Stem-Like Cell Characteristics from Breast Milk of Mothers with Preterm Infants as Compared to Mothers with Term Infants.

Science.gov (United States)

Briere, Carrie-Ellen; Jensen, Todd; McGrath, Jacqueline M; Young, Erin E; Finck, Christine

2017-04-01

Breast milk stem cells are hypothesized to be involved in infant health and development. Our research team is the first known team to enroll mothers of hospitalized preterm infants during the first few weeks of lactation and compare stem cell phenotypes and gene expression to mothers of healthy full-term infants. Participants were recruited from a Level IV Neonatal Intensive Care Unit (preterm dyads) and the community (full-term dyads) in the northeastern United States. Mothers of hospitalized preterm infants (mothers of healthy full-term infants (>39 weeks gestational age at birth). Breast milk stem-like cell populations were identified in both preterm and full-term breast milk samples. The data suggest variability in the proportion of stem cell phenotypes present, as well as statistically significant differential expression (both over- and underexpression) of stem cell-specific genetic markers when comparing mothers' milk for preterm and full-term births. Our findings indicate that (1) stem cells are present in preterm breast milk; (2) differential expression of stem cell-specific markers can be detected in preterm and full-term breast milk samples; and (3) the percentage of cells expressing the various stem cell-specific markers differs when preterm and full-term breast milk samples are compared.

Flavobacterium meningosepticum sepsis in an infant with a diarrheal prodrome.

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Springer, S C; Johnson, G M

1999-02-01

A full term, previously normal 2 1/2-month-old black boy was transferred to our hospital from an outlying facility on hospital day 5 for failure to thrive. Three weeks before transfer, the infant was hospitalized for a diarrheal illness with fever. The baby received 3 days of ceftriaxone empirically and was discharged home after the sepsis evaluation was negative. Mild diarrhea and steady weight loss continued and the baby was readmitted. Blood culture done on admission grew Flavobacterium meningosepticum, an organism previously described as an uncommon cause of sepsis in neonates and immunocompromised individuals. As it is water-borne, it has been associated with infection via contaminated water. This organism is usually resistant to antibiotics commonly used for empiric treatment. To our knowledge, this is the first reported case of Flavobacterium bacteremia associated with a prodromal and concurrent diarrheal illness.

An Overview of Iron in Term Breast-Fed Infants

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Wafaa A. Qasem

2015-01-01

Full Text Available Background Iron is an essential nutrient for normal growth and neurodevelopment of infants. Iron deficiency (ID remains the most common micronutrient deficiency worldwide. There are convincing data that ID is associated with negative effects on neurological and psychomotor development. Objectives In this review, we provide an overview of current knowledge of the importance of iron in normal term breast-fed infants with a focus on recommendations, metabolism, and iron requirements. Conclusions Health organizations around the world recommend the introduction of iron-rich foods or iron supplements for growing infants to prevent ID. However, there is no routine screening for ID in infancy. Multicenter trials with long-term follow-up are needed to investigate the association between iron fortification/supplementation and various health outcomes.

Influence of prenatal cocaine exposure on full-term infant neurobehavioral functioning.

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Morrow, C E; Bandstra, E S; Anthony, J C; Ofir, A Y; Xue, L; Reyes, M L

2001-01-01

This study investigated infant neurobehavioral functioning during the newborn period in 334 full-term, African American neonates (187 cocaine exposed, 147 non-cocaine exposed) enrolled prospectively at birth, with documentation of drug exposure status through maternal interview and urine and meconium toxicology assays. Infants were assessed using the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) during the newborn period (0-6 postnatal days). Findings from multivariate profile analyses support a consistent, modest effect of prenatal cocaine exposure on neurobehavioral functioning in full-term neonates. All of the BNBAS cluster scores, with the exception of abnormal reflexes, were similarly affected, sharing a common slope (D=-0.14; 95% CI=-0.27, -0.003; P=.046) representing a -0.14 point difference between cocaine-exposed and non-cocaine-exposed infants after controlling for prenatal exposure to alcohol, tobacco, and marijuana (ATM); maternal age, education, employment, primigravida status, and prenatal care visits; and infant sex and postnatal age in days. Fetal growth was also related to neurobehavioral functioning and, in part, mediated the relationship between cocaine exposure and the BNBAS cluster scores. Cocaine exposure during each trimester similarly influenced infant neurobehavioral profiles, with cocaine-associated deficits most pronounced in infants with exposure in all three trimesters. Results from qualitative and quantitative urine and meconium bioassay indicators further substantiated these results. Findings, while significant, represent modest effect sizes in full-term infants.

Long-term memory for pitch in six-month-old infants.

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Plantinga, Judy; Trainor, Laurel J

2003-11-01

We examined 6-month-old infants' long-term memory representations for the pitch of familiar melodies. Infants remembered the relative pitch of the melodies, but the absolute pitch was either not remembered or not a particularly salient attribute.

Exogenous Attention Influences Visual Short-Term Memory in Infants

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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…

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

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

2012-05-01

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

Docosahexaenoic Acid and Neurodevelopmental Outcomes of Term Infants.

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Meldrum, Suzanne; Simmer, Karen

2016-01-01

Docosahexaenoic acid (DHA), a long-chain polyunsaturated fatty acid, is essential for normal brain development. DHA is found predominantly in seafood, fish oil, breastmilk and supplemented formula. DHA intake in Western countries is often below recommendations. Observational studies have demonstrated an association between DHA intake in pregnancy and neurodevelopment of offspring but cannot fully adjust for confounding factors that influence child development. Randomised clinical trials of DHA supplementation during pregnancy and/or lactation, and of term infants, have not shown a consistent benefit nor harm on neurodevelopment of healthy children born at term. The evidence does not support DHA supplementation of healthy pregnant and lactating women, nor healthy infants. © 2016 S. Karger AG, Basel.

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

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

2012-08-01

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

Delivery room management of term and preterm newly born infants.

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Saugstad, Ola Didrik

2015-01-01

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

A psychometric study of the Bayley Scales of Infant and Toddler Development - 3rd Edition for term and preterm Taiwanese infants.

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Yu, Yen-Ting; Hsieh, Wu-Shiun; Hsu, Chyong-Hsin; Chen, Li-Chiou; Lee, Wang-Tso; Chiu, Nan-Chang; Wu, Ying-Chin; Jeng, Suh-Fang

2013-11-01

The Bayley Scales of Infant and Toddler Development - 3rd Edition (Bayley-III) was updated to enhance its usefulness for contemporary child developmental assessment. However, recent data in Western countries have implicated the overestimation of child development by the new instrument. This study aimed to investigate the psychometric features of the Bayley-III for term and preterm infants in Taiwan. Forty-seven term infants and 167 preterm infants were prospectively examined with the Bayley Scales of Infant Development - 2nd Edition (BSID-II) and the Bayley-III at 6, 12, 18, and 24 months of age (corrected for prematurity). The psychometric properties examined included reliability, construct validity, and known-group validity. The intra- and inter-rater reliabilities of the Bayley-III were good to excellent. The correlations between the BSID-II and Bayley-III raw scores were good to excellent for the cognitive and motor items and low to excellent for the language items. Term infants achieved higher composite scores than preterm infants on all of the Bayley-III scales (pcognitive, language, and motor delay, respectively, as defined by the BSID-II index score<70. The Bayley-III is a reliable instrument that extends its previous edition, especially in early language assessment. However, the upward adjustment of its cut-off score is recommended for the accurate identification of developmental delay in term and preterm Taiwanese infants. Copyright © 2013 Elsevier Ltd. All rights reserved.

Magnetic resonance imaging at term and neuromotor outcome in preterm infants

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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.

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

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......-point 'any symptom-day' (yes/no) and by standard linear regression with the end-point 'number of symptom-days'. The results showed no systematic association between risk for wheezing symptoms and the levels of these air pollutants with various indoor and outdoor sources. In conclusion, we found no evidence...... 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...

Development of long-term event memory in preverbal infants: an eye-tracking study.

Science.gov (United States)

Nakano, Tamami; Kitazawa, Shigeru

2017-03-08

The development of long-term event memory in preverbal infants remains elusive. To address this issue, we applied an eye-tracking method that successfully revealed in great apes that they have long-term memory of single events. Six-, 12-, 18- and 24-month-old infants watched a video story in which an aggressive ape-looking character came out from one of two identical doors. While viewing the same video again 24 hours later, 18- and 24-month-old infants anticipatorily looked at the door where the character would show up before it actually came out, but 6- and 12-month-old infants did not. Next, 12-, 18- and 24-month-old infants watched a different video story, in which a human grabbed one of two objects to hit back at the character. In their second viewing after a 24-hour delay, 18- and 24-month-old infants increased viewing time on the objects before the character grabbed one. In this viewing, 24-month-old infants preferentially looked at the object that the human had used, but 18-month-old infants did not show such preference. Our results show that infants at 18 months of age have developed long-term event memory, an ability to encode and retrieve a one-time event and this ability is elaborated thereafter.

Infant temperament: stability by age, gender, birth order, term status, and socioeconomic status.

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Bornstein, Marc H; Putnick, Diane L; Gartstein, Maria A; Hahn, Chun-Shin; Auestad, Nancy; O'Connor, Deborah L

2015-01-01

Two complementary studies focused on stability of infant temperament across the 1st year and considered infant age, gender, birth order, term status, and socioeconomic status (SES) as moderators. Study 1 consisted of 73 mothers of firstborn term girls and boys queried at 2, 5, and 13 months of age. Study 2 consisted of 335 mothers of infants of different gender, birth order, term status, and SES queried at 6 and 12 months. Consistent positive and negative affectivity factors emerged at all time points across both studies. Infant temperament proved stable and robust across gender, birth order, term status, and SES. Stability coefficients for temperament factors and scales were medium to large for shorter ( 10 months) intervals. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

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

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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.

Fundamental Frequency Variation of Neonatal Spontaneous Crying Predicts Language Acquisition in Preterm and Term Infants.

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Shinya, Yuta; Kawai, Masahiko; Niwa, Fusako; Imafuku, Masahiro; Myowa, Masako

2017-01-01

Spontaneous cries of infants exhibit rich melodic features (i.e., time variation of fundamental frequency [ F 0 ]) even during the neonatal period, and the development of these characteristics might provide an essential base for later expressive prosody in language. However, little is known about the melodic features of spontaneous cries in preterm infants, who have a higher risk of later language-related problems. Thus, the present study investigated how preterm birth influenced melodic features of spontaneous crying at term-equivalent age as well as how these melodic features related to language outcomes at 18 months of corrected age in preterm and term infants. At term, moderate-to-late preterm (MLP) infants showed spontaneous cries with significantly higher F 0 variation and melody complexity than term infants, while there were no significant differences between very preterm (VP) and term infants. Furthermore, larger F 0 variation within cry series at term was significantly related to better language and cognitive outcomes, particularly expressive language skills, at 18 months. On the other hand, no other melodic features at term predicted any developmental outcomes at 18 months. The present results suggest that the additional postnatal vocal experience of MLP preterm infants increased F 0 variation and the complexity of spontaneous cries at term. Additionally, the increases in F 0 variation may partly reflect the development of voluntary vocal control, which, in turn, contributes to expressive language in infancy.

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

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

2010-02-01

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. To measure the serum lutein concentrations among infants fed human milk or formulas with and without added lutein. A prospective, double-masked trial was conducted in healthy term formula-fed infants (n = 26) randomized between 9 and 16 days of age to study formulas containing 20 (unfortified), 45, 120, and 225 mcg/l of lutein. A breastfed reference group was studied (n = 14) and milk samples were collected from their mothers. Primary outcome was serum lutein concentration at week 12. Geometric mean lutein concentration of human milk was 21.1 mcg/l (95% CI 14.9-30.0). At week 12, the human milk group had a sixfold higher geometric mean serum lutein (69.3 mcg/l; 95% CI 40.3-119) than the unfortified formula group (11.3 mcg/l; 95% CI 8.1-15.8). Mean serum lutein increased from baseline in each formula group except the unfortified group. Linear regression equation indicated breastfed infants had a greater increase in serum lutein (slope 3.7; P milk lutein than formula-fed infants (slope 0.9; P lutein concentrations than infants who consume formula unfortified with lutein. These data suggest approximately 4 times more lutein is needed in infant formula than in human milk to achieve similar serum lutein concentrations among breastfed and formula fed infants.

A Conditioning Analysis of Infant Long-Term Memory.

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Sullivan, Margaret W.; And Others

1979-01-01

Assesses the long-term retention of conditioned operant footkicks by three-month-old infants. Views a conditioning analysis as a logical means by which to bridge the gap between animal and adult human models of memory. (Author/RH)

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

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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.

Impact of airway obstruction on lung function in very preterm infants at term.

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Hilgendorff, Anne; Reiss, Irwin; Gortner, Ludwig; Schüler, Daniel; Weber, Katrin; Lindemann, Hermann

2008-11-01

Morbidity and mortality in preterm infants is significantly determined by the development of pulmonary complications. We thus investigated the impact of obstructive ventilatory disorders on lung function in very preterm infants with a history of respiratory distress syndrome and/or bronchopulmonary dysplasia using repeated body plethysmographic measurements before and after bronchodilation. Lung function, including effective airway resistance (Raw), specific conductance (SGaw), functional residual capacity (FRCbox), and total respiratory system compliance (Crs, multiple occlusion technique) was assessed in 27 preterm infants pound31 wks gestational age at a median postmenstrual age of 38 wks after mild oral sedation before and after inhalation of nebulized salbutamol (1.25 mg/2.5 mL; PARI JuniorBOY N) using the MasterScreen Baby Body (Jaeger, Hoechberg, Germany). In preterm infants median Raw was initially found to be within the normal range as determined for healthy term newborns, but decreased significantly after administration of salbutamol; SGaw changed accordingly. FRCbox was significantly reduced compared with healthy term newborns (16.6 vs. 19.6 mL/kg, mean) and decreased further after bronchodilation, whereas Crs was not significantly altered. This is the first report quantifying the important impact of obstructive ventilatory disorders on lung function in very preterm infants at term. Besides its important role in preterm lung function consecutive overinflation could furthermore be shown to mask reduction of lung volume in these infants. Thus, body plethysmographic measurements seem to be an important diagnostic tool in preterm infants at term before hospital discharge in order to quantify ventilation disorders and to define therapeutic strategies.

Long-term Non-Invasive Ventilation in Infants: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Bedi, Prabhjot K; Castro-Codesal, Maria Luisa; Featherstone, Robin; AlBalawi, Mohammed M; Alkhaledi, Bashar; Kozyrskyj, Anita L; Flores-Mir, Carlos; MacLean, Joanna E

2018-01-01

The use of long-term non-invasive ventilation (NIV) to treat sleep and breathing disorders in children has increased substantially in the last decade; however, less data exist about its use in infants. Given that infants have distinct sleep and breathing patterns when compared to older children, the outcomes of infants on long-term NIV may differ as well. The aim of this study is to systematically review the use and outcomes of long-term NIV in infants. Ovid Medline, Ovid Embase, CINAHL (via EbscoHOST), PubMed, and Wiley Cochrane Library were systematically searched from January 1990 to July 2017. Studies on infants using long-term NIV outside of an acute care setting were included. Data were extracted on study design, population characteristics, and NIV outcomes. A total of 327 studies were full-text reviewed, with final inclusion of 60. Studies were distributed across airway (40%), neuromuscular (28%), central nervous system (10%), cardio-respiratory (2%), and multiple (20%) disease categories. Of the 18 airway studies reporting on NIV outcomes, 13 (72%) reported improvements in respiratory parameters. Of the 12 neuromuscular studies exclusively on spinal muscular atrophy type 1 (SMA1), six (50%) reported decreased hospitalizations and nine (75%) reported on mortality outcomes. Risk of bias was moderate to serious, and quality of the evidence was low to very low for all studies. Most studies had an observational design with no control group, limiting the potential for a meta-analysis. The outcomes reported in studies differed by the disease category being studied. Studies on airway conditions showed improvements in respiratory parameters for infants using NIV. Studies on neuromuscular disorder, which were almost exclusively on SMA1, reported decreased hospitalizations and prolonged survival. Overall, it appears that NIV is an effective long-term therapy for infants. However, the high risk of bias and low quality of the available evidence limited strong

Development of long-term event memory in preverbal infants: an eye-tracking study

OpenAIRE

Nakano, Tamami; Kitazawa, Shigeru

2017-01-01

The development of long-term event memory in preverbal infants remains elusive. To address this issue, we applied an eye-tracking method that successfully revealed in great apes that they have long-term memory of single events. Six-, 12-, 18- and 24-month-old infants watched a video story in which an aggressive ape-looking character came out from one of two identical doors. While viewing the same video again 24?hours later, 18- and 24-month-old infants anticipatorily looked at the door where ...

[Quality analyses of the development of preterm infants: results of the Lower-Saxonian preterm infant follow-up project and a comparison group of term infants].

Science.gov (United States)

Damm, Gabriele; Macha, Thorsten; Petermann, Franz; Voss, Wolfgang; Sens, Brigitte

2015-01-01

Based on perinatal and neonatal quality assurance programmes, a follow-up project for the high-risk group of extremely preterm infants, unparalleled in Germany, was initiated in the federal state of Lower Saxony in 2004. Here we describe the new approach of examining a comparison group of term infants, which, for the first time, allows a valid interpretation of the collection of area-wide long-term outcome data on preterm children. The prospective long-term outcome project investigates the medical care situation for children born at less than 28 weeks of gestation up to school age. Based on the information obtained about the children's development the quality of health care will be optimised. A standardised examining concept with established development tests at defined follow-up intervals (at the age of 6 months, 2, 5 and 10 years) is used. At the age of five years 75 % of the examined premature children exhibited impairments. In order to better assess remarkable results, a comparison group of term infants (n=305) selected by a matched-pairs method was examined at the age of five using an analogous concept in kindergartens in Lower Saxony. The results were compared with the first two age cohorts of the follow-up-project (n=226) and quality analyses performed. As expected, significant differences have been found in the children's motor, cognitive and linguistic development between the preterm and term infants examined. This fact draws attention to the importance of early support for the majority of extremely premature infants. Feedback on the results given to the medical staff involved allows for the implementation of best practices and quality improvements. Identifying potential for improvement in everyday health care will help to develop specific optimisation measures. Copyright © 2015. Published by Elsevier GmbH.

Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia.

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Hung-Yang Chang

Full Text Available Neonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants.This retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5-37.5°C, mild hypothermia (36.0-36.4°C, moderate hypothermia (32.0-35.9°C, and severe hypothermia (< 32°C. We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.We studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02 and smaller birth weight (1004 g vs. 1187 g, P < .001 compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001, respiratory distress syndrome (RDS (58.0% vs. 39.2%, P = .006, and mortality (18.5% vs. 5.1%, P = .005. Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years' corrected age. Mild hypothermia had no effect on short-term or long-term outcomes.Admission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment.

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

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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

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

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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.

Visual short-term memory guides infants' visual attention.

Science.gov (United States)

Mitsven, Samantha G; Cantrell, Lisa M; Luck, Steven J; Oakes, Lisa M

2018-08-01

Adults' visual attention is guided by the contents of visual short-term memory (VSTM). Here we asked whether 10-month-old infants' (N = 41) visual attention is also guided by the information stored in VSTM. In two experiments, we modified the one-shot change detection task (Oakes, Baumgartner, Barrett, Messenger, & Luck, 2013) to create a simplified cued visual search task to ask how information stored in VSTM influences where infants look. A single sample item (e.g., a colored circle) was presented at fixation for 500 ms, followed by a brief (300 ms) retention interval and then a test array consisting of two items, one on each side of fixation. One item in the test array matched the sample stimulus and the other did not. Infants were more likely to look at the non-matching item than at the matching item, demonstrating that the information stored rapidly in VSTM guided subsequent looking behavior. Copyright © 2018 Elsevier B.V. All rights reserved.

Tolerance, bone mineral content, and serum vitamin D concentration of term infants fed partially hydrolyzed whey-based infant formula

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The objective of the study was to assess the tolerance (intake, incidence of spit up/vomit, and stool patterns), bone mineral status, and vitamin D status of healthy, term infants fed one of two partially hydrolyzed bovine whey protein infant formulas from birth to 56 or 84 days of age. The control ...

Obstetric interventions and perinatal asphyxia in growth retarded term infants

DEFF Research Database (Denmark)

Langhoff-Roos, J; Lindmark, G

1997-01-01

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...... 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......-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...

Vasoparalysis associated with brain damage in asphyxiated term infants

International Nuclear Information System (INIS)

Pryds, O.; Greisen, G.; Lou, H.; Friis-Hansen, B.

1990-01-01

The relationship of cerebral blood flow to acute changes in arterial carbon dioxide and mean arterial blood pressure (MABP) was determined during the first day of life in 19 severely asphyxiated term infants supported by mechanical ventilation. For comparison, 12 infants without perinatal asphyxia were also investigated. Global cerebral blood flow (CBF infinity) was determined by xenon 133 clearance two or three times within approximately 2 hours. During the cerebral blood flow measurement, the amplitude-integrated electroencephalogram and visual-evoked potential were recorded. Changes in arterial carbon dioxide pressure followed adjustments of the ventilator settings, whereas MABP fluctuated spontaneously. Arterial oxygen pressure and blood glucose concentration were in the normal range. Five of the asphyxiated infants had isoelectric electroencephalograms and died subsequently with severe brain damage. They had a high CBF infinity (mean 30.6 ml/100 gm/min) and abolished carbon dioxide and MABP reactivity. Lower CBF infinity (mean 14.7 ml/100 gm/min) and abolished MABP reactivity were found in another five asphyxiated infants with burst-suppression electroencephalograms in whom computed tomographic or clinical signs of brain lesions developed. The carbon dioxide reactivity was preserved in these infants. In the remaining nine asphyxiated infants without signs of central nervous system abnormality, carbon dioxide and MABP reactivity were preserved, as was also the case in the control group. We conclude that abolished autoregulation is associated with cerebral damage in asphyxiated infants and that the combination of isoelectric electroencephalograms and cerebral hyperperfusion is an early indicator of very severe brain damage

Vasoparalysis associated with brain damage in asphyxiated term infants

Energy Technology Data Exchange (ETDEWEB)

Pryds, O.; Greisen, G.; Lou, H.; Friis-Hansen, B. (Rigshospitalet, Copenhagen (Denmark))

1990-07-01

The relationship of cerebral blood flow to acute changes in arterial carbon dioxide and mean arterial blood pressure (MABP) was determined during the first day of life in 19 severely asphyxiated term infants supported by mechanical ventilation. For comparison, 12 infants without perinatal asphyxia were also investigated. Global cerebral blood flow (CBF infinity) was determined by xenon 133 clearance two or three times within approximately 2 hours. During the cerebral blood flow measurement, the amplitude-integrated electroencephalogram and visual-evoked potential were recorded. Changes in arterial carbon dioxide pressure followed adjustments of the ventilator settings, whereas MABP fluctuated spontaneously. Arterial oxygen pressure and blood glucose concentration were in the normal range. Five of the asphyxiated infants had isoelectric electroencephalograms and died subsequently with severe brain damage. They had a high CBF infinity (mean 30.6 ml/100 gm/min) and abolished carbon dioxide and MABP reactivity. Lower CBF infinity (mean 14.7 ml/100 gm/min) and abolished MABP reactivity were found in another five asphyxiated infants with burst-suppression electroencephalograms in whom computed tomographic or clinical signs of brain lesions developed. The carbon dioxide reactivity was preserved in these infants. In the remaining nine asphyxiated infants without signs of central nervous system abnormality, carbon dioxide and MABP reactivity were preserved, as was also the case in the control group. We conclude that abolished autoregulation is associated with cerebral damage in asphyxiated infants and that the combination of isoelectric electroencephalograms and cerebral hyperperfusion is an early indicator of very severe brain damage.

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

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

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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.

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

International Nuclear Information System (INIS)

Tansug, Nermin; Yildirim, Sule Aslan; Canda, Ebru; Ozalp, Deniz; Yilmaz, Ozge; Taneli, Fatma; Ersoy, Betuel

2011-01-01

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.

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

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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.

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

OpenAIRE

Buckles, Kasey; Guldi, Melanie

2016-01-01

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

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

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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.

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…

Long-term memory, forgetting, and deferred imitation in 12-month-old infants

OpenAIRE

Klein, Pamela J.; Meltzoff, Andrew N.

1999-01-01

Long-term recall memory, as indexed by deferred imitation, was assessed in 12-month-old infants. Independent groups of infants were tested after retention intervals of 3 min, 1 week and 4 weeks. Deferred imitation was assessed using the ‘observation-only’ procedure in which infants were not allowed motor practice on the tasks before the delay was imposed. Thus, the memory could not have been based on re-accessing a motor habit, because none was formed in the first place. After the delay, memo...

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

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

2010-08-15

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

Sensory processing and cognitive development of preterm and full term infants

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Flávia Regina Ribeiro Cavalcanti Buffone

2016-10-01

Full Text Available Introduction: Current studies show the repercussion of sensory processing disorder in infant neurodevelopment. Little is known about the influence of these disorders in the infant’s cognitive development, however, it is known that they negatively interfere on daily life activities and remain during life course. Objective:To evaluate the relationship between sensory processing and cognitive development in infants and the association between prematurity and sensory processing in this population. Method: This is a cross-sectional study conducted in the Childcare Outpatient Department of the Hospital das Clínicas, Federal Universidade de Pernambuco, from December 2009 to August 2010. The sample consisted of 182 infants from 8 to 15 months, of which 54 (29.7% were born preterm with the prematurity age correction made to 40 weeks of gestational age. We used the Test of Sensory Functions in Infants (TSFI to evaluate the sensory processing and the Bayley Scales of Infant and Toddler Development III to assess cognitive development. Results: There was a significantly higher frequency of at risk and deficient sensory processing among preterm infants (37% when compared to term infants (21.9%. Cognitive delay was significantly higher (8.3% in infants with at risk and deficient sensory processing when compared to those with normal sensory processing (1.5%. Conclusion: Prematurity was a risk factor for sensory processing disorder, and infants diagnosed with this disorder showed cognitive delay more frequently. Prematurity alone was not associated with cognitive delay.

The Effects of Antenatal Corticosteroids on Short- and Long-Term Outcomes in Small-for-Gestational-Age Infants

Science.gov (United States)

Ishikawa, Hiroshi; Miyazaki, Ken; Ikeda, Tomoaki; Murabayashi, Nao; Hayashi, Kazutoshi; Kai, Akihiko; Ishikawa, Kaoru; Miyamoto, Yoshihiro; Nishimura, Kunihiro; Kono, Yumi; Kusuda, Satoshi; Fujimura, Masanori

2015-01-01

Aim: To evaluate the effect of antenatal corticosteroids (ANS) on short- and long-term outcomes in small-for-gestational age (SGA) infants. Methods: A retrospective database analysis was performed. A total of 1,931 single infants (birth weight <1,500 g) born at a gestational age between 22 weeks and 33 weeks 6 days who were determined to be SGA registered in the Neonatal Research Network Database in Japan between 2003 and 2007 were evaluated for short-term outcome and long-term outcome. Results: ANS was administered to a total of 719 infants (37%) in the short-term outcome evaluation group and 344 infants (36%) in the long-term outcome evaluation group. There were no significant differences between the ANS group and the no-ANS group for primary short-term outcome (adjusted odds ratio (OR) 0.73; 95% confidence interval (CI) 0.45-1.20; P-value 0.22) or primary long-term outcome (adjusted OR 0.69; 95% CI 0.40-1.17; P-value 0.17). Conclusions: Our results show that ANS does not affect short- or long-term outcome in SGA infants when the birth weight is less than 1500 g. This study strongly suggests that administration of ANS resulted in few benefits for preterm FGR fetuses. PMID:25897289

Gross motor development in full-term Greek infants assessed by the Alberta Infant Motor Scale: reference values and socioeconomic impact.

Science.gov (United States)

Syrengelas, Dimitrios; Kalampoki, Vassiliki; Kleisiouni, Paraskevi; Konstantinou, Dimitrios; Siahanidou, Tania

2014-07-01

The aims of this study were to investigate gross motor development in Greek infants and establish AIMS percentile curves and to examine possible association of AIMS scores with socioeconomic parameters. Mean AIMS scores of 1068 healthy Greek full-term infants were compared at monthly age level with the respective mean scores of the Canadian normative sample. In a subgroup of 345 study participants, parents provided, via interview, information about family socioeconomic status. Multiple linear regression analysis was performed to evaluate the relationship of infant motor development with socioeconomic parameters. Mean AIMS scores did not differ significantly between Greek and Canadian infants in any of the 19 monthly levels of age. In multiple linear regression analysis, the educational level of the mother and also whether the infant was being raised by grandparents/babysitter were significantly associated with gross motor development (p=0.02 and psocioeconomic factors are associated with the infants' motor development. Copyright © 2014 Elsevier Ltd. All rights reserved.

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 (pshort-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.

Long-term memory for music: infants remember tempo and timbre.

Science.gov (United States)

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

2004-06-01

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 preferred to listen to a novel folk song, indicating that they remembered the familiarized melody. However, if the tempo (25% faster or slower) or instrument timbre (harp vs. piano) of the familiarized melody was changed at test, infants showed no preference, indicating that they remembered the specific tempo and timbre of the melodies. The results are consistent with an exemplar-based model of memory in infancy rather than one in which structural features are extracted and performance features forgotten.

Acompanhamento da icterícia neonatal em recém-nascidos de termo e prematuros tardios Follow-up of neonatal jaundice in term and late premature newborns

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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.

Alpha-lactalbumin and casein-glycomacropeptide do not affect iron absorption from formula in healthy term infants

Science.gov (United States)

Iron absorption from infant formula is relatively low. Alpha-lactalbumin and casein-glycomacropeptide have been suggested to enhance mineral absorption. We therefore assessed the effect of alpha-lactalbumin and casein-glycomacropeptide on iron absorption from infant formula in healthy term infants. ...

Term-equivalent functional brain maturational measures predict neurodevelopmental outcomes in premature infants.

Science.gov (United States)

El Ters, Nathalie M; Vesoulis, Zachary A; Liao, Steve M; Smyser, Christopher D; Mathur, Amit M

2018-04-01

Term equivalent age (TEA) brain MRI identifies preterm infants at risk for adverse neurodevelopmental outcomes. But some infants may experience neurodevelopmental impairments even in the absence of neuroimaging abnormalities. Evaluate the association of TEA amplitude-integrated EEG (aEEG) measures with neurodevelopmental outcomes at 24-36 months corrected age. We performed aEEG recordings and brain MRI at TEA (mean post-menstrual age of 39 (±2) weeks in a cohort of 60 preterm infants born at a mean gestational age of 26 (±2) weeks. Forty-four infants underwent Bayley Scales of Infant Development, 3rd Edition (BSID-III) testing at 24-36 months corrected age. Developmental delay was defined by a score greater than one standard deviation below the mean (neurodevelopmental outcomes was assessed using odds ratio, then adjusted for confounding variables using logistic regression. Infants with developmental delay in any domain had significantly lower values of SEF 90 . Absent cyclicity was more prevalent in infants with cognitive and motor delay. Both left and right SEF 90  neurodevelopmental outcomes. Therefore, a larger study is needed to validate these results in premature infants at low and high risk of brain injury. Copyright © 2018. Published by Elsevier B.V.

Effects of stress and social support on mothers and premature and full-term infants.

Science.gov (United States)

Crnic, K A; Greenberg, M T; Ragozin, A S; Robinson, N M; Basham, R B

1983-02-01

This study examined the relationships of stress and social support to maternal attitudes and early mother-infant interactive behavior. 52 mother-premature infant pairs and 53 mother-full-term infant pairs were seen for structured home interviews at 1 month, and behavioral interactions at 4 months. Maternal life stress, social support, life satisfaction, and satisfaction with parenting were assessed at the 1-month home visit. Although no group differences were found, both stress and support significantly predicted maternal attitudes at 1 month and interactive behavior at 4 months when data were pooled. Mothers with greater stress were less positive in their attitudes and behavior, while mothers with greater support were significantly more positive. Intimate support proved to have the most general positive effects. Additionally, social support moderated the adverse effects of stress on mother's life satisfaction and on several behavioral variables. Maternal social support was further found to have several significant effects on infant interactive behavior. Results are discussed in terms of the ecological significance of social support to parenting and infants' early development.

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

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Kerstin Pannek

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

Conditioning and Long-Term Memory in Three-Month-Old Infants with Down Syndrome.

Science.gov (United States)

Ohr, Phyllis, S.; Fagen, Jeffrey W.

1991-01-01

This study of 20 3-month-old infants with Down's syndrome and 20 nondisabled infants found that both groups were successfully trained to produce movement in an overhead crib mobile by kicking, and displayed long-term retention a week later. Conditioning and retention-test performance of the two groups did not differ. (Author/JDD)

Differences between late preterm and full-term infants: comparing effects of a short bout of practice on early reaching behavior.

Science.gov (United States)

de Almeida Soares, Daniele; Cunha, Andréa Baraldi; Tudella, Eloisa

2014-11-01

This study compared the effects of a short bout of practice on reaching behavior between late preterm and full-term infants at the onset of goal-directed reaching. Twelve late preterm infants and twelve full-term infants received reaching practice based on a serial schedule. Late preterm and full-term infants were assessed in 3.3±1.4 and 2.6±1.0 days after the onset of goal-directed reaching in two measures in a single day: immediately before practice (pre-test) and immediately after practice (post-test). During the assessments, the infants were placed in a baby chair and a rubber toy was presented at their midline within reaching distance for 2 min. Between assessments, the infants received practice of toy-oriented reaching in 3 activities repeated for approximately 4 min. The activities were elicited in a pre-established serial sequence and were applied by a physical therapist. During the pre-test, late preterm infants presented lower range of proximal adjustments, greater proportion of reaches with semi-open hand, and greater proportion of reaches without grasping than the full-term infants. During the post-test, late preterm infants presented greater motor variability of proximal adjustments, but explored and selected distal control and grasping outcomes less compared to the full-term group. Differences in reaching and gross motor behavior between late preterm and full-term infants can be found at the age of reaching onset. Practice provided new opportunities for late preterm infants to improve perception-action coupling to reach; however, relative to full-terms, they seemed less advanced in benefiting from the experience for more refined manual tasks. Copyright © 2014 Elsevier Ltd. All rights reserved.

Infants' long-term memory for the sound patterns of words and voices.

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Houston, Derek M; Jusczyk, Peter W

2003-12-01

Infants' long-term memory for the phonological patterns of words versus the indexical properties of talkers' voices was examined in 3 experiments using the Headturn Preference Procedure (D. G. Kemler Nelson et al., 1995). Infants were familiarized with repetitions of 2 words and tested on the next day for their orientation times to 4 passages--2 of which included the familiarized words. At 7.5 months of age, infants oriented longer to passages containing familiarized words when these were produced by the original talker. At 7.5 and 10.5 months of age, infants did not recognize words in passages produced by a novel female talker. In contrast, 7.5-month-olds demonstrated word recognition in both talker conditions when presented with passages produced by both the original and the novel talker. The findings suggest that talker-specific information can prime infants' memory for words and facilitate word recognition across talkers. ((c) 2003 APA, all rights reserved)

Mothers of Pre-Term Infants in Neonate Intensive Care

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MacDonald, Margaret

2007-01-01

In this study, eight mothers of pre-term infants under the care of nursing staff and neonatologists in the Neonatal Intensive Care Unit (NICU) of Children's Hospital in Vancouver, British Columbia, were observed and interviewed about their birth experience and their images of themselves as mothers during their stay. Patterns and themes in the…

Evolving Understanding of Hypoxic-Ischemic Encephalopathy in the Term Infant

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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

Anxiety, Post-Traumatic Stress Disorder and Social Supports Among Parents of Premature and Full-Term Infants

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Ghorbani, Maryam; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid

2014-01-01

Background: Premature birth is one of the most important unresolved reproductive health problems. Premature birth is often traumatic and a source of distress for parents. Increased parental stress during the first year of their infant's life is a risk factor for later behavioral problems in infants. Objectives: This study was designed to compare anxiety, post-traumatic stress, and social supports in parents of premature and mature infants. Patients and Methods: This was a comparative descriptive study conducted at healthcare centers of Qom city, in 2012. In this study, 82 couples (164 parents) divided into two groups including parents who have preterm and term infants. Questionnaires including items such as demographic characteristics, obstetric and post-traumatic stress disorders, Spielberger anxiety and Multidimensional Scale of Perceived Social Support were completed two months after childbirth. Data were analyzed using χ2 test, Fisher’s exact test, Mann-Whitney test, independent t-test, and regression logistic using SPSS18 software. Results: The levels of anxiety was not significantly different in mothers and fathers in the two groups, but the trait anxiety level of mothers (P Post-traumatic stress disorder was significantly greater in mothers of preterm infants than those of term infants (P = 0.03), but this amount was not significantly different between the two groups of fathers. Mothers' social support did not differ significantly (P = 0.08), however, it was significantly different in fathers (P = 0.01). Conclusions: Premature infants' parents are more at risk of mental disorders than term infants' parents. This result shows the need of interventions, so these parents can better deal with the problems of premature infants. PMID:24829766

The temperament of pre-term, low birth weight infants and its potential biological substrates.

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Weiss, Sandra J; Jonn-Seed, Mary St; Wilson, Peggy

2004-12-01

Temperament profiles of pre-term, low birth weight (LBW) infants were assessed at 6 months of age using standardized norms from the Revised Infant Temperament Questionnaire (RITQ). The contributions of perinatal risk, ethnicity, and gender to various temperament dimensions were examined. The sample included 152 infants with a mean birth weight of 1687 g and a mean gestational age of 31 weeks. Eighty percent of the infants were classified as having temperaments that were difficult to manage. Irregularity of the infants' biorhythms, slowness in their ability to adapt to changes, and distractibility were the most problematic. Birth weight, gestational age, and gender were not associated with temperament. Perinatal morbidity was related to the temperament dimension of infant persistence, with implications for the infant's attention span and task performance. Euro American infants were rated as more persistent and less intense in emotional expression than were infants of other ethnic groups. Results suggest the need for a more direct assessment of the effects of neurobiological processes on development of temperament phenotypes and for measurement of temperament that is socioculturally appropriate.

Latent iron deficiency at birth influences auditory neural maturation in late preterm and term infants.

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Choudhury, Vivek; Amin, Sanjiv B; Agarwal, Asha; Srivastava, L M; Soni, Arun; Saluja, Satish

2015-11-01

In utero latent iron deficiency has been associated with abnormal neurodevelopmental outcomes during childhood. Its concomitant effect on auditory neural maturation has not been well studied in late preterm and term infants. The objective was to determine whether in utero iron status is associated with auditory neural maturation in late preterm and term infants. This prospective cohort study was performed at Sir Ganga Ram Hospital, New Delhi, India. Infants with a gestational age ≥34 wk were eligible unless they met the exclusion criteria: craniofacial anomalies, chromosomal disorders, hemolytic disease, multiple gestation, third-trimester maternal infection, chorioamnionitis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex virus infections (TORCH), Apgar score 75 ng/mL) at birth. Twenty-three infants had latent iron deficiency. Infants with latent iron deficiency had significantly prolonged wave V latencies (7.10 ± 0.68 compared with 6.60 ± 0.66), III-V interpeak latencies (2.37 ± 0.64 compared with 2.07 ± 0.33), and I-V interpeak latencies (5.10 ± 0.57 compared with 4.72 ± 0.56) compared with infants with normal iron status (P neural maturation in infants at ≥34 wk gestational age. This trial was registered at clinicaltrials.gov as NCT02503397. © 2015 American Society for Nutrition.

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

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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

Delivery room continuous positive airway pressure and early pneumothorax in term newborn infants.

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Clevenger, L; Britton, J R

2017-01-01

To assess the association between delivery room (DR) continuous positive airway pressure (CPAP) and pneumothorax (PT) in term newborns. Two studies performed in community hospitals used data extracted from computerized records of term newborns. Infants receiving positive pressure ventilation in the DR were excluded. Tabulated data included receipt of DR CPAP, PT on the day of birth, and gestational age (GA). In a case-control study from 2001-2013, infants with PT were compared to controls without PT but with respiratory distress or hypoxia persisting from birth for receipt of DR CPAP. In a cohort study from 2014-2016, infants receiving and not receiving DR CPAP were compared for the incidence of PT. In the case-control study, data were obtained for 169 cases and 850 controls. Compared to controls, PT infants were more likely to have received DR CPAP (16.8% vs. 40.2%, respectively, P CPAP (Adjusted Odds Ratio [AOR] = 3.30, 95% confidence interval [CI] = 2.31, 4.72, P CPAP and 4.8% of 228 infants receiving DR CPAP (P CPAP significantly predicted PT (OR = 59.59, 95% CI = 23.34, 147.12, P CPAP in delivery rooms are associated with increased risk of PT. A cause-and-effect relationship between CPAP and PT cannot be claimed in this study. Further research is needed to better understand this relationship.

Posterior fossa abnormalities in high-risk term infants: comparison of ultrasound and MRI

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Steggerda, S.J.; Smits-Wintjens, V.E.H.J.; Verbon, P.; Walther, F.J. [Leiden University Medical Centre, Department of Neonatology, Leiden (Netherlands); Bruine, F.T. de [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Wezel-Meijler, G. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Isala Hospital, Department of Neonatology, Zwolle (Netherlands)

2015-09-15

We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. (orig.)

Posterior fossa abnormalities in high-risk term infants: comparison of ultrasound and MRI

International Nuclear Information System (INIS)

Steggerda, S.J.; Smits-Wintjens, V.E.H.J.; Verbon, P.; Walther, F.J.; Bruine, F.T. de; Wezel-Meijler, G. van

2015-01-01

We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. (orig.)

Four-month-old infants' long-term memory for a stressful social event.

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Rosario Montirosso

Full Text Available Infants clearly show an early capacity for memory for inanimate emotionally neutral events. However, their memory for social stress events has received far less attention. The aim of the study was to investigate infants' memory for a stressful social event (i.e., maternal unresponsiveness during the Still-Face paradigm after a 15-day recall interval using changes in behavioral responses and salivary post-stress cortisol reactivity as measures of memory. Thirty-seven infants were exposed to social stress two times (experimental condition; the first time when they were 4 months of age and second exposure after a 2 week interval. Infants in the control condition (N = 37 were exposed to social stress just one time, at the age corresponding to the second exposure for infants in the experimental condition (4 months plus 2 weeks. Given individual differences in infants' reactivity to social stress events, we categorized infants as increasers or decreasers based on their cortisol reactivity after their initial exposure to the stress of the maternal still-face. Infants in the experimental condition, both increasers and decreasers, showed a significant change in cortisol response after the second exposure to the maternal still-face, though change was different for each reactivity group. In contrast, age-matched infants with no prior exposure to the maternal still-face showed similar post-stress cortisol reactivity to the reactivity of the experimental infants at their first exposure. There were no behavioral differences between increasers and decreasers during the Still-Face paradigm and exposures to the social stress. Thus differences between the experimental and control groups' post-stress cortisol reactivity was associated with the experimental group having previous experience with the social stress. These findings indicate long-term memory for social stress in infants as young as 4 months of age.

Four-month-old infants' long-term memory for a stressful social event.

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Montirosso, Rosario; Tronick, Ed; Morandi, Francesco; Ciceri, Francesca; Borgatti, Renato

2013-01-01

Infants clearly show an early capacity for memory for inanimate emotionally neutral events. However, their memory for social stress events has received far less attention. The aim of the study was to investigate infants' memory for a stressful social event (i.e., maternal unresponsiveness during the Still-Face paradigm) after a 15-day recall interval using changes in behavioral responses and salivary post-stress cortisol reactivity as measures of memory. Thirty-seven infants were exposed to social stress two times (experimental condition); the first time when they were 4 months of age and second exposure after a 2 week interval. Infants in the control condition (N = 37) were exposed to social stress just one time, at the age corresponding to the second exposure for infants in the experimental condition (4 months plus 2 weeks). Given individual differences in infants' reactivity to social stress events, we categorized infants as increasers or decreasers based on their cortisol reactivity after their initial exposure to the stress of the maternal still-face. Infants in the experimental condition, both increasers and decreasers, showed a significant change in cortisol response after the second exposure to the maternal still-face, though change was different for each reactivity group. In contrast, age-matched infants with no prior exposure to the maternal still-face showed similar post-stress cortisol reactivity to the reactivity of the experimental infants at their first exposure. There were no behavioral differences between increasers and decreasers during the Still-Face paradigm and exposures to the social stress. Thus differences between the experimental and control groups' post-stress cortisol reactivity was associated with the experimental group having previous experience with the social stress. These findings indicate long-term memory for social stress in infants as young as 4 months of age.

Nocturnal oxygen saturation profiles of healthy term infants.

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Terrill, Philip Ian; Dakin, Carolyn; Hughes, Ian; Yuill, Maggie; Parsley, Chloe

2015-01-01

Pulse oximetry is used extensively in hospital and home settings to measure arterial oxygen saturation (SpO2). Interpretation of the trend and range of SpO2 values observed in infants is currently limited by a lack of reference ranges using current devices, and may be augmented by development of cumulative frequency (CF) reference-curves. This study aims to provide reference oxygen saturation values from a prospective longitudinal cohort of healthy infants. Prospective longitudinal cohort study. Sleep-laboratory. 34 healthy term infants were enrolled, and studied at 2 weeks, 3, 6, 12 and 24 months of age (N=30, 25, 27, 26, 20, respectively). Full overnight polysomnography, including 2 s averaging pulse oximetry (Masimo Radical). Summary SpO2 statistics (mean, median, 5th and 10th percentiles) and SpO2 CF plots were calculated for each recording. CF reference-curves were then generated for each study age. Analyses were repeated with sleep-state stratifications and inclusion of manual artefact removal. Median nocturnal SpO2 values ranged between 98% and 99% over the first 2 years of life and the CF reference-curves shift right by 1% between 2 weeks and 3 months. CF reference-curves did not change with manual artefact removal during sleep and did not vary between rapid eye movement (REM) and non-REM sleep. Manual artefact removal did significantly change summary statistics and CF reference-curves during wake. SpO2 CF curves provide an intuitive visual tool for evaluating whether an individual's nocturnal SpO2 distribution falls within the range of healthy age-matched infants, thereby complementing summary statistics in the interpretation of extended oximetry recordings in infants. 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.

Does docosahexaenoic acid supplementation in term infants enhance neurocognitive functioning in infancy?

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Heaton, Alexandra E; Meldrum, Suzanne J; Foster, Jonathan K; Prescott, Susan L; Simmer, Karen

2013-11-20

The proposal that dietary docosahexaenoic acid (DHA) enhances neurocognitive functioning in term infants is controversial. Theoretical evidence, laboratory research and human epidemiological studies have convincingly demonstrated that DHA deficiency can negatively impact neurocognitive development. However, the results from randomized controlled trials (RCTs) of DHA supplementation in human term-born infants have been inconsistent. This article will (i) discuss the role of DHA in the human diet, (ii) explore the physiological mechanisms by which DHA plausibly influences neurocognitive capacity, and (iii) seek to characterize the optimal intake of DHA during infancy for neurocognitive functioning, based on existing research that has been undertaken in developed countries (specifically, within Australia). The major observational studies and RCTs that have examined dietary DHA in human infants and animals are presented, and we consider suggestions that DHA requirements vary across individuals according to genetic profile. It is important that the current evidence concerning DHA supplementation is carefully evaluated so that appropriate recommendations can be made and future directions of research can be strategically planned.

Does docosahexaenoic acid supplementation in term infants enhance neurocognitive functioning in infancy?

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Alexandra Elizabeth Heaton

2013-11-01

Full Text Available The proposal that dietary docosahexaenoic acid (DHA enhances neurocognitive functioning in term infants is controversial. Theoretical evidence, laboratory research and human epidemiological studies have convincingly demonstrated that DHA deficiency can negatively impact neurocognitive development. However, the results from randomized controlled trials (RCTs of DHA supplementation in human term-born infants have been inconsistent. This article will i discuss the role of DHA in the human diet, ii explore the physiological mechanisms by which DHA plausibly influences neurocognitive capacity and iii seek to characterize the optimal intake of DHA during infancy for neurocognitive functioning, based on existing research that has been undertaken in developed countries (specifically, within Australia. The major observational studies and RCTs that have examined dietary DHA in human infants and animals are presented, and we consider suggestions that DHA requirements vary across individuals according to genetic profile. It is important that the current evidence concerning DHA supplementation is carefully evaluated so that appropriate recommendations can be made and future directions of research can be strategically planned.

Readmission of Preterm Infants Less Than 32 Weeks Gestation Into Early Childhood

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Ralser Elisabeth MD

2014-09-01

Full Text Available The aim of the study was to investigate the frequency of and the predictors for rehospitalization in preterm infants into early childhood, focusing on gender differences. All preterm infants born at <32 weeks of gestation in North Tyrol between January 2003 and December 2005 were enrolled in this survey. About one fifth of all children were readmitted, showing an inverse downward trend with increasing age. The most common reason for readmission in the third (36.5% and fourth (42.9% years of life was respiratory infection, but changed to miscellaneous surgeries in the fifth (52.1%. Male sex showed significantly higher readmission rates and more miscellaneous surgeries. Additionally, male sex and chronic lung disease were risk conditions for rehospitalization in the multivariate analysis. Readmission rates and respiratory infections in preterm-born children showed an inverse downward trend with increasing age. In early childhood, gender difference still plays a role with regard to rehospitalization.

Fetal/Placental weight ratio in term Japanese pregnancy: its difference among gender, parity, and infant growth.

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Matsuda, Yoshio; Ogawa, Masaki; Nakai, Akihito; Hayashi, Masako; Satoh, Shoji; Matsubara, Shigeki

2015-01-01

The "inappropriately heavy placenta" has been considered to be associated with various pregnancy disorders; however, data is scarce what factors affect it. To determine whether the following three affect it; (1) infant gender and mother's parity, (2) growth restriction, and (3) preeclampsia. We employed fetal/placental weight ratio (F/P). Subjects consisted of 53,650 infants and their placentas from women who vaginally delivered singleton live term infants. First, we examined whether F/P differs among the infant's gender or mother's parity. We classified the population into 4 categories according to gender and parity: male, nulliparous (n=7,431), male, multiparous (n=7,859), female, nulliparous (n=7,559), female, multiparous (n=7,800), and, compared F/P among the four groups. Next, we determined whether F/P differs in "small" or "large" for gestational age (SGA or LGA) infants, compared with appropriate for gestational age infants. Last, we determined whether preeclampsia (representative disorder of SGA) affects F/P. (1) F/P significantly differed according to infant gender and parity: female and nulliparity had significantly smaller F/P. F/P was significantly smaller in (2) SGA infants, and (3) infants from preeclamptic mothers. We for the first time showed that in Japanese term vaginally-delivered singleton population, the following three had significantly smaller F/P than controls thus had "inappropriately heavy placenta": (1) female gender and nulliparity, (2) SGA infants, and (3) infants from preeclamptic mothers. We recommend that these factors should be taken into account in evaluating placental weight. These data may also be useful for further clarifying the fetal-placental pathophysiology in these conditions.

Longitudinal associations between maternal disrupted representations, maternal interactive behavior and infant attachment: a comparison between full-term and preterm dyads.

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

2015-04-01

This prospective study examined whether or not a mother's representations of her infant were more often disrupted after premature childbirth. Furthermore, the study examined if different components of maternal interactive behavior mediated the relation between maternal disrupted representations and infant attachment. The participants were mothers of full-term (n = 75), moderately preterm (n = 68) and very preterm infants (n = 67). Maternal representations were assessed by the Working Model of the Child Interview at 6 months post-partum. Maternal interactive behavior was evaluated at 6 and 24 months post-partum, using the National Institute of Child Health and Human Development Early Care Research Network mother-infant observation scales. Infant attachment was observed at 24 months post-partum and was coded by the Attachment Q-Set. The results reveal that a premature childbirth does not necessarily generate disrupted maternal representations of the infant. Furthermore, maternal interactive behavior appears to be an important mechanism through which maternal representations influence the development of infant attachment in full-term and preterm infants. Early assessment of maternal representations can identify mother-infant dyads at risk, in full-term and preterm samples.

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

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Ivars, Katrin; Nelson, Nina; Theodorsson, Annette; Theodorsson, Elvar; Ström, Jakob O; Mörelius, Evalotte

2015-01-01

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.

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

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

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

The Groningen LCPUFA Study : No Effect of Short-Term Postnatal Long-Chain Polyunsaturated Fatty Acids in Healthy Term Infants on Cardiovascular and Anthropometric Development at 9 Years

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de Jong, Corina; Boehm, Gunther; Kikkert, Hedwig K.; Hadders-Algra, Mijna

2011-01-01

Conflicting evidence exists on the effect of long-chain polyunsaturated fatty acid (LCPUFA) formula supplementation on cardiovascular health in term infants. It is known that LCPUFA supplementation does not affect infant growth, but long term outcome data are not available. The current study

Apnea in the term infant.

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Patrinos, Mary Elaine; Martin, Richard J

2017-08-01

Whereas apnea of prematurity has been well defined and its pathophysiology extensively studied, apnea in the term infant remains a greater challenge. Unfortunately, clear diagnostic criteria are lacking and pathogenesis and management vary widely. In this review we have arbitrarily organized the discussion chronologically into earlier and later postnatal periods. In the first days of life, presumed apnea may reflect physiologic events such as positional or feeding etiologies, or may be a manifestation of serious pathophysiology, such as a seizure disorder. Beyond the neonatal period, presumed apnea may be characterized as a BRUE event (brief resolved unexplained event; formerly referred to as ALTE: apparent life-threatening event) and most frequently a precipitating event cannot be identified. Medical providers are left with somewhat of a dilemma regarding the need to hospitalize and/or work up such patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

S100B Protein concentration in milk-formulas for preterm and term infants. Correlation with industrial preparation procedures.

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Nigro, Francesco; Gagliardi, Luigi; Ciotti, Sabina; Galvano, Fabio; Pietri, Amedeo; Tina, Gabriella Lucia; Cavallaro, Daniela; La Fauci, Luca; Iacopino, Leonardo; Bognanno, Matteo; Li Volti, Giovanni; Scacco, Antonio; Michetti, Fabrizio; Gazzolo, Diego

2008-05-01

Human milk S100B protein possesses important neurotrophic properties. However, in some conditions human milk is substituted by milk formulas. The aims of the present study were: to assess S100B concentrations in milk formulas, to verify any differences in S100B levels between preterm and term infant formulas and to evaluate the impact of industrial preparation at predetermined phases on S100B content. Two different set of samples were tested: (i) commercial preterm (n = 36) and term (n = 36) infant milk formulas; ii) milk preterm (n = 10) and term infant (n = 10) formulas sampled at the following predetermined industrial preparation time points: skimmed cow milk (Time 0); after protein sources supplementation (Time 1); after pasteurization (Time 2); after spray-drying (Time 3). Our results showed that S100B concentration in preterm formulas were higher than in term ones (p 0.05) at Time 2, whereas a significant (p pasteurization but not spry-drying. New feeding strategies in preterm and term infants are therefore warranted in order to preserve S100B protein during industrial preparation.

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

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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…

The difference in the appearance of proximal humeral epiphyseal ossification center on chest radiograph between the preterm and full-term infants

International Nuclear Information System (INIS)

Park, Hee Hong; Kim, Seung Cheol; Chang, Young Pyo; Park, Jin Young; Kwon, Ho Jang; Lee, Jee Young; Yoo, Dong Soo; Kim, You Me; Jeong, Chun Keun; Lee, Young Seok

1997-01-01

To assess the difference in the appearance of the proximal humeral epiphyseal ossification center, as seen on chest radiograph, between preterm and full-term infants at the same corrected ages. Forty two preterm infants born at 26--35 weeks of gestational age and 218 normal full-term infants born at 38-42 weeks were investigated. Because of various perinatal problems, the preterm infants were treated at a neonatal intensive care unit. Proximal humeral epiphyseal ossification centers were evaluated from chest radiographs, and in cases of preterm infants, the corrected age of 0 month was defined as postconceptional 40 weeks. In preterm infants, the numbers of chest radiographs obtained were 42 at 0 month, 40 at 1 month, 37 at 2 months and 36 at 3 months of corrected age, while in those who were full-term, the numbers were 103 cases at 0 month, 42 at 1 month, 42 at 2 months and 31 at 3 months of age In the preterm group, alkaline phosphatase, calcium, phosphorus levels and simple wrist radiographs were checked. We then evaluated the difference of appearance of the proximal humeral epiphyseal ossification center between preterm and full-term infants at the same corrected ages, as well as the difference between causative diseases, between the normal and abnormal serologic group and between the normal and abnormal wrist group in preterm infants at the same corrected ages. Using Fisher's exact test, the data were analysed. The incidences of the proximal humeral epiphyseal ossification center in preterm infants were 2.4% (1/42) at 0 month, 20.0% (8/40) at 1 month, 43.2% (16/37) at 2 months and 69.4%(25/36) at 3 months; in full-term infants, the figures were 24.3% (25/103) at 0 month, 66.7%(28/42) at 1 month, 83.3% (35/42) at 2 months and 90.3% (28/31) at 3 months. At 0, 1, and 2 months, the incidences were thus seen to be lower in preterm than in full-term infants(p 0.05). In preterm infants, there were no statistical differences between causative diseases, between the

Supplementation of milk formula with galacto-oligosaccharides improves intestinal micro-flora and fermentation in term infants.

Science.gov (United States)

Ben, Xiao-ming; Zhou, Xiao-yu; Zhao, Wei-hua; Yu, Wen-liang; Pan, Wei; Zhang, Wei-li; Wu, Sheng-mei; Van Beusekom, Christien M; Schaafsma, Anne

2004-06-01

Oligosaccharides in human milk may protect infants by improving the intestinal micro-flora and fermentation. This study was to investigate effects of infant formula milk consisting of galacto-oligosaccharide (GOS) on intestinal microbial populations and the fermentation characteristics in term infants in comparison with that of human milk. The test formula (Frisolac H, Friesland, Netherland) was supplemented with GOS at a concentration of 0.24 g/dl. Human milk and another formula without oligosaccharides (Frisolac H, Friesland, Netherland) were used as positive and negative control respectively. Growth, stool characteristics, and side effects of the recruited infants were recorded after 3 and 6 months' follow-up, and the fecal species were collected for the analysis of intestinal micro-flora, short chain fatty acid (SCFA) and pH. At the end of 3- and 6-month feeding period, intestinal Bifidobacteria and Lactobacilli were significantly increased in infants fed with GOS supplemented formula and human milk when compared with infants fed with negative control formula; however, there was no statistically significant difference between GOS supplemented formula and human milk groups. Stool characteristics were influenced by the supplement and main fecal SCFA (acetic), and stool frequency were significantly increased in infants fed with GOS supplemented formula and human milk, while the fecal pH was significantly decreased as compared with that of negative control (P effects (including crying, regurgitation and vomiting). Supplementing infant formula with GOS at a concentration of 0.24 g/dl stimulates the growth of Bifidobacteria and Lactobacilli in the intestine and stool characteristics are similar to in term infants fed with human milk.

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

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

The Efficiency of Infants' Exploratory Play Is Related to Longer-Term Cognitive Development

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Muentener, Paul; Herrig, Elise; Schulz, Laura

2018-01-01

In this longitudinal study we examined the stability of exploratory play in infancy and its relation to cognitive development in early childhood. We assessed infants' (N = 130, mean age at enrollment = 12.02 months, SD = 3.5 months; range: 5–19 months) exploratory play four times over 9 months. Exploratory play was indexed by infants' attention to novelty, inductive generalizations, efficiency of exploration, face preferences, and imitative learning. We assessed cognitive development at the fourth visit for the full sample, and again at age three for a subset of the sample (n = 38). The only measure that was stable over infancy was the efficiency of exploration. Additionally, infants' efficiency score predicted vocabulary size and distinguished at-risk infants recruited from early intervention sites from those not at risk. Follow-up analyses at age three provided additional evidence for the importance of the efficiency measure: more efficient exploration was correlated with higher IQ scores. These results suggest that the efficiency of infants' exploratory play can be informative about longer-term cognitive development. PMID:29904360

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

Science.gov (United States)

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

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

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

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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.

Follow-up into young adulthood after cardiopulmonary resuscitation in term and near-term newborn infants. II. Neuropsychological consequences.

Science.gov (United States)

Viggedal, G; Lundälv, E; Carlsson, G; Kjellmer, I

2002-01-01

Brain injury after neonatal cardiopulmonary resuscitation in the term baby is often described as an all-or-nothing phenomenon, but little is known about possible late cognitive consequences. The aim of this study was therefore to investigate whether children who needed cardiopulmonary resuscitation because of presumed mild and moderate intra-partum asphyxia with no evidence of neurological impairments at 18 mo of age may display neuropsychological impairments later in life. A long-term follow-up of young adults was carried out. A blinded comprehensive neuropsychological assessment of the main aspects of cognitive functions was made. The subjects who were resuscitated were divided into two groups according to the clinical course: 20 cases with mild asphyxia and 11 cases with moderate asphyxia, all followed prospectively and compared with 18 healthy controls. The 31 subjects were born at term or near-term and selected randomly from 59 infants born in 1969-1978 at Sahlgren's Hospital, Göteborg. All infants with early neurological impairments were excluded. No major differences could be established between the two clinical groups and normal controls in any aspects of cognitive function or intelligence. All the groups performed within the normal range in all tests. A tendency toward minor deficits in verbal ability in the mild group compared to the controls was found. Only one subject had a clear, defined memory deficit. Infants who underwent cardiopulmonary resuscitatation at birth without neurological deficits at 18 mo of age did not show any cognitive deficits or neuropsychological impairments in adulthood even though inferior performance on some verbal subtests was observed compared to the control group.

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…

Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy

Directory of Open Access Journals (Sweden)

Ratna B Basak

2011-01-01

Full Text Available A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.

Very preterm/very low birthweight infants' attachment: infant and maternal characteristics.

Science.gov (United States)

Wolke, Dieter; Eryigit-Madzwamuse, Suna; Gutbrod, Tina

2014-01-01

To investigate whether there are differences in attachment security and disorganisation between very preterm or very low birthweight (VP/VLBW) (infants (37-42 weeks gestation) and whether the pathways to disorganised attachment differ between VP/VLBW and full-term infants. The sample with complete longitudinal data consisted of 71 VP/VLBW and 105 full-term children and their mothers matched for twin status, maternal age, income and maternal education. Infant attachment was assessed with the Strange Situation Assessment at 18 months of age. Maternal sensitivity in the VP/VLBW and full-term samples was rated by neonatal nurses and community midwives in the neonatal period, respectively, and mother-infant interaction was observed at 3 months. Infant difficultness was assessed by maternal report at 3 months and infant's developmental status was assessed with the Bayley Scales (BSID-II). Most VP/VLBW (61%) and full-term (72%) children were found to be securely attached. However, more VP/VLBW (32%) than full-term children (17%) had disorganised attachment. Longitudinal path analysis found that maternal sensitivity was predictive of attachment disorganisation in full-term children. In contrast, infant's distressing cry and infant's developmental delay, but not maternal sensitivity, were predictive of disorganised attachment in VP/VLBW children. A third of VP/VLBW children showed disorganised attachment. Underlying neurodevelopmental problems associated with VP/VLBW birth appear to be a common pathway to a range of social relationship problems in this group. Clinicians should be aware that disorganised attachment and relationship problems in VP/VLBW infants are frequent despite sensitive parenting.

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

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

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

2016-04-01

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

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.

The structure of memory in infants and toddlers: an SEM study with full-terms and preterms.

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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, 2, and 3 years--on a battery containing tasks of immediate and delayed recognition, recall, and memory span (a measure of short-term capacity). Results were in accord with adult models which assume that short- and long-term memory are distinct, and that two processes--familiarity and recollection--underlie recognition memory, while one alone--recollection--supports recall. The finding that prematurity, which entails risk of hippocampal compromise, affected recollection, but not familiarity, accords well with adult findings that hippocampal damage selectively affects recollection. These findings reveal striking similarity between the structure and theoretical underpinnings of infant and adult memory. © 2010 Blackwell Publishing Ltd.

Precursors of social emotional functioning among full-term and preterm infants at 12 months: Early infant withdrawal behavior and symptoms of maternal depression.

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Moe, Vibeke; Braarud, Hanne Cecilie; Wentzel-Larsen, Tore; Slinning, Kari; Vannebo, Unni Tranaas; Guedeney, Antoine; Heimann, Mikael; Rostad, Anne Margrethe; Smith, Lars

2016-08-01

This study forms part of a longitudinal investigation of early infant social withdrawal, maternal symptoms of depression and later child social emotional functioning. The sample consisted of a group of full-term infants (N=238) and their mothers, and a group of moderately premature infants (N=64) and their mothers. At 3 months, the infants were observed with the Alarm Distress Baby Scale (ADBB) and the mothers completed the Edinburgh Postnatal Depression Scale (EPDS). At 12 months, the mothers filled out questionnaires about the infants' social emotional functioning (Infant Toddler Social Emotional Assessment and the Ages and Stages Questionnaire-Social Emotional). At 3 months, as we have previously shown, the premature infants had exhibited more withdrawal behavior and their mothers reported elevated maternal depressive symptoms as compared with the full-born group. At 12 months the mothers of the premature infants reported more child internalizing behavior. These data suggest that infant withdrawal behavior as well as maternal depressive mood may serve as sensitive indices of early risk status. Further, the results suggest that early maternal depressive symptoms are a salient predictor of later child social emotional functioning. However, neither early infant withdrawal behavior, nor gestational age, did significantly predict social emotional outcome at 12 months. It should be noted that the differences in strength of the relations between ADBB and EPDS, respectively, to the outcome at 12 months was modest. An implication of the study is that clinicians should be aware of the complex interplay between early infant withdrawal and signs of maternal postpartum depression in planning ports of entry for early intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

Fractured long bones in a term infant delivered by cesarian section

International Nuclear Information System (INIS)

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

1987-01-01

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. (orig.)

The patent ductus arteriosus in term infants, children, and adults.

Science.gov (United States)

Schneider, Douglas J

2012-04-01

During fetal life, the ductus arteriosus is a normal and essential structure that connects the pulmonary artery to the distal aortic arch, permitting right ventricular ejection into the aorta. After birth, with commencement of pulmonary blood flow and a 2-ventricle circulation, a variety of physiological and biochemical signals normally result in complete closure of the ductus. Persistent patency of the ductus arteriosus may impair systemic cardiac output and result in deleterious effects on the cardiovascular system and lungs. Although surgery is still the treatment of choice for most premature infants with patent ductus arteriosus (PDA), transcatheter techniques have largely supplanted surgery for closure of PDA in children and adults. This article is a review of the PDA in term infants, children, and adults, with focus on the clinical manifestations and management. Copyright © 2012 Elsevier Inc. All rights reserved.

Normal Cerebellar Growth by Using Three-dimensional US in the Preterm Infant from Birth to Term-corrected Age.

Science.gov (United States)

Benavente-Fernández, Isabel; Rodríguez-Zafra, Enrique; León-Martínez, Jesús; Jiménez-Gómez, Gema; Ruiz-González, Estefanía; Fernández-Colina, Rosalía Campuzano; Lechuga-Sancho, Alfonso M; Lubián-López, Simón P

2018-04-03

Purpose To establish cross-sectional and longitudinal reference values for cerebellar size in preterm infants with normal neuroimaging findings and normal 2-year neurodevelopmental outcome by using cranial ultrasonography (US). Materials and Methods This prospective study consecutively enrolled preterm infants admitted to a neonatal intensive care unit from June 2011 to June 2014 with a birth weight of less than or equal to 1500 g and/or gestational age (GA) of less than or equal to 32 weeks. They underwent weekly cranial US from birth to term-equivalent age and magnetic resonance (MR) imaging at term-equivalent age. The infants underwent neurodevelopmental assessments at age 2 years with Bayley Scales of Infant and Toddler Development, 3rd edition (BSID-III). Patients with adverse outcomes (death or abnormal neuroimaging findings and/or BSID-III score of growth in preterm infants, which may be included in routine cranial US. © RSNA, 2018 Online supplemental material is available for this article.

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

OpenAIRE

Coret, Catherine D; Suero, Michael B; Tierney, Neena K

2014-01-01

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...

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

Science.gov (United States)

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

2013-03-01

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

Long-Term Neurodevelopmental Outcomes of Premature Infants in Singapore.

Science.gov (United States)

Teo, Charmaine M; Poon, Woei Bing; Ho, Selina Ky

2018-02-01

Neonatal care advances have resulted in improved survival but have raised concerns of increase in neurodevelopmental impairment. This study looked at long-term neurodevelopmental outcomes at ages 5 and 8 years of very low birthweight infants born in the 2000s as compared to the 1990s. Neurodevelopmental assessment at 2 years old was compared to that at 5 and 8 years to determine if assessment at 2 years was predictive of later outcomes. A retrospective cohort study of consecutive infants with birthweight less than 1250 grams admitted to a tertiary centre in Singapore between January 1994 to December 1995 (Epoch I) and January 2004 to December 2005 (Epoch II) were included. Neurodevelopmental impairment was defined as having intelligence quotient (IQ) of less than 70, cerebral palsy, legal blindness, or hearing impairment requiring hearing aids. Mean gestational age was lower for Epoch II compared to Epoch I (28.1 ± 2.5 vs 29.4 ± 2.7 weeks, P = 0.004). Death or neurodevelopmental impairment rates did not differ (24.3% and 17.1% at 5 years old, P = 0.398; 29.1% and 25.0% at 8 years old, P = 0.709). There was improvement in visual impairment rate at 8 years in Epoch II (10.7% vs 34.0%, P = 0.024). Mean IQ was better in Epoch II (109 and 107 vs 97 and 99 at 5 [ P = 0.001] and 8 years [ P = 0.047], respectively). All infants with no neurodevelopmental impairment at 2 years remained without impairment later on. Over a decade, neurodevelopmental outcomes did not worsen despite lower mean gestational age. Long- term improvement in IQ scores and a reduction in visual impairment rates were seen. Our data suggests that children without neurodevelopmental impairment at 2 years are without impairment later on; therefore, they may need only developmental monitoring with targeted assessments instead of routine formal IQ assessments.

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.

Relationship of neonatal cerebral blood flow velocity asymmetry with early motor, cognitive and language development in term infants.

Science.gov (United States)

Wu, Ying-Chin; Hsieh, Wu-Shiun; Hsu, Chyong-Hsin; Chiu, Nan-Chang; Chou, Hung-Chieh; Chen, Chien-Yi; Peng, Shinn-Forng; Hung, Han-Yang; Chang, Jui-Hsing; Chen, Wei J; Jeng, Suh-Fang

2013-05-01

The objective of this study was to examine the relationships of Doppler cerebral blood flow velocity (CBFV) asymmetry measures with developmental outcomes in term infants. Doppler CBFV parameters (peak systolic velocity [PSV] and mean velocity [MV]) of the bilateral middle cerebral arteries of 52 healthy term infants were prospectively examined on postnatal days 1-5, and then their motor, cognitive and language development was evaluated with the Bayley Scales of Infant and Toddler Development, Third Edition, at 6, 12, 18 and 24 months of age. The left CBFV asymmetry measure (PSV or MV) was calculated by subtracting the right-side value from the left-side value. Left CBFV asymmetry measures were significantly positively related to motor scores at 6 (r = 0.3-0.32, p cognitive or language outcome. Thus, the leftward hemodynamic status of the middle cerebral arteries, as measured by cranial Doppler ultrasound in the neonatal period, predicts early motor outcome in term infants. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

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

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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.

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.

Estimation of tidal ventilation in preterm and term newborn infants using electromagnetic inductance plethysmography

International Nuclear Information System (INIS)

Williams, E M; Pickerd, N; Kotecha, S; Eriksen, M; Øygarden, K

2011-01-01

Tidal volume (VT) measurements in newborn infants remain largely a research tool. Tidal ventilation and breathing pattern were measured using a new device, FloRight, which uses electromagnetic inductive plethysmography, and compared simultaneously with pneumotachography in 43 infants either receiving no respiratory support or continuous positive airway pressure (CPAP). Twenty-three infants were receiving CPAP (gestational age 28 ± 2 weeks, mean ± SD) and 20 were breathing spontaneously (gestational age 34 ± 4 weeks). The two methods were in reasonable agreement, with VT (r 2 = 0.69) ranging from 5 to 23 ml (4–11 ml kg −1 ) with a mean difference of 0.4 ml and limit of agreement of −4.7 to + 5.5 ml. For respiratory rate, minute ventilation, peak flow and breathing pattern indices, the mean difference between the two methods ranged between 0.7% and 5.8%. The facemask increased the respiratory rate (P < 0.001) in both groups with the change in VT being more pronounced in the infants receiving no respiratory support. Thus, FloRight provides an easy to use technique to measure term and preterm infants in the clinical environment without altering the infant's breathing pattern

Cerebellar Volume and Proton Magnetic Resonance Spectroscopy at Term, and Neurodevelopment at 2 Years of Age in Preterm Infants

Science.gov (United States)

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

2012-01-01

Aim: To assess the relation between cerebellar volume and spectroscopy at term equivalent age, and neurodevelopment at 24 months corrected age in preterm infants. Methods: Magnetic resonance imaging of the brain was performed around term equivalent age in 112 preterm infants (mean gestational age 28wks 3d [SD 1wk 5d]; birthweight 1129g [SD 324g]).…

n-3 Fatty Acid Supplementation in Mothers, Preterm Infants, and Term Infants and Childhood Psychomotor and Visual Development: A Systematic Review and Meta-Analysis.

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Shulkin, Masha; Pimpin, Laura; Bellinger, David; Kranz, Sarah; Fawzi, Wafaie; Duggan, Christopher; Mozaffarian, Dariush

2018-03-01

Epidemiologic studies link maternal seafood and n-3 (ω-3) polyunsaturated fatty acid (PUFA) consumption with improved childhood cognitive development; trials show mixed results. We investigated effects of n-3 PUFA supplementation on child cognitive and visual outcomes. We systematically reviewed and meta-analyzed randomized controlled trials of n-3 PUFA supplementation in mothers or infants (age ≤2 y) and evaluated standardized measures of cognitive or visual development up to age 18 y. Of 6286 abstracts and 669 full-text articles, 38 trials with 53 intervention arms were included. Data were extracted independently in duplicate. Findings were pooled using random-effects meta-analysis across supplementation periods (maternal, preterm, term infant); we also explored subgroup analyses stratified by supplementation period. Heterogeneity was explored using I2, stratified analysis, and meta-regression. Cognitive development was assessed by Bayley Scales of Infant Development mental and psychomotor developmental indexes (MDI, PDI) and intelligence quotient (IQ); visual acuity was assessed by electrophysiological or behavioral measures. The 38 trials (mothers: n = 13; preterm infants: n = 7; term infants: n = 18) included 5541 participants. When we explored effects during different periods of supplementation, n-3 PUFA supplementation improved MDI in preterm infants (3.33; 95% CI: 0.72, 5.93), without statistically significant effects on PDI or IQ in different intervention period subgroups. Visual acuity [measured as the logarithm of the minimum angle of resolution (logMAR)] was improved by supplementation in preterm (-0.08 logMAR; 95% CI: -0.14, -0.01 logMAR) and term infants (-0.08 logMAR; 95% CI: -0.11, -0.05 logMAR), with a nonsignificant trend for maternal supplementation (-0.02 logMAR; 95% CI: -0.04, 0.00 logMAR). In main analyses pooling all supplementation periods, compared with placebo, n-3 PUFA supplementation improved MDI (n = 21 trials; 0.91; 95% CI

Psicoterapia breve pais-bebê: revisando a literatura Short-term parent-infant psychotherapy: a review of the literature

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Luiz Carlos Prado

2009-01-01

Full Text Available Este artigo apresenta uma revisão da literatura a respeito da psicoterapia breve pais-bebê. Inicialmente são apresentados aspectos históricos, desde o surgimento da psicoterapia breve, passando pelas formulações teóricas que enfatizaram a importância das relações iniciais pais-bebê até a constituição do campo da psicoterapia breve pais-bebê propriamente dita. Constata-se que várias abordagens compõem o panorama atual das psicoterapias pais-bebê, as quais apresentam uma ampla diversidade de referenciais teóricos e técnicos. Foram também revisados, em particular, estudos empíricos sobre a utilização dessa abordagem no contexto da depressão materna. Por fim, apresentam-se os procedimentos utilizados pelos autores deste artigo em uma pesquisa em andamento envolvendo o atendimento psicoterápico breve pais-bebê em famílias com mães deprimidas. Essa abordagem tem se mostrado efetiva na promoção de um melhor relacionamento mãe-pai-bebê na presença sintomas depressivos da mãe.This article presents a review of the literature on short-term parent-infant psychotherapy. Initially, some historical aspects are presented since the emergence of short-term psychotherapy, including the theoretical formulations that highlighted the importance of early parent-infant relationships and helped to implement the field of short-term parent-infant psychotherapy. There are several approaches to parent-infant psychotherapy, representing a broad diversity of theoretical and technical frameworks. Empirical studies were also reviewed, especially those using parent-infant psychotherapy in the context of maternal depression. Finally, the authors' experience with short-term parent-infant psychotherapy involving families with depressive mothers was presented. This approach has shown to be effective in the promotion of better mother-father-infant relationship in the presence of maternal depressive symptoms.

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

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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.)

Measurement of humerus and radius bone mineral content in the term and preterm infant

International Nuclear Information System (INIS)

Vyhmeister, N.R.; Linkhart, T.A.

1988-01-01

We compared two anatomic sites for single-photon absorptiometric measurement of bone mineral content (BMC) in term and preterm infants. The distal one third of the radius and the midportion of the humerus were evaluated for measurements of BMC with an unmodified, commercially available bone densitometer. We assessed reproducibility of BMC and bone width (BW) measurements and defined normal at-birth ranges of BMC, BW, and BMC/BW ratio for infants with gestational ages of 24 to 42 weeks. Humerus BMC correlated with gestational age, birth weight, and BW of patients and did not differ from humerus BMC values determined over the same range of gestational ages at another center. Representative serial measurements of two very low birth weight (VLBW) infants are presented to demonstrate the feasibility of using humerus BMC in longitudinal studies to assess changes in bone mineralization. We conclude that bone densitometer measurements of mid-humerus BMC can be successfully performed and are preferable to similar measurements of the radius for VLBW infants. Normal humerus BMC values were defined for use in diagnosis and evaluation of the efficacy of treatment in VLBW infants who are at high risk of developing osteopenia of prematurity

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

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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.

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

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

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

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K V Radhakrishna

Full Text Available 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.Clinical Trail Registration India (CTRI CTRI

Preschool outcome of less than 801-gram preterm infants compared with full-term siblings.

Science.gov (United States)

Kilbride, Howard W; Thorstad, Karla; Daily, Donna K

2004-04-01

Extremely low birth weight (ELBW) infants are at greater risk for neurodevelopmental delay than full-term infants. Outcomes may be compromised secondary to abnormal brain development associated with complications of prematurity. Long-term cognitive outcome has also been reported to be significantly influenced by postnatal factors. The objective of this study was to clarify the effects of prematurity separate from environmental factors on growth and neurodevelopmental outcomes by comparing ELBW children with their full-term siblings. The study consisted of 25 ELBW children, a subset selected from a larger population of infants who were siblings. Twenty-three sets of siblings were evaluated at 5 years of age and 2 sets at 3 years of age with standardized medical, social, cognitive, motor, and language testing. Physical and neurodevelopmental outcomes were compared between groups, controlling for gender and socioeconomic status (SES). At follow-up, ELBW children were lighter, were shorter, and had smaller head circumference. The ELBW children had lower Stanford-Binet IQs (85 +/- 12 [mean +/- SD] and 95 +/- 11), with lower Stanford-Binet subtests except short-term memory and quantitative reasoning, lower spelling scores on the Wide Range Achievement Test, and lower Peabody motor quotients (79 +/- 11 and 92 +/- 17). Preschool Language Scale quotients were not different, but other receptive language measures were lower for ELBW children. High SES seemed to modify the impact of preterm status on cognitive and language but not motor scores. The mean IQ for high-SES ELBW children was equivalent to that of the low-SES term siblings. Preschool-age cognitive and language functioning in ELBW children seemed to be affected by both prenatal and birth influences (preterm status) and postnatal influences (SES variables). Motor scores were significantly related to preterm status but not to SES.

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

Application of Pattern Recognition Techniques to the Classification of Full-Term and Preterm Infant Cry.

Science.gov (United States)

Orlandi, Silvia; Reyes Garcia, Carlos Alberto; Bandini, Andrea; Donzelli, Gianpaolo; Manfredi, Claudia

2016-11-01

Scientific and clinical advances in perinatology and neonatology have enhanced the chances of survival of preterm and very low weight neonates. Infant cry analysis is a suitable noninvasive complementary tool to assess the neurologic state of infants particularly important in the case of preterm neonates. This article aims at exploiting differences between full-term and preterm infant cry with robust automatic acoustical analysis and data mining techniques. Twenty-two acoustical parameters are estimated in more than 3000 cry units from cry recordings of 28 full-term and 10 preterm newborns. Feature extraction is performed through the BioVoice dedicated software tool, developed at the Biomedical Engineering Lab, University of Firenze, Italy. Classification and pattern recognition is based on genetic algorithms for the selection of the best attributes. Training is performed comparing four classifiers: Logistic Curve, Multilayer Perceptron, Support Vector Machine, and Random Forest and three different testing options: full training set, 10-fold cross-validation, and 66% split. Results show that the best feature set is made up by 10 parameters capable to assess differences between preterm and full-term newborns with about 87% of accuracy. Best results are obtained with the Random Forest method (receiver operating characteristic area, 0.94). These 10 cry features might convey important additional information to assist the clinical specialist in the diagnosis and follow-up of possible delays or disorders in the neurologic development due to premature birth in this extremely vulnerable population of patients. The proposed approach is a first step toward an automatic infant cry recognition system for fast and proper identification of risk in preterm babies. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

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

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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.

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

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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

Initial Resuscitation at Delivery and Short Term Neonatal Outcomes in Very-Low-Birth-Weight Infants.

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Cho, Su Jin; Shin, Jeonghee; Namgung, Ran

2015-10-01

Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birth, chest compression was performed on only 104 infants (5.4%) and epinephrine was administered to 80 infants (4.1%). Infants who received cardiac compression and/or epinephrine administration at birth (DR-CPR) were significantly more acidotic (P CPR resulted in greater early mortality of less than 7 days (OR, 5.64; 95% CI 3.25-9.77) increased intraventricular hemorrhage ≥ grade 3 (OR, 2.71; 95% CI 1.57-4.68), periventricular leukomalacia (OR, 2.94; 95% CI 1.72-5.01), and necrotizing enterocolitis (OR, 2.12; 95% CI 1.15-3.91) compared with those infants who needed only PPV. Meticulous and aggressive management of infants who needed DR-CPR at birth and quality improvement of the delivery room management will result in reduced morbidities and early death for the vulnerable VLBWI.

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

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Dan Wu

2017-06-01

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

The effect of airway pressure and oscillation amplitude on ventilation in pre-term infants

NARCIS (Netherlands)

Miedema, M.; de Jongh, Franciscus H.C.; Frerichs, I.; van Veenendaal, M.B.; van Kaam, A.H.

2012-01-01

We determined the effect of lung recruitment and oscillation amplitude on regional oscillation volume and functional residual capacity (FRC) in high-frequency oscillatory ventilation (HFOV) used in pre-term infants with respiratory distress syndrome (RDS). Changes in lung volume, oscillation volume

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

2011-07-01

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 versus low). EEG indicators in response to old and novel objects were probed directly after the familiarization phase (immediate recognition), and following a 1-week delay (delayed recognition). In immediate recognition, the amplitude of positive slow-wave activity was modulated by joint attention. In the delayed recognition, the amplitude of the Pb component differentiated between high and low joint attention. In addition, the positive slow-wave amplitude during immediate and delayed recognition correlated with the frequency of infants' looks to the experimenter during familiarization. Under both high- and low-joint-attention conditions, the processing of unfamiliar objects was associated with an enhanced Nc component. Our results show that the degree of joint attention modulates EEG during immediate and delayed recognition. We conclude that joint attention affects long-term memory processing in 9-month-old infants by enhancing the relevance of attended items. © 2010 Blackwell Publishing Ltd.

Bronchoalveolar lavage with diluted porcine surfactant in mechanically ventilated term infants with meconium aspiration syndrome.

Science.gov (United States)

Lista, Gianluca; Bianchi, Silvia; Castoldi, Francesca; Fontana, Paola; Cavigioli, Francesco

2006-01-01

To evaluate the efficacy and safety of bronchoalveolar lavage (BAL) with diluted porcine surfactant in mechanically ventilated term infants with severe acute respiratory distress syndrome (ARDS) due to meconium aspiration syndrome (MAS). Eight consecutive mechanically ventilated term infants with severe ARDS due to MAS underwent BAL with 15 mL/kg of diluted (5.3mg phospholipid/mL) surfactant saline suspension (porcine surfactant [Curosurf]). Treatment was administered slowly in aliquots of 2.5 mL. The mean age of neonates at treatment was 3.5 (range 1-8) hours. Heart rate, systemic blood pressure and oxygen saturation were monitored continuously. Arterial blood gases were measured immediately before treatment, and again at 3 and 6 hours post-treatment. Chest x-rays were taken 6 and 24 hours after treatment. Radiological improvement was evident in all eight patients 6 hours post-treatment. Compared with pre-BAL values, significant improvements (p fluids that had been meconium-stained prior to BAL were clear of meconium after BAL. Only one patient required nitric oxide therapy for transient pulmonary hypertension. No adverse sequelae of treatment occurred during the study. BAL with dilute porcine surfactant administered slowly in 2.5 mL aliquots improved oxygenation and chest x-ray findings, without causing major adverse effects, in mechanically ventilated term infants with ARDS due to MAS.

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

Science.gov (United States)

Zinke, Katharina; Thöne, Leonie; Bolinger, Elaina M; Born, Jan

2018-01-01

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 post-stimulus interval. Overall

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

International Nuclear Information System (INIS)

Morigeri, C.; Mukhopadhyay, K.; Narang, A.; Bhattacharya, A.; Mittal, B.R.

2008-01-01

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. 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 suspected cases

Infant nutrition in Saskatoon: barriers to infant food security.

Science.gov (United States)

Partyka, Brendine; Whiting, Susan; Grunerud, Deanna; Archibald, Karen; Quennell, Kara

2010-01-01

We explored infant nutrition in Saskatoon by assessing current accessibility to all forms of infant nourishment, investigating challenges in terms of access to infant nutrition, and determining the use and effectiveness of infant nutrition programs and services. We also examined recommendations to improve infant food security in Saskatoon. Semi-structured community focus groups and stakeholder interviews were conducted between June 2006 and August 2006. Thematic analysis was used to identify themes related to infant feeding practices and barriers, as well as recommendations to improve infant food security in Saskatoon. Our study showed that infant food security is a concern among lower-income families in Saskatoon. Barriers that limited breastfeeding sustainability or nourishing infants through other means included knowledge of feeding practices, lack of breastfeeding support, access and affordability of infant formula, transportation, and poverty. Infant nutrition and food security should be improved by expanding education and programming opportunities, increasing breastfeeding support, and identifying acceptable ways to provide emergency formula. If infant food security is to be addressed successfully, discussion and change must occur in social policy and family food security contexts.

Reference Ranges of Reticulocyte Haemoglobin Content in Preterm and Term Infants: A Retrospective Analysis.

Science.gov (United States)

Lorenz, Laila; Peter, Andreas; Arand, Jörg; Springer, Fabian; Poets, Christian F; Franz, Axel R

2017-01-01

Despite iron supplementation, some preterm infants develop iron deficiency (ID). The optimal iron status parameter for early detection of ID has yet to be determined. To establish reference ranges for reticulocyte haemoglobin content (Ret-He) in preterm and term infants and to identify confounding factors. Retrospective analyses of Ret-He and complete blood count in infants with a clinically indicated blood sample obtained within 24 h after birth. Mean (SD) Ret-He was 30.7 (3.0) pg in very preterm infants with a gestational age (GA) of pH (r = -0.07). There was a slight variation in Ret-He with mode of delivery [normal vaginal delivery: 32.3 (3.2) pg, secondary caesarean section (CS): 31.4 (3.0) pg, instrumental delivery: 31.3 (2.7) pg and elective CS: 31.2 (2.8) pg]. GA at birth has a negligible impact on Ret-He, and the lower limit of the normal reference range in newborns within 24 h after birth can be set to 25 pg. Moreover, Ret-He seems to be a robust parameter which is not influenced by perinatal factors within the first 24 h after birth. © 2016 S. Karger AG, Basel.

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.

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...

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…

Cranial computed tomography and real-time sonography in full-term neonates and infants

International Nuclear Information System (INIS)

Siegel, M.J.; Patel, J.; Gado, M.H.; Shackelford, G.D.

1983-01-01

The results of cranial ultrasonography (US) and computed tomography (CT) were compared in 52 full-term neonates and young infants. The chief indications for examination included: increasing head size, dysmorphic features, myelomeningocele, inflammatory disease, and asphyxia. Disorders detected included hydrocephalus, parenchymal abnormalities, intracranial hemorrhage, extraparenchymal fluid collections, and vascular and other developmental malformations. CT and US essentially were equivalent in detecting hydrocephalus, moderate to large intraventricular hemorrhages or subdural collections, and large focal parenchymal lesions, although CT was somewhat better in determining the level and cause of obstruction in patients with hydrocephalus and characterizing parenchymal abnormalities. CT was more sensitive than ultrasound in detecting subarachnoid hemorrhage (100% vs. 0%), diffuse parenchymal abnormality (100% vs. 33%), and small intraventricular hemorrhages (100% vs. 0%) but these lesions often were not clinically significant. The results suggest that US should be used as the primary neuroradiological examination in term infants; CT probably should be reserved for further investigation after US in those patients with a history of hypoxia and progressive clinical deterioration

Lysine requirement of the enterally fed term infant in the first month of life

NARCIS (Netherlands)

Huang, L.; Hogewind-Schoonenboom, J.E.; de Groof, F.; Twisk, J.W.R.; Voortman, G.J.; Dorst, K.; Schierbeek, H.; Boehm, G.; Huang, Y.; Chen, C.; van Goudoever, J.B.

2011-01-01

Background: Infant nutrition has a major impact on child growth and functional development. Low and high intakes of protein or amino acids could have a detrimental effect. Objective: The objective of the study was to determine the lysine requirement of enterally fed term neonates by using the

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

Directory of Open Access Journals (Sweden)

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

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 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.

Vacuum characteristics of the sucking cycle and relationships with milk removal from the breast in term infants.

Science.gov (United States)

Cannon, Anna Maria; Sakalidis, Vanessa Susanna; Lai, Ching Tat; Perrella, Sharon Lisa; Geddes, Donna Tracy

2016-05-01

The importance of an infant's intra-oral vacuum in milk removal from the breast has been established. However, the relationship between the vacuum curve and milk transfer is not well understood. To investigate the parameters of the infant suck cycle in relation to the volume of milk removed from the breast. Cross-sectional study to elucidate the role of infant intra-oral vacuum in efficient milk removal from the breast. Nineteen fully breastfed term infants. Intra-oral vacuum was recorded during monitored breastfeeds using a pressure transducer. Ultrasound imaging (milk flow) and respiratory inductive plethysmography (swallowing) were used to determine the nutritive sucking (NS) portion of the feed. Milk intake was determined by weighing infants before and after feeds. Vacuum traces of the first and next 2min of NS from the first breast were analysed. The volumes of milk removed during both NS periods were negatively associated with peak vacuum (pmilk removal during breastfeeding. It also appears that infants modify their sucking dynamics to adapt to changes in milk flow during milk ejection as the breast empties. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The effects of preterm birth on mother-infant interaction and attachment during the infant's first two years.

Science.gov (United States)

Korja, Riikka; Latva, Reija; Lehtonen, Liisa

2012-02-01

Early mother-infant relationships in preterm populations were evaluated in the context of a systematic review of the literature. A systematic search of three electronic databases (PsychINFO, PubMed and Cochrane Library) was undertaken. Three studies of maternal attachment, 18 studies of mother-preterm infant interaction and eight studies of infant attachment were included. Studies of preterm infant attachment were also evaluated using a meta-analysis. Studies of mother-preterm infant interactions showed that the differences in maternal interaction behavior between mothers of preterm infants and mothers of full-term infants seem to be most evident during the first six months of life. Differences in the preterm infant's interaction behavior seem also to continue for six months after birth. However, five of 18 studies showed an equal or even higher quality of mother-infant interaction in groups of preterm compared to groups of full-term infants. Studies of maternal and infant attachment indicated that preterm infants and their mothers are not at higher risk of insecure attachment than full-term infants and their mothers. The mother-preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. It is important to decrease maternal stress and early separation in every possible way during hospitalization as well as after discharge. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Early cranial ultrasound changes as predictors of outcome during first year of life in term infants with perinatal asphyxia.

Science.gov (United States)

Boo, N Y; Chandran, V; Zulfiqar, M A; Zamratol, S M; Nyein, M K; Haliza, M S; Lye, M S

2000-08-01

To identify the types of early cranial ultrasound changes that were significant predictors of adverse outcome during the first year of life in asphyxiated term infants. This was a prospective cohort study. Shortly after birth, cranial ultrasonography was carried out via the anterior fontanelles of 70 normal control infants and 104 asphyxiated infants with a history of fetal distress and Apgar scores of less than 6 at 1 and 5 min of life, or requiring endotracheal intubation and manual intermittent positive pressure ventilation for at least 5 min after birth. Neurodevelopmental assessment was carried out on the survivors at 1 year of age. Abnormal cranial ultrasound changes were detected in a significantly higher proportion (79.8%, or n = 83) of asphyxiated infants than controls (39.5%, or n = 30) (P < 0.0001). However, logistic regression analysis showed that only three factors were significantly associated with adverse outcome at 1 year of life among the asphyxiated infants. These were: (i) decreasing birthweight (for every additional gram of increase in birthweight, adjusted odds ratio (OR) = 0.999, 95% confidence interval (CI) 0.998, 1.000; P = 0.047); (ii) a history of receiving ventilatory support during the neonatal period (adjusted OR = 8.3; 95%CI 2.4, 28.9; P = 0.0009); and (iii) hypoxic-ischaemic encephalopathy stage 2 or 3 (adjusted OR = 5.8; 95%CI 1.8, 18.6; P = 0.003). None of the early cranial ultrasound changes was a significant predictor. Early cranial ultrasound findings, although common in asphyxiated infants, were not significant predictors of adverse outcome during the first year of life in asphyxiated term infants.

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.

Phototherapy causes DNA damage in peripheral mononuclear leukocytes in term infants.

Science.gov (United States)

Aycicek, Ali; Kocyigit, Abdurrahim; Erel, Ozcan; Senturk, Hakan

2008-01-01

Our aim was to determine whether endogenous mononuclear leukocyte DNA strand is a target of phototherapy. 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. Mean values of DNA damage scores in both the intensive and conventional phototherapy groups were significantly higher than those in the control group (p Total oxidant status levels in both the intensive and conventional phototherapy groups were significantly higher than those in the control group (p = 0.005). Mean (standard deviation) values were 18.1 (4.2), 16.9 (4.4), 13.5 (4.2) micromol H2O2 equivalent/L, respectively. Similarly, oxidative stress index levels in both the intensive and conventional phototherapy groups were significantly higher than those in the control group (p = 0.041). Plasma total antioxidant capacity and total bilirubin levels did not differ between the groups (p > 0.05). There were no significant correlations between DNA damage scores and bilirubin, total oxidant status and oxidative stress levels in either phototherapy group (p > 0.05). Both conventional phototherapy and intensive phototherapy cause endogenous mononuclear leukocyte DNA damage in jaundiced term infants.

The influence of training views on infants' long-term memory for simple 3D shapes.

Science.gov (United States)

Kraebel, Kimberly S; West, Rebecca N; Gerhardstein, Peter

2007-05-01

This investigation explored infants' ability to retrieve a memory for a simple 3D shape from a novel view following a 24-hr delay. Tests of memory for shape in infancy have typically used extremely short delay intervals between familiarization and test in examining the ability to equate between substantially different views of a 3D object. The current study used longer delays to assess the content of a long-term memory representation. Infants 3-4 months of age learned to kick to move a mobile displaying a simple 3D shape (brick or cylinder). Results of three experiments show that infants can recognize 3D shapes in a novel viewpoint across a 24-hr delay, provided that experience with a sufficiently wide range of views is available during training. The results suggest a capacity for the perception of 3D shape that enables access, across long delays, to a memory representation of sufficient detail that discrimination between two simple shapes (i.e., a cylinder and a brick) is possible. The results suggest that this representation is of a sufficiently abstract nature that perception of the 3D form of the object, independent of the changes in specific features accompanying changes in viewpoint, is also possible. This finding suggests that infants, like adults, possess a functional memory system for the distal shape of simple 3D objects, and can transfer training to a novel view using long-term memory, but that this ability is not as strong as in the mature system. These results have implications for the development of shape perception and for theories of object recognition in general. (c) 2007 Wiley Periodicals, Inc.

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…

Vitamin B6 vitamer concentrations in cerebrospinal fluid differ between preterm and term newborn infants

NARCIS (Netherlands)

Albersen, Monique; Groenendaal, Floris; van der Ham, Maria; de Koning, Tom J; Bosma, Marjolein; Visser, Wouter F; Visser, Gepke; de Sain-van der Velden, Monique G M; Verhoeven-Duif, Nanda M

BACKGROUND AND OBJECTIVE: Vitamin B(6) plays a pivotal role in brain development and functioning. Differences in vitamin B(6) homeostasis between preterm and term newborn infants have been reported. The authors sought to investigate whether B(6) vitamers in cerebrospinal fluid (CSF) of preterm and

Impact of Vitamin D Supplementation on Gross Motor Development of Healthy Term Infants: A Randomized Dose-Response Trial.

Science.gov (United States)

Wicklow, Brandy; Gallo, Sina; Majnemer, Annette; Vanstone, Catherine; Comeau, Kathryn; Jones, Glenville; L'Abbe, Mary; Khamessan, Ali; Sharma, Atul; Weiler, Hope; Rodd, Celia

2016-08-01

In addition to benefits for bone health, vitamin D is implicated in muscle function in children and adults. To determine if vitamin D dosage positively correlated with gross motor development at 3 and 6 months of age. We hypothesized that higher doses would be associated with higher scores for gross motor skills. A consecutive sample of 55 healthy, term, and breastfed infants from Montreal, Canada were recruited from a randomized trial of vitamin D supplementation between 2009 and 2012. Infants were randomized to 400 International Units (IU) (n = 19), 800 IU (n = 18) or 1,200 IU (n = 18) vitamin D3/day. Motor performance at 3 and 6 months was quantified by the Alberta Infant Motor Scale (AIMS). Plasma vitamin D3 metabolites were measured by tandem mass spectrometry. AIMS scores did not differ at 3 months. However, total AIMS scores and sitting subscores were significantly higher at 6 months in infants receiving 400 IU/day compared to 800 IU/day and 1,200 IU/day groups (p gross motor achievements were significantly higher in infants receiving 400 IU/day vitamin D. Our findings also support longer infants being slightly delayed.

Effect of neonatal hemoglobin concentration on long-term outcome of infants affected by fetomaternal hemorrhage.

Science.gov (United States)

Kadooka, Mizuho; Kato, Hiromi; Kato, Akihiko; Ibara, Satoshi; Minakami, Hisanori; Maruyama, Yuko

2014-09-01

Fetomaternal hemorrhage (FMH) can cause severe morbidity. However, perinatal risk factors for long-term poor outcome due to FMH have not been extensively studied. To determine which FMH infants are likely to have neurological sequelae. A single-center retrospective observational study. Perinatal factors, including demographic characteristics, Kleihauer-Betke test, blood gas analysis, and neonatal blood hemoglobin concentration ([Hb]), were analyzed in association with long-term outcomes. All 18 neonates referred to a Neonatal Intensive Care Unit of Kagoshima City Hospital and diagnosed with FMH during a 15-year study period. All had a neonatal [Hb] neonates tested had Kleihauer-Betke test result >4.0%. Poor long-term outcome was defined as any of the following determined at 12 month old or more: cerebral palsy, mental retardation, attention deficit/hyperactivity disorder, and epilepsy. Nine of the 18 neonates exhibited poor outcomes. Among demographic characteristics and blood variables compared between two groups with poor and favorable outcomes, significant differences were observed in [Hb] (3.6±1.4 vs. 5.4±1.1g/dL, P=0.01), pH (7.09±0.11 vs. 7.25±0.13, P=0.02) and base deficits (17.5±5.4 vs. 10.4±6.0mmol/L, P=0.02) in neonatal blood, and a number of infants with [Hb]≤4.5g/dL (78%[7/9] vs. 22%[2/9], P=0.03), respectively. The base deficit in neonatal arterial blood increased significantly with decreasing neonatal [Hb]. Severe anemia causing severe base deficit is associated with neurological sequelae in FMH infants. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

Intravenous paracetamol with a lower dose is also effective for the treatment of patent ductus arteriosus in pre-term infants.

Science.gov (United States)

Tekgündüz, Kadir Şerafettin; Ceviz, Naci; Caner, İbrahim; Olgun, Haşim; Demirelli, Yaşar; Yolcu, Canan; Şahin, İrfan Oğuz; Kara, Mustafa

2015-08-01

Haemodynamically significant patent ductus arteriosus is a significant cause of morbidity and mortality in pre-term infants. This retrospective study was conducted to investigate the usefulness of lower-dose paracetamol for the treatment of patent ductus arteriosus in pre-term infants. A total of 13 pre-term infants who received intravenous paracetamol because of contrindications or side effects to oral ibuprofen were retrospectively enrolled. In the first patient, the dose regimen was 15 mg/kg/dose, every 6 hours. As the patient developed significant elevation in transaminase levels, the dose was decreased to 10 mg/kg/dose, every 8 hours in the following 12 patients. Echocardiographic examination was conducted daily. In case of closure, it was repeated after 2 days and when needed thereafter in terms of reopening. A total of 13 patients received intravenous paracetamol. Median gestational age was 29 weeks ranging from 24 to 31 weeks and birth weight was 950 g ranging from 470 to 1390 g. The median postnatal age at the first intravenous paracetamol dose was 3 days ranging from 2 to 9 days. In 10 of the 13 patients (76.9%), patent ductus arteriosus was closed at the median 2nd day of intravenous paracetamol ranging from 1 to 4 days. When the patient who developed hepatotoxicity was eliminated, the closure rate was found to be 83.3% (10/12). Intravenous paracetamol may be a useful treatment option for the treatment of patent ductus arteriosus in pre-term infants with contrindication to ibuprofen. In our experience, lower-dose paracetamol is effective in closing the patent ductus arteriosus in 83.3% of the cases.

Infant long-term memory for associations formed during mere exposure.

Science.gov (United States)

Giles, Amy; Rovee-Collier, Carolyn

2011-04-01

We previously found that young infants spontaneously associate stimuli that they merely see together. Using a sensory preconditioning paradigm with 6- and 9-month-olds, we asked how long such associations remain latent before being forgotten and what exposure conditions affect their persistence. Groups were preexposed to two puppets for 1h/day for 2 days, 1h on 1 day, or 1h on 1 day in two sessions; 1-27 days later, target actions were modeled on one puppet, and infants were tested with the other puppet 1 day later. The longest delay after which infants imitated the actions on the other puppet defined how long they remembered the association. The data revealed that the preexposure regimen determined retention. Regardless of exposure time, both ages remembered the association longer after two sessions, and younger infants remembered longer than older infants--for 4 weeks--after two 30-min sessions on 1 day. Copyright © 2011 Elsevier Inc. All rights reserved.

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

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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.

Electroencephalogram abnormalities in full term infants with history of severe asphyxia

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Susanti Halim

2016-11-01

Full Text Available Background An electroencephalogram (EEG is an electroimaging tool used to determine developmental and electrical problems in the brain. A history of severe asphyxia is a risk factor for these brain problems in infants. Objective To evaluate the prevalence of abnormal EEGs in full term neonates and to assess for an association with severe asphyxia, hypoxic ischemic encephalopathy (HIE, and spontaneous delivery. Methods This cross-sectional study was conducted at the Pediatric Outpatient Department of Sanglah Hospital, Denpasar, from November 2013 to January 2014. Subjects were fullterm infants aged 1 month who were delivered and/or hospitalized at Sanglah Hospital. All subjects underwent EEG. The EEGs were interpreted by a pediatric neurology consultant, twice, with a week interval between readings. Clinical data were obtained from medical records. Association between abnormal ECG and severe asphyxia were analyzed by Chi-square and multivariable logistic analyses. Results Of 55 subjects, 27 had a history of severe asphyxia and 28 were vigorous babies. Forty percent (22/55 of subjects had abnormal EEG findings, 19/22 of these subjects having history of severe asphyxia, 15/22 had history of hypoxic-ischemic encephalopathy (HIE, and 20/22 were delievered vaginally. There were strong correlations between the prevalence of abnormal EEG and history of severe asphyxia, HIE, and spontaneous delivery. Conclusion Prevalence of abnormal EEG among full-term neonates referred to neurology/growth development clinic is around 40%, with most of them having a history of severe asphyxia. Abnormal EEG is significantly associated to severe asphyxia, HIE, and spontaneous delivery.

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

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

2015-08-01

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

The relationship between air pollution and low birth weight: effects by mother's age, infant sex, co-pollutants, and pre-term births

International Nuclear Information System (INIS)

Bell, Michelle L; Ebisu, Keita; Belanger, Kathleen

2008-01-01

Previously we identified associations between the mother's air pollution exposure and birth weight for births in Connecticut and Massachusetts from 1999-2002. Other studies also found effects, though results are inconsistent. We explored potential uncertainties in earlier work and further explored associations between air pollution and birth weight for PM 10 , PM 2.5 , CO, NO 2 , and SO 2 . Specifically we investigated: (1) whether infants of younger (≤24 years) and older (≥40 years) mothers are particularly susceptible to air pollution's effects on birth weight; (2) whether the relationship between air pollution and birth weight differed by infant sex; (3) confounding by co-pollutants and differences in pollutants' measurement frequencies; and (4) whether observed associations were influenced by inclusion of pre-term births. Findings did not indicate higher susceptibility to the relationship between air pollution and birth weight based on the mother's age or the infant's sex. Results were robust to exclusion of pre-term infants and co-pollutant adjustment, although sample size decreased for some pollutant pairs. These findings provide additional evidence for the relationship between air pollution and birth weight, and do not identify susceptible sub-populations based on infant sex or mother's age. We conclude with discussion of key challenges in research on air pollution and pregnancy outcomes.

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

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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

Neurodevelopmental outcomes of near-term small-for-gestational-age infants with and without signs of placental underperfusion.

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Parra-Saavedra, Miguel; Crovetto, Francesca; Triunfo, Stefania; Savchev, Stefan; Peguero, Anna; Nadal, Alfons; Parra, Guido; Gratacos, Eduard; Figueras, Francesc

2014-04-01

To evaluate 2-year neurodevelopmental outcomes of near-term, small-for-gestational-age (SGA) newborns segregated by presence or absence of histopathology reflecting placental underperfusion (PUP). A cohort of consecutive near-term (≥ 34.0 weeks) SGA newborns with normal prenatal umbilical artery Doppler studies was selected. All placentas were inspected for evidence of underperfusion and classified in accordance with established histologic criteria. Neurodevelopmental outcomes at 24 months (age-corrected) were then evaluated, applying the Bayley Scale for Infant and Toddler Development, Third Edition (Bayley-III) to assess cognitive, language, and motor competencies. The impact of PUP on each domain was measured via analysis of covariance, logistic and ordinal regression, with adjustment for smoking, socioeconomic status, gestational age at birth, gender, and breastfeeding. A total of 83 near-term SGA deliveries were studied, 46 (55.4%) of which showed signs of PUP. At 2 years, adjusted neurodevelopmental outcomes were significantly poorer in births involving PUP (relative to SGA infants without PUP) for all three domains of the Bayley scale: cognitive (105.5 vs 96.3, adjusted-p = 0.03), language (98.6 vs 87.8, adjusted-p<0.001), and motor (102.7 vs 94.5, adjusted-p = 0.007). Similarly, the adjusted likelihood of abnormal cognitive, language, and motor competencies in instances of underperfusion was 9.3-, 17.5-, and 1.44-fold higher, respectively, differing significantly for the former two domains. In a substantial fraction of near-term SGA babies without Doppler evidence of placental insufficiency, histologic changes compatible with PUP are still identifiable. These infants are at greater risk of abnormal neurodevelopmental outcomes at 2 years. Copyright © 2014 Elsevier Ltd. All rights reserved.

Predicting hospital mortality among frequently readmitted patients: HSMR biased by readmission

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2011-01-01

Background Casemix adjusted in-hospital mortality is one of the measures used to improve quality of care. The adjustment currently used does not take into account the effects of readmission, because reliable data on readmission is not readily available through routinely collected databases. We have studied the impact of readmissions by linking admissions of the same patient, and as a result were able to compare hospital mortality among frequently, as opposed to, non-frequently readmitted patients. We also formulated a method to adjust for readmission for the calculation of hospital standardised mortality ratios (HSMRs). Methods We conducted a longitudinal retrospective analysis of routinely collected hospital data of six large non-university teaching hospitals in the Netherlands with casemix adjusted standardised mortality ratios ranging from 65 to 114 and a combined value of 93 over a five-year period. Participants concerned 240662 patients admitted 418566 times in total during the years 2003 - 2007. Predicted deaths by the HSMR model 2008 over a five-year period were compared with observed deaths. Results Numbers of readmissions per patient differ substantially between the six hospitals, up to a factor of 2. A large interaction was found between numbers of admissions per patient and HSMR-predicted risks. Observed deaths for frequently admitted patients were significantly lower than HSMR-predicted deaths, which could be explained by uncorrected factors surrounding readmissions. Conclusions Patients admitted more frequently show lower risks of dying on average per admission. This decline in risk is only partly detected by the current HSMR. Comparing frequently admitted patients to non-frequently admitted patients commits the constant risk fallacy and potentially lowers HSMRs of hospitals treating many frequently admitted patients and increases HSMRs of hospitals treating many non-frequently admitted patients. This misleading effect can only be demonstrated by an

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

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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.)

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

International Nuclear Information System (INIS)

Leitner, Yael; Weinstein, Maya; Myers, Vicki; Uliel, Shimrit; Geva, Karen; Berger, Irit; Marom, Ronella; Bashat, Dafna Ben; Ben-Sira, Liat; Geva, Ronny; Gross-Tsur, Varda

2014-01-01

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.)

Infant Skin Care Products: What Are the Issues?

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Kuller, Joanne McManus

2016-10-01

Infant skin is susceptible to dryness and irritation from external factors, including topical skin care products not formulated for the infant's skin. This may increase the risk of contact dermatitis. Parents frequently express concern regarding potential harm from ingredients in skin care products and seek information. This is complicated by several skin care myths. The purpose of this literature review was to provide evidence-based information to educate parents on the use of products for preterm and term infants. Multiple searches using PubMed were conducted including the search terms "infant skin care," "infant products," "infant bath," "emollients," "diaper skin care," and "diaper wipes." Reference lists of comprehensive reviews were also scanned. Google searches were used to assess consumer information, product information, and regulatory guidelines. There is little scientific evidence to support safety of natural/organic products on infant skin. Raw materials originate from different sources, complicating testing and comparisons of ingredients. Research shows that cleansers formulated for infant skin do not weaken the skin barrier the way harsher soaps and detergents can. Oils with the lowest oleic acid content provide a lower risk of irritant contact dermatitis. Nurses must be informed about natural and organic products, preservatives, and fragrances and know the definition of commonly used marketing terms. Decisions regarding the use of infant products in preterm and term infants should be evidence based. More research is needed to support claims regarding the safety of products used on infant skin.

Nap-dependent learning in infants.

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Hupbach, Almut; Gomez, Rebecca L; Bootzin, Richard R; Nadel, Lynn

2009-11-01

Sleep has been shown to aid a variety of learning and memory processes in adults (Stickgold, 2005). Recently, we showed that infants' learning also benefits from subsequent sleep such that infants who nap are able to abstract the general grammatical pattern of a briefly presented artificial language (Gomez, Bootzin & Nadel, 2006). In the present study, we demonstrate, for the first time, long-term effects of sleep on memory for an artificial language. Fifteen-month-old infants who had napped within 4 hours of language exposure remembered the general grammatical pattern of the language 24 hours later. In contrast, infants who had not napped shortly after being familiarized with the language showed no evidence of remembering anything about the language. Our findings support the view that infants' frequent napping plays an essential role in establishing long-term memory.

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

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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

Measuring Infant Memory.

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Bogartz, Richard S.

1996-01-01

Reviews three response rate measures (in a baseline measurement, immediately after acquisition, and at a long-term retention test) of infant memory that are used in experiments involving infants' conditioned kicking. Compares these measures to a new measure, the fraction of kicking rate remaining after the retention interval. Explains the…

Visual and Cardiac Responses to Animate and Inanimate Faces by Young Term and Preterm Infants.

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Field, Tiffany Martini

This paper presents a study of the looking and looking away or gaze alternation behavior of both full term and preterm infants in the presence of varying degrees of facial animation. The faces used in the study included, in increasing order of animation, a Raggedy Ann doll's face, a moving and talking doll's face, a mother's less animated face…

Maternal postpartum depression and infant social withdrawal among human immunodeficiency virus (HIV) positive mother-infant dyads.

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Hartley, C; Pretorius, K; Mohamed, A; Laughton, B; Madhi, S; Cotton, M F; Steyn, B; Seedat, S

2010-05-01

Maternal postpartum depression poses significant risks for mother-child interaction and long-term infant outcomes. Human immunodeficiency virus (HIV) status has also been implicated in the development of postpartum depression, but the association between maternal depression and infant social behavior in the context of HIV infection has not been fully investigated. First, we examined the relationship between maternal postpartum depression and infant social withdrawal at 10-12 months of age in HIV-infected mothers and infants. Second, we ascertained whether infant social withdrawal could be significantly predicted by maternal postpartum depression. The sample consisted of 83 HIV-infected mother-infant dyads. Mothers were assessed for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS), and infant social withdrawal behavior was rated using the Modified Alarm Distress Baby Scale (m-ADBB). 42.2% of the mothers scored above the cut-off point for depression on the EPDS, and a third of infants (31%) were socially withdrawn. Notably, maternal depression did not predict infant social withdrawal as measured by the m-ADBB. Infant social withdrawal was also not significantly associated with failure to thrive or gender. These preliminary findings need further investigation with respect to the impact on long-term neurodevelopmental and behavioral outcomes.

Causes of death and infant mortality rates among full-term births in the United States between 2010 and 2012: An observational study.

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Bairoliya, Neha; Fink, Günther

2018-03-01

While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates. In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births. Linked birth and death records for the period 2010-2012 were used to identify the state- and cause-specific burden of infant mortality among full-term infants (born at 37-42 weeks of gestation). Multivariable logistic models were used to assess the extent to which state-level differences in full-term infant mortality (FTIM) were attributable to observed differences in maternal and birth characteristics. Random effects models were used to assess the relative contribution of state-level variation to FTIM. Hypothetical mortality outcomes were computed under the assumption that all states could achieve the survival rates of the best-performing states. A total of 10,175,481 infants born full-term in the US between January 1, 2010, and December 31, 2012, were analyzed. FTIM rate (FTIMR) was 2.2 per 1,000 live births overall, and ranged between 1.29 (Connecticut, 95% CI 1.08, 1.53) and 3.77 (Mississippi, 95% CI 3.39, 4.19) at the state level. Zero states reached the rates reported in the 6 low-mortality European countries analyzed (FTIMR 2.75. Sudden unexpected death in infancy (SUDI) accounted for 43% of FTIM; congenital malformations and perinatal conditions accounted for 31% and 11.3% of FTIM, respectively. The largest mortality differentials between states with good and states with poor FTIMR were found for SUDI, with particularly large risk differentials for deaths due to sudden infant death syndrome (SIDS) (odds ratio [OR] 2.52, 95% CI 1.86, 3.42) and suffocation (OR 4.40, 95% CI 3.71, 5.21). Even though these mortality differences

The behavior of the full-term but underweight newborn infant.

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Als, H; Tronick, E; Adamson, L; Brazelton, T B

1976-10-01

Ten underweight full-term newborns were compared with 10 full-weight newborns on the Brazelton Neonatal Behavioral Assessment Scale. The Brazelton examination differentiated the two groups clearly on the reflexes of walking, crawling and passive movements of arms and legs, and on rooting and sucking. More importantly, it differentiated the two groups on behaviors which are important for the caretaker of the baby: these are attractiveness, need for stimulation, interactive processes and motor processes. The 10 underweight infants were followed up at a later date during the first year. They showed temperamental organizational difficulties and some indication of psychosomatic reaction to stress. It is possible that the underweight newborn's fragile organization elicits anxiety in the caretaker which makes interaction difficult.

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:…

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

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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.)

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

International Nuclear Information System (INIS)

Sirgiovanni, Ida; Groppo, Michela; Bassi, Laura; Passera, Sofia; Schiavolin, Paola; Fumagalli, Monica; Mosca, Fabio; Avignone, Sabrina; Cinnante, Claudia; Triulzi, Fabio; Lista, Gianluca

2014-01-01

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.)

Effects of maternal postpartum depression in a well-resourced sample: Early concurrent and long-term effects on infant cognitive, language, and motor development.

Science.gov (United States)

Smith-Nielsen, Johanne; Tharner, Anne; Krogh, Marianne Thode; Vaever, Mette Skovgaard

2016-12-01

This study examined early and long-term effects of maternal postpartum depression on cognitive, language, and motor development in infants of clinically depressed mothers. Participants were 83 mothers and their full-term born children from the urban region of Copenhagen, Denmark. Of this group, 28 mothers were diagnosed with postnatal depression three to four months postpartum in a diagnostic interview. Cognitive, language, and motor development was assessed with the Bayley Scales of Infant and Toddler Development third edition, when the infants were 4 and 13 months of age. We found that maternal postpartum depression was associated with poorer cognitive development at infant age four months, the effect size being large (Cohen's d = 0.8) and with similar effects for boys and girls. At 13 months of age infants of clinical mothers did not differ from infants of non-clinical mothers. At this time most (79%) of the clinical mothers were no longer, or not again, depressed. These results may indicate that maternal depression can have an acute, concurrent effect on infant cognitive development as early as at four months postpartum. At the same time, in the absence of other risk factors, this effect may not be enduring. The main weaknesses of the study include the relatively small sample size and that depression scores were only available for 35 of the non-clinical mothers at 13 months. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Pregnancy and infant outcomes among HIV-infected women taking long-term ART with and without tenofovir in the DART trial.

Directory of Open Access Journals (Sweden)

Diana M Gibb

Full Text Available Few data have described long-term outcomes for infants born to HIV-infected African women taking antiretroviral therapy (ART in pregnancy. This is particularly true for World Health Organization (WHO-recommended tenofovir-containing first-line regimens, which are increasingly used and known to cause renal and bone toxicities; concerns have been raised about potential toxicity in babies due to in utero tenofovir exposure.Pregnancy outcome and maternal/infant ART were collected in Ugandan/Zimbabwean HIV-infected women initiating ART during The Development of AntiRetroviral Therapy in Africa (DART trial, which compared routine laboratory monitoring (CD4; toxicity versus clinically driven monitoring. Women were followed 15 January 2003 to 28 September 2009. Infant feeding, clinical status, and biochemistry/haematology results were collected in a separate infant study. Effect of in utero ART exposure on infant growth was analysed using random effects models. 382 pregnancies occurred in 302/1,867 (16% women (4.4/100 woman-years [95% CI 4.0-4.9]. 226/390 (58% outcomes were live-births, 27 (7% stillbirths (≥22 wk, and 137 (35% terminations/miscarriages (0.4. Of 219 surviving infants, 182 (83% enrolled in the follow-up study; median (interquartile range [IQR] age at last visit was 25 (12-38 months. From mothers' ART, 62/9/111 infants had no/20%-89%/≥90% in utero tenofovir exposure; most were also zidovudine/lamivudine exposed. All 172 infants tested were HIV-negative (ten untested. Only 73/182(40% infants were breast-fed for median 94 (IQR 75-212 days. Overall, 14 infants died at median (IQR age 9 (3-23 months, giving 5% 12-month mortality; six of 14 were HIV-uninfected; eight untested infants died of respiratory infection (three, sepsis (two, burns (one, measles (one, unknown (one. During follow-up, no bone fractures were reported to have occurred; 12/368 creatinines and seven out of 305 phosphates were grade one (16 or two (three in 14 children

Pregnancy and infant outcomes among HIV-infected women taking long-term ART with and without tenofovir in the DART trial.

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Gibb, Diana M; Kizito, Hilda; Russell, Elizabeth C; Chidziva, Ennie; Zalwango, Eva; Nalumenya, Ruth; Spyer, Moira; Tumukunde, Dinah; Nathoo, Kusum; Munderi, Paula; Kyomugisha, Hope; Hakim, James; Grosskurth, Heiner; Gilks, Charles F; Walker, A Sarah; Musoke, Phillipa

2012-01-01

Few data have described long-term outcomes for infants born to HIV-infected African women taking antiretroviral therapy (ART) in pregnancy. This is particularly true for World Health Organization (WHO)-recommended tenofovir-containing first-line regimens, which are increasingly used and known to cause renal and bone toxicities; concerns have been raised about potential toxicity in babies due to in utero tenofovir exposure. Pregnancy outcome and maternal/infant ART were collected in Ugandan/Zimbabwean HIV-infected women initiating ART during The Development of AntiRetroviral Therapy in Africa (DART) trial, which compared routine laboratory monitoring (CD4; toxicity) versus clinically driven monitoring. Women were followed 15 January 2003 to 28 September 2009. Infant feeding, clinical status, and biochemistry/haematology results were collected in a separate infant study. Effect of in utero ART exposure on infant growth was analysed using random effects models. 382 pregnancies occurred in 302/1,867 (16%) women (4.4/100 woman-years [95% CI 4.0-4.9]). 226/390 (58%) outcomes were live-births, 27 (7%) stillbirths (≥22 wk), and 137 (35%) terminations/miscarriages (0.4). Of 219 surviving infants, 182 (83%) enrolled in the follow-up study; median (interquartile range [IQR]) age at last visit was 25 (12-38) months. From mothers' ART, 62/9/111 infants had no/20%-89%/≥90% in utero tenofovir exposure; most were also zidovudine/lamivudine exposed. All 172 infants tested were HIV-negative (ten untested). Only 73/182(40%) infants were breast-fed for median 94 (IQR 75-212) days. Overall, 14 infants died at median (IQR) age 9 (3-23) months, giving 5% 12-month mortality; six of 14 were HIV-uninfected; eight untested infants died of respiratory infection (three), sepsis (two), burns (one), measles (one), unknown (one). During follow-up, no bone fractures were reported to have occurred; 12/368 creatinines and seven out of 305 phosphates were grade one (16) or two (three) in 14

Comparison of bilirubin level in term infants born by vaginal delivery and C/S

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Ahmad Shah Farhat

2016-12-01

Full Text Available Background: Given the overriding importance of neonatal jaundice and scarcity of studies on the role of route of delivery on its occurrence, this study aimed to investigate the association between neonatal bilirubin level and the route of delivery (i.e., normal vaginal delivery [NVD] and cesarean section [CS]. Methods: This prospective, cross-sectional study was conducted in 2012 in Imam Reza Hospital of Mashhad, Iran, 2012. In all term infants, who met the inclusion criteria, serum bilirubin level was measured by the bili-test device between the second and seventh days after birth. In cases with skin bilirubin level>5 mg/dl, serum bilirubin was also checked. The collected data were analyzed using SPSS, version 16. Results: A total of 182 neonates were enrolled in the study, 56% of whom were male. The mean bilirubin levels in the NVD and CS groups were 9.4±2.9 mg/dl and 9.8±3.4 mg/dl, respectively (P=0.53. Additionally, comparison of the mean bilirubin levels between the two groups based of demographic characteristics demonstrated no significant differences. Conclusion: This study showed no significant correlation between neonatal jaundice in term infants and the route of delivery.

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

African Journals Online (AJOL)

Results: The commonest diagnoses at admission were schizophrenia spectrum disorders (47.4%) and bipolar spectrum disorders (30.7%). Overall diagnostic stability as measured by prospective consistency in this study was 72.8%.The most stable diagnostic category was Major Depressive Disorder (100% prospective ...

Unbound Bilirubin and Auditory Neuropathy Spectrum Disorder in Late Preterm and Term Infants with Severe Jaundice.

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Amin, Sanjiv B; Wang, Hongyue; Laroia, Nirupama; Orlando, Mark

2016-06-01

This study evaluates whether unbound bilirubin is a better predictor of auditory neuropathy spectrum disorder (ANSD) than total serum bilirubin (TSB) or the bilirubin:albumin molar ratio (BAMR) in late preterm and term neonates with severe jaundice (TSB ≥20 mg/dL or TSB that met exchange transfusion criteria). Infants ≥34 weeks' gestation with severe jaundice during the first 2 weeks of life were eligible for the prospective observational study. A comprehensive auditory evaluation was performed within 72 hours of peak TSB. ANSD was defined as absent or abnormal auditory brainstem evoked response waveform morphology at 80-decibel click intensity in the presence of normal outer hair cell function. TSB, serum albumin, and unbound bilirubin were measured using the colorimetric, bromocresol green, and modified peroxidase method, respectively. Five of 44 infants developed ANSD. By logistic regression, peak unbound bilirubin but not peak TSB or peak BAMR was associated with ANSD (OR, 4.6; 95% CI, 1.6-13.5; P = .002). On comparing receiver operating characteristic curves, the area under the curve for unbound bilirubin (0.92) was significantly greater (P = .04) compared with the area under the curve for TSB (0.50) or BAMR (0.62). Unbound bilirubin is a more sensitive and specific predictor of ANSD than TSB or BAMR in late preterm and term infants with severe jaundice. Copyright © 2016 Elsevier Inc. All rights reserved.

Characteristics of antigravity spontaneous movements in preterm infants up to 3 months of corrected age.

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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.

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

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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.

Prematurity Stereotype: Effects of Labeling on Adults' Perceptions of Infants.

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Stern, Marilyn; Hildebrandt, Katherine A.

1984-01-01

Two studies were conducted in which college students and mothers were asked to rate unfamiliar infants shown on videotapes. Infants were described as either full-term or premature and as either male or female. Infants labeled premature were rated more negatively than those labeled full-term, but infants labeled male and female were rated…

Predicting hospital mortality among frequently readmitted patients: HSMR biased by readmission

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Kelder Johannes C

2011-03-01

Full Text Available Abstract Background Casemix adjusted in-hospital mortality is one of the measures used to improve quality of care. The adjustment currently used does not take into account the effects of readmission, because reliable data on readmission is not readily available through routinely collected databases. We have studied the impact of readmissions by linking admissions of the same patient, and as a result were able to compare hospital mortality among frequently, as opposed to, non-frequently readmitted patients. We also formulated a method to adjust for readmission for the calculation of hospital standardised mortality ratios (HSMRs. Methods We conducted a longitudinal retrospective analysis of routinely collected hospital data of six large non-university teaching hospitals in the Netherlands with casemix adjusted standardised mortality ratios ranging from 65 to 114 and a combined value of 93 over a five-year period. Participants concerned 240662 patients admitted 418566 times in total during the years 2003 - 2007. Predicted deaths by the HSMR model 2008 over a five-year period were compared with observed deaths. Results Numbers of readmissions per patient differ substantially between the six hospitals, up to a factor of 2. A large interaction was found between numbers of admissions per patient and HSMR-predicted risks. Observed deaths for frequently admitted patients were significantly lower than HSMR-predicted deaths, which could be explained by uncorrected factors surrounding readmissions. Conclusions Patients admitted more frequently show lower risks of dying on average per admission. This decline in risk is only partly detected by the current HSMR. Comparing frequently admitted patients to non-frequently admitted patients commits the constant risk fallacy and potentially lowers HSMRs of hospitals treating many frequently admitted patients and increases HSMRs of hospitals treating many non-frequently admitted patients. This misleading effect can

Convergence and accommodation development is pre-programmed in premature infants

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

2015-01-01

Purpose This study investigated whether vergence and accommodation development in pre-term infants is pre-programmed or is driven by experience. Methods 32 healthy infants, born at mean 34 weeks gestation (range 31.2-36 weeks) were compared with 45 healthy full-term infants (mean 40.0 weeks) over a 6 month period, starting at 4-6 weeks post-natally. Simultaneous accommodation and convergence to a detailed target were measured using a Plusoptix PowerRefII infra-red photorefractor as a target moved between 0.33m and 2m. Stimulus/response gains and responses at 0.33m and 2m were compared by both corrected (gestational) age and chronological (post-natal) age. Results When compared by their corrected age, pre-term and full-term infants showed few significant differences in vergence and accommodation responses after 6-7 weeks of age. However, when compared by chronological age, pre-term infants’ responses were more variable, with significantly reduced vergence gains, reduced vergence response at 0.33m, reduced accommodation gain, and increased accommodation at 2m, compared to full-term infants between 8-13 weeks after birth. Conclusions When matched by corrected age, vergence and accommodation in pre-term infants show few differences from full-term infants’ responses. Maturation appears pre-programmed and is not advanced by visual experience. Longer periods of immature visual responses might leave pre-term infants more at risk of development of oculomotor deficits such as strabismus. PMID:26275135

Convergence and Accommodation Development Is Preprogrammed in Premature Infants.

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

2015-08-01

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

Lutein and preterm infants with decreased concentrations of brain carotenoids.

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Vishwanathan, Rohini; Kuchan, Matthew J; Sen, Sarbattama; Johnson, Elizabeth J

2014-11-01

Lutein and zeaxanthin are dietary carotenoids that may influence visual and cognitive development. The objective of this study was to provide the first data on distribution of carotenoids in the infant brain and compare concentrations in preterm and term infants. Voluntarily donated brain tissues from 30 infants who died during the first 1.5 years of life were obtained from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Brain and Tissue Bank. Tissues (hippocampus and prefrontal, frontal, auditory, and occipital cortices) were extracted using standard lipid extraction procedures and analyzed using reverse-phase high-pressure liquid chromatography. Lutein, zeaxanthin, cryptoxanthin, and β-carotene were the major carotenoids found in the infant brain tissues. Lutein was the predominant carotenoid accounting for 59% of total carotenoids. Preterm infants (n = 8) had significantly lower concentrations of lutein, zeaxanthin, and cryptoxanthin in their brain compared with term infants (n = 22) despite similarity in postmenstrual age. Among formula-fed infants, preterm infants (n = 3) had lower concentrations of lutein and zeaxanthin compared with term infants (n = 5). Brain lutein concentrations were not different between breast milk-fed (n = 3) and formula-fed (n = 5) term decedents. In contrast, term decedents with measurable brain cryptoxanthin, a carotenoid that is inherently low in formula, had higher brain lutein, suggesting that the type of feeding is an important determinant of brain lutein concentrations. These data reveal preferential accumulation and maintenance of lutein in the infant brain despite underrepresentation in the typical infant diet. Further investigation on the impact of lutein on neural development in preterm infants is warranted.

Probabilistic diffusion tractography of the optic radiations and visual function in preterm infants at term equivalent age.

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Bassi, Laura; Ricci, Daniela; Volzone, Anna; Allsop, Joanna M; Srinivasan, Latha; Pai, Aakash; Ribes, Carmen; Ramenghi, Luca A; Mercuri, Eugenio; Mosca, Fabio; Edwards, A David; Cowan, Frances M; Rutherford, Mary A; Counsell, Serena J

2008-02-01

Children born prematurely have a high incidence of visual disorders which cannot always be explained by focal retinal or brain lesions. The aim of this study was to test the hypothesis that visual function in preterm infants is related to the microstructural development of white matter in the optic radiations. We used diffusion tensor imaging (DTI) with probabilistic diffusion tractography to delineate the optic radiations at term equivalent age and compared the fractional anisotropy (FA) to a contemporaneous evaluation of visual function. Thirty-seven preterm infants (19 male) born at median (range) 28(+4) (24(+1)-32(+3)) weeks gestational age, were examined at a post-menstrual age of 42 (39(+6)-43) weeks. MRI and DTI were acquired on a 3 Tesla MR system with DTI obtained in 15 non-collinear directions with a b value of 750 s/mm(2). Tracts were generated from a seed mask placed in the white matter lateral to the lateral geniculate nucleus and mean FA values of these tracts were determined. Visual assessment was performed using a battery of nine items assessing different aspects of visual abilities. Ten infants had evidence of cerebral lesions on conventional MRI. Multiple regression analysis demonstrated that the visual assessment score was independently correlated with FA values, but not gestational age at birth, post-menstrual age at scan or the presence of lesions on conventional MRI. The occurrence of mild retinopathy of prematurity did not affect the FA measures or visual scores. We then performed a secondary analysis using tract-based spatial statistics to determine whether global brain white matter development was related to visual function and found that only FA in the optic radiations was correlated with visual assessment score. Our results suggest that in preterm infants at term equivalent age visual function is directly related to the development of white matter in the optic radiations.

Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants

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Jessica Rose, PhD

2014-01-01

Results suggest that at near-term age, thalamus WM microstructure may be particularly vulnerable to certain neonatal risk factors. Interactions between albumin, bilirubin, phototherapy, and brain development warrant further investigation. Identification of physiological risk factors associated with selective vulnerability of certain brain regions at near-term age may clarify the etiology of neurodevelopmental impairment and inform neuroprotective treatment for VLBW preterm infants.

Surfactant therapy in late preterm infants

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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

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

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Alvarez Marina M

2011-05-01

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

Hyperglycemia - infants

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... 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 ...

What Infant Memory Tells Us about Infantile Amnesia: Long-Term Recall and Deferred Imitation

OpenAIRE

Meltzoff, Andrew N.

1995-01-01

Long-term recall memory was assessed using a nonverbal method requiring subjects to reenact a past event from memory (deferred imitation). A large sample of infants (N = 192), evenly divided between 14- and 16-months old, was tested across two experiments. A delay of 2 months was used in Experiment 1 and a delay of 4 months in Experiment 2. In both experiments two treatment groups were used, In one treatment group, motor practice (immediate imitation) was allowed before the delay was imposed;...

Recurrent gastric lactobezoar in an infant

OpenAIRE

Castro, Leonor; Berenguer, Alberto; Pilar, Carla; Gon?alves, Rute; Nunes, Jos? L.

2014-01-01

Lactobezoars are a type of bezoar composed of undigested milk and mucus. The aetiology is likely multifactorial, being classically described in association with pre-term, low-birth weight infants fed with hyperconcentrated formula. The authors present a case of lactobezoar recurrence in a pre-term infant with oesophageal atresia. To our knowledge, this is the first report of recurrence of lactobezoar.

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

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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 PCLD. 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. Additional randomized trials are needed to confirm these findings, to

Motor development of preterm and term infants in the fundamental movement phase: a cross-sectional study

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Joyce Karla Machado da Silva

Full Text Available Abstract Introduction: Motor development is a continuous process of motor behavior changes throughout life, allowing for movement control. Premature birth can affect this process, with a greater risk of delays in acquiring these skills. Objective: Compare motor development during the fundamental movement phase of preterm infants submitted to early stimulation and full-term babies. Methods: An analytical cross-sectional study with convenience sampling, performed with twenty 3-year-old children of both sexes, distributed into two groups: the preterm group (n = 10, which received physical therapy in the first months of life, and the term group (n = 10. Motor development stages were assessed between January and April 2013, using the Motor Development Scale (Escala de Desenvolvimento Motor - EDM developed by Francisco Rosa Neto, with an average execution time of thirty minutes. Statistical analysis was performed using BioEstat 5.0 software, and the Shapiro-Wilk test was applied to verify data normality. A significance level of p ≤ 0.05 was adopted, analyzed using the Mann-Whitney test. Results: The term group exhibited significant differences in relation to the preterm group for the variables Fine and Gross Motor Skills, and Spatial and Temporal Awareness, with no differences in Balance and Body Scheme. Conclusion: Only the premature infants submitted to early intervention achieved normal levels of Balance and Body Scheme on the EDM Scale.

Infant Contingency Learning in Different Cultural Contexts

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Graf, Frauke; Lamm, Bettina; Goertz, Claudia; Kolling, Thorsten; Freitag, Claudia; Spangler, Sibylle; Fassbender, Ina; Teubert, Manuel; Vierhaus, Marc; Keller, Heidi; Lohaus, Arnold; Schwarzer, Gudrun; Knopf, Monika

2012-01-01

Three-month-old Cameroonian Nso farmer and German middle-class infants were compared regarding learning and retention in a computerized mobile task. Infants achieving a preset learning criterion during reinforcement were tested for immediate and long-term retention measured in terms of an increased response rate after reinforcement and after a…

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 Gardosi...... with lower term birthweights (39.9%) - Portugal, Italy and France - and higher term birthweights, namely Denmark, the Netherlands, Sweden (28.9%; p third...

Infant Development: Birth to 3 Months

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... that your tone of voice communicates ideas and emotions as well. Change positions. Hold your baby facing ... infant-and-toddler-health/in-depth/infant-development/art-20048012 . Mayo Clinic Footer Legal Conditions and Terms ...

The relationship between air pollution and low birth weight: effects by mother's age, infant sex, co-pollutants, and pre-term births

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Bell, Michelle L; Ebisu, Keita [School of Forestry and Environmental Studies, Yale University, 205 Prospect Street, New Haven, CT 06511 (United States); Belanger, Kathleen [Department of Epidemiology and Public Health, School of Medicine, Yale University, One Church Street, 6th Floor, New Haven, CT 06510 (United States)], E-mail: michelle.bell@yale.edu

2008-10-15

Previously we identified associations between the mother's air pollution exposure and birth weight for births in Connecticut and Massachusetts from 1999-2002. Other studies also found effects, though results are inconsistent. We explored potential uncertainties in earlier work and further explored associations between air pollution and birth weight for PM{sub 10}, PM{sub 2.5}, CO, NO{sub 2}, and SO{sub 2}. Specifically we investigated: (1) whether infants of younger ({<=}24 years) and older ({>=}40 years) mothers are particularly susceptible to air pollution's effects on birth weight; (2) whether the relationship between air pollution and birth weight differed by infant sex; (3) confounding by co-pollutants and differences in pollutants' measurement frequencies; and (4) whether observed associations were influenced by inclusion of pre-term births. Findings did not indicate higher susceptibility to the relationship between air pollution and birth weight based on the mother's age or the infant's sex. Results were robust to exclusion of pre-term infants and co-pollutant adjustment, although sample size decreased for some pollutant pairs. These findings provide additional evidence for the relationship between air pollution and birth weight, and do not identify susceptible sub-populations based on infant sex or mother's age. We conclude with discussion of key challenges in research on air pollution and pregnancy outcomes.

Neonatal Hyperbilirubinemia in infants with G6PD c.563C > TVariant

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Moiz Bushra

2012-08-01

Full Text Available Abstract Background There is a strong correlation between glucose-6-phosphate dehydrogenase (G6PD deficiency and neonatal hyperbilirubinemia with a rare but potential threat of devastating acute bilirubin encephalopathy. G6PD deficiency was observed in 4–14% of hospitalized icteric neonates in Pakistan. G6PD c.563C > T is the most frequently reported variant in this population. The present study was aimed at evaluating the time to onset of hyperbilirubinemia and the postnatal bilirubin trajectory in infants having G6PD c.563C > T. Methods This was a case–control study conducted at The Aga Khan University, Pakistan during the year 2008. We studied 216 icteric male neonates who were re-admitted for phototherapy during the study period. No selection was exercised. Medical records showed that 32 were G6PD deficient while 184 were G6PD normal. Each infant was studied for birth weight, gestational age, age at the time of presentation, presence of cephalhematoma, sepsis and neurological signs, peak bilirubin level, age at peak bilirubin level, days of hospitalization, whether phototherapy or exchange blood transfusion was initiated, and the outcome. During hospital stay, each baby was tested for complete blood count, reticulocyte count, ABO and Rh blood type, direct antiglobulin test and quantitative G6PD estimation [by kinetic determination of G6PDH]. G6PDgenotype was analyzed in 32 deficient infants through PCR-RFLP analysis and gene sequencing. Results G6PD variants c.563C > T and c.131 C > G were observed in 21 (65% and three (9% of the 32 G6PD deficient infants, respectively. DNA of eight (25% newborns remained uncharacterized. In contrast to G6PD normal neonates, infants with c.563C > T variant had significantly lower enzyme activity (mean ± 1SD; 0.3 ± 0.2 U/gHb vs. 14.0 ± 4.5 U/gHb, p p = 0.008 which peaked earlier after birth (mean ± 1SD 2.9 ± 1.6 vs. 4.3 ± 2.3 days, p = 0.007. No statistically significant

Long-Term Results of Transcatheter Closure of Patent Ductus Arteriosus in Infants Using Amplatzer Duct Occluder

Science.gov (United States)

Behjati-Ardakani, Mostafa; Behjati-Ardakani, Mohammad-Amin; Hosseini, Seyed-Habibolla; Noori, Noormohammad

2013-01-01

Objective Patent ductus arteriosus (PDA) is one of the most frequently seen congenital heart diseases. Its closure is recommended because of the risk of infective endocardis, as well as morbidity and mortality in the long. The aim of this study was to assess the long term results of the transcatheter closure of PDA in infants using amplatzer duct occlude (ADO). Methods From May 2004 to September 2011, forty eight infants underwent transcatheter closure of PDA. A lateral or right anterior oblique view aortogram was done to locate PDA and to measure its size. Before discharge, repeat aortogram was performed to evaluate eventual residual shunt and to confirm the appropriate deployment of the ADO. Follow up evaluations were done with transthoracic echocardiography at discharge, 1 month, 6 months, 12 months and yearly thereafter. Findings The mean age of patients at procedure was 9.18±2.32 (range 3 to 12) months, mean weight 6.73±1.16 (range 4.5 to 10.1) kg. The PDA occluded completely in 20 out of the 48 patients. Twenty four patients had trivial or mild shunt and two patients had moderate residual shunt which disappeared in one patient within 24 hours and other patient with moderate shunt in 1 month. One patient (age 8 months) had mild LPA stenosis. The device emobolization occurred in two patients, immediately after the procedure in one and during night in the other patient Conclusion The long term results suggested that transcatheter closure of PDA using Amplatzer duct occluder is a safe and effective treatment in infants less than 1 year of age with minimal complications. PMID:24427494

A 12-year-experience with tracheostomy for neonates and infants in northern Taiwan: Indications, hospital courses, and long-term outcomes

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Chia-Huei Chen

2018-04-01

Full Text Available Background: Tracheostomy is a valuable procedure in infants and neonates with chronic respiratory failure or severe airway obstruction. The aim of this study is to identify the indication, hospital course, and long-term outcome in a cohort of infants who required tracheostomy in a neonatal and pediatric tertiary care center in northern Taiwan. Methods: Medical records of infants, who underwent tracheostomy between January 2002 and December 2013, were retrospectively reviewed. Demographics, indication for tracheostomy, hospital course, discharge disposition, further hospitalization and surgery, and long-term outcome data were collected. Results: Fifty-six patients were enrolled. The median gestational age was 38.0 weeks, and median birth weight was 2770 g. he median age at tracheostomy was 104.5 days. The primary indications for tracheostomy were airway obstruction in 35 patients (62.5%, craniofacial anomalies in 7 (12.5%, neuromuscular disorder in 7 (12.5%, cardiopulmonary disorder in 5 (8.9%, and brain injury-related problem in 2 (3.6%. Twenty-two patients (39.3% were decannulated successfully, and the median time from tracheostomy to decannulation was 2.1 years. Overall mortality rate was 3.6%, but no death was related to tracheostomy. Forty-nine patients underwent regular follow-up at our hospital, and 46 patients (93.9% required further hospitalization, and 30 (61.2% underwent further surgery related to a respiratory problem or tracheostomy. Ratio of delayed growth at the time of tracheostomy (28.6% did not have significant difference at 1 year of age (21.4% and 2 years of age (25.0%. Conclusion: In this study, the most common indication for tracheostomy in neonates and infants was airway obstruction. Excluding patients with neuromuscular diseases, a successful decannulation rate of >50% can be achieved. Key Words: decannulation, indication, infant, outcome, tracheostomy

Feeding of preterm infants and fortification of breast milk

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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.

Motor Development of Premature Infants Born between 32 and 34 Weeks

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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.

Four-Month-Old Infants? Long-Term Memory for a Stressful Social Event

OpenAIRE

Montirosso, Rosario; Tronick, Ed; Morandi, Francesco; Ciceri, Francesca; Borgatti, Renato

2013-01-01

Infants clearly show an early capacity for memory for inanimate emotionally neutral events. However, their memory for social stress events has received far less attention. The aim of the study was to investigate infants' memory for a stressful social event (i.e., maternal unresponsiveness during the Still-Face paradigm) after a 15-day recall interval using changes in behavioral responses and salivary post-stress cortisol reactivity as measures of memory. Thirty-seven infants were exposed to s...

Initial Resuscitation at Delivery and Short Term Neonatal Outcomes in Very-Low-Birth-Weight Infants

OpenAIRE

Cho, Su Jin; Shin, Jeonghee; Namgung, Ran

2015-01-01

Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birt...

Changes in the body weight of term infants, born in the tropics, during the first seven days of life.

Science.gov (United States)

Turner, Claudia; Carrara, Verena; Thien, Naw Aye Mya; Paw, Naw Moo Ku; Rijken, Marcus; McGready, Rose; Nosten, François

2013-06-14

Identifying unwell neonates, particularly in the first week of life, is often subjective. If normal values are known, calculating the weight lost or gained from birth weight can be a useful adjunct in the evaluation of the health of a neonate. Serial body weights of well, term, breast fed infants who were attending for routine follow up, were recorded at the Shoklo Malaria Research Unit clinic in Maela Camp for displaced persons on the Thailand Myanmar border. Newborn examination was routine. Weight loss, expressed as percent weight lost from birth weight, and weight gain, expressed as a velocity (g/kg/day), was calculated for the first seven days of life. The results from normal birth weight infants, low birth weight infants (gestational age infants (SGA) were examined. In the first week of life there were no significant differences in weight gained or lost across the three study groups. The maximum weight lost was 4.4% (95% CI 4.1 - 4.6%), which occurred on day three. Weight gain ranged from 13 g/kg/day [95% CI 10 - 16] on day four to 18 g/kg/day [95% CI 15 - 20] on days six and seven. Use of these normal values for weight gain and loss, allows infants falling outside of the expected range (95% CI) to be easily identified and subsequently highlighted as needing further medical review.

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

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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.

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.

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.

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

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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.

The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program follow-up.

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Hesketh, Kylie D; Campbell, Karen; Salmon, Jo; McNaughton, Sarah A; McCallum, Zoe; Cameron, Adrian; Ball, Kylie; Gold, Lisa; Andrianopoulos, Nick; Crawford, David

2013-01-01

The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program, is a community-based, cluster-randomised controlled trial of an obesity prevention intervention delivered to first-time parents of infants from age 4-20 months. Conducted from 2008 to 2010, the program had high uptake and retention and showed positive impacts on some dietary outcomes and television viewing. Funding was secured for a follow-up study of participants two and 3.5 years post intervention (at child ages ~3.5 and 5 years). The follow-up study aims to assess intervention effects, mediators and moderators of effects, and program cost-effectiveness over the longer term. The 492 families still enrolled in the Melbourne InFANT Program at intervention conclusion will be recontacted and renewed consent sought to participate in this follow-up study. No further intervention will occur. Home visit data collections will occur approximately two and 3.5 years post intervention. Main outcomes to be assessed include child body mass index, waist circumference, diet (3 × 24-hour recalls; food frequency questionnaire), physical activity (8 days ActiGraph accelerometer data; parent reported active play) and sedentary time (8days ActiGraph accelerometer and ActivPAL inclinometer data; parent reported screen time). Follow-up of participants of the Melbourne InFANT Program at two and 3.5 years post intervention will allow assessment of longer term intervention effects, investigation of potential mediators and moderators of such effects, and economic evaluation of the longer term outcomes. This information will be valuable to researchers and policy makers in progressing the field of early childhood obesity prevention. Copyright © 2012 Elsevier Inc. All rights reserved.

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

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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 × 10 10  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 Log 10 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 jaundice, number of illnesses, sick doctor visits, or diagnoses of eczema were different for the groups at any point. The B. infantis EVC001 supplement was safely consumed and well-tolerated. Stools were fewer and better formed in infants in the BiLS group compared with LS group. Adverse events were those expected in healthy infants and not different between groups. ClinicalTrials.gov NCT02457338 . Registered May 27, 2015.

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

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.

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

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Ravinder Nagpal

2016-12-01

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

[Compassionate care for terminally ill term and preterm infants].

Science.gov (United States)

Schulze, A; Wermuth, I

2007-04-01

Involvement of the family in decisions to withhold or withdraw intensive care and parental involvement in care planning for terminally ill infants does not aggravate or prolong parents' grief responses, their feelings of guilt, or the incidence of pathological grief responses. Effective physical pain and symptom management is critically important. Compassionate care plans, however, need to implement a number of other and equally important components. Parents are not uniform in their perceived needs to make various kinds of contacts with their dying infant. They should be allowed to make their individual choices regarding contact with their baby during that time. The perinatal loss of a twin infant appears to evoke no less serious stress and risks to parents' compared to the loss of a singleton. The disruption of family life during a perinatal loss affects siblings of the baby, and their specific needs should be acknowledged. Post-death or post-autopsy meetings with the family should routinely be scheduled a few weeks after death, and bereavement support should actively be offered. Parents need to be informed about differences to be expected between maternal and paternal grief responses. The risk of pathological grief variants and chronic grief should be mentioned to parents because professional help is required in such occurrence.

Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study

Science.gov (United States)

2014-01-01

Background Few studies have focused on cerebral complications among newborn infants delivered by vacuum extraction (VE). The aim of this study was to determine the risk for intracranial haemorrhage and/or cerebral dysfunction in newborn infants delivered by VE and to compare this risk with that after cesarean section in labour (CS) and spontaneous vaginal delivery, respectively. Methods Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010 including all singleton newborn infants delivered at term after onset of labour by VE (n = 87,150), CS (75,216) or spontaneous vaginal delivery (n = 851,347), we compared the odds for neonatal intracranial haemorrhage, traumatic or non-traumatic, convulsions or encephalopathy. Logistic regressions were used to calculate adjusted (for major risk factors and indication) odds ratios (AOR), using spontaneous vaginal delivery as reference group. Results The rates of traumatic and non-traumatic intracranial hemorrhages were 0.8/10,000 and 3.8/1,000. VE deliveries provided 58% and 31.5% of the traumatic and non-traumatic cases, giving a ten-fold risk [AOR 10.05 (4.67-21.65)] and double risk [AOR 2.23 (1.57-3.16)], respectively. High birth weight and short mother were associated with the highest risks. Infants delivered by CS had no increased risk for intracranial hemorrhages. The risks for convulsions or encephalopathy were similar among infants delivered by VE and CS, exceeding the OR after non-assisted spontaneous vaginal delivery by two-to-three times. Conclusion Vacuum assisted delivery is associated with increased risk for neonatal intracranial hemorrhages. Although causality could not be established in this observational study, it is important to be aware of the increased risk of intracranial hemorrhages in VE deliveries, particularly in short women and large infants. The results warrant further studies in decision making and conduct of assisted vaginal delivery. PMID:24444326

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.

Achieving definitive results in long-chain polyunsaturated fatty acid supplementation trials of term infants: factors for consideration.

Science.gov (United States)

Meldrum, Suzanne J; Smith, Michael A; Prescott, Susan L; Hird, Kathryn; Simmer, Karen

2011-04-01

Numerous randomized controlled trials (RCTs) have been undertaken to determine whether supplementation with long-chain polyunsaturated fatty acids (LCPUFAs) in infancy would improve the developmental outcomes of term infants. The results of such trials have been thoroughly reviewed with no definitive conclusion as to the efficacy of LCPUFA supplementation. A number of reasons for the lack of conclusive findings in this area have been proposed. This review examines such factors with the aim of determining whether an optimal method of investigation for RCTs of LCPUFA supplementation in term infants can be ascertained from previous research. While more research is required to completely inform a method that is likely to achieve definitive results, the findings of this literature review indicate future trials should investigate the effects of sex, genetic polymorphisms, the specific effects of LCPUFAs, and the optimal tests for neurodevelopmental assessment. The current literature indicates a docosahexaenoic acid dose of 0.32%, supplementation from birth to 12 months, and a total sample size of at least 286 (143 per group) should be included in the methodology of future trials. © 2011 International Life Sciences Institute.

Current insights in brain protection for the sick newborn infant

OpenAIRE

KOOI E.M.W.

2015-01-01

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

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

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

Science.gov (United States)

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

2016-01-01

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

Infants' Recognition Memory for Hue

Science.gov (United States)

Bornstein, Marc H.

1976-01-01

Fifty 4-month-old infants were habituated to one wavelength of light and then tested for recognition with the original and two new spectral lights. After short- and long-term delays with different types of retroactive interference, the results indicated that the infants' recognition memory for hue was quite resilient to interference or delay. (JMB)

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

NARCIS (Netherlands)

van Kooij, B.J.M.; van Pul, C.; Benders, M.J.N.L.; van Haastert, I.C.; de Vries, L.S.; Groenendaal, F.

2011-01-01

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

Intrauterine growth restriction affects the preterm infant's hippocampus.

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Lodygensky, Gregory A; Seghier, Mohammed L; Warfield, Simon K; Tolsa, Cristina Borradori; Sizonenko, Stephane; Lazeyras, François; Hüppi, Petra S

2008-04-01

The hippocampus is known to be vulnerable to hypoxia, stress, and undernutrition, all likely to be present in fetal intrauterine growth restriction (IUGR). The effect of IUGR in preterm infants on the hippocampus was studied using 3D magnetic resonance imaging at term-equivalent age Thirteen preterm infants born with IUGR after placental insufficiency were compared with 13 infants with normal intrauterine growth age matched for gestational age. The hippocampal structural differences were defined using voxel-based morphometry and manual segmentation. The specific neurobehavioral function was evaluated by the Assessment of Preterm Infants' Behavior at term and at 24 mo of corrected age by a Bayley Scales of Infant and Toddler Development. Voxel-based morphometry detected significant gray matter volume differences in the hippocampus between the two groups. This finding was confirmed by manual segmentation of the hippocampus with a reduction of hippocampal volume after IUGR. The hippocampal volume reduction was further associated with functional behavioral differences at term-equivalent age in all six subdomains of the Assessment of Preterm Infants' Behavior but not at 24 mo of corrected age. We conclude that hippocampal development in IUGR is altered and might result from a combination of maternal corticosteroid hormone exposure, hypoxemia, and micronutrient deficiency.

Long-term mother and child mental health effects of a population-based infant sleep intervention: cluster-randomized, controlled trial.

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Hiscock, Harriet; Bayer, Jordana K; Hampton, Anne; Ukoumunne, Obioha C; Wake, Melissa

2008-09-01

Maternal depression is an established risk for adverse child development. Two thirds of clinically significant depressive symptoms occur in mothers reporting an infant sleep problem. We aimed to determine the long-term effects of a behavioral intervention for infant sleep problems on maternal depression and parenting style, as well as on child mental health and sleep, when the children reached 2 years of age. We conducted a cluster-randomized trial in well-child centers across 6 government areas of Melbourne, Australia. Participants included 328 mothers reporting an infant sleep problem at 7 months, drawn from a population sample (N = 739) recruited at 4 months. We compared the usual well-child care (n = 154) versus a brief behavior-modification program designed to improve infant sleep (n = 174) delivered by well-child nurses at ages 8 to 10 months and measured maternal depression symptoms (Edinburgh Postnatal Depression Scale); parenting practices (Parent Behavior Checklist); child mental health (Child Behavior Checklist); and maternal report of a sleep problem (yes or no). At 2 years, mothers in the intervention group were less likely than control mothers to report clinical depression symptoms: 15.4% vs 26.4% (Edinburgh Postnatal Depression Scale community cut point) and 4.2% vs 13.2% (Edinburgh Postnatal Depression Scale clinical cut point). Neither parenting style nor child mental health differed markedly between the intervention and control groups. A total of 27.3% of children in the intervention group versus 32.6% of control children had a sleep problem. The sleep intervention in infancy resulted in sustained positive effects on maternal depression symptoms and found no evidence of longer-term adverse effects on either mothers' parenting practices or children's mental health. This intervention demonstrated the capacity of a functioning primary care system to deliver effective, universally offered secondary prevention.

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

Directory of Open Access Journals (Sweden)

Aurelie Naud

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

[Impact of screening and treatment of low systemic blood flow in the prevention of severe intraventricular haemorrhage and/or death in pre-term infants].

Science.gov (United States)

Oulego Erroz, Ignacio; Alonso Quintela, Paula; Jiménez Gonzalez, Aquilina; Terroba Seara, Sandra; Rodríguez Blanco, Silvia; Rosón Varas, María; Castañón López, Leticia

2018-04-02

To assess the effect of a protocolised intervention for low systemic blood flow (SBF) in the occurrence of severe intraventricular haemorrhage (IVH) or death in pre-term infants. A study with a quasi-experimental design with retrospective controls was conducted on pre-term infants of less than 30weeks of gestational age, born between January 2016 and July 2017, who were consecutively included in the intervention period. The control cohort included pre-term infants (born between January 2013 and December 2015) matched by gestational age, birth weight, and gender (two controls for each case). The cases of low SBF diagnosed according to functional echocardiography during the study period received dobutamine (5-10μg/kg/min) for 48hours. The study included 29 cases (intervention period) and 54 controls (pre-intervention period). Ten out of 29 (34.5%) infants received dobutamine for low SBF during the intervention period, with 3/29 (10.3%) cases of severe IVH and/or death compared to 17/54 (31.5%) in the control cohort (p=.032). There was an independent association between the intervention and a decreased occurrence of severe IVH/death after adjusting for confounding factors both in the logistic regression model [OR 0.11 (95%CI: 0.01-0.65), p=.015], as well as in the sensitivity analysis using inverse probability of treatment weighting [OR 0.23 (95%CI: 0.09-0.56); p=.001]. In this study with retrospective controls, a protocolised screening, and treatment for low SBF was associated with a decreased occurrence of severe IVH or death in preterm infants. Large, adequately powered trials, are needed in order to determine whether postnatal interventions directed at low SBF can improve neurological outcomes. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Bronchiolitis-associated encephalopathy in critically-ill infants: an underestimated complication?

Science.gov (United States)

Antonucci, Roberto; Chiappe, Stefano; Porcella, Annalisa; Rosatelli, Daniela; Fanos, Vassilios

2010-05-01

To investigate the bronchiolitis-associated encephalopathy in critically ill infants. The records of infants with severe bronchiolitis admitted to our intensive care unit between 1991 and 2003 were reviewed. Subjects with underlying neurological disorders were excluded. Encephalopathy was defined as occurrence of seizures or at least two nonconvulsive neurologic manifestations. A semistructured telephone interview investigated long-term neurodevelopmental outcome. Twenty-one infants (11 newborns) were enrolled. All patients required oxygen supplementation and 14 required mechanical ventilation. Encephalopathy occurred in 10 infants, six of whom developed seizures. Encephalopathic infants frequently (six of nine) showed transient EEG abnormalities, and occasionally (one of nine) cranial ultrasound abnormalities. A positive respiratory syncytial virus test was found in five of nine encephalopathic infants. One encephalopathic patient died, while 20 infants clinically normalised before discharge and showed a good neurodevelopmental outcome. Acute encephalopathy was frequently observed in our patients with severe bronchiolitis. Long-term prognosis of encephalopathic infants was good.

Early dyadic patterns of mother-infant interactions and outcomes of prematurity at 18 months.

Science.gov (United States)

Forcada-Guex, Margarita; Pierrehumbert, Blaise; Borghini, Ayala; Moessinger, Adrien; Muller-Nix, Carole

2006-07-01

With the increased survival of very preterm infants, there is a growing concern for their developmental and socioemotional outcomes. The quality of the early mother-infant relationship has been noted as 1 of the factors that may exacerbate or soften the potentially adverse impact of preterm birth, particularly concerning the infant's later competencies and development. The first purpose of the study was to identify at 6 months of corrected age whether there were specific dyadic mother-infant patterns of interaction in preterm as compared with term mother-infant dyads. The second purpose was to examine the potential impact of these dyadic patterns on the infant's behavioral and developmental outcomes at 18 months of corrected age. During a 12-month period (January-December 1998), all preterm infants who were compliance, difficult, and passivity). At 18 months, behavioral outcomes of the children were assessed on the basis of a semistructured interview of the mother, the Symptom Check List. The Symptom Check List explores 4 groups of behavioral symptoms: sleeping problems, eating problems, psychosomatic symptoms, and behavioral and emotional disorders. At the same age, developmental outcomes were evaluated using the Griffiths Developmental Scales. Five areas were evaluated: locomotor, personal-social, hearing and speech, eye-hand coordination, and performance. Among the possible dyadic patterns of interaction, 2 patterns emerge recurrently in mother-infant preterm dyads: a "cooperative pattern" with a sensitive mother and a cooperative-responsive infant (28%) and a "controlling pattern" with a controlling mother and a compulsive-compliant infant (28%). The remaining 44% form a heterogeneous group that gathers all of the other preterm dyads and is composed of 1 sensitive mother-passive infant; 10 controlling mothers with a cooperative, difficult, or passive infant; and 10 unresponsive mothers with a cooperative, difficult, or passive infant. Among the term control

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

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

Science.gov (United States)

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

2013-03-01

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

Enhancement of object-permanence performance in the Down's syndrome infant.

Science.gov (United States)

Morss, J R

1984-01-01

Four infants with Down's syndrome (aged 19-33 months) were presented with a restructured version of an object-permanence task. Restructuring consisted of the embedding of single trials of the task within a sequence of simpler, related steps. Following failure on a standard presentation of the task, three Down's syndrome (DS) infants demonstrated success on trials embedded in the training sequence. Comparison was made with the performance of normal infants (aged 14-19 months) matched in terms of failure on the pre-test. Only two out of nine normal infants registered success on the embedded trials. Results are discussed in terms of the differences between the DS infant and the normal infant, and the former's reliance on the deliberate structuring of his learning environment by a parent or educator.

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 haemod...

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.

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

Science.gov (United States)

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

2016-03-01

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

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

Science.gov (United States)

Coret, Catherine D; Suero, Michael B; Tierney, Neena K

2014-01-01

To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. 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. 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, Pproduct-related adverse events. The natural baby skin-care products were well tolerated by infants and toddlers when used alone or as part of a skin-care regimen.

Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants.

Science.gov (United States)

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

2014-01-01

Structural brain abnormalities identified at near-term age have been recognized as potential predictors of neurodevelopment in children born preterm. The aim of this study was to examine the relationship between neonatal physiological risk factors and early brain structure in very-low-birth-weight (VLBW) preterm infants using structural MRI and diffusion tensor imaging (DTI) at near-term age. Structural brain MRI, diffusion-weighted scans, and neonatal physiological risk factors were analyzed in a cross-sectional sample of 102 VLBW preterm infants (BW ≤ 1500 g, gestational age (GA) ≤ 32 weeks), who were admitted to the Lucile Packard Children's Hospital, Stanford NICU and recruited to participate prior to routine near-term brain MRI conducted at 36.6 ± 1.8 weeks postmenstrual age (PMA) from 2010 to 2011; 66/102 also underwent a diffusion-weighted scan. Brain abnormalities were assessed qualitatively on structural MRI, and white matter (WM) microstructure was analyzed quantitatively on DTI in six subcortical regions defined by DiffeoMap neonatal brain atlas. Specific regions of interest included the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, the thalamus, and the globus pallidus. Regional fractional anisotropy (FA) and mean diffusivity (MD) were calculated using DTI data and examined in relation to neonatal physiological risk factors including gestational age (GA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis, as well as serum levels of C-reactive protein (CRP), glucose, albumin, and total bilirubin. Brain abnormalities were observed on structural MRI in 38/102 infants including 35% of females and 40% of males. Infants with brain abnormalities observed on MRI had higher incidence of BPD (42% vs. 25%) and sepsis (21% vs. 6%) and higher mean and peak serum CRP levels, respectively, (0.64 vs. 0.34 mg/dL, p = .008; 1.57 vs. 0.67�

CPR: Infant

Medline Plus

Full Text Available ... 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 Contact Us Privacy Policy Terms and Conditions All rights reserved. 2011 American National Red Cross.

Maternal Responses and Development of Communication Skills in Extremely Preterm Infants

Science.gov (United States)

Benassi, Erika; Guarini, Annalisa; Savini, Silvia; Iverson, Jana Marie; Caselli, Maria Cristina; Alessandroni, Rosina; Faldella, Giacomo; Sansavini, Alessandra

2018-01-01

The present study examined maternal responses to infants' spontaneous communicative behaviors in a sample of 20 extremely-low-gestational-age (ELGA) infants and 20 full-term (FT) infants during 30 minutes of play interaction when infants were 12 months of age. Relations between maternal responses and infants' communication skills at 12 and 24…

Wolff-Parkinson-White Syndrome in a Term Infant Presenting With Cardiopulmonary Arrest.

Science.gov (United States)

Hoeffler, Christina D; Krenek, Michele E; Brand, M Colleen

2016-02-01

Wolff-Parkinson-White syndrome is a congenital abnormality of the cardiac conduction system caused by the presence of an abnormal accessory electrical pathway between the atria and the ventricles. This can result in intermittent tachyarrhythmias such as supraventricular tachycardia. In rare occasions, sudden death may occur from atrial fibrillation with rapid ventricular conduction. Supraventricular tachycardia typically has a sudden onset and offset, classified as a paroxysmal arrhythmia. Because of the variable occurrence, Wolff-Parkinson-White syndrome may go undiagnosed in the immediate newborn period. To highlight arrhythmia as a possible cause of sudden decompensation in infants. The clinical presentation of this infant is complex and a number of potential diagnoses were considered. Preexcitation on electrocardiogram resulted in the diagnosis of Wolff-Parkinson-White syndrome. Nurses caring for infants should be alert to tachycardia and irregularities of the heart rate, including those in the prenatal history, and should report them for evaluation. While all parents should be taught to watch for signs of illness, parents of infants with Wolff-Parkinson-White have additional learning needs, including recognizing early signs and symptoms of heart failure.

Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: a randomized controlled trial.

Science.gov (United States)

Mercer, J S; Erickson-Owens, D A; Collins, J; Barcelos, M O; Parker, A B; Padbury, J F

2017-03-01

The objective of the study was to measure the effects of a 5-min delay (DCC) versus immediate cord clamping (ICC) on residual placental blood volume (RPBV) at birth, and hemoglobin and serum bilirubin at 24 to 48 h of age. In this prospective randomized controlled trial, 73 women with term (37 to 41 weeks) singleton fetuses were randomized to DCC (⩾5 min; n=37) or ICC (protocol violations. Cord milking was the proxy for DCC (n=11) when the provider could not wait. Infants randomized to DCC compared with ICC had significantly less RPBV (20.0 versus 30.8 ml kg -1 , Phemoglobin levels (19.4 versus 17.8 g dl -1 , P=0.002) at 24 to 48 h, with no difference in bilirubin levels. Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia.

Breast-Feeding Analgesia in Infants: An Update on the Current State of Evidence.

Science.gov (United States)

Benoit, Britney; Martin-Misener, Ruth; Latimer, Margot; Campbell-Yeo, Marsha

To provide an updated synthesis of the current state of the evidence for the effectiveness of breast-feeding and expressed breast milk feeding in reducing procedural pain in preterm and full-term born infants. A systematic search of key electronic databases (PubMed, CINAHL, EMBASE) was completed. Of the 1032 abstracts screened, 21 were found eligible for inclusion. Fifteen studies reported on the use of breast-feeding or expressed breast milk in full-term infants and 6 reported on preterm infants. Direct breast-feeding was more effective than maternal holding, maternal skin-to-skin contact, topical anesthetics, and music therapy, and was as or more effective than sweet tasting solutions in full-term infants. Expressed breast milk was not consistently found to reduce pain response in full-term or preterm infants. Studies generally had moderate to high risk of bias. There is sufficient evidence to recommend direct breast-feeding for procedural pain management in full-term infants. Based on current evidence, expressed breast milk alone should not be considered an adequate intervention.

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

Directory of Open Access Journals (Sweden)

Maria Angélica de Almeida Porto

2011-10-01

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

Bone mineral content (BMC) and serum vitamin D concentrations of infants fed partially hydrolyzed infant formulas

Science.gov (United States)

The purpose of the study was to compare the bone status of healthy, term infants fed partially hydrolyzed whey formulas during the first 3 mo of life. Between 0 and 8 d of age, 89 infants were randomized to Good Start Supreme (GSS) or an experimental whey-based formula (EF) to 84 d of age. BMC was a...

Infant Development: Milestones from 4 to 6 Months

Science.gov (United States)

... safe, secure and loved. When you hold or rock your baby, talk quietly or sing soothing songs. ... infant-and-toddler-health/in-depth/infant-development/art-20048178 . Mayo Clinic Footer Legal Conditions and Terms ...

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

Science.gov (United States)

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

2016-07-01

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

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

Science.gov (United States)

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

2015-01-01

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

Enteral nutrition for preterm infants: by bolus or continuous? An update

Directory of Open Access Journals (Sweden)

Valentina Bozzetti

2017-06-01

Full Text Available Optimization of nutritional management of preterm infants is crucial for achievement of their long-term health. Enteral nutrition is preferred to total parenteral nutrition (TPN because the former avoids complications related to vascular catheterization, sepsis, adverse effects of TPN, and fasting. Due to the lack of ability of preterm infants to coordinate suckling, swallowing, and breathing, tube feeding is necessary for most infants less than 1500 g to ensure sufficient feeding tolerance, to support optimal growth and to reduce the risk of aspiration. Therefore, feeding by orogastric or nasogastric tube using either continuous or intermittent bolus delivery of formula or human milk is common practice for these infants. Theoretical risks and benefits of both continuous nasogastric milk feeding and intermittent bolus milk feeding have been proposed. According to the literature, continuous nutrition could be preferred in smaller infants (as those with a birthweight below 1250 g or hemodynamically impaired infants; in stable growing infants nutrition can be administered intermittently as in healthy term infants.

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

Localised photoplethysmography imaging for heart rate estimation of pre-term infants in the clinic

Science.gov (United States)

Chaichulee, Sitthichok; Villarroel, Mauricio; Jorge, João.; Arteta, Carlos; Green, Gabrielle; McCormick, Kenny; Zisserman, Andrew; Tarassenko, Lionel

2018-02-01

Non-contact vital-sign estimation allows the monitoring of physiological parameters (such as heart rate, respiratory rate, and peripheral oxygen saturation) without contact electrodes or sensors. Our recent work has demonstrated that a convolutional neural network (CNN) can be used to detect the presence of a patient and segment the patient's skin area for vital-sign estimation, thus enabling the automatic continuous monitoring of vital signs in a hospital environment. In a study approved by the local Research Ethical Committee, we made video recordings of pre-term infants nursed in a Neonatal Intensive Care Unit (NICU) at the John Radcliffe Hospital in Oxford, UK. We extended the CNN model to detect the head, torso and diaper of the infants. We extracted multiple photoplethysmographic imaging (PPGi) signals from each body part, analysed their signal quality, and compared them with the PPGi signal derived from the entire skin area. Our results demonstrated the benefits of estimating heart rate combined from multiple regions of interest using data fusion. In the test dataset, we achieved a mean absolute error of 2.4 beats per minute for 80% (31.1 hours) from a total recording time of 38.5 hours for which both reference heart rate and video data were valid.

Infant foods: Debatable questions and real answers

Directory of Open Access Journals (Sweden)

S. V. Belmer

2015-01-01

Full Text Available In Ms/her practice, a pediatrician frequently faces ambiguous questions about foods for infants during the first year of life in particular. Not only parents ask pediatricians these questions - the latter naturally arise during work and attempts to pinpoint the problem of adequate nutrition during infancy. These questions are whether complementary foods containing starch cause allergy in an infant; gluten is a detrimental ingredient of infant foods; hydrolysis of cereal polysaccharides is essential; palm oil is dangerous to an infant's health; butter fat as an ingredient infant foods may be harmful to a child. Among other things, butter fat in globules is shown to contain phospholipids, gangliosides, cholesterol, which are essential for a child's development and absent in infant formulas. In this connection, addition of fat globule membranes to foods is promising in terms of the provision of an infant with lipids of full value. There is a need for further in-depth investigations of infant feeding practices, by keeping in mind numerous features of an infant's organism.

Altered Amygdala Development and Fear Processing in Prematurely Born Infants

Science.gov (United States)

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

2016-01-01

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

Outcomes for Extremely Premature Infants

Science.gov (United States)

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

2015-01-01

Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (CPAP, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages. The striking similarities in response to extreme prematurity in the lung and brain imply that agents and

Soy protein-based infant formulas with supplemental fructooligosaccharides: gastrointestinal tolerance and hydration status in newborn infants.

Science.gov (United States)

Lasekan, John; Baggs, Geraldine; Acosta, Sonja; Mackey, Amy

2015-04-22

Unlike milk-based infant formulas, soy-based infant formulas containing supplemental fructooligosaccharides (FOS) have not been clinically evaluated. A randomized, double-blind, 28 day parallel feeding trial compared gastrointestinal (GI) tolerance and hydration in healthy term newborn infants fed either a commercialized soy formula (with history of safe use) containing sucrose as 20% of total carbohydrate, no supplemental short-chain FOS (scFOS) and no mixed carotenoids (lutein, lycopene, beta-carotene) as a control (CF, n = 62 infants) or one of two experimental soy-based formulas, EF1 (n = 64) and EF2 (n = 62) containing scFOS (2.5 g/L) and mixed carotenoids. EF1 differed from EF2 by containing sucrose. Results indicated no significant study group differences (p > 0.05) in study completion rates (CF = 81, EF1 = 86, & EF2 = 87%), growth, mean rank stool consistency, stool frequency, formula intake, spit-up/vomit, and safety measures (urine specific gravity, USG; hydration status and adverse events). Mean USGs for study groups were normal ( CF group in percent yellow stools (p < 0.01 at age 14 days). In conclusion, the study suggested that term infants fed soy-based formulas supplemented with scFOS and mixed carotenoids, with or without sucrose in the 1st 35 days of infancy demonstrated good tolerance and hydration comparable to the control soy-based formula with history of safe use.

Timely sleep facilitates declarative memory consolidation in infants

OpenAIRE

Seehagen, Sabine; Konrad, Carolin; Herbert, Jane S.; Schneider, Silvia

2015-01-01

The potential benefits of infant sleep for memory processing are largely unexplored. Here we show evidence that having an extended nap (≥30 min) within 4 h of learning helps 6- and 12-month-old infants to retain their memories for new behaviors across a 4- and 24-h delay. These results suggest that infants rely on frequent naps for the formation of long-term memories.

[Macronutrients and energy in milk from mothers of premature infants].

Science.gov (United States)

He, Bi-Zi; Sun, Xiu-Jing; Quan, Mei-Ying; Wang, Dan-Hua

2014-07-01

To study the dynamic changes in macronutrients and energy in human milk from mothers of premature infants. A total of 339 human milk samples were collected from 170 women who delivered preterm or full-term infants in the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital between November 2012 and January 2014. Macronutrients (proteins, fats and carbohydrates and energy were measured using a MIRIS human milk analyzer and compared between groups. In milk samples from premature infants' mothers, the protein levels were the highest in colostrum (2.22±0.49 g/dL), less in transitional milk (1.83±0.39 g/dL), and the least in mature milk (1.40±0.28 g/dL) (Pmacronutrients and energy in milk from mothers of premature infants vary significantly between colostrum, transitional milk, and mature milk. Protein levels are significantly higher in colostrum from premature infants' mothers than in colostrum from term infants' mothers, but the significant difference is not seen for mature milk. Macronutrient and energy levels show significant differences between milk samples from mothers of premature infants with different gestational ages, so as to meet different needs of premature infants.

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

Science.gov (United States)

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

2015-01-01

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

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...

Post partum emotional distress in mothers of preterm infants: a ...

African Journals Online (AJOL)

More mothers of preterm neonates(27.3%) had GHQ-30 scores which categorised them as having significant emotional distress than mothers of full term normal infants(3.7%). Similarly more mothers of preterm neonates(15.1%) were more depressed than mothers of full term normal infants(3.7%). These differences were ...

Analysis of sensory processing in preterm infants.

Science.gov (United States)

Cabral, Thais Invenção; da Silva, Louise Gracelli Pereira; Martinez, Cláudia Maria Simões; Tudella, Eloisa

2016-12-01

Premature birth suggests condition of biological vulnerability, predisposing to neurological injuries, requiring hospitalization in Neonatal Intensive Care Units, which, while contributing to increase the survival rates, expose infants to sensory stimuli harmful to the immature organism. To evaluate the sensory processing at 4 and 6months' corrected age. This was a descriptive cross-sectional study with a sample of 30 infants divided into an experimental group composed of preterm infants (n=15), and a control group composed of full-term infants (n=15). The infants were assessed using the Test of Sensory Functions in Infants. The preterm infants showed poor performance in the total score of the test in reactivity to tactile deep pressure and reactivity to vestibular stimulation. When groups were compared, significant differences in the total score (p=0.0113) and in the reactivity to tactile deep pressure (psensory processing. These changes were most evident in reactivity to tactile deep pressure and vestibular stimulation. Copyright © 2016. Published by Elsevier Ireland Ltd.

Association of Age With Risk of Hospitalization for Respiratory Syncytial Virus in Preterm Infants With Chronic Lung Disease.

Science.gov (United States)

Winterstein, Almut G; Choi, Yoonyoung; Meissner, H Cody

2018-02-01

It is unknown whether the age threshold (≤24 months) for preterm infants with chronic lung disease (CLD) to receive immunoprophylaxis for respiratory syncytial virus (RSV) as currently recommended by American Academy of Pediatrics guidelines correctly identified infants at higher risk for hospitalization for RSV. To determine the age when the risk of hospitalization for RSV among preterm infants with CLD becomes equivalent to the risk for healthy, 1-month-old term infants who do not qualify for immunoprophylaxis. A retrospective cohort study was conducted of 1 018 593 healthy term infants and 5181 preterm infants with CLD using Medicaid billing records (Medicaid Analytic eXtract files) from January 1, 1999, to December 31, 2010, linked to Florida and Texas birth and death certificates. Age-trend discrete time logistic regression models within a survival analysis framework were developed, adjusting for covariates including the use of immunoprophylaxis, to compare the risk of hospitalization of preterm infants (CLD at 3 through 34 months of age with the risk of hospitalization of term infants (37-41 weeks' gestational age) at 1 month of age. Age at which risk of hospitalization for RSV among preterm infants with CLD equals the risk for healthy term infants at age 1 month. The study cohort included 1 018 593 healthy term infants and 5181 preterm infants with CLD; because patients could reenter the cohort for a second or third season, the total study cohort consisted of 1 880 531 healthy term infant-seasons (926 206 girls and 954 325 boys; mean [SD] age at first season entry, 12.6 [9.6] months) and 8680 CLD infant-seasons (3519 girls and 5161 boys; mean [SD] age at first season entry, 15.1 [9.1] months). Among term infants with siblings, the risk of hospitalization for RSV averaged across all covariate strata was 9.0 (95% CI, 8.4-9.6) per 1000 patient season-months at 1 month of age. The risk of hospitalization for RSV among preterm infants with CLD

Copenhagen infant mental health project

DEFF Research Database (Denmark)

Væver, Mette Skovgaard; Smith-Nielsen, Johanne; Lange, Theis

2016-01-01

such as physical and mental health, educational and labor market success, social network and establishing of family. Secure attachment is associated with optimal outcomes in all developmental domains in childhood, and both insecure and disorganized attachment are associated with a range of later problems......Background: Infant mental health is a significant public health issue as early adversity and exposure to early childhood stress are significant risk factors that may have detrimental long-term developmental consequences for the affected children. Negative outcomes are seen on a range of areas...... in the City of Copenhagen, Denmark. During the project a general population of an estimated 17.600 families with an infant aged 2–12 months are screened for two known infant mental health risks, maternal postnatal depression and infant social withdrawal. Eligible families (N = 314), who agree to participate...

Benefits of human milk in preterm infant feeding

OpenAIRE

Enrico Bertino; Paola Di Nicola; Francesca Giuliani; Chiara Peila; Elena Cester; Cristina Vassia; Alice Pirra; Paola Tonetto; Alessandra Coscia

2012-01-01

Mother’s own milk is widely recognized as the optimal feeding not only for term but also for preterm infants. Evidence documents short and long-term metabolic, immunologic and neurodevelopmental advantages of breastfeeding when compared to formula. Moreover benefits of breastfeeding on psychological and relational aspects have to be considered. In order to meet the unique nutritional requirements of preterm infants and preserve the singular benefit of breastfeeding, human milk should be forti...

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

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

Science.gov (United States)

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

2015-01-01

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

Neonatal Morphine Exposure in Very Preterm Infants – Cerebral Development and Outcomes

Science.gov (United States)

Steinhorn, Rachel; McPherson, Chris; Anderson, Peter J; Neil, Jeffrey; Doyle, Lex W; Inder, Terrie

2015-01-01

Objective To investigate the association of morphine exposure in very preterm infants with cerebral volumes and neurodevelopmental outcome from birth through middle childhood. Study design Observational study of very preterm infants in the Victorian Infant Brain Study cohort. 230 infants born neonatal intensive care unit (NICU) of the Royal Women’s Hospital. 57 (25%) infants received morphine analgesia during their NICU stay at the attending physician’s discretion. Primary outcomes were regional brain volumes at term and 7 years; neurobehavioral performance at term; and cognitive, motor, emotional, behavioral, communication, and executive function scores at age 2 and 7 years. Linear regressions were used to compare outcomes between participants who did and did not receive morphine. Results At term, preterm infants who received morphine had similar rates of grey matter injury to no-morphine infants, but a trend towards smaller cortical volumes in the orbitofrontal (pleft=0.002, pright=0.01) and subgenual (pleft=0.01) regions. At seven years, cortical volumes did not differ between groups. At 2 years, morphine-exposed children were more likely to show behavioral dysregulation (p=0.007) than no-morphine children, but at seven years no detrimental impacts of morphine on neurobehavioral outcome were observed. Conclusions Low-dose morphine analgesia received during neonatal intensive care was associated with early alterations in cerebral structure and short-term neurobehavioral problems that did not persist into childhood. PMID:25919729

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…

Automated respiratory support in newborn infants.

Science.gov (United States)

Claure, Nelson; Bancalari, Eduardo

2009-02-01

A considerable proportion of premature infants requires mechanical ventilatory support and supplemental oxygen. Due to their immaturity, exposure to these forms of respiratory support contributes to the development of lung injury, oxidative stress and abnormal retinal development. These conditions are associated with poor long-term respiratory and neurological outcome. Mechanically ventilated preterm infants present with frequent fluctuations in ventilation and gas exchange. Currently available ventilatory modes and manual adjustment to the ventilator or supplemental oxygen cannot effectively adapt to these recurrent fluctuations. Moreover, the respiratory support often exceeds the infant's real needs. Techniques that adapt the mechanical ventilatory support and supplemental oxygen to the changing needs of preterm infants are being developed in order to improve stability of gas exchange, to minimise respiratory support and to reduce personnel workload. This article describes the preliminary evidence on the application of these new techniques in preterm infants and animal models.

Parenting stress in mothers of very preterm infants -- influence of development, temperament and maternal depression.

Science.gov (United States)

Gray, Peter H; Edwards, Dawn M; O'Callaghan, Michael J; Cuskelly, Monica; Gibbons, Kristen

2013-09-01

To measure levels of parenting stress and postnatal depression in mothers of very preterm infants in comparison with mothers of infants born at term is the objective of this study. The study also aimed to explore factors associated with parenting stress in the mothers of the preterm infants. One hundred and five mothers who delivered 124 babies at ≤30 weeks gestation were enrolled together with 105 term mothers who delivered 120 babies. At one year of age (corrected for prematurity for the preterm cohort), the mothers completed the Parenting Stress Index Short Form (PSI), the Edinburgh Postnatal Depression Scale (EPDS) and the Short Temperament Scale for Toddlers. The infants had neurodevelopmental assessment. The preterm and term groups were compared. Questionnaires were completed by 101 of the preterm mothers and 98 of the term mothers. The mean PSI Total Stress score was significantly higher for the preterm mothers (70.28 vs 64.52, p = 0.022), with 19% of the preterm group and 9% of the term group having high scores (p = 0.038).There was no group difference on the EPDS or measures of temperament, with disability being greater in the preterm infants. For the preterm group, maternal depression and infant temperament were independent predictors of Total Stress scores on multivariate analysis. Parenting stress in mothers of preterm infants at one year of age is significantly greater than that found in mothers of term infants. For preterm mothers, symptoms of depression and infant temperament are independent risk factors for higher levels of parenting stress. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2016-02-01

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

Postdischarge growth assessment in very low birth weight infants.

Science.gov (United States)

Park, Joon-Sik; Han, Jungho; Shin, Jeong Eun; Lee, Soon Min; Eun, Ho Seon; Park, Min-Soo; Park, Kook-In; Namgung, Ran

2017-03-01

The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months ( P =0.045 for weight and P =0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months ( P <0.001 for weight and P =0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards ( P <0.001). Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

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.

White Matter Injury and General Movements in High-Risk Preterm Infants.

Science.gov (United States)

Peyton, C; Yang, E; Msall, M E; Adde, L; Støen, R; Fjørtoft, T; Bos, A F; Einspieler, C; Zhou, Y; Schreiber, M D; Marks, J D; Drobyshevsky, A

2017-01-01

Very preterm infants (birth weight, cognitive and motor impairment, including cerebral palsy. These adverse neurodevelopmental outcomes are associated with white matter abnormalities on MR imaging at term-equivalent age. Cerebral palsy has been predicted by analysis of spontaneous movements in the infant termed "General Movement Assessment." The goal of this study was to determine the utility of General Movement Assessment in predicting adverse cognitive, language, and motor outcomes in very preterm infants and to identify brain imaging markers associated with both adverse outcomes and aberrant general movements. 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 movements were assessed at 10-15 weeks' postterm age, and neurodevelopmental outcomes were evaluated at 2 years by using the Bayley Scales of Infant and Toddler Development III. Nine infants had aberrant general movements and were more likely to have adverse neurodevelopmental outcomes, compared with infants with normal movements. In infants with aberrant movements, Tract-Based Spatial Statistics analysis identified significantly lower fractional anisotropy in widespread white matter tracts, including the corpus callosum, inferior longitudinal and fronto-occipital fasciculi, internal capsule, and optic radiation. The subset of infants having both aberrant movements and abnormal neurodevelopmental outcomes in cognitive, language, and motor skills had significantly lower fractional anisotropy in specific brain regions. Aberrant general movements at 10-15 weeks' postterm are associated with adverse neurodevelopmental outcomes and specific white matter microstructure abnormalities for cognitive, language, and motor delays. © 2017 by American Journal of Neuroradiology.

Soy Protein-Based Infant Formulas with Supplemental Fructooligosaccharides: Gastrointestinal Tolerance and Hydration Status in Newborn Infants

Directory of Open Access Journals (Sweden)

John Lasekan

2015-04-01

Full Text Available Unlike milk-based infant formulas, soy-based infant formulas containing supplemental fructooligosaccharides (FOS have not been clinically evaluated. A randomized, double-blind, 28 day parallel feeding trial compared gastrointestinal (GI tolerance and hydration in healthy term newborn infants fed either a commercialized soy formula (with history of safe use containing sucrose as 20% of total carbohydrate, no supplemental short-chain FOS (scFOS and no mixed carotenoids (lutein, lycopene, beta-carotene as a control (CF, n = 62 infants or one of two experimental soy-based formulas, EF1 (n = 64 and EF2 (n = 62 containing scFOS (2.5 g/L and mixed carotenoids. EF1 differed from EF2 by containing sucrose. Results indicated no significant study group differences (p > 0.05 in study completion rates (CF = 81, EF1 = 86, & EF2 = 87%, growth, mean rank stool consistency, stool frequency, formula intake, spit-up/vomit, and safety measures (urine specific gravity, USG; hydration status and adverse events. Mean USGs for study groups were normal (<1.03. The EF1 > CF group in percent yellow stools (p < 0.01 at age 14 days. In conclusion, the study suggested that term infants fed soy-based formulas supplemented with scFOS and mixed carotenoids, with or without sucrose in the 1st 35 days of infancy demonstrated good tolerance and hydration comparable to the control soy-based formula with history of safe use.

Infant Imitation After a 1-Week Delay: Long-Term Memory for Novel Acts and Multiple Stimuli.

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Meltzoff, Andrew N

1988-07-01

Deferred imitation after a 1-week delay was examined in 14-month-old infants. Six actions, each using a different object, were demonstrated to each infant. One of the six actions was a novel behavior that had a zero probability of occurrence in spontaneous play. In the imitation condition, infants observed the demonstration but were not allowed to touch the objects, thus preventing any immediate imitation. After the 1-week delay, infants returned to the laboratory and their imitation of the adult's previous actions was scored. Infants in the imitation condition produced significantly more of the target actions than infants in control groups who were not exposed to the modeling; there was also strong evidence for the imitation of the novel act. From a cognitive perspective deferred imitation provides a means of assessing recall memory and representation in children. From a social-developmental viewpoint the findings illustrate that the behavioral repertoire of infants and their knowledge about objects can expand as a result of seeing the actions of others.

Infants' long-term memory for a serial list: recognition and reactivation.

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Gulya, M; Galluccio, L; Wilk, A; Rovee-Collier, C

2001-04-01

Serial lists contain information about item identity and item order. Using a task designed for nonverbal animals, we previously found that 3- and 6-month-olds exhibited a primacy effect after 24 hr, remembering both item identity and item order. Presently, we examined their memory of list information after longer delays. In Experiment 1, the serial-position curve reverted to a U-shape after 1 week at both ages, revealing that the common practice of attributing primacy and recency effects to long- and short-term memory, respectively, is flawed. In Experiment 2, a precuing procedure confirmed that 6-month-olds' memory still contained order information after 1 week, but 3-month-olds' reactivated memory contained none. Experiments 3A and 3B confirmed that increasing the complexity of information that was learned shortened the delay after which it could be retrieved. Testing infants after delays longer than have previously been used with animals or human adults sheds new light on an old phenomenon. Copyright 2001 John Wiley & Sons, Inc.

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

OpenAIRE

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

2011-01-01

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

Peripheral nervous system maturation in preterm infants: longitudinal motor and sensory nerve conduction studies.

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Lori, S; Bertini, Giovanna; Bastianelli, M; Gabbanini, S; Gualandi, D; Molesti, E; Dani, C

2018-04-10

To study the evolution of sensory-motor nerves in the upper and lower limbs in neurologically healthy preterm infants and to use sensory-motor studies to compare the rate of maturation in preterm infants at term age and full-term healthy neonates. The study comprised 26 neurologically normal preterm infants born at 23-33 weeks of gestational age, who underwent sensory nerve conduction and motor nerve conduction studies from plantar medial and median nerves and from tibial and ulnar nerves, respectively. We repeated the same neurophysiological studies in 19 of the preterm infants every 2 weeks until postnatal term age. The data from the preterm infants at term was matched with a group of ten full-term babies a few days after birth. The motor nerve conduction velocity of the tibial and ulnar nerves showed progressive increases in values in relation to gestational age, but there was a decrease of values in distal latencies and F wave latencies. Similarly, there was a gradual increase of sensory nerve conduction velocity values of the medial plantar and median nerves and decreases in latencies in relation to gestational age. At term age, the preterm infants showed significantly lower values of conduction velocities and distal latencies than the full-term neonates. These results were probably because the preterm infants had significantly lower weights, total length and, in particular, distal segments of the limbs at term age. The sensory-motor conduction parameters were clearly related to gestational age, but extrauterine life did not affect the maturation of the peripheral nervous system in the very preterm babies who were neurologically healthy.

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

Science.gov (United States)

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

2013-01-01

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

CT findings and prognosis of 70 full-term infants having spasm due to hypoxic ischemic encephalography following asphyxia

International Nuclear Information System (INIS)

Ogita, Yasutoki; Kawakami, Tadashi; Tsunei, Mikio; Ohta, Yuko; Sone, Yoshiharu; Akamatsu, Hiroshi

1984-01-01

Relationship between cranial CT findings and prognosis at 12 months or more after birth was studied in 70 full-term (appropriate for date and large for date) infants who had spasm due to hypoxic ischemic encephalopathy following neonatal asphyxia. There was correlation between the prognosis of the infants and neonatal CT findings showing slight and marked low density areas in the brain parenchyma. However, it was sometimes difficult to estimate the prognosis when the low density area was moderate on CT. Therefore, follow-up CT at one and six months and one year after birth was required to examine changes in low density areas for the estimation of prognosis. The prognosis was unfavorable in cases of the disease accompanied by hemorrhage in the brain parenchyma or cerebral ventricle, persistent cerebral edema on neonatal CT, and low density areas in the atrophied brain by the follow-up CT. There was no consistent relationship between subarachnoid hemorrhage and the prognosis. (Namekawa, K.)

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…

Influence of Labeling on Ratings of Infants: A Prematurity Prejudice.

Science.gov (United States)

Miller, Michael D.; Ottinger, Donald R.

Two full term and two preterm infants were videotaped while being administered six items from the Brazelton Scale. Infants were assigned alternately the labels "preterm" and "fullterm" and shown to a group of 256 undergraduate students. It was hypothesized that: (1) subjects who view infants labeled as preterm would rate them lower on objective…

Managing hypertension in the newborn infants

Directory of Open Access Journals (Sweden)

Azar Nickavar

2014-01-01

Full Text Available 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 umbilical artery catheterization, congenital renal structural malformation, renovascular disease, aortic coarctation, as well as acute kidney injury and certain medications. A careful diagnostic evaluation should lead to identification of the underlying cause of hypertension in most infants. Treatment options should be tailored to the severity; and underlying cause of hypertension, including intravenous and/or oral therapy. This review summarizes recent work in these areas, focusing on optimal BP measurement, definition, evaluation and management of hypertension as well as advances in drug therapy of neonatal hypertension.

Social cues at encoding affect memory in 4-month-old infants.

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Kopp, Franziska; Lindenberger, Ulman

2012-01-01

Available evidence suggests that infants use adults' social cues for learning by the second half of the first year of life. However, little is known about the short-term or long-term effects of joint attention interactions on learning and memory in younger infants. In the present study, 4-month-old infants were familiarized with visually presented objects in either of two conditions that differed in the degree of joint attention (high vs. low). Brain activity in response to familiar and novel objects was assessed immediately after the familiarization phase (immediate recognition), and following a 1-week delay (delayed recognition). The latency of the Nc component differentiated between recognition of old versus new objects. Pb amplitude and latency were affected by joint attention in delayed recognition. Moreover, the frequency of infant gaze to the experimenter during familiarization differed between the two experimental groups and modulated the Pb response. Results show that joint attention affects the mechanisms of long-term retention in 4-month-old infants. We conclude that joint attention helps children at this young age to recognize the relevance of learned items.

Determinants of body composition in preterm infants at the time of hospital discharge.

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Simon, Laure; Frondas-Chauty, Anne; Senterre, Thibault; Flamant, Cyril; Darmaun, Dominique; Rozé, Jean-Christophe

2014-07-01

Preterm infants have a higher fat mass (FM) percentage and a lower fat-free mass (FFM) than do term infants at the time of hospital discharge. We determined perinatal and nutritional factors that affect the body composition of preterm infants at discharge. A total of 141 preterm infants born at FFM was compared with reference data in term infants according to sex and gestational age. Linear regression produced an excellent model to predict absolute FFM from perinatal characteristics and nutrition (R(2) = 0.82) but not the FM percentage (R(2) = 0.24). Gestational and postnatal ages played an equal role in absolute FFM accretion, as did the initial growth (between birth and day 5) and growth between day 5 and discharge. Antenatal corticosteroid treatment slightly reduced FFM accretion. As concerns nutritional intake, a higher protein:energy ratio at days 10 and 21 was significantly associated with decreased risk of an FFM deficit when preterm infants were compared with reference values for term infants. Boys had higher risk of an FFM deficit than did girls. The initial growth and quality of nutrition were significantly associated with absolute FFM accretion during a hospital stay in preterm infants. This trial was registered at clinicaltrials.gov as NCT01450436. © 2014 American Society for Nutrition.

The Sleeping Infant Brain Anticipates Development.

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Friedrich, Manuela; Wilhelm, Ines; Mölle, Matthias; Born, Jan; Friederici, Angela D

2017-08-07

From the age of 3 months, infants learn relations between objects and co-occurring words [1]. These very first representations of object-word pairings in infant memory are considered as non-symbolic proto-words comprising specific visual-auditory associations that can already be formed in the first months of life [2-5]. Genuine words that refer to semantic long-term memory have not been evidenced prior to 9 months of age [6-9]. Sleep is known to facilitate the reorganization of memories [9-14], but its impact on the perceptual-to-semantic trend in early development is unknown. Here we explored the formation of word meanings in 6- to 8-month-old infants and its reorganization during the course of sleep. Infants were exposed to new words as labels for new object categories. In the memory test about an hour later, generalization to novel category exemplars was tested. In infants who took a short nap during the retention period, a brain response of 3-month-olds [1] was observed, indicating generalizations based on early developing perceptual-associative memory. In those infants who napped longer, a semantic priming effect [15, 16] usually found later in development [17-19] revealed the formation of genuine words. The perceptual-to-semantic shift in memory was related to the duration of sleep stage 2 and to locally increased sleep spindle activity. The finding that, after the massed presentation of several labeled category exemplars, sleep enabled even 6-month-olds to create semantic long-term memory clearly challenges the notion that immature brain structures are responsible for the typically slower lexical development. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Relation between sleep status of preterm infants aged 1-2 years and mothers' parenting stress.

Science.gov (United States)

Asaka, Yoko; Takada, Satoshi

2013-08-01

The aim of this study was to compare infants' sleep measures through an actigraph and maternal parenting stress among preterm and full-term mothers, and to explore the factors affecting maternal parenting stress in relation to infants' sleep. The subjects were 44 pairs of mothers and children. Twenty-one were in the preterm group, and 23 were in the full-term group. Inclusion criteria for preterm infants were born at less than 36 weeks and birthweight of less than 2500 g. The Parenting Stress Index (PSI) Short Form assesses maternal perception of the degree of parenting stress: the children's domain, and the parent's domain. An actigraph was applied to assess the infants' sleep measures. The PSI showed significant differences, with high scores in parenting stress in the preterm group. Also, the number of mothers who complained about their infant's sleep issues was significantly higher in the preterm group. Most of the sleep measures showed improvement by their age in both preterm and full-term infants. Multiple linear regression analysis showed that sleep efficiency, longest sleep duration at nighttime accounted for 71% of stress in the children's domain of the PSI of the preterm group. The parenting stress among mothers of preterm infants was significantly higher than that of mothers of full-term infants. The mothers of preterm infants were concerned about their infant's nocturnal sleep quality. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Family Centered Intervention with Infant Failure to Thrive.

Science.gov (United States)

Drotar, Dennis

The experience of consultants in a pediatric hospital indicates that infant failure to thrive is almost always associated with strain in the relationships of the infant's caregivers. Consequently, a nontraditional, long-term, home-based, and family-centered model of evaluation and treatment of failure to thrive has been developed which involves…

[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.

The Utility of Routine Echocardiography in Newborn Infants with a Persistent Oxygen Requirement

LENUS (Irish Health Repository)

Walsh, N

2018-05-01

In the era of antenatal screening for congenital heart disease (CHD), infants presenting with an undiagnosed significant CHD are rare. However, term infants admitted with an initial diagnosis of TTN and a prolonged oxygen requirement often undergo an echocardiogram. We aimed to assess whether this practice yields any additional cases of undiagnosed CHD. We performed a retrospective chart review over a three year period [2013 – 2015] of term (> 36 weeks) infants admitted to the NICU for ≥ 5 days with a diagnosis of TTN and received an echocardiogram. The presence of CHD on the echocardiogram was assessed. Forty-seven infants were enrolled. The median age of echocardiogram was day four [2 – 8]. No infant had a diagnosis of significant CHD on the postnatal echocardiogram. A small muscular VSD was identified in two infants. Routine echocardiography for this cohort of infants to rule out major CHD appears to be unwarranted.

Music therapy with hospitalized infants-the art and science of communicative musicality.

Science.gov (United States)

Malloch, Stephen; Shoemark, Helen; Črnčec, Rudi; Newnham, Carol; Paul, Campbell; Prior, Margot; Coward, Sean; Burnham, Denis

2012-07-01

Infants seek contingent, companionable interactions with others. Infants in a Neonatal Intensive Care Unit (NICU), while receiving care that optimizes their chances of survival, often do not have the kind of interactions that are optimal for their social development. Live music therapy (MT) with infants is an intervention that aims for contingent, social interaction between therapist and infant. This study, with a limited numbers of infants, examined the effectiveness of an MT intervention in the NICU at The Royal Children's Hospital Melbourne. Two groups of late pre-term and full-term infants were recruited to the study; one was given MT and the other was not. A healthy group of infants not given MT served as an additional control. The effect of MT was indexed using two measures reflecting infant social engagement: the Neurobehavioral Assessment of the Preterm Infant (NAPI) and the Alarm Distress Baby Scale (ADBB). Results suggest that the MT intervention used at The Royal Children's Hospital Melbourne supports infants' neurobehavioral development. In particular, hospitalized infants who received MT were better able to maintain self-regulation during social interaction with an adult, were less irritable and cried less, and were more positive in their response to adult handling, when compared with infants who did not receive the intervention. These are important prerequisites for social interaction and development. Further and larger scale research using MT with this population is indicated. Copyright © 2012 Michigan Association for Infant Mental Health.

Does CT scan performed at one week of age help predict neurodevelopmental outcome following perinatal hypoxic-ischaemic injury in term infants?

International Nuclear Information System (INIS)

Gunn, M.; Battin, M.R.; Teele, R.L.; O'Connor, K.; Hope, J.A.

2002-01-01

Full text: Cerebral imaging may be used as an adjunct to clinical assessment to help prognostician following a perinatal hypoxic ischaemic insult. A good correlation has been shown between MRI and neurologic outcome but data obtained using CT is less clear. The aim of this study was to determine whether CT of the brain performed at one week of age was prognostic for neurodevelopmental outcome in term infants with hypoxic ischaemic encephalopathy. Term infants with an umbilical artery pH<7.1 or Apgar score <6 at 5 minutes plus evidence of encephalopathy and no evidence of major congenital anomalies were reviewed and data obtained. Nearly all of the infants in the study (35) were part of a trial of selective head cooling. CT scans were randomised and reviewed independently by three practising neuroradiologists on two occasions. The CTs were graded as 0) normal; 1) white matter oedema; 2a) mild watershed infarction; 2b) moderate watershed infarction; 3) severe generalised infarction; 4) involvement of basal ganglia. Follow up neurological examination was performed at regular intervals, until 18 months of age, by a neonatologist. Developmental testing at 18 months using the revised Bailey Scales of Infant Development was performed by a psychologist. The study group consisted of 36 infants. Mean birth weight was 3555 (SD+/- 510)g, gestational age was 39.7 (+/- 1.4) weeks, umbilical or first arterial pH was 6.9 (+/- 0.2) and 5 min Apgar scores was 4.3 (+/- 1.9). Neurological outcome was designated as cerebral palsy (7), tone abnormalities before 12 months but only mild abnormality or normal examination at 18 months (2), developmental delay but normal physical examination (1) and functionally normal at 18 months (24). In 27% of infants the images were with normal limits. In only 17% there was overt basal ganglia damage and in 56% there was some degree of white matter abnormality. Overall, an abnormal CT had a sensitivity of 78%, and a specificity of 91% for the prediction

Can we define an infant's need from the composition of human milk?

NARCIS (Netherlands)

Stam, Jose; Sauer, Pieter J. J.; Boehm, Guenther

Human milk is recommended as the optimal nutrient source for infants and is associated with several short- and long-term benefits for child health. When accepting that human milk is the optimal nutrition for healthy term infants, it should be possible to calculate the nutritional needs of these

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

Feeding preterm infants after hospital discharge: a commentary by the ESPGHAN Committee on Nutrition.

Science.gov (United States)

Aggett, Peter J; Agostoni, Carlo; Axelsson, Irene; De Curtis, Mario; Goulet, Olivier; Hernell, Olle; Koletzko, Berthold; Lafeber, Harry N; Michaelsen, Kim F; Puntis, John W L; Rigo, Jacques; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; Weaver, Lawrence T

2006-05-01

Survival of small premature infants has markedly improved during the last few decades. These infants are discharged from hospital care with body weight below the usual birth weight of healthy term infants. Early nutrition support of preterm infants influences long-term health outcomes. Therefore, the ESPGHAN Committee on Nutrition has reviewed available evidence on feeding preterm infants after hospital discharge. Close monitoring of growth during hospital stay and after discharge is recommended to enable the provision of adequate nutrition support. Measurements of length and head circumference, in addition to weight, must be used to identify those preterm infants with poor growth that may need additional nutrition support. Infants with an appropriate weight for postconceptional age at discharge should be breast-fed when possible. When formula-fed, such infants should be fed regular infant formula with provision of long-chain polyunsaturated fatty acids. Infants discharged with a subnormal weight for postconceptional age are at increased risk of long-term growth failure, and the human milk they consume should be supplemented, for example, with a human milk fortifier to provide an adequate nutrient supply. If formula-fed, such infants should receive special postdischarge formula with high contents of protein, minerals and trace elements as well as an long-chain polyunsaturated fatty acid supply, at least until a postconceptional age of 40 weeks, but possibly until about 52 weeks postconceptional age. Continued growth monitoring is required to adapt feeding choices to the needs of individual infants and to avoid underfeeding or overfeeding.

When Infants Talk, Infants Listen: Pre-Babbling Infants Prefer Listening to Speech with Infant Vocal Properties

Science.gov (United States)

Masapollo, Matthew; Polka, Linda; Ménard, Lucie

2016-01-01

To learn to produce speech, infants must effectively monitor and assess their own speech output. Yet very little is known about how infants perceive speech produced by an infant, which has higher voice pitch and formant frequencies compared to adult or child speech. Here, we tested whether pre-babbling infants (at 4-6 months) prefer listening to…

Urinary tract infections in the infant.

Science.gov (United States)

Arshad, Mehreen; Seed, Patrick C

2015-03-01

Urinary tract infection (UTI) in an infant may be the first indication of an underlying renal disorder. Early recognition and initiation of adequate therapy for UTI is important to reduce the risk of long-term renal scarring. Ampicillin and gentamicin are traditionally the empiric treatment of choice; however, local antibiotic resistance patterns should be considered. Maternal antibiotics during pregnancy also increase the risk of resistant pathogens during neonatal UTI. Long-term management after the first UTI in infants remains controversial because of lack of specific studies in this age group and the risk-benefit issues for antibiotic prophylaxis between reduced recurrent disease and emergent antibiotic resistance. Copyright © 2015 Elsevier Inc. All rights reserved.

Evidence for the essentiality of arachidonic and docosahexaenoic acid in the postnatal maternal and infant diet for the development of the infant's immune system early in life.

Science.gov (United States)

Richard, Caroline; Lewis, Erin D; Field, Catherine J

2016-05-01

Long-chain polyunsaturated fatty acids (LCPUFA), especially the balance between arachidonic (AA) and docosahexaenoic (DHA) acids are known to have important immunomodulatory roles during the postnatal period when the immune system is rapidly developing. AA and DHA are required in infant formula in many countries but are optional in North America. The rationale for adding these LCPUFA to full-term formula is based on their presence in breast milk and randomized controlled studies that suggest improved cognitive function in preterm infants, but results are more variable in full-term infants. Recently, the European Food Safety Authority has proposed, based on a lack of functional evidence, that AA is not required in infant formula for full-term infants during the first year of life but DHA should remain mandatory. The purpose of this review is to review the evidence from epidemiological and intervention studies regarding the essentiality of AA and DHA in the postnatal infant and maternal diet (breast-feeding) for the immune system development early in life. Although studies support the essentiality of DHA for the immune system development, more research is needed to rule out the essentiality of AA. Nevertheless, intervention studies have demonstrated improvement in many markers of immune function in infants fed formula supplemented with AA and DHA compared with unsupplemented formula, which appears to consistently result in beneficial health outcomes including reduction in the risk of developing allergic and atopic disease early in life.

Functional interpretation of metabolomics data as a new method for predicting long-term side effects: treatment of atopic dermatitis in infants.

Science.gov (United States)

Lee, Seul Ji; Woo, Sung-il; Ahn, Soo Hyun; Lim, Dong Kyu; Hong, Ji Yeon; Park, Jeong Hill; Lim, Johan; Kim, Mi-kyeong; Kwon, Sung Won

2014-12-10

Topical steroids are used for the treatment of primary atopic dermatitis (AD); however, their associated risk of serious complications is great due to the presence of vulnerable lesions in young children with AD. Topical calcineurin inhibitors (TCIs) are steroid-free, anti-inflammatory agents used for topical AD therapy. However, their use is prohibited in infants side effects. The 1% pimecrolimus cream displayed similar efficacy and exceptional safety compared with the 0.05% desonide cream. Metabolomics-based long-term toxicity tests effectively predicted long-term side effects using short-term clinical models. This applicable method for the functional interpretation of metabolomics data sets the foundation for future studies involving the prediction of the toxicity and systemic reactions caused by long-term medication administration.

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.

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

Science.gov (United States)

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

2016-03-01

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

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

Science.gov (United States)

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

2011-01-01

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

PREDICTIVE VALUE OF GENERAL MOVEMENTS IN ASPHYXIATED FULL-TERM INFANTS

NARCIS (Netherlands)

PRECHTL, HFR; FERRARI, F; CIONI, G

1993-01-01

The developmental course of spontaneous motility was investigated in a group of 26 fullterm infants, affected by mild to severe hypoxic-ischaemic encephalopathy. Serial 1-h videorecordings were carried out from birth to 15-22 weeks and a quality assessment of general movements (GMs) was made from a

MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants.

Science.gov (United States)

Bruno, Christie J; Bengani, Shreyans; Gomes, William A; Brewer, Mariana; Vega, Melissa; Xie, Xianhong; Kim, Mimi; Fuloria, Mamta

2017-01-01

Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis. To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age. This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants. Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI. Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships. © 2017 S. Karger AG, Basel.

Regional Brain Biometrics at Term-Equivalent Age and Developmental Outcome in Extremely Low-Birth-Weight Infants.

Science.gov (United States)

Melbourne, Launice; Murnick, Jonathan; Chang, Taeun; Glass, Penny; Massaro, An N

2015-10-01

This study aims to evaluate individual regional brain biometrics and their association with developmental outcome in extremely low-birth-weight (ELBW) infants. This is a retrospective study evaluating term-equivalent magnetic resonance imaging (TE-MRI) from 27 ELBW infants with known developmental outcomes beyond 12 months corrected age. Regional biometric measurements were performed by a pediatric neuroradiologist blinded to outcome data. Measures included biparietal width, transcerebellar diameter (TCD), deep gray matter area (DGMA), ventricular dilatation, corpus callosum, and interhemispheric distance. The relationship between regional biometrics and Bayley-II developmental scores were evaluated with linear regression models. The study cohort had an average±standard deviation birth weight of 684±150 g, gestational age of 24.6±2 weeks and 48% males. DGMA was significantly associated with both cognitive and motor outcomes. Significant associations were also observed between TCD and corpus callosum splenium with cognitive and motor outcomes, respectively. Other biometric measures were not associated with outcome (p>0.05). DGMAbiometrics reflecting impaired deep gray matter, callosal, and cerebellar size is associated with worse early childhood cognitive and motor outcomes. DGMA may be the most robust single biometric measure to predict adverse developmental outcome in preterm survivors. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Safety of routine early MRI in preterm infants

International Nuclear Information System (INIS)

Plaisier, Annemarie; Feijen-Roon, Monique; Heemskerk, Anneriet M.; Dudink, Jeroen; Raets, Marlou M.A.; Govaert, Paul; Starre, Cynthia van der; Lequin, Maarten H.

2012-01-01

Cerebral MRI performed on preterm infants at term-equivalent 30 weeks' gestational age (GA) is increasingly performed as part of standard clinical care. We evaluated safety of these early MRI procedures. We retrospectively collected data on patient safety of preterm infants who underwent early MRI scans. Data were collected at fixed times before and after the MRI scan. MRI procedures were carried out according to a comprehensive guideline. A total of 52 infants underwent an MRI scan at 30 weeks' GA. Although no serious adverse events occurred and vital parameters remained stable during the procedure, minor adverse events were encountered in 26 infants (50%). The MRI was terminated in three infants (5.8%) because of respiratory instability. Increased respiratory support within 24 h after the MRI was necessary for 12 infants (23.1%) and was significantly associated with GA, birth weight and the mode of respiratory support. Hypothermia (core temperature < 36 C) occurred in nine infants (17.3%). Temperature dropped significantly after the MRI scan. Minor adverse events after MRI procedures at 30 weeks GA were common and should not be underestimated. A dedicated and comprehensive guideline for MRI procedures in preterm infants is essential. (orig.)

Safety of routine early MRI in preterm infants

Energy Technology Data Exchange (ETDEWEB)

Plaisier, Annemarie; Feijen-Roon, Monique; Heemskerk, Anneriet M.; Dudink, Jeroen [Erasmus Medical Centre - Sophia, Division of Neonatology, Department of Pediatrics, Rotterdam (Netherlands); Erasmus Medical Centre - Sophia, Division of Pediatric Radiology, Department of Radiology, Rotterdam (Netherlands); Raets, Marlou M.A.; Govaert, Paul [Erasmus Medical Centre - Sophia, Division of Neonatology, Department of Pediatrics, Rotterdam (Netherlands); Starre, Cynthia van der [Erasmus Medical Centre - Sophia, Division of Neonatology, Department of Pediatrics, Rotterdam (Netherlands); Erasmus Medical Centre - Sophia, Intensive Care, Department of Pediatrics and Pediatric Surgery, Rotterdam (Netherlands); Lequin, Maarten H. [Erasmus Medical Centre - Sophia, Division of Pediatric Radiology, Department of Radiology, Rotterdam (Netherlands)

2012-10-15

Cerebral MRI performed on preterm infants at term-equivalent 30 weeks' gestational age (GA) is increasingly performed as part of standard clinical care. We evaluated safety of these early MRI procedures. We retrospectively collected data on patient safety of preterm infants who underwent early MRI scans. Data were collected at fixed times before and after the MRI scan. MRI procedures were carried out according to a comprehensive guideline. A total of 52 infants underwent an MRI scan at 30 weeks' GA. Although no serious adverse events occurred and vital parameters remained stable during the procedure, minor adverse events were encountered in 26 infants (50%). The MRI was terminated in three infants (5.8%) because of respiratory instability. Increased respiratory support within 24 h after the MRI was necessary for 12 infants (23.1%) and was significantly associated with GA, birth weight and the mode of respiratory support. Hypothermia (core temperature < 36 C) occurred in nine infants (17.3%). Temperature dropped significantly after the MRI scan. Minor adverse events after MRI procedures at 30 weeks GA were common and should not be underestimated. A dedicated and comprehensive guideline for MRI procedures in preterm infants is essential. (orig.)

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

International Nuclear Information System (INIS)

Twomey, Eilish; Ryan, Stephanie; Twomey, Anne; Murphy, John; Donoghue, Veronica B.

2010-01-01

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.)

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.)

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

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

NARCIS (Netherlands)

M.A. Riedijk (Maaike); G.J. Voortman (Gardi); R.H.Th. van Beek (Ron); M.G.A. Baartmans (Martin); L.S. Wafelman (Leontien); J.B. van Goudoever (Hans); R.H.Th. van Beek (Ron)

2008-01-01

textabstractOBJECTIVE. 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

Production of emotional facial expressions in European American, Japanese, and Chinese infants.

Science.gov (United States)

Camras, L A; Oster, H; Campos, J; Campos, R; Ujiie, T; Miyake, K; Wang, L; Meng, Z

1998-07-01

European American, Japanese, and Chinese 11-month-olds participated in emotion-inducing laboratory procedures. Facial responses were scored with BabyFACS, an anatomically based coding system. Overall, Chinese infants were less expressive than European American and Japanese infants. On measures of smiling and crying, Chinese infants scored lower than European American infants, whereas Japanese infants were similar to the European American infants or fell between the two other groups. Results suggest that differences in expressivity between European American and Chinese infants are more robust than those between European American and Japanese infants and that Chinese and Japanese infants can differ significantly. Cross-cultural differences were also found for some specific brow, cheek, and midface facial actions (e.g., brows lowered). These are discussed in terms of current controversies about infant affective facial expressions.

Perspectives on neonatal and infant tracheostomy.

Science.gov (United States)

DeMauro, Sara B; Wei, Julie L; Lin, Richard J

2016-08-01

Neonates and infants may need a tracheostomy for many different reasons, ranging from airway obstruction to a requirement for long term mechanical ventilator support. Here, we present the pathophysiology of the many congenital and acquired conditions that might be managed with a tracheostomy. Decisions about tracheostomy demand consideration of not only the benefits, but also the potential side-effects, which may differ in the short and long term and may be attributable to underlying conditions as well as the tracheostomy. Evaluation of potential advantages of tracheostomy will influence decisions about optimal timing. In many cases, an infant may 'graduate' from dependence on a tracheostomy and resume a natural airway, although some will require reconstructive airway surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

Dietary transition difficulties in preterm infants: critical literature review

Directory of Open Access Journals (Sweden)

Carla Lucchi Pagliaro

2016-01-01

Conclusion: Very low birth weight preterm newborns are more likely to have feeding problems in early postnatal stages and during childhood when compared with full‐term infants. Monitoring the feeding of these infants after hospital discharge is strictly recommended in an early intervention program aiming at better development of feeding skills.

Infant-mother and infant-sibling attachment in Zambia.

Science.gov (United States)

Mooya, Haatembo; Sichimba, Francis; Bakermans-Kranenburg, Marian

2016-12-01

This study, the first in Zambia using the Strange Situation Procedure (SSP) to observe attachment relationships and the "very first" observational study of infant-sibling attachment, examined patterns of infant-mother and infant-sibling attachment, and tested their association. We included siblings who were substantially involved in caregiving activities with their younger siblings. We hypothesized that infants would develop attachment relationships to both mothers and siblings; the majority of infants would be classified as securely attached to both caregivers, and infant-mother and infant-sibling attachment would be unrelated. The sample included 88 low-income families in Lusaka, Zambia (average of 3.5 children; SD = 1.5). The SSP distributions (infant-mother) were 59% secure, 24% avoidant and 17% resistant, and 46% secure, 20% avoidant, 5% resistant and 29% disorganized for three- and four-way classifications, respectively. The infant-sibling classifications were 42% secure, 23% avoidant and 35% resistant, and 35% secure, 23% avoidant, 9% resistant and 33% disorganized for three- and four-way classifications, respectively. Infant-mother and infant-sibling attachment relationships were not associated.

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

Science.gov (United States)

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

2018-03-15

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

Parent-Infant Psychotherapy, the Transition to Parenthood and Parental Narcissism: Implications for Treatment

Science.gov (United States)

Espasa, Francisco Palacio

2004-01-01

In this article the author discusses some of the indications for short- or long-term parent-infant psychotherapeutic interventions in terms of what he defines as "problems of parenthood" and "problems of parental narcissism". Brief parent-infant psychotherapeutic interventions are most frequently indicated in the case of the former: more neurotic…

Dissociation between Features and Feature Relations in Infant Memory: Effects of Memory Load.

Science.gov (United States)

Bhatt, Ramesh S.; Rovee-Collier, Carolyn

1997-01-01

Four experiments examined effects of the number of features and feature relations on learning and long-term memory in 3-month olds. Findings suggested that memory load size selectively constrained infants' long-term memory for relational information, suggesting that in infants, features and relations are psychologically distinct and that memory…

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....... The goals for research include testing the benefit and harms of cerebral oximetry in large-scale randomized trials, improved definition of the hypoxic threshold, better understanding the effects of intensive care on cerebral oxygenation, as well as improved precision of oximeters and calibration among...

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 ...

Article Commentary: The Influence of Early Infant-Feeding Practices on the Intestinal Microbiome and Body Composition in Infants

Directory of Open Access Journals (Sweden)

Aifric O'Sullivan

2015-01-01

Full Text Available Despite many years of widespread international recommendations to support exclusive breastfeeding for the first six months of life, common hospital feeding and birthing practices do not coincide with the necessary steps to support exclusive breastfeeding. These common hospital practices can lead to the infant receiving formula in the first weeks of life despite mothers’ dedication to exclusively breastfeed. Consequently, these practices play a role in the alarmingly high rate of formula-feeding worldwide. Formula-feeding has been shown to alter the infant gut microbiome in favor of proinflammatory taxa and increase gut permeability and bacterial load. Furthermore, several studies have found that formula-feeding increases the risk of obesity in later childhood. While research has demonstrated differences in the intestinal microbiome and body growth between exclusively breast versus formula-fed infants, very little is known about the effects of introducing formula to breastfed infants either briefly or long term on these outcomes. Understanding the relationships between mixed-feeding practices and infant health outcomes is complicated by the lack of clarity in the definition of mixed-feeding as well as the terminology used to describe this type of feeding in the literature. In this commentary, we highlight the need for hospitals to embrace the 10 steps of the Baby Friendly Hospital Initiative developed by UNICEF and the WHO for successful breastfeeding. We present a paucity of studies that have focused on the effects of introducing formula to breastfed infants on the gut microbiome, gut health, growth, and body composition. We make the case for the need to conduct well-designed studies on mixed-feeding before we can truly answer the question: how does brief or long-term use of formula influence the health benefits of exclusive breastfeeding?

Corneal Aberrations in Former Preterm Infants: Results From The Wiesbaden Prematurity Study.

Science.gov (United States)

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

2017-12-01

To compare corneal aberrations in former preterm infants to that of full-term infants. A prospective cross-sectional study was carried out measuring the corneal shape with Scheimpflug imaging in former preterm infants of gestational age (GA) ≤32 weeks and full-term infants with GA ≥37 weeks now being aged between 4 to 10 years. The main outcome measures were corneal aberrations including astigmatism (Zernike: Z2-2; Z22), coma (Z3-1; Z31), trefoil (Z3-3; Z33), spherical aberration (Z40) and root-mean square of higher-order aberrations (RMS HOA). Multivariable analysis was performed to assess independent associations of gestational age groups and of retinopathy of prematurity (ROP) occurrence with corneal aberrations adjusting for sex and age at examination. A total of 259 former full-term and 226 preterm infants with a mean age of 7.2 ± 2.0 years were included in this study. Statistical analysis revealed an association of extreme prematurity (GA ≤28 weeks) with higher-order and lower-order aberrations of the total cornea. Vertical coma was higher in extreme prematurity (P prematurity rather than with ROP occurrence.

Lean body mass in small for gestational age and appropriate for gestational age infants

International Nuclear Information System (INIS)

Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

1988-01-01

Dual photon absorptiometry using 153 Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation

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

Science.gov (United States)

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

2014-04-24

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

Short term evaluation of respiratory effort by premature infants supported with bubble nasal continuous airway pressure using Seattle-PAP and a standard bubble device

Science.gov (United States)

Welty, Stephen E.; Rusin, Craig G.; Stanberry, Larissa I.; Mandy, George T.; Gest, Alfred L.; Ford, Jeremy M.; Backes, Carl H.; Richardson, C. Peter; Howard, Christopher R.; Hansen, Thomas N.

2018-01-01

Background Almost one million prematurely born infants die annually from respiratory insufficiency, predominantly in countries with limited access to respiratory support for neonates. The primary hypothesis tested in the present study was that a modified device for bubble nasal continuous positive airway pressure (Bn-CPAP) would provide lower work of spontaneous breathing, estimated by esophageal pressure-rate products. Methods Infants born CPAP with FiO2 CPAP, then 2 h with Bn-CPAP using a modified bubble device presently termed Seattle-PAP, which produces a different pattern of pressure fluctuations and which provided greater respiratory support in preclinical studies, then 2 h on standard Bn-CPAP. Results All 40 infants enrolled completed the study and follow-up through 36 wks post menstrual age or hospital discharge, whichever came first. No infants were on supplemental oxygen at completion of follow-up. No infants developed pneumothoraces or nasal trauma, and no adverse events attributed to the study were observed. Pressure-rate products on the two devices were not different, but effort of breathing, assessed by areas under esophageal pressure-time curves, was lower with Seattle-PAP than with standard Bn-CPAP. Conclusion Use of Seattle-PAP to implement Bn-CPAP lowers the effort of breathing exerted even by relatively healthy spontaneously breathing premature neonates. Whether the lower effort of breathing observed with Seattle-PAP translates to improvements in neonatal mortality or morbidity will need to be determined by studies in appropriate patient populations. PMID:29590143

Early Parent-infant Interactions; Are Health Visitors' Observations Reliable?

DEFF Research Database (Denmark)

Kristensen, Ingeborg Hedegaard; Simonsen, Marianne; Trillingsgaard, Tea

2014-01-01

-infant relations, and there was no significant difference between the two groups according to intentions, self-efficacy, age, years educated and working part or full time. Certificated Marte Meo-therapists had significantly higher skills assessing mother- infant interactions and they scored significantly higher...... high intention and self-efficacy to work with parent-infant relation, professionals certified as Marte Meo-therapists are 8-12% superior in terms of observation skills and knowledge. Further research is needed to determinate whether the level of knowledge and observation skills is associated...

Prelinguistic Behavior of Infants of Assisted Reproductive Techniques

Science.gov (United States)

Noori, Soudabeh; Nedaeifard, Leila; Agarasouli, Zahra; Koohpaiehzadeh, Jalil; Kermani, Ramin Mozafari; Fazeli, Abolhasan Shahzadeh

2012-01-01

Objective The aim of this study is assessment of effects of different assisted reproductive techniques (ART) like in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI) on prelinguistic behavior of infants conceived by these techniques. Methods In this descriptive, cross sectional study, prelinguistic behavior of 151 full term ART infants of Royan Institute have been assessed in Children's Health and Development Research Center of Tehran from August 2007 until August 2009. Questionnaires were completed by parents at 9 months old. The questionnaire was standard according to Early Language Milestone Scale-2 (ELM-2). Data were analyzed by SPSS version 16 and using chi-square test. Findings Twenty-two (14.5%) of infants were conceived by IVF and 129 (85.4%) by ICSI. Number of infants with delay in reduplicated babbling in ICSI method was more than in IVF. There was only a significant difference in echolalia delay in the two sexes. Echolalia was delayed more in boys. Delay of reduplicated babbling was more in infants of younger mothers. There was no relation between speech and language defect of parents and infants. Conclusion This study showed that prelingustic behavior of ART infants are affected by kind of ART method, infant sex, and mother's age at the time of pregnancy. PMID:23431035

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...

Skin-to-Skin Care for Term and Preterm Infants in the Neonatal ICU.

Science.gov (United States)

Baley, Jill

2015-09-01

“Kangaroo mother care” was first described as an alternative method of caring for low birth weight infants in resource-limited countries, where neonatal mortality and infection rates are high because of overcrowded nurseries, inadequate staffing, and lack of equipment. Intermittent skin-to-skin care (SSC), a modified version of kangaroo mother care, is now being offered in resource-rich countries to infants needing neonatal intensive care, including those who require ventilator support or are extremely premature. SSC significantly improves milk production by the mother and is associated with a longer duration of breastfeeding. Increased parent satisfaction, better sleep organization, a longer duration of quiet sleep, and decreased pain perception during procedures have also been reported in association with SSC. Despite apparent physiologic stability during SSC, it is prudent that infants in the NICU have continuous cardiovascular monitoring and that care be taken to verify correct head positioning for airway patency as well as the stability of the endotracheal tube, arterial and venous access devices, and other life support equipment.

Glucose kinetics in infants of diabetic mothers

International Nuclear Information System (INIS)

Cowett, R.M.; Susa, J.B.; Giletti, B.; Oh, W.; Schwartz, R.

1983-01-01

Glucose kinetic studies were performed to define the glucose turnover rate with 78% enriched D-[U-13C] glucose by the prime constant infusion technique at less than or equal to 6 hours of age in nine infants of diabetic mothers (four insulin-dependent and five chemical diabetic patients) at term. Five normal infants were studied as control subjects. All infants received 0.9% saline intravenously during the study with the tracer. Fasting plasma glucose, insulin, and glucose13/12C ratios were measured during the steady state, and the glucose turnover rate was derived. The average plasma glucose concentration was similar during the steady state in the infants of the diabetic mothers and in the control infants, and the glucose turnover rate was not significantly different among the groups: 2.3 +/- 0.6 mg . kg-1 min-1 in infants of insulin-dependent diabetic patients; 2.4 +/- 0.4 mg . kg-1 min-1 in infants of chemical diabetic patients; and 3.2 +/- 0.3 mg . kg-1 min-1 in the control subjects. Good control of maternal diabetes evidenced by the normal maternal hemoglobin A1c and plasma glucose concentration at delivery and cord plasma glucose concentration resulted in glucose kinetic values in the infants of diabetic mothers that were indistinguishable from those of control subjects. The data further support the importance of good control of the diabetic state in the pregnant woman to minimize or prevent neonatal hypoglycemia

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...

Reliability of Alberta Infant Motor Scale Using Recorded Video Observations Among the Preterm Infants in India: A Reliability Study

Directory of Open Access Journals (Sweden)

Veena Kirthika S

2017-10-01

Full Text Available Background: Assessment of motor function is a vital characteristic of infant development. Alberta Infant Motor scale (AIMS is considered to be one of the tool available for screening the developmental delays, but this scale was formulated by using western samples. Every country has its own ethnic and cultural background and various differences are observed in the culture and ethnicity. Therefore, there is a need to obtain reliability for the use of AIMS in south Indian population. Purpose: To find the intra-rater and inter-rater reliability of Alberta Infant Motor Scale (AIMS on pre-term infants using the recorded video observations in Indian population. Method: 30 preterm infants in three age groups, 0-3 months (10 infants, 4-7 months (10 infants, 8-18 months (10 infants were recruited for this reliability study. The AIMS was administered to the preterm infants and the performance was videotaped. The performance was then rescored by the same therapist, immediately from the video and on another two consecutive months to estimate intra-rater reliability using ICC (3,1, two-way mixed effects model. For reporting inter-rater reliability, AIMS was scored by three different raters, using ICC (2,k two-way random effects model and by two other therapists to examine the inter and intra-rater reliability. Results: The two-way mixed effects model for intra-rater reliability of AIMS, ICC (3,1 = 0.99 and for reporting inter-rater reliability of AIMS by two-way random effects model, ICC (2,k = 0.96. Conclusion: AIMS has excellent intra and inter-rater reliability using recorded video observations among the preterm infants in India

Otolaryngological aspects of sudden infant death syndrome.

Science.gov (United States)

Marom, Tal; Cinamon, Udi; Castellanos, Paul F; Cohen, Marta C

2012-03-01

Sudden infant death syndrome (SIDS) is characterized by the sudden death of an apparently otherwise healthy infant, typically during sleep, and with no obvious case after a thorough post-mortem and scene death examination. To address the problem from the otolaryngologist's perspective, describe relevant pathologies, discuss controversies and suggest preventive measures in high-risk populations. A MEDLINE search and hand search were conducted to identify reports published between 1969 and 2011 in the English language on the pathophysiology of SIDS related to the head and neck organs. Search terms included SIDS (MeSH term), SIDS and pathophysiology (text words), and SIDS and autopsy (text words). A growing number of reports suggested head and neck organs involvement in SIDS autopsies. Laryngeal, oropharyngeal, maxillofacial, otologic, cervical vascular abnormalities and infectious etiologies, were recognized and discussed. Otolaryngologists should be aware of relevant pathologies, as some are treatable, if identified early enough in infancy. A proactive risk-management approach is warranted in infants presenting with certain abnormalities reviewed here. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

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

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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

Infant Visual Recognition Memory: Independent Contributions of Speed and Attention.

Science.gov (United States)

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

2003-01-01

Examined contributions of cognitive processing speed, short-term memory capacity, and attention to infant visual recognition memory. Found that infants who showed better attention and faster processing had better recognition memory. Contributions of attention and processing speed were independent of one another and similar at all ages studied--5,…

Amplitude-integrated electroencephalographic activity is suppressed in preterm infants with high scores on illness severity

NARCIS (Netherlands)

ter Horst, Hendrik J.; Jongbloed-Pereboom, Marjolein; van Eykern, Leo A.; Bos, Arend F.

Background: The neonatal acute physiology score. SNAP-II, reflects the severity of illness in newborns. In term newborns, amplitude integrated EEG (aEEG), is depressed following asphyxia. In preterm infants aEEG is discontinuous, and therefore more difficult to assess compared to term infants. Aims:

Infant Mortality

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... After hours (404) 639-2888 Contact Media Infant Mortality Recommend on Facebook Tweet Share Compartir On This ... differences in rates among population groups. About Infant Mortality Infant mortality is the death of an infant ...

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.

Parenting stress trajectories in mothers of very preterm infants to 2 years.

Science.gov (United States)

Gray, Peter H; Edwards, Dawn M; Gibbons, Kristen

2018-01-01

To examine levels of parenting stress in mothers of preterm and term infants when the children were 2 years old; to determine the trajectory of stress over three time periods and to examine the association of maternal and neonatal factors and developmental outcomes with parenting stress. It is a prospective longitudinal study to determine parenting stress in mothers of preterm and term infants with outcomes having been previously obtained at 4 and 12 months. At 2 years, 79 preterm mothers (96 babies) and 64 term mothers (77 babies) participated. The mothers completed the Parenting Stress Index-Short Form (PSI-SF), the Depression, Anxiety, Stress Scale (DASS) and the Child Behaviour Checklist (CBCL). The infants had a neurological examination and the Bayley-III scales were administered. The mean total PSI-SF at 2 years was significantly higher for the preterm group compared with the term group of mothers (p=0.007). There was a significant increase in the mean total PSI over time for the preterm mothers (pparenting stress and abnormal scores on the DASS (pparenting stress and maternal demographics, neonatal factors or Bayley-III results. Parenting stress in mothers of preterm infants continues to be high at 2 years having increased over time. Maternal mental health problems and infant behavioural issues contribute to the stress. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Infant Imitation after a 1-Week Delay: Long-Term Memory for Novel Acts and Multiple Stimuli.

Science.gov (United States)

Meltzoff, Andrew N.

1988-01-01

Investigated deferred imitation ability for six actions in 14-month-old infants. After a week's delay, infants were tested on their ability to imitate the actions.Those who had been exposed to modeling produced significantly higher instances of the target actions. (SKC)

The experiences of parents with infants in Neonatal Intensive Care Unit

OpenAIRE

Heidari, Haydeh; Hasanpour, Marzieh; Fooladi, Marjan

2013-01-01

Background: In recent years significant medical science advances have been made in the field midwifery and infant care. The premature, low birth weight and ill infants are admitted to the technologically advanced NICU for care and they often require long-term stay. This study addresses parental experiences with the infant care in NICU, explores their concerns regarding nursing supports for parents and offers nurses? perspectives on performing duties. Materials and Methods: A qualitative induc...

Parent-infant psychotherapy for improving parental and infant mental health.

Science.gov (United States)

Barlow, Jane; Bennett, Cathy; Midgley, Nick; Larkin, Soili K; Wei, Yinghui

2015-01-08

or execution of the trial. The included studies also involved relatively few participants and wide CI values (imprecision), and, in some cases, we detected clinical and statistical heterogeneity (inconsistency). Lower quality evidence resulted in lower confidence in the estimate of effect for those outcomes. Although the findings of the current review suggest that PIP is a promising model in terms of improving infant attachment security in high-risk families, there were no significant differences compared with no treatment or treatment-as-usual for other parent-based or relationship-based outcomes, and no evidence that PIP is more effective than other methods of working with parents and infants. Further rigorous research is needed to establish the impact of PIP on potentially important mediating factors such as parental mental health, reflective functioning, and parent-infant interaction.

Accuracy of the Alberta Infant Motor Scale (AIMS) to detect developmental delay of gross motor skills in preterm infants: a systematic review.

Science.gov (United States)

de Albuquerque, Plínio Luna; Lemos, Andrea; Guerra, Miriam Queiroz de Farias; Eickmann, Sophie Helena

2015-02-01

To assess, through a systematic review, the ability of Alberta Infant Motor Scale (AIMS) to diagnose delayed motor development in preterm infants. Systematic searches identified five studies meeting inclusion criteria. These studies were evaluated in terms of: participants' characteristics, main results and risk of bias. The risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies--second edition (QUADAS-2). All five studies included a high risk of bias in at least one of the assessed fields. The most frequent biases included were presented in patient selection and lost follow up. All studies used the Pearson correlation coefficient to assess the diagnostic capability of the Alberta Infant Motor Scale. None of the assessed studies used psychometric measures to analyze the data. Given the evidence, the research supporting the ability of Alberta Infant Motor Scale to diagnose delayed motor development in preterm infants presents limitations. Further studies are suggested in order to avoid the above-mentioned biases to assess the Alberta Infant Motor Scale accuracy in preterm babies.

Maternal nutrition and optimal infant feeding practices: executive summary.

Science.gov (United States)

Raiten, Daniel J; Kalhan, Satish C; Hay, William W

2007-02-01

Much recent attention has been paid to the effect of the fetal environment on not only healthy birth outcomes but also long-term health outcomes, including a role as an antecedent to adult diseases. A major gap in our understanding of these relations, however, is the effect of maternal nutrition and nutrient transport on healthy fetal growth and development. In addition, this gap precludes evidence-based recommendations about how to best feed preterm infants. The biological role of the mother and the effect of her nutritional status on infant feeding extend to postnatal infant feeding practices. Currently, evidence is incomplete about not only the composition of human milk, but also the maternal nutritional needs to support extended lactation and the appropriate nutrient composition of foods that will be used to complement breastfeeding at least through the first year of life. Consequently, a conference, organized by the National Institute of Child Health and Human Development, the National Institutes of Health Office of Dietary Supplements, and the US Department of Agriculture Children's Nutrition Research Center was held to explore current knowledge and develop a research agenda to address maternal nutrition and infant feeding practices. These proceedings contain presentations about the effect of maternal nutrition and the placental environment on fetal growth and birth outcomes, as well as issues pertaining to feeding preterm and full-term infants.

On the Limits of Infants' Quantification of Small Object Arrays

Science.gov (United States)

Feigenson, Lisa; Carey, Susan

2005-01-01

Recent work suggests that infants rely on mechanisms of object-based attention and short-term memory to represent small numbers of objects. Such work shows that infants discriminate arrays containing 1, 2, or 3 objects, but fail with arrays greater than 3 [Feigenson, L., & Carey, S. (2003). Tracking individuals via object-files: Evidence from…

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

OpenAIRE

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

2018-01-01

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

Supplementation of prebiotics in infant formula

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Močić Pavić A

2014-06-01

Full Text Available Ana Močić Pavić, Iva Hojsak Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Zagreb, Croatia Background: In recent years prebiotics have been added to infant formula to make it resemble breast milk more closely and to promote growth and development of beneficial intestinal microbiota. This review aims to present new data on the possible positive effects of prebiotics in infant formula on intestinal microbiota (bifidogenic and lactogenic effect and on clinical outcomes including growth, infections, and allergies. With that aim, a literature search of the Cochrane Central Register of Controlled Trials (CENTRAL, EMBASE, Scopus, PubMed/Medline, Web of Science, and Science Direct in the last 10 years (December 2003 to December 2013 was performed. Results: Altogether 24 relevant studies were identified. It was found that during intervention, prebiotics can elicit a bifidogenic and lactogenic effect. As far as clinical outcomes were concerned, 14 studies investigated the effect of infant formula supplemented with prebiotics on growth and found that there was no difference when compared with non-supplemented infant formula. All available data are insufficient to support prebiotic supplementation in order to reduce risk of allergies and infections. Conclusion: There is currently no strong evidence to recommend routine supplementation of infant formulas with prebiotics. Further well-designed clinical studies with long-term follow-up are needed. Keywords: prebiotics, infant formula, growth, allergy, infections, supplementation

Infants' Delayed Recognition Memory and Forgetting

Science.gov (United States)

Fagan, Joseph F., III

1973-01-01

Infants 21- to 25-weeks-old devoted more visual fixation to novel than familiar stimuli on immediate and delayed recognition tests. The experiments confirm the existence of long-term recognition memory for pictorial stimuli in the early months of life. (DP)

From alienation to familiarity: experiences of mothers and fathers of preterm infants.

Science.gov (United States)

Jackson, Karin; Ternestedt, Britt-Marie; Schollin, Jens

2003-07-01

The birth of a preterm infant has a long-term impact on both parents. Mothers report more stress and poor adjustment compared with fathers. Influencing factors, such as family situation and health status of the child, can support or weaken the coping ability of the parents. Studies on experiences of fathers are sparse. The aim of this research was to study how mothers and fathers of preterm infants describe their experiences of parenthood during the infant's first 18 months of life. Seven consecutively selected sets of parents of preterm infants born at mothers and fathers described their parental roles involved concern for the child, insecurity, adjustment and relationship with the child. Regarding differences, mothers experienced having more responsibility and control of the care and a need to be confirmed as a mother, while fathers described confidence in leaving the care to the staff and wanted to find a balance between work and family life. Important turning points in parenthood experiences often occurred when the infant could be removed from the incubator, discharged from the ward, and when the infant looked normal compared to full-term infants. The structure of the phenomenon of parenthood was formed by the integration of the syntheses of alienation, responsibility, confidence and familiarity. The structure seems to be based on the parents' expectations of the parental role, the infant's health condition and the health care environment. These interacting factors are influenced by cultural beliefs.

Interrelationships between maternal carotenoid status and newborn infant macular pigment optical density and carotenoid status.

Science.gov (United States)

Henriksen, Bradley S; Chan, Gary; Hoffman, Robert O; Sharifzadeh, Mohsen; Ermakov, Igor V; Gellermann, Werner; Bernstein, Paul S

2013-08-15

Deposition of the macular pigment carotenoids lutein and zeaxanthin in the human retina occurs early in life. In this study, we examined the interrelationships of maternal carotenoid status and newborn infant macular pigment levels and systemic carotenoid status. As a secondary measure, we also evaluated the effects of intrauterine growth restriction (IUGR) on carotenoid status in term newborn infants. We measured mother and infant skin carotenoids using resonance Raman spectroscopy (RRS), serum carotenoids by HPLC, and mother breast milk carotenoids by HPLC. We measured infant macular pigment levels using noninvasive blue light reflectometry. We enrolled 30 healthy term infants, their mothers, and 10 IUGR infants and their mothers. A subset of 16 infants was imaged for macular pigment optical density (MPOD). Infant serum zeaxanthin levels correlated with MPOD (r = 0.68, P = 0.007). Mother serum zeaxanthin levels correlated with infant MPOD (r = 0.59, P = 0.032). Infant and mother serum lutein did not correlate with MPOD. Mother-infant correlations were found for total serum carotenoids (r = 0.42, P = 0.020) and skin carotenoids (r = 0.48, P = 0.001). No difference was seen between IUGR infants and controls in total serum or skin carotenoids. Mothers of IUGR infants had lower total serum carotenoids (P = 0.019) and breast milk carotenoids than controls (P = 0.006). Our findings suggest that maternal zeaxanthin status may play a more important role than lutein status in macular pigment deposition in utero. Controlled trials are needed to determine whether maternal zeaxanthin prenatal supplementation can raise infant macular pigment levels and/or improve ocular function.

Self-Regulation and Infant-Directed Singing in Infants with Down Syndrome.

Science.gov (United States)

de l'Etoile, Shannon K

2015-01-01

Infants learn how to regulate internal states and subsequent behavior through dyadic interactions with caregivers. During infant-directed (ID) singing, mothers help infants practice attentional control and arousal modulation, thus providing critical experience in self-regulation. Infants with Down syndrome are known to have attention deficits and delayed information processing as well as difficulty managing arousability, factors that may disrupt their efforts at self-regulation. The researcher explored responses to ID singing in infants with Down syndrome (DS) and compared them with those of typically developing (TD) infants. Behaviors measured included infant gaze and affect as indicators of self-regulation. Participants included 3- to 9-month-old infants with and without DS who were videotaped throughout a 2-minute face-to-face interaction during which their mothers sang to them any song(s) of their choosing. Infant behavior was then coded for percentage of time spent demonstrating a specific gaze or affect type. All infants displayed sustained gaze more than any other gaze type. TD infants demonstrated intermittent gaze significantly more often than infants with DS. Infant status had no effect on affect type, and all infants showed predominantly neutral affect. Findings suggest that ID singing effectively maintains infant attention for both TD infants and infants with DS. However, infants with DS may have difficulty shifting attention during ID singing as needed to adjust arousal levels and self-regulate. High levels of neutral affect for all infants imply that ID singing is likely to promote a calm, curious state, regardless of infant status. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The present challenges of parenteral nutrition in preterm infants and children

NARCIS (Netherlands)

van Goudoever, Johannes B.; Vlaardingerbroek, Hester

2013-01-01

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

Sirenomelia with an angiomatous lumbosacral myelocystocele in a full-term infant.

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Browne, Marybeth; Fitchev, Philip; Adley, Brian; Crawford, Susan E

2004-05-01

Sirenomelia, also known as the mermaid syndrome, is a rare congenital malformation of uncertain etiology. It is characterized by fusion of the lower limbs and commonly associated with severe urogenital and gastrointestinal malformations. In this report, we describe the first case of an infant with sirenomelia and a massive angiomatous lumbosacral myelocystocele.

The Effect of Crying on Long-Term Memory in Young Infants.

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Ohr, Phyllis S.; Fagen, Jeffrey W.

The influence of negative affect on the retrieval of information from memory during infancy was investigated in two studies through the use of an operant conditioning paradigm. The procedure used, known as "mobile conjugate reinforcement," involves a free operant task in which an infant is reinforced for footkicking by the movement of an…

Abnormal infant neurodevelopment predicts schizophrenia spectrum disorders.

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Fish, Barbara; Kendler, Kenneth S

2005-06-01

The aim of this study was to detect infants who carry a schizophrenic genotype and study the development of schizophrenia spectrum disorders (SZSD) from birth. In the 1940s, Bender described uneven maturation in childhood schizophrenics and in 1952 found this in the infant histories of 6 schizophrenic children. We tested a possible index for defective neural integration in infants termed "pandysmaturation" (PDM). This required retarded cranial growth plus retarded and erratic gross motor development on a single exam. Twelve offspring of hospitalized schizophrenic mothers and 12 infants in a "Well Baby Clinic," were examined 10 times between birth and 2 years of age. Psychiatric interviews and psychological testing were done at 10, 15, and 22 years of age, plus follow-up at 27-35 years of age. Six infants had PDM at 2, 6, or 13 months of age. Five individuals have been blindly diagnosed (by KSK) as having lifetime SZSD; all 5 had PDM before 8 months. Chi-square one-tailed tests confirmed the predictions: (1) PDM was related to subsequent SZSD (chi(2) = 11.43; p < 0.0005); (2) schizophrenic mothers had more infants with PDM than nonschizophrenic mothers (chi(2) = 3.28; p < 0.05); and (3) schizophrenic mothers had more SZSD offspring than nonschizophrenic mothers (chi(2) = 6.39; p < 0.0125). These first behavioral observations of aberrant neurodevelopment in pre- SZSD infants support the evidence of early neurodevelopmental disorder seen in studies of brain pathology in SZSD adults.

Clinical Outcomes Associated with a Failed Infant Car Seat Challenge.

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Shah, Malika D; Dookeran, Keith A; Khan, Janine Y

2017-01-01

To assess comorbid conditions and clinical outcomes among late preterm and low birth weight term infants (Baby Unit. This was a retrospective chart review of consecutive infants who failed ICSC on the Mother-Baby Unit and were subsequently admitted to the neonatal intensive care unit at Prentice Women's Hospital between January 1, 2009, and December 31, 2015. Regression models were used to estimate risk differences (RDs) with 95% CIs for factors related to length of stay. A total of 148 infants were studied (43% male; 37% delivered via cesarean). ICSC failure in the Mother-Baby Unit was due to desaturation, bradycardia, and tachypnea in 59%, 37%, and 4% of infants, respectively. During monitoring on the neonatal intensive care unit, 39% of infants experienced apnea (48% in preterm vs 17% in term infants) in the supine position, 19% received phototherapy, and 2% and 6.8% received nasogastric and thermoregulatory support, respectively. Univariate predictors of increased duration of stay (days) were younger gestational age, apnea, nasogastric support, intravenous fluids, and antibiotics (all P < .05). In multivariable analysis adjusted for gestational age and discharge weight, only apnea (RD, 4.87; 95% CI, 2.99-6.74; P < .001), administration of antibiotics (RD, 3.25; 95% CI, 0.29-6.21; P < .032), and intravenous fluid support (RD, 4.87; 95% CI, 0.076-9.66; P < .047) remained independent predictors of a longer duration of stay. Infants who failed ICSC were at risk for comorbid conditions that prolonged hospital stay beyond the neonatal intensive care unit observation period. Almost one-half of late preterm infants who failed ICSC had apnea events in the supine position. Copyright © 2016 Elsevier Inc. All rights reserved.

Flow-Synchronized Nasal Intermittent Positive Pressure Ventilation for Infants <32 Weeks' Gestation with Respiratory Distress Syndrome

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C. Gizzi

2012-01-01

Full Text Available Aim. To evaluate whether synchronized-NIPPV (SNIPPV used after the INSURE procedure can reduce mechanical ventilation (MV need in preterm infants with RDS more effectively than NCPAP and to compare the clinical course and the incidence of short-term outcomes of infants managed with SNIPPV or NCPAP. Methods. Chart data of inborn infants 0.4, respiratory acidosis, or intractable apnoea that occurred within 72 hours of surfactant administration. Results. Eleven out of 31 (35.5% infants in the NCPAP group and 2 out of 33 (6.1% infants in the SNIPPV group failed the INSURE approach and underwent MV (. Fewer infants in the INSURE/SNIPPV group needed a second dose of surfactant, a high caffeine maintenance dose, and pharmacological treatment for PDA. Differences in O2 dependency at 28 days and 36 weeks of postmenstrual age were at the limit of significance in favor of SNIPPV treated infants. Conclusions. SNIPPV use after INSURE technique in our NICU reduced MV need and favorably affected short-term morbidities of our premature infants.

Risk Factors and In-Hospital Outcomes following Tracheostomy in Infants.

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

2016-06-01

To describe the epidemiology, risk factors, and in-hospital outcomes of tracheostomy in infants in the neonatal intensive care unit. We analyzed electronic medical records from 348 neonatal intensive care units for the period 1997 to 2012, and evaluated the associations among infant demographics, diagnoses, and pretracheostomy cardiopulmonary support with in-hospital mortality. We also determined the trends in use of infant tracheostomy over time. We identified 885 of 887 910 infants (0.1%) who underwent tracheostomy at a median postnatal age of 72 days (IQR, 27-119 days) and a median postmenstrual age of 42 weeks (IQR, 39-46 weeks). The most common diagnoses associated with tracheostomy were bronchopulmonary dysplasia (396 of 885; 45%), other upper airway anomalies (202 of 885; 23%), and laryngeal anomalies (115 of 885; 13%). In-hospital mortality after tracheostomy was 14% (125 of 885). On adjusted analysis, near-term gestational age (GA), small for GA status, pulmonary diagnoses, number of days of forced fraction of inspired oxygen >0.4, and inotropic support before tracheostomy were associated with increased in-hospital mortality. The proportion of infants requiring tracheostomy increased from 0.01% in 1997 to 0.1% in 2005 (P Tracheostomy is not commonly performed in hospitalized infants, but the associated mortality is high. Risk factors for increased in-hospital mortality after tracheostomy include near-term GA, small for GA status, and pulmonary diagnoses. Copyright © 2016 Elsevier Inc. All rights reserved.

CoQ10 plasmatic levels in breast-fed infants compared to formula-fed infants.

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Compagnoni, G; Giuffrè, B; Lista, G; Mosca, F; Marini, A

2004-01-01

Coenzyme Q10 has been recognized as an important antioxidant factor besides its main role in bioenergetic metabolism. CoQ10 tissue levels depend both on exogenous dietetic intake and on endogenous biosynthesis, as this compound can be partly synthesized in human cells. Q10 plasma levels reflect the tissue content of the coenzyme and can be used to evaluate the presence of this compound in the human organism. Aim of the study was to measure CoQ10 plasmatic levels in a newborn breast-fed population and to compare them to CoQ10 levels in a newborn formula-fed population in order to verify whether changes in CoQ10 plasmatic contents could be related to a different dietetic intakes. We measured CoQ10 plasmatic levels in 25 healthy term neonates with different dietetic intakes: 15 breast-fed and 10 bottle-fed with a common infant formula. These infants were evaluated prospectively during the first month of life. The analyses were performed on the mothers' blood samples and cord blood samples at the time of delivery, then on infants at 4 and 28 days of age. Our results showed markedly reduced Q10 levels in cord blood samples compared to maternal Q10 plasmatic levels at the time of delivery, suggesting placental impermeability towards this molecule or increased fetal utilization during labor and delivery. At 4 days of age Q10 levels had increased in both groups of neonates, but significantly more in breast-fed infants compared to formula-fed babies (p <0.05). At 4 weeks of age no significant changes occurred in breast-fed infants, while values increased significantly in formula-fed infants (p <0.05). The content of Q10 in breast milk samples was lower than in infant formula. The results of this study show that CoQ10 plasmatic levels are at least partly influenced by the exogenous dietetic supply.

Infants Hierarchically Organize Memory Representations

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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…

Household chaos and family sleep during infants' first year.

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Whitesell, Corey J; Crosby, Brian; Anders, Thomas F; Teti, Douglas M

2018-05-21

Household chaos has been linked with dysregulated family and individual processes. The present study investigated linkages between household chaos and infant and parent sleep, a self-regulated process impacted by individual, social, and environmental factors. Studies of relations between household chaos and child sleep have focused on older children and teenagers, with little attention given to infants or parent sleep. This study examines these relationships using objective measures of household chaos and sleep while controlling for, respectively, maternal emotional availability at bedtime and martial adjustment, in infant and parent sleep. Multilevel modeling examined mean and variability of sleep duration and fragmentation for infants, mothers, and fathers when infants were 1, 3, 6, 9, and 12 months (N = 167). Results indicated infants in higher chaos homes experienced delays in sleep consolidation patterns, with longer and more variable sleep duration, and greater fragmentation. Parent sleep was also associated with household chaos such that in higher chaos homes, mothers and fathers experienced greater variability in sleep duration, which paralleled infant findings. In lower chaos homes, parents' sleep fragmentation mirrored infants' decreasingly fragmented sleep across the first year and remained lower at all timepoints compared to parents and infants in high chaos homes. Collectively, these findings indicate that after controlling for maternal emotional availability and marital adjustment (respectively) household chaos has a dysregulatory impact on infant and parent sleep. Results are discussed in terms of the potential for chaos-induced poor sleep to dysregulate daytime functioning and, in turn, place parent-infant relationships at risk. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

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Tooten Anneke

2012-06-01

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

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

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

2016-11-01

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

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

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

2007-09-01

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

Differences in the stratum corneum of Indonesian infants and adults

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Tsutomu Fujimura

2017-02-01

Full Text Available Background Although understanding the stratum corneum (SC of infant skin is important to avoid skin diseases such as atopic dermatitis, there has been no such investigation in Indonesian infants to date. Objective  To obtain a basic knowledge of SC characteristics in Indonesian infants in order to develop methods for infant-specific skin care and to prevent dermatitis and infection. Methods Seventy-two healthy, full term infants aged 1 to 24 months who were native Indonesians residing in Jakarta were enrolled in this study. Some of the mothers were also enrolled in the study as adults (n=30. Transepidermal water loss (TEWL and hydration of the SC (capacitance on the thigh, buttock, and upper arm were measured after sufficient acclimation in an air-conditioned room, in both infants and mothers. Results The SC hydration was significantly higher in infants than adults at all sites measured, including the buttocks, which is a diaper area. Infant TEWL values were also significantly higher than in adults at all sites. Hydration of the SC and TEWL values showed no significant correlation with age of infant for any site. The SC hydration and TEWL values of Indonesian infants did not decrease to adult values within 24 months, which indicates that the SC characteristics in infants continue to develop after 24 months of age. Conclusion  Indonesian infants aged 0-24 months have significantly higher SC hydration and TEWL values than Indonesian mothers. However, infant age has no correlation to SC hydration or to TEWL values.

Echocardiographic Evaluation of Patent Ductus Arteriosus in Preterm Infants

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Romaine Arlettaz

2017-06-01

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

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

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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, α s1 -casein, osteopontin, and κ-casein. The absolute number of peptides differed by GA and LS with 30 and 41 differing sequences respectively (p 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.

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

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

2015-01-01

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

Endocardial Pacemaker Implantation in Neonates and Infants

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Canan Ayabakan

2006-04-01

Full Text Available Transvenous pacemaker lead implantation is the preferred method of pacing in adult patients. Lead performance and longevity are superior and the implantation approach can be performed under local anaesthetic with a very low morbidity. In children, and especially in neonates and infants, the epicardial route was traditionally chosen until the advent of smaller generators and lead implantation techniques that allowed growth of the child without lead displacement. Endocardial implantation is not universally accepted, however, as there is an incidence of venous occlusion of the smaller veins of neonates and infants with concerns for loss of venous access in the future. Growing experience with lower profile leads, however, reveals that endocardial pacing too can be performed with low morbidity and good long-term results in neonates and infants.

The clinical effect of a new infant formula in term infants with constipation: a double-blind, randomized cross-over trial

NARCIS (Netherlands)

Bongers, Marloes E. J.; de Lorijn, Fleur; Reitsma, Johannes B.; Groeneweg, Michael; Taminiau, Jan A. J. M.; Benninga, Marc A.

2007-01-01

BACKGROUND: Nutrilon Omneo (new formula; NF) contains high concentration of sn-2 palmitic acid, a mixture of prebiotic oligosaccharides and partially hydrolyzed whey protein. It is hypothesized that NF positively affects stool characteristics in constipated infants. METHODS: Thirty-eight constipated

Early MRI in term infants with perinatal hypoxic–ischaemic brain injury: Interobserver agreement and MRI predictors of outcome at 2 years

International Nuclear Information System (INIS)

Goergen, S.K.; Ang, H.; Wong, F.; Carse, E.A.; Charlton, M.; Evans, R.; Whiteley, G.; Clark, J.; Shipp, D.; Jolley, D.; Paul, E.; Cheong, J.L.Y.

2014-01-01

Aim: To compare diffusion-weighted imaging (DWI) and non-DWI magnetic resonance imaging (MRI), proton MR spectroscopy (1H-MRS), and clinical biomarkers for prediction of 2 year developmental outcome in term infants with perinatal hypoxic–ischaemic encephalopathy (HIE). Materials and methods: Nineteen infants ≥36 weeks gestation with HIE were recruited and MRI performed day 3–7 (mean = 5). MRI was scored independently by three radiologists using a standardized scoring system. Lactate-to-N-acetylaspartate ratio (Lac:NAA) in the lentiform nucleus was calculated. Developmental assessment was performed at 2 years using the Bayley Scales of Infant and Toddler Development (BSID-III). Interobserver agreement about abnormality in 10 brain regions was measured. Univariate analysis was performed to determine variables associated with adverse outcome (i.e., death or Bayley score for any domain <70). Results: Good interobserver agreement (kappa = 0.61–0.69) on scores for DWI was obtained for the cortex, putamen, and brainstem, but not for any region on non-DWI. A significant association was found between outcome and Lac:NAA (p < 0.003) and DWI scores for lentiform nucleus, thalamus, cortex, posterior limb of the internal capsule (PLIC), and paracentral white matter (p = 0.001–0.013), but for non-DWI score only in the vermis or brainstem. A combination of Lac:NAA ≥0.25 or DWI/apparent diffusion coefficient (ADC) signal abnormality in the PLIC had 100% specificity and sensitivity for poor outcome. Conclusion: Interobserver agreement for non-DWI performed during the first week is poor. Agreement by three radiologists about the presence of abnormal signal within the PLIC on ADC/DWI images or elevation of Lac:NAA above 0.25 improved sensitivity without reducing the prognostic specificity of MRS in the 19 patients, but this requires validation in a larger group of infants with HIE who have been treated with hypothermia

Hyperinsulinism associated with gestational exposure to bupropion in a newborn infant.

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Gisslen, Tate; Nathan, Brandon; Thompson, Theodore; Rao, Raghavendra

2011-01-01

This case report describes severe hyperinsulinism in a term newborn infant without typical perinatal risk factors for transient hyperinsulinism. The mother had received bupropion, an antidepressant and aid to smoking cessation, throughout pregnancy. The infant presented with profound hypoglycemia and seizures on the 3rd day of life. Laboratory investigation confirmed hyperinsulinism. Stable euglycemia could be achieved only after starting diazoxide. The infant was weaned from diazoxide by 10 weeks of age without recurrence of hypoglycemia, signifying the transient nature of hyperinsulinism. This is the first reported case of a potential association between maternal bupropion use during pregnancy and neonatal hyperinsulinism, and highlights the importance of close monitoring of similar infants.

A Statistical Model of Head Asymmetry in Infants with Deformational Plagiocephaly

DEFF Research Database (Denmark)

Lanche, Stéphanie; Darvann, Tron Andre; Ólafsdóttir, Hildur

2007-01-01

Deformational plagiocephaly is a term describing cranial asymmetry and deformation commonly seen in infants. The purpose of this work was to develop a methodology for assessment and modelling of head asymmetry. The clinical population consisted of 38 infants for whom 3-dimensional surface scans...... quantitative description of the asymmetry present in the dataset....

Physical activity programs for promoting bone mineralization and growth in preterm infants.

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Schulzke, Sven M; Kaempfen, Siree; Trachsel, Daniel; Patole, Sanjay K

2014-04-22

Lack of physical stimulation may contribute to metabolic bone disease of preterm infants, resulting in poor bone mineralization and growth. Physical activity programs combined with adequate nutrition might help to promote bone mineralization and growth. The primary objective was to assess whether physical activity programs in preterm infants improve bone mineralization and growth and reduce the risk of fracture.The secondary objectives included other potential benefits in terms of length of hospital stay, skeletal deformities and neurodevelopmental outcomes, and adverse events.Subgroup analysis:• Given that the smallest infants are most vulnerable for developing osteopenia (Bishop 1999), a subgroup analysis was planned for infants with birth weight affect an infant's ability to increase bone mineral content (Kuschel 2004). Therefore, an additional subgroup analysis was planned for infants receiving different amounts of calcium and phosphorus, along with full enteral feeds as follows. ∘ Below 100 mg/60 mg calcium/phosphorus or equal to/above 100 mg/60 mg calcium/phosphorus per 100 mL milk. ∘ Supplementation of calcium without phosphorus. ∘ Supplementation of phosphorus without calcium. The standard search strategy of the Cochrane Neonatal Review Group (CNRG) was used. The search included the Cochrane Central Register of Controlled Trials (CENTRAL) (2012, Issue 9), MEDLINE, EMBASE, CINAHL (1966 to March 2013), and cross-references, as well as handsearching of abstracts of the Society for Pediatric Research and the International Journal of Sports Medicine. Randomized and quasi-randomized controlled trials comparing physical activity programs (extension and flexion, range-of-motion exercises) versus no organized physical activity programs in preterm infants. Data collection, study selection, and data analysis were performed according to the methods of the CNRG. Eleven trials enrolling 324 preterm infants (gestational age 26 to 34 weeks) were included in this

Reduced brain resting-state network specificity in infants compared with adults.

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Wylie, Korey P; Rojas, Donald C; Ross, Randal G; Hunter, Sharon K; Maharajh, Keeran; Cornier, Marc-Andre; Tregellas, Jason R

2014-01-01

Infant resting-state networks do not exhibit the same connectivity patterns as those of young children and adults. Current theories of brain development emphasize developmental progression in regional and network specialization. We compared infant and adult functional connectivity, predicting that infants would exhibit less regional specificity and greater internetwork communication compared with adults. Functional magnetic resonance imaging at rest was acquired in 12 healthy, term infants and 17 adults. Resting-state networks were extracted, using independent components analysis, and the resulting components were then compared between the adult and infant groups. Adults exhibited stronger connectivity in the posterior cingulate cortex node of the default mode network, but infants had higher connectivity in medial prefrontal cortex/anterior cingulate cortex than adults. Adult connectivity was typically higher than infant connectivity within structures previously associated with the various networks, whereas infant connectivity was frequently higher outside of these structures. Internetwork communication was significantly higher in infants than in adults. We interpret these findings as consistent with evidence suggesting that resting-state network development is associated with increasing spatial specificity, possibly reflecting the corresponding functional specialization of regions and their interconnections through experience.