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Sample records for prematurely born very-low-birth-weight

  1. Size and Composition of the Lexicon in Prematurely Born Very-Low-Birth-Weight and Full-Term Finnish Children at Two Years of Age

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    Stolt, Suvi; Klippi, Anu; Launonen, Kaisa; Munck, Petriina; Lehtonen, Liisa; Lapinleimu, Helena; Haataja, Leena

    2007-01-01

    This paper focuses on the aspects of the lexicon in 66 prematurely born very-low-birth-weight and 87 full-term Finnish children at 2;0, studied using the Finnish version of the "MacArthur Communicative Developmental Inventory". The groups did not differ in vocabulary size. Furthermore, the female advantage in vocabulary size was not seen…

  2. Screening for Dysregulation among Toddlers Born Very Low Birth Weight

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    Erickson, Sarah J.; MacLean, Peggy; Duvall, Susanne Woolsey; Lowe, Jean R.

    2013-01-01

    Background: Children born very low birth weight (VLBW) are at increased risk for regulatory difficulties. However, identifying toddlers at risk has been impeded by a lack of screening measures appropriate for this population. Methods: We studied the nature of dysregulation in toddlers born VLBW (N = 32) using the Infant-Toddler Social and…

  3. Do the early development of gestures and receptive and expressive language predict language skills at 5;0 in prematurely born very-low-birth-weight children?

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    Stolt, S; Lind, A; Matomäki, J; Haataja, L; Lapinleimu, H; Lehtonen, L

    2016-01-01

    It is unclear what the predictive value of very early development of gestures and language is on later language ability in prematurely born very-low-birth-weight (VLBW; birth weight ≤1500g) children. The aim of the present study was to analyse the predictive value of early gestures and a receptive lexicon measured between the ages of 0;9 and 1;3, as well as the predictive value of receptive and expressive language ability at 2;0 for language skills at 5;0 in VLBW children. The subjects were 29 VLBW children and 28 full-term children whose language development has been followed intensively between the ages of 0;9 and 2;0 using the Finnish version of the MacArthur Developmental Inventory and the Reynell Developmental Language Scales (RDLS III). At 5;0, five selected verbal subtests of the Nepsy II test and the Boston Naming Test (BNT) were used to assess children's language skills. For the first time in VLBW children, the development of gestures measured between the ages of 0;9 and 1;3 was shown to correlate significantly and positively with language skills at 5;0. In addition, both receptive and expressive language ability measured at 2;0 correlated significantly and positively with later language skills in both groups. Moreover, according to the hierarchical regression analysis, the receptive language score of the RDLS III at 2;0 was a clear and significant predictor for language skills at 5;0 in both groups. The findings particularly underline the role of early receptive language as a significant predictor for later language ability in VLBW children. The results provide evidence for a continuity between early language development and later language skills. After reading this article, readers will understand the associations between the very early (≤2 years of age) development of gestures and language (i.e. early receptive lexicon, expressive lexicon at 2;0, receptive and expressive language ability at 2;0) and the language skills at 5;0 in prematurely born

  4. Children born with very low birth weight show difficulties with sustained attention but not response inhibition.

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    Johnson, Katherine A; Healy, Elaine; Dooley, Barbara; Kelly, Simon P; McNicholas, Fiona

    2015-01-01

    Children born with very low birth weight perform poorly on executive function and attention measures. Any difficulties with sustained attention may underpin impairments in performance on tasks measuring higher order cognitive control. Previous sustained attention research in very low birth weight cohorts has used tasks that involve arousing stimuli, potentially spoiling the measure of sustained attention. The aim of this study was to compare the performance of very low birth weight and normal birth weight children on a well-controlled task of sustained attention. The Fixed and Random versions of the Sustained Attention to Response Task were given to 17 very low birth weight and 18 normal birth weight children. The very low birth weight group performed the Fixed and Random Sustained Attention to Response Tasks in a similar manner as the normal birth weight group on all measures except for the omission error and Slow Frequency Area under the Spectra variables on the Fixed Sustained Attention to Response Task. These measures index lapses in sustained attention that may be underpinned by declining arousal. The very low birth weight group showed no response inhibition deficits. Omission errors and slow-timescale response-time variability on predictable tasks may thus present sensitive indices of difficulties with sustained attention and arousal associated with premature birth and low birth weight.

  5. Blood Pressure in Young Adults Born at Very Low Birth Weight: Adults Born Preterm International Collaboration

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    Hovi, P.; Vohr, B.; Ment, L.R.; Doyle, L.W.; McGarvey, L.; Morrison, K.M.; Evensen, K.A.I.; Pal, S. van der; Grunau, R.E.; Brubakk, A.M.; Andersson, S.; Saigal, S.; Kajantie, E.

    2016-01-01

    Adults born preterm at very low birth weight (VLBW; <1500 g) have higher blood pressure than those born at term. It is not known whether all VLBW adults are at risk or whether higher blood pressure could be attributed to some of the specific conditions underlying or accompanying preterm birth. To

  6. Blood Pressure in Young Adults Born at Very Low Birth Weight: Adults Born Preterm International Collaboration

    NARCIS (Netherlands)

    Hovi, P.; Vohr, B.; Ment, L.R.; Doyle, L.W.; McGarvey, L.; Morrison, K.M.; Evensen, K.A.I.; Pal, S. van der; Grunau, R.E.; Brubakk, A.M.; Andersson, S.; Saigal, S.; Kajantie, E.

    2016-01-01

    Adults born preterm at very low birth weight (VLBW; <1500 g) have higher blood pressure than those born at term. It is not known whether all VLBW adults are at risk or whether higher blood pressure could be attributed to some of the specific conditions underlying or accompanying preterm birth. To id

  7. Blood Pressure in Young Adults Born at Very Low Birth Weight: Adults Born Preterm International Collaboration.

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    Hovi, Petteri; Vohr, Betty; Ment, Laura R; Doyle, Lex W; McGarvey, Lorcan; Morrison, Katherine M; Evensen, Kari Anne I; van der Pal, Sylvia; Grunau, Ruth E; Brubakk, Ann-Mari; Andersson, Sture; Saigal, Saroj; Kajantie, Eero

    2016-10-01

    Adults born preterm at very low birth weight (VLBW; blood pressure than those born at term. It is not known whether all VLBW adults are at risk or whether higher blood pressure could be attributed to some of the specific conditions underlying or accompanying preterm birth. To identify possible risk or protective factors, we combined individual-level data from 9 cohorts that measured blood pressure in young adults born at VLBW or with a more stringent birth weight criterion. In the absence of major heterogeneity, we performed linear regression analysis in our pooled sample of 1571 adults born at VLBW and 777 controls. Adults born at VLBW had 3.4 mm Hg (95% confidence interval, 2.2-4.6) higher systolic and 2.1 mm Hg (95% confidence interval, 1.3-3.0) higher diastolic pressure, with adjustment for age, sex, and cohort. The difference in systolic pressure was present in men (1.8 mm Hg; 95% confidence interval, 0.1-3.5) but was stronger in women (4.7 mm Hg; 95% confidence interval, 3.2-6.3). Among the VLBW group, blood pressure was unrelated to gestational age, maternal smoking, multiple pregnancy, retinopathy of prematurity, or bronchopulmonary dysplasia. Blood pressure was higher than that of controls among VLBW adults unexposed to maternal preeclampsia. Among those exposed, it was even higher, especially if born appropriate for gestational age. In conclusion, although female sex and maternal preeclampsia are additional risk factors, the risk of higher blood pressure is not limited to any etiologic subgroup of VLBW adults, arguing for vigilance in early detection of high blood pressure in all these individuals. © 2016 American Heart Association, Inc.

  8. Clinical application of transcranial Doppler ultrasonography in premature, very-low-birth-weight neonates

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    Gabriel, Marta Lucia [Fundacao Faculdade Regional de Medicina (FUNFARME), Sao Jose do Rio Preto, SP (Brazil). Hospital de Base; Piatto, Vania Belintani [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil); Souza, Antonio Soares, E-mail: depimagem@famerp.b [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Dept. de Diagnostico por Imagem

    2010-07-15

    Objective: the present study was aimed at analyzing the value of the early diagnosis of hemodynamic changes in hemorrhages and hypoxic-ischemic events in premature, very-low-birth-weight neonates through the evaluation of images and resistance index measurement by means of transcranial Doppler ultrasonography. Materials and methods: fifty premature, very-low-birth-weight neonates were submitted to transcranial Doppler ultrasonography with sequential transfontanellar and transtemporal techniques. Results: cerebral abnormalities were detected in 32% of the neonates (22% with intracranial hemorrhage, 8% with periventricular leukomalacia, and 2% with toxoplasmosis). Among the 34 cases (68%) of neonates in whom no brain lesion was detected at transcranial Doppler ultrasonography, 18 (53%) presented changes in the resistance index. Such resistance index varied according to the time of the examination. Conclusion: there is a correlation between the presence of cerebral hemodynamic changes demonstrated by resistance index measurements and the subsequent development of hemorrhages and hypoxic-ischemic lesions. Although not being a death predictor, changes in the resistance index are associated with the severity of the clinical conditions in preterm, very-low-birth-weight neonates. (author)

  9. Local and global aspects of biological motion perception in children born at very low birth weight.

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    Williamson, K E; Jakobson, L S; Saunders, D R; Troje, N F

    2015-01-01

    Biological motion perception can be assessed using a variety of tasks. In the present study, 8- to 11-year-old children born prematurely at very low birth weight (body structure, and the ability to carry out higher order processes required for action recognition and person identification. Preterm children exhibited difficulties in all 4 aspects of biological motion perception. However, intercorrelations between test scores were weak in both full-term and preterm children--a finding that supports the view that these processes are relatively independent. Preterm children also displayed more autistic-like traits than full-term peers. In preterm (but not full-term) children, these traits were negatively correlated with performance in the task requiring structure-from-motion processing, r(30) = -.36, p children and suggest that a core deficit in social perception/cognition may contribute to the development of the social and behavioral difficulties even in members of this population who are functioning within the normal range intellectually. The results could inform the development of screening, diagnostic, and intervention tools.

  10. Social attribution skills of children born preterm at very low birth weight.

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    Williamson, Kathryn E; Jakobson, Lorna S

    2014-11-01

    Children born prematurely at very low birth weight (<1500 g) are at increased risk for impairments affecting social functioning, including autism spectrum disorders (e.g., Johnson et al., 2010). In the current study, we used the Happé-Frith animated triangles task (Abell, Happé, & Frith, 2000) to study social attribution skills in this population. In this task, typical viewers attribute intentionality and mental states to shapes, based on characteristics of their movements. Participants included 34 preterm children and 36 full-term controls, aged 8-11 years. Groups were comparable in terms of age at test, gender, handedness, and socioeconomic status; they also performed similarly on tests of selective attention/processing speed and verbal intelligence. Relative to full-term peers, preterm children's descriptions of the animations were less appropriate overall; they also overattributed intentionality/mental states to randomly moving shapes and underattributed intentionality/mental states to shapes that seemed to be interacting socially. Impairments in the ability to infer the putative mental states of triangles from movement cues alone were most evident in children displaying more "autistic-like" traits, and this may reflect atypical development of and/or functioning in, or atypical connections between, parts of the social brain.

  11. 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.

  12. CHARACTERISTICS AND THE OUTCOME OF VERY LOW BIRTH WEIGHT INFANT BORN IN SANGLAH HOSPITAL DENPASAR

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    Yoga Putra

    2013-04-01

    Full Text Available Very low birth weight (VLBW infants is one of the most important medical problem especially in developing countries. This issue is due to its high morbidity and mortality rate. On the other hand, the long term impact of VLBW infants are poor growth and development including physical, emotional, intelectual (IQ, and disabilities, therefore it could decrease the quality of human resources and become a burden to their family. The objective of this study was to describe the characteristics and outcome among VLBW infants born in the Sanglah Hospital. This was a retrospective study. Data were collected from medical record of all infants with VLBW delivered in Sanglah Hospital from January to Desember 2009. Uncompleted infants and mother medical records were excluded from this study. Of 64 VLBW infants enrolled into the study of which 54.7%  of this subjects was male, median of weight was 1300 g, mean gestational of age was 30.9 (SD 2.28 weeks, and mean lenght of stay was 30.9 (SD 19.7 days. The survival of VLBW infants in this study was 62.5%,  mortality in the early neonatal period was 70,8%. The percentage of VLBW infants who survive was still low and the major causes mortality were HMD (50% and sepsis (41.6%. The mortality of VLBW happened mostly in early neonatal periode.

  13. 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

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

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    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

  15. Born Too Soon: What Can We Expect? Nature of Home Literacy Experiences for Children with Very Low Birth Weight

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    Ragusa, G.

    2009-01-01

    This study documents the home literacy experiences of children born with very low birth weight (VLBW). The study's design was modelled after Purcell-Gates' study of social domains mediated by print as home literacy experiences. A design combining purposeful sampling, semi-structured data collection and descriptive case study analysis was employed…

  16. Total and carboxylated osteocalcin associate with insulin levels in young adults born with normal or very low birth weight.

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    Päivi M Paldánius

    Full Text Available OBJECTIVE: Osteocalcin (OC, a bone-derived protein, has been implicated in the regulation of glucose and energy metabolism. Young adults born with very low birth weight (VLBW have altered glucose regulation and lower bone mineral density (BMD compared with those born at term. The aim of this study was to explore the association between bone and glucose metabolism in healthy young adults born prematurely or at term. METHODS: The cohort of this cross-sectional study comprised 332 non-diabetic young adults (age 18 to 27 years born either preterm with VLBW (n = 163 or at term (n = 169. OC, carboxylated osteocalcin (cOC and markers of glucose metabolism were measured at fasting and after a 75-g oral glucose tolerance test (OGTT. RESULTS: VLBW adults were shorter, had lower BMD (p<0.001 and higher fasting OC (p = 0.027 and cOC (p = 0.005 than term-born subjects. They also had higher 2-hour insulin (p = 0.001 and glucose (p = 0.037 concentrations. OGTT induced a significant reduction in OC (p<0.001, similar in both groups. OC reduction was not associated with OGTT-induced increases in insulin (p = 0.54. However, fasting total OC and cOC correlated negatively with fasting insulin after adjustment for age, gender, BMD and VLBW status (r = -0.182, p = 0.009 and r = -0.283, p<0.001, respectively. CONCLUSION: Adults born with VLBW have higher OC and cOC than their peers born at term. This may in part reflect the mechanisms that underlie their lower BMD and decreased insulin sensitivity. Serum OC appears to be negatively associated with long-term glucose regulation whereas acute changes during OGTT may be mediated via other mechanisms.

  17. Rerouting surgery of cardiac type total anomalous pulmonary venous return in a premature newborn with very low birth weight.

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    Wu, En-Ting; Huang, Shu-Chien; Wu, Mei-Hwan; Wang, Jou-Kou; Chang, Chung-I

    2007-02-01

    Intracardiac repair for complex congenital heart defects in premature neonates with very low birth weight (VLBW) is still a challenge to pediatric cardiac surgeons. We report the successful rerouting of cardiac type total anomalous pulmonary venous return (TAPVR) in a premature newborn (36th gestational week) with VLBW (1250 g). She had severe hypoxemia and low cardiac output despite medical treatment. Rerouting surgery of TAPVR was performed under deep hypothermia circulatory arrest at the age of 20 days. The sternum was left open and approximated 2 days later. Follow-up echocardiography showed good ventricular function without pulmonary venous obstruction. The endotracheal tube was removed 7 days postoperatively. She was then discharged without complication. In conclusion, with improved cardiopulmonary bypass technique and perioperative care, open heart surgery can be performed in premature newborns with VLBW.

  18. IGF-I and relation to growth in infancy and early childhood in very-low-birth-weight infants and term born infants

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    de Jong, Miranda; Cranendonk, Anneke; Twisk, Jos W. R.; van Weissenbruch, Mirjam M.

    2017-01-01

    Background In very-low-birth-weight infants IGF-I plays an important role in postnatal growth restriction and is probably also involved in growth restriction in childhood. We compared IGF-I and its relation to growth in early childhood in very-low-birth-weight infants and term appropriate for gestational age born infants. Methods We included 41 very-low-birth-weight and 64 term infants. Anthropometry was performed at all visits to the outpatient clinic. IGF-I and insulin were measured in blood samples taken at 6 months and 2 years corrected age (very-low-birth-weight children) and at 3 months, 1 and 2 years (term children). Results Over the first 2 years of life growth parameters are lower in very-low-birth-weight children compared to term children, but the difference in length decreases significantly. During the first 2 years of life IGF-I is higher in very-low-birth-weight children compared to term children. In both groups there is a significant relationship between IGF-I and (change in) length and weight over the first 2 years of life and between insulin and change in total body fat. Conclusions Considering the relation of IGF-I to growth and the decrease in difference in length, higher IGF-I levels in very-low-birth-weight infants in early childhood probably have an important role in catch-up growth in length. PMID:28182752

  19. Diurnal Cortisol Patterns and Dexamethasone Suppression Test Responses in Healthy Young Adults Born Preterm at Very Low Birth Weight.

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    Kaseva, Nina; Pyhälä, Riikka; Pesonen, Anu-Katriina; Räikkönen, Katri; Järvenpää, Anna-Liisa; Andersson, Sture; Eriksson, Johan G; Hovi, Petteri; Kajantie, Eero

    2016-01-01

    Early life stress, such as painful and stressful procedures during neonatal intensive care after preterm birth, can permanently affect physiological, hormonal and neurobiological systems. This may contribute to altered programming of the hypothalamic-pituitary-adrenal axis (HPAA) and provoke changes in HPAA function with long-term health impacts. Previous studies suggest a lower HPAA response to stress in young adults born preterm compared with controls born at term. We assessed whether these differences in HPAA stress responsiveness are reflected in everyday life HPAA functioning, i.e. in diurnal salivary cortisol patterns, and reactivity to a low-dose dexamethasone suppression test (DST), in unimpaired young adults born preterm at very low birth weight (VLBW; <1500 g). The participants were recruited from the Helsinki Study of Very Low Birth Weight Adults cohort study. At mean age 23.3 years (2.1 SD), 49 VLBW and 36 controls born at term participated in the study. For cortisol analyzes, saliva samples were collected on two consecutive days at 0, 15, 30 and 60 min after wake-up, at 12:00 h, 17:00 h and 22:00 h. After the last salivary sample of the first study day the participants were instructed to take a 0.5 mg dexamethasone tablet. With mixed-effects model no difference was seen in overall diurnal salivary cortisol between VLBW and control groups [13.9% (95% CI: -11.6, 47.0), P = 0.31]. Salivary cortisol increased similarly after awakening in both VLBW and control participants [mean difference -2.9% (29.2, 33.0), P = 0.85]. Also reactivity to the low-dose DST (awakening cortisol ratio day2/day1) was similar between VLBW and control groups [-1.1% (-53.5, 103.8), P = 0.97)]. Diurnal cortisol patterns and reactivity to a low-dose DST in young adulthood were not associated with preterm birth.

  20. Prevalence and Predisposing Factors of Retinopathy of Prematurity in Very Low-Birth-Weight Infants Discharged from NICU

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    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.

  1. Dificuldade de aprendizagem em escolares de muito baixo peso ao nascer Learning difficulties in schoolchildren born with very low birth weight

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    Maura C. C. de Rodrigues

    2006-02-01

    school by means of a systematic review of the literature, identifying patterns of learning difficulties among these schoolchildren, possible cognitive correlations, peculiarities of the lowest birth weight ranges and any interference with outcomes by socioeconomic and/or clinical factors. SOURCES OF DATA: Bibliographic search (MEDLINE, LILACS, Excerpta Medica, reference lists of original articles, periodicals related to the subject, information from experts in the area and thesis and dissertation databases on the keywords: prematurity/very low birth weight, learning difficulties/academic achievement/school performance, follow-up/results/cohort. SUMMARY OF THE FINDINGS: The search returned 114 articles and the 18 of these were selected as having investigated learning difficulties in schoolchildren born with very low birth weights using appropriate methodology. The academic performance of these children was observed to be inferior the whole study population was compared with those born full term. The subject most compromised was mathematics. The risk of suffering from learning difficulties increased in inverse proportion to birth weight. An association was identified between very low birth weight and cognitive compromise. CONCLUSIONS: The systematic approach corroborated the results obtained by published studies: schoolchildren born with very low birth weights exhibited increased risk of learning difficulties when compared with those born at full term. There was a predominance of children with multiple academic subjects compromised and mathematics was the most affected. Risk was observed to follow an ascending gradient as birth weight reduced. There was an association between very low birth weight and cognitive compromise.

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

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    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.

  3. Lower conditioning leisure-time physical activity in young adults born preterm at very low birth weight.

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    Nina Kaseva

    Full Text Available BACKGROUND: Adults born preterm at very low birth weight (VLBW, <1500 g have elevated levels of risk factors for cardiovascular diseases and type 2 diabetes. Preliminary observations suggest that this could partly be explained by lower rates of physical activity. The aim of this study was to assess physical activity in healthy young adults born preterm at very low birth weight compared with term-born controls. METHODOLOGY/PRINCIPAL FINDINGS: We studied 94 unimpaired young adults, aged 21-29 years, born at VLBW and 101 age-, sex-, and birth hospital-matched term-born controls from one regional center in Southern Finland. The participants completed a validated 30-item 12-month physical activity questionnaire and the NEO-Personality Inventory based on the Big Five taxonomy, the most commonly used classification of personality traits. Yearly frequency, total time, total volume and energy expenditure of conditioning and non-conditioning leisure-time physical activity (LTPA and commuting physical activity were compared between VLBW and term-born subjects. A subset of participants underwent dual-energy x-ray absorptiometry for body composition measurement. Data were analyzed by multiple linear regression. Compared with controls, VLBW participants had lower frequency [-38.5% (95% CI; -58.9, -7.7], total time [-47.4% (95% CI; -71.2, -4.1], total volume [-44.3% (95% CI; -65.8, -9.2] and energy expenditure [-55.9% (95% CI; -78.6, -9.4] of conditioning LTPA when adjusted for age, sex, body mass index, smoking, parental education and personality traits. Adjusting for lean body mass instead of body mass index attenuated the difference. There were no differences in non-conditioning LTPA or commuting physical activity. CONCLUSIONS/SIGNIFICANCE: Compared with term-born controls, unimpaired VLBW adults undertake less frequent LTPA with lower total time and volume of exercise resulting in lower energy expenditure. Differences in personality that exist between the

  4. Executive functions, social information processing, and social adjustment in young children born with very low birth weight.

    Science.gov (United States)

    Wolfe, Kelly R; Vannatta, Kathryn; Nelin, Mary Ann; Yeates, Keith Owen

    2015-01-01

    Children born with very low birth weight (VLBW) are at risk for neurocognitive and behavioral sequelae. Although VLBW infants are at higher risk for deficits in executive functions (EFs) and social functioning during school-age years, few studies have investigated those sequelae or their association in young children born VLBW. We examined the associations between EFs and social functioning in preterm, VLBW children age 4-6 years (n = 20) and matched, term-born, normal birth weight controls admitted to the neonatal intensive care unit (NICU) after birth (n = 18). The groups did not differ significantly on measures of EFs, social information processing, or parent-reported social adjustment. The VLBW group had lower IQs than controls, though both group means were in the average range. Within the VLBW group, medical predictors of better EFs included older gestational age at birth and no history of bronchopulmonary dysplasia. Across groups, EFs and social information processing were positively correlated. Deficits in EFs and social functioning may emerge after the preschool years in VLBW children, or improved care of children born VLBW may be reducing the cognitive and psychosocial sequelae observed in earlier cohorts. Among children born VLBW, early EFs may be directly related to social information processing.

  5. 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.

  6. 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

  7. Reproductive outcomes of women and men born very preterm and/or with a very low birth weight in 1983 : a longitudinal cohort study in the Netherlands

    NARCIS (Netherlands)

    Gendt, A.W. van; Pal, S.M. van der; Hermes, W.; Walther, F.J.; Pal-de Bruin, K.M. van der; Groot, C.J.M. de

    2015-01-01

    The aims of this study were to analyze reproductive outcomes of women and men born very preterm (gestational age <32 weeks) or with a very low birth weight (<1500 g) in 1983 in the Netherlands and to compare their reproductive outcomes with the total population at a similar age of 28 years. Young ad

  8. Association between clinical variables related to asthma in schoolchildren born with very low birth weight with and without bronchopulmonary dysplasia.

    Science.gov (United States)

    Gonçalves, Emília da Silva; Mezzacappa-Filho, Francisco; Severino, Silvana Dalge; Ribeiro, Maria Ângela Gonçalves de Oliveira; Marson, Fernando Augusto de Lima; Morcilo, Andre Moreno; Toro, Adyléia Aparecida Dalbo Contrera; Ribeiro, José Dirceu

    2016-09-01

    to assess the prevalence, spirometry findings and risk factors for asthma in schoolchildren who were very low birth weight infants with and without bronchopulmonary dysplasia. Observational and cross-sectional study. The parents and/or tutors answered the International Study of Asthma and Allergies in Childhood questionnaire. The schoolchildren were submitted to the skin prick test and spirometry assessment. 54 schoolchildren who were very low birth weight infants were assessed and 43 met the criteria for spirometry. Age at the assessment (bronchopulmonary dysplasia=9.5±0.85; without bronchopulmonary dysplasia=10.1±0.86 years) and birth weight (bronchopulmonary dysplasia=916.7±251.2; without bronchopulmonary dysplasia=1,171.3±190.5g) were lower in the group with bronchopulmonary dysplasia (p<0.05). The prevalence of asthma among very low birth weight infants was 17/54 (31.5%), being 6/18 (33.3%) in the group with bronchopulmonary dysplasia. There was an association between wool blanket use in the first year of life (p=0.026) with the presence of asthma at school age. The skin prick test was positive in 13/17 (76.5%) and 23/37 (62.2%) of patients with and without asthma, respectively. The schoolchildren with asthma had lower z-score values of forced expiratory flow between 25% and 75% of forced vital capacity (n=16; -1.04±1.19) when compared to the group of patients without asthma (n=27; -0.38±0.93) (p=0.049). There was no difference between the spirometry variables in the groups regarding the presence or absence of bronchopulmonary dysplasia. Very low birth weight infants with and without bronchopulmonary dysplasia showed a high prevalence of asthma (33.3% and 30.6%, respectively). Pulmonary flow in the small airways was lower in children with asthma. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Fatores prognósticos para o desenvolvimento cognitivo de prematuros de muito baixo peso Prognostic factors for cognitive development of very low birth weight premature children

    Directory of Open Access Journals (Sweden)

    Maria Dalva Barbosa Baker Méio

    2003-06-01

    Full Text Available OBJETIVO: Crianças prematuras, de muito baixo peso, podem apresentar alterações em seu desenvolvimento cognitivo. No Brasil, pouco se conhece sobre a evolução dessas crianças na idade pré-escolar. O objetivo do estudo foi descrever o desenvolvimento cognitivo de uma população de recém-nascidos prematuros de muito baixo peso e verificar possíveis fatores prognósticos para desenvolvimento cognitivo anormal. MÉTODOS: Um estudo de coorte foi realizado com uma população de crianças pré-escolares, nascidas prematuras, de muito baixo peso, entre janeiro de 1991 e setembro de 1993. O desenvolvimento cognitivo foi avaliado por meio do teste WPPSI-R (Wechsler Preschool and Primary Intelligence Scales aplicado por psicólogas, utilizando dois pontos de corte para definição de anormalidade: escores abaixo de 1 e 2, desvios padrões da média (DP. RESULTADOS: Foram avaliadas 79 crianças de quatro a cinco anos de idade. A média do escore total do teste WIPPSI-R foi de 75,6 (±11,9. A incidência de escore total anormal foi de 77,2% e de 32,9% (1DP e 2 DP, respectivamente. Após o ajuste por "tipo de parto", ser pequeno para a idade gestacional (OR=6,19; IC95% 1,60-23,86, ultra-som transfontanela anormal (OR=5,90; IC95% 1,04-9,83 e ser do sexo masculino (OR=3,20; IC 95% 1,32-26,35 foram os fatores que predisseram escore total OBJECTIVE: Very low birth weight premature children often show cognitive development abnormalities. There is scarce information about the outcome of these children at preschool age in Brazil.The objective of the study is to describe the cognitive development of a population of premature newborns and to assess possible prognostic factors for abnormalities. METHODS: A cohort study was conducted in a preschool children population whose subjects were very low birth weight premature babies born between January 1991 and September 1993. WPPSI-R Test was used for cognitive evaluation and it was applied by psychologists. Two

  10. 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.

  11. Blunted hypothalamic-pituitary-adrenal axis and insulin response to psychosocial stress in young adults born preterm at very low birth weight.

    Science.gov (United States)

    Kaseva, Nina; Wehkalampi, Karoliina; Pyhälä, Riikka; Moltchanova, Elena; Feldt, Kimmo; Pesonen, Anu-Katriina; Heinonen, Kati; Hovi, Petteri; Järvenpää, Anna-Liisa; Andersson, Sture; Eriksson, Johan G; Räikkönen, Katri; Kajantie, Eero

    2014-01-01

    Young adults born preterm at very low birth weight (VLBW, ≤1500 g) have higher levels of cardiovascular risk factors, including impaired glucose regulation, than their term-born peers. This could be mediated through altered hypothalamic-pituitary-adrenal axis (HPAA) response to stress. To compare HPAA, glucose and insulin responses provoked by psychosocial stress in VLBW subjects versus a comparison group of term-born controls. We studied 54 unimpaired young adults, aged 19-27 years, born at VLBW and a comparison group of 40 adults born at term, group-matched for age, sex and birth hospital, from one regional centre in southern Finland. The participants underwent a standardized psychosocial stress test (Trier Social Stress Test, TSST). In conjunction with TSST, we measured salivary cortisol, plasma ACTH, cortisol, glucose and insulin. Data were analysed with mixed-effects model and multiple linear regression analyses. Baseline concentrations for cortisol, ACTH, insulin and glucose were similar in VLBW and comparison groups. During TSST, analysed with mixed-effects model, overall concentrations of plasma cortisol were 17·2% lower (95% CI; 3·5 to 28·9) in the VLBW group. The VLBW group also had lower salivary (P = 0·04) and plasma cortisol (P = 0·02) responses to TSST. Insulin and glucose concentrations correlated with changes in cortisol concentrations. Accordingly, VLBW subjects had 26·5% lower increment in insulin (95% CI; 9·8-40·1). Analyses were adjusted for age, sex, body mass index, hormonal contraception, menstrual cycle phase, time of day and parental education. VLBW adults have lower HPAA responses to psychosocial stress than term-born controls. This is accompanied by a lower insulin response. © 2013 John Wiley & Sons Ltd.

  12. Leptin and IGF-I/II during the first weeks of life determine body composition at 2 years in infants born with very low birth weight.

    Science.gov (United States)

    Hernandez, Maria Isabel; Rossel, Katherine; Peña, Verónica; Cavada, Gabriel; Avila, Alejandra; Iñiguez, German; Mericq, Verónica

    2012-01-01

    Rapid early growth is associated with adverse metabolic outcome. The aim of this study was to determine whether there are differences in body composition (BC) between very-low-birth-weight preterm (VLBWPT) infants born appropriate for gestational age (AGA) and small for gestational age (SGA) and whether these differences relate to first-year growth. Twenty-six VLBWPT (15 AGA and 11 SGA). The BC was analyzed by dual X-ray absorptiometry at 2 years, and insulin-like growth factors (IGFs) I and II and leptin were administered weekly for 8 weeks and at 1, 3, 6, and 12 months. At 24 months, the VLBW SGA infants were lighter and had less peripheral fat and lean mass than VLBW AGA infants. In all patients, the percentage of fat mass correlated inversely with the change in weight [standard deviation scores (SDS)] from newborn to 2 and 4 weeks and the 1-month leptin and lean mass (SDS) correlated inversely with the change in weight (SDS) from newborn to 2, 4, and 8 weeks and with 4-week IGF-I and 8-week IGF-II. Lean mass (SDS) inversely correlated with 6-month IGF-I and directly correlated with 1-week and 3-month IGF-I in SGA VLBW infants only. A longer follow-up period will show whether additional differences will develop later.

  13. Differential associations between infant affective and cortisol responses during the still face paradigm among infants born very low birth weight versus full-term.

    Science.gov (United States)

    Erickson, Sarah J; Maclean, Peggy; Qualls, Clifford; Lowe, Jean R

    2013-06-01

    Psychological stress responses may have both emotional and cortisol reactivity correlates, but there are limited data addressing the association between generalized negative and positive emotional states and cortisol reactivity to a psychological stressor among infants born very low birth weight (VLBW; cortisol) responses may provide insight into the nature of regulation difficulties identified in infants born VLBW. The purpose of this study was to assess the association between infant affective and cortisol responses to the Still Face paradigm (SF) in a cohort of six- to eight-month old infants born VLBW compared with infants born full-term (N=53 total; N=29 and N=24, respectively). Infant affect was coded in 1-s intervals while mother-infant dyads participated in the SF paradigm, and percent positive affect and percent negative affect were calculated separately for each SF episode. We had hypothesized that because infants born VLBW are at increased risk for dysregulation, they would show, compared to full-term controls, greater dysregulation in the form of less synchrony (i.e., less correlated affective and cortisol responses) across the two SF stressors (episodes 2 and 4). This hypothesis was largely supported: the associations between affective and cortisol responses were different for the two groups across the two stressors for percent positive affect (both stressor episodes 2 and 4) and percent negative affect (episode 4 only). For the full-term group, follow up correlations revealed significant negative associations between percent positive affective and cortisol responses for both stressors. Mothers' responsiveness did not explain the term group association differences between infant affective and cortisol responses across stressors. The (lack of) association of stress reactivity systems may index dysregulation or dysregulation correlates in preterm children. Understanding how this lack of coordination among stress systems relates to greater dysregulation

  14. 极低出生体重早产儿早期干预的临床效果%The clinical effect of early intervention on very low birth weight premature infants

    Institute of Scientific and Technical Information of China (English)

    雷克竞; 李永佳; 唐国红; 张本金

    2015-01-01

    Objective To explore the influence of early intervention on physical and intelligent development of premature infants with very low birth weight. Methods Selected 32 premature infants of very lowbirth weight treated in neonatal intensive care unit during November 2011 to October 2012 as the intervention group. To avoid the violation of medical ethics, we select another 32 premature infants with very low birth weight who were born before November 2011and aged between 9 to 15 months as the control group. The intervention group was treated with early intervention, including regular physical development evaluation, neuromotor examination and test of intelligence. The intervention group was followed-up until correction age of 1 year and the control group was only at the year of correction age of 1 year. Results The physical development in the intervention group was better than the control group at the age of 1, the mental development index (MDI) and psychomotor development index (PDI) significantly higher than those of the control group as well. The incidences of low intelligence and cerebral palsy were lower than those of the control group. The differences were statistically significant. Conclusion Early intervention is obviously effective in promoting the physical and intelligent development of very low birth weight premature infants, reducing the incidence of low intelligence and cerebral palsy, and improving the long-term living quality of the survivors. Still, the method centers on family, and therefore, is feasible and effective. So the doctors for children′s care from basic hospitals should vigorously promote the method.%目的:探讨早期干预对极低出生体重早产儿体格及智能发育的影响。方法:选择本院2011年11月至2012年10月新生儿重症监护病房救治存活的极低出生体重早产儿32例做为干预组,选择2011年11月以前出生的9~15个月极低出生体重早产儿连续收录32例做为对照组,对干

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

    Science.gov (United States)

    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.

  16. Therapy of patent ductus arteriosus in very-low-birth-weight premature infants%极低体重早产儿动脉导管未闭的治疗

    Institute of Scientific and Technical Information of China (English)

    朱燕林; 郭立琳; 徐瑞燚; 朱文玲; 苗齐

    2011-01-01

    目的:探讨极低体重早产儿动脉导管未闭(PDA)的治疗方法.方法:本研究回顾性分析6例经外科手术治疗的PDA的极低体重早产儿的临床特点.结果:4例患者布洛芬治疗失败、2例患者因药物禁忌行动脉导管结扎术,术后由对呼吸机依赖转为3~4 d过渡脱机,胃肠内喂养耐受性及体重增加显著改善[(45±41)∶(258±77)g/周,P<0.001],5例存活患者均无手术并发症,1例患者死于早产儿并发症.结论:对于有手术指征的PDA的极低体重早产儿,外科手术结扎是安全而有效的方法.%To explore the therapy of patent ductus arteriosus (PDA) in very low birth weight pre mature infants. Method: Clinical features of six very low birth weight premature infants who underwent surgical ligation of PDA were analyzed. Result:Six infants underwent surgical closure of PDA after failure (4/6) of or hav ing contraindications (2/6) to medical treatment. Five infants who were ventilator dependent stopped ventilator use in 3 -4 days after operation. Surgical ligation of PDA improved enteral feeding tolerance and body growth [45 + 41]g/week vs [258+77]g/week, P<0. 001). There was one death caused by complications of prematurity af ter operation. Conclusion; Surgical ligation is safe and effective for PDA in very low birth weight premature infantswith indication.

  17. Catch-up growth up to ten years of age in children born very preterm or with very low birth weight

    NARCIS (Netherlands)

    Knops, N.B.B.; Sneeuw, K.C.A.; Brand, R.; Hille, E.T.M.; Ouden, A.L. den; Wit, J.M.; Verloove-Vanhorick, S.P.

    2005-01-01

    Background: Improved survival due to advances in neonatal care has brought issues such as postnatal growth and development more to the focus of our attention. Most studies report stunting in children born very preterm and/or small for gestational age. In this article we study the growth pattern of t

  18. Aplicação clínica da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso Clinical application of transcranial Doppler ultrasonography in premature, very-low-birth-weight neonates

    Directory of Open Access Journals (Sweden)

    Marta Lúcia Gabriel

    2010-08-01

    Full Text Available OBJETIVO: Analisar o valor do diagnóstico precoce de alterações hemodinâmicas em hemorragias e eventos hipóxico-isquêmicos pela avaliação de imagens e mensuração do índice de resistência por meio da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso. MATERIAIS E MÉTODOS: Cinquenta neonatos prematuros de muito baixo peso foram submetidos a ultrassonografia craniana com Doppler com a técnica transfontanela anterior e transtemporal sequenciais. RESULTADOS: Foram detectadas alterações cerebrais em 32% dos prematuros, sendo 22% com hemorragia intracraniana, 8% com leucomalácia periventricular e 2% com toxoplasmose. Dentre os 34 casos (68%, do total de neonatos, nos quais não foram detectadas lesões cerebrais pela ultrassonografia craniana, 18 (53% apresentaram alterações no índice de resistência. O índice de resistência variou conforme a época do exame. CONCLUSÃO: Existe correlação entre a presença de alterações na hemodinâmica cerebral e subsequente desenvolvimento de hemorragias e lesões hipóxico-isquêmicas, pela mensuração do índice de resistência. Alterações do índice de resistência, embora não preditoras de morte, estão relacionadas com a gravidade do quadro clínico em neonatos prematuros de muito baixo peso.OBJECTIVE: The present study was aimed at analyzing the value of the early diagnosis of hemodynamic changes in hemorrhages and hypoxic-ischemic events in premature, very-low-birth-weight neonates through the evaluation of images and resistance index measurement by means of transcranial Doppler ultrasonography. MATERIALS AND METHODS: Fifty premature, very-low-birth-weight neonates were submitted to transcranial Doppler ultrasonography with sequential transfontanellar and transtemporal techniques. RESULTS: Cerebral abnormalities were detected in 32% of the neonates (22% with intracranial hemorrhage, 8% with periventricular leukomalacia, and 2% with toxoplasmosis

  19. Predicting neurodevelopmental outcomes at preschool age for children with very low birth weight.

    Science.gov (United States)

    Howe, Tsu-Hsin; Sheu, Ching-Fan; Hsu, Yung-Wen; Wang, Tien-Ni; Wang, Lan-Wan

    2016-01-01

    The purpose of this study was to examine predictors of neurodevelopmental outcome in very low birth weight children without major impairment at 5 years of age, as well as to identify the contribution of early neurodevelopmental assessment to preterm children's later developmental outcomes. The participants in this study included 126 children who were prematurely born with very low birth weight. Outcomes of the childrens' later development were measured in tests that factored cognitive function, motor performance, and adaptive behavior. The results indicated that more than 50% of full-scale intelligence and 30% of both motor performance and adaptive behavior at the age of 5 can be explained by four predictors. The four predictors include preterm children's medical complications at birth, maternal education, early motor assessments, and cognitive assessments. Adding each test score obtained in early ages provides additional information to predict children's cognitive, motor, and adaptive behavior at 5 years of age. Manifold assessments conducted in multiple time periods strengthen the predictive values of later developmental outcomes. In addition, the findings of this study indicate that very low birth weight children tend to have lower adaptive behavior at 5 years old. With regard to our findings, we believe that having adaptive function is a reflection of a child's overall integrated abilities. Further study is warranted to increase understanding of this topic, as well as to be able to predict adaptive strengths and weakness and pinpoint limiting factors that may be useful for targeting behaviors in intervention.

  20. Growth during the first two years predicts pre-school height in children born with very low birth weight (VLBW): results of a study of 1,320 children in Germany.

    Science.gov (United States)

    Trebar, Branko; Traunecker, Richard; Selbmann, Hans-Konrad; Ranke, Michael B

    2007-08-01

    Children born with very low birth weight (VLBW) are at risk of impaired growth. We aimed to study VLBW survivors (90.8%) born in 1998/1999 in the state of Baden-Württemberg (n = 2103) for whom growth data were available up to age six. Classification as appropriate for gestational age (AGA) or small for gestational age (SGA) depended on size at birth. Models to predict height SDS at 5 y were developed using data for 1 yr (Model 1) and 2 yrs (Model 2). The data of 1320 (63%) children were available: SGA: n = 730, AGA: n = 590. At 6 yrs, 8.3% AGA and 13.4% SGA children were short (weight SDS, birth weight SDS; (b) Model 2 (n = 991; R2 = 0.72; error: 0.65 SDS): 1st yr Ht SDS; change (2nd yr) in Ht and weight SDS; MPH SDS; 1st yr weight SDS; birth weight SDS. Thus, some AGA and SGA children born VLBW remain short and preventive strategies need to be developed for those at risk.

  1. 极低出生体重儿童学龄期的行为适应分析%Analysis of behavioral adjustment in school-aged children born with very low birth weight

    Institute of Scientific and Technical Information of China (English)

    曾小璐; 钟敏泉; 岑超群; 邹小兵; 杨杰; 钟向明

    2013-01-01

    [Objective] To evaluate behavioral adjustment and its influential factors among school-aged children born with very low birth weight(VLBW). [Method] The BASICS Behavioral Adjustment Scale was used to investigate 235 very low birth weight children and 396 normal birth weight(NBW) children who studied in mainstream schools, parents of the children completed the questionaire. [Results] A total of 570 out of 631 questionaires were completed, with a response rate of 90. 3%. Scores for VLBW group in dimension of achievement, self-relations, internal state and total scores were significantly higher than those of the NBW group (respectively 3. 06±0. 93,3. 62 ± 0. 88,4. 11 ± 1. 18 and 3. 19 ± 0. 71 vs 2. 29 ± 0. 85,2. 27 ± 0. 78,2. 45 ± 0. 86 and 2. 31 ± 0. 75,P all<0. 05). Multiple regression analysis showed that higer family economics status and main caregiver education level were predictors of better behavioral adjustment among the VLBW group. While those with neonatal intracranial hemorrhage and higer doses of corticosteroid had worse behavioral adjustment.[conclusion] VLBW children have increased behavior problems, early evaluation and intervention is recommended.%[目的]评估极低出生体重(very low birth weight,VLBW)儿童学龄期行为适应状况并探讨相关的影响因素. [方法]采用BASICS行为适应量表对235名就读主流学校的极低出生体重儿童和396名正常出生体重儿童的家长进行问卷调查. [结果]调查的631个家庭中570个家庭完成问卷,应答率90.3%.极低出生体重儿童组成就[(3.06±0.93)分]、自我关系[(3.62±0.88)分]、内在状态[(4.11±1.18)分]得分及行为适应总分[(3.19±0.71)分]高于正常出生体重儿童组,分别为[(2.29±0.85)分],[(2.27±0.78)分],[(2.45±0.86)分]和[(2.31±0.75)分],差异有统计学意义(P<0.05).多元线性回归分析结果显示,家庭收入高、主要管教者受教育程度高的VLBW儿童行为适应较好,新生儿期患颅内出血

  2. Predictive factors for neuromotor abnormalities at the corrected age of 12 months in very low birth weight premature infants Fatores preditivos para anormalidades neuromotoras aos 12 meses de idade corrigida em prematuros de muito baixo peso

    Directory of Open Access Journals (Sweden)

    Rosane Reis de Mello

    2009-06-01

    Full Text Available BACKGROUND: The increase in survival of premature newborns has sparked growing interest in the prediction of their long-term neurodevelopment. OBJECTIVE: To estimate the incidence of neuromotor abnormalities at the corrected age of 12 months and to identify the predictive factors associated with altered neuromotor development in very low birth weight premature infants. METHOD: Cohort study. The sample included 100 premature infants. The outcome was neuromotor development at 12 months classified by Bayley Scale (PDI and neurological assessment (tonus, reflexes, posture. A multivariate logistic regression model was constructed. Neonatal variables and neuromotor abnormalities up to 6 months of corrected age were selected by bivariate analysis. RESULTS: Mean birth weight was 1126g (SD: 240. Abnormal neuromotor development was presented in 60 children at 12 months corrected age. CONCLUSION: According to the model, patients with a diagnosis including bronchopulmonary dysplasia, hypertonia of lower extremities, truncal hypotonia showed a 94.0% probability of neuromotor involvement at 12 months.INTRODUÇÃO: O aumento na sobrevida de recém-nascidos prematuros tem suscitado interesse crescente na predição do seu neurodesenvolvimento a longo prazo. OBJETIVO: Estimar a incidência de anormalidades neuromotoras aos 12 meses de idade corrigida e identificar os fatores associados ao desenvolvimento neuromotor alterado em prematuros de muito baixo peso. MÉTODO: Estudo de coorte. A amostra incluiu 100 crianças prematuras.O desfecho foi o desenvolvimento neuromotor aos 12 meses. Modelo de regressão logística multivariado foi construído. Variáveis neonatais e anormalidades neuromotoras até os 6 meses de idade corrigida foram selecionadas por análise bivariada. RESULTADOS: O peso de nascimento médio foi 1126g (DP:240. Aos 12 meses 60% das crianças apresentaram desenvolvimento neuromotor alterado. CONCLUSÃO: De acordo com o modelo, pacientes com diagn

  3. Prediction of height achievement at five years of age in children born very preterm or with very low birth weight : Continuation of catch-up growth after two years of age

    NARCIS (Netherlands)

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

    1993-01-01

    To predict height at five years in a cohort of 565 very preterm and/or very low-birth-weight children, hypothesized growth determinants were subjected to discriminant analysis. Many neonatal parameters were not significantly associated with short stature at five years of age. A correct classificatio

  4. Guidelines for Feeding Very Low Birth Weight Infants

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    Sourabh Dutta

    2015-01-01

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

  5. Severe acute malnutrition in very low birth weight preterm infants.

    Science.gov (United States)

    Enweronu-Laryea, Christabel C; Aryee, Irene N A; Adei, Eunice A P

    2012-05-01

    Malnutrition in preterm low birth weight infants has adverse long-term metabolic, growth, and neurodevelopmental effects. In the past 3 decades, parenteral nutrition, enriched preterm formula, and fortification of human milk have been used to alleviate these adverse effects. Unfortified human breast milk does not provide sufficient nutrients for the growth and development of preterm infants at the volumes recommended; however, it is usually the only source of nutrition available for such infants in low-resource countries. Many newborns, including very low birth weight infants, are surviving in these countries because of concerted efforts to achieve the fourth millennium development goal. These efforts have not addressed the nutrition needs of sick preterm very low birth weight infants. The authors report 3 cases of severe acute malnutrition in very low birth weight newborns and suggest possible interventions.

  6. Family factors and social support in the developmental outcomes of very low-birth weight children.

    Science.gov (United States)

    Hogan, D P; Park, J M

    2000-06-01

    This study used data that were representative of the normative population of all infants born in 1988 and were followed during the first 3 years of life. Large developmental delays and limitations in function were common among children weighing less than 1500 g at birth. Among very low-birth weight infants, minority status and living in a household headed by a single mother further worsen the disadvantages associated with a very low birth weight. Nor could the disadvantages associated with very low birth weight be accounted for by controls for other risk factors or buffering statuses and behaviors. Among all children (including those of very low birth weight) poverty, reliance on Medicaid and other government sources for health insurance, a history of risky behaviors, and inadequate prenatal care are the major risk factors for developmental delays, limitations in function, and impairment at birth. State program benefit levels have no obvious effects on child outcomes, taking into account participation in individual programs. An important finding in light of TANF is that maternal work, the use of child care, and the form and cost of child care did not influence developmental delay, limitation in function, or impairment, the outcomes that we were able to measure during the first 3 years of life. TANF eligibility requirements, however, may increase difficulty in obtaining prenatal and other medical services for mothers and children in need--factors shown here to be related strongly to increased risk of low birth weight and developmental delays, limitations, and impairments. Race and ethnicity, poverty status, and family structure are fundamental factors in early child development and function. Minority status, poverty, and single-parent households greatly increase the likelihood that a mother will engage in risky behaviors (smoking, alcohol use, illegal drug use) during pregnancy and receive inadequate prenatal care. Risky behaviors and inadequate prenatal care are

  7. Mathematics Deficiencies in Children with Very Low Birth Weight or Very Preterm Birth

    Science.gov (United States)

    Taylor, H. Gerry; Espy, Kimberly Andrews; Anderson, Peter J.

    2009-01-01

    Children with very low birth weight (VLBW, less than 1500 g) or very preterm birth (VPTB, less than 32 weeks gestational age or GA) have more mathematics disabilities or deficiencies (MD) and higher rates of mathematics learning disabilities (MLD) than normal birth weight term-born children (NBW, greater than 2500 g and greater than 36 weeks GA).…

  8. Reading difficulty in school-aged very low birth weight infants in Japan.

    Science.gov (United States)

    Takeuchi, Akihito; Koeda, Tatsuya; Takayanagi, Toshimitsu; Sato, Kazuo; Sugino, Noriko; Bonno, Motoki; Kada, Akiko; Nakamura, Makoto; Kageyama, Misao

    2016-10-01

    To investigate the prevalence of and the perinatal risk factors related to reading difficulty in school-aged very low birth weight infants (VLBWI) with normal intelligence. Subjects were 79 Japanese children in the second to fourth grade of elementary school who had been born at very low birth weight and who regularly visited a follow-up clinic at one of four hospitals. All members had a full-scale IQ score of 80 or higher. Perinatal information was obtained retrospectively from medical records. Each subject underwent four reading tasks, testing monomoratic syllable reading, word reading, non-word reading and short sentence reading. Subjects with an SD reading time score greater than 2.0 in two or more tasks were considered to have reading difficulty (RD). Furthermore we investigated the relations between RD and perinatal factors using logistic regression analysis adjusted for potential confounding factors. Twenty-five (31.6%) out of 79 subjects had RD. We discovered that treated retinopathy of prematurity (tRoP) was a significant risk factor (adjusted OR=5.80, 95% confidence interval=1.51-22.33). The rate of RD in school-aged VLBWI was higher than the estimated prevalence of dyslexia in Japan. Even in children with normal intelligence, long-term developmental follow-up including support for reading skills is necessary for VLBWI. Further investigation is desired to elucidate the relations between visual problems and RD in school-aged children. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  9. Changes in Perinatal Care and Predictors of In-Hospital Mortality for Very Low Birth Weight Preterm Infants

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    Ying Dong

    2012-09-01

    Full Text Available Objective: Mortality of very low birth weight premature infants is of great public health concern. To better guide local intervention program, it is essential that current and reliable statistics be collected to understand the factors associated with mortality of these infants.Methods: Data of very low birth weight premature infants admitted to a neonatal unit during 2002-2009 was retrospectively collected. Changes in perinatal care between two halves of the study period (2002-2005 and 2006-2009 were identified. Factors associated with in-hospital mortality were found by logistic regression and a predictive score model was established.Findings: A total of 475 cases were enrolled. In-hospital mortality decreased from 29.8% in 2002-2005 to 28.1% in 2006-2009 (P>0.05. More infants born<28 gestational weeks survived to discharge in the latter epoch (38.1% vs 8.3%, P<0.05. Persistent pulmonary hypertension of newborn, pulmonary hemorrhage,birth weight <000 grams, gestational age <33 weeks, feeding before 3 postnatal days and enteral feeding were found predictors of in-hospital mortality by logistic regression. The discriminating ability of the predictivemodel was 82.4% and the cutoff point was -0.56.Conclusion: Survival of very low birth weight premature neonates was not significantly improved in 2006-2009 than 2002-2005. Infants with a score higher than -0.56 were assessed to be at high risk of in-hospital mortality. Multi-center studies of planned follow-up are needed to develop a comprehensive and applicable score system.

  10. Nutritional support of very low birth weight newborns.

    Science.gov (United States)

    Ditzenberger, Georgia

    2009-06-01

    Nutritional support to promote optimal postnatal growth for very low birth weight (VLBW) newborns less than 1500 g at birth during the initial prolonged hospitalization is a significant issue. This article reviews the concepts involved in the nutritional support of VLBW newborns, including definitions and discussions of growth, optimal postnatal growth, body composition, initial weight loss, growth expectations, growth assessment tools used during the postnatal period, the relation between inadequate nutrition and neurodevelopment, the relation between protein intake and cognitive outcome, postnatal nutrition balance, the potential for programming of future adult-onset chronic conditions, a review of fetal nutritional intake, and current recommendations for nutritional support of VLBW newborns.

  11. 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

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    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

  12. Neurodevelopment of very low birth weight infants in the first two years of life in a Havana tertiary care hospital.

    Science.gov (United States)

    Cejas, Gianny; Gómez, Yahima; Roca, María del Carmen; Domínguez, Fernando

    2015-01-01

    Improved survival rates of neonates with very low birth weight (Havana tertiary care hospital. A case-series study was conducted to assess neurodevelopment outcomes of very low birth weight infants over their first two years of life. The study population comprised 116 surviving neonates with very low birth weight (Havana, Cuba, 2006-2010. A longitudinal, multidisciplinary and interdisciplinary follow up of all infants' neurodevelopment was performed, from hospital discharge to age two years, corrected for gestational age at birth. Data on each infant's perinatal variables were collected: birth weight in grams, gestational age at birth, and 1-minute and 5-minute Apgar scores. Patients were classified as having normal neurodevelopment, mild abnormalities and moderate-to-severe abnormalities. Pearson's chi-square test was used to determine possible relationships between perinatal variables studied and neurodevelopment, with exact sampling distribution and 95% confidence level. Normal neurodevelopment was observed in 69% of very low birth weight infants, 25.9% had mild abnormalities, and 5.2% displayed moderate-to-severe abnormalities. The results demonstrate a statistically significant relationship between gestational age and neurodevelopmental outcomes; more neurodevelopmental abnormalities were found in infants born at earlier gestational age (<30 weeks). Surviving very low birth weight neonates with lower gestational age at birth face a higher risk of neurodevelopmental abnormalities.

  13. Clinical comparison of early prophylactic application of nasal continuous positive airway pressure and pulmonary surfactant in the premature very low birth weight infants%早产极低出生体重儿早期预防性应用鼻塞式持续气道正压与肺表面活性物质的临床比较

    Institute of Scientific and Technical Information of China (English)

    高薇薇; 谭三智; 杨杰; 张永; 叶秀桢; 聂川; 王越; 王俊平

    2012-01-01

    目的:探讨在早产极低出生体重儿中生后早期使用鼻塞式持续气道正压(nCPAP)或应用肺表面活性剂(PS)以预防新生儿呼吸窘迫综合征(NRDS)的临床疗效比较.方法:采用前瞻性对照研究,对出生后早期使用nCPAP辅助通气或早期使用PS替代治疗的早产极低出生体重儿进行对照研究,观察其死亡率、支气管肺发育不良发生率、辅助通气时间及临床并发症.结果:共106例患儿人选,死亡率和支气管肺发育不良(BPD)发生率组间比较差异无统计学意义.机械辅助通气、总用氧时间组间比较差异无统计学意义;nCPAP组PS使用数少于对照组(Odds Ratio:0.37,90% CI 0.209~0.655);气漏发生率低(Odds Ratio:0.476,90% CI0.233~0.971),IVH发生率低(Odds Ratio:o.778,90%CI 0.319~1.898).其他临床并发症组间比较差异无统计学意义.结论:早期应用nCPAP是预防早产极低出生体重儿呼吸窘迫综合征另一良好选择.%Objective; To explore the clinical effects of early prophylactic application of nasal continuous positive airway pressure (nCPAP) and pulmonary surfactant (PS) in prevention of neonatal respiratory distress syndrome ( NROS) among the premature very low birth weight infants. Methods: The clinical effects of early prophylactic application of nCPAP and PS in the premature very low birth weight infants were compared, the death rates, the incidences of bronchopulmonary dysplasia, the duration times of assisted ventilation, and clinical complications in the two groups were observed. Results; A total of 106 infants were enrolled in the study. There was no significant difference in the death rate and the incidence of bronchopulmonary dysplasia between the two groups. There was no significant difference in the duration time of mechanical ventilation and total using oxygen time between the two groups; the number of infants using PS in nCPAP group was fewer than that in control group (Odds ratio; 0. 37, 90

  14. EEG maturation and stability of cerebral oxygen extraction in very low birth weight infants.

    Science.gov (United States)

    El-Dib, M; Govindan, R; Aly, S; Mohamed, M; du Plessis, A; Aly, H

    2016-04-01

    Fractional cerebral tissue oxygen extraction (FTOE) can be continuously monitored by simultaneous near-infrared spectroscopy (NIRS) and pulse oximetry. The objective of this study is to test the hypothesis that in very low birth weight (VLBW) infants, the more mature EEG activity is, the less variable FTOE is. A prospective study was conducted on VLBW infants (transcutaneous carbon dioxide tension. Increased maturation of EEG activity is associated with decreased variability in cerebral oxygen extraction. The implications of increased variability in FTOE on brain injury in premature infants need further exploration.

  15. Gut microbiota of the very-low-birth-weight infant.

    Science.gov (United States)

    Unger, Sharon; Stintzi, Alain; Shah, Prakeshkumar; Mack, David; O'Connor, Deborah L

    2015-01-01

    The microbiome, of which the bacterial component alone (microbiota), is estimated to include 10 times more cells than human cells of the body, blooms immediately after birth and evolves in composition and complexity throughout childhood. The gut microbiome has a profound impact on gastrointestinal tract development, maintenance of mucosal surface integrity, and contributes to the nutritional status of the host and thus plays a pivotal role in health and disease. New technologies have enabled the detailed characterization of normal microbial symbionts and dysbiosis-disease associations. This review summarizes the stepwise establishment of the intestinal microbiota, influential environmental factors, and how this may be perturbed in preterm very-low-birth-weight infants. The contribution of the microbiota to provision of energy and nutrients for intestinal development and the nutritional status of the host are reviewed. In addition, the crucial role of the gut microbiota in maintaining mucosal integrity is explored along with how its breakdown can lead to sepsis, necrotizing enterocolitis, and systemic inflammatory response syndrome. Finally, the role of enteral feeding type (human milk, formula, and nutrient fortification) in mediating these processes is discussed, and guidance is provided for nutritional strategies to promote health in these fragile infants.

  16. Risk factors for late onset septicemia in very low birth weight infants born small for gestational age%小于胎龄极低出生体质量儿晚发型败血症危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈燕; 王杨; 赵倩; 徐豆豆

    2016-01-01

    目的 探讨新生儿重症监护室小于胎龄极低出生体质量儿( VLBWI)晚发型败血症的危险因素. 方法 回顾性分析安徽医科大学第一附属医院新生儿重症监护室2009年1月至2014年12月收治的胎龄7 d VLBWI的相关临床资料,分析其中小于胎龄VLBWI晚发型败血症临床特点、实验室结果、危险因素及预后等. 结果 296例纳入本研究的VLBWI中,小于胎龄儿组165例,其中发生晚发型败血症者56例,经单因素分析结果显示,小于胎龄VLBWI晚发型败血症危险因素包括极早产(胎龄18 h、预防应用抗菌药物>7 d、经外周中心静脉插管>7d、经鼻持续气道正压通气、机械通气、留置胃管>7d、静脉营养时间及住院时间长等. 有统计学意义的变量进入logistic多元回归分析显示,其独立危险因素为留置胃管>7 d和胎膜早破>18 h. 结论 在VLBWI中小于胎龄儿更易发生晚发型败血症,今后临床工作中应对这一特殊群体采取个性化预防措施,凡胎膜早破>18 h者需动态连续监测血象指标,尽早开始经口肠道微量喂养,缩短留置胃管时间.%Objective To investigate the risk factors for late onset septicemia(LOS) in very low birth weight(VLBW)infants born small for gestational age(SGA). Methods The VLBW infants whose birth weight were less than 1500g and hospital stays were more than 7 days in neonatal intensive care unit( NICU) of The First Affiliated Hospital of Anhui Medical University from January 2009 to December 2014 were analyzed retrospectively. Outcomes were compared between VLBW infants born SGA( birth weight less than tenth percentile according to gestational age and gender) and non-SGA infants. Clinical characteristics,laboratory features,risk factors and prognosis of VLBWI born small for gestational age with late onset septicemia were analyzed. Result 296 VLBW infants were included,of them,165 cases were SGA ,among them 56 episodes of late onset septicemia were

  17. 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

  18. Evaluation of growth in very low birth weight preterm babies.

    Science.gov (United States)

    Yeşinel, Serdar; Aldemir, Esin Yıldız; Kavuncuoğlu, Sultan; Yeşinel, Seda; Yıldız, Hayrettin

    2014-12-01

    The aim of this study was to evaluate physical growth of very low birth weight (VLBW) preterm babies at a mean age of three years and to investigate the factors which affected growth. The factors including maternal problems, prenatal problems, early neonatal problems, nutrition, familial socioeconomical status and presence of chronic disease which affected catch-up growth in terms of height and weight in VLBW infants followed up in the neonatal intensive care unit (NICU) of our hospital were examined. The target height formula was used in assessment of growht in height and the contribution of genetic properties was investigated. The points of the subjects on the growth curve were plotted according to the Percentile Curve of the Turkish Children prepared by Neyzi et al. The states of the subjects with and without intrauterine growth retardation (were compared. The study was intitiated after obtaining approval from the ethics committeee of our hospital (100/25.10.2005). One hundred and seventeen preterm babies (57 females and 60 males) with a mean adjusted age of 35.8±2.39 80 of whom were appropriate for gestational age (AGA), 28 of whom were symmetrical (small gestational age) SGA and 9 of whom were asymmetrical SGA were included in the study. The mean gestational age (GA) was found to be 31±2.16 weeks and the mean birth weight (BW) was found to be 1271±226 g. The mean current height was found to be 92.06±4.90 cm. The mean weight was found to be 12.98±1.94 kg. The mean target height was calculated to be 163.66±8.1 cm (157.20 cm for the girls and 170.20 cm for the boys). It was found that 15 preterm babies (12.8%) could not achieve the target height (girls: 6%, boys: 6.8%). The risk factors related with failure to achieve target height were found to include ventilator treatment, presence of chronic disease, advanced stage intracranial bleeding (ICB), posthemorrhagic hydrocephalus, absence of breastfeeding, failure to sit at the table with the family and

  19. Clinical Study on Preventive and Curative Effects of Caffeine Citrate on Apnea of Prematurity of Children with Very Low Birth Weight%枸橼酸咖啡因防治极低出生体重儿呼吸暂停的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵剑锋; 李俊燕

    2016-01-01

    目的:探讨枸橼酸咖啡因对极低出生体重儿呼吸暂停的防治情况。方法收集极低体重儿80例,随机将患儿分成两组,咖啡因预防组40例,对照组40例,咖啡因预防组患儿入组即给予枸橼酸咖啡因,对照组患儿发生呼吸暂停后及时给予枸橼酸咖啡因。结果咖啡因预防组早产儿呼吸暂停(AOP)发病人数为11例(36.7%),对照组发病人数为24例(80.0%),差异有统计学意义(P<0.05);两组患儿治疗有效率比较,差异无统计学意义(P>0.05)。结论枸橼酸咖啡因对极低体重患儿呼吸暂停有预防作用,且疗效显著。%Objective To study the preventive and curative effects of caffeine citrate on apnea of prematurity (AOP) of children with very low birth weight. Methods 80 children with very low birth weight were included in this study, which were divided into two groups randomly. 40 patients are included in control group, and the other 40 patients were included in intervention group. The patients in intervention group were given caffeine citrate immediately, and the children in the control group were treated with caffeine citrate after onset of apnea. Results There were 11 AOP cases in caffeine prevention group (incidence of 36.7%) and 24 AOP cases in the control group (incidence of 80.0%), the difference was statistically significant (P0.05). Conclusion Caffeine citrate can prevent the onset of AOP, and the curative effect is significant.

  20. Risk factors associated with growth failure in the follow-up of very low birth weight newborns.

    Science.gov (United States)

    Rover, Milene M S; Viera, Cláudia S; Silveira, Rita C; Guimarães, Ana T B; Grassiolli, Sabrina

    2016-01-01

    To determine risk factors during neonatal hospital stay and follow-up associated with failure to thrive in the first year of life of very low birth weight newborns. Study of preterm very low birth weight newborns followed from 2006 to 2013 in a public institutional hospital program. The study included newborns that attended at least one appointment in each of the three periods: Period I, up to 3 months of corrected age (CA); Period II, 4-6 months of CA; and Period III, 7-12 months of CA. The variables were analyzed by logistic regression with XLSTAT 2014 software (Microsoft®, WA, USA). Failure to thrive (Z-score below -2 SD) was classified as a dichotomous dependent variable (0 - failure/1 - success), while the other variables were classified as explanatory variables for the hospitalization periods and for each of the follow-up periods (I, II, and III). Children born adequate for gestational age increased the chance of Z-score for weight at discharge>-2 SD (OR=10.217; 95% CI: 1.117-93.436). Metabolic bone disease and retinopathy of prematurity in Period I, as well as hospital readmissions in Periods II and III during follow-up increased the chance of Z-score<-2 SD. Failure to thrive is influenced by intrauterine factors and, subsequently, by several morbidities, both in the birth and hospitalization period, as well as in the post-discharge period and thus, such variables should be prioritized in the follow-up. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. A Major Cause of Mortality and Morbidity of Very Low Birth Weight Infants: Patent Ductus Arteriosus

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    Fatih Aygün

    2012-04-01

    Full Text Available In­tro­duc­ti­on: Patent Ductus Arteriosus (PDA, a cardiac pathology commonly seen in preterm infants, has negative effects on mortality and morbidity. Persistent patency of PDA is positively correlated with respiratory distress syndrome (RDS, prolonged respiratory support, pulmonary hemorrhage, broncopulmonary dysplasia (BPD, necrotizing enterocolitis (NEC, intraventricular hemorrhage, renal failure, neurodevelopmental impairment (cerebral palsy, retinopathy of prematurity and death. The standard treatment regimen is to close symptomatic PDA and cyclooxygenase inhibitors such as indomethacin, ibuprofen are the first choises. Our aim in this study is to report PDA rate, treatment and complications in premature infants. Materials and Methods: This study retrospectively enrolled 103 infants born <33 gestational weeks, without any major congenital anomaly or congenital heart defects between January 2010-November 2011. Echocardiograms was performed in the first week. PDA related pulmonary hemorrhage, NEC, BPD, ROP and death were demonstrated.Results: Among of 103 infants, 45 were male and 58 were female. Seventy infants were born with cesarian section and 33 were born with normal labor. The mean gestational week was 29.7±2.2, the mean gestational week of infants with PDA was 28.8±2.3. The mean birth weight of infants was 1323±375 grams. The mean Apgar score was 7.25±1.83, the scores of infants with patent ductus arteriosus were significantly low (6.7±1.9. Echocardiography was performed on the mean of 4.8±4.4 days, PDA was determined in 48 of 103 infants (%46. The mean of birth weight of infants with persistant PDA was 1162±351 grams, it was 1465±340 g in the closed group. The rate of pulmonary hemorrhage, NEC, BPD, ROP and death was significantly higher in infants with PDA compared with infants having ductal closure (p<0.05.Conclusion: The early closure of PDA in very low birth weight infants will reduce both mortality and early or late

  2. Evaluation of postnatal growth in very low birth weight infants: a neonatologist's dilemma.

    Science.gov (United States)

    Bertino, E; Boni, L; Rossi, C; Coscia, A; Giuliani, F; Spada, E; Milani, S; Fabris, C

    2008-09-01

    Very low birth weight (VLBW) infants' survival has greatly increased in the last few decades thanks to the improvement in obstetrical and neonatal care. The correct evaluation of postnatal growth of these babies is nowadays of primary concern, although the definitions of their optimal nutrition and postnatal growth pattern are still controversial. It is known that VLBW infants have a specific postnatal growth pattern markedly different from that of higher birthweight full-term infants. Prospective longitudinal studies are needed to trace VLBW infants growth charts for weight, length and head circumference. These charts will be a useful tool to monitor postnatal growth of VLBW infants both during hospitalisation and after discharge, up to 2 or 3 years of age. A useful tool in VLBW infants growth evaluation could also be absolute velocity charts that, allowing a better and earlier identification of growth anomalies, could permit the observation of phenomena not yet visible on distance charts. Very low birth weight (VLBW) infants' survival has greatly increased in the last few decades thanks to the improvement in obstetrical and neonatal care. These neonates represent about 1-1.5% of all live born infants in developed countries (1) and they constitute the large majority of the population in neonatal intensive care units (NICUs). For this reason, the correct evaluation of their postnatal growth is of primary concern nowadays although the definitions of optimal nutrition and postnatal growth pattern are still controversial.

  3. Associação entre o uso de sais de ferro durante a gestação e nascimento pré-termo, baixo peso ao nascer e muito baixo peso ao nascer Association between iron supplementation during pregnancy and prematurity, low birth weight, and very low birth weight

    Directory of Open Access Journals (Sweden)

    Tatiane da Silva Dal Pizzol

    2009-01-01

    very low birth weight (OR = 0.58; 95%CI: 0.29-1.13. The results suggest that iron supplementation up to the 28th gestational week does not reduce the risk of prematurity, low birth weight, or very low birth weight.

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

    Science.gov (United States)

    Groothuis, Jessie R; Makari, Doris

    2012-04-01

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

  5. Enteral glutamine supplementation for very low birth weight infants decreases morbidity.

    Science.gov (United States)

    Neu, J; Roig, J C; Meetze, W H; Veerman, M; Carter, C; Millsaps, M; Bowling, D; Dallas, M J; Sleasman, J; Knight, T; Auestad, N

    1997-11-01

    Glutamine, described as a "conditionally essential" amino acid for critically ill patients, has not been routinely added to parenteral amino acid formulations for critically ill neonates and is provided in only small quantities by the enteral route when enteral intake is low. We conducted a blinded, randomized study of enteral glutamine supplementation in 68 very low birth weight neonates randomly assigned to receive glutamine-supplemented premature formula versus premature formula alone between days 3 and 30 of life. Primary end points consisted of hospital-acquired sepsis, tolerance to subsequent enteral feedings (days with no oral intake), and duration of hospital stay. Hospital acquired sepsis was 30% (control group) and 11% (glutamine group). Logistic regression with birth weight as a covariate showed that: (1) feeding group was significant (p = 0.048) in determining the probability of developing proven sepsis over the course of hospitalization and (2) the estimated odds of developing sepsis were 3.8 times higher for infants in the control group than for those treated with glutamine. Glutamine-supplemented infants had better tolerance to enteral feedings as measured by percent of days on which feedings needed to be withheld (mean percentage of 8.8 vs 23.8, p = 0.007). Analysis of T cells demonstrated a blunting of the rise in HLA-DR+ and CD16 subsets in glutamine-supplemented infants. There were no differences in growth; in serum ammonia, urea, liver transaminase, or prealbumin concentrations; or in mean hospital stay. This study provides evidence for decreased morbidity in very-low-birth-weight neonates who receive enteral glutamine supplementation.

  6. Altered Methylation of IGF2 Locus 20 Years after Preterm Birth at Very Low Birth Weight.

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    Karoliina Wehkalampi

    Full Text Available People born preterm at very low birth weight (VLBW, ≤1500g have higher rates of risk factors for adult-onset diseases, including cardiovascular diseases and type 2 diabetes. These risks may be mediated through epigenetic modification of genes that are critical to normal growth and development.We measured the methylation level of an imprinted insulin-like-growth-factor 2 (IGF2 locus (IGF2/H19 in young adults born preterm at VLBW and in their peers born at term. We studied 158 VLBW and 161 control subjects aged 18 to 27 years from the Helsinki Study of Very Low Birth Weight Adults. Methylation fraction at two IGF2 differentially methylated regions (DMRs - IGF2 antisense transcript (IGF2AS, also known as IGF2 DMR0 and last exon of IGF2 (IGF2_05, also known as IGF2 DMR2 - were measured with Sequenom Epityper. We used linear regression and adjustment for covariates to compare methylation fractions at these DMRs between VLBW and control subjects.At one IGF2AS CpG site, methylation was significantly lower in VLBW than in control subjects, mean difference -0.017 (95% CI; -0.028, -0.005, P = 0.004. Methylation at IGF2_05 was not different between the groups.Methylation of IGF2AS is altered 20 years after preterm birth at VLBW. Altered methylation may be a mechanism of later increased disease risk but more data are needed to indicate causality.

  7. Pericardial effusion with cardiac tamponade caused by a central venous catheter in a very low birth weight infant.

    Science.gov (United States)

    Chioukh, Fatma-Zohra; Ameur, Karim Ben; Hmida, Hayet Ben; Monastiri, Kamel

    2016-01-01

    With more and more extreme premature and very low-birth weight babies being resuscitated, umbilical central venous catheterisation is now being used more frequently in neonatal intensive care. One of the life-threatening complications is pericardial effusion and cardiac tamponade; however, it is potentially reversible when it is caught in time. The authors present a case of cardiac tamponade following umbilical venous catheterisation in a neonate. The patient was diagnosed at the appropriate time by echocardiography and urgent pericardiocentesis proved lifesaving.

  8. Quality of Life and Its Associated Factors among School - Aged Children Born with Very Low Birth Weight%极低出生体质量儿童学龄期的生存质量及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    曾小璐; 岑超群; 钟敏泉; 翟琼香; 卢奕云; 杨杰; 钟向明

    2012-01-01

    Objective To investigate the quality of life( QOL) and its associated factors among school - aged children born with very low birth weight( VLBW), which may provide scientific evidences for early clinical intervention. Methods In this cross - sectional case control study ,235 children with VLBW and 396 healthy children with normal birth weight( NBW) were recruited from mainstream schools. The postal paediatric quality of life inventory( PedsQLTM4.0) generic core scales containing 23 items was used and completed by the parents.and the proxy questionnaire included questions on physical functioning,emotional functioning,social functioning and role functioning about their children. The scores of total scale and all dimensions were calculated to analyze the differences of QOL between 2 groups and related factors of VI.BW children. Results A total of 570 out of 631 questionnaires sent out were completed,with a response rate of 90.3%. The mean age of VLBW group at the time of PedsQL completion was (9.6 ± 2.5) years old, with 1 004 - 1 498 g[ (1 201 ± 279) g] of birth weight. The mean age of NBW cases was (9.7 ±3.1) years old,with 2 512-3 955 g[ (3 216 ±435) g] of birth weighl,and scores of VLBW group in terms of emotional function, role function and total scores were significantly lower than those of the NBW group [ respectively (73.12 ± 16.67) scores, (70.43 ±20.67) scores, (75.98 ± 17. 53) scores vs (79. 16 ±17. 22) scores, (77. 43 ±19.63) scores, (80. 21 ± 17. 29) scores, P, < 0. 05]. Multiple regression analysis showed that among the VLBW group, children whose mothers had higher educational level had better QOL,while those with neonatal intracranial hemorrhage and retinopathy of prematurity had worse QOL. Conclusions QOL of children born with VLBW are worse than that of NBW children, especially in the aspects of emotional function and role function. Maternal educational level and pathophysiological slate during neonatal period are important influential

  9. Very Low Birth Weight and Attention Deficit/Hyperactivity Disorder

    NARCIS (Netherlands)

    van der Meere, Jaap; Börger, Norbert A.; Potgieter, Stephanus Theron; Pirila, Silja; De Cock, Paul

    2009-01-01

    It is well recognized that reaction time performance of term-born children with a normal birth weight (NBW > 2500 g) who fulfill the DSM-IV criteria for attention deficit/hyperactivity disorder (ADHD) in the primary school age is sensitive for the presentation rate of stimuli. They have been found t

  10. Effects of immune nutritional enhancing therapy on the prognosis of premature very low birth weight infants%免疫强化营养治疗对早产极低出生体质量儿预后的影响

    Institute of Scientific and Technical Information of China (English)

    李素萍

    2014-01-01

    Objective To observe and analyze the effects of immune nutritional enhancing therapy on the prognosis of premature very low birth weight infants(VLBWI). Methods One hundred and six cases of premature VLBWI were se-lected as the research objects and randomly divided into the observation group and the control group. Fifty-three cases were included into each group. The newborn infants in the observation group were fed with breast milk combined with human milk fortifier,while newborn infants in the control group were fed with formative milk for the premature infants. The hospi-talized time and serum albumin levels,weight at discharge,hospital infection rates and the incidences of gastrointestinal dysfunction of the infants in the two groups were observed and compared. Results The differences of the hospitalized time and the weight at discharge of the infants in the two groups were not significant(P > 0. 05),while the serum albumin level of the observation group was significantly higher than that of the control group(P 0. 05). Conclusions Early application of breast feeding combined with human milk fortifier in the treatment of premature VLBWI can significantly improve the nutritional status of the infants,and contribute to the achievement of the‘catch-up growth’. Meanwhile,the effects of promoting the immune function of the premature infants of this therapy are equivalent to the application of the formula milk feeding.%目的:观察和分析免疫强化营养治疗对早产极低出生体质量儿(VLBWI)预后的影响。方法选取106例早产 VLBWI 作为研究对象,将其随机分为观察组和对照组,每组53例,观察组新生儿应用母乳加母乳强化剂的喂养方式,对照组新生儿应用早产儿配方奶进行喂养,对两组新生儿的住院时间和血清白蛋白水平、出院时体质量、住院期间感染发生率和胃肠功能紊乱发生率的情况进行观察和比较。结果两组在住院时间和出院体质

  11. Risk Factors Associated with Very Low Birth Weight in a Large Urban Area, Stratified by Adequacy of Prenatal Care.

    Science.gov (United States)

    Xaverius, Pamela; Alman, Cameron; Holtz, Lori; Yarber, Laura

    2016-03-01

    This study examined risk and protective factors associated with very low birth weight (VLBW) for babies born to women receiving adequate or inadequate prenatal care. Birth records from St. Louis City and County from 2000 to 2009 were used (n = 152,590). Data was categorized across risk factors and stratified by adequacy of prenatal care (PNC). Multivariate logistic regression and population attributable risk (PAR) was used to explore risk factors for VLBW infants. Women receiving inadequate prenatal care had a higher prevalence of delivering a VLBW infant than those receiving adequate PNC (4.11 vs. 1.44 %, p inadequate PNC regarding Black race (36.4 vs. 79.0 %, p inadequate PNC. Among women with inadequate PNC, Medicaid was protective against (aOR 0.671, 95 % CI 0.563-0.803; PAR -32.6 %) and smoking a risk factor for (aOR 1.23, 95 % CI 1.01, 1.49; PAR 40.1 %) VLBW. When prematurity was added to the adjusted models, the largest PAR shifts to education (44.3 %) among women with inadequate PNC. Community actions around broader issues of racism and social determinants of health are needed to prevent VLBW in a large urban area.

  12. Trends in Infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight Tendencia de la mortalidad infantil y de neonatos menores de 32 semanas y de muy bajo peso Tendência da mortalidade infantil e dos neonatos menores de 32 semanas e de muito baixo peso

    Directory of Open Access Journals (Sweden)

    René Mauricio Barría-Pailaquilén

    2011-08-01

    Full Text Available The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at Para evaluar la tendencia de la mortalidad infantil entre 1990-2004 y la mortalidad de prematuros menores de 32 semanas de edad de gestación y niños de muy bajo peso al nacer, entre 2000-2005, se compararon los datos secundarios globales por componentes del Servicio de Salud Valdivia con los totales del país, en Chile. Se calculó la mortalidad específica, por mil nacidos vivos, para los Para avaliar a tendência da mortalidade infantil, entre 1990 e 2004, a mortalidade de prematuros <32 semanas de idade gestacional e crianças de muito baixo peso ao nascer, entre 2000 e 2005, compararam-se dados secundários globais e por componentes do Serviço de Saúde Valdivia, e do total do país (Chile. Calculou-se a mortalidade específica em <32 semanas e <1.500g, por mil nascidos vivos, estabelecendo causas de óbito e avaliando sua relação com intervenções específicas, como uso de surfactante e corticoides pré-natais. A mortalidade infantil deteve sua queda a partir do ano 2000, com referência à década precedente, e a brecha que existia, entre os valores nacionais e locais antes de 2000, reduziu drasticamente. A mortalidade em <32 semanas e <1.500g variou entre 88 e 200‰ nascidos vivos, destacando a síndrome da angústia respiratória como principal causa de morte. O uso de corticoides e surfactante coincidiu com reduções da mortalidade.

  13. Protective effect of Budesonide mixed with pulmonary surfactant on brain damage of very low birth weight premature treated with mechanical ventilation%布地奈德联合肺表面活性物质对机械通气极低出生体质量儿脑损伤的保护作用

    Institute of Scientific and Technical Information of China (English)

    晏路标; 韩树萍; 储晓彬; 郭锡熔; 余章斌

    2014-01-01

    目的 探讨对机械通气极低出生体质量儿使用肺表面活性物质(PS)联合布地奈德(BUD)后对脑血流的影响,寻求对脑损伤的保护机制.方法 2010年8月至2012年3月南京妇幼保健院收治的胎龄< 34周,出生体质量<1 500 g,出生1h内发生呼吸窘迫综合征(RDS)需要机械通气的早产儿40例,随机分为研究组和对照组.研究组使用PS和BUD混合剂(每70 mg PS中加入0.25 mg BUD),剂量PS 70 mg/kg,BUD 0.25mg/kg.对照组单独使用PS,剂量70 mg/kg.在出生30 ~ 60 min由气管内滴入.通过多普勒超声监测2组患儿大脑中动脉血流速度指标和血管弹性指标[包括收缩期峰值流速(Vs)、舒张末期血流速度(Vd)、平均血流速度(Vm)、血流阻力指数(RI)、搏动指数(PI)],随访2组患儿脑室周围-脑室内出血(PVH-IVH)和脑室周围白质软化(PVL)的发生率.结果 研究组Vs稳定上升,对照组不稳定,第4、5、6、7天2组间比较差异均有统计学意义(t=3.21、2.95、3.12、3.43,P均<0.05);研究组Vd稳定上升,对照组不稳定,第4、5、6、7天2组间比较差异均有统计学意义(t=4.21、3.10、3.98、4.56,P均<0.05);研究组Vm高于对照组,第4、5、6、7天2组间比较差异均有统计学意义(t=2.68、2.98、3.98、3.57,P均<0.05);研究组RI值高于对照组,第5、6、7天2组间比较差异均有统计学意义(t=3.10、3.98、4.06,P均<0.05);PI值研究组平稳,对照组不稳定,第5、6、7天2组间比较差异均有统计学意义(t =4.18、3.23、3.02,P均<0.05).研究组重度PVH-IVH发生率比对照组减少(x2 =4.80,P<0.05);PVL发生率研究组比对照组减少,差异有统计学意义(x2=3.31,P<0.05).结论 使用BUD联合PS可以稳定机械通气极低出生体质量儿脑血流变化,减少脑损伤发生.%Objective To explore the influence of middle cerebral artery blood flow on mechanical ventilation in very low birth weight premature after using Budesonide(BUD) mixed with

  14. Outcomes and milestone achievement differences for very low-birth-weight multiples compared with singleton infants.

    Science.gov (United States)

    Kirkby, Sharon; Genen, Linda; Turenne, Wendy; Dysart, Kevin

    2010-06-01

    We examined if very low-birth-weight (VLBW) infants of multiple gestation pregnancies experience more complications and take longer to achieve clinical milestones compared with similar singletons. We performed a retrospective analysis of all infants less than 1500 g at birth in a large neonatal database. Singletons were compared with twins and higher-order multiples for demographic, morbidities, and process milestones including feeding, respiratory, thermoregulation, and length of stay. Multivariable regression analyses were performed to control for potential confounding variables. A total of 5507 infants were included: 3792 singletons, 1391 twins, and 324 higher-order multiples. There were no differences in Apgar scores, small for gestational age status, and incidence of necrotizing enterocolitis, severe retinopathy of prematurity, severe intraventricular hemorrhage, sepsis, bronchopulmonary dysplasia, or the need for surgery. Multiples had higher rates of apnea and patent ductus arteriosus than singletons. VLBW multiples achieved milestones at similar rates in most areas compared with singletons except for the achievement of full oral feedings. Length of stay, after controlling for confounding variables, did not differ between the groups. Compared with singletons, VLBW multiples had similar morbidity and achieved most feeding and thermoregulation milestones at similar rates.

  15. 品管圈干预下纯母乳喂养对极低体重早产儿生长发育的影响%Effects of Exclusive Breastfeeding on the Growth and Development of Very Low Birth Weight Premature Infants Under the Influence of the Quality Control Circle

    Institute of Scientific and Technical Information of China (English)

    赵英荣

    2016-01-01

    目的:探讨品管圈干预下纯母乳喂养对极低体重早产儿生长发育的影响。方法我院将2013年2月~2014年1月收治的60例纯母乳喂养的极低体重早产儿进行随机分组为对照组与观察组,对照组实施传统的护理,观察组实施品管圈方案干预,并观察两组早产儿的日均体质量增长值、周均身长增长值、周均头围增长值。结果观察组纯母乳喂养的上述各项指标均高于对照组,P<0.05。结论品管圈干预下纯母乳喂养对极低体重早产儿生长发育的影响显著。%Objective To investigate the QCC intervention of exclusive breastfeeding in very low birth weight child growth and development.MethodsIn the hospital,60 cases of exclusive breastfeeding for very low birth weight infants were randomly divided into the control group and the observation group from February 2013 to January 2014. control group was in the implementation of traditional nursing,the observation group implemented QCC program interventions and observed daily weight gain in preterm children the values of the two groups,both circumferential length value growth, increase the value of head circumference al week.Results The above indicators of exclusive breastfeeding in the observation group were higher,P<0.05. Conclusion The growth and development of very low birth weight preterm children under QCC intervention,the effect of exclusive breastfeeding was significantly.

  16. Mathematics deficiencies in children with very low birth weight or very preterm birth.

    Science.gov (United States)

    Taylor, H Gerry; Espy, Kimberly Andrews; Anderson, Peter J

    2009-01-01

    Children with very low birth weight (VLBW, mathematics disabilities or deficiencies (MD) and higher rates of mathematics learning disabilities (MLD) than normal birth weight term-born children (NBW, >2500 g and >36 weeks GA). MD are found even in children without global disorders in cognition or neurosensory status and when IQ is controlled, and they are associated with other learning problems and weaknesses in perceptual motor abilities and executive function. Factors related to poorer mathematics outcomes include lower birth weight and GA, neonatal complications, and possible abnormalities in brain structure. While little is known about the nature of MD in these children, studies of MLD in other neurodevelopmental disorders and in children with learning disabilities provide useful models for further investigation. Further investigation of the neuropsychological and neuropathological correlates of distinct types of mathematics difficulties is also needed. Studies along these lines will yield information about the unique features of MD in children with VLBW/VPTB and about the nature and origins of poor mathematics achievement more generally.

  17. Hospital transfers and patterns of mortality in very low birth weight neonates with surgical necrotizing enterocolitis.

    Science.gov (United States)

    Fullerton, Brenna S; Sparks, Eric A; Morrow, Kate A; Edwards, Erika M; Soll, Roger F; Jaksic, Tom; Horbar, Jeffrey D; Modi, Biren P

    2016-06-01

    The objectives of this study were to evaluate mortality rates in very low birth weight (VLBW) infants with surgical necrotizing enterocolitis (NEC) by level of available surgical resources and to determine the effect of hospital transfer on mortality. Mortality among 4328 VLBW neonates with surgical NEC born 2009-2013 was assessed using the Vermont Oxford Network database. NICUs were classified by availability of resources as a marker of overall center capability: type A (restrictions on ventilation or do not routinely perform major neonatal surgery), type B (perform major neonatal surgery but not cardiac bypass), and type C (perform major surgery, including cardiac bypass in infants). Mortality was higher among those who had surgery at type B centers versus type C centers (44.3% vs 36.4%, adjusted prevalence ratio 1.20 (95% CI: 1.08, 1.33)). Neonates who were not transferred between birth and surgery had a higher mortality compared to those transferred (44.6% vs 31.6%, adjusted prevalence ratio 1.39 (95% CI: 1.25, 1.55)). Transfer between birth and surgery and a higher level of surgical resources at the operative center were associated with lower mortality. Early transfer of high risk neonates to centers with higher levels of surgical resources may be warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Effect of using pulmonary surfactant mixed with budesonide on blood gas analysis in very low birth weight premature with acute respiratory distress syndrome%肺表面活性物质联合布地奈德对急性呼吸窘迫综合征极低出生体质量儿血气分析的影响

    Institute of Scientific and Technical Information of China (English)

    魏红娟; 任秀伟; 刘俊影; 王会悦; 宋思佳

    2015-01-01

    目的:探讨肺表面活性物质( PS)联合布地奈德对急性呼吸窘迫综合征( ARDS)极低出生体质量儿血气分析的影响,并评价用药的治疗效果。方法:2013年12月~2014年11月在大庆油田总医院新生儿科收治的的胎龄<33周、出生体质量<1500 g、出生6小时内发生ARDS的早产儿28例,随机分为实验组和治疗组,实验组使用肺表面活性物质(固尔苏)100mg/kg+布地奈德0.25mg /kg(男8例,女6例)气管内滴入配合机械通气,治疗组单独使用肺表面活性物质100mg/kg(男9例,女5例)气管内滴注配合机械通气,药物滴注时间在出生60分钟内。监测2组的血气情况。结果:实验组新生儿与治疗组第1、6、12、24小时血气分析pH值、氧分压( Pa O2)、二氧化碳分压( pa CO2)、肺泡动脉氧分压差( AaDO2)比较均有显著差异( P<0.05)。结论:用PS联合布地奈德对极低出生体质量儿ARDS血气分析明显改善,改善呼吸困难,缩短吸氧时间,有利于早产儿尽早停氧,降低了肺损伤,减轻了患者的医疗费用,值得临床推广。%Objective:To explore the influence of Blood gas analysis in very low birth weight premature with acute respiratory distress syndrome ( ARDS) after using pulmonary surfactant(PS) mixed with budesonide,and evaluate the therapeutic effect of combination. Methods:Twenty-eight premature infants with gestational age <33weeks,birth weight <1500 g,whose ARDS occurred within 6 hours after birth were andomly assigned into the experimental group and treatment group in Daqing Oil Field Gneral Hspital from December 2013 to November 2014,Experimental group using lung pulmonary surfactant 100mg/kg +budesonide 0.25mg/kg (male 8 cases, female 6 ca-ses) drip endotracheal cooperate with mechanical ventilation.The treatment group used alone lung pulmonary surfactant ( male 9 case,fe-male 5 cases) , 100mg/kg endotracheal

  19. No relationship between mode of delivery and neonatal mortality and neurodevelopment in very low birth weight infants aged two years.

    Science.gov (United States)

    Zhu, Jia-Jun; Bao, Ying-Ying; Zhang, Guo-Lian; Ma, Li-Xin; Wu, Ming-Yuan

    2014-08-01

    To compare neonatal mortality and neurodevelopmental outcomes at two years of age in very low birth weight infants (≤1500 g) born by cesarean with those by vaginal delivery. In this retrospective, case-control study, we evaluated neonatal mortality, medical conditions and neurodevelopmental outcomes at two years of corrected age in 710 very low birth weight (VLBW) infants born between January 2005 and December 2010. Of the 710 infants, 351 were born by the cesarean and 359/710 by vaginal route. There were no significant differences in neonatal mortality between the cesarean delivery group and vaginal delivery group [56/351 (15.9%) vs. 71/359 (19.8%), P=0.20]. VLBW infants delivered by the cesarean procedure had a higher incidence of respiratory distress syndrome than those born by the vaginal route [221/351 (63.0%) vs. 178/359 (49.6%), Pbirth offered significant advantages to VLBW infants. Moreover, the operation might be associated with an increased risk of respiratory distress syndrome for VLBW infants. The mode of delivery of VLBW infants should be largely based on obstetric indications and maternal considerations rather than perceived better outcomes for the neonate.

  20. No relationship between mode of delivery and neonatal mortality and neurodevelopment in very low birth weight infants aged two years

    Institute of Scientific and Technical Information of China (English)

    Jia-Jun Zhu; Ying-Ying Bao; Guo-Lian Zhang; Li-Xin Ma; Ming-Yuan Wu

    2014-01-01

    Background: To compare neonatal mortality and neurodevelopmental outcomes at two years of age in very low birth weight infants (≤1500 g) born by cesarean with those by vaginal delivery. Methods: In this retrospective, case-control study, we evaluated neonatal mortality, medical conditions and neurodevelopmental outcomes at two years of corrected age in 710 very low birth weight (VLBW) infants born between January 2005 and December 2010. Of the 710 infants, 351 were born by the cesarean and 359/710 by vaginal route. Results: There were no significant differences in neonatal mortality between the cesarean delivery group and vaginal delivery group [56/351 (15.9%) vs. 71/359 (19.8%), P=0.20]. VLBW infants delivered by the cesarean procedure had a higher incidence of respiratory distress syndrome than those born by the vaginal route [221/351 (63.0%) vs. 178/359 (49.6%), P Conclusions: In neither neurodevelopment nor neonatal mortality did cesarean birth offered significant advantages to VLBW infants. Moreover, the operation might be associated with an increased risk of respiratory distress syndrome for VLBW infants. The mode of delivery of VLBW infants should be largely based on obstetric indications and maternal considerations rather than perceived better outcomes for the neonate.

  1. Survival Rate of Low and Very Low Birth Weight Neonates in an Iranian Community

    Directory of Open Access Journals (Sweden)

    A Puyanfar

    2012-02-01

    Full Text Available Background: This study aimed to assess the incidence and survival rates of neonates weighing less than 2500g for duration of the first 28 days in an Iranian community.Methods: In this prospective longitudinal study, all neonates with birth weight less than 2500g were selected from the list of all neonates born in the only public-sector referral hospital, for a six months period. The weight of neonates at birth along with some demographic variables was recorded on a checklist. A cohort of neonates with birth weight less than 2500g were followed for 28 days. Mortality within 28 days of birth was used as end point. Continuous variables were summarized using mean and 95% confidence intervals, while categorical variables were presented as ratios and percentages.Results: About 1750 neonates were born of which 168 neonates with birth weights less than 2500g were recorded giving a proportion of 9.6%. Of 168 neonates, 21 (12.5% had very low birth weights (VLBW (birth weights<1500g. Survival rates for the groups of LBW (1500

  2. Experience of early breast milk feeding in preterm very low birth weight infants.

    Science.gov (United States)

    Islam, M Z; Islam, Q R; Roy, S; Akhter, N; Hoque, M M

    2012-04-01

    Although human milk is generally accepted as the gold standard for the feeding of term infants, its use in the preterm and very low birth weight (VLBW) infants particularly in the initial period of birth has been more controversial. Little is known about the risks and benefits of early introduction of breast feeding on preterm VLBW infants. The primary object of this study was to evaluate the safety and benefit of early breast milk feeding in preterm VLBW newborns during their initial hospitalization periods. Therefore a prospective observational study was conducted among 37 preterm VLBW infants who were admitted to the Neonatal ward of Sir Salimullah Medical College and Mitford Hospital during the period of February 15th to July 25th, 2003. Oral feeding with breast milk was started within one hour of birth, and weight gain, feeding tolerance, nosocomial infection rate as well as other associated problems of pre-maturity, and postnatal growth curve were recorded upto 16th postnatal day. Seventy three percent of the newborns tolerate breast milk well from the very beginning, and the rest did not tolerate initially but all of them tolerate within 24 hours of birth. Infants had less initial weight loss (20 ± 10 gm) and faster recovery of birth weight. They regained their birth weight at 12th postnatal day. Hyper-bilirubinaemia was found in only 22% cases, and was observed in the group who initially didn't tolerate breast milk and was on intravenous fluid. Nobody developed symptomatic hypoglycemia or necrotizing enterocolitis (NEC). Two cases of sepsis and another two cases of minor infection like conjunctivitis and oral thrush have occurred. In conclusion it can be said that early breast milk feeding is safe in preterm VLBW infants and it helps to promote growth and reduce the need for intravenous line.

  3. Risk Factors for Intraventricular Hemorrhage in Very Low Birth Weight Infant

    Directory of Open Access Journals (Sweden)

    Tahereh Larijani

    2007-05-01

    Full Text Available Objective: The purpose of this study was to determine the risk factors which predispose to the development of high grade IVH (grade 3 and 4 in very low birth weight infants. Material & Methods: In a retrospective case control clinical study files of all premature infants with birth weights less than 1500 grams admitted between April 2004 and Oct 2005 to the neonatal intensive care unit of Akbar Abadi hospital in Tehran were reviewed. 39 infants with IVH grade 3 and 4 were identified. A control group of 82 VLBW infants matched for gestational age and birth weight were selected. Prenatal data, delivery characteristics, neonatal course data and reports of cranial ultrasonography were carefully collected for both groups. Those variables that achieved significance (p<0.05 in univariate analysis entered to multivariate logistic regression analysis. Findings: A total of 325 VLBW infants were evaluated. Mortality rate was 21.5%. Of the remaining the incidence of high grade IVH was 15.5%. Multivariate logistic analysis showed that following factors are associated with greater risk of high grade IVH occurrence: Low gestational age (OR: 3.72; 95% CI: 1.65-8.38, low birth weight (OR: 3.42; 95% CI: 1.65-8.38, low Apgar score at 5 minute (OR:1.58; 95% CI:1.59-6.32, hyaline membrane disease (HMD, OR: 3.16; 95% CI: 1.42-7.45 and maternal tocolytic therapy with magnesium sulfate (OR: 4.40; 95% CI: 1.10-24.5. Conclusion: Our results showed that maternal tocolytic therapy, mechanical ventilation, low gestational age, low birth weight, apnea, and low 5 minute Apgar score increased the risk of major IVH.

  4. Actual and Prescribed Energy and Protein Intakes for Very Low Birth Weight Infants: An Observational Study

    Science.gov (United States)

    Abel, Deborah Marie

    2012-01-01

    Objectives: To determine (1) whether prescribed and delivered energy and protein intakes during the first two weeks of life met Ziegler's estimated requirements for Very Low Birth Weight (VLBW) infants, (2) if actual energy during the first week of life correlated with time to regain birth weight and reach full enteral nutrition (EN) defined as…

  5. Actual and Prescribed Energy and Protein Intakes for Very Low Birth Weight Infants: An Observational Study

    Science.gov (United States)

    Abel, Deborah Marie

    2012-01-01

    Objectives: To determine (1) whether prescribed and delivered energy and protein intakes during the first two weeks of life met Ziegler's estimated requirements for Very Low Birth Weight (VLBW) infants, (2) if actual energy during the first week of life correlated with time to regain birth weight and reach full enteral nutrition (EN) defined as…

  6. Survival Analysis of Very Low Birth Weight Infant Mortality in Taiwan

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); W. Chen (Wei); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ This paper examines the determinants of very low birth weight infant (or neonatal) mortality using the Taiwan National Health Insurance Research database from 1997 to 2009. After infants are discharged from hospital, it is not possible to track their mortality, so the

  7. Survival Analysis of very Low Birth Weight Infant Mortality in Taiwan

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); W. Chen (Wei); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ This paper examines the determinants of very low birth weight infant (or neonatal) mortality using the Taiwan National Health Insurance Research database from 1997 to 2009. After infants are discharged from hospital, it is not possible to track their mortality, so the

  8. Treatment Failure of Nosocomial Pertussis Infection in a Very-Low-Birth-Weight Neonate

    Science.gov (United States)

    Bonacorsi, Stéphane; Farnoux, Caroline; Bidet, Philippe; Caro, Valérie; Aizenfisz, Sophie; Benhayoun, Mounir; Aujard, Yannick; Guiso, Nicole; Bingen, Edouard

    2006-01-01

    We describe a case of nosocomial maternal transmission of Bordetella pertussis to a very-low-birth-weight (VLBW) neonate in whom treatment was unsuccessful. This case underscores the need for rapid and sensitive PCR diagnosis in VLBW neonates and in parents with clinical signs of pertussis and suggests that standard treatment may not be appropriate for VLBW neonates. PMID:17021121

  9. Survival Analysis of Very Low Birth Weight Infant Mortality in Taiwan

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); W. Chen (Wei); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ This paper examines the determinants of very low birth weight infant (or neonatal) mortality using the Taiwan National Health Insurance Research database from 1997 to 2009. After infants are discharged from hospital, it is not possible to track their mortality, so the C

  10. Survival Analysis of very Low Birth Weight Infant Mortality in Taiwan

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); W. Chen (Wei); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ This paper examines the determinants of very low birth weight infant (or neonatal) mortality using the Taiwan National Health Insurance Research database from 1997 to 2009. After infants are discharged from hospital, it is not possible to track their mortality, so the C

  11. Cytokine responses in very low birth weight infants receiving glutamine-enriched enteral nutrition

    NARCIS (Netherlands)

    A. van den Berg; R.M. van Elburg; L. Vermeij; A. van Zwol; G.R. van den Brink; J.W.R. Twisk; E.E.S. Nieuwenhuis; W.P.F. Fetter

    2009-01-01

    Objective: Very low birth weight (VLBW) infants receiving glutamine-enriched enteral nutrition may present with a lower infection rate, which may result from enhanced antimicrobial innate or Th1 cytokine responses. We investigated whether glutamine-enriched enteral nutrition in VLBW infants increase

  12. Increased risk for bronchitis after discharge in non-vaccinated very low birth weight infants.

    Science.gov (United States)

    Stichtenoth, G; Härtel, C; Spiegler, J; Dördelmann, M; Möller, J; Wieg, C; Orlikowsky, T; Stein, A; Herting, E; Goepel, W

    2015-03-01

    In very low birth weight (VLBW) infants, obstructive bronchitis is a frequent cause of hospital re-admission. For VLBW infants, early vaccinations starting at 2 months after birth have been recommended. To analyze risk factors for bronchitis during the first year after discharge and the effects of in-hospital standard vaccination (hexavalent/pneumococci) and/or RSV immunoprophylaxis with palivizumab. A standardized questionnaire was sent to the parents of VLBW infants 7 month after discharge. The reported episodes of bronchitis were correlated with clinically recorded parameters including risk factors for pulmonary morbidity. The effects of in-hospital vaccination were assessed in a subgroup discharged after day 60. A sample of 1 967 responses of infants born 2009-2011 was analyzed. Risk factors for bronchitis were male gender and older siblings. 24% of the population had episodes of bronchitis. In the subgroup discharged after day 60, episodes of bronchitis were reported for 31% of infants who were not vaccinated in-hospital. A significant reduction of the bronchitis rate was found in infants who received palivizumab±standard vaccination (17% bronchitis, p=0.003). Interestingly, in-hospital standard vaccination without RSV immunoprophylaxis was protective (20% bronchitis; p=0.037) as well. Non-vaccinated male VLBW infants with older siblings are at increased risk for bronchitis during the first year after discharge. Vaccination according to schedule seems to have protective effects, while underlying mechanisms are unknown. The rate of timely vaccination in preterm infants should be increased. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Does visceral osteopathic treatment accelerate meconium passage in very low birth weight infants?- A prospective randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Nadja Haiden

    Full Text Available To determine whether the complementary approach of visceral manipulative osteopathic treatment accelerates complete meconium excretion and improves feeding tolerance in very low birth weight infants.This study was a prospective, randomized, controlled trial in premature infants with a birth weight <1500 g and a gestational age <32 weeks who received a visceral osteopathic treatment 3 times during their first week of life or no treatment.Passage of the last meconium occurred after a median of 7.5 days (95% confidence interval: 6-9 days, n = 21 in the intervention group and after 6 days (95% confidence interval: 5-9 days, n = 20, in the control group (p = 0.11. However, osteopathic treatment was associated with a 8 day longer time to full enteral feedings (p = 0.02, and a 34 day longer hospital stay (Median = 66 vs. 100 days i.e.; p=0.14. Osteopathic treatment was tolerated well and no adverse events were observed.Visceral osteopathic treatment of the abdomen did not accelerate meconium excretion in VLBW (very low birth weight-infants. However infants in the osteopathic group had a longer time to full enteral feedings and a longer hospital stay, which could represent adverse effects. Based on our trial results, we cannot recommend visceral osteopathic techniques in VLBW-infants.Clinical trials.gov: NCT02140710.

  14. Cognitive function and MRI findings in very low birth weight infants

    Energy Technology Data Exchange (ETDEWEB)

    Imamura, Atsuko; Takagishi, Yuka; Takada, Satoru; Uetani, Yoshiyuki; Nakamura, Toru; Nakamura, Hajime [Kobe Univ. (Japan). School of Medicine; Inagaki, Yuko

    1996-07-01

    Twenty-two very low birth weight infants at preschool ages of 5-6 years were studied to clarify the correlation between cognitive function and MRI findings. Cognitive function was evaluated by the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Frostig developmental test of visual perception. Ventricular enlargement, assessed by the bioccipital index (B.I.) measured on MRI, was correlated to cognitive disorders. Children with periventricular high intensity areas (T{sub 2}-weighted images) extending from the posterior periventricular region to the parietal lobe tend to highly suffer from cerebral palsy and visuoperceptual impairment. These results indicate that the disorders of cognitive function in very low birth weight infants were caused by a damage of association fibers in periventricular areas which was detectable by MRI. (author)

  15. The emergence of grammar in very-low-birth-weight Finnish children at two years of age.

    Science.gov (United States)

    Stolt, Suvi; Matomäki, Jaakko; Haataja, Leena; Lapinleimu, Helena; Lehtonen, Liisa

    2013-03-01

    It is not well understood how grammar emerges in very-low-birth-weight (VLBW) children. The main aim of the present study was to gain information on the emergence of grammar in this group at 2 ; 0. The Finnish version of the Communicative Development Inventory was used to collect data from VLBW children (N = 156) and full-term controls (N = 146). At a group level, the grammatical skills of the VLBW children were significantly weaker than those of the controls. However, when the effect of lexicon size and premature birth on the emergence of grammar was analyzed in detail, few significant differences were found between the groups. The results suggest that even though grammar emerges more slowly for the VLBW children, it emerges in a manner comparable to that of the controls, when the effect of lexicon size is taken into consideration.

  16. Early nCPAP versus intubation in very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Pedro Neves Tavares

    2013-06-01

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

  17. Risk factors and clinical analysis of candidemia in very-low-birth-weight neonates.

    Science.gov (United States)

    Fu, Jinjian; Wang, Xingmin; Wei, Ba; Jiang, Yongjiang; Chen, Jichang

    2016-11-01

    Candidemia is the third leading cause of morbidity and mortality in preterm or very-low-birth-weight infants. The incidence and risk factors of candidemia in this population are poorly known in western China. A case-control retrospective study of candidemia was conducted from January 2012-November 2015 in the Liuzhou Maternity and Child Healthcare Hospital. Data were analyzed by univariate analysis and multivariate logistic regression. Forty-eight confirmed cases of candidemia were identified during the study period, indicating an incidence of 106.9 per 1,000 admissions of very-low-birth-weight infants. Candida albicans was the most common pathogen and was isolated in 39.6% of infants with candidemia. The mortality rate of the case group was 10.4% versus 2.1% in the control group (P = .128). The multivariable logistic regression model identified that carbapenem use (odds ratio [OR], 11.39; 95% confidence interval [CI], 3.28-39.54), total parenteral nutrition (OR, 10.16; 95% CI, 2.25-45.94), and prolonged hospitalization (OR, 1.04; 95% CI, 1.01-1.07) were all associated with the risk of developing neonatal candidemia. Very-low-birth-weight infants are at a significantly high risk of developing candidemia. The local neonatal intensive care unit management teams should effectively focus on decreasing the overall use of carbapenems, improving catheter care, removing catheters early, and shortening hospitalizations to reduce the incidence of candidemia. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Lodha, Abhay; Ly, Linh; McNamara, Patrick J. [Hospital for Sick Children, Division of Neonatology, Toronto (Canada); Brindle, Mary [Hospital for Sick Children, Department of Surgery, Toronto (Canada); Daneman, Alan [Hospital for Sick Children, Department of Radiology, Toronto (Canada)

    2005-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Thayana Regina de Souza Grance

    2015-03-01

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

  20. Length and weight of very low birth weight infants in Germany at 2 years of age: does it matter at what age they start complementary food?

    Science.gov (United States)

    Spiegler, J; Eisemann, N; Ehlers, S; Orlikowsky, T; Kannt, O; Herting, E; Göpel, W

    2015-06-01

    We analysed at what age parents start complementary food in very low birth weight infants, determined risk factors for early introduction of complementary food (post-term age) and analysed whether the age at introduction of complementary food influences height or weight at 2 years of age. Parents of premature infants born in 2009-2011 answered questionnaires regarding introduction of complementary food in the first year of life (N=2262) and were followed up at a post-term age of 2 years (N=981). Length and weight were compared with full-term infants from the KiGGs study. Logistic and linear regression analyses were conducted to study predictors for early introduction of complementary food and the influence of age at introduction of complementary food on later height and weight. Average age at introduction of complementary food was 3.5 months post-term age. The lower the gestational age at birth, the earlier (post-term age) vegetables and meat were introduced. Age at introduction of complementary food was influenced by intrauterine growth restriction, gestational age at birth, maternal education and a developmental delay perceived by the parents. Length and weight at a post-term age of 2 years was not negatively influenced by early introduction of complementary food. VLBW infants are introduced to complementary food on average before a post-term age of 4 months. There was no negative effect of early introduction of complementary food on height and weight at 2 years of age.

  1. An audit of caesarean sections for very low birth weight babies.

    LENUS (Irish Health Repository)

    Khalifeh, A

    2012-02-01

    This study reviewed caesarean sections for very low birth weight babies in a tertiary referral maternity hospital. Maternal and neonatal complications were recorded and classified according to uterine incision type. We reviewed medical records of 89 women over a period of 2 years. The indication for the caesarean section influenced the type of uterine incision made (p = 0.004). Women who had antepartum haemorrhage were more likely to need a vertical incision. There was also a higher incidence of vertical incisions for gestations <28 weeks (p = 0.029). Surprisingly, when the computerised discharge summaries were reviewed retrospectively, all the vertical uterine incisions were recorded as lower segment caesarean sections. This would have a clinical impact on those women in future pregnancies, especially in a highly mobile population.

  2. 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

  3. Neonatal Biomarkers of Inflammation: Correlates of Early Neurodevelopment and Gait in Very-Low-Birth-Weight Preterm Children.

    Science.gov (United States)

    Rose, Jessica; Vassar, Rachel; Cahill-Rowley, Katelyn; Hintz, Susan R; Stevenson, David K

    2016-01-01

    Neonatal biomarkers of inflammation were examined in relation to early neurodevelopment and gait in very-low-birth-weight (VLBW) preterm children. We hypothesized that preterm infants exposed to higher levels of neonatal inflammation would demonstrate lower scores on Bayley Scales of Infant Toddler Development, 3rd ed. (BSID-III) and slower gait velocity at 18 to 22 months adjusted age. A total of 102 VLBW preterm infants (birthweight [BW] ≤ 1,500 g, gestational age [GA] ≤ 32 weeks) admitted to neonatal intensive care unit [NICU] were recruited. Neonatal risk factors examined were GA at birth, BW, bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, sepsis, and serum C-reactive protein (CRP), albumin, and total bilirubin over first 2 postnatal weeks. At 18 to 22 months, neurodevelopment was assessed with BSID-III and gait was assessed with an instrumented mat. Children with neonatal CRP ≥ 0.20 mg/dL (n = 52) versus low-level neonatal inflammation and neurodevelopment suggest early biomarkers that may inform neuroprotective treatment for preterm children. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Preschool motor skills following physical and occupational therapy services among non-disabled very low birth weight children.

    Science.gov (United States)

    Watkins, Stephanie; Jonsson-Funk, Michele; Brookhart, M Alan; Rosenberg, Steven A; O'Shea, T Michael; Daniels, Julie

    2014-05-01

    Children born very low birth weight (VLBW) are at an increased risk of delayed development of motor skills. Physical and occupational therapy services may reduce this risk. Among VLBW children, we evaluated whether receipt of physical or occupational therapy services between 9 months and 2 years of age is associated with improved preschool age motor ability. Using data from the Early Childhood Longitudinal Study Birth Cohort we estimated the association between receipt of therapy and the following preschool motor milestones: skipping eight consecutive steps, hopping five times, standing on one leg for 10 seconds, walking backwards six steps on a line, and jumping distance. We used propensity score methods to adjust for differences in baseline characteristics between children who did and did not receive physical or occupational therapy, since children receiving therapy may be at higher risk of impairment. We applied propensity score weights and modeled the estimated effect of therapy on the distance that the child jumped using linear regression. We modeled all other end points using logistic regression. Treated VLBW children were 1.70 times as likely to skip eight steps (RR 1.70, 95 % CI 0.84, 3.44) compared to the untreated group and 30 % more likely to walk six steps backwards (RR 1.30, 95 % CI 0.63, 2.71), although these differences were not statistically significant. We found little effect of therapy on other endpoints. Providing therapy to VLBW children during early childhood may improve select preschool motor skills involving complex motor planning.

  5. Clinical and Microbiologic Characteristics of Early-onset Sepsis Among Very Low Birth Weight Infants: Opportunities for Antibiotic Stewardship.

    Science.gov (United States)

    Mukhopadhyay, Sagori; Puopolo, Karen M

    2017-05-01

    Most very low birth weight (VLBW, birth weight onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years and to identify opportunities for antibiotic stewardship. Retrospective cohort study includes VLBW infants admitted from 1990 to 2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained at labor, preterm rupture of membranes and/or the obstetrical diagnosis of chorioamnionitis were present in 106/109 cases (97%). Obligate anaerobic organisms accounted for 16% of cases. Time to culture positivity was 36 hours for 88% and 48 hours for 98% of cases. From 1999 to 2013, 97% of VLBW infants were evaluated for EOS and 90% administered empiric antibiotics; 22% of these infants were born by cesarean section to mothers with preeclampsia and without preterm labor or chorioamnionitis and had a 12-fold lower incidence of EOS compared with the remaining infants. Decisions to initiate and discontinue empiric antibiotics among VLBW infants can be informed by the delivery characteristics of infected infants and by local microbiologic data.

  6. Contributing death factors in very low-birth-weight infants by path method analysis

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    Morteza Ghojazadeh

    2014-01-01

    Full Text Available Background: Neonatal deaths account for 40% of deaths under the age of 5 years worldwide. Therefore, efforts to achieve the UN Millennium Development Goal 4 of reducing childhood mortality by two-thirds by 2015 are focused on reducing neonatal deaths in high-mortality countries. The aim of present study was to determine death factors among very low-birth-weight infants by path method analysis. Materials and Methods: In this study, medical records of 2,135 infants admitted between years 2008 and 2010 in neonatal intense care unit of Alzahra Educational-Medical centre (Tabriz, Iran were analysed by path method using statistical software SPSS 18. Results: Variables such as duration of hospitalisation, birth weight, gestational age have negative effect on infant mortality, and gestational blood pressure has positive direct effect on infant mortality that at whole represented 66.5% of infant mortality variance (F = 1018, P < 0.001. Gestational age termination in the positive form through birth weight, and also gestational blood pressure in negative form through hospitalisation period had indirect effect on infant mortality. Conclusion: The results of the study indicated that the duration of low-birth-weight infant′s hospitalisation is also associated with infant′s mortality (coefficient -0.7; P < 0.001. This study revealed that among the maternal factors only gestational blood pressure was in relationship with infants′ mortality.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-08-01

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

  8. Very Low Birth Weight and Perinatal Periods of Risk: Disparities in St. Louis

    Directory of Open Access Journals (Sweden)

    Pamela Xaverius

    2014-01-01

    Full Text Available Objective. Very low birth weight (VLBW is a significant issue in St. Louis, Missouri. Our study evaluated risk factors associated with VLBW in this predominantly urban community. Methods. From 2000 to 2009, birth and fetal death certificates were evaluated (n=160, 189, and mortality rates were calculated for perinatal periods of risk. The Kitagawa method was used to explore fetoinfant mortality rates (FIMR in terms of birth weight distribution and birthweight specific mortality. Multivariable logistic regression was used to assess the magnitude of association of selected risk factors with VLBW. Results. VLBW contributes to 50% of the excess FIMR in St. Louis City and County. The highest proportion of VLBW can be attributed to black maternal race (40.6% in St. Louis City, inadequate prenatal care (19.8%, and gestational hypertension (12.0% among black women. Medicaid was found to have a protective effect for VLBW among black women (population attributable risk (PAR = −14.5. Discussion. Interventions targeting the health of women before and during conception may be most successful at reducing the disparities in VLBW in this population. Interventions geared towards smoking cessation and improvements in Medicaid and prenatal care access for black mothers and St. Louis City residents can greatly reduce VLBW rates.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-12-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-15

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

  11. Late-onset sepsis in very low birth weight infants: a Brazilian Neonatal Research Network Study.

    Science.gov (United States)

    de Souza Rugolo, Ligia Maria Suppo; Bentlin, Maria Regina; Mussi-Pinhata, Marisa; de Almeida, Maria Fernanda Branco; Lopes, José Maria de Andrade; Marba, Sergio Tadeu Martins; Fiori, Humberto Holmer; Procianoy, Renato Soibelmann; Leone, Clea Rodrigues

    2014-12-01

    Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants. To determine the incidence, risk factors and etiology of LOS. LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs). Inclusion criteria included inborn, 23-33 weeks of gestational age, 400-1499 g birth weight, who survived >3 days. Of 1507 infants, 357 (24%) had proven LOS and 345 (23%) had clinical LOS. Infants with LOS were more likely to die. The majority of infections (76%) were caused by Gram-positive organisms. Independent risk factors for proven LOS were use of central venous catheter and mechanical ventilation, age at the first feeding and number of days on parenteral nutrition and on mechanical ventilation. LOS incidence and mortality are high in Brazilian VLBW infants. Most risk factors are associated with routine practices at NICU. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Somatosensory processing abilities of very low-birth weight infants at school age.

    Science.gov (United States)

    DeMaio-Feldman, D

    1994-07-01

    The purpose of this study was to examine the relationship between somatosensory processing abilities of children at school age and their earlier experiences in the intensive care nursery as very low-birth weight (VLBW) infants. The subjects were 35 VLBW children at school age (20 girls, 15 boys) who were free of congenital deformity and developmentally appropriate for gestational age. The subjects were part of an ongoing longitudinal study. Birth weight, number of days supported by mechanical ventilation, and number of days in the neonatal intensive care unit were examined in relation to somatosensory functions. Somatosensory functions measured were manual form perception, kinesthesia, finger identification, graphesthesia, and localization of tactile stimuli. VLBW children were significantly different on all measures of somatosensory processing when compared with the standardization group. Further research on the VLBW infant's somatosensory functioning will add to the existing body of knowledge concerning development and guide practice. The finding that the infants in this study, who did not have therapy intervention, later presented diminished somatosensory functioning supports the need to develop measures of somatosensory development for use in assessments and treatment during all developmental phases.

  13. Can we safely administer the recommended dose of phenobarbital in very low birth weight infants?

    Science.gov (United States)

    Oztekin, Osman; Kalay, Salih; Tezel, Gonul; Akcakus, Mustafa; Oygur, Nihal

    2013-08-01

    We investigated whether the recommended phenobarbital loading dose of 15-20 mg/kg with maintenance of 3-4 mg/kg/day can safely be administered to very low birth weight preterm newborns with seizures. Twenty-four convulsive preterms of Phenobarbital was administered intravenously with a loading dose of 15 mg/kg in approximately 10-15 min. After 24 h, the maintenance dose of 3 mg/kg/day was administered as a single injection. Blood samples were obtained 2, 24, 48, 72, and 96 h after the phenobarbital loading dose was administered, immediately before the next phenobarbital dose was injected. None of the cases had plasma phenobarbital concentrations above the therapeutic upper limit of 40 μg/mL on the 2nd hour; one case (4.7%), on the 24th; 11 cases (45.8%), on the 48th; 15 cases (62.5%), on the 72nd; and 17 cases (70.8%), on the 96th hour. A negative correlation was detected between the serum concentrations of phenobarbital and gestational age on the 72th (p, 0.036; r, -0.608) and 96th hour (p, 0.043; r, -0.769). We suggest that particular attention should be done while administering phenobarbital in preterms, as blood levels of phenobarbital are higher than the reference ranges that those are often reached with the recommended doses in these groups of babies.

  14. Dental Caries and Enamel Defects in Very Low Birth Weight Adolescents

    Science.gov (United States)

    Nelson, S.; Albert, J.M.; Lombardi, G.; Wishnek, S.; Asaad, G.; Kirchner, H.L.; Singer, L.T.

    2011-01-01

    Objectives The purpose of this study was to examine developmental enamel defects and dental caries in very low birth weight adolescents with high risk (HR-VLBW) and low risk (LR-VLBW) compared to full-term (term) adolescents. Methods The sample consisted of 224 subjects (80 HR-VLBW, 59 LR-VLBW, 85 term adolescents) recruited from an ongoing longitudinal study. Sociodemographic and medical information was available from birth. Dental examination of the adolescent at the 14-year visit included: enamel defects (opacity and hypoplasia); decayed, missing, filled teeth of incisors and molars (DMFT-IM) and of overall permanent teeth (DMFT); Simplified Oral Hygiene Index for debris/calculus on teeth, and sealant presence. A caregiver questionnaire completed simultaneously assessed dental behavior, access, insurance status and prevention factors. Hierarchical analysis utilized the zero-inflated negative binomial model and zero-inflated Poisson model. Results The zero-inflated negative binomial model controlling for sociodemographic variables indicated that the LR-VLBW group had an estimated 75% increase (p enamel defects in the permanent incisors and first molars. Term children had increased caries compared to the LR-VLBW group. The effect of birth group and enamel defects on caries has to be investigated longitudinally from birth. PMID:20975268

  15. Urinary oxalate excretion by very low birth weight infants receiving parenteral nutrition.

    Science.gov (United States)

    Campfield, T; Braden, G

    1989-11-01

    Renal calcifications have been described in very low birth weight (VLBW) infants, and diuretic drug-associated hypercalciuria is believed to play a role in the pathogenesis of this lesion. Hyperoxaluria is an important cause of renal stone formation in children and adults. Because parenteral nutrition solutions contain the oxalate precursors ascorbate and glycine, the relationship between total parenteral nutrition administration and oxalate excretion in VLBW infants was examined. Administration of approximately 0.5 g of total parenteral nutrition protein per kilogram per day to VLBW infants was associated with an increased urinary oxalate concentration and an increased urinary oxalate to creatinine ratio, when compared with VLBW infants receiving a glucose and electrolyte solution. A further increase in urinary oxalate concentration and oxalate to creatinine ratio was noted when total parenteral nutrition protein was increased to approximately 1.5 g of protein per kilogram per day. In VLBW infants who receive total parenteral nutrition, elevated urinary oxalate concentrations may develop and may be a factor in the pathogenesis of nephrocalcinosis in these infants.

  16. Thermal support for the very-low-birth-weight infant: role of supplemental conductive heat.

    Science.gov (United States)

    Topper, W H; Stewart, T P

    1984-11-01

    Heated water pads were placed underneath very-low-birth-weight preterm infants receiving care under overhead radiant warmers with plastic heat shields to evaluate the effects on their thermal environments. The electrical input (watts) to the overhead warmer was monitored and temperatures at various locations in the environment and on the infants were recorded. The electrical input to the radiant warmers decreased significantly (P = 0.0015) with the introduction of the heated water pads. Several of the temperatures recorded during the study also showed significant changes, including increased abdominal skin temperatures in these prone infants (P = 0.007) and decreased back-to-abdomen skin temperature gradients (P = 0.007). Less marked changes included higher mattress or pad temperatures (P = 0.019), lower ambient air temperatures within the plastic heat shields (P = 0.022), and increased infant foot temperatures (P = 0.036). We believe that conduction has a significant influence on the thermal environment of the VLBW infant cared for under an overhead radiant warmer and that the use of a heated water pad can markedly alter heat transfer. The impact of conduction appears to have been previously underestimated.

  17. Evaluation of postnatal weight growth in very low birth weight infants.

    Science.gov (United States)

    Bertino, Enrico; Milani, Silvano; Boni, Luisa; Coscia, Alessandra; Rossetti, Gessica; Testa, Tiziana; Giuliani, Francesca; Appino, Irene; Spada, Elena; Fabris, Claudio

    2007-12-01

    There is general agreement about the need for longitudinal studies of very low birth weight infants (VLBWI) to evaluate their postnatal growth and to generate distance and velocity charts that allow neonatologists and pediatricians to detect earlier whether a child is not growing adequately. There are no satisfactory growth charts for VLBWI. We analyzed the weight growth of 262 VLBWIs from birth to 2 years of corrected age. Individual growth profiles were fitted with a 7-constant exponential-logistic function suitable for modelling weight growth pattern. After a postnatal weight loss, all VLBWIs showed a late neonatal peak of velocity between the seventh and 21st weeks; the large majority of them also experienced an early neonatal peak between the second and the sixth weeks. Small-for-gestational-age VLBWIs with major morbidities grew less than reference appropriate-for-gestational-age VLBWIs without major morbidities: at 2 years, the difference in weight was about 860 g. The more severe growth impairment in VLBWIs with major morbidities was almost entirely due to the reduced height of the late neonatal peak of velocity. The mathematical function used in this study is expected to be a useful tool to trace model-based longitudinal distance and velocity charts specific for VLBWIs. Moreover, this function also could be used to evaluate to what extent different pathological conditions or nutritional and medical care protocols affect growth kinetics.

  18. 早期干预对极低出生体重早产儿智能发育的影响研究%Effect of early intervention on intelligence development in very low-birth weight preterm children

    Institute of Scientific and Technical Information of China (English)

    梁莉丹; 林振浪; 陈尚勤; 赵凯怡; 陈翔

    2015-01-01

    目的探讨早期干预对极低出生体重早产儿智能发育的影响,为极低出生体重早产儿的早期干预提供依据。方法239例极低出生体重早产儿为早产随访组,采用鲍秀兰早期教育资料制定的干预计划,进行系统干预,并与326例失访的早产儿童以及与随访组相似的326例正常儿童进行对照分析。采用Gesel 儿童发育量表等标准化工具进行发育评估。结果早产随访组Gesel 儿童发育量表5项均分、总发育商(developmental quotient,DQ)总分与早产失访组相比差异均有统计学差异(均 P<0.05)。结论早期干预能显著促进极低出生体重早产儿的智能发育,提高患儿的生活质量。%Objective To investigate the effects of early intervention on intel igence development in very low- birth weight preterm children. Methods Total 329 very low- birth weight premature infants born in our hospital received systematic invention based on the early education program developed by Bao Xiulan (intervention group);326 very low- birth weight preterm children served as non- intervention group and 326 normal children served as normal control group. The intel igence development was assessed with Gese1l child development scale and other standardized tools. Results The average scores of 5 items in Gese1l child development scale and the total developmental quotient(DQ) score of intervention group were significantly higher than those of non- intervention group (P<0.05). Conclusion Early intervention can significantly promote intel igence development of the premature infants who have extremely low birth weight.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Grandi

    2015-06-01

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

  1. Very low birth weight piglets show improved cognitive performance in the spatial cognitive holeboard task

    Directory of Open Access Journals (Sweden)

    Alexandra eAntonides

    2015-02-01

    Full Text Available Low birth weight (LBW is common in humans and has been found to cause lasting cognitive and developmental deficits later in life. It is thought that the primary cause is intra-uterine growth restriction due to a shortage of oxygen and nutrients supply to the fetus. Pigs appear to be a good model animal to investigate long-term cognitive effects of LBW, as LBW is common in commercially farmed breeds of pigs. Moreover, pigs are developmentally similar to humans and can be trained to perform complex tasks. In this study, we trained ten very low birth weight (vLBW piglets and their ten normal birth weight (NBW siblings in a spatial cognitive holeboard task in order to investigate long-term cognitive effects of LBW. In this task, four out of sixteen holes contain a hidden food reward, which allows measuring working memory (short-term and reference memory (long-term in parallel. Piglets were trained for 46-54 trials during the acquisition phase, followed by a 20-trial reversal phase in which a different set of four holes was baited. Both groups acquired the task and improved their performance over time. A mixed model repeated measures ANOVA revealed that vLBW piglets showed a better reference memory performance than NBW piglets in both the acquisition and reversal phase. Additionally, the vLBW piglets fell back less in working memory scores than the NBW animals when switched to the reversal phase. These findings are contrary to findings in humans. Moreover, vLBW pigs had lower hair cortisol concentrations than NBW pigs in flank hair at 12 weeks of age. These results could indicate that restricted intra-uterine growth causes compensatory mechanisms to arise in early development that result in beneficial effects for vLBW piglets, increasing their low survival chances in early-life competition.

  2. Patient-specific FDG dosimetry for adult males, adult females, and very low birth weight infants

    Science.gov (United States)

    Niven, Erin

    Fluorodeoxyglucose is the most commonly used radiopharmaceutical in Positron Emission Tomography, with applications in neurology, cardiology, and oncology. Despite its routine use worldwide, the radiation absorbed dose estimates from FDG have been based primarily on data obtained from two dogs studied in 1977 and 11 adults (most likely males) studied in 1982. In addition, the dose estimates calculated for FDG have been centered on the adult male, with little or no mention of variations in the dose estimates due to sex, age, height, weight, nationality, diet, or pathological condition. Through an extensive investigation into the Medical Internal Radiation Dose schema for calculating absorbed doses, I have developed a simple patient-specific equation; this equation incorporates the parameters necessary for alterations to the mathematical values of the human model to produce an estimate more representative of the individual under consideration. I have used this method to determine the range of absorbed doses to FDG from the collection of a large quantity of biological data obtained in adult males, adult females, and very low birth weight infants. Therefore, a more accurate quantification of the dose to humans from FDG has been completed. My results show that per unit administered activity, the absorbed dose from FDG is higher for infants compared to adults, and the dose for adult women is higher than for adult men. Given an injected activity of approximately 3.7 MBq kg-1, the doses for adult men, adult women, and full-term newborns would be on the order of 5.5, 7.1, and 2.8 mSv, respectively. These absorbed doses are comparable to the doses received from other nuclear medicine procedures.

  3. Actual and prescribed energy and protein intakes for very low birth weight infants: An observational study

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    Allevato, Anthony J.

    Objectives: To determine (1) whether prescribed and delivered energy and protein intakes during the first two weeks of life met Ziegler's estimated requirements for Very Low Birth Weight (VLBW) infants, (2) if actual energy during the first week of life correlated with time to regain birth weight and reach full enteral nutrition (EN) defined as 100 kcal/kg/day, (3) if growth velocity from time to reach full EN to 36 weeks' postmenstrual age (PMA) met Ziegler's estimated fetal growth velocity (16 g/kg/day), and (4) growth outcomes at 36 weeks' PMA. Study design: Observational study of feeding, early nutrition and early growth of 40 VLBW infants protein (89% [3.1 g/kg/day]) were significantly less than theoretical estimated requirements. Delivered intakes were 15% less than prescribed because of numerous interruptions in delivery and medical complications. During the second week, the delivered intakes of energy (90% [86 kcal/kg/day]) and protein (102% [3.5 g/kg/day]) improved although the differences between prescribed and delivered were consistently 15%. Energy but not protein intake during the first week was significantly related to time to reach full EN. Neither energy nor protein intake significantly correlated with days to return to birth weight. The average growth velocity from the age that full EN was attained to 36 weeks' PMA (15 g/kg/day) was significantly less than the theoretical estimated fetal growth velocity (16 g/kg/day) (pintakes were consistently less than 15% of the prescribed intakes. Growth velocity between the age when full EN was achieved and 36 weeks' PMA was 6.7% lower than Ziegler's estimate. One-third to one-half of the infants have EUGR at 36 weeks' PMA.

  4. Increasing illness severity in very low birth weight infants over a 9-year period

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    Locke Robert G

    2006-02-01

    Full Text Available Abstract Background Recent reports have documented a leveling-off of survival rates in preterm infants through the 1990's. The objective of this study was to determine temporal changes in illness severity in very low birth weight (VLBW infants in relationship to the outcomes of death and/or severe IVH. Methods Cohort study of 1414 VLBW infants cared for in a single level III neonatal intensive care unit in Delaware from 1993–2002. Infants were divided into consecutive 3-year cohorts. Illness severity was measured by two objective methods: the Score for Neonatal Acute Physiology (SNAP, based on data from the 1st day of life, and total thyroxine (T4, measured on the 5th day of life. Death before hospital discharge and severe intraventricular hemorrhage (IVH were investigated in the study sample in relation to illness severity. The fetal death rate was also investigated. Statistical analyses included both univariate and multivariate analysis. Results Illness severity, as measured by SNAP and T4, increased steadily over the 9-year study period with an associated increase in severe IVH and the combined outcome of death and/or severe IVH. During the final 3 years of the study, the observed increase in illness severity accounted for 86% (95% CI 57–116% of the variability in the increase in death and/or severe IVH. The fetal death rate dropped from 7.8/1000 (1993–1996 to 5.3/1000 (1999–2002, p = .01 over the course of the study. Conclusion These data demonstrate a progressive increase in illness in VLBW infants over time, associated with an increase in death and/or severe IVH. We speculate that the observed decrease in fetal death, and the increase in neonatal illness, mortality and/or severe IVH over time represent a shift of severely compromised patients that now survive the fetal time period and are presented for care in the neonatal unit.

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

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    Elin W. Blakstad

    2016-12-01

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

  6. [Homologous human milk supplement for very low birth weight preterm infant feeding].

    Science.gov (United States)

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

    2015-01-01

    To develop a homologous additive of human milk for feeding the very low weight infants with an original and simplified methodology, to know the nutritional composition of fortified human milk with this additive and to evaluate its suitability for feeding these infants. For the production and analysis of human milk with the homologous additive, 25 human milk samples of 45 mL have undergone a lactose removal process, lyophilization and they were diluted in 50 mL of human milk. Doses of lactose, proteins, lipids, energy, sodium, potassium, calcium, phosphorus and osmolality were measured. The composition of the additive milk was lactose 9.22 ± 1.00 g/dL; proteins 2.20 ± 0.36 g/dL; lipids 2.91 ± 0.57 g/dL; calories 71.93 ± 8.69 kcal/dL; osmolality 389.6 ± 32.4 mOsmol/kg H2O; sodium 2.04 ± 0.45 mEq/dL; potassium 1.42 ± 0.15 mEq/dL; calcium 43.44 ± 2.98 mg/dL; and phosphorus 23.69 ± 1.24 mg/dL. According to the nutritional contents analyzed, except for calcium and phosphorus, the human milk with the proposed additive can achieve the nutritional needs of the very low birth weight preterm infant. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Preterm birth during influenza season is associated with adverse outcome in very-low-birth-weight infants

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    Christoph Härtel

    2016-11-01

    Full Text Available Objective: We investigated the relationship between influenza seasonality and outcome of very-low-birth-weight infants (VLBWI in a large observational cohort study of the German Neonatal Network (GNN.Materials and Methods: Within the observational period (July 2009 until Dec 2014 5 influenza seasons occurred (mean duration: 97 days, range: 48-131 days. We stratified VLBWI (n=10187 according to date of birth into three categories; (1 before influenza season, (2 during influenza season and (3 three months after the end of the respective season. Outcomes were assessed in univariate and logistic regression analyses. In a subgroup of infants (n=1497 the number of respiratory infections during the first 24 months of life was assessed.Results: VLBWI born during influenza season carried a higher risk for clinical sepsis (31.0% vs. 28.2%; p=0.014 and periventricular leukomalacia (PVL, 3.7 vs. 2.5%, p=0.004. In a multivariate logistic regression model birth during influenza season was associated with PVL [OR 1.47 (1.11-1.95, p=0.007] and clinical sepsis [OR 1.13 (1.01-1.27, p=0.036], independent of known risk factors, i.e. gestational age, multiple birth, gender and small-for-gestational age. The risk for bronchopulmonary dysplasia was not influenced by influenza seasonality. In the small subgroup with information on 24 months follow-up (n=1497, an increased incidence of common cold and bronchitis episodes was noted in infants born during influenza season.Conclusions: Our observational data indicate that preterm birth during influenza season is associated with PVL and sepsis. These are novel aspects which deserve further investigations to address underlying causes and to include virus surveillance.

  8. Relationship between Proton Magnetic Resonance Spectroscopy of Frontoinsular Gray Matter and Neurodevelopmental Outcomes in Very Low Birth Weight Children at the Age of 4.

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    Wojciech Durlak

    Full Text Available Very low birth weight is associated with long term neurodevelopmental complications. Macroscopic brain abnormalities in prematurity survivors have been investigated in several studies. However, there is limited data regarding local cerebral metabolic status and neurodevelopmental outcomes. The purpose of this study was to characterize the relationship between proton magnetic resonance spectra in basal ganglia, frontal white matter and frontoinsular gray matter, neurodevelopmental outcomes assessed with the Leiter scale and the Developmental Test of Visual Perception and selected socioeconomic variables in a cohort of very low birth weight children at the age of four. Children were divided in three groups based on the severity of neurodevelopmental impairment. There were no differences in spectroscopy in basal ganglia and frontal white matter between the groups. Lower concentrations of N-acetylaspartate (NAA, choline (Cho and myoinositol (mI were observed in the frontoinsular cortex of the left hemisphere in children with neurodevelopmental impairment compared to children with normal neurodevelopmental outcomes. Higher parental education, daycare attendance and breastfeeding after birth were associated with more favorable neurodevelopmental prognosis, whereas rural residence was more prevalent in children with moderate and severe impairment. Our study demonstrates the role of long term neurometabolic disruption in the left frontoinsular cortex and selected socioeconomic variables in determination of neurodevelopmental prognosis in prematurity survivors.

  9. Functional outcomes and participation in young adulthood for very preterm and very low birth weight infants : The Dutch project on preterm and small for gestational age infants at 19 years of age

    NARCIS (Netherlands)

    Hille, Elysee T. M.; Weisglas-Kuperus, Nynke; van Goudoever, J. B.; Jacobusse, Gert W.; Ens-Dokkum, Martina H.; de Groot, Laila; Wit, Jan M.; Geven, Wil B.; Kok, Joke H.; de Kleine, Martin J. K.; Kollee, Louis A. A.; Mulder, A. L. M.; van Straaten, H. L. M.; de Vries, Linda S.; van Weissenbruch, Mirjam M.; Verloove-Vanhorick, S. Pauline

    2007-01-01

    OBJECTIVE. Young adults who were born very preterm or with a very low birth weight remain at risk for physical and neurodevelopmental problems and lower academic achievement scores. Data, however, are scarce, hospital based, mostly done in small populations, and need additional confirmation. METHODS

  10. Functional outcomes and participation in young adulthood for very preterm and very low birth weight infants: The Dutch project on preterm and small for gestational age infants at 19 years of age

    NARCIS (Netherlands)

    Hille, E.T.M.; Weisglas-Kuperus, N.; Goudoever, J.B. van; Jacobusse, G.W.; Ens-Dokkum, M.H.; Groot, L. de; Wit, J.M.; Geven, W.B.; Kok, J.H.; Kleine, M.J.K. de; Kollée, L.A.A.; Mulder, A.L.M.; Straaten, H.L.M. van; Vries, L.S. de; Weissenbruch, M.M. van; Verloove-Vanhorick, S.P.

    2007-01-01

    OBJECTIVE. Young adults who were born very preterm or with a very low birth weight remain at risk for physical and neurodevelopmental problems and lower academic achievement scores. Data, however, are scarce, hospital based, mostly done in small populations, and need additional confirmation. METHODS

  11. Implementation of a protocol proposed by the Brazilian National Health Surveillance Agency for antibiotic use in very low birth weight infants.

    Science.gov (United States)

    Pinto, Maria Cristina F Guedes; Bueno, Arnaldo C; Vieira, Alan A

    2013-01-01

    To analyze the implementation of a protocol proposed by the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) to improve sepsis diagnosis in very low birth weight newborns. This was a prospective study that evaluated the implementation of a protocol involving clinical and laboratory criteria (hematologic scoring system of Rodwell and C-reactive protein serial measurements), recommended by ANVISA, to improve the diagnosis of neonatal sepsis in very low birth weight newborns. The study included all patients who were born and remained in the neonatal intensive care unit until discharge or death, and excluded those with congenital diseases. The main outcomes measured in newborns before (2006-2007) and after implementation of the protocol (2008) were the rates of early and late-onset sepsis, use of antibiotics, and mortality. Means were compared by Student's t-test and categorical variables were compared by the chi-squared test; the significance level for all tests was set at 95%. The study included 136 newborns with very low birth weight. There was no difference between groups regarding general clinical characteristics in the studied periods. There was, however, a decrease in the number of diagnoses of probable early-onset sepsis (p<0.001), use of antimicrobial regimens (p<0.001), and overall mortality and infection-related mortality (p=0.009 and p=0.049, respectively). The implementation of the protocol allowed improvement of sepsis diagnosis by reducing the diagnosis of probable early-onset sepsis, thus promoting efficient antimicrobial use in this population. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  12. Screening of congenital hypothyroidism in preterm, low birth weight and very low birth weight neonates: A systematic review.

    Science.gov (United States)

    Hashemipour, Mahin; Hovsepian, Silva; Ansari, Arman; Keikha, Mojtaba; Khalighinejad, Pooyan; Niknam, Negar

    2017-07-22

    Evidence from different screening programs indicated that the rate of congenital hypothyroidism (CH) was higher in pre-term and low-birth-weight (LBW) newborns than normal ones. Incomplete development of hypothalamic-pituitary axis in this group of neonates results in the delayed rise of TSH and missing cases with CH. Hence, there is a great need for a practicable systematic screening method for proper diagnosis of CH in this group of neonates. In this review, we systematically reviewed papers with the following key words ([Congenital Hypothyroidism AND Screening AND Thyroxine AND Thyroid Stimulating Hormone AND Low Birth Weight AND Premature]) in international electronic databases including PubMed, Scopus, and Google Scholar. After quality assessment of selected documents, data of finally included papers were extracted. In this review, 1452 papers (PubMed: 617; Scopus: 714; Google scholar: 121) were identified through electronic database search. One hundred and ninety four articles were assessed for eligibility, from which 36 qualified articles were selected for final evaluation. From the reviewed articles, 38.9%, 11.11% and 8.3% recommended rescreening in this group of neonates, lowering the screening cutoff of TSH and using cutoffs according to the gestational age, respectively. Some of them (13.9%) recommended using both TSH and T4 for screening of preterm infants. After reviewing available data, we recommend repeating the screening test in pre-term, LBW and very-low- birth-weight (VLBW) infants at age of two, six and ten weeks by measuring TSH and FT4 levels simultaneously and considering TSH = 10 mU/L as the cutoff level for positive and suspicious cases. Copyright © 2017. Published by Elsevier B.V.

  13. Development and Predictive Value of Early Vocalizations in Very-Low-Birth-Weight Children: A Longitudinal Study

    Science.gov (United States)

    Stolt, Suvi; Lehtonen, Liisa; Haataja, Leena; Lapinleimu, Helena

    2012-01-01

    The aim of the present study was to analyze early vocalization development, the predictive value of this development in terms of later language skills, and possible gender difference in early vocalization development in a selected cohort of 32 very-low-birth-weight (VLBW) children and 35 full-term controls. The data on early vocalization…

  14. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children

    NARCIS (Netherlands)

    C.S.H. Aarnoudse-Moens (Cornelieke); N. Weisglas-Kuperus (Nynke); J.B. van Goudoever (Hans); J. Oosterlaan (Jaap)

    2009-01-01

    textabstractOBJECTIVE: Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (≤33 weeks' gestation) and/or very low birth weight (VLBW) (≤1500 g) children. Great variability in the published results, however, hind

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

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    Regina Coeli Azeredo Cardoso

    2013-09-01

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

  16. Early versus Late Trophic Feeding in Very Low Birth Weight Preterm Infants

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    Niloofar Satarzadeh

    2012-06-01

    Full Text Available Objective: Improved survival of preterm infants, beneficial effects of trophic feeding and limited data on timing management of enteral feeding for very low birth weight preterm infants requires more researches to determine the exact starting time and increased volumes. This study aims to compare early (72h trophic feeding with respect to important neonatal outcomes.Methods: In a cohort study from September 2007 to October 2008, a total of 170 preterm infants (1000-1500gram, 26-31 weeks consisting of 125 who received trophic feeding enterally within the first 48 hours of birth(early group and 45 fed enterally after 72 h0urs (late group, without major congenital birth defects and severe asphyxia entered the study. Bolus feeding was started in both groups at 1-2 cc/kg every 4-6 hours of human milk or preterm infant formula and was advanced 1-2 cc/kg/day if tolerated along with parenteralnutrition. Feeding intolerance, possibility of necrotizing entrocolitis (NEC, episodes of sepsis, body weight,length of NICU stay, and duration of parenteral nutrition were assessed serially.Findings: There were no statistically significant differences in the clinical and maternal characteristics ofinfants in the two groups. The time to gain birth weight (13.75±5.21 vs 20.53±6.31 (P<0.001, duration of parenteral nutrition (9.26±4.572 days vs 14.11±6.415 days (P<0.001, hospital stay (12.14±8.612 vs 21.11±1.156 (P<0.001 were significantly shorter in early compared to late feeding group; none of the twogroups experienced a high incidence of late onset sepsis (P=0.73. There was 1 case of confirmed NEC in every group.Conclusion: The benefits of early trophic feeding shown by this study strongly support its use for the preterm infants without adding to complications.

  17. Plasma and urine riboflavin and pyridoxine concentrations in enterally fed very-low-birth-weight neonates.

    Science.gov (United States)

    Porcelli, P J; Adcock, E W; DelPaggio, D; Swift, L L; Greene, H L

    1996-08-01

    Preterm infant formulas (PIFs) for very-low-birth-weight (VLBW) infants (birth weight, pyridoxine at levels up to five-fold greater than in term infant formula and 18-fold greater than in human milk. We evaluated plasma riboflavin and pyridoxine concentrations in VLBW infants who received PIF during their first postnatal month. Eighty-eight plasma and 124 urine samples were collected for riboflavin- and pyridoxine-concentration measurements from 57 clinically healthy VLBW infants weekly during their first postnatal month. Concentrations were measured using high-performance liquid chromatography. At the time of the sample, patients were receiving > or = 80% of their total calories via enteral feedings. Plasma riboflavin concentrations rose from 45.3 +/- 7.3 ng/ml at baseline (mean +/- SEM) to 173.5 +/- 20.3 ng/ml by 1 week of age and remained at 177.3-199.7 ng/ml during the following three weekly measurements; values were up to 14-fold above baseline concentration. Urine riboflavin concentration increased from 534 +/- 137 ng/ml at baseline to 3,521 +/- 423 ng/ml by 1 week of age and remained at 4,451-5,216 ng/ml during the next 3 weeks. In a similar pattern, baseline plasma (69.4 +/- 10.4 ng/ml) and urine (145 +/- 30 ng/ml) pyridoxine concentrations were significantly increased by 1 week postnatal age; they remained at 163-248 ng/ml (plasma) and 1,573-2,394 ng/ml (urine) through the first postnatal month. Plasma and urine riboflavin and pyridoxine concentrations in enterally fed VLBW infants increased from baseline concentrations by 1 week of postnatal age and remained elevated for the first postnatal month. High daily intake and immature renal development are probable contributing causes of the elevated plasma riboflavin and pyridoxine concentrations. We suggest that lower daily enteral administration of riboflavin and pyridoxine should maintain adequate blood concentrations and minimize potential toxicity.

  18. Transcutaneous Carbon Dioxide Monitoring with Reduced-Temperature Probes in Very Low Birth Weight Infants.

    Science.gov (United States)

    Aly, Safwat; El-Dib, Mohamed; Mohamed, Mohamed; Aly, Hany

    2017-04-01

    Background Obtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO2) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO2 monitoring using reduced-temperature probes (41°C). Objective The objective of this study was to assess reliability and safety of tcPCO2 monitoring at reduced-temperature probe in VLBW infants. Design and Methods A prospective study was conducted on VLBW infants. tcPCO2 was monitored for 12 hours. Default skin probe temperature was adjusted at 41°C. Blood gases were done as clinically indicated. Arterial partial pressure of CO2 (PaCO2) as well as capillary CO2 were compared with simultaneous tcPCO2. Results A total of 124 data points were identified from 50 patients (gestational age [GA] = 28.1 ± 2.4 weeks and birth weight [BW] = 1,035 ± 291 g). Patients were supported with continuous positive airway pressure (40%), noninvasive positive pressure ventilation (16%), mechanical ventilation (18%), and high-frequency oscillation ventilation (24%). PaCO2 was measured using either capillary (58%) or arterial (42%) samples. Mean CO2 did not differ between tcPCO2 (51.3 ± 16) and PaCO2 (49.1 ± 13.7) mm Hg. tcPCO2 showed positive correlation with partial pressure of CO2 (r = 0.6, p < 0.001). This correlation continued to be significant after controlling for GA, postmenstrual age, type of sample, and pH. No skin complications were reported. Conclusion tcPCO2 monitoring using a temperature of 41°C is feasible and reliable in VLBW infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Current Status of Therapeutic Strategies for Patent Ductus Arteriosus in Very-Low-Birth-Weight Infants in Korea.

    Science.gov (United States)

    Lee, Jin A; Kim, Myo-Jing; Oh, Sohee; Choi, Byung Min

    2015-10-01

    This study aimed to investigate current therapeutic strategies for patent ductus arteriosus (PDA) in very-low-birth-weight (VLBW) infants in Korea. A total of 2,254 VLBW infants among 2,386 from Korean Neonatal Network cohort born from January 2013 to June 2014 were included. No PDA was seen for 1,206 infants (53.5%) and the infants diagnosed or treated for PDA were 1,048 infants (46.5%). The proportion of infants with PDA was decreased according to the increase in gestational age (GA) and birthweight. Infants with PDA were divided into groups according to the therapeutic strategies of PDA: prophylactic treatment (PT, n = 69, 3.1%), pre-symptomatic treatment (PST, n = 212, 9.4%), symptomatic treatment (ST, n = 596, 26.4%), and conservative treatment (CT, n = 171, 7.6%). ST was the most preferred treatment modality for preterm PDA and the proportion of the patients was decreased in the order of PST, CT, and PT. Although ST was still the most favored treatment in GA < 24 weeks group, CT was more preferred than PST or ST when compared with GA ≥ 32 weeks group [CT vs. PST, OR 5.3, 95% CI 1.56-18.18; CT vs. ST, OR 2.9, 95% CI 1.03-8.13]. A total of 877 infants (38.9%) received pharmacological or surgical treatment about PDA, and 35.5% (801 infants) received pharmacological treatment, mostly with ibuprofen. Seventy-six infants (3.4%) received primary ligation and 8.9% (201 infants) received secondary ligation. Diverse treatment strategies are currently used for preterm PDA in Korea. Further analyses of neonatal outcomes according to the treatment strategies are necessary to obtain a standardized treatment guideline for preterm PDA.

  20. Association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants.

    Science.gov (United States)

    Lee, Jan Hau; Greenberg, Rachel G; Quek, Bin H; Clark, Reese H; Laughon, Matthew M; Smith, P Brian; Hornik, Christoph P

    2017-06-19

    In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical outcomes may depend on the accuracy of diagnosis and the timing of administration. The objective of the present study was to characterise the association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants. This retrospective cohort study used electronic health record data on inborn infants of gestational age ⩽28 weeks and birth weight patent ductus arteriosus was diagnosed in 31,712/48,551 (65%). The diagnosis was more common in infants who had undergone early echocardiography (14,549/15,971 [91%] versus 17,163/32,580 [53%], ppatent ductus arteriosus (odds ratio 1.01, 95% CI 0.90-1.15). Early echocardiography was associated with an increased diagnosis of patent ductus arteriosus, but not with decreased mortality.

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

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    Panina O.S.

    2014-12-01

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

  2. Neonatal sepsis and neurodevelopment in very low birth weight infants in Matanzas, Cuba 2006-2010: a prospective cohort study.

    Science.gov (United States)

    Robaina Castellanos, Gerardo Rogelio; Riesgo Rodríguez, Solangel de la Caridad

    2016-04-07

    Neonatal sepsis has been associated with poor neurodevelopmental outcome in very low birth weight infants (VLBW infants). The impact of neonatal sepsis on neurodevelopment in very low birth weight infants discharged from Cuban neonatal intensive care units is unknown. To determine the impact of neonatal sepsis as a risk factor of neurodevelopmental disorders in a Cuban very low birth weight infants’ population. A cohort study was carried out that enrolled 89 infants with birth weight less than 1500 g who were admitted during the period 2006-2010 to the Teaching Provincial Gynecological and Obstetrical Hospital of Matanzas. All patients were followed-up at the outpatient clinic until two years of corrected gestational age. Then they were divided into two groups: those who had been diagnosed with neonatal sepsis (n=19) and those who had not (n=70). The association power of neonatal sepsis with neurodevelopmental disorders was determined with calculation of relative risk (RR) and their confidence intervals at 95% (CI95%). A multivariate analysis with logistic regression enabled us to compare sepsis with other neonatal variables as risk factors. Very low birth weight infants with neonatal sepsis had an increased risk of neurodevelopmental disorders (47.4 vs 17.1%; RR 2.7 CI95% 1.3-5.5; p=0.005). This risk was significant after correction for other variables (male sex, mechanical respiratory assistance, bronchopulmonary dysplasia and hyperbilirrubinemia >15 mg/dl) (odds ratio 4.0; CI95% 1.1-14.3; p=0.03). Neonatal sepsis should be considered an important factor among the multiple events related to poor neurodevelopmental outcome in the preterm newborn.

  3. Visual function in very low birth weight adolescents : Fifteen-year follow-up of children in southeast Sweden

    OpenAIRE

    Hellgren, Kerstin

    2009-01-01

    Background: Very low birth weight (VLBW < 1500 g) carries an increased risk of visual and cognitive deficits. Long term follow-up studies are sparse. The associations between neural structure and visual and cognitive outcome need to be more fully explored. Aims: To describe visual functions in adolescents with VLBW in comparison with a matched control group and to investigate associations with white matter damage of immaturity (WMDI), optic disc measurements and cognitive ...

  4. Use of a computerized C-reactive protein (CRP based sepsis evaluation in very low birth weight (VLBW infants: a five-year experience.

    Directory of Open Access Journals (Sweden)

    Sarah A Coggins

    Full Text Available BACKGROUND: Serial C-reactive protein (CRP values may be useful for decision-making regarding duration of antibiotics in neonates. However, established standard of practice for its use in preterm very low birth weight (<1500 g, VLBW infants are lacking. OBJECTIVE: Evaluate compliance with a CRP-guided computerized decision support (CDS algorithm and compare characteristics and outcomes of compliant versus non-compliant cases. Measure correlation between CRPs and white blood count (WBC indices. METHODS: We examined 3 populations: 1 all preterm VLBW infants born at Vanderbilt 2006-2011 - we assessed provider compliance with CDS algorithm and measured relevant outcomes; 2 all patients with positive blood culture results admitted to the Vanderbilt NICU 2006-2012 - we tested the correlation between CRP and WBC results within 7 days of blood culture phlebotomy; 3 1,000 randomly selected patients out of the 7,062 patients admitted to the NICU 2006-2012 - we correlated time-associated CRP values and absolute neutrophil counts. RESULTS: Of 636 VLBW infants in cohort 1, 569 (89% received empiric antibiotics for suspected early-onset sepsis. In 409 infants (72% the CDS algorithm was followed; antibiotics were discontinued ≤48 hours in 311 (55% with normal serial CRPs and continued in 98 (17% with positive CRPs, resulting in significant reduction in antibiotic exposure (p<0.001 without increase in complications or subsequent infections. One hundred sixty (28% were considered non-compliant because antibiotics were continued beyond 48 hours despite negative serial CRPs and blood cultures. Serial CRPs remained negative in 38 (12% of 308 blood culture-positive infants from cohort 2, but only 4 patients had clinically probable sepsis with single organisms and no immunodeficiency besides extreme prematurity. Leukopenia of any cell type was not linked with CRPs in cohorts 2 and 3. CONCLUSIONS: CDS/CRP-guided antibiotic use is safe and effective in culture

  5. 极低出生体重儿159例临床分析%Analysis of clinical data of 159 infants with very low birth weight

    Institute of Scientific and Technical Information of China (English)

    宋文萍; 晋芙莉

    2013-01-01

    Objective To explore the related factors affecting the survival rate of very low birth weight infants .Methods Totally 159 cases of very low birth weight infants were divided into 3 groups according to weight , and retrospective analysis was conducted on the clinical data .Results Multiple pregnancy , premature rupture of membranes and gestational hypertension were common causes of very low birth weight infants, and apnea, infection, brain injury, asphyxia, cold injury were major clinical problems .Respiratory distress, sepsis and brain injury were the major causes of neonatal death and poor prognosis .There were significant differences in the incidence of respiratory distress, sepsis and craniocerebral injury among different groups (χ2 value was 14.601, 6.752 and 5.012, respectively, all P<0.05).The differences were statistically significant (χ2 value was 14.601, 6.752 and 5.012 respectively, all P<0.05).Conclusion Good perinatal care , timely and effective respiratory support , prevention of high risk factors such as premature birth , asphyxia and infection are the key to reduce the mortality of very low birth weight infants .%目的探讨影响极低出生体重儿存活率的相关因素。方法将159例极低出生体重儿按体重分3组,对其临床资料进行回顾性分析。结果多胎、胎膜早破、妊娠期高血压是极低出生体重儿的常见发生原因,呼吸障碍、感染、颅脑损伤、窒息、寒冷损伤等是极低出生体重儿的主要临床问题。呼吸窘迫、败血症和颅脑损伤是引起新生儿死亡和预后不良的主要疾病。不同出生体重的极低出生体重儿呼吸窘迫、败血症和颅脑损伤的发生率比较差异均有统计学意义(χ2值分别为14.601、6.752、5.012,均P<0.05)。结论做好围产期保健,及时有效的呼吸支持,预防早产、窒息、感染等高危因素,是降低极低出生体重儿死亡率的关健。

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

    Directory of Open Access Journals (Sweden)

    Abeer El Sakka

    2016-10-01

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

  7. Post Discharge Formula Fortification of Maternal Human Milk of Very Low Birth Weight Preterm Infants: An Introduction of a Feeding Protocol in a University Hospital

    Science.gov (United States)

    El Sakka, Abeer; El Shimi, Mohamed Sami; Salama, Kareem; Fayez, Hend

    2016-01-01

    The objective of this study is to determine the growth parameters and nutritional biochemical markers and complications of fortification of human milk by post discharge formula of preterm very low birth weight newborns (VLBW). Fifty preterm infants less than 37 weeks with weight less than 1500 g were enrolled in the study. They received parental nutrition and feeding according to our protocol. When enteral feeding reached 100 cc/kg/day, infants were randomized into two groups: group I, Cases, n=25, where post discharge formula (PDF) was used for fortification, group II, Controls, n=25 with no fortification. Infants of both groups were given 50% of required enteral feeding as premature formula. This protocol was used until infants’ weight reached 1800 g. Daily weight, weekly length and head circumference were recorded. Hemoglobin, albumin (Alb), electrolytes, blood urea nitrogen (BUN) and clinical complications were documented. Human milk fortification with PDF resulted in better growth with increase in weight 16.8 and 13.78 g/kg/day (P=0.0430), length 0.76 and 0.58 cm/week (P=0.0027), and head circumference of 0.59 and 0.5 cm/week (P=0.0217) in cases and controls respectively. Duration of hospital stay was less in cases (22.76 versus 28.52 days in Controls), P=0.02. No significant changes were found in serum electrolytes, BUN, or Alb between both groups. Hemoglobin was significantly higher in Cases, P=0.04. There were no significant clinical complications. Our feeding protocol of fortification of human milk with PDF in preterm very low birth weight newborns resulted in better growth and decrease in length of hospital stay. The use of PDF could be an alternative option for fortification of mothers’ milk for preterm VLBW infants in developing countries with low resources. PMID:27777705

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

    Science.gov (United States)

    Dempsey, Eugene; Miletin, Jan

    2010-06-16

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

  9. Randomized Controlled Trial of Slow Versus Rapid Enteral Feeding Advancements on the Clinical Outcomes in Very Low Birth Weight Neonates.

    Science.gov (United States)

    Ahmed, F; Mannan, M A; Dey, A C; Nahar, N; Hasan, Z; Jahan, I; Dey, S K; Shahidullah, M

    2017-04-01

    Starting and advancement of feeding in very low birth weight (VLBW) infants are big challenges for the neonatal practitioners. Wide variations in volume of feed advancement have observed in earlier trials both in slow and rapid advancement groups. Volume advancement in slow advancement groups have ranged from 10ml/kg/day to 23ml/kg/day and in rapid advancement groups have ranged from 15ml/kg/day to 45ml/kg/day in earlier different studies. This randomized controlled trial was conducted in neonatal intensive care unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2013 to July 2014 to evaluate the effects of slow versus rapid rates of feeding advancements on the clinical outcomes in very low birth weight infants. A total 95 infants were enrolled into two strata according to their birth weight. Infants of each stratum were randomly allocated to either slow or rapid advancement group during initiation of feeding. After gut priming over five days, feeding was advanced daily 10ml/kg in slow and 15ml/kg in rapid advancement group for 1000 - rapid advancement group. The primary outcome variable was time taken to achieve full enteral feed. Total 82 infants completed the trial. Demographically both groups were same. Infants in the rapid feeding advancement group achieved full enteral feedings before the slow advancement group, had significantly fewer days of parenteral nutrition and regained birth weight earlier. There were no statistical differences in episodes of feed interruption, number of infants with apnea, feed intolerance or diagnosis of sepsis. Rapid enteral feeding advancements were well tolerated by very low birth weight infants.

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

    LENUS (Irish Health Repository)

    Dempsey, Eugene

    2012-01-31

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

  11. Very Low Birth Weight Infant Necessitating Nissen Fundoplication for Weaning off the Mechanical Ventilator

    Directory of Open Access Journals (Sweden)

    İpek Güney Varal

    2014-05-01

    Full Text Available Gastro-esophageal reflux (GER is one of the common problems of neonatal intensive care units. Although this condition does not always need to be treated, it occasionally causes clinically serious consequences. Initial management is medical; however, in some cases surgery might be required. A premature neonate with birth weight of 1370 grams was managed in our ICU. The patient was mechanical ventilator dependent due to GER. The patient needed Nissen fundoplication for successfully weaning off the ventilator.

  12. Neuro-Cognitive Performance of Very Preterm or Very Low Birth Weight Adults at 26 Years

    Science.gov (United States)

    Eryigit Madzwamuse, Suna; Baumann, Nicole; Jaekel, Julia; Bartmann, Peter; Wolke, Dieter

    2015-01-01

    Background: Children born very preterm (VP low birth weight (VBLW <1500 g; subsequently VP/VLBW) have been previously reported to have more cognitive impairment and specific executive functioning problems than term children; however, it remains unclear whether these problems persist into adulthood. This…

  13. Evaluation of growth and development pattern in normal, low and very low birth weight neonates at 18 months of age.

    Science.gov (United States)

    Abdeyazdan, Zahra; Ehsanpour, Soheila; Hemmati, Elahe

    2014-01-01

    Growth and development monitoring could lead to general judgment about children's health. With advances in NICUs establishment, the survival rate of very low birth weight (VLBW) neonates has increased in many countries including Iran. Because of the lack of studies about growth and development pattern of low birth weight (LBW) and VLBW neonates in Iran, the present study aimed to compare growth and development of normal, low and very low birth weight neonates at 18 months of age. In a cross- sectional descriptive study, 214 children with age 18 months were enrolled (90 LBW, 90 LBW and 34 VLBW) and their growth and development were assessed. Data gathering tool was a researcher made questionnaire including anthropometrics measures and developmental key points. Data analyzed by descriptive (mean and SD) and inferential (ANOVA) tests using SPSS version 15. There were significant differences in the mean of anthropometric indexes between three groups. Majority of subjects in three groups had normal weight growth trend. Mean scores of gross motor and fine motor development indexes had significant association with birth weight. Meanwhile, there was no significant association between mean scores of social/cognitive and also language developmental aspects and birth weight. Findings revealed that in LBW and VLBW children, growth indexes at the age of 18 months are so far from those of NBW neonates. Further nationwide prospective studies, with a longer period of time is needed to estimate when Iranian LBW children reach at the levels of NBW ones.

  14. Peri-intraventricular hemorrhage and oxidative and inflammatory stress markers in very-low birth weight newborns.

    Science.gov (United States)

    Caldas, Jamil P S; Braghini, Carolina A; Mazzola, Taís N; Vilela, Maria M S; Marba, Sérgio T M

    2015-01-01

    To evaluate the association between oxidative and inflammatory stress markers with peri-intraventricular hemorrhage (PIVH) in very-low birth weight newborns. This was a prospective study conducted in a level III neonatal unit. Basal and stimulated reactive oxygen intermediates (ROIs), reduced glutathione (GSH), and interleukin-6 (IL-6) levels were measured in umbilical cord blood. Newborns underwent serial ultrasound at the bedside, at 6, 12, 24, and 72hours of life and at seven days for the diagnosis of PIVH, classified as grades I to IV. Two groups were assessed, those with and without PIVH; maternal and neonatal control variables were used for comparison. Univariate and multiple regression analyses were applied. A total of 125 newborns were assessed. PIVH incidence rate was 12.0%. In the univariate analysis, basal ROI, the use of two or more doses of corticosteroids, birth weight<1,000g, ventilatory support use, and SNAPPE II value ≥ 22 were significantly associated with PIVH. However, in the multivariate analysis, only antenatal steroid use was independently associated with the disease (OR 0,194; 95% CI: 0,048 to 0,773; p=0,02). ROI, GSH, and IL-6 levels were not associated with the occurrence of PIVH in very-low birth weight infants. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  15. Peri-intraventricular hemorrhage and oxidative and inflammatory stress markers in very-low birth weight newborns

    Directory of Open Access Journals (Sweden)

    Jamil P.S. Caldas

    2015-08-01

    Full Text Available OBJECTIVES: To evaluate the association between oxidative and inflammatory stress markers with peri-intraventricular hemorrhage (PIVH in very-low birth weight newborns.METHODS: This was a prospective study conducted in a level III neonatal unit. Basal and stimulated reactive oxygen intermediates (ROIs, reduced glutathione (GSH, and interleukin-6 (IL-6 levels were measured in umbilical cord blood. Newborns underwent serial ultrasound at the bedside, at 6, 12, 24, and 72 hours of life and at seven days for the diagnosis of PIVH, classified as grades I to IV. Two groups were assessed, those with and without PIVH; maternal and neonatal control variables were used for comparison. Univariate and multiple regression analyses were applied.RESULTS: A total of 125 newborns were assessed. PIVH incidence rate was 12.0%. In the univariate analysis, basal ROI, the use of two or more doses of corticosteroids, birth weight < 1,000 g, ventilatory support use, and SNAPPE II value ≥ 22 were significantly associated with PIVH. However, in the multivariate analysis, only antenatal steroid use was independently associated with the disease (OR 0,194; 95% CI: 0,048 to 0,773; p=0,02.CONCLUSION: ROI, GSH, and IL-6 levels were not associated with the occurrence of PIVH in very-low birth weight infants

  16. Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Alan H. Jobe

    2010-02-01

    Full Text Available The increased survival of very preterm infants is generally attributed to improved care strategies. This review develops the thesis that the features of abnormal pregnancies responsible for very preterm deliveries also provide an explanation of why very preterm infants often survive. A normal fetus born at 24 weeks is very unlikely to survive. However, pregnancies that result in deliveries at 24 weeks are generally highly abnormal, and may have been so for prolonged periods prior to the preterm deliveries. Inflammatory or vascular developmental abnormalities resulting in very preterm birth can alter fetal development in such a way that organ system maturation is induced. This is supported clinically by the relative lack of very preterm infants with respiratory distress syndrome. Interventions such as antenatal corticosteroid treatment and postnatal surfactant treatment for infants with respiratory distress syndrome and gentle ventilation strategies maximize fetal adaptations to the abnormal fetal environment and improve outcomes.

  17. Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

    Directory of Open Access Journals (Sweden)

    Fatemeh Nayeri

    2013-05-01

    Full Text Available The objective of this study is to determine risk factors causing increase in very low birth way (VLBW neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004 were studied. Two groups of neonates (living and dead were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02, low birth weight, lower than 1000 g (P=0.001, Apgar score <6 at 5th minutes (P=0.001, resuscitation at birth (P=0.001, respiratory distress syndrome (P=0.001 need for mechanical ventilation (P=0.001, neurological complications (P=0.001 and intraventricular hemorrhage (P=0.001. Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

  18. 极低出生体重儿发育迟缓的相关因素探讨%Study on the relative factors of very low birth weight infants with growth retardation

    Institute of Scientific and Technical Information of China (English)

    张杜燕; 李经猷; 张冰; 李洁敏

    2016-01-01

    目的:探讨极低出生体重儿在宫外生长过程中发生发育迟缓的比率和影响因素。方法:从极低出生体重儿中选出181例胎龄<32周的早产儿,记录其胎龄、出生体重、身长、头围、性别、恢复出生体重时间、首次肠内营养供给时间、首次完全肠内营养供给时间。同时在其生长到37~42周时测量患儿的体重、身长、头围,研究宫外发育迟缓几率和各类危险因素,并同时研究适于胎龄儿和小于胎龄儿宫外发育迟缓发生几率。结果:发育迟缓的患儿胎龄、出生时的体重、身长以及头围均明显低于发育正常新生儿,同时其恢复出生体重时间、首次肠内营养供给时间、首次完全肠内营养供给时间均大于正常发育新生儿,且小于胎龄儿发育迟缓发生几率明显高于适于胎龄儿。结论:极低出生体重儿发育迟缓的影响因素包括胎龄、营养摄入时间等。%Objective To investigate the rate and influence factors of very low birth weight infants with extrauterine growth re-tardation.Method 181 premature infants of gestational age less than 32 weeks were selected from very low birth weight infant born, and recorded data such as gestational age,birth weight,height,head circumference,gender,gestational age children nature,respirato-ry distress rate,birth weight recovery time,the first time of enteral nutrition supply,the first full enteral nutrition feeding time.While growted to 37 ~42 weeks,then measured children′s weight,height,head circumference,studied the extrauterine growth retardation rates and all kinds of risk factors,and also studied the the extrauterine growth retardation rates of gestational age and below gesta-tional age children.Results Compared to normal neonates,the gestational age,birth weight,height,head circumfere nce of children with growth retardation were significantly lower,the birth weight recovery time,first time of enteral nutrition

  19. Maternal and cord blood LC-HRMS metabolomics reveal alterations in energy and polyamine metabolism, and oxidative stress in very-low birth weight infants.

    Science.gov (United States)

    Alexandre-Gouabau, Marie-Cécile; Courant, Frédérique; Moyon, Thomas; Küster, Alice; Le Gall, Gwénaëlle; Tea, Illa; Antignac, Jean-Philippe; Darmaun, Dominique

    2013-06-07

    To assess the global effect of preterm birth on fetal metabolism and maternal-fetal nutrient transfer, we used a mass spectrometric-based chemical phenotyping approach on cord blood obtained at the time of birth. We sampled umbilical venous, umbilical arterial, and maternal blood from mothers delivering very-low birth weight (VLBW, with a median gestational age and weight of 29 weeks, and 1210 g, respectively) premature or full-term (FT) neonates. In VLBW group, we observed a significant elevation in the levels and maternal-fetal gradients of butyryl-, isovaleryl-, hexanoyl- and octanoyl-carnitines, suggesting enhanced short- and medium chain fatty acid β-oxidation in human preterm feto-placental unit. The significant decrease in glutamine-glutamate in preterm arterial cord blood beside lower levels of amino acid precursors of Krebs cycle suggest increased glutamine utilization in the fast growing tissues of preterm fetus with a deregulation in placental glutamate-glutamine shuttling. Enhanced glutathione utilization is likely to account for the decrease in precursor amino acids (serine, betaine, glutamate and methionine) in arterial cord blood. An increase in both the circulating levels and maternal-fetal gradients of several polyamines in their acetylated form (diacetylspermine and acetylputrescine) suggests an enhanced polyamine metabolic cycling in extreme prematurity. Our metabolomics study allowed the identification of alterations in fetal energy, antioxidant defense, and polyamines and purines flux as a signature of premature birth.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    Necrotizing enterocolitis (NEC) is a critical intestinal emergency condition, which mainly occurs in preterm very low birth weight (PVLBW) infants. Despite remarkable advances in the care of PVLBW infants, with considerable improvement of the survival rate in recent decades, the incidence of NEC...... and NEC-related mortality have not declined accordingly. The fast progression from nonspecific signs to extensive necrosis also makes primary prevention the first priority. Recently, increasing evidence has indicated the important role of several nutrients in primary prevention of NEC. Therefore, the aim...... of this review is to summarize some potential immunomodulatory nutrients in the prevention of NEC, including bovine colostrum, probiotics, prebiotics (e.g., human milk oligosaccharides), long chain polyunsaturated fatty acids, and amino acids (glutamine, cysteine and N-acetylcysteine, l-arginine and l...

  1. Total body bone development during early childhood in very low birth weight infants without cerebral palsy and mental retardation.

    Science.gov (United States)

    Osamura, T; Hasegawa, K; Yoshioka, H; Mizuta, R; Sawada, T

    1998-04-01

    Total body bone mineral density was measured by dual energy X-ray absorptiometry in 52 children who were very low birth weight (VLBW) infants without cerebral palsy and mental retardation (postconceptional age, from 10 mo to 6 y and 6 mo). VLBW infants in this study seemed to show compensatory acceleration of total body bone development, catching up with the control group during early childhood. However, in VLBW infants with at least one of the three factors such as total parenteral nutrition for 1 week or more, assisted ventilation for 1 week or more, or oxygen therapy for 28 d or more in their early stage after birth, adequate mineral supplementation might be especially important for long-term bone development.

  2. Serial investigation of continuous glucose monitoring in a very low birth weight infant with transient late-onset hyperglycemia.

    Science.gov (United States)

    Nakamura, Toshihiko; Hatanaka, Daisuke; Nakamura, Mari; Kusakari, Michiko; Takahashi, Hidehiro; Kamohara, Takashi

    2016-12-16

    Transient late-onset hyperglycemia was detected in a very low birth weight (VLBW) infant (gestational age 28 weeks, birth weight 1,082 g) by routine point-of-care glucose monitoring. The infant had no clinical symptom. Serial continuous glucose monitoring (CGM) was conducted for 3 days at 31, 35, and 39 weeks' post conceptual age. The difference values between the maximum and minimum blood glucose levels during the interval from one enteral feeding to the next enteral feeding were 32.3±14.3 mg/dL, 47.5±22.9 mg/dL, and 27.5±12.9 mg/dL for the 1(st), 2(nd), and 3(rd) CGM, respectively. The serial change in the values was statistically significant (plate-onset hyperglycemia was investigated by serial CGM.

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

    Science.gov (United States)

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

    2014-01-01

    to evaluate neonatal sepsis as a risk factor for abnormal neuromotor and cognitive development in very low birth weight preterm infants at 12 months of corrected age. this was a prospective cohort study that followed the neuromotor and cognitive development of 194 very low birth weight preterm infants discharged from a public neonatal intensive care unit. The Bayley Scale of Infant Development (second edition) at 12 months of corrected age was used. The outcomes were the results of the clinical/neurological evaluation and the scores of the psychomotor development index (PDI) and mental development index (MDI) of the Bayley Scale of Infant Development II. The association between neonatal sepsis and neuromotor development and between neonatal sepsis and cognitive development was verified by logistic regression analysis. mean birth weight was 1,119g (SD: 247) and mean gestational age was 29 weeks and 6 days (SD: 2). Approximately 44.3%(n=86) of the infants had neonatal sepsis and 40.7% (n=79) had abnormal neuromotor development and/or abnormal psychomotor development index (PDI < 85) at 12 months of corrected age. On the mental scale, 76 (39.1%) children presented abnormal cognitive development (MDI<85). Children with neonatal sepsis were 2.5 times more likely to develop changes in neuromotor development (OR: 2.50; CI: 1.23-5.10). There was no association between neonatal sepsis and cognitive development impairment. neonatal sepsis was an independent risk factor for neuromotor development impairment at 12 months of corrected age, but not for mental development impairment. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

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

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    Rachel C. Ferreira

    2014-06-01

    Full Text Available OBJECTIVE: to evaluate neonatal sepsis as a risk factor for abnormal neuromotor and cognitive development in very low birth weight preterm infants at 12 months of corrected age. METHODS: this was a prospective cohort study that followed the neuromotor and cognitive development of 194 very low birth weight preterm infants discharged from a public neonatal intensive care unit. The Bayley Scale of Infant Development (second edition at 12 months of corrected age was used. The outcomes were the results of the clinical/neurological evaluation and the scores of the psychomotor development index (PDI and mental development index (MDI of the Bayley Scale of Infant Development II. The association between neonatal sepsis and neuromotor development and between neonatal sepsis and cognitive development was verified by logistic regression analysis. RESULTS: mean birth weight was 1,119 g (SD: 247 and mean gestational age was 29 weeks and 6 days (SD: 2. Approximately 44.3%(n = 86 of the infants had neonatal sepsis and 40.7% (n = 79 had abnormal neuromotor development and/or abnormal psychomotor development index (PDI < 85 at 12 months of corrected age. On the mental scale, 76 (39.1% children presented abnormal cognitive development (MDI < 85. Children with neonatal sepsis were 2.5 times more likely to develop changes in neuromotor development (OR: 2.50; CI: 1.23-5.10. There was no association between neonatal sepsis and cognitive development impairment. CONCLUSION: neonatal sepsis was an independent risk factor for neuromotor development impairment at 12 months of corrected age, but not for mental development impairment.

  5. Early Caffeine Use in Very Low Birth Weight Infants and Neonatal Outcomes: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Park, Hye Won; Lim, Gina; Chung, Sung-Hoon; Chung, Sochung; Kim, Kyo Sun; Kim, Soo-Nyung

    2015-12-01

    The use of caffeine citrate for treatment of apnea in very low birth weight infants showed short-term and long-term benefits. A systematic review and meta-analysis of the literature was undertaken to document the effect providing caffeine early (0-2 days of life) compared to providing caffeine late (≥3 days of life) in very low birth weight infants on several neonatal outcomes, including bronchopulmonary dysplasia (BPD). We searched MEDLINE, the EMBASE database, the Cochrane Library, and KoreaMed for this meta-analysis. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and Jadad's scale. Studies were included if they examined the effect of the early use of caffeine compared with the late use of caffeine. Two reviewers screened the candidate articles and extracted the data from the full-text of all of the included studies. We included a total of 59,136 participants (range 58,997-59,136; variable in one study) from a total of 5 studies. The risk of death (odds ratio [OR], 0.902; 95% confidence interval [CI], 0.828 to 0.983; P=0.019), bronchopulmonary dysplasia (BPD) (OR, 0.507; 95% CI, 0.396 to 0.648; Pcaffeine group. Early caffeine use was not associated with a risk of necrotizing enterocolitis (NEC) and NEC requiring surgery. This meta-analysis suggests that early caffeine use has beneficial effects on neonatal outcomes, including mortality and BPD, without increasing the risk of NEC.

  6. The effect of comprehensive infection control measures on the rate of late-onset bloodstream infections in very low-birth-weight infants.

    Science.gov (United States)

    Wicker, Linda; Saslow, Judy; Shah, Sahil; Bhat, Vishwanath; Sannoh, Sulaiman; Brandon, Emma; Kemble, Nicole; Pyon, Kee; Stahl, Gary; Aghai, Zubair H

    2011-03-01

    Late-onset bloodstream infection (LOBI) is a significant problem in very low-birth-weight (VLBW) infants and can lead to increased mortality and morbidity. The incidence of LOBI in VLBW infants in our unit was >35% before 2004, much higher than 20% reported in other studies. A comprehensive infection control measure was introduced in our unit in 2005. Here we report the effects of comprehensive infection control measures on the rate of LOBI in VLBW infants. Infants in the preintervention group (born 2001 to 2004) were compared with the intervention group (born 2005 to 2008) for baseline demographics, risk factors for infection, and the rate of LOBI. LOBI was defined as a positive blood and/or cerebrospinal fluid culture after 3 days of life. Three hundred thirty-four VLBW infants were admitted to our unit during the preintervention period and 303 during the intervention period. There was no significant difference in baseline demographics and risk factors for LOBI between the two groups. The incidence of LOBI was significantly reduced from 38% before intervention to 23% after intervention ( P control measures significantly reduced the rate of LOBI in VLBW infants. © Thieme Medical Publishers.

  7. Attention Regulation in Low-Risk Very Low Birth Weight Preschoolers: The Influence of Child Temperament and Parental Sensitivity

    Science.gov (United States)

    Davis, Deborah Winders; Harris, Ruby Carrie; Burns, Barbara M.

    2010-01-01

    Even in the absence of major disabilities, children born prematurely are at high risk for academic delays and deficits. Research suggests that some differences in outcomes may relate to problems with self-regulation, especially attention regulation. Previous research has demonstrated that individual differences in attention regulation is…

  8. Postnatal changes in adrenal size in very low-birth-weight infants: sonographic evaluation for the prediction of late-onset glucocorticoid-responsive circulatory collapse.

    Science.gov (United States)

    Iijima, Shigeo; Uga, Naoki; Ohzeki, Takehiko

    2010-06-01

    We investigated the postnatal pattern of changes in adrenal size in very low-birth-weight (VLBW) infants and its relation to late-onset glucocorticoid-responsive circulatory collapse (LGCC) that may be associated with adrenal insufficiency. In 36 VLBW infants born at birth and unchanged at 3 weeks; group B (N = 24), the actual adrenal area was greater than or equal to the predicted value and decreased at 3 weeks; and group C (N = 6), the actual adrenal area was less than the predicted value and unchanged at 3 weeks. Five infants developed LGCC, and all five were in group A. These observations suggest that the life of the adrenal fetal zone might be extended beyond 3 weeks after birth in some VLBW infants and that prolonged fetal zone activity might correlate with LGCC. On the other hand, adrenal maturation might have already occurred at birth in some VLBW infants. Sonographic evaluation of adrenal size may enable prediction of subsequent LGCC in VLBW infants.

  9. Effect of red blood cell storage time on markers of hemolysis and inflammation in transfused very low birth weight infants.

    Science.gov (United States)

    Kalhan, Tamara G; Bateman, David A; Bowker, Rakhee M; Hod, Eldad A; Kashyap, Sudha

    2017-07-24

    Prolonged storage of transfused red blood cells (RBCs) is associated with hemolysis in healthy adults and inflammation in animal models. We aimed to determine whether storage duration affects markers of hemolysis (e.g., serum bilirubin, iron, and non-transferrin-bound iron (NTBI)) and inflammation (e.g., interleukin (IL)-8 and monocyte chemoattractant protein (MCP)-1) in transfused very low birth weight (VLBW) infants. Blood samples from 23 independent transfusion events were collected by heel stick before and 2-6 h after transfusion. Serum iron, total bilirubin, NTBI, and MCP-1 levels were significantly increased after transfusion of RBCs (P<0.05 for each comparison). The storage age of transfused RBCs positively correlated with increases in NTBI following transfusion (P<0.001; R(2)=0.44). No associations between storage duration and changes in the other analytes were observed. Transfusion of RBCs into VLBW infants is associated with increased markers of hemolysis and the inflammatory chemokine MCP-1. RBC storage duration only correlated with increases in NTBI levels following transfusion. NTBI was only observed in healthy adults following 35 days of storage; however, this study suggests that VLBW infants are potentially more susceptible to producing this pathological form of iron, with increased levels observed after transfusion of only 20-day old RBCs.Pediatric Research accepted article preview online, 24 July 2017. doi:10.1038/pr.2017.177.

  10. The prevalence and predictive value of weak language skills in children with very low birth weight--a longitudinal study.

    Science.gov (United States)

    Stolt, Suvi; Matomaki, Jaakko; Lind, Annika; Lapinleimu, Helena; Haataja, Leena; Lehtonen, Liisa

    2014-06-01

    Previous findings regarding the prevalence and predictive value of weak language skills in preterm children with very low birth weight (VLBW) are unclear. This study analysed the prevalence of weak language skills, the predictive value of early weak language skills on later weak language skills, and the sensitivity and specificity of cognitive scores for identifying concurrent weak language skills in a longitudinal sample of VLBW children (n = 141) and their full-term controls (n = 146). Data on language skills and cognitive development were gathered at two and five years of age. Weak language skills were defined by the 10th percentile value of the controls. In VLBW children, the prevalence of weak language skills varied between 16% and 18% at 2 years of age (controls: 8 to 10%) and between 20% and 27% at 5 years of age (controls: 10%). Early weak language skills predicted later weak language skills in VLBW children. Cognitive scores were specific, but their sensitivity for identifying concurrent weak language skills was low. The prevalence of weak language skills in VLBW children increased during the follow-up period and was higher than the controls. Language-sensitive methods should be used in the clinical follow-up of VLBW children.

  11. Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition

    Directory of Open Access Journals (Sweden)

    Priscila Castro Cordeiro Fernandes

    2011-08-01

    Full Text Available INTRODUCTION: The purpose of this study was to establish the late onset sepsis (LOS rate of our service, characterize the intestinal microbiota and evaluate a possible association between gut flora and sepsis in surgical infants who were receiving parenteral nutrition (PN. METHODS: Surveillance cultures of the gut were taken at the start of PN and thereafter once a week. Specimens for blood culture were collected based on clinical criteria established by the medical staff. The central venous catheter (CVC tip was removed under aseptic conditions. Standard laboratory methods were used to identify the microorganisms that grew on cultures of gut, blood and CVC tip. RESULTS: 74 very low birth weight infants were analyzed. All the infants were receiving PN and antibiotics when the gut culture was started. In total, 21 (28.4% infants experienced 28 episodes of LOS with no identified source. Coagulase negative staphylococci were the most common bacteria identified, both in the intestine (74.2% and blood (67.8%. All infections occurred in patients who received PN through a central venous catheter. Six infants experienced episodes of microbial translocation. CONCLUSIONS: In this study, LOS was the most frequent episode in neonates receiving parenteral nutrition who had been submitted to surgery; 28.6% of this infection was probably a gut-derived phenomenon and requires novel strategies for prevention.

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

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    Ping Zhou

    2015-08-01

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

  13. Metabolic and energy balance in small- and appropriate-for-gestational-age, very low-birth-weight infants.

    Science.gov (United States)

    Picaud, J C; Putet, G; Rigo, J; Salle, B L; Senterre, J

    1994-12-01

    This study compared nutrient utilization and postnatal weight gain composition in eight appropriate for gestational age (AGA: birth weight 1293 +/- 107 g; gestational age 28.8 +/- 1.4 weeks) and eight symmetrically growth-retarded (SGA: birth weight 1110 +/- 230 g; gestational age 32.7 +/- 1.9 weeks), very low-birth-weight (VLBW) infants. There was no significant difference in protein, mineral and energy intake between AGA and SGA infants. Nitrogen absorption (84 +/- 3 and 83 +/- 4%) and nitrogen retention (356 +/- 48 and 352 +/- 43 mg/kg/day) were similar in both groups. Fat absorption tended to be lower in AGA (78 +/- 15%) than in SGA (87 +/- 4%) infants. Calcium, phosphorus and magnesium absorptions were similar in AGA and SGA infants. Metabolizable energy utilization was similar in both groups; about 55% was expended and 45% stored in new tissues. Energy expenditure was 58 +/- 4 kcal/kg/day in SGA infants and 61 +/- 9 kcal/kg/day in AGA infants. Weight gain and its composition were similar in both groups. We conclude that nutrient and energy utilization are similar in AGA and symmetrically growth-retarded, VLBW infants.

  14. Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report

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    Maria Lúcia Silveira Ferlin

    Full Text Available CONTEXT: Central diabetes insipidus (CDI is a rare cause of hypernatremia during the neonatal period. The diagnosis is particularly difficult in very low birth weight (VLBW newborns. CASE REPORT: We report on a preterm newborn who presented CDI soon after birth. On the third day of life, signs of dehydration were present despite normal fluid supply. The diuresis rate was 4.4 ml/kg/h. Although the fluid supply was then increased, the dehydration continued, with hypernatremia, normal glycemia, diuresis of 7.4 ml/kg/h and urine density of 1005 mOsmol/l. Thus, a diagnostic hypothesis of diabetes insipidus was raised. A test with a nasal vasopressin analogue (dDAVP was performed and CDI was confirmed. Reduction of the fluid supply became possible through appropriate treatment. CONCLUSION: The diagnosis of CDI is rarely made during the neonatal period, especially in VLBW newborns, because of the difficulty in detecting elevated diuresis. Persistent hypernatremia, usually accompanied by hyperthermia despite abundant fluid supply, weight loss and low urine osmolality are important signs of alert.

  15. The effects of varying protein and energy intakes on the growth and body composition of very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Costa-Orvay Juan Antonio

    2011-12-01

    Full Text Available Abstract Objective To determine the effects of high dietary protein and energy intake on the growth and body composition of very low birth weight (VLBW infants. Study design Thirty-eight VLBW infants whose weights were appropriate for their gestational ages were assessed for when they could tolerate oral intake for all their nutritional needs. Thirty-two infants were included in a longitudinal, randomized clinical trial over an approximate 28-day period. One control diet (standard preterm formula, group A, n = 8, 3.7 g/kg/d of protein and 129 kcal/kg/d and two high-energy and high-protein diets (group B, n = 12, 4.2 g/kg/d and 150 kcal/kg/d; group C, n = 12, 4.7 g/kg/d and 150 kcal/kg/d were compared. Differences among groups in anthropometry and body composition (measured with bioelectrical impedance analysis were determined. An enriched breast milk group (n = 6 served as a descriptive reference group. Results Groups B and C displayed greater weight gains and higher increases in fat-free mass than group A. Conclusion An intake of 150 kcal/kg/d of energy and 4.2 g/kg/d of protein increases fat-free mass accretion in VLBW infants.

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

    Science.gov (United States)

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

    2008-08-01

    This study examined the effects of a standardized hand hygiene program on the rate of nosocomial infection (NI) in very low birth weight (VLBW) infants (birth weight < 1500 g) admitted to our neonatal intensive care unit (NICU). We compared the rate of NI in VLBW infants in 2 separate periods. In the first period, staff were encouraged to perform handwashing using a plain fluid detergent (0.5% triclosan). In the second period, a standardized hand hygiene program was implemented using antimicrobial soap (4% chlorhexidine gluconate) and alcohol-based hand rubs. NI after 72 hours of life was detected in 16 of the 85 VLBW infants in the first period and in 5 of the 80 VLBW infants in the second period. The rate of central venous catheter colonization was significantly lower in the second period (5.8%) than in the first period (16.6%). In our NICU, the incidence of NI in VLBW infants was significantly reduced after the introduction of a standardized handwashing protocol. In our experience, a proper hand hygiene program can save approximately 10 NI episodes/year, at a cost of $10,000 per episode. Therefore, improving hand hygiene practice is a cost-effective program in the NICU.

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

    Science.gov (United States)

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

    2011-08-01

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

  18. A mathematical algorithm for detection of late-onset sepsis in very-low birth weight infants: a preliminary diagnostic test evaluation.

    Science.gov (United States)

    Gur, Ilan; Markel, Gal; Nave, Yaron; Vainshtein, Igor; Eisenkraft, Arik; Riskin, Arieh

    2014-08-01

    To study the diagnostic ability of RALIS (computerized mathematical algorithm and continuous monitoring device) to detect late onset sepsis among very low birth weight preterm neonates. Randomly chosen 24 very low birth weight infants with proven sepsis were compared to 22 infants without sepsis. The clinical parameters were retrospectively collected from the medical records. The ability of RALIS to detect late onset sepsis was calculated. RALIS positively identified 23 of the 24 infants with sepsis (sensitivity 95.8%). It indicated sepsis alert median 2.0 days earlier than clinical suspicion. A false positive alert was indicated in 23% (5/22) infants. The specificity, and positive and negative predictive ability of RALIS were 77.3%. 82.1% and 94.4%, respectively. RALIS may aid in the early diagnosis of late onset sepsis in very low birth weight preterm infants.

  19. Positive Effect of Human Milk Feeding during NICU Hospitalization on 24 Month Neurodevelopment of Very Low Birth Weight Infants: An Italian Cohort Study

    OpenAIRE

    Dino Gibertoni; Luigi Corvaglia; Silvia Vandini; Paola Rucci; Silvia Savini; Rosina Alessandroni; Alessandra Sansavini; Maria Pia Fantini; Giacomo Faldella

    2015-01-01

    The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 very low birth weight newborns (weight ≤ 1500 g) was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths ...

  20. Making a diagnosis of hypertension and defining treatment threshold in very low birth weight infants’ need revision?

    Science.gov (United States)

    Viswanathan, Sreekanth; Kumar, Deepak; Sykes, Craig; Olbrych, Stephanie; Patel, Nishant; Super, Dennis M.; Darusz, Jessica; Raina, Rupesh

    2016-01-01

    Introduction: Recent evidence suggests that preterm birth is a possible risk factor for high blood pressure (BP) in later life. The most widely quoted blood pressure centiles for very low birth weight (VLBW, ≤1500 g birth weight) infants at corrected term gestation is based on a cohort with mostly late preterm or term infants (Zubrow curves). Objectives: The objective of this study was to determine the clinical utility of the Zubrow curves in diagnosis of hypertension in VLBW infants at their term corrected gestational age (CGA). Patients and Methods: In a case-control study, we compared BP in 75 VLBW infants at 40 weeks CGA (cases) to 69 full term infants admitted to neonatal intensive care unit (NICU) (controls). Results: In spite of having lower weights, VLBW infants compared to term infants (2612.8 ± 546 vs. 3308.2 ± 373 g, P ≤ 0.001) had higher average systolic (88.8 ± 7.6 vs. 82.33 ± 8.5 mm Hg; P ≤ 0.001) and mean BP (61.2 ± 6.6 vs. 57.61 ± 6.9, P = 0.01). Although 41% (31/75) VLBW infants would have met the criteria for hypertension according to Zubrow curves only 4% (3/75) were diagnosed with hypertension. Conclusion: Since Zubrow BP centiles were based on a heterogeneous population of infants including preterm and term infants, new BP centiles based on chronological data from VLBW infants would allow a better definition of hypertension in these infants and identify the threshold BP for initiating treatment. PMID:27471735

  1. Preterm prelabor rupture of membranes and outcome of very-low-birth-weight infants in the German Neonatal Network.

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    Kathrin Hanke

    Full Text Available It was the aim of our study to evaluate the independent effect of preterm prelabor rupture of membranes (PPROM as a cause of preterm delivery on mortality during primary hospital stay and significant morbidities in very-low-birth-weight (VLBW infants < 32 weeks of gestation.Observational, epidemiological study design.Population-based cohort, German Neonatal Network (GNN.6102 VLBW infants were enrolled in GNN from 2009-2012, n=4120 fulfilled criteria for primary analysis (< 32 gestational weeks, no pre-eclampsia, HELLP (highly elevated liver enzymes and low platelets syndrome or placental abruption as cause of preterm birth.Multivariable logistic regression analyses included PPROM as potential risk factors for adverse outcomes and well established items such as gestational age in weeks, birth weight, antenatal steroids, center, inborn delivery, multiple birth, gender and being small-for-gestational-age.PPROM as cause of preterm delivery had no independent effect on the risk of early-onset sepsis, clinical sepsis and blood-culture proven sepsis, while gestational age proved to be the most important contributor to sepsis risk. The diagnosis of PPROM was associated with an increased risk for bronchopulmonary dysplasia (BPD; OR: 1.25, 95% CI: 1.02-1.55, p=0.03 but not with other major outcomes.The diagnosis of PPROM per se is not associated with adverse outcome in VLBW infants < 32 weeks apart from a moderately increased risk for BPD. Randomized controlled trials with primary neonatal outcomes are needed to determine which subgroup of VLBW infants benefit from expectant or intentional management of PPROM.

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

    LENUS (Irish Health Repository)

    Moran, M

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    Miletin, J

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    Miletin, J

    2012-02-01

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

  5. [Reduction in necrotising enterocolitis after implementing an evidence-based enteral nutrition protocol in very low birth weight newborns].

    Science.gov (United States)

    Sánchez-Tamayo, Tomás; Espinosa Fernández, María Gracia; Affumicato, Laura; González López, María; Fernández Romero, Verónica; Moreno Algarra, María Concepción; Salguero García, Enrique

    2016-12-01

    An unexpected increase in the incidence of necrotising enterocolitis (NEC) cases was observed in our hospital. Just in case, our feeding policy could be responsible, it was decided to conduct a systematic review and develop a clinical guideline regarding enteral nutrition of very low birth weight infants (VLBW). To assess the impact of the new feeding protocol in the incidence of NEC. A "before" (2011) and "after" (May 2012 - April 2013) study was performed on the new feeding protocol. This included initiation of enteral feeding in the absence of haemodynamic problems, a trophic feeding period of 5-7 days, and subsequent increments of 20-30ml/kg/day, of breast milk/donor human milk from the beginning. Probiotics were not administered. incidence of NEC II 2 Bell's stage. focal intestinal perforation, overall mortality and mortality due to NEC, nosocomial sepsis; weight at 28 days and 36 weeks; % of infants with weight

  6. Early relations between language development and the quality of mother-child interaction in very-low-birth-weight children.

    Science.gov (United States)

    Stolt, S; Korja, R; Matomäki, J; Lapinleimu, H; Haataja, L; Lehtonen, L

    2014-05-01

    It is not clearly understood how the quality of early mother-child interaction influences language development in very-low-birth-weight children (VLBW). We aim to analyze associations between early language and the quality of mother-child interaction, and, the predictive value of the features of early mother-child interaction on language development at 24 months of corrected age in VLBW children. A longitudinal prospective follow-up study design was used. The participants were 28 VLBW children and 34 full-term controls. Language development was measured using different methods at 6, 12 and at 24 months of age. The quality of mother-child interaction was assessed using PC-ERA method at 6 and at 12 months of age. Associations between the features of early interaction and language development were different in the groups of VLBW and full-term children. There were no significant correlations between the features of mother-child interaction and language skills when measured at the same age in the VLBW group. Significant longitudinal correlations were detected in the VLBW group especially if the quality of early interactions was measured at six months and language skills at 2 years of age. However, when the predictive value of the features of early interactions for later poor language performance was analyzed separately, the features of early interaction predicted language skills in the VLBW group only weakly. The biological factors may influence on the language development more in the VLBW children than in the full-term children. The results also underline the role of maternal and dyadic factors in early interactions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Mortality in the first 24h of very low birth weight preterm infants in the Northeast of Brazil

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    Eveline Campos Monteiro de Castro

    2016-03-01

    Full Text Available Abstract Objective: To evaluate factors associated with neonatal death within 24 hours after birth in very low birth weight preterm newborns. Methods: Prospective cohort of live births with gestational age of 230/7–316/7 weeks, birth weight of 500–1499g without malformations, in 19 public maternity hospitals in nine capitals in northeastern Brazil from July to December 2007. The 19 hospitals were assessed in relation to physical resources, equipment, human resources and aiming at quality in care initiatives. Hospital, maternal and neonatal characteristics, neonatal morbidity, neonatal procedures and interventions were compared between preterm newborns that died or survived up to 24 hours of life. The variables associated with death within 24 hours after birth were determined by logistic regression. Results: Of the 627 newborns enrolled in the study, 179 (29% died within 168 hours after birth, of which 59 (33% up to 24 hours and 97 (54% up to 48 hours after birth. The variables associated with death <24h were: weight <1000g (2.94; 1.32–6.53, 5th minute Apgar <7 (7.17; 3.46–14.88, male gender (2.99; 1.39–6.47. A better hospital structure was a protective factor for early neonatal death (odds ratio: 0.34; 95% confidence interval: 0.17–0.71. Conclusions: The high neonatal mortality on the first day of life in capital cities of Northeast Brazil is associated with biological variables such as weight and gender of the newborn, as well as low vitality at birth and a worse infrastructure of the hospital where the birth occurred.

  8. Mortality in the first 24h of very low birth weight preterm infants in the Northeast of Brazil

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    de Castro, Eveline Campos Monteiro; Leite, Álvaro Jorge Madeiro; Guinsburg, Ruth

    2016-01-01

    Abstract Objective: To evaluate factors associated with neonatal death within 24 hours after birth in very low birth weight preterm newborns. Methods: Prospective cohort of live births with gestational age of 230/7–316/7 weeks, birth weight of 500–1499g without malformations, in 19 public maternity hospitals in nine capitals in northeastern Brazil from July to December 2007. The 19 hospitals were assessed in relation to physical resources, equipment, human resources and aiming at quality in care initiatives. Hospital, maternal and neonatal characteristics, neonatal morbidity, neonatal procedures and interventions were compared between preterm newborns that died or survived up to 24 hours of life. The variables associated with death within 24 hours after birth were determined by logistic regression. Results: Of the 627 newborns enrolled in the study, 179 (29%) died within 168 hours after birth, of which 59 (33%) up to 24 hours and 97 (54%) up to 48 hours after birth. The variables associated with death Apgar <7 (7.17; 3.46–14.88), male gender (2.99; 1.39–6.47). A better hospital structure was a protective factor for early neonatal death (odds ratio: 0.34; 95% confidence interval: 0.17–0.71). Conclusions: The high neonatal mortality on the first day of life in capital cities of Northeast Brazil is associated with biological variables such as weight and gender of the newborn, as well as low vitality at birth and a worse infrastructure of the hospital where the birth occurred. PMID:26726002

  9. Blood Culture Proven Early Onset Sepsis and Late Onset Sepsis in Very-Low-Birth-Weight Infants in Korea.

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    Lee, Soon Min; Chang, Meayoung; Kim, Ki-Soo

    2015-10-01

    Neonatal sepsis remains one of the most important causes of death and co-morbidity in very-low-birth-weight (VLBW) infants. The aim of this study was to determine the current incidences of early-onset sepsis (EOS) and late-onset sepsis (LOS), the distribution of pathogens, and the impact of infection on co-morbidities in VLBW infants. We analyzed the data including sepsis episode from 2,386 VLBW infants enrolled in Korean Neonatal Network from January 2013 to June 2014. We defined EOS as a positive blood culture occurring between birth and 7 days of life and LOS after 7 days of life. Sepsis was found in 21.1% of VLBW infants. The risk of sepsis was inversely related to birth weight and gestational age. EOS was found in only 3.6% of VLBW infants, however the mortality rate was as high as 34.1%. EOS was associated with the increased odds for bronchopulmonary dysplasia and intraventricular hemorrhage. The vast majority of EOS was caused by Gram-positive organisms, particularly coagulase-negative staphylococci (30.6%). LOS developed in 19.4% of VLBW infants with a 16.1% mortality rate. Pathogens in LOS were dominated by coagulase-negative staphylococci (38.3%). Twenty-five percent and fifty percent of first LOS episode occurred after 12 days and 20 days from birth, respectively. Younger and smaller VLBW infants showed the earlier occurrence day for the 25% of first LOS episode. This study provides a recent nationwide epidemiology of sepsis in VLBW infants in Korea. Based on this study, successful strategies to reduce infections would improve survival and reduce morbidity.

  10. IL-10, IL-6 and CD14 polymorphisms and sepsis outcome in ventilated very low birth weight infants

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    Yanamandra Krishna

    2006-04-01

    Full Text Available Abstract Background Genetic variation in the innate immune system of the host may play a role in determining the risk of developing infection, as well as outcome from infection. Methods Infectious complications were retrospectively determined in 293 (233 African-American (AA, 57 Caucasian and 3 Hispanic mechanically ventilated very low birth weight (VLBW infants ( Results The IL-6 -174C allele was associated with an increased incidence of late blood stream infection (BSI in AA but not Caucasian infants. In AA infants with the C allele the incidence of late BSI was 20/29 (69% compared to 94/204 (46% in homozygous GG infants (RR 2.6, 95% CI: 1.1–6.0, p = 0.021. The IL-10 -1082A allele was associated with an increased incidence of late BSI. One or more episodes of late BSI developed in 14 (35% of 40 infants with the GG genotype, 71 (49% of 145 infants with the GA genotype and 63 (58% of 108 infants with the AA genotype (p = 0.036. Infants with the A allele (AA or GA genotypes had an incidence of late BSI that was 134/253 (53% compared to 14/40 (35% in homozygous GG infants (RR 2.1, 95% CI: 1.04–4.19, p = 0.035. The CD14 -260 C/T SNP did not alter the overall risk for BSI in ventilated VLBW infants. Multiple BSI episodes were more common in the TT genotype group (CC: 17%, CT: 11%, TT: 30%, p = 0.022. This effect was due to the strong effect of the TT genotype on the incidence of multiple BSI in AA infants (CC: 15%, CT: 11%, TT: 39%, p = 0.003. Conclusion The IL-6 -174 G/C, IL-10 -1082 G/A and CD14 -260 C/T SNPs may alter risk for BSI in ventilated VLBW infants.

  11. Delivery room management of very low birth weight infants in Germany, Austria and Switzerland - a comparison of protocols

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    Roehr CC

    2010-11-01

    Full Text Available Abstract Background Surveys from the USA, Australia and Spain have shown significant inter-institutional variation in delivery room (DR management of very low birth weight infants (VLBWI, Objective To investigate protocols for DR management of VLBWI in Germany, Austria and Switzerland and to compare these with the 2005 ILCOR guidelines. Methods DR management protocols were surveyed in a prospective, questionnaire-based survey in 2008. Results were compared between countries and between academic and non-academic units. Protocols were compared to the 2005 ILCOR guidelines. Results In total, 190/249 units (76% replied. Protocols for DR management existed in 94% of units. Statistically significant differences between countries were found regarding provision of 24 hr in house neonatal service; presence of a designated resuscitation area; devices for respiratory support; use of pressure-controlled manual ventilation devices; volume control by respirator; and dosage of Surfactant. There were no statistically significant differences regarding application and monitoring of supplementary oxygen, or targeted saturation levels, or for the use of sustained inflations. Comparison of academic and non-academic hospitals showed no significant differences, apart from the targeted saturation levels (SpO2 at 10 min. of life. Comparison with ILCOR guidelines showed good adherence to the 2005 recommendations. Summary Delivery room management in German, Austrian and Swiss neonatal units was commonly based on written protocols. Only minor differences were found regarding the DR setup, devices used and the targeted ranges for SpO2 and FiO2. DR management was in good accordance with 2005 ILCOR guidelines, some units already incorporated evidence beyond the ILCOR statement into their routine practice.

  12. Research progress in oropharyngeal administration of colostrum in very low birth weight infants%极低出生体重儿初乳口腔涂抹的研究进展

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    季福婷; 张玉侠

    2016-01-01

    近年来,初乳对于新生儿尤其是早产儿的免疫保护作用越来越为人们所熟知。但是极低出生体重儿由于自身疾病和吞咽乏力等原因早期不能经口喂养,降低了初乳对新生儿的免疫保护作用。为使极低出生体重儿早期即得到来自初乳的保护,有学者提出早期使用初乳对极低出生体重儿进行口腔涂抹。本文将围绕初乳口腔涂抹的理论基础、初乳口腔涂抹的安全性、可行性、操作标准及效果等4个方面进行探讨。%In recent years, more and more people were familiar with the immune protective effect of colostrum on newborn infants, especially on premature infants. But for very low birth weight infants, due to their own disease andimmature, they couldn′t be fed by oral in the early days of life, which reduced the immune protective effect of colostrum on the newborns. In order to make the very low birth weight infants get the protection, some scholarsput forward the earlyoropharyngeal administration of colostrum for very low birth weight infants. This paper would focus on the four aspects of oropharyngeal colostrumadministration, that was theoretical basis,safety, feasibility,operating standards and the effect.

  13. Zinc supplementation reduces morbidity and mortality in very-low-birth-weight preterm neonates: a hospital-based randomized, placebo-controlled trial in an industrialized country.

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    Terrin, Gianluca; Berni Canani, Roberto; Passariello, Annalisa; Messina, Francesco; Conti, Maria Giulia; Caoci, Stefano; Smaldore, Antonella; Bertino, Enrico; De Curtis, Mario

    2013-12-01

    Zinc plays a pivotal role in the pathogenesis of many diseases and in body growth. Preterm neonates have high zinc requirements. The objective of the study was to investigate the efficacy of zinc supplementation in reducing morbidity and mortality in preterm neonates and to promote growth. This was a prospective, double-blind, randomized controlled study of very-low-birth-weight preterm neonates randomly allocated on the seventh day of life to receive (zinc group) or not receive (control group) oral zinc supplementation. Total prescribed zinc intake ranged from 9.7 to 10.7 mg/d in the zinc group and from 1.3 to 1.4 mg/d in the placebo control group. The main endpoint was the rate of neonates with ≥ 1 of the following morbidities: late-onset sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, periventricular leucomalacia, and retinopathy of prematurity. Secondary outcomes were mortality and body growth. We enrolled 97 neonates in the zinc group and 96 in the control group. Morbidities were significantly lower in the zinc group (26.8% compared with 41.7%; P = 0.030). The occurrence of necrotizing enterocolitis was significantly higher in the control group (6.3% compared with 0%; P = 0.014). Mortality risk was higher in the placebo control group (RR: 2.37; 95% CI: 1.08, 5.18; P = 0.006). Daily weight gain was similar in the zinc (18.2 ± 5.6 g · kg⁻¹ · d⁻¹) and control (17.0 ± 8.7 g · kg⁻¹ · d⁻¹) groups (P = 0.478). Oral zinc supplementation given at high doses reduces morbidities and mortality in preterm neonates. This trial was registered in the Australian New Zealand Clinical Trial Register as ACTRN12612000823875.

  14. A multicenter randomized controlled trial comparing effectiveness of two nasal continuous positive airway pressure devices in very-low-birth-weight infants.

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    Bober, Klaudiusz; Świetliński, Janusz; Zejda, Jan; Kornacka, Katarzyna; Pawlik, Dorota; Behrendt, Jakub; Gajewska, Elżbieta; Czyżewska, Małgorzata; Korbal, Piotr; Witalis, Janusz; Walas, Wojciech; Wilińska, Maria; Turzańska, Agnieszka; Zieliński, Grzegorz; Czeszyńska, Beata; Bachman, Thomas

    2012-03-01

    Many studies suggest nasal continuous positive airway pressure is an effective and relatively complication-free means of respiratory support in premature infants. However, only limited data exist regarding the practical aspects of nasal continuous positive airway pressure delivery, including the best way to provide the positive airway pressure. Our aim was to compare the results of treatment using two different nasal continuous positive airway pressure devices: variable flow Infant Flow and constant flow nasal continuous positive airway pressure in two different groups of very-low-birth-weight infants in a multicenter randomized controlled trial. The indication groups were elective to avoid intubation and weaning from mechanical ventilation. Twelve leading tertiary care neonatal centers in Poland. Among 276 infants (weighing between 750-1500g, with a gestational age ≤32 wks) enrolled, 51% were randomized to receive Infant Flow and 49% to receive constant flow nasal continuous positive airway pressure. Treatment success (i.e., no need for intubation/reintubation) occurred in 75% of our patients with a nonstatistically significant advantage seen with Infant Flow. The incidence of severe nasal complications and necrotizing enterocolitis were statistically significantly lower in the infants treated with Infant Flow. In our study, factors associated with elective nasal continuous positive airway pressure failure were birth weight ≤1000 g, gestational age ≤28 wks, clinical risk index for babies score >1, and PaO(2)/FIO(2) ratio of <150. Only birth weight ≤1000 g was associated with weaning failure. We found fewer severe nasal complications but no statistically significant advantage in treatment success in infants assigned to Infant Flow nasal continuous positive airway pressure compared with those assigned to constant flow nasal continuous positive airway pressure treatment. Significant risk factors of treatment failure include small size, maturity, and severity

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  16. Taiwanese women's experiences of becoming a mother to a very-low-birth-weight preterm infant: a grounded theory study.

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    Lee, Shu-Nu Chang; Long, Ann; Boore, Jennifer

    2009-03-01

    Significant improvements have occurred in the survival rates of small preterm infants. As more infants survive their preterm birth, the number of parents associated with this experience has also increased. Clearly, the birth of very-low-birth-weight (VLBW) preterm infants poses considerable challenges for all mothers. These challenges are further compounded in Taiwan, where women are traditionally required to practise the cultural ritual (Zuo Yue Zi) which includes confinement to the house with a special balanced diet for the first month postnatally. Moreover, there is a deficit of information on mothers' experiences when their preterm infants are in neonatal intensive care units (NICUs). The aim of this study was to explore Taiwanese mothers' (n=26) parenting experiences when their preterm infants were in NICUs. A qualitative research approach, grounded theory, was used to explore the mothers' lived reality of these experiences. In-depth interviews and participant observations were conducted to gain insight into the experience of parenting. A theoretical model was formulated from the findings delineating Taiwanese mothers' parenting experiences during their preterm infants stay in hospital. The findings indicated that the preterm birth, together with the admission of their infants to a NICU, presented mothers with an unexpected crisis. The particular cultural postnatal ritual posed this group of Taiwanese mothers with an additional difficulty in establishing physical interactions. However, the Taiwanese mothers created alternative channels of contact with their hospitalised infants using emotional connections, while the physical interactions were certainly limited. Despite all the difficulties this group of Taiwanese mothers faced and resolved, they all gradually captured and embraced the parenting role. The finding of this study further indicated that the support the mothers received from the healthcare professionals and the social networks the mothers made

  17. Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocolitis in Very Low-Birth-Weight Infants.

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    Patel, Ravi M; Knezevic, Andrea; Shenvi, Neeta; Hinkes, Michael; Keene, Sarah; Roback, John D; Easley, Kirk A; Josephson, Cassandra D

    2016-03-01

    Data regarding the contribution of red blood cell (RBC) transfusion and anemia to necrotizing enterocolitis (NEC) are conflicting. These associations have not been prospectively evaluated, accounting for repeated, time-varying exposures. To determine the relationship between RBC transfusion, severe anemia, and NEC. In a secondary, prospective, multicenter observational cohort study from January 2010 to February 2014, very low-birth-weight (VLBW, ≤1500 g) infants, within 5 days of birth, were enrolled at 3 level III neonatal intensive care units in Atlanta, Georgia. Two hospitals were academically affiliated and 1 was a community hospital. Infants received follow-up until 90 days, hospital discharge, transfer to a non-study-affiliated hospital, or death (whichever came first). Multivariable competing-risks Cox regression was used, including adjustment for birth weight, center, breastfeeding, illness severity, and duration of initial antibiotic treatment, to evaluate the association between RBC transfusion, severe anemia, and NEC. The primary exposure was RBC transfusion. The secondary exposure was severe anemia, defined a priori as a hemoglobin level of 8 g/dL or less. Both exposures were evaluated as time-varying covariates at weekly intervals. Necrotizing enterocolitis, defined as Bell stage 2 or greater by preplanned adjudication. Mortality was evaluated as a competing risk. Of 600 VLBW infants enrolled, 598 were evaluated. Forty-four (7.4%) infants developed NEC. Thirty-two (5.4%) infants died (all cause). Fifty-three percent of infants (319) received a total of 1430 RBC transfusion exposures. The unadjusted cumulative incidence of NEC at week 8 among RBC transfusion-exposed infants was 9.9% (95% CI, 6.9%-14.2%) vs 4.6% (95% CI, 2.6%-8.0%) among those who were unexposed. In multivariable analysis, RBC transfusion in a given week was not significantly related to the rate of NEC (adjusted cause-specific hazard ratio, 0.44 [95% CI, 0.17-1.12]; P = .09). Based

  18. Performance of a Novel Molecular Method in the Diagnosis of Late-Onset Sepsis in Very Low Birth Weight Infants.

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    Jonathan Davis

    Full Text Available To compare the use of a generic molecular assay to 'standard' investigations used to assist the diagnosis of late onset bacterial sepsis in very low birth weight infants (VLBW, <1500 g.VLBW infants, greater than 48 hours of age, who were clinically suspected to have sepsis were investigated using standard tests (full blood count, C-reactive protein (at presentation and blood culture, in addition, blood was taken for a universal molecular assay (16S rRNA reverse transcriptase PCR for comparison. Clinical data were recorded during the suspected infection episode. A validated sepsis score (NEO-KISS was used to retrospectively determine the presence of sepsis (independent of blood culture. The performance of each of the tests were compared by sensitivity, specificity, positive/negative likihood ratios (+/-LR and postive/negative predictive values (PPV/NPV.Sixty-five babies with suspected clinical sepsis were prospectively included. The performance indicators are presented with 95% confidence limits. For the detection of bacteria, blood culture had sensitivity of 0.57 (0.34-0.78, specificity of 0.45 (0.30-0.61; +LR of 1.05 (0.66-1.66 and-LR of 0.94 (0.52-1.7; PPV of 33.3 (18.56-50.97 and NPV of 68.97 (49.17-87.72. Serum CRP had sensitivity of 0.92 (0.64-1 and specificity of 0.36 (0.17-0.59; +LR of 1.45 (1-2.1 and-LR of 0.21 (0.03-1.5; PPV of 44.46 (26.6-66.6 and NPV of 88.9 (51.8-99.7. The universal molecular assay had sensitivity of 0.76 (0.53-0.92, specificity of 0.95 (0.85-0.99; +LR of 16.8 (4.2-66.3 and-LR of 0.25 (0.1-0.5; PPV of 88.9 (65.3-98.6 and NPV of 89.4 (76.9-96.5.In VLBW infants this universal molecular assay performed better in the diagnosis of late onset sepsis (LOS than blood culture and CRP. Further development is required to explore and improve the performance of the assay in real-time diagnosis.

  19. Association Between Antibiotic Use and Neonatal Mortality and Morbidities in Very Low-Birth-Weight Infants Without Culture-Proven Sepsis or Necrotizing Enterocolitis.

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    Ting, Joseph Y; Synnes, Anne; Roberts, Ashley; Deshpandey, Akhil; Dow, Kimberly; Yoon, Eugene W; Lee, Kyong-Soon; Dobson, Simon; Lee, Shoo K; Shah, Prakesh S

    2016-12-01

    Excessive antibiotic use has been associated with altered bacterial colonization and may result in antibiotic resistance, fungemia, necrotizing enterocolitis (NEC), and mortality. Exploring the association between antibiotic exposure and neonatal outcomes other than infection-related morbidities may provide insight on the importance of rational antibiotic use, especially in the setting of culture-negative neonatal sepsis. To evaluate the trend of antibiotic use among all hospitalized very low-birth-weight (VLBW) infants across Canada and the association between antibiotic use rates (AURs) and mortality and morbidity among neonates without culture-proven sepsis or NEC. A retrospective cohort study was conducted among VLBW infants (neonatal intensive care units between January 1, 2010, and December 31, 2014, using data obtained from the Canadian Neonatal Network database. Duration of antibiotic use during the hospitalization period. The AUR was defined as the number of days an infant was exposed to 1 or more antimicrobial agents divided by the total length of hospital stay. The composite primary outcome was defined as mortality or major morbidity, including any of the following: persistent periventricular echogenicity or echolucency on neuroimaging, chronic lung disease, and stage 3 or higher retinopathy of prematurity. Multivariable regression analysis was used to calculate adjusted odds ratios (aORs) and 95% CIs for the association between AURs and outcomes. Among 13 738 eligible VLBW infants, 11 669 (84.9%) (mean [SD] gestational age, 27.7 [2.5] weeks; 47.4% female) received antibiotics during their hospital course and were included in the study. The annual AUR decreased from 0.29 in 2010 to 0.25 in 2014 (slope for the best-fit line, -0.011; 95% CI, -0.016 to -0.006; P sepsis from 19.0% in 2010 to 13.8% in 2014 during the same period. Of the 11 669 infants who were treated with antibiotics of varying duration during their hospital stay, 2845 were diagnosed

  20. Weight-based policy of hepatitis B vaccination in very low birth weight infants in Taiwan: a retrospective cross-sectional study.

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    Chien-Yi Chen

    Full Text Available BACKGROUND: The current recommendation of giving the first dose of hepatitis B vaccine to very low birth weight (VLBW infants at 30 days of chronologic age usually is not practical, because most VLBW infants are not medically stable at that age. We use an alternative body-weight-based protocol, and evaluate its efficacy in an endemic area under a universal immunization program. METHODS: The immunogenicity of the current hepatitis B vaccination strategy in 155 VLBW preterm infants was evaluated at age 2 to 13 years, with parental consent. All of the infants were born between 1995 and 2006, and received their first dose of hepatitis B vaccine when they reached 2,000-2,200 g, irrespective of chronological age. Hepatitis B immunoglobulin (HBIG was given at birth to infants born to HBsAg(+/HBeAg(+ mothers. RESULTS: All 155 of the recruited children were HBsAg and anti-HBc negative. The anti-HBs seropositivity rate (geometric mean titer was 84.1% (146.5 mIU/mL for children under 3 years, 73.5% (68.8 mIU/mL for 4- to 7-year-olds, 27.7% (55.4 mIU/mL for 8- to 11-year-olds and 20% (6.0 mIU/mL for children ≥12 years of age. More than 90% of these children received the first vaccination after 30 days of age, half (51% at 60 to 90 days, and 29 children (18.6% after 90 days of age. Of the 26 infants born to HBsAg(+ mothers, 6/6 infants of HBeAg(+ mothers received HBIG at birth, and 12/20 infants of HBeAg(- mothers received HBIG. None of the 26 infants became infected. CONCLUSIONS: Delaying hepatitis B vaccinations in VLBW preterm infants until they reach a weight of 2,000 g, with the administration of HBIG at birth for infants of HBsAg(+ mothers provided adequate immunogenicity and protection in a highly endemic area. Weight-based policy of hepatitis B vaccination is an effective and practical alternative strategy for VLBW infants.

  1. [Nutrition and Metabolism Group of the Spanish Neonatology Society: recommendations and evidence for dietary supplementation with probiotics in very low birth weight infants].

    Science.gov (United States)

    Narbona López, E; Uberos Fernández, J; Armadá Maresca, M I; Couce Pico, M L; Rodríguez Martínez, G; Saenz de Pipaon, M

    2014-12-01

    Clinical practice guidelines are an important tool for improving healthcare. In recent years there has been accumulating evidence on the impact of nutritional supplementation with probiotics in the very low birth weight infants. With no uniformity in microorganisms and strains used. The Spanish Neonatology Society (SENeo), through its Nutrition and Metabolism Group has undertaken to develop recommendations that will be useful as a guide for the neonatologist in this field.

  2. Salivary and serum cortisol and relation to blood pressure in infancy and early childhood in very-low-birth-weight infants.

    Science.gov (United States)

    de Jong, Miranda; Cranendonk, Anneke; van Weissenbruch, Mirjam M

    2015-10-01

    Programming of the hypothalamic-pituitary-adrenal (HPA) axis possibly explains the relation between intrauterine growth restriction (IUGR) and/or preterm birth and elevated blood pressure in later life. Very-low-birth-weight infants (birth weight blood pressure, already in early childhood. We investigated cortisol levels, relation to blood pressure and reliability of salivary cortisol in infancy and early childhood in very-low-birth-weight infants. We included 41 children, participating in the randomized controlled Neonatal Insulin Replacement Therapy in Europe (NIRTURE) trial. Serum and salivary samples for cortisol measurement (immunoassay) were taken simultaneously at 6 mo and separately at 2 y corrected age. Blood pressure was measured at 2 y corrected age. Serum cortisol was significantly correlated to systolic and diastolic blood pressure in boys and in the early-insulin treated group. At 2 y corrected age serum cortisol was significantly higher in the early-insulin group compared to the standard care group. At 6 mo corrected age salivary cortisol was significantly correlated to serum cortisol. In very-low-birth-weight boys, the positive correlation between cortisol and blood pressure is present at 2 y corrected age. Early insulin therapy could affect programming of the HPA axis. Salivary cortisol mirrors serum levels at 6 mo corrected age.

  3. Inhaled versus systemic corticosteroids for preventing chronic lung disease in ventilated very low birth weight preterm neonates.

    Science.gov (United States)

    Shah, Sachin S; Ohlsson, Arne; Halliday, Henry L; Shah, Vibhuti S

    2012-05-16

    Chronic lung disease (CLD) remains an important cause of mortality and morbidity in preterm infants and inflammation plays an important role in its pathogenesis. The use of inhaled corticosteroids may modulate the inflammatory process without concomitant high systemic steroid concentrations and less risk of adverse effects. To determine the effect of inhaled versus systemic corticosteroids started within the first two weeks of life on preventing CLD in ventilated very low birth weight (VLBW) infants. Randomised and quasi-randomised trials were identified by searching The Cochrane Library, MEDLINE , EMBASE , CINAHL, reference lists of published trials and abstracts published in Pediatric Research or electronically on the Pediatric Academic Societies web site in June 2007.This search was updated in June 2011 and included additional searches of Clinicaltrials.gov, Controlled-trials.com and Web of Science. Randomised or quasi-randomised clinical trials comparing inhaled versus systemic corticosteroid therapy (regardless of the dose and duration of therapy) started in the first two weeks of life in VLBW infants receiving assisted ventilation. Outcomes including CLD at 28 days or 36 weeks postmenstrual age (PMA), mortality, the combined outcome of death or CLD at 28 days or 36 weeks PMA, other pulmonary outcomes and adverse effects were evaluated. All data were analysed using RevMan 5.1. Meta-analyses were performed using relative risk (RR), risk difference (RD), and mean difference (MD) with their 95% confidence intervals (CI). If RD was significant, the numbers needed to benefit (NNTB) or to harm (NNTH) were calculated. No new trials were identified in this update. Two trials qualified for inclusion in this review. The incidence of CLD at 36 weeks PMA was increased (of borderline statistical significance) in the inhaled steroid group [RR 1.45 (95% CI 0.99 to 2.11); RD 0.11 (95% CI 0.00 to 0.21), p = 0.05, one trial, n = 278]. The incidence of CLD at 36 weeks PMA among

  4. Epidemic microclusters of blood-culture proven sepsis in very-low-birth weight infants: experience of the German Neonatal Network.

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    Christoph Härtel

    Full Text Available INTRODUCTION: We evaluated blood culture-proven sepsis episodes occurring in microclusters in very-low-birth-weight infants born in the German Neonatal Network (GNN during 2009-2010. METHODS: Thirty-seven centers participated in GNN; 23 centers enrolled ≥50 VLBW infants in the study period. Data quality was approved by on-site monitoring. Microclusters of sepsis were defined as occurrence of at least two blood-culture proven sepsis events in different patients of one center within 3 months with the same bacterial species. For microcluster analysis, we selected sepsis episodes with typically cross-transmitted bacteria of high clinical significance including gram-negative rods and Enterococcus spp. RESULTS: In our cohort, 12/2110 (0.6% infants were documented with an early-onset sepsis and 235 late-onset sepsis episodes (≥72 h of age occurred in 203/2110 (9.6% VLBW infants. In 182/235 (77.4% late-onset sepsis episodes gram-positive bacteria were documented, while coagulase negative staphylococci were found to be the most predominant pathogens (48.5%, 95%CI: 42.01-55.01. Candida spp. and gram-negative bacilli caused 10/235 (4.3%, 95%CI: 1.68% -6.83% and 43/235 (18.5% late-onset sepsis episodes, respectively. Eleven microclusters of blood-culture proven sepsis were detected in 7 hospitals involving a total 26 infants. 16/26 cluster patients suffered from Klebsiella spp. sepsis. The median time interval between the first patient's Klebsiella spp. sepsis and cluster cases was 14.1 days (interquartile range: 1-27 days. First patients in the cluster, their linked cases and sporadic sepsis events did not show significant differences in short term outcome parameters. DISCUSSION: Microclusters of infection are an important phenomenon for late-onset sepsis. Most gram-negative cluster infections occur within 30 days after the first patient was diagnosed and Klebsiella spp. play a major role. It is essential to monitor epidemic microclusters of sepsis in

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

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    Gopal K. Singh

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    余华娟

    2013-01-01

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

  7. Effects of a very low birth weight newborn on family: literature review Efectos del peso extremadamente bajo al nacimiento sobre la familia: revisión bibliográfica

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    T. Konstantyner

    2007-04-01

    Full Text Available Objective: The present study is a literature review to identify the effects of a very low birth weight newborn on family. This is an important instrument to clarify epidemiological issues and to suggest the directions for health policy efforts. Method: A three-step review was carried out using databases of journals indexed for Medline/Lilacs/Scielo/Cochrane published between 1966 and 2005 using specific criteria of inclusion. The first step selected 12 articles from 2,889 when searching for the keyword "very low birth weight infant"; the second step used the crossing of keyword "premature infant" with other pertinent keywords and terms resulting in 191 articles generating 7 more articles matching the criteria of inclusion. The third step was to analyze the references of articles in steps 1 and 2 (12 + 7 = 19, selecting 3 additional ones totalizing 22 selected articles. Result: Evidences in literature state that the families of very low birth weight newborns suffer potential negative effects on their operational dynamics, which is associated to the clinical seriousness, the age and the neuropsycomotor development of such children. It seems that the mother is the most affected member due to the situation imposed to the family, and the one who needs psychosocial support more frequently. Conclusion: The number of existing studies is still insufficient to clarify whether the effects on the family considering all their aspects are preponderantly positive or negative.Objetivo: este estudio es una revisión bibliográfica para intentar identificar los efectos que el recién nacido de peso muy bajo tiene en una familia. Este es un instrumento importante para aclarar los aspectos epidemiológicos y sugerir las directrices en los esfuerzos de políticas sanitaria. Método: se realizó una revisión en tres pasos empleando las bases de datos de las revistas indexadas en Medline/Lilacs/Scielo/Cochrane con fecha de publicación entre 1966 y 2005, utilizando

  8. A randomised controlled trial of early insulin therapy in very low birth weight infants, "NIRTURE" (neonatal insulin replacement therapy in Europe

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    Cornette Luc

    2007-08-01

    Full Text Available Abstract Background Studies in adult intensive care have highlighted the importance of insulin and improved glucose control on survival, with 32% reduction in mortality, 22% reduction in intensive care stay and halving of the incidence of bacteraemia. Very low birth weight infants requiring intensive care also have relative insulin deficiency often leading to hyperglycaemia during the first week of life. The physiological influences on insulin secretion and sensitivity, and the potential importance of glucose control at this time are not well established. However there is increasing evidence that the early postnatal period is critical for pancreatic development. At this time a complex set of signals appears to influence pancreatic development and β cell survival. This has implications both in terms of acute glucose control but also relative insulin deficiency is likely to play a role in poor postnatal growth, which has been associated with later motor and cognitive impairment, and fewer β cells are linked to risk of type 2 diabetes later in life. Methods A multi-centre, randomised controlled trial of early insulin replacement in very low birth weight babies (VLBW, birth weight Trial Registration Current Controlled Trials ISRCTN78428828. EUDRACT Number 2004-002170-34

  9. Age of sitting unsupported and independent walking in very low birth weight preterm infants with normal motor development at 2 years.

    Science.gov (United States)

    Marín Gabriel, M A; Pallás Alonso, C R; De La Cruz Bértolo, J; Caserío Carbonero, S; López Maestro, M; Moral Pumarega, M; Alonso Díaz, C; Lora Pablos, D

    2009-11-01

    The aims of this study is to (i) determine the age of sitting unsupported and independent walking in preterm infants with birth weight under 1500 g (very low birth weight, VLBW); (ii) estimate differences between VLBW children and a reference population and (iii) estimate the association between clinical characteristics and late age at sitting and walking. A longitudinal study was conducted of a cohort of 876 children with VLBW. The World Health Organization (WHO) motor development study population was used as a reference. Ages for both skills were established by interview with parents. Means were compared with t-test, ANOVA and Bonferroni adjustment where appropriate. The inclusion criteria were complied with 694 patients; 50% of VLBW sat at 7 m corrected age (CA) and walked at 13 m CA. Both motor skills were acquired later (7.3 +/- 1.5 and 13.6 +/- 2.8 m) compared with the control group (6 +/- 1.1 and 12.1 +/- 1.8 m). Weight or head circumference at birth below the 10th percentile or the presence of bronchopulmonary dysplasia were associated with delayed acquisition of both skills. Very low birth weight infants typically sit unsupported and walk later than term infants. Tables describing reference values for milestones acquisition for different categories of infants (gestational age, birth weight and other determinants) may contribute to inform the decision making process on access to available resources.

  10. Brain microstructural development at near-term age in very-low-birth-weight preterm infants: an atlas-based diffusion imaging study.

    Science.gov (United States)

    Rose, Jessica; Vassar, Rachel; Cahill-Rowley, Katelyn; Guzman, Ximena Stecher; Stevenson, David K; Barnea-Goraly, Naama

    2014-02-01

    At near-term age the brain undergoes rapid growth and development. Abnormalities identified during this period have been recognized as potential predictors of neurodevelopment in children born preterm. This study used diffusion tensor imaging (DTI) to examine white matter (WM) microstructure in very-low-birth-weight (VLBW) preterm infants to better understand regional WM developmental trajectories at near-term age. DTI scans were analyzed in a cross-sectional sample of 45 VLBW preterm infants (BW≤1500g, GA≤32weeks) within a cohort of 102 neonates admitted to the NICU and recruited to participate prior to standard-of-care MRI, from 2010 to 2011, 66/102 also had DTI. For inclusion in this analysis, 45 infants had DTI, no evidence of brain abnormality on MRI, and were scanned at PMA ≤40weeks (34.7-38.6). White matter microstructure was analyzed in 19 subcortical regions defined by DiffeoMap neonatal brain atlas, using threshold values of trace 0.15. Regional fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated and temporal-spatial trajectories of development were examined in relation to PMA and brain region location. Posterior regions within the corona radiata (CR), corpus callosum (CC), and internal capsule (IC) demonstrated significantly higher mean FA values compared to anterior regions. Posterior regions of the CR and IC demonstrated significantly lower RD values compared to anterior regions. Centrally located projection fibers demonstrated higher mean FA and lower RD values than peripheral regions including the posterior limb of the internal capsule (PLIC), cerebral peduncle, retrolenticular part of the IC, posterior thalamic radiation, and sagittal stratum. Centrally located association fibers of the external capsule had higher FA and lower RD than the more peripherally-located superior longitudinal fasciculus (SLF). A significant relationship between PMA-at-scan and FA, MD, and RD was

  11. Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus

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    Lilian S.R. Sadeck

    2014-12-01

    Full Text Available OBJECTIVE: To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g with patent ductus arteriosus (PDA, from the Brazilian Neonatal Research Network (BNRN on: death, bronchopulmonary dysplasia (BPD, severe intraventricular hemorrhage (IVH III/IV, retinopathy of prematurity requiring surgical (ROPsur, necrotizing enterocolitis requiring surgery (NECsur, and death/BPD. METHODS: This was a multicentric cohort study, retrospective data collection, including newborns (BW < 1000 g with gestational age (GA < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 - conservative approach (without treatment, G2 - pharmacologic (indomethacin or ibuprofen, G3 - surgical ligation (independent of previous treatment. Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II, respiratory distress syndrome (RDS, late sepsis (LS, mechanical ventilation (MV, surfactant (< 2 h of life, and time of MV. Outcomes: death, O2 dependence at 36 weeks (BPD36wks, IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Statistics: Student's t-test, chi-squared test, or Fisher's exact test; Odds ratio (95% CI; logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator software, version 12.1.4.0. p-values < 0.05 were considered statistically significant. RESULTS: 1,097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%, G2 - 205 (41.5%, and G3 - 102 (20.6%. The highest mortality was observed in G1 (51.3% and the lowest in G3 (14.7%. The highest frequencies of BPD36wks (70.6% and ROPsur were observed in G3 (23.5%. The lowest occurrence of

  12. Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants.

    Science.gov (United States)

    Almadhoob, Abdulraoof; Ohlsson, Arne

    2015-01-30

    dysplasia, intraventricular haemorrhage, periventricular leukomalacia, retinopathy of prematurity).2. To evaluate the effects of sound reduction on sleep patterns at three months of age.3. To evaluate the effects of sound reduction on staff performance.4. To evaluate the effects of sound reduction in the neonatal intensive care unit (NICU) on parents' satisfaction with the care. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, CINAHL, abstracts from scientific meetings, clinical trials registries (clinicaltrials.gov; controlled-trials.com; and who.int/ictrp), Pediatric Academic Societies Annual meetings 2000 to 2014 (Abstracts2View(TM)), reference lists of identified trials, and reviews to November 2014. Preterm infants (sound reduction. We made a deviation from our protocol and included this study in which some infants would have been > 48 hours old. There was no significant difference in weight at 34 weeks postmenstrual age (PMA): mean difference (MD) 111 g (95% confidence interval (CI) -151 to 374 g) (n = 23). There was no significant difference in weight at 18 to 22 months corrected age between the groups: MD 0.31 kg, 95% CI -1.53 to 2.16 kg (n = 14). There was a significant difference in Mental Developmental Index (Bayley II) favouring the silicone earplugs group at 18 to 22 months corrected age: MD 14.00, 95% CI 3.13 to 24.87 (n = 12), but not for Psychomotor Development Index (Bayley II) at 18 to 22 months corrected age: MD -2.16, 95% CI -18.44 to 14.12 (n =12). To date, only 34 infants have been enrolled in a randomised controlled trial (RCT) testing the effectiveness of reducing sound levels that reach the infants' ears in the NICU. Based on the small sample size of this single trial, we cannot make any recommendations for clinical practice. Larger, well designed, conducted and reported trials are needed.

  13. Unique risks of red blood cell transfusions in very-low-birth-weight neonates: associations between early transfusion and intraventricular hemorrhage and between late transfusion and necrotizing enterocolitis.

    Science.gov (United States)

    Christensen, Robert D; Baer, Vickie L; Del Vecchio, Antonio; Henry, Erick

    2013-10-01

    Red blood cell transfusions can be life-saving for neonates with severe anemia or active hemorrhage. However, risks of transfusions exist and should always be weighed against potential benefits. At least two transfusion risks are unique to very low birth weight neonates. The first is an association between transfusions given in the first days after birth and the subsequent occurrence of a grade 3 or 4 intraventricular hemorrhage. The second is an association between "late" RBC transfusions and the subsequent occurrence of necrotizing enterocolitis. Much remains to be discovered about the pathogenesis of these two outcomes. Moreover, work is needed to clearly establish whether transfusions are causatively-associated with these outcomes or are co-variables. This review will provide basic data establishing these associations and propose mechanistic explanations.

  14. A Fortified Donor Milk Policy is Associated With Improved In-Hospital Head Growth and Weight Gain in Very Low-Birth-Weight Infants.

    Science.gov (United States)

    Ginovart, Gemma; Gich, Ignasi; Gutiérrez, Antonio; Verd, Sergio

    2017-08-01

    Previous research has reported that infants fed donor milk grow slower than those fed formula. However, most of the trials used unfortified donor milk, which limits the ability to generalize the results to current clinical practice. To evaluate the impact of early human milk feeding (donor milk and/or mother's own milk) with standard fortification on in-hospital growth of very low-birth-weight infants. This pre-/postretrospective study included selected newborn infants less than 1500 g admitted to a level IV neonatal intensive care unit before and after the introduction of a policy providing donor milk when mother's own milk was not available in sufficient quantity to meet her infant's need. When enteral feeds reached 80 mL/kg per day, all human milk was fortified. Seventy-two "before" (any formula-fed) and 114 "after" (human milk-fed) infants were enrolled in this study. Infant characteristics and neonatal morbidity were similar in both groups. Outcomes revealed that an initial human milk diet with standard fortification was associated with significantly higher early extrauterine weight gain and head growth in very low-birth-weight infants than a formula-fed diet. Very early initiation of fortified breast and/or donor milk feeding can help promote in-hospital head growth and weight gain of preterm infants. Formula may not be appropriate for early use among preterm infants. Further large-scale clinical trials are needed to determine the best initiation and composition of enteral feeding for preterm infants.

  15. Positive effect of human milk feeding during NICU hospitalization on 24 month neurodevelopment of very low birth weight infants: an Italian cohort study.

    Science.gov (United States)

    Gibertoni, Dino; Corvaglia, Luigi; Vandini, Silvia; Rucci, Paola; Savini, Silvia; Alessandroni, Rosina; Sansavini, Alessandra; Fantini, Maria Pia; Faldella, Giacomo

    2015-01-01

    The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 very low birth weight newborns (weight ≤ 1500 g) was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths Mental Development Scale. The effect of human milk nutrition on neurodevelopment was first investigated using a multiple linear regression model, to adjust for the effects of gestational age, small for gestational age, complications at birth and during hospitalization, growth restriction at discharge and socio-economic status. Path analysis was then used to refine the multiple regression model, taking into account the relationships among predictors and their temporal sequence. Human milk feeding during NICU hospitalization and higher socio-economic status were associated with better neurodevelopment at 24 months in both models. In the path analysis model intraventricular hemorrhage-periventricular leukomalacia and growth restriction at discharge proved to be directly and independently associated with poorer neurodevelopment. Gestational age and growth restriction at birth had indirect significant effects on neurodevelopment, which were mediated by complications that occurred at birth and during hospitalization, growth restriction at discharge and type of feeding. In conclusion, our findings suggest that mother's human milk feeding during hospitalization can be encouraged because it may improve neurodevelopment at 24 months corrected age.

  16. Positive effect of human milk feeding during NICU hospitalization on 24 month neurodevelopment of very low birth weight infants: an Italian cohort study.

    Directory of Open Access Journals (Sweden)

    Dino Gibertoni

    Full Text Available The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 very low birth weight newborns (weight ≤ 1500 g was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths Mental Development Scale. The effect of human milk nutrition on neurodevelopment was first investigated using a multiple linear regression model, to adjust for the effects of gestational age, small for gestational age, complications at birth and during hospitalization, growth restriction at discharge and socio-economic status. Path analysis was then used to refine the multiple regression model, taking into account the relationships among predictors and their temporal sequence. Human milk feeding during NICU hospitalization and higher socio-economic status were associated with better neurodevelopment at 24 months in both models. In the path analysis model intraventricular hemorrhage-periventricular leukomalacia and growth restriction at discharge proved to be directly and independently associated with poorer neurodevelopment. Gestational age and growth restriction at birth had indirect significant effects on neurodevelopment, which were mediated by complications that occurred at birth and during hospitalization, growth restriction at discharge and type of feeding. In conclusion, our findings suggest that mother's human milk feeding during hospitalization can be encouraged because it may improve neurodevelopment at 24 months corrected age.

  17. Lesões isquêmicas cerebrais no recém-nascido pré-termo de muito baixo peso Ischemic brain damage in very low birth weight preterm newborn infants

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    Rita C. Silveira

    2005-03-01

    Full Text Available OBJETIVO: Apresentar uma revisão crítica e atualizada sobre as lesões cerebrais isquêmicas no recém-nascido pré-termo de muito baixo peso. FONTES DE DADOS: As referências foram obtidas através do banco de dados MEDLINE, sendo selecionadas as mais representativas a critério dos autores. SÍNTESE DOS DADOS: A hemorragia com evolução para lesão isquêmica cerebral, a leucomalácia periventricular cística e a lesão difusa da substância branca cerebral são as lesões isquêmicas mais freqüentes em recém-nascidos pré-termo de muito baixo peso. Todas são doenças de causas multifatoriais, em que podem estar envolvidos fatores vasculares, hemodinâmicos, inflamatórios e infecciosos. São doenças que podem causar seqüelas neuropsicomotoras importantes e levar à paralisia cerebral e/ou déficit cognitivo e comportamental. CONCLUSÕES: O diagnóstico precoce e uma estratégia terapêutica adequada podem minimizar as seqüelas causadas por essas doenças. A prevenção da prematuridade é a principal medida preventiva a ser tomada.OBJECTIVE: To present a critical and up-to-date review of ischemic brain damage in premature, very low birth weight infants. SOURCES OF DATA: Articles were obtained by means of a search of the MEDLINE database, with those considered most representative by the authors being selected. SUMMARY OF THE FINDINGS: The most frequent ischemic injuries among preterm, very low birth weight neonates are hemorrhage progressing to with ischemic brain damage, cystic periventricular leukomalacia and diffuse lesions of the cerebral white matter. All of these conditions have multiple causative factors, which may include vascular, hemodynamic, inflammatory and infectious factors. These are disorders that can cause significant neuropsychomotor sequelae and lead to cerebral palsy and/or cognitive and behavioral deficits. CONCLUSIONS: Early diagnosis and adequate management of the patient can minimize long-term problems caused

  18. Growth Rate of Very Low Birth Weight Preterm Children and Influencing Factors%极低出生体重早产儿的生长速率和影响因素

    Institute of Scientific and Technical Information of China (English)

    丁凤

    2014-01-01

    目的:探讨影响极低出生体重早产儿生长速率的影响因素,以更好地指导极低出生体重早产儿的治疗。方法选择我院NICU病室收治的198例极低出生体重早产儿为对象,按照患儿出生后生长速率是否≥15 g·kg-1·d-1,将患儿分为正常生长组和缓慢生长组。其中:正常组患儿76例,缓慢生长组122例。统计患儿出生胎龄、出生时体重、氨基酸开始日龄、氨基酸总量、脂肪乳开始日龄、脂肪乳总量、开始喂养日龄、总热卡达120 kcal·kg-1·d-1日龄和奶量达150 mL·kg-1·d-1日龄,并采用单因素分析方法,探讨影响极低出生体重早产儿生长速率的因子。结果患儿在出生第1周体重下降,从第2周开始体重一直增长。单因素结果表明:出生时体重、氨基酸总量、脂肪乳总量、开始喂养时间、奶量达标时间、总热卡达标时间是影响极低出生体重早产儿生长速率的显著性因素(P 0.05)。结论对于极低出生体重早产儿采取积极的营养支持策略,可以有效地促进患儿生长。%Objective To investigate the factors that influence VLBW children's growth rate to better guide VLBW children's treatment. Methods 198 cases of very low birth weight preterm children were divided into normal-growth group (76 cases) and slow-growth group (122 cases), according to whether the growth rate of children born≥15 g·kg-1·d-1. The birth gestational age, birth weight, age of amino acids beginning, the total amount of amino acids, age of fat emulsion beginning, total amount of fat milk, age of start feeding, age of total heat Qatar 120 kcal·kg-1·d-1 and age of milk capacity of 150 mL·kg-1·d-1 were analysed. By single-factor analysis, we explored the influencing factors of very low birth weight preterm children growth rate. Results Children born in the first week in weight loss, weight from the first two weeks has started to grow. Univariate results showed

  19. Leche humana y nutrición en el prematuro pequeño Human milk and very low birth weight nutrition

    Directory of Open Access Journals (Sweden)

    G. Torres

    2004-07-01

    con bacteriología ("Programa Lactario de 24 Horas". Resultados: La alimentación precoz con leche humana (nutrición enteral trófica y con fortificadores de leche humana mejoró la tolerancia enteral, y disminuyó los días en recuperar el peso de nacimiento, los días de ayuno y también el tiempo en alcanzar el aporte enteral total, todos de manera significativa. Las extracciones frecuentes de leche humana aumentaron el volumen disponible para aportar a los recién nacidos y permitió la relactación. Luego del alta, las madres pudieron mantener una lactancia materna parcial con curvas de crecimiento aceptables al año de edad corregida. Conclusión: Los recién nacidos prematuros de muy bajo peso, en condiciones estables, deben ser alimentados precozmente con leche humana y luego con la combinación de leche humana y fortificadores de leche humana. Nuestro estudio demostró un mejor crecimiento postnatal y mantuvo una buena producción láctea de las madres. Comentario: Alimentar a este grupo de recién nacidos de alto riesgo con leche humana y fortificadores de leche humana no sólo constituye un gran desafío por la alta motivación y compromiso que debe tener el equipo de salud neonatal, sino que implica abordar con firme decisión clínica la nutrición de bebés de alto riesgo, oponiéndose a respetadas corrientes de opinión, que no le otorgan un lugar apropiado a la alimentación natural. En nuestras comunidades latinoamericanas, conservar el amamantamiento por más largo tiempo es una recomendación sanitaria de máxima prioridad.Introduction: Enteral feeding strategies of very low birth weight (VLBW infants and when to start them have changed significantly in the last few years. Controversy exists on which is the best regimen to feed this high risk group, since human milk has insufficient quantities of some nutrients. Fortification of human milk improves growth rates and maintains immunologic, metabolic and emotional benefits. Objective: To examine if

  20. Cerebral MRI findings in very-low-birth-weight and small-for-gestational-age children at 15 years of age

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    Skranes, Jon S.; Brubakk, Ann-Mari [Norwegian University of Science and Technology, Department of Laboratory Medicine, Children' s and Women' s Health, Trondheim (Norway); Martinussen, Marit; Smevik, Olaug; Myhr, Gunnar [Norwegian University of Science and Technology, Department of Circulation and Imaging, Trondheim (Norway); Indredavik, Marit [Norwegian University of Science and Technology, Department of Neuroscience, Trondheim (Norway); Vik, Torstein [Norwegian University of Science and Technology, Department of Community Medicine and General Practice, Trondheim (Norway)

    2005-08-01

    A high prevalence of abnormal cerebral MRI findings has been reported in low-birth-weight children. To compare MRI findings in very-low-birth-weight (VLBW) and term small-for-gestational-age (SGA) children with controls in early adolescence. Cerebral MRI was used to examine 55 VLBW, 54 SGA and 66 controls at 15 years of age. The MR images were qualitatively assessed, and size of ventricles, white-matter and grey-matter abnormalities were reported. The VLBW teenagers had a higher prevalence of various MRI abnormalities than SGA children and controls. Dilation of the ventricular system, especially of the occipital horns, was found in 82% of the VLBW group, in 19% of the SGA group and in 21% of controls. White-matter reduction was found in 53% of the VLBW, in 6% of the SGA and in 2% of controls. Corpus callosum thinning was found in 47% of the VLBW, in 2% of the SGA and in 6% of controls. Periventricular gliosis was found in 29% of the VLBW, in 4% of the SGA and in 8% of controls. Cerebral MRI pathology in white matter is a common finding in VLBW teenagers. The findings may indicate minor perinatal PVL with resulting loss of white-matter tissue and ventricular dilation. (orig.)

  1. Teamwork in the NICU Setting and Its Association with Health Care-Associated Infections in Very Low-Birth-Weight Infants.

    Science.gov (United States)

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

    2017-08-01

    Background and Objective Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale-level and item-level associations with health care-associated infection (HAI) rates in very low-birth-weight (VLBW) infants. Methods Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6,663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2,073 of 3,294 eligible NICU health professionals (response rate 63%). The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (odds ratio, 0.82; 95% confidence interval, 0.73-0.92, p = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion Improving teamwork may be an important element in infection control efforts. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Review of interventional procedures in the very low birth-weight infant (<1.5 kg): complications, lessons learned and current practice

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    Laffan, Eoghan E. [Children' s Hospital of Eastern Ontario, Department of Diagnostic Imaging, Ottawa, ON (Canada); McNamara, Patrick J.; Whyte, Hilary; L' Herault, Johanne [The Hospital for Sick Children, Division of Neonatology, Toronto, ON (Canada); Amaral, Joao; Temple, Michael; John, Philip; Connolly, Bairbre L. [The Hospital for Sick Children, The Image-Guided Therapy Unit, Toronto, ON (Canada)

    2009-08-15

    Interventional radiology (IR) procedures in very low birth-weight (VLBW) infants (<1.5 kg) are challenging due to size, immaturity, comorbidities and lack of devices of suitable size. Infants are moved from the neonatal intensive care unit to the IR suite, further exposing them to risk. Our purpose was to review our experience of interventional procedures in VLBW infants, specifically complications and potential risks. VLBW infants referred for image-guided therapy between 1998 and 2005 were identified and medical records reviewed. ''Complications'' were divided into: major or minor, periprocedural or postprocedural, and intervention-/device-related, patient-related or equipment-related. Transport risk index of physiological stability (TRIPS) scores were calculated. A total of 116 infants (68 male, 48 female) underwent 176 procedures (159 vascular access-related and 17 nonvascular). Of 158 complications identified, 116 were major and 42 were minor. Major complications included hypothermia (n=33), line manipulations/removals (n=25), bleeding (n=12), thrombosis (n=4), cardiac arrest (n=3), tamponade (n=2), and multiorgan failure (n=1). Of the complications, 119 were categorized as intervention-/device-related, 32 patient-related and 7 equipment-related. There were no significant differences between pre- and postprocedural TRIPS scores. Successful completion of IR procedures in the VLBW infant is possible, but complications still occur in these fragile infants. (orig.)

  3. Efficacy of Probiotics Versus Placebo in the Prevention of Necrotizing Enterocolitis in Preterm Very Low Birth Weight Infants: A Double-Blind Randomized Controlled Trial.

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    Chowdhury, Tanjina; Ali, Muhammad Manajjir; Hossain, Muhammad Monir; Singh, Jugindra; Yousuf, Abu Noyeem Muhammad; Yasmin, Fatema; Chowdhury, Fazle Rabbi

    2016-09-01

    To evaluate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis (NEC) in preterm very low birth weight (VLBW) infants. Arandomized double blind controlled trial. The Paediatrics Department of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet Bangladesh, from July 2012 to June 2015. Preterm (28 - 33 weeks gestation) VLBW (birth weight 1000 - 1499 g) neonates were enrolled. The study group was fed with probiotics once daily with breast milk from first feeding, and the control group with only breast milk without the addition of probiotics. Both the groups received other standard care. The primary outcome was the development of NEC (stage II and III), categorized by modified Bell's classification. In 108 neonates, development of NEC was significantly lower in the study group than that of control group [1 (1.9%) vs. 6 (11.5%); p=0.044]. Age of achievement of full oral feeding was significantly earlier in the study group than that in the control group (14.88 ±3.15 and 18.80 ±4.32 days; p control group (15.82 ±2.94 days vs. 19.57 ±4.26 days; p birth weight. It is also associated with faster achievement of full oral feeding and short duration of hospital stay.

  4. Development of Left Ventricular Longitudinal Speckle Tracking Echocardiography in Very Low Birth Weight Infants with and without Bronchopulmonary Dysplasia during the Neonatal Period

    Science.gov (United States)

    Czernik, Christoph; Rhode, Stefanie; Helfer, Sven; Schmalisch, Gerd; Bührer, Christoph; Schmitz, Lothar

    2014-01-01

    Objectives In preterm infants, postnatal myocardial adaptation may be complicated by bronchopulmonary dysplasia (BPD). We aimed to describe the development of left ventricular function by serial 2D, Doppler, and speckle tracking echocardiography (2D-STE) in infants with and without BPD during the neonatal period and compare these to anthropometric and conventional hemodynamic parameters. Study Design Prospective echocardiography on day of life (DOL) 1, 7, 14, and 28 in 119 preterm infants 10%) were seen for the apical segment. While anthropometric parameters show rapid development during the first 4 weeks of life, the speckle tracking parameters did not differ statistically significantly during the neonatal period. Infants with and without BPD differed significantly (p<0.001) in the development of anthropometric parameters, conventional hemodynamic parameters except for heart rate, and 2D-STE parameters: global longitudinal systolic strain rate (GLSSR) and longitudinal systolic strain for the mid left wall (LSSR). The largest differences were seen at DOL 1 and 7 in GLSSR (p<0.001) and in LSSR (p<0.01). Conclusions Reproducible 2D-STE measurements are possible in preterm infants <1500 g. Cardiac deformation reveals early (DOL 1 and 7) ventricular changes (GLSSR and LSSR) in very low birth weight infants who develop BPD. PMID:25184634

  5. Glutamine-enriched enteral nutrition in very low birth weight infants. Design of a double-blind randomised controlled trial [ISRCTN73254583

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    Twisk Jos WR

    2004-09-01

    Full Text Available Abstract Background Enteral feeding of very low birth weight (VLBW infants is a challenge, since metabolic demands are high and administration of enteral nutrition is limited by immaturity of the gastrointestinal tract. The amino acid glutamine plays an important role in maintaining functional integrity of the gut. In addition, glutamine is utilised at a high rate by cells of the immune system. In critically ill patients, glutamine is considered a conditionally essential amino acid. VLBW infants may be especially susceptible to glutamine depletion as nutritional supply of glutamine is limited in the first weeks after birth. Glutamine depletion has negative effects on functional integrity of the gut and leads to immunosuppression. This double-blind randomised controlled trial is designed to investigate the effect of glutamine-enriched enteral nutrition on feeding tolerance, infectious morbidity and short-term outcome in VLBW infants. Furthermore, an attempt is made to elucidate the role of glutamine in postnatal adaptation of the gut and modulation of the immune response. Methods VLBW infants (gestational age

  6. Timing of nutritional interventions in very-low-birth-weight infants: optimal neurodevelopment compared with the onset of the metabolic syndrome.

    Science.gov (United States)

    Lafeber, Harrie N; van de Lagemaat, Monique; Rotteveel, Joost; van Weissenbruch, Mirjam

    2013-08-01

    Recent nutritional research in very-low-birth-weight (VLBW) infants is focused on the prevention of protein malnutrition during the first postnatal weeks. At this early age, nutritional protein fortification depends on amino acid infusion via a central vein because of the immature gastrointestinal tract. In 2010 new guidelines on nutrition were proposed by the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition nutrition committee. In particular, the relative increase in the protein fraction in the nutrition of these infants aims to prevent early postnatal weight loss, to prevent morbidity, and to stimulate neurodevelopment. On the other hand, an increasing number of follow-up studies in VLBW infants indicate that, in particular, those infants who show rapid growth after preterm birth are at risk of metabolic consequences and cardiovascular disease later in life. In this review, we describe the quest to develop a customized diet that offers optimal nutrition at several time points of growth and development during the first year of life. This diet should prevent early malnutrition, enhance neurodevelopment, and limit the increase in total body fat during the first 6 mo. We question whether one type of early diet suffices for normal neurodevelopment with a normal body composition in later life or whether we need several types of diet at various stages of development.

  7. Pilot study of a new mathematical algorithm for early detection of late-onset sepsis in very low-birth-weight infants.

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    Gur, Ilan; Riskin, Arieh; Markel, Gal; Bader, David; Nave, Yaron; Barzilay, Bernard; Eyal, Fabien G; Eisenkraft, Arik

    2015-03-01

    Diagnosis of late onset sepsis (LOS) in very low birth weight (VLBW) preterm infants relies mainly on clinical suspicion, whereas prognosis depends on early initiation of antibiotic treatment. RALIS is a mathematical algorithm for early detection of LOS incorporating six vital signs measured every 2 hours. The aim of this study is to study RALIS ability to detect LOS before clinical suspicion. A total of 118 VLBW preterm infants (gestational age detection of LOS between RALIS and clinical/culture evidence of LOS. Of the 2,174 monitoring days, RALIS indicated sepsis in 590 days, and LOS was positively diagnosed in 229 days. Sensitivity, specificity, positive, and negative predictive values were 74.6, 80.7, 38.8, and 95.1%, respectively. RALIS provided an indication for sepsis 3 days on the average before clinical suspicion. RALIS has a promising potential as an easy to implement noninvasive early indicator of LOS, especially for ruling out LOS in VLBW high-risk infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Clinical Indicators of Late-Onset Sepsis Workup in Very Low-Birth-Weight Infants in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Das, Anirudha; Shukla, Sonia; Rahman, Nazia; Gunzler, Douglas; Abughali, Nazha

    2016-07-01

    Background Late-onset sepsis (LOS) in very low-birth-weight (VLBW) infants is associated with significant morbidity and mortality. Objectives To determine the incidence of LOS workup, association, and predictive value of clinical indicators leading to culture-positive versus culture-negative sepsis workup. Methods All sepsis workups performed after 7 days of life, in neonates with birth weight of birth weight, corrected gestational age, and chronological age, at the time of workup. The clinical indicators leading to the performance of sepsis workup were compared between cases and controls. Results The incidence of culture-positive workup was 87/345 (25.2%) and that of LOS was 84/279 (30.1%). Among various clinical indicators, hypothermia and apnea were significantly associated with culture-positive sepsis workup (p = 0.015 and 0.004, respectively), with a positive predictive value of 81.2 and 71.4%, respectively. Conclusion In VLBW infants, one-fourth of sepsis workups resulted in a positive culture. Apnea and hypothermia were the most significant predictors of culture-positive workup after matching for GA, birth weight, chronological age, and corrected GA at the time of the workup.

  9. Development of left ventricular longitudinal speckle tracking echocardiography in very low birth weight infants with and without bronchopulmonary dysplasia during the neonatal period.

    Directory of Open Access Journals (Sweden)

    Christoph Czernik

    Full Text Available OBJECTIVES: In preterm infants, postnatal myocardial adaptation may be complicated by bronchopulmonary dysplasia (BPD. We aimed to describe the development of left ventricular function by serial 2D, Doppler, and speckle tracking echocardiography (2D-STE in infants with and without BPD during the neonatal period and compare these to anthropometric and conventional hemodynamic parameters. STUDY DESIGN: Prospective echocardiography on day of life (DOL 1, 7, 14, and 28 in 119 preterm infants 10% were seen for the apical segment. While anthropometric parameters show rapid development during the first 4 weeks of life, the speckle tracking parameters did not differ statistically significantly during the neonatal period. Infants with and without BPD differed significantly (p<0.001 in the development of anthropometric parameters, conventional hemodynamic parameters except for heart rate, and 2D-STE parameters: global longitudinal systolic strain rate (GLSSR and longitudinal systolic strain for the mid left wall (LSSR. The largest differences were seen at DOL 1 and 7 in GLSSR (p<0.001 and in LSSR (p<0.01. CONCLUSIONS: Reproducible 2D-STE measurements are possible in preterm infants <1500 g. Cardiac deformation reveals early (DOL 1 and 7 ventricular changes (GLSSR and LSSR in very low birth weight infants who develop BPD.

  10. Development of lung function in very low birth weight infants with or without bronchopulmonary dysplasia: Longitudinal assessment during the first 15 months of corrected age

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    Schmalisch Gerd

    2012-03-01

    Full Text Available Abstract Background Very low birth weight (VLBW infants ( Methods Comprehensive lung function assessment was performed at about 50, 70, and 100 weeks of postmenstrual age in 55 sedated VLBW infants (29 with former BPD [O2 supplementation was given at 36 weeks of gestational age] and 26 VLBW infants without BPD [controls]. Mean gestational age (26 vs. 29 weeks, birth weight (815 g vs. 1,125 g, and the proportion of infants requiring mechanical ventilation for ≥7 d (55% vs. 8%, differed significantly between BPD infants and controls. Results Both body weight and length, determined over time, were persistently lower in former BPD infants compared to controls, but no significant between-group differences were noted in respiratory rate, respiratory or airway resistance, functional residual capacity as determined by body plethysmography (FRCpleth, maximal expiratory flow at the FRC (V'max FRC, or blood gas (pO2, pCO2 levels. Tidal volume, minute ventilation, respiratory compliance, and FRC determined by SF6 multiple breath washout (representing the lung volume in actual communication with the airways were significantly lower in former BPD infants compared to controls. However, these differences became non-significant after normalization to body weight. Conclusions Although somatic growth and the development of some lung functional parameters lag in former BPD infants, the lung function of such infants appears to develop in line with that of non-BPD infants when a body weight correction is applied. Longitudinal lung function testing of preterm infants after discharge from hospital may help to identify former BPD infants at risk of incomplete recovery of respiratory function; such infants are at risk of later respiratory problems.

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

    Science.gov (United States)

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

    2016-03-01

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

  12. Amino acid-based formula as a rescue strategy in feeding very-low-birth-weight infants with intrauterine growth restriction.

    Science.gov (United States)

    Raimondi, Francesco; Spera, Anna Maria; Sellitto, Maria; Landolfo, Francesca; Capasso, Letizia

    2012-05-01

    Very-low-birth-weight (VLBW) neonates may develop severe intolerance to standard preterm formula especially if they are associated with intrauterine growth restriction (IUGR). We tested the hypothesis that these infants may tolerate an elemental, amino acid-based formula as a rescue feeding strategy. In a prospective, case-control pilot study, we enrolled VLBW IUGR infants enterally fed with standard preterm formula (SPF) at daily increments of 16 mL/kg. If gastric residuals accounted for >70% of milk feed in the previous 24 hours, then feedings were temporarily withheld and then resumed with amino acid formula (AAF) increased at the same speed. Cases on AAF were compared to controls on SPF and with cases themselves while on SPF. Primary outcome was the time to reach full enteral feedings. Secondary outcomes were time on parenteral nutrition, time on central venous catheter, and formula tolerability based on the amount of gastric residual volume. Sixty-four infants (22 cases) were enrolled. Although during the total duration of nutrition, cases had worse primary and secondary outcomes, when on AAF, cases were comparable to controls in time to full enteral feeding (14.4 vs 14 days), time on parenteral nutrition, and time on central venous catheter. Cases on AAF and controls had similar gastric residual volumes. At day 3 after AAF introduction, cases had a significantly reduced number (%) of gastric residual volume >5 mL/kg over total number of feedings (5.6 vs 1.5%; P Growth at 12 months of corrected age was also comparable. In our population of VLBW IUGR newborns with severe feeding intolerance, a short course on AAF was a safe and effective means of nutritional rescue.

  13. The role of serum and urinary urea in the evaluation of enteral protein intake in adequate and small-for-gestational-age very low birth weight infants

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    Silvana Darcie

    Full Text Available CONTEXT AND OBJECTIVE: Very low birth weight (VLBW infants have special nutritional needs. There is a current tendency to individualize their protein needs. The objective of this study was to determine the suitability of serum and urinary urea as indicators for protein intake in adequate-for-gestational-age (AGA and small-for-gestational-age (SGA VLBW infants. DESIGN AND SETTING: Prospective study in the nursery attached to the Maternity Ward of the "Prof. Pedro de Alcântara" Children's Institute, Hospital das Clínicas, Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, Brazil. METHODS: Seventy-two VLBW infants (mean protein intake = 3.7 mg/kg/day were enrolled in a prospective cohort study in two groups: AGA (n = 34 and SGA (n = 38. Blood samples, six-hour urine (6hUr collections and urine sample tests (STUr were obtained for urea and creatinine assays at three and five weeks of life. Statistical analysis: Student's t test, Pearson correlation and linear regression (p < 0.05. RESULTS: There were no differences between groups for serum urea, 6hUr and STUr, or between two assessments within each group. Serum urea correlated with 6hUr in both AGA and SGA, and to STUr in SGA; 6hUr correlated with STUr in both AGA and SGA. There was no correlation between protein intake and serum or urine urea. CONCLUSIONS: Serum and urinary urea did not reflect protein intake when mean intakes of 3.7 g/kg/day were used. Sample tests of urinary urea can be as reliable as urea from urine collected over longer periods.

  14. Evaluation of altitude-appropriate reference ranges for neutrophils in diagnosis of sepsis in very low birth weight infants: A multicenter retrospective study

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    Yu, Jialin; Fan, Juan; He, Yu; Dong, Wenhui; Wang, Zhengli

    2017-01-01

    Background The circulating neutrophil count was commonly believed to be influenced by altitude. At present, neutrophil reference ranges (RRs) for very low birth weight (VLBW) neonates are only available from the sea level and from high altitude. This study aimed to construct RRs for neutrophils in VLBW infants in an intermediate-altitude area and assess its usefulness in evaluation for sepsis. Methods This was a multicenter retrospective study of 2173 VLBW infants admitted to 20 hospitals in Chongqing in southwest of China with altitude from 1000 to 2600 feet. The RRs for absolute total neutrophils (ATN), absolute total immature neutrophils (ATI), and immature: total neutrophil proportion were constructed based on “normal” neonates (unlikely infection). Values of neutrophil from septic and uninfected neonates were respectively assessed using the revised RRs and the previous Mouzinho’s and Schmutz’s RRs. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were compared using the McNemar’s test or χ2 test. Results The upper limits for ATN and ATI using the revised RRs were much higher than those using Mouzinho’s RRs, but lower than those using Schmutz’s RRs. The revised RRs and Mouzinho’s RRs had higher sensitivities than Schmutz’s RRs at 73–672 h. The revised RRs had a higher specificity than Mouzinho’s RRs at both 0–72 h and 73–672 h. The NPV for any abnormality in neutrophil values was high at both 0–72 h and 73–672 h irrespective of the RRs used. Conclusion Altitude-appropriate RRs for neutrophils is more suitable to guide the diagnosis and management of neonatal sepsis in VLBW infants. PMID:28182674

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

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    Claudia Regina Hentges

    2014-01-01

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

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

    Science.gov (United States)

    Sangtawesin, Varaporn; Singarj, Yupayao; Kanjanapattanakul, Wiboon

    2011-08-01

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

  17. Prevalence of antibiotic resistance in multi-drug resistant coagulase-negative staphylococci isolated from invasive infection in very low birth weight neonates in two Polish NICUs.

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    Brzychczy-Wloch, Monika; Borszewska-Kornacka, Maria; Gulczynska, Ewa; Wojkowska-Mach, Jadwiga; Sulik, Malgorzata; Grzebyk, Monika; Luchter, Malgorzata; Heczko, Piotr B; Bulanda, Malgorzata

    2013-12-20

    Multi-drug resistant coagulaso-negative staphylococci (CNS) have become an increasing problem in nosocomial infections connected with the presence of medical devices. The paper aimed to analyze the prevalence of antibiotic resistance in CNS isolated from invasive infection in very low birth weight (VLBW) neonates. Continuous prospective target surveillance of infections was conducted in 2009 at two Polish NICUs that participated in the Polish Neonatology Surveillance Network (PNSN). The study covered 386 neonates with VLBW (≤1500 g), among which 262 cases of invasive infection were detected with predominance of CNS (123; 47%). Altogether, 100 CNS strains were analyzed. The resistance phenotypes were determined according to EUCAST. Resistance genes: mecA, ermA, ermB, ermC, msrA, aac(6')/aph(2''), ant(4')-Ia and aph(3')-IIIa were detected using multiplex PCR. The most common species was S. epidermidis (63%), then S. haemolyticus (28%) and other CNS (9%). Among S. epidermidis, 98% of isolates were resistant to methicillin, 90% to erythromycin, 39% to clindamycin, 95% to gentamicin, 60% to amikacin, 36% to ofloxacin, 2% to tigecycline, 3% to linezolid and 13% to teicoplanin. Among S. haemolyticus isolates, 100% were resistant to methicillin, erythromycin and gentamicin, 18% to clindamycin, 50% to amikacin, 86% to ofloxacin, 14% to tigecycline and 4% to teicoplanin. No resistance to linezolid was detected for S. haemolyticus isolates. Moreover, all isolates of S. epidermidis and S. haemolyticus were susceptible to vancomycin. The mecA gene was detected in 98% of S. epidermidis isolates and all of S. haemolyticus ones. Among macrolide resistance isolates, the ermC was most common in S. epidermidis (60%) while msrA was prevalent in S. haemolyticus (93%). The ermC gene was indicated in all isolates with cMLSB, whereas mrsA was found in isolates with MSB phenotype. Of the aminoglycoside resistance genes, aac(6')/aph(2'') were present alone in 83% of S. epidermidis

  18. Clinical Relevance of Pathogens Detected by Multiplex PCR in Blood of Very-Low-Birth Weight Infants with Suspected Sepsis - Multicentre Study of the German Neonatal Network.

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    Tröger, Birte; Härtel, Christoph; Buer, Jan; Dördelmann, Michael; Felderhoff-Müser, Ursula; Höhn, Thomas; Hepping, Nico; Hillebrand, Georg; Kribs, Angela; Marissen, Janina; Olbertz, Dirk; Rath, Peter-Michael; Schmidtke, Susanne; Siegel, Jens; Herting, Egbert; Göpel, Wolfgang; Steinmann, Joerg; Stein, Anja

    2016-01-01

    In the German Neonatal Network (GNN) 10% of very-low-birth weight infants (VLBWI) suffer from blood-culture confirmed sepsis, while 30% of VLBWI develop clinical sepsis. Diagnosis of sepsis is a difficult task leading to potential over-treatment with antibiotics. This study aims to investigate whether the results of blood multiplex-PCR (SeptiFast®) for common sepsis pathogens are relevant for clinical decision making when sepsis is suspected in VLBWI. We performed a prospective, multi-centre study within the GNN including 133 VLBWI with 214 episodes of suspected late onset sepsis (LOS). In patients with suspected sepsis a multiplex-PCR (LightCycler SeptiFast MGRADE-test®) was performed from 100 μl EDTA blood in addition to center-specific laboratory biomarkers. The attending neonatologist documented whether the PCR-result, which was available after 24 to 48 hrs, had an impact on the choice of antibiotic drugs and duration of therapy. PCR was positive in 110/214 episodes (51%) and blood culture (BC) was positive in 55 episodes (26%). Both methods yielded predominantly coagulase-negative staphylococci (CoNS) followed by Escherichia coli and Staphylococcus aureus. In 214 BC-PCR paired samples concordant results were documented in 126 episodes (59%; n = 32 were concordant pathogen positive results, n = 94 were negative in both methods). In 65 episodes (30%) we found positive PCR results but negative BCs, with CoNS being identified in 43 (66%) of these samples. Multiplex-PCR results influenced clinical decision making in 30% of episodes, specifically in 18% for the choice of antimicrobial therapy and in 22% for the duration of antimicrobial therapy. Multiplex-PCR results had a moderate impact on clinical management in about one third of LOS-episodes. The main advantage of multiplex-PCR was the rapid detection of pathogens from micro-volume blood samples. In VLBWI limitations include risk of contamination, lack of resistance testing and high costs. The high rate of

  19. Application of family stage comprehensive health guidance in very low birth weight infants%家庭阶段性综合保健指导在极低出生体重儿中的应用

    Institute of Scientific and Technical Information of China (English)

    孟群; 张菊玲; 秦珊珊; 周小芬

    2013-01-01

    OBJECTIVE To investigate the stage of comprehensive home health guidance in very low birth weight children. METHODS 15 very low birth weight premature infants were followed up regularly and received early intervention comprehensive guidance. Arranged person responsible for the 15 infants, with CD, books "Baby fitness scientific method ", "Create the best start in life", "0-2 years moving backward family training" from Professor Bao Xiulan for teaching. Early intervention was in five stages, trained VLBW children in four aspects of action, language, cognitive ability and personal social intercourse, at the same time, focused on the physical development and disease prevention of VLBW. Guided parents to do early intervention in family. All cases were followed for regular development examination. RESULTS 15 cases completed 18 months of full monitoring, in 12 cases with complete CDCC, including 1 case of MDI < 69, 14 cases with MDI between 71-112 score; PDI was in the normal range, without cerebral palsy. CONCLUSION Family stage comprehensive health intervention guidance emphasizes family rehabilitation as the core, attaches importance to both basic health care and rehabilitation, could promote the development of extremely low birth weight infants' intelligence.%目的 探讨家庭阶段性综合保健指导在极低出生体重儿中的应用.方法 15例极低出生体重儿早产儿,出生病情稳定后即开始接受早期综合干预指导,早期干预分5个阶段,专人负责,以鲍秀兰教授等编制的光盘、书籍:《婴儿科学健身法》、《塑造最佳人生开端》、《0~2岁运动落后的家庭指导》为教材,对VLBW儿童在动作、语言、认知能力及个人-社会交往4个方面进行训练指导,同时重视VLBW的体格发育及疾病预防.干预措施主要通过家长在家庭中实施,每月进行发育评估.结果 15例均完成18月龄的全程监测,12例完成CDCC测查,其中1例MDI< 69,14例MDI在71~112分之间

  20. Relationship between Stereoscopic Vision, Visual Perception, and Microstructure Changes of Corpus Callosum and Occipital White Matter in the 4-Year-Old Very Low Birth Weight Children

    Directory of Open Access Journals (Sweden)

    Przemko Kwinta

    2015-01-01

    Full Text Available Aim. To assess the relationship between stereoscopic vision, visual perception, and microstructure of the corpus callosum (CC and occipital white matter, 61 children born with a mean birth weight of 1024 g (SD 270 g were subjected to detailed ophthalmologic evaluation, Developmental Test of Visual Perception (DTVP-3, and diffusion tensor imaging (DTI at the age of 4. Results. Abnormal stereoscopic vision was detected in 16 children. Children with abnormal stereoscopic vision had smaller CC (CC length: 53±6 mm versus 61±4 mm; p<0.01; estimated CC area: 314±106 mm2 versus 446±79 mm2; p<0.01 and lower fractional anisotropy (FA values in CC (FA value of rostrum/genu: 0.7±0.09 versus 0.79±0.07; p<0.01; FA value of CC body: 0.74±0.13 versus 0.82±0.09; p=0.03. We found a significant correlation between DTVP-3 scores, CC size, and FA values in rostrum and body. This correlation was unrelated to retinopathy of prematurity. Conclusions. Visual perceptive dysfunction in ex-preterm children without major sequelae of prematurity depends on more subtle changes in the brain microstructure, including CC. Role of interhemispheric connections in visual perception might be more complex than previously anticipated.

  1. 极低出生体重儿23例早期护理干预效果研究%Study on the effect of early nursing intervention on 23 very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    赵建华

    2011-01-01

    目的:探讨早期护理干预对极低出生体重儿存活率及并发症的影响.方法:将46例极低出生体重儿随机分为观察组和对照组各23例.观察组给予早期护理干预(微量喂养、抚触、体位管理等),对照组给予常规护理.观察两组极低出生体重儿护理后体重增长情况、不良反应发生率.结果:与对照组比较,观察组极低出生体重儿体重增长速度快(P<0.01),呕吐、哭闹、胃潴留、腹胀发生率明显降低(P<0.01).结论:早期护理干预能够提高极低出生体重儿的存活率,减少并发症,值得临床推广.%Objective: To investigate the effect of early nursing intervention on the survival rate and complications of very low birth weight infants.Methods: 46 very low birth weight infants were randomly divided into an observation group and a control group ( 23 cases for each group ).The early nursing intervention ( micro - amount feeding, massage, position management,etc.) was given to the infants in the observation group and the infants in the control group received routine nursing care.The weight gain and incidence of adverse reactions of very low birth weight infants were observed after nursing care in both groups.Results: The weight gain of very low birth weight infants was faster in the observation group than the control group (P <0.01 );the incidence of vomiting, crying, gastric retention, abdominal distension was significantly lower in the observation group than the control group ( P < 0.01 ).Conclusion: The early nursing intervention can improve the survival rate of very low birth weight infants and reduce the incidence of complications.

  2. 极低出生体质量儿的早期积极营养支持%Early nutritional support for very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    顾谦学; 顾红兵; 李双双; 陆超; 胡毓华

    2016-01-01

    Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) % vs (5.46 ± 2.64) %,P < 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P < 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P < 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P < 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2% vs 56.7%),extrauterine growth retardation (34.3% vs 73.3%),cholestasis (6.2% vs 23.3%),feeding intolerance (15.6% vs 53.3%) and necrotizing enterocolitis (0 vs 16.7%) (all P < 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4

  3. Serum ferritin in very low birth weight infants and its influence factors%极低出生体重儿血清铁蛋白水平及影响因素

    Institute of Scientific and Technical Information of China (English)

    李亮亮; 王雯雯

    2016-01-01

    Objective To identify iron nutritional status in very low birth weight infants (VLBWI) and its influence factors.Methods A total of 115 babies admitted from January to December 2014 were included in the study.Serum ferritin of new born infants was analyzed.The clinical data of gestational age,birth weight,hemoglobin,iatrogenic blood loss,cumulative volume of blood transfusion and pregnancy maternal diseases(diabetes,hypertension and anemia) were analyzed.Results The serum ferritin of 115 VLBWI were 100.8 to 210.3 μg/L,the average were(140.32 ± 13.21) μg/L;the minimum serum ferritin of babies born < 32 weeks gestational age were(124.5 ± 31.3) μg/L.Smaller the VLBWI gestational age,the lower the basic baby serum ferritin(F =14.367,P =0.000).More severe the maternal anemia,the lower the basic baby serum ferritin levels [no anemia:(230.9 ± 68.7) μg/L,mild anemia:(189.5 ± 75.3) μg/L,moderate anemia:(133.5 ± 88.1) μg/L,severe anemia:(122.2 ± 56.8) μg/L;P < 0.05].Lower the level of hemoglobin,the lower the basic level of serum ferritin(P < 0.05).Volume of blood transfusion had a huge impact on the last serum ferritin levels (P < 0.05).Conclusion Improvement of the basic baby serum ferritin level in the early stage is useful to ensure the VLBWI iron reserves.It is necessary to regularly monitor serum ferritin during hospitalization and even after discharge.%目的 分析极低出生体重儿(very low birth weight infants,VLBWI)的铁营养状况及影响其变化的因素.方法 收集2014年1月至12月我院收治的115例VLBWI,检测其基础血清铁蛋白及出院前末次血清铁蛋白水平,并对可能的影响因素如胎龄、出生体重、基础血红蛋白、住院期间累积输血量、累积失血量,孕母糖尿病、高血压及贫血等临床资料进行分析.结果 115例VLBWI的基础血清铁蛋白为100.8 ~210.3 μg/L,平均(140.32±13.21) μg/L;不同胎龄的VLBWI基础血清铁蛋白水平比

  4. 极低出生体重儿早期死亡的围生期危险因素分析%Analysis of perinatal risk factors for early neonatal death among very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    李月凤; 周平; 吴香兰; 陈睿; 卢光进

    2012-01-01

    [Objective] To investigate the relationship between perinatal risk factors and early neonatal death among very low birth weight (VLBW) infants. [Methods] A retrospective cohort of 143 VLBW infants admitted to NICU was studied. The dependent variable was the outcome, either survival or death at 7 days of life. The independent variables were assigned into three levels: distal, intermediate and proximal according to hierarchical model. All variables were subjected to univariate analysis and multivariate logistic regression. [Results] Early neonatal mortality was 13. 29% (19/143) in VLBW infants. After the adjustment of variables through multivariate Logistic regression it showed that infants born to mother with cord prolapse had higher risk exposure for early death than those of mother without cord prolapse in the distal level (AOR:8. 69;95%C/:1. 128~67. 002). At the intermediate level,infants with gestational age (GAX28 weeks and 5-min Apgar scores<7 had higher odds of early death than those of GA≥28 weeks and 5-min Apgar scores≥7 (AOR: 11. 47, 13. 55;95%CJ:2. 066~63. 712,3. 156 - 58. 221 respectively). At the proximal level, infants with intracranial hemorrhage (ICH) had higher risk of early death than those without ICH (AORS4. 56,95%C7:1. 088 - 19. 170). [Conclusions] The early neonatal mortality among VLBW infants is still high and continues to be a significant public health problem. Asphyxia at birth is the highest risk factor of early neonatal death. Reducing birth asphyxia through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to decrease early neonatal death of VLBW infants.%[目的]探讨极低出生体重(very low birth weight,VLBW)儿早期死亡的围生期高危因素. [方法]选取在本院新生儿科住院的143例VLBW儿为研究对象.生后7d的结果:生存或死亡作为应变量,根据分层分析模型将围产期高危因素(自变量)分为远端、中间和近端3

  5. 挤压脐带胎盘输血方法对极低出生体质量儿的影响%Effects of placental transfusion of umbilical cord milking on very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    郭芳; 朱进秋; 罗维真; 李佳; 张静; 普玲; 张霞

    2015-01-01

    目的:探讨挤压脐带的胎盘输血方法对极低出生体质量(VLBW)早产儿的影响。方法以2011年9月至2014年5月出生并行挤压脐带的57例VLBW早产儿作为挤压组,2008年1月至2011年8月出生并行常规脐带结扎的61例VLBW早产儿作为对照组,分析两组VLBW早产儿常见并发症发生率以及输血情况、肺泡表面活性物质(PS)使用、呼吸机使用时间、吸氧时间和病死率的差异。结果挤压组的重度窒息、侧脑室出血及贫血的发生率低于对照组,差异有统计学意义(P<0.05);挤压组的输血次数、输血量和机械通气时间明显少于对照组,差异有统计学意义(P<0.05)。结论VLBW出生时行脐带挤压能减轻窒息、减少脑室出血及贫血,并能降低其对输血、机械通气的需求。%ObjectiveTo study the effects of placental transfusion of umbilical cord milking on very low birth weight (VLBW) infants. Methods Fifty-seven VLBW infants born from September 2011 to May 2014 who had umbilical cord milking at birth were selected as experimental group. Sixty-one VLBW infants born from January 2008 to August 2011 who had normal cord clamping at birth were selected as control group. The complications of VLBW infants, blood transfusion, frequency of using pulmonary surfactant (PS), the duration of mechanical ventilation, the duration of oxygen and mortality were compared between two groups.Results The incidence of severe asphyxia, IVH and anemia was signiifcantly lower in experimental group than in control group (P< 0.05). The blood transfusion and transfusion volume, duration of mechanical ventilation, and duration of oxy-gen were signiifcantly lower in experimental group than in control group (P< 0.05).Conclusions Umbilical cord milking can reduce the incidence of severe asphyxia, IVH and anemia. It also can reduce the blood transfusion, the duration of mechanical ventilation, and the duration of oxygen in VLBW infants.

  6. Visual Perception and Visual-Motor Integration in Very Preterm and/or Very Low Birth Weight Children: A Meta-Analysis

    Science.gov (United States)

    Geldof, C. J. A.; van Wassenaer, A. G.; de Kieviet, J. F.; Kok, J. H.; Oosterlaan, J.

    2012-01-01

    A range of neurobehavioral impairments, including impaired visual perception and visual-motor integration, are found in very preterm born children, but reported findings show great variability. We aimed to aggregate the existing literature using meta-analysis, in order to provide robust estimates of the effect of very preterm birth on visual…

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

    Institute of Scientific and Technical Information of China (English)

    王恋; 李娟; 毛健; 张静; 陈丹

    2014-01-01

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

  8. The effect of dexamethasone on respirator-dependent very-low-birth-weight infants is best predicted by chest X-ray

    Energy Technology Data Exchange (ETDEWEB)

    Schrod, L.; Neuhaus, T. [Dept. of Paediatrics, Univ. of Wuerzburg (Germany); Horwitz, A.E. [Dept. of Radiology/Paediatric Radiology, Univ. of Wuerzburg (Germany); Speer, C.P. [Dept. of Neonatology, Univ. of Tuebingen (Germany)

    2001-05-01

    Background. Chronic lung disease (CLD) in premature infants shows a variable clinical course with different radiological manifestations. Objective. To evaluate the correlation between parameters of transmembrane permeability [albumin/secretory component (SC)] and oxidative stress [malondialdehyde (MDA)/SC] in tracheal aspirate fluid (TAF) and radiological findings with the effect of a 5-day course of dexamethasone (0.5 mg/kg per day). Materials and methods. Fifty ventilator-dependent premature infants with birth weights < 1,500 g (gestational ages 23-31 weeks) and radiological signs of early chronic lung disease (CLD) were treated with dexamethasone at day of life 5-27 (median 10 days) because of respiratory deterioration. TAF was collected serially. Chest X-rays taken before and 8-10 days after dexamethasone were scored for changes of opacification, consolidation and hyperinflation/emphysema, and classified into three groups. Results. Twenty-four infants had a positive response to dexamethasone, defined as a reduction of the ventilation index FiO{sub 2} x mean airway pressure > 40 % at day 5, compared to pretreatment values. About 80 % of the responders showed homogeneous lung opacification on chest X-ray, reflecting leaky lung syndrome. In contrast, seven of eight infants with predominantly emphysema on radiology were non-responders; 80 % of infants with a mixed radiological picture characterized by predominance of consolidations alternating with regions of emphysema were also non-responders. Ratios of albumin/SC and MDA/SC in TAF decreased significantly within 3 days after the onset of dexamethasone. However, MDA/SC was persistently higher in non-responders compared to responders. Opaque lungs were largely improved by dexamethasone, in contrast to streaky or patchy consolidations and emphysema. In a logistic regression model, radiographic classification was the most important factor influencing the response to dexamethasone with a positive predictive value of 86

  9. Intraventricular hemorrhage in very low birth weight infants: associated risk factors and outcome in the neonatal period Hemorragia intracranianana: evolução dos recém-nascidos de baixo peso no período neonatal

    Directory of Open Access Journals (Sweden)

    Monique Catache Mancini

    1999-10-01

    Full Text Available Intraventricular hemorrhage (IVH is a severe complication in very low birth weight (VLBW newborns (NB. With the purpose of studying the incidence of IVH, the associated risk factors, and the outcomes for these neonates, we studied all the VLBW infants born in our neonatal unit. Birth weight, gestational age, presence of perinatal asphyxia, mechanical ventilation, length of hospitalization, apnea crisis, hydrocephalus, and periventricular leukomalacia were analyzed. The diagnosis of IVH was based on ultrasound scan studies (Papile's classification performed until the tenth day of life and repeated weekly in the presence of abnormalities. Sixty-seven/101 neonates were studied. The mortality rate was 30.6% (31/101 and the incidence of IVH was 29.8% (20/67 : 70% grade I, 20% grade III and 10% grade IV. The incidence of IVH in NB A hemorragia intracraniana constituí uma grave complicação na evolução dos recém-nascidos de muito baixo peso (RN-MBP no período neonatal. Realizou-se este estudo, incluindo os recém-nascidos de muito baixo peso admitidos no Berçário Anexo à Maternidade do Hospital das Clínicas da FMUSP, com o objetivo de determinar a incidência de hemorragia intracraniana (HIC, os fatores de risco associados e sua evolução no período neonatal. Foram analisados o peso de nascimento, idade gestacional, presença de asfixia neonatal, uso de ventilação mecânica, tempo de internação, presença de episódios de apnéia, hidrocefalia e leucoencefalomalácia. O diagnóstico de HIC baseou-se no exame ultra-sonográfico realizado até o décimo dia de vida, de acordo com a classificação de Papille. Foram admitidos no período 101 RN-MBP, dos quais 67 preencheram aos critérios de inclusão. A taxa de mortalidade do período foi de 30,6% (31/101 e a incidência de HIC foi de 29,8% (20/67, sendo 70% grau I, 20 grau II e 10% grau IV. A incidência de HIC em recém-nascidos com peso de nascimento menos do que 1000g foi de 53,8% (p

  10. Research of gastric residuals in necrotizing enterocolitis of very low birth weight infants%极低出生体重儿坏死性小肠结肠炎中胃潴留的研究

    Institute of Scientific and Technical Information of China (English)

    刘欣; 刘汉楚; 孙金枝

    2011-01-01

    Objective: To determine the characteristics of gastric residuals in very low birth weight infants (VLBW) with necrotizing enterocolitis (NEC) and evaluate the role of gastric residuals in early identification of NEC. Methods: In a case-control study, 30 NEC patients were matched with control infants by birth weight, gestalional age. sex and were born from September 2008 to September 2010 in our department. Feeding characteristics were recorded from birth to the days at diagnosis of NEC in both groups, and the data in the two groups were compared. Results: Mean maximum residual from birth to NEC onset (5.35±2.14) ml was significantly higher in patients than that in control infants (2.38±2.72) ml, and maximum residual as percentage of the corresponding feed volume was also higher in patient (42.10±14.65)% than that in the control infants (21.30±7.51)% (P<0.05). The percentage of infants with hemorrhagic residuals in patients (63.33%) was significantly higher than in control infants (26.67%) (P<0.05). Conclusion: Gastric residuals seem to be the best predictor for NEC because Gastric residuals.%目的:研究极低出生体重儿坏死性小肠结肠炎(NEC)中胃潴留的特征,探讨胃潴留在NEC早期诊断中的意义.方法:选取2008年9月~2010年9月我科住院治疗的NEC患儿30例,同期住院的患儿按出生体重、性别、胎龄相当的非NEC患儿30例为对照组配对.记录NEC组患儿出生到确诊当日,胃潴留的液量以及性质的变化,对照组患儿在相同时间段亦进行相应的记录.比较两组间的差异.结果:NEC组胃潴留最大量(5.35±2.14)ml显著高于对照组的(2.38±2.72)ml,以及潴留量所占前次喂养量的最大比率(42.10±14.65)%亦高于对照组的(21.30±7.51)%,差异均有统计学意义(均P<0.05);NEC组出血性胃潴留的比例(63.33%)亦显著高于对照组(26.67%)(P<0.05).结论:NEC患儿胃潴留明显增加,且易出现出血性胃潴留,提示胃潴留的监测

  11. Sepse neonatal como fator de risco para leucomalácia periventricular em pré-termos de muito baixo peso Periventricular leukomalacia in very low birth weight preterm neonates with high risk for neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Rita C. Silveira

    2008-06-01

    Full Text Available OBJETIVO: Verificar a associação de leucomalácia periventricular (LPV e sepse neonatal em recém-nascidos de muito baixo peso (RNMBP. MÉTODOS: Foram incluídos RNMBP com suspeita clínica de infecção nascidos na instituição de 01/08/2005 a 31/07/2007. Foram excluídos óbitos antes dos 14 dias, malformações do sistema nervoso central e infecções congênitas. Foi realizado ultra-som cerebral no terceiro dia e semanalmente até a sexta semana de vida ou alta. LPV foi diagnosticada por hiperecogenicidade difusa periventricular persistente por mais de 7 dias, ou por cistos periventriculares. RNMBP foram divididos em grupos com e sem LPV. Sepse foi definida por manifestação clínica com cultura positiva. Os testes t, Mann-Whitney, qui-quadrado e regressão logística foram usados. RESULTADOS: Foram incluídos 88 RNMBP, sendo que 62 (70,5% sobreviveram e 51 (57,8% tiveram LPV. Os grupos foram semelhantes no peso de nascimento, idade gestacional, escore de Apgar, tipo de parto, SNAPPE-II, presenças de enterocolite necrosante, persistência de canal arterial e óbitos. Sepse e ventilação mecânica foram mais freqüentes no grupo com LPV (23,5 e 2,7%, p = 0,005; 86 e 59%, p = 0,004, respectivamente. Na regressão logística, ambos foram fatores de risco independentes para LPV (p = 0,027 e 0,015, respectivamente. CONCLUSÃO: Corioamnionite é fator de risco definido para LPV. Demonstramos que sepse neonatal também é fator de risco importante. Acreditamos que a resposta inflamatória sistêmica seja o principal fator envolvido na etiopatogenia da LPV em RNMBP.OBJECTIVE: To investigate the association between periventricular leukomalacia (PVL and neonatal sepsis in very low birth weight infants (VLBWI. METHODS: We studied VLBWI with a clinical suspicion of infection who had been born at our institution between the 1st of August, 2005 and the 31st of July, 2007. Children were excluded if they died before reaching 14 days, had malformations

  12. The Angiotensin Converting Enzyme Insertion/Deletion polymorphism is not associated with an increased risk of death or bronchopulmonary dysplasia in ventilated very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Baier R John

    2004-12-01

    Full Text Available Abstract Background The ACE gene contains a polymorphism consisting of either the presence (insertion, I or absence (deletion, D of a 287 bp alu repeat in intron 16. The D allele is associated with increased ACE activity in both tissue and plasma. The DD genotype is associated with risk of developing ARDS and mortality. The frequency of the D allele is higher in patients with pulmonary fibrosis, sarcoidosis and berylliosis. The role of this polymorphism has not been studied in the development of BPD in the premature newborn. Methods ACE I/D genotype was determined in 245 (194 African-American, 47 Caucasian and 4 Hispanic mechanically ventilated infants weighing less than 1250 grams at birth and compared to outcome (death and/or development of BPD. Results The incidence of the D allele in the study population was 0.58. Eighty-eight (35.9% infants were homozygous DD, 107 (43.7% were heterozygous ID and 50 (20.4% were homozygous II. There were no significant differences between genotype groups with respect to ethnic origin, birth weight, gestation, or gender. There was no effect of the ACE I/D polymorphism on mortality or development of BPD (O2 on 28 days or 36 weeks PCA. Secondary outcomes (intraventricular hemorrhage and periventricular leukomalacia similarly were not influenced by the ACE ID polymorphism. Conclusions The ACE I/D polymorphism does not significantly influence the development of BPD in ventilated infants less than 1250 grams.

  13. C-Reactive Protein and Procalcitonin Diagnostic Value in Congenital Infection in Newborns with Extremely Low and Very Low Birth Weight

    Directory of Open Access Journals (Sweden)

    O. V. Mikhaylova

    2015-01-01

    Full Text Available The high frequency of infectious complications in the early neonatal period of adaptation in infants with extremely low (ELBW and very low birth weight (VLBW attracts particular attention. The aim of our study was to evaluate the sensitivity (Se and specificity (Sp of C-reactive protein and procalcitonin in congenital pneumonia and congenital sepsis in newborn infants with extremely low and very low birth weight.Methods. In 160 preterm newborns that were included in our prospective study, 33 had early neonatal sepsis, 42 children had congenital pneumonia, and 85 infants were without neonatal infection. A comprehensive clinical and laboratoryinstrumental examination of the newborn was done, including determining the concentration of C-reactive protein and procalcitonin at the age of 48–72 hours of life. Results. Low sensitivity of CRP at the age of 48–72 hours of life in congenital sepsis and congenital pneumonia was observed. However, under these pathological conditions CRP and PCT are characterized by high specificity. It should also be noted that PCT has a high sensitivity in children with congenital sepsis aged 48–72 hours. Moreover, PCT also has a high specificity (Sp 80,6%, which determines its advantage in the use of sepsis diagnosis in extremely premature infants compared to CRP.Conclusion. Maximum specificity reaches 100%, co-located with the assessment of CRP and PCT, which determines the feasibility of using this combination for verification of congenital infectious conditions such as sepsis and pneumonia in children ELBW and VLBW aged 48–72 hours.

  14. Mode of delivery and antenatal steroids and their association with survival and severe intraventricular hemorrhage in very low birth weight infants.

    Science.gov (United States)

    Hübner, M E; Ramirez, R; Burgos, J; Dominguez, A; Tapia, J L

    2016-10-01

    To determine whether CS delivery and receipt of antenatal steroids (ANS) in vertex-presenting singletons with a gestational age (GA) between 24 and 30 weeks is associated with improved survival and improved severe intraventricular hemorrhage (sIVH)-free survival. Multicenter cohort, retrospective analysis of prospectively collected data. Vertex-presenting singletons newborns with GA 24 to 30 weeks, birth weight between 500 and 1500 g, without major congenital malformations, born between 2001 and 2011 at Neocosur centers were included. Four thousand three hundred and eighty-six infants fulfilled inclusion criteria: 45.8% were delivered vaginally and 54.2% by cesarean section (CS). Newborns delivered vaginally received less ANS, had lower GA, Apgar scores and a lower incidence of survival and sIVH-free survival (P<0.001). Newborns with better survival were those with ANS, independent of mode of delivery. At 24 to 25 weeks GA, increased survival and sIVH-free survival were associated with ANS and CS delivery, compared with those who received ANS and delivered vaginally. Among vertex-presenting singletons with GA 24 to 30 weeks, better survival and IVH-free survival were associated with ANS, independent of mode of delivery. In infants at 24 to 25 weeks gestation the combination of ANS/CS was associated with improvement in both outcomes.

  15. Analysis on high risk factors of bronchopulmonary dysplasia in very low birth weight infants%极低出生体重儿支气管肺发育不良的高危因素分析

    Institute of Scientific and Technical Information of China (English)

    杨亚娟; 刘晓红; 齐利峰; 李腾; 卫敏超

    2013-01-01

    Objective: To explore the clinical high risk factors of bronchopulmonary dysplasia (BPD) in very low birth weight infants. Methods: The clinical data of 199 very low birth weight infants who were treated in NICU of the hospital were analysed retrospectively, then they were divided into BPD group and nori - BPD group; the probable risk factors of BPD were analyzed. Results: Among 199 very low birth weight infants, 48 infants were diagnosed as BPD, the morbidity was 24. 1%. There were statistically significant differences in the time of mechanical ventilation, the time of oxygen inhalation, the time of oxygen inhalation with oxygen concentration >40% , intrauterine infection, combined with patent ductus arteriosus, and nosocomial infection between BPD group and non - BPD group (P 40% were the risk factors of BPD. Conclusion: Preventing intrauterine infection can reduce the morbidity of BPD, mechanical ventilation for a long time and oxygen inhalation with high oxygen concentration are high risk factors of BPD.%目的:探讨极低出生体重儿发生支气管肺发育不良(Bronchopulmonary Dysplasia,BPD)的临床高危因素.方法:回顾性分析NICU收治的极低出生体重儿199例患儿的临床资料,根据是否发生BPD分为BPD组和非BPD组,分析BPD发生的可能危险因素.结果:199例低出生体重儿中有48例发生BPD,发病率为24.1%.与非BPD患儿组相比,BPD组患儿在机械通气时间、总吸氧时间、吸氧浓度>40%时间、宫内感染、合并动脉导管未闭、院内感染等方面比较差异有统计学意义(P<0.05),Logistic回归分析结果显示机械通气时间、宫内感染、吸氧浓度>40%时间为疾病发生的危险因素.结论:预防宫内感染可降低BPD的发生率,长时间机械通气及高浓度吸氧为BPD发生的高危因素.

  16. 极低出生体重儿生长发育及神经发育状况140例临床研究%The Clinical Research of Growth and Neuro Development Status OF 140 Patients with Very Low Birth Weight Infants

    Institute of Scientific and Technical Information of China (English)

    赵慧贞; 吴秋萍; 刘清明; 林晓虹; 王培锋

    2015-01-01

    Objective: To explore the perinatal conditions,growth and development of very low birth weight infants (VLBWI) to improve the diagnosis and the life quality. Methods: The 140 patients with VLBWI born in Zhuhai in Child health division of Zhuhai maternity and child health hospital were divided into three groups according to birth weight from Jan 2010 to Dec 2014. The perinatal conditions,complication after birth,weight,height,head circumference,neuro developmental, visual and auditory were compared. Results: Among the 140 cases, twins, gestational hypertension, premature rupture of membranes,pregnancy-related medical disorders, in vitro fertilization-embryo transfer and uterine cancer were the high six risks of VLBWI, neonatal respiratory distress syndrome,anemia, pneumonia,electrolyte disorder,asphyxia,hyperbilirubinemia were the top six complications. One of the abnormal weight,height or head circumference in VLBWI was 28.6%. The neuro developmental abnormality rate was 28.1%. The incidence of retinopathy of prematurity was 16.0%. The hearing impairment rate was 7.75‰. Conclusion:Strengthen prenatal care and diagnosis of prenatal risk factors can improve the life quality of the VLBWI. The regular physical examination can be used as an effective measure for early screening of children with developmental abnormity.%目的:探讨极低出生体重儿(VLBWI)的围产高危因素、并发症及近期生长发育情况,以提高VLBWI诊治和生存质量。方法:选取2010年1月至2014年12月在珠海市出生,且于珠海市妇幼保健院儿保科体检的140例 VLBWI 按出生体重分为三组,比较其围产期情况、并发症、体重、身高(长)、头围、神经发育及视听功能。结果:本组140例VLBWI前6位围产高危因素是双胎、妊娠期高血压、胎膜早破、妊娠期内科相关疾病、体外受精-胚胎移植和子宫肿瘤,前6位的并发症是新生儿呼吸窘迫综合征、贫血、肺炎、电解

  17. THE ANALYSIS ON THE SURVIVAL RISK FACTORS OF 122 CASES OF VERY LOW BIRTH-WEIGHT%122例极低出生体重儿生存危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈长英; 陈立民

    2011-01-01

    [目的]探讨极低出生体重儿(VLBWI)出生的危险因素及影响其存活率的因素,为降低其死亡率提供帮助.[方法]122例VLBWI按出生体重分为3组,即≤1000 g,1001~1250 g和1251~1500 g,并对其临床资料进行回顾性分析.[结果]治愈69例,治愈率56.56%,治愈率随体重增加而上升(P=0.018);死亡13例,病死率10.66%,死亡率随体重增加而降低(P=0.000).导致VLBWI的主要原因有妊娠高血压综合征(30人,24.59%),胎膜早破(28,22,95%),多胎妊娠(24人,19.67%),前置胎盘/胎盘早剥(12例,9.83%),妊娠期母患内科疾病(10人,8.19%).,胎儿宫内窘迫(6人,4.92%),原因不明(12人,9.83%).住院的VLBWI均有1种或1种以上并发症,主要有代谢性酸中毒(94例,77.05%),高胆红素血症(74例,60.65%),新生儿暂时性凝血功能异常(72例,59.02%),新生儿贫血(68例,55.74%),新生儿心肌损伤(52例,42.62%),新生儿肺透明膜病(40例,32.79%),肺炎(26例,21.31%),早产儿视网膜病变(18例,14.75%),颅内出血(12例,9.83%),肺出血(4例,3.27%).死亡的主要原因为急性呼吸窘迫综合征(RDS),肺出血,感染和脑室内出血.[结论]加强对VLBW1围生期高危因素的认识,积极预防早产,采取综合治疗措施,减少并发症的发生,可降低其病死率,提高VLBWI的生存质量.%[Objective] To investigate the risk factors and the factors which influenced the survival rate, give clinical help for decreasing the mortality rate of very low birth weight infants (VLBWI). [Methods] The clinic data of 122 case of VLBWI were analyzed retrospectively by dividing patients into three groups according to the birth weight (BW), as BW≤ 1 000 g, 1 001-1 250 g and 1 251-1 500 g. [Results] Cured 69 cases, and the cure rate was 56.56%, cure rate increased along with the increase of body weight (P= 0.018); 13 death cases, the mortality was 10.66%, mortality decreased with increase of body weight (P = 0.000). The major causes induced VLBWI were gestational

  18. 117 例极低和超低出生体重儿并发症及结局分析%Complications and outcomes of 117 cases of extremely low birth weight and very low birth weight

    Institute of Scientific and Technical Information of China (English)

    曾军安; 李占魁; 李清红; 邓科委

    2015-01-01

    目的 了解极低出生体重儿( VLBWI)和超低出生体重儿( ELBWI)常见并发症及影响预后的相关因素,为提高极早早产儿救治水平提供参考. 方法 选择西北妇女儿童医院新生儿重症监护病房(NICU)2014年1月1日至12月31日收治的117例VLBWI和ELBWI,根据预后情况分为预后良好组和预后不良组,对其临床资料进行整理和统计分析. 结果 117例患儿中治愈或好转(预后良好)89例(76.1%),放弃治疗或死亡(预后不良)28例(23.9%). VLBWI和ELBWI主要并发症发生率前6位依次是:呼吸窘迫综合征(53.0%),早产儿贫血(50.4%),颅内出血(45.3%),败血症(早发型和晚发型)(36.8%),病理性黄疸(34.2%),呼吸暂停(27.4%). 预后良好组与预后不良组相比较,胎龄较大(t=3.56,P<0.05)、出生体重较重(t=5.30,P<0.05),产时窒息、妊娠期高血压疾病、妊娠糖尿病、肺出血、先天畸形和机械通气率较低(χ2 值分别为4.92、10.73、11.36、5.13、8.79、6.78,均P<0.05). 结论 VLBWI和ELBWI易出现各种并发症,严重并发症及母孕期疾病易导致患儿死亡,并影响家属救治信心,导致预后不良发生,因此,要加强围产期保健,并加强对其并发症的认识,进行及时有效的处理,尽量减少这类患儿的病死率.%Objective To investigate the common complications of very low birth weight infant ( VLBWI) and extremely low birth weight infant ( ELBWI) and related factors influencing prognosis, so as to provide reference for improving the level of treating very preterm infants.Methods From January 1 to December 31 in 2014, totally 117 VLBWIs and ELBWIs treated in neonatal intensive care unit (NICU) of Northwest Women and Children' s Hospital were divided into good prognosis group and poor prognosis group according to prognosis.All these clinical data were collected and analyzed.Results Eighty-nine cases ( 76.1%) were cured or improved ( good prognosis) and 28 cases (23.9%) gave up or died (poor diagnosis

  19. Reduced Cholinergic Basal Forebrain Integrity Links Neonatal Complications and Adult Cognitive Deficits After Premature Birth.

    Science.gov (United States)

    Grothe, Michel J; Scheef, Lukas; Bäuml, Josef; Meng, Chun; Daamen, Marcel; Baumann, Nicole; Zimmer, Claus; Teipel, Stefan; Bartmann, Peter; Boecker, Henning; Wolke, Dieter; Wohlschläger, Afra; Sorg, Christian

    2017-07-15

    Prematurely born individuals have an increased risk for long-term neurocognitive impairments. In animal models, development of the cholinergic basal forebrain (cBF) is selectively vulnerable to adverse effects of perinatal stressors, and impaired cBF integrity results in lasting cognitive deficits. We hypothesized that cBF integrity is impaired in prematurely born individuals and mediates adult cognitive impairments associated with prematurity. We used magnetic resonance imaging-based volumetric assessments of a cytoarchitectonically defined cBF region of interest to determine differences in cBF integrity between 99 adults who were born very preterm and/or with very low birth weight and 106 term-born control subjects from the same birth cohort. Magnetic resonance imaging-derived cBF volumes were studied in relation to neonatal clinical complications after delivery and intelligence measures (IQ) in adulthood. In adults who were born very preterm and/or with very low birth weight, cBF volumes were significantly reduced compared with term-born adults (-4.5% [F1,202 = 11.82, p = .001]). Lower cBF volume in adults who were born very preterm and/or with very low birth weight was specifically associated with both neonatal complications (rpart,92 = -.35, p premature birth and links neonatal complications with long-term cognitive outcome. Data suggest that cholinergic system abnormalities may play a relevant role for long-term neurocognitive impairments associated with premature delivery. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Minimal enteral feeding of extensively hydrolyzed infant formula in nutritional support for very low birth weight infants%深度水解蛋白配方奶配合早期微量喂养在极低出生体重儿营养支持中的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    刘瑛; 李海燕; 储寅玥; 陈影宇; 江焘; 周俊雍; 谢玮; 彭瑞山; 罗永锋

    2015-01-01

    目的 评价深度水解蛋白配方奶配合早期微量喂养在极低出生体重儿营养支持中的临床应用效果.方法 选取2013年1月至2014年11月出生12小时内人住惠东县妇幼保健院新生儿科的极低出生体重儿90例,按抽签法随机分为A、B、C组.A组:12小时内给予深度水解蛋白配方奶(eHF)微量喂养,14天后改等量的早产儿配方奶(SPF)继续喂养;B组:12小时内给予SPF微量喂养;C组:为对照组,给予常规治疗,12小时以后开始SPF喂养.比较三组患儿恢复出生体重的日龄、喂养不耐受的发生率及新生儿贫血、宫外发育迟缓和NEC的发生率.结果 恢复出生体重时间A组短于B、C组,喂养不耐受发生率A组低于B组、C组,差异均有统计学意义;三组喂养方式下,A组新生儿贫血、宫外发育迟缓和NEC发生率低于B组和C组.结论 深度水解蛋白配方奶配合早期微量喂养可促进极低出生体重儿体重的早期恢复,改善喂养不耐受的发生率.%Objective To evaluate the clinical efficacy of minimal enteral feeding of extensively hydrolyzed infant formula in nutritional support for very low birth weight infants.Methods 90 very low birth weight infants born within 12 hours and admitted into Department of Neonates,Huidong Children and Maternal Hospital from January 2013,to November,2014 were selected and were randomly divided into group A,group B,and group C according to lottery method.Group A were minimally fed with extensively hydrolyzed infant formula (eHF) within 12 hours,14 days from then with the same amount of standard preterm infant formula (SPF);group B with SPF within 12 hours;and group C (a control group) conventionally treated and with SPF 12 hours after being admitted.The time recovering to birth weight and the incidences of feeding intolerance,anemia,extra uterine growth restriction (EUGR),and necrotizing enterocolitis (NEC).Results The time recovering to birth weight was significantly shorter and

  1. 人工气道温度设定对极低体重儿核心体温的影响%The effects of temperature setting of artificial airway on core temperature in very low birth weight infant

    Institute of Scientific and Technical Information of China (English)

    魏春兰; 唐淑云; 凌秀红

    2014-01-01

    Objective:To study the effects of the temperature of inspiratory gas with artificial airway on core temperature in very low birth weight infants. Methods:45 very low birth weight infants with artificial airway were randomly divided into three groups according to the temperature of inspiratory gas. The temperature of inspiratory gas was 36. 5-37. 3℃ in the group A,34. 5-35℃ in the group B,and 38. 5-39℃ in the group C. The gas temperature at the side of patents′mouth as the setting temperature was dicided by the inductor. The rectal temperature of the infants were recorded every 2 hours. Results:The core temperature in the infant was maintained at neutral temperature when the setting temperature was 36. 5-37. 3℃(group A)(P<0. 05). The core tem-perature was lower than neutral temperature when the setting temperature was 34. 5-35℃(group B). The core temperature was higher than neutral temper-ature when the setting temperature was 38. 5-39 ℃(group C). Conclusion:The core temperature in very low birth weight infant with artificial airway could be maintained at neutral temperature when the temperature of inspiratory gas was 36. 5-37. 3 ℃. At the same time,It could decrease oxygen consumption, the loss of evaporative heat,metabolism,and reduce complication.%目的:探讨人工气道吸入气体温度对极低体重儿核心体温的影响。方法:将我院符合入组标准的45例建立人工气道的极低体重儿随机等分为3组,A组吸入气体温度设置为36.5~37.3℃,B组吸入气体温度设置为34.5~35℃,C组吸入气体温度设置为38.5~39℃。均以感应器测定的到达患儿口边的气体温度为设定温度,每2 h测量3组患儿体温(肛温)1次并记录。结果:A组患儿核心温度维持在中性温度,B组患儿核心温度低于中性温度,C组则高于中性温度。结论:极低体重儿建立人工气道时将吸入气体温度调到36.5~37.3℃可使极低体重儿的核心体温度维持在中性温度,同

  2. 布拉氏酵母菌对不同喂养方式极低出生体重儿坏死性小肠结肠炎的影响研究%Efficacy comparison of Saccharomyces boulardii on Necrotizing enterocolitis between different feeding patterns of very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    陈凌; 陈煜; 黄萍

    2015-01-01

    Objective To investigate the impact of Saccharomyces boulardii on morbidity and severity of Necrotizing enterocolitis between different feeding patterns of very low birth weight infants.Methods Very low birth weight infants born between April, 2014 to March, 2015 were enrolled. Breast milk group and pretermformula group were generated according to different feeding patterns.Each group was randomized either to receive feeding supplementation with Saccharomyces boulardii or not.The morbidity and severity of Necrotizing enterocolitis were analyzed.Results Compared with Breast milk group, pretermformula group had higher morbidity and more severe cases ( Stage Ⅲ) .In Breast milk group, Saccharomyces boulardii reduced the morbidity and severity of Necrotizing enterocolitis.In pretermformula group, Saccharomyces boulardii also had adverse effect on severity while no influence on morbidity.Conclusions Breast milk is a better feeding type than pretermformula.Saccharomyces boulardii reduces the severity of Necrotizing enterocolitis in both feeding patterns and morbidity in Breast milk feeding infants. However, the occurrence of Necrotizing enterocolitis in pretermformula feeding infants remains constant.%目的 在不同喂养方式的极低出生体重儿中,探讨布拉氏酵母菌对坏死性小肠结肠炎发病率和严重程度的影响. 方法 选取2014年4月1日至2015年3月1日收治的极低出生体重儿患者,根据喂养方式分为母乳喂养组和早产儿奶喂养组,在各组中均随机分出治疗组和对照组,治疗组使用布拉氏酵母菌治疗,观察坏死性小肠结肠炎发病率和严重程度. 结果 早产儿奶喂养组比母乳喂养组NEC发病率更高,第Ⅲ期以上严重病例者增多( P0.05). 结论 母乳喂养是最佳的喂养方式,布拉氏酵母菌在母乳喂养方式的患儿中能减少NEC发病率和降低严重程度,在早产儿奶喂养方式的患儿中NEC发病率虽无明显变化,但疾病严重程度得到降低.

  3. 极低出生体重儿初乳口腔涂抹安全性和可行性的研究%Study on safety and feasibility of colostrum oropharyngeal administration for very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    季福婷; 张玉侠

    2016-01-01

    Objective:To explore the safety and clinical feasibility of colostrum oropharyngeal administration for very low birth weight infants.Methods:The convenience sampling method was adopted to carry out health edu-cation on the families of very low birth weight infants who were admitted to the neonatal intensive care unit (NICU)of Fudan University Pediatric Hospital from March to August in 2015 to obtain fresh colostrum.The obtained colostrum was smeared with 0.2 mL,once every 4 h for 7 days.The vital signs such as heart rate, blood oxygen saturation and respiration were observed before,during and after the smearing.At the same time to record the beginning time of colostrum oropharyngeal administration,tube feeding,breastfeeding and the pro-portion of colostrum oropharyngeal administration.Results:A total of 205 cases of very low birth weight infants were observed,130 cases met the inclusion criteria,and 104 cases of family members expressed willingness to send the colostrum for oral daub every day during the first 7 days.A total of 77 cases(59.23%)persisted in sending fresh colostrum to the hospital,and successfully finished a period of 7 days of colostrum oropharyngeal administration intervention,in the same means that 74.04%(77/104)of the volunteers successfully completed colostrum oropharyngeal administration.durins the smear,the children’s heart rate,blood oxygen saturation were stable,there were 9 Apnea occured in 7 cases during the smear.Conclusion:It was safe to apply colostrum oropharyngeal administration for NICU infants with very low birth weight based on the reasonable education.It was convenient to obtain fresh colostrum and the colostrum oropharyngeal administration had higher feasibility.%[目的]探究使用初乳对极低出生体重儿进行口腔涂抹的安全性及临床推广的可行性。[方法]采用便利抽样法,对2015年3月—8月入住复旦大学附属儿科医院新生儿重症监护病房(NICU)的新生极低出生体重儿家属

  4. Controvérsias a respeito da sepse fúngica no pré-termo extremo: profilaxia e esquemas terapêuticos Controversies about the management of invasive fungal infections in very low birth weight infants

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    Maria E. L. Moreira

    2005-03-01

    weight infants, keeping health professionals updated about this growing problem observed in neonatal units. SOURCES OF DATA: Original and review articles published over the past 15 years were searched in MEDLINE and Lilacs, using the following keywords: preterm infant, very low birth weight infants, sepsis, fungal infection, antifungal, Candida, amphotericin and fluconazole. SUMMARY OF THE FINDINGS: Invasive fungal infections affect especially preterm infants. Although new drugs (echinocandins to treat fungal infection are available, amphotericin is the most widely used drug for the treatment of systemic candidiasis at this stage of life. Currently, there are four types of antifungal agents used in the treatment of fungal infections in neonates: polyene macrolides (amphotericin B deoxycholate and lipid preparations, azoles (triazoles, fluorinated pyrimidines (flucytosine and echinocandins (caspofungin and micafungin. Two drugs capable of preventing invasive fungal infection are described: nystatin and fluconazole. The pharmacokinetics of fluconazole in the neonatal period is widely known and its prophylactic administration during the first six weeks of life has been associated with less invasive fungal infection in infants weighing less than 1,000 g at birth. CONCLUSIONS: Fungal infections constitute an important problem in the neonatal intensive care unit and a better understanding of the incidence, diagnosis, clinical management, treatment, and prophylaxis is important in order to reduce morbidity and mortality. The identification of high-risk preterm infants and the implementation of prophylactic measures and early treatment may improve the outcome of these patients.

  5. Prevention of peripherally inserted central line-associated blood stream infections in very low-birth-weight infants by using a central line bundle guideline with a standard checklist: a case control study.

    Science.gov (United States)

    Wang, Wei; Zhao, Chunling; Ji, Qinglian; Liu, Ying; Shen, Guirong; Wei, Lili

    2015-06-18

    Catheter-related infections (CRIs) are one of the severe complications of PICC placement. If treatment is not timely or correct, the incidence of infection and mortality rate can be high. A central line bundle (CLB) guideline was first proposed by the Institute for Healthcare Improvement, and included five key measures. Very low-birth-weight infants (VLBWIs) have a low immune response and indistinct symptoms after infection compared with other populations (Costa P, Kimura AF, de Vizzotto MP, de Castro TE, West A, Dorea E. Prevalence and reasons for non-elective removal of peripherally inserted central catheter in neonates. Rev Gaucha Enferm. 2012;33:126-33). Some reviews have focused on the effect and safety of a CLB in VLBWIs and its preventive effect on bacterial colonization and infection. Fifty-seven VLBWIs who underwent PICC insertion at a hospital in Qingdao, China, between November 2012 and June 2013, and for whom a CLB guideline and a standard checklist were adopted, were included in the CLB group. In contrast, 53 VLBWIs who underwent PICC insertion, but for whom a CLB guideline and a standard checklist were not adopted, were included in the control group. The incidence of CRIs was compared between before and after the treatment. The incidence of infection showed a statistically significant reduction from 10.0 to 2.20 per 1000 catheter days in the control group (P control group and 31.9 ± 15.0 days in the study group (P < 0.05), and these values were significantly different. The use of a CLB guideline with a standard checklist could be effective and feasible for preventing CRIs in VLBWIs and prolonging indwelling catheter time.

  6. 极低出生体重早产儿动脉导管未闭的治疗%Treatment of patent ductus arteriosus in very low birth weight preterm infants

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    陈涵强; 杨长仪; 杨文庆; 石惠英; 林云峰

    2011-01-01

    Objective To investigate the treatment of symptomatic patent ductus arteriosus (PDA) in very low birth weight preterm infants. Methods From January 1, 2008 to December 31, 2010, 78 very low birth weight preterm infants (birth weight<1500 g) were diagnosed as symptomatic PDA. Among which, 42 cases administered orally with indomethacin (0.2 mg/kg, every 12 hrs for three times) were taken as treatment group, while five cases in this group who failed to indomethacin treatment were interrupted with video-assisted thoracoscopic surgery. And 36 cases who did not receive treatment for ductus arteriosus were taken as control group. The clinical outcomes, complications and prognosis of these patients were observed. Results There were no significant differences between the gentle percentage, gestational age, diameter of ductus arteriosus, rate of complicated with heart failure, sepsis, neonatal respiratory distress syndrome and intraventricular hemorrhage of two groups (P>0.05, respectively). The ductus arteriosus closed in 33 patients of treatment group (78.6%) and in nine patients of control group (25.0%)(χ2=22.39,P=0.000). There were no significant differences in serum creatinine level and platelet count between before and after the treatment in treatment group(P>0.05). Compared with control group, the treatment group had lower incidence of intraventricular hemorrhage (z=1.167, P=0.030), shorter duration of oxygen therapy [(8.0±5.5) d vs (13.3±9.3) d, t=2.225, P=0.032] and shorter hospital stay [(39.0±7.7) d vs (43.6±10.6) d, t=2.229, P=0.029]; while the incidence of bronchopulmonary dysplasia and necrotizing enterocolitis were similar (P>0.05). The five cases of PDA who received video-assisted thoracoscopic surgery were successfully interrupted with no residual shunt left, while three of them had lung infections and one had pleural effusion, but no pneumothorax and infant death associated with surgery occurred. Conclusions Symptomatic PDA of very low birth weight

  7. Growth Assessment with Z Score of Weight for Very Low Birth Weight Infant During Hospital Stay%胎龄别体重Z评分法评价早产极低出生体重儿生后早期营养状况的分析

    Institute of Scientific and Technical Information of China (English)

    李乔红; 邹永蓉; 谭学蓉; 唐文秀; 高月; 陈伟; 王一

    2014-01-01

    Objective To evaluate the nutrition status in very low birth weight at reture birth weight and discharge with Z score of weight for correct age( CA) . Methods 141 appropriate for gestational age( GA) premature infants with hospital stay ex-ceeding 2 weeks but no major congenital diseases were included. Z scores of weight for age were calculated at birth and reture birth weight and discharge. Their clinical data were retrospectively analyzed. Results At all the subgroups( categorized by GA at birth or by nutrition support method or by nutrition status at discharge) ,The Z scores at reture birth weight and discharge were positively related with Z scores at birth(P<0. 001);Different nutrition support method were significantly related with Z score at reture birth weight and discharge(P<0. 001). The lower Z scores at birth, the time of reture birth weight and discharge were longer. Conclu-sion Very low birth weight infants occurred growth retardation during admission. Nutritional support strategy is helpful for nutri-tion condition in premature infants.%目的:采用纠正胎龄别体重Z评分法评估极低出生体重儿入院时、恢复出生体重时与出院时营养状况,探讨其与出生时营养状况、生后营养支持方式、恢复出生体重时间及住院时间之间的关系。方法选择出生胎龄28~33+6周,出生体重<1500g,生后24h内入院,住院时间≥2周新生儿,分别按出生胎龄和营养支持方式、出院时营养状况分组,比较每组出生时、恢复出生体重时和出院时的Z评分,以及恢复出生体重所需时间和住院时间的关系。结果每组患儿出院时Z评分均低于入院时;小出生胎龄组恢复出生体重时和出院时Z评分均高于大胎龄组;营养支持滞后组,恢复出生体重时及出院时Z评分均较积极组更低,滞后组恢复出生体重所需时间和住院时间也均更长;出生时Z评分越低,恢复出生体重时Z评分和出院时Z评分越低,恢复出

  8. Avaliação do neurodesenvolvimento de prematuros de muito baixo peso ao nascer entre 18 e 24 meses de idade corrigida pelas escalas Bayley III Neurodevelopmental assessment of very low birth weight preterm infants at corrected age of 18-24 months by Bayley III scales

    Directory of Open Access Journals (Sweden)

    Luciana Volpiano Fernandes

    2012-12-01

    Full Text Available OBJETIVO: Avaliar a prevalência de atraso e fatores associados aos escores de desenvolvimento em crianças nascidas prematuras. MÉTODOS: Estudo transversal para avaliar o desenvolvimento por escalas Bayley III, incluindo-se prematuros de muito baixo peso de 18 a 24 meses de idade corrigida, acompanhados no Ambulatório de Prematuros da instituição. Excluíram-se: malformação congênita, síndrome genética, infecção congênita sintomática ao nascimento, surdez e cegueira. As variáveis numéricas foram comparadas por teste t de Student ou Mann-Whitney, e as categóricas, por qui-quadrado ou teste exato de Fisher. Para análise dos fatores associados aos escores de desenvolvimento, utilizou-se a regressão linear, considerando-se significante p OBJECTIVE: To evaluate the prevalence of delay and factors associated with neurodevelopmental scores in premature infants. METHODS: Cross-sectional study to assess the development by Bayley Scales III, including very low birth weight preterm infants aged 18 to 24 months who were under follow-up at the outpatient clinic for preterm infants. Congenital malformation, genetic syndrome, symptomatic congenital infection at birth, deafness, and blindness were excluded. Numerical variables were compared by Mann-Whitney or Student t test and categorical variables by chi-square or Fisher's exact test. Factors associated with developmental scores were analyzed by linear regression, and statistical significance level was established at p < 0.05. RESULTS: Out of the 58 children included, four (6.9% presented cognitive delay, four (6.9% motor, 17 (29.3% language, 16 (27.6% social-emotional and 22 (37.0% adaptive-behavior delay. By multiple linear regression, the variables: social classes CDE (-13.27; 95%CI: -21.23 to -5.31, oxygen dependency at 36 weeks of corrected age (-8.75; 95%CI: -17.10 to -0.39 decreased the cognitive developmental score. Periventricular leukomalacia decreased the cognitive (-15.21; 95%CI

  9. Fatores de risco para a mortalidade de recém-nascidos de muito baixo peso em Unidade de Terapia Intensiva Neonatal Factores de riesgo para la mortalidad de recién nacidos de muy bajo peso en Unidad de Terapia Intensiva Neonatal Risk factors for the mortality of very low birth weight newborns at a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Jair Almeida Carneiro

    2012-09-01

    Full Text Available OBJETIVO: Identificar os fatores associados à mortalidade de recém-nascidos de muito baixo peso internados em uma Unidade de Terapia Intensiva Neonatal de referência no Norte de Minas Gerais, Brasil. MÉTODOS: Estudo transversal baseado na análise de prontuários de uma amostra aleatória de recém-nascidos admitidos em uma Unidade de Terapia Intensiva Neonatal de janeiro de 2007 a junho de 2010. Foram considerados elegíveis para o estudo recém-nascidos com peso inferior a 1500g, provenientes do bloco obstétrico da própria instituição. Foram identificadas variáveis demográficas maternas, variáveis relacionadas às condições de gestação e parto e variáveis do recém-nascido. A associação entre as variáveis foi aferida por meio do teste do qui-quadrado e Odds Ratio. As variáveis associadas até o nível de 25% (pOBJETIVO: Identificar los factores asociados a la mortalidad de recién nacidos de muy bajo peso, internados en una Unidad de Terapia Intensiva Neonatal de referencia en el Norte de Minas Gerais, Brasil. MÉTODOS: Estudio transversal, basado en el análisis de prontuarios de una muestra aleatoria de recién nacidos admitidos en una Unidad de Terapia Intensiva Neonatal desde enero de 2007 hasta junio de 2010. Fueron considerados elegibles para el estudio los recién nacidos con peso inferior a 1.500g, provenientes del bloque obstétrico de la propia institución. Fueron identificadas variables demográficas maternas, variables relacionadas a las condiciones de gestación y parto y variables del recién nacido. La asociación entre las variables fue verificada por medio de la prueba de chi cuadrado y Odds Ratio. Las variables asociadas hasta el nivel de 25% (pOBJECTIVE: To identify variables associated with mortality among very low birth weight infants admitted to a Neonatal Intensive Care Unit in Minas Gerais, Southeastern Brazil. METHODS: Cross-sectional study based on chart data of a random sample of premature

  10. Effects of corticosteroids in very low birth weight newborns dependent on mechanical ventilation Efeitos de corticosteróides em recém-nascidos de muito baixo peso, dependentes de ventilação mecânica

    Directory of Open Access Journals (Sweden)

    Marta M. G. B. Mataloun

    2005-04-01

    Full Text Available Corticosteroids have been used in bronchopulmonary dysplasia prevention because of their antiinflammatory effects. Among their effects is a decrease in the incidence of bronchopulmonary dysplasia. However, short- and long-term side effects have been detected in preterm newborns. PURPOSE: To analyze the effects of corticosteroids on bronchopulmonary dysplasia, length of stay, mortality, growth, as well as the adverse effects in very low birth weight newborns between 10 and 14 days of life and dependent on mechanical ventilation. METHODS: Cohort study. All newborns with a birth weight under 1500 g, mechanical ventilation-dependent between 10 and 14 days of life, during the period January 2000 and June 2001 were included (n = 38. They were divided into 2 groups: Group I with corticosteroids (n = 16 and Group II without corticosteroids (n = 22. Dexamethasone administration: from the 10th day of life, d1 - d3, 0.3 mg/kg/d; d4 - d6, 0.2 mg/kg/d; d7 - d9, 0.1 mg/kg/d. Respiratory evolution, bronchopulmonary dysplasia (oxygen dependence at 28 days of life, growth pattern and the presence of adverse effects were analyzed. RESULTS: The incidence of bronchopulmonary dysplasia was 6.5% (Group I and 30% (Group II, P = .07. A decrease in growth was detected in Group I compared with Group II (change in weight: Group I - 47 g/week, Group II - 85.5 g/week, P = .06; change in head circumference: Group I - 0.75 cm/week, Group II - 1 cm/week, P = .05. CONCLUSION: Use of corticosteroids in very low birth weight infants dependent on mechanical ventilation during the first 10 to 14 days of life did not affect the respiratory evolution and occurrence of bronchopulmonary dysplasia, but the velocity of growth was reduced.Devido às suas ações anti-inflamatórias, os corticosteróides têm sido utilizados para prevenção de displasia broncopulmonar, sendo descrita, uma redução da incidência desta patologia. No entanto, efeitos adversos a curto e a longo prazo t

  11. Risk factors for late onset infection of very low birth weight infants in Ghana%极低出生体重儿晚发感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    邵红梅; 严建江; Salma B

    2013-01-01

    Objective To examine the incidence and mortality for late onset infection of very low birth weight infant(VLBWI) and associated risk factors in neonatal intensive care unit(NICU) of Korle-Bu teaching hospital in Ghana.Methods Data on all infants 1 500 g or below admitted to Korle-Bu teaching hospital NICU between Nov 2011 and Apr 2012 were analyzed for late onset infection,including:clinical information,positive blood or/and cerebrospinal fluid culture,biochemical data occurring after 7 days of life.Late onset infection was defined as clinical signs of infection starting more than 7 days after birth.The risk factors associated with late onset infection were investigated by Logistic regression.Results The overall survival of the 244 study infants was 61.9% (151/244).The rate of late onset infection was 30.3% (74/244).The mortality in those with late onset infection was 32.3% (21/65).The most common infection organism was Klebsiella pneumoniae,accounting for 38.5% (25/65) of infection and 47.6% (10/21) of deaths in infants with infection,followed by coagulase-negative staphylocci,16.9% (11/65) and 14.3 % (3/21),respectively.On logistic regression analysis,risk factors for Gram-negative infection were endotracheal intubation at birth,respiratory distress syndrome and blood transfusion.Hypoglycemia was associated with Gram-positive infection.Birth weight < 1 000 g,gestational age < 28 weeks,mechanical ventilation,central venous catherization were associated with both infection above.Conclusion Multifactor cause late onset infection in VLBWI.The supervision should be extended to decrease the incidence and mortality of the infection in NICU.%目的 调查加纳Korle-Bu教学医院NICU住院的极低出生体重儿(very low birth weight infant,VLBWI)晚发感染的发生率和病死率,并分析晚发感染的相关危险因素.方法 收集2011年11月至2012年4月加纳Korle-Bu教学医院NICU住院的所有VLBWI的临床及实验室资料,分析与

  12. S-腺苷蛋氨酸联合熊去氧胆酸治疗极低出生体质量患儿肠外营养相关性胆汁淤积症的疗效观察%Efficacy of S-adenosylmethionine and ursodeoxycholic acid on parenteral nutrition associated cholestasis in very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    何伟彬; 杨辉; 戴怡蘅

    2013-01-01

    目的 观察S-腺苷蛋氨酸联合熊去氧胆酸治疗极低出生体质量患儿肠外营养相关性胆汁淤积症的疗效.方法 研究对象为本院2008年1月-2012年10月出生的极低出生体质量患儿67例,出生后接受静脉营养(PN)并出现肠外营养相关性胆汁淤积症(PNAC),随机分为观察组36例,对照组31例.对照组在减少肠外营养基础上给予口服熊去氧胆酸10~30mg/(kg·d)治疗10d,观察组在对照组治疗基础上联合S-腺苷蛋氨酸30~50mg/(kg·d)治疗10d.治疗前后分别检测2组患儿血清谷丙转氨酶(ALT)、总胆红素(TBIL)、直接胆红素(DBIL)和总胆酸(TBA)的水平.结果 2组各观察指标ALT、TBIL、DBIL、TBA的水平均较治疗前下降,差异有统计学意义(P<0.01).观察组ALT、TBIL、DBIL、TBA的水平较对照组下降更明显(P<0.05).结论 S-腺苷蛋氨酸联合熊去氧胆酸治疗极低出生体质量患儿胆汁淤积症疗效更显著,安全性高,值得临床推广.%Objective To observe the efficacy of the S - adenosylmethionine and ursodeoxy-cholic acid on parenteral nutrition associated cholestasis in very low birth weight infants. Methods Sixty-seven very low birth weight infants received parenteral nutrition (PN) after born, and suffered from parenteral nutrition associated cholestasis (PN AC). They were randomly divided into observation group (n =36) and the control group (n = 31). In the control group, the patients received the reduced dose of parenteral nutrition, and were treated with ursodeoxycholic acid of dosage 10 - 30 mg/(kg·d) for 10 days. In the observation group, the patients received same treatment as those in the control group, and treated with S- adenosylmethionine of dosage 30~50 mg/(kg·d) for 10 days. Before and after treatment in two groups, we detected their serum levels of alanine amino-transferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL), and total bile acid (TBA). Results Levels of ALT, TBIL, DBIL and TBA in

  13. Atención de la salud en niños de muy bajo peso al nacer en Montevideo,Uruguay: comparación entre los sectores publico y privado Health care of very low birth weight infants in Montevideo, Uruguay: a comparison between public and private sectors

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    Alicia Matijasevich

    2001-08-01

    Full Text Available OBJETIVO: comparar morbilidad y mortalidad de los niños de muy bajo peso al nacer de Montevideo, Uruguay, atendidos en unidades intensivas del sector público y privado. METODOLOGIA: delineamiento longitudinal. Se incluyeron los recién nacidos de muy bajo peso al nacer del sector público de la ciudad de Montevideo, Uruguay, nacidos desde el 1/5 al 31/10/1999, siguiéndose hasta su alta o muerte. Se comparó atención recibida, morbilidad y mortalidad entre los trasladados inmediatamente al nacimiento a unidades de cuidados intensivos neonatales privadas con los que permanecieron en unidades públicas sin haber sido nunca trasladados. RESULTADOS: nacieron 141 niños de muy bajo peso al nacer. Se excluyeron del estudio 19 niños (13 murieron en sala de partos y 6 nacidos en el sector público trasladados a unidades intensivas públicas. De los 122 niños incluidos, 61 quedaron en la unidad del hospital público en que nacieron y 61 fueron referidos a unidades privadas. Los atendidos en el sector privado resultaron más prematuros y con mayor frecuencia de depresión neonatal. Sin embargo, la mortalidad en el sector público fue casi dos veces mayor (Hazard Ratio 1.8, IC 95% 1.1-3.4, p=0,04, fundamentalmente en los menores de 1000 gramos (Hazard Ratio 2.4, IC 95% 1.1-5.5, p=0,04. CONCLUSIÓN: se realizó una evaluación de la atención de los niños de muy bajo peso atendidos en unidades intensivas públicas y privadas de Montevideo, Uruguay. Hubo menor mortalidad en los niños atendidos en el sector privado y algunas evidencias de que la calidad de atención es mejor en éste sector.OBJECTIVE: to compare morbidity and mortality in very low birthweight infants admitted to public and private intensive care units in Montevideo, Uruguay. METHODS: longitudinal design. All very low birth weight infants born in public hospitals of Montevideo between May 1st and October 31st, 1999, were included in the study and followed up until they were discharged

  14. Relationship of Gastric pH Value and Feeding Intolerance in Very Low Birth Weight Infants (VLB-WI)%极低出生体重儿胃液 pH 值与喂养不耐受的相关性研究

    Institute of Scientific and Technical Information of China (English)

    郝群英

    2016-01-01

    Objective]To explore the relationship of gastric pH value and feeding intolerance in very low birth weight infant (VLBWI).[Method]80 cases of very low birth weight children in our hospital from January 2010 to December 2014 also in the neonatal intensive care unit were chosen for our study.Using the feeding intolerance di-agnostic criteria,the children were selected and divided into two groups.Group 1 had no feeding intolerance (36 cases)and Group 2 had feeding in tolerance (44 cases).The two groups of children were observed in respect to gastric pH value,feeding conditions (feeding time,the amount of intake and gastric residue),and feeding toler-ance (bloating times,frequency of vomiting,abnormal stool frequency).[Results]Group 1 had a feeding intoler-ance rate of 100%,significantly higher than the 8.33% rate in Group 2 (P <0.05),while the average gastric pH value was also higher in Group 1 than Group 2 (P <0.05).The occurrence of VLBWI feeding intolerance and gas-tric pH value were positively correlated r =0.77,P =0.00.[Conclusion]Gastric pH value in very low weight new-borns with feeding intolerance showed significant correlation with the gastric pH levels in the infants.It is worthy of effective monitoring to help clinicians and nurses to understand neonatal gastrointestinal function and promote neonatal rehabilitation reference.%【目的】探讨极低出生体重儿(VLBWI)胃液 pH 值与喂养不耐受的关系。【方法】选取2010年1月至2014年12月本院新生儿重症监护室(NICU)收治的 VLBWI 80例。参照喂养不耐受诊断标准,将入选患儿分为喂养耐受组36例,喂养不耐受组44例。比较两组患儿的胃液 pH 值、喂养耐受情况(胃残留量、腹胀、呕吐、大便异常)。【结果】喂养不耐受组喂养不耐受发生率为100%,高于喂养耐受组的8.33%(P <0.05),同时其平均胃液 pH 值高于喂养不耐受组(P <0.05);VLBWI 胃液 pH 值与胃残留量呈正相关,r =0.77,P =0.00

  15. INFLUENCES OF COMPREHENSIVE INTERVENTION ON GROWTH AND DEVELOPMENT OF VERY LOW BIRTH WEIGHT INFANT IN INFANCY%综合干预对极低出生体重儿婴儿期生长发育的影响

    Institute of Scientific and Technical Information of China (English)

    韩庆华; 刘霞

    2015-01-01

    [ABSTRACT]Objective: To explore the influences of early comprehensive intervention out of hospital on physical and motor development of very low birth weight infants (VLBWI).Methods: 35 VLBWI that hospitalized in our hospital were used as intervention group, 40 healthy full term infants as control group. The infants in intervention group were given early systemic comprehensive intervention. The physical and motor developments of infants in 2 groups were respectively observed at 3 months, 6 months, 9 months and 12 months age.Results: The physical and motor development of VLBWI at birth, 3 months and 6 months age were obviously lagged behind healthy full term infants(P0.05); but the head circumference of VLBWI was still less than that of healthy full term infants (P0.05).Conclusions: Early comprehensive intervention out of hospital in infancy can stimulate the growth potential of VLBWI and help them achieve normal developmental level.%目的::探讨出院后早期综合干预对极低出生体重儿婴儿期体格和运动发育的影响。方法:以我院35例极低出生体重儿为干预组,以同期40例正常健康足月儿为对照组,干预组早期给予系统化的综合干预。分别于3月龄、6月龄、9月龄、12月龄时观察两组体格发育和运动发育情况。结果:干预组极低出生体重儿在出生、3月龄、6月龄时体格和运动发育均明显落后于对照组足月儿(P<0.05)。9月龄时,极低出生体重儿身长、体重和运动发育已达足月儿水平(P>0.05);但干预组极低出生体重儿的头围仍小于对照组足月儿(P<0.05)。12月龄时,极低出生体重儿的体格发育和运动发育均已达足月儿水平(P>0.05)。结论:出院后早期对极低出生体重儿实施综合干预,能使极低出生体重儿在婴儿期完成体格和运动发育的追赶生长,达到正常发育的水平。

  16. 分时段中心静脉置管在极低出生体质量儿中的应用%Application of Combined Central Venous Catheterization in Divided Period in Very Low Birth Weight Infants

    Institute of Scientific and Technical Information of China (English)

    黄朝梅; 邵巧仪; 罗英; 邓桂珍

    2013-01-01

    Objective To explore the application of umbilical venous catheter (UVC) combined with peripherally inserted central catheter (PICC) in divided period in very low birth weight infants (VLBWI). Methods One hundred and eleven VLBWIs from January 2010 to December 2011 were divided into combined catheter group (UVC and PICC) with 51 cases and PIV (peripheral vein) plus PICC group with 60 cases. Venous catheter situation, physical indications and catheter infection during hospitalization were monitored. Results The one-shot success rate in combined catheter group was higher than that of PIV plus PICC group, but lower incidence of infusion extravasation in combined catheter group. Correction time of hypoglycemia had no significant difference between the two groups, however but the frequency of apnoea and the time of weight up to 2 kg had (P<0.01). Conclusion With combined central venous catheterization, a higher success rate of intravenous puncture could be achieved with longer retention time, but lower incidence of infusion extravasation, which provides a safe and effective venous channel for VLBWI.%  目的探讨分时段脐静脉置管和经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)置管在极低出生体质量儿中的应用效果。方法选取2010年1月—2011年12月入院的极低出生体质量儿111例,分为分时段应用脐静脉置管、PICC组(观察组)51例和外周静脉置管加PICC组(对照组)60例,监测两组住院期间的静脉置管情况、患儿身体指征反应及导管感染情况。结果观察组PICC 1次置管成功率高于对照组,输液外渗发生率低(P<0.01);两组患儿纠正低血糖所需时间差异无统计学意义;呼吸暂停次数、体质量增长至2 kg时间经比较差异有统计学意义(P<0.01)。结论采用分时段中心静脉置管具有穿刺成功率高,留置时间长,输液外渗发生率低,且不增加感染的优点,能最大限

  17. Effect of systematic health care on physical development of preterm infants under 32 weeks' gestational age and very low birth weight infants%系统保健对32周以下早产儿及VLBWI体格发育的影响

    Institute of Scientific and Technical Information of China (English)

    李慧丽; 王强; 任路忠; 王为实; 邓顺莲; 宁玉峰; 钱刚

    2015-01-01

    目的:探讨系统保健对胎龄小于32周早产儿及极低出生体重儿(VLBWI)校正胎龄12个月时体格发育的影响。方法将2011-2012年度在深圳市龙岗区妇幼保健院出生的胎龄0.05)。结论1岁以内对胎龄32周以下早产儿及VLBWI实施系统保健可促进其1岁时体格发育,降低营养不良的发生率。%Objective To discuss the effect of systematic health care on physical development of pre-term infants under 32 weeks' gestational age and very low birth weight infants (VLBWI) at the age of 12 months. Methods Sixty preterm infants under 32 weeks' gestational age and VLBWI who were born in Shenzhen Long-gang Maternal and Child Health Care Hospital between 2011 and 2012 were divided into systematic health care group (n=30, group A) and non systematic health care group (n=30, group B). At the same time, 30 normal term in-fants who were born in the same hospital between 2011 and 2012 were randomly selected as control group (group C). Infants of group A accepted a general examination once a month before 6 months corrected gestational age, once two months after 6 months corrected gestational age. Infants of group B did not accept the general examination. Infants of group C accepted a general examination once three months. Examined their physical development at the age of 12 months, compared the index of physical development and incidence of malnutrition. Results At the age of 12 months the weight, height and head circumference of infants in group A and group C were higher than those of group B, the differences were statistically significant (P0.05). Conclusion Systematic health care can improve physical development and reduce malnutrition rate for preterm infants at the age of 12 months.

  18. Desenvolvimento cognitivo de crianças prematuras de muito baixo peso na idade pré-escolar Pre-school cognitive development of very low birth weight preterm children

    Directory of Open Access Journals (Sweden)

    Maria D. B. B. Méio

    2004-12-01

    Full Text Available OBJETIVO: Avaliar o desenvolvimento cognitivo na idade pré-escolar de recém-nascidos prematuros de muito baixo peso. MÉTODOS: Uma coorte de prematuros nascidos entre janeiro de 1991 e setembro de 1993, com peso igual ou menor que 1.500 g, egressos de uma unidade de terapia intensiva neonatal pública, foi avaliada na idade pré-escolar pelo teste WPPSI-R, aplicado por psicólogas. Foram excluídas crianças com malformações, síndromes genéticas ou infecção congênita, transferidas de outra instituição, nascidas de parto domiciliar e com condições que impedissem a aplicação do teste. Avaliaram-se crianças pré-escolares de uma escola na mesma cidade, nascidas a termo, para comparação. RESULTADOS: Foram estudados 79/129 crianças, com peso de nascimento médio de 1.219,6 g (±168,9; 44/61 delas (72,1% estavam na escola. Não houve diferença estatisticamente significativa entre os grupos (estudo e perda. As médias dos escores obtidos pelas crianças do estudo foram: total - 75,6±11,9; executivo - 77±12,9; e verbal - 78,6±11,1. Nas crianças da escola, as médias foram: total - 85,1±13,2; executivo - 85,3±13,8; e verbal - 87,7±13,9. Essa diferença foi significativa tanto para os escores total (p OBJECTIVE: To examine the cognitive development of school-aged children born preterm and with very low birthweight. METHODS: A cohort of premature infants born between January, 1991, and September, 1993 was examined at pre-school age. All fo them were born in a public Neonatal Intensive Care Unit, with birth weight less than 1,500g. The WPPSI-R Test was used for cognitive evaluation and applied by psychologists. Babies with malformations, genetic syndromes, congenital infections, transferred from other institutions or born at home, and those with conditions which precluded the application of the test, were excluded. A group of pre-school children in the same city, born at term, were tested for comparison. RESULTS: 79 children were

  19. 静脉补充谷氨酰胺对极低出生体重儿肠道功能的影响%Effect of parenteral glutamine supplementation on gut function in very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    王莹; 蔡威; 陶晔璇; 汤庆娅; 冯一; 吴江

    2008-01-01

    Objective To assess the effect of parenteral (PN) glutamine supplementation on gut function in the very low birth weight infants(VLBWIs). Methods A muhicentered, randomized, double-blinded, clinical trial was conducted. Thirty VLBWIs (<1500 g at birth) at two children's medical centers were randomly and equally assigned to either control group [sPN; amino acid was given at the dosage recommended by Chinese guidelines for the use of nutritional support in critically ill neonates(Jun. 2006)] or glutamine-supplemented group [GInPN; glutamine intake, 0. 3 g/(kg · d)]. The primary endpoints were the time to achieve full enteral nutrition, the incidence of gastric residuals, duration of parenteral nutrition and mortality. Results There were no significant differences between GInPN and sPN group in the time to achieve full enteral nutrition [(20±6)d vs (21±9)d], the number of gastric residuals [(3±4) vs (1±2)] and duration of parenteral nutrition [(17±7)d vs (17±8)d]. Of the 15 infants in the GlnPN group, 2 dropped out and 4 suspended treatment, and 4 in the control group suspended treatment (intention-to-treat analysis showed RR= 1.182; 95%CI:0. 937-1. 490). Conclusions Parenteral glutamine supplementation can not shorten the time to achieve full enteral nutrition and duration of parenteral nutrition, or reduce the incidence of gastric residuals and mortality in VLBWIs.%目的 评价含丙氨酰谷氨酰胺(Ala-Gln)肠外营养(parenteral-nutrition,PN)对极低出生体重儿肠道功能的影响.方法 对两家儿童医疗中心2006年4月至2007年2月收治的30例极低出生体重儿进行研究,采用平行、随机、双盲、对照试验,随机分为常规PN组(对照组)和常规PN+Ala-Gin组(研究组),两组各15例,对照组按照常规给予肠外营养支持,氨基酸的剂量按照中国新生儿营养支持临床应用指南给予[从1.0~2.0 g/(kg·d)开始,增至3.5 g/(kg·d)];研究组添加0.3 g/(kg·d)Ala-Gln双肽,其中Ala-Gln双肽取

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

    Institute of Scientific and Technical Information of China (English)

    林素; 吴百威; 王能里; 刘花兰; 胡淑英; 林振浪

    2010-01-01

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

  1. Laterality in Prematurely-Born Children.

    Science.gov (United States)

    Segalwitz, Sidney J.; Chapman, Jacqueline S.

    The study examined the relationship between perinatal stress and decreased right handedness and decreased left cerebral dominance for speech with 215 children born prematurely, followed from birth, and tested at age 5. Results indicated that neither hand preference nor hand performance correlated with degree of perinatal stress and that eye…

  2. Impact of lactose-free hydrolyzed protein formula on feeding intolerance and weight gain in very low birth weight infants%无乳糖水解蛋白奶粉对极低出生体重儿喂养不耐受和体重增长的影响

    Institute of Scientific and Technical Information of China (English)

    杨欢欢; 李菁; 孙建华

    2016-01-01

    目的 探讨无乳糖水解蛋白奶粉对极低出生体重儿喂养不耐受及体重增长的影响.方法 根据入院单双号将2010年8月至2013年8月在本院新生儿重症监护室住院的极低出生体重早产儿(胎龄≤34周,出生体重≤1500 g)分为无乳糖水解蛋白奶粉喂养组(简称水解蛋白组)和普通早产儿奶粉喂养组(简称早产儿奶组).统计两组患儿出生基本情况(出生体重、胎龄、分娩方式、性别、出生时是否存在窒息)、开始喂养日龄、前白蛋白水平、肠道热卡摄入、肠外营养热卡摄入、恢复出生体重所需天数、体重增加指数、肠外营养停止日龄、喂养不耐受发生例数及宫外发育迟缓例数等指标.结果 共纳入83例患儿,其中水解蛋白组40例,早产儿奶组43例,两组出生基本情况差异无统计学意义(P>0.05).水解蛋白组患儿体重增加指数高于早产儿奶组[(13.5±2.4)g/d比(11.9±3.7)g/d,P=0.036],喂养不耐受发生率低于早产儿奶组(28/40比38/43,P=0.038),差异有统计学意义;水解蛋白组患儿宫外发育迟缓(21/40比25/43)和坏死性小肠结肠炎(1/40比2/43)发生率低于早产儿奶组,但差异无统计学意义(P>0.05).结论 无乳糖水解蛋白奶粉能明显降低极低出生体重早产儿喂养不耐受发生率,促进早产儿早期体重增长.%Objective To study whether a lactose-free,hydrolyzed protein formula would ameliorate feeding intolerance and weight gain in very low birth weight infants.Methods The study was conducted on very low birth weight infants ( gestational age ≤34 weeks, birth weight ≤1500 g) in our NICU from August 2010 to August 2013. According to the number of admission, the cases were assigned into lactose-free hydrolyzed protein formula group ( hydrolyzed protein group) and preterm formula group. The data of basic information ( gestational age, birth weight, way of labor, sex, asphyxia ), commencement of feeding time ( days) , enteral

  3. 极低出生体重儿肠道喂养延迟的近期临床结局和围生期危险因素分析%Analysis of short-term clinical outcomes and perinatal risk factors in very low birth weight infants with delayed enteral feeding

    Institute of Scientific and Technical Information of China (English)

    李月凤; 张敏; 刘方; 周平; 卢光进

    2013-01-01

    目的 探讨极低出生体重儿(very low birth weight infants,vLBwI)肠道喂养延迟的近期临床结局和围生期因素与VLBWI肠道喂养延迟的关系.方法 选取2007年1月至2011年10月入住我科的355例VLBWI为研究对象,根据生后肠道喂养开始时间分为两组:延迟喂养组57例(开奶时间≥5 d)和早期喂养组298例(开奶时间≤4d),并比较住院天数>14d、治愈或好转出院的299例VLBWI近期临床结局(包括延迟喂养组44例和早期喂养组255例).采用单因素和多因素Logistic回归对VLBWI的围生期高危因素进行分析.结果 355例VLBWI喂养延迟发生率为16.05% (57/355).延迟喂养组患儿恢复到出生体重的时间明显长于早期喂养组[(11.86±3.86) dvs (9.76±3.83)d,P<0.01].延迟喂养组患儿合并静脉营养相关性胆汁淤积症和出院时宫外发育迟缓的比例为27.27%(12/44)和79.55% (35/44),亦明显高于早期喂养组[分别为11.76%(30/255)和61.57%(157/255),P<0.05)].多因素Logistic回归分析显示,胎盘早剥和机械通气增加了VLBWI生后肠道喂养延迟的风险(OR =2.74,95% CI 1.06 ~7.05;OR =3.51,95% CI 1.92~ 6.42,P<0.05).结论 胎盘早剥和机械通气是VLBWI生后肠道喂养延迟的独立危险因素.加强产前保健及产儿合作是改善早产儿结局、减少肠道喂养延迟的关键.%Objective To investigate the short-term clinical outcomes and perinatal risk factors in very low birth weight infants (VLBWI) with delayed enteral feeding (DEF).Methods Three hundred and fifty-five cases of VLBWI admitted to neonatal intensive care unit from Jan 2007 to Oct 2011 served as study objects,and the clinical data of which were analysed retrospectively.According to days to initiate enteral feeding after birth,355 VLBWI were divided into two groups:DEF group (initiate enteral feeds ≥5 days,n =55)and early feeding group (initiate enteral feeds ≤4 days,n =298).The short-term clinical outcomes were

  4. Displasia broncopulmonar: incidência, fatores de risco e utilização de recursos em uma população sul-americana de recém-nascidos de muito baixo peso Bronchopulmonary dysplasia: incidence, risk factors and resource utilization in a population of South-American very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Jose L. Tapia

    2006-02-01

    .OBJECTIVE: To determine the incidence of bronchopulmonary dysplasia, its risk factors and resource utilization in a large South American population of very low birth weight infants. METHODS: Data were prospectively collected from infants weighing 500 to 1,500 g born at 16 NEOCOSUR Network centers from 10/2000 through 12/2003. Multivariate relative risk and 95% confidence intervals were estimated by Poisson regression with robust error variance to find factors that affected the risk of bronchopulmonary dysplasia. RESULTS: 1,825 very low birth weight infant survivors were analyzed. Mean birth weight and gestational age were 1085+279 g and 29+3 weeks respectively. Bronchopulmonary dysplasia incidence averaged 24.4% and survival without bronchopulmonary dysplasia augmented with increasing gestational age. Higher birth weight and gestational age and a female gender all decreased the risk for bronchopulmonary dysplasia. Factors that independently increased that risk were surfactant requirement, mechanical ventilation, air leak, patent ductus arteriosus, late onset sepsis and necrotizing enterocolitis. Bronchopulmonary dysplasia infants had more days of hospitalization (91±27 vs. 51±19, on mechanical ventilation (19±20 vs. 4±7 and oxygen therapy (72±30 vs. 8±14 in comparison with non BPD infants. CONCLUSIONS: Bronchopulmonary dysplasia incidence was 24.4% in a large South American population and is related to greater resource utilization. Risk factors for bronchopulmonary dysplasia in this study were: surfactant requirement, mechanical ventilation, air leak, patent ductus arteriosus, late onset sepsis and necrotizing enterocolitis. These studies may provide information useful to the design of effective preventive perinatal strategies.

  5. Alterations in Functional Connectivity for Language in Prematurely Born Adolescents

    Science.gov (United States)

    Schafer, Robin J.; Lacadie, Cheryl; Vohr, Betty; Kesler, Shelli R.; Katz, Karol H.; Schneider, Karen C.; Pugh, Kenneth R.; Makuch, Robert W.; Reiss, Allan L.; Constable, R. Todd; Ment, Laura R.

    2009-01-01

    Recent data suggest recovery of language systems but persistent structural abnormalities in the prematurely born. We tested the hypothesis that subjects who were born prematurely develop alternative networks for processing language. Subjects who were born prematurely (n = 22; 600-1250 g birth weight), without neonatal brain injury on neonatal…

  6. Avaliação dos fatores associados ao estado nutricional na idade corrigida de termo em recém-nascidos de muito baixo peso Evaluation of the nutritional status at 40 weeks corrected gestational age in a cohort of very low birth weight infants

    Directory of Open Access Journals (Sweden)

    Nicole M. Gianini

    2005-02-01

    Full Text Available OBJETIVO: Avaliar a adequação do peso ao termo em uma coorte de recém-nascidos com peso de nascimento menor que 1.500 g e correlacioná-la a variáveis clínicas e nutricionais. MÉTODOS: Estudo longitudinal onde recém-nascidos de muito baixo peso de oito hospitais (divididos em duas categorias: tipo I - aporte nutricional agressivo; tipo II - outras práticas foram acompanhados prospectivamente de novembro de 1999 a abril de 2000. O estado nutricional foi avaliado pelo escore z, sendo considerado como desnutrição o escore z menor ou igual a -2, segundo a curva do Canadian Perinatal Surveillance System. Os dados foram analisados por meio de regressão linear múltipla e regressão logística. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa. RESULTADOS: 63% da população estudada (126/200 foi classificada como desnutrida ao termo. O peso ao termo apresentou correlação negativa com o tempo de internação, com a idade gestacional ao nascimento, com o tempo para a recuperação do peso de nascimento e com o clinical risk index for babies (p OBJECTIVE: To evaluate the nutritional status at term of a cohort of newborn babies with birth weights of less than 1,500 g and to correlate this with nutritional practices and clinical variables. METHODS: Very low birth weight infants admitted to eight neonatal intensive care units from November 1999 to April 2000 were studied prospectively. The units were defined as Type I if they employed aggressive nutritional support techniques and Type II if other nutritional practices were used. Babies' were defined as malnourished if their z-score for weight was less than or equal to -2 on the Canadian Perinatal Surveillance System growth curves. Data was analyzed using multivariate linear regression and logistic regression. The study was approved by the Committee for Ethics in Research. RESULTS: Sixty-three percent (126/200 of the study population were classed as being malnourished at term. Weight

  7. 发育支持护理结合音乐疗法在极低出生体重儿护理中的应用研究%The Clinical Analysis on Developmental Supportive Care Combined with Music Therapy in the Very Low Birth Weight Infant

    Institute of Scientific and Technical Information of China (English)

    张金凤; 陈玲; 王龙燕; 王敏

    2015-01-01

    Objective To evaluate the curative effect in the very low birth weight infant(VLBWI) which used the treat‐ment of developmental supportive care(DSC) combined with music therapy .Methods 102 VLBWI were randomly divided in‐to observation group(51 VLBWI) and control group(51 VLBWI) ,the VLBWI in observation group were treated with DSC combined with music therapy after birth ,while the VLBWI in control group were treated with routine nursing .Two groups of hospitalization time ,daily milk intake ,weight growth rate ,sucking and swallowing function setup time ,tube feeding time , complications and death were recorded in detail .The data were analyzed using SPSS13 .0 statistical software to evaluate the clinical effect .Results The hospitalization time ,tube feeding time and sucking swallowing function setup time of VLBWI in observation group were significantly less than those in control group(P<0 .05) ,while the weight growth rate and daily milk intake were significantly higher than those in control group(P< 0 .05) ,there is no significant difference between the two groups in mortality due to complications .Conclusions In VLBWI ,the use of DSC combined with music therapy compared routine nursing can obviously promote early growth and development of premature infants .%目的:探讨发育支持护理(DSC)结合音乐疗法在极低出生体重儿(VLBWI)护理中的应用效果。方法选取2010年8月~2014年5月我院就诊的102例VLBWI作为研究对象,随机分为研究组和对照组,各51例。研究组在常规护理的基础上采用DSC结合音乐疗法。对照组采用常规护理方法。记录两组住院时间、每日进奶量、体重增长速度、吸吮及吞咽功能建立时间、管饲时间、并发症及死亡情况,并进行比较。结果研究组住院天数、管饲时间和吸吮、吞咽功能建立时间显著少于对照组(P<0.05),体重增长速度(除入院时、7天外)及每日进奶

  8. Fatores de risco associados à mortalidade de recém-nascidos de muito baixo peso na cidade de Botucatu, São Paulo, no período 1995-2000 Risk factors for mortality in very low birth-weight infants in the city of Botucaty, State of São Paulo, during the period 1995-2000

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    Maria Laura H. Prigenzi

    2008-03-01

    Full Text Available OBJETIVOS: avaliar as práticas assistenciais, a ocorrência de doenças, a mortalidade durante a hospitalização e os fatores associados em recém-nascidos prematuros de muito baixo peso (PT-MBP. MÉTODOS: estudo transversal comparando dois períodos: 1995-1997 e 1998-2000 e envolvendo todos os PT-MBP nascidos vivos (n= 451, em um centro perinatal, em Botucatu, São Paulo, Brasil. Os fatores de risco pré-natal e pós-natal foram submetidos a análise multivariada. RESULTADOS: a mortalidade diminuiu de 36,2% para 29,5%. A sobrevida melhorou e foi superior a 50% a partir de 28 semanas e de 750 g de peso. O uso de corticosteróide antenatal aumentou de 25% para 42%, o surfactante exógeno de 14% para 28%, com redução na incidência e gravidade da síndrome do desconforto respiratório. A regressão logística mostrou que a síndrome do desconforto respiratório grave, Odds ratio=18, e a sepse precoce, Odds ratio=2,8, foram importantes fatores de risco para morte em 1995-1997. No período de 1998-2000, a sepse precoce e tardia, Odds ratio=10,5 e 12, respectivamente, aumentaram o risco de morte. CONCLUSÕES: a melhora na assistência perinatal diminuiu a mortalidade do PT-MBP. O aumento na exposição antenatal ao corticosteróide diminuiu a gravidade da síndrome do desconforto respiratório. Em 1998-2000, a sepse foi o único fator de risco para morte.OBJECTIVES: to evaluate perinatal care, the incidence of diseases, and mortality during hospitalization and associated risk factors in very low birth-weight infants (VLBW. METHODS: a cross sectional survey comparing two periods: 1995-1997 and 1998-2000, including all live-born VLBW preterm infants (n= 451, delivered at a level III perinatal center in the city of Botucatu, State of São Paulo, Brazil. The antenatal and postnatal risk factors were analyzed using multivariable techniques. RESULTS: mortality decreased from 36.2% to 29.5%. The survival of infants 750 g, and 28 weeks' gestation

  9. Variabilidade do risco do tempo de permanência ajustado para lactentes de muito baixo peso ao nascer entre centros da Neocosur South American Network Center variability in risk of adjusted length of stay for very low birth weight infants in the Neocosur South American Network

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    Guillermo Marshall

    2012-12-01

    Full Text Available OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH em lactentes de muito baixo peso ao nascer (MBPN e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92. O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.OBJECTIVES: To develop a prediction model for hospital length of stay (LOS in very low birth weight (VLBW infants and to compare this outcome among 20 centers within a neonatal network. METHODS: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant

  10. 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.

  11. Comparison on Effects of Two Mechanical Ventilation Modes for Very Low Birth Weight Newborns with Respiratory Distress Syndrome%两种机械通气方法对极低出生体质量儿呼吸窘迫综合征的疗效比较

    Institute of Scientific and Technical Information of China (English)

    苏增玲; 温艳芬; 黄善周

    2016-01-01

    目的:比较常频通气和高频震荡通气治疗极低出生体质量儿呼吸窘迫综合征的疗效。方法回顾性分析2012年4月至2014年3月在我院NICU使用过常频通气或高频震荡通气治疗呼吸窘迫综合征的极低出生体质量儿113例的临床资料,比较两种机械通气的治疗效果。结果与通气前比较,两组患儿通气后的氧合指数均有显著提升(P0.05)。结论高频震荡通气可以有效改善极低出生体质量儿呼吸窘迫综合征预后,但不能有效降低病死率,及时调整机械通气参数和规范医学操作对减少并发症有着关键的作用。%Objective To compare the effects of normal frequency ventilation and high-frequency oscillatory ventilation in the treatment of very low birth weight newborns with respiratory distress syndrome. Methods A retrospective analysis was taken for the clinical data of 113 cases of very low birth weight newborns with respiratory distress syndrome, who were treated with normal frequency ventilation or high-frequency oscillatory ventilation from April 2012 to March 2014 in NICU in our hospital, to compare the therapeutic effects of two kinds of mechanical ventilation. Results Both groups had significantly increased oxygenation index after ventilatio n compared with that before ventilation, and the oxygenation index after ventilation of high-frequency oscillatory ventilation group was significantly higher than that of normal frequency ventilation group (P0.05). Conclusions High-frequency oscillatory ventilation can effectively improve the prognosis of very low birth weight newborns with respiratory distress syndrome, but cannot effectively reduce the fatality rate. Timely adjustment of mechanical ventilation parameters and normative medical operations play key roles in the reduction of complications.

  12. Fatores maternos e neonatais na incidência de displasia broncopulmonar em recém-nascidos de muito baixo peso Maternal and neonatal factors affecting the incidence of bronchopulmonary dysplasia in very low birth weight newborns

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    Gicelle S. Cunha

    2003-11-01

    Full Text Available OBJETIVO: Obter a incidência de displasia broncopulmonar (DBP; avaliar os fatores maternos e neonatais associados com a doença; determinar a correlação entre DBP e a evolução dos recém-nascidos. MÉTODOS: Os dados foram coletados prospectivamente de 153 recém-nascidos com peso de nascimento inferior a 1.500 g, nascidos em Campinas de setembro de 2000 a abril de 2002 e tratados no Hospital Universitário. Foram utilizados razão de taxas de incidências com intervalo de confiança de 95% (IC 95%, regressão Breslow-Cox, teste t de Student, regressão linear e teste exato de Fisher. RESULTADOS: Entre os 124 recém-nascidos que sobreviveram aos 28 dias de vida, 33 (26,6% apresentavam DBP. Peso de nascimento OBJECTIVE: To determine the incidence of bronchopulmonary dysplasia, to identify maternal and neonatal factors associated with the disease, and to determine the correlation between bronchopulmonary dysplasia and the progress of newborns. METHODS: Data were prospectively collected on 153 infants born in Campinas (state of São Paulo, Brazil from September 2000 to April 2002 weighing less than 1,500 g and treated at the University Hospital. The ratio of incidence rates with 95% CI, Breslow-Cox regression, Student's t test, linear regression and the Fisher's exact test were utilized. RESULTS: Among the 124 babies who survived until 28 days of age, 33 (26.6% developed bronchopulmonary dysplasia. Birthweight < 1,000 g (5.6; 95% CI 3.0, 10.4 and gestational age < 30 weeks (4.0; 95% CI 2.1, 7.2 were correlated with increased incidence of bronchopulmonary dysplasia. Breslow-Cox regression showed that other factors including gender, Apgar score, hyaline membrane disease, antenatal steroid therapy, pregnancy-induced hypertension, delivery route and maternal age were not associated with bronchopulmonary dysplasia. Mean duration of hospitalization and ventilator therapy in newborns with and without bronchopulmonary dysplasia was 78.8 days (SD = 26

  13. Medida da freqüência respiratória e do volume corrente para prever a falha na extubação de recém-nascidos de muito baixo peso em ventilação mecânica Evaluation of respiratory rate and tidal volume to predict extubation failure in mechanically ventilated very low birth weight infants

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    Josy Davidson

    2008-03-01

    Full Text Available OBJETIVO: Verificar se a freqüência respiratória (FR, o volume corrente (VC e a relação FR/VC poderiam prever a falha na extubação em recém-nascidos de muito baixo peso submetidos à ventilação mecânica. MÉTODOS: Estudo prospectivo, observacional, de recém-nascidos com idade gestacional OBJECTIVE: To verify if respiratory rate (RR, tidal volume (TV and respiratory rate and tidal volume ratio (RR/TV could predict extubation failure in very low birth weight infants submitted to mechanical ventilation. METHODS: This prospective observational study enrolled newborn infants with gestational age <37 weeks and birth weight <1,500g, mechanically ventilated from birth during 48 hours to 30 days and thought to be ready for extubation. As soon as the physicians decided for extubation, the neonates received endotracheal continuous positive airway pressure (CPAP for 10 minutes while spontaneous RR, TV and RR/TV were measured using a fixed-orifice pneumotachograph positioned between the endotracheal tube and the ventilator circuit. Thereafter, the neonates were extubated to nasal CPAP. Extubation failure was defined as the need for reintubation within 48 hours. RESULTS: Of the 35 studied infants, 20 (57% were successfully extubated and 15 (43% required reintubation. RR and RR/TV before extubation had a trend to be higher in unsuccessfully extubated infants. TV was similar in both groups. Sensitivity and specificity of these parameters as predictors of extubation failure were 50 and 67% respectively for RR, 40 and 67% for TV and 40 and 73% for RR/TV. CONCLUSIONS: RR, TV and RR/TV showed low sensitivity and specificity to predict extubation failure in mechanically ventilated very low birth weight infants.

  14. Fosfluconazole for Antifungal Prophylaxis in Very Low Birth Weight Infants

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    Daijiro Takahashi

    2009-01-01

    Full Text Available We conducted a retrospective case series study to evaluate the safety of fosfluconazole prophylaxis for preventing invasive fungal infection in VLBW infants with a central vascular access. Fosfluconazole was administered intravenously at a dose of 6 mg/kg everyday during which time a central venous catheter was placed. A total of 23 infants met the criteria for enrollment in our study. No cases of fungal infection were detected during the central venous catheter placement in the group. None of the infants had an elevated β-D-glucan, and all of them were still alive at discharge. Regarding the liver and renal function, no statistically significant differences were observed before and at the end of fosfluconazole prophylaxis. The results of this study demonstrate that fosfluconazole prophylaxis in preventing invasive fungal infection was well tolerated by VLBW infants. This is a first report to describe antifungal prophylaxis using fosfluconazole for VLBW infants.

  15. 230例极低出生体质量儿随访至纠正6月龄生存质量分析%Analysis of the quality of life of 230 very low birth weight infants followed up to 6 months of corrected age

    Institute of Scientific and Technical Information of China (English)

    蒋青莲; 包蕾

    2016-01-01

    目的:分析极低出生体质量(VLBW)婴儿的短期预后。方法回顾性分析2013年12月至2014年12月收治的VLBW婴儿随访至纠正6月龄的生存质量。结果共入选230例符合标准的VLBW婴儿,出院时死亡30例(13.0%),放弃治疗40例(17.4%),好转签字出院60例(26.1%),治愈100例(43.5%)。30例死亡VLBW婴儿中,主要为新生儿呼吸窘迫综合征18例、肺出血5例、败血症3例。200例存活婴儿随访至纠正6月龄时,13例(6.5%)失访;54例(27.0%)死亡,其中40例是因经济原因放弃治疗或好转签字出院的。纠正1、3、6月龄时,继续随访的VLBW婴儿身长、体质量均随月龄增长逐渐接近儿童生长标准,但至纠正6月龄时仍明显落后于儿童生长标准;身长落后较体质量落后更明显。109例患儿行眼底筛查,其中早产儿视网膜病变Ⅰ期21例、Ⅱ期7例,眼底出血行激光光凝术6例;98例患儿行听力筛查,单侧未通过5例,双侧未通过11例;95例患儿行头颅磁共振成像(MRI)检查,颅内出血10例,早产儿脑损伤9例。49例患儿纠正胎龄42周行新生儿神经行为测定(NBNA)均≤35分;纠正3月龄时,36例患儿行Gesell发育量表评估,轻度发育迟缓11例、中度2例;纠正6月龄时,24例行Gesell发育量表评估,轻度发育迟缓2例。VLBW婴儿在适应能力、社交行为、大运动方面进步较快。结论经济条件及新生儿呼吸窘迫综合征、肺出血、败血症是影响VLBW婴儿存活及生存质量的重要因素;存活VLBW婴儿的生长发育均有逐渐好转现象。%Objective To analyze the short term prognosis of very low birth weight (VLBW) infants. Methods The clinical data of VLBW infants who were hospitalized from December 2013 to December 2014 and followed up to 6 months of corrected age were retrospectively analyzed. Results A total of 230 VLBW infants were enrolled. Thirty infants (13.0%) died during hospitalization

  16. 间断与持续鼻饲喂养对极低出生体重儿喂养耐受性和胃泌素水平的影响%Effects of intermittent bolus gavage and continuous nasogastric gavage on the feeding tolerance and gastrin level in very low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    高明

    2012-01-01

    Objective:To explore the effects of intermittent bolus gavage (IBG)and continuous nasogastric gavage(CNG) on the feeding tolerance and gastrin level in very low birth weight infants ( VLBWI) . Methods: Seventy cases of VLBWI who were fed on partial parenteral nutrition were randomly divided into IBG feeding group and CNG feeding group. The time of reaching full enteral feeding ( FEF) of both groups was observed. The gastrin level of two groups was compared on the first day and the tenth day: and the effects of the two feeding patterns on the intolerance of VLBWI was analyzed. Results: Compared with the CNG group, the incidence rate of intolerance in IBG group was lower(P 0. 05) ,but on the tenth day, the gastrin level of IBG group increased significantly (P0.05),喂养第10天IBG组较CNG组血液中胃泌素水平显著增高(P<0.01).结论 IBG喂养方式对VLBWI喂养耐受性好,且能提高胃泌素分泌水平.

  17. Evaluación de la severidad, proporcionalidad y riesgo de muerte de recién nacidos de muy bajo peso con restricción del crecimiento fetal: análisis multicéntrico sudamericano An assessment of the severity, proportionality and risk of mortality of very low birth weight infants with fetal growth restriction: a multicenter South American analysis

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    Carlos Grandi

    2005-06-01

    Full Text Available OBJETIVOS: 1 evaluar la severidad y la proporcionalidad de los PEG para diferentes grados de prematurez; 2 estimar el riesgo de mortalidad de los PEG según la severidad y proporcionalidad. MATERIAL Y MÉTODOS: Diseño observacional y analítico. Población: todos los recién nacidos de muy bajo peso (RNMPB entre 25 y 36 semanas que mantiene el grupo NEOCOSUR (n = 1.518. Índices antropométricos: a peso de nacimiento (PN 0,55 y la transformación z del índice ponderal (Ponderal Index, PI = g/cm³ x 100. Restricción del crecimiento intrauterino (RCIU asimétrico: score z OBJECTIVES: To evaluate the clinical severity and proportionality of small for gestational age, very low birth weight neonates (< 1,500 g and to estimate the neonatal mortality risk associated with the condition of being small for gestational age according to the degree of severity and proportionality. METHODS: Observational design. All of the NEOCOSUR Collaborative Group's very low birth weight infants (25-36 weeks' gestation were included (n = 1,518. Anthropometric indices: birth weight < 3rd and 10th percentile. Severity (fetal growth ratio = observed weight/mean birth weight for gestational age; no growth restriction: fetal growth ratio 0.90-1.10, mild: fetal growth ratio 0.80-0.89, moderate: fetal growth ratio 0.75-0.79 and severe: fetal growth ratio < 0.75. Proportionality: coefficient of bimodality and z score for ponderal index (PI = g/cm³ *100. Neonatal mortality until discharge. RESULTS: < 3rd percentile: 13.5% (p < 0.001; < 10th percentile: 31% (p < 0.001; fetal growth ratio: 0.90±0.21 (p < 0.001, mild restriction: 20.8%, moderate restriction: 8.7% and severe restriction: 32.6%. Coefficient of bimodality: 0.53; PI z score < -1: 8%. Maternal hypertensive disease was systematically associated with being small for gestational age (aOR 1.20, 95% CI 0.86-1.67, fetal growth ratio < 0.89 (aOR 1.71, 1.24-2.36 and PI z score < -1 (aOR 1.60, 1.03-2.41. Adjusted odds ratios

  18. Nutritional assessment of very low birth weight infants: relationships between anthropometric and biochemical parameters Evaluación nutricional de lactantes de muy bajo peso al nacimiento: relaciones entre los parámetros antropométricos y bioquímicos

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    L. E. Monteiro Bigélli Cardoso

    2007-06-01

    Full Text Available Objective: Analyze the importance of biochemical data and their relationship with anthropometric data in the longitudinal nutritional assessment of very low birth weight infants. Methods: A prospective cohort study was performed on 55 very low birth weight preterm infants (birth weight Objetivo: Analizar la importancia de los datos bioquímicos y su relación con los datos antropométricos en la evaluación nutricional longitudinal de los lactantes de muy bajo peso al nacimiento. Métodos: Se realizó un estudio de cohortes prospectivo en 55 lactantes prematuros de muy bajo peso al nacimiento (peso al nacer < 1.500 g y < 37 semanas de edad gestacional. Se realizaron mediciones del peso, longitud, las circunferencias cefálica y de la mitad del brazo, el cociente circunferencia de la mitad del brazo: circunferencia cefálica,índice ponderal y el índice de masa corporal. Como parámetros bioquímicos se midieron la prealbúmina sérica y la proteína fijadora de retinol. Todas las variables se recogieron al nacimiento y a los 14 y 28 días de vida. Resultados: El peso medio al nacimiento de los lactantes fue de 1,076,7 ± 286 g y la edad gestacional media de 30,7± 2,1 semanas. Al nacimiento, el promedio de la prealbúmina sérica fue de 7,0 ± 1,7 mg/dl y de la proteína fijadora de retinol fue de 1,3 ± 0,4 mg/dl. Hubo una elevación significativa de todas las variables estudiadas desde el nacimiento hasta el día 28. De acuerdo con la idoneidad nutricional, no hubo diferencias entre los lactantes con edad gestacional adecuada y aquellos con edad gestacional pequeña ni en los parámetros antropométricos ni en los bioquímicos. Las medidas antropométricas no se correlacionaban con las medidas bioquímicas. Las concentraciones de proteínas séricas se convirtieron a masa de proteína sérica (MPS como sigue: MPS = concentración de proteína sérica x (100 x peso x (1 - hematocrito, puesto que las proteínas estudiadas son principalmente

  19. 双歧杆菌防治极低出生体重儿坏死性小肠结肠炎的作用研究%A research on the effect of bifidobacterium in the field of preventing and curing the NEC of very low birth weight children

    Institute of Scientific and Technical Information of China (English)

    黄柏枝; 刘仿

    2011-01-01

    目的:观察应用双歧杆菌预防极低出生体重儿坏死性小肠结肠炎(NEC)的有效性.方法:回顾性分析2005年1月~2008年5月在我院NICU住院治疗的生后存活7 d并且开始胃肠道喂养的极低出生体重儿183例的临床资料.结果:预防组NEC发病率为2.10%(2/95),对照组NEC发生率为11.36%(10/88),两组比较差异有统计学意义(P<0.01).住院期间预防组每日体质量增加(8.108±2.205)g,对照组为(6.256±2.298)g,两组比较差异有统计学意义(P<0.01).治疗后7 d两组患儿肠道细菌总数、杆菌、球菌总数及杆球菌比值差异均有统计学意义(P0.05).治疗前两组患儿大便双歧杆菌数的比较差异均无统计学意义(P>0.05);治疗后7 d两组患儿大便双歧杆菌数的比较差异有统计学意义(P0.05).结论:给予极低出生体重儿预防性口服双歧杆菌能够降低NEC发病率,促进其体质量增长.其机制与口服双歧杆菌后促进新生儿肠道正常菌群的定植和优势化、维持肠道正常菌群比率有关.%Objective: To observe the preventing effectiveness of applying bifidobacterium to very low birth weight children with NEC. Methods: The clinical data of 183 patients of NICU hospitalization survival 7 d after birth and fed the gastrointestinal tract of very low birth weight children in our hospital from January 2005 to May 2008 were retrospectively analyzed. Results: From the results, the NEC incidence rate of the preventive group was 2.10% (2/95), while the control group was 11.36% (10/88); the daily weight increase of the preventive group was (8.108±2.205) g, while the control group Was (6.256±2.298) g There were statistical significance in the comparison of both groups (all P

  20. Neurosensory outcome of prematurely born children following intracranial hemorrhage

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    Velisavljev-Filipović Gordana

    2011-01-01

    Full Text Available Introduction. More and more survival of newborns with small or extremely small body mass at birth, as well as increasing percent of prematurely born babies, have emphasized the significance of intracranial haemorrhage problem. Prematurely born infants are under increased risk for strabismus, amblyopia, blinding and hearing loss. Objective. Establishing the frequency of sensory damages (damage of sight and hearing in prematurely born infants with various degrees of intracranial haemorrhage. Methods. The study is prospective, controlled and included 120 prematurely born infants with diagnosed four different grade intracranial haemorrhage on ultrasonic examination of the central nervous system. The study excluded prematurely born children from twin pregnancies with congenital malformations and stoppage of intrauterine growth. Ophthalmological examination was done at 9, 12, and 36 months of postnatal age. Audilogical examination was done after delivery, at 2 months of age. Results. There are statistically significant differences (p<0.01 related to the presence of strabismus among groups of examinees with vairious hemorrhage degrees. Strabismus was present only in one premature infant with 1st and in 10 children (33.3% with the 4th degree. Amblyopia occurred only among examinees with 4th degree hemorrhage. There were statistically significant differences (p<0.01 related to the finding of transitory otoacoustic emission of the left ear and the right ear among the groups. The finding of the right ear was not usual in 7 examinees from the 4th degree hemorrhage. The finding of the left ear was not usual in 1 examinee from the third and in 7 examinees from the fourth group. Conclusion. Prematurely born children with a higher degree intracranial hemorrhage have a greater risk for the loss of hearing and development of visual handicap.

  1. Behaviour Difficulties and Cognitive Function in Children Born Very Prematurely

    Science.gov (United States)

    Bayless, Sarah; Pit-ten Cate, Ineke M.; Stevenson, Jim

    2008-01-01

    Children born very prematurely are at risk of low average IQ and behaviour difficulties throughout childhood and adolescence. Associations among preterm birth, IQ and behaviour have been reported; however, the nature of the relationship among these outcomes is not fully understood. Some studies have proposed that the consequences of preterm birth,…

  2. Emergência dos esquemas simbólicos em crianças com síndrome de Down, prematuros muito baixo peso e crianças com desenvolvimento típico Emergence of symbolic schemes in children with Down syndrome, very-low-birth-weight preterm, and typically developing children

    Directory of Open Access Journals (Sweden)

    Lenice de Fátima da Silva

    2010-06-01

    Full Text Available OBJETIVO: verificar a emergência dos esquemas simbólicos simples e combinados e seus respectivos subtipos em 20 crianças prematuras muito baixo peso, 20 crianças com síndrome de Down e 20 crianças com desenvolvimento típico. MÉTODOS: todos os sujeitos foram acompanhados mensalmente durante seis meses, a partir da avaliação inicial em que estavam localizados no final da quinta fase do período sensório-motor. Para tanto, foi utilizado o Protocolo para Observação do Desenvolvimento Cognitivo e da Linguagem Expressiva - versão revisada (PODCLE-r. Os dados foram analisados de forma quantitativa e qualitativa. RESULTADOS: os resultados revelaram que os esquemas simbólicos simples e combinados emergiram de forma semelhante para todos os grupos, embora se tenha observado ritmo de desenvolvimento mais lento para as crianças prematuras muito baixo peso e crianças com síndrome de Down, quando comparadas às crianças com desenvolvimento típico. A análise qualitativa, referente à diversidade e complexidade dos esquemas simbólicos produzidos, mostrou que as crianças prematuras muito baixo peso apresentaram pior desempenho quando comparadas às crianças com síndrome de Down e às com desenvolvimento típico, apresentando também dificuldades específicas quanto ao uso de esquemas simbólicos aplicados a objetos não-figurativos, ou seja, quanto à construção da representação por meio de significantes arbitrários. CONCLUSÃO: estes dados reforçam a importância de se acompanhar a emergência e o desenvolvimento dos esquemas simbólicos simples e combinados nessas crianças, com o objetivo de monitorar e estimular esse desenvolvimento, com vistas a minimizar os efeitos da defasagem cognitiva e a favorecer o desenvolvimento da linguagem.PURPOSE: to check the emergence of isolated and combined symbolic schemes as well as their respective subtypes in 20 very-low-birth-weight (VLBW preterm children, 20 children with Down syndrome (DS

  3. Fatores de risco para a doença por refluxo gastroesofágico em recém-nascidos de muito baixo peso portadores de displasia broncopulmonar Risk factors for gastroesophageal reflux disease in very low birth weight infants with bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Thaís B. Mendes

    2008-04-01

    Full Text Available OBJETIVO: Conhecer os fatores de risco para a doença por refluxo gastroesofágico (DRGE em recém-nascidos de muito baixo peso com displasia broncopulmonar. MÉTODOS: Realizou-se um estudo caso-controle incluindo 23 casos e 23 controles com displasia broncopulmonar, sendo realizada investigação por monitorização prolongada do pH esofágico no período de janeiro de 2001 a outubro de 2005. Para cada caso, selecionou-se um controle, e foram comparados pela idade gestacional, peso ao nascimento, gênero, uso de corticóide pré-natal, tempo de ventilação assistida, tempo de oxigenoterapia, tempo de uso de sonda gástrica, uso de xantinas, idade pós-conceptual e peso durante a monitorização do pH esofágico. Realizou-se a análise por regressão logística múltipla para estabelecer o odds ratio (OR com intervalo de confiança de 95% (IC95%. RESULTADOS: Os dois grupos (com e sem DRGE não apresentaram diferenças significativas em relação às variáveis demográficas e de evolução pós-natal, uso de corticóide pré e pós-natal, bem como ao tempo de uso de cafeína, ventilação mecânica e oxigenoterapia. Entretanto, as variáveis intolerância alimentar (OR = 6,55; IC95% 1,05-40,8 e tempo de uso de sonda gástrica (OR = 1,67; IC95% 1,11-2,51 comportaram-se como fatores de risco para DRGE. A variável idade pós-conceptual ao exame de monitorização do pH (OR = 0,02; IC95% OBJECTIVE: To assess risk factors for gastroesophageal reflux disease (GERD in very low birth weight infants with bronchopulmonary dysplasia. METHODS: A case-control study was carried out in 23 cases and 23 control subjects with bronchopulmonary dysplasia submitted to 24-hour esophageal pH monitoring between January 2001 and October 2005. Cases and controls were compared for gestational age, birth weight, gender, use of antenatal steroids, duration of assisted ventilation, duration of oxygen therapy, length of gastric tube use, administration of xanthines

  4. Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition Sepse de ataque tardio e colonização bacteriana intestinal em neonatos de muito baixo peso recebendo nutrição parenteral total

    Directory of Open Access Journals (Sweden)

    Priscila Castro Cordeiro Fernandes

    2011-08-01

    Full Text Available INTRODUCTION: The purpose of this study was to establish the late onset sepsis (LOS rate of our service, characterize the intestinal microbiota and evaluate a possible association between gut flora and sepsis in surgical infants who were receiving parenteral nutrition (PN. METHODS: Surveillance cultures of the gut were taken at the start of PN and thereafter once a week. Specimens for blood culture were collected based on clinical criteria established by the medical staff. The central venous catheter (CVC tip was removed under aseptic conditions. Standard laboratory methods were used to identify the microorganisms that grew on cultures of gut, blood and CVC tip. RESULTS: 74 very low birth weight infants were analyzed. All the infants were receiving PN and antibiotics when the gut culture was started. In total, 21 (28.4% infants experienced 28 episodes of LOS with no identified source. Coagulase negative staphylococci were the most common bacteria identified, both in the intestine (74.2% and blood (67.8%. All infections occurred in patients who received PN through a central venous catheter. Six infants experienced episodes of microbial translocation. CONCLUSIONS: In this study, LOS was the most frequent episode in neonates receiving parenteral nutrition who had been submitted to surgery; 28.6% of this infection was probably a gut-derived phenomenon and requires novel strategies for prevention.INTRODUÇÃO: O objetivo deste estudo foi estabelecer a taxa de sepse de ataque tardio (LOS do nosso serviço, caracterizar a microbiota intestinal e avaliar uma possível associação entre a flora intestinal e sepse em recém-nascidos cirúrgicos que estavam recebendo nutrição parenteral (NP. MÉTODOS: Culturas do intestino foram colhidas no início da nutrição parenteral e, posteriormente, uma vez por semana. As amostras para a cultura de sangue foram coletadas com base em critérios clínicos estabelecidos pela equipe médica. A ponta do cateter

  5. Effect of breastfeeding quality improvement on breastfeeding rate in very low birth weight and extremely low birth weight infants%母乳喂养质量改进对极低和超低出生体重儿亲母母乳喂养率的影响

    Institute of Scientific and Technical Information of China (English)

    刘凤; 韩树萍; 余章斌; 张俊; 陈小慧; 吴薇敏; 楚雪; 刘蓓蓓

    2016-01-01

    ObjectiveTo study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU). MethodsA retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group). The parameters including condition of breastfeeding (breastfeeding rate, breastfeeding amount, and breastfeeding time), duration of parenteral nutrition, time to enteral feeding, and incidence of feeding intolerance were compared between the two groups. ResultsThe implementation of breastfeeding quality improvement measures signiifcantly increased breastfeeding rate and amount, signiifcantly shortened time to addition of human milk fortiifer, duration of parenteral nutrition, and time to enteral feeding, and signiifcantly decreased the incidence of feeding intolerance.ConclusionsBreastfeeding quality improvement measures can increase breastfeeding rate in the NICU and decrease gastrointestinal complications in preterm infants.%目的:探讨NICU中母乳喂养质量改进措施对极低和超低出生体重儿亲母母乳喂养率的影响。方法回顾性调查收集2014年7月至2015年7月收治的极低和超低出生体重儿(质量改进前组)以及实施母乳质量改进措施后的2015年8月至2016年6月的极低和超低出生体重儿(质量改进后组)资料。对两组患儿住院期间亲母母乳喂养情况(喂养率、喂养量、喂养时间)、静脉营养持续时间、达到全肠道喂养的时间,喂养不耐受发生率等指标进行比较。结果实施质量改进后,亲母母乳喂养率和喂养量均明显增高,母乳强化剂添加时间、静脉营养时间、达全肠道喂养时间

  6. Effects of Non - nutritive Sucking and Abdominal Massage on Weight Gain in Very Low Birth Weight Infants%非营养性吸吮联合腹部抚触对极低出生体重儿重增长的影响研究

    Institute of Scientific and Technical Information of China (English)

    余霞

    2011-01-01

    of gastric residue was significantly lower , the birth - weight regaining time was significantly shorter, the velocity of weight gain was significantly higher, and the sleep time was prolonged in the treatment group. Conclusion Non - nutritive sucking (NNS) and abdominal massage can accelerate the process of gastric evacuation, improve the gastrointestinal function and weight gain of very low birth weight infants during intermittent nasogastric feeding.

  7. Association between fluid intake during the first ten days of life and risk of chronic lung disease in very low birth weight infants%极低出生体重儿生后10天液体入量与慢性肺疾病的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张谦慎; 朱小瑜; 连朝辉

    2008-01-01

    Objective To demonstrate the association between fluid intake and sodium intake during the first 10 days of life and the risk of chronic lung disease (CLD) in very low birth weight (VLBW) infants.Methods A retrospective analysis of data from VLBW infants enrolled in the Neonatal Department of our hospital; 130 infants with birth weight between 790 and 1 470 g were randomized, among which 12 infants was diagnosised CLD. The daily fluid intake and sodium intake during the first 10 days of life were compared between the infants without CLD and those who developed CLD. Demographic and clinical neonatal variables were also compared. Results 118 infants survived without CLD and 12 infants developed CLD. Analysis showed that the daily fluid intakes were higher (day 2~10) and weight loss less (day 6~9) in the group of infants who developed CLD. In addition, the daily sodium intakes were also higher (day 2~6) in infants who developed CLD. Conclusion In the VLBW infants treated during the post surfactant era, higher fluid or sodi-um intake during the first 10 days of life were associated with an increased risk of CLD. The finding suggests that careful attention to fluid balance might be an important means to reduce the incidence of CLD.%目的 评估极低出生体重儿(VLBW)生后前10 d液体和钠摄入量与发生慢性肺疾病(CLD)的风险性.方法 回顾性分析我院新生儿科住院的130例VLBW的资料,比较无CLD的存活早产儿和患有CLD的新生儿在生后前10 d每天液体和钠摄入量和体重下降的情况.同时比较临床表现方面的变量.结果 无CLD的存活新生儿118例,患有CLD的新生儿12例.单变量分析显示发生CLD的新生儿组每日液体摄入量更高(第2~10d),体重下降更少(第6~9d).CLD组钠的摄入量更高(第2~6 d).除此之外,出生体重较低、胎龄较小、男孩、较长时间的辅助通气等都与CLD的发生率较高相关.结论 VLBW新生儿生后前10 d较高的液体、钠

  8. 早期应用脂肪乳对极低出生体重儿胃肠外营养相关性胆汁淤积的影响%Effect of early fat emulsion usage on parenteral nutrition associated with cholestasis of very low birth weight infant

    Institute of Scientific and Technical Information of China (English)

    杨军; 李水霞

    2015-01-01

    objectiveTo study the effect of fat emulsion ociated in parenteral nutrition (PN) associated with cholestasis (PNAC) of very low birth weight infant (VLBWI) .MethodsTo study retrospectively the clinical data of 18 VLBWI PNAC (PNAC group,18 cases) and 36 without PNAC (non-PNAC group,36 cases) ,matched by stop taking food of time ,gestational age, birth weight and duration of PN , Meanwhile, the associated factors with PNAC were also analyzed in two groups.Results Within 2 weeks after birth fat emulsion calories, PNAC group was significantly higher than non PNAC,( 23.0±7.3)% vs(15.1±4.5)%, t= 3.815,p= 0.016, the difference was statistically significant. Two groups in the ratio of total calories, the ratio of amino acid calories,the ratio of sugar calories difference has no statistical significance (P> 0.05). PN in use process, the two groups in the fat emulsion, amino acid and sugar intake of total difference has no statistical significance (P > 0.05).ConclusionsThe occurrence of PNAC is associated with higher calorie ratio of fat emulsion intake during the first two weeks of PN support after birth in VLBWI.Further prospective randomized double blind controlled studies should be performed.%目的:探讨胃肠外营养(PN)中的脂肪乳对极低出生体重儿(VLBWI)胃肠外营养相关性胆汁淤积(PNAC)的影响。方法:回顾性分析2009年1月至2015年4月静脉营养(PN)超过14d的VLBWI中的PNAC病例和配对非PNAC病例临床资料(两组在胎龄、出生体重、PN持续时间和禁食时间相匹配),比较两组发生PNAC相关因素的差异。结果:PNAC组(18例)生后2周内脂肪乳热卡比明显高于非PNAC组(36例),为23.0±7.3%vs 15.1±4.5%,t=3.815,p=0.016,差异有统计学意义,而在总热卡比、氨基酸热卡比及糖热卡比差异无统计学意义(P>0.05)。两组在PN应用期间脂肪乳、氨基酸及糖的累计摄入量差异无统计学意义(P>0.05)。结论:极低出生体

  9. 极低出生体重儿行PICC置管时患儿体表测量长度和理想置管深度的关系%Relationship analysis of length of body surface measurement and ideal depth of tube detaining in very low birth weight infant with PICC

    Institute of Scientific and Technical Information of China (English)

    房莉; 史德利; 郝祥梅

    2014-01-01

    Objective To study the relationship of length of body surface (LBSM ) measurement and ideal depth of tube detaining (IDTD) in very low birth weight infant (VLBWI) with PICC. Methods From May 2012 to January 2014, in NICU of the Children's Hospital of Xuzhou City, 40 VLBWI with upper PICC and 24 VLBWI with cephalic vein and cubital vein PICC were selected. The relationship of LBSM and IDTD at PICC was analyzed. Results The results of 40 VLBWI with upper PICC showed that the highest was IDTD acquired, for 67.50%, the next was followed placed too deep, the lowest was too shallow into the lowest percentage, only 12.50%. The result of Pearson correlation analysis showed except the left cephalic vein of LBSM had no correlation with IDTD (r=0.397, P=0.512), the rest were corre-lated throughout the vein. By regression analysis, LBSM and IDTD regression equation was as follows, the right side of the vein:Y =-6.23±1.01X;the right of the cephalic vein:Y =-14.36±1.15X;the right of the median cubital vein;Y =4.12±0.82X; the left side of your vein; Y = 2.86±0.84X; the left of the cubital vein: Y = -19.52±1.23X. Conclusion When the right side of VLBWI vein catheterization to have a good correlation with IDTD LBSM, the clinical treatment should be valued.%目的:分析极低出生体重儿(VLBWI)行PICC置管时患儿体表测量长度(LBSM)和理想置管深度(IDTD)的关系。方法选择2012年5月~2014年1月于徐州市儿童医院新生儿重症监护室上肢植入PICC的40例贵要静脉置管及24例头静脉和肘正中静脉PICC置管的VLBWI患儿。分析对行PICC置管时LBSM和IDTD的关系。结果40例贵要静脉置管结果表明,获得理想深度的比例最高,为67.50豫;置入过深次之,置入过浅的比例最低,仅为12.50豫。 Pearson相关性分析显示,除左侧头静脉的LBSM与IDTD无相关性之外(r =0.397,P=0.512),其余各处静脉均有相关性。经回归分析,LBSM与IDTD的回归方程如下

  10. Investigation on the Hospitalization Expenses of 78 Cases of Very Low Birth Weight Infants and Relevant ;Influencing Factors%78例极低出生体重儿住院费用调查及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王华; 侯东敏; 赵欣; 程玉梅; 陈永萍

    2016-01-01

    Objectives To investigate the hospitalization expenses of 78 very low birth weight infants (VLBWI) and relevant influencing factors. Methods To collect VLBWI inpatient data through HIS system in hospital and analyze the constitute ratio of hospitalization expenses of VLBWI. 78 VLBWI infants were divided into high cost group and the low cost group according to the average total hospitalization cost, then analyzed the differences of hospitalization cost between the two groups of VLBWI, as well as and further studied the effect of clinical factors on VLBWI hospitalization expenses. Results The top five projects influenced the hospitalization cost of VLBWI included: ventilator, oxygen and custody fee; drugs; check and test fees; material cost; treatment fee. High costs group in the days of hospitalization, total cost per patient, ventilator and oxygen cost, medicine, inspection and examination fees, treatment costs, and the cost of materials was significantly higher than that of the low cost group. Gestational age, body weight of VLBWI in high cost group was significantly lower than in low cost group, and neonatal respiratory distress syndrome (RDS), the incidence of late sepsis was significantly higher than the low cost group. Conclusions Lower gestational age, birth weight, higher incidence of RDS and late onset of sepsis might be resulted in higher hospitalization costs in high costs group of VLBWI.%目的:了解极低出生体重儿(VLBWI)住院费用情况及其影响因素。方法通过住院HIS 系统中提取VLBWI住院病例资料,分析VLBWI患儿住院费用的构成比,再根据人均住院总费用产生的情况将VLBWI患儿分为高费用组及低费用组,分析两组VLBWI住院费用差别,并进一步研究临床因素对VLBWI住院费用的影响。结果影响VLBWI住院费用前5位的项目分别为:呼吸机、氧气及监护费;药费;检查及化验费;材料费;治疗费。高费用组在住院天数、人均住院

  11. Influence of different postures care on sleep qual ity and respiratory function of very low birth weight children%不同体位护理对极低体重出生儿睡眠质量及呼吸功能的影响

    Institute of Scientific and Technical Information of China (English)

    霍秋桂

    2014-01-01

    [目的]探讨不同体位护理对极低体重出生儿(VLBW)睡眠质量、呼吸功能及并发症的影响。[方法]将84例 VLBW按照随机数字表法分为观察组及对照组各42例,两组患儿均给予常规性护理,同时配合轻弹足底、全身抚触及轻叩背部,对照组喂奶后采用仰卧位,而观察组患儿采用俯卧位,即喂奶20 min 后抬高头部并倾斜15°,头偏向一则,四肢呈蛙状,左右交替,头偏向一侧。两组患儿每隔2h~4h改变1次体位,连续干预7 d 后评价干预效果。[结果]与对照组相比,观察组患儿进奶量、体重显著增加,安静睡眠时间显著延长,患儿呼吸次数、呼吸暂停次数、心率、心率变异幅度、呼吸变异幅度显著下降,而血氧饱和度显著增加,差异有统计学意义(P<0.05)。观察组患儿腹胀、呕吐、胃出血、呼吸暂停、心动过缓发生率显著低于对照组,差异有统计学意义(P<0.05)。[结论]应用俯卧位干预可有效促进VLBW生长发育,改善患儿睡眠质量,减少患儿并发症。%Obj ective:To probe into influence of different postures care on sleep quality and respiratory function and complications of very low birth weight children.Methods:A total of 84 cases of VLBW were randomly divided into observation group and control group based on random num-ber table,42 cases in each.Both groups of children were given routine care,in combination with a flick of the foot,body massage and tapping the back.The cases in control group adopted supine position after feeding, and the children in the observation group were fed after 20 min raise the head and tilted 1 5 °,head to one thing,the limbs were frog like,around the turn,head to one side.Two groups of children changed once position every 2 h~4 h,and the intervention effect was evaluated after 7 d of con-tinuous intervention.Results:Compared with the control group,eating milk amount and body weight were increased

  12. Effects and costs of two different of intravenous infusion routes for very low birth weight infants%极低出生体质量儿应用两种静脉输液途径效果评价及成本分析

    Institute of Scientific and Technical Information of China (English)

    李建丽; 董艳; 郭永琴; 王莉; 候国强

    2016-01-01

    目的 对极低出生体质量儿(VLBWI)应用外周静脉短导管(PIV)和经外周静脉置入中心静脉导管(PICC)两种输液途径进行效果评价及成本分析.方法 选取2013年7月至2015年8月山西省长治市妇幼保健院新生儿重症监护室(NICU) 95例应用PICC的VLBWI和同期90例留置PIV的VLBWI,分别作为PICC组和PIV组,比较两组患儿体质量增长、平均住院日、导管相关并发症发生率和护理成本及效果.结果 两组患儿体质量增长比较,PICC组每周体质量增长高于PIV组,差异有统计学意义(P<0.05).两组患儿平均住院日比较,PICC组短于PIV组[(48.2±5.2)d比(53.2±8.1)d],差异有统计学意义(P<0.05).两组患儿导管相关并发症发生率比较,PICC组(35.4%)低于PIV组(44.9%),其中静脉炎(PICC组21例次,PIV组169例次)、液体渗出或外渗(PICC组2例次,PIV组185例次)、导管脱出(PICC组3例次,PIV组145例次)差异有统计学意义(均P<0.05);导管堵塞(PICC组7例次,PIV组84例次)和其他(静脉穿刺栓塞、感染)(PICC组1例次,PIV组3例次)差异无统计学意义(均P>0.05).两种静脉输液途径成本比较,PICC月成本(1 951.5元)稍低于PIV(2 008.5元),单次成本(1 691.5元)高于PIV(129.9元),PICC成本-效果比值(30.22)优于PIV(36.45).结论 对于VLBWI,PICC可减少患儿静脉穿刺次数,降低并发症发生率,促进患儿体质量增长.但单月成本两者相近,其原因可能与本研究观察时间过短有关,对于HCC,随着留置时间延长,其卫生经济学优点将更突出.%Objective To compare the effects and cost of peripheral intravenous catheter (PIV) and peripherally inserted central catheter (PICC) on very low birth weight infants (VLBWI).Methods From July 2013 to August 2015,95 VLBWI with PICC (PICC group) and 90 VLBWI with PIV (PIV group) admitted to the Neonatal Intensive Care Unit (NICU) of Changzhi Maternal and Child Care Hospital were included in the analysis.The two groups were

  13. 预防性和治疗性二极管蓝光照射防治极低出生体质量儿高胆红素血症的疗效比较%Comparison of Efficacy of Prophylactic and Therapeutic Blue-Light Light Emitting Diode Phototherapy for Management of Hyperbilirubinemia in Very Low Birth Weight Infants

    Institute of Scientific and Technical Information of China (English)

    舒桂华; 徐翔; 严语; 朱玲玲

    2014-01-01

    目的比较预防性和治疗性二极管(LED)蓝光照射防治极低出生体质量儿(VLBWI)高胆红素血症的临床疗效。方法选择2012年11月至2014年2月扬州大学临床医学院产科转入新生儿重症监护中心(NICU)住院的80例 VLBWI为研究对象,并采用随机数字表法将其分为采用预防性 LED 蓝光照射的预防组和采用治疗性 LED蓝光照射的治疗组,每组各为40例。观察两组患儿总照射时间、胆红素峰值、黄疸消褪时间、高胆红素血症(血清胆红素水平>171.0μmol/L)发生率及治疗不良反应(发热、腹泻、皮疹、低钙血症、贫血、青铜症)发生情况。本研究遵循的程序符合扬州大学临床医学院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书。两组患儿入院胎龄、体质量、入院时间、性别、分娩方式比较,差异均无统计学意义(P>0.05)。结果预防组患儿总照射时间长于治疗组,但两组比较,差异无统计学意义(P>0.05),其胆红素峰值、黄疸消褪时间明显低于治疗组,二者比较,差异有统计学意义(P0.05)。结论预防性 LED 蓝光照射防治VLBWI高胆红素血症虽然总照射时间略长于治疗性 LED蓝光照射,但其临床疗效显著优于后者,具有便捷、高效、安全、治疗不良反应小等优点。%Objective To compare the clinical effects of prophylactic and therapeutic blue-light light emitting diode (LED)phototherapy for the management of hyperbilirubinemia in very low birth weight infant(VLBWI).Methods From November 2012 to February 2014,a total of 80 VLBWI who hospitalized in neonatal intensive care unit(NICU)from maternity ward were included in the study.They were divided into prophylactic group and treatment group with 40 cases in each group according to random number table. The duration of phototherapy,peak levels

  14. Nutrition and weight gain in very low birth weight infants during hospitalization%极低出生体重儿住院期间营养状况及体重关系的多因素回归分析

    Institute of Scientific and Technical Information of China (English)

    诸宏伟; 潘家华

    2011-01-01

    Aim To analyze the nutrition state and weight gain in very low birth weight infants( VLBWI )during hospitalization. Methods 180 VLBWIs were admitted in NICU of authors' hospitals from Jan 2006 to Dec 2010. The clinical data were retrospectively analyzed.The risk factors which can lead to growth retardation of VLBWIs were assessed with logistic regression. P < 0.05 was considered as significant. Results Mean gestational age was( 224.9 ± 15.2 )d. Mean birth weight was( 1 342.4 ± 140.8 )g. The time of initial enteral feeding was 2 d. For parenteral nutrion,amino acid was administered in 53.9% of patients. The time to begin was( 4.2 ± 2.7 )d. The duration of administration was( 8.7 ± 6.2 )d. The initial dose was( 0.92 ± 0.39 )g · kg -1. Lipid emulsions was administered in 53.9% patients.The time to begin was( 4.2 ± 2.2 )d. The duration of administration was( 10.4 ±7.4 )d. The initial dose was( 0.84 ± 0.19 )g · kg -1. Total energy intake of 120 kcal · kg · d -1 was achieved at( 13.2 ± 5.4 )d. Enteral feeding of 100 kcal · kg · d -1 was achieved at( 14.5 ± 5.4 )d. The average growth rate after regaining birth weight was( 15.1 ± 4.0 )g · kg -1 d-1 . Of 118 singletons,63.6% patients had growth retardation by weight at birth,while 73.7% at discharge. Gastational age, birth weight, feeding intolerance and intrauterine growth restriction were risk factors of extrauterine growth restriction. Conclusions Most VLBWIs had problems with nutrition and growth during hospitalization and failed to reach growth rate as desired for normal intrauterine growth rate. It is very important to begin parenteral nutrition as early as possible and parenteral nutrition should be admitted as supplement to parenteral nutrition.%目的 观察极低出生体重儿住院期间的营养支持情况和生长状况关系,探讨影响其体重增长的因素.方法 收集2006年1月~2010年12月住院的极低出生体重儿,回顾性分析患儿的营养状况和体重增

  15. 延续护理对极低出生体重早产儿母亲心理影响的研究%The effect of continuing care on mental health in mothers of very low birth weight premature infants

    Institute of Scientific and Technical Information of China (English)

    钱小芳; 刘桂华; 欧萍; 葛品; 徐玉英; 黄龙生; 谢燕钦

    2015-01-01

    目的 探讨延续护理干预模式对极低出生体重早产儿母亲心理状态的影响.方法 选取2012年11月至2013年4月就诊于福建省妇幼保健院儿童保健科的极低出生体重早产儿的母亲100例,随机分为试验组和对照组各50例,试验组失访4例,对照组失访7例.试验组采用院外延续护理干预模式,对照组接受常规门诊护理模式,于产后2个月、4个月、6个月、8个月、10个月和12个月收集两组母亲的症状自评量表(Symptom Checklist 90,SCL-90)和短式亲职压力量表(Parenting Stress Index-Short Form,PSI-SF)得分.结果 试验组母亲SCL-90因子总均分及抑郁和焦虑因子得分低于对照组(P<0.05);试验组PSI-SF总分低于对照组(P<0.01).结论 院外延续护理模式可缓解极低出生体重早产儿母亲的抑郁、焦虑情绪和亲职压力状态.

  16. Visual and visuocognitive development in children born very prematurely.

    Science.gov (United States)

    Atkinson, Janette; Braddick, Oliver

    2007-01-01

    Preterm birth is a risk factor for deficits of neurological and cognitive development. Four cohort studies are reported investigating the effects of very premature birth (development correlated with the severity of brain abnormality observed on structural MRI at and before term, and were sensitive predictors of neurodevelopmental outcome at 2 years. The second study compared VERP measures for orientation-reversal and direction-reversal (DR) stimuli, from 2 to 5 months post-term age, in healthy very premature infants compared to infants born at term. The groups did not differ on the development of OR-VERP responses, but the development of the DR-VERP motion responses was delayed in the premature group despite the absence of any brain damage visible on ultrasound, consistent with the developmental vulnerability we have identified in the dorsal cortical stream. The third study used the Atkinson Battery of Child Development for Examining Functional Vision (ABCDEFV) to assess sensory, perceptual, cognitive and spatial visual functions, together with preschool tests of attention and executive function. The premature group showed delays on these tests in line with severity of observed perinatal brain damage on structural MRI at term age. Deficits on certain spatial tasks (e.g. block-construction copying) and executive function tests (e.g. the detour box task) were apparent even in children with minimal damage apparent on MRI. The fourth study tested a large cohort of 6- to 7-year old children born before 32 weeks gestation, across a wide range of cognitive domains, including new tests of spatial cognition and memory. The premature group as a whole showed significant deficits on both auditory and visual tests of attention and attentional control from the TEA-Ch battery, on tests of location memory, block construction and on many visuocognitive and visuomotor tests. Development was generally relatively normal on language tests and on WPPSI scores. Factor analysis showed

  17. 早产极低出生体重儿宫外生长迟缓发生状况及其危险因素%Incidence of extrauterine growth retardation and associated factors in very low birth weight preterm infants

    Institute of Scientific and Technical Information of China (English)

    杨晓华; 黄越芳; 庄思齐; 张琼琼; 李晓瑜; 李易娟

    2015-01-01

    目的 研究早产极低出生体重儿(very low birth weight infant,VLBWI)宫外生长迟缓(extrauterine growth retardation,EUGR)的发生状况,以及营养支持和疾病对EUGR的影响.方法 本研究为回顾性研究.收集2005年1月至2010年12月中山大学附属第一医院新生儿重症监护病房住院、出生胎龄<34周的VLBWI的临床资料.根据出院时体重是否低于同胎龄胎儿宫内生长速率的第10百分位,分为EUGR组(67例)和非EUGR组(40例).比较2组新生儿的围产期情况、生长发育和营养摄入情况以及并发症发生情况,分析VLBWI的EUGR发生状况及其影响因素.采用独立样本t检验、秩和检验、x2检验和Logistic多元回归分析进行统计学处理. 结果 共107例早产VLBWI存活至出院,EUGR发生率为62.6%(67/107).小于胎龄儿EUGR发生率为86.0%(36/42),明显高于适于胎龄儿的47.7%(31/65),差异有统计学意义(x2=15.757,P<0.01).EUGR组平均出生胎龄小于非EUGR组[(30.0±2.1)周与(30.9±1.1)周,t=2.904,P=0.002],而母亲妊娠期高血压疾病的发生率明显高于非EUGR组[40.3%(27/67)与20.0%(8/40),x2-4.689,P-0.030].EUGR组出生体重标准差得分(standard deviation score,SDS)、出院时体重SDS和体重增长速度均明显低于非EUGR组[出生体重SDS:(-1.9±0.8)与(-1.1±0.7),t=5.418,P<0.01;出院时体重SDS:-2.6(-3.0~-2.0)与-0.5(-0.9~-0.1),U=30.271,P<0.01;体重增长速度:(1 2.0±4.4)g/(kg·d)与(16.1±4.0)g/(kg·d),t=1.879,P=0.036],而体重下降的最大程度和恢复出生体重的日龄均大于非EUGR组[分别为(13.2±1.7)%与(9.0±1.6)%,t=12.832,P<0.01; (13.4±3.5)与(10.9±4.3)d,t=3.113,P=0.01].EUGR组达到全胃肠喂养日龄、蛋白质摄入量达3 g/(kg·d)口龄和热量达120 kcal/(kg·d)(l kcal=4.184kJ)日龄均大于非EUGR组[分别为(39.7±8.2)与(30.8±6.1)d,t=6.293,P=0.007;(21.4±5.8)与(17.5±1.3)d,t=4.286,P=0.002以及(28.4±6.0)与(20.3±5.4)d,t=7.198,P=0.015].EUGR组生后2

  18. Efficacy of caffeine combined with non-invasive respiratory support on the treatment of apnea in very low birth weight preterm infants%咖啡因联合无创呼吸支持治疗极低出生体重儿呼吸暂停的疗效观察

    Institute of Scientific and Technical Information of China (English)

    蒲伟丛; 刘翠青

    2014-01-01

    目的 比较咖啡因联合加温湿化高流量鼻导管通气(heated humidified high-flow nasal cannula,HHHFNC)与经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)治疗早产儿呼吸暂停的有效性和安全性.方法 将2013年9月至2014年3月在河北省儿童医院NICU住院,诊断为早产儿原发性呼吸暂停的极低出生体重儿80例,按照呼吸支持的模式采用随机数字表法随机分为HHHFNC组(39例)和nCPAP组(41例),两组患儿均给予咖啡因治疗.比较两组患儿频繁呼吸暂停的发生率、需要气管插管的比例、氧暴露时间、无创辅助通气时间、喂养情况以及不良事件的发生率.结果 两组患儿在性别比、胎龄、日龄、出生体重等方面差异无统计学意义(P>0.05);两组患儿频繁呼吸暂停的发生率[15.4% (6/39) vs 12.2%(5/41)]、需要气管插管的比例[17.9% (7/39) vs 19.5%(8/41)]、氧暴露时间[(183.1 ±31.2)h vs (175.9 ±32.1)h]、无创辅助通气时间[(163.3 ±25.1)h vs(153.0±26.2)h]等方面差异均无统计学意义(P>0.05).HHHFNC组患儿腹胀[7.7% (3/39) vs24.4%(10/41)]、鼻损伤[2.6%(1/39) vs 19.5% (8/41)]、头部塑形发生率[0.0% (0/39) vs 29.3%(12/41)]均低于nCPAP组(P<0.05),且HHHFNC组开奶日龄较nCPAP组提前[(67.5 ±19.1)h vs(96.3±18.7)h,P<0.05],达到足量经口喂养时间缩短[(346.8±28.6)h vs(371.0 ±29.4)h,P<0.05].结论 HHHFNC联合咖啡因治疗极低出生体重早产儿呼吸暂停和nCPAP组同样有效,且早产儿易耐受,不良反应少,是一种有效的无创呼吸支持模式.%Objective To compare the efficacy and safety of caffeine combined with humidified high-flow nasal cannula(HHHFNC) and nasal continuous positive airway pressure(nCPAP) on the treatment of apnea in very low birth weight (VLBW) preterm infants.Methods Totally 80 VLBW preterm infants with neonatal apnea,who were enrolled in the NICU of Hebei Province Children Hospital from

  19. Application of fecal calprotectin in diagnosing necrotizing enterocolitis of very low birth weight infants%粪便钙卫蛋白水平检测在极低出生体质量儿坏死性小肠结肠炎中的意义

    Institute of Scientific and Technical Information of China (English)

    李红新; 侯德红; 屠文娟; 张琴芬; 解鹏; 吴薇

    2015-01-01

    diagnostic value of neutrophil-derived fecal marker fecal calprotectin (FC)in diagnosing necrotizing enterocolitis (NEC)for very low birth weight (VLBW)infants. Methods A total of 35 cases of VLBW infants with NEC symptoms who were gathered from Changzhou Children′s Hospital and Changzhou Maternal and Child Health Care Hospital between July 201 1 to June 2013 were selected as NEC group.NEC group were further divided into diagnosed NEC sub-group (n=1 5) and suspected NEC sub-group (n = 20 ).Meanwhile,30 VLBW infants with feeding intolerance were selected into feeding intolerance group (n = 30 ),and 30 VLBW infants with normal milk-feeding and no gastrointestinal symptoms were selected into control group(n=30).The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Changzhou Children′s Hospital and Changzhou Maternal and Child Health Care Hospital. Informed consent was obtained from the parents of each participating child.The FC levels and occult blood (OB)were detected among different groups.And the FC levels and positive detection rates of OB among 4 groups were compared.Results The FC levels in the early stage and critical stage of diagnosed NEC sub-group were higher than that of control group (t=6.62,8.44;P 0.05).Furthermore, there was significant difference in the aspect of positive detection rate of OB between critical stage in diagnosed NEC sub-group and control group (χ2 = 1 5.469,P 0.05).But there were no significant differences between suspected stage in suspected NEC sub-group and control group,recovery stage in suspected NEC sub-group and control group,feeding intolerance group and control group (χ2 =2.000,0.000,0.185;P >0.05).Conclusions Compared with fecal OB test,the examination of FC was more sensitive in diagnosing early-stage NEC.FC level can be considered as an effective index to diagnose and evaluate VLBW infants combined with NEC.It can also be used to distinguish NEC and feeding intolerance.

  20. Persistent unexplained congenital clitoromegaly in females born extremely prematurely

    Science.gov (United States)

    Williams, C.E.; Nakhal, R.S.; Achermann, J.C.; Creighton, S.M.

    2013-01-01

    Objective Unexplained clitoromegaly is a rare but well recognised feature in girls born premature. Although detected at birth, girls may re-present during childhood to paediatric urologists and gynaecologists who should be aware of this condition. The aim of the study was to describe the clinical findings and management of a series of girls presenting with persistent congenital clitoromegaly associated with prematurity. Materials and methods This was a retrospective notes review set in a tertiary referral centre for Paediatric and Adolescent Gynaecology (PAG). Results Eight girls with a mean age of 6 years were seen over an eight year period. In all cases a Disorder of Sex Development (DSD) had been previously excluded. The main symptoms were discomfort or concern about appearance. On examination five girls had excess skin over the clitoris and three had enlarged corporal tissue. Management included reassurance and simple measures to ease discomfort. In two cases the parents requested referral to a paediatric urologist to consider clitoral surgery. Conclusion As survival rates for extreme prematurity improve, paediatric urologists and gynaecologists are likely to see more of these cases. Clinicians must be familiar with this condition to ensure children are managed appropriately. PMID:23619354

  1. Social representations of premature birth from the perspective of individuals born preterm in the 1990s.

    Science.gov (United States)

    Leavy, Pía; Violeta Prina, Martina; Martínez Cáceres, María José; Bauer, Gabriela

    2015-01-01

    Prematurity is a public health problem that calls to focus on its causes and consequences through a trans disciplinary approach. There are no studies analyzing premature birth from the perspective of individuals born preterm. To identify social representations associated with premature birth of individuals born preterm in the 1990s in Argentina. Twelve focus groups were conducted with individuals born preterm with a birth weightPrematurity is a significant element, especially in those who suffered major sequelae. Adolescents and youth give a warning on the negative effects caused by overprotective parents and reveal the possibility of redefining the challenges associated with their history of premature birth.

  2. Perfil de prescripción de nutrición parenteral en recién nacidos de muy bajo peso al nacer: período 2006 a 2010 Profile of parenteral nutrition prescription in very low birth weight infants: period 2006 to 2010

    Directory of Open Access Journals (Sweden)

    P. Gomis Muñoz

    2012-12-01

    .Introduction: Early administration of nutrients in adequate amounts is of vital importance to preterm infants because it decreases the time needed to reach the expected weight and tolerate enteral nutrition as well as reducing their hospital stay. The main objective of this study was to analyze the prescription of parenteral nutrition (PN in patients weighing less than 1,500 g at birth in their first 7 days of life during the years 2006-2010 in our hospital and the adequacy of those requirements to the recommendations. Materials and methods: Amino acids, glucose, lipids (g/ kg/day and calories (kcal/kg/day prescribed in the PN of the first week of life were collected. Results: We studied 1899 parenteral nutrition prescriptions from 2006 to 2010 corresponding to the first week of life of 360 patients weighing less than 1,500 g. The caloric content increased from an average of 41.83 kcal/kg/day (1.89 g/kg/ day of amino acids and 0.69 g/kg/day lipids on the first day of life to 80.61 kcal/kg/day (3.2 g/kg/day of amino acids and 2.4 g/kg/day of lipids on the seventh day. About 70% of prescriptions for the children who had PN on the first day of life contained lipids. But when all children who had PN on the fourth day were considered, only 17% of these patients had lipid intake on the first day of life. No prescription exceeded 120 kcal/kg/day. Only 17.9% on the sixth day and 25.5% on the seventh day received more than 90 kcal/kg/day. In our hospital PN is not prepared on Sundays and holidays. 30.1% and 56.9% of children born on weekdays received PN the first and second day versus 11.6% and 38.8% of those born on a holiday or the day before holiday. Conclusions: A high percentage of premature babies do not get the recommended amounts of nutrients in their first week of life in our hospital.

  3. Behavioral and social development of children born extremely premature

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Hansen, Bo Mølholm; Munck, Hanne

    2004-01-01

    A cohort of extremely prematurely born children and matched term controls was assessed at 5 years of age. The parents completed a questionnaire on their behavioral and social development. The purpose was to illuminate whether the children's general intellectual ability and parental sensitivity were...... associated with behavioral and social development. The index children exhibited more hyperactive behavior and had poorer social skills than the controls. Lower Full Scale IQ (FSIQ) was associated with outward reacting and hyperactive behavior and poorer social skills. Sensitive parenting was associated...... with less outward reacting and less hyperactive behavior. When controlling for differences in FSIQ and parental sensitivity, the index children persisted to have an increased risk of exhibiting hyperactive behavior but not poorer social skills. The index children with normal intellectual development...

  4. 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.

  5. Relationship between very low birth weight, environmental factors, and motor and cognitive development of children of 5 and 6 years old Relação entre muito baixo peso ao nascimento, fatores ambientais e o desenvolvimento motor e o cognitivo de crianças aos 5 e 6 anos

    Directory of Open Access Journals (Sweden)

    Gisele E. Oliveira

    2011-04-01

    Full Text Available OBJECTIVE: To examine the relationships between birth weight, preterm birth, environmental factors and the motor and cognitive development of 5 to 6 year-old children. METHODS: A case control study in which the motor and cognitive performance, as well as the home environment of children aged 5-6 years, born pre-term and weighing OBJETIVO: Examinar as relações entre baixo peso ao nascimento, prematuridade, fatores ambientais e os desenvolvimentos motor e cognitivo de crianças aos 5 e 6 anos de idade. MÉTODOS: Estudo caso-controle no qual os desempenhos motor e cognitivo e o ambiente domiciliar de crianças com idade de 5-6 anos, nascidas pré-termo e com peso < 1.500 gramas, foram comparados com os de pares nascidos a termo e com peso adequado (PA. Foram utilizados os testes Movement Assessment Battery for Children (MABC, Developmental Coordination Disorder Questionnaire (DCDQ, as provas de vocabulário e de cubos do Weschsler Intelligence Test for Children-III (WISC, o Swanson, Nolan and Pelham IV Scale (SNAP IV e o Observation for Measurement of the Environment (HOME. RESULTADOS: 50,54% das crianças nascidas com muito baixo peso (MBP foram a óbito, e 15,2% deste grupo desenvolveram sequelas severas. Os escores para os grupos de MBP e de PA foram: HOME 33,83±7,81(MBP, 39,61±8,75(PA; MABC 8,17±7,10(MBP, 3,06±3,80(PA; DCDQ 54,0±11,3(MBP, 63,0±7,5(PA; WISC Cubos 8,35±2,15(MBP, 10,57±2,25(PA; WISC Vocabulário 9,61±2,62(MBP, 13,48±2,45(PA; SNAP IV 4,04±4,95(MBP, 1,57±3,27(PA. Foram encontradas diferenças significativas entre os grupos, com melhor desempenho em todos os testes no grupo de PA. Os resultados dos testes motores e cognitivos tiveram correlação com o peso ao nascer (p<0,01 e com o HOME (p<0,05. CONCLUSÕES: Os resultados reforçaram as evidências de que crianças nascidas prematuras e de MBP são mais propensas a apresentar dificuldades motoras e cognitivas que seus pares nascidos a termo e de PA. Fatores ambientais

  6. Indicadores de salud reproductiva y perinatal en mujeres inmigrantes y autóctonas residentes en Cataluña y en la Comunitat Valenciana (2005-2006 Reproductive and perinatal health indicators in immigrant and Spanish-born women in Catalonia and Valencia (2005-2006

    Directory of Open Access Journals (Sweden)

    Isabel Río

    2010-04-01

    Full Text Available Objetivos: Determinar la prevalencia de nacimientos de madres adolescentes, de prematuridad y de bajo peso al nacer en mujeres españolas e inmigrantes originarias de Latinoamérica, Europa del Este, Magreb y África Subsahariana, residentes en Cataluña y en la Comunitat Valenciana, durante los años 2005 y 2006. Métodos: A partir de los datos proporcionados por los registros de metabolopatías de ambas comunidades autónomas, se obtuvieron las proporciones y sus respectivos intervalos de confianza al 95% de: 1 madres menores de 20 años, 2 neonatos prematuros (Objectives: To determine the prevalence of teenage maternity, preterm birth and low birth weight in Spanish and immigrant mothers from Latin America, eastern Europe, Maghreb and sub-Saharan Africa resident in Catalonia and Valencia from 2005 and 2006. Methods: Using data from congenital metabolic disorders registers in both regions, proportions and 95% confidence intervals were obtained for the following: 1 mothers aged less than 20 years; 2 preterm (<37 weeks and very preterm (<32 weeks births; and 3 low birth weight (<2500g and very low birth weight (<1500g neonates. The calculations were performed for mothers from each of the geographical areas of origin (Spain, Latin America, Eastern Europe, Maghreb and Sub-Sahara. These proportions were compared in Spanish-born and immigrant women and the significance of differences was assessed using chi-squared tests. Results: The prevalence of teenage mothers was between three and five times higher in immigrants than in Spanish women, the highest rate being found in women from eastern Europe. Preterm births, very preterm births and very low birth weight were more frequent in eastern European women than in Spanish women. The prevalence of prematurity and very low birth weight was higher in sub-Saharan mothers than in Spanish women. Conclusions: The number of births in teenage mothers was higher in immigrant mothers from all origins than in

  7. Effect of early breast feeding on the extrauterine growth of very low weight premature infants in NICU%早期母乳喂养对 NICU 住院早产极低体重儿宫外生长发育的影响

    Institute of Scientific and Technical Information of China (English)

    梁玉美; 冯燕妮; 杨松媚; 林梅

    2016-01-01

    Objective To explore the effect of early breast feeding on the growth and feeding related adverse events of very low birth weight premature infants.Methods According to the ways of feeding,the very low birth weight premature in-fants were divided into early breast feeding group and premature milk feeding group.The former group were fed with maternal breast milk from the opening of milk to the volume of maternal breast milk increasing to 100 ml·kg-1 ·d-1 ,and then were fed with premature milk until they left hospital. The latter group were fed with premature milk until they left hospital.The change of weight,length,head circumference,etc of two groups during their hospitalization were monitored.In addition,the rate of growth,the time of recovering to the weight of born,application time of intravenous nutrition and time of the volume increas-ing to 100 ml·kg-1 ·d-1 ,the days of hospitalization,the incidence rate of extrauterine growth retardation upon leaving hospi-tal and the adverse events related to feeding during hospital stay between two groups were compared.Results No statistically significant difference was found in the growth rate of weight,length,head circumference,the time of recovering to the weight of born,application time of intravenous nutrition and time of the volume increasing to 100 ml·kg-1 ·d-1 ,and the incidence rate of extrauterine growth retardation upon leaving hospital between the two groups(P>0.05).The incidence rate of adverse events such as feeding intolerance,neonatal necrotizing ulcerative colitis( NEC)and the incidence of infection of breast feeding group was lower than that of the premature milk feeding group,and the hospital stay was shorter as well,so difference between the two groups was statistically significant(P0.05)。母乳组喂养相关不良事件即喂养不耐受、新生儿坏死性小肠结肠炎(NEC)及感染发生率较早产奶组低,住院时间短,差异有统计学意义(P<0.05)。结论早期

  8. Determinants of survival in very low birth weight neonates in a public sector hospital in Johannesburg

    Directory of Open Access Journals (Sweden)

    Cooper Peter A

    2010-05-01

    Full Text Available Abstract Background Audit of disease and mortality patterns provides essential information for health budgeting and planning, as well as a benchmark for comparison. Neonatal mortality accounts for about 1/3 of deaths Methods This was a retrospective chart review of 474 VLBW infants admitted within 24 hours of birth, between 1 July 2006 and 30 June 2007, to the neonatal unit of Charlotte Maxeke Johannesburg Academic Hospital (CMJAH in Johannesburg, South Africa. Binary outcome logistic regression on individual variables and multiple logistic regression was done to identify those factors determining survival. Results Overall survival was 70.5%. Survival of infants below 1001 grams birth weight was 34.9% compared to 85.8% for those between 1001 and 1500 grams at birth. The main determinant of survival was birth weight with an adjusted survival odds ratio of 23.44 (95% CI: 11.22 - 49.00 for babies weighing between 1001 and 1500 grams compared to those weighing below 1001 grams. Other predictors of survival were gender (OR 3. 21; 95% CI 1.6 - 6.3, birth before arrival at the hospital (BBA (OR 0.23; 95% CI: 0.08 - 0.69, necrotising enterocolitis (NEC (OR 0.06; 95% CI: 0.02 - 0.20, hypotension (OR 0.05; 95% CI 0.01 - 0.21 and nasal continuous positive airways pressure (NCPAP (OR 4.58; 95% CI 1.58 - 13.31. Conclusions Survival rates compare favourably with other developing countries, but can be improved; especially in infants

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    1993-01-01

    Not keeping scheduled visits for medical care is a major health care issue. Little research has addressed how the interaction of demographic and biomedical parameters with psychosocial processes has an impact on appointment keeping. Typical factors are stress of daily living, methods of coping, social support, and instrumental support (that is, tangible assistance). In this study, the authors examine the role of these parameters and processes in the risk status for dropping out of a developme...

  11. Hearing screening follow-up return rate in a very low birth weight ...

    African Journals Online (AJOL)

    A retrospective record review. S. A ... speech-language delay, or other auditory disorders should be ... With regard to the current retrospective study, initial participant ..... For full prescribing information, please refer to the package inserts approved by the Medicines Control Council. ... Divergence of fine and gross motor.

  12. Growth of a cohort of very low birth weight infants in Johannesburg, South Africa

    Directory of Open Access Journals (Sweden)

    Cooper Peter A

    2011-05-01

    Full Text Available Abstract Background Little is known about the growth of VLBW infants in South Africa. The aim of this study was to assess the growth of a cohort of VLBW infants in Johannesburg. Methods A secondary analysis of a prospective cohort was conducted on 139 VLBW infants (birth weight ≤1500 g admitted to Charlotte Maxeke Johannesburg Academic Hospital. Growth measurements were obtained from patient files and compared with the World Health Organization Child Growth Standards (WHO-CGS and with a previous cohort of South African VLBW infants. The sample size per analysis ranged from 11 to 81 infants. Results Comparison with the WHO-CGS showed initial poor growth followed by gradual catch up growth with mean Z scores of 0.0 at 20 months postmenstrual age for weight, -0.8 at 20 months postmenstrual age for length and 0.0 at 3 months postmenstrual age for head circumference. Growth was comparable with that of a previous cohort of South African VLBW infants in all parameters. Conclusions Initial poor growth in the study sample was followed by gradual catch up growth but with persistent deficits in length for age at 20 months postmenstrual age relative to healthy term infants.

  13. Sepsis-Related Mortality of Very Low Birth Weight Brazilian Infants: The Role of Pseudomonas aeruginosa

    Science.gov (United States)

    Pereira, Sylvia Maria Porto; de Almeida Cardoso, Maria Helena Cabral; Figuexeds, Ana Lucia; Mattos, Haroldo; Rozembaum, Ronaldo; Ferreira, Vanessa Isidoro; Portinho, Maria Antonieta; Gonçalves, Ana Cristina; da Costa, Elaine Sobral

    2009-01-01

    The aim of this study is to identify risk factors for sepsis-related mortality in low birth weight (1000 g), five-minute Apgar ≤7, gram-negative sepsis, mechanical ventilation (6.7 times higher than no use), and intravascular catheter. Sepsis-related mortality was due, mainly, to Pseudomonas aeruginosa; birth weight ≤1000 g and mechanical ventilation were strong sepsis-related mortality predictors. PMID:20182631

  14. Acquisition of motor abilities up to independent walking in very low birth weight preterm infants.

    Science.gov (United States)

    Volpi, Sandra C P; Rugolo, Lígia M S S; Peraçoli, José C; Corrente, José Eduardo

    2010-01-01

    To determine chronological and corrected ages at acquisition of motor abilities up to unaided walking in very low weight preterms and to determine up to what point it is necessary to use corrected age. This was a longitudinal study of preterms with birth weight walking. Nine percent of the 155 preterms recruited were excluded from the study, leaving a total of 143 patients. The mean gestational age was 30+/-2 weeks, birth weight was 1,130+/-222 g, 59% were female and 44% were small for gestational age. Preterms achieved head control in their second month, could sit unaided at 7 months and walked at 12.8 months' corrected age, corresponding to the 4th, 9th and 15th months of chronological age. There were significant differences between chronological age and corrected age for all motor abilities. Preterms who were small for their gestational age acquired motor abilities later, but still within expected limits. Very low weight preterms, free from neurosensory disorders, acquired their motor abilities within the ranges expected for their corrected ages. Corrected age should be used until unaided walking is achieved.

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

    Directory of Open Access Journals (Sweden)

    Alvaro Proaño

    2016-03-01

    Full Text Available OBJETIVOS Determinar las ingestas nutricionales en los recién nacidos de muy bajo peso al nacer y su respectivo crecimiento en el primer mes de vida. Adicionalmente, identificar factores para un desenlace negativo en el periodo neonatal de esta población. METODOS Estudio de serie de casos desarrollado en un hospital de tercer nivel en Lima, Perú desde 2011 a 2012. La información se obtuvo de las historias médicas. No se utilizó un protocolo de nutrición durante el estudio. La ingesta diaria del volumen, la energía y las proteínas fue registrada al igual que el puntaje z del peso de manera semanal. Se utilizó regresión logística para identificar factores asociados a un desenlace adverso, que se define como mortalidad neonatal o restricción de crecimiento extrauterino en los primeros 28 días de vida. RESULTADOS Luego del criterio de selección, se incluyeron a 76 participantes. Las ingestas nutricionales fueron similares a los valores descritos en la literatura, pero la ingesta proteica fue sub óptima durante las cuatro semanas. El puntaje z del peso al nacer se asocia con un desenlace adverso (p=0,035. Se determinó que un puntaje z menor de 1,09 predice un desenlace negativo con un área bajo la curva ROC de 96,8% (93,5%, 100%, con un intervalo de confianza del 95%. CONCLUSIÓN Las ingestas proteicas fueron sumamente deficientes en este estudio. Sin embargo, un desenlace adverso se asocia más a un pobre puntaje z al nacer que a factores relacionados a la nutrición.

  16. Parenteral nutrition in very low birth weight infants in the United Kingdom and Ireland.

    LENUS (Irish Health Repository)

    Hopewell, J

    2012-02-01

    Parenteral nutrition (PN) plays an important role in providing nutrients for infants unable to tolerate enteral feeds study was to look at PN prescribing in neonatal units in the United Kingdom (U.K.) and Ireland, in particular in infants < 1.5 kg. A postal questionnaire was administered to the 235 neonatal units. The response rate was 179 (76%), of which 136 (76%) used PN. The initial amount of protein prescribed was 0.1-2 g\\/kg\\/day in 102 units (91%), >2 g\\/kg\\/day in 4 (4%) and 5 (5%) used no protein. 88 (80%) started lipids with the first PN prescription. Only 5 units (5%) started with >1 g\\/kg\\/day. The maximum dose of lipids and protein both varied from 2 - >4 g\\/kg\\/day. The initial glucose infusion rate was 4-8 mg\\/kg\\/min. Interestingly only 44% of units started PN in the first 24 hours of age. Hence results show great variation in PN prescribing.

  17. Practices related to late-onset sepsis in very low-birth weight preterm infants.

    Science.gov (United States)

    Bentlin, Maria Regina; Rugolo, Ligia M S S; Ferrari, Ligia S L

    2015-01-01

    To understand the practices related to late-onset sepsis (LOS) in the centers of the Brazilian Neonatal Research Network, and to propose strategies to reduce the incidence of LOS. This was a cross-sectional descriptive multicenter study approved by the Ethics Committee. Three questionnaires regarding hand hygiene, vascular catheters, and diagnosis/treatment of LOS were sent to the coordinator of each center. The center with the lowest incidence of LOS was compared with the others. All 16 centers answered the questionnaires. Regarding hand hygiene, 87% use chlorhexidine or 70% alcohol; alcohol gel is used in 100%; 80% use bedside dispensers (50% had one dispenser for every two beds); practical training occurs in 100% and theoretical training in 70% of the centers, and 37% train once a year. Catheters: 94% have a protocol, and 75% have a line insertion team. Diagnosis/treatment: complete blood count and blood culture are used in 100%, PCR in 87%, hematological scores in 75%; oxacillin and aminoglycosides is the empirical therapy in 50% of centers. Characteristics of the center with lowest incidence of LOS: stricter hand hygiene; catheter insertion and maintenance groups; use of blood culture, PCR, and hematological score for diagnosis; empirical therapy with oxacillin and aminoglycoside. The knowledge of the practices of each center allowed for the identification of aspects to be improved as a strategy to reduce LOS, including: alcohol gel use, hand hygiene training, implementation of catheter teams, and wise use of antibiotic therapy. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. Iron overload in very low birth weight infants: Serum Ferritin and adverse outcomes

    LENUS (Irish Health Repository)

    Barrett, M

    2011-11-01

    Adequate iron isessential for growth and haematpoiesis. Oral iron supplementation is the standard of care in VLBW infants. Post mortem evidence has confirmed significant iron overload. Excessive free iron has been associated with free radical formation and brain injury in term infants.

  19. Diagnosis and Risk Factors of Acute Kidney Injury in Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Ankana Daga

    2017-06-01

    Conclusion: The determination of AKI using the pRIFLE and AKIN criteria yielded different results. pRIFLE appears to be more sensitive in VLBW infants. A high CRIB II score was recorded for AKI. Future studies are necessary to develop a uniform definition and identify the risk factors to improve the outcomes in this population.

  20. Pituitary-adrenal response in preterm very low birth weight infants after treatment with antenatal corticosteroids

    National Research Council Canada - National Science Library

    Ng, P C; Wong, G W; Lam, C W; Lee, C H; Wong, M Y; Fok, T F; Wong, W; Chan, D C

    1997-01-01

    Antenatal corticosteroids have been widely used for the prevention of respiratory distress syndrome in preterm neonates, yet little is known about their effects on the hypothalamic-pituitary-adrenal...

  1. Cyst(e)ine requirements in enterally fed very low birth weight preterm infants

    NARCIS (Netherlands)

    Riedijk, Maaike A.; Voortman, Gardi; van Beek, Ron H. T.; Baartmans, Martin G. A.; Wafelman, Leontien S.; van Goudoever, Johannes B.

    2008-01-01

    OBJECTIVE. Optimal nutrition is of utmost importance for the preterm infant's later health and developmental outcome. Amino acid requirements for preterm infants differ from those for term and older infants, because growth rates differ. Some nonessential amino acids, however, cannot be sufficiently

  2. Practices related to late-onset sepsis in very low-birth weight preterm infants

    Directory of Open Access Journals (Sweden)

    Maria Regina Bentlin

    2015-04-01

    Full Text Available OBJECTIVE: To understand the practices related to late-onset sepsis (LOS in the centers of the Brazilian Neonatal Research Network, and to propose strategies to reduce the incidence of LOS. METHODS: This was a cross-sectional descriptive multicenter study approved by the Ethics Committee. Three questionnaires regarding hand hygiene, vascular catheters, and diagnosis/treatment of LOS were sent to the coordinator of each center. The center with the lowest incidence of LOS was compared with the others. RESULTS: All 16 centers answered the questionnaires. Regarding hand hygiene, 87% use chlorhexidine or 70% alcohol; alcohol gel is used in 100%; 80% use bedside dispensers (50% had one dispenser for every two beds; practical training occurs in 100% and theoretical training in 70% of the centers, and 37% train once a year. Catheters: 94% have a protocol, and 75% have a line insertion team. Diagnosis/treatment: complete blood count and blood culture are used in 100%, PCR in 87%, hematological scores in 75%; oxacillin and aminoglycosides is the empirical therapy in 50% of centers. Characteristics of the center with lowest incidence of LOS: stricter hand hygiene; catheter insertion and maintenance groups; use of blood culture, PCR, and hematological score for diagnosis; empirical therapy with oxacillin and aminoglycoside. CONCLUSION: The knowledge of the practices of each center allowed for the identification of aspects to be improved as a strategy to reduce LOS, including: alcohol gel use, hand hygiene training, implementation of catheter teams, and wise use of antibiotic therapy.

  3. Bloodstream Infections in Very Low Birth Weight Infants with Intestinal Failure

    NARCIS (Netherlands)

    Cole, Conrad R.; Hansen, Nellie I.; Higgins, Rosemary D.; Bell, Edward F.; Shankaran, Seetha; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Das, Abhik; Stoll, Barbara J.

    2012-01-01

    Objective To examine pathogens and other characteristics associated with late-onset bloodstream infections (BSIs) in infants with intestinal failure (IF) as a consequence of necrotizing enterocolitis (NEC). Study design Infants weighing 401-1500 g at birth who survived for >72 hours and received car

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  5. A Program of Stimulation for Infants Born Prematurely.

    Science.gov (United States)

    Barnard, Kathryn

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

  6. Respiratory Failure in Premature Babies Born from Multiple Pregnancy

    Directory of Open Access Journals (Sweden)

    S. A. Perepelitsa

    2010-01-01

    Full Text Available Objective: to reveal the factors that are responsible for the development of respiratory distress syndrome (RDS and the specific features of its course in preterm twin neonates. Subjects and methods. Twenty-three patients who had had twin pregnancy, including 9 (39.1% and 14 (60% with monochorial and bichorial biamniotic twin pregnancies, respectively, were examined. Their mean age was 28.5±5.4 years. Obstetric and gynecologic histories, conditions at conception, the course of pregnancy, the type of pla-centation, and fetal presentation were considered. The placentas were morphologically examined. In all the patients, pregnancy ended in birth of 46 premature neonates, of them there were 19 (41.3% boys and 27 (58.7% girls. The gestational age of the neonates averaged 31.7±2.3 weeks. The evaluation of the efficiency of performed therapy used clinical assessment of the status of the premature neonates; measurement of partial oxygen tension (pO2 and calculation of alveolar-arterial oxygen gradient (A-a DO2, respiratory index (RI, and oxygenation index (OI; death rates were analyzed. Results. The main cause of respiratory failure (RF was RDS in premature twins. Neonatal blood aspiration-caused pneumonia occurred in one case. The course of RDS was variable. Most neonatal infants needed exogenous surfactant replacement therapy and mechanical ventilation (MV. No signs of RF were present in 7 (15.2% premature neonates. Conclusion. Premature twins are a high RDS risk group. The unfavorable factors that contribute to the development of the disease are multiple pregnancy, a past maternal obstetric history, in-vitro fertilization-induced pregnancy, severe gestosis in the second half of pregnancy, and preterm delivery. The type of placentation affects the fetal status after birth. Fatal outcome occurred in infants from the monochorial bioamniotic twins. In multiple pregnancies, there are pathological changes in the placenta, its membranes, and umbilical

  7. Subjective visual vertical and postural capability in children born prematurely.

    Directory of Open Access Journals (Sweden)

    Maria Pia Bucci

    Full Text Available We compared postural stability and subjective visual vertical performance in a group of very preterm-born children aged 3-4 years and in a group of age-matched full-term children.A platform (from TechnoConcept was used to measure postural control in children. Perception of subjective visual vertical was also recorded with posture while the child had to adjust the vertical in the dark or with visual perturbation. Two other conditions (control conditions were also recorded while the child was on the platform: for a fixation of the vertical bar, and in eyes closed condition.Postural performance was poor in preterm-born children compared to that of age-matched full-term children: the surface area, the length in medio-lateral direction and the mean speed of the center of pressure (CoP were significantly larger in the preterm-born children group (p < 0.04, p < 0.01, and p < 0.04, respectively. Dual task in both groups of children significantly affected postural control. The subjective visual vertical (SVV values were more variable and less precise in preterm-born children.We suggest that poor postural control as well as perception of verticality observed in preterm-born children could be due to immaturity of the cortical processes involved in the motor control and in the treatment of perception and orientation of verticality.

  8. [Extremely prematurely born children's and their parents' need for support

    DEFF Research Database (Denmark)

    Esbjorn, B.H.; Madsen, B.M.; Munck, H.

    2008-01-01

    INTRODUCTION: During the 1990s, knowledge on the psychosocial consequences of extremely preterm birth was requested. The Danish Paediatric Society therefore launched a prospective longitudinal study of all children born in Denmark in 1994-95 with a gestational age of ... of children and a group of children born at term were assessed at 5 years of age and the parents filled in a questionnaire. Quantitative data were analysed, qualitative data and impressions received through conversations with the parents were considered...... on the basis of a psychological understanding of loss and grief. RESULTS: During the first year of life, index children were more ill and were cared for in the home for a longer time than were reference children. From the 3rd year of life, differences in illness were minimal. Index parents received more...

  9. [Extremely prematurely born children's and their parents' need for support

    DEFF Research Database (Denmark)

    Esbjorn, B.H.; Madsen, B.M.; Munck, H.

    2008-01-01

    INTRODUCTION: During the 1990s, knowledge on the psychosocial consequences of extremely preterm birth was requested. The Danish Paediatric Society therefore launched a prospective longitudinal study of all children born in Denmark in 1994-95 with a gestational age of ... of children and a group of children born at term were assessed at 5 years of age and the parents filled in a questionnaire. Quantitative data were analysed, qualitative data and impressions received through conversations with the parents were considered...... on the basis of a psychological understanding of loss and grief. RESULTS: During the first year of life, index children were more ill and were cared for in the home for a longer time than were reference children. From the 3rd year of life, differences in illness were minimal. Index parents received more...

  10. Determining the size of retinal features in prematurely born children by fundus photography.

    Science.gov (United States)

    Knaapi, Laura; Lehtonen, Tuomo; Vesti, Eija; Leinonen, Markku T

    2015-06-01

    The purpose was to study the effect of prematurity on the macula-disc centre distance and whether it could be used as a reference tool for determining the size of retinal features in prematurely born children by fundus photography. The macula-disc centre distance of the left eye was measured in pixels from digital fundus photographs taken from 27 prematurely born children aged 10-11 years with Topcon fundus camera. A conversion factor for Topcon fundus camera (194.98 pixel/mm for a 50° lens) was used to convert the results in pixels into metric units. The macula-disc centre distance was 4.74 mm, SD 0.29. No correlation between ametropia and the macula-disc centre distance was found (r = -0.07, p > 0.05). One child (subject 20) had high myopia and retinopathy of prematurity (ROP), and the macula-disc centre distance was longer than average (6.35 mm). The macula-disc centre distance in prematurely born children at the age of 10-11 years provides an easy-to-use reference tool for evaluating the size of retinal features on fundus photographs. However, if complications of ROP, for example temporal macular dragging or high ametropia, are present, the macula-disc centre distance is potentially altered and a personal macula-disc centre distance should be determined and used as a refined reference tool. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. Cortical Recruitment Patterns in Children Born Prematurely Compared with Control Subjects During a Passive Listening Functional Magnetic Resonance Imaging Task

    Science.gov (United States)

    Ment, Laura R.; Peterson, Bradley S.; Vohr, Betty; Allan, Walter; Schneider, Karen C.; Lacadie, Cheryl; Katz, Karol H.; Maller-Kesselman, Jill; Pugh, Kenneth; Duncan, Charles C.; Makuch, Robert W.; Constable, R. Todd

    2008-01-01

    Objectives To use functional magnetic resonance imaging (fMRI) to test the hypothesis that subjects who were born prematurely develop alternative systems for processing language. Study design Subjects who were born prematurely (n = 14; 600-1250 g birthweight) without neonatal brain injury and 10 matched term control subjects were examined with a fMRI passive listening task of language, the Clinical Evaluation of Language Fundamentals (CELF) and portions of the Comprehensive Test of Phonological Processing (CTOPP). The fMRI task was evaluated for both phonologic and semantic processing. Results Although there were differences in CELF scores between the subjects born prematurely and control subjects, there were no significant differences in the CTOPP measures in the 2 groups. fMRI studies demonstrated that the groups differentially engaged neural systems known to process language. Children born at term were significantly more likely to activate systems for the semantic processing of language, whereas subjects born prematurely preferentially engaged regions that subserve phonology. Conclusions At 12 years of age, children born prematurely and children born at term activate neural systems for the auditory processing of language differently. Subjects born prematurely engage different networks for phonologic processing; this strategy is associated with phonologic language scores that are similar to those of control subjects. These biologically based developmental strategies may provide the substrate for the improving language skills noted in children who are born prematurely. PMID:17011320

  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. 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 ...

  14. Clinical Observation of Yinzhihuang Oral Liquid(茵栀黄口服液) on Prevention of the Premature Infantile Jaundice

    Institute of Scientific and Technical Information of China (English)

    陈升平; 田莉莉; 刘凤玲

    2009-01-01

    Objective:To observe the clinical efficacy of Yinzhihuang Oral Liquid(YOL,茵栀黄口服液)to prevent the premature infantile jaundice.Methods:After excluded hemolytic,suffocation,infection,and the very low birth weight,242 cases of premature infants were randomly assigned to two groups,the treatment group and the control group.Both groups were taken conventional procedures,such as warmth,feeding,and blood glucose monitoring,and the treated group was administered YOL 5 mL each time,twice daily additionally,and the...

  15. Cerebral Damage May Be the Primary Risk Factor for Visual Impairment in Preschool Children Born Extremely Premature

    DEFF Research Database (Denmark)

    Slidsborg, Carina; Bangsgaard, Regitze; Fledelius, Hans Callø;

    2012-01-01

    OBJECTIVES To investigate the importance of cerebral damage and retinopathy of prematurity (ROP) for visual impairment in preschool children born extremely premature and to determine the primary risk factor of the two. METHODS A clinical follow-up study of a Danish national cohort of children bor...

  16. Short- and Long-term Pulmonary Outcome of Palivizumab in Children Born Extremely Prematurely.

    Science.gov (United States)

    Prais, Dario; Kaplan, Eytan; Klinger, Gil; Mussaffi, Huda; Mei-Zahav, Meir; Bar-Yishay, Ephraim; Stafler, Patrick; Steuer, Guy; Sirota, Lea; Blau, Hannah

    2016-03-01

    Palivizumab reduces the severity of respiratory syncytial virus infection in premature infants, but whether there is a protective effect beyond the preschool age is unknown. This study sought to assess the short- and long-term effects of palivizumab immunization on respiratory morbidity and pulmonary function at school age in children born extremely prematurely. Infants born before 29 weeks' gestation in 2000 to 2003 were assessed at school age by parental questionnaire, hospital chart review, and lung function tests. Children born immediately before the introduction of routine palivizumab prophylaxis were compared with age-matched children who received palivizumab prophylaxis during the first respiratory syncytial virus season. Sixty-three children with a mean age 8.9 years were included: 30 had received palivizumab and 33 had not (control subjects). The groups were similar in terms of gestational age, birth weight, need for mechanical ventilation, and oxygen supplementation. Fifty-three percent of the palivizumab group, compared with 39% of the control group, had bronchopulmonary dysplasia (P = .14). Wheezing occurred in the first 2 years of life in 27% of the palivizumab group and in 70% of control subjects (P = .008); respective hospitalization rates were 33% and 70% (P = .001). At school age, rates of hyperresponsiveness (provocative concentration leading to a 20% fall in FEV1 < 1 mg/mL) were 33% and 48%, respectively (P = .38). Spirometry, lung volumes, diffusion, and exhaled nitric oxide were within normal limits, with no significant differences between groups. Palivizumab prophylaxis was associated with reduced wheezing episodes and hospitalizations during the first 2 years of life in children born extremely prematurely. However, it did not affect pulmonary outcome at school age. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  17. Early oral-motor management on feeding performance in premature neonates

    Directory of Open Access Journals (Sweden)

    Yan-Lin Liu

    2013-03-01

    Conclusion: Abnormal brain sonography [odds ratio (OR: 2.222, p = 0.047 and necrotizing enterocolitis (NEC (OR: 2.857, p = 0.017 did affect the first trial in the study group. Early intervention of oral-motor management in very-low-birth-weight premature infants improved feeding performance and neonatal outcome in terms of shorter hospital days. Abnormal brain image and NEC could interfere with the success rate of initial challenge of transitioning from tube to oral feeding in the study group.

  18. Factors influencing the motor development of prematurely born school-aged children in Brazil.

    Science.gov (United States)

    Moreira, Rafaela S; Magalhães, Lívia C; Dourado, Jordana S; Lemos, Stela M A; Alves, Claudia R L

    2014-09-01

    Despite technological advances in neonatology, premature children are still susceptible to disruptions in neurological development. The current study aimed to analyze the factors that influence motor development in prematurely born school-aged children in Brazil. This cross-sectional study involved 100 "apparently normal" children, aged 8-10 years, born at less than 35 weeks of gestation or with birth weightmotor development was assessed using the Movement Assessment Battery for Children (MABC-2). The children's neuropsychological and academic performance was assessed with the Token Test (TT) and Teste de Desempenho Escolar (TDE), respectively. Parents answered questions regarding the child's clinical history and behavior using the Strengths and Difficulties Questionnaire (SDQ) and family environment resources (RAF). Hierarchical multivariate analyses revealed that 39% of the children scored lower on the MABC-2, as compared to that expected for their age (manual dexterity: 49%; balance: 35%; throwing/catching a ball: 26%). Multivariate analysis indicated that the lower the birth weight, the maternal age at childbirth, and the RAF score, the greater was the chance of impairment on the MABC-2 scores. The probability of having an impairment MABC-2 scores was four times higher when the mother was not employed. We also found associations between MABC-2 scores and the tasks of tying shoes and opening/closing zippers and buttons. Factors related to children's home environments and birth weight are associated with deficient motor performance in prematurely born Brazilian school-aged children. Deficient motor skills were also associated with difficulty in performing functional tasks requiring greater manual dexterity.

  19. Processing of intentional and automatic number magnitudes in children born prematurely: evidence from fMRI.

    Science.gov (United States)

    Klein, Elise; Moeller, Korbinian; Kiechl-Kohlendorfer, Ursula; Kremser, Christian; Starke, Marc; Cohen Kadosh, Roi; Pupp-Peglow, Ulrike; Schocke, Michael; Kaufmann, Liane

    2014-01-01

    This study examined the neural correlates of intentional and automatic number processing (indexed by number comparison and physical Stroop task, respectively) in 6- and 7-year-old children born prematurely. Behavioral results revealed significant numerical distance and size congruity effects. Imaging results disclosed (1) largely overlapping fronto-parietal activation for intentional and automatic number processing, (2) a frontal to parietal shift of activation upon considering the risk factors gestational age and birth weight, and (3) a task-specific link between math proficiency and functional magnetic resonance imaging (fMRI) signal within distinct regions of the parietal lobes-indicating commonalities but also specificities of intentional and automatic number processing.

  20. Ultrasound in detection of developmental hip dysplasia in premature born children.

    Science.gov (United States)

    Misanovic, Verica; Jonuzi, Fedzat; Maksic-Kovacevic, Hajra; Rahmanovic, Selma

    2015-04-01

    Developmental hip dysplasia represents the most common deformation of locomotor system in children. Developmental modulation of the hip is expressed during first year of life which is important for early diagnosis and treatment. Therefore, in the practice, it is very important to set a diagnosis early with application of simple and convenient methods (ultrasound) in order to achieve fast and efficient therapeutical effect and avoid permanent disability. The aim of this paper is to point out the increase of prematurely born infants and their survival thanks to the development of Unit for Intensive Neonatal Care at the Pediatric Clinics in Sarajevo. Clinical investigation included 150 infants (77 girls and 73 boys) in whom the developmental hip dysplasia was diagnosed with clinical exam, ultrasound exam and x-ray of the hips. The exams were done in period of January 2012 to August 2014. Two groups of patients were formed. The first one consisted of premature infants, total number of 75 (34 girls and 41 boys), with developmental hip dysplasia that was diagnosed at the first exam at the Ultrasound unit of the Pediatric clinics and at the Intensive Neonatal Care Unit of the Pediatric Clinics in Sarajevo. Second (control) group consistsed of patients-on term infants who had diagnosed one of developmental hip dysplasia, total of 75 (43 girls and 32 boys) during first exam in the Ultrasound unit of the Pediatric clinics in Sarajevo. The frequency of premature birth is between 5 and 10% of all labors and demonstrates increasing trend. We suggest ultrasound examination of hips in each newborn, term or premature, at the age of 6 weeks after birth.

  1. 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

  2. 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

  3. 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.

  4. [The relationship between placental lesions and early hemorrhagic-ischemic cerebral injury in very low birth weight infants].

    Science.gov (United States)

    Vaihinger, Mara; Mazzitelli, Nancy; Balanian, Nora; Grandi, Carlos

    2013-01-01

    Introducción: El examen histopatológico de la placenta es trascendente para evidenciar desordenes relacionados con el embarazo que se asocian a lesiones isquémico hemorrágicas cerebrales (LIHC) en recién nacidos prematuros (RNPT). Objetivo: Estudiar la asociación entre lesiones placentarias y LIHC precoces detectadas con ecografía en RNPT ≤ 1500 g y 32 semanas. Material y Métodos: diseño caso – control. Criterios de inclusión: RNPT ≥ 24 y ≤ 32 semanas, ≥ 500 y ≤ 1500 g, nacidos en la Maternidad Sardá entre años 2006 y 2012. Criterios de exclusión: RNPT gemelares, con malformaciones o infecciones intrauterinas específicas y los fallecidos antes de las 24 horas de vida. Resultados: fueron incluidos 198 RNPT, 49 con LIHC (casos) y 149 sin LIHC (controles). No se encontraron diferencias en las lesiones histopatológicas placentarias entre los dos grupos, aunque se apreció una clara tendencia de lesiones inflamatorias en los casos (67.3%) en comparación con los controles (48 %, p = 0.018). La ruptura prematura de las membranas (p = 0.027) y la corioamnionitis clínica fueron más frecuentes en los casos. Complicaciones fuertemente asociadas a prematurez fueron estadísticamente más evidentes entre los casos. La hemorragia intraventricular fue la lesión cerebral más hallada. El 50% de los casos persistieron con LIHC a las 36-40 semanas, mientras que a mayor edad gestacional el riesgo de LIHC fue menor . Conclusiones: las lesiones histopatológicas placentarias no estuvieron asociadas independientemente a mayor riesgo de LIHC, aunque se observó un predominio de lesiones inflamatorias en los casos.

  5. Neonatal sepsis and neurodevelopment in very low birth weight infants in Matanzas, Cuba 2006-2010: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gerardo Rogelio Robaina Castellanos

    2016-04-01

    Full Text Available Resumen INTRODUCCIÓN La sepsis neonatal se ha asociado a peor resultado del neurodesarrollo en recién nacidos de muy bajo peso. En Cuba se desconoce el impacto de la sepsis neonatal en el neurodesarrollo de los recién nacidos de muy bajo peso, egresados de sus unidades de cuidados intensivos neonatales. OBJETIVO Determinar el impacto de la sepsis neonatal como factor de riesgo de alteraciones del neurodesarrollo en una población de recién nacidos cubanos de muy bajo peso. MÉTODOS Se realizó un estudio de cohorte con 89 neonatos con peso al nacer 15 mg/dl (odds ratio 4,0; IC 95%: 1,1-14,3; p=0,03. CONCLUSIONES La sepsis neonatal debe considerarse como una causa importante, dentro de los múltiples eventos causales, de daño cerebral en el recién nacido pretérmino.

  6. Late-Onset Enterobacter cloacae Sepsis in Very-Low-Birth-Weight Neonates: Experience in a Medical Center

    Directory of Open Access Journals (Sweden)

    Hsiao-Neng Chen

    2009-02-01

    Conclusion: E. cloacae infection in VLBW neonates usually presents with non-specific symptoms and signs. Early recognition of sepsis and empirical combination of piperacillin (or piperacillin and tazobactam and gentamicin (or amikacin may be useful for treatment of sepsis caused by this highly virulent pathogen.

  7. Neonatal sepsis and neurodevelopment in very low birth weight infants in Matanzas, Cuba 2006-2010: a prospective cohort study

    OpenAIRE

    Gerardo Rogelio Robaina Castellanos; Solangel de la Caridad Riesgo Rodríguez

    2016-01-01

    Resumen INTRODUCCIÓN La sepsis neonatal se ha asociado a peor resultado del neurodesarrollo en recién nacidos de muy bajo peso. En Cuba se desconoce el impacto de la sepsis neonatal en el neurodesarrollo de los recién nacidos de muy bajo peso, egresados de sus unidades de cuidados intensivos neonatales. OBJETIVO Determinar el impacto de la sepsis neonatal como factor de riesgo de alteraciones del neurodesarrollo en una población de recién nacidos cubanos de muy bajo peso. MÉT...

  8. Emergence of symbolic schemes in children with Down syndrome, very-low-birth-weight preterm, and typically developing children

    OpenAIRE

    Lenice de Fátima da Silva; Fabíola Custódio Flabiano; Karina Elena Bernardis Bühler; Suelly Cecilia Olivan Limongi

    2010-01-01

    OBJETIVO: verificar a emergência dos esquemas simbólicos simples e combinados e seus respectivos subtipos em 20 crianças prematuras muito baixo peso, 20 crianças com síndrome de Down e 20 crianças com desenvolvimento típico. MÉTODOS: todos os sujeitos foram acompanhados mensalmente durante seis meses, a partir da avaliação inicial em que estavam localizados no final da quinta fase do período sensório-motor. Para tanto, foi utilizado o Protocolo para Observação do Desenvolvimento Cognitivo e d...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    of this review is to summarize some potential immunomodulatory nutrients in the prevention of NEC, including bovine colostrum, probiotics, prebiotics (e.g., human milk oligosaccharides), long chain polyunsaturated fatty acids, and amino acids (glutamine, cysteine and N-acetylcysteine, l-arginine and l......-citrulline). Based on current research evidence, probiotics are the most documented effective method to prevent NEC, while others still require further investigation in animal studies and clinical randomized controlled trials....

  10. Vitamin A, E, and D Deficiencies in Tunisian Very Low Birth Weight Neonates: Prevalence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Samira Fares

    2014-06-01

    Conclusion: Vitamin A, E, and D deficiencies are very common in Tunisian VLBW neonates and are associated with pre-eclampsia. Improved nutritional and health support for pregnant women and high dose vitamins A, E, and D supplementation in VLBW neonates are strongly required in Tunisia.

  11. Population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years

    Directory of Open Access Journals (Sweden)

    Rüegger Christoph

    2012-02-01

    Full Text Available Abstract Background Over the last two decades, improvements in medical care have been associated with a significant increase and better outcome of very preterm (VP, Methods Our population-based observational cohort study used the Minimal Neonatal Data Set, a database maintained by the Swiss Society of Neonatology including information of all VP- and VLBW infants. Perinatal characteristics, mortality and morbidity rates and the survival free of major complications were analysed and their temporal trends evaluated. Results In 1996, 2000, 2004, and 2008, a total number of 3090 infants were enrolled in the Network Database. At the same time the rate of VP- and VLBW neonates increased significantly from 0.87% in 1996 to 1.10% in 2008 (p Conclusions Over the 12-year observation period, the number of VP- and VLBW infants increased significantly. An unchanged overall mortality rate and an increase of survivors free of major complication resulted in a considerable net gain in infants with potentially good outcome.

  12. Early administration of inhaled corticosteroids for preventing chronic lung disease in very low birth weight preterm neonates.

    Science.gov (United States)

    Shah, Vibhuti S; Ohlsson, Arne; Halliday, Henry L; Dunn, Michael

    2017-01-04

    Chronic lung disease (CLD) remains a common complication among preterm infants. There is increasing evidence that inflammation plays an important role in the pathogenesis of CLD. Due to their strong anti-inflammatory properties, corticosteroids are an attractive intervention strategy. However, there are growing concerns regarding short- and long-term effects of systemic corticosteroids. Theoretically, administration of inhaled corticosteroids may allow for beneficial effects on the pulmonary system with a lower risk of undesirable systemic side effects. To determine the impact of inhaled corticosteroids administered to preterm infants with birth weight up to 1500 grams (VLBW) beginning in the first two weeks after birth for the prevention of CLD as reflected by the requirement for supplemental oxygen at 36 weeks' postmenstrual age (PMA). Randomised and quasi-randomised trials were identified by searching the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 12) in the Cochrane Library (searched 5 January 2016), MEDLINE (1966 to 5 January 2016), Embase (1980 to 5 January 2016), CINAHL (1982 to 5 January 2016), reference lists of published trials and abstracts published in Pediatric Research or electronically on the Pediatric Academic Societies web-site (1990 to May 2016). We included in this review randomised controlled trials of inhaled corticosteroid therapy initiated within the first two weeks of life in VLBW preterm infants. We evaluated data regarding clinical outcomes, including: CLD at 28 days or 36 weeks' PMA; mortality; combined outcome of death or CLD at 28 days of age and at 36 weeks' PMA; the need for systemic corticosteroids; failure to extubate within 14 days; and adverse effects of corticosteroids. All data were analysed using Review Manager (RevMan) 5. Meta-analyses were performed using relative risk (RR) and risk difference (RD), along with their 95% confidence intervals (CI). If RD was significant, the number needed to treat for an additional beneficial outcome (NNTB) was calculated. We used the GRADE approach to assess the quality of evidence. According to GRADE the quality of the studies was moderate. Three additional trials are included in this update. The present review includes data analyses based on 10 qualifying trials that enrolled 1644 neonates. There was no significant difference in the incidence of CLD at 36 weeks' PMA in the inhaled steroid versus the placebo group (5 trials, 429 neonates) among all randomised (typical RR 0.97, 95% CI 0.62 to 1.52; typical RD -0.00, 95% CI -0.07 to 0.06). There was no heterogeneity for this outcome (typical RR I² = 11%; typical RD I² = 0%). There was a significant reduction in the incidence of CLD at 36 weeks' PMA among survivors (6 trials, 1088 neonates) (typical RR 0.76, 95% CI 0.63 to 0.93; typical RD -0.07, 95% CI -0.13 to -0.02; NNTB 14, 95% CI 8 to 50). There was a significant reduction in the combined outcome of death or CLD at 36 weeks' PMA among all randomised neonates (6 trials, 1285 neonates) (typical RR 0.86, 95% CI 0.75 to 0.99; typical RD -0.06, 95% CI -0.11 to -0.00) (P = 0.04); NNTB 17, 95% CI 9 to infinity). There was no significant heterogeneity for any of these analyses (I² = 0%). A lower rate of reintubation was noted in the inhaled steroid group compared with the control group in one study. There were no statistically significant differences in short-term complications between groups and no differences in adverse events at long-term follow-up reported. Long-term follow-up of infants enrolled in the study by Bassler 2015 is ongoing. Based on this updated review, there is increasing evidence from the trials reviewed that early administration of inhaled steroids to VLBW neonates is effective in reducing the incidence of death or CLD at 36 weeks' PMA among either all randomised infants or among survivors. Even though there is statistical significance, the clinical relevance is of question as the upper CI limit for the outcome of death or CLD at 36 weeks' PMA is infinity. The long-term follow-up results of the Bassler 2015 study may affect the conclusions of this review. Further studies are needed to identify the risk/benefit ratio of different delivery techniques and dosing schedules for the administration of these medications. Studies need to address both the short- and long-term benefits and adverse effects of inhaled steroids with particular attention to neurodevelopmental outcome.

  13. Short-term growth and substrate use in very-low-birth-weight infants fed formulas with different energy contents

    NARCIS (Netherlands)

    J.B. van Goudoever (Hans); E.J. Sulkers; H.N. Lafeber (Harrie); P.J.J. Sauer (Pieter)

    2000-01-01

    textabstractBACKGROUND: Currently available preterm formulas with energy contents of 3350 kJ (800 kcal)/L promote weight and length gain at rates at or above intrauterine growth rates but disproportionately increase total body fat. OBJECTIVE: The objective of this

  14. Environmental temperature control in very low birth weight infants (less than 1000 grams) cared for in double-walled incubators.

    Science.gov (United States)

    Chessex, P; Blouet, S; Vaucher, J

    1988-08-01

    To evaluate the effect of fluctuations in environment and body temperatures on preterm infants, we recorded these variables in very immature newborn infants (birth weight less than 1000 gm) cared for in double-walled incubators (Air-Shields model C-100 and Ohio model IC). Both incubators maintained environmental temperatures corresponding overall to the set point, despite incubator openings. Under skin temperature servocontrol, however, environmental temperature fluctuations were greater than 2 degrees C even in strictly controlled conditions. The pattern of incubator temperature fluctuations depended on the set point rather than on the type of incubator (conventionally heated or heated by warm air blown between the double walls). The long-term clinical significance of the incubator temperature variability remains to be determined; the choice between air and skin servocontrolling should depend in part on the need for environmental stability.

  15. Kangaroo care and behavioral and physiologic pain responses in very-low-birth-weight twins: a case study.

    Science.gov (United States)

    Cong, Xiaomei; Cusson, Regina M; Hussain, Naveed; Zhang, Di; Kelly, Sharon P

    2012-09-01

    The purpose of this case study was to describe pain responses in three study conditions: longer (30 minutes) kangaroo care (KC) before and throughout heel stick (KC30), shorter (15 minutes) KC before and throughout heel stick (KC15), and incubator care throughout heel stick (IC) in 28-week gestational age twins. Pain responses were measured by crying time, Preterm Infant Pain Profile (PIPP), and heart rate variability indexes, including low-frequency power (LF, representing sympathetic activity), high-frequency power (HF, parasympathetic activity), and LF/HF ratio (sympathetic-parasympathetic balance). Both twins cried more and had higher PIPP pain scores and tachycardia during heel stick in the IC condition. Infant B had an incident of apnea and tachycardia by the end of the heel stick and a bradycardia episode during recovery in the IC condition. The twins had lower LF/HF ratios (better autonomic nervous system balance) during recovery in both longer and shorter KC conditions compared with the IC condition. Infant B had difficulty returning to LF/HF ratio baseline level after the painful procedure in the IC condition. These data suggest that both longer and shorter KC before and throughout painful procedures can be helpful in reducing behavioral and physiologic pain responses in preterm infants.

  16. Functional connectivity to a right hemisphere language center in prematurely born adolescents.

    Science.gov (United States)

    Myers, Eliza H; Hampson, Michelle; Vohr, Betty; Lacadie, Cheryl; Frost, Stephen J; Pugh, Kenneth R; Katz, Karol H; Schneider, Karen C; Makuch, Robert W; Constable, R Todd; Ment, Laura R

    2010-07-15

    Prematurely born children are at increased risk for language deficits at school age and beyond, but the neurobiological basis of these findings remains poorly understood. Thirty-one PT adolescents (600-1250g birth weight) and 36 T controls were evaluated using an fMRI passive language task and neurodevelopmental assessments including: the Wechsler Intelligence Scale for Children-III (WISC-III), the Peabody Picture Vocabulary Test-Revised (PPVT-R), the Comprehensive Test of Phonological Processing (CTOPP) and the Test of Word Reading Efficiency (TOWRE) at 16years of age. Neural activity was assessed for language processing and the data were evaluated for connectivity and correlations to cognitive outcomes. PT subjects scored significantly lower on all components of the WISC-III (p<0.05) compared to term subjects, but there was no significant difference in PPVT-R scores between the groups. Functional connectivity (fcMRI) between Wernicke's area (left BA 22) and the right supramarginal gyrus (BA 40) was increased in preterm subjects relative to term controls (p=0.03), and the strength of this connection was inversely related to performance on both the PPVT-R (R(2)=0.553, p=0.002), and the verbal comprehension index (R(2)=0.439, p=0.019). Preterm adolescents engage a dorsal right hemisphere region for language at age 16years. Those with the greatest cognitive deficits demonstrate increasing reliance on this alternate pathway.

  17. 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.

  18. Successful surgical management of retinopathy of prematurity showing rapid progression despite extensive retinal photocoagulation

    Directory of Open Access Journals (Sweden)

    Salil S Gadkari

    2015-01-01

    Full Text Available The management of retinopathy of prematurity (ROP can be challenging in preterm babies with a gestational age <30 weeks, those with very low birth weight and multiple risk factors (eg., oxygen therapy for respiratory distress, sepsis, neonatal jaundice. A premature infant presented with "hybrid" zone 1 disease in the right eye and aggressive posterior ROP in the left eye. Both eyes were adequately treated with laser photocoagulation; however, the eyes deteriorated and progressed to stage 4 ROP. Both eyes eventually underwent intravitreal bevacizumab followed by lens sparing vitrectomy with good anatomical and visual outcome. Anticipation of progression despite laser photocoagulation in certain clinical scenarios, frequent follow-up and timely surgical intervention is paramount.

  19. 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.

  20. 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

  1. Parent-Child Interaction Therapy for Children Born Premature: A Case Study and Illustration of Vagal Tone as a Physiological Measure of Treatment Outcome

    Science.gov (United States)

    Bagner, Daniel M.; Sheinkopf, Stephen J.; Miller-Loncar, Cynthia L.; Vohr, Betty R.; Hinckley, Matthew; Eyberg, Sheila M.; Lester, Barry M.

    2009-01-01

    Evidence-based psychosocial interventions for externalizing behavior problems in children born premature have not been reported in the literature. This single-case study describes Parent-Child Interaction Therapy (PCIT) with a 23-month-old child born at 29 weeks gestation weighing 1,020 grams, who presented with significant externalizing behavior…

  2. Parent-Child Interaction Therapy for Children Born Premature: A Case Study and Illustration of Vagal Tone as a Physiological Measure of Treatment Outcome

    Science.gov (United States)

    Bagner, Daniel M.; Sheinkopf, Stephen J.; Miller-Loncar, Cynthia L.; Vohr, Betty R.; Hinckley, Matthew; Eyberg, Sheila M.; Lester, Barry M.

    2009-01-01

    Evidence-based psychosocial interventions for externalizing behavior problems in children born premature have not been reported in the literature. This single-case study describes Parent-Child Interaction Therapy (PCIT) with a 23-month-old child born at 29 weeks gestation weighing 1,020 grams, who presented with significant externalizing behavior…

  3. Determinants and Predictors of School Adaptation and Academic Achievement in Prematurely Born Children.

    Science.gov (United States)

    Kalmar, Magda; Varga, Magdolna Estefan

    The study followed up 30 premature Hungarian infants of low birthweight (less than 2500 grams) but no other major perinatal complications. Subjects were tested at age 6 on the Budapest-Binet IQ test, the Goodenough's "Draw a Person" test, the Bender Gestalt test, and a school entry test battery. Test performances at age 6 found that the…

  4. Determinants and Predictors of School Adaptation and Academic Achievement in Prematurely Born Children.

    Science.gov (United States)

    Kalmar, Magda; Varga, Magdolna Estefan

    The study followed up 30 premature Hungarian infants of low birthweight (less than 2500 grams) but no other major perinatal complications. Subjects were tested at age 6 on the Budapest-Binet IQ test, the Goodenough's "Draw a Person" test, the Bender Gestalt test, and a school entry test battery. Test performances at age 6 found that the…

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Antenatal betamethasone and fetal growth in prematurely born children: implications for temperament traits at the age of 2 years.

    Science.gov (United States)

    Pesonen, Anu-Katriina; Räikkönen, Katri; Lano, Aulikki; Peltoniemi, Outi; Hallman, Mikko; Kari, M Anneli

    2009-01-01

    We explored whether repeated dose of antenatal betamethasone and variation in intrauterine growth of prematurely born children predict temperament characteristics at the age of 2 years. The patients (n = 142) were prematurely born children (mean gestational age: 31.0 weeks; range: 24.6-35.0 weeks) who participated in a randomized and blinded trial testing the effects of a repeated dose of antenatal betamethasone in imminent preterm birth. Fetal growth was estimated as weight, length, and head circumference in SDs according to Finnish growth charts. Parents assessed their toddlers' temperament with 201 items of the Early Childhood Temperament Questionnaire (mean child corrected age: 2.1 years). No significant main effects of repeated betamethasone on toddler temperament existed. However, a significant interaction between study group and duration of exposure to betamethasone emerged; those exposed to a repeated dose for >24 hours before delivery were more impulsive. One-SD increases in weight, length, and head circumference at birth were associated with 0.14- to 0.19-SD lower levels of negative affectivity (fearfulness, anger proneness, and sadness); 1-SD increases in length, weight, and head circumference at birth were associated with 0.14- to 0.18-SD higher levels of effortful control (self-regulation). Repeated antenatal betamethasone did not induce alterations in toddler temperament. The results, however, suggest that a longer duration of exposure is associated with higher impulsivity scores. Regardless of betamethasone exposure, slower fetal growth exerted influences on temperament. Our findings indicate prenatal programming of psychological development and imply that more attention is needed to support the development of infants born at the lower end of the fetal growth distribution.

  7. Developmental Outcome of Very Low Boy Weight Babies Born in a Regional Public Hospital in Hong Kong%Regional Public Hospital in Hong Kong

    Institute of Scientific and Technical Information of China (English)

    KNR Yuen; CB Chow; D Allison

    2009-01-01

    Objectives To investigate the Short term development outcome of a cohort of Very low Birth Weight(VLRW)babies(i.e.Birth-weight less than 1500 g.)born in a Hong Kong regional public hospital in 2001.Design Non-randomized prospective cohort Study.Setting Regional public hospital in Hong Kong.Partieipants 29 babies with birth weight of less than 1500 g(i.e.very low birth weight babies)who were bom and survived to discharge in Kwong Wah Hospital in the period between lst January 2001 to 31st December 2001.Main outoome measures Deveiopmcntal outcome.Results A total of 27 very low birth weight babies(15 males and 12 females)were included in the study.The mean gestational age of the cohort was 28.6 weeks±3.08 weeks.The mean birth weight of the cohort of babies was 1120 g±270 g.Two patients defaulted follow up and assessment in the first two years of life.At the chronological age of 4 vears old,21 out of 25 babies (84%)had normal growth and development.Four out of 25 babies were found to have developmental delay,including one baby with severe handicap.Conehmion With advances in medical care,many low birth weight babies can now 8urvive,but a number of these high risk babies may have long term developmental problems.It is important to monitor these patients closely after discharge from hospital so that early identification and rehabilitation of developmental problems can be possible.

  8. 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.

  9. Application of the ommaya reservoir in the treatment of hydrocephalus in prematurely born children: Correlation with animal results

    Directory of Open Access Journals (Sweden)

    Mihajlović Miljan

    2013-01-01

    Full Text Available Introduction. Intraventricular hemorrhage occurs in almost one fifth of prematurely born children. Due to present complications, such as hydrocephalus and neurological deficit, it endangers the child’s life, therefore there is the need for understanding and prevent risk factors as well as the need for finding most optimal methods of treatment. Objective. The aim of the study was to point out the current therapeutic modalities of the treatment of posthemorrhagic hydrocephalus in prematurely born children. Methods. The study included 60 patients divided into two groups of 30 patients treated at the University Children’s Hospital of Belgrade in the period 2003-2008. Results. Treatment outcome of the control group of patients treated by standard methods was influenced by gestational age (p=0.024, head circumference on birth (p=0.043, body mass on birth (p=0.006, Apgar score on birth (p<0.001, peripartum asphyxia (p<0.001, cardiorespiratory arrest (p<0.001, respiratory distress (p=0.002 and intraventricular hemorrhagic grade (p<0.001. As statistically significant predictors of the poor treatment outcome of the experimental group of patients treated by using Ommaya reservoir were identified: low body mass on birth (p<0.05, low Apgar score (p<0.05, prolonged number of days on assisted ventilation (p<0.05, presence of peripartum asphyxia (p<0.05 and cardiorespiratory arrest (p<0.05. Conclusion. No statistically significant difference was detected in the outcome between the patients treated by the standard method and those with installed Ommaya reservoir. However, the difference of 10% in mortality between the two groups may be clinically significant so that further studies of larger samples are necessary.

  10. Health Issues of Premature Babies

    Science.gov (United States)

    ... Text Size Email Print Share Health Issues of Premature Babies Page Content Because premature babies are born before they are physically ready ... associated with prematurity. Because of these health concerns, premature babies are given extra medical attention and assistance ...

  11. Executive function skills are associated with reading and parent-rated child function in children born prematurely.

    Science.gov (United States)

    Loe, Irene M; Lee, Eliana S; Luna, Beatriz; Feldman, Heidi M

    2012-02-01

    Preterm children are at risk for executive function (EF) problems, which have been linked to behavior and learning problems in full term children. In this study, we examine the relationship between EF and functional outcomes in preterm children. To evaluate (1) EF skills of 9- to 16-year-old children born across the spectrum of gestational age (GA), (2) relationship of degree of prematurity to EF skills, and (3) contributions of EF skills to two functional outcomes - reading scores and parent-rated child function. Preterm children reading, and parent-ratings of child function. Multiple regression models evaluated contributions to EF skills and functional outcomes. Compared to full term controls, preterm children had poorer EF performance on a complex planning and organization task and did not increase planning time as task difficulty increased. Their spatial memory capacity was not different. GA contributed to EF skills, but was mediated by IQ. EF contributed to the variance in reading skills but did not add to the variance in reading when IQ was considered. EF skills significantly contributed to the variance in parent-rated child function, but IQ did not. EF skills contribute to measures of functional outcome in this high-risk population. The use of EF skills as an early marker for learning and functional problems and as a target for intervention in children born preterm warrants future study. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Characterization of blood borne microparticles as markers of premature coronary calcification in newly menopausal women.

    Science.gov (United States)

    Jayachandran, Muthuvel; Litwiller, Robert D; Owen, Whyte G; Heit, John A; Behrenbeck, Thomas; Mulvagh, Sharon L; Araoz, Philip A; Budoff, Matthew J; Harman, S Mitchell; Miller, Virginia M

    2008-09-01

    While the risk for symptomatic atherosclerotic disease increases after menopause, currently recognized risk factors do not identify ongoing disease processes in low-risk women. This study tested the hypothesis that circulating cell-derived microparticles may reflect disease processes in women defined as low risk by the Framingham risk score. The concentration and phenotype of circulating microparticles were evaluated in a cross-sectional study of apparently healthy menopausal women, screened for enrollment into the Kronos Early Estrogen Prevention Study. Microparticles were evaluated by flow cytometry, and coronary artery calcification (CAC) was scored using 64-slice computed tomography scanners. The procoagulant activity of isolated microparticles was determined with a sensitive fluorescent thrombin generation assay. Chronological age, body mass index, serum lipids, systolic blood pressure (Framingham risk score 50; range, 93-315 Agatston units) CAC compared with women without calcification. The total concentration and percentage of microparticles derived from platelets and endothelial cells were greatest in women with high CAC scores. The thrombin-generating capacity of the isolated microparticles correlated with phosphatidylserine expression, which also was greatest in women with high CAC scores. The percentages of microparticles expressing granulocyte and monocyte markers were not significantly different among groups. Therefore, the characterization of platelet and endothelial microparticles may identify early menopausal women with premature CAC who would not otherwise be identified by the usual risk factor analysis.

  13. 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.

  14. Risk Factors of Catheter-related Bloodstream Infection With Percutaneously Inserted Central Venous Catheters in Very Low Birth Weight Infants: A Center's Experience in Taiwan

    Directory of Open Access Journals (Sweden)

    Jen-Fu Hsu

    2010-12-01

    Conclusion: It is important to avoid inserting a PICC at the femoral site. Strict catheter care protocol should also be applied to reduce local site bacterial colonization and removal of PICCs as soon as they are no longer essential for patient care to reduce the incidence of infection.

  15. Association of inhibitors of gastric acid secretion and higher incidence of necrotizing enterocolitis in preterm very low-birth-weight infants.

    Science.gov (United States)

    More, Kiran; Athalye-Jape, Gayatri; Rao, Shripada; Patole, Sanjay

    2013-11-01

    Inhibitors of gastric acid (IGA) are used for upper gastrointestinal bleeding or gastroesophageal reflux in preterm infants. The resultant increase in gastric pH may enhance the growth of pathogens and increase the risk of necrotizing enterocolitis (NEC). Our systematic review examined the association between IGA and NEC in preterm infants. Standard methodology of systematic reviews was followed. PubMed, Embase, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched in August 2012. One case-control and one prospective cohort study (n = 11,346), both evaluating H2-blockers as IGA, were included. Meta-analysis showed a significant association between NEC and IGA (odds ratio [OR]: 1.78, 95% confidence interval [CI]: 1.4, 2.27, p < 0.00001). The prospective cohort study found higher incidence of infection (sepsis, pneumonia, urinary tract infection) with IGA (37.4% versus 9.8%, OR: 5.5, 95% CI: 2.9 to 10.4, p < 0.001). Exposure to H2 receptor antagonists may be associated with increased risk of NEC and infections in preterm infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Resolution of human immunodeficiency virus type 1 infection-related severe pulmonary hypertension in a very low-birth-weight infant.

    Science.gov (United States)

    Feiterna-Sperling, Cornelia; Hüseman, Dieter; Timme, Jens; Bührer, Christoph; Obladen, Michael

    2008-06-01

    Pulmonary arterial hypertension (PAH) affects approximately 0.5% of human immunodeficiency virus (HIV)-infected adults with poor prognosis. The effectiveness of highly active antiretroviral therapy for treatment of HIV-related PAH (HIV-PAH) remains controversial. Little is known about the incidence, clinical course, and therapy options for PAH in HIV-1-infected pediatric patients. Here, we report the case of a preterm infant with HIV-related life-threatening PAH, which resolved after initiation of highly active antiretroviral therapy.

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

    Science.gov (United States)

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

    2005-03-01

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

  18. 极低出生体重儿高频振荡通气%High-frequency oscillatory ventilation in very low birth weight infant

    Institute of Scientific and Technical Information of China (English)

    孙眉月

    2002-01-01

    @@ 高频通气(HFV)用于新生儿呼吸衰竭的治疗已20余年,积累了许多实验资料及临床经验,检索到的文献达1300余篇[1].由于通气策略的不断改进,早期HFV常作为对新生儿严重呼吸衰竭常规呼吸机治疗失败后的营救性治疗.极低出生体重(VLBW)儿行常规通气(CV)治疗呼吸衰竭时易产生多种急、慢性肺部并发症,影响治疗效果及预后.近年来在用高频振荡通气(HFOV)减少肺损伤和对肺采取保护性治疗策略方面进行了探讨,简述如下. 1 HFV的主要种类及其作用 HFV有三种类型:即高频喷射通气(HFJV)(以Bunnell公司的Lifepulse为代表),目前已较少应用;高频气流阻断(HFFI)(以Infransouics公司的Infant star为代表);HFOV(以Sensormedics公司的Sensormedics 3100A为代表).其他尚有德国Drger公司的Babylog 8000及英国的SLE 200等.前述三种呼吸机内部功能不完全相同,但通气容量均近于或小于死腔气容量.HFOV为目前广泛应用的一类,Infant star虽以HFFI形式进行通气,由于以呼气为主动,其作用也可理解为HFOV.Sensormedics 3100A通气时设高频率,吸、呼比值为1∶ 2,而Infant star行HFV时除设置高频率外尚需与CV联合应用,设2~5/min,间歇强制通气(IMV).

  19. Evaluation of the clinical risk index in very low birth weight newborns at a public tertiary maternity in the city of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Pedro Alexandre Breuel

    2007-12-01

    Full Text Available Objective: To evaluate the clinical risk index in very low birthweight newborns at a public maternity hospital, its associationwith mortality, some selected neonatal respiratory diseases andsurfactant therapy. Methods: A cohort prospective study carriedout at the Hospital Municipal Vila Nova Cachoeirinha e MaternidadeEscola, in São Paulo, Brazil. All newborns with gestational age< 31 weeks and birth weight < 1500 g were evaluated for theapplication of the clinical risk index for babies (CRIB. Newbornswho died in the first 12 hours of life or were referred from othermaternities were excluded from this study. Statistical analysesused logistic regression, Spearman correlation test and Student’st test. Results: Seventy-one cases were studied. The meangestational age was 27.30 ± 2.61 weeks; the mean weight was1032.61 ± 280.62 g. Birth weight and gestational age showedbetter predictive values for neonatal mortality than the clinicalrisk index for babies (80.30%, 76.10%, 73.20%. Twins showed nosignificant index differences (t = 0.601; p = 0.748. The scorewas inversely related to Apgar scores at 1 and 5 minutes and wasassociated with the respiratory distress syndrome, pneumothoraxand the use of surfactants. There was no significant correlation withchronic lung disease. Conclusion: The clinical risk index for babieswas not the best predictor for neonatal mortality as compared toweight and gestational age, but showed a significant associationwith 1 and 5-minute Apgar scores, respiratory distress syndrome,extrapulmonary air and the use of surfactants. It was not predictivefor chronic lung disease. Twins were not associated with CRIB.

  20. Probiotics Prevent Late-Onset Sepsis in Human Milk-Fed, Very Low Birth Weight Preterm Infants: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Aceti, Arianna; Maggio, Luca; Beghetti, Isadora; Gori, Davide; Barone, Giovanni; Callegari, Maria Luisa; Fantini, Maria Pia; Indrio, Flavia; Meneghin, Fabio; Morelli, Lorenzo; Zuccotti, Gianvincenzo; Corvaglia, Luigi

    2017-08-22

    Growing evidence supports the role of probiotics in reducing the risk of necrotizing enterocolitis, time to achieve full enteral feeding, and late-onset sepsis (LOS) in preterm infants. As reported for several neonatal clinical outcomes, recent data have suggested that nutrition might affect probiotics' efficacy. Nevertheless, the currently available literature does not explore the relationship between LOS prevention and type of feeding in preterm infants receiving probiotics. Thus, the aim of this systematic review and meta-analysis was to evaluate the effect of probiotics for LOS prevention in preterm infants according to type of feeding (exclusive human milk (HM) vs. exclusive formula or mixed feeding). Randomized-controlled trials involving preterm infants receiving probiotics and reporting on LOS were included in the systematic review. Only trials reporting on outcome according to feeding type were included in the meta-analysis. Fixed-effects models were used and random-effects models were used when significant heterogeneity was found. The results were expressed as risk ratio (RR) with 95% confidence interval (CI). Twenty-five studies were included in the meta-analysis. Overall, probiotic supplementation resulted in a significantly lower incidence of LOS (RR 0.79 (95% CI 0.71-0.88), p preterm infants (RR 0.75 (95% CI 0.65-0.86), p preterm infants. Further efforts are required to clarify the relationship between probiotics supplementation, HM, and feeding practices in preterm infants.

  1. Umbilical Cord Blood Use for Admission Blood Tests of VLBW (Very Low Birth Weight) Preterm Neonates: A Multi-center Randomized Clinical Trial

    Science.gov (United States)

    2016-09-12

    collection of information if it does not display a currently valid OMB control number. Umbilical Cord Blood Use for Admission Blood Tests of VLBW Preterm...to help decrease the risk of anemia and the need for transfusion. These include delayed cord clamping , cord stripping, erythropoiesis stimulating...transcutaneous measurements[3, 6]. Another approach used to decrease the risk of anemia and need for transfusion is the use of umbilical cord blood

  2. Probiotics Prevent Late-Onset Sepsis in Human Milk-Fed, Very Low Birth Weight Preterm Infants: Systematic Review and Meta-Analysis

    National Research Council Canada - National Science Library

    Arianna Aceti; Luca Maggio; Isadora Beghetti; Davide Gori; Giovanni Barone; Maria Luisa Callegari; Maria Pia Fantini; Flavia Indrio; Fabio Meneghin; Lorenzo Morelli; Gianvincenzo Zuccotti; Luigi Corvaglia; on behalf of the Italian Society of Neonatology

    2017-01-01

    ... (exclusive human milk (HM) vs. exclusive formula or mixed feeding). Randomized-controlled trials involving preterm infants receiving probiotics and reporting on LOS were included in the systematic...

  3. Limited effects of intravenous paracetamol on patent ductus arteriosus in very low birth weight infants with contraindications for ibuprofen or after ibuprofen failure

    NARCIS (Netherlands)

    D.W.E. Roofthooft (Daniella); I.M. van Beynum (I.); J.C.A. de Klerk (Johan C. A.); M. van Dijk (Monique); J.N. van den Anker (John); I.K.M. Reiss (Irwin); D. Tibboel (Dick); S.H. Simons (Sinno)

    2015-01-01

    textabstractFinding the optimal pharmacological treatment of a patent ductus arteriosus (PDA) in preterm neonates remains challenging. There is a growing interest in paracetamol as a new drug for PDA closure. In this prospective observational cohort study, we evaluated the effectiveness of intraveno

  4. Probiotics Prevent Late-Onset Sepsis in Human Milk-Fed, Very Low Birth Weight Preterm Infants: Systematic Review and Meta-Analysis

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    Arianna Aceti

    2017-08-01

    Full Text Available Growing evidence supports the role of probiotics in reducing the risk of necrotizing enterocolitis, time to achieve full enteral feeding, and late-onset sepsis (LOS in preterm infants. As reported for several neonatal clinical outcomes, recent data have suggested that nutrition might affect probiotics’ efficacy. Nevertheless, the currently available literature does not explore the relationship between LOS prevention and type of feeding in preterm infants receiving probiotics. Thus, the aim of this systematic review and meta-analysis was to evaluate the effect of probiotics for LOS prevention in preterm infants according to type of feeding (exclusive human milk (HM vs. exclusive formula or mixed feeding. Randomized-controlled trials involving preterm infants receiving probiotics and reporting on LOS were included in the systematic review. Only trials reporting on outcome according to feeding type were included in the meta-analysis. Fixed-effects models were used and random-effects models were used when significant heterogeneity was found. The results were expressed as risk ratio (RR with 95% confidence interval (CI. Twenty-five studies were included in the meta-analysis. Overall, probiotic supplementation resulted in a significantly lower incidence of LOS (RR 0.79 (95% CI 0.71–0.88, p < 0.0001. According to feeding type, the beneficial effect of probiotics was confirmed only in exclusively HM-fed preterm infants (RR 0.75 (95% CI 0.65–0.86, p < 0.0001. Among HM-fed infants, only probiotic mixtures, and not single-strain products, were effective in reducing LOS incidence (RR 0.68 (95% CI 0.57–0.80 p < 0.00001. The results of the present meta-analysis show that probiotics reduce LOS incidence in exclusively HM-fed preterm infants. Further efforts are required to clarify the relationship between probiotics supplementation, HM, and feeding practices in preterm infants.

  5. Effects of neonatal enteral glutamine supplementation on cognitive, motor and behavioural outcomes in very preterm and/or very low birth weight children at school age.

    Science.gov (United States)

    de Kieviet, Jorrit F; Oosterlaan, Jaap; van Zwol, Annelies; Boehm, Guenther; Lafeber, Harrie N; van Elburg, Ruurd M

    2012-12-28

    In very preterm ( glutamine supplementation between day 3 and day 30 of life had neither beneficial nor detrimental effects on long-term cognitive, motor and behavioural outcomes of very preterm and/or VLBW children at school age, although visuomotor abilities were poorer in children that received glutamine.

  6. Relationship Between Perinatal and Neonatal Indices and Intelligence Quotient in Very Low Birth Weight Infants at the Age of 6 or 8 Years

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    Shu-Chi Mu

    2008-04-01

    Conclusion: Conclusion: In our study, the children with lower gestational age had lower FSIQ. There was no significant association between small for gestational age and IQ performance. The neonatal outcomes of VLBW infants did have less impact on IQ performance later in life.

  7. A case of Candida famata sepsis in a very low birth weight infant successfully treated with fluconazole following antifungal susceptibility testing

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    Shilpee Raturi

    2015-01-01

    This case report highlights the growing number of cases arising due to nonalbicans Candida infections in the neonatal intensive care units and the usefulness of antifungal susceptibility testing in deciding optimal antifungal therapy and preventing the emergence of drug resistance.

  8. [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.

  9. Delayed umbilical cord clamping in premature neonates.

    Science.gov (United States)

    Kaempf, Joseph W; Tomlinson, Mark W; Kaempf, Andrew J; Wu, YingXing; Wang, Lian; Tipping, Nicole; Grunkemeier, Gary

    2012-08-01

    Delayed umbilical cord clamping is reported to increase neonatal blood volume. We estimated the clinical outcomes in premature neonates who had delayed umbilical cord clamping compared with a similar group who had early umbilical cord clamping. This was a before-after investigation comparing early umbilical cord clamping with delayed umbilical cord clamping (45 seconds) in two groups of singleton neonates, very low birth weight (VLBW) (401-1,500 g) and low birth weight (LBW) (greater than 1,500 g but less than 35 weeks gestation). Neonates were excluded from delayed umbilical cord clamping if they needed immediate major resuscitation. Primary outcomes were provision of delivery room resuscitation, hematocrit, red cell transfusions, and the principle Vermont Oxford Network outcomes. In VLBW neonates (77 delayed umbilical cord clamping, birth weight [mean±standard deviation] 1,099±266 g; 77 early umbilical cord clamping 1,058±289 g), delayed umbilical cord clamping was associated with less delivery room resuscitation, higher Apgar scores at 1 minute, and higher hematocrit. Delayed umbilical cord clamping was not associated with significant differences in the overall transfusion rate, peak bilirubin, any of the principle Vermont Oxford Network outcomes, or mortality. In LBW neonates (172 delayed umbilical cord clamping, birth weight [mean±standard deviation] 2,159±384 g; 172 early umbilical cord clamping 2,203±447 g), delayed umbilical cord clamping was associated with higher hematocrit and was not associated with a change in delivery room resuscitation or Apgar scores or with changes in the transfusion rate or peak bilirubin. Regression analysis showed increasing gestational age and birth weight and delayed umbilical cord clamping were the best predictors of higher hematocrit and less delivery room resuscitation. Delayed umbilical cord clamping can safely be performed in singleton premature neonates and is associated with a higher hematocrit, less delivery room

  10. Biomarkers of brain injury in the premature infant

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    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.

  11. 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.

  12. Respostas cardiopulmonares durante o esforço em crianças e adolescentes nascidas prematuras Cardiopulmonary outcomes during stress in children and adolescents born prematurely

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    Josy Davidson

    2011-09-01

    Full Text Available OBJETIVO: Descrever as respostas cardiopulmonares durante o esforço em crianças e adolescentes nascidos prematuros. FONTES DE DADOS: Busca nas bases científicas em saúde SciELO, Lilacs e PubMed, utilizando-se os descritores: "pressão arterial", "capacidade física", "cardiovascular", "prematuro", "criança", adolescente", "função pulmonar", nos idiomas inglês e português. Foram selecionados artigos publicados nos últimos 20 anos. SÍNTESE DOS DADOS: Crianças e adolescentes com histórico de prematuridade apresentam sinais de obstrução das vias aéreas, menores valores de função pulmonar e de capacidade ao exercício, maior incidência de hipertensão arterial e/ou valores mais elevados da pressão arterial sistólica do que os nascidos a termo. Além disso, há indícios de que as alterações na resistência vascular sistêmica desde os primeiros dias de vida comprometam o desenvolvimento cardiovascular até a idade adulta, predispondo a maiores riscos cardiovasculares. CONCLUSÕES: O esforço físico nos indivíduos nascidos prematuros acarreta respostas cardiopulmonares diferentes dos nascidos a termo, atribuídas a particularidades no desenvolvimento desses sistemas inerentes ao prematuro.OBJECTIVE: To describe cardiopulmonary outcomes during physical stress in prematurely born children and adolescents. DATA SOURCES: Studies were obtained from PubMed, SciELO and Lilacs in Portuguese and in English from the last 20 years. The following key-words were searched: "arterial pressure", "physical capacity", "cardiovascular", "premature", "children", "adolescent" and "pulmonary function". DATA SYNTHESIS: Prematurely born children and adolescents have airway obstruction, worse lung function and exercise capacity, more frequency of hypertension and/or higher systolic arterial pressure than those born at term. Furthermore, studies suggest that these infants have cardiovascular resistance alterations since their first days of life that

  13. A Functional Magnetic Resonance Imaging Study of the Long-term Influences of Early Indomethacin Exposure on Language Processing in the Brains of Prematurely Born Children

    Science.gov (United States)

    Ment, Laura R.; Peterson, Bradley S.; Meltzer, Jed A.; Vohr, Betty; Allan, Walter; Katz, Karol H.; Lacadie, Cheryl; Schneider, Karen C.; Duncan, Charles C.; Makuch, Robert W.; Constable, R. Todd

    2008-01-01

    Background Previous studies have demonstrated that indomethacin lowers the incidence and decreases the severity of intraventricular hemorrhage, as well as improves the cognitive outcome, in prematurely born male infants. Objective The purpose of this work was to use functional magnetic resonance imaging to test the hypothesis that neonatal indomethacin treatment would differentially affect brain activation across genders in school-aged, prematurely born children during performance of a language task. Methods Forty-seven prematurely born children (600–1250-g birth weight) and 24 matched term control subjects were evaluated using a functional magnetic resonance imaging passive language task and neurodevelopmental assessments that included the Wechsler Intelligence Scale for Children-III and the Peabody Picture Vocabulary Test-Revised. Neural activity was assessed during both phonologic and semantic processing in the functional magnetic resonance imaging protocol. Results Neurodevelopmental assessments demonstrated significant differences in full-scale, verbal, and performance intelligence quotient, as well as Peabody Picture Vocabulary Test scores, between the preterm and term control subjects. Rates of perinatal complications did not differ significantly across preterm treatment groups, but male preterm subjects randomly assigned to saline tended to have lower Peabody Picture Vocabulary Test-Revised scores than did all of the other preterm groups. During phonological processing, a significant treatment-by-gender effect was demonstrated in 3 brain regions: the left inferior parietal lobule, the left inferior frontal gyrus (Broca's area), and the right dorsolateral prefrontal cortex. Conclusions These data demonstrate a differential effect of indomethacin administration early in postnatal life on the subsequent development of neural systems that subserve language functioning in these male and female preterm infants. PMID:16950986

  14. Cardiovascular follow-up at school age after perinatal glucocorticoid exposure in prematurely born children: perinatal glucocorticoid therapy and cardiovascular follow-up.

    Science.gov (United States)

    de Vries, Willem B; Karemaker, Rosa; Mooy, Nicole F; Strengers, Jan L M; Kemperman, Hans; Baerts, Wim; Veen, Sylvia; Visser, Gerard H A; Heijnen, Cobi J; van Bel, Frank

    2008-08-01

    To study whether antenatal or neonatal glucocorticoid therapy to reduce the incidence and severity of chronic lung disease in preterm infants is associated with long-term adverse cardiac effects and hypertension. Retrospective matched-cohort study. Outpatient clinic of a tertiary care hospital. One hundred ninety-three children aged 7 to 10 years who had been born prematurely between December 2, 1993, and September 15, 1997. Main Exposure Neonatal treatment with dexamethasone disodium phosphate(n = 48) or the clinically equally effective glucocorticoid hydrocortisone (n = 51), or only antenatal treatment with betamethasone disodium phosphate and betamethasone acetate (n = 51). These 3 groups were compared with a reference group of prematurely born children who had not been exposed to perinatal glucocorticoid therapy (n = 43). General hemodynamic data (heart rate and blood pressure), cardiovascular function as assessed at echocardiography, intima-media thickness of the carotid arteries, and cardiac biochemical features as early markers of expansion and volume overload of the cardiac left ventricle (B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide). No significant group differences were found for heart rate, blood pressure, biochemical features, intima-media thickness, or systolic or diastolic left ventricular function. Although no differences were found in blood pressure and cardiovascular function at school age in children antenatally or neonatally treated with glucocorticoids, further cardiovascular follow-up may be advisable because cardiovascular dysfunction may become apparent only later in life.

  15. The study of lipid profile, diet and other cardiovascular risk factors in children born to parents having premature ischemic heart disease

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    M R Savitha

    2011-01-01

    Full Text Available Background: Dyslipidemia is a marker for ischemic heart disease (IHD, which can be detected in early childhood and tracks to adulthood. Dyslipidemia, along with factors like diet, obesity and sedentary activity, increases the risk of a child developing IHD in adulthood. Early detection and modification of these risk factors can prevent IHD. Objectives: To study the lipid profile in children born to parents with history of premature IHD and also to study the effect of diet, lifestyle factors, and obesity in the study group. Materials and Methods: Fifty children of parents with premature IHD and 50 control children without any family history of IHD were analyzed for cardiovascular risk factors such as lipid profile, body mass index (BMI and hypertension. The effects of modifiable risk factors like diet and physical activity on lipid profile were analyzed. The correlation between parent and child lipid profile was studied. Results: Mean total cholesterol, low density lipoprotein cholesterol and triglycerides were significantly higher (P<0.05 in children with family history of IHD as compared to children without family history. There was a positive correlation between lipid levels of parents and their children. Children with elevated BMI, a sedentary lifestyle, and excess oily/junk diet intake showed increased incidence of dyslipidemia (P<0.05. Conclusions: Children of IHD patients have significant incidence of dyslipidemia. The risk factors like BMI, diet and physical activity increase the incidence of dyslipidemia. Therefore, all children of premature IHD patients should be screened for dyslipidemia.

  16. Prematuridade e interação mãe-criança: revisão sistemática da literatura Prematuridad e interacción madre-niño: revisión sistemática de la literatura Prematurity and mother-child interaction: a systematic bibliographycal review

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    Vivian Caroline Klein

    2006-08-01

    niño. Los estudios identificaron diferencias en la interacción entre dualidades madre-niño ex prematura y la termo en las fases parvulario, escolar y adolescencia. Las conductas interactivas maternales ejercieron un efecto moderador diferencial en el desarrollo de niños vulnerables con antecedentes de riesgo biológico.The aim of the present study was to analyse the scientific publications, from 1998 to 2004, about interaction between mothers and their pre-term born children and their development at pre-school and school age. A systematic bibliographical review about empirical studies indexed on MEDLINE, PsycINFO and LILACS data bases was done, using as key-words the terms: 'preterm' (very low birth weight, prematurity, premature birth and 'mother-child interaction' (mother child dyads, mother child relationship, mother child relations, maternal mediation. Thirty-three articles were identified, 26 were selected and 22 were achieved. Most studies assessed mother-child interaction at the first four years of life, as well as its impact on children's developmental outcome. The studies identified differences in the interaction between mother-pre term born child dyads and mother- full term born child dyads at pre-school and school age and at adolescence. Maternal interactive behaviors exerted a differential moderator effect on the developmental outcome of vulnerable children who presented previous biologic risk factors.

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

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    Angell Linda

    2005-06-01

    , dependence on ventilation, and use of postnatal steroids were intertwined. Simultaneous presence of these factors seems to indicate severe disease status. Conclusion Prolonged and late postnatal steroids treatment in very low birth weight infants may pose an increased risk for the development of severe retinopathy of prematurity; however, use of postnatal steroids may also be a marker for severity of illness. Further studies need to focus on biologic markers in the pathogenesis of retinopathy of prematurity and to better understand the influence of therapies.

  18. Innate Immunity and Human Milk MicroRNAs Content: A New Perspective for Premature Newborns

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    Erika Cione

    2017-02-01

    Full Text Available Context The premature newborns are prone to develop both early onset and late onset neonatal sepsis. The major causes of this phenomenon rely on the immaturity of the immune system, which has reduced capability to respond adequately to pathogens. Evidence Acquisition Titles and abstracts of previous papers were scanned before reading the full-text, in order to retrieve appropriate information. The databases used for searching were PubMed, Cochrane, and Embase for articles published before 1st of July, 2016. Secondary search for articles cited in reference lists were identified by the primary search. This review focused on neonatal sepsis incidence and the associated immune response with regards to microRNAs of human milk as a new microelement that enables regulation of innate immunity functions. Results Since human milk is a valuable source of microRNAs, a better understanding of its content will open a new therapeutic avenue for the clinical management of infectious diseases affecting premature newborns. The variation in miRNAs quantity in human milk needs to be considered. Mother’s milk can have different amounts of miRNAs and the identification of a microMilk batch richer of miRNAs can be a nutrition intervention method for modulating innate immunity in clinical management of premature newborns. Conclusions Routine translation of the microMilk concept for neonatal intensive care unit (NICU, in the management of premature newborns could be a way of defending premature newborns and Very Low Birth Weight (VLBW infants from both early and late sepsis.

  19. Avaliação tomográfica pulmonar tardia em prematuros com displasia broncopulmonar e persistência de canal arterial Late pulmonary tomography assessment in premature infants with bronchopulmonary dysplasia submitted to patent ductus arteriosus managemnent

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    Lilian Beani

    2007-12-01

    Full Text Available OBJETIVO: Avaliação tomográfica do parênquima pulmonar de crianças nascidas prematuras de muito baixo peso, com persistência do canal arterial submetidas a tratamento clínico ou cirúrgico e que apresentaram displasia broncopulmonar. MÉTODOS: Entre dezembro de 2006 e janeiro de 2007, 14 crianças foram submetidas à tomografia computadorizada de alta resolução (TCAR, que nasceram prematuras, peso inferior a 1500 gramas, com displasia broncopulmonar (DBP e persistência do canal arterial (PCA, os quais necessitaram tratamento para oclusão do canal, sendo divididos em dois grupos: A - clínico (n = 6 e B - cirúrgico (n = 8. Nove pacientes eram do sexo masculino e cinco, do feminino, com idade média de 36,5±4,3 meses. As TCAR foram analisadas por dois observadores independentes e as lesões quantificadas em cada paciente. Para análises estatísticas, foi utilizado o teste de Mann-Whitney e considerados significantes valores de pOBJECTIVE: To assess through high-resolution computed tomography the pulmonary parenchyma of children prematurely born with both very low birth weight and patent ductus arteriosus submitted to medical or surgical treatment that developed bronchopulmonary dysplasia. METHODS: Between December 2006 and January 2007, 14 children prematurely born with a weight less than 1500g with bronchopulmonary dysplasia (BPD and patent ductus arteriosus (PDA were submitted to high-resolution computed tomography (HRCT. All of them underwent surgical closure of the canal divided into two groups: A - medical (n=6 and B - surgical (n=8. The pool of patients comprised 9 baby boys and 5 girls who were 36.5±4.3 month-old. The HRCT were analyzed by two independent observers and quantified in each patient. The statistical analyses were assessed using the Mann-Whitney test, and p<0.05 was considered statistically significant. RESULTS: Three patients presented normal tomographies, being two of A group and one of B. In A, the most

  20. Fine Motor Skill Mediates Visual Memory Ability with Microstructural Neuro-correlates in Cerebellar Peduncles in Prematurely Born Adolescents.

    Science.gov (United States)

    Thomas, Alyssa R; Lacadie, Cheryl; Vohr, Betty; Ment, Laura R; Scheinost, Dustin

    2017-01-01

    Adolescents born preterm (PT) with no evidence of neonatal brain injury are at risk of deficits in visual memory and fine motor skills that diminish academic performance. The association between these deficits and white matter microstructure is relatively unexplored. We studied 190 PTs with no brain injury and 92 term controls at age 16 years. The Rey-Osterrieth Complex Figure Test (ROCF), the Beery visual-motor integration (VMI), and the Grooved Pegboard Test (GPT) were collected for all participants, while a subset (40 PTs and 40 terms) underwent diffusion-weighted magnetic resonance imaging. PTs performed more poorly than terms on ROCF, VMI, and GPT (all P VMI (all P VMI and left middle cerebellar peduncle FA. Novel strategies to target fine motor skills and the cerebellum may help PTs reach their full academic potential. © The Author 2017. Published by Oxford University Press.

  1. [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

  2. Prematuridade entre recém-nascidos de mães com Amniorrexe Prematura Prematuridad entre recién nacidos de nadres com Amniorrexis Prematura Prematurity among new-borns of Mothers with Premature Amniorrexis

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    Fernanda Lima Batista Santos

    2006-12-01

    ,5% 2-5 consultas y 27,1% refieren 6 o más, 16,2% de las madres presentaron Dolencia Hipertensiva del Estado Gestacional (DHEG, y 51,3% tuvieran parto normal. Se concluye que la prematuridad fué elevada, representando importante causa de la morbimortalidad neonatal, como también acarretar complicaciones clínicas y obstétricas para la madre. La DHEG aún representa um risco para la gestación. És necesário que nuevos estúdios sobre la temática sean realizados para se conocer la verdadera magnitud del problema.This is a descriptive study that took place in a public maternity in Fortaleza Ce, with objective to characterize the prematureness among newly born (RN interned in the Unidade Neonatal due to the premature amniorrexe. It was analyzed 37 newborns along with their mothers. From the newborns it was analyzed: prematureness degree, Apgar and reanimation need; and from their mothers: gestational age, pre natal care, birth and gestational pathologies. It was found that 35,1% of the babies are premature and 29,7% had a 0-6 Agar during the first minute of life, needing reanimation. As for the gestational age, 35,1% presented membrane ruptures before the 37th week of birth, 5,4% did not go through pre natal care, 67,5% attended from 2 to 5 appointments and 27,1% attended to 6 or more, 16,2% of the mothers presented Gestational Specific Highblood Pressure Disease (GSHPD and 51,3% of the mothers went through normal delivery. It was concluded that the prematureness was high, being a main cause of newborn morbid/mortality and that it also brings clinical and obstetric complications for the mothers. The GSHPD still represents a risk to pregnancy. More studies on the subject are needed in order to acknowledged the real magnitude of the problem.

  3. Desenvolvimento de crianças nascidas pré-termo avaliado pelo teste de Denver-II: revisão da produção científica brasileira Development of children born preterm evaluated by the Denver-II test: a review of the Brazilian scientific production

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    Zaira Aparecida de Oliveira Custódio

    2012-01-01

    Full Text Available Este artigo objetivou analisar a produção científica sobre o desenvolvimento de crianças brasileiras nascidas pré-termo e de muito baixo peso avaliado por meio do Teste de Denver-II, no período de 2000 a 2009. Realizou-se levantamento bibliográfico de estudos empíricos indexados nas bases de dados Medline, Lilacs e Scielo, por meio da combinação das palavras chave: pré-termo, muito baixo peso, fatores de risco, desenvolvimento, Denver-II. Foram identificados 26 artigos e selecionados oito conforme critérios de inclusão. A maioria dos estudos avaliou crianças pré-termo entre 5 a 24 meses de idade. Os estudos identificaram associação entre as variáveis neonatais e ambientais e o desempenho no Teste de Denver-II. Crianças nascidas pré-termo devem ser acompanhadas ambulatorialmente para prevenir e detectar riscos no desenvolvimento.This article aims to analyze the scientific literature on the development of children born preterm with very low birth weight assessed by the Denver-II test in the period from 2000 to 2009. A survey of empirical literature indexed in Medline, Lilacs and Scielo was carried out through the combination of the keywords: preterm, very low birth weight, risk factors, development, and Denver-II. Twenty six articles were identified and eight were selected following the inclusion criteria. Most studies evaluated preterm children between 5 and 24 months of age. The studies identified a significant association between neonatal and environmental variables and the performance on Denver-II Test. Children born preterm must be followedup at outpatient Units to prevent and detect risks in development.

  4. 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.

  5. 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

  6. Premature Contractions

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Premature Contractions - PACs and PVCs Updated:Dec 15,2016 ... You felt this more-forceful beat. Types of premature contractions Premature atrial contractions (PACs) start in the ...

  7. Avaliação neurológica de recém-nascidos pré-termo de muito baixo peso com displasia broncopulmonar Neurological assessment of very low birth weight infants with bronchopulmonary dysplasia

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    Tathiana Ghisi de Souza

    2009-03-01

    Full Text Available OBJETIVO: Descrever e comparar a avaliação neurológica e comportamental de recém-nascidos pré-termos com e sem displasia broncopulmonar (DBP. MÉTODOS: Recém-nascidos prematuros com peso ao nascer inferior a 1500g e idade gestacional menor de 32 semanas foram avaliados com 40 semanas de idade gestacional corrigida, no Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas. Utilizou-se a Avaliação Neurológica de Dubowitz, com 29 itens divididos em seis categorias: tônus, padrões de tônus, reflexos, movimentos, sinais anormais e comportamento. O estado de consciência do recém-nascido foi graduado segundo Brazelton (1973. Utilizaram-se os testes do qui-quadrado e exato de Fischer para variáveis qualitativas e o de Mann-Whitney para as numéricas não-paramétricas, com nível de significância de 5%. RESULTADOS: No per