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Sample records for term infants readmitted

  1. Short-term diagnostic stability among re-admitted psychiatric in ...

    African Journals Online (AJOL)

    Objective: To determine the prospective and retrospective consistency of diagnoses among readmitted psychiatric in-patients at the Moi Teaching and Referral Hospital in Eldoret, Kenya. Method: Admission and discharge diagnoses among a consecutive sample of 114 psychiatric in-patients readmitted at the Moi Teaching ...

  2. Prevalence of significant weight loss and hypernatremia in breast feeding jaundice infants readmitted to Phramongkutklao Hospital within 1 month of age.

    Science.gov (United States)

    Suksumek, Nithipun; Pirunnet, Tanin; Chamnanvanakij, Sangkae; Saengaroon, Preyapan

    2010-11-01

    Neonatal jaundice, especially breast feeding jaundice is the most common cause of neonatal re-admission within the first month of life. Good maternal support and closed follow-up of newborn infants can promote successful breast feeding without causing any complications. To determine the rate of significant weight loss and hypernatremia in infants with breast feeding jaundice readmitted to Phramongkutklao Hospital within 1 month of age. Cross-sectional descriptive study was conducted in infants of gestational age > or = 35 weeks and birth weight > or = 2,000 grams who had breast feeding jaundice readmitted between January, 1st and December 31st, 2008. Maternal and neonatal history, laboratory result, complications and treatment were reviewed. Rates of significant weight loss and hypernatremia were calculated. The associations between weight loss and factors, serum sodium, serum bilirubin and weight loss were analyzed using Chi-square and Mann-Whitney U test. There were 30 infants in the study. 12 (40%) were male. The median gestational age and birth weight were 37 (35-40) weeks and 2,945 (2,100-3,810) grams, respectively. Three infants had significant weight loss more than 10% of birth weights. No infant had hyperbilirubinemia. Severity of weight loss was associated with weight loss at the time before discharge from hospital. Weight loss was not associated with gestational age, sex, parity, cesarean section, exclusive breast feeding, serum sodium level, and serum bilirubin level. Complications of dehydration such as hypernatremia was not observed in infants with breast feeding jaundice in this study. Maternal education, serial weight measurements and awareness of breast-feeding jaundice problems are helpful strategies to promote successful breast feeding.

  3. Nutrition for healthy term infants

    OpenAIRE

    1998-01-01

    Nutrition for Healthy Term Infants is the new national statement on nutrition for infants from birth to 24 months, developed collaboratively by the Canadian Paediatric Society, Dietitians of Canada and Health Canada.

  4. [Differential features of DRG 541 readmitting patients].

    Science.gov (United States)

    López Pérez, J; López Álvarez, J; Montero Ruiz, E

    2015-01-01

    Hospital readmission is considered an adverse outcome, and the hospital readmission ratio is an indicator of health care quality. Published studies show a wide variability and heterogeneity, with large groups of patients with different diagnoses and prognoses. The aim of the study was to analyse the differences between patients readmitted and those who were not, in patients grouped into the diagnosis related group (DRG) 541. A retrospective observational study was conducted on DRG 541 patients discharged in 2010. Readmission is defined as any admission into any hospital department, and for any reason at ≤30 days from discharge. An analysis was performed that included age, sex, day of discharge, month of discharge, number of diagnoses and drugs at discharge, respiratory depressant drugs, length of stay, requests for consultations/referrals, Charlson comorbidity index, feeding method, hospitalisations in the previous 6 months, albumin and haemoglobin levels and medical examinations within 30 days after discharge. Of the 985 patients included in the study, 189 were readmitted. On multivariate analysis, significant variables were: Haemoglobin -0.6g/dl (95% confidence interval [95%CI] -0.9 to -0.3), gastrostomy feeding odds ratio (OR) 5.6 (95%CI: 1.5 to 21.6), hospitalisations in previous 6 months OR 1.9 (95%CI: 1.3 to 2.8), visits to emergency department OR 17.4 (95%CI: 11.3 to 26.8), medical checks after discharge OR 0.4 (95%CI: 0.2 to 0.8). DRG 541 readmitting patients have some distinctive features that could allow early detection and prevent hospital readmission. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  5. Cranial sonography in term and near-term infants

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    Yikilmaz, Ali [Gevher Nesibe Hospital and Erciyes Medical School, Department of Radiology, Talas, Kayseri (Turkey); Taylor, George A. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2008-06-15

    Sonographic patterns of brain injury in the term and near-term infant are quite different from those in the premature infant. Although periventricular leukomalacia and germinal matrix hemorrhage are rarely seen in term infants, selective neuronal injury, parasagittal infarction, focal stroke, diffuse hypoxic-ischemic injury, and deep parenchymal hemorrhages are more common lesions. In addition, congenital brain tumors, hamartomatous lesions, such as hemimegalencephaly, and tuberous sclerosis can mimic ischemic and hemorrhagic injury. Sonography remains an important tool in the initial evaluation of intracranial abnormalities in critically ill term and near-term infants. An understanding of the differences in etiology, sonographic patterns, and limitations of sonography in the term infant is essential for accurate and effective diagnoses in this age group. (orig.)

  6. Respiratory distress of the term newborn infant.

    Science.gov (United States)

    Edwards, Martin O; Kotecha, Sarah J; Kotecha, Sailesh

    2013-03-01

    Respiratory distress is recognised as any signs of breathing difficulties in neonates. In the early neonatal period respiratory distress is common, occurring in up to 7% of newborn infants, resulting in significant numbers of term-born infants being admitted to neonatal units. Many risk factors are involved; the increasing number of term infants delivered by elective caesarean section has also increased the incidence. Additionally the risk decreases with each advancing week of gestation. At 37 weeks, the chances are three times greater than at 39-40 weeks gestation. Multiple conditions can present with features of respiratory distress. Common causes in term newborn infants include transient tachypnoea of the newborn, respiratory distress syndrome, pneumonia, meconium aspiration syndrome, persistent pulmonary hypertension of the neonate and pneumothorax. Early recognition of respiratory distress and initiation of appropriate treatment is important to ensure optimal outcomes. This review will discuss these common causes of respiratory distress in term-born infants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Multicystic encephalomalacia in term infants.

    Science.gov (United States)

    Frigieri, G; Guidi, B; Costa Zaccarelli, S; Rossi, C; Muratori, G; Ferrari, F; Cavazzuti, G B

    1996-12-01

    The terms "multicystic encephalomalacia" and "subcortical leucomalacia" (SCL) are used to describe the presence of areas of necrosis that develop into cystic lesions inside the brain. These lesions are generally due to severe asphyxia and/or hypotension. The designation SCL can also be used to describe the extent and the seat of the lesion in the brain or to distinguish subcortical lesions from periventricular and/or combined ones. In this study we give an account of our experience with eight newborns admitted to our neonatal intensive care unit, who presented clinical-neurological alterations and encephalomalacic lesions whose presence was documented by ultrasonography.

  8. Preterm Infants Exhibit Greater Variability in Cerebrovascular Control than Term Infants

    Science.gov (United States)

    Fyfe, Karinna L.; Odoi, Alexsandria; Yiallourou, Stephanie R.; Wong, Flora Y.; Walker, Adrian M.; Horne, Rosemary S.C.

    2015-01-01

    Study Objectives: Sudden infant death syndrome (SIDS) remains an important cause of infant death, particularly among infants born preterm. Prone sleeping is the major risk factor for SIDS and this has recently been shown to alter cerebrovascular control in term infants. As preterm infants are at greater risk for SIDS than those born at term, we hypothesized that their cerebrovascular control in the prone position would be reduced compared to term infants. Patients or Participants: There were 35 preterm (mean gestation 31.2 ± 0.4 w) and 17 term (mean gestation 40.1 ± 0.3 w) infants. Design: Infants underwent daytime polysomnography at 2–4 w, 2–3 mo, and 5–6 mo postterm age. Infants slept both prone and supine and were presented with cardiovascular challenges in the form of 15° head-up tilts (HUT). Measurements and Results: Cerebral tissue oxygenation index (TOI) was recorded using near-infrared spectroscopy (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and mean arterial pressure (MAP) was recorded using a Finometer cuff (Finapres Medical Systems, Amsterdam, The Netherlands). In the prone position TOI increased following the HUT (P < 0.05), whereas no change was seen in the supine position. The overall pattern of response was similar in both groups, but more variable in preterm than term infants (P < 0.05). Conclusions: Cerebrovascular control differs between the prone and supine positions in preterm infants. Although overall the responses to head-up tilts were similar between term and preterm infants, greater variability of responses in preterm infants suggests persisting immaturity of their cerebrovascular control in the first year of life, which may contribute to their increased risk of sudden infant death syndrome. Citation: Fyfe KL, Odoi A, Yiallourou SR, Wong FY, Walker AM, Horne RS. Preterm infants exhibit greater variability in cerebrovascular control than term infants. SLEEP 2015;38(9):1411–1421. PMID:25669192

  9. Serum lutein concentrations in healthy term infants fed human milk or infant formula with lutein

    OpenAIRE

    Bettler, Jodi; Zimmer, J. Paul; Neuringer, Martha; DeRusso, Patricia A.

    2009-01-01

    Background Lutein is a carotenoid that may play a role in eye health. Human milk typically contains higher concentrations of lutein than infant formula. Preliminary data suggest there are differences in serum lutein concentrations between breastfed and formula-fed infants. Aim of the study To measure the serum lutein concentrations among infants fed human milk or formulas with and without added lutein. Methods A prospective, double-masked trial was conducted in healthy term formula-fed infant...

  10. Early term birth: understanding the health risks to infants.

    Science.gov (United States)

    Craighead, Debra Vela

    2012-01-01

    Early term birth, which occurs at 37 to 38 weeks gestation, is often elective and can carry significant health risks to infants, including short-term and long-term health outcomes. Nurses and other health care providers involved in the care of pregnant women and infants need to be aware of these infants' physiologic vulnerability and potential short- term and long-term care requirements. Nurses can educate patients and raise awareness of the risks associated with early term birth. © 2012 AWHONN.

  11. Preterm Infants Exhibit Greater Variability in Cerebrovascular Control than Term Infants.

    Science.gov (United States)

    Fyfe, Karinna L; Odoi, Alexsandria; Yiallourou, Stephanie R; Wong, Flora Y; Walker, Adrian M; Horne, Rosemary S C

    2015-09-01

    Sudden infant death syndrome (SIDS) remains an important cause of infant death, particularly among infants born preterm. Prone sleeping is the major risk factor for SIDS and this has recently been shown to alter cerebrovascular control in term infants. As preterm infants are at greater risk for SIDS than those born at term, we hypothesized that their cerebrovascular control in the prone position would be reduced compared to term infants. There were 35 preterm (mean gestation 31.2 ± 0.4 w) and 17 term (mean gestation 40.1 ± 0.3 w) infants. Infants underwent daytime polysomnography at 2-4 w, 2-3 mo, and 5-6 mo postterm age. Infants slept both prone and supine and were presented with cardiovascular challenges in the form of 15° head-up tilts (HUT). Cerebral tissue oxygenation index (TOI) was recorded using near-infrared spectroscopy (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and mean arterial pressure (MAP) was recorded using a Finometer cuff (Finapres Medical Systems, Amsterdam, The Netherlands). In the prone position TOI increased following the HUT (P position. The overall pattern of response was similar in both groups, but more variable in preterm than term infants (P positions in preterm infants. Although overall the responses to head-up tilts were similar between term and preterm infants, greater variability of responses in preterm infants suggests persisting immaturity of their cerebrovascular control in the first year of life, which may contribute to their increased risk of sudden infant death syndrome. © 2015 Associated Professional Sleep Societies, LLC.

  12. Exogenous Attention Influences Visual Short-Term Memory in Infants

    Science.gov (United States)

    Ross-Sheehy, Shannon; Oakes, Lisa M.; Luck, Steven J.

    2011-01-01

    Two experiments examined the hypothesis that developing visual attentional mechanisms influence infants' Visual Short-Term Memory (VSTM) in the context of multiple items. Five- and 10-month-old infants (N = 76) received a change detection task in which arrays of three differently colored squares appeared and disappeared. On each trial one square…

  13. Delay in Retinal Photoreceptor Development in Very Preterm Compared to Term Infants

    OpenAIRE

    Vajzovic, Lejla; Rothman, Adam L.; Tran-Viet, Du; Cabrera, Michelle T.; Freedman, Sharon F.; Toth, Cynthia A.

    2015-01-01

    Photoreceptor development in very preterm infants appears delayed when compared to term infants, suggesting photoreceptor immaturity in premature infants. Delayed maturation of photoreceptors could contribute to differences in visual function in some very preterm infants.

  14. Obstetric interventions and perinatal asphyxia in growth retarded term infants

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Lindmark, G

    1997-01-01

    -fold (6-8%) for growth retarded infants both in SGA infants in general and infants with asymmetric body proportions. The immediate perinatal outcome, however, was favorable with Apgar below 8 at 5 min in only 2% irrespective of the type of growth retardation, in spite of the fact that less than 25......% of the SGA pregnancies and 10% of those with asymmetric fetal growth had been eligible for close antenatal fetal monitoring. CONCLUSION: With a moderate increase in interventions at delivery, perinatal outcome was highly favorable for term infants with a weight for gestational age, weight for length...

  15. Short-term outcome for term and near-term singleton infants with intrapartum polyhydramnios.

    Science.gov (United States)

    Leibovitch, Leah; Schushan-Eisen, Irit; Kuint, Jacob; Weissmann-Brenner, Alina; Maayan-Metzger, Ayala

    2012-01-01

    To evaluate rates of early short-term neonatal complications among term and near-term newborn infants with polyhydramnios. Retrospective data were collected on 788 term infants with prenatal diagnosis of polyhydramnios and 1,576 matched controls, including information on maternal condition and on infant perinatal complications. The total rate of major congenital malformations among infants born to mothers with polyhydramnios was 2.3% compared to 0.13% for those with normal amniotic fluid index (p polyhydramnios, but no major congenital malformations, are at increased risk for minor congenital malformations (4.2%) as well as for postnatal complications, such as respiratory distress (5.7%), cardiovascular manifestations (mainly delayed closure of the ductus arteriosus; 3.1%) and hypoglycemia (7%) compared to controls. Multivariate logistic regression revealed that polyhydramnios was associated only with postnatal respiratory distress and hypoglycemia. The severity of polyhydramnios was not associated with an increased rate of neonatal complications. Although infants with polyhydramnios, but no major congenital malformations, were found to have increased rates of respiratory distress and hypoglycemia, these clinical manifestations were mild and had little effect on the babies' well-being and length of hospital stay. Copyright © 2011 S. Karger AG, Basel.

  16. A retrospective evaluation of term infants treated with surfactant therapy

    Directory of Open Access Journals (Sweden)

    Özge Sürmeli-Onay

    2015-04-01

    Full Text Available Aim: To investigate the clinical and therapeutic characteristics and outcomes of term infants who received surfactant therapy (ST for severe respiratory failure in our neonatal intensive care unit (NICU. Methods: The medical records of term infants (gestational age ≥ 370/7 weeks who received ST between 2003-2012 in NICU of Hacettepe University Ihsan Dogramaci Children’s Hospital were evaluated retrospectively. Results: During ten years period, 32 term infants received ST; the mean gestational age was 38.1 ± 0.88 wk and the mean birth weight was 2,936 ± 665 g. The underlying lung diseases were severe congenital pneumonia (CP in 13 (40.6%, acute respiratory distress syndrome (ARDS in 5 (15.6%, meconium aspiration syndrome (MAS in 5 (15.6%, congenital diaphragmatic hernia (CDH in 4 (12.5%, respiratory distress syndrome in 3 (9.4% and pulmonary hemorrhage in 2 (6.3% infants. The median time of the first dose of ST was 7.75 (0.5-216 hours. Pulmonary hypertension accompanied the primary lung disease in 9 (28.1% infants. Mortality rate was 25%. Conclusion: In term infants, CP, ARDS and MAS were the main causes of respiratory failure requiring ST. However, further prospective studies are needed for defining optimal strategies of ST in term infants with respiratory failure.

  17. Kernicterus in late preterm infants cared for as term healthy infants.

    Science.gov (United States)

    Bhutani, Vinod K; Johnson, Lois

    2006-04-01

    To compare the clinical profile and health care experiences related to management of newborn jaundice and hyperbilirubinemia in preterm infants ( or =37(0/7) weeks) and develop acute and/or chronic posticteric sequelae. Retrospective study of a convenient sample of term and near term infants voluntarily reported to the Pilot Kernicterus Registry (1992-2003). Study infants were required to meet the clinical definitions for acute bilirubin encephalopathy (moderate or advanced severity) and/or the classical signs of kernicterus. Main outcome measures were the comparison of etiology, severity and duration of extreme hyperbilirubinemia (TSB levels >20 mg/dL), response to interventions of intensive phototherapy and exchange transfusion, and health care delivery experiences in preterm as compared with term infants. No targeted attention was accorded to preterm infants during their neonatal health care experiences as related to predischarge risk assessment, feeding, discharge follow-up instructions, or breastfeeding, regardless of the known vulnerability of preterm infants to safely transition during the first week after birth. The TSB levels, age at re-hospitalization, and birth weight distribution were similar for late preterm and term infants. Large for gestational age and late preterm infants disproportionately developed kernicterus as compared with those who were appropriate for gestational age and term. Clinical management of extreme of hyperbilirubinemia, by the attending clinical providers, was not impacted or influenced by the gestational age, clinical signs, or risk assessment. This resulted in severe posticteric sequelae which was more severe and frequent in late preterm infants. Late prematurity (34(0/7) to 36(6/7) weeks) of healthy infants was not recognized as a risk factor for hazardous hyperbilirubinemia by clinical practitioners. Unsuccessful lactation experience was the most frequent experience; being large for gestational age as well as the other known

  18. Infants long-term memory for complex music

    Science.gov (United States)

    Ilari, Beatriz; Polka, Linda; Costa-Giomi, Eugenia

    2002-05-01

    In this study we examined infants' long-term memory for two complex pieces of music. A group of thirty 7.5 month-old infants was exposed daily to one short piano piece (i.e., either the Prelude or the Forlane by Maurice Ravel) for ten consecutive days. Following the 10-day exposure period there was a two-week retention period in which no exposure to the piece occurred. After the retention period, infants were tested on the Headturn Preference Procedure. At test, 8 different excerpts of the familiar piece were mixed with 8 different foil excerpts of the unfamiliar one. Infants showed a significant preference for the familiar piece of music. A control group of fifteen nonexposed infants was also tested and showed no preferences for either piece of music. These results suggest that infants in the exposure group retained the familiar music in their long-term memory. This was demonstrated by their ability to discriminate between the different excerpts of both the familiar and the unfamiliar pieces of music, and by their preference for the familiar piece. Confirming previous findings (Jusczyk and Hohne, 1993; Saffran et al., 2000), in this study we suggest that infants can retain complex pieces of music in their long-term memory for two weeks.

  19. Leukocyte recruitment in preterm and term infants.

    Science.gov (United States)

    Karenberg, Katinka; Hudalla, Hannes; Frommhold, David

    2016-12-01

    Impaired cellular innate immune defense accounts for susceptibility to sepsis and its high morbidity and mortality in preterm infants. Leukocyte recruitment is an integral part of the cellular immune response and follows a well-defined cascade of events from rolling of leukocytes along the endothelium to firm adhesion and finally transmigration which is concerted by a variety of adhesion molecules. Recent analytical advances such as fetal intravital microscopy have granted new insights into ontogenetic regulation and maturation of fetal immune cell recruitment. Understanding the fetal innate immune system is essential for targeted prevention and therapy of premature infants with severe infections or disorders of the immune system. This review gives an overview of the basic principles of leukocyte recruitment, particularly neutrophil trafficking, and its development during early life and highlights technical limitations to our current knowledge.

  20. Lutein-fortified infant formula fed to healthy term infants: evaluation of growth effects and safety

    Directory of Open Access Journals (Sweden)

    Davis Anne M

    2010-05-01

    Full Text Available Abstract Background/Objectives Breast milk contains lutein derived from the mother's diet. This carotenoid is currently not added to infant formula, which has a small and variable lutein content from innate ingredients. This study was conducted to compare the growth of infants fed lutein-fortified infant formula with that of infants fed infant formula without lutein fortification. Subjects/Methods This 16-week study was prospective, randomized, controlled, and double-blind with parallel groups of healthy term infants fed either control formula (Wyeth S-26 Gold, designated as Gold or experimental formula (Wyeth S-26 Gold fortified with lutein at 200 mcg/l, designated as Gold + Lutein. Two hundred thirty-two (232 infants ≤ 14 days postnatal age were randomized and 220 (94.8% completed the study. Weight (g, head circumference (cm, and length (cm were measured at Weeks 4, 8, 12, and 16. The primary endpoint was weight gain (g/day from baseline to Week 16. Safety was assessed through monitoring of study events (SEs throughout the study and evaluation of selected blood chemistry tests performed at Week 16. Results Infants in both treatment groups demonstrated appropriate growth. No differences between treatment groups were found in any of the measures of growth at any of the measurement time points. Both study formulas were well tolerated. The mean values of all measured blood chemistry parameters fell within the modified normal ranges for infants, and the values for both groups for any measured parameter were similar. Conclusions Infants fed lutein-fortified S-26 Gold demonstrated growth equivalent to that of infants fed unfortified lutein formula.

  1. [Low Apgar score in term newborn infants and delivery pattern].

    Science.gov (United States)

    Atanasova, V; Slavkova, N; Yonov, M; Valkova, A

    2012-01-01

    Examine the influence of delivery pattern over neonatal condition in the first minutes of life. We have studied 3624 term newborns of single pregnancies for period of 2 years in the city of Pleven. The patients were divided in 4 groups by the delivery pattern: vaginal delivery with head presentation (2497 infants), vaginal delivery with instrumental assist (45 infants), per vias naturales in breech presentation (44 infants), delivery via Caesarean section (1038 infants). According to our results the Apgar score differs itself from the pathology of a given newborn. Neonatal deaths are significantly higher in the newborns with low Apgar score than deaths in the general population. From all cases of low Apgar score without other clinical problems the highest is the percentage in the infants delivered via Caesarean section. The goal of the Apgar score is to focus attention on the infant's condition in the first few minutes of its life and the need of resuscitation. Low Apgar score is an important predictor of the newborn morbidity and death rate. The Apgar score alone is not a proof for intrapartal asphyxia and is not associated with long-term neurological damage.

  2. Obstetric interventions and perinatal asphyxia in growth retarded term infants

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Lindmark, G

    1997-01-01

    neonatal outcome at term have been studied in relation to different types of fetal growth retardation, including sub-groups with low ponderal index or low amount of subcutaneous fat. RESULTS: The need for obstetric intervention indicated by suspected fetal asphyxia before or during labor was increased 3......BACKGROUND: The monitoring of fetal growth during pregnancy is usually justified because of the increased perinatal risk of these babies. METHODS: In 1552 infants from the Scandinavian Small for Gestational Age Study the need for obstetric interventions, risk of fetal asphyxia and immediate......-fold (6-8%) for growth retarded infants both in SGA infants in general and infants with asymmetric body proportions. The immediate perinatal outcome, however, was favorable with Apgar below 8 at 5 min in only 2% irrespective of the type of growth retardation, in spite of the fact that less than 25...

  3. Synbiotics, probiotics or prebiotics in infant formula for full term infants: a systematic review

    Directory of Open Access Journals (Sweden)

    Mugambi Mary N

    2012-10-01

    Full Text Available Abstract Background Synbiotics, probiotics or prebiotics are being added to infant formula to promote growth and development in infants. Previous reviews (2007 to 2011 on term infants given probiotics or prebiotics focused on prevention of allergic disease and food hypersensitivity. This review focused on growth and clinical outcomes in term infants fed only infant formula containing synbiotics, probiotics or prebiotics. Methods Cochrane methodology was followed using randomized controlled trials (RCTs which compared term infant formula containing probiotics, prebiotics or synbiotics to conventional infant formula with / without placebo among healthy full term infants. The mean difference (MD and corresponding 95% confidence intervals (CI were reported for continuous outcomes, risk ratio (RR and corresponding 95% CI for dichotomous outcomes. Where appropriate, meta-analysis was performed; heterogeneity was explored using subgroup and sensitivity analyses. If studies were too diverse a narrative synthesis was provided. Results Three synbiotic studies (N = 475, 10 probiotics studies (N = 933 and 12 prebiotics studies (N = 1563 were included. Synbiotics failed to significantly increase growth in boys and girls. Use of synbiotics increased stool frequency, had no impact on stool consistency, colic, spitting up / regurgitation, crying, restlessness or vomiting. Probiotics in formula also failed to have any significant effect on growth, stool frequency or consistency. Probiotics did not lower the incidence of diarrhoea, colic, spitting up / regurgitation, crying, restlessness or vomiting. Prebiotics in formula did increase weight gain but had no impact on length or head circumference gain. Prebiotics increased stool frequency but had no impact on stool consistency, the incidence of colic, spitting up / regurgitation, crying, restlessness or vomiting. There was no impact of prebiotics on the volume of formula tolerated, infections and gastrointestinal

  4. Benign "setting sun" phenomenon in full-term infants.

    Science.gov (United States)

    Yoshikawa, Hideto

    2003-06-01

    I report two normally developed infants showing benign" setting sun" phenomenon. A 2(2-12)-year-old boy and a 7-year-old boy, who were born without any complications at full term, developed brief episodes of downward gazing during sucking and crying after birth However, there were no other clinical or laboratory findings, and they developed normally. The phenomenon was not visible until 6 months and 7 months, respectively. The "setting sun" phenomenon usually indicates underlying severe brain damage and can also be seen, although rarely, in healthy full-term infants until 1 to 5 months. However, the benign "setting sun" phenomenon might exist until 6 or 7 months of age in normal infants.

  5. Improvement of conventional transcutaneous bilirubinometry results in term newborn infants.

    Science.gov (United States)

    Felc, Zlata

    2005-05-01

    This prospective study was performed to determine a way to improve conventional transcutaneous bilirubinometry results in healthy term newborn infants. In 118 infants during phototherapy (group A), and in 118 infants without phototherapy (group B), bilirubin determinations were done in duplicate using the Minolta AirShields Jaundice Meter type 101 (transcutaneous bilirubin index [TcB]), and the diazometric method on the Hitachi 717 Automated Analyzer (total reacting serum bilirubin [SeB]). In 112 infants (group C), bilirubin determinations were done in triplicate, using simple direct-reading photometry on the Moltronic Bilirubinometer (direct serum bilirubin [BiB]). A close correlation between TcB and SeB values was observed in group A ( r = 0.69; p < 0.001) and in group B ( r = 0.59; p < 0.001). The 95% confidence intervals of TcB readings corresponding to SeB were +/- 80.7 micromol/L in group A and +/- 76.9 micromol/L in group B, respectively. In group C, using a correctly calibrated BiB with adult sera containing bilirubin concentration in the range 271 to 344 micromol/L, the 95% confidence intervals of parallel TcB and BiB readings corresponding to SeB were +/- 28 micromol/L. Parallel determinations of the TcB and the BiB in healthy term newborn infants give results almost identical to those of bilirubin determination by the laboratory method.

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

    Science.gov (United States)

    Saugstad, Ola Didrik

    2015-01-01

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

  7. Free amino acids in full-term and pre-term human milk and infant formula.

    Science.gov (United States)

    Chuang, Chih-Kuang; Lin, Shuan-Pei; Lee, Hung-Chang; Wang, Tuen-Jen; Shih, Yu-Shu; Huang, Fu-Yuan; Yeung, Chun-Yan

    2005-04-01

    Although the nutritional value of human milk has been thoroughly studied, few reports describing its free amino acid (FAA) content have been published. Although infant formulas are designed to approximate the nutrient composition of human milk, the content and concentration of free amino acids are unknown. We compared the FAA concentrations of milk from mothers of preterm and full-term infants with those in several infant formulas. Human milk was obtained during three different stages of lactation (colostral, transitional and mature milk). Sixty-seven samples were collected from 44 healthy mothers of term infants and 23 mothers of premature infants 29 to 36 weeks gestation (mean 33 weeks). Two brands of powdered term formula (TF-A and TF-B) and two brands designed for preterm infants (PTF-A and PTF-B )were also studied. Ion exchange chromatography was used for free amino acid analysis. The mean concentration of total FAA in human milk was significantly higher than any of the infant formulas (8139 micromol/L for pre-term human milk; 3462 micromol/L for full term human milk; TF-A, 720 micromol/L; TF-B, 697 micromol/L; PTF-A, 820 micromol/L; PTF-B, 789 micromol/L) (P milk was significantly higher than in human transitional and mature milks (P milk and preterm milk except for phosphoethanolamine, hydroxyproline, asparagine, and alpha-amino-eta-butyric acid. There were significant differences in all FAA concentrations between all human milks and infant formulas (P milk and decreases through the transitional and mature milk stages. FAA is higher in all human milks than in infant formulas.

  8. Icterus Neonatorum in Near-Term and Term Infants; An overview

    Directory of Open Access Journals (Sweden)

    Rehan Ali

    2012-05-01

    Full Text Available Neonatal jaundice is the yellowish discoloration of the skin and/or sclerae of newborn infants caused by tissue deposition of bilirubin. Physiological jaundice is mild, unconjugated (indirect-reacting bilirubinaemia, and affects nearly all newborns. Physiological jaundice levels typically peak at 5 to 6 mg/dL (86 to 103 μmol/L at 72 to 96 hours of age, and do not exceed 17 to 18 mg/dL (291–308 μmol/L. Levels may not peak until seven days of age in Asian infants, or in infants born at 35 to 37 weeks’ gestation. Higher levels of unconjugated hyperbilirubinaemia are considered pathological and occur in a variety of conditions. The clinical features and management of unconjugated hyperbilirubinaemia in healthy near-term and term infants, as well as bilirubin toxicity and the prevention of kernicterus, are reviewed here. The pathogenesis and aetiology of this disorder are discussed separately.

  9. Efficacy and Safety of Acupuncture in Preterm and Term Infants

    OpenAIRE

    Wolfgang Raith; Berndt Urlesberger; Georg M Schmölzer

    2013-01-01

    The aim of the paper was to review the literature about safety and efficiency of acupuncture therapy in term and preterm infants. We searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials using a predefined algorithm, reviewed abstracts from the Pediatric Academic Society annual meetings (2000–2012), and performed a manual search of references in narrative and systematic reviews. A total of 26 studies identified met our search criteria. Only 6 of these studies met our in...

  10. Efficacy and Safety of Acupuncture in Preterm and Term Infants

    Directory of Open Access Journals (Sweden)

    Wolfgang Raith

    2013-01-01

    Full Text Available The aim of the paper was to review the literature about safety and efficiency of acupuncture therapy in term and preterm infants. We searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials using a predefined algorithm, reviewed abstracts from the Pediatric Academic Society annual meetings (2000–2012, and performed a manual search of references in narrative and systematic reviews. A total of 26 studies identified met our search criteria. Only 6 of these studies met our inclusion criteria; however, two studies had to be excluded because the manuscripts were published in Chinese. Hence, only four studies were included in our analysis. Three of the four studies evaluated the effects of acupuncture on infantile colic, and one assessed pain reduction during minor painful procedures in preterm babies. The limited data available suggests that acupuncture could be a safe nonpharmacologic treatment option for pain reduction in term and preterm infants and could also be a non-pharmacologic treatment option to treat infantile colic. Currently acupuncture in infants should be limited to clinical trials and studies evaluating short- and long-term effects and should be performed only by practitioners with adequate training and experience in neonatal/pediatric acupuncture.

  11. Efficacy and safety of acupuncture in preterm and term infants.

    Science.gov (United States)

    Raith, Wolfgang; Urlesberger, Berndt; Schmölzer, Georg M

    2013-01-01

    The aim of the paper was to review the literature about safety and efficiency of acupuncture therapy in term and preterm infants. We searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials using a predefined algorithm, reviewed abstracts from the Pediatric Academic Society annual meetings (2000-2012), and performed a manual search of references in narrative and systematic reviews. A total of 26 studies identified met our search criteria. Only 6 of these studies met our inclusion criteria; however, two studies had to be excluded because the manuscripts were published in Chinese. Hence, only four studies were included in our analysis. Three of the four studies evaluated the effects of acupuncture on infantile colic, and one assessed pain reduction during minor painful procedures in preterm babies. The limited data available suggests that acupuncture could be a safe nonpharmacologic treatment option for pain reduction in term and preterm infants and could also be a non-pharmacologic treatment option to treat infantile colic. Currently acupuncture in infants should be limited to clinical trials and studies evaluating short- and long-term effects and should be performed only by practitioners with adequate training and experience in neonatal/pediatric acupuncture.

  12. Long-term oral sensitivity and feeding skills of low-risk pre-term infants.

    Science.gov (United States)

    Dodrill, Pamela; McMahon, Sandra; Ward, Elizabeth; Weir, Kelly; Donovan, Tim; Riddle, Bena

    2004-01-01

    This study examined the oral sensitivity and feeding skills of low-risk pre-term infants at 11-17 months corrected age. Twenty pre-term infants (PT) born between 32 and 37 weeks at birth without any medical comorbidities were assessed. All of this PT group received supplemental nasogastric (NG) tube feeds during their birth-stay in hospital. A matched control group of 10 healthy full-term infants (FT) was also assessed. Oral sensitivity and feeding skills were assessed during a typical mealtime using the Royal Children's Hospital Oral Sensitivity Checklist (OSC) and the Pre-Speech Assessment Scale (PSAS). Results demonstrated that, at 11-17 months corrected age, the PT group displayed significantly more behaviours suggestive of altered oral sensitivity and facial defensiveness, and a trend of more delayed feeding development than the FT group. Further, results demonstrated that, relative to the FT group, pre-term infants who received greater than 3 weeks of NG feeding (PT>3NG) displayed significantly more facial defensive behaviour, and displayed significant delays across more aspects of their feeding development than pre-term infants who received less than 2 weeks of NG feeding (PToral sensitivity and facial defensiveness, as well as feeding delays. These observations warrant further investigation on this topic.

  13. Electrophysiological assessment of the brain function in term SGA infants.

    Science.gov (United States)

    Ozdemir, Ozmert M A; Ergin, Hacer; Sahiner, Türker

    2009-05-13

    Small for gestational age (SGA) infants are defined as babies having a birth weight below the 10th percentile for gestational age. A great number of studies have shown that children with SGA have an increased risk of impaired neurodevelopment. Electroencephalography (EEG) is an excellent method for measuring brain maturation in newborns. In this study, the effect of SGA on the maturation of cerebrocortical electrographic activity was investigated by the EEG and also analyzed with power spectral analysis. Serial EEGs were performed in 40 term SGAs, and 20 term appropriate for gestational age (AGA) infants in 1st week, 1st and 3rd month. Power spectral analysis was performed quantitatively in five channels (Fp1-C3, C3-O1, Fp2-C4, C4-O2, and Cz-C4 channels). Amplitude levels of the SGA group were significantly lower than the AGA group in all records. Delta frequency was the major frequency component in the groups. Delta frequency activities in the midline vertex region were decreased in the AGA group with increasing postconceptual age while the activities of the SGA group were increased. Contrarily, beta frequency activities in the midline vertex region were increased in the AGA group with increasing postconceptual age while these activities of the SGA group were decreased. Theta frequency activities in the fronto-central regions were lower in the SGA group. In terms of the vertex, k-complex, and sleep spindle, there was no difference between the two groups. We conclude that cerebrocortical electrophysiological maturation has been delayed in term SGA infants during the first three months of postnatal life.

  14. Disparities in mortality rates among US infants born late preterm or early term, 2003-2005.

    Science.gov (United States)

    King, Jennifer P; Gazmararian, Julie A; Shapiro-Mendoza, Carrie K

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Effects of employment and education on preterm and full-term infant mortality in Korea.

    Science.gov (United States)

    Ko, Y-J; Shin, S-H; Park, S M; Kim, H-S; Lee, J-Y; Kim, K H; Cho, B

    2014-03-01

    The infant mortality rate is a sensitive and commonly used indicator of the socio-economic status of a population. Generally, studies investigating the relationship between infant mortality and socio-economic status have focused on full-term infants in Western populations. This study examined the effects of education level and employment status on full-term and preterm infant mortality in Korea. Data were collected from the National Birth Registration Database and merged with data from the National Death Certification Database. Prospective cohort study. In total, 1,316,184 singleton births registered in Korea's National Birth Registration Database between January 2004 and December 2006 were included in the study. Multivariate logistic regression analysis was performed. Paternal and maternal education levels were inversely related to infant mortality in preterm and full-term infants following multivariate adjusted logistic models. Parental employment status was not associated with infant mortality in full-term infants, but was associated with infant mortality in preterm infants, after adjusting for place of birth, gender, marital status, paternal age, maternal age and parity. Low paternal and maternal education levels were found to be associated with infant mortality in both full-term and preterm infants. Low parental employment status was found to be associated with infant mortality in preterm infants but not in full-term infants. In order to reduce inequalities in infant mortality, public health interventions should focus on providing equal access to education. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Spontaneous movements in the supine position of healthy term infants and preterm infants with or without periventricular leukomalacia.

    Science.gov (United States)

    Kouwaki, Masanori; Yokochi, Mitsuko; Togawa, Yasuko; Kamiya, Takeshi; Yokochi, Kenji

    2013-04-01

    The individual motor elements presumed to be essential for motor development were determined from spontaneous movements involving the entire body of normal term and preterm infants. Then, diagnostic items for motor abnormality in infants with periventricular leukomalacia (PVL) were investigated. Video recordings of 24 healthy term infants, 21 normal preterm infants (8 males, 13 females; median gestational age 30 weeks; median birth weight 1216g) and 14 preterm infants with PVL (6 males, 8 females; median gestational age 30 weeks; median birth weight 1360g) were analyzed. In healthy term infants, predominant shoulder rotation was noticed until 1 month of age. After 2 months of age, isolated movements of the shoulder, elbow, hip, knee, and ankle frequently emerged. In preterm infants with PVL at the corrected age of 2 months, startle response and predominant shoulder rotation were more frequently seen and isolated neck, shoulder, elbow, hip, knee, and ankle movements were less frequently seen than in the normal preterm infants (Fisher's exact test, p<0.025). At 2 months of age, isolated movements evolve, and their failure to occur is suggested to be a useful sign for the diagnosis of cerebral motor disorders. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  18. Prognostic correlative values of the late-infancy MRI pattern in term infants with perinatal asphyxia.

    Science.gov (United States)

    Tekgul, Hasan; Serdaroglu, Gul; Yalman, Osman; Tutuncuoglu, Sarenur

    2004-07-01

    The aim of this study was to define the risk ratios of the late-infancy magnetic resonance imaging pattern for long-term outcome in term infants with perinatal asphyxia. We evaluated 65 term infants with perinatal asphyxia and performed magnetic resonance imaging examinations between 4-12 months of age. Magnetic resonance imaging scans were classified as follows: (1) periventricular leukomalacia in 21 (32%) infants, (2) marked cortical atrophy in 17 (26%) infants, (3) multicystic encephalomalacia in 10 (15%) infants, (4) deep gray matter involvement in 8 (12%) infants, (5) focal cortical involvement in 6 (9%) infants, (6) myelination delay in 3 (5%) infants. The overall outcome was favorable in 19 (29%) of 65 infants. Infants with diffuse cortical involvement (multicystic encephalomalacia and marked cortical atrophy) are four times (odds ratio: 4.4 and 4.1 respectively) more likely to attain the unfavorable outcome than the infants with other patterns of magnetic resonance imaging. Infants with focal cortical involvement had relatively favorable outcome in 60% of the cases. In conclusion, it appears that the overall outcome of infants with perinatal asphyxia correlated well with the magnetic resonance imaging patterns obtained between 4 and 12 months of age.

  19. Characteristics of patients readmitted to intensive care unit: a nested case-control study.

    Science.gov (United States)

    Tam, O Y; Lam, S M; Shum, H P; Lau, C W; Chan, Kenny K C; Yan, W W

    2014-06-01

    To evaluate the pattern of unplanned readmissions to the intensive care unit and identify patients at risk of readmission. Nested case-referent study. Tertiary hospital, Hong Kong. A total of 146 patients with unplanned intensive care unit readmission were compared with 292 control patients who were discharged from the intensive care unit alive and never readmitted. Cases and controls were matched for age, gender, and disease severity. Patient demographics, initial and pre-discharge clinical parameters, reasons for readmission, and outcomes were studied. During the 30-month study period, the readmission rate was 5.1%. Readmitted patients had significantly higher mortality and longer mean hospital lengths of stay (both Pintensive care unit readmission. Incomplete resolution of respiratory conditions remained an important reason for potentially preventable intensive care unit readmission. Attention to fluid balance and sputum quantity before intensive care unit discharge might prevent unplanned intensive care unit readmission.

  20. Visual Short-Term Memory for Complex Objects in 6- and 8-Month-Old Infants

    Science.gov (United States)

    Kwon, Mee-Kyoung; Luck, Steven J.; Oakes, Lisa M.

    2014-01-01

    Infants' visual short-term memory (VSTM) for simple objects undergoes dramatic development: Six-month-old infants can store in VSTM information about only a simple object presented in isolation, whereas 8-month-old infants can store information about simple objects presented in multiple-item arrays. This study extended this work to examine…

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

    NARCIS (Netherlands)

    Beijers, R.; Cillessen, L.J.G.; Zijlmans, M.A.C.

    2016-01-01

    In premature infants, daily skin-to-skin contact (SSC) has various beneficial effects on the health of the infant and the mother. These beneficial effects might extend to full-term infants. This experimental within-subject study examines the immediate effects of SSC on full-terms’ cortisol

  2. Improvement in long-term breastfeeding for very preterm infants.

    Science.gov (United States)

    Sharp, Mary; Campbell, Catherine; Chiffings, Debbie; Simmer, Karen; French, Noel

    2015-04-01

    The extensive health benefits of breastfeeding preterm infants for both mother and infant have been widely reported. However, establishing and maintaining breastfeeding for very preterm (VP) infants remain challenging. The aim of this study was to examine changes in breastfeeding of VP infants over time. Breastfeeding questionnaires were administered to two cohorts of parents of VP infants (breastfeeding in C2 compared with those in C1 (65.6%) (pbenefits of breastfeeding were endorsed by more women in C2 (45.8%) compared with C1 (11.4%) (pbreastfeeding of the VP infant over time. This improvement was associated with attitudinal shifts in mothers about the benefits of breastfeeding.

  3. Home care practices for preterm and term infants after hospital discharge in Massachusetts, 2007 to 2010.

    Science.gov (United States)

    Hwang, S S; Lu, E; Cui, X; Diop, H; Barfield, W D; Manning, S E

    2015-10-01

    The objective of this study was to compare the prevalence of home care practices in very to moderately preterm (VPT), late preterm (LPT) and term infants born in Massachusetts. Using 2007 to 2010 Massachusetts Pregnancy Risk Assessment Monitoring System data, births were categorized by gestational age (VPT: 23 to 33 weeks; LPT: 34 to 36 weeks; term: 37 to 42 weeks). Home care practices included breastfeeding initiation and continuation, and infant sleep practices (supine sleep position, sleeping in a crib, cosleeping in an adult bed). We developed multivariate models to examine the association of infant sleep practices and breastfeeding with preterm status, controlling for maternal sociodemographic characteristics. Supine sleep position was more prevalent among term infants compared with VPT and LPT infants (77.1%, 71.5%, 64.4%; P=0.02). In the adjusted model, LPT infants were less likely to be placed in supine sleep position compared with term infants (adjusted prevalence ratio=0.86; 95% confidence interval: 0.75 to 0.97). Breastfeeding initiation and continuation did not differ among preterm and term groups. Nearly 16% of VPT and 18% of LPT and term infants were not sleeping in cribs and 14% of LPT and term infants were cosleeping on an adult bed. Compared with term infants, LPT infants were less likely to be placed in supine sleep position after hospital discharge. A significant percent of preterm and term infants were cosleeping on an adult bed. Hospitals may consider improving their safe sleep education, particularly to mothers of LPT infants.

  4. Craniocerebral birth injuries in term newborn infants: a retrospective series.

    Science.gov (United States)

    Nachtergaele, Pieter; Van Calenbergh, Frank; Lagae, Lieven

    2017-11-01

    In an attempt to further define the spectrum of cranial birth injuries, we analyzed 21 consecutive cranial birth injuries in term neonates presenting to the neurosurgical department of our institution over the period 1994-2015. We performed a retrospective chart review from the medical records of the University Hospitals of the KU Leuven, from 1994 to 2015. We included 21 infants of 36-week gestational age or older with a diagnosis of cranial birth injury. The types and locations of injuries, the presenting signs, symptoms and their timing, and the required treatment(s) were recorded. Various maternal and neonatal factors and the mode of delivery were recorded. We recorded the different modes of delivery rates at our institution in the year 2013 and the rates in the Flemish community between 1995 and 2013, in order to compare the mode of delivery rates in the study group with current practice at our institution and with general practice over the years in the Flemish community. The most common clinical presentations were swelling (43% of cases) and seizures (19% of cases). Average Apgar scores were 6.57 at 1 min and 8.43 at 5 min; 48% of children had abnormally low Apgar scores at 1 min and 9.5% had abnormally low scores at 5 min. The most common intracranial lesion was skull fractures (33%). Operative treatment was required in 11 infants (52%). One infant died. Assisted mechanical delivery by either forceps and/or vacuum extraction occurred in 43% of infants. In comparison, in the year 2013, only 13.97% of deliveries at our institution were mechanically assisted. Over the period 1995-2013, the highest mechanically assisted delivery rates in the Flemish community were 14.1% in 1996. Although our series is too small to make firm conclusions, it is remarkable that the rates of assisted mechanical deliveries in our series far exceeded the assisted mechanical delivery rates at our institution in the year 2013 and even the highest vacuum and forceps delivery rates in

  5. Supine sleep positioning in preterm and term infants after hospital discharge from 2000 to 2011.

    Science.gov (United States)

    Hwang, S S; Smith, R A; Barfield, W D; Smith, V C; McCormick, M C; Williams, M A

    2016-09-01

    Supine sleep positioning (SSP) has been shown to reduce the risk of sudden infant death syndrome (SIDS) and preterm infants are at higher risk for SIDS. Population-based estimates of SSP are lacking for the preterm population. The objectives of this study are: (1) compare the prevalence of SSP after hospital discharge for preterm and term infants in the United States; and (2) assess racial/ethnic disparities in SSP for preterm and term infants. We analyzed the 2000 to 2011 data from the Pregnancy Risk Assessment Monitoring System of Centers for Disease Control and Prevention from 35 states. We measured prevalence of SSP by preterm and term gestational age (GA) categories. We calculated adjusted prevalence ratios (APR) to evaluate the likelihood of SSP for each GA category compared with term infants and the likelihood of SSP for non-Hispanic black (NHB) and Hispanic infants compared with non-Hispanic white (NHW) infants. Prevalence of SSP varied by GA: ⩽27, 59.7%; 28 0/7 to 33 6/7, 63.7%; 34 0/7 to 36 6/7 (late preterm), 63.6%; and 37 0/7 to 42 6/7 (term) weeks, 66.8% (Ppreterm infants were slightly less likely to be placed in SSP compared with term infants (APR: 0.96, confidence interval: 0.95 to 0.98). There were racial/ethnic disparities in SSP for all GA categories when NHB and Hispanic infants were compared with NHW infants. All infants had suboptimal adherence to SSP indicating a continued need to better engage families about SSP. Parents of late preterm infants and families of NHB and Hispanic infants will also require greater attention given their decreased likelihood of SSP.

  6. Long-term exposure to indoor air pollution and wheezing symptoms in infants

    DEFF Research Database (Denmark)

    Raaschou-Nielsen, O.; Hermansen, M.N.; Loland, L.

    2010-01-01

    of an association between long-term exposure to indoor air pollution and wheezing symptoms in infants, suggesting that indoor air pollution is not causally related to the underlying disease. Practical Implications Nitrogen oxides, formaldehyde and fine particles were measured in the air in infants' bedrooms......Long-term exposure to air pollution is suspected to cause recurrent wheeze in infants. The few previous studies have had ambiguous results. The objective of this study was to estimate the impact of measured long-term exposure to indoor air pollution on wheezing symptoms in infants. We monitored...... wheezing symptoms in diaries for a birth cohort of 411 infants. We measured long-term exposure to nitrogen oxides (NO(x)), NO(2), formaldehyde, PM(2.5) and black smoke in the infants' bedrooms and analyzed risk associations during the first 18 months of life by logistic regression with the dichotomous end...

  7. Respiratory syncytial virus hospitalization outcomes and costs of full-term and preterm infants.

    Science.gov (United States)

    McLaurin, K K; Farr, A M; Wade, S W; Diakun, D R; Stewart, D L

    2016-11-01

    Infection with respiratory syncytial virus (RSV), which causes lower respiratory tract infections, is the leading cause of hospitalization among children preterm and full-term infants without chronic lung disease or other high-risk conditions. This analysis used Truven Health Market Scan Multi-State Medicaid and Commercial Claims and Encounters databases, which contain a combined 4 million births from 2003 to 2013. Infants with comorbid conditions associated with increased risk for RSV infection were excluded. Infants were classified as preterm (position. Costs of RSV hospitalizations were captured and reported in 2014 USD. Inpatient claims for RSV hospitalizations were evaluated for the presence of codes indicating admission to the intensive care unit (ICU), use of mechanical ventilation (MV) and length of stay. These three measures were used to describe hospital severity. Chronologic age at the time of RSV hospitalization was also captured. Data were summarized and no statistical comparisons were conducted. There were 1 683 188 infants insured through Medicaid and 1 663 832 infants insured through commercial plans born from 1 July 2003 to 30 June 2013. Of those, 10.8 and 8.8% in each database, respectively, were born prematurely. There were 29 967 Medicaid-insured infants and 16 310 commercially insured infants with an RSV hospitalization during their first year of life. Mean first-year RSV hospitalization costs were higher for preterm infants, ranging from $8324 and $10 570 for full-term infants to $15 839 and $19 931 for preterm infants 33-34 wGA, and to $39 354 and $40 813 for preterm infants preterm infants, with longer lengths of stay, a higher proportion of infants admitted to the intensive care unit (ICU) and increased use of MV compared with full-term infants. Mean costs of RSV hospitalizations with a PICU admission ranged from approximately $35 000 to $89 000. In both Medicaid and commercial groups, costs were greater for

  8. Tolerance of a standard intact protein formula versus a partially hydrolyzed formula in healthy, term infants

    Directory of Open Access Journals (Sweden)

    Marunycz John D

    2009-06-01

    Full Text Available Abstract Background Parents who perceive common infant behaviors as formula intolerance-related often switch formulas without consulting a health professional. Up to one-half of formula-fed infants experience a formula change during the first six months of life. Methods The objective of this study was to assess discontinuance due to study physician-assessed formula intolerance in healthy, term infants. Infants (335 were randomized to receive either a standard intact cow milk protein formula (INTACT or a partially hydrolyzed cow milk protein formula (PH in a 60 day non-inferiority trial. Discontinuance due to study physician-assessed formula intolerance was the primary outcome. Secondary outcomes included number of infants who discontinued for any reason, including parent-assessed. Results Formula intolerance between groups (INTACT, 12.3% vs. PH, 13.7% was similar for infants who completed the study or discontinued due to study physician-assessed formula intolerance. Overall study discontinuance based on parent- vs. study physician-assessed intolerance for all infants (14.4 vs.11.1% was significantly different (P = 0.001. Conclusion This study demonstrated no difference in infant tolerance of intact vs. partially hydrolyzed cow milk protein formulas for healthy, term infants over a 60-day feeding trial, suggesting nonstandard partially hydrolyzed formulas are not necessary as a first-choice for healthy infants. Parents frequently perceived infant behavior as formula intolerance, paralleling previous reports of unnecessary formula changes. Trial Registration clinicaltrials.gov: NCT00666120

  9. Interrupter technique in infancy: Higher airway resistance and lower short-term variability in preterm versus term infants.

    Science.gov (United States)

    Usemann, Jakob; Demann, Désirée; Anagnostopoulou, Pinelopi; Korten, Insa; Gorlanova, Olga; Schulzke, Sven; Frey, Urs; Latzin, Philipp

    2017-10-01

    In preschool children, measurement of airway resistance using interrupter technique (Rint) is feasible to assess the degree of bronchial obstruction. Although some studies measured Rint in infancy, values of Rint and its variability in preterm infants are unknown. In this study, Rint and its variability was measured at infancy and compared between healthy term and preterm infants. High quality Rint measurements in term (n = 50) and preterm (n = 48) infants were obtained at postmenstrual age of 42-50 weeks in two study centers in Switzerland. Intra-measurement variability of Rint in one measurement and inter-measurement variability between two subsequent measurements was assessed by coefficient of variation (CV). Mean Rint in term infants was 4.2 ± (SD; 1.9) kPa · s · L -1 and in preterm infants was 5.6 ± (2.8) kPa · s · L -1 . Mean CV in term infants was 29.6 ± (14.9)% and in preterm infants was 20.2 ± (8.4)%. Rint was significantly lower (95%CI -2.31 to -0.38; P = 0.007) and CV significantly higher (95%CI 4.53-14.3; P preterm infants. There were no differences in mean Rint and mean CV between the first and the second measurement obtained in a subgroup of term (n = 24, 48%) and preterm (n = 22, 45%) infants. Our results suggest that differences in airway mechanics between term and preterm infants can be assessed with the interrupter technique during early infancy. Before clinical application of Rint measurements in this age group, reasons underlying the variability of measurements should be further investigated. © 2017 Wiley Periodicals, Inc.

  10. Short-term diagnostic stability among re-admitted psychiatric in ...

    African Journals Online (AJOL)

    settings such as Sub-Saharan Africa. Many prospective studies have concluded that schizophrenia is the most stable diagnosis (up to 90%) with schizophreniform disorder, schizo-affective disorder and psychotic disorder not otherwise specified amongst the least stable initial diagnoses.1-10. Stability has been reported to ...

  11. Short-term diagnostic stability among re-admitted psychiatric in ...

    African Journals Online (AJOL)

    measuring the reliability of various components of a patient assessment in ... psychologist, nurses, social workers and occupational therapists. ... Data was then collected from the patients' records, including socio- demographic data, previous admissions, diagnoses made and the treatment that was given. Data storage and ...

  12. Long-term developmental outcome of infants with iron deficiency.

    Science.gov (United States)

    Lozoff, B; Jimenez, E; Wolf, A W

    1991-09-05

    Iron-deficiency anemia has been associated with lowered scores on tests of mental and motor development in infancy. However, the long-term developmental outcome of infants with iron deficiency is unknown, because developmental tests in infancy do not predict later intellectual functioning. This study is a follow-up evaluation of a group of Costa Rican children whose iron status and treatment were documented in infancy. Eighty-five percent (163) of the 191 children in the original group underwent comprehensive clinical, nutritional, and psychoeducational assessments at five years of age. The developmental test battery consisted of the Wechsler Preschool and Primary Scale of Intelligence, the Spanish version of the Woodcock-Johnson Psycho-Educational Battery, the Beery Developmental Test of Visual-Motor Integration, the Goodenough-Harris Draw-a-Man Test, and the Bruininks-Oseretsky Test of Motor Proficiency. All the children had excellent hematologic status and growth at five years of age. However, children who had moderately severe iron-deficiency anemia as infants, with hemoglobin levels less than or equal to 100 g per liter, had lower scores on tests of mental and motor functioning at school entry than the rest of the children. Although these children also came from less socioeconomically advantaged homes, their test scores remained significantly lower than those of the other children after we controlled for a comprehensive set of background factors. For example, the mean (+/- SD) adjusted Woodcock-Johnson preschool cluster score for the children who had moderate anemia in infancy (n = 30) was 448.6 +/- 9.7, as compared with 452.9 +/- 9.2 for the rest of the children (n = 133) (P less than 0.01); the adjusted visual-motor integration score was 5.9 +/- 2.1, as compared with 6.7 +/- 2.3 (P less than 0.05). Children who have iron-deficiency anemia in infancy are at risk for long-lasting developmental disadvantage as compared with their peers with better iron status.

  13. Nutrition for healthy term infants, birth to six months: An overview

    OpenAIRE

    Critch, Jeffrey N

    2013-01-01

    Nutrition for healthy term infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada that was most recently updated in September 2012 with recommendations from birth to six months of age. This practice point outlines the development process, principles of infant feeding, and recommendations for clinicians. Health professionals involved in counselling families about infant nutrition are advised to read the st...

  14. Goniometer Measurements of Oral Labial Angle and Evaluation of Oral Motor Reflexes in Preterm Infants: Comparison to Findings in Term Infants.

    Science.gov (United States)

    Ince, Deniz Anuk; Tugcu, Ali Ulas; Ecevit, Ayşe; Ciyiltepe, Muzeyyen; Kurt, Abdullah; Abbasoğlu, Aslıhan; Tekindal, Mustafa Agah; Tarcan, Aylin

    2015-10-01

    To date, no study has evaluated changes in oral labial angle as preterm infants mature. The main purpose of this study was to document goniometer measurements of the labial angle of the mouth in preterm infants, to assess changes with development, to compare to findings in healthy term infants, and also evaluate oral motor reflexes in these groups. Seventy-eight preterm infants and 45 healthy term infants were recruited for the prospective study. Labial angle was assessed via goniometer, and oral motor reflexes and the volume of milk ingested were evaluated. There was significant difference between term and preterm infants' labial angles (P Goniometer measurements of the oral labial angle may reveal oral motor performance in preterm infants and may be relevant for feeding skills assessment in this group of infants. © The Author(s) 2015.

  15. Lung volume, breathing pattern and ventilation inhomogeneity in preterm and term infants.

    Directory of Open Access Journals (Sweden)

    Philipp Latzin

    Full Text Available BACKGROUND: Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques. METHODOLOGY/PRINCIPAL FINDINGS: We studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg than preterm infants without BPD (23.4 mL/kg and term-born infants (22.6 mL/kg, though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t(PTEF/t(E than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity. CONCLUSIONS: Our results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.

  16. Impact of Parent Practices of Infant Positioning on Head Orientation Profile and Development of Positional Plagiocephaly in Healthy Term Infants.

    Science.gov (United States)

    Leung, Amy; Mandrusiak, Allison; Watter, Pauline; Gavranich, John; Johnston, Leanne M

    2017-04-04

    The influence of infant positioning on the development of head orientation and plagiocephaly is not clear. This study explored the relationship between infant body and head positioning, with the development of asymmetrical head orientation and/or positional plagiocephaly. Methods: Clinician measurement of head orientation profile and parent-reported infant positioning data were collected for 94 healthy term infants at 3, 6, and 9 weeks of age. Plagiocephaly was measured at 9 weeks with the modified Cranial Vault Asymmetry Index. More severe plagiocephaly was associated with longer supine-sleep-maximum (p = 0.001) and longer supine-lying-total (p = 0.014) at 6 weeks. Prone positioning was not associated with plagiocephaly. Parent-reported head asymmetry during awake and sleep time at 3 weeks identified infants with clinician-measured head asymmetry at 9 weeks. Better symmetry in head turning was associated with more side-lying-total time by 9 weeks (p = 0.013). Our results showed that infant positioning is associated with early head orientation and plagiocephaly development. Early parent-reported asymmetry during awake and sleep time is an important indicator for the need for professional assessment and advice. A Plagiocephaly Prevention Strategy and Plagiocephaly Screening Pathway are provided for clinicians and parents.

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

    Science.gov (United States)

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

    2012-01-01

    Aim: To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. Method: A cohort study based on the Avon Longitudinal Study of Parents and Children. Cognitive measures were assessed between the ages of 8 and 11 years. Exposure groups were defined as moderate/late preterm (32-36 weeks' gestation) or term…

  18. Early vs delayed clamping of the umbilical cord in full term, preterm and very preterm infants

    DEFF Research Database (Denmark)

    Moller, N.K.; Weber, T.

    2008-01-01

    Randomized studies from 2006 and two meta-analyses published in 2007 agree that clamping of the umbilical cord can be delayed. For the preterm and very preterm infant benefits include less need for blood transfusion and less morbidity, especially for the very preterm male infant. For the term...

  19. DEVELOPMENT OF MUSCLE POWER IN PRETERM INFANTS - INDIVIDUAL TRAJECTORIES AFTER TERM AGE

    NARCIS (Netherlands)

    DEGROOT, L; HOPKINS, B; TOUWEN, BCL; VANDERHOEK, AM

    In a longitudinal study individual trajectories were traced for the developing relationship between active and passive muscle power in preterm (n = 37) and fullterm (n = 20) infants from term to 24 weeks (corrected) age. Such trajectories should enable the identification of those infants at highest

  20. Effect of massage stimulation on weight gain in full term infants

    Directory of Open Access Journals (Sweden)

    Nyoman Nursari Dewi

    2011-08-01

    Full Text Available Background Massage is a tactile/kinesthetic stimulation with biochemical and physiological effects on the body. Newborn infant massage stimulation given by mothers may promote maternal-infant bonding and attachment, enhance infant weight gain and stimulate the production of breast milk. There have been few studies on the effect of massage stimulation on weight gain in full term infants, and this topic remains controversial. Objective To examine the effect of massage stimulation on weight gain in full term infants. Methods This quasi-experimental study was held in Sanglah Hospital and Bunda Setia Maternity Clinic. Massage stimulation was performed by mothers once daily for a four week period. Massage stimulation was given to 30 full term infants and their weight gain was compared to 31 control infants who did not receive massages. Results There were no differences in subject characteristics between the massage and control groups. Median weight gain in the massage group was 1230 grams, while that in the control group was 830 grams (P=0.028. Conclusion Weight gain in full term infants in the massage group was significantly greater than that in the control group after 4 weeks.

  1. Reliability of Neurobehavioral Assessments from Birth to Term Equivalent Age in Preterm and Term Born Infants.

    Science.gov (United States)

    Eeles, Abbey L; Olsen, Joy E; Walsh, Jennifer M; McInnes, Emma K; Molesworth, Charlotte M L; Cheong, Jeanie L Y; Doyle, Lex W; Spittle, Alicia J

    2017-02-01

    Neurobehavioral assessments provide insight into the functional integrity of the developing brain and help guide early intervention for preterm (term equivalent age. Few neurobehavioral assessments used in the preterm period have established interrater reliability. To evaluate the interrater reliability of the Hammersmith Neonatal Neurological Examination (HNNE) and the NICU Network Neurobehavioral Scale (NNNS), when used both preterm and at term (>36 weeks). Thirty-five preterm infants and 11 term controls were recruited. Five assessors double-scored the HNNE and NNNS administered either preterm or at term. A one-way random effects, absolute, single-measures interclass correlation coefficient (ICC) was calculated to determine interrater reliability. Interrater reliability for the HNNE was excellent (ICC > 0.74) for optimality scores, and good (ICC 0.60-0.74) to excellent for subtotal scores, except for 'Tone Patterns' (ICC 0.54). On the NNNS, interrater reliability was predominantly excellent for all items. Interrater agreement was generally excellent at both time points. Overall, the HNNE and NNNS neurobehavioral assessments demonstrated mostly excellent interrater reliability when used prior to term and at term.

  2. Time course study of blood pressure in term and preterm infants immediately after birth.

    Directory of Open Access Journals (Sweden)

    Gerhard Pichler

    Full Text Available To describe temporal changes in systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively in term and preterm infants immediately after birth.Prospective observational two-center study. In term infants SBP, DBP, and MBP were assessed non-invasively every minute for the first 15 minutes, and in preterm infants every minute for the first 15 minutes, as well as at 20, 25, 30, 45, and 60 minutes after birth. Regression analyses were performed by gender and respiratory support in all neonates; and by mode of delivery, cord clamping time, and development of ultrasound-detected brain injury in preterm neonates.Term infants (n = 54 had a mean (SD birth weight of 3298 (442 g and gestational age of 38 (1 weeks, and preterm infants (n = 94 weighed 1340 (672 g and were 30 (3 weeks gestation. Term infants' SBP, DBP and MBP within the first 15 minutes after birth were independent of gender or respiratory support. Linear mixed regression analysis showed that preterm infants, who were female, born vaginally, had delayed cord clamping and did not require positive pressure ventilation nor develop periventricular injury or ventriculomegaly, had significantly higher SBP, DBP, and MBP at some measurement points within the first hour after birth.We present novel reference ranges of BP immediately after birth in a cohort of term and preterm neonates. They may aid in optimization of cardiovascular support during early transition at all gestations.

  3. Demography and burden of care associated with patients readmitted for urinary tract infection.

    Science.gov (United States)

    MacVane, Shawn H; Tuttle, Lindsay O; Nicolau, David P

    2015-10-01

    Urinary tract infection (UTI) is one of the most prevalent admission diagnoses in hospital-based clinical practice. Despite its frequency, few data are available regarding its demographics and economic implications. To describe the demography, epidemiology, and burden of care of patients admitted to hospital with UTI and compare these characteristics depending on admission status. A retrospective cohort study using an administrative database of patients admitted to Hartford Hospital (September 2011-August 2012) with UTI. Patient demographics, hospital characteristics, and total costs of care were examined. A total of 2345 unique patients were included. The mean age of the patients was 78 years and 71% were female. Median length of stay and total cost were 5 days and $8326 (interquartile range $5388-$14,179), respectively. A total of 359 patients (16.4%) were readmitted within 30 days, of which 111 patients (5.1%) had UTI on readmission. Only 16.3% of readmitted patients were infected with the same causative pathogen. A significant increase in the incidence of Enterococcus faecalis (1.2% vs. 9.3%; p = 0.046) occurred upon readmission, whereas occurrence of Enterobacteriaceae infection decreased in the readmission group (50.0% vs. 25.6%; p = 0.006), including a lower proportion of Escherichia coli (32.5% vs. 11.6%; p < 0.001). A higher proportion of readmission pathogens were nonsusceptible, including significant changes to cefazolin (24.4% vs. 63.6%; p = 0.004) and cefepime (8.7% vs. 27.6; p = 0.05). UTI is highly prevalent and is associated with significant utilization of health-care resources among hospitalized patients. These findings, coupled with considerable rates of 30-day readmission, stress the importance of proper diagnosis and treatment. Copyright © 2014. Published by Elsevier B.V.

  4. Growth and neurodevelopment outcome in symmetric versus asymmetric small for gestational age term infants.

    Science.gov (United States)

    Maciejewski, E; Hamon, I; Fresson, J; Hascoet, J-M

    2016-08-01

    Few studies compared growth and neurodevelopment outcome between asymmetric (aSYM) and symmetric (SYM) small for gestational age (SGA) term infants. We aimed at evaluating their respective outcome at 9 months postnatal age. A cohort study including infants born in 2010 to 2011 with a birth weight Lezine test items. Of 6586 infants, 194 were SGA: 38.7% SYM and 61.3% aSYM. The aSYM group showed better catch-up growth (85% versus 70%, P=0.03) with larger HC (44.9±1.6 versus 43.7±1.2 cm, P<0.0001). No difference in neurodevelopmental screening was observed between SGA groups, but infants without any catch-up growth were at higher risk of delayed outcome. Term SGA infants must be closely followed, regardless of their characteristics, to improve their outcome.

  5. Development of Sucking Patterns in Pre-Term Infants with Bronchopulmonary Dysplasia

    NARCIS (Netherlands)

    da Costa, Saakje P.; van der Schans, Cees P.; Zweens, Mar J.; Boelema, Sarai R.; van der Meij, Eva; Boerman, Mieke A.; Bos, Arend F.

    2010-01-01

    Background: Pre-term infants with bronchopulmonary dysplasia (BPD) are at risk of acquiring brain abnormalities. Combined with ongoing breathing difficulties, this may influence the development of their sucking patterns. Objective: To determine the longitudinal development of sucking patterns from

  6. Prognostic Factors of Developmental Outcome in Neonatal Seizures in Term Infants

    Directory of Open Access Journals (Sweden)

    Yin-Hsuan Lai

    2013-06-01

    Conclusion: In term infants with neonatal seizures, several risk factors related to adverse outcome were recognized. Physicians should pay more attention to these factors when handling patients with neonatal seizures.

  7. Causes and short-term outcomes of preterm infants

    Directory of Open Access Journals (Sweden)

    Xu Aiqun

    2017-01-01

    Full Text Available Introduction/Objective. Preterm birth (PB is the most important reason of neonatal mortality, and the second most common direct cause of death for children under the age of five years. The aim of this study was to analyze the clinical features and outcomes of preterm infants. Methods. The clinical data of 307 preterm infants delivered in the Qingdao University hospital from January 1, 2012 to December 31, 2012 were retrospectively analyzed. Results. The incidence of PB was 6.52%. There were 143 cases of preterm prelabour rupture of membranes (PPROM (46.58%, 66 cases of spontaneous PB (21.5%, and 98 cases of therapeutic PB (31.92%. Deliveries with gestational weeks (GW < 32 were mainly vaginal (60.72%, but deliveries with GW ≥ 32 exhibited higher C-section rate (60.99% than the vaginal delivery rate (p < 0.05. The birth weight was 2,340.46 ± 606.26 g, and the Z-score at birth was -0.15 ± 1.08. The Z-score in the group with GW within 28 to 31+6 weeks was less than that in the group with GW within 32 to 33+6 and with GW ≥ 34 (р < 0.05. The average hospital stay of preterm infants was 15.17 ± 12.35 days, and the most common complication in these preterm infants was respiratory distress syndrome with 13.92%. Conclusion. PB could cause a variety of serious complications in infants. The main causes of PB, such ас PPROM, should be actively prevented and treated; meanwhile, preterm infants should also be actively treated so as to improve their outcomes.

  8. Preterm and Term Infants' Perception of Temporally Coordinated Syllable-Object Pairings: Implications for Lexical Development

    Science.gov (United States)

    Gogate, Lakshmi; Maganti, Madhavilatha; Perenyi, Agnes

    2014-01-01

    Purpose: This experimental study examined term infants (n = 34) and low-risk near-term preterm infants (gestational age 32-36 weeks) at 2 months chronological age (n = 34) and corrected age (n = 16). The study investigated whether the preterm infants presented with a delay in their sensitivity to synchronous syllable-object pairings when compared…

  9. Long-Term Effects of a Home-Visiting Intervention for Depressed Mothers and Their Infants

    Science.gov (United States)

    Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; Van Doesum, Karin T. M.; Hoefnagels, Cees

    2010-01-01

    Background: Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term effects of an intervention for mothers with postpartum…

  10. Long-term effects of a home-visiting intervention for depressed mothers and their infants

    NARCIS (Netherlands)

    Kersten-Alvarez, L.E.; Hosman, C.M.H.; Riksen-Walraven, J.M.A.; Doesum, K.T.M. van; Hoefnagels, C.C.J.

    2010-01-01

    Background - Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term

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

    Science.gov (United States)

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

    2016-10-23

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

  12. Comparison of the phospholipid classes in human milk in Japanese mothers of term and preterm infants.

    Science.gov (United States)

    Shoji, Hiromichi; Shimizu, Toshiaki; Kaneko, Noritsugu; Shinohara, Koichi; Shiga, Seigo; Saito, Masami; Oshida, Kyoichi; Shimizu, Takashi; Takase, Mitsunori; Yamashiro, Yuichiro

    2006-08-01

    Phospholipids (PLs) play an essential role in the growth and brain development of infants. To investigate PL composition in human milk (HM), including lysophosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, phosphatidylserine, phosphatidylcholine (PC) and sphingomyelin (SM), from healthy Japanese mothers. Analyses were performed on colostrum, transitional milk and mature milk from mothers of preterm and term infants. HM samples were collected from mothers of 15 term infants (term group) and of 19 preterm infants (preterm group). PL composition was determined by two-dimensional thin-layer chromatography in conjunction with phosphorus analysis. In both groups, the PL content (% of total lipid) of mature milk was significantly lower than in colostrum. SM and PC were the main PLs in HM, but in the preterm group, the percentage of SM in mature milk was significantly higher and PC in mature milk was significantly lower than in the term group. The transition from colostrum to mature milk leads to an increase in SM and a decrease in PC in the HM of preterm infants, along with a decrease in PL content. This is the first report to demonstrate the differences in PL composition in HM between mothers of preterm and term infants.

  13. Lung function at term in extremely preterm-born infants: a regional prospective cohort study.

    Science.gov (United States)

    Bentsen, Mariann Haavik; Markestad, Trond; Øymar, Knut; Halvorsen, Thomas

    2017-10-25

    To compare lung function of extremely preterm (EP)-born infants with and without bronchopulmonary dysplasia (BPD) with that of healthy term-born infants, and to determine which perinatal characteristics were associated with lung function at term and how predictive these measurements were for later respiratory health in EP-born infants. Perinatal variables were recorded prospectively, and tidal breathing parameters were measured at term-equivalent age using electromagnetic inductance plethysmography. Respiratory morbidity was defined by hospital readmissions and/or treatment with asthma medications during the first year of life. Fifty-two EP-born infants (mean gestational age 261, range 226-276 weeks) and 45 term-born infants were included. There was evidence of significant airway obstruction, higher tidal volumes and increased minute ventilation in the EP-born infants with and without BPD, although generally more pronounced for those with BPD. Male gender, antenatal steroids and number of days on continuous positive airway pressure were associated with lung function outcomes at term. A prediction model incorporating two unrelated tidal breathing parameters, BPD, birth weight z-score and gender, predicted respiratory morbidity in the first year of life with good accuracy (area under the curve 0.818, sensitivity and specificity 81.8% and 75.0%, respectively). Lung function measured at term-equivalent age was strikingly abnormal in EP-born infants, irrespective of BPD. Tidal breathing parameters may be of value in predicting future pulmonary health in infants born premature. NCT01150396; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Nutrition for healthy term infants, six to 24 months: An overview.

    Science.gov (United States)

    Critch, Jeffrey N

    2014-12-01

    Nutrition for Healthy Term Infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada. It was republished in September 2012, with recommendations on infant feeding from birth to six months of age. The statement was most recently updated in April 2014, with recommendations for feeding older infants and young children from six to 24 months of age. The present practice point outlines the statement development process and principles of feeding, with specific recommendations for clinicians. Health professionals who counsel families on nutrition in infants and young children are advised to read the statement in its entirety because discussion in the longer document expands on and clarifies advice summarized in the principles and recommendations given here. The complete statement is available on Health Canada's website: www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/index-eng.php.

  15. Differences in walking attainment ages between low-risk preterm and healthy full-term infants

    Directory of Open Access Journals (Sweden)

    Ana P. Restiffe

    2012-08-01

    Full Text Available OBJECTIVE: To compare gross motor development of preterm infants (PT without cerebral palsy with healthy full-term (FT infants, according to Alberta Infant Motor Scale (AIMS; to compare the age of walking between PT and FT; and whether the age of walking in PT is affected by neonatal variables. METHODS: Prospective study compared monthly 101 PT and 52 FT, from the first visit, until all AIMS items had been observed. Results: Mean scores were similarity in their progression, except from the eighth to tenth months. FT infants were faster in walking attainment than PT. Birth weight and length and duration of neonatal nursery stay were related to walking delay. CONCLUSION: Gross motor development between PT and FT were similar, except from the eighth to tenth months of age. PT walked later than FT infants and predictive variables were birth weight and length, and duration of neonatal intensive unit stay.

  16. Respiratory muscle activity related to flow and lung volume in preterm infants compared with term infants

    NARCIS (Netherlands)

    Hutten, Gerard J.; van Eykern, Leo A.; Latzin, Philipp; Thamrin, Cindy; van Aalderen, Wim M.; Frey, Urs

    2010-01-01

    Infants with chronic lung disease (CLD) have a capacity to maintain functional lung volume despite alterations to their lung mechanics. We hypothesize that they achieve this by altering breathing patterns and dynamic elevation of lung volume, leading to differences in the relationship between

  17. Is it correct to correct? Developmental milestones in 555 "normal" preterm infants compared with term infants.

    NARCIS (Netherlands)

    Ouden, L. den; Rijken, M.; Brand, R.; Verloove-Vanhorick, S.P.; Ruys, J.H.

    1991-01-01

    To determine whether correction for preterm birth should be applied during developmental assessment, we conducted a prospective national survey of very premature infants (born at less than 32 weeks of gestation); neurodevelopment in the first 2 years was studied with the Dutch child health care

  18. Formula milk versus term human milk for feeding preterm or low birth weight infants.

    Science.gov (United States)

    McGuire, W; Anthony, M Y

    2001-01-01

    Term (mature) human breast milk, compared with artificial formula milks, may provide insufficient nutrition for growth and development in preterm or low birth weight infants. However, human milk may confer advantages to infants in terms of a decreased incidence of adverse outcomes. To determine if formula milk compared with term human breast milk leads to improved growth and development without significant adverse effects in low birth weight or preterm infants. The standard search strategy of the Cochrane Neonatal Review Group was used. This included electronic searches of the Cochrane Controlled Trials Register, MEDLINE, EMBASE and previous reviews including cross references. Randomised controlled trials comparing feeding with formula milk versus term human milk in low birth weight or preterm infants. Data were extracted using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author and synthesis of data using relative risk, risk difference and weighted mean difference. Six trials, all initiated more than 20 years ago, fulfilled the pre-specified inclusion criteria. Four small trials compared feeding with standard calorie formula milk versus unfortified term human milk. Two trials compared feeding with calorie-enriched formula milk versus unfortified term human milk. No trials comparing feeding with formula milk versus nutrient-fortified term human milk were found. Only one trial reported longer term follow up of growth and development. In preterm and low birth weight infants, enteral feeding with formula milk compared with unfortified term human milk resulted in a greater rate of growth in the short term. We did not find a statistically significant difference in the incidence of necrotising enterocolitis, but this was evaluated as a pre-defined outcome in only one trial. The single trial that evaluated longer-term outcomes did not find evidence of an effect on longer-term growth and

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

    Directory of Open Access Journals (Sweden)

    Jordan E. Pinsker

    2013-04-01

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

  20. Long-term follow-up of benign positional vertical opsoclonus in infants: retrospective cohort.

    Science.gov (United States)

    Sternfeld, Amir; Lobel, Daniella; Leiba, Hana; Luckman, Judith; Michowiz, Shalom; Goldenberg-Cohen, Nitza

    2017-09-13

    Benign positional vertical opsoclonus in infants, also described as paroxysmal tonic downgaze, is an unsettling phenomenon that leads to extensive work-up, although benign course has been reported in sporadic cases. We describe long-term follow-up of a series of infants with the phenomenon. This retrospective cohort included all infants diagnosed with rapid downgaze eye movement in 2012-2015 and followed until 2016. The databases of two medical centres were retrospectively reviewed. Benign positional vertical opsoclonus was diagnosed based on clinical findings of experienced neuro-ophthalmologists. Data were collected on demographics, symptoms and signs, neuro-ophthalmological and neurological evaluations, and outcome. Imaging studies were reviewed. Main outcome measures were long-term outcome and findings of the thorough investigation. The cohort included six infants. All infants were born at term. Age at presentation was several days to 12 weeks. Episodes lasted a few seconds and varied in frequency from <10 to dozens per day. In five infants, symptoms occurred in the supine position. There was a wide variability in the work-up without any pathological findings. Follow-up ranged from 1 to 2.5 years. Ocular symptoms gradually decreased until resolution. Infants reached normal developmental milestones. Our identification of six patients in only 3 years suggests benign positional vertical opsoclonus may be more prevalent than previously described. In our experience, it affects otherwise healthy infants and resolves spontaneously. In view of the good long-term outcome, a comprehensive clinical investigation may not be necessary. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. "The effect of fluid supplementation on serum bilirubin level during phototerapy in term infants "

    OpenAIRE

    Torkaman M; Afsharpeyman SH; Khalili Matinzadeh Z; Amirsalary S; Kavehmanesh Z; Hashemi S.A

    2007-01-01

    Background: Jaundice is a common and benign problem in neonatal period. Several therapeutic procedures for decreasing of serum bilirubin level has been recommended. phototherapy is most common them. Our goal Form this study is the evaluation of serum therapy effects in decreasing of serum bilirubin concentration in icteric infants that are treated with phototherapy. Methods: This is a prospective clinical trial in Najmeih Hospital in 2002. In this study 80 term icteric infants with bilirubin ...

  2. Cortisol, contingency learning, and memory in preterm and full-term infants

    Science.gov (United States)

    Haley, David W.; Weinberg, Joanne; Grunau, Ruth E.

    2005-01-01

    Summary Cortisol plays an important role in learning and memory. An inverted-U shaped function has been proposed to account for the positive and negative effects of cortisol on cognitive performance and memory in adults, such that too little or too much impair but moderate amounts facilitate performance. Whether such relationships between cortisol and mental function apply to early infancy, when cortisol secretion, learning, and memory undergo rapid developmental changes, is unknown. We compared relationships between learning/memory and cortisol in preterm and full-term infants and examined whether a greater risk for adrenal insufficiency associated with prematurity produces differential cortisol–memory relationships. Learning in three-month old (corrected for gestational age) preterm and full-term infants was evaluated using a conjugate reinforcement mobile task. Memory was tested by repeating the same task 24 h later. Salivary cortisol samples were collected before and 20 min after the presentation of the mobile. We found that preterm infants had lower cortisol levels and smaller cortisol responses than full-term infants. This is consistent with relative adrenal insufficiency reported in the neonatal period. Infants who showed increased cortisol levels from 0 to 20 min on Day 1 had significantly better memory, regardless of prematurity, than infants who showed decreased cortisol levels. PMID:16122876

  3. Cardiac arrest in infants, children, and adolescents: long-term emotional and behavioral functioning

    NARCIS (Netherlands)

    L. van Zellem (Lennart); E.M.W.J. Utens (Elisabeth); M.J. Madderom (Marlous); J.S. Legerstee (Jeroen); F.K. Aarsen (Femke); D. Tibboel (Dick); C.M.P. Buysse (Corinne)

    2016-01-01

    textabstractVery little is known about the psychological consequences of a cardiac arrest (CA) during childhood. Our aim was to assess long-term emotional and behavioral functioning, and its predictors, in survivors of CA in childhood. This long-term follow-up study involved all consecutive infants,

  4. Changes in quantitative ultrasound in preterm and term infants during the first year of life

    Energy Technology Data Exchange (ETDEWEB)

    Tansug, Nermin, E-mail: ntansug@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Yildirim, Sule Aslan, E-mail: sulesln@yahoo.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Canda, Ebru, E-mail: ebruerbass@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Ozalp, Deniz, E-mail: bluexxdeniz@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Yilmaz, Ozge, E-mail: oyilmaz_76@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Taneli, Fatma, E-mail: fatma.taneli@bayar.edu.tr [Celal Bayar University, Faculty of Medicine, Department of Biochemistry, 45020 Manisa (Turkey); Ersoy, Betuel, E-mail: betul_e@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey)

    2011-09-15

    Since most of in utero bone mass accretion occurs during the third trimester and postnatal need for bone nutrients is increased, preterm infants have an increased risk of low bone mass. Early identification of the risk is of crucial importance. Quantitative ultrasound, which is a relatively inexpensive, portable, noninvasive, and radiation-free method, gives information about bone density, cortical thickness, elasticity and microarchitecture. The aim of this study was to obtain quantitative ultrasound measurements of tibial speed of sound of preterm and term infants and to assess clinical factors associated with these measurements during the first year of life. Seventy-eight preterm and 48 term infants were enrolled in this study. Measurements were made on the 10th day of life in both groups, and were repeated on the 2nd, 6th and 12th months for preterm infants and on the12th month for the term infants. Speed of sound on preterm infants was significantly decreased on the 2nd month but significantly increased on the 12th month (P = 0.00). Comparing speed of sound of term and preterm infants, 10th day measurements were significantly different (P = 0.00), but there was not any significant difference between the 12th month values (P = 0.26). There was not any relation between biochemical parameters and speed of sound. The technique has potential clinical value for assessment of bone status. Further studies with long term follow up are needed to evaluate the value of quantitative ultrasound with other bone markers to predict the risk of fracture.

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

    Science.gov (United States)

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

    2015-01-01

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

  6. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding.

    Science.gov (United States)

    Jaafar, Sharifah Halimah; Ho, Jacqueline J; Jahanfar, Shayesteh; Angolkar, Mubashir

    2016-08-30

    To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Concerns have been raised that offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast-milk production and shorten duration of breastfeeding. To assess the effect of restricted versus unrestricted pacifier use in healthy full-term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2016) and reference lists of retrieved studies. Randomised and quasi-randomised controlled trials comparing restricted versus unrestricted pacifier use in healthy full-term newborns who have initiated breastfeeding. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach. We found three trials (involving 1915 babies) for inclusion in the review, but have included only two trials (involving 1302 healthy full-term breastfeeding infants) in the analysis. Meta-analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.01; 95% confidence interval (CI) 0.96 to 1.07, two studies, 1228 infants), and at four months of age (RR 1.01; 95% CI 0.94 to 1.09, one study, 970 infants, moderate-quality evidence), and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.98 to 1.02, two studies, 1228 infants), and at four months of age (RR 0.99; 95% CI 0

  7. Sleep-wake cycle of the healthy term newborn infant in the immediate postnatal period.

    Science.gov (United States)

    Korotchikova, Irina; Stevenson, Nathan J; Livingstone, Vicki; Ryan, C Anthony; Boylan, Geraldine B

    2016-04-01

    To examine sleep-wake cycle (SWC) composition of healthy term infants in the immediate postnatal period using EEG, and investigate factors that might influence it. Multichannel video-EEG was recorded for a median of 61.9 min (IQR: 60.0-69.3). The absolute and relative scores of sleep states were calculated for each infant's recording. Parametric/non-parametric statistical tests and multiple linear regression analysis were used to investigate the influence of perinatal factors on SWC composition. Eighty healthy term infants aged 1-36 h were studied. A well-developed SWC was evident as early as within the first 6h after birth. The mean (SD) percentage of active sleep (AS) was 52.1% (12.9) and quiet sleep (QS) was 38.6% (12.5). AS was longer and QS shorter in infants delivered by elective caesarean section (CS) compared to infants delivered by vaginal delivery or emergency CS. This is the first large cohort EEG study that has quantified neonatal sleep. SWC is clearly present immediately after birth, it is dominated by AS, and is influenced by mode of delivery. This knowledge of the early neonatal EEG/SWC can be used as reference data for EEG studies of neurologically compromised infants. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  8. Nutrition for healthy term infants, birth to six months: An overview.

    Science.gov (United States)

    Critch, Jeffrey N

    2013-04-01

    Nutrition for healthy term infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada that was most recently updated in September 2012 with recommendations from birth to six months of age. This practice point outlines the development process, principles of infant feeding, and recommendations for clinicians. Health professionals involved in counselling families about infant nutrition are advised to read the statement in its entirety, because the underlying discussions expand upon and clarify the advice summarized in the principles and recommendations. The complete statement is available on Health Canada's website (www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/index-eng.php).

  9. Follow-up of neonatal jaundice in term and late premature newborns.

    Science.gov (United States)

    Facchini, Fernando P; Mezzacappa, Maria Aparecida; Rosa, Izilda R; Mezzacappa Filho, Francisco; Aranha-Netto, Abimael; Marba, Sergio Tadeu

    2007-01-01

    To report on the results of a project following term and near term newborn infants who were jaundiced during the neonatal period. Neonates were referred to the follow-up clinic with weight >/= 2,000 g and/or gestational age >/= 35 weeks, and jaundice at discharge was initially assessed with an Ingram icterometer or Bilicheck and, if indicated, with a Unistat bilirubinometer (Leica). These newborn infants had bilirubinemia at or above the 40th percentile on the nomogram developed by Bhutani. All infants treated with phototherapy while in hospital were reassessed by laboratory methods 24 hours after withdrawal of treatment. Patients were rehospitalized for intensive phototherapy if their level was greater than or equal to 20 mg/dL. From a total sample of 11,259 neonates, 2,452 (21.8%) were referred to the follow-up clinic, 87.2% (2,140) of whom did return. Eighty returned neonates were readmitted. Return appointments were set for 2,452 patients, 180 (7.3%) of whom had bilirubinemia >/= 15 mg/dL at discharge. Of these 180, 151 returned for follow-up. Twenty (13.2%) were readmitted for treatment. Of the total number of readmitted patients, two newborn infants had levels >/= 25 mg/dL and none >/= 30 mg/dL. All responded rapidly to intensive phototherapy, and there was no need for exchange transfusions. Our results suggest that the regime adopted is effective for detecting and preventing hyperbilirubinemia at risk of causing bilirubin-induced encephalopathy in term and near term newborn infants.

  10. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding.

    Science.gov (United States)

    Jaafar, Sharifah Halimah; Jahanfar, Shayesteh; Angolkar, Mubashir; Ho, Jacqueline J

    2011-03-16

    To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast milk production and shorten duration of breastfeeding; however, this remains unclear. To assess the effect of pacifier use versus no pacifier use in healthy full-term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2010). Randomised and quasi-randomised controlled trials comparing pacifier use versus no pacifier use in healthy full-term newborns who have initiated breastfeeding regardless of whether they were born at home or in the hospital. Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We found three trials (involving 1915 babies) for inclusion in the review but have included only two trials (involving 1302 healthy full-term breastfeeding infants) in the analysis. Meta-analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.00; 95% confidence interval (CI) 0.95 to 1.06), and at four months of age (RR 0.99; 95% CI 0.92 to 1.06) and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.97 to 1.02), and at 4 months of age (RR 1.01; 95% CI 0.98 to 1.03). Pacifier use in healthy term breastfeeding infants, started from birth or after lactation is established, did not significantly affect the prevalence or duration of

  11. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 2: The palate of the preterm/low birthweight infant

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-10-01

    Full Text Available Abstract Background Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1. The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. Methods An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. Results Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. Conclusion There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and

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

    Science.gov (United States)

    Buckles, Kasey; Guldi, Melanie

    2017-01-01

    Early term birth is defined as birth at 37 or 38 weeks gestation. While infants born early term are not considered premature, the medical literature suggests that they have an increased risk of serious adverse health outcomes compared to infants born at term (39 or 40 weeks). Despite these known harms, we document a rise in early term births in the United States from 1989 to the mid-2000s, followed by a decline in recent years. We posit that the recent decline in early term births has been driven by changes in medical practice advocated by the American College of Obstetricians and Gynecologists, programs such as the March of Dimes’ "Worth the Wait" campaign, and by Medicaid policy. We first show that this pattern cannot be attributed to changes in the demographic composition of mothers, and provide some evidence that efforts to reduce early term elective deliveries (EEDs) through Medicaid policy were effective. We next exploit county-level variation in the timing of these changes in medical practice to examine the effect of early term inductions (our proxy for EEDs) on infant and maternal health. We find that early term inductions lower birth weights and increase the risks of precipitous labor, birth injury, and required ventilation. Our results suggest that reductions in early term inductions can explain about one-third of the overall increase in birth weights between 2010 and 2013 for births at 37 weeks gestation and above.

  13. Cardioventilatory coupling in preterm and term infants: effect of position and sleep state.

    Science.gov (United States)

    Elder, Dawn E; Larsen, Peter D; Galletly, Duncan C; Campbell, Angela J

    2010-11-30

    This study documented the effect of position on cardioventilatory coupling (CVC), the triggering of inspiratory onset by a preceding heartbeat, in infants. Cardiorespiratory signals and corresponding oxygen saturation (SpO(2)) were downloaded from Quiet Sleep (QS) and Active Sleep (AS) in prone and supine from preterm (PT) and term (T) infants. Inspiratory onsets (I) and timing of the corresponding ECG R wave were determined and R-R and R-I intervals calculated. The RI(-1) interval (time between inspiration and the preceding R wave) dispersion was measured using proportional Shannon Entropy of the RI(-1) interval (SH(α)), to provide a quantitative measure of CVC. CVC was more frequently seen in QS in PT (p=0.002) and T (p=0.02) infants but not influenced by position (p=0.71, p=0.46). CVC correlated with SpO(2) in PT (r=-0.230, p=0.03) but not T infants (r=0.085, p=0.34). These data imply an augmentation of cardiac influence on ventilatory rhythm in infants in QS. In preterm infants CVC may have a role in supporting oxygenation. Copyright © 2010 Elsevier B.V. All rights reserved.

  14. A cross-sectional study of plasma and urinary aluminum levels in term and preterm infants.

    Science.gov (United States)

    Bougle, D; Bureau, F; Voirin, J; Neuville, D; Duhamel, J F

    1992-01-01

    High aluminum levels have been reported in sick and intravenously fed premature infants; however, aluminum is a ubiquitous pollutant of food. This study compares the usual aluminum levels of healthy newborns from birth to the third month of life with those of enterally fed premature infants free of renal failure. Plasma and urine concentrations were determined 66 times in full-term newborns (n = 58), 56 times in a group of preterm infants whose gestational age at birth was 28 to 32 weeks (n = 36) and 54 times in another group of preterm infants whose gestational age at birth was 33 to 36 weeks (n = 50). Daily aluminum intakes (+/- SE) of the full-term infants and the two groups of preterm infants were 0.42 +/- 0.05, 0.64 +/- 0.03, and 0.52 +/- 0.03 mumol/kg per day, respectively (p = .05). Plasma aluminum levels were 0.29 +/- 0.05, 0.49 +/- 0.06, and 0.39 +/- 0.05 mumol/L (p = .007); urine excretion levels were 0.80 +/- 0.12, 0.77 +/- 0.21, and 0.78 +/- 0.2 mumol of aluminum/mmol of creatinine (p value not significant). Although the metabolic consequences of the high aluminum intakes and blood levels we have observed in very low birth weight infants remain to be assessed, these results suggest that more attention should be paid to the aluminum status and intake of healthy premature babies.

  15. Peripherally inserted central catheters for long-term parenteral nutrition in infants with intestinal failure.

    Science.gov (United States)

    Piper, Hannah G; de Silva, Nicole T; Amaral, Joao G; Avitzur, Yaron; Wales, Paul W

    2013-05-01

    Infants with intestinal failure often require long-term central access for delivery of parenteral nutrition (PN). Traditionally, surgically placed central venous catheters (CVCs) have been used; however, the complications associated with these catheters can lead to significant morbidity. Peripherally inserted central catheters (PICCs) are potentially superior to CVCs because they tend to be smaller, and can be placed without general anesthesia. The purpose of the study is to report the use of PICCs for long-term administration of PN in infants with intestinal failure and compare with previously published catheter infection and venous thrombosis rates. A 4-year review of infants younger than 12 months with intestinal failure and a PICC for PN delivery was performed to determine the incidence of catheter-related bloodstream infections (CRBSIs) and PICC-associated venous thrombosis. The complication rates were compared with those reported for CVCs and PICCs in the pediatric literature. A total of 45 infants with intestinal failure, receiving PN through a PICC were included in the study. Data from 95 PICCs accounting for 10,189 catheter days were collected. The overall incidence of CRBSI was 5.3/1000 catheter days and the incidence of venous thrombosis was 2.0/1000 catheter days. PICCs offer an advantage over CVCs in that they can often be inserted without a general anesthesia and do not require manipulation of the vein. Given the low rate of CRBSI and venous thrombosis, we recommend PICCs for infants with intestinal failure requiring PN.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  17. The qualitative assessment of general movements in preterm, term and young infants - Review of the methodology

    NARCIS (Netherlands)

    Einspieler, C; Prechtl, HFR; Ferrari, F; Cioni, G; Bos, AF

    1997-01-01

    We describe the state of the art of Prechtl's method for the qualitative assessment of general movements as a diagnostic tool for early detection of brain dysfunction, After discussing the optimal technique for video recording general movements in preterm, term and young infants, attention is

  18. Fractured long bones in a term infant delivered by cesarian section

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, M.; Dollberg, M.; Wajntraub, G.; Itzchaki, M.

    1987-03-01

    A term infant was delivered uneventfully by repeat cesarian section. At the age of 1 week there was clinical and radiographic evidence of fractures of the left tibia and right radius. The fractures most likely occurred during the cesarian section. Birth trauma should not be excluded on the basis of cesarian section delivery.

  19. Long-Term Memory for Music: Infants Remember Tempo and Timbre

    Science.gov (United States)

    Trainor, Laurel J.; Wu, Luann; Tsang, Christine D.

    2004-01-01

    We show that infants' long-term memory representations for melodies are not just reduced to the structural features of relative pitches and durations, but contain surface or performance tempo- and timbre-specific information. Using a head turn preference procedure, we found that after a one week exposure to an old English folk song, infants…

  20. Magnetic resonance imaging at term and neuromotor outcome in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Valkama, A.M.; Paeaekkoe, E.L.E.; Vainionpaeae, L.K.; Lanning, F.P.; Ilkko, E.A.; Koivisto, M.E

    2000-07-01

    In order to evaluate the value of neonatal brain magnetic resonance imaging (MRI) for prediction neuro motor outcome in very low birthweight (VLBW) preterm infants, 51 such infants with gestational age less than 34 wk underwent brain MRI at term age. Myelination, parenchymal lesions (haemorrhage, leukomalacia, infarction, reduction of white matter), parenchymal lesions without subependymal haemorrhage, ventricular/brain ratios and widths of the extra cerebral spaces were assessed. The MRI findings were compared with cranial ultrasound (US) performed at term. Infants' neuro motor development was followed up until 18 mo corrected age. Parenchymal lesions seen in MRI at term predicted cerebral palsy (CP) with 100 % sensitivity and 79 % specificity, the corresponding figures for US being 67 % and 85 %, respectively. Parenchymal lesions in MRI, excluding subependymal haemorrhages, predicted CP with a sensitivity of 82 % and specificity of 97 %, the corresponding figures for US being 58 % and 100 % respectively. Delayed myelination, ventricular/brain ratios and widths of the extra cerebral spaces failed to predict CP. Term age is a good time for neuroradiological examinations in prematurely born high-risk infants. Parenchymal lesions seen in MRI are reliable predictors for CP.

  1. Postmortem lung volume/body weight standards for term and preterm infants.

    Science.gov (United States)

    De Paepe, Monique E; Shapiro, Svetlana; Hansen, Katrine; Gündoğan, Füsun

    2014-01-01

    Assessment of lung growth is a critical component of the perinatal autopsy. Increased lung liquid content may lead to overestimation of lung growth based on (wet) lung weight. In contrast, lung volume is not influenced by intraalveolar lung liquid. Our aim was to establish age-specific reference values for postmortem lung volume/BW in preterm and term infants. We performed a retrospective analysis of fetuses/infants (16-41 weeks' gestation) without (N = 134) or with (N = 79) risk factors for pulmonary hypoplasia. Lungs were inflated at standardized pressure and volumes determined by water immersion method. Lung volume increased 11-fold between 16 and 41 weeks' gestation, concomitant with a 16-fold increase in BW. Mean lung volume/BW remained constant at 33-34 ml/kg between 16 and 31 weeks' gestation and decreased to 23.4 ml/kg at term. Lung volume/BW of infants with severe risk factors (renal anomalies, diaphragmatic hernia) was significantly lower than age-matched standards. In this group, all fetuses/infants diagnosed as having lung hypoplasia by lung volume/BW also had lung hypoplasia LW/BW standards. However, in infants with "softer" risk factors (rupture of membranes, chromosomal anomalies), 5/26 cases diagnosed with lung hypoplasia based on lung volume/BW had normal LW/BW ratios. In these discrepant cases, lung sections showed significant inflammation and edema, likely accounting for increased wet lung weight. In conclusion, we determined age-specific lung volume/BW reference values for preterm and term infants. In selected situations assessment of lung volume/BW may represent a useful complementary tool to LW/BW for postmortem evaluation of lung size. Copyright © 2013 Wiley Periodicals, Inc.

  2. Long-term experience with ZENPEP in infants with exocrine pancreatic insufficiency associated with cystic fibrosis.

    Science.gov (United States)

    Wooldridge, Jamie L; Schaeffer, David; Jacobs, David; Thieroff-Ekerdt, Ruth

    2014-11-01

    The objective of our study was to determine whether infants with cystic fibrosis who developed exocrine pancreatic insufficiency in early infancy would tolerate long-term treatment with ZENPEP (pancrelipase) delayed-release capsules, containing 3000 US Pharmacopeia units of lipase/capsule, and demonstrate consistent long-term growth. The most common treatment-emergent adverse events were diarrhea, vomiting, and constipation (mild or moderate). At study completion, median weight-for-age percentiles increased from 22nd to 49th, median length-for-age percentiles increased from 36.5th to 42nd, and median weight-for-length percentiles increased from 41.5th to 55.5th. Long-term treatment (up to 12 months) of infants with exocrine pancreatic insufficiency owing to cystic fibrosis with ZENPEP was well tolerated and associated with improved growth parameters. This is the first long-term study of pancreatic enzyme replacement therapy conducted in this patient population.

  3. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 1: The palate of the term newborn

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-10-01

    Full Text Available Abstract Background The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinical studies are needed. The objective of this review is to provide a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development. One focus of this review is the analysis of studies on the palate of the term newborn, since knowing what is 'normal' is a precondition of being able to assess abnormalities. Methods A search profile based on Cochrane search strategies applied to 10 medical databases was used to identify existing studies. Articles, mainly those published before 1960, were identified from hand searches in textbooks, encyclopedias, reference lists and bibliographies. Sources in English, German, and French of more than a century were included. Data for term infants were recalculated if particular information about weight, length, or maturity was given. The extracted values, especially those from non-English paper sources, were provided unfiltered for comparison. Results The search strategy yielded 182 articles, of which 155 articles remained for final analysis. Morphology of the term newborn's palate was of great interest in the first half of the last century. Two general methodologies were used to assess palatal morphology: visual and metrical descriptions. Most of the studies on term infants suffer from lack of reliability tests. The groove system was recognized as the distinctive feature of the infant palate. The shape of the palate of the term infant may vary considerably, both visually and metrically. Gender, race, mode of delivery, and nasal deformities were identified as causes contributing to altered palatal morphology. Until today, anatomical features of the newborn's palate are subject to a non-uniform nomenclature. Conclusion Today's knowledge of a newborn's 'normal' palatal

  4. Postpartum CT examination of the heads of full term infants

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, B.; Brand, M.; Brockerhoff, P.

    1980-11-01

    Intracranial hemorrhage and decreased density of the cerebral parenchyma were the major findings on CT of 150 full term newborns in the first week of life. Clinically silent hemorrhage was rare. All neonates with severe intracranial bleeding had neurological abnormalities. A correlation was not found between hemorrhage and the mode of delivery. The site of hemorrhage has an important bearing on brain development. Periventricular hypodensity is an ambiguous finding which should be interpreted in conjunction with the clinical findings.

  5. Neonatal Pneumopericardium in a Nonventilated Term Infant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Smita Roychoudhury

    2017-01-01

    Full Text Available Neonatal pneumopericardium (PPC is a rare form of neonatal air leak syndrome with high morbidity and mortality. Air leak syndrome in the newborn is usually associated with active resuscitation, respiratory distress syndrome, meconium aspiration syndrome, mechanical ventilation, or trauma associated with labour. Neonatal PPC can be associated with other air leak syndromes such as pneumomediastinum, pneumothorax, pneumoperitoneum, and subcutaneous and interstitial emphysema. Spontaneous PPC is a rare event in the neonatal period. We report a case of PPC in association with pneumothorax in a nonventilated term infant. The infant responded to thoracocentesis without the need for pericardiocentesis.

  6. Long-chain polyunsaturated fatty acid supplementation in infants born at term.

    Science.gov (United States)

    Simmer, Karen; Patole, Sanjay K; Rao, Shripada C

    2011-12-07

    The n-3 and n-6 fatty acids linolenic acid and linoleic acid are precursors of the n-3 and n-6 long chain fatty acids (LCPUFA). Infant formula has historically only contained the precursor fatty acids. Over the last few years, some manufacturers have added LCPUFA to formulae and marketed them as providing an advantage for the development of term infants. To assess whether supplementation of formula with LCPUFA is safe and of benefit to term infants. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, April, 2011), MEDLINE (1966 to April 2011), EMBASE (1980 to April 2011), CINAHL (December 1982 to April 2011) and abstracts of the Society for Pediatric Research (1980 to 2010). No language restrictions were applied. Randomised and quasi randomised trials comparing LCPUFA supplemented vs. non-supplemented formula milk and with clinical endpoints were reviewed. Methodological quality of studies was assessed using the guidelines of Cochrane neonatal review group. Data were sought regarding effects on visual acuity, neurodevelopmental outcomes and physical growth. When appropriate, meta-analysis was conducted to provide a pooled estimate of effect. Twenty-five randomised studies were identified; fifteen were included (n = 1889) and ten excluded.Visual acuity was assessed by nine studies. Visual evoked potential was used in six studies, two used Teller cards and one used both. Four studies reported beneficial effects while the remaining five did not.Neurodevelopmental outcome was measured by eleven studies. Bayley scales of infant development (BSID) was used in nine studies; only two showed beneficial effects. Meta-analysis did not show significant benefits of supplementation. One study followed the infants up to nine years of age and did not find benefit of supplementation. One study reported better novelty preference measured by Fagan Infant test at nine months. Another study reported better problem solving at 10 months. One study used

  7. Inhaled Nitric Oxide Therapy for Pulmonary Disorders of the Term and Preterm Infant

    OpenAIRE

    Sokol, Gregory M.; Konduri, G. Ganesh; Van Meurs, Krisa P.

    2016-01-01

    The 21st century began with the FDA approval of inhaled nitric oxide therapy for the treatment of neonatal hypoxic respiratory failure associated with pulmonary hypertension in recognition of the two randomized clinical trials demostrating a significant reduction in the need for extracorporeal support in the term and near-term infant. Inhaled nitric oxide is one of only a few therapeutic agents approved for use through clinical investigations primarily in the neonate. This article provides an...

  8. Health Services Use by Late Preterm and Term Infants From Infancy to Adulthood: A Meta-analysis.

    Science.gov (United States)

    Isayama, Tetsuya; Lewis-Mikhael, Anne-Mary; O'Reilly, Daria; Beyene, Joseph; McDonald, Sarah D

    2017-07-01

    Late-preterm infants born at 34 to 36 weeks' gestation have increased risks of various health problems. Health service utilization (HSU) of late-preterm infants has not been systematically summarized before. To summarize the published literature on short- and long-term HSU by late-preterm infants versus term infants from infancy to adulthood after initial discharge from the hospital. We searched Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Cohort and case-control studies that compared HSU (admissions, emergency department visits, etc) between late-preterm infants and term infants were included. Data extracted included study design, setting, population, HSU, covariates, and effect estimates. Fifty-two articles were included (50 cohort and 2 case-control studies). Meta-analyses with random effect models that used the inverse-variance method found that late-preterm infants had higher chances of all-cause admissions than term infants during all the time periods. The magnitude of the differences decreased with age from the neonatal period through adolescence, with adjusted odds ratios from 2.34 (95% confidence intervals 1.19-4.61) to 1.09 (1.05-1.13) and adjusted incidence rate ratios from 2.62 (2.52-2.72) to 1.14 (1.11-1.18). Late-preterm infants had higher rates of various cause-specific HSU than term infants for jaundice, infection, respiratory problems, asthma, and neurologic and/or mental health problems during certain periods, including adulthood. Considerable heterogeneity existed and was partially explained by the variations in the adjustment for multiple births and gestational age ranges of the term infants. Late-preterm infants had higher risks for all-cause admissions as well as for various cause-specific HSU during the neonatal period through adolescence. Copyright © 2017 by the American Academy of Pediatrics.

  9. Long-Term Outcome of Catheter-Related Arterial Thrombosis in Infants with Congenital Heart Disease.

    Science.gov (United States)

    Rizzi, Mattia; Kroiss, Sabine; Kretschmar, Oliver; Forster, Ishilde; Brotschi, Barbara; Albisetti, Manuela

    2016-03-01

    To investigate the long-term outcome of catheter-related arterial thrombosis in children. Data from clinical and radiologic long-term follow-up of infants with congenital heart disease developing arterial thrombosis following femoral catheterization are presented. Ninety-five infants with radiologically proven arterial thrombosis because of cardiac catheter (n = 52; 55%) or indwelling arterial catheter (n = 43; 45%) were followed for a median time of 23.5 months (IQR 13.3-47.3). Overall, radiologic complete thrombus resolution was observed in 64 (67%), partial resolution in 8 (9%), and no resolution in 23 (24%) infants. Complete resolution was significantly more frequent in infants with indwelling arterial catheter-related thrombosis compared with cardiac catheter-related thrombosis (P = .001). Patients with complete resolution had a significantly lower blood pressure difference and increased ankle-ankle index compared with patients with partial or no resolution (P < .0001). However, symptoms of claudication were present only in 1 case and clinical significant legs growth retardation (≥ 15 mm) was present in 1%. A significant percentage of persistent occlusion is present in children with arterial catheter-related thrombosis on long-term follow-up. In these children, the magnitude of leg growth retardation is small and possibly not clinically relevant. However, in children with congenital heart disease, the high prevalence of persistent arterial occlusion may hamper future diagnostic and/or interventional catheterization. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Iron status at birth and at 4 weeks in preterm-SGA infants in comparison with preterm and term-AGA infants.

    Science.gov (United States)

    Mukhopadhyay, Kanya; Yadav, Ramesh Kumar; Kishore, Sai Sunil; Garewal, Gurjeevan; Jain, Vanita; Narang, Anil

    2012-08-01

    To determine the iron status at birth in preterm small for gestational age (SGA) in comparison with preterm appropriate for gestation (AGA) and term-AGA infants. Mother-infant pairs with gestation of SGA, and preterm-AGA and term-AGA as control were enrolled. Maternal, cord blood and infant blood samples at 4 weeks were obtained for various iron indices - cord serum ferritin, proportion of infants with "low" serum ferritin, serum ferritin at 4 weeks and correlation among maternal and neonatal iron indices - hemoglobin,serum ferritin and total iron-binding capacity. There were 50 mother-infant pairs in each group. Cord serum ferritin levels were less in preterm-SGA group as compared to preterm-AGA group (median [interquartile range]: 68 [30 113] vs. 120 [73 127], p = 0.002) and preterm-AGA had less cord ferritin than term-AGA (141 [63 259], p = 0.006). The proportion of the infants with "low" serum ferritin was more in preterm-SGA than in preterm-AGA (16 [32%] vs. 5 [10%], p = 0.01). The serum ferritin levels at follow-up were also less in preterm-SGA as compared to preterm-AGA (143.5 ± 101 vs. 235.1 ± 160, p = 0.004). Other cord blood iron indices and follow-up serum ferritin levels were similar. There was no correlation among various maternal and neonatal cord iron parameters. Preterm-SGA infants have lesser total iron stores as compared to gestation-matched AGA infants, which is again lesser than term infants. Future studies can be planned to look at iron status at 12 months as well as their neurodevelopmental outcome.

  11. Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review.

    Science.gov (United States)

    Johns, Helene M; Forster, Della A; Amir, Lisa H; McLachlan, Helen L

    2013-11-19

    Expressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing. Databases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression. A total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded by imprecise definitions of

  12. Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review

    Science.gov (United States)

    2013-01-01

    Background Expressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing. Methods Databases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression. Results A total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded

  13. Infant auditory short-term memory for non-linguistic sounds.

    Science.gov (United States)

    Ross-Sheehy, Shannon; Newman, Rochelle S

    2015-04-01

    This research explores auditory short-term memory (STM) capacity for non-linguistic sounds in 10-month-old infants. Infants were presented with auditory streams composed of repeating sequences of either 2 or 4 unique instruments (e.g., flute, piano, cello; 350 or 700 ms in duration) followed by a 500-ms retention interval. These instrument sequences either stayed the same for every repetition (Constant) or changed by 1 instrument per sequence (Varying). Using the head-turn preference procedure, infant listening durations were recorded for each stream type (2- or 4-instrument sequences composed of 350- or 700-ms notes). Preference for the Varying stream was taken as evidence of auditory STM because detection of the novel instrument required memory for all of the instruments in a given sequence. Results demonstrate that infants listened longer to Varying streams for 2-instrument sequences, but not 4-instrument sequences, composed of 350-ms notes (Experiment 1), although this effect did not hold when note durations were increased to 700 ms (Experiment 2). Experiment 3 replicates and extends results from Experiments 1 and 2 and provides support for a duration account of capacity limits in infant auditory STM. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants.

    Directory of Open Access Journals (Sweden)

    Katrin Ivars

    Full Text Available Cortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life.130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30, noon (10:00-12:00 and evening (19:30-21:30, each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist.A significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life.Cortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.

  15. Correlation between echocardiographic superior vena cava flow and short-term outcome in infants with asphyxia.

    Science.gov (United States)

    Kumagai, Takeshi; Higuchi, Ryuzo; Higa, Asumi; Tsuno, Yoshinobu; Hiramatsu, Chisako; Sugimoto, Takuya; Booka, Mina; Okutani, Takahiro; Yoshikawa, Norishige

    2013-05-01

    To assess the relationship between superior vena cava (SVC) flow and short-term outcome in infants with perinatal asphyxia. Infants in sequence born after more than 35 weeks of gestation who had been hospitalized at the NICU and normal neonatal wards of Wakayama Medical University between May 2005 and September 2010 were recruited for this observational cohort study. The study eligibility criterion was the presence of perinatal asphyxia, as evidenced by abnormal fetal heart rate monitoring and an Apgar score of 7 or less at 1 min or need for resuscitation using positive pressure ventilation. SVC flow was measured in the first three days of life by Doppler echocardiography as described by Kluckow and Evans. Short-term outcome was defined as poor if MRI demonstrated bilateral lesions of the basal ganglia and thalamus and/or multicystic encephalomalacia due to hypoxic ischemia. In the head cooling group, SVC flow in infants with a good outcome was lower than that in infants with a poor outcome at 12h (36.9±7.7 vs. 113.4±42.4 ml/kg/min (p=0.01)), 24h (75.2±25.3 vs. 155.6±45.7 ml/kg/min (p=0.03)), and 48 h (92.5±34.2 vs. 161.1±46.7 ml/kg/min (p=0.04)) after birth. SVC flow decreased promptly after introduction of head cooling in infants who had a good outcome, whereas it increased gradually after head cooling in those who had a poor outcome. We speculate that regulation of brain circulation is disrupted in infants with asphyxia who show a poor outcome. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Discharge timing, outpatient follow-up, and home care of late-preterm and early-term infants.

    Science.gov (United States)

    Hwang, Sunah S; Barfield, Wanda D; Smith, Ruben A; Morrow, Brian; Shapiro-Mendoza, Carrie K; Prince, Cheryl B; Smith, Vincent C; McCormick, Marie C

    2013-07-01

    To compare the timing of hospital discharge, time to outpatient follow-up, and home care practices (breastfeeding initiation and continuation, tobacco smoke exposure, supine sleep position) for late-preterm (LPT; 34 0/7-36 6/7 weeks) and early-term (ET; 37 0/7-38/6/7 weeks) infants with term infants. We analyzed 2000-2008 data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System. χ(2) Analyses were used to measure differences in maternal and infant characteristics, hospital discharge, outpatient care, and home care among LPT, ET, and term infants. We calculated adjusted risk ratios for the risk of adverse care outcomes among LPT and ET infants compared with term infants. In the adjusted analysis, LPT infants were less likely to be discharged early compared with term infants, whereas there was no difference for ET infants (risk ratio [RR; 95% confidence interval (CI)]: 0.65 [0.54-0.79]; 0.95 [0.88-1.02]). [corrected]. LPT and ET infants were more likely to have timely outpatient follow-up (1.07 [1.06-1.08]; 1.02 [1.02-1.03]), more likely to experience maternal tobacco smoke exposure (1.09 [1.05-1.14]; 1.08 [1.06-1.11]), less likely to be initially breastfed (0.95 [0.94-0.97]; 0.98 [0.97-0.98]), less likely to be breastfed for ≥10 weeks (0.88 [0.86-0.90]; 0.94 [0.93-0.96]), and less likely to be placed in a supine sleep position (0.95 [0.93-0.97]; 0.97 [0.96-0.98]). Given that LPT and ET infants bear an increased risk of morbidity and mortality, greater efforts are needed to ensure safe and healthy posthospitalization and home care practices for these vulnerable infants.

  17. Circulating insulin-like growth factor I levels in newborn premature and full-term infants followed longitudinally.

    Science.gov (United States)

    Lineham, J D; Smith, R M; Dahlenburg, G W; King, R A; Haslam, R R; Stuart, M C; Faull, L

    1986-02-01

    Longitudinal circulating levels of insulin-like growth factor I (IGF-I) were measured by radioimmunoassay after acid/ethanol extraction of serum or plasma in 44 appropriate-for-gestational age (AGA) premature infants, 7 small-for-gestational age (SGA) premature infants and 9 AGA full-term infants. The subjects were divided into cohorts with gestational age at birth 26-29 weeks, 30-33 weeks, 34-37 weeks and 38-42 weeks (full-term). The premature infants in this study exhibited diminished growth as compared with normal intrauterine growth. In all but the earliest premature infant cohort there was an immediate fall from the mean fetal IGF-I level, as reflected by the cord value, to a basal postnatal circulating level of IGF-I. The basal level of circulating IGF-I in premature infants was related only to gestational age. It increased slowly from 25 weeks gestation until four weeks after full-term equivalent and was independent of time of birth. Full-term infants were distinguished from early premature infants by the occurrence of a prominent postnatal surge in circulating IGF-I levels that was characterised by a significant (P less than 0.02) increase between day 1 and days 10-15. The SGA and AGA infants in the 34-37 week cohort showed similar profiles of circulating IGF-I with no significant difference in cord values between the two groups.

  18. Short-Term Effects of Pacifier Texture on NNS in Neurotypical Infants

    Directory of Open Access Journals (Sweden)

    Austin L. Oder

    2013-01-01

    Full Text Available The dense representation of trigeminal mechanosensitive afferents in the lip vermilion, anterior tongue, intraoral mucosa, and temporomandibular joint allows the infant’s orofacial system to encode a wide range of somatosensory experiences during the critical period associated with feed development. Our understanding of how this complex sensorium processes texture is very limited in adults, and the putative role of texture encoding in the infant is unknown. The purpose of this study was to examine the short-term effects of a novel textured pacifier experience in healthy term infants (N=28. Nonnutritive suck (NNS compression pressure waveforms were digitized in real time using a variety of custom-molded textured pacifiers varying in spatial array density of touch domes. MANCOVA, adjusted for postmenstrual age at test and sex, revealed that infants exhibited an increase in NNS burst attempts at the expense of a degraded suck burst structure with the textured pacifiers, suggesting that the suck central pattern generator (sCPG is significantly disrupted and reorganized by this novel orocutaneous experience. The current findings provide new insight into oromotor control as a function of the oral somatosensory environment in neurotypically developing infants.

  19. Early additional food and fluids for healthy breastfed full-term infants.

    Science.gov (United States)

    Smith, Hazel A; Becker, Genevieve E

    2016-08-30

    Health organisations recommend exclusive breastfeeding for six months. However, the addition of other fluids or foods before six months is common in many countries. Recently, research has suggested that introducing solid food at around four months of age while the baby continues to breastfeed is more protective against developing food allergies compared to exclusive breastfeeding for six months. Other studies have shown that the risks associated with non-exclusive breastfeeding are dependent on the type of additional food or fluid given. Given this background we felt it was important to update the previous version of this review to incorporate the latest findings from studies examining exclusive compared to non-exclusive breastfeeding. To assess the benefits and harms of additional food or fluid for full-term healthy breastfeeding infants and to examine the timing and type of additional food or fluid. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 March 2016) and reference lists of all relevant retrieved papers. Randomised or quasi-randomised controlled trials in infants under six months of age comparing exclusive breastfeeding versus breastfeeding with any additional food or fluids. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two review authors assessed the quality of the evidence using the GRADE approach. We included 11 trials (2542 randomised infants/mothers). Nine trials (2226 analysed) provided data on outcomes of interest to this review. The variation in outcome measures and time points made it difficult to pool results from trials. Data could only be combined in a meta-analysis for one primary (breastfeeding duration) and one secondary (weight change) outcome. None of the trials reported on physiological jaundice. Infant mortality was only reported in one trial.For the majority of older trials, the description of study methods was inadequate to

  20. The Relationship Between Infant Feeding Outcomes and Maternal Emotional Well-Being Among Mothers of Late Preterm and Term Infants. A Secondary, Exploratory Analysis

    Science.gov (United States)

    Tully, Kristin P.; Holditch-Davis, Diane; Silva, Susan; Brandon, Debra

    2016-01-01

    Background Late preterm birth is associated with lower rates of breastfeeding and earlier breastfeeding cessation than term birth. Purpose The objectives of this secondary analysis were to compare the incidence of exclusive breastfeeding after late preterm and term childbirth and to examine the association between infant feeding outcomes and maternal emotional well-being. Methods Participants were 105 mother-infant dyads (54 late preterm and 51 term) at a southeastern U.S. medical center. Face-to-face data collection and telephone follow up occurred during 2009-2012. Results Late preterm mothers were less likely to exclusively provide their milk than were term mothers during hospitalization. Feeding at one month did not differ between late preterm and term infants. Among late preterm mothers, (1) formula supplementation during hospitalization was associated with greater severity of anxiety compared to those exclusively providing formula and (2) exclusive provision of human milk at one month was associated with less severe depressive symptoms relative to those supplementing or exclusively formula feeding. Among term mothers, feeding outcome was not related to emotional well-being measures at either time point. Implications for Practice Mothers of late preterm infants may particularly benefit from anticipatory guidance and early mental health screening, with integrated, multidisciplinary lactation teams to support these interrelated health care needs Implications for Research Prospective research is critical to document women’s intentions for infant feeding and how experiences with childbirth and the early postpartum period impact achievement of their breastfeeding plans. PMID:27533332

  1. The Relationship Between Infant Feeding Outcomes and Maternal Emotional Well-being Among Mothers of Late Preterm and Term Infants: A Secondary, Exploratory Analysis.

    Science.gov (United States)

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

    2017-02-01

    Late preterm birth is associated with lower rates of breastfeeding and earlier breastfeeding cessation than term birth. The objectives of this secondary analysis were to compare the incidence of exclusive breastfeeding after late preterm and term childbirth and to examine the association between infant feeding outcomes and maternal emotional well-being. Participants were 105 mother-infant dyads (54 late preterm and 51 term) at a southeastern US medical center. Face-to-face data collection and telephone follow-up occurred during 2009-2012. Late preterm mothers were less likely to exclusively provide their milk than were term mothers during hospitalization. Feeding at 1 month did not differ between late preterm and term infants. Among late preterm mothers, (1) formula supplementation during hospitalization was associated with greater severity of anxiety than among those exclusively providing formula and (2) exclusive provision of human milk at 1 month was associated with less severe depressive symptoms than among those supplementing or exclusively formula feeding. Among term mothers, feeding outcome was not related to emotional well-being measures at either time point. Mothers of late preterm infants may particularly benefit from anticipatory guidance and early mental health screening, with integrated, multidisciplinary lactation teams to support these interrelated healthcare needs. Prospective research is critical to document women's intentions for infant feeding and how experiences with childbirth and the early postpartum period impact achievement of their breastfeeding goals.

  2. Trunk position in supine of infants born preterm and at term: an assessment using a computerized pressure mat.

    Science.gov (United States)

    Dusing, Stacey; Mercer, Vicki; Yu, Bing; Reilly, Marie; Thorpe, Deborah

    2005-01-01

    Trunk position may influence motor, cognitive, and social development during infancy and early childhood and has not been quantitatively assessed. The purpose of this study was to assess the trunk positions of infants born at term and preterm in supine using a computerized pressure mat. Trunk position was represented as a ratio of head and pelvis to trunk pressure. Eighteen healthy infants born preterm with a mean gestational age of 31.9 weeks (25.0-34.6) and fifteen healthy infants born at term with a mean gestational age of 38.9 weeks (37.3-40.6) were assessed at 38 to 43 weeks gestational age. Infants born at term spent more than two-thirds of the time in either flexed or neutral trunk positions. No significant differences were found between infants born preterm and those born at term in total duration of flexion or extension or in flexion event duration. This study provides evidence that infants born preterm may not exhibit greater trunk extension tendencies in supine than infants born at term. Results should be interpreted with caution, however, because of the small sample size and large variability observed within the subject groups. Infants born at less than 30 weeks of gestation may demonstrate greater extension tendencies than those born at more than 30 weeks of gestation.

  3. Characteristics and Outcomes of Patients Readmitted to The Medical Intensive Care Unit: A Retrospective Study in a Tertiary Hospital in Taiwan

    Directory of Open Access Journals (Sweden)

    Ching-Lung Liu

    2017-12-01

    Conclusion: Readmitted ICU patients, especially the geriatric group, had a very poor prognosis. The worsened APACHE score might be a good predictor for readmission survival. The Charlson score was an important hospital survival predictor.

  4. Transcutaneous bilirubin nomogram for predicting neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants.

    Science.gov (United States)

    Yu, Zhang-Bin; Dong, Xiao-Yue; Han, Shu-Ping; Chen, Yu-Lin; Qiu, Yu-Fang; Sha, Li; Sun, Qing; Guo, Xi-Rong

    2011-02-01

    Identifying infants that will develop significant hyperbilirubinemia with the risk of kernicterus, and planning appropriate follow-up strategies, is particularly challenging. In this study, 36,921 transcutaneous bilirubin (TcB) measurements were obtained from 6,035 healthy neonates (gestational age ≥ 35 weeks and birth weight ≥ 2,000 g) between January 1 and December 31, 2009. All measurements were performed with the JM-103 bilirubinometer at designated times between 0 and 168 postnatal hours. TcB percentiles were calculated and used to develop an hour-specific nomogram. The rate of increase in TcB was higher during the first 72 h of age, after which levels declined to a plateau by 72-108 h of age. We constructed a TcB nomogram by using the 40th, 75th, and 95th percentile values of TcB for every 12 h of the studied interval. The 75th percentile curve of the nomogram may be an ideal cutoff point for intensive follow-up of the neonate for hyperbilirubinemia as it carries very high sensitivity (78.7%) and negative predictive value (98.5%). The specificity (45.7%) and positive predictive value (15.5%) decreased to reach their lowest levels at the 40th percentile. Of the neonates in the high-risk zone, 167 (48.8%) infants had persistent subsequent hyperbilirubinemia post-discharge, compared with 292 (27.0%) infants in the high-intermediate-risk zone at discharge. One-hundred and seventeen (5.5%) infants in the low-intermediate-risk zone moved into the high-risk zone during follow-up. No newborn infants in the low-risk zone became high-risk during follow-up. We provide an hour-specific TcB nomogram to predict neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants.

  5. Short-term, early intensive power mobility training: case report of an infant at risk for cerebral palsy.

    Science.gov (United States)

    Ragonesi, Christina B; Galloway, James Cole

    2012-01-01

    This case report describes the feasibility of quantifying short-term, intensive power mobility training for an infant soon after a diagnosis of cerebral palsy. An 11-month-old infant with significant mobility impairments and her parents were filmed during 14 consecutive daily training sessions. The infant moved the power chair with hand-over-hand assistance and performed open exploration of the joystick and toys. Mobility measures, coded from video, were compared across training. Frequency and combination of looking at and interacting with the joystick, percentage of time of moving independently, and average percentage of success in moving when prompted, all increased across the training. Quantifying short-term, intensive power mobility training for infants is feasible and may have yielded positive short-term effects for this infant. The "who," "when," and "how" of early power mobility training, as well as the critical need for paradigm shifts in power mobility training, are discussed.

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

    Science.gov (United States)

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

    2017-01-01

    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. 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). 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. 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.

  7. Intermediate-term results of the Ross procedure in neonates and infants.

    Science.gov (United States)

    Shinkawa, Takeshi; Bove, Edward L; Hirsch, Jennifer C; Devaney, Eric J; Ohye, Richard G

    2010-06-01

    Although good intermediate-term results for the Ross procedure in adults and older children have been reported, only short-term outcomes of this procedure in neonates and infants have been published. The objective of this study was to review our intermediate-term results of the Ross procedure for neonates and infants. The records of all 31 neonates and infants undergoing a Ross procedure between March 1993 and June 2008 were reviewed. Major study outcomes included patient survival, autograft function, and need for reoperation. The median age at the time of operation was 18 days, and median weight was 3.95 kg. Fifteen patients had aortic stenosis with or without insufficiency, 2 patients had isolated severe aortic insufficiency, and 14 patients had aortic stenosis with other left-side heart lesions, such as arch obstruction or mitral valve disease. Twenty-five patients required aortic annular enlargement (Ross-Konno procedure), and 14 required concomitant arch or mitral valve surgery. There were 5 early and 2 late deaths at a median follow-up of 6.0 years (range, 1.1 to 15.4 years). All early deaths were in patients requiring concomitant arch or mitral valve repair. Actuarial survival rate was 76.7% at 5, 10, and 15 years. There were 19 reinterventions, including 2 procedures on the autograft. Overall freedom from reoperation was 59.1% at 5 years and 50.6% at 10 years. Freedom from autograft reoperation was 95.2% at 5 and 10 years and 63.5% at 15 years. The Ross procedure for neonates and infants has good intermediate-term results with low mortality and acceptable rates of reintervention. The patients requiring concomitant arch or mitral valve surgery have higher initial operative risks although conditional survival remains good. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Inadvertent intramuscular administration of high dose bacillus Calmette Guerin vaccine in a pre-term infant

    Directory of Open Access Journals (Sweden)

    Asima Banu

    2013-01-01

    Full Text Available This case report examined the natural course of reaction after accidental intramuscular administration of high dose Bacille Calmette-Guιrin (BCG vaccine into the anterolateral aspect of thigh of a pre-term infant as a part of routine vaccination instead of intra-dermal injection into the arm. There is no consensus on the best management of this complication, although in this case healing was prolonged but was spontaneous without anti-tubercular chemotherapy.

  9. Postural adjustments in preterm infants at 4 and 6 months post-term during voluntary reaching in supine position

    NARCIS (Netherlands)

    Fallang, B; Saugstad, OD; Hadders-Algra, M

    2003-01-01

    Gradually it is getting clear that motor development - in particular balance control - in so-called "low-risk" preterm infants often differs from that in full-term infants. However, little is known on the etiology and pathophysiology of these problems. The aim of this study was to evaluate postural

  10. Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment.

    Science.gov (United States)

    Rothman, Adam L; Sevilla, Monica B; Mangalesh, Shwetha; Gustafson, Kathryn E; Edwards, Laura; Cotten, C Michael; Shimony, Joshua S; Pizoli, Carolyn E; El-Dairi, Mays A; Freedman, Sharon F; Toth, Cynthia A

    2015-12-01

    To assess retinal nerve fiber layer (RNFL) thickness at term-equivalent age in very preterm (compare very preterm infant RNFL thickness with brain anatomy and neurodevelopment. Cohort study. RNFL was semi-automatically segmented (1 eye per infant) in 57 very preterm and 50 term infants with adequate images from bedside portable, handheld spectral-domain optical coherence tomography imaging at 37-42 weeks postmenstrual age. Mean RNFL thickness was calculated for the papillomacular bundle (-15 degrees to +15 degrees) and temporal quadrant (-45 degrees to +45 degrees) relative to the fovea-optic nerve axis. Brain magnetic resonance imaging (MRI) scans clinically obtained in 26 very preterm infants were scored for global structural abnormalities by an expert masked to data except for age. Cognitive, language, and motor skills were assessed in 33 of the very preterm infants at 18-24 months corrected age. RNFL was thinner for very preterm vs term infants at the papillomacular bundle ([mean ± standard deviation] 61 ± 17 vs 72 ± 13 μm, P brain MRI lesion burden index (R(2) = 0.35, P = .001) and lower cognitive (R(2) = 0.18, P = .01) and motor (R(2) = 0.17, P = .02) scores. Relationships were similar for temporal quadrant. Thinner RNFL in very preterm infants relative to term-born infants may relate to brain structure and neurodevelopment. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Lidocaine response rate in aEEG-confirmed neonatal seizures : Retrospective study of 413 full-term and preterm infants

    NARCIS (Netherlands)

    Weeke, Lauren C.|info:eu-repo/dai/nl/413986446; Toet, Mona C.|info:eu-repo/dai/nl/28827024X; Van Rooij, Linda G M; Groenendaal, Floris|info:eu-repo/dai/nl/073282596; Boylan, Geraldine B.; Pressler, Ronit M.; Hellström-Westas, Lena; Van Den Broek, Marcel P H; De Vries, Linda S.|info:eu-repo/dai/nl/072995408

    2016-01-01

    OBJECTIVE: To investigate the seizure response rate to lidocaine in a large cohort of infants who received lidocaine as second- or third-line antiepileptic drug (AED) for neonatal seizures. METHODS: Full-term (n = 319) and preterm (n = 94) infants, who received lidocaine for neonatal seizures

  12. Long-chain polyunsaturated fatty acids and neurological developmental outcome at 18 months in healthy term infants

    NARCIS (Netherlands)

    Bouwstra, H; Dijck-Brouwer, DAJ; Boehm, G; Boersma, ER; Muskiet, FAJ; Hadders-Algra, M

    Aim: Previously, we found a beneficial effect of 2 mo supplementation of infant formula with long-chain polyunsaturated fatty acids (LC-PUFA) on neurological condition at 3 mo in healthy term infants. The aim of the present follow-up study was to evaluate whether the effect on neurological condition

  13. The Structure of Memory in Infants and Toddlers: An SEM Study with Full-Terms and Preterms

    Science.gov (United States)

    Rose, Susan A.; Feldman, Judith F.; Jankowski, Jeffery J.; Van Rossem, Ronan

    2011-01-01

    There is considerable dispute about the nature of infant memory. Using SEM models, we examined whether popular characterizations of the structure of adult memory, including the two-process theory of recognition, are applicable in the infant and toddler years. The participants were a cohort of preterms and full-terms assessed longitudinally--at 1,…

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

    NARCIS (Netherlands)

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

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

  15. Olive oil enema in a pre-term infant with milk curd syndrome.

    Science.gov (United States)

    Watanabe, Toshihiko; Takahashi, Masataka; Amari, Shoichiro; Ohno, Michinobu; Sato, Kaori; Tanaka, Hideaki; Miyasaka, Mikiko; Fuchimoto, Yasushi; Ito, Yushi; Kanamori, Yutaka

    2013-08-01

    Milk curd syndrome was first reported in the 1960s, but was gradually forgotten because of its low incidence thereafter. This condition in pre-term infants has been reported over the last decade and has again attracted neonatologists' attention. The present report describes a pre-term infant with milk curd syndrome. Abdominal distension was evident 14 days after the start of feeding with fortified expressed milk. Abdominal X-ray showed multiple intraluminal masses surrounded by a halo of air, and ultrasound indicated hyperechoic masses. Along with that history and the appearance of fecal impaction, the diagnosis of milk curd syndrome was confirmed. This baby was treated with olive oil enemas and successive colonic lavage for 3 days, and the symptoms were relieved. Olive oil enema, which softens hard stools and induces smooth movement of these stools, may be an effective and safe first-line treatment in pre-term infants with milk curd syndrome. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  16. 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; affect) and physiological (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

  17. Prone sleeping impairs circulatory control during sleep in healthy term infants: implications for SIDS.

    Science.gov (United States)

    Yiallourou, Stephanie R; Walker, Adrian M; Horne, Rosemary S C

    2008-08-01

    To determine the effects of sleeping position on development of circulatory control in infants over the first 6 months of postnatal age (PNA). Effects of sleeping position, sleep state and PNA on beat-beat heart rate (HR) and mean arterial pressure (MAP) responses to a head-up tilt (HUT) were assessed during sleep in infants at 2-4 wks, 2-3 mo and 5-6 mo PNA. Daytime polysomnography was performed on 20 full-term infants (12 F/8 M) and MAP was recorded continuously and noninvasively (Finometer). HUTs of 15 degrees were performed during active sleep (AS) and quiet sleep (QS) in both the prone and supine sleeping positions. MAP and HR data were expressed as the percentage change from baseline, and responses were divided into initial, middle and late phases. In the supine position HUT usually resulted in an initial increase (P sleeping throughout the HUT. Prone sleeping alters MAP responses to a HUT during QS at 2-3 mo PNA. Decreased autonomic responsiveness may contribute to the increased risk for SIDS of infants sleeping in the prone position.

  18. The relationship of human milk leptin and macronutrients with gastric emptying in term breastfed infants.

    Science.gov (United States)

    Cannon, Anna M; Gridneva, Zoya; Hepworth, Anna R; Lai, Ching T; Tie, Wan J; Khan, Sadaf; Hartmann, Peter E; Geddes, Donna T

    2017-07-01

    BackgroundInfants breastfed on demand exhibit a variety of feeding patterns and self-regulate their nutrient intake, but factors influencing their gastric emptying (GE) are poorly understood. Despite research into appetite regulation properties of leptin, there is limited information about relationships between human milk leptin and infant GE.MethodsGastric volumes were calculated from ultrasound scans of infants' stomachs (n=20) taken before and after breastfeeding, and then every 12.5 min (median; range: 3-45 min) until the next feed. Skim milk leptin and macronutrient concentrations were measured and doses were calculated.ResultsThe leptin concentration was (mean±SD) 0.51±0.16 ng/ml; the leptin dose was 45.5±20.5 ng per feed. No relationships between both concentration and dose of leptin and time between the feeds (P=0.57; P=1, respectively) or residual stomach volumes before the subsequent feed (P=0.20; P=0.050) were found. Post-feed stomach volumes (GE rate) were not associated with leptin concentration (P=0.77) or dose (P=0.85).ConclusionGE in term breastfed infants was not associated with either skim milk leptin concentration or dose. Further investigation with inclusion of whole-milk leptin and other hormones that affect gastrointestinal activity is warranted.

  19. High-density diffuse optical tomography of term infant visual cortex in the nursery

    Science.gov (United States)

    Liao, Steve M.; Ferradal, Silvina L.; White, Brian R.; Gregg, Nicholas; Inder, Terrie E.; Culver, Joseph P.

    2012-08-01

    Advancements in antenatal and neonatal medicine over the last few decades have led to significant improvement in the survival rates of sick newborn infants. However, this improvement in survival has not been matched by a reduction in neurodevelopmental morbidities with increasing recognition of the diverse cognitive and behavioral challenges that preterm infants face in childhood. Conventional neuroimaging modalities, such as cranial ultrasound and magnetic resonance imaging, provide an important definition of neuroanatomy with recognition of brain injury. However, they fail to define the functional integrity of the immature brain, particularly during this critical developmental period. Diffuse optical tomography methods have established success in imaging adult brain function; however, few studies exist to demonstrate their feasibility in the neonatal population. We demonstrate the feasibility of using recently developed high-density diffuse optical tomography (HD-DOT) to map functional activation of the visual cortex in healthy term-born infants. The functional images show high contrast-to-noise ratio obtained in seven neonates. These results illustrate the potential for HD-DOT and provide a foundation for investigations of brain function in more vulnerable newborns, such as preterm infants.

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

    Directory of Open Access Journals (Sweden)

    Tripathi T

    2015-11-01

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

  1. A first step towards a consensus static in vitro model for simulating full-term infant digestion.

    Science.gov (United States)

    Ménard, O; Bourlieu, C; De Oliveira, S C; Dellarosa, N; Laghi, L; Carrière, F; Capozzi, F; Dupont, D; Deglaire, A

    2018-02-01

    In vitro alternatives to clinical trials are used for studying human food digestion. For simulating infant digestion, only a few models, lacking physiological relevance, are available. Thanks to an extensive literature review of the in vivo infant digestive conditions, a gastrointestinal static in vitro model was developed for infants born at term and aged 28days. The model was applied to the digestion of a commercial infant formula. Kinetics of digestion, as well as the structural evolution, were compared with those obtained while submitting the same formula to the adult international consensus protocol of in vitro static digestion. The kinetics of proteolysis and lipolysis differed according to the physiological stage resulting mainly from the reduced level of enzymes and bile salts, as well as the higher gastric pH in the infant model. This in vitro static model of infant digestion is of interest for scientists, food or pharmaceutical manufacturers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. [Fatty acid composition of human milk from mothers of preterm and full-term infants].

    Science.gov (United States)

    Marín, María C; Sanjurjo, Adriana L; Sager, Gustavo; Margheritis, César; de Alaniz, María J T

    2009-08-01

    Human milk is an essential food for newborns and affects life in the long or short terms. Its composition is modified by nutritional status and maternal diet as well as by gestational age of the newborn. It provides human milk-fed infants with the medium-chain fatty acids which are a source of energy, and essential fatty acids and their metabolic derivatives which have been involved in the neural maturation. Due to the fact that there is little local data concerning the fatty acid composition in human milk of pre-term and full-term newborns, the present study was carried out in women living in the urban area of the Buenos Aires Province. Samples were provided by the Bank of Human Milk, H.I.G.A. San Martín Hospital. They corresponded to mothers who had delivered preterm infants (28-36 weeks of gestational age) or full-term infants (37-42 weeks of gestational ages). Total lipids were extracted, and the fatty acid composition was determined by gas-liquid chromatography. Results showed increases in saturated fatty acids up to 14 carbon atoms and in polyunsaturated fatty acids in mothers of preterm newborns compared with those of full-term newborns. It can be concluded that gestational age affects human milk fatty acid composition. This food is essential for pre-term newborns as it is the source of energetic compounds (saturated fatty acids) as well as plastic compounds, (polyunsaturated fatty acids) which are essential for the synthesis of structural lipids and neural development.

  3. Neonatal Pain in Very Preterm Infants: Long-Term Effects on Brain, Neurodevelopment and Pain Reactivity

    Directory of Open Access Journals (Sweden)

    Ruth Eckstein Grunau

    2013-10-01

    Full Text Available Effects of early life psychosocial adversity have received a great deal of attention, such as maternal separation in experimental animal models and abuse/neglect in young humans. More recently, long-term effects of the physical stress of repetitive procedural pain have begun to be addressed in infants hospitalized in neonatal intensive care. Preterm infants are more sensitive to pain and stress, which cannot be distinguished in neonates. The focus of this review is clinical studies of long-term effects of repeated procedural pain-related stress in the neonatal intensive care unit (NICU in relation to brain development, neurodevelopment, programming of stress systems, and later pain sensitivity in infants born very preterm (24–32 weeks’ gestational age. Neonatal pain exposure has been quantified as the number of invasive and/or skin-breaking procedures during hospitalization in the NICU. Emerging studies provide convincing clinical evidence for an adverse impact of neonatal pain/stress in infants at a time of physiological immaturity, rapidly developing brain microstructure and networks, as well as programming of the hypothalamic-pituitary-adrenal axis. Currently it appears that early pain/stress may influence the developing brain and thereby neurodevelopment and stress-sensitive behaviors, particularly in the most immature neonates. However, there is no evidence for greater prevalence of pain syndromes compared to children and adults born healthy at full term. In addressing associations between pain/stress and outcomes, careful consideration of confounding clinical factors related to prematurity is essential. The need for pain management for humanitarian care is widely advocated. Non-pharmacological interventions to help parents reduce their infant’s stress may be brain-protective.

  4. Respiratory variability in preterm and term infants: Effect of sleep state, position and age.

    Science.gov (United States)

    Elder, Dawn E; Campbell, Angela J; Larsen, Peter D; Galletly, Duncan

    2011-02-15

    The influence of sleep state and position on respiratory variability (RV) was studied in 13 preterm infants (PTIs) and 19 term infants (TIs). Temporally matched epochs of nasal pressure and oxygen saturation (Spo₂) data were extracted from nap polysomnography. Inspiratory onset times (I) were determined, and variability measures of the I-I interval compared in quiet sleep and active sleep, prone and supine and with age. Sleep state influenced respiratory variability (RV) in PTI and TI but Spo₂ only varied with sleep state in PTI (p=0.03). Position had no effect on RV in TI but influenced the standard deviation of ventilatory frequency (SDf) in PTI (p=0.04). Age did not influence RV in PTI but SDf and the coefficient of variation of ventilatory frequency (CVf) decreased in TI from birth to 3 months. These data confirm sleep state as the predominant influence on RV in healthy term and convalescent preterm infants, with horizontal prone positioning having little effect when sleep state is controlled for. Copyright © 2010 Elsevier B.V. All rights reserved.

  5. Radiologic differences in white matter maturation between preterm and full-term infants: TBSS study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ah Young; Jang, Sung Ho; Ahn, Sang Ho; Cho, Hee Kyung; Jo, Hae Min; Son, Su Min [Yeungnam University, Department of Physical Medicine and Rehabilitation, College of Medicine, Taegu (Korea, Republic of); Lee, Eunsil [Yeungnam University, Department of Pediatrics, College of Medicine, Taegu (Korea, Republic of)

    2013-03-15

    Widespread white matter (WM) pathology in preterm children has been proposed. The purpose of this study was to investigate maturational differences of WM between preterm infants with thinning of the corpus callosum and full-term infants. A total of 18 preterm children and 18 full-term children were divided into three subgroups according to the corrected age at the time of diffusion tensor imaging scanning. Tract-based spatial statistics was used for assessing differences in fractional anisotropy (FA) between preterm and full-term children, and between each age-related subgroup in preterm and in full-term children. In the preterm group, FA values of overall WM showed an increase with age. This trend indicates that WM maturation is a gradual occurrence during a child's first 2 years. In the full-term group, most WM structures had reached maturation at around 1 year of age; however, centrum semiovale level showed sustained maturation during the first 2 years. Results of our study demonstrate radiologic maturational differences of WM and provide evidence of the need for therapeutic intervention within 2 years of birth to prevent specific functional impairment and to improve clinical outcome in preterm children. (orig.)

  6. Leptin determination in colostrum and early human milk from mothers of preterm and term infants.

    Science.gov (United States)

    Eilers, Elisabeth; Ziska, Thomas; Harder, Thomas; Plagemann, Andreas; Obladen, Michael; Loui, Andrea

    2011-06-01

    Leptin is involved in the regulation of food intake and energy expenditure and is therefore important for growth and brain development. Analytical methods used for leptin measurement in human milk differ widely in the literature and yield varying results. To compare different preparation methods for the analysis of leptin in human milk and to investigate the leptin levels in colostrum and mature human milk from mothers of preterm or term infants. Mothers delivering a preterm (n=37) or a term infant (n=40) were recruited for a prospective study and were ask to collect breast milk on the 3rd and 28th day of lactation. Leptin, protein and fat concentrations were analysed. Clinical data of mother and child were recorded prospectively. Skim milk was most appropriate for leptin analysis. Human milk leptin concentrations did not differ between preterm and term human milk. In term milk, leptin concentration on day 28 was lower than on day 3 (pMilk leptin levels on the 3rd and 28th day were positively correlated with mothers' body mass index, but not with fat content in milk. Skim milk was the most stabile preparation for leptin analysis. Preterm and term human milk contain leptin in equal concentrations. Human milk leptin depends on mothers' body mass index. Copyright © 2011. Published by Elsevier Ireland Ltd.

  7. Decreased arousals among healthy infants after short-term sleep deprivation.

    Science.gov (United States)

    Franco, Patricia; Seret, Nicole; Van Hees, Jean Noël; Scaillet, Sonia; Vermeulen, Françoise; Groswasser, José; Kahn, André

    2004-08-01

    arousal. After the induced arousal, the infants were allowed to return to sleep to complete their naps. Sleep deprivation lasted a median of 120 minutes (range: 90-272 min). Most sleep characteristics were similar for the normal and sleep-deprived conditions, including sleep efficiency, time awake, percentages of REM sleep and non-REM sleep, frequency and duration of central apnea and of periodic breathing, duration of obstructive apnea, mean heart rate and variability, and mean breathing rates during REM sleep and non-REM sleep. After sleep deprivation, the duration of the naps increased, whereas there were decreases in the latency of REM sleep and in the density of body movements. More-intense auditory stimuli were needed for arousal when the infants were sleep-deprived, compared with normal nap sleep. Sleep deprivation was associated with a significant increase in the frequency of obstructive sleep apnea episodes, especially during REM sleep. No significant differences were noted when the effects of morning and afternoon sleep deprivation were compared. No correlation was found between the duration of sleep deprivation and either the frequency of obstructive apnea or the changes in arousal thresholds, although the infants who were more sleep-deprived exhibited tendencies toward higher auditory arousal thresholds and shorter REM sleep latencies, compared with less sleep-deprived infants. There were tendencies for a negative correlation between the auditory arousal thresholds and REM sleep latencies and for a positive correlation between the auditory arousal thresholds and the frequencies of obstructive apnea during REM sleep. Short-term sleep deprivation among infants is associated with the development of obstructive sleep apnea and significant increases in arousal thresholds. As already reported, sleep deprivation may induce effects on respiratory control mechanisms, leading to impairment of ventilatory and arousal responses to chemical stimulation and decreases in

  8. Health care utilization in the first year of life among small- and large- for-gestational age term infants.

    Science.gov (United States)

    Dietz, Patricia M; Rizzo, Joanne H; England, Lucinda J; Callaghan, William M; Vesco, Kimberly K; Bruce, F Carol; Bulkley, Joanna E; Sharma, Andrea J; Hornbrook, Mark C

    2013-08-01

    The objective of the study was to assess if small- and large-for gestational age term infants have greater health care utilization during the first year of life. The sample included 28,215 singleton term infants (37-42 weeks) without major birth defects delivered from 1998 through 2007 and continuously enrolled at Kaiser Permanente Northwest for 12 months after delivery. Birth weight for gestational age was categorized into 3 levels: 90th percentile (LGA). Length of delivery hospitalization, re-hospitalizations and sick/emergency room visits were obtained from electronic records. Logistic regression models estimated associations between birth weight category and re-hospitalization. Generalized linear models estimated adjusted mean number of sick/emergency visits. Among term infants, 6.2 % were SGA and 13.9 % were LGA. Of infants born by cesarean section, SGA infants had 2.7 higher odds [95 % 1.9, 3.8] than AGA infants of staying ≥5 nights during the delivery hospitalization; of those born vaginally, SGA infants had 1.5 higher adjusted odds [95 % 1.1, 2.1] of staying ≥4 nights. LGA compared to AGA infants had higher odds of re-hospitalization within 2 weeks of delivery [OR 1.25, 95 % CI 0.99, 1.58] and of a length of stay ≥4 days during that hospitalization [OR 2.6, 95 % CI 1.3, 5.0]. The adjusted mean number of sick/emergency room visits was slightly higher in SGA (7.8) than AGA (7.5) infants (P < .05). Term infants born SGA or LGA had greater health care utilization than their counterparts, although the increase in utilization beyond the initial delivery hospitalization was small.

  9. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study

    DEFF Research Database (Denmark)

    Hansen, Anne Kirkeby; Wisborg, Kirsten; Uldbjerg, Niels

    2007-01-01

    of the newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn) and serious respiratory morbidity (oxygen therapy for more than two days, nasal continuous positive airway pressure, or need for mechanical ventilation). RESULTS: 2687 infants were delivered by elective caesarean...... section. Compared with newborns intended for vaginal delivery, an increased risk of respiratory morbidity was found for infants delivered by elective caesarean section at 37 weeks' gestation (odds ratio 3.9, 95% confidence interval 2.4 to 6.5), 38 weeks' gestation (3.0, 2.1 to 4.3), and 39 weeks......-eclampsia, and intrauterine growth retardation, or by breech presentation. CONCLUSION: Compared with newborns delivered vaginally or by emergency caesarean sections, those delivered by elective caesarean section around term have an increased risk of overall and serious respiratory morbidity. The relative risk increased...

  10. A systematic review of controlled trials of lower-protein or energy-containing infant formulas for use by healthy full-term infants.

    Science.gov (United States)

    Abrams, Steven A; Hawthorne, Keli M; Pammi, Mohan

    2015-03-01

    Infant formulas have historically been developed based on providing macronutrients at intake concentrations approximately matching the composition of human milk. In most countries, targets of 1.4-1.5 g of protein/dL and 20 kcal/oz (67-68 kcal/dL) have been set as the protein and energy concentrations for formulas during the first year of life, although this may be an overestimation of these contents. Recent introduction of lower-protein and -energy formulas in full-term infants led us to systematically review the literature for its effects on growth. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, our inclusion criteria were studies that enrolled healthy full-term infants and evaluated lower-protein or lower-energy formula, reported anthropometric outcomes including weight and length, and followed infants for at least 6 mo. Six studies were eligible for inclusion. These studies varied in the content of nutrients provided in the intervention and control groups, by additional dietary components in the study groups, and the timing and length of the intervention, which limit their usefulness for interpreting newly introduced lower-protein and -energy formulas in the United States. These studies suggest adequate growth during infancy and early childhood with infant formulas with concentrations of protein and energy slightly below historical standards in the United States. Further long-term research is needed to assess the impact of the use of lower-protein and/or lower-energy products, especially for nutritionally at-risk populations such as preterm infants and infants who are born small for gestational age. © 2015 American Society for Nutrition.

  11. Impact on parents of bronchiolitis hospitalization of full-term, preterm and congenital heart disease infants

    Directory of Open Access Journals (Sweden)

    Lapillonne Alexandre

    2012-10-01

    Full Text Available Abstract Background The objective of this work was to explore the impact on parents of the bronchiolitis hospitalization of their infant using the Impact of Bronchiolitis Hospitalization Questionnaire (IBHQ©. Methods Four hundred sixty-three infants aged less than 1 year and hospitalized for bronchiolitis were included in a French observational study during the 2008–2009 season. Parents were asked to complete the IBHQ at hospital discharge and 3 months later. IBHQ scores, ranging from 0 (no impact to 100 (highest impact, were compared according to gestational age (full-term, 33–36 wGA, ≤ 32 wGA and the presence of congenital heart disease (CHD. The potential drivers of impact were explored using multivariate linear regressions. Results The study included 332 full-terms, 71 infants born at 33–36 wGA, and 60 at ≤ 32 wGA; 28 infants had a CHD. At hospital discharge, 9 of the 12 IBHQ mean scores were above 40, indicating a marked impact on parents. Three months later, all mean scores were lower but 5 were still greater than 40. At discharge, the length of hospitalization had a significant effect on IBHQ worries and distress, fear for future, guilt and impact on daily organization scores (p Conclusions Bronchiolitis hospitalization has conspicuous emotional, physical and organizational consequences on parents and siblings, which persist 3 months after hospital discharge. The main drivers of the impact were length of hospital stay and parents’ educational level, while infants’ gestational age or the presence of a CHD had little influence.

  12. Impact on parents of bronchiolitis hospitalization of full-term, preterm and congenital heart disease infants

    Science.gov (United States)

    2012-01-01

    Background The objective of this work was to explore the impact on parents of the bronchiolitis hospitalization of their infant using the Impact of Bronchiolitis Hospitalization Questionnaire (IBHQ©). Methods Four hundred sixty-three infants aged less than 1 year and hospitalized for bronchiolitis were included in a French observational study during the 2008–2009 season. Parents were asked to complete the IBHQ at hospital discharge and 3 months later. IBHQ scores, ranging from 0 (no impact) to 100 (highest impact), were compared according to gestational age (full-term, 33–36 wGA, ≤ 32 wGA) and the presence of congenital heart disease (CHD). The potential drivers of impact were explored using multivariate linear regressions. Results The study included 332 full-terms, 71 infants born at 33–36 wGA, and 60 at ≤ 32 wGA; 28 infants had a CHD. At hospital discharge, 9 of the 12 IBHQ mean scores were above 40, indicating a marked impact on parents. Three months later, all mean scores were lower but 5 were still greater than 40. At discharge, the length of hospitalization had a significant effect on IBHQ worries and distress, fear for future, guilt and impact on daily organization scores (pinfants was for the physical impact score at discharge (p=0.004). Conclusions Bronchiolitis hospitalization has conspicuous emotional, physical and organizational consequences on parents and siblings, which persist 3 months after hospital discharge. The main drivers of the impact were length of hospital stay and parents’ educational level, while infants’ gestational age or the presence of a CHD had little influence. PMID:23114197

  13. Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants.

    Science.gov (United States)

    Bai, Dorothy Li; Fong, Daniel Yee Tak; Lok, Kris Yuet Wan; Wong, Janet Yuen Ha; Tarrant, Marie

    2017-02-01

    To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. A total of 2450 mother-infant pairs were recruited in 2006-2007 and 2011-2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped. Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006-2007 and from 18·0 to 19·8 % in 2011-2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months. Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers' reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.

  14. Radionuclide scintigraphy in the evaluation of gastroesophageal reflux in symptomatic and asymptomatic pre-term infants

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    Morigeri, C.; Mukhopadhyay, K.; Narang, A. [Postgraduate Institute of Medical Education and Research (PGIMER), Division of Neonatology, Department of Paediatrics, Chandigarh (India); Bhattacharya, A.; Mittal, B.R. [Postgraduate Institute of Medical Education and Research (PGIMER), Department of Nuclear Medicine, Chandigarh (India)

    2008-09-15

    Gastroesophageal reflux (GER) is very common in pre-term infants. The diagnosis based on symptoms is always questionable. The incidence of GER in symptomatic babies varies from 22% to 85%, but literature regarding the incidence of reflux in asymptomatic pre-term infants is lacking. We used radionuclide scintigraphy to evaluate the incidence of GER in symptomatic as well as asymptomatic pre-term neonates and to assess whether symptoms have any relation with positive scintigraphy. We studied 106 pre-term infants (52 symptomatic, 54 asymptomatic) of less than 34 weeks of gestation, who fulfilled the eligibility criteria. Babies were considered symptomatic in the presence of vomiting, regurgitation, apnea, de-saturations, unexplained bradycardia and recurrent lung collapses. Radionuclide scintigraphy was conducted at post-conceptional age of 32-34 weeks when they were clinically stable for 72 h. Feeding was avoided for 2 h preceding the study. {sup 99m}Tc sulphur colloid was administered in a dose of 1.85 MBq (0.05 mCi) in 1 ml, followed by milk (full feed) through an orogastric tube, prior to imaging under a gamma camera. Reflux was graded as low or high, and reflux episodes during the study were counted. The incidence of GER in the symptomatic group was 71.2% and in asymptomatic babies 61.1% (p=0.275). High-grade reflux was more common (71.4%) than low-grade (28.6%) in both groups (p=0.449). Mean number of reflux episodes in 20 min was 4.4{+-}2.4 in symptomatic babies and 4.9 {+-}2.2 in asymptomatic babies (p=0.321). Babies with positive scintigraphy were similar in birth weight, gestation, time to achieve full feeds, weight and age at discharge to those with negative scintigraphy. GER is common in pre-term infants of less than 34 weeks gestation. The incidence of positive scintigraphy and grade of reflux is not significantly different in symptomatic vs. asymptomatic babies. Though radionuclide scintigraphy is a simple, quick and non-invasive investigation in

  15. Associations between respiratory arrhythmia and fundamental frequency of spontaneous crying in preterm and term infants at term‐equivalent age

    Science.gov (United States)

    Shinya, Yuta; Kawai, Masahiko; Niwa, Fusako

    2016-01-01

    ABSTRACT This study investigated whether lower vagal function in preterm infants is associated with increased fundamental frequency (F 0; frequency of vocal fold vibration) of their spontaneous cries. We assessed respiratory sinus arrhythmia (RSA) during quiet sleep as a measure of vagal function, and its relationship with the F 0 of spontaneous cries in healthy preterm and term infants at term‐equivalent age. The results showed that preterm infants have significantly lower RSA, and higher overall F 0 than term infants. Moreover, lower RSA was associated with higher overall F 0 in preterm infants, whereas higher RSA was positively associated with mean and maximum F 0, and a larger F 0 range in term infants. These results suggest that individual differences in vagal function may be associated with the F 0 of spontaneous cries via modulation of vocal fold tension in infants at an early developmental stage. © 2016 The Authors. Developmental Psychobiology Published by Wiley Periodicals, Inc. Dev Psychobiol 58:724–733, 2016. PMID:27037599

  16. Neurodevelopmental outcomes in preterm infants: comparison of infants with and without diffuse excessive high signal intensity on MR images at near-term-equivalent age.

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    Jeon, Tae Yeon; Kim, Ji Hye; Yoo, So-Young; Eo, Hong; Kwon, Jeong-Yi; Lee, Jeehun; Lee, Munhyang; Chang, Yun Sil; Park, Won Soon

    2012-05-01

    To compare the neurodevelopmental outcomes between preterm infants with diffuse excessive high signal intensity (DEHSI) and those without DEHSI on magnetic resonance (MR) images, in association with other white matter lesions. This retrospective study was approved by the institutional review board, and requirement to obtain informed consent was waived. High-risk preterm infants (n = 126) who underwent screening brain MR imaging at near-term-equivalent age were classified into two groups according to the presence of DEHSI. Bayley Scales of Infant Development-II, presence of cerebral palsy, and neurosensory impairment between 18 and 24 months of age were compared between the two groups. The associations of MR findings of other white matter lesions (cystic encephalomalacia, punctate lesions, loss of volume, ventricular dilatation, and delayed myelination) and subsequent outcomes were also analyzed. Outcome data were evaluated by using exact logistic regression analyses and Fisher exact test. DEHSI was present in 75% (95 of 126) of infants. Subsequent neurodevelopmental outcomes did not differ significantly between the two groups. Severe motor delay and cerebral palsy were more common in infants with both DEHSI and other white matter lesions as compared with infants with normal white matter (P = .001 and P cystic encephalomalacia (odds ratio, 19.6; 95% confidence interval: 1.3, 333.3) and punctate lesions (odds ratio, 90.9; 95% confidence interval: 6.4, 1000) were significant predictors of cerebral palsy. Although the incidence of DEHSI was high (75%) in preterm infants at near-term-equivalent age MR imaging, DEHSI was not predictive of following adverse outcomes. Cystic encephalomalacia and punctate lesions were more significant predictors of cerebral palsy.

  17. Posture and movement in very preterm infants at term age in and outside the nest.

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    Zahed, M; Berbis, J; Brevaut-Malaty, V; Busuttil, M; Tosello, B; Gire, C

    2015-12-01

    The objective of this study is to evaluate the use of nests on general movements (GM) and posture in very preterm infants at term age. Seventeen high-risk preterm infants-less than 30 weeks of gestation (GA)-underwent a video recording, lying in supine position, with or without nest. Posture, GM quality, and movements made around the child's midline, as well as abrupt movements and frozen postures-in extension or flexion of the four limbs-were analyzed. Nest did not modify quality of GM. Children significantly adopted a curled-up position. The nest system was associated with an increase in movements toward or across the midline, as well as reduction of the hyperextension posture and head rotation movements. Frozen postures in flexion or extension, as well as abrupt movements of the four limbs, were reduced but not significantly. Nest helps very preterm infants to adopt semi-flexed posture and facilitates movements across the midline and reduces movements of spine hyperextension, without GM global quality modifications.

  18. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 3: Discussion and Conclusion

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    Ehmer Ulrike

    2005-11-01

    Full Text Available Abstract Background It has been hypothesized that prematurity and adjunctive neonatal care is 'a priori' a risk for disturbances of palatal and orofacial development which increases the need for later orthodontic or orthognathic treatment. As results on late consequences of prematurity are consistently contradictory, the necessity exists for a fundamental analysis of existing methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. Method A search of the literature was conducted based on Cochrane search strategies including sources in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered in tables for comparison (Parts 1 and 2. Results Morphology assessment of the infant palate is subject to non-standardized visual and metrical measurements. Most methodologies are inadequate for measuring a three-dimensional shape. Several confounding factors were identified as causes contributing to disturbances of palatal and orofacial development. Conclusion Taking into account the abovementioned shortcomings, the following conclusions may be drawn for practitioners and prospective investigators of clinical studies. 1 The lack of uniformity in the anatomical nomenclature of the infant's palate underlines the need for a uniform definition. 2 Metrically, non-intubated preterm infants do not exhibit different palatal width or height compared to matched term infants up to the corrected age of three months. Beyond that age, no data on the subject are currently available. 3 Oral intubation does not invariably alter palatal morphology of preterm and low birthweight infants. 4 The findings on palatal grooving, height, and asymmetry as a consequence of orotracheal intubation up to the age of 11 years are inconsistent. 5 Metrically

  19. Short-term outcomes of mothers and infants exposed to antenatal amphetamines.

    Science.gov (United States)

    Oei, J; Abdel-Latif, M E; Clark, R; Craig, F; Lui, K

    2010-01-01

    To determine the short-term outcomes of newborn infants and mothers exposed to antenatal amphetamines in the state of New South Wales and the Australian Capital Territory during 2004. Amphetamine exposure was determined retrospectively using ICD-10 AM morbidity code searches of hospital medical records and from records of local drug and alcohol services. Records were reviewed on site. All public hospitals (n = 101) with obstetric services were included. Amphetamines were used by 200 (22.9%) of the 871 identified drug-using mothers. Most women (182, 91%) injected amphetamines intravenously. Compared with the other 669 drug users, amphetamine-using mothers were significantly more likely to use multiple classes of drugs (45.0% vs 7.8%), be subject to domestic violence (32.1% vs 17.5%), be homeless (14.8% vs 4.9%) and be involved with correctional services (19.8% vs 9.7%). The incidence of comorbid psychiatric illnesses were significantly higher (57.4% vs 41.7%) and their infants were more likely to be preterm (29.5% vs 20.4%), notified as children at risk (67.0% vs 32.8%), fostered before hospital discharge (14.5% vs 5.5%) and less likely to be breastfed (27.0% vs 41.6%). Amphetamine-exposed mothers and infants in public hospitals of NSW and the ACT are at significantly higher risk of adverse social and perinatal outcomes even when compared with mothers and infants exposed to other drugs of dependency. Increased vigilance for amphetamine exposure is recommended due to a high prevalence of use, especially in Australia, as a recreational drug.

  20. Inhaled Nitric Oxide Therapy for Pulmonary Disorders of the Term and Preterm Infant

    Science.gov (United States)

    Sokol, Gregory M.; Konduri, G. Ganesh; Van Meurs, Krisa P.

    2016-01-01

    The 21st century began with the FDA approval of inhaled nitric oxide therapy for the treatment of neonatal hypoxic respiratory failure associated with pulmonary hypertension in recognition of the two randomized clinical trials demostrating a significant reduction in the need for extracorporeal support in the term and near-term infant. Inhaled nitric oxide is one of only a few therapeutic agents approved for use through clinical investigations primarily in the neonate. This article provides an overview of the pertinent biology and chemistry of nitric oxide, discusses potential toxicities, and reviews the results of pertinent clinical investigations and large randomized clinical trials including neurodevelopmental follow-up in term and preterm neonates. The clinical investigations conducted by the Eunice Kennedy Shriver NICHD Neonatal Research Network will be discussed and placed in context with other pertinent clinical investigations exploring the efficacy of inhaled nitric oxide therapy in neonatal hypoxic respiratory failure. PMID:27480246

  1. Fatty acid composition in breast milk and serum phospholipids of healthy term Chinese infants during first 6 weeks of life.

    Science.gov (United States)

    Peng, Y M; Zhang, T Y; Wang, Q; Zetterström, R; Strandvik, B

    2007-11-01

    To compare the fatty acid (FA) pattern in early and mature breast milk with that in plasma phospholipids of cord blood and breast-fed infants. Forty-five mother-infant pairs from western Shanghai were studied. All infants, born at term with normal weight and length, were examined at birth and days 5 and 42. FA was analyzed by capillary gas-liquid chromatography. Cord blood showed higher concentration of long-chain polyunsaturated FA (LCPUFA) but lower saturated (SFA) and monounsaturated (MUFA) FA than postnatal infants' plasma. SFA decreased with age in the infants, but MUFA and linoleic acid (LA, 18:2omega6) increased. LCPUFA were lower in the plasma of 5-day-old infants than in cord blood, but LA was 80%, alpha-linolenic acid (ALA, 18:3omega3) 33% and the ratio omega-6/omega-3 42% higher. At day 42, LA increased further, LCPUFA remained similar, and was in breast milk lower than at day 5, while ALA and gamma-linolenic acid (18:3omega6) were higher. The activity index of desaturases indicated high Delta9 activity in breast milk and high activity of Delta5 desaturase in the infants. Breast milk FA composition changed markedly from day 5 to 42 with increasing correlation to infants' plasma. Calculation of desaturase activities suggested high capacity of LCPUFA synthesis.

  2. Infants with complex congenital heart diseases show poor short-term memory in the mobile paradigm at 3 months of age.

    Science.gov (United States)

    Chen, Chao-Ying; Harrison, Tondi; Heathcock, Jill

    2015-08-01

    The purpose of this study was to examine learning, short-term memory and general development including cognitive, motor, and language domains in infants with Complex Congenital Heart Defects (CCDH). Ten infants with CCHD (4 males, 6 females) and 14 infants with typical development (TD) were examined at 3 months of age. The mobile paradigm, where an infant's leg is tethered to an overhead mobile, was used to evaluate learning and short-term memory. The Bayley Scales of Infant Development 3rd edition (Bayley-III) was used to evaluate general development in cognitive, motor, and language domains. Infants with CCHD and infants with TD both showed learning with significant increase in kicking rate (pparadigm, but only infants with TD demonstrated short-term memory (p=0.017) in the mobile paradigm. There were no differences on cognitive, motor, and language development between infants with CCHD and infants with TD on the Bayley-III. Early assessment is necessary to guide targeted treatment in infants with CCHD. One-time assessment may fail to detect potential cognitive impairments during early infancy in infants with CCHD. Supportive intervention programs for infants with CCHD that focuses on enhancing short-term memory are recommended. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Ambient Air Pollution and Birth Weight in Full-Term Infants in Atlanta, 1994–2004

    Science.gov (United States)

    Darrow, Lyndsey A.; Klein, Mitchel; Strickland, Matthew J.; Mulholland, James A.; Tolbert, Paige E.

    2011-01-01

    Background An emerging body of evidence suggests that ambient levels of air pollution during pregnancy are associated with fetal growth. Objectives We examined relationships between birth weight and temporal variation in ambient levels of carbon monoxide, nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone, particulate matter ≤ 10 μm in diameter (PM10), ≤ 2.5 μm (PM2.5), 2.5 to 10 μm (PM2.5–10), and PM2.5 chemical component measurements for 406,627 full-term births occurring between 1994 and 2004 in five central counties of metropolitan Atlanta. Methods We assessed relationships between birth weight and pollutant concentrations during each infant’s first month of gestation and third trimester, as well as in each month of pregnancy using distributed lag models. We also conducted capture-area analyses limited to mothers residing within 4 miles (6.4 km) of each air quality monitoring station. Results In the five-county analysis, ambient levels of NO2, SO2, PM2.5 elemental carbon, and PM2.5 water-soluble metals during the third trimester were significantly associated with small reductions in birth weight (−4 to −16 g per interquartile range increase in pollutant concentrations). Third-trimester estimates were generally higher in Hispanic and non-Hispanic black infants relative to non-Hispanic white infants. Distributed lag models were also suggestive of associations between air pollutant concentrations in late pregnancy and reduced birth weight. The capture-area analyses provided little support for the associations observed in the five-county analysis. Conclusions Results provide some support for an effect of ambient air pollution in late pregnancy on birth weight in full-term infants. PMID:21156397

  4. Urinary tract infection in full-term newborn infants: risk factor analysis

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    Falcão Mário Cícero

    2000-01-01

    Full Text Available OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997 including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability, or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9% and Group II, n = 19 (31.1%. The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter were more frequent in Group II (p<0.05. Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

  5. 3D MR ventricle segmentation in pre-term infants with post-hemorrhagic ventricle dilation

    Science.gov (United States)

    Qiu, Wu; Yuan, Jing; Kishimoto, Jessica; Chen, Yimin; de Ribaupierre, Sandrine; Chiu, Bernard; Fenster, Aaron

    2015-03-01

    Intraventricular hemorrhage (IVH) or bleed within the brain is a common condition among pre-term infants that occurs in very low birth weight preterm neonates. The prognosis is further worsened by the development of progressive ventricular dilatation, i.e., post-hemorrhagic ventricle dilation (PHVD), which occurs in 10-30% of IVH patients. In practice, predicting PHVD accurately and determining if that specific patient with ventricular dilatation requires the ability to measure accurately ventricular volume. While monitoring of PHVD in infants is typically done by repeated US and not MRI, once the patient has been treated, the follow-up over the lifetime of the patient is done by MRI. While manual segmentation is still seen as a gold standard, it is extremely time consuming, and therefore not feasible in a clinical context, and it also has a large inter- and intra-observer variability. This paper proposes a segmentation algorithm to extract the cerebral ventricles from 3D T1- weighted MR images of pre-term infants with PHVD. The proposed segmentation algorithm makes use of the convex optimization technique combined with the learned priors of image intensities and label probabilistic map, which is built from a multi-atlas registration scheme. The leave-one-out cross validation using 7 PHVD patient T1 weighted MR images showed that the proposed method yielded a mean DSC of 89.7% +/- 4.2%, a MAD of 2.6 +/- 1.1 mm, a MAXD of 17.8 +/- 6.2 mm, and a VD of 11.6% +/- 5.9%, suggesting a good agreement with manual segmentations.

  6. Long chain polyunsaturated fatty acid supplementation in infants born at term.

    Science.gov (United States)

    Jasani, Bonny; Simmer, Karen; Patole, Sanjay K; Rao, Shripada C

    2017-03-10

    The long chain polyunsaturated fatty acids (LCPUFA) docosahexaenoic acid (DHA) and arachidonic acid (AA) are considered essential for maturation of the developing brain, retina and other organs in newborn infants. Standard infant milk formulae are not supplemented with LCPUFA; they contain only alpha-linolenic acid and linoleic acid, from which formula-fed infants must synthesise their own DHA and AA, respectively. Over the past few years, some manufacturers have added LCPUFA to formula milk and have marketed these products as providing an advantage for the overall development of full-term infants. To assess whether supplementation of formula milk with LCPUFA is both safe and beneficial for full-term infants, while focusing on effects on visual function, neurodevelopment and physical growth. Two review authors independently searched the Cochrane Central Register of Controlled Trials (CENTRAL; December 2016), MEDLINE (Ovid, 1966 to December 2016), Embase (Ovid, 1980 to December 2016), the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1980 to December 2016) and abstracts of the Pediatric Academic Societies (2000 to 2016). We applied no language restrictions. We reviewed all randomised controlled trials (RCTs) evaluating effects of LCPUFA supplemented versus non-supplemented formula milk on visual function, neurodevelopment and physical growth. We did not include trials reporting only biochemical outcomes. Two review authors extracted data independently. We assessed risk of bias of included studies using the guidelines of the Cochrane Neonatal Review Group. When appropriate, we conducted meta-analysis to determine a pooled estimate of effect. We identified 31 RCTs and included 15 of these in the review (N = 1889).Nine studies assessed visual acuity, six of which used visual evoked potentials (VEP), two Teller cards and one both. Four studies reported beneficial effects, and the remaining five did not. Meta-analysis of three RCTs showed significant

  7. Development of the forward parachute reaction and the age of walking in near term infants: a longitudinal observational study

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    Palermo Filippo

    2009-02-01

    Full Text Available Abstract Background Near term infants are a main part of preterms. They are at higher risk for mortality and morbidity than term infants and could show a quite different development of tone and reflexes from them. The aim of the present study was to describe longitudinally, in a large sample of healthy near term infants, the development of the forward parachute reaction (FPR and its correlation with the age of acquisition of independent walking. Methods The assessment of FPR (as absent, incomplete or complete was performed at 3, 6, 9, 12 months of corrected age in 484 infants, with a gestational age between 35.0 and 36.9 weeks. The age of acquisition of independent walking was monitored until its appearance. A correlation analysis was done between the age of walking and the acquisition of a complete or incomplete FPR, using the Spearman Rank correlation. The Mann-Withney U test was used to identify significant gestational age differences for the age of FPR appearance. Results Most of infants had a two-step development pattern. In fact, they showed at first an incomplete and then a complete FPR, which was observed more frequently at 9 months. An incomplete FPR only, without a successive maturation to a complete FPR, was present in the 21% of the whole sample. Infants with a complete FPR walked at a median age of 13 months, whereas those with an incomplete FPR only walked at a median age of 14 months. Conclusion We identified two groups within our sample of near term infants. The first group showed a progressive maturation of FPR, whereas the second one was characterised by the inability to get a complete pattern, within the one year observation's period. Furthermore, we observed a trend toward a delayed acquisition of independent walking in the latter group of infants.

  8. Middle latency auditory evoked responses in normal term infants: a longitudinal study.

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    Rogers, S H; Edwards, D A; Henderson-Smart, D J; Pettigrew, A G

    1989-05-01

    Middle latency auditory evoked responses (MLAERs) were measured in 21 normal term infants, three to five days after birth and then at 6 weeks, 7 months and 1 year of age. A polyphasic waveform was elicited during natural sleep in all infants at each recording session by monaural click stimulation at a rate of 9 per second. A 70 dBHL stimulus was found to be optimal as the MLAER became less well defined when the stimulus intensity approached the threshold hearing level. The first 60 to 70 msec of the waveform was found to be most stable, with decreasing detectability of peaks at longer latencies. There was no change in wave latency or reproducibility of MLAERs recorded during different sleep states. Waves Po and Na showed a significant decrease in latency with increasing stimulus intensity at term and/or 6 weeks of age. This was not evident for the remainder of the waveform. Waves Po, Na, Pa, Nb, Pb and Nc exhibited significant decreases in latency with age, attaining values indistinguishable from adults by 7 months of age.

  9. The Relationship Between Thyroxine Level and Short Term Clinical Outcome Among Sick Newborn Infants

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    Maliheh Kadivar

    2011-02-01

    Full Text Available Premature and critically sick infants frequently experience several interventions, including blood transfusions, parentral nutrition, and prescriptions during hospitalization that could affect the result of thyroid function test. This study aims to investigate the correlation between thyroxine level and clinical short term outcome among the newborn infants in the neonatal intensive care unit (NICU. We assessed serum levels of thyroxine and thyroid stimulating hormone of 99 neonates who were admitted in the NICU from September 1st 2004 to March 30th 2005. Number of patients with low thyroxin level (less than 6.5 µg/dl was determined and the relation between serum total thyroxine level and birth weight, gestational age, duration of hospitalization, clinical diagnosis, and final outcome was investigated. Short term outcome was considered as duration of hospitalization and discharge alive from hospital. Prevalence of hypothyroxinemia was 26 percent. Later assessment of thyroxine level within 3 weeks revealed normal level of this parameter (8.12 µg/dl ±1.36. Patients with lower gestational age and lower birth weight had lower thyroxine level (7.15 µg/dl ±2.56, and P=0.03, 6.72 µg/dl ±3.03, and P=0.08. Low thyroxine level was not associated with adverse short-term clinical outcome (mortality rates; 3(11% and 9(12%, and duration of hospitalization among 17.7±9.8 vs 16.7± 13.0 in patients with hypothyroxinemia and low thyroxine level respectively. Hypothyroxinemia has considerable prevalence in neonatal intensive care setting and is related with lower birth weight and gestational age. Whether thyroxin levels are a marker or mediator of short term clinical outcome remains to be determined by further studies.

  10. Postural adjustments in preterm infants at 4 and 6 months post-term during voluntary reaching in supine position.

    Science.gov (United States)

    Fallang, Bjorg; Saugstad, Ola Didrik; Hadders-Algra, Mijna

    2003-12-01

    Gradually it is getting clear that motor development - in particular balance control - in so-called "low-risk" preterm infants often differs from that in full-term infants. However, little is known on the etiology and pathophysiology of these problems. The aim of this study was to evaluate postural behavior during reaching by means of kinetic and kinematic measurements. Preterm infants (n = 32) without cerebral palsy were investigated longitudinally at the corrected ages of 4 and 6 mo. Thirteen age-matched full-term infants served as controls. Cognitive and motor development were assessed by means of the quality of General Movements (GMs) at 4 mo and Bayley scales at 6 and 12 mo. The infants were lying supine on a forceplate reaching for a toy and the kinetics of the total body's Center of Pressure (COP) was measured in cranial-caudal and medial-lateral direction. The analysis focused on COP displacement, Vmax and oscillatory changes of the COP displacement during reaching. The kinematic analysis of reaching focused on movement units, Vmax and a compound kinematic variable reflecting the quality of reaching. The results showed that preterm infants showed a remarkable "still" postural behavior, which differed significantly from the mobile COP behavior of the full-term infants. More "still" postural behavior at 6 mo was associated with a better quality of reaching movements and with normal GMs at 4 mo. We concluded that "still" postural behavior is an adequate postural strategy of preterm infants. But it might be that this postural behavior is an indicator of later dysfunction.

  11. Gaze Behaviors of Preterm and Full-Term Infants in Nonsocial and Social Contexts of Increasing Dynamics: Visual Recognition, Attention Regulation, and Gaze Synchrony

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    Harel, Hagar; Gordon, Ilanit; Geva, Ronny; Feldman, Ruth

    2011-01-01

    Although research has demonstrated poor visual skills in premature infants, few studies assessed infants' gaze behaviors across several domains of functioning in a single study. Thirty premature and 30 full-term 3-month-old infants were tested in three social and nonsocial tasks of increasing complexity and their gaze behavior was micro-coded. In…

  12. Reduced Breastfeeding Rates in Firstborn Late Preterm and Early Term Infants

    Science.gov (United States)

    Alligood-Percoco, Natasha; Martin, Ashley; Zhu, Junjia; Kjerulff, Kristen H.

    2016-01-01

    Abstract Objectives: The primary objective was to determine the rate of breastfeeding by gestational age reported by new mothers 1 month postpartum, with particular focus on early term newborns (37–386/7 weeks). Materials and Methods: Three thousand six primiparous women aged 18–36 years were interviewed during their third trimester and again 1 month postpartum. Logistic regression analysis was used to model the association between gestational age and breastfeeding 1 month postpartum among those who reported that they planned to breastfeed, controlling for potentially confounding variables. Results: Two thousand seven hundred seventy-two women planned to breastfeed (92.2%), among whom 116 (4.2%) delivered late preterm (34–366/7 weeks), 519 (18.7%) early term (37–386/7 weeks), and 2,137 (77.1%) term or postterm (39+ weeks). Among those who delivered late preterm, 63.8% were breastfeeding 1 month postpartum, early term 72.6%, and term or postterm 76.5%. This relationship was verified by a multivariate logistic regression analysis; late preterm newborns were significantly less likely to be breastfeeding 1 month postpartum than the term or postterm newborns (odds ratio [OR] 0.44; 95% confidence interval [CI] 0.28–0.69; p ≤ 0.0001), as were early term newborns (OR 0.77; 95% CI 0.60–0.99; p = 0.038). Conclusions: In this large prospective study of first-time mothers and newborns, gestational age was significantly associated with breastfeeding 1 month postpartum; highlighting late preterm and early term infants as populations at risk for shortened breastfeeding duration and the need to create specific breastfeeding support and education. PMID:27007890

  13. Cardiac arrest in infants, children, and adolescents: long-term emotional and behavioral functioning.

    Science.gov (United States)

    van Zellem, Lennart; Utens, Elisabeth M; Madderom, Marlous; Legerstee, Jeroen S; Aarsen, Femke; Tibboel, Dick; Buysse, Corinne

    2016-07-01

    Very little is known about the psychological consequences of a cardiac arrest (CA) during childhood. Our aim was to assess long-term emotional and behavioral functioning, and its predictors, in survivors of CA in childhood. This long-term follow-up study involved all consecutive infants, children, and adolescents surviving CA in a tertiary-care university children's hospital between January 2002 and December 2011. Emotional and behavioral functioning was assessed with the Child Behavior Checklist (CBCL), Teacher's Report Form (TRF), and Youth Self-Report (YSR). Of the eligible 107 CA survivors, 52 patients, parents, and/or teachers filled out online questionnaires. Compared with normative data, parents and teachers reported significantly more attention and somatic problems (age range 6-18 years). Parents also reported more attention problems for age range 1.5-5 years. Twenty-eight percent of the children (n = 14) scored in the psychopathological range (i.e., for age range 1.5-18 years; p < 0.001) according to parent reports. Male gender, older age, and basic life support were significantly related to worse scores on the scales internalizing problems, externalizing problems, and total problems and subscale attention problems. Long-term deficits in attention and somatic complaints were reported. Attention problems after childhood CA can interfere with school performance. Long-term follow-up with neuropsychological assessment should be organized. • Critical illness has a significant influence on the presence of long-term emotional and behavioral problems. • Long-term emotional and behavioral problems have been described for various groups of critically ill children such as congenital heart disease, meningococcal septic shock, and neonatal asphyxia. What is new: • This is the first study that addresses long-term emotional and behavioral problems in a relatively large consecutive series of children and adolescents surviving cardiac arrest. • Long-term

  14. Incidence and predisposing factors for severe disease in previously healthy term infants experiencing their first episode of bronchiolitis.

    Science.gov (United States)

    Papoff, Paola; Moretti, Corrado; Cangiano, Giulia; Bonci, Enea; Roggini, Mario; Pierangeli, Alessandra; Scagnolari, Carolina; Antonelli, Guido; Midulla, Fabio

    2011-07-01

    To determine the incidence and predisposing factors for severe bronchiolitis in previously healthy term infants first episode of bronchiolitis. Epidemiological, clinical and virological data were prospectively collected. Severity was assessed by the need for ventilatory support. Of the 310 infants enrolled, 16 (5.1%) presented with severe bronchiolitis requiring ventilatory support (11 since admission). Compared with infants with less severe bronchiolitis, infants with severe disease presented with lower birth weight, gestational age, postnatal weight and postnatal age, and were more likely to be born by cesarian section. C-reactive protein positive results (>0.8 mg/dL) and pulmonary consolidation on chest X-ray were more common among infants with severe disease. Severity was independently associated with younger age on admission bronchiolitis is uncommon in previously healthy term infants <12 months of age and when present develops soon after disease onset. Severity is predicted by young age and RSV carriage, whereas epidemiologic variables seem less likely to intervene. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  15. Comparison of a new transcutaneous bilirubinometer (Bilimed®) with serum bilirubin measurements in preterm and full-term infants

    Science.gov (United States)

    2009-01-01

    Background The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Bilimed®, a new transcutaneous bilirubinometer, suggests more accuracy compared to the existing non-invasive bilirubinometers because of its new technology. It furthermore takes into account different skin colours. No contact with the skin is needed during measurement, no additional material costs occur. Our aim was to assess the agreement between the Bilimed® and serum bilirubin in preterm and term infants of different skin colours. Methods The transcutaneous bilirubin measurements were performed on the infant's sternum and serum bilirubin was determined simultaneously. The agreement between both methods was assessed by Pearson's correlation and by Bland-Altman analysis. Results A total of 117 measurement cycles were performed in 99 term infants (group1), further 47 measurements in 38 preterm infants born between 34 - 36 6/7 gestational weeks (group 2), and finally 21 measurements in 13 preterm infants born between 28 - 33 6/7 gestational weeks (group 3). The mean deviation and variability (+/- 2SD) of the transcutaneous from serum bilirubin were: -14 (+/- 144) μmol/l; -0.82 (+/- 8.4) mg/dl in group 1, +16 (+/- 91) μmol/l;+0.93(+/- 5.3) mg/dl in group 2 and -8 (+/- 76) μmol/l; -0.47 (+/- 4.4) mg/dl in group 3. These limits of agreement are too wide to be acceptable in a clinical setting. Moreover, there was to be a trend towards less good agreement with increasing bilirubin values. Conclusion Despite its new technology the Bilimed® has no advantages, and more specifically no better agreement not only in term and near-term Caucasian infants, but also in non-Caucasian and more premature infants. PMID:19909530

  16. Comparison of a new transcutaneous bilirubinometer (Bilimed) with serum bilirubin measurements in preterm and full-term infants.

    Science.gov (United States)

    Karen, Tanja; Bucher, Hans Ulrich; Fauchère, Jean-Claude

    2009-11-12

    The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Bilimed, a new transcutaneous bilirubinometer, suggests more accuracy compared to the existing non-invasive bilirubinometers because of its new technology. It furthermore takes into account different skin colours. No contact with the skin is needed during measurement, no additional material costs occur. Our aim was to assess the agreement between the Bilimed and serum bilirubin in preterm and term infants of different skin colours. The transcutaneous bilirubin measurements were performed on the infant's sternum and serum bilirubin was determined simultaneously. The agreement between both methods was assessed by Pearson's correlation and by Bland-Altman analysis. A total of 117 measurement cycles were performed in 99 term infants (group1), further 47 measurements in 38 preterm infants born between 34 - 36 6/7 gestational weeks (group 2), and finally 21 measurements in 13 preterm infants born between 28 - 33 6/7 gestational weeks (group 3). The mean deviation and variability (+/- 2SD) of the transcutaneous from serum bilirubin were: -14 (+/- 144) micromol/l; -0.82 (+/- 8.4) mg/dl in group 1, +16 (+/- 91) micromol/l;+0.93(+/- 5.3) mg/dl in group 2 and -8 (+/- 76) micromol/l; -0.47 (+/- 4.4) mg/dl in group 3. These limits of agreement are too wide to be acceptable in a clinical setting. Moreover, there was to be a trend towards less good agreement with increasing bilirubin values. Despite its new technology the Bilimed has no advantages, and more specifically no better agreement not only in term and near-term Caucasian infants, but also in non-Caucasian and more premature infants.

  17. Comparison of a new transcutaneous bilirubinometer (Bilimed® with serum bilirubin measurements in preterm and full-term infants

    Directory of Open Access Journals (Sweden)

    Bucher Hans

    2009-11-01

    Full Text Available Abstract Background The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Bilimed®, a new transcutaneous bilirubinometer, suggests more accuracy compared to the existing non-invasive bilirubinometers because of its new technology. It furthermore takes into account different skin colours. No contact with the skin is needed during measurement, no additional material costs occur. Our aim was to assess the agreement between the Bilimed® and serum bilirubin in preterm and term infants of different skin colours. Methods The transcutaneous bilirubin measurements were performed on the infant's sternum and serum bilirubin was determined simultaneously. The agreement between both methods was assessed by Pearson's correlation and by Bland-Altman analysis. Results A total of 117 measurement cycles were performed in 99 term infants (group1, further 47 measurements in 38 preterm infants born between 34 - 36 6/7 gestational weeks (group 2, and finally 21 measurements in 13 preterm infants born between 28 - 33 6/7 gestational weeks (group 3. The mean deviation and variability (+/- 2SD of the transcutaneous from serum bilirubin were: -14 (+/- 144 μmol/l; -0.82 (+/- 8.4 mg/dl in group 1, +16 (+/- 91 μmol/l;+0.93(+/- 5.3 mg/dl in group 2 and -8 (+/- 76 μmol/l; -0.47 (+/- 4.4 mg/dl in group 3. These limits of agreement are too wide to be acceptable in a clinical setting. Moreover, there was to be a trend towards less good agreement with increasing bilirubin values. Conclusion Despite its new technology the Bilimed® has no advantages, and more specifically no better agreement not only in term and near-term Caucasian infants, but also in non-Caucasian and more premature infants.

  18. Postnatal weight loss in term infants: what is normal and do growth charts allow for it?

    Science.gov (United States)

    Wright, C M; Parkinson, K N

    2004-05-01

    Although it is a well known phenomenon, limited normative data on neonatal weight loss and subsequent gain are available, making it hard to assess individual children with prolonged weight loss. To establish, using data from a large prospective population based cohort study, norms and limits for postnatal weight loss and its impact on current growth reference charts. A cohort of 961 term infants were recruited at birth and followed using parental questionnaires and community nursing returns. Routine weights were collected for half the cohort at 5 days and for all at 12 days and 6 weeks. Less weight loss was seen than the 3-6% suggested by previous studies, but one in five infants had not regained their birth weight by 12 days. Those lightest at birth showed least weight loss. Twenty six (3%) children had more than 10% weight loss, but none showed evidence of major organic disease. Actual weights in the first fortnight are half to one centile space lower than growth charts suggest, while birthweight centiles for children born at 37 weeks were two centile spaces lower. Neonatal weight loss is brief, with few children remaining more than 10% below birth weight after 5 days. Growth charts are misleading in the first 2 weeks, because they make no allowance for neonatal weight loss.

  19. Trends of abnormal birthweight among full-term infants in Newfoundland and Labrador.

    Science.gov (United States)

    Edwards, Nicole M; Audas, Richard P

    2010-01-01

    The objective of this study was to investigate whether any observed trends in birthweight are accompanied by changes in maternal sociodemographic characteristics, including age, marital status, and education. We conducted a population-based study of term singletons born in Newfoundland and Labrador, Canada, between 1992 and 2005 (N = 66,638). Large-sample significance tests for two population proportions were used to test whether differences in mean birthweight, the proportion of low and high birthweight infants, and differences in maternal socio-demographic characteristics between 1992-95 and 2002-05 were statistically significant. Chi-square tests were used to test for associations between birthweight group and maternal age, education and marital status. Multivariate logistic regression was used to examine the interaction of these effects across time periods. Of the 66,638 infants included in the study, 54,256 (81.4%) were born in the normal birthweight range (2500-4000 grams) while 11,305 (17.0%) were high birthweight (> 4000 grams) and 1,077 (1.6%) were low birthweight (Newfoundland and Labrador.

  20. "The effect of fluid supplementation on serum bilirubin level during phototerapy in term infants "

    Directory of Open Access Journals (Sweden)

    Torkaman M

    2007-04-01

    Full Text Available Background: Jaundice is a common and benign problem in neonatal period. Several therapeutic procedures for decreasing of serum bilirubin level has been recommended. phototherapy is most common them. Our goal Form this study is the evaluation of serum therapy effects in decreasing of serum bilirubin concentration in icteric infants that are treated with phototherapy. Methods: This is a prospective clinical trial in Najmeih Hospital in 2002. In this study 80 term icteric infants with bilirubin level greater than 17 mg/dl were randomized in two groups, both groups underwent phototherapy and in the case group intravenous fluid supplementation was added. There were no significant differences in the mean gestational age, birth weight, hemoglobin, and also in total serum bilirubin level at admission in the two groups. Results: There were no significant differences in the mean rate of of serum bilirubin level decline during first 24 and 48 hours of hospitalization and also the time of bilirubin decreasing to less than 15 mg/dl and the length of hospitalization in two groups. Conclution: Our study showed intravenous fluid supplementation could be limited to special cases of neonatal icter such as moderate to severe dehydration.

  1. Breast-Feeding and Diabetes: Long-Term Impact on Mothers and Their Infants

    Science.gov (United States)

    Gunderson, Erica P.

    2010-01-01

    In the general population, breast-feeding is associated with a reduced risk of the offspring being overweight later in life by 22% to 24% across the age spectrum, from preschool children to adults. There is a dose-response gradient with increasing duration of breast-feeding, and lowest risk with prolonged, exclusive breast-feeding. Breast-feeding has been shown to slow infant growth up to 2 years of age. By contrast, the scientific evidence is inconclusive about whether breast-feeding protects against the onset of overweight and subsequent development of type 2 diabetes among offspring whose mothers had diabetes during pregnancy. Moreover, evidence is insufficient to determine if lactation protects against development of type 2 diabetes later in life in women with a diabetes history during pregnancy. Given the paucity of the evidence and equivocal findings about the long-term effects of breast-feeding on future health of women with diabetes during pregnancy and their infants, further research is recommended. PMID:18631440

  2. Tolerance of natural baby skin-care products on healthy, full-term infants and toddlers

    Directory of Open Access Journals (Sweden)

    Coret CD

    2014-02-01

    Full Text Available Catherine D Coret, Michael B Suero, Neena K Tierney Johnson & Johnson Consumer Companies, Inc, Skillman, NJ, USA Purpose: To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. Materials and methods: Healthy, full-term infants and toddlers aged 1–36 months were enrolled. In study 1, a lightly fragranced natural baby hair and body wash (n=30, a lightly fragranced natural baby shampoo (n=30, or a lightly fragranced natural baby lotion (n=32 were assessed over 2 weeks. In study 2, a lightly fragranced natural baby hair and body wash and a lightly fragranced natural baby lotion (n=33 were assessed as a regimen over 4 weeks. The wash and shampoo were used three or more times per week, but not more than once daily. Lotions were applied in the morning or after a bath. Clinicians assessed the arms, legs, torso, or scalp for erythema, dryness, peeling/flakiness (study 1 only, tactile roughness, edema (study 1 only, rash/irritation (study 2 only, and overall skin condition (study 2 only at baseline, week 1, and weeks 2 or 4. Parents completed skin assessment questionnaires. In study 2, stratum corneum hydration was measured. Subjects were monitored for adverse events. Results: No significant changes in clinical grading scores were observed, indicating that all products were well tolerated. By the end of each study, >90% of parents/caregivers believed each product was mild and gentle. In study 2, improvement in stratum corneum hydration was observed (+37% at week 1 and +48% at week 4, P<0.05 for both. In study 1, one baby experienced mild erythema on the neck and scalp after using the shampoo (possibly related to treatment. In study 2, there were no product-related adverse events. Conclusion: The natural baby skin-care products were well tolerated by infants and toddlers when used alone or as part of a skin-care regimen. Keywords: bath, cleanser, natural, infant, lotion, shampoo

  3. Parity and risk of low birth weight infant in full term pregnancy

    Directory of Open Access Journals (Sweden)

    Lelly Andayasari

    2016-07-01

    birth during the period of January 1 to December 31, 2011. Multivariat logistic regression model was used to analyze the risks of low birth weight. Results: From a total of 4191 sample size, 2242 met the inclusion criteria and used for analysis. The proportion of  low birth weight was 9.5% nulliparous increased 1.6 fold higher  risk  to have low birth weight baby compared to multiparous (P=0.010, meanwhile  primiparous and multiparous had the same risk to have a low birth weight baby (0.614. In term of sex of infant, male infant had 1.4 fold higher risk of having low birth weight than the female infant(P=0.017. Conclusion: Nulliparous women and female infant were at higher risk of  having low birth weight. Keyword: parity, sex of infant, low birth weight

  4. Lung Volume, Breathing Pattern and Ventilation Inhomogeneity in Preterm and Term Infants

    NARCIS (Netherlands)

    Latzin, Philipp; Roth, Stefan; Thamrin, Cindy; Hutten, Gerard J.; Pramana, Isabelle; Kuehni, Claudia E.; Casaulta, Carmen; Nelle, Matthias; Riedel, Thomas; Frey, Urs

    2009-01-01

    Background: Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants,

  5. Maternal Intention to Breastfeed and Breastfeeding Outcomes in Term and Preterm Infants: PRAMS 2000–2003

    Science.gov (United States)

    Colaizy, Tarah T.; Saftlas, Audrey F.; Morriss, Frank H.

    2012-01-01

    Objective To determine the effect of intention to breastfeed on short-term breastfeeding outcomes in women delivering term and preterm infants Design Data from the CDC Pregnancy Risk Assessment Monitoring System (PRAMS) for three states, Ohio, Michigan and Arkansas during 2000–2003 were analyzed. SAS 9.1.3 and SUDAAN 10 were used for analyses. Results 16839 subjects were included, 9.7% delivered preterm. 52.5% expressed definite intention to breastfeed, 16.8% tentative intention, 4.3% were uncertain, 26.8% had no intention to breastfeed. 65.2% initiated breastfeeding, 45.2% breastfed ≥ 4weeks, 30% breastfed ≥ 10 weeks. Women with definite intention were more likely to initiate (OR 24.3, 95% CI 18.4, 32.1), to breastfeed ≥ 4 weeks (OR 7.12, 95% CI 5.95, 8.51), and to breastfeed ≥ 10 weeks (OR 2.75, 95% CI 2.2, 3.45) compared to tentative intention. Levels of intention did not differ between women delivering preterm and term. Women delivering at < 34 weeks were more likely to initiate breastfeeding (OR 2.24, 95% CI 1.64, 3.06), and to breastfeed ≥ 4 weeks (OR 2.58, 95% CI 1.96, 3.41), but less likely to breastfeed ≥ 10 weeks (OR 0.55, 95% CI 0.44, 0.68) compared to term. Women delivering between 34 and 36 weeks were less likely to breastfeed ≥ 10 weeks than those delivering at term (OR 0.63, 95% CI 0.49, 0.81). Conclusions Prenatal intention to breastfeed is a powerful predictor of short-term breastfeeding outcomes in women delivering both at term and prematurely. PMID:21936968

  6. Child-rearing history and emotional bonding in parents of preterm and full-term infants

    NARCIS (Netherlands)

    Hall, R.A.S.; Hoffenkamp, H.N.; Tooten, A.; Braeken, J.; Vingerhoets, A.J.J.M.; van Bakel, H.J.A.

    2015-01-01

    Some parents fail to develop strong emotional bonds with their newborn infants. As the quality of the parent–infant relationship contributes to the infant’s development, it is of great importance to identify protective and risk factors that facilitate or impede the development of the parent–infant

  7. Human milk peptides differentiate between the preterm and term infant and across varying lactational stages.

    Science.gov (United States)

    Dingess, Kelly A; de Waard, Marita; Boeren, Sjef; Vervoort, Jacques; Lambers, Tim T; van Goudoever, Johannes B; Hettinga, Kasper

    2017-10-18

    Variations in endogenous peptide profiles, functionality, and the enzymes responsible for the formation of these peptides in human milk are understudied. Additionally, there is a lack of knowledge regarding peptides in donor human milk, which is used to feed preterm infants when mother's own milk is not (sufficiently) available. To assess this, 29 human milk samples from the Dutch Human Milk Bank were analyzed as three groups, preterm late lactation stage (LS) (n = 12), term early (n = 8) and term late LS (n = 9). Gestational age (GA) groups were defined as preterm (24-36 weeks) and term (≥37 weeks). LS was determined as days postpartum as early (16-36 days) or late (55-88 days). Peptides, analyzed by LC-MS/MS, and parent proteins (proteins from matched peptide sequences) were identified and quantified, after which peptide functionality and the enzymes responsible for protein cleavage were determined. A total of 16 different parent proteins were identified from human milk, with no differences by GA or LS. We identified 1104 endogenous peptides, of which, the majority were from the parent proteins β-casein, polymeric immunoglobulin receptor, αs1-casein, osteopontin, and κ-casein. The absolute number of peptides differed by GA and LS with 30 and 41 differing sequences respectively (p human milk peptides. These results explain some of the variation in endogenous peptides in human milk, leading to future targets that may be studied for functionality.

  8. Rates of and factors associated with delivery-related perinatal death among term infants in Scotland.

    Science.gov (United States)

    Pasupathy, Dharmintra; Wood, Angela M; Pell, Jill P; Fleming, Michael; Smith, Gordon C S

    2009-08-12

    Rates of obstetric intervention in labor, including cesarean delivery, have increased significantly in most developed countries. It is, however, unclear if this has been paralleled by decreased rates of perinatal and neonatal death associated with complications of labor at term. To determine whether rates of perinatal death at term, either during labor or in the neonatal period, have changed in Scotland during the last 20 years and whether this was associated with a reduction in deaths ascribed to intrapartum anoxia. A population-based, retrospective cohort study of linked data from a registry of births (Scottish Morbidity Record 02) and a registry of perinatal deaths (Scottish Stillbirth and Infant Death Survey) between 1988 and 2007. Participants included all births of a singleton infant in a cephalic presentation at term (N = 1,012,266), excluding those with perinatal death due to congenital anomaly or antepartum stillbirth. Delivery-related perinatal death, defined as intrapartum stillbirth or neonatal death unrelated to congenital abnormality. These events were also subdivided into those events ascribed to intrapartum anoxia and all other causes. The risk of death was modeled using logistic regression and analyses were adjusted for maternal age, height, parity, socioeconomic deprivation status, gestational age, birth weight percentile, fetal sex, onset of labor, and the annual number of births per hospital. During the study period, the risk of delivery-related perinatal death decreased from 8.8 to 5.5 per 10,000 births (unadjusted change, -38%; 95% confidence interval [CI], -51% to -21%). When analyzed by the cause of death, there was a significant decrease in the risk of death ascribed to intrapartum anoxia (5.7 to 3.0 per 10,000 births; unadjusted change, -48%; 95% CI, -62% to -29%), but no significant change in the risk of death ascribed to other causes. When deaths ascribed to intrapartum anoxia were analyzed by the time of death in relation to delivery

  9. Effect of infant and follow-on formulas containing B lactis and galacto- and fructo-oligosaccharides on infection in healthy term infants.

    Science.gov (United States)

    Bocquet, Alain; Lachambre, Emmanuelle; Kempf, Christian; Beck, Laurence

    2013-08-01

    The aim of the present study was to compare the effect of Bifidobacterium animalis subspecies lactis (B lactis) alone or with 90% galacto-oligosaccharide (GOS) and 10% fructo-oligosaccharide (FOS) on infections in infants. In a multicenter trial, healthy, term, newborn infants ages 42 days or younger whose mothers had decided not to breast-feed beyond this age received infant and follow-on formulas containing B lactis (10 colony-forming units/g) + GOS/FOS (0.4 g/100 mL, intention-to-treat, n = 261) or B lactis alone (10⁷ colony-forming units/g, intention-to-treat, n = 267). Investigators accessed computer-generated randomization sequences via a remote server. Infants were exclusively fed formulas until 4 to 6 months of age and along with complementary feeding thereafter up to 12 months. The primary outcome was the mean number of annual infections reported by the investigators. Secondary outcomes were mean gains in anthropometric measurements, frequency of antibiotic use, and occurrence of adverse events based on investigators' records at each visit and gastrointestinal tolerance (daily stool frequency and consistency) and volume of formula intake recorded in 6-day diaries by parents. Mean ± standard deviation infection rates in infants followed up to 12 months (full analysis set) were 4.9 ± 3.2 per infant per year in the B lactis + GOS/FOS group (n = 219) and 4.5 ± 3.0 per infant per year in the B lactis group (n = 220; analysis of variance, P = 0.18). Mean daily weight gain was slightly lower in the B lactis + GOS/FOS than the B lactis group (16.1 ± 2.9 vs 16.6 ± 2.6 g/day, P = 0.046), but was not clinically significant. Other outcomes were not significantly different between groups. Formulas containing B lactis + GOS/FOS did not reduce infection rates beyond those containing only B lactis.

  10. Very pre-term infants' behaviour at 1 and 2 years of age and parental stress following basic developmental care

    NARCIS (Netherlands)

    Pal, S.M. van der; Maguire, C.M.; Bruil, J.; Cessie, S. le; Zwieten, P. van; Veen, S.; Wit, J.M.; Walther, F.J.

    2008-01-01

    This study explored the effects of basic developmental care on the behaviour of very pre-term infants and parental stress at I and 2 years of corrected age. A randomized controlled trial was done to compare basic Developmental Care (standardized nests and incubator covers) and controls (standard

  11. Central cortico-subcortical involvement: a distinct pattern of brain damage caused by perinatal and postnatal asphyxia in term infants

    NARCIS (Netherlands)

    Rademakers, R. P.; van der Knaap, M. S.; Verbeeten, B.; Barth, P. G.; Valk, J.

    1995-01-01

    The MR findings in a characteristic pattern of hypoxic-ischemic brain damage in term infants are described. The MR images of seven patients with cerebral palsy and a specific pattern of central cortico-subcortical cerebral damage were studied retrospectively and correlated with clinical findings.

  12. [Risks factors associated with intra-partum foetal mortality in pre-term infants].

    Science.gov (United States)

    Zeballos Sarrato, Susana; Villar Castro, Sonia; Ramos Navarro, Cristina; Zeballos Sarrato, Gonzalo; Sánchez Luna, Manuel

    2017-03-01

    Pre-term delivery is one of the leading causes of foetal and perinatal mortality. However, perinatal risk factors associated with intra-partum foetal death in preterm deliveries have not been well studied. To analyse foetal mortality and perinatal risk factors associated with intra-partum foetal mortality in pregnancies of less than 32 weeks gestational age. The study included all preterm deliveries between 22 and 31 +1 weeks gestational age (WGA), born in a tertiary-referral hospital, over a period of 7 years (2008-2014). A logistic regression model was used to identify perinatal risk factors associated with intra-partum foetal mortality (foetal malformations and chromosomal abnormalities were excluded). During the study period, the overall foetal mortality was 63.1% (106/168) (≥22 weeks of gestation) occurred in pregnancies of less than 32 WGA. A total of 882 deliveries between 22 and 31+6 weeks of gestation were included for analysis. The rate of foetal mortality was 11.3% (100/882). The rate of intra-partum foetal death was 2.6% (23/882), with 78.2% (18/23) of these cases occurring in hospitalised pregnancies. It was found that Assisted Reproductive Techniques, abnormal foetal ultrasound, no administration of antenatal steroids, lower gestational age, and small for gestational age, were independent risk factors associated with intra-partum foetal mortality. This study showed that there is a significant percentage intra-partum foetal mortality in infants between 22 and 31+6 WGA. The analysis of intrapartum mortality and risk factors associated with this mortality is of clinical and epidemiological interest to optimise perinatal care and improve survival of preterm infants. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Normative Data for Bone Mass in Healthy Term Infants from Birth to 1 Year of Age

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    Sina Gallo

    2012-01-01

    Full Text Available For over 2 decades, dual-energy X-ray absorptiometry (DXA has been the gold standard for estimating bone mineral density (BMD and facture risk in adults. More recently DXA has been used to evaluate BMD in pediatrics. However, BMD is usually assessed against reference data for which none currently exists in infancy. A prospective study was conducted to assess bone mass of term infants (37 to 42 weeks of gestation, weight appropriate for gestational age, and born to healthy mothers. The group consisted of 33 boys and 26 girls recruited from the Winnipeg Health Sciences Center (Manitoba, Canada. Whole body (WB as well as regional sites of the lumbar spine (LS 1–4 and femur was measured using DXA (QDR 4500A, Hologic Inc. providing bone mineral content (BMC for all sites and BMD for spine. During the year, WB BMC increased by 200% (76.0±14.2 versus 227.0±29.7 g, spine BMC by 130% (2.35±0.42 versus 5.37±1.02 g, and femur BMC by 190% (2.94±0.54 versus 8.50±1.84 g. Spine BMD increased by 14% (0.266±0.044 versus 0.304±0.044 g/cm2 during the year. This data, representing the accretion of bone mass during the first year of life, is based on a representative sample of infants and will aid in the interpretation of diagnostic DXA scans by researchers and health professionals.

  14. Gender-related differences of inguinal hernia and asymptomatic patent processus vaginalis in term and preterm infants.

    Science.gov (United States)

    Burgmeier, Christine; Dreyhaupt, Jens; Schier, Felix

    2015-03-01

    The aim of this study was to analyze the gender-related differences of inguinal hernia (IH) and patent processus vaginalis (PPV) in term and preterm infants. Over a nine-year-period 411 infants underwent laparoscopic herniorrhaphy within the first six months of life. 246 term (191 male; 55 female) and 165 preterm (118 male; 47 female) infants were included in this retrospective study. Initial presentation of IH and intraoperative anatomical findings of PPV were reviewed. We found that term boys (58.6%) and girls (58.2%) predominantly presented with right-sided IH whereas preterm boys (36.4%) and girls (44.7%) mostly presented with bilateral IH. Female babies had a higher incidence of initial left-sided IH. Term and preterm girls with initial left-sided hernia were found to have highest incidence of PPV. Male term babies with initial left-sided IH were found to have the lowest incidence of PPV (25.0%). The highest incidence of PPV in male was found in preterm boys with either left- or right-sided IH. Incidence and laterality of IH and PPV differ between term and preterm girls and boys. In open hernia repair decision concerning contralateral groin exploration should consider term/preterm birth as well as gender. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants

    Directory of Open Access Journals (Sweden)

    Zoya Gridneva

    2016-12-01

    Full Text Available Human milk (HM components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE, a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo. Stomach volumes (SV were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001 GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001, and longer GE times (0.24 [0.03, 0.46], p = 0.033. Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023. Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002 and dose (0.02 [0.01, 0.03], p = 0.005, and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003. FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

  16. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants.

    Science.gov (United States)

    Gridneva, Zoya; Kugananthan, Sambavi; Hepworth, Anna R; Tie, Wan J; Lai, Ching T; Ward, Leigh C; Hartmann, Peter E; Geddes, Donna T

    2016-12-28

    Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (-0.07 [-0.10, -0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (-65.89 [-107.13, -2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

  17. Failure to Thrive in the Term and Preterm Infants of Mothers Depressed in the Postnatal Period: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Drewett, Robert; Blair, Peter; Emmett, Pauline; Emond, Alan

    2004-01-01

    Aims: To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. Method: In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional…

  18. Early skin-to-skin contact for healthy full-term infants after vaginal and caesarean delivery : A qualitative study on clinician perspectives

    NARCIS (Netherlands)

    Koopman, Inez; Callaghan-Koru, Jennifer A.; Alaofin, Oluwatope; Argani, Cynthia H.; Farzin, Azadeh

    2016-01-01

    Aims and objectives: This study aims to provide insight into key factors from a clinician's perspective that influence uninterrupted early skin-to-skin contact after vaginal and caesarean delivery of healthy full-term infants. Background: Early skin-to-skin contact of healthy full-term infants

  19. Effects of Joint Attention on Long-Term Memory in 9-Month-Old Infants: An Event-Related Potentials Study

    Science.gov (United States)

    Kopp, Franziska; Lindenberger, Ulman

    2011-01-01

    Joint attention develops during the first year of life but little is known about its effects on long-term memory. We investigated whether joint attention modulates long-term memory in 9-month-old infants. Infants were familiarized with visually presented objects in either of two conditions that differed in the degree of joint attention (high…

  20. Etiology and Short-term Outcome of First Seizure in Hospitalized Infants.

    Science.gov (United States)

    Nikunj, Niraj Kumar; Mishra, Devendra; Juneja, Monica; Talukdar, Bibek

    2016-10-08

    We enrolled 75 consecutive infants presenting with history of first seizure at a tertiary care hospital in New Delhi, India. Clinical and biochemical work-up for etiology, and electroencephalography were performed in all infants. Developmental assessment was done 3-month after discharge. 72% had generalized seizures, and fever was the commonest co-morbidity (57.3%). 68% had provoked seizures, mainly due to hypocalcemia (34.3%) or neuro-infections (29.3%). Seven (9.3%) infants died during hospital stay; mostly those with neuro-infections. 13 (20.3%) infants had developmental delay.

  1. Effect of oronasopharyngeal suction on arterial oxygen saturation in normal, term infants delivered vaginally: a prospective randomised controlled trial.

    Science.gov (United States)

    Modarres Nejad, V; Hosseini, R; Sarrafi Nejad, A; Shafiee, G

    2014-07-01

    Oronasopharyngeal suction (ONPS) with a suction bulb at birth is a traditional practice in the initial management of healthy infants in Iran and many other countries. The purpose of this study was to compare the effects of oronasopharyngeal suction (ONPS) with those of no suction in normal, term newborns delivered vaginally. A total of 170 healthy term infants of first and single uncomplicated pregnancies, with clear amniotic fluid, vaginal delivery and cephalic presentation, enrolled in the trial during labour. Newborns were randomised into one of the two groups, according to the use of the ONPS procedure. Arterial oxygen saturation (SaO2) levels, heart rates, blood gases of umbilical cord and Apgar scores were determined. The mean SaO2 values over the first and fifth min of birth were similar in the two groups. The maximum time to reach SaO2 of ≥ 92% was shorter in the no suction group. There were no statistically significant differences in the mean of heart rates, respiratory rates and Apgar scores between the groups. Apgar scores at 5 and 10 min were between 8 and 10 for all infants, respectively. Newborns receiving suction showed a statistically significant, lower mean partial carbon dioxide pressure (PCO2) and a significantly higher partial oxygen pressure (PO2) of umbilical artery. Although the differences were statistically significant, these were not considered clinically significant because values remained within normal ranges. According to this study, ONPS is not recommended as a routine procedure in normal, term infants delivered vaginally.

  2. Developmental Readiness of Normal Full Term Infants To Progress from Exclusive Breastfeeding to the Introduction of Complementary Foods: Reviews of the Relevant Literature Concerning Infant Immunologic, Gastrointestinal, Oral Motor and Maternal Reproductive and Lactational Development.

    Science.gov (United States)

    Naylor, Audrey J., Ed.; Morrow, Ardythe L., Ed.

    This review of the developmental readiness of normal, full-term infants to progress from exclusive breastfeeding to the introduction of complementary foods is the result of the international debate regarding the best age to introduce complementary foods into the diet of the breastfed human infant. After a list of definitions, four papers focus on:…

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

    LENUS (Irish Health Repository)

    Tarrant, R C

    2010-11-01

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

  4. Short-term outcome of newborn infants: spinal versus general anesthesia for elective cesarean section. A prospective randomized study.

    Science.gov (United States)

    Kavak, Z N; Başgül, A; Ceyhan, N

    2001-12-10

    To compare general and spinal anesthesia with respect to the short-term outcome of newborns born by elective cesarean deliveries. Pregnant women admitted to our hospital from January 1999 to July 2000, for whom elective repeat cesareans were planned after 37 weeks gestation, were allocated randomly after their informed consent to spinal anesthesia or general anesthesia. Maternal age, gestational age, birth weight, Apgar's score, hospital stay duration, and duration of cesarean section time were all noted. The rate of the neonatal respiratory depression, perinatal asphyxia, and admittance to the neonatal intensive care unit of the infants were documented. We also studied arterial samples withdrawn from the cord for the pH, bicarbonate, PaO(2) (oxygen pressure, arterial), and PaCO(2) (carbon dioxide pressure, arterial). The serum levels of creatine kinase with myocardial-specific isoform, aspartate aminotransferase, alanine aminotransferase, and total cortisol levels of the newborns were measured and served in ruling out perinatal stress and in confirming the diagnosis of perinatal asphyxia (and of myocardial damage). Statistical analyses was performed with the use of an unpaired Student's t-test, Chi-square test, and a power calculation was done. From the randomly selected patients, we had 38 (45.2%) infants for general anesthesia and 46 (54.8%) for spinal anesthesia. None of our primary endpoints favored any of the study groups, and the clinical short-term outcome of the infants was similar in the neonates born both by spinal and general anesthesia (P>0.05). The biochemical assays did not rule out or confirm any differences in the occurrence of perinatal stress (P>0.05). Anesthesia type does not seem to influence the short-term outcome of the newborn infants for the elective cesarean deliveries. We believe that both spinal and general anesthesia could be performed in elective term cesarean deliveries without any risk to the newborn infants.

  5. Cochlear function in 1-year-old term infants born with hypoxia-ischaemia or low Apgar scores.

    Science.gov (United States)

    Jiang, Ze D; Zang, Zeng; Wilkinson, Andrew R

    2012-02-01

    To examine the influence of perinatal hypoxia-ischaemia (HI) or low Apgar scores on distortion product otoacoustic emissions (DPOAEs) in infants at 1 year and detect any postnatal changes. Eighty-eight term infants born with perinatal HI or low Apgar scores alone were recruited at 1 year of age. The ears with type A tympanogram (normal) were studied with DPOAEs at 10 frequencies between 0.5 kHz and 10 kHz. DPOAE pass rates were decreased at all frequencies 1-10 kHz, particularly 1 and 2 kHz in both infants born with HI and those with low Apgar scores (χ(2) = 3.80-15.09, P Apgar score. Compared with those recorded at 1 and 6 months, DPOAE pass rates at 1 year were increased slightly in infants born with HI, but showed no marked changes in those born with low Apgar scores. DPOAE pass rates, mainly at 1 and 2 kHz, were decreased at 1 year in infants born with perinatal HI and low Apgar scores, suggesting a relative poor cochlear function. Further studies are needed to ascertain the hearing acuity. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  6. Fiber tracking at term displays gender differences regarding cognitive and motor outcome at 2 years of age in preterm infants.

    Science.gov (United States)

    van Kooij, Britt J M; van Pul, Carola; Benders, Manon J N L; van Haastert, Ingrid C; de Vries, Linda S; Groenendaal, Floris

    2011-12-01

    White matter microstructural changes can be detected with diffusion tensor imaging. It was hypothesized that diffusion parameters in the posterior limb of the internal capsule (PLIC) and corpus callosum (CC) bundles in preterm infants at term equivalent age (TEA) were associated with neurodevelopment at 2 y corrected age. In 67 preterm infants, fiber tracking was performed at TEA for the CC and both PLIC bundles. Volume, length, fractional anisotropy (FA), mean diffusivity, axial diffusivity, and radial diffusivity were determined for the three bundles. These parameters were assessed in relation to outcome on the Bayley Scales of Infant and Toddler Development III. In girls, volume and length of the CC bundle and right PLIC bundle volume were associated with cognition. In boys, volume, FA, mean and radial diffusivity, and length of the left PLIC were associated with fine motor scores. Correction for GA, birth weight, intraventricular hemorrhage, white matter injury, and maternal education did not change the results. Fiber tracking parameters in the PLIC and CC bundles in preterm infants at TEA revealed different associations with neurodevelopment between boys and girls. This study suggested that fiber tracking is a useful method to predict neurodevelopment in preterm infants.

  7. Effectiveness of zinc supplementation to full term normal infants: a community based double blind, randomized, controlled, clinical trial.

    Directory of Open Access Journals (Sweden)

    K V Radhakrishna

    Full Text Available UNLABELLED: The study was aimed to test whether zinc supplementation, if initiated early, can prevent stunting and promote optimum body composition in full term infants. For this, full term pregnant women from low income urban community were enrolled and were followed-up for 24 months postpartum. Body mass index (BMI was calculated from maternal weight and height that were collected one month after delivery. Infants' weight, and length, head, chest and mid upper arm circumferences and skin fold thicknesses at triceps, biceps and subscapular area were collected at baseline (before randomization and once in three months up till 24 months. Three hundred and twenty four infants were randomized and allocated to zinc (163 or placebo (161 groups respectively. Supplementation of zinc was initiated from 4 months of age and continued till children attained 18 months. The control (placebo group of children received riboflavin 0.5 mg/day, whereas the intervention (zinc group received 5 mg zinc plus riboflavin 0.5 mg/day. When infants were 18 months old, dietary intakes (in 78 children were calculated by 24 hour diet recall method and hemoglobin, zinc, copper and vitamin A were quantified in blood samples collected from 70 children. The results showed prevalence of undernutrition (body mass index <18.5 in 37% of the mothers. Mean±SD calorie consumption and zinc intakes from diets in infants were 590±282.8 Kcal/day and 0.97±0.608 mg/day respectively. Multiple linear regression models demonstrated maternal weight as a strong predictor of infants' weight and length at 18 months of age. As expected, diarrhea duration impacted infants' linear growth and weight gain adversely. Zinc supplementation for a mean period of 190 days, starting from 4 months up to 18 months of age, in full term normal infants, consuming an average energy of 590 Kcal/day, had significant effect on the skin fold thicknesses, but not on their linear growth. TRIAL REGISTRATION: Clinical

  8. Regulatory competence and social communication in term and preterm infants at 12 months corrected age. Results from a randomized controlled trial.

    Science.gov (United States)

    Olafsen, Kåre S; Rønning, John A; Handegård, Bjørn Helge; Ulvund, Stein Erik; Dahl, Lauritz Bredrup; Kaaresen, Per Ivar

    2012-02-01

    Temperamental regulatory competence and social communication in term and preterm infants at 12 months corrected age was studied in a randomized controlled intervention trial aimed at enhancing maternal sensitive responsiveness. Surviving infants competence was measured with the Infant Behavior Questionnaire, and social communication with the Early Social Communication Scales. Preterm intervention infants with low regulatory competence had higher responding to joint attention than preterm control infants. A sensitizing intervention may moderate the association between temperament and social communication, and thus allow an alternative functional outlet for preterm infants low in regulatory competence. The finding may have implications for conceptualizations of the role of early sensitizing interventions in promoting important developmental outcomes for premature infants. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Music Cognition in Early Infancy: Infants' Preferences and Long-Term Memory for Ravel

    Science.gov (United States)

    Ilari, Beatriz; Polka, Linda

    2006-01-01

    Listening preferences for two pieces, Prelude and Forlane from "Le tombeau de Couperin" by Maurice Ravel (1875-1937), were assessed in two experiments conducted with 8-month-old infants, using the Headturn Preference Procedure (HPP). Experiment 1 showed that infants, who have never heard the pieces, could clearly make a distinction between the…

  10. Birthweight of term infants and maternal occupation in a prospective cohort of pregnant women. The ALSPAC Study Team.

    Science.gov (United States)

    Farrow, A; Shea, K M; Little, R E

    1998-01-01

    To study the relation between birthweight of term infants and maternal occupation. Information on job titles since the age of 16, and sociodemographic and other lifestyle factors were obtained by means of questionnaires as part of the Avon longitudinal study of pregnancy and childhood (ALSPAC), from a cohort of 14,000 pregnant women. The British 1990 standard occupational classification was used to code jobs within nine major job groups. For 9282 women who delivered term infants and reported a job for the relevant period, there was a significant difference in mean birthweight among the nine major job groups. A 148 g difference was found between the mean birthweight of infants born to women with professional occupations and those with plant and machine operative jobs. Multiple regression analysis adjusted for sex of infant, parity, maternal height, smoking, caffeine consumption, and race. After adjustment the maternal job was no longer significantly associated with birthweight. Despite the absence of a significant association between birthweight and job after adjustment, there were several findings which agreed with publications on maternal occupation and pregnancy outcome. The major job groups with the lowest birthweights included the following jobs; metal forming or welding, electric or electronic work, jobs in the textile trade, and assembling and working with equipment (mobile and stationary). The lack of an association may indicate that the study was of insufficient power to detect a small difference; it may indicate the presence of confounding variables that were not adjusted for or it may indicate that no association exists.

  11. 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

  12. [Magnetic resonance imaging of premature infants with punctate white matter damage and short-term neurodevelopmental outcome].

    Science.gov (United States)

    Niu, Ying; Fu, Jianhua; Xue, Xindong

    2014-01-01

    To investigate the early diagnosis with MRI changes, MRI types and short-term neurodevelopmental outcome of preterm infants with punctate white matter damage (PWMD). There were 44 preterm infants with PWMD (group A) from March 2009 to August 2010 at the neonatal ward of Shengjing Hospital of China Medical University, according to the number, shape and distribution of the lesions, group A was divided into dot injury group (A1), clusters group (A2) and linear group (A3), the first MRI and DWI scan of all cases were within 14 days after birth, and 17 subjects received re-examination with the MRI in the hospital. Twenty preterm infants with normal MRI (group B) received the follow-up, according to the age, 20 normal full-term infants were selected (group C) as the control group using paired design. Mental development index (MDI) and psychomotor development index (PDI) were determined using Bayley scales of infant development-II. First MRI scan:in 44 infants with PWMD, group A1, A2, A3 separately had, 10, and 9 infants. MRI follow up in 17 cases showed that in 4 cases of A1 group the dot lesions disappeared; in 3 of 4 cases in clusters group who received re-examination, the lesions disappeared, 1 case had periventricular leukomalacia (PVL); in 5 of the 9 cases who had re-examination in linear group the lesions disappeared, while in 4 cases the lesions evolved into PVL. MDI and PDI: Group A [MDI (102.9 ± 15.5) , PDI (107.7 ± 17.5) ] was lower than that of group B[MDI (114.0 ± 13.1) , PDI (120.8 ± 9.4) ], group C [MDI (114.2 ± 12.2) , PDI (119.5 ± 10.7) ] (P A2 [MDI (100.8 ± 12.5) , PDI (105.0 ± 12.1) ] showed significantly reduced values compared with group B, Group C, Group A1 (P A2 (P dot-like and clustered injury that are easy to be absorbed and disappear, but the linear lesions are likely to evolve into PVL. In addition, the cluster-like and linear injury have an influence on short-term cognition and motion development, especially the outcome of linear injury

  13. Long-term outcome in term breech infants with low Apgar score--a population-based follow-up

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Thorngren-Jerneck, K

    2001-01-01

    and 218 controls. RESULTS: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP...

  14. Beneficial Effects of Long-Term Growth Hormone Treatment on Adaptive Functioning in Infants With Prader-Willi Syndrome.

    Science.gov (United States)

    Lo, Sin T; Festen, Dederieke A M; Tummers-de Lind van Wijngaarden, Roderick F A; Collin, Philippe J L; Hokken-Koelega, Anita C S

    2015-07-01

    The aim of this study was to investigate the effect of growth hormone treatment on adaptive functioning in children with Prader-Willi syndrome. Vineland Adaptive Behavior Scale (VABS) was assessed during a randomized controlled trial (RCT) and after 7 years of growth hormone treatment. In the RCT, 75 children (42 infants and 33 prepubertal children) with Prader-Willi syndrome were included. Subsequently, 53 children were treated with long-term growth hormone. Our study demonstrates a marked delay in adaptive functioning in infants and children with Prader-Willi syndrome, which was associated with older age and lower intelligence. Results of the repeated measurements show that the earlier growth hormone treatment was started during infancy, the better the adaptive skills were on the long-term.

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

    National Research Council Canada - National Science Library

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

    2016-01-01

    .... Because body composition modulates later health outcomes and human milk is recommended as the normal method for infant feeding, we sought to investigate whether human milk feeding in early life...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

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

  17. Long-term effects of presurgical infant orthopedics in patients with cleft lip and palate: a systematic review.

    Science.gov (United States)

    Uzel, Aslıhan; Alparslan, Z Nazan

    2011-09-01

    This study aimed to assess the scientific evidence on the efficiency of presurgical infant orthopedic appliances in patients with cleft lip and palate to shed light on a specific, contemporary discussion of whether the appliances have long-term advantages with respect to treatment outcomes. A systematic review. Two literature surveys from the five electronic databases were performed with a 1-month interval. Randomized controlled trials and controlled clinical trials (controls had no presurgical infant orthopedics) that had follow-up periods of a minimum of 6 years were included in the study. The exceptions to the follow-up limit were studies related to feeding and parent satisfaction. Of the 319 articles retrieved in the literature surveys, 12 were qualified for the final analysis. The level of evidence of these articles ranged from 1b to 4. Eight randomized controlled trials and four controlled clinical trials were available on eight treatment outcomes. The longest follow-up period of the randomized controlled trials was 6 years. No randomized controlled trials were found on active presurgical infant orthopedic appliances and on nasoalveolar molding appliances. Based on the results, presurgical infant orthopedic appliances have no long-term positive effects on seven of the eight studied treatment outcomes in patients with cleft lip and palate. More randomized controlled trials need to be done to have evidence regarding the effects of presurgical infant orthopedics in different surgical protocols. Also, the encouraging results about the effect of nasolaveolar molding appliances on nasal symmetry have to be supported by future randomized controlled trials.

  18. Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants.

    Science.gov (United States)

    Innis, Sheila M; Friesen, Russell W

    2008-03-01

    Docosahexaenoic acid (DHA) is important to neural development. Whether DHA intakes are low enough in some pregnant women to impair infant development is uncertain. We sought to determine whether DHA deficiency occurs in pregnant women and contributes to poor infant development. Biochemical cutoffs, dietary intakes, or developmental scores indicative of DHA deficiency are not defined. Infant development has a distribution in which an individual's potential development is unknown. This was a randomized intervention to establish a distribution of developmental scores for infants of women with DHA intakes considered to be above requirements against which to compare the development of infants of mothers consuming their usual diet. DHA (400 mg/d; n = 67) or a placebo (n = 68) was consumed by the women from 16 wk gestation until delivery. We determined maternal red blood cell ethanolamine phosphoglyceride fatty acids, dietary intakes at 16 and 36 wk gestation, and infant visual acuity at 60 d of age. We described an approach to identify DHA deficiency when biochemical and functional markers of deficiency are unknown. In multivariate analyses, infant visual acuity was related to sex (beta = 0.660, SE = 0.93, and odds ratio = 1.93) and maternal DHA intervention (beta = 1.215, SE = 1.64, and odds ratio = 3.37). More infant girls in the placebo than in the DHA intervention group had a visual acuity below average (P = 0.048). Maternal red blood cell ethanolamine phosphoglyceride docosatetraenoic acid was inversely related to visual acuity in boys (rho = -0.37, P pregnant women in our study population were DHA-deficient.

  19. Comparison of Neutrophil Apoptosis by the Pseudomonas Aeruginosa Exotoxins between Healthy Individuals and Term Infants

    Directory of Open Access Journals (Sweden)

    Soheila Khazaei

    2013-04-01

    Full Text Available Background: Pseudomonas aeruginosa may be colonized in different human tissues and result in some infections potentially. Thus, considering that these bacteria are resistance to most of the current antibiotics, an examination on pathogenesis mechanisms of such bacteria can be effective in controlling the infections developed by it.Materials and Methods: In this project, among 40 blood samples (20 healthy persons, 20 infants, an amount of 5 ml (2 ml in the infants heparinized blood was collected form each and then neutrophils were isolated by a standard method and were counted by neubauer lam. After culturing Pseudomonas bacteria in broth medium, some tubes with densities of 1, 2, 3 and 4 McFarland were prepared and the bacteria were isolated by centrifuge method with 3000rpm for 10 minutes and then its exotoxin were exposed to neutrophils of the groups under study. The effect of time and the bacteria count on the amount of the secreted toxin and in adjacency to neutrophils was measured.Results: There were 11 men and 9 women in the health group and the infants group consisted of 12 boys and 8 girls. Death cell percentage of neutrophils was 100% in the health group and 8.90% in the infants group. Percentage of bacterial growth in the medium 1 and 2 McFarland was zero; in the medium 3 McFarland, it was 12.5% in the healthy group and 1% in the infants group (p<0.10. The average rate of cell death in the minute 15th was different in two groups (68.5% in health group vs. 92.5% in the infants (p<0.0005. Conclusion: This study showed the effect of Pseudomonas bacteria on the development of early cell death in the infants very well. As it was shown, this effect is time-dependent and this cell death (apoptosis is occurred in the infants earlier than health people.

  20. Birthweight of term infants and maternal occupation in a prospective cohort of pregnant women. The ALSPAC Study Team

    OpenAIRE

    Farrow, A.; Shea, K. M.; Little, R. E.

    1998-01-01

    OBJECTIVE: To study the relation between birthweight of term infants and maternal occupation. METHODS: Information on job titles since the age of 16, and sociodemographic and other lifestyle factors were obtained by means of questionnaires as part of the Avon longitudinal study of pregnancy and childhood (ALSPAC), from a cohort of 14,000 pregnant women. The British 1990 standard occupational classification was used to code jobs within nine major job groups. RESULTS: For 9282 women who d...

  1. Assessment and Stability of Early Learning Abilities in Preterm and Full-Term Infants across the First Two Years of Life

    Science.gov (United States)

    Lobo, Michele A.; Galloway, James C.

    2013-01-01

    Infants born preterm have increased risk for learning disabilities yet we lack assessments to successfully detect these disabilities in early life. We followed 23 full-term and 29 preterm infants from birth through 24 months to assess for differences in and stability of learning abilities across time. Measures included the Bayley-III cognitive…

  2. Procollagen type I N-terminal peptide in preterm infants is associated with growth during the first six months post-term

    NARCIS (Netherlands)

    van de Lagemaat, Monique; van der Veer, Eveline; van Weissenbruch, Mirjam M.; Lafeber, Harrie N.; Rotteveel, Joost

    2014-01-01

    ObjectiveTo identify growth-related collagen and bone parameters in small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) preterm infants during the first six months post-term. In SGA preterm infants, increased growth and decreased bone acquisition, which we demonstrated

  3. Irreversible Respiratory Failure in a Full-Term Infant with Features of Pulmonary Interstitial Glycogenosis as Well as Bronchopulmonary Dysplasia

    Directory of Open Access Journals (Sweden)

    Maresa E. C. Jiskoot-Ermers

    2015-10-01

    Full Text Available Pulmonary interstitial glycogenosis (PIG is a rare interstitial lung disease in the newborns. We report on the clinical presentation and pathological findings of a full-term male infant with pulmonary hypertension requiring extracorporeal membrane oxygenation (ECMO. An open lung biopsy demonstrated interstitial changes resembling pulmonary interstitial glycogenosis as well as bronchopulmonary dysplasia (BPD, without convincing evidence of maturational arrest, infection, alveolar proteinosis, or alveolar capillary dysplasia. The boy was treated with glucocorticoids and, after a few days, was weaned from ECMO. A few hours later, the patient died due to acute severe pulmonary hypertension with acute right ventricular failure. The etiology and underlying pathogenic mechanisms of PIG are unknown. The clinical outcomes are quite varied. Deaths have been reported when PIG exists with abnormal lung development and pulmonary vascular growth and congenital heart disease. No mortality has been reported in PIG together with BPD in full-term infants. In this article, we reported on a full-term infant with interstitial changes resembling PIG and BPD who expired despite no convincing evidence of an anatomical maturational arrest or congenital heart disease.

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

    Directory of Open Access Journals (Sweden)

    Dan Wu

    2017-06-01

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

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

    NARCIS (Netherlands)

    van Haastert, I.C.

    2011-01-01

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

  6. The ratio of high-molecular weight adiponectin and total adiponectin differs in preterm and term infants.

    Science.gov (United States)

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

    2009-05-01

    Adiponectin consists of three subspecies (high-, middle- and low-molecular weight adiponectin). Among these, high-molecular weight adiponectin (H-adn) is suggested to be an active form of this protein. To assess the relationship between H-adn and postnatal growth in preterm infants (PIs), serum H-adn and total adiponectin (T-adn) were measured in 46 PIs at birth and at corrected term, and 26 term infants (TI) at birth. T-adn and H-adn concentrations, and the ratio of H-adn to T-adn (H/T-adn) were significantly greater in TI and PI at corrected term than in PI at birth (p adn and H-adn concentrations in PI at corrected term were similar to those in TI, but H/T-adn in PI at corrected term was less than that in TI (p adn and serum concentrations of T- and H-adn in PI at corrected term were different from those in TI. These data suggest that quality of early postnatal growth in PIs is different from that in normally developed TI. Postnatal growth accompanying adipose tissue similar to TI may be important for PI to prevent future development of cardiovascular disease.

  7. Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants

    Directory of Open Access Journals (Sweden)

    Ann Anderson-Berry

    2012-12-01

    Full Text Available Nutrition support practitioners are currently dealing with shortages of parenteral nutrition micronutrients, including multivitamins (MVI, selenium and zinc. A recent survey from the American Society of Enteral and Parenteral Nutrition (ASPEN indicates that this shortage is having a profound effect on clinical practice. A majority of respondents reported taking some aggressive measures to ration existing supplies. Most premature infants and many infants with congenital anomalies are dependent on parenteral nutrition for the first weeks of life to meet nutritional needs. Because of fragile health and poor reserves, they are uniquely susceptible to this problem. It should be understood that shortages and rationing have been associated with adverse outcomes, such as lactic acidosis and Wernicke encephalopathy from thiamine deficiency or pulmonary and skeletal development concerns related to inadequate stores of Vitamin A and D. In this review, we will discuss the current parenteral shortages and the possible impact on a population of very low birth weight infants. This review will also present a case study of a neonate who was impacted by these current shortages.

  8. Serum caffeine concentrations and short-term outcomes in premature infants of ⩽29 weeks of gestation.

    Science.gov (United States)

    Alur, P; Bollampalli, V; Bell, T; Hussain, N; Liss, J

    2015-06-01

    Caffeine is effective in the treatment of apnea of prematurity but it is not well known if the therapeutic concentration of the drug has an impact on other neonatal outcomes such as chronic lung disease (CLD). The aim of this study was to determine if there is an association between caffeine concentrations and the incidence of CLD in premature infants of ⩽29 weeks of gestation. A retrospective chart review of all the infants born ⩽29 weeks of gestation from 2007 to 2011, who survived until discharge or 36 weeks postmenstrual age, was conducted. Caffeine concentrations were obtained weekly on infants getting the drug. Average caffeine concentrations (ACCs) were determined for the duration of caffeine therapy and correlated with CLD, length of stay (LOS), oxygen at discharge (OD), duration of ventilation (DV) and total charges for hospitalization for each patient. Of the 222 eligible infants, 198 met the inclusion criteria. ACC for infants without CLD was 17.0±3.8 μg ml(-1) compared with infants with CLD 14.3±6.1 μg ml(-1) (P14.5 μg ml(-1)) had lower incidence of patent ductus arteriosus, lesser number of days on ventilator and oxygen, lesser need for diuretics, lower incidence of CLD, were more likely to go home without supplemental OD and had lower LOS and lower total hospital charges (all differences were significant Pcaffeine concentrations were significantly associated with decrease in CLD. Receiver operating curve analysis confirmed a significant predictive ability of caffeine concentration for CLD with a cutoff concentration of 14.5 μg ml(-1) (sensitivity of 42.6 and specificity of 86.8). The AUC (area under the curve) for the prediction of CLD was 0.632 (95% confidence interval 0.56-0.69, P=0.009). Caffeine concentrations >14.5 μg ml(-1) were strongly correlated with reduced CLD in infants born at ⩽29 weeks of gestation. Higher caffeine concentrations were associated with decreased total hospital charges, DV, OD and LOS

  9. Isolated acute non-cystic white matter injury in term infants presenting with neonatal encephalopathy.

    LENUS (Irish Health Repository)

    Barrett, Michael Joseph

    2013-03-01

    We discuss possible aetiological factors, MRI evolution of injury and neuro-developmental outcomes of neonatal encephalopathy (NE). Thirty-six consecutive infants diagnosed with NE were included. In this cohort, four infants (11%) were identified with injury predominantly in the deep white matter on MRI who were significantly of younger gestation, lower birthweight with higher Apgars at one and five minutes compared to controls. Placental high grade villitis of unknown aetiology (VUA) was identified in all four of these infants. Our hypothesis states VUA may induce white matter injury by causing a local inflammatory response and\\/or oxidative stress during the perinatal period. We underline the importance of continued close and systematic evaluation of all cases of NE, including examination of the placenta, in order to come to a better understanding of the clinical presentation, the patterns of brain injury and the underlying pathophysiological processes.

  10. Long-term physical and neurologic development in newborn infants with isolated single umbilical artery.

    Science.gov (United States)

    Chetty-John, Shilpa; Zhang, Jun; Chen, Zhen; Albert, Paul; Sun, Liping; Klebanoff, Mark; Grewal, Una

    2010-10-01

    This study compared birth parameters and the longitudinal course in physical and neurologic development between children with 2 and 3 vessel umbilical cords. Our study of the Collaborative Perinatal Project included singletons of at least 24 weeks' gestation with single umbilical artery at birth and no identifiable congenital anomalies. Demographics that were collected included maternal age, race, smoking status, and socioeconomic index. Delivery data included gestational age, birthweight, Apgar scores, placental weight, and umbilical cord insertion and length. Growth and neurodevelopmental parameters were collected at various intervals from birth to 7 years. There were 263 infants with isolated single umbilical artery and 41,415 infants with 3 vessel cords. A random effect model that controlled for potential confounders did not show clinically significant differences in the physical and neurodevelopment measures between these groups. Our study shows no evidence of differential longitudinal physical growth or neurologic outcomes between infants with 2 or 3 vessel cords. Published by Mosby, Inc.

  11. The contribution of attenuated selection in utero to small-for-gestational-age (SGA) among term African American male infants.

    Science.gov (United States)

    Goodman, Julia M; Karasek, Deborah; Anderson, Elizabeth; Catalano, Ralph A

    2013-07-01

    Natural selection conserves mechanisms allowing women to spontaneously abort gestations least likely to yield fit offspring. Small gestational size has been proposed as an indicator of fitness observable by maternal biology. Previous research suggests that exposure to ambient stress in utero results in more "culling" of small fetuses and therefore lower rates of small-for-gestational-age (SGA). However, African American women persistently have higher rates of SGA than non-Hispanic white women, despite experiencing more ambient stress. This paper tests whether attenuation of the stress response among highly stressed African American women, as suggested by the weathering hypothesis, may help to explain this apparent inconsistency. We apply time-series modeling to over 2 million African American and non-Hispanic white male term births in California over the period of January 1989 through December 2010. We test for the parabolic (i.e., "U" shaped) relationship, implied by an attenuated stress response, between unusually strong labor market contraction and the rate of SGA among African American term male infants, and a linear relationship among non-Hispanic whites. We find the hypothesized parabolic relationship among term male African American infants. As expected, we find a linear relationship between unexpected layoffs and the rate of SGA among term male non-Hispanic whites. These results are robust to sensitivity analyses. These results may help to explain the high rates of SGA among term male African American infants, despite greater maternal exposure to ambient stress during pregnancy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Dissociating Long and Short-term Memory in Three-Month-Old Infants Using the Mismatch Response to Voice Stimuli

    Directory of Open Access Journals (Sweden)

    Katharina Zinke

    2018-01-01

    Full Text Available Auditory event-related potentials (ERPs have been successfully used in adults as well as in newborns to discriminate recall of longer-term and shorter-term memories. Specifically the Mismatch Response (MMR to deviant stimuli of an oddball paradigm is larger if the deviant stimuli are highly familiar (i.e., retrieved from long-term memory than if they are unfamiliar, representing an immediate change to the standard stimuli kept in short-term memory. Here, we aimed to extend previous findings indicating a differential MMR to familiar and unfamiliar deviants in newborns (Beauchemin et al., 2011, to 3-month-old infants who are starting to interact more with their social surroundings supposedly based on forming more (social long-term representations. Using a voice discrimination paradigm, each infant was repeatedly presented with the word “baby” (400 ms, interstimulus interval: 600 ms, 10 min overall duration pronounced by three different female speakers. One voice that was unfamiliar to the infants served as the frequently presented “standard” stimulus, whereas another unfamiliar voice served as the “unfamiliar deviant” stimulus, and the voice of the infant’s mother served as the “familiar deviant.” Data collection was successful for 31 infants (mean age = 100 days. The MMR was determined by the difference between the ERP to standard stimuli and the ERP to the unfamiliar and familiar deviant, respectively. The MMR to the familiar deviant (mother’s voice was larger, i.e., more positive, than that to the unfamiliar deviant between 100 and 400 ms post-stimulus over the frontal and central cortex. However, a genuine MMR differentiating, as a positive deflection, between ERPs to familiar deviants and standard stimuli was only found in the 300–400 ms interval. On the other hand, a genuine MMR differentiating, as a negative deflection, between ERPs to unfamiliar deviants from ERPs to standard stimuli was revealed for the 200–300 ms

  13. Long-term oscillations in the sleep/wake cycle of infants

    Science.gov (United States)

    Diambra, L.; Malta, C. P.; Capurro, A.

    2009-11-01

    The development of circadian sleep-wakefulness rhythm was investigated by a longitudinal study of six normal infants. We propose an entropy based measure for the sleep/wake cycle fragmentation. Our results confirm that the sleep/wake cycle fragmentation and the sleep/wake ratio decrease, while the circadian power increases during the maturation process of infants. In addition to these expected linear trends in the variables devised to quantify sleep consolidation, circadian power and sleep/wake ratio, we found that they present infradian rhythms in the monthly range.

  14. Factors affecting the course of body and kidney growth in infants with urolithiasis: A critical long-term evaluation

    Directory of Open Access Journals (Sweden)

    Kemal Sarica

    2016-12-01

    Full Text Available Objective: To investigate the possible effects of dietary, patient and stone related factors on the clinical course of the stone disease as well as the body and renal growth status of the infants. Patients and Methods: A total of 50 children with an history of stone disease during infancy period were studied. Patient (anatomical abnormalities, urinary tract infection - UTI, associated morbidities, stone (obstruction, UTI and required interventions and lastly dietary (duration of sole breast feeding, formula feeding related factors which may affect the clinical course of the disease were all evaluated for their effects on the body and renal growth during long-term follow-up. Results: Mean age of the children was 2.40 ± 2.65 years. Our findings demonstrated that infants receiving longer period of breast feeding without formula addition seemed to have a higher rate of normal growth percentile values when compared with the other children. Again, higher frequency of UTI and stone attacks affected the growth status of the infants in a remarkable manner than the other cases. Our findings also demonstrated that thorough a close follow-up and appropriately taken measures; the possible growth retardation as well as renal growth problems could be avoided in children beginning to suffer from stone disease during infancy period. Conclusions: Duration of breast feeding, frequency of UTI, number of stone attacks and stone removal procedures are crucial factors for the clinical course of stone disease in infants that may affect the body as well as kidney growth during long-term follow-up.

  15. MR imaging of term infants with hypoxic-ischaemic encephalopathy as a predictor of neurodevelopmental outcome and late MRI appearances

    Energy Technology Data Exchange (ETDEWEB)

    Twomey, Eilish; Ryan, Stephanie [Children' s University Hospital, Department of Radiology, Dublin (Ireland); Twomey, Anne; Murphy, John [National Maternity Hospital, Department of Neonatology, Dublin (Ireland); Donoghue, Veronica B. [National Maternity Hospital, Department of Radiology, Dublin (Ireland); Children' s University Hospital, Department of Radiology, Dublin (Ireland)

    2010-09-15

    detailed neurodevelopmental assessment at 2 years of age, infants were classified into two groups according to whether they had a favourable or unfavourable outcome. Of the 26 infants, 6 infants died before formal assessment at the age of 2 years. A further 5 infants had moderate to severe cerebral palsy in addition to severe cognitive impairment. The remaining 15 infants were categorized in the favourable outcome group. The US appearance performed well in terms of predicting final outcome (P = 0.005). The pattern of ischaemia seen on early MRI was a significant predictor of outcome (P < 0.0001). The BG, BG/W and S scores of the diffusion imaging were significantly associated with outcome (P < 0.0001, P < 0.0001 and P = 0.0005 respectively). DWI was predictive of outcome group (P < 0.0001), as were the early T1- and T2-W sequences (P = 0.002) and cranial US (P = 0.005). Assessment of the PLIC in infants with watershed or atypical patterns of ischaemia was found to be less reliable in predicting outcome. The measured ADC value in the PLIC was significantly reduced in those children who had an unfavourable outcome (P = 0.03). While early MRI performed better than cranial US, the sonography findings were useful. The pattern of ischaemia on early MRI was a good predictor of prognosis. All infants with watershed or atypical patterns had a favourable outcome. The majority of infants with central patterns of ischaemia had an unfavourable outcome and all infants with a diffuse pattern had an unfavourable outcome. DWI was predictive of outcome group, as were early T1- and T2-W sequences and cranial US. (orig.)

  16. Vitamin A supplementation to prevent mortality and short- and long-term morbidity in very low birth weight infants.

    Science.gov (United States)

    Darlow, Brian A; Graham, P J; Rojas-Reyes, Maria Ximena

    2016-08-22

    Vitamin A is necessary for normal lung growth and the integrity of respiratory tract epithelial cells. Preterm infants have low vitamin A status at birth and this has been associated with an increased risk of developing chronic lung disease. To evaluate supplementation with vitamin A on the incidence of death or neonatal chronic lung disease and long-term neurodevelopmental disability in very low birth weight (VLBW) infants compared with a control (placebo or no supplementation), and to consider the effect of the supplementation route, dose, and timing. For the original review and subsequent updates, we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, Science Citation Index, and the Oxford Database of Perinatal Trials. The reference lists of relevant trials, paediatric and nutrition journals, and conference abstracts and proceedings were handsearched up to 2010.For the 2016 update, we used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 4), MEDLINE via PubMed (1 May 2016), EMBASE (1 May 2016), and CINAHL (1 May 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised controlled trials comparing vitamin A supplementation with a control (placebo or no supplementation) or other dosage regimens in VLBW infants (birth weight ≤ 1500 grams or less than 32 weeks' gestation). Two review authors screened the search results, extracted data, and assessed the trials for risk of bias. Results were reported as risk ratios (RR), risk differences (RD), and number needed to treat to benefit (NNTB), all with 95% confidence intervals (CI). Trialists were contacted for additional data. Eleven trials met the inclusion criteria. Ten trials (1460 infants) compared vitamin A supplementation with a

  17. Length Normalized Indices for Fat Mass and Fat-Free Mass in Preterm and Term Infants during the First Six Months of Life

    Directory of Open Access Journals (Sweden)

    Ipsita Goswami

    2016-07-01

    Full Text Available Objective: Postnatal tissue accretion in preterm infants differs from those in utero, affecting body composition (BC and lifelong morbidity. Length normalized BC data allows infants with different body lengths to be compared and followed longitudinally. This study aims to analyze BC of preterm and term infants during the first six months of life. Methods: The BC data, measured using dual energy X-ray absorptiometry, of 389 preterm and 132 term infants from four longitudinal studies were combined. Fat-mass/length2 (FMI and fat-free mass/length2 (FFMI for postmenstrual age were calculated after reaching full enteral feeding, at term and two further time points up to six months corrected age. Results: Median FMI (preterm increased from 0.4 kg/m2 at 30 weeks to 2.5, 4.3, and 4.8 kg/m2 compared to 1.7, 4.7, and 6 kg/m2 in term infants at 40, 52, and 64 weeks, respectively. Median FFMI (preterm increased from 8.5 kg/m2 (30 weeks to 11.4 kg/m2 (45 weeks and remained constant thereafter, whereas term FFMI remained constant at 11 kg/m2 throughout the tested time points. Conclusion: The study provides a large dataset of length normalized BC indices. Followed longitudinally, term and preterm infants differ considerably during early infancy in the pattern of change in FMI and FFMI for age.

  18. Gentamicin pharmacokinetics in term newborn infants receiving high-frequency oscillatory ventilation or conventional mechanical ventilation: a case-controlled study.

    Science.gov (United States)

    Bhatt-Mehta, Varsha; Donn, Steven M

    2003-10-01

    To compare the pharmacokinetics of gentamicin in infants receiving high-frequency oscillatory ventilation (HFOV) with infants receiving conventional mechanical ventilation. A case-controlled study design was used to compare the pharmacokinetics of gentamicin in critically ill infants receiving HFOV and conventional mechanical ventilation. Medical records of all full-term newborn infants (> or =37 weeks gestational age) who received either high-frequency mechanical ventilation or conventional mechanical ventilation between 1991 and 2001 were reviewed and relevant patient demographics, renal function tests and gentamicin administration and plasma concentration data collected. Elimination rate constant, half-life, volume of distribution and clearance for both groups were calculated using standard kinetics equations. A tertiary care children's hospital. Newborn infants, > or =37 weeks gestational age, receiving gentamicin and high-frequency mechanical ventilation or conventional mechanical ventilation. In total, 18 patients were included in the conventional mechanical ventilation group and 15 in the HFOV group. The mean gentamicin dose for conventional mechanical ventilation and HFOV groups infants were 2.52+/-0.07 and 2.5+/-0.07 mg/kg/dose, respectively. Initial dosing interval was 12 hours in all of the conventional mechanical ventilation infants and 13 of the 15 HFOV infants. The dosing interval for the remaining two HFOV infants was 18 hours. No patient in either group demonstrated oliguria. Statistical analysis using the Student t-test for unequal variances yielded significant differences between the two groups with regard to elimination rate constant, half-life, volume of distribution and clearance, with a p value of mechanical ventilation group (13.4+2.23) (p>0.05). Infants receiving HFOV had reduced gentamicin clearance. Full-term infants receiving HFOV should be initiated at gentamicin dosing intervals of 18 hours rather than the traditional 12 hours

  19. Human milk peptides differentiate between the preterm and term infant and across varying lactational stages

    NARCIS (Netherlands)

    Dingess, Kelly A.; Waard, de Marita; Boeren, Sjef; Vervoort, Jacques; Lambers, Tim T.; Goudoever, van Johannes B.; Hettinga, Kasper

    2017-01-01

    Variations in endogenous peptide profiles, functionality, and the enzymes responsible for the formation of these peptides in human milk are understudied. Additionally, there is a lack of knowledge regarding peptides in donor human milk, which is used to feed preterm infants when mother's own milk is

  20. Good short-term outcomes of kangaroo mother care in infants with a ...

    African Journals Online (AJOL)

    Results. Regarding the mothers' obstetric history (n=87), gravidity ranged from 1 to 7 (median 3), with a 43% incidence of miscarriage. The median birth weight of the infants (n=87) was 1.5 kg (first assessment), the discharge weight (third assessment) was 1.8 kg, and a week after discharge (fourth assessment) it was 2.2 kg.

  1. Skin bilirubin measurement during phototherapy in preterm and term newborn infants.

    Science.gov (United States)

    Zecca, Enrico; Barone, Giovanni; De Luca, Daniele; Marra, Rosa; Tiberi, Eloisa; Romagnoli, Costantino

    2009-08-01

    The few existing studies evaluating the reliability of transcutaneous bilirubin monitoring during phototherapy gave controversial results. To evaluate the accuracy of transcutaneous bilirubin measurement in a large population of newborn infants, during phototherapy. Total serum bilirubin and transcutaneous bilirubin on patched and unpatched skin areas were simultaneously measured in newborn infants undergoing phototherapy. Transcutaneous measurements were performed with a multiwavelength transcutaneous bilirubinometer (Respironics BiliCheck). The Passing-Bablok regression and the Bland-Altman plot were used to estimate the relationship between serum and transcutaneous bilirubin. We studied 364 newborn infants with a mean (SD) gestational age of 34.6 (3) weeks and a mean birth weight of 2371 (805) grams. Total serum bilirubin, patched transcutaneous bilirubin and unpatched transcutaneous bilirubin were similar before phototherapy. After 52 (33) hours of phototherapy, the difference between serum bilirubin and patched transcutaneous bilirubin was 0.2 (3.1) mg/dL (not significant) while the difference between serum bilirubin and unpatched transcutaneous bilirubin was 3.2 (3.0) mg/dL (pBiliCheck can be safely used for the evaluation of bilirubin levels in newborn infants under phototherapy. Its reliability on patched skin of the forehead is high enough to consistently reduce blood draws and to ascertain when to discontinue phototherapy. Because of the individual variance, any clinical decision has to be taken on the basis of the transcutaneous bilirubin trend more than on a single value.

  2. Short-term Outcome of Pulmonary Hemorrhage in Very-Low-Birth-Weight Preterm Infants

    Directory of Open Access Journals (Sweden)

    Ting-An Yen

    2013-10-01

    Conclusion: This data suggests that our current strategy is effective for treating severe pulmonary hemorrhage in VLBW infants. Surfactant therapy for severe pulmonary hemorrhage may also be beneficial for improving lung function and may shorten the duration of high oxygen requirement.

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

    Directory of Open Access Journals (Sweden)

    Ravinder Nagpal

    2016-12-01

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

  4. Adequacy and safety of an infant formula with a protein/energy ratio of 1.8 g/100 kcal and enhanced protein efficiency for term infants during the first 4 months of life.

    Science.gov (United States)

    Turck, Dominique; Grillon, Christophe; Lachambre, Emmanuelle; Robiliard, Patrick; Beck, Laurence; Maurin, Jean-Luc; Kempf, Christian; Bernet, Jean-Paul; Marx, Jacques; Lebrun, Françoise; Van Egroo, Louis-Dominique

    2006-09-01

    Excess protein in infant formula may lead to renal overload and play a role in later obesity. The objective of this controlled, prospective, randomized, double-blind study was to assess the suitability and safety of a modified protein content infant formula and its noninferiority as compared to a conventional formula. Healthy term infants age energy ratio: 2.6 g/100 kcal) or the isocaloric whey-predominant study formula (protein/energy ratio: 1.8 g/100 kcal) for 120 days. Primary outcome was daily weight gain between D0 and D120 (noninferiority criterion: difference in daily weight gain index at monthly intervals. Tolerance and safety were assessed at each visit. 162 infants were enrolled, 84% of the formula-fed infants and 36% of the breast-fed infants completing the study. Mean daily weight gain from D0 to D120 in the formula-fed groups differed by 0.38 g/day [95% CI: -2.59; 1.83] signifying the noninferiority of the study formula. Secondary outcomes did not differ between the 2 groups at any time and were comparable to outcomes in the breast-fed group. Tolerance was good and adverse events were not different between study groups. The whey-predominant study infant formula with a protein/energy ratio of 1.8 g/100 kcal and enhanced protein efficiency is safe and not inferior to a conventional formula in ensuring normal growth during the first four months of life.

  5. Diffuse excessive high signal intensity in low-risk preterm infants at term-equivalent age does not predict outcome at 1 year: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Leitner, Yael [Tel Aviv Sourasky Medical Centre, Child Development Centre, Dana-Dwek Children' s Hospital, Tel Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Weinstein, Maya [Tel Aviv Sourasky Medical Centre, Functional Brain Centre, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Bar Ilan University, Department of Psychology, Gonda Multidisciplinary Brain Research Centre, Ramat-Gan (Israel); Myers, Vicki [Tel Aviv Sourasky Medical Centre, Functional Brain Centre, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Uliel, Shimrit; Geva, Karen [Tel Aviv Sourasky Medical Centre, Child Development Centre, Dana-Dwek Children' s Hospital, Tel Aviv (Israel); Berger, Irit; Marom, Ronella [Tel Aviv Sourasky Medical Centre, Department of Neonatology, Lis Maternity Hospital, Tel Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Bashat, Dafna Ben [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Tel Aviv University, Sagol School of Neuroscience, Tel Aviv (Israel); Ben-Sira, Liat [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Tel Aviv Sourasky Medical Centre, Department of Radiology, Tel Aviv (Israel); Geva, Ronny [Bar Ilan University, Department of Psychology, Gonda Multidisciplinary Brain Research Centre, Ramat-Gan (Israel); Gross-Tsur, Varda [Shaare-Zedek Medical Centre, Neuropediatric Unit, Jerusalem (Israel)

    2014-08-15

    The outcome of premature infants with only diffuse excessive high signal intensity (DEHSI) is not clear. We explored the relationship between DEHSI, white matter (WM) diffusion characteristics, perinatal characteristics, and neurobehavioral outcome at 1 year in a homogenous group of preterm infants without major brain abnormalities. Fifty-eight preterm infants, gestational age 29 ± 2.6 weeks, underwent an MRI at term-equivalent age (TEA). Griffiths Mental Developmental Scales, neurological assessment, and Parental Stress Index (PSI) were performed at 1 year corrected age. These measures were compared between preterm infants according to DEHSI classification (none, mild, moderate). Diffusion tensor imaging was used in major WM volumes of interest to objectively measure the degree of WM maturation. No significant differences were detected in the perinatal risk characteristics, neurobehavioral outcome, and PSI at 1 year between infants with different DEHSI classifications. In infants with DEHSI, increased axial and radial diffusivities were detected in the optic radiations, centrum semiovale, and posterior limb of the internal capsule, indicating less advanced maturation of the WM. Significant correlations were detected between the time interval from birth to MRI and the WM microstructure in infants without DEHSI. DEHSI in premature infants is neither a predictive measure for short-term adverse neurobehavioral outcome nor related to perinatal risk characteristics. Extrauterine exposure time had a differential effect on WM maturational trajectories in infants with DEHSI compared to those without. We suggest DEHSI may represent an alteration in WM maturational characteristics. Further follow-up studies may verify later consequences of DEHSI in premature infants. (orig.)

  6. Regional volumetric assessment of the brain in moderately preterm infants (30-35 gestational weeks) scanned at term-equivalent age on magnetic resonance imaging.

    Science.gov (United States)

    Niwa, Tetsu; Suzuki, Keiji; Sugiyama, Nobuyoshi; Imai, Yutaka

    2017-08-01

    Early volume analyses of the infantile brain may help predict neurodevelopmental outcome. However, brain volumes are not well understood in moderately preterm infants at term-equivalent age (TEA). This study retrospectively investigated the relationship between regional brain volumes and infant gestational age (GA) at birth in moderately preterm infants (30-35weeks' GA) on magnetic resonance imaging (MRI) at TEA. Forty infants scanned at TEA were enrolled. Regional brain volumes were estimated by manual segmentation on MRI, and their relationship with GA at birth was assessed. The regional volumes of the cerebral hemispheres and deep gray matter were larger (Spearman ρ=0.40, P=0.01, and Spearman ρ=0.48, P<0.01, respectively), and volumes of the lateral ventricles were smaller (Spearman ρ=-0.32, P=0.04) in infants born at a later GA. The volumes of the cerebral hemispheres of the infants born at 30weeks' GA were significantly smaller than those born at 33 and 35weeks' GA (P<0.05). No associations were found between the volume of the cerebellum and brainstem, and GA at birth (Spearman ρ=0.24, P=0.13, and Spearman ρ=0.24, P=0.14, respectively). The volumes of the cerebral hemispheres at TEA may be smaller in infants born at 30weeks' GA, whereas those of the cerebellum and brainstem may not be correlated with GA among moderately preterm infants. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Safety and tolerability of Bifidobacterium longum subspecies infantis EVC001 supplementation in healthy term breastfed infants: a phase I clinical trial.

    Science.gov (United States)

    Smilowitz, Jennifer T; Moya, Jackelyn; Breck, Melissa A; Cook, Chelsea; Fineberg, Annette; Angkustsiri, Kathleen; Underwood, Mark A

    2017-05-30

    Historically, bifidobacteria were the dominant intestinal bacteria in breastfed infants. Still abundant in infants in developing nations, levels of intestinal bifidobacteria are low among infants in developed nations. Recent studies have described an intimate relationship between human milk and a specific subspecies of Bifidobacterium, B. longum subsp. infantis (B. infantis), yet supplementation of breastfed, healthy, term infants with this organism, has not been reported. The IMPRINT Study, a Phase I clinical trial, was initiated to determine the safety and tolerability of supplementing breastfed infants with B. infantis (EVC001). Eighty mother-infant dyads were enrolled in either lactation support plus B. infantis supplementation (BiLS) or lactation support alone (LS). Starting with Day 7 postnatal, BiLS infants were fed 1.8-2.8 × 1010 CFU B. infantis EVC001 daily in breast milk for 21 days. Mothers collected fecal samples, filled out health questionnaires, and kept daily logs about their infants' feeding and gastrointestinal symptoms from birth until Day 61 postnatal. Safety and tolerability were determined from maternal reports. There were no differences in the mean gestational age at birth, weight 1 and 2 months postnatal, and breast milk intake between groups. The mean Log10 change in fecal Bifidobacterium from Day 6 to Day 28 was higher (p = 0.0002) for BiLS (6.6 ± 2.8 SD) than for LS infants (3.5 ± 3.5 SD). Daily stool number was higher (p < 0.005) for LS and lower (p < 0.05) for BiLS infants during supplementation than at Baseline. During supplementation, watery stools decreased and soft stools increased by 36% over baseline in BiLS infants (p < 0.05) with no significant changes in stool consistency for the LS infants. None of the safety and tolerability endpoints, including flatulence, bloody stool, body temperature, ratings of gastrointestinal symptoms, use of antibiotics or gas-relieving medications, infant colic, jaundice, number of

  8. Hyperglycemia - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007228.htm Hyperglycemia - infants To use the sharing features on this page, please enable JavaScript. Hyperglycemia is abnormally high blood sugar. The medical term ...

  9. A prospective study of iron status in exclusively breastfed term infants up to 6 months of age.

    Science.gov (United States)

    Raj, Shashi; Faridi, Mma; Rusia, Usha; Singh, Om

    2008-03-01

    Can exclusive breastfeeding until six months of age maintain optimum iron status in term babies? We evaluated iron status of exclusively breastfed term infants in relation to breast milk iron and lactoferrin. In this prospective study in Delhi, India, during the period 2003-2004 normally delivered babies of non-anemic [(Hemoglobin (Hb) = 11 g/dl, n = 68] and anemic (Hb 7 - 10.9 g/dl, n = 61) mothers were followed until 6 months of age. Iron parameters were measured in the cord blood at 14 weeks and 6 months. Breast milk iron and lactoferrin were measured at the same intervals. Iron parameters in babies of both groups were within normal limits at birth, 14 weeks and 6 months. Mean breast milk iron and lactoferrin in non-anemic (day 1: 0.89, 6 months: 0.26 mg/l; day 1: 12.02, 6 months: 5.85 mg/ml) and anemic mothers (day 1: 0.86, 6 months: 0.27 mg/l; day 1: 12.91, 6 months: 6.37 mg/ml) were not different on day one or at other times. No relationship was found between breast milk iron, lactoferrin and iron status of the babies. Exclusively breastfed infants of non-anemic and anemic mothers did not develop iron deficiency or iron deficiency anemia by six months of age.

  10. The difference of bone mineral density of lumbar spine and wrist in the preterm and full-term infants: using dual energy X-ray absorptiometry

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Min Jung; Kim, Seung Cheol; Lee, Young Seok; Chang, Young Pyo; Park, Jin Young [Dankook University Hospital, College of Medicine, Dankook University, Seoul (Korea, Republic of)

    2000-09-01

    To assess the differences in bone mineral density (BMD) of lumbar spine and wrist between preterm infants of postconceptional age 40 weeks and normal full-term infants.Sixty-eight preterm infants born at conceptional age 26-36 weeks and 31 normal full-term infants born at 38-42 weeks were investigated. Bone mineral densities of the lumbar spine (from the second to the fourth segment) and wrist were measured by dual energy X-ray absorptiometry. In preterm infants, the corrected age of 0 month was defined as postconceptional 40 weeks. Full-term infants were compared. In the preterm group, birth weight and conceptional age were correlated with lumbar spinal and wrist bone mineral densities. Data were analyzed by student's t-test and Pearson's correlation coefficient, and a p value of less than 0.05 was considered significant. In preterm infants, the values of bone mineral densities of the lumbar spine and wrist were 0.137 {+-} 0.018 g/cm{sup 2} (0.061-0.202 g/cm{sup 2}) and 0.089 {+-} 0.013 g/cm{sup 2} (0.065-0.123 g/cm{sup 2}), respectively, while the respective values for full-term infants were 0.214 {+-} 0.030 g/cm{sup 2} (0.160-0.296 g/cm{sup 2}) and 0.118 {+-} 0.014 g/cm{sup 2} (0.096-0.162 g/cm{sup 2}). In the preterm group, lumbar spinal BMD correlated significantly with conceptional age (r=3D0.384, p less than 0.05) and birth weight (r=3D0.438, p less than 0.05). While wrist BMD correlated significantly with birth weight (r=3D0.281, p less than 0.05), its correlation with conceptional age was not significant (r=3D0.223, p greater than 0.05). The lumbar spinal and wrist BMDs of preterm infants at corrected age 0 were lower than those of normal full-term infants. In the preterm group, BMD values for the lumbar spine were lower in infants of lower conceptional age and birth weight. (author)

  11. Effectiveness of skin-to-skin contact versus care-as-usual in mothers and their full-term infants: Study protocol for a parallel-group randomized controlled trial

    NARCIS (Netherlands)

    Cooijmans, K.H.M.; Beijers, R.; Rovers, A.C.; Weerth, C. de

    2017-01-01

    Background: Twenty-to-forty percent of women experience postpartum depressive symptoms, which can affect both the mother and infant. In preterm infants, daily skin-to-skin contact (SSC) between the mother and her infant has been shown to decrease maternal postpartum depressive symptoms. In full-term

  12. The creamatocrit, fat and energy concentration in human milk produced by mothers of preterm and term infants.

    Science.gov (United States)

    Kociszewska-Najman, Bozena; Borek-Dzieciol, Beata; Szpotanska-Sikorska, Monika; Wilkos, Ewa; Pietrzak, Bronislawa; Wielgos, Miroslaw

    2012-09-01

    The objective of this study was to investigate the composition of breast milk which had been gathered from mothers for over first 2 weeks of lactation and to compare the changes in composition of preterm and term milk. A prospective, single center study was provided in Warsaw, Poland. The samples of breast milk from 22 mothers who had delivered prematurely and 39 mothers who had given birth to term infants were collected. The creamatocrit, energy and fat concentration were estimated in each participant's breast milk sample twice a day (morning and night hours). The lowest creamatocrit, calories and fat concentration was indicated in the preterm milk obtained in the morning (4.86%, 663.8 kcal/L and 33.6 g/L, respectively). The highest milk parameters were observed in the night samples of full-term milk and measured (9.6%, 919.7 kcal/L, and 60.7 g/L, respectively). No significant differences in analysed parameters were observed between preterm and full-term milk (p>0.05). In summary, creamatocrit, calories and lipid concentration in breast milk shows the daily differences. Colostrum and mature milk from mothers of preterm neonates differed from colostum and mature milk from mothers of term neonates. They had lipid contents, creamatocrit level and calorific value.

  13. Effects of basic developmental care on neonatal morbidity, neuromotor development, and growth at term age of infants who were born at <32 weeks.

    Science.gov (United States)

    Maguire, Celeste M; Veen, Sylvia; Sprij, Arwen J; Le Cessie, Saskia; Wit, Jan M; Walther, Frans J

    2008-02-01

    The goal of this study was to investigate the effect of basic elements of developmental care (incubator covers and positioning aids) on days of respiratory support and intensive care, growth, and neuromotor development at term age in infants who were born at Neuromotor development was defined as definitely abnormal (presence of a neonatal neurologic syndrome, such as apathy or hyperexcitability, hypotonia or hypertonia, hyporeflexia or hyperreflexia, hypokinesia or hyperkinesia, or a hemisyndrome), mildly abnormal (presence of only part of such a syndrome), or normal. A total of 192 infants were included (developmental care: 98; control: 94). Thirteen infants (developmental care: 7; control: 6) were excluded according to protocol (admitted for less than or died within the first 5 days: n = 12; taken out at parents' request: n = 1), which left a total of 179 infants who met inclusion criteria. In-hospital mortality was 12 (13.2%) of 91 in the developmental care group and 8 (9.1%) of 88 in the control group. There was no significant difference in the number of days of respiratory support, number of intensive care days, short-term growth, or neuromotor developmental outcome at term age between the developmental care and control groups. Duration of the intervention, whether only during the intensive care period or until hospital discharge, had no significant effect on outcome. Providing basic developmental care in the NICU had no effect on short-term physical and neurologic outcomes in infants who were born at <32 weeks' gestation.

  14. Transcutaneous bilirubinometer: its use in Chinese term infants and the effect of haematocrit and phototherapy on the TcB index.

    Science.gov (United States)

    Fok, T F; Lau, S P; Hui, C W; Fung, K P; Wan, C W

    1986-05-01

    The application of the transcutaneous bilirubinometer in screening for neonatal jaundice was evaluated in 259 full-term Chinese infants: 202 who had not received any treatment and 57 who were receiving phototherapy. The transcutaneous bilirubin index correlated well with the serum bilirubin level (SB) of the untreated infants and the coefficient of correlation was slightly higher for TcB readings obtained over the mid-sternal area (r = 0.91; P less than 0.001) than those over the forehead (r = 0.85; P less than 0.001). Transcutaneous bilirubinometry was unreliable in predicting the SB level in infants receiving phototherapy even if the SB readings were obtained over shaded skin. The haematocrit of the infants, though having a statistically significant effect on the TcB index, contributed only minimally to the regression line and correlation coefficient between the TcB index and SB level.

  15. Low-fat, high-carbohydrate parenteral nutrition (PN) may potentially reverse liver disease in long-term PN-dependent infants

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Skytte; Jørgensen, Marianne Hørby; Husby, Steffen

    2015-01-01

    INTRODUCTION: Parenteral nutrition-associated cholestasis (PNAC) is a complication of long-term parenteral nutrition (PN). Removal of lipids may reverse PNAC but compromises the energy to ensure infant growth. The purpose of this study was to test whether a low-fat, high-carbohydrate PN regimen......, which prevents and reverses PNAC in adults, could do the same in infants. This regimen could potentially avoid the problem of diminished energy input after removing nutritional lipids. METHODS: Infants developing PNAC over a 2-year period were started on a low-fat PN regimen with calories primarily from...... carbohydrates. The fat-free PN, containing 314 kJ/ml, was provided 5-6 times a week and fat, including essential fatty acids and fat-soluble vitamins, 1-2 times a week. Enteral feeding was continued according to individual tolerance. RESULTS: The study included 10 infants with short bowel syndrome (six...

  16. A longitudinal study of urinary phthalate excretion in 58 full-term and 67 preterm infants from birth through 14 months.

    Science.gov (United States)

    Frederiksen, Hanne; Kuiri-Hänninen, Tanja; Main, Katharina M; Dunkel, Leo; Sankilampi, Ulla

    2014-09-01

    Some phthalates have shown antiandrogenic effects in rat offspring. Premature infants may be exposed to high amounts of specific phthalates during hospitalization, and thus are potentially at risk. We evaluated longitudinal phthalate exposure and metabolism in full-term (FT) and preterm (PT) infants. Fifty-eight FT and 67 PT (gestational age, 24.7-36.6 weeks) infants were recruited at birth and followed until 14 months (nine times). Urinary concentrations of metabolites of diethyl phthalate (DEP), dibutyl phthalate isomers (DiBP and DnBP), butylbenzyl phthalate (BBzP), di(2-ethylhexyl) phthalate (DEHP), and diisononyl phthalate (DiNP) were measured in 894 samples. Daily intake and a hazard index for antiandrogenic effects were estimated, and excretion patterns of DEHP and DiNP metabolites were analyzed. Metabolites of BBzP, DiNP, and DEHP were 5-50 times higher at day 7 (D7) and month 1 (M1) in PT than in FT infants. Thereafter, metabolite concentrations were similar between the two groups. The estimated hazard index for combined DiBP, DnBP, BBzP, and DEHP exposures 7 days after birth exceeded the antiandrogenic threshold in > 80% of PT and > 30% of FT infants, and after M2, in 30% of all infants. The excretion pattern of DEHP and DiNP metabolites changed with age. Most PT infants and approximately one-third of healthy FT newborns were exposed to phthalates during early life at a potentially harmful level according to the European Food Safety Authority's recommended limits of daily exposure. Changes in the relative proportions of secondary phthalate metabolites over time were consistent with maturation of infant metabolic pathways during the first year of life. Further research is needed on the health effects of phthalate exposures and the influence of changes in metabolic capacity in neonates and infants.

  17. [The clinical course and one year forcast for a cohort of premature infants who were discharged with home oxygen in Bogota, Colombia].

    Science.gov (United States)

    Charpak, Nathalie; Ruiz, Juan Gabriel; Motta, Sylvia

    2012-01-01

    Documenting the clinical course and forecast for a concurrent cohort of discharged preterm infants who received home oxygen in Bogota, Colombia. This was a prospective study of a concurrent cohort of 194 newborn infants having 34 weeks gestational age (GA) or less at birth who were born in 12 institutions and followed up for one year of corrected age to assess mortality, morbidity, growth and development. Oxygen dependency was mild in 49 infants (25.3 %) and moderate-severe in 145 of them (74.7 %). There were 3 deaths; vital status was known in 169 infants at 40 weeks GA (87.1 %) and 103 (53%) at 1 year. Breast feeding at term was successful in 147 (75.8 %) infants. Growth indices at one year were appropriate (8,991 g weight, 73 cm height and 46.2 cm head circumference) 74.1 % of the cohort were still receiving home oxygen at 40 weeks and and 22.7 % at 3 months and oxygen was discontinued on average on postnatal day 109. 56.8 % of the cohort were readmitted to hospital at least once, 47% of them because of respiratory conditions. Only 71 % had ophthalmological screening and retinopathy of prematurity (ROP) was detected in 38 % of cases (4 severe cases: 3 laser surgery and 1 blind infant). Neuro-psychomotor and sensorial screening tests were only performed on 19 % of the infanys. More than 60 % of newborn infants discharged with home oxygen lacked structured follow-up. Oxygen-dependancy in infants is complex; our data suggested that there is plenty of room for improvement in Bogotá in that respect.

  18. Long-term Effects of Hepatitis B Immunization of Infants in Preventing Liver Cancer.

    Science.gov (United States)

    Chang, Mei-Hwei; You, San-Lin; Chen, Chien-Jen; Liu, Chun-Jen; Lai, Ming-Wei; Wu, Tzee-Chung; Wu, Shu-Fen; Lee, Chuan-Mo; Yang, Sheng-Shun; Chu, Heng-Cheng; Wang, Tsang-Eng; Chen, Bor-Wen; Chuang, Wan-Long; Soon, Maw-Soan; Lin, Ching-Yih; Chiou, Shu-Ti; Kuo, Hsu-Sung; Chen, Ding-Shinn

    2016-09-01

    The incidence of hepatocellular carcinoma (HCC) increases with age, but protective antibody responses decrease with time after infants are immunized against hepatitis B virus (HBV). We investigated whether immunization of infants against HBV prevents their developing HCC as adults. We also searched for strategies to maximize the cancer-preventive effects. We collected data from 2 Taiwan HCC registry systems on 1509 patients (6-26 years old) diagnosed with HCC from 1983 through 2011. Data on history of HBV immunization and prenatal maternal levels of HBV antigens of all HCC patients born after July 1984 were retrieved from the HBV immunization data bank of the Taiwan Center for Disease Control. We collected data on birth cohort-specific populations (6-26 years old) of Taiwan using the National Household Registry System. Rates of HCC incidence per 10(5) person-years were derived by dividing the number of patients with HCC by the person-years of the general population. Relative risks (RR) for HCC were estimated by Poisson regression analysis in vaccinated vs unvaccinated birth cohorts. We stratified patients by age group to evaluate the association of birth cohorts and HCC risks. Of the 1509 patients with HCC, 1343 were born before, and 166 were born after, the HBV vaccination program began. HCC incidence per 10(5) person-years was 0.92 in the unvaccinated cohort and 0.23 in the vaccinated birth cohorts. The RRs for HCC in patients 6-9 years old, 10-14 years old, 15-19 years old, and 20-26 years old who were vaccinated vs unvaccinated were 0.26 (95% confidence interval [CI], 0.17-0.40), 0.34 (95% CI, 0.25-0.48), 0.37 (95% CI, 0.25-0.51), and 0.42 (95% CI, 0.32-0.56), respectively. The RR for HCC in 6- to 26-year-olds was lower in the later vs the earlier cohorts (born in 1992-2005 vs 1986-1992; P liver cancer. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  19. Effects of ultrasound pregnancy dating on neonatal morbidity in late preterm and early term male infants: a register-based cohort study.

    Science.gov (United States)

    Kullinger, Merit; Haglund, Bengt; Kieler, Helle; Skalkidou, Alkistis

    2016-10-31

    Assessing gestational age by ultrasound can introduce a systematic bias due to sex differences in early growth. This cohort study included data on 1,314,602 births recorded in the Swedish Medical Birth Register. We compared rates of prematurity-related adverse outcomes in male infants born early term (gestational week 37-38) or late preterm (gestational week 35-36), in relation to female infants, between a time period when pregnancy dating was based on the last menstrual period (1973-1978), and a time period when ultrasound was used for pregnancy dating (1995-2010), in order to assess the method's influence on outcome by fetal sex. As expected, adverse outcomes were lower in the later time period, but the reduction in prematurity-related morbidity was less marked for male than for female infants. After changing the pregnancy dating method, male infants born early term had, in relation to female infants, higher odds for pneumothorax (Cohort ratio [CR] 2.05; 95 % confidence interval [CI] 1.33-3.16), respiratory distress syndrome of the newborn (CR 1.99; 95 % CI 1.33-2.98), low Apgar score (CR 1.26; 5 % CI 1.08-1.47), and hyperbilirubinemia (CR 1.12; 95 % CI 1.06-1.19), when outcome was compared between the two time periods. A similar trend was seen for late preterm male infants. Misclassification of gestational age by ultrasound, due to size differences, can partially explain currently reported sex differences in early term and late preterm infants' adverse neonatal outcomes, and should be taken into account in clinical decisions and when interpreting study results related to fetal sex.

  20. Preservation of native esophagus in infants with pure esophageal atresia has good long-term outcomes despite significant postoperative morbidity.

    Science.gov (United States)

    Zani, Augusto; Cobellis, Giovanni; Wolinska, Justyna; Chiu, Priscilla P L; Pierro, Agostino

    2016-02-01

    To evaluate long-term outcomes of pure esophageal atresia (EA) repair with preservation of native esophagus. Infants with pure EA treated at our institution (2000-2010) and with minimum 5-year follow-up were reviewed (REB:1000046653). Data analysed included demographics, management and outcomes and are reported as mean ± SD/median (range). Of 185 infants with EA, 12 (7 %) had pure EA (gestational age: 36 ± 2.4 weeks, birth weight: 2353 ± 675 g). Ten had associated anomalies, including trisomy-21 (n = 2) and duodenal atresia (n = 1). 1 patient (short gap) underwent primary thoracoscopic anastomosis, 11 had gastrostomy (Stamm, n = 5; image-guided, n = 6) as initial procedure. At definitive repair (age: 128 ± 91 days; weight 5.5 ± 2.3 kg): ten had primary anastomosis and 1 had Collis gastroplasty. No patient had esophageal replacement surgery. three patients had gastrostomy dehiscence requiring re-operation. At post-operative esophagram, seven had anastomotic leak successfully treated conservatively. Seven patients developed strictures requiring balloon dilatations (median two dilatations, range 1-10), six received antireflux surgery. At 7-year follow-up (range 5-15 years), all patients had the gastrostomy closed and were on full oral feeds. The management of pure EA continues to be challenging. The preservation of native esophagus is possible with significant morbidity. The long-term outcomes are favourable.

  1. Lidocaine response rate in aEEG-confirmed neonatal seizures: Retrospective study of 413 full-term and preterm infants.

    Science.gov (United States)

    Weeke, Lauren C; Toet, Mona C; van Rooij, Linda G M; Groenendaal, Floris; Boylan, Geraldine B; Pressler, Ronit M; Hellström-Westas, Lena; van den Broek, Marcel P H; de Vries, Linda S

    2016-02-01

    To investigate the seizure response rate to lidocaine in a large cohort of infants who received lidocaine as second- or third-line antiepileptic drug (AED) for neonatal seizures. Full-term (n = 319) and preterm (n = 94) infants, who received lidocaine for neonatal seizures confirmed on amplitude-integrated EEG (aEEG), were studied retrospectively (January 1992-December 2012). Based on aEEG findings, the response was defined as good (>4 h no seizures, no need for rescue medication); intermediate (0-2 h no seizures, but rescue medication needed after 2-4 h); or no clear response (rescue medication needed Lidocaine had a good or intermediate effect in 71.4%. The response rate was significantly lower in preterm (55.3%) than in full-term infants (76.1%, p lidocaine was significantly better than midazolam as second-line AED (21.4% vs. 12.7%, p = 0.049), and there was a trend for a higher response rate as third-line AED (67.6% vs. 57%, p = 0.086). Both lidocaine and midazolam had a higher response rate as third-line AED than as second-line AED (p lidocaine were the following: higher gestational age, longer time between start of first seizure and administration of lidocaine, lidocaine as third-line AED, use of new lidocaine regimens, diagnosis of stroke, use of digital aEEG, and hypothermia. Multivariable analysis of seizure response to lidocaine included lidocaine as second- or third-line AED and seizure etiology. Seizure response to lidocaine was seen in ~70%. The response rate was influenced by gestational age, underlying etiology, and timing of administration. Lidocaine had a significantly higher response rate than midazolam as second-line AED, and there was a trend for a higher response rate as third-line AED. Both lidocaine and midazolam had a higher response rate as third-line compared to second-line AED, which could be due to a pharmacologic synergistic mechanism between the two drugs. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  2. The qualitative assessment of general movements in preterm, term and young infants--review of the methodology.

    Science.gov (United States)

    Einspieler, C; Prechtl, H F; Ferrari, F; Cioni, G; Bos, A F

    1997-11-24

    We describe the state of the art of Prechtl's method for the qualitative assessment of general movements as a diagnostic tool for early detection of brain dysfunction. After discussing the optimal technique for video recording general movements in preterm, term and young infants, attention is focused on the proper analysis of this spontaneous motor pattern. Recently, a group of active researchers in the field reached consensus on the various qualities of normal and abnormal general movements. These definitions are reported here in full. Since it is a newly introduced method careful investigation into its reliability is required. Various groups of investigators have obtained data which demonstrate the robust character of the method (interscorer agreement: 78-98%). Finally, we discuss the validity of this early assessment method on the basis of the reports published so far. While the method's sensitivity is similar in all age groups studied (preterm, term, first month, second month, and third month age epochs), and averages 94.5%, the specificity of the method is age-dependent. It is low during the early ages, increases gradually and reaches 82 to 100% at 3 months post-term. This phenomenon is explained by spontaneous recovery of early dysfunction. In contrast, consistent abnormalities of general movements are linked to neurological deficits found at the 2 year follow-up.

  3. Dexmedetomidine sedation combined with caudal anesthesia for lower abdominal and extremity surgery in ex-preterm and full-term infants.

    Science.gov (United States)

    Waurick, Katrin; Sauerland, Cristina; Goeters, Christiane

    2017-06-01

    Awake caudal anesthesia is a potentially attractive option, because the administration of general anesthesia is associated with a high rate of respiratory complications and hemodynamic disturbances and potential neurotoxic effects. To facilitate the caudal puncture and subsequent surgical intervention, additional sedatives are commonly administered. We aimed to establish a new, safe, and effective anesthetic procedure for very young children with comorbidities. We retrospectively analyzed 23 children who underwent lower abdominal or lower extremity surgery with dexmedetomidine sedation and caudal anesthesia from January 2015 to August 2015. Dexmedetomidine was initiated with a total bolus infusion of 0.7-1.1 μg·kg(-1) followed by a continuous infusion of 1 μg·kg(-1) ·h(-1) . Bupivacaine (2.5 mg·kg(-1) ) was supplemented with 5-10 μg·kg(-1) epinephrine to strengthen and prolong motor block. According to maturity at birth, two groups were defined: ex-preterm and full-term infants. There were 12 ex-preterm and 10 full-term infants available for analysis. The median postmenstrual age was 44 (38-52) weeks in ex-preterm and 46.5 (40-72) weeks in full-term infants. Without any additional intervention, surgery was successfully accomplished in 82% of all cases. While respiratory complications were not a problem, hemodynamic disturbances commonly occurred. Maximum decreases in heart rate (HR) of 30% were accompanied by maximum decreases in mean arterial pressure (MAP) of 38%. No infant had a heart rate below 100 bpm. MAP declined in one ex-preterm infant to a minimum value of 32 mmHg. Caudal anesthesia combined with dexmedetomidine sedation is an effective anesthetic technique for lower abdominal and extremity surgery in ex-preterm and full-term infants with severe comorbidities. © 2017 John Wiley & Sons Ltd.

  4. Validity of behavioral and physiologic parameters for acute pain assessment of term newborn infants

    Directory of Open Access Journals (Sweden)

    Andrea Lübe de S Thiago Pereira

    1999-03-01

    Full Text Available CONTEXT: The subjectivity of pain causes enormous difficulties in evaluating neonatal pain with a single, practical and easy-to-apply tool. Pain evaluation in the neonatal period should be performed by valid, safe, useful and feasible methods. OBJECTIVE: To evaluate the validity of the Neonatal Facial Coding System (NFCS, Neonatal Infant Pain Scale (NIPS, heart rate (HR and O2 saturation (O2 sat for neonatal pain assessment. DESIGN: Prospective, double-blind randomized trial. SETTING: A secondary level maternity hospital. PARTICIPANTS: 70 healthy neonates requiring bilirubin dosage were randomly assigned to receive a venous puncture (P: n=33, BW 3.2kg, SD 0.6; GA 39wk, SD 1; 59h of life, SD 25 or an alcohol swab friction (F: n=37; BW 3.1kg, SD 0.5; GA 39wk, SD 1; 52h of life, SD 17. INTERVENTION: All measurements were taken prior to (PRE, during (T0, and 1(T1, 3(T3, 5(T5 and 10(T10 minutes after the procedure. MEASUREMENTS: A neonatologist evaluated NFCS, NIPS, HR and O2 sat by pulse oxymetry. RESULTS: Median NFCS and NIPS results at T0, T1 and T3 were higher in P group, compared to F. More P neonates presented NFCS >2 and/or NIPS >3 at T0, T1 and T3. HR was lower in P group at T1. Average O2 sat was above 90% during the whole study period in both groups. CONCLUSION: NFCS and NIPS are suitable instruments for neonatal pain evaluation. Heart rate and O2 saturation can be used only as auxiliary methods.

  5. Kernicterus in preterm infants.

    Science.gov (United States)

    Okumura, Akihisa; Kidokoro, Hiroyuki; Shoji, Hiromichi; Nakazawa, Tomoyuki; Mimaki, Masakazu; Fujii, Katsunori; Oba, Hiroshi; Shimizu, Toshiaki

    2009-06-01

    We sought to clarify the features of kernicterus in preterm infants. The subjects of this study were 8 preterm infants with athetoid cerebral palsy whose gestational ages were 15 mg/dL were observed in 3 infants. No infant showed neurologic symptoms characteristic of classical acute bilirubin encephalopathy during the neonatal period. Dystonic posture and abnormal muscle tone were first recognized within 6 months' corrected age in all patients. During infancy, MRI was performed in 7 infants. Abnormal high-intensity areas were observed in the bilateral globi pallidi in all 7 infants. However, MRI during the neonatal period or after 1 year's corrected age showed no abnormal findings. BAEP measurements were abnormal in 7 of the 8 infants. Preterm infants with athetotic cerebral palsy showed rather homogeneous features, similar to term infants with kernicterus, with marked hyperbilirubinemia. This combination of clinical, laboratory, neuroimaging, and neurophysiological data will contribute to the increased recognition of preterm infants with kernicterus.

  6. The Groningen LCPUFA study : no effect of postnatal long-chain polyunsaturated fatty acids in healthy term infants on neurological condition at 9 years

    NARCIS (Netherlands)

    de Jong, Corina; Kikkert, Hedwig K.; Fidler, Vaclav; Hadders-Algra, Mijna

    Long-chain PUFA (LCPUFA) supplementation of formula can have beneficial effects on neurodevelopmental outcome in early infancy, but uncertainty exists regarding effects after 6 months. The present study is the first to investigate whether consumption by term infants of formula containing LCPUFA for

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

    Science.gov (United States)

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

    2015-10-01

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

  8. Neonatal jaundice and stool production in breast- or formula-fed term infants

    NARCIS (Netherlands)

    Buiter, Hannah D.; Dijkstra, Sebastiaan S. P.; Elferink, Rob F. M. Oude; Bijster, Peter; Woltil, Henk A.; Verkade, Henkjan J.

    It has remained unclear whether the amount of fecal fat excreted in the stool and stool production influences the severity of neonatal jaundice. We determined the relationship between stool production, fecal fat excretion and jaundice in healthy breast-fed (BF) or formula-fed (FF) (near-)term

  9. Dyadic Transition to Parenthood: A Longitudinal Assessment of Personal Growth among Parents of Pre- and Full-term Infants.

    Science.gov (United States)

    Porat-Zyman, Ginna; Taubman-Ben-Ari, Orit; Spielman, Varda

    2017-02-01

    This study examined the contribution of birth circumstances (premature and full-term birth) and individual and spousal factors (attachment orientations, parental self-efficacy and perceived infant temperament), measured 1 month post-partum, to the personal growth of first-time parents (n = 121) 1 and 5 months post-partum. The study overcame the limitations of prior research by accurately measuring actor effects while controlling for and assessing partner effects, by applying the actor-partner interdependence model. The findings confirm that becoming a parent, under normative and stressful circumstances, can lead to personal growth and parents of premature babies experience higher levels of growth than parents of full terms. Moreover, 1 month post-partum, actor effects were found for higher attachment anxiety and higher parental self-efficacy. Furthermore, personal growth at 1 month post-partum was found to be the strongest predictor of personal growth 5 months after childbirth. Five months post-partum, a positive partner effect was found for parental self-efficacy. Mothers reported higher growth than fathers only 5 months after the birth. It seems time plays an important role as to which variables contribute to personal growth. In the early stages of parenthood, personal growth is mostly an individual experience. Theoretical and clinical implications are discussed. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Prevalence and associated factors of strabismus in former preterm and full-term infants between 4 and 10 Years of age.

    Science.gov (United States)

    Fieß, Achim; Kölb-Keerl, Ruth; Schuster, Alexander K; Knuf, Markus; Kirchhof, Bernd; Muether, Philipp S; Bauer, Jacqueline

    2017-12-02

    Limited data exist collating most of the associated factors for strabismus in one analysis. The aim of this study was to assess the prevalence of strabismus and to analyse associated factors in former preterm and full-term infants. In this cross-sectional study, 239 former preterm infants with gestational age (GA) ≤ 32 weeks and 264 former full-term born infants with GA ≥ 37 weeks underwent detailed ophthalmologic examination in the age of 4-10 years and perinatal data assessment for risk factor analysis. Ophthalmologic examinations included cover testing, best corrected visual acuity, cycloplegic objective refraction, slit lamp as well as fundus examinations. For association analysis with strabismus, the following data was collected and included in multivariable analysis: sex, age at examination, anisometropia, myopic and hyperopic refractive error (≥ 3 dioptres), astigmatism, birth weight percentile, gestational age, retinopathy of prematurity occurrence, maternal age at childbirth, mother smoking, breastfeeding artificial ventilation, intraventricular bleeding, and other perinatal adverse events. Overall, 4/264 (2%) full-term infants, 15/125 (12%) preterm-infants with GA 29-32 weeks without ROP, 13/59 (22%) preterm infants with GA ≤ 28 weeks without ROP and 14/55 (26%) with GA ≤ 32 weeks with retinopathy of prematurity were affected by strabismus. In the multivariable regression model strabismus was associated with GA (OR = 0.84 per week; p = 0.001), hyperopic refractive error (OR = 4.22; p = 0.002) and astigmatism (OR = 1.68; p = 0.02). This investigation highlights that low gestational age and refraction of the eye are independent risk factors for strabismus, while the other factors show less independent influence.

  11. The Paradox of Prematurity: The Behavioral Vulnerability of Late Preterm Infants and the Cognitive Susceptibility of Very Preterm Infants at 36 months Post-term

    Science.gov (United States)

    Shah, Prachi E.; Robbins, Natashia; Coelho, Renuka B.; Poehlmann, Julie

    2013-01-01

    We explored associations among preterm status (very preterm infant (VPI: cognitive and behavioral outcomes. We hypothesized that LPIs would demonstrate better health and neurobehavioral outcomes compared with more premature infants, and that preterm status would moderate the association between parenting quality and 3-year outcomes. Sample included 123 preterm infants (gestation behavior at 36-months, and maternal depressive symptoms and parenting at all timepoints. Group differences were explored using MANOVAs while predictors of child outcomes were explored using hierarchical regression analyses. MANOVAs indicated that LPIs had more optimal neonatal health during the hospital stay, yet more externalizing (p= .043), aggressive (p= .006) and oppositional behaviors (p= .008) at 3-years compared with VPIs. There were no IQ differences between VPIs, MPIs and LPIs. However, preterm infants who experienced less negative parenting had higher IQs at 36 months (β = −3.245, p= .017), with the greatest effects seen in VPIs (β = 0.406, p = .01) compared with LPIs (β= 0.148, p= .381). LPIs manifested similar IQ, but more externalizing, oppositional and aggressive behavior symptoms compared to VPIs. VPIs appeared to be differentially susceptible to parenting effects, with VPIs demonstrating the highest cognitive scores in the context of more positive parenting. PMID:23261789

  12. Long-term development of low-risk low birth weight preterm born infants: neurodevelopmental aspects from childhood to late adolescence.

    Science.gov (United States)

    Reuner, Gitta; Hassenpflug, Anne; Pietz, Joachim; Philippi, Heike

    2009-07-01

    Most studies on clinical outcome of preterm born infants focus on high-risk infants, whereas little is known about the long-term prognosis of low-risk low birth weight preterm born infants (LBW). To examine physical growth, school outcome, behavioural aspects, quality of life, and intervention impact on LBW in late adolescence compared to term born controls and to analyse developmental pathways from childhood to adolescence for these groups. In late adolescence 65 LBW and 41 matched term born controls were assessed with a structured telephone interview and standardized questionnaires with regard to physical growth, school career, therapeutic interventions, behavioural aspects, and quality of life. Longitudinal analysis comprised data from birth, infancy, school age, and adolescence. Growth in height of LBW was highly variable, but correlated significantly with birth parameters and was below those of controls with regard to percentiles. School enrollment of LBW was more often delayed, and there was a trend toward lower school graduation in LBW. The groups did not differ with regard to general or health-related quality of life and behavioural aspects, but LBW received significantly more therapeutical interventions. In general, LBW showed no major deficits in late adolescence. However, a prolonged school career and a higher demand for therapeutic interventions indicate subtle neurodevelopmental deficits in LBW. This underscores the need for professional follow-up programmes for this majority of preterm born infants.

  13. Long-term serological outcome of infants who received frozen-thawed milk from human T-lymphotropic virus type-I positive mothers.

    Science.gov (United States)

    Ando, Yoshiya; Ekuni, Yutaka; Matsumoto, Yoshinari; Nakano, Shiro; Saito, Kensuke; Kakimoto, Kazuhiro; Tanigawa, Takuo; Kawa, Motohiro; Toyama, Takenori

    2004-12-01

    Human T-lymphotropic virus type-I (HTLV-I) infection occurs via mothers' milk during feeding. However, freeze-thaw processing can eliminate the infectivity of the mother's milk of HTLV-I carriers. A long-term follow-up survey was conducted to investigate the HTLV-I infectivity of frozen-thawed mothers' milk among infants whose mothers were HTLV-I seropositive. Infants fed frozen-thawed mothers' milk did not become HTLV-I antibody-positive up until 1 year old, and all children followed up until an age of 11-12 years were antibody negative. This study showed that freeze-thaw processing can eliminate the HTLV-I infectivity of mothers' milk, and that HTLV-I carriers can indirectly feed their infants using frozen-thawed mothers' milk as a way to prevent HTLV-I infection.

  14. Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review.

    Science.gov (United States)

    Gyan, Thomas; Strobel, Natalie; McAuley, Kimberley; Shannon, Caitlin; Newton, Sam; Tawiah-Agyemang, Charlotte; Amenga-Etego, Seeba; Owusu-Agyei, Seth; Forbes, David; Edmond, Karen

    2016-03-01

    There has been an expansion of circumcision services in Africa as part of a long-term HIV prevention strategy. However, the effect of infant male circumcision on morbidity and mortality still remains unclear. Acute morbidities associated with circumcision include pain, bleeding, swelling, infection, tetanus or inadequate skin removal. Scale-up of circumcision services could lead to a rise in these associated morbidities that could have significant impact on health service delivery and the safety of infants. Multidisciplinary training programmes have been developed to improve skills of health service providers, but very little is known about the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. This review aims to evaluate the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. The review will include studies comparing health service providers who have received education and/or training to improve their skills for infant male circumcision with those who have not received education and/or training. Randomised controlled trials (RCTs) and cluster RCTs will be included. The outcomes of interest are short-term morbidities of the male infant including pain, infection, tetanus, bleeding, excess skin removal, glans amputation and fistula. Long-term morbidities include urinary tract infection (UTI), HIV infection and abnormalities of urination. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL and DARE), WHO databases and reference list of papers will be searched for relevant articles. Study selection, data extraction and synthesis and risk of bias assessment using the Cochrane risk of bias assessment tool will be conducted. We will calculate the pooled estimates of the difference in means and risk ratios using random effects models. If

  15. Specific characteristics of spontaneous movements in preterm infants at term age are associated with developmental delays at age 3 years.

    Science.gov (United States)

    Kanemaru, Nao; Watanabe, Hama; Kihara, Hideki; Nakano, Hisako; Takaya, Rieko; Nakamura, Tomohiko; Nakano, Junji; Taga, Gentaro; Konishi, Yukuo

    2013-08-01

    The aim of this study was to investigate the relationship between the characteristics of spontaneous movements in preterm infants at term age and developmental delay at 3 years of age. We analysed video recordings of the spontaneous movements in the supine position of 124 preterm infants (44 males, 80 females) at 36 to 44 weeks postmenstrual age (PMA). The infants were born preterm (22-36wks PMA; birthweight 489-1696g) and had not received a diagnosis of a neurological or developmental disorder by the age of 3 years. The recorded spontaneous movements were quantified using six movement indices, which were calculated from two-dimensional trajectories of all limbs. The infants were divided into three developmental groups, normal, borderline, or delayed, based on their developmental quotient as calculated using the Kyoto Scale of Psychological Development 2001 (Kyoto Scale) at 3 years of age. Group differences in the movement indices were analysed. In the delayed group, average velocity of arms and legs were significantly lower (ppreterm infants. © 2013 Mac Keith Press.

  16. Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life.

    Science.gov (United States)

    Faust, Kirstin; Härtel, Christoph; Preuß, Michael; Rabe, Heike; Roll, Claudia; Emeis, Michael; Wieg, Christian; Szabo, Miklos; Herting, Egbert; Göpel, Wolfgang

    2015-09-01

    To evaluate lowest mean arterial blood pressure during the first 24 h of life (minMAP(24)) in very-low-birthweight (VLBW) infants and to identify associations between hypotension and short-term outcome. Retrospective cohort analysis of the minMAP(24) of 4907 VLBW infants with a gestational age Hypotension was defined as minMAP(24) being lower than the median value of all patients of the same gestational age. MinMAP(24) values correlated with gestational age. Median minMAP(24) values of VLBW infants ≤29 weeks' gestation were 1-2 mm Hg lower than gestational age in completed weeks. Hypotensive infants had a higher rate of intraventricular haemorrhage (IVH, 20.3% vs 15.9%, pHypotension during the first 24 h of life is associated with adverse outcomes in VLBW infants. This underlines the need for randomised controlled trials on the use of vasoactive drugs in this vulnerable patient cohort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Placental pathology in full-term infants with hypoxic-ischemic neonatal encephalopathy and association with magnetic resonance imaging pattern of brain injury.

    Science.gov (United States)

    Harteman, Johanna C; Nikkels, Peter G J; Benders, Manon J N L; Kwee, Anneke; Groenendaal, Floris; de Vries, Linda S

    2013-10-01

    To investigate the relationship between placental pathology and pattern of brain injury in full-term infants with neonatal encephalopathy after a presumed hypoxic-ischemic insult. The study group comprised full-term infants with neonatal encephalopathy subsequent to presumed hypoxia-ischemia with available placenta for analysis who underwent cerebral magnetic resonance imaging (MRI) within the first 15 days after birth. Macroscopic and microscopic characteristics of the placenta were assessed. The infants were classified according to the predominant pattern of brain injury detected on MRI: no injury, predominant white matter/watershed injury, predominant basal ganglia and thalami (BGT) injury, or white matter/watershed injury with BGT involvement. Maternal and perinatal clinical factors were recorded. Placental tissue was available for analysis in 95 of 171 infants evaluated (56%). Among these 95 infants, 34 had no cerebral abnormalities on MRI, 27 had white matter/watershed injury, 18 had BGT injury, and 16 had white matter/watershed injury with BGT involvement. Chorioamnionitis was a common placental finding in both the infants without injury (59%) and those with white matter/BGT injury (56%). On multinomial logistic regression analysis, white matter/watershed injury with and without BGT involvement was associated with decreased placental maturation. Hypoglycemia was associated with an increased risk of the white matter/BGT injury pattern (OR,5.4; 95% CI, 1.4-21.4). The BGT injury pattern was associated with chronic villitis (OR, 12.7; 95% CI, 2.4-68.7). A placental weight brain injury, especially for the BGT pattern (OR, 0.1; 95% CI, 0.01-0.7). Placental weight <10th percentile was mainly associated with normal cerebral MRI findings. Decreased placental maturation and hypoglycemia <2.0 mmol/L were associated with increased risk of white matter/watershed injury with or without BGT involvement. Chronic villitis was associated with BGT injury irrespective of white

  18. The low birthweight, term infant and the need for admission to special care nurseries.

    Science.gov (United States)

    Parry, Michael; Davies, Mark W

    2013-12-01

    We aimed to determine, in full-term newborns born between 2000 and 2499 g, what proportion develop problems or the need for interventions that would likely require admission to a special care nursery (SCN) (i.e., needed an intravenous line (IV) or a nasogastric tube (NGT). A multicentre, retrospective audit of all babies born from 1 January to 30 June 2011 was used. Eligible babies were term, inborn at one of four centres in south-east Queensland, with a birthweight between 2000 and 2499 g. The cohort of 98 babies had a mean (SD) birthweight of 2340 (122.3) g and a mean (SD) gestational age of 38.3 (1.0) weeks. Forty-three had at least one low temperature, 55 had at least one low blood glucose, 35 had an NGT, 22 had an IV cannula. In the entire cohort, 48 babies (49%) required either an IV cannula or an NGT. Fifteen per cent had a second problem (either low blood glucose or low temperature) at a median (interquartile range) age of 11 (5.5-25.5) h: none required a second NGT or IV. The proportion of babies that required either an NGT or an IV was larger in the 2000-2199 g group (P = 0.026). About half of the babies born with a birthweight of 2000-2499 g will require some intervention that will require them to be admitted to a SCN. However, about half would be able to avoid an SCN admission if they are well and admitted to the post-natal ward. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  19. Effects of antenatal corticosteroid administration on mortality and long-term morbidity in early preterm, growth-restricted infants

    NARCIS (Netherlands)

    Schaap, AH; Wolf, H; Bruinse, HW; Smolders-De Haas, H; Van Ertbruggen, [No Value; Treffers, PE

    Objective: To evaluate the effect of antenatal corticosteroids on mortality, morbidity, and disability or handicap rate in early preterm, growth-restricted infants. Methods: This case-control study in two tertiary care centers included all live-born singleton infants with growth-restriction due to

  20. The Infant Fish Oil Supplementation Study (IFOS): design and research protocol of a double-blind, randomised controlled n--3 LCPUFA intervention trial in term infants.

    Science.gov (United States)

    Meldrum, S J; D'Vaz, N; Dunstan, J; Mori, T A; Prescott, S L

    2011-09-01

    The Infant Fish Oil Supplementation Study is a double-blind randomised controlled trial investigating whether the incidence of allergic disease can be reduced and developmental outcomes enhanced through supplementation with omega-3 fatty acids. Infants at high risk of developing allergic disease will be randomised to receive either fish oil or olive oil supplements until 6 months of age and followed up at six postnatal clinic visits to assess allergy outcomes and infant neurodevelopment. Study groups to consist of a treatment group allocated to receive 650 mg of fish oil daily (250-280 mg docosahexaenoic acid and at least 60 mg eicosapentaenoic acid and a placebo group (olive oil) from birth to 6 months of age. Allergy outcomes will be assessed by clinical history, clinical assessments and allergen skin prick tests at the 12, 30 and 60 month visits. Neurodevelopmental assessments to be conducted at 18 months, and language questionnaires at 12, 18 and 30 months. Samples will be collected from mothers antenatally, from infants at birth, and at clinic visits from 6 months onwards for immunological assessments. Fatty acid composition to be measured in erythrocytes and plasma (at birth and after the supplementation period) to assess the effect of the intervention on fatty acid status. Information on medical history, diet and other lifestyle factors at an antenatal clinic visit and postnatal clinic visits will also be collected. This study is designed to examine clinically relevant effects of a novel, non-invasive and potentially low cost approach to reduce the incidence of allergic disease and facilitate neurodevelopment during early childhood. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Effect of Early Expressed Human Milk on Insulin-Like Growth Factor 1 and Short-Term Outcomes in Preterm Infants.

    Directory of Open Access Journals (Sweden)

    Francesca Serrao

    Full Text Available Preterm breast milk contains high levels of bioactive components, including insulin-like growth factor 1 (IGF-1, that are reduced by Holder pasteurization. Animal studies have shown that milk-borne IGF-1 is likely absorbed intact in a bioactive form by the intestines. The aim of this study was to assess if early non-pasteurized expressed breast milk nutrition may affect IGF-1 plasma levels in premature infants. We also investigated the possible association between early expressed milk nutrition and short-term outcomes.Fifty-two preterm infants with gestational age < 31 weeks were divided into two groups according to expressed breast milk intake (< or ≥ 50 mL/Kg/day until 32 weeks of postmenstrual age when blood sampling for IGF-1 analysis was performed.In our population, early expressed breast milk does not affect IGF-1 plasma levels (p 0.48. An association was observed between early expressed milk nutrition and a lower incidence of bronchopulmonary dysplasia, sepsis, feeding intolerance, need for parenteral nutrition and length of hospitalization.Contrary to the results in some animal studies, our results did not seem to show that early expressed breast milk can help to maintain postnatal IGF-1 near foetal levels in preterm infants. The observed protective effect of expressed breast milk on short-term outcomes can be the starting point for further study of the effects of non-pasteurized human milk in preterm infants.

  2. Traditional Long-Term Central Venous Catheters Versus Transhepatic Venous Catheters in Infants and Young Children.

    Science.gov (United States)

    Marshall, Amanda Marie; Danford, David A; Curzon, Christopher L; Anderson, Venus; Delaney, Jeffrey W

    2017-10-01

    Children with congenital heart disease may require long-term central venous access for intensive care management; however, central venous access must also be preserved for future surgical and catheterization procedures. Transhepatic venous catheters may be an useful alternative. The objective of this study was to compare transhepatic venous catheters with traditional central venous catheters regarding complication rate and duration of catheter service. Retrospective review of 12 congenital heart disease patients from September 2013 to July 2015 who underwent placement of one or more transhepatic venous catheters. Single freestanding pediatric hospital located in the central United States. Pediatric patients with congenital heart disease who underwent placement of transhepatic venous catheter. Cohort's central venous catheter complication rates and duration of catheter service were compared with transhepatic venous catheter data. Twelve patients had a total of 19 transhepatic venous lines. Transhepatic venous lines had a significantly longer duration of service than central venous lines (p = 0.001). No difference between the two groups was found in the number of documented thrombi, thrombolytic burden, or catheter sites requiring wound care consultation. A higher frequency of infection in transhepatic venous lines versus central venous lines was found, isolated to four transhepatic venous lines that had a total of nine infections. All but one was successfully managed without catheter removal. The difference in the proportion of infections to catheters in transhepatic venous lines versus central venous lines was significant (p = 0.0001), but no difference in the rate of infection-related catheter removal was found. Without compromising future central venous access sites, transhepatic venous lines had superior duration of service without increased thrombosis, thrombolytic use, or insertion site complications relative to central venous lines. Transhepatic venous

  3. [Long-term outcomes after cataract surgery in infants with congenital cataract].

    Science.gov (United States)

    Qi, J Y; Xiao, W; Wang, M Y; Zhao, D X; Pu, W

    2017-04-11

    Objective: To observe the long-term outcomes after congenital cataract surgery performed prior to 36 months of age. Methods: A retrospective case study was conducted. Thirty-two cases (57 eyes) of congenital cataract were included from January 2004 to January 2012. All patients received intraocular lens (IOL) implantation with posterior continuous curvilinear capsulorhexies and anterior vitrectomy after cataract extraction and were followed up. At the last visit, the best corrected visual acuity (BCVA) was determined and postoperative complications were evaluated during follow-up with a longest time of 13 years. Non-normal distribution showed in median M (minimum and maximum). Data were analyzed by Kruskal Wallis single factor variance analysis and multiple comparison. The independent Mann-Witney U test was used to analyze non-normal distribution data. Results: There were thirty-two cases (57 eyes) of congenital cataract including 7 unilateral cases and 25 bilateral cases. The median age at cataract extraction was 6.0months; the median IOL implantation age was 28.0 months and the median duration of follow-up after cataract extraction was 67.0 months. The median postoperative BCVA was (LogMAR) 0.52. Unilateral and bilateral cataract postoperative BCVA difference had no statistical significance (U=107, P>0.05). Patients received cataract surgery in 2 to 4 months, the postoperative BCVA was better than in 5 to 8 months. The difference was statistical significance (H=-15.33, Pcataract surgeries performed prior to 36 mouths of life together with the implantation of IOL can achieve good visual acuity. No serious complications occurred. (Chin J Ophthalmol, 2017, 53: 266-273).

  4. The 5-minute Apgar score: survival and short-term outcomes in extremely low-birth-weight infants.

    Science.gov (United States)

    Phalen, Ann Gibbons; Kirkby, Sharon; Dysart, Kevin

    2012-01-01

    The Apgar score is a standardized tool for evaluating newborns in the delivery room. Despite its long history and widespread use, debate remains over its reliability of predicting neonatal outcomes, especially in extremely low-birth-weight premature infants. The aim of the study was to examine the relationship between the 5-minute Apgar score of extremely low-birth-weight infants, as it relates to survival and morbidities associated with prematurity and length of hospital stay. A retrospective query of the Alere neonatal database from 2001 to 2011 examined all infants less than 32 weeks' gestation and less than 1000-g birth weight. The 5-minute Apgar score was divided into 2 groups, score of 4 or greater or less than 4. The study compared results of the 5-minute Apgar score and associated morbidities in surviving infants. Statistical analyses included chi-square, Fisher exact test, t test, and multivariate regression. The sample consisted of 3898 infants with an 86.4% (n = 3366) survival rate. Controlling for gestational age and birth weight, surviving infants with a 5-minute Apgar score of less than 4 were more likely to demonstrate nonintact survival. Infants with a low 5-minute Apgar score have greater risk for mortality and morbidities associated with prematurity.

  5. Pre-exposure Prophylaxis Use by Breastfeeding HIV-Uninfected Women: A Prospective Short-Term Study of Antiretroviral Excretion in Breast Milk and Infant Absorption.

    Directory of Open Access Journals (Sweden)

    Kenneth K Mugwanya

    2016-09-01

    Full Text Available As pre-exposure prophylaxis (PrEP becomes more widely used in heterosexual populations, an important consideration is its safety in infants who are breastfed by women taking PrEP. We investigated whether tenofovir and emtricitabine are excreted into breast milk and then absorbed by the breastfeeding infant in clinically significant concentrations when used as PrEP by lactating women.We conducted a prospective short-term, open-label study of daily oral emtricitabine-tenofovir disoproxil fumarate PrEP among 50 HIV-uninfected breastfeeding African mother-infant pairs between 1-24 wk postpartum (ClinicalTrials.gov Identifier: NCT02776748. The primary goal was to quantify the steady-state concentrations of tenofovir and emtricitabine in infant plasma ingested via breastfeeding. PrEP was administered to women through daily directly observed therapy (DOT for ten consecutive days and then discontinued thereafter. Non-fasting peak and trough samples of maternal plasma and breast milk were obtained at drug concentration steady states on days 7 and 10, and a single infant plasma sample was obtained on day 7. Peak blood and breast milk samples were obtained 1-2 h after the maternal DOT PrEP dose, while maternal trough samples were obtained at the end of the PrEP dosing interval (i.e., 23 to 24 h after maternal DOT PrEP dose. Tenofovir and emtricitabine concentrations were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS assays. Of the 50 mother-infant pairs enrolled, 48% were ≤12 wk and 52% were 13-24 wk postpartum, and median maternal age was 25 y (interquartile range [IQR] 22-28. During study follow-up, the median (IQR daily reported frequency of infant breastfeeding was 15 times (12 to 18 overall, 16 (14 to 19 for the ≤12 weeks, and 14 (12 to 17 for the 13-24 wk infant age groups. Overall, median (IQR time-averaged peak concentrations in breast milk were 3.2 ng/mL (2.3 to 4.7 for tenofovir and 212.5 ng/mL (140.0 to 405.0 for

  6. Effect of Tactile-Kinesthetic Stimulation in weight gaining of pre-term infants hospitalized in intensive care unit

    Directory of Open Access Journals (Sweden)

    Keshavarz M

    2009-08-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Many studies have demonstrated that pre-term neonates gained more weight over the 10 days stimulation period. This research has been conducted to determine the effects of five days Tactile- Kinesthetic stimulation (TKS on weight gaining of pre-term infants hospitalized in Fatemiye neonatal intensive care unit."n"n Methods: Fifty one babies who graduated from the NICU to the intermediate care nursery were randomly allocated into test and control groups (24 and 27 neonate respectively. TKS was provided for three 20 minute periods per day for five consecutive days to the test group, with the massages consisting of moderate pressure strokes in left and right lateral position and kinesthetic exercises consisting of flexion and extension of the limbs. They were observed for changes in physiologic parameters and weight gaining during five days stimulation in hospital."n"n Results: Over the five days TKS an increase in weight was seen in the test group (p=0.018, 43.1 vs 5.4. Infants in both the test and control groups were matched for mean weight before study and days in which they received antibiotics and photo therapy. Mean temperature and O² saturation had no meaningful difference, but an increase in

  7. Early short-term infant food supplementation, maternal weight loss and duration of breast-feeding: a randomised controlled trial in rural Senegal.

    Science.gov (United States)

    Ly, C T; Diallo, A; Simondon, F; Simondon, K B

    2006-02-01

    Early supplementation of breastfed infants may have consequences both for the mother and the child. We hypothesised that it would result in decreased maternal weight loss and in shorter durations of breastfeeding and birth intervals. Controlled randomised population-based trial. Six villages in the Sine area of Senegal, West Africa. Healthy breastfed infants and their mothers, 68 controls and 66 supplemented infants at randomization. Supplementation with high-energy, nutrient dense food from 4 to 7 months of age, twice daily under supervision of field workers. Both controls and supplemented infants were free to eat other complementary foods. Maternal weight was measured monthly. Dates of breastfeeding cessation and of subsequent births were collected prospectively through weekly demographic surveillance, and were analysed using Cox's regression models and 'intent-to-supplement' approach. Mean maternal weight gain from 4 to 7 months postpartum tended to be greater in the supplemented group (+0.25 kg/months, 95% confidence interval (CI): -0.07, +0.57). Supplemented infants were breastfed for significantly longer durations than controls (medians: 24.9 and 23.7 months, respectively, P: 0.034). Their adjusted hazard ratio (HR) for breastfeeding cessation was 0.59 (95% CI: 0.40, 0.89). Their mothers had a lower risk of a new birth than mothers of controls (adjusted HR: 0.57, 95% CI: 0.36, 0.92). Early short-term infant supplementation tended to decrease maternal postpartum weight loss, but it increased, rather than shortened, the duration of breastfeeding and birth interval. This study was supported by a grant from the French Ministry of Research (Grant 92L0623).

  8. Iodine-Induced Hypothyroidism in Full-term Infants With Congenital Heart Disease: More Common Than Currently Appreciated?

    National Research Council Canada - National Science Library

    Thaker, V. V; Leung, A. M; Braverman, L. E; Brown, R. S; Levine, B

    2014-01-01

    Context: Iodine is a micronutrient essential for thyroid hormone synthesis. Thyroid hormone is critical for normal neurocognitive development in young infants, and even transient hypothyroidism can cause adverse neurodevelopmental outcomes...

  9. Oscillometric and intra-arterial blood pressure in preterm and term infants: extent of discrepancy and factors associated with inaccuracy.

    Science.gov (United States)

    Shimokaze, Tomoyuki; Akaba, Kazuhiro; Saito, Emi

    2015-02-01

    Securing an arterial line to monitor continuous blood pressure (BP) is difficult in infants. We aimed to reveal the extent of discrepancies between oscillometric and direct BP. Infants who required continuous BP monitoring were prospectively enrolled. Direct and indirect BP were simultaneously recorded. Disposable BP cuffs matching one-half to two-thirds of the upper arm circumference were used. A total of 74 infants were studied (gestational age [GA], 24-42 weeks). The correlation coefficients of systolic, diastolic, and mean arterial BP of indirect and direct measurements were 0.87, 0.82, and 0.84, respectively (p Oscillometric measurements significantly underestimated systolic BP in light-for-gestational-age infants and diastolic BP in infants without fentanyl administration. There were no significant correlations between discrepant BP measurements and edema, vasopressor administration, arterial line location, GA, postnatal age, body weight, pulse rate, or hemoglobin level. In 4.1% of infants, systolic BP increased by 10 to 15 mm Hg at the time of cuff expansion. We recommend intra-arterial BP measurement when the BP values seriously influence the therapeutic protocol. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Use of multiple linear regression and logistic regression models to investigate changes in birthweight for term singleton infants in Scotland.

    Science.gov (United States)

    Bonellie, Sandra R

    2012-10-01

    To illustrate the use of regression and logistic regression models to investigate changes over time in size of babies particularly in relation to social deprivation, age of the mother and smoking. Mean birthweight has been found to be increasing in many countries in recent years, but there are still a group of babies who are born with low birthweights. Population-based retrospective cohort study. Multiple linear regression and logistic regression models are used to analyse data on term 'singleton births' from Scottish hospitals between 1994-2003. Mothers who smoke are shown to give birth to lighter babies on average, a difference of approximately 0.57 Standard deviations lower (95% confidence interval. 0.55-0.58) when adjusted for sex and parity. These mothers are also more likely to have babies that are low birthweight (odds ratio 3.46, 95% confidence interval 3.30-3.63) compared with non-smokers. Low birthweight is 30% more likely where the mother lives in the most deprived areas compared with the least deprived, (odds ratio 1.30, 95% confidence interval 1.21-1.40). Smoking during pregnancy is shown to have a detrimental effect on the size of infants at birth. This effect explains some, though not all, of the observed socioeconomic birthweight. It also explains much of the observed birthweight differences by the age of the mother.   Identifying mothers at greater risk of having a low birthweight baby as important implications for the care and advice this group receives. © 2012 Blackwell Publishing Ltd.

  11. Relation between hand function and gross motor function in full term infants aged 4 to 8 months

    Science.gov (United States)

    Nogueira, Solange F.; Figueiredo, Elyonara M.; Gonçalves, Rejane V.; Mancini, Marisa C.

    2015-01-01

    Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development. PMID:25714437

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

    Directory of Open Access Journals (Sweden)

    Zhangbin Yu

    2014-06-01

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

  13. Term and Preterm Infants

    NARCIS (Netherlands)

    Turck, Dominique; van Goudoever, Johannes B.

    2017-01-01

    Health professionals involved in child care are convinced nowadays that nutrition in early life (the general concept of the so-called 1,000 days) is of paramount importance not only on growth patterns and development in infancy, but also on many health outcomes later in life. In the present chapter

  14. Desenvolvimento motor de crianças prematuras e a termo: uso da Alberta Infant Motor Scale Desarrollo motor de niños prematuros y a término: uso de la Alberta Infant Motor Scale Motor development of preterm and term infants: using the Alberta Infant Motor Scale

    Directory of Open Access Journals (Sweden)

    Polyana Candeia Maia

    2011-01-01

    Full Text Available OBJETIVOS: Comparar o desenvolvimento motor de crianças nascidas pré-termo e a termo aos quatro e seis meses de idade, aplicando a Alberta Infant Motor Scale-AIMS na versão brasileira. MÉTODOS: Estudo longitudinal, comparativo, realizado em Fortaleza-Ceará, entre novembro/ 2009 e maio/2010. amostragem por conveniência, foi constituída por 24 crianças pré-termo e 24 a termo. RESULTADOS: Nas crianças de quatro meses, verificou-se diferença estatisticamente significante na posição em pé (p=0,014 e, nas de seis meses, em todas as posições (prono, supina, sentada, em pé e escores totais. Quanto ao percentil, aos quatro e seis meses, respectivamente, 37,5% das crianças pré-termo mostraram desempenho excelente e 54,2%, normais. CONCLUSÃO: A análise estatística do desempenho motor grosso entre os grupos de crianças estudadas mostrou diferenças no desenvolvimento e evolução dos percentis da AIMS.OBJETIVOS: Comparar el desarrollo motor de niños nacidos pretérmino y a término a los cuatro y seis meses de edad, aplicando la Alberta Infant Motor Scale-AIMS en la versión brasileña. MÉTODOS: Estudio longitudinal, comparativo, realizado en Fortaleza-Ceará, entre noviembre/2009 y mayo/2010. La muestra por conveniencia, estuvo constituída por 24 niños pretérmino y 24 a término. RESULTADOS: En los niños de cuatro meses, se verificó una diferencia estadísticamente significativa en la posición podálica (p=0,014 y, en las de seis meses, en todas las posiciones (prona, supina, sentada, podálica y scores totales. En cuanto al percentil, a los cuatro y seis meses, respectivamente, el 37,5% de los niños pretérmino mostraron desempeño excelente y el 54,2%, normales. CONCLUSIÓN: El análisis estadístico del desempeño motor grueso entre los grupos de niños estudiados mostró diferencias en el desarrollo y evolución de los percentiles de la AIMS.OBJECTIVES: To compare the motor development of infants born preterm and term at

  15. The Societal Importance of Embracing Counterintuitive Thought in Science: Assisted Exercise in Preterm Infants for Long-term Health Outcomes.

    Science.gov (United States)

    Olshansky, Ellen; Vaughan, Jessica; Sando, Kelsi; Rich, Julia; Lakes, Kimberley; Cooper, Daniel

    For research to lead to progressive change, scientists and society must embrace what may seem counterintuitive. While there is often resistance to changing views of what we presume to already understand, we must be open to evolving knowledge and evidence. Our research is examining the effect of a novel intervention designed to increase physical activity of premature babies in their first year of life on: (1) body composition, (2) associated biochemical and cellular mechanisms of growth and inflammation, and (3) quality of maternal care. This study is novel because it is counterintuitive to prevailing knowledge of the care and treatment of infants born prematurely. Traditionally, we swaddle infants and restrict their movement in order to minimize energy expenditure. We are proposing the opposite: to increase energy expenditure in a systematic, controlled way in order to increase muscle mass and bone density, with the ultimate goal of preventing diseases associated with lack of muscle mass or bone density. Our research actively engages the mothers in the study by learning about their perceptions and their experiences of doing the exercise with their infants because the mothers, too, are aware of the prevailing views that are counter to what they are being asked to do. The mothers have taught us, however, that they are willing to participate in this exercise study, while paradoxically also viewing their infants as "fragile" and are fearful of hurting their infants. Our thesis in this research-based paper is that science and society must work in tandem to be effective.

  16. Effect of vitamin D supplementation of low birth weight term Indian infants from birth on cytokine production at 6 months.

    Science.gov (United States)

    Trilok-Kumar, G; Arora, H; Rajput, M; Chellani, H; Singh, V; Raynes, J; Arya, S; Aggarwal, S; Srivastava, N; Sachdev, H P S; Filteau, S

    2012-06-01

    Vitamin D deficiency has been associated with impaired resistance to infection, which may be mediated by alterations in cytokine responses. We investigated the effect of vitamin D supplementation to infants on whole blood in-vitro cytokine production and on the inflammatory marker, plasma C-reactive protein (CRP). Blood samples were taken at 6 months of age from infants participating in the DIVIDS (Delhi Infant Vitamin D Supplementation) randomized controlled trial of weekly vitamin D supplements (1400 IU = recommended intake) from birth to 6 months with the aim of decreasing mortality and severe morbidity. We measured plasma CRP and whole blood in-vitro production of tumour necrosis factor-α (TNFα), interferon-γ (INFγ), interleukin (IL)-10 and IL-13 following no stimulation or stimulation with lipopolysaccharide or phytohemagglutinin. Although the intervention improved vitamin D status in a severely deficient population, there were no differences between treatment groups in plasma CRP or in the production of any of the cytokines in either unstimulated or stimulated cultures. Recent illness had limited association with immunological markers. Plasma 25-hydroxyvitamin D levels were not associated with CRP or production of any cytokines. Vitamin D supplementation did not affect plasma CRP or whole blood cytokine production of vitamin D-deficient low birth weight infants. This is consistent with the lack of effect of vitamin D on mortality and severe morbidity among infants in the DIVIDS trial.

  17. Differences in fat content and fatty acid proportions among colostrum, transitional, and mature milk from women delivering very preterm, preterm, and term infants.

    Science.gov (United States)

    Moltó-Puigmartí, Carolina; Castellote, Ana Isabel; Carbonell-Estrany, Xavier; López-Sabater, M Carmen

    2011-02-01

    Human milk composition changes according to gestational age and stage of lactation, but infants fed banked human milk often receive pooled milk. We studied the changes in fat content and fatty acid proportions throughout lactation in very preterm, preterm, and full term milk, and the differences among gestational age groups. Samples from women delivering before 30 (n = 10), between 30 and 37 (n = 10), and between 38 and 42 (n = 23) weeks of gestation were analyzed. Fat content was higher in very preterm than in preterm and full term samples (p milk, medium-chain saturated fatty acid proportions were highest in the very preterm group, and decreased with gestational age (p milk obtained at different gestational ages and stages of lactation may impact preterm infants' health. Therefore they could be taken into account when feeding newborns banked human milk and when designing infant formulas or human milk fortifiers. Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Maternal overweight and obesity and risks of severe birth-asphyxia-related complications in term infants: a population-based cohort study in Sweden.

    Directory of Open Access Journals (Sweden)

    Martina Persson

    2014-05-01

    Full Text Available BACKGROUND: Maternal overweight and obesity increase risks of pregnancy and delivery complications and neonatal mortality, but the mechanisms are unclear. The objective of the study was to investigate associations between maternal body mass index (BMI in early pregnancy and severe asphyxia-related outcomes in infants delivered at term (≥37 weeks. METHODS AND FINDINGS: A nation-wide Swedish cohort study based on data from the Medical Birth Register included all live singleton term births in Sweden between 1992 and 2010. Logistic regression analyses were used to obtain odds ratios (ORs with 95% CIs for Apgar scores between 0 and 3 at 5 and 10 minutes, meconium aspiration syndrome, and neonatal seizures, adjusted for maternal height, maternal age, parity, mother's smoking habits, education, country of birth, and year of infant birth. Among 1,764,403 term births, 86% had data on early pregnancy BMI and Apgar scores. There were 1,380 infants who had Apgar score 0-3 at 5 minutes (absolute risk  = 0.8 per 1,000 and 894 had Apgar score 0-3 at 10 minutes (absolute risk  = 0.5 per 1,000. Compared with infants of mothers with normal BMI (18.5-24.9, the adjusted ORs (95% CI for Apgar scores 0-3 at 10 minutes were as follows: BMI 25-29.9: 1.32 (1.10-1.58; BMI 30-34.9: 1.57 (1.20-2.07; BMI 35-39.9: 1.80 (1.15-2.82; and BMI ≥40: 3.41 (1.91-6.09. The ORs for Apgar scores 0-3 at 5 minutes, meconium aspiration, and neonatal seizures increased similarly with maternal BMI. A study limitation was lack of data on effects of obstetric interventions and neonatal resuscitation efforts. CONCLUSION: Risks of severe asphyxia-related outcomes in term infants increase with maternal overweight and obesity. Given the high prevalence of the exposure and the severity of the outcomes studied, the results are of potential public health relevance and should be confirmed in other populations. Prevention of overweight and obesity in women of reproductive age is important

  19. Maternal overweight and obesity and risks of severe birth-asphyxia-related complications in term infants: a population-based cohort study in Sweden.

    Science.gov (United States)

    Persson, Martina; Johansson, Stefan; Villamor, Eduardo; Cnattingius, Sven

    2014-05-01

    Maternal overweight and obesity increase risks of pregnancy and delivery complications and neonatal mortality, but the mechanisms are unclear. The objective of the study was to investigate associations between maternal body mass index (BMI) in early pregnancy and severe asphyxia-related outcomes in infants delivered at term (≥37 weeks). A nation-wide Swedish cohort study based on data from the Medical Birth Register included all live singleton term births in Sweden between 1992 and 2010. Logistic regression analyses were used to obtain odds ratios (ORs) with 95% CIs for Apgar scores between 0 and 3 at 5 and 10 minutes, meconium aspiration syndrome, and neonatal seizures, adjusted for maternal height, maternal age, parity, mother's smoking habits, education, country of birth, and year of infant birth. Among 1,764,403 term births, 86% had data on early pregnancy BMI and Apgar scores. There were 1,380 infants who had Apgar score 0-3 at 5 minutes (absolute risk  = 0.8 per 1,000) and 894 had Apgar score 0-3 at 10 minutes (absolute risk  = 0.5 per 1,000). Compared with infants of mothers with normal BMI (18.5-24.9), the adjusted ORs (95% CI) for Apgar scores 0-3 at 10 minutes were as follows: BMI 25-29.9: 1.32 (1.10-1.58); BMI 30-34.9: 1.57 (1.20-2.07); BMI 35-39.9: 1.80 (1.15-2.82); and BMI ≥40: 3.41 (1.91-6.09). The ORs for Apgar scores 0-3 at 5 minutes, meconium aspiration, and neonatal seizures increased similarly with maternal BMI. A study limitation was lack of data on effects of obstetric interventions and neonatal resuscitation efforts. Risks of severe asphyxia-related outcomes in term infants increase with maternal overweight and obesity. Given the high prevalence of the exposure and the severity of the outcomes studied, the results are of potential public health relevance and should be confirmed in other populations. Prevention of overweight and obesity in women of reproductive age is important to improve perinatal health.

  20. Effect of Breast Milk Odor on Physiological and Behavioral Pain Responses Caused by Hepatitis B Vaccine in Full-term Infants

    Directory of Open Access Journals (Sweden)

    M.Sajjadi

    2017-09-01

    Full Text Available Aims: Uncontrolled pain in human infants can lead to permanent damages, so it is important to manage pain for infants. The aim of this study was to determine the effect of breast milk smell on physiological and behavioral responses of the hepatitis B vaccine pain in newborns. Materials & Methods: In this two-group randomized controlled clinical trial that was performed in 2015, in 9th of Dey Hospital of Torbat Heydarieh City, Iran, 60 three-day term healthy infants at an age that were supposed to receive the first dose of hepatitis B vaccine were selected by random sampling method and were assigned to 2 test (the breast milk smell and control groups. In the experimental group, the infants were exposed to the breast milk smell during the vaccination and the control group received no intervention. Data was collected by the checklist of demographic information, registration form of physiological responses and behavioral pain tools (MBPS. Physiological data (heart rate and oxygen saturation was recorded immediately before and after the intervention by pulse oximeter. Data was analyzed by SPSS 20 statistical software using independent and paired T tests. Findings: There were no significant differences between the control and the test groups in terms of heart rate mean and oxygen saturation mean before the intervention (p>0.05, but significant differences were observed between them after the intervention (p<0.05. In addition, there was a significant difference between the two groups in the average of behavioral responses after the intervention (p<0.05. Conclusion: Olfactory stimulation with breast milk has a positive effect on reducing the neonatal pain during hepatitis B vaccination.

  1. Reduced birth weight in relation to pesticide mixtures detected in cord blood of full-term infants

    Science.gov (United States)

    Wickerham, Erin L.; Lozoff, Betsy; Shao, Jie; Kaciroti, Niko; Xia, Yankai; Meeker, John D.

    2012-01-01

    Previous research has shown that prenatal exposure to pesticides may be associated with decreased fetal growth. The specific pesticides investigated and results reported across studies have been inconsistent, and there is a mounting need for the consideration of mixtures rather than individual agents in studies of health outcomes in relation to environmental exposures. There are also many individual pesticides that have not been investigated in human health studies to date. We conducted a pilot study in rural Zhejiang province, China, measuring 20 non-persistent pesticides (10 insecticides, 6 herbicides, 3 fungicides, and 1 repellant) in umbilical cord blood of 112 full term (>37 weeks) infants. The pesticides detected with the greatest frequency were diethyltoluamide (DEET) (73%), a repellant, and vinclozolin (49%), a fungicide. The samples had detectable concentrations for a mean of 4.6 pesticides (SD=1.9) with a maximum of 10. Adjusting for potential confounders, newborn birth weight was inversely associated with the number of pesticides detected in cord blood (p = 0.04); birth weight decreased by a mean of 37.1 grams (95% CI, −72.5 to −1.8) for each detected pesticide. When assessing relationships by pesticide type, detection of fungicides was also associated with decreased birth weight (adjusted β = −116 grams [95% CI, −212 to −19.2]). For individual pesticides analyzed as dichotomous (detect vs. non-detect) variables, only vinclozolin (adjusted β = −174 grams [95% CI, −312 to −36.3] and acetochlor (adjusted β = −165 grams [95% CI, −325 to −5.7]) were significantly associated with reduced birth weight. No significant associations were seen between birth weight and individual pesticides assessed as continuous or 3-level ordinal variables. Our findings from this pilot investigation suggest that exposure to fungicides may adversely impact fetal growth. Exposure to mixtures of multiple pesticides is also of concern and should be explored

  2. Long-term effects of neonatal glutamine-enriched nutrition in very-low-birth-weight infants

    NARCIS (Netherlands)

    van Zwol, Annelies; Neu, Josef; van Elburg, Ruurd M.

    2011-01-01

    Several studies in very-low-birth-weight (VLBW) infants have investigated the effect of parenteral or enteral glutamine supplementation on morbidity, mortality, and outcome in the neonatal period. No evidence of toxicity of glutamine supplementation was found in these clinical trials, but the

  3. Variation in term birthweight across European countries affects the prevalence of small for gestational age among very preterm infants

    DEFF Research Database (Denmark)

    Zeitlin, Jennifer; Bonamy, Anna-Karin Edstedt; Piedvache, Aurelie

    2017-01-01

    AIM: This study assessed the prevalence of small for gestational age (SGA) among very preterm (VPT) infants using national and European intrauterine references. METHODS: We generated country-specific and common European intrauterine growth references for 11 European countries, according to Gardos...

  4. The Effects of Intersensory Redundancy on Attention and Memory: Infants' Long-Term Memory for Orientation in Audiovisual Events

    Science.gov (United States)

    Flom, Ross; Bahrick, Lorraine E.

    2010-01-01

    This research examined the effects of bimodal audiovisual and unimodal visual stimulation on infants' memory for the visual orientation of a moving toy hammer following a 5-min, 2-week, or 1-month retention interval. According to the intersensory redundancy hypothesis (L. E. Bahrick & R. Lickliter, 2000; L. E. Bahrick, R. Lickliter, & R. Flom,…

  5. Electrophysiological evidence of statistical learning of long-distance dependencies in 8-month-old preterm and full-term infants.

    Science.gov (United States)

    Kabdebon, C; Pena, M; Buiatti, M; Dehaene-Lambertz, G

    2015-09-01

    Using electroencephalography, we examined 8-month-old infants' ability to discover a systematic dependency between the first and third syllables of successive words, concatenated into a monotonous speech stream, and to subsequently generalize this regularity to new items presented in isolation. Full-term and preterm infants, while exposed to the stream, displayed a significant entrainment (phase-locking) to the syllabic and word frequencies, demonstrating that they were sensitive to the word unit. The acquisition of the systematic dependency defining words was confirmed by the significantly different neural responses to rule-words and part-words subsequently presented during the test phase. Finally, we observed a correlation between syllabic entrainment during learning and the difference in phase coherence between the test conditions (rule-words vs part-words) suggesting that temporal processing of the syllable unit might be crucial in linguistic learning. No group difference was observed suggesting that non-adjacent statistical computations are already robust at 8 months, even in preterm infants, and thus develop during the first year of life, earlier than expected from behavioral studies. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

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

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    D Campos

    2007-02-01

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

  8. Customised and Noncustomised Birth Weight Centiles and Prediction of Stillbirth and Infant Mortality and Morbidity: A Cohort Study of 979,912 Term Singleton Pregnancies in Scotland.

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    Stamatina Iliodromiti

    2017-01-01

    Full Text Available There is limited evidence to support the use of customised centile charts to identify those at risk of stillbirth and infant death at term. We sought to determine birth weight thresholds at which mortality and morbidity increased and the predictive ability of noncustomised (accounting for gestational age and sex and partially customised centiles (additionally accounting for maternal height and parity to identify fetuses at risk.This is a population-based linkage study of 979,912 term singleton pregnancies in Scotland, United Kingdom, between 1992 and 2010. The main exposures were noncustomised and partially customised birth weight centiles. The primary outcomes were infant death, stillbirth, overall mortality (infant and stillbirth, Apgar score <7 at 5 min, and admission to the neonatal unit. Optimal thresholds that predicted outcomes for both non- and partially customised birth weight centiles were calculated. Prediction of mortality between non- and partially customised birth weight centiles was compared using area under the receiver operator characteristic curve (AUROC and net reclassification index (NRI.Birth weight ≤25th centile was associated with higher risk for all mortality and morbidity outcomes. For stillbirth, low Apgar score, and neonatal unit admission, risk also increased from the 85th centile. Similar patterns and magnitude of associations were observed for both non- and partially customised birth weight centiles. Partially customised birth weight centiles did not improve the discrimination of mortality (AUROC 0.61 [95%CI 0.60, 0.62] compared with noncustomised birth weight centiles (AUROC 0.62 [95%CI 0.60, 0.63] and slightly underperformed in reclassifying pregnancies to different risk categories for both fatal and non-fatal adverse outcomes (NRI -0.027 [95% CI -0.039, -0.016], p < 0.001. We were unable to fully customise centile charts because we lacked data on maternal weight and ethnicity. Additional analyses in an

  9. Customised and Noncustomised Birth Weight Centiles and Prediction of Stillbirth and Infant Mortality and Morbidity: A Cohort Study of 979,912 Term Singleton Pregnancies in Scotland.

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    Iliodromiti, Stamatina; Mackay, Daniel F; Smith, Gordon C S; Pell, Jill P; Sattar, Naveed; Lawlor, Debbie A; Nelson, Scott M

    2017-01-01

    There is limited evidence to support the use of customised centile charts to identify those at risk of stillbirth and infant death at term. We sought to determine birth weight thresholds at which mortality and morbidity increased and the predictive ability of noncustomised (accounting for gestational age and sex) and partially customised centiles (additionally accounting for maternal height and parity) to identify fetuses at risk. This is a population-based linkage study of 979,912 term singleton pregnancies in Scotland, United Kingdom, between 1992 and 2010. The main exposures were noncustomised and partially customised birth weight centiles. The primary outcomes were infant death, stillbirth, overall mortality (infant and stillbirth), Apgar score customised birth weight centiles were calculated. Prediction of mortality between non- and partially customised birth weight centiles was compared using area under the receiver operator characteristic curve (AUROC) and net reclassification index (NRI). Birth weight ≤25th centile was associated with higher risk for all mortality and morbidity outcomes. For stillbirth, low Apgar score, and neonatal unit admission, risk also increased from the 85th centile. Similar patterns and magnitude of associations were observed for both non- and partially customised birth weight centiles. Partially customised birth weight centiles did not improve the discrimination of mortality (AUROC 0.61 [95%CI 0.60, 0.62]) compared with noncustomised birth weight centiles (AUROC 0.62 [95%CI 0.60, 0.63]) and slightly underperformed in reclassifying pregnancies to different risk categories for both fatal and non-fatal adverse outcomes (NRI -0.027 [95% CI -0.039, -0.016], p customise centile charts because we lacked data on maternal weight and ethnicity. Additional analyses in an independent UK cohort (n = 10,515) suggested that lack of data on ethnicity in this population (in which national statistics show 98% are white British) and maternal weight

  10. Avaliação neurológica pelo método Dubowitz em recém-nascidos prematuros com idade corrigida de termo comparada a de nascidos a termo Neonatal neurological assessment by the Dubowitz method in preterm infants at term corrected age compared with term infants

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    Marina Ortega Golin

    2009-12-01

    Full Text Available OBJETIVO: Comparar a avaliação neurológica de recém-nascidos pré-termo em idade de termo com a de recém-nascidos a termo e verificar a presença de associação entre alterações na avaliação neurológica e características e intercorrências clínicas nos prematuros. MÉTODO: Estudo transversal de 60 nascidos a termo e 30 prematuros do Hospital Estadual Mário Covas, em Santo André (SP, avaliados pelo método Dubowitz. Os pontos de corte da pontuação total foram 30,5 e 26 para comparar recém-nascidos pré-termo e a termo, respectivamente. Os prematuros foram avaliados com idade correspondente ao termo, na 37ª semana, e os do grupo controle, 48 horas após o nascimento. Todos os neonatos foram avaliados pela mesma examinadora, entre as mamadas, nos estágios 4 e 5 de sono e vigília. Para análise estatística, utilizaram-se testes de associação. RESULTADOS: 90% dos nascidos pré-termo não atingiram a pontuação esperada para a idade de termo (pOBJECTIVE: To compare neonatal neurological assessment of preterm newborn infants at term corrected age with term infants, and to identify the presence of association between neurologic abnormalities in preterm infants and demographic characteristics and neonatal clinical conditions. METHODS: This cross-sectional study enrolled 60 term and 30 preterm infants born at the Mario Covas State Hospital in Santo André, São Paulo, Brazil. The Dubowitz method was applied to assess neurobehavior. The total score cut-offs of 30.5 and 26 were used to compare respectively preterm and term infants and to analyze the variables related to performance in the preterm group. Preterm newborns were evaluated at 37 post-conceptual weeks and the control group was evaluated 48 hours after birth. All newborns were evaluated by the same neurologist, between feedings and at sleep-awake stages 4 or 5. Statistical analysis was performed by association tests. RESULTS: 90% of the preterm infants did not reach the

  11. Cerebral oxygenation in preterm infants.

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    Fyfe, Karinna L; Yiallourou, Stephanie R; Wong, Flora Y; Odoi, Alexsandria; Walker, Adrian M; Horne, Rosemary S C

    2014-09-01

    Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P preterm compared with term infants at 2 to 4 weeks, in both positions (P preterm infants in the prone position at 2 to 3 months (P position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk. Copyright © 2014 by the American Academy of Pediatrics.

  12. Tetanus and diphtheria immunity among term and preterm infant-mother pairs in Turkey, a country where maternal and neonatal tetanus have recently been eliminated.

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    Erener-Ercan, Tugba; Aslan, Mustafa; Vural, Mehmet; Erginoz, Ethem; Kocazeybek, Bekir; Ercan, Gokmen; Turkgeldi, Lale Wetherilt; Perk, Yildiz

    2015-03-01

    The aim of our study was to investigate the anti-tetanus and anti-diphtheria antibody titres and the placental transfer of these antibodies in a group of vaccinated and unvaccinated mothers and their term or preterm offsprings. Anti-tetanus and anti-diphtheria toxoid IgG antibodies were measured quantitatively by ELISA in 91 infant-mother pairs. Protective concentrations of anti-tetanus and anti-diphtheria were found in 58.3 and 50% of mothers in the unvaccinated group and 94.5 and 85.5% of the mothers in the vaccinated group. Protective concentrations were found in 63.9 and 50% of cord samples, respectively, in the unvaccinated group and in 96.4 and 85.5% of cord samples, respectively, in the vaccinated group (p = 0.0001). There were no differences in the maternal and cord geometric mean concentrations (GMCs) of anti-toxoid antibodies between those who received two doses or one dose of Td. The GMCs of maternal and cord anti-tetanus and anti-diphtheria were statistically similar between preterm and term groups. Placental transfer ratios (TR) for anti-tetanus and anti-diphtheria were 175 and 150%, respectively, in the preterm group and 213 and 178%, respectively, in the term group. There was a strong correlation between maternal and cord anti-toxoid antibody levels. Maternal vaccination was the only predictor of having protective concentrations of anti-toxoid antibodies in cord blood. Vaccinating pregnant women with at least one dose of Td would confer protection for both the term and preterm infant-mother pairs. Therefore, health personnel caring for pregnant women have the responsibility to emphasize the importance of Td vaccination to avoid missed immunization opportunities.

  13. Long-Term Maternal Stress and Post-traumatic Stress Symptoms Related to Developmental Outcome of Extremely Premature Infants.

    Science.gov (United States)

    Zerach, Gadi; Elsayag, Adi; Shefer, Shahar; Gabis, Lidia

    2015-08-01

    In this study, we examined the relations between the severity of developmental outcomes of extremely low birth weight (ELBW) children and their mothers' stress and post-traumatic stress disorder (PTSD) symptoms, 4-16 years after birth. Israeli mothers (N = 78) of a cohort of extremely premature infants (24-27 weeks) born 4-16 years earlier were asked to report about the medical and developmental condition of their child and their current perceived stress and PTSD symptoms. Results show that mothers of ELBW children with normal development reported the lowest perceived stress compared with mothers of ELBW children with developmental difficulties. We also found that 25.6% of the mothers had the potential to suffer from PTSD following the birth of an ELBW child. Furthermore, the severity of prematurity developmental outcomes made a significant contribution to mothers' perceived stress. To sum, mothers of ELBW infants' perceived stress is related to their children's severity of prematurity developmental outcomes, 4-16 years after birth. Clinical implications of these findings are discussed. Copyright © 2013 John Wiley & Sons, Ltd.

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

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    Maria Angélica de Almeida Porto

    2011-10-01

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

  15. Maternal intention to breast-feed and breast-feeding outcomes in term and preterm infants: Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2003.

    Science.gov (United States)

    Colaizy, Tarah T; Saftlas, Audrey F; Morriss, Frank H

    2012-04-01

    To determine the effect of intention to breast-feed on short-term breast-feeding outcomes in women delivering term and preterm infants. Data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) for three states, Ohio, Michigan and Arkansas, during 2000-2003 were analysed. SAS 9·1·3 and SUDAAN 10 statistical software packages were used for analyses. Arkansas, Michigan and Ohio, USA. Mothers of recently delivered infants, selected by birth certificate sampling. Of 16,839 mothers included, 9·7% delivered preterm. Some 52·2% expressed definite intention to breast-feed, 16·8% expressed tentative intention, 4·3% were uncertain and 26·8% had no intention to breast-feed. Overall 65·2% initiated breast-feeding, 52·0% breast-fed for ≥4 weeks and 30·8% breast-fed for ≥10 weeks. Women with definite intention were more likely to initiate (OR = 24·3, 95% CI 18·4, 32·1), to breast-feed for ≥4 weeks (OR = 7·12, 95% CI 5·95, 8·51) and to breast-feed for ≥10 weeks (OR = 2·75, 95% CI 2·20, 3·45) compared with women with tentative intention. Levels of intention did not differ between women delivering preterm and term. Women delivering at breast-feeding (OR = 2·24, 95% CI 1·64, 3·06) and to breast-feed for ≥4 weeks (OR = 2·58, 95% CI 1·96, 3·41), but less likely to breast-feed for ≥10 weeks (OR = 0·55, 95% CI 0·44, 0·68), compared with those delivering at term. Women delivering between 34 and 36 weeks were less likely to breast-feed for ≥10 weeks than those delivering at term (OR = 0·63, 95% CI 0·49, 0·81). Prenatal intention to breast-feed is a powerful predictor of short-term breast-feeding outcomes in women delivering both at term and prematurely.

  16. Effects of secondhand smoke on the birth weight of term infants and the demographic profile of Saudi exposed women.

    Science.gov (United States)

    Wahabi, Hayfaa A; Alzeidan, Rasmieh A; Fayed, Amel A; Mandil, Ahmed; Al-Shaikh, Ghadeer; Esmaeil, Samia A

    2013-04-15

    Maternal exposure to tobacco smoke during pregnancy is associated with detrimental effects on the mother and the fetus including; impaired fetal growth, low birth weight and preterm delivery. In utero exposure to tobacco is implicated in the etiology of many adults' diseases including obesity, diabetes and hypertension.The objectives of this study were to evaluate the effects of Secondhand Tobacco Smoke (SHS) exposure on newborns' anthropometric measurements and to compare the demographic profile of the women exposed to SHS to those who were not. This is a retrospective cohort study investigating the effects of SHS during pregnancy on newborns' anthropometry. Women who self-reported SHS exposure were compared with those not exposed. The primary outcomes were birth weight, newborn length and head circumference. Univariate analysis and multivariate regression analysis were performed. Adjusted differences with 95% confidence intervals were calculated. Mothers exposed to SHS constituted 31% of the cohort. The mean birth weight of infants of exposed mothers was significantly lower by 35 g, 95% CI: 2-68 g, (P = 0.037) and the mean length was shorter by 0.261 cm, 95% CI 0.058-0.464 cm, (P = 0.012) compared to the infants of unexposed mothers. Women exposed to SHS, were younger, of lower parity and more likely to be illiterate than those who were not exposed in addition, exposed women were less likely to be primiparous. The prevalence of exposure of Saudi pregnant women to SHS is high at 31% and it is associated with reduced birth weight, and shorter length of the newborn.

  17. The long-term health-related quality of life in children treated for burns as infants 5-9 years earlier.

    Science.gov (United States)

    Laitakari, Elina; Koljonen, Virve; Pyörälä, Sari; Rintala, Risto; Roine, Risto P; Sintonen, Harri

    2015-09-01

    The long-term outcome after infant burn was queried 5-9 years after the initial accident. All participants had been treated for burn in Children's Hospital, Helsinki, Finland, before the age of 1 year. We hypothesized that the health-related quality of life (HRQoL) in young burn survivors may be impaired compared to healthy age matched peers. The health-related quality of life of 126 infant burned patients with a mean total body surface area (TBSA) of 3.5% was queried with the standardized and validated 17D questionnaire. The HRQoL of the respondents was compared to that of a representative sample of the general age-standardized population. A total of 44 (35%) children with a mean age of 7 years responded, and 64% of them were male. The median time from trauma was 6.3 years. Burn related features, age at burn time, burn size and site, and the treatment given were similar in the respondents group and all children approached. The mean HRQoL score of the respondents was better than that of the control population (pbreathing, and friends (pchildren was good, and on some dimensions (sleeping, learning, discomfort and symptoms, breathing, depression, and appearance) even better, than that of the control population. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  18. Calcium and fat metabolic balance, and gastrointestinal tolerance in term infants fed milk-based formulas with and without palm olein and palm kernel oils: a randomized blinded crossover study.

    Science.gov (United States)

    Leite, Maria Efigênia de Queiroz; Lasekan, John; Baggs, Geraldine; Ribeiro, Tereza; Menezes-Filho, Jose; Pontes, Mariana; Druzian, Janice; Barreto, Danile Leal; de Souza, Carolina Oliveira; Mattos, Ângela; Costa-Ribeiro, Hugo

    2013-12-24

    Effects of palm olein (POL) on calcium and fat metabolic balance and gastrointestinal (GI) tolerance have been clinically evaluated but its use in combination with palm kernel oil (PKO), and canola oil has not been similarly assessed in infants. Calcium and fat balance and GI tolerance were evaluated in 33 healthy term infants (age = 68-159 d) in a randomized, double-blinded, 14 d crossover trial at a day care center in Salvador, Brazil; followed by a 4d hospital ward metabolic balance study in 17 of the male subjects. The study compared two commercially available milk-based powdered formulas in Brazil; one containing POL (44% of total fat), PKO (21.7%) and canola oil (18.5%) as predominant fats (PALM), and the other containing none (NoPALM). Occasional human milk (HM) supplementation was allowed at home. Formula and HM intakes, and growth were not different (p > 0.05). Calcium absorption (%) for infants fed NoPALM (58.8 ± 16.7%; means ± SD) was higher (p = 0.023) than those fed PALM (42.1 ± 19.2%), but was not significant (p = 0.104) when calcium intake was used as a covariate. Calcium intake was higher (p Fat absorption (%) for NoPALM was greater than PALM fed infants (NoPALM = 96.9 ± 1.2 > PALM = 95.1 ± 1.5; p = 0.020 in Study Period I). Mean rank stool consistency was softer in infants fed NoPALM versus PALM (p 0.05). Formula acceptability was high and comparable for both formula feedings, regardless of HM supplementation. Term infants fed PALM based formula (containing palm olein, palm kernel and canola oils) demonstrated lower calcium retention and fat absorption, and less softer stool consistency versus infants fed NoPALM based formula. Study suggested formula fat differences may affect GI function in infants.

  19. The Effect of Levocarnitine on Dynamics of the Brain Bioelectrical Activity Formation in Term Infants Delivered by Cesarean Section: Open Randomized Study Results

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    Tatiana S. Tumaevа

    2017-01-01

    Full Text Available The brain activity of a newborn affects postnatal adaptation, the disorder of which can cause dysfunction of organs and systems of the immature organism and the development of diseases in more distant periods of maturation.Objective: Our aim was to study the effect of levocarnitine on dynamics of the brain bioelectrical activity formation in term infants delivered by cesarean section.Methods. The study included term infants (gestation period 38–40 weeks delivered by cesarean section, with perinatal hypoxic lesion of the central nervous system (cerebral ischemia. Children were randomized into groups of standard (recommended treatment and standard treatment enhanced with levocarnitine (plus levocarnitine — 30% oral solution at a dose of 100 mg/kg per day for 3 weeks starting from the 7th day of life. The brain bioelectrical activity was assessed with electroencephalography (EEG of the natural sleep period on the 3rd–6th day and then at 3, 6, and 12 months.Results. 45 children were randomized into groups of standard treatment and standard treatment plus levocarnitine, of which 44 and 40 children completed the study, respectively. Initially, the delayed formation of age-related brain activity was detected in 16/40 (40% children receiving levocarnitine and in 19/44 (43% in the experimental group (p = 0.767, disturbances in the EEG sleep pattern with generation of background anomalies — in 17 (43% and 16 (36% (p = 0.565, pathological graph elements — in 1 (3% and 2 (5% children (p = 0.536, respectively. According to the dynamic EEG control results, it was found that after 1 year the cerebral dysfunction was registered less frequently in children receiving levocarnitine — in 32 (80% vs. 42 (96% children in the group of standard treatment (p = 0.028.Conclusion. Adminisration of levocarnitine in the neonatal period reduces the risk of developing cerebral dysfunction by the end of the first year of life. 

  20. Effect of intrauterine growth pattern on serum visfatin concentrations in full-term infants at birth and at 6 months of life.

    Science.gov (United States)

    El Shemi, M S; Mohamed, M H; AbdelRahman, A O; Abdel Al, H; Ramadan, N M

    2016-01-01

    Visfatin is a hormone discovered in fat cells and is directly related to diabetes. We aimed to investigate the relationship between intrauterine growth pattern and serum visfatin concentrations in full-term infants at birth and at 6 months of life. Cord blood visfatin concentrations were assessed in 90 full-term neonates enrolled into; Group I: 30 appropriate for gestational age (AGA) neonates to healthy mothers, Group II: 30 intra-uterine growth restricted (IUGR) neonates, 19 were born to mothers with pre-eclampsia, Group III: 30 large for gestational age (LGA) neonates, 16 were infants of diabetic mothers (IDMs). Neonates were followed up at six months of age for visfatin concentrations. Cord blood visfatin concentrations were increased in IUGR compared to AGA group (p = 0.002). Cord blood visfatin concentrations were increased in LGA compared to AGA and IUGR groups (P IDMs were higher than in those born to mothers without pre-eclampsia and to non-diabetic mothers (p = 0.040, p = 0.002 respectively). At six months, serum visfatin concentrations decreased compared to cord blood visfatin concentrations in IUGR and LGA groups (p <  0.001). Levels in LGA were still higher than IUGR (p = 0.004). Serum visfatin concentrations were positively correlated to cord visfatin in IUGR neonates (r = 0.497, p = 0.005). Cord blood visfatin concentrations were increased in LGA and IUGR neonates. At six months, serum visfatin concentrations decreased compared to cord blood visfatin concentrations in LGA and IUGR groups, still higher in the former than the latter.

  1. [Relationship between energy intake and catch-up growth in full-term small-for-gestational-age infants under 6 months of age].

    Science.gov (United States)

    Yang, Qin; Cheng, Qian; Zhang, Xuan

    2015-12-01

    To explore the relationship between nutrition and catch-up growth in full-term small-for-gestational-age infants under 6 months of age. A prospective cohort study was conducted to collect clinical data of full-term small for gestational-age infants (SGA) and full-term appropriate-for-gestational-age infants (AGA) from the Department of Health Care of the Children's Hospital of Chongqing Medical University. According to inclusion criteria, between February 2014 and April 2015, the infants were divided into three groups: AGA, SGA with catch-up growth (ΔSDS of weight≥0.67), and SGA with no catch-up growth (ΔSDS growth and no catch-up growth groups. Analysis of variance was used to compare differences between the three groups in daily energy intake and protein to energy ratios. Totally 180 SGA infants within 6 months of age were enrolled, among whom 63 were male, 117 were female; and 48 AGA infants were enrolled, among whom 19 were male, 29 were female. There were no significant differences in the feeding patterns (breast feeding, partial breast feeding or full formula feeding) of SGA catch-up and SGA no catch-up groups at 1, 3 or 6 months during the first year (43 (75.4%) vs. 75 (61.0%), 7 (12.3%) vs. 25 (20.3%), 7 (12.3%) vs. 23 (18.7%) at 1 month, 70 (66.7%) vs. 39 (53.4%), 13 (12.4%) vs. 12 (16.4%), 22 (21.0%) vs. 22 (30.1%) at 3 months, 30 (31.6%) vs. 16 (23.5%), 14 (14.7%) vs. 12 (17.6%), 51 (53.7%) vs. 40 (58.8%) at 6 months, χ(2)=3.263, 3.207, 1.308 respectively, all P>0.05). The total daily energy intake (kJ/d) of the SGA no catch-up group was significantly lower than that of the AGA group at 1, 3 and 6 months of age (1 668±350 vs. 1 841±426, 1 889±276 vs. 2 330±379, 2 175±349 vs. 2 556±354, respectively, all Penergy intake of the SGA catch-up group was significantly lower than that of the AGA group at 3 and 6 months (2 118±361 vs. 2 330±379, 2 336±374 vs. 2 556±354, respectively, all Penergy intake (kJ/(kg·d)) of the SGA no catch-up group was

  2. Infant botulism.

    Science.gov (United States)

    Fenicia, Lucia; Anniballi, Fabrizio

    2009-01-01

    Infant botulism is a rare disease that affects infant less than 12 months of age. The illness results from absorption of botulinum toxin produced in situ by neurotoxigenic clostridia that can temporarily colonize the intestinal tract of infants. To date, all inhabited continents except Africa have reported cases of infant botulism. Recognition of cases seem directly related to physician awareness and clinical suspicion. This review summarizes microbiological, clinical and epidemiological features of infant botulism.

  3. Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Evgeniy Viktorovich Mikhalev

    2015-03-01

    Full Text Available The article reviews the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes; possible mechanisms of their development are also highlighted. The review describes changes in blood glucose concentration in term newborns from women with gestational diabetes, and their impact on the child's condition. In addition to already known factors causing macrosomia and other metabolic disorders in term neonates, the role of leptin (peptide hormone that regulates energy metabolism is quite discussable. Low leptin levels lead to the development of obesity. It is also confirmed, that leptin influences brain development of the newborn, leading to later cognitive deficits in children from women with GDM.The aim of the review is to summarize the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes.

  4. Acompanhamento da icterícia neonatal em recém-nascidos de termo e prematuros tardios Follow-up of neonatal jaundice in term and late premature newborns

    Directory of Open Access Journals (Sweden)

    Fernando Perazzini Facchini

    2007-08-01

    bilirubinometer (Leica. These newborn infants had bilirubinemia at or above the 40th percentile on the nomogram developed by Bhutani. All infants treated with phototherapy while in hospital were reassessed by laboratory methods 24 hours after withdrawal of treatment. Patients were rehospitalized for intensive phototherapy if their level was greater than or equal to 20 mg/dL. RESULTS: From a total sample of 11,259 neonates, 2,452 (21.8% were referred to the follow-up clinic, 87.2% (2,140 of whom did return. Eighty returned neonates were readmitted. Return appointments were set for 2,452 patients, 180 (7.3% of whom had bilirubinemia > 15 mg/dL at discharge. Of these 180, 151 returned for follow-up. Twenty (13.2% were readmitted for treatment. Of the total number of readmitted patients, two newborn infants had levels > 25 mg/dL and none > 30 mg/dL. All responded rapidly to intensive phototherapy, and there was no need for exchange transfusions. CONCLUSIONS: Our results suggest that the regime adopted is effective for detecting and preventing hyperbilirubinemia at risk of causing bilirubin-induced encephalopathy in term and near term newborn infants.

  5. Sudden Infant Death Syndrome (SIDS)

    Science.gov (United States)

    ... or a waterbed can block an infant's airway. Sharing a bed. While the risk of SIDS is lowered if an infant sleeps ... There's no evidence that routine immunizations increase SIDS risk. Some evidence indicates immunizations can help ... and Terms Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy ...

  6. Effect of position of infant during phototherapy in management of hyperbilirubinemia in late preterm and term neonates: a randomized controlled trial.

    Science.gov (United States)

    Bhethanabhotla, S; Thukral, A; Sankar, M J; Agarwal, R; Paul, V K; Deorari, A K

    2013-10-01

    To evaluate the effect of supine position when compared with periodic change of position during phototherapy in late preterm and term neonates (35 to 42 weeks) with hyperbilirubinemia on the duration of phototherapy. We randomly allocated enrolled neonates with hyperbilirubinemia to either no change in position (supine group (SG); n=54) or two-hourly change of position from supine to prone and vice versa (turning group (TG); n=46). All the infants received single surface phototherapy by two dedicated compact fluorescent light units. Total serum bilirubin (TSB) was measured at the start of phototherapy and then every 12 ± 2 h until the end of phototherapy. Phototherapy was stopped when two values were below the cut-off for age and gestational age as per the American Academy of Pediatrics Subcommittee on Hyperbilirubinemia guidelines nomogram for the management of hyperbilirubinemia in infants >35 weeks of gestation. The primary outcome was duration of phototherapy and secondary outcome was rate of fall of bilirubin within the first 24 ± 2 h after the initiation of phototherapy. Baseline characteristics including birth weight (g, 2752 ± 478 vs 2748 ± 416 P=0.96), gestation (week, 37.1 ± 1.2 vs 37.4 ± 1.3, P=0.26) were similar in the two groups. There was no difference in the duration of phototherapy between the SG (mean ± s.d., hour, 25.5 ± 8) and TG (mean ± s.d., hour, 24.8 ± 5), mean difference (95% confidence interval), hour, 0.7 (-2.03, 3.44, P=0.6). Rate of fall of bilirubin was also similar in both supine and turning groups with mean difference of -0.020 (95% confidence interval: -0.061, 0.021, P=0.34). Nursing babies in supine position when compared with periodic position change during phototherapy does not decrease the duration of phototherapy.

  7. Identification of generic and pathogen-specific cord blood monocyte transcriptomes reveals a largely conserved response in preterm and term newborn infants.

    Science.gov (United States)

    de Jong, Emma; Hancock, David G; Hibbert, Julie; Wells, Christine; Richmond, Peter; Simmer, Karen; Burgner, David; Strunk, Tobias; Currie, Andrew J

    2017-11-13

    Escherichia coli and Staphylococcus epidermidis are predominant causes of neonatal sepsis, particularly affecting preterm infants. Susceptibility to infection has been attributed to "immature" innate monocyte defences, but no studies have assessed global transcriptional responses of neonatal monocytes to these pathogens. Here, we aimed to identify and characterise the neonatal monocyte transcriptional responses to E. coli and S. epidermidis and the role of common modifiers such as gestational age (GA) and exposure to chorioamnionitis (a common complication of preterm birth) to better understand early life innate immune responses. RNA-sequencing was performed on purified cord blood monocytes from very preterm (neonatal monocyte response to infection, largely mediated by TLR/NF-κB/TREM-1 signalling. In addition, we observed an activated interferon-centred immune response specific to stimulation with E. coli in both preterm and term infants. These data provide novel insights into the functionality of neonatal monocytes at birth and highlight potential pathways that could be targeted to reduce the harmful effects of bacterial-induced inflammation in sepsis. E. coli and S. epidermidis elicit common transcriptional changes in cord monocytes. The common transcriptional response is mediated by TLR/NF-κB/TREM-1 signalling. IFN genes are differentially regulated by E. coli and S. epidermidis in monocytes. These responses are largely unaffected by GA or exposure to chorioamnionitis. E. coli and S. epidermidis elicit common transcriptional changes in cord monocytes. The common transcriptional response is mediated by TLR/NF-κB/TREM-1 signalling. IFN-genes are differentially regulated by E. coli and S. epidermidis in monocytes. These responses are largely unaffected by GA or exposure to chorioamnionitis.

  8. High rates of school readiness difficulties at 5 years of age in very preterm infants compared with term controls.

    Science.gov (United States)

    Roberts, Gehan; Lim, Jeremy; Doyle, Lex W; Anderson, Peter J

    2011-01-01

    School readiness is best understood as a framework for assessing profiles of strengths and vulnerabilities of the preschool-age child. Very preterm (VPT) children are at high risk of difficulties in school, and understanding their school readiness skills has the potential to aid successful transition into school. The aim of this study was to determine the school readiness skills of a cohort of VPT children, compared with term controls. VPT children (gestational age school readiness skills were evaluated using a combination of parent questionnaires and direct assessments. The 5 domains of school readiness assessed were health and physical development, social-emotional skills, approaches to learning, communication skills, and cognitive skills. VPT children had standard scores ~½ to 1 SD below those of the term controls in all domains of school readiness, and these differences were not greatly affected by adjustment for social risk differences. Overall, 44% of the VPT group had vulnerabilities in more than 1 domain of school readiness, compared with only 16% of the term controls. VPT children are more likely than term controls to have significant vulnerabilities in multiple domains of school readiness, and these differences are mostly independent of social risk.

  9. Macronutrient composition of human milk from Korean mothers of full term infants born at 37-42 gestational weeks

    Science.gov (United States)

    Jung, Ji A; Kim, Hyesook; Jo, Ara; Kang, Sujeong; Lee, Si-Won; Yi, Hyunju; Kim, Jihee; Yim, Jong-Gap; Jung, Byung-Moon

    2015-01-01

    BACKGROUND/OBJECTIVES Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS Milk samples were obtained from 2,632 healthy lactating women (mean age; 32.0 ± 3.3 years), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk. PMID:26244084

  10. Macronutrient composition of human milk from Korean mothers of full term infants born at 37-42 gestational weeks.

    Science.gov (United States)

    Chang, Namsoo; Jung, Ji A; Kim, Hyesook; Jo, Ara; Kang, Sujeong; Lee, Si-Won; Yi, Hyunju; Kim, Jihee; Yim, Jong-Gap; Jung, Byung-Moon

    2015-08-01

    Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. Milk samples were obtained from 2,632 healthy lactating women (mean age; 32.0 ± 3.3 years), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.

  11. Trend of head circumference as a predictor of microcephaly among term infants born at a regional center in Malaysia between 2011-2015

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    Sutan R

    2018-01-01

    Full Text Available Rosnah Sutan,1 May Luu Yeong,1 Zaleha Abdullah Mahdy,2 Ahmad Shuhaila,2 Jaafar Rohana,3 Shareena Ishak,3 Khadijah Shamsuddin,1 Aniza Ismail,1 Idayu Badillah Idris,1 Saperi Sulong4 1Department of Community Health, 2Department of Obstetrics and Gynecology, 3Department of Pediatrics, 4Department of Medical Records, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia Introduction: The aim of this study was to determine the trend of head circumference as predictor of microcephaly among term infants born in a teaching hospital in Malaysia from 2011 to 2015. Methodology: This was a cross-sectional study using data from the electronic birth census. The independent variables were mothers’ age and height, parity, birth weight and birth length. All term newborns, both alive and stillbirth, with 37–41 completed gestational weeks, and a birth weight of at least 500 g was extracted from the census. Results: A total of 26,503 newborns fulfilled the inclusion criteria (13,655 males, 12,840 females. The mean head circumferences for male and female newborns were 32.93 cm (± SD 1.32 and 32.56 cm (± SD 1.31. The average head circumference for Malaysian newborns was found to be smaller than the World Health Organization Standard Growth Chart for Term Infant. A total of 17.6% (n=4,669 of the total samples were observed to have microcephaly. Among them, 73.2% (n=3,419 were non-proportionate microcephaly with normal birth weight of 2.5kg and above. Bivariate analyses showed that all independent variables were significant predictors of microcephaly. Both simple and multiple logistic regressions demonstrated that low birth weight was the most significant predictors for microcephaly (adjusted OR 12.14, 95% CI 10.80, 13.65. Conclusion: There is an increasing trend of microcephaly across the years and the low birth weight was noted as the main predictor of microcephaly. Future studies are needed to determine the possible cause of increasing

  12. Early short-term infant food supplementation, maternal weight loss and duration of breast-feeding : a randomised controlled trial in rural Senegal

    OpenAIRE

    Ly, C.T.; Diallo, A.; Simondon, François; Simondon, Kirsten

    2006-01-01

    Objective: Early supplementation of breastfed infants may have consequences both for the mother and the child. We hypothesised that it would result in decreased maternal weight loss and in shorter durations of breastfeeding and birth intervals. Design: Controlled randomised population-based trial. Setting: Six villages in the Sine area of Senegal, West Africa. Subjects: Healthy breastfed infants and their mothers, 68 controls and 66 supplemented infants at randomization. Intervention: Supplem...

  13. Premature infant

    Science.gov (United States)

    ... into the stomach. In very premature or sick infants, nutrition may be given through a vein until the baby is stable enough to receive all nutrition through the stomach. If the infant has breathing problems: A tube may be placed ...

  14. Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children.

    Science.gov (United States)

    Bradford, Natalie K; Edwards, Rachel M; Chan, Raymond J

    2015-11-23

    Guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) around the world vary greatly. Most institutions recommend the use of heparin to prevent occlusion, however there is debate regarding the need for heparin and evidence to suggest 0.9% sodium chloride (normal saline) may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased cost. To assess the clinical effects (benefits and harms) of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (last searched April 2015) and the Cochrane Register of Studies (Issue 3, 2015). We also searched the reference lists of retrieved trials. Randomised controlled trials that compared the efficacy of normal saline with heparin to prevent occlusion of long term CVCs in infants and children aged up to 18 years of age were included. We excluded temporary CVCs and peripherally inserted central catheters (PICC). Two review authors independently assessed trial inclusion criteria, trial quality and extracted data. Rate ratios were calculated for two outcome measures - occlusion of the CVC and central line-associated blood stream infection. Other outcome measures included duration of catheter placement, inability to withdraw blood from the catheter, use of urokinase or recombinant tissue plasminogen, incidence of removal or re-insertion of the catheter, or both, and other CVC-related complications such as dislocation of CVCs, other CVC site infections and thrombosis. Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin, however, between studies, all used different protocols for the standard and experimental arms with different concentrations of heparin and

  15. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  16. Amino acid composition of parturient plasma, the intervillous space of the placenta and the umbilical vein of term newborn infants

    Directory of Open Access Journals (Sweden)

    J.S. Camelo Jr.

    2004-05-01

    Full Text Available The objective of the present study was to determine the levels of amino acids in maternal plasma, placental intervillous space and fetal umbilical vein in order to identify the similarities and differences in amino acid levels in these compartments of 15 term newborns from normal pregnancies and deliveries. All amino acids, except tryptophan, were present in at least 186% higher concentrations in the intervillous space than in maternal venous blood, with the difference being statistically significant. This result contradicted the initial hypothesis of the study that the plasma amino acid levels in the placental intervillous space should be similar to those of maternal plasma. When the maternal venous compartment was compared with the umbilical vein, we observed values 103% higher on the fetal side which is compatible with currently accepted mechanisms of active amino acid transport. Amino acid levels of the placental intervillous space were similar to the values of the umbilical vein except for proline, glycine and aspartic acid, whose levels were significantly higher than fetal umbilical vein levels (average 107% higher. The elevated levels of the intervillous space are compatible with syncytiotrophoblast activity, which maintain high concentrations of free amino acids inside syncytiotrophoblast cells, permitting asymmetric efflux or active transport from the trophoblast cells to the blood in the intervillous space. The plasma amino acid levels in the umbilical vein of term newborns probably may be used as a standard of local normality for clinical studies of amino acid profiles.

  17. The influence of a formula supplemented with dairy lipids and plant oils on the erythrocyte membrane omega-3 fatty acid profile in healthy full-term infants: a double-blind randomized controlled trial.

    Science.gov (United States)

    Giannì, Maria Lorella; Roggero, Paola; Baudry, Charlotte; Ligneul, Amandine; Morniroli, Daniela; Garbarino, Francesca; le Ruyet, Pascale; Mosca, Fabio

    2012-10-17

    Human milk is the optimal nutrition for infants. When breastfeeding is not possible, supplementation of infant formula with long chain polyunsaturated fatty acids appears to promote neurodevelopmental outcome and visual function. Plant oils, that are the only source of fat in most of infant formulas, do not contain specific fatty acids that are present in human and cow milk and do not encounter milk fat triglyceride structure. Experimental data suggest that a mix of dairy lipids and plant oils can potentiate endogenous synthesis of n-3 long chain polyunsaturated fatty acids. This trial aims to determine the effect of an infant formula supplemented with a mixture of dairy lipids and plant oils on the erythrocyte membrane omega-3 fatty acid profile in full-term infants (primary outcome). Erythrocyte membrane long chain polyunsaturated fatty acids and fatty acids content, the plasma lipid profile and the insulin-growth factor 1 level, the gastrointestinal tolerance, the changes throughout the study in blood fatty acids content, in growth and body composition are evaluated as secondary outcomes. In a double-blind controlled randomized trial, 75 healthy full-term infants are randomly allocated to receive for four months a formula supplemented with a mixture of dairy lipids and plant oils or a formula containing only plant oils or a formula containing plant oils supplemented with arachidonic acid and docosahexaenoic acid. Twenty-five breast-fed infants constitute the reference group. Erythrocyte membrane omega-3 fatty acid profile, long chain polyunsaturated fatty acids and the other fatty acids content, the plasma lipid profile and the insulin-growth factor 1 level are measured after four months of intervention. Gastrointestinal tolerance, the changes in blood fatty acids content, in growth and body composition, assessed by means of an air displacement plethysmography system, are also evaluated throughout the study. The achievement of an appropriate long chain

  18. Comparison of the fatty acid composition of transitional and mature milk of mothers who delivered healthy full-term babies, preterm babies and full-term small for gestational age infants.

    Science.gov (United States)

    Bobiński, R; Mikulska, M; Mojska, H; Simon, M

    2013-09-01

    The fatty acid (FA) composition of breast milk throughout the period of lactation is fairly well understood. What is not known, however, is the FA composition of breast milk at the interface of physiology and pathology of pregnancy. We therefore decided to analyse and compare the differences in the FA composition of transitional and mature milk of mothers who delivered small for gestational age (SGA) neonates born at term; infants delivered at 35-37 weeks of gestation, that is 'late preterm'; and that of mothers who gave birth to appropriate for gestational age neonates (AGA). The FAs were analysed by HPLC equipped with MS detector. We found differences in the percentage share of the studied FA pool regarding levels of capric, lauric and gadoleic acids. Comparing transitional and mature milk, the greatest diversity was seen in the group of mothers of AGA neonates and the least was noted in the group of mothers of SGA neonates. Both 'late prematurity' and reduced neonatal weight of children born at term affect the FA composition of breast milk. Even a small degree of fetal malformation alters the composition of breast milk, which is probably related to the child's needs and condition.

  19. The effect of non-nutritive sucking on Physiological and Behavioral Pain Responses Caused by First Turn Hepatitis B Vaccine in Term Infants

    Directory of Open Access Journals (Sweden)

    Moosa Sajjadi

    2017-05-01

    Full Text Available Background and Aim: Pain management is very important in neonates. The use of non- pharmacological methods can be effective in reducing  pain in neonates. The current study aimed at assessing the effect of non-nutritive sucking on the physiological and behavioral pain responses to B Hepatitis vaccine in term infants. Materials and Methods: In this clinical- trial study in Ninth Day Hospital of Torbate Heidarryyeh in 2016,60 qualified neonates randomly were assigned to two groups of experimental and control. In the experimental group, the neonates performed non-nutritive sucking through vaccination. In the control group, no particular interference was done. Data collection means included a demography questionnaire, a physiological responses record questionnaire,  and the modified behavioral pain scale. Having collected the required data, analysis was performed through SPSS software( version 20. Results: It was found  that the mean of neonates’ behavioral responses scores was significantly different after the interference in the two groups (P0.05 But, t-test results showed that after the interference, there was a significant difference in the two groups(P0.05. But t-test results showed that after intervention it was significantly different in the two groups(P<0.05. Conclusion: Non-nutritive sucking  can be effective in the management of pain in neonates.

  20. Report about term infants with severe hyperbilirubinemia undergoing exchange transfusion in Southwestern China during an 11-year period, from 2001 to 2011.

    Directory of Open Access Journals (Sweden)

    Canfeng Yu

    Full Text Available This study was intended to explore the etiology and risk factors of severe neonatal hyperbilirubinemia and to analyze the adverse events associated with ECT (Exchange Transfusion, as well as to identify the factors related to the poor prognosis.All of the full-term neonates who had undergone ECT for hyperbilirubinemia at Children's Hospital of Chongqing Medical University from January 2001 to December 2011 were enrolled in this study. General demographic characteristics, comorbidities, pre- and post-exchange TSB(Total Serum Bilirubin levels, duration and frequency of ECT, and clinical outcomes were recorded and analyzed anonymously.Of 614 total infants, 368 patients (59.9% with ABO incompatibility were identified, of whom 197 (53.5% developed acute bilirubin encephalopathy (ABE and 16 (4.3% suffered a poor prognosis. The etiology was unidentified in 103 patients (16.8%, of whom 62 (60.1% developed ABE and 9 (8.7% had a poor prognosis. Identified adverse events secondary to ECT included thrombocytopenia (54.6%, hyperglycemia (42.8%, apnea (3.3% and necrotizing enterocolitis (NEC (1.3%. No ECT-related mortality was documented in this study.The etiology, peak TSB level before ECT, and time of ECT had a significant impact on the outcome of severe neonatal hyperbilirubinemia. ABO incompatibility was the most common cause of extreme neonatal hyperbilirubinemia. Pathological weight loss could be involved in the development of extreme hyperbilirubinemia with an unidentified cause.

  1. Breast milk composition in a cohort of pre-term infants' mothers followed in an ambulatory programme in Colombia.

    Science.gov (United States)

    Charpak, N; Ruiz, J G

    2007-12-01

    Describing preterm breast milk evolution and composition according to gestational age (GA) and postnatal age (PNA) in a cohort of mothers cared for in an ambulatory Kangaroo Mother Care Program (KMCP) in a developing country. A cohort involving 113 mothers who delivered 'healthy' preterms adequate for GA was assembled. Mothers received intensive breastfeeding support before discharge. Samples of both fore- and hind milk were obtained at entry into KMCP and weekly thereafter, until term. Composition was described according to PNA and postconceptional age (PCA). Protein concentration varied inversely with both PCA and PNA. Fat concentration was consistently higher in hind milk than in fore milk samples of the same feed. Lactose increased steadily with PCA. Calcium/phosphorus ratios were stable, close to 2:1 and content of both was similar in samples of different PCA and PNA. Minerals concentration could be inadequate for preterms. Protein concentration decreases steadily to mature milk levels by the third week of PNA, regardless of birth GA. Therefore, from the third week of PNA onwards, protein content could be insufficient to satisfy needs of preterms born at 32 weeks or less. Feeding hind milk could increase caloric density and fat intake to better meet preterms' nutritional needs.

  2. Changing perspectives in pre-existing diabetes and obesity in pregnancy: maternal and infant short- and long-term outcomes.

    Science.gov (United States)

    Barbour, Linda A

    2014-08-01

    Climbing obesity rates in women have propelled the increasing prevalence of type 2 diabetes mellitus (T2DM) in pregnancy, and an increasing number of women with type 1 diabetes mellitus (T1DM) are also affected by obesity. Increasing recognition that an intrauterine environment characterized by obesity, insulin resistance, nutrient excess, and diabetes may be fueling the obesity epidemic in children has created enormous pressure to re-examine the conventional wisdom of our current approaches. Compelling data in pregnancies complicated by diabetes, in particular those accompanied by insulin resistance and obesity, support a fetal programming effect resulting in increased susceptibility to metabolic disease for the offspring later in life. Recent data also underscore the contribution of obesity, lipids, and lesser degrees of hyperglycemia on fetal fat accretion, challenging the wisdom of current gestational weight gain recommendations with and without diabetes. The risks of adverse pregnancy outcomes in T2DM are at least as high as in T1DM and there remains controversy about the ideal glucose treatment targets, the benefit of different insulin analogues, and the role of continuous glucose monitoring in T1DM and T2DM. It has become unmistakably evident that achieving optimal outcomes in mothers with diabetes is clearly impacted by ideal glycemic control but goes far beyond it. The intrauterine metabolic environment seems to have long-term implications on the future health of the offspring so that the effectiveness of our current approaches can no longer be simply measured by whether or not maternal glucose values are at goal.

  3. Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.

    Directory of Open Access Journals (Sweden)

    Erika Ota

    Full Text Available Small for gestational age (SGA is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes among twenty-nine countries in Africa, Latin America, the Middle East and Asia in 359 health facilities in 2010-11.We analysed facility-based, cross-sectional data from the WHO Multi-country Survey on Maternal and Newborn Health. We constructed multilevel logistic regression models with random effects for facilities and countries to estimate the risk factors for SGA infants using country-specific birthweight reference standards in preterm and term delivery, and SGA's association with adverse perinatal outcomes. We compared the risks and adverse perinatal outcomes with appropriate for gestational age (AGA infants categorized by preterm and term delivery.A total of 295,829 singleton infants delivered were analysed. The overall prevalence of SGA was highest in Cambodia (18.8%, Nepal (17.9%, the Occupied Palestinian Territory (16.1%, and Japan (16.0%, while the lowest was observed in Afghanistan (4.8%, Uganda (6.6% and Thailand (9.7%. The risk of preterm SGA infants was significantly higher among nulliparous mothers and mothers with chronic hypertension and preeclampsia/eclampsia (aOR: 2.89; 95% CI: 2.55-3.28 compared with AGA infants. Higher risks of term SGA were observed among sociodemographic factors and women with preeclampsia/eclampsia, anaemia and other medical conditions. Multiparity (> = 3 (AOR: 0.88; 95% CI: 0.83-0.92 was a protective factor for term SGA. The risk of perinatal mortality was significantly higher in preterm SGA deliveries in low to high HDI countries.Preterm SGA is associated with medical conditions related to preeclampsia, but not with sociodemographic status. Term SGA is associated with sociodemographic status and various medical conditions.

  4. What Is Infant Mental Health?

    Science.gov (United States)

    Osofsky, Joy D.; Thomas, Kandace

    2012-01-01

    Unfortunately, the term "infant mental health" can be confusing for some people because it may be understood as translating into "mental illness." Others may not appreciate that babies and toddlers have the capacity to experience complex emotions. The Guest Editors of this issue of the Journal explore the meaning of infant mental health.

  5. Supplementation of DHA but not DHA with arachidonic acid during pregnancy and lactation influences general movement quality in 12-week-old term infants

    NARCIS (Netherlands)

    van Goor, Saskia A.; Dijck-Brouwer, D. A. Janneke; Doornbos, Bennard; Erwich, Jan Jaap H. M.; Schaafsma, Anne; Muskiet, Frits A. J.; Hadders-Algra, Mijna

    2010-01-01

    DHA and arachidonic acid (AA) are important for neurodevelopment. A traditional neonatal neurological examination and the evaluation of general movement quality are sensitive techniques for assessing neurodevelopment in young infants. Mildly abnormal general movement,,; at 3 months have been

  6. Inter-pregnancy Weight Change and Risks of Severe Birth-Asphyxia-Related Outcomes in Singleton Infants Born at Term: A Nationwide Swedish Cohort Study.

    Directory of Open Access Journals (Sweden)

    Martina Persson

    2016-06-01

    Full Text Available Maternal overweight and obesity are associated with increased risks of birth-asphyxia-related outcomes, but the mechanisms are unclear. If a change of exposure (i.e., maternal body mass index [BMI] over time influences risks, this would be consistent with a causal relationship between maternal BMI and offspring risks. Our objective was to investigate associations between changes in maternal BMI between consecutive pregnancies and risks of birth-asphyxia-related outcomes in the second offspring born at term.This study was a prospective population-based cohort study that included 526,435 second-born term (≥37 wk infants of mothers with two consecutive live singleton term births in Sweden between January 1992 and December 2012. We estimated associations between the difference in maternal BMI between the first and second pregnancy and risks of low Apgar score (0-6 at 5 min, neonatal seizures, and meconium aspiration in the second-born offspring. Odds ratios (ORs were adjusted for BMI at first pregnancy, maternal height, maternal age at second delivery, smoking, education, mother´s country of birth, inter-pregnancy interval, and year of second delivery. Analyses were also stratified by BMI (<25 versus ≥25 kg/m2 in the first pregnancy. Risks of low Apgar score, neonatal seizures, and meconium aspiration increased with inter-pregnancy weight gain. Compared with offspring of mothers with stable weight (BMI change of -1 to <1 kg/m2, the adjusted OR for a low Apgar score in the offspring of mothers with a BMI change of 4 kg/m2 or more was 1.33 (95% CI 1.12-1.58. The corresponding risks for neonatal seizures and meconium aspiration were 1.42 (95% CI 1.00-2.02 and 1.78 (95% CI 1.19-2.68, respectively. The increased risk of neonatal seizures related to weight gain appeared to be restricted to mothers with BMI < 25 kg/m2 in the first pregnancy. A study limitation was the lack of data on the effects of obstetric interventions and neonatal resuscitation

  7. Inter-pregnancy Weight Change and Risks of Severe Birth-Asphyxia-Related Outcomes in Singleton Infants Born at Term: A Nationwide Swedish Cohort Study.

    Science.gov (United States)

    Persson, Martina; Johansson, Stefan; Cnattingius, Sven

    2016-06-01

    Maternal overweight and obesity are associated with increased risks of birth-asphyxia-related outcomes, but the mechanisms are unclear. If a change of exposure (i.e., maternal body mass index [BMI]) over time influences risks, this would be consistent with a causal relationship between maternal BMI and offspring risks. Our objective was to investigate associations between changes in maternal BMI between consecutive pregnancies and risks of birth-asphyxia-related outcomes in the second offspring born at term. This study was a prospective population-based cohort study that included 526,435 second-born term (≥37 wk) infants of mothers with two consecutive live singleton term births in Sweden between January 1992 and December 2012. We estimated associations between the difference in maternal BMI between the first and second pregnancy and risks of low Apgar score (0-6) at 5 min, neonatal seizures, and meconium aspiration in the second-born offspring. Odds ratios (ORs) were adjusted for BMI at first pregnancy, maternal height, maternal age at second delivery, smoking, education, mother´s country of birth, inter-pregnancy interval, and year of second delivery. Analyses were also stratified by BMI (pregnancy. Risks of low Apgar score, neonatal seizures, and meconium aspiration increased with inter-pregnancy weight gain. Compared with offspring of mothers with stable weight (BMI change of -1 to offspring of mothers with a BMI change of 4 kg/m2 or more was 1.33 (95% CI 1.12-1.58). The corresponding risks for neonatal seizures and meconium aspiration were 1.42 (95% CI 1.00-2.02) and 1.78 (95% CI 1.19-2.68), respectively. The increased risk of neonatal seizures related to weight gain appeared to be restricted to mothers with BMI pregnancy. A study limitation was the lack of data on the effects of obstetric interventions and neonatal resuscitation efforts. Risks of birth-asphyxia-related outcomes increased with maternal weight gain between pregnancies. Preventing weight gain

  8. Fatty acids in formulae for term infants: compliance of present recommendations with the actual human milk fatty acid composition of geographically different populations.

    Science.gov (United States)

    Smit, E N; Martini, I A; Kemperman, R F J; Schaafsma, A; Muskiet, F A J; Boersma, E R

    2003-07-01

    Recommendations for formula fatty acids (FA) are largely based on the mature human milk FA composition. This study aimed to investigate whether current recommendations for formula FA for term infants comply with the actual breast-milk FA composition of geographically distinct populations and to provide more realistic grounds for future recommendations. 455 mature breast-milk samples were collected in different countries over 25 y. Recommendations of different organizations were projected on their FA data. FA interrelationships were calculated with Spearman's rank tests. FA compositions of 30 formulae were compared with those of breast milk. Many samples from non-Western communities did not meet the recommendations for formula 12:0, 14:0 and 18:2omega6, since these are mainly based on breast milk of mothers living in Western countries. Recommendations for 18:3omega3, 18:2omega6/18:3omega3, 20:4omega6 and 22:6omega3 were not met by many milk samples, which may point to the poorly developed recommendations for long-chain polyunsaturated FA. Most of the investigated breast-milk FA (12:0, 14:0, 16:0, 18:0, 18:3omega3, 22:6omega3, 18:2omega6, 20:4omega6, 18:1omega9) were either positively or negatively interrelated. Many formulae had FA compositions that were not consistent with the physiological interrelationships of FA in breast milk. Future recommendations, if based on human milk, should derive from its FA balance, as indicated by the FA interrelationships. A "humanized" formula FA composition would in this sense be any composition that cannot be distinguished from that of breast milk by techniques such as principal component analysis.

  9. Prevalence of macrosomia and its risk factors in china: a multicentre survey based on birth data involving 101,723 singleton term infants.

    Science.gov (United States)

    Li, Guanghui; Kong, Lijun; Li, Zhiwen; Zhang, Li; Fan, Ling; Zou, Liying; Chen, Yi; Ruan, Yan; Wang, Xiaorong; Zhang, Weiyuan

    2014-07-01

    Macrosomia, defined as a birthweight at least 4000 g, is a public health problem because of its adverse influences on maternal and neonatal outcomes. Studies show that there is an increasing prevalence of macrosomia births in developing countries. However, information on the epidemiology of macrosomia is limited in China. This study aimed to determine the prevalence and geographic variability of macrosomia in China and risk factors that can be targeted for intervention. A hospital-based, cross-sectional survey was conducted in 14 provinces in China, covering a wide range of geographic areas. The medical records of 101,723 singleton term infants born in 39 hospitals during 2011 were reviewed. Multiple logistic regression analysis was used to examine the associations between demographic characteristics and the risk of macrosomia. The total prevalence of macrosomia was 7.3%. The prevalence varied between provinces, ranging from 4.1% to 13.4%. The prevalence of macrosomia in northern China (8.5%) was significantly higher than that in southern China (5.6%). Logistic regression analyses showed that risk of macrosomia was positively associated with maternal age, pre-pregnant body mass index (BMI), gravidity, parity, maternal height, gestational weight gain (GWG), gestational diabetes mellitus (GDM), and male fetal sex. Maternal BMI, gestational week, and GWG were the three risk factors most strongly associated with macrosomia. The prevalence of macrosomia varied dramatically between different areas of China. High pre-pregnancy BMI and GWG represent main modifiable risk factors for macrosomia and need more attention from health care providers. © 2014 John Wiley & Sons Ltd.

  10. Infant Jaundice

    Science.gov (United States)

    ... Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family HealthInfants and Toddlers Kids and Teens Pregnancy and ... Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family HealthInfants and Toddlers Kids and Teens Pregnancy and ...

  11. weight infants

    African Journals Online (AJOL)

    transfused infants and the volume of blood wasted during each transfusion, and to identify from this baseline information specific categories of infants who would benefit from the introduction of a limited donor exposure programme (LDEP). Study setting. Neonatal wards and neonatal intensive care unit (NICU), Tygerberg ...

  12. Length of stay for childbirth in Trentino (North-East of Italy): the impact of maternal characteristics and organizational features of the maternity unit on the probability of early discharge of healthy, term infants.

    Science.gov (United States)

    Pertile, Riccardo; Pavanello, Lucia; Soffiati, Massimo; Manica, Laura; Piffer, Silvano

    2017-11-07

    Early discharge (ED) of healthy term infants has become a common practice due to current social and economic needs. The primary objective of the present study was to evaluate trends in early discharge of healthy term neonates (≥ 37 gestational weeks) by delivery method (cesarean and vaginal) in maternity units in the Province of Trento. The secondary objective was to identify the socio-demographic characteristics (including the area of residence and distance from the designated hospital) and clinical characteristics of mothers whose infants were discharged early. This retrospective study reviewed records of live births from 2006 to 2016, for a total of 45, 314 healthy term infants. The trend for ED grew significantly during the period 2006-2016, for both cesarean and vaginal deliveries. The multiple logistic regression analysis shows how the determinants of ED are maternal age, birth order, citizenship of mother, maternal smoking, maternal employment status, and the number of births at the hospital on the day of birth. The post-partum length of stay should be adjusted based on the characteristics and needs of the mother-infant dyad, identifying the criteria for safe discharge. In Trento, various procedures and programs are becoming more uniform today with the intention to provide family assistance service. What is Known: • Admission for childbirth is one of the primary causes of hospitalization in industrialized countries. • The length of stay for childbirth has been steadily declining in recent decades, with the aim of reducing costs while also demedicalizing pregnancy. What is New: • A higher rate of early discharge (ED) was recorded for neonates of women having foreign citizenship, entrepreneurs, self-employed professionals or managers. • ED was more common when the new mother gave birth on a day in which there was a higher number of births at the hospital, indicating overcrowding in the maternity unit.

  13. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Roggeri DP

    2016-08-01

    Full Text Available Daniela Paola Roggeri,1 Alessandro Roggeri,1 Elisa Rossi,2 Salvatore Cataudella,2 Nello Martini,3 1ProCure Solutions, Nembro, Bergamo, 2CINECA Interuniversity Consortium, Bologna, 3Accademia Nazionale di Medicina, Rome, Italy Purpose: Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods: Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3 with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures. Results: Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively. The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in

  14. A LONG-TERM FOLLOW-UP STUDY OF A RANDOMIZED CONTROLLED TRIAL OF MOTHER-INFANT PSYCHOANALYTIC TREATMENT: OUTCOMES ON MOTHERS AND INTERACTIONS.

    Science.gov (United States)

    Salomonsson, Majlis Winberg; Sorjonen, Kimmo; Salomonsson, Björn

    2015-01-01

    An earlier randomized controlled trial (RCT) compared 80 mother-infant dyads in a Stockholm sample. One had received mother-infant psychoanalytic treatment [mother-infant psychoanalytic therapies (MIP) group], and the other received Child Health Center care (CHCC group). Effects were found on mother-reported depression and expert-rated mother-infant relationship qualities and maternal sensitivity. When the children were 412 years, the dyads were followed up with assessments of the children's attachment representations, social and emotional development, and global functioning, and the mothers' psychological well-being and representations of the child as well as the mother-child interactions. We gathered data from 66 cases approximately 312 years' posttreatment. All scores involving the mothers had now approached community levels. We found effects on maternal depression in favor of MIP, but no other between-group differences. The MIP treatments seemed to have helped the mothers to recover more quickly on personal well-being, to become more sensitive to their babies' suffering, and to better support and appreciate their children throughout infancy and toddlerhood. If so, this would explain why the MIP children had a better global functioning and were more often "OK" and less often "Troubled" at 412 years. © 2015 Michigan Association for Infant Mental Health.

  15. Long-term risk for readmission, methicillin-resistant Staphylococcus aureus (MRSA) infection, and death among MRSA-colonized veterans.

    Science.gov (United States)

    Quezada Joaquin, Nestor M; Diekema, Daniel J; Perencevich, Eli N; Bailey, George; Winokur, Patricia L; Schweizer, Marin L

    2013-03-01

    While numerous studies have assessed the outcomes of methicillin-resistant S. aureus (MRSA) colonization over the short term, little is known about longer-term outcomes after discharge. An assessment of long-term outcomes could provide information about the utility of various MRSA prevention approaches. A matched-cohort study was performed among Veterans Affairs (VA) patients screened for MRSA colonization between the years 2007 and 2009 and followed to evaluate outcomes until 2010. Cox proportional-hazard models were used to evaluate the association between MRSA colonization and long-term outcomes, such as infection-related readmission and crude mortality. A total of 404 veterans were included, 206 of whom were MRSA carriers and 198 of whom were noncarriers. There were no culture-proven MRSA infections on readmission among the noncarriers, but 13% of MRSA carriers were readmitted with culture-proven MRSA infections on readmission (P MRSA carriers were significantly more likely to be readmitted, to be readmitted more than once due to proven or probable MRSA infections, and to be readmitted within 90 days of discharge than noncarriers (P MRSA carriers than among noncarriers after statistically adjusting for potential confounders. Among a cohort of VA patients, MRSA carriers are at high risk of infection-related readmission, MRSA infection, and mortality compared to noncarriers. Noncarriers are at very low risk of subsequent MRSA infection. Future studies should address whether interventions such as nasal or skin decolonization could result in improved outcomes for MRSA carriers.

  16. Long-term Deleterious Impact of Surgeon Care Fragmentation After Colorectal Surgery on Survival: Continuity of Care Continues to Count.

    Science.gov (United States)

    Justiniano, Carla F; Xu, Zhaomin; Becerra, Adan Z; Aquina, Christopher T; Boodry, Courtney I; Swanger, Alex; Temple, Larissa K; Fleming, Fergal J

    2017-11-01

    Surgical care fragmentation at readmission impacts short-term outcomes. However, the long-term impact of surgical care fragmentation is unknown. The purpose was to evaluate the impact of surgical care fragmentation, encompassing both surgeon and hospital care, at readmission after colorectal surgery on 1-year survival. This was a retrospective cohort study. The study included patients undergoing colorectal resection in New York State from 2004 to 2014. Included were 20,016 patients undergoing colorectal resection who were readmitted within 30 days of discharge and categorized by source-of-care fragmentation. Each readmission was classified by the source of fragmentation: readmission to the index hospital and managed by another provider, readmission to another hospital by the index surgeon, and readmission to another hospital by another provider. Patients readmitted to the index hospital and managed by the index surgeon served as controls. One-year overall survival and 1-year colorectal cancer-specific survival were the outcomes measured. After propensity adjustment, surgeon care fragmentation was independently associated with decreased survival. In comparison with patients without surgical care fragmentation (patients readmitted to the index hospital and managed by the index surgeon), patients readmitted to the index hospital and managed by another provider had over a 2-fold risk (HR, 2.33; 95% CI, 2.10-2.60) and patients readmitted to another hospital by another provider had almost a 2-fold risk (HR, 1.91; 95% CI, 1.63-2.25) of 1-year mortality. Among 9545 patients with a colorectal cancer diagnosis, surgical care fragmentation was once again associated with decreased survival with patients readmitted to the index hospital and managed by another provider having a HR of 2.12 (95% CI, 1.76-2.56) and patients readmitted to another hospital by another provider having a HR of 1.57 (95% CI, 1.17-2.11) compared with patients readmitted to the index hospital and managed

  17. Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: A systematic review.

    Science.gov (United States)

    Bradford, Natalie K; Edwards, Rachel M; Chan, Raymond J

    2016-07-01

    Around the world, guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) vary greatly. To prevent occlusion, most institutions recommend the use of heparin when the CVC is not in use. However, there is debate regarding the need for heparin and evidence to suggest normal saline may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased costs. To assess the clinical effects (benefits and harms) of heparin versus normal saline to prevent occlusion in long-term central venous catheters in infants, children and adolescents. A Cochrane systematic review of randomised controlled trials was undertaken. The Cochrane Vascular Group Specialised Register (including MEDLINE, CINAHL, EMBASE and AMED) and the Cochrane Register of Studies were searched. Hand searching of relevant journals and reference lists of retrieved articles was also undertaken. Data were extracted and appraisal undertaken. We included studies that compared the efficacy of normal saline with heparin to prevent occlusion. We excluded temporary CVCs and peripherally inserted central catheters. Rate ratios per 1000 catheter days were calculated for two outcomes, occlusion of the CVC, and CVC-associated blood stream infection. Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin. However, between studies, all used different protocols with various concentrations of heparin and frequency of flushes. The quality of the evidence ranged from low to very low. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). It

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

    Directory of Open Access Journals (Sweden)

    Ana Paula d'Oliveira Gheti Kao

    2011-09-01

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

  19. A case of Mycoplasma hominis meningo-encephalitis in a full-term infant: rapid recovery after start of treatment with ciprofloxacin

    NARCIS (Netherlands)

    Wolthers, Katja C.; Kornelisse, René F.; Platenkamp, Gert J. J. M.; Schuurman-van der Lem, M. Inge; van der Schee, Cindy; Hartwig, Nico G.; Verduin, Cees M.

    2003-01-01

    The role of Mycoplasma hominisas a causative agent for neonatal sepsis and meningitis is still unclear. Meningitis secondary to M. hominisis well-described in the literature; however, M. hominiscan also be isolated from cerebrospinal fluid (CSF) obtained from infants without signs of meningitis. We

  20. A mixture of three prebiotics does not affect vaccine specific antibody responses in healthy term infants in the first year of life

    NARCIS (Netherlands)

    Stam, Jose; van Stuijvenberg, Margriet; Garssen, Johan; Knipping, Karen; Sauer, Pieter J. J.

    2011-01-01

    Background: Previous studies have shown, that prebiotics can modulate the immune response in infants at risk for allergy, leading to a lower incidence of atopic dermatitis. Few studies have evaluated the effect of prebiotic carbohydrates alone on the vaccine-specific antibody response as a marker

  1. Neutropenia - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007230.htm Neutropenia - infants To use the sharing features on this page, please enable JavaScript. Neutropenia is an abnormally low number of white blood ...

  2. CPR: Infant

    Medline Plus

    Full Text Available Refresher Center Home FIRST AID, CPR and AED LIFEGUARDING Refresher Putting It All Together: CPR—Infant (1:52) Refresher videos only utilize this player QUICK LINKS Home RedCross.org Purchase Course ...

  3. CPR - infant

    Science.gov (United States)

    ... and strollers. Never leave an infant in a mesh playpen with one side down. Follow the guidelines ... S875. PMID: 20956229 www.ncbi.nlm.nih.gov/pubmed/20956229 . Easter JS, Scott HF. Pediatric resuscitation. In: ...

  4. Orientation-reversal and phase-reversal visual evoked potentials in full-term infants with brain lesions: a longitudinal study.

    Science.gov (United States)

    Mercuri, E; Braddick, O; Atkinson, J; Cowan, F; Anker, S; Andrew, R; Wattam-Bell, J; Rutherford, M; Counsell, S; Dubowitz, L

    1998-08-01

    The onset and maturation of visual cortical mechanisms can be recorded by using steady-state visual evoked potentials. The aim of this study was to evaluate and compare orientation-reversal (OR) and phase-reversal (PH) VEP as indicators of the maturation of cortical function in a population of fullterm infants with brain lesions on neonatal MRI. Forty-six infants with brain lesions on neonatal MRI were tested on both PH and OR VEP at 8 reversals/second at the age of 5 months and, if the responses were not significant, at a lower temporal frequency (4 reversals/second). Children whose VEPs were not significant at 5 months were tested longitudinally at 6, 9, 12 and 18 months. The results showed that 23 of the 46 infants (50%) did not show significant responses at 5 months and that while in 7 of the 23 (14% of the whole cohort) the responses became significant between 5 and 12 months, in the other 16 infants (34%) the VEP responses were persistently abnormal. Children with focal lesions, such as focal infarction or haemorrhages, tended to show normal or only mildly delayed VEP while more generalised lesions, such as the ones seen in infants with hypoxic-ischaemic encephalopathy grade 2 and 3, tended to be associated with abnormal VEP responses. The involvement of the optic radiations and occipital cortex was not always associated with abnormal VEP responses but the concomitant involvement of the basal ganglia was always associated with abnormal VEP. We were also able to demonstrate that VEP can be also used as a prognostic indicator: while normal OR VEP are reliably associated with a normal visual and neurodevelopmental outcome, abnormal 4 OR or 8 PH at 5 months are consistently associated with abnormal outcome.

  5. Focused breastfeeding counselling improves short- and long-term success in an early-discharge setting

    DEFF Research Database (Denmark)

    Nilsson, Ingrid M. S.; Strandberg-Larsen, Katrine; Knight, Christopher H.

    2017-01-01

    Length of postnatal hospitalization has decreased and has been shown to be associated with infant nutritional problems and increase in readmissions. We aimed to evaluate if guidelines for breastfeeding counselling in an early discharge hospital setting had an effect on maternal breastfeeding self......-efficacy, infant readmission and breastfeeding duration. A cluster randomized trial was conducted and assigned nine maternity settings in Denmark to intervention or usual care. Women were eligible if they expected a single infant, intended to breastfeed, were able to read Danish, and expected to be discharged...... within 50 hr postnatally. Between April 2013 and August 2014, 2,065 mothers were recruited at intervention and 1,476 at reference settings. Results show that the intervention did not affect maternal breastfeeding self-efficacy (primary outcome). However, less infants were readmitted 1 week postnatally...

  6. Characteristics of antigravity spontaneous movements in preterm infants up to 3 months of corrected age.

    Science.gov (United States)

    Miyagishima, Saori; Asaka, Tadayoshi; Kamatsuka, Kaori; Kozuka, Naoki; Kobayashi, Masaki; Igarashi, Risa; Hori, Tsukasa; Yoto, Yuko; Tsutsumi, Hiroyuki

    2016-08-01

    We investigated whether spontaneous antigravity limbs movements in very low birth weight preterm infants were insufficient compared to those in term infants. The relationship between the quality of general movements (GMs) and antigravity limbs movements was also examined. Preterm infants with very low birth weight without central nervous system disorders nor severe respiration disorders, and healthy term infants were recruited. The infants were set in a supine position. The distance between both hands and between both feet, and the height of both hands and feet from the floor were recorded at 1-3 corrected months for preterm infants, and at 1-3 months for term infants by a 3D motion capture system. The measurements were adjusted for body proportions. GMs in preterm and term infants were assessed similarly. Thirteen preterm and 15 term infants completed the study. In preterm infants, the distance between both hands and between both feet were longer, and the height of both hands and feet were lower than those in term infants in all measurements. In term infants, the height of both hands and feet increased as they developed, but no change was observed in preterm infants. In preterm infants with abnormal GMs, the distance between both hands was longer, and the height of both hands and feet was lower than that in those with normal GMs. There were no such differences between preterm infants with normal GMs and term infants with normal GMs. Antigravity limbs movements in preterm infants within the first 3 month of corrected age were insufficient compared with those in term infants. Furthermore, no improvement with development was observed in preterm infants. In addition, preterm infants with abnormal GMs showed worse antigravity limbs movements than preterm and term infants with normal GMs. The preterm infants with normal GMs could behave similar to the full term infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants

    Directory of Open Access Journals (Sweden)

    Wai Ho Lim

    2012-08-01

    Conclusion: Unlike term infants, Gram-negative organism and E coli were the leading pathogen of EOS among VLBW infants. Judicious and timely use of antibiotic therapy is crucial in the care of VLBW infants.

  8. Cerebral oximetry in preterm infants

    DEFF Research Database (Denmark)

    Greisen, Gorm; Andresen, Bjørn; Plomgaard, Anne Mette

    2016-01-01

    Preterm birth constitutes a major cause of death before 5 years of age and it is a major cause of neurodevelopmental impairment across the world. Preterm infants are most unstable during the transition between fetal and newborn life during the first days of life and most brain damage occurs...... in this period. The brain of the preterm infant is accessible for tissue oximetry by near-infrared spectroscopy. Cerebral oximetry has the potential to improve the long-term outcome by helping to tailor the support of respiration and circulation to the individual infant's needs, but the evidence is still lacking...

  9. Infant mortality statistics from the 2007 period linked birth/infant death data set.

    Science.gov (United States)

    Mathews, T J; MacDorman, Marian F

    2011-06-29

    This report presents 2007 period infant mortality statistics from the linked birth/infant death data set (linked file) by a variety of maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. Descriptive tabulations of data are presented and interpreted. The U.S. infant mortality rate was 6.75 infant deaths per 1,000 live births in 2007, not significantly different than the rate of 6.68 in 2006. Infant mortality rates ranged from 4.57 per 1,000 live births for mothers of Central and South American origin to 13.31 for non-Hispanic black mothers. Infant mortality rates were higher for those infants who were born in multiple deliveries; for those whose mothers were born in the 50 states or the District of Columbia; and for mothers who were unmarried. Infant mortality was also higher for male infants and infants born preterm or at low birthweight. The neonatal mortality rate was essentially unchanged from 2006 (4.46) to 2007 (4.42). The postneonatal mortality rate increased 5 percent from 2.22 in 2006 to 2.33 in 2007, similar to the rate in 2005 (2.32). Infants born at the lowest gestational ages and birthweights have a large impact on overall U.S. infant mortality. For example, more than one-half of all infant deaths in the United States in 2007 (54 percent) occurred to the 2 percent of infants born very preterm (less than 32 weeks of gestation). Still, infant mortality rates for late preterm infants (34-36 weeks of gestation) were 3.6 times, and those for early term (37-38 weeks) infants were 1.5 times, those for infants born at 39-41 weeks of gestation, the gestational age with the lowest infant mortality rate. The three leading causes of infant death--congenital malformations, low birthweight, and sudden infant death syndrome--accounted for 45 percent of all infant deaths. The percentage of infant deaths that were "preterm-related" was 36.0 percent in 2007. The preterm-related infant

  10. Soy infant formula: is it that bad?

    Science.gov (United States)

    Vandenplas, Yvan; De Greef, Elisabeth; Devreker, Thierry; Hauser, Bruno

    2011-02-01

    The objective of this study is to review the indications of soy infant formula (SIF). Structured review of publications is made available through standard search engines (Pubmed,…). The medical indications for SIF are limited to galactosaemia and hereditary lactase deficiency. In the treatment of cow's milk allergy, SIF is used for economic reasons, as extensive hydrolysates are expensive. SIF is dissuaded mainly because of its phytooestrogen content. Isoflavone serum levels are much higher in SIF-fed infants than in breastfed or cow milk formula-fed infants. Administration of pure isoflavones to animals causes decreased fertility, but clinically relevant adverse effects of SIF in infants are not reported.   Soy infant formula remains an option for feeding of term born infants if breastfeeding is not possible and if standard infant formula is not tolerated. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

  11. The anterior to midaxillary line between the 4th or 5th intercostal space (Buelau position) is safe for the use of thoracostomy tubes in preterm and term infants.

    Science.gov (United States)

    Eifinger, Frank; Lenze, Miriam; Brisken, Katrin; Welzing, Lars; Roth, Bernhard; Koebke, Jürgen

    2009-06-01

    Thoracostomy tubes are widely used in neonatology. Complications occurred significantly more frequently in infants, especially neonates, than in adults. Principally, the access is the modified Buelau position which takes place in the anterior axillary line at the 4th or 5th intercostal space above the margin of the ribs. This study seeks to determine the characteristics and topographic conditions of the anatomical structures at the ventral and lateral thoracic wall in the preterm and term neonate. Fifteen formalin-fixed stillborns were prepared (nine male, six female, 28-43 weeks gestational age). The anatomical preparation involved the complete thoracic wall region. In all preparations, a venous vessel was detected at the lateral wall and was identified as v. thoracoepigastrica without accompanying artery. Arteria (a.) and vena (v.) thoracica interna were regularly found close to the sternal plate on both sides between rib and fascia. With increasing gestational ages the course of the v. thoracoepigastrica varied significantly between the left and right thoracic wall. It was demonstrated that the v. thoracoepigastrica regularly arose within the abdominal or thoracic subcutaneous fat and drained into the v. subclavia. The variance between its course was almost 5-12 mm to the lateral or medial side. At both thoracic sides, no other organs or organ structures except lung parenchyma could be detected when using the Buelau position. The anterior to midaxillary line between the 4th or 5th intercostal space (Buelau position) is safe for the use of thoracostomy tubes in preterm and term infants.

  12. Neurocomportamento de recém-nascidos a termo, pequenos para a idade gestacional, filhos de mães adolescentes Neurobehavior of full-term small for gestational age newborn infants of adolescent mothers

    Directory of Open Access Journals (Sweden)

    Marina C. de Moraes Barros

    2008-06-01

    Full Text Available OBJETIVO: Comparar o neurocomportamento de recém-nascidos a termo pequenos (PIG e adequados (AIG para a idade gestacional, filhos de mães adolescentes. MÉTODOS: Estudo transversal prospectivo de nascidos a termo AIG e PIG, com 24-72 horas de vida, sem afecções do sistema nervoso central. Os neonatos foram avaliados por meio da Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS para: habituação, atenção, despertar, controle, manobras para a orientação, qualidade dos movimentos, excitabilidade, letargia, reflexos não ótimos, assimetria, hipertonia, hipotonia e sinais de estresse e abstinência. A comparação dos grupos AIG e PIG foi feita por análise de variância e teste do qui-quadrado. Aplicou-se a regressão multivariada para analisar os fatores associados ao escore de cada variável do NNNS. RESULTADOS: Dos 3.685 nascidos no local do estudo, 928 (25% eram de mães adolescentes. Desses, 477 satisfizeram os critérios de inclusão, sendo 419 (88% AIG e 58 (12% PIG. A análise univariada não mostrou diferença em nenhuma das variáveis da NNNS entre os PIG e os AIG. Na análise multivariada, os PIG nascidos de parto vaginal apresentaram menor escore na variável qualidade de movimentos do que os nascidos por cesárea. Os PIG nascidos com anestesia local ou sem anestesia apresentaram maior escore na variável excitabilidade do que os nascidos sob anestesia loco-regional. Os PIG femininos tiveram menor escore na variável sinais de estresse/abstinência que os masculinos. CONCLUSÃO: Os recém-nascidos PIG de mães adolescentes mostraram menor qualidade de movimento, mais excitabilidade e mais sinais de estresse, em associação com o sexo do neonato e com variáveis relacionadas ao parto.OBJECTIVE: To compare the neurobehavior of small (SGA and adequate (AGA for gestational age full-term neonates born to adolescent mothers. METHODS: This prospective cross-sectional study included full-term newborn infants aged 24

  13. Long-term efficacy of an internet-based intervention for infant and toddler sleep disturbances: one year follow-up.

    Science.gov (United States)

    Mindell, Jodi A; Du Mond, Courtney E; Sadeh, Avi; Telofski, Lorena S; Kulkarni, Neema; Gunn, Euen

    2011-10-15

    To examine at one-year follow-up the efficacy of an internet-based intervention for infant and toddler sleep disturbances, as well as to assess any indirect benefits to maternal sleep and confidence. Participants included 171 (64.8%) of 264 mothers of an infant or toddler (ages 18-48 months) who had previously participated in a 3-week study. Families had been randomly assigned to one of 2 intervention groups (algorithmic internet-based intervention alone or in combination with a prescribed bedtime routine) or a control group. After a one-week baseline, the intervention groups followed personalized sleep recommendations. The initial internet-intervention was found to be efficacious at 2 weeks post-intervention. The current study investigates a one-year follow-up, with mothers completing a short survey that included 8 questions from the Brief Infant Sleep Questionnaire and 1 question from the Pittsburgh Sleep Quality Index. Improvements in difficulty falling asleep, number/duration of night wakings, and longest continuous sleep period were maintained at one year follow-up in the 2 intervention groups compared to baseline and end of the initial study, p < 0.001. Children in the control group, in which limited changes were seen in the initial study, showed improvements in the duration of night wakings and longest continuous sleep period compared to the end of the initial study. Mothers in all groups were less likely to describe their child's sleep as a problem. These results suggest that a brief internet-intervention for early childhood sleep problems is effective in improving child and maternal sleep, with improvements maintained one year later.

  14. Infant Formula

    Science.gov (United States)

    ... iron-fortified formula.Some formulas are made from soy milk instead of cow’s milk. If your baby seems ... cow’s milk, your doctor may suggest using a soy-milk formula.If you’re not breastfeeding, use infant ...

  15. CPR: Infant

    Medline Plus

    Full Text Available Refresher Center Home FIRST AID, CPR and AED LIFEGUARDING Refresher Putting It All Together: CPR—Infant (1:52) Refresher videos only utilize this player QUICK LINKS Home RedCross.org Purchase Course Materials Shop Our Store ...

  16. Optimizing Nutrition in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Bai-Horng Su

    2014-02-01

    Full Text Available Extrauterine growth restriction is common in very preterm infants. The incidence in very-low-birth-weight infants ranges between 43% and 97% in various centers, with a wide variability due to the use of different reference growth charts and nonstandard nutritional strategies. Extrauterine growth restriction is associated with an increased risk of poor neurodevelopmental outcome. Inadequate postnatal nutrition is an important factor contributing to growth failure, as most very preterm infants experience major protein and energy deficits during neonatal intensive care unit hospitalization. First-week protein and energy intake are associated with 18-month developmental outcomes in very preterm infants. Early aggressive nutrition, including parenteral and enteral, is well tolerated in the very preterm infant and is effective in improving growth. Continued provision of appropriate nutrition (fortified human milk or premature formula is important throughout the growing care during the hospitalization. After discharge, exclusively breast-fed infants require additional supplementation. If formula-fed, nutrient-enriched postdischarge formula should be continued for approximately 9 months corrected age. Supplementation of the preterm formulas with protein would increase the protein/energy ratio (3 g/100 kcal, leading to increased lean mass with relatively decreased fat deposition. Further research is required to optimize the nutritional needs of preterm infants and to evaluate the effects of nutritional interventions on long-term growth, neurodevelopment, and other health outcomes.

  17. Breast-feeding among Mothers of Low Birth Weight Infants

    OpenAIRE

    Lefebvre, Francine

    1990-01-01

    The physical and emotional condition of the mother delivering a premature or low birth weight infant may be quite different than that of the mother of a healthy term infant when initiating breast-feeding. Despite this difference, incidence and duration of lactation among mothers of pre-term or low birth weight infants was found to be quite good compared with that of mothers of term infants. Considerable problems, however, are encountered by premature or low birth weight infants when breast-fe...

  18. Early postoperative physical therapy for improving short-term gross motor outcome in infants with cyanotic and acyanotic congenital heart disease.

    Science.gov (United States)

    Haseba, Sumihito; Sakakima, Harutoshi; Nakao, Syuhei; Ohira, Misaki; Yanagi, Shigefumi; Imoto, Yutaka; Yoshida, Akira; Shimodozono, Megumi

    2017-04-07

    We analysed the gross motor recovery of infants and toddlers with cyanotic and acyanotic congenital heart disease (CHD) who received early postoperative physical therapy to see whether there was any difference in the duration to recovery. This study retrospectively evaluated the influence of early physical therapy on postoperative gross motor outcomes of patients with CHD. The gross motor ability of patients with cyanotic (n = 25, average age: 376.4 days) and acyanotic (n = 26, average age: 164.5 days) CHD was evaluated using our newly developed nine-grade mobility assessment scale. Physical therapy was started at an average of five days after surgery, during which each patient's gross motor ability was significantly decreased compared with the preoperative level. Patients (who received early postoperative physical therapy) with cyanotic (88.0%) and acyanotic CHD (96.2%) showed improved preoperative mobility grades by the time of hospital discharge. However, patients with cyanotic CHD had a significantly prolonged recovery period compared to those with acyanotic CHD (p physical therapy promotes gross motor recovery. Implications of Rehabilitation Infants and toddlers with cyanotic congenital heart disease are likely at greater risk of gross motor delays and have a prolonged recovery period of gross motor ability compared to those with acyanotic congenital heart disease. Early postoperative physical therapy for patients with congenital heart disease after cardiac surgery promoted gross motor recovery. The postoperative recovery period to preoperative mobility grade was affected by pre-, intra-, and postoperative factors. Rehabilitation experts should consider the risk of gross motor delays of patients with congenital heart disease after cardiac surgery and the early postoperative physical therapy to promote their gross motor recovery.

  19. Surveillance of extreme hyperbilirubinaemia in Denmark. A method to identify the newborn infants

    DEFF Research Database (Denmark)

    Bjerre, J.V.; Petersen, Jes Reinholdt; Ebbesen, F.

    2008-01-01

    AIM: To describe the incidence of infants born at term or near-term with extreme hyperbilirubinaemia. METHODS: The study period was between 1 January 2002 and 31 December 2005, and included all infants born alive at term or near-term in Denmark. Medical reports on all newborn infants with a total...

  20. Neurodesenvolvimento de lactentes nascidos a termo pequenos para a idade gestacional no segundo mês de vida Neurodevelopment of full-term small-for-gestacional age infants in the second month of life

    Directory of Open Access Journals (Sweden)

    Maura M. Fukujima Goto

    2005-03-01

    Full Text Available O objetivo deste estudo foi avaliar e comparar o neurodesenvolvimento de lactentes nascidos a termo, com peso adequado (AIG ou pequeno para a idade gestacional (PIG, no 2º mês de vida. Avaliaram-se 67 lactentes: 43 AIG e 24 PIG, utilizando as Bayley Scales of Infant Development. O Index Score (IS nas Escalas Mental e Motora foi significativamente menor no grupo PIG. Considerando a proporcionalidade corporal (Grupos Controle, Assimétrico e PIG-Simétrico, houve diferença significativa na Escala Motora (p=0,003, com menores pontuações no grupo PIG-Simétrico. Comparados aos percentis de IS do grupo Controle, na Escala Mental, houve diferença entre os grupos Assimétrico X PIG-Simétrico; na Escala Motora, houve diferença entre os grupos Assimétrico X Controle (p=0,039 e PIG-Simétrico X Controle (p=0,0007; não houve diferença entre os grupos Assimétrico e PIG-Simétrico, ambos apresentando menores pontuações que o grupo Controle.The objective of the present study was to assess and to compare the neurodevelopment of full-term adequate (AGA or small-for-gestational age (SGA infants in the second month of life. Sixty-seven infants were evaluated: 43 AGA and 24 SGA, making use of the Bayley Scales of Infant Development. The SGA group Index Score (IS was significantly lower in Mental and Motor Scales. Considering the body proportionality (Asymmetric, Symmetric-SGA and Control group there was difference in Motor Scale (p=0.003 with lower scores in the Symmetric-SGA group. Comparing to the Control group IS percentiles, in Mental Scale there was difference between Asymmetric X Symmetric-SGA; in Motor Scale, there was difference between the Asymmetric X Control (p=0.039 and Symmetric-SGA X Control (p=0.007 groups; there was no difference between Asymmetric and Symmetric-SGA although both exhibited lower scores than the Control group.

  1. Infant weaning.

    Science.gov (United States)

    1990-07-01

    This communication supplement provides instructions for weaning an infant through the 1st year of life. Since a new born infant grows much faster than an older child, the baby requires sufficient nourishment. The order of foods, though, is important. The baby should begin with liquid foods, then semisolid foods, and lastly solid foods. The best food for an infant, breast milk, contains all the necessary nutrients for a baby. It is clean, safe, easy to digest, and it protects the new born from disease and infection. But when the baby reaches 4 months of age, the weaning process should begin. Fruit juice and soup made of green leafy vegetables contain the vitamins and minerals that the baby needs. Beginning in the 5th month, the baby's diet should include boiled mashed potatoes and smashed bananas. And by the 7th month, the baby is able to digest semisolid food such as khichadi or dalia (roasted cereal which is grounded and mixed with water and dal, and then cooked). Parents should realize that the weaning process does not beginning immediately after birth, and when it begins, the food should be introduced gradually. The food should not contain any spices and should be freshly prepared (the hands should be washed and the utensils cleaned before preparing the foods). To prevent diarrhea and other infections, the food must be kept covered, protected from dust and flies. By the end of the 1st year, the baby should able to eat the normal diet of the family.

  2. Crescimento de nascidos a termo com peso baixo e adequado nos dois primeiros anos de vida Growth of full term low and adequate birth weight infants during the first two years of life

    Directory of Open Access Journals (Sweden)

    Sophie H Eickmann

    2006-12-01

    Full Text Available OBJETIVO: Verificar o padrão de crescimento de crianças nascidas a termo com peso baixo e adequado nos primeiros dois anos de vida e identificar fatores determinantes no momento de desaceleração máxima do crescimento. MÉTODOS: Estudo de coorte prospectiva com 148 lactentes nascidos a termo, em cinco municípios do Estado de Pernambuco. Os recém-nascidos foram recrutados nas maternidades no período de janeiro de 1993 a janeiro de 1994 e tiveram as medidas antropométricas aferidas com um, dois, quatro, seis, 12 e 24 meses. Os fatores de risco foram avaliados por análise de regressão linear multivariada. RESULTADOS: Houve incremento na média dos índices peso/idade e comprimento/idade mais evidente nas crianças com baixo peso do que nas com peso adequado ao nascer, especialmente nos dois primeiros meses de vida. A partir desta idade, observou-se desaceleração progressiva do crescimento até os 12 meses. O padrão de crescimento pôndero-estatural foi semelhante entre todas as crianças. Contudo, as nascidas com peso adequado mantiveram peso e comprimento acima das nascidas com baixo peso. As variáveis socioeconômicas explicaram 23% da variação do índice peso/idade, e o peso ao nascer, 4%. A condição socioeconômica explicou 28% da variação do índice comprimento/idade, seguido do peso ao nascer, altura materna e ocorrência de diarréia. CONCLUSÕES: Intervenções visando ao crescimento adequado devem ser direcionadas à assistência pré-natal e aos fatores socioambientais durante a infância, como forma de garantir a expressão máxima do potencial genético neste grupo populacional.OBJECTIVE: To assess the growth pattern of full term low and adequate birth weight infants during the first two years of life and to identify the determinants at the time of the greatest growth deceleration. METHODS: A prospective cohort study was conducted with 148 full term infants in five small towns of the state of Pernambuco, Northeastern

  3. Mother-infant attachment in adoptive families.

    Science.gov (United States)

    Singer, L M; Brodzinsky, D M; Ramsay, D; Steir, M; Waters, E

    1985-12-01

    Data from 2 separate samples using the Strange Situation paradigm were combined to assess the quality of attachment relationships in adoptive and nonadoptive mother-infant pairs. Infants were between 13 and 18 months at the time of observation. Results indicated no differences in mother-infant attachment between nonadopted and intraracial adopted subjects or between intraracial and interracial adopted subjects. Interracial adoptive mother-infant pairs did show a higher incidence of insecure attachment in comparison to nonadoptive pairs. Mothers of interracial adopted infants also were less comfortable having others care for their babies and perceived less emotional support from extended family and friends for their decision to adopt a child prior to the actual adoption than did other mothers. No relation was found, however, between quality of mother-infant attachment and either perceived social support, infant developmental quotient, infant temperament, number of foster homes experienced by the infant, or infant's age at the time of adoption placement. It was suggested that the higher incidence of psychological problems found among adoptees in middle childhood and adolescence cannot be explained in terms of insecure attachment relationships during the infancy years.

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

    Science.gov (United States)

    Fullar, Suzanne A.

    2008-01-01

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

  5. Probiotics in premature infants: focus on necrotising enterocolitis

    African Journals Online (AJOL)

    neonatal intensive care units (NICU).1-3 NEC is rare in term infants, whereas in the ... The premature infant may also be exposed to antibiotic treatment during this ... researchers believe that probiotics should be offered as routine therapy for preterm infants, and that additional placebo-controlled trials are not necessary.

  6. Health Visiting in the Infant's Home in Denmark.

    Science.gov (United States)

    Wagner, Mary; Wagner, Marsden G.

    A program of infant home visiting was established in Denmark as a result of concern about the rate of infant mortality. The objectives, problems, and promise of the infant Home Visiting Program are summarized and evaluated in terms of their implications for the United States. Although the results of the program have been overwhelmingly favorable…

  7. Percutaneous Balloon Angioplasty for Severe Native Aortic Coarctation in Young Infants Less Than 6 Months: Medium- to Long-term Follow-up

    Directory of Open Access Journals (Sweden)

    Lan He

    2015-01-01

    Full Text Available Background: Although balloon angioplasty (BA has been performed for more than 20 years, its use as a treatment for native coarctation of the aorta (CoA during childhood, especially in young infants, remains controversial. This study aimed to assess the effects and potential role of percutaneous transcatheter BA for native CoA as an alternative therapy to surgical repair in young infants. Methods: The 37 patients aged from 6 days to 6 months with severe CoA in congestive heart failure or circulatory shock were admitted for BA. Patient′s weight ranged from 2.4 to 6.1 kg. All 37 patients were experiencing cardiac dysfunction, and eight patients were in cardiac shock with severe metabolic acidosis. Eleven patients had an isolated CoA, whereas the others had a CoA associated with other cardiac malformations. Cardiac catheterization and aortic angiography were performed under general anesthesia with intubation. Transfemoral arterial approaches were used for the BA. The size of the balloon ranged from 3 mm × 20 mm to 8 mm × 20 mm, and a coronary artery balloon catheter was preferred over a regular peripheral vascular balloon catheter. Results: The femoral artery was successfully punctured in all but one patient, with that patient undergoing a carotid artery puncture . The systolic peak pressure gradient (PG across the coarctation was 41.0 ± 16.0 mmHg (range 13-76 mmHg. The mean diameter of the narrowest coarctation site was 1.7 ± 0.6 mm (range 0.5-2.8 mm. All patients had successful dilation; the PG significantly decreased to 13.0 ± 11.0 mmHg (range 0-40 mmHg, and the diameter of coarctation significantly improved to 3.8 ± 0.9 mm (range 2.5-5.3 mm. No intraoperative complications occurred for any patients. However, in one case that underwent a carotid artery puncture, a giant aneurysm formed at the puncture site and required surgical repair. The following observations were made during the follow-up period from 6-month to 7-year: (1 The PG

  8. Do Infants Born Very Premature and Who Have Very Low Birth Weight Catch up with Their Full Term Peers in Their Language Abilities by Early School Age?

    Science.gov (United States)

    Zimmerman, Emily

    2018-01-01

    Purpose: This study examined the extent to which children born preterm (< 37 weeks) and/or who have low birth weight (< 2,500 g) catch up with their full term peers in terms of their language abilities at early school age (= 5 to < 9 years). Method: A systematic literature search identified empirical studies that fit the inclusion…

  9. Peripheral intravenous line - infants

    Science.gov (United States)

    PIV - infants; Peripheral IV - infants; Peripheral line - infants; Peripheral line - neonatal ... A peripheral intravenous line (PIV) is a small, short, plastic tube, called a catheter. A health care provider puts the PIV through the ...

  10. Session 6: Infant nutrition: future research developments in Europe EARNEST, the early nutrition programming project: EARly Nutrition programming - long-term Efficacy and Safety Trials and integrated epidemiological, genetic, animal, consumer and economic research.

    Science.gov (United States)

    Fewtrell, M S

    2007-08-01

    Increasing evidence from lifetime experimental studies in animals and observational and experimental studies in human subjects suggests that pre- and postnatal nutrition programme long-term health. However, key unanswered questions remain on the extent of early-life programming in contemporary European populations, relevant nutritional exposures, critical time periods, mechanisms and the effectiveness of interventions to prevent or reverse programming effects. The EARly Nutrition programming - long-term Efficacy and Safety Trials and integrated epidemiological, genetic, animal, consumer and economic research (EARNEST) consortium brings together a multi-disciplinary team of scientists from European research institutions in an integrated programme of work that includes experimental studies in human subjects, modern prospective observational studies and mechanistic animal work including physiological studies, cell-culture models and molecular techniques. Theme 1 tests early nutritional programming of disease in human subjects, measuring disease markers in childhood and early adulthood in nineteen randomised controlled trials of nutritional interventions in pregnancy and infancy. Theme 2 examines associations between early nutrition and later outcomes in large modern European population-based prospective studies, with detailed measures of diet in pregnancy and early life. Theme 3 uses animal, cellular and molecular techniques to study lifetime effects of early nutrition. Biomedical studies are complemented by studies of the social and economic importance of programming (themes 4 and 5), and themes encouraging integration, communication, training and wealth creation. The project aims to: help formulate policies on the composition and testing of infant foods; improve the nutritional value of infant formulas; identify interventions to prevent and reverse adverse early nutritional programming. In addition, it has the potential to develop new products through industrial

  11. Neurodevelopmental outcomes at 7 years’ corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial

    Science.gov (United States)

    Gibson, Robert A; Anderson, Peter J; McPhee, Andrew J; Sullivan, Thomas R; Gould, Jacqueline F; Ryan, Philip; Doyle, Lex W; Davis, Peter G; McMichael, Judy E; French, Noel P; Colditz, Paul B; Simmer, Karen; Morris, Scott A; Makrides, Maria

    2015-01-01

    Objective To determine if improvements in cognitive outcome detected at 18 months’ corrected age (CA) in infants born DHA) compared with standard-DHA diet were sustained in early childhood. Design Follow-up of a multicentre randomised controlled trial. Randomisation was stratified for sex, birth weight (DHA (≈1% total fatty acids) enteral feeds compared with standard-DHA (≈0.3% total fatty acids) from age 2–4 days until term CA. Primary outcome Full Scale IQ of the Wechsler Abbreviated Scale of Intelligence (WASI) at 7 years CA. Prespecified subgroup analyses based on the randomisation strata (sex, birth weight) were conducted. Results 604 (92% of the 657 originally randomised) consented to participate (291 high-DHA, 313 standard-DHA). To address missing data in the 604 consenting participants (22 for primary outcome), multiple imputation was performed. The Full Scale IQ was not significantly different between groups (high-DHA 98.3, SD 14.0, standard-DHA 98.5, SD 14.9; mean difference adjusted for sex, birthweight strata and hospital −0.3, 95% CI −2.9 to 2.2; p=0.79). There were no significant differences in any secondary outcomes. In prespecified subgroup analyses, there was a significant sex by treatment interaction on measures of parent-reported executive function and behaviour. Scores were within the normal range but girls receiving the high-DHA diet scored significantly higher (poorer outcome) compared with girls receiving the standard-DHA diet. Conclusions Supplementing the diets of preterm infants with a DHA dose of approximately 1% total fatty acids from days 2–4 until term CA showed no evidence of benefit at 7 years’ CA. Trial registration number Australian New Zealand Clinical Trials Registry: ACTRN12606000327583. PMID:25787990

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

    Science.gov (United States)

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

    2015-08-06

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

  13. Occurrence of Cleft Lip and Palate in terms of Maternal Health, Parents' Kinship, and Neonate Weight: a Case Study in the Infants of Southeastern part of Iran

    Directory of Open Access Journals (Sweden)

    Sirous Risbaf Fakour

    2016-12-01

    Full Text Available Oral clefts including cleft lip (CL, cleft palate with or without cleft lip (CP/L are one of the most common congenital deformities. The present study was conducted through a descriptive-retrospective study to examine the frequency of cleft lip and palate based on demographic factors including mother's health condition, parents kinship and weight of infants born in hospitals of Zahedan during 2001_2011 years. The result is based on the available hospital records of 142534 live births (there were 71717 boys and 70817 girls collected from 4 hospitals of Zahedan city. Results indicate that mothers of about 0.12% of neonates were not having any disease history whereas 0.15% neonates born with cleft palate, lip, or lip and palate were from such mothers who were suffering from some diseases during pregnancy. Conclusively, the higher occurrence rate of clefts among baby boys was from such mothers who had the positive history of illness during pregnancy time or parents were kinship.

  14. Infant Memory for Musical Experiences.

    Science.gov (United States)

    Saffran, Jenny R.; Loman, Michelle M.; Robertson, Rachel R. W.

    2000-01-01

    Two experiments examined memory of 7-month-olds after 2-week retention interval for passages of two Mozart movements heard daily for 2 weeks. Results suggested that the infants retained familiarized music in long-term memory and that their listening preferences were affected by the extent to which familiar passages were removed from the musical…

  15. Infants Hierarchically Organize Memory Representations

    Science.gov (United States)

    Rosenberg, Rebecca D.; Feigenson, Lisa

    2013-01-01

    Throughout development, working memory is subject to capacity limits that severely constrain short-term storage. However, adults can massively expand the total amount of remembered information by grouping items into "chunks". Although infants also have been shown to chunk objects in memory, little is known regarding the limits of this…

  16. Managing hypertension in the newborn infants

    OpenAIRE

    Azar Nickavar; Farahnak Assadi

    2014-01-01

    Hypertension in newborn infants, particularly those requiring intensive care, is becoming increasingly recognized, with prevalence of 0.2-3%. Recent studies have established normative tables for blood pressure (BP) in both term and pre-term infants based on the gestational age, postnatal age, gender, weight and height, identifying the neonates at increased risk for early-onset cardiovascular disease. Common causes of neonatal hypertension include thromboembolic complications secondary to umbi...

  17. ASPHYXIA AND DEVELOPMENTAL OUTCOME IN HIGH RISK INFANTS

    Directory of Open Access Journals (Sweden)

    Valentina DUKOVSKA

    2010-04-01

    Full Text Available Asphyxia is a risk factor that is very often related to neuro-developmental issues in high risk infants and equally affects preterm and term infants, however its outcome on the developed brain differs from the outcome on the preterm brain.In preterm infants, asphyxia usually exerts a hemorrhagic or ischaemic event and periventricular leukomalacia.In term infants, asphyxia leads to cerebral edema and atrophy of the brain, which may later lead to hypoxic ischaemic encephalopathy (HIE.The number of term infants with HIE who have survived is lower than those of preterm infants, while the percentage of term infants with HIE who have neuro-developmental issues is higher. Preemies face more problems in their motor development as a result of the brain damage, while term infants suffer from encephalopathy and their cognitive abilities are more affected.We have conducted a study about the effects that asphyxia has on the developmental outcomes in high risk infants. In our study, we did a longitudinal developmental follow-up of 30 high risk infants and an evaluation of their developmental outcome using the Griffiths Mental Development Scales, from the 4th month of life until the end of the 36th month. First, we found that high risk infants had a much lower developmental outcome than the control group during the trial. Finally, we found that asphyxia makes a difference in the developmental outcome of preterm infants without asphyxia who have a very low birth weight, the preterm infants with asphyxia, and the term infants with HIE-II.

  18. Prematurity, Immune Function and Infant Feeding Practices

    OpenAIRE

    Hampton, Shelagh M

    1999-01-01

    Recently, there has been much interest in the literature in the role of early nutrition and the health of the individual in adulthood. A majority of infants in the UK are born full term, while pretem infants account for 4-6 % of the total births. Milk feeding practices are divided into three groups: breast, combination (breast-fed with formula as ‘top-up’) and bottle (formula). In studies conducted by our group and other researchers immune function in full-term and preterm infants has been...

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

    Science.gov (United States)

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

    2012-01-01

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

  20. Zinc for preterm infants: Who needs it and how much is needed?

    Science.gov (United States)

    The establishment of micronutrient requirements for infants remains a challenge. For healthy full-term infants, breast milk is an appropriate standard for virtually all nutrients. In contrast, guidelines for infants who are not healthy, and infants who are born preterm, are much more tenuous....

  1. Parent Cognitions and Parent-Infant Interaction: The Relationship with Development in the First 12 Months

    Science.gov (United States)

    Ferrier-Lynn, Melissa; Skouteris, Helen

    2008-01-01

    This study examined parent cognitions and parent-infant interaction in terms of their contribution to infant development in the first 12 months. With a sample of 95 mother-infant dyads, results using structural equation modelling confirmed the expected finding that parent-infant interaction mediates the association between parent cognitions and…

  2. Ethical Challenges in Infant Feeding Research

    Directory of Open Access Journals (Sweden)

    Colin Binns

    2017-01-01

    Full Text Available Infants have a complex set of nutrient requirements to meet the demands of their high metabolic rate, growth, and immunological and cognitive development. Infant nutrition lays the foundation for health throughout life. While infant feeding research is essential, it must be conducted to the highest ethical standards. The objective of this paper is to discuss the implications of developments in infant nutrition for the ethics of infant feeding research and the implications for obtaining informed consent. A search was undertaken of the papers in the medical literature using the PubMed, Science Direct, Web of Knowledge, Proquest, and CINAHL databases. From a total of 9303 papers identified, the full text of 87 articles that contained discussion of issues in consent in infant feeding trials were obtained and read and after further screening 42 papers were included in the results and discussion. Recent developments in infant nutrition of significance to ethics assessment include the improved survival of low birth weight infants, increasing evidence of the value of breastfeeding and evidence of the lifelong importance of infant feeding and development in the first 1000 days of life in chronic disease epidemiology. Informed consent is a difficult issue, but should always include information on the value of preserving breastfeeding options. Project monitoring should be cognisant of the long term implications of growth rates and early life nutrition.

  3. Neurologic condition of healthy term infants at 18 months : Positive association with venous umbilical DHA status and negative association with umbilical trans-fatty acids

    NARCIS (Netherlands)

    Bouwstra, Hylco; Dijck-Brouwer, Janneke; Decsi, Tamas; Boehm, Guenther; Boersma, E. Rudy; Muskiet, Frits A. J.; Hadders-Algra, Mijna

    Prenatal long-chain polyunsaturated fatty acids (LCPUFAs) and trans-fatty acids may affect neurodevelopment. In healthy term children, we determined relationships between relative fatty acid contents of umbilical arteries and veins and neurodevelopment at 18 mo. The study comprised a mixed group of

  4. Reversibility of cortical hyperostosis following long-term prostaglandin E1 therapy in infants with ductus-dependent congenital heart disease

    DEFF Research Database (Denmark)

    Høst, A; Halken, S; Andersen, P E

    1988-01-01

    Two neonates with complex cyanotic congenital heart disease, receiving long-term prostaglandin E1 infusion, for 59 and 78 days respectively, demonstrated significant radiographic changes of symmetric cortical hyperostosis of the long bones. Bone biopsies from one of the patients elucidated...

  5. Short- and long-term outcome of infants born after maternal (pre)-eclampsia, HELLP syndrome and thrombophilia a retrospective, cohort study

    NARCIS (Netherlands)

    Boomsma, Jooske M. F.; van Lingen, Richard A.; van Eyck, Jim; Tamminga, Pieter; Kollen, Boudewijn J.; van Elburg, Ruurd M.

    2010-01-01

    Objectives To investigate the short- and long-term outcome of children born from mothers with pre-eclampsia eclampsia and/or HELLP syndrome and to determine the differences between children born from mothers with and without underlying thrombophilic disorder Study design Four hundred and nine

  6. Motor development in 3-month-old healthy term-born infants is associated with cognitive and behavioural outcomes at early school age

    NARCIS (Netherlands)

    Hitzert, Marrit; Roze, Elise; Van Braeckel, Koenraad N. J. A.; Bos, Arend F.

    AIM To determine whether motor development at 3 months of age is associated with cognitive, motor, and behavioural outcomes in healthy children at early school age. METHOD In this cohort study, we included 74 term-born, healthy children (44 males, 30 females; median gestational age 40.1wks, range

  7. Noradrenaline in preterm infants with cardiovascular compromise.

    Science.gov (United States)

    Rowcliff, Kirsten; de Waal, Koert; Mohamed, Abdel-Latif; Chaudhari, Tejasvi

    2016-12-01

    Noradrenaline (NA) is beneficial in the treatment of term newborns with cardiovascular compromise due to sepsis or pulmonary hypertension, but experiences with NA in preterm infants are limited. The aim of this study is to describe the efficacy and safety of NA in preterm infants. Patient records of preterm infants ≤32 weeks' gestation admitted to two hospitals between 2004 and 2015 and who received NA were reviewed for perinatal morbidities and mortality. Clinical details were collected at the time of NA use, and response on blood pressure, perfusion and oxygenation was documented as well as possible side effects. Forty-eight infants with primary diagnoses of sepsis (63 %) and pulmonary hypertension (23 %) received NA. Normotension was achieved at a median of 1 h in all but one infant at a median dose of 0.5 mcg/kg/min. Infants who died (46 %) were of younger gestational age and had worse cardiovascular function at start of NA compared to infants who survived. Tachycardia was common (31 %), but no additional effects were found on kidney or liver function. NA appears to be tolerated safely by preterm infants with no major side effects. However, effectiveness needs to be studies further in structured trials. What is Known: • Noradrenaline is beneficial in the treatment of term newborns and infants with cardiovascular compromise. • Noradrenaline is known for its potent vasoconstrictive effects and, therefore, infrequently used in preterm infants. What is New: • Noradrenaline used in relative low dose and as first or second line support increases blood pressure in preterm infants with cardiovascular compromise. • Tachycardia was common, but no additional side effects were found.

  8. Outcomes for Extremely Premature Infants

    Science.gov (United States)

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

    2015-01-01

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

  9. Advances in nutrition of the newborn infant.

    Science.gov (United States)

    Harding, Jane E; Cormack, Barbara E; Alexander, Tanith; Alsweiler, Jane M; Bloomfield, Frank H

    2017-04-22

    Nutrition of newborn infants, particularly of those born preterm, has advanced substantially in recent years. Extremely preterm infants have high nutrient demands that are challenging to meet, such that growth faltering is common. Inadequate growth is associated with poor neurodevelopmental outcomes, and although improved early growth is associated with better cognitive outcomes, there might be a trade-off in terms of worse metabolic outcomes, although the contribution of early nutrition to these associations is not established. New developments include recommendations to increase protein supply, improve formulations of parenteral lipids, and provide mineral supplements while encouraging human milk feeding. However, high quality evidence of the risks and benefits of these developments is lacking. Clinical trials are also needed to assess the effect on preterm infants of experiencing the smell and taste of milk, to determine whether boys and girls should be fed differently, and to test effects of insulin and IGF-1 supplements on growth and developmental outcomes. Moderate-to-late preterm infants have neonatal nutritional challenges that are similar to those infants born at earlier gestations, but even less high quality evidence exists upon which to base clinical decisions. The focus of research in nutrition of infants born at term is largely directed at new formula products that will improve cognitive and metabolic outcomes. Providing the most effective nutrition to preterm infants should be prioritised as an important focus of neonatal care research to improve long-term metabolic and developmental outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. The eye of the begetter: predicting infant attachment disorganization from women's prenatal interpretations of infant facial expressions.

    Science.gov (United States)

    Bernstein, Rosemary E; Tenedios, Catherine M; Laurent, Heidemarie K; Measelle, Jeffery R; Ablow, Jennifer C

    2014-01-01

    Infant-caregiver attachment disorganization has been linked to many long-term negative psychosocial outcomes. While various prevention programs appear to be effective in preventing disorganized attachment, methods currently used to identify those at risk are unfortunately either overly general or impractical. The current investigation tested whether women's prenatal biases in identifying infant expressions of emotion--tendencies previously shown to relate to some of the maternal variables associated with infant attachment, including maternal traumatization, trauma symptoms, and maternal sensitivity--could predict infant attachment classification at 18 months postpartum. Logistic regression analyses revealed that together with women's adult history of high betrayal traumatization, response concordance with a normative reference sample in labeling infant expressions as negatively valenced, and the number of infant facial expressions that participants classified as "sad" and "angry" predicted subsequent infant attachment security versus disorganization. Implications for screening and prevention are discussed. © 2014 Michigan Association for Infant Mental Health.

  11. Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health-An Appeal for Continuous Family Care and Interdisciplinary Communication.

    Science.gov (United States)

    Arabin, Birgit; Baschat, Ahmet A

    2017-01-01

    Physiologic adaptations during pregnancy unmask a woman's predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa, pregnancy diseases also indicate maternal and even grandparent's risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms "fetal programming" and "pregnancy complications combined with maternal disease" until January 2017. Studies linking pregnancy complications to future cardiovascular, metabolic, and thrombotic risks for mother and offspring were reviewed. Women with a history of miscarriage, fetal growth restriction, preeclampsia, preterm delivery, obesity, excessive gestational weight gain, gestational diabetes, subfertility, and thrombophilia more frequently demonstrate with echocardiographic abnormalities, higher fasting insulin, deviating lipids or clotting factors and show defective endothelial function. Thrombophilia hints to thrombotic risks in later life. Pregnancy abnormalities correlate with future cardiovascular and metabolic complications and earlier mortality. Conversely, women with a normal pregnancy have lower rates of subsequent diseases than the general female population creating the term: "Pregnancy as a window for future health." Although the placenta works as a gatekeeper, many pregnancy complications may lead to sickness and earlier death in later life when the child becomes an adult. The epigenetic mechanisms and the mismatch between pre- and postnatal life have created the term "fetal origin of adult disease." Up to now, the impact of cardiovascular, metabolic, or thrombotic risk profiles has been investigated separately for mother and child. In this manuscript, we strive to illustrate the consequences for both, fetus and mother within a cohesive perspective and

  12. Fototerapia causa danos ao DNA de leucócitos mononucleares periféricos em recém-nascidos a termo Phototherapy causes DNA damage in peripheral mononuclear leukocytes in term infants

    Directory of Open Access Journals (Sweden)

    Ali Aycicek

    2008-04-01

    Full Text Available OBJETIVO: Determinar se a fita de DNA de leucócitos mononucleares endógenos é alvo de fototerapia. MÉTODOS: O estudo incluiu 65 recém-nascidos a termo com idades entre 3 e 10 dias que haviam sido expostos a fototerapia intensiva (n = 23 ou convencional (n = 23 por pelo menos 48 horas devido à icterícia neonatal, além de um grupo controle (n = 19. Dano ao DNA foi avaliado por eletroforese alcalina em gel de célula única (ensaio cometa. A capacidade antioxidante total plasmática e os níveis de estado oxidativo total também foram medidos, e a correlação entre danos ao DNA e estresse oxidativo foi investigada. RESULTADOS: Os valores médios de escores de danos ao DNA nos grupos de fototerapia intensiva e convencional foram significativamente maiores do que os do grupo controle (p 0,05. Não houve correlações significativas entre escores de danos ao DNA e bilirrubina, estado oxidante total e níveis de estresse oxidativo entre os grupos de fototerapia (p > 0,05. CONCLUSÕES: Tanto a fototerapia intensiva quanto a convencional causam danos ao DNA dos leucócitos mononucleares endógenos em recém-nascidos a termo com icterícia.OBJECTIVE: Our aim was to determine whether endogenous mononuclear leukocyte DNA strand is a target of phototherapy. METHODS: The study included 65 term infants aged between 3-10 days that had been exposed to intensive (n = 23 or conventional (n = 23 phototherapy for at least 48 hours due to neonatal jaundice, and a control group (n = 19. DNA damage was assayed by single-cell alkaline gel electrophoresis (comet assay. Plasma total antioxidant capacity and total oxidant status levels were also measured, and correlation between DNA damage and oxidative stress was investigated. RESULTS: Mean values of DNA damage scores in both the intensive and conventional phototherapy groups were significantly higher than those in the control group (p 0.05. There were no significant correlations between DNA damage scores and

  13. [Factors influencing the language development of preterm infants].

    Science.gov (United States)

    Niu, Jie; Chen, Yong-Xiang; Zhu, Li-Qi

    2012-01-01

    Along with the development of pediatric emergency technology, more preterm infants with extremely small gestational age and birth weight can survive, yet the long-term follow-up of their neuropsychological development needs to be focused. Language development of preterm infants is an important component of their intellectual development, which reflects the development of their nervous system. Studies about how language develops in preterm infants and what factors are relevant yield inconsistent results. This paper describes the factors influencing the language development of preterm infants, such as gestational age, birth weight and gender. It provides suggestions as to future research and clinical intervention for the language development of preterm infants.

  14. Jaundice and kernicterus in the moderately preterm infant.

    Science.gov (United States)

    Wallenstein, Matthew B; Bhutani, Vinod K

    2013-12-01

    Moderate preterm infants remain at increased risk for adverse outcomes, including acute bilirubin encephalopathy (ABE). Evidence-based guidelines for management of hyperbilirubinemia in preterm infants less than 35 weeks' gestational age are not yet optimized. High concentrations of unconjugated bilirubin can cause permanent posticteric neurologic sequelae (kernicterus). Clinical manifestations of ABE in preterm infants are similar to, but often more subtle than, those of term infants. This review outlines clinical strategies to operationalize management of hyperbilirubinemia in moderately preterm infants to meet recently published consensus-based recommendations. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-01-01

    Prematurely born children have a high risk of developmental and behavioral disabilities. Cerebral abnormalities at term age have been clearly linked with later behavior alterations, but existing studies did not focus on the amygdala. Moreover, studies of early amygdala development after premature birth in humans are scarce. To compare amygdala volumes in very preterm infants at term equivalent age (TEA) and term born infants, and to relate premature infants' amygdala volumes with their performance on the Laboratory Temperament Assessment Battery (Lab-TAB) fear episode at 12 months. Eighty one infants born between 2008 and 2014 at the University Hospitals of Geneva and Lausanne, taking part in longitudinal and functional imaging studies, who had undergone a magnetic resonance imaging (MRI) scan at TEA enabling manual amygdala delineation. Amygdala volumes assessed by manual segmentation of MRI scans; volumes of cortical and subcortical gray matter, white matter and cerebrospinal fluid (CSF) automatically segmented in 66 infants; scores for the Lab-TAB fear episode for 42 premature infants at 12 months. Amygdala volumes were smaller in preterm infants at TEA than term infants (mean difference 138.03 mm(3), p motor activity in the fear episode. Our results indicate that premature birth is associated with a reduction in amygdala volumes and white matter volumes at TEA, suggesting that altered amygdala development might be linked to alterations in white matter connectivity reported in premature infants. Moreover, our data suggests that such alterations might affect infants' fear-processing capabilities.

  16. Surfactant therapy in late preterm infants

    Directory of Open Access Journals (Sweden)

    Murat Yurdakök

    2013-06-01

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

  17. Long-term effects of infant attachment organization on adult behavior and health in nursery-reared, captive chimpanzees (Pan troglodytes).

    Science.gov (United States)

    Clay, Andrea W; Bloomsmith, Mollie A; Bard, Kim A; Maple, Terry L; Marr, Marcus J

    2015-05-01

    This research traces the long-term effects on health, well-being, personality, and behavior of adult chimpanzees as a function of their attachment to a primary human caregiver assessed when they were 1 year of age. Of the 46 chimpanzees assessed at 1 year of age, we assessed health in 43 individuals, adult behavior in 20 individuals, and adult well-being and personality in 21 individuals. Attachment disorganization was found to be a significant predictor of stereotypic rocking in adult chimpanzees, F(1, 18) = 7.50, p = .013. For those subjects (N = 24) with a full 20 years (birth through age 20 years) of health data available, both rearing experience and disorganized attachment were significant predictors of upper respiratory infection frequency, F(2, 21) = 8.86, p = .002. Chimpanzees with disorganized attachment exhibited average subjective well-being as adults, whereas chimpanzees with organized strategies exhibited higher than average subjective well-being as adults. These results support the findings of human attachment research and are in line with attachment-based predictions for chimpanzees, such that the consequences of an early history of disorganized attachment may be adverse and long lasting. (c) 2015 APA, all rights reserved).

  18. Motor development in 3-month-old healthy term-born infants is associated with cognitive and behavioural outcomes at early school age.

    Science.gov (United States)

    Hitzert, Marrit M; Roze, Elise; Van Braeckel, Koenraad N J A; Bos, Arend F

    2014-09-01

    To determine whether motor development at 3 months of age is associated with cognitive, motor, and behavioural outcomes in healthy children at early school age. In this cohort study, we included 74 term-born, healthy children (44 males, 30 females; median gestational age 40.1 wks, range 38.0-42.6 wks). From video recordings (median 12.9 wks, range 9.3-18.6 wks), we assessed the quality of fidgety movements, and calculated a motor optimality score. At school age (median 5 y 11 mo, range 5 y 8 mo-7 y 6 mo), we performed detailed cognitive, motor, and behavioural assessments. We examined whether aspects of motor development were associated with functional outcomes. An age-adequate motor repertoire, in particular the presence of antigravity, midline leg, and manipulation movements, was related to poorer cognition, whereas variable finger postures was related to better cognition. Children with a monotonous concurrent motor repertoire had better ball skills but experienced more behavioural problems. The presence of antigravity movements tended to be associated with abnormal recognition (odds ratio [OR] 4.4, 95% confidence interval [CI], 0.9-21; R(2) =0.17; p=0.070), where the absence of variable finger postures was associated with borderline and abnormal visual-spatial perception (OR 20, 95% CI, 1.7-238; R(2) =0.39; p=0.018). Detailed aspects of motor development at 3 months of age are associated with cognition and behaviour, but not with motor outcome, in healthy children at early school age. Our findings suggest that early motor development may be the basis for later cognitive and behavioural performance. Since the associations were only moderate, possible environmental influences should be acknowledged. © 2014 Mac Keith Press.

  19. Association between Infant Feeding and Early Postpartum Infant Body Composition: A Pilot Prospective Study

    Directory of Open Access Journals (Sweden)

    Alex Kojo Anderson

    2009-01-01

    Full Text Available Research studies have produced conflicting results of the impact of breastfeeding on overweight/obesity. This study evaluated the impact of infant feeding on infant body composition. There were two groups of mother-infant pairs (exclusive breastfeeding [EBF; n=27] and mixed feeding [MF; n=13] in this study. At baseline, participants were similar in their demographic characteristics except prepregnancy weight, where MF mothers tended to be heavier than their EBF counterparts (67.3 kg versus 59.9 kg; P=.034. Infant birth weight was slightly higher among the MF group than their EBF counterparts (3.5 kg versus 3.4 kg, although the differences were not statistically significant. At 3 months postpartum, mean infant FMI (4.1 kg/m2 versus 3.8 kg/m2 and percent body fat (24.4% versus 23.1% were slightly higher among EBF infants than MF infants. In terms of growth velocity, EBF infants gained weight faster than their MF counterparts, although the differences were not statistically significant. The findings from this study suggest that EBF may promote faster weight gain and increase in both fat mass index (FMI and percent body fat in the early postpartum period in addition to the numerous health benefits enjoyed by the infant and the mother who exclusively breastfeeds her newborn.

  20. Osteopenia - premature infants

    Science.gov (United States)

    Neonatal rickets; Brittle bones - premature infants; Weak bones - premature infants; Osteopenia of prematurity ... AW, Diamond FB. Disorders of mineral homeostasis in children and adolescents. In: Sperling MA ed. Pediatric Endocrinology . ...

  1. Urinary catheter - infants

    Science.gov (United States)

    Bladder catheter - infants; Foley catheter - infants; Urinary catheter - neonatal ... A urinary catheter is a small, soft tube placed in the bladder. This ... are not making much urine. Babies can have low urine output ...

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

    Directory of Open Access Journals (Sweden)

    Carolina Schlindwein Mariano Ferreira

    2018-01-01

    Conclusions: Humoral responses to measles and varicella were similar between infants born prematurely and full-term infants. Measles antibody levels were negatively associated with antenatal corticosteroid use; varicella antibodies were positively associated with prolonged breastfeeding.

  3. Uniform treatment thresholds for hyperbilirubinemia in preterm infants : Background and synopsis of a national guideline

    NARCIS (Netherlands)

    van Imhoff, Deirdre Elisabeth; Dijk, Peter Hendrik; Hulzebos, Christian Victor

    Background: To prevent severe hyperbilirubinemia and bilirubin neurotoxicity, the American Academy of Pediatrics' management guideline for hyperbilirubinemia in near term infants is used worldwide. A leading guideline for jaundiced preterm infants is lacking whereas the risk on severe

  4. Caudal ropivacaine in infants

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Ilett, K F; Reid, C

    2001-01-01

    Ropivacaine is a new long-acting amino-amide local anesthetic. However, there are no data on its use in infants. In the current study, the authors investigated the pharmacokinetics of caudal ropivacaine in 30 infants younger than 12 months.......Ropivacaine is a new long-acting amino-amide local anesthetic. However, there are no data on its use in infants. In the current study, the authors investigated the pharmacokinetics of caudal ropivacaine in 30 infants younger than 12 months....

  5. Infant crying and abuse

    NARCIS (Netherlands)

    Reijneveld, S.A.; van der Wal, M.F.; Brugman, E.; Hira Sing, R.A.; Verloove-Vanhorick, S.P.

    2004-01-01

    Child abuse and neglect are important causes of child morbidity and death. We assessed potentially detrimental parental actions induced by infant crying in 3259 infants aged 1-6 months, in the Netherlands. In infants aged 6 months, 5.6% (95% CI 4.2-7.0) of parents reported having smothered, slapped,

  6. Infant crying and abuse

    NARCIS (Netherlands)

    Reijneveld, S.A.; Wal, M.F.V.D.; Brugman, E.; Sing, R.A.H.; Verloove-Vanhorick, S.P.

    2004-01-01

    Child abuse and neglect are important causes of child morbidity and death. We assessed potentially detrimental parental actions induced by infant crying in 3259 infants aged 1-6 months, in the Netherlands. In infants aged 6 months, 5·6% (95% CI 4·2-7·0) of parents reported having smothered, slapped,

  7. Hip Problems in Infants

    Science.gov (United States)

    ... babies have hip problems that can lead to dislocation of the hip bones. This is also called dysplasia (say: “diss- ... March 2014 Categories: Family Health, Infants and ToddlersTags: dislocation, dysplasia, external, femoral, hip, infants, internal, problems, socket, torsion Family Health, Infants ...

  8. Preclinical assessment of infant formula.

    Science.gov (United States)

    Lönnerdal, Bo

    2012-01-01

    Infant formulas are the sole or predominant source of nutrition for many infants and are fed during a sensitive period of development and may therefore have short- and long-term consequences for infant health. Preclinical safety assessment therefore needs to include both short-term and long-term studies in animals. It is recommended that procedures are instituted by which experts may serve as independent scientists for companies developing novel products, without having their integrity compromised, and later serve the legislative institutions. A two-level assessment approach to determine the potential toxicity of a novel ingredient, its metabolites, and their effects in the matrix on developing organ systems has been suggested by IOM. This appears reasonable, as novel ingredients can be of different levels of concern. The use of modern methods in genomics and proteomics should be considered in these evaluation processes as well as novel methods to evaluate outcomes, including metabolomics and molecular techniques to assess the microbiome. Copyright © 2012 S. Karger AG, Basel.

  9. The effect of massage on heart rate variability in preterm infants

    Science.gov (United States)

    Smith, SL.; Lux, R.; Haley, S.; Slater, H.; Beechy, J.; Moyer-Mileur, LJ.

    2012-01-01

    Objective To test the hypothesis that massage would improve autonomic nervous system (ANS) function as measured by heart rate variability (HRV) in preterm infants. Study Design Medically stable, 29- to 32-week preterm infants (17 massage, 20 control) were enrolled in a masked, randomized longitudinal study. Licensed massage therapists provided the massage or control condition twice a day for 4 weeks. Weekly HRV, a measure of ANS development and function, was analyzed using SPSS generalized estimating equations. Results Infant characteristics were similar between groups. HRV improved in massaged infants but not in the control infants (PMassaged males had a greater improvement in HRV than females (Pmassaged infants was on a trajectory comparable to term-born infants by study completion. Conclusion Massage-improved HRV in a homogeneous sample of hospitalized, medically stable, preterm male infants and may improve infant response to exogenous stressors. We speculate that massage improves ANS function in these infants. PMID:22538325

  10. Gender and discipline in 5-12-month-old infants: a longitudinal study.

    Science.gov (United States)

    Ahl, Richard Evan; Fausto-Sterling, Anne; García-Coll, Cynthia; Seifer, Ronald

    2013-04-01

    We examined the effects of infant age and gender on the behaviors of infants and mothers during discipline interactions using longitudinal, naturalistic, home-based, taped observations of 16 mother-infant dyads (eight males and eight females). These observations were conducted between the child ages of 5 and 12 months and used a devised Maternal Discipline Coding System to code for the occurrence of discipline events. During discipline interactions, mothers vocalized longer, used harsher tones, and used more explanations with older compared to younger infants. Male infants were more likely than female infants to cry or whine during discipline events. Mothers of male infants used longer vocalizations, more words, and more affectionate terms than mothers of female infants. Male infants were more difficult during discipline interactions than female infants, but it appeared that mothers of males responded to this difficulty by using milder discipline techniques. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Lower transplacental antibody transport for measles, mumps, rubella and varicella zoster in very preterm infants.

    Directory of Open Access Journals (Sweden)

    Jolice P van den Berg

    Full Text Available BACKGROUND: Maternal antibodies, transported over the placenta during pregnancy, contribute to the protection of infants from infectious diseases during the first months of life. In term infants, this protection does not last until the first recommended measles-mumps-rubella vaccination at 14 months in the Netherlands, while these viruses still circulate. The aim of the study was to investigate the antibody concentration against measles, mumps, rubella and varicella (MMRV in mothers and preterm infants or healthy term infants at birth. METHODS: Antibody concentrations specific for MMRV were measured in cord blood samples from preterm (gestational age <32 weeks and/or birth weight <1500 g and term infants, and matched maternal serum samples, using a fluorescent bead-based multiplex immune-assay. RESULTS: Due to lower placental transfer ratios of antibodies against MMRV in 96 preterm infants (range 0.75-0.87 compared to 42 term infants (range 1.39-1.65, the preterm infants showed 1.7-2.5 times lower geometric mean concentrations at birth compared to term infants. Maternal antibody concentration is the most important determinant of infant antibody concentration against MMRV. CONCLUSIONS: Preterm infants benefit to a lesser extent from maternal antibodies against measles, mumps, rubella and varicella than term infants, posing them even earlier at risk for infectious diseases caused by these still circulating viruses.

  12. Renal Calcification in Very Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Hung-Yang Chang

    2011-06-01

    Conclusion: The incidence of renal calcification in very low birth weight infants in this study was relatively low, and the calcification was transient in one-half of the infants. Extremely premature, sick infants requiring long-term ventilation, and those receiving furosemide or dexamethasone were more likely to have renal calcification. Clinicians should be aware that renal calcification may develop beyond the neonatal stage.

  13. 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.

  14. Human milk for the premature infant

    Science.gov (United States)

    Underwood, Mark A.

    2012-01-01

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

  15. Motor development of preterm infants assessed by the Alberta Infant Motor Scale: systematic review article

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    Rubia do N. Fuentefria

    Full Text Available Abstract Objective: Premature newborns are considered at risk for motor development deficits, leading to the need for monitoring in early life. The aim of this study was to systematically review the literature about gross motor development of preterm infants, assessed by the Alberta Infant Motor Scale (AIMS to identify the main outcomes in development. Data source: Systematic review of studies published from 2006 to 2015, indexed in Pubmed, Scielo, Lilacs, and Medline databases in English and Portuguese. The search strategy included the keywords: Alberta Infant Motor Scale, prematurity, preterm, motor development, postural control, and follow-up. Data summary: A total of 101 articles were identified and 23 were selected, according to the inclusion criteria. The ages of the children assessed in the studies varied, including the first 6 months up to 15 or 18 months of corrected age. The percentage variation in motor delay was identified in the motor outcome descriptions of ten studies, ranging from 4% to 53%, depending on the age when the infant was assessed. The studies show significant differences in the motor development of preterm and full-term infants, with a description of lower gross scores in the AIMS results of preterm infants. Conclusions: It is essential that the follow-up services of at-risk infants have assessment strategies and monitoring of gross motor development of preterm infants; AIMS is an assessment tool indicated to identify atypical motor development in this population.

  16. Infant-Infant Interaction in a Daycare Setting.

    Science.gov (United States)

    Durfee, Joan T.; Lee, Lee C.

    The Infant-Infant Contact Code, developed to observe the social behavior in infants, is described. Results from using this scale with nine infants under nine months indicated that contacts between infants are complex in nature, that there are developmental changes in models of encounter, and that babies take different roles in relation to the…

  17. Ontogenesis of the Gut Microbiota Composition in Healthy, Full-Term, Vaginally Born and Breast-Fed Infants over the First 3 Years of Life: A Quantitative Bird's-Eye View.

    Science.gov (United States)

    Nagpal, Ravinder; Tsuji, Hirokazu; Takahashi, Takuya; Nomoto, Koji; Kawashima, Kazunari; Nagata, Satoru; Yamashiro, Yuichiro

    2017-01-01

    Early-life intestinal microbiota development is crucial for host's long-term health and is influenced by many factors including gestational age, birth and feeding modes, birth environment, ethnic/geographical background, etc. However, 'quantitative' data on the actual population levels of gut bacterial communities when these influences are controlled for is relatively rare. Herein, we demonstrate a quantitative perspective of microbiota development in natural and healthy milieus, i.e., in healthy, full-term, vaginally born and breast-fed infants ( n = 19) born at same clinic. Fecal microbiota at age 1 and 7 days, 1, 3, and 6 months and 3 years is quantified using highly sensitive reverse-transcription-quantitative-PCR assays targeting bacterial rRNA molecules. At day 1, we detect one or more bacteria in all (100%) of the babies, wherein the microbiota is composed mainly of enterobacteria (35%), Bacteroides fragilis group (23%), enterococci (18%), staphylococci (13%), and bifidobacteria (9%). Altogether, facultative anaerobes predominate during first few weeks whereafter obligate anaerobes including bifidobacteria, B. fragilis group, Clostridium coccoides group, and Clostridium leptum subgroup gradually start prevailing. At 3 years, the composition is represented almost entirely (99%) by obligate anaerobes including C. leptum subgroup (34%), bifidobacteria (22%), B. fragilis group (21%), C. coccoides group (17%), Atopobium cluster (4%), and Prevotella (1%). The overall obligate/facultative proportion is 32/68, 37/63, 54/46, 70/30, 64/36, and 99/1% at 1 and 7 days, 1, 3, and 6 months and 3 years, respectively. However, interestingly, considerable individual-specific variations in the obligate/facultative ratios as well as in the proportions of Firmicutes, Bacteroides, Actinobacteria, and Proteobacteria communities are seen among these babies. This disparity even within this highly homogenous cohort manifests the magnitude of diverse patterns of gut microbiota

  18. Excessive crying in infants

    Directory of Open Access Journals (Sweden)

    Ricardo Halpern

    2016-06-01

    Full Text Available ABSTRACT Objective: Review the literature on excessive crying in young infants, also known as infantile colic, and its effects on family dynamics, its pathophysiology, and new treatment interventions. Data source: The literature review was carried out in the Medline, PsycINFO, LILACS, SciELO, and Cochrane Library databases, using the terms “excessive crying,” and “infantile colic,” as well technical books and technical reports on child development, selecting the most relevant articles on the subject, with emphasis on recent literature published in the last five years. Summary of the findings: Excessive crying is a common symptom in the first 3 months of life and leads to approximately 20% of pediatric consultations. Different prevalence rates of excessive crying have been reported, ranging from 14% to approximately 30% in infants up to 3 months of age. There is evidence linking excessive crying early in life with adaptive problems in the preschool period, as well as with early weaning, maternal anxiety and depression, attention deficit hyperactivity disorder, and other behavioral problems. Several pathophysiological mechanisms can explain these symptoms, such as circadian rhythm alterations, central nervous system immaturity, and alterations in the intestinal microbiota. Several treatment alternatives have been described, including behavioral measures, manipulation techniques, use of medication, and acupuncture, with controversial results and effectiveness. Conclusion: Excessive crying in the early months is a prevalent symptom; the pediatrician's attention is necessary to understand and adequately manage the problem and offer support to exhausted parents. The prescription of drugs of questionable action and with potential side effects is not a recommended treatment, except in extreme situations. The effectiveness of dietary treatments and use of probiotics still require confirmation. There is incomplete evidence regarding alternative

  19. Feeding of preterm infants and fortification of breast milk

    Directory of Open Access Journals (Sweden)

    Giovanna Mangili

    2017-06-01

    Full Text Available The administration of the adequate amount of nutrients helps to improve a correct short-term linear growth and long-term neurocognitive development. To reduce the extra-uterine growth delay in very low birth weight infants (VLBW the best strategy of nutrition (parenteral or enteral should be established rapidly, since the first day of life. In preterm infants, nutrition can be administered parenterally and enterally. Prematurity is the most frequent indication for parenteral nutritional support due to intestinal functional immune deficiency, deficiency of digestive enzymatic systems and reduced nutritional reserve of these infants. In terms of enteral nutrition, breast milk is the first choice. In case of preterm and VLBW infants, fortifiers are used to overcome breast milk’s protein and mineral deficiencies. When breast milk is not available, specific infant formula is the alternative.

  20. Defecation patterns in infants: a prospective cohort study.

    Science.gov (United States)

    Kramer, Esther A H; den Hertog-Kuijl, Jolanda H; van den Broek, Leonard M C L; van Leengoed, Ellen; Bulk, Anneke M W; Kneepkens, C M Frank; Benninga, Marc A

    2015-06-01

    Data regarding prevalence and natural history of infant dyschezia, defined by the Rome III criteria as straining and crying for at least 10 min before successful passage of soft stools, are lacking. We aimed to investigate prevalence and natural history of infant dyschezia. In 2003, 124 youth healthcare doctors participated in a national study on defecation patterns of infants. Using standardised questionnaires and bowel diaries, these were recorded of infants aged 1, 3 and 9 months old. Out of 1292 infants, 46.4% had no gastrointestinal complaints. At 1 and 3 months old, 3.9% and 0.9% infants, respectively, fulfilled the Rome III criteria for infant dyschezia. However, at the same time points, parents of 17.3% and 6.5% of infants, respectively, reported symptoms preceding defecation while not strictly fulfilling the Rome III criteria ('modified Rome III criteria'). Dyschezia-like symptoms (Rome III criteria) were also reported in 0.9% of 9-month-old infants, with 5.7% having symptoms (modified Rome III criteria). Only 3/61 (4.9%) Rome III dyschezia infants and 1/306 (0.3%) infants with modified Rome III criteria at 1 or 3 months had symptoms fitting the diagnosis of infant functional constipation at 9 months old. The present definition of infant dyschezia seems too strict. We propose to widen the definition in terms of symptoms as well as age in order to better fit the appreciation of the parents. The prevalence of infant dyschezia declines with age. There seems to be no relation to the development of functional constipation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study.

    Science.gov (United States)

    Hajizadeh, Negin; Goldfeld, Keith; Crothers, Kristina

    2015-03-01

    We performed a retrospective cohort study of patients with chronic obstructive lung disease (COPD) on long-term oxygen treatment (LTOT) who received invasive mechanical ventilation for COPD exacerbation. Of the 4791 patients, 23% died in the hospital, and 45% died in the subsequent 12 months. 67% of patients were readmitted at least once in the subsequent 12 months, and 26.8% were discharged to a nursing home or skilled nursing facility within 30 days. We conclude that these patients have high mortality rates, both in-hospital and in the 12 months postdischarge. If patients survive, many will be readmitted to the hospital and discharged to nursing home. These potential outcomes may support informed critical care decision making and more preference congruent care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Post partum emotional distress in mothers of preterm infants: a ...

    African Journals Online (AJOL)

    Objectives: To investigate whether mothers of preterm infants experience more psychological distress than mothers of normal full term infants in the immediate postpartum period. Design: Cross sectional prospective study of postpartal women using the Beck Depression Inventory(BDI) and the GHQ-30. Setting: Neonatal ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-04-01

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

  4. Relationship quality for mothers of very preterm infants.

    Science.gov (United States)

    Edwards, Dawn M; Gibbons, Kristen; Gray, Peter H

    2016-01-01

    There is a paucity of information on couple relationship quality in mothers of preterm infants during the first year of life. To determine couple relationship quality in mothers of very preterm infants in comparison to mothers of term infants and to examine maternal and infant factors associated with impaired couple relationship for the preterm mothers. At 4 and 12 months (corrected for prematurity for the preterm cohort), the mothers completed the Dyadic Adjustment Scale, the Edinburgh Postnatal Depression Scale, the Parenting Stress Index and the Short Temperament Scale. At 12 months, the infants had a neurodevelopmental assessment. 86 mothers of preterm infants and 97 term mothers participated at 4 months, with 101 mothers of the preterm infants and 98 term mothers participating at 12 months. Comparisons of the two groups revealed no differences in Dyadic Adjustment or for any of the subscales. For the preterm mothers at 4 months, the independent variables associated with poor dyadic adjustment were ethnicity and higher levels of parenting stress. At 12 months, parenting stress was also an independent variable associated with impaired couple relationship. No differences in the incidence of poor quality couple relationship was found between mothers of very preterm and term infants. For preterm mothers, impaired couple relationship was associated with parenting stress. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. The use of prebiotics and probiotics in infant formula | Ackerberg ...

    African Journals Online (AJOL)

    Gastrointestinal flora influences health, but the composition of flora can be changed with prebiotics or probiotics. The addition of probiotics to powdered infant formula has not been demonstrated to be harmful to healthy term infants. However, evidence of clinical efficacy regarding their addition is insufficient to recommend ...

  6. Acquired methemoglobinemia in infants

    Directory of Open Access Journals (Sweden)

    Mehmet Mutlu

    2011-06-01

    Full Text Available Objective: This study aimed to determine the etiologic factors of acquired methemoglobinemia in infants younger than three months in our region. Material and Methods: This study was carried out retrospectively in infants with methemoglobinemia admitted to Karadeniz Technical University, Pediatric Clinic, during the period 2000-2009. Infants with methemoglobinemia were identified according to the medical records or ICD-10 code. Results: Nine infants with acquired methemoglobinemia (8 male, 1 female were included in the study. Seven cases were associated with the use of prilocaine for circumcision, one case with the use of prilocaine-lidocaine for local pain therapy, and one case with neonatal sepsis caused by Staphylococcus aureus.Conclusion: Prilocaine should not be used in infants less than three months of age because of the risk of methemoglobinemia. Ascorbic acid is an effective therapy if methylene blue is not obtained. It should not be forgotten that sepsis caused by S. aureus may cause methemoglobinemia in infants.

  7. The apgar score and infant mortality.

    Science.gov (United States)

    Li, Fei; Wu, Ting; Lei, Xiaoping; Zhang, Hao; Mao, Meng; Zhang, Jun

    2013-01-01

    To evaluate if the Apgar score remains pertinent in contemporary practice after more than 50 years of wide use, and to assess the value of the Apgar score in predicting infant survival, expanding from the neonatal to the post-neonatal period. The U.S. linked live birth and infant death dataset was used, which included 25,168,052 singleton births and 768,305 twin births. The outcome of interest was infant death within 1 year after birth. Cox proportional hazard-model was used to estimate risk ratio of infant mortality with different Apgar scores. Among births with a very low Apgar score at five minutes (1-3), the neonatal and post-neonatal mortality rates remained high until term (≥ 37 weeks). On the other hand, among births with a high Apgar score (≥7), neonatal and post-neonatal mortality rate decreased progressively with gestational age. Non-Hispanic White had a consistently higher neonatal mortality than non-Hispanic Black in both preterm and term births. However, for post-neonatal mortality, Black had significantly higher rate than White. The pattern of changes in neonatal and post-neonatal mortality by Apgar score in twin births is essentially the same as that in singleton births. The Apgar score system has continuing value for predicting neonatal and post-neonatal adverse outcomes in term as well as preterm infants, and is applicable to twins and in various race/ethnic groups.

  8. Newborn infant skin: physiology, development, and care.

    Science.gov (United States)

    Visscher, Marty O; Adam, Ralf; Brink, Susanna; Odio, Mauricio

    2015-01-01

    Infant skin is critical to the newborn child's transition from the womb environment to the journey to self-sufficiency. This review provides an integrative perspective on the skin development in full term and premature infants. There is a particular focus on the role of vernix caseosa and on the implications of skin development for epidermal penetration of exogenous compounds. Healthy full-term newborn skin is well-developed and functional at birth, with a thick epidermis and well-formed stratum corneum (SC) layers. Transepidermal water loss is very low at birth, equal to, or lower than adults, indicating a highly effective skin barrier. Vernix facilitates SC development in full-term infants through a variety of mechanisms including physical protection from amniotic fluid and enzymes, antimicrobial effects, skin surface pH lowering, provision of lipids, and hydration. Premature infants, particularly those of very low birth weight, have a poor skin barrier with few cornified layers and deficient dermal proteins. They are at increased risk for skin damage, increased permeability to exogenous agents and infection. The SC barrier develops rapidly after birth but complete maturation requires weeks to months. The best methods for caring for infant skin, particularly in the diaper region, are described and related to these developmental changes. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. The apgar score and infant mortality.

    Directory of Open Access Journals (Sweden)

    Fei Li

    Full Text Available OBJECTIVE: To evaluate if the Apgar score remains pertinent in contemporary practice after more than 50 years of wide use, and to assess the value of the Apgar score in predicting infant survival, expanding from the neonatal to the post-neonatal period. METHODS: The U.S. linked live birth and infant death dataset was used, which included 25,168,052 singleton births and 768,305 twin births. The outcome of interest was infant death within 1 year after birth. Cox proportional hazard-model was used to estimate risk ratio of infant mortality with different Apgar scores. RESULTS: Among births with a very low Apgar score at five minutes (1-3, the neonatal and post-neonatal mortality rates remained high until term (≥ 37 weeks. On the other hand, among births with a high Apgar score (≥7, neonatal and post-neonatal mortality rate decreased progressively with gestational age. Non-Hispanic White had a consistently higher neonatal mortality than non-Hispanic Black in both preterm and term births. However, for post-neonatal mortality, Black had significantly higher rate than White. The pattern of changes in neonatal and post-neonatal mortality by Apgar score in twin births is essentially the same as that in singleton births. CONCLUSIONS: The Apgar score system has continuing value for predicting neonatal and post-neonatal adverse outcomes in term as well as preterm infants, and is applicable to twins and in various race/ethnic groups.

  10. FOOD ALLERGY IN INFANTS

    Directory of Open Access Journals (Sweden)

    I.I. Balabolkin

    2006-01-01

    Full Text Available The article deals with the etiology, growth mechanisms, clinical implications, diagnostics and treatment of the infant food allergy. The author highlights the status of the allergy to the proteins of cow milk within this age group of children. Alongside the article describes the modern approaches to the diet therapy of the infants with the allergy to the proteins of cow milk.Key words: infant, food allergy, allergy to the proteins of cow milk, diet therapy.

  11. The role of taurine in infant nutrition.

    Science.gov (United States)

    Chesney, R W; Helms, R A; Christensen, M; Budreau, A M; Han, X; Sturman, J A

    1998-01-01

    The importance of taurine in the diet of pre-term and term infants has not always been clearly understood and is a topic of interest to students of infant nutrition. Recent evidence indicates that it should be considered one of the "conditionally essential" amino acids in infant nutrition. Plasma values for taurine will fall if infants are fed a taurine-free formula or do not have taurine provided in the TPN solution. Urine taurine values also fall, which is indicative of an attempt by the kidney to conserve taurine. The very-low-birth-weight infant, for a variety of reasons involving the maturation of tubular transport function, cannot maximally conserve taurine by enhancing renal reabsorption and, hence, is potentially at greater risk for taurine depletion than larger pre-term or term infants, and certainly more than older children who have taurine in their diet. Taurine has an important role in fat absorption in pre-term and possibly term infants and in children with cystic fibrosis. Because taurine-conjugated bile acids are better emulsifiers of fat than glycine-conjugated bile acids, the dietary (or TPN) intake has a direct influence on absorption of lipids. Taurine supplementation of formulas or TPN solutions could potentially serve to minimize the brain phospholipid fatty acid composition differences between formula-fed and human milk-fed infants. Taurine appears to have a role in infants, children, and even adults receiving most (> 75%) of their calories from TPN solutions in the prevention of granulation of the retina and electroencephalographic changes. Taurine has also been reported to improve maturation of auditory-evoked responses in pre-term infants, although this point is not fully established. Clearly, taurine is an important osmolyte in the brain and the renal medulla. At these locations, it is a primary factor in the cell volume regulatory process, in which brain or renal cells swell or shrink in response to osmolar changes, but return to their

  12. A six-month intervention with two different types of micronutrient-fortified complementary foods had distinct short- and long-term effects on linear and ponderal growth of vietnamese infants

    DEFF Research Database (Denmark)

    Phu, Pham V.; Hoan, Nguyen V.; Salvignol, Bertrand

    2012-01-01

    Traditional complementary foods (CF) with a low nutrient density have been implicated in growth faltering, stunting, and other adverse outcomes in children. The efficacy of 2 types of locally produced, micronutrient-fortified CF to prevent stunting of infants living in rural Vietnam was evaluated....... In a village-randomized controlled study, 426 infants, 5 mo of age, received for 6 mo a fortified CF, either as an instant flour (FF) or a food complement (FC) in village canteens, or traditional CF at home (C). After 6 mo of intervention, weight, length, length-for-age Z-score (LAZ) and weight-for-age Z...

  13. Resting heart rate in infants and toddlers: variations associated with early infant diet and the omega 3 fatty acid DHA

    Science.gov (United States)

    Although early postnatal nutrition can have long-term effects on developmental processes, the influence of infant diet on the maturation of cardiac development has not been documented. To study this relationship we recorded resting heart-rate (HR) in awake, healthy infants and toddlers exclusively b...

  14. Flash visual evoked potentials in preterm infants.

    Science.gov (United States)

    Feng, Jing-Jing; Wang, Wei-Ping; Guo, Shu-Juan; Liu, Zhi-Wei; Xu, Xiu

    2013-03-01

    To describe the development of flash visual evoked potentials (FVEPs) in preterm infants from 1 to 18 months and to determine if the maturation of FVEPs is similar to that of term infants. Longitudinal follow-up study. Twenty very low birth weight (VLBW) preterm infants, 42 low birth weight (LBW) preterm infants, and 41 term infants underwent FVEP recordings and neurodevelopmental examinations at 1, 3, 6, 9, 12, and 18 months of corrected and chronological ages. The FVEP recordings were carried out with the VikingQuest-IV neuroelectrophysiological device (VikingQuest, Nicolet, WI), and neurodevelopmental assessments were made by the Development Screen Test and Bayley Scales of Infant Development, Second Edition. At 1, 3, 6, and 9 months of age, neurodevelopment was measured with the Mental Index and Developmental Quotient. At 12 and 18 months, neurodevelopment was assessed using the Mental Developmental Index and Psychomotor Developmental Index. Two FVEP values were analyzed: the P2 amplitude (peak to peak from the preceding N2 wave) and the latency of the P2 wave. There was no significant difference for age-dependent decreased pattern of FVEP P2 latency between preterm infants and the control group. This pattern consisted of a rapid decrease in the first 6 months of life, a gradual decline from 6 to 12 months of age, and a steady reduction from 12 to 18 months of age. The P2 latencies were prolonged significantly at all 6 recorded times in the VLBW group compared with the controls and showed a delay in the LBW group at 1 and 3 months of corrected age. The maturation of P2 latency in LBW infants is similar to that of the controls at 3 months of corrected age, but the maturation of P2 latency in VLBW children remained delayed when compared with the controls until 18 months of corrected age. Although the FVEP development pattern of preterm infants was similar to that of healthy full-term infants, the former had deficits in visual electrophysiologic maturation

  15. The practical aspects of enteral nutrition in preterm infants

    Directory of Open Access Journals (Sweden)

    Rahmi Örs

    2013-04-01

    Full Text Available Preterm infants have higher nutrient requirements than term infants. Enteral tube feeding is the preferred route to feed preterm infants because premature infants are unable to coordinate sucking, swallowing, and breathing. There are two common tube feeding methods: intermittent (bolus or continuous infusion. Minimal enteral nutrition or trophic feeding has many advantages for preterms and should be started as soon as possible if an infant is clinically stable. Mother’s own milk is the best food for preterm infants. It also has many important non-nutrient advantages for preterm infants. However, breast milk alone may not meet their special nutritional needs. For this reason, it is common clinical practice to fortify human milk. Fortified human milk is an appropriate nutritional source for preterm infants compared to preterm formula and unfortified human milk. Fortification of maternal breast milk begins when feeding volume reaches 100 ml/kg/day. In the absence of mother’s own milk, donor milk and premature infant formula may be used. The aim of this brief review is to discuss the current practical concepts about enteral feeding in preterm infants.

  16. The effect of an interventional program based on the Theory of Ethology on infant breastfeeding competence

    Directory of Open Access Journals (Sweden)

    aghdas karimi

    2014-08-01

    Full Text Available Introduction: according to the ethology theory mother infant separation immediately after birth can interfere with the infants innate behaviors for the initiation of breastfeeding. The aim of this study was to the effect of an interventional program based on the Theory of Ethology on infant breast feeding competence Materials and Methods: 114 primiparous, Iranian, healthy, full term mothers between 18-35 years with normal vaginal delivery who intended to breastfeed their babies. They were put in direct skin to skin contact with their infants immediately after birth for two hours. Then, rates of infant breastfeeding competence were compared with a control group receiving routine hospital cares. Results: Rates of infant breastfeeding competence were higher in the skin to skin contact group compared to routine care group (p=0.0001. Conclusion: mother- infant early skin to skin contact promotes infants natural feeding behaviors leading to higher rates of infant breastfeeding competence. These findings confirm the Theory of Ethology.

  17. The effect of an interventional program based on the Theory of Ethology on infant breastfeeding competence

    Directory of Open Access Journals (Sweden)

    aghdas karimi

    2014-12-01

    Full Text Available Introduction: according to the ethology theory mother infant separation immediately after birth can interfere with the infants innate behaviors for the initiation of breastfeeding. The aim of this study was to the effect of an interventional program based on the Theory of Ethology on infant breast feeding competence Materials and Methods: 114 primiparous, Iranian, healthy, full term mothers between 18-35 years with normal vaginal delivery who intended to breastfeed their babies. They were put in direct skin to skin contact with their infants immediately after birth for two hours. Then, rates of infant breastfeeding competence were compared with a control group receiving routine hospital cares. Results: Rates of infant breastfeeding competence were higher in the skin to skin contact group compared to routine care group (p=0.0001. Conclusion: mother- infant early skin to skin contact promotes infants natural feeding behaviors leading to higher rates of infant breastfeeding competence. These findings confirm the Theory of Ethology.

  18. 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

    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 synthesized

  19. Risk Factors of Sudden Infant Death Syndrome and Risk Factors for Sleep Disturbances

    Science.gov (United States)

    Kelmanson, Igor A.

    2011-01-01

    Relationship between major risk factors of sudden infant death syndrome (SIDS) and sleep disorders in the infants is the subject of review and discussion. Improper micro-environmental characteristics (especially poor environmental organisation and lack of developmental stimulation), pre-term delivery and/or infant low birth weight, prone sleep…

  20. Growth in Preterm Infants Until Six Months Postterm: The Role of Insulin and IGF-I

    NARCIS (Netherlands)

    van de Lagemaat, M.; Rotteveel, J.; Heijboer, A.C.; Lafeber, H.N.; van Weissenbruch, M.M.

    2013-01-01

    Background/Aims: Since insulin-like growth factor type I (IGF-I) and insulin regulate growth in term infants, they were studied in relation to nutrient intake and growth until 6 months corrected age (CA) in preterm infants. Methods: In 138 preterm infants (51% male, gestational age (expressed as

  1. Mothers' amygdala response to positive or negative infant affect is modulated by personal relevance

    Science.gov (United States)

    Understanding, prioritizing and responding to infant affective cues is a key component of motherhood, with long-term implications for infant socio-emotional development. This important task includes identifying unique characteristics of one's own infant, as they relate to differences in affect valen...

  2. 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

  3. White Matter Injury and General Movements in High-Risk Preterm Infants

    NARCIS (Netherlands)

    Peyton, C.; Yang, E.; Msall, M. E.; Adde, L.; Stoen, R.; Fjortoft, T.; Bos, Arie; Einspieler, C.; Zhou, Y; Schreiber, M. D.; Marks, J. D.; Drobyshevsky, A.

    BACKGROUND AND PURPOSE: Very preterm infants (birth weight, MATERIALS AND METHODS: In this prospective study of 47 preterm infants of 24-30 weeks' gestation, brain MR imaging was performed at term-equivalent age. Infants underwent T1- and T2-weighted imaging for volumetric analysis and DTI. General

  4. Lactation Support and Breastfeeding Duration in Jaundiced Infants: A Randomized Controlled Trial

    OpenAIRE

    Catherine M Pound; Katherine Moreau; Kristina Rohde; Nick Barrowman; Mary Aglipay; Farion, Ken J.; Plint, Amy C.

    2015-01-01

    Objectives Neonatal jaundice is the most common problem in full-term infants during the immediate post-natal period. We examined the effect of a lactation support intervention on breastfeeding duration in hospitalized jaundiced infants. Study Design We conducted a randomized controlled trial with a qualitative component involving mothers of hospitalized jaundiced breastfed infants

  5. Sudden Infant Death Syndrome (SIDS)

    Science.gov (United States)

    Sudden infant death syndrome (SIDS) Overview Sudden infant death syndrome (SIDS) is the unexplained death, usually during sleep, of a seemingly healthy baby ... year old. SIDS is sometimes known as crib death because the infants often die in their cribs. ...

  6. Infant Mortality and Hispanic Americans

    Science.gov (United States)

    ... AIDS Immunizations Infant Health & Mortality Mental Health Obesity Organ and Tissue Donation Stroke Stay Connected OMH Home > Policy and Data > ... contents2016.htm Leading Causes of Infant Mortality: Infant deaths and mortality rates for the top 4 leading ...

  7. Body composition in preterm infants with intrauterine growth restriction: a cohort study.

    Science.gov (United States)

    Villela, Letícia Duarte; Méio, Maria Dalva Barbosa Baker; Gomes Junior, Saint Clair S; de Abranches, Andrea Dunshee; Soares, Fernanda Valente Mendes; Moreira, Maria Elisabeth Lopes

    2018-02-06

    The comparison of body composition parameters between the small for gestational age (SGA) and appropriate for gestational age (AGA) at term, 1, 3 and 5 months corrected ages in very preterm infants. This cohort study included 92 preterm infants at term age, younger than 32 weeks or preterm infants had less lean mass (g), fat mass (g) and percent fat mass but a greater LM/FM index than AGA infants (Ppreterm infants when compared to AGA preterm infants. However, the SGA preterm infants remained lighter, shorter and with smaller head circumferences than the AGA preterm infants until 3 months of corrected age. The greater lean tissue deficits and an earlier "catch-up" in fat in the SGA group can reflect growth patterns variability since the early life.

  8. [Inguinal herniotomy in prematurely born infants].

    Science.gov (United States)

    Marinković, S; Bukarica, S; Cvejanov, M; Peković-Zrnić, V; Jokić, R; Dobanovacki, D

    1998-01-01

    Inguinal hernia is the most common surgical condition in childhood; more than half of the cases occur during infancy (1, 2). As the number of surviving premature infants continues to grow, the pediatric surgeon has become more involved in the management of these hernias (3, 4). Several issues are contentious, such as the optimal time for herniotomy after diagnosis (5), the role of contralateral exploration, and the proper management for incarcerated inguinal hernia (6). Based on our experience, we attempted to study the above points in the infant population and we also examined the role of ventilator therapy in the etiology of inguinal hernia. We performed a retrospective review of records of all infants under 6 months of age who underwent a repair of inguinal hernia at the Clinic for Pediatric Surgery in Novi Sad between January 1994 and December 1996. After surgery, all infants were included in a 6-week follow-up examination. During this period, 144 infants under 6 months of age underwent inguinal hernia repair. There were 114 males and 30 females. Fourteen patients had bilateral hernias at the time of presentation. Incarceration occurred in 32 infants (22%), that is in 27 of the 99 full-term cases (27%) and in 5 of the 45 preterm cases (11%). Only in three cases (8%) did it occur while the infant was awaiting repair. Over 90% of the full-term infants had their hernias repaired within 3 weeks from diagnosis. After reduction of incarceration, our policy is to operate within 24 to 48 hours. Four testicles appeared to be ischemic; one of these was excised. Patchy bowel ischemia was present in six cases, and bowel resection was required in one. The ovary and tube were twisted and ischemic at the time of operation, requiring oophorectomy in two female infants. Forty-five infants were premature. The mean age at the time of diagnosis was 8 weeks; at the time of herniotomy, it was 13 weeks. In the 24- to 28-week group, 44 of hernias were bilateral, and 7 of the 9 infants

  9. Infant sleep problems and interventions: A review.

    Science.gov (United States)

    Field, Tiffany

    2017-05-01

    Infant sleep problems have been the focus of a growing literature over the last few years. The current review is based on literature searches of Pubmed and PsycInfo for studies published over the last few years including randomized controlled trials, systematic reviews and meta-analyses on infant sleep problems and resulting developmental effected, risk factors and interventions. Several risk/protective factors for sleep problems have been identified including health literacy, TV in the room, feeding, close contact and arousing activities at bedtime, intolerance for infant crying, co-sleeping, maternal depression and infant temperament. Cross-cultural differences have been noted both for infant sleep problems and parents' perceived distress by those problems. A number of interventions have been tried to ameliorate infant sleep problems including consultations, teaching sessions on extinction and bedtime fading, internet-based interventions and nighttime massages by parents. Some of these studies have shown improvements and others have suggested only short-term or negligible effects. Significant methodological problems exist with this literature including the almost sole use of parent report as well as the mixed age samples and the potential confounding variables. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Infants' discrimination of happy and sad music.

    Science.gov (United States)

    Flom, Ross; Gentile, Douglas A; Pick, Anne D

    2008-12-01

    Infants can detect information specifying affect in infant- and adult-directed speech, familiar and unfamiliar facial expressions, and in point-light displays of facial expressions. We examined 3-, 5-, 7-, and 9-month-olds' discrimination of musical excerpts judged by adults and preschoolers as happy and sad. In Experiment 1, using an infant-controlled habituation procedure, 3-, 5-, 7-, and 9-month-olds heard three musical excerpts that were rated as either happy or sad. Following habituation, infants were presented with two new musical excerpts from the other affect group. Nine-month-olds discriminated the musical excerpts rated as affectively different. Five- and seven-month-olds discriminated the happy and sad excerpts when they were habituated to sad excerpts but not when they were habituated to happy excerpts. Three-month-olds showed no evidence of discriminating the sad and happy excerpts. In Experiment 2, 5-, 7-, and 9-month-olds were presented with two new musical excerpts from the same affective group as the habituation excerpts. At no age did infants discriminate these novel, yet affectively similar, musical excerpts. In Experiment 3, we examined 5-, 7-, and 9-month-olds' discrimination of individual excerpts rated as affectively similar. Only the 9-month-olds discriminated the affectively similar individual excerpts. Results are discussed in terms of infants' ability to discriminate affect across a variety of events and its relevance for later social-communicative development.

  11. US infant mortality and the President's party.

    Science.gov (United States)

    Rodriguez, Javier M; Bound, John; Geronimus, Arline T

    2014-06-01

    Infant mortality rates in the US exceed those in all other developed countries and in many less developed countries, suggesting political factors may contribute. Annual time series on overall, White and Black infant mortality rates in the US were analysed over the 1965-2010 time period to ascertain whether infant mortality rates varied across presidential administrations. Data were de-trended using cubic splines and analysed using both graphical and time series regression methods. Across all nine presidential administrations, infant mortality rates were below trend when the President was a Democrat and above trend when the President was a Republican. This was true for overall, neonatal and postneonatal mortality. Regression estimates show that, relative to trend, Republican administrations were characterized by infant mortality rates that were, on average, 3% higher than Democratic administrations. In proportional terms, effect size is similar for US Whites and Blacks. US Black rates are more than twice as high as White, implying substantially larger absolute effects for Blacks. We found a robust, quantitatively important association between net of trend US infant mortality rates and the party affiliation of the president. There may be overlooked ways by which macro-dynamics of policy impact microdynamics of physiology, suggesting the political system is a component of the underlying mechanism generating health inequality in the USA. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2013; all rights reserved.

  12. Transplacental transport of IgG antibodies specific for pertussis, diphtheria, tetanus, haemophilus influenzae type b, and Neisseria meningitidis serogroup C is lower in preterm compared with term infants

    NARCIS (Netherlands)

    van den Berg, Jolice P.; Westerbeek, Elisabeth A. M.; Berbers, Guy A. M.; van Gageldonk, Pieter G. M.; van der Klis, Fiona R. M.; van Elburg, Ruurd M.

    2010-01-01

    Maternal antibodies, transported through the placenta during pregnancy, contribute to the protection of infants from infectious diseases during the first months of life. The aim of this study was to measure the concentration of antibodies against several vaccine-preventable diseases in paired

  13. Neurologic Outcomes in Very Preterm Infants Undergoing Surgery.

    LENUS (Irish Health Repository)

    2012-01-31

    OBJECTIVE: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome. STUDY DESIGN: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30). Nineteen infants were excluded because of incomplete or unsuitable data. The surgical and nonsurgical groups were compared in terms of clinical demographic data, white matter injury, and brain volume at term. Neurodevelopmental outcome was assessed at age 2 years. RESULTS: Compared with the nonsurgical group, the infants in the surgical group were smaller and more growth-restricted at birth, received more respiratory support and oxygen therapy, and had longer hospital stays. They also had smaller brain volumes, particularly smaller deep nuclear gray matter volumes. Infants who underwent bowel surgery had greater white matter injury. Mental Developmental Index scores were lower in the surgical group, whereas Psychomotor Developmental Index scores did not differ between the groups. The Mental Developmental Index difference became nonsignificant after adjustment for confounding variables. CONCLUSION: Preterm infants exposed to surgery and anesthesia had greater white matter injury and smaller total brain volumes, particularly smaller deep nuclear gray matter volumes. Surgical exposure in the preterm infant should alert the clinician to an increased risk for adverse cognitive outcome.

  14. Postnatal weight loss in substitute methadone-exposed infants: implications for the management of breast feeding.

    Science.gov (United States)

    Dryden, Carol; Young, David; Campbell, Nicole; Mactier, Helen

    2012-05-01

    It is widely accepted that maternal drug-exposed infants demonstrate excessive early weight loss, but this has not previously been quantified. Among 354 term, substitute methadone-exposed infants, median maximal weight losses were 10.2% and 8.5% for breast- and formula-fed infants, respectively (p=0.003). Weight loss was less in small for gestational age compared to appropriately grown infants (plactation and may help to guide management of breast feeding in this population.

  15. Sudden Infant Death Syndrome.

    Science.gov (United States)

    Barnett, Henry L.; And Others

    There is a growing body of evidence that Sudden Infant Death Syndrome (SIDS) victims are not completely normal and healthy, as was once believed. A variety of new information from several disciplines strongly suggests that the infant who dies suddenly and unexpectedly may do so because of subtle developmental, neurologic, cardiorespiratory, and…

  16. Ultrasound: Infant Hip

    Science.gov (United States)

    ... Habits for TV, Video Games, and the Internet Ultrasound: Infant Hip KidsHealth > For Parents > Ultrasound: Infant Hip Print A A A What's in ... en los lactantes What It Is A hip ultrasound is a safe and painless test that uses ...

  17. Cow's milk - infants

    Science.gov (United States)

    ... cow's milk. To provide the best diet and nutrition for your infant, the AAP recommends: If possible, you should feed ... and the A.D.A.M. Editorial team. Infant and Newborn Nutrition Read more NIH MedlinePlus Magazine Read more Health ...

  18. Acidified infant formula explained

    African Journals Online (AJOL)

    2013-01-21

    Jan 21, 2013 ... children.1 The development of effective methods to prevent acute gastroenteritis in infants remains ... over non-acidified formula in children with mild digestive problems (or in situation in which .... Bifidobacterium lactis: impact on infant diarrhea in residential care settings. J. Pediatr Gastroenterol Nutr. 2004 ...

  19. Adipokines in breast milk and preterm infants.

    Science.gov (United States)

    Savino, Francesco; Liguori, Stefania Alfonsina; Lupica, Maria Maddalena

    2010-07-01

    Studies have shown that the early life environment affects feeding behaviour, food intake and energy balance in later life, suggesting there is a link between foetal and infant growth and the risk of metabolic disorders in adulthood. Although there is an evident epidemiological association between low birth weight and adult-onset diseases, the incidence of metabolic diseases in adulthood among people who were born prematurely is still unknown. Considerable advances have been made during the last years in the scientific knowledge of the benefits of early nutrition, such as breastfeeding, on health and well-being later in life. Nutritional researchers have focussed their attention on the biological characteristics of human breast milk, which represents the main source of nutrients in the first months of life for breastfed infants. Recently, leptin and ghrelin have been detected in the breast milk of mothers of term and preterm infants. Adiponectin and resistin, present in term human milk, have not been investigated in the breast milk of mothers of preterm infants. These hormones are involved in the regulation of energy balance and may have a role in the regulation of growth and development in the neonatal period and infancy, as well as long-term effects on metabolic programming. Leptin, adiponectin and resistin have been found at lower levels in pre-term infants compared with term newborns, whereas there seems to be no difference in ghrelin levels. Future research is necessary to clarify the role of hormones present in breast milk for identifying potential short- and long-term effects of breastfeeding on the health of children born prematurely. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  20. Human milk and the premature infant.

    Science.gov (United States)

    Bhatia, Jatinder

    2013-01-01

    Human milk is the preferred feeding for both term and preterm infants. While being considered optimal for term infants, human milk, even from mothers delivering preterm infants, is lacking in protein, energy, sodium, calcium, and phosphorus, resulting in poorer growth and nutrient deficiencies when compared to formulas designed