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Sample records for premature infants study

  1. 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 ...

  2. 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 ...

  3. Metabolic studies of transient tyrosinemia in premature infants

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    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.

  4. 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.

  5. 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))

  6. 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

  7. 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.

  8. 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/.

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

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    de Róiste, Aine

    2004-12-01

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

  10. [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.

  11. 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

  12. 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

  13. [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

  14. 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…

  15. 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…

  16. 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

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

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    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.

  18. 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.).

  19. 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

  20. The effects of massage therapy on physical growth and gastrointestinal function in premature infants: A pilot study.

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    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.

  1. Optimal oxygen saturation in premature infants

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    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.

  2. 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.

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

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    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.

  4. 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

  5. Premature infants' health at multiple induced pregnancy.

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    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.

  6. 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

  7. [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.

  8. 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.

  9. Emotional reactions of mothers facing premature births: study of 100 mother-infant dyads 32 gestational weeks.

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    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.

  10. 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

  11. 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

  12. 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

  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. 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.

  15. Intestinal absorption of lipid emulsion in premature infants: a pilot study.

    Science.gov (United States)

    Janvier, A; Beaumier, L; Barrington, K J

    2011-01-01

    Adequate nutritional intake is essential in the very-low-birth-weight infant, but difficult to achieve in the first few postnatal days. Can lipids be given enterally in the first few days of life in sick preterm infants? To determine tolerance and absorption of lipid emulsion when fed enterally to very-low-birth-weight infants. Infants had a birth weight control group which received no oral lipid emulsion was enrolled. We then enrolled group 2 infants who were fed 3 g/kg/day with the same protocol as group 1. Group 3 infants were fed enteral lipid emulsion starting in the first 72 h of life. The infants were fed 1, 2 and 3 g/kg/day subsequently for 48 h each. Fat absorption was measured. Gestational age was 24.6-30.8 weeks and birth weight was 620-1,400 g. One infant (group 1) developed necrotizing enterocolitis 1 week after the study. There were no other adverse clinical findings. On average, enteral lipid emulsion was started on day 8 of life in groups 1 and 2, and on day 2 in group 3. The intestinal lipid absorption was 93.6% (min. = 76%). There was no difference in fat absorption between the 4 groups (p > 0.05). Lipid emulsions are an isotonic high-calorie source which can be given safely enterally instead of intravenously in the immediate neonatal period of very-low-birth-weight infants without clinical adverse effects and with almost complete absorption. There are potential advantages to oral administration of a lipid emulsion starting in early life which require further investigation. Copyright © 2011 S. Karger AG, Basel.

  16. 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.

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

    Science.gov (United States)

    Newman, L F

    1986-01-01

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

  18. Longitudinal analysis of the premature infant intestinal microbiome prior to necrotizing enterocolitis: a case-control study.

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    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.

  19. 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...

  20. 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

  1. 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.

  2. 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.

  3. 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.

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

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    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.

  5. 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.

  6. Enteral nutrition of the premature infant

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    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.

  7. 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.

  8. 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

  9. 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.

  10. A randomized controlled study about the use of eHealth in the home health care of premature infants

    Directory of Open Access Journals (Sweden)

    Gund Anna

    2013-02-01

    Full Text Available Abstract Background One area where the use of information and communication technology (ICT, or eHealth, could be developed is the home health care of premature infants. The aim of this randomized controlled study was to investigate whether the use of video conferencing or a web application improves parents’ satisfaction in taking care of a premature infant at home and decreases the need of home visits. In addition, nurses’ attitudes regarding the use of these tools were examined. Method Thirty-four families were randomized to one of three groups before their premature infant was discharged from the hospital to home health care: a control group receiving standard home health care (13 families; a web group receiving home health care supplemented with the use of a web application (12 families; a video group with home health care supplemented with video conferencing using Skype (9 families. Families and nursing staff answered questionnaires about the usefulness of ICT. In addition, semi-structured interviews were conducted with 16 families. Results All the parents in the web group found the web application easy to use. 83% of the families thought it was good to have access to their child’s data through the application. All the families in the video group found Skype easy to use and were satisfied with the video calls. 88% of the families thought that video calls were better than ordinary phone calls. 33% of the families in the web group and 75% of those in the video group thought the need for home visits was decreased by the web application or Skype. 50% of the families in the web group and 100% of those in the video group thought the web application or the video calls had helped them feel more confident in caring for their child. Most of the nurses were motivated to use ICT but some were reluctant and avoided using the web application and video conferencing. Conclusion The families were satisfied with both the web application and video

  11. 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.

  12. 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...

  13. Neonatal Magnesium Levels Correlate with Motor Outcomes in Premature Infants: a Long-Term Retrospective Cohort Study

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    Elizabeth eDoll

    2014-11-01

    Full Text Available ObjectiveChronic neurological deficits are a significant complication of preterm birth. Magnesium supplementation has been suggested to have neuroprotective function in the developing brain. Our objective was to determine whether higher neonatal serum magnesium levels were associated with better long-term neurodevelopmental outcomes in very low birth weight infants.Study DesignA retrospective cohort of 75 preterm infants (<1500 g, gestational age <27 weeks had follow-up for the outcomes of abnormal motor exam and for epilepsy. Average total serum magnesium level in the neonate during the period of prematurity was the main independent variable assessed, tested using a Wilcoxon rank-sum test. ResultsHigher average serum magnesium level was associated with a statistically significant decreased risk for abnormal motor exam (p 0.037. A lower risk for epilepsy in the group with higher magnesium level did not reach statistical significance (p 0.06. ConclusionThis study demonstrates a correlation between higher neonatal magnesium levels and decreased risk for long-term abnormal motor exam. Larger studies are needed to evaluate the hypothesis that higher neonatal magnesium levels can improve long-term neurodevelopmental outcomes.

  14. Music Therapy With Premature Infants and Their Caregivers in Colombia – A Mixed Methods Pilot Study Including a Randomized Trial

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    Mark Ettenberger

    2014-07-01

    Full Text Available 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 and help mothers to reduce anxiety and strengthen the relationship with their baby. The data collection included the babies´ weight gain, heart rate, oxygen saturation, size, cephalic perimeter and length of hospitalization. Mothers filled out the State-Trait Anxiety Inventory (STAI-C and the Mother-to-Infant Bonding Scale (MIBS before the first and after the last intervention. Thematic analysis was used to analyze the qualitative data obtained through questionnaires. A trend towards an increased weight gain for both intervention groups and a shorter length of hospitalization for one of the intervention groups was noticed. Anxiety and bonding in mothers appears not to follow linear trends, as new challenges arise for parents at different stages during hospitalization. Mothers stated that music therapy was helpful for them, their baby and their relationship with the baby. Mothers across the groups think that music therapy should be a regular offer in the NICU and that music therapy helps to humanize the NICU environment.

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

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    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.

  16. [Five steps to decreasing nosocomial infections in large immature premature infants: A quasi-experimental study].

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    García González, Ana; Leante Castellanos, José Luis; Fuentes Gutiérrez, Carmen; Lloreda García, José María; Fernández Fructuoso, José Ramón; Gómez Santos, Elisabet; García González, Verónica

    2017-07-01

    An evaluation is made of the impact of a series of five interventions on the incidence of hospital-related infections in a level iii neonatal unit. Quasi-experimental, pre-post intervention study, which included preterm infants weighing 1,500g at birth or delivered at <32 weeks gestation, admitted in the 12 months before and after the measures were implemented (January 2014). The measures consisted of: optimising hand washing, following a protocol for insertion and handling of central intravenous catheters, encouraging breastfeeding; applying a protocol for rational antibiotic use, and establishing a surveillance system for multi-resistant bacteria. The primary endpoint was to assess the incidence of hospital-acquired infections before and after implementing the interventions. Thirty-three matched patients were included in each period. There was an incidence of 8.7 and 2.7 hospital-related infections/1,000 hospital stay days in the pre- and post-intervention periods, respectively (P<.05). Additionally, patients in the treatment group showed a statistically-significant decrease in days on mechanical ventilation, use of blood products, and vasoactive drugs. The strategy, based on implementing five specific measures in a unit with a high rate of hospital-related infections, proved effective in reducing their incidence. This reduction could contribute to lowering the use of mechanical ventilation, blood products, and vasoactive drugs. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Maternal assessment of pain in premature infants

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    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.

  18. Effect of parenteral glutamine supplementation in premature infants

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    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

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

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    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.

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

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    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.

  1. 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.

  2. Recombinant Activated Factor VIIa (rFVIIa) Treatment in Very-Low-Birth-Weight (VLBW) Premature Infants with Acute Pulmonary Hemorrhage: A Single-Center, Retrospective Study.

    Science.gov (United States)

    Cosar, Hese; Isik, Halil; Cakır, Salih Cagrı; Yar, Nese; Goksen, Bulent; Tokbay, Hakan; Kertmen, Hasan; Erdoğan, Nihal; Durak, Ikbal

    2017-02-01

    We aimed to evaluate the efficacy of intravenous administration of recombinant activated factor VIIa (rFVIIa) for acute pulmonary hemorrhage treatment in very-low-birth-weight (VLBW) premature infants. This study was carried out retrospectively in premature infants with pulmonary hemorrhage that were ≤30 weeks gestational age or premature infants with pulmonary hemorrhage who were hospitalized in our neonatal intensive care unit between 01 January 2013 and 31 December 2015 were evaluated. Group 1 (n = 21) received rFVIIa support within the first 30 min of pulmonary hemorrhage plus conventional treatment, while Group 2 (n = 21) received conventional treatment only. The number of patients whose pulmonary hemorrhage was stopped within the first 2 h was significantly higher in Group 1 than Group 2 (n = 14 vs n = 4; p = 0.002). After pulmonary hemorrhage, hemoglobin values of Group 1 were higher than Group 2 (11.12 ± 1.06 vs 10.14 ± 1.59 g/dL; p = 0.024). Erythrocyte suspension (1.43 ± 4.51 vs 5.71 ± 7.46 mL/kg; p = 0.030) and fresh frozen plasma use (5.71 ± 8.10 vs 19.52 ± 12.44 mL/kg; p premature infants.

  3. [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.

  4. 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.

  5. 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.

  6. 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.

  7. Retinopathy of Prematurity in Infants with Late Retinal Examination

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    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

  8. Prostaglandin E2 and patent ductus arteriosus in premature infants

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    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.

  9. 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.

  10. 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.

  11. Mode of delivery and neurosonographic findings in premature infants

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    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

  12. Results of Thyroid Function Tests in Premature Infants

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    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.

  13. Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants

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    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.

  14. 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…

  15. 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…

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. [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.

  1. 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.

  2. 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.

  3. 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)

  4. 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...

  5. 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.

  6. 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.

  7. 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...

  8. 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.

  9. What matters to the parents? A qualitative study of parents' experiences with life-and-death decisions concerning their premature infants.

    Science.gov (United States)

    Brinchmann, Berit Støre; Førde, Reidun; Nortvedt, Per

    2002-07-01

    The aim of this article is to generate knowledge about parents' participation in life-and-death decisions concerning their very premature and/or critically ill infants in hospital neonatal units. The question is: what are parents' attitudes towards their involvement in such decision making? A descriptive study design using in-depth interviews was chosen. During the period 1997-2000, 20 qualitative interviews with 35 parents of 26 children were carried out. Ten of the infants died; 16 were alive at the time of the interview. The comparative method (grounded theory) was used to analyse the data. The analysis was carried out continuously and in parallel with data collection. Six categories were revealed by the analysis: indecision and uncertainty (ambivalence); information and communication; participate, but do not decide; seeming to be included; the parents' child; and individual consideration. The findings appear to indicate that parents agree that they should not have the final word in decisions concerning their infants' future life or death. Such a responsibility would put too heavy a burden on parents who lack the medical knowledge and the professional experience needed to make such a decision, and would be likely to lead to them experiencing strong feelings of guilt. The findings show that parents should be well informed and listened to during the whole decision-making process. Their primary concern was how nurses and physicians communicate with parents who are experiencing a crisis, and how this serious information is presented.

  10. 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.

  11. 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.

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

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    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

  13. 早产儿视网膜病变筛查分析%A Screening Study on Premature Infants with Retinopathy of Prematurity

    Institute of Scientific and Technical Information of China (English)

    钟捷; 刘三梅; 唐晶; 樊映川

    2010-01-01

    目的 探讨早产儿视网膜病变(retinopathy of prematurity,ROP)的发生率及危险因素.方法 收集2007年12月-2008年12月在四川省人民医院、成都市妇幼保健院、成都市妇产科医院住院的85例体重≤2 000 g或有严重疾病的早产儿,自出生后4~6周或矫正胎龄32周开始筛查,至周边视网膜血管化.结果 85例早产儿中,有9例发生ROP,发病率10.58%.其中出生体重<1 500 g的早产儿ROP发病率为17.07%,孕周<30周的早产儿ROP发病率为40%.结论 低体重、胎龄小、吸氧为早产儿发生ROP的重要危险因素;尽早进行眼底筛查是早期发现、诊断及治疗ROP的关键.

  14. 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...

  15. 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.

  16. 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.

  17. 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…

  18. A CLINICAL STUDY ON INCIDENCE OF RETINOPATHY OF PREMATURITY CHANGES IN PRETERM INFANTS AND ASSOCIATED RISK FACTORS IN A TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Sneha

    2014-03-01

    Full Text Available OBJECTIVE: This is a hospital based, prospective clinical study on incidence of retinopathy of prematurity changes in preterm infants and associated risk factors. METHODS: Neonates with gestational age <37wks and/ or birth weight ≤ 2500gms born over one year period were examined by indirect ophthalmoscopy between 2 to 4 weeks after birth, and followed up till retinal vascularization was complete. Maternal and neonatal risk factors were noted and data analyzed by statistical package SPSS-15. RESULTS: 100 babies were thus examined. The overall incidence of retinopathy of prematurity was 40%, 22%in babies’ ≤34wks of gestation and 52% in babies with a birth weight1500-2000g. Majority were in stage 2. Gestational age (<32weeks, Birth weight (<1500g, RDS, surfactant therapy, PDA were found to be risk factors. CONCLUSION: Meticulous fundus examination with indirect ophthalmoscopy in all preterm babies with gestational age<37weeks and birth weight ≤ 2500gms is essential noninvasive method for early detection of ROP and its progression. Screening should be intensified in the presence of factors like RDS, oxygen administration and presence of PDA

  19. 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.

  20. 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.

  1. 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

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

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    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.

  3. 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.

  4. 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.

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

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    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.

  6. 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.

  7. 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

  8. 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

  9. 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. 

  10. 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.

  11. 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...

  12. Safety and efficacy of delayed umbilical cord clamping in multiple and singleton premature infants - A quality improvement study.

    Science.gov (United States)

    Ruangkit, C; Moroney, V; Viswanathan, S; Bhola, M

    2015-01-01

    To evaluate the safety and efficacy of a quality improvement (QI) program of delayed umbilical cord clamping (DCC) in multiple and singleton preterm infants born at our center. After DCC protocol implementation, compliance and success rate were assessed. Clinical outcomes of selected 150 preterm infants <34 weeks gestation born in 2014 after protocol implementation (Epoch II) were compared to those of preterm infants born in 2013 before protocol implementation (Epoch I). Overall protocol compliance rate was 92% (246/267). DCC was successfully performed in 77% (205/267) after protocol implementation. There were higher multiple births in Epoch II compared to Epoch I (27.3 vs. 15.3% , p <  0.01). At birth, infants in Epoch II had significantly decreased need for intubation in delivery room (23.3 vs. 39.3% , p <  0.01), had higher hematocrit (46.4±7.3 vs. 44.0±7.1% , p <  0.01) and less metabolic acidosis (base excess -4.1±2.7 vs. -5.3±4.2 mmol/L, p <  0.01) compared to those born in Epoch I. During hospital stay, fewer infants in Epoch II received rescue surfactant therapy (45.3 vs. 56.7% , p = 0.05), medical treatment for PDA (6.7 vs. 16.6% , p = 0.04%) and red blood cell transfusions (20.7 VS. 32.0% , p <  0.01) compared to Epoch I. Protocol-guided practice of DCC for 30 seconds can be safely performed in multiple and singleton preterm infants. In addition to higher initial hematocrit, infants in our QI project had lower need for delivery room resuscitation and less metabolic acidosis at birth. We also observed decreased need for rescue surfactant therapy, medical treatment for PDA and red blood cell transfusions after DCC protocol implementation.

  13. 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.

  14. [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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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....

  1. 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

  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. [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.

  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. 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

  6. 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…

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. Study on Temperament Characteristics of Premature Infants and Relative Influencing Factors%早产儿的气质特征及其影响因素研究

    Institute of Scientific and Technical Information of China (English)

    陈卫红; 王慧文; 汪颖烨

    2011-01-01

    目的 了解衢州市早产儿气质特征以及气质维度和气质类型的相关影响因素.方法 选择衢州市接受儿童系统管理的早产儿170人和正常足月儿154人,应用《5 ~11月要儿气质问卷》,以及自行设计的出生和家庭养育环境调查表,进行气质评定和相关因素调查.结果 早产儿气质类型以中间型为主,其次是困难型.不同胎龄早产儿气质维度中适应性和持久性得分有差异.家庭经济水平影响早产儿气质的节律性、心境、适应性和反应阈等多个维度,母亲文化程度影响活动水平和持久性,胎龄和出生窒息影响趋避性,出生体重影响节律性,母亲年龄、喂养方式和出生时肺发育异常影响注意分散.早产儿困难型气质类型的影响因素有胎龄、分娩方式和出生后放保温箱.结论 早产胎龄越小适应性越慢,且持久性短暂.胎龄小、难产且出生后需要放保温箱的早产儿容易出现困难型气质.母亲文化程度高,家庭经济条件比较好,重视孕期保健,有利于儿童形成良好的气质.%Objective To investigate the temperament characteristics, dimensions and types of premature infants and relative factors in Quzhou. Methods Subjects including 170 premature infants and 154 term infants who were managed in Quzhou children system, accepted temperament assessment and investigation of influencing factors with the "5-11 Month Old Infant Temperament Questionnaire" and the self - designed questionnaire about birth and family nurture environment. Results We found that the most predominant temperament characteristic of premature infant was intermediate type, which was followed by difficult type. The adaptability and persistence scores of temperament dimension were various across different gestational age groups. And It was found that family economic level effected several aspects of temperament dimensions; mothers' educational level was related to the degrees of activity and

  14. 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

  15. NURSING AND CARING OF THE PREMATURE INFANTS

    DEFF Research Database (Denmark)

    Aagaard, Hanne; Jørgensen, Eva; Hall, Elisabeth

    2006-01-01

    The study is a control quasi-experimental intervention. The investigation is a multi-centre study, involving two different and similar Neonatal Care Units on University Hospital in DK. The aim is to investigate which effects systematically intervention of Newborn Individualized Developmental Care...

  16. 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.

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

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    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.

  18. Sleep deprivation, pain and prematurity: a review study

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    Kelly Cristina Santos de Carvalho Bonan

    2015-02-01

    Full Text Available The aim was to describe current reports in the scientific literature on sleep in the intensive care environment and sleep deprivation associated with painful experiences in premature infant. A systematic search was conducted for studies on sleep, pain, premature birth and care of the newborn. Web of Knowledge, MEDLINE, LILACS, Cochrane Library, PubMed, EMBASE, Scopus, VHL and SciELO databases were consulted. The association between sleep deprivation and pain generates effects that are observed in the brain and the behavioral and physiological activity of preterm infants. Polysomnography in intensive care units and pain management in neonates allow comparison with the first year of life and term infants. We have found few references and evidence that neonatal care programs can influence sleep development and reduce the negative impact of the environment. This evidence is discussed from the perspective of how hospital intervention can improve the development of premature infants.

  19. 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.

  20. Study on intellectual development and temperament behavior of premature infants in their infant period%早产儿在婴幼儿时期智能发育和气质行为的队列研究

    Institute of Scientific and Technical Information of China (English)

    黄静; 毛萌; 杨慧明; 康琳敏; 杨凡; 唐章慧

    2013-01-01

    Objective To analyze the differences among the intellectual development and temperament behavior of premature infants and those of normal full-term infants in their infant period, so as to explore the law to promote the health growth of the intelligence and temperament behavioral of premature infants. Methods 68 cases of premature infants appropriate for gestational age and 102 cases of normal full-term infants were randomly selected for the establishment of cohort as the research subjects. The data of their developmental screening test (DST) at 12 months old were reviewed; and they respectively received Gesell infant intellectual development check at 18, 24, 30 months old, and their parents also received Carey infant temperament questionnaire (RITQ), and received Achenbach infant behavior checklist at 30 months old of the infants. A longitudinal analysis was performed on the differences among the results of the intellectual developments in 5 functional areas(applicability, large motion, fine motion, language, personal-social competence) with the increase in ages and the results of temperament checklist and dimension. The Student's t test, variance analysis, SNK-q test was used as statistical methods, and χ2 analysis was used for the comparison among the constituent ratios of segmental information. Results Compared with the full-term infants, the developmental quotient(DQ) and mental index(MI) at 12-month-old, as well as the DQ of five major functional areas at 18-month-old, 24-month-old and 30-month-old of the premature infants were lower; for the premature infants with corrected gestational age, their adaptability, large motion, fine motor and language at 18-month-old was statistically significant (P<0.05); their adaptability and language at 24-month-old were weaker than those of the full-term infants (P<0.05);and their language and personal social ability were weaker than those of the full-term infants (P<0.05). On aspect of temperament, each temperament

  1. 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.

  2. 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

  3. Qualitative study of breastfeeding experience of mothers with premature infants underwent mother - infant separation%母婴分离早产儿母亲母乳喂养体验的质性研究

    Institute of Scientific and Technical Information of China (English)

    周明芳; 刘蕾; 王楠; 晏玲; 藤本荣子

    2011-01-01

    Objective To describe the breastfeeding experience of mothers who had premature infants in neonatal intensive care unit, so as to provide theoretical preferences for effective breastfeeding guideline. Methods Using qualitative research method,a total of 18 mothers who had premature infants 1 week after discharge from neonatal intensive care unit were investigated by in - depth interview. Telephone interview was conducted 2 weeks and one month after discharge. Results After the discharge,the mothers who had premature infants experienced several puzzles,including the difficulty of direct breastfeeding,the confusion of breeding uncertainty,insufficient of breast milk,and lack of breeding knowledge. Conclusion The mothers who had premature infants experienced difficulties and puzzles in breastfeeding after discharge from hospitals. It is important to enhance the nursing instruction about the physical character of premature infants, breast breeding knowledge,and breast breeding skills,which is an important issue currently facing of the obstetric and pediatric department.%目的 了解新生儿重症监护室出院早产儿母亲的母乳喂养体验,为制订有效的母乳喂养指导方案提供依据.方法 采用质性研究法,对18名新生儿重症监护室早产儿母亲在早产儿出院后1周内通过家庭访问进行深度访谈,出院第2周、1个月时进行电话访谈.结果 母亲在早产儿出院后的母乳喂养中经历了直接母乳喂养的困难、哺乳不确定性的困惑、母乳不足的烦恼以及哺乳知识的缺乏所带来的困惑.结论 母婴分离早产儿母亲在早产儿出院后遭遇了母乳喂养方面的困难与不安,加强母亲对早产儿生理特征、母乳喂养知识、母乳喂养技巧的护理指导是产科和儿科当前面临的重要课题.

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

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    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.

  5. 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.

  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. 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...

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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

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

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    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.

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

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    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. 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

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

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    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.

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

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    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.

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

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    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.

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

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    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.

  2. Longitudinal study on sleep/wake patterns of premature infants%早产儿睡眠/觉醒模式发展轨迹的纵向研究

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    张风华; 黄小娜; 乔秀英; 王绘新; 许茜

    2014-01-01

    infants aged from birth to 4 months corrected gestational age.Methods31 preterm infants from the NICU of Qingdao Women & Children's Hospital were enrolled from November in 2011 to August in 2013. Data was collected with the use of actigraphy over 3 days continuously about 60 hours on 2 days, 10 days, 1, 2, 3, 4 months corrected gestational age after birth respectively.Results The 24 h sleep duration and daytime sleep duration during the first four months corrected gestational ages decreased with age(F=16.782,P<0.001;F=3.740,P<0.01), while the nocturnal sleep duration increased slowly(F=42.055, P<0.001). Compared with 2 days after birth, the 24 h sleep duration and daytime sleep at four months corrected gestational ages decreased 4.80 h and 5.19 h respectively, the nighttime sleep increased 1.25 h. The differences were all statistically significant(t=6.01,P<0.001;t=10.02,P<0.001;t=3.51,P<0.05). The reduction of the 24 h sleep duration was due to the shrink of daytime sleep duration, which was especially tremendous in the first 2 months. For preterm infants, daytime sleep was dominated in the first 2 months, and later evolved to nocturnal sleep predominately. The numbers of naps changed slowly within the first 4 months corrected gestational ages, at 3-4 times each day. There were no significant differences between adjacent ages. The numbers of nighttime awakening after birth decreased with age(F=15.50,P<0.01). There was no statistically different between adjacent ages. The ability of the longest continuous sleep strengthened gradually. The longest sleep duration at 4 months was more longer than that at 2 days(t=3.83, P<0.01). The longest continuous sleep duration did not change statistically between adjacent ages. Later bedtime and earlier morning wake time appeared as the infants growing. There was no sex statistical differences in the indexes mentioned above.Conclusion The developmental trend of sleep/wake pattern in premature infants show catching up and the sleep

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

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    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

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

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    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. 

  5. A possible role of the Infant/Toddler Sensory Profile in screening for autism: a proof-of-concept study in the specific sample of prematurely born children with birth weights <1,500 g.

    Science.gov (United States)

    Beranova, Stepanka; Stoklasa, Jan; Dudova, Iva; Markova, Daniela; Kasparova, Martina; Zemankova, Jana; Urbanek, Tomas; Talasek, Tomas; Luukka, Pasi; Hrdlicka, Michal

    2017-01-01

    The objective of this study was to explore the potential of the Infant/Toddler Sensory Profile (ITSP) as a screening tool for autism spectrum disorders (ASD) in prematurely born children. Parents of 157 children with birth weights value is value is ≥45.5 and the z-score of the Sensation Seeking subscale of ITSP is ≥1.54, then the screening is positive; 3) otherwise, the screening is negative. The use of CSBS-DP-ITC in combination with the Sensation Seeking subscale of the ITSP improved the accuracy of autism screening in preterm children.

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

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    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

  7. 早产儿支气管肺发育不良危险因素前瞻性队列研究%Prospective cohort study on risk factor for bronchopulmonary dysplasia in the premature infant

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    钟美珍; 白海涛; 刘登礼; 王礼周; 庄德义

    2011-01-01

    目的 探讨早产儿支气管肺发育不良(BPD)的发生率及危险因素.方法 应用前瞻性队列研究的方法,对我院产科2009年1月至2010年6月出生的所有活产早产儿进行研究,统计BPD发生率,并分析相关危险因素.结果 (1)共有425例早产儿入组研究,其中男266例,女159例;胎龄(33.9±2.4)周(26~ 36周);出生体重(2038±660) g(770 ~3150 g),其中极低出生体重儿85例,超低出生体重儿7例.发生BPD 45例,发生率10.6%,死亡(包括自动出院撤机后死亡)7例,BPD病死率15.6%.BPD患儿胎龄≤32周36例(80.0%),出生体重<1500 g 29例(64.4%).(2)多因素Logistic回归分析显示胎龄<30周(OR =3.10)、出生体重<1500 g(OR=2.29)、感染性肺炎(OR =2.74)、动脉导管未闭(OR =2.12)、机械通气(OR =9.57)、H2受体抑制剂( OR=1.36)、应用碳青霉烯类抗生素>4周(OR=2.59)是BPD发病的独立危险因素(P均<0.05).结论 早产儿发生BPD的独立危险因素较多,需要综合防治才能有效控制BPD的发生.%Objective To investigate the incidence and the risk factors for bronchopulmonary dysplasia ( BPD) in premature infants in Xiamen. Methods This was a single-center prospective clinical cohort study. A total of 425 premature infants in the first hospital affiliated to Xiamen university, between January 1,2009 and June 01,2010, were enrolled. Measurements of the demographic and potential risk factors reflecting illness severity were performed. Results ( 1 ) Among 425 cases of premature infants, 266 (62.6%) cases are male, and 159 (37.4%) cases are female, with average gestational age ( 33. 9 ± 2. 4) wk, and birth weight 750 ~ 2800 g, with an average of (1820 ± 462 ) g, of which 97 cases were of very low birth weight infants. Among these infants, there were 45 BPD cases with the incidence of 10. 6% , 7 of them were death cases (including the deaths after automatic discharge from hospital and weaning mechanical ventilation) with the rough

  8. 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

  9. 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.

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

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    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.

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

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    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.

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

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    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.

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

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    Gaurav Sanghi

    2014-01-01

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

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

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    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.

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

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    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

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

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    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.

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

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    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

  18. [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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. [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

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

    Directory of Open Access Journals (Sweden)

    Figueras-Aloy Jose

    2008-12-01

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

  7. 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.

  8. 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

  9. Clinical study of early intervention on neuromotor and cognitive development of premature infant%早期干预对早产儿神经发育影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    李后权; 姚宏智; 龙吟云

    2012-01-01

    Objective To explore the clinical effect of early intervention on neuromotor and cognitive development of premature infants. Methods A total of 80 premature infants were recruited into study and randomly divided into observation group and control group, each group contain 40 cases. In the observation group, the premature infants received early intervention and control group received routine care. The neurodevelopment of premature infants between two groups were compared. Results Scale determination by the CDCC (child development center of China) found in 6, 12, 18, and 24 month of age, the average scores of mental development index (MDI) and psychomotor development index (PDI) were significantly higher in early intervention group than those of control group. In addition to the MDI in 6month of age was no significant difference between two group (P > 0.05), and the rest months of age the differences were statistically significant (all P < 0.05). Gesell test intervention group show better clinical behavior in observation group better than that of control group, there was significant different between two groups (P < 0.05). Conclusion Early intervention of health care guidance and family to participate could promote neuromotor development of the premature infants.%目的 探讨运用早期干预的方法对早产儿神经发育的影响.方法 选取2008年1月~2009年1月我院门诊接诊的早产儿80例,将其随机分为观察组及对照组,每组各40例,观察组采取医护指导与家庭干预相结合的模式,对照组采取常规的养育方式,比较两组早产儿的神经发育情况.结果 经CDCC(child development center of China)量表测定比较发现在6、12、18及24月龄时,观察组早产儿的智力发育指数(MDI)及运动发育指数(PDI)均高于对照组,除6月龄时两组早产儿智力发育指数比较差异无统计学意义外(P > 0.05),其余各月龄差异均具有统计学意义(均P < 0.05);Gesell发育量表检测,观

  10. 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).

  11. 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

  12. 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.

  13. Effects of Probiotic Lactobacillus Reuteri (DSM 17938 on the Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Premature Infants

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    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.

  14. 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

  15. 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...

  16. 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.

  17. Study on analgesic effects of nonpharmacologic interventions in fundus oculi screening of premature infants%非药物干预方法在早产儿眼底筛查中的镇痛效果研究

    Institute of Scientific and Technical Information of China (English)

    周红; 肖甜甜; 巨容

    2015-01-01

    目的:探讨不同非药物干预方法对早产儿眼底筛查的镇痛效果。方法选择2013年12月至2014年3月在成都市妇女儿童中心医院新生儿科住院,并且需首次进行眼底筛查的160例早产儿为研究对象。将其按照入院顺序号随机分为4组:非营养性吸吮(NNS)组、宫内体位支持组、联合组及对照组,每组各40例。分别在早产儿眼底筛查前、后2 min 采用新生儿疼痛量表(NIPS)对受试者进行疼痛评分,并比较各组评分差异。本研究遵循的程序符合成都市妇女儿童中心医院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人知情同意,并与监护人签署临床研究知情同意书。各组患儿胎龄、出生体质量及首次眼底筛查纠正胎龄比较,差异均无统计学意义(P >0.05)。结果各组早产儿在接受筛查前,NIPS 评分结果均为0分。在筛查后,各组 NIPS 评分结果均为正值。对照组早产儿筛查后NIPS 评分显著高于筛查前,且差异有统计学意义(P 0.05)。结论′早产儿对疼痛敏感,NNS 及宫内体位支持对早产儿均有明显镇痛作用,二者联合的干预方法具有协同镇痛作用。对进行眼底筛查的早产儿需进行疼痛管理。%Objective To study the analgesic effects of different nonpharmacological pain-relieving interventions for fundus oculi screening of premature infants.Methods A total of 1 60 premature infants who were hospitalized and need to be done fundus oculi screening for the first time in department of Neonatal,Chengdu Women′s & Children′s Central Hospital from December 2013 to March 2014 were chosen as study subjects.They were randomly divided into four groups according to the order of admission:non-nutritive sucking (NNS)group,intrauterine position support group,combination group of both and control group,each group had forty premature infants.According to Neonatal Infant Pain Scale (NIPS

  18. Retinopathy of prematurity and risk factors: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Angell Linda

    2005-06-01

    Full Text Available Abstract Background Increased survival of extremely low birth infants due to advances in antenatal and neonatal care has resulted in a population of infants at high risk of developing retinopathy of prematurity (ROP. Therapeutic interventions include the use of antenatal and postnatal steroids however, their effects on the severity of ROP is in dispute. In addition, it has not been investigated whether severe ROP is due to therapeutic interventions or due to the severity of illness. The aim of the present study was to assess the association between the incidence of severe retinopathy of prematurity (greater than stage 2 – International classification of ROP and mechanical ventilation, oxygen therapy, gestational age, antenatal and postnatal steroids in extremely low birth weight infants. Methods Neonates admitted to the neonatal intensive care unit in Lansing, Michigan, during 1993–2000 were followed to determine factors influencing the development of severe retinopathy of prematurity. Ophthalmologic examinations were started at 6 weeks and followed until resolution. We used logistic regression to estimate the relative risk (odds ratio associated with risk factors of ROP. Results Of the neonates with ≤ 1500 g birth weight, admitted to the neonatal intensive care unit, 85% (616/725 survived. Severe retinopathy of prematurity was detected in 7.8% of 576 neonates who had eye examinations. Neonates of lower gestational age (≤ 25 weeks and 26–28 weeks had an increased odds ratio of 8.49 and 3.19 for the development of severe retinopathy of prematurity, respectively, compared to those 29 weeks and older. Late postnatal steroid treatment starting after 3 weeks of life showed 2.9-fold increased odds ratio, in particular administration for two weeks and more (OR: 4.09, 95% CI: 1.52–11.03. With increasing antenatal steroids courses the risk of severe retinopathy of prematurity decreased, however, it was not significant. Lower gestational age

  19. 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

  20. Study on the Effects of Prone Nursing on Heart and Lung Function and Sleep in Premature Infants%俯卧护理对早产儿心肺功能及睡眠的影响研究

    Institute of Scientific and Technical Information of China (English)

    刘瑛

    2015-01-01

    目的:分析不同体位护理对早产儿心肺功能及睡眠影响。方法选取90例早产儿作为研究对象,随机分为 A、B、C 三组各30例;A 组给予俯卧护理,B 组给予侧卧护理;C 组给予仰卧护理;比较三组早产儿心肺功能及睡眠情况。结果A 组、B 组心率、呼吸均明显好于 C 组,睡眠时间长于 C 组,且 A 组略好于 B 组。结论俯卧护理有助于改善早产儿心肺功能,提高睡眠质量,护理期间应及时调整护理角度以及患儿睡眠姿势,以确保早产儿健康发育。%Objective To analyze the effects of prone nursing on heart and lung function and sleep in premature infants. Meth-ods 90 premature infants were as the research objects,were randomly divided into three groups(group A,B and C),30 cases in each group. Premature infants in group A were given prone nursing,premature infants in group B were given lateral prone nursing,premature infants in group C were given supine nursing. heart and lung function and sleep in the three group were compared. Results Heart rate and breathing in group A and B was significantly better than group C,the sleep time was longer than that in group C,and group A was better than B group. Conclusion Prone nursing helps to improve heart and lung function of premature infants,improve sleep quality, should adjust the point of nursing and children sleep posture during nursing,to ensure the healthy development of premature infants.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. Comparison of the Effects of Attachment Training for Mothers on the Behavioral Responses of Premature Infants: A Randomized Clinical Trial

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    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.

  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. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  17. 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.

  18. 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.

  19. 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.

  20. A Clinical study on the Safety Evaluation of Blood Ammonia Detection in Parenteral Nutrition for Premature Infants%血氨检测对早产儿胃肠外营养安全评估的临床研究

    Institute of Scientific and Technical Information of China (English)

    冯彬彬; 肖娟; 曹蓓; 王鷁超; 谭浩; 李素萍; 曾云清; 彭湘莲; 龚瑾; 侯皓

    2015-01-01

    目的:探讨血氨检测在早产儿胃肠外营养安全评估的价值,为早产儿早期营养支持与诊治提供临床检测依据。方法:随机选取2012年7月1日~2014年6月30日在我院妇产科出生后24小时内需胃肠外营养的早产儿56例作为实验组,选取同期出生的24例无需胃肠外营养的早产儿作为对照组。对照组患儿给予早产儿配方奶粉或母乳喂养,实验组给予等量的胃肠外营养支持。分别测定两组早产儿治疗前、治疗后2d、7d 及出院时的血氨、尿素氮、胆红素和前白蛋白等生化指标数据,比较实验组与对照组早产儿治疗期间的血氨水平变化差异。结果:两组早产儿治疗前临床资料无明显差异,治疗后第2天实验组与对照组早产儿生化指标中血氨水平和胆红素出现显著统计学差异;治疗第7天实验组与对照组早产儿生化指标中血氨水平和尿素氮指标有显著性差异。在患儿出院时实验组与对照组早产儿的血氨、尿素氮、前白蛋白、胆红素等生化指标均无明显差异。结论:早产儿胃肠外营养支持与母乳喂养早产儿的血氨指标具有明显的差异,可将血氨检测作为早产儿胃肠外营养支持安全评估的评价指标。%Objective To evaluate the safety of blood ammonia detection in parenteral nutrition for premature infants so as to provide the clinical detection basis for early nutritional support and treatment of premature infants. Methods 56 premature infants who needed parenteral nutrition within 24 hours after their birth were randomly selected in our hospital from July 1st, 2012 to June 30th, 2014 and set as the experimental group, whereas 24 cases of premature infants born in the same period with-out the need of parenteral nutrition were set as the control group. The preterm infants in the control group were given powdered formulas or breastfed,while the infants in experimental group were given the

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  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. Study of refractive development state and clinic affective factors in premature infants without retinopathy during their early life%早产儿生后第一年屈光发育及其影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    童梅玲; 王淼; 魏宁; 吴广强; 张桂英; 薛子颖

    2011-01-01

    [Objective] To explore the development of the refractive status and clinical risk factors in premature infants without retinopathy during their first year after birth. [Methods] 94 medical health premature infants at 6 months of corrected age during January 2008 to March 2010 were selected, and their refractive development to 12 months were tracked up. Refraction was determined at 6 months, 9 months and 12 months old by Suresight Welch. The impact of gestational age and birth weight on refractive status of premature infants were analyzed. [Results] High incidence of astigmatism was found on preterm infants, and it declined with the age increasing. At 9 and 12 months old of corrected age, birth weight was an influencing factor of refractive error in premature infants. At 12 months old of corrected age, gestational age was another important influencing factor of refractive error in premature infants. [Conclusions] During the first year after birth, refraction of premature infants is changeable. The incidence of ametropia, especially the degree of astigmatism, is decreased with age increasing. Birth weight and gestational age both are important factors which can influence refraction of premature infants.%[目的]探讨无视网膜病变早产儿在出生后第一年屈光发育特征和影响其发育的临床因素,了解早产儿的早期视觉发育.[方法]选取2008年12月-2010年3月在本院随访的早产儿94人,从校正月龄6月龄起跟踪随访至12月龄的屈光发育.分别检测6月龄、9月龄、12月龄时屈光状态,分析不同出生体重、胎龄对眼屈光状态发育的影响.[结果]早产儿远视和近视的发生率在不同月龄组间差异无统计学意义,而散光的发生率及程度均较高,分别为6月龄(55%),9月龄(22%),12月龄(10%),差异具有统计学意义,随年龄增长散光呈下降趋势.早产儿校正9月龄和12月龄组显示出生体重影响着屈光不正发生率,在12月龄时显示胎龄越小屈光

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

    Science.gov (United States)

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

  9. 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....

  10. 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…

  11. 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

  12. 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...

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. Clinical studies of citron acid caffeine and aminophylline in treatment of premature infant apnea%枸椽酸咖啡因与氨茶碱治疗早产儿呼吸暂停的临床研究

    Institute of Scientific and Technical Information of China (English)

    林春繁; 黄珊华

    2015-01-01

    Objective To investigate clinical efficacy of citron acid caffeine and aminophylline in the treatment of premature infant apnea.Methods 72 cases of premature infant apnea in our hospital from June 2013 to July 2015 were selected as study group.According to the random digit grouping method, they were divided into observation group (36 cases), treated by citron acid caffeine and control group (36 cases), treated by aminophylline.Clinical curative effect and adverse reactions of two groups were analyzed.Results Three days after drug treatment, the effective rate of observation group(94.45%) and 7 days after drug treatment, the effective rate of observation group (97.22%) were significantly higher than that of control group, (P<0.05);The clinical total adverse reaction rate of observation group ( 8.33%) was significantly lower than the control group (44.44%), (P<0.05).Conclusions Compared with aminophylline, citrate caffeine in the treatment of premature infant apnea has better clinical curative effect, less adverse reaction.%目的 总结分析枸橼酸咖啡因与氨茶碱在早产儿呼吸暂停治疗中的应用效果. 方法 选择2013年6月至2015年7月期间我院产科发生的72例早产儿呼吸暂停病例为研究对象,根据随机数字分组法分为观察组与对照组各36例,对照组患者应用氨茶碱治疗,观察组患者给予枸橼酸咖啡因治疗,观察比较两组患儿的临床疗效与不良反应. 结果 观察组患儿用药后第3天治疗有效率94.45%以及第7天治疗有效率97.22%均明显高于对照组,差异具有统计学意义(P<0.05);观察组患儿临床总不良反应率8.33%明显低于对照组44.44%,组间差异具有统计学意义(P<0.05). 结论 与氨茶碱相比,枸橼酸咖啡因治疗早产儿呼吸暂停的临床疗效更加,不良反应更少,值得推广使用.

  2. 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

  3. 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

  4. 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...

  5. 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

  6. 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.

  7. 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.

  8. 新生儿重症监护病房中早产儿营养相关状况多中心调查974例报告%Multicenter study of the nutritional status of premature infants in neonatal intensive care unit in China: Report of 974 cases

    Institute of Scientific and Technical Information of China (English)

    早产儿营养调查协作组

    2009-01-01

    Objective Extrauterine growth restriction ir preterm infants secondary to suboptimal nutrition is a major problem in neonatal intensive care units (NICUs). This study was designed to investigate the nutritional support and growth of premature infants who were discharged from 10 tertiary NICUs in different areas in China and evaluate the effects of high risk factors on their growth. Methods Data of 1000 premature infants (100 infants from each hospital) were retrospectively collected, the data included their gestational age, the growth parameters at birth, complications, enteral and parenteral nutritional support strategies, the growth parameters at discharge and length of hospital stay from Jan. 1, 2005 to Jun. 30, 2006. The growth parameters, including body weight, length and head circumference, were evaluated according to growth curve of newborns in China with their gestational age at birth and corrected gestational age on discharge. Growth retardation was defined as less than the 10th percentile of the expected value. The risk factors which might result in growth retardation of premature infants were assessed with logistic regression. P <0.05 was considered as significant. Results Of the 1000 premature infants enrolled in this study, the data of 974 premature infants were finally eligible. The median gestational age of the 974premature infants was 32.6 (31.0-34.1) weeks and median birth weight was 1732.2 (1447.9-2030.3) g. Three hundred and seventy-eight premature infants were born at < 32 weeks of gestational age and the body weight of 285 premature infants was < 1500 g at birth. The median time for initial enteral feeding was 2.0 (1,3) days of life, 77.0% of the premature infants were fed with formulas for low birth weight, and 13.6% were fed with human milk mixed with the formulas for low birth weight. For parenteral nutrition, amino acid solutions were administered in 87.3% of premature infants and median time to begin was 2.5 (2, 3) days of life, median

  9. Comparative study of visual functions in premature pre-school children with and without retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Lígia Beatriz Bonotto

    2014-01-01

    Full Text Available Purpose: Observe whether there are differences in visual functions among premature infants with treated retinopathy of prematurity (ROP in relation to preterm infants with ROP and spontaneous regression; and among these two groups with ROP and the control group without ROP. Methods: Crosssectional observational no blind study. Premature infants were born between 06/199206/2006 and were exam between 06/200912/2010; registered in data of Hospital de Olhos Sandalla Amin Ghanem; with gestational age less than or equal to 32 weeks and 1,599 g born weigh; without ROP and ROP stages II or III, in one of the eyes, with spontaneous regression or with treatment; at least three visits during the selection period at maximum 6 months in the first exam and minimum 4 years of age in reassessment (chronological age were include. Premature that did not respond or were not located for reassessment and those that did not have conditions to do the exams were exclude. Study's groups: G1 ROP posttreatment; G2ROP postspontaneous regression; G3 without ROP (control. Visual function evaluated with visual acuity (VA, contrast sensitivity test (CST, color test (CT, eye movement, stereopsis. Results: Overall, there were 24 premature infants and 48 eyes. Normal VA: 64.28% (G1, 87.5% (G2 and 100% (G3; Normal CST: 66.67% (G1, 100% (G2 and 55.56% (G3; Normal Ishihara CT: 100% (G1 and G2 and 86% (G3; Normal Farnsworth CT: 20% (G1, 75% (G2 and 50% (G3. Normal stereoacuity: 0.00% (G1; 25% (G2 and 3.5% (G3. Strabismus: 37% (G2, 0.00% (G1 and G3. The prevalent tendency for lower response in CST and CT between the premature children in group G3 and Farnsworth color test in G1 is a curious result of this work and more study is necessary about these visual functions in older premature children. Conclusion: The visual functions showed no statistically significant difference among the groups studied.

  10. 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 ...

  11. A possible role of the Infant/Toddler Sensory Profile in screening for autism: a proof-of-concept study in the specific sample of prematurely born children with birth weights <1,500 g

    Science.gov (United States)

    Beranova, Stepanka; Stoklasa, Jan; Dudova, Iva; Markova, Daniela; Kasparova, Martina; Zemankova, Jana; Urbanek, Tomas; Talasek, Tomas; Luukka, Pasi; Hrdlicka, Michal

    2017-01-01

    Objective The objective of this study was to explore the potential of the Infant/Toddler Sensory Profile (ITSP) as a screening tool for autism spectrum disorders (ASD) in prematurely born children. Methods Parents of 157 children with birth weights tools subsequently underwent clinical examination including the Autism Diagnostic Observation Schedule. Results We used classification trees to answer the question whether ITSP (or some of its subscales) could be combined with the M-CHAT and/or the CSBS-DP-ITC or its subscales into an effective ASD screening tool. Using the CSBS-DP-ITC, overall score, and the Sensation Seeking subscale of the ITSP, we obtained a screening tool that was able to identify all of the ASD children in our sample (confirmed by cross-validation). The proposed screening tool is scored as follows: 1) if the overall CSBS-DP-ITC value is <45.5, then the screening is positive; 2) if the overall CSBS-DP-ITC value is ≥45.5 and the z-score of the Sensation Seeking subscale of ITSP is ≥1.54, then the screening is positive; 3) otherwise, the screening is negative. Conclusion The use of CSBS-DP-ITC in combination with the Sensation Seeking subscale of the ITSP improved the accuracy of autism screening in preterm children. PMID:28182143

  12. 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.

  13. 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.

  14. Retinopathy of prematurity: A study of prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Abdel H. A. A. Hakeem

    2012-01-01

    Full Text Available Background: Retinopathy of prematurity (ROP is a serious complication of prematurity treatment and can lead to blindness unless recognized and treated early. Objective: The objective was to estimate the prevalence of ROP in preterm infants in the Neonatal Intensive Care Unit (NICU, to identify the risk factors which predispose to ROP, and to assess the outcome of these cases. Materials and Methods: A ROP prospective screening survey was performed enrolling all prematures admitted to the NICU from January 2009 to December 2010, with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less. Infants whose gestational age was >32 weeks or birth weight was >1500 g were included if they were exposed to oxygen therapy for more than 7 days. A total of 172 infants (84 males and 88 females had retinal evaluation by indirect ophthalmoscopy from the fourth postnatal week and followed up periodically. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Infants who progressed to stage 3 ROP were given laser therapy. Results: Out of the studied 172 infants, 33 infants (19.2% developed ROP in one or both eyes; 18 (54.5% cases stage 1, 9 (27.3% cases stage 2, and 6 (18.2% cases stage 3. None of the studied neonates presented ROP at stages 4 or 5. The six cases diagnosed as ROP stage 3 underwent laser ablative therapy. Univariate analysis showed that there was a significant relationship between the occurrence of ROP and gestational age (P = 0.000, sepsis (P = 0.004, oxygen therapy (P = 0.018, and frequency of blood transfusions (P = 0.030. However, an insignificant relationship was found between the occurrence of ROP and sex, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, hypotension, phototherapy, duration of oxygen therapy, mechanical ventilation, and CPAP (all P > 0.05. Gestational age, sepsis, oxygen therapy, and frequency of

  15. 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.

  16. 小于2岁婴幼儿乳房早发育临床随访研究%A clinical follow-up study of premature thelarche in infants under two years of age

    Institute of Scientific and Technical Information of China (English)

    王应旻; 梁黎; 方燕兰; 傅君芬; 董关萍; 王春林

    2013-01-01

    目的 了解小于2岁婴幼儿乳房发育的临床现况及转归,分析影响乳房消退的相关因素.方法 分析2009年10月至2010年9月间因乳房早发育来我院内分泌科就诊的863例2岁以下患儿临床及实验诊断资料并进行纵向随访研究.结果 小于2岁单纯乳房早发育患儿中绝大多数(89.3%)在3周岁内消退,乳房消退平均年龄为17±6月龄;小部分(10.7%)反复或持续增大,3岁后仍不消退,极少数转变为中枢性性早熟.初诊时乳房Tanner分期和基础E2值升高与否是影响乳房消退的独立危险因素.结论 小于2岁婴幼儿乳房早发育在临床并不少见,大多呈自限性病程,3周岁内可消退,但对2岁以上乳房增大持续不消退者要定期随访.%Objective To investigate the clinical status and natural course of premature thelarche (PT) in infants under 2 years of age and to analyze the predictive factors for regression of thelarche. Methods The clinical and laboratory data of 863 infants under 2 years of age, who visited the department of endocrinology in our hospital due to PT between October 2009 and September 2010, were analyzed. A a longitudinal follow-up study was performed. Results Of the infants under 2 years of age with isolated PT, 89. 3% showed a regression before the age of 3 years (mean 17 ± 5. 6 months), 10.7% had recurrent or persistent thelarche, with no regression after the age of 3 years, and some even developed into central precocious puberty. The independent predictive factors for regression of thelarche were Tanner stage at the first visit and whether baseline estradiol level had increased. Conclusions PT in infants under 2 years of age is not rare in the clinical setting, and it usually runs a self-limited course, subsiding before the age of 3 years. However, regular follow-ups should be performed for infants aged over 2 years with persistent thelarche.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 早产儿胎龄和体重对儿童糖尿病的预测作用%Study on the Prediction Function of Gestational Age and Body Weight of Premature Infants on Diabetes in C hildren

    Institute of Scientific and Technical Information of China (English)

    陈召金; 黎见乐; 姚慧梅; 兰红霞

    2014-01-01

    目的:探究并分析早产儿胎龄和体重对儿童糖尿病的预测作用。方法回顾性分析200例早产儿的临床资料。按照早产儿的胎龄分为A1、A2、A3、A4组,根据出生体重分为B1、B2、B3、B4组,根据喂养方式分为C1、C2、C3组。跟踪随访15年后,记录早产儿儿童糖尿病的发病率。结果28~30周胎龄组早产儿儿童糖尿病发病率为80.0%,明显高于其他胎龄组;出生体重≤999 g早产儿发病率为80.0%,较其他组早产儿高;人工喂养组早产儿发病率为60.8%,明显高于其余两组(P均<0.05),具有统计学意义。结论儿童糖尿病的发病率与早产儿胎龄和出生体重密切相关。%Objective To explore and analyze the prediction function of gestational age and body weight of premature infants on diabetes in children .Methods The retrospective analysis of clinical data was taken ,in-cluding 200 cases of premature infants .According to their gestational age ,they were divided into A1,A2,A3, A4 four groups,with B1 ,B2,B3,B4 four groups according to their birth weight ,C1,C2,C3 three groups accord-ing to the feeding patterns .After a follow-up visit for 15 years,records were written down on the incidences of diabetes in these children .Re sults The incidence of diabetes was 80%in group of premature infants with 28~30 weeks'gestational age ,significantly higher than other age groups .So was the morbidity rate of those with birth weight ≤999g,which accounted for 80.0%.The morbidity rate of premature infants ,who were treated with arti-ficial feeding was 60.8%,significantly higher than the other two groups (P<0.05).Besides,the morbidity rate in group of infants with non-nutritive sucking accounted for 50 .9%.Conclusion The incidence of diabetes in children is closely related to the gestational age and birth weight of these premature infants .

  2. 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.

  3. 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.

  4. 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 ...

  5. 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 ...

  6. Extrauterine growth retardation in premature infants and the risk factors:a retrospective study%早产儿宫外生长迟缓发生情况及相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    柳洁; 肖绪武; 刁敬军; 王莉; 侯莹

    2011-01-01

    Objective To study the incidence and the risk factors of premature neonates associated with extrauterine growth retardation (EUGR). Methods 184 premature neonates born in the Maternal and Children's Hospital, Dalian in 2008 were monitored the weights. The incidence of EUGR was calculated and logistic regression analysis was applied to investigate the risk factors correlating with EUGR. Results By weight, the incidence of intrauterine growth restriction retardation (defined as measured growth parameters < 10th percentile on the growth curves, IUGR) of the 184 infants was 20. 1% on birth, the incidence of postnatal growth retardation was 46. 2% at discharge. The risk factors correlating with EUGR were low gestational age ( OR = 6. 62 ), low birth weight ( OR = 24. 02), intrauterine growth restriction ( OR = 3. 56), the complications after birth ( OR = 2. 14), P < 0. 05. Conclusion The causes of EUGR are muti-factorial, the risk factors for EUGR were low gestational age, low birth weight, intrauterine growth restriction on birth, and the complications after birth.%目的 探讨早产儿宫外生长迟缓(EUGR)发生情况及相关危险因素.方法 选择本院2008年出生的早产儿,生后进行体重监测,分析EUGR发生情况,应用Logistic多元回归分析EUGR的相关危险因素.结果 184例早产儿出生时以体重计,宫内生长受限(低于同胎龄第10百分位点,IUGR)的发生率20.1%,出院时EUGR的发生率46.2%.出院时表现为EUGR的患儿围产期有关的危险因素包括低胎龄(OR=6.62)、低出生体重(OR=24.02)、出生时IUGR(OR=3.56)及生后并发症(OR =2.14),P均<0.05.结论 EUGR的发生与多因素有关,其相关的危险因素有低胎龄、低体重、IUGR及住院期间并发症.

  7. The Perceived Needs of Maine Parents of Premature Children for Services and Supports: A Retrospective Longitudinal Study

    Science.gov (United States)

    McPhee, Karen Boulos

    2010-01-01

    The purpose of the study was to examine the perceived needs and correlates of Maine parents of premature infants related to the chronological distance from the NICU. The study focused on identifying the perceived service needs of parents of premature children and how these needs changed over time, revealed the relationships between perceived…

  8. 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.

  9. 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 ...

  10. 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.

  11. Study on the effects of early system intervention to intelligence and physical growth of premature infants%早期系统干预对早产儿智能及体格发育的影响

    Institute of Scientific and Technical Information of China (English)

    梁茂萍; 赖卫文; 李美清; 吴国清; 李文珍

    2011-01-01

    Objective To explore the effects of early system intervention to intelligence and physical growth of premature infants. Methods 179 cases of premature low birth weight infants were randomly divided into intervention group of 93 cases, 86 cases in control group, premature children of two groups had regular physical examinations and health guidance, the intervention group regularly accepted early intervention from the 42nd day after birth. In correcting age as 1 year old, babies of two groups were measured in length and weight, assessment of their intelligence by belle infant development scale. Results The Mental development index (MDI), psychomotor development index (PDI) of intervention group were higher than those of control group, there was a significant difference (P< 0.05), the weight, height development indicators of both groups had no significant difference (P > 0.05) .Conclusion Early intervention to premature children can promote their intellectual development.%目的 探讨早期干预对早产儿智能及体格发育的影响.方法 将179例早产低体重儿随机分为干预组93例和对照组86例;两组早产儿均定期进行体格检查及保健指导,干预组从42天始定期接受早期干预.两组婴儿均于纠正年龄1岁时进行体重、身长测定及用贝莉婴幼儿发育量表进行智能评估.结果干预组智能发育指数(MDI)[(113.4±15.5)vs(102.4±19.4)]、运动发育指数(PDI)[(89.7±13.1)vs(84.4±15.4)]均明显高于对照组,差异有显著性(P<0.05);两组体重生长发育指标比较差异无显著性(P>0.05).结论对早产儿进行早期干预,可促进其智能发育.

  12. 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.

  13. A comparative study on pathogenic characteristics of premature infants and full term neonates with infection in NICU%NICU早产儿与足月新生儿感染病原菌特性对比研究

    Institute of Scientific and Technical Information of China (English)

    黄桂芳; 李金华

    2012-01-01

    目的:比较NICU早产儿与足月儿感染病原菌分布及耐药情况,指导临床合理用药.方法:选取因感染在NICU住院的患儿100例,按照孕龄分为两组:足月组与早产组,每组均为50例.每个患儿应用常规方法分离培养及鉴定病原菌,并予以K-B法药敏试验.比较组间的病原微生物及药敏试验资料.结果:足月组共检出病原菌213株,其中革兰阴性菌(G-)129株,占60.56%,革兰阳性菌(G+)64株,占30.05%,真菌20株,占9.39%;而早产组共检出病原菌297株,其中G-菌94株,占31.65%,G+菌157株,占52.86%,真菌46株,占15.45%(P值均<0.05).足月组检出前5位病原菌为克雷伯菌属、凝固酶阴性葡萄球菌、不动杆菌、铜绿假单胞菌和大肠埃希菌;而早产组为铜绿假单胞菌、金黄色葡萄球菌、肠球菌属、真菌和克雷伯菌属.足月组病原菌对抗菌药物的耐药率明显较早产组低(P值均<0.05).结论:NICU早产儿与足月儿导致感染的病原菌分布特点及耐药性均有差异.%Objective: To compare the pathogenic distribution and drug resistance between premature infants and full term neonates with infection in neonatal intensive care unit (NICU) , direct rational drug use in clinic. Methods: A total of 100 hospitalized infants because of infection were selected from NICU in the hospital, then they were divided into full term group and premature labor group according to gestational age. Routine separation, culture, and identification of pathogens were conducted in each infants, and drug sensitive test was performed by K-B method. The data of pathogenic microorganisms and drug sensitive test were compared between the two groups. Results; A total of 213 strains of pathogenic bacteria were detected in full term group, including 129 strains of Gram negative bacteria (60.56%) , 64 strains of Gram positive bacteria (30.05 %) , and 20 strains of fungus (9. 39%) . A total of 297 strains of pathogenic bacteria were

  14. 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

  15. 孕妇牙周炎对早产低体重儿的影响研究及分析#%Study and Analysis of the Effect of Pregnant Women with Periodontitis on Premature Birth and Low Birth Weight Infants

    Institute of Scientific and Technical Information of China (English)

    孟卫东; 王瑞平; 张立巧; 陈志岭; 李巧磊

    2016-01-01

    Objective: To investigate the effect of pregnant women with periodontitis on premature birth and low birth weight.Methods:Randomly selected Xingtai City,the Third Hospital of stomatology in 2008 July to 2013 February treatment of pregnant and lying in women as the object of study,including pregnancy found suffering from periodontitis and timely treatment (group 1),found during pregnancy periodontitis and active treatment (GroupⅠ),pregnancy with periodontitis without treatment or treatment is not complete (GroupⅢ),pregnancy and pre pregnancy were not suffering from periodontitis of healthy pregnant women (Group IV) four groups,200,to carry out the questionnaire and oral examination,compared with four groups of maternal neonatal outcomes.Results:There was no significant difference in the rate of preterm birth and low birth weight infants (P>0.05),and the rate of preterm birth and low birth rate in group B was significantly lower than that in groupP<0.05.Conclusion:Pregnancy with periodontitis without active treatment or treatment is not proper,prematurity and low birth weight infants is extremely easy to occur,therefore,we should strengthen during pregnancy oral health instruction,the inclusion of oral health care in promoting the eugenics,minimize adverse pregnancy.%目的:探讨孕妇牙周炎对早产低体重儿的影响。方法:随机抽取邢台市第三医院口腔科2008年7月到2015年2月就诊的孕产妇作为研究对象,包括孕前发现患有牙周炎并及时治疗(Ⅰ组)、孕期发现牙周炎并积极治疗(Ⅱ组)、孕期患牙周炎未治疗或治疗不彻底(Ⅲ组)、孕期及孕前均未患牙周炎的健康孕妇(Ⅳ组)四个组别,各200名,实施问卷调查与口腔检查,对比四组孕产妇新生儿结局。结果:Ⅰ组与Ⅳ组在早产率、低体重儿率上无明显差异(P>0.05),均明显低于Ⅲ组(P<0.05)。结论:孕期患牙周炎不积极治疗或治疗不彻底,极

  16. 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.

  17. 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.

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

    Science.gov (United States)

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

  19. 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.

  20. 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.

  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. 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…

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. [Use of the intraosseous route in a premature infant].

    Science.gov (United States)

    Nasimi, A; Gorin, P; Berthier, M; Boussemart, T; Follet-Bouhamed, C; Oriot, D

    1998-04-01

    The intraosseous route (IOR) is a rehabilitated vascular access in emergency situations. Its indications and duration are defined, although the age limit at which it is usable is not clearly established. A 34-week-old preterm neonate, without infection, receiving gastric gavage, developed, at 8 days of life, a severe septic shock requiring ventilatory support and emergency volume expansion via a subclavian catheter. During the chest X-ray to check its position, the catheter was unfortunately pulled out. The child presented an acute desaturation with bradycardia, requiring bag ventilation and endotracheal epinephrine. The umbilical vein being unusable, an intraosseous access (20 G, distal hole, Cook) was performed at the upper tibial level to continue resuscitation and left in place for 14 hours to infuse antibiotics, inotropic support, blood products and colloids. Blood cultures grew Klebsiella pneumoniae. After a severe initial phase, course was favorable with normal examination at 3 years without complication of the IOR. To our knowledge, it is the youngest child in whom IOR was performed. For neonates and especially preterms, the site of puncture is just below the tibial superior tuberosity, otherwise there is a risk of fracture of the diaphysis. This risk justifies the control of the IOR by X-ray. The place of the IOR among emergency vascular accesses in neonates, seems to us to be reserved to situations when umbilical vein is unusable. Although no study compared IOR to superior longitudinal sinus access, we suggest to reserve the sinus access only when IOR has failed, because of its potential cerebral complications.

  11. 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.

  12. 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.

  13. 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.

  14. 双胎早产儿神经精神发育水平随访研究%Research of neuropsychological development in twin premature infants

    Institute of Scientific and Technical Information of China (English)

    杨丽; 钟庆华; 齐志业; 周艺; 魏来; 李琪; 贺湘英

    2014-01-01

    目的 探讨双胎早产儿神经精神发育情况,并分析其危险因素.方法 将2010年6月至2012年6月在昆明医科大学第一附属医院新生儿病房住院的早产几分为2组:双胎早产儿为研究组,单胎早产儿为对照组.对其中88例早产儿在纠正胎龄1岁时行神经精神发育随访,由儿童保健科专人采用贝利婴幼儿发展量表进行测试,其中研究组根据量表正常测试结果分为神经精神发育异常组[智力发展指数(MDI)≤79分]和神经精神发育正常组(MDI >79分),并对2组资料进行统计学分析.结果 研究组MDI得分频数分布呈偏态分布,其中59%(27/46例)为神经精神发育异常(MDI≤79分);对照组MDI得分频数分布呈近似正态分布,其中仅12%(5/42例)为神经精神发育异常.1岁时双胎早产儿头围、身长、体质量、MDI、精神运动发展指数(PDI)均低于单胎早产儿,差异均有统计学意义(P均<0.05).单因素分析中双胎早产儿神经精神发育异常的高危因素有胎龄、出生体质量、母亲育龄、父母亲文化程度、喂养方式、新生儿高胆红素血症、新生儿低血糖症、新生儿脓毒症、感染.多因素Logistic回归分析显示新生儿高胆红素血症是双胎早产儿神经精神发育异常的独立危险因素.结论 同胎龄双胎早产儿的神经精神发育落后于单胎早产儿.新生儿高胆红素血症有可能是导致双胎早产儿神经精神发育异常的高危因素,早期积极处理新生儿高胆红素血症有利于促进双胎早产儿的神经精神发育.%Objective To explore the neuropsychological development in twin premature infants,and to analyze the risk factors for the retardation of development.Methods The premature infants hospitalized in the Neonatal Ward First Affiliated Hospital of Kunming Medical University from Jun.2010 to Jun.2012 were divided into study groups of twin premature infants and a control group of singleton premature

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. Early intervention of intellectual development in premature infants%早产儿婴儿期智能发育的早期干预

    Institute of Scientific and Technical Information of China (English)

    温天莲; 吕兴梅; 孙咏梅; 曹永利

    2006-01-01

    increases year by year, but the cerebral growth of premature infants is immature, so the intellectual development of premature infants is slower than that of normal infants.OBJECTIVE: To explore the effect of family-oriented early intervention,which took material nutrition, information stimulation and petting as main interventional content, on level of intellectual development in premature infants in infantile age.DESIGN: Randomized sampling controlled observation.SETTING: Department of Pediatrics, Clinical Medical College of ShanPARTICIPANTS: Totally 35 premature infants of 31-36 weeks (18 males and 17 females) were enrolled as early interventional subjects, who were born at Jinan Municipal Central Hospital between May 2000 and July 2002. Meanwhile, 33 premature infants of 31-36 weeks (18 males and 15females) born in the same period and 49 mature neonates (26 males and 23females) were enrolled in control group.METHODS: The family-oriented early intervention, which considered nutrition, information stimulation and petting as chief interventional content,were performed in premature infants, and health archives was established.Taction and point massage were conducted. Home visit was done twice in one month. One routine health examination was determined at 3, 6 and 10months in the two control groups. The level of intellectual development was assessed in infants of 10-month old of each group with Gesell Developmental Schedules (GDS) and Japanese S-M Social Living Ability Scale.MAIN OUTCOME MEASURES: Evaluation of level of intellectual development in infants of each group.RESULTS: In the premature interventional group, 1 premature infant died, 2 withdrew from the study, and 32 eligible cases with the eligible rate of 91.4%; Among the 33 premature infants in the premature control group, there were 3 withdrawing from the study, and 30 eligible cases with the eligible rate of 90.9%. Among the 49 infants in the term infant control group, there were 3 withdrawing from the study and

  20. Effect of Spike Lavender Lakhlakhe on Pain Intensity Due to Phlebotomy Procedure in Premature Infants Hospitalized in Neonatal Intensive Care Unit: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Noushin Beheshtipoor

    2017-06-01

    Full Text Available Background: A Premature infants undergo multiple painful procedures during treatment; thus, it must be tried to limit complications caused by diagnostic and treatment procedures using simple and practical methods. This study was performed to evaluate the effect of spike lavender lakhlakhe on pain intensity due to phlebotomy in hospitalized premature infants.Methods: This single-arm, randomized clinical trial was performed on 30 infants chosen through convenience sampling method. Each newborn was considered as its own control. For the test group, one drop of pure (100% spike lavender lakhlakhe was taken by a standard dropper and diluted with 4 ml of warm distilled water by the research assistant. This mixture was stirred at 2-3 cm distance of the newborns’ nose from 60 minutes before until 2 minutes after phlebotomy, such that it could be smelled by the newborns. In both groups, heart rate and blood oxygen saturation were measured by a standard portable device, and the corresponding data was recorded in data collection sheets. Moreover, the infants’ facial expression changes were recorded by a camera and the intensity of pain was measured by Premature Infant Pain Profile before and after the procedure. Finally, the data was analyzed by paired comparison analysis test in SPSS, version 17.Results: Comparison of mean pain intensity caused by phlebotomy in the control and test groups showed a significant difference (7.667±0.311 vs. 4.882±0.311; P

  1. Affect study of swim combined with touch for the nutritional status and intellectual development of premature infants%游泳联合抚触对早产儿营养状态及智能发育的影响研究

    Institute of Scientific and Technical Information of China (English)

    钟翠霞; 周萍

    2015-01-01

    Objective To study the affect of swim combined with touch for the nutritional status and intellectual devel-opment of premature infants. Methods 84 premature infants in our hospital from June 2012 to September 2014 were selected as research object,and they were randomly divided into control group (They were used conventional interven-tion) and observation group(They were given swim and touch on the basis of control group),with 42 cases in each group. The nutritional status related indexes and Gesell score evaluation indexes of two groups before the intervention and at different time after the intervention was compared. Results The nutritional status related indexes and Gesell score eval-uation indexes in observation group was significantly better than those of control group at different time after the inter-vention, the difference was significant between two groups (P<0.05). Conclusion The influence of swim combined with touch for the nutritional status and intellectual development of premature infants are great,and it can effectively im-prove the mental and physical development state of premature infants.%目的:探讨游泳联合抚触对早产儿营养状态及智能发育的影响。方法选取2012年6月~2014年9月本院的84例早产儿为研究对象,将其随机分为对照组(采用常规干预)和观察组(常规干预基础上加游泳和抚触),每组42例。将两组早产儿干预前及干预后的营养状态相关指标及Gesell量表评估结果进行比较。结果观察组早产儿干预后不同时间的营养状态相关指标及Gesell量表评估结果均显著优于对照组,两组差异有统计学意义(P<0.05)。结论游泳联合抚触对早产儿的营养状态及智能发育影响较大,可有效改善早产儿的身心发育状态。

  2. Study on the application of early comprehensive development model in premature infants%儿童早期综合发展模式在早产儿中的应用研究

    Institute of Scientific and Technical Information of China (English)

    刘文; 何雪萍; 袁展红

    2016-01-01

    目的:探讨早期综合发展模式对早产儿体格、智能及神经心理发育的影响,探索早产儿早期综合发展模式在儿保门诊普遍应用的可行性。方法干预组90例早产儿从出院前开始介入,进行连续监测及综合干预,包括常规系统保健、养育指导、亲子活动、发育监测、智力测评、个体化指导等,对有异常情况者及时矫治;对照组90例在纠正月龄1个月后进行常规儿童保健。结果3月龄时对照组检出神经系统异常192例次,干预组检出129例次,对照组神经系统异常检出率高于干预组(χ2=14.574,P=0.000);干预组12月龄时身长为(74.31±2.34)cm,对照组为(72.82±2.13)cm;干预组12月龄时体质量为(9.42±0.93)kg,对照组为(8.11±0.90)kg,干预组的体质量、身长的增长均高于对照组,差异有统计学意义(t=4.467、9.602,P<0.05);同时测评智能发育水平,干预组大运动(96.40±7.83)分,精细动作(95.45±7.87)分,适应能力(98.33±10.87)分,社交行为(105.65±7.51)分,发育商(101.45±7.36)分,对照组分别为(92.53±6.57)、(89.27±8.02)、(94.26±9.88)、(100.31±8.13)、(95.65±6.93)分,2组差异有统计学意义(t=2.628~5.443,P<0.05)。结论儿童早期综合发展模式在早产儿中的应用,能早期发现神经发育偏离的儿童,有助于对早产儿进行早期干预,采用家庭与门诊相结合的干预模式,可减少神经系统异常的发生,提高智力测评各能区的发育水平,促进早产儿的智能、运动发育和社会适应能力。%Objective To discuss the effect of early comprehensive development mode on physical, intelligence and mental development of premature infants, and explore the feasibility of comprehensive development mode of preterm infants generally applied in child care clinic. Methods 90 cases of premature infants in intervention

  3. 889例早产儿的预后及其影响因素分析%Prognosis of 889 premature infants and its influence factors

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    麦凤鸣; 钟为平; 王晓萍; 钟柳英

    2013-01-01

    Objective To investigate the prognosis of premature infants and its influence factors. Methods A retrospective study was designed, and a total of 724 pregnant women with premature delivery in the Third Affiliated Hospital of Guangzhou Medical College, Guangzhou Severe Maternal Treatment Center from Jun. 2008 to Dec. 2009 were included in our study, with 889 premature infant. The prognosis of premature infants and its influence factors were analyzed. Results (1) The main complications of premature infant were asphyxia (11.40%), RDS (5.29%), pneumonia (6.64%), anemia (12.37%), acid-base imbalance (27.00%), retinopathy (6.97%). (2) The mortality rate, incidence of asphyxia, NRDS and pulmonary hemorrhage of premature infant were negatively correlated with gestational age and neonatal weight. (3) Plmonary hemorrhage, RDS and MSOF were the main causes of death for premature infant. (4) Factors of unfavourable prognosis for premature infant were gestational age, neonatal weight, asphyxia, RDS, pneumonia, alimentary tract hemorrhage, acid-base imbalance, and PROM, prccclampsia, fetal distress, polyhy-dramnios or oligohydramnios of pregnant woman (P<0.05). Conclusion The control of the risk factors of premature delivery can avoid or delay the occurrence of premature birth, improved maternal and neonatal outcomes.%目的 观察早产儿的预后并探讨其影响因素.方法 选取广州医学院第三附属医院、广州市重症孕产妇救治中心2008年1月至2009年12月间分娩的889例早产儿,分析早产儿的结局及影响早产儿预后的因素.结果 (1)早产儿的主要并发症有窒息(11.4%)、NRDS (5.29%)、肺炎(6.64%)、贫血(12.37%)、酸碱失衡(27%)、视网膜病变(6.97%)等.(2)早产儿胎龄、出生体重与窒息、NRDS、肺出血等并发症发生率和死亡率与呈负相关(P<0.05).(3)早产儿死亡原因前三位分别为肺出血、NRDS及多器官衰竭.(4)早产儿预后不良的相关因素是:早产儿低胎龄、低出生

  4. Decreased free water clearance is associated with worse respiratory outcomes in premature infants.

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    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. A clinical follow up study of premature thelarche in 0 to 2-year-old infants%0~2岁婴幼儿乳房早发育的临床随访研究

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    杨玉; 石乔

    2015-01-01

    Objective To investigate the risk factors associated with premature thelarche in 0 to 2-year-old infants,and analyze the related factors of the regression.Methods A total of 807 infants with premature thelarche,who visited the Department of Endocrinology in Children's Hospital of Jiangxi Province from April 2012 to March 2013,were followed up by two years.Questionnaire survey inquiring information about families,social factors,life-style and diet was repeated and basic levels of serum sex hormones were reassessed.Results In 807 infants with premature thelarche,234 cases lost follow-up and the other 573 cases were followed up successfully.88.8% (509/573) premature thelarche faded gradually at the average age of 16.6 ± 8.3 months.11.2% (64/573)had recurrent or persistent thelarche,but only a minority turned into precocious puberty.A multi factor Logistic regression analysis was conducted in 213 infants with returned questionnaires.The related factors of the regression of premature thelarche were families near polluted factories [odd ratio (OR) =5.846,95 % CI:1.051-32.521,P =0.044],unharmonious relationship between parents (OR =4.087,95% CI:1.126-14.839,P =0.032),mothers had an early age of menarche (OR =3.133,95% CI:1.108-8.859,P =0.031),frequently use of plastic products (bottles,tableware,toys,food packing materials,et al.OR =6.235,95 % CI:1.912-20.336,P =0.002),high intake of animal food,high protein diet (OR =3.885,95% CI:1.452-10.393,P =0.007),high intake of sucker pigmented foods containing preservatives such as fired food,beverage,puffed food (OR =2.927,95% CI:1.070-8.007,P =0.037),feeding patterns (formula feeding,mixed feeding,OR =7.249,95% CI:2.000-26.280,P =0.003;OR =6.220,95% CI:1.499-25.803,P =0.012),estradiol level (OR =8.500,95% CI:2.149-33.618,P=0.002) and Tanner staging of breast at the first visit (OR =5.325,95%CI:1.744-16.257,P=0.003).Conlusions Premature thelarche fade in mosto to 2-year-dd infants.Unfaded or recurrent

  6. The role of surfactant and non-invasive mechanical ventilation in early management of respiratory distress syndrome in premature infants

    Institute of Scientific and Technical Information of China (English)

    Narayan Prabhu Iyer; Maroun Jean Mhanna

    2014-01-01

    Background: Surfactant replacement therapy has been used for few decades for the treatment of respiratory distress syndrome (RDS) and has significantly improved morbidity and mortality in premature infants. Non-invasive respiratory support has recently emerged as a strategy in the early management of RDS. In this review, we discuss the different strategies of early management of RDS. Data sources: A literature search of PubMed database was conducted to review the subject. The quality of evidence of key clinical studies was graded according to a modified grading system of the international GRADE group. Results: Continuous positive airway pressure (CPAP) with selective surfactant is a safe alternative to routine intubation, surfactant and mechanical ventilation in preterm infants with spontaneous breathing, and such an approach has been associated with decreased risk of death and bronchopulmonary dysplasia. There is a risk of pneumothorax when using a high pressure of CPAP (≥8 cm of H2O), a high partial pressure of carbon dioxide (PCO2 >75 mm of Hg), and a high fraction of inspired oxygen (FiO2 >0.6) as a threshold for intubation while on CPAP. Conclusion: Not all preterm infants need surfactant treatment, and non-invasive respiratory support is a safe and effective approach.

  7. RETINOPATHY OF PREMATURITY SCREENING OF 500 INFANTS IN A LEVEL II NEONATAL INTENSIVE CARE UNIT AT A MEDICAL COLLEGE HOSPITAL IN SOUTHERN KARNATAKA

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    Keerthi

    2014-09-01

    Full Text Available INTRODUCTION: Retinopathy of prematurity (ROP is the leading cause of infant blindness and predominantly affects premature, low birth weight babies.1 India and other middle-income countries are said to be suffering from the ‘third epidemic’. ROP is multi-factorial and early detection and treatment of threshold ROP with timely laser treatment results in excellent outcome.3-8 OBJECTIVES: 1. To determine the yield of ROP in a level II neonatal intensive care unit (NICU at a Government Medical College Hospital in Mandya district. 2. To determine disease characteristics and outcome of treatment. METHODOLOGY: The study is a prospective analysis of infants admitted during March 1st 2009 and November 30th, 2011(33 months at the NICU of Mandya Institute of Medical Sciences (MIMS Hospital. All infants weighing Infants outside these criteria were screened at the discretion of the neonatologist if deemed at risk. The disease was classified according to the ICROP classification and treated according to the ETROP guidelines. Data was analyzed using Epi-info 2.0.1 software. RESULTS: During the study period, 508 (Male =264, Female=244 infants were enrolled for screening. Of these, 104 (20.47% had incomplete follow up and were excluded. Of the 404 who had complete follow up, 141 infants (34.9%, n=404 had ROP. Of these, 19 (12.93%, n=141 progressed to treatment threshold ROP and underwent laser photo ablation. All treated infants (100% showed a favorable outcome following treatment. CONCLUSION: This is the largest study of a rural hospital reporting ROP incidence thus far. A yield of 34.9% is comparable with level III NICU’s in larger cities. With improving neonatal care, a collaborative, timely and appropriate screening strategy is necessary in the community to prevent ROP blindness in rural infants.

  8. Study on early recognition of procalcitonin and paltelet in premature infants on sepsis%降钙素原及血小板对早产儿败血症标示作用的研究

    Institute of Scientific and Technical Information of China (English)

    赵有为; 傅万海; 何叶

    2015-01-01

    Objective To research the role in early recognition of procalcitonin( PCT) and platelet in premature infants on nosocomial infection.Methods A retrospective analysis was performed in premature infants who was suspected nosocomial infection on clinical date 2012 January to 2013 December, collecting the results of the gestational age, birth weight, the time of infection, blood culture, platelet.Results According to the last diagnosis, 127 cases of premature babies divided to two groups: non-infected group ( 59 ) , spesis group ( 68 ) . sepsis group, the platelet of 46 cases was reduced, the minimum:2.8 ×109/L,compared with non-infected groupχ2 =56.184, P=0.000.the mean of spesis was 26.43 ±9.43ng /ml, compared with non-infected group t=15. 201, P=0.008.the mean of PCT of 65 case cured while blood culture was negative was 0.925 ±0.347ng /ml, compared with non-infected group t =0.837, P =0.046, platelet was normal.Conclusions PCT, platelets change can effectively help recognize nosocomial infections in preterm children:sepsis.%目的:研究降钙素原( procalcitonin,PCT)及血小板对早产儿是否发生院内感染,败血症的早期识别作用。方法回顾性分析我科2012年1月至2013年12月住院期间怀疑发生院内感染的早产儿,统计患儿胎龄、出生体重、发生感染的时间及血培养、PCT、血小板等检查结果。结果本资料127例患儿分为两组,非感染组(59例),败血症组(68例),败血症组血小板减少46例,血小板最低值:5×109/L,与非感染组血小板减少人数比较χ2=56.184,P=0.000。 PCT均数(20.43±9.43) ng/ml,与非感染组降钙素原相比t=15.201,P=0.008。治愈出院65例患儿复查血培养阴性时PCT均数(0.925±0.347)ng/ml,与诊断败血症时降钙素原结果比较,t=0.837,P=0.046,血小板正常。结论 PCT、血小板改变可有效帮助识别早产儿院内感染:败血症。

  9. 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.

  10. The effects of oral sucrose on pain due to nasogastric tube insertion in premature infants: A crossover clinical trial

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    Jebreili M

    2014-11-01

    Full Text Available Background and Objective: Pain in neonates may have adverse impacts. Therefore, relieving pain through harmless, simple, and applicable methods, in order to prevent its dangerous consequences, is of great importance. The aim of the present study is to determine the impact of oral sucrose on relieving nasogastric tube insertion pain in premature neonates. Materials and Method: The present study is a crossover clinical trial on 38 preterm infants (gestational age between 28-34 weeks hospitalized in Bistonoh-e-Bahman Hospital, Tabriz, Iran, in 2013. The subjects were selected by convenience sampling and divided into two groups using randomized block design. In the first group, nasogastric tube insertion was carried out in the routine way for the first time, and for the second time, by administration of oral sucrose. In the second group, the procedure was performed in the reverse order of that in the first group. In both groups the emerging pain was measured by the Premature Infant Pain Profile (PIPP tool 2 minutes before, during, and 5 minutes after the procedure. Data were analyzed using, chi-square t-test, Students' independent test, paired t-test, and repeated measures ANOVA in SPSS version 18 to examine the trend of change in pain in time. P values of less than 0.05 were considered statistically significant. Results: The results showed that oral sucrose reduces the pain response of infants. The mean pain score during the insertion of nasogastric tube and administration of oral sucrose was 5.95 ± 2.35 and during routine procedures was 9.93 ± 2.89 (P < 0.001. The mean pain score 5 minutes after insertion of nasogastric tube with administration of oral sucrose was 3.66 ± 0.57 and routine procedure was 6.38 ± 0.83 (P = 0.017. Conclusion: It was revealed that oral sucrose can relieve pain caused by nasogastric tube insertion. Therefore, its implementation as a harmless and simple method can reduce pain in preterm infants.

  11. Role of Insulinlike Growth Factor 1 in Fetal Development and in the Early Postnatal Life of Premature Infants.

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    Hellström, Ann; Ley, David; Hansen-Pupp, Ingrid; Hallberg, Boubou; Ramenghi, Luca A; Löfqvist, Chatarina; Smith, Lois E H; Hård, Anna-Lena

    2016-09-01

    The neonatal period of very preterm infants is often characterized by a difficult adjustment to extrauterine life, with an inadequate nutrient supply and insufficient levels of growth factors, resulting in poor growth and a high morbidity rate. Long-term multisystem complications include cognitive, behavioral, and motor dysfunction as a result of brain damage as well as visual and hearing deficits and metabolic disorders that persist into adulthood. Insulinlike growth factor 1 (IGF-1) is a major regulator of fetal growth and development of most organs especially the central nervous system including the retina. Glucose metabolism in the developing brain is controlled by IGF-1 which also stimulates differentiation and prevents apoptosis. Serum concentrations of IGF-1 decrease to very low levels after very preterm birth and remain low for most of the perinatal development. Strong correlations have been found between low neonatal serum concentrations of IGF-1 and poor brain and retinal growth as well as poor general growth with multiorgan morbidities, such as intraventricular hemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia, and necrotizing enterocolitis. Experimental and clinical studies indicate that early supplementation with IGF-1 can improve growth in catabolic states and reduce brain injury after hypoxic/ischemic events. A multicenter phase II study is currently underway to determine whether intravenous replacement of human recombinant IGF-1 up to normal intrauterine serum concentrations can improve growth and development and reduce prematurity-associated morbidities.

  12. Comparing effects of Beractant and Poractant alfa in decreasing mortality rate due to respiratory distress syndrome in premature infants

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    Saeidi R

    2011-02-01

    Full Text Available "nBackground: Exogenous natural and synthetic surfactants is a rescue treatment for respiratory distress syndrome (RDS. The goals of the study were to compare the clinical response and side-effects of two frequently used surfactants, poractant alfa (Curosurf and beractant (Survanta, for the treatment of respiratory distress syndrome in preterm infants."n "nMethods: This clinical trial study was performed during a two-year period in the Neonatal Intensive Care Unit of Ghaem Hospital in Mashhad, Iran. Sample size calculated by a 95% confidence and power of 80, included 104 premature neonates, 74 in survanta and 30 in curosurf groups. The level of statistical significance was considered to be < 0.05."n "nResults: There were no statistically significant differences between the infants treated by survanta or cursurf groups regarding their mean gestational age (30.58 Vs. 29.00 weeks and birth weight (1388 Vs. 1330 g, (p=0.3 There were also no significant differences between the two groups regarding incidences of broncho- pulmonary dysplasia (BPD (40.5% Vs. 40%, intraventricular hemorrhage (IVH grades III/IV (13.5% Vs. 13.3%, pneumothorax (both 20%, patent ductus arteriosus (PDA (28/3% Vs. 20% or death (28% Vs. 26.6% on the 28th day postpartum."n "nConclusion: This study showed that survanta and curosurf had similar therapeutic effects in the treatment of neonatal respiratory distress syndrome.

  13. Pneumothorax in premature infants with respiratory distress syndrome: focus on risk factors

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    Sabina Terzic

    2016-02-01

    Full Text Available Introduction: Pneumothorax is a life threatening condition, more often seen in immature infants receiving mechanical ventilation. It carries a significant risk of death and impaired outcome.Objective: To determine predictive factors for the occurrence of pneumothorax in preterm infants with respiratory distress syndrome (RDS.Patients and methods: The present study was conducted in a tertiary research and educational hospital, NICU, Pediatric Clinic UKC Sarajevo, from January 2010 to December 2013. All infants had chest X-ray at admission, and were treated due to RDS with nasal continuous positive airway pressure (CPAP, mechanical ventilation, or high frequency oscillatory ventilation. At admission we registered data regarding birth weight, gestational age, Apgar score, prenatally given steroids. Inclusion criteria were fulfilled by 417 infants. Data about timing, circumstances, side and treatment of pneumothorax were gathered from medical records.Results: Mean birth weight was 1,477 g, mean gestational age 29.6 weeks. We report 98 infants who did not survive. We also report incidence of pneumothorax in 5% of the infants with RDS. In this study pneumothorax and non-pneumothorax groups didn’t differ regarding sex, gestational age (median 29 and 30 nor birth weight (p = 0.818. Apgar score at the 1st and 5th minute of life had no influence in genesis of pulmonary air leak, neither prenatally given steroids (p = 0.639, nor surfactant administration. There was a low coverage of preterm infants with prenatal steroids (overall 28.29%. We found that FiO2 ≥ 0.4 in the first 12 hours of life, and need for mechanical ventilation are predicting factors for developing pneumothorax (p < 0.05.Conclusion: Together with mechanical ventilation, inspired fraction of oxygen higher than 40%, needed to provide adequate oxygenation in the first 12 hours of life in preterm infants, could be a predictive factor in selecting the highest risk babies for development of

  14. CLINICAL AND PHARMACOECONOMIC REASONABILITY OF USING PROBIOTIC ENTEROCOCCUS STRAIN FOR THE COMPLEX DEVELOPMENTAL CARE PROGRAM FOR PREMATURE INFANTS

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    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.

  15. Reduced oxygen protocol decreases the incidence of threshold retinopathy of prematurity in infants of <33 weeks gestation.

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    Tokuhiro, Yumiko; Yoshida, Tomoko; Nakabayashi, Yoshinobu; Nakauchi, Shohei; Nakagawa, Yumi; Kihara, Minako; Mitsufuji, Nobuto; Kizaki, Zenro

    2009-12-01

    The relationship between oxygen and retinopathy of prematurity (ROP) has been studied frequently, and a pulse oximeter has the potential to facilitate the control of oxygen fluctuation in neonates. The objective of the present study was to compare the incidence of threshold ROP (stage 3 requiring laser treatment and stage 4) in infants of Kyoto First Red Cross Hospital neonatal intensive care unit (NICU) from 1 July 2004 to 31 October 2007 (closed 1 December 2006-30 March 2007 for reconstruction). A reduced oxygen protocol was implemented to maintain oxygen saturation (SpO(2)) values using a pulse oximeter between 88% and 92%. The incidence of threshold ROP in the earlier period (1 July 2004-31 December 2005) and the later period (1 January 2006-31 October 2007) were compared. The incidence of threshold ROP significantly decreased from 32.2% to 16.7%, after changing to the reduced oxygen protocol (P < 0.05). A significant decrease in the rate of threshold ROP in infants of <33 weeks gestation was observed after implementation of the new clinical O(2) management practice.

  16. Morbidity and mortality trends in very-very low birth weight premature infants in light of recent changes in obstetric care.

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    Varga, Péter; Berecz, Botond; Gasparics, Ákos; Dombi, Zsófia; Varga, Zsuzsa; Jeager, Judit; Magyar, Zsófia; Rigó, János; Joó, József Gábor; Kornya, László

    2017-04-01

    In this study, we describe trends in morbidity and mortality of preterm infants with less than 500mg birth weight in the changing landscape of obstetric and neonatal care. During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006-2010; n=39) versus the second half (2011-2015; n=27) of the study period comparing clinical outcomes in the two groups. We also assessed several clinical parameters for association with postnatal survival by comparing relative frequencies for each clinical parameter among surviving infants versus mortality cases. Survival rate for preterm neonates with less than 500mg birth weight born between 2006 and 2010 was 30.8%. This survival rate rose to 70.4% in the second half of the study period between 2011 and 2015 (ppremature birth was found to be predominantly associated with maternal hypertension or intrauterine growth restriction while in those who died premature birth due to premature rupture of membranes and spontaneous preterm labor were significantly more common. All surviving infants with less than 500mg birth weight were born via cesarean section whereas among those who died cesarean section had been performed in only 80% and vaginal delivery in 20% representing a significant difference between the groups (ppremature neonates with less than 500mg birth weight preterm delivery due to premature rupture of membranes and intrauterine infections represents the worse mortality risk. Steroid prophylaxis and measures to prevent and treat intrauterine infections with appropriate use of antibiotics can markedly improve survival in these cases. In premature neonates with less than 500mg birth weight survival is more favorable after cesarean section compared to vaginal delivery. Copyright © 2017. Published by Elsevier B.V.

  17. 枸橼酸咖啡因治疗早产儿呼吸暂停的临床研究%Clinical study of caffeine citrate in treatment of premature infants with apnea

    Institute of Scientific and Technical Information of China (English)

    黄海燕; 黄国盛; 毕雷; 黄培禄

    2015-01-01

    .29%[5/35] vs.52.63%[20/38],P<0.05).No adverse reactions of nervous system occurred in two groups .Conclusion Compared with aminophylline ,caffeine citrate owns better effects and less adverse reactions in the treatment of premature infants with primary apnea .It is safe and effective .

  18. Association of Maternal Age to Development and Progression of Retinopathy of Prematurity in Infants of Gestational Age under 33 Weeks

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    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.

  19. Low-frequency blood pressure oscillations and inotrope treatment failure in premature infants.

    Science.gov (United States)

    Vesoulis, Zachary A; Hao, Jessica; McPherson, Christopher; El Ters, Nathalie M; Mathur, Amit M

    2017-07-01

    The underlying mechanism as to why some hypotensive preterm infants do not respond to inotropic medications remains unclear. For these infants, we hypothesize that impaired vasomotor function is a significant factor and is manifested through a decrease in low-frequency blood pressure variability across regulatory components of vascular tone. Infants born ≤28 wk estimated gestational age underwent prospective recording of mean arterial blood pressure for 72 h after birth. After error correction, root-mean-square spectral power was calculated for each valid 10-min data frame across each of four frequency bands (B1, 0.005-0.0095 Hz; B2, 0.0095-0.02 Hz; B3, 0.02-0.06 Hz; and B4, 0.06-0.16) corresponding to different components of vasomotion control. Forty infants (twenty-nine normotensive control and eleven inotrope-exposed) were included with a mean ± SD estimated gestational age of 25.2 ± 1.6 wk and birth weight 790 ± 211 g. 9.7/11.8 Million (82%) data points were error-free and used for analysis. Spectral power across all frequency bands increased with time, although the magnitude was 20% less in the inotrope-exposed infants. A statistically significant increase in spectral power in response to inotrope initiation was noted across all frequency bands. Infants with robust blood pressure response to inotropes had a greater increase compared with those who had limited or no blood pressure response. In this study, hypotensive infants who require inotropes have decreased low-frequency variability at baseline compared with normotensive infants, which increases after inotrope initiation. Low-frequency spectral power does not change for those with inotrope treatment failure, suggesting dysfunctional regulation of vascular tone as a potential mechanism of treatment failure.NEW & NOTEWORTHY In this study, we examine patterns of low-frequency oscillations in blood pressure variability across regulatory components of vascular tone in normotensive and

  20. The transverse diameter of the chest on routine radiographs reliably estimates gestational age and weight in premature infants

    Energy Technology Data Exchange (ETDEWEB)

    Dietz, Kelly R. [University of Minnesota, Department of Radiology, Minneapolis, MN (United States); Zhang, Lei [University of Minnesota, Biostatistical Design and Analysis Center, Minneapolis, MN (United States); Seidel, Frank G. [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States)

    2015-08-15

    Prior to digital radiography it was possible for a radiologist to easily estimate the size of a patient on an analog film. Because variable magnification may be applied at the time of processing an image, it is now more difficult to visually estimate an infant's size on the monitor. Since gestational age and weight significantly impact the differential diagnosis of neonatal diseases and determine the expected size of kidneys or appearance of the brain by MRI or US, this information is useful to a pediatric radiologist. Although this information may be present in the electronic medical record, it is frequently not readily available to the pediatric radiologist at the time of image interpretation. To determine if there was a correlation between gestational age and weight of a premature infant with their transverse chest diameter (rib to rib) on admission chest radiographs. This retrospective study was approved by the institutional review board, which waived informed consent. The maximum transverse chest diameter outer rib to outer rib was measured on admission portable chest radiographs of 464 patients admitted to the neonatal intensive care unit (NICU) during the 2010 calendar year. Regression analysis was used to investigate the association between chest diameter and gestational age/birth weight. Quadratic term of chest diameter was used in the regression model. Chest diameter was statistically significantly associated with both gestational age (P < 0.0001) and birth weight (P < 0.0001). An infant's gestational age and birth weight can be reliably estimated by comparing a simple measurement of the transverse chest diameter on digital chest radiograph with the tables and graphs in our study. (orig.)

  1. 早产儿Apgar评分与脐动脉血气值相关性44例分析%Correlation between Apgar Score and Umbilical Artery Blood Gas Values of Premature Infant:Analysis on 44 Cases

    Institute of Scientific and Technical Information of China (English)

    杨静波; 隋广涛

    2011-01-01

    [Objective] To study the correlation between Apgar score and blood gas analysis among premature infant, so as to guide the clinical diagnosis and treatment of asphyxia in premature infants. [ Methods ] By using i-STAT blood gas analyzer, the blood gas analysis was conducted in umbilical arterial blood of 44 premature infants and 36 full-term infants at 1 and 5 minutes after birth, and correlation between the results and Aptgar score was analyzed. [ Results ] The blood pH in the premature infant group and the full-term infant group was 7.24 ± 0.04 and 7.22 ± 0.04, respectively. In the premature infant group, there were 13 infants whose l-min Apgar score was ≤7, which accounted for 29.5%, there were 7 infants whose 5-min Apg ar score was ≤7, which accounted for 15.9%. In the full-term infant group, there were 3 infants whose l-min and 5-min Apgar score was ≤7, which accounted for 8. 3%. [ Conclusion ] Apgar score should be combined with umbilical artery blood gas values in diagnosis of asphyxia in premature infants, and the umbilical artery blood gas values is more important.%目的:研究早产儿生后Apgar评分与血气分析的相关性,以指导临床对早产儿窒息的诊断及处理.方法:用i-STAT型血气分析仪对44例早产儿及36例足月儿生后1、5 min脐动脉血进行血气分析,并与Apgar评分进行相关分析.结果:血pH值:早产儿组为7.24±0.04,足月儿组为7.22±0.04.Apgar评分:早产儿组1 min Apgar评分≤7分的有13名,占总数的29.5%;5 min Apgar评分47分的有7名,占总数的15.9%;足月儿1 min和5 min Apgar评分≤7分的共有3名,占总数的8.3%.结论:诊断早产儿窒息时应将Apgar评分与脐动脉血气值相结合,且以脐动脉血气结果为主.

  2. Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

    Science.gov (United States)

    Profit, J; Zupancic, J A F; McCormick, M C; Richardson, D K; Escobar, G J; Tucker, J; Tarnow‐Mordi, W; Parry, G

    2006-01-01

    Objective To compare gestational age at discharge between infants born at 30–34+6 weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design Prospective observational cohort study. Setting Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures Gestational age at discharge home. Results The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p  =  0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI −1.2 to 3.0) days earlier in Massachusetts. Conclusions Infants of 30–34+6 weeks gestation at birth admitted and cared for in hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants. PMID:16449257

  3. Impact of Prematurity and Perinatal Antibiotics on the Developing Intestinal Microbiota: A Functional Inference Study

    Directory of Open Access Journals (Sweden)

    Silvia Arboleya

    2016-04-01

    Full Text Available Background: The microbial colonization of the neonatal gut provides a critical stimulus for normal maturation and development. This process of early microbiota establishment, known to be affected by several factors, constitutes an important determinant for later health. Methods: We studied the establishment of the microbiota in preterm and full-term infants and the impact of perinatal antibiotics upon this process in premature babies. To this end, 16S rRNA gene sequence-based microbiota assessment was performed at phylum level and functional inference analyses were conducted. Moreover, the levels of the main intestinal microbial metabolites, the short-chain fatty acids (SCFA acetate, propionate and butyrate, were measured by Gas-Chromatography Flame ionization/Mass spectrometry detection. Results: Prematurity affects microbiota composition at phylum level, leading to increases of Proteobacteria and reduction of other intestinal microorganisms. Perinatal antibiotic use further affected the microbiota of the preterm infant. These changes involved a concomitant alteration in the levels of intestinal SCFA. Moreover, functional inference analyses allowed for identifying metabolic pathways potentially affected by prematurity and perinatal antibiotics use. Conclusion: A deficiency or delay in the establishment of normal microbiota function seems to be present in preterm infants. Perinatal antibiotic use, such as intrapartum prophylaxis, affected the early life microbiota establishment in preterm newborns, which may have consequences for later health.

  4. Impact of Prematurity and Perinatal Antibiotics on the Developing Intestinal Microbiota: A Functional Inference Study.

    Science.gov (United States)

    Arboleya, Silvia; Sánchez, Borja; Solís, Gonzalo; Fernández, Nuria; Suárez, Marta; Hernández-Barranco, Ana M; Milani, Christian; Margolles, Abelardo; de Los Reyes-Gavilán, Clara G; Ventura, Marco; Gueimonde, Miguel

    2016-04-29

    The microbial colonization of the neonatal gut provides a critical stimulus for normal maturation and development. This process of early microbiota establishment, known to be affected by several factors, constitutes an important determinant for later health. We studied the establishment of the microbiota in preterm and full-term infants and the impact of perinatal antibiotics upon this process in premature babies. To this end, 16S rRNA gene sequence-based microbiota assessment was performed at phylum level and functional inference analyses were conducted. Moreover, the levels of the main intestinal microbial metabolites, the short-chain fatty acids (SCFA) acetate, propionate and butyrate, were measured by Gas-Chromatography Flame ionization/Mass spectrometry detection. Prematurity affects microbiota composition at phylum level, leading to increases of Proteobacteria and reduction of other intestinal microorganisms. Perinatal antibiotic use further affected the microbiota of the preterm infant. These changes involved a concomitant alteration in the levels of intestinal SCFA. Moreover, functional inference analyses allowed for identifying metabolic pathways potentially affected by prematurity and perinatal antibiotics use. A deficiency or delay in the establishment of normal microbiota function seems to be present in preterm infants. Perinatal antibiotic use, such as intrapartum prophylaxis, affected the early life microbiota establishment in preterm newborns, which may have consequences for later health.

  5. 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.

  6. 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.

  7. The Effects of Massage with Coconut and Sunflower Oils on Oxygen Saturation of Premature Infants with Respiratory Distress Syndrome Treated With Nasal Continuous Positive Airway Pressure

    Directory of Open Access Journals (Sweden)

    Sousan Valizadeh

    2012-11-01

    Full Text Available Introduction: Nowadays particular emphasis is placed on the developmental aspects of premature infants care. Massage therapy is one of the best-known methods of caring. Due to the minimal touch policy in neonatal intensive care units (NICUs, massaging is not usually performed on premature infants. However, there is not sufficient evidence to support the claim that newborn infants with complex medical conditions should not be massaged. This study aimed to determine the effects of massage with coconut and sunflower oils on oxygen saturation of infants with respiratory distress syndrome (RDS treated with nasal continuous positive airway pressure (NCPAP. Methods: This was a randomized controlled trial on 90 newborns who were admitted to Alzahra Hospital (Tabriz, Iran. The infants were divided into control and massage therapy groups (massage with coconut and sunflower oils. Data was collected using a hospital documentation form. A 15-minute daily massage was performed for 3 days. Respiratory rate (RR, fraction of inspired oxygen (FiO2 and oxygen saturation were measured 5 minutes before the massage, 3 times during the massage, and 5 minutes after the massage. The collected data was analyzed using a mixed model. Results: In comparison to coconut oil and control groups, mean oxygen saturation of sunflower oil group was improved. In addition, the coconut massage group showed lower oxygen saturation than the control group but was all values were within the normal range. Although massage decreased oxygen saturation, there was no need to increase FiO2. Conclusion: Massage therapy can provide developmental care for infants treated with NCPAP.

  8. 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.

  9. A qualitative study on the child care experience in mothers of premature infants discharged from the neonatal intensive care unit%新生儿重症监护室出院早产儿母亲育儿生活体验的质性研究

    Institute of Scientific and Technical Information of China (English)

    周明芳; 藤本荣子; 晏玲; 王楠; 刘蕾

    2012-01-01

    目的 了解新生儿重症监护室出院早产儿母亲的育儿生活体验.方法 采用质性研究法,对16例早产儿母亲在婴儿出院后1个月时进行深度访谈.结果 母亲在早产儿出院后经历了“母乳喂养困难与哺乳不确定性的困惑”“自我育儿能力低下的无措感”“对早产儿常见症状的不安”“育儿负担感”“育儿信息所致的混乱与不安”等育儿体验.结论 早产儿母亲存在育儿困难,在育儿过程中感受到强烈的不安,探讨这个群体母亲的护理支持方案是当前急需解决的课题之一.%Objective To understand the child care experience in mothers of premature infants discharged from the neonatal intensive care unit (NICU). Methods In-depth interview was conducted on 16 mothers of premature infants one month after discharge from NICU. Results After discharged from NICU,the mothers experienced uncertainty of breastfeeding and frustration due to lack of breeding knowledge,sense of incompetency in child care,anxiety about symptoms of premature infants,burden of parenting, and confusion about conflict information for child care. Conclusion The mothers of premature infants experience difficulties and anxieties in child care. It is essential to further explore an effective nursing support program for the mothers of premature infants.

  10. 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

  11. Positive rolandic sharp waves in the EEG of the premature newborn: a five year prospective study.

    Science.gov (United States)

    Marret, S; Parain, D; Jeannot, E; Eurin, D; Fessard, C

    1992-07-01

    In a prospective study of 301 premature newborn infants, neonatal tracings were done to evaluate the use of the electroencephalogram (EEG) and positive rolandic sharp waves (PRSW) in the diagnosis and prognosis of periventricular leucomalacia. Each infant had ultrasonographic studies and standardised neurological examinations at 1 year of age or later. Two hundred and eighty infants were followed up at 1 year. This study demonstrated that the absence of PRSW was correlated with a favourable motor development (98.2%) and confirmed the great value of PRSW in the diagnosis and the prognosis of periventricular leucomalacia. PRSW were sensitive (98%) and specific (84%) markers of developmental motor disability and were a sensitive (96%) marker of severe spastic diplegia. A frequency above 2/minute was a specific (92%) sign of severe spastic diplegia. Social and language developmental abnormalities were not correlated with the neonatal EEG.

  12. 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.

  13. 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.

  14. 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.

  15. [Pilot study on stress and resilience in families with premature newborns].

    Science.gov (United States)

    Escartí, A; Boronat, N; Llopis, R; Torres, R; Vento, M

    2016-01-01

    Prematurity is associated with severe clinical conditions, long hospital stays, and uncertainty about patient outcomes. These circumstances lead to a stressful situation that may affect family functioning. The aim of this study was to study risk and protection factors affecting family functioning in preterm as compared to healthy term infants. Preterm infants with and without pathological conditions (n=40) were recruited at 24 months post-conception age, together with a control group of healthy term newborn infants (n=31). Parents or usual caregivers responded to the Inventory of Family Protection Factors and Parental Stress scales. The results were compared using the Student t test, unidirectional analysis of variance and the Tukey test. Parents of the control group attained higher scores than those of the preterm group for all the items studied; however, parents of preterm infants with pathological conditions perceived significantly less family resilience and more stress related to the upbringing of their child. Prematurity itself is a risk factor for family dysfunction because it causes an elevated degree of parental stress and difficulties in the development of protection factors such as resilience. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  16. Cerebellar Microstructural Organization is Altered by Complications of Premature Birth: A Case-Control Study.

    Science.gov (United States)

    Brossard-Racine, Marie; Poretti, Andrea; Murnick, Jonathan; Bouyssi-Kobar, Marine; McCarter, Robert; du Plessis, Adre J; Limperopoulos, Catherine

    2017-03-01

    To compare regional cerebellar microstructure, as measured by diffusion tensor imaging (DTI), between preterm infants at term-equivalent age and healthy term-born control neonates, and to explore associations between DTI findings and clinical risk factors. In this case-control study, DTI studies were performed in 73 premature infants born ≤32 weeks and ≤1500 g birth weight and 73 full-term-born controls from healthy pregnancies. Using a region of interest approach, fractional anisotropy (FA) and mean diffusivity (MD) were extracted in 7 cerebellar regions including the anterior vermis, the right/left superior cerebellar peduncles, the middle cerebellar peduncle, and the dentate nuclei. To validate further our DTI measurements, we measured FA and MD in the genu of the corpus callosum and splenium. FA and MD were compared between groups using analyses of multiple linear regression models. Preterm infants at term-equivalent age presented with higher FA in the dentate nuclei (premature birth are associated with altered cerebellar microstructural organization when compared with term-born control infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 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.

  18. Hypothyroxinemia of prematurity: rite of passage or therapeutic necessity?

    Science.gov (United States)

    Beeram, M R; Wilson, D P

    2000-11-01

    Hypothyroxinemia is a common finding in premature infants, presumably resulting from an immature hypothalamic-pituitary-thyroid axis. Because dynamic studies of thyroid function in premature infants are normal and the condition resolves spontaneously, HOP has been considered physiologic rather than pathologic. Thus, thyroid hormone supplementation has been assumed to be not required in premature infants. True hypothyroidism of hypothalamic pituitary or thyroid origin, however, does occur in premature as well as in term infants and should be investigated aggressively and treated appropriately. Current studies in premature infants with hypothyroxinemia suggest the following: infants with more than 27 weeks of gestation do not appear to benefit and may, in fact, be harmed by thyroid hormone supplementation; and short-term thyroid hormone supplementation in infants born before 27 weeks of gestation may be important to diminish morbidity and to improve neurodevelopmental outcome.

  19. Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity.

    LENUS (Irish Health Repository)

    Dempsey, Eugene

    2012-01-31

    BACKGROUND: Screening examinations for retinopathy of prematurity (ROP) are performed routinely in the neonatal intensive care unit and are a recognised cause of pain in the newborn. OBJECTIVES: To determine the effect of instillation of topical anaesthetic eye drops compared with placebo or no treatment on pain in infants undergoing ROP screening. SEARCH STRATEGY: We used the standard search strategy of the Cochrane Neonatal Review Group. This included a search of the Cochrane Neonatal Group register and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 10, 2010). We identified relevant studies by searching the following: (1) computerised bibliographic databases: MEDLINE (1966 to October 2010), EMBASE (1988 to October 2010) and Web of Science (1975 to March 2010; (2) the Oxford Database of Perinatal Trials. We searched electronically abstracts from PAS from 2000 to 2010 and handsearched abstracts from ESPR from 2000 to 2009. SELECTION CRITERIA: All randomised, or quasi-randomised controlled trials, or randomised cross-over trials. DATA COLLECTION AND ANALYSIS: We used the standard methods of the Cochrane Neonatal Review Group. MAIN RESULTS: We identified two studies for inclusion. Both studies were randomised cross-over trials performed in single centres. Both studies used the Premature Infant Pain Profile (PIPP) score as a measure of pain response. Different methods of evaluating PIPP scores are presented including the absolute PIPP score, a PIPP score > 10 or > 12 and an increase in PIPP >\\/= 4 from the baseline value. There is a nonsignificant reduction in pain scores at one minute and a nonsignificant increase at five minutes post insertion of the speculum. PIPP score > 12 at one minute resulted in a statistically significant reduction in the number of patients who experienced pain (typical risk ratio (RR) 0.56, 95% CI 0.36 to 0.89; typical risk difference (RD) -0.23, 95% CI -0.39 to -0.86; number needed to treat to

  20. A cumulative risk factor model for early identification of academic difficulties in premature and low birth weight infants

    NARCIS (Netherlands)

    Roberts, G.; Bellinger, D.; McCormick, Marie C.

    2007-01-01

    Objectives: Premature and low birth weight children have a high prevalence of academic difficulties. This study examines a model comprised of cumulative risk factors that allows early identification of these difficulties. Methods: This is a secondary analysis of data from a large cohort of premature

  1. Two-Year Follow-Up Outcomes of Premature Infants Enrolled in the Phase I Trial of Mesenchymal Stem Cells Transplantation for Bronchopulmonary Dysplasia.

    Science.gov (United States)

    Ahn, So Yoon; Chang, Yun Sil; Kim, Ji Hye; Sung, Se In; Park, Won Soon

    2017-06-01

    To determine the long-term safety and outcomes of mesenchymal stem cells (MSCs) for bronchopulmonary dysplasia in premature infants enrolled in a previous phase I clinical trial up to 2 years of corrected age (CA). We assessed serious adverse events, somatic growth, and respiratory and neurodevelopmental outcomes at visit 1 (4-6 months of CA), visit 2 (8-12 months of CA), and visit 3 (18-24 months of CA) in a prospective longitudinal follow-up study up to 2 years' CA of infants who received MSCs (MSC group). We compared these data with those from a historical case-matched comparison group. One of 9 infants in the MSC group died of Enterobacter cloacae sepsis at 6 months of CA, the remaining 8 infants survived without any transplantation-related adverse outcomes, including tumorigenicity. No infant in the MSC group was discharged with home supplemental oxygen compared with 22% in the comparison group. The average rehospitalization rate in the MSC group was 1.4/patient because of respiratory infections during 2 years of follow-up. The mean body weight of the MSC group at visit 3 was significantly higher compared with that of the comparison group. No infant in the MSC group was diagnosed with cerebral palsy, blindness, or developmental delay; in the comparison group, 1 infant was diagnosed with cerebral palsy and 1 with developmental delay. Intratracheal transplantation of MSCs in preterm infants appears to be safe, with no adverse respiratory, growth, and neurodevelopmental effects at 2 years' CA. ClinicalTrials.gov: NCT01632475. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  2. Correlation between risk factors during the neonatal period and appearance of retinopathy of prematurity in preterm infants in neonatal intensive care units in Alexandria, Egypt

    Directory of Open Access Journals (Sweden)

    Abdel Hadi AM

    2013-05-01

    Full Text Available Ahmed Mahmoud Abdel Hadi, Islam Shereen HamdyDepartment of Ophthalmology, Alexandria University Hospital, Alexandria, EgyptBackground: This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012.Methods: A prospective cohort study was undertaken in infants weighing < 1250 g and maternal postmenstrual age < 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP. Perinatal variables considered were: birth weight, gestational age, gender, method of ventilation (nasal continuous airway pressure or intermittent mechanical ventilation, packed red blood cell and/or plasma transfusion, occurrence of sepsis, neonatal indirect hyperbilirubinemia, intraventricular hemorrhage, and patent ductus arteriosus. After obtaining informed consent from the parents, infants at risk were examined for ROP using indirect ophthalmoscopy, ie, RetCam II fundus photography.Results: The study included 152 infants of mean gestational age 31.02 weeks and mean birth weight 1.229 kg. Seventy-two cases (47.5% were male and 80 cases (52.5% were female. Of the cases screened, 100 (65.6% had no ROP, 52 had ROP of any stage (34.4%, and 27 (18% had stage 1, five (3.3% had stage 2, 17 (11.5% had stage 3, and three (1.6% had stage 4 disease. No infants had stage 5 ROP. Of all our cases with ROP, 15 (28.6% had prethreshold disease type 1 that required treatment, comprising 9.8% of all cases screened for ROP. Using stepwise logistic regression analysis, all risk factors studied were found to be significantly associated with the development of ROP, except for neonatal indirect hyperbilirubinemia. Severity of ROP was inversely proportional to birth weight and gestational age.Conclusion: ROP occurred in 34.4% of all infants screened in the neonatal intensive

  3. 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.

  4. Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers.

    Science.gov (United States)

    Raffray, Marie; Semenic, Sonia; Osorio Galeano, Sandra; Ochoa Marín, Sandra Catalina

    2014-01-01

    To explore Colombian health care provider perceptions of barriers and facilitators to preparing families with premature infants for discharge home from the neonatal intensive care unit (NICU). Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with fifteen neonatal health care providers (HCPs) in Colombia. Data were analyzed using qualitative content analysis. Participant responses centered on three main themes: 1) establishment of the parent-infant bond, 2) acquisition of parenting skills, and 3) getting ready for the transition from hospital to home. Barreirs to preparing parents for NICU discharge included obstacles to parental visiting in the NICU, communication barriers, difficulties related to the establishment of successful breastfeeding, insufficient human resources and poor links between hospital and community-based resources. Facilitators included the availability of social aids for vulnerable families, 24-hour telephone access to the neonatal units, tailored educational materials and group sessions, continuing education for staff and the community-based Kangaroo Program available to parents post-discharge. Adolescent mothers, indigenous parent and working fathers were identified as particularly challenging to reach and engage in discharge preparation. Neonatal HCPs identified numerous challenges as well as helpful strategies for preparing families for hospital discharge. Additional studies are needed on the experience of neonatal discharge from the perspective of parents of premature infants in Colombia, to help inform optimal interventions for supporting families during the transition from hospital to home.

  5. Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers

    Directory of Open Access Journals (Sweden)

    Marie Raffray

    2014-12-01

    Full Text Available Objective. To explore Colombian health care provider perceptions of barriers and facilitators to preparing families with premature infants for discharge home from the neonatal intensive care unit (NICU. Methodology. Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with fifteen neonatal health care providers (HCPs in Colombia. Data were analyzed using qualitative content analysis. Results. Participant responses centered on three main themes: 1 establishment of the parent-infant bond, 2 acquisition of parenting skills, and 3 getting ready for the transition from hospital to home. Barreirs to preparing parents for NICU discharge included obstacles to parental visiting in the NICU, communication barriers, difficulties related to the establishment of successful breastfeeding, insufficient human resources and poor links between hospital and community-based resources. Facilitators included the availability of social aids for vulnerable families, 24-hour telephone access to the neonatal units, tailored educational materials and group sessions, continuing education for staff and the community-based Kangaroo Program available to parents post-discharge. Adolescent mothers, indigenous parent and working fathers were identified as particularly challenging to reach and engage in discharge preparation. Conclusion. Neonatal HCPs identified numerous challenges as well as helpful strategies for preparing families for hospital discharge. Additional studies are needed on the experience of neonatal discharge from the perspective of parents of premature infants in Colombia, to help inform optimal interventions for supporting families during the transition from hospital to home.

  6. Surgical findings during exploratory laparotomy are closely related to mortality in premature infants with necrotising enterocolitis

    DEFF Research Database (Denmark)

    Hansen, M L; Juhl, Sandra Meinich; Fonnest, G;

    2017-01-01

    AIM: This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. METHODS: We included infants admitted within one day of birth to our tertiary neonatal department at Rigshos......AIM: This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. METHODS: We included infants admitted within one day of birth to our tertiary neonatal department...... at Rigshospitalet, Denmark, from 2006 to 2015, who underwent a laparotomy for acute NEC. They were classified according to the locality and extent of intestinal necrosis by a paediatric surgeon, based on the surgical findings. We correlated the surgical findings with postoperative outcomes, namely death and, or...

  7. The effect of neutral oligosaccharides on fecal microbiota in premature infants fed exclusively with breast milk: A randomized clinical trial

    Science.gov (United States)

    Armanian, Amir-Mohammad; Sadeghnia, Alireza; Hoseinzadeh, Maryam; Mirlohi, Maryam; Feizi, Awat; Salehimehr, Nima; Torkan, Moloud; Shirani, Zahra

    2016-01-01

    Objective: This study was designed to compare the efficacy and safety of enteral supplementation of a prebiotic mixture (SCGOS/LCFOS) on faecal microbiota in very premature infants who fed exclusively with human-milk. Methods: This double-center randomized control trial was conducted from December 2012 to November 2013 in the tertiary Neonatal Intensive Care Units of the Isfahan University of Medical Sciences. Fifty preterm infants (birth weight ≤1500 g who were not fed with formula) were randomly allocated to have enteral (tube feeding) supplementation with a prebiotic mixture (SCGOS/LCFOS; 9:1) or receive no prebiotics. Findings: The primary outcome (e.g., the effect of the prebiotic mixture on fecal microbiota pattern) was clearly different between the two groups. Despite greater coliforms colony counts in first stool cultures in the prebiotic group (Group P) (P = 0.67), coliforms were significantly lower in the third stool cultures in the Group P (P < 0.001). Furthermore, despite the much higher Lactobacillus colony counts, in the first stool cultures, in the control group (Group C) (P = 0.005); there was a trend toward significantly increased Lactobacillus colony counts in the Group P during the study, but the difference between Lactobacillus colony counts, in the third stool cultures, between two groups was no longer statistically significant (P = 0.11). Interestingly, the median length of hospital stay was significantly less in the Group P (16 [12.50–23.50] vs. 25 [19.50–33.00] days; P = 0.003). Conclusion: This suggests that it might have been “the complete removal of formula” which manifests a synergistic effect between nonhuman neutral oligosaccharides (prebiotics) and human oligosaccharides, which in turn, led to the rapid growth of beneficial Lactobacillus colonies in the gut of breast milk-fed preterm infants, while decreasing the number of pathogenic coliforms microorganisms. Therefore, further studies with larger sample sizes are

  8. 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.

  9. Comprehensive evaluation of 11 cytokines in premature infants with surgical necrotizing enterocolitis.

    Directory of Open Access Journals (Sweden)

    Thomas Benkoe

    Full Text Available OBJECTIVE: A prospective study to investigate the pattern of pro- and anti-inflammatory cytokine responses in neonates with surgical necrotizing enterocolitis (NEC and identify those cytokines being the most promising for future research. METHODS: A panel of 11 different cytokines were measured in 9 infants with proven NEC and compared with 18 age-matched healthy neonates. RESULTS: The serum concentrations of the interleukins (IL-6, IL-8, and IL-10 were significantly (32-fold to 56-fold higher in NEC infants compared with controls. In contrast, IL-5, IFN gamma, IL-4 and IL-2 showed slightly (1.4-fold to 5.9-fold lower levels in the NEC samples. However, these cytokines showed a very low absolute concentration in infants with NEC and in controls. The sum of the serum concentrations of IL-6, IL-8 and IL-10 was able to clearly separate infants with NEC from control samples. IL-1 beta and TNF-alpha showed no statistically different levels. The serum levels of TNF-beta and IL-12p70 were below the detection limit in more than 50% of all samples per group. CONCLUSION: In spite of strong local inflammation only three out of eleven cytokines (IL-6, IL-8, and IL-10 showed strongly increased serum levels indicating an important role of them in the pathogenesis of NEC. At least two of these three cytokines were elevated in every single NEC patient. Thus, longitudinal monitoring of combined IL-8, IL-6, and IL-10 levels could reveal their potency in being clinical relevant markers in NEC.

  10. Frequency of neonatal complications after premature delivery

    Directory of Open Access Journals (Sweden)

    Gordana Grgić

    2013-04-01

    Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group, while 300 infants were born in time (37-42 weeks of gestation-control group.Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

  11. 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....

  12. 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...

  13. 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。

  14. 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.

  15. 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.

  16. Radiation Exposure to Premature Infants in a Neonatal Intensive Care Unit in Turkey

    Energy Technology Data Exchange (ETDEWEB)

    Olgar, Turan; Bor, Dogan [Ankara University, Ankara (Turkmenistan); Onal, Esra; Okumus, Nurullah; Atalay, Yildiz; Turkyilmaz, Canan; Ergenekon, Ebru; Koc, Esin [Gazi University, Ankara (Turkmenistan)

    2008-10-15

    The aim of this work was to determine the radiation dose received by infants from radiographic exposure and the contribution from scatter radiation due to radiographic exposure of other infants in the same room. We retrospectively evaluated the entrance skin doses (ESDs) and effective doses of 23 infants with a gestational age as low as 28 weeks. ESDs were determined from tube output measurements (ESD{sub TO}) (n = 23) and from the use of thermoluminescent dosimetry (ESD{sub TLD}) (n = 16). Scattered radiation was evaluated using a 5 cm Perspex phantom. Effective doses were estimated from ESD{sub TO} by Monte Carlo computed software and radiation risks were estimated from the effective dose. ESD{sub TO} and ESD{sub TLD} were correlated using linear regression analysis. The mean ESD{sub TO} for the chest and abdomen were 67 muGy and 65 muGy per procedure, respectively. The mean ESD{sub TLD} per radiograph was 70 muGy. The measured scattered radiation range at a 2 m distance from the neonatal intensive care unit (NICU) was (11-17 muGy) per radiograph. Mean effective doses were 16 and 27 muSv per procedure for the chest and abdomen, respectively. ESD{sub TLD} was well correlated with ESD{sub TO} obtained from the total chest and abdomen radiographs for each infant (R2 = 0.86). The radiation risks for childhood cancer estimated from the effective dose were 0.4 x 10{sup -6} to 2 x 10{sup -6} and 0.6 x 10{sup -6} to 2.9 x 10{sup -6} for chest and abdomen radiographs, respectively. The results of our study show that neonates received acceptable doses from common radiological examinations. Although the contribution of scatter radiation to the neonatal dose is low, considering the sensitivity of the neonates to radiation, further protective action was performed by increasing the distance of the infants from each other

  17. 血清S100B和髓鞘碱性蛋白与早产儿脑室周围白质软化的相关性研究%Correlation Study of Serum S100B and Myelin Basic Protein in Premature Infants With Periventricular Leukomalacia

    Institute of Scientific and Technical Information of China (English)

    张应金; 梁凤潇; 李剑峰

    2014-01-01

    Objective To investigate the changes of serum S100B and myelin basic protein (MBP)in premature infants with periventricular leukomalacia (PVL ) and their reliability in predicting outcome. Methods From 1st July 2010 to 31st December 2012,a total of 121 premature infants who were hospitalized in Maternal and Child Health Hospital,Jinan University were enrolled in the study.They were divided into PVL group(78 cases)and normal group (43 cases)according to their results of ultrasound and MRI.Serum MBP and S100B levels on the 1st day,3rd day,7th day and 14th day after birth were detected. Developmental quotients (DQ)were measured using Gesell development schedules until their correted gestational age reached 1 year old.They were also divided into group 1(normal premature infants),group 2 (PVL infants with decreased serum S100B and MBP level)and group 3(PVL infants with increased serum S100B and MBP level)according to their lab results at the 7th day after birth.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternal and Child Health Hospital of Jinan University. Informed consent was obtained from each participants′ parents. Results ①The serum S100B concentration of infants in PVL group were obviously higher than those of normal group at the 1st day,3rd day,7th day after birth.And no significant difference was found at the 14th day after birth between two groups.②The serum MBP concentration of infants in PVL group were significantly higher than those of normal group at the 1st day,3rd day,7th day and 14th day after birth.③ Infants whose serum MBP and S100B levels increased at the 7th day after birth had poor outcomes. Conclusions The serum MBP and S100B levels are correlated with severity of central nervous system injury.The increases in serum S100B and MBP at the 7th day after birth are associated with poor outcomes.%目的探讨脑白质损伤(PVL)早产儿血清 S100B及髓鞘碱性蛋白(MBP)水平的变化及

  18. The experience of premature birth for fathers: the application of the Clinical Interview for Parents of High-Risk Infants (CLIP) to an Italian sample

    Science.gov (United States)

    Candelori, Carla; Trumello, Carmen; Babore, Alessandra; Keren, Miri; Romanelli, Roberta

    2015-01-01

    Aim: The study explored fathers’ experience of premature birth during the hospitalization of their infants, analyzing levels of depressive and anxiety symptoms as compared with mothers. Moreover the Italian version of the Clinical Interview for Parents of High-Risk Infant (CLIP) was tested through confirmatory factor analysis. Methods: Couples of parents (N = 64) of preterm infants (gestational age < 37 weeks) were administered a socio-demographic questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory and the CLIP after the admission to the Neonatal Intensive Care Unit (NICU). Results: Significant levels of anxiety and depressive symptoms and high percentages of subjects above the corresponding risk thresholds were found among fathers and mothers with higher scores among the latters. Confirmatory factor analysis of the CLIP showed an adequate structure, with better fit for mothers than for fathers. Conclusion: Results highlighted the importance for nurses and clinicians working in the NICU to consider not only the maternal difficulties but also the paternal ones, even if these are often more hidden and silent. In addition the CLIP may be considered an useful interview for research and clinical purposes to be used with parents of high-risk infants. PMID:26483712

  19. 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.

  20. Body growth and brain development in premature babies: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Tzarouchi, Loukia C.; Zikou, Anastasia; Kosta, Paraskevi; Argyropoulou, Maria I. [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); Drougia, Aikaterini; Andronikou, Styliani [University of Ioannina, Intensive Care Unit, Child Health Department, Medical School, Ioannina (Greece); Astrakas, Loukas G. [University of Ioannina, Department of Medical Physics, Medical School, Ioannina (Greece)

    2014-03-15

    Prematurity and intrauterine growth restriction are associated with neurodevelopmental disabilities. To assess the relationship between growth status and regional brain volume (rBV) and white matter microstructure in premature babies at around term-equivalent age. Premature infants (n= 27) of gestational age (GA): 29.8 ± 2.1 weeks, with normal brain MRI scans were studied at corrected age: 41.2 ± 1.4 weeks. The infants were divided into three groups: 1) appropriate for GA at birth and at the time of MRI (AGA), 2) small for GA at birth with catch-up growth at the time of MRI (SGA{sub a}) and 3) small for GA at birth with failure of catch-up growth at the time of MRI (SGA{sub b}). The T1-weighted images were segmented into 90 rBVs using the SPM8/IBASPM and differences among groups were assessed. Fractional anisotropy (FA) was measured bilaterally in 15 fiber tracts and its relationship to GA and somatometric measurements was explored. Lower rBV was observed in SGA{sub b} in superior and anterior brain areas. A positive correlation was demonstrated between FA and head circumference and body weight. Body weight was the only significant predictor for FA (P< 0.05). In premature babies, catch-up growth is associated with regional brain volume catch-up at around term-equivalent age, starting from the brain areas maturing first. Body weight seems to be a strong predictor associated with WM microstructure in brain areas related to attention, language, cognition, memory and executing functioning. (orig.)

  1. 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.

  2. 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

  3. Study on the correlation between Ureaplasma urealyticum infection and blood system and inflammatory reaction of premature infants%解脲支原体感染与早产儿血液系统、炎症反应相关性研究

    Institute of Scientific and Technical Information of China (English)

    寿文祥; 方慧英; 毛立英

    2012-01-01

    Objective: To explore the relationship between Ureaplasma urealyticum infection and blood system, inflammatory reaction, and pulmonary injury of premature infants. Methods; The sputum samples of the premature infants who were treated in the hospital from January to December in 2010 were collected for Ureaplasma urealyticum detection, 49 positive premature infants were detected (positive group) , 80 negative premature infants were selected as control group, the results of blood routine examination, the levels of interleukin -6 and interleukin -8, the results of chest film examination, and the incidences of premature rupture of membrane (PROM) in the two groups were compared. Results; In positive group, the total amount of white blood cells was (19. 12 ± 1.52) x 109/L, the level of interleukin -6 was (47.19±1.50) pg/ml, the level of interleukin-8 was (18. 81 ±1. 21) pg/ml, the incidence of chest film abnormality was 45. 80% , the incidence of PROM was 53. 60% , all the indexes above - mentioned were significantly higher than those in control group (P < 0. 05 ) . Conclusion: Ureaplasma urealyticum infection is related to blood system, inflammatory reaction, and pulmonary injury of premature infants, Ureaplasma urealyticum DNA detection should be performed early among the premature infants, then the results were analyzed combined with blood routine examination, interleukin -6 and interleukin -8 levels, and chest film examination, so early diagnosis and treatment are conducted.%目的:探讨解脲支原体感染与早产儿血液系统、炎症反应、肺部损伤的关系.方法:对2010年1~12月该院收治的早产儿采集痰液进行解脲支原体检测,检出49例阳性患儿(阳性组),另外选择80例阴性患儿(对照组),比较两组血常规、IL-6、IL-8、胸片、胎膜早破率.结果:阳性组白细胞总数(19.12±1.52)×109/L、IL-6 (47.19±1.50) pg/ml、IL-8 (18.81±1.21) pg/ml、胸片异常率为45.80%、胎膜早破率为53.60

  4. 多胎妊娠早产儿191例ROP筛查结果分析%Outcomes of retinopathy of prematurity screening in 191 multiple pregnancy premature infants

    Institute of Scientific and Technical Information of China (English)

    程海霞; 姚家奇; 陈志钧

    2013-01-01

    Objective To observe the occurrence of multiple pregnancy premature ROP (Retinopathy of prematurity,ROP),and to discuss the related risk factors.Methods Of 191 cases of multiple pregnancy premature included in the study,fundus examinations were performed with Retcam Ⅱ,the incidence of the ROP and and its relationship with related risk factors were studied.The SPSS 17.0 software was applied in the statistical analysis.Results The incidence of ROP was 9.95% (19/191) in 191 cases of multiple pregnancy premature,twins was 8.79% (16/182); triplets were 33.33%(3/9).The average birth weight of 19 infants with ROP was (1.47±0.45) kg,172 cases without ROP was (1.90 ±0.45) kg,birth weight between two groups had statistical significance (t =3.91,P =0.0001); The average born age of 19 infants with ROP was (29.53 ±2.25) weeks,172 cases without ROP was (32.93 ±2.93) weeks,between the two groups,born age had statistical significance (t =6.75,P <0.0001).Conclusions The incidence of ROP with multiple pregnancy premature is higher,gestational age and birth weight are important risk factors for ROP.%目的 观察多胎妊娠早产儿ROP的发生情况,探讨相关危险因素.方法 191例多胎妊娠早产儿纳入研究,所有患儿均由经验丰富的视网膜专科医师用二代广角数码视网膜成像系统(RetCamⅡ)进行检查,研究早产儿视网膜病变(Retinopathy of prematurity,ROP)的发生率及其与胎龄、出生体重、分娩方式及有无吸氧史的关系.应用SPSS17.0统计软件分析结果.结果 191例多胎妊娠早产儿ROP发生率9.95% (19/191),发现ROP征象的19例患儿有明确吸氧史者16例.双胎妊娠ROP发生率8.79% (16/182);三胎妊娠ROP发生率33.33%(3/9);顺产100例8例发现ROP,剖宫产91例11例发现ROP; 19例ROP患儿平均出生体重(1.47±0.45) kg,无ROP的172例早产儿平均出生体重(1.90±0.45) kg,两组出生体重比较具有统计学意义(t=3.91.P=0.0001); 19

  5. Prevalência e fatores de risco para a retinopatia da prematuridade: estudo com 450 pré-termos de muito baixo peso Prevalence and risk factors for retinopathy of prematurity: study with 450 very low birth weight preterm infants

    Directory of Open Access Journals (Sweden)

    João Borges Fortes Filho

    2009-02-01

    Full Text Available OBJETIVO:Analisar prevalência e fatores de risco para a retinopatia da prematuridade (ROP entre pré-termos com peso de nascimento (PN d"1.500 gramas e/ou idade gestacional (IG d"32 semanas admitidos em uma instituição hospitalar universitária de nível terciário. MÉTODOS: Estudo de coorte institucional, prospectivo e descritivo, realizado entre outubro de 2002 e julho de 2008, incluindo todos os pré-termos com PN d"1.500 gramas e/ou com IG d"32 semanas, que sobreviveram até a 42ª semana de IG corrigida. Foram determinadas a prevalência da ROP em seus vários estadiamentos evolutivos. Os principais fatores de risco para o surgimento da ROP no período pós-natal foram comparados por análises uni e multivariadas entre os pacientes que desenvolveram e os que não desenvolveram a doença. Para a análise das variáveis contínuas entre os dois grupos, foi usado o Teste t (Student para amostras independentes e para a comparação das variáveis categóricas, o Qui-Quadrado. A regressão logística incluiu as variáveis com significância após a análise univariada. RESULTADOS:Foram estudadas 450 crianças cuja média de PN e IG foram 1.213,50 gramas (± 277,4 e 30,3 semanas (± 2,2, respectivamente. A ROP, em qualquer estadiamento, afetou 24,2% das crianças. Doença limiar, necessitando de tratamento pela fotocoagulação, ocorreu em 24 pacientes (5,3%. Após análise univariada, a IG, o PN, o ganho ponderal do nascimento até a 6ª semana de vida, o uso de oxigenioterapia em ventilação mecânica e de indometacina, as ocorrências de sepse e hemorragia intraventricular e a necessidade de transfusões sanguíneas, estiveram associados com a ROP. A regressão logística confirmou a importância da IG (OR: 0,856; IC95%: 1,141-1,447; P=0,014, do baixo ganho ponderal (OR: 0,997; IC95%: 0,996-0,999; PPURPOSE: This study aims to analyze prevalence and risk factors for retinopathy of prematurity (ROP among preterms with birth weight (BW d"1

  6. 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…

  7. 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.

  8. Does ibuprofen treatment in patent ductus arteriosus alter oxygen free radicals in premature infants?

    Science.gov (United States)

    Akar, Melek; Yildirim, Tulin G; Sandal, Gonca; Bozdag, Senol; Erdeve, Omer; Altug, Nahide; Uras, Nurdan; Oguz, Serife S; Dilmen, Ugur

    2016-06-20

    Introduction Ibuprofen is used widely to close patent ductus arteriosus in preterm infants. The anti-inflammatory activity of ibuprofen may also be partly due to its ability to scavenge reactive oxygen species and reactive nitrogen species. We evaluated the interaction between oxidative status and the medical treatment of patent ductus arteriosus with two forms of ibuprofen. Materials and methods This study enrolled newborns of gestational age ⩽32 weeks, birth weight ⩽1500 g, and postnatal age 48-96 hours, who received either intravenous or oral ibuprofen to treat patent ductus arteriosus. Venous blood was sampled before ibuprofen treatment from each patient to determine antioxidant and oxidant concentrations. Secondary samples were collected 24 hours after the end of the treatment. Total oxidant status and total antioxidant capacity were measured using Erel's method.

  9. Synaptogenesis and Myelination in the Nucleus/Tractus Solitarius: Potential Role in Apnea of Prematurity, Congenital Central Hypoventilation, and Sudden Infant Death Syndrome.

    Science.gov (United States)

    Sarnat, Harvey B; Flores-Sarnat, Laura

    2016-05-01

    Fetuses as early as 15 weeks' gestation exhibit rhythmical respiratory movements shown by real-time ultrasonography. The nucleus/tractus solitarius is the principal brainstem respiratory center; other medullary nuclei also participate. The purpose was to determine temporal maturation of synaptogenesis. Delayed synaptic maturation may explain neurogenic apnea or hypoventilation of prematurity and some cases of sudden infant death syndrome. Sections of medulla oblongata were studied from 30 human fetal and neonatal brains 9 to 41 weeks' gestation. Synaptophysin demonstrated the immunocytochemical sequence of synaptogenesis. Other neuronal markers and myelin stain also were applied. The nucleus/tractus solitarius was similarly studied in fetuses with chromosomopathies, metabolic encephalopathies, and brain malformations. Synapse formation in the nucleus solitarius begins at about 12 weeks' gestation and matures by 15 weeks; myelination initiated at 33 weeks. Synaptogenesis was delayed in 3 fetuses with different conditions, but was not specific for only nucleus solitarius. Delayed synaptogenesis or myelination in the nucleus solitarius may play a role in neonatal hypoventilation, especially in preterm infants and in some sudden infant death syndrome cases.

  10. Comparative study on nasal continuous positive airway pressure combined with pulmonary surfactant in treatment of premature infants' Hyaline membrane disease%鼻塞式持续气道正压通气联合肺表面活性物质治疗早产儿肺透明膜病对照研究

    Institute of Scientific and Technical Information of China (English)

    刘勇; 程国平

    2011-01-01

    Objective To study the difference in curative effects of nasal continuous positive airway pressure (NCPAP) combined with pulmonary surfactant (PS) and NCPAP combined with Mucosolvan ( MU) on premature infants' Hyaline membrane disease ( HMD). Methods 90 premature infants with HMD were randomly divided into NCPAP combined with PS ( NC + PS treatment) group and MU ( NC + MU treatment) group. Curative effects, arterial blood gas, short and long term complications were compared after treatment. Results ( NC + PS) group' s total effective rate was higher than ( NC + MU) group, while the time of dyspnea remission , respirator treatment and mean hospitalization were lower than ( NC + MU) group with statistical significance (P 0.05 ) . They all increased after treatment except PaCO2, the differences in both group had statistical significance ( P < 0. 05 ). The main short term complications were pneumonia, intracranial hemorrhage and pulmonary hemorrhage; the main long term complications were cerebral palsy, hearing disorder and retinopathy of prematurity. Comprehensive situation in short and long term complications were significantly better in (NC + PS) group than (NC +MU) group (P<0.05). Conclusion NCPAP combined with PS could significantly promote curative effect on hyaline membrane disease with few short and long term complications. It is significantly better than NCPAP combined withMU.%目的 探讨鼻塞式持续气道正压通气(NCPAP)联合肺表面活性物质(PS)和NCPAP联合沐舒坦(MU)两种方法治疗早产儿肺透明膜病的疗效差异.方法 将90例肺透明膜病(HMD)早产儿随机分为NCPAP联合PS(NC+PS治疗组)和NCPAP联合MU(NC+ MU治疗组),分别进行治疗,并比较两组的疗效、动脉血气分析和近远期并发症的差异.结果 (NC+PS)组的总有效率显著高于( NC+ MU)组,而在呼吸困难缓解时间、上呼吸机时间和平均住院时间方面均小于(NC+MU)组,两组间的差异具有统计学意义(P<0.05).治

  11. Left thoracic sympathectomy in a premature infant with long QT syndrome and heart failure.

    Science.gov (United States)

    Surendran, Sushitha; Kumar, Thittamaranahalli K S; Knott-Craig, Christopher J

    2017-01-01

    Left thoracic sympathectomy has been shown to be an effective treatment for adults with long QT syndrome who are refractory to medical therapy. We report the successful use of left thoracic sympathectomy for the management of a 10-week-old premature baby with long QT syndrome and heart failure from a large ventricular septal defect and patent ductus arteriosus.

  12. Is arterial hypertension crucial for the development of cerebral haemorrhage in premature infants?

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1979-01-01

    . It is suggested that premature neonates are hypertensive when their blood-pressure is compared with that in utero, and that events that lead to further rises in pressure are common. Their capillaries are not protected against rises in arterial pressure because autoregulation is impaired. Furthermore...

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

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    Yao-Chia Chuang

    2004-12-01

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

  14. Lung mechanics and high-resolution computed tomography of the chest in very low birth weight premature infants

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    Rosane Reis de Mello

    Full Text Available CONTEXT: Premature infant lung development may be affected by lung injuries during the first few weeks of life. Lung injuries have been associated with changes in lung mechanics. OBJECTIVE: To evaluate an association between lung mechanics and lung structural alterations in very low birth weight infants (birth weight less than 1500 g. DESIGN: A cross-sectional evaluation of pulmonary mechanics (lung compliance and lung resistance and high resolution computed tomography of the chest at the time of discharge, in 86 very low birth weight infants born at Instituto Fernandes Figueira, a tertiary public healthcare institution in Rio de Janeiro, Brazil. Lung compliance and resistance were measured during quiet sleep. High resolution computed tomography was performed using Pro Speed-S equipment. MAIN MEASUREMENTS: Statistical analysis was performed by means of variance analysis (ANOVA/ Kruskal Wallis. The significance level was set at 0.05. RESULTS: Abnormal values for both lung compliance and lung resistance were found in 34 babies (43%, whereas 20 (23.3% had normal values for both lung compliance and lung resistance. The mean lung compliance and lung resistance for the group were respectively 1.30 ml/cm H2O/kg and 63.7 cm H2O/l/s. Lung alterations were found via high-resolution computed tomography in 62 (72% infants. Most infants showed more than one abnormality, and these were described as ground glass opacity, parenchymal bands, atelectasis and bubble/cyst. The mean compliance values for infants with normal (1.49 ml/cm H2O/kg high resolution computed tomography, 1 or 2 abnormalities (1.31 ml/cm H2O/kg and 3 or more abnormalities (1.16 ml/cm H2O/kg were significantly different (p = 0.015. Our data were insufficient to find any association between lung resistance and the number of alterations via high-resolution computed tomography. CONCLUSION: The results show high prevalence of lung functional and tomographic abnormalities in asymptomatic very low

  15. Lung mechanics and high-resolution computed tomography of the chest in very low birth weight premature infants

    Energy Technology Data Exchange (ETDEWEB)

    Mello, Rosane Reis de; Dutra, Maria Virginia Peixoto; Ramos, Jose Roberto; Daltro, Pedro; Boechat, Marcia; Andrade Lopes, Jose Maria de [Fundacao Inst. Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ (Brazil). Instituto Fernandes Figueira

    2003-07-01

    Premature infant lung development may be affected by lung injuries during the first few weeks of life. Lung injuries have been associated with changes in lung mechanics. The objective is to evaluate an association between lung mechanics and lung structural alterations in very low birth weight infants (birth weight less than 1500 g). The design presents a cross-sectional evaluation of pulmonary mechanics (lung compliance and lung resistance) and high resolution computed tomography of the chest at the time of discharge, in 86 very low birth weight infants born at Instituto Fernandes Figueira, a tertiary public health care institution in Rio de Janeiro, Brazil. Lung compliance and resistance were measured during quiet sleep. High resolution computed tomography was performed using Pro Speed-S equipment. Statistical analysis was performed by means of variance analysis (ANOVA/ Kruskal Wallis). The significance level was set at 0.05. The results showed abnormal values for both lung compliance and lung resistance were found in 34 babies (43%), whereas 20 (23.3%) had normal values for both lung compliance and lung resistance. The mean lung compliance and lung resistance for the group were respectively 1.30 ml/cm H{sub 2} O/kg and 63.7 cm H{sub 2} O/l/s. Lung alterations were found via high-resolution computed tomography in 62 (72%) infants. Most infants showed more than one abnormality, and these were described as ground glass opacity, parenchymal bands, atelectasis and bubble/cyst. The mean compliance values for infants with normal (1.49 ml/cm H{sub 2} O/kg) high resolution computed tomography, 1 or 2 abnormalities (1.31 ml/cm H{sub 2} O/kg) and 3 or more abnormalities (1.16 ml/cm H{sub 2} O/kg) were significantly different (p = 0.015). Our data were insufficient to find any association between lung resistance and the number of alterations via high-resolution computed tomography. The conclusion was that the results show high prevalence of lung functional and tomographic

  16. Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants

    DEFF Research Database (Denmark)

    Dahl, Marianne; Holmskov, Uffe; Husby, Steffen

    2006-01-01

    of SP-D in capillary blood day 1 was 1,466 ng/mL (range 410-5,051 ng/mL), with lowest values in infants born with ROM and delivered vaginally. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be more likely in infants in need for respiratory support or surfactant...

  17. Auditory evoked potentials in premature and full-term infants Potenciais evocados auditivos em lactentes pré-termo e a termo

    Directory of Open Access Journals (Sweden)

    Maria Angélica de Almeida Porto

    2011-10-01

    Full Text Available Accurate information about type, degree, and configuration of hearing loss are necessary for successful audiological early interventions. Auditory brainstem response with tone burst stimuli (TB ABR and auditory steady-state response (ASSR exams provide this information. AIM: To analyze the clinical applicability of TB ABR and ASSR at 2 kHz in infants, comparing responses in full-term and premature neonates. MATERIAL AND METHOD: The study was cross-sectional, clinical and experimental. Subjects consisted of 17 premature infants and 19 full-term infants. TB ABR and ASSR exams at 2000 Hz were done during natural sleep. RESULTS: The electrophysiological minimum response obtained with TB ABR was 32.4 dBnHL (52.4 dBSPL; the ASSR minimum was 13.8 dBHL (26.4 dBSPL. The exams required 21.1 min and 22 min, respectively. Premature and full-term infant responses showed no statistically significant differences, except for auditory steady-state response duration. CONCLUSIONS: Both exams have clinical applicability at 2 kHz in infants, with 20 min of duration, on average. In general, there are no differences between premature and full-term individuals.O sucesso de uma intervenção audiológica precoce depende de informações precisas quanto ao tipo, grau e configuração da perda auditiva. O potencial evocado auditivo de tronco encefálico com o estímulo tone burst (PEATE TB e a resposta auditiva de estado estável (RAEE proporcionam tais informações. OBJETIVO: Investigar a aplicabilidade clínica, em lactentes, do PEATE TB e da RAEE na frequência de 2 kHz, comparando as respostas dos lactentes nascidos a termo e prétermo. MATERIAL E MÉTODO: O estudo (transversal, clínico e experimental foi realizado com uma casuística de 17 lactentes pré-termo e 19 a termo submetidos ao PEATE TB e RAEE em 2000 Hz. RESULTADOS: A resposta eletrofisiológica mínima obtida com o PEATE TB foi de 32,4 dBnNA (52,4 dBNPS e com a RAEE de 13,8 dBNA (26,4 dBNPS, com dura

  18. Comparison of cerebral oxygen saturation in premature infants by near-infrared spatially resolved spectroscopy: observations on probe-dependent bias

    DEFF Research Database (Denmark)

    Sorensen, Line C; Leung, Terence S; Greisen, Gorm

    2008-01-01

    Spatially resolved spectroscopy (SRS) allows the estimation of absolute tissue oxygen saturation, the ratio of oxygenated to total hemoglobin concentration, which may facilitate the comparison of results among patients. Eighty-two premature infants were included over two years. The cerebral tissue...

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

    NARCIS (Netherlands)

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

    1994-01-01

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

  20. 早产儿肠道外营养支持技术%Approach to parenteral nutrition in premature infants

    Institute of Scientific and Technical Information of China (English)

    印学蕾; 贲晓明

    2015-01-01

    After birth,the premature infants usually need a proper way for intestinal nutrition.The composition and configuration of nutrition admixture must meet the special requirements of the premature infants.In the first few days,because of invisible water lose,they should maintain a stable internal environment,and 1 week later,they need to gradually achieve a stable growth rate.Parenteral nutrition may lead to various complications,such as infection,metabolic complications,etc.monitoring the index,then adjusting the dosage,and achieving full enteral nutrition as soon as possible,may be effective prevention measures.%早产儿出生后常需要选择合适的肠道外营养输入途径.而早产儿静脉营养液的组成和配置也有特殊要求,以满足早产儿独特的生理特点和发育规律.早产儿出生后最初几天不显性失水较多,需要维持内环境稳定,而1周后则需要逐渐实现稳定的增长速率.静脉营养可能发生各种并发症,如感染、代谢性并发症等.注意监测指标,及时调整剂量,以及尽早过渡到全肠内营养,可以有效预防并发症的发生.

  1. Treatment for Retinopathy of Prematurity in an Infant with Adenoviral Conjunctivitis

    Directory of Open Access Journals (Sweden)

    Murat Gunay

    2015-01-01

    Full Text Available Retinopathy of prematurity (ROP has been a major problematic disorder during childhood. Laser photocoagulation (LPC has been proven to be effective in most of the ROP cases. Adenoviral conjunctivitis (AVC is responsible for epidemics among adult and pediatric population. It has also been reported to be a cause of outbreaks in neonatal intensive care units (NICU several times. We herein demonstrate a case with AVC who underwent LPC for ROP. And we discuss the treatment methodology in such cases.

  2. Effect of closed endotracheal suction in high-frequency ventilated premature infants measured with electrical impedance tomography

    NARCIS (Netherlands)

    van Veenendaal, M.B.; Miedema, M.; de Jongh, F.H.C.; van der Lee, J.H.; Frerichs, I.; van Kaam, A.H.

    2009-01-01

    Objective: To determine the global and regional changes in lung volume during and after closed endotracheal tube (ETT) suction in high-frequency ventilated preterm infants with respiratory distress syndrome (RDS). Design: Prospective observational clinical study. Setting: Neonatal intensive care

  3. 抚触对早产儿生长发育的影响%Influence of massage on growth and development of premature infants

    Institute of Scientific and Technical Information of China (English)

    吴广华

    2011-01-01

    目的:探讨抚触对早产儿生长发育的影响.方法:选择住院期间病情稳定后的早产儿70 例,将其随机分为抚触组(40 例)和对照组(30 例),抚触组给予正规的抚触,于第42 天评估两组体格(头围、身长及体重)增长幅度、摄入母乳量和睡眠时间,于纠正胎龄40 周时进行20 项新生儿行为神经测定,并作组间比较.结果:抚触组体格的增长、摄入量、睡眠时间及行为神经的发育明显优于对照组(P<0.05).结论:抚触对早产儿的生长发育有明显的促进作用.%Objective: To assess the influence of massage on the growth and development of premature infants. Methods: 70 premature infants who were considered medically stable were randomly divided into message group (ra=40) and control group (/I=30). The premature infants of massage group received routine massage. The premature infants in two groups were assessed in terms of physical growth (head circumference, length and weight), breast milk intakes and sleep time at the 42th postnatal day. They were assessed with twenty-item neonatal behavior neurologic assessment (NBNA) at 40 weeks of correcting gestational age. Comparison was done between the two groups. Results: Physical growth, breast milk, sleep time intakes and 20 developmental items in the massage group were significantly better than the control group (P<0.05). Conclusion: Massage can obviously promote the growth and development of premature infants.

  4. 早产儿视网膜病变的筛查及其相关因素研究%Screening of Retinopathy of Premature Infants and Its Related Factors

    Institute of Scientific and Technical Information of China (English)

    甘轶文

    2016-01-01

    目的:分析早产儿视网膜病变的筛查结果及其相关因素。方法选取我院2012年1月~2016年5月收治的320例早产儿作为本次实验的目标对象,对320例早产儿的临床资料进行回顾性分析,并对其实施视网膜病变筛查,分析筛查结果及其相关因素。结果320例早产儿经筛查显示,有23例(7.19%)为ROP,同时研究发现,ROP组早产儿和非ROP组早产儿之间的体质量、胎龄、机械通气、吸氧>10 d、输血治疗机率对比,差异均具有统计学意义,P<0.05。结论导致早产儿发生视网膜病变的因素主要为低体质量、小胎龄、长时间吸氧、机械通气治疗、输血治疗等。%Objective To analyze the screening results and related factors of retinopathy of premature infants.Methods From January 2012 to May 2016, 320 cases of premature infants in our hospital were selected as the experimental object, the clinical data of 320 cases of premature infants were retrospectively analyzed, and the implementation of retinopathy screening, screening results and related factors analysis.Results 320 cases of premature infants after screening showed that there were 23 cases (7.19%) of ROP, while the study found that between ROP group and non ROP preterm premature infants body weight, gestational age, mechanical ventilation, oxygen > 10 d, blood transfusion treatment, there were signiifcant differences,P< 0.05.Conclusion The main factors that lead to the occurrence of retinopathy in preterm infants are low body mass, small gestational age, long time oxygen inhalation, mechanical ventilation, blood transfusion.

  5. Early enteral fat supplementation with microlipid® and fish oil in the treatment of two premature infants with short bowel.

    Science.gov (United States)

    Yang, Qing; Welch, Cherrie D; Ayers, Kathleen; Turner, Charles; Pranikoff, Thomas

    2010-01-01

    The infusion of Intralipid® is a main risk factor for parenteral nutrition-associated cholestasis in infants with short bowel syndrome. Early provision of enteral fat to reduce the use of Intralipid while providing adequate fat for the growth of infants with short bowel has not been reported. We present 2 cases of premature infants with short bowel who received early supplementation of enteral Microlipid® and fish oil. This approach allowed us to discontinue Intralipid shortly after initiating feedings. The infants tolerated Microlipid/fish oil well without adverse reactions, had appropriate weight gain and ostomy output. They underwent bowel reanastomosis 3 weeks after enteral feeding began, and were discharged on full oral feedings. In case 1, the infant did not develop parenteral nutrition-associated cholestasis; in case 2, cholestasis had developed before initiating feeds, but was not aggravated by enteral fat and was improving prior to discharge.

  6. Magnetic Resonance Imaging--Insights into Brain Injury and Outcomes in Premature Infants

    Science.gov (United States)

    Mathur, Amit; Inder, Terrie

    2009-01-01

    Preterm birth is a major public-health issue because of its increasing incidence combined with the frequent occurrence of subsequent behavioral, neurological, and psychiatric challenges faced by surviving infants. Approximately 10-15% of very preterm children (born less than 30 weeks gestational age) develop cerebral palsy, and 30-60% of them…

  7. An Epidemiological Study on Infant Mortality and Factors Affecting it in Rural Areas of Birjand, Iran

    Directory of Open Access Journals (Sweden)

    Kokab Namakin

    2008-12-01

    Full Text Available Objective: Infant mortality rate is one of the most expressive indicators of development in all countries. The aim of this study was to determine the cause of infant mortality and risk factors in rural areas of Birjand in Iran. Methods: This population based case-control study covered 156 infants who died when aged less than one-year in health houses of Birjand between January 2004 and December 2005. For each case, two controls were selected matching one-to-one to the case considering variables of residency and their date of birth. The data was collected through interview with mothers and reviewing infants files in health houses. Findings: 57.7 percent of deaths in under one year old infants happened during the first month of their lives. The most important causes of death in neonates were prematurity and low birth weight (44.4% later gastroenteritis (30.3%. In addition, the study showed that 9.6 percent of infants had died because of narcotic toxicosis. Moreover, the study showed a significant relationship between infant mortality and parents level of education, mothers addiction, age of mother in the first pregnancy, prematurity, low birth weight, type of delivery and exclusive breast feeding. Conclusion: Special attention to infantile period and special care for infants born to at-risk mothers, as well as providing special health education can cause a dramatic reduction in infants mortality rate.

  8. 发展性照顾在早产儿护理中的应用%Developmental Care in Premature Infant Care Application

    Institute of Scientific and Technical Information of China (English)

    齐红

    2013-01-01

      目的探讨发展性照顾在早产儿护理中的应用。方法将我院收治的70例早产儿随机分为观察组和对照组各35例,观察组采用发展性照顾,对照组采用儿科常规护理,比较两组早产儿进奶量、平均体质量增长速度以及住院天数。结果观察组早产儿进奶量、平均体质量增长速度以及住院天数均显著优于对照组,两组比较,差异具有统计学意义(P<0.05)。结论对早产儿应用发展性照顾,有利于促进早产儿的发育,提高早产儿进奶量、增加体质量、缩短住院时间,帮助早产儿健康成长,提高早产儿的存活质量。%Objective Discusses developmental care in premature infant care application. Methods Will be our hospital from 70 cases of premature infants were randomly divided into observation group and control group the 35 patients, the observation group and control group in the developmental care by pediatric conventional nursing, compare two groups of premature into milk quantity, average weight growth speed and hospitalization days. Results The observation group premature into milk quantity, average weight growth speed and hospitalization days were significantly superior to control group, two groups of comparisons, the difference is statistically significant (P<0.05). Conclusion To take care of premature application development, promote the development of premature infants, and improve the premature into milk supply, increase weight, shorter hospital stay and help premature healthy growth, improve the quality of the survival of the premature infant.

  9. Nutritional strategies for premature infants%早产儿临床营养支持策略

    Institute of Scientific and Technical Information of China (English)

    邬方彦; 贲晓明

    2015-01-01

    As survival of premature infants has increased,nutritional support has become a more prominent component of patient care.Aggressive nutritional strategies can reduce the incidence of extrauterine growth retardation (EUGR),speed up the physical growth and promote the development of intelligence.But excessive weight gain may also increase the risk of obesity and cardiovascular diseases in the future.This review mainly introduces and interprets the "enteral nutrient supply for preterm infants:commentary from the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN),2010",to provide an evidence-based medicine nutritional guideline for preterm infants.%随着近年来早产儿成活率的提高,营养支持成为新生儿重症监护的一个重要内容.积极的营养支持策略可减少宫外生长发育迟缓,加快体格生长,促进智能发育.但体质量过度增长,也可能会增加远期肥胖和心血管疾病的风险.现主要介绍并解读“2010欧洲儿科胃肠肝病学与营养学会(ESPGHAN)对于早产儿肠内营养需求的建议”,为早产儿医护人员提供一个循证医学的营养摄入指南.

  10. The nutritional status of the hospitalized premature infants with very low birth weight in China:a retrospective multicenter study%极低出生体质量早产儿院内营养现状多中心调查

    Institute of Scientific and Technical Information of China (English)

    中国医师协会新生儿专业委员会-营养专家委员会协作组

    2015-01-01

    Objective The aim of this study was to investigate the nutritional status of the hospitalized premature infants with birth weight lower than 1 500 g in the different areas in China, and to analyze the related inlfuence factors of extrauterine growth restriction (EUGR). Methods The retrospective survey method was used to collect clinical data of the premature infants with birth weight lower than 1 500 g and hospital stay of more than 2 weeks in 15 hospitals between January 1, 2012 and December 31, 2012. A descriptive analysis was performed for intestinal and parenteral nutrition and weight gain, and the related inlfuence factors of EUGR were analyzed. Results A total of 572 premature infants were selected. The mean gestational age was 30.6±2.0 weeks, and the mean birth weight was 1255.7±164.8 g. The mean enteral feeding starting time after birth was 68.2±85.4 hours, and the mean age to reach oral calorie of 100 kcal/(kg·d) was 29.9±14.1 days. During hospitalization, the mean weight growth velocity after return to birth weight was 11.8±5.5 g/(kg·d). The duration of hospitalization was 42.2±20.8 days and the corrected gestational age was 36.6±2.7 weeks at the time of discharge. At birth, the percentage of birth weight below P10 was 52.6%, and below P3 was 29.0%. At the time of discharge, the percentage of weight below P10 was 80.9%, and below P3 was 63.6%. There were differences between two time points (P2周、出生体质量<1500 g的早产儿临床资料,包括住院期间的喂养方式、营养状况、并发症及诊断和治疗,并对早产儿住院期间的肠内外营养、体质量增长情况进行描述性分析,并分析EUGR的相关因素。结果入选572例早产儿,出生胎龄(30.6±2.0)周,出生体质量(1255.7±164.8)g;开始肠道喂养的时间为(68.2±85.4)h,口服能量达到100 kcal/(kg·d)(1cal=418.68J)的日龄为(29.9±14.1)d;住院期间在恢复至出生体质量后其体质量增长速度为(11.8±5.5)g

  11. Necrotizing fasciitis: a case report of a premature infant with necrotizing enterocolitis.

    Science.gov (United States)

    Casey, Denise M; Stebbins, Karen; Howland, Victoria

    2013-01-01

    Necrotizing fasciitis (NF) is a severe infection involving the superficial fascia, subcutaneous tissue, and, occasionally, deeper tissue layers. Usual treatment is with surgical debridement in combination with antibiotics. In review of the literature there is one neonatal report of NF associated with necrotizing enterocolitis. We present a case report of a 25 week gestation infant with necrotizing fasciitis and the complexity of wound and pain management presented for the nursing staff in the neonatal intensive care unit.

  12. [Comparative evaluation of the effectiveness of various schedules of phototherapy in premature newborn infants with hyperbilirubinemia].

    Science.gov (United States)

    Rudenko, E B; Kalinicheva, V I

    1990-01-01

    As many as 118 premature neonates weighing from 900 to 2500 g at birth, afflicted with hyperbilirubinemia were examined. In 80 children, the use of phototherapy (PT) appeared an indispensable condition of the treatment of jaundice. The regimen of radiation varied: 28 children received intermittent treatment lasting 24 hours; 52 children were given continuous treatment, with the period of radiation amounting to 48 or 72 hours. Part of the children were on PT combined with alpha-tocopherol acetate. Bilirubin concentration in the blood serum, lipid peroxidation, the lipid and phospholipid spectra of red blood cell membranes were used as criteria for the treatment efficacy. The highest therapeutic effect was attained in the children who received continuous radiation lasting 48 hours. The efficacy of PT turned out enhanced on its combination with alpha-tocopherol acetate.

  13. [Determination of the bacterial density of the mid-stream urine in premature infants].

    Science.gov (United States)

    Veleminský, M

    1982-12-01

    Bacteriuria was investigated in midstream urine samples taken from 1255 apparently healthy premature neonate; 24% of the samples had a bacterial count of 10(5) per ml. The results were found to fit the lognormal distribution. We suggest that the diagnosis of urinary tract infection in the preterm should take the clinical state into account and that a bacteriuria of 10(5) per ml should not be considered significant. In our opinion only bacterial counts of 10(7) per ml or higher should be regarded as asymptomatic bacteriurias in this age group, since at this concentration the probability of error is only 4% which is an acceptable limit from the statistical point of view. If an uncontaminated urine specimen is needed in a preterm neonate percutaneous needle aspiration or catheterization of the urinary bladder is essential.

  14. The effect of decibel level of music stimuli and gender on head circumference and physiological responses of premature infants in the NICU.

    Science.gov (United States)

    Cassidy, Jane W

    2009-01-01

    The purpose of this study was to examine different protocols with regard to the presentation of music stimuli and compare gender differential reactions to those stimuli. Subjects for this study (N = 63) were premature infants in the Neonatal Intensive Care Unit (NICU) between the gestational ages of 28 and 33 weeks. Half of the experimental infants listened to 20 mins of lullaby music (female voice with orchestral background) on 2 days followed by 20 mins of classical music (Mozart string music) on 2 days. The other half listened to the same music in the reverse order. One quarter of the males and one quarter of the females listened to music presented at an average of 65 dB, one quarter at an average of 70 dB, one quarter at an average of 75 dB, and one quarter did not listen to any music and served as control subjects. Head circumference data were collected four times by the researcher: (a) upon receipt of parental consent, (b) on the first day of music presentation (1 week after consent), (c) on the last day of music presentation, and (d) 1 week after music presentation. Physiological data (heart rate, respiratory rate, oxygen saturation) were recorded by the researcher at 2-minute intervals starting 4 minutes prior to and ending 4 minutes after music presentation. There was a significant difference (p < .0001) in average daily head growth across time, but this seems unrelated to the music condition as the same curvilinear trend (larger gain during days of treatment, smaller gain during baseline before and after treatment) was noted for control infants who did not listen to music. Results indicate a significant (p = .002), but biologically unimportant, decrease in heart rate over the course of data collection. No differences due to gender were noted.

  15. Study Shows How Zika Attacks Infant Brain

    Science.gov (United States)

    ... gov/news/fullstory_162514.html Study Shows How Zika Attacks Infant Brain Virus can copy itself thousands ... New research paints a chilling portrait of how Zika ravages the infant brain. Scientists from the U.S. ...

  16. Use of Biphasic Continuous Positive Airway Pressure in Premature Infant with Cleft Lip–Cleft Palate

    Directory of Open Access Journals (Sweden)

    Lovya George

    2015-10-01

    Full Text Available Preterm infants (PIs often require respiratory support due to surfactant deficiency. Early weaning from mechanical ventilation to noninvasive respiratory support decreases ventilation-associated irreversible lung damage. This wean is particularly challenging in PIs with cleft lip and cleft palate due to anatomical difficulties encountered in maintaining an adequate seal for positive pressure ventilation. PI with a cleft lip and palate often fail noninvasive respiratory support and require continued intubation and mechanical ventilation. We are presenting the first case report of a PI with cleft lip and palate who was managed by biphasic nasal continuous positive airway pressure.

  17. Increased risk of ALL among premature infants is not explained by increased prevalence of pre-leukemic cell clones

    DEFF Research Database (Denmark)

    Lausten-Thomsen, Ulrik; Madsen, Hans Ole; Vestergaard, Therese Risom

    2010-01-01

    in the prevalence and magnitude of preleukaemic t(12;21)-positive cells compared to previously published data from mature children could be demonstrated. This indirectly supports the theory that prevalence and quantity of preleukaemic t(12;21)-positive cells peaks at term or early childhood and that exogenous......The multi-hit hypothesis for paediatric leukemogenesis states that an initial genetic hit (often occurring prenataly) must be followed by one or more hit(s) before a cell become leukeamic. Studies have demonstrated the presence of pre-leukaemic t(12;21)-positive cells at levels 10(-3) to 10...... and quantity of pre-leukaemic t(12;21)-positive children born prematurely. Using a sensitive qRT-PCR assay, we screened messenger RNA from fresh umbilical cord-blood samples from 256 premature children. In none of the neonates, t(12;21)-positive cells could be demonstrated. Therefore, no increase...

  18. Effects of flow amplitudes on intraprong pressures during bubble versus ventilator-generated nasal continuous positive airway pressure in premature infants.

    Science.gov (United States)

    Kahn, Doron J; Habib, Robert H; Courtney, Sherry E

    2008-11-01

    The goal were to characterize the flow dependence of bubble nasal continuous positive airway pressure delivery in a cohort of preterm infants and to compare the actual (delivered) intraprong continuous positive airway pressure with the intended (set) nasal continuous positive airway pressure for both ventilator-generated nasal continuous positive airway pressure and bubble nasal continuous positive airway pressure delivery. A range of set values and constant flow rates were studied in the same preterm infants. For 12 premature infants of pressures were measured at 3 increasing flow settings, repeated for set nasal continuous positive airway pressures (or desired immersion depths) of 4 and 6 cm H(2)O. Next, intraprong pressures were measured at bubble nasal continuous positive airway pressure expiratory tubing submersion depths and ventilator-generated nasal continuous positive airway pressure set expiratory pressures of 2, 3, 4, 5, and 7 cm H(2)O while the flow rate was held constant. Actual (delivered) intraprong pressure during bubble nasal continuous positive airway pressure delivery was highly flow dependent and increased as the flow rate increased. During ventilator-generated nasal continuous positive airway pressure delivery, actual pressure at the nasal prongs closely approximated the pressure set at the ventilator. During bubble nasal continuous positive airway pressure delivery at constant flow rate, the average delivered prong pressure was 1.3 cm H(2)O (range: 0.5-2.2 cm H(2)O) higher than that set through submersion of the expiratory tubing, and the relative difference between the set and actual pressures increased at lesser immersion depths. Prong pressure during bubble nasal continuous positive airway pressure delivery is highly variable and depends on the interaction of submersion depth and flow amplitudes.

  19. Risk factors for adverse events after vaccinations performed during the initial hospitalization of infants born prematurely.

    Science.gov (United States)

    Wilińska, Maria; Warakomska, Małgorzata; Głuszczak-Idziakowska, Ewa; Jackowska, Teresa

    There are significant delays in implementing vaccination among preterm infants. Description of the frequency and kinds of adverse events following immunization in preterms. Establishment of the group of preterms who will distinctively be susceptible to adverse events. Demographical, clinical data and the occurrence of adverse events after DTaP, HIB and pneumococcal vaccination among preterms during their initial hospitalization were prospectively collected with the use of an electronic data form between 1st June 2011 and 31st May 2015. The analysis was conducted on 138 patients. The groups were divided according to maturity (I: ≤ GA 28w n=73 and GA 29-36 w n=65). There were no statistically significant differences between the groups in the occurrence of adverse events. Out of the total group, following vaccination apnoea developed in 6 newborns (4%) and activity dysfunctions were observed in 13 newborns (10%). The occurrence of apnoea after vaccination positively correlated with the time of non-invasive ventilation and the occurrence of late infection. There were no statistically significant demographical or clinical risk factors for the development of activity dysfunctions following vaccination. Term vaccination in clinically stable preterm infants is a safe medical procedure. However, long-term non-invasive respiratory support and late infections are risk factors for apnea following vaccinations. In these patients vaccinations should be considered during hospitalization.

  20. Clinical effect of caffeine citrate on primary premature apnea in premature infants%枸橼酸咖啡因在早产儿原发性呼吸暂停中的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵强; 宋红; 李志洁

    2016-01-01

    Objective To evaluate the effect of caffeine citrate on pri-mary premature apnea in premature infants.Methods Ninety premature infants with primary premature apnea were divided into treatment group and control group.Premature infants in control group were treated by loading dose of 5 mg· kg -1 of amnophyllinea, maintaining doses of 2.5 mg· kg-1.Premature infants in treatment group were treated by loading dose of 20 mg· kg-1 of caffeine citrate, maintaining doses of 5 mg· kg-1.The treatment lasted for 5 days.Effective rate,the disappearance time of clinical symptoms, length of hospital, expense and mortality between 2 groups were analyzed and compared before and after treatment.Results The effective rate of treatment group was 95.2%, which was higher than that of control group (77.0%, P0.05).Conclusion The short course of caffeine citrate on premature infants with primary premature apnea has better effects without obvious adverse drug reaction, and finally relieves patients’ financial burden.%目的:观察短疗程枸橼酸咖啡因在早产儿原发性呼吸暂停中的疗效。方法90例原发性呼吸暂停的早产儿分为试验组42例和对照组48例。对照组给予首剂量氨茶碱5 mg· kg-1,12 h后给予维持量2.5 mg· kg-1,每日2次;试验组给予首剂量枸橼酸咖啡因20 mg· kg-1,24 h后给予维持量5 mg· kg-1,每日1次,均连续给药5 d,比较2组有效率、临床症状消失时间,住院时间、住院费用及死亡率。结果治疗后,试验组有效率(95.2%)显然高于对照组(77.0%)。试验组临床症状消失时间、住院时间及住院费用均低于对照组(P<0.05),2组死亡率差异无统计学意义(P>0.05)。结论短疗程枸橼酸咖啡因治疗早产儿原发性呼吸暂停疗效较好,未增加明显不良反应,又减轻患者负担。

  1. 早产儿动脉导管未闭现状和危险因素调查研究%Investigation on the present situation and risk factors of premature infants with patent ductus arteriosus

    Institute of Scientific and Technical Information of China (English)

    石小娟; 冯璇

    2013-01-01

    Objective To study the present situation of premature infants with patent ductus arteriosus and its risk factors.Methods A total of 824 premature infants in our hospital from October 2011 to October 2012 were selected as research object,then the patent ductus arteriosus rate of all the premature infants was investigated,and the rates of premature infants with different maternal factors and neonatal factors were compared.Results 190 cases of 824 premature infants were with patent ductus arteriosus,the rate was 23.05%,the patent ductus arteriosus rate of premature infants with meconium stained amniotic fluid,oligohydramnios,infection during pregnancy and gestational diabetes mellitus were higher than those of others,the rate of those with maternal hormone application was lower than that without hormone,the rates of those with lower gestational age and birth weight,intrauterine distress,Apgar score < 8 points were all higher than those of others (all P < 0.05),there were significant differences.Conclusions The risk factors of premature infants with patent ductus arteriosus is more,and it mainly includes the maternal gestational factors and neonatal factors.So they should be paid enough attention.%目的 调查分析早产儿动脉导管未闭的现状及其危险因素.方法 选取2011年10月至2012年10月的824例早产儿为研究对象,将其动脉导管未闭发生率进行调查,并将其中不同母体因素及新生儿因素的发生率进行比较.结果 824例早产儿中发生动脉导管未闭190例,发生率为23.05%;羊水粪染、羊水过少、孕期感染及妊娠期糖尿病患者的动脉导管未闭发生率高于其他患者,而母体应用激素者低于未用激素者(P均<0.05);胎龄及出生体重较小、宫内窘迫、Apgar评分<8分患儿动脉导管未闭发生率均高于其他患儿,差异有统计学意义(P<0.05).结论 早产儿动脉导管未闭的危险因素较多,主要包括母体妊娠期因素及新生儿因素,应给予充分重视.

  2. Use of 2% 2-phenoxyethanol and 0.1% octenidine as antiseptic in premature newborn infants of 23-26 weeks gestation.

    Science.gov (United States)

    Bührer, C; Bahr, S; Siebert, J; Wettstein, R; Geffers, C; Obladen, M

    2002-08-01

    In preterm newborn infants, topical iodine-containing antiseptics disturb thyroid hormone regulation while alcohol-based disinfectants may cause local burns. We therefore investigated the use of an aqueous solution containing 0.1% octenidine and 2% 2-phenoxyethanol for skin disinfection during the first seven days of life in premature newborns with a gestational age octenidine/phenoxyethanol solution prior to umbilical vessel catheterization. No other local reactions were observed. The urinary concentration of 2-phenoxyethanol was octenidine and 2-phenoxyethanol does not cause major skin damage in premature newborn infants <27 weeks' gestation. 2-Phenoxyethanol is readily absorbed by the newborn's skin but apparently undergoes extensive oxidative metabolization to 2-phenoxyacetic acid.

  3. 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

  4. 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.

  5. A LONGITUDINAL DESCRIPTIVE STUDY ON RETINOPATHY OF PREMATURITY IN A TERTIARY CARE CENTRE IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Mary

    2016-04-01

    Full Text Available BACKGROUND To find out the incidence of threshold Retinopathy of Prematurity, its association with birth weight and gestational age and outcome of management in a tertiary care centre. MATERIALS AND METHODS A longitudinal descriptive study by retrospective analysis of records. Screening was done for all neonates of 30 weeks gestational age, 11.1% of infants were >1500 grams of birth weight. Threshold retinopathy was not seen above 35 weeks of gestational age and 1860 grams birth weight. All infants improved with treatment and vascularisation extended to periphery. None of them progressed to stage 4 or 5. CONCLUSION Only 4.10% of the screened babies needed treatment and was in par with the standards of developed countries. Even with high standards of neonatal care in our centre, larger and heavier babies developed severe retinopathy. Being an institutional based small group study, this cannot be considered as a representation of the whole country and it is the limitation of this study. Correct identification of the threshold disease and prompt management will prevent severe visual disability in children and prevent them from being a burden to the family and society

  6. Investigation of an Equivalence of Pain Assessment by a ]apanese Version of the Premature Infant Pain Profile among Neonatal Nurses

    OpenAIRE

    小澤, 未緒; 砂金, 直子; 菅田, 勝也; 平田, 倫生; 草川, 功; 鈴木, 智恵子

    2012-01-01

    日本語版 Premature Infant Pain Profile (PIPP)の臨床での活用可能性を検討することを目的として,異なる施設に所属する Neonatal Intensive Care Unit (NICU)看護師8名を対象とし,28の同一採血場面を日本語版PIPPで採点した場合の評価者間信頼性を検討した。また,NICU勤務経験5年以上の群と5年未満の群で疼痛評価に違いがあるのかも検討した。評価者間信頼性は先行研究よりも低かったが,NICU勤務経験5年以上の群と5年未満の群でPIPP総得点の有意な違いはなかった。これらのことから,日本語版PIPPは臨床における新生児の疼痛評価に有用であると考えられた。...

  7. TRADUÇÃO E ADAPTAÇÃO DO PREMATURE INFANT PAIN PROFILE PARA A LÍNGUA PORTUGUESA

    Directory of Open Access Journals (Sweden)

    Mariana Bueno

    2013-01-01

    Full Text Available El objetivo del estudio fue traducir y adaptar la versión del Premature Infant Pain Profile para el portugués de Brasil. Es un estudio transversal y metodológico para validación de la tradición de instrumento. El proceso se llevó a cabo en cuatro etapas: traducción inicial, síntesis, re-traducción y análisis por jueces. Se establecieron cuatro versiones distintas del instrumento traducido al portugués y una versión sintética fue producida a partir de traducciones anteriores. Posteriormente, dos versiones fueron re-traducidas independientemente y no mostraron diferencias importantes del original. Un comité de jueces revisó la versión resumida y las retraducciones con respecto a la equivalencia semántica y idiomática y consideraron adecuada la versión del instrumento en portugués. El instrumento Perfil da Dor no Recém-Nascido Pré-termo fue considerado adaptado al idioma portugués, para su aplicación en la investigación y en la práctica clínica. Esto contribuye, especialmente, para la internacionalización de los resultados de la investigación en Brasil.

  8. Supporting Techniques of Oral Feeding in Premature Infants%早产儿经口喂养的支持技术

    Institute of Scientific and Technical Information of China (English)

    彭文涛; 王丹华; 魏珉

    2014-01-01

    The primary goal of care for premature infants during hospitalization in the neonatal intensive care unit(NICU)is to promote oral feeding.The success of oral feeding decide a premature infant transform from parenteral nutrition and gavage to oral feeding,smoothly.Furthermore,successful oral feeding will effectively improve short-term and long-term prognosis of hospitalization premature infants.The purpose of this article is to summarize the literature regarding theories,assessment and interventions of oral feeding.%促进早产儿经口喂养是新生儿重症监护室(NICU)住院早产儿管理的重点,经口喂养成功与否决定早产儿能否顺利完成从肠外营养-管饲喂养-经口喂养的转换。经口喂养能有效改善住院早产儿近期和远期预后。笔者拟就早产儿经口喂养支持技术的相关理论、评估方法及干预措施,进行综述如下。

  9. 危重早产儿肠外营养支持研究进展%Research Progress of Parenteral Nutrition Support in Premature Infants with Heavy Diseases

    Institute of Scientific and Technical Information of China (English)

    黄剑飞

    2013-01-01

    Because of the organ hypoplasia,premature infants suffer from malnutrition easily. The application of parenteral nutrition support in premature infants can significantly improve the survival rate and quality of life. The parenteral nutrition support include the infusion of glucose, amino acids, fat, electrolyte, vitamin and trace elements. The infusion pathways mainly include peripheral intravenous infusion and central intravenous infusion. Here is to make a review on the research progress of parenteral nutrition support in premature infants.%危重早产儿由于器官功能发育不全,出生后往往容易出现营养不良的情况,肠外营养支持在危重早产儿治疗中的应用能显著提高早产儿的存活率和生存质量.肠外营养支持主要包括葡萄糖、氨基酸、脂肪以及电解质、维生素和多种微量元素的输注,输注途径主要包括经外周静脉输注和经中心静脉输注两大途径.现对危重早产儿肠外营养支持的研究进展进行综述.

  10. 早产儿贫血现状及防治研究进展%Anemia in premature infants:current status and progress of prevention and therapy

    Institute of Scientific and Technical Information of China (English)

    姜红

    2011-01-01

    The survival rate of premature infants has been improving remarkably with the progress of modem medical technology. While anemia m premature infants remains a common nutritional problem. The main methods of prevention and therapy for this symptom are iron supplementation through various routes, red blood cell transfusion and use of recombinant human erythropoietin. However, each method has its advantages and disadvantages. This review focuses on the current status oi anemia m premature infants anc recent progress of its prevention and therapy.%随着现代医疗技术水平的不断提高,早产儿存活率也在不断提高,但早产儿贫血目前仍是早产儿营养管理上的常见问题之一.防治早产儿贫血的主要方法有不同途径的补充铁剂、红细胞输注及合理使用重组人红细胞生成素等,但上述防治方法各有利弊.文章就早产儿贫血的现状及防治方面进展进行论述.

  11. Retrospective study shows that doxapram therapy avoided the need for endotracheal intubation in most premature neonates.

    Science.gov (United States)

    Flint, Robert; Halbmeijer, Nienke; Meesters, Naomi; van Rosmalen, Joost; Reiss, Irwin; van Dijk, Monique; Simons, Sinno

    2017-05-01

    Using doxapram to treat neonates with apnoea of prematurity might avoid the need for endotracheal intubation and invasive ventilation. We studied whether doxapram prevented the need for intubation and identified the predictors of the success. This was a retrospective study of preterm infants born from January 2006 to August 2014 who received oral or intravenous doxapram. Success was defined as no need for endotracheal intubation, due to apnoea, during doxapram therapy. Univariable and multivariable logistic regression analyses identified predictors of success during the first 48 hours of doxapram therapy. Data on 203 patients with a median gestational age of 26.1 (interquartile range 25.1-27.4) weeks were analysed. During the first 48 hours of doxapram therapy, 157 (77%) patients did not need endotracheal intubation and 127 (63%) patients were successfully treated over the entire treatment course. The median postnatal age at the start of doxapram therapy was 20 days (interquartile range 12-30). Postnatal age and a lower fraction of inspired oxygen at the start of doxapram therapy were significant predictors of success (odds ratio 0.964, 95% confidence interval 0.938-0.991, p = 0.001). Oral and intravenous doxapram effectively treated most cases of apnoea in preterm infants, avoiding the need for intubation. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Effect of closed endotracheal suction in high-frequency ventilated premature infants measured with electrical impedance tomography

    NARCIS (Netherlands)

    M.B. van Veenendaal; M. Miedema; F.H.C. de Jongh; J.H. van der Lee; I. Frerichs; A.H. van Kaam

    2009-01-01

    Objective: To determine the global and regional changes in lung volume during and after closed endotracheal tube (ETT) suction in high-frequency ventilated preterm infants with respiratory distress syndrome (RDS). Design: Prospective observational clinical study. Setting: Neonatal intensive care uni

  13. Large spot transpupillary thermotherapy: A quicker laser for treatment of high risk prethreshold retinopathy of prematurity - A randomized study

    Directory of Open Access Journals (Sweden)

    Shah Parag

    2011-01-01

    Full Text Available To compare structural and functional outcome and time efficiency between standard spot sized conventional pulsed mode diode laser and continuous mode large spot transpupillary thermotherapy (LS TTT for treatment of high risk prethreshold retinopathy of prematurity (ROP. Ten eyes of five preterm babies having bilateral symmetrical high risk prethreshold ROP were included in this study. One eye of each baby was randomized to get either standard spot sized conventional pulsed mode diode laser or continuous mode LS TTT. There was no significant difference between structural or functional outcome in either group. The mean time taken for conventional diode laser was 20.07 minutes, while that for LS TTT was 12.3 minutes. LS TTT was 40% more time efficient than the conventional laser. It may be better suited for the very small fragile premature infants as it is quicker than the conventional laser.

  14. Avaliação da dor em recém-nascidos prematuros durante a fisioterapia respiratória Pain assessment in premature infants during respiratory physiotherapy

    Directory of Open Access Journals (Sweden)

    Carla Marques Nicolau

    2008-09-01

    Full Text Available OBJETIVOS: avaliar a presença de dor durante a fisioterapia respiratória em prematuros submetidos à ventilação mecânica. MÉTODOS: estudo prospectivo realizado entre fevereiro de 2003 e maio de 2004, sendo incluídos prematuros com idade gestacional OBJECTIVES: to assess pain in premature newborns undergoing mechanical ventilation during respiratory physiotherapy. METHODS: prospective study from February 2003 to May 2004, covering premature newborns with a gestational age of <34 weeks and birth weight <1.500 g, undergoing mechanical ventilation, between the 3rd and 7th day of life. The premature newborns underwent the necessary routine respiratory physiotherapy procedures. The Neonatal Infant Pain Scale (NIPS was used to measure pain. The scale was applied before, immediately after commencing physiotherapy, and immediately following airway aspiration. RESULTS: 30 premature newborns were studied (15 male. The average gestational age was 30.70±2.10 weeks and the average birth weight was 1.010.70±294.60 grams. Each newborn was submitted to an average of 7.33 physioterapy sessions. It was verified that there was no statistically significant difference in the presence of pain before and after respiratory physiotherapy, (p=0.09; although there was a statistically significant difference in the presence of pain before and after airway aspiration (p<0.001. CONCLUSIONS: respiratory physiotherapy does not cause pain, although the aspiration procedure, as it is invasive, is potentially painful.

  15. Agenesis of the corpus callosumina premature infant associated with Langdon-Down syndrome

    Directory of Open Access Journals (Sweden)

    Velisavljev-Filipović Gordana

    2005-01-01

    Full Text Available Introduction Agenesis of the corpus callosum is an abnormality of the part of the brain connecting the two cerebral hemispheres. It can be partial, complete or atypical. The fibers from the cerebral cortex project towards the homotypical region of the contra-lateral cortex passing through the corpus callosum, and crossing the middle line. The absence of corpus callosum causes failure of information transfer from one hemisphere to the other. Children with this anomaly present with learning disabilities and trouble with memorizing facts. Agenesis of corpus callosum may be of syndromic or non-syndromic type. The more common form is the one not associated with any syndrome. The agenesis of corpus callosum is more frequent in male children. Case report This paper presents a child from a twin pregnancy with partial absence of corpus callosum. The pregnancy was not controlled. It ended in premature birth. The afflicted twin is a boy, second in birth order. Apart from agenesis of corpus callosum, he also suffers from Down syndrome. The first twin is healthy, with corpus callosum and with normal karyotype. There was no consanguinity. In the 6th month of pregnancy the mother suffered from infection of the upper respiratory tract that might be the etiological factor of this anomaly. The child was born with hypotrophy, and all anthropometric parameters were below the third percentile. In the neonatal period, the agenesis of corpus callosum was diagnosed by ultrasonic examination and confirmed by CT and MR examinations. The child is now three and a half month old. Active monitoring of the psychical and motor development will show whether there will be any retardation in the psycho-motor development and later deficiency of the higher cortical functions and intelligence. Discussion and Conclusion The clinical characteristics of this anomaly are numerous. They range from asymptomatic cases, with normal intellectual capacity, to severe mental retardation

  16. 音乐干预对早产儿生长发育的影响%Effects of music intervention on growth and development of premature infants

    Institute of Scientific and Technical Information of China (English)

    于小华; 周雪梅; 王芳

    2010-01-01

    Objective To explore the effects of music intervention on growth and development of premature infants. Methods 112 premature infants were randomly divided into the observation group and the control group with 56 cases in each. The control group received conventional nursing measures, and the observation group was simultaneously given music intervention besides the conventional routine nursing measures. Weight increase, hospitalization time, milk-intake volume and feeding tolerance were compared between the two groups. Results The weight increase in the observation group was higher than that in the control group. Hospitalization time and rate of feeding intolerance for the observation group was lower compared with that of the control group. The premature infants in the observation group took in more milk than those in the control group. Conclusions Music intervention can elevate feeding tolerance, facilitate nutrition and increase weight of premature infant, so it is beneficial to the growth and development of premature infant.%目的 探讨音乐干预对早产儿生长发育的影响.方法 将112例早产儿随机分为观察组和对照组各56例,对照组给予早产儿常规护理,观察组在此基础上实施音乐干预,比较2组早产儿每日体质量增长、住院时间、进奶量及喂养耐受情况.结果 观察组每日体质量增长高于对照组,住院时间短于对照组,进奶量较对照组显著增加,发生喂养不耐受明显减少.结论 音乐干预能提高早产儿喂养耐受性,增进营养,加快体质量增长,有利于早产儿的生长发育.

  17. 低出生体重儿及早产儿心脏手术的早期疗效分析%Early Outcome of Open Heart Surgery for Congenital Heart Diseases in Low Birth Weight Infants and Premature Infants

    Institute of Scientific and Technical Information of China (English)

    曾嵘; 庄建; 陈寄梅; 岑坚正; 丁以群; 王晟

    2012-01-01

    Objective To analyze the early outcomes of open heart surgery for congenital heart diseases in sixty low birth weight infants and premature infants. Methods Sixty low birth weight infants (body weight < 2 500 g) and premature infants with congenital heart diseases undergoing surgical repair from May 2003 to October 2011 were studied retrospectively in Guangdong Cardiovascular Institute. There were 43 male patients and 17 female patients with their mean gestational age of 33.5±4.1 weeks (ranging from 26 to 42 weeks) and mean age at operation of 24.9±12.5 d (ranging from 4 to 55 d). Among them there were 47 premature infants with their mean birth weight of 1 729.3±522.5 g (ranging from 640 to 2 500 g) and mean weight at operation of 1 953.2±463.6 g(ranging from 650 to 2 712 g). All the patients received preoperative treatment in newborn intensive care unit (NICU) and underwent surgical repair under general anesthesia, including 29 patients without cardiopulmonary bypass (CPB) and 31 patients with CPB . All surviving patients received postoperative monitoring and treatment in NICU, and their postoperative complications and in-hospital death were reported. Results A total of 13 patients died during hospitalization with a total in-hospital mortality of 21.7% (13/60), including 4 intra-operative deaths, 6 early deaths (within 72 h postoperatively) and 3 patients giving up postoperative treatment. CPB time was 121.0±74.7 min, aortic clamp time was 74.8±44. 7 min, and postoperative mechanical ventilation time was (136.9±138.1) h. Thirteen patients underwent delayed sternal closure. Eight patients underwent reexploation for postoperative bleeding. Ten patients had severe pneumonia, 2 patients had pulmonary hypertensive crisis, and 8 patients had low cardiac output syndrome. All the postoperative complications were resolved or improved after proper treatment. Follow-up was complete in 47 patients from 2 to 12 monthes. And all the patients were alive during follow

  18. 103例超未成熟儿及超低出生体重儿转归及影响因素分析%Outcome and influencing factors of 103 cases of extremely premature infant and extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    王晓磊; 梅花; 刘春枝; 张亚昱; 刘春丽; 宋丹; 张钰恒

    2016-01-01

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

  19. Respiratory severity score on day of life 30 is predictive of mortality and the length of mechanical ventilation in premature infants with protracted ventilation.

    Science.gov (United States)

    Malkar, Manish B; Gardner, William P; Mandy, George T; Stenger, Michael R; Nelin, Leif D; Shepherd, Edward G; Welty, Stephen E

    2015-04-01

    We tested the hypothesis that Respiratory Severity Score (RSS) on day of life 30 is predictive of mortality and length of mechanical ventilation in premature infants on prolonged mechanical ventilation. A retrospective chart review was performed using the Nationwide Children's Hospital medical record and Vermont-Oxford Network databases. The primary outcome variable was survival to hospital discharge and the secondary outcome was length of mechanical ventilation after day of life 30. We identified 199 neonates admitted to Nationwide Children's Hospital between 2004 and 2007 with birth weight less than 1,500 g that received prolonged mechanical ventilation in the first 30 days of their life. A total of 184 infants were included in the analysis, excluding 14 patients with congenital anomalies and one infant with incomplete data. RSS on day of life 30 was significantly greater in the group of infants that died compared to those that survived (P = 0.003, 95% CI = [0.08, 0.40]). Further analysis demonstrated that the maximum difference in mortality was obtained with a threshold RSS of 6. Of the 109 patients who had RSS less than 6 on day of life 30, mortality rate was 4.6% (5/109) while those greater than or equal to 6 had a mortality rate of 21.3% (16/75). Both Kaplan-Meier survival curves comparing mortality and length of mechanical ventilation in infants with RSS < 6 versus those with RSS ≥ 6 demonstrated strong associations between RSS on day of life 30 and survival (P = 0.002) and length of ventilation after day of life 30 (P < 0.001). RSS ≥ 6 on day of life 30 is associated with higher mortality and longer period of mechanical ventilation in premature infants requiring mechanical ventilation through 30 days of life. © 2014 Wiley Periodicals, Inc.

  20. Comparison of the Clinical Characteristics of Newborn Respiratory Distress Syndrome between Full-term and Premature Infants%足月儿与早产儿呼吸窘迫综合征发病临床比较分析

    Institute of Scientific and Technical Information of China (English)

    张怡

    2011-01-01

    Objective To compare the clinical characteristics of newborn respiratory distress syndrome between full-term and premature infants, and to further explore the similarities and differences between them.Methods Eighty-six eases of confirmed respiratory distress syndrome with different gestational age in ICU of the department of Newborn in our hospital from January, 2007 to August, 2010, were enrolled in this study. They were divided into two groups: the premature infant group (50 cases, < 37 weeks) and the full-term group (36cases, > 37 weeks). The cause of disease, the onset time, X-ray performance, the treatment and complications of them were analyzed retrospectively. Results The causes of disease in full-term infants were the meeonium aspiration pneumonia, asphyxia, cesarean section and so on. The causes of disease in premature infants were premature delivery, premature rupture of memberane, asphyxia, cesarean section and aspiration pneumonia. Progressive dyspnea and cyanosis appeared in full-term infants ( 10.5 ± 4.1 ) h after birth, the mechanical ventilation time was (97.7 ± 17.2) h. While Progressive dyspnea, groaning and eyanosis appeared in premature infants (3.9 ± 2.7) h after birth, the mechanical ventilation time was (79.7 ± 7.6) h. The chest X-ray of infants in the two groups showed obvious diffused infiltrating shade in double lungs and air bronchogram.Most full-term infants with respiratory distress syndrome were complicated with the protopathy signs.Conclusions The incidence of respiratory distress syndrome is later, and the mechanical ventilation time was longer in full-term infants than in premature infants. Meconium aspiration pneumonia, asphyxia, and cesarean section are high risk factors of respiratory distress syndrome in full-term infants, while insufficient generative capacity of pulmonary surfactant is the high risk factor in premature infants.%目的 比较足月新生儿与早产儿呼吸窘迫综合征发病的临床特点,以进

  1. The last and first frontier – emerging challenges for HIV treatment and prevention in the first week of life with emphasis on premature and low birth weight infants

    Directory of Open Access Journals (Sweden)

    Mark F Cotton

    2015-12-01

    Full Text Available Introduction: There is new emphasis on identifying and treating HIV in the first days of life and also an appreciation that low birth weight (LBW and preterm delivery (PTD frequently accompany HIV-related pregnancy. Even in the absence of HIV, PTD and LBW contribute substantially to neonatal and infant mortality. HIV-exposed and -infected infants with these characteristics have received little attention thus far. As HIV programs expand to meet the 90-90-90 target for ending the HIV pandemic, attention should focus on newborn infants, including those delivered preterm or of LBW. Discussion: In high prevalence settings, infant diagnosis of HIV is usually undertaken after the neonatal period. However, as in utero infection may be diagnosed at birth, earlier initiation of therapy may limit viral replication and prevent early damage. Globally, there is growing awareness that preterm and LBW infants constitute a substantial proportion of births each year. Preterm infants are at high risk for vertical transmission. Feeding difficulties, apnoea of prematurity and vulnerability to sepsis occur commonly. Feeding intolerance, a frequent occurrence, may compromise oral administration of medications. Although there is growing experience with post-exposure prophylaxis for HIV-exposed term newborn infants, there is less experience with preterm and LBW infants. For treatment, there are even fewer options for preterm infants. Only zidovudine has adequate dosing recommendations for treating term and preterm infants and has an intravenous formulation, essential if feeding intolerance occurs. Nevirapine dosing for prevention, but not treatment, is well established for both term and preterm infants.HIV diagnosis at birth is likely to be extremely stressful for new parents, more so if caring for preterm or LBW infants. Programs need to adapt to support the medical and emotional needs of young infants and their parents, where interventions may be lifesaving

  2. Genome-wide association study and premature ovarian failure.

    Science.gov (United States)

    Christin-Maitre, S; Tachdjian, G

    2010-05-01

    Premature ovarian failure (POF) is defined as an amenorrhea for more than 4months, associated with elevated gonadotropins, usually higher than 20mIU/ml, occurring in a woman before the age of 40. Some candidate genes have been identified in the past 15years, such as FOXL2, FSHR, BMP15, GDF9, Xfra premutation. However, POF etiology remains unknown in more than 90% of cases. The first strategy to identify candidate gene, apart from studying genes involved in ovarian failure in animal models, relies on the study of X chromosome deletions and X;autosome translocations in patients. The second strategy is based on linkage analysis, the third one on Comparative Genomic Hybridization (CGH) array. The latest strategy relies on Genome-Wide Association Studies (GWAS). This technique consists in screening single nucleotide polymorphisms (SNPs) in patients and controls. So far, three studies have been performed and have identified different loci potentially linked to POF, such as PTHB1 and ADAMTS19. However, replications in independent cohorts need to be performed. GWAS studies on large cohorts of women with POF should find new candidate genes in the near future.

  3. Effect of liquid milk on the nutritional status in premature infants%液态奶喂养对早产儿营养状况的影响

    Institute of Scientific and Technical Information of China (English)

    袁贵龙; 黄文珍; 李盛强

    2011-01-01

    Objective To investigate the effect of liquid milk on the nutritional status in premature infants with a gestational age of less than 36 weeks and give some suggestions on feeding in premature infants. Methods Ninety-five premature infants were divided into full -term in fant formula feeding group and liquid milk in premature feeding group. The rates of weight gain, length increment, head circumference increment and the incidence of extrauterine growth restriction (EUGR) were observed and compared between two groups before and after the time of full enteral feeding. Results The average daily weight gain[( 12. 1 ±2. 3 )g/( kg · d)v. s( 10. 5±2. 1)g/(kg· d),P< 0.01 ),head circumference increment[(0. 85 +0.29)v. s (0.71 +0.31)cm/W,P <0. 05 ) and length increment[(0. 76 + 0. 24) v. s ( 0. 65 + 0. 27 ) cm/W, P < 0. 05 ) were significantly better in the infants fed with liquid milk in premature compared with the infants fed with full - term children formula. There was obvious difference in the incidence of EUGR between two groups ( P < 0. 05 ) . Conclusion The growth and development of premature infants fed with liquid milk in premature were better than those of full - term in fant formula.%研究液态奶喂养对胎龄< 36周早产儿营养状况的影响,并对早产儿喂养方式提出建议。方法2009年11月至2010年5月收住我科治疗的符合标准的95例早产儿研为究对象,将其分为两组,分别应用足月儿配方奶粉喂养(48例)及早产儿液态奶喂养(47例),观察在达到全肠道营养前后两组早产儿的体质量、身长及头围增长速度,并作组间比较;同时比较两组早产儿宫外生长迟缓的发生率。结果液态奶喂养组和配方奶粉喂养组的体质量平均增加速度分别为(12.1 +2.3)g/(kg·d)和(10.5±2.1)g/(kg·d)(P<0.01),每周头围增长速度分别为(0.85±0.29 )cm和(0.71 +0.31) cm (P<0.05),每周身长增长速度分别为(0.76±0.24) cm和(0.65

  4. The design and methodology of premature ejaculation interventional studies.

    Science.gov (United States)

    McMahon, Chris G

    2016-08-01

    Large well-designed clinical efficacy and safety randomized clinical trials (RCTs) are required to achieve regulatory approval of new drug treatments. The objective of this article is to make recommendations for the criteria for defining and selecting the clinical trial study population, design and efficacy outcomes measures which comprise ideal premature ejaculation (PE) interventional trial methodology. Data on clinical trial design, epidemiology, definitions, dimensions and psychological impact of PE was reviewed, critiqued and incorporated into a series of recommendations for standardisation of PE clinical trial design, outcome measures and reporting using the principles of evidence based medicine. Data from PE interventional studies are only reliable, interpretable and capable of being generalised to patients with PE, when study populations are defined by the International Society for Sexual Medicine (ISSM) multivariate definition of PE. PE intervention trials should employ a double-blind RCT methodology and include placebo control, active standard drug control, and/or dose comparison trials. Ejaculatory latency time (ELT) and subject/partner outcome measures of control, personal/partner/relationship distress and other study-specific outcome measures should be used as outcome measures. There is currently no published literature which identifies a clinically significant threshold response to intervention. The ISSM definition of PE reflects the contemporary understanding of PE and represents the state-of-the-art multi-dimensional definition of PE and is recommended as the basis of diagnosis of PE for all PE clinical trials.

  5. Clinician perspectives on barriers to and opportunities for skin-to-skin contact for premature infants in neonatal intensive care units.

    Science.gov (United States)

    Lee, Henry Chong; Martin-Anderson, Sarah; Dudley, R Adams

    2012-04-01

    Our objective was to investigate key factors in promoting skin-to-skin contact (STSC) in the neonatal intensive care unit (NICU). As part of a California Perinatal Quality Care Collaborative on improving nutrition and promoting breastmilk feeding of premature infants, a multidisciplinary group of representatives from 11 hospitals discussed the progress and barriers in pursuing the project. A key component of the collaborative project was promotion of STSC. Sessions were audio-recorded, transcribed, and assessed using qualitative research methods with the aid of Atlas Ti software (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany). Two primary investigators studied the transcripts for themes related to STSC. Using an iterative approach, selected themes were explored, and representative quotes were selected. Barriers to promoting STSC fell into broad themes of implementation, institutional, and familial factors. The main challenge identified in implementation was defining a clinically stable eligible population of patients. Key institutional factors were education and motivation of staff. Familial factors involved facilitation and sustained motivation of mothers. In response to these barriers, opportunities for promoting STSC were enacted or suggested by the group, including defining clinical stability for eligibility, facilitating documentation, strategies to increase parent and staff education and motivation, and encouraging maternal visitation and comfort. Our findings may be useful for institutions seeking to develop policies and strategies to increase STSC and breastmilk feeding in their NICUs.

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

    Directory of Open Access Journals (Sweden)

    Asad Rahman

    2015-08-01

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

  7. Meta-analysis of the risk factors for intracranial hemorrhage in premature infants%早产儿颅内出血危险因素的meta分析

    Institute of Scientific and Technical Information of China (English)

    马江林; 卢红艳; 王秋霞

    2013-01-01

    Objective To evaluate the risk factors for intracranial hemorrhage in premature infants. Methods Cochrane Library, PubMed, ScienceDirect, Chinese Academic Literature Main Database, Chinese Science and Technology Periodi-cal Database, Wanfang Periodicals and Dissertation Database were searched for articles published from January 2000 to December 2012 on the risk factors of intracranial hemorrhage in premature infants, with retrospective retrieval and manual retrieval as supplement. RavMan5.2 provided by Cochrane was used for meta-analysis. Fixed-or random-effects models were selected according to the results of heterogeneity test. Results Nine studies were conifrmed to be eligible. Odds ratio (OR) and 95%conifdence interval (CI) of the risk factors were as follows:gestation age≤32 weeks (OR=3.29, 95%CI=2.76-3.91), birth weight≤1 500g (OR=2.68, 95% CI=2.24-3.20), maternal complications (OR=1.59, 95% CI=1.23-2.06), intrauterine distress or birth asphyxia (OR=2.42, 95% CI=2.06-2.84), mechanical ventilation (OR=3.23, 95% CI=2.55-4.09), metabolic acidosis (OR=2.88, 95%CI=2.04-4.05), use of high concentration of oxygen (OR=2.98, 95%CI=1.63-5.44), prenatal use of dexametha-sone (OR=0.69, 95%CI=0.55-0.86), respiratory distress syndrome (OR=1.57, 95%CI=1.04-2.39). Those differences were all statistically signiifcant. There was no difference in caesarean section (OR=0.99, 95%CI=0.84-1.17), multiparity (OR=1.05, 95%CI=0.79-1.40) and gender (OR=1.25, 95%CI=0.97-1.59). Conclusions The risk factors for intracranial hemorrhage in premature infants are gestation age≤32 weeks, birth weight≤1 500 g, maternal complications, intrauterine distress or birth asphyxia, mechanical ventilation, metabolic acidosis, use of high concentration of oxygen, respiratory distress syndrome, but prenatal use of dexamethasone can reduce the incidence of intracranial hemorrhage in premature infants.%目的综合评价早产儿颅内出血的危险因素。方法检索Cochrane图书馆、PubMed

  8. Early Brain Activity Relates to Subsequent Brain Growth in Premature Infants

    NARCIS (Netherlands)

    Benders, Manon J.; Palmu, Kirsi; Menache, Caroline; Borradori-Tolsa, Cristina; Lazeyras, Francois; Sizonenko, Stephane; Dubois, Jessica; Vanhatalo, Sampsa; Hüppi, Petra S.

    2015-01-01

    Recent experimental studies have shown that early brain activity is crucial for neuronal survival and the development of brain networks; however, it has been challenging to assess its role in the developing human brain. We employed serial quantitative magnetic resonance imaging to measure the rate o

  9. 早产儿眼病的筛查及早期治疗%Screening and early treatment on ophthalmopathy of premature infant

    Institute of Scientific and Technical Information of China (English)

    赵宏; 王瑞峰; 狄浩浩; 李彩红; 沈策英

    2016-01-01

    Objective To investigate the clinical significance of screening and early treatment on the eye disease of premature infant.Methods The fundus examination results with children wide-area digital fundus imaging system and photographs of 2852 eyes of 1426 premature infants from July 2013 to July 2015 in our hospital were taken.The data were analyzed and the early treatment was given.Results Among the fundus of 2852 eyes of premature infants,there were 182 eyes of retinopathy of prematurity,18eyes of congenital cataract,5 eyes of familial exudative vitreoretinopathy,4 eyes of persistent hyperplastic primary vitreous,3 eyes of congenital choroidal coloboma,2 eyes of congenital optic disc dysplasia,and 2eye of congenital microphthalmia.There were 216 (7.57%) infants suffering from ophthalmopathy in total.In the 182 eyes of retinopathy of prematurity,37 eyes received retinal laser photocoagulation,16 eyes received intravitreal injection,15 eyes received intravitreal injection combined with retinal laser photocoagulation,5 eyes received vitrectomy combined with retinal laser photocoagulation,and some infants gave up the treatment.Conclusion Screening and early treatment on oculopathy of premature infant improve the vision and survival quality.%目的 探讨早产儿眼病筛查以及早期治疗的临床意义.方法 对2013年7月至2015年7月在我院行儿童数字化广域眼底成像系统(Children wide-area digital fundus imaging system,Ret-CamⅢ)检查的1426例(2852眼)早产儿进行眼底检查并照像,对收集的资料进行分析和风险评估并进行早期治疗.结果 对1426例(2852眼)早产儿进行眼病筛查,其中早产儿视网膜病变182眼、先天性白内障18眼、家族性渗出性玻璃体视网膜病变5眼、永存原始玻璃体增生症4眼、先天性脉络膜缺损3眼、先天视盘发育异常2眼、先天性小眼球2眼,共检查出患儿眼病216眼(7.57%).其中早产儿视网膜病变进行患儿视网膜激光光凝37

  10. Vitamin K prophylaxis for premature infants: 1 mg versus 0.5 mg.

    Science.gov (United States)

    Costakos, Dennis T; Greer, Frank R; Love, Laureen A; Dahlen, Lynn R; Suttie, John W

    2003-11-01

    We studied babies (22 to 32 weeks gestational age) of mothers wishing to breast-feed. Group 1 received 1 mg of vitamin K and Group 2 received 0.5 mg of vitamin K. The Day 2 plasma levels of vitamin K were 1900 to 2600 times higher on average, and the Day 10 vitamin K levels 550 to 600 times higher on average, relative to normal adult plasma values, whether an initial prophylaxis dose of 0.5 mg or 1 mg was used. We conclude that 0.5 mg as the initial dose of vitamin K intramuscularly or intravenously would likely be more than adequate to prevent hemorrhagic disease of the newborn, and that 0.3 mg/per kg may be used for babies with birth weights below 1000 g. To decrease vitamin K intakes in this population, new preparations of total parenteral nutrition multivitamins are needed.

  11. 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

  12. Serum fructosamine and retinopathy of prematurity.

    Science.gov (United States)

    Bozdag, Senol; Oguz, Serife Suna; Gokmen, Tulin; Tunay, Zuhal; Tok, Levent; Uras, Nurdan; Erdeve, Omer; Dilmen, Ugur

    2011-12-01

    To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants. One hundred sixty seven premature infants who had a birth weight of < 1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants' eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first. Corrected fructosamine was 319.6 ± 59.6 and 272.8 ± 50.6 mmol/l for group 1 on 1(st) and 30(th) day respectively; 320 ± 61.7 and 268.2 ± 47.3 mmol/l for groups 2 + 3 on 1(st) and 30(th) day respectively which did not differ between groups (p = 0.766 and p = 0.665), whereas duration of hyperglycemia was 1.69 ± 1.1 day in group 1 compared with 3.05 ± 2.4 day in groups 2 + 3 which was significantly different (p = 0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09-9.80; p = 0.035). Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants.

  13. Apnea of Prematurity (For Parents)

    Science.gov (United States)

    ... other babies. The apnea of prematurity does not cause brain damage. A healthy baby who is apnea free for a week will probably never have AOP again. Although sudden infant death syndrome (SIDS) does happen more often in premature infants, no relationship between AOP and SIDS has ...

  14. Parenting difficulties and coping behaviors of mothers of premature infants discharged from NICU%NICU出院早产儿母亲的育儿困难与应对行为

    Institute of Scientific and Technical Information of China (English)

    周明芳; 藤本荣子

    2013-01-01

    [目的]了解新生儿重症监护病房(NICU)出院早产儿母亲育儿生活中的困难及应对行为.[方法]采用质性研究法,在早产儿出院后1周、1个月时分别利用面谈和电话访谈的方式对18名母亲进行深度访谈.[结果]母亲在早产儿出院后经历了困难的母乳喂养、哺乳不确定性的困惑、自我育儿能力低下的无措与自责、对早产儿常见症状的担心与不安、疲劳及育儿负担感、育儿信息所致的混乱等育儿困难及不安,母亲采取积极应对和消极逃避两种方式应对育儿过程中所遇到的困难.[结论]早产儿母亲在育儿过程中存在育儿困难,为提高早产儿母亲的育儿能力,探讨医院—社区—家庭一体化的连续性护理服务模式势在必行.%Objective:To know about the difficulties and coping behaviors of mothers of premature infants discharged from NICU during parenting life.Methods:The qualitative study method and personal interview and telephone interview styles were used for taking a depth interview on 18 mothers whose premature infants discharged from NICU respectively after a week and a month.Results:After preterm infants discharging mothers experienced the parenting difficulties and anxiety including difficulties of breastfeeding,confusion on breastfeeding uncertainty,flawless and remorse on low self-parenting skills,fears and uncertainty to common symptoms of premature infants,fatigue and parenting burden sense,confusion caused by parenting information.Mothers took the positive coping and negative escape to deal with the difficulties during the parenting process Conclusion:Preterm infants' mothers had difficulties during the parenting.In order to promote mothers' parenting skills,it is necessary to probe into the continuity of nursing service model with hospital-community family integration.

  15. Preliminary study of evaluation criterion for continuing health education in parents of very low birth weight premature infants%极低出生体质量早产儿家长延续性健康教育评价标准体系的初步研究

    Institute of Scientific and Technical Information of China (English)

    刘桂华; 钱小芳; 欧萍; 徐玉英; 谢燕钦

    2014-01-01

    目的 构建极低出生体质量早产儿家长院外延续性健康教育评价标准,并检测其信效度.方法 通过文献回顾法、理论分析法和质性研究法初步建立条目池,并运用德尔菲函询法构建极低出生体质量早产儿家长延续性健康教育评价标准,对1 12例极低出生体质量早产儿家长进行信效度测评.结果 以健康教育知信行理论为框架,参照护理结局分类与护理措施分类系统,构建涵盖院外延续性健康教育知识、信念、行为三个维度共29个条目的评价标准,量表内容效度指数为0.944,主成分提取3个公因子,累计贡献率分别为49.70%、73.25%、46.90%,总量表的Cronbach'α系数为0.934,重测信度为0.865,评分者间一致信度为0.940.结论 极低出生体质量早产儿家长院外延续性护理健康教育评价标准具有较好的信效度,可作为我国极低出生体质量早产儿院外延续性护理健康教育效果的测量工具,也为构建院外延续性护理模式提供依据.%Objective To develop and evaluate the reliability and validity of evaluation criterion for continuing health education in very low birth weight premature infants.Methods The literature review,theoretical analysis,qualitative research and Delphi technique were conducted to identify the evaluation criterion for continuing health education.The reliability and validity of evaluation criterion was tested in 112 parents of very low birth weight premature infants.Results The evaluation criterion which was based on the frame of KABP Model and Nursing Outcomes Classification as well as Nursing Interventions Classification consisted of 3 projects with 29 specific items.The content validity index for the scale was 0.950.Three common factors were extracted by the principal components extraction analysis and the cumulative contribution rate was 49.70%,73.25% and 46.90% respectively.The Cronbach' s alpha coefficient was 0.934,the retest

  16. An experimental study on mother-infant skin-to-skin contact in full-terms.

    Science.gov (United States)

    Beijers, Roseriet; Cillessen, Linda; Zijlmans, Maartje A C

    2016-05-01

    In premature infants, daily skin-to-skin contact (SSC) has various beneficial effects on the health of the infant and the mother. These beneficial effects might extend to full-term infants. This experimental within-subject study examines the immediate effects of SSC on full-terms' cortisol physiology during SSC and subsequent physiological and behavioral reactions to a mild stressor (a bathing session). Additionally, the effects of SSC on the quality of maternal behavior are examined. Between 5 and 7 weeks postpartum, 17 full-term infant-mother dyads were visited at home twice. During one home visit, a bathing session was proceeded by 50min of mother-infant SSC, while during the other visit the bathing session was proceeded by 50min of the infant resting alone. The order of the home visits was counterbalanced. Infant salivary cortisol measures were taken to measure the cortisol response to the experimental condition (SSC versus solitary resting) and the bathing session. Furthermore, infant behavioral distress and the quality of maternal behavior during the bathing session were scored from videotapes. Two-way within-subject repeated measures ANOVA's showed that, when compared to solitary resting, full-terms' cortisol concentrations significantly decreased during SSC, followed by higher cortisol reactivity in response to the subsequent bathing session. No effects of SSC on infant behavioral distress and maternal caregiving behavior were found. Apparently, a single session of mother-infant SSC can affect infant cortisol physiology in full-term infants. Future SSC research is needed to investigate the neurobiological mechanisms and dose-response relations in full-term infants.

  17. Late prematurity in twins: a Polish multicenter study.

    Science.gov (United States)

    Kosinska-Kaczynska, Katarzyna; Szymusik, Iwona; Bomba-Opon, Dorota; Madej, Anna; Oleszczuk, Jan; Patro-Malysza, Jolanta; Marciniak, Beata; Breborowicz, Grzegorz; Drews, Krzysztof; Seremak-Mrozikiewicz, Agnieszka; Szymankiewicz, Marta; Zimmer, Mariusz; Pomorski, Michal; Olejek, Anita; Slawska, Helena; Wielgos, Mirosław

    2014-10-01

    The study aimed at investigating the impact of late prematurity (LPT) on neonatal outcome in twins and neonatal morbidity and mortality within LPT with regard to the completed weeks of gestation. The study was conducted in six tertiary obstetric departments from different provinces of Poland (Warsaw, Lublin, Poznan, Wroclaw, Bytom). It included 465 twin deliveries in the above centers in 2012. A comparative analysis of maternal factors, the course of pregnancy and delivery and neonatal outcome between LPT (34 + 0-36 + 6 weeks of gestation) and term groups (completed 37 weeks) was performed. The neonatal outcome included short-term morbidities. The analysis of neonatal complication rates according to completed gestational weeks was carried out. Out of 465 twin deliveries 213 (44.8%) were LPT and 156 (33.55%) were term. There were no neonatal deaths among LPT and term twins. One-third of LPT newborns suffered from respiratory disorders or required antibiotics, 40% had jaundice requiring phototherapy, and 30% were admitted to NICU. The analysis of neonatal morbidity with regard to each gestational week at delivery showed that most analyzed complications occurred less frequently with the advancing gestational age, especially respiratory disorders and NICU admissions. The only two factors with significant influence on neonatal morbidity rate were neonatal birth weight (OR = 0.43, 95% CI = 0.2-0.9, p = .02) and gestational age at delivery (OR = 0.62, 95% CI = 0.5-0.8, p twins. Gestational age and neonatal birth weight seem to play a crucial role in neonatal outcome in twins.

  18. 护理干预对早产儿生长发育的影响%The influence of nursing intervention on growth and development among premature infants

    Institute of Scientific and Technical Information of China (English)

    梁锦霞; 全小芳; 林笑玲; 黄红连; 崔伟伦

    2014-01-01

    Objective To explore the influence of early nursing intervention on the growth of premature infants, in order to maximize quality of life of the premature. Methods 126 cases of premature infants were randomly divided, with 65 cases in the intervention group and 61 cases in the control group. The control group used conventional nursing and health care, while the intervention group added environmental intervention, sensory stimulation, exercise and more reasonable on body position nursing care. Weight gain, added feed milk and new cases with complications were compared after 7 days' intervention among the two groups. Results Intervention group premature increased Weight gain, added feed milk were higher in the intervention group compared with the control group, the difference of which was statistically significant(P<0.05);new cases with complications(neonatal pneumonia, diarrhea, apnea) were less than that of the control group, the difference of which was statistically significant(P<0.05). Conclusion Early nursing intervention is helpful for growth and development of premature infants, helps hormone secretion reaches the best level, reduces physical weight loss, shortens weight recovery time, improves the sleep time and quality, which will help to increase the weight of premature infants and improve the premature disease resistance.%目的:探讨早期护理干预对早产儿生长发育的影响,以最大程度地提高早产儿的生活质量。方法将126例早产儿随机分成干预组65例和对照组61例,对照组采用常规的护理及保健,干预组在对照组的基础上,添加环境干预、多感官刺激、运动锻炼及合理体位护理。比较2组干预7d后早产儿体重增加、食奶量增加情况及并发症新发情况。结果干预组早产儿体重增加、食奶量增加情况优于对照组,差异有统计学意义(P<0.05);干预组早产儿新发并发症(新生儿肺炎、腹泻、呼吸暂停)情况少于

  19. Parameter selection for and implementation of a web-based decision-support tool to predict extubation outcome in premature infants

    Directory of Open Access Journals (Sweden)

    Hulsey Thomas C

    2006-03-01

    Full Text Available Abstract Background Approximately 30% of intubated preterm infants with respiratory distress syndrome (RDS will fail attempted extubation, requiring reintubation and mechanical ventilation. Although ventilator technology and monitoring of premature infants have improved over time, optimal extubation remains challenging. Furthermore, extubation decisions for premature infants require complex informational processing, techniques implicitly learned through clinical practice. Computer-aided decision-support tools would benefit inexperienced clinicians, especially during peak neonatal intensive care unit (NICU census. Methods A five-step procedure was developed to identify predictive variables. Clinical expert (CE thought processes comprised one model. Variables from that model were used to develop two mathematical models for the decision-support tool: an artificial neural network (ANN and a multivariate logistic regression model (MLR. The ranking of the variables in the three models was compared using the Wilcoxon Signed Rank Test. The best performing model was used in a web-based decision-support tool with a user interface implemented in Hypertext Markup Language (HTML and the mathematical model employing the ANN. Results CEs identified 51 potentially predictive variables for extubation decisions for an infant on mechanical ventilation. Comparisons of the three models showed a significant difference between the ANN and the CE (p = 0.0006. Of the original 51 potentially predictive variables, the 13 most predictive variables were used to develop an ANN as a web-based decision-tool. The ANN processes user-provided data and returns the prediction 0–1 score and a novelty index. The user then selects the most appropriate threshold for categorizing the prediction as a success or failure. Furthermore, the novelty index, indicating the similarity of the test case to the training case, allows the user to assess the confidence level of the prediction with

  20. Molecular detection of late-onset neonatal sepsis in premature infants using small blood volumes: proof-of-concept.

    Science.gov (United States)

    Kasper, David C; Altiok, Ipek; Mechtler, Thomas P; Böhm, Judith; Straub, Julia; Langgartner, Michaela; Pollak, Arnold; Herkner, Kurt R; Berger, Angelika

    2013-01-01

    Conventional blood culture is still the gold standard for sepsis diagnosis but results are not immediately available and pathogens are only detected in approximately 25% of cases. New molecular assays for the detection of blood stream pathogens are promising diagnostic tools. The aim of the study was to adapt and evaluate a multiplex PCR system using 100 µl blood. - 46 blood specimens of very low birth weight infants (818 ± 242 g) with suspected sepsis were analyzed using the Roche SeptiFast MGRADE PCR with a modified DNA extraction protocol and software handling tool for decreased blood volume requirements. In the non-infected group, 5/21 infants had a positive PCR result with coagulase-negative staphylococci. All pathogens detected in the blood culture positive group (n = 15) were also detected by PCR. In addition, 4/6 patients had a positive PCR result in the clinical sepsis group (clinical and laboratory signs of sepsis but negative blood culture). Overall, the PCR was demonstrated to have a higher sensitivity (90.5%; 95%CI 68.2-98.3%) in comparison to blood culture (71.4%; 95%CI 47.7-87.8%) including clinical sepsis cases, even though it had a lower specificity (80.0%; 95%CI 58.7-92.4% versus 100.0%; 95%CI 83.4-100.0%). These first data demonstrate the usability and potential benefit of this multiplex PCR using a modified DNA extraction for the rapid detection of nosocomial sepsis in preterm infants in addition to blood culture. Copyright © 2013 S. Karger AG, Basel.

  1. Progress of Treatment of Bronchopulmonary Dysplasia in Premature Infants%早产儿支气管肺发育不良的治疗进展

    Institute of Scientific and Technical Information of China (English)

    黄婕; 郑直

    2013-01-01

    Bronchopulmonary dysplasia( BPd) is currently one of the most common complications of premature infants,which has become one of the most difficult problems in neonatal intensive care unit.The pathogenesis of BPd is extremely complex, so that there is no effective treatment at present.This paper has introduced the latest definition,and progress of prevention and treatment of BPd in premature infants both in domestic and foreign.%早产儿支气管肺发育不良(broncho-pulmonary dysplasia,BPd )是目前早产儿最常见的并发症之一,已经成为新生儿重症监护病房最棘手的问题之一。BPd的发病机制极其复杂,目前尚无有效的治疗方法。现主要介绍国内外有关早产儿BPd的定义、预防及治疗新进展。

  2. Junctional Bradycardia as Early Sign of Digoxin Toxicity in a Premature Infant with Congestive Heart Failure due to a Left to Right Shunt.

    Science.gov (United States)

    Dasgupta, Soham; Aly, Ashraf M; Jain, Sunil K

    2016-03-01

    Introduction Congestive heart failure due to left to right cardiac shunt is usually managed medically with diuretics, angiotensin converting enzyme inhibitors, and, in some cases, with the addition of digoxin. Case We report a 31-week gestation premature male infant who did not respond to such treatment and developed hyperaldosteronism and severe hypokalemia secondary to activation of the renin angiotensin aldosterone system. The hypokalemia was not responsive to intravenous KCL supplementation and induced digoxin toxicity despite a relatively normal digoxin level. The earliest signs of digoxin toxicity in the patient were junctional rhythm and bradycardia. The discontinuation of digoxin and the administration of digoxin specific immunoglobulin fragments (Fab) reversed those changes. The addition of spironolactone (an aldosterone antagonist) had a dramatic effect, resulting in clinical improvement of the patient coupled with normalization of Q4 serum and urine electrolytes. Conclusion Serum Digoxin level alone may fail as an independent guide in the diagnosis of digoxin toxicity when hypokalemia is present. In premature infants with congestive heart failure and hypokalemia, addition of an aldosterone antagonist should be considered.

  3. New Information About Premature Births (For Consumers)

    Centers for Disease Control (CDC) Podcasts

    2006-10-06

    A new study finds that prematurity is the most frequent cause of infant death in the United States. Learn more.  Created: 10/6/2006 by CDC Division of Reproductive Health.   Date Released: 10/6/2006.

  4. Plasticity of neonatal neuronal networks in very premature infants: Source localization of temporal theta activity, the first endogenous neural biomarker, in temporoparietal areas.

    Science.gov (United States)

    Routier, L; Mahmoudzadeh, M; Panzani, M; Azizollahi, H; Goudjil, S; Kongolo, G; Wallois, F

    2017-01-23

    Temporal theta slow-wave activity (TTA-SW) in premature infants is a specific signature of the early development of temporal networks, as it is observed at the turning point between non-sensory driven spontaneous local processing and cortical network functioning. The role in development and the precise location of TTA-SW remain unknown. Previous studies have demonstrated that preterms from 28 weeks of gestational age (wGA) are able to discriminate phonemes and voice, supporting the idea of a prior genetic structural or activity-dependent fingerprint that would prepare the auditory network to compute auditory information at the onset of thalamocortical connectivity. They recorded TTA-SW in 26-32 wGA preterms. The rate of TTA-SW in response to click stimuli was evaluated using low-density EEG in 30 preterms. The sources of TTA-SW were localized by high-density EEG using different tissues conductivities, head models and mathematical models. They observed that TTA-SW is not sensory driven. Regardless of age, conductivities, head models and mathematical models, sources of TTA-SW were located adjacent to auditory and temporal junction areas. These sources become situated closer to the surface during development. TTA-SW corresponds to spontaneous transient endogenous activities independent of sensory information at this period which might participate in the implementation of auditory, language, memory, attention and or social cognition convergent and does not simply represent a general interaction between the subplate and the cortical plate. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

  5. 106例早产儿甲状腺功能低下临床分析%An clinical analysis of 106 premature infants suffering from thyroid hypofunction

    Institute of Scientific and Technical Information of China (English)

    滑心恬; 唐军; 母得志

    2013-01-01

    目的 探讨早产儿甲状腺功能低下的危险因素、临床表现、类型及治疗效果,为临床提供诊治依据.方法 对2010年8月~2012年8月于本院新生儿科住院治疗的106例诊断甲状腺功能低下的早产儿资料进行回顾性分析.结果 双胎、新生儿窒息、妊娠期糖尿病、新生儿呼吸窘迫综合征等高危因素存在于这些惠儿中.临床表现有呼吸暂停、黄疸时间延长、喂养不耐受等.大胎龄组患儿易出现水肿表现.各种类型中以暂时性低甲状腺素血症多见,其它还有暂时性甲状腺功能减退、低T3综合征、高TSH血症等类型.大胎龄组患儿易表现为低T3综合征.小剂量左甲状腺素钠片治疗有效,且大胎龄组患儿对治疗更敏感.结论 早产儿甲状腺功能低下发病率高,并且不能通过新生儿筛查及时发现.应在生后1~2周对早产儿进行甲状腺功能检查、及时干预.%Objective To investigate the risk factors,clinical manifestations,classifications and treatment outcomes of premature infants suffering from thyroid hypofunction.Methods 106 preterm babies in our hospital during August 2010 to August 2012 suffering from thyroid hypofunction were retrospective analyzed.Results Twins,neonatal asphyxia,gestational diabetes mellitus,neonatal respiratory distress syndrome(NRDS),et al,are existed in these patients as risk factors.Main clinical manifestations include apnea,prolonged jaundice,feeding intolerance,et al.The older gestational age babies manifest edema more often.There are transient thyroid hypofunction,transient hypothyroxinaemia,low-T3 syndrome and hyperthyrotropinemia 4 common types of thyroid hypofunction showed in our study.The older gestational age babies are easier suffering from low-T3 syndrome.L-T4 treatment is effective,and the older gestational age babies are more sensitive.Conclusion The morbidity of hypothyroidism is high in premature babies while the congenital hypothyroidism screening

  6. Infants Can Study Air Science.

    Science.gov (United States)

    Ward, Alan

    1983-01-01

    Provided are activities and demonstrations which can be used to teach infants about the nature of air, uses of air, and objects that fly in the air. The latter include airships, hot-air balloons, kites, parachutes, airplanes, and Hovercraft. (JN)

  7. 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

  8. Related Factors Analysis of 52 Premature Infants of Intracranial Hemorrhage%52例早产儿颅内出血相关因素分析

    Institute of Scientific and Technical Information of China (English)

    刘祖霞

    2013-01-01

    Objective:To investigate the cause of intracranial hemorrhage (ICH) in premature infants associated risk factors. Methods:Research points trial group and control group,the objects in our hospital the neonatal intensie care unit (NICU) of 221 cases were premature from January 2009 to January 2011.52 cases of intracranial bleeding as research group,the rest of the 169 cases of premature infants as control group,retrospective analysis of premature intracranial bleeding risk factors.Results:ICH group and control group for comparison of prenatal abnormal factors,palace distress,amniotic fluid anomaly,pregnancy hypertension sickness,lead the placenta,the umbilical unusual cord,Phenobarbital Sodium,the difference was statistically significant (P<0.05);ICH group and control group premature birth risk factors comparison with Apgar score,birth weight,gestational age,the difference was statistically significant (P<0.05). Conclusion:Premature infants' intracranial hemorrhage may be with palace distress,amniotic fluid anomaly,pregnancy and high blood pressure,lead the placenta,an umbilical cord,Phenobarbital Sodium and Apgar score,birth weight and the gestational age.%  目的:探讨早产儿颅内出血发生的危险因素.方法:本研究分观察组和对照组,选取本院自2009年1月2012年1月新生儿重症监护病房(NICU)收治的221例的早产儿,其中颅内出血52例作为观察组,其余未发生颅内出血的早产儿169例作为对照组,回顾性分析早产儿颅内出血发生的危险因素.结果:对ICH组和对照组的产前异常因素进行比较,宫内窘迫、羊水异常、妊高征、前置胎盘、脐带异常、是否预防应用苯巴比妥钠差异有统计学意义(P<0.05);ICH组和对照组新生儿出生时的异常因素的比较,与Apgar评分、出生体重、胎龄差异有统计学意义(P<0.05).结论:早产儿颅内出血的发生可能与宫内窘迫、羊水异常、妊高征、前置胎盘、脐带

  9. Factors associated with weaning practices in term infants: a prospective observational study in Ireland.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2010-11-01

    The WHO (2001) recommends exclusive breast-feeding and delaying the introduction of solid foods to an infant\\'s diet until 6 months postpartum. However, in many countries, this recommendation is followed by few mothers, and earlier weaning onto solids is a commonly reported global practice. Therefore, this prospective, observational study aimed to assess compliance with the WHO recommendation and examine weaning practices, including the timing of weaning of infants, and to investigate the factors that predict weaning at ≤ 12 weeks. From an initial sample of 539 pregnant women recruited from the Coombe Women and Infants University Hospital, Dublin, 401 eligible mothers were followed up at 6 weeks and 6 months postpartum. Quantitative data were obtained on mothers\\' weaning practices using semi-structured questionnaires and a short dietary history of the infant\\'s usual diet at 6 months. Only one mother (0.2%) complied with the WHO recommendation to exclusively breastfeed up to 6 months. Ninety-one (22.6%) infants were prematurely weaned onto solids at ≤ 12 weeks with predictive factors after adjustment, including mothers\\' antenatal reporting that infants should be weaned onto solids at ≤ 12 weeks, formula feeding at 12 weeks and mothers\\' reporting of the maternal grandmother as the principal source of advice on infant feeding. Mothers who weaned their infants at ≤ 12 weeks were more likely to engage in other sub-optimal weaning practices, including the addition of non-recommended condiments to their infants\\' foods. Provision of professional advice and exploring antenatal maternal misperceptions are potential areas for targeted interventions to improve compliance with the recommended weaning practices.

  10. Caregiver-Infant Interaction and Early Cognitive Development in Preterm Infants

    Science.gov (United States)

    Beckwith, Leila; And Others

    1976-01-01

    Caregiver-infant transactions with 51 premature infants were studied in naturalistic observations in the home when the infants were aged 1, 3, and 8 months. Gesell developmental schedules and a sensorimotor scale were administered at 9 months. (Author/JH)

  11. <