremely prematurely born infant presenting with late-onset blueberry muffin lesions.

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

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

    2012-08-01

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

  6. The hematology of bacterial infections in premature infants.

    Science.gov (United States)

    Zipursky, A; Palko, J; Milner, R; Akenzua, G I

    1976-06-01

    A series of premature infants was studied for the presence of bacterial infection. On the basis of clinical evidence and bacteriological studies, they were divided into three groups in which sepsis was considered to be proven, possible, or unlikely. Band neutrophil counts were elevated most frequently in the "sepsis-proven" group and the elevation occurred usually within 24 hours of onset of signs of disease. Qualitative changes in neutrophils (Döhle bodies, toxic granulation, and vacuolization) were more frequent in the sepsis-proven group and, together with the band count, provided valuable techniques for the diagnosis of bacterial infections. Thrombocytopenia occurred frequently in the sepsis-proven group and seemed to result from increased utilization or destruction of platelets rather than failure of production. In such cases, evidence of intravascular coagulation was minimal and it was concluded that thrombocytopenia had resulted from a direct effect of the bacteria or its products on platelets and/or endothelium.

  7. Adherence to discharge guidelines for late-preterm newborns.

    Science.gov (United States)

    Goyal, Neera K; Fager, Corinne; Lorch, Scott A

    2011-07-01

    To evaluate trends in adherence to American Academy of Pediatrics recommendations for early discharge of late-preterm newborns and to test the association between hospital characteristics and early discharge. This study was a population-based cohort study using statewide birth-certificate and hospital-discharge data for newborns in California, Missouri, and Pennsylvania from 1993 to 2005. A total of 282 601 late-preterm newborns at 611 hospitals were included. Using logistic regression, we studied the association of early discharge with regional and hospital factors, including teaching affiliation, volume, and urban versus rural location, adjusting for patient factors. From 1995 to 2000, early discharge decreased from 71% of the sample to 40%. However, by 2005, 39% were still discharged early. Compared with Pennsylvania, California (adjusted odds ratio [aOR]: 5.95 [95% confidence interval (CI): 5.03-7.04]), and Missouri (aOR: 1.56 [95% CI: 1.26-1.93]) were associated with increased early discharge. Nonteaching hospitals were more likely than teaching hospitals to discharge patients early if they were uninsured (aOR: 1.91 [95% CI: 1.35-2.69]) or in a health maintenance organization plan (aOR: 1.40 [95% CI: 1.06-1.84]) but not patients with fee-for-service insurance (aOR: 1.04 [95% CI: 0.80-1.34]). A similar trend for newborns on Medicaid was not statistically significant (aOR: 1.77 [95% CI: 0.95-3.30]). Despite a decline in the late 1990s, early discharge of late-preterm newborns remains common. We observe differences according to state, hospital teaching affiliation, and patient insurance. Additional research on the safety and appropriateness of early discharge for this population is necessary. Copyright © 2011 by the American Academy of Pediatrics.

  8. Relationship between late preterm birth and expression of attention-deficit hyperactivity disorder in school-aged children: clinical, neuropsychological, and neurobiochemical outcomes

    Directory of Open Access Journals (Sweden)

    Ben Amor L

    2012-08-01

    Full Text Available L Ben Amor,1,2 S Chantal,3 A Bairam41Department of Psychiatry, Hotel Dieu de Levis, 2Department of Psychiatry, Laval University, 3Enfant Jesus Hospital, 4Department of Paediatrics, Laval University, Quebec, CanadaAbstract: Attention-deficit hyperactivity disorder (ADHD is a common neurodevelopmental disorder in school-aged children, and prematurity is a recognized risk factor. Late-preterm birth, which represents 75% of premature births, is associated with ADHD symptoms, impaired cognitive performance, and behavior problems. However, little is known of the characteristics of ADHD associated with late prematurity. The purpose of this study was to compare the clinical, neuropsychological, and neurobiochemical characteristics associated with late-preterm ADHD with those of at-term ADHD.Methods: Eighty-six children with ADHD, aged 5–13 years, were recruited. They included 20 late-preterm children with ADHD and 66 at-term children with ADHD. The Diagnostic Interview Schedule for Children-IV and the Continuous Performance Test (CPT were used to evaluate their clinical and neuropsychological characteristics. Proton magnetic resonance spectroscopy was used to measure the ratio of metabolites (glutamate, choline, and N-acetyl-aspartate to creatine in both the prefrontal and striatal regions as well as the left cerebellum.Results: The groups did not differ in regards to clinical outcomes. However, the ADHD late-preterm group had worse omissions and commissions T-scores on CPT (P ≤ 0.05 than the ADHD at-term group. The ADHD late-preterm group also had lower ratios of glutamate in the left prefrontal cortex than the ADHD at-term group (P ≤ 0.05.Conclusion: Among children with ADHD, those born at late preterm have lower attention scores as evaluated by CPT and are associated with lower relative concentrations of glutamate in the prefrontal region than those born at term. Etiological factors could play a role in the expression of ADHD

  9. Early discharge of premature infants. A critical analysis.

    Science.gov (United States)

    Raddish, M; Merritt, T A

    1998-06-01

    Although significant advances in the medical management of acutely ill preterm infants have resulted in unprecedented rates of survival, issues surrounding the convalescent care, discharge preparation, and readiness of parents or other caregivers have been less well studied and represent the art of medicine. Recent consensus statements provide a degree of content validity; however, important areas of scientific inquiry remain. Much is left to understand about the pathophysiology, management, and outcomes of apnea, bradycardia, and oxygen desaturation episodes continuing at term. Why do the most immature infants have a delay in the maturation of respiratory control? Do breathing studies really provide information that predicts subsequent respiratory control abnormalities? If methylxanthines are used at discharge, what criteria should be adhered to regarding their discontinuation? How is nutrition best provided while transitioning to home? In infants whose mothers desire exclusive breast-feeding, should gavage feeds be used to supplement in order to avoid bottle-feedings? How long should breast milk be fortified, and when should supplemented artificial milks be used and for what period of time postdischarge should these more expensive special-discharge artificial milks be used? What other supplements, such as inositol, vitamins, or antioxidants, should be provided in order to achieve optimal growth and development? Technology-dependent infants pose even greater complexities. Some infants and families adapt to extensive use of technology in the home. In other situations, basic infant care is difficult to achieve. What are the essential components for successful early discharge, and how can the studies involving selected families be made universal? How can NICUs better prepare fathers and mothers for premature parenthood? To what extent are we overwhelming families with additional responsibilities and expectations that may compromise their competency in basic parenting

  10. Oxygen resuscitation and oxidative-stress biomarkers in premature infants

    Directory of Open Access Journals (Sweden)

    Kumar VH

    2014-05-01

    Full Text Available Vasanth HS Kumar,1 Vivien Carrion,1 Karen A Wynn,1 Lori Nielsen,1 Anne Marie Reynolds,1 Rita M Ryan2 1Department of Pediatrics, The Women and Children's Hospital of Buffalo, Buffalo, NY, 2Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA Background: Resuscitation of premature infants with 100% O2 may initiate significant oxidant stress during development, predisposing them to bronchopulmonary dysplasia. In the study reported here, we examined the effects of three different oxygen concentrations at resuscitation on oxygen saturations (SpO2 and oxidant stress in premature infants. Study design: Infants <32 weeks gestational age were randomized to 21%, 40%, or 100% O2 and resuscitated as per 2005 neonatal resuscitation guidelines. Oxygen groups and SpO2 were unmasked at 10 minutes of age and FiO2 adjusted to maintain an SpO2 of 85%–95% for the next 20 minutes. Blood was collected at 24 hours, 1 week, and 4 weeks for measurement of the oxidative-stress markers, such as a reduced glutathione (GSH to oxidized glutathione (GSSG ratio (GSH/GSSG, nitrotyrosine levels, and 8-hydroxydeoxyguanosine (8-OHdG levels. The study was stopped at 30% enrollment following publication of the 2010 neonatal resuscitation guidelines. Results: We enrolled 18 patients during the study period. SpO2 increased over time (P<0.0001; however, this increase was not different among the three oxygen groups in the first 10 minutes after birth. FiO2 was significantly higher in the 100% O2 group, despite weaning (P<0.02 to maintain target saturations at 30 minutes of age. The GSH/GSSG ratio was significantly lower in the 100% O2 group at 24 hours than in the other groups (P<0.01. Plasma nitrotyrosine was significantly higher in the 40% and 100% O2 groups over time (P<0.01. Levels of 8-OHdG were significantly higher at 4 weeks compared with at 24 hours, independent of the oxygen group (P<0.0001. Conclusion: In this study, we defined the natural

  11. Functional and genetic predisposition to rhinovirus lower respiratory tract infections in prematurely born infants

    NARCIS (Netherlands)

    Drysdale, Simon B.; Alcazar, Mireia; Wilson, Theresa; Smith, Melvyn; Zuckerman, Mark; Hodemaekers, Hennie M.; Janssen, Riny; Bont, Louis; Johnston, Sebastian L.; Greenough, Anne

    2016-01-01

    Term born infants are predisposed to human rhinovirus (HRV) lower respiratory tract infections (LRTI) by reduced neonatal lung function and genetic susceptibility. Our aim was to investigate whether prematurely born infants were similarly predisposed to HRV LRTIs or any other viral LRTIs. Infants bo

  12. Late prematurity: a systematic review

    Directory of Open Access Journals (Sweden)

    Luís Carlos Machado Júnior

    2014-06-01

    Full Text Available Objective: this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation in its several aspects. Sources: the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time. Data synthesis: numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group. Conclusions: numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed.

  13. Late prematurity: a systematic review.

    Science.gov (United States)

    Machado Júnior, Luís Carlos; Passini Júnior, Renato; Rodrigues Machado Rosa, Izilda

    2014-01-01

    this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation) in its several aspects. the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time. numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group. numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  14. Nurses' expectations of using music for premature infants in neonatal intensive care unit.

    Science.gov (United States)

    Pölkki, Tarja; Korhonen, Anne; Laukkala, Helena

    2012-08-01

    This study aimed to describe nurses' expectations of using music for premature infants in the neonatal intensive care unit (NICU) and to find out about the related background factors. The subjects consisted of 210 Finnish nurses who were recruited from the country's five university hospitals providing premature infant care in NICU. The data were collected by validated questionnaire, and the response rate was 82%. Most nurses preferred recorded music to live music in the NICU. They expected that music would have positive effects on premature infants, parents, and staff. Few demographic and many background factors of the respondents' music-related experiences correlated significantly with the expectations concerning their preference. In conclusion, the nurses' expectations were positive regarding the use of music in the NICU, which supports evidence regarding the efficacy of music therapy for premature infants.

  15. US and MR imaging of candidiasis of the nervous system in premature infants: two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyo Nam; Woo, Joung Joo; Bahk, Yong Whee; Kim, Soon Yong; Kim, Eun Ryoung [Sungae Hospital, Seoul (Korea, Republic of)

    2001-07-01

    Candidiasis of central nervous system (CNS) is rare condition and like other opportunistic fungal infections, most commonly occurs in immune-compromised patients. Because of the increasing use of antibiotics and the improving survival rate of premature infants requiring intensive care, the incidence of fungal infection in the brain has increased. We report the findings of ultrasonography and MR imaging in two cases of candidiasis of the CNS in premature infants.

  16. Fatal Primary Capillary Leak Syndrome in a Late Preterm Newborn.

    Science.gov (United States)

    Kulihova, Katarina; Prochazkova, Martina; Semberova, Jana; Janota, Jan

    2016-10-01

    Primary capillary leak syndrome is a rare disease of unknown etiology, characterized by episodes of vascular collapse and plasma extravasation, which may lead to multiple organ failure. Primary capillary leak is extremely rare in children. The authors report a case of a late preterm newborn with fatal capillary leak syndrome of unknown etiology, manifesting as hypotension unresponsive to treatment, extravasation leading to generalised edema, disseminated intravascular coagulation and finally, multiple organ dysfunction syndrome. Aggressive volumotherapy and a combination of inotropes and high doses of terlipressin did not influence systemic vascular collapse and plasma extravasation. The newborn developed multiple organ failure and died on day 27 of life. Investigations performed failed to reveal any specific cause of capillary leak. This is the first report of a fatal primary capillary leak syndrome in a newborn.

  17. What accounts for the association between late preterm births and risk of asthma?

    Science.gov (United States)

    Voge, Gretchen A.; Carey, William A.; Ryu, Euijung; King, Katherine S.; Wi, Chung-Il

    2017-01-01

    Background: Although results of many studies have indicated an increased risk of asthma in former late preterm (LPT) infants, most of these studies did not fully address covariate imbalance. Objective: To compare the cumulative frequency of asthma in a population-based cohort of former LPT infants to that of matched term infants in their early childhood, when accounting for covariate imbalance. Methods: From a population-based birth cohort of children born 2002–2006 in Olmsted County, Minnesota, we assessed a random sample of LPT (34 to 36 6/7 weeks) and frequency-matched term (37 to 40 6/7 weeks) infants. The subjects were followed-up through 2010 or censored based on the last date of contact, with the asthma status based on predetermined criteria. The Kaplan-Meier method was used to estimate the cumulative incidence of asthma during the study period. Cox models were used to estimate the hazard ratio and 95% confidence interval for the risk of asthma, when adjusting for potential confounders. Results: LPT infants (n = 282) had a higher cumulative frequency of asthma than did term infants (n = 297), 29.9 versus 19.5%, respectively; p = 0.01. After adjusting for covariates associated with the risk of asthma, an LPT birth was not associated with a risk of asthma, whereas maternal smoking during pregnancy was associated with a risk of asthma. Conclusion: LPT birth was not independently associated with a risk of asthma and other atopic conditions. Clinicians should make an effort to reduce exposure to smoking during pregnancy as a modifiable risk factor for asthma. PMID:28234052

  18. Music and 25% glucose pain relief for the premature infant: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Maria Vera Lúcia Moreira Leitão Cardoso

    2014-10-01

    Full Text Available OBJECTIVE: to analyze the total Premature Infant Pain Profile scores of premature infants undergoing arterial puncture during music and 25% glucose interventions, and to assess their association with neonatal and therapeutic variables.METHOD: a randomized clinical trial with 80 premature infants; 24 in the Experimental Group 1 (music, 33 in the Experimental Group 2 (music and 25% glucose, 23 in the Positive Control Group (25% glucose. All premature infants were videotaped and a lullaby was played for ten minutes before puncture in Experimental Groups 1 and 2; 25% glucose administered in Experimental Group 2 and the Positive Control Group two minutes before puncture.RESULTS: 60.0% of premature infants had moderate or maximum pain; pain scores and intervention groups were not statistically significant. Statistically significant variables: Experimental Group 1: head and chest circumference, Apgar scores, corrected gestational age; Experimental Group 2: chest circumference, Apgar scores, oxygen therapy; Positive Control group: birth weight, head circumference.CONCLUSION: neonatal variables are associated with pain in premature infants. Brazilian Registry of Clinical Trials: UTN: U1111-1123-4821.

  19. Late preterm birth is associated with short-term morbidity but not with adverse neurodevelopmental and physical outcomes at 1 year

    DEFF Research Database (Denmark)

    Hughes, Alice; Greisen, Gorm; Arce, Joan-Carles

    2014-01-01

    . The women were part of a clinical trial to investigate the tocolytic effect of the oxytocin antagonist barusiban. Babies born late preterm (34-36(+6) weeks) had a significantly increased risk of short-term morbidity (hepatobiliary disorders, respiratory disorders, metabolic disorders, nervous system......We compared the neonatal and infant outcomes at one year (Bayley mental and psychomotor development index, and physical growth) of babies who were (n = 63) or were not (n = 100) delivered prior to 37 weeks in women admitted in threatened late preterm labor (34-35(+6) weeks) with a cervix ≤15 mm...... disorders, infection; p born at term, but there were no significant differences in the neurodevelopmental and physical outcomes at one year (p > 0.05 for both one-year outcomes)....

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  2. A meta-analysis of the efficacy of music therapy for premature infants.

    Science.gov (United States)

    Standley, Jayne M

    2002-04-01

    This meta-analysis on music research with premature infants in neonatal intensive care units (NICU) showed an overall large, significant, consistent effect size of almost a standard deviation (d =.83) (Cohen, 1998). Effects were not mediated by infants' gestational age at the time of study, birthweight, or type of music delivery nor by physiologic, behavioral, or developmental measures of benefit. The homogeneity of findings suggests that music has statistically significant and clinically important benefits for premature infants in the NICU. The unique acoustic properties that differentiate music from all other sounds are discussed and clinical implications for research-based music therapy procedures cited.

  3. The effectiveness of video interaction guidance in parents of premature infants: A multicenter randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Tooten Anneke

    2012-06-01

    Full Text Available Abstract Background Studies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children. One of the explanations proposed for the relation between neonatal problems and adverse parenting is a possible delay or disturbance in the bonding process between the parent and infant. This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded. The disruption of an optimal parent-infant bond -on its turn- may predispose to distorted parent-infant interactions and thus facilitate abusive or neglectful behaviours. Video Interaction Guidance (VIG is expected to promote the bond between parents and newborns and is expected to diminish non-optimal parenting behaviour. Methods/design This study is a multi-center randomised controlled trial to evaluate the effectiveness of Video Interaction Guidance in parents of premature infants. In this study 210 newborn infants with their parents will be included: n = 70 healthy term infants (>37 weeks GA, n = 70 moderate term infants (32–37 weeks GA which are recruited from maternity wards of 6 general hospitals and n = 70 extremely preterm infants or very low birth weight infants (i.e. full term infants and their parents, receiving care as usual, a control group (i.e. premature infants and their parents, receiving care as usual and an intervention group (i.e. premature infants and their parents, receiving VIG. The data will be collected during the first six months after birth using observations of parent-infant interactions, questionnaires and semi-structured interviews. Primary outcomes are the quality of parental bonding and parent-infant interactive behaviour. Parental secondary outcomes are (posttraumatic stress symptoms, depression, anxiety and feelings of anger and hostility. Infant secondary outcomes are behavioral aspects such as crying

  4. Acetaminophen developmental pharmacokinetics in premature neonates and infants

    DEFF Research Database (Denmark)

    Anderson, Brian J; van Lingen, Richard A; Hansen, Tom G

    2002-01-01

    The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens.......The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens....

  5. PSYCHOMOTOR DEVELOPMENT IN PREMATURE INFANTS UNTIL THE END OF THEIR THIRD YEAR OF LIFE

    Directory of Open Access Journals (Sweden)

    Valentina DUKOVSKA

    2009-06-01

    Full Text Available Psychomotor development in premature infants has specific characteristics with increased tendency towards neuro-developmental difficulties, such as the fact that certain percent of the developmentally challenged people belongs in this category of children.Many factors contribute to the neuro-developmental difficulties in premature infants. A large number of studies have shown that the birth weight (BW and gestational age (GA have strong correlation with the neuro-developmental outcome.In order to establish the general developmental outcome and the developmental outcome in specific areas of early development, that is the first three years of life in preemies, we have conducted a research on our own population. We conducted a longitudinal study on 20 premature newborns with very low birth weight (VLBW, with a follow-up period from 4 weeks CGA until 36 weeks GA.The research results showed that the largest difference in developmental areas between the group of premature infants with VLBW and the control group is present at the end of the 36th month of life and the general development quotient (GDQ in the premature group was significantly lower during the whole follow-up period, except at the end of month 4 - in different developmental areas. We also concluded that 20% of the premature infants with VLBW have developmental difficulties and severe difficulties in their motor development.

  6. SOCIOPSYCHOLOGICAL TRIAL OF MATERNAL ATTITUDES TOWARDS THE PROCESS OF BREASTFEEDING OF PREMATURE INFANTS

    Directory of Open Access Journals (Sweden)

    M. S. Rtishcheva

    2014-01-01

    Full Text Available The current standards of live birth dictate new requirements for feeding of small premature infants. Native breast milk of the mothers of premature infants features a unique and balanced composition of substances required for feeding premature infants and protecting them from infectious agents. Low awareness of the real value of breast milk results in early introduction of supplementary feeding with adaptive formulae, which are not equivalent to breast milk. The article presents results of a poll of mothers of premature infants staying together at inpatient hospitals for the second stage of developmental care. The form on breastfeeding developed by the authors presents information on the development of maternal attitudes and lactation dominant. Results of the study helped to discern negative and positive factors affecting a mother’s attitude to maintenance of lactation and breastfeeding. The obtained data contribute to arrangement of conditions for targeted medical‑psychological‑pedagogic aid to mothers at inpatient hospitals in order to support motivation for breastfeeding premature infants

  7. 晚期早产儿呼吸系统疾病患病临床特点%Clinical features of respiratory diseases in late preterm neonates

    Institute of Scientific and Technical Information of China (English)

    崔蕴璞; 童笑梅; 韩彤妍; 汤亚南

    2012-01-01

    Objective To evaluate the clinical features of respiratory diseases of late preterm neonates. Methods Six hundred and thirty late preterm infant(gestational age: 34 ~ 36+6 weeks) ,4401 cases of term infants and 328 early preterm infants who were bom at the obstetrical department of Peking University 3rd Hospital from January 2009 to December 2010 were enrolled. Among them 84 late preterm infants, 135 term infants and 182 early preterm infants developed respiratory diseases. The incidence of respiratory diseases, clinical features and the severity of the diseases were compared among the three groups. Results The incidence and mortality rates of respiratory diseases and the percentage of severe cases were significantly higher in the late preterm group than in the term group, but lower than in the early preterm group (P < 0.01). The symptoms of respiratory disease occurred earlier in the late preterm group than in the term group, but later than in the early preterm group (P <0. 01 ). The late preterm group had a significantly higher incidence of tachypnea and lower incidence of retraction sign when compared with the term and early preterm groups (P <0. 05). The percentages requiring oxygen therapy and mechanical ventilation in the late preterm group were both significantly higher than in the term group, but lower than in the early preterm group (P <0. 05). The multiple linear regression analysis showed 11 factors associated with the severity of respiratory diseases; decreased arterial partial pressure of oxygen, hematokrit, pH value and respiratory rate, arterial oxyhemoglobin saturation, systolic arterial pressure, 5 minute Apgar score and gestational age, and increased blood urea nitrogen, heart rate and respiratory rate. Conclusions Late preterm infants are more likely to develop respiratory diseases than term infants, and to develop a more severe condition and need a more intensive respiratory support treatment. Tachypnea is a common presentation of dyspnea in

  8. Evaluation of the Effect of Nest Posture on the Sleep-wake State of Premature Infants

    Directory of Open Access Journals (Sweden)

    Tayebeh Reyhani

    2016-04-01

    Full Text Available Background: Premature birth is a major cause of infant mortality in developed countries. Newborns confined to neonatal intensive care units (NICUs are in a rapid stage of brain development. As such, sleep plays a pivotal role in the proper brain development of newborns. However, this developmental aspect is often disregarded due to the lack of information. Aim: This study aimed to evaluate the effect of nest posture on the sleep-wake state of premature infants. Method: This cross-over clinical trial was conducted on 60 premature infants admitted in the NICU of Ghaem Hospital in Mashhad, Iran in 2015. Infants were divided into two groups of experimental and control. Data were collected using the Assessment of Premature Infants' Behavior (APIB. Neonates in the control group were placed in an incubator, and neonates in the experimental group were positioned in a nest. Between-group comparison was performed using paired-samples T-test for normal variables and Wilcoxon test for non-normal variables. Results: In this study, no statistically significant differences were observed between the two groups in terms of the scores of deep sleep state before (P=0.50 and after the intervention (P=0.59. However, during the intervention, mean score of deep sleep was higher in the experimental group (P=0.08. Moreover, mean score of slow wake state had no significant difference between the study groups before (P=0.67, after (P=0.86, and during the intervention (P=0.81. Implications for Practice: According to the results of this study, nest posture increased the deep sleep hours of premature infants as the most imperative state of brain development. Therefore, it is recommended that nest posture be used to improve the deep sleep state of premature infants.

  9. Serum Phosphorus Levels in Premature Infants Receiving a Donor Human Milk Derived Fortifier

    Directory of Open Access Journals (Sweden)

    Katherine E. Chetta

    2015-04-01

    Full Text Available An elevated serum phosphorus (P has been anecdotally described in premature infants receiving human milk fortified with donor human milk-derived fortifier (HMDF. No studies have prospectively investigated serum P in premature infants receiving this fortification strategy. In this single center prospective observational cohort study, extremely premature infants ≤1250 grams (g birth weight (BW were fed an exclusive human milk-based diet receiving HMDF and serum P levels were obtained. We evaluated 93 infants with a mean gestational age of 27.5 ± 2.0 weeks (Mean ± SD and BW of 904 ± 178 g. Seventeen infants (18.3% had at least one high serum P level with a mean serum P of 9.2 ± 1.1 mg/dL occurring at 19 ± 11 days of life. For all infants, the highest serum P was inversely correlated to the day of life of the infant (p < 0.001, R2 = 0.175 and positively correlated with energy density of HMDF (p = 0.035. Serum P was not significantly related to gender, BW, gestational age, or days to full feeds. We conclude that the incidence of hyperphosphatemia was mild and transient in this population. The risk decreased with infant age and was unrelated to gender, BW, or ethnicity.

  10. [Association between neontal morbidity, gestational age and developmental delays in moderate to late preterm children].

    Science.gov (United States)

    Schonhaut, Luisa; Pérez, Marcela; Muñoz, Sergio

    2015-01-01

    There is evidence that children born moderate-to-late preterm (MLP) have a higher risk of hospitalisation, neonatal morbidity, and developmental delay (DD). To determine the association between DD, gestational age, and neonatal morbidity in MLP children. A case control study design nested in a cohort of MLP children born between 2006 and 2009 at a private hospital located in the Metropolitan area of Santiago. The children were assessed with the Bayley-III Scales of Infant Development at 8 or 18 months corrected age, or at 30 months of chronological age. Neonatal records were retrospectively reviewed. A multivariate analysis was performed to determine the effect of neonatal morbidity on development. A total of 130 MLP children, 25 cases and 105 controls, were studied. Most of them (83.8%) were hospitalised during the neonatal period. Significant differences between cases and controls regarding maternal age and symptomatic hypoglycaemia were observed (crude OR 3.5, adjusted OR 8.18). It was concluded that the variables that negatively affect the rate of development are male gender, being a twin, and gestational age. Symptomatic hypoglycaemia is the main risk factor for DD, while being a twin, male gender, and gestational age influenced the total development rate obtained. It is essential to develop strategies for prevention, screening, and early management of this metabolic disorder to prevent future DD. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Elisabet Forsum

    2016-04-01

    Full Text Available (1 Background: Assessing the quality of growth in premature infants is important in order to be able to provide them with optimal nutrition. The Pea Pod device, based on air displacement plethysmography, is able to assess body composition of infants. However, this method has not been sufficiently evaluated in premature infants; (2 Methods: In 14 infants in an age range of 3–7 days, born after 32–35 completed weeks of gestation, body weight, body volume, fat-free mass density (predicted by the Pea Pod software, and total body water (isotope dilution were assessed. Reference estimates of fat-free mass density and body composition were obtained using a three-component model; (3 Results: Fat-free mass density values, predicted using Pea Pod, were biased but not significantly (p > 0.05 different from reference estimates. Body fat (%, assessed using Pea Pod, was not significantly different from reference estimates. The biological variability of fat-free mass density was 0.55% of the average value (1.0627 g/mL; (4 Conclusion: The results indicate that the Pea Pod system is accurate for groups of newborn, moderately premature infants. However, more studies where this system is used for premature infants are needed, and we provide suggestions regarding how to develop this area.

  12. The effect of EMLA cream on minimizing pain during venipuncture in premature infants.

    Science.gov (United States)

    Hui-Chen, Fan; Hsiu-Lin, Chen; Shun-Line, Chen; Tai-Ling, Tasi; Li-Jung, Wang; Hsing-I, Tseng; San-Nan, Yang

    2013-02-01

    Painful procedures for premature infants in neonatal intensive care units remain inevitable. The goal of this study is to evaluate the effect of an eutectic mixture of local anesthetic (EMLA) cream for minimizing pain in premature infants during venipuncture in neonatal intensive care units. This study enrolled 32 premature infants. A repeated-measures design was used. The scores of the 'Neonatal Pain, Agitation and Sedation Scale' (N-PASS) of each enrolled preterm infant were measured before, during and 10 min after venipuncture without and with EMLA cream use. Paired t-tests were used to compare the difference of N-PASS scores without and with EMLA cream use. Paired t-tests revealed a significant decrease in N-PASS scores during venipuncture in infants with EMLA cream. There was no significant change of N-PASS scores before, during and 10 min after venipuncture with EMLA cream by analysis of repeated analysis of variance. EMLA cream for minimizing pain during venipuncture could be recommended for premature infants.

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

    Science.gov (United States)

    Forsum, Elisabet; Olhager, Elisabeth; Törnqvist, Caroline

    2016-04-22

    (1) BACKGROUND: Assessing the quality of growth in premature infants is important in order to be able to provide them with optimal nutrition. The Pea Pod device, based on air displacement plethysmography, is able to assess body composition of infants. However, this method has not been sufficiently evaluated in premature infants; (2) METHODS: In 14 infants in an age range of 3-7 days, born after 32-35 completed weeks of gestation, body weight, body volume, fat-free mass density (predicted by the Pea Pod software), and total body water (isotope dilution) were assessed. Reference estimates of fat-free mass density and body composition were obtained using a three-component model; (3) RESULTS: Fat-free mass density values, predicted using Pea Pod, were biased but not significantly (p > 0.05) different from reference estimates. Body fat (%), assessed using Pea Pod, was not significantly different from reference estimates. The biological variability of fat-free mass density was 0.55% of the average value (1.0627 g/mL); (4) CONCLUSION: The results indicate that the Pea Pod system is accurate for groups of newborn, moderately premature infants. However, more studies where this system is used for premature infants are needed, and we provide suggestions regarding how to develop this area.

  14. Role of Early Onset Neutropenia in Development of Candidemia in Premature Infants.

    Science.gov (United States)

    Ramy, Nermin; Hashim, Mohamed; Abou Hussein, Heba; Sawires, Happy; Gaafar, Maha; El Maghraby, Ayat

    2017-04-24

    The aim of the study was to assess the effect of early-onset neutropenia (EON) on the development of candidemia in premature infants and evaluate other risk factors. This prospective study was carried out in a neonatal intensive care unit of Cairo University Hospital. Fifty neutropenic premature infants were matched to 50 non-neutropenics. Subjects were then regrouped into candidemics and non-candidemics to study other risk factors such as central venous catheters, mechanical ventilation, parenteral nutrition, drugs as corticosteroids and others. Candidemia was assessed by Bactec and then seminested polymerase chain reaction for culture negatives. Candidemia developed in 28 neutropenic preterms and in 8 non-neutropenics (odds ratio  = 6.68, 95% confidence interval = 2.61-17.1, p  candidemia in multivariate regression analysis included EON, mechanical ventilation and steroid therapy. EON is an independent risk factor for candidemia in premature infants.

  15. Anatomical configurations associated with posthemorrhagic hydrocephalus among premature infants with intraventricular hemorrhage.

    Science.gov (United States)

    Tully, Hannah M; Wenger, Tara L; Kukull, Walter A; Doherty, Dan; Dobyns, William B

    2016-11-01

    OBJECTIVE Intraventricular hemorrhage (IVH) is a complication of prematurity often associated with ventricular dilation, which may resolve over time or progress to posthemorrhagic hydrocephalus (PHH). This study investigated anatomical factors that could predispose infants with IVH to PHH. METHODS The authors analyzed a cohort of premature infants diagnosed with Grade III or IV IVH between 2004 and 2014. Using existing ultrasound and MR images, the CSF obstruction pattern, skull shape, and brain/skull ratios were determined, comparing children with PHH to those with resolved ventricular dilation (RVD), and comparing both groups to a set of healthy controls. RESULTS Among 110 premature infants with Grade III or IV IVH, 65 (59%) developed PHH. Infants with PHH had more severe ventricular dilation compared with those with RVD, although ranges overlapped. Intraventricular CSF obstruction was observed in 36 (86%) of 42 infants with PHH and 0 (0%) of 18 with RVD (p < 0.001). The distribution of skull shapes in infants with PHH was similar to those with RVD, although markedly different from controls. No significant differences in supratentorial brain/skull ratio were observed; however, the mean infratentorial brain/skull ratio of infants with PHH was 5% greater (more crowded) than controls (p = 0.006), whereas the mean infratentorial brain/skull ratio of infants with RVD was 8% smaller (less crowded) than controls (p = 0.004). CONCLUSIONS Among premature infants with IVH, intraventricular obstruction and infratentorial crowding are strongly associated with PHH, further underscoring the need for brain MRI in surgical planning. Prospective studies are required to determine which factors are cause and which are consequence, and which can be used to predict the need for surgical intervention.

  16. Ultrasound measurement of the corpus callosum and neural development of premature infants.

    Science.gov (United States)

    Liu, Fang; Cao, Shikao; Liu, Jiaoran; Du, Zhifang; Guo, Zhimei; Ren, Changjun

    2013-09-15

    Length and thickness of 152 corpus callosa were measured in neonates within 24 hours of birth. Using ultrasonic diagnostic equipment with a neonatal brain-specific probe, corpus callosum length and thickness of the genu, body, and splenium were measured on the standard mid-sagittal plane, and the anteroposterior diameter of the genu was measured in the coronal plane. Results showed that corpus callosum length as well as thickness of the genu and splenium increased with tional age and birth weight, while other measures did not. These three factors on the standard mid-sagittal plane are therefore likely to be suitable for real-time evaluation of corpus callosum velopment in premature infants using cranial ultrasound. Further analysis revealed that thickness of the body and splenium and the anteroposterior diameter of the genu were greater in male infants than in female infants, suggesting that there are sex differences in corpus callosum size during the neonatal period. A second set of measurements were taken from 40 premature infants whose gestational age was 34 weeks or less. Corpus callosum measurements were corrected to a gestational age of 40 weeks, and infants were grouped for analysis depending on the outcome of a neonatal behavioral neurological assessment. Compared with infants with a normal neurological assessment, corpus callosum length and genu and splenium thicknesses were less in those with abnormalities, indicating that corpus callosum growth in premature infants is associated with neurobehavioral development during the early extrauterine stage.

  17. The effects of music listening on inconsolable crying in premature infants.

    Science.gov (United States)

    Keith, Douglas R; Russell, Kendra; Weaver, Barbara S

    2009-01-01

    Over the decades, medical staff have developed strategies to manage crying episodes of the critically ill and convalescing premature infant. These episodes of crying occur frequently after infants are removed from ventilation, but before they are able to receive nutrition orally. Not only are these episodes stressful to infants and upsetting to parents, but they are also stressful and time consuming for the staff that take care of these patients. Although the literature supports the benefits of music therapy in regard to physiological and certain behavioral measures with premature infants, no research exists that explores the use of music therapy with inconsolability related to the "nothing by mouth" status. This study explored the effects of music therapy on the crying behaviors of critically ill infants classified as inconsolable. Twenty-four premature infants with gestational age 32-40 weeks received a developmentally appropriate music listening intervention, alternating with days on which no intervention was provided. The results revealed a significant reduction in the frequency and duration of episodes of inconsolable crying as a result of the music intervention, as well as improved physiological measures including heart rate, respiration rate, oxygen saturation, and mean arterial pressure. Findings suggest the viability of using recorded music in the absence of a music therapist or the maternal voice to console infants when standard nursing interventions are not effective.

  18. Auditory brain stem responses of premature infants to bone-conducted stimuli: a feasibility study.

    Science.gov (United States)

    Hooks, R G; Weber, B A

    1984-01-01

    The feasibility of bone conduction auditory brain stem response (ABR) audiometry in intensive care nursery neonates was investigated. Forty premature infants were tested with both air- and bone-conducted stimuli. Bone-conducted stimuli resulted in more identifiable ABRs and a greater number of subjects passing the hearing screening. The findings of this study suggest that bone conduction ABR audiometry is a feasible technique with premature infants. Due to the lower frequency composition of the bone-conducted click, it may be more effective than an air-conducted click when the immature cochlea is being evaluated.

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

    Science.gov (United States)

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

    2015-02-01

    The low-weight newborns and especially the premature infants have difficulty in maintaining their temperature in the range considered to be normal. Several studies revealed the importance of thermal environment and moisture to increase the survival rate of newborns. This work models the process of heat exchange and energy balance in premature newborns during the first hours of life in a closed incubator. In addition, a control problem was proposed and solved in order to maintain thermal stability of premature newborns to increase their rate of survival and weight. For this purpose, we propose an algorithm to control the temperature inside the incubator. It takes into account the measurements of the body temperature of a premature newborn which are recorded continuously. We show that using this model the temperature of a premature newborn inside the incubator can be kept in a thermal stability range. Copyright © 2014. Published by Elsevier Ltd.

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

    Directory of Open Access Journals (Sweden)

    Lingling Yu

    2016-01-01

    Full Text Available We aim to determine risk factors and clinical outcomes for bowel perforation in premature infants with NEC. We analyzed clinical data of 57 cases of premature infants with NEC at our NICU between January 2010 and December 2012. Based on the presence of bowel perforation, we divided these infants into two groups: perforated NEC group (n=10 and nonperforated NEC group (n=47. We compared general information, clinical characteristics, and laboratory findings between groups. The perforated NEC group, compared to the nonperforated NEC group, had significantly lesser gestational age, lower birth weight, higher prevalence of apnea, mechanical ventilation, sepsis and shock, lower blood pH, higher levels of blood glucose, abnormal WBC count and thrombocytopenia, and elevated CRP (all P<0.05. Moreover, the perforated NEC group had significantly longer durations of fasting and TPN usage, higher incidences of EUGR and cholestasis, longer duration of antibiotics, higher frequency of advanced antibiotics use, and poorer prognosis than the nonperforated NEC group (all P<0.05. Bowel perforation in premature infants with NEC was associated with multiple risk factors. Early identification of some of these risk factors in premature infants with NEC may help implement early intervention to reduce the incidence of bowel perforation and thereby improve the prognosis.

  1. Effects of music therapy on oxygen saturation in premature infants receiving endotracheal suctioning.

    Science.gov (United States)

    Chou, Lih-Lih; Wang, Ru-Hwa; Chen, Shu-Jen; Pai, Lu

    2003-09-01

    The purpose of this study was to investigate how premature infants' oxygen saturation changed in response to music therapy while they were receiving endotracheal suctioning. A convenience sample of 30 premature infants was selected from three neonatal intensive care units. A one-group repeated measures design was adopted for this study. The oxygen saturation of all subjects was first measured while they were receiving endotracheal suctioning during a four-hour control period with regular care. Then, four hours after the control period was completed, an experimental period began in which the music " Transitions " was played. One minute before suctioning, the level of oxygen saturation was measured to provide the baseline data. During a period of 30 minutes after suctioning, the oxygen saturation was recorded every minute to analyze the clinical effects of music therapy. The results showed that premature infants receiving music therapy with endotracheal suctioning had a significantly higher SPO(2); than that when not receiving music therapy (p music therapy (p music therapy as developmental care to premature infants when performing any nursing intervention may enhance not only the quality of nursing care but also quality of the infant's life.

  2. Language acquisition in premature and full-term infants.

    Science.gov (United States)

    Peña, Marcela; Pittaluga, Enrica; Mehler, Jacques

    2010-02-23

    We tested healthy preterm (born near 28 +/- 2 weeks of gestational age) and full-term infants at various different ages. We compared the two populations on the development of a language acquisition landmark, namely, the ability to distinguish the native language from a rhythmically similar one. This ability is attained 4 months after birth in healthy full-term infants. We measured the induced gamma-band power associated with passive listening to (i) the infants' native language (Spanish), (ii) a rhythmically close language (Italian), and (iii) a rhythmically distant language (Japanese) as a marker of gains in language discrimination. Preterm and full-term infants were matched for neural maturation and duration of exposure to broadcast speech. We found that both full-term and preterm infants only display a response to native speech near 6 months after their term age. Neural maturation seems to constrain advances in speech discrimination at early stages of language acquisition.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  4. Deficits in Top-Down Sensory Prediction in Infants At Risk due to Premature Birth.

    Science.gov (United States)

    Emberson, Lauren L; Boldin, Alex M; Riccio, Julie E; Guillet, Ronnie; Aslin, Richard N

    2017-02-06

    A prominent theoretical view is that the brain is inherently predictive [1, 2] and that prediction helps drive the engine of development [3, 4]. Although infants exhibit neural signatures of top-down sensory prediction [5, 6], in order to establish that prediction supports development, it must be established that deficits in early prediction abilities alter trajectories. We investigated prediction in infants born prematurely, a leading cause of neuro-cognitive impairment worldwide [7]. Prematurity, independent of medical complications, leads to developmental disturbances [8-12] and a broad range of developmental delays [13-17]. Is an alteration in early prediction abilities the common cause? Using functional near-infrared spectroscopy (fNIRS), we measured top-down sensory prediction in preterm infants (born identification of infants at risk and could guide early intervention regimens.

  5. Pigtail Catheters Versus Traditional Chest Tubes for Pneumothoraces in Premature Infants Treated in a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Yi-Hsuan Wei

    2014-10-01

    Conclusion: Pigtail catheters are a safe and effective alternative to traditional chest tubes for premature infants receiving treatment for pneumothoraces in a neonatal intensive care unit. Placement of pigtail catheters is an easy and quick bedside procedure and is particularly useful for premature infants who require immediate air drainage.

  6. Anatomical Closure of Left-to-Right Shunts in Premature Infants with Bronchopulmonary Dysplasia and Pulmonary Hypertension: A Cautionary Tale

    Directory of Open Access Journals (Sweden)

    Narendra R. Dereddy

    2015-10-01

    Full Text Available Closure of a systemic to pulmonary shunt in premature infants with bronchopulmonary dysplasia may be beneficial, but in the presence of pulmonary hypertension is controversial. Here, we discuss two premature infants with pulmonary hypertension who developed acute pulmonary hypertensive crisis after closure of these shunts and hence advise caution.

  7. Delayed early primary visual pathway development in premature infants: high density electrophysiological evidence.

    Directory of Open Access Journals (Sweden)

    Emmanuel Tremblay

    Full Text Available In the past decades, multiple studies have been interested in developmental patterns of the visual system in healthy infants. During the first year of life, differential maturational changes have been observed between the Magnocellular (P and the Parvocellular (P visual pathways. However, few studies investigated P and M system development in infants born prematurely. The aim of the present study was to characterize P and M system maturational differences between healthy preterm and fullterm infants through a critical period of visual maturation: the first year of life. Using a cross-sectional design, high-density electroencephalogram (EEG was recorded in 31 healthy preterms and 41 fullterm infants of 3, 6, or 12 months (corrected age for premature babies. Three visual stimulations varying in contrast and spatial frequency were presented to stimulate preferentially the M pathway, the P pathway, or both systems simultaneously during EEG recordings. Results from early visual evoked potentials in response to the stimulation that activates simultaneously both systems revealed longer N1 latencies and smaller P1 amplitudes in preterm infants compared to fullterms. Moreover, preterms showed longer N1 and P1 latencies in response to stimuli assessing the M pathway at 3 months. No differences between preterms and fullterms were found when using the preferential P system stimulation. In order to identify the cerebral generator of each visual response, distributed source analyses were computed in 12-month-old infants using LORETA. Source analysis demonstrated an activation of the parietal dorsal region in fullterm infants, in response to the preferential M pathway, which was not seen in the preterms. Overall, these findings suggest that the Magnocellular pathway development is affected in premature infants. Although our VEP results suggest that premature children overcome, at least partially, the visual developmental delay with time, source analyses reveal

  8. Asthma and atopic dermatitis in children born moderately and late preterm.

    Science.gov (United States)

    Haataja, Paula; Korhonen, Päivi; Ojala, Riitta; Hirvonen, Mikko; Paassilta, Marita; Gissler, Mika; Luukkaala, Tiina; Tammela, Outi

    2016-06-01

    This national register study aimed to evaluate the need of asthma medication reimbursement and hospitalization due to asthma and atopic dermatitis up to 7 years of age in moderately preterm (MP) (32-33 weeks) and late preterm (LP) (34-36 weeks) children compared to very preterm (VP) (children. Altogether, 1,018,302 children born in Finland between 1991 and 2008 were assessed. The MP and LP groups received asthma medication reimbursement more frequently than term controls (8.0 and 5.7 vs. 3.8 %), but less frequently than VP children (15.4 %). Hospitalization due to asthma was more common among MP (10.6 %) and LP (7.3 %) children than term children (4.8 %) but less common than in VP children (20.1 %). Hospitalization due to atopic dermatitis was more frequent among term (5.2 %) compared to MP (4.2 %) and LP (4.7 %) children. Male sex, maternal smoking, maternal diabetes, and ventilator therapy predicted asthma medication in the MP and/or LP children. MP and LP children seem to need medication and hospitalization for asthma more often than term controls but less frequently than VP children followed by 7 years of age. Hospitalization due to atopic dermatitis becomes more common with increasing gestational age. • MP and LP infants have an increased risk for early respiratory morbidity and to asthma. • Less is known on the occurrence of atopic dermatitis in this patient group. What is New: • Medication and hospital care due to asthma were more frequent in school-aged MP and LP than in term infants. Male sex, maternal smoking, maternal diabetes and ventilator therapy predicted asthma. • Hospitalization due to atopic dermatitis became more common with increasing gestational age.

  9. Effects of the pacifier activated lullaby on weight gain of premature infants.

    Science.gov (United States)

    Cevasco, Andrea M; Grant, Roy E

    2005-01-01

    Within the past 5 years there has been an increase of premature infants surviving in the neonatal intensive care unit as well as an increasing cost for each day the infant is kept there. It is important for the premature infant to acquire the feeding skills necessary for weight gain, which lead to discharge from the hospital, and recent advancements have indicated the effectiveness in using contingent music to teach sucking skills to premature infants. The purpose of the first analysis in this study was to determine the effects of Pacifier Activated Lullaby (PAL) trials on weight gain of premature infants. During a 2-year time period, 62 infants from a sample of 188 met criteria for analysis. A one-way analysis of variance showed no significance in daily weight gain for the number of PAL trials completed. The mean weight gains for infants with 1 PAL trial = 13.85 grams, 2 trials = 26.67, 3 trials = 29.64, and 4 or more = 22.89. The Pearson product-moment correlation between the mean percent of music earned via nonnutritive sucking (NNS) and mean weight gain of all trials approached significance (p = .077, r = 0.18). In a second analysis, weight gained prior to use of PAL, during use of PAL, and post use of PAL was analyzed. Results indicated no significant difference between weight gain 1 day prior to use of PAL, the day of PAL trial, and 1 day post use of PAL. Mean weight gain for those infants who participated in 1 PAL trial was 8.49 grams for 1 day prior to use of PAL, 18.73 the day of PAL trial, and 24.81 for 1 day post use of PAL. Mean weight gain for 3 days prior to using the PAL was 10.78, 11.30 on the day of PAL trial, and 24.78 grams for 3 days post PAL use. The analyses show definite trends of greater weight gain with PAL use; however, individual variability within groups was greater than group differences leading to no significance in statistical analysis. In the third analysis the effect of proximity between premature infants' feeding schedule and PAL

  10. FEATURES OF INTENSIVE NUTRITIONAL SUPPORT OF PREMATURE INFANTS IN THE POSTRESUSCITATION PERIOD AFTER DISCHARGE FROM HOSPITAL (PART 2

    Directory of Open Access Journals (Sweden)

    K.V. Romanenko

    2011-01-01

    Full Text Available This review considers specific problems of premature infants in the first year of life related to nutritional deficiencies and lack of basic food nutrients. The features of nutritional support of premature infants who underwent resuscitation phase in the first year of life, the usefulness of the new «mixes for premature infants, discharged from the hospital» in order to intensify the programming power of artificial feeding are discussed. Key words: preterm infants, very low body weight, extremely low body weight, intensive care and neonatal intensive care, enteral nutrition, special mixtures for premature, «the mixture for premature infants, discharged from the hospital». (Pediatric Pharmacology. — 2011; 8 (5: 91–96.

  11. Analysis of the horizontal corneal diameter, central corneal thickness, and axial length in premature infants

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir

    2014-08-01

    Full Text Available Purpose: To determine the horizontal corneal diameter, central corneal thickness, and axial length in premature infants. Methods: Infants with a birth weight of less than 2,500 g or with a gestation period of less than 36 weeks were included in the study. Infants with retinopathy of prematurity (ROP were allocated to Group 1 (n=138, while those without ROP were allocated to Group 2 (n=236. All infants underwent a complete ophthalmologic examination, including corneal diameter measurements, pachymetry, biometry, and fundoscopy. Between-group comparisons of horizontal corneal diameter, central corneal thickness, and axial lengths were performed. Independent sample t-tests were used for statistical analysis. Results: Data was obtained from 374 eyes of 187 infants (102 female, 85 male. The mean gestational age at birth was 30.7 ± 2.7 weeks (range 25-36 weeks, the mean birth weight was 1,514 ± 533.3 g (range 750-1,970 g, and the mean postmenstrual age at examination was 40.0 ± 4.8 weeks. The mean gestational age and the mean birth weight of Group 1 were statistically lower than Group 2 (p0.05. Conclusions: The presence of ROP in premature infants does not alter the horizontal corneal diameter, central corneal thickness, or axial length.

  12. Carnitine deficiency in premature infants receiving total parenteral nutrition: effect of L-carnitine supplementation.

    Science.gov (United States)

    Schmidt-Sommerfeld, E; Penn, D; Wolf, H

    1983-06-01

    To investigate whether L-carnitine supplementation may correct nutritional carnitine deficiency and associated metabolic disturbances in premature infants receiving total parenteral nutrition, an intravenous fat tolerance test (1 gm/kg Intralipid over four hours) was performed in 29 premature infants 6 to 10 days of age (15 receiving carnitine supplement 10 mg/kg . day L-carnitine IV, and 14 receiving no supplement). Total carnitine plasma values were normal or slightly elevated in supplemented but decreased in nonsupplemented infants. In both groups, fat infusion resulted in an increase in plasma concentrations of triglycerides, free fatty acids, D-beta-hydroxybutyrate, and short-chain and long-chain acylcarnitine, but total carnitine values did not change. After fat infusion, the free fatty acids/D-beta-hydroxybutyrate ratios were lower and the increase of acylcarnitine greater in supplemented infants of 29 to 33 weeks' gestation than in nonsupplemented infants of the same gestational age. This study provides evidence that premature infants of less than 34 weeks' gestation requiring total parenteral nutrition develop nutritional carnitine deficiency with impaired fatty acid oxidation and ketogenesis. Carnitine supplementation improves this metabolic disturbance.

  13. Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection.

    Science.gov (United States)

    Vachharajani, A; Vricella, G J; Najaf, T; Coplen, D E

    2015-05-01

    The 2011 American Academy of Pediatrics (AAP) guidelines address imaging after initial febrile urinary tract infection (UTI) in infants >2 months of age. We sought to determine the frequency of upper urinary tract anomalies (hydronephrosis and vesicoureteral reflux (VUR)) in hospitalized premature infants with UTI. We retrospectively reviewed the electronic medical records of neonatal intensive care unit (NICU) admissions at a tertiary care children's hospital between 1 January 2006 and 31 December 2010. We queried the records for UTI, renal ultrasound (US) and voiding cystourethrogram (VCUG). We identified 3518 unique admissions. UTI occurred in 118 infants (3%). Sixty-nine (60%) had a normal US. Renal dilation was predominantly renal pelvic dilation (12%) and isolated caliectasis (22%). VUR was identified in 15 (14%) infants evaluated with a VCUG. VUR was identified in nine (12%) infants without and in seven (16%) with an abnormality on US. Reflux was identified in 7% of male and 38% of female infants with a UTI. Anatomic abnormalities of the upper urinary tract are uncommon in premature infants with a UTI that occurs during neonatal hospitalization. In concordance with the AAP guidelines, a VCUG may not be required in all NICU infants under age 2 months after a single UTI.

  14. Infant intralimb coordination and torque production: Influence of prematurity.

    Science.gov (United States)

    Sargent, Barbara; Reimann, Hendrik; Kubo, Masayoshi; Fetters, Linda

    2017-09-07

    The purpose of this study is to investigate changes in leg joint coordination, intersegmental dynamics, and their relation in infants born preterm (PT) during the first months of life. Kicking actions were analyzed of 11 infants born PT at 6 and 15-weeks corrected age (CA) using three-dimensional kinematics and kinetics; results were compared to the kicking actions of 10 infants born full-term (FT). Both groups changed from a predominately in-phase coordination at 6-weeks CA to a less in-phase coordination at 15-weeks CA, however, at 6-weeks CA, infants born PT demonstrated less in-phase coordination of their ankle joints with their hip and knee joints. Between groups and across ages, both groups demonstrated consistent net and partitioned joint torque profiles, however, at 6-weeks CA infants born PT demonstrated more complex patterns of torque components. In both groups, less in-phase hip-knee coordination was associated with reduced active knee muscle torque and increased passive knee torques, however, passive knee torques had a greater influence on the kicks of infants born PT at 6-weeks CA. At 6-weeks CA, infants born PT, compared to FT, generated kicks with less in-phase hip-knee coordination, hip excursion, hip angular velocity, and hip muscle torque impulse. By 15-weeks CA, differences resolved in all variables except hip muscle torque impulse. These results highlight a different trajectory of leg joint coordination and torque production for infants born PT compared to FT. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    1990-02-01

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

  16. Evidence for the safety of ascorbic acid administration to the premature infant.

    Science.gov (United States)

    Bass, W T; Malati, N; Castle, M C; White, L E

    1998-02-01

    Ascorbic acid (AA), a plasma antioxidant, is maintained at high levels in premature fetal blood and declines rapidly postpartum. The sudden reduction in blood AA levels secondary to premature delivery may increase the risk of oxidant injury, that is, bronchopulmonary dysplasia and intraventricular hemorrhage. There is concern that administration of AA to premature infants, in an effort to increase antioxidant capacity, may cause hemolysis. We felt that the benefits of early AA administration and prevention of the immediate postnatal drop in blood AA levels, might outweigh the risks of erthrocyte damage. Fifty one high-risk premature infants were randomized to receive either normal saline or 100 mg/kg of AA, daily for the first week of life. Double-blind comparisons were made of hemoglobin, hematocrit, erythrocyte morphology, bilirubin, number of blood transfusions and days of phototherapy, renal function tests, the incidence of infection, bronchopulmonary dysplasia, and intraventricular hemorrhage during the first month of life. The administration of AA prevented the immediate postnatal drop in AA and was not associated with evidence of increased hemolysis. No significant differences in renal function, rate of infection, bronchopulmonary dysplasia, or intraventricular hemorrhage were seen between the two groups. This study suggests that AA administration to the premature infant is safe and supports the designing and performance of larger clinical studies of the antioxidant properties of AA.

  17. Altered Gray Matter Volume and School Age Anxiety in Children Born Late Preterm

    Science.gov (United States)

    Rogers, Cynthia E; Barch, Deanna M; Sylvester, Chad M; Pagliaccio, David; Harms, Michael P; Botteron, Kelly N; Luby, Joan L

    2014-01-01

    Objectives To determine if late preterm (LP) children differ from full term (FT) children in volumes of the cortex, hippocampus, corpus callosum, or amygdala and whether these differences are associated with anxiety symptoms at school-age. Study design LP children born between 34 and 36 weeks gestation and FT children born between 39 and 41 weeks gestation from a larger longitudinal cohort had MRI scans at school-age. Brain volumes, cortical surface area and thickness measures were obtained. Anxiety symptoms were assessed using a structured diagnostic interview annually beginning at preschool-age and following the MRI. Results LP children (n=21) had a smaller percentage of total, right parietal, and right temporal lobe gray matter volume than FT children (n=87). There were no differences in hippocampal, callosal, or amygdala volumes or cortical thickness. LP children also had a relative decrease in right parietal lobe cortical surface area. LP children had greater anxiety symptoms over all assessments. The relationship between late prematurity and school-age anxiety symptoms was mediated by the relative decrease in right temporal lobe volume. Conclusion LP children, comprising 70% of preterm children, are also at increased risk for altered brain development particularly in the right temporal and parietal cortices. Alterations in the right temporal lobe cortical volume may underlie the increased rate of anxiety symptoms among these LP children. These findings suggest that LP delivery may disrupt temporal and parietal cortical development that persists until school-age with the right temporal lobe conferring risk for elevated anxiety symptoms. PMID:25108541

  18. RISK OF LATE PRETERM STILLBIRTH AND NEONATAL MORBIDITY FOR MONOCHORIONIC AND DICHORIONIC TWINS

    Science.gov (United States)

    BURGESS, Jennifer L.; UNAL, Elizabeth R.; NIETERT, Paul J.; NEWMAN, Roger B.

    2014-01-01

    Objectives To determine the prospective risk of IUFD ≥ 34 weeks’ gestation for monochorionic (MC) and dichorionic (DC) twins receiving intensive antenatal fetal surveillance. The secondary objective is to calculate the incidence of prematurity-related neonatal morbidity/mortality, stratified by gestational week and chorionicity. Study Design A retrospective cohort study of all twins ≥ 34 weeks delivered at MUSC (1987–2010) was performed. Twins were cared for in a longstanding Twin Clinic with standardized management and surveillance protocols; supervised by a consistent Maternal-Fetal Medicine specialist. Gestational age specific fetal/neonatal mortality and composite neonatal morbidity rates were compared by chorionicity. A generalized linear mixed model was used to identify variables associated with increased composite neonatal morbidity. Results Among 768 twin gestations (601 DC and 167 MC), only one dichorionic IUFD occurred. The prospective risk of IUFD ≥34 weeks was 0.17% for DC twins and 0% for MC twins. Composite neonatal morbidity decreased with each gestational week (p<0.0001). Morbidity was increased by white race, gestational diabetes and elective indication for delivery. The nadir of composite neonatal morbidity occurred at 36/0-36/6 weeks for MC twins and 37/0-37/6 weeks for DC twins. Conclusions Our data do not support concern for an increased risk of stillbirth in uncomplicated intensively managed MC twins ≥34 weeks’ gestation. However, our data do show significantly increased rates of neonatal morbidity in late preterm MC twins that cannot be justified by a corresponding reduction in the risk of stillbirth. We feel that our data support delivery of uncomplicated MC twins at 37 weeks’ gestation. PMID:24607757

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

    Science.gov (United States)

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

  20. Candida albicans septicemia in a premature infant successfully treated with oral fluconazole

    DEFF Research Database (Denmark)

    Bodé, S; Pedersen-Bjergaard, Lars; Hjelt, K

    1992-01-01

    A premature male infant, birth-weight 1460 g, was treated successfully for a Candida albicans septicemia with orally administered fluconazole for 20 days. Dosage was 5 mg/kg/day. No side effects were seen. Fluconazole may present a major progress in treatment of invasive C. albicans infections in...... in neonatology....

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

    Science.gov (United States)

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

    2004-01-01

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

  2. Usefulness of the bilirubin/albumin ratio for predicting bilirubin-induced neurotoxicity in premature infants

    NARCIS (Netherlands)

    Hulzebos, C. V.; van Imhoff, D. E.; Bos, A. F.; Ahlfors, C. E.; Verkade, H. J.; Dijk, P. H.

    2008-01-01

    Unconjugated hyperbilirubinaemia occurs in almost all premature infants and is potentially neurotoxic. Treatment is based on total serum bilirubin (TSB), but treatment thresholds are not evidence based. Free bilirubin (Bf) - that is, not bound to albumin, seems a better parameter for bilirubin neuro

  3. Candida albicans septicemia in a premature infant successfully treated with oral fluconazole

    DEFF Research Database (Denmark)

    Bodé, S; Pedersen-Bjergaard, Lars; Hjelt, K

    1992-01-01

    A premature male infant, birth-weight 1460 g, was treated successfully for a Candida albicans septicemia with orally administered fluconazole for 20 days. Dosage was 5 mg/kg/day. No side effects were seen. Fluconazole may present a major progress in treatment of invasive C. albicans infections...

  4. Emergency repair of inguinal hernia in the premature infant is associated with high direct medical costs

    NARCIS (Netherlands)

    J. Verhelst (Joost); B. de Goede (Barry); B.J.H. van Kempen (Bob); H.R. Langeveld-Benders (Hester); M.J. Poley (Marten); G. Kazemier (Geert); J. Jeekel (Hans); R.M.H. Wijnen (René); J.F. Lange (Johan)

    2015-01-01

    textabstractPurpose: Inguinal hernia repair is frequently performed in premature infants. Evidence on optimal management and timing of repair, as well as related medical costs is still lacking. The objective of this study was to determine the direct medical costs of inguinal hernia, distinguishing b

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

    Science.gov (United States)

    Belgaumkar, T K; Scott, K E

    1975-01-01

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

  6. Lowered electroencephalographic spectral edge frequency predicts the presence of cerebral white matter injury in premature infants

    NARCIS (Netherlands)

    Inder, TE; Buckland, L; Williams, CE; Spencer, C; Gunning, MI; Darlow, BA; Volpe, JJ; Gluckman, PD

    2003-01-01

    Objective. Current methods for early identification of cerebral white matter injury in the premature infant at the bedside are inadequate. This study investigated the utility of advanced spectral analysis of the neonatal electroencephalogram (EEG) in the early diagnosis of white matter injury in the

  7. Design of an Incubator for Premature Infant Based on LabVIEW.

    Science.gov (United States)

    Zhang, Lina; Zhou, Runjing

    2005-01-01

    This paper introduces the system structure, hardware circuits, control algorithms, and software program of the incubator for premature infant based on LabVIEW. The main advantages of this device are that preheating is less time than others, the capability of meeting of emergency is provided, control track of temperature and humidity are visible, operation is easy to clinical practice, and maintainability is possessed.

  8. Impact of Tactile Stimulation on Neurobehavioral Development of Premature Infants in Assiut City

    Science.gov (United States)

    Sayed, Atyat Mohammed Hassan; Youssef, Magda Mohamed E.; Hassanein, Farouk El-Sayed; Mobarak, Amal Ahmed

    2015-01-01

    Objective: To assess impact of tactile stimulation on neurobehavioral development of premature infants in Assiut City. Design: Quasi-experimental research design. Setting: The study was conducted in the Neonatal Intensive Care Unit at Assiut University Children Hospital, Assiut General Hospital, Health Insurance Hospital (ElMabarah Hospital) and…

  9. Establishment of the Relationship Between Fathers and Premature Infants in Neonatal Units.

    Science.gov (United States)

    Martel, Marie-Josée; Milette, Isabelle; Bell, Linda; Tribble, Denise St-Cyr; Payot, Antoine

    2016-10-01

    Parents and their preterm infants (born between 32-37 weeks of gestation) are often overlooked by the healthcare system. And very little attention is given to the relationship parents develop with their infants in the neonatal unit (NNU). Specifically, very few studies focused on fathers and how they establish a relationship with their infants. However, we know that the father-infant relationship is extremely important for their future social development and more. This article presents the results of a qualitative study of the establishment of the father-premature infant relationship in an NNU. The study's theoretical framework was Bell's model of the parent-infant relationship, which encompasses discovery, physical proximity, communication, involvement, and emotional attachment. Ten fathers of premature infants (gestational age: 32-37 weeks) participated in 2 semistructured interviews (1 individual and 1 "in situ," ie, at the infant's bedside) during the first week following the premature birth. The results confirm the emergence of different components of the relationship between fathers and their children from the first days of hospitalization in the NNU. The commitment component is the basis for the development of other components in the relationship with their children. Furthermore, involvement influences the deployment of emotional attachment, discovery, physical proximity, and communication toward premature infants. Similarly, the 5 themes of the model can be seen as forming a dynamic nexus in which each theme influences the others. For neonatal nurses, this model of the early father-child relationship helps the understanding of the deployment of that relationship according to 5 components. Similarly, it provides awareness of the experiences of fathers so that nurses can be better equipped to support and individualize interventions tailored to their specific needs, thus helping them develop and sustain the relationship with their children. This study allows

  10. Umbilical cord milking improves transition in premature infants at birth.

    Directory of Open Access Journals (Sweden)

    Anup Katheria

    Full Text Available BACKGROUND: Umbilical cord milking (UCM improves blood pressure and urine output, and decreases the need for transfusions in comparison to immediate cord clamping (ICC. The immediate effect of UCM in the first few minutes of life and the impact on neonatal resuscitation has not been described. METHODS: Women admitted to a tertiary care center and delivering before 32 weeks gestation were randomized to receive UCM or ICC. A blinded analysis of physiologic data collected on the newborns in the delivery room was performed using a data acquisition system. Heart rate (HR, SpO2, mean airway pressure (MAP, and FiO2 in the delivery room were compared between infants receiving UCM and infants with ICC. RESULTS: 41 of 60 neonates who were enrolled and randomized had data from analog tracings at birth. 20 of these infants received UCM and 21 had ICC. Infants receiving UCM had higher heart rates and higher SpO2 over the first 5 minutes of life, were exposed to less FiO2 over the first 10 minutes of life than infants with ICC. CONCLUSIONS: UCM when compared to ICC had decreased need for support immediately following delivery, and in situations where resuscitation interventions were needed immediately, UCM has the advantage of being completed in a very short time to improve stability following delivery. TRIAL REGISTRATION: ClinicalTrials.gov NCT01434732.

  11. Umbilical Cord Milking Improves Transition in Premature Infants at Birth

    Science.gov (United States)

    Katheria, Anup; Blank, Doug; Rich, Wade; Finer, Neil

    2014-01-01

    Background Umbilical cord milking (UCM) improves blood pressure and urine output, and decreases the need for transfusions in comparison to immediate cord clamping (ICC). The immediate effect of UCM in the first few minutes of life and the impact on neonatal resuscitation has not been described. Methods Women admitted to a tertiary care center and delivering before 32 weeks gestation were randomized to receive UCM or ICC. A blinded analysis of physiologic data collected on the newborns in the delivery room was performed using a data acquisition system. Heart rate (HR), SpO2, mean airway pressure (MAP), and FiO2 in the delivery room were compared between infants receiving UCM and infants with ICC. Results 41 of 60 neonates who were enrolled and randomized had data from analog tracings at birth. 20 of these infants received UCM and 21 had ICC. Infants receiving UCM had higher heart rates and higher SpO2 over the first 5 minutes of life, were exposed to less FiO2 over the first 10 minutes of life than infants with ICC. Conclusions UCM when compared to ICC had decreased need for support immediately following delivery, and in situations where resuscitation interventions were needed immediately, UCM has the advantage of being completed in a very short time to improve stability following delivery. Trial Registration ClinicalTrials.gov NCT01434732 PMID:24709780

  12. [Clinical effect of latamoxef on newborn and premature infants].

    Science.gov (United States)

    Takimoto, M; Oka, T; Yoshioka, H; Tsuchida, A; Sanae, N; Maruyama, S

    1983-09-01

    Eleven infants ranging 2 days to 3 months of age were studied for clinical evaluation. Ten of them were diagnosed as sepsis or suspected to be septic. Another one contracted umbilical infection. In 7 of 10 cases, causative bacteria were detected by blood culture, that is S. epidermidis in 3 cases, E. cloacae in 2 cases, K. pneumoniae in 1 case and A. calcoaceticus in another. Those infants were treated by parenteral LMOX. Dosage was 30 to 75 mg/kg per day. Clinical results were excellent in 6 cases (3 cases of S. epidermidis, 2 of E. cloacae and 1 of K. pneumoniae) and good in another case (A. calcoaceticus). The other 3 infants clinically diagnosed as sepsis but not proven by blood culture were also treated successfully. The result of the umbilical infection in 1 case was good. Another group of 5 infants ranging 4 to 22 days of age were also treated by LMOX because of suspected bacterial infections. With these infants pharmacokinetic study was done. Peak serum levels after 1 hour drip infusion of 20 mg/kg ranged from 43 to 53 micrograms/ml. Average of half-lives was 2.7 hours. Estimation of distribution volume resulted in 350 to 523 ml/kg body weight.

  13. Music therapy for improving premature infants' well-being and communication skills and enhancing mother-infant bonding : a case study

    OpenAIRE

    Antonakopoulou, Stefania

    2016-01-01

    Over the last few decades, mother-child attachment has received increasing attention in early intervention with prematurely born infants. In these early years, physical interactions constitute a crucial arena for early learning and brain development, and together with the strong emotional bonding between the mother and her infant, they build the foundation for later interaction relationships. Premature birth is a challenging experience for the mother-infant relationship and is always a risk f...

  14. The relationship between eosinophilia and bronchopulmonary dysplasia in premature infants at less than 34 weeks' gestation

    Science.gov (United States)

    Yang, Joo Yun; Cha, Jihei; Shim, So-Yeon; Cho, Su Jin

    2014-01-01

    Purpose Eosinophilia is common in premature infants, and its incidence increases with a shorter gestation period. We investigated the clinical significance of eosinophilia in premature infants born at Eosinophilia was defined as an eosinophil percentage of >3% of the total leukocytes. Perinatal parameters and clinical parameters were also analyzed. Results Of the 261 infants born at eosinophilia at birth. The eosinophil percentage peaked in the fourth postnatal week at 7.5%. The incidence of severe eosinophilia increased after birth up to the fourth postnatal week when 8.8% of all patients had severe eosinophilia. Severity of eosinophilia was positively correlated with a lower gestational age, birth weight, and Apgar score. Respiratory distress syndrome, bronchopulmonary dysplasia, nephrocalcinosis, intraventricular hemorrhage, and sepsis were associated with a higher eosinophil percentage. The eosinophil percentage was significantly higher in infants with bronchopulmonary dysplasia from the first postnatal week and the percentage was the highest in the fourth postnatal week, with the maximal difference being 4.1% (PEosinophilia is common in premature infants and reaches peak incidence and severity in the fourth postnatal week. The eosinophil percentage was significantly higher in bronchopulmonary dysplasia patients from the first postnatal week. Severe eosinophilia was significantly associated with the incidence of bronchopulmonary dysplasia even after adjusting for other variables. PMID:24868214

  15. Erythrocyte incorporation and absorption of 58Fe in premature infants treated with erythropoietin.

    Science.gov (United States)

    Widness, J A; Lombard, K A; Ziegler, E E; Serfass, R E; Carlson, S J; Johnson, K J; Miller, J E

    1997-03-01

    We hypothesized that treatment of very low birth weight premature infants with r-HuEPO would increase erythrocyte incorporation and gastrointestinal absorption of iron. Infants with birth weights absorption of 58Fe was not different between the epo and placebo groups after both early dosing (30 +/- 22% versus 34 +/- 8%) and late dosing (32 +/- 9% versus 31 +/- 6%). Absorption of nonlabeled elemental iron and 58Fe were significantly correlated with one another. The percentage of the absorbed 58Fe dose incorporated into Hb was not different between groups. We conclude that, although erythropoietin treatment stimulates erythrocyte iron incorporation in premature infants, it has no effect on iron absorption at the r-HuEPO dose studied.

  16. Bone mineralisation in premature infants cannot be predicted from serum alkaline phosphatase or serum phosphate

    DEFF Research Database (Denmark)

    Faerk, J; Peitersen, Birgit; Petersen, S

    2002-01-01

    BACKGROUND: The bone mineral content of premature infants at term is lower than in mature infants at the same postconceptional age. Serum alkaline phosphatase and serum phosphate are often used as indicators of bone mineralisation. OBJECTIVE: To analyse the association between bone mineral content...... and serum alkaline phosphatase and serum phosphate. METHODS: Serum alkaline phosphatase and phosphate were measured at weekly intervals during admission in 108 premature infants of gestational age below 32 weeks (mean (SD) gestational age 29 (2) weeks; mean (SD) birth weight 1129 (279) g). Bone mineral...... content was measured at term (mean gestational age 41 weeks) by dual energy x ray absorptiometry and corrected for body size. RESULTS: Serum alkaline phosphatase was significantly negatively associated with serum phosphate (p serum alkaline...

  17. Probiotics in premature infants: focus on necrotising enterocolitis

    African Journals Online (AJOL)

    the latter, it is crucial that, if probiotics is chosen as a preventive measure, the selection of a safe product with documented ... care environment rather than their mother's vaginal canal and skin surface.13 These infants often also receive antibiotic treatment ... they lower the pH of the intestinal environment and create a locally.

  18. [Metabolic bone disease in premature infants and genetic polymorphisms

    NARCIS (Netherlands)

    Funke, S.; Morava, E.; Czako, M.; Vida, G.; Ertl, T.; Kosztolanyi, G.Y.

    2007-01-01

    Metabolic bone disease is an important complication among infants very-low-birth-weight (< 1500 g). In adults, osteoporosis has been shown to be associated with polymorphisms of vitamin D receptor, estrogen receptor, and collagen Ialpha1 receptor genes. AIM: The primary goal of the study was to i

  19. Music modulates behaviour of premature infants following heel lance.

    Science.gov (United States)

    Butt, M L; Kisilevsky, B S

    2000-03-01

    The physiological and behavioural effects of music during recovery from heel lance were examined in 14 preterm infants at 29 to 36 weeks post-conceptual age (PCA). Infants were tested on 2 occasions: during a music condition and during a no-music control condition. Each condition was videotaped during 3 periods: baseline, heel lance, and recovery. Infants were divided into 2 age groups for data analyses: less than and greater than 31 weeks PCA. Mixed model ANOVAs showed that heel lance elicited a stress response (i.e., increased heart rate, decreased oxygen saturation, increased state-of-arousal, and increased facial actions indicative of pain) in both age groups. The stress response was greater in the older group. During recovery, the older group had a more rapid return of heart rate, behavioural state, and facial expressions of pain to baseline levels in the presence of compared to the absence of music. It was concluded that music is an effective NICU intervention following a stress-provoking stimulus in infants older than 31 weeks PCA.

  20. Your Premature Baby

    Science.gov (United States)

    ... birth defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since ... Complications & Loss > Preterm labor & premature birth > Premature babies Premature babies E-mail to a friend Please fill ...

  1. Premature infants have impaired airway antiviral IFNγ responses to human metapneumovirus compared to respiratory syncytial virus

    Science.gov (United States)

    Pancham, Krishna; Perez, Geovanny F.; Huseni, Shehlanoor; Jain, Amisha; Kurdi, Bassem; Rodriguez-Martinez, Carlos E.; Preciado, Diego; Rose, Mary C.; Nino, Gustavo

    2017-01-01

    BACKGROUND It is unknown why human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) cause severe respiratory infection in children, particularly in premature infants. Our aim was to investigate if there are defective airway antiviral responses to these viruses in young children with history of prematurity. METHODS Nasal airway secretions were collected from 140 children ≤3 y old without detectable virus (n = 80) or with PCR-confirmed HMPV or RSV infection (n = 60). Nasal protein levels of IFNγ, CCL5/RANTES, IL-10, IL-4, and IL-17 were determined using a multiplex magnetic bead immunoassay. RESULTS Full-term children with HMPV and RSV infection had increased levels of nasal airway IFNγ, CCL5, and IL-10 along with an elevation in Th1 (IFNγ)/Th2 (IL-4) ratios, which is expected during antiviral responses. In contrast, HMPV-infected premature children (< 32 wk gestation) did not exhibit increased Th1/Th2 ratios or elevated nasal airway secretion of IFNγ, CCL5, and IL-10 relative to uninfected controls. CONCLUSION Our study is the first to demonstrate that premature infants have defective IFNγ, CCL5/RANTES, and IL-10 airway responses during HMPV infection and provides novel insights about the potential reason why HMPV causes severe respiratory disease in children with history of prematurity. PMID:26086642

  2. Temperaments of premature infants%早产儿气质研究进展

    Institute of Scientific and Technical Information of China (English)

    王敏

    2011-01-01

    Temperament is the first distinct and stable personality after infants' birth. The development and type of the temperament is mainly associated with genetics factors, premature birth, low birth weight and clinical complications. This article describes the domestic and abroad researches and progress on premature infants' temperament in recent years, including research methods, temperament characteristic and influence factors of temperament types, and emphersizes the importance of the study on the premature infants' temperament. We raise the point that analyzing the temperament of premature children in early stage could discover temperament disorders earlier, and guide targeted training or behavior education based on different temperaments, which do good to intelligence and psychological development of premature infants.%气质是婴儿出生后最早表现出来的较为明显而稳定的人格特征,遗传、早产、低出生体质量以及与早产相关的临床并发症对气质的发展和类型有重要影响.该文通过总结近年来国内外早产儿气质研究的成果和进展,综述了早产儿气质研究的研究方法、早产儿气质特点及气质类型的影响因素,强调早产儿气质研究的重要性,提出对早产儿进行气质分析可以早期发现问题,循序渐进地对不同气质儿童进行针对性培养和行为教育,有助于早产儿智能和心理的健康发育.

  3. Ultrasound measurement of the corpus callosum and neural development of premature infants*

    Institute of Scientific and Technical Information of China (English)

    Fang Liu; Shikao Cao; Jiaoran Liu; Zhifang Du; Zhimei Guo; Changjun Ren

    2013-01-01

    Length and thickness of 152 corpus cal osa were measured in neonates within 24 hours of birth. Using ultrasonic diagnostic equipment with a neonatal brain-specific probe, corpus cal osum length and thickness of the genu, body, and splenium were measured on the standard mid-sagittal plane, and the anteroposterior diameter of the genu was measured in the coronal plane. Results showed that corpus cal osum length as wel as thickness of the genu and splenium increased with gesta-tional age and birth weight, while other measures did not. These three factors on the standard mid-sagittal plane are therefore likely to be suitable for real-time evaluation of corpus cal osum de-velopment in premature infants using cranial ultrasound. Further analysis revealed that thickness of the body and splenium and the anteroposterior diameter of the genu were greater in male infants than in female infants, suggesting that there are sex differences in corpus cal osum size during the neonatal period. A second set of measurements were taken from 40 premature infants whose ges-tational age was 34 weeks or less. Corpus cal osum measurements were corrected to a gestational age of 40 weeks, and infants were grouped for analysis depending on the outcome of a neonatal behavioral neurological assessment. Compared with infants with a normal neurological assessment, corpus cal osum length and genu and splenium thicknesses were less in those with abnormalities, indicating that corpus cal osum growth in premature infants is associated with neurobehavioral de-velopment during the early extrauterine stage.

  4. Hot Executive Function Following Moderate-to-Late Preterm Birth: Altered Delay Discounting at 4 Years of Age

    Science.gov (United States)

    Hodel, Amanda S.; Brumbaugh, Jane E.; Morris, Alyssa R.; Thomas, Kathleen M.

    2016-01-01

    Interest in monitoring long-term neurodevelopmental outcomes of children born moderate-to-late preterm (32-36 weeks gestation) is increasing. Moderate-to-late preterm birth has a negative impact on academic achievement, which may relate to differential development of executive function (EF). Prior studies reporting deficits in EF in preterm…

  5. Risk factors associated with late preterm births in the underdeveloped region of China: A cohort study and systematic review

    Directory of Open Access Journals (Sweden)

    Liqun Lu

    2015-12-01

    Conclusion: A number of factors are associated with late preterm births, and the incidence in underdeveloped regions is high. The inconsistent results between our study and previous reports indicate more attention towards preventing late preterm births in undeveloped regions is needed.

  6. Changes in Heart Rate Variability in a Premature Infant with Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Zuzana Uhrikova

    2012-11-01

    Full Text Available Objective - To define changes of heart rate variability in premature infant with hydrocephalus before and after drainage procedure. Study Design - The authors report a case of a premature infant with hydrocephalus with analysis of heart rate variability before and after drainage procedure. Three subsequent recordings of the electrocardiography and heart rate variability were done: the first at the age of 22 days before insertion of ventriculoperitoneal shunt, the second at the age of 36 days with functional shunt, the third at the age of 71 days (before discharge. Results - Before drainage operation, there was reduced heart rate variability in time and spectral domains, and sympathetic activity was dominant. After surgery, an increase in heart rate variability parameters was found, particularly with spectral analysis. The ratio of low-frequency/high-frequency band and relative power of the low-frequency band decreased, reflecting enhanced parasympathetic activity. Conclusion - Results of the heart rate variability analysis in a preterm infant with hydrocephalus before and after drainage procedure showed marked improvement in chronotropic cardiac regulation. Evaluation of heart rate variability in premature infants with hydrocephalus with increased intracranial pressure can be an additional method for monitoring of cardiac dysregulation and improvement of the cardiovascular control after successful drainage procedure.

  7. Changes in heart rate variability in a premature infant with hydrocephalus.

    Science.gov (United States)

    Uhrikova, Zuzana; Kolarovszki, Branislav; Javorka, Kamil; Javorka, Michal; Matasova, Katarina; Kolarovszka, Hana; Zibolen, Mirko

    2012-11-01

    Objective To define changes of heart rate variability in premature infant with hydrocephalus before and after drainage procedure. Study Design The authors report a case of a premature infant with hydrocephalus with analysis of heart rate variability before and after drainage procedure. Three subsequent recordings of the electrocardiography and heart rate variability were done: the first at the age of 22 days before insertion of ventriculoperitoneal shunt, the second at the age of 36 days with functional shunt, the third at the age of 71 days (before discharge). Results Before drainage operation, there was reduced heart rate variability in time and spectral domains, and sympathetic activity was dominant. After surgery, an increase in heart rate variability parameters was found, particularly with spectral analysis. The ratio of low-frequency/high-frequency band and relative power of the low-frequency band decreased, reflecting enhanced parasympathetic activity. Conclusion Results of the heart rate variability analysis in a preterm infant with hydrocephalus before and after drainage procedure showed marked improvement in chronotropic cardiac regulation. Evaluation of heart rate variability in premature infants with hydrocephalus with increased intracranial pressure can be an additional method for monitoring of cardiac dysregulation and improvement of the cardiovascular control after successful drainage procedure.

  8. Glycerin enemas and suppositories in premature infants: a meta-analysis.

    Science.gov (United States)

    Livingston, Michael H; Shawyer, Anna C; Rosenbaum, Peter L; Williams, Connie; Jones, Sarah A; Walton, J Mark

    2015-06-01

    Premature infants are often given glycerin enemas or suppositories to facilitate meconium evacuation and transition to enteral feeding. The purpose of this study was to assess the available evidence for this treatment strategy. We conducted a systematic search of Medline, Embase, Central, and trial registries for randomized controlled trials of premature infants treated with glycerin enemas or suppositories. Data were extracted in duplicate and meta-analyzed using a random effects model. We identified 185 premature infants treated prophylactically with glycerin enemas in one trial (n = 81) and suppositories in two other trials (n = 104). All infants were less than 32 weeks gestation and had no congenital malformations. Treatment was associated with earlier initiation of stooling in one trial (2 vs 4 days, P = .02) and a trend towards earlier meconium evacuation in another (6.5 vs 9 days, P = .11). Meta-analysis demonstrated no effect on transition to enteral feeding (0.7 days faster, P = .43) or mortality (P = 0.50). There were no reports of rectal bleeding or perforation but there was a trend towards increased risk of necrotizing enterocolitis with glycerin enemas or suppositories (risk ratio = 2.72, P = .13). These three trials are underpowered and affected by one or more major methodological issues. As a result, the quality of evidence is low to very low. Three other trials are underway. The evidence for the use glycerin enemas or suppositories in premature infants in inconclusive. Meta-analyzed data suggest that treatment may be associated with increased risk of necrotizing enterocolitis. Careful monitoring of ongoing trials is required. Copyright © 2015 by the American Academy of Pediatrics.

  9. Urinary nitrite excretion after prophylactic intravenous immunoglobulin in premature infants.

    Science.gov (United States)

    Ozkan, H; Uzuner, N; Oren, H; Cabuk, N; Işlekel, H

    2000-02-01

    To investigate the correlation between the prophylactic administration of intravenous immunoglobulin (IVIG) to preterm infants and urinary nitrite levels, which can be utilized as an index of endogenous nitric oxide (NO) formation, and to determine if NO formation plays a role in both therapeutic and adverse effects of IVIG. 28 healthy preterm infants were included in this prospective study. They had a mean gestational age of 29.4 +/- 2.2 weeks and weight of 1,387 +/- 371 g. Prophylactic IVIG infusion at a dose of 0.5 g/kg/day was administered when they were 3-10 days old. Urine samples of the neonates were obtained for analysis on days 1, 2 and 3 after IVIG administration as well as 1 day before. Urinary nitrite levels obtained in the subjects were normalized for urinary creatinine concentrations. The mean urinary nitrite levels were: 2.77 +/- 1.66 micromol/mmol creatinine before IVIG administration; 4.33 +/- 3.88 micromol/mmol creatinine on the 1st day of IVIG; 3.77 +/- 2.73 micromol/mmol creatinine on the 2nd day, and 3.64 +/- 3.28 micromol/mmol creatinine on the 3rd day. There was a significant increase in urinary nitrite levels between before and after IVIG administration. There was no statistical difference in urinary nitrate levels between days 1, 2 and 3 after IVIG administration. We demonstrated that urinary nitrite excretion is significantly elevated in preterm infants after prophylactic IVIG administration and this result suggests that endogenous NO formation may play an important role in both the therapeutic and adverse effects of IVIG. Copyright 2000 S. Karger AG, Basel

  10. Transient Hypothyroidism in Premature Infants After Short-term Topical Iodine Exposure: An Avoidable Risk?

    Directory of Open Access Journals (Sweden)

    Jordan E. Pinsker

    2013-04-01

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

  11. Feeding premature infants while low umbilical artery catheters are in place: a prospective, randomized trial.

    Science.gov (United States)

    Davey, A M; Wagner, C L; Cox, C; Kendig, J W

    1994-05-01

    The objective of this prospective, randomized clinical trial was to test the hypothesis that there is no difference in the frequency of feeding problems and necrotizing enterocolitis between a group of premature infants who received early enteral feedings while low umbilical artery catheters (LUACs) were in place, and a late group who were not fed until 24 hours after removal of LUACs. Twenty-nine premature infants (born at 28.5 +/- 3.0 SD weeks of gestational age) who were in stable condition received early enteral feedings at a median of 2 days while a LUAC was in place; 31 infants (born at 28.6 +/- 2.7 SD weeks of gestational age) received late enteral feedings at a median of 5 days of age, 24 hours after the removal of the LUAC. Feeding complications and interventions and nutritional characteristics were recorded prospectively. There were no differences in the baseline perinatal characteristics of the two groups. The incidence of gastric residua and the incidence of abdominal distention were the same in both groups. The early feeding group had significantly fewer percutaneous central venous catheters, evaluations for sepsis, and episodes of receiving nothing by mouth while a gastric suction tube was in place. Infants in the early group received parenteral alimentation-lipid emulsion infusions for a median of 13 days versus 30 days for the late-fed group (p = 0.0028 by Wilcoxon test). There were two cases of necrotizing enterocolitis in the early group versus four cases in the late group. Premature infants in stable condition who receive enteral feedings while LUACs are in place do not have an increased incidence of feeding problems compared with infants who do not receive enteral feedings until 24 hours after removal of LUACs.

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

    Science.gov (United States)

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

    2017-09-01

    To identify genetic variants associated with sepsis (early-onset and late-onset) using a genome-wide association (GWA) analysis in a cohort of extremely premature infants. Previously generated GWA data from the Neonatal Research Network's anonymised genomic database biorepository of extremely premature infants were used for this study. Sepsis was defined as culture-positive early-onset or late-onset sepsis or culture-proven meningitis. Genomic and whole-genome-amplified DNA was genotyped for 1.2 million single-nucleotide polymorphisms (SNPs); 91% of SNPs were successfully genotyped. We imputed 7.2 million additional SNPs. p Values and false discovery rates (FDRs) were calculated from multivariate logistic regression analysis adjusting for gender, gestational age and ancestry. Target statistical value was p<10(-5). Secondary analyses assessed associations of SNPs with pathogen type. Pathway analyses were also run on primary and secondary end points. Data from 757 extremely premature infants were included: 351 infants with sepsis and 406 infants without sepsis. No SNPs reached genome-wide significance levels (5×10(-8)); two SNPs in proximity to FOXC2 and FOXL1 genes achieved target levels of significance. In secondary analyses, SNPs for ELMO1, IRAK2 (Gram-positive sepsis), RALA, IMMP2L (Gram-negative sepsis) and PIEZO2 (fungal sepsis) met target significance levels. Pathways associated with sepsis and Gram-negative sepsis included gap junctions, fibroblast growth factor receptors, regulators of cell division and interleukin-1-associated receptor kinase 2 (p values<0.001 and FDR<20%). No SNPs met genome-wide significance in this cohort of extremely low birthweight infants; however, areas of potential association and pathways meriting further study were identified. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

    Directory of Open Access Journals (Sweden)

    Sissel J. Moltu

    2014-05-01

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

  14. Serial diffusion tensor imaging detects white matter changes that correlate with motor outcome in premature infants.

    Science.gov (United States)

    Drobyshevsky, Alexander; Bregman, Joanne; Storey, Pippa; Meyer, Joel; Prasad, P V; Derrick, Matthew; MacKendrick, William; Tan, Sidhartha

    2007-01-01

    The objective of the study was to assess predictive value of serial diffusion tensor MRI (DTI) for the white matter injury and neurodevelopmental outcome in a cohort of premature infants. Twenty-four infants less than 32 weeks' gestation were stratified to a control group (n = 11), mild brain injury with grades 1-2 of intraventricular hemorrhage (n = 6) and severe brain injury with grades 3-4 intraventricular hemorrhage (n = 4). Serial DTI studies were performed at around 30 and 36 weeks' gestation. Fractional anisotropy (FA) and apparent diffusion coefficient were calculated. Twelve infants were followed up for developmental outcome. Developmental testing was performed with the Bayley Scales of Infant Development to obtain psychomotor index (Performance Developmental Index). Apparent diffusion coefficient was higher in the severe injury group at the second MRI in the central and occipital white matter, and corona radiata; FA was lower in optic radiation compared to controls. Performance Developmental Index score correlated with FA on the scan taken at the 30th week and inversely with the change of FA between scans in internal capsule and occipital white matter. A low value of FA at 30 weeks and a higher change of FA predicted less favorable motor outcome at 2 years and suggests that early subtle white matter injury can be detected in premature infants even without obvious signs of injury. 2007 S. Karger AG, Basel

  15. Immunologic and infectious consequences of immediate versus delayed umbilical cord clamping in premature infants: a prospective, randomized, controlled study.

    Science.gov (United States)

    Kugelman, Amir; Borenstein-Levin, Liron; Kessel, Aharon; Riskin, Arieh; Toubi, Elias; Bader, David

    2009-01-01

    To evaluate the immunologic and infectious consequences of delayed versus immediate cord clamping in premature infants (cord clamping (ICC) at 5-10 s and 30 infants to delayed cord clamping (DCC), at 30-45 s (14 and 15 infants in each group were cord clamping did not affect the immunologic or the infectious status of infants born at <35 weeks during the neonatal period.

  16. Sociocultural dimension of parents of premature infants discharged from a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Isis Vanessa Nazareth

    2014-10-01

    Full Text Available This study aimed at identifying and analyzing the social and cultural dimensions of parents of premature infants discharged from neonatal intensive care units. It is a qualitative and descriptive study, based on ethno-nursing and in the Theory of Diversity and Universality Cultural Care with 12 participants. The setting was a university hospital in the city of Rio de Janeiro, RJ, Brazil. Data collection occurred between November, 2012 and April, 2013, through a social economic and cultural questionnaire and from the observation, participation and reflection. The analysis based on ethno-nursing and on the use of Atlas-ti software allowed to find the analytical category: the sociocultural structure of parents of premature infants discharged from a neonatal intensive care unit. Results should be used to promote a culturally relevant care and respecting the popular knowledge of parents while taking care of the children discharged from neonatal intensive care units.

  17. NEUROSPECIFIC ENOLASE IN DIAGNOSTICS FOR PERINATAL DAMAGE TO THE CENTRAL NERVOUS SYSTEM IN PREMATURE INFANTS

    Directory of Open Access Journals (Sweden)

    E.G. Novopol'tseva

    2010-01-01

    Full Text Available Neurospecific enolase is an endoenzyme of the central nervous system (CNS present in neurons of the brain and peripheral neuraltissue. This is currently the only known general marker of all differentiated neurons. The article illustrates the results of determining this enzyme in premature infants with fetal infections and assessment of their importance as a marker of damage to CNS in this group of children. A high level of neurospecific enolase in children with infectious and inflammatory diseases is not only the marker of damage to blood-brain barrier, but also reflects the nature of damage (hypoxia, intoxication, inflammation. This parameter in premature infants with various pathologies may serve as a degree of perinatal damage severity, and along with other parameters, determine the performed therapy tactics. Key words: neurospecific enolase, marker of CNS damage, perinatal damage, children. (Pediatric Pharmacology. – 2010; 7(3:66-70

  18. Co-occurrence of developmental and behavioural problems in moderate to late preterm-born children

    NARCIS (Netherlands)

    Potijk, Marieke R; de Winter, Andrea F; Bos, Arend F; Kerstjens, Jorien M; Reijneveld, Sijmen A

    2016-01-01

    Objective To determine the occurrence of emotional and behavioural problems (EBP) in moderate to late preterm (MLP) and full-term children with developmental delay. Design Participants were recruited from 13 randomly selected preventive child healthcare (PCH) centres in the Netherlands. We included

  19. Exercise during pregnancy and risk of late preterm birth, cesarean delivery, and hospitalizations

    Science.gov (United States)

    Tinloy, Jennifer; Zhu, Junjia; Pauli, Jaimey; Kraschnewski, Jennifer L.; Kjerulff, Kristen H.

    2013-01-01

    Background Federal physical activity guidelines recommend at least 150 minutes of moderate-intensity exercise per week during pregnancy. We studied whether regular exercise during pregnancy is associated with preterm birth, cesarean delivery, and hospitalization during pregnancy. Methods Self-reported weekly exercise was ascertained in 3,006 women during the 3rd trimester of pregnancy. Using multivariable logistic regression, we report the relationship between regular exercise (at least 150 minutes per week) and late preterm birth, cesarean delivery, and hospitalization during pregnancy, controlling for age, race, marital status, education, poverty status, pre-pregnancy BMI weight category, gestational weight gain, and prepregnancy diabetes or hypertension. Results Nearly one-third of women reported meeting current federal physical activity recommendations during pregnancy. Five percent had late preterm birth, 29% had cesarean deliveries, and 20% reported hospitalization during pregnancy. In multivariable analysis, regular exercise during pregnancy was not associated with late preterm birth or hospitalization during pregnancy. Physical activity of 150 or more minutes/week was associated with reduced odds of cesarean delivery compared with less than 60 minutes/week, but the finding was not statistically significant (adjusted OR 0.86, 95% CI 0.69 – 1.07). Conclusion In the First Baby Study, physical activity was not associated with late preterm birth or hospitalizations, and may be associated with decreased odds of cesarean delivery. PMID:24439953

  20. Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

    Science.gov (United States)

    Rogers, Cynthia E.; Lenze, Shannon N.; Luby, Joan L.

    2013-01-01

    Objective: Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early…

  1. Co-occurrence of developmental and behavioural problems in moderate to late preterm-born children

    NARCIS (Netherlands)

    Potijk, Marieke R; de Winter, Andrea F; Bos, Arend F; Kerstjens, Jorien M; Reijneveld, Sijmen A

    Objective To determine the occurrence of emotional and behavioural problems (EBP) in moderate to late preterm (MLP) and full-term children with developmental delay. Design Participants were recruited from 13 randomly selected preventive child healthcare (PCH) centres in the Netherlands. We included

  2. Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

    Science.gov (United States)

    Rogers, Cynthia E.; Lenze, Shannon N.; Luby, Joan L.

    2013-01-01

    Objective: Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early…

  3. Antenatal betamethasone improves postnatal transition in late preterm lambs with persistent pulmonary hypertension of the newborn

    Science.gov (United States)

    Konduri, Girija G.; Bakhutashvili, Ivane; Eis, Annie; Afolayan, Adeleye

    2013-01-01

    Background Persistent pulmonary hypertension of the newborn (PPHN) is associated with increased oxidative stress in pulmonary arteries (PA). Betamethasone decreases the oxidative stress and improves anti-oxidant balance in PPHN. We investigated whether antenatal betamethasone improves pulmonary vasodilation and postnatal oxygenation in late preterm lambs with PPHN. Methods PPHN was induced by constriction of fetal ductus arteriosus from 128 to 136d gestation. Ewes were given 2 i.m. doses of betamethasone or saline at 24h and 12h before Cesarian-section delivery at 136d gestation, simulating late preterm birth. Newborn lambs were mechanically ventilated for 8h with monitoring of blood gas and hemodynamic variables. Lungs were harvested post mortem to determine oxidative stress markers and in vitro responses of PA. Results Postnatal arterial partial pressure of oxygen and pH were higher and the oxygenation index and arterial partial pressure of carbon dioxide lower in betamethasone treated lambs. PA pressure was lower and systemic pressure higher in betamethasone lambs. Betamethasone decreased the oxidative stress markers and increased endothelial nitric oxide synthase expression in ventilated PPHN lungs. Conclusion Antenatal betamethasone decreases oxidative stress and improves postnatal transition in late preterm lambs with PPHN. This study suggests a potential benefit for antenatal betamethasone in late preterm births. PMID:23370411

  4. Longitudinal Growth and Neuropsychological Functioning at Age 7 in Moderate and Late Preterms

    NARCIS (Netherlands)

    Dotinga, Baukje M.; Eshuis, Milou S.; Bocca-Tjeertes, Inger F.; Kerstjens, Jorien M.; Van Braeckel, Koenraad N. J. A.; Reijneveld, Sijmen A.; Bos, Arend F.

    2016-01-01

    OBJECTIVE: To determine the association between longitudinal growth measures (height, abstract weight, head circumference, and extent of catch-up growth) and neuropsychological functioning at 7 years in moderately and late preterm children. METHODS: This study was part of a prospective, community-ba

  5. Iodine content of infant formulas and iodine intake of premature babies: high risk of iodine deficiency.

    Science.gov (United States)

    Ares, S; Quero, J; Durán, S; Presas, M J; Herruzo, R; Morreale de Escobar, G

    1994-11-01

    As part of a study of thyroid function in premature babies, the iodine content of their mothers' breast milk, that of 32 formulas from different brands used in Spain, and that of 127 formulas used in other countries was determined. Breast milk contained more iodine--mean (SEM) 10 (1) microgram/dl--than most of the formulas, especially those for premature babies. Iodine intakes were therefore below the recommended daily amount (RDA) for newborns: babies of 27-30 weeks' gestational age took 3.1 (1.1) micrograms/day at 5 days of age and 29.8 (2.7) micrograms by 2 months of age. This problem is not exclusive to Spanish premature babies as the iodine content of many of the formulas on sale in other countries was also inadequate. It is concluded that preterm infants who are formula fed are at high risk of iodine deficiency.

  6. Clinical sonography in premature infant: Sonographic analysis of incidence and grade of germinal metrixhemorrhage according to gestational age,risk

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hyoung; Kim, I. W.; Yeon, K. M. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    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.

  7. Effect of mouse nerve growth factor on brain development in premature infants

    Institute of Scientific and Technical Information of China (English)

    Yi Ban; Zhong-He Wan

    2016-01-01

    Objective:To analyze the effect of application of mouse nerve growth factor in neonatal period on brain development in premature infants.Methods:A total of 37 cases of premature infants given birth in our hospital from 1st January, 2015 to 30th December, 2015 were selected as research subjects and divided into observation group (n=18) and control group (n=19) according to different ways of intervention. Control group didn’t receive exogenous drugs, observation group received mouse nerve growth factor (NGF) treatment in neonatal period, and then differences in results of brain magnetic resonance imaging, electroencephalogram, brainstem auditory evoked potential, scores of Gesell developmental scale, levels of NSE, S-100β, 8-OHdG and 8-I-PGF2α and levels of TLR-4, TNF-α, IL-18 and so on of two groups after intervention were compared.Results:Proportions of normal MRI, EEG and BAEP of observation group were higher than those of control group, and proportions of severely abnormal were significantly lower than those of control group; scores of Gesell developmental scale motor, adaptive behavior, language and social skills of observation group in 3 months and 6 months of corrected gestational age were higher than those of control group; serum NSE, S-100β, 8-OHdG and 8-I-PGF2α levels of observation group after 3 months and 6 months of corrected gestational age were lower than those of control group ; serum TLR-4, TNF-α, IL-18, NF-κB and MMP-9 levels of observation group after 6 months of corrected gestational age were lower than those of control group, and levels of EGF and SOD were higher than those of control group.Conclusion: Application of mouse nerve growth factor in neonatal period of premature infants helps to promote nerve cell growth and development and optimize brain function of premature infants, and it has active clinical significance.

  8. Temporal comparative analysis of computed tomography with ultrasound for intracranial hemorrhage in premature infants

    Energy Technology Data Exchange (ETDEWEB)

    Quisling, R.G.; Reeder, J.D.; Kaude, J.V.; Setzer, E.S.

    1983-02-01

    This study focuses on comparison of computed tomography and ultrasound in premature infants with intracranial hemorrhage and its complications. It was determined that close correlation (95%) exists between CT and ultrasound for evaluations of ventriculomegaly. Although there is reasonable correlation for the identification and localization of periventricular, intraventricular and choroidal hemorrhages, ultrasound defined such lesions at higher rates. Subarachnoid blood and periventricular edema were diagnosed better or exclusively by CT.

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

    Directory of Open Access Journals (Sweden)

    Wen-Jue Soong

    2007-04-01

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

  10. Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    Yates Robert

    2006-05-01

    Full Text Available Abstract Background The patent ductus arteriosus (PDA is an important problem in premature infants. Surgical PDA ligation is usually only be considered when medical treatment has either failed or was contraindicated. The aims of our study were to determine the mortality and morbidity following patent ductus arteriosus ligation in premature infants, and whether prostaglandin synthetase inhibitor (PSI use prior to ligation affects outcome. Methods A retrospective case note review study to determine the outcome of premature infants undergoing patent ductus arteriosus ligation in one tertiary neonatal intensive care unit and two paediatric cardiothoracic centres. Results We had follow-up data on 87 infants. Cumulative mortality rates at 7 days, 30 days and at hospital discharge were 2%, 8% and 20% respectively. The incidence of chronic lung disease, intraventricular haemorrhage, necrotising enterocolitis and retinopathy of prematurity were 77%, 39%, 26% and 28% respectively. There was no difference in mortality, incidence of chronic lung disease or duration of oxygen dependence between those who had and those who had not received a PSI prior to surgical ligation. In those who had received 2 or more courses of PSI prior to surgical ligation, there was a trend to increase in the duration of oxygen therapy and chronic lung disease, but no difference in mortality. Conclusion This study shows that patent ductus arteriosus ligation is a relatively safe procedure (30 day survival 92% but there is substantial late mortality and a high incidence of morbidity in the survivors. 2 or more courses of PSI prior to surgical ligation trends to increased oxygen dependence and chronic lung disease. This high risk population requires careful follow-up. A definitive prospective cohort study is lacking.

  11. Communication with parents of a prematurely born infant in the intensive care and therapy unit

    OpenAIRE

    Urbančič, Klaudia

    2015-01-01

    Tri article describes communication in the frames of nursing care between a nurse and parents of a prematurely born infant in the frames of nursing care and health education counseling. Communication is presented as a skill of interpersonal relations which forms a part of certain environments and can be learned through experience. Communication takes place on three levels: professional communication, communication with a client and communication within the organizational unit. In interaction ...

  12. Do Hospitalized Premature Infants Benefit from Music Interventions? A Systematic Review of Randomized Controlled Trials

    OpenAIRE

    Van Der Heijden, Marianne J. E.; Araghi, Sadaf Oliai; Jeekel, Hans; Reiss, Irwin; Hunink, M G M; van Dijk, Monique

    2016-01-01

    textabstractObjective: Neonatal intensive care units (NICU) around the world increasingly use music interventions. The most recent systematic review of randomized controlled trials (RCT) dates from 2009. Since then, 15 new RCTs have been published. We provide an updated systematic review on the possible benefits of music interventions on premature infants' well-being. Methods: We searched 13 electronic databases and 12 journals from their first available date until August 2016. Included were ...

  13. The Effect of Gestational Age on Axial Length of the Eyes of Premature Infants

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Sekeroglu

    2016-01-01

    Full Text Available Aim: The aim of the present study is to evaluate the axial length of the eyes of premature infants without retinopathy of prematurity and to document the relationship with gestational age and changes as infants grew-up. Material and Method: The axial length of the eyes were measured by using a mobile A-scan ultrasonographic biometry device just before the first retinopathy of prematurity screening examination and 4-weeks thereafter. Results: One-hundred and thirty-six infants with a mean gestational age of 31,7±2,7 weeks and a birth-weight of 1561.0±379.3 g were included in the study. Axial length measurements were done at a mean postconceptional age of 35.8 ±2.6 (31-40 and 39.8±2.7 (35-44 weeks, consecutively. The mean axial length at first and second visits were 16.43±0.42 mm (15.28-17.13 and 16.69±0.41 mm (15.60-17.70, consecutively (p

  14. VACCINATION OF PREMATURE INFANTS AND CHILDREN WITH CONGENITAL HEART DISEASE IN IRKUTSK USING CONJUGATED PNEUMOCOCCAL VACCINES

    Directory of Open Access Journals (Sweden)

    S. V. Il'ina

    2013-01-01

    Full Text Available Study aim: analyzing the results of pneumococcal infection vaccination conducted to reduce infantile morbidity and mortality in 2011-2012 at the expenses of the Irkutsk municipal budget. Patients and methods. Vaccination using the 7- and 13-valent pneumococcal conjugated vaccine was conducted for more than 700 risk group children: premature infants, children with congenital heart diseases or bronchopulmonary dysplasia from 2 months to 2 years of age. 193 vaccinated children had been observed for 1.5 years. 30% of premature infants and 46% of children with congenital heart diseases were vaccinated using the PCV7/PCV13 vaccine at the age of 2-6 months, 52 and 40% - at the age of 7-11 months, accordingly. The PCV7/PCV13 vaccine was administered together with other vaccines of the national preventive vaccination calendar in 65% of cases. Results. Rate of general post-vaccinal reactions (body temperature increase from 37.6 to 38.0oC – 4%; no local reactions were registered. No other unfavorable phenomena were noted in the post-vaccinal period. No cases of pneumonia, meningitis, acute otitis media and bronchoobstructive syndrome were registered within the observation period. Conclusions: pneumococcal infection vaccination of premature infants with congenital heart diseases and bronchopulmonary dysplasia conducted in Irkutsk proved high efficacy and safety of the used vaccine – PCV7/PCV13. 

  15. NIH consensus development conference: Inhaled nitric oxide therapy for premature infants.

    Science.gov (United States)

    Cole, F Sessions; Alleyne, Claudia; Barks, John D E; Boyle, Robert J; Carroll, John L; Dokken, Deborah; Edwards, William H; Georgieff, Michael; Gregory, Katherine; Johnston, Michael V; Kramer, Michael; Mitchell, Christine; Neu, Josef; Pursley, DeWayne M; Robinson, Walter; Rowitch, David H

    2010-10-29

    To provide healthcare providers, patients, and the general public with a responsible assessment of currently available data on the use of inhaled nitric oxide in early routine, early rescue, or later rescue regimens in the care of premature infants biostatistics, child psychology, clinical trials, ethics, family-centered care, neonatology, neurodevelopmental follow-up, nursing, pediatric epidemiology, neurobehavior, neurological surgery, neurology, and pulmonology, perinatology, and research methodology. In addition, 18 experts from pertinent fields presented data to the panel and conference audience. Presentations by experts and a systematic review of the literature prepared by the Johns Hopkins University Evidence-based Practice Center, through the Agency for Healthcare Research and Quality. Scientific evidence was given precedence over anecdotal experience. The panel drafted its statement based on scientific evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. This statement is a report of the panel and is not a policy statement of the NIH or the Federal Government. (1) Taken as a whole, the available evidence does not support use of inhaled nitric oxide in early routine, early rescue, or later rescue regimens in the care of premature infants pharmaceutical industry should avoid marketing inhaled nitric oxide for premature infants <34 weeks gestation.

  16. Time-frequency relationships between heart rate and respiration: A diagnosis tool for late onset sepsis in sick premature infants

    OpenAIRE

    Carrault, Guy; Beuchée, Alain; Pladys, Patrick; Senhadji, Lotfi; Hernandez, Alfredo

    2009-01-01

    International audience; The diagnosis of late onset sepsis in premature infants remains difficult because clinical signs are subtle and non-specific and none of the laboratory tests, including CRP and blood culture, have high predictive accuracy. Heart rate variability (HRV) analysis emerges as a promising diagnostic tool. Entropy and long-range fractal correlation are decreased in premature infants with proven sepsis. Besides this, respiration and its relations to HRV appear to be less. The ...

  17. Association of external cephalic version before term with late preterm birth.

    Science.gov (United States)

    Poole, Kristie L; McDonald, Sarah D; Griffith, Lauren E; Hutton, Eileen K

    2017-08-01

    While evidence suggests that beginning an external cephalic version (ECV) before term (34(0/7) to 36(6/7) weeks) compared with after term may be associated with an increase in late preterm birth (34(0/7) to 36(6/7) weeks), it remains unknown what might account for this risk. The objective of the present study is to further investigate the association between ECV before term and late preterm birth. Secondary analysis of data collected from the international, multicenter Early ECV trials. We evaluated the relation between ECV exposure and late preterm birth (34(0/7) to 36(6/7) weeks), as well as whether additional risk factors for preterm birth (such as maternal age, height, body mass index, parity, placental location, and perinatal mortality rate) moderated this relation. Generalized linear mixed methods were used to account for center effect and adjust for covariates. Among 1765 women with breech pregnancies and without a prior preterm birth, 749 (42.4%) received at least one ECV before term. Exposure to an ECV before term was not associated significantly independently with odds of preterm birth. However, placenta location moderated the association between early ECV exposure and late preterm birth. The odds of preterm birth in women who were exposed to an ECV before term and who also had an anterior placenta were doubled (OR 2.05; 95% CI 1.12-3.71; p = 0.02). In a large cohort of women without known risks for preterm birth, those with an anterior placenta who undergo an ECV before term constitute a subgroup at particular risk for late preterm birth. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

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

    Science.gov (United States)

    de Róiste, Aine

    2004-12-01

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

  19. Intravitreal Injection of Bevacizumab for Retinopathy of Prematurity in an Infant with Peters Anomaly

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Minami

    2014-10-01

    Full Text Available Purpose: To report our findings in an infant with Peters anomaly type II whose retinopathy of prematurity (ROP was treated with an anti-VEGF agent and surgeries. Case Report: A male infant weighing 548 g was born prematurely at 23 weeks and 1 day with corneal opacity and shallow anterior chambers in both eyes. At the postmenstrual age of 35 weeks and 3 days, the infant was tentatively diagnosed with stage 3 ROP because of a dilated tunica vasculosa lentis and ultrasonographic findings. The boy was treated with bilateral intravitreal injections of bevacizumab (IVB because laser photocoagulation of the retina could not be performed due to the corneal opacity. The retina in the right eye detached 3 times, namely 5 days, 16 days, and 7 months after the IVB; encircling the scleral buckle and a vitrectomy with endolaser photocoagulation were therefore required. In his left eye, the retina was reattached after the initial IVB, and no additional treatment was required. ROP was not reactivated in both eyes until the last examination at the age of 2 years and 6 months. Conclusions: Our results showed that IVB is a useful treatment for ROP in patients with Peters anomaly. However, a retinal detachment can be a complication after IVB. The optimal timing of IVB for ROP in infants with hazy media needs to be determined.

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

    Directory of Open Access Journals (Sweden)

    Gaurav Sanghi

    2014-01-01

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

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

    Science.gov (United States)

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

    2003-01-01

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

  2. Current perspectives for management of acute respiratory insufficiency in premature infants with acute respiratory syndrome.

    Science.gov (United States)

    Chen, Peng; Zhang, Ying; Li, Long-Yun

    2014-09-01

    Current perspectives for management of acute respiratory insufficiency in premature infants with acute respiratory syndrome and the pathology of acute respiratory insufficiency in the preterm infant, including the current therapy modalities on disposition are presented. Since the therapeutical challenge and primary clinical goal are to normalize ventilation ratio and lung perfusion, when respiratory insufficiency occurs, it is very important to introduce the respiratory support as soon possible, in order to reduce development of pulmonary cyanosis and edema, and intrapulmonary or intracardial shunts. A characteristic respiratory instability that reflects through fluctuations in gas exchange and ventilation is often present in premature infants. Adapting the respiratory support on a continuous basis to the infant's needs is challenging and not always effective. Although a large number of ventilation strategies for the neonate are available, there is a need for additional consensus on management of acute respiratory distress syndrome in pediatric population lately redefined by Berlin definition criteria, in order to efficiently apply various modes of respiratory support in daily pediatrician clinical use.

  3. Insulin-like growth factor binding protein-3 in preterm infants with retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Manizheh Mostafa Gharehbaghi

    2012-01-01

    Full Text Available Background: Retinopathy of prematurity (ROP is the main cause of visual impairment in preterm newborn infants. Objective: This study was conducted to determine whether insulin-like growth factor binding protein -3 (IGFBP-3 is associated with proliferative ROP and has a role in pathogenesis of the disease in premature infants. Materials and Methods: A total of 71 preterm infants born at or before 32 weeks of gestation participated in this study. Studied patients consisted of 41 neonates without vaso-proliferative findings of ROP as the control group and 30 preterm infants with evidence of severe ROP in follow up eye examination as the case group. Blood samples obtained from these infants 6-8 weeks after birth and blood levels of IGFBP-3 were measured using enzyme-linked immunosorbent assay (ELISA. Results: The mean gestation age and birth weight of the studied patients were 28.2±1.6 weeks and 1120.7±197 gram in the case group and 28.4±1.6 weeks and 1189.4±454 gram in the control group (P=0.25 and P=0.44 respectively. The infants in the case group had significantly lower Apgar score at first and 5 min after birth. Insulin-like growth factor binding protein -3 (IGFBP-3 was significantly lower in the patients with proliferative ROP than the patients without ROP [592.5±472.9 vs. 995.5±422.2 ng/ml (P=0.009]. Using a cut-off point 770.45 ng/ml for the plasma IGFBP-3, we obtained a sensitivity of 65.9% and a specificity of 66.7% in the preterm infants with vasoproliferative ROP. Conclusion: Our data demonstrated that the blood levels IGFBP-3 was significantly lower in the patients with ROP and it is suspected that IGFBP-3 deficiency in the premature infants may have a pathogenetic role in proliferative ROP.

  4. The effect of music reinforcement for non-nutritive sucking on nipple feeding of premature infants.

    Science.gov (United States)

    Standley, Jayne M; Cassidy, Jane; Grant, Roy; Cevasco, Andrea; Szuch, Catherine; Nguyen, Judy; Walworth, Darcy; Procelli, Danielle; Jarred, Jennifer; Adams, Kristen

    2010-01-01

    In this randomized, controlled multi-site study, the pacifier-activated-lullaby system (PAL) was used with 68 premature infants. Dependent variables were (a) total number of days prior to nipple feeding, (b) days of nipple feeding, (c) discharge weight, and (d) overall weight gain. Independent variables included contingent music reinforcement for non-nutritive sucking for PAL intervention at 32 vs. 34 vs. 36 weeks adjusted gestational age (AGA), with each age group subdivided into three trial conditions: control consisting of no PAL used vs. one 15-minute PAL trial vs. three 15-minute PAL trials. At 34 weeks, PAL trials significantly shortened gavage feeding length, and three trials were significantly better than one trial. At 32 weeks, PAL trials lengthened gavage feeding. Female infants learned to nipple feed significantly faster than male infants. It was noted that PAL babies went home sooner after beginning to nipple feed, a trend that was not statistically significant.

  5. Auditory stimuli mimicking ambient sounds drive temporal "delta-brushes" in premature infants.

    Directory of Open Access Journals (Sweden)

    Mathilde Chipaux

    Full Text Available In the premature infant, somatosensory and visual stimuli trigger an immature electroencephalographic (EEG pattern, "delta-brushes," in the corresponding sensory cortical areas. Whether auditory stimuli evoke delta-brushes in the premature auditory cortex has not been reported. Here, responses to auditory stimuli were studied in 46 premature infants without neurologic risk aged 31 to 38 postmenstrual weeks (PMW during routine EEG recording. Stimuli consisted of either low-volume technogenic "clicks" near the background noise level of the neonatal care unit, or a human voice at conversational sound level. Stimuli were administrated pseudo-randomly during quiet and active sleep. In another protocol, the cortical response to a composite stimulus ("click" and voice was manually triggered during EEG hypoactive periods of quiet sleep. Cortical responses were analyzed by event detection, power frequency analysis and stimulus locked averaging. Before 34 PMW, both voice and "click" stimuli evoked cortical responses with similar frequency-power topographic characteristics, namely a temporal negative slow-wave and rapid oscillations similar to spontaneous delta-brushes. Responses to composite stimuli also showed a maximal frequency-power increase in temporal areas before 35 PMW. From 34 PMW the topography of responses in quiet sleep was different for "click" and voice stimuli: responses to "clicks" became diffuse but responses to voice remained limited to temporal areas. After the age of 35 PMW auditory evoked delta-brushes progressively disappeared and were replaced by a low amplitude response in the same location. Our data show that auditory stimuli mimicking ambient sounds efficiently evoke delta-brushes in temporal areas in the premature infant before 35 PMW. Along with findings in other sensory modalities (visual and somatosensory, these findings suggest that sensory driven delta-brushes represent a ubiquitous feature of the human sensory cortex

  6. Management guidelines of premature infants%早产儿管理指南

    Institute of Scientific and Technical Information of China (English)

    中华医学会儿科学分会新生儿学组

    2005-01-01

    Prematurity is one of the leading causes of death and disability in neonates. To improve the management of premature infants, the Subspecialty Group of Neonatology, Pediatric Society, Chinese Medical Association established the guideline on the 7th National Neonatal Academic Conference in October 2004. The guideline makes references to management at birth, respiration management, prevention and treatment of cerebral injury of premature infants, prevention and treatment of infection, maintenance of stable blood glucose, nutritional management, management of feeding intolerance, fluid balance, management of patent ducts arteriosus (PDA), prevention and treatment of anemia, treatment of jaundice of prematurity, prevention and treatment of retinopathy of prematurity (ROP), hearing screening, nursing and follow-up following discharge.%早产是新生儿发病和围产儿死亡最常见的因素,为提高早产儿的管理水平,降低病死率和致残率,新生儿学组经过2年多的讨论,于2004年10月第七届全国新生儿学术会议(海口)通过本指南,供各单位参考.本指南就早产儿出生时处理,呼吸管理,脑损伤的防治,感染的防治,保持血糖稳定,营养支持,消化问题的处理,液体平衡,动脉导管开放,贫血的防治,黄疸的治疗,早产儿视网膜病的防治,听力筛查,护理,出院后的随访等15个问题制定了具体的管理方案.

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

    Directory of Open Access Journals (Sweden)

    Melissa Thoene

    2014-01-01

    Full Text Available The use of human milk fortifiers (HMF helps to meet the high nutritional requirements of the human milk-fed premature infant. Previously available powdered products have not met the protein requirements of the preterm infant population and many neonatologists add powder protein modulars to help meet protein needs. The use of powdered products is discouraged in neonatal intensive care units (NICU due to concern for invasive infection. The use of a commercially available acidified liquid product with higher protein content was implemented to address these two concerns. During the course of this implementation, poor growth and clinically significant acidosis of infants on Acidified Liquid HMF (ALHMF was observed. The purpose of this study was to quantify those observations by comparing infant outcomes between groups receiving the ALHMF vs. infants receiving powdered HMF (PHMF. A retrospective chart review compared outcomes of human milk-fed premature infants <2000 g receiving the ALHMF (n = 23 and the PHMF (n = 46. Infant growth, enteral feeding tolerance and provision, and incidence of necrotizing enterocolitis (NEC, metabolic acidosis, and diaper dermatitis were compared between the two groups. No infants were excluded from this study based on acuity. Use of ALHMF resulted in a higher incidence of metabolic acidosis (p = 0.002. Growth while on HMF as measured in both g/kg/day (10.59 vs. 15.37, p < 0.0001 and in g/day (23.66 vs. 31.27, p = 0.0001 was slower in the ALHMF group, on increased mean cal/kg/day (128.7 vs. 117.3, p = 0.13 with nearly twice as many infants on the ALHMF requiring increased fortification of enteral feedings beyond 24 cal/ounce to promote adequate growth (48% vs. 26%, p = 0.10. Although we were not powered to study NEC as a primary outcome, NEC was significantly increased in the ALHMF group. (13% vs. 0%, p = 0.03. Use of a LHMF in an unrestricted NICU population resulted in an increase in clinical complications within a high

  8. Frequency of Thyroid Function Disorders among a Population of Very-Low-Birth-Weight Premature Infants

    Directory of Open Access Journals (Sweden)

    Amir Mohammad Armanian

    2016-10-01

    Full Text Available Background: Thyroid function disorders, particularly congenital hypothyroidism (CHT, are important endocrine dysfunctions associated with permanent morbidities. CHT is more prevalent among preterm low-birth-weight neonates compared to term infants with normal weight. Methods: This prospective cohort study was conducted on 126 very-low-birth-weight (VLBW neonates referred to the neonatal intensive care units (NICUs of two tertiary referral hospitals affiliated to Isfahan University of Medical Sciences in Isfahan, Iran during 2012-2014. On day five of birth and two, four, and six weeks after birth, blood samples were collected from the infants to determine thyroid function disorders, including transient hypothyroxinemia, neonatal hypothyroidism, transient primary neonatal hypothyroidism, and transient hyperthyrotropinemia. Results: In total, 126 infants with mean gestational age of 30.5±2.29 weeks and mean birth weight of 1246.90±193.58 g were enrolled in this study. Thyroid-stimulating hormone (TSH level of Conclusion: According to the results of this study, thyroid function disorders are relatively common in preterm VLBW neonates, and serum T4 level is correlated with gestational age in these infants. Therefore, thyroid function tests with a consistent protocol are required for premature infants. It is recommended that further research be performed on larger sample sizes to investigate the prevalence of thyroid function disorders in preterm infants.

  9. Effects of white matter injury on resting state fMRI measures in prematurely born infants.

    Directory of Open Access Journals (Sweden)

    Christopher D Smyser

    Full Text Available The cerebral white matter is vulnerable to injury in very preterm infants (born prior to 30 weeks gestation, resulting in a spectrum of lesions. These range from severe forms, including cystic periventricular leukomalacia and periventricular hemorrhagic infarction, to minor focal punctate lesions. Moderate to severe white matter injury in preterm infants has been shown to predict later neurodevelopmental disability, although outcomes can vary widely in infants with qualitatively comparable lesions. Resting state functional connectivity magnetic resonance imaging has been increasingly utilized in neurodevelopmental investigations and may provide complementary information regarding the impact of white matter injury on the developing brain. We performed resting state functional connectivity magnetic resonance imaging at term equivalent postmenstrual age in fourteen preterm infants with moderate to severe white matter injury secondary to periventricular hemorrhagic infarction. In these subjects, resting state networks were identifiable throughout the brain. Patterns of aberrant functional connectivity were observed and depended upon injury severity. Comparisons were performed against data obtained from prematurely-born infants with mild white matter injury and healthy, term-born infants and demonstrated group differences. These results reveal structural-functional correlates of preterm white matter injury and carry implications for future investigations of neurodevelopmental disability.

  10. Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants.

    Science.gov (United States)

    Timkovic, Juraj; Pokryvkova, Martina; Janurova, Katerina; Barinova, Denisa; Polackova, Renata; Masek, Petr

    2017-03-01

    Retinopathy of Prematurity (ROP) is a potentially serious condition that can afflict preterm infants. Timely and correct identification of individuals at risk of developing a serious form of ROP is therefore of paramount importance. WinROP is an online system for predicting ROP based on birth weight and weight increments. However, the results vary significantly for various populations. It has not been evaluated in the Czech population. This study evaluates the test characteristics (specificity, sensitivity, positive and negative predictive values) of the WinROP system in Czech preterm infants. Data on 445 prematurely born infants included in the ROP screening program at the University Hospital Ostrava, Czech Republic, were retrospectively entered into the WinROP system and the outcomes of the WinROP and regular screening were compared. All 24 infants who developed high-risk (Type 1 or Type 2) ROP were correctly identified by the system. The sensitivity and negative predictive values for this group were 100%. However, the specificity and positive predictive values were substantially lower, resulting in a large number of false positives. Extending the analysis to low risk ROP, the system did not provide such reliable results. The system is a valuable tool for identifying infants who are not likely to develop high-risk ROP and this could help to substantially reduce the number of preterm infants in need of regular ROP screening. It is not suitable for predicting the development of less serious forms of ROP which is however in accordance with the declared aims of the WinROP system.

  11. Presentation of Aural Stimuli to Newborns and Premature Infants: An Audiological Perspective.

    Science.gov (United States)

    Cassidy

    1999-01-01

    The purpose of this study was twofold: (a) to examine extant research in the field of music with premature and full term infants in order to identify protocols being used in the presentation of musical stimuli to neonates and (b) to use knowledge gleaned from audiology as a basis for suggesting a standardized protocol for use of musical stimuli with infants. Articles considered appropriate for inclusion in the analysis met the following criteria: (a) presented data for the effects of music on a dependent measure, (b) had subjects who were identified as either premature or term newborns receiving treatment after birth and prior to discharge from the hospital, and (c) used music for some or all of the aural stimuli. Articles (N = 20) were categorized by demographic information, types of aural stimuli, independent variables, dependent measures, and protocol used to present the musical stimuli. Of primary importance to this study was the protocol used in each study to present musical stimuli. Data regarding total duration of stimuli per day, longest duration of stimuli per day, method of stimuli presentation, placement of speakers, decibel level of stimuli, and where;he decibel level was measured reveal that there is no standard protocol being followed with regard to the presentation of aural stimuli. Recommendations include future research on (a) determining a minimum gestational age where music therapy may be appropriate, (b) determining the frequency spectrum perceived by a premature infant, (c) determining the decibel levels reaching the ear drum and assessing appropriate levels for minimum stimulation with maximum results, and (d) carefully considering the method of stimulus presentation as it will have an impact on the decibel level reaching the ear drum of these infants.

  12. The Mother-Infant Feeding Relationship across the First Year and the Development of Feeding Difficulties in Low-Risk Premature Infants

    Science.gov (United States)

    Silberstein, Dalia; Feldman, Ruth; Gardner, Judith M.; Karmel, Bernard Z.; Kuint, Jacob; Geva, Ronny

    2009-01-01

    Although feeding problems are common during infancy and are typically accompanied by relational difficulties, little research observed the mother-infant feeding relationship across the first year as an antecedent to the development of feeding difficulties. We followed 76 low-risk premature infants and their mothers from the transition to oral…

  13. Assessing the potential impact of extending antenatal steroids to the late preterm period.

    Science.gov (United States)

    Souter, Vivienne; Kauffman, Ellen; Marshall, Alice J; Katon, Jodie G

    2017-10-01

    In 2016, guidance statements were issued by the Society for Maternal-Fetal Medicine and the American Congress of Obstetricians and Gynecologists about extending antenatal steroid use to selected late preterm singleton pregnancies. We sought to review antenatal steroid use prior to the 2016 guidance statements and assess the potential impact of these. This cohort study used chart-abstracted data from singleton deliveries from Jan. 1, 2012, through March 31, 2016, at 12 centers participating in the Obstetrics Clinical Outcomes Assessment Program, a quality initiative in Washington State. Pregnancies with missing gestation at delivery, fetal anomalies, or antepartum demise were excluded. Antenatal steroid use prior to the 2016 guidance was evaluated based on the percentage of early preterm deliveries (23(+0)-33(+6) weeks) and the percentage of all pregnancies that received antenatal steroids. Newborn complication rates were calculated for late preterm deliveries (34+0(+0)-36(+6) weeks), grouped by whether they would be potentially eligible or ineligible for antenatal steroids based on the 2016 guidance statements. The opportunity for antenatal steroids was missed in 21.8% (226/1034) of early preterm deliveries and of all those who received antenatal steroids, 32.2% (614/1908) delivered at term. Of preterm deliveries, 74% (n = 2942) were in the late preterm period. In all, 80% (n = 2363) of late preterm deliveries were potentially eligible for antenatal steroids and 60% of these (n = 1411) delivered at 36 weeks. The rate of respiratory complications in newborns delivering at 34 and 35 weeks was higher in the group potentially eligible for late preterm antenatal steroids compared to those in the ineligible group. Of those delivering at 36 weeks, no differences were detected in prevalence of respiratory complications by potential eligibility for antenatal steroids; however, compared with the ineligible group, those potentially eligible had a lower risk of neonatal

  14. Nutrition of premature infants after hospital discharge. Effect on growth and the risk of allergic disease within the first year of life

    DEFF Research Database (Denmark)

    Zachariassen, Gitte; Færk, Jan; Halken, Susanne

    to continue with fortification or premature formula after hospital discharge. The aim of the study is to describe breast-feeding rate at discharge among very preterm infants, whether it is possible to supply breastfeeding with fortification after discharge, eating habits after discharge, growth...... Background and Aims: Human milk offers many advantages for the premature infant, but the content of macro-nutrients might be inadequate. Fortification of mothers own milk or premature formula have shown to improve growth among premature infants while they are hospitalized. It might be beneficial......-velocity and registration of allergic symptoms within the first year of life among premature infants. Methods: The study is a randomized controlled study where premature infants born with a gestational age (GA) ≤ 32+0 weeks are fed premature formula or (if the mother is breastfeeding) randomized to either breastfeeding...

  15. [Pharmacokinetic and clinical studies of latamoxef (moxalactam) in neonates and premature infants].

    Science.gov (United States)

    Fujii, R; Hashira, S; Takimoto, M; Oka, T; Yoshioka, H; Tsuchida, A; Sanae, N; Maruyama, S; Tojo, M; Sunakawa, K

    1984-06-01

    Studies were carried out on the in vivo kinetics and clinical efficacy of latamoxef (LMOX) in neonates and premature infants. The results are summarized below. Serum concentration and T1/2 following intravenous injection of LMOX to neonates LMOX was intravenously administered to neonates as one shot doses of 10 mg/kg and 20 mg/kg. The serum concentration of LMOX showed a dose-response to the 10 and 20 mg/kg doses in each of the 0--3 day-old group, 4--7 day-old group and 8--28 day-old group. The T 1/2 values were as follows; for the 10 mg/kg dose, 5.17 hours in the 0--3 day-old group, 3.28 hours in the 4--7 day-old group and 2.79 hours in the 8--28 day-old group; for the 20 mg/kg dose, 5.58 hours in the 0--3 day-old group, 3.46 hours in the 4--7 day-old group and 3.14 hours in the 8--28 day-old group. Thus, it is seen that the half-life of both dosages decreased as the infants became older. Serum concentration and T 1/2 following intravenous injection of LMOX to premature infants Similar to the case of neonates described above, the concentration of LMOX in the serum of the premature infants showed a dose-response to the 10 mg/kg and 20 mg/kg dosages. The T 1/2 values for the 0--3, 4--7 day-old and 8--28 day-old groups were 7.54, 3.93 hours and 6.25 hours, respectively, for the 10 mg/kg dose, and 10.8, 4.05 hours and 3.23 hours, respectively, for the 20 mg/kg dose. Again, it is seen that the half-life of both dosages decreased as the age of the prematurely-born infants increased. Serum concentration and T1/2 following 1-hour intravenous drip infusion of LMOX to neonates LMOX was administered to neonates in doses of 10 mg/kg and 20 mg/kg, by i.v. drip infusion over a 1-hour period. With both dosages, the peak serum concentration of LMOX occurred at the time of completion of the infusion. The T1/2 values for the 0--3, 4--7 day-old and 8--28 day-old groups were 5.41, 3.68 hours and 1.92 hours, respectively, for the 10 mg/kg dose, and 5.31, 2.67 hours and 4.86 hours

  16. Determinants of Indices of Cerebral Volume in Former Very Premature Infants at Term Equivalent Age

    Science.gov (United States)

    Wirth, Maelle

    2017-01-01

    Conventional magnetic resonance imaging (MRI) at term equivalent age (TEA) is suggested to be a reliable tool to predict the outcome of very premature infants. The objective of this study was to determine simple reproducible MRI indices, in premature infants and to analyze their neonatal determinants at TEA. A cohort of infants born before 32 weeks gestational age (GA) underwent a MRI at TEA in our center. Two axial images (T2 weighted), were chosen to realize nine measures. We defined 4 linear indices (MAfhlv: thickness of lateral ventricle; CSI: cortex-skull index; VCI: ventricular-cortex index; BOI: bi occipital index) and 1 surface index (VS.A: volume slice area). Perinatal data were recorded. Sixty-nine infants had a GA (median (interquartile range)) of 30.0 weeks GA (27.0; 30.0) and a birth weight of 1240 grams (986; 1477). MRI was done at 41.0 (40.0; 42.0) weeks post menstrual age (PMA). The inter-investigator reproducibility was good. Twenty one MRI (30.5%) were quoted abnormal. We observed an association with retinopathy of prematurity (OR [95CI] = 4.205 [1.231–14.368]; p = 0.017), surgery for patent ductus arteriosus (OR = 4.688 [1.01–21.89]; p = 0.036), early onset infection (OR = 4.688 [1.004–21.889]; p = 0.036) and neonatal treatment by cefotaxime (OR = 3.222 [1.093–9.497]; p = 0.03). There was a difference for VCI between normal and abnormal MRI (0.412 (0.388; 0.429) vs. 0.432 (0.418; 0.449); p = 0,019); BOI was higher when fossa posterior lesions were observed; VS.A seems to be the best surrogate for cerebral volume, 80% of VS.As’ variance being explained by a multiple linear regression model including 7 variables (head circumference at birth and at TEA, PMA, dopamine, ibuprofen treatment, blood and platelets transfusions). These indices, easily and rapidly achievable, seem to be useful but need to be validated in a large population to allow generalization for diagnosis and follow-up of former premature infants. PMID:28125676

  17. Atypical perceptual narrowing in prematurely born infants is associated with compromised language acquisition at 2 years of age.

    Science.gov (United States)

    Jansson-Verkasalo, Eira; Ruusuvirta, Timo; Huotilainen, Minna; Alku, Paavo; Kushnerenko, Elena; Suominen, Kalervo; Rytky, Seppo; Luotonen, Mirja; Kaukola, Tuula; Tolonen, Uolevi; Hallman, Mikko

    2010-07-30

    Early auditory experiences are a prerequisite for speech and language acquisition. In healthy children, phoneme discrimination abilities improve for native and degrade for unfamiliar, socially irrelevant phoneme contrasts between 6 and 12 months of age as the brain tunes itself to, and specializes in the native spoken language. This process is known as perceptual narrowing, and has been found to predict normal native language acquisition. Prematurely born infants are known to be at an elevated risk for later language problems, but it remains unclear whether these problems relate to early perceptual narrowing. To address this question, we investigated early neurophysiological phoneme discrimination abilities and later language skills in prematurely born infants and in healthy, full-term infants. Our follow-up study shows for the first time that perceptual narrowing for non-native phoneme contrasts found in the healthy controls at 12 months was not observed in very prematurely born infants. An electric mismatch response of the brain indicated that whereas full-term infants gradually lost their ability to discriminate non-native phonemes from 6 to 12 months of age, prematurely born infants kept on this ability. Language performance tested at the age of 2 years showed a significant delay in the prematurely born group. Moreover, those infants who did not become specialized in native phonemes at the age of one year, performed worse in the communicative language test (MacArthur Communicative Development Inventories) at the age of two years. Thus, decline in sensitivity to non-native phonemes served as a predictor for further language development. Our data suggest that detrimental effects of prematurity on language skills are based on the low degree of specialization to native language early in development. Moreover, delayed or atypical perceptual narrowing was associated with slower language acquisition. The results hence suggest that language problems related to

  18. Atypical perceptual narrowing in prematurely born infants is associated with compromised language acquisition at 2 years of age

    Directory of Open Access Journals (Sweden)

    Suominen Kalervo

    2010-07-01

    Full Text Available Abstract Background Early auditory experiences are a prerequisite for speech and language acquisition. In healthy children, phoneme discrimination abilities improve for native and degrade for unfamiliar, socially irrelevant phoneme contrasts between 6 and 12 months of age as the brain tunes itself to, and specializes in the native spoken language. This process is known as perceptual narrowing, and has been found to predict normal native language acquisition. Prematurely born infants are known to be at an elevated risk for later language problems, but it remains unclear whether these problems relate to early perceptual narrowing. To address this question, we investigated early neurophysiological phoneme discrimination abilities and later language skills in prematurely born infants and in healthy, full-term infants. Results Our follow-up study shows for the first time that perceptual narrowing for non-native phoneme contrasts found in the healthy controls at 12 months was not observed in very prematurely born infants. An electric mismatch response of the brain indicated that whereas full-term infants gradually lost their ability to discriminate non-native phonemes from 6 to 12 months of age, prematurely born infants kept on this ability. Language performance tested at the age of 2 years showed a significant delay in the prematurely born group. Moreover, those infants who did not become specialized in native phonemes at the age of one year, performed worse in the communicative language test (MacArthur Communicative Development Inventories at the age of two years. Thus, decline in sensitivity to non-native phonemes served as a predictor for further language development. Conclusion Our data suggest that detrimental effects of prematurity on language skills are based on the low degree of specialization to native language early in development. Moreover, delayed or atypical perceptual narrowing was associated with slower language acquisition. The

  19. Macular edema in Asian Indian premature infants with retinopathy of prematurity: Impact on visual acuity and refractive status after 1-year

    Directory of Open Access Journals (Sweden)

    Anand Vinekar

    2015-01-01

    Full Text Available Purpose: To report the impact of transient, self-resolving, untreated "macular edema" detected on spectral domain optical coherence tomography in Asian Indian premature infants with retinopathy of prematurity (ROP on visual acuity (VA and refraction at 1-year of corrected age. Materials and Methods: Visual acuity and refraction of 11 infants with bilateral macular edema (Group A was compared with gestational age-matched 16 infants with ROP without edema (Group B and 17 preterms infants without ROP and without edema (Group C at 3, 6, 9 and 12 months of corrected age using Teller Acuity Cards and cycloplegic retinoscopy. Sub-group analysis of the previously described pattern A and B macular edema was performed. Results: Visual acuity was lower in infants with macular edema compared with the other two control groups throughout the study period, but statistically significant only at 3 months. Visual improvement in these infants was highest between the 3 rd and 6 th month and plateaued by the end of the 1 st year with acuity comparable to the other two groups. The edema cohort was more hyperopic compared to the other two groups between 3 and 12 months of age. Pattern A edema had worse VA compared to pattern B, although not statistically significant. Conclusion: Macular edema, although transient, caused reduced VA as early as 3 months of corrected age in Asian Indian premature infants weighing <2000 g at birth. The higher hyperopia in these infants is possibly due to visual disturbances caused at a critical time of fovealization. We hypothesize a recovery and feedback mechanism based on the principles of active emmetropization to explain our findings.

  20. Pain-associated stressor exposure and neuroendocrine values for premature infants in neonatal intensive care.

    Science.gov (United States)

    Rohan, Annie J

    2016-01-01

    Recurrent stress during neonatal intensive care taxes the adaptive capacity of the premature infant and may be a risk factor for suboptimal developmental outcomes. This research used a descriptive, cross-sectional design and a life course perspective to examine the relationship between resting adrenocorticoid values at 37 postmenstrual weeks of age and cumulative pain-associated stressor exposure in prematurely born infants. Subjects were 59 infants born at under 35 completed weeks of gestation, who were at least 2 weeks of age, and who had been cared for in the NICU since birth. No significant relationships were identified between cortisol values and any of the study variables (number of skin breaking procedures, hours of assisted ventilation, gestational age at birth, exposure to antenatal steroids, history of severe academia, birthweight, days of age to attain birthweight, weight at testing, days of age at testing, recent pain-associated procedures, and 17-OHP value). A significant negative correlation (Spearman rank, one-tailed) between the number of skin-breaking procedures and 17-OHP values was identified (r = -.232, p = .039). Recurrent pain-associated stressor exposure may be a more important factor in explaining the variance of 17-OHP values at 37 postmenstrual weeks of age than birthweight, gestational age, or chronological age.

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

    Science.gov (United States)

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

    1984-01-01

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

  2. Degree of dependence on the ventilator according to sleep states in artificially ventilated premature infants.

    Science.gov (United States)

    Curzi-Dascalova, L; Relier, J P; Peirano, P; Castex, M; Vasseur, O

    1986-07-01

    Polygraphic recordings were performed in 14 sleeping premature infants receiving ventilation for respiratory distress syndrome. All were clinically stabilized, with normal EEG and neurologic status and differentiated sleep states (coded according to EEG and REM criteria). They all had two respiratory patterns: passive, completely dependent on the ventilator, and active, with autonomous respiratory movements and/or inspiratory diaphragmatic activity added to passive respiration. We found that in infants ventilated at the rate of 18-54/min, respiration was more active and autonomous in active REM sleep and more passive and dependent on the machine in quiet NREM sleep (P less than 0.005). Within the limits of the values observed in our study, differences between sleep states were not due to other factors that could possibly interfere with and modify the degree of respiratory autonomy. We found no significant correlation between the percentage of time passed with active respiration on one hand and age (gestational, postnatal, conceptional) or diagnostic or physical parameters of artificial ventilation and blood gas levels on the other hand. Our results suggest that in artificially ventilated but neurologically normal premature infants, differences between respiratory control in both sleep states exist as early as 28 weeks conceptional age (lower limit of our study).

  3. Quantification of EUGR as a Measure of the Quality of Nutritional Care of Premature Infants.

    Directory of Open Access Journals (Sweden)

    Zhenlang Lin

    Full Text Available To develop an index of the quality of nutritional care of premature infants based on the change in weight Z score from birth to discharge and to illustrate the use of this index in comparing the performance of different NICUs.Retrospective data analysis was performed to compare the growth of premature infants born in three perinatal centers. Infants with gestational age ≤ 32 weeks who survived to discharge from 2006 to 2010 were included. Weight Z scores at birth and discharge were calculated by the method of Fenton. Using data from one NICU as the reference, a multivariable linear regression model of change in weight Z score from birth to discharge was developed. Employing this model, a benchmark value of change in weight Z score was calculated for each baby. The difference between this calculated benchmark value and the baby's observed change in weight Z score was defined as the performance gap for that infant. The average value of the performance gaps in a NICU serves as its quality care index.1,714 infants were included for analysis. Change in weight Z score is influenced by birth weight Z score and completed weeks of gestation; thus the model for calculating the benchmark change in weight Z score was adjusted for these two variables. We found statistically significant differences in the average performance gaps for the three units.A quality care index was developed based on change in weight Z score from birth to discharge adjusted for two initial risk factors. This objective, easily calculated index may be used as a measurement of the quality of nutritional care to rank the performance of different NICUs.

  4. ANAESTHETIC MANAGEMENT OF A 5 MONTH OLD PREMATURE INFANT WITH RESPIRATORY STRIDOR FOR PDA CLOSURE

    Directory of Open Access Journals (Sweden)

    Sushanta Kumar

    2015-08-01

    Full Text Available Management of a premature infant with PDA poses a significant challenge in the perioperative period for the anaesthesiologist. The risk is multiplied when it is associated with other congenital respiratory anomalies. In our case a premature child at 5 month of age presented with PDA and tracheomalacia. There was a risk of airway collapse during sedation or induction of anaesthesia along with a n anticipated difficu lt intubation. We have managed the case by inducing and intubating the patient in the lateral position without using muscle relaxants. We have used Sevoflurane as the sole anaesthetic agent for inducing and intubating the patient. Postoperatively patient w as extubated in lateral position and succesfully discharged from ICU.

  5. Early or Late Surgical Ligation of Medical Refractory Patent Ductus Arteriosus in Premature Infants

    Directory of Open Access Journals (Sweden)

    Chien-Chou Hsiao

    2009-01-01

    Full Text Available Optimal time to surgical ligation of patent ductus arteriosus (PDA in very-low-birth-weight ( 14 days groups. Basic clinical features, major morbidity of prematurity and mortality were compared. Clinical features and major outcomes were similar. The early ligation group had earlier onset of symptomatic PDA (5.7 ± 1.6 days vs. 8.1 ± 3.6 days, p = 0.024, and fewer days of total parenteral nutrition (TPN (39.6 ± 13.9 days vs. 60.4 ± 31.4 days, p = 0.025 and ventilator use (11.1 ± 6.7 days vs. 18.6 ± 10.5 days, p = 0.019. Early ligation of medical refractory PDA in very-low-birth-weight premature infants improves enteral feeding tolerance and reduces TPN and ventilator use, but long-term benefits need further investigation.

  6. Parental Leave Policy as a Strategy to Improve Outcomes among Premature Infants.

    Science.gov (United States)

    Greenfield, Jennifer C; Klawetter, Susanne

    2016-02-01

    Although gains have been made in premature birth rates among racial and ethnic minority and low socioeconomic status populations, tremendous disparities still exist in both prematurity rates and health outcomes for preterm infants. Parental involvement is known to improve health outcomes for preterm babies. However, a gap in evidence exists around whether parental involvement can help ameliorate the disparities in both short- and long-term out-comes for their preterm children. Families more likely to experience preterm birth are also less likely to have access to paid leave and thus experience significant systemic barriers to involvement, especially when their newborns are hospitalized. This article describes the research gap in this area and explores pathways by which social workers may ameliorate disparities in preterm birth outcomes through practice, policy, and research.

  7. Fathering premature infants and the technological imperative of the neonatal intensive care unit: an interpretive inquiry.

    Science.gov (United States)

    Pohlman, Shawn

    2009-01-01

    The experiences of 9 fathers of premature infants in the technological environment of the neonatal intensive care unit were examined using interpretive methods. Fathers were interviewed 6 to 8 times each. Findings revealed emotional costs for fathers as technology often took precedence. Fathers' feelings of frustration, fear, and alienation were hidden from nurses, as fathers were silent and silenced. Fathers perceived a power dynamic between themselves and nurses, which may be due, in part, to a complex interplay between the technological imperative and gender dynamics. Two exemplars illustrated how fathers forged emotional connections with their babies despite the technological imperative.

  8. Different ventilation modes combined with ambroxol in the treatment of respiratory distress syndrome in premature infants

    Science.gov (United States)

    Zhou, Bin; Zhai, Jing-Fang; Wu, Jie-Bin; Jin, Bao; Zhang, Yan-Yan

    2017-01-01

    The aim of the present study was to compare the effectiveness of different modes of mechanical ventilation in combination with secretolytic therapy with ambroxol in premature infants with respiratory distress syndrome. Seventy-three premature infants with hyaline membrane disease (HMD) (stage III–IV), also known as respiratory distress syndrome, who were supported by mechanical ventilation in the neonatal intensive care unit (NICU) of Xuzhou Central Hospital, were involved in the present study, between January 2013 and February 2015. Forty cases were randomly selected and treated with high frequency oscillatory ventilation (HFOV), forming the HFOV group, whereas 33 cases were selected and treated with conventional mechanical ventilation (CMV), forming the CMV group. Patients in the two groups were administered ambroxol intravenously at a dosage rate of 30 mg/kg body weight at the beginning of the study. The present study involved monitoring the blood gas index as well as changes in the respiratory function index in the two groups. Additionally, the incidence of complications in the premature infants in the two groups was observed prior to and following the ventilation. Pulmonary arterial oxygen tension (PaO2), the PaO2/fraction of inspired oxygen (FiO2) ratio, the oxygenation index [OI = 100 × mean airway pressure (MAP) × FiO2/PaO2], as well as the arterial/alveolar oxygen partial pressure ratio (a/APO2) = PaO2/(713 × FiO2 partial pressure of carbon dioxide (PaCO2)/0.8) of the patients in the HFOV group after 1, 12 and 24 h of treatment were significantly improved as compared to the patients of the CMV group. However, there was no significant difference between patients in the two groups with regard to the number of mortalities, complications such as pneumothorax, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and the time of ventilation. In conclusion, combining HFOV

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

    Science.gov (United States)

    Belgaumkar, T K; Scott, K

    1975-01-01

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

  10. Validade concorrente e confiabilidade da Alberta Infant Motor Scale em lactentes nascidos prematuros Concurrent validity and reliability of the Alberta Infant Motor Scale in premature infants

    Directory of Open Access Journals (Sweden)

    Kênnea Martins Almeida

    2008-10-01

    Full Text Available OBJETIVO: Verificar a validade concorrente e a confiabilidade interobservador da Alberta Infant Motor Scale (AIMS em lactentes prematuros acompanhados no ambulatório de seguimento do Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz. MÉTODOS: Foram avaliados 88 lactentes nascidos prematuros no ambulatório de seguimento do IFF/Fiocruz entre fevereiro e dezembro de 2006. No estudo de validade concorrente, 46 lactentes com 6 (n = 26 ou 12 (n = 20 meses de idade corrigida foram avaliados pela AIMS e pela escala motora da Bayley Scales of Infant Development, 2ª edição, por dois observadores diferentes, utilizando-se o coeficiente de correlação de Pearson para análise dos resultados. No estudo de confiabilidade, 42 lactentes entre 0 e 18 meses foram avaliados pela AIMS por dois observadores diferentes, utilizando-se o intraclass correlation coefficient (ICC para análise dos resultados. RESULTADOS: No estudo de validade concorrente, a correlação encontrada entre as duas escalas foi alta (r = 0,95 e estatisticamente significativa (p OBJECTIVE: To verify the concurrent validity and interobserver reliability of the Alberta Infant Motor Scale (AIMS in premature infants followed-up at the outpatient clinic of Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz, in Rio de Janeiro, Brazil. METHODS: A total of 88 premature infants were enrolled at the follow-up clinic at IFF/Fiocruz, between February and December of 2006. For the concurrent validity study, 46 infants were assessed at either 6 (n = 26 or 12 (n = 20 months' corrected age using the AIMS and the second edition of the Bayley Scales of Infant Development, by two different observers, and applying Pearson's correlation coefficient to analyze the results. For the reliability study, 42 infants between 0 and 18 months were assessed using the Alberta Infant Motor Scale, by two different observers and the results analyzed using the intraclass correlation

  11. Breastfeeding for premature infants%呵护早产儿从母乳喂养开始

    Institute of Scientific and Technical Information of China (English)

    王丹华

    2012-01-01

    母乳喂养是降低新生儿死亡率的重要干预手段之一,对早产儿尤其如此.早产母乳中的成分与足月母乳不同,其营养价值和生物学功能更适合早产儿的需求.在NICU积极推进母乳喂养能降低早产相关疾病的发生率,改善神经行为发育,降低成年慢性非传染性疾病的发病风险.对低出生体质量早产儿,强化母乳喂养是最佳的喂养方式,能优化蛋白质摄入,促进早产儿体格增长和骨骼矿化.应当以积极的支持策略来保证早产儿母乳喂养的顺利实施.%Breastfeeding is one of the important methods of intervention to reduce the neonatal mortality, especially for premature infants. The composition in breast milk of mothers with premature infants is different from that of mothers with term infants. Their nutritional content and biological function are more suitable for the needs of premature infants. Promoting breastfeeding in the NICU can reduce the incidence of some diseases in premature infants, improve neurobehavioral development and reduce the risk of the chronic disease in adulthood. Fortified breastfeeding which optimize protein intake, promote physical growth and bone mineralization is the best way of feeding for premature infants with low birth weight. The active support strategies should be made to ensure breastfeeding success for premature infants.

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

    Science.gov (United States)

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

    2015-01-01

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

  13. The participation of Occupational Therapy in a team from the monitoring Program of Premature Infants Discharged from NICUs

    Directory of Open Access Journals (Sweden)

    Dani Laura Peruzzolo

    2014-04-01

    Full Text Available The Occupational Therapy course of the Federal University of Santa Maria (UFSM was created in 2009. Since then, its faculty has sought the inclusion in the three lines (primary, secondary and tertiary of health care services. Within the university premises, there is a University Hospital (HUSM that offers services in several complexities. The Pediatric Clinic, which holds the Monitoring Program of Premature Infants discharged from Neonatal Intensive Care Units (NICU, is among them. This service was created at government level and implemented in hospitals that are considered regional references to monitor premature infants discharged from NICUs. The significant increase in the number of infants who survive prematurity initiated the need for continuous monitoring, because infants are still considered at risk even after hospital discharge. This paper aims to present a descriptive report of the experience participation of the occupational therapist together with the team and the population that is attended in the Monitoring Program of Premature Infants discharged from the NICU of the HUSM. The report is contextualized by the proposal description of the Monitoring Program implanted at the HUSM, presenting the protocols defined by the assessment team, as follows: Bayley Scale of Infant Development, Denver Developmental Screening Test II, and Clinical Indicators of Risk for Child Development. After that, it presents the process of inclusion of the occupational therapist in the Monitoring. Finally, some considerations are highlighted in relation to the contribution of the occupational therapist to the team and the population attended.

  14. Assessment of pulmonary function in a follow-up of premature infants: our experience

    Directory of Open Access Journals (Sweden)

    F. Ciuffini

    2014-06-01

    Full Text Available Respiratory diseases are a major cause of morbidity in neonates, especially preterm infants; a long term complication of prematurity such as bronchopulmonary dysplasia (BPD is particularly relevant today. The exact role of the Pulmonary Function Test (PFT in this area is not yet well defined; the PFT in newborns and infants - in contrast to what happens in uncooperative children and adults - are routinely used only in a few centers. The assessment of pulmonary function in newborns and infants, however, is nowadays possible with the same reliability that in cooperative patients with the possibility to extend the assessment of polmonary function from bench to bed. The assessment of pulmonary function must be carried out with non invasive and safe methods, at the bedside, with the possibility of continuous monitoring and providing adequate calculation and management of data. The ability to assess lung function helps to define the mechanisms of respiratory failure, improving the treatment and its effects and is therefore a useful tool in the follow-up of newborn and infant with pulmonary disease.

  15. Assessment of pulmonary function in a follow-up of premature infants: our experience

    Directory of Open Access Journals (Sweden)

    F. Ciuffini

    2013-10-01

    Full Text Available Respiratory diseases are a major cause of morbidity in neonates, especially preterm infants; a long term complication of prematurity such as bronchopulmonary dysplasia (BPD is particularly relevant today. The exact role of the Pulmonary Function Test (PFT in this area is not yet well defined; the PFT in newborns and infants - in contrast to what happens in uncooperative children and adults - are routinely used only in a few centers. The assessment of pulmonary function in newborns and infants, however, is nowadays possible with the same reliability that in cooperative patients with the possibility to extend the assessment of polmonary function from bench to bed. The assessment of pulmonary function must be carried out with non invasive and safe methods, at the bedside, with the possibility of continuous monitoring and providing adequate calculation and management of data. The ability to assess lung function helps to define the mechanisms of respiratory failure, improving the treatment and its effects and is therefore a useful tool in the follow-up of newborn and infant with pulmonary disease.

  16. End tidal carbon dioxide levels during the resuscitation of prematurely born infants.

    Science.gov (United States)

    Murthy, Vadivelam; O'Rourke-Potocki, Anthony; Dattani, Nikesh; Fox, Grenville F; Campbell, Morag E; Milner, Anthony D; Greenough, Anne

    2012-10-01

    Successful resuscitation of prematurely born infants is dependent on achieving adequate alveolar ventilation and vasodilation of the pulmonary vascular bed. Elevation of end-tidal carbon dioxide (ETCO(2)) levels may indicate pulmonary vasodilation. This research aims to study the temporal changes in ETCO(2) levels and the infant's respiratory efforts during face mask resuscitation in the labour suite, and to determine if the infant's first inspiratory effort was associated with a rise in the ETCO(2) levels, suggesting pulmonary vasodilation had occurred. This study is an observational one. The subjects of the study are forty infants with a median gestational age of 30 weeks (range 23-34). Inflation pressures, expiratory tidal volumes and ETCO(2) levels were measured. The median expiratory tidal volume of inflations prior to the onset of the infant's respiratory efforts (passive inflations) was lower than that of the inflation associated with the first inspiratory effort (active inflation) (1.8 (range 0.1-7.3) versus 6.3 ml/kg (range 1.9-18.4), plevels (0.3 (range 0.1-2.1) versus 3.4 kPa (0.4-11.5), plevel (2.2 kPa (range 0.3-9.3)) of the two passive inflations following the first active inflation were also higher than the median expiratory tidal volume and ETCO(2) levels of the previous passive inflations (pcarbon dioxide elimination, likely due to pulmonary vasodilation, occurred with the onset of the infant's respiratory efforts. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Do Hospitalized Premature Infants Benefit from Music Interventions? A Systematic Review of Randomized Controlled Trials

    Science.gov (United States)

    Oliai Araghi, Sadaf; Jeekel, Johannes; Reiss, Irwin K. M; Hunink, M. G. Myriam; van Dijk, Monique

    2016-01-01

    Objective Neonatal intensive care units (NICU) around the world increasingly use music interventions. The most recent systematic review of randomized controlled trials (RCT) dates from 2009. Since then, 15 new RCTs have been published. We provide an updated systematic review on the possible benefits of music interventions on premature infants’ well-being. Methods We searched 13 electronic databases and 12 journals from their first available date until August 2016. Included were all RCTs published in English with at least 10 participants per group, including infants born prematurely and admitted to the NICU. Interventions were either recorded music interventions or live music therapy interventions. All control conditions were accepted as long as the effects of the music intervention could be analysed separately. A meta-analysis was not possible due to incompleteness and heterogeneity of the data. Results After removal of duplicates the searches retrieved 4893 citations, 20 of which fulfilled the inclusion/exclusion criteria. The 20 included studies encompassed 1128 participants receiving recorded or live music interventions in the NICU between 24 and 40 weeks gestational age. Twenty-six different outcomes were reported which we classified into three categories: physiological parameters; growth and feeding; behavioural state, relaxation outcomes and pain. Live music interventions were shown to improve sleep in three out of the four studies and heart rate in two out of the four studies. Recorded music improved heart rate in two out of six studies. Better feeding and sucking outcomes were reported in one study using live music and in two studies using recorded music. Conclusions Although music interventions show promising results in some studies, the variation in quality of the studies, age groups, outcome measures and timing of the interventions across the studies makes it difficult to draw strong conclusions on the effects of music in premature infants. PMID

  18. Assessing the need for transfusion of premature infants and role of hematocrit, clinical signs, and erythropoietin level.

    Science.gov (United States)

    Keyes, W G; Donohue, P K; Spivak, J L; Jones, M D; Oski, F A

    1989-09-01

    There are no clear criteria for administration of blood to premature infants. In the past, indications for transfusion have included tachypnea, tachycardia, poor weight gain, apnea, bradycardia, pallor, lethargy, decreased activity, or poor feeding. Some have suggested that erythropoietin levels may also be useful in determining the need for transfusion. Data were studied from 11 premature infants with birth weights less than 1500 g collected throughout 469 hospital days. During that period the infants received a total of 37 blood transfusions. No overall relationship was found between hematocrit of 19% to 64% and heart rate, respiratory rate, or the occurrence of bradycardia; ie, these variables proved to be clinically unreliable as indicators of hematocrit. Furthermore, no predictable effect of transfusion could be identified on heart rate, respiratory rate, or on the incidence of apnea or bradycardia. It was anticipated that frequent episodes of apnea or bradycardia might increase serum erythropoietin concentration. To the contrary, more frequent bradycardia was associated with the low erythropoietin levels because those infants tended to receive transfusions for "symptomatic" anemia. The data are consistent with the concept that "anemia of prematurity" is not predictably associated with symptoms classically attributed to anemia. Possible reasons for this are that the premature infant has a different inherent response to anemia; that it is inappropriate to extrapolate symptoms of severe acute anemia to persons with mild or moderate chronic anemia; or, most likely, that other determinants of heart rate, respiratory rate, and apnea/bradycardia are of more importance than mild or moderate anemia.

  19. Stability of Developmental Problems after School Entry of Moderately-Late Preterm and Early Preterm-Born Children.

    Science.gov (United States)

    Hornman, Jorijn; de Winter, Andrea F; Kerstjens, Jorien M; Bos, Arend F; Reijneveld, Sijmen A

    2017-08-01

    To assess the stability of developmental problems in moderately-late preterm-born children compared with early preterm and full term-born children before school entry at age 4 years and 1 year after school entry at age 5 years. We included 376 early preterm, 688 born moderately-late preterm, and 403 full term-born children from the Longitudinal Preterm Outcome Project (LOLLIPOP) cohort study. Developmental problems were assessed by the total score and the 5 domain scores of the Ages and Stages Questionnaire at ages 4 (ASQ-4) and 5 (ASQ-5). From the combinations of normal and abnormal ASQ-4 and ASQ-5 scores we constructed 4 categories: consistently normal, emerging, resolving, and persistent problems. The ASQ-4 total score was abnormal more frequently in moderately-late preterm (7.9%, P = .016) and early preterm-born children (13.0%, P preterm-born children had persistence and change comparable with full term-born children, and early preterm-born children had significantly greater rates than full term-born children of persistent (8.4% vs 2.2%, P preterm and moderately-late preterm-born children had mainly emerging motor problems and resolving communication problems, but the changing rates of moderately-late preterm-born children were lower. After school entry, the overall development of moderately-late preterm-born children had stability patterns comparable with full term-born children, whereas early preterm-born children had greater rates of persistent and emerging problems. On the underlying domains, moderately-late preterm-born children had patterns comparable with early preterm-born children but at lower rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Effects of developmental music groups for parents and premature or typical infants under two years on parental responsiveness and infant social development.

    Science.gov (United States)

    Walworth, Darcy D

    2009-01-01

    The purpose of this study was to examine the effect of music therapy intervention on premature infants' and full term infants' developmental responses and parents' responsiveness. Subjects (n=56) were parent-infant dyads who attended developmental music groups or a control condition assessing responsiveness during toy play. All subjects were matched according to developmental age and were also matched by group for socioeconomic status and for maternal depression. Types of infant play and parent responsiveness were measured using observation of a standardized toy play for parent-infant dyads. Observations were coded with the number of seconds spent in each behavior using the SCRIBE observation program. Parents completed a questionnaire on the perception of their infant's general development, interpretations of their child's needs, the purpose of using music with their child, and their child's response to music. The infants attending the developmental music groups with their parents demonstrated significantly more social toy play (p music groups. While not significant, graphic analysis of parent responsiveness showed parents who attended the developmental music groups engaged in more positive and less negative play behaviors with their infants than parents who did not attend the music groups. This study demonstrates the first findings of positive effects of developmental music groups on social behaviors for both premature and full term infants under 2 years old.

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

    Science.gov (United States)

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

    2012-03-01

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

  2. Neonatology oxidative status in preterm infants with premature preterm rupture of membranes and fetal inflammatuar response syndrome.

    Science.gov (United States)

    Özalkaya, Elif; Karatekin, Güner; Topçuoğlu, Sevilay; Karatepe, Hande Özgün; Hafızoğlu, Taner; Baran, Pervin; Ovalı, Fahri

    2017-10-01

    The aim of this study, to determine an index of oxidative stress index in preterm infants less than 34 weeks gestational age with premature preterm rupture of membrane (PPROM) and fetal inflammatory response syndrome (FIRS). This study was designed as a prospective study. Fifty-one premature infants less than 35 weeks of gestational age were included in the study. The umbilical cord blood concentrations of IL-6, TAC (total antioxidant capacity) and PON-1 (paraoxonase-1) levels and TOS (total oxidative stress) were studied. The oxidative stress index (OSI = TAC/TOS) was calculated in all of prematüre infants. PPROM was defined as rupture of membranes at least 24 hours before the onset of labor. FIRS was defined by an umbilical cord IL-6 level greater than 11 pg/mL. Premature infants included in the study were divided into 4 groups. Group 1 included preterm infants without FIRS and with PPROM (n = 16), while Group 2 included preterm infants without PPROM and with FIRS (n = 9), Group 3 consisted of premature infants with PPROM and FIRS (n = 21) and Group 4 included premature infants without PPROM or FIRS (n = 5). Umbilical cord TOS level was found to be higher in the preterm infants without FIRS and with PPROM (36.1 μmol H2O2 Equiv./L) compared to the preterm infants without PPROM or FIRS (11.9 μmol H2O2 Equiv./L) (p = 0.03). Umbilical cord PON-1 level was found to be lower in the preterms without FIRS and with PPROM (32 U/L), preterms without PPROM and with FIRS (30. 3 U/L) and the preterm infants with both PPROM and FIRS (48.6 U/L) compared to the preterm infants having no PPROM or FIRS (85.6 U/L) (p = 0.001). High pro-oxidant capacity was found in PPROM and low antioxidant capacity in PPROM and FIRS. Copyright © 2017. Published by Elsevier B.V.

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

    Science.gov (United States)

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

    1982-12-01

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

  4. Highest Plasma Phenylalanine Levels in (Very Premature Infants on Intravenous Feeding; A Need for Concern.

    Directory of Open Access Journals (Sweden)

    Ernesto Cortés-Castell

    Full Text Available To analyse the association in newborns between blood levels of phenylalanine and feeding method and gestational age.This observational, cross-sectional study included a sample of 11,829 infants between 2008 and 2013 in a Spanish region. Data were recorded on phenylalanine values, feeding method [breast, formula, mixed (breast plus formula, or partial or fully intravenous feeding], gestational age in weeks (<32, 32-37, ≥37, gender and days since birth at the moment of blood collection. Outcomes were [phenylalanine] and [phenylalanine] ≥95th percentile. Associations were analysed using multivariate models [linear (means difference and logistic regression (adjusted odds ratios].Higher phenylalanine values were associated with lower gestational age (p<0.001 and with intravenous feeding (p<0.001.The degree of prematurity and intravenous feeding influenced the plasma concentration of phenylalanine in the newborn. Caution should be taken in [phenylalanine] for newborns with intravenous feeding, monitoring them carefully. Very preterm infants given the recommended amount of amino acids should also be strictly monitored. These findings should be taken into consideration and call for adapting the amounts to the needs of the infant.

  5. Oxygen consumption and temperature control of premature infants in a double-wall incubator.

    Science.gov (United States)

    Marks, K H; Lee, C A; Bolan, C D; Maisels, M J

    1981-07-01

    The effects of a double wall in a forced convection-heated incubator were studied on ten naked, nondistressed, premature infants by measuring their mean skin temperature, esophageal temperature, and oxygen consumption when they were in thermal steady state, with, and without, the double wall in place. The incubator air temperature was maintained within the recommended thermoneutral zone during the consecutive paired experiments. Ambient room temperature and relative humidity were constant and the infant's activity (quiet sleep) and postprandial state were the same in both conditions. Together with a significant rise in operative temperature (P less than .05) induced by the double wall (accounted for by a 0.9 C mean increased in incubator wall temperature nearest the baby), their mean skin temperature and esophageal temperatures increased (P less than .025), while a decrease in oxygen consumption occurred in nine of the ten infants (P less than .05). These findings suggest that the double wall reduced radiant and total heat loss from the baby by diminishing the temperature gradient between the skin and incubator surfaces and that metabolic heat production (oxygen consumption) was reduced when the double wall was in place.

  6. Clinical features of late-onset circulatory dysfunction in premature infants

    Directory of Open Access Journals (Sweden)

    Koyama N

    2014-07-01

    Full Text Available Norihisa Koyama,1 Masanori Kouwaki,1 Taihei Tanaka,2 Shigeru Ohki,3 Kazuhiro Iwase,4 Shunichi Terasawa,5 Masanao Miyaji,6 Toshimitsu Iwaki,7 Minoru Kokubo,8 Satoru Kobayashi,9 Haruo Mizuno,10 Shinji Fujimoto,10 Hajime Togari10 1Department of Pediatrics, Toyohashi Municipal Hospital, Toyohashi, 2Department of Pediatrics, Nagoya Daini Red Cross Hospital, Nagoya, 3Department of Pediatrics, Seirei Hamamatsu General Hospital, Hamamatsu, 4Department of Pediatrics, Nagoya City West Medical Center, Nagoya, 5Department of Pediatrics, Ichinomiya Municipal Hospital, Ichinomiya, 6Department of Pediatrics, Shizuoka Saiseikai General Hospital, Shizuoka, 7Department of Pediatrics, Gifu Prefectural Tajimi Hospital, Tajimi, 8Department of Pediatrics, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Yatomi, 9Department of Pediatrics, Seirei Mikatabara General Hospital, Hamamatsu, 10Department of Pediatrics, Neonatology and Congenital Disorders, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan Background: Sudden unpredictable hypotension during the post-transitional period, termed late-onset circulatory dysfunction (LCD of premature infants, has been reported in low birth-weight infants who overcame major problems during the early neonatal period. We investigated the clinical features of LCD and factors associated with the occurrence of LCD. Methods: A multicenter retrospective case-control study. The clinical records of 1,004 children born at less than 32 weeks of gestation were reviewed. Patients with LCD were compared with age-matched non-LCD controls. Results: Of the 1,004 infants, 73 (7.3% were diagnosed with LCD, with the incidence differing significantly among institutions (P<0.0001. The median age of diagnosis was 16 days of age (range: 4–50 days and 29 weeks of postmenstrual age (range: 25–35 weeks. The incidence of LCD was inversely correlated with gestational age at birth, except at 22 and

  7. Factors associated with preterm, early preterm and late preterm birth in Malawi.

    Directory of Open Access Journals (Sweden)

    Nynke R van den Broek

    Full Text Available BACKGROUND: Assessment of risk factors for preterm birth in a population with high incidence of preterm birth and HIV infection. METHODS: Secondary analysis of data for 2,149 women included in a community based randomized placebo controlled trial for the prevention of preterm birth (APPLe trial (ISRCTN84023116 with gestational age at birth determined through ultrasound measurement in early pregnancy. Multivariate Logistic Regression analyses to obtain models for three outcome variables: all preterm, early preterm, and late preterm birth. FINDINGS: No statistical differences were noted for the prevalence of HIV infection (p = 0.30 or syphilis (p = 0.12 between women who delivered preterm versus term. BMI (Adjusted OR 0.91 (0.85-0.97; p = 0.005 and weight gain (Adjusted OR 0.89 (0.82-0.97; p = 0.006 had an independent, protective effect. Previous preterm birth doubled the odds of preterm birth (Adjusted OR 2.13 (1.198-3.80; p = 0.01. Persistent malaria (despite malaria prophylaxis increased the risk of late preterm birth (Adjusted OR 1.99 (1.05-3.79; p = 0.04. Age <20 (Adjusted OR 1.73 (1.03-2.90; p = 0.04 and anemia (Adjusted OR 1.95 (1.08-3.52; p = 0.03 were associated with early preterm birth (<34 weeks. CONCLUSIONS: Despite claims that HIV infection is an important cause of preterm birth in Africa, we found no evidence of an association in this population (unexposed to anti-retroviral treatment. Persistent malaria was associated with late preterm birth. Maternal undernourishment and anemia were independently associated with early preterm birth. The study did not assess whether the link was direct or whether a common precursor such as chronic infection was responsible for both maternal effects and early labour.

  8. The effects of massage therapy on physical growth and gastrointestinal function in premature infants: A pilot study.

    Science.gov (United States)

    Choi, HyeJeong; Kim, Shin-Jeong; Oh, Jina; Lee, Myung-Nam; Kim, SungHee; Kang, Kyung-Ah

    2016-09-01

    To promote the growth and development of premature infants, effective and tender care is required in neonatal intensive care units (NICUs). The purpose of this study was to test the potential effects of massage therapy on increasing physical growth and promoting gastrointestinal function in premature infants. Twenty subjects were divided into two groups in the NICU of one general hospital located in South Korea. The experimental group (n = 10) were given massage therapy and the control group (n = 10) received routine care. Massage therapy was performed twice daily for 14 days, for 15 minutes per session. In the physical growth, height and chest circumference were significantly increased in the experimental group. In assessing gastrointestinal function, frequency of pre-feed gastric residual was significantly decreased and numbers of bowel movements were significantly increased in the experimental group. This study showed massage therapy has the potential effects on increasing physical growth and gastrointestinal function in premature infants. The massage in the NICU might be utilized as a part of developmental care, but more research needs to be done. NICU nurses need to be trained in massage therapy techniques to provide more effective clinical care for premature infants.

  9. Effects of Probiotic Lactobacillus Reuteri (DSM 17938 on the Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Premature Infants

    Directory of Open Access Journals (Sweden)

    Mahmoud Nouri Shadkam

    2015-12-01

    Full Text Available Background: Feeding intolerance is a common problem among premature infants. There is limited information on the safety and effects of oral probiotic supplements, especially products containing Lactobacillus reuteri, and the incidence of necrotizing enterocolitis (NEC in low birth weight preterm infants. This study aimed to evaluate the effects of Lactobacillus reuteri on the gastrointestinal complications and feeding tolerance in premature infants. Methods: This randomized triple-blind clinical trial was conducted on 60 premature infants divided into two groups of intervention and placebo. Subjects in the intervention group received one drop/kg of supplementary oral probiotic with 0.5 ml of distilled water, and infants in the placebo group only received 0.5 ml of distilled water. Probiotic administration continued to reach full enteral feeding. Results: In this study, mean time to reach full enteral feeding was 12.83 and 16.75 days in the intervention and placebo groups, respectively, which was indicative of a significant difference (P=0.01. However, mean of neonatal weight at discharge had no significant difference between the two groups. In addition, 6.7% and 36.7% of infants in the intervention and placebo groups were diagnosed with NEC, respectively, which showed a significant difference (P=0.005. Also, prevalence of jaundice and sepsis was not significantly different between the study groups. Conclusion: According to the results of this study, Lactobacillus reuteri could reduce the time to reach full enteral feeding while diminishing the incidence of NEC in very low birth weight premature infants.

  10. Treatment trends for retinopathy of prematurity in the UK: active surveillance study of infants at risk

    Science.gov (United States)

    Adams, Gillian G W; Xing, Wen; Butler, Lucilla; Long, Vernon; Reddy, Aravind

    2017-01-01

    Objectives To estimate the incidence of severe retinopathy of prematurity (ROP) requiring treatment and describe current treatment patterns in the UK. Design Nationwide population-based case ascertainment study via the British Ophthalmic Surveillance Unit and a national collaborative ROP special interest group. Practitioners completed a standardised case report form (CRF). Setting All paediatric ophthalmologists providing screening and/or treatment for retinopathy in the UK were invited to take part. Participants Any baby with ROP treated or referred for treatment between 1 December 2013 and 30 November 2014, treated with laser, cryotherapy, vascular endothelial growth factor (VEGF) inhibitor or vitrectomy/scleral buckling, or a combination. Main outcome measure Incidence of ROP requiring treatment. Results We received 370 CRFs; 327 were included. Denominator from epidemiological data: 8112 infants with birth weight of <1500 g. The incidence of ROP requiring treatment was 4% (327/8112, 95% CI 3.6% to 4.5%). Median gestational age was 25 weeks (IQR 24.3–26.1), and median birth weight 706 g (IQR 620–821). Median age at first treatment was 80 days (IQR 71–96). 204 right eyes (62.39%) had type 1 ROP, and 27 (8.26%) had aggressive posterior ROP. Infants were also treated for milder disease: 9 (2.75%) right eyes were treated for type 2 ROP, and 74 (22.63%) for disease milder than type 1 with plus or preplus, which we defined here as ‘type 2 plus’ disease. First-line treatment was diode laser photoablation of the avascular retina in 90.5% and injection of VEGF inhibitor in 8%. Conclusions ROP treatment incidence in the UK is 2.5 times higher than previously estimated. 8% of treated infants receive intravitreal VEGF inhibitor, currently unlicensed. Research is needed urgently to establish safety and efficacy of this approach. Earlier treatment and increasing numbers of surviving premature infants require an increase in appropriate eye care facilities and

  11. Improved growth and development in premature infants managed with nasal continuous positive airway pressure.

    Science.gov (United States)

    Flesher, Susan Lee; Domanico, Renee S

    2014-01-01

    Our goal was to assess the association between the use of nasal continuous positive airway pressure (NCPAP) vs. conventional ventilation (CV) in premature infants and its effects on: 1) growth in the NICU and at follow up visits 2) neurodevelopmental outcomes measured by Bayley Infant Neurodevelopmental Screener (BINS) 3) the incidence of retinopathy of prematurity (ROP) and chronic lung disease (CLD). A retrospective chart review of two groups of NICU patients was conducted. The first group was from 1/1999-12/2000 (n = 140) and was managed by CV. The second group (n = 168) was from 1/2003-12/2004 and was managed primarily by NCPAP. Categorical variables were analyzed using Pearson Chi Square. Mean numerical values were analyzed with the student t-test. There was no statistical difference between the groups in regard to 15 demographic and interventional variables. There were significant differences between the two groups in CLD (p < 0.05) and ROP (p < 0.01), mean weight at one month (p < 0.05), 9-12 months (p < 0.01) and 15-18 months (p < 0.01), length at 4-6 months (p < 0.05), 9-12 months (p < 0.05), 15-18 months (p < 0.01), and 2 years (p = .05), and in BINS scores at 9-12 months (p < 0.01) and 15-18 months (p < 0.01). Managing babies with NCPAP therapy when compared with CV, significantly increased the weight at one month which was sustained at the 9-12 month and 15-18 month visits, increased length at all follow up visits, increased BINS scores at the 9-12 month and 15-18 month visits, and decreased the incidence of ROP and CLD.

  12. Effect of Infant Prematurity on Auditory Brainstem Response at Preschool Age

    Directory of Open Access Journals (Sweden)

    Sara Hasani

    2013-03-01

    Full Text Available Introduction: Preterm birth is a risk factor for a number of conditions that requires comprehensive examination. Our study was designed to investigate the impact of preterm birth on the processing of auditory stimuli and brain structures at the brainstem level at a preschool age.   Materials and Methods: An auditory brainstem response (ABR test was performed with low rates of stimuli in 60 children aged 4 to 6 years. Thirty subjects had been born following a very preterm labor or late-preterm labor and 30 control subjects had been born following a full-term labor.   Results: Significant differences in the ABR test result were observed in terms of the inter-peak intervals of the I–III and III–V waves, and the absolute latency of the III wave (P

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Melissa Thoene

    2016-07-01

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

  15. Ceruloplasmin levels and erythrocyte superoxide dismutase activity in small preterm infants during the early anemia of prematurity.

    Science.gov (United States)

    Hågå, P

    1981-11-01

    Ceruloplasmin plasma levels and erythrocyte superoxide dismutase activity were studied in appropriate for gestational age preterm infants (birth weights less than or equal to 1500 g) during the first 10 weeks of life. Preterm infants had significantly lower ceruloplasmin concentrations in cord blood than term infants, the mean level in the preterm infants being 0.07 g/l. At 1 week of age ceruloplasmin levels had risen significantly, whereupon a fall occurred at 2 weeks of age. Ceruloplasmin concentrations increased slowly and progressively from 4 weeks of age. The low ceruloplasmin concentration during the early anemia of prematurity seems not to interfere with iron mobilization. The superoxide dismutase activity per gram hemoglobin in cord blood erythrocytes from normal term infants was significantly lower than that of red blood cells from adults. When the activity was expressed per erythrocyte no difference was found. The normochromic macrocytic red blood cells of the neonate most likely explain this discrepancy. The erythrocyte superoxide dismutase activity of the preterm infants did not change from birth until 10 weeks of age, and the levels seemed adequate judged from the levels found in red blood cells from adults and cord blood from term infants. Neither ceruloplasmin nor erythrocyte superoxide dismutase activity seem to play a role in the etiology of the early anemia of prematurity.

  16. Effects of Gentle Human Touch and Field Massage on Urine Cortisol Level in Premature Infants: A Randomized, Controlled Clinical Trial

    Science.gov (United States)

    Asadollahi, Malihe; Jabraeili, Mahnaz; Mahallei, Majid; Asgari Jafarabadi, Mohammad; Ebrahimi, Sakine

    2016-01-01

    Introduction: Hospitalization in neonatal intensive care unit may leads to many stresses for premature infants. Since premature infants cannot properly process stressors, identifying interventions that reduce the stress level for them is seems necessary. The aim of present study was to compare the effects of Field massage and Gentle Human Touch (GHT) techniques on the urine level of cortisol, as an indicator of stress in preterm infants. Methods: This randomized, controlled clinical trial was carried out in Al-Zahra hospital, Tabriz. A total of 84 premature infants were randomly assigned into three groups. First groups were touched by their mothers three times a day (15 minutes in each session) for 5 days by GHT technique. The second group was received 15 minutes Field massage with sunflower oil three times a day by their mothers for 5 days. The third group received routine care. In all groups, 24-hours urine samples were collected in the first and sixth day after the intervention and analyzed for cortisol level. Data were analyzed by SPSS software. Results: There were significant differences between mean of changes in cortisol level between GHT and control groups and Field massage and control groups (0.026). Conclusion: Although the massage with Field technique resulted in a significant reduction in blood cortisol level, but the GHT technique have also a similar effect. So, both methods are recommended for decreasing of stress in preterm infants. PMID:27752484

  17. Long-chain saturated and monounsaturated fatty acids associate with development of premature infants up to 18 months of age.

    Science.gov (United States)

    Strandvik, Birgitta; Ntoumani, Eleni; Lundqvist-Persson, Cristina; Sabel, Karl-Göran

    2016-04-01

    Myelination is important perinatally and highly dependent on long-chain saturated and monounsaturated fatty acids. Long-chain polyunsaturated fatty acids, nowadays often supplemented, inhibit oleic acid synthesis. Using data from a premature cohort, we studied if nervonic, lignoceric and oleic acids correlated to growth and early development up to 18 months corrected age. Small for gestational age infants had lower concentrations than infants appropriate for gestational age. Only oleic acid was negatively correlated to long-chain polyunsaturated fatty acids. Oleic and lignoceric acids correlated to social interaction at one month, and nervonic acid to mental, psychomotor and behavioral development at 6, 10 and 18 months, also when adjusted for several confounders. Negative association between oleic acid and long-chain polyunsaturated fatty acids suggests inhibition of delta-9 desaturase, and nervonic acid´s divergent correlation to lignoceric and oleic acids suggests different metabolism in neonatal period. Our results may have implications for the supplementation of premature infants.

  18. Critical issues with clinical research in children: the example of premature infants.

    Science.gov (United States)

    Welty, Stephen E

    2005-09-01

    Research in pediatrics has led to marked improvements in survival in pediatric patients. In no other age group have these improvements been more dramatic than in neonatology, where antenatal steroid administration to mothers and postnatal utilization of surfactant have led to marked improvements in survival so that infants born at 24 weeks gestation now have a greater than 50% chance of survival. Unfortunately, more than 50% of these patients develop significant complications of prematurity with potential long-term impact on the health of these infants. Therefore, additional research must be done in these patients to prevent these complications or reduce the impact of these complications. There are many practical and some ethical issues that could impede research in the area. Interventional studies have succeeded because literally decades of research defined unequivocally the pathophysiology of diseases such as surfactant deficiency in RDS. Unfortunately, the pathophysiology leading to the complications of prematurity has been extrapolated from old concepts without verification as the population has become smaller and more premature than the previous era. Thus, an extremely important practical issue in pediatric research is whether to design interventions to address the extrapolated pathophysiology risking misinterpretations of the results of such studies. Or should our efforts be focused on defining endpoints associated with the development of diseases and complications which may define pathophysiology more completely but delay the design of interventions to improve the outcomes of patients. Another crucial practical issue in pediatric research is how to power studies so that interventions can be studied adequately. In the US, large neonatal networks have been formed so that large databases can be created and large multi-center trials can be performed. The practical issues associated with these network studies is the center to center variability in patient care

  19. Outcome of patent ductus arteriosus ligation in premature infants in the East of England: a prospective cohort study.

    Science.gov (United States)

    Kang, Sok-Leng; Samsudin, Salehuddin; Kuruvilla, Minju; Dhelaria, Anshoo; Kent, Sue; Kelsall, Wilfred A

    2013-10-01

    Surgical ligation of patent ductus arteriosus is considered when medical treatment fails or is contraindicated. This study aims to determine the mortality and morbidity of preterm neonates referred for patent ductus arteriosus ligation. A prospective study was conducted in the East of England to follow the outcome of premature infants under 37 weeks’ gestation undergoing patent ductus arteriosus ligation. A standardised proforma was used to collect information before and after the procedure. A total of 102 premature infants were recruited, and patent ductus arteriosus ligation was performed in 92. Surgical complications occurred in 8.7% (8/92), which included pneumothorax (5/8), recurrent laryngeal nerve palsy (2/8), and chylothorax (1/8). Morbidity outcome data were not available for all infants. The incidence of chronic lung disease was 88% (88/99); intraventricular haemorrhage was 49% (49/100); necrotising enterocolitis 39% (39/99), and retinopathy of prematurity 42% (41/97). The overall mortality rate in our study was 7.8% (8/102). Mortality rate in infants who had patent ductus arteriosus ligation was 4.3% (4/92). The 30-day survival rate after ligation was 99% (91/92). Beyond 30 days post-ligation, three infants died from other causes that were not directly related to surgery. Patent ductus arteriosus ligation in premature infants is associated with low mortality and complication rates; however, there is a high incidence of neonatal morbidity. Surgical capacity for patent ductus arteriosus ligation needs to be carefully planned nationally as the duration of ‘‘waiting time’’ and transport to another surgical centre could adversely affect outcomes in this high-risk population.

  20. CLINICAL AND PHARMACOECONOMIC REASONABILITY OF USING PROBIOTIC ENTEROCOCCUS STRAIN FOR THE COMPLEX DEVELOPMENTAL CARE PROGRAM FOR PREMATURE INFANTS

    Directory of Open Access Journals (Sweden)

    N. V. Gonchar

    2015-01-01

    Full Text Available Introduction. Possibilities of using probiotic enterococci in premature neonates undergoing inpatient antibacterial therapy remains understudied. The article is aimed at analyzing clinical and pharmacoeconomic reasonability of using probiotic Enterococcus faecium L3 strain in premature infants with very low body weight in the framework of complex inpatient developmental care. Patients and methods. 55 children randomized into 2 groups were observed: the control group (n = 26 was undergoing standard developmental care program, the primary group (n = 29 was introduced liquid probiotic Enterococcus faecium L3 strain (titer — 108 CFU/ml or more (0.5 ml TID for 14 days after attaining the enteral feeding volume of 5.0 ml. Results. Analysis of the clinical symptoms characteristic of non-smooth course of developmental care over premature infants helped to reveal higher frequency of infectious complications in the control group children than in the primary group (14 [53.8%] vs. 6 [20.7%]; p < 0.05. Acute food intolerance was observed less frequently in the primary group than in the control group (6 [20.7%] vs. 10 [38.5%], p > 0.05. The primary group's children featured significant decrease in the frequency of monocytosis, positive changes of intestinal microbiotic composition (increase in the amount of bifidum bacteria, lactobacilli, enterococci, decrease in the amount of Clostridium difficile and antibiotic-resistant clinical Klebsiella pneumoniae strains. Conclusion. Favorable outcome of developmental care over premature infants (absence of infectious complications was less expensive in the primary group's children.

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

    Science.gov (United States)

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

    2010-04-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  3. Comparison of the Effects of Attachment Training for Mothers on the Behavioral Responses of Premature Infants: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mitra Edraki

    2015-06-01

    Full Text Available Background: Premature infants are among high-risk groups in community who need to be hospitalized at intensive care units for survival and receiving basic or special care. Hospitalization at neonatal intensive care units (NICUs unsettles the family and leads to the separation of parents from their infants. This study aimed to determine the effects of maternal attachment behaviors on the behavioral responses of premature infants, hospitalized at NICUs. Methods: In this randomized clinical trial, 64 premature infants, who were hospitalized at NICUs and were eligible for the study, were randomly allocated to study and control groups. Attachment behaviors including touching, massage and kangaroo care were applied for the study group, while the conventional attachment method was adopted for the control group. Behavioral responses were evaluated two hours before and two hours after training attachment behaviors. Data were analyzed, using Chi-square and student’s t-test. Results: The mean difference in the duration of deep sleep and consciousness was more significant in the study group, compared to the control group. Furthermore, the duration of drowsiness was significantly less in the study group, compared to the control group. Conclusion: The implementation of attachment training at NICUs decreased the time of drowsiness and improved behavioral responses, deep sleep time and consciousness.

  4. Association of Maternal Age to Development and Progression of Retinopathy of Prematurity in Infants of Gestational Age under 33 Weeks

    Directory of Open Access Journals (Sweden)

    Atsuro Uchida

    2014-01-01

    Full Text Available Aim. To find predictive and indicative markers of risk for development of retinopathy of prematurity (ROP and its progression to the stage requiring laser treatment, in premature infants whose gestational age (GA was under 33 weeks. Methods. We retrospectively reviewed medical records of 197 premature infants born in 2005–2010 whose GA<33 weeks and underwent eye screening at Keio University Hospital. The association between candidate risk factors and development or progression of ROP was assessed. Results. Among the 182 eligible infants (median GA, 29.1 weeks; median birth weight (BW, 1028 g, 84 (46% developed any stage of ROP, of which 45 (25% required laser treatment. Multivariate analysis using a stepwise method showed that GA (P=0.002; 95% confidence interval (CI, 0.508–0.858, BW (P<0.001; 95% CI, 0.994–0.998, and lower maternal age (P=0.032; 95% CI, 0.819–0.991 were the risk factors for ROP development and GA (P<0.001; 95% CI, 0.387–0.609 and lower maternal age (P=0.012; 95% CI, 0.795–0.973 were for laser treatment. The odds ratio of requiring laser treatment was 3.3 when the maternal age was <33 years. Conclusion. ROP was more likely to be developed and progressed in infants born from younger mother and low GA.

  5. Factors Associated with Preterm, Early Preterm and Late Preterm Birth in Malawi

    Science.gov (United States)

    van den Broek, Nynke R.; Jean-Baptiste, Rachel; Neilson, James P.

    2014-01-01

    Background Assessment of risk factors for preterm birth in a population with high incidence of preterm birth and HIV infection. Methods Secondary analysis of data for 2,149 women included in a community based randomized placebo controlled trial for the prevention of preterm birth (APPLe trial (ISRCTN84023116) with gestational age at birth determined through ultrasound measurement in early pregnancy. Multivariate Logistic Regression analyses to obtain models for three outcome variables: all preterm, early preterm, and late preterm birth. Findings No statistical differences were noted for the prevalence of HIV infection (p = 0.30) or syphilis (p = 0.12) between women who delivered preterm versus term. BMI (Adjusted OR 0.91 (0.85–0.97); p = 0.005) and weight gain (Adjusted OR 0.89 (0.82–0.97); p = 0.006) had an independent, protective effect. Previous preterm birth doubled the odds of preterm birth (Adjusted OR 2.13 (1.198–3.80); p = 0.01). Persistent malaria (despite malaria prophylaxis) increased the risk of late preterm birth (Adjusted OR 1.99 (1.05–3.79); p = 0.04). Age <20 (Adjusted OR 1.73 (1.03–2.90); p = 0.04) and anemia (Adjusted OR 1.95 (1.08–3.52); p = 0.03) were associated with early preterm birth (<34 weeks). Conclusions Despite claims that HIV infection is an important cause of preterm birth in Africa, we found no evidence of an association in this population (unexposed to anti-retroviral treatment). Persistent malaria was associated with late preterm birth. Maternal undernourishment and anemia were independently associated with early preterm birth. The study did not assess whether the link was direct or whether a common precursor such as chronic infection was responsible for both maternal effects and early labour. PMID:24595186

  6. Stability of Developmental Problems after School Entry of Moderately-Late Preterm and Early Preterm-Born Children

    NARCIS (Netherlands)

    Hornman, Jorijn; de Winter, Andrea F.; Kerstjens, Jorien M.; Bos, Arend F.; Reijneveld, Sijmen A.

    Objective To assess the stability of developmental problems in moderately-late preterm-born children compared with early preterm and full term-born children before school entry at age 4 years and 1 year after school entry at age 5 years. Study design We included 376 early preterm, 688 born

  7. Stability of Developmental Problems after School Entry of Moderately-Late Preterm and Early Preterm-Born Children

    NARCIS (Netherlands)

    Hornman, Jorijn; de Winter, Andrea F; Kerstjens, Jorien M; Bos, Arend F; Reijneveld, Sijmen A

    OBJECTIVE: To assess the stability of developmental problems in moderately-late preterm-born children compared with early preterm and full term-born children before school entry at age 4 years and 1 year after school entry at age 5 years. STUDY DESIGN: We included 376 early preterm, 688 born

  8. The Florida Investigation of Primary Late Preterm and Cesarean Delivery: the accuracy of the birth certificate and hospital discharge records.

    Science.gov (United States)

    Clayton, Heather B; Sappenfield, William M; Gulitz, Elizabeth; Mahan, Charles S; Petersen, Donna J; Stanley, Kara M; Salihu, Hamisu M

    2013-07-01

    (1) Assess the accuracy of public health data sources used to investigate primary late preterm cesarean delivery (PLPCD) and (2) compare differences in data accuracy by hospital PLPCD rate classification. This analysis uses data from the Florida Investigation of Late Preterm and Cesarean Delivery (FILPCD), an investigation of singleton, PLPCD's that occurred from 2006 to 2007 in hospitals classified with either a low or high PLPCD rate (high rate 39.4-58.3 %, low rate 11.9-25.1 %). Three data sources were validated with maternal medical records: birth certificates, hospital discharge data, and combined birth certificate and hospital discharge data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa values were calculated. A summary measure of kappa values was compared by hospital PLPCD rate classification using the paired sample Wilcoxon signed rank test. Large variations in accuracy of data elements were found by hospital PLPCD rate classification, with low PLPCD rate hospitals demonstrating higher overall data accuracy. The summary measure of agreement was significantly higher for low PLPCD rate hospitals compared to high PLPCD rate hospitals (0.60 vs. 0.50, p late preterm birth are vital for public health practitioners and policy makers who seek to address the growing concern over recent increases in CD and late preterm birth. Understanding the potential for systematic differences in reporting accuracy by hospital PLPCD rate is important to data quality improvement efforts.

  9. Measurement and monitoring of electrocardiogram belt tension in premature infants for assessment of respiratory function

    Directory of Open Access Journals (Sweden)

    Hegyi Thomas

    2007-04-01

    Full Text Available Abstract Background Monitoring of the electrocardiogram (ECG in premature infants with conventional adhesive-backed electrodes can harm their sensitive skin. Use of an electrode belt prevents skin irritation, but the effect of belt pressure on respiratory function is unknown. A strain gauge sensor is described which measures applied belt tension. Method The device frame was comprised of an aluminum housing and slide to minimize the device weight. Velcro tabs connected housing and slide to opposite tabs located at the electrode belt ends. The slide was connected to a leaf spring, to which were bonded two piezoresistive transducers in a half-bridge circuit configuration. The device was tested for linearity and calibrated. The effect on infant respiratory function of constant belt tension in the normal range (30 g–90 g was determined. Results The mechanical response to a step input was second order (fn = 401 Hz, ζ = 0.08. The relationship between applied tension and output voltage was linear in the range 25–225 gm of applied tension (r2 = 0.99. Measured device sensitivity was 2.18 mV/gm tension using a 5 V bridge excitation voltage. When belt tension was increased in the normal range from 30 gm to 90 gm, there was no significant change in heart rate and most respiratory functions during monitoring. At an intermediate level of tension of 50 gm, pulmonary resistance and work of breathing significantly decreased. Conclusion The mechanical and electrical design of a device for monitoring electrocardiogram electrode belt tension is described. Within the typical range of application tension, cardiovascular and respiratory function are not substantially negatively affected by electrode belt force.

  10. Clinical analysis of high risk factors for premature and prognosis of premature infants%早产高危因素及早产儿预后的临床分析

    Institute of Scientific and Technical Information of China (English)

    晏金荣

    2016-01-01

    目的:分析早产高危因素及早产儿预后的影响因素。方法:回顾性分析55例早产儿的临床资料,分析早产原因及影响预后的因素。结果:导致早产的高危因素主要包括胎膜早破、前置胎盘、重度子痫前期、高龄、妊娠期贫血、多胎妊娠和瘢痕子宫等。影响早产儿预后的因素主要包括胎龄、体重、分娩方式。结论:早产的高危因素复杂。重视围生期保健、防治妊娠并发症可降低早产的发生率。%Objective:To analyze the high risk factors for premature and the influence factors for prognosis of premature infants. Methods:The clinical data of 55 cases of premature infants were analyzed retrospectively.The high risk factors for premature and the influence factors for prognosis of premature infants were analyzed.Results:The high risk factors causing premature included premature rupture of membrane,placenta previa,severe preeclampsia,age,gestational anemia,multiple pregnancy and scarred uterus.The factors affecting the prognosis of premature infants included gestational age,body weight and delivery mode.Conclusion:The high risk factors of preterm were complex.Paying attention to the perinatal health care and taking measures to prevent and control the pregnancy complications actively could reduce the incidence of premature infants.

  11. Plasma fatty acids in premature infants with hyperbilirubinemia: before-and-after nutrition support with fish oil emulsion.

    Science.gov (United States)

    Klein, Catherine J; Havranek, Thomas G; Revenis, Mary E; Hassanali, Zahra; Scavo, Louis M

    2013-02-01

    Infants who are dependent on parenteral nutrition (PN) sometimes develop PN-associated cholestasis (PNAC). A compassionate use protocol, approved by the U.S. Food and Drug Administration and the institutional review board, guided enrollment of hospitalized infants with PNAC (3 weeks). Plasma concentrations of essential fatty acids were monitored before and after a soybean-based PN lipid, infused at 3 g/kg body weight/d, was replaced by an experimental fish oil-based intravenous fat emulsion (FO-IVFE) at 1.0 g/kg/d. All participants were born premature (n = 10; 20% male). At enrollment, infants were (mean ± SD) 86.5 ± 53.5 days of life and weighed 2.24 ± 0.87 kg; direct bilirubin was 5.5 ± 1.3 mg/dL. After treatment, blood concentrations significantly increased from baseline (P effects were observed attributable to FO-IVFE. Discontinuation of FO-IVFE was typically due to infants (body weight 3.76 ± 1.68 kg) transitioning to enteral feeding rather than for resolution of hyperbilirubinemia (direct bilirubin 7.9 ± 4.8 mg/dL). These exploratory results suggest that FO-IVFE raises circulating ω-3 fatty acids in premature infants without development of ω-6 deficiency in the 8.3 ± 5.8-week time frame of this study.

  12. Risk Factors of Premature Infants in the Rural Areas of Azadshahr City: a Case-Control Study

    Directory of Open Access Journals (Sweden)

    Marzieh Gorzin

    2016-10-01

    Full Text Available Background: Preterm birth is one of the most remarkable reasons for neonatal and infant mortality and morbidity across the world. This study aimed to determine risk factors of premature infants in the rural area of Azadshahr city, Iran. Materials and Methods: Acase-control study was conducted on all premature and low birth neonates (less than 37 weeks and weight less than 2500 grams. Data were collected by records in 30 health houses located in the rural areas of Azadshahr city durring 2013 to 2016. Two groups (case and control were matched by gender and health houses. A trained midwife was collected data by using of a researcher-made checklist. To describe mean and standard deviation of the demo­graphic characteristics, descriptive methods were used.To analyze, inferential statistic tests such as Chi- square, and independent t-test were implemented through SPSS (version,16. Significant level was also taken

  13. Emotional reactions of mothers facing premature births: study of 100 mother-infant dyads 32 gestational weeks.

    Directory of Open Access Journals (Sweden)

    Julien Eutrope

    Full Text Available OBJECTIVES: This current study has been conducted to clarify the relationship between the mother's post-traumatic reaction triggered by premature birth and the mother-infant interactions. In this article, the precocious maternal feelings are described. METHODS: A multicenter prospective study was performed in three French hospitals. 100 dyads with 100 very premature infants and their mothers were recruited. Mothers completed, at two different times self-questionnaires of depression/anxiety, trauma and social support. The quality of interactions in the dyads was evaluated. RESULTS: Thirty-nine percent of the mothers obtained a score at HADS suggesting a high risk of depression at the first visit and approximately one-third at visit two. Seventy-five percent of the mothers were at risk of suffering from an anxiety disorder at visit one and half remained so at visit two. A "depressed" score at visits one and two correlated with a hospitalization for a threatened premature labor. We noted a high risk of trauma for 35% of the mothers and high interactional synchrony was observed for approximately two-thirds of the dyads. The mothers' psychological reactions such as depression and anxiety or postnatal depression correlate strongly with the presence of an initial trauma. At visit one and visit two, a high score of satisfaction concerning social support correlates negatively with presence of a trauma. A maternal risk of trauma is more frequent with a C-section delivery. CONCLUSIONS: Mothers' psychological reactions such as depression and anxiety correlate greatly with the presence of an initial trauma. The maternal traumatic reaction linked to premature birth does not correlate with the term at birth, but rather with the weight of the baby. Social support perceived by the mother is correlated with the absence of maternal trauma before returning home, and also seems to inhibit from depressive symptoms from the time of the infant's premature birth.

  14. Emotional Reactions of Mothers Facing Premature Births: Study of 100 Mother-Infant Dyads 32 Gestational Weeks

    Science.gov (United States)

    Eutrope, Julien; Thierry, Aurore; Lempp, Franziska; Aupetit, Laurence; Saad, Stéphanie; Dodane, Catherine; Bednarek, Nathalie; De Mare, Laurence; Sibertin-Blanc, Daniel; Nezelof, Sylvie; Rolland, Anne-Catherine

    2014-01-01

    Objectives This current study has been conducted to clarify the relationship between the mother's post-traumatic reaction triggered by premature birth and the mother-infant interactions. In this article, the precocious maternal feelings are described. Methods A multicenter prospective study was performed in three French hospitals. 100 dyads with 100 very premature infants and their mothers were recruited. Mothers completed, at two different times self-questionnaires of depression/anxiety, trauma and social support. The quality of interactions in the dyads was evaluated. Results Thirty-nine percent of the mothers obtained a score at HADS suggesting a high risk of depression at the first visit and approximately one-third at visit two. Seventy-five percent of the mothers were at risk of suffering from an anxiety disorder at visit one and half remained so at visit two. A “depressed” score at visits one and two correlated with a hospitalization for a threatened premature labor. We noted a high risk of trauma for 35% of the mothers and high interactional synchrony was observed for approximately two-thirds of the dyads. The mothers' psychological reactions such as depression and anxiety or postnatal depression correlate strongly with the presence of an initial trauma. At visit one and visit two, a high score of satisfaction concerning social support correlates negatively with presence of a trauma. A maternal risk of trauma is more frequent with a C-section delivery. Conclusions Mothers' psychological reactions such as depression and anxiety correlate greatly with the presence of an initial trauma. The maternal traumatic reaction linked to premature birth does not correlate with the term at birth, but rather with the weight of the baby. Social support perceived by the mother is correlated with the absence of maternal trauma before returning home, and also seems to inhibit from depressive symptoms from the time of the infant's premature birth. PMID:25153825

  15. Early rapid growth, early birth: Accelerated fetal growth and spontaneous late preterm birth

    Science.gov (United States)

    Kusanovic, Juan Pedro; Erez, Offer; Espinoza, Jimmy; Gotsch, Francesca; Goncalves, Luis; Hassan, Sonia; Gomez, Ricardo; Nien, Jyh Kae; Frongillo, Edward A.; Romero, Roberto

    2011-01-01

    The past two decades in the United States have seen a 24 % rise in spontaneous late preterm delivery (34 to 36 weeks) of unknown etiology. This study tested the hypothesis that fetal growth was identical prior to spontaneous preterm (n=221, median gestational age at birth 35.6 weeks) and term (n=3706) birth among pregnancies followed longitudinally in Santiago, Chile. The hypothesis was not supported: Preterm-delivered fetuses were significantly larger than their term-delivered peers by mid-second trimester in estimated fetal weight, head, limb and abdominal dimensions, and they followed different growth trajectories. Piecewise regression assessed time-specific differences in growth rates at 4-week intervals from 16 weeks. Estimated fetal weight and abdominal circumference growth rates faltered at 20 weeks among the preterm-delivered, only to match and/or exceed their term-delivered peers at 24–28 weeks. After an abrupt decline at 28 weeks attenuating growth rates in all dimensions, fetuses delivered preterm did so at greater population-specific sex and age-adjusted weight than their peers from uncomplicated pregnancies (p<0.01). Growth rates predicted birth timing: one standard score of estimated fetal weight increased the odds ratio for preterm birth from 2.8 prior to 23 weeks, to 3.6 (95% confidence interval, 1.82–7.11, p<0.05) between 23 and 27 weeks. After 27 weeks, increasing size was protective (OR: 0.56, 95% confidence interval, 0.38–0.82, p=0.003). These data document, for the first time, a distinctive fetal growth pattern across gestation preceding spontaneous late preterm birth, identify the importance of mid-gestation for alterations in fetal growth, and add perspective on human fetal biological variability. PMID:18988282

  16. Reversal of severe mitral regurgitation by device closure of a large patent ductus arteriosus in a premature infant.

    Science.gov (United States)

    Kheiwa, Ahmed; Ross, Robert D; Kobayashi, Daisuke

    2017-01-01

    We report a critically ill premature infant with severe mitral valve regurgitation associated with pulmonary hypertension and a severely dilated left atrium from a large patent ductus arteriosus. The mitral valve regurgitation improved significantly with normalisation of left atrial size 4 weeks after percutaneous closure of the patent ductus arteriosus. This case highlights the potential reversibility of severe mitral valve regurgitation with treatment of an underlying cardiac shunt.

  17. Transcatheter closure of hemodynamic significant patent ductus arteriosus in 32 premature infants by amplatzer ductal occluder additional size-ADOIIAS.

    Science.gov (United States)

    Morville, Patrice; Akhavi, Ahmad

    2017-05-04

    The advent of Amplatzer Duct Occluder II additional Size (ADOIIAS) provided the potential to close hemodynamic significant patent ductus arteriosus (HSPDA) and to analyze the feasibility, safety and efficacy of the device. Treatment of a patent ductus arteriosus (PDA) in very premature neonates is still a dilemma for the neonatalogist who has to consider its significance and has to choose among different treatment options. Because surgical ligation and medical therapy both have their drawbacks, interventional catheterization might provide an alternative means of closing HSPDA. Between September 2013 and June 2015, 32 premature infants with complications related to HSPDA defined by ultrasound (US) underwent transcatheter closure. The procedure was performed in the catheterization laboratory by venous cannulation without angiography. The position of the occluder was directed by X-ray and US. In particular we looked at procedural details, device size selection, complications, and short and mid-term outcomes. Thirty two premature infants, all of whom had clinical complications related to HSPDA, born at gestational ages ranging between 23.6 and 36 weeks (mean ± standard deviation 28 ± 3 weeks) underwent attempted transcatheter PDA closure using the ADOIIAS. Their mean age and weight at the time of procedure was 25 days (range 8-70 days) and 1373 g (range 680-2480 g), respectively. Ten infants weighed ≤1,000g. All ducts were tubular. The mean PDA and device waist diameters were 3.2 ± 0.6mm (range 2.2-4) and 4.4 ± 0.6 mm, respectively, and the mean PDA and device lengths 5.2 ± 2.0 mm (range 2-10) and 3.4 ± 1.3 mm. Median fluoroscopy and procedural times were 11 min (range 3-24) and 28 min (range 10-90), respectively. Complete closure was achieved in all but one patient. There was no device migration. A left pulmonary artery (LPA) obstruction developed in one patient. Five infants died. Four deaths were related to complications of

  18. A Case-control Study of Mother-related Factors for Late Preterm Births%晚期早产母源性因素的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    柳锡永; 刘小媚; 金志彪; 徐兰飞; 吴燕

    2015-01-01

    目的:探讨晚期早产发生的母源性影响因素。方法选取2012年1月至2013年12月住院分娩的970例晚期早产产妇为研究对象,并以同期早期早产(207例)和全部足月产(11985例)产妇为对照,比较分析晚期早产的母源性影响因素。结果年龄<20岁、外来流动人口、小学及以下文化程度、无业人员、双胎妊娠、无定期产前检查、胎膜早破、前置胎盘、胎盘早剥、妊娠合并肝内胆汁淤积与晚期早产和早期早产均有关(P<0.01);流产次数≥3次、胚胎移植术妊娠、妊娠合并高血压与晚期早产有关(P<0.05、0.01);妊娠合并贫血与早期早产有关(P<0.01)。结论除早产共有的影响因素外,流产次数≥3次、胚胎移植术妊娠、妊娠合并高血压是晚期早产独有的母源性因素,应采取针对性的措施减少和预防晚期早产的发生。%Objective To investigate the mother-related factors of late preterm births.Methods A case-control study of mother-related factors for late preterm births from January 2012 to December 2013 was performed, 970 women with late preterm birth as the case group, 207 women with early preterm birth and 11985 women with term birth as the control group.Results Age below 20 years old, the lfoating population, primary school education, the unemployed, twin pregnancies, without regular prenatal examination, premature rupture of fetal membranes, placenta praevia, placental abruption and pregnancy with intrahepatic cholestasis were associated with late preterm birth and early preterm birth(P<0.01). More than 3 abortion, regnancy embryo thansplantation and pregnancy with hypertension were associated with late preterm birth(P<0.05 and 0.01). Pregnancy with anemia was associated with early preterm birth(P<0.01).Conclusion In addition to the common inlfuencing factors of preterm birth, more than 3 abortion, regnancy embryo transplantation and pregnancy with

  19. Computerized analysis of retinal vessel width and tortuosity in premature infants.

    Science.gov (United States)

    Wilson, Clare M; Cocker, Kenneth D; Moseley, Merrick J; Paterson, Carl; Clay, Simon T; Schulenburg, William E; Mills, Monte D; Ells, Anna L; Parker, Kim H; Quinn, Graham E; Fielder, Alistair R; Ng, Jeffrey

    2008-08-01

    To determine, with novel software, the feasibility of measuring the tortuosity and width of retinal veins and arteries from digital retinal images of infants at risk of retinopathy of prematurity (ROP). The Computer-Aided Image Analysis of the Retina (CAIAR) program was developed to enable semiautomatic detection of retinal vasculature and measurement of vessel tortuosity and width from digital images. CAIAR was tested for accuracy and reproducibility of tortuosity and width measurements by using computer-generated vessel-like lines of known frequency, amplitude, and width. CAIAR was then tested by using clinical digital retinal images for correlation of vessel tortuosity and width readings compared with expert ophthalmologist grading. When applied to 16 computer-generated sinusoidal vessels, the tortuosity measured by CAIAR correlated very well with the known values. Width measures also increased as expected. When the CAIAR readings were compared with five expert ophthalmologists' grading of 75 vessels on 10 retinal images, moderate correlation was found in 10 of the 14 tortuosity output calculations (Spearman rho = 0.618-0.673). Width was less well correlated (rho = 0.415). The measures of tortuosity and width in CAIAR were validated using sequential model vessel analysis. On comparison of CAIAR output with assessments made by expert ophthalmologists, CAIAR correlates moderately with tortuosity grades, but less well with width grades. CAIAR offers the opportunity to develop an automated image analysis system for detecting the vascular changes at the posterior pole, which are becoming increasingly important in diagnosing treatable ROP.

  20. Influence of varied stimuli on development of motor patterns in the premature infant.

    Science.gov (United States)

    Chapman, J S

    1979-01-01

    The premature infant is at risk for both mortality and morbidity. His writhing contributes to weight loss, and his extrauterine environment does not contain the multi-modality patterned afferent stimuli that impinge upon the developing brain in utero. Sound is the most effective modality to achieve concurrent decrement in motility along with enhancement of cortical activity. It was anticipated that subjects exposed to 5 minutes of patterned sound 6 times a day would, by 36 weeks gestation, evidence: (a) less gross motor activity, (b) the normal predominance of upper over lower limb activity, and (c) beginning laterality. The sample consisted of 80 males and 73 females whose gestational age at birth was 26--33 weeks. By random assignment 52 subjects were exposed to the routine ambient noise of the isolette and nursery, 50 to a tape recording of their mother's voice, and 51 to an orchestral arrangement of Brahm's Lullaby. Limb activity was measured just prior to discharge by accelerometers worn unilaterally for a 24-hour period on the ankle and wrist prior to transfer to the alternate side for an additional 24 hours. No statistically significant differences were demonstrated among the limb patterns of the 3 groups. Large intragroup variation in gross activity precluded demonstration of between-group differences. The majority of subjects evidenced predominance of upper limb activity and laterality.

  1. Gestational therapy with an angiotensin II receptor antagonist and transient renal failure in a premature infant.

    Science.gov (United States)

    Bass, J Kirk; Faix, Roger G

    2006-07-01

    The fetotoxic effects of angiotensin converting enzyme inhibitors when used during the second half of pregnancy are well known. The more recently developed angiotensin II receptor antagonists appear to yield similar fetal abnormalities. We report a premature infant born to a 41-year-old mother with a long history of infertility who had received losartan therapy for hypertension throughout an undetected pregnancy. Ultrasound examination 2 days prior to delivery identified a single fetus at 29 weeks gestation, anhydramnios, and an empty fetal bladder. The neonatal course was complicated by oliguria, hyperkalemia, marked renal dysfunction, respiratory failure, joint contractures, and a large anterior fontanelle with widely separated sutures. Hypotension (mean arterial pressurerenal disease. Since then, weight and length have been at the 5th percentile or less, with apparent renal tubular acidosis necessitating the addition of sodium citrate supplements. This case emphasizes the importance of maintaining a high index of suspicion for potential pregnancy when contemplating the use of a drug of this class, and considering serial testing for pregnancy when using such drugs, even in patients with a longstanding history of infertility.

  2. Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

    Directory of Open Access Journals (Sweden)

    Daniela Franco Rizzo Komatsu

    Full Text Available Summary Objective: To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV and continuous positive airway pressure (nCPAP. Method: Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA ≤ 36 weeks and birth weight (BW > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation. Results: Among the 36 premature infants randomized to nIPPV, six (16.6% presented extubation failure in comparison to 11 (30.5% of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study. Conclusion: We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.

  3. 晚期早产儿的神经发育%Neurodevelopment in late preterm infant

    Institute of Scientific and Technical Information of China (English)

    鲁利群; 母得志

    2014-01-01

    晚期早产儿神经发育障碍的发生率明显高于足月儿,例如脑性瘫痪、发育迟缓、智力障碍、学习问题和行为问题等.原因与其脑发育不完善、疾病、监护和教育的影响等有关,应通过病史、早期神经发育评估、电生理学评估和神经影像学评估等方法,综合进行神经发育障碍的早期识别,并制定适宜的干预措施,包括日常功能训练、康复训练、心理治疗、特殊学校教育等,给予长期的评估、监测和随访,以改善人类健康状况.

  4. Prediction model of RSV-hospitalization in late preterm infants : An update and validation study

    NARCIS (Netherlands)

    Korsten, Koos; Blanken, Maarten O; Nibbelke, Elisabeth E; Moons, Karel G M; Bont, Louis

    2016-01-01

    BACKGROUND: New vaccines and RSV therapeutics have been developed in the past decade. With approval of these new pharmaceuticals on the horizon, new challenges lie ahead in selecting the appropriate target population. We aimed to improve a previously published prediction model for prediction of RSV-

  5. Prediction model of RSV-hospitalization in late preterm infants: An update and validation study

    NARCIS (Netherlands)

    Korsten, K.; Blanken, M.O.; Nibbelke, E.E.; Moons, K.G.; Bont, L.; Liem, K.D.

    2016-01-01

    BACKGROUND: New vaccines and RSV therapeutics have been developed in the past decade. With approval of these new pharmaceuticals on the horizon, new challenges lie ahead in selecting the appropriate target population. We aimed to improve a previously published prediction model for prediction of RSV-

  6. Correlation of serum KL-6 and CC16 levels with neurodevelopmental outcome in premature infants at 12 months corrected age

    Science.gov (United States)

    Zhang, Zhiqun; Lu, Hui; Zhu, Yunxia; Xiang, Junhua; Huang, Xianmei

    2015-01-01

    The aim of this study was to evaluate KL-6 and CC16 levels and their correlation with neurodevelopmental outcome among very low birth weight pre-term infants at 12 months corrected age. This prospective cohort study was performed from 2011 to 2013 by enrolling pre-term neonates of gestational age ≤ 32 weeks and birth weight ≤ 1500 g. Serum KL-6 and CC16 levels were determined 7 days after birth and their correlation with neurodevelopment was evaluated using Gesell Mental Developmental Scales. Of the 86 eligible pre-term infants, 63 completed follow-up, of which 15 had bronchopulmonary dysplasia. At 12 months corrected age, 49 infants had favorable outcomes and 14 infants had poor neurodevelopmental outcome. KL-6 levels were higher and CC16 levels were lower in infants with poor neurodevelopmental outcome compared with those infants who had favourable neurodevelopmental outcome. Serum KL-6 levels less than 90.0 ng/ml and CC16 levels greater than 320.0 pg/ml at 7 days of life were found to be predictive of a favourable outcome at 12 months corrected age. These biological markers could predict neurodevelopmental outcome at 12 months corrected age in very low birth weight premature infants, and help the clinician plan early therapeutic interventions to minimize or avoid poor neurodevelopmental outcome. PMID:25631862

  7. Behavioral observation differentiates the effects of an intervention to promote sleep in premature infants: a pilot study.

    Science.gov (United States)

    Lacina, Linda; Casper, Tammy; Dixon, Melodie; Harmeyer, Joann; Haberman, Beth; Alberts, Jeffrey R; Simakajornboon, Narong; Visscher, Marty O

    2015-02-01

    Sleep and ongoing cycling of sleep states are required for neurosensory processing, learning, and brain plasticity. Many aspects of neonatal intensive care environments such as handling for routine and invasive procedures, bright lighting, and noise can create stress, disrupt behavior, and interfere with sleep in prematurely born infants. The study empirically investigated whether a 30-minute observation of infant sleep states and behavior could differentiate an intervention to promote sleep in premature infants with feeding difficulties relative to conventional care (standard positioning, standard crib mattress [SP]). We included an intervention to determine the ability of the method to discriminate treatments and generate a benchmark for future improvements. The intervention, a conformational positioner (CP), is contoured around the infant to provide customized containment and boundaries. To more fully verify the 30-minute observational sleep results, standard polysomnography was conducted simultaneously and sleep outcomes for the 2 modalities were compared. In a randomized crossover clinical trial, 25 infants, 31.5 ± 0.6 weeks' gestational age and 38.4 ± 0.6 weeks at the study, with gastrointestinal conditions or general feeding difficulties used each intervention during an overnight neonatal intensive care unit sleep study. Infant sleep states and behaviors were observed during two 30-minute periods--that is, on the positioner and mattress--using the naturalistic observation of newborn behavior. Two certified developmental care nurses assessed sleep state, self-regulatory, and stress behaviors during 2-minute intervals and summed over 30 minutes. Sleep characteristics from standard polysomnography were measured at the time of behavior observations. Infants on CP spent significantly less time in alert, active awake, or crying states by observation compared with SP. Surgical subjects spent more time awake, active awake, or crying and displayed a higher number

  8. Scalp congenital hemangioma with associated high-output cardiac failure in a premature infant: Case report and review of literature.

    Science.gov (United States)

    Shah, Sumedh S; Snelling, Brian M; Sur, Samir; Ramnath, Alexandra R; Bandstra, Emmalee S; Yavagal, Dileep R

    2017-02-01

    Introduction Scalp congenital hemangiomas (CHs) are rare vascular malformations among infants; they can be associated with an array of complications, including cardiac and cosmetic issues. Here, we report the endovascular treatment of a premature infant with a suspected large right parietal scalp hemangioma and associated high-output cardiac failure. Case description A two-day-old female premature infant (29 weeks gestational age; 1330 g birth weight) was referred by the neonatologists to our department for consultation and potential treatment of a large right parietal CH causing abrupt hypotension and high-output cardiac failure. Doppler ultrasound imaging at bedside revealed areas of arterial-venous shunting from the scalp and the presence of a superior sagittal sinus waveform, consistent with intracranial venous drainage. To alleviate cardiac dysfunction secondary to this lesion, trans-arterial embolization via n-butyl cyanoacrylate (nBCA) glue and deployment of detachable coils was performed via umbilical artery to occlude the right superficial temporal and occipital artery branches supplying the CH. Following treatment, the infant continued to require ventilator management, vasopressor support, and correction of coagulopathy, but by post-operative day two, her condition improved remarkably and the mass size began decreasing. The patient was discharged after a relatively uncomplicated subsequent 2½-month course in the neonatal intensive care unit. Conclusion Endovascular therapy proved effective and safe in treating cardiac failure associated with scalp CH, despite potential complications associated with neuro-interventional surgery in premature infants. Appropriate consideration in this patient population should be given to factors including blood loss, contrast use, radiation exposure, operative time, and possible intra-/post-operative complications.

  9. Clinical Analysis of Apnea in Premature Infants%早产儿呼吸暂停的临床分析

    Institute of Scientific and Technical Information of China (English)

    王艳

    2016-01-01

    目的:通过对早产儿呼吸暂停的相关因素分析,探讨其发生的高危因素,以指导临床工作。方法对64例早产儿呼吸暂停进行回顾性分析。结果胎龄越小、体重越低的早产儿原发性呼吸暂停的发生率越高,继发性呼吸暂停与缺氧、低体温、酸中毒、脑损伤、感染等因素有关。结论呼吸暂停与胎龄、体重、缺氧、低体温、低血糖、酸中毒、感染、颅脑损伤等多因素有关。对有相关高危因素的早产儿应足够重视,预防呼吸暂停发生,已发生呼吸暂停的早产儿应重点监护,尽早干预,及时治疗,避免后遗症的发生。%Objective Through the analysis of the related factors of premature infant apnea,of this study was to evaluate the risk factors,and to guide clinical work.Methods 64 cases of premature infant apnea were retrospectively analyzed. Results The smaller the gestational age,weight,the lower the higher the incidence of occurrence of primary apnea of premature infants,secondary apnea with, hypothermia,acidosis,hypoxia brain injury,infection and other factors.Conclusion Apnea and gestational age,weight, hypoxia,low temperature,low blood sugar,acidosis,infection,craniocerebral injury and so on many factors.Of related risk factors of premature infants should be sufficient attention,prevent apnea occurs,there have been apnea should focus on care for premature infants,early intervention and treatment in time,avoid the occurrence of sequelae.

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

    Science.gov (United States)

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

    2016-07-01

    This article explores the feasibility of running "PremieStart," a nine-individual-session maternal-premature infant interaction program, within a neonatal unit (NNU) in England. Four mothers of premature infants completed seven sessions on the NNU and two at home. Mothers and NNU staff provided feedback on PremieStart. Measures of maternal-infant relationship, maternal well-being, and maternal reflective functioning were completed before and after intervention. Thematic analysis of mothers' feedback highlighted the emotional, but cathartic, experience of engaging with PremieStart. NNU staff feedback indicated the need to include them more in PremieStart. Both mothers and staff were supportive of future implementation of PremieStart and highlighted the ongoing need for psychological support on the NNU. PremieStart was implemented with positive feedback from mothers and staff, with support shown for the continued use of PremieStart in the NNU. However, for future implementation, the self-report outcome measures need reviewing, and more involvement of fathers and NNU staff is needed. In addition, a larger sample with a control group should be utilized. © 2016 Michigan Association for Infant Mental Health.

  11. Prevalence and Predisposing Factors of Retinopathy of Prematurity in Very Low-Birth-Weight Infants Discharged from NICU

    Directory of Open Access Journals (Sweden)

    Sina Ahmadi

    2009-03-01

    Full Text Available Objective: Retinopathy of prematurity (ROP is a disease of the eye caused by disorganized growth of retinal blood vessels resulting in scarring and retinal detachment. All preterm babies are at high risk for ROP, and very low birth weight is an additional risk factor. An increased incidence of ROP is expected in Iran because of improved survival of low birth weight and premature babies, and it is obvious that pediatricians and ophthalmologists are concerned about prevention and timely treatment of ROP in these children. To asses the real situation of ROP in our NICU we studied its prevalence and risk factors. Methods: This was a retrospective analysis of premature infants with birth weight of ≤1500 grams or gestational age of ≤32 weeks, admitted April 1, 2005 to March 28, 2006, to the Neonatal Intensive Care Unit of Qaem Hospital, Mashhad, Iran. The collected data of 47 cases in this cross-sectional study are analyzed by SPSS (Mann_Whitney, t-Student. Findings: Forty five infants were included in the study. Out of these, 4 (8.5% developed ROP (inclusive all stages. Our analysis revealed that low gestational age, sepsis and respiratory distress syndrome were independent predictors for the development of ROP. Conclusion:The frequency of ROP in our hospital was lower than the range reported in developed countries, and our risk factors were a little different.

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

    Science.gov (United States)

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

    2015-08-01

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

  13. Time at treatment of severe retinopathy of prematurity in China: recommendations for guidelines in more mature infants.

    Directory of Open Access Journals (Sweden)

    Yi Chen

    Full Text Available To investigate the postmenstrual (PMA age at treatment of severe retinopathy of prematurity (i.e. Type 1 prethreshold or threshold in infants in a tertiary referral center in China.76.6% (359/469 of infants were treated for threshold disease. 67.5% (317/469 of infants had a birth weight (BW of 1250 g or above and almost 30% (126 had a gestational age (GA of 32 weeks or above. There was little difference in the characteristics of infants treated for Type 1 prethreshold or threshold ROP. After controlling for GA, PMA age at treatment was highest in infants with BW ≥2000 g (mean PMA 40.3±4.4 weeks, p34 weeks, p<0.001. For every three weeks increase in GA there was a two-week increase in PMA at treatment (R2 = 0.20, p<0.001. The time at treatment of Type 1 prethreshold disease was similar to that for threshold disease i.e. chronological age 5.6∓7.4 weeks, or PMA 34.1∓40.2 weeks but the lower end of the 95% confidence interval for chronological age for Type 1 prethreshold disease among infants with BW ≥2000 g was 3.7 weeks (i.e. before the recommended interval of 4∓6 weeks after birth.The Chinese guidelines regarding timing of the first examination are appropriate for infants with BW <2000 g, but more mature infants should be examined a little earlier, at 3 weeks after birth, in order to detect Type 1 prethreshold disease which has a better prognosis than threshold.

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

    Directory of Open Access Journals (Sweden)

    Hsin-Chung Huang

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

  15. Longitudinal analysis of the premature infant intestinal microbiome prior to necrotizing enterocolitis: a case-control study.

    Directory of Open Access Journals (Sweden)

    Yanjiao Zhou

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

  16. Eye size in threshold retinopathy of prematurity, based on a Danish preterm infant series

    DEFF Research Database (Denmark)

    Fledelius, Hans Callø; Fledelius, Christian

    2012-01-01

    To validate a hypothesis of restricted postnatal ocular growth associated with advanced retinopathy of prematurity (ROP), with a view also to preceding intrauterine growth retardation.......To validate a hypothesis of restricted postnatal ocular growth associated with advanced retinopathy of prematurity (ROP), with a view also to preceding intrauterine growth retardation....

  17. The preterm pig as a model of premature infant gait ataxia

    DEFF Research Database (Denmark)

    Bergström, A.; Ryom, K.; Vanden Hole, C.

    Aims/background Compromised gait, balance and motor coordination (ataxia) as observed in cases of cerebral palsy is a serious complication to premature birth. The cerebellum is a central region with regards to these brain functions and its development shows high sensitivity to premature birth. Our...

  18. Frequency of Spontaneous BOLD Signal Differences between Moderate and Late Preterm Newborns and Term Newborns.

    Science.gov (United States)

    Wu, Xiushuang; Wei, Luqing; Wang, Nan; Hu, Zhangxue; Wang, Li; Ma, Juan; Feng, Shuai; Cai, Yue; Song, Xiaopeng; Shi, Yuan

    2016-10-01

    Little is known about the frequency features of spontaneous neural activity in the brains of moderate and late preterm (MLPT) newborns. We used resting-state functional magnetic resonance imaging (rs-fMRI) and the amplitude of low-frequency fluctuation (ALFF) method to investigate the frequency properties of spontaneous blood oxygen level-dependent (BOLD) signals in 26 MLPT and 35 term newborns. Two frequency bands, slow-4 (0.027-0.073 Hz) and slow-5 (0.01-0.027 Hz), were analyzed. Our results showed widespread differences in ALFF between the two bands; differences occurred mainly in the primary sensory and motor cortices and to a lesser extent in association cortices and subcortical areas. Compared with term newborns, MLPT newborns showed significantly altered neural activity predominantly in the primary sensory and motor cortices and in the posterior cingulate gyrus/precuneus. In addition, a significant interaction between frequency bands and groups was observed in the primary somatosensory cortex. Intriguingly, these primary sensory and motor regions have been proven to be the major cortical hubs during the neonatal period. Our results revealed the frequency of spontaneous BOLD signal differences between MLPT and term newborns, which contribute to the understanding of regional development of spontaneous brain rhythms of MLPT newborns.

  19. Executive functions in extremely low birth weight and late-preterm preschoolers: effects on working memory and response inhibition.

    Science.gov (United States)

    Baron, Ida Sue; Kerns, Kimberly A; Müller, Ulrich; Ahronovich, Margot D; Litman, Fern R

    2012-01-01

    Executive function (EF) refers to fundamental capacities that underlie more complex cognition and have ecological relevance across the individual's lifespan. However, emerging executive functions have rarely been studied in young preterm children (age 3) whose critical final stages of fetal development are interrupted by their early birth. We administered four novel touch-screen computerized measures of working memory and inhibition to 369 participants born between 2004 and 2006 (52 Extremely Low Birth Weight [ELBW]; 196 late preterm; 121 term-born). ELBW performed worse than term-born on simple and complex working memory and inhibition tasks and had the highest percentage of incomplete performance on a continuous performance test. The latter finding indicates developmental immaturity and the ELBW group's most at-risk preterm status. Additionally, late-preterm participants performed worse compared with term-born on measures of complex working memory but did not differ from those term-born on response inhibition measures. These results are consistent with a recent literature that identifies often subtle but detectable neurocognitive deficits in late-preterm children. Our results support the development and standardization of computerized touch-screen measures to assess EF subcomponent abilities during the formative preschool period. Such measures may be useful to monitor the developmental trajectory of critical executive function abilities in preterm children, and their use is necessary for timely recognition of deficit and application of appropriate interventional strategies.

  20. 早产儿脑病的临床研究进展%Research Progress of Encephalapathy of Premature Infants

    Institute of Scientific and Technical Information of China (English)

    倪美艳(综述); 陈娟(审校)

    2014-01-01

    Recently,the incidence rate of preterm birth is increasing and accounts for 5%-1 5% in all neonates.With the development of neonatal intensive care techniques and the establishment of neonatal intensive care unit,the survival rate of premature infants increased markedly.However,the premature infants brain inj ury rate has been increasing and become an enormous public health problem.Encephalopathy of prematurity includes various lesions,most notably periventricular leukomalacia (PVL)and periventricular haemorrhage-intra ventricular haemorrhage (PVH-IVH ), which could lead to death and neurological disabilities.This review integrates research progress in the pathogenesis, diagnosis, treatment and prevention in encephalopathy of prematurity.%近年来,早产率呈不断上升的趋势,发生率为5%~15%。由于早产儿生命救治支持技术的提高及新生儿重症监护病房在我国各地相继建立,早产儿存活率较以往显著提高,但早产儿脑病发生率仍不断增加,已成为一个严重的公共健康问题。脑室周围白质软化(PVL)和脑室周围-脑室内出血(PVH-IVH)是早产儿常见脑损伤类型,也是导致新生儿死亡及神经系统后遗症的重要原因。笔者拟就早产儿脑病的主要病理学类型、诊断方法及防治进展进行综述如下。

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

    Science.gov (United States)

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

    2017-01-01

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

  2. Treatment with exogenous surfactant stimulates endogenous surfactant synthesis in premature infants with respiratory distress syndrome

    NARCIS (Netherlands)

    Bunt, JEH; Carnielli, VP; Janssen, DJ; Wattimena, JLD; Hop, WC; Sauer, PJ; Zimmermann, LJI

    2000-01-01

    Objective: Treatment of preterm infants with respiratory distress syndrome (RDS) with exogenous surfactant has greatly improved clinical outcome. Some infants require multiple doses, and it has not been studied whether these large amounts of exogenous surfactant disturb endogenous surfactant metabol

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

    Science.gov (United States)

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

    2017-05-01

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

  4. Late preterm infant—Nature's unfinished master piece%晚期早产儿—大自然未完成的杰作

    Institute of Scientific and Technical Information of China (English)

    Raja Nandyal; Kris Sekar

    2013-01-01

    晚期早产儿(late preterm infants)是指胎龄为34~36+6周的早产儿.由于生理和代谢功能不成熟,与足月儿相比,晚期早产儿发病率和病死率较高.晚期早产儿是“极好的冒充者和假装者”,因为他们冒充并假装成足月儿.因其体型大小与足月儿相似,他们常常被当作足月儿,从而造成潜在的不良后果.本综述阐述了晚期早产的发生率和高危因素、早期疾病、晚期并发症,以及医疗护理.我们使用关键词“晚期早产儿”和“近足月儿”对2005年1月至2012年3月期间PubMed、OVID、Embase等计算机数据库的文献进行了检索.通过详细检索,我们获得了用于晚期早产儿监护的一些循证指南.

  5. Hyperhomocysteinemia and MTHFR Polymorphisms as Antenatal Risk Factors of White Matter Abnormalities in Two Cohorts of Late Preterm and Full Term Newborns

    Science.gov (United States)

    Marseglia, Lucia M.; Nicotera, Antonio; Salpietro, Vincenzo; Giaimo, Elisa; Cardile, Giovanna; Bonsignore, Maria; Alibrandi, Angela; Caccamo, Daniela; Manti, Sara; D'Angelo, Gabriella; Mamì, Carmelo; Di Rosa, Gabriella

    2015-01-01

    Higher total homocysteine (tHcy) levels, and C677T and A1298C methylenetetrahydrofolate (MTHFR) polymorphisms, have been reported in preterm or full term newborns with neonatal encephalopathy following perinatal hypoxic-ischemic insult. This study investigated the causal role of tHcy and MTHFR polymorphisms together with other acquired risk factors on the occurrence of brain white matter abnormalities (WMA) detected by cranial ultrasound scans (cUS) in a population of late preterm and full term infants. A total of 171 newborns (81 M, 47.4%), 45 (26.3%) born <37 wks, and 126 (73.7%) born ≥37 wks were recruited in the study. cUS detected predominant WMA pattern in 36/171 newborns (21.1%) mainly characterized by abnormal periventricular white matter signal and mild-to-moderate periventricular white matter volume loss with ventricular dilatation (6/36, 16.6%). WMA resulted in being depending on tHcy levels (P < 0.014), lower GA (P < 0.000), lower Apgar score at 1 minutes (P < 0.000) and 5 minutes (P < 0.000), and 1298AC and 677CT/1298AC genotypes (P < 0.000 and P < 0.000). In conclusion, both acquired and genetic predisposing antenatal factors were significantly associated with adverse neonatal outcome and WMA. The role of A1298C polymorphism may be taken into account for prenatal assessment and treatment counseling. PMID:25829992

  6. Hyperhomocysteinemia and MTHFR Polymorphisms as Antenatal Risk Factors of White Matter Abnormalities in Two Cohorts of Late Preterm and Full Term Newborns

    Directory of Open Access Journals (Sweden)

    Lucia M. Marseglia

    2015-01-01

    Full Text Available Higher total homocysteine (tHcy levels, and C677T and A1298C methylenetetrahydrofolate (MTHFR polymorphisms, have been reported in preterm or full term newborns with neonatal encephalopathy following perinatal hypoxic-ischemic insult. This study investigated the causal role of tHcy and MTHFR polymorphisms together with other acquired risk factors on the occurrence of brain white matter abnormalities (WMA detected by cranial ultrasound scans (cUS in a population of late preterm and full term infants. A total of 171 newborns (81 M, 47.4%, 45 (26.3% born <37 wks, and 126 (73.7% born ≥37 wks were recruited in the study. cUS detected predominant WMA pattern in 36/171 newborns (21.1% mainly characterized by abnormal periventricular white matter signal and mild-to-moderate periventricular white matter volume loss with ventricular dilatation (6/36, 16.6%. WMA resulted in being depending on tHcy levels (P<0.014, lower GA (P<0.000, lower Apgar score at 1 minutes (P<0.000 and 5 minutes (P<0.000, and 1298AC and 677CT/1298AC genotypes (P<0.000 and P<0.000. In conclusion, both acquired and genetic predisposing antenatal factors were significantly associated with adverse neonatal outcome and WMA. The role of A1298C polymorphism may be taken into account for prenatal assessment and treatment counseling.

  7. Music Therapy With Premature Infants and Their Caregivers in Colombia – A Mixed Methods Pilot Study Including a Randomized Trial

    OpenAIRE

    Mark Ettenberger; Helen Odell-Miller; Cátherine Rojas Cárdenas; Sergio Torres Serrano; Mike Parker; Sandra Milena Camargo Llanos

    2014-01-01

    This article reports the results of a three-arm mixed methods pilot study of music therapy with premature infants and their caregivers in a Neonatal Intensive Care Unit (NICU) in Bogotá, Colombia. The study included 19 medically stable babies born between the 30th and 37th week of gestation and their caregivers. Two intervention groups were compared with a control group. The objectives were to find out whether music therapy could help the neonates to stabilize their physiological states a...

  8. The Effect of Fish Oil-Based Lipid Emulsion and Soybean Oil-Based Lipid Emulsion on Cholestasis Associated with Long-Term Parenteral Nutrition in Premature Infants

    Science.gov (United States)

    Wang, Leilei; Zhang, Jing; Gao, Jiejin; Qian, Yan; Ling, Ya

    2016-01-01

    Purpose. To retrospectively study the effect of fish oil-based lipid emulsion and soybean oil-based lipid emulsion on cholestasis associated with long-term parenteral nutrition in premature infants. Methods. Soybean oil-based lipid emulsion and fish oil-based lipid emulsion had been applied in our neonatology department clinically between 2010 and 2014. There were 61 qualified premature infants included in this study and divided into two groups. Soybean oil group was made up of 32 premature infants, while fish oil group was made up of 29 premature infants. Analysis was made on the gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, age at which feeding began, usage of lipid emulsions, and incidence of cholestasis between the two groups. Results. There were no statistical differences in terms of gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, and age at which feeding began. Besides, total incidence of cholestasis was 21.3%, and the days of life of occurrence of cholestasis were 53 ± 5.0 days. Incidence of cholestasis had no statistical difference in the two groups. Conclusion. This study did not find the different role of fish oil-based lipid emulsions and soybean oil-based lipid emulsions in cholestasis associated with long-term parenteral nutrition in premature infants. PMID:27110237

  9. The Effect of Fish Oil-Based Lipid Emulsion and Soybean Oil-Based Lipid Emulsion on Cholestasis Associated with Long-Term Parenteral Nutrition in Premature Infants

    Directory of Open Access Journals (Sweden)

    Leilei Wang

    2016-01-01

    Full Text Available Purpose. To retrospectively study the effect of fish oil-based lipid emulsion and soybean oil-based lipid emulsion on cholestasis associated with long-term parenteral nutrition in premature infants. Methods. Soybean oil-based lipid emulsion and fish oil-based lipid emulsion had been applied in our neonatology department clinically between 2010 and 2014. There were 61 qualified premature infants included in this study and divided into two groups. Soybean oil group was made up of 32 premature infants, while fish oil group was made up of 29 premature infants. Analysis was made on the gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, age at which feeding began, usage of lipid emulsions, and incidence of cholestasis between the two groups. Results. There were no statistical differences in terms of gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, and age at which feeding began. Besides, total incidence of cholestasis was 21.3%, and the days of life of occurrence of cholestasis were 53±5.0 days. Incidence of cholestasis had no statistical difference in the two groups. Conclusion. This study did not find the different role of fish oil-based lipid emulsions and soybean oil-based lipid emulsions in cholestasis associated with long-term parenteral nutrition in premature infants.

  10. The Effect of Fish Oil-Based Lipid Emulsion and Soybean Oil-Based Lipid Emulsion on Cholestasis Associated with Long-Term Parenteral Nutrition in Premature Infants.

    Science.gov (United States)

    Wang, Leilei; Zhang, Jing; Gao, Jiejin; Qian, Yan; Ling, Ya

    2016-01-01

    Purpose. To retrospectively study the effect of fish oil-based lipid emulsion and soybean oil-based lipid emulsion on cholestasis associated with long-term parenteral nutrition in premature infants. Methods. Soybean oil-based lipid emulsion and fish oil-based lipid emulsion had been applied in our neonatology department clinically between 2010 and 2014. There were 61 qualified premature infants included in this study and divided into two groups. Soybean oil group was made up of 32 premature infants, while fish oil group was made up of 29 premature infants. Analysis was made on the gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, age at which feeding began, usage of lipid emulsions, and incidence of cholestasis between the two groups. Results. There were no statistical differences in terms of gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, and age at which feeding began. Besides, total incidence of cholestasis was 21.3%, and the days of life of occurrence of cholestasis were 53 ± 5.0 days. Incidence of cholestasis had no statistical difference in the two groups. Conclusion. This study did not find the different role of fish oil-based lipid emulsions and soybean oil-based lipid emulsions in cholestasis associated with long-term parenteral nutrition in premature infants.

  11. Effects of music therapy on pain responses induced by blood sampling in premature infants: A randomized cross-over trial

    Science.gov (United States)

    Shabani, Fidan; Nayeri, Nahid Dehghan; Karimi, Roghiyeh; Zarei, Khadijeh; Chehrazi, Mohammad

    2016-01-01

    Background: Premature infants are subjected to many painful procedures during care and treatment. The aim of this study was to assess the effect of music therapy on physiological and behavioral pain responses of premature infants during and after blood sampling. Materials and Methods: This study was a cross-over clinical trial conducted on 20 infants in a hospital affiliated to Tehran University of Medical Sciences for a 5-month period in 2011. In the experimental group, Transitions music was played from 5 min before until 10 min after blood sampling. The infants’ facial expressions and physiological measures were recorded from 10 min before until 10 min after sampling. All steps and measurements, except music therapy, were the same for the control group. Data were analyzed using SAS and SPSS software through analysis of variance (ANOVA) and Chi-square tests. Results: There were significant differences between the experimental and control groups (P = 0.022) in terms of heart rate during needle extraction and at the first 5 min after sampling (P = 0.005). Considering the infant's sleep–wake state in the second 5 min before sampling, the statistical difference was significant (P = 0.044). Difference was significant (P = 0.045) during injection of the needle, in the first 5 min after sampling (P = 0.002), and in the second 5 min after sampling (P = 0.005). There were significant difference in infants’ facial expressions of pain in the first 5 min after sampling (P = 0.001). Conclusions: Music therapy reduces the physiological and behavioral responses of pain during and after blood sampling. PMID:27563323

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

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir

    2015-06-01

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

  13. Surfactant treatment in premature infants with Respiratory Distress Syndrome in Curacao

    NARCIS (Netherlands)

    Verhagen, AAE; Keli, SO; van der Meulen, GN; Wiersma, H; Arias, M; Angelista, IR; Muskiet, FD

    2001-01-01

    Surfactant replacement therapy for Respiratory Distress Syndrome (RDS) in premature neonates has been established as an effective treatment, although significant mortality and morbidity remain. In Curacao, surfactant became available as a therapeutic option in 1994. A retrospective cohort study was

  14. [Positive rolandic sharp waves, periventricular ischemia and neurologic outcome. Prospective study in 66 premature infants].

    Science.gov (United States)

    Marret, S; Jeannot, E; Parain, D; Samson-Dollfus, D; Fessard, C

    1989-04-01

    A prospective study concerning 66 prematures born after 32 weeks of gestation showed a 33% incidence of positive rolandic sharp waves (PRSW) on EEGs. The results showed a good sensitivity (Se = 95%) and specificity (Sp = 93%) of PRSW for the diagnosis of periventricular ischemia with motor sequelae. A PRSW frequency higher than one per minute and its persistence on 2 successive EEGs constitutes an indication of severity of the lesions. This study emphasizes the necessity of several EEG recordings in prematures.

  15. THE ROLE OF PANCREATIC ENZYMOTHERAPY IN POSTNATAL ADAPTATION OF THE PREMATURE INFANTS UNDER ARTIFICIAL FEEDING

    Directory of Open Access Journals (Sweden)

    V.V. Dashichev

    2007-01-01

    Full Text Available Due to immaturity of the digestive system of the premature children under artificial feeding there may often be effects of gastrointestinal tract dysfunctions, which disturb postnatal adaptation among these newborns. The purpose of this research was to analyze a number of indices, characterizing the dynamics of the body weight and functional status of the gastrointestinal tract among the premature children, who received modern active digestive ferment at different periods of time. The authors presented the findings of the retrospective analysis of the case history among 29 premature children, who were held in the department of the premature children of the perinatal center. Children received pancreatine ferment (Creon 10000, Solvay Pharma, Germany. The ferment was introduced in the dosage of 150mg/day. This dose was orally introduced by minimicrospheres during every feeding and in some cases through the nasogastric probe. The ferment intake started in the early neonatal period among 13 children and in the late neonatal period among 16 children. During the course of the ferment therapy the frequency of the symptoms of the gastrointestinal tract dysfunctions drastically reduced. When the course of the ferment therapy was prescribed at an early age, the body weight increase tended to higher indices among premature children during the first month of their lives.Key words: premature children, pancreatic enzymotherapy, gastrointestinal tract dysfunctions.

  16. Aleitamento materno em prematuros: manejo clínico hospitalar Breastfeeding in premature infants: in-hospital clinical management

    Directory of Open Access Journals (Sweden)

    Maria Beatriz R. do Nascimento

    2004-11-01

    Full Text Available OBJETIVO: Abordar a importância do aleitamento materno e sua promoção no manejo clínico-hospitalar de recém-nascidos pré-termo. FONTE DOS DADOS: Foi realizada extensa revisão bibliográfica sobre o tópico, sendo selecionado material oriundo de livros-texto, teses, publicações de organismos nacionais e internacionais e artigos publicados selecionados a partir de pesquisa na base de dados MEDLINE referente ao período de 1990 a 2003, utilizando as palavras-chave breastfeeding and low birth weight e breastfeeding and preterm infant. Algumas referências relevantes dos trabalhos selecionados também foram utilizadas. SÍNTESE DOS DADOS: A partir da literatura levantada, verifica-se que vários aspectos tornam o leite materno particularmente adequado para a alimentação do recém-nascido prematuro. No entanto, observa-se, de modo geral, uma baixa incidência de êxito na amamentação de prematuros, especialmente em unidades neonatais de risco, apesar de haver evidências de que uma postura hospitalar favorável possibilite o aleitamento nessas crianças. CONCLUSÕES: Amamentar prematuros ainda é um desafio, mas é factível desde que haja apoio e suporte apropriados, principalmente pelos profissionais de saúde. As mães de prematuros necessitam de mais informações sobre a importância da amamentação para que possam tomar decisões sobre a nutrição dos seus filhos.OBJECTIVE: To describe the importance of breastfeeding and its promotion in the in-hospital clinical management of premature newborns. SOURCE OF DATA: The authors made an extensive literature review on the topic, including technical books, theses, publications of national and international organizations, and search on MEDLINE database (1990 to 2003, using the following key words and boolean operators: "breastfeeding AND low birth weight" and "breastfeeding AND preterm infant". Some significant references cited in the reviewed publications were used as well. SUMMARY OF THE

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

    Science.gov (United States)

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

    2016-03-01

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

  18. A histopathological study of premature and mature infants with pontosubicular neuron necrosis: neuronal cell death in perinatal brain damage.

    Science.gov (United States)

    Takizawa, Yuji; Takashima, Sachio; Itoh, Masayuki

    2006-06-20

    Perinatal hypoxic-ischemic brain damage is a major cause of neuronal and behavior deficits, in which the onset of injury can be before, at or after birth, and the effects may be delayed. Pontosubicular neuron necrosis (PSN) is one of perinatal hypoxic-ischemic brain injury and its pathological peculiarity is neuronal apoptosis. In this study, we investigated whether apoptotic cascade of PSN used a caspase-pathway or not, and whether hypoglycemia activated apoptosis or not. Sections of the pons of PSN with and without hypoglycemia were stained using terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and immunohistochemistry for glial fibrillary acidic protein (GFAP), Bcl-2, Bcl-x and activated caspase 3. Additionally, we performed immunoblot analysis of Bcl-2, Bcl-x and activated caspase 3. TUNEL-positive cell was closely associated with the presence of karyorrhexis. Under combination of karyorrhectic and TUNEL-positive cells, number of apoptotic cells in premature brains was significantly more than in mature brains. Hypoxic-ischemic brain injury was considered to easily lead to apoptosis in premature infants. Moreover, as this pathophysiology, caspase-pathway activation contributed to neuronal death from caspase-immunoexpression analyses. PSN with hypoglycemia showed large number of apoptotic cells and higher expression of activated caspase 3. The result may be more severe with the background of hypoglycemia and prematurity complicated by hypoxia and/or ischemia.

  19. Downregulation of notch signaling pathway in late preterm and term placentas from pregnancies complicated by preeclampsia.

    Directory of Open Access Journals (Sweden)

    Persefoni Fragkiadaki

    Full Text Available Preeclampsia (PE is a major cause of maternal mortality and morbidity, affecting 3-5% of all pregnancies. The Notch signaling pathway plays an important role during placental development, activating several target genes. Defects in the Notch pathway have adverse effect on placentation. The aim of this study was to investigate the expression of receptors NOTCH1,-2,-3,-4, ligands DLL1,-3,-4, JAG1,-2 and target genes HEY1,-2 in placental tissue samples from 20 late preterm or term pregnancies complicated by PE versus 20 normal pregnancies. mRNA levels of the studied molecules were measured by quantitative Real-Time PCR (qRT-PCR, while the protein expression of the intracellular domain of NOTCH2 (NICD2 and NOTCH3 (NICD3 was measured by Western Blot (WB. qRT-PCR analysis revealed that NOTCH1, NOTCH4 and DLL1 were not expressed in the placenta. On the contrary, NOTCH2, NOTCH3, DLL3, DLL4, JAG1, JAG2, HEY1 and HEY2 mRNA levels were downregulated in PE samples vs. controls (p<0.01. WB confirmed that NICD2 (p = 0.014 and NICD3 (p<0.001 protein levels were also lower in PE specimens. Statistical analysis revealed several significant associations: of NOTCH3 mRNA expression with smoking during pregnancy (p = 0.029, of NICD3 protein levels (p = 0.028 and DLL3 mRNA levels (p = 0.041 with birth weight centile, and of HEY2 transcript levels with parity (p = 0.034 and mode of delivery (p = 0.028. Our results suggest that Notch pathway downregulation is associated with PE. Further studies are required in order to determine the role of these molecules in PE pathogenesis and to evaluate their potential use for the early detection and treatment of PE.

  20. Downregulation of Notch Signaling Pathway in Late Preterm and Term Placentas from Pregnancies Complicated by Preeclampsia

    Science.gov (United States)

    Fragkiadaki, Persefoni; Soulitzis, Nikolaos; Sifakis, Stavros; Koutroulakis, Demetrios; Gourvas, Victor; Vrachnis, Nikolaos; Spandidos, Demetrios A.

    2015-01-01

    Preeclampsia (PE) is a major cause of maternal mortality and morbidity, affecting 3–5% of all pregnancies. The Notch signaling pathway plays an important role during placental development, activating several target genes. Defects in the Notch pathway have adverse effect on placentation. The aim of this study was to investigate the expression of receptors NOTCH1,-2,-3,-4, ligands DLL1,-3,-4, JAG1,-2 and target genes HEY1,-2 in placental tissue samples from 20 late preterm or term pregnancies complicated by PE versus 20 normal pregnancies. mRNA levels of the studied molecules were measured by quantitative Real-Time PCR (qRT-PCR), while the protein expression of the intracellular domain of NOTCH2 (NICD2) and NOTCH3 (NICD3) was measured by Western Blot (WB). qRT-PCR analysis revealed that NOTCH1, NOTCH4 and DLL1 were not expressed in the placenta. On the contrary, NOTCH2, NOTCH3, DLL3, DLL4, JAG1, JAG2, HEY1 and HEY2 mRNA levels were downregulated in PE samples vs. controls (p<0.01). WB confirmed that NICD2 (p = 0.014) and NICD3 (p<0.001) protein levels were also lower in PE specimens. Statistical analysis revealed several significant associations: of NOTCH3 mRNA expression with smoking during pregnancy (p = 0.029), of NICD3 protein levels (p = 0.028) and DLL3 mRNA levels (p = 0.041) with birth weight centile, and of HEY2 transcript levels with parity (p = 0.034) and mode of delivery (p = 0.028). Our results suggest that Notch pathway downregulation is associated with PE. Further studies are required in order to determine the role of these molecules in PE pathogenesis and to evaluate their potential use for the early detection and treatment of PE. PMID:25962154

  1. 早产儿体液免疫变化及影响因素研究%Study on changes and influence of humoral immunity in premature infants

    Institute of Scientific and Technical Information of China (English)

    王春红; 魏建和; 刘振奎; 肖佩霞; 张雅静; 袁二伟

    2013-01-01

    Objective To study changes of humoral immunity of the premature infants in different pathological conditions and detect the reason of the deficiency of humoral immunity in premature infants .Methods Two hundred and forty-six prematur were enrolled and 30 healthy neonates were selected as control group .The percentages of IgG ,IgA ,IgM and comp lement C3 ,C4 were detected by full automatic biochemical analyzer .Results The results showed that IgG ,IgM ,IgA ,C3 and C4 in the premature in-fants were lower than those in the normal term infants and there was a highly significant difference with the decrease of fetal age . IgG ,IgM ,IgA ,C3 and C4 of the group of the premature infants ranging from 32 to 36 weeks had reduced in different degree ,rela-tive to the groups of BW <2 000 g ,hypertension during pregnancy ,cesarean section(P<0 .05) .Conclusion The results showed that function of humoral immunity in the premature infants was depressed and low gestational age ,low birth weight ,cesarean sec-tion and hypertension during pregnancy may be the leading cause of the deficiency of humoral immunity .%目的研究早产儿体液免疫功能变化,探讨早产儿体液免疫功能低下的病因。方法收集246例早产儿组和30例健康新生儿(健康对照组)静脉血标本3 mL ,采用全自动生化分析仪检测各组新生儿IgG、IgM、IgA和补体C3、C4水平。结果

  2. The impact of probiotics (Lactobacillus reuteri Protectis on the treatment, course and outcome of premature infants in the Intensive Care Unit in Mostar

    Directory of Open Access Journals (Sweden)

    Marjana Jerković Raguž

    2016-09-01

    Full Text Available Aim: The aim of this study was to analyse the treatment, course and outcome of premature infants treated with probiotics (Lactobacillus reuteri Protectis in the Intensive Care Unit (ICU. Study design: This retrospective cohort study included 100 preterm infants of gestational age up to 30-34 + 6/7 weeks. The first group of infants who were given probiotics in their dairy meal in the course of their medical treatment during hospitalization in the year 2014 were compared to a second group of infants who did not receive probiotics in the year 2013.Results: A statistically significant difference in the number of days of treatment in the ICU (p < 0.05, administration of ranitidine (p < 0.05 and feeding intolerance (p < 0.05 was found between the two groups of preterm infants. No statistically significant differences were found in the other variables under study.Conclusion: Probiotics probably have a positive effect on the course and outcome of treatment of premature infants in the ICU. Our newborns who received probiotics spent shorter time in intensive care, they began full peroral intake of milk sooner and received antiulcer medicine for shorter time, which is an important step towards the improvement of treatment outcome in premature infants.

  3. Oxygen as a cause of blindness in premature infants: "autopsy" of a decade of errors in clinical epidemiologic research.

    Science.gov (United States)

    Jacobson, R M; Feinstein, A R

    1992-11-01

    Several intellectual "autopsies" have recently reviewed errors in clinical epidemiologic studies of causation, such as the original claim that amyl nitrite "poppers" caused AIDS. The current autopsy was done to determine why it took more than a decade--1942 to 1954--to end an iatrogenic epidemic in which high-dose oxygen therapy led to retrolental fibroplasia (RLF) in premature infants, blinding about 10,000 of them. The autopsy revealed a museum of diverse intellectual pathology. When first noted, RLF was regarded as neither a new disease nor a postnatal effect. In early investigations, the ophthalmologists did not establish explicit criteria for diagnosis and confused RLF with malformations previously seen in full-term infants. Because the patients were not referred until months after birth, the ophthalmologists assumed that the lesion, which resembled an embryologic structure, must have occurred prenatally. Other events suggesting a prenatal cause for RLF were its strong statistical associations with fetal anomalies, multiple gestations, and maternal infections. Although these events were also associated with prematurity, it was ignored when the RLF cases were compared with controls who were mainly full-term infants. The postnatal timing of RLF was eventually recognized when investigators did cohort studies in premature infants and found that RLF could develop in eyes that were normal at birth. As the search for a cause turned to events occurring after birth, statistical associations were produced for agents such as light, vitamins, iron, vitamin E deficiency, and hypoadrenalism. Each study had its own methodologic flaws: controls were missing for light; co-maneuvers were ignored for vitamins and iron; objective diagnosis was not used for vitamin E deficiency; and the research on hypoadrenalism contained biases in susceptibility and detection as well as problems of a competing outcome event. When the role of oxygen administration was first considered, the

  4. Decreased free water clearance is associated with worse respiratory outcomes in premature infants.

    Directory of Open Access Journals (Sweden)

    Tuomo Vuohelainen

    Full Text Available OBJECTIVE: The goal was to elucidate predictors of decreased free water clearance (DFWC in very low birth weight (VLBW infants. We hypothesized that DFWC and fluid retention are linked to the severity of pulmonary problems and prolonged respiratory support, especially to nCPAP treatment. METHODS: The investigation was carried out at Tampere University Hospital between 2001 and 2006. The study population comprised 74 VLBW infants born at 29.21 (24.57-34.14 weeks of gestation. Median birth weight was 1175 (575-1490 grams. We measured plasma and urine osmolality and 24-hour urine volume to calculate free water clearance (FWC for each infant. If FWC was less than 30 ml/kg/day the infant was classified as having DFWC. RESULTS: There were 38 (51.4% infants with DFWC in the study population. The median duration of the observed DFT period was 14 (4-44 days. The gestational age at birth was lower for DFWC infants compared to infants with normal FWC (NFWC, 28.29 (24.57-32.86 vs. 30.00 (25.57-34.14 weeks (p = 0.001. DFWC infants also needed longer ventilator treatment, 2 (0-23 vs. 0.50 (0-23 days (p = 0.046, nCPAP treatment 30 (0-100 vs. 3 (0-41 days (p<0.0001 and longer oxygen supplementation 47 (0-163 vs. 22 (0-74 days (p = 0.011 than NFWC infants. All values presented here are medians with ranges. CONCLUSIONS: DFWC appears to be frequently connected with exacerbation and prolongation of pulmonary problems in VLBW infants. Cautious fluid administration seems to be indicated in VLBW infants with prolonged respiratory problems and DFWC.

  5. Taste-Mediated Calming in Premature, Preterm, and Full-Term Human Infants.

    Science.gov (United States)

    Smith, Barbara A.; Blass, Elliott M.

    1996-01-01

    Preterm and term infants were given a sucrose solution, a glucose solution, or water during a test period in which the amount of their crying was measured. Sucrose reduced crying in preterm and term infants by 91% and 93%, respectively, and glucose by 86% and 81%, respectively. Water was ineffective in reducing crying in both preterm and term…

  6. 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.

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

    Science.gov (United States)

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

    2009-06-10

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